bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of neovascularization myopic with ranibizumab: 18‐month results
Authors: EGEA ESTOPINAN MC , TORRON FERNANDEZ‐BLANCO C , GUERRI MONCLUS N , PRIETO CALVO E , FERRER NOVELLA E , RUIZ MORENO O , PABLO LE 
Published: September 2009

Abstract Purpose To evaluate the efficacy of intravitreal Ranibizumab as treatment for choroidal neovascularisation due to pathological myopia Methods A retrospective, non‐comparative study of 21 eyes treated with intravitreal injections of Ranibizumab. Ten eyes had been treated previously with photodynamic therapy and eleven received Ranibizumab as first therapy. After thorough ophtalmologic examination, fluorescein angiography (FAG) and optical coherence tomography (OCT) intraocular injection was practised, a new treatment was decided according to the subjective impression of the patient, visual acuity, presence or absence of metamorphopsia, biomicroscopy and OCT examination. Results Twenty one eyes from 17 patients were finally included. Patients were followed up for 18 months. The mean age at initial treatment was 55.71 years. Mean refractive error was ‐12.6 diopters. Regarding AGF all neovascular membranes were classical and sub or yuxtafoveal localised. At the end of the 18 months after treatment 16 eyes (76.19%) showed better visual acuity ranging from one or more lines on Snellen chart, 10 eyes(47.61%) improved two lines or more, 4 eyes(19%) did not show any changes and one eye(4.76%) worsened two lines. At 18 months the mean best‐corrected visual acuity (BCVA) improved from 0.28 to 0.50 (p= 0.001). The mean central macular thickness decreased Conclusion Ranibizumab may be a good therapeutic option as treatment for choroidal neovascularisation due to pathological myopia, it improved visual acuity and anatomical features, even in non‐responders to photodynamic therapy.
Age‐related macular degeneration: hemodynamic changes
Authors: POURNARAS CJ , POURNARAS JAC , MENDRINOS E 
Published: September 2009

Abstract Purpose Metabolic changes of the RPE associated to the dysfunction of choriocapillaries(CC)/RPE complex may induces the AMD‐related changes. Additional vascular changes in the choroid potentially have deleterious effects on the RPE. Methods Quantification of CC number and lumen diameters in cross sections and alkaline phosphatase (APase) flat‐embedding technique, expressing high constitutive APase activity in choriocapillaris and choroidal veins on human RPE/Bruch’s Membrane/CC complex, significantly contributed to the analysis of the choroidal vasculature. Laser Doppler flowmetry (LDF) data provided additional information on the assessment of hemodynamic changes in AMD. Results Choroidal vascular density reduction and significant vasoconstriction of the choriocapillaries, occurs during the evolution of AMD. In eyes with geographic atrophy, the RPE degenerates first while CC loss is secondary to RPE degeneration. In eyes with exudative AMD, degeneration of the CC layer occurs while RPE is still functional. LDF data indicated choroidal blood flow decrease according to age and the degree of severity of AMD; the decrease in flow preceding the formation of choroidal CNV, strongly suggest that these changes may have a role in the development of CNV. As a result of vascular dysfunction, the choroidal blood flow is dysregulated in patients with neovascular AMD. The choroidal watershed zone (WZ) courses through the fovea more often in patients suffering from AMD than in age‐matched controls, particularly in the presence of CNV. Choroidal neovascularisation usually arises within these WZ. Conclusion The role of choroidal ischemia in the pathophysiology of AMD is supported by the observed choroidal microcirculation anatomical and fucntional abnormalities.
Biosynthetic corneas – evaluation in humans
Authors: FAGERHOLM P , LAGALI N , GRIFFITH M 
Published: September 2009

AbstractCollagen‐based biosynthetic corneas, designed to mimic the extracellular matrix of the corneal stroma have been developed and extensively evaluated in animal models over the last 7 years. Human recombinant collagen type III (RHC III) was crosslinked with water‐soluble carbodiimides and fabricated into optically transparent corneal substitutes for transplantation. Following study approval of the Medical Product Agency, Sweden and the Human Ethics Committee, University of Linköping, Sweden, a Phase I study was initiated. 10 patients who were scheduled for corneal grafting were enrolled into the study. Nine had keratoconus and one had a deep scar following Pseudomonas keratitis. A central 6 mm diameter deep lamellar button was excised and was replaced by a 6.25 mm diameter 500 µm thick construct. Six overlying sutures were used to anchor the graft. Topical 0.1% dexametasone and chloramphenicol was used for the first 1 month postoperatively. The sutures were removed after 5‐7 weeks. The patients were followed clinically and evaluated for UCVA, BSCVA and VA with contact lenses. Corneal touch sensitivity (Cochet‐Bonnet) and tear production (Schirmer ) were tested. Photography, OCT (Visante), topography (Orbscan II) and in vivo confocal microscopy (Heidelberg) was documented. After 3 months all patients had stably epithelialized and implants were anchored by recipient keratocyte ingrowth. The mean BSCVA at 6 months (20/133) improved slightly at 12 months (20/90). The mean BCLCVA was 20/50 at 12 months and was notably better in younger patients (mean of 20/40 in the 5 youngest). One patient had BCLVA of 20/20 at 12 months. The mean central corneal thickness was stable between 3 and 12 months at about 400µm.The mean 5min Schirmer values were 20 ± 10mm in operated eyes and 17 ± 8 mm in fellow eyes. At 12 months the mean touch sensitivity was 25mm in operated eyes and 60mm in fellow eyes, which was the same as in penetrating grafts. In‐vivo confocal microscopy revealed the ingrowth of corneal nerves at the subbasal epithelium. We have shown for the first time that bioengineered collagen‐based corneal substitutes are fully compatible and promote regeneration of corneal cells. The 18 months follow‐up results will be presented aswell.
Improving the optics of KPros
Authors: HULL C , GOMAA A , LIU C 
Published: September 2009

Abstract Purpose The purpose of this talk is to review the clinically relevant optical and visual requirements of keratoprostheses. Methods Modelling of designs using commerical and purpose‐written optical design software as well as clinical measurments on a small number of patients implanted with the osteo‐odonto keratprosthesis optical cylinder. Results The important visual optical proerties of any keratoprosthesis optic are the foveal image quality (affecting the acuity) and the field of view. These fundamentally depend upon the pupil size, and the length and diameter of the optic since the power must be fixed to give emmetropia. The axial image quality can be changed by controlling the spherical aberration. However, maximising axial (foveal) image quality causes poorer off‐axis image quality potentially reducing the effective visual field. Shorter, larger diameter optics help improve the visual field as well as consideration of off‐axis image quality. Conclusion The theoretical properties of keratoprosthesis optics must be balanced against other clinical requirements such as longterm complications and stability. The clinical requirements provide the constraints on the optical design. However, discussions can usefully happen between surgeons and those involved in the design of the optics to give the best possible visual rehabilitation.
The clinical psychologist’s role in the OOKP clinic. A one year review
Authors: BUSUTTIL A , HOIT C , CAMIC P , GOMAA A , HEROLD J , THORP S , LIU C 
Published: September 2009

AbstractOOKP Surgery places complex Physical and Psychological demands on patients. Attention to Psychological factors is likely to facilitate good outcome and improve Quality of Life. This presentation outlines an innovative addition to the OOKP service at Sussex Eye Hospital, Brighton UK, incorporating a Clinical Psychologist as a member of the OOKP medical team. It will describe the first year's work including a study which has identified four subgroups of patients presenting for OOKP and the psychological needs of each group. The presentation describes how the service aims to address the particular psychological needs of these patient groups from assessment to psychological follow up. The presentation will also include a summary of a second Qualitative Interview study looking at patients' reports of their experiences of undergoing OOKP from a bio‐psychosocial perspective.The National Health Service, UK seeks to use patient experience and feedback to shape clinical services and the implications of the outcomes of the research for the service will be discussed.
Repeatability of retinal nerve fiber layer and macular thickness measurements using Cirrus Fourier‐domain optical coherence.
Authors: GARCIA MARTIN E , PINILLA I , IDOIPE M , GIL ARRIBAS L , FUERTES I , PUEYO V 
Published: September 2009

Abstract Purpose To test intrasession, intersession, intervisit, and interoperator reproducibility of retinal nerve fiber layer (RNFL) measurements and retinal thickness using Cirrus Fourier‐domain optical coherence tomography (OCT). Methods Seventy‐two eyes of 72 healthy subjects underwent three macular 512x128 volume cube centered on the fovea and three 360° optic disc circular scans done by the same observer. This sequence was repeted by another observer on a second visit within a 2‐week period. Descriptive statistics, analysis of variance, intraclass correlation coefficients (ICC), and coefficients of variation (COV) were calculated for the 9 macular areas described by the Early Treatment Diabetic Retinopathy Study (ETDRS) in the macular protocol and for quadrants and RNFL clock hour sectors. Results All measurements were highly reproducible. The ICCs ranged from 0.823 to 0.992 using macular volume cube and from 0.886 to 0.984 with optic disc cube protocol. Mean differences between both operators were lower than 3 μm in all measurements and no significant differences were found. Total retinal thickness mean was 285.17 ±15.31 μm by observer 1 and 284.20 ±12.89 μm by observer 2. Mean COV was 1.2 ±0.99% (ranged from 0.5 to 1.8%) for the nine ETDRS areas. Lowest COV was found for the nasal inner area. Mean RNFL average thickness was 95.99 ±7.67 and 95.72 ±7.87 μm by observer 1 and 2, respectively. Mean COV was 4.41 ±3.01% (ranged from 1.43 to 6.66%). Conclusion Retinal and RNFL thickness measurements obtained using Cirrus Fourier‐domain OCT show good reproducibility for healthy eyes. The device is an important tool for to the diagnosis and follow‐up of retinal and optic nerve pathologies.
Serpiginous choroiditis revisited
Authors: MACKENSEN F 
Published: September 2009

Abstract Purpose Serpiginous Choroiditis (SC) is a subtype of posterior uveitis with often unfavorable visual prognosis, often requiring intensive immunosuppressive treatment. Histological and clinical evidence has been reported linking tuberculosis to cases of chorioiditis and specifically to serpiginous‐like chorioiditis . A potential tuberculous origin is of concern as the treatment would be completely different. Tuberculin skin test has limited power for diagnosing tuberculosis since active disease cannot be differentiated from immunity and because of cross‐reactivity with bacillus Calmette‐Guérin (BCG). It is one of the oldest diagnostic tests still in use worldwide with variable sensitivity and specificity depending on the cut‐off used and the population screened.Therefore, we used an interferon‐γ release assay (QuantiFERON TB‐Gold; Cellestis, Australia) to obtain a diagnosis of tuberculosis in patients with serpiginous like chorioditis. Methods Quantiferon is an approved, antigen‐specific test that utilizes synthetic peptides representing M. tuberculosis proteins. After incubation, interferon‐γ secreted by T‐lymphocytes in response to these antigens is measured. Results In our cohort 52 % of SC patients were tested positive. Patients with SC also showed higher absolute Tb antigen responses as compared to Quantiferon positive patients with other uveitis subtypes. Conclusion Our findings support a tuberculous origin in SC. Other groups also found evidence of Tb association with SC, proven by radiologic imaging. These patients seem to improve with anti‐Tb treatment. The diagnostic significance of Quantiferon and other Tb testing in patients with SC and treatment implications will be discussed.
Significance of autofluorescence in choriocapillaritis
Authors: MANTOVANI A , HERBORT CP 
Published: September 2009

Abstract Purpose To investigate the autofluorescence findings associated with choriocapillaritis Methods Illustrative cases of Primary Inflammatory Choriocapillaropathies(PICCPs)including Multiple Evanescent White Dot Syndrome (MEWDS), Acute Placoid Multifocal Pigment Epitheliopathy (APMPPE) or Multifocal Choroiditis (MFC), where Fundus Autofluorescence(FAF) images were obtained in the short wave mode(488nm), lipofuscin‐related, or in near‐infrared mode(787), melanin‐related. Results In the groups of MEWDS and MFC patients, the more striking FAF alteration is an increase in autofluorescence. The areas of FAF do not strictly correspond to areas of ICGA hypofluorescence, with less FAF in areas of more pronounced ICGA hypofluorescence. The areas of increased FAF regress almost totally in the convalescent stage. In the APMPPE group, the placoid lesions are very often hypoautofluorescent except the margins that can be hyperautofluorescent. In the convalescent stage, altered FAF regresses, but bright FAF is often seen in the center of chorioretinal scars, corresponding to accumulation of fluorophores debris. Conclusion FAF is a complementary imaging technique in PICCPs indicating RPE cell dysfunction, but the information we have so far is scarce and has to be elucidated. In less severely hypoperfused areas,such as MEWDS and MFC, FAF488 is increased because the metabolism of the RPE cell is affected, which explains the accumulation of lipofuscin in its lysosomes. In conditions with severely nonperfused areas, such as APMPPE, FAF488 is very often decreased because RPE cell metabolism is probably affected to such a degree that it does not ingest any more lipofuscin and does not cause autofluorescence.
Clinically useful wide‐field high‐resolution retinal imaging optics with a dual‐conjugate adaptive instrument
Authors: SJÖSTRAND J , KNUTSSON P , POPOVIC Z , THAUNG J 
Published: September 2009

Abstract Purpose The aim of this project is to apply the technique of multi‐conjugate adaptive optics (MCAO) for high‐resolution imaging of the retina over a wide field‐of‐view (FOV). Methods MCAO is the principal technique to overcome the limitations of conventional AO systems by increasing the corrected FOV. The current system incorporates two deformable mirrors (DMs). Optically, these two DMs correspond to separate planes along the optical axis of the eye. This allows the correction of field‐dependent aberrations and subsequent wide‐field high‐resolution retinal imaging over a wide FOV. Normative data from healthy subjects was collected in order to determine clinical potential and limitations. Results We have demonstrated the MCAO concept with a current FOV of 7x7 deg on both model and human eyes. The diffraction‐limited resolution is around 2 µm on the retina, allowing most cone photoreceptors to be resolved. Retinal morphology of healthy subjects was investigated. The estimated cone separation at a retinal eccentricity of 1.2 deg and 2.5 deg from the fovea was 6 µm and 9 µm, respectively, in agreement with the literature. The relatively narrow depth of focus enables us to image different layers of the retina. Focusing on deeper layers allows us to image the cone photoreceptor layer. By focusing on the upper layers we can also image the retinal capillary layer and nerve fibre layer with the same high resolution. Conclusion Our instrument allows retinal features down to 2 µm to be resolved over a 7x7 deg FOV. We believe that this new technique has a future potential for clinical imaging with an impact particularly important for early diagnosis of retinal diseases.
Local and genetical determinants of vascular endothelial growth factor in vision threating proliferative diabetic retinopathy
Authors: GLOBOCNIK PETROVIC M , HAWLINA M , KOSNIK M , KOROSEC P , PETROVIC D 
Published: September 2009

Abstract Purpose To search for the association between the –634 C/G polymorphism of the VEGF gene and vision threating proliferative diabetic retinopathy (PDR) and to determine whether vitreous levels of VEGF were affected by genetic factors. Methods In this cross sectional case‐control study 349 unrelated Slovene subjects (Caucasians) with type 2 diabetes mellitus were enrolled: 206 patients with vision threating PDR in whom vitrectomy was performed, and the control group of 143 subjects with type 2 diabetes of duration of more than 10 years who had no clinical signs of diabetic retinopathy. In 68 out of 206 patients with PDR (71 eyes) vitreous fluid samples (0.3 ml) were obtained by vitreoretinal surgery. Results The –634 C/G VEGF gene polymorphism was not associated with PDR. Moreover, significantly higher vitreous levels of VEGF were demonstrated in diabetics with the CC genotype compared to those with the other (CG + GG) genotypes. Conclusion Despite the effect of the –634 C/G VEGF gene polymorphism on vitreous levels of VEGF in PDR, it failed to contribute to the genetic susceptibility to PDR.
Visual function vs quality of life assessment in patients with laser‐treated diabetic macular oedema
Authors: PEARCE L , SIVAPRASAD S , CHONG V 
Published: September 2009

Abstract Purpose To compare different visual function assessments in patients with laser‐treated diabetic macular oedema (DMO) to the self‐assessment of visual dysfunction and quality of life (QoL) time trade‐off (TTO) utility measures. Methods Forty patients with DMO previously treated with laser were assessed for best corrected visual acuity (distance and near), reading speed, fixation location and stability, microperimetry with Nidek MP‐1, and optical coherent topography (OCT). Subjective analogue self‐assessment of distance and near visual dysfunction and QoL TTO utility measures were also assessed. Results Distance visual acuity correlate well with fixation location and stability, and central retinal thickness of OCT. Near visual acuity and reading speed correlate well with relative scotoma size. However, visual dysfunction and QoL TTO utility correlations are more complex, reading speed in the better seeing eye is best to correlate with QoL TTO utility after correcting for age. Conclusion Laser treated DMO patients often report subjective visual dysfunction that cannot be explained by best corrected distance visual acuity. Scotoma size affects near vision and reading speed, leading to poor quality of life.
Ocular and systemic endothelial function in the offspring of diabetics: a pilot study
Authors: PATEL S , GHERGHEL D , HEITMAR R , BENAVENTE‐PEREZ A , QIN L , MCINTYRE D , BALANOS G , GIBSON J 
Published: September 2009

Abstract Purpose To investigate ocular and systemic correlates of endothelial function in the normoglycaemic offspring of Type 2 Diabetics (T2DM). Methods Healthy participants aged between 25‐65 with (n=30) and without (n=39) a family history were recruited. Retinal vessel reactivity was assessed by using the Retinal Vessel Analyser (RVA, Imedos GmBH). In addition, systemic endothelial function was assessed by using the flow mediated dilation (FMD) technique. Results Parametric testing showed no significant differences in anthropometric, blood assay or ocular and systemic function between both groups (p>0.05). The average maximum dilation in the measured retinal artery correlated significantly with the maximum dilation of the measured brachial artery (p=0.002 R=0.55) in healthy controls; however, this was not true for subjects with family history of T2DM. Conclusion Subjects with family history of T2DM show possibly early signs of endothelial dysfunction that, in certain conditions, could contribute to the higher risk of this group of developing similar pathology to their parents.
Bilateral central serous chorioretinopathy in a patient with focal segmental glomerulosclerosis
Authors: PRIETO CALVO E , EGEA ESTOPINAN MC , GUERRI MONCLUS N , RUIZ MORENO O 
Published: September 2009

Abstract Purpose The central serous chorioretinopathy (CSCR) is a frequent ocular disease characterized by a serous detachment of the neurosensory retina at the posterior pole. This sporadic and self‐finished disease can become chronical in some cases, resulting in a degeneration and atrophy of the underlying retinal pigment epithelium (RPE). The more severe cases of CSCR had been recognized in patients treated with high systemic corticosteroid doses and in haemodialysis patients. Methods A 37‐year‐old‐man was attended in emergency with history of several days of blurring of vision. He was being haemodialysis by chronical renal failure secondary to a focal segmental glomerulosclerosis. The patient presented a visual acuity of 0,4 in the OR and 0,8 in the OL, with an image of bilateral CSCR on the fundus examination that was confirmed by optical coherence tomography (OCT). Results We reported the chronical evolution of the process until a kidney transplantation was done to the patient, reaching a spontaneous healing. Four and half months after the transplantation, evidences of a disappearance of sub‐retinal fluid with a persistence of drusen‐like retinal pigment epithelial alterations were found in the OCT‐image. Conclusion Immune‐complex deposits similar to the glomerular deposits can be identified near the Bruch membrane in patients with glomerulonephritis, these deposits prove the RPE‐barrier dysfunction and the appearance of disorders like macular drusens, sub‐retinal fluid or choroidal neovascularization. The case highlights the importance of ophthalmological assessment in these patients to recognise sight‐threatening complications.
Mechanics of a macular hole: formation and surgical closure
Authors: PEDDADA R , WEINBERG D 
Published: September 2009

Abstract Purpose To elucidate the mechanics of the formation and surgical closure of a macular hole. Methods A parafoveal insertion of vitreous is examined in relation to its effect on the fovea. A force vector analysis is performed to understand the stages of a macular hole formation. A viscoelastic mechanical model is introduced to interpret the time constant of closure of the hole in terms of the physical properties of retina and the surrounding viscous fluid. Results Macular hole develops due to a combination of a tangential (radially outward from the fovea) and perpendicular force components arising from the posterior hyaloid separation (insertion) close to the fovea. The perpendicular force leads to the anterior deformation of the fovea, and therefore in cysts and schisis ("cavitation")formation. The subsequent separation of the photoreceptors from the RPE is also a consequence of the same perpendicular force. The loss of contact with the RPE in the presence of a tangential force lowers the resistance to the radially outward deformation of the foveal tissue and eventual hole formation. The hole closure occurs due to the stored elastic energy of the retina. The relaxation of the fovea is slowed or prevented by the viscosity of the surrounding fluid. Therefore, the hole closure may occur as soon as a few hours or it may never occur depending on the residual fluid and its viscosity at the conclusion of the surgery. The contribution of ILM peeling is discussed. Conclusion Macular hole forms as a consequence of both tangential and perpendicular components of the vitreous traction. The hole closure is promoted by the elasticity of the retina, and retarded by the viscosity of the residual fluid in the foveal region.