bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large optico‐reconstructive corneal grafts in complicated cases
Authors: BARRAQUER J 
Published: August 2012

AbstractPurpose Demonstration of different procedures for eye surface reconstruction and visual rehabilitation in complicated conditions.Methods Case 1: LASIK photokeratomileusis is demonstrated in a case previously operated for penetrating keratoplasty. Case 2: Optico‐reconstructive penetrating 11 mm keratoplasty performed in a case of bilateral keratoconus‐keratoglobus. The fellow eye had been operated for 11 mm penetrating keratoplasty 20 years earlier, with good result. Two years after the operation of the second eye opacification of the graft developed in the second eye due to irreversible homograft reaction. A second penetrating graft, 7.6 mm in diameter was performed in the center of the previous, opaque, graft. The procedure was combined with simultaneous extracapsular lens removal and IOL implantation.Results The excellent results of these three examples of complicated large penetrating corneal grafts are demonstrated in all three cases with video and slides.Conclusion The prognosis of large diameter optico‐reconstructive penetrating keratoplasties in apparently unfavourable situations can be definitely improved selecting appropriate surgical indications, combined with a meticoulus surgical technique, adequate postoperative medication (local and systemic corticosteroids, cyclosporine A eye drops 2 %, immunosuppressors, topical cycloplegics, etc.)and rigurous postoperative follow‐up control.
Investigation of bacterial contamination of corneal donors using molecular biology
Authors: ROBERT PY , DUBOIS A , CHAIGNIER D , GARNIER F , PLOY MC 
Published: August 2012

AbstractPurpose transmission of infectious agents is a major concern for every graft process. Corneal transplantation has been associated to transmission of virus and non conventional agents, but bacterial hazard remains possible in eyebanks. In this prospective study, we investigated the presence of resistant bacteriae in contact with the cornea throughout the whole preservation process.Methods Samples were taken from donor aqueous humor, conjonctival cul‐de‐sac and limbus, and from Corneaprep®, Corneamax® and Corneajet® media. Scleral rim was harvested as well after surgery. Bacterial contamination was investigated using direct exam, culture and 16S RNA detection.Results 164 corneas of 83 donors were included. Cul‐de‐sacs conjonctivaux (CS). 131 cul‐de‐sac (79,9%) and 119 limbus (72,6%) were contaminated, from S. epidermidis in 50%. 7 aqueous humors (4%) were positive, 5 with S. epidermidis and 2 with Bacillus. We encountered 34 hemocultures (41%), 6 Corneaprep (4%), 6 Corneamax (4%), 0 Corneajet (0%) and 0 scleral rim (0%) positive.Conclusion 16S RNA detection did not increase the number of positive samples. 92% of Coag. Neg. Staphylococcus, 19% of S. Aureus, 33% of enterobacteriae, 49% of streptococcus and 75% of enterococcus had an acquired phenotype of resistance to antibiotics. No link between blood contamination and corneal contamination is evidenced. Routine eyebank procedures achieve efficient antimicrobial security.
DBSV – A success story in forming a patient organization for blind and partially sighted people
Authors: HOLZAPFEL S , OSTROWSKI A 
Published: August 2012

AbstractPurpose To develop a support and service system in form of counseling centers or mobile units to address the needs of the increasing number of partially sighted people, especially those who experience sight loss at a later stage in life, as well as their relatives and formal carers.Methods The situation of support systems in Germany was analyzed. Predominantly partially sighted people were trained and instructed to create a network to other partners, like ophthalmologists, optometrists and rehabilitation specialists. With the support of the organization “Aktion Mensch!” and the “Bernd Mettmann Foundation” pilot projects were created. These new regional centers have been working since the beginning of 2012.Results Meanwhile consultation centers, mobile units or working groups are running in five regions in Germany. The number of consultations is increasing. The centers are establishing a network of different experts, their organizations and other self‐help groups and patient organizations. Project workers assist the regional groups of the German Federation of the Blind and Partially Sighted (DBSV) in creating an area‐wide structure to support partially sighted people and their relatives. They have published various information material and papers to raise awareness of the issue of visual impairment.Conclusion Patients as experts to support partially sighted people, relatives and formal carers in a network of support centers is a successful way to respond efficiently to the increasing number of partially sighted people. Starting in 2013, therefore the regional projects will be extended nationwide. Our positive experiences suggest that the concept of support centers where patients support patients could be transferred to other countries too.
Visual impairment, blindness in an aging society
Authors: SUTTIE A 
Published: August 2012

AbstractPurpose We face a global growth in the prevalence of age related sight loss and yet services even in well developed countries in Europe, do not currently meet the rehabilitation needs of elderly blind. Nearly 25% of people in the European Union will be over the age of 65 by 2030. It is currently estimated that there are 12 million visually impaired older people in Europe and this is set to grow. The prevalence of serious sight loss increases exponentially with age, from 3.27% between 60 and 69 years up to 15% between 80 and 89 years. We need to think about how we meet the needs of the older old.Methods Both the European and World Blind Union’s have supported expert groups looking to bring together knowledge and expertise in this area. Collaborative working across member countries has both raised the profile of age related sight loss and led to a better understanding of service design.Results Current practice in the field of vision rehabilitation is primarily geared to meeting the needs of younger blind and partially sighted people. The vast majority of blind and partially sighted people in Europe are: female, over the age of 85 years, living alone and with useful residual sight. They often live with co‐morbid conditions such as memory loss, impaired hearing and other frailties of older age.Conclusion Services firstly need to be designed around an understanding of co‐morbidity and partnership with those having expertise in the care of older people. They should encourage and facilitate maximum use of residual vision working on the key principles of size, lighting and tonal contrast. Above all they should help to address the major challenge of social isolation, resulting from living alone with a serious sight loss.
Prevention of AMD
Authors: CREUZOT C 
Published: August 2012

AbstractPurpose The prevention of Age Related Macular Degeneration (ARMD) depends on the identification of the main risk factors of the disease.Methods Clinicians will have to consider genetic and environmental risk factors like smoking habits and obesity. Nowadays, the identification of genetic risk factors mainly depends on the familial past history of the patient. However, an individual identification of the main genetic risk markers will probably have to be considered in the future.Results Patients without any risk factors are mainly concerned by primary prevention based on nutritional advices based on the intake of macular pigments and polyunsaturated fatty acids. Patients with either genetic or environmental risk factors can benefit from nutritional advices based on the results given by epidemiological studies with higher dietary intake of antioxidants,macular pigments and polyunsaturated fatty acids.Conclusion Clinicians should give dietary advices to post pone the consequences of ARMD in all patients especially those at high genetic risk.
Non diabetic CME
Authors: LOEWENSTEIN A 
Published: August 2012

AbstractPurpose Cystoid macular edema (CME) occurs in a variety of pathological conditions beside diabetic retinopathy, such as retinal vein occlusion, pseudophakia, penetrating ocular injury and uveitis. CME is a major cause of vision loss following cataract and vitreoretinal surgery. This presentation overviews the major developments in the treatment of CME, and the contribution of recent clinical trials to the understanding of the pathophysiology and factors that play a role in non‐diabetic CME and outcomes of treatment, as well as the problems that remain to be solved by both the basic and clinical researchers.Methods Differential diagnosis is essential for management and distinction between diabetic, age‐related macular degeneration, and other causes of CME. Pseudophakic CME is characterized by poor visual acuity following surgery. Clinically significant CME generally develops 4‐12 weeks after surgery. The workup of CME is performed with fluorescein angiography and optical coherence tomography. While pseudophakic CME can resolve spontaneously, some cases of CME require treatment.Refined surgical techniques contribute to reducing the incidence of CME. Intraoperative complications may elevate the risk of developing postoperative CME.Results Peri‐ or intraocular corticosteroids can be useful in persistent cases. Topical non‐steroidal anti‐inflammatory drugs (NSAIDs) and corticosteroids show the highest success rate for post‐surgical CME.Conclusion While the etiology of CME remains to be elucidated, the recent years have been the framework of major advances in treatment of CME. The response to antiangiogenic treatment is currently under evaluation, with some reported improvements from bevacizumab monotherapy, and combination therapies with NSAIDs and corticosteroids. Surgical treatment is considered in severe case.
Commercial interest
Etiologic distribution of necrotizing retinopathies : a nine‐year experience at a university referral centre
Authors: JOUFFROY T , BODAGHI B , ROZENBERG F , LEHOANG P 
Published: August 2012

AbstractPurpose To assess the etiologic distribution of necrotizing retinopathies based on an extensive work‐up including molecular tools applied to ocular fluidsMethods All patients referred for the diagnostic and therapeutic management of an atypical posterior or panuveitis underwent an extensive work‐up to exclude an infectious condition. All patients underwent anterior chamber paracentesis or vitrectomy for diagnostic purposes. PCR and cytology were performed in order to confirm an infectious entity or a masquerade syndromeResults The clinical findings of 218 patients were analyzed in this retrospective study. The sex‐ratio (M/F) was 1.44 including 129 men and 89 women. The mean age was 46.6 years (range from 7 To 90 yo). A viral infection was confirmed in 146 cases (67,5%). Viral distribution determined 55 CMV retinitis, 48 VZV retinitis, 34 HSV 1 or 2 retinitis and 9 EBV panuveitis. Nonviral causes of infectious or inflammatory retinopathies were determined in 66 cases, masquerading as a viral retinopathy. Most of the cases were due to a parasitic infection (59%) followed by a primary intraocular lymphoma (12,1%), a bacterial uveitis (7,5%), Behçet’s disease (7,5%), endogenous endophthalmitis (3%), sarcoidosis (1,5%) and others (9,4%). Six cases remained idiopathicConclusion All patients with an atypical retinopathy and a suspicion of infectious etiology deserve an extensive work‐up, including ocular fluid analysis. The yield of PCR technology remains excellent for viral retinopathies. Even though most of the cases are viral‐induced, other entities may present with similar clinical findings. Therefore, prompt diagnosis remains the best strategy to avoid further sight and rarely life‐threatening complications
Ocular prognosis of congenital toxoplasmosis (genotypes II and III)
Authors: DELMAS J , DARDE ML , AJZENBERG D , ADENIS JP , ROBERT PY 
Published: August 2012

AbstractPurpose There are in France 3 main strains of T. gondii (genotypes I, II and III). Ocular lesions of congenital toxoplasmosis have been reported in 80% of untreated, infected children. But no data were available in Europe on the genotype, on the prevalence of the different strains of T. gondii and on their virulence. Our purpose was to investigate the genotype of strains and the outcome of babies born with congenital toxoplasmosis in our university hospital.Methods From 1980, every newborn with congenital toxoplasmosis was prospectively referred to the Parasitology Department. Date of birth, sex, time of congenital contamination, pre‐ and post‐natal treatment were recorded. We designed a retrospective follow‐up of all these children. Fetal infection was detected using serologic analysis and parasitologic investigations, such as mice inoculation and PCR from samples of amniotic fluid or placenta. For 43 newborns, genotyping of T. gondii strains was performed, using multilocus analysis.Results The median follow‐up was 38.6 months. 28,2% of 78 infected children were treated in‐utero upon detection of the maternal infection. 66.1% of 71 alive new borns underwent a post‐natal treatment.Genotype of T. gondii was analysed for 55% of infected children. 41 strains were identified as genotype II and 2 strains as genotype III. Among the 10 children with at least 1 retinochoroidal lesion, 5 strains were analyzed: 4 were genotype II (2 peripheral lesions, 1 macular, 1 peripapillar) and 1 was genotype III (1 macular lesion).Conclusion Genotype II is confirmed to be the most common strain in France. Percentages of ophthalmological lesions accorded to the literature. No prognostic factor was identified for the occurrence or the seriousness of retinal lesions.
Boleslaw Wicherkiewicz: interesting contributor to European ophthalmology
Authors: GRZYBOWSKI A , SCHMIDT D 
Published: August 2012

AbstractPurpose Boleslaw Wicherkiewicz (1847–1915) was the most prominent Polish ophthalmologist at the end of the 19th century and beginning of the 20th century. Between 1877 and 1895, he founded in Poznan and developed the largest and internationally best known 19th century ophthalmic hospital in Poland. In 1895, the hospital had a total of 80 beds. With his extensive experience gained abroad, Wicherkiewicz was well prepared to become in 1895 the head of the most important university ophthalmology centre in Poland – the Department of Ophthalmology at the Jagiellonian University in Cracow. In 1899, Wicherkiewicz founded the first Polish ophthalmic journal ‘Progress in Ophthalmology'.Methods The study is based on analysis of all papers written by Wicherkiewicz, mainly in Polish and German. The biographical details were verified in National Archives in Poznan and Cracow, cities where he lived and worked. The secondary sources, including review articles and other reports about his life and activities, were also collected and analyzed.Results Original contributions on oculoplastic surgery (epicanthus, lid coloboma, ectropion and enctropion, trichiasis, distichiasis, lid replacement, free skin transplantation), cornea transplants (first in Poland), glaucoma surgery (sclerotomia cruciata posterior superficialis), cataract surgery (cataract irrigation technique), clear lens surgery in myopia (before Fukala).Conclusion Wicherkiewicz played a crucial role in the development of Polish ophthalmology. He was internationally recognized due to his surgery innovations and scientific activities. He was a member of majority of ophthalmic European societies (including many honorary memberships), and he was given honorary doctorate by Leuven University in 1909.
Evaluation of the retinal fiber layer thickness as a biomarker for sleep apnea syndrome
Authors: FERRANDEZ ARENAS B , GIL‐ARRIBAS L , FERRERAS AMEZ A , ARA GABARRE M , SATUE M , BAMBO MP , CALVO PEREZ P 
Published: August 2012

AbstractPurpose To evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness measured with spectral‐domain optical coherence tomography (OCT) in obstructive sleep apnea syndrome (OSA) patients, as a biological marker of neuronal damage.Methods Sixty‐four OSA patients and one hundred twenty‐nine healthy controls were consecutive and prospectively selected. Only one eye per subject was randomly chosen. AOS patients were classified in three groups according to apnea/hipopnea index: mild, moderate and severe. All participants performed a comprehensive ophthalmologic examination and at least a reliable standard automated perimetry (SAP). Peripapillary RNFL thicknesses were measured with the Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). After checking for a normal distribution of variables, differences between both groups were tested by Student t test.Results Age was 50.6 ± 9.3 years in control eyes and 47.8 ± 11.5 years in AOS patients (p = 0.09). Mean deviation of SAP was ‐0.50 ± 1.0 dB and ‐1.4± 2.3 dB, in control and AOS patients, respectively (p<0.001). Pattern standard deviation and Visual Field Index (VFI) of SAP were also different between both groups. The RNFL thickness at temporal superior segment and the superior segment had lower thicknesses in AOS patients compared to healthy individuals.Conclusion OCT detected a mild reduction of RNFL thickness in AOS patients compared with healthy subjects. Visual field indices were also different between both groups.
Cataract and glaucoma surgery, combined or staged: where do we stand?
Authors: SUNARIC MEGEVAND G 
Published: August 2012

AbstractPurpose Glaucoma surgery in presence of a cataract is a challenging problem. Are patients better served by combined glaucoma and cataract surgery, or would cataract extraction alone be sufficient or is it best to establish a bleb before performing cataract surgery? As the techniques have evolved during the past years, the literature has enriched with new evidences and new suggestions. During this part of the course we will review in detail the past and actual literature in this field as well as more recent data from meta‐analysis studies.Methods literature reviewResults discussion of the most pertinent studiesConclusion see above
Staging the surgeries: glaucoma first or cataract first?
Authors: ZEYEN T 
Published: August 2012

AbstractA combined Phaco‐Trabeculectomy will often not have the same result as both procedures separately. The IOP lowering effect of a combined procedure is usually less than that of Trabeculectomy alone. Likewise, post‐operative fluctuations of the anterior chamber depth after a combined procedure will influence the post‐operative refraction, especially in the early post‐operative period and/or if additional procedures (e.g. needling) are necessary to rescue a failing bleb. Therefore, most surgeons will prefer to stage both procedures. Since cataract surgery might compromise an existing filtering bleb, it is recommended to perform Phaco first if the IOP is not too elevated. If the glaucoma is at risk to deteriorate in the short term, filtering surgery should be performed first. It is advisable to wait 6 months between the cataract and glaucoma surgery.
Combined approach: practical tips
Authors: MCNAUGHT A 
Published: August 2012

AbstractPurpose The presentation will feature practical advice on undertaking combined phacoemulsification/IOL insertion with trabeculectomy. The specific indications, and particular advantages of this combined technique in groups of patients will be highlighted, and the techniques covered will include:Methods 1) Approach to the case: whether a combined approach is optimal in the individual patient, contraindications, and choice of antimetabolite 2) Technical details: including ajustable suture techniques 3) Postoperative managementResults Video examples will be used to illustrate the surgical techniques discussed
An ex vivo assay to measure the intravitreal mobility of nanomedicines for retinal gene therapy
Authors: MARTENS TF , VERCAUTEREN D , FORIER K , DESCHOUT H , REMAUT K , DEMEESTER J , DE SMEDT SC , BRAECKMANS K 
Published: August 2012

AbstractPurpose In retinal gene therapy, intravitreal injection is a promising technique for administering nanomedicines, granted they remain mobile in the vitreous humour. Here, we optimized an ex vivo assay to measure this mobility in intact bovine vitreous. The results from this work and the newly developed methodology are expected to aid in the rational design of nanomedicines for retinal drug delivery.Methods Excised bovine eyes were prepared in such a way to preserve the fragile structure of the vitreous humour, while permitting fluorescence microscopy inside the bovine vitreous. This assay was used to determine by single particle tracking analysis the intravitreal mobility of both model polystyrene beads with different sizes and surface groups, as well as gene nanomedicines composed of poly(amido amine)s and plasmid DNA.Results Cationic nanoparticles were readily immobilized in the vitreous humour, while anionic polystyrene beads remained mobile. Surface modification with the hydrophilic polymer polyethylene glycol (PEG) resulted in the best mobility of the polystyrene beads. In correspondence with these results, the cationic gene nanomedicines were immobilized in the vitreous humour, while modification with PEG resulted in a drastic improvement of their mobility.Conclusion Here an ex vivo assay is presented to study nanoparticle mobility in intact vitreous humour by single particle tracking microscopy, which showed that cationic surface charge limits intravitreal diffusion of nanoparticles by binding to biopolymer structures, while anionic and PEGylated nanoparticles remain mobile. These results should help in the rational design of nanomedicines used for intravitreal drug delivery.
Ghrelin’s expression in the eye and its implication in the reduction of intraocular pressure
Authors: ROCHA DE SOUSA A , PEREIRA‐SILVA P , AZEVEDO‐PINTO S , RODRIGUES‐ARAUJO J , TAVARES‐SILVA M , PINHO S 
Published: August 2012

AbstractPurpose To investigate ghrelin’s and GHSR‐1 distribution in the rat’s ocular tissue and ghrelin’s role in the modulation of IOP in animal models of acute glaucoma.Methods Immunolocalization of ghrelin and GHSR‐1 was performed in male Wistar rats (200–300g). Acute glaucoma was induced in male New Zealand white rabbits (2,0‐3,0Kg) and male Wistar rats (200–300g) through an intravitreous injection of 20% NaCl. Afterwards either ghrelin or des‐acyl ghrelin was subconjunctivaly injected. In the rabbit, ghrelin’s effect in the presence of L‐NAME or ketorolac.Results Ghrelin and GHSR‐1 were detected in the rat’s eye, being ghrelin expressed in the ciliary processes, having co‐localization with lectin, an endothelial cell marker, been also verified. GHSR‐1 expression was detected in the base of the ciliary body and in the choroid, presenting focal co‐localization with α‐smooth muscle actin. Ghrelin, but not des‐acyl ghrelin, decreased the IOP in rabbit’s and rat’s glaucomatous eyes (maximal percentual decrease relative to peak versus control in rabbit: 65,9±12,4%; maximal percentual decrease relative to peak versus control in rat:27,45±4,8%). In the rabbit, this effect was blunted in the presence of L‐NAME and ketorolac.Conclusion Ghrelin and GHSR‐1 are expressed in the rat’s eye. Ghrelin promoted a decrease in the IOP of rat’s and rabbit’s glaucomatous eyes. These data suggest a role for ghrelin in the pathophysiology of glaucoma.
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