bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpes simplex and zoster keratitis
Authors: LABETOULLE M 
Published: November 2010

AbstractHerpes simplex virus (HSV) and varicella‐zoster virus (VZV) are two leading causes of corneal infection with potential severely impaired visual acuity. These two viruses share multiple characteristics, including the ability to become latent in the trigeminal ganglia, before reactivation and migration along the trigeminal fibers innervating the cornea. The clinical settings of keratitis may vary from an epithelial defect (dendritic of geographic) to a more severe disease involving the stroma and/or the endothelium. Classically, HSV keratitis occurs from the second decade of life, and associated skin disease is not frequent and only involves the eyelids. In contrast, VZV keratitis mostly occurs after the sixth decade, as an associated finding of herpes zoster ophthalmicus (HZO). However, several studies recently highlighted that the rate of HSV keratitis increases with age, even in elderly, and some other studies reported VZV keratitis in children, either isolated or associated with HZO. Antiviral drugs currently available are highly efficient to reduce the severity on ongoing HSV‐ or VZV keratitis, but preventive treatments still have to be optimized. For HSV keratitis, the usual preventive treatment, as defined by the HEDS study, only reduces the rate of relapses in a two‐fold manner, and the optimal dosage has not been settled for patient with severe herpetic disease. For VZV, the two vaccines against chickenpox and HZO probably will lead in the future to a reduction of the incidence of keratitis, but they are not widely used, even in most of developed countries.
Psychological preparation for the ophthalmic operation, suggestive techniques guiding the patient during the procedures
Authors: JAKUBOVICS E , KEKECS Z 
Published: November 2010

Abstract Purpose An illness, pain, an emotionally demanding situation (e.g. an injury, being frightened) are associated with certain conditions of the psyche, in which suggestions have strong effects on people. During the operation the patient’s thoughts focus on their conditions and the challenges ahead. The fear of pain, temporary loss of usual references, being placed in helpless positions, the light from the microscope, the surgical drapes (which excluded the environmental stimuli), being confronted by alarming machines and seemingly incomprehensible actions of hospital staff, brings the spontaneously altered state of mind. Our working hypothesis was that if the patients are psychologically well prepared before the operation and if this is followed by positive verbal suggestions during the procedure, their pain relief requirement will be less and their condition will improve faster. Methods We developed a specific verbal suggestion protocol for the patients and observed the patients’ psychological and physiological state in the perioperative period. Results The protocol worked well in reducing patients’ fear and improved their satisfaction. This protocol is easy for doctors and staff to learn. Based on the literature and our studies, younger people are more susceptible. Conclusion Except the excellent painless surgical technique, the comfortable environment, the psychological drive of patients around the procedure has a robust factor to improve the patients satisfactory.
Anaesthesia in cataract surgery
Authors: BODROGI P 
Published: November 2010

AbstractI would like to give a review of anaesthetic methods used in cataract surgery. Retrobulbar (RB) anaesthesia via injection provides not only painlessness, but also akinesia and cuts off autonomic reflexes. Although unfortunatelly it has many possible sideeffects, like perforation of the globe, retrobulbar haemorrhage or injury of the optic nerve, it is still widely used. Parabulbar (PB) anaesthesia was introduced to eliminate traumatic sideeffects of RB, but it did not fulfill all expectations. There are also subconjunctival and sub‐Tenon anaesthesia, the latter also results in akinesia. Since the introduction of phacoemulsification topical anaesthesia has become current. Due to the gentle surgical technique, if the wound is corneal and there is no severe fluctuation of depth of the anterior chamber, it can provide sufficient anaesthesia. They apply it in form of drops, gel or special sponge. It can be replenished with intracameral Lidocain. Before surgery it is widely used to apply systemic sedatives, which helps to attenuate the patients' angst because of surgery. Supporting attitude of medical crew and positive verbal communication is also beneficial at this task. General anaesthesia is still the only possibility used in cataract surgery of children and other people unable to cooperate.
Techniques and complications of anaesthesia for vitreoretinal surgery and a new technique of local anaesthesia
Authors: GOMBOS K 
Published: November 2010

Abstract Purpose Since the 1970s, the methods of vitrectomy procedures in ophthalmology have changed due to technical developments. Consequently certain procedures are less painful and less time consuming. On the other hand, due the modern technology more difficult cases can be operated, which may result in increase the time and strain of the operation. Methods General anaesthesia (GA) is one possibility, but it may have lots of side effects, can cause serious life threatening complications, is time consuming, expensive and sometimes to organise general anaesthesia leads to delay of the operation, consequently possibly hindering the proper timing of it. Despite these, the GA seemed to be necessary when a longer procedure planned. Results Using our method we could avoid some of the well‐known complications of RBA and PBA. Painless operations were provided and the surgeons were satisfied with the anaesthesia. The serum Lidocain level was lower in cRBA compared with the single dose technique. Moreover the presence of postoperative pain could be reduced by using anaesthesia via cannula. Conclusion The benefits and disadvantages of cRBA will be apparent only by the spread of the new technique, which could also contribute to its improvement. This method means a perspective for postoperative pain relief. Hopefully more widespread use of this method helps continuous regional techniques to find their well deserved place in ophthalmic anaesthesia.
How to choose the best surgical procedure?
Authors: POURNARAS CJ 
Published: November 2010

Abstract Purpose Dealing to the localization and sealing retinal breaks, the surgical success rate for the cure of rhegmatogenous retinal detachment greatly changed with the introduction of scleral buckling (SB), intraocular gas injection, and pars plana vitrectomy (PPV). Methods In localized cases, pneumatic retinopexy and scleral buckling surgery (SB) remains the most popular surgical methods. Complicated cases with PVR grade B or C, giant tears, or macular holes are most commonly treated with primary pars plana vitrectomy. A large group of rhegmatogenous RDs with medium severity that comprise about 30% of all primary rhegmatogenous RDs in the Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment recruitment study, were treated by SB and PPV. Advances in vitrectomy instrumentation and wideangle imaging systems have increased the popularity of PPV. Results The decision by the surgeon to use scleral buckling rather than PPV depends on a number of factors, including the lens status, size and location of breaks, patient compliance, and individual experience. Initial PPV may be successful for phakic patients. However, the SPR study shows a benefit of SB in phakic eyes with respect to BCVA improvement. Although no difference in BCVA was demonstrated in the pseudophakic trial, PPV was recommend for pseudophakic RD based on a better anatomical outcome. Conclusion There was a significant trend towards more frequently employing primary PPV (with or without SB) for the management of primary RRD. A significant improvement in the primary success rates for RD, were shown for all retinal surgical modalities applied for the treatment of rhegmatogenous retinal detachment.
Failure of pattern recognition
Authors: PURVIN V , KAWASAKI A 
Published: November 2010

Abstract Purpose This course focuses on areas of frequent diagnostic confusion in neuro‐ophthalmic diagnosis. Methods The course uses a case‐based format. Cases are presented as unknowns, each illustrating the specific clinical feature or features that should point to the correct diagnosis. Results We hope that highlighting common errors in this way will help inspire the clinician to master the material so that such “pitfalls” can be avoided. Conclusion The common theme among the cases is that most neuro‐ophthalmic diagnoses derive from the history and careful examination rather than the results of ancillary testing.
Over‐reliance on negative test results
Authors: PURVIN V , KAWASAKI A 
Published: November 2010

Abstract Purpose This course focuses on areas of frequent diagnostic confusion in the field of neuro‐ophthalmology. Methods The course uses a case‐based method. Cases are presented as unknowns, each illustrating the specific clinical feature or features that should point to the correct diagnosis. Results Certain tests may provide misleading information, apparently "ruling out" a particular disorder, when in fact that is the correct diagnosis. Examples include serologic tests for ocular myasthenia, falsely negative temporal artery biopsy for giant cell arteritis and MRI scans in certain some disorders. Conclusion In order to interpret the results of ancillary testing we must know the clinical features of the disease in question and the limitations of the tests we use.
Diagnostic look‐a‐likes
Authors: KAWASAKI A 
Published: November 2010

Abstract Purpose To provide the clinician with specific tips on how to distinguish between two common “look‐alike” diagnoses Methods Case studies Results We will highlight the one best feature that differentiates the two disorders presented as look‐alikes Conclusion It is important to recognize disorders that have similar presentation and to know how best to differentiate between them
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Diagnosis of adult ophthalmic tumours: role of clinical history, symptoms and signs
Authors: KIVELÄ T 
Published: November 2010

Abstract Purpose To summarise signs and symptoms useful in diagnosing adult ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results According to studies from the United Kingdom, Finland and United States, 28‐42% of adult patients with intraocular tumours may experience delays because the lesion is either misdiagnosed (e.g. as macular degeneration, naevus, rhegmatogenous retinal detachment) or missed at the initial visit. Of these patients, 72‐87% have symptoms attributable to the tumour such as blurred vision, photopsia, floaters, metamorphopsia, and visual field loss. These symptoms can also be caused by many benign conditions (e.g. vitreous detachment) but should not be interpreted as innocent without thorough clinical examination. Signs specific for iris and ciliary body tumours include a tumour mass, sentinel vessels, acquired astigmatism, and cataracts. Choroidal tumours may induce serous retinal detachments, subretinal and vitreous bleedings and, sometimes, lipid exudation. Finally, orange subretinal pigment suggests the diagnosis of a uveal melanoma whereas many drusen point to a long‐standing naevus. Conclusion Signs and symptoms of ophthalmic tumours are mostly nonspecific, necessitating an appropriately high level of suspicion and a systematic approach to clinical examination to avoid delayed or missed diagnoses. Earlier diagnosis could be achieved especially if dilated fundus examinations were performed without exception and if all suspicious naevi were referred for a second opinion.
Diagnostic tools for adult intraocular tumours
Authors: ZOGRAFOS L 
Published: November 2010

Abstract Purpose Fundus examination completed with Fundus drawings and panoramic, fundus pictures, standard and panoramic fluorescein angiography, standard and panoramic ICG, 10, 20 and 50 MHz ultrasonography, and OCT are the main diagnostic tools for intraocular tumours in adult’s patients. Methods These various diagnostic techniques provide complementary informations contributing to the final diagnosis. A document tumour growth during a periodic observation may be recorded with standard or panoramic fundus pictures. The modifications of the pigmant epithelium as well as an increase permeability of the tumour vessels may be recorded with standard or panoramic fluorescein angiography. Intra‐tumoral and Peri‐tumoral with hemodynamic modifications may be recorded with standard and panoramic ICG. Results Tumour shape, and tumour height is recorded with standard 10 or 20 MHz ultrasonography. The volume and the shape of anteriorly located intra ocular tumours are recorded with 50 MHz UBM. Conclusion The presence of the retinal detachment in contact with the tumours may be recorded with modern OCT. Additional examinations which can be used in ocular oncology are: Fundus auto‐ fluorescence, MRI, and computed tomography. An intraocular biopsy can be required in specific cases.
Diagnosis of retinoblastoma
Authors: DESJARDINS L , GAUTHIERS‐VILLARS M 
Published: November 2010

Abstract Purpose Retinoblastoma is the most frequent malignant intra ocular tumors in childhood. The incidence is one out of 15000 to 18000 births. The median age at diagnosis is 24 months for unilateral and 12 months for bilateral. The genetic predisposition is autosomal do Methods In 1971 Knudson made the hypothesis that 2 genetic alterations in the same retinal cell were necessary. In bilateral disease there is one germline and one somatic mutation and in unilateral non hereditary, 2 somatic mutations. The Rb1gene is located on chromosome 13 q 1‐4 . The Rb 1 protein is a pocket protein involved in the cell cycle regulation Results Most frequent symptoms are leukocoria and strabismus Later symptoms include heterochromia iridis,rubeosis, buphtalmia, pseudo hypopion, uveitis, inflammatory pseudo tumor and exophtalmia. Diagnosis of retinoblastoma is made by fundus examination. Imaging of the orbits and brain should be performed using MRI if possible. Ultrasonography with B and A scan is also useful as well as the use of Retcam . Differential diagnosis is sometimes easy when there is colobomas ,persistance of hyperplastic primary vitreous ,hamartomas or astrocytomas It can be difficult in cases of advanced Coats disease or when there is diffuse infiltrating retinoblastoma. Conclusion We have made a retrospective study on patients sent for suspicion of retinoblastoma in our institute from January 2003 to December 2005 If we compare this serie to the serie published in the literature we can say that the pourcentage of well diagnosed retinoblastoma is improving. We have found 16% of wrong diagnostics. There was 30% in the serie of Balmer in 1988 and 42% in the serie of Shields in 1991. The most frequent differential diagnosis reported in all series is Coats disease
History of disease, facial nerve grading systems & clinical evaluation
Authors: MAVRIKAKIS I 
Published: November 2010

AbstractObtaining an accurate history of the onset, progress and associated symptoms of newly acquired facial nerve palsy is extremely helpful in determining the potential cause of the palsy. More importantly it serves as a guide for prognosis and timing of any necessary surgical intervention. Acute versus chronic facial nerve palsy, complete versus incomplete facial nerve palsy, recovery and recurrence of the disease will be discussed. The gold standard for grading facial nerve function is the House‐Brackmann grading scale. Due to the limitations and subjectivity of this scale, several new scales of various degrees of objectivity and ease of use have been introduced. These include the Nottingham system, the Sunnybrook scale, the Yanagihara and the Sydney system, all with their advantages and disadvantages. Clinical evaluation of a patient with facial nerve palsy include evaluation of upper eyelid retraction, blink reflex, lagophthalmos, brow ptosis, paralytic ectropion, midface ptosis, mouth symmetry, platysma muscle strength, hearing, corneal sensation, Bell’s phenomenon, tear function and synkinesis.
Fluorescein angiography: first step for macular degeneration diagnosis
Authors: SOUBRANE G 
Published: November 2010

Abstract Purpose To recall that fluorescein angiography (FA) is not only the basis of our knowledge but also mandatory to improve our understanding. Methods Macular disciform lesions have been described and drawed since about 150 years. It is only in 1977 with the advent of fluorescein that the connection with choroidal new vessels (CNV) was performed. The identification of drusen as precursors of CNV was the following stage. With time a number of precursors and clinical forms of macular degeneration were described. Results Currently, the precursors (Age‐Related Maculopathy) are distinguished from the neovasdcular or atrophic complications (Age‐Related Macular Degeneration). The precursors presenting an early hyperfuorescence can be either hard drusen or RPE atrophy distinguished from each other on the late phase of FA.The late hyperfluorescence of soft drusen particularly when confluent requires a careful analysis of the complete FA sequence to ensure the diagnosis. The neovascular stage presents mainly as sub epithelial occult lesions of which the other types develop that display different angiographic behaviours. Specific aspects have been described gradually based on their FA features. The atrophic stage of the disease seems to behave in a stereotyped way but sub goups are presently identified. Conclusion The fluorescein features of the different component of AMD remain the reference for all other more recent imaging technics and helps to understand and differentiate the various aspects of the disease.
OCT: from single use to combined use in macular degeneration
Authors: CREUZOT C 
Published: November 2010

Abstract Purpose Optical Coherence Tomography (OCT) plays a key role in the diagnosis and the treatment of Age Macular Degeneration (AMD). Authors will present the different signs observed in OCT in exudative AMD. Methods Authors will present clinical cases to illustrate the place of the OCT in AMD diagnosis. OCT has progressively replaced the first‐line tool played by angiography especially for the following of the patient once the treatment initiated. The different schemas currently proposed emphasize the role of the OCT combined with visual acuity measurement and fundus examination. Results However, the role of fluorescein and indocyanin green angiography remained essential especially to precise the clinical form before treatment. The combination of OCT and angiography remained a "key association" especially when there is some discrepancy between results or in case of treatment failure to consider another option. It is also the only opportunity for us to understand better the prognosis of these cases under treatment. Conclusion OCT has dramatically changed the supervision of exudative AMD especially during treatment. However, the combination with fluorescein and indocyanin angiograms is highly recommended not only for initial diagnosis but also in difficult cases during follow‐up.
Autofluorescence: new tool to follow dry eye AMD?
Authors: MENKE MN , WOLF‐SCHNURRBUSCH U , WOLF S 
Published: November 2010

Abstract Purpose In the pathophysiolgy of dry (atrophic) age related macular degeneration (AMD) aging of the retinal pigment epithelium (RPE) plays a key role. Accumulation of lipofuscin granules in the RPE cells represents a common downstream pathogenetic pathway in AMD. Lipofuscin is derived from chemically modified residues of incompletely digested photoreceptor outer segment discs. Detection of lipofuscin in vivo is possible by using fundus autofluorescence (FAF) imaging. The clinical application and possible implications of autofluorescence imaging in dry AMD will be discussed. Methods When stimulated with light in the blue to green range, lipofuscin granules emit a characteristic yellow fluorescence. FAF imaging using a scanning laser ophthalmoscope allows visualization of the topographic distribution of lipofuscin over large retinal areas. Examples of FAF images will be presented to demonstrate various FAF patterns and to discuss the clinical significance of these findings. Results In areas of geographic atrophy FAF images show very low autofluorescence intensity. This is due to the loss of RPE cells including the lipofuscin granules. In the junctional zone between atrophic and normal retina, levels of increased autofluorescence intensity may occur due to excessive accumulation of lipofuscin in the RPE cells. Longitudinal observations further suggest that the extension of the total area with increased autofluorescence intensity surrounding atrophy at baseline has a strong positive correlation with atrophy progression rate over time. Conclusion FAF imaging is an important diagnostic tool to follow the progression of dry AMD and other degenerative macular diseases and should always be considered in cases were the status of the RPE is unknown.
The author, the reviewer and the associate editor: a literary drama triangle
Authors: KIVELÄ T 
Published: November 2010

Abstract Purpose To provide an insight into interactions between authors, reviewers and editors. Methods Personal experience of the author as a writer, reviewer and associate editor is used to discuss the scholarly interaction involved in having a manuscript reviewed and eventually published. Results The drama triangle is a psychological model of human interaction first described by Karpman. It proposes three ancestral psychological roles which people often take in a social situation: 1. The person who is treated as, or accepts the role of, a victim, 2. the person who pressures or persecutes the victim, and 3. the rescuer, who intervenes to help the situation or the underdog; this role often is one of a mixed or covert motive. The scenario of most novels, plays and movies is based on the drama triangle. Moreover, most of us are neurologically programmed to play any of the three roles. Depending on the context, we will thus ‐ consciously or unconsciously ‐ choose one of them. The roles can consequently also insinuate into the manuscript review process: the author is liable to become the victim and the reviewer the villain; the editorial staff member may then assume the role of the rescuer. Be as it may, the editors should try to identify reviewers whose comments are ‐ often unconsciously ‐ hostile from those whose advice is constructively critical, and then filter these in their targeted advice, keeping a neutral position. Sometimes he may need to guide an author who declares himself a victim or a reviewer who plays rescuer. Conclusion The best way to avoid being trapped in a drama triangle is by being watchful not take one of the three roles. Ideally, all three players work in unison toward a paper which makes best use of the data and of the talent of the authors and reviewers.