bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhegmatogenous retinal detachment associated to vitreous hemorrhage. Role of primary vitrectomy?
Authors: POURNARAS CJ 
Published: December 2011

AbstractPurpose The incidence of retinal break formation following acute posterior vitreous detachment is variously reported as occurring in between 8% to 15% of patients, associated up to 39% of the eyes with rhegmatogenous retinal detachment.Methods Retrospective review of noncomparative interventional case series and cases treated in our departmentResults The management of patients with fundus‐obscuring dense vitreous haemorrhage due to presumptive retinal tears advocates waiting for spontaneous resolution. Surgery is indicated only when a definite retinal tear or retinal detachment is identified. However, the degree of agreement between ultrasound and clinical findings, indicate retinal diagnosed and localized accurately in only 44% of eyes. Early vitrectomy for spontaneous dense fundus‐obscuring vitreous haemorrhage and posterior vitreous detachment seems safe. Rhegmatogenous retinal detachment with severe VH is associated with longer duration of preoperative haemorrhage, a higher incidence of severe PVR and worse visual outcome. An 75% incidence of retinal detachment was reported in eyes with a history of retinal detachment in the contralateral eye. Close follow‐up and aggressive surgical interventions are suggested in these patients.Conclusion Acute, spontaneous, nontraumatic posterior vitreous separation with dense fundus‐obscuring vitreous hemorrhage is associated with a high incidence of retinal tears and detachment. Close follow‐up with clinical examination and ultrasonography is necessary, because many of these eyes may eventually require surgical intervention. Aggressive management with early vitrectomy should be considered when there is a history of retinal detachment in the contralateral eye.
Primary vitrectomy alone for pseudophakic retinal detachment
Authors: MENDRINOS E 
Published: December 2011

AbstractPurpose To report the anatomic and functional results of primary vitrectomy without scleral buckling for the treatment of pseudophakic rhegmatogenous retinal detachment(PsRD)Methods One hundred eyes of 98 patients with PsRD were operated by vitrectomy alone. Internal subretinal fluid drainage, cryocoagulation and/or endolaser and fluid‐air exchange with sulfur hexafluoride 20% was applied in all cases. The preoperative and postoperative characteristics were analyzed. Main outcome measures were anatomic success rates after initial surgical intervention and after reoperation for primary failures, visual outcome at the last follow‐up visit,and complications.Results Mean follow‐up +/‐ standard deviation (SD) was 12 +/‐ 6.3 months (range, seven to 36 months). Mean final visual acuity +/‐ SD was 0.42 +/‐ 0.45 logarithm of the minimum angle of resolution (logMAR) compared with 0.95 +/‐ 0.73 logMAR before surgery (P < .01). Mean number +/‐ SD of retinal breaks found before surgery was 1.36 +/‐ 1.12 (range, zero to five), and an additional 1.58 +/‐ 2.26 (range, zero to 15) retinal breaks were found during surgery. The retina was reattached successfully after a single surgery in 92 eyes (92%). Recurrence of retinal detachment occurred in eight eyes (8%), caused by proliferative vitreoretinopathy in six eyes (75%) and by new breaks in two eyes (25%). Final anatomic reattachment was obtained in these cases after a mean of 1.75 subsequent operations. Three eyes required permanent silicone oil tamponade so that final anatomic success was achieved in 97 eyes (97%). The most common postoperative complication was ocular hypertonia of more than 21 mm Hg, observed in 36 (36%) eyes, which was managed successfully.Conclusion Primary vitrectomy provides high anatomic success rate in PsRD eyes
A Case of Lattice Corneal Dystrophy due to the L527R Mutation in the TGFBI Gene in Korea
Authors: CHO KJ , MOK JW , JOO CK 
Published: December 2011

AbstractPurpose The purposes of this study are to report the first case of LCD type Ⅳ with different phenotype in each eye.Methods A 67‐year‐old Korean female patient who was otherwise in good medical health presented with gradual impairment of vision over the previous 1 year. After informed consent was given, slit lamp biomicroscopy and genetic analysis were performed. All the exons from the entire coding regions of stromal corneal dystrophy related genes, TGFBI, CHST6 and M1S1 genes, were directly sequenced to determine if there were any mutations.Results Relatively thick lattice lines that extended from limbus to limbus in the superficial stromal layers were observed in the right eye by slit lamp biomicroscopy, whereas gray‐colored nodular deposits deep in the central stroma were observed in the left eye. We could not find lattice lines in the left eye or any nodular deposits in the right eye. We detected a heterozygous point mutation, CTG  CGG (c.1580 T>G: Leu527Arg in exon 12 by IC3D classification) in codon 527 of TGFBI.Conclusion Given that we identified a Korean patient with lattice corneal dystrophy due to the L527R Mutation in the TGFBI Gene, although this mutation is very rare, LCD type Ⅳ may occur in individuals of races other than Japanese.
What limits normal visual performance in the dark?
Authors: RAUSCHER F 
Published: December 2011

AbstractPurpose Visual performance is affected by changes in the spatial and temporal properties of the retina and/or changes in the quality of the retinal image as a result of increased aberrations and scattered light. The aim of the study was to establish the extent to which retinal and/or optical factors set the limits of visual performance at low light levels.Methods Pupil size, ocular aberrations, scattered light, chromatic sensitivity and contrast acuity were measured as a function of retinal illuminance. Pupil size was measured continuously and display luminance adjusted for constant retinal illuminance.Results Mesopic vision describes the range of light levels over which signals from both rods and cones contribute to the visual response. Visual performance changes with light level: Both the amount of scattered light and the rms wavefront aberration were found to increase rapidly with decreasing light level in the mesopic range. This was paralleled by a massive increase in contrast acuity thresholds and a rapid loss of both red‐green and blue‐yellow chromatic sensitivity.Conclusion The gradual increase in rod signal as the light levels decreases causes changes in the overall spectral sensitivity of the eye with consequences for visual effectiveness. Cone dominated vision is affected most by optical factors; in rod dominated vision the limiting factor becomes the resolving power of the retina. Key aspects of visual performance, such as spatial and temporal contrast sensitivity and acuity, visual delay and colour sensitivity change with light level. Linking such changes allows us to predict visual performance at low light levels where characteristics of the rod and cone system are so different.
Fluorescein angiography in uveitis
Authors: KHAIRALLAH M , JELLITI B 
Published: December 2011

AbstractPurpose Fluorescein angiography (FA) is an important test in the evaluation and management of patients with uveitis. FA in uveitis is giving information principally on the superficial structures of the fundus (retina, retinal vessels and optic nerve head / disc), on the retinal pigment epithelium, on the choriocapillaris in the first 60 seconds of angiography as well as immediatelly subclinical pathology such as subretinal neovascular membranes.Methods FA is indicated when a posterior segment involvement is present or suspected. It should examine the posterior pole, optic disc, and periphery, with angiograms at early, intermediate, and late phases. FA results should be interpreted in relation to the results of clinical examination and other testsResults There are many roles for FA in the evaluation of patients with uveitis 1. Evaluation of the activity and extent of chorioretinitis: 2. Diagnosis of uveitic entities with typical features. 3. Evaluation of retinal vascular involvement : focal, multifocal, or diffuse retinal vascular leakage, occlusive complications, optic disc or retinal neovascularization, 4.Identication of macular complications 5. Evaluation of optic disc involvement. 6. Monitoring of response to treatmentConclusion FA can be helpful in the diagnosis, treatment, and monitoring of patients with posterior segment inflammation.
Cataract and glaucoma surgery, combined or consecutive, where do we stand?
Authors: SUNARIC MEGEVAND G 
Published: December 2011

AbstractThe surgical management of concomitant cataract and glaucoma, uncontrolled despite maximum tolerated medical therapy, may be consecutive or combined during the same surgical session. Combined procedures are more demanding techniques with potentially more complication but decrease durably the IOP and allow longer preservation of the visual field. However results in various studies using different surgical techniques give contradictory results and recommendations. During the course an analysis of the actual state of knowledge from the literature will be discussed in details covering the aspect of surgical techniques, efficacy in IOP lowering, visual function, quality of life as well as cost of these two different surgical approaches.
Combined approach, the yield of micro incisions for cataract surgery
Authors: BRON AM 
Published: December 2011

AbstractCataract extraction combined with glaucoma surgery remains controversial. Some authors advocate consecutive surgeries arguing that the expected lower inflammation will allow a better outcome of the filtering surgery. However it is well known that cataract extraction after a filter may impair the long term efficacy of glaucoma surgery. Conversely the combined approach is more convenient for the patient with one operation and generally a better visual result. However it is generally considered that the IOP‐lowering effect is less effective in combined procedures. Rather than opposing these two approaches, it is probable than according to the characteristics of the patient and the type and the stage of glaucoma, a consecutive or a combined surgery is more appropriate. Therefore the surgeon must be prepared to perform the two types of surgery. Micro incisions for cataract surgery (MICS) offer some substantial advantages vs conventional corneal incisions; a better tightness of the surgical wound allows a better control of IOP during the surgery. Therefore glaucoma surgeries (penetrating or not) are much easier to perform without changing your technique. In this presentation some surgical tips will be given in order to facilitate your combined procedures.
Staging: glaucoma first or cataract first?
Authors: ZEYEN T 
Published: December 2011

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.
Role of 3.0 Tesla MRI in diagnosis and treatment planning of iridocilairy and choroidal melanocytic tumors
Authors: DE KEIZER RJW , RAZZAQ L , MARINKOVIC M , VERBIST B , VERSLUIS M , VAN DUINEN SG , LUYTEN GPM 
Published: December 2011

AbstractPurpose To evaluate the role of 3 Tesla MRI in the diagnosis, measurement and treatment planning of choroidal and iridociliary melanoma and comparison of results with Ultrasound and histology to measure the accuracy of MRI.Methods : Prospective analyses of consecutive 12 patients, four with iridociliary and eight having choroidal melanocytic tumors. All these patients had ultrasound (10MHz) or UBM (50MHz), 3 Tesla MRI and underwent primary enucleation. The enucleated eyes were examined for gross measurements and histopathology was done.Results Iris/iridociliary melanocytic tumors showed that MRI was positive in two cases and comparable to UBM. In one case tumor was identifiable only on saggital sections while in one case of Leiomyoma MRI gave much details and enhancement patterns. For posterior tumors MRI was positive in all the eight cases and results were comparable to ultrasound and macroscopic pathology in six cases.Conclusion 3 Tesla MRI showed comparable results to UBM /USG and macroscopic pathology in 80% of patients. MRI should be performed if clinical and USG are in doubt to get additional information for diagnosis of other melanocytic tumors. An important finding was that for iris‐iridociliary melanomas MRI saggital images should be used for interpretation.
Percentage of aberrant cells in uveal melanoma correlates with the patient’s prognosis
Authors: VAN DEN BOSCH T , VAN BEEK J , VAARWATER J , VERDIJK R , NAUS N , PARIDAENS D , DE KLEIN A , KILIC E 
Published: December 2011

AbstractPurpose Uveal melanoma (UM) is the most common type of intra‐ocular malignancy in adults with an annual incidence of 5‐7 cases per million. Almost half of all patients with UM eventually die due to often late appearing metastases. Several clinical, pathological, and genetic factors have been identified as prognostic markers in UM. Non‐random chromosomal alterations for instance are present in over 80% of cases and complete loss of chromosome 3, (seen in 50% of all UM) relates to a 4‐year overall survival rate of only 30%.Methods Fluorescence in situ hybridisation (FISH) can be used to evaluate aneuploidy in the tumour cells. This FISH technique enables an in situ analysis of exact number/ percentage of tumour cells displaying that particular chromosomal aberration. Tumour heterogeneity has been observed in UM and an obvious question is whether lower percentages of abnormal cells are related to a change in patient’s outcome or prognosis.Results In this study, we assessed the percentages of aberrant tumour cells with FISH for each tumour (N=221) using chromosome 3 and 8 probes.Conclusion For both anomalies we could demonstrate that a high percentage aberrant tumour cells correlate well with a significantly worse prognosis for the patient.
Commercial interest
Genetic and histological heterogeneity in uveal melanoma: a peculiar case
Authors: ANGI M , KALIRAI H , BAUDO MM , BIDDOLPH S , COUPLAND SE , DAMATO BE 
Published: December 2011

AbstractPurpose Intratumour heterogeneity of uveal melanoma (UM) has become a relevant issue in the era of sampling for prognostication purposes. We present the case of a UM consisting of two very distinct components.Methods A 53‐year‐old man was referred for an infero‐nasal, collar‐stud UM with associated retinal detachment in the right eye. On ultrasonography, the tumour measured 14 x 16mm, with a thickness of 11mm. The patient chose enucleation over other treatment options. The eye was examined morphologically, immunohistochemically and using multiplex ligation‐dependent probe amplification (MLPA).Results Histological sections demonstrated two distinct components: a pale basal part consisting of amelanotic epithelioid melanoma cells with extensive diffuse involvement of the ocular structures. In contrast, the apical part was heavily pigmented comprised only of spindle B cells. Interestingly, MLPA demonstrated complete chromosome 3 loss in the apical (spindle) region but only partial chromosome 3 deletion in the basal (epithelioid) part. Both areas showed polysomy 8. Conversely, immunohistochemistry showed more aggressive features in the basal part rather than in the apical part.Conclusion This case provides further evidence that there is heterogeneity in UM, and that a single intraocular biopsy may not be reliable for prognostication purposes.
Effect of SOCS1 overexpression on RPE cells activated by cytokines
Authors: BAZEWICZ M , MAKHOUL M , DRAGANOVA D , CHTARTO A , TENENBAUM L , EL MALEH V , CASPERS L , BRUYNS C , WILLERMAIN F 
Published: December 2011

AbstractPurpose Retinal pigmented epithelium (RPE) cell activation by cytokines plays an important role in autoimmune uveitis development. The aim of this study was to investigate if Suppressors of Cytokine Signaling (SOCS1) overexpression in RPE cells can modulate this activation.Methods SOCS clone and control clone were isolated after stable transfection of APRE‐19 with plasmids containing or not the SOCS1 gene. qRT‐PCR was used to measure SOCS1 mRNA expression. Clones were stimulated by IFNγ or/and TNFα. Membrane expression of MHCII and CD54 was measured by flow cytometry, IL‐8 secretion by ELISA and (P‐)STAT‐1 and IκBα expression by Western Blot.Results We found a stable high expression of SOCS1 in the SOCS clone as compared to the control clone or native ARPE cells. This SOCS1 overexpression strongly decreased IFNγ‐mediated STAT‐1 phosphorylation, MHCII induction and CD54 upregulation. On the contrary, SOCS1 overexpression had no effect on TNFα‐mediated IκBα degradation, IL‐8 upregulation, but weakly inhibited CD54 upregulation. During simultaneous IFNγ and TNFα stimulation, SOCS1 overexpression canceled the inhibitory effect of IFNγ on TNFα‐induction of IL‐8 secretion.Conclusion SOCS1 overexpression can block IFNγ but have almost no effect on TNFα activation of retinal pigmented epithelium cells. Those data suggest that SOCS1 overexpression might only affect certain cytokine pathways important in autoimmune uveitis development.
Demodex infestation in the normal population, blepharitis patients and among people who work with microscopes
Authors: UDZIELA M , SZAFLIK JP , GARBACEWICZ A , GRYTNER‐ZIECINA B , SZAFLIK J 
Published: December 2011

AbstractPurpose Aim of the study was to estimate the prevalence of Demodex spp. infections of lid margin in Polish populationMethods 264 individuals were enrolled in the study. Patients were divided into four groups. First two groups consisted of young people (mean age 22 years) and seniors (mean age 66 years). The third group was made up of people who work with microscopes. Forth group consisted of patients with diagnosed blepharitis. From every individual 3‐4 lashes were epilated from upper and lower lid margin of each eye and examined under the microscope for Demodex mites.Results The lowest number of infected individuals was observed in the young group‐ only 5%, the highest in blepharitis patients‐ 74% infected. Among microscope users (mean age 44 years) 30% were infected, in senior group (mean age 66 years) also 30% were infected.Conclusion Demodex mites are etiological factors of blepharitis. There is a significant correlation between Demodex spp. infection and the age of the examined individual. People who work with microscopes are in a risk group for Demodex infection of lid margins.
General Pathophysiology
Authors: AUGUSTIN A 
Published: December 2011

AbstractMacular edema represents a common final pathway of many intraocular and systemic diseases, which usually involve the retinal vessels. It typically occurs with painless impairment of visual acuity in one eye, but can also be bilateral, depending on the etiology. A macular edema is a nonspecific sign of many ocular disorders. Usually the symptoms progress slowly. Nevertheless, patients often may notice this entity suddenly – this is the case when they examine one eye separately. The appearance can differ with several subtypes existing, depending on the etiology. In this presentation the following mechanisms and problems of this non‐specific disease entity will be discussed: Unique construction of the blood‐retinal‐barrier und general possibilities of alteration. Inflammatory mediators with major focus on Angiotensin II, VEGF and Prostaglandins. Other cytokines and Chemokines as well as Matrix metalloproteinases. Sorbitol pathway and oxidation (Diabetes) – relation to inflammation. Mechanical issues (venous diseases). In addition it will be mentioned how this knowledge on pathophysiology translates into clinical praxis when we design treatment strategies for our patients.
Retinal Vein Occlusion
Authors: COSCAS G 
Published: December 2011

AbstractMacular edema is a major complication of both ischemic and non ischemic Retinal vein occlusions (RVO). Fluorescein angiography (FA) is the most effective method to determine the presence of macular cystoid edema (CME), its extension, persistence, regression, the degree of ischemia (perfused or non‐perfused RVO). Spectral domain OCT (SD‐OCT) helps to quantify the changes in retinal thickness, the amount of CME, the presence of sub retinal fluid accumulation and precise analysis of the outer retinal layers, useful as a guide for treatment. According to the recent results of the SCORE Trial, Grid Laser photocoagulation remains the reference treatment for macular edema due to branch retinal vein occlusion (BRVO) but not recommended in Central RVO Recent prospective randomized trials strongly suggest an anti‐edematous effect of intravitreal steroids (particularly dexamethasone in a slow release device) and intravitreal anti‐VEGF drugs, that may at least temporarily reduce foveal edema and improve visual function. Surgical treatment modalities have been reported for RVOs with a positive action of vitrectomy; the combination with intravitreal steroids and/or tissue plasminogen activator could permit a more rapid and lasting action. Taking into consideration the recent advances in diagnostic tools and management options, recent European practical recommendations and Guidelines, prepared by a collaborative group of retina specialists, are presented to provide the ophthalmologists with guidelines for the clinical approach of RVO.
Macular edema of choroidal origin
Authors: SOUBRANE G 
Published: December 2011

AbstractAge‐related macular degeneration (AMD) is the result of an advanced alteration of the choriocapillaris and/or the retinal pigment epithelium (RPE), and/or the photoreceptor (PR) layers. The neural retina is only partially involved, and additional pathways are required for the development of edema within the retina. The exudative form of AMD is due to choroidal neovascularization (CNV) that causes a serous detachment of the neurosensory retina which development and importance depends on the activity of the new vessels. Edema involving the outer and ultimately the inner retina develops progressively. The presence of cystoid macular edema is more likely if the retinal serous detachment is long‐standing and if the choroidal neovascular membrane has involved most of the subfoveal region. The classic clinical definition of macular edema is an accumulation of serous fluid within the neuro sensory retina increasing thickness of the central retina. However in exudative AMD, the leakage of fluid from the choroidal new vessels may be the origin of fluid collection underneath and within the neuro sensory retina. The normal choriocapillaris leaks on the side facing the RPE in order to assure the nutrition of the photoreceptors. CNV being of choroidal origin presents the same structure histologically as the choriocapillaris. In AMD, the associated inflammatory reactions induce the rupture of the external retinal blood barrier and leads to an exudation within the subretinal space. In addition, after prolonged detachment, the retinal capillaries may become damaged and contribute to the leakage of dye into the extracellular compartment of the retina. The consequent damage of the outer retinal layers determines alterations of the overlying (and underlying) tissues. Several inflammatory mediators and inflammatory cells are likely the key signals, that initiate secretion of numerous cytokines one being vascular permeability factor, referred to as vascular endothelial growth factor (VEGF), present at the site of the angiogenic stimulus. All these factors interact in a complex chain reaction, which is not yet completely understood.