bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic disease in small uveal melanomas : retrospective review of 368 patients
Authors: DESJARDINS L , LEVY GABRIEL C , LUMBROSO‐LEROUIC L , DENDALE R , PLANCHER C , ASSELAIN B 
Published: September 2009

Abstract Purpose To determine the metastatic rate and survival curves of small uveal melanomas and find the smallest uveal melanoma associated with metastatic disease. Methods We studied uveal melanomas patients treated with radiotherapy in Curie Institute between 1992 and 2004. We selected the tumors with a diameter inferior or equal to 12 mm and a thickness inferior or equal to 3 mm. All the datas concerning initial tumor findings, radiotherapy treatment and follow up were routinely entered in the data base. Retrospective review and statistical analysis were performed. Results Among 2258 patients treated during this period, 368 had small tumors. Median tumor diameter was 9 mm and median tumor thickness was 2,5 mm. Retinal detachment was present in 32 patients. 282 patients were treated by proton beam therapy, 77 by iodine plaque and 9 by transpupillary thermotherapy. Median follow up is 109 months. 71 patients died and 20 patients developped metastatic disease. Local recurrence was observed in two cases. Overall survival at 5 years was 92%and at 10 years 78% survival without metastasis at 5 years was 96% and at 10 years 93%. According to our data the smallest tumor associated with metastatic death was 5mm in diameter and 1,5 mm in thickness and 14 of the tumors had a diameter of less than 10 mm develloped. Half of the metastatic patients developped metastasis 5 years or more after treatment. Conclusion Very small uveal melanoma can be responsible for metastatic death.
Open‐sky biopsy of ciliary body or choroidal tumors of undetermined origin: utility and safety
Authors: SCHALENBOURG A , CHAMOT L , UFFER S , ZOGRAFOS L 
Published: September 2009

Abstract Purpose In the presence of a ciliary body or choroidal tumor of undetermined origin, an open‐sky biopsy is performed in selected cases to establish a diagnosis and specify the therapeutic approach. We explored the frequency and reliability of this diagnostic procedure. Methods Retrospective, consecutive, histopathologic case series of 30 biopsies since 1989 of ciliary body or choroidal tumors of undetermined origin. Results Eighteen tumors originated from the ciliary body, 12 from the choroid. Diagnosis was respectively adenoma/adenocarcinoma (4;0), mesectodermal leiomyoma (4;1), metastatic tumor (2;0), melanocytic tumor (4;5), lymphoma (1;3); hemangioma (1;0) or posterior nodular scleritis (0;3). In 2 cases, there was insufficient material to make a diagnosis. There were no cases where the biopsy complicated local or systemic tumor control. Conclusion Open‐sky biopsy is only performed in cases whose clinical appearance doesn’t permit to confidently establish a diagnosis; its goal is to guide the therapeutic approach.
Interest of QuantiFERON®‐TB (QT) Gold test (Cellestis) in patients with positive Tuberculin Skin Test (TST) in etiologic and therapeutic work‐up in uveitis
Authors: DE MONCHY I , GENDRON G , KASWIN G , POGORZALEK N , OFFRET H , LABETOULLE M 
Published: September 2009

Abstract Purpose Define the interest of QuantiFERON®‐TB Gold test (Cellestis) in patients with positive Tuberculin Skin Test (TST) to improve etiologic and therapeutic work‐up in uveitis. Methods All patients followed in the Ophthalmology Department of Bicêtre Hospital between April 2007 and March 2009 for uveitis had an extensive work‐up including Tuberculin Skin Test (TST). Among them, 14 patients had a very positive TST making suspect an active tuberculosis infection. Then all of these patients had systematically a quantiFERON®‐TB Gold test. Finally, charts from clinical exam and therapeutic management were retrospectively analysed. Results The mean age at the time of presentation was 58 years (+/‐ 9) and sex ratio (F/M) was 43%. Uveitis was bilateral in 43% of cases, and the location of inflammation was anterior in 43% of the cases, intermediate (21.4%), posterior (21.4%) or total (7%). The average of PPD test was 21.75mm (+/‐ 4mm, 15‐65mm) and minimal delay between PPD and quantiFERON®‐TB Gold test was 3 days (mean: 42 days +/‐ 17). QuantiFERON®‐TB Gold test was positive in 9 patients (64.3%) enjoining introduction of a full anti‐tuberculosis therapeutic treatment in 8 patients (57.1%), that preceded oral steroids regimen in 42.8% of cases. Visual acuity increased dramatically (6 lines) in 4 patients and was unmodified for the others. Conclusion QuantiFERON®‐TB Gold test seems usefull in systematic diagnostic strategy in uveitis; it stays negative in 35.7% of the case suggesting that positive results are significant. However, further studies are necessary to define its place in diagnostic procedure in uveitis.
Semi‐automated assessment of microaneurysm formation rate from color fundus photographs in patients with mild NPDR
Authors: BERNARDES R , NUNES S , PEREIRA I , LOBO C , CUNHA‐VAZ J 
Published: September 2009

Abstract Purpose To assess the reliability of microaneurysm (MA) formation rate, computed from color fundus photographs, in type‐2 diabetic patients with mild NPDR. Methods In a 2‐years observational and prospective study of 400 type‐2 diabetic patients with mild NPDR, MA formation rate (MAFR) was computed using a new method (MA‐Tracker). This method allows graders to earmark MAs location on color fundus photographs. By using image co‐registration, it became possible to track previously identified MAs and to identify newly earmarked ones. The reliability of the procedure, assessed using 3 independent graders and a total of 235 color fundus photographs from a previous dataset, demonstrated a very good agreement between graders for the number of MAs (ICC=0.964) and for the MAFR (ICC=0.981). Results Sixty‐three of the 400 patients/eyes that completed the baseline and the 6‐month visits had MAFR computed using the MA‐Tracker. While the number of MAs earmarked at baseline (mean±SD: 2.0±2.5 MAs) and at 6‐months (2.7±3.7 MAs) showed no statistically significant increase (P=0.105), the MAFR, on the other hand, showed a high MA turnover (mean±SD: 2.7±3.7 new MAs for this 6‐months period of follow‐up). Conclusion Microaneurysm formation rate obtained from color fundus photographs using the MA‐Tracker show a very good reliability between graders making it a new tool with potential to be used as a biomarker of DR progression.
AlphaCor, Pintucci, Supradescemetic
Authors: PROSDOCIMO G 
Published: September 2009

Abstract Purpose To report the long term results of a supradescemetic corneal implant to restore vision Methods A Keralia "soft" keratoprosthesis was implanted in one eye of a seventy years old woman bilaterally blind and affected by a bilateral limbal stem cells deficiency. Results After four years the implant is still insite, well tolerated. Thi initial visual recovery has been compromized , during the last year, by a progressive opacification of the superficial layer of the device. Conclusion The Keralia supradescemtic implant seems well tolerated in the long term by the human eye. Problems related to the stability of the material should be solved in future.
Immunimodulation of corneal epithelial cells following electroporation with mRNA encoding IL‐10 and FasL
Authors: ZAKARIA N 
Published: September 2009

Abstract Purpose The aim of this project is to transfect corneal epithelial cells with mRNA encoding IL‐10 and FasL in order to evoke down modulation of allogenic T cell responses in an ex vivo model. Methods The corneal epithelial cells (CECs) will be electroporated initially using a reporter gene, EGFP, in order to optimize the transfection efficiency of the cells which will be detected using flow cytometry. Following this, we intend to transfect the cells with mRNA encoding IL‐10 and FasL. The cells will then be labeled with antibodies against IL‐10 and FasL and checked for expression of these molecules using flow cytometry. Cytokine secretion will also be detected using ELISA. IL‐10 and FasL transfected cells will be co cultured with allogenic T cells and compared with control co cultures of allo‐T cells with mock‐electroporated CECs. After 5 days of culture, T cells will be analyzed for allogenic reactivity by ELISA for IFN‐γ production in the culture supernatant. Results We intend to show that it is possible to electroporate corneal epithelial cells effectively ex vivo with a reporter gene as well as with IL‐10 and FasL. We hypothesize that this may induce tolerance in allogenic T cells and we intend to illustrate this in an ex vivo model using an epithelial‐allo T cell co‐culture. Conclusion This project aims to illustrate, in an ex vivo model, how gene insertion into corneal epithelial cells could possibly lead to improved cultivated limbal stem cell graft acceptance in patients with vascularized corneas.
Retinal pigment epithelial tears following administration of intravitreal bevacizumab (3 case reports)
Authors: KUOLIENE K , CIMBALAS A , AUKSTIKALNIENE M , ASOKLIS R 
Published: September 2009

Abstract Purpose To report three cases of retinal pigment epithelial (RPE) tears after repeated intravitreal injection of bevacizumab for the treatment of neovascular age‐related macular degeneration (AMD). To present fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) findings. Methods Out of 433 patients treated with intravitreal bevacizumab injections for choroidal neovascularization, three patients with vascularized RPE detachment developed RPE tear. Case 1: the patient developed RPE tear shortly after the third intravitreal injection into the left eye; cases 2 and 3: the patients developed RPE tear after a single injection into the right eye and left eye, respectively. Visual acuity testing, fundus photography and OCT were performed for all patients monthly for over a year after the first injection. Results The preoperative size of the RPE detachment was 9.14 sq. mm for case 1, 5.16 sq. mm for case 2 and 5.93 sq. mm for case 3. At diagnosis of RPE tear, the patients suffered vision loss of three lines in cases 1 and 2 and two lines in case 3. After further treatment with bevacizumab, visual acuity at 12‐month follow‐up improved by two lines in case 1 and one line in cases 2 and 3. Conclusion 1. RPE tear can occur following treatment with intravitreal bevacizumab and is associated with significant visual loss. 2. Large RPE detachment may be a predictor for RPE tear. 3. Visual acuity improved in all three cases after further treatment with bevacizumab following RPE tear.
Fundamentals of cataract development
Authors: WEGENER A 
Published: September 2009

AbstractThe lens is a highly specialized tissue in the vertebrate eye, whose growth characteristics and metabolic turn‐over are designed for longevity in respect to its optical function. It grows throughout life and does neither shed any of its cells, nor excrete any degraded proteins. The lens manages to maintain an optical and a biochemical gradient based on the high protein content (crystallins) and slow metabolic turn‐over in the superficial fibre cells. It is well equipped with anti‐oxidative defence mechanisms, can seal off groups of damaged fibre cells and changes its transmission properties during ageing. The 3 main ageing characteristics in the lens are a tissue layer specific increase in light scattering, a yellowish discoloration of the proteins and a loss of accommodative capacity. Cataract development can be triggered by a wide selection of factors including genetic predisposition, certain diseases, optical and ionizing radiation, chemical compounds, drugs, nutritional and environmental factors, as well as trauma. Patho‐physiological mechanisms involved are DNA damage in epithelial cells, protein glycosylation and aggregation and molecular cross linking in lens fibre cells, metabolic breakdown of selected groups of fibre cells or of a whole layer, protein degradation and finally globular degeneration and liquefaction. Ageing in this context is the time line which allows an increasing number of noxious factors to interact in the lens at decreasing metabolic capacities. While the sensitivity of the lens to oxidative damage increases during ageing, its sensitivity to low dose ionizing radiation decreases. The function of molecular receptors for acetylcholine, steroids, the sigma receptor and other receptors found in the lens is still unknown, but might explain the specific reaction to certain drugs.
The use of animal models for the evaluation of ocular antiviral agents
Authors: ROMANOWSKI EG 
Published: September 2009

AbstractAnimal models have been used extensively in the evaluation and development of topical ocular antiviral agents. Rabbit ocular models have proven predictive of the clinical efficacy of topical antiviral agents for HSV‐1 epithelial keratitis and in clinical trials for adenoviral ocular infections. The current presentation will discuss the limitations of these models and present data on potential new topical antiviral agents, focusing primarily on antivirals for adenoviral ocular infections.
The treatment of uveal melanoma with iodine plaque brachytherapy
Authors: KIVELÄ T 
Published: September 2009

Abstract Purpose To provide an overview of managing uveal melanoma (UM) with iodine brachytherapy (IBT). Methods Personal experience of the author in using IBT since 1990. Results IBT is an effective option for managing a UM of any size, although it is mostly used for medium‐sized tumours, preference being given to ruthenium brachytherapy (RBT) when the tumour is <5‐6 mm thick and to transscleral local resection when thickness is >6 mm, especially when vision is good. IBT is also a safe alternative to enucleation of large UM >10 mm in thickness if the patient is keen to preserve the eye and motivated to accept eventual complications. The plaque is positioned over the UM with a 1‐2 mm safety margin when using a collimated/rimmed plaque. Because of stray radiation, a safety margin is not mandatory when the plaque is non‐collimated/non‐rimmed. Otherwise, surgical technique does not differ from RBT. An advantage of IBT is that the radioactive seeds are separate from the plaque, allowing economical use of plaques of many different sizes and shapes and individual positioning of the seeds in a conformal way. A disadvantage is a short half‐life; the seeds need to be changed every 6 months. The dose the author uses is 80 Gy to tumour apex, which is reduced on an individual basis to 60‐70 Gy when the UM is very thick. Local tumour control rate is 90% and, paradoxically, not worse for large UM as compared to smaller ones. There are no unequivocal safety distances for avoiding radiation cataract, maculopathy and optic neuropathy, which are more or less frequent depending on the size and location of the UM. Conclusion IBT achieves good local tumour control of UM of all sizes, but preservation of vision is decidedly less frequent than after RBT, which is always given preference.
Tibial Bone KPro technique and long term results
Authors: TEMPRANO J 
Published: September 2009

AbstractThe operation is performed in three stages. The first stage consists in preparing the eye to receive and maintain the keratoprosthesis. For this purpose the anterior surface of the eye is cleaned and regularized, eliminating fibrous tissue and the entire epithelium. Subsequently we obtain a 2 x 3 cm graft of buccal mucosa from the inferior lip comprising the entire mucosal and submucosal thickness. The graft is sutured to cover the anterior pole of the eye to promote revitalization. The second stage consists in preparing the keratoprosthesis. A 10 mm disk of tibial bone from the superior part of the medial face of the tibia is obtained using a crown drill. The posterior part of the piece of bone obtained is then cut with a chisel to obtain a thickness of 3 mm. Subsequently the obtained disk of bone is cleaned and a central opening of 3.5 mm is performed to introduce in this opening a PMMA optic cylinder, 9 mm in length, 3.5 mm in diameter in its narrow portion, 4 mm in the wider portion. Fixation is achieved with cyanoacrylate. This is left to dry and then it is introduced into a palpebral pocket of the inferior lid of the patient. The pocket is closed with sutures and the piece is left in place for three months. For the third stage we remove the keratoprosthesis device from the palpebral pocket and if it is found to be in perfect conditions we dissect the buccal mucous membrane which is covering the cornea and perform a central window with a 4.5 mm trephine to remove the transparent or cataractous lens and perform a total iridectomy. The posterior portion of the optic cylinder is introduced into the anterior chamber. The prosthesis is sutured to the anterior pole of the eye with non‐absorbible sutures. Finally the buccal mucosa is replaced, covering the entire area. One point of blepharorraphy is applied. Long term results. We started to use this technique in 1988 and after 21 years of experience we have 80% of anatomically perfect results. In 20 % of the cases the prosthesis extruded due to total or partial resorption of the bone. It has to be emphasized that these were cases without any other possibility of treatment. We did 143 cases during these years. The longest follow‐up of a prosthesis “in situ” is 19 years. The earliest extrusion was after one year. The complications are the same as for OOKP (glaucoma, retinal detachment, vitritis, extrusion) The functional results depend on the conditions of the retina and the optic nerve. There were many cases with 20/20 vision. The mean value of retention of the prosthesis is 15 years.
Management of oculoplastic problems in the OOKP eye
Authors: GOMAA A , MORRIS S , BRITTAIN P , HEROLD J , THORP S , LIU C 
Published: September 2009

AbstractOOKP surgery (either stage 1 or 2) can result in complex oculoplastic complications. The majority of these are mucous membrane graft‐related, including graft thinning, ulceration and infection or overgrowth onto the anterior optical cylinder. However, lid malposition, forniceal shortening and widening of the palpebral aperture may also occur. Appropriate timely surgical intervention of these is crucial to protect the underlying OOKP lamina. In addition, correcting over‐exposure of the globe aids in improved comfort for the patient. Adjustments of the lid and forniceal abnormalities can enhance comfort, cosmesis and prosthetic shell stability. Retrospective case note analysis of all patients treated 1996 – 2009 at the Sussex Eye Hospital, Brighton, UK, was performed. This study reports the prevalence and type of oculoplastic complications found and describes the surgical management for each.
Occludin changes in retinal vessels after experimental vein thrombosis in rats
Authors: TSILIMBARIS M , TSOKA P , BOCHATON‐PIALLAT ML , CHRISTODOULAKIS E , GILODI N , POURNARAS CJ 
Published: September 2009

Abstract Purpose To evaluate the changes in occludin after experimental vein thrombosis in rats. Occludin is an integral plasma‐membrane protein located specifically at tight junctions. Methods The retinal veins of 24 pigmented rats were occluded by means of fluorescein augmented laser photocoagulation. The animals were sacrificed after 4 and 24 hours, their eyes were enucleated and retinas were harvested. Retina whole mounts were prepared for indirect immunohistochemistry using an anti‐occludin primary antibody and were examined under confocal microscope. The retinas of 4 normal animals were used as controls. Results The characterisitc reticular fluorescense of occludin was detected along vascular branches in a three‐dimentional manner with the help of the confocal microscope. Alterations in occludin distribution could be detected along thrombosed veins, peripheraly to the site of thrombosis. These alterations included irregular linear fluorescence and increased spaces of absent fluorescence in major vein branches compared to controls. The alterations in the superficial and deep vascular plexuses were less prominent including a reduced fluorescence of occludin. No changes were detected at the arteriolar walls. All findings were more prominent at 24 hours. Conclusion Blood‐retina barrier impairment is expressed with morphological alterations of occludine distribution 24 hours after experimentally induced vein thrombosis
Structural consequences after intravitreal bevacizumab injection in a retinopathy of prematurity mouse model
Authors: AKKOYUN I , YILMAZ G , OTO S , KARABAY G , HABERAL N , ERKANLI L , BACANLI D , AKOVA A Y 
Published: September 2009

Abstract Purpose To evaluate the effect of different bevacizumab concentrations on retinal endothelial cell proliferation and retinal structures in a retinopathy of prematurity (ROP) mouse‐model Methods A total of 35 of C57BL/J6 mice were exposed to 75±2% oxygen from postnatal day 7 to postnatal day 12. On day 12, 10 mice (group‐C) were injected with 2.5μg intravitreal bevacizumab (IVB), 11 mice (group‐D) with 1.25μg IVB, and 14 mice (group‐E) with 0.625μg IVB in one eye. The contralateral eyes were injected with isotonic saline (control group=group‐B). Four nonexposed mice served as negative controls (group‐A). Neovascularization was quantified by counting the endothelial cell nuclei on the vitreal side of the inner limiting membrane of the retina. Histologic and ultrastructural changes were examined by light and electron microscopy. Results The endothelial cell count per histological section was lower in group C (p<0.0001), D (p<0.0001) and E (p<0.0001) compared with the control group‐B. Histologic evaluation showed no retinal toxicity in any group. Electron microscopy revealed hyperoxia induced mitochondrial dysmorphology in group‐B and mitochondrial dysmorphology displayed dose dependent increase in IVB injected eyes. Conclusion Bevacizumab suppresses endothelial cell proliferation in a ROP‐mouse‐model. In addition to hyperoxia induced vulnerability of C57BL/J6 retina, morphological findings implicate further ultrastructural vulnerability due to bevacizumab.
Circulating bone marrow‐derived endothelial precursor cells contribute to neovascularization in diabetic epiretinal membranes
Authors: ABU EL ASRAR A , STRUYF S , VERBEKE H , VAN DAMME J , GEBOES K 
Published: September 2009

Abstract Purpose Role of vasculogenesis, recruitment and differentiation of circulating bone marrow‐derived endothelial precursor cells into mature endothelium, in proliferative diabetic retinopathy (PDR) remains undefined. We investigated the presence of bone marrow‐derived endothelial precursor cells and the expression of the chemotactic pathway SDF‐1/CXCL12?CXCR4 in PDR epiretinal membranes. Methods Membranes from 8 patients with active PDR and 9 patients with inactive PDR were studied by immunohistochemistry using antibodies against CD133, vascular endothelial growth factor receptor‐2 (VEGFR‐2), CD14, SDF‐1 and CXCR4. Results Blood vessels expressed CD133, VEGFR‐2, CD14, SDF‐1 and CXCR4 in 10, 10, 10, 7 and 7 out of 17 membranes, respectively. There were significant correlations between number of blood vessels expressing CD34 and number of blood vessels expressing CD133 (rs=0.646; p=0.005), VEGFR‐2 (rs=0.704; p=0.002), CD14 (rs=0.564; p=0.018), and SDF‐1 (rs=0.577; p=0.015). Stromal cells in close association with blood vessels expressed CD133, VEGFR‐2, CD14, and CXCR4 in 10, 12, 13, and 14 membranes, respectively. Number of blood vessels expressing CD133 (p=0.013), VEGFR‐2 (p=0.005), CD14 (p=0.008) and SDF‐1 (p=0.005), and stromal cells expressing CD133 (p=0.003), VEGFR‐2 (p=0.013) and CD14 (p=0.002) was significantly higher in active membranes than in inactive membranes. Conclusion Bone marrow‐derived CD133+ endothelial progenitor cells and CD14+ monocytes may contribute to vasculogenesis in PDR.