bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune modulation in the next decade
Authors: DICK A 
Published: December 2011

AbstractPurpose Moving away from the morbidity of steroid therapy for inflammatory disease or the overburdonsome adverse events of immunosuppressive therapy, the advent of understanding of immune response during non‐infectious uveitis alongside the explosion in biotechnology has facilitated the development of biologic therapy. This has generated a new era for increasing equisitely specific therapy.Methods The review will highlight experimental evidence of targets of inhibiting T cell activation, B cell responses, Trafficking of cells, and cytokine inhibition. However, most importantly is the increasing abibility to predict and therefore target responses.Results We will highlight the strength of predicting response to steroid and highlighting mechanisms of steroid refractiveness has generated avenues of approach for specific therapy. In addition the efficacy of regulating trafficking and inhibiting myeloid cell function shows promise in the future treatments of non‐infectious intraocular inflammatory disease.Conclusion Biologic therapy has the opportunity to not only specifically and powerfully immunomodulate but also with the increase in understanding of individual immune response adapt to generate a more stratified and personalised approach to therapy.
Commercial interest
Immune modulation in uveitis:Biologicals ‐ [bdquo]Golden calf“ or [bdquo]Gold Standard“?
Authors: BODAGHI B 
Published: December 2011

AbstractUveitis is a sight‐threatening auto‐immune condition. Most of the cases require corticosteroids and conventional immunosuppressors. Until recently, safety issues limited the use of new therapeutic strategies such as biological agents. Anti‐TNF alpha and interferon alpha are the two major drugs, used for more than 12 years with well‐defined results and side‐effects. Behçet's disease is the principal indication of biologicals with a dramatic improvement of uveitis and a long‐lasting remission. Dosing and duration remain controversial. Anti‐TNF alpha are used in severe cases with a direct visual threat. The intravitreal use of the drug seems to be inefficient. Interestingly, other molecules such as anti‐IL1 molecules did not show a significant control of uveitis in a randomized multicentre clinical trial. Refractory cases of JIA‐associated uveitis are another indication of anti‐TNF alpha drugs. Even though, etanercept is highly effective on the rheumatological component of the disease, it is ineffective on uveitis. On the other hand, adalimumab is effective on uveitis but less commonly on arthritis. In the future, we will probably welcome new types of biologicals agents in the field of uveitis. However, it seems paramount to determine the best route and rhythm of administration, dosages and duration of therapy. Side effects are also important to consider before any further conclusions, especially in children.
Thyroid and ocular hypertension
Authors: BOSCHI A 
Published: December 2011

AbstractPurpose To present and discuss the association between thyroid disorders and the development of glaucoma. Several population‐based cross‐sectional sample studies support the hypothesis that thyroid disorders may increase the risk of glaucoma. However, because the self‐report studies, data on specific type of glaucoma and /or thyroid disorders as well as severity and duration are not available. In Graves orbitopathy (GO), different mechanisms leading to intraocular pressure (IOP) increase are: eyeball compression by enlarged extra‐ocular muscles, and episcleral venous pressure elevation secondary to intraorbital content and pressure increase. But, the prevalence of glaucoma in GO patient doesn’t seem to be increased compared to the general population. However, most of the studies were retrospective and with a short‐term follow‐up.Methods Clinical features of GO and risk factors associated with high IOP and glaucoma in GO pat will be discuss, as well as management recommendations
Limitations of 'hard' Keratoprosthesis in Clinical Practice ‐ can 'soft' KPs lead the way out?
Authors: LIU CS , AVADHANAM V 
Published: December 2011

AbstractTwo winners have emerged among dozens of keratoprostheses (KPros) which have come and gone. The Osteo‐odonto‐keratoprosthesis is the device of choice for end stage inflammatory ocular surface disease associated with a dry eye, such as Stevens Johnson syndrome and ocular cicatricial pemphigoid. The Boston Type 1 keratoprosthesis is successful for wet blinking eyes and can be considered as an alternative to high risk keratoplasty in highly vascularised corneae or in multiple previous graft failure. The main advantage of these "hard" KPros is optical clarity. Whilst the field of view may be somewhat limited, there is no astigmatism and the optical surface is usually bare and clear. Hard KPros depend mostly on bio‐inertness as opposed to biointegration. Soft KPros have the theoretical advantages of the possibility of having the same mechanical moduli as the host tissue thus reducing stress at the interface when the eye is subjected to minor trauma, intraocular pressure measurement by applanation, and drug penetration. However, much effort has to be directed towards adequate integration (healing), and either total and smooth epithelialisation or no epithelialisation whatsoever. Partial epithelialisation, tear meniscus, and buckling of a soft optic contribute to poor optical performance and thus poor vision.
Mesechymal Stem Cell Properties in the Endothelium ‐ bioengineered EC for lamellar Keratoplasty?
Authors: FUCHSLUGER T 
Published: December 2011

AbstractPurpose Corneal endothelium (EC) is crucial to maintain corneal transparency. Loss of EC finally results in blindness with the need of corneal transplantation. As lamellar grafting is globally spreading, engineering EC sheets are rational. However, in‐depth knowledge of precursor or stem cell‐like properties in EC and the precise anatomical locations are not yet clearly identified. These progenitor cells might serve as basis for tissue engineering. This study aims to identify the distribution and localization of EC with mesenchymal stem‐cell (MSC) and progenitor characteristics.Methods To study the distribution of putative MSC in the cornea and in the anterior chamber, typical MSC markers (CD44, CD73, CD90, CD105,stro‐1) were studied by immunohisto‐ and immunocytochemistry in sections of eyes, corneas and whole mount staining (Balb/C and C57BL6 mice, human tissue).Results CD44 expression was identified in the periphery of the lens epithelium, in single cells located in the peripheral parts of EC and in the limbus, but not in central parts of cornea. Moreover, CD44 was detected on cell borders of specific cell clusters throughout the endothelium (7%).Conclusion To our knowledge, we identified for the first time CD44+ cells with potential stem cell properties in the cornea. This was localized in the peripheral part of the EC and the limbus. Therefore, the peripheral cornea might be a potential source for future tissue engineering approaches for corneal endothelium.
Premacular haemorrhage in patient with leukaemia
Authors: PRIETO CALVO E , EGEA ESTOPINAN C , IDOIPE CORTA M , DE LA MATA G , ABECIA MARTINEZ E , FERNANDEZ LARRIPA S , GARCIA MARTIN E 
Published: December 2011

AbstractPurpose Blood dyscrasia has been associated with premacular haemorrhages. The combination of severe anaemia and thrombocytopenia has been hypothesised to cause reduced coagulability and loss of endothelial cell integrity, allowing blood leakages through the jeopardised endothelial barrier.Methods Prospective, interventional, single case report. A 20‐year‐old man, treated with chemotherapy for acute lymphoid leukaemia, is referred with a sudden loss of vision in his left eye (LE). Funduscopic examination revealed a sharply demarcated, dome‐shaped premacular haemorrhage, with approximately one diameter‐disk of size. The spectral‐domain OCT(SD‐OCT) scan showed that the cleavage plane of blood accumulation was located under the internal limiting membrane (sub‐ILM). Considering the location and the size of the haemorrhage we decided to perform a conservative management with periodic checks.Results Four months later, the macular haemorrhage had been reabsorbed and vision had improved. The SD‐OCT scan revealed the total absorption of blood, with signs of thickening of the internal limiting membrane.Conclusion Therapeutic options in premacular haemorrhages (conservative management, laser membranotomy or vitrectomy) should be established on an individual basis, considering in each case, the underlying disease, bilaterality of the process, duration and severity of bleeding, lens transparency, age and general condition of the patient.
Proliferative diabetic retinopathy: from screening to treatment
Authors: TADROS C , MANSOUR T , PETO T 
Published: December 2011

AbstractPurpose To assess if the guidelines for referral and treatment of proliferative diabetic retinopathy (PDR) in the English National Screening Programme are being followed in Tower Hamlets Diabetic Retinopathy Screening Service(THDRSS). The guidelines mandate that all patients with PDR must be seen within 2 weeks in an eye clinic and should be treated within 4 weeks if needed. This can potentially decrease blindness related to PDR in the underprivileged population of Tower Hamlets of East London, UK.Methods During the period from 01/04/2010‐31/03/2011, 34 patients were diagnosed with retinal changes characteristic of PDR at THDRSS. All patients were referred to Moorfields Eye Hospital (MEH). The times between screening and referral and referral to treatment were measured. Images were reviewed if there was a discrepancy between screening and clinical diagnosis.Results All patients were referred to MEH on the same day of screening. Five patients did not attend any appointments given and were referred back to THDRSS and education on eye health. The remaining 29 patients were examined at MEH within 6 weeks from screening but only five (17.24%) were examined within the recommended 2 weeks. Half of those requiring laser for PDR were treated on the day of the first consultation and the other half within 4 weeks. Three patients had asymmetrical disease and these were confirmed to be retinal vein occlusions.Conclusion Referral guidelines were followed by THDRSS with 100% of the patients referred on time. Guidelines for timely treatment of PDR patients were followed at MEH. This may contribute to the prevention of severe complications from PDR in this population. The delay between screening and first appointment will warrant further investigation.
C[omicron]mbined cataract surgery with anti‐VEFG agents in patients with quiescent proliferative diabetic retinopathy with no macular edema
Authors: SOKOLAKIS THOMA , SPAI SOFIA , GOURGOULI IOANA 
Published: December 2011

AbstractPurpose The study of visual acuity and the course of diabetic retinopathy after combined cataract surgery and injection of ANTI‐VEGF agents in diabetic patients with quiescent proliferative diabetic retinopathy without macular edema.Methods The study included 22 patients with quiescent proliferative diabetic retinopathy with no macular edema aged 62‐75 years of both sexes (15 men and 7 women). The preoperative visual acuity was of 1/10 to 4/10 and the time monitoring the patients after cataract surgery was 18 months.Results The visual acuity improved in all patients and follow up of 18 months showed that only one patient developed macular edema after 6 months who was treated with subsequent monthly infusions of Anti‐VEGF (4.5%). At a percentage of 72.7% (16 patients), visual acuity improved and at a rate of 22.8% (5 patients), visual acuity remained unchangedConclusion The combination of cataract surgery and Anti‐VEGF helps in the greater improvement of visual acuity and of proliferative diabetic retinopathy.
Pivotal role for SD‐OCT in the diagnosis of acute zonal occult outer retinopathy
Authors: DE ZAEYTIJD J , KESTELYN P , LEROY BP 
Published: December 2011

AbstractPurpose Acute Zonal Occult Outer Retinopathy (AZOOR) is characterized by an acute partial loss of outer retinal function with corresponding visual field defects and electroretinographic (ERG) abnormalities in one or both eyes. Spectral domain optical coherence tomography (SD‐OCT) findings are described as a key to the early diagnosis of AZOOR in a patient.Methods A 25 ‐year‐old man developed acute painless central vision loss together with photopsia in the right eye (RE). He underwent a full ophthalmological work‐up including fluorescein and ICG‐angiography, SD‐OCT, specialized imaging, visual field testing (VFs) and electrophysiological testing.Results On initial evaluation visual acuity was 15/10 in both eyes. Fundoscopy revealed a subtle loss of the foveal reflex with very limited foveal mottling in the RE. Fluorescein and ICG‐angiography were unremarkable. Static and kinetic perimetry showed an absolute scotoma inferotemporal of fixation and a slightly enlarged blind spot in the RE. Most remarkable were the inner/outer segment boundary defects visible on SD‐OCT. One month later, small changes were observed on infrared imaging and reduced responses were seen on multifocal ERG corresponding to the scotoma on VFs. A full‐field ERG and EOG were normal. The unilateral scotoma stabilized over the next 2 months.Conclusion AZOOR is a rare condition with subtle and often vague signs and symptoms, which makes diagnosing it quite a challenge. The added value of SD‐OCT is that it allows identification of specific inner segment/outer segment boundary defects at presentation.
Diabetic retinopathy and type 2 macular telangiectasia
Authors: TADROS C , MANSOUR T , LEUNG I , SALLO F , CLEMONS T , PETO T , MACTEL GROUP 
Published: December 2011

AbstractPurpose To establish the severity and progression of diabetic retinopathy (DR) and maculopathy (DMac) in patients with both Type 2 macular telangiectasia (MacTel) and diabetes mellitus (DM) and relate these to characteristics of MacTel.Methods MacTel is a bilateral retinal disease affecting central vision. The MacTel Project enrols from 27 sites around the world; those in the study have multiple imaging performed yearly. Colour fundus, fluorescein angiographic, OCT and autofluorescence images were graded at the Reading Centre of Moorfields Eye Hospital, UK for characteristics of MacTel, DR and DMac; diabetes status and clinical data were obtained from the co‐ordinating centre (EMMES). Grading for DR and DMac was on 7‐field stereo images for baseline, and 3‐fields for follow‐ups using ETDRS standards.Results The mean age of MacTel patients at diagnosis was 57±9 years. Diabetes was diagnosed in 188 out of 555 MacTel patients enrolled. MacTel patients with DM had an average HbA1c of 6.9±1.4%. Over 70% of patients had no DR at baseline. Only one patient developed mild and one moderate non‐proliferative DR during the over 3 years follow‐up. Only one patient developed DMac requiring laser treatment. MacTel patients with DM had significantly lower visual acuity at baseline (No DM 70.3±0.7 letters, DM 65.±1.6; p=0.02). MacTel patients with DM progressed significantly more on NEI‐VFQ and on OCT characteristics at the fovea, such as foveal empty cavities and neuroretinal changes (all p<0.05). Progression of the severity of MacTel was significantly modified by DM (p<0.05).Conclusion DM has a clinically meaningful impact on visual functioning and progression of MacTel. Further study is required to understand the relationship between the two diseases.
Fluorescein angiography based classification of retinopathy of prematurity
Authors: SUZANI M , TRAVERSA E , BARILLà D , GUAGLIANO R , BERTONE C , ANSELMETTI G , BIANCHI PE 
Published: December 2011

AbstractPurpose To select fluorescein angiography (FA) signs detected in Retinopathy of prematurity (ROP) in order to propose a new classification.Methods From December 2009 to December 2010, 15 patients affected by ROP (stage 2 or 3, zone 2, no plus) were evaluated at San Matteo Hospital(Pavia) and Maria Vittoria Hospital (Torino) along with their FA exams by an expert in paediatric retina diseases. Among the multiple FA features in ROP, we considered: ischaemic area posterior to the shunt, leakage at the vascularised/avascularised junction (v/av j) and peripheral plus (vessel tortuosity just beyond the v/av).Results Patient group characteristics were: Mean Gestational age: 25 weeks Mean Weight at Birth: 657 g Mean Age at ROP diagnosis: 30 weeks Considering the described criteria, we were able to detected a new class of ROP patients; they were all described as type 2 ROP on the basis of fundus examinations, while FA characteristics permitted to: ‐ Identify a more aggressive subtype of ROP type 2, in need of a sudden treatment ‐ Plan FA based laser administration which involved the ischaemic area near the shunt All the patients in the study received a laser treatment with favourable structural and visual outcome.Conclusion FA classification allows to advance and/or improve laser administration in FA selected patients with retinopathy of prematurity.
Ocular surface and refractive surgery
Authors: COCHENER B 
Published: December 2011

AbstractPurpose Dry eye represents nowadays the most common complication after PRK and even more frequent after lasik. Preoperative dry eye constitutes a risk factor for postoperative severe dryness; that it why it appears crucial to detect and treat surface disorder before the surgery.Methods We will remind the list and hierarchy of tests available for the assessment of ocular surface. Unfortunately, values of the defined criteria are variable and there are a lot of variations in the methods. Moreover, the correlation between clinical symptoms and tests results is very poor. The access to tear osmolarity (TearLab©) could be an interesting new biomarker. A study will be presented showing that 44% of patients, candidates to Lasik have an asymptomatic dryness before surgery (mild to moderate stage.Results Related to the principle of these two procedures, the cause of ocular surface deregulation lies on neurotrophic disturbances (secondary to nerves section) and inflammation ( wound healing process). In addition, changes in corneal shape can affect the tear dynamics with an increase in ocular surface dessication. All these phenomenon are systematically observed after photoablation for a transitory period of 1 to 3 months. But, sometimes, they do persist beyond one year (20%), becoming chronic and source of a great discomfort and dissatisfaction (10%). The strategy of treatment will be discussed, in graduating the medications according the growing severity.Conclusion Is there a difference between surface PRK and Lasik ? Hinged flap induced transection of large number of afferent sensory nerve fibers during lamellar cut, that impacts the integrated lacrymal gland OS functional unit. Finally, Lasik is responsible of more dry eye syndrome that PRK, that should be prefered in case of preoperative Ocular surface disorder.
Technical and topographical variability in automatic retinal oximetry
Authors: PALSSON O , HARDARSON SH , STEFANSSON E 
Published: December 2011

AbstractPurpose To assess if retinal vessel oxygen saturation measurements are affected by (1) which eye is measured (2) photographic flashes (3) image angle (4) location within the retina (quadrant).Methods The Oxymap retinal oximeter simultaneously acquires fundus images at 570nm and 600nm and calculates relative oxygen saturation in retinal vessels. Oximetry images were obtained from 26 healthy individuals, 18‐30 years. Images were taken of one eye at different angles and at the same angle with at least two photographic flashes in between. In addition, one image from the other eye was obtained. Retinal vessel oxygen saturation was measured with the Oxymap analysis software.Results (1) No difference was found between the left and right eyes (n=24, p>0.68). (2) Saturation increased by 0.5±1.0%, (p=0.028, mean±SD, hemoglobin saturation percentage) in arterioles and 0.9±1.9% (p=0.020) in venules after three or more photographic flashes. (3) Saturation was higher in both arterioles (1.3±1.7%, p=0.0004) and venules (1.9±2.4%, p=0.0007) when the subject gazed down than when looking straight. (4) Significant topographical variations were found within the retina, up to ‐3.1±2.4% difference from average saturation in arterioles and ‐5.4±4.0% in venules.Conclusion The left and right eye are comparable in retinal vessel oxygen saturation measurements. A few photographic flashes have a small effect on the measurement. The difference in saturation by angle is significant when the subject is looking down and the topographical difference in saturation is notable between quadrants. It is important to standardise image acquistion and analysis.
Commercial interest
Daily skills performed by previously blind RP patients with subretinal electronic implant Alpha IMS
Authors: ZRENNER E , BARTZ‐SCHMIDT U , BESCH D , BRUCKMANN A , GREPPMAIER U , GEKELER F , KOITSCHEV A , SACHS H , SLIESORAITYTE I , STINGL K , WILHELM B 
Published: December 2011

AbstractPurpose To investigate visual perception of previously blind retinitis pigmentosa (RP) patients using electronic subretinal implants.Methods The new Alpha IMS chip (Retina Implant AG) with its 1500 photodiodes, amplifiers and electrodes powered wirelessly via a subdermal coil was implanted subretinally in 7 retinitis pigmentosa patients for indoor and outdoor use.Results VA was up to 21/1000 within a field of 11° by 11° (see previous pilot study http://rspb.royalsocietypublishing.org/content/early/2010/11/01/rspb.2010.1747). A) Near vision: Localizing, cutlery and tableware, plates and content in 4AFC mode and in restaurants, facial characteristics of persons, items on working desk. B) Far vision: Recognizing clouds, clothes of people, borders of cars by metallic reflections, discerning smaller from larger persons. C) Spatial resolution: Position of clock hands, stripe patterns up to approx. 0.33 – 0.44 cpd, reading letters 4 to 8 cm high, localization and recognition of square, round or rectangular objects . D) Contrast: Differentiation of 7 to 10 shades of grey; increased sensitivity for infrared radiation. E) Motion: Hand movement, walking direction of a goose, circumvention of obstacles. F) Eye‐hand coordination: Pointing at objects and moving them.Conclusion Subretinal Alpha IMS implants allow RP‐ patients within few days of exercising to localize objects and to perform visuomotor tasks for improved orientation and mobility. This device thereby can provide considerable support to blind RP patients in mastering tasks of daily life, indoor and outdoor, as shown in an ongoing clinical study.
Commercial interest