bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limitations of correcting aberrations with soft contact lenses
Authors: LOPEZ‐GIL N , CASTEJON‐MOCHON JF , BONAQUE S 
Published: October 2007

Abstract Purpose: In this paper, we study the limitations of correcting aberrations with soft contact lenses, which are custom‐designed for each subject aberrations with special interest on the effect of measuring and correcting wavefront in different planes (pupil and cornea plane). Methods: We analyze, by experiments, theoretical methods and computer simulations, issues such as aberration dynamics, lens movement and errors in pupil plane localization. The study is carried out for three types of eyes: normal, keratoconus, and eyes that have gone through penetrating queratoplasty. Results: Main factor limiting this type of aberration correction is the static horizontal and vertical translation as well as the rotation of the contact lenses on the eye. Typical rotations (3º, 5º) and translations (0.5 mm) of the soft contact lenses could null the benefit of the high‐order corrections in normal eyes. The correction of the wavefront in a different plane were it has been measured is not negligible when the aberrations (low and high order) are high. Conclusions: We found that customized correction for normal eyes leads to a loss of optical quality, compared to standard correction (sphere and cylinder), when displacements of the contact lenses appear. In spite of the mentioned effects, there are, however, pathologic cases in which it is possible to reduce the RMS and increase visual quality, especially in the keratoconus eyes. In those high aberrated eyes special care should be taken due to the changes of the wavefront when propagating from the cornea plane to the pupil plane.
Wavefront guided custom ablation: facts and fiction
Authors: NGUYEN KHOA JL 
Published: October 2007

AbstractWavefront guided customized ablation is an exciting new tool for the modern refractive practice. Wavefront aberrometry gives us an accurate “fingerprint” of the eye. However, we should ask ourselves the following questions: First, can we improve visual acuity outcomes? Secondly, how can we or can we avoid and fix high order aberrations ? In this presentation we describe in detail the new optical challenges of refractive surgery. Thru a review of the literature and based on personal experience we show you the basics of custom wavefront technology, the promises but also the potential pitfalls of aberration guided laser ablation.
The problem of non‐adherence with medical therapy
Authors: GEORGIADOU I 
Published: October 2007

Abstract Purpose: To discuss the topic of non‐adherence with medical therapy. Methods: Adherence may be defined as the extent to which a patient’s behaviour coincides with medical advice. The success of long‐term therapy in chronic diseases depends upon patient’s adherence. Results: Unfortunately, published evidence suggests that poor adherence is the single most important problem in long‐term medical therapy. The level of non‐adherence is generally underestimated by clinicians. Improving adherence depends upon a successful doctor‐patient communication but numerous other factors also influence adherence e.g. ease of medical therapy administration etc. Good adherence is critical for preventing disease progression. Conclusions: New approaches are needed to enhance adherence with chronic medical therapy in real‐life practice.
Adherence with antiglaucoma therapy
Authors: CARASSA RG 
Published: October 2007

AbstractIn recent years an increasing attention has been drawn towards the performance of drugs in the real world. Beyond the mere IOP lowering effect, the treatment success implies a number of issues regarding the acceptance and adherence to the therapy.Health outcome studies and studies on compliance showed poor persistency and adherence levels for glaucoma medical therapy with higher scores for prostaglandine analogues. Adherence is in fact linked to many variables: regimen factors (as complexity of treatment, tolerability, side effects), patient factors (as memory, motivation, knowledge), provider factors (as dissatisfaction or poor communication with the physician) and situational factors ( as competing activities, change in routine). The choice of a therapeutic strategy capable of minimally influencing the patients’ quality of life is crucial for optimal adherence and improving doctor‐patient communication is essential in favouring patient’s decision‐making about health‐promoting behaviors.
Patient reported problems and adherence to glaucoma medications in the United States and India
Authors: SLEATH B 
Published: October 2007

Abstract Purpose: The purpose of this research was to examine patient reported adherence and problems in using glaucoma medications. Methods: In the United States, 324 patients on adjunctive therapy who were seen at four geographically distinct ophthalmology practices participated. In India, 243 patients seen at a glaucoma clinic in an eye hospital in Southern India participated. All patients were asked to complete a survey before their visits with their ophthalmologists. Results: The U.S. sample ranged in age from 20 to 91 (mean age 68 years) and was 48% female. The India sample ranged in age from 19 to 90 (mean 63 years) and was 36% female. Sixty‐one percent of the U.S. sample and 42% of the India sample reported one or more problems in using their glaucoma medications. Fourteen percent of the U.S. sample reported being less than 100% adherent in taking their glaucoma medications in the past week. Patients who had difficulty remembering to take their glaucoma medications and those who reported other problems or concerns were significantly more likely to report being less adherent. Six percent of the India sample reported being less than 100% adherent in the past week. Patients who reported difficulty squeezing the bottle and those who reported difficulty opening the bottle were significantly more likely to reported being less adherent. Conclusions: Patients in the U.S. and India reported many problems in using their glaucoma medications and in each country specific types of problems were related to patient non‐adherence.
Objective evaluation of adjunctive glaucoma therapy
Authors: ROBIN A 
Published: October 2007

Abstract Purpose: To measure adherence with electronic monitoring in two populations of subjects: those using once‐daily prostaglandin analogs (q.d.), and those on adjunctive medicine to the prostaglandin analog. Methods: Single‐site, open‐label, non‐randomized, parallel, 60 day study. 62 open angle glaucoma or ocular hypertension adult subjects currently using either a topical prostaglandin as sole ocular hypotensive medical therapy q.d. (“1‐drug” subjects, n=31) or a topical prostaglandin plus an adjunctive topical ocular hypotensive product either q.d., twice‐daily (b.i.d.), or three‐times‐daily (t.i.d.) in the same eye(s) (“2‐drug” subjects, n = 31). An electronic event medication monitoring device was used to record each opening of the bottle containing the ocular hypotensive medication. The main outcome measures were dosing errors (number of under or over‐adherence events) and coverage (proportion of pharmacological duration covered by dosing) relative to ophthalmologist‐prescribed regimen. Results: Adherence to the prostaglandins q.d. was good in both groups by all measures (≤10% of subjects with >5 dosing errors and mean coverage of 97.2±6.1%). Adherence to the second medication in the 2‐drug group was poorer (37% of subjects with > 5 dosing errors and mean coverage of 85.6 ± 12.6%). For the subjects on β‐adrenoceptor antagonists, 24.8±18.4% of doses were taken at less than 10 hour intervals (over‐adherence). Conclusions: The use of electronic monitoring provides more information than simple “pill count,” bottle weighing methods, or prescription refill rate, as it incorporates a time component. We found that more complex dosing regimens result in poorer adherence, although q.d. drugs in a complex dosing regimen were found to have good adherence.
Update on a new randomised adherence study
Authors: TSIRONI S 
Published: October 2007

Abstract Purpose: To present the design and aims of a new randomised adherence study, investigating the value of an intervention on the level of adherence with glaucoma therapy. Methods: Poor adherence with prescribed treatments significantly undermines treatment of glaucoma. In a new randomized study we will investigate the impact of intensive teaching and other measures on the level of adherence in consecutive newly diagnosed ocular hypertensive or glaucoma patients. A novel device, TDA, will be employed to facilitate adherence monitoring in the present study. This device may help physician in objectively assessing adherence with selective glaucoma therapy. This study will validate this monitoring device. Results: Documentation of the impact of intensive teaching on the level of glaucoma patients’ adherence. Conclusions: The results of this study may determine if adherence of glaucoma patients is modifiable by education and consequently, it will indicate if we should focus our efforts in this approach in the future management of glaucoma.
Epidemiology and clinical findings of exfoliation syndrome and glaucoma
Authors: TSIRONI S 
Published: October 2007

Abstract Purpose: To review the most important information on epidemiology and clinical picture of exfoliation syndrome. Methods: The reported prevalence of exfoliation syndrome varies widely over the world, reflecting a combination of differences due to race, age, environment, ethnicity and other yet‐to‐be defined reasons. Exfoliation syndrome is frequently associated with severe chronic secondary open‐angle glaucoma. Results: The typical clinical identification of exfoliation can be relied upon the biomicroscopical detection of exfoliation material after pupillary dilatation. Whereas the classic picture of manifest exfoliation syndrome has often been described, the early stages of beginning exfoliation have not been yet defined. Next to the lens, exfoliation material is most prominent at the pupillary border. Pigment loss from the iris sphincter region and its deposition on anterior chamber structures is a hallmark of the exfoliation syndrome. Its ocular manifestations affect all of the structures of the anterior segment as well as conjunctiva and orbital structures. Exfoliation syndrome often is an asymmetric condition, though never truly unilateral. Consequently exfoliation glaucoma is usually asymmetric and it is typically associated with higher mean IOP levels, greater diurnal fluctuations in IOP and marked pressure spikes. Conclusions: Exfoliation syndrome is a condition of worldwide distribution and significance. It has characteristic clinical features and is currently the most important single identifiable risk factor for open‐angle glaucoma.
New insights into pathophysiology of exfoliation
Authors: SCHLOETZER SCHREHARDT U 
Published: October 2007

Abstract Purpose: Pseudoexfoliation (PEX) glaucoma is the most common identifiable cause of open‐angle glaucoma worldwide comprising the majority of glaucoma in some countries. The underlying disorder, PEX syndrome, is a generalized process of the extracellular matrix characterized by the production and progressive accumulation of a fibrillar extracellular material in intra‐ and extracellular tissues. New insights into its molecular pathophysiology have increased the understanding of this disorder and the current concepts of pathogenetic mechanisms of PEX syndrome/glaucoma will be presented in this review. Methods: Basic science, clinical‐pathologic correlations, and review of the literature. Results: Recent molecular biologic data support the pathogenetic concept of PEX syndrome as a type of stress‐induced elastosis, an elastic microfibrillopathy, with TGF‐ß1, increased oxidative stress, a dysbalance of proteolytic enzymes and their inhibitors, an impaired proteasome system, and low grade inflammatory processes being key factors in pathogenesis. Active involvement of trabecular meshwork cells in local production of PEX material in the juxtacanalicular area may be the primary cause of outflow resistance and chronic pressure elevation in PEX patients. Additional pathogenetic factors include marked pigment dispersion, increased aqueous humor protein concentrations, and pressure‐independent risk factors including an impaired ocular and retrobulbar perfusion. Conclusions: PEX syndrome may not only cause severe open‐angle glaucoma but also a spectrum of other complications and imply an increased risk for cardiovascular disease. A thorough awareness of its pathologic features and its effects on ocular tissues is critical for an early recognition and accurate diagnosis.
Current concepts in the management of exfoliative glaucoma
Authors: KONSTAS AGP 
Published: October 2007

Abstract Purpose: To review current concepts in the management of exfoliative glaucoma (XFG) Methods: Presentation of recently published studies on the success of medical, laser and surgical therapy in XFG Results: The management of XFG should be different to that employed in POAG. Due to the worse 24‐hour IOP characteristics in XFG, optimal control of 24‐hour IOP is needed to improve long‐term prognosis in XFG. There is cumulative evidence that new medications may show a different response in XFG compared with POAG. Directed therapy in XFG may employ fixed combinations or laser as initial therapy. Prompt surgical intervention is more often needed in XFG. The role of non‐penetrating surgery in XFG requires further elucidation. Conclusions: Overall, the management of XFG remains a challenge.
Large intraocular pressure fluctuations: a risk factor for glaucoma progression
Authors: ASRANI S 
Published: October 2007

Abstract Purpose: We are aware of the detrimental effects of peaks of intraocular pressure (IOP) above the normal range. However, we have observed that many of our patients continue to experience glaucomatous progression despite their mean IOP being below what the physician considers an adequate target IOP for that individual. We studied the risk associated with diurnal IOP variations in open angle glaucoma. Methods: The patients who were enrolled in the study used the Zeimer self‐tonometer to measure IOP over a period of 5 days. The readings were taken upon waking, noon, mid‐afternoon, dinnertime and bedtime. Visual fields over the 10‐year duration of the study were reviewed for progression. We performed statistical analyses on these readings to study the relative risk of disease progression. Results: Baseline office IOP had no predictive value (relative hazard: 0.98). The IOP range over multiple days was a significant risk factor for progression even after adjusting for office IOP, age, race and visual field damage at baseline (relative hazard ratio 5.76). 88% of patients in the upper 25 percentile of IOP fluctuation, and 57% of patients in the lower 25th percentile of IOP fluctuation, progressed within 8 years Conclusions: In this presentation, corroborating studies, common IOP fluctuations and proposed mechanisms for IOP fluctuations will be presented. Ways to control IOP spikes will be discussed and pharmacotherapy options will be explored.Diurnal fluctuations in IOP present a greater risk of visual‐field loss to the patient with glaucoma compared to mean IOP. By monitoring IOP more closely and by prescribing medication that offers the best control of IOP with the least amount of fluctuation, ophthalmologists can offer their patients the best therapy for glaucoma.
What have we learned about neuroprotection in the lab?
Authors: WHEELER LA , HARE WA , DONG CJ 
Published: October 2007

Abstract Purpose: Work with both in vitro and in vivo models has provided insights into how and why retinal ganglion cells (RGCs) might die in glaucoma. In vitro and in vivo models have identified mechanisms of stress or injury‐induced death of RGCs. Techniques used were cell culture, retinal whole mount and slice prepartions to more complex in vivo models. These approaches have identified activation of the alpha‐2 pathway and blockade of the NMDA receptor has important targets in neuroprotection Methods: In vitro studies used high speed confocal Ca2+ imaging at the IPL of living rat retinal slices. Changes of cytosolic free Ca2+ were monitored with the Ca2+ dye fluo‐4. Simultaneous recordings of ERG and single‐unit RGC activity were obtained from rabbit retina flat mounts. Experimental ocular hypertension was induced by laser in rats (WoldeMussie, IOVS, 2001) and primates (Hare, IOVS, 2002 Results: At the IPL, the Ca2+ signal was suppressed in a dose‐dependent manner by brimonidine and other alpha‐2 receptor agonists. The action of brimonidine was blocked by yohimbine, an alpha‐2 receptor antagonist. Application of NMDA to rabbit retinal flat mounts induced an increase in action potential spiking that was blocked by memantine. In vivo brimonidine and memantine reduced hypertensive injury to the optic nerve and retina Conclusions: These findings suggest that a function of the retinal alpha 2 system is the regulation of synaptic transmission at IPL and that brimonidine may protect RGCs by preventing abnormal elevation of cytosolic free Ca2+ either in RGCs, in their presynaptic cells, or in both. Memantine is able to block NMDA‐induced increases in in RGC spiking activity at concentrations that had little or no effect on retinal light signaling.
Vasoactive intestinal peptide loaded in liposomes: a new immunomodulatory agent for the local treatment of experimental autoimmune uveoretinitis (EAU)
Authors: CAMELO S , LAJAVARDI L , BOCHOT A , FATTAL E , GOLDENBERG B , NAUD MC , BEHAR‐COHEN F , DE KOZAK Y 
Published: October 2007

Abstract Purpose: Local delivery of therapeutic molecules is a promising method to treat ocular diseases, while at the same time, reducing severe systemic side effects. We tested the efficacy of one intravitreal injection (IVT) of rhodamine‐labeled liposomes loaded with Vasoactive Intestinal Peptide (VIP‐Rh‐Lip) to reduce experimental autoimmune uveoretinitis (EAU). Methods: Injection of VIP‐Rh‐Lip was performed simultaneously with or 6 or 12 days after immunization with S‐Ag in CFA. Therapeutic efficacy on EAU was determined by clinical slit lamp examination. Retinal tissue destruction was assessed by histological examination, inflammatory cells infiltration by immuno‐histochemistry. Intraocular cytokine production was determined by multiplex ELISA. The proliferation and cytokine secretion by cells isolated from inguinal LN were measured. Results: IVT injection of VIP‐Rh‐Lip simultaneously and 6 days after S‐Ag immunization decreased EAU clinical score and protected retinal tissue from destruction compared to control animals. In treated rats intraocular inflammatory cytokines and NO production by intraocular macrophages was decreased suggesting they were deactivated. In vivo and in vitro T cell reactivity to S‐Ag was reduced. IL‐10 production by cells isolated from inguinal LN, re‐stimulated in vitro in presence of S‐Ag was increased in VIP‐Rh‐Lip injected rats compared to control animals. Conclusions: A single intraocular injection of VIP‐Rh‐Lip is an effective therapeutic strategy to protect ocular tissues during uveitis, by reducing intraocular inflammation and by diminishing T cell reactivity at the systemic level.
Control of experimental uveoretinitis by specific or nonspecific regulatory T‐cells
Authors: TERRADA C , DE KOZAK Y , LEHOANG P , SALOMON B , BODAGHI B 
Published: October 2007

Abstract Purpose: We have previously described a murine model of experimental uveoretinitis. In this study, we have compared the therapeutic effects of polyclonal versus antigen specific CD4+CD25+ regulatory T cells after intravenous or intravitreal injection according to the activation statut Methods: In mice expressing hemagglutinin (HA) in the retina after subretinal injection of rAAV, uveitis was induced by intravenous administration of 2 x 106 activated HA‐specific T cells. These cells were obtained from purified Thy‐1.1 TCR‐HA CD25‐ cells and stimulated by irradiated BALB/c splenocytes and HA peptide for 4 days. At the same time or 4 days later, in vitro‐activated or fresh HA‐specific or polyclonal BALB/c CD4+CD25+ T cells were injected intravenously or intravitreally(IVI). A challenge was performed by intravenous activated HA‐specific effector T cells, 21 days after the induction of uveitis. Intraocular inflammation was clinically and histologically studied in all animals. Results: Fresh CD4+CD25+ T cells controlled uveitis only if they were specific for the target antigen (HA). Compared to intravenous injection, the effect observed after intravitreal injection was obtained with low number of cells. Furthermore, protection against a challenge was achieved only after local administration of HA‐specific regulatory T cells. Activated polyclonal BALB/c CD4+CD25+ T cells IVI controled the disease but have no effect after a challenge. Conclusions: Regulation of experimental uveoretinitis may be obtained by using CD4+CD25+ T‐cells. Specificity and activation status of these cells are critical points. In order to develop new in situ therapeutic strategies, in vitro‐activated polyclonal T regs are relevant cells.
Animal models of primary intraocular lymphoma
Authors: TOUITOU V , BODAGHI B , DE KOZAK Y , LEHOANG P , FRIDMAN C , FISSON S 
Published: October 2007

Abstract Purpose: Primary intraocular lymphoma (PIOL) is a high grade non‐Hodgkin lymphoma which pathogenesis is still unclear. Few animal models exist in order to study this condition. We discuss and evaluate the contribution of different animal models available for intraocular lymphoma. Methods: Although intraocular lymphoma in human is usually a B‐cell lymphoma, most of existing models are based on T‐cell proliferation. Recently, a major step forward has been realized with the development of new models of intraocular B‐cell lymphoma. Moreover, to evaluate the role of the immune microenvironment in this condition, a murine model of intraocular B‐cell lymphoma was developed in immunocompetent hosts after intravitreal injection of a syngeneic lymphomatous B‐cell line. Results: These animal models of primary intraocular T‐cell or B‐cell lymphoma contributed to a better characterization of the molecular and cellular microenvironment of PIOL. New therapeutic tools, such as the use of lymphotoxin, or the manipulation of the immune microenvironment in order to control the tumor are being evaluated in these models. Conclusions: These more relevant experimental models will allow the development of new tools for the understanding of PIOL pathogenesis and its therapeutic control.