bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Tono‐Pen Avia with Goldmann applanation tonometer
Authors: MUSCHART F , POURJAVAN S 
Published: September 2008

Abstract Purpose 1. To compare the IOP readings taken by Tono‐Pen Avia (Reichert) With the GAT. 2. To assess the influence of central corneal thickness (CCT) on these measurements Methods Prospective, controlled study including one eye at random of 30 glaucomatous patients and 30 healthy subjects. Patients with previous refractive surgery or corneal pathology were excluded. GAT measurement was followed by Tono‐Pen Avia after a 10 min break. Only Reading with 95% statistical confidence index were taken into account. Pachymetry measurements were done at the end of the examination. Pearson correlation coefficient to assess the correlation between GAT and Avia tonometer. The agreement between IOP readings from GAT and Avia was assessed using the Bland‐Altman plots Results Mean IOP in glaucoma was 18.3 ± 6.7 mmHg with GAT and 16.7 ± 4.7 with Avia. Mean IOP in control group was 16.4 ± 3.8 mmHg with GAT and 15.2 ± 4.2 mmHg with Avia. Mean CCT was 545 ±101.2 µ in glaucoma and 546.7 ± 99.4 µ in control group. There was no correlation between CCT and the IOP readings with GAT or Avia in both groups(p<0.05) Conclusion Tono‐Pen Avia is a very easy‐to‐use handheld applanation tonometer that functions in any position especially for in‐bed or wheelchair patients. It can be used for screening purposes providing a lower IOP value than GAT and indicating a need for further investigation in suspect cases
Visualization drugs for vitreoretinal surgery
Authors: TADAYONI R 
Published: September 2008

Abstract Purpose To discuss data on the potential or real toxicity of intraocular visualization drugs, based on animal and human studies. Methods The course will be based on last experimental and clinical data available in the literature or from our studies. Results There is a larger choice of visualizations drugs with a clear benefit of helping the surgeon. Each of them has its own advantages and risks. The decision to use or not these drugs should also take into account the goal for which they may be used and the expected benefit from it. Conclusion Visualizations drugs, as most drugs, may represent risks that have to be weighed up against awaited benefits.
Experimental and clinical studies of transconjunctival vitrectomy 20G, 23G and 25G
Authors: CHIQUET C 
Published: September 2008

Abstract Purpose Microincision transconjunctival vitrectomy has gained popularity in the recent years. This surgical innovation needs to be evaluated in prospective and controlled studies. Methods A prospective study concerning 23‐Gauge vitrectomy (with cryoapplication and gas tamponade) in 20 patients with retinal detachment and 4 patients with acute endophthalmitis was performed and litterature data (Pubmed database research) was analyzed. Results Performance of microincision transconjunctival vitrectomy may be maximized with use of high duty cycle, largest internal diameter (23G), a sharp guillotine and a high cut rate. Sclerotomy construction is a key point of this technique. In retinal detachment surgery on a selected population, the rate of anatomic reattachment and visual recovery were similar between 23G PPV and 20G PPV. In one patient 23G PPV was complicated by a choroidal detachment secondary to a displacement of the infusion cannula. The redetachment in one 23G case was secondary to a sclerotomy related retinal tear. Microincision transconjunctival vitrectomy for acute endophthalmitis is feasible but has limited capacities as compared with 20G technique. Conclusion The main advantage of sutureless vitrectomy remains the confort of patient after complicated surgeries, but this point should be analyzed with quality of life. This trend toward smaller incisions will lead to improvement of instrumentations, better understanding of the surgical techniques (wound construction, performance of vitreous cutters). 23G PPV is suitable for patients with retinal detachment treated with PPV‐cryo‐gas technique. Sutureless vitrectomy is usefull only in selected cases of acute endophthalmitis .
Eye‐Associated Lymphoid Tissue (EALT) – the local branch of the physiological mucosal immune system at the ocular surface and appendage
Authors: KNOP E , KNOP N 
Published: September 2008

Abstract Purpose Eye‐associated lymphoid tissue (EALT) is the local branch of the mucosal immune system located at the ocular surface proper and its mucosal appendage: the lacrimal gland, conjunctiva (as CALT), and lacrimal drainage system (as LDALT). It is equivalent and follows the nomenclature of other parts of the mucosal immune system such as GALT in the gut or BALT in the bronchial tract. Methods We investigated complete tissues of the human, rabbit, rat and mouse including the lacrimal gland, conjunctival sac and lacrimal drainage system by morphology and molecular biology. Results A diffuse lymphoid tissue was regularly found in the lacrimal gland of all species. In the conjunctiva, a typical mucosal immune system with similar characteristics occurs in human and rabbit and is also reported in several other species. The same is true for the lacrimal drainage system. Hence, a continuous mucosal immune system is present in the embryologically connected tissues of the ocular surface from the gland via its excretory ducts into the conjunctiva and through the lacrimal puncta into the lacrimal drainage system. These tissues share common antigens and protective factors as well as specialised vessels for lymphocyte recirculation and hence act together as an efficient functional unit for ocular surface defence. As a surprise, the conjunctiva of the common laboratory animals rat and mouse, however, contains almost no lymphoid cells. Conclusion The ocular surface and appendage together form an Eye‐Associated Lymphoid Tissue (EALT) that represents a part of the mucosal immune system of the body and provides cellular and secretory immunity. Deregulation of this system may explain important aspects of ocular surface disease.
Electronic compliance monitoring in glaucoma patients used to topical therapy
Authors: BRON AM , HERMANN M , DIESTELHORST M , CREUZOT CP 
Published: September 2008

Abstract Purpose Individual compliance of glaucoma and ocular hypertensive patients with Brimonidine was studied with regards to total dose, dosage intervals, coverage, drug waste, attempts per application and risk factors for low compliance. Methods Thirty‐eight men and 26women aged 70 ±11 years [42‐89] received conventional Brimonidine vials (Alphagan®, Allergan™) equipped with a microprocessor‐controlled monitoring device capable to record date and time of each eye drop application with a known detection sensitivity for eye drop applications ~ 99%. 48 glaucoma and 16 ocular hypertensive patients used to eye drop therapy for 11 ±8 years [1‐35] were enrolled and randomly assigned to Brimonidine therapy b.i.d or t.i.d daily for 4 weeks. Results Electronic records revealed a mean of 1.4 applications per day (range: 0.7‐2.2) for patients assigned to Brimonidine 2x daily with a mean treatment interval of 18.2 hours (range: 11.2‐38.4 h). Patients on Brimonidine 3x daily showed a mean rate of 1.8 applications per day (range: 1.0‐2.7) and a mean treatment interval of 12.4 h (range: 9.1‐39.7 h). 10 patients ceased therapy before completing the 4 weeks period, therein 4 with side effects and 6 patients having emptied the bottle prematurely. Conclusion Almost 10 percent of the patients emptied their vial in less than 4 weeks by using more than one drop per application and thereby do need refills more often than usually calculated. Our data confirm the need for larger studies on individual compliance with topical ocular therapy in glaucoma. Electronic compliance monitoring may be a useful tool in ophthalmic practice to recognize low‐compliant patients.
The action of pro‐inflammatory cytokines on retinal endothelial cell barrier permeability: protective effect of corticosteroids
Authors: AMBROSIO AF , AVELEIRA CA , WOLPERT E , ANTONETTI DA 
Published: September 2008

Abstract Purpose The pro‐inflammatory cytokines interleukin‐1β (IL‐1β) and tumor necrosis factor‐alpha (TNF‐α) were found to be increased in the vitreous of diabetic patients and in diabetic rat retinas, and increased cytokine levels were correlated with elevated retinal vascular permeability. In this work, we investigated the mechanisms underlying IL‐1β‐ and TNF‐α‐induced retinal endothelial cell permeability and evaluated the ability of a glucocorticoid, dexamethasone (DEX), to prevent changes in permeability. Methods Primary cultures of bovine retinal endothelial cells (BRECs) were grown on transwell filters and exposed to IL‐1β and TNF‐α. BRECs permeability to 70 kDa RITC‐dextran was measured. The content and localization of tight junction proteins was assessed by Western blotting and immunocytochemistry. Results IL‐1β and TNF‐α increased retinal endothelial cell permeability in a concentration‐ and time‐dependent manner, but TNF‐α was more effective (increased permeability at a lower dose and shorter time‐point). The increase in permeability was not due to changes in cell viability. IL‐1β and TNF‐α altered ZO‐1 and claudin‐5 content. TNF‐α also decreased ZO‐1 staining at the cell border. Pre‐treatment with DEX prevented TNF‐α‐induced cell permeability, and the protective effect of DEX was partially abolished by the glucocorticoid receptor antagonist RU486. Conclusion These data demonstrate that TNF‐α and IL‐1β potently induce endothelial cell permeability through alterations in tight junctions. Also, the study supports the potential therapeutic use of glucocorticoids to reduce retinal vascular permeability. Support: FCT (Portugal), NIH, JDRF and Allergan
Therapeutic implications and perspectives
Authors: SHIMA DT 
Published: September 2008

Abstract Purpose Vascular endothelial growth factor‐A (VEGF‐A) has recentlybeen recognized as an important neuroprotectantin the central nervous system. Given its positionas an anti‐angiogenic target in the treatment ofhuman diseases, understanding the extent of VEGF’srole in neural cell survival is paramount. Methods We have examined if VEGF‐A is necessary and sufficient for retinal neuroprotection in a model of ischemia‐reperfusion injury. Results VEGF‐A effects on neurons have been documented in several experimmental systems, including now, the retina. VEGF‐A's effects are likley mediated by direct signaling in neurons via VEGFR2. Conclusion These findings have implications for both neural pathologies and for the use of potent VEGF‐A antagonists in chronic ocular vascular diseases, such as diabetic retinopathy. Translateability of these animal findings to patients, and potential next steps will be discussed.
Commercial interest
Subconjuntival injection of bevacizumab in side of filtering bleb in the end of trabeculectomy : first experience
Authors: PICCIRILLO V , SAVASTANO A , SBORDONE S , FORTE R , TAMBURRINI L , SAVASTANO MC , SAVASTANO S 
Published: September 2008

Abstract Purpose To evaluate safety and local effects of ‐in the end of trabeculectomy Avastin injection on filtering bleb vascularisation and bleb failing trend. Methods 1 male patients 65yo with a clinical history of pharmacologically uncontrolled primary open angle glaucoma in right eye (IOP 36 mmHg,CCT=525 µ)underwent to trabeculectomy without use of antiproliferative agents. A traditional surgical approach with a 12 o’clock scleral wedge(4 x 4 mm) and a double Nylon 10/0 made sclerocorneal suture using modified Meduri’s technique was performed.At the end of the surgery ,0.05 ml of bevacizumab ( Avastin 25 mg/ml , Roche) were injected in the subconjutival space above the sclera wedge.The IOP and bleb vascularisation have been recordered in the post op each day during the first week and one time a week in the following three months.A digital camera mounted on slit lamp was used for images acquisition. Results IOP was stable on 9 mmHg during the first three weeks , increasing to 16 mmHg during the follow up and stable until the end of the study despite removing Meduri’ sclerocorneal sutures . No complications were seen in the anterior chamber . Filtering bleb did not show any sign of inflammation or swelling with a “ quite “ vascularisation as clinical marker during the follow up . Conclusion Our short experience demonstrates the safety of subconjuntival injection of Avastin and effects on bleb’s vascularisation regardless of incidence of bleb failure.Further investigations in multicentric randomized studies on larger sample size are necessary to confirm current results .
Predictive value of a dexamethasone provocative test prior to intravitreal triamcinolone acetonide injection
Authors: ZEYEN T , BREUSEGEM C , VANDEWALLE E , VAN CALSTER J , FIEUWS S , STALMANS I 
Published: September 2008

Abstract Purpose To investigate the diagnostic value of a topical dexamethasone (DXM) provocative test for steroid‐induced ocular hypertension after intravitreal triamcinolone acetonide (IVTA) injection. Methods Patients scheduled for IVTA received DXM 4x over 4 weeks. IVTA was injected in those with no or moderate DXM steroid response (6 mmHg≤IOP rise≤15 mm Hg). High DXM steroid responders (IOP rise>15 mmHg) received no IVTA and were subsequently excluded. IOP was measured at baseline, 4 weeks after DXM drops, and at day 1, weeks 1, 2, and 4, and months 3 and 6 following IVTA. Results Thirty‐six patients (36 eyes) were included. After the DXM test, 4 patients (11%) and 2 patients (5%) were moderate and high steroid responders, respectively. After IVTA, 12 patients (33%) and 4 patients (11%) were moderate and high steroid responders, respectively. The DXM test had a sensitivity of 25% (95%CI[0.07,0.52]), a specificity of 100% (95%CI[0.83,1.00]), a positive predictive value of 100% (95%CI[0.40,1.00]), and a negative predictive value of 62% (95%CI[0.44,0.79]) for a moderate to high steroid response after IVTA. The IOP rise after IVTA was significantly higher in previous topical DXM responders vs. DXM nonresponders, 17.0±7.8 mmHg vs. 5.0±4.4 mmHg, respectively (P=.005, Mann Whitney U). Conclusion We found a low sensitivity, a high specificity, a high positive predictive value and a moderate negative predictive value for the topical DXM provocative test with regard to a steroid response after IVTA. These findings indicate that a topical DXM test is clinically useful in predicting steroid response after IVTA. However, a negative DXM provocative test does not rule out steroid response after IVTA.
Eye‐derived systemic immune regulation : ACAID
Authors: TAKEUCHI M 
Published: September 2008

AbstractA form of systemic tolerance is created when antigenic material is placed in the anterior chamber of the eye, an immune privileged site. Termed anterior chamber associated immune deviation (ACAID), this form of tolerance insures that the systemic immune response to eye‐derived antigens is devoid of T cells that mediate delayed hypersensitivity and antibodies that fix complement. ACAID arises when antigen is captured by intraocular antigen presenting cells, then carried to the spleen where a microenvironment is created that activates antigen‐specific T cells to differentiate into regulatory cells that interfere with the induction of delayed hypersensitivity as well as its expression. Several cytokines and neuropeptides, constitutively present in the aqueous humor of the eye, imposes distinctive properties on antigen presenting cells, which play primary roles to the induction of ACAID. In this SIS, I would like to provide up‐to‐date information of what kinds of diseases ACAID can be effective for and whether human monocytes can acquire the specific functions as ACAID‐inducing antigen presenting cells, in addition to molecules, cells, and concepts newly recognized as contributing to tolerance induction induced in ACAID. Evidence is given to support the idea that application of such information may lead to potential for therapeutic applications of ACAID mechanisms in prevention of progression of immune‐inflammatory diseases in humans.
Role of ocular pigment epithelial cells in regional ocular immunity
Authors: SUGITA S , MOCHIZUKI M 
Published: September 2008

Abstract Purpose To whether soluble factors by retinal pigment epithelial cells (RPE) promote the generation of T regulatory cells in vitro. Methods Primary cultured RPE cells were established from normal C57BL/6 mice. T cells were co‐cultured with RPE, x‐irradiated, and used as regulators (RPE Treg cells). Target bystander T cells were established from normal splenic T cells with anti‐CD3 antibodies. T‐cell activation was assessed for proliferation by [3H]–thymidine incorporation. Expression of cytotoxic T lymphocyte antigen‐2α (CTLA‐2α) and cathepsin L on RPE and T cells was evaluated with oligonucleotide microarray, RT‐PCR, immune staining, western blots and flow cytometry. Recombinant mouse CTLA‐2α and anti‐mouse CTLA‐2α abs were used for the assay. For induction of experimental autoimmune uveitis (EAU), mice were immunized with interphotoreceptor retinoid‐binding protein peptide emulsified in complete Freund’s adjuvant. Results RPE converted CD4+ T cells into Treg cells by producing and secreting CTLA‐2α, a cathepsin L inhibitor. CTLA‐2α secreted by RPE cells selectively inhibited cathepsin L in the T cells and the cathepsin L‐lacking T cells exhibited Treg phenotype, i.e. expression of Foxp3 and production of transforming growth factor beta (TGFβ). CTLA‐2α enhanced their production of active forms of TGFβ. In addition, CD4+ T cells from EAU‐induced cathepsin L knockout (KO) donors contained high population of Foxp3+ T cells and EAU in cathepsin L KO mice was significantly less than those in wild type mice. Furthermore, treatment with recombinant CTLA‐2α significantly suppressed EAU. Conclusion These results indicate that immunosuppressive factors derived from RPE participate in the establishment of immune regulation in the posterior segment of the eye.
Molecular diagnosis of X‐linked retina diseases
Authors: HARDCASTLE AJ 
Published: September 2008

Abstract Purpose X‐linked retinal dystrophies present as clinically severe in affected males, whereas heterozygous carrier females show a wide spectrum of clinical signs from normal to marked abnormalities. A range of phenotypes will be discussed, and phenotype/genotype correlation explored. Methods Patient DNA was analysed for mutations in X‐linked genes by a combination of PCR and sequencing. Clinical tests included fundus examination and ERG recordings. Results Molecular screening has resulted in identification of the causative mutation in many cases. Interpretation of the pathogenicity of a sequence alteration can be problematic in the absence of a functional test for sequence changes. Examples of mutations identified will be presented with associated clinical outcomes, with particular emphasis on RPGR as a cause of retinitis pigmentosa, cone‐rod dystrophy, or syndromic RP. Conclusion A molecular diagnosis is often necessary to determine carrier status of at risk females in X‐linked pedigrees. Phenotypes vary between and within families with mutations in the genes RPGR and RP2. However, phenotype and genotype can be correlated for X‐linked congenital stationary night blindness caused by mutations in the NXY and CACNA1F genes.
Optimisation of diagnostic strategy in severe ocular sicca syndrome
Authors: DE MONCHY I , MARIETTE X , GENDRON G , OFFRET H , LABETOULLE M 
Published: September 2008

Abstract Purpose To define the interest of phenol red thread in diagnosis of ocular sicca syndrome, and to estimate the agreement with the Schirmer I test. Methods The PRT test was performed before (PRT1) and after (PRT2) the Schirmer I test, in both eyes of 72 patients complaining of ocular dryness secondary to Sjögren’s syndrome, 71 patients with Sicca Asthenia Polyalgia Syndrome and 40 healthy volunteers. Only the lowest result for each test was used in statistical analysis and cut‐off values were determined using the Receiver Operating Curve procedure. Groups were matched by age and sex. Results The ROC procedure showed weak sensitivity/specificity couples whatever PRT1 cut‐off value. A cut‐off value of 15mm for PRT2 provided the best ratio between sensitivity and specificity (68% and 90% respectively) and 10mm for Schirmer I test permitted a sensitivity of 77.80% and specificity of 82.50%. Maximal agreement between PRT2 and Schirmer I test was found for a PRT2 value of 15mm with however a mean agreement (Kappa index~ 0.5); however none of PRT2 test alone or Schirmer I test alone was better than the other for diagnosis of ocular sicca syndrome. In contrast, the combination of Schirmer I test (≤10mm), PRT2 test (≤15mm) and negative“deltaPRT” (PRT2 < PRT1) permitted to increase sensitivity and specificity to 92% and 95%, respectively. Conclusion Schirmer I test must certainly be used firstable in diagnostic step. However PRT2 and negative « deltaPRT » permit classification of patients « forgotten » by Schirmer I test. Finally, association Schirmer I test, PRT2 and negative « deltaPRT » offers characteristics of diagnostic test (high specificity (90%) and sensitivity (85%)) with a high positive predictive value (73, 3%) for SGS.
Tufting enteropathy: ocular surface and conjunctival markers
Authors: BREMOND‐GIGNAC D , COPIN H , BRIGNOLE‐BAUDOUIN F , MILAZZO S , BAUDOUIN C 
Published: September 2008

Abstract Purpose to describe clinical impairment and ocular surface anomalies in a case of tufting enteropathy (intestinal epithelial dysplasia) and to characterized conjunctival markers Methods We studied a case of a 5 year‐old girl presenting a tufting enteropathy which is a rare congenital disease with persistent diarrhea. Systemic anomalies were associated. She presented a tearing since 8 months‐old. At 5 years old she developed a marked keratitis with itching and blepharospasm non‐responding to treatment. At fundus a unilateral coloboma was noted. Conjunctival impression cytology specimen were processed and markers were analyzed using flow cytometry and were expressed by determining the percentage of cells expressing the markers. CC chemokine receptor 4 (CCR4), CC chemokine receptor 5 (CCR5) expression and HLA‐DR were studied. Conjunctival biopsies were studied in optical microscopy. Results Markers obtained with conjunctival impression cytology specimens were described showing CCR4 CCR4 was overexpressed related to the Th2 inflammatory pathways. More than 60% are associated with a non specific keratitis. Allergic and dry eye syndrome could be both implicated in the mechanism of the keratitis. Conjunctival biopsy showed acute inflammation of the conjunctiva with epithelial cells exfoliation. This typical aspect of the conjunctiva could be related with the observed disorganization of surface enterocytes with focal crowding forming tuft. Conclusion A better understanding of ocular surface disorders in tufting enteropathy might help to elucidate the molecular mechanisms of corneal and intestinal epithelial diseases.