bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐TNF‐alpha therapy for exudative ARMD
Authors: MISSOTTEN T , BAARSMA GS , VINGERLING JR , MARTINEZ‐CIRIANO JP , VAN HAGEN PM 
Published: October 2007

Abstract Purpose: Angiogenesis is a major pathway in the pathogenesis of exudative age related macular degeneration (ARMD). There is evidence of an important inflammatory component as well. In ARMD patients with co‐existing inflammatory diseases treated with anti‐TNFa, a positive effect of these drugs on exudative ARMD was reported. As theoretical and clinical elements provided a rationale for the use of anti‐TNFa medication in ARMD, a prospective non‐randomised study was started. Methods: A non‐randomised pilot study (calculated n=40) included patients with active CNV in ARMD. Treatment consisted of Infliximab IV, standard dose/scheme, for 1 year. ETDRS VA, contrast sensitivity, OCT, Fluorescein/ICG angiography, QOL and serological examinations were performed at set time points according to an IRB‐Ethical committee approved protocol. All patients were aware of the standard of care (intravitreal anti‐VEGF injections/risk endophthalmitis 1/1000) and the experimental nature of this study. All participants could switch to anti‐VEGF therapy at any time. Results: Compared to baseline, change in visual acuity (ETDRS lines) was 0.04±0.5 ; 0.04±1.0 ; ‐0.33±1.0 ETDRS lines at 2 (n=20),4 (n=12) and 6 (n=6) months after start of Infliximab.1 patient switched to anti‐VEGF therapy when disease remained active. 2 patients left the study for unrelated causes. Conclusions: Preliminary results of this non‐randomised prospective study using IV anti‐TNFa therapy for exudative ARMD are promising. So far, in all but one patient, stabilisation of disease and VA could be found. Final study results are necessary to confirm these preliminary results. If confirmed, a combination of anti‐VEGF and anti‐TNFa therapy could be an attractive treatment modality for ARMD.
Profile of the Spanish ophthalmologist dedicated to retinal pathology. Preliminary results
Authors: SANCHEZ CHICHARRO DI , PASTOR JIMENO JC , FERNANDEZ I , ROJAS J 
Published: October 2007

Abstract Purpose: Define the profile of ophthalmologists dedicated to retinal pathologies Methods: After approval of the Spanish Society of Retina and Vitreous(SERV) a data base of professionals dedicated to treat retinal diseases was created from three sources: members of SERV, V‐R specialist according to pharmaceutics companies and suggested by well known V‐R specialists. A confidential questionnaire was sent. We used Chi‐squared and Fisher’s Exact test for qualitative variables and non‐parametric Kruskall Wallis test for quantitative variables Results: 490 possible V‐R specialist were identified, obtaining 248 answers. The answers belonged to teaching hospitals 61%, non‐teaching hospitals 22%, teaching private institute 5.4%, non‐teaching private institute 11%. The mean population covered by public centres was 230.000 habitants, with a mean of 14.5 ophthalmologists and a median of 4 V‐R specialists per centre. 82% of V‐R specialist finished their training after 1980. 93.5% received V‐R training: residency (81%), medical retina master(13.8%), surgical retina master(11.6%) and from expert colleagues(63.3%). The preferential clinical practise was: medical retina 23%, surgical retina 12%, both 65%. 93% attend V‐R special consultation every week. 22% practice retinal surgeries, 14% cataract surgeries and 62% both. 79% practice vitrectomies(80/year), 84% intravitreal injections(2/week), 45% photodynamic therapy PTD(2.5/week) and 88% prescribe PDT(1/week). 90% is member of the Spanish Society of Ophthalmology Conclusions: We approximately know the number of ophthalmologists dedicated to retinal pathologies, their specialist training and their clinical activity
Effects of primary open‐angle glaucoma on the globe, cross sectional area and morphology of the optic nerve and volume of the lateral geniculate body: a longitudinal study
Authors: CEZAYIRLI E , TUGLU I , GUNGOR K , VAROL T , BEKIR N 
Published: October 2007

AbstractGlaucoma is a group of disorders that lead to damage to the optic nerve, which, in turn, causes vision loss that may progress to blindness. Glaucoma is characterized by increased pressure within the globe.Open‐angle glaucoma is by far the most common type of glaucoma. In open angle glaucoma, Schlemm channels in the irido‐corneal angle gradually narrow with time, impairing the drainage of the aqueous humor. Thebuildup of aqueous humor causes an increase in the intra‐ocular pressure. This increased pressure pushes on the junction of the optic nerve and the retina, reducing the blood supply to the optic nerve.Twelve patients with primary open‐angle glaucoma and twelve age‐, sex‐ and stature‐matched healthy controls had high resolution MRI of the eye. T1 and T2 weighted MR images were acquired with a 1.5 Tesla imager (GE Medical Systems, Milwaukee, USA) using inversion recovery and fast spin echo sequences. Linear measurements of the distance between the angles formedby iris and ciliary muscle, depth of the anterior chamber, thickness and diameter of the lens, distance between the anterior and posterior poles of the globe were performed. Cross‐sectional area of the optic nerve was calculated at 5 mm anterior to the optic chiasm using planimetric methods. The boundaries of the lateral geniculate body were delineated on orthogonal images and its volume was measured by multiplying the slice thickness with the area of each section. MR imaging and measurement protocol was repeated a year later to examine the changes.No significant changes were found in distance between the irido‐corneal angles, anterior chamber depth, lens thickness and diameter, and the distance between the anterior and posterior poles of the globe between thefirst and second scans among the patients or controls. We found a significant difference between patients and controls in the cross sectional area of the optic nerve in both scans. There was a decrease in the cross‐sectional area of the optic nerve in the patients but not controls. No significant changes could be demonstrated in the volume of the lateralgeniculate body.
Genetic markers for proliferative diabetic retinopathy in type 2 diabetes
Authors: GLOBOCNIK PETROVIC M , HAWLINA M , PETERLIN BORUT , PETROVIC D 
Published: October 2007

Abstract Purpose: The purpose of this cross–sectional study was to define genetic markers of advanced proliferative diabetic retinopathy in patients with type 2 diabetes. Methods: In retrospective study 186‐386 unrelated Caucasians with type 2 diabetes were enrolled and divided into 2 groups: advanced PDR (diabetics with PDR in wich vitrectomy was performed) and control group (diabetics with duration of diabetes of more than 15 years, without retinopathy).The PCR was used to analyse candidate genes: gene polymorphism G‐174C of the interleukin –6 (IL‐ 6), ‐553 T/A, –834 T/A and ‐921 C/G of the beta fibroblast growth factor (BFGF), 634 C/G and –2549 insertion/deletion of the vascular endothelial growth factor (VEGF), (AC)n of the aldose reductase, K469E of the intercellular adhesion molecule (ICAM), Bgl II of the α2β1 integrin, –429 T/C and –374T/A of the receptor of advanced glycation end products (RAGE) and mutations C282Y and H63D of the hemochromatosis. Results: Genetic risk factors for PDR in Caucasians with type 2 diabetes were the alele Z‐2 of the aldose reductase (AC)n gene polymorphism (OR 2.0, 95% confidence interval 1.4‐3.8; p = 0.03), the C282Y mutation of the hemochromatosis gene (OR = 3.0, 95 % confidence interval = 1.2‐8.0; p = 0.02) and the genotype EE of the E/K ICAM polymorphism (OR 2.3, 95% confidence interval 1.1‐4.7; p = 0.025). We failed to demonstrate other tested gene polymorphisms as genetic risk factors for PDR in Caucasians with type 2 diabetes. Conclusions: Gene polymorphisms of the aldose reductase, the ICAM, and the hemochromatosis mutations could be used as genetic markers for PDR.
Corneal molding and crosslinking
Authors: BARRAQUER RI , LAMARCA J , SALVADOR B , ALVAREZ DE TOLEDO JP 
Published: October 2007

Abstract Purpose: To develop an experimental setup in human donor eyes to study the feasibility of combining corneal crosslinking (CCL) with molding techniques such as orthokeratology and intracorneal arcuate implants. Methods: 6 pairs of fresh human donor eyes with corneas unsuitable for transplantation but otherwise normal were maintained at constant 20 mm Hg intraocular pressure (IOP). The epithelium was removed and an orthokeratologic PMMA contact lens of 11.8 mm diameter and 10 mm main curvature radius was fixed to one cornea of each pair with 6 sutures of 9‐0 vicyl. A standard CCL protocol (0.1 riboflavin phosphate, 370 nm UVA at 3 mW/cm2 for 30 minutes) was applied simultaneously to both corneas. We measured pre‐ and postoperative IOP, central pachymetry, corneal topography (EyeSys), corneal hysteresis (CH) and resistance factor (CRF) (ORA). Results: Average topographic cylinder (SimK) went from 1.66 diopters (D) to 2.01 D and from 1.55 to 1.06 D pre‐ to postoperatively, respectively in the orthoK‐CCL and CCL‐only corneas. Average maximal K value changed from 44.8 to 43.7 D in the orthoK‐CCL and from 43.8 to 43.4 in the CCL‐only group. None of these differences was statistically significant. Average CH went from 11.0 to 13.4 and from 9.0 to 13.7, respectively in the orthoK‐CCL and CCL‐only groups, while CRF went from 11.9 to 14.9 and from 10.7 to 14.6 respectively. Both groups showed a significant increase in pre‐ to postoperative CH and CRF, without significant differences between them. Conclusions: An experimental setup has been devised, able for testing combined CCL and corneal molding techniques in donor human eyes. Corneal molding by a sutured standard orthokeratology contact lens combined with CCL does not appear to induce a permanent change in corneal curvature parameters.
Vitreoretinal management in osteo‐odonto‐keratoprosthesis surgery
Authors: WONG D 
Published: October 2007

Abstract Purpose: To review the strategies, problems and technical issues in dealing with vitreo‐retinal pathology in eyes before, during and after osteo‐odonto keratoprosthesis (OOKP) surgery. Methods: A retrospective review of eight consecutive cases in which vitreo‐retinal intervention was required in the OOKP programme in the Singapore National Eye Centre. Results: Six eyes had retinal detachments. Three of these had limited previously untreated retinal detachments with traction, detected on b‐scan ultrasonography. Repair of the retinal detachments preceded completion of the OOKP procedures although one eye required a repeat vitrectomy for a recurrent detachment with the prosthesis in place. One eye had a massive choroidal haemorrhage resulting in abortion of OOKP stage two surgery. The choroidal haemorrhage resolved, leaving a localized traction‐associated retinal detachment that was repaired during repeat stage two surgery. Two eyes had prior retinal surgery for presumed detachments with silicone oil in place prior to OOKP surgery. Stage two surgery was completed with assessment and confirmation of stability of retinal pathology.Two eyes required vitreo‐retinal intervention for endophthalmitis. One developed infection after stage two surgery and was successfully salvaged. The other developed endophthalmitis after endoscopic cyclophotocoagulation for glaucoma 18 months after stage two surgery. This eye was lost in spite of aggressive intervention.The use of temporary keratoprostheses and vitrectomy endoscopes during surgery was necessary in most of these eyes. Conclusions: OOKP surgery presents challenges for the vitreo‐retinal colleague. Assessment of the anatomical and functional integrity of the retina prior to and often after OOKP surgery is hampered. An accurately interpreted b‐scan ultrasound examination provides the most useful information. Vitreo‐retinal surgical intervention is technically demanding and requires the use of temporary keratoprostheses and endoscopes. An individualized and realistic management strategy has to be derived for patients with vitreo‐retinal pathology when OOKP surgery is embarked upon.
Genes and gene‐environmental interactions for retinal diseases
Authors: LIEW G 
Published: October 2007

Abstract Purpose: To review the latest developments in identifying genes and gene environment interactions on risk of Agerelated macular degeneration (AMD). Methods: Review of the literature and some original data from the Blue Mountains Eye Study. Results: One of the major successes of the Human Genome Project is the identification of novel genes related to riskof AMD. At least two genes have been consistently identified in most studies to date, and a number of other candidategenes are being investigated. CFHY402H on chromosome 1 is the most consistently identified gene, and many studieshave found a single copy of the at risk allele confers 2‐3 fold higher risk of AMD, particularly drusen development.A DNA variant on chromosome 10 at the LOC387715 locus also appears to confer similar risk of AMD, with a stronger effect on progression to neovascular AMD than geographic atrophy. A number of other genes may also be related to AMD risk (e.g. APOE). CFHY402H codes for a variant of complement factor H, a key molecule in the alternative complement pathway. Certain CFH haplotypes may be protective against AMD. The gene product of LOC387715 is unknown, but evidence suggests it may be HTRA1, a serine protease. Finally, the currently available evidence suggests that CFHy402H does not interact with smoking to increase risk of AMD, whereas a few studies have indicated a LOC387715 interaction with smoking. CFHY402H may interact with obesity, with increased risk in persons with body mass index >=25, and potentially with higher fish intake. Conclusions: CFHY402H and LOC387715 may explain the majority of cases of AMD progression. There is some evidence that CFHY402H may interact with obesity, whereas LOC387715 may interact with smoking, to increase AMD risk.
Retinal oximetry in humans: effect of laser
Authors: HARDARSON SH 
Published: October 2007

Abstract Purpose: According to theory, laser treatment of the retina decreases the demand for oxygen and increases available oxygen for the remaining retinal tissue. Animal studies have shown that preretinal or intraretinal partial pressure of oxygen (PO2) decreases following experimental branch retinal vein occlusion (BRVO) and the PO2 rises again following laser treatment. Confirming the beneficial effect of laser on retinal oxygenation in humans has been difficult because practical non‐invasive technology for oxygen measurements has been lacking. Our research group has studied retinal oxygenation in humans with retinal vein occlusion. Methods: The retinal oximeter is composed of a fundus camera, beam splitter and a digital camera. It yields fundus images with isosbestic and non‐isosbestic wavelengths of light simultaneously. Custom‐designed software analyses the images and estimates haemoglobin oxygen saturation in retinal vessels. Measurements have been made on 25 patients with retinal vein occlusion, in some cases before and after laser treatment. Results: In the 5 patients with BRVO, who were measured both before and after laser, the oxygen saturation in affected venules rose from 45±10% (mean±SD) before laser treatment to 53±6% after treatment (p= 0.041). Cases of hemivein and central vein occlusion have shown low oxygen saturation before laser and increased oxygen saturation after laser. Conclusions: The preliminary data indicates that, in some cases, low oxygen saturation is measureable in venules affected by retinal vein occlusion and that the saturation increases after laser. In some cases, notably where clinical signs are mild, the saturation appears to be normal even if no treatment has been applied but further studies are needed to establish the variability.
Endoscopic dacryocystorhinostomy and balloon‐dacryocystorhinostomy and transcanalicular DCR
Authors: UNGERECHTS R 
Published: October 2007

AbstractWith the development of miniaturisation of instruments endoscopic techniques got more and more important in ophthalmology. In this abstract endocanalicular endoscopic techniques will be presented. The significance of an endoscopic diagnostics will be shown.Developments in the ongoing development in endonasal surgery made it possible that the success rate in internal endonasal Dacryocystorhinostomy is similar to those of an external DCR.With the possibilities of endocanalicular endoscopy of the lacrimal duct and the options in surgery which result from that even more options opened up. These minimised the surgical effort and the postoperative rehabilitation. Judging the actual situation of the mucosa endoscopically regarding the position and degree of the stenoses there are different possibilities in rechanneling. With stenoses of the canaliculus or the lacrimal sac there’s the possibility of using the Erbium‐YAG‐Lasercaryoplasty. With subtotal stenoses which show clinically as total stenoses the rechanneling with a miniaturised drill is indicated, a Microdrilldacryoplasty. Both methods have a success rate of 78‐80%.
OOKP ‐ the Singapore Experience
Authors: WONG D 
Published: October 2007

Abstract Purpose: The management of severe ocular surface diseases and end‐stage dry eye disorders such as Stevens Johnson syndrome, ocular cicatricial pemphigoid and chemical burns with conventional keratoplasty or keratolimbal allografting remains unsatisfactory. The Osteo‐Odonto Keratoprosthesis (OOKP) is a form of keratoprosthesis (artificial cornea) surgery designed to treat the most severe of these cases, and good outcomes with long‐term retention have been reported. We present the moderate‐term clinical results of Asian patients who have had this device implanted within our Singapore OOKP Program. Methods: OOKP surgery involves a radical two‐stage procedure – in stage 1, an autologous canine tooth is removed, modified to receive an optical PMMA cylinder, and implanted into the cheek. The entire ocular surface is denuded and replaced with a full thickness buccal mucosal graft. Stage 2 surgery, performed 2‐4 months later, involves retrieval of the tooth‐cylinder complex and implanting it into the cornea, after lifting of the buccal mucosal flap, corneal trephination, iris and lens removal and anterior vitrectomy. Concurrent glaucoma and vitreo‐retinal procedures may also be performed at either stage, if required. Indications for OOKP surgery include bilateral severe blindness, not amenable to keratoplasty or ocular surface transplantation or with previous failed attempts. Results: In February 2004, the Singapore National Eye Centre embarked on its OOKP program, in collaboration with the National Dental Centre. We have now performed OOKP surgery on 22 patients, with the longest follow‐up being 39 months. Of 16 patients with a mean of 19.1 months follow‐up (range 5‐39 months), no major keratoprosthesis‐related complications have occurred, with full anatomical stability and retention in all cases. 73.3% of patients attained at least 6/12 or better vision, while 90% attained 6/6 vision, and remaining patients have attained, and retained their best visual potential with the exception of one patient who lost vision unrelated to the KPro device (endophthalmitis following glaucoma surgery occurred 1 year after KPro surgery). Conclusions: OOKP surgery appears to be a highly promising procedure which has the potential to restore excellent vision to the most severe cases of end‐stage corneal disease, when all else has failed. Longer follow‐up of these cases is currently underway.
An update on the AlphaCor
Authors: CRAWFORD G , HICKS C 
Published: October 2007

AbstractAlphaCor is a new generation of artificial cornea made entirely of pHEMA. It is a flexible 2 part composite device with a transparent centre and a porous skirt, which allows bio‐integration into surrounding host corneal tissue. As a treatment modality AlphaCor exists between traditional keratoprostheses and human donor penetrating keratoplasty. It is most commonly used in high risk corneal regrafts where there is a poor chance of human graft survival.Data has been obtained on every case of AlphaCor implanted, making it the largest series of keratoprostheses published. With this data and resultant alterations in protocol, there has been a gradual decline in the complication rate for this device. The main complications relate to corneal melting, optic deposition, and posterior inflammatory membranes. Because of the design and technique of implantation, post operative glaucoma is uncommon. The probability of retention at one year is 80% and the visual acuity ranges from PL to 6/6 (20/20). The procedure is “reversible” if necessary so the eye is not lost.The data indicates that AlphaCor is an effective alternative to donor corneal transplantation in cases at high risk of graft failure. Excellent visual potential and a wide visual field can be obtained.
Validating the Helsinki University Central Hospital (HUCH) working formulation for staging metastatic uveal melanoma
Authors: ESKELIN S , PIPERNO‐NEUMANN S , DESJARDIN L , SCHMITTEL A , BECHRAKIS N , MIDENA E , GRANGE JD , RACT‐MADOUX G , MARSHALL E , DAMATO B , LEYVRAZ S , ZOGRAFOS L , KIVELÄ T 
Published: October 2007

Abstract Purpose: To validate the Helsinki University Central Hospital (HUCH) Working Formulation, the first substaging system designed to predict prognosis of metastatic uveal melanoma and to facilitate design, reporting and interpretation of controlled clinical trials. Methods: Data of 226 patients who died of disseminated uveal melanoma were collected from members of the European Ophthalmic Oncology Group (OOG). Karnofsky or WHO performance status, largest diameter of largest metastasis and serum alkaline phosphatase (AP) level at diagnosis of metastases, and time to death were requested. The working formulation is based on a multivariate model that identified these variables as independent predictors of survival, modeling time on chemotherapy as a confounding variable (Eskelin et al. Cancer 2003; 97: 65–75). Patients whose predicted survival was less than 6 months were assigned to stage IVc, between 6 and 12 months to stage IVb and over 12 months to stage IVa. Observed survival time was calculated for each stage. Results: The median AP level was 0.69 (range, 0.24‐11) times upper normal limit, median largest metastasis was 3.5 cm (range, 0.8‐19), and percentage of patients representing WHO performance index 0, 1‐2 and 3 was 61%, 38% and 1%, respectively. Of the 226 patients, 100 (44%) were assigned to stage IVa, 97 (43%) to IVb and 29 (13%) to IVc. The median observed survival times were 18.3, 10.0 and 4.6 months, respectively. In Kaplan‐Meier analysis, the stages reflected best to worst survival (P<0.0001, log‐rank test for trend). Conclusions: The collaborative OOG study confirms the HUCH Working Formulation as a repeatable, valid system for dividing patients with metastatic uveal melanoma into groups of differing prognosis.