bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of the congenital anophthalmic/crytophthalmic socket
Authors: BRISCOE D , VARDIZER M 
Published: October 2007

Abstract Purpose: We discuss considerations and the difficulties encountered in socket reconstruction of three cases of congenital anophthalmic /cryptophthalmic socket. Methods: 3 cases of congenital anophthalmic / cryptophthalmic socket underwent surgery following a period of socket expansion using prosthesic expanders. 2 cases had socket reconstruction using baseball implant and buccal mucous membrane grafting , and the third case had socket expansion surgery by lateral orbital wall burring and buccal mucous membrane grafting. Results: The 2 cases with baseball implants had late postoperative problems. One case had implant migration causing lower eyelid ectropion, and chronic infections. The second case had an over prominent implant causing difficulty with eyelid closure which became worse over one year. Both cases underwent further surgery with implant exchange for Dermis Fat Grafts, giving satisfgactory results. The third case had an initially good result, but with growth of his head the orbit remained smaller than the other side. Conclusions: We recommend the primary use of Dermis Fat Graft in congenital anophthalmic / cryptophthalmic sockets and in our opinion baseball implants should not be used in these cases. In our experience Buccal Mucous membrane grafting has only limited success in these cases.
Treating ocular surface squamous neoplasia by topical Mitomycin C
Authors: FRUCHT‐PERY J , PE'ER J 
Published: October 2007

Abstract Purpose: Ocular surface squamous neoplasia, which include conjunctival epithelial dysplasia, carcinoma‐in‐situ and invasive squamous cell carcinoma and which may involve also the cornea, were traditionally treated by surgical excision with the possible addition of cryotherapy, local irradiation, or external beam irradiation. Since 1992 we have treated the intraepithelial types of OSNN by topical Mitomycin C. Other centers have followed our steps. We will describe our and others' experience using this type of treatment. Methods: Our protocol for treating intraepithelial OSSN consists of applying 0.02% (0.2 μg/ml) Mitomycin drops four times daily for two weeks, with additional such courses if needed, including a two‐week intermission between the courses. Results: About 95% of our patients with intraepithelial OSSN responded to this treatment. About half of them needed only one course of two weeks, about 35% needed two courses, and the rest needed 3 to 5 courses. In those patients with corneal involvement, marked improvement of the visual acuity was noticed. Main side effects were conjunctival hyperemia and corneal epitheliopathy. No permanent complications were noticed. Conclusions: Topical Mitomycin C is an effective and safe method for treating intraepithelial OSSN with relatively mild and temporary side effects. It can replace the surgical approach, especially for lesions that spread over large areas of conjunctiva and cornea and necessitate extensive excision.
Treating conjunctival primary acquired melanosis with atypia by topical Mitomycin C
Authors: PE'ER J , FRUCHT‐PERY J 
Published: October 2007

Abstract Purpose: Conjunctival primary acquired melanosis can appear with or without atypia. The lesions with atypia can become transformed to melanoma, and some consider them as melanoma‐in‐situ. The PAM lesion shows waxing and waning, and its boundaries are difficult to detect. Therefore, one can never be sure that the lesion was totally excised by the traditional method of surgical excision and cryotherapy. Since 1994 we have been treating our patients with PAM with atypia proven by biopsy, with topical Mitomycin C. Other centers have used the same methods. We will describe our experience in using this method of treatment. Methods: The protocol we have been using consists of 0.04% (0.4 μg/ml) Mitomycin C drops four times daily for two weeks. Currently we apply 3 such courses, with two weeks' intermission between courses. Results: The vast majority of our patients showed partial or complete disappearance of the pigmentation. One patient had recurrence of the PAM and in one patient the recurrence was in the form of conjunctival melanoma. The main side effects were temporary conjunctival hyperemia and corneal epitheliopathy. In two patients the epitheliopathy was severe and longstanding, possibly due to limbal stem‐cell deficiency following a higher concentration of the Mitomycin C drops. Conclusions: Topical Mitomycin C chemotherapy can be used as a good alternative to surgical excision and cryotherapy in treating conjunctival PAM with atypia, with reasonable side effects. We recommend not to use this method in treating invasive conjunctival melanoma.
Using intravitreal methotrexate for treating vitreoretinal lymphoma
Authors: PE'ER J , SIEGAL T , FRENKEL S 
Published: October 2007

Abstract Purpose: Vitreoretinal involvement occurs in approximately one‐quarter of patients with primary CNS lymphoma (PCNSL), and in some patients with systemic lymphoma who may later develop CNS lymphoma. The traditional method for treating vitreoretinal lymphoma, which is the common type of intraocular lymphoma, is by external beam radiation, or intravenous or intrathecal chemotherapy; however, recurrences are common. We describe our ten years of experience in treating vitreoretinal involvement of PCNSL by intravitreal injections of methotrexate (MTX). Methods: Biopsy‐proven vitreoretinal lymphoma has been treated by intravitreal injections of 400 μg/ml methotrexate. According to our protocol, injections are administered twice weekly for 4 weeks, once weekly for 8 weeks, and then once monthly for 9 months for a total of 25 injections. Results: Forty‐four eyes of 26 patients have been treated; 7 patients had monocular involvement and 19 binocular. Twenty‐three patients had B‐cell lymphoma and 3 patients had T‐cell lymphoma. In all patients remission of the intraocular lymphoma was achieved after 6.1 + 3.5 injections (range 2 – 16 injections). None of the patients had an intraocular recurrence. Among the side effects, the most common were conjunctival hyperemia and corneal epitheliopathy, which usually subsided when the interval between the injections increased. Conclusions: In our experience, treatment by intravitreal injections of methotrexate provides complete remission of vitreoretinal lymphoma with, so far, no recurrences and with bearable side effects, and can be considered as alternative treatment to radiotherapy and systemic or intrathecal chemotherapy.
Neuro‐ophthalmological analysis and imaging of optic nerve tumours
Authors: MILEA D 
Published: October 2007

Abstract Purpose: To describe correlations between the clinical manifestations and the neuro‐radiological features of optic nerve tumors. Methods: Description of the available radiological techniques for the appropriate evaluation of an optic nerve tumor. MR imaging of the orbit is the most common method and it should include standard enhanced fat‐suppression, T1 and T2‐weighted axial and coronal images, other sequences being optional. Results: The two most primary common optic nerve tumors are optic nerve glioma and optic nerve meningioma, other tumors (gangliogliomas, medulloepitheliomas, haemangioblastomas haemangiopericytomas, etc.) being more rare, diagnosed on pathological, not radiological grounds.Optic nerve meningiomas, occurring most commonly in middle‐aged females, have a tubular appearance on CT or MR as opposed to the fusiform or globular shape of optic gliomas. Optic nerve sheath meningiomas are usually isointense or hypointense on T1‐weighted imaging, enhancing after contrast injection.Metastatic carcinomas to the optic nerve are very unusual, and may be sometimes radiographically indistinguishable from optic nerve meningioma. In most of the cases a thourough history and accurate clinical examination may help the interpretation of the radiological findings, pathology being however at times necessary in atypical cases. Conclusions: Neuro‐imaging allows most often to distinguish different types of optic nerve tumors. This is the reason why it is widely accepted now to use radiotherapy for treatment of optic nerve sheath meningiomas without pathological confirmation of the diagnosis. In individual cases with atypical clinical or radiological features, pathology is nevertheless needed for firm diagnosis.
The use of VEP in the evaluation of optic nerve lesions
Authors: HOLDER GE 
Published: October 2007

Abstract Purpose: To describe the use of VEP and other electrophysiological investigations in the assessment of optic nerve function. Methods: The techniques for recording ISCEV Standard VEP, ERG and PERG will be demonstrated. The clinical application of these techniques will be illustrated using selected cases. Results: The nature of the VEP changes in various disorders of optic nerve function will be described. Particular emphasis will be placed on the ability of electrophysiology directly to assess the function of the retinal ganglion cells, and to facilitate, in most cases, the distinction between optic nerve and macular dysfunction. Conclusions: The objective data provided by VEP and other electrophysiological investigations play an important role in the mangement of patients with suspected optic nerve disease.
Histopathology of optic nerve tumours
Authors: HEEGAARD S 
Published: October 2007

Abstract Purpose: To evaluate the distribution in Denmark of histologically verified optic nerve lesions during a period of 60 years. Histological diagnosis, gender and age of patients were collected. Changes in frequency of parameters during the observation period were calculated. Methods: All optic nerve lesions reported at the Eye Pathology Institute, University of Copenhagen, during the period 1940–99 were investigated. All similar lesions reported at all pathological departments in Denmark during 1974–99 were also investigated. Results: The number of optic nerve lesions identified totalled 313 in 298 patients. The frequency of histopathological optic nerve lesions increased significantly over the last 25 years. At present, an average of 12 lesions per year is recorded. Lesions in children accounted for 42% (130). Benign tumours constituted 33% (44) of the total number of tumours in adults and 61% (62) in children. Frequencies of glioma and optic nerve sheath meningioma increased significantly during the last 25 years. Subjects presenting with optic nerve sheath meningioma exhibited a significant difference in age at presentation: the mean age of women at presentation was seen to be 48.8 years, while the mean age of men at presentation was seen to be 29.7 years. The most frequent lesion seen in children was glioma and in adults invasion from malignant uveal melanoma. Conclusions: Histologically diagnosed optic nerve lesions are rare and consist primarily of tumours. The increase in frequency of optic nerve lesions in Denmark during the last 25 years is due to an increase in the number of benign tumours.
MMPs in ocular physiology
Authors: EICHHORN M 
Published: October 2007

Abstract Purpose: Metalloproteinases (MMP) are a family of more than 20 enzymes. with the common ability to degrade extracellular matrix (ECM) components. Since MMPs may also destruct signaling molecules or release them from ECM, MMPs shape not only the structural, but also the functional aspects of a distinct ECM compartment. As a consequence MMPs are implicated in a wide range of physiological and pathological processes in the eye (e.g. corneal wound healing, AMD, diabetic retinopathy, choroidal neovascularization, and glaucomatous changes in trabecular meshwork and optic nerve head.).This review will summerise our knowledge of MMPs in ocular tissues and our present understanding of the regulation of MMP activity. Methods: Review of the literature. Results: MMPs are zinc endopeptidases which can be subdivided in 4 subgroups. Collagenases process fibrillar collagen types I, II and III. Gelatinases degrade basement membrane collagen types IV and V. Stromlysins recognize nonfibrillar collagens, laminin, fibronectin and proteogylcans. Recently, membrane type MT‐MMPs were detected bound to cell membranes.MMP activity is controlled basically on three levels. Synthesis is regulated by transcription factors. Secreted, inactive proMMPs must be activated, mainly by plasmin. Plasmin itself is regulated by plasminogen activators (PA) and their counterpart plasminogen activator inhibitors (PAI). Finally, active MMPs may be blocked by tissue inhibitors of MMPs (TIMPs). Conclusions: The variety of MMPs, their ubiquitous presence and their broad range of substrates develop a complex system with tight regulation on several levels. To date our understanding is far from satisfying and further work is necessary to reach a more comprehensive look especially at the biological impact of this family of enzymes.
MMPs in CNV
Authors: LAMBERT V , RAKIC JM , NOEL A , FOIDART JM 
Published: October 2007

Abstract Purpose: Matrix metalloproteinase 2 (MMP‐2) and MMP‐9 are increased in human choroidal neovascularization (CNV) occurring during the exudative most aggressive form of age‐related macular degeneration (AMD), but their precise role and potential interactions remain unclear. Methods: To address the question of MMP‐2 and MMP‐9 functions, mice deficient in the expression of MMP‐ 2 (MMP‐2 KO), MMP‐9 (MMP‐9 KO), and both MMP‐2 and MMP‐9 (MMP‐2,9 KO) with their corresponding wild‐type mice (WT) underwent CNV induction by laser‐induced rupture of the Bruch’s membrane. Results: Both the incidence and the severity of CNV were strongly attenuated in double deficient compared with single gene deficient mice or corresponding WT controls. The reduced neovascularization was accompanied by fibrinogen/fibrin accumulation. Furthermore, overexpression of the endogenous MMP inhibitors TIMP‐1 or TIMP‐2 (delivered by adenoviral vectors) in WT mice or daily injection of a synthetic and gelatinase selective MMP inhibitor (Ro 26‐2853) significantly decreased the pathological reaction. Conclusions: These findings suggest that MMP‐2 and MMP‐9 may cooperate in the development of AMD and that their selective inhibition represents an alternative strategy for the treatment of choroidal neovascularization.
Fluorescein and ICG angiograms : still a gold standard
Authors: O’TOOLE L 
Published: October 2007

Abstract Purpose: To review the role of Fluorescein Angiography and ICG in the management of ARMD Methods: Fundus Fluorescein Angiography (FFA) is the gold standard for classification of Choroidal Neovascular Membranes (CNVMs) in Age Related Macular Degeneration (ARMD). CNVMs may be defined as classic, minimally classic or occult by their filling patterns observed on angiography. The findings of the large TAP and VIP studies are based on angiographically defined CNVMs. FFA in the setting of ARMD is indicated when the patient complains of new metamorphopsia, experiences unexplained blurred vision or there is evidence of subretinal fluid, haemorrhages or hard exudates1,2 .Fluorescein Angiography is an invasive procedure and carries a risk of anaphylaxis and death. There should be on site facilities readily available to manage any potential complications of an FFA.Indocyanine Green Angiography (ICG) is used to evaluate the choroidal circulation and is of particular use in the diagnosis of Idiopathic Polypoidal Choroidal Vasculopathy. Results: With the advent of new therapeutic modalities there is a need for frequent monitoring of the response of the CNVM to treatment. Ocular Coherence Topography complements FFAs and ICG, reducing the number of angiograms required during the quiescent phase of treatment. In spite of this invasive angiography remains the gold standard for diagnosis and treatment Conclusions: References1 Summary benchmarks for Preferred Practice Benchmarks in the Setting of ARMD. www.aao.org2 International Clinical Guidelines for ARMD. www.icoph.org
Phenotype‐Genotype correlations : more than identifying risks ?
Authors: AUDO I , LEVEILLARD T , SAHEL JA 
Published: October 2007

Abstract Purpose: To critically review current knowledge on genetic susceptibility for AMD and its relevance in a clinical setting. Methods: AMD is a multifactorial disorder with both environmental and genetic risk factors. Genetic knowledge of the disease made a real breakthrough in 2005 after 3 concomitant publications incriminating complement factor H (CFH) as a susceptibility gene, confirming the major role of inflammation in the disease pathogenesis. Further studies suggested the existence of other susceptibility genes, such as the C2/Complement Factor B or LOC387715/PLEKHA1/HTAR1. Identification of other susceptibility genes is expected and groups, including ours, are putting together large cohorts of patients using an unbiased genome wide scan (GWS) approach. Discovery of new genes will generate potential molecular targets useful to develop novel therapeutic approaches. However, these new genetic findings raised different questions that will be discussed based on our experience and the current literature:‐ How can we refine correlation analysis between specific susceptibility alleles, environmental factors, systemic biomarkers and specific subgroups of AMD? In particular, how pertinent are the current AMD classifications to outline these correlations and should new classifications, based for instance on OCT, fundus autofluorescence patterns or functional data, be generated?‐ Due to the important relative risk associated with the CFH or LOC387715 susceptibility allele and regarding the coast of genotyping approaches such as GWS, how can we narrow down the targeted population to increase the likelihood of finding new susceptibility genes?‐ Is a systematic genotyping strategy for CFH and LOC387715 of any AMD patient relevant in a clinical setting?
Microperimetry : understanding what went wrong or predicting therapeutic routes
Authors: VUJOSEVIC S 
Published: October 2007

Abstract Purpose: To investigate macular sensitivity and fixation patterns with automatic fundus perimetry (microperimetry) in patients with early and late age‐related macular degeneration (ARMD). Methods: A hundred and twenty eyes of 101 consecutive patients with early ARMD or with subfoveal choroidal neovascularization (CNV) secondary to ARMD were evaluated. Best corrected visual acuity (ETDRS charts), fundus photography, and fluorescein angiography were performed. Microperimetry (MP1, Nidek Technologies, Padova, Italy) was used to quantify macular sensitivity and fixation patterns (location and stability). Results: Macular sensitivity was significantly decreased over large drusen and over pigment abnormalities (p<0.0001) and in patients with CNV when compared to normal age‐related values (p<0.0001). Fixation moved from central to eccentric and from stable to unstable in patients with active CNV, (p<0.001 and p<0.05) respectively. Angiographic classification of subfoveal CNV (occult versus classic) was not significantly related to fixation pattern (p>0.05). In cases that responded to treatment retinal sensitivity and fixation characteristics improved significantly, (p<0.05). Conclusions: Microperimetric quantification of macular sensitivity and fixation patterns in eyes with early and late ARMD offers new data about the impact of visual impairment in these eyes. In retinal areas affected by early ARMD retinal sensitivity deteriorates, despite good visual acuity. Microperimetry may allow early detection of functional impairment due to these lesions. Moreover, microperimetry may be of value in predicting the outcome of CNV when different treatments (laser, PDT, anti‐VEGF drugs, macular translocation and RPE transplants) are planned in current or future studies
A system to perform quantitative fluorescein angiography
Authors: SCHWARTZ A 
Published: October 2007

Abstract Purpose: To develop a system with which fluorescein angiograms may be quantitatively compared across time, patients and laboratories. Methods: Sets of standard solutions of the fluorescein were developed in media that mimics the physical and chemical environments of compartments of the eye, i.e., serum and vitreous, in which the measurement is taken. Images from these sets of standards were obtained at exactly the same time and under the same instrument settings as the data from the eye on the same angiogram. Computer software was developed to quantitatively analyze the angiogram that established calibration plots and converted the grey image to an absolute color scale image of the data, as well as provide quality control information as to the performance of the instrument. Results: The position and shape of the excitation and emission spectra of the fluorescein standards matched those of fluorescein in serum and vitreous media. The 80% reduction in quantum efficiency of fluorescein in serum compared to fluorescein in PBS at pH 7.4 was equal to fluorescein in synthetic serum and/or PBS at pH 5.5. The reduction in quantum efficiency of fluorescein in vitreous was only 3% and equal to fluorescein in PBS at pH 7.3.The resulting computer generated color scale angiogram images were directly compared across time and patients and the initial results appeared consistent and reasonable. In addition, by evaluating the calculated instrument performance parameters, e.g., linearity, dynamic range, detection threshold and Window of Anaylsis, a determination of the quality of the angiogram could be made. Conclusions: This system provides data that is independent of the instrument and operator, and promises that quantitative comparisons can be made across time, patients and laboratories.
Instrumentation adaptation for quantitative fluorescein angiograms
Authors: BERNARDES R 
Published: October 2007

Abstract Purpose: To obtain quantitative fluorescein angiograms that are independent of instrument setup and operator influence. Methods: Sets of five standard fluorescein solutions were developed to mimic the environmental conditions of the plasma and vitreous compartments. Images from the eye fundus (after patient dye administration) and from these fluorescein solutions were simultaneously obtained at different focal planes via a beam splitter and lens system attached to an HRA scanning laser ophthalmoscope. Software was developed to calculate calibration plots and to convert the angiography gray‐scale images into absolute concentration image maps for both eye compartments. This methodology provided instrument calibration data for each image obtained. Results: A system of standards, beam splitting adaptor and software was developed which provides quantitative data on an absolute color scale derived from calibration standards which are designed to provide information that is independent of the instrument and operator. Such quantitative data would be comparable across patients, laboratories and time. Conclusions: This methodology provides a breakthrough in fluorescence angiography in that it allows direct comparison between different fluorescein angiograms either from the same patient over time or across patients and laboratories.