bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic retinopathy : facts and resources
Authors: MIDENA E 
Published: September 2008

AbstractDiabetic retinopathy (DR) is the most frequent ocular complication in patients with diabetes and the main cause of blindness in the working age population in industrialized and developing countries. The most important risk factors that contribute to the pathogenesis of DR are chronic hyperglycaemia, hyperlipidemia and hypertension. Epidemiologic data show that each year 12 percent of new cases of legal blindness are attributed to diabetic retinopathy (DR) and that its prevalence increases with both increased duration of diabetes and the age of patients. Of insulin‐dependent patients with diabetes for 30 or more years, 12% are blind. Diabetic macular edema (DME) is a frequent manifestation of DR and the leading cause of legal blindness in patients with type 2 diabetes. Over a 10‐year period, non clinically significant DME and clinically significant DME will respectively develop in 14% and 10% of known diabetic patients. Approximately half of patients with DME will loose two or more lines of visual acuity within 2 years. Overall social costs (expenditures and lost productivity) caused by DR are about $174 billion in the USA. Approximately 20% of health care expenditures for persons with DM (50% with DM as a co‐morbidity), 10% of expenditures for complications of DM and 15% of expenditures for health care for DM are ophthalmic. Therefore, DR accounts for significant economic costs that can be reduced with early diagnosis, achieved with screening methods. Screening of DR allows for timely treatment, vision preservation and consequent saving costs. Implementation of screening systems in different environments worldwide is the first necessary step in order to prevent blindness caused by diabetes mellitus.
A novel murine model of aging of the human retina
Authors: BRETILLON L , ACAR N , SEELIGER MW , MAIRE MA , GREGOIRE S , JUANEDA P , MARTINE L , JOFFRE C , BRON AM , CREUZOT CP 
Published: September 2008

Abstract Purpose Accumulation of lipids, and especially of cholesteryl esters, under the retinal pigment epithelium and within Bruch’s membrane is a normal feature of aging and has also been observed in human eyes with age‐related maculopathy. Our objective was to evaluate the retinal phenotype of apoB100,LDLR‐/‐ mice, a model for lipid metabolism dysfunction and potentially of aging of the retina. Methods ApoB100,LDLR‐/‐ mice were studied at 7 and 14 months of age by standard scotopic and photopic electroretinography by comparison to control animals. Fundus images were obtained with a confocal SLO (Heidelberg Retina Angiograph). The integrity of the vascular system was investigated by means of fluoresceine and indocyanine green angiography. Sections of eye cups were stained by filipin to detect cholesterol deposits. Results Both scotopic and photopic b‐wave amplitudes were reduced in apoB100,LDLR‐/‐ mice compared to control mice (Rmax=125 µV vs 208 µV for the scotopic b‐wave amplitude at 7 months, and 83 µV vs 162 µV at 14 months). Similarly rods and cones sensitivity was 0.5log unit lower in apoB100,LDLR‐/‐ mice at 14 months, compared to control mice. Although the retinal and the choroidal vascular systems were normal, apoB100,LDLR‐/‐ mice displayed white auto‐fluorescent dots in the retinal pigment epithelium layer which likely corresponded to cholesterol deposits. Conclusion The present apoB100,LDLR‐/‐ mouse, is one of the only models with neutral lipid deposits at the basement of RPE that can potentially be very useful to study the mechanisms of lipid deposition that occurs universally in human retina while aging.
In vivo confocal microscopy in the diagnosis of corneal conjunctivalization
Authors: LANZINI M , NUBILE M , CALIENNO R , COLESANTI E , CIAFRE M , CURCIO C , MASTROPASQUA L 
Published: September 2008

Abstract Purpose The diagnosis of corneal conjunctivalization (CC) due to limbal stem cells deficiency(LSCD)is usually based on clinical features and on impression cytology (IC) which provides ex vivo morphology and immunoistochemical features of the corneal epithelium. The aim of this study was to validate laser scanning in vivo confocal microscopy (IVCM) as a new method to assess CC, based on the morphology of epithelium in central cornea and microstructural analysis of the limbal architecture Methods 15eyes of 15patients with suspected CC were enrolled. All patients underwent IVCM (HRT2‐Heidelberg Eng.)on the central cornea and limbus. CC was defined as presence of monolayered epithelium with goblet cells and subepithelial fibrovascular tissue. These findings were related with limbal alterations. Patients underwent IC of the central cornea to evaluate epithelial features in a masked fashion by mean of PAS and immunofluorescence CK12 staining. The epithelia were then classified into corneal,conjunctival and mixed pattern and the diagnostic hypotheses of in vivo and ex‐vivo findings were compared . Results The diagnostic hypotheses were concordant in 87% of the cases. In 3 we found corneal epithelium with corneal morphology by IVCM, no goblet cells and k12 positive cells by IC. In 2 we found an epithelium with conjunctival morphology by IVCM, presene of goblet cells and ck12 negative cells by IC.In 5 we found mixed epithelia with both methods.The last two cases were discordant.IVCM showed limbal alterations in the cases of mixed and conjunctival epithelium. Conclusion IVCM is a useful non invasive method to help the diagnosis of LSCD and CC which well correlates with IC allowing also the analysis of the limbal structure.
Diagnostic and therapeutic applications of alcohol delamination (ALD) of the corneal epithelium
Authors: RAJ A , SAID DG , RAJ DEV , DUA HS 
Published: September 2008

Abstract Purpose Application of a weak alcohol solution to delaminate the corneal epithelium was first popularised for LASEK (Laser subepithelial keratomielusis). We subsequently reported successful results using ALD for the treatment of recurrent corneal erosion syndrome. In this study we explored the uses of this technique for other therapeutic and diagnostic indications. Methods Eight patients were studied. In 3 the indication was for diagnosis only, in 3 it was for diagnosis and treatment and in 2 for treatment only. Following slitlamp evaluation, a 6mm well was placed over the site to be delaminated and 20% alcohol applied for 30‐40 seconds following which the alcohol was removed and the cornea washed before peeling off the loosened epithelial sheet, which was spread on paper and covered with fixative for light and/or electron microscopy. Results Of the 3 that had ALD for diagnosis, clinical suspicion of conjunctival intraepithelial neoplasia was confirmed in all 3 with preservation of cell morphology and orientation. 3 patients had chronic epitheliopathies manifesting as persisting epithelial defects and sick corneal epithelium. One showed epithelial cell apoptosis and the other 2 showed non specific or conjunctival features. All conditions resolved with visual improvement. Two symptomatic patients, 1 with extensive basement membrane dystrophy and the other with recurrence of granular dystrophy in the epithelium of a graft, showed improvement after ALD. Histology confirmed the diagnosis. Conclusion ALD is a simple, safe and effect intervention for removal of an intact epithelial sheet that can be histologically examined with proper tissue orientation facilitating accurate diagnosis. It also serves as a therapeutic intervention.
Comparison between liposomes spray and non preserved tears substitutes in patients with meibomian gland dysfunction
Authors: LANGMAN ME , AMOUROUX GICQUEL N , GICQUEL JJ 
Published: September 2008

Abstract Purpose Many elderly people present with lachrymal film lipid phase disorder caused by a meibomian dysfunction. During a prospective randomised study performed in Poitou‐Charente, we compared the use of vegetal liposomes in spray (intended for stabilizing the lipid phase) against one of the gold standard lachrymal substitutes. Methods 50 patients aged 75 years old or older with a functional dry eye syndrome due to a meibomian dysfunction were studied between March and June 2007 in the department of ophthalmology of St Louis Hospital. The first group was treated with vegetal liposomes spray (Vyséo®) (3 sprays /day, eyelids closed). The control group received lachrymal substitutes (Refresh Tears® (Polyvynilic alcohol and Polyvidone) 1 eyedrop 6 tid). The following criteria have been studied: inflammation of the eyelids edge, lid‐parallel conjunctival folds (LIPCOF), break up time (BUT), Schirmer I, best corrected visual acuity (BCVA) and Root Mean Square (RMS) with the Imagine Eyes IRX3 wavefront aberrometer. The statistical analysis was done with Prism for Windows. Results The improvement of inflammation at the eyelids edge, LIPCOF, BUT, and RMS was significantly higher in the group treated by Vyséo®. The Schirmer I had not been modified in neither of the two groups. The best patients’ satisfaction and ease of use scores were found in the Vyséo® group. Conclusion Vegetal liposomes spray is easy to use for elderly patients with meibomian dysfunction and provide them with effective long term discomfort relief.
Role of oxidative stress in glaucoma
Authors: ERB C 
Published: September 2008

Abstract Purpose Glaucoma is the second major cause of permanent blindness worldwide. It is a group of chronic progressive neuropathies of the optic nerve with a loss of visual field resulting from the death of retinal ganglion cells. There are a lot of risk factors known like genetic susceptibility factors, elevated intraocular pressure (IOP), increased age, myopia and vascular diseases but the real pathophysiology is still unknown. Methods In the past several experimentel and clinical studies showed that oxidative stress is involved in this complex process. Results First of all, mitochondria seems to be genetically vulnerable in glaucoma patients as well as damaged by elevated IOP. In the anterior segment trabecular meshwork cells show oxidative DNA damage as well as increased aging and lipid peroxidation. In addition aqueous humor has an reduced antioxidative status. In the posterior segment retina and the optic nerve are involved by an reduced antioxidative status, increased lipid peroxidation and increased apoptosis. Conclusion In summary, oxidative stress is one of the major players in the glaucoma disease and should be taken into the therapeutic management .
Retinal microvascular signs as biomarkers of cardiovascular disease
Authors: KAWASAKI R 
Published: September 2008

Abstract Purpose To review associations of retinal microvascular signs and cardiovascular disease. Methods The retina is a unique site where the in vivo microvasculature can be directly observed and monitored repeatedly over time. Assessing the characteristics of the retinal small arteries and arterioles offers a surrogate means to evaluate associations of changes in the microcirculation in other organs that may be associated with systemic conditions in vivo. Recent advances in retinal photographic imaging techniques have facilitated the development of computer‐assisted methods to measure and quantify subtle variations and abnormalities in the retinal microvasculature. These quantitative assessments have been applied to large populations, of both adults and children, and in community and clinic settings. Results Existing data now convincingly show links between a range of retinal microvascular signs to both clinical and subclinical ocular, cerebro‐vascular, cardiovascular and metabolic outcomes. This presentation will outline the major retinal vascular imaging methods used in large population based studies and provide an overview of novel methods under development. Conclusion Retinal microvascular signs can be biomarkers of cardiovascular disease as well as ocular diseases, independent of traditional risk factors.
The predictive risk factors and grading of pathologic myopia for retinal photographs
Authors: SAW SM 
Published: September 2008

Abstract Purpose To determine the predictive factors and grading for pathologic myopia in several population‐based studies. Methods More than 12,000 fundus photographs are available from large population‐based studies in Singapore including the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) of 1,600 children and SIMES of Malays aged 40 to 80 years. Refractive error measures were performed using the Canon RK‐F1 machine and fundus photographs using the Canon CR6‐45NM non‐mydriatic camera. The number, type and position of the following will be assessed: staphylomas, lacquer cracks, cytotorsion of optic disc, Fuch’s spots, choroidal neovascularization, lattice degeneration, and B peripapillary atrophy. In SCORM, the predictive factors including age of onset of myopia will be assessed. Additionally, genome‐wide analyses (GWA) studies using the Illumina Sentrix HumanHap 550K BeadChips were performed in 1043 SCORM samples. Results The different grades of pathologic myopia with severity of refractive error or axial length will be correlated. In 679 children in SCORM with myopia and 100 with emmetropia, the prevalence of lattice degeneration was 0.15%, there was increased PPA‐to‐disc area ratio with increased axial length and smaller cup‐to‐disc ratios in myopes compared with emmetropes. The GWA scans were run on 969 buccal‐derived and 74‐saliva derived) after excluding 82 samples. Conclusion Myopia has a huge burden because high myopia is associated with potentially visually disabling ocular pathology. Further research should identify the environmental and genetic risk factors for pathologic myopia.
Grading techniques for the assessment of retinal
Authors: GROSSO A 
Published: September 2008

AbstractHistorical perspective Brief history of vascular measurement ‐Leishman ‐Kagan ‐Parr ‐Wisconsin (WESDR, ARIC, CHS) ‐CERA, Melbourne Retinal vessel measurement ‐Validation as epidemiological tool ‐Brief history of technology ‐Retinal arteriolar signs predict various vascular diseases Application of retinal vessel measurement to retinal diseases ‐Diabetic retinopathy, retinal vascular occlusive disorders, uveitis, age‐related macular degeneration, glaucoma ‐Response to treatment (laser, VEGF inhibitors) Exploration of vessel measurement as a vascular test ‐Retinal microvascular evaluation to predict systemic disease Challenges regarding vessel measurement Conclusion
Follow up of a slowly growing melanocytic lesion during 12 years
Authors: VAN GINDERDEUREN R , BLANCKAERT J , LEYS A , SPILEERS W , VAN DEN OORD J 
Published: September 2008

Abstract Purpose We report an atypical case of a very slowly growing and rather flat pigmented lesion in the posterior pole. Methods A women 53 years old at presentation, was followed during more than 12 years for a posterior pole lesion. Periodical fundoscopy, fluoangiography, ICG angiography and ultrasounds were performed. After enucleation in 2008, the definitive diagnosis was made after histopathologic examination. Results Visual decrease because of macular oedema in the left eye was the reason for referral. Fundus examination and fluo‐angiography revealed a slowly enlarging subretinal lesion with abnormal pigmentation and leakage with signs of chronic neurosensory detachment; ultrasound examination showed a cystic lesion with macular oedema. The lesion increased very slowly in thickness until a maximum of 1.5mm. Finally a chronic retinal detachment caused an intractable neovascular glaucoma and necessitated enucleation in 2008. Histopathology showed a diffuse proliferation of small spindled melanocytes with bland, uniform nuclei lacking mitotic activity with some small nests of larger, haevely pigmented epitheloid melanocytes with nuclear pleimorphism, embedded in collageneous matrix. The cell proliferation marker Ki67 showed only rare tumor cells with immunoreactive nuclei,indicating a very low fraction of cycling tumor cells. Other immunohistochemical markers are currently performed in order to elucidate the biological behaviour. Conclusion This case shows a unusually slowly growing lesion with classical histological features of melanoma and suggests the existence of a type of ocular melanoma of extremely low grade malignancy. Further phenotypical profiling is warranted in order to understand the cause of this "benign" behaviour.
Structural and cellular diagnosis of ocular surface squamous neoplasia using in‐vivo confocal microscopy
Authors: PARROZZANI R , GHIRLANDO A , CORTESE M , MIOTTO S , URBAN F , MIDENA E 
Published: September 2008

Abstract Purpose Aim of this study was to analyze in‐vivo structural and cellular features of ocular surface squamous (OSS) neoplasia using clinical confocal microscopy (CM). Methods Ten consecutive cases of OSS neoplasia were investigated using in‐vivo corneo‐conjunctival CM (ConfoScan4, Nidek, Gamagori, Japan) with a 40X surface‐ noncontact objective. Data obtained using CM were also compared to standard histopathology or cytologic samples obtained by scraping technique. Results CM analysis of OSS neoplasia showed good agreement with correspondent tumor cytology or histopathology, revealing some structural and cellular features of the lesions, including: loss of the normal epithelium structure in 10 cases (100%), high‐reflective areas in 10 cases (100%), inhomogeneous cell density in 8 cases (80%), cells debris in 8 cases (80%), abrupt demarcation at the lateral edge of the lesion in 7 cases (70%), nodular zone of cell proliferation in 6 cases (70%), fibrovascular structures in 3 cases (30%), keratin pearls in 1 case (10%) and pre‐Bowman space involvement in 1 case (10%). No anterior stroma involvement was documented. Cells anisocytosis, pleocytosis and anisonucleosis were also documented in 9 of 10 tumors (90%). Conclusion In‐vivo CM seems a reliable, non‐invasive method useful for in‐vivo diagnosis of OSS neoplasia.
Foreign body conjunctival granuloma
Authors: MACHOWICZ‐MATEJKO E , RYMGAYLLO‐JANKOWSKA B 
Published: September 2008

Abstract Purpose To present a case of a small inflammatory epibulbar mass developed soon after a branch of the tree injury. Methods 57‐years old healthy men presented to our Department with complaints of discomfort, foreign body sensation, mild tearing and redness of his left eye. The patient sustained branch tree injury two weeks before. Slit lamp examination demonstrated a small red mass measuring about 3mm in diameter, located at the 3 o`clock position, loosely connected with adjacent tissues. An excisional biopsy of the mass was performed and tissue was send to histopathology laboratory for microscopic analysis. Results Microscopic examination revealed a massive infiltrate composed with multiple giant cell (of foreign body type) surrounding organic material (pieces of wood and plants) together with multiple plasma cells and lymphocytes. Focally neutrophils were also present. Histopathology diagnosis: foreign body conjunctival granuloma. Clinical differential diagnosis should considered: conjunctival benign lesions, Splendore‐Hoeppli fenomenon, inclusion conjunctival cyst or nodular episcleritis. Conclusion 1.Foreign body granuloma should be considered in differential diagnosis of conjunctival epibulbar lesions. 2.Histopathology is crucial for proper and final diagnosis.
Unmet needs in the treatment of glaucoma related to compliance, tolerability and concomitant dry eye
Authors: HOLLO G 
Published: September 2008

Abstract Purpose Compliance to long‐term topical treatment of glaucoma can be less than optimal. This may decrease the efficacy of the treatment. This presentation summarises the unmet needs in the current topical treatment of glaucoma related to compliance, tolerability and concomitant dry eye and discusses the expectations for future therapies. Results Glaucoma is a life long conditions and its management is multifactorial. However, compliance to topical glaucoma treatment can be less than optimal. Forgetfulness and topical side effects have been identified as important reasons for non‐compliance. Topical side effects decrease the quality of life of the patient, which impacts on compliance. Dry eye and glaucoma are often concomitant diseases. Therefore, it is advisable to consider the management of both diseases together for the optimal care for these patients. Preservative free preparations may have benefits for the long term treatment of glaucoma patients, especially those with dry/sensitive eyes. Conclusion Compliance remains a key issue in the management of glaucoma. Glaucoma and dry eye as concomitant diseases present specific challenges for the optimal care of the patient.
Switching from latanoprost to preservative‐free tafluprost
Authors: KAARNIRANTA K 
Published: September 2008

AbstractOcular signs and symptoms of irritation may be of concern for glaucoma patients using preserved eye drops over long term. Jeannen et. al. have shown that switching from preserved beta‐blockers to preservative free beta‐blockers reduces these signs and symptoms in a statistically significant manner(1). This open‐label, multinational, phase IIIb study investigated the changes in ocular signs and symptoms when patients were switched from preserved latanoprost 0.005% to preservative‐free tafluprost 0.0015% (q.d. at 20:00) for 12 weeks. Patients with open‐angle glaucoma or ocular hypertension who had received latanoprost for at least 6 months and had at least 2 ocular symptoms or one symptom and one sign were enrolled (n=158). Change from screening in ocular signs and symptoms were main endpoints. (1)Jeannen at. al. Eur J Ophthalmol 2007; 17(3): 341‐49
To investigate the effectiveness of transpupillary thermotherapy (TTT) for neovascular age‐related macular degeneration (ARMD)
Authors: THIAGARAJAN M , MATTHEWS N 
Published: September 2008

Abstract Purpose The effectiveness of TTT was investigated in terms of the change in Snellen visual acuity (VA) in patients having neovascular ARMD. Methods A total of 84 patients with neovascular ARMD were recruited and the main outcome measures were Snellen VA both before and after TTT. Those with persistent oedema were retreated when assessed after 8 weeks with FFA or after subsequent visits. Results No more than 1 Snellen line was lost in 44(68.8%) patients at 3 months, 41(71.9%) patients at 6 months, and 23 (53.5%) patients at 12 months. There was more than 2 Snellen lines lost in 20(31.2%) patients at 3 months, 16(28.1%) patients at 6 months and 20(46.5%) patients at 12 months. Only 24 patients required more than a single treatment. Conclusion TTT treatment for neovascular ARMD shows the VA to be stable in the short‐term as the majority had no more than a single Snellen line of VA loss. The limitations of this study are the mean follow‐up of 6 months and no more than 50% having 12‐month follow‐up.