bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endophthalmitis prophylaxis in cataract surgery and intravitreal injection in the US
Authors: Schwartz Stephen G. 
Published: December 2022

AbstractEndophthalmitis is not a “never event” following cataract surgery or intravitreal injection, therefore the occurrence of endophthalmitis does not necessarily imply a break in technique or that the surgeon somehow “did something wrong”. Endophthalmitis cannot be prevented, but its rate can be reduced using evidence‐based measures. Endophthalmitis prophylaxis techniques include more than the use of antibiotics; specifically, prep/drape, speculum use, wound construction, etc.In the US, intracameral antibiotics are not universally used. The decision to use routine intracameral antibiotics appears to depend on many “non‐medical” factors, including internal health system policies, local standards of care, and other concerns. In the US, there is no packaged antibiotic that is specifically approved for intracameral use so all such agents are used “off‐label”; this factor appears to be suppressing the use of intracameral antibiotics at least in some locations.In the US, intravitreal injections are almost always performed in the clinic rather than in an operating room or similar setting. (In fact, it can be difficult to get reimbursed for anti‐VEGF drugs injected in an operating room.) Many practices use a standard examination room rather than a minor procedure room or a room dedicated to performing injections. Eyelid speculums are very widely used, although there is a growing acceptance of the use of bimanual retraction from a skilled assistant, rather than an eyelid speculum. In many practices, topical antibiotics are not used.It is the author's opinion (although there is little or no evidence from randomized clinical trials to support this opinion) that post‐surgical endophthalmitis differs from post‐injection endophthalmitis in how the microorganisms gain access to the intraocular space. Following cataract surgery, it seems most likely that microorganisms enter the eye through the incision in the postoperative period; this would explain the relatively later onset of infection, as well as the apparent benefits of postoperative topical antibiotics, proper wound construction, and suturing the incision when necessary. Following intravitreal injection, it seems most likely that microorganisms enter the eye at the moment of the injection; this would explain the relatively sooner onset of infection, as well as the apparent lack of benefit of postoperative topical antibiotics.
Endophthalmitis prophylaxis in cataract surgery and intravitreal injection in Europe
Authors: Grzybowski Andrzej 
Published: December 2022

AbstractEndophthalmitis is a significant complication of cataract surgery and intravitreal injections (IVI), leading in severe cases to blindness. The improvements of surgical technology, techniques and procedures have significantly reduced the incidence of postoperative infections in recent years; however, it is impossible to eliminate this problem completely. The incidence of post‐cataract endophthalmitis varies among several countries from 0.03% to 0.7%. The recommendations of the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO), have set the maximum acceptable level of postoperative endophthalmitis (POE) after cataract extractions at 0.05%. Awareness about risk factors and prevention measures is necessary for ophthalmic surgeons. Surgical complications (wound leak, posterior capsule rupture, vitreous loss or zonular complications) are related with higher incidence of postoperative endophthalmitis. Elderly patients (>85 years), those with clear corneal incisions versus scleral tunnel incisions, and those without intracameral injection of cefuroxime have also a higher risk of infection.The available evidence suggests that intracameral antibiotic lowers the POE. Of the two most commonly used IC antibiotics, moxifloxacin and cefuroxime, there is no clear evidence that one is better than the other. Vancomycin is not recommended for routine ICAP because of both the risk of HORV (extremely low) and concerns regarding the use of an indispensable agent to treat multi‐drug‐resistant endophthalmitis as routine prophylaxis. Topical antibiotics may not provide an additional benefit, as has been suggested by several studies.In IVI, perioperative antibiotics cannot be considered the standard of care, as there is no evidence of prophylactic effects with regard to POE when using perioperative antibiotics. Topical administrations of 5% povidone‐iodine over at least 30 s into the conjunctival sac is recommended. Current clinical practices include minimized physician/patient talking during IVI, wearing of surgical face masks, and using face masks for nurses, technicians and physicians.
Novel options in diagnosis and treatment of endophthalmitis
Authors: Lytvynchuk Lyubomyr 
Published: December 2022

AbstractEndophthalmitis remains the most vision‐threatening condition that in most severe cases can result in a loss of an eye and systemic spreading of the infection. It is defined as an acute inflammation of the inner tissues of the eyeball and is usually caused by intraocular contamination and colonization of infectious agents with exudation within intraocular space. The development of endophthalmitis as well as its clinical presentation and functional and anatomical outcomes is predefined by its type, kind of infection and therapy applied. There is a risk of progression of endophthalmitis to panophthalmitis, which could end up with evisceration or enucleation. The involvement of the general physician and other medical specialists into the treatment of the patients with endophthalmitis shall be always considered and should not be underestimated. As one of the most severe emergencies in ophthalmology, this condition requires urgent therapeutical or/and surgical intervention. Numerous studies compare the efficacy of the first line treatment for different types of endophthalmitis. Since decades the management of endophthalmitis is based on prompt recognition of infectious agents, immediate intraocular antimicrobial therapy and removal of the purulent exudate form the eye. Novel diagnostic options for endophthalmitis shall be considered in order to increase the precision of to treat patients with endophthalmitis. Improvement of the surgical techniques with the development of the new less traumatic instruments and he novel antimicrobial drugs can stablish a new standards of endophthalmitis care.
New strategies that can be neuroprotective
Authors: Cvenkel Barbara 
Published: December 2022

AbstractGlaucoma is considered a neurodegenerative disease and shares some common mechanisms with other neurodegenerative diseases. Therefore, research into the triggers and drivers of neurodegeneration can identify novel areas of therapeutic intervention to preserve and restore vision. Neuroprotection in glaucoma is focused on preserving the neuronal structure and/or function. Currently, lowering of intraocular pressure (IOP) is the only clinically proven neuroprotective strategy. Alternatives to IOP‐lowering approach can be grouped into targets that interfere with excitotoxicity, oxidative stress and mitochondrial dysfunction, inflammation‐abnormal immune response, glial cell modulation, and stem cell therapy. However, any division is arbitrary as most targets are involved in several pathways and/or mechanism of action are incompletely understood. Many agents have shown neuroprotective effect in glaucoma research models but translation into well‐designed human trials and clinical practice represents a major challenge. Several compounds with antioxidant function including vitamin E, C, flavonoids, coenzyme Q10, and citicoline have shown neuroprotective effect in neurodegenerative diseases. Recently, oral nicotinamide supplementation has led to a short‐term improvement of inner retinal function in glaucoma patients. Immune system modulation such as blocking selectively excessive TNF‐alpha and targeting antibodies against ϒ‐Synuclein may prove beneficial. Recently, the receptor agonists of the incretin hormone glucagon‐like‐peptide‐1 (GLP‐1), used for the treatment of diabetes, have shown neuroprotective effects in preclinical and clinical studies on neurodegenerative diseases in both the brain and the retina. Platelet‐derived growth factor and ciliary neurotrophic factor (CNTF) protect cells from neurodegeneration and phase I studies using intraocular implants with slow CNTF release are ongoing. Intravitreal administration of mesenchymal stromal stem cells has shown neuroprotective effect. Gene therapy in glaucoma is still in preclinical phase. A novel adeno‐associated viral vector gene therapy increased production of brain‐derived neurotrophic factor and its receptor and had neuroprotective effect over several months. Altered levels of microRNAs, small non‐coding RNAs involved in post transcriptional regulation of gene expression, were found to be implicated in retinal ganglion cell apoptosis in glaucoma. MicroRNAs may become a novel neuroprotective strategy.
Algorithms for decision on intrastromal ring segment implantation
Authors: Barraquer Rafael I. 
Published: December 2022

AbstractSuccess in improving vision with intracorneal ring segment (ICRS) implantation for keratoconus depends on understanding the phenotype/pattern present in a particular cornea, the relative weight of the different aberrations (astigmatism, coma, spherical), the mechanism of action of the implants, and the possible modalities of implantation. The application of a particular nomogram makes sense only there has been a decision on the location of the implants relative to the selected landmarks (axis of refractive or topographic astigmatism, coma axis, etc.). It is possible to define all possible modalities of implantation of 1 or 2 ICRS based on only two features: whether there is implantation symmetry and the position of the center of the implant relative to one significant landmark (usually the flat topographic meridian) what we call “axiality”. The resulting matrix/classification includes 6 possible modalities. This presentation will develop on the author's methodology for ICRS selection based on this concept.
The origin of the cyclops myth
Authors: Ascaso Francisco Javier 
Published: December 2022

AbstractSince Polyphemus's appearance in The Odyssey nearly three millennia ago, the cyclops has been always linked to the human imagination. Ancient sources for the depiction of a cyclops are numerous. Although Homer's classical poem appears to be the earliest, other Greek and Latin authors mention this group of oddly visaged giants with one large eye in the middle of their foreheads. If adult cyclopes cannot possibly exist, where did the ancient Greeks and Romans get this idea? The answer is unclear, although researchers in a variety of fields have several hypotheses. Throughout this session I will try to solve this question.
The influence of visual pathology on painting
Authors: Mateo Javier 
Published: December 2022

AbstractPainting is, along with sculpture and architecture, the most visual of the Fine Arts and it is probably the most ancient of them. The oldest known paintings were discovered on the walls of caves in Indonesia and Spain and are believed to be more than 40 000 years old.In painting, vision is crucial both for the artists and for the viewers. Diseases affecting the eyes can have a huge impact in the artistic expression of the painters, for instance refractive errors like myopia, hyperopia and astigmatism, disorders related with age such as cataracts, presbyopia and age related macular degeneration or different pathologies including colour blindness, diabetic retinopathy, vitreal haemorrhage, retinal dystrophies, strabismus, tumours… seem to have influenced the paintings of many artists.However, it is difficult to evaluate the degree of the impact that these disorders actually have on the works of the painters. The style of an artist depends on many factors including the time or era they live in, the School of painting they belonged to, religion, politics, the influence of teachers and colleagues and, of course, their own stylistic choice. The way they perceive the world that surrounds them is surely an important factor that affects their creations, but not the only one.In this speech, we will try to look over some famous painters' works and try to explain how their ocular problems influenced their production. We will also discuss some widespread theories about alleged visual problems affecting various artists and their (lack of) accuracy.
History of diagnosis and treatment of cystoid macular edema
Authors: Schwartz Stephen G. 
Published: December 2022

AbstractFollowing the introduction of the ophthalmoscope by Helmholtz in 1851, very early descriptions of macular edema were reported by Jaeger in 1856 and Nettleship in 1872. Macular disease following cataract surgery was described by Hruby in 1950, Irvine in 1953, Chandler in 1954, Nicholls in 1954, and Maumenee in 1957, among others. The introduction of fluorescein angiography by Novotny and Alvis in 1961, with subsequent modifications by David, Sever and Justice, greatly facilitated the diagnosis of this condition. Using fluorescein angiography, Gass and Norton reported 44 patients with “cystoid macular edema” (CME) in 1966, which appears to be the first use of this term. The eponym “Irvine‐Gass syndrome” appears to have been published first in 1971. In 1991, Puliafito and colleagues reported the first use of optical coherence tomography, and published one case of postoperative CME in 1995.Treatments for CME developed as the pathophysiology became better understood. Early reported treatments included oral vasodilators (Laws, 1964), oral prednisone (Gehring, 1968), and pulsed ruby photocoagulation (Zweng and colleagues, 1968). Alternatively, other investigators recommended observation for at least 12 months, including Gass and Norton in 1969 and Jacobson and Dellaporta in 1974. Miyake reported good results with topical indomethacin prophylaxis in 1977; other investigators subsequently reported benefit with topical or oral indomethacin, including Yannuzzi and colleagues in 1979 and Kraff and colleagues in 1982. Various surgical factors, including posterior (rather than anterior) chamber intraocular lenses, were found to be beneficial during the 1980s. Multiple topical medications, including prednisolone acetate, flurbiprofen, ketorolac, diclofenac, and others, were investigated in the 1990s and 2000s. Gaudric and colleagues published treatment of CME with intravitreal triamcinolone acetonide in 2003.At the present time, the use of topical corticosteroids and nonsteroidal anti‐inflammatory agents is widely used in the prophylaxis and treatment of CME, but there is relatively little evidence from randomized clinical trials to support this practice. In both the US and Europe, no agent has achieved regulatory approval for the treatment of postoperative CME; all agents are used “off‐label”.
A comparative map of macroautophagy and mitophagy in retinal cells
Authors: Boya Patricia 
Published: December 2022

AbstractAutophagy is a catabolic pathway that promotes the degradation and recycling of cellular components. This process degrades proteins, lipids, and even whole organelles, which are engulfed in autophagosomes and delivered to the lysosome. Autophagy is a stress‐response that mediates the elimination of harmful cell components and recycles them to generate the nutrients and building blocks required to sustain cellular homeostasis. In addition, it plays an important role in cellular quality control, particularly in neurons, in which the total burden of altered proteins and damaged organelles cannot be reduced by redistribution to daughter cells through cell division. The role of autophagy in the retina and eye diseases is started to be investigated. I will review our main studies describing the role of autophagy in retinal development and cell differentiation, and discuss the implications of autophagy dysregulation both in physiological aging and in important diseases such as glaucoma and retinal dystrophies. Our findings reinforce the essential role of autophagy in maintaining proper retinal function and highlight novel therapeutic approaches for blindness and other diseases of the eye.
The French approach
Authors: Rousseau Antoine 
Published: December 2022

AbstractIf one could define one French specificity regarding the medical management of glaucoma, it would certainly be a high propensity to consider the ocular surface when treating a patient. Therefore, the first part will focus on why the interactions between ocular surface and glaucoma treatments are so important, and how to manage them.Regarding the surgical aspect, French ophthalmologists, more than other, have a preference for non‐penetrating deep sclerectomy, which is considered for many as the reference surgical procedure for open angle glaucoma. Thus, in the second part, we'll consider the pros and cons, and some tips to succeed with this technique.
The aging retina of wild‐type and mouse model of Alzheimer's disease
Authors: Bernardes Rui 
Published: December 2022

AbstractSeveral neurological diseases have been shown to have measurable correlates in the eye, thus further supporting the idea of the retina as a window to brain and neurodegeneration. Retinal imaging techniques, way less complex, more affordable and widely available than their counterparts for the brain, have the potential to provide alternatives to brain imaging techniques such as magnetic resonance imaging (MRI). Also, animal models of disease are expected to allow the investigation of neurodegenerative diseases at states that would be inaccessible in a human patient, particularly at the onset of diseases that may occur decades before diagnosis. In this talk, we will present and discuss data and findings from wild‐type and triple‐transgenic mouse model of Alzheimer's disease by optical coherence tomography (OCT) at the ages of 1, 2, 3, 4, 8, 12, and 16 months old. In addition to commonplace retinal thickness measurements, texture analysis findings and findings from a neural network fed with OCT B‐scans and a neural network fed with OCT computed fundus images will be present and discussed.Funding: This study was funded by The Portuguese Foundation for Science and Technology (FCT) through PTDC/EMD‐EMD/28039/2017 and by FEDER‐COMPETE through POCI‐01‐0145‐FEDER‐028039.
Interaction of immune cells and lymphatic vessels in corneal transplantation
Authors: Bock Felix 
Published: December 2022

AbstractImmune‐mediated graft rejections remain the most common cause for graft failure after organ and tissue transplantation. There is a great unmet medical need for pharmacologic strategies to promote graft survival without unduly compromising the health of the recipient.Corneal allograft rejection is histologically characterized by massive infiltration of CD4+ T‐cells, macrophages and the invasion of blood and lymphatic vessels.We could show that lymphatic vessels determine the high‐risk status of a corneal graft recipient. The healthy cornea is devoid of blood and lymphatic vessels. In contrast, in the high risk situation graft rejection is highly correlated with the degree of corneal vascularisation and presence of numerous pro‐inflammatory immune cells.CD11c+ CD11b+ myeloid dendritic cells (DCs) are present throughout the anterior stroma – even in the healthy cornea. Inflammatory stimuli determine the maturation stage of DCs and their immunogenic properties. It is known that an increasing number of MHC class II‐bearing, antigen specific DCs in cervical draining lymph nodes arise only a few hours after transplantation. This implies that DCs at different maturation stages might be the main initiators of this devastating tissue destruction.The origin of donor antigen presenting cells can be either from the donor tissue or the host. Thereby allo‐antigens from the grafted tissues travel via lymphatic vessels towards the draining lymph nodes of the recipient. Here they are recognized by host T cells either by the direct pathway, which involves the recognition of intact donor MHC molecules on donor‐derived APCs, or by the indirect pathway, which involves the recognition of donor major or minor MHC‐derived peptides, processed and presented by recipient APCs to host T cells. Nowadays it is widely accepted that resident MHC class II APC populations are present in the cornea. These cells are capable of expressing MHC class II antigen and accessory molecules (CD40, CD80) after transplantation. We and others could demonstrate that the immune reaction is triggered by the above described “direct allo‐sensitisation” where APCs travel from the donor tissue via corneal pathological lymphatic vessels into the local draining lymph nodes of the recipient and present the foreign antigen.Recent studies could show that lymphatic vessels not just display an exit route for leukocytes but are in close interaction with these cells and regulate the entry and trafficking of antigen presenting cells into and via lymphatic vessels.This presentation will summarize the current knowledge about the interaction of immune cells and lymphatic vessels in corneal transplantation.