Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 4th International Conference on Clinical & Experimental Ophthalmology Baltimore, USA.

Day 1 :

  • Workshop on
Location: Harbor Room
Speaker

Chair

Carlota Saldanha

University of Lisbon, Portugal

Speaker

Co-Chair

Paulo Filipe

University of Lisbon, Portugal

  • Track 3: Glaucoma: Visual field loss
    Track 4: Neuro-Ophthalmology
Location: Harbor Room
Speaker

Chair

Rebecca M. Sappington

Vanderbilt University School of Medicine, USA

Speaker

Co-Chair

Janardan Kumar

Becker College, USA

Session Introduction

Rebecca M. Sappington

Vanderbilt University School of Medicine, USA

Title: Potential Contribution of IL-6 trans-signaling to the pathophysiology of glaucoma

Time : 11:15-11:35

Speaker
Biography:

Rebecca Sappington earned her M.S. and Ph.D. in Neuroscience from the University of Rochester School of Medicine and Dentistry, where she studied mechanisms of ganglion cell death in glaucoma. Rebecca continued her work on neuronal-glial interactions in glaucoma as a postdoctoral fellow at the Vanderbilt Eye Institute, Vanderbilt University School of Medicine (2004-2009). In 2009, Rebecca joined the faculty at the Vanderbilt Eye Institute, where her laboratory focuses on neuroinflammation in retinal neurodegeneration. Rebecca’s training was supported by institutional training grants from the National Institute for Neurological Disease and Stroke and the National Eye Institute as well as a predoctoral fellowship from the American Foundation for Aging Research and a postdoctoral fellowship from Fight for Sight, Inc.. Her work is currently supported by a RO1 from the National Eye Institute and a Career Development Award from Research to Prevent Blindness, Inc.

Abstract:

Interleukin-6 (IL-6) is a potential neuroprotective factor for retinal ganglion cells (RGCs) exposed to elevated pressure. In glaucomatous retina, IL-6 is produced primarily by microglia and RGCs are the primary targets of IL-6 signaling via expression of IL-6 receptor (IL-6R). We recently examine the impact of IL-6 depletion on disease progression and outcomes in the microbead model of murine glaucoma. Contrary to findings from in vitro studies, our data suggests that global depletion of IL-6 improves RGC and visual outcomes in vivo. Like many cytokines, IL-6 signaling can occur through one of two pathways, the classical pathway and the trans-signaling pathway. The classical pathway is mediated by membrane-bound IL-6R, while trans-signaling is mediated by the soluble form of the IL-6 binding subunit (sIL-6Rα) of the receptor. The trans-signaling pathway is often associated with neurodestructive outcomes of IL-6 signaling. As such, we examined the potential for the trans-signaling to contribute to IL-6-mediated outcomes in glaucoma. Using protein fractionation and immunohistochemical analysis, we determined that expression of sIL-6Rα is elevated in both aged and glaucomatous retina. Interestingly, sIL-6Rα appears to be produced by RGCs and is primarily associated with RGC axons in the nerve fiber layer. Given the axogenic nature of RGC degeneration in glaucoma, these findings have potential implications for identifying novel mechanisms of neuronal-glial interactions that impact axon degeneration in glaucoma.

Speaker
Biography:

Janardan Kumar holds a Ph.D. degree in chemistry under kind supervision of Dr. C.M. Gupta, ex-director, CDRI, Lucknow, India. In the United States, first he received postdoctoral training on motor proteins in the laboratory of Michael P. Sheetz, a lasker award winner, at Duke University Medical Center, North Carolina. He published his work on kinectin, a myocilin like protein, in Science (1995), and an abnormality in myocilin has been predicted to be involved in the pathogenesis of glaucoma. Prior to coming to Becker College, while a research Assistant Professor at Tufts University, Kumar engineered a new real time perfusion system used for the discovery of drugs to treat glaucoma. Presently, Kumar is Chair of the natural sciences department, and is actively engaged in the advancement of course curriculum in microbiology, chemistry, and developing the biotechnology/biology major at Becker College.

Abstract:

Glaucoma is characterized by cupping of the optic nerve head and irreversible loss of retinal ganglion cells. Elevated intraocular pressure due to reduction in aqueous outflow facility is a major causal risk factor in glaucoma. The extracellular matrix (ECM) proteins form a matrix assembly outside the cells which are important for proper maintenance of resistance in the aqueous outflow pathway. Evidence is increasing that correlates increased outflow resistance with an excessive accumulation of extracellular matrix proteins, ECM/ECM-remodeling. However, the relationship of these events to the interaction of outflow pathway cells with their ECM is not fully understood. The most studied factors associated with glaucoma such as corticosteroids and TGF-beta, are also known for increased expression of integrins and ECM proteins in the trabecular meshwork, whereas integrins are a major determinant of ECM deposition in other cellular systems. Since it is well understood in other cellular systems that arginylglycylaspartic acid (RGD-peptide) competes with integrin-ECM interactions and inhibits ECM protein cross-linking, the RGD- containing peptides were perfused in the eyes ex-vivo. Several laboratories have shown inconsistent effects of RGD peptide perfusion on outflow facility either as increased outflow or as having no effects that could be species specific. Clearly, our findings and others support the hypothesis that outflow facility increased by perfusion of RGD-containing peptides in porcine eyes. Our research also suggests the significance, of RGD-containing peptides as potential therapy for glaucoma and/or induction to vitreolysis.

Noelle S Matta

Eye Group in Lancaster Pennsylvania, USA

Title: Use of the Cogan lid twitch to identify Myasthenia gravis

Time : 11:55-12:15

Speaker
Biography:

Noelle Matta has been an orthoptist for 8 years and is chief orthoptist at Family Eye Group in Lancaster Pennsylvania where she has worked for 15 years. She is involved in research and has published over 38 peer reviewed papers, presented over 67 posters and has presented over 48 lectures in many countries including the United States, China, Turkey, Romania and Colombia. Noelle has been involved with the many related committees in organizations including the American Association for Pediatric Ophthalmology & Strabismus, The American Association of Certified Orthoptists, The International Pediatric Ophthalmology and Strabismus Council and The International Orthoptic Association.

Abstract:

Purpose: To evaluate the reliablity of the Cogan Lid Twitch test in a neuro-ophthalmology clinic.
Methods: Cogan Lid Twitch testing was perfromed on adult patients presenting to the neuro-ophthalmology clinic by the neuro-ophthalmologist. The patients were instructed to look straight ahead, up, down and straight ahead again. The upper eyelids were carefully evaluated immediately following this movement for the presence of a brief upward twitch of the upper eyelid, which would indicate a positive Cogan Lid Twitch Test. The test was repeated as needed. We evaluated the findings from the ophthalmology examination along with results of available tests such as serologica findings, MRI’s and CT’s.
Results: Of 117 patients evaluated, 24 patients were found to have Myasthenia Gravis, and 18 of these patients had a positive lid twitch. Of the 98 patients who did not display a positive Cogan twitch, 6 had Myasthenia gravis. We calculated the specificity of the Cogan Lid Twitch to be 99%, with a sensitivity 75% and false positive rate 1%.
Conclusion: The Cogan Lid Twitch test is a specific and sensitive test to use in a nueor-ophthalmology clinic to evaluate for Myasthenia gravis

Speaker
Biography:

Stephen Cook MBBCh, FCS (Ophth (SA)). Resident in East London in the rural Eastern Cape province of South Africa. A general Ophthalmologist with interests incorporating Vitreoretinal, Glaucoma, Cataract and refractive and Occuloplastic surgery. A Director of the Eye Centre East London. He has developed the East London Eye Hospital and African Eye Foundation (PBO). His vision is to develop systems to improve access to a healthcare and training in Africa. Public sector appointment at Frere Hospital. Lecturer at Walter Sisulu medical school. Developed screening methodologies for glaucoma and diabetic retinopathy for implementation into the diverse South African healthcare scenario.

Abstract:

Screening for Glaucoma is difficult at the primary level. Part of the problem is to know whom to refer for expensive investigations. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. The tool utilizes known risk factors that are available in a low-tech environment. This free, web based service is useful in situations where access to specialist care is difficult. The process is educational and assists screeners at the primary level to develop competence in risk assessment. The ELGPS system utilizes a user specific database that can be reported on by individual, screener classification and as a whole data set. Glaucoma has a relatively low incidence in the general population. Linking glaucoma screening to screening for another more prevalent disease such as diabetic retinopathy increases disease detection. The methodology for Glaucoma screening has influenced the establishment of the South African diabetic retinopathy system. This system also utilizes a free, web based database with patient tracking capacity to allow non-screening healthcare professionals access to the screening records. The system incorporates systemic risk for developing sight-threatening retinopathy. This presentation describes the results of the first 400 patients of known diagnosis used to validate the ELGPS tool. Biostatistical analysis a correlation with the established diagnosis with sensitivity of 88% and a specificity of 75%. With this basis for screening, the process behind the development of the SA diabetic retinopathy system is described.

Speaker
Biography:

Talbot completed her medical school at the University of Ottawa (Canada). She then pursued an ophthalmology residency at the University of British Columbia in Vancouver. After graduation, she returned to Ottawa where she works in a private practice. In the summer of 2014, Talbot will be returning to Vancouver for a glaucoma fellowship.

Abstract:

The purpose of our research was to evaluate the accuracy of the visual field index, created for the Humphrey Visual Field Analyzer, in a population of patients with mild to moderate glaucoma. Our study included 42 patients (61 eyes) who had at least 11 years of follow-up in the same glaucoma clinic. Each patient was required to have completed at least one reliable visual field per year. We then divided the compiled visual fields into 2 series; years 1-5 and years 6-11. The first series was used to provide the predicted visual field outcome value and the second series was used as the actual observed value. During our collection of data, a subgroup of patients with at least 1 unreliable visual field in their series was identified. Initially, the unreliable fields were removed to render our predictions. The unreliable fields were then reintroduced to create a comparison. We found that the visual field index software rendered an accurate prediction with a slight overestimation of visual field deterioration. Further evaluation revealed that the software was most accurate for those patients whose predicted visual field index was greater than 90%. The accuracy then declined when the predicted visual field index fell below 90%. There was no statistical difference between the reliable and unreliable groups of visual fields.

Speaker
Biography:

Buys obtained his Ph.D. from the Department of Molecular Biology, Gent University and Flanders Institute of Biotechnology. He is currently an Assistant Professor in Anesthesia at the Massachusetts General Hospital where he studies the role of nitric oxide-cGMP signaling in systemic hypertension (funded by the American heart Association) and primary open angle glaucoma (Funded by an NIH-R01). He has co-authored 46 manuscripts since 2006.

Abstract:

Primary open angle glaucoma (POAG) is a leading cause of blindness worldwide. The molecular signaling involved remains largely unknown. Currently, there is no cure for POAG, available therapies offer incomplete protection, and the disease often goes undetected until irreparable damage has been done. Together, these considerations highlight the need for novel therapeutic approaches, drug targets, and biomarkers. We recently reported that female mice lacking the α1 subunit of the nitric oxide (NO) receptor soluble guanylate cyclase (sGCα1-/- mice) develop POAG, characterized by age-related RNFL thinning, loss of retinal ganglion cells, and optic neuropathy in the setting of an open iridocorneal angle. The optic neuropathy associated with sGCα1-deficiency was accompanied by modestly increased intraocular pressure and retinal vascular dysfunction. In addition, we identified a variant in the GUCY1A3/GUCY1B3 locus (encoding the α1 and β1 subunit genes of sGC, arranged in tandem) that was associated with POAG. Together, these data provide new insights into the pathogenesis and genetics of POAG and identify sGC as a potential therapeutic target for POAG.

Chris Lange-Kuettner

London Metropolitan University, UK

Title: Does seeing in viewpoint perspective require awareness ?

Time : 14:20-14:40

Speaker
Biography:

Chris (tiane) Lange-Küttner obtained her Ph.D. at the Max Planck Institute of Human Development, Berlin, and worked thereafter as a post-doc in Cognitive Science at the Free University of Berlin. Since 1994, she holds an academic faculty position in the UK, initially at the University of Aberdeen, and up to now at the London Metropolitan University. From 2009-2011 she was Professor of Developmental Psychology at the University of Konstanz, Germany. She is also affiliated faculty at the University of Bremen, Germany.

Abstract:

Drawing in perspective seems to involvea prolonged development and is not usually present in children’s drawings before about age nine - at least as found in previous research. This is why psychologists think that seeing in perspective requires awareness. In the present study, we built several 3D spatial models to simulate the developmental stages of children’s spatial drawing systems, a simple platform without spatial constraints (stage 1), a platform with walls and a skylid (earth model) (stage 2). Stage 3 (orthogonal) and stage 4 (perspective) models had explicit boundaries around the spatial field to denote areas, and a matched control that controlled for the surround area outside the boundaries. Four age groups from seven to 10 years of age drew fivenon-overlapping figures.All age groups adapted the average figure size to the level of the spatial system (stage) of the models, but only when explicit spatial field boundaries were available: The more advanced the spatial system, the smaller the average figure size. Strikingly, 7- to 8-year-old children drew in perspective as often as 9- to 10-year-olds when the spatial models had a trapezoid field with converging diagonal sides. This earlyperspective mapping may have occurred because of the agreement between retinal image (appearance) and design (identity) of the perspective models (embodied perspective). Hence, this is the first study to show that typically developing young children can access low-level visual information and draw in viewpoint perspective without awareness of the visual-mathematical concept of perspective construction.

  • Track 1: Cornea & External Eye Disease
Location: Harbor Room
Speaker

Chair

Manuel B. Datiles

National Institutes of Health, USA

Speaker

Co-Chair

Yassine Daoud

The Johns Hopkins University School of Medicine, USA

Speaker
Biography:

Manuel B. Datiles III, M.D. is a medical officer, senior attending ophthalmologist, senior clinical investigator and former chief of the OGCSB cataract section for the National Eye Institute-NIH. He conducts studies on the pathogenesis of cataracts and development of anti-cataract agents. He has published over a hundred papers in the major ophthalmology journals and serves as an ad hoc editorial board member and reviewer for these major ophthalmic journals. He sees consult eye patients from within NIH including those with ocular graft versus host disease, and is visiting lecturer at the Wilmer Eye Institute of Johns Hopkins University Hospital.

Abstract:

Cataract remains the main cause of blindness in world, and medical treatment is needed. Recently, Alpha crystallin proteins have been found to act as built-in anti-cataract lens proteins, functioning as molecular chaperones to protect other lens proteins from oxidative stress damage, thereby preventing cataracts from forming. We have developed a Dynamic Light Scattering clinical device (DLS) that can measure alpha crystallins in the lens clinically (as Alpha Crystallin Index or ACI). Results from a large cross sectional study conducted at the NEI/NIH on patients with age related cataracts and normal controls showed that alpha crystallin protects the lens from nuclear cataract formation and that loss of ACI over time is associated with nuclear cataract formation and progression. This study suggested that ACI may be a useful measure of protective alpha crystallin molecular chaperone reserve in the lens, analogous to creatinine clearance in estimating renal functional reserve. We recently conducted a longitudinal study at the Wilmer Eye Institute of Johns Hopkins Hospital on 45 patients (66 eyes) followed every 6 months for a mean of 19 months (range, 6-35.5 months). We found that those eyes with the highest levels of ACI were least likely to develop cataracts and those with the lowest levels of ACI had the highest risk for cataract and cataract surgery. Since DLS detects loss of ACI associated with oxidative stress damage to lens proteins, ACI may be useful as a biomarker for oxidative stress damage to other body tissues resulting in aging and age related diseases.

Yassine Daoud

The Johns Hopkins University School of Medicine, USA

Title: Use of femtosecond laser in cataract surgery

Time : 15:00-15:20

Speaker
Biography:

Daoud specializes in cataract and refractive surgery, as well as the diagnosis and treatment of corneal disorders including Fuchs dystrophy and keratoconus. Daoud received his M.D. degree from Harvard Medical School and completed an internship at Johns Hopkins Hospital where he was the recipient of the “Best Bedside Skills” Teamwork Award. His ophthalmology residency was completed at Duke University Eye Center and he completed his cornea fellowship at the Wilmer Eye Institute. In addition to his commitment to excellent patient care, Daoud is a published author in multiple ophthalmology journals and is involved in research to improve ocular health.

Abstract:

Cataract is the leading cause of blindness worldwide, and cataract surgery is one of the most common surgical procedures. In developed country settings, cataract surgery is most commonly performed by phacoemulsification (PE). Recently, a new procedure, Femtosecond-laser-assisted cataract surgery (FLACS), has been introduced in which a laser is used to perform certain important steps of cataract surgery. There is the potential for FLACS to reduce complications of cataract surgery, in particular as they relate to corneal endothelial damage and wound architecture. The former is associated with pseudophakic bullous keratopathy (PBK), a complication of cataract surgery in which corneal endothelial cells are lost. An improvement in wound architecture may reduce the rate of post-operative endophthalmitis (POE) and wound leaks. However, actual clinical benefits from use of FLACS have not been documented in controlled studies. Further, the outcome of FLACS has not been studied in an objective and methodical way. Such studies are particularly required given the substantial increase in operative time and expense associated with FLACS. In this talk, we will objectively assess the major studies that have been published to date addressing FLACS.

Break: Coffee Break 15:20-15:35 @ Prefunction Area
Speaker
Biography:

Arpitha Parthasarathy completed her Ph.D. from Aravind Eye Hospitals, India and Postdoc from National Institutes of Health, Maryland. She had her short postdoctoral stints at GWU and University of Kentucky in corneal wound healing and angiogenesis of retina and cornea. She has published in many peer reviewed ophthalmic journals and is now the “Director of Translational and Molecular Biology Research” at Jerome Canady Research Institute for advanced Biological and Technical Sciences, US Medical Innovations, Takoma Park, Maryland.

Abstract:

Corneal epithelial stem cells at the limbus in response to wound are triggered to migrate and suppress proliferation at leading edge. Increased proliferation of basal epithelial cells containing stem cells and concomitant stratification occurs leading to migration of epithelial cell sheet. The extracellular and intracellular signaling pathways that regulate these processes in corneal epithelium by modulating the cell-cell matrix and cell-cell adhesion are less understood. In order to understand the maintenance and functioning of stable cell-cell junctions in corneal epithelium, we studied the protein CDK5 at cell-cell and cell-matrix adhesions during migration. Immuno fluorescence showed co-localization of CDK5, p35, and CDK5(pY15, active form of CDK5) with E-cadherin at cell-cell boundaries indicating that they form an intracellular complex. Inhibiting CDK5 activity with olomoucine (pharmacological inhibitor of CDK5) increased the degradation of surface-biotinylated E-cadherin, generating a degradation product of 29KDa. In contrast, p120 catenin levels were increased two-fold. Similar changes in E-cadherin and p120 expression were seen in cells treated with the CDK5 inhibitor, olomoucine. Reduced E-cadherin immunofluorescence intensity in ShCDK5 was similar to olomoucine treated cells. TIRF analysis of pEGFP-E cadherin in live transfected cells revealed trafficking of cadherin was reduced as opposed to p120. Suppression of CDK5 expression with Sh RNA confirmed previous results obtained with olomoucine and indicating arole for CDK5 instabilizing cell-cell junctions. CDK5 Kinaseis therefore required to prevent the dissociation, degradation and cadherin–catenins witch, indicating that CDK5 was required for maintaining stable epithelial cell-cell adhesions, homeostasis and tissue repair.

Speaker
Biography:

Miguel Rechichi has completed his training in ophthalmology at 28 and his Ph.D. at 32 from Magna Graecia University and Diploma of Specialist Superior in Ophthalmology from University of Lugano (Switzerland). He’s actually a researcher for Magna Graecia University and Director of Corneal and Refractive Surgery service of S. Lucia Eye Clinic, Cosenza, Italy. He was a pioneer of crosslinking clinical application and actually is involved in developing new accelerated cxl protocols for which he’s invited as opinion leader to several meetings.

Abstract:

Prior to the advent of the corneal collagen cross-linking procedure, no conservative treatment for corneal ectasia existed, with 20 percent of keratoconus patients progressing to eventually require penetrating keratoplasty. Crosslinking has not only revolutionized the treatment of ectatic disorders, but has also become a platform technology with numerous additional clinical applications. The speaking will be focues on a comprehensive understanding of the science and clinical applications of corneal cross-linking including the advances in surgical techniques and riboflavin solutions (someone personally proposed and published) that have been derived from the clinical experience. An overview on the evolution of cxl device will be discussed on the light of actual evidence, technology and trends. Finally the discussion will close with a glimpse into the exciting future of corneal cross-linking and cutting edge crosslining technology that will be early present in the market.

Speaker
Biography:

Sowmya Ravikumar completed her optometry training in India at the Elite School of Optometry, Birla Institute of Technology and Science. She did her clinical internship at Sankara Nethralaya Eye Hospital at Chennai, India. Following this she completed her doctoral studies at Indiana University Bloomington at the School of Optometry. Her thesis work focused on the effects of optical aberrations on image quality and visual performance. Since graduation she has pursued a post-doctoral fellowship at the University of California Berkeley under the guidance of Dr. Banks. For her post-doctoral work, she has focused on binocular visual performance with presbyopic corrections.

Abstract:

Purpose: To evaluate the impact of target distance on polychromatic image quality in a virtual model eye implanted with hybrid refractive/diffractive lenses. SETTING: Indiana University, Bloomington, Indiana, USA.
Design: The study used a virtual eye model as the primary computational technique.
Methods: A model eye was constructed by incorporating a phase delay map for a diffractive optical element into a reduced-eye model incorporating ocular chromatic aberration, pupil apodization, and higher order monochromatic aberrations. The diffractive element was either a monofocal lens of +3.2D diffractive power, or two types of bifocal lenses (unapodized or apodized) of +2.92D ‘add’ power. Polychromatic point-spread functions and image quality for white and monochromatic light were quantified for a series of target vergences, wavelengths and pupil diameters, using modulation transfer functions and a variety of image quality metrics.
Results: Ocular longitudinal chromatic aberration was largely corrected by the monofocal design and by both bifocal designs for near targets. In the bifocal design, add-power and the ratio of distance-near image quality changes significantly with wavelength and pupil size. Also, image quality for distance is better with the apodized design.
Conclusions: Achromatization, by the diffractive lens provides significant improvement in polychromatic retinal image quality. Along with apodization and higher order aberrations, it can significantly affect the near/distance balance provided by a diffractive multifocal lens.

Oleksiy Buznyk

Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine, Ukraine

Title: Past, present and future of artificial corneas: Ukraine experience

Time : 16:35-16:55

Speaker
Biography:

Oleksiy Buznyk earned his M.D. from Crimea Medical University and ophthalmology residency from Odessa Medical University. He has completed his Ph.D. at the age of 29 from Filatov Institute of Eye Diseases and Postdoctoral studies from Linköping University. He is the Head of Eye Burns Department at Filatov Institute, specialized center that exclusively deals with and treats eye burns and their consequences, being one of the leading international Keratoprosthesis Centers. Buznyk’s main areas of expertise are cornea and oculoplastic surgery with special interest in human donor cornea substitutes. He has published 26 papers in peer-reviewed journals.

Abstract:

i) Filatov Institute (FI) develops human donor cornea substitutes since 1960-s. Original keratoprosthesis models and their implantation methods were developed during this period. 1060 keratoprosthesis surgeries were performed. Main indications were leukomas contra-indicated to conventional keratoplasty (burn, pemphigoid, aphakic keratopathy, etc.). As a result of keratoprosthesis, visual acuity of 2/200-20/20 was restored and preserved in 1023/1060 eyes (96.5%) in 1-35 year follow-up. Stable keratoprosthesis fixation in the cornea was achieved in 986/1060 eyes (93%). ii) At FI in collaboration with Ternopil Medical University there was developed technology of porcine cornea processing to fit it to xenotransplantation in human. First-in-man clinical trial of cryo-lyophilized porcine cornea transplantation in patients with severe cornea disease (extensive corneal ulcer, melt, perforation) was started in 2010. 57 patients (61 eyes) underwent tectonic xenocornea grafting. All eye globes were saved and light perception was preserved in 1-4 years follow-up. iii) Next generation keroprosthesis – collagen-based cell-free implant – is being developed at FI in collaboration with Linkoping University since 2009. First-in-man clinical trial to test safety and effectiveness of the implants in patients with corneal ulcers was initiated at FI: 4 patients (4 eyes) were grafted with developed implants after lamellar excision of the ulcerated areas. After 6-12 months post-grafting, all implanted corneas had a stable epithelium and visual acuity improved compared to pre-operative levels. Due to increasing worldwide shortage of human donor corneas, keratoprosthesis, cornea xenotransplantation and biosynthetic collagen implant technologies developed and being developed at FI are perspective methods for eye globe preservation and vision restoration.

Yassine J. Daoud

The Johns Hopkins University School of Medicine, USA

Title: Surgical management of dislocated IOL's.
Speaker
Biography:

Daoud specializes in cataract and refractive surgery, as well as the diagnosis and treatment of corneal disorders including Fuchs dystrophy and keratoconus. Daoud received his M.D. degree from Harvard Medical School and completed an internship at Johns Hopkins Hospital where he was the recipient of the “Best Bedside Skills” Teamwork Award. His ophthalmology residency was completed at Duke University Eye Center and he completed his cornea fellowship at the Wilmer Eye Institute. In addition to his commitment to excellent patient care, Daoud is a published author in multiple ophthalmology journals and is involved in research to improve ocular health.

Abstract:

The optimal treatment of intraocular lens (IOL) subluxation remains contested, and clinical trials comparing the various methods employed are limited. The possible surgical approaches to treat IOL subluxation include IOL exchange to an anterior chamber IOL or an iris-claw IOL; scleral fixation of a posterior chamber (PC) IOL; or iris fixation (including iris suture fixation). Typically, a surgeon�s technique of choice for the treatment of subluxated IOLs depends largely on that surgeon's experience with a certain method. This presentation will discuss some of these techniques through video presentations with special emphasis on the instruments needed for the surgery as well as pearls for a successful surgical outcome.

  • Track 2: Retina & Retinal Disorders
Location: Benjamin Banneker
Speaker

Chair

Sayon Roy

Boston University School of Medicine, USA

Speaker

Co-Chair

Eugenia Poliakov

National Eye Institute, USA

Session Introduction

Chi-Chao Chan

National Institutes of Health, USA

Title: Animal models of age-related macular degeneration in different species

Time : 13:20-13:40

Speaker
Biography:

Chi-Chao Chan earned her M.D. from Johns Hopkins University and ophthalmology residency from Stanford University School of Medicine. She has completed two post-doctoral fellowships: ophthalmic pathology at Wilmer Institute, Johns Hopkins and clinical ocular immunology at National Eye Institute, National Institutes of Health. Chan is the Chief of Immunopathology Section, Laboratory of Immunology and Head of Histopathology Core, National Eye Institute, the federal government medical research institute in the US. She has published more than 600 papers in peer-reviewed journals and one textbook. She also serves as an editorial board member for 20 medical journals.

Abstract:

While the best animal model for age-related macular degeneration (AMD) should be the nonhuman primate because it has a macula leutea, the cost, availability, and ethical issues have largely limited its usage. Instead, researchers prefer to use the mouse as it can be genetically manipulated. Although the mouse has no maculae and rarely develops drusen, its neuroretina and retinal pigment epithelium (RPE) can develop lesions simulating certain features of AMD. Such lesions include focal RPE and photoreceptor degeneration as well as increased A2E levels. Different genetically engineered AMD mouse models often provide valuable information into AMD pathogenesis and have become useful tools for screening novel preventive and therapeutic compounds for the disease. While using a mouse model can have great benefit on this preclinical research, appropriate controls are critical to assess experiments. In general, there are group control and self control paradigms for the experimental design. In the group control experiment, the genetically manipulated mice with retinal AMD-like lesions and the wild type control mice without retinal AMD-like lesions are randomized by age, size, and weight. The AMD mice and control mice are further divided to treated and non-treated (or placebo-treated) groups (4 total). At the end of the experiment, the group of treated mice is compared to control group of the same mouse strain to determine the efficacy of treatment. In the self control experiment, the two eyes of the same mouse are treated differently; one eye receives a therapeutic agent and the contralateral eye receives a control agent or placebo. At the end of the experiment, the same mouse’s eyes are compared. However, in addition to the lack of macula, the mouse models have other limitations, including small globe size and simple retinal structure, for which some other models have been developed to address. Rat models have the advantage of larger eye size than mouse. Rabbits has a totally dissimilar retinal vasculature compared to human eyes and can be only applied for evaluation of pharmacokinetics and pharmacodynamics. While the pig eye has similar measurements and an area of enriched cone density like humans, more studies are required in this animal to validate its usefulness in AMD studies. In any of these models, findings may not always reflect those in AMD patients. Careful interpretations of animal experiments with clinical and in vitro data will improve our understanding of AMD pathogenesis and our ability to prevent and treat the disease.

Sudhakar Akul-Yakkanti

Stanford Research Institute (SRI) International, USA

Title: Angioinhibitory signaling mechanism(s) in choroidal endothelial cells by endogenous metabolite

Time : 13:40-14:00

Speaker
Biography:

Sudhakar Yakkanti, Associate Director/Senior Scientist at Center for Cancer & Metabolism, Cell Signaling Laboratory, Bioscience Division, Stanford Research Institute (SRI) International, Menlo Park, California. Earlier he was founder Director of Cell Signaling, Retinal and Tumor Angiogenesis Laboratory at BTNRH, Omaha, NE, USA (2004-2012). He did his postdoctoral training at Harvard Medical School, Boston, MA, USA (2003). He received President’s fellowship (1992), GATE (1996) and CSIR (2007-2000) fellowships from Government of India. He received Mahindra & Mahindra Educational Award (2000) and Young Clinical Scientist Awards from Flight Attendant Medical Research Institute (FAMRI) in 2007 and 2010. He also received Bio-Bio Young Scientist Award from OMICS publishing group; Michael A. O’Connor Young Investigator Award; RO1 grant Award from NIH/NCI and Research Scholar Grant Award from ACS (2010). He was served as AIBS/NIH-RO1 Grant reviewer for DT study section. He has published more than 40 research articles in several top journals including Science, Cancer Cell, JCI, Blood, PNAS, Gastroenterology, Cancer Research, JBC, IOVS, PLOS ONE etc. He is serving as an Editor-in-Chief and Editorial board member of reputed journals and is serving as a reviewer for many scientific journals including JCI, Blood, Circulation, Circulation Research, Cancer research, Clinical Cancer research, IOVS etc. He was honored as honorable gust, keynote speaker, session chair and organizing committee member for many national and international conferences.

Abstract:

Choroidal Neovascularization (CNV) leads to loss of vision in Age Related Macular Degeneration (AMD) that affects approximately 1 in 3 individuals over the age of 65. CNV of AMD is as common as cancer and one of the most prevalent causes of blindness in the world. It has long been recognized that drugs targeting neovascularization may provide new and useful tools for the treatment of patients with CNV of AMD. The present available therapies in clinical trials come in the form of antibodies or antibody fragments that inhibit VEGF, which can only slow the progression of this eye disease. A renewed effort must therefore be made to identify efficient endogenous molecules that could be exploited as therapeutic agents. Thus, the present study identified angioinhibitory signalling mechanism(s) of endogenous metabolite, whose mechanism of actions is yet to be deciphered

Patrice E. Fort

University of Michigan, USA

Title: Key role of alpha- Crystallins in aging-related retinal disorders

Time : 14:00-14:20

Speaker
Biography:

Fort earned his M.S. in Neurosciences and Ph.D. in Cellular and Molecular Aspects of Biology from the University of Strasbourg (France) before joining in 2005 the Penn State Retina Research Group to study the diabetes associated mechanisms that lead to vision loss. Promoted faculty in 2008, he characterized the role and regulation of crystallin proteins in the retina during diabetes. He was then recruited in 2011 as an Assistant Professor in the Department of Ophthalmology of the University of Michigan where he continues to study the regulation of intrinsic protective mechanisms in the retina under normal and pathological conditions.

Abstract:

One of the major visual complications due to aging is cataract formation and is often associated to mutations and alterations affecting crystallin proteins. Because of this, the roles of crystallins in the lens during aging have been extensively studied, but recent observations have raised growing interest about their implication in normal and pathological aging of the retina. Function and regulation of α-crystallins were analyzed using biochemical approaches on tissues from ko-α-crystallin animals under normal and pathological conditions. Ko-α-crystallin mice were also used to dissect the respective functions of αA- and αB-crystallins in the retina during normal and pathological aging. Retinal anatomy and functionwere analyzed by performing longitudinal studies using non-invasive methods. Additionally mass spectrometry was used to study the post-translational modifications affecting α-crystallins in relation to their functional activity. We demonstrated that protein-protein interactions involving αA- and αB-crystallinsare disrupted in pathological aging conditions. In addition we demonstrated that under these conditions, their solubility and sub-cellular properties were altered and that it is associated with specific changes of phosphorylation affecting their chaperone function. Interestingly while absence of αA- or both αA- and αB-crystallin led to a larger increase in retinal cell death and perturbations of retinal functions during aging, absence of αB-crystallin prevented any anatomical or functional defects. This work clearly demonstrates that pathological aging is associated with disruption of the protective function of α-crystallins in the retina through alterations of protein-protein interaction associated with post-translational modifications and biochemical alterations. This study demonstrates how pathological aging can alter the action and regulation of intrinsic protective mechanisms in the retina.

Speaker
Biography:

Eugenia Poliakov has completed her Ph.D. in chemistry at the age of 26 years from Case Western Reserve University and Postdoctoral studies from National Eye Institute, NIH. From 2006 to present she is a Staff Scientist at Laboratory of Retinal Molecular and Cell Biology, NEI, NIH. She has published more than 20 papers in per-reviewed journals.

Abstract:

Incomplete degradation of outer segments (OS) by retinal pigment epithelium (RPE) leads to the accumulation of storage bodies containing autofluorescent lipofuscin, which consists of a mixture of lipids and bisretinoids including A2E. A2E and its oxidation products are major components of lipofuscin and its accumulation is implicated in pathology of Age-Related Macular Degeneration (AMD). However, A2E accumulates in RPE during normal aging. In this study we developed a cell model to determine the coping mechanisms of RPE cells to A2E accumulation. To distinguish between pathologic and normal response of RPE to A2E accumulation we used fully differentiated ARPE19 cells multiply treated with low micromolar amounts of A2E. Then the A2E-treated ARPE19 cells were challenged with OS and compared with non-treated cells for lysosomal functions, degree of OS degradation and melanization. We found that fully differentiated ARPE19 cells uptake, accumulate and partially oxidize A2E under dim light conditions. A2E is stored in lysosomes and leads to an increase in lysosomal pH. Upon challenge with ROS, A2E-treated ARPE-19 cells show an increase in melanin pigment. In addition, the specific activities of the lysosomal enzymes cathepsin D and acid phosphatase are decreased in A2E treated cells. We have developed a new ARPE19 cell model where melanization was elicited as a response to chronic accumulation of RPE’s natural toxin A2E. We found that although A2E treatment leads to lysosomal alkalinization and some lysosomal impairment, as has been previously reported, ARPE19 cells compensate by increased production of a special type of lysosomes – melanized lysosomes.

Frank LaFranco

Northwestern University, USA

Title: Current choices in the repair of primary retinal detachments

Time : 15:00-15:20

Speaker
Biography:

LaFranco received his M.D. degree from Loyola University Stritch School of Medicine in June 1971. His Ophthalmology training was done at Northwestern University and he continued his training at Cornell University in New York with Professor Harvey Lincoff as his retinal fellow. There he met Professor Ingrid Kreissig. Lafranco returned to Chicago,Illinois and joined the teaching staff of Northwestern University where he is currently an Assistant Professor. LaFranco has participated in over 30 of Professor Kreissig's International Teaching Courses around the world as a faculty member speaking and many subjects related to retinal and vitreous surgery. Through her he has met and worked with many leading retinal and vitreous surgeons from China, Japan, Thailand,Korea, Ukraine, Russia, Poland, Slovakia, Sudan, Romania, Bulgaria, Great Britain, Italy, and Germany. His current project relates to assembling the collective experiences of these International lecturers to determine the current concepts being used to repair primary retinal detachments.

Abstract:

The field of retinal surgery has been progressing rapidly around the world with many options available for surgical repair of primary rhegmatogenous retinal detachments. The preferred treatment varies markedly around the world. Primarily the two most common forms of treatment are an extraocular approach utilizing scleral indentation to close the retinal break abexterno or an intraocular approach to relieve traction on the retinal break ab interno. Professor Ingrid Kreissig has been at the forefront of retinal education for two decades. She has taught over one hundred courses around the world utilizing experienced retinal surgeons from numerous countries as her faculty for these courses. The experience and expertise of these faculty members will be documented by using a questionnaire to each faculty member presenting numerous cases and asking them to provide their strategy for deciding which of the current forms of treatment they would recommend. The respondents would represent leading retinal surgeons from the USA, Germany, England, Italy, Greece, Spain, Bulgaria, Japan, Romania and other countries. By analyzing the results of the questionnaire, we hope to elucidate the current strategies for the repair of retinal detachments in use today around the world.

Break: Coffee Break 15:20-15:35 @ Prefunction Area
Speaker
Biography:

Elia Duh is Associate Professor of Ophthalmology at the Wilmer Eye Institute in the Johns Hopkins School of Medicine. He specializes in retinal vascular diseases such as diabetic retinopathy. He received his bachelor degree in molecular biophysics and biochemistry from Yale University. He subsequently earned his medical degree at Harvard Medical School. Duh completed his ophthalmology residency and fellowship in medical retina at the Wilmer Eye Institute.

Abstract:

Inflammation and oxidative stress play an important role in the development and progression of diabetic retinopathy and other retinal vascular diseases. These processes contribute significantly to retinal damage and dysfunction in these conditions, including vascular permeability, neuronal impairment, and capillary degeneration. It is therefore critical to gain further insights into the mechanisms governing oxidative stress and inflammation in the retina, as well as approaches for modulating these processes. The transcription factor nuclear factor erythroid-2-related factor 2 (also known as NFE2L2 or NRF2) is an important regulator of oxidative stress and also has anti-inflammatory effects. It is well-known to play a cytoprotective role in many tissues systemically, but its effects in the retina have been less clear. Our lab has shown that Nrf2 is expressed in the retina in multiple cell types. In order to determine the role of Nrf2, we are examining the effects of Nrf2 deficiency in mouse models of retinal vascular disease, including ischemia-reperfusion injury and diabetic retinopathy. We find that Nrf2 knockout mice (Nrf2 -/-) exhibit significant exacerbation of oxidative stress and inflammation in these models. In addition, Nrf2 knockout mice exhibit increase in pathological endpoints in these models, including retinal vascular permeability, neuronal impairment, and capillary degeneration. With systemic administration of a triterpenoid, we are able to activate Nrf2 in the retina and thereby ameliorate retinal damage. Together, this indicates that Nrf2 plays a protective role in the retina, and pharmacologic modulation of Nrf2 represents a potential therapeutic strategy for retinal vascular disease processes.

Speaker
Biography:

Luiz Guilherme, is graduated in Medicine from the University of Grande Rio - RJ- Brazil, He did his Ophthalmology residency at the Hospital de Olhos Santa Luzia / Santa Luzia Foundation (Recife - PE - Brazil). He did his fellowship in Retina and Vitreous by Federal University of Goias, after graduating from the Federal University of Goias. He is a member of the Brazilian Council of Ophthalmology (CBO), Brazilian Society of Retina and Vitreous, International Member of the American Academy of Ophthalmology, the American Society of Retina Specialists also he posses the membership of Scientific reviewer of the Brazilian Archives of Ophthalmology, the Expert Board and Scientific reviewer of the International Journal of Ophthalmology. He contributes as author of scientific publications and chapters books of ophthalmology, he is serving as a professor of the Ophthalmology Residency at the Hospital de Olhos Santa Luzia.

Abstract:

Purpose: To evaluate the feasibility of the combined use of bevacizumab (Avastin®) and combined with infliximab (Remicade®) in the treatment of naive choroidal neovascularization (CNV) due to age-related macular degeneration (ARMD) eyes. Methods: Intravitreal injections of bevacizumab combined with infliximab in 6 neovascular ARMD eyes. All patients underwent complete ophthalmologic examination on the initial visit and at days 1, 30, 60, 90, 120, 150 and 180 following the first injection. Optical coherence tomography (OCT) and fluorescein angiography (FA) were performed during at initial visit and monthly during the 6 months follow-up period. Electroretinography was performed before and 30 days after initial injection, in order to evaluate retinal toxicity induced by such treatment. Results: Thirty days after the first injection, 5 eyes (83%) shown decrease in macular thickness. No change was seen in electroretinogram (ERG) in any eyes compared to initially performed electroretinogram. |All phakic eyes developed cataract. One patient developed vitritis and was submitted to medical treatment successfully. At the end of the 6 months follow-up period, 4 patients showed significant improvement in the exudative process of choroidal neovascularization (CNV). One eye had mild persistent sub macular fluid without active choroidal neovascularization, and, intraretinal fluid with observed in the remaining eye due to active choroidal neovascularization. Conclusion: The combined use of bevacizumab with infliximab in eyes with neovascular age-related macular degeneration was effective in reducing leakage and improving the macular thickness. However, it’s not possible to assert that the results were related to synergic effects of the combination therapy .A controlled study with more cases is necessary to precisely define the complication rates; however the dosage and/or association of drugs studied in this research shouldn’t be recommended in clinical practice due to cataract as well as inflammatory reaction.

Speaker
Biography:

Nadia Kičová has completed her M.D. in 2007 from Faculty of Medicine of Giessen, Germany. She completed her ophthalmology residency in University of Marburg. She obtained the title of FEBO in 2012 (Fellow of European Board of Ophthalmology). Her Ph.D. thesis was based on Electrophysiological Characterisation of Escherichia coli`s α-Hämolysin induced Membrane Pores in Human Embryonic Kidney Cells (at the age of 30). She has published 8 papers in reputed journals and is the reviewer of 3 international journals.

Abstract:

Purpose: To find the most reliable and efficient non-invasive technique to detect a posterior vitreous detachment.
Design: In a prospective study on 30 eyes of 30 patients with macular pucker or macular hole formation the posterior vitreous cortex was examined by three independent investigators via slit-lamp biomicroscopy, 10 MHz b-scan ultrasound and optical coherence tomography via OCT III Stratus® (Carl Zeiss Meditec Inc. Dublin, CA) and RTVue-100-OCT (Optovue Corp., Fremont, CA). In each examination the state of the posterior vitreous adhaesion was classified as “attached“ or “detached“. These findings were compared during a triamcinolone-acetonide-assisted vitrectomy one day later.
Results: Vitrectomy showed in 60% a posterior vitreous detachment and in 40% an attached posterior vitreous cortex. B-scan ultrasound and biomicroscopy revealed the highest, correct evaluation of the posterior vitreous status with 83% and 76% respectively. The prediction of the OCT only applied in 12.5% of all cases. In all other cases the evaluation by OCT was not possible or inadequate.
Conclusion: The prognostic most reliable, but investigator-dependent methods to detect whether the posterior vitreous cortex is detached, are b-scan-ultrasound and biomicroscopy. The objective technique of the high-resolution, two-dimensional time-domain OCT allows only in a few cases a clear differentiation of preretinal structures.

Speaker
Biography:

Ana Miguel has completed her M.D. in 2007 from Faculty of Medicine of Oporto University, Portugal. She completed her ophthalmology residency in Central University Hospital of Coimbra. She obtained the title of FEBO in 2013 (Fellow of European Board of Ophthalmology). Her Ph.D. thesis was based on detection of adverse drug reactions: validation of methodologies and application in Ophthalmology (at the age of 30). She has published 22 papers in reputed journals, she is the reviewer of 6 international journals and editorial board member of: World Journal of Meta-analysis, Journal of Ocular Diseases and Therapeutics and Clinical Case Reports Journal.

Abstract:

Purpose: We intended to perform a videotaped evaluation of the difficulties in eyedrop administration and in daily tasks in patients with advanced glaucoma, and to project and design a new device for aid in eyedrop administration.
Methods: After approval by the hospital ethics committee, we conducted structured interviews with questionnaires (demographic data, quality of life) and ophthalmologic evaluation to patients with advanced glaucoma and visual impairment, during 5 months, if patients respected inclusion criteria and gave informed consent. We videotaped patients while performing standardized daily tasks (eyedrop instillation, stairs, walking in a room with obstacles and walking in an irregular floor). Knowledge gained about difficulties in self-instilling eyedrops was used for designing a new device that could aid patients in this task.
Results: Of twenty five patients, seventeen reported no difficulty self-administrating the eyedrops but 20% were unable to do so after several attempts. Eighteen patients stated never touching the eye with the bottle but 10 touched the eye. There was moderate difficulty in other tasks. Quality of life was reduced.
Conclusions: There was poor awareness by patients regarding their difficulties. Some patients had proprioceptive adaptations that allowed them to perform better than expected in tasks; these should be taught to others. The correct administration of glaucoma eyedrops is fundamental for avoiding glaucoma progression, therefore new devices for aid in self-administration of eyedrops should be explored.

Vijaya Juturu

OmniActive Health Technologies Inc. Morristown, USA

Title: Soluble lutein (lutemax2020®) prevents retinal damage in streptozotocin (stz)-induced diabetic rats

Time : 16:55-17:15

Speaker
Biography:

Juturu has a doctoral degree in Clinical Nutrition (Cardiovascular Nutrition) from S.V. University in India (1996) and completed her postdoctoral research in Cardiovascular Nutrition at Penn State University (1997-2000). Dr. Juturu is working as a Manager, Scientific and Clinical Affairs at Omni Active Health Technologies, Inc. She worked in research and development to consumer companies for more than fifteen years. She is an adjunct faculty to teach nutrition courses, NY. She has published research papers in reputed journals, text books, monographs and CEs. She is a reviewer and editorial board member of several national and international journals. She has received awards from Indian Council of Medical Research, Indian Society of Atherosclerosis Research, Cardiology Society of India, American College of Nutrition, Academy of Nutrition and Dietetics and Tinsley Harrison Award from Southern Society of Clinical Investigators. She was honored as honorable speaker, session chair and working committee member for Professional societies such as American Diabetes Association, Academy of Nutrition and Dietetics and American College of Nutrition.

Abstract:

The aim of the present study was to investigate the protective effects of Lutein in streptozotocin-induced (STZ) diabetic rat retina. Male Wistar rats were divided into four groups [Group I, Control (standard diet); Group II, DM; Group III: Group II + regular lutein [RL, lutein 0.5 %]and Group IV [Group II +soluble lutein [SL,Lutemax2020® 0.5 %]. All the animals were housed in individual cages maintained on their respective diets for 12 weeks and drinking water was provided ad libitum throughout the study period. DM was induced in overnight fasted animals by a single intraperitoneal injection of STZ (30 mg/ kg) in 0.1 M citrate buffer, pH 4.5.SL significantly prevented reduction in total retinal thickness better than that of RL as evidenced by H & E stainingqRT PCR, western blot and immunohistochemistry studies showed lowered expression of VEGF and PDGF (stimulates vasculogenesis and angiogenesis in the retina) in group-SL when compared to group-D. SL prevented loss of rhodopsin and nerve growth factor proteins as assessed by qRT PCR and immunofluorescence. Increased expression of stress proteins like glialfibrillary acidic protein (GFAP) and hypoxia-inducible factor 1-alpha (HIF-1A) is prevented by the SL more effectively than the RL. These results demonstrate that lutein has great potential in preventing diabetes-induced retinal degeneration.

Shahid Wahab

Dow University of Health Sciences, Pakistan

Title: Preventive management of pre-clinical diabetic macular edema

Time : 17:15-17:35

Speaker
Biography:

Shahid Wahab is Professor & Chairman Eye Department Dow University of Health Sciences Karachi, since 2005. There are many international, oral & video presentations to his credit. He is Editor in Chief of Pakistan Journal of Ophthalmology & on the Editorial Board of Ophthalmic Journals. He has been awarded highest Presidential award for excellance. He is regional secretary SAARC academy of Ophthalmology. He has innovated new instruments & techniques. His main interest is in vitreoretinal & is involved in training program. He has developed second sub-specialty fellowship in vitreoretina for which he is examiner at College of Physician & Surgeons Pakistan.

Abstract:

Objective: To find out effects of preventive management of co morbid on progression of diabetic macular edema.
Background: So far the recommended management for diabetic maculopathy covers curative aspects of the disease either by laser photocoagulation, intra vitreal anti-VEGF or surgical treatment, when it becomes clearly evident on fundscopy. Intervention is deferred till disease progressed to blinding cascade. Various risk factors had been identified that cause worsening of diabetic macular edema (DME) and diabetic retinopathy (DR). Hypertension or hyperlipidemia in diabetic patients, accelerate the disease process by altering the morphological and hemodynamic changes in microcirculation of retina. Co-morbids are alarming indicators for particular patient which should be managed urgently upon preclinical diagnosis of DME. Our new preventive strategy to identify and treat such co-morbid at early stage is the key to prevent the vicious cycle of maculopathy/retinopathy.
Material and Methods: A non-randomized, prospective study enrolled patients of either gender of all age groups with type II diabetes mellitus. Two groups were identified in the follow up period on the basis of their glycemic control and control of their co morbid. Macular thickness was assessed by OCT. All patients received expert consultation from physician for hypertension and hyperlipidemia, nephrologist for kidney status/nephropathy, neurologist for neuropathy, diabetologists for glycemic control, dietician and counselor to encourage alteration in their life style for prevention.
Results: Intra vitreal anti VEGF and laser photocoagulation were required in group where comorbid and glycemic control was poor while maculopathy was arrested in well managed comorbid and good glycemic control group.
Conclusion: Progression of maculopathy is highly dependent on glycemic control and early preventive management of co morbid. Uncontrolled hypertension and hyperlipdaemia are bad prognostic indicators and directly affect worsening of maculopathy.

Speaker
Biography:

Mohammad Ali Faraz is currently studying Medical Sciences at Western University, Canada. He was awarded two Natural Sciences and Engineering Council of Canada Undergraduate Summer Research Awards. Starting in 2012, Ali contributed to research projects under the supervision of Dr. Kathleen Hill (Biology, Western Ontario) with a focus on understanding early mechanisms of retinal degeneration in murine models. He was awarded the 2013 Best Oral Presentation at the Annual London Region Ophthalmology Research Day Conference. Currently, he is comparing human and mouse models of mitochondrial dysfunction leading to retinal degeneration.

Abstract:

Oculodentodigital dysplasia (ODDD) is a human disease with glaucoma due to mutations in the connexin43 (Cx43) gene GJA1. Gja1Jrt/+ mice have a G60S substitution with a dominant negative effect on wild-type connexin43 gap junction formation. Previously, we compared the ocular phenotypes of 37 Gja1Jrt/+ mice to age-matched, wild-type mice (1 to 48 weeks of age) using ocular coherence tomography and intraocular pressure assessments with post mortem ocular histological examination. Ocular disease initiates with deformation of the ciliary body and progresses to retinal degeneration. The retinal pigmented epithelium, a major component of the blood:retinal barrier (BRB), is well coupled with the Cx43 protein. It is unknown what BRB effects the G60S mutation has in Gja1Jrt/+ mice. Here, we confirm anterior origins of ODDD retinal degeneration and rule out a hypothesis of compromised (BRB). BRB integrity was assessed in five Gja1Jrt/+ mice with advanced disease compared to age-matched, wild-type mice. Intravenous injection of Evans Blue dye (EB; 45 mg/kg) with a 30 minute circulation period followed by post mortem phosphate-buffered saline perfusion was used to detect EB presence in retina, brain and liver. Formamide was used to recover EB for spectrophotometric assessment of tissue EB concentration (peak and background absorbance at 620 and 740 nm, respectively). Background-subtracted absorbance values in retina were normalized to 1 mg of tissue and, using standard curves, EB concentration values were calculated and normalized for liver EB concentration. Genotypes and tissues were compared to detect significant differences (two-factor ANOVA, p<0.05). Elevated liver EB concentrations confirmed assay performance. Unchanged retinal and brain EB concentrations are consistent with no loss of BRB and blood:brain barrier integrity in Gja1Jrt/+ mice. Overall, ocular disease onset and progression in Gja1Jrt/+ mice are consistent with disease mechanisms originating in the anterior segmentation culminating in retinal degeneration with retention of BRB integrity.

Break: 18:15-19:15 Cocktails sponsored by Journal of Clinical & Experimental Ophthalmology @ Prefunction Area