Conference Schedule

Day1: August 16, 2018

Keynote Forum

Biography

Ingrid Kreissig has served as Professor and Chairman at University Tuebingen/Germany from 1979-2000; Adjunct Professor at University Mannheim, Heidelberg/Germany since 2001; Adjunct Professor at New York-Cornell Medical Center/USA since 1982. She has her specialization in Posterior Segment of the Eye: St. Gall/Switzerland; Bonn/Germany; New York Cornell Medical Centre/USA. Since 1991, she gave presented 130 Teaching Courses on Retinal and Vitreous Surgery, Diabetes, AMD. She has many Publications: 418 inclusive 39 chapters on:Retinal detachment, cryopexy, histology, AMD, tumours, diabetic retinopathy; 15 books in 6 languages on: Retinal and vitreous surgery. She has received 18 awards. She has been Professor hc for research in 2011: in 2011, during Meeting of the American Academy of Ophthalmology in Orlando, an interview was taken between Prof. Kreissig /Germany and Prof. Lincoff /USA. They are discussing the development and various issues of retinal detachment surgery. If you click on the 4th link at the bottom of the typed page you can hear them talking: https://tinyurl.com/LincoffKreissig.

Abstract

Purpose: The evolution of present surgical techniques for reattaching a primary retinal detachment will be analysed by starting from 1929 to present in regard to their morbidity, reoperation and long-term visual function. Literature of retinal detachment operations during the past 85 years is reviewed. There had been a change from surgery of the entire retinal detachment to a surgery limited to thebreak and a  change from extraocular to intraocular surgery. The 4 major surgical techniques for repair of a primary retinal detachment is applied in the beginning of the 21st century, have still one in common: to find and close the retinal break which caused the detachment and which would cause a redetachment, if not sealed off
sufficiently.
 
Conclusion: To find and close sufficiently the break in a primary retinal detachment has accompanied the efforts of retinal detachment surgeons during the past 85 years. This is still the premise for sustained reattachment. However, today 4 postulates have to be fulfilled: (1) Retinal reattachment should be obtained with the 1st operation; (2) the procedure should have a minimum of morbidity, (3) should not harbour secondary complications jeopardizing regained visual acuity and (4) be performed on a small budget in local anaesthesia.

Biography

B Shukla (MAMS, FAMS, FICS, FACS, FAICO, PhD, D.Sc) is working as Director of Research and Training at Ratan Jyoti Netralaya and Ophthalmic Institute, Gwalior. He has been the President of All India Ophthalmological Society and recipient of its Life Time Achievement Award in addition to Dr P Siva Reddy International Award. He was the Founder Secretary of Ocular Trauma Society of India, its’ Past President and is now the Patron. He received Air Marshal Boparai Oration Award for his work in the society and recently he has been awarded Padma Bhushan Dr Hari Mohan Award for his outstanding contribution to ocular trauma. He is recipient of 10 national and 10 state level awards. He has attended 28 international and 40 national conferences. He is a Member of International Society of Ocular Trauma (I.S.O.T.) and participated in its 7 conferences in different countries.

Abstract

To avoid confusion in various terms used in ocular trauma Kuhn et al defined most of the terms and made a classification of global injuries. These are divided into closed globe and open globe types. For convenience he coined the term eye wall which comprises of cornea and sclera. In closed globe there is partial thickness wound whereas in latter there is full thickness wound of eye wall. In the closed type is included contusion and lamellar laceration. In the open type are included rupture, penetration, perforation and intraocular foreign bodies. In closed globe many other conditions can also be included like traumatic squint, glaucoma and extra-ocular foreign bodies (E.O.F.B.). Some small F.B. are located within the eye wall which have been termed intra-mural F.B. They are not included. The word laceration implies full thickness wound of eye wall. In penetration there is single and in perforation there are two lacerations in globe. Ophthalmology is basically derived from general surgery where many examples show clearly that penetration is always in a solid structure and perforation in a hollow structure filled with fluid or gas. Eyeball is grossly a hollow structure filled with aqueous and vitreous. If any object pierces the eyeball it would be of perforation and not penetration. A kidney or liver are penetrated because they are solid whereas gall bladder or urinary bladders are perforated because they are hollow. An injection needle penetrates biceps muscle and a thorn penetrates the heal because they are solid. Similarly when some pathological event is repeated you cannot give it a different name. Thus when the globe is pierced by an object twice it is logical to call it a double perforation rather than call the former as penetration and the latter as perforation as mentioned in the current classification.

Biography

Pedro Grimaldos has focused his large clinical activity on anterior segment eye surgery for nearly 30 years. In early 90s worked hard to improve modern cataract phacoemulsification technique with topical anesthesia. Seven international meetings were held to introduce worldwide significant advances. In 1996 he started laser assisted keratomileusis procedures to correct myopia, hyperopia and astigmatism errors. Since 1999, he introduced an innovative technique to treat presbyopia with only laser, named Presbylaser, a gold standard so far. In 2010 several research lines were addressed to correct any pigmentary iris disorder as heterochromia, congenital and secondary as well. Finally, in 2012 Laser Cosmetic Iridoplasty clinical trials were stablished in order to reach a safe, effective and predictable procedure. Now, after a remarkable effort on innovation, he introduced IRÎZ workstation, an integral laser system to change permanently eye color.

Abstract

Statement of the problem: Since 2012, a strong effort on innovation and research has been conducted with a number of collaborators in order to create a new major eye procedure and then a new medical specialty. In 2014 and 2017 I presented in national meetings an update about my first results and late follow up of cosmetic laser iridoplasty to safely correct any congenital and secondary heterochromia case. From beginning, our main goal was to demonstrate safety, effectiveness and predictability.
 
Methodology & Theoretical Orientation: Several studies were conducted about visual acuity, eye pressure, iris histology, OCT, angle gonioscopy and specular microscopy, and after one year, all of them showed no vision impairment. Safety level was then successfully tested and new works were designed to develop innovative tools to improve laser accuracy. Engineering teams were joined to our project and dramatic advances were reached to increase effectiveness and final outcome prediction. Current step has been designed to introduce worldwide a quick, safe and effective technique (IRÎZ Workstation) as gold standard.
 
Conclusion & Significance: At this point, success evidence is so clear based on more than 4.000 regular procedures and hundreds of real eye photos published. Cosmetic iridoplasty by IRÎZ workstation is a non-contact, painless, blade free, at the office outpatient procedure to treat any iris pigmented disorder and cosmetic indication. IRÎZ is an integrated laser system, with non-sterile requirements, scanner pattern, white and IR eye tracker and OCT module, to perform customized treatments based on preop analysis.

 

Biography

El Mansoury has completed her Residency at Temple University Hospital in Philadelphia PA, she pursuits a fellowship in Paediatric Ophthalmology and Neuro Ophthalmology at WillsEye Hospital in  Philadelphia PA. Currently she is working as a Consultant at King Faisal speciality hospital as Consultant Paediatric Ophthalmologist. She is interested in the topic Pathophysiology of Eye Movements. She is also interested to find out the role of Orthoptic Treatment and Its Effect on Binocular Vision Development.

Abstract

Strabismus is one of the most relevant health problems of the world, and infantile esotropia is perhaps the most visually significant yet the least understood. There is still debate on what is the proper time to operate. Review of the literature demonstrates that the risks and benefits of both interfering early to encourage the development of binocular vision versus late surgery when sensory testing can be obtained and surgery performed later in life. Both groups claim better alignment and better motor and sensory achievement. During the last couple of years Botox has been increasingly used for small angle esotropia in certain parts of the world with encouraging results however proper selection and timing is critical. The treatment of strabismus remains straight forward in most children. It includes the prescription of glasses, patching or penalization for amblyopia and finally surgery if deviation persists

Biography

Ligia Beatriz Bonotto is a Doctor in Surgical Clinic of the Health Sciences Sector from the Federal University of Paraná (2012). She completed her Master's degree in Surgical Clinic of the Health Sciences Sector from the Federal University of Paraná (2003) and has Graduation in Medicine from the Faculty of Medicine of Petrópolis–RJ (1984). Currently is an Ophthalmologist at the Clínica de Oftalmologia e Oftalmopediatria-Lígia Beatriz Bonotto (COOLBB). She is the Ophthalmologist responsible for the screening of Retinopathy of Prematurity of the Neonatal ICU of the Unimed De Joinville-Sc Hospital Center. Her research topics include Retinopathy of Prematurity, Risk Factors, Maternal Factors and Connective-Visual Development of the Premature Child. She is responsible for the creation and maintenance of the Home Page: www.oftalmopediatria.com.br and Faceboock: f / draligiabeatrizbonotto.

Abstract

Objectives: To observe the incidence of the retinopathy of prematurity (ROP) and its correlation with the clinical risk factors, among premature babies treated in the neonatal unit intensive care of one 3rd level hospital. To recognize predictive factors for ROP those are preventable in neonatal period.
 
Study Methodology: It was a retrospective cross-sectional observation study of clinical data obtained from the electronic charts of premature babies born between Nov’2014 and Apr’2017. Premature babies with gestational age (GA) ≤32 weeks and birth weight (BW) ≤ 1.600 grams, attended at neonatal intensive unit care of the referrer hospital (UTINCHU), during above referred period, with registered ophthalmological evaluation data. And they needed to present a minimum of one ophthalmological exam, during the neonatal UTI period that was included. For those who did not attend, the inclusion factors were excluded. Two groups were formed in statistical study of the clinical variables of risk of ROP: G1 (any stage of ROP) and group G2 (without ROP). The clinical variables were: BW, GA, Apgar, corporal temperature of first hour
of life, neonatal infection and oxygen therapy. The exam was made by obeying the established international criteria. The software statistical package for the Social Science version 21.0 statistical program was used and p<0.05 was considered.
 
Results: 48/168 premature babies were studied: G1 with 21% premature with ROP (GA medium 26.1w and e BW 865,0g), did not have aggressive ROP and above stage three. G2 group were 38 premature without ROP. The GA, BW (p<0.01) and hypothermia (p= 0.02) were presented statistical difference wrt ROP (univariate analysis). There wasn’t independent factor for the development of the ROP (multivariate analysis), in this study.
 
Conclusion: The incidence of ROP was still high. The GA, BW and corporal temperature were predictive factors for ROP. The stabilization of corporal temperature in first hour is necessary to consider.

Tracks

  • Latest Eye Research | Ophthalmology Surgery | Types of Ophthalmic Surgery | Optometry and Vision Science | Advancements in Ophthalmic Surgery | Oculoplastic Surgery | Diabetic Retinopathy | LASIK | Robotic Surgery | Neuro Ophthalmology | Pediatric ophthalmology
Location: Londres
Speaker

Pedro Grimaldos

Eyecos Corp, Spain

Chair

Speaker

B Shukla

Ratan Jyoti Netralaya & Ophthalmic Institute, India

Co Chair

Biography

Dr Marta Calatayud-Pinuaga Md PhD, completed her education as Ophthalmologist in 1998 at Autonoma University of Barcelona, Spain. Since then, she has been performing comeal and anterior segment surgery as consultant at the public and prívate practice. Now a days she is the Director of Instituto Oftalmológico Quironsalud in Barcelona. She has published several papers in reputed journals, book chapters and an e-book related to the topic of this paper. She took part of several investigation projects promoted by the Spanish government about regenerative medicine with limbal stem cells. Sara Martín-Nalda MD is a consultant at Centro Dr. Sabala and Vall d'Hebron Hospitals in Autonoma University of Barcelona since 2008, with special focus in corneal surgery. Her professional activity includes publications and clinical trials related to the ocular surface. She is also co-author of the e-book related to this paper. Manuel Romera is a consultant in eyelid and orbital surgery, with ophthalmology specialization, since 2004. Today she works as a consultant at Institut Comtal D'Oftalmología in Barcelona, he has published several papers in reputed journals about his speciality.

Abstract

Lamellar corneal surgery is increasing frequency as penetrating corneal transplantation decreases it' s indications in corneas with normal endothelium. Intraoperative OCT helps the surgeon to dissect the stroma and preserve the descemet' s membrane and endothelium, eventhough the big bubble technique fails. Lamellar surgery ensures a quicker and better rehabilitation for the eye, a lower and shorter topical steroid treatrnent and so, unfrequent complications related to it.

Biography

Lori Young has completed her Doctorate Degree from the University of Washington in Biomedical Engineering. Her graduation studies examined the use of a targeted delivery of silver metalloporphyrin to localize in tumours to enhance the absorption of ionizing radiation dose and improve treatment outcomes. Her postdoctoral studies in the Applied Physics Laboratory of the University of Washington focused on High Intensity Focused Ultrasound for therapeutic medical applications. She is a Clinical Medical Physicist for the Seattle Cancer Care Alliance Department of Radiation Oncology, an Assistant Professor of Medical Physics in the Department of Radiation Oncology, and the director of the Brachytherapy Simulation and Training Laboratory at the University of Washington. She has published over 15 papers in reputed journals on various topics related to therapeutic radiological physics and dosimetry.

Abstract

Background: Radiation therapy with low energy electrons is particularly beneficial for treating ocular lymphomas involving the conjunctiva. The anterior lens, being a highly radiosensitive structure, has a dose tolerance range of 10 to 18 Gy. Lens shielding used in conjunction with electron beam therapy can reduce the risk of high-grade cataracts following treatment with prescriptive doses of 25 to 30 Gy. Bolus may be required in some clinical situations to ensure superficial tumour coverage. This work evaluates the effects of a suspended eye shield, placement of bolus, and varying electron energies.
 
Methods: GafChromic film dosimetry and relative output factors were measured for 6, 8, and 10 MeV electron energies. A customized 5-cm diameter circle electron orbital cutout was constructed with a suspended lens shield (8-mm diameter Cerrobend cylinder, 2.2-cm length). Point doses were measured using an electron diode in a solid water phantom at depths representative of the anterior and posterior lens. Depth dose profiles were compared for 0 mm, 3 mm, and 5 mm bolus thicknesses.
 
Results: At 5 mm (approximate distance of the anterior lens from the surface of the cornea), the percent depth dose under the suspended lens shield was reduced to 15%, 15%, and 14% for electron energies 6, 8, and 10 MeV, respectively. Applying bolus reduced the benefit of lens shielding by increasing the estimated doses under the block to 27% for 3 mm and 44% for 5-mm bolus for a 6 MeV incident electron beam. This effect is decreased with 8 MeV electron beams. For orbital lymphomas treated with 6 MeV electrons, the lens block and 3-mm bolus combination reduces anterior lens dose to 8 Gy, and incrementally less with higher electron energies.
 
Conclusion: Careful selection of electron energy, consideration of suspended lens shield effects, and bolus must be evaluated to ensure tumour coverage, while decreasing anterior lens dose to mitigate cataract formation.

Biography

Fleur Goezinne has studied Medical Biology (specialization Neurobiology) and Medicine at the University of Amsterdam. In May 2003, she obtained her medical exams there. She completed her specialization Ophthalmology from 2003 to 2008 in the academic hospital Maastricht. She then went through a fellowship in Vitreoretinal Surgery. Since 2010, she has been a staff member at the Ophthalmology department of the azM. She has graduated in Maastricht on 6 September 2013 with her thesis 'Retinal detachment surgery: pre and postoperative prognostic factors'. Her focus areas are Vitreoretinal Surgery (retina / vitreous surgery), Front Segment Surgery (eg cataract surgery) and Medical Retina (diabetes mellitus, macular degeneration).

Abstract

Purpose: To determine the predictability of the visual acuity (VA) outcome of inner limiting membrane (ILM) peeling, as estimated by vitreoretinal surgeons pre-operative OCT scans.
 
Patients & Methods: All patients who underwent trans pars plana vitrectomy (TPPV) for internal limiting membrane (ILM) peeling in the University Eye Clinic Maastricht between Jan’ 2015 and Jan’ 2016 were included in this retrospective study. Pre-operative OCT images were collected and were assessed anonymously reviewed by 3 vitreoretinal surgeons and a fellow vitreoretinal surgery, after which pre- and postoperative VA was estimated by them and compared to the real postoperative VA.
 
Results: 136 eyes underwent surgery, of which in 129 eyes pre- and postoperative VA was known. Of these, 5 patients were excluded due to retinal detachment within 3 months after surgery. The mean age of the remaining 124 patients, 69 men and 55 women, was 72.2±6.8 years. The mean postoperative LogMAR VA, 0.27±0.27, was significantly better than the pre-operative VA: 0.42±0.24 (p<001). We found a significant correlation between the assessed postoperative VA and the actual postoperative VA in 3 of the 4 vitreoretinal surgeons. The correlation was low (range 0.17-0.44). Moreover, significant differences between the surgeons in the estimates of the postoperative vision (p<0.001) were seen.
 
Conclusions: Generally, results from TPPV ILM peeling are good. In this study, vitreoretinal surgeons could not reliably predict post-operative VA, by reviewing pre-operative OCT images.

Biography

Manuela Ciocca has graduated in Medical Engineering from University of Rome Tor Vergata in October 2016 defending a Master thesis about developing and testing organic semiconducting polymers or hybrid thin films and their possible interfacing with retinal system to develop Artificial Retinas. In 2016, she started her PhD in Electronic Engineering on development of Artificial Retinas for sight restoration using organic polymeric thin films. She won the ITWIIN (Italian Women Inventor & Innovator) Awards-Special Mention Material Conne Xion-Best Innovative woman 2016, and the EIWIIN (European International Women Inventors & Innovators), Special Recognition Award 2017 for ingenious and innovative achievements. In the past she has worked for ISATEL SRL on the design and development of a multi-functional medical device for physiotherapy and post-traumatic rehabilitation. Currently she is based at the University of Surrey (UK) for her 2nd PhD year, working on the development of an ink-jet printed polymeric Artificial Retina (project funded by Lazio Region-TORNOSUBITO programme).

Abstract

According to the World Health Organization there are 285 million people visually impaired worldwide. Medical treatments are improving rapidly with the development of biomedical engineering and bionics. Biomedicalelectronic engineering can play a vital role in developing innovative prosthetics, in particular in sight restoration via artificial vision. Interfacing living systems with organic electronics is the forefront of bioengineering, while never without risks, technological breakthroughs promise innovative solutions. In our research-work we propose a novel printed and photolithographically defined Retina-System based on organic semiconducting polymers. SIROH project focuses on the development of a bio-hybrid-photosensitive device for retinal photostimulation. It consists of a biocompatible polymeric thin film, a retinal tissue and biological electrolyte, all sandwiched between two parallel transparent electrodes. The device will evoke electrical photoresponses in (healthy and/or degenerated) retinas which could be analysed in a novel approach. The results stemming from SIROH-device will find medical applications in treatments for eye diseases, i.e. Age Related Macular Degeneration (AMD) and Retinitis Pigmentosa (RP). Furthermore, it will introduce a new platform to unravel the visual system networking replacing and/or supporting the standard electrophysiological instrumentation (patchclamp amplifier or multi-electrodes array). The first step of our research is to develop a device system to interface with retinal tissue. The printed devicesystem is presented in the form of an array of thin-film round ‘pixels’ composed of semiconducting polymer-P3HT of around 70μm diameter, and also, a continuous, 0.8x0.8 cm2 spin coated, 80 nm thick P3HT film. The device aims to mimic retinal photoreceptors activities in order to substitute the deteriorated photoreceptors. The first realized prototype shows high sensitivity to light, an absorbance spectra similar to the retinal green cones (λmax=520 nm), and elicited photocurrent values (~ nA) suitable for photoreceptors stimulation. This cross-cutting research project brings together engineering, biomedicine and neuroscience to introduce a revolutionizing approach in the field of visual prostheses.

Biography

Aim: To evaluate the postoperative surgical and cosmetic outcomes after maximal levator aponeurosis resection with Whitnalls ligament partial lysis for congenital ptosis with poor levator function.
 
Design: A retrospective non-comparative study
 
Material & Methods: Ten patients with primary congenital ptosis with poor levator function were included in the study. Evaluating eyelid elevation, lagophthalmos, lid contour, and postoperative complications following maximal levator aponeurosis resection with partial lysis of Whitnalls ligament.
 
Conclusion: Maximal levator aponeurosis resection with partial lysis of Whitnalls ligament is easy and effective in patients with primary congenital ptosis with poor levator function

Abstract

Mohamed Mahmoud Elsayed Mahmoud is professor at Faculty of Medicine Cairo University, Egypt. He is member of Egyptian Society of Ophthalmology & he is one of the renowned speakers from Egypt, Also he is member of many international ophthalmology societies.

Biography

Waldensius Girsang is a Senior Consultant Ophthalmologist in the Surgical and Medical Retina division at Jakarta Eye Center (JEC) Hospital, the largest eye centre in Indonesia. He obtained his Medical Doctor certification from Faculty of Medicine, University of North Sumatera and his Ophthalmologist certification from Faculty of Medicine, University of Indonesia. He joined a fellowship program at JEC and Vitreoretinal Training at Zhongshan Ophthalmologic Center, Sun Yat Sen University, Guangzhou, China. He has his expertise in General Ophthalmology, Cataract, and Vitreoretinal Surgery. Girsang’s clinical works and research focus is on diseases of the retina. His practice involves the management and surgery for retinal diseases in combination with anterior segment disease. He is one of the scientific committee members in Indonesia Ophthalmology Association (IOA), Indonesian Medical Association [IMA] – IDI, and European Society of Retina
Specialist [EURETINA].

Abstract

Retinal detachment (RD) remains one of the most challenging cases in vitreoretinal surgery. It becomes more challenging as the condition advances, marked by abnormal cellular accumulation creating traction to the retina known as proliferative vitreoretinopathy (PVR). The presence of PVR may reduce the anatomical success rate of RD treatment due to double burden and difficulty level of the surgery. Surgical treatment of RD with PVR may involve multiple procedures including scleral buckling, membrane peeling, retinotomy, retinectomy and intraocular tamponande injection. To date, vitrectomy, membrane peeling, retinotomy with additional silicon oil tamponade has been considered as the best technique for treatment of RD with advanced PVR. Retinotomy has been widely used for their management. Subsequent development of 360°, circumferential retinotomy was done for advanced PVR. Recently, peripheral 360° retinotomy, anterior flap retinectomy and radial retinotomy were combined to improve anatomical outcomes of RD with advance PVR. These techniques are shown to have considerable anatomical success rate than previous retinotomy alone. However, recent report has suggested that only a small portion of patients achieved good visual acuity and there were substantial number of post-operative complications such as persistent hypotony, corneal damage and retinal redetachment. Theoretically, in RD, there is tangential force caused by PVR that plays key role in creating the traction and ultimately reduce the success rate of postoperative retinal reattachment. Therefore, any procedures performed during surgical treatment of RD with PVR should aim to reduce or eliminate this tangential force to achieve anatomical reattachment of the retina. This review aimed to show high success rate of radial relaxing retinectomy as a novel method in eliminating tangential force due to RD with advanced PVR. As an alternative to silicone oil, this technique combined with intravitreal gas as tamponade was able to yield excellent anatomical and functional outcomes

Biography

El Mansoury has completed her Residency at Temple University Hospital in Philadelphia PA, she pursuits a fellowship in Paediatric Ophthalmology and Neuro Ophthalmology at Wills Eye Hospital in Philadelphia PA. Currently she is working as a Consultant at King Faisal speciality hospital as Consultant Paediatric Ophthalmologist. She is interested in the topic Pathophysiology of Eye Movements. She is also interested to find out the role of Orthoptic Treatment and Its Effect on Binocular Vision Development.

Abstract

Worth 4 dot test flashlight projects onto a central retinal area of 1 degree or less when viewed at ten feet well within the 1 to 4 degrees of small angle deviations. The four dot test is commonly used to test the sensory status of patients with phorias or tropias in cooperative patients. We performed the test on 35 patients who had strabismus. A masked examiner predicted what will be the response of the patient, the test was then performed and the results compared with the masked examiner. We did not find any difference between the results of the masked examiner and the interpretation of the patient. If surgery is performed early in life what is the implication of sensory testing and what is consequences on the binocular vision later in life? These questions remain to be answered.

Biography

Marsida Krasniqi has completed her PhD from Our Lady of Good Counsel University in Tirana, Albania. She is a Lecturer in the Department of Medical Science at Aleksandër Moisiu University of Durrës. She has authored or co-authored the book Manual of Management of Refractive Errors and has over 35 publications in peer-reviewed journals at regional, national and international conferences.

Abstract

The aim of this study is to evaluate the effect of aflibercept in cases with non-proliferative diabetic retinopathy with macular edema that has an inadequate response with bevacizumab treatment. This study was conducted in the Department of Ophthalmology of Mother Teresa Hospital in Tirana. This is a prospective study that includes 23 eyes diagnosed with non proliferative diabetic retinopathy with recurrent refractory macular edema of duration more than 6 months. All the patients were treated with bevacizumab intravitreal injection, but with no improvement of macular edema. To all this patients we started the treatment with aflibercept intravitreal injection. OCT and bestcorrected visual acuity was done before and 12 months after the treatment with aflibercept intravitreal injection. Data was collected and analyzed. In 23 eyes included in this study, 65% (15) were female and 35% (8) were male. The mean age of the patients was 58.08±5.58 years old. Mean number of bevacizumab injection before enrollments into study were 4.50±1.50. Mean numbers of aflibercept injections were 7(6-10.5). The OCT of 12 months after aflibercept intravitreal injection shows a central decrease of macular thickness in 87% of patients and in 79% we had an improvement of best corrected visual acuity. The treatment with aflibercept intravitreal injection in patients with recurrence diabetic macular edema shows decrease of central macular thickness and improvement of best-corrected visual acuity.

Biography

Aditi S Nigam hails from Mumbai, India and now settled in New Delhi. She has gained her MBBS degree from the prestigious Padma shree D Y medical college, Pune. Afterwards, she has completed her Post Graduation in Ophthalmology from esteemed institute D Y Patil Kohlapur where she did her thesis on Comparative Study of Intraoperative Complications in Pseudoexfoliation Syndrome with Normal Patients in Cataract Surgery which got published in international journal of advanced research (IJAR) volume 5 issue 2 February 2017. After completing her formal education, she wanted a global exposure and thus started attending various conferences and seminars and did short courses in Ophthalmology sub branches from University of Michigan and London school of Tropical Medicine and Hygiene. She is currently working at Centre for Sight, New Delhi as a Senior Resident and recently attended the training session held at Mumbai in LASIK under Dr Rupal Shah, one of the finest refractive surgeon in India. She aims at becoming one of the finest Ophthalmologist, the world has to offer and therefore in her free time she loves to read all about who’s who of ophthalmological world. She also loves to open a charitable foundation one day and truly contribute in the vision 2020. She loves sketching and cant travel without her first optical instrument she calls camera.

Abstract

Purpose: To evaluate epi–off corneal collagen crosslinking (CXL) using refractive stromal lenticule of another patient undergoing small incision femtosecond lenticule extraction in patients having keratectasia with thinnest pachymetry value of less than 400 microns and not treatable using standard de-epithelialization techniques
 
Methods: Sixteen eyes of fifteen patients affected by progressive keratectasias (11 keratoconus and 5 post lasik ectasia) with thinnest pachymetry values ranging from 360 μm to 397 μm underwent CXL using a modified technique using refractive stromal lenticule from patients undergoing small incision femtosecond lenticule extraction for moderate myopia in Visumax and thickness ranging from 110 to 120 μm. Epithelium was debrided and stromal lenticule 6.0 mm in diameter, harvested simultaneously, was placed so that the centre corresponded to the apex of the cone. Riboflavin 0.1 % drops were put and CXL carried out in the standard manner. The patients underwent complete ophthalmological examination, including endothelial cell density measurements and computerized videokeratography, before CXL and at one, 6, and 12 and 24 months.
 
Results: Epithelial healing was complete in all patients within 5 days of use of a soft bandage contact lens. No side effects or damage to the limbal region was observed during the follow-up period. All patients showed stability of K readings after 6 months, 1 and 2 years. Demarcation line was observed in all the cases.
 
Conclusion: The new technique of using refractive stromal lenticule for CXL increases the corneal thickness in most physiological way. In our series, it was found to be a safe, effective and viable for ultrathin corneas.

Biography

Markosyan Armida Grishai has completed Moscow Medical Academy of I M Sechenov. She has completed Clinical Residency in Ophthalmology, at the State Research Institute of Eye Diseases (Russian Academy of Medical Sciences). In 2007 she has received PhD up on defending her thesis for the Degree of Candidate of Medical Science on the subject of Anatomical and Physiological Features of the Lachrymal Gland in Accordance with Modern, Digital Ultrasound Diagnostic Methods. From 2006 to 2012, she worked at the Department of Eye Diseases at Moscow medical academy I M Sechenova, first off as an Assistant and in later years as a Senior Professor. In late Sep’2016 began work at GVM care and research medical center, as a Senior Ophthalmological Specialist. Her Specialties include Auto Immunological Eye Diseases, Anterior Eye Segments Inflammatory Disease, Lachrymal Gland Diseases, Orbital Tumor and Pseudo Tumor, Optometry and Vision Correction, in Complex Cases. She is an author of well over 34 scientific papers and over years of practice has already acquired 3 patents for inventions.

Abstract

The human lacrimal gland combines two functions: exocrine and immune surveillance in orbit. The combination of two important physiological functions explains the high frequency of involvement of this glandular organ in various pathological processes: inflammatory, autoimmune and neoplastic. Clinical symptoms of these diseases at certain stages of development are so similar that it is sometimes not possible to differentiate one process from another on the basis of one clinical picture. Meanwhile, for the diagnosis and determination of adequate tactics of therapeutic measures, the assessment of the state of the lacrimal gland is necessary.
 
Material & Methods: The study is based on clinical and functional investigation of 120 patients (240 orbits) during 2005-2018 years. The age of participants ranged from 13 to 75 and averaged 45.1 years. Women prevailed in numbers (66%), while men constituted only 34%. Physical, laboratory, and instrumental examinations includes transbronchial lymph node biopsy, MRI and СТ.
 
Results & Discussion: The unchanged lacrimal gland was defined as an elongated moderately-hypo-echogenic structure located in a space limited by ultrasound sections of the upper-outer edge of the orbit and the eyeball, while depending on the shape and size of this space, it occupied a different longitudinal position, transverse and oblique most commonly found longitudinal location of the lacrimal gland. Form of the lacrimal gland on the ultrasound section irregular oval, triangular, pear. Lacrimal gland was separated from the surrounding tissues by a narrow moderate-hyperechogenic capsule. Echographic features of the lacrimal gland in disease and Sjogren's syndrome. Examined were 35 patients, the average age of patients were 49±17 years, and among the examined patients prevailed females (87.2%) in all patients of this group the diagnosis was verified on the basis of the results of clinical and laboratory instrumenter survey. 12 patients were visualized precise contours of the lacrimal glands; in 23 cases, the lacrimal glands did not have clear contours; in 2 patients, the capsule surrounding the lacrimal glands was well traced in most patients of this group (23 people), a significant decrease in the size of the lacrimal glands, an increase in their density, a decrease in the vasculogenesis index. Echographic features of the lacrimal gland in acute dacryoadenitis. 15 people with clinical manifestations of acute unilateral dacryoadenitis. Lacrimal gland was visualized in the form of moderately hypoechogenic, often with indistinct contours and inhomogeneous echostructure. In all cases there was an increase in the size of the lacrimal gland with normal values of the average longitudinal size was 2.08±0.22 cm, the transverse dimension of 1.07±0.17 cm figure, ultrasonic density ranged from 58 to 69 UE, and averaged 60±11.1
 
Conclusion: Modern diagnostic ultrasound technologies also provide the opportunity for intravital assessment of the lacrimal gland and evaluation of possible changes in its condition. They allow measuring dimensions of the gland, determining its shape and structure, as well as topographic relationship with other orbital structures. Different systemic diseases, can affect the gland both directly and indirectly, causing structural changes in its tissue or a functional reaction, characteristic for organs of immune surveillance

Biography

Yaroub Elloumi, received his PhD in co-Supervision with the University of Paris-Est Marne-la-Vallee (France) and the University of Sfax (Tunisia) in 2013. He received his MS in Real-Time Systems from the University of Sousse (Tunisia) in, 2008. He currently teaches and does research with the position of Assistant Professor in Computer Sciences. He is a member of both Gaspard Monge Computer Science Laboratory (LIGM CNRS UMR 8049) and Medical Technology and Image Processing Laboratory (LabTIM LR12ES06). His research interests are computer vision, parallel computing and real-time image processing.

Abstract

The Optic Disk (OD) is a main anatomic structure in fundus image. The OD detection presents an important step in many diagnostic systems for ophthalmic diseases. As an example, several works proceed to locate ROI having a higher contrast, and hence remove the OD in order to deduce Hard Exudates or drusens, which correspond to the Moderate Diabetic Retinopathy and the Age-related Macular Degeneration, respectively. Moreover, other works detect the OD and then the neovascularized vessels or the optic cup in order to deduce respectively the Proliferative Diabetic Retinophathy and the Glaucoma.
 
The smartphone use is growing in ophthalmology where several optical lenses have been introduced to capturing the retina. Our work described in proposes a mobile computer aided system for OD detection using the D-EYE lens Such system allows ophthalmologic diagnosis in remote locations with limited access to clinical facilities. Moreover, our system promotes the telemedicine for eye examination. However, several differences are distinguished between fundus images captured with different optical lenses. In fact, each lens requires a specific distance from fundus. Moreover, the handheld aspect leads to different angles of view. Consequently, the OD is illustrated with different sizes and locations in the fundus which leads to an inaccurate OD detection. This paper proposes an adaptive method to detect OD in fundus image captured by different optical lenses where OD size sOD is provided by the user. Thereafter, the fundus image is splitted into sub-images in terms of the sOD. Then, Radon Transform (RT) projections are modelled based on sOD in order to be applied to all sub-images. Afterwards, the RT results are then explored to select the sub-image containing the OD. The experimental results indicate that our adaptive method provides a higher performance of OD detection in fundus images captured by different optical lenses.