Biography:

Beatrice Schuler-Thurner (Head of Experimental Immunotherapy, Head of GMP regulated production and qualified person), is a board examined Dermatologist and has profound experience in “The guidance of a GMP facility”. She has a plethora of experience in “Performing investigator initiated clinical trials with peptide-loaded and RNA transfected dendritic cells”.

Abstract:

Accumulating evidence suggests that T cells recognizing mutated cancer antigens are crucial for successful cancer immunotherapy. They seem to represent the common mechanistic pathway to control tumors and prolong overall survival in active antigen-specific (vaccination) as well as passive antigen-non-specific (checkpoint blockade) therapies. Dendritic cells (DC) besides mutated antigens are the other key to develop better T-based vaccines. Our group has systematically developed the adoptive transfer of these monocyte-derived DC for cancer vaccination loaded with antigens in form of peptides or RNA transfection. In lately secluded trials, high immunogenicity and long-term clinical benefit correlating with certain biomarkers in blood (including simple ones such as eosinophilia) became evident. Using autologous tumor RNA for loading of dendritic cells has the advantage of using not only patient unique mutations as antigens but also the abnormal ligandome generated by abnormal splicing und processing inherent in malignant cells. Following preclinical work and evidence for clinical efficacy in metastatic melanoma, we have started a randomized phase III (NCT01983748) trial in high risk (monosomy 3) uveal melanoma using RNA-transfected DC to vaccinate against the total antigenic repertoire of patient´s individual tumors to retard or prevent metastases after resection of the primary tumor in the eye. A total of 200 patients are randomized into arm A (DC vaccination) or arm B (observation as standard of care). Twenty million mature, monocyte-derived DC loaded with autologous tumor RNA are administered respectively at eight vaccination time points over two years. Objectives are to: Prolong DFS; prolong OS and; induce and measure immune responses. The trial has been started in 2014 and is currently performed in cooperation with Departments of Ophthalmology at eight University Hospitals in Germany (Erlangen, Essen, Hamburg Eppendorf, Homburg/Saar, Köln, Lübeck, Tübingen, and Würzburg).

Biography:

Gustavo Rojas Damiano studied Medicine at Unibersidad Iberoamerican; Ophthalmology at Hospital Elias Santana in Dominican Republic; two year Fellowship in Retina and Vitreous at IPS Boris J. Bajaire in Bogota Colombia

Abstract:

Aim: Aim of this study is to evaluate the effectiveness of the intravitreal implant of dexamethasone 0.7 mg in patients with cystoid macular edema (CME) in a four months period.

Methods: The medical records of three eyes of three patients with CME after cataract surgery who were treated with the implant were made. Baseline and follow-up visits included best corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT) as measured by spectral domain optical coherence tomography was performed at baseline in month one and four.

Results: The mean CMT in the visit prior the implant for the three cases was 473 microns with a mean of 12 mm Hg IOP and a mean BCVA with logMar of 0.53. At first month of the implant of dexamethasone 0.7 mg, the CMT mean was 258 microns, the mean IOP 16 mm Hg and the mean BCVA with logMar 0.3. At 4^th month, mean CMT was 293 microns, the mean IOP 15 mm Hg and mean logMar was 0.23.

Conclusion: The implant of dexamethasone 0.7 mg for patients that have a CME is a real option for treating patients with this disease.

Biography:

Born in March 23 of 1949, medical studies 1967/77, including residency in Cardiology and Artificial Kidney Unit.SFO Member since 1980, SFO Oral Presentation 2005, E Poster and Film 2014/ E poster 2015/16.
EVRS Member since 2006, Best scientific Poster 2006 ASRS/EVRS Meeting Cannes Retina Festival, EVRS Oral presentation Prague2008/Sevilla2012/ and Film Porto2014. All présentations up on the Vortex Vien Occlusion VVO concept.

Abstract:

A dialyzing structure consists of two compartments separated by a semipermeable membrane and animated by opposite flows, which increases the exchange surface. A pressure gradient (a dialyzing bath depression) between both compartments directs fluid and ion exchanges but not necessarily those of gases. Clotting is avoided by heparinization of the hemodialysis blood compartment. According to Poiseuille's law [D=flow rate= ((Πr4)/(8n l))×(P1-P2)], the session’s efficiency depends on the homogeneity and the importance of the blood flow which will condition the exchange surface. All rheological disorder from hyper-viscosity or partial thrombosis will alter this efficiency by reducing flow and condition the presence of deposits called “protein-cakes” on the dialysis membrane, compounded by depression of the bath. The aim of the study was to compare the anatomical and functional unit choriocapillaris/posterior retina [pigmentary epithelium (PE)+outer segments of vision cells (OSVC)] to that of a dialyzing structure. An anatomical structural comparative analysis between an artificial capillary kidney cartridge and the couple choriocapillaris/macular posterior retina is performed. It is confronted with the drusen and pseudo-vitelliform deposit wash-out resorption flows obtained by vortex vein occlusion (VVO) in AMD. That flow will be characterized by the mean of cine angiography ICG and OCT exams before and after VVO procedure. The two compartments are firstly choriocapillaris which may be equated with a dialyzing bath driven by a rather centrifugal flow; secondary the couple PE+OSVC as the dialyzed sector is driven by a centripetal flow. The bruch membrane composed partly of protein glycans (similar to heparin composition) is the semi-permeable membrane. The pressure gradient is consisted by the epithelial pigment physiological one. Drusen and basal linear deposits on bruch's membrane reveals analogy with the “protein-cakes” deposit. The drusen resorption flow observed by OCT follows centrifugal choriocapillaris blood flow direction. That was demonstrated by cine angiography ICG comparison before and after VVO procedure, showing choriocapillaris new recruitment flow restoration and confirming the existence of a dialyzing function. Disruption of the rheological choriocapillaris hemodynamics could limit or alter the function of the dialyzing choriocapillaris upon posterior macular retina and be a starter in some choroidal pathogenic diseases, especially in AMD, where the ischemia is a cofactor recognized. This is for a choriocapillaris supply disease but the dialyzing function impairment could be realized by failure of the venous drainage proximal or distal. In those cases venous staining will provoke consequently local hyper-pressure and create a collection of edema by pigment epithelium pump blockage. Central Serous Chorio-Retinopathy (CSCR) seems to be a concerned disease by this pathogenesis. Anatomical and functional resemblance to that of a dialyzing artificial capillary kidney cartridge, the choriodialysis term is suited to describe the purifying function of the choriocapillaris upon posterior macular retina.

Biography:

Georgii Kliuiev completed his speciality in Medical treatment at Odessa Medical Institute named by N I Pirogov in 1982. In 1982-1988, he has worked as an Ophthalmic Surgeon at Filatov Eye Disease and Tissue Therapy Institute of Odessa. He completed his Doctor of Medicine in 1992. He is the Chief of Ophthalmology department in Health Technology Ltd. In 2015, he got the certificate in Child Ophthalmology. He has published 52 scientific publications and has five patents. He has 35 years of varied experience in Ophthalmic Surgery

Abstract:

The method of micropulse transscleral contact-compression diode laser cyclocoagulation (MTCCLCC) is considered to be safe and rather effective method of treatment for lowering intraocular pressure (IOP) in glaucoma. Especially it is very important for patients that act as resistant to medical and surgical treatment. In recent years, MTCCLCC is becoming a more common procedure as an alternative to surgical interventions for refractory glaucoma, which is difficult to treat. In this context, the aim of our study is to evaluate the effectiveness of our methodology of MTCCLCC in the treatment of patients with refractory glaucoma. To assess the effectiveness of MTCCLCC in 84 patients (88 eyes) with refractory glaucoma, it was researched IOP before and after treatment. The patient’s condition was observed up to three years. MTCCLCC have been repeated if the IOP was not adequate after one month of observation. Data are presented as M±m. For data analysis, paired Wilcoxon test with SPSS 10 was used. Before applying MTCCLCC to patients with refractory glaucoma, IOP was in the range of 18-58 mm Hg on maximum medical therapy. The average value of the group was 33.05 mm Hg. There was a significant reduction already after one day of observation among patients after the one-time treatment of MTCCLCC. These patients had the IOP 24.07±2.06 mm Hg which accounted 72.8% compared with the original data (33.05±1.13 mm Hg). In the average period of observation (7-10 days) was noted a steady decrease of IOP and it was 22.19±1.99 mm Hg 67.1% compared to the original data. After treatment, the IOP of patients was significantly reduced to 20.89±1.78 mm Hg which accounted for 63.2% compared with the original data. The obtained data confirm high efficiency of treatment of patients with refractory glaucoma by using our techniques of micropulse transscleral contact-compression diode laser cyclocoagulation (MTCCLCC). 

Biography:

Ibrahim Kocak has completed his PhD from Istanbul University and Post-doctoral studies from Istanbul Training Hospital and Medipol University School of Medicine. He is an Assistant Professor in Ophthalmology department at Medipol University. He has published almost 40 papers in medical journals

Abstract:

Background: Treatment of pigment epithelial (RPE) detachment (PED) is a controversial issue and there are no recommended guidelines for their management. The treatment options have been laser grid or scattered photocoagulation, photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF) therapy with ranibizumab or bevacizumab, nevertheless most of them are reported to be ineffective or with high complication rates.

Method: Large landmark clinical trials like ANCHOR and MARINA did not report the PED response to ranibizumab treatment. A smaller study, pronto, highlighted the resistance of PEDs to ranibizumab therapy compared to sub-retinal fluid and intra-retinal fluid. Similar results were reported for bevacizumab therapy in terms of sub-RPE fluid resistance. However, some promising reports show efficacy of aflibercept in those resistant cases. In our institution’s experience, we have promising results with aflibercept in PED cases.

Results: Aflibercept treatment may have a reasonable rationale by virtue of recalcitrant feature of PED. In previous studies, Major, He, Kanesa, Broadhead all reported reduction in PED dimensions and some of them reported visual acuity improvement. In our institution’s experience, we observed significant decrease in PED dimensions and visual acuity improvement after transitioning aflibercept.

Conclusion & Significance: Aflibercept seems to have promising functional and anatomical outcomes in treatment resistant PED cases. Further investigations are needed to provide a recommended treatment guideline and to define more treatment sensitive subtypes of PED.

Biography:

Ivan Fiser completed his Graduation at Charles University in Prague in 1985 and Surgical Retinal training in 1993. He has been working as a Director of Vitreoretinal Service at 3^rd Medical Faculty in Prague and at Lexum Eye Clinic. He completed his PhD in 2007. He has published more than 20 papers in journals and was the co-author of five textbooks. He has presented over 200 talks at home and abroad. He is a member of the board of the European Vitreoretinal Society and a previous member of the board of the Czech Vitreoretinal Society

Abstract:

Background: Central serous chorioretinopathy is easy to treat when the focus of leakage is obvious; however, in diffuse leakage the treatment is unknown. We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage.

Methods: A group of 88 patients with diagnosed CSC included various, very different findings. We excluded 20 eyes which healed spontaneously within several months and also five eyes where the finding was questionable and it reminded AMD. We treated 30 eyes where the focus was clearly defined with focal laser, even in eyes where the focus was juxtafoveal. Here, we used threshold energy. In nine eyes in which the focus could not be clearly defined, we used threshold or sub-threshold laser into the anticipated focus. In 13 eyes with multiple leakage or diffuse leakage, we used a “stimulation laser” in the areas of leakage, believing in the activation of the RPE leading to the sealing of the area of leakage. In six cases, we first tried topical steroid drops in an intensive mode of application, i.e. every hour within one to two weeks, or Avastin, Triamcinolone, or Eylea injections.

Results: The laser treatment was followed with a complete recovery not only in cases of focal treatment of the leakage point but also in the eyes with very chronic (even lasting seven years) leakage from undefined site. Steroid drops as a mono-therapy also helped with healing of two patients but neither Avastin nor Eylea and Triamcinolone did not bring a convincing effect.

Take home message: CSC can be treated with laser not only in cases with clearly focal leakage but even in cases with poorly defined, only anticipated or diffuse leakage.

Biography:

Zeyad A. Alzaben received his bachelor degree in Optometry (2013) at the Jordan University of Science & Technology (JUST), and the first MSc degree in Science of Vision and Optometry (2014) at the Universitat Politècnica de Catalunya (UPC), and the second MSc degree in Visual Rehabilitation (2014) at Universida de Valladolid (UVa) / Medicine Faculty,  and he is a PhD candidate in Optical Engineering doctoral program (2014-2016)  at Universitat Politècnica de Catalunya (UPC). He is currently employed as full-time optometrist at the Department of Low Vision of Optipunt Eye Clinic (www.optipunt.com). He has conducted two new researches about normal patients and patients affected by pathological myopia using OCT and MAIA microperimeter, waiting the acceptance letters to be published. Student of Corporate Program for Management Development / Advanced Program for Optics Management in ESADE Bussines School in Barcelona (2014-2017). He is looking for helping people, giving the higher care to the elder patients, kids and youths. Using his skills to improve his experiences and keep learning more with respect to the challenges about using his valuable assessments. Making the last aim how could he improve his substantial life. 

Abstract:

Optical coherence tomography (OCT) is a useful non-invasive technique to assess the retina without the need for pupil dilation. In particular, the macular and optic disc areas may be explored in detail and with a high level of spatial resolution. A transversal study was designed in which a spectral-domain 3D-OCT-2000 (Topcon, Inc., Barcelona, Spain) was employed to evaluate several retinal parameters in a sample of 37 young Caucasian adults aged between 12 and 23 years (spherical equivalent from -3.00 to +4.00 D). Normal inter-ocular asymmetry values were determined and 95% inter-ocular difference tolerance values were obtained. Inter-ocular statistically significant differences were uncovered in mean and superior RNFL thickness, as well as in central macular thickness, with larger values in the left eye in all instances, and with tolerance limits of inter-ocular asymmetry (2.5^th and 97.5^th percentiles) of -9.00 µm to 6.00 µm, -28.00 µm to 9 µm and -39.00 µm to 29.00 µm, respectively. In addition, statically significant differences were found between males and females in mean thickness of the retinal nerve fiber layer (RNFL) in the right eye. These findings give support to the exploration of the normal asymmetries of the retina as an effective approach for an early detection of pathologies such as glaucoma. Differences in instrumentation and sample characteristics compromise direct comparison with published research and warrant the need for further studies.

Biography:

Juan Carlos Luna da Costa has completed his formation from Universidade Federal da Paraíba, Resident and fellowship programs from Centro Oftálmico Tarcízio Dias (CENOFT), Brazil. He is the Supervisor of Resident Program at CENOFT. He has published several papers in reputed journals.

Abstract:

Aim: This paper describes a rare case of bilateral symptomatic iris pigment epithelium (IPE) cysts successfully treated with frequency-doubled Nd:YAG laser photocoagulation.

Methods: Frequency-double Nd:YAG laser (532 nm) was the treatment of choice to rupture the wall (cystotomy), drain the cyst content and shrink the remnants of the pigment epithelium, using laser parameters at the lowest effective levels.

Results: Four primary iris cysts at the pupillary margin were treated with laser photocoagulation. Despite the increase of pigment at anterior chamber angle, no complication was observed during six months of follow up.

Conclusions: This is the first paper to describe frequency-doubled Nd:YAG laser (532 nm) photocoagulation as a therapeutic option for patients with symptomatic primary IPE cysts at pupillary margin.

Biography:

Mariyah Selmi is a Junior Doctor at Royal Oldham Hospital, Manchester, United Kingdom. She has completed her MBChB with a 1^st class Honors degree in Imaging Sciences at Kings’ College London. She has multiple publications in the field of Radiology with a special interest in “Radiation awareness and dosimetry”.

Abstract:

CT head examinations may result in irradiation to the lens of the eye, one of the most radiosensitive tissues in the body. Standard CT head examinations expose the lens to approximately 25-103 mGy. The International Commission on Radiological Protection estimates opacity formation with doses as low as 0.5 Gy. In younger age groups, the likelihood of repeat head CT scans is increased and with it the risk of accelerated cataract formation if the lens is not avoided. Common reasons for mal-positioning include confusion, dementia and arthritis limiting mobility; features generally less prominent in the young. Undoubtedly, the diagnostic information gained from CT head scans is vital for management. In emergency cases, the need for rapid scanning may outweigh the risk to the lens; however in non-emergency cases in the young, every effort should be made to avoid this. A preliminary study across Pennine Acute Trust demonstrated >50% inclusion rate of the lens with similar results in other trust. Therefore, it is important for both specialties to integrate knowledge and experience to ensure patient safety. Departmental teaching on positioning of radiographic baseline, setting region of interest and use of head rests to achieve optimum positioning has led to radiographers obtaining anatomically sound images without the need to angulate the gantry incurring a radiation dose penalty; with promising feedback. Using our findings a new protocol is being developed, with the hope to reduce the unnecessary radiation burden to the lens during CT head scans minimizing the risk of visual impairment.

Biography:

I am a final year medical student at University of Liverpool with an interest in academic ophthalmology research. I took time out of training to do a Masters in Research in Eye and Vision Sciences degree at the Institute of Aging and Chronic Diseases in Liverpool. During this time, my research was primarily focused on corneal and ocular surface diseases. This experience broadened my understanding  in corneal and ocular surface stem cell biology using pluripotent stem cells as models. In the next year, I will be taking up a position as an academic junior doctor, which would allow me to further develop my research experience.  

Abstract:

Biography:

Dana Ghazaleh was born and raised in Palestine, and is now a final year medical student at An-Najah National University, Palestine. Her passion for medicine has come to surface ever since high school where she founded a weekly medical show in the school broadcast to promote health and wellness among the community. She has been part of many voluntary projects which fostered her desire more and more in pursuing her career as a physician. During college years, she expressed great interest in providing competent and compassionate care for a wide variety of patients. Moreover, she realized the role of scientific research as a major contributor to medical care development, so she became a research assistant. Dana was the student representative for a whole of 4 years. Her professional interests include internal medicine and ophthalmology. In her spare time, she loves reading novels, she also enjoys outdoor activities such as Tennis and swimming 

Abstract:

Biography:

Mayla Myrina Bianchim Monteiro is a Speech Therapist, Post-doctoral student in Health interdisciplinary and Rehabilitation at State University of Campinas, School of Medical Sciences. She has knowledge in the areas of language and visual impairment.

Abstract:

Introduction: The growth of the elderly population led to interest in studies of aging and the quality of life. Aging well depends on the balance between the limitations and potential of the individual who selects priority areas in this stage of life and have different motivations and abilities. Among the limitations that occur as age advances, those related to vision and importance are regarded as priorities.

Aim: Aim of this study is to evaluate the quality of life of elderly with visual impairment focusing on optical aids and routine activities through the LVQOL and VFQ-25 questionnaires.

Method: Two questionnaires on quality of life, LVQOL and VFQ-25 were applied before and after therapeutic intervention within thrice-monthly meetings.

Results: 52 subjects of both sexes were studied, 41% aged between 60 and 70 years; 38% between 71 and 80 years and 21% over 80 years. The main causes of low vision found were macular degeneration (38%), cataract (38%), glaucoma (20%), diabetic retinopathy (10%), and optic nerve atrophy (5%). Regarding the use of optical aid before the intervention, 37 subjects (61%) were using the aid, and after the intervention these figures rose to 45 subjects (86%).

Conclusions: After participating in the therapeutic intervention, the elderly were prone to improvement in performing not only the daily activities, but also using of optical aids, as well as in reading and writing activities, leading to a better quality of life.

Biography:

Wino Vrieda Vierlia completed her Medical degree at University of Brawijaya, Indonesia in 2007. She has been interested in Neuro-ophthalmology subdivision and has joined some courses to improve the knowledge. She has attended several international ophthalmology conferences.

Abstract:

Traumatic isolated sixth cranial nerve palsy is a rare condition that has been reported to be as low as 1% to 2.7% following traumatic brain injury. The sixth nerve innervates the ipsilateral lateral rectus which abducts the eye. Isolated loss of lateral gaze with no other cranial nerve signs and muscular entrapment is thought to be resulted from an injury to the peripheral nerve along its course from the brain stem to the lateral rectus. We presented a case of traumatic isolated unilateral sixth cranial nerve palsy in a 44-year-old female patient who was referred to our department with diagnosis of head trauma and multiple facial fractures after an alleged motor vehicle accident. She had suffered traumatic brain injury and transient altered level of consciousness. She complained of diplopia and restriction movement in the lateral gaze of left eye with no diminution of vision noted in both eyes. An urgent brain magnetic resonance imaging (MRI) revealed zygomatic comaxillary complex fractures and retrobulbar hemorrhage of the left eye with cerebral edema. Eye examination showed isolated sixth cranial nerve palsy. Vision tests and fundoscopy examination were normal. She was undergone open reduction and internal fixation to treat the facial fractures. Systemic steroid treatment with tapering dose was also given postoperatively. Improvement of the lateral gaze restriction and reduction of diplopia were gained after ten weeks of follow up.