bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphology‐Structural software: Interests for AMD DRUSENOID DEPOSITS “L”, Lipid type, Density, Structural, Volume analysis and Evolution. 5 years follow‐up
Authors: Gonzalez Corinne
Published: December 2022

Purpose: To study AMD drusenoid deposits “L”, about their density, structure volume,evolution with morphology‐structural software to enhance drusenoid deposits “L” knowledge, evolving potential, etiopathogenesis.

Methods: 134 eyes of 74 patients, with AMD drusenoid deposits “L”, Lipid Type (soft Drusen, Drusenoid PED “L”). Deposits were evaluated by OCT, notably OCT en Face (Spectralis HRA‐OCT), and Morphology‐Structural software (M‐S software). M‐S software let analyse drusenoid deposit volume, contours, 3D deposit reconstruction, display in 3D space, let drusenoid deposit contents analyse, discrimination, differentiation, let grading (volume, contours analyse), let measurements: density (grey levels of deposits), structure(structural measures texture parameters), volume (in μm3), evaluation and characterization of those “L” type deposits. Evaluation, comparison for each eye, patient, between all, was done every 6 months, so evolution assessment too. 5 years follow‐up.

Results: AMD Drusenoid Deposits “L” are: dark grey, optical empty, fatty, equal and the same in all cross‐section(OCT/OCT enface).From M‐S software, “L” have rather Low density, each density parameter having not only its own profile, curve modulation and up and down during evolution, but difference in between, and likeness between both eyes. Structural and Volume parameters have also their own profile and similarity between both eyes. Cycle evolution was seen for all parameters curve, specific for each curve, with also similarity between both eyes. M‐S software allows better AMD Drusenoid Deposits “L” knowledge, physiopathology understanding, evolving potential, particularly to atrophy.

Conclusions: Morphology‐Structural Software let to study, better knowledge of AMD Drusenoid deposits “L”, especially regarding their contents, so contribute to AMD physiopathology, etiopathogenesis understanding and hypothesis formulations.

References.

1. Gonzalez C. AMD Drusenoid deposits “L”, Lipid type and “P”, Protein‐cellular type, structural analysis, evolution study with Multimodal Imaging and Morphology‐Structural software, ARVO 2019.
Possibilities of monitoring intraocular pressure using easyton transpalpebral tonometer
Authors: del Buey Sayas María Ángeles , Pascual Paula Casas , Rodriguez Nuria López , Marco Monzon Sara , Ascaso Javier , Sancho Elena Lanchares
Published: December 2022

Purpose: To compare the effectiveness of transpalpebral scleral tonometry (TPST) and Goldmann applanation tonometry (GAT) in a control group patients, in order to consider TPST as an objective IOP control in early postoperative period of patients undergoing corneal and surface surgery.

Methods: Three measurements TPST, using EASYTON tonometer, and IOP using GAT, have been sequentially performed on 73 right eyes of 73 control patients (aged 24–83) (mean age 57.4 ± 16.3 years). In addition, 12 eyes of 12 patients undergoing corneal or surface surgery (PK, DSAEK, pterigium) have been evaluated with TPST and digital palpation tonometry in the immediate postoperative period (1–2 and 7 days). We evaluated the post‐surgical cases subjectively in normal tone by palpation, ocular hypotonia and hypertonia. Subsequently, we carried out an objective IOP measurement with Easyton and assessed the correlation of results.

Results: Mean IOP spread (as demonstrated by three consecutive IOP measurements with EASYTON) was 1.32 mm Hg thus showing a high degree of repeatability. IOP measured using the TPST was 18.2 ± 2.9 mmHg in the control group. With GAT were 18.3 ± 2.5 mmHg in the control group. There are no statistically significant differences between both variables for the same sample. During the second evaluation, a high degree of the similarity of IOP measurements with palpation and TPST was demonstrated in the operated eyes after corneal and surface surgery.

Conclusions: EASYTON tonometry demonstrated repeatability of IOP indicators when measuring the same eye three times sequentially. There are no statistically significant differences between TPST and GAT in the control group. EASYTON transpalpebral IOP tonometer prevents the subjectivity of IOP measurements after PK and other corneal or surface surgeries and makes an objective tonometry available. The lack of the contact with the cornea, a rather high accuracy and repeatability, and the lack of negative effects allow for using this device in these cases.
Characterizing a novel retinal organoid model of Oculocutaneous albinism and optic nerve misrouting
Authors: Wagstaff Ellie , Bakker Reinier , Emri Eszter , ten Asbroek Anneloor , Bergen Arthur
Published: December 2022

Purpose: Albinism refers to a group of genetic disorders typically characterized by a loss/reduction of melanin in the hair, skin and eyes of affected patients. Apart from pigment changes, all albinism patients present with foveal hypoplasia and optic nerve misrouting, and have blurred vision. The molecular mechanisms that link this lack of pigment with neural retinal development are poorly understood, with foveal and optic tract development being difficult to model. To advance our knowledge, we developed a novel retinal organoid model of albinism, and characterized the development and outgrowth of retinal ganglion cells affected during albinism as a model for future studies.

Methods: Human oculocutaneous albinism 1 (OCA1) patient‐derived stem cells were differentiated alongside controls into retinal organoids, as published previously1,2. Early retinal ganglion cells develop in the first 4 weeks of differentiation, at which point whole organoids could be plated to allow for optic nerve‐like outgrowth. Whole organoids were also fixed and analysed with immunohistochemistry (IHC) to visualize contralateral and ipsilateral ganglion cells present in the organoid.

Results: IHC analysis showed differences in the number of ipsilateral and contralateral retinal ganglion cells between the healthy control and albinism organoids, in line with in vivo observations. Further, optic nerve‐like outgrowth could be achieved with both models, allowing for future research into optic nerve misrouting in albinism.

Conclusions: We generated a novel retinal organoid model of oculocutaneous albinism, and characterized the retinal ganglion cell development and outgrowth. This will allow us in the future to study a different and sometimes overlooked aspect of albinism; optic nerve misrouting.

References

1. Wagstaff, P. E., Ten Asbroek, A., Ten Brink, J. B., Jansonius, N. M. & Bergen, A. A. B. An alternative approach to produce versatile retinal organoids with accelerated ganglion cell development. Sci Rep 11, 1101, doi:10.1038/s41598‐020‐79651‐x (2021).

2. Ohlemacher, S. K. et al. Stepwise Differentiation of Retinal Ganglion Cells from Human Pluripotent Stem Cells Enables Analysis of Glaucomatous Neurodegeneration. Stem Cells 34, 1553–1562, doi:10.1002/stem.2356 (2016).
Different formulas to calculate mean blood pressure entail significantly different results
Authors: Gene‐Morales Javier , Gené‐Sampedro Andrés , Bueno‐Gimeno Inmaculada , Babiloni‐Lopez Carlos , Colado Juan C.
Published: December 2022

Purpose: Mean ocular perfusion pressure (MOPP) is calculated as the difference between mean brachial arterial pressure (MBP; with a correction factor to compensate for differences in flow resistance and hydrostatic pressure between the arm and eye) and intraocular pressure (IOP). The main aim was to evaluate differences between the most used formulas to calculate MOPP and the effects that physical exercise may have in this parameter.

Methods: Fifteen physically active, healthy subjects (6 female, 24.07 ± 3.65 years) voluntarily performed a 15‐minute protocol consisting of combined exercise including, mobility, bodyweight exercises, running, dynamic stretching, and three sets of barbell back squat at low intensities. Five different formulas retrieved from the scientific literature were used to calculate MBP. Formulas used to calculate MOPP pressure were 1) 2/3*(MBP)–IOP; 2) 2/3*(MBP–IOP); 3) 95/140*(MBP)–IOP. A three‐way analysis of variance evaluated the effect of the exercise, the formula used to calculate MBP, and the formula used to calculate the mean ocular perfusion pressure.

Results: Significant effects of the exercise (F(1, 14) = 135.21, p < 0.001, η2 = 0.91), formula used to calculate mean blood pressure (F(1.06, 14.87) = 250.37, p < 0.001, η2 = 0.95), formula used to calculate mean ocular perfusion pressure (F(1.01, 14.14) = 163.98, p < 0.001, η2 = 0.92) and their interaction (F(1.48, 20.68) = 47.35, p < 0.001, η2 = 0.77) were observed. The post‐hoc results showed significant differences between most of the formulas both preexercise and postexercise.

Conclusions: The results presented suggest that caution should be applied when using indirect formulas to estimate mean ocular perfusion pressure. Future research should objectively evaluate ocular perfusion pressure with a direct method to find the most reliable formula. Meanwhile, this study is published to raise awareness on the importance of choosing one or other methods when aiming to estimate physiological parameters with formulas.
Establishment and measurement of myopia in mice with ON‐bipolar cell defects
Authors: Baptiste Wilmet , Robert Duvoisin , Jacques Callebert , Ruben Goulet , Christophe Tourain , Christelle Michiels , Julie Degardin , Helen Frederiksen , Quenol Cesar , Manuel Simonutti , Olivier Marre , José‐Alain Sahel , Audo Isabelle , Serge Picaud , Zeitz Christina
Published: December 2022

Purpose: Myopia is a multifactorial eye disorder caused by genetic and environmental factors and is inhibited by light exposure. Complete congenital stationary night blindness (cCSNB) a group of genetically and clinically heterogeneous retinal disorders associated with high myopia in patients. Mutations in cCSNB‐associated genes have been found to disrupt the transmission of ON‐bipolar cells (ON‐BC) in the retina. As ON‐BCs are responsible for the retinal integration of the perception of surrounding light intensity, which is disrupted in myopia, we seek to determine whether cCSNBs models are more susceptible to develop myopia.

Methods: We evaluated the levels of retinal Dopamine (DOPA) and its metabolite 3,4‐Dihydroxyphenylacetic acid (DOPAC), commonly used markers of myopia, in three cCSNB mouse models lacking Grm6, Gpr179 or Lrit3. Using an eccentric infrared photorefractometer, we measured the refractive development of two cCSNB mouse models lacking Gpr179 or Lrit3. To assess the sensitivity of cCSNB mouse lines to myopia induction, we developed a lens‐induced myopia (LIM) model and measured the induced refractive error in mice lacking Gpr179 or Lrit3.

Results: Our preliminary data revealed decreased levels of both retinal DOPA and DOPAC in all tested cCSNB mouse models. All tested groups presented the same kinetic of refractive development. Mice lacking Gpr179 displayed a higher sensitivity to LIM as shown by an increase in the mean interocular shift compared to wild‐type littermates. Mice lacking Lrit3 with LIM will be measured to document the refractive errors induced by the ON‐BC defect.

Conclusions: These results suggest that disruption of the ON‐BC pathway contributes to the development of myopia and that mouse models of cCSNB represent good models to study myopia. Our data strengthen the hypothesis of an impact of ON‐BC dysfunction upon the onset of myopia. These findings provide the basis for the development of pharmacological and optical therapies.
Myopic macular Bruch's membrane defects
Authors: Jonas Jost , Panda‐Jonas Songhomitra , Jonas Rahul
Published: December 2022

Purpose: To examine peculiarities of macular Bruch's membrane defects (BMD) in axially elongated eyes.

Methods: Using light microscopy, enucleated human globes were histomorphometrically.

Results: The study included 247 eyes (axial length: 20.0–37.0 mm). BMDs were detected in 15 (6.1%) eyes (axial length: 30.6 ± 2.4 mm) (1.9 ± 0.9 BMD/eye with BMDs), located in the macular region in 10 eyes. Mean BMD size was 1.93 ± 1.62 mm (range: 0.22 mm–6.24 mm). Prevalence and size of BMDs were associated with longer axial length (OR: 1.52; p = 0.001) and higher prevalence of scleral staphyloma (OR: 16.3; p < 0.001). BMD width was smaller than the defect width in the overlying retinal pigment epithelium (RPE) layer (p = 0.003) and larger than the length of a defect in the overlying inner nuclear layer (0.43 ± 0.76 mm; p = 0.008) and the width of an inner limiting membrane bridge (0.13 ± 0.33 mm; p = 0.001). Choriocapillaris thickness (8.8 ± 5.0 μm vs. 7.9 ± 3.2 μm; p = 0.94), BM thickness (3.1 ± 0.6 μm versus 3.0 ± 0.5 μm; p = 0.43) and RPE cell density (31.6 ± 8.4 cells/480 μm vs. 27.4 ± 8.8 cells/480 μm; p = 0.051) did not differ significantly between the region at the BDM margin and neighbouring regions. The sclera was thinner in the BDM region than in the neighbouring regions (0.28 ± 0.19 mm vs. 0.36 ± 0.13 mm; p = 0.006).

Conclusions: BMDs as hallmark of myopic macular degeneration are characterized by a larger defect in the overlying RPE layer, smaller defects in the overlying retinal outer nuclear layer and inner nuclear layer, localized scleral thinning and an association with scleral staphylomas. Thickness of the choriocapillaris and density of the RPE cell layer, both absent within the BDMs, do not differ between the BMD margin and neighbouring regions. The results suggest an association between BDMs and absolute scotomas, stretching of the overlying retinal nerve fiver layer, an axial elongation‐associated stretching effect as aetiology of the BDMs, and a biomechanical role BM may play.
Hand grip strength and ocular associations: The Ural eye and medical study
Authors: Jonas Jost , Zainullin Rinat , Gilmanshin Timur , Iakupova Ellina , Gyulli M. , Panda‐Jonas Songhomitra , Tuliakova Azaliia , Fakhretdinova Albina , Leisan Gilemzyanova , Mukharram Bikbov
Published: December 2022

Purpose: To explore associations between the hand grip strength (HGS) and ocular parameters and diseases.

Methods: Participants of the population‐based Ural Eye and Medical Study, including 5899 (80.5%) out of 7328 eligible individuals aged 40+ years, underwent systemic and ophthalmological examinations including dynamometric HGS measurement.

Results: The study included 5381 (90.4%) individuals (age: 58.6 ± 10.6 years; range: 40–94 years) with HGS measurements. Higher HGS (mean: 30.6 ± 11.7 dekaNewton) correlated (multivariable analysis) with better visual acuity (beta: 0.02; p = 0.02), longer ocular axial length (beta: 0.03; p = 0.003), higher intraocular pressure (beta: 0.03; p = 0.001), thicker peripapillary retinal nerve fibre layer (beta: 0.03; p = 0.001), and lower prevalence of diabetic retinopathy (beta: −0.03; p = 0.007), after adjusting for younger age, male sex, Russian ethnicity, higher body height and waist‐hip ratio, higher educational level, higher physical total score, lower smoking package years, higher serum concentration of haemoglobin, higher prothrombin index, lower leucocyte cell count, lower prevalence of non‐alcoholic fatty liver disease, lower depression score, and lower arthritis prevalence. In that model, HGS was not correlated with the prevalence of nuclear cataract (p = 0.38), cortical cataract (p = 0.67), subcapsular posterior cataract (p = 0.50), open‐angle glaucoma (p = 0.22), or angle‐closure glaucoma (p = 0.27).

Conclusions: In addition to parameters such as lower physical activity, higher depression score and worse general health status, a reduced HGS is associated with visual impairment, shorter axial length, lower intraocular pressure, thicker peripapillary retinal nerve fibre layer, and higher prevalence of diabetic retinopathy. HGS dynamometry or a handshake may give additional clinical information for the ophthalmologist about the general health and ocular parameters of the patient.
Animal model for metabolomic diffusion studies in the eye
Authors: Hiller John Kim , Sandås Elise Mørk , Rootwelt Helge , Vassli Anja Østeby , Utheim Tor Paaske , Moe Morten Carstens , Elgstøen Katja Benedikte Prestø , Petrovski Goran
Published: December 2022

Purpose: To explore the diffusion capacities between the anterior and posterior chambers in an ex vivo pig eye model using a mix of isotope‐labelled acylcarnitines with different physical and chemical properties and targeted analysis using mass spectrometry (MS).

Methods: Enucleated pig eyes were injected in the anterior or posterior chamber of the eye with an acylcarnitine mix (FC‐D3, C2‐D3, C3‐D3, C4‐D3, C8‐D3, FC‐D3, C2‐D3, C3‐D3, C4‐D3, C8‐D3 and C16‐D3 – having an increasing hydrophobicity in that order), then samples were collected from each chamber at 3, 6 and 24 h post‐incubation for further targeted analysis using MS.

Results: The acylcarintine concentrations of FC‐D3, C2‐D3, C3‐D3, C4‐D3, C8‐D3 in the posterior chamber after injection in the anterior chamber increased with time, with the largest increase in concentration observed from 6 to 24 h of incubation; C12‐D3 and C16‐D3 seemed to deviate from that pattern. The acylcarnitine concentrations in the anterior chamber after injection in the posterior chamber showed significant decrease in FC‐D3, C2‐D3, C3‐D3, C4‐D3, C8‐D3 and C12‐D3 from 3 to 24 h of incubation, while C16‐D3 – a longer chain molecule, showed an increase in its concentration up to 24 h from injection.

Conclusion: We hereby show a distinct diffusion pattern of molecules with different hydrophobicity within and between the anterior and posterior chamber. These results can be useful for optimizing choices and design of therapeutic molecules with higher retaining or depot properties into the two chambers of the eye for future treatment purposes.
Determining subclinical edema in fuchs endothelial corneal dystrophy: Scheimpflug versus anterior segment‐optical coherence tomography
Authors: Cortez Oliver Dorado , Crouzet Emmanuel , Poinard Sylvain , Gain Philippe , Garcin Thibaud , Okumura Naoki , Koizumi Noriko , Thuret Gilles
Published: December 2022

Purpose: To compare the capacity of anterior segment optical coherence tomography (AS‐OCT) and Scheimpflug camera in detecting subclinical corneal edema in patients with Fuchs endothelial corneal dystrophy (FECD).

Methods: 177 eyes of 103 patients with FECD without obvious corneal edema were included and analysed in this single‐center prospective study (NCT03974230). Tomographic analyses were performed successively using Scheimpflug imaging (Pentacam HR, Oculus) and a swept‐source AS‐OCT (Casia SS‐1000 Tomey). All measurements were performed more than 4 hours after awaking to have a stabilized corneal thickness. The resulting images were analysed by two experienced independent observers. AS‐OCT and Scheimpflug images were analysed independently. The main outcome was the agreement between the ability of the two devices to detect subclinical corneal edema, assessed using inter‐device reliability measured by the Cohen kappa statistic. The criteria for subclinical corneal edema were as follows: the presence of irregular isopachs, displacement of the thinnest point of the cornea, and the presence of posterior surface depression.

Results: The agreement between the two devices to detect subclinical corneal edema was high. The inter‐device reliability for loss of parallel isopachs, as measured by the Cohen kappa coefficient, was 0.75; for the displacement of the thinnest point of the cornea, it was 0.65; and for the focal posterior corneal surface depression, it was 0.53. The inter‐device reliability for the detection of subclinical corneal edema was 0.70. Subclinical corneal edema was detected in 77% of cases analysed with both devices.

Conclusions: Subclinical corneal edema in patients with FECD can be detected by AS‐OCT as well as by Scheimpflug imaging. Both devices can facilitate surgical decision‐making when evaluating the risk of corneal edema after cataract surgery in eyes with FECD.
A scoping review of three‐dimensional ophthalmic anatomy smartphone applications
Authors: Liu George , Naveed Hasan , Liu Christopher
Published: December 2022

Purpose: Patient education and understanding has been shown to improve outcomes by enabling engagement. Information relating to ophthalmic disease and surgery is often complex, pertaining to microanatomy of the eye and adnexa. The use of three‐dimensional anatomical models in clinical consultations is one method that can improve patients' understanding of their ophthalmic condition(s) and procedure(s). Our research group surveyed the current app marketspace for virtual smartphone anatomical models that can be readily deployed in any ophthalmic clinic setting for the benefit of patients and clinicians alike.

Methods: We conducted a systematic review of Google's ‘Play Store’ and Apple's ‘App Store’ – the two most commonly used app stores – using the key term ‘eye anatomy’. Apps were excluded if they were not related to ophthalmology and if they did not offer a 3D function that could rotate 360°. All relevant apps were evaluated by three parameters: 3D Features, Highlights individual anatomical features, and Cost.

Results: The ‘Play Store’ generated 250 results of which 20 were relevant. The ‘App Store’ generated 211 results of which 12 were relevant. Between the ‘Play Store’ and ‘App Store’ there was an overlap of 7 apps. These apps offered a variety of 3D features including 360° rotation, X‐ray and animation modes, and virtual/augmented/mixed reality options. Of the relevant 25 Google and Apple apps, 76% (19/25) offered a function to highlight individual anatomical features. 32% (8/25) of these apps were free and the remaining 68% (17/25) had a price range from £0.89 to £36.62, averaging at £10.36 per app.

Conclusions: The availability of medical smartphone applications has proliferated over the past two decades. Whilst there is a wealth of applications available to aid ophthalmology anatomy learning, further improvements and content regulation from specialists is required to maintain a high standard of content. This study is the first to systematically evaluate smartphone apps within the context of ophthalmic anatomy.
The impact of cannabis consumption on visual processing
Authors: Lalonde Melanie , Nguyen Hong‐An , Mostofian Fargol , Karanjia Rustum , Coupland Stuart
Published: December 2022

Purpose: Cannabis is one of the most widely used recreational drug in Canada. The purpose of this study is to evaluate the effect of cannabis consumption on the visual pathway via non‐invasive, objective electrophysiological testing.

Methods: Full field electroretinograms (ffERGs) including photopic negative responses (PhNRs), and visual evoked potentials (VEPs) were recorded in non‐users (control group) and in cannabis users. International Society for Clinical Electrophysiology of Vision (ISCEV) standard clinical protocols were used for all exams. Cannabis users were tested twice: at least 12 h after their last cannabis consumption (chronic group) and 2.5 h following their last consumption (acute group).

Results: When comparing the chronic and acute groups via paired t‐tests (n = 15), there was a statistically significant decrease in (1) the scotopic a‐wave amplitude (chronic −139.8 ± 7.4 μV and acute −114.8 ± 6.8 μV; p = 0.03; stimulus 10.0), (2) PhNR amplitude (chronic −32.2 ± 4.8 μV and acute −26.6 ± 3.1 μV; P = 0.01; stimulus 7 cd•s/m2), and the amplitude of the following two VEP parameters (3) N75 (chronic −2.6 ± 0.9 μV and acute −2.0 ± 1.1 μV; p = 0.04; stimulus 30 min), and (4) N135 (chronic −15.0 ± 1.4 μV and acute −12.3 ± 1.2 μV; p = 0.03; stimulus 15 min). PhNR implicit time was statistically significantly increased when comparing the control (63.4 ± 1.5 ms; n = 18) and the acute (69.1 ± 1.9 ms; n = 15) group (p = 0.03; stimulus 7 cd•s/m2). There were no statistically significant changes in ffERGs and VEPs between the control and chronic groups.

Conclusions: The results of this pilot study suggest that acute use of cannabis temporarily causes a reduction in photoreceptor activity with a downstream decrease in cortical activity. These changes appear to be reversible as there was no difference between the chronic exposure and the control groups.
Repeated measures of coffee and tea consumption in relation to open‐angle glaucoma risk and intraocular pressure regulation
Authors: Vergroesen Joëlle , Voortman Trudy , Klaver Caroline , Ramdas Wishal
Published: December 2022

Purpose: Previous studies suggest that caffeine is involved in the pathophysiology of open‐angle glaucoma (OAG) and the regulation of the intraocular pressure (IOP). However, prospective studies with availability of repeated measures on coffee and tea consumption are limited. The purpose of this study is to identify if and to what extent coffee and tea consumption over time is associated with OAG risk and IOP regulation.

Methods: Participants of the Rotterdam Study, a longitudinal population‐based cohort study, were regularly monitored for OAG. Data on coffee and tea consumption were collected using questionnaires. At baseline, 9731 participants were free of OAG; 8522 were assessed at a second visit; 3916 continued to a third visit; and 1297 participants were seen a fourth time. Over time, 201 participants developed OAG. The association between coffee and tea consumption and OAG or IOP was analysed using generalized estimating equations, adjusted for age, sex, body mass index, total energy intake, alcohol consumption, and follow‐up time. Additional adjustment for lifestyle factors (physical activity, diet quality, and smoking status) or comorbidities (diabetes mellitus and hypertension) was also performed.

Results: Neither coffee (Odds ratio [OR] with corresponding 95% confidence interval [95% CI]: 1.06 [0.95; 1.17] per cup [125 g] increase) nor tea (OR [95% CI]: 1.01 [0.92; 1.10] per cup [150 g] increase) consumption was associated with OAG risk. Coffee consumption was significantly associated with lower IOP (beta [95% CI]: −0.03 [−0.06; −0.01] per cup increase). Participants drinking the most coffee (4 cups or more per day) had the largest IOP reduction (beta [95% CI]: −0.28 [−0.54; −0.03]) as compared to non‐users (p‐tend = 0.02). We also found a significant association between tea consumption and lower IOP (beta [95% CI]: −0.05 [−0.08; −0.03] per cup increase). Highest tea consumption (3 cups or more per day) was associated with the largest IOP reduction (beta [95% CI]: −0.26 [−0.40; −0.07]) as compared to non‐users (p‐tend <0.001).

Conclusions: Although coffee and tea consumption were not associated with OAG risk, both were associated with significantly lower IOP. Our findings confirm earlier reported associations between coffee and tea consumption and IOP.
Metabolic effects of the retina in a murine model of AD (TgSwDI)
Authors: García‐Bermúdez Mariana Yolotzin , Vohra Rupali , Freude Kristine , Thomsen Maj Schneider , Aldana Blanca Irene , Kolko Miriam
Published: December 2022

* Shared co‐author.

Purpose: Previous cerebral studies of Alzheimer's disease (AD) have provided evidence for a neuronal metabolic dysfunction, which precede the cognitive decline. Since the retina is one of the most energy demanding tissues in the body and considered an extension of the brain due to its origin from the neural tissue, we speculate whether dysfunctional energy metabolism is present in AD models. Thus, the aim of the study is to evaluate energy metabolism and tissue survival in retinal explants in a murine model of AD (TgSwDI) during aging.

Methods: The 8‐, 12‐, and 24‐month‐old TgSwDI mouse model was compared with age‐matched wild‐type (WT) mice. Tissue survival was assessed by lactate dehydrogenase (LDH) viability assays of retinal explants at 2, 4 and 24 hours of incubation with culture media. Total ATP levels were quantified by bioluminescence assays to assess energy metabolism in TgSwDI mice.

Results: Retinal explant survival was reduced in the TgSwDI model compared to the age‐matched WT model with LDH assay at 8 months. The 8‐month‐old AD TgSwDI mice showed a tendency to decrease in total ATP levels after 2 hours of retinal explant incubation (p = 0.07).

Conclusions: Retinal tissue survival is impaired in the TgSwDI model during various ages, and tendencies of decreased retinal ATP levels were established at 8 months, implying disrupted retinal energy metabolism similar to changes observed in the AD brain.
A unique case report of Vogt‐Koyanagi‐Harada syndrome following COVID‐19 vaccination
Authors: Lee Vanessa , Zhou Wenting
Published: December 2022

Purpose: To report a case of Vogt–Koyanagi–Harada‐like disease (VKH) associated with COVID‐19 vaccination.

Methods: Analysis of a single case report in a single tertiary institution.

Results: A 48‐year‐old female presented with bilateral progressive blurring of vision 2 days after receiving her first dose of Pfizer‐BioNTech COVID‐19 vaccine. Clinical examination revealed multiple deep yellow lesions in the posterior pole and multifocal serous retinal detachments. Serological test for infective and autoimmune markers were negative. The patient was started on oral corticosteroids and had resolution of symptoms with near‐total improvement in visual acuity.

Conclusions: There have been previous cases of vaccine associated uveitis from reported cases of hepatitis B vaccine, human papilloma virus vaccine and influenza vaccine1,2,3,4,5. The exact mechanism of vaccine‐associated uveitis is currently not clear. In this present case, because of the short time interval between COVID‐19 vaccination and the onset of ocular inflammation in our patient, this raises the possibility that COVID‐19 vaccination may be a possible trigger for VKH.

References

1. Benage M, Fraunfelder FW. Vaccine‐associated uveitis. Mo Med. 2016; 113(1): 48–52.

2. Holt HD, Hinkle DM, Falk NS, Fraunfelder FT, Fraunfelder FW. Human papilloma virus vaccine associated uveitis. Curr Drug Saf 2014; 9(1): 65–8. doi:10.2174/15748863113086660062

3. Cunningham ET, Jr., Moorthy RS. Vaccine‐Associated Posterior Uveitis. Retina 2020; 40(4): 595–8. doi:10.1097/IAE.0000000000002816

4. Escott S, Tarabishy AB, Davidorf FH. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination. Clin Ophthalmol 2013; 7: 363–5. doi:10.2147/OPTH.S37443

5. Fraunfelder FW, Suhler EB, Fraunfelder FT. Hepatitis B vaccine and uveitis: an emerging hypothesis suggested by review of 32 case reports. Cutan Ocul Toxicol 2010; 29(1): 26–9. doi:10.3109/15569520903427717
Acute phase of epidemic keratoconjunctivitis: Management in practice
Authors: Choura Racem , Sayadi Jihene , GOUIDER Dhouha , Raihan Haythem , Mekni Manel , Aidi Nourhene , Zeghal Imene , Malek Ines , Nacef Leila
Published: December 2022

Purpose: To describe current trends in therapeutic modalities to manage acute epidemic keratoconjunctivitis.

Methods: We ran a descriptive study of 87 eyes of 61 patients diagnosed with acute epidemic keratoconjunctivitis confirmed by the presence of subepithelial infiltrates (SEIs) in the cornea. A clinical score based on a complete biomicroscopic examination, the measurement of visual acuity, the number of subepithelial infiltrates (SEIs), the break‐up‐time, and the value of the Schirmer type 1, has been established to evaluate symptoms.

Results: The mean age of the study population was 36 ± 17 years‐old. The treatments taken in the acute phase were either prescribed by a general practitioner (10%) or an ophthalmologist (60%), or taken as self‐medication (30%). None of our patients has received nonsteroidal anti‐inflammatory eye drops. Antivirals including ganciclovir were taken by 40% of the study group, artificial tears in 81 eyes (93%), antiseptics in 21% of the cases, and local antibiotics in 46 eyes (53%). The mean clinical score was 4.2 ± 2.6. There was no significant difference in the final clinical score, visual acuity, number of SEIs, break‐up time and Schirmer's value between the groups who instilled ganciclovir, artificial tears, local antibiotics as well as the healing agents and those who did not. Visual acuity was better in patients who did not use antiseptic eye drops.

Conclusions: The latest treatment recommended for the acute phase of epidemic keratoconjunctivitis are artificial tears with cold compresses, local povidone‐iodine and ganciclovir. Topical antibiotics are only used in confirmed bacterial superinfection. Our studied sample did not respond much to these recommendations.
The long and short‐‘sightedness’ of BMP3 in eye development
Authors: Findlay Amy , Stanton Chloe , Drake Camilla , Jackson Ian , Vitart Veronique
Published: December 2022

Purpose: Following genome‐wide association study for risk factors for retinal detachment, a locus overlapping the BMP3 gene, previously reported to be associated with myopia, was identified and selected for further examination. We prioritized an associated missense plausibly deleterious variant within the BMP3 gene for functional analysis. The BMP signalling pathway has long been implicated in the patterning and development of the eye, but BMP3's role both within this pathway and during eye development and disease is unclear.

Methods: The region around the associated missense variant is conserved between human and mouse, and the missense variation was introduced using CRISPR‐cas9 genome editing; loss of function mutations were also produced in the process. Our unit is uniquely equipped to analyse mouse eye phenotypes and using Optical Coherence Tomography (OCT), electroretinogram (ERG) and Optokinetic Drum (OKD) these mice were comprehensively phenotyped through to adulthood. RNA sequencing analysis was also used in cell lines and in primary mouse tissue to further investigate disrupted signalling pathways and potential downstream targets of Bmp3.

Results: OCT of mice showed no gross morphological abnormalities in either mice carrying the missense variant or loss of function mutations. ERG and OKD also showed that retinal function and visual acuity was unaltered in either line. However axial length measurements of adult mice showed a significant increase in length of the eye – indicative of myopia. Transcriptional analysis of two different retinal pigmented epithelial cell lines carrying loss of function mutations have been compared to results obtained from whole eye cups of mutant mice, and we have highlighted potential differences and similarities between the two.

Conclusions: Future work is required to assess how much the mouse and human cell line results converge, but our mouse results support a role for a BMP pathway in myopia development.
Intra‐corneal implantation of 3D bio‐printed mesenchymal stem cells using femtosecond‐laser‐ assisted intrastromal keratoplasty
Authors: Lemonche Gerard Boix , Nagymihaly Richard M. Nagymihaly M. , Niemi Essi M. , Josifovska Natasha , Johansen Stian , Moe Morten Carstens , Scholz Hanne , Petrovski Goran
Published: December 2022

Purpose: Regeneration of the cornea due to trauma or disease is a complex biological process, involving a delicate balance between cell differentiation, migration and a multitude of secreted factors and signalling molecules. We hereby present a tissue‐engineering technique as a possible first step towards getting a bench‐to‐bedside approach to assist corneal regeneration and ultimately, corneal transplantation.

Methods: 3D extrusion‐based bioprinting and femtosecond laser‐assisted intrastromal keratoplasty (FLISK) were used in the study. Ex vivo cultured mesenchymal stem cells (MSCs) derived from adipose tissue, bone marrow and corneal stroma were bioprinted in a complex, collagen I‐containing hydrogel. The transparent, cell‐loaded nanocellulose and alginate‐based 3D constructs were then implanted into a pig cornea organ culture model. The 3D printed intrastromal constructs were first cultivated ex vivo, while the de novo extracellular matrix (ECM) synthesis and migration of cells was followed by optical coherence tomography and immunohistochemistry.

Results: The ex vivo cultured, MSC‐loaded 3D bioprinted constructs supported cell survival and propagation for all three types of MSCs used. The transparency of the corneal stroma substitute was not compromised by the presence of MSCs in the bioprinted matrix. At day 14, the 3D‐bioprinted scaffolds appeared intact, as analysed by optical coherence tomography, while immunofluorescent staining using ECM and MSCs markers demonstrated the cellular presence in the constructs.

Conclusions: Optimization of the bioink composition, cellular content and properties of the bioprinted material to be used in corneal transplantation and regeneration studies are essential in fine‐tuning the technique towards its clinical use.
Correlation between visual field index (VFI) and quality of life in glaucoma patients
Authors: Rossi Gemma Caterina Maria , Bosi Chiara , Ssavini Lorenzo , de Silvestri Annalisa , Milano Giovanni
Published: December 2022

Purpose: The goal of glaucoma treatment is to avoid progression, to preserve vision and to maintain a sustainable quality of life (QoL). Aim of the study was to investigate the correlation between QoL and visual field index (VFI).

Methods: Cross‐sectional, monocentric study. Quality of life was examined with the 25‐item National Eye Institute‐Visual Functioning Questionnaire (NEI‐VFQ‐25) and the Glaucoma Symptom Scale (GSS). The visual field was performed with the Humphrey Field Analyser, with SITA fast 24‐2 program. The variables considered were: age, gender, comorbidities, years at visit (at diagnosis and duration of the illness), treatment and related active principles (n. of bottles and n. instillation and/or previous surgery), IOP min and max, visual acuity min and max. The analysis has been performed on both the better and the worse eye. Statistical analysis: linear regression univariate analysis and multivariate analyses.

Results: 193 patients (103 females) have been enrolled. The mean age (±SD) was 71 ± 10 ys, most patients presented hypertension (109, 62%) as main comorbidity. Patients were mostly on monotherapy (176, 45%). The mean value of the VFI was 81 ± 26, the total mean of the NEI‐VFQ was 80 ± 18, and the GSS total score was 77 ± 2. The linear regression analysis of the association between the variables and NEI VFQ‐25 found relation to: age (r = −0.29, p = 0.016); years of illness (r = −0.32, p = 0.02); visual acuity (r = 2.03, p < 0.001); IOP (r = 1.12, p = 0.002); number of previous surgeries (r = −3.93, p < 0.001). The multivariate analysis found relation to: gender (r = 5.13, p = 0.02), VA (r = 3.16, p < 0.001) previous surgeries (r = −1.8, p = 0.03). Regarding GSS, the linear regression analysis found relation to visual acuity; VFI, previous surgeries and number of instillations. A higher VFI has a positive impact on QoL questionnaires.

Conclusions: The study demonstrated the correlation between the VFI and the QoL, supporting a role of VFI as a metric instrument in the follow up.
P2X7R and TNFR1 antagonism neuroprotects rodent retinal ganglion cells in a sepsis model
Authors: Ramírez Kristy Tatiana Rodríguez , Calzaferri Francesco , Rios Cristobal De Los , Vidal‐Sanz Manuel , Agudo‐Barriuso Marta
Published: December 2022

Purpose: i/ To analyse the time course of retinal ganglion cell death (RGCs) after systemic injection of LPS in mice. ii/ To analyse the neuroprotective effect of P2X7 or TNFR1 receptor antagonism after LPS treatment.

Methods: Male C57BL/6J mice were given an intraperitoneal injection of increasing doses of LPS and retinas were analysed at 3 days. Once the dose was set, to test the neuroprotective effect of the antagonism of the P2X7 and the TNFR1 receptors, antagonists were administered subcutaneously or intraperitoneally, alone or in combination. Control groups were intact animals and animals treated with LPS + vehicle. In all groups, retinas were dissected flat and the total number of RGCs immunodetected with Brn3a was quantified.

Results: Significant death of RGCs was observed with doses higher than 4 mg/kg of LPS. In LPS treated animals, the loss of RGCs was observed at 3 days a progressed up to 7 days when 31% of the original RGC population was lost. From 7 to 21 days RGC loss did not progress. Antagonism of P2X7R or TNFR1 rescued 95% and 92% respectively of the original RGC population. Combination of both treatments did not improve each one alone.

Conclusions: A single injection of LPS causes RGC death which is rescued by more than 90% by antagonizing the inflammasome or the extrinsic pathway of apoptosis.
Leber hereditary optic neuropathy (LHON): Retinal structure and function correlations
Authors: Pajic Sanja Petrovic , Barboni Mirella , Habjan Maja Sustar , Hawlina Marko
Published: December 2022

Purpose: LHON mainly affects small‐calibre ganglion cells in the papillomacular bundle which is electroretinographically reflected mainly as abnormal wave N95 of the pattern ERG (PERG) and photopic negative response (PhNR). In this study we investigated whether there is a reflection of the disease in oscillatory potentials (OPs), which are thought to reflect activity of the inner retinal generators, and whether there is a correlation with retinal structure as assessed by OCT segmentation to explore potential structural/functional biomarkers in LHON.

Methods: Seven patients (mean age = 28.4 ± 5.6) with genetically confirmed LHON were compared to 12 healthy volunteers (mean age = 35.0 ± 12.1). PhNR, dark and light adapted OPs were derived from full‐field ERG signals. Segmentation analysis of retinal layers in ETDRS rings performed using the Heidelberg Engineering Spectralis SD‐OCT was correlated with oscillatory potentials derived from dark‐adapted and light‐adapted ERG signals filtered at 75 Hz cut‐off frequency that were shown to be affected in LHON in a previous study shown at this EVER meeting (Barboni et al.).

Results: Dark‐adapted OP2 component filtered at 75 Hz cutoff frequency displayed a significant negative correlation with outer plexiform layer (OPL) thickness (Spearman correlation = 0.94; p = 0.005) for outer ETDRS ring. The OP3 and OP4 showed marginal correlation with the outer ETDRS ring (Spearman correlation = 0.812; p = 0.050 and Spearman correlation = 0.840; p = 0.036). Marginally significant positive correlation was found with the OP3 (Spearman correlation = 0.812; p = 0.050). We found no significant correlation between OPs and any other retinal layers, nor were light‐adapted PhNRs associated with OCT layer thickness.

Conclusions: In chronic stage of the LHON, oscillatory potentials may be associated with OCT parameters, most notably dark adapted OP2 with OPL thickness. These data emphasize possible involvement of fast retinal generators as an additional biomarker in LHON patients.
12‐month outcomes of trabecular microbypass iStent inject W implantation combined with cataract surgery in open‐angle glaucoma eyes
Authors: El Bakkali Ismael Bakkali , Arias Pablo Cisneros , Rivasés Guillermo Pérez , Moscarda Eva Josefina Núñez , De Rivas Marta Orejudo , Fernández Miguel Castillo , Clavería Julia Aramburu , Martínez Marta Suñer , García Diana Pérez , Ascaso Javier , Ibañez Juan
Published: December 2022

Purpose: To evaluate the effectiveness (lowering medication) of a single trabecular microbypass stent (iStent Inject® W, Glaukos) implantation in combination with phacoemulsification in open‐angle glaucoma eyes over a 12‐month period.

Methods: Non‐randomized, single‐centre, retrospective case series of glaucoma eyes undergoing iStent implantation with phacoemulsification. Patients with no prior glaucoma surgery and intolerant or non‐compliant with medications were eligible for inclusion. Primary outcome effectiveness measures include reduction number of glaucoma medications and stabilization of intraocular pressure (IOP).

Results: 30 eyes of 24 patients (mean age 74.9 ± 8.4) were included in this study. Mean baseline IOP was 17.7 ± 3.5 mmHg and was reduced to 16.1 ± 2.6 and 15.7 ± 2.5 at 6‐ and 12 months respectively (p = 0.002). Mean number of medications was 2.3 ± 1 at baseline and was significantly reduced to 0.7 ± 0.9 at 12 months (p < 0.001; −68%). No eye was medication free at baseline versus 50% (n = 15) at 12 months. In controlled glaucoma eyes (≤18 mmHG), mean IOP was stable (15.5 ± 2.1 at baseline; 15.3 ± 2.4 at 12‐month) while medications were reduced from 1.9 ± 0.7 at baseline to 0.5 ± 0.6, whereas in uncontrolled glaucoma eyes (>18mmHG at baseline) both IOP and medications were reduced from 20.7 ± 2.5 and 2.7 ± 1.2 at baseline to 16.2 ± 2.6 and 1.1 ± 1.1 at 12‐month respectively. There was no statistically significant change in retinal nerve fibre layer (RNFL) thickness at 12 months (p = 0.32). No eyes have experienced adverse events such as postoperatively IOP spikes or hyphema.

Conclusions: iStent Inject W implantation with phacoemulsification results in a significant reduction in mean glaucoma medications in glaucoma eyes. IOP was also reduced and there was no loss of visual acuity or RNFL. In uncontrolled IOP eyes, the stent implantation has brought IOP under control and reduced the number of medications, while in controlled IOP eyes, it has lowered the number of medications.
Traumatic acute retrobulbar haemorrhage complicated with central retinal artery occlusion
Authors: Gouider Dhouha , Sayadi Jihene , Choura Racem , Aidi Nourhene , Raihan Haythem , Mekni Manel , Zeghal Imene , Malek Ines , Nacef Leila
Published: December 2022

Purpose: To present the vascular complications of traumatic acute retrobulbar haemorrhage and describe its management through a case report.

Methods: A case report of a patient having an acute retrobulbar haemorrhage complicated with central retinal artery occlusion (CRAO).

Results: A 50‐year‐old male patient exposed to blunt orbital trauma two hours prior was referred to the emergency with complaints of pain and loss of vision in the left eye. The negative light perception was noted in this eye. A tense hematoma, proptosis, ophthalmoplegia, and a non‐reactive pupil were also noted. Biomicroscopic examination, revealed corneal edema, subconjunctival haemorrhage, and chemosis. The fundus examination was not possible. Intraocular pressure (IOP) was 60 mmHg. The patient was diagnosed with acute retrobulbar haemorrhage. Computerized tomography was performed immediately showing a fracture of the left medial orbital wall and haemorrhage within the retrobulbar space. Intravenous mannitol and topical dorzolamide‐timolol associated with oral corticosteroid were administered. IOP decreased to 30 mmHg, but the patient's visual acuity did not improve. The fundus examination revealed a total CRAO confirmed by the fluorescein angiography and OCT‐A showing massive ischemic edema and occluded perimacular arterioles with interruption to the choroidal blood flow. OCT images demonstrated an increased reflectivity and thickness of the inner retina and subretinal fluid, which corresponds to the acute phase of CRAO. The time of surgical treatment was missed, and as a result, the patient missed their chance for visual recovery.

Conclusions: Retrobulbar haemorrhage is a complication from ocular trauma that may cause permanent vision loss. Retrobulbar haemorrhage can potentially lead to dangerous increases in intraorbital pressure, a condition that is also described as orbital compartment syndrome. This increase in pressure is sufficient to cause vision loss, whether through direct compression of the optic nerve leading to optic neuropathy, a central retinal artery occlusion, or compression of the vessels that provide nutrition to the optic nerve.