bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated intraocular pressure‐induced interlamellar keratitis in a patient with LASIK surgery 14 years ago
Authors: Arias Pablo Cisneros , El Bakkali Ismael Bakkali , Puyuelo Javier Ascaso , Muro Enrique Minguez , Moscarda Eva Nuñez , de Rivas Marta Orejudo , Pérez‐Rivasés Guillermo , Murillo Ana Boned , Barreda Maria Dolores Díaz
Published: January 2022

Purpose

To describe a case of interlamellar keratitis induced by elevated intraocular pressure (IOP) in a patient with a history of LASIK surgery and the importance of having a strong diagnostic suspicion for establishing adequate treatment.

Methods

Intraocular pressure‐induced interlamellar keratitis is one of the potential complications of LASIK refractive surgery. The cases described generally occur a few months after surgery although there are some cases that have been described several years after surgery, usually in a context of uveitis and corticosteroid treatment or silent glaucoma. We present a case of 43‐year‐old woman who came to the emergency room with visual acuity (VA) impairment in the left eye in the setting of elevated intraocular pressure‐induced interlamellar keratitis secondary to the intravitreal corticosteroid implant in her left eye due to a diabetic retinopathy. She underwent LASIK surgery 14 years ago.

Results

The treatment was based on lowering the intraocular pressure. Oral acetazolamide and topical timolol, bimatoprost and brinzolamide were used. The patient recovered her baseline VA and the IOP were properly controlled posteriorly.

Conclusions

This case shows the importance of considering this diagnosis in patients with corneal haze, elevated intraocular pressure and a history of LASIK surgery to establish an adequate treatment. A full recovery is expected.

Bibliography

1. Galal A, Artola A, Belda J, (2006) Interface corneal edema secondary to steroid‐induced elevation of intraocular pressure simulating diffuse lamellar keratitis. Journal of refractive surgery.

2. Lee V, Sulewski M, Zaidi A (2010) Elevated Intraocular Pressure–Induced Interlamellar Stromal Keratitis Occurring 9 Years After Laser In Situ Keratomileusis. Corneal Journal.

3. Lyle W, Jin G, Jin Y (2003) Interface fluid after laser in situ keratomileusis. Journal of refractive surgery.

4. Tourtas T, Kopsachilis N, Meiller R, et al. (2010). Pressure‐Induced Interlamellar Stromal Keratitis After Laser In Situ Keratomileusis. Corneal Journal.
Use of the corneal bioreactor to evaluate the anti‐edema effect and the ulcer healing rate between two commercial hyperosmotic eye drops: ODM5 and Muro 128
Authors: Peyret Benjamin , Crouzet Emmanuel , Chauchat Laure , Dumollard Jean Marc , Thuret Gilles , Gain Philippe
Published: January 2022

Purpose

The corneal bioreactor (BR) in our laboratory, with an intraocular pressure (IOP) of 21 mmHg and the renewal of the culture medium, allows to maintain the homeostasis of the 3 layers of the cornea. We showed that an IOP reduced to 10 mmHg allowed to simulate a corneal edema (760 ± 57 µm) with a healthy epithelium.

Aim

To compare 2 hyperosmolar eye drops in the evolution of corneal deturgescence and epithelial ulcer healing: ODM5 composed mainly of NaCl 5% and hyaluronic acid (Horus Pharma, Saint‐Laurent‐du‐Var, France) and Muro 128 composed mainly of NaCl 5% and various excipients (Bausch+Lomb, Bridgewater, NJ)

Methods

Beforehand, 3 pairs of human corneas were preserved for 2 weeks in the BR filled with CorneaMax (Eurobio, France), with a pressure maintained at 10 mmHg. A central epithelial ulcer of 6.64 ± 0.04 mm in diameter was made (D0). Each cornea received a drop of Muro 128 or ODM5 four times a day. Corneal central volume measurement (Casia 1, Tomey) was performed daily at the beginning and end of the day. Ulcer healing was monitored daily by fluorescein labelling and quantified by image analysis (Fiji) taken with a macroscope. At D14, the corneas were removed and fixed for immunostaining of E‐Cad (cell architecture), Zo‐1 (tight junctions), MUC16 (mucins), K3K12 (cell maturity) and for histology (Saffron Eosin Hemathein).

Results

Mean daily volume loss was comparable: 2.43 ± 1.55 mm3 with ODM5 vs. 2.18 ± 1.71 mm3 with Muro 128 (p = 0.698 3). Corneal ulcers in all 3 pairs healed at D4, D5, D5 with ODM5 vs. D5, D13, and 1 cornea never healed with Muro 128. In IHC and histology, the epithelium was of better quality with ODM5.

Conclusions

The efficacy of the 2 eye drops is comparable. Epithelial preservation is partly better with ODM5, possibly related to the presence of hyaluronic acid.
Surgically induced, pharmacologically mediated endothelial corneal proliferation
Authors: Tanev Ivan , Kirkova Radina
Published: January 2022

Purpose

The aim of our study is to evaluate the possibility for pharmaceutically mediated endothelial corneal proliferation in patients with corneal dystrophies.

Methods

It’s a cohort prospective study. We perform full ophthalmic examination /best corrected visual acuity for distance and near, tonometry, biomicroscopy, ophthalmoscopy, endothelial cell count/. We divide our patients with corneal endothelial dystrophies into two groups for therapeutic options: Group A and Group B. Patients from group A recieved only pharmaceutical product – a Rho‐kinase inhibitor to stimulate the proliferation of corneal endothelial cells. In Group B stripping of Descemet membrane is performed, in combination with a Rho‐kinase inhibitor.

Results

All data from our study were statistically analyzed.

Conclusions

Surgically induced pharmaceutically mediated corneal endothelial profileration showed promising results.
Study of corneal backscatter by Scheimpflug imaging in patients with keratoconus treated with corneal Cross‐linking
Authors: Moscarda Eva Josefina Núñez , Boned‐Murillo Ana , Díaz‐Barreda Mª Dolores , El Bakkali Ismael Bakkali , Rivasés Guillermo Pérez , Cisneros Pablo , deRivas Marta Orejudo , Del Buey Sayas María Ángeles , Pascual Paula Casas
Published: January 2022

Purpose

To compare corneal densitometry obtained using Pentacam HR in the eyes of patients with keratoconus treated with corneal collagen cross‐linking (CXL) versus the eyes of healthy controls.

Methods

An observational case‐control study was carried out on 18 eyes of 15 patients with keratoconus treated with CXL (classical therapy), and 30 eyes of 15 healthy controls, in which ocular pathology had previously been ruled out. All patients underwent a Scheimpflug corneal tomography with Pentacam HR. For the analysis, the backscattering of light is measured in the anterior (120 µm) central and posterior (60 µm) corneal layers.

Results

The group of patients treated with CXL therapy were 11 men and 4 women, the mean age was 28.06 years (range 17–44 years). In the CXL group the mean light scattering in the previous layer was 24.35 ± 1.074 (C: 21.6 ± 0.68 p > 0.05); central layer 14.68 ± 0.53 (C: 14.48 ± 0.41 p <0.05); posterior layer 10.75 ± 0.35 (C: 11.04 ± 0.36 p < 0.05) and full thickness 16.6 ± 0.62 (C: 15.71 ± 0.44 p < 0.05).

Conclusions

There are statistically significant differences in the densitometry values of the anterior layer of patients with keratoconus treated with CXL compared to healthy controls. We did not find statistically significant differences for the central, posterior and total variables.
Measurement of electroretinogram responses in OPA1‐associated autosomal dominant optic atrophy using a handheld device
Authors: Rufus‐Toye Remi , Jurkute Neringa , Leo Shaun , Mahroo Omar , Yu‐Wai‐Man Patrick
Published: January 2022

Purpose

Autosomal dominant optic atrophy (ADOA) associated with OPA1 variants is the most common inherited optic neuropathy in the population. The utility of the Ganzfeld electroretinogram (ERG) in evaluating ADOA has not been extensively investigated. In this study, we explored the potential of using a handheld ERG device (RETeval®) to measure ERG responses in a cohort of patients with ADOA carrying pathogenic OPA1 mutations.

Methods

The Ganzfeld photopic ERG was recorded in 15 individuals with OPA1‐associated ADOA in response to series of flashes (200, automatically adjusted in intensity to pupil diameter) using the RETeval® handheld ERG device and skin electrodes. Two to three series were obtained from each eye. The recordings were analysed for noise and drift manually. Both visual acuity measurements, and optical coherence tomography ganglion cell layer (GCL) and retina nerve fibre layer (RNFL) thicknesses were recorded to explore correlation with ERG parameters.

Results

There was a significant correlation between LogMAR visual acuity and both the a‐wave (ρ = ‐0.60, p = 0.02, n = 15) and b‐wave (ρ = ‐0.54, p = 0.04, n = 15) peak times. As a‐wave and b‐wave peak time correlated with age, a multiple linear regression analysis was performed to exclude age as a confounder. With respect to the a‐wave analysis, the coefficients for visual acuity and age were ‐0.66 (p = 0.019) and 0.015 (p = 0.14), respectively. With respect to b‐wave analysis, the coefficients for visual acuity and age were ‐1.32 (p = 0.017) and 0.028 (p = 0.16), respectively. There was no significant correlation between a‐wave and b‐wave peak times with the OCT structural parameters that were analysed.

Conclusions

In patients with OPA1‐associated ADOA, a‐wave and b‐wave peak times correlated negatively with LogMAR visual acuity, independent of the effects of age. The pathophysiological relevance of these findings requires further investigation in a larger patient cohort.
The physicochemical properties of preserved and preservative‐free latanoprost eye drops and their impact on human conjunctival goblet cells
Authors: Müllertz Olivia , Nagstrup Anne , Mouhammad Zaynab Ahmad , Freiberg Josefine Clement , Nagymihaly Richard , Jacobsen Jette , Larsen Susan , Bair Jeffrey , Utheim Tor Paaske , Dartt Darlene , Heegaard Steffen , Petrovski Goran , Kolko Miriam
Published: January 2022

Purpose

To investigate the impact on human conjunctival goblet cell (GC) survival and mucin release for benzalkonium chloride (BAK) preserved and preservative‐free (PF) 0.005% (w/v) latanoprost (LT) eye drops, and to compare the eye drops’ physicochemical properties.

Methods

GC cultures were established from human conjunctival donor tissue. The impact of eye drops on GC survival was assessed using lactate dehydrogenase (LDH) and tetrazolium dye (MTT) colorimetric assays. Mucin release was evaluated through mucin‐specific immunostaining. pH‐value, osmolality, drop mass and surface tension for all LT eye drops were measured.

Results

After application with PF‐LT for 30 minutes (min), the GC survival was maintained (p = 0.7043), while all BAK‐LT eye drops reduced survival to approximately 70% (p<0.0001). Following application with PF‐LT for 30 min, mucin was found around the GC nucleus, as seen in the vehicle control, indicating no secretion. In contrast, BAK‐LT caused diffuse staining of mucin, similar to the secretagogue histamine, indicating stimulation of secretion. The pH of the BAK‐LT and PF‐LT eye drops were 6.0‐6.9 and 6.8, respectively. The osmolality was 258‐288 mOsm/kg for the BAK‐LT eye drops and 276 for PF‐LT eye drop. The mean drop mass was 26‐31 mg for the BAK‐LT eye drops and 30mg for PF‐LT. The surface tension was lower for all BAK‐LT eye drops (31.1‐32.1 mN/m) compared to PF‐LT (42 mN/m).

Conclusions

PF‐LT compared to various branded and generic LT preparations containing BAK should be used to improve goblet cell tolerability and ocular surface health.
Cytotoxicity evaluation of a novel latanoporst 0.005% nanoemulsion
Authors: Tau Julia , Aguilar Alejandro , Berra Alejandro , del Papa Melina Sol , Passerini María Silvia
Published: January 2022

Purpose

To evaluate the cytotoxicity of a new Latanoprost Benzalkonium chloride (BAK)‐free nanoemulsion and to compare it with a Latanoprost solution containing BAK.

Methods

Normal Human Conjunctival epithelial cells (IOBA‐NHC) were incubated for 15, 30, and 60 minutes with 1:6 dilutions of either latanoprost solution containing BAK (LSc), (latanoprost 0.005%, BAK 0.02%, Xalatan, Pfizer) or latanoprost nanoemulsion (LNe), (latanoprost 0.005%, potassium sorbate 0.18%; Louten Emulsion, POEN). Cytotoxicity was determined by MTT assay. Cell death was measured by flow cytometry using annexin V‐FITC and propidium iodide.

Results

Cytotoxicity evaluation: the values of cell viability and proliferation obtained from cells exposed to LNe were between 80 and 90% relative to control group, whereas values obtained from cells exposed to LSc were around 30% relative to control group at all study times (p < 0.05 at 15 and 30 minutes; p < 0.01 at 60 minutes).

Cell death evaluation: the percentage of viability was significantly lower in cells exposed to LSc compared with those incubated with LNe at all study times (p < 0.05 at 15 and 30 minutes; p < 0.01 at 60 minutes). Viability of cells exposed to LNe was higher than 90% at all study times, whereas there was a time‐dependent decrease in cells exposed to Lsc. The percentage of viable cells in the LNe group was comparable to the viability of control group (93.1%) at all study times. No statistical differences between groups reached in early apoptotic cells. A significant increase of late apoptosis and necrosis cells were observed at all study times for those incubated with Lsc (p < 0.05; p < 0.01 at 30 and 60 minutes).

Conclusions

The new latanoprost nanoemulsion is significantly less cytotoxic on human conjunctival cells than LSc. It suggests that the new formulation could be gentler on the eye surface than currently available BAK preserved latanoprost solutions, with levels of cytotoxicity equivalent to control.
Valve cyclodialysis with implantation of a non‐absorbable collagen implant in the cyclodialysis tunnel in surgical management of open‐angle glaucoma: long‐term results
Authors: Kumar Vinod , Shradqa Ahmad , Frolov Mikhail , Dushina Galina , Bezzabotnov Andrej
Published: January 2022

Purpose

To assess long‐term efficacy and safety of valve cyclodialysis (VC) with implantation of a non‐absorbable collagen implant (NCI) in cyclodialysis tunnel (CT) in decreasing intraocular pressure (IOP) in open‐angle glaucoma patients.

Methods

Sixty‐one patients (25 male, 36 females; average age ‐ 73.4±8.8 years; 61 eyes) were included in this study. Surgical technique included dissection of a superficial scleral flap, creation of a scleral valve (2*1mm) out of deep scleral layers 4 mm away from limbus, creation of a CT (2*4mm) and implantation of a NCI in the CT. The scleral valve helped to minimize trauma to ciliary body while inserting NCI. Among other patients, 20 patients (32.8%) with failed filtering surgeries and 45 patients (73.8%) with cataract were included. Thirty‐three patients (54.1%) had advanced stage of glaucoma. Post‐operative follow‐up was up to 24 months. Outcome measures were: IOP change, reduction in hypotensive medication use, need for repeat surgery and intra‐ and postoperative complications. The data were processed by the method of variation statistics.

Results

Baseline mean IOP was 28.0±5.5 mmHg [95% confidence interval (CI) 24.8‐29.2]. At 18 and 24 months, mean IOP decreased to 19.2±1.8 mmHg (n=61, 95% CI 18.1‐19.0) and 18.9±1.8 mmHg (n=30, 95% CI 18.2‐19.5), making a decrease by 29.5±11.4% and 28.0±12.4% respectively. The hypotensive drugs use was reduced from 2.6±0.9 to 0.5±1.0 and 0.5±1.0 respectively. Repeat surgery was required in 2 cases at 18 months. Intraoperative hemorrhage while creating the CT was observed in 6 patients (9.8%). In the early postoperative period hyphema was prevalent in 1 patient, shallow AC – in 2 patients, hypotony – in 1 patient, and some exudative reaction in 3 patients. No complication was noticed in any of the cases in the late postoperative period.

Conclusions

Long‐term results showed that VC with implantation of a NCI in the CT is an effective and safe surgical glaucoma procedure.
A modified non‐penetrating bleb less glaucoma surgery to activate uveolymphatic outflow of aqueous humor – short‐term clinical and optical coherence tomography evaluation results
Authors: Kumar Vinod , Abu Zaalan Kamal Abdulmuhsen , Frolov Mikhail , Shradqa Ahmad , Dushina Galina , Bezzabotnov Andrej
Published: January 2022

Purpose

To study the safety and effectiveness of a modified bleb less glaucoma surgery in decreasing intraocular pressure (IOP) in open‐angle glaucoma (OAG) patients having visually significant cataract (VSC).

Methods

Twenty OAG patients with VSC underwent combined surgery. After fashioning out a superficial scleral flap, a scleral bridge (4*1 mm) 2 mm away and parallel to limbus was dissected from deep scleral layers. Sclera posterior to bridge was excised exposing uvea. Deep sclerectomy anterior to bridge deroofing the Schlemm’s canal was performed. No trabeculo‐Descemet’s window was created. A strip of dry collagen implant (5*2*0.1 mm) was inserted under the scleral bridge. Superficial scleral flap was sutured back. YAG laser trabeculotomy was performed after 7–10 days after surgery. Minimum follow‐up – 3 months. Surgery sites were evaluated by optical coherence tomography (OCT). Outcome measures: IOP change, reduction in hypotensive drugs use, complications and need for repeat surgery.

Results

At 3 (n = 20) and 6 months (n = 13) mean IOP decreased from 26.5 ± 8.2 mmHg to 13.6 ± 4.8 mmHg and 15.3 ± 3.5 mmHg, making a decrease by 46.1 ± 18% and 37.8 ± 22.7%; the hypotensive drugs use reduced from 2.8 ± 0.9 to 0.3 ± 0.8 and 0.5 ± 1.1 and target IOP with or without medications could not be achieved in 1 patient (5%) and 4 patients (30.7%) respectively. No complication was encountered intraoperatively. Postoperative period was smooth. On OCT no bleb was detected in any of the case. Instead lymphatic vessels with bicuspid valves were detected near to surgery sites. With time the lymphatics reduced in size and number. In failure cases, there were no detectable lymphatics vessels.

Conclusions

The proposed technique is safe and effective in managing glaucoma in cataract patients. The absence of bleb formation and aqueous humor outflow via lymphatics was confirmed by OCT. For predictable hypotensive outcomes, every caution should be taken in glaucoma surgery to preserve the lymphatics.
Characteristics and variability of iridocorneal angle: an anterior segment optical coherence tomography study
Authors: Meriem Ouederni , Fehmy Nafaa , Maamouri Rym , Hela Sassi , Mrad Insaf , monia cheour
Published: January 2022

Purpose

We aimed to assess the iridocorneal angle by Anterior Segment Optical Coherence Tomography (AS‐OCT) and to identify relations between angle measurements and subject factors in a healthy Caucasian Tunisian population.

Methods

A prospective cross‐sectional study was performed in 201 right eyes of 201 healthy subjects.

All patients underwent a complete ophthalmic examination, automated refraction, ultrasound biometry and AS‐OCT examination at the same day. The iridocorneal angle measurements including trabecular iris angle (TIA), angle opening distance 500 (AOD500) and trabecular iris space area 500 (TISA500) were manually measured using AS‐OCT. Correlations and associations were examined between angle measurements and demographic, clinical and ocular factors.

Results

The means recorded were TIA = 34.6 ± 11.4 degrees, AOD500 = 515 ± 260.7 µm and TISA = 500 0.178 ± 0.091 mm². We found that 90.3% of the iridocorneal angles were open.

Correlations were detected between angle means and age (R = −0.414; p < 0.01), intraocular pressure (R = −0.145; p < 0.01), spherical error (R = −0.410; p < 0.01), anterior chamber depth (R = 0.734; p < 0.01), axial length (R = 0.489; p < 0.01) and lens thickness (R = −0.519; p < 0.01).

No relation was observed with sex (p = 0.084).

Conclusions

AS‐OCT is a non‐invasive tool to identify subjects at risk of angle closure. In this Caucasian population, 90.3 % of the iridocorneal angles were open. AOD 500 and TISA 500 were as reliable as TIA in iridocorneal angle assessment. The angle width was correlated with demographic and ocular factors. Among the main limitations, was the fact that we did not measure the lens vault despite the known contribution of this factor to angle width variation.
Evolution of practice and management of neovascular glaucoma: a landmark review
Authors: Ramji Saajan , Nagi Gurnoor , Ansari Abdus Samad , Lee Elsa , Kailani Obeda
Published: January 2022

Purpose

A comprehensive systematic review (SR) was completed evaluating patient outcomes following medical and surgical interventions targeted at controlling iris neovascularization (NVI) and neovascular glaucoma (NVG).

Methods

Data sources used were MEDLINE, EMBASE and Web of Science. Studies included both surgical and medical treatments in patients with NVI and NVG. Outcomes measured were intraocular pressure (IOP) lowering, failure rates, loss of visual acuity and disease regression. The SR was registered with PROSPERO.

Results

The majority of studies retrieved during this time period were population based. A total of 159 studies were included with 148 studies being population based. 59.5% of studies were retrospective in nature and 40.5% were prospective. There were 7 randomised controlled trials and 4 non‐randomised controlled trials. The mean number of patients and eyes studied were 39 ± 42 (range 3–386) and 40 ± 47 (3–428) respectively. The mean follow‐up for all studies was 18.2 ± 24.1 (range 0.25–216) months. Significant differences were observed between glaucoma drainage devices (GDDs), diode laser and trabeculectomy in IOP lowering efficacy and failure rates; particularly with the advent of Anti‐VEGFs.

Conclusions

The unpredictable, uncommon nature of NVG is a significant limitation to high‐quality evidence on the subject. Our findings are primarily based on real‐life, non‐RCT data. We present a necessary update on the medical and surgical treatment of neovascular glaucoma particularly with increased incidence in the era of COVID‐19.
Treatment of open angle glaucoma or ocular hypertension with preservative‐free tafluprost/timolol fixed dose combination in a real‐world setting: analysis by diagnostic sub‐group at study entry
Authors: Oddone Francesco , Saborio Gabriela , Pavicic‐Astalos Jasna , Scorcia Vincenzo , Moreno‐Valladares Antonio , Holló Gabor
Published: January 2022

Purpose

The VISIONARY study assessed the efficacy of the preservative‐free tafluprost/timolol fixed‐dose combination (PF tafluprost/timolol FC) in patients with open‐angle glaucoma (OAG) or ocular hypertension (OHT) who were inadequately controlled with prostaglandin analogue (PGA) or beta‐blocker (BB) monotherapy. This analysis examined IOP reduction by diagnosis and prior treatment type.

Methods

IOP was recorded at baseline for adults (≥18 years) receiving topical PGA or BB monotherapy for OAG/OHT and treatment was switched to PF tafluprost/timolol FC. IOP was recorded at Weeks 4, 12 and 24. The primary endpoint was mean absolute change in IOP from baseline at Month 6. Baseline diagnoses were OHT (n = 110), primary open‐angle glaucoma (POAG; n = 425), normal tension glaucoma (NTG; n = 13), or pseudoexfoliative glaucoma (PEX; n = 19).

Results

Mean (SD) baseline IOP was 21.5 (5.00) mmHg, 22.3 (4.30) mmHg, 17.2 (2.68) mmHg and 21.7 (4.13) mmHg for patients with POAG, OHT, NTG and PEX, respectively. Respective Month 6 relative IOP reductions were 25.4%, 26.1%, 15.8% and 17.6%. Mean (SD) baseline IOP was 21.9 (4.36) mmHg and 21.4 (4.48) mmHg for BB and PGA users, respectively. Month 6 respective IOP reduction from baseline was 6.6 (4.16) mmHg (28.5%) and 5.4 (4.04) mmHg (23.6%) (p < 0.0001). PF tafluprost/timolol FC was generally well tolerated; 14 patients discontinued due to poor local tolerance or insufficient IOP control.

Conclusions

In this real‐world study, PF tafluprost/timolol FC was effective and well‐tolerated in patients previously uncontrolled on BB or PGA monotherapy, irrespective of initial diagnosis and type of previous topical medication. Patients with OHT, POAG, NTG and PEX showed IOP reductions at Week 4 that were maintained throughout the study period.

Bibliography

Oddone F, et al. Treatment of Open‐Angle Glaucoma and Ocular Hypertension with Preservative‐Free Tafluprost/Timolol Fixed‐Dose Combination Therapy: The VISIONARY Study. Adv Ther.2020;37(4):1436–51.
Optic nerve head assessment in Light‐field fundus images – A case study
Authors: Dietzel Alexander , Schramm Stefan , Blum Maren‐Christina , Link Dietmar , Klee Sascha
Published: January 2022

Purpose

A suspicious optic nerve head (ONH) appearance, with abnormal cupping or increased cup‐to‐disc ratio, is associated to a strong risk factor for glaucoma. Typical devices to analyse the structure of the ONH are optical coherence tomography or scanning laser ophthalmoscopy. Those devices provide parameters to describe the status of an ONH like its depth, width or volume. We show that these parameters for glaucoma diagnosis can be obtained with a commercial fundus camera using an adapted light field (LF) camera providing a one‐shot 3d retinal image.

Methods

We examined a human eye (32 years, male) 5 times during one session in compliance with the Declaration of Helsinki. The images were taken with a fundus camera (FF450, Carl Zeiss Meditec AG, Germany) combined with an industrial LF camera (RX12, Raytrix GmbH, Germany). The generic depth estimation was performed with the Raytrix LF software (RxLive 5.0.031.0) using the Depth Raycast Light algorithm. The results were exported as 3d point lists in ascii XYZ format and for further processing imported in Matlab (R2018b, MathWorks, U.S.). The imported data were pre‐processed, the papilla midpoints automatically detected and the optic nerve head was horizontally sliced in 0.01 virtual depth steps starting from the base upwards until the papilla rim was reached. We compared the overall virtual depth, the virtual volume and the virtual area per virtual depth step, each as relative difference.

Results

All LF images showed visually a very good image quality. The depth estimations were successful and covered the complete image areas. The overall virtual depth range was 95.9% to 101.4% with mean of 100% (±2.36%). The overall virtual volume range was 97.5% to 102.2% with mean of 100% (±2.1%). The area per virtual depth range was 2.5% to 174.5% with mean of 100% (±10.9%) whereas the larger deviations appeared in the lowermost slices.

Conclusions

Fundus cameras with LF technique are able to provide one‐shot 3d retinal images. This light field images allow the evaluation of typical parameters for glaucoma diagnosis and show a very good reproducibility.
Relation between Histone deacetylase expression in uveal melanoma and the presence of infiltrating leukocytes
Authors: Souri Zahra , Jochemsen A.G. , Verdijk Rob , Jager Martine
Published: January 2022

Purpose

Uveal Melanoma is a rare ocular malignancy; high‐risk monosomy 3 tumors often show an increased density of tumor‐infiltrating lymphocytes and macrophages. Histone deacetylases (HDACs) are a group of epigenetic modifiers, some of which are increased in monosomy 3 UM. We compared HDAC expression in Uveal Melanoma (UM) with the presence of infiltrating leukocytes. We furthermore determined whether expression was modifiable by interferon‐gamma.

Methods

The expression of nine HDACs and CD3E, CD8 and CD68 leukocyte markers was determined using an Illumina HT12V4 array in 64 primary UM. In addition, HDAC and infiltrate data were obtained from the TCGA for 80 cases. Four UM cell lines were treated with two doses of IFNɤ (50 IU, 200 IU), for 48 hrs. Quantitative PCR (qPCR) was used for mRNA measurement of HDAC expression in‐vitro.

Results

HDACs 1, 3, 7, and 8 were positively associated with CD3E, CD8A and CD68 leukocyte markers (P ≤ 0.05). Analysis from the TCGA similarly showed that HDACs 1, 3, and 8 were positively correlated with the presence of CD3E and CD8A.

When looking at the possible effect of IFNɤ on four UM cell lines (OMM1, OMM2.5, MP38 and Mp46) we found that (in contrast to HLA‐A and HLA‐B mRNA expression which was induced in all four cell lines), HDACs 1, 4, 5, 7, and 8 were induced in two out of four UM cell lines (OMM2.5 and MP38).

Conclusions

As HDACs were previously shown to be upregulated in high‐risk monosomy 3 UM tumors, we wondered whether they are associated with the presence of tumor‐infiltrated lymphocytes and macrophages. Our findings indicate that several HDACs show positive correlation with tumor‐infiltrating lymphocytes and macrophages. As these HDACs were sensitive to induction, there may be a role for the infiltrating leukocytes in the upregulation of HDACs in Uveal melanoma.
Cytokine profile in tear and aqueous humor of primary open‐angle glaucoma patients as a prognostic factor for trabeculectomy outcome
Authors: Burgos‐Blasco Barbara , Vidal Beatriz , Sáenz‐Francés Federico , Fernandez‐Vigo Jose Ignacio , Espino Laura , Feijoo Julian Garcia , Martinez‐de‐la‐Casa Jose Maria
Published: January 2022

Purpose

To evaluate the cytokine profile in tear and aqueous humor before trabeculectomy and correlate cytokine levels with the surgical outcome.

Methods

Prospective study. Twenty‐nine patients with primary open‐angle glaucoma undergoing primary trabeculectomy were included. Levels of 27 cytokines were measure in tear an aqueous humor using the Bio‐Plex Pro Human Cytokine 27‐Plex Immunoassay kit (Bio‐Rad Laboratories, Hercules, CA, USA).

Results

29 patients who underwent trabeculectomy were included and their first‐year follow‐up visits were recorded. Mean age was 76.0 ± 7.0 years (range 56–84), mean intraocular pressure was 18.2 ± 3.6 mmHg and mean number of topical medications was 2.3 ± 0.9. At the one‐year visit, 5 patients were classified as surgical failure. In aqueous humor, preoperative cytokine levels of regulated on activation normal T cell expressed and secreted (RANTES) were significantly higher in those patients with surgical failure at one year. IL‐8 in tear and interferon gamma‐induced protein (IP‐10) in aqueous humor correlated positively with one‐year IOP reduction. No statistically significant correlations were found with changes in visual field mean defect or global peripapillary retinal nerve fiber layer thickness (all, p > 0.05).

Conclusions

Preoperative RANTES levels in aqueous humor as well as other cytokines could serve as useful biomarkers for trabeculectomy outcome.
Benefits and new features of modern international internet data‐base “IOLCon” for updated and optimized IOL constants
Authors: Scholtz Sibylle , Eppig Timo , Schwemm Michael , Langenbucher Achim
Published: January 2022

Purpose

By inventing optical biometry about 20 years ago cataract surgery has changed fundamentally. Today, by establishing the most modern up‐to‐date internationally available database for IOL constants, “IOLCon” meets nowadays standards and requirements of a WEB based database for intraocular lens specifications and constants and provides essential data for successful cataract surgery. Biometer manufacturers are implementing the open XML interface to integrate IOLCon into their devices.

Methods

Close cooperation with Institute of Experimental Ophthalmology, University Homburg/Saar (Germany).

Results

Haigis´ ULIB (User Group for Laser Interference Biometry) was the first database of its time to set a milestone in providing optimized constants for cataract surgery. From today's perspective, it no longer meets modern requirements. By launching IOLCon in 2017 a modern data base is worldwide available today which is open to all IOL and biometer manufacturers. By its self‐explanatory functionality it is providing its users all relevant lens parameters. IOLCon fulfills the requirements of a modern biometry database and established itself as an indispensable tool for cataract surgeons by today.

Conclusions

Since its launch, IOLCon has grown steadily: As of February 2021, IOLCon offers data on approximately 489 IOL models from 29 manufacturers with almost 21.000 clinical data and optimizations for 121 IOL models. Thus, by implementing IOLCon a biometry database is now available, which will also meet the future demands of ongoing developing ophthalmo‐surgery. Today, IOLCon is a globally available internet‐based database which meets all requirements of modern ophthalmic surgery, it can be accessed at: https://iolcon.org.
Molecular diagnoses in the congenital malformations caused by ciliopathies cohort of the 100 000 genomes project
Authors: Best Sunayna , Lord Jenny , Roche Matthew , Watson Christopher , Poulter James , Szymanska Katarzyna , Ellingford Jamie , Carmichael Jenny , Brittain Helen , Toomes Carmel , Inglehearn Chris , Johnson Colin , Wheway Gabrielle
Published: January 2022

Purpose

To improve molecular diagnostic rates for participants recruited to the UK 100 000 Genomes Project suspected to have congenital malformations caused by ciliopathies.

Methods

Bespoke variant filtering and analysis strategy.

Results

Eighty‐three pre‐screened probands were recruited in the following disease categories: Bardet‐Biedl syndrome (n = 45), Joubert syndrome (n = 14) and Rare Multisystem Ciliopathy Disorders (n = 24). We determined a research molecular diagnosis for n = 43/83 (51.8%) of probands, n = 33 (39.8%) classified as confident or probable diagnoses. The diagnosis rate is 19.3% higher than the n = 27/83 (32.5%) previously reported by Genomics England. Interestingly, 19/43 (44.2%) of diagnoses are not ciliopathies. 4 patients have causative variants in eye disease genes not directly linked to cilia (PRPF8, RHO, PROM1, OPA1) and 15 in genes causative of non‐ciliopathy multisystemic conditions. This may reflect difficulties in clinical recognition of ciliopathies and highlights the importance of looking beyond the initial panel. n = 11/83 probands (13.3%) had at least one causative variant outside of the Tiers 1 and 2 variant annotation categories (defined by the Genomics England Rare Disease Tiering Process), which would otherwise be excluded in standard diagnostic strategies. These include 4 SVs and 3 predicted by SpliceAI to cause non‐canonical splicing defects. We found two homozygous truncating variants in the candidate ciliopathy genes LRRC45 and CFAP45 in a single proband. Identification of further individuals with ciliopathy phenotypes with pathogenic variants in these genes would strengthen confidence in their status as ciliopathy disease genes.

Conclusions

This study shows the value of research collaborations to improve interpretation of genomic data. Improved integration of SV and splice variant analysis tools, such as SpliceAI, will be essential to maximise the diagnostic potential of WGS data beyond coding variants in exons of virtual panels of genes.
Esotropia management: outcomes and prognostic factors
Authors: Lajmi Houda , Choura Racem , Hmaied Wassim , El Fekih Lamia
Published: January 2022

Purpose

We aimed to study the epidemiological and the clinical characteristics of esotropia, to report the results of the medico‐surgical management, and to analyze the various factors that may influence the postoperative prognosis.

Methods

Medical records of 130 patients who underwent esotropia surgery between 2000 and 2015 were retrospectively reviewed. Ophthalmological examination and complete sensorimotor assessment were performed for each patient. All surgeries were made by the same surgeon. We operated simultaneously on the horizontal and vertical elements. Total optical correction and amblyopia treatment were started before surgery. We studied the influence of certain prognostic factors on motor outcome, such as strabismus type, age at the onset, delay of surgical management, degree of amblyopia, preoperative deviation angle, and a vertical syndrome presence.

Results

The mean age was 8 ± 4.20 years. Our patients had infantile esotropia in 52.3% of cases. The age of strabismus onset was 2 years ± 2.2 years on average. Our patients had amblyopia in 70.7% of cases. A bilateral medial rectus muscle recession was performed in half of our patients with an associated Faden operation in 46.2%. We obtained a motor success rate of 85.38% after a single operation and a global success rate of 91.54%. A stable fusion and stereoscopic vision were present in only 4.6% of cases preoperatively and 6.92% of cases postoperatively. Surgical dosage and postoperative day 1 angle were significantly associated with motor outcome (p = 0.009 and p < 0.001).

Conclusions

Esotropia represents 83.3% of all strabismus. The infantile esotropia group had the worst motor and sensory status. Concerning the surgical protocol, the vertical syndrome is often operated on the same time as the horizontal deviation. Bilateral medial rectus muscle recession is the most practiced surgery. Unilateral surgery of recession/plication is indicated for deviations between 30 and 45 diopters and in the case of amblyopia. Bilateral surgery on 3 horizontal muscles is indicated in deviations of more than 45 diopters. Faden operation is indicated in angle variability of more than 15 diopters. The success rate for convergent strabismus varies between 48 to 90%.
OCT retinal imaging as differential diagnostic tool between Parkinson disease and essential tremor
Authors: Castro‐Roger Luisa , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Altabás María José Vicente , Tello Alvaro , Satue Maria
Published: January 2022

Purpose

To evaluate neuroretinal measurements in Parkinson disease (PD) and essential tremor (ET) patients, and to compare results with healthy controls.

Methods

A total of 214 subjects (214 eyes) were included in our study (146 healthy controls, 42 PD patients and 26 ET patients). Retinal examination in the peripapillary zone and the macular zone (retinal nerve fiber layer [RNFL] and ganglion cell layer [GCL] thickness) was performed for each subject using Swept source ocular coherence tomography (OCT) Triton and Spectralis OCT. Additionally, macular vascularization was analysed with OCT angiography (OCT‐A).

Results

A significant reduction in the peripapillary RNFL and CGL was observed in PD patients compared to ET patients (p < 0.001). Also, the RNFL in the macular area was significantly thinner in PD patients compared to ET (p < 0.001).ET patients showed significant thinning in both GCL and RNFL compared with controls only in nasal sectors (p < 0.001) Although vascularisation showed higher density in healthy controls compared to PD and ET, this parameter did not reach significance levels. According to the correlation analysis, global OCT angiography was associated inversely with disease duration in PD (r = −0.600; p = 0.018). Logistic regression analysis was performed, obtaining two linear discriminant functions (LDF) for differencing PD from ET or controls. These LDF included density of OCT‐A and GCL macular thickness (for Triton OCT) and RNFL peripapillary thickness (for Spectralis). They yielded a receiver operating characteristic curve (ROC) of 0.796 (p = 0.020) for Triton OCT; and 0.627 (p = 0.033) for Spectralis OCT.

Conclusions

Both PD and ET present retinal thinning compared with healthy controls. However, compared to ET, PD has a higher decrease affecting more areas of the RNFL and GCL, which might help differentiate both diseases. Considering the fact that OCT test is non‐invasive, quick and mostly available in every ophthalmological clinic, it could be considered as a potential tool for differential diagnosis between these two entities.
Retinal nerve fiber layer and optical coherence tomography angiography analysis in fibromyalgia using logistic regression
Authors: Tello Alvaro , Castro‐Roger Luisa , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Altabás María José Vicente , Satue Maria
Published: January 2022

Purpose

To evaluate the retinal nerve fiber layer thickness (RNFL) and the vascular density (VD) at the superficial vascular plexus (SVP) of the retina of patients with Fibromyalgia (FM) using Optical coherence tomography‐Angiography (OCT‐A) and to compare results with measurements of healthy eyes.

Methods

Fifty eyes of 50 patients with FM were included and compared with 232 healthy eyes. All subjects underwent peripapillary and macular RNFL thickness evaluation and macular SVP VD assessment using swept source OCT Triton and its OCTA module (Topcon, Japan). Both groups were compared, and the statistically significant different variables were used to create a logistic regression model. A Linear Discriminant Function (LDF) and its receiver operating characteristic curve (ROC) was obtained from the model.

Results

Statistically significant thinning was found at the peripapillary (temporal, p = 0.006; and supero‐temporal, p = 0.026) and macular (inferior, p = 0.029) RNFL thickness in the FM group compared to healthy controls. The best resultant LDF after logistic regression analysis was (Triton: −9.102 + (0.434 * RNFL macular inferior) + (0.088 * peripapillary RNFL nasal sector) – (0.220 * peripapillary RNFL temporal sector) showing a ROC curve with an area under curve (AUC) equal to 0.758. On the other hand, the SVP VD obtained with OCT‐A showed no statistically significant differences between groups in any of the analyzed areas (central p = 0.788; nasal p = 0.165; inferior p = 0.073; temporal p = 0.250; superior p = 0.538) so the data were not included in the regression analysis

Conclusions

FM patients present a reduction in the RNFL thickness compared to controls. The RNFL measurements might be a useful biomarker in the diagnosis of FM, complementing the current criteria based on clinical symptoms. However, it is necessary to explore the different imaging protocols to include them into a more robust statistical model.
The incidence and characteristics of Charles Bonnet syndrome in Leber’s hereditary optic neuropathy in a large cohort
Authors: Kreimei Mohammad , Karanjia Rustum , Mollanji Eisi , Poincenot Lissa
Published: January 2022

Purpose

To investigate the incidence and characteristics of Charles Bonnet syndrome (CBS) in patients with Leber’s hereditary optic neuropathy (LHON) via an online questionnaire shared with the LHON patient community.

Methods

A recently validated French‐Canadian CBS screening questionnaire was adapted to an online bilingual (English‐French) format while being tailored to LHON patients. It was distributed to numerous mailing lists and online communities consisting of LHON patients. The 62‐item questionnaire was organized into 3 parts to cover 9 dimensions: Demographics, Screening questions for CBS, Characteristics of hallucinations, Psychological impact, Psychopathological origin, Coping strategies, Context of appearance of hallucinations, Time‐related matters, Psychosocial support. Quantitative and qualitative response data were used for cross‐sectional analysis.

Results

A total of 63 LHON patients (71% male) completed the questionnaire – with 56% screening positive for CBS. Comparing CBS‐positive and CBS‐negative patients revealed significantly different LHON mutation distributions (p = 0.01137).

Among CBS‐positive patients, 74% reported experiencing hallucinations for at least one year. Furthermore, 37% said the images disturb their sleep, while 49% reported they negatively affect their mood. Additionally, only 49% had heard of CBS before and just a single patient (3%) had been diagnosed with CBS by a healthcare professional.

Conclusions

The results show there is a significant prevalence of CBS among LHON patients, but only a minority of these patients are being assessed and managed for the condition. There is also an indication that CBS tends to be long‐lasting and can be associated with various negative health outcomes. Early diagnosis and counseling of patients are important to help alleviate stress and anxiety related to CBS and improve quality of life.
When angle alpha modifies the visual aspect of an ocular deviation
Authors: Rateaux Maxence , Bremond‐Gignac Dominique , Robert Matthieu
Published: January 2022

Purpose

Ocular optics relies on several specific axes and angles. Angle alpha is the angle between the optical and the visual axes while the angle kappa is formed by the pupillary and the visual axes. The literature reports a non‐null angle kappa range between 1,91° ± 0,14° and 5,73° ± 0,10° in the healthy population. There is a positive correlation between the both angles. High positive angles can be found in high hypermetropia or genetic disorders such as albinism and aniridia. In strabological practice, a high angle can modify the visual aspect of the strabismus. A failed strabismus screening and divergence between visual appearance and Prism Covert Test (PCT) measurement can result from the presence of a high angle. We aim to purpose a classification of the visual appearance of the strabismus according to the PCT and the angle alpha value.

Methods

Patients were recruited in the ophthalmology department. For each patient, the best corrected visual acuity was performed. Monocular and binocular corneal light reflex was evaluated and the ocular deviation was measured by PCT. Monocular picture with flash was realized. The angle alpha was calculated using the algorithm developed in the department.

Results

We report a case series of five patients (3 boys and 2 girls) exhibiting an esotropia. Age range was 5.5 to 19 years‐old (med = 15, sd = 5.77). Esotropia range was 8 to 90∆ (med = 30, sd = 32.27) and angle alpha range was 8.37° to 26.49° (med = 17.7, sd = 4.93). According to values of angle alpha and strabismus deviation, five categories of visual aspect can be defined.

Conclusions

According to the angle value, a confusion between the visual aspect and the ocular deviation measurement can modify the diagnosis of strabismus. Five categories of visual aspect could be described. Then, the digital assessment of the angle alpha is a new tool which combined to the PCT, will help the practitioner to the correct evaluation of the ocular deviation and the strabismus screening.
Analyzing changes in tear proteins of Sjogren’s syndrome patients with timsTOF pro
Authors: Akkurt Arslan Murat , Kolman Ioannis , Chardonnet Solenne , Pionneau Cedric , Baudouin Christophe , Brignole‐Baudouin Françoise , Kessal Karima
Published: January 2022

Purpose

To investigate changes in the tear proteome of patients with Sjögren's syndrome (SSp) using a high‐resolution trapped ion mobility spectrometry (TIMS) powered with parallel accumulation–serial fragmentation (PASEF).

Methods

Tear samples were collected using Schirmer strips from healthy controls (HC) and SSp, then extracted in ammonium bicarbonate. The protein content of each sample was normalized to 250 ng. Proteomics analysis was performed by using TIMS coupled quadrupole time‐of‐flight (timsTOF Pro) followed by data processing using MaxQuant software for protein identification. Differentially expressed proteins were detected by a Limma statistical test with a false discovery rate (FDR)˂1%. Protein Gene Ontology classification was performed by using Panther.

Results

The proteins identified decreased by 23.9% in SSp compared to HC. Off the proteins identified in SSp, 90% were common with HC while only 68% of the proteins identified in HC were detected in SSp. A total of 175 proteins were significantly modulated in SSp with a fold‐change ≥ 1.5 (p‐value ≤0.05). None of the proteins detected only in SSp was among significantly modulated proteins but 25 proteins identified only in HC were significantly modulated. Catalytic activity (46.9%) and binding proteins (38.5%) formed the major molecular function groups among significantly modulated proteins. Proteins that exhibit binding activity were mainly down‐regulated in SSp while proteins involved in apoptosis such as caspase‐3 and proteasome subunits were up‐regulated. Several oxidoreductase enzymes (18) such as sulfhydryl oxidase‐1, Glutathione peroxidase‐3 and lactoperoxidase have been down‐regulated. Actins, actin‐binding proteins, tubulins, microtubule‐binding proteins were decreased in SSp. These results highlight an alteration in cellular process and antioxidase activity.

Conclusions

A large amount of proteins expressed differently in SSp that involve important biological processes and signalling pathways have been revealed. The improved spatial resolution, sensitivity, speed, and specificity of timsTOF Pro can dramatically increase the ability to fully investigate the molecular factors behind the pathophysiology of SS.