bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of the corneal biomechanical properties in pseudoexfoliation glaucoma, primary open angle glaucoma, and healthy subjects using corvis scheimpflug technology
Authors: Ohn Kyoung , Jung Younhea
Published: January 2025

Aims/Purpose: The purpose of this study was to compare corneal biomechanical properties using Corvis Scheimpflug Technology (ST) among pseudoexfoliation glaucoma (PXG), primary open angle glaucoma (POAG), and healthy controls.

Methods: Sixty eyes of 60 patients were enrolled in the study. These include 20 eyes with PXG, 20 eyes with POAG and 20 eyes of normal controls. Corneal biomechanical properties measured by Corvis ST were compared among PXG, POAG, and normal control groups. Corneal biomechanical parameters, which included deformation amplitude (DA) ratio maximum (Max) (2mm), Ambrosio relational thickness (ARTh), Integrated radius, and corneal biomechanical index (CBI), were compared and analyzed after adjusting for intraocular pressure and age.

Results: There were no significant differences in age, central corneal thickness, and intraocular pressure among the PXG group, POAG group, and normal control group (p = 0.133, p = 0.797, and p = 0.983, respectively). The DA ratio Max (2mm) value was significantly higher in the PXG group compared to normal control group after adjusting for IOP and age (4.48 ± 0.07 vs. 4.22 ± 0.07, p = 0.026). The Integrated Radius value was significantly higher in the PXG group compared to the POAG group after adjusting for IOP and age (8.42 ± 0.18 vs. 7.85 ± 0.17, p = 0.072).

Conclusions: PXG showed significant differences compared to POAG and normal controls in corneal biomechanical properties. Even after adjusting for intraocular pressure and age, the cornea in the PXG group exhibited greater flexibility and deformation compared to the POAG and normal control groups. These results suggest that corneal biomechanical properties may influence intraocular pressure measurement in PXG patients and may be related to optic nerve vulnerability.
Pre‐clinical evaluation of the Hyaguard™ sub‐conjunctival insert in maintaining post‐trabeculectomy intra‐ocular pressure vs MMC and Prednisolone drops
Authors: Alambiaga‐Caravaca Adrián , Lemoine Mark , Salimbeigi Golestan , Ahmad Tauseef , Pohler Nina , O'Brien Fergal , O'Brien Colm , Hibbitts Alan
Published: January 2025

Aims/Purpose: Post‐trabeculectomy rabbit model efficacy and safety evaluation of HyaGuard™; a biodegradable sub‐conjunctival drug eluting platform, designed to replace Mitomycin C (MMC) and post‐operate steroid drops in glaucoma drainage surgeries.

Methods: Pre‐clinical evaluation was conducted on normotensive New Zealand White rabbits (8‐12 weeks old, 50/50 male/female). A 4x4 mm trabeculectomy was performed on the left eye of each rabbit. All animals received Ofloxacin 3mg/ml (2 drops) 4 times daily for one week. Control and 1% w/w prednisolone HyaGuard groups did not receive MMC or prednisolone drops, whereas positive control animals were treated with 0.04% MMC for 4 minutes followed by prednisolone acetate 0.5% drops (2 drops) 4 times daily for two weeks. Intraocular pressure (IOP) was measured using TonoVet® pre‐operatively (week ‐1) and on days 3, 7, 14, and 28 post operation. Ophthalmic examinations were performed. Post study, eyes were histologically analyzed using H+E staining.

Results: 1% prednisolone HyaGuard inserts demonstrated significantly better welfare and safety scores than standard of care. Histological analysis revealed no fibrotic encapsulation and intact conjunctivas. From an initial average IOP of 11.5 (± 1.0) mm Hg, the Day 28 ΔIOP (% of starting IOP) was ‐35.38 ±19.75% for MMC‐drops (p < 0.01), ‐8.61 ±10.56% for blank HyaGuard (non‐significant), and ‐24.54 ±10.20% for 1% prednisolone HyaGuard (p < 0.05). The 1% prednisolone HyaGuard group maintained a significantly greater reduction in IOP compared to the negative control (p < 0.01) and was statistically equivalent to the positive control.

Conclusions: HyaGuard demonstrated improved tolerability and safety following subconjunctival insertion in rabbits. The 1% prednisolone loaded HyaGuard effectively maintained significant decreases in post trabeculectomy IOP, without the need for MMC or repeat drop administration, suggesting its potential as a viable solution to the long running fibrotic failures associated with bleb forming drainage surgeries.
Effects and clinical features of cataract combined surgery with I stent inject in open angle glaucoma patient
Authors: Park Keesup , Kim Ju Mi , Jun Ji Ho , Song Yong Yeon , Lee Jongha
Published: January 2025

Aims/Purpose: The purpose of this study was to compare the effectiveness of intraocular pressure lowering and clinical outcome in patients with open‐angle glaucoma who underwent combined I Stent inject® and cataract surgery.

Methods: From August 2022 to August 2023, patients with open‐angle glaucoma were divided into 30 eyes in the group (Group 1) that underwent only cataract surgery and 30 eyes in the group (Group 2) that underwent combined i stent injection and cataract surgery. We analyzed the preoperative clinical features between the two groups, the intraocular pressure lowering effect, the number of intraocular pressure lowering eye drops, and the course of complications up to 6 months after surgery.

Results: In the group that underwent combined i stent injection and cataract surgery and the group that performed only cataract surgery, preoperative intraocular pressure was 15.96±3.47 mmHg in group 1 and 22.00±7.97 mmHg in group 2 (p = 0.001), which was significantly higher in group 2. The number of intraocular pressure lowering drugs in use was 1.54±0.99 in group 1 and 3.39±1.10 in group 2 (p < 0.05), with group 2 using more eye drops. In group 1, the intraocular pressure of 15.12±1.69mmHg at 6 months after surgery was significantly lower than 16.82±2.58mmHg before surgery. (p = 0.025) In addition, in group 2, the intraocular pressure of 15.71±2.58mmHg at 6 months after surgery was significantly lower than 22.00±6.46mmHg before surgery. (p = 0.007). There is no significant difference in the number of intraocular pressure lowering medications in group 1 compared to before surgery. (p = 0.579), In group 2, the number was significantly smaller at 2.43±0.76 at 6 months after surgery than 3.21±1.05 before surgery (p < 0.005). Complications included hyphema in group 1 and short‐term increase in intraocular pressure in group 2 occurred, and low intraocular pressure or central macular edema did not occur in both groups.

Conclusions: In the group that underwent combined i stent injection and cataract surgery for open‐angle glaucoma, there was an effect of lowering intraocular pressure before and after surgery. Even compared to the group that underwent cataract surgery alone, there was a significant intraocular pressure lowering effect. There was no significant difference in complications between the two groups.
Dual agonism of FP and EP3 receptors by ricinoleic acid: Plausible therapeutic in glaucoma
Authors: Nath Madhu , Das Sudipto , Dada Tanuj , Kumari S. Senthil , Thirumurthy Velpandian
Published: January 2025

Aims/Purpose: Prostaglandin analogues used in glaucoma therapy act on prostaglandin F (FP) receptor to enhance the uveoscleral outflow, however they do not have affinity for prostaglandin E3 (EP3) receptors which are extensively present in iris‐ciliary body‐trabecular meshwork. Ricinoleic acid (RA) derived from the castor oil used as labor inducer as it causes EP3 receptor agonism and release of prostaglandins. This property of dual agonism, makes it an ideal candidate for ocular hypotensive therapy. Therefore, this study was designed to study the interaction RA with FP and EP3 receptor.

Methods: The three‐dimensional structure modeling and docking was performed for FP and E3 receptor with ricinoleic acid and their respective positive controls. To study interaction of RA with FP and EP3 receptor, calcium binding and cAMP release assay were performed in ovarian, kidney, corneal epithelial and trabecular meshwork cell lines. The variable concentration of RA were compared to the positive and negative controls. The ovarian and trabecular meshwork cells supernatant were assessed for the levels of PGF2alpha using ELISA.

Results: The in‐silico study showed RA higher binding affinity for EP3 receptor as compared to its natural (PGE2) and synthetic ligand (Misoprostol). The RA had comparatively less affinity for FP receptor compared to controls. In calcium release and cAMP assay, RA variable doses (10‐1000nM) were able to increase the release of calcium and decrease the cAMP levels in dose dependent manner. The dose response of RA for the EP3 agonism was significantly higher than latanoprost, and travoprost. The EP3 agonism by RA caused the release of PGF2alpha at lower levels, which plateaued after the 200nM dose.

Conclusions: The study shows that at lower doses RA had higher interaction with EP3 but comparable affinity for FP receptors. The release of prostaglandin by EP3 agonism might be responsible for its dual agonism. The compound can be tested further for its hypotensive properties in glaucoma.
Microshunt preserflo revision by anterior vitrectomy
Authors: Plata Carlos Santana , Navarro Damian Garcia , Rufas Ines Munuera , Perez Elisa Funes , Merino Jacobo Yañez , Pinilla Maria Sopeña , Ciubotaru Olga Ciubotaru , Bestué Ana Pueyo , Bestué Ignacio Leonardo Pueyo , Monclus Noemi Güerri , Larripa Sofia Fernandez , Velasco Diego Fernandez
Published: January 2025

Aims/Purpose: To describe a clinical case involving the obstruction of a glaucoma drainage device (GDD) caused by the presence of vitreous in the anterior chamber, a rare cause of this type of obstruction.

Methods: We report the case of a 79‐year‐old patient with pseudoexfoliative secondary open‐angle glaucoma in the left eye. Despite being under hypotensive treatment with four active principles, the patient showed poor intraocular pressure (IOP) control and progression of glaucomatous damage. It was decided to implant a PreserFlo MicroShunt. During the preoperative examination, vitreous strands and capsular debris were evident in the anterior chamber, probably due to zonular dehiscence secondary to previous cataract surgery. Although the PreserFlo MicroShunt implantation and drainage bleb were performed correctly, the IOP remained elevated in the first week. Obstruction of the valvular tube by the vitreous strand was identified as the cause of GDD failure.

Initially, conservative treatment with YAG laser vitreolysis was attempted but was not effective. Therefore, a new surgical intervention consisting of anterior vitrectomy, revision of the valvular tube and drainage bleb was proposed. During surgery, triamcinolone acetonide was used to stain the vitreous, as well as brilliant blue to check the patency of the valvular tube. The leakage bleb and the most distal portion of the tube were checked by conjunctival dissection and Tenon's capsule.

Results: As a result of the surgical intervention, the patient was able to achieve the target IOP. Future revisions are expected to confirm stabilization of glaucomatous damage.

Conclusions: In conclusion, the vitreous and capsular debris should be removed by performing a wide anterior vitrectomy prior to GDD placement if necessary. YAG laser vitreolysis may be a temporary solution, but anterior vitrectomy ensures long‐lasting patency of the drainage device.
An unusual cause of retinal vein occlusion
Authors: Iatissam  , Sencanic Ivan , Mchachi Adil , Benhmidoune Laila , Rachid Rayad , Elbelhadji Mohamed
Published: January 2025

Aims/Purpose: Among the rare causes of acute angle closure and refractory glaucoma is primary iris cysts, that are benign asymptomatic lesions.

In this case report, we report the case of a young patient presenting with retinal vein occlusion (RVO) that led to the diagnosis of bilateral iridociliary cysts and glaucoma.

Methods: A 34 years old male presented sudden unilateral vision loss. Visual acuity was 20/100, tonus was 35mmhg and examination found a narrow anterior chamber, and a central retinal vein occlusion (CRVO). The patient was treated with glaucoma drops and imaging showed a closed angle on gonioscopy, altered RNFL on OCT, and a large deficit in campimetry. UBM found multiple iridociliary cysts, and a plateau iris configuration. A peripheral laser iridectomy was performed and follow‐up showed no improvement of visual acuity.

Results: RVO is thought to be due to glaucomatous structural changes of retinal vessels or hemodynamic abnormality due to the intraocular hypertension. In young patients with no history of open angle or familial glaucoma, the presence of a shallow anterior chamber is linked to iris cysts in 38% of cases, and UBM shows cysts in 54% of these asymptomatic patients.

Conclusions: Although rare and asymptomatic, early diagnosis of iridociliary cysts can prevent glaucoma and its potential complications. When faced with retinal veinous occlusion, a thorough gonioscopy and UBM can rule them out as an etiology and will help save vision of young patients.

References

He M, Wang D, Jiang Y. Overview of ultrasound biomicroscopy J Curr Glaucoma Pract. 2012;6:25–53

Kunimatsu S, Araie M, Ohara K, Hamada C. Ultrasound biomicroscopy of ciliary body cysts Am J Ophthalmol. 1999;127:48–55
Consistency of OCT hood report visual field predictions with standardized automated perimetry in gluacoma patients and glaucoma suspects in Jordan
Authors: Khalil Mohammed , Barqawi Mohammad , Alkyam Ahmed , Rihani Heba , Tareef Raed Bin , Baydoun Mousa
Published: January 2025

Aims/Purpose: To study the level of consistency between OCT Hood report visual field predictions and standardized automated perimetry in gluacoma patients and glaucoma suspects in Jordan.

Methods: This is a retrospective analysis of 289 patient images from the Middle East Eye Hospital in Amman, Jordan. Each patient's eye had undergone a single wide‐field OCT scan to generate the Hood report (Triton OCT, Topcon Inc.), in addition to either a 10‐2 or 24‐2 visual field test (Humphrey field analyzer 3, Zeiss Inc.). The leading observer (MBK) is a glaucoma specialist, while the 2nd (HR) and 3rd (RT) observers are retina specialists, the 2nd very much familiar with the Hood report. First, each observer reviewed the Hood report and described the predicted scotoma in the designated eye using classical clinical terms e.g. superior arcuate, paracentral and diffuse. Then the observer examined the actual 24‐2 and/or 10‐2 visual fields and described the scotoma using the same clinical terminology. Regardless of the actual point by point matching, if a reasonable compatibility was determined, the observer labeled the case as a ‘good match’, and if not, ‘no match’.

Results: 174 cases were labeled as ‘good match’ between Hood report and the actual perimetry by the leading observer (60%). A significant interobserver agreement with a p‐value = 6.2356 E‐22, kappa = 0.56 (moderate) was found between the leading and 2nd observer (HR). When comparing only 10‐2 cases, interobserver agreement was substantial between the leading and 2nd observer (p‐value = 5.628E‐12, kappa = 0.699). Similar results were obtained for different stages of glaucoma (early, moderate and advanced), and also for cases labeled as neurological hemianopias. An agreement of a lesser degree was found with the 3rd observer (RT) possibly due to previous unfamiliarity with the Hood report.

Conclusions: The single wide‐filed OCT scan Hood report is a practically accurate tool in the prediction of glaucoma and neurological scotomas, satisfactorily replacing the need for an actual perimetry more than 50% of time. Future modifications can improve it further.

References

Evaluation of a One‐Page Report to Aid in Detecting Glaucomatous Damage. Hood DC, Raza AS, De Moraes CG, Alhadeff PA, Idiga J, Blumberg DM, Liebmann JM, Ritch R.Transl Vis Sci Technol. 2014 Dec 17;3(6):8
Implementing artificial intelligence glaucoma screening: Glaucoma post study
Authors: Lima‐Cabrita Afonso , Whitfield Rafael , Lobo Vasco , Monteiro Bernardo , Vistas Sofia , Ourique Matilde , Barão Rafael Correia , Marques‐Neves Carlos , Santos Veronica , Carrapiço Eunice , Marques Rodrigo , Pazos Marta , Ferreira Joana , Stalmans Ingeborg , Pinto Luis Abegão
Published: January 2025

Aims/Purpose: Report results of a novel AI‐powered population‐level glaucoma screening protocol.

Methods: Individuals aged 55‐65 were invited for glaucoma screening in a primary‐care setting. Screening involved disc‐centered fundus photography and intraocular pressure (IOP) measurement. Glaucoma risk was assessed by an AI tool, MONA G‐Risk, using the images. A positive result was defined by either a risk score higher than 0.73 (range 0‐1) or an IOP of ≥24mmHg. Participants with a positive result were referred to a glaucoma clinic for further tests, including OCT (Heidelberg Spectralis®️) for peripapillary retinal nerve fiber layer (ppRNFL) and Bruch's membrane opening (BMO) evaluation, along with visual field (VF) testing using Humphrey 24‐2 perimetry. VF analysis followed the ocular hypertension treatment study protocol, glaucoma diagnosis followed Thessaloniki eye study criteria. Clinicaltrial.gov:NCT05875090.

Results: 1038 patients were contacted, 830 accepted, 671 attended. Of these, 112 subjects performed opportunistic screening and had not been contacted previously. Most screened patients were diabetic (567/671). Mean IOP and risk scores were 14.3 mmHg (±3.9) and 0.54 (±0.12), respectively. 82 (12.2%) of subjects (diabetics: 65/567; non‐diabetics: 17/107) met referral criteria: 66 for high AI risk (9.8%), 16 (2.3%) for high IOP‐only criteria. 72 subjects underwent glaucoma clinic evaluation (AI: n = 54; IOP: n = 14; AI+IOP: n = 4). 34 met glaucoma criteria (5.1% prevalence). In glaucoma criteria eyes (n = 46), mean IOP was 15.9mmHg (±5.5), MD was ‐6.0dB (±6.1) and ppRNFL was 90.4μm (±13.5). 10 patients presented at least moderate glaucoma (MD < ‐6dB). Mean circuit time of screening was 48.7 days (±24.3).

Conclusions: Our AI‐powered glaucoma screening protocol appears effective in detecting referrable patients. IOP cutoffs‐only appear insufficient for glaucoma screening. Glaucoma prevalence detected matches published data. Our protocol's circuit time shows that glaucoma healthcare was provided in a timely manner.
Dysfunction in amino acid synthesis pathways: Potential biomarkers for early glaucoma detection
Authors: Andrés‐Blasco Irene , Bisbal M. Carmen MArtínez , Gallego‐Martínez Alex , Tufanisco Elena Bendala , Martinez Francisco Cavas , Marabotto Marina Botello , Martinez‐Mañez Ramon , Durán Maria Dolores Pinazo
Published: January 2025

Aims/Purpose: Amino acids have been proposed as preclinical biomarkers of the risk of developing neurodegenerative and metabolic diseases. We used proton nuclear magnetic resonance (1H‐NMR) in tears for the first time to investigate alterations in essential amino acids in patients with primary open‐angle glaucoma (POAG).

Methods: We planned an analytical pilot case‐control study for 30 participants aged 40‐80 years, divided into: POAG group (n = 11) and control group (CG; n = 19). Tears were obtained from each eye using capillarity. The samples were studied using 1H‐NMR spectroscopy, acquiring one‐dimensional spectra for each sample, and assigning the peaks according to their chemical shift (profiling) and information from various databases. The data from the chemometric analysis are shown as mean and standard deviation.

Results: A total of 40 metabolites were assigned based on their chemical shifts, multiplicity, and scalar coupling between J cores. Our multivariate model included 11 to discriminate between POAG and CG: phenylalanine, phenylacetate, leucine, taurine, glycine, urea, glucose, N‐acetylated compounds, unsaturated fatty acid, formic acid, and uridine. Thus, the most relevant metabolites were phenylalanine, phenylacetate, leucine, taurine, glycine, urea, and glucose, showing a significant reduction in concentration in the tears of the POAG group for phenylalanine, phenylacetate, leucine, N‐acetylated compounds, formic acid, and uridine, compared to the CG.

Conclusions: Our results suggested that the alteration in phenylalanine, tyrosine, and tryptophan signaling pathways and their effects are associated with an increased risk for POAG. Their decrease in tears maybe considered a potential biomarker to identify patients in the early stages of glaucoma.
Exploring the interplay between self‐reported glaucoma, physical shape, and exercise: Findings from a Danish eye and vision cohort – Project forever
Authors: Sjö Astrid , Rovelt Jens , Freiberg Josefine , Toft‐Petersen Anne Pernille , Kolko Miriam
Published: January 2025

Purpose: To investigate the associations between self‐reported glaucoma, intraocular pressure, and self‐reported physical activity and shape in a Danish cohort.

Methods: Questionnaire responses from project FOREVER (Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability) reported information on age, biological sex, height, weight, intraocular pressure status, smoking habits, physical activity and shape, and eye diseases. Generalized linear regression models were used to examine associations between glaucoma and physical exercise. Associations between intraocular pressure and physical shape or physical exercise were investigated using linear regression models. All models were adjusted for age and sex.

Results: A total of 34,218 subjects were included in the study, predominantly female (62%), with a median age of 57 years (interquartile range 48‐67). Among them, 545 reported having glaucoma. We observed a significant decrease in the odds of having glaucoma among people reporting to be in good physical shape compared to those in moderate shape (Odds ratio (OR) 0.79, 95% CI 0.65‐0.97, p‐value < 0.05). Increased intraocular pressure was associated with increased odds of being in poor (OR 0.13, 95% CI 0.01‐0.25, p‐value < 0.05) or very poor physical shape (OR 0.21, 95% CI 0.01‐0.40, p‐value < 0.05).

Conclusion: Good physical shape was associated with reduced odds of glaucoma whereas increasing intraocular pressure was associated with poor or very poor physical shape. Further research is warranted to elucidate the underlying mechanisms and identify potential preventive interventions, from which patients may benefit.
Impact of citicoline and coenzyme Q10 (COQUN Combo) on retinal ganglion cell survival in a experimental glaucoma model
Authors: Matamoros José A. , Fernández‐Albarral José A. , Salobrar‐Garcia Elena , Elvira‐Hurtado Lorena , López‐Cuenca Inés , Sanchez‐Puebla Lidia , Martínez‐López Miguel A. , Rubio‐Casado Sara , de Hoz Rosa , Gallardo Meritxell Lopez , Marco Eva M. , Ramirez Jose Manuel , Salazar Juan Jose , De La Villa Pedro , Ramirez Ana Isabel
Published: January 2025

Aims/Purpose: Treatments for glaucoma damage have focused on lowering intraocular pressure (IOP). However, despite controlled IOP, the neurodegenerative process continues. Therefore, it is necessary to study new molecules with neuroprotective properties for treatment. The aim of this study was to investigate the survival of retinal ganglion cells (RGCs) in an experimental model of ocular hypertension (OHT) following the administration of a combination of citicoline and coenzyme Q10 (COQUN Combo).

Methods: Four groups of Swiss albino mice were used: vehicle control (Vehicle, n = 6), COQUN Combo control (COQUN Combo, n = 5), laser with vehicle (LG+Veh, n = 6), and laser with COQUN Combo (LG+COQUN Combo, n = 6). COQUN Combo was administered daily mixed with gelatin, 15 days prior to laser induction and 7 days post‐induction in COQUN Combo and LG+COQUN Combo groups. The Vehicle and LG+Veh groups received only neutral gelatin. OHT was induced in the left eye by laser photocoagulation of the limbal and episcleral veins, analyzing hypertensive eyes and their contralateral. IOP was measured different time points after‐laser (24h, 48h, 3, 5, and 7 days). Retinal whole‐mounts were processed with 1) Anti‐Brn3a to semi‐automatically quantify the number of Brn3a+ RGCs; and 2) Anti‐melanopsin to manually quantify the number of melanopsin+ RGCs.

Results: At 24 hours post‐laser, both vehicle and COQUN Combo hypertensive eyes exhibited a significant increase in IOP. However, the increase was lower in the COQUN Combo OHT eyes (p value < 0.0001). In vehicle OHT eyes, the number of Brn3a+ RGCs was significantly lower compared to the vehicle control. However, the COQUN Combo‐treated OHT eyes maintained similar values to vehicle control eyes, as did the contralateral vehicle and contralateral COQUN Combo eyes. The number of melanopsin+ RGCs was similar in all study groups.

Conclusions: The COQUN Combo may be a neuroprotective strategy in glaucomatous pathology.
Citicoline and coenzyme Q10 (COQUN Combo) reduce inflammation in an experimental glaucoma model
Authors: Matamoros José A. , Fernández‐Albarral José A. , Salobrar‐Garcia Elena , Elvira‐Hurtado Lorena , López‐Cuenca Inés , Sanchez‐Puebla Lidia , Martínez‐López Miguel A. , Rubio‐Casado Sara , de Hoz Rosa , Gallardo Meritxell Lopez , Marco Eva M. , Ramirez Jose Manuel , Salazar Juan Jose , De La Villa Pedro , Ramirez Ana Isabel
Published: January 2025

Aims/Purpose: To investigate the anti‐inflammatory effects of citicoline and coenzyme Q10 (COQUN Combo) in an experimental model of ocular hypertension (OHT).

Methods: Swiss albino mice were used: vehicle control (Vehicle n = 6), COQUN Combo control (COQUN Combo n = 5), laser vehicle (LG+Veh, n = 6), and laser COQUN Combo (LG+COQUN Combo, n = 6). COQUN Combo was administered daily with gelatin 15 days prior to laser induction and 3 days post‐induction in COQUN Combo and LG+COQUN Combo groups. The Vehicle and LG+Veh groups received neutral gelatin. OHT was induced in the left eye by laser photocoagulation of the limbal and episcleral veins, analyzing hypertensive eyes and their contralateral eyes. Retinal whole‐mounts were processed with: 1) Anti Iba‐1 to quantify: Number of Iba‐1+ cells (Iba1‐cn) in outer segments (OS), outer plexiform layer (OPL) and inner plexiform layer (IPL); Retinal area occupied by Iba‐1+ cells (Iba1‐RA) in the nerve fiber layer‐ganglion cell layer (NFL‐GCL); Cell body area (Iba1‐cba) of Iba‐1+ cells in OPL, IPL and NFL‐GCL; and arbor area (Iba1‐aa) of Iba‐1+ cells in OPL and IPL. 2) Anti‐P2RY12 to differentiate activated microglia.

Results: No significant differences were observed between the control groups. Both OHT eyes and their contralaterals of LG+Veh, as well as LG+COQUN Combo OHT eyes and their contralaterals, showed significant differences compared to controls in Iba1‐cn, Iba1‐ RA, Iba1‐cba, and Iba1‐aa in all layers analyzed. However, these changes were significantly smaller in LG+COQUN Combo OHT and their contralateral eyes compared to LG+Veh OHT and their contralateral eyes. In the Vehicle, Iba‐1+ cells were P2RY12+. P2RY12 expression was downregulated in both OHT eyes of LG+Veh and LG+ COQUN Combo; however, this downregulation was less pronounced in the OHT eyes of LG+COQUN Combo. In the contralateral eyes, P2RY12 expression remained similar to that of the controls

Conclusions: COQUN Combo can attenuate the inflammatory process in glaucoma.
Monitoring glaucoma progression from Fundus photos using a deep learning‐based trend analysis
Authors: Hemelings Ruben , Wong Damon , Stalmans Ingeborg , Schmetterer Leopold
Published: January 2025

Aims/Purpose: To assess the agreement between established tools to monitor glaucoma progression and a linear regression on deep learning (DL)‐based glaucoma risk predictions obtained from color fundus photos (CFPs).

Methods: CFPs and clinical metadata were retrospectively collected from three university hospitals in Belgium. Eyes with at least five CFP visits were included based on the availability of progression ground truth labels.

Ground truth labels for glaucoma progression were derived from within‐eye linear regression on either average retinal nerve fiber layer thickness (aRNFL) as measured by optical coherence tomography (OCT) or mean deviation (MD) from visual field testing. A significant MD slope (p < 0.05) from linear regression was selected as a biomarker for functional glaucoma progression, tested with a minimum of 4, 5, and 6 values. For structural progression, a significant aRNFL slope (p < 0.05) was assessed, requiring 3 or 4 visits due to data scarcity and lower test‐retest variability in OCT data.

Preprocessed CFPs were input into a previously trained deep learning model (G‐RISK). The within‐eye linear regression of G‐RISK predictions, referred to as the G‐RISK slope, was then obtained. Agreement was evaluated using the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. We varied the MD slope between 0 and ‐4 dB per year and computed AUC using G‐RISK slopes as predictions. Similarly, we varied the aRNFL slope between 0 and ‐4 μm per year.

Results: A total of 5875 eyes had at least four visits with MD values, and 313 eyes had at least three visits with aRNFL values. For functional progression, AUC climbed up to 0.67 [0.58; 0.75] at an MD slope of at least ‐2.5 dB per year. For structural progression, AUC reached up to 0.99 [0.98; 1] with a yearly aRNFL decrease exceeding 3.4 μm.

Conclusions: Both MD and RNFL slopes showed significant agreement with G‐RISK slope, supporting its potential as a novel biomarker for glaucoma management.

References

Hemelings, R., Elen, B., Barbosa‐Breda, J. et al. Deep learning on fundus images detects glaucoma beyond the optic disc. Sci Rep 11, 20313 (2021).
Improving dynamic vessel analysis: A new pipeline for localized retinal vessel response evaluation
Authors: Beeckmans Lennert , Van Eijgen Jan , Vilser Walthard , Kotliar Konstantin , Hanssen Henner , De Vos Maarten , Stalmans Ingeborg
Published: January 2025

Aims/Purpose: Dynamic Vessel Analysis (DVA) is a non‐invasive imaging modality that evaluates the reactivity of retinal arteriolar and venular vessels in response to flicker light stimulation. This study aims to introduce a novel data‐processing pipeline that involves noise reduction techniques localized to different locations along the vessel wall. Additionally, it employs standardized parameter extraction, allowing for a more precise assessment of retinal vessel responses across these locations.

Methods: Previous studies used robust principal component analysis (RPCA) on averaged time series data for arteries and veins, combining one averaged time series per patient into arterial and venous matrices. Our method retains individual location time series for each arteriole and venule, preserving local responses. We combine these individual time series into arteriolar and venular matrices and apply RPCA, resulting in sparse matrices containing noise and low‐rank matrices capturing common features. The low‐rank matrices, containing the noise‐reduced information, are then used for further analysis. This approach maintains the granularity of local vascular responses.

Results: We identified and integrated key parameters from existing literature to delineate vasodilation and vasoconstriction profiles. By applying analysis of covariance (ANCOVA) for age, sex, baseline vessel dilation, and mean arterial pressure, we identified significantly lower Baseline‐Corrected Flicker Response of the proximal retinal venules in normal tension glaucoma patients (2.46%, n = 23) compared to healthy controls (4.23%, n = 21, p = 0.049).

Conclusions: Our novel pipeline adds to all previously published methods and effectively identified altered neurovascular responses in glaucoma patients after the necessary adjustments. This standardized and automated approach is a promising catalysator for DVA research, offering a more localized and precise understanding of retinal vascular dynamics.
Inflammation and neurodegeneration in glaucoma: Isolated eye disease or a part of a systemic disorder? ‐ Serum proteomic analysis
Authors: Zarzecki Mateusz , Okruszko Michał , Szabłowski Maciej , Michnowska‐Kobylińska Magdalena , Lisowski Łukasz , Łapińska Magda , Stachurska Zofia , Szpakowicz Anna , Kamiński Karol , Konopińska Joanna
Published: January 2025

Aims/Purpose: To investigate serum expression of inflammatory and neurotrophic factors in glaucoma patients.

Methods: We investigated the serum expression of 92 inflammatory and neurotrophic factors in glaucoma patients. The study group consisted of 26 glaucoma patients and 192 healthy subjects based on digital fundography.

Results: Patients with glaucoma had significantly lower serum expression of IL‐2Rβ, TWEAK, CX3CL1, CD6, CD5, LAP TGF‐beta1, LIF‐R, TRAIL, NT‐3, and CCL23 and significantly higher expression of IL‐22Rα1.

Conclusions: Our results indicate that patients with glaucoma tend to have lower levels of neuroprotective proteins and higher levels of neuroinflammatory proteins, similar to those observed in psychiatric, neurodegenerative and autoimmune diseases, indicating a potential link between these conditions and glaucoma pathogenesis.

References: Glaucoma is the most common optic neuropathy and the leading cause of irreversible blindness worldwide, which affects 3.54% of the population aged 40–80 years. Despite numerous published studies, some aspects of glaucoma pathogenesis, serum biomarkers, and their potential link with other diseases remain unclear. Recent articles have proposed that autoimmune, oxidative stress and inflammation may be involved in the pathogenesis of glaucoma.
Ab‐externo Xen glaucoma microstent implantation in the treatment of glaucoma – A 1‐year retrospective observational study
Authors: Langosz Paulina , Maruszczyk Wojciech , Eder Krzysztof , Mrozek Agnieszka , Dygas Dominik , Porwolik Mateusz , Janiszewska‐Salamon Julia , Wyględowska‐Promieńska Dorota , Smedowski Adrian
Published: January 2025

Aims/Purpose: The purpose of our work was to evaluate the efficacy and complications of ab‐externo XEN gel microstent (XEN, Aquesys, Inc.) implantations as a treatment modality for various types of glaucoma.

Methods: We have analyzed 28 patients (28 eyes) that underwent 32 XEN stent implantations over the past year as a treatment for diverse types of glaucoma. The mean age of the population was 65 (IQR 47‐71), with the mean length of glaucoma pharmacotherapy beforehand of 6.5 (2.0‐12.5) years. 20 eyes were pseudophakic and 22 have undergone a prior invasive glaucoma treatment, with 6 precedent stent implantations.

Eyes have been observed for 9±3 months especially in terms of post‐implantation BCVA and IOP profile. Surgical complications, need for further glaucoma pharmacotherapy during the observation period have been analyzed. Subjective ailments reported by the patients have been numbered.

Results: We have observed an IOP drop from 30.0 (22.5‐39.5) on admission to 8.0 (8.0‐10.0) on discharge, with further values of 11.0 (7.0‐15.0); 14.0 (11.5‐19.0); 17.0 (14.0‐20.0); 18.0 (14.0‐19.0) at the 1‐week, 1, 3, and 6‐month control points respectively. Number of glaucoma topical medications dropped from 3 (3‐4) pre‐surgery to 0 (0‐0) immediately post‐op. BCVA pre‐op was 0.15 (0.05‐0.61) logMAR and improved to 0.1 (0.00‐0.52) at the 6‐month observation point. 14 of the patients required a surgical revision of the stent and 5 of all the eyes have been further qualified to repeated surgical treatment in different modality.

Conclusions: The ab externo method for XEN microstent implantation has been proved to be an effective glaucoma treatment modality, drastically decreasing the necessity for both further pharmacotherapy and/or follow‐up surgical procedures. The subjective ailments reported by patients have been found to be at a acceptable level.
The relationship between social deprivation and glaucoma‐related quality of life (QOL)
Authors: Teo Ryan , Tsakiris Kleonikos
Published: January 2025

Aims/Purpose: Glaucoma carries a considerable global health burden. As it is generally accepted that glaucoma is incurable, it is critical to maintain or improve the QOL of afflicted patients.

Social deprivation is known to be associated with poor vision. However, less is known about the relationship between social deprivation and its impact on glaucoma‐related QOL.

It must be noted that QOL is an entirely different concept as a glaucoma patient with poor vision could still maintain a good vision‐related QOL.

The purpose of this project was to identify a potential gap in the provision of care for socially deprived glaucoma patients and advance the European Glaucoma Society's aim of glaucoma treatment, which is to maintain QOL in affected patients at a sustainable cost.

Methods: The research study included:

Systematic Literature Review to determine the best instruments to measure social deprivation and glaucoma‐related QOL

Patient Questionnaire Study (280 patients) to investigate the correlation between social deprivation and glaucoma‐related QOL

Statistical Analysis of the results from the Patient Questionnaire Study

It was decided that the best tool to assess social deprivation was the Scottish Index of Multiple Deprivation (SIMD) and the best instrument to measure glaucoma‐related QOL in this context was the 25‐item National Eye Institute Visual Functioning Questionnaire (VFQ‐25).

Results: 280 patients, 142 males and 138 females, undertook the questionnaire.

The mean age was 73, all of Caucasian race.

Those with lower SIMD scores (more socially deprived) reported lower VFQ‐25 scores (lower quality of life).

Statistical analysis established that Pearson correlation coefficient r = 0.535 with p‐value = 0.011

The significance threshold was set at 0.05 for the p‐value.

Conclusions: This study has now established that greater social deprivation leads to a lower glaucoma‐related QOL, which encompasses the physical, psychological, emotional and social well‐being of the patient.

This is extremely useful as it highlights that more can and should be done to help socially deprived glaucoma patients. The research poster proposes some measures to implement to help improve the overall well‐being of socially deprived glaucoma patients, and thereby maintain their independence and QOL.
Phacolytic glaucoma: About a case report
Authors: Younes Laarif , Nihal El Arari , Ouadghiri Soukayna , Salma Hamidi , Benchekroun Saad , Elhachimi Rim , Abdellah Amazouzi , Oufae Cherkaoui Lalla
Published: January 2025

Aims/Purpose: We report the case of a 70‐year‐old patient with chronic renal failure secondary to amyloidosis of undetermined etiology as well as multiple episodes of red eye with notion of self‐medication for 2 years consulting for an episode of red eye painful for 3 days.

Methods: The ophthalmic examination revealed a best corrected visual acuity at counting fingers at 1 meter and light perception respectively in OD and in OS.

Examination of the anterior segment showed a calm anterior segment in OD with normal ocular tonus and a grade 3 nuclear cataract and in OS a slight conjunctival hyperemia, ocular tonus at 30 mmHg, a 1+ flare and a dense morganian cataract.

The ocular fundus was inaccessible in both eyes.

The ocular ultrasound found a normal posterior segment in both eyes.

Results: A phacolytic glaucoma diagnosis has been made and the patient was started on local steroid therapy and local and systemic antiglaucoma treatment and then benefited 3 days later from cataract surgery which took place without notable incident.

The post‐operative period was marked by an improvement in visual acuity and a reduction in intraocular inflammation. Phacolytic glaucoma occurs mainly in the context of hypermature or even Morgagnian senile cataract. Over time, the cortical fibers of the lens degenerate into water‐soluble protein aggregates. These high molecular weight lens proteins escape through a grossly intact lens capsule into the anterior chamber, where they induce intense macrophage activity.

Conclusions: Although curable, cataract remain the most significant cause of blindness in developing countries, mainly affecting the elderly.

Delayed treatment leads to serious complications such as lens induced glaucoma, which can lead to irreversible vision loss. Cataract surgery is the most effective treatment for lowering IOP and restoring vision in these patients if undertaken early enough.

References

Macovei ML, Canache M, Neagoe BM. Phacolytic glaucoma ‐ case report. Rom J Ophthalmol. 2021 Apr‐Jun;65(2):191‐195. doi: 10.22336/rjo.2021.38. PMID: 34179587; PMCID: PMC8207859.
A low dose bimatoprost 0.01% & Timolol 0.1% eye gel compared to bimatoprost 0.03% & Timolol 0.5% eye drops: A Phase III Randomized study
Authors: Stalmans Ingeborg , Cordeiro M. Francesca
Published: January 2025

Aims/Purpose: To compare the efficacy and safety of preservative‐free (PF) fixed combination, bimatoprost 0.01%/timolol 0.1% eye gel (BTFC eye gel) with bimatoprost 0.03%/timolol 0.5% eye drops (BTFC eye drops) in patients with open‐angle glaucoma (OAG) or ocular hypertension (OHT).

Methods: Phase III, international, multicentre, randomised, 2 parallel groups, investigator‐masked, 3‐month treatment duration study. Patients with OHT or OAG, insufficiently controlled with a first‐line monotherapy, and requiring a dual therapy, were randomized to receive either PF BTFC eye gel (bimatoprost 0.01%/timolol 0.1%) or PF BTFC eye drops (bimatoprost 0.03%/timolol 0.5%), once daily for 12 weeks. The primary efficacy endpoint was the change from baseline (Day 1) to Week 12 in IOP at 08:00, in the study eye. Noninferiority was based on a predetermined criteria (upper 95% confidence interval margin of 1.5 mmHg at Week 12 at 08:00). Further efficacy and safety endpoints were assessed as secondary outcomes.

Results: The mean change from baseline to Week 12 in IOP at 08:00 was −10.96±3.43 mmHg for BTFC eye gel and −11.14±3.56 mmHg for BTFC eye drops. Noninferiority of T4030 was demonstrated, based on the predetermined criteria. IOP‐lowering efficacy was also similar between treatment groups at Week 6 (08:00; 10:00; 16:00) and Week 12 (10:00; 16:00). The safety profile was similar between T4030 and Ganfort; however, more patients withdrew from the study due to a treatment‐related adverse event (AE) with BTFC eye drops (8 patients [21 AEs]), compared to BTFC eye gel (no patients). Global tolerance was considered as satisfactory/very satisfactory by the investigator for more patients in the T4030 (96.4%) versus Ganfort (91.6%) at Week 6, with a statistically significant between group difference (p = 0.020).

Conclusions: A low dose PF bimatoprost 0.01%/timolol 0.1% eye gel can be considered as a safe and effective tool in the therapeutic management of glaucoma and OHT.
Does semaglutide provide neuroprotection in models of glaucoma?
Authors: Mouhammad Zaynab , Aldana Blanca , Williams Pete , Tribble James , Rombaut Anne , Bermudez Mariana Yolotzin Garcia , Vohra Rupali , Kolko Miriam
Published: January 2025

Aims/Purpose: Semaglutide, a prominent member of the GLP‐1 receptor agonists, has gained considerable attention for its efficacy in managing type 2 diabetes and obesity. However, emerging evidence expand its therapeutic potentials far beyond glycemic control and weight management. Preclinical studies indicate that through anti‐inflammatory, anti‐oxidative and anti‐apoptotic effects GLP‐1 receptor agonists offer a promising new approach to neuroprotection in neurodegenerative conditions. In this study, we assess the neuroprotective properties of semaglutide in animal models of retinal neurodegeneration.

Methods: C57BL/6 mice were treated with semaglutide (5mg/kg) for a week and then received intravitreal injections of 1% DMSO or the Complex I inhibitor rotenone. Retinas were isolated as either retinal explants or flat mounts. Retinal ganglion cell (RGC) degeneration was assessed using immunofluorescence and metabolic effects through stable isotope labeling (13C) and gas chromatography‐mass spectrometry (GC‐MS). We furthermore induced ocular hypertension through injection of magnetic beads into the anterior chamber of Brown Norway rats and initiated semaglutide treatment simultaneously; naïve rats served as controls. In the rats, RGC degeneration and glial cell changes were assessed through immunofluorescence.

Results: We observed increased RGC survival upon treatment with semaglutide in rotenone insulted retinas. Furthermore, we found an increased metabolism of glucose in retinas exposed to semaglutide, and a compromised metabolism in retinas exposed to rotenone. We found no increased RGC survival in the rats, but a decreased macroglia activation upon treatment with semaglutide.

Conclusions: Our results confirm the potential neuroprotective role of semaglutide involving metabolic and inflammatory pathways. Further studies are needed to elucidate the potential clinical implications of the current findings.
Bacterial contamination of extraocular fluid and antibiotic susceptibility during cataract surgery and vitrectomy
Authors: Lee Seung Min
Published: January 2025

Aims/Purpose: We performed a retrospective case‐series study to investigate the extent of bacterial contamination and antibiotic susceptibility of extraocular fluid at the beginning and end of cataract surgery and vitrectomy after disinfection.

Methods: Medical records of consecutive patients who underwent cataract surgery or vitrectomy with extraocular fluid culture were reviewed. Patients with infection, recent ocular trauma, immunocompromised state, or antibiotics treatment were excluded. During surgical skin preparation, povidone‐iodine (PvI) was poured through palpebral fissure was done. At the initiation, a flush of PvI and BSS irrigation was added into the conjunctival sac. 1ml of fluid was collected at the beginning (Pre‐fluid) and end of the surgery (Post‐fluid). Sample were collected from both canthi while instilling BSS. The samples were injected into the BacT/Alert PF pediatric blood culture bottle. Bacterial identification and antibiotics susceptibility test were performed. The χ2 test or Fisher's exact test was performed to determine differences in results depending on surgical method or timing of sample collection.

Results: Two hundred thirty‐three eyes were enrolled, including 72 eyes with cataract surgery and 161 eyes with vitrectomy. There were 31 (13.3%) positive cultures in Pre‐fluid and 71 (30.5%) positive cultures in Post‐fluid. The positive culture rate was higher in Post‐fluid (p < 0.001, χ2 test). The following organisms were frequently identified: Staphylococcus epidermidis (sample size N = 74), S. aureus (N = 10) and S. lugdunensis (N = 6). All types of strains didn’t showed resistance to vancomycin or 3rd generation cephalosporin.

Conclusions: Despite disinfection in ocular surgery, bacterial contamination may occur at the surgical site, and bacterial contamination was confirmed more frequently at the end of surgery. The most common organism was S. epidermidis, and most of them were susceptible to empirical antibiotics.