bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterior bilateral optic neuritis as a complication of Varicella‐Zoster virus (VZV)
Authors: Cabo Ana , Pascual‐Santiago Antonio , Cuba‐Sulluchuco Fiorella Katherine , Domingo‐Gordo Blanca
Published: January 2025

Aims/Purpose: To shed light on optic neuritis as a potential ocular complication of Varicella‐Zoster virus (VZV) infection.

Methods: Presentation of a clinical case.

Results: We present the case of a 70‐year‐old woman, who arrived at the Emergency Room complaining of a bilateral acute loss of visual acuity. She had received treatment on several occasions for a recurring zoster involving the left V2 territory, the last episode being one month before her visit. She had a visual acuity of 0.3 on her right eye, and 0.6 on her left eye. Pupil examination evidenced a relative afferent pupillary defect (RAPD) on her right eye. Dyschromatopsia was documented by red desaturation and Ishihara tests. Fundus examination displayed an asymmetrical bilateral papillitis, predominant in her right eye. This finding was confirmed by an Optic Coherence Tomography (OCT). A cranial CT scan and a general blood analysis were performed, and both returned normal results. The patient was admitted to the Hospital to start treatment with intravenous steroids. Additional tests were performed, including blood serological tests, a temporal artery Doppler ultrasound, a cranial MRI, and a lumbar puncture. Blood serological tests showed positive high titles of IgG VZV, and came back negative for IgM VZV. Lastly, the polymerase chain reaction (PCR) test on the CSF sample turned out positive for VZV, shedding light on the diagnosis. Steroids were suspended and the patient was started on intravenous Acyclovir. Clinical evolution was favorable, and her visual acuity on the 2‐month follow‐up visit had climbed up to 0.6 on her right eye and 0.7 on her left eye.

Conclusions: This case illustrates the relevance of ruling out infectious causes of optic neuritis, specifically VZV, in patients in which other causes are less likely, those who present a bad evolution on inflammatory treatment, or who have a recent episode of VZV infection. MRI demyelination is a frequent finding in both demyelinating and infectious diseases, therefore not ruling out the latter. Positive blood serology indicates previous contact with VZV, but has little sensibility for detecting an active infection. All these reasons justify the need to select patient who may benefit of a lumbar puncture, as an early diagnosis radically changes the therapeutical approach.
Bartonella neuroretinitis: Case report and literature review
Authors: Daghouj Ghizlane , Ettouri Sara , Rokaya Chahir , Rami Ali , El Maaloum Loubna , Allali Bouchra , El Kettani Asmaa
Published: January 2025

Aims/Purpose: The interest of this observation is to lead to think about bartonella among the etiologies of neuroretinitis

Methods: We report the case of a child carrying unilateral stellar neuroretinitis in the context of cat scratch disease with a favorable evolution under treatment

Results: 13‐year‐old without particular pathological history presenting a decrease in acuity with visual fog with sweating and asthenia. The initial examination found in the right eye a visual acuity at 4/10, a normal anterior segment, normal tone, and at the fundus a flat retina with stage 4 papillary edema and stellar maculopathy. The left eye was strictly normal. Faced with the notion of cat bite and scratch 5 weeks before the onset of symptomatology a bartonella serology was requested and returned positive. An angiography confirmed the fundus. An OCT highlighted a serous retinal detachment. We managed this patient with bolus of corticosteroids with a maintenance dose with prednisolone 1 mg/kg/day with adjuvant therapy. A month later visual acuity goes back to 8/10 with continuous regression of papillary edema and stellar maculopathy. The child was examinated regularly. Visual acuity at 10/10 with total regression of papillary edema and stellar maculopathy were achieved after 5 months. Angiography and OCT at this stage showed disappearance of stellar maculopathy and retinal edema with reapplication of serous retinal detachment. The degression of corticosteroid therapy has been started.

Conclusions: Cat's scratch disease is an uncommon pathology. The diagnosis and management are simple but the several complications can appear including ophthalmological, visceral, neurological, osteoarticular which can engage the visual prognosis but also vital sometimes especially in immunocompromised subjects. The preventive measures for CSD would require avoidance of close contacts with cats and cat fleas with increased awareness of the risk of cats scratche.

References

Ocular complications of cat scratch disease | British Journal of Ophthalmology. Accessed October 30, 2022. https://bjo.bmj.com/content/104/12/1640

Whorff J. Case Report: Treatment of Severe Neuroretinitis and other Sequelae Associated with Cat Scratch Disease. Optometry and Vision Science. 2022;99(8):662‐669.
Evaluating combination therapies for myopia control: Insights from a retrospective study‐combining atropine %0.05 with peripheric defocus progressive addition lenses
Authors: Akagun Nilay , Altiparmak Emrah
Published: January 2025

Aims/Purpose: This retrospective study aimed to assess the additive effect of combining Myopi‐X progressive addition lenses with 0.05% atropine therapy compared to monotherapies with either Myopi‐X lenses or 0.05% atropine alone.

Methods: Clinical records of patients using Myopi‐X lenses (Group 1), receiving atropine 0.05% eye drop treatment (Group 2), and undergoing combined Myopi‐X lenses and atropine 0.05% eye drop treatment (Group 3) were reviewed. Baseline characteristics, including age, sex, spherical equivalent (SE), and axial length (AL), were analyzed. Changes in SE and AL at 12 months were assessed.

Results: The study comprised 76 eyes of 38 patients. At baseline, the groups were similar in age, SE, and AL. At 12 months, no significant difference was observed in SE change among the groups. However, the atropine 0.05% group showed less SE progression compared to the Myopi‐X group (p = 0.01). No significant difference was noted between Myopi‐X and Myopi‐X plus atropine 0.05% groups. Similarly, no significant difference in AL change was found among the groups at 12 months.

Conclusions: Combining Myopi‐X PALs with 0.05% atropine therapy did not exhibit an additive effect on individual treatment efficacy compared to monotherapies. The findings suggest that monotherapy may be preferred for myopia control, highlighting the need for further research to optimize treatment strategies. This study contributes to the limited literature on combination therapies for myopia control.

References

Erdinest N, London N, Lavy I, Levinger N, Pras E, Morad Y. Myopia control utilizing low‐dose atropine as an isolated therapy or in combination with other optical measures: A retrospective cohort study. Taiwan J Ophthalmol. 2022 Aug 1;13(2):231‐237.

Nucci P, Lembo A, Schiavetti I, Shah R, Edgar DF, Evans BJW. A comparison of myopia control in European children and adolescents with defocus incorporated multiple segments (DIMS) spectacles, atropine, and combined DIMS/atropine. PLoS One. 2023 Feb 16;18(2):e0281816.

Erdinest N, Atar‐Vardi M, London N, Landau D, Smadja D, Pras E, Lavy I, Morad Y. Treatment of Rapid Progression of Myopia: Topical Atropine 0.05% and MF60 Contact Lenses. Vision. 2024; 8(1):3.
Peripheral defocus spectacle lenses versus single‐vision spectacle lenses for myopia control: Systematic review and meta‐analysis
Authors: Lima João Pedro , Vital Flávia Maria , Cardoso Júlia Vargas Moreira Pillar
Published: January 2025

Aims/Purpose: Myopic children wearing traditional single‐vision lenses (SVL) will continue to increase in nearsightedness as eye growth occurs. However, peripheral defocus lenses (PDL) are specialized spectacles based on the retinal‐defocus theory, designed to slow down the progression of myopia. Therefore, we aimed to perform a meta‐analysis exploring the effectiveness of PDL and SVL in controlling myopia.

Methods: We searched PubMed, Embase, Cochrane, Web of Science, Epistemonikos and BVS for studies comparing the PDL to SVL in children and adolescents with myopia. Outcomes were spherical equivalent refraction (SER) and axial length (AL). The RoB 2 tool was used to assess the risk of bias.

Results: We included 673 patients from 5 randomized clinical trials. PDL was used to control myopia in 403 (59,9%) patients. The mean age was 9.4 years old. Follow‐up ranged from 6 to 12 months. In the pooled analysis, the SER (RR 4.41; 95% CI 1.76, 11.08; I2 = 0%) and AL (RR 28.10; 95% CI 5.57, 141.58; I2 = 18%) was lower in patients using PDL compared to SVL. In the segment analysis, all segments showed a deceleration of the SER of PDL when compared to SVL. The 6 month was the only one to show a result with low heterogeneity (WMD ‐0.19; 95% CI ‐0.26, ‐0.13; I2 = 21%). The analysis at 12 months showed substantial heterogeneity (WMD ‐0.35; 95% CI ‐0.44, ‐0.26; I2 = 57%). When analyzing AL, it can be seen that PDL grows less than SVL in all the segments analyzed. The differences between 6 months (WMD 0.11; 95% CI 0.22, 0.19; I2 = 88%) and 12 months (WMD 0.14; 95% CI 0.10, 0.17; I2 = 70%) were small and with significant heterogeneity.

Conclusions: PDLs were associated with more effectiveness at slowing down the progression of myopia, as assessed by both spherical equivalent and axial growth. The substantial heterogeneity between the studies suggests the need for additional research without conflict of interest bias to confirm these results and understand the variations in the effects of the different PDL designs.
Performance comparison of peripheral defocus spectacle lenses
Authors: Lembo Andrea , Schiavetti Irene , Serafino Massimiliano , Caputo Roberto , Nucci Paolo
Published: January 2025

Aims/Purpose: To compare the effectiveness of myopia control spectacle lenses with Highly Aspherical Lenslets (HAL) to Defocus Incorporated Multiple Segments (DIMS) in European children with progressive myopia after 12M & 24M of lens usage.

Methods: In this retrospective study, data from 146 progressive myopic patients (73 treated with DIMS vs. 73 treated with HAL), aged 6‐17 years (mean age ±SD, 11.3±2.36) with Spherical Equivalent Refraction (SER) between ‐0.50D to ‐9.25D and no associated ocular pathology were included. Spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, 12M and 24M.

Results: The mean change in SER from baseline to 12M and baseline to 24M for the HAL and DIMS groups were ‐0.30±0.30D and ‐0.34±0.46D (12M) and ‐0.63±0.56D and ‐0.50±0.64D (24M), respectively. The mean difference was ‐0.04 (95%CI: ‐0.17 ‐ 0.08) at 12M and ‐0.13 (95%CI: ‐0.07 ‐ 0.32) with no statistically significant difference between the two groups both at 12M and 24M (Mann‐Whitney U Test, p = 0.80 and p = 0.05 respectively). The mean change in AL from baseline to 12M and baseline to 24M for the HAL and DIMS groups were 0.15±0.47mm and 0.19±0.56mm (12M) and 0.32±0.72mm and 0.29±0.63mm (24M), respectively. The mean difference was 0.04 (95%CI: ‐0.13 ‐ 0.21) and ‐0.03 (95%CI: ‐0.25 ‐ 0.19) with no statistically significant difference between the two groups both at 12M and 24 M (Mann‐Whitney U Test, p = 0.34 and p = 0.71 respectively).

Conclusions: Data from these retrospective analyses demonstrate and highlight that both optical interventions are effective in controlling myopia progression at 12M and 24M (i.e. non‐inferiority of DIMS vs. HAL) in European children with progressive myopia.
Efficacy of topical insulin for refractory persistent corneal epithelial defects: A case series
Authors: Mancini Alessandra , Mancini Maura , Scorcia Vincenzo , Aragona Pasquale , Taloni Andrea , Bifezzi Luca , Giannaccare Giuseppe
Published: January 2025

Aims/Purpose: This study aims to report the successful clinical outcomes achieved in cases of refractory persistent corneal epithelial defects through the utilization of insulin eye drops.

Methods: This case series, conducted in three University Centers, included patients with persistent epithelial defects (PEDs) refractory to conventional treatment. The participants were treated with Insulin eye drops (1 unit per mL) 4 times a day in all cases. Demographic data, etiology of PED, corneal sensitivity, previous treatments, area of epithelial defect over time (using imageJ software), and healing rate were examined.

Results: Twelve eyes of eleven patients (6 male, 5 female, mean age 54 ±14.83 years) affected by epithelial defects refractory to conventional medical therapy were included. Each patient received topical insulin drops (1 unit per mL) 4 times a day. At T0, the mean area of the corneal epithelial defects was 19.64 ± 16.4 mm2 while corneal sensitivity was absent in 10 out 12 cases. Complete corneal re‐epithelialization occurred in 12 out 12 cases (100%) within 15 to 30 days of therapy. Neither adverse events nor episodes of recurrence were reported during follow‐up visits.

Conclusions: Topical insulin represents as an easy to obtain, inexpensive and effective treatment for refractory persistent corneal epithelial defects. Further studies are needed to determine the clinical efficacy and side effect profile of this treatment.
Factors associated with the speed of response to perfluorohexyloctane eye drops (SHR8058) in dry eye disease associated with meibomian gland dysfunction: A post‐hoc analysis of a randomised, phase 3 trial
Authors: Gu Hao
Published: January 2025

Aim: In a randomised, double‐masked, phase 3 trial, perfluorohexyloctane eye drops (SHR8058) significantly improved signs and symptoms compared to 0.6% sodium chloride (NaCl) in patients (pts) with dry eye disease (DED) associated with meibomian gland dysfunction (MGD). Here, we present a post‐hoc analysis of this phase 3 trial to identify factors associated with the speed of sign and symptom responses to SHR8058.

Methods: Adult pts with DED associated with MGD were randomized 1: 1 to receive SHR8058 or 0.6% NaCl 4 times daily for 57 days. In this post‐hoc analysis, pts were divided into rapid‐ and non‐rapid‐response groups based on the speed of sign or symptom response to SHR8058. Rapid response was defined as a response in total corneal fluorescein staining (tCFS) scores ( ≥ 3 reduction from baseline) at day 29 for signs and in eye dryness scores (EDS, ≥ 30% reduction from baseline) at day 15 for symptoms.

Results: A total of 143 pts who responded to SHR8058 in either signs or symptoms were included in this analysis, with 90 pts in the rapid‐response group for signs and 51 for symptoms. Univariate logistic regression analysis showed that baseline tCFS score (OR 1.4, 90% CI 1.06–1.74, p = 0.040) was significantly associated with a rapid response for signs, and none of the other baseline factors showed an association (all p > 0.05), including age, sex, DED‐related eye symptoms, EDS, sticky feeling, burning/stinging sensation, foreign body sensation, itchiness, blurred vision, sensitivity to light, pain, awareness of DED symptoms, frequency of dryness, ocular surface disease index scores, tear film breakup time, MGD scores, Schirmer I test results, menopause and refractive error. However, none of the above factors were correlated with rapid response for symptoms (all p > 0.05).

Conclusions: In pts with DED associated with MGD, baseline tCFS score is markedly associated with sign response speed to SHR8058, whereas no baseline factor shows an association with symptom response speed.
Tear substitutes and native tear protein interaction. A pilot study to evaluate possible chemical structural interferences
Authors: Astolfi Gloria , Ponzini Erika , Orlando Marco , Tavazzi Silvia , Versura Piera
Published: January 2025

Aims/Purpose: The loss of ocular surface homeostasis leads to the Dry Eye Disease (DED) onset. Although tear substitutes are the front‐line treatment for DED, recent advances suggest new therapeutic approaches to modulate the different mechanisms leading to the ocular surface impairment [1]. For this reason, there is a need to better understand the specific interactions between the new formulations and the native components of the tears. This pilot study is focused on assessing the chemical stability of two major human tear proteins, lysozyme C (LYS‐C) and lactoferrin (Lf), after the contact with formulations containing trehalose (Thealoz Duo, A) and trehalose plus N‐acetyl‐aspartyl‐glutamic acid (Thealoz Total, B).

Methods: Human LYS‐C and Lf (Sigma) were resuspended in saline, incubated at 37°C with A and B previously diluted to simulate the final concentration in a real‐life condition, up to 2 hours. The chemical structures of LYS‐C and Lf were analyzed by circular dichroism (CD) (J‐815, Jasco) as alone, and after the incubation with A and B, with blank subtraction performed on saline.

Results: Data from CD showed that the contribution of both formulations had no impact on the structural conformation change of both LYS‐C and Lf. The spectra of the protein structures remained unchanged showing a chemically matched profile of the secondary structure elements in native proteins (Wavelength 208‐222 nm). Further studies will be focused on assessing if protein stability could be affected after longer incubation times.

Conclusions: Thealoz Duo and Thealoz Total did not produce any conformational change in native LYS‐C and Lf. Data suggest that analysis of possible chemical interactions with the native tear proteins could be of benefit during the process of new tear substitute formulation.

References

Barabino, S et al.“Dry eye disease treatment: the role of tear substitutes, their future, and an updated classification.” Eur Rev Med Pharmacol Sci.2020; 24(17): 8642‐8652.
The burden of medical contraindications to corneal donation: Time for review
Authors: Thuret Gilles , Cortez Oliver Dorado , Poinard Sylvain , Magali Epinat , Fanny Collange , Ninotta Sandrine , Perrot Jean Luc , Gain Philippe
Published: January 2025

Aims/Purpose: The risk of transmission of systemic diseases from donor to recipient is particularly low, since in 50 years and 2.5 million transplants, only 8 cases of rabies, 2 cases of hepatitis B and 2 cases of Creuzfeldt‐Jakob disease (CJD) have been well documented. Conversely, other cases of rabies, HIV, hep C, hep B and CJD have not been transmitted. Nevertheless, the list of contraindications (CI) to donation also includes diseases for which no risk has been identified: neurodegenerative diseases, haematological malignancies, melanomas, tumours of the central nervous system and carcinomatous meningitis and lymphangitis.

Methods: In order to measure the precise impact of these CI, we analyzed 45 months of exhaustive data from the hospital coordination for organ and tissue procurement at St‐Etienne University Hospital (2020‐2023). All stages of donor selection were analysed.

Results: Out of 2349 consecutive potential donors, 1346 (57%) had a CI to donation. Neurodegenerative diseases were the most frequent, accounting for 29% of CIs. Of these, 75% were related to cognitive disorders. The 5 families of diseases that we question concerned 712 donors, corresponding to 30% of the files examined and 53% of all CIs. Of the 1003 deceased without CI, 738 families (74%) were contacted. No objection to donation was received in 52% of cases, enabling 385 procurements to be carried out. Eliminating these 5 CIs would have increased the number of donors by 71% (658 instead of 385).

Conclusions: Eliminating 5 categories of CI to corneal donation that are not based on any medical or scientific rationale would have a major effect on reducing the shortage of donors and combating corneal blindness. We propose that this elimination should be accompanied by a prospective evaluation process, by allocating the corneas of these donors to patients aged 75 and over, and by monitoring them for a minimum of 5 years.
Pituitary adenylate cyclase activating polypeptide counteracts high glucose‐induced inflammation in corneal epithelial cells
Authors: Maugeri Grazia , D'Amico Agata Grazia , Magrì Benedetta , D'Agata Velia
Published: January 2025

Aims/Purpose: The purpose of the current work was to evaluate the role of pituitary adenylate cyclase‐activating polypeptide (PACAP) to counteract inflammatory events characterizing diabetic keratopathy (DK).

Methods: Rabbit corneal epithelial cells (SIRCs) were cultured in either normal glucose (5 mM) or high glucose (25 mM) ± PACAP (100 nM). The corneal epithelial barrier was assessed by measuring transepithelial electrical resistance (TEER). The inflammatory event was evaluated by analyzing the expression levels of tumor necrosis factor‐alpha (TNF‐α), interleukin (IL)‐1ß, and nuclear factor kappa‐light‐chain‐enhancer of activated B cells (NF‐kB), through western blot analysis, ELISA and immunofluorescence analysis.

Results: In SIRCs, high glucose concentration led to the alteration of corneal epithelial barrier integrity and triggered the inflammatory events as demonstrated by the overexpression of TNF‐α and IL‐1β, and the activation of NF‐kB. The treatment with PACAP markedly restored corneal epithelial barrier integrity. Moreover, the treatment with the peptide significantly reduced the TNF‐α and IL‐1β cytokines expression and NF‐κB activation.

Conclusions: Inflammation is enhanced in the diabetic cornea, and concurs with corneal epithelial barrier alteration. PACAP treatment has been shown to prevent high glucose‐induced inflammatory processes and maintain corneal epithelial barrier integrity. Therefore, PACAP therapy may represent a useful approach for the management of DK.

Additional information: Study funded by MUR (PRIN PNRR P2022JRBMB).

Reference

Maugeri G et al. doi: 10.1016/j.peptides.2023.171107.
Impact of residual stromal thickness on the outcomes of manual deep anterior lamellar keratoplasty
Authors: Taloni Andrea , Alessio Giuseppe , Romeo Maria Angela , Bifezzi Luca , Mancini Alessandra , Rossi Costanza , Borselli Massimiliano , Giannaccare Giuseppe , Scorcia Vincenzo , Lucisano Andrea , Scalzo Giovanna Carnovale
Published: January 2025

Aims/Purpose: To analyze how postoperative outcomes of manual deep anterior lamellar keratoplasty (DALK) are influenced by the thickness of the residual stromal bed of the recipient, and to explore predictive factors for this parameter.

Methods: This is a retrospective case series of patients affected by keratoconus undergone manual DALK. Best spectacle‐corrected visual acuity (BSCVA) and tomographic parameters were evaluated preoperatively (T0) and postoperatively after complete suture removal (1 year, T1). The residual stromal bed of the recipient at T1 was assessed using the “flap thickness” module of CASIA SS‐1000 optical coherence tomography (Tomey, Tokyo, Japan). Measurements were performed at the center of the graft and at 12 peripheral points, 2 mm inside the margin of the corneal graft, along 6 different meridians equally spaced at 30 degrees. Then, mean peripheral thickness was calculated.

Results: Data from 40 eyes undergone manual DALK were evaluated. BSCVA significantly improved at T1 (1.11 ± 0.55 LogMAR [95% CI, 0.94‐1.28] vs 0.17 ± 0.16 LogMAR [95% CI, 0.12‐0.22]). A significant linear correlation was found between postoperative BSCVA and the mean apical thickness of the residual stromal bed (72.85 ± 27.77 μm [95% CI, 64.24‐81.46]; r = 0.48, p = 0.002), but not with the mean peripheral thickness of the residual stromal bed (78.47 ± 25.32 μm [95% CI, 70.62‐86.31]; r = 0.28, p = 0.09). Multivariate regression analysis found mean posterior and anterior keratometry (K) readings of the axial power map to be the strongest predictive factors for the apical thickness of the residual stromal bed (R2 = 0.32, p < 0.001).

Conclusions: Postoperative BSCVA is significantly correlated with the apical thickness of the residual stromal bed. The preoperative mean posterior and anterior K readings may be predictors of the postoperative apical thickness of the residual stromal bed.
Comparison of two commercial media for corneal organ culture and deswelling: CorneaMax/CorneaJet versus Tissue‐C/Carry C
Authors: He Zhiguo , Ninotta Sandrine , Toubeau David , Sagnial Tomy , Poinard Sylvain , Cortez Oliver Dorado , Goin Paul , Gain Philippe , Muraine Marc , Thuret Gilles
Published: January 2025

Aims/Purpose: Corneal storage in organ culture (OC) at 31‐34°C is the reference method in Europe. In France, eye banks have traditionally used CorneaMax/CorneaJet media (Eurobio, Les Ulis, France) for several decades. Recently, Tissue‐C/Carry‐C media (Alchimia‐Moria, Antony, France) became available. This study aims at comparing the quality of corneas stored in these two media.

Methods: Eye banks in Saint Etienne and Rouen participated in the study. In Rouen, two experiments were conducted. The first included 18 pairs of corneas, with endothelial cell density (ECD) measured by routine eye bank methods on days ‐10 and ‐30 of OC, and 4 days after deswelling. In the second experiment, the protocol for Tissue‐C was modified by renewing the medium on day‐10. ECD was measured on days ‐10 and ‐22 of OC, and 4 days after deswelling. The ECD of 10 pairs of corneas was measured on days ‐4 and ‐28 at the Eye Bank of Saint‐Etienne. After 2 days of deswelling, the viable ECD was assessed using Hoechst‐Calcein‐AM staining. Corneal thickness was also measured.

Results: In the first experiment in Rouen, ECD was higher in CorneaMax on day‐30 (2202 ± 403 vs 2004 ± 434 cells/mm2, p = 0.008) compared to Tissue‐C, and higher in CorneaJet after 4 days of deswelling (2088 ± 399 vs 1852 ± 419 cells/mm2, p = 0.019) compared to Carry‐C. In the second experiment in Rouen, with the medium renewal for Tissue‐C and reduced OC duration, the ECD difference disappeared. In Saint Etienne, with medium renewal for Tissue‐C during OC, no significant difference in ECD was found during OC. However, the viable ECD of corneas deswelled in CorneaJet was significantly higher than in Carry‐C (1647 ± 324 vs 1436 ± 235 cells/mm2, p = 0.018).

Conclusions: CorneaMax recommends renewing the medium after the first ECD count, while Tissue‐C does not. When following these instructions, CorneaMax showed better ECD results than Tissue‐C. However, when the medium for Tissue‐C was also renewed during OC, the ECD difference during OC disappeared. The viable ECD indicated that CorneaJet, a deswelling medium was superior to Carry‐C. This could be related to the greater thickness of corneas in Tissue‐C during OC.
Ocular findings in erythema multiforme major
Authors: Aoun Safa Ben , Ferchichi Molka , Romdhani Sana , Maamouri Rym , Fendouli Ines , Badri Talel , Cheour Monia
Published: January 2025

Aims/Purpose: To describe the ocular findings in two cases of erythema multiforme major (EMM).

Methods: Case series of 2 patients admitted to the dermatology department for episodes of EMM following oral herpes infections.

Results: The first patient is a 38‐year‐old pregnant woman with a history of recurrent EMM. Eight days after the onset of her most recent episode, she started complaining of redness in her right eye, without visual blurring or pain. Her visual acuity was 20/20 in both eyes. Slit‐lamp examination revealed signs of episcleritis in her right eye and bilateral punctate epithelial defects. She was started on lubricating eye drops. Intravenous methylprednisolone was administered to alleviate the pain from oral ulcers. Two days later, her symptoms improved with reduced ocular redness but she developed severe bilateral blepharitis. She was started on topical azithromycin and advised on eyelid hygiene, leading to progressive improvement. The second patient is an 18‐year‐old male with EMM who reported bilateral eye redness that coincided with the onset of the cutaneous eruption. His visual acuity was 20/20 in both eyes. Slit‐lamp examination showed bilateral diffuse conjunctival injection, severe blepharitis, and punctate epithelial defects. He was treated with lubricants, topical dexamethasone, and ofloxacin eye drops. Significant improvement of his symptoms was observed within two days.

Conclusions: Our observations highlight the importance of thorough ophthalmic evaluation in patients with EMM to ensure prompt management and prevent potential sight‐threatening complications. The presence of unilateral episcleritis or punctate epithelial defects in this context may suggest a herpes simplex virus infection, necessitating close follow‐up, especially when topical steroids are used.
Pattern ERG (PERG) and photopic negative response (PHNR) in glaucoma suspects vs primary open angle glaucoma
Authors: Kaliaperumal Subashini , Sathyababu Jawahar , Behera Geeta , Ramanathan Priyanka
Published: January 2025

Purpose: To assess the pattern electroretinogram (PERG) and photopic negative response (PhNR) in glaucoma patients (G), glaucoma suspects (GS), and controls (C). To correlate the PERG and PhNR parameters with spectral domain optical coherence tomography (SD‐OCT) and standard automated perimetry (SAP) parameters.

Methods: In this prospective, cross‐sectional, analytical study, 141 participants (47 in each group) were recruited into 3 groups. All underwent measurement of retinal nerve fibre layer (RNFL) and ganglion cell layer‐inner plexiform layer (GCL‐IPL) thickness by SD‐OCT and SAP by Humphrey's Field Analyzer (HFA). The PERG was recorded binocularly (RETI‐port/scan 21 system, Roland Consult, Germany) in the light‐adapted state. PhNR was elicited using a Ganzfeld Q 450 colour dome stimulator. Correlation analysis between PERG and PhNR with SD‐OCT and SAP was performed.

Results: The PERG and PhNR parameters were significantly progressively lower in the glaucoma and glaucoma suspects than normals [P50 Amplitude‐μV: G: 2.22(1.67, 2.56), GS: 3.02(2.89, 3.14), C: 4.86(3.98, 5.87), p < 0.001; N95 Latency‐ms: G: 92.1(87.6, 100.6), GS: 87.6(78.8, 92.4), C: 75.4(71.1, 78.7), p < 0.001; PhNR amplitude‐μV: G: 14.4(13.6, 15.8), GS: 24.9(23.7, 27.9), C: 29.0(24.7, 34.5), p < 0.001; PhNR/b wave ratio: G: 0.13(0.11, 0.15), GS: 0.18 (0.16, 0.18), C: 0.45(0.32, 0.52), p < 0.001]. This was not seen in most SAP/OCT parameters (GS ≤ C). PERG and PhNR showed significant correlations (p < 0.001) between N95 Amplitude, PhNR amplitude, and PhNR/b wave ratio in glaucoma suspects.

Conclusion: Pattern ERG and PhNR parameters were significantly progressively lower in glaucoma suspects and glaucoma than controls, whereas many SAP and SD‐OCT parameters were similar for glaucoma suspects and controls. N95 Amplitude and PhNR amplitude showed a strong correlation in glaucoma suspects. It is possible that electrophysiological changes precede RNFL/GCL‐IPL and SAP changes.
Flicker modulation sensitivity with dual‐focus contact lenses for myopia control
Authors: Puell María , Ruiz‐Pomeda Alicia , Robledo‐Pacheco Cecilia , Capdevila‐Muñoz Laura , Carballo‐Álvarez Jesús
Published: January 2025

Aims/Purpose: Myopic children are increasingly prescribed soft multifocal contact lenses to slow the progression of myopia. Their impact on central and peripheral vision is not fully understood beyond visual acuity, a measurement that is not sensitive enough to detect small changes in visual performance caused by increased higher‐order aberrations and scattered light. The aim of this study was to investigate up to what extent Dual‐focus (DF) contact lenses, designed for myopia control, affect flicker modulation sensitivity (FMS) measured in central vision and near periphery across photopic and mesopic light levels.

Methods: Right eyes of twenty‐five myopic and non‐presbyopic young adults were fitted with two soft contact lens designs, a DF with addition power of +2.00 D located in the near periphery and a single‐vision (SV) contact lens of the same material and parameters, in random order. 30 minutes after contact lens insertion, photopic and mesopic FMS were measured foveally (0 degrees) and at four near peripheral locations selected diagonally away from fixation at an eccentricity of 5 degrees in each of the four quadrants to produce a measure of overall peripheral FMS.

Results: The mean visual acuity did not vary significantly between the DF and SV contact lenses. Mean central fovea FMS were 0.12 log units worse in the DF than the SV contact lens, under both photopic (p < 0.001) and mesopic (p = 0.001) luminance conditions. Mean peripheral FMS were 0.04 log units worse with the DF contact lens than SV contact lens, under both photopic (p = 0.002) and mesopic (p = 0.048) light levels.

Conclusions: DF contact lenses designed for myopia control reduced FMS compared to SV contact lenses, with the reduction being greater for central fovea FMS than for near periphery FMS, for both photopic and mesopic luminance conditions. The blurred background noise created by the peripheral power of DF contact lenses is likely to influence both central and peripheral vision.
Evaluation and evolution of an algorithm‐based subjective refraction in children
Authors: Francois Daniel , Ong Wee Sing , Lam Andrew Kwok‐cheung , Liu Kenneth Ka‐king , Longo Adele
Published: January 2025

Aims/Purpose: Assessing a method for refracting children using the Vision‐R™ 800, evaluating usability, followed by examining consistency and clinical relevance of an improved refraction protocol, time savings and children's experience.

Methods: Two studies involved Chinese children aged 6 to 13. Study 1 (N = 159) assessed subjective refraction using Vision‐R™ 800 algorithm‐based software (SR1), followed by manual subjective refraction (SSR) and a second algorithm‐based refraction post‐cycloplegia (SR2). Study 2 (N = 66) evaluated SR1 using a modified algorithm and a manual subjective refraction (SSR2) following standard practice post‐cycloplegia.

The primary outcomes were the differences and 95% Limits of Agreement (LoA) between the refraction methods, being secondary outcomes method‐duration and children's feedback. Results of right eyes are presented.

Results: Study 1 average spherical equivalent (M) of ‐1.50 ± 1.50 D for SR1, ‐1.33 ± 1.57 D for SSR, and ‐1.35 ± 1.58 D for SR2. SR1 was ‐0.17 D more negative than SSR, and LoA was ± 0.75 D (p < 0.01) with no significant differences between SSR and SR2. Astigmatism differences were clinically insignificant. Timewise, SR1 took 7.64 ± 2.41 mins, SSR 4.94 ± 1.36 mins, and SR2 6.92 ± 2.51 mins. Ratings: SR1: “Okay” 60.4%, “Really Good” 32.1%, “Fantastic” 6.3%.

The initial algorithm protocol was usable and well‐received, with 95% of children completing the examination.

Study 2 found M values of ‐1.14 ± 1.49 D for SR1 and ‐0.93 ± 1.52 D for SSR2, with SR1 being ‐0.22 D more negative than SSR2 (p < 0.01). The LoA were ± 0.50 D for sphere, ± 0.35 D for J0, and ± 0.30 D for J45. These values showed greater consistency and smaller standard deviations in M (0.26D vs.0.38D) compared to Study 1. The modified algorithm reduced refraction time to 5.70 mins for SR1 vs. 4.77 mins for SSR2 (p < 0.05), with SR1 ratings: “Okay” 17%, “Really good” 44.7%, “fantastic” 38.3%, outperforming the earlier program.

Conclusions: While cycloplegic subjective refraction remains the standard for children, the proposed algorithm‐based, non‐cycloplegic refraction with the Vision‐R™ 800 showed reasonable agreement with the cycloplegic standard. This advancement is crucial for exploring alternatives to cycloplegic refraction in future pediatric clinical practices.
Agreement of pentacam axl and IOL master in determining axial length in irregular cornea
Authors: Yekta Abbas Ali , Khabazkhoob Mehdi , Hashemi Hasan , Irandoust Niloufar , Ostadimoghaddam Hadi , Ehsaei Asieh , Heravian Javad , Sardari Sara , Khorasani Abbas Azimi , Yekta Yeganeh
Published: January 2025

Aims/Purpose: To determine the agreement of axial length (AL) between the Pentacam AXL and IOL Master 500 in irregular corneas.

Methods: Uncorrected and best‐corrected visual acuity, objective and subjective refractions, anterior and posterior segment examinations, ocular biometry by using the Pentacam AXL and IOL Master 500 performed in this study.

Results: In this study, 141 eyes of 141 individuals with irregular cornea aged 60 to 91 years (64 ± 15.7) were included. The mean difference of axial length (AL) measurements between the Pentacam AXL and IOL Master 500 was 0.12 ± 0.65 mm (p = 0.047). The 95% limits of agreement (LoA) between the two devices were ‐1.15 to 1.14. The greatest difference was found in eyes with AL longer than 24.5 mm (0.52 ± 1.81 mm), the 95% limits of agreement was ‐3.02 to 4.07. The agreement of the 95% limits of agreement was ‐0.91 to 1.37 in eyes with an axial length of less than 22 mm.

Conclusions: The results of this study showed that in irregular corneas, Pentacam AXL does not have a high agreement with the IOL master 500 in measuring the axial length and the agreement of the two devices decreased with increasing of the axial length in irregular corneas.
Femtosecond laser assisted phacoemulsification plus IOL implant: Toric IOL vs astigmatism keratotomy
Authors: Chao Howard Wen‐Haur , Chao Windsor Wen‐Jin , Chao Hsiao‐Ming
Published: January 2025

Aims/Purpose: This study aimed at comparing the clinical outcomes of femtosecond laser‐assisted cataract surgery (FSACS) performing astigmatic keratotomy (AK) and toric intraocular lens (IOLt) implantation for astigmatism correction.

Methods: Based on autorefractor and corneal topography, all patients underwent pre‐operative and postoperative examinations including comparatively assessing refractive astigmatism, best corrected visual acuity and corneal high order aberrations.

Results: This retrospective case series comprised a total of 20 eyes (IOLt: AK = 10: 10) of 16 patients (mean age: 62.70 ± 1.89 years). Refraction status was 1.98 ± 0.22 in IOLt (0.75~3.00 D) vs 1.95 ± 0.23 in AK (0.55~3.08 D). The follow‐up periods 9.63 ± 1.15 months after surgery.

Total corneal astigmatism (CAtot) were 1.73 ± 0.20 D in IOLt/2.28 ± 0.23 D in AK preoperatively and significantly (p < 0.01/p < 0.001) reduced to 0.80 ± 0.17 D in IOLt/1.13 ± 0.07 D in AK. The pre‐operative and postoperative reduction in astigmatism between IOLt (0.93 ± 0.32 D) and AK (1.15 ± 0.21) was not significantly (p = 0.56) different. However, anterior corneal astigmatism (CAant) were 1.99 ± 0.21 D in IOLt/1.95 ± 0.23 in AK preoperatively and not significantly/significantly (p = 0.36/p < 0.05) reduced to 1.73 ± 0.18 D in IOLt/1.10 ± 0.18 D in AK. Regarding CAant, the pre‐operative and postoperative reduction in astigmatism between IOLt (0.36 ± 0.25 D) and AK (0.69 ± 0.21 D) was not significantly (p = 0.3) different.

Pre‐FSACS IOLt total corneal HOAs (0.47 ± 0.15) decreased, but not significantly, after FSACS IOLt (0.41 ± 0.11; p = 0.76). However, pre‐FSACS AK total corneal HOAs (0.19 ± 0.02) significantly increased after FSACS AK (0.29 ± 0.03; p < 0.01). Furthermore, the pre‐operative and postoperative changes in total corneal HOAs between IOLt (‐0.06 ± 0.04) and AK (0.10 ± 0.02 D) were significantly (p < 0.01) different.

Best corrected visual acuity (Snellen E) was preoperatively 0.42 ± 0.02 in IOLt/0.38 ± 0.02 in AK and significantly (p < 0.001) increased to 0.82 ± 0.06 in IOLt/0.74 ± 0.07 in AK postoperatively. The preoperative and postoperative BCVA alteration was not significant between two groups (IOLt vs AK: 0.40 ± 0.04 vs 0.36 ± 0.07; p = 0.64).

Conclusions: IOLt implantation efficient and harmless for correcting preoperative astigmatism in FSACS in a short period.
Visual outcomes after implantation of trifocal intraocular lens pairing two complementary light distributions
Authors: Puche Ana Belen Plaza , del Barrio Jorge Alió , Yebana Pilar , Martínez‐Abad Antonio , Cantó‐Cerdán Mario
Published: January 2025

Aims/Purpose: The aim of this study is to analyze the visual, refractive and aberrometric outcomes in patients implanted with a new IOL family of trifocal diffractive IOLs with same addition power (3.5D and 1.75D) and two distinct light energy distributions.

Methods: This is an observational, prospective study. Patients underwent a complete preoperative and postoperative examination: far, near and intermediate visual acuity (VA), subjective refraction, contrast sensitivity, defocus curve and ocular aberrometry. Subjective visual function was evaluated using the Quality of Vision (QoV) questionnaire and the satisfaction surgery (NAVQ‐10). Vivinex Gemetric family (Hoya, Japan) is a trifocal diffractive IOL with same addition power (3.5D (near) and 1.75D (intermediate)) (Gemetric and Gemetric Plus) that differ in the amount of light distribution to each focus: Gemetric: 50.8% for far, 17.3% for intermediate and 21.8% for near; Gemetric Plus 39.2% for far, 16.9% for intermediate and 32.8% for near (3mm pupil).

Results: Fifty‐six eyes (28 patients) were included. Mean age was 56.7 ± 6.9 years. Mean binocular uncorrected VA obtained (LogMAR) was ‐0.01 ± 0.12 for far vision, 0.05 ± 0.08 for intermediate vision and 0.01 ± 0.11 for near vision. The near VA with distance correction was 0.01 ± 0.11. Mean higher order aberration (HOA) was 0.29 ± 0.14μm, spherical aberration 0.01 ± 0.05 μm and a mean Strehl Ratio of 0.2355 ± 0.0793. Contrast sensitivity measurement showed mean values within the normal range for patients in a similar age range to our sample. The defocus curve shows a profile providing a range of sharp vision (above AV 0.2) between ‐3.50 and +1.00D. 90% of patients reported to enjoy spectacle independence for far and near vision and 95% for intermediate vision postoperatively.

Conclusions: Pairing these two trifocal lenses with complementary light distribution achieved good full range of vision from far to close near vision and high quality of vision based on patient's satisfaction.
The use of the smart eye camera device for cataract screening in the endocrine and ophthalmology clinics in a general hospital in Jordan
Authors: Khalil Mohammed , Abu‐Ismail Luai , Imran Mohammed Abu , Khemlani Rohan , Nakayama Shintaro , Nishimura Hiroki , Shimizu Eisuke
Published: January 2025

Aims/Purpose: To asses the usefuleness of the Smart Eye Camera (SEC) slit light device by OUI Inc. in comparing the prevalence of cataract in diabetic and non‐diabetic patients in an outpatient setting in a general hospital in Jordan. The study aims also to delineate risk factors for the development of cataract in diabetic patients.

Methods: 207 patients (414 eyes) were examined using the SEC device which captures videos of the anterior segment similar to a slit lamp exam. After completion of data collection, web‐saved videos were reviewed and grades of cataract or each eye were recorded using a modified LOCS III (lens opacity classification system). The assigned observer recorded nuclear, cortical and posterior subcapsular grades for each eye from 0 to 5.

Results: Mean age was 55 (range 40‐85). After exclusion of 19 pseudophakic eyes and 3 low quality images, 204 patients (392 eyes, 198 right (OD) and 194 OS (left) eyes) were analyzed. Nuclear cataract was found in 114 eyes (29%), cortical cataract in 104 eyes (27%) and posterior subcapsuar in 77 eyes (20%). Overall, odds ratio for developing cataract in diabetes in this study population was 1.606, with a p‐value of 0.09. Also the relative risk of developing cataract in diabetes was 1.123. A second and third observer independently evaluated the SEC videos and recorded their findings. Interobserver agreement kappa value was fair to moderate especially for nuclear cataract. Posterior subcapsular cataract was difficult to assess with no means of retroillumination on the device. Additionally, we looked into possible assosiations between DM control, comorbidities and medciations used by diabetic patients and the development of cataract, especially hypertension, thyroid disease and hyperlipidemia. All diabetic patients were type 2 with 34.2% having a Hba1c > 7.5

Conclusions: The Smart Eye Camera is a small, fast and accurate tool for the diagnosis and grading of cataract in the outpatient setting and would be very helpful on a national scale for cataract screening, especially in the rural areas and in clinical trials. Moreover, cataract tends to be more common in diabetic patients in Jordan probably through multifactorial mechanisms.

References

Evaluation of Nuclear Cataract with Smartphone‐Attachable Slit‐Lamp Device by Hiroyuki Yazu et al in Diagnostics 2020, 10, 576
Using long‐read adaptive nanopore sequencing to decipher a novel pathogenic duplication in the PRPH2 gene in patients with macular dystrophy
Authors: Backlund Michael , Gasparian Suzie , Repo Pauliina , Kangas Harri , Donner Kati , Seitsonen Sanna , Paavo Maarjaliis , Kivelä Tero , Sierpina David , Turunen Joni
Published: January 2025

Purpose: Detailed genetic characterization of three individuals from two families with macular dystrophy caused by exon 2 duplication of the PRPH2 gene.

Methods: Two of the affected members (P1, P2) from one family were treated in the Helsinki University Hospital, Finland and one (P3) at Loma Linda University Eye Institute, CA, USA. The patients underwent comprehensive ophthalmic examination, and their genomic DNA was subjected to macular (P2) and retinal dystrophy (P3) gene panels or targeted genetic testing (P1). Additionally, Oxford nanopore adaptive sequencing was used for characterizing and mapping the breakpoints of the identified partial duplication of the PRPH2 gene.

Results: Based on the ophthalmic examination, the mother (P1) of the Finnish family was diagnosed with butterfly‐shaped pattern dystrophy (BPD) and the daughter (P2) with vitelliform macular dystrophy. P3 (male) from the USA was diagnosed with BPD in the right eye and central areolar choroidal dystrophy in the left eye. Exome‐based genetic testing indicated that all patients are heterozygous for the same 482 bp duplication c.(581+1_582‐1)_(828+1_829‐1)dup between introns 1 and 2 of the PRPH2 gene, duplicating exon 2 (NM_000322.5). In‐depth analysis of the patients DNA samples by long‐read adaptive nanopore sequencing revealed the duplication to be ∼4kb in size. For all patients the 3’ breakpoint (BP) is located directly upstream from an intronic alu‐element (AluYM1). In the Finnish family the 5’BP resides in a novel alu‐element (AluYa5) lacking from the hg38 reference genome. The P3 lacks the novel‐alu element found in the Finnish family and instead the 5’BP resides in a known alu‐element (AluSq), located some 300bp upstream.

Conclusions: We report here that the macular dystrophy in the two families is caused by duplication involving exon 2 of the PRPH2 gene. The alu‐elements at the breakpoints indicate non‐allelic homologous recombination as a possible mechanism for the duplication event.