bluuebunny/crossref_metadata_2025 huggingface dataset:
Is there a common factor for vision?
Authors: Herzog Michael , Garobbio Simona , Pfau Maximilian , Scholl Hendrik
Published: January 2025

Aims/Purpose: Eye diseases are implicitly assumed to affect vision generally. However, only visual acuity and contrast sensitivity are usually measured to determine perceptual deficits. What about orientation and motion perception?

Methods: To address these questions, we first conducted 19 visual tests, including visual acuity (determined by Landolt Cs and verniers), various motion tests, etc., in a large sample of 104 young and 92 older healthy participants. Second, we investigated 50 patients with age‐related macular degeneration (AMD) and 49 age matched controls, administering a battery of six perceptual tests. In addition, OCT images of the retina, choroid, and optic nerve were recorded.

Results: Surprisingly, in the young and old healthy population, the tests correlated only weakly, and the factor structure was rather flat. Hence, single eye tests tell very little about vision in the healthy population. What about disease? AMD patients were impaired in all perceptual tests compared to age matched controls, except for motion perception. Detailed OCT analysis and retinal layer segmentation showed that the thickness of the retinal pigment epithelium drusen complex (RPEDC) determines deficits most strongly (r=0.40). We found moderate correlations between the tests, which we attribute to the thickness of the RPEDC layer. However, motion perception was independent of RPEDC thickness, suggesting that AMD does not affect all visual abilities equally.

Conclusions: Our results show the need to investigate healthy and clinical vision with batteries of tests rather than with a single contrast or spatial acuity measure.
The effect of peri‐ and preoperative anxiety on cardio‐vascular parameters and intraocular pressure of patients awaiting cataract surgery
Authors: Dimitrova Galina , Gjorgjiovska Ana , Ljubic Antonela , Jordanovska Sofija Milanovska
Published: January 2025

Aims/Purpose: To evaluate peri‐ and preoperative anxiety in patients scheduled for cataract surgery and its effect and correlation with cardio‐vascular parameters and intraocular pressure (IOP).

Methods: Thirty patients scheduled for cataract surgery were included in the study. Exclusion criteria were any previous ocular surgery on both eyes, glaucoma and any sign of acute or chronic ocular inflammation. In addition to the general ophthalmic examination at the initial evaluation patients were asked to define their level of anxiety using a visual facial anxiety scale (VFAS). Systemic blood pressure (BP) and heart rate (HR) were measured using an automated brachial sphygmomanometer and IOP was measured using an air‐puff tonometer. Mean of three measurements was calculated for both BP, HR and IOP. VFAS, BP, HR and IOP measurements were repeated on the day of surgery. T test was used to compare the peri‐ and preoperative parameters and Pearson's coefficient of correlation was used to study correlation between VFAS, BP, HR and IOP.

Results: The mean level of anxiety according to patients’ self‐evaluation was mild to moderate both at the peri‐ and at the preoperative day. The cardio‐vascular parameters and IOP were not significantly different at the peri‐ and preoperative days. IOP was significantly correlated to HR in the perioperative period (R=0.62, p < 0.001), whereas in the pre‐operative day it was significantly correlated with systolic BP (R=0.47, p = 0.009) and with level of anxiety (R=0.29, p = 0.04). Patients with moderate to high levels of anxiety (grades 3‐5) had significantly higher IOP (17.06 ± 1.69 mmHg) than patients with none to mild/moderate anxiety (grades 0‐2) (14.74 ± 2.41 mmHg; p = 0.006).

Conclusions: Systemic cardio‐vascular parameters are correlated with IOP and the level of anxiety in patients scheduled for cataract surgery. IOP is higher in patients with higher degrees of anxiety.
Congenital aniridia: Experience of 26 years in the department of pediatric ophtalmology of Casablanca, Morocco
Authors: Daghouj Ghizlane , Ettouri Sara , Rokaya Chahir , Rami Ali , El Maaloum Loubna , Allali Bouchra , El Kettani Asmaa
Published: January 2025

Aims/Purpose: Report the experience of 26 years in the department of pediatric ophthalmology in Casablanca.

Methods: Retrospective study from 1996 to 2022 about 30 eyes with congenital aniridia.

Results: The average age is 83.35 months. Male at 53% and female at 47% .46% with nystagmus. 20% of the eyes were with corneal involvement. 56.6% of the lenses are cataract. 30% of lenses were dislocated. 30% of aniridia were associated with glaucoma .33.3% of fundus where passage were possible: 22% were normal and the rest pathological. Glaucoma: 2 of the 9 eyes with glaucoma were operated on and the rest under hypotonic medical treatment. Cataract: 13 operated eyes. All children received optical correction and amblyopia treatment. All abdominal ultrasounds were normal. The gain in visual acuity on average was 1 line after therapeutic measures.

Conclusions: Aniridia is rare but can significantly and progressively impair vision by reaching the entire eyeball with polymorphic manifestations. Management of aniridia remains difficult, it must be both proactive and responsive, with medical or surgical management or both of them. In sporadic forms an abdominal ultrasound is necessary to rule out the presence of Wilms tumor.

References

Efficacy and Safety of Plasma Rich in Growth Factor in Patients with Congenital Aniridia and Dry Eye Disease. Lozano‐Sanroma J, Barros A, Alcalde I, Alvarado‐Villacorta R, Sánchez‐Ávila RM, Queiruga‐Piñeiro J, Cueto LF, Anitua E, Merayo‐Lloves J.Diseases. 2024 Apr 11;12(4):76. doi: 10.3390/diseases12040076.

Epidemiology of PAX6 Gene Pathogenic Variants and Expected Prevalence of PAX6‐Associated Congenital Aniridia across the Russian Federation: A Nationwide Study. Vasilyeva TA, Marakhonov AV, Voskresenskaya AA, Kadyshev VV, Sukhanova NV, Minzhenkova ME, Shilova NV, Latyshova AA, Ginter EK, Kutsev SI, Zinchenko RA.Genes (Basel). 2023 Nov 4;14(11):2041. doi: 10.3390/genes14112041.

Congenital aniridia and cataract. C. Speeg‐Schatz. Journal francais d’ophtalmologie, Volume35‐ N°4, Avril 2012. Doi: 10.1016/j.jfo.2011.04.017
Retinal ischemia: Therapeutic effects and mechanisms of paeoniflorin
Authors: Chao Winsdor Wen‐Jin , Chao Howard Wen‐Haur , Chao Hsiao‐Ming
Published: January 2025

Aims/Purpose: Retinal ischemia‐associated ocular disorders are vision threatening. The aim of the present study is to assess the potential of paeoniflorin in alleviating retinal ischemic injury and to uncover the mechanisms involved.

Methods: Cultured retinal cells were subjected to oxygen glucose deprivation (OGD; N2/CO2/O2: 95 %/5 %/1 %) with pre‐OGD (1h) administration of paeoniflorin (0.25/0.5 mM). The cell viability were evaluated by MTT assay.

High intraocular pressure‐induced retinal ischemia (I) was established by raising IOP to 120 mmHg for 60 minutes followed by reperfusion (R) for 7 days in an ischemic eye in a Wistar rat. The physiological effects of the retina were evaluated by electrophysiology and fluorogold retrograde labelling RGCs. The protein levels of angiopoietin, pyruvate kinase M2 (PKM2), Wnt3a and β‐catenin were assessed by Western blotting.

Results: Pre‐ischemic administration of paeoniflorin dose‐dependently (less effect at 0.25 mM) and significantly (p < 0.05; 0.5 mM) alleviated OGD induced significant (p < 0.001) decrease in RGC‐5 cell viability. Furthermore, pre‐ischemic administration of paeoniflorin dose‐dependently (less effect at 0.25 mM) and significantly (p < 0.05/p < 0.001; 0.5 mM) attenuated ischemia‐induced significant (p < 0.001/ p < 0.05) reduction in ERG b‐wave amplitude/RGC cell number.

Compared to eyes treated with vehicle, paeoniflorin (p < 0.05/p < 0.01/p < 0.05; 0.5 mM) seemed to protect against retinal ischemia by regulating angiopoietin, β‐catenin, WNT and PKM2 expression.

Conclusions: The treatment with paeoniflorin is able to effectively reduce retinal ischemia by affecting angiopoietin, β‐catenin, WNT and PKM2 biomarkers.

References

Windsor Wen‐Jin Chao, Howard Wen‐Haur Chao, Hung‐Fu Lee, Hsiao‐Ming Chao. The Effect of S‐Allyl L‐Cysteine on Retinal Ischemia: The Contributions of MCP‐1 and PKM2 in the Underlying Medicinal Properties. Int J Mol Sci. 2024 Jan 22;25(2):1349.

Chao HM, Osborne NN. Topically applied clonidine protects the rat retina from ischaemia/reperfusion by stimulating alpha(2)‐adrenoceptors and not by an action on imidazoline receptors. Brain Res. 2001 Jun 15;904(1):126‐36.
Actin‐related proteomic changes in age‐related, diabetic and post‐vitrectomy cataract
Authors: Karakosta Christina , Samiotaki Martina , Parayotou George , Papaconstantinou Dimitrios , Moschos Marilita
Published: January 2025

Aims/Purpose: Actin has been implicated in lens opacification; however, the specific actin‐related pathways involved in cataracts remain unclear. In this study, actin‐related signaling pathways involved in the development of different types of cataract were evaluated.

Methods: Two sample types were collected during routine cataract surgery; the anterior capsule (AC) and phacoemulsification cassette contents (PCC). Participants were divided into three groups. Age‐related cataract (ARC) group included 12 patients without a history of DM, and age > 75 years; Diabetic cataract (DC) group included 11 patients with diabetes mellitus (DM) and age < 65 years.; and Post‐vitrectomy cataract (PVC) group included 7 patients without a history of DM, who had vitrectomy surgery in the past 12 months. The sample preparation was based on Sp3 protocol (Single‐Pot, Solid‐Phase‐enhanced, Sample‐Preparation). Liquid chromatography online with tandem mass spectrometry was used for protein recognition and quantification. DIA‐NN software was applied for data analysis. Statistical analysis was performed on Perseus software.

Results: In PCC samples, proteins with significant differential expression in ARC compared to DC and PVC were involved in pathways including actin binding, actin cytoskeleton reorganization, and small GTPase‐mediated signal transduction pathways. In AC samples, proteins with significant differential expression in ARC compared to DC and PVC were involved in actin binding and actin cytoskeleton reorganization pathways.

Conclusions: Our findings suggested that actin‐binding pathway may be involved in ARC formation by causing abnormal lens fiber cell elongation and differentiation. The results of the present study revealed that small GTPase‐mediated signal transduction pathway exhibit lower expression in ARC than in the DC and PVC groups in PCC, and this may be linked to ARC formation through abnormal fiber cell organization, leading to lens opacification and cataract.
A novel artificial intelligence‐based classification of highly myopic eyes based on visual function and fundus features
Authors: Meng Jiaqi , Song Yunxiao , He Wenwen , Lu Zhong‐Lin , Chen Yuxi , Wei Ling , Zhang Keke , Qi Jiao , Du Yu , Lu Yi , Zhu Xiangjia
Published: January 2025

Aims/Purpose: To develop a novel classification of highly myopic eyes using artificial intelligence (AI) and investigate its relationship with contrast sensitivity function (CSF) and fundus features.

Methods: 616 highly myopic eyes of 616 patients were enrolled. CSF was measured using the quantitative CSF method. Myopic macular degeneration (MMD) was graded according to the International META‐PM Classification. Thickness of the macula and peripapillary retinal nerve fiber layer (p‐RNFL) were assessed by fundus photography and optical coherence tomography, respectively. Classification was performed by combining CSF and fundus features with principal component analysis and k‐means clustering.

Results: With 83.35% total variance explained, highly myopic eyes were classified into 4 categories. The percentages of categories 1 to 4 were 14.9%, 37.5%, 36.2%, and 11.4%, respectively. CSF of the eyes in category 1 were the highest, followed by those in category 2 and then category 3, while the lowest was seen in category 4. Compared to those in category 1, eyes in category 2 presented higher percentage of MMD2 and thinner temporal p‐RNFL. Eyes in categories 3 and 4 presented significantly higher percentage of MMD≥3, thinner nasal macular thickness and p‐RNFL (p < 0.05). Multivariate regression showed category 4 had higher MMD grades, thinner macular and p‐RNFL thickness compared to category 3.

Conclusions: We proposed an AI‐based classification of highly myopic eyes by integrating features from both visual function and fundus. It might be an important tool to comprehensively evaluate highly myopic eyes.
Regulation of the stress response of Müller cells after retinal detachment by amniotic membrane secretome in vitro
Authors: Hillenmayer Anna , Christian Wertheimer , Thomas Sterz , Azza Dammak , Armin Wolf
Published: January 2025

Aims/Purpose: Müller cells play a key role in retinal homeostasis, structural support and immune response. They respond to retinal detachment and subsequent hypoxic conditions with increased stress response leading to structural changes. Due to the stabilizing properties of the amniotic membrane, first potential intraocular applications in vitreoretinal pathologies have been published. The aim was to investigate possible effects of amnion on Müller cells in the context of hypoxic damage after retinal detachment in vitro.

Methods: Secretome was isolated from cryopreserved amniotic membranes. Immortalized Müller cells (MIO‐M1) with and without hypoxia treatment were incubated with the secretome and toxicity was excluded by a life/death assay and a cell death detection ELISA. A Wst‐1 and BrdU assay were performed for cell activity and proliferation; Western blot analysis and immunofluorescence staining were used to detect changes in protein expression of alpha‐SMA, SOX‐2 and GFAP.

Results: Both hypoxia and the addition of amniotic secretome significantly reduced the metabolic activity of the cells. Incubation with secretome led to a statistically significant stagnation under both normoxic (p = 0.005) and hypoxic conditions (p > 0.01) in cell proliferation. Hypoxia led to increased expression of alpha‐SMA (p = 0.6), GFAP (p = 0.02) and SOX‐2 (p = 0.03) in Western blot analysis while secretome led to a normalization of alpha‐SMA (p = 0.03), GFAP (p = 0.1) and SOX‐2 (p = 0.001) under normoxic as well as hypoxic conditions. This observation was affirmed in immunofluorescence. Toxicity was excluded.

Conclusions: In vitro simulation of hypoxic conditions in retinal detachment leads to stress responses of Müller cells. The amniotic secretome appears to regulate Müller cell behavior in vitro by supporting a stable phenotype under normoxic and hypoxic conditions. Further studies are needed to evaluate the clinical potential of the amniotic secretome after retinal detachment.
Correlation between diabetes and glaucoma risk: Insights from a population‐based glaucoma screening (NCT 05875090)
Authors: Monteiro Bernardo , Lima‐Cabrita Afonso , Lobo Vasco , Whitfield Rafael , Marques Rodrigo , Ourique Matilde , Varandas Teresa , Barão Rafael , Pazos Marta , Stalmans Ingeborg , Abegão‐Pinto Luís
Published: January 2025

Aims/Purpose: To evaluate the association between Glaucoma referral and Diabetes in participants in a population‐based glaucoma screening using artificial intelligence (AI).

Methods: Analysis of cohort characteristics at baseline contact (screening visit). Glaucoma referral was defined by intraocular pressure (IOP) ≥ 24mmHg or AI score ≥ 0.73. Diabetes information, including HbA1C, was collected from electronic medical records. Our analysis used descriptive and bivariate statistics, including chi‐square tests. Significance was p < 0.05 with 95% confidence intervals (CI).

Results: Data from 837 participants were analyzed, comprising 54% males, with an average age of 62±4 years, across 11 functional units of Santa Maria Local Health Unit. A significant portion of participants had diabetes (69%), of which 8.3% were referred. AI scores were lower in diabetic patients compared to the non‐diabetic sub‐cohort (0.57 vs 0.61; p = 0,009). Intrigingly, while no correlation in the overall range of HbA1C with the AI score was detected, there was a detectable trend towards higher AI scores in decompensated diabetic patients (HbA1C > 9%; n = 10): (ρ = 0.591; CI‐0.083‐0.894; p = 0.072)

Conclusions: Overall, diabetes diagnosis may influence glaucoma referral programs. AI threshold for referral may be adapted to the setting (particularly if a dual diabetic retinopathy and glaucoma screening is considered). Interestingly, AI appears to detect retinal/disc abnormalities in metabolic decompensated patients.
Recovery of the glaucoma service after the COVID‐19 pandemic; Barnsley glaucoma audit
Authors: Sharma Rohit , Awwad Mohamed , Firan Anne Marie
Published: January 2025

Aims/Purpose: To audit the new referrals to the Glaucoma Unit at Barnsley Hospital for compliance with NICE guidelines and compare them to the 2020 audit.

Methods: Between August and September 2023, we audited newly referred patients to the glaucoma service at Barnsley Hospital. We assessed the management of these patients based on the NICE guidelines, specifically in terms of recording visual acuity, Goldmann applanation tonometry (GAT), pachymetry, standard automated perimetry, gonioscopy, OCT optic disc and macula, and family history of glaucoma. We compared our findings to a previous audit conducted in October 2020.

Results: We examined 30 newly referred patients. We conducted visual acuity, GAT, and OCT optic disc and ensured proper follow‐up requests for 100% of the patients. Additionally, 97% of patients underwent standard automated perimetry and pachymetry, while 87% had their family history recorded and underwent gonioscopy. We managed to discover treatable maculopathy in 40% of patients. Our compliance with NICE guidelines regarding pachymetry, gonioscopy, and family history recording was significantly higher than the 2020 audit.

Conclusions: Our glaucoma unit has complied better with NICE guidelines during the recovery from the COVID‐19 pandemic. We've minimized virtual clinics and discovered silent progression in glaucoma patients.
Analysis of the influence of genotype on the response to prostaglandin analogues, prostamides, and beta‐blockers in patients with ocular hypertension and glaucoma
Authors: Tejado Sara Carlota Labay , Toro Valeria Opazo , Hernáez Mar , Brunet Mercè , Milla Elena
Published: January 2025

Aims/Purpose: The objective of the study is to analyse the genotype that predicts the phenotypic characteristics of a cohort of patients with glaucoma and ocular hypertension (OH), and its correlation with the individual pharmacological response to beta‐blockers (BB), prostaglandin analogues (PGA), and prostamides (PM).

Methods: This is a prospective study that included 193 eyes of 109 patients with glaucoma or OH under monotherapy with BB, PGA, and PM. Five single nucleotide polymorphisms were genotyped using real‐time PCR assays: prostaglandin‐F2α receptor (rs3766355, rs3753380); cytochrome P450 2D6 (rs16947, rs769258); and beta‐2‐adrenergic receptor (rs1042714). The main variables studied were previous ocular interventions, mean deviation of the visual field (MD), baseline intraocular pressure (bIOP), and treated (tIOP), and the rate of variation of intraocular pressure (vIOP).

Results: From the total of eyes, 112 were treated with PGA (58%), 59 with BB (30.6%), and 22 with PM (11.4%). 25 patients had previously undergone a glaucoma procedure. The mean bIOP and tIOP were 23.57 ± 4.8 mmHg and 19.99 ± 4.87 mmHg, respectively. Statistically significant differences were observed in tIOP between heterozygotes (HT) and homozygotes (HM) rs769258 compared to wildtype (WT) individuals (p = 0.049). For rs3753380, differences were observed in vIOP in the PGA group (p = 0.032) and in tIOP in the PM group (p = 0.03). Differences were also observed for rs1042714 in MD (p < 0.001) and vIOP (p = 0.017). Finally, a significant influence on vIOP (p = 0.019) was found for systemic treatment metabolized by CYP2D6 among those treated with BB.

Conclusions: These preliminary findings suggest the potential of pre‐emptive pharmacogenetic tests as a guide to achieve personalised treatment preventing adverse reactions and improving efficacy and the clinical evolution of patients with glaucoma.
Plateau iris syndrome: A case report
Authors: Mabrouk Amira , Zahaf Amine , Lajmi Houda , Achour Besma Ben , Hmaied Wassim
Published: January 2025

Purpose: We report the case of plateau iris syndrome (PIS) in a middle‐aged woman, controlled by medical treatment.

Methods: Case report

Results: A 37‐year‐old woman, presented to our department with paroxysmal periorbital pain and progressive decline in VA in the left eye.Best corrected VA was 10/10 in both eyes.Anterior chamber(AC) was peripherally shallowed,but normal in the center bilaterally.Intra ocular pressure (IOP) was normal in OD and 38 in OS. C/d ratio was 0.3 in OD,0.4 in OS.On gonioscopy,angle was occludable in OD.In OS,it revealed convex iris,closed angle/360°,opening by indentation with double hump sign.Visual field showed no abnormalities. Bilateral laser peripheral iridotomy (LPI) was performed.Angle depth improved only in OD.The diagnosis of IPS was made.An UBM made revealed a lens volt (LV)measuring 1.11mm with an occludable angle in the OD.In the OS, LV was elevated 1.20mm, the angle was closed with peripheral anterior synechiae.Iridoplasty wasn't done.We discussed the phacoemulsification but as the patient was controlled by medical treatment and hadn't cataract, we opted to treat medically with regular controls.

Conclusions: Although PIS represents a diagnostic trap,based on a cautious anamnesis and a thorough gonioscopy,the accurate diagnosis can be made.Treatment may be challenging in some cases with many considerations.
How do patients relate to preservatives in eye drops and what do they know?
Authors: Saruhanian Arevak , Andreasen Jens Rovelt , Toft‐Petersen Anne , Korsgaard Maiken , Kolko Miriam
Published: January 2025

Aims/Purpose: The purpose of this questionnaire was to investigate how glaucoma patients relate to preservatives in eye drops and the impact on their quality of life and eye discomfort.

Methods: This study was designed as a questionnaire‐based cross‐sectional study. Inclusion criteria included the present use of intraocular pressure‐lowering eye drops, > 18 years of age, and the ability to read and understand Danish. Questionnaires with self‐rated compliance of < 60% or inadequate replies were excluded. Participants were classified into two groups depending on preservative status of their eye drops: participants using only preservative‐free eye drops (PF) and participants using only preservative‐containing eye drops or a combination of both preservative‐containing and preservative‐free eye drops (PC). Further questions were asked regarding awareness of preservative status of eye drops, and willingness to pay more for preservative free options. 146 questionnaires were included in total.

Results: No statistically significant differences were found between the groups concerning the Glaucoma Symptom Scale (GSS) score (PC: 66.16 + 21.49 vs. PF: 67.55 + 21.77; p > 0.05), the Glaucoma Quality of life (GQL‐15) score (PC 30.31 + 15.13 vs. 31.33 + 16.80; p > 0.05), or the eye discomfort score (PC/PF OR; 0.90, 95% CI; 0.66‐1.21, p > 0.05). We found that most of the participants in the PC group were unaware of the preservative status of their eyedrops (PC; 74%), as well as unaware of the possibility to avoid preservatives, by using a preservative‐free option (PC; 67%). However, regardless of the knowledge on preservative status most participants were willing to pay more for preservative‐free eyedrops (PC; 83%, PF; 93%)

Conclusions: No significant difference in GSS, GQL‐15 or eye discomfort was observed. A severe lack of information was however observed regarding patient‐awareness on the preservative status of IOP‐lowering eye drops, as well as significant willingness to pay more for preservative‐free options.
Initial evaluation of State‐of‐the‐Art deep learning models on data of project forever
Authors: Reimann Marcel , Andreasen Jens Rovelt , Dahl Anders Bjorholm , Kolko Miriam
Published: January 2025

Aims/Purpose: We investigated state‐of‐the‐art deep learning models trained on the dataset Artificial Intelligence for Robust Glaucoma Screening Challenge [1] on a cohort subset of Project FOREVER. In addition, we investigated how the current evaluation metrics can be applied to a real‐world screening scenario.

Methods: We followed and combined the reported best‐performing model designs on the challenge dataset [1] to assess the generalizability of these models to our dataset. The entire pipeline was built using open‐source packages and model weights to ensure reproducibility. The optic disc segmentation and quality assessment were performed using AutoMorph [2]. Afterward, a vision transformer is used to classify the cropped images into non‐referable and referable glaucoma. The model is then applied to a labeled subset of participants of Project FOREVER.

Results: Using AutoMorph resulted in a much smaller good‐quality training set compared to what is reported in the AIROGS challenge. It classified one‐fifth of the images as ungradable. In addition, it failed to segment the optic disc in numerous images. Overall, we achieved similar performances on our test split of the AIROGS dataset. Our results also showed that, although high specificity and sensitivity values can be reached, the precision scores of the algorithms were generally low.

Conclusions: We suggest including precision as a standard metric to report when evaluating screening algorithms. Specificity and sensitivity are insufficient as they do not capture the economic aspects of the proposed models. Low precision algorithms might introduce high burdens on the healthcare systems due to a high number of false positive referrals.

References

C. de Vente et al., "AIROGS: Artificial Intelligence for Robust Glaucoma Screening Challenge," in IEEE Transactions on Medical Imaging, vol. 43, no. 1, pp. 542‐557, Jan. 2024, doi: 10.1109/TMI.2023.3313786.

Zhou Y, Wagner SK, Chia MA, Zhao A, Woodward‐Court P, Xu M, Struyven R, Alexander DC, Keane PA. AutoMorph: Automated Retinal Vascular Morphology Quantification Via a Deep Learning Pipeline. Transl Vis Sci Technol. 2022 Jul 8;11(7):12. doi: 10.1167/tvst.11.7.12. PMID: 35833885; PMCID: PMC9290317.
Improved early detection of glaucoma progression
Authors: Soderberg Per , Tumer Tolga , Kisonaite Konstancija , Holm Jonatan , Yu Zhaohua
Published: January 2025

Aims/Purpose: To establish a strategy for early detection of glaucoma progression

Methods: In the Uppsala Glaucoma Detection study (UGDS) both eyes in 89, patients with at least one glaucoma suspect eye at inclusion were measured with iterated measurements every 4 month for five years, including measurements of IOP, visual field, HTR‐CD, HRT‐NRA, OCR‐RNFLT and Gdx‐Tsnit. Typically, measurements are compared to population tolerance for evaluation. We estimated within subject variability based on the residual variance of not glaucoma suspect eyes followed over time. A critical limit for no progression in subsequent measurements within the same subject was estimated as the extreme confidence limit for the tolerance limit. We set the tolerance to 0.95 and the confidence coefficient to 0.95.

Results: We estimated the within subject standard deviation for subjects to 2.2 mmHg, 0.76 dB, 2.2 x10‐2 rel., 4.7 x10‐2 mm2, 3.4 μm, 1.5 μm for IOP, MD, NRA, RNFLT and Tsnit, respectively. For a specific baseline measurement of each of the different quantities, figure before bracket, this resulted in the critical limits in brackets 17 (21) mmHg, ‐1.53 (‐2.9) dB, 0.45 (0.49) rel., 1.85 (1.76) mm2, 110 (103) μm, and 55 (52) μm, respectively.

Conclusions: Estimation of the within subject variability allows estimation of critical limit for detection of progression closer to the subject specific baseline level.
Soft matter 3D printed drug‐loaded subconjunctival inserts for post‐surgical anti‐inflammatory drug delivery
Authors: Alambiaga‐Caravaca Adrián , Bernat‐Just Lucia , Luembe Esther Nginyu , Hibbitts Alan
Published: January 2025

Aims/Purpose: The aim of this study is to develop 3D printed drug‐loaded subconjunctival inserts to reduce inflammation post‐trabeculectomy by delivering antifibrotic therapies in a controlled and targeted manner.

Methods: Different gelatin derivatives were functionalized with methacrylate anhydride to create printable hydrogels. Methacrylation was confirmed by FT‐IR and quantified by 1H NMR, identifying optimal functionalization methods. Various water‐soluble co‐polymers, were incorporated to enhance the mechanical properties, stability, and biocompatibility of the hydrogels as well as a photo‐initiator. The stability of the formulations was assessed by immersing them in PBS at 37°C for up to three months. Extrusion and printability tests were conducted to select the best‐performing blends, which were then used to print different models under UV light exposure to cross‐link the blends and control drug release based on surface contact.

Results: The incorporation of polymers improved the stability of the gelatin hydrogels, with controlled degradation possible between 2 and 12 weeks depending on polymer blend. Extrusion and printability tests identified lead candidates. Optimal candidates exhibited controlled drug release over a three‐month period, meeting the therapeutic goal for post‐surgical inflammation management.

Conclusions: The development of 3D printed drug‐loaded subconjunctival inserts shows promise in providing targeted antifibrotic therapy post‐trabeculectomy. The optimized hydrogels exhibit improved stability and controlled drug release, potentially enhancing post‐operative outcomes and reducing intraocular pressure effectively. Further studies are warranted to evaluate the ex vivo biodistribution, the in vitro performance in cell culture and long‐term benefits of these customized drug delivery systems.

References: Barroso IA, Man K, Robison TE, Cox SC, Ghag AK. Photocurable GelMA Adhesives for Corneal Perforations. Bioengieering. 2022, 9, 53.
Correlation between dyslipidaemia and glaucoma risk: Insights from a population‐based glaucoma screening (NCT 05875090)
Authors: Whitfield Rafael , Lima‐Cabrita Afonso , Lobo Vasco , Monteiro Bernardo , Marques Rodrigo , Ourique Matilde , Leal Inês , Barão Rafael , Pazos Marta , Stalmans Ingeborg Stalmans , Abegão‐Pinto Luís
Published: January 2025

Aims/Purpose: Glaucoma, a leading cause of irreversible blindness globally, is often associated with elevated intraocular pressure (IOP). However, other risk factors may play a role, particular vascular related parameters. This investigation aimed to explore the association between glaucoma and dyslipidaemia (DL) in participants in a primary care screening pilot. NCT 05875090

Methods: analysis at screening visit comparing the odds of a positive referral between participants with and without DL. Secondary outcomes were medication with statins. Positive referral was defined by IOP≥24mmHg or AI≥0.73. Descriptive and bivariate analyses were used to compare the glaucoma proportions and IOP/AI means between groups. Significance was set at p < 0.05 with 95% confidence intervals (CI).

Results: Data from 839 participants (54% male, 62 ± 4 years) across 11 functional units were analysed. Many had low educational attainment (69%), diabetes (81,1%), hypertension (63,4%), and DL (66,2%). Among participants with DL, 7,38% had glaucoma positive outcome at screening. No difference in glaucoma odds was found between DL and non‐DL patients (OR 0.782; CI 0.400‐1.528), nor between DL patients medicated with statins compared to those non‐medicated (OR 2.083; CI 0.597‐7.276). Interestingly, DL may be associated with a positive referral due to high IOP (but not disc damage) when compared to non‐DL subjects (OR 0.404; CI 0.155‐1.055; p = 0.09), but further analyses with larger samples are needed.

Conclusions: Analysing the association between dyslipidaemia and glaucoma revealed a significant prevalence of DL, with 7,38% meeting positive referral criteria. While the study suggests a potential difference in glaucoma based on IOP between individuals with and without DL, this finding lacks statistical significance. Further analyses, including consideration of confounders and biases, are necessary for confirmation. Continued research and clinical observation are vital for a deeper understanding of this association.
Correlation between diabetes and glaucoma risk: Insights from a population‐based glaucoma screening (NCT 05875090)
Authors: Monteiro Bernardo , Lima‐Cabrita Afonso , Lobo Vasco , Whitfield Rafael , Marques Rodrigo , Ourique Matilde , Varandas Teresa , Barão Rafael , Pazos Marta , Stalmans Ingeborg , Abegão‐Pinto Luís
Published: January 2025

Aims/Purpose: To evaluate the association between Glaucoma referral and Diabetes in participants in a population‐based glaucoma screening using artificial intelligence (AI).

Methods: Analysis of cohort characteristics at baseline contact (screening visit). Glaucoma referral was defined by intraocular pressure (IOP) ≥ 24mmHg or AI score ≥ 0.73. Diabetes information, including HbA1C, was collected from electronic medical records. Our analysis used descriptive and bivariate statistics, including chi‐square tests. Significance was p < 0.05 with 95% confidence intervals (CI).

Results: Data from 837 participants were analyzed, comprising 54% males, with an average age of 62±4 years, across 11 functional units of Santa Maria Local Health Unit. A significant portion of participants had diabetes (69%), of which 8.3% were referred. AI scores were lower in diabetic patients compared to the non‐diabetic sub‐cohort (0.57 vs 0.61; p = 0,009). Intrigingly, while no correlation in the overall range of HbA1C with the AI score was detected, there was a detectable trend towards higher AI scores in decompensated diabetic patients (HbA1C > 9%;n = 10): (ρ = 0.591; CI‐0.083‐0.894; p = 0.072)

Conclusions: Overall, diabetes diagnosis may influence glaucoma referral programs. AI threshold for referral may be adapted to the setting (particularly if a dual diabetic retinopathy and glaucoma screening is considered). Interestingly, AI appears to detect retinal/disc abnormalities in metabolic decompensated patients.
Prognostic impact and correlation with disease activity of three‐dimensional OCT biomarkers in Vogt‐Koyanagi‐Harada patients
Authors: Lima‐Cabrita Afonso , Vieira Diogo Fróis , Fernandes João Lourenço , Salbany João , Sousa David , Sanches João , Marques‐Neves Carlos , Leal Ines
Published: January 2025

Aims/Purpose: Vogt‐Koyanagi‐Harada syndrome (VKH) is an autoimmune disease characterized by a chronic bilateral granulomatous panuveitis accompanied by extraocular manifestations, namely of the nervous, auditory, and integumentary systems. Retinal changes documented by optical coherence tomography (OCT) were found to have prognostic value, including detachments between retinal layers with fluid accumulation. The aim of this study was to estimate the total detachment volume (TDV) between retinal layers with fluid accumulation that characterizes the Vogt‐Koyanagi‐Harada syndrome.

Methods: An OCT analysis framework was developed in Python which, after a parameter tuning process, automatically segments the 3D detachments between retinal layers and calculates the TDV. The pipeline processes each slice individually following a chain of image processing steps: image enhancement; binarization; size filter; and contour detection. To validate this strategy, this method was applied to one 3D OCT image of a patient with VKH, and the resulting masks were compared with the ground truth obtained after manual segmentation by an expert.

Results: Our pipeline has revealed an Intersection of Union (IoU) score of 84%, demonstrating its ability to efficiently segment retinal detachments after a parameter tuning process. As a consequence of such capability, the relative deviation between the experimental and ground truth TDV was 8.3%.

Conclusions: This semi‐automated approach offers a promising tool for clinicians to detect retinal changes in VKH patients. By enabling early and precise detection of fluid accumulation and retinal detachments, this method can enhance prognostic evaluations and potentially improve patient management and treatment outcomes. Future work should focus on validating this framework across a larger dataset and refining the processing pipeline to further improve segmentation accuracy and robustness.
Automated OCT‐angiography segmentation of the optic nerve head to distinguish optic disc edema and pseudo‐edema
Authors: Battista Marco , Oakley Jonathan , Carbonelli Michele , Coutinho Catarina , Galzignato Alice , Brotto Luigi , Amore Giulia , Mularoni Cecilia , Bosello Francesca , Erba Stefano , Nucci Paolo , Lenzetti Chiara , Gagliano Caterina , Capobianco Matteo , Dell'Arti Laura , Carelli Valerio , Bandello Francesco , La Morgia Chiara , Cascavilla Maria Lucia , Barboni Piero
Published: January 2025

Aims/Purpose: To study the optic nerve head (ONH) dimension in symptomatic and asymptomatic patients with Leber hereditary optic neuropathy (LHON) and to correlate ONH parameters with genotype and clinical phenotype.

Methods: Seventy‐eight affected patients, 175 asymptomatic carriers, and 29 age‐matched healthy controls were enrolled in the study. All patients underwent ONH optical coherence tomography (OCT) measurements by DRI OCT Triton (Topcon, Japan) and were analyzed with the Orion custom software (Volexeron, CA, USA). The following parameters were obtained for each eye: disc area, horizontal and vertical diameter; retinal nerve fiber layer (RNFL) and ONH volume. For the comparison of the different parameters the ANOVA with Bonferroni post‐hoc test was performed.

Results: LHON‐affected patients appeared to have smaller ONH size parameters compared to control cases, but only the vertical disc diameter of patients with mutations 11778 and 14484 were statistically significant. Also, carrier patients with the mutation 11778 presented a statistical significantly smaller vertical disc diameter compared to controls, instead 14484 carriers presented a bigger diameter. ONH volume of all affected patients was significantly smaller. Moreover, asymptomatic 11778 carriers older than 35 years were significantly smaller. Linear regression sustained the relationship between age, volume, and RNFL, unlike between age and disc area.

Conclusions: This study exposed the differences of ONH size in LHON‐affected and ‐carrier patients with different mutations: smaller disc in 11778 affected and unaffected patients and larger disc in 14484 carriers. A strong correlation was found between ONH volume both in affected patients and carriers older than 35 years old. These results highlight the importance of the 3D ONH structure as a potential biomarker to support clinicians in the characterization of symptomatic LHON patients and possibly at‐risk mutation carriers with different genetic mutations and clinical course.
Complete blindness revealing pituitary apoplexy with recovery after transsphenoidal decompression
Authors: Mabrouk Amira , Achour Besma Ben , Hmaied Wassim
Published: January 2025

Aim/Purpose: We report the case of middle aged man,who developed sudden onset of bilateral no light perception (NLP) vision after pituitary apoplexy (PA).Transsphenoidal pituitary decompression(TPPD) was performed.Three months later,the patient regained excellent functional vision in one eye but had residual visual field loss.

Methods: Case report:A 37‐year‐old man,with a history of diabetes mellitus,presented to our department for acute onset of bilateral blurry vision.Ophthalmic examination was notable for bilateral NLP,sluggishly reactive pupils.Eye movements were conserved.Fundus examination showed cup‐to‐disc ratios of 0.5 bilaterally without disc swelling.Investigations revealed an elevated prolactin and growth hormone level.A CT scan and an MRI done showed a hemorrhagic pituitary macroadenoma.TPPD was realised.On later controls,VA in the right eye(OD) had improved to 10/10 while it remained NLP in the left eye(OS).His right pupil was briskly reactive to light but sluggishly in his OS.Humphrey visual field testing of OD revealed peripheral loss of visual field.

Results: PA involves the sudden expansion of a pituitary mass due to either hemorrhage or infarction.Bitemporal hemianopsia is the most common visual disturbance due to optic chiasm compression,but others presentations can be seen.NLP is rare.Headache and limitation of extraocular movements are relatively frequent.Clinical outcomes after PA vary depending on initial presentation's severity and treatment.Although TPPD can improve VA in cases of PA,the final outcome may be poorer in patients with NLP.Despite the positive outcome of both early and late surgery,literature generally supports early intervention,particularly in severe visual compromise.

Conclusions: We report a case of bilateral blindness presenting after PA,with partial vision's recovery following TPPD seven days after the apoplectic event.This case highlights the possibility of functional vision's return after relatively late surgery despite initial NLP.

References

Recovery of Complete Blindness and Internal Ophthalmoplegia After Transsphenoidal Decompression of Pituitary Apoplexy.Cureus2022Sep
Six‐month efficacy of red‐light therapy and customised orthokeratology for myopia control in Spanish children
Authors: Velazquez Fernando Fernandez , Fidalgo María Fernández , Ferrel Victoria Ferigo
Published: January 2025

Aims/Purpose: To evaluate the efficacy and safety of repeated low‐level red‐light (RLRL) therapy with customised orthokeratology (Ortho‐K) for myopia control in Spanish children.

Methods: This single‐site, randomised, parallel‐group, non‐blinded trial enrolled 26 children aged 10‐13 years with myopia. A total of 26 children were enrolled, completing the 6‐month follow‐up in May 2024. Children were randomly assigned to either the RLRL combined with the Ortho‐K or the Ortho‐K‐only group. The Ortho‐K group was required to wear Ortho‐K lenses for at least 8 hours per night. In addition to wearing Ortho‐K lenses in the adjunct therapy group, daily RLRL therapy was administered twice a day for 3 minutes per session. The primary outcome was the axial length (AL) change measured at 6 months relative to baseline.

Results: Twenty‐six children completed the study (11 in the RLRL + Ortho‐K group and 15 in the Ortho‐K group). After 6 months, the mean AL change was ‐0.06 mm (95% CI, ‐0.12 to 0.01 mm) in the RLRL +Ortho‐K group, significantly lower than in the Ortho‐K group (0.04 mm [‐0.12 to 0.01 mm], p = 0.001). In the RLRL + Ortho‐K group, 5 children (45.5%) achieved significant axial shortening (AL changes < = ‐0.05 mm). The mean change in macular thickness was 0.66 μm (95% CI, 0.05 to 1.28 μm) in the RLRL + Ortho‐K group, significantly greater than in the Ortho‐K group (0.08 μm [0.001 to 0.15 μm], p = 0.022). No severe adverse events were reported, such as vision loss, scotoma, functional visual loss, or structural damage on OCT scans. No significant corneal findings were observed.

Conclusions: Combining RLRL therapy with customised Ortho‐K shows promise for controlling myopia progression in Spanish children. This approach may provide clinical benefits in managing myopia without severe adverse effects.
Modified nishida procedure for the treatment of complete cranial nerve palsies: A case series
Authors: Santos Miguel , Ferreira Rui , Fernandes Emanuel , Teixeira Filipa , Gama Rita
Published: January 2025

Aims/Purpose: To describe the clinical characteristics and outcomes of a series of strabismus patients with horizontal recti palsies treated surgically with a Modified Nishida Procedure (MNP).

Methods: A retrospective review of patients who underwent a MNP at Hospital de Santa Maria in Lisbon, Portugal, between November 2023 and February 2024 (n = 5). MNP is a no‐tenotomy, no‐splitting transposition of 1/3 of the muscle body of the vertical recti to the midpoint between itself and the affected horizontal rectus muscle. Inclusion criteria included diplopia due to Grade IV or V palsies of the lateral rectus (LR, n = 4) due to VI nerve palsy or of the medial rectus (MR, n = 1) due to III nerve palsy. A 3‐month post‐operative follow‐up was required. Surgical success was defined as post‐operative horizontal deviation ≤14 prism diopters (PD) and absence of horizontal diplopia in primary gaze.

Results: Mean age was 60±13 years. Two patients had bilateral LR palsy with > 85PD esotropia (ET) and received bilateral MNP combined with 6mm MR recession, with additional MR botulinum toxin (BT) injection two weeks later. Two patients had unilateral LR palsy with 45 PD ET with previous 7mm MR recession: these received unilateral MNP. Surgical success was achieved in 3 of these 4 cases. The unsuccessful case had 40PD residual ET and diplopia at 4 months follow‐up. There were two cases of self‐limiting post‐operative ptosis and one case of a surgical complication where the whole vertical rectus body was transposed due to high muscle friability. The MR paralysis patient had 40PD exotropia and MNP was combined with 7mm LR recession. Surgical success was achieved in this case, and no intra‐ or post‐operative complications occurred. No cases of anterior segment ischemia were detected in this series.

Conclusions: MNP is an effective surgical option as it greatly reduces the horizontal deviations and diplopia associated with severe cranial nerve palsies and has a reduced risk of complications.
Predictive accuracy of saggital height measurements in optimizing scleral contact lens fitting
Authors: Velazquez Fernando Fernandez , Ferrel Victoria Ferigo
Published: January 2025

Aims/Purpose: To evaluate the accuracy of corneal and scleral tomography analysis for determining the initial selection of a 16.5 mm scleral lens to enhance fitting outcomes and patient comfort.

Methods: This single‐site, consecutive study fitted scleral lenses in 30 eyes in 16 patients (mean age 39.7 yrs., 11 males)). Patients underwent comprehensive evaluations, including detailed corneal and scleral tomography. Initial fitting used the manufacturer's standard protocol. Lens fitting was assessed with Anterior Segment OCT after 1 hour of wear, focusing on vaulting and overall fit. The required 300‐micron central sagittal vaulting was compared with tomography measurements at 10 mm, the limbal area, and 15 mm.

Results: The group included 24 eyes with keratoconus, 2 with high regular astigmatism, and 4 with dry eyes. The mean HVID was 12.05 mm (SD = 0.33 mm, 95% CI: 11.92‐12.18 mm). The mean central corneal astigmatism was 2.91 D (SD = 1.74 D, 95% CI: 2.22‐3.60 D). Mean sagittal heights were 1869.3 microns (SD = 172.4, 95% CI: 1800.7‐1937.9) at 10 mm, 2727.7 microns (SD = 287.6, 95% CI: 2620.4‐2835.0) at the limbus, and 3970.5 microns (SD = 308.5, 95% CI: 3850.0‐4091.0) at 15 mm. The estimated ideal sagittal depth was 4321.8 microns (SD = 258.6, 95% CI: 4233.6‐4410.0). Sagittal height at 15 mm was the strongest predictor for ideal lens fitting (R2 = 0.9367). The multiple regression model, including all three measurements, showed a marginal improvement in accuracy (R2 = 0.947).

Conclusions: The sagittal height at 15 mm is a highly effective predictor for initial scleral lens fittings, providing significant accuracy. This measurement can streamline the fitting process, reduce chair time, improve clinical outcomes, and increase patient comfort.