bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of vitreous immunity using OCT in rats with steroid‐induced glaucoma
Authors: Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Munuera Ines , Montolio Alberto , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Pablo Luis
Published: December 2022

Purpose: The subclinical immune response mediates a homeostatic role in healthy situations, but in pathological situations it misbalances. Glaucoma is a multifactorial pathology in which immunity is involved. Optical coherence tomography (OCT) detects the immune response in vitreous as hyperreflective opacities. The aim of this study is to monitor vitreous parainflammation in two steroid induced glaucoma (SIG) animal models, comparing both sexes and healthy controls over 6 months.

Methods: Two SIG models were induced by injecting a suspension of PLGA‐Ms loaded with dexamethasone or dexamethasone/fibronectine into the anterior chamber of rat eyes. Intraocular pressure (IOP) was measured by rebound tonometer every week and vitreous‐retinal interface was evaluated with OCT at 0, 4, 8, 12, 18 and 24 weeks of follow‐up. Vitreous images were exported as AVI videos and then we designed a computational analysis that characterizes and classifies the vitreous hyperreflective opacities based on their size into isolated cells (10 microns2), non‐activated cells (10–50 microns2), activated cells (50–250 microns2) and complexes (>250 microns2). Vitreous/retinal pigment epithelium (VIT/RPE) relative intensity, opacity/cell intensity, eccentricity and orientation were analysed.

Results: SIG eyes showed tendency of greater intensity, and number of vitreous opacities (p < 0.05) with dynamic fluctuations. Both SIG models showed an antinflammatory profile, with non‐activated cells as the highest population over the study. However, smaller opacities (isolated cells) seems to be the first responder to noxa since they were the most rounded (recruitment) coinciding with IOP peak increase, showed the highest mean intensity (intracellular machinery) even in contralateral eye, and the greatest change in orientation (motility).

Conclusions: Study the features of hyper‐reflective opacities in vitreous using OCT could be a biomarker of glaucoma onset and progression.
Occipital cortex activity in response to melanopsin in healthy humans
Authors: Minier Astrid , Kostic Corinne , Murray Micah M. , Kawasaki Aki
Published: December 2022

Purpose: Melanopsin‐expressing retinal ganglion cells (mRGCs) signal light information to the brain and mediate non‐visual physiologic responses. Animal studies suggest that melanopsin also influences the visual pathway via synaptic contacts in the lateral geniculate nucleus and the superior colliculus. In healthy and blind humans, blue light exposure results in modulation of occipital activity in neuroimaging studies, presumably from melanopsin interaction with photoreceptors. This study examined if melanopsin activation influences the visual evoked potential (VEP).

Methods: We recorded VEPs to light flash stimuli to activate cones, rods and melanopsin in 30 healthy volunteers (red: 630 nm, blue: 445 nm, intensities: 0.00003 to 150 cd/m2). Dark adaptation was used to sensitize rods. At 2 log cd/m2, rods are saturated, and bright blue lights are considered more melanopsin activating. Under photopic conditions, red light activates M‐L cones. Amplitude and latency of the N2 and P2 components of the VEP were evaluated.

Results: P2 obtained from the melanopsin stimulus presented under dark‐adaptation (MEL1) had the largest amplitude and shortest latency of all VEPs including the melanopsin stimulus presented non‐dark adapted condition (MEL2). There was no difference of N2 between MEL1 and MEL2 conditions. The latency of N2 and P2 from rods was longer than that from MEL1 and MEL2. P2 from MEL2 was equivalent in amplitude and latency to the P2 of the brightest cone stimulus (30 cd/m2 red light).

Conclusion: Under non‐dark‐adapted conditions, bright blue light evokes a similar VEP as bright red light, suggesting that cones are the predominant influence in these conditions. However, bright blue light presented under dark adaptation modified the VEP latency and amplitude. As rod VEPs are distinguished by slow latencies, then we propose that these changes arise from mRGCs influence on cone‐mediated visual pathways to the occipital cortex.
Longitudinal neuroretinal analysis in patients with fibromyalgia
Authors: Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Munuera Inés , Satue Maria , Garcia‐Martin Elena
Published: December 2022

Purpose: To analyse macular ganglion cell layer (GCL) and visual parameters in patients with Fibromyalgia (FM) over 5 years, compared with controls.

Methods: Eighty patients with FM and 38 sex‐matched healthy subjects underwent a complete ophthalmic evaluation, including assessment of visual acuity (VA) with ETDRS chart, contrast sensitivity vision (CSV) with Pelli Robson, colour vision with Farnsworth and Lanthony D15 tests and retinal evaluation using Spectral domain Optical coherence tomography (SD‐OCT). Only one eye per subject was randomly selected and included. Patients were classified into three different groups (1, atypical; 2, depressive; 3, biologic) to analyse progression depending on the disease phenotype. All subjects were re‐evaluated after 5 years to quantify changes in visual function parameters, ganglion cell layer (GCL) and retinal nerve fibre layer (RNFL) thickness. Association between progressive ophthalmologic changes and disease severity was analysed.

Results: After a period of 5 years of follow up, patients with FM showed progressive changes in visual function parameters and GCL thickness. They presented low contrast VA (p = 0.024) and decreased GCL thickness and the RFNL. Changes in GCL thickness were associated with disease severity. In atypical and biological phenotypes, correlations between disease severity scores and structural changes were observed.

Conclusions: In patients with FM has been detected progressive visual dysfunction and neuroretinal degeneration. The evaluation of visual parameters and GCL/RNFL thickness using SD‐OCT could be a non‐invasive and useful tool for monitoring FM progression.
Neurodegeneration in chronic glaucoma analysed according to different hypertensive models induced in rats
Authors: Perié Manuel Subías , Campo Lorena Arias , Munuera Ines , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Pablo Luis , Rodrigo Maria Jesus
Published: December 2022

Purpose: To compare four different animal models of chronic glaucoma with normal ageing over 6 months.

Methods: Chronic glaucoma was induced in 138 Long‐Evans rats and compared to 43 healthy rats (healthy cohort). Rats were injected in their right eye to increase intraocular pressure (IOP). 25 rats received biweekly episcleral vein sclerosis injections (EVS cohort) and the remaining rats received an intraocular injection with a suspension of biodegradables microspheres (Ms): 25 rats received no‐loaded Ms at 0‐2‐4‐8‐12‐16 and 20 weeks (Ms20/10 cohort), 45 rats received Ms loaded with dexamethasone at baseline and week 4 (MsDexa cohort), and 43 rats received Ms co‐loaded with dexamethasone and fibronectine at baseline (MsDexaFibro cohort), in the anterior chamber of the eye. IOP, functionality of neuroretina by electroretinography (ERG), structure of neuroretina and vitreous interface by optical coherence tomography (OCT) were analysed.

Results: The EVS cohort showed the steepest and strongest increase in IOP, whereas the Ms models had a more progressive increase. Each model showed a specific retinal damage and vitreous signal in OCT. The EVS cohort experienced the highest vitreous intensity and percentage loss in ganglion cell layer, MsDexa in the retinal nerve fibre layer and MsDexaFibro in total thickness of the retina at 24 weeks of the study. Ganglion cells' signal using ERG was bigger in the glaucomatous cohorts compared to healthy rats.

Conclusions: Different models of chronic glaucoma resulted in different curves of IOP and patterns of neuroretinal degeneration. Modulable degeneration was generated using models by the injection of biodegradable Ms. The biodegradable Ms models simulated accurately the neurodegeneration seen in human chronic glaucoma. Our results reinforced the multifactorial condition of glaucoma according to several noxa.
Evaluating the challenges in implementation of the royal college of ophthalmologists (RCOphth) 2020 guidelines on hydroxychloroquine retinopathy screening at Rochdale eye unit, United Kingdom
Authors: Noor Maha , Khan Rehna , Kafle Suresh
Published: December 2022

Purpose: The Royal College of Ophthalmologists (RCOphth) updated their hydroxychloroquine (HCQ) retinopathy screening guidelines in 2020. The aim of our study was to analyse the implementation of these guidelines at Rochdale Eye Unit, UK, along with identification of any challenges/areas for development.

Methods: A retrospective study of patients visiting the hydroxychloroquine screening clinic at Rochdale Eye Unit between 1st January – 1st of March 2022 was performed. Utilizing the 2020 RCOphth guidelines as a “gold standard” screening clinic checklist, data were collected determining if patients fulfilled screening criteria, if the department's data collection proforma identified patients with risk factors for developing retinopathy, the investigations undertaken, documentation and communication of the diagnosis, and selection of an appropriate outcome.

Results: 54 patients were identified, 14 males and 40 females, 100% of whom were on HCQ therapy. 37% did not meet the screening criteria. A paper proforma comprising of drug, dose, duration, renal disease, tamoxifen use, and macular co‐morbidity was completed for 100% of patients, however, did not include patient's ethnicity, weight (cumulative dose calculation), or last renal function. 51 patients (94%) had SD‐OCT and FAF as first line investigation. 10 patients (19%) also had Visual Field‐10‐2. Currently, there is no standardized process for interpretation of investigations and documentation of findings. Although, 100% of diagnoses were communicated to the GP, there no was evidence of written information about HCQ retinopathy or results of investigations being sent to patients at present. 19 patients (35%) had the incorrect outcome selected, including re‐invitation for annual monitoring despite treatment cessation or prior to >5 years of HCQ treatment.

Conclusions: To address the encountered challenges, we recommend review of all bookings unfulfilling screening criteria, devising a more comprehensive proforma (including ethnicity, weight, last renal function) and a six‐point clinician's checklist comprising of proforma review, investigation interpretation/documentation aid, prompt for communicating with patient/referrer, considering driving eligibility, and guidance for selecting appropriate outcome.
Adaptive chin rest device for optimizing visual field testing
Authors: Dogahe Sepideh Jamali , Wentworth Adam , Sadeghmousavi Mostafa , Khanna Sunil , Khanna Cheryl
Published: December 2022

Purpose: Evaluation of an adjustable chin rest apparatus for visual field machine.

Methods: The HFA 60‐4 visual field test was performed in the primary position and then repeated in the optimum head turn angle using an adjustable chin rest to maximize a visual field for each subject. The optimum head turn angle was calculated using a 3D face model. A 3D model of the face of the subjects was reconstructed using a single facial photo and a Convolutional Neural Networks (CNN), which is a deep learning algorithm. The angles between visual axis and all points around it on the face surface were calculated and the points on the 3D face model with the angle less than 60 degrees was used to predict the optimal head turn angle. A chin rest apparatus for a visual field system was made by 3D printing. The chin rest apparatus includes a moveable chin rest insert coupled to the base and configured to be adjusted to one of a plurality of head turn angles.

Results: Three eyes from three healthy subjects (2 female and 1 male) with the mean age of 27.33, CI: 7.37 were enrolled. The visual field defects cause by the facial contour of the subject was decreased by turning the subject's head relative to a vertical axis away from (nasally) the eye being tested using a visual field system with the adaptive chin rest. The mean threshold of the visual field tests of all eyes in the primary angle and optimized angle was 1496, CI: 380.22 and 1567.67, CI: 295.37 respectively. Mean of the degree of head turn to maximize the visual field for all individuals was 6.67 degrees, CI: 2.88.

Conclusions: The described adaptive chin rest can be used to position a subject's head at an optimal head turn angle that minimizes the visual field defects caused by the facial contours and maximizes the measured visual field of the subject. This technology can be used in far peripheral visual field tests for early detection of glaucoma as well as accurate follow up of disease progression.
The association between ocular biometric components and corneal aberrations in elderly
Authors: Yekta Abbas Ali , Hashemi Hasan , Khabazkhoob Mehdi , Mesbahi Shima , Moghaddam Hadi Ostadi , Shandiz Javad Heravian , Yekta Yeganeh , Khorasani Abbas Azimi , Ehsaei Asieh
Published: December 2022

Purpose: To determine the association between ocular biometric components and corneal aberrations in individuals aged 60 years and older.

Methods: In a cross‐sectional study, multi‐stage cluster sampling was performed in Tehran, the capital of Iran. After selecting the samples, all study participants underwent ophthalmic examinations including visual acuity, refraction, anterior and posterior segment examination using slit‐lamp biomicroscopy as well as corneal imaging by Pentacam AXL. The corneal aberrations were measured for a sub‐sample.

Results: This report analysed 644 eyes of 415 individuals after applying the inclusion and exclusion criteria. Of these, 236 (56.9%) were females. The mean age of participants was 66.36 ± 4.70 years (range: 60–79 years). According to the generalized estimation equation (GEE), the root mean square (RMS) of higher‐order aberrations (HOA) was related to age (β = 0.081, p = 0.002), crystalline lens thickness (β = 0.08, p < 0.001), and corneal diameter (β = −0.04, p = 0.014). The RMS of total Coma aberration was directly related to the intraocular ocular pressure (β = 0.001, p = 0.044), female sex (β = 0.02, p = 0.05), and crystalline lens thickness (β = 0.06, p < 0.001). There was a direct relationship between the RMS of third‐ and fourth‐order HOAs and crystalline lens thickness (p < 0.001). Spherical aberration was directly related to the male sex (β = −0.02, p = 0.004), axial length (β = 0.05, p < 0.001), central corneal thickness (β = 0.001, p = 0.025), and inversely related to anterior chamber depth (β = −0.07, p = 0.031) and crystalline lens thickness (β = −0.25, p < 0.001).

Conclusions: The results of this study showed that ocular biometric components are related to corneal aberrations in the elderly. It is necessary to pay attention to this finding in the clinical affairs of the elderly.
Geographic atrophy in AMD ‐ prognostic factors based on long‐term follow‐up
Authors: Cedro Luca , Hoffmann Laura , Katja Hatz
Published: December 2022

Purpose: So far, the natural course of geographic atrophy (GA) progression in age‐related macular degeneration (AMD) has primarily been investigated by colour fundus photography (CF) and fundus autofluorescence (FAF) imaging. The aim of this long‐term retrospective, observational clinical study was to show the enlargement rate (ER) of GA, defined as complete retinal pigment epithelium and outer retinal atrophy (cRORA) and to find predictors of progression.

Methods: All patients available in the database of Vista Augenklinik Binningen, Switzerland, with follow‐up of at least 24 months and existing GA in at least one eye, regardless of neovascular AMD (nAMD) being present initially or in the course of disease, were included. SD‐OCT and FAF evaluations were performed according to a standardized protocol. The cRORA area ER (mm2/year), the cRORA square root area ER (mm/yr), the FAF GA area and the condition of the outer retina (inner−/outer segment (IS/OS) and external limiting membrane (ELM) disruption scores) were determined.

Results: 204 eyes of 129 patients (64% females) were included. Mean follow‐up time was 4.2 ± 2.2 (range 2–10) years. 109 of 204 (53.4%) eyes were classified as wet AMD (neovascular aspect being present initially or in the course of disease), 95 of 204 (46.6%) eyes were classified as exclusively dry AMD. The primary lesion was unifocal in 146 (72%) eyes and multifocal in 58 (28%) eyes. A strong correlation was observed between the area of cRORA (SD‐OCT) and the FAF GA area (r = 0.924; p < 0.001). Mean ER was 1.44 ± 1.2 mm2/year and mean square root ER 0.29 ± 0.19 mm/year. There was no significant difference in mean ER between eyes without (dry AMD) and with intravitreal anti‐VEGF injections (nAMD) (0.30 ± 0.19 mm/year vs. 0.28 ± 0.20 mm/year; p = 0.466). Eyes with a multifocal atrophy pattern at baseline (n = 58) had a significantly higher mean ER compared to eyes with a unifocal pattern (0.34 ± 0.19 mm/year vs. 0.27 ± 1.19 mm/year; p = 0.008). There were moderate significant correlations between ELM and IS/OS disruption scores and visual acuity at baseline, 5 and 7 years (all r values ca. −0.5; p < 0.001).

Conclusions: SD‐OCT evaluated cRORA area might serve as a GA parameter comparable to traditional FAF measurement. The dispersion pattern might be a predictor of ER, whereas anti‐VEGF treatment seems not to be associated with ER.
Analysis of progression rate of idiopathic macular hole and optimal cut‐off for baseline minimum linear diameter and base diameter
Authors: Kim Joo Young , Kim Raeyoung , Kim Mirinae , Park Young Gun , Park Young‐Hoon
Published: December 2022

Purpose: To determine the cut‐off points of minimum linear diameter (MLD) and base diameter (BD) at which the progression rate of idiopathic macular hole (MH) decreases before vitrectomy.

Methods: This retrospective study compared optical coherence tomography (OCT) taken at baseline and on operation day for patients with stage 2, 3, and 4 idiopathic MH to determine the changes in MLD, BD, height, and MH index. The idiopathic MH progression rate was calculated by dividing each difference in OCT parameters by the time interval.

Results: A total of 244 eyes of 235 patients were included. The average age of the patients was 64.12 ± 7.69 (40–85) years. The average time interval from baseline to operation was 36.65 ± 25.20 (7–197) days. Unclosed MHs were found in 14 eyes (5.7%). The progression rate obtained through simple linear regression decreased as the baseline MLD and BD increased (p = 0.044 and p = 0.002, respectively). The optimal cut‐off points obtained through piecewise regression were 295.0 μm for MLD and 414.0 μm for BD.

Conclusions: In idiopathic MH with MLD < 295.0 μm or BD < 414.0 μm, the progression rates of MLD and BD were significantly faster. It would ultimately be beneficial for visual prognosis to perform vitrectomy without delay in patients with idiopathic MH with an MLD < 295.0 μm or BD < 414.0 μm.
Efficacy and safety of preoperative intravitreal dexamethasone implants for cataract surgery in patients with uveitis with persistent inflammation
Authors: Hong Seo‐Yeon , Kim Raeyoung
Published: December 2022

Purpose: This study aimed to evaluate the efficacy and safety of intravitreal dexamethasone implants for cataract surgery in patients with uveitis with frequent recurrence according to injection timing.

Methods: We retrospectively reviewed medical records of patients with non‐infectious uveitis who underwent cataract surgery in Seoul St. Mary's hospital. Patients received intravitreal dexamethasone implant injections into the eyes within 3 months prior to cataract surgery. Patients were divided into two groups: patients administered intravitreal dexamethasone implant injections within 1 month (group 1) or between 1 to 3 months (group 2) prior to cataract surgery. Recurrence of uveitis, postoperative visual outcomes, and safety were reviewed. The time gap between the first uveitis recurrence and cataract surgery, anterior chamber/vitreous cell, best corrected visual acuity(BCVA), and intraocular pressure(IOP) were measured. Patients were followed up for at least 6 months after cataract surgery.

Results: In total, 70 eyes of 70 patients were included in the analysis (group 1: 40, group 2: 30). Mean age was 46.60 ± 16.93 and 50.73 ± 13.42 years, respectively(p > 0.05). Groups 1 and 2 included 20(50%) and 10(33.3%) patients with uveitis‐related systemic diseases, respectively (p > 0.05). BCVA was significantly improved at postoperative day 1, week 1, and months 1 and 6 in both groups (all p < 0.05). No significant between‐group differences in BCVA were observed at any time point (p > 0.05). The recurrence of uveitis after cataract surgery was significantly earlier in group 2 than in group 1 (p = 0.04). The occurrence of cystoid macular edema was significantly lower in Group 1 (p = 0.03) Survival analysis of uveitis recurrence did not reveal a significant difference (p > 0.05).

Conclusions: Intraoperative intravitreal dexamethasone implant within 3 months before cataract surgery may be considered a safe and effective option for patients with uveitis with poorly controlled inflammation.
Inner retinal layers' thickness changes in relation to age in healthy eyes
Authors: Remis‐Gonzalez Melisa , Moreira‐Estebaranz Carolina , Puell María , Cedrun‐Sanchez Juan
Published: December 2022

Purpose: Characterizing the structural change of the macula produced by aging in healthy eyes is essential to discriminate physiological alterations typical of aging from other pathological signs. In this study, macular thicknesses measured by spectral‐domain optical coherence tomography (SD‐OCT) were characterized in young, middle‐aged, and older subjects without ocular pathology.

Methods: The study design was observational cross‐sectional and was conducted in 154 eyes of 154 healthy participants between 20 and 80 years (mean 44 ± 18 years of age) divided into three age groups: young (20–39), middle‐aged (40–59) and older (60–80). Macular thicknesses were measured through SD‐OCT using the grid employed of the Early Treatment Diagnostic Retinopathy Study (ETDRS). We analysed five sub‐fields: the central fovea and the four regions (temporal, nasal, superior, inferior) of the parafoveal ring. Mean macular thicknesses were recorded for each of the three retinal segmentations: the inner retinal layer (IRL), the outer retinal layer (ORL) and the total retinal layer. Comparisons of macular thicknesses across age groups were performed.

Results: Mean total and ORL thicknesses were not significantly different in the central subfield and each region of the parafoveal ring of the ETDRS grid (temporal, nasal, nasal, inferior and overall) for the three age groups. However, age had a significant effect on IRL thickness in each region of the parafoveal ring. In the superior, nasal and inferior regions, mean IRL thicknesses decreased significantly in the older age group compared to the other age groups (all p < 0.0001). In the temporal region, mean IRL thickness decreased with age and was significantly different for each of the three age groups (p < 0.0001).

Conclusions: Age did not significantly influence total and ORL thicknesses in the macula. However, the macular thickness of the IRL decreased in subjects older than 60 years of age.
Combining retinal neuronal and microvascular measurements improves discriminative power for multiple sclerosis patients without previous optic neuritis
Authors: Chua Jacqueline , Bostan Mihai , Sim Yin Ci , Bujor Inna , Schmetterer Leopold , Popa‐Cherecheanu Alina
Published: December 2022

Purpose: Quantitative thinning of optic nerves and changes in retinal microvasculature have been detected in multiple sclerosis patients without optic neuritis (MSNON). However, data on how both retinal neuronal and microvascular parameters jointly influence the diagnostic performance is lacking. To investigate the diagnostic performance of neuronal and microvascular changes to detect the presence of MSNON from normal controls.

Methods: This is a cross‐sectional study of 51 MS participants (n = 76 eyes) and 71 age‐ and sex‐matched healthy controls (n = 117 eyes). Retinal macular ganglion cell complex (GCC) and retinal nerve fibre layer (RNFL) thicknesses and capillary densities from the superficial (SCP) and deep capillary plexuses (DCP) were obtained from the optical coherence tomography (Cirrus AngioPlex model HD‐OCT 5000). We also compensated RNFL thickness for ocular anatomical factors. Thickness and vascular measurements and their corresponding areas under the receiver operating characteristic curves (AUCs) were compared between groups.

Results: All retinal structural and vascular parameters were significantly altered in MS (p ≤ 0.012). The best neuronal parameter for detecting MS was compensated RNFL from the optic nerve head region (AUC = 0.85), followed by GCC from the macular region (AUC = 0.79) while the best microvasculature parameter was the SCP (AUC = 0.66). Combining retinal neuronal and microvascular parameters improved its diagnostic performance for MS detection (AUC = 0.90; P < 0.001). The joint model including both neuronal and microvasculature significantly improved the discrimination between MS and normal compared with each parameter separately (p = 0.027).

Conclusions: Combining retinal neuronal and microvasculature parameters improved the discrimination of MSNON. Further studies may be warranted to evaluate the clinical utility of retinal parameters in risk prediction for disease progression.
Ocular hypo pressure treatment in rats with chronic glaucoma: Refractive, functional and structural neuroretinal study
Authors: Campo Lorena Arias , Rufas Ines Munuera , Perié Manuel Subías , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Pablo Luis , Rodrigo Maria Jesus
Published: December 2022

Purpose: To evaluate the effect of ocular hypo‐pressure treatment on refraction and neuroretina of rat eyes with chronic glaucoma by sex over 24 weeks, as compared to glaucomatous rats non‐treated and healthy controls.

Methods: One hundred and fifty five Long‐Evans rat's eyes were analysed retrospectively. 25 glaucomatous (G) rat's eyes, 60 glaucomatous eyes treated with a hipo pressure formulation of Brimonidine ‐ LAPONITE® (G‐B) and 70 healthy (H) eyes. Intraocular pressure (IOP) was measured with rebound tonometer, retinal ganglion cells (RGC) functionality with electroretinography (ERG), and diopter power (D) and neuroretinal estructure with peripapilary retinal nerve fibre layer (pRNFL) and ganglion cell layer (GCL) protocols using non‐invasive technology of optic coherence tomography, over 6 months.

Results: G‐B cohort presented lower IOP values during weeks 1, 4 and 8 (p < 0.001) compared to G cohort no treated, and even to H eyes during first week (10.36 ± 1.21 vs. 13.37 ± 2.58 mmHg; p < 0.001). All cohorts both sexes experienced a trend to emmetropia throughout the follow‐up, especially throughout the first 8 weeks of the study and in males (p < 0.033). G cohort showed the lowest diopter value (1.06 ± 3.94 D; p < 0.035), G‐B cohort showed the biggest value and no differences in refraction compared to H eyes (3.67 ± 0.00 vs 3.61 ± 1.90 D; p > 0.203) in week 24. pRNFL thickness differences were mainly found on the inferior sectors. G‐B cohort showed bigger thickness in pRNFL (p = 0.034) and GCL (p = 0.038) compared to G cohort at week 24. G‐B cohort registered higher ERG signal compared to G cohort (41.20 ± 8.75 vs. 18.68 ± 24.77 μV; p = 0.012) and even H eyes (41.2 ± 8.75 vs. 26.00 ± 22.50 μV; p = 0.001) at week 24.

Conclusions: Ocular hypo pressure treatment slowed the trend of diopter power and neurorretinal thickness loss, and preserved better functionality of RGC compared to glaucomatous eyes non‐treated.
Evaluation of generated synthetic OCT images in deep‐learning models for glaucoma detection
Authors: Wong Damon , Jith Ashish , Chong Rachel , Crowston Jonathan , Chua Jacqueline , Bujor Inna , Hussain Rahat , Vithana Eranga , Girard Michael , Ting Daniel , Ching‐Yu Cheng , Aung Tin , Popa‐Cherecheanu Alina , Schmetterer Leopold
Published: December 2022

Purpose: To evaluate the use of synthetically generated OCT images for the development of deep‐learning models in glaucoma detection.

Methods: Progressively Grown Generative Adversarial Network (PGGAN) models for glaucoma and healthy eyes were developed with data from 862 Asian glaucoma eyes and 990 Asian normal eyes to generate synthetic circumpapillary OCT images. Glaucoma detection deep‐learning models were trained using 1200, 10 000, 60 000 or 200 000 of the generated images, equally split between glaucoma and normal. Detection performance was evaluated on real images from an Asian dataset of 140 eyes from 112 subjects and a Caucasian dataset of 300 eyes from 160 subjects, with half of each being glaucoma. Results were compared with a glaucoma detection model trained with real images from 600 glaucoma and 600 healthy eyes, and with global retinal nerve fibre layer (RNFL) measurements using Area Under the Curve (AUC) analysis.

Results: Glaucoma detection performance improved with increasing synthetic dataset size, from an AUC of 0.945 [95% CI: 0.917–0.974] and 0.856 [95% CI: 0.819–0.889] on the Asian and Caucasian test data respectively when 1200 synthetic images were used, to AUCs of 0.969 [95% CI: 0.949–0.987] and 0.897 [95% CI: 0.867–0.927] when 200 000 synthetic images were used. The model trained on 200 000 synthetic images was significantly better (p < 0.05) than the model trained on real images on the Caucasian test data (0.838 [95% CI: 0.800–0.874]) but not on the Asian test data (0.962 [95% CI: 0.939–0.985]). Both detection models showed significantly better AUCs than that of global RNFL for both Asian (0.920 [95% CI: 0.884–0.957]) and Caucasian (0.833 [95% CI: 0.793–0.869]) test datasets.

Conclusions: Synthetically circumpapillary OCT images used to train deep‐learning glaucoma detection models showed similar performance to a model trained with real data, and could potentially be used to facilitate sharing of imaging data while addressing privacy considerations.
Mitfmi/+ as a new mouse model of cone dystrophy
Authors: Llorca Andrea Garcia , Ólafsson Knútur Haukstein , Sigurdsson Arnór Thorri , Eysteinsson Thor
Published: December 2022

Purpose: Mutations in the Mitf gene can lead to hypopigmentation, microphthalmia, retinal degeneration, deafness and blindness1. We have previously shown that RPE function and structure is affected in mice with various mutations in the Mitf gene, which is expressed specifically in the RPE, resulting in some cases in retinal degeneration2. The current study is the first of its kind to analyse visual and retinal function in Mitfmi/+ mice.

Methods: Mitfmi/+ and C5BL/6 J (as control) mice were used in this study. All mice were 1‐ and 3‐months old. Electroretinography (ERG) was performed under both dark‐ and light‐adapted conditions, along with fundus photography from anaesthetised mice. The ERG dark‐adapted a‐, b‐ and c‐waves were analysed. Light‐adapted b‐wave amplitude was analysed. Fundus photography was performed to visualize and compare fundus images from wild type and Mitfmi/+ mice.

Results: Light‐adapted a‐wave amplitude was significant lower in 3‐month‐old mutants (7.34 ± 1.34 μV, 6.72 ± 1.19 μV, 8.58 ± 1.03 μV; p < 0.05) compared to wild type mice at 3, 5 and 7 cd*sec/m2 respectively. Light‐adapted b‐wave amplitude was also significantly reduced in 3‐month‐old mutants (22.13 ± 0.95 μV, 35.09 ± 2.72 μV, 57.715 ± 5.17 μV, 66.16 ± 4.48 μV, 85.87 ± 4.27 μV; p < 0.05) compared to control animals at all luminance tested. Interestingly, ERG c‐wave amplitude was significantly lower in 1‐month‐old Mitfmi/+ (150.80 ± 11.91 μV; p < 0.05) compared to control mice at 10 cd*sec/m2 light intensity. Progressive hyper‐ and hypopigmentation areas were found in the fundi from the mutants.

Conclusions: Retinal function was greatly affected in Mitfmi/+ mutant mice. Significantly lower c‐wave response and hypopigmentation provide evidence for severe RPE pigmentation and likely dysfunction as well in the mutants at 1‐month‐old. Furthermore, lower light‐adapted a‐ and b‐ wave responses indicates selective cone‐dystrophy in this heterozygous mutation in the Mitf gene.

References

1 Steingrímsson E et al. Annu Rev Genet, 2004; 38:365–411.

2 García‐Llorca A et al. Sci Rep, 2019; 28; 9(1):15386.
Pupillary light responses after uncomplicated cataract surgery
Authors: Ollero Juan Antonio Miralles De Imperial , López‐Alacid Alberto , Franco Pedro Esteban Quilez , Perez Maria Paz Villegas
Published: December 2022

Purpose: To study the effect of standard cataract surgery in the static and dynamic pupillary light responses.

Methods: An observational prospective study was carried out in patients scheduled for cataract surgery. Exclusion criteria were previous ocular surgeries or diseases or intraoperative complications. Cataract surgery was done using phacoemulsification and intrasaccular monofocal intraocular lens implantation. Monocular infrared dynamic pupillometry was performed using white light (Corneal Analyser CA‐800, Topcon) just before surgery (same day), and at 1 week and 1 month after surgery. Pupil diameter was analysed under scotopic (SPD) and photopic (PPD) conditions, and latency to constriction (LC), latency to plateau (LP) and duration of constriction (DC) were also analysed. Statistical analysis was carried out with One Way ANOVA for paired data.

Results: Twenty‐seven eyes from 27 patients (10 males and 17 females) were included. The mean age was 69.5 ± 9 years. Preoperative SPD and PPD values were 5.21 ± 1.1 mm and 2.78 ± 0.8 mm and decreased significantly by 1 week and 1 month after surgery (p = 0.0002 and p = 0.012, respectively). Preoperative LC, LP and DC values were 2.52 ± 0.09 s, 4.84 ± 0.35 s, and 10.9 ± 1.71 s and these values did not change significantly after surgery.

Conclusions: Cataract surgery decreases the pupillary diameter both in photopic and scotopic conditions but does not modify the pupillary responses to light.
From difficult to general ‐ a new approach to the ROP neovascularization system
Authors: Kovalevskaya Maria , Pererva Oxana
Published: December 2022

Purpose: to develop criteria for quantitative analysis of the treatment result of plus‐disease in ROP.

Methods: 3126 RetCam images of ROP 448(896 eyes) were divided into 5 groups 1‐I stage 312(624 eyes), 2‐II stage 96(192 eyes), 3‐III stage 17(34 eyes), 4‐posterior aggressive ROP 23(46 eyes), 5‐retinal immaturity 60(120 eyes). Images of 16 patients who underwent laser coagulation due to the presence of a plus‐disease were automatically modelled on the “Key to Diagnosis I" platform. The fractal dimension (Df) and complexity of vascular system(CVS) of wide‐field images were analysed. CVS was 1 (A) for immature network, 2 (B) normal vascular system, 3 (C) neovascularization.

Results: The efficiency of the module for automatic modelling of wide‐field retinal images has been proven on two RetCam bases. Statistically significant differences were obtained in the plus‐disease before and after the treatment. Df before treatment 1.426 ± 0.009, after 1.395 ± 0.01, CVS before 2.5 ± 0.16, after 2.1 ± 0.1. Any calculations and measurements (including the thickness of the retina) cannot reflect all the features of the development of the young neovascular net, so we propose a register of CVS. Along with the Df, this general indicator brings it closer to the stage of the ROP process [1].

Conclusions: Df and CVS ‐ general criteria for selective choice of plus disease treatment. But the current estimation of the specified parameters is based on the configuration of the wide‐field images.

Acknowledgment: to Rascheskov A. PhD and the head of “Children's Republican Clinical Hospital of Tatarstan” Zaitdinov A.

References

1. Pererva O, Kovalevskaya M. Approaches to the accuracy in ROP diagnosis. Investigative Ophthalmology&Visual Science 62.8(2021):3245–3245.
Influence of scan direction on subfoveal choroidal vascularity index using optical coherence tomography
Authors: Kim Yung‐Hwi , Jin Hyung‐Nam , Kim Hyun‐Ji , Lee Jong‐Hoon , Ji Yong‐Sok
Published: December 2022

Purpose: To investigate the influence of scan direction on subfoveal choroidal vascularity index (CVI) measurements using spectral‐domain optical coherence tomography (SD‐OCT) in young healthy subjects.

Methods: Seventy‐eight eyes of 41 healthy volunteers were included. Choroidal structures were obtained using SD‐OCT with enhanced depth imaging (EDI) through radial scans at the center of the macula at 30° × 30°. The subfoveal choroidal images in the horizontal (0°), 45°, vertical (90°) and −45° directions were recorded and CVIs were analysed according to their respective directions, using image binarization. Additionally, subfoveal choroidal thickness (SFCT) and axial eye length were measured.

Results: The SFCT and subfoveal CVI showed a negative correlation but were only significant for the 45° scan (Pearson's r = −0.262, p = 0.021). The axial eye length and subfoveal CVI had no significant correlation in any direction (all p > 0.05). In the Bland–Altman plot, the subfoveal CVI measurement showed high agreement among the four scan directions. When the SFCT was ≥300 μm, there was no difference in the measured values of the subfoveal CVI among the four scan directions; however, when the SFCT was <300 μm, there was a significant difference in subfoveal CVI among the scan directions (one‐way analysis of variance, F = 4.685, p = 0.004).

Conclusions: In subfoveal CVI measurement, it is considered that the horizontal (0°) scan can represent the vertical (90°) or oblique (45°, −45°) scans. However, when the SFCT is thinner, the subfoveal CVI in each direction of radial scan may vary significantly. Hence, caution is required in the interpretation.
Single nucleotide polymorphisms in pigmentation‐related dopachrome tautomerase and melanocortin‐1 receptor genes are associated with wet age‐related macular degeneration in a Finnish cohort
Authors: Koskela Ali , Reinisalo Mika , Helisalmi Seppo , Liukkonen Mikko , Kaarniranta Kai , Urtti Arto , Honkakoski Paavo
Published: December 2022

Purpose: Melanin in intracellular organelles, melanosomes, protects the retinal pigment epithelium from ultraviolet radiation and oxidative stress (OS). However, despite the role of OS in the development of age‐related macular degeneration (AMD), the effect of pigmentation‐related genes on the risk of AMD onset is unclear.

Methods: Finnish wet AMD patients and control subjects were genotyped for selected pigmentation‐related genes. 26 selected variants for tyrosinase (TYR), tyrosinase‐related protein 1 (TYRP1), dopachrome tautomerase (DCT), melanocortin‐1 receptor (MC1R), microphthalmia‐associated transcription factor (MITF), and orthodenticle homeobox‐2 (OTX2) were analysed using the Sequenom iPlex platform (Sequenom, Hamburg, Germany). Binary logistic regression analyses were performed to find genetic associations.

Results: An intronic variant rs1407995 (T > C) of the DCT gene and a two base pair deletion variant rs3212351 (AT > del) in the regulatory region of the MC1R gene were associated with wet AMD in a crude recessive model (OR = 3.250, 95% CI = 1.036–10.195, p = 0.043 and OR = 1.714, 95% CI = 1.004–2.924, p = 0.048, respectively). The age‐ and gender‐adjusted recessive model revealed a stronger association of rs1407995 to AMD (OR = 4.514, 95% CI = 1.300–15.669, p = 0.018), whereas rs3212351 was no longer statistically significant (OR = 1.612, 95% CI = 0.923–2.819, p = 0.093).

Conclusions: Several mutations in DCT and MC1R genes are known to associate with the blond or red hair phenotype with increasing ratio of red pro‐oxidant pheomelanin to protective brown eumelanin pigments. Furthermore, MC1R has been linked to the regulation of ocular inflammation, another key event in the pathogenesis of AMD. In conclusion, two polymorphisms in genes regulating melanin production and oxidative balance in pigmented cells were observed in a Finnish cohort evoking interest in their role in AMD onset.
Analysis of RNFL and GCL in patients with multiple sclerosis and fibromyalgia
Authors: Palomar Elisa Viladés , Ciordia Beatriz Cordón , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Munuera Inés , Satue Maria , Garcia‐Martin Elena
Published: December 2022

Purpose: To evaluate the differences in RNFL and GCL between patients with relapsing–remitting multiple sclerosis (RR‐MS), fibromyalgia (FM) and healthy controls, as well as their correlation with disease time and severity.

Methods: 94 eyes of RR‐MS patients, 55 eyes of FM patients and 90 eyes of healthy controls were evaluated using the Spectralis OCT Posterior Pole protocol (64‐cell array grid). The thicknesses of both layers were compared for each of the 64 cells between the three groups, the correlation of each layer with the time of the disease was studied, as well as with the EDSS in the case of RR‐MS and with the questionnaires FIQ and EQ‐5D in the case of FM.

Results: We observed a significant thinning (p < 0.05) of the GCL in both pathologies compared to healthy subjects, being the damage significantly greater in RR‐MS. Regarding the RNFL, a significant thinning was observed in the RR‐EM but not in the FM. On the other hand, GCL was correlated with the time of evolution in RR‐MS patients, but not in those with FM, and was significantly correlated with a greater impact of FM (FIQ and EQ‐5D), but not with the EDSS in the case of RR‐MS. In addition, it is in the GCL where a high concentration of cells (>50%) which a greater ability to discriminate between healthy and pathological subjects (AUC > 0.5) was found.

Conclusions: The GCL damage in FM patients, similar to that in RR‐MS patients, suggests that there is an underlying neurodegenerative process in this pathology. In the absence of other biomarkers, OCT could be postulated as a potential biomarker in FM, since GCL shows significant thinning and correlates with the impact of this disease on quality of life.
In vitro evaluation of sodium hyaluronate protective effect against benzalkonium chloride toxicity
Authors: Pizzano Manuela , Vereertbrugghen Alexia , Galletti Jeremias , del Papa Melina Sol , Passerini María Silvia
Published: December 2022

Purpose: To evaluate the protective effect of different concentrations of sodium hyaluronate (SH) on the Benzalkonium chloride (BAK)‐induced toxicity using an in vitro model.

Methods: The NAV14 cell line (SV40‐immortalized murine conjunctival epithelium) was used. Cell monolayers were exposed to different combinations of BAK (0.001%; 0.005%; 0.01%) and SH (0.2%; 0.3%; 0.4%) for 15 minutes; then cells were washed, and fresh culture media was added. Cell viability was evaluated after 2 h by resazurin reduction and lactate dehydrogenase (LDH) release. Also, cell migration and proliferation over 24 hours were determined by the scratch wound‐healing assay. Data were analysed by two‐way ANOVA and are shown as mean ± SD of two independent experiment with 4–6 replicates each.

Results: BAK induced a concentration‐dependent decrease on cell viability (BAK 0.001%: 91 ± 14%, BAK 0.005%: 45 ± 9% and BAK 0.01%: 22 ± 10% of control cells, p < 0.001) and an increase in LDH release (no BAK:0.22 ± 0.02, BAK 0.001%: 0.31 ± 0.02, BAK 0.005%: 1.14 ± 0.05 and BAK 0.01%: 1.21 ± 0.05, p < 0.001). Conversely, SH neutralized these effects also in a concentration‐dependent manner (p < 0.001). In the presence of SH 0.4% (highest effect), cell viability was BAK 0.001%: 104 ± 22%, BAK 0.005%: 109 ± 9% and BAK 0.01%: 75 ± 13% of control cells (p < 0.001 for BAK 0.005–0.01%) while LDH release was no BAK: 0.24 ± 0.03, BAK 0.001%: 0.26 ± 0.01, BAK 0.005%: 0.37 ± 0.02 and BAK 0.01%: 0.49 ± 0.22, (vs. no SH: p < 0.001 for BAK 0.005–0.01%). BAK also reduced wound closure in vitro (after 24 h, no BAK: 76 ± 14%, BAK 0.001%: 42 ± 12%, BAK 0.005%: 17 ± 16% and BAK 0.01%: 0.0% wound closure, p < 0.001 for all BAK). Conversely, SH neutralized this effect in a concentration‐dependent fashion (p < 0.001). In the presence of SH 0.4% (highest effect), wound closure at 24 h was: no BAK: 81 ± 15%, BAK 0.001%: 58 ± 6%, BAK 0.005%: 63 ± 10%, BAK 0.01%: 60 ± 8% (vs no SH: p < 0.001 for BAK 0.005–0.01%).

Conclusions: Sodium hyaluronate neutralized BAK toxicity on conjunctival epithelial cells in a concentration‐dependent manner. SH 0.4% was even protective at the highest preservative concentrations. These findings support the use of SH to mitigate BAK toxicity in long‐term antiglaucomatous treatment, although more studies are needed.
Case report of a large, right, temporal arteriovenous malformation in the brain manifested by a progressive visual field defect
Authors: Hall Caterina , Marinescu Anca
Published: December 2022

Purpose: Emphasizing the importance of regular vision screening with visual fields and rapid MRI investigations where a field defect is unexplained. A 44 yo patient with a history of headache and incipient development of hemianopia gradually noticed bumping into things on the left‐hand side. In the last 6 months she also described 2 clear episodes of 5 min absence seizures, when she was staring into space. She has a history of iron deficiency being treated. Visual acuity was 6/6 corrected, right eye and 6/6‐2, corrected left eye. Normal pupillary reflexes. Visual fields showed gross left homonymous hemianopia. Optic discs showed no palor or cupping.

Methods: Brain MRI showed a complex right temporal arteriovenous malformation (AVM) predominately supplied from the middle cerebral artery. There is a variceal dilation. There was some gliosis in the right temporal lobe suggesting previous bleed.

Results: Urgent neurosurgeon assessment and catheter angiogram found a complex AVM which will likely be treated with gamma knife or embolization given patient age and previous evidence of bleed.

Conclusions: This interesting case illustrates the importance of urgent imaging when faced with an abnormal visual field defect with no other underlying pathology.

References

1. M. J. Kupersmith, M. E. Vargas, A. Yashar, M. Madrid, K. Nelson, A. Seton, A. Berenstein Occipital arteriovenous malformations Visual disturbances and presentation. 1996. DOI: https://doi.org/10.1212/WNL.46.4.953

2. Homonymous hemianopia: challenges and solutions. Clin Ophthalmol. 2014; 8: 1919–1927. Published online 2014 Sep 22. doi: 10.2147/OPTH.S59452

3. Nisha S. Dhawlikar and Yosbelkys Martin Paez. Man presents with visual field changes over 1 year https://www.healio.com/news/ophthalmology/20210827/man-presents-with-visual-field-changes-over-1-year
iOCT‐assisted DSAEK tamponade for spontaneous corneal perforation with secondary bleb formation in pellucid marginal degeneration
Authors: Reinhold Aja , Scholl Hendrik , Gkatzioufas Zisis
Published: December 2022

Purpose: Intraoperative optical coherence tomography (iOCT) was initially used in vitreoretinal surgery. Nowadays, iOCT is also used in anterior segment surgery, providing increased precision and therefore more safety in complex anterior segment procedures, such as in corneal transplantation.

Methods: Our case reports on a 50‐year‐old patient who suffered a spontaneous corneal perforation with secondary bleb formation on the ground of advanced pellucid marginal degeneration (PMD).

Results: After initial repair with histoacryl glue, the corneal perforation was successfully managed by iOCT‐guided DSAEK tamponade. The secondary bleb resolved spontaneously.

Conclusion: Intraoperative optical coherence tomography is a good additional tool in complex anterior segment surgery to reach a higher precision and to provide more safety.