bluuebunny/crossref_metadata_2025_split huggingface dataset:
QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY PARAMETER VARIATIONS AFTER TREATMENT OF MACULAR NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATION
Authors: Arrigo Alessandro , Aragona Emanuela , Bordato Alessandro , Amato Alessia , Borghesan Federico , Bandello Francesco , Parodi Maurizio B. 
Published: December 2020

Purpose:
Macular neovascularization (MNV) secondary to age-related macular degeneration can be characterized by quantitative optical coherence tomography angiography. The aim of the study was to assess the evolution of quantitative optical coherence tomography angiography parameters after 1 year of antivascular endothelial growth factor injections.

Methods:
Naive age-related macular degeneration–related MNV eyes were prospectively recruited to analyze optical coherence tomography and optical coherence tomography angiography parameters, including MNV vessel tortuosity (VT) and reflectivity, at baseline and at the end of the follow-up. Macular neovascularization eyes were categorized by a MNV VT cutoff, and quantitative parameter variations were documented after 1 year of treatment. We divided MNV eyes into Group 1 (MNV VT < 8.40) and Group 2 (MNV VT > 8.40).

Results:
Thrity naive age-related macular degeneration–related MNV eyes (30 patients) were included. Our cohort included 18 Type 1 MNV and 12 Type 2 MNV lesions. Baseline central macular thickness (411 ± 85 µm) improved to 323 ± 54 µm at 1 year (P < 0.01). Only Group 1 MNV displayed significant visual improvement. Macular neovascularization VT values remained stable over the follow-up in both subgroups. Group 2 MNV eyes showed increased MNV reflectivity and increased MNV area at the end of the follow-up. Quantitative retinal capillary plexa parameters were found to be worse in Group 2 MNV. Outer retinal atrophy occurred in 2 of the 18 eyes in MNV Group 1 (11%) and in 6 of the 12 eyes in MNV Group 2 (50%) after 1 year. Vessel density proved to be always worse in Group 2 than in Group 1.

Conclusion:
Macular neovascularization VT provides information on the blood flow and identifies two subgroups with different final anatomical and visual outcomes, regardless of the treatment effect.
OUTCOME OF REVISION PROCEDURES FOR FAILED PRIMARY MACULAR HOLE SURGERY
Authors: Maguire Matthew J. , Steel David H. , Yorston David , Hind Jennifer , El-Faouri Muhannd , Jalil Assad , Tyagi Pallavi , Wickham Louisa , Laidlaw Alistair H. 
Published: December 2020

Purpose:
To analyze the outcomes of revision surgery for idiopathic full-thickness macular holes that have failed to close after primary surgery, and also to assess factors predicting success and to review the relative effect of adjunctive surgical techniques.

Methods:
A multicenter retrospective study. Anatomical closure rates and visual acuity change between pre and postrevision surgery were assessed. Hole size, age, symptom duration, surgical interval, and reduced hole size were analyzed as predictive factors for success. Effectiveness of adjunctive surgical techniques was reviewed.

Results:
Seventy-seven eyes were included in the study. Anatomical closure was achieved in 71% (55/77) cases. There was a median gain of 11 Early Treatment of Diabetic Retinopathy Score letters in all holes and 14 letters in closed holes. Full-thickness macular holes that increased in size by more than 10% following primary surgery had a closure rate of 50% compared with 80% in holes that reduced by 10% or stayed the same (P = 0.015). Increasing hole size is associated with a modest reduction in odds of closure (odds ratio = 0.99; P = 0.04). Surgical interval <2 months is not associated with better outcomes compared with >2 months (P = 0.14).

Conclusion:
Revision surgery for full-thickness macular holes that have failed to close after primary surgery is associated with high closure rates and significant visual gains.
Glaucoma care during the coronavirus disease 2019 pandemic
Authors: Vinod Kateki , Sidoti Paul A. 
Published: December 2020

Purpose of review
The current article reviews the impact of the coronavirus disease 2019 (COVID-19) pandemic on the delivery of ophthalmic, and specifically, glaucoma care.

Recent findings
Literature from the review period includes case series demonstrating the presence of severe acute respiratory syndrome coronavirus 2 RNA in the conjunctival secretions of patients with laboratory-confirmed COVID-19. The global ophthalmology community published reports outlining the enhanced infection control measures undertaken by different institutions around the world to mitigate transmission of the novel coronavirus. Telemedicine has been increasingly implemented in glaucoma practices to reduce in-office patient volume. New data regarding the efficacy and feasibility of tools for home monitoring of intraocular pressure, virtual visual field testing, and remote disc photography are reviewed.

Summary
COVID-19 has posed a global public health threat due to the severity of its contagion and associated morbidity and mortality. Glaucoma specialists have responded to the pandemic with innovative modifications to reduce viral transmission and optimize patient and staff safety in the office and operating room. The role of teleglaucoma has expanded and will continue to evolve as remote diagnostic devices undergo further refinement and validation.
Safety profile of minimally invasive glaucoma surgery
Authors: Vinod Kateki , Gedde Steven J. 
Published: December 2020

Purpose of review
This article reviews the safety profile of trabecular meshwork/Schlemm's canal-based, subconjunctival, and suprachoroidal minimally invasive glaucoma surgery (MIGS).

Recent findings
Prospective randomized clinical trials and metaanalyses published during the 2019–2020 review period provided important data regarding the safety profile of trabecular meshwork/Schlemm's canal-based MIGS. Transient hyphema and intraocular pressure spikes are among the most common complications associated with this category of MIGS, but more serious adverse events such as cyclodialysis cleft formation may also occur. Trabecular bypass microstents and the intracanalicular scaffold are further subject to device-related complications, including malposition and obstruction. Recent case reports and retrospective case series have further characterized the safety profile of the subconjunctival gel stent, with adverse events ranging from self-limited hypotony to visually devastating endophthalmitis and suprachoroidal hemorrhage. Five-year results of the COMPASS XT study demonstrated significantly greater endothelial cell loss in patients randomized to receive CyPass Micro-Stent (Alcon Laboratories, Fort Worth, TX, USA) in combination with cataract surgery versus those who underwent cataract surgery alone, and ultimately led to a Food and Drug Administration Class I recall of the device.

Summary
Trabecular meshwork/Schlemm's canal-based procedures are generally among the safest MIGS, with mostly self-limited and nonvision-threatening complications. Subconjunctival gel stent insertion is associated with both bleb-related and stent-specific adverse events, which are similar to those observed with trabeculectomy and tube shunt surgery, respectively. Removal of the CyPass Micro-Stent from the market underscores the need for high-quality, long-term safety data regarding MIGS.
Contribution of Bowman layer to corneal biomechanics
Authors: Torres-Netto Emilio A. , Hafezi Farhad , Spiru Bogdan , Gilardoni Francesca , Hafezi Nikki L. , Gomes Jose Alvaro P. , Randleman J. Bradley , Sekundo Walter , Kling Sabine 
Published: December 2020

Purpose:
To compare the elastic modulus of thin corneal lamellas using 2D stress–strain extensometry in healthy ex vivo human corneal lamellas with or without the presence of Bowman layer.

Setting:
Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland; ELZA Institute, Dietikon, Switzerland; Department of Ophthalmology, Philipps University of Marburg, Germany.

Design:
Prospective experimental laboratory study.

Methods:
Healthy human corneas were stripped of Descemet membrane and the endothelium for Descemet membrane endothelial keratoplasty. After epithelium removal, corneas were divided into 2 groups. In Group 1, Bowman layer was ablated with an excimer laser (20 μm thick, 10 mm). In Group 2, Bowman layer was left intact. Then, a lamella was cut from the anterior cornea with an automated microkeratome. Elastic and viscoelastic material properties were analyzed by 2D stress–strain extensometry between 0.03 and 0.70 N.

Results:
Twenty-six human corneas were analyzed. The mean lamella thickness was 160 ± 37 μm in corneas with Bowman layer and 155 ± 22 μm in corneas without. No statistically significant differences between flaps with and without Bowman layer were observed in the tangential elastic modulus between 5% and 20% strain (11.5 ± 2.9 kPa vs 10.8 ± 3.7 kPa, P > .278).

Conclusions:
The presence or absence of Bowman layer did not reveal a measurable difference in corneal stiffness. This may indicate that the removal of Bowman layer during photorefractive keratectomy does not represent a disadvantage to corneal biomechanics.
PresbyPRK vs presbyLASIK using the SUPRACOR algorithm and micromonovision in presbyopic hyperopic patients: visual and refractive results at 12 months
Authors: Boucenna William , Hagège Alain , Lussato Mikhael , Morfeq Hussein , Kochbati Elias , Jany Benjamin , Froussart-Maille Françoise , Delbarre Maxime 
Published: December 2020

Purpose:
To compare the visual outcome and refractive results between presbyopic photorefractive keratectomy (presbyPRK) and presbyopic laser in situ keratomileusis (presbyLASIK) in presbyopic hyperopic patients using micromonovision and the SUPRACOR algorithm.

Setting:
Percy Military Hospital and private Laser Victor Hugo Center, France.

Design:
Observational retrospective nonrandomized.

Methods:
Twenty-three patients who had undergone presbyPRK or presbyLASIK were included and followed up for 12-months. Far and near visual acuity without correction in monocular and binocular, measurement of distance visual acuity with correction in monocular, evaluation of spherical equivalent (SE), aberrometry, and patient satisfaction were measured and analyzed in this study.

Results:
The study included 26 eyes of 13 patients in the presbyLASIK group and 20 eyes of 10 patients in the presbyPRK group. The mean age was 55.43 ± 4.6 years. Uncorrected binocular distance visual acuity was 0.030 ± 0.05 logMAR in the presbyLASIK group and 0 logMAR in the presbyPRK group (P = .066). Binocular near visual acuity without correction was 0.21 ± 0.11 logMAR in the presbyLASIK group and 0.30 ± 0.15 logMAR in the presbyPRK group (P = .0398). For the dominant eyes, the SE was −0.08 ± 0.48 diopters (D) in the presbyLASIK group and 0.16 ± 0.82 D in the presbyPRK group (P = .3995). For nondominant eyes, the SE was −0.44 ± 0.50 D in the presbyLASIK group and 0.12 ± 0.65 D in the presbyPRK group (P = .0254).

Conclusions:
PresbyPRK and presbyLASIK were comparable in efficacy, stability, predictability, and safety. PresbyPRK could be a safe and effective surgical alternative for the hyperopic presbyopic patient.
Knot-free suture scleral fixation of dislocated intraocular lenses: clinical results of a novel surgical technique
Authors: Genç Selim , Esen Fehim 
Published: December 2020

Purpose:
To describe and report surgical outcomes of a novel, knot-free technique to manage dislocated intraocular lenses (IOLs).

Setting:
Beyoglu Eye Education and Research Hospital, Istanbul, Turkey.

Design:
Retrospective observational clinical study.

Methods:
The files of 47 patients were retrospectively reviewed, and the patients who had a follow-up time of 6 months or more were included in this study. The surgery of every case was watched for the surgical complications and calculation of the surgical time. The postoperative complications and success rate were specifically tabulated.

Results:
Thirty-five eyes of 35 patients were included in this study (23 men, 12 women; mean age 63.1 ± 19.2 years). The mean follow-up time was 22.5 ± 9.9 months. The mean surgical time was 28.2 ± 6.8 minutes. Corrected distance visual acuity improved significantly after surgery (P = .001). Anatomic success rate was 97.1% after a single surgery. Most common complications included transient intraocular pressure (IOP) elevation (n = 2), persistent IOP elevation (n = 1), mild IOL tilt (n = 1), mild IOL decentration (n = 1), secondary IOL dislocation requiring intervention (n = 1), transient corneal edema (n = 1), and bullous keratopathy (n = 1).

Discussion:
Knot-free suture scleral fixation of dislocated IOLs was a minimally invasive approach for the management of dislocated IOLs and required only two 20-gauge corneal incisions without the need for scleral flaps or incisions. This technique had a low complication rate and delivered successful results in most cases.
Repeatability of intraoperative Hartmann-Shack wavefront sensing in cataract surgery
Authors: Georgiev Stefan , Hirnschall Nino , Fişuş Andreea-Dana , Ruiss Manuel , Hienert Julius , Leisser Christoph , Findl Oliver 
Published: December 2020

Purpose:
To evaluate the repeatability of aphakic intraoperative wavefront aberrometry and compare it with preoperative and postoperative aberrometry.

Setting:
Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.

Design:
Prospective case series.

Methods:
Patients scheduled for cataract surgery were each measured 3 consecutive times using Hartmann-Shack wavefront sensing (HS-WFS) preoperatively, intraoperatively in aphakia, and 2 months postoperatively after intraocular lens implantation by a single examiner. Intraclass correlation coefficients (ICCs) of spherical equivalent (SE) values were evaluated for each timepoint. Intrasubject standard deviation (Sw) as repeatability (Sr) with corresponding repeatability limit (

) and mean SE differences with corresponding limits of agreement (LoA) were calculated for comparison.

Results:
A high consistency of repeated measurements was found with ICCs above 0.9 for each of the 3 timepoints. Intraobserver repeatability (Sr) and repeatability limit (r) of intraoperative aberrometry SE measurements (30 eyes of 30 patients) were 0.34 diopters (D) and 0.95 D, respectively. The LoA for intraoperative aphakic SE across 3 consecutive measurements were −0.71 to +0.85 D. For comparison, Sr and r for phakic preoperative measurements in the cataractous state (30 eyes of 30 patients) and postoperative measurements in the pseudophakic state (24 eyes of 24 patients) were 0.33 D and 0.93 D and 0.23 D and 0.64 D, respectively. Similarly, the LoA for preoperative and postoperative SE measurements were −0.66 to +0.60 D and −0.27 to +0.45 D, respectively.

Conclusions:
HS-WFS test–retest reliability was high for all 3 timepoints, but the intraoperative setting resulted in a lower repeatability and broadened the agreement range.
Telehealth technology: Reducing barriers for rural residents seeking genetic counseling
Authors: Rhoads Sarah , Rakes Anna Laura 
Published: December 2020

ABSTRACT
Many rural residents do not receive genetic counseling or testing when needed because of health care access barriers, such as lack of providers in rural areas and the requirement for rural residents to travel to larger cities for these services. Telehealth technology can reduce these barriers by allowing rural residents to receive genetic counseling through a two-way interactive audio/video secure connection in a local clinic setting or in their homes. Telegenetics is a satisfactory solution for both patient and provider and provides benefits for rural patients despite ethical, legal, and reimbursement considerations.
Adequate duration of therapy in severe fungal infections
Authors: Bassetti Matteo , Giacobbe Daniele R. , Berruti Marco , Del Puente Filippo , Vena Antonio 
Published: December 2020

Purpose of review
To highlight recent findings on the adequate duration of antifungal therapy in patients with invasive fungal disease (IFD).

Recent findings
Plenty of published data available suggest that there is no additional clinical benefit at a certain point after initiation of antifungal treatment in patients with confirmed IFD. Moreover, the prolonged antifungal exposure can be associated with an increased risk of side effects and toxicity as well as striking risk for developing antifungal resistance or rising unnecessary healthcare costs. Recent data suggest that, in the presence of an adequate initial antifungal therapy and adequate source control of the infection, new stratified approaches integrating clinical judgment, biomarkers and microbiological eradication, should be considered as an alternative to the ‘one-size-fits-all’ treatment duration currently used worldwide.

Summary
The optimal duration of antifungal therapy is still an unresolved issue that depends by many key elements including the host; the pathogen and its microbiological eradication, the adequateness of initial antifungal therapy and the promptness of source control of the infection. In general, many patients with invasive candidiasis can be treated with a 2 weeks course of antifungal therapy. Longer antifungal course (6 weeks or more) is generally required for patients with invasive aspergilosis.
Monitoring the patient for a safe-assisted ventilation
Authors: Yoshida Takeshi , Fujino Yuji 
Published: December 2020

Purpose of review
A growing evidence shows that injurious spontaneous breathing, either too weak or too strong, may injure lung and diaphragm. The purpose of review is to understand why we need monitoring for safe spontaneous breathing, and to know the target value of each monitoring to preserve safe spontaneous breathing during assisted ventilation.

Recent findings
Lung protection sometimes goes counter to diaphragm protection. For instance, silence of respiratory muscle activity is necessary to minimize lung injury from vigorous spontaneous effort in acute respiratory distress syndrome, but it may also have a risk of diaphragm atrophy. Thus, our current goal is to preserve spontaneous breathing activity at modest level during assisted ventilation. To achieve this goal, several monitoring/techniques are now available at the bedside (e.g., plateau pressure measurement, airway occlusion pressure, end-expiratory airway occlusion, esophageal balloon manometry, electrical impedance tomography). The target value of each monitoring is vigorously being investigated, facilitating ‘safe’ spontaneous breathing effort from the perspective of lung and diaphragm protection.

Summary
We summarize why we need monitoring for safe spontaneous breathing during assisted ventilation and what the target value of each monitoring is to facilitate ‘safe’ spontaneous breathing during assisted ventilation.
Bedside noninvasive monitoring of mechanically ventilated patients
Authors: Via Gabriele , Vasques Francesco , Hussain Arif , Barrett Nicholas A. , Camporota Luigi 
Published: December 2020

Purpose of review
Among noninvasive lung imaging techniques that can be employed at the bedside electrical impedance tomography (EIT) and lung ultrasound (LUS) can provide dynamic, repeatable data on the distribution regional lung ventilation and response to therapeutic manoeuvres.
In this review, we will provide an overview on the rationale, basic functioning and most common applications of EIT and Point of Care Ultrasound (PoCUS, mainly but not limited to LUS) in the management of mechanically ventilated patients.

Recent findings
The use of EIT in clinical practice is supported by several studies demonstrating good correlation between impedance tomography data and other validated methods of assessing lung aeration during mechanical ventilation. Similarly, LUS also correlates with chest computed tomography in assessing lung aeration, its changes and several pathological conditions, with superiority over other techniques. Other PoCUS applications have shown to effectively complement the LUS ultrasound assessment of the mechanically ventilated patient.

Summary
Bedside techniques – such as EIT and PoCUS – are becoming standards of the care for mechanically ventilated patients to monitor the changes in lung aeration, ventilation and perfusion in response to treatment and to assess weaning from mechanical ventilation.
Preparedness of ICU networks for pandemics
Authors: Florio Gaetano , Zanella Alberto , Pesenti Antonio 
Published: December 2020

Purpose of review
The recent COVID-19 outbreak has clearly shown how epidemics/pandemics can challenge developed countries’ healthcare systems. Proper management of equipment and human resources is critical to provide adequate medical care to all patients admitted to the hospital and the ICU for both pandemic-related and unrelated reasons.

Recent findings
Appropriate separate paths for infected and noninfected patients and prompt isolation of infected critical patients in dedicated ICUs play a pivotal role in limiting the contagions and optimizing resources during pandemics. The key to handle these challenging events is to learn from past experiences and to be prepared for future occurrences. Hospital space should be redesigned to quickly increase medical and critical care capacity, and healthcare workers (critical and noncritical) should be trained in advance.

Summary
A targeted improvement of hospital and ICU protocols will increase medical care quality for patients admitted to the hospital for any clinical reasons during a pandemic.
Hospital care: improving outcomes in type 1 diabetes
Authors: Boeder Schafer , Kulasa Kristen 
Published: December 2020

Purpose of review
Caring for patients with type 1 diabetes (T1D) in the hospital presents unique challenges. This review provides an update on significant issues relevant to the inpatient management of T1D. Topics include trends in diabetic ketoacidosis (DKA), hypoglycemia, and adapting ambulatory technologies for inpatient use.

Recent findings
Rates of DKA in the United States are rising. Although socioeconomic status, health insurance coverage, and hemoglobin A1c are persistently associated with DKA in individuals with T1D, newer risk factors have also emerged. These include the off-label use of sodium-glucose cotransporter inhibitor medications, immune checkpoint inhibitor-induced diabetes, and infection with severe acute respiratory syndrome coronavirus 2. Hypoglycemia is common among hospitalized patients with T1D. Use of validated hypoglycemia risk prediction models and multidisciplinary care initiatives can reduce the risk of inpatient hypoglycemia. Finally, continuous glucose monitoring is being adapted for use in the hospital setting and has shown promise during the coronavirus disease 2019 (COVID-19) pandemic.

Summary
Evidence-based treatment algorithms, risk prediction calculators, multidisciplinary interventions, and wearable technology hold promise for improved outcomes in hospitalized patients with T1D.