bluuebunny/crossref_metadata_2025_split huggingface dataset:
Μicrovascular foveal changes determined by optical coherence angiography following vitrectomy for idiopathic epiretinal membrane
Authors: Parikakis Efstratios , Kontomichos Loukas , Batsos Georgios , Christodoulou Eleni , Chatzirallis Alexandros , Peponis Vasileios , Karagiannis Dimitrios 
Published: January 2021

PurposeTo present microvascular changes in fovea following pars plana vitrectomy for idiopathic epiretinal membrane (ERM). Optical coherence tomography angiography (OCTA) was performed preoperatively and postoperatively.MethodsEleven patients diagnosed with idiopathic epiretinal membrane were enrolled in the study. OCTA was conducted before and 6 months after internal limiting membrane (ILM) peeling and pars plana vitrectomy performed by the same vitreoretinal surgeon. Foveal avascular zone (FAZ) and foveal vessel density (VD) in superficial capillary plexus were estimated by OCTA preoperatively and 6 months postoperatively. Contralateral healthy eye of the same patient served as controls.ResultsSuperficial FAZ preoperatively was significantly smaller in eyes with ERM compared to that of healthy eyes. Six months postoperatively, a significant increase in FAZ was observed, without reaching the levels of the FAZ of fellow healthy eyes. Foveal VD was significantly increased in eyes with ERM, whereas 6 months postoperatively a decrease of VD was observed. Greater differences in FAZ between the eye with ERM and the healthy control eye of the same patient as well as smaller FAZ were associated with worse best‐corrected visual acuity (BCVA) postoperatively.ConclusionsOCT angiography has been proven recently a noninvasive and useful tool for many foveal vascular lesions. In our case series, it showed foveal microvascular and morphological changes following surgical repair of epiretinal membrane with ILM peeling. There seems to be a significant association between these microvascular changes and visual prognosis.
Evaluation of ocular surface disease in elderly patients with glaucoma: expression of matrix metalloproteinase‐9 in tears
Authors: Lim Suho 
Published: January 2021

PurposeTo evaluate the symptoms and signs of ocular surface disease (OSD) and tear film matrix metalloproteinase‐9 (MMP‐9) overexpression using point‐of‐care testing (InflammaDry test) in patients with primary open‐angle glaucoma (POAG).MethodsThis prospective, case‐control study included sixty‐seven patients diagnosed with POAG and forty‐seven healthy control subjects. The OSD assessment included Schirmer‐I test, the Oxford corneal stain scale, tear breakup time (TBUT), and the 5‐Item Dry Eye Questionnaire (DEQ‐5). Measurement of extracellular MMP‐9 was performed using the InflammaDry test. The OSD parameters and MMP‐9 expression levels were compared between the POAG and control groups. Additional subgroup analysis in the POAG group was performed according to the number of topical glaucoma medications (1, 2, or 3 bottles).ResultsThere were significant differences between the control and POAG groups for all OSD parameters. MMP‐9 overexpression was observed in 71.6% of POAG group, whereas only 31.9% of control group showed MMP‐9 overexpression. The subgroup analysis revealed that DEQ‐5, Oxford stain score, Schirmer‐I, and MMP‐9 overexpression demonstrated no significant difference among the three groups. Abnormal TBUT (≤ 5sec) was observed in 37.5%, 59.1%, and 76.2% of each subgroup according to number of medications (1, 2, and 3), and strong MMP‐9 overexpression was detected in 25.0%, 40.9%, and 61.9%, respectively (p = 0.032, p = 0.043).ConclusionsThe use of preservative‐containing medications may affect the ocular surface in patients with POAG. Graded measurement of tear‐film MMP‐9 could provide more information on OSD and might be a more useful marker for inflammation than conventional results obtained using an MMP‐9 kit.
Combined cilioretinal artery and vein occlusion and glaucoma: genetics in two siblings
Authors: Ventura Abreu Nestor , Alforja Castiella Socorro , Pazos Marta , Carreras Castañer Xavier , Milla Elena 
Published: January 2021

PurposeHere we present two siblings with combined cilioretinal artery and vein occlusion (CLARVO), with genetic confirmation of glaucoma as the underlying etiology and discovering of two novel variants of CARD10 and OLFM2.MethodsAncillary tests were performed to rule out other etiologies, and genetic tests using next generation sequencing (NGS) were performed in the two siblings. An extensive literature research was performed of similar cases of CLARVO and glaucoma, as well as the genetics (NCBI Genes Database) found in our patients.ResultsIn April 2016, a 39‐years‐old man and a 45‐year‐old woman came to the Emergency Room referring visual loss on their right eye, also both with an onset of the symptoms differing only two weeks. They denied any abnormalities, recent travels or drugs abuse. On the examination, both presented CLARVO in the right eye, a more severe condition in the female patient along with lower visual acuity. Both patients showed a pigmentary dispersion glaucoma with a higher cup‐to‐disc ratio in their right eye. IOP was controlled with medical treatment, and in the female peripheral iridotomies and selective trabeculoplasty were also needed. A genetic analysis with NGS showed variants of CARD10 (pThr436Met) in both siblings, and in OLFM2 (p.ARg460=) in the female. These genes have been related to a higher risk of increased IOP (CARD10) and normal development of the structures of the eye (OLFM2). Also, OLFM2 has been recently linked to vascular smooth muscle cells regulation.ConclusionsCLARVO is a rare entity. As in other vascular retinal diseases, like in retinal vein occlusion, even in younger patients, classic predisposing factors like glaucoma should be considered. When available, genetic tests should be performed, especially in presumed familiar association. The combination of the genetic variants in our patients could be related to both a higher predisposition of high‐pressure glaucoma, along with an increased susceptibility of the retinal vasculature; however, further research is needed to confirm this association between CLARVO and glaucoma.
Inflammation‐related MiRNAs are associated with Monosomy 3 in Uveal Melanoma
Authors: Souri Zahra , Jochemsen Aart G. , Verdijk Robert , van der Velden Pieter A. , Luyten Gregorius , Jager Martine 
Published: January 2021

PurposeInflammation is a bad prognostic sign in Uveal Melanoma (UM), but it is as yet unclear how it is regulated. We set out to investigate the relation between microRNA’s and inflammation in UM and their potential regulation by chromosome 3 and 8.MethodsThe expression of 125 microRNA’s was determined using an Illumina HT12V4 array in 64 primary UM. Similarly, the mRNA expression of HLA‐A, HLA‐B and markers of tumor‐infiltrating lymphocytes (TIL) such as CD3E, CD4, CD8, and tumor‐associated macrophages (TAM), such as CD68 and CD163, was obtained from the array.ResultsWhen looking at all 64 UM tumors, expression levels of seven of the 125 miRNA’s that were analysed correlated with the presence of tumor‐infiltrating lymphocytes (TIL), tumor‐associated macrophages (TAM) and HLA Class I expression. Increased levels of miRNA 22 and 155 were associated with increased HLA expression and high numbers of TIL and TAM, while expression of miRNAs 7, 98, 125, 302 and 599 was associated with less infiltrate and a lower HLA expression. MiRNAs 22 (p ≤ 0.001) and 155 (p = 0.005) were upregulated in monosomy 3 tumors and expression of miRNAs 7 (p = 0.35), 98 (p = 0.26), 125 (p = 0.91) and 599 (p = 0.80) was not related to monosomy 3, while miR‐302 (p = 0.02) was slightly higher in D3 tumors. MiR‐22 was positively associated to chromosome 8q gain (p = 0.01) but miRNA’s 7 (p = 0.004), 98 (p = 0.002), 125 (p = 0.005), 302 (p = 0.02), and 599 (p ≤ 0.001) were all decreased in tumours with 8q gain.ConclusionsWe identified a set of microRNA’s associated with inflammatory markers (HLA Class I, TIL’s and TAM’s) in UM. The microRNA’s that are positively associated with inflammation are highly expressed in tumors with one copy of chromosome 3 and 8q gain while this is the opposite for microRNA’s negatively associated with inflammation. We propose a regulatory role for chromosome 3 and 8q abnormality in the control of inflammation‐related microRNA’s and suggest a potential involvement of these microRNA’s in the development of inflammation in UM.
Proteomic analysis of tear film composition in diabetic dogs
Authors: Winiarczyk Dagmara , Winiarczyk Mateusz , Winiarczyk Stanisław , Adaszek Łukasz , Michalak Katarzyna 
Published: January 2021

AbstractPurposeDiabetes mellitus is becoming an increasing concern in veterinary practice and research. Not treated, it can lead to serious systemic complications and even animal death. The most common form of diabetes in dogs resembles type 1 diabetes in humans. Tear film is easily accessible fluid that can be collected during routine veterinary visit. Based on research conducted in humans, we propose that diabetes can reflect on tear film proteomic composition.MethodsThe study was conducted on 49 dogs. Enrollment was restricted to clinically stable diabetic dogs. Nineteen healthy age‐ and sex‐matched dogs were included as a control group. Tear film was collected with Schirmer strips from the diabetes and sex‐ and age‐matched control group. Two‐dimensional electrophoresis was performed followed by MALDI‐TOF mass spectrometry identification of differential proteins. Quantitative analysis of the differentiating electrophoretic spots was done with 2Delta software. Metabolic pathways associated with those proteins were identified with Panther GO software.ResultsNine out of a total 489 proteins detected on all of the gels were identified as significantly differentially expressed (p ≤ 0.05) in tear film samples collected from diabetic patients. Eight of the nine proteins were assigned to downregulated, namely Phosphatydylinositol‐4 kinase, Pro‐melanin concentrating hormone, Flotillin‐1, Protein mono‐adp ribosyltransferase, ATP‐dependent RNA helicase, GRIP and coiled coil domain containing protein 2, Tetratricopeptide repeat protein 36, Myosin light chain 6B and Prelamin A/C. One of the nine proteins (SRC kinase signalling inhibitor 1) was assigned to upregulated.ConclusionsTear film obtained from dogs with diabetes differs from the healthy controls. Those findings correspond with research conducted in humans, and can add value to our understanding about the course of the disease in dogs. Also, dogs serve well as an animal model of various human diseases.
A rare cause of ophtalmoplegia: about a case
Authors: Abdi Rhizlane , Siham Chariba , Maadan Asmae , Sekhsoukh Rachid 
Published: January 2021

AbstractPurposeWernicke's encephalopathy (WE) is an acute neurological disorder induced by a thiamine (vitamin b1) deficiency, secondary to undernutrition or malabsorption. It is a rare but serious complication requiring urgent treatment. Characterized by: mental confusion, ophthalmoplegia and ataxia. In the absence of treatment, the progression is towards Korsakov syndrome where the lesions become irreversible. The objective of our work is to alert clinicians to the seriousness of this pathology, which in our case, the revelation was ophthalmological.MethodsWe report the case of a patient who consults in ophthalmological emergencies for bilateral ophthalmoplegia sudden installation and whose etiological diagnosis was in favor of Wernicke encephalitisResultsFifty‐year‐old patient who presented to the ophthalmic emergency department for reduced visual acuity with eye pain. The general examination finds a patient confused, disoriented in time and space with an unbalanced gait.The ophthalmological examination finds:

ODG total ophthalmoplegia
Lazy direct and consensual photomotor reflex.
Bilateral stage I papillary edema.The rest of the ophthalmological examination is unremarkable.
An MRI was requested which objectified a hyper signal of the thalamus in flair and T2 sequence. In front of this clinical and radiological picture, the diagnosis of gayet Wernicke's encephalitis was evoked and confirmed by the dosage of vitamin B1 which was lowered. She benefited from an injectable vitamin B1 treatment at a dose of 400 mg/day as soon as the diagnosis was suspected, followed by an oral relay (250 mg, twice a day). The evolution was favorable with improvement of consciousness after the 5th day, regression of visual disturbances and resumption of walking. The 6‐month follow‐up showed a normal fundus and a normal brain MRI.ConclusionsGayet Wernicke's encephalitis is a rare condition, which remains under diagnosed to this day. It is a diagnostic emergency requiring early treatment to prevent complications.
Analysis of Merkel cell carcinoma of the eyelid: a population‐based study 1998–2016
Authors: Tadrosse Abanoob , Mikhael Sandra , Tadrosse Marina , Tadrosse Mark , Langer Paul D. 
Published: January 2021

AbstractPurposeMerkel cell carcinoma of the eyelid (MCCE) is a rare malignancy. We sought to analyze its epidemiologic and survival trends using a population‐based study.MethodsThe Surveillance, Epidemiology, and End Results US database was used to extract MCCE patient data from 1998 to 2016. Incidence was estimated in number of cases/million/year. Disease‐specific survival (DSS) was conducted using the Kaplan‐Meier method. Multivariate Cox regression analysis was used to calculate hazard ratios (HR).ResultsOne hundred eighty‐two cases of MCCE were identified. Forty‐five percent were males and the mean age at diagnosis was 78 years. Racial composition was: non‐Hispanic White, 79.1%; Hispanic, 9.9%; Black, 2.7%; Other, 8.3%. The overall incidence in the time period studied was 0.12. Incidence was not significantly different at the two tail ends of the study—1998–2002 (0.15) and 2012–2016 (0.13) (p = 0.39). Gender did not impact incidence (male: 0.10; female: 0.13; p = 0.20). Incidence significantly differed based on race: Non‐Hispanic White, 0.13; Black, 0.05; Hispanic, 0.18 (p = 0.02). Merkel cell carcinoma of the eyelid (MCCE) incidence statistically differed by age group: 0.02 (45–59 years old), 0.40 (60–74), 0.75 (75–84), 2.60 (85–100) (p < 0.001). Incidence was stable comparing 1998–2002 and 2012–2016 in all age and racial subgroups. Five‐year DSS was similar between 1998–2003 (85.3%) and 2006–2011 (83.3%; p = 0.48). Female gender (HR: 0.8; p = 0.022) and married status (HR: 0.58; p = 0.012) were shown to be favorable prognostic factors.ConclusionsOverall, MCCE incidence has not changed over the study's time period. Males and females are equally affected, but incidence increases significantly with age. Merkel cell carcinoma of the eyelid (MCCE) incidence is lowest in the black population. Between 1998–2002 and 2012–2016, the incidence of MCCE has been stable among all racial and age groups. Five‐year DSS has not changed during the study's timeframe. Female gender and married status portend favorable prognosis.BibliographySurveillance Research Program, National Cancer Institute SEER*Stat software (www.seer.cancer.gov/seerstat) version 8.3.6.1
Decreased thickness of peripapillary retinal nerve fiber layer and ganglion cell complex in patients with Werner's syndrome
Authors: Yokouchi Hirotaka , Oshitari Toshiyuki 
Published: January 2021

AbstractPurposeWerner's syndrome is a rare autosomal recessive disorder that is characterized by a premature aged‐appearance, for example, grey hair, scleroderma‐like skin in young adults. It typically starts in the 20–30s followed by age‐related disorders such as juvenile cataracts, diabetes mellitus, atherosclerosis, cancers, and osteoporosis. The purpose of this study was to assess the alterations of the peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCC) in patients with Werner syndrome. The retinal images obtained by spectral‐domain optical coherence tomography (SD‐OCT) from eight patients with Werner's syndrome were compared to those of 10 age‐matched healthy controls.MethodsSixteen eyes of eight patients with Werner's syndrome consisting of four men and four women were studied. The 16 eyes of the Werner's patients were compared to 20 eyes of 10 volunteers (five men and five women) who had no high myopia, glaucoma, or other macular disorders as healthy controls. There was no significant difference in the ages (p > 0.05) and the axial length (WS, 23.91 ± 0.85 mm; Control, 23.7 ± 1.04 mm; p > 0.05) between the two groups. We quantified the mean thickness of the pRNFL and the GCC from the OCT images for both groups. The significance of the differences in the findings was determined with the Mann–Whitney U‐test. Statistical significance was defined as p < 0.05.ResultsThe mean pRNFL thickness in the Werner's group was 88.1 ± 16.9 μm which was significantly thinner that of the control group at 109.8 ± 13.0 μm (p < 0.05). The mean GCC thickness was 80.8 ± 10.3 μm in the Werner's group which was also significantly thinner than that of the control group at 95.4 ± 5.65 μm (p < 0.05).ConclusionsThe significantly thinner pRNFL and GCC in the Werner's group than the control group indicates that ophthalmologists should consider Werner's syndrome in their differential diagnosis when a similar finding is made in a young individual.
Outcomes of surgical management of intermittent exotropia in a paediatric age group—a retrospective study in a multi‐ethnic metropolitan population
Authors: Qadir Muhammed Omar , El‐Defrawy Hany , Abu‐Ain Mohammad 
Published: January 2021

AbstractPurposeIntermittent exotropia is one of the most common types of strabismus in children especially in Asian and South Asian populations. Prevalence of exotropia in this group is estimated to range from 7–18.5× higher than esotropia. Spontaneous resolution is rare and if neglected may lead to loss of Binocular Single Vision (BSV) and negative psychosocial consequences. We aim to evaluate the outcomes of surgical management for intermittent exotropia at a unit in Birmingham (UK), an area unique for its high non‐White ethnic population (43%), majority of who are Asian/South‐Asian.MethodsRetrospective case notes review of patients diagnosed with intermittent exotropia who underwent strabismus surgery in 2019–2020 by two surgeons using two different surgical approaches with a 3 month follow‐up. Measures included pre‐ and post‐operative visual acuity and stereopsis, surgical indications, near and distance strabismus angle with refractive correction, type of surgery performed and parental satisfaction at follow‐up.ResultsNineteen children underwent surgery during this period with a mean age of 7 range (4–12). Eighteen patients had surgery for functional reasons and one for cosmetic. Two patients recovered BSV where previously Frisby negative, remaining patients maintained BSV. The mean preoperative near and distance exodeviation in prism dioptres (PD) was 30.16 and 34.47, respectively. The mean postoperative near and distance exodeviation was 1.53 PD & 5.16 PD, respectively at 3 months. Two patients developed suture granulomas which resolved with steroid drops post‐operatively. No significant difference between the two surgical techniques was noted. In all cases, parents were satisfied with the results.ConclusionsOutcomes in our multi‐ethnic population have been excellent in terms of improvement in exodeviation and maintenance of BSV. Long‐term follow‐up is required to see how many patients will show evidence of recurrence requiring reoperation and whether ethnicity impacts this.
Association between nutritional guidance or ophthalmological examination and discontinuation of physician visits in patients with newly diagnosed diabetes: A retrospective cohort study using a nationwide database
Authors: Okada Akira , Ono Sachiko , Yamaguchi Satoko , Yamana Hayato , Ikeda Kurakawa Kayo , Michihata Nobuaki , Matsui Hiroki , Nangaku Masaomi , Yamauchi Toshimasa , Yasunaga Hideo , Kadowaki Takashi 
Published: January 2021

AbstractAims/IntroductionDiscontinuation of diabetes care has been studied mostly in patients with prevalent diabetes and not in patients with newly diagnosed diabetes, whose dropout risk is highest. Because enrolling patients in a prospective study will influence adherence, we retrospectively examined whether guideline‐recommended practices, defined as nutritional guidance or ophthalmological examination, can prevent patient discontinuation of diabetes care after its initiation.Materials and MethodsWe retrospectively identified adults with newly screened diabetes during checkups using a large Japanese administrative claims database (JMDC, Tokyo, Japan) that contains laboratory data and lifestyle questionnaires. We defined discontinuation of physician visits as a follow‐up interval exceeding 6 months. We divided the patients into those who received guideline‐recommended practices (nutritional guidance or ophthalmology consultation) within the same month as the first visit and those who did not. We calculated propensity scores and carried out inverse probability of treatment weighting analyses to compare discontinuation between the two groups.ResultsWe identified 6,508 patients with at least one physician consultation for diabetes care within 3 months after their checkup, including 4,574 patients without and 1,934 with guideline‐recommended practices. After inverse probability of treatment weighting, patients with guideline‐recommended practices had a significantly lower proportion of discontinuation than those without (17.2% vs 21.8%; relative risk 0.79, 95% confidence interval 0.69–0.91).ConclusionsThis study is the first to show that after adjustment for both patient and healthcare provider factors, guideline‐recommended practices within the first month of physician consultation for diabetes care can decrease subsequent discontinuation of physician visits in patients with newly diagnosed diabetes.
Metabolically healthy obesity and lipids may be protective factors for pathological changes of alzheimer’s disease in cognitively normal adults
Authors: Huang Shu‐Juan , Ma Ya‐Hui , Bi Yan‐Lin , Shen Xue‐Ning , Hou Xiao‐He , Cao Xi‐Peng , Ou Ya‐Nan , Zhao Bing , Dong Qiang , Tan Lan , Yu Jin‐Tai 
Published: January 2021

AbstractThe associations between obesity and Alzheimer's disease (AD) at different ages have been debated. Recent evidence implied the protective effects of metabolically healthy obesity on AD. We hypothesized that obesity and lipids could mitigate the detrimental impacts of AD pathological changes among metabolically healthy individuals in late life. In this study, a total of 604 metabolically healthy participants with normal cognition were included from the Chinese Alzheimer's Biomarker and LifestylE (CABLE) database. Multiple linear regression models were used to test the associations of body mass index (BMI) or lipids with cerebrospinal fluid (CSF) biomarkers after adjustment for age, gender, education, and Apolipoprotein E‐ɛ4 (APOE‐ɛ4). The results showed the lower CSF levels of total tau protein (t‐tau: p = .0048) and phosphorylated tau protein (p‐tau: p = .0035) in obese participants than in non‐obese participants, even after correcting for covariates. Moreover in late life, higher BMI was associated with decreased CSF t‐tau (β: −0.15, p = .0145) and p‐tau (β: −0.17, p = .0052). As for lipids, higher levels of total cholesterol (TC) and low‐density lipoprotein cholesterol (LDL‐C) were associated with decreased CSF t‐tau (TC: β: −0.16, p = .0115; LDL‐C: β: −0.16, p = .0082) and p‐tau (TC: β: −0.15, p = .0177; LDL‐C: β: −0.14, p = .0225) in obese participants. Furthermore, these associations were only significant in participants with late‐life obesity and APOE‐ɛ4 non‐carriers. Overall, in a cognitively normal population, we found metabolically healthy obesity and lipids in late life might be protective factors for neurodegenerative changes.
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