bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEW INSIGHTS INTO THE ASSOCIATION BETWEEN CHOROIDAL VESSELS AND CHORIOCAPILLARIS IN NORMAL EYES
Authors: Sun Gongpeng , Chen Changzheng , Jiang Jingwen , Yi Zuohuizi , Wang Xiaoling , Miao Qingmei , Xu Amin , He Lu 
Published: June 2021

Purpose:
To determine the relationship between large-sized and medium-sized choroidal vessels and choriocapillaris using the three-dimensional choroidal vascularity index (3D CVI) and percentage of flow deficits (FD%).

Methods:
Prospective observational study. The main outcome measures included choroidal volume parameters (3D CVI, mean choroidal thickness, total choroidal volume, choroidal luminal volume, and choroidal stromal volume), choriocapillaris parameters (FD%, average area of FD, and FD count), and age and axial length.

Results:
A total of 63 healthy individuals with an average age of 40.60 ± 12.32 years were included in this study. Univariate analysis showed that FD% (R = 0.295, P = 0.019) and area of FD (R = 0.276, P = 0.028) were significantly positively associated with 3D CVI, and FD count was negatively associated with 3D CVI (R = −0.297, P = 0.018). After adjusting for age and axial length, a significant correlation between FD% and 3D CVI (R = 0.264, P = 0.039) and between area of FD and 3D CVI remained (R = 0.267, P = 0.037). However, no significant correlation was found between FD count and 3D CVI after adjusting for axial length (R = −0.220, P = 0.085).

Conclusion:
In healthy individuals, choroidal vessel dilatation as suggested by elevated 3D CVI may lead to decreased choriocapillaris perfusion, which was correlated with an enlarged area of FD in choriocapillaris.
LONG-TERM COURSE AND VISUAL OUTCOMES OF PRECHOROIDAL CLEFT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION AND POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Kim Jae Hui , Kim Jong Woo , Kim Chul Gu , Lee Dong Won 
Published: June 2021

Purpose:
To evaluate the regression of prechoroidal cleft, its influence on visual outcomes, and differences in visual outcomes between neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

Methods:
This retrospective study included 61 patients exhibiting prechoroidal cleft who were treated with antivascular endothelial growth factors. The patients were divided into two groups according to the following categories: 1) regression of prechoroidal cleft: regression group versus nonregression group and 2) type of neovascularization: neovascular age-related macular degeneration group versus polypoidal choroidal vasculopathy group. Changes in the visual acuity during the follow-up period were also compared between the two groups.

Results:
During the 52.4 ± 17.4-month follow-up period, regression of prechoroidal cleft was noted in 17 patients (27.9%) at a mean of 25.7 ± 18.3 months after the first identification. The degree of the logarithm of the minimum angle of resolution of visual deterioration was greater in the nonregression group (0.59 ± 0.56, n = 17) than that in the regression group (0.25 ± 0.61, n = 44) (P = 0.007) and in the neovascular age-related macular degeneration group (0.56 ± 0.61, n = 51) than that in the polypoidal choroidal vasculopathy group (0.18 ± 0.33, n = 10) (P = 0.034).

Conclusion:
Approximately 27.9% of prechoroidal cleft cases eventually regressed, in conjunction with relatively favorable visual outcomes. Considering the poor visual prognosis in neovascular age-related macular degeneration accompanied by prechoroidal cleft, more caution is required for this condition.
REVISED PREDICTIVE BIOMARKER FOR OCRIPLASMIN THERAPY IN VITREOMACULAR TRACTION DISORDERS
Authors: Al-Nawaiseh Sami , Rickmann Annekatrin , Seuthe Anna-Maria , Al-Rimawi Dalia , Viktor Stanzel Boris , Szurman Peter 
Published: June 2021

Purpose:
To determine a statistically optimal limit of adhesion size in vitreomacular traction (VMT) syndrome for ocriplasmin treatment.

Methods:
In this retrospective, consecutive, interventional study, we included 106 patients treated with ocriplasmin injection because of VMT between July 2013 and January 2018. A univariate and multivariate risk analysis was performed with grouped factors and continuous factors. We used a receiver operating characteristic curve to measure the prognostic relevance of each continuous factor for therapy success and determined the statistically optimal cutoff value at which specificity and sensitivity are simultaneously maximized.

Results:
Among the grouped factors, only a phakic lens status showed a highly significant positive influence on the resolution of the VMT. For the continuous factors, only the adhesion diameter before injection was a good predictor of anatomical success. The statistically optimal threshold value for the adhesion size was calculated to be 480 µm. Eyes below this limit had a 6.84-fold better chance of VMT resolution compared with eyes with a larger adhesion diameter.

Conclusion:
The threshold value of the VMT diameter for ocriplasmin therapy could be statistically defined as 480 µm and may thus be a new quantitative biomarker to predict treatment success.
A Novel Virtual Wet Lab–Using a Smartphone Camera Adapter and a Video Conference Platform to Provide Real-Time Surgical Instruction
Authors: Cervantes Lorenzo J. , Tallo Christian A. , Lopes Caithlin A. , Hellier Erik A. , Chu David S. 
Published: June 2021

Purpose:
Proctored surgical instruction has traditionally been taught through in-person interactions in either the operating room or an improvised wet lab. Because of the COVID-19 pandemic, live in-person instruction was not feasible owing to social distancing protocols, so a virtual wet lab (VWL) was proposed and implemented. The purpose of this article is to describe our experience with a VWL as a Descemet membrane endothelial keratoplasty (DMEK) skills-transfer course. This is the first time that a VWL environment has been described for the instruction of ophthalmic surgery.

Methods:
Thirteen participant surgeons took part in VWLs designed for DMEK skills transfer in September and October 2020. A smartphone camera adapter and a video conference software platform were the unique media for the VWL. After a didactic session, participants were divided into breakout rooms where their surgical scope view was broadcast live, allowing instructors to virtually proctor their participants in real time. Participants were surveyed to assess their satisfaction with the course.

Results:
All (100%) participants successfully injected and unfolded their DMEK grafts. Ten of the 13 participants completed the survey. Respondents rated the experience highly favorably.

Conclusions:
With the use of readily available technology, VWLs can be successfully implemented in lieu of in-person skills-transfer courses. Further development catering to the needs of the participant might allow VWLs to serve as a viable option of surgical education, currently limited by geographical and social distancing boundaries.
Efficacy of Topical Ivermectin 1% in the Treatment of Demodex Blepharitis
Authors: Choi Young , Eom Youngsub , Yoon Eun Gyu , Song Jong Suk , Kim Il-Hwan , Kim Hyo Myung 
Published: June 2021

Purpose:
The purpose of this study was to evaluate the efficacy of topical ivermectin 1% cream application on the eyelashes in combination with eyelid hygiene in the treatment of Demodex blepharitis.

Methods:
One hundred two eyes of 102 patients with symptomatic Demodex blepharitis were divided into 2 groups according to the use of topical ivermectin in this retrospective case–control study. The ivermectin group (n = 51) applied topical ivermectin 1% cream on the eyelashes for 15 minutes once weekly, but the control group (n = 51) did not. In both groups, eyelid hygiene was performed once daily. The Standard Patient Evaluation of Eye Dryness (SPEED) symptom questionnaire score, Oxford staining score, eyelid debris, eyelid redness/swelling, and telangiectasia were assessed during the follow-up visits.

Results:
The mean follow-up periods of the ivermectin and control groups were 15.1 ± 9.7 weeks and 14.8 ± 8.6 weeks, respectively. The SPEED score and eyelid debris grade were significantly improved in both groups during the follow-up, although the SPEED score and eyelid debris grade showed greater changes in the ivermectin group than in the control group. The Oxford staining score, eyelid redness/swelling grade, and telangiectasia grade were significantly improved only in the ivermectin group but not in the control group.

Conclusions:
In patients with Demodex blepharitis, the use of topical ivermectin 1% cream for 15 minutes once weekly in addition to eyelid hygiene had more significantly improved symptoms, ocular surface staining, eyelid debris, redness/swelling, and telangiectasia as compared with eyelid hygiene alone. These findings support the efficacy of topical ivermectin 1% cream application in the treatment of Demodex blepharitis.
The Agreement Between an iPad Visual Field App and Humphrey Frequency Doubling Technology in Visual Field Screening at Health Fairs
Authors: Kitayama Ken , Young Andrew G. , Ochoa Alejandro , Yu Fei , Wong Kylie Yuen-Sum , Coleman Anne L. 
Published: June 2021

Precis:
This is the first exploratory study demonstrating the promising potential of app-based visual fields testing in a low-resource health fair setting for community screening of high-risk Latino adults.

Purpose:
To compare the “Visual Fields Easy” (VFE) iPad application against the Humphrey Frequency Doubling Technology (FDT) N-30-5 in detecting abnormal visual fields in a low-resource health fair setting.

Methods:
Latinos aged 40 to 80 years were recruited at a health fair in Los Angeles, California, in November 2017. Both eyes were tested using VFE and FDT. To account for possible nested correlations between participants and eyes, linear mixed effects models were used to estimate the difference in test time and the association in percent of missed points. A Bland-Altman plot and receiver operator characteristic curve were constructed for further comparisons.

Results:
Forty-five participants with a mean age of 58.5 years (SD=9.5 y) were recruited and both eyes were tested (90 eyes). VFE testing took on average 141 seconds longer per eye than FDT (95% confidence interval: 137-145 s), and FDT resulted in having 7.50% more missed points than VFE (95% confidence interval: 2.56%-12.43%, P=0.002). The Bland-Altman plot depicted reduced agreement with increasing average of percent of points missed. The sensitivity and specificity of VFE were 67% and 77%, respectively, with an area under the receiver operator characteristic curve of 0.71.

Conclusions:
In this exploratory study, VFE exhibited moderate discrimination for identifying Latino adults with abnormal visual fields compared with FDT. Agreement between FDT and VFE was greater for patients with mild-to-moderate visual field loss. Further software enhancements of app-based fields testing, in concert with other portable testing, represents promising screening methods for high-risk groups in resource-limited environments.
Diurnal Variation of Retinal Vessel Density in Healthy Human Eyes
Authors: Wu Jo-Hsuan , Penteado Rafaella C. , Moghimi Sasan , Zangwill Linda M. , Proudfoot James A. , Weinreb Robert N. 
Published: June 2021

Precis:
A small increase in optic nerve head vessel density (VD), but not macular VD, in the evening compared with the morning is observed in healthy subjects.

Purpose:
To evaluate the diurnal variation of the macular and optic nerve head (ONH) VD in healthy eyes as measured with optical coherence tomography angiography (OCT-A).

Methods:
In this prospective study of healthy individuals older than 18 years old, VD parameters, including macular whole image vessel density, parafoveal vessel density, ONH whole image vessel density, ONH whole image capillary density, circumpapillary vessel density (cpVD), and circumpapillary capillary density, were measured with OCT-A at 4 time points throughout the day (8 am, 12 pm, 4 pm, and 8 pm).

Results:
Twenty-nine healthy eyes were included from 15 subjects (mean age: 30.9 y). After adjustment for age and mean ocular perfusion pressure, a significant positive rate of change was found for cpVD (0.05%/h; P=0.027). In contrast, macular VD changes were not significantly different. When comparing morning (8 am and 12 pm) and evening (4 pm and 8 pm) measurements, there were small, but statistically significant, increases for all ONH measurements. The greatest increase was found for cpVD (0.58%; P=0.022). Significant but small increases in mean arterial pressure and mean ocular perfusion pressure were also observed.

Conclusions:
There was a small increase in ONH VD, but not macular VD, in the evening compared with the morning in healthy human eyes. As the observed difference was within the measurement variability, our results suggest the timing of OCT-A examination does not affect retinal VD measurements.
Two-Year Experience With Latanoprostene Bunod in Clinical Practice
Authors: Radell Jake E. , Sharma Himanshu K. , Auyeung Kelsey L. , Paul Megan E. , Gagliuso Donna J. , Chadha Nisha , Tsai James C. , Serle Janet B. 
Published: June 2021

Precis:
We retrospectively reviewed records of patients prescribed latanoprostene bunod 0.024% (LBN) to assess its efficacy and safety in a real-world clinical setting. LBN was efficacious in lowering intraocular pressure (IOP) and had a favorable safety profile.

Purpose:
The aim of this study was to evaluate the usage of LBN, the first topical nitric oxide-donating prostaglandin analog (PGA) for reducing IOP, in clinical practice.

Patients and Methods:
Retrospective review identified patients prescribed LBN by 5 glaucoma specialists at an academic center from January 2018 to November 2019. Fifty-six patients (102 eyes) met inclusion criteria of an IOP measured at the visit LBN was prescribed and at 2 visits ≥7 days after beginning treatment, with no surgeries, lasers or medication changes during follow-up. Main outcome measures were IOP, number of ocular medications, and adverse effects.

Results:
IOP (mean±SD, mm Hg) at the visit LBN was prescribed was 16.2±4.3 on 3.2±1.5 glaucoma medications. IOP at most recent visit was 13.7±3.8 on 3.2±1.6 medications. Mean IOP reduction was 2.1±3.5 (P<0.0001) at first follow-up, after 38.7±36.5 days, and 2.5±3.3 (P<0.0001) at last follow-up, after 235.9±160.8 days. Pressure decreased ≥2 mm Hg in 60%, ≥3 mm Hg in 46%, and ≥4 mm Hg in 34% of eyes. All patients received LBN as replacement for a PGA or latanoprost/netarsudil fixed-dose combination. Forty-three patients remained on LBN throughout the follow-up period. Seven were discontinued for insufficient pressure control, 4 for adverse effects including pain and itching, and 2 for financial reasons.

Conclusions:
In 2 years of clinical use of LBN, patients exhibited IOP reductions that were statistically significant overall and clinically meaningful in 60% of patients. LBN was well-tolerated and may be more efficacious than traditional PGAs.
Early Experience With Full-scope Shared-care Teleglaucoma in Canada
Authors: Elson Molly J. , Giangiacomo Annette , Maa A.Y. , Branson Sara V. , Maika Eric , Lin Amy , Gill Kulbir , Machuk Robert W.A. , Behn Darren , Kanjee Raageen , Dotchin Stephanie A. , Strungaru Hermina , Lee Thomas , Ramstead Cory , Gan Kenman 
Published: June 2021

Précis:
Large Canadian full-scope, shared-care teleglaucoma facilitates efficient management and diversion of medically stable patients away from overburdened subspecialty clinics while allowing patients the convenience of shorter travel, shorter wait time, and continuity with one provider. This report shares Care1 protocol, early patient characteristics, and quality data.

Purpose:
This paper describes early experience with Care1, a large full-scope, shared-care teleglaucoma program. Optometrists located in high-demand locations saw patients in-person, acquired clinical history, performed a physical examination, organized diagnostic testing, then uploaded data to a proprietary online platform where they were able to collaborate with participating ophthalmologists to make plans for patient care.

Materials and Methods:
The Care1 database was queried for all patients with a diagnosis of glaucoma or glaucoma suspect seen between February 2016 and March 2017. Clinical characteristics like diagnosis, ocular medication history, best-corrected visual acuity, intraocular pressure, cup-to-disc ratios, optical coherence tomography imaging results, and central corneal thickness were collected. Quality metrics studied included rates of referral to an in-person ophthalmologist and consistency of cup-to-disc assessments between in-person optometrists and remote ophthalmologists.

Results:
A total of 4070 patients received care at a Care1 teleophthalmology site in 2 provinces for glaucoma assessment from February 2016 to March 2017. The population was 55.1% female, and the average age was 57.8 years. Overall, 97.3% of patients had a best-corrected visual acuity between 20/20 and 20/40 and 3.3% had an intraocular pressure >26. An in-person consultation with an ophthalmologist was recommended for 1.9% of patients.

Conclusion:
Early experience with this full-scope, shared-care teleglaucoma program in Canada indicates it is a convenient, collaborative model of care for glaucoma suspects, and medically stable glaucoma patients.
Agreement between swept-source optical biometry and Scheimpflug-based topography measurements of posterior corneal curvature
Authors: Kose Bulent 
Published: June 2021

Purpose:
To evaluate agreement of posterior corneal curvature parameters between a swept-source optical coherence tomography–based biometer (IOLMaster 700) and Scheimpflug topography (Pentacam HR) in healthy, myopic eyes.

Setting:
Department of Ophthalmology, Osmangazi Aritmi Hospital, Bursa, Turkey.

Design:
Retrospective study.

Methods:
In this study, 59 eyes of 59 patients who applied as candidates for refractive surgery were included. Measurements of the posterior corneal curvature were performed using IOLMaster 700 and Pentacam HR. J0 and J45 vector components were calculated using astigmatic values. Posterior corneal keratometry (K) measurements at flat (K flat) and steep (K steep) axes and J0 and J45 values were compared between the 2 devices. The agreement between the devices was analyzed using the Bland-Altman method. Intraclass correlation coefficients and within-subject SD were calculated to assess the repeatability.

Results:
59 eyes of 59 patients were included in this study. The IOLMaster 700 provided significantly flatter K flat and K steep values (P < .001, for both). Significant differences were found in J0 and J45 values (P = 0.13 and P < .001, respectively). The mean differences between K flat, K steep, and J0 and J45 values were 0.49 diopter (D), 0.53 D, 0.04 D, and −0.05 D, respectively.

Conclusions:
The IOLMaster 700 and the Pentacam HR could not be used interchangeably to measure K flat, K steep, and J0 and J45 values of the posterior corneal curvature in healthy, myopic eyes. Both devices showed high repeatability for posterior corneal curvature measurement.
Comparison of contact lens–assisted and transepithelial corneal crosslinking with standard epithelium-off crosslinking for progressive keratoconus: 24-month clinical results
Authors: Malhotra Chintan , Gupta Barkha , Jain Arun K. , Dhar Supriya , Gupta Amit , Balyan Monika 
Published: June 2021

Purpose:
To compare the outcomes of contact lens–assisted corneal crosslinking (CACXL) and transepithelial CXL (TECXL) with standard epithelium-off (epi-off) CXL for progressive keratoconus.

Setting:
Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Design:
Retrospective, comparative study.

Methods:
Patients with progressive keratoconus undergoing CXL with a minimum follow-up of 24 months were included. CACXL and TECXL were performed in patients with epithelium-on minimal pachymetry between 350 μm and 450 μm. The main outcome measures included change in maximum keratometry (Kmax), corrected distance visual acuity (CDVA), and efficacy in halting progression (increase in Kmax ≥1 diopter [D]).

Results:
Standard epi-off CXL, CACXL, and TECXL were performed in 34, 14, and 10 eyes, respectively. Baseline Kmax and CDVA were comparable for all groups. Kmax reduced significantly by −2.83 ± 3.35 D, −3.18 ± 2.74 D, and −2.02 ± 1.66 D in the standard epi-off CXL (P < .01), CACXL (P = .001), and TECXL (P = .004) groups, respectively; the reduction was comparable for all groups (P = .63). CDVA improved by −0.14 ± 0.24, −0.04 ± 0.19, and −0.12 ± 0.17 logMAR in the standard epi-off CXL (P = .006), CACXL (P = .42), and TECXL (P = .05) groups, respectively; the reduction was comparable for all groups (P = .46). Progression was documented in 2 eyes (6%) in the standard epi-off CXL group and in 0 eyes of the CACXL and TECXL groups (P = .61).

Conclusions:
CACXL and TECXL were comparable with the standard epi-off CXL for progressive keratoconus.
Neuronal basis for pain-like and anxiety-like behaviors in the central nucleus of the amygdala
Authors: Chen Wei-Hsin , Lien Cheng-Chang , Chen Chien-Chang 
Published: June 2021

Abstract
Chronic pain is often accompanied by anxiety and depression disorders. Amygdala nuclei play important roles in emotional responses, fear, depression, anxiety, and pain modulation. The exact mechanism of how amygdala neurons are involved in pain and anxiety is not completely understood. The central nucleus of the amygdala contains 2 major subpopulations of GABAergic neurons that express somatostatin (SOM+) or protein kinase Cδ (PKCδ+). In this study, we found about 70% of phosphorylated ERK–positive neurons colocalized with PKCδ+ neurons in the formalin-induced pain model in mice. Optogenetic activation of PKCδ+ neurons was sufficient to induce mechanical hyperalgesia without changing anxiety-like behavior in naïve mice. Conversely, chemogenetic inhibition of PKCδ+ neurons significantly reduced the mechanical hyperalgesia in the pain model. By contrast, optogenetic inhibition of SOM+ neurons induced mechanical hyperalgesia in naïve mice and increased phosphorylated ERK–positive neurons mainly in PKCδ+ neurons. Optogenetic activation of SOM+ neurons slightly reduced the mechanical hyperalgesia in the pain model but did not change the mechanical sensitivity in naïve mice. Instead, it induced anxiety-like behavior. Our results suggest that the PKCδ+ and SOM+ neurons in the central amygdala exert different functions in regulating pain-like and anxiety-like behaviors in mice.
The Impact of Serotonin Transporter Binding Affinity on the Risk of Bleeding Related to Antidepressants
Authors: Gahr Maximilian , Connemann Bernhard J. , Muche Rainer , Zeiss René 
Published: June 2021

Abstract

Purpose/Background
The alleged primary mechanism underlying bleeding events associated with antidepressants is inhibition of serotonin uptake in platelets resulting in reduced platelet aggregability and activity, and prolonged bleeding time. There is some evidence that a substance's degree of serotonin reuptake inhibition in terms of its binding affinity to the serotonin transporter (SERT) affects the magnitude of bleeding risk increase.

Methods/Procedure
To test this hypothesis, we performed data mining in the worldwide largest pharmacovigilance database (VigiBase) and conducted pharmacodynamically informed quantitative signal detection. Reporting odds ratios related to the standardized Medical Dictionary of Regulatory Activities query term “haemorrhages” and 24 antidepressants were calculated, and SERT binding affinities (pK
i) were obtained and correlated (Pearson correlation).

Findings/Results
A strong and statistically significant correlation between substance-related reporting odds ratios and SERT binding affinities was found (r = 0.63; 95% confidence interval, 0.30–0.82; P = 0.00097).

Implications/Conclusions
Our findings strengthen the hypothesis that inhibition of serotonin uptake contributes to the antidepressant-related bleeding risk and suggest an association between the degree of the SERT binding affinity and the bleeding risk. This supports the preferential use of antidepressants with low or no SERT binding affinity in depressed patients at risk of bleeding.