bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microspherophakia and Lens Subluxation in Klinefelter Syndrome: A Case Report
Authors: Van Laeken Jana , Leysen Laura , Keer Karel Van 
Published: June 2024

Purpose:
To report a rare case of microspherophakia and lens subluxation in a young patient with Klinefelter syndrome who underwent cataract surgery, emphasizing the importance of a thorough general health assessment and anamnesis prior to cataract surgery.

Methods:
The case concerns a 52-year-old male referred for phacoemulsification under general anesthesia. A review of literature was performed.

Results:
Preoperative assessment revealed a corticonuclear cataract in both eyes, with dislocation of the crystalline lens in the left eye in an area of zonular dehiscence. Upon careful examination, both eyes showed a microspherophakic lens with an increased lens thickness and the lens equator being visible over 360° in the left eye. The patient denied any trauma or medical conditions. His medical health record revealed the coexistence of Klinefelter syndrome (47, XXY). The association between Klinefelter syndrome and microspherophakia has only once been reported in the literature. Intraoperatively, a more cautious approach was withheld and a capsular tension ring was used. Postoperative outcome was successful with good visual outcome and no interoperative complications.

Conclusions:
This case report highlights the importance of proper preoperative assessment before cataract surgery, especially in unusual cases such as early-onset cataract and/or lens subluxation. In addition, it stresses the importance of a systemic and/or genetic evaluation in patients with microspherophakia and an ophthalmological examination in patients with Klinefelter syndrome.
Risk of Missed Diagnosis of Primary Open-Angle Glaucoma by Eye Care Providers
Authors: Doozandeh Azadeh , Yazdani Shahin , Pakravan Mohammad , Ghasemi Zohreh , Hassanpour Kiana , Hatami Mehdi , Ansari Iman 
Published: June 2024

Purpose:
To evaluate the efficacy of opportunistic case finding in glaucoma detection and to determine factors associated with failure of glaucoma detection by eye health providers.

Methods:
This study was conducted on 154 new definite primary open-angle glaucoma (POAG) patients presenting to our glaucoma clinic. A questionnaire was prepared to determine if these subjects had sought eye care up to 12 months before presentation. The type of eye care provider and the principal reason for the visit were probed. The primary outcome measure was the frequency of a correct glaucoma diagnosis in their index visit. The secondary outcomes were factors associated with missed POAG diagnosis.

Results:
The great majority of study subjects (132 cases, 85.7%) had sought at least one ocular examination within 1 year before presentation. Among these patients, 73 cases (55.3%) had remained undiagnosed after the examination. Among the probed variables, age, gender, visual acuity, visual field defects, intraocular pressure, cup/disc ratio, nerve fiber layer thickness of the worse eye at presentation, and family history of glaucoma were comparable between correctly diagnosed and missed POAGs. The only factors significantly associated with missed POAG diagnosis were lack of significant refractive errors and visiting an optometrist rather than an ophthalmologist.

Conclusions:
The efficacy of opportunistic case finding for POAG seems to be less than ideal in our settings. Lack of a significant refractive error and visiting an optometrist rather than an ophthalmologist were associated with a missed diagnosis of POAG. These observations reflect the need to adopt policies to improve glaucoma screening by eye care providers.
Supracor Multifocal Corneal Laser-Assisted In Situ Keratomileusis Procedure for the Correction of Presbyopia in Hyperopic Eyes
Authors: Hashemian Seyed Javad , Hadi Yasaman , Es’haghi Acieh , Jafari Mohammad Ebrahim 
Published: June 2024

Purpose:
To investigate the outcomes of unilateral Supracor treatment to enhance near vision while maintaining good distance vision in hyperopic eyes.

Methods:
This prospective interventional study includes consecutive hyperopic patients with presbyopia. All eyes underwent femtosecond laser-assisted in situ keratomileusis treatment for hyperopia with an additional Supracor multifocal treatment algorithm in nondominant eyes. Monocular and binocular uncorrected and spectacle-corrected distance visual acuity (UCDVA and SCDVA), monocular and binocular uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity at 40 cm and high-order aberration changes and complications were evaluated for 6 months.

Results:
Sixty-four patients with a mean age of 51.91 ± 3.64 were enrolled. After 6-month follow-up, the mean binocular UCDVA and UNVA were 0.03 ± 0.05 and 0.04 ± 0.06 logMAR, respectively. UCDVA (logMAR) of nondominant and dominant eyes was 0.30 ± 0.18 and 0.03 ± 0.05, respectively. Preoperative and postoperative mean ± standard deviation manifest refraction spherical equivalent was +1.84 ± 0.75 and −0.48 ± 0.57, respectively, in nondominant eyes and +1.77 ± 0.69 and +0.12 ± 0.33, respectively, in dominant eyes. No complications were observed.

Conclusion:
Supracor procedure in nondominant eyes may improve functional near, intermediate, and distance vision without significant photic phenomena in presbyopic patients with low and moderate hyperopia.
Agreement between a Spectral-Domain Ocular Coherence Tomography Biometer with a Swept-Source Ocular Coherence Tomography Biometer and an Optical Low-Coherence Reflectometry Biometer in Eyes with Cataract
Authors: Zarei-Ghanavati Siamak , Nikpayam Majid , Namdari Maral , Bakhtiari Elham , Hassanzadeh Samira , Ziaei Mohammed 
Published: June 2024

Purpose:
To assess the agreement between biometric parameters measured by a spectral-domain optical coherence tomography optical biometer device (Optopol Revo NX) with a validated swept-source biometer (IOLMaster 700) and a validated optical low-coherence reflectometry biometer (Lenstar LS 900), in cataract surgery candidates.

Methods:
In this prospective comparative study, 100 patients (100 eyes) who were eligible for cataract surgery were involved. Bland–Altman plots were used to assess agreement between devices for biometric parameters including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT).

Results:
AL measurements were successful in 82 eyes (82.0%) with Revo NX, in 91 eyes (91.0%) with Lenstar LS 900, and in 97 eyes (97.0%) with IOLMaster 700. When Revo NX was compared to IOL Master 700 and Lenstar LS 900, the mean differences were as follows: −0.02 ± 0.02 mm and −0.02 ± 0.03 mm (P = 0.313, P = 0.525) for AL, 0.01 ± 0.03 mm and 0.10 ± 0.03 mm (P = 0.691, P = 0.002) for ACD, −0.15 ± 0.03 mm and 0.001 ± 0.04 mm (P < 0.001, P = 0.95) for LT, and −2.29 ± 0.92 μm, and 0.73 ± 1.43 μm (P = 0.015, P = 0.612) for CCT. Three devices were highly correlated for AL, ACD, LT, and CCT (interclass correlation coefficient > 0.75). Bland–Altman plots showed a narrower 95% limit of agreement (−0.35 to 0.31) between Revo NX and IOLMaster 700 in measuring AL.

Conclusions:
Despite the higher measurement failure rate in eyes with cataract, the Revo NX showed very good agreement with the IOLMaster 700 and Lenstar LS 900 optical biometers in measuring AL, ACD, LT, and CCT. However, ACD and LT measurements cannot be considered interchangeable between these devices.
A Giant Mass in the Eyelid: Peripheral T-Cell Lymphoma, Not Otherwise Specified
Authors: Yuksel Nilay , Koc Sule Idaci , Can Ferda , Dilek Imdat 
Published: June 2024

Purpose:
To report a case with an unusual giant mass in the eyelid which was diagnosed as peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS).

Methods:
A 40-year-old woman was referred with a 1-year history of rapidly and constantly growing eyelid mass.

Results:
The patient underwent an incisional biopsy and histopathological examination revealed a PTCL-NOS. After achieving regression by the combination of cyclophosphamide, hydroxydoxorubicin, vincristine (oncovin), etoposide, and prednisolone therapy, the remaining crusts were debrided, the eyelids were separated, and the wound was left to heal by secondary intention. Cicatricial ectropion of the lower eyelid occurred during follow-up and it was corrected with a free skin graft successfully.

Conclusion:
PTCL-NOS is uncommon but it may reach massive dimensions in the eyelid region.
Plateau Iris: A Review
Authors: Tabatabaei Seyed Mehdi , Fakhraie Ghasem , Ansari Shabnam , Hamzeh Nikoo , Safizadeh Mona , Beikmarzehei Alireza 
Published: June 2024

Purpose:
To review the concept of plateau iris and summarize the recent evidence on its diagnosis and management.

Methods:
This is a narrative review on the plateau iris. A literature review was conducted in PubMed, Google Scholar, and Scopus databases using keywords: angle-closure glaucoma, glaucoma, nonpupillary block glaucoma, plateau iris, and plateau iris management.

Results:
This review defined the current knowledge about plateau iris. First of all, the anatomy and epidemiology were discussed. Then, we outlined the available evidence on the diagnosis of plateau iris and its differential diagnosis. Conclusively, the treatment options were mentioned.

Conclusions:
Plateau iris is a condition in which nonpupillary block mechanisms are responsible for intraocular pressure elevation and angle closure attack when a patent peripheral iridotomy has removed the relative pupillary block. An anteriorly positioned ciliary body causes mechanical obstruction of trabecular meshwork in these patients. It is usually seen in younger patients with angle closure and is diagnosed by gonioscopic examination and imaging modalities such as Ultrasound biomicroscopy. Despite the known mechanism of plateau iris, there is no consensus over treatment. Low-dose pilocarpine and Argon laser peripheral iridoplasty are nonsurgical treatments for these patients, but their effects are short-term. Cataract extraction with/without endocyclophotocoagulation (ECP), endocycloplasty, excisional goniotomy, and transscleral cyclophotocoagulation are alternative treatments. Patients should be examined periodically for further progression or recurrence of plateau iris. In cases of glaucoma unresponsive to conventional medical treatments, surgical treatments such as trabeculectomy and drainage devices should be considered.
Retinal Optical Coherence Tomography Angiography Findings following Retinoblastoma Treatment by Chemotherapy
Authors: Riazi-Esfahani Hamid , Shamouli Hadi , Pour Elias Khalili , Fadakar Kaveh , Khodabandeh Alireza , Masoomian Babak , Hatami Vahid , Ghassemi Fariba 
Published: June 2024

Purpose:
To investigate the macular microvascular changes after different kinds of chemotherapy in patients with extramacular retinoblastoma (RB).

Methods:
In this study, 28 eyes of 19 patients with bilateral RB treated with intravenous systemic chemotherapy (IVSC group) and 12 eyes of 12 patients with unilateral RB treated with intra-arterial chemotherapy (IAC group) were compared with 6 normal fellow eyes of 6 patients with unilateral RB treated with IVSC (IVSC fellow eye group), and 7 normal fellow eyes of 7 unilateral RB patients treated with IAC (IAC fellow eye group), as well as 12 age-matched normal eyes. Enhanced depth imaging optical coherence tomography measurements of central macular and subfoveal choroidal thickness (CMT and SFCT) as well as optical coherence tomography angiography measurements such as retinal superficial capillary density (SCD), deep capillary density (DCD), and choriocapillaris density were documented.

Results:
Images of 2 eyes in the IVSC group and 8 eyes in the IAC group were excluded from the final image analysis due to severe retinal atrophy. Overall, 26 eyes with bilateral RB treated with IVSC and 4 eyes of 4 patients with unilateral RB treated with IAC were compared with the mentioned control groups. Best-corrected visual acuity was 1.03 logMAR in the IAC patients compared to 0.46 logMAR in the IVSC group at the time of imaging. While the CMT and SFCT were lower in the IAC group in comparison with the IAC fellow eye and normal groups (P < 0.05 for all), no remarkable difference was observed between the IVSC group and the control groups based on the mentioned parameters. Although the SCD showed no significant difference between the IVSC and control groups, this parameter was significantly lower in the eyes receiving IAC relative to the corresponding fellow eye group (P = 0.042) and normal control eyes (P = 0.047). The mean DCD was considerably lower in both the treatment groups compared to the control groups (P < 0.05 for all).

Conclusion:
Our study showed a substantial decrease in SCD, DCD, CMT, and choroidal thickness in the IAC group, which may explain the lower visual outcome in this group.
Comparison of Intraocular Lens Power Calculation between Standard Partial Coherence Interferometry-Based and Scheimpflug-Based Biometers: The Importance of Lens Constant Optimization
Authors: Sardari Sara , Khabazkhoob Mehdi , Jafarzadehpur Ebrahim , Fotouhi Akbar 
Published: June 2024

Purpose:
To compare the intraocular lens (IOLs) power calculated with Haigis, Hoffer Q, Holladay 1, and SRK/T formulas between the IOLs Master 500 and Pentacam AXL according to the lens status.

Methods:
In this cross-sectional study, sampling was done in subjects above 60 years living in Tehran using multi-stage cluster sampling. All participants underwent optometric examinations including the measurement of visual acuity and refraction as well as slit-lamp biomicroscopy to determine the lens status. Biometric measurements and IOLs power calculation were done using the IOL Master 500 and Pentacam AXL. The order of imaging modalities was random in subjects. IOL power calculation was done according to optimized ULIB constants for the Alcon SA60AT lens. The IOL power was calculated according to a target refraction of emmetropia in all subjects.

Results:
After applying the exclusion criteria, 1865 right eyes were analyzed. The mean IOL difference between the two devices was −0.33 ± 0.35, −0.38 ± 0.39, −0.41 ± 0.43, and −0.51 ± 0.43 according to the SRK/T, Holladay, Hoffer Q, and Haigis formulas, respectively. The Pentacam calculated larger IOL power values in all cases. The 95% limits of agreement (LoA) between the two devices for the above formulas were −1.01 to 0.35, −1.14 to 0.39, −1.25 to 0.43, and −1.35 to 0.33, respectively. The best LoA were observed in normal lenses for all formulas. The difference in the calculated IOL power between the two devices using the four formulas had a significant correlation with axial length, mean keratometry reading, and anterior chamber depth. According to the results of the four formulas, mean keratometry reading had the highest standardized regression coefficient in all formulas.

Conclusion:
Although the difference in the calculated IOL power between IOL Master 500 and Pentacam AXL is not significant clinically, the results of these two devices are not interchangeable due to the wide LoA, especially for the Haigis formula; therefore, it is necessary to optimize lens constants for the Pentacam.
Unplanned Reoperation following Vitreoretinal Surgery
Authors: Akbarzadeh Ali , Zand Amin , Rahimi Masoud , Mirshahi Reza , Parvaresh Mohammad Mehdi , Falavarjani Khalil Ghasemi 
Published: June 2024

Purpose:
To evaluate the incidence of unplanned return to the operating room following vitreoretinal surgery and assess the reasons.

Methods:
In this retrospective case series, medical records of all patients who underwent vitreoretinal surgery were reviewed to determine the incidence and reasons of early (<30 days postoperatively) and late (≥30 days postoperatively) unplanned reoperations after the surgery.

Results:
A total of 488 eyes of 468 patients with a mean age of 55.84 ± 18.23 years were included. Fourteen percent (68/488) of eyes required one or more unplanned reoperation following their primary surgery. These include 3.9% (19/488) for the early and 10.0% (49/488) for the late reoperation. The most common primary reason for baseline surgery was rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy (PVR, 38.2%), followed by RD with PVR (23.5%), and tractional RD (TRD, 19.1%). Unplanned reoperations were most common in RD with PVR (19.3%), RRD without PVR (17.2%), and TRD (14.4%). Overall, the most common reasons of the first unplanned reoperation were repeated RD with PVR (27.9%), repeated RD (19.1%), and the presence of silicone oil (SO) in the anterior chamber (AC) (10.3%). For early unplanned reoperations, SO in AC, postoperative endophthalmitis, and persistent hyphema were the most common causes. Repeated RD with PVR was the most prevalent cause of late unplanned reoperations (34.7%). In the multivariate analysis, preoperative best-corrected visual acuity (BCVA) was significantly lower in eyes with unplanned reoperation than in eyes without (P = 0.011).

Conclusions:
Unplanned reoperation following vitreoretinal surgery is not very common, and occurs mostly in the setting of PVR, RRD, and TRD. Lower preoperative BCVA may indicate an increased chance of future unplanned reoperation(s).
An Update on Anti-Vascular Endothelial Growth Factor Treatment for Retinopathy of Prematurity
Authors: Nowroozzadeh M. Hossein , Sadeghi Elham , Shahriari-Garaee Hossein , Badie Mohammad Reza , Banihashemi Javad , Garg Sunir J. 
Published: June 2024

Purpose:
To present updated information on the role of anti-vascular endothelial growth factor (anti-VEGF) therapy for treating retinopathy of prematurity (ROP).

Methods:
We searched through PubMed and Scopus databases using the keywords of this article and gathered relevant published articles from the year 2005 to December 2022. The selected articles were classified and summarized, and reasonable conclusions were made accordingly.

Results:
Considering the current evidence, anti-VEGF agents are superior to laser therapy for the initial treatment of type 1 ROP in zone 1 or posterior zone 2. However, there is a substantial risk of reactivation or persistent avascular retina after solo treatment with anti-VEGFs, and many cases may require laser therapy within the following weeks or months. Thus, vigilant follow-up examinations are mandatory.

Conclusions:
The role of anti-VEGF agents in the treatment of ROP is indispensable. However, future studies are required to improve indications and dosage and determine long-term ocular and systemic safety.
Ab-interno Trabeculotomy Procedures: A Review
Authors: Meshksar Aidin , Razeghinejhad Mohammad Reza , Azimi Ali 
Published: June 2024

Purpose:
To discuss the safety and efficacy of various forms of ab-interno trabeculotomy procedures.

Methods:
A comprehensive search in PubMed and Google Scholar was done using the keywords “glaucoma”, “microinvasive glaucoma surgery”, “complications”, “goniotomy”, and “trabeculotomy”. Publications discussing ab-interno trabeculotomy procedures were selected; furthermore, the relevant references in these articles were gathered and the search was updated during the article preparation. Since gonioscopy-assisted transluminal trabeculotomy was first introduced in 2014, we had no time restriction.

Results:
Ab-interno trabeculotomy procedures, as a type of minimally invasive glaucoma surgeries, facilitate the natural trabecular outflow and lower the intraocular pressure (IOP) while preserving the conjunctiva for possible future glaucoma surgeries. It can be done alone or in combination with cataract surgery and effectively lowers the IOP and the number of antiglaucoma medications in various forms of glaucoma.

Conclusion:
By appropriate patient selection, ab-interno trabeculotomy could be selected as a safe and effective procedure in the management of various forms of glaucoma either as an isolated procedure or in combination with cataract extraction.
Peripapillary Retinal Nerve Fiber Layer Thickness and its Ocular and Systemic Determinants in an Elderly Population: A Population-Based Study
Authors: Rafati Shokoofeh , Khabazkhoob Mehdi , Mortazavi Mehdi , Asharlous Amir 
Published: June 2024

Purpose:
To determine the distribution, ocular, and systemic determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) using spectral-domain optical coherence tomography (SD-OCT) in an elderly population.

Methods:
This report is a part of the Tehran Geriatric Eye Study, a population-based cross-sectional study conducted in Tehran, the capital of Iran. The study population was all residents aged 60 years and above in Tehran. The sampling was performed using a multi-stage stratified random cluster sampling method. All study participants underwent ocular examination (including measurement of visual acuity, objective and subjective refraction, and slit-lamp biomicroscopy), anterior segment imaging using Pentacam HR, and ocular biometry using IOLMaster 500. The OCT imaging was performed for a random subsample (1307 individuals) using Spectralis SD-OCT.

Results:
Two thousand two hundred and forty-six eyes of 1189 individuals were analyzed for this report. Of these, 691 (58.1%) were female, and the mean age of the participants was 67.3 ± 5.9 years (60–94 years). The mean overall pRNFLT was 98.6 μ (95% confidence interval [CI]: 98.0–99.3). There was a statistically significant difference in pRNFLT between different quadrants; the highest and lowest mean pRNFLT was related to inferior and temporal quadrants, respectively (P < 0.001). The multiple generalized estimating equation model showed that older age (coefficient: −0.15 [95% CI: −0.24 to −0.06], P = 0.001), diabetes (coefficient: −1.69 [95% CI: −2.82 to −0.55], P = 0.004), and longer axial length (coefficient: −0.52 [95% CI: −0.83 to −0.22], P < 0.001) were significantly associated with a decreased overall pRNFLT. Higher body mass index was significantly related to an increased overall pRNFLT (coefficient: 0.19 [95% CI: 0.07 to 0.30], P = 0.002).

Conclusions:
The results of the present study can be used as a reference database for pRNFLT in the elderly population. Considering ocular and systemic determinants of pRNFLT is necessary for correct clinical interpretation of this parameter.