bluuebunny/crossref_metadata_2025_split huggingface dataset:
Basic concepts of exercise physiology for the vision and eye research community
Authors: Aracil‐Marco Adolfo 
Published: January 2024

The epidemiology of the second half of the 20th century has been marked by a transition from infectious to non‐communicable diseases. Instead of having a unique etiological cause, the non‐communicable diseases are believed to develop by the temporal confluence of several risk factors on a given individual. Risk factors of genetic origin are considered non‐modifiable nowadays. In contrast, behavioural risk factors, including lifestyle, are considered modifiable, and, therefore the preventive and adjuvant interventions aimed to reduce the risk or modify the natural course of non‐communicable diseases are based in lifestyle changes.Since the seminal work of Jeremy Morris in the 50's (the so‐called “London Bus Study”) epidemiological evidences have been accumulating over time on the potential role of a reduced physical activity in every domain of daily life as a risk factor for several non‐modifiable diseases. This is aggravated by the progressive trend of a reduced physical activity performed by the worldwide population during the last decades. The relationship of physical inactivity and/or sedentarism with several systemic diseases is clearly proven nowadays, and the underlying pathophysiological explanations are starting to be understood.In contrast what it happens in other organs or systems the potential effects of physical activity on ocular physiology and/or pathophysiology are still almost unknown. The design and development of future studies focused on these topics would need that the eye and vision research community is familiarized with: a) the current terminology on the field of physical activity and exercise; b) the hormetic properties of exercise, and consequently, the differences among acute responses and chronic adaptations to it; and, c) the potential physiological mechanisms ‐ranging from classical neuroendocrine responses to the recent concept of exerquines‐ that may explain them. All of them will be presented and discussed at this talk.
Can physical exercise influence the ocular surface homeostasis?
Authors: Serramito‐Blanco María 
Published: January 2024

Over the last two decades, physical exercise has experienced a great increase in its practice in developed populations, thanks to which the quality of life of people has improved and the risk of suffering from certain diseases has been reduced. The scientific literature has described what happens in some organs of the human organism concerning exercise, however, one of the little‐known organs in relation to physical exercise is the human eye.Recently, understanding what happens in the human eye with physical activity has gained interest among scientists. Specifically, in the last 5 years, studies have begun to be carried out on physical activity in relation to the changes it can cause on the ocular surface. The scientific literature currently available is diverse in terms of the population evaluated, the study design, and the analysis methodology. Published studies have described some effects on the ocular surface after acute exercise and others with chronic exercise. Some of them have followed an experimental design such as clinical trials or tear analysis and others an observational design utilizing subjective questionnaires on dry eye symptoms, obtaining promising results. A summarized vision of the most representative works on the field will be presented and discussed.
Natural history of mitochondrial optic neuropathies
Authors: Klopstock Thomas 
Published: January 2024

Mitochondrial optic neuropathies (MON) may occur as a single organ disease (non‐syndromic MON) or in the context of a multisystem mitochondrial disorder (syndromic MON). By far the most frequent MON are Leber's hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (ADOA). LHON is in most cases caused by mitochondrial DNA (mtDNA) mutations m.11778G>A, m.3460G>A or m.14484T>C, while ADOA is most frequently due to mutations in the OPA1 gene. As therapy trials have been performed, are ongoing or are planned for LHON and ADOA, it is important to know about the natural history of these disorders which may help to design trials or may serve as an external comparator.In LHON, an international observational retrospective registry (REALITY) analysed the visual course and outcome in 44 LHON patients, and found (after an average follow‐up time of 32.5 months) the mean best‐corrected visual acuity (BCVA) to be 1.46 LogMAR in m.11778G>A, 1.52 LogMAR in m.3460G>A, and 0.97 LogMAR in m.14484T>C mutations carriers. In line with previous findings, children below age 12 years at onset had the best visual prognosis. Since 25 of the 44 patients had taken idebenone at some point, this work does not qualify as a natural history study, though.A meta‐analysis of 12 retrospective and 3 prospective studies included data from 695 LHON patients with the m.11778G>A mutation. This meta‐analysis was hampered by the poor and variable definition of recovery among studies, and by the fact that idebenone use could not always be excluded. Main findings were some degree of recovery in 14.4% of patients, and 11.3% in those above age 15 years. Final BCVA of better than 1.0 logMAR was rare.In an own study of 83 LHON patients (73.5% with m.11778G>A mutation), BCVA at last observation was better than 1.0 logMAR in 18.1%, between 1.0 and 1.68 logMAR in 33.7% and worse than 1,68 logMAR (off‐chart) in 48.2%. Spontaneous recovery by at least 0.2 logMAR occurred in 16.3% of patients.In OPA1‐ADOA, a retrospective analysis of data from 64 affected patients showed a mean age at visual failure onset of 7.0 years (range 1.0–16.0 years), and a mean BCVA at last observation of 1.02 LogMAR. Longitudinal data in 43 OPA1 patients with a mean follow‐up duration of 18.0 years showed on average a slow visual decline of 0.032 LogMAR/year, but some patients deteriorated much faster (range 0–0.171 LogMAR/year).In conclusion, currently available data on the natural history of MON are hampered by retrospective analysis, low sample sizes, unsystematic phenotyping, variable definitions of key outcomes (eg, recovery) and often incomplete information on the administration of idebenone or other drugs. Large multicenter studies on natural history are needed but are more and more difficult to perform with the advent and sometimes even approval of disease‐modifying treatments.
Differences in Müller's glia between the central and peripheral retina and its effect in glaucoma
Authors: Vecino Elena , Pereiro Xandra , Ruzafa Noelia 
Published: January 2024

Glaucoma is a neurodegenerative disease and the leading cause of irreversible blindness in the world, whose main risk factor is increased intraocular pressure. When visual problems are first detected in patients with glaucoma, already half of the retinal ganglion cells (RGCs), the neurons that send visual information from the eye to the brain, have died principally in the peripheral retina. The timeframe of cell death is prolonged, lasting even decades after an initial diagnosis. Müller glia (MG) are the main macroglial cell in the retina, play prominent roles regulating normal and pathological physiology and react to neuronal injury in glaucoma. The change to a reactive phenotype of MG initiates signalling cascades that may serve a neuroprotective role, but may also proceed to promote damaging effects on RGCs. However, the underlying mechanisms and signalling pathways that specifically promote protective versus destructive roles of reactive glial cells are mostly unclear.Using cell cultures of Müller cells, retinal ganglion cells or cocultures subjected to hydrostatic pressure, we have been able to prove that Müller cells in the periphery react to pressure by secreting harmful proteins that induce ganglion cell death. Proteomic analysis has provided us with information on the different behaviour of Müller cells in the periphery versus those in the center.Elevated hydrostatic pressure on MG induces the expression of proteins associated to apoptosis, oxidative stress and inflammation in the peripheral MG. This study confirms that MG could have a role in RGCs death in glaucoma opening new avenues for research. Preventing MG response to elevated pressure, MG can neuroprotect RGCs in early stages of glaucoma.Supported by ELKARTEK (KK‐2019/00086), MINECO‐Retos (PID2019‐111139RB‐I00), PIBA (2020_1_0026), Grupos Consolidados Gobierno Vasco, UPV/EHU:
Inhibiting myopia development by the digital chromatic filters
Authors: Swiatczak Barbara 
Published: January 2024

We had previously found that simulated chromatic defocus, imposed by spatially filtering the RGB channels of the computer screen, induces significant changes in choroidal thickness already after 45 min (Swiatczak and Schaeffel, 2022). In emmetropes, the “red in focus” filter, which blurs the image in the blue channel and simulates myopic chromatic defocus, induced thickening of the choroid and eye shortening, while the “blue in focus” filter, which blurs the image in the red channel and simulates hyperopic chromatic defocus, induced thinning of the choroid and eye elongation. Strikingly, eyes that were already myopic were not responsive to these filters, suggesting that (1) they may no longer detect longitudinal chromatic aberration (LCA), (2) the imposed signal was too weak to induce significant changes in choroidal thickness, or (3) the signal was detected by the retina, but it was not transmitted to the choroidal tissue. To gain a better understanding of the underlying mechanisms and their roles in emmetropization, we measured in emmetropic and myopic subjects (1) the long‐term effect of repetitive exposure to the “red in focus” filter over 12 days of treatment, followed by 2 days of recovery, (2) the accommodation responses to visual targets with simulated myopic and hyperopic LCA, and (3) visual acuity and contrast sensitivity in red and blue light.Our results showed that as previously found for choroidal changes, simulated hyperopic or myopic LCA also affected accommodation. The “blue in focus” filter induced more accommodation than the “red in focus” filter (difference in emmetropes: 0.13D, p < 0.05). Strikingly, accommodation in myopic eyes was not responsive to simulated LCA. Moreover, visual acuity was severely reduced when subjects were looking through a short‐pass blue filter (cut‐off at 490 nm) compared to visual acuity in red light (long‐pass red filter, cut‐off at 610 nm) which was observed in both emmetropic and myopic subjects. Furthermore, emmetropes displayed higher contrast sensitivity in red than in blue light, but this difference was not found in myopes.Our findings confirm that there is a difference in retinal processing between emmetropes and myopes which includes lower sensitivity to LCA in myopes. Furthermore, we showed that these differences show up in both, changes in choroidal thickness as well as accommodation.
Soemmerring's rings developed in‐vivo can present internal transparent areas
Authors: D'Antin Justin Christopher , Tresserra Francesc , Barraquer Rafael I. , Michael Ralph 
Published: January 2024

Purpose: To test whether any part of Soemmerring's rings developed, in‐vivo, in adults could be transparent and how this transparency relates to morphological factors.Methods: Sixteen Soemmerring's rings were extracted from donor eye globes. After frontal imaging, they were thickly sectioned sagittally in order to analyse the degrees of transparency of the cross‐section both at the periphery and center. All samples were also histologically analysed using alpha smooth muscle actin, Vimentin, wheat germ agglutinin and DAPI in order to correlate transparency to certain morphological factors.Results: When viewed frontally within the dark field, all Soemmerring's ring samples were apparently opaque. However, after sectioning, 20 of the 30 samples were more transparent in the center than at the periphery. Of the morphological factors that we analysed, only lens fibre organization at the bow region and an increased area of mature lens fibre cells had a significant relation to the degree of transparency at the center of cross‐sections.Conclusions: Soemmerring's rings can maintain the ability to produce organized and transparent areas of lens cells.
Immunonutrition in glaucoma patients: A new microbiota‐based treatment
Authors: Zanon‐Moreno V. 
Published: January 2024

Glaucoma is one of the main causes of irreversible blindness, producing 12.3% of blindness worldwide. There are about 4.5 million people with glaucoma in the world. However, the real number should be much higher if we consider all people with undiagnosed glaucoma.Glaucoma is an age‐related multifactorial disease determined by both genetic and environmental factors. The cause remains unknown. So, efforts are focused on preventing blindness through early diagnosis and hypotensive treatment, which is not always effective. Currently, neuroprotective treatment is also considered.Among the most studied processes in relation to optic nerve degeneration in glaucoma are inflammation and apoptosis. Several studies show that genes associated with inflammation are upregulated in the trabecular meshwork, which could be related to the onset or progression of glaucoma. However, the most visible manifestations of inflammation in glaucoma occur on the ocular surface. This produces, for example, an infiltration of inflammatory cells and a reduction in corneal sensitivity. Like inflammatory processes, apoptosis has been associated with glaucomatous disease. In fact, vision loss is caused by the death of retinal ganglion cells (RGCs), whose axons form the fibres of the optic nerve. The survival of RGCs is key to the prevention of glaucomatous blindness.The ocular microbiota has recently been studied, analysing the possible association between the inflammatory molecules produced by the ocular microbiome and the etiopathogenic mechanisms of this optic neuropathy.The aim of these studies is the development of probiotics as a therapy for glaucoma. Probiotic strains allow a rapid and stable recovery of the normal ocular microbiota, providing faster anti‐inflammatory and antihistamine effects. In addition, they are antagonists of the pathogens without the risk of the appearance of resistance, which avoids the use of antibiotics. In this way, probiotics represent an alternative to the abusive use of antibiotics, thus avoiding the problem of resistance development. In this sense, polyphenols are very interesting since they are capable of exerting neuroprotective and immunomodulatory effects and also can remodel the microbiota.
Glaucoma pharmacogenetics. Role in neuroprotection
Authors: Milla Elena 
Published: January 2024

Glaucoma is a blinding disease that can occur at all ages, with Mendelian inheritance typical for the rare early onset disease (before age 40) and complex inheritance evident in common adult‐onset forms of disease. Genetic and genomic studies, including genome‐wide association studies (GWAS) have identified new genetic variants contributing to glaucoma in the last years. Genes correlating with glaucoma risk may involve: ocular development, intraocular pressure, trabecular meshwork function or some of them are directly related to optic nerve susceptibility such as retinal ganglion cell membranes, mitochondrial function, reactive oxygen species production and management, and mechanisms controlling apoptosis. These findings are providing new insights into the underlying molecular mechanisms responsible for glaucoma that could eventually lead to novel gene‐based therapies, including strategies for neuroprotection.We present our study about the genetic analysis of a cohort of Spanish patients with primary open‐angle glaucoma to determine the contribution of rare variants associated with this disease through next generation sequencing (NGS) glaucoma gene panel, as a future method of diagnosis and early treatment. We found some rare variants associated with optic disk parameters and function in some families with high and normal tension glaucoma with allelic frequencies significantly higher than the frequency in the general population by NGS. Those rare variants are located in SIX6, CARD10, MFN1, OPTN, and WDR36 glaucoma‐related genes.These risk variants have been associated to the alteration of retinal ganglion cells through different mechanisms, thereby increasing the risk of glaucoma‐associated vision loss.The discovery of new genetic variants associated with augmented susceptibility of the optic nerve may in the future open the door to designing new neuroprotection gene therapies aimed at repairing damaged genes or providing them through different vectors.
Surgery after corneal grafts
Authors: Karmiris Efthymios 
Published: January 2024

There is one available donor per 70 patients so we need to identify those whose vision would benefit from corneal transplantation and minimize risks that could jeopardize corneal graft survival possibility1.The two leading causes of graft failure post Penetrating Keratoplasty (PKP) are graft rejection and secondary glaucoma development. The existence of preoperative glaucoma increases two to three times the chances of graft rejections in any corneal transplantation2,3. The 10‐year Cornea Donor Study also confirmed that pre‐existing glaucoma is a risk factor for graft failure4. The 3‐year graft survival rate has been shown to be 71% in patients with preop glaucoma and 89% in patients without preop glaucoma5.In cases following Descemet Striping Endothelial Keratoplasty (DSAEK), Ocular Hypertension (OHT) ranges in otherwise healthy eyes from 29 to 47% and increases to 43 to 54% in cases with pre‐existing glaucoma or high‐risk eyes. Glaucoma can be presented in up to 15% in post‐DSAEK cases which increases twice the relative risk of rejection. Concurrent gonio‐synechiolysis is considered an additional risk factor whereas 18.6% of high IOP cases considered as secondary to steroid administration. Acute raise in IOP can be attributed in pupillary block at an estimated rate of 13%6,7.In cases of Descemet Membrane Endothelial Keratoplasty (DMEK) OHT or intraocular pressure (IOP) elevation is presented to 6.5 up to 11.1% and de novo glaucoma can be found from 2.8 to 6.5%, whereas progression of pre‐existing glaucoma is less than 2.5%8. In cases with simultaneous DMEK and cataract surgery there is greater likelihood of post‐op OHT or glaucoma. In DMEK cases the early postoperative increase in pressure is usually due to a combination of anterior (inferior) and posterior (superior) pupillary blocks when patient is sitting upright9.The late post‐DMEK IOP increase is attributed to Blockage of TM by inflammatory cells, PAS formation or steroid use. However, steroid‐induced glaucoma post‐DMEK is not as common as that in post‐PKP or post‐DSAEK due to the shortest steroid regime post‐DMEK cases. Treatment methods include medical treatment, trabeculectomy or tubes. Some cases with Xen®10 and Micropulse cyclodidode11 laser have been reported in endothelial cases, however with little degree of evidence.Controversy still exists to which surgical procedure is the best for graft survival and IOP control, as well as when is the best time of the surgery in patients with pre‐existing glaucoma, before, simultaneously or after, and if needed, graft surgery. Certainly a “try not to create glaucoma” strategy needs always to be followed by not producing additional iatrogenic risk factors with improved technique(s) and by respecting the tissue(s).
Macular pigment profile characteristics and stability over periods of up to 25 years
Authors: Robson Anthony G. , Van Kuijk Frederik , Pauleikhoff Daniel , Moreland Jack 
Published: January 2024

This study compares the foveal and total retinal macular pigment (MP) amount in healthy subjects and examines the stability of MP spatial distribution profiles, measured almost annually for periods of up to 25 years.Measurements of MP spatial distribution profiles were made by 51 subjects using the psychophysical technique of minimum motion photometry, utilizing a moving bichromatic grating (test 460 nm, comparison 580 nm). Two foveal fields (0.9° and 2.2° diameter) and 11 annular segments (eccentricities from 0.8° to 7.5°) were used. The total amount of MP within the central 15 degrees was estimated by numerical integration and compared with foveal values. Four subjects with widely different MP profiles underwent almost annual testing for periods of 19–25 years. Eleven of the same subjects and 19 others underwent 2‐wavelength autofluorescence (AF) assessment of MP using a scanning laser ophthalmoscope (incident radiation 488 nm and 514 nm), allowing quantification of the peak relative optical density, distribution and total complement of MP over the central 21 degrees.Detailed examinations revealed widely different MP distribution profiles using motion photometry and/or 2‐wavelength fundus autofluorescence. There was a lack of correlation between peak MP optical density at the fovea and assessments of the total complement of MP within the central 15 or 21 degrees. Serial psychophysical assessments over periods of 19–25 years in 4 cases demonstrated a high degree of stability at all macular locations including the fovea; plots of peak MP optical density against time showed minimal positive and negative gradients (<0.0003).The total amount of macular pigment cannot be accurately estimated from foveal or central values. Widely different MP distribution profiles in healthy subjects demonstrate a high degree of long‐term stability, relevant to investigations that aim to monitor MP or fundus autofluorescence in disease or in studies that aim to modify MP through dietary supplementation.
Different techniques in transscleral cyclophotocoagulation
Authors: Palarie Natalia 
Published: January 2024

Transscleral cyclophotocoagulation (TSCPC) is a minimally invasive laser procedure used to reduce intraocular pressure in patients with glaucoma. By selectively coagulating the ciliary body, TSCPC reduces the production of aqueous humour and lowers intraocular pressure. TSCPC can be performed using various laser delivery methods, including “pop”‐titrated (PT–CPC), “slow‐burn” (SB‐CPC), and micropulse techniques (MP‐CPC).MP‐TSCPC has been shown to be effective in lowering IOP in patients with mild to moderate glaucoma, but may be less effective in patients with more advanced glaucoma or those with higher baseline IOP levels. PT/SB‐CPC, on the other hand, has been shown to be effective in lowering IOP in patients with refractory glaucoma who have not responded to other treatment options. Although there is a lot of research on the efficacy and safety of TSCPC, there is still limited data available, particularly comparing different TSCPC techniques.The present talk will summarize our experience with different TSCPC techniques, including patient selection, potential risks and benefits.
Application of gonioscopy‐assisted transluminal trabeculotomy (GATT) in the management of refractory glaucoma in Poland
Authors: Kosior‐Jarecka Ewa 
Published: January 2024

Goniotomy assisted transluminal trabeculotomy (GATT) is a kind of ab interno angle procedure. GATT spares conjunctiva and sclera, so it is a real mini invasive glaucoma surgery (MIGS). MIGS techniques are typically used in cases of early and moderate open angle glaucoma.The aim is to present the possibility of GATT application in the selected types of refractory glaucoma or secondary open angle glaucoma which are believed to be difficult in management.The results of GATT application in refractory glaucoma, inflammatory glaucoma and silicon oil glaucoma will be presented with the evaluation of IOP lowering potential in short term observation. Additionally, selected clinical cases will be showed.