bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of visual electrophysiology measures in optic neuropathy
Authors: Thompson Dorothy , Prise Katrina , Tucker Lisa , Roche Dermot , Handley Sian , Marmoy Oliver 
Published: January 2024

Aims/Purpose: Our aim is to explore the inter‐relationship of clinical PVEP and PERG measurements with each other and the optic nerve structure in children investigated for possible optic neuropathies.Methods: ISCEV Standard PVEPs and PERGs to 50′ check widths to large 30 and standard 15 degree fields were reviewed from children suspected to have optic neuropathy of various pathology. Amplitudes and peak times of PERG P50, N95, the N95:P50 amplitude ratio, the amplitude of the N95 from baseline and at 30 ms from the P50‐N95 slope were measured. Spectralis OCT RNFL sector measures and macular ganglion cell volumes were collated.Results: PERG, PVEP with OCT measurements were available for 42 patients, (83 eyes) aged 6‐17 yrs. Those with abnormal PVEPs (33 eyes) had the most severe macular RGC volume loss (mean 0.26 mm3 in 3.45 mm) with mean LogMAR VA 0.52 (range − 0.01 to 1.00). These patients had inherited optic neuropathies, optic neuritis associated with MOGAD and RMMS. In contrast, patients with papilledema, such as associated with IIH, or presenting with headache and reduced vision and full discs had normal PVEPs. Mean VA LogMAR 0.23 (range − 1.0 to 0.9), and mean macular RGC volume 0.45 mm3 in 3.45 mm circle. N95:P50 amplitude ratios ranged from 1.83 to 0.44 in 30 degree fields and 2.16 to 0.36 in 15 degree fields. The N95:P50 amplitude ratios, slope at 30 ms and N95 from baseline correlated with macular RGC volume, but the best PERG discriminator (AUC 0.83) in the large field was the N95 slope measured at 30 ms. RNFL values were confounded by disc oedema in many cases.Conclusions: Pattern reversal VEPs were abnormal in all patients with severe RGC volume loss. The PERG measures correlate with macular RGC volume. RNFL was confounded by disc oedema, but was helpful in highlighting temporal sector thinning in optic neuritis and inherited optic atrophy such as LHOA.References1. Odom JV, Bach M, Brigell M. et al. ISCEV standard for clinical visual evoked potentials: (2016 update). Doc Ophthalmol 133, 1–9 (2016). https://doi.org/10.1007/s10633-016-9553-y2. Bach M, Brigell MG, Hawlina M, Holder GE, Johnson MA, McCulloch DL, Meigen T, Viswanathan S. ISCEV standard for clinical pattern electroretinography (PERG): 2012 update. Doc Ophthalmol 2013 Feb;126(1):1–7. doi: 10.1007/s10633‐012‐9353‐y. Epub 2012 Oct 17. PMID: 23073702.
Visual acuity testing in preschool children: Freiburg acuity test (FrACT) vs LEA symbols test
Authors: Farassat Navid , Jehle Vanessa , Heinrich Sven , Lagrèze Wolf , Bach Michael 
Published: January 2024

Aims/Purpose: Cross‐sectional study to compare testability and performance of the Freiburg Visual Acuity Test (FrACT) and LEA Symbols Test (LEA) and to determine test–retest variability of visual acuities (VAs) achieved with the FrACT in preschool children.Methods: Monocular VA of both eyes was measured in 136 preschool children (268 eyes) aged 3.0 to 6.8 years – once with the LEA and twice with a 4‐orientation Landolt C version of the FrACT. The monocular FrACT runs were preceded by a binocular run for explanatory purposes. The test order alternated between subjects. Optotypes were presented either on a computer monitor (FrACT) or on cards (Lighthouse Single Symbol Book; LEA) at a distance of 3 m.Results: The overall testability of children was 70.1% for FrACT (188 of 268 eyes) and 90.3% for LEA (242 of 268 eyes). Testability depended markedly on age, with children aged <4 years at 23.0% (FrACT), 73.0% (LEA); ≥ 4 years: 88.1% (FrACT), 96.9% (LEA). The mean VA difference between FrACT and LEA was 0.11 LogMAR, with LEA reporting better acuity. The difference depended on age, with children aged <4 years exhibiting greater VA differences (0.27 LogMAR) while differences were smaller in children aged ≥4 years (0.09 LogMAR); in an additional adult control group the VA values of LEA and FrACT were even closer with 0.02 LogMAR mean difference. The 95% limits of agreement of test–retest‐variability of VAs in the FrACT were ± 0.29 LogMAR with a bias of 0.017 LogMAR (better acuity for the first test run).Conclusions: The FrACT, as an examiner‐independent tool using international reference Landolt C optotypes, can be reliably used to assess VA in preschool children aged 4 years and older. We confirm that the LEA Symbols Test reports better acuity than tests based on Landolt rings.
Factors contributing to the development of choroidal microvasculature dropout in glaucoma suspects and patients with glaucoma
Authors: Shin Hee Jong , Park Chan Kee , Park Hae‐Young 
Published: January 2024

Aims/Purpose: We aimed to characterize and compare the occurrence of MvD between glaucoma suspects and patients with glaucoma. In addition, the factors related to the development of parapapillary MvD in glaucoma suspects and patients with glaucoma were investigated.Methods: Total 150 eyes, 68 eyes of glaucoma suspects and 82 eyes of glaucoma patients were analysed in this study. Disc photography, VF, OCT, HRT, OCTA examinations were performed every year. Student's t‐test and the χ2 test were used to compare continuous and categorical variables, respectively. Slope of OCT, HRT, and VF parameters were calculated as change per year using linear regression. Univariate and multivariate logistic regression analyses were used to identify factors associated with MvD development.Results: Comparison between group who developed MvD and group without MvD, there was a significant difference in the slope of cup volume by OCT, central VF progression, and ONH surface depression measured by HRT. Thinner baseline GCIPL thickness, central VF progression, and the slope of cup shape measures by HRT were found to be significant associated factors to MvD development in multivariate analysis in total subjects. In the regression analysis of glaucoma suspect group, greater axial length and baseline cup volume among the baseline factors and the slope of GCIPL thickness and central VF progression among follow‐up factors were significantly associated with the MvD development. In the glaucoma group, central VF progression and ONH depression among follow‐up elements were observed as significant factors and the baseline factor had little relationship.Conclusions: MvD appears not only as a result of the progression of axonal loss of RGC in glaucoma but may also be developed by structural changes and mechanical susceptibility of the ONH associated with baseline characteristics, including myopia, thin central corneal thickness, and higher baseline IOP. Analysing the structural susceptibility of the ONH can predict the occurrence of MvD, which is can be helpful in predicting the progression of glaucoma.
Retinal neurodegeneration in intraocular pressure fluctuation rat model
Authors: Park Chan Kee , In Jung Kyoung , Han Jeong‐Sun 
Published: January 2024

Aims/Purpose: The role of IOP fluctuation is controversial in development and progression of glaucoma in clinical trials. We investigated effects of intraocular pressure fluctuation on retinal neurodegeneration and their mechanisms in rats.Methods: Male Sprague–Dawley rats were treated with IOP‐lowering eyedrops (brinzolamide and latanoprost) or saline for 8 weeks. IOP‐lowering eyedrops were put on Monday and Thursday for the irregular instillation group or daily for the regular instillation group, and saline was put daily for the control group. IOP was measured daily under general anaesthesia using a rebound tonometer. Oxidative stress, reaction of microgliosis and the number of retinal ganglion cells (RGCs) were measured.Results: Mean IOP was lower both in the irregular instillation group (9.6 ± 0.4 mmHg) and the regular instillation group (9.5 ± 0.4) than the control group (10.1 ± 0.4 mmHg, p < 0.001). Standard deviation (SD) of IOP was higher in the irregular instillation group (0.8 ± 0.1 mmHg) than the regular instillation group (0.5 ± 0.1 mmHg) or the control group (0.6 ± 0.3 mmHg, p < 0.001). Oxidative stress measured by dihydroethidium, oxidative DNA damage exhibited by 8‐hydroxy‐2′‐deoxyguanosine, and immunostaining for nitrotyrosine were upregulated (All p < 0.001). Expression of glial fibrillary acidic protein in the optic nerve head was more increased in irregular instillation group than the control group, but not in the regular instillation of eyedrops (p = 0.001). Expression of anti‐ionized calcium binding adaptor molecule (Iba‐1), a marker for microglia and P2Y12 known as a chemotactic receptor for microglia did not show a significant difference between the irregular instillation group and the control group. Expression of cleaved caspase‐3 was greater in the irregular instillation group than other two groups (p < 0.001). The number of RGCs stained with anti‐Brn3a antibody was lower in the irregular instillation group than other two groups (p = 0.002).Conclusions: IOP fluctuation induced by treatment of irregular instillation of IOP‐lowering eyedrops reduced the number of RGCs. Our findings indicate that IOP fluctuation induced by treatment of irregular instillation of IOP‐lowering eyedrops could lead to degeneration of RGCs probably by increasing oxidative stress and microgliosis.
Evaluating the diagnostic performance with neurovascular segregation of the retinal nerve fibre layer in glaucoma
Authors: Wong Damon , Yow Ai Ping , Chua Jacqueline , Schmetterer Leopold 
Published: January 2024

Aims/Purpose: To evaluate the diagnostic performance in detecting eyes with glaucoma by segregating the neuronal and vascular components in circumpapillary optical coherence tomography (OCT) and OCT angiography (OCTA) scans.Methods: In this study, 93 participants with glaucoma were age‐ and gender‐matched with normal controls with no ocular diseases. OCT and OCTA volumetric images of one eye from each participant were acquired using a prototype high resolution swept source OCT imaging system (Zeiss PlexElite) using a 6 mm x 6 mm imaging protocol centered at the optic nerve head. Circumpapillary OCT and OCTA images with a diameter of 3.46 mm were subsequently generated. Information from the circumpapillary and enface OCTA images were used to isolate and segregate the vascular components from the circumpapillary retinal nerve fibre layer (RNFL), which was obtained using a deep learning segmentation approach. Thicknesses of the RNFL with and without the vascular components were measured and diagnostic performance was evaluated using area under the receiving operating characteristic curve (AUC) analysis. Both global and quadrant (superior, inferior, nasal and temporal) measurements around the optic nerve head were considered.Results: Imaging data of one eye from 154 healthy and 143 glaucoma participants were acquired. Using only the global RNFL thickness, the detection of glaucoma achieved an AUC of 0.877 ± 0.021. With the vascular components excluded from the global RNFL thickness, an AUC of 0.890 ± 0.020 was obtained. When the vascular and non‐vascular components of the RNFL in the different quadrants were modelled separately, AUC improved to 0.927 ± 0.015, and was found to be significantly higher than the detection of glaucoma using global measures (p < 0.001).Conclusions: Segregation of vascular and non‐vascular components in the retinal nerve fibre layer led to an improvement in glaucoma detection. Further improvements were observed when the contributions of the components in the RNFL quadrants were modelled separately.
Central contrast sensitivity as an outcome measure in randomized controlled trials in glaucoma ‐ a systematic review
Authors: Møller Jens Riis , Sverstad Alexander , Virgili Gianni , Azuara‐Blanco Augusto , Freiberg Josefine Clement , Ahrensberg Simone , Kristianslund Olav , Petrovski Goran , Kolko Miriam 
Published: January 2024

Aims/Purpose: Standard automated perimetry (SAP) is currently the gold standard for diagnosing and assessing glaucoma progression. However, contrast sensitivity (CS) has shown promise as a valuable diagnostic tool in the early stages of glaucoma. This study aims to describe the evaluation of central CS as an outcome measure in randomized controlled trials on glaucoma.Methods: A descriptive systematic review was conducted, searching multiple databases for relevant literature and abstracts. Two independent authors screened the records and collected data, with a third reviewer available for resolution in case of disagreements. Eligibility criteria included the use of central CS as an outcome measure, publication in English with no restrictions on the date, glaucoma of any type (including suspects and ocular hypertension), and no limitations on age, sex, ethnicity, or geographical location. Any type of intervention and comparator was included, while animal studies were excluded.Results: The initial search yielded 990 articles and abstracts for title and abstract screening, of which 29 met the eligibility criteria for full‐text data extraction. The review is currently in progress.Conclusions: Glaucoma affects not only peripheral visual functions but also central visual functions in the early stages. SAP detects visual field defects only after a significant loss of retinal ganglion cells. Visual acuity (VA) is routinely used in glaucoma evaluation but provides limited information on the disease stage, focusing mainly on foveal involvement. Currently, there are no widely accepted examinations of central visual functions routinely performed for suspected or established glaucoma patients. Studies have shown that CS declines in the early stages of glaucoma. This review aims to provide insight into the tests used to assess CS in glaucoma and their performance.
Risk factors and macular microvascular changes in open angle glaucoma progression: A longitudinal study using OCT‐A
Authors: del Mar Schilt‐Catafal Maria , Pérez‐Torregrosa Vicente T. , Duch‐Samper Antonio M. 
Published: January 2024

Aims/Purpose: To investigate prospectively macular microvascular changes in patients with glaucoma and identify common characteristics among the progressive eyes.Methods: A 12‐month prospective longitudinal study was performed with 124 open‐angle‐glaucoma‐eyes (GE). Glaucomatous progression was defined as a decrease of ≥5 μm in average or ≥7 μm in a sector of RNFL thickness. OMAG OCT microangiography (Angioplex, HD OCT, Cirrus 5000, Zeiss) was used to analyse the macular region. The statistical analysis was performed using the SPSS version 23.0 statistical package (SPSS Inc., IL).Results: Among the GE group, 22.36% of eyes showed progression, being the decrease of the Complete Region Macular Vessel Density (MVD) and Macular Capillary Perfusion Density (MPD) greater (−1.14 mm/mm2 and −3.18%) compared to non‐progressive eyes (−0.42 mm/mm2 and −1.02%) [p = 0.123 and 0.057], being the temporal and superior sectors for both MVD and MPD, the ones that showed greater differences (−1.44 mm/mm2, −1.11 mm/mm2, −3.6% and −2.95% respectively) [p > 0.05 for all]. Characteristics as elevated intraocular pressure (IOP) (17.29 vs 14.87 mmHg), thinner central corneal thickness (CCT) (521.53 vs 538.65 μm) and lower ocular perfusion pressure (OPP) (45.88 vs 49.21 mmHg) were significantly different in those progressive GE [p < 0′05 for all]. Nevertheless, increased vertical cup to disc ratio (CDV) (0.64 vs 0.63) and minimum ganglion cell layer thickness (GCLM) (58,82 vs 56.51 μm) were not significantly different in progressive GE [p = 0.768 and 0.249].Conclusions: Data showed that when glaucomatous progression took place, stronger vascular changes occurred in the macular area, as greater decrease of MVD and MPD specially in the temporal and superior sectors. In addition, common characteristics as elevated intraocular pressure, thinner central corneal thickness and lower ocular perfusion pressure were identified in progressive GE. Nevertheless, further research with larger population and larger follow‐up is needed to obtain stronger results.
Fluvoxamine supresses transforming growth factor beta‐2‐induced fibrotic changes in trabecular meshwork cells
Authors: Medveczki Timea , Tran Minh N. , Besztercei Balazs , Torok Gyorgy , Kovacs Illes , Szabo Attila J. , Fekete Andrea , Hodrea Judit 
Published: January 2024

Aims/Purpose: Primary open‐angle glaucoma is the leading cause of blindness worldwide, but no definitive treatment is available. Fibrotic‐like changes of trabecular meshwork (TM) results in increased stiffness and impaired outflow leading to increased IOP. Transforming growth factor‐β2 (TGF‐β2), a main driver of eye fibrosis, is increased in the aqueous humour of glaucoma patients. Recently, we proved that the specific sigma‐1 receptor agonist fluvoxamine (FLU) is antifibrotic in the kidney but its role in the TM is unknown. Therefore, we investigated the effects of FLU on the TGF‐β2‐induced fibrotic response in TM cells.Methods: Fibrosis of the AS was induced in C57BL/6J mice by intracameral TGF‐β2 injection. AS were collected and F‐actin was visualized with Phalloidin and detected with confocal microscopy. The effect of FLU on TGF‐β2‐induced cell proliferation, cytoskeletal rearrangement, and fibrosis‐related proteins was investigated by MTT (3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5 diphenyl tetrazolium bromide) assay, Phalloidin staining and Western blotting, respectively.Results: TGF‐β2 injection resulted in F‐actin enhancement in vivo, indicating fibrotic‐like changes. In vitro, TGF‐β2 induced cytoskeletal rearrangement with increased F‐actin‐ bundles and clumps formation (p < 0.001) which were reduced by FLU (p < 0.001). Furthermore, FLU also inhibited cell proliferation (p < 0.05) in TGF‐β2‐treated cells. The profibrotic protein levels of connective tissue growth factor, fibronectin and collagen type IV were elevated by TGF‐β2 treatment (p < 0.001), while FLU prevented the elevation of these elements (p < 0.01; p < 0.001). FLU also hindered the TGF‐β2 caused decrease of Matrix Metalloproteinase‐2 (p < 0.05) thus facilitating ECM degradation.Conclusions: FLU may reduce the fibrotic response of trabecular meshwork and could be a potential candidate for the treatment of fibrosis‐induced ocular hypertension.Grants: OTKA‐ K135398, LP2021‐3/2021, TKP2021‐EGA‐24, Stipendium Hungaricum.
2 Year results of combined phacoemulsification‐ iStent inject W, from a single centre
Authors: Tsakiris Kleonikos , Gialelis Themistoklis , Vergados Athanasios 
Published: January 2024

Aims/Purpose: Our aim is to review the 2 year results of combined phacoemulsification and iStent inject W implantation in a single centre in East London.Methods: Patients were listed for surgery when cataract surgery was needed and further control of glaucoma was necessary. Electronic medical records were reviewed of all the patients who underwent the procedure in the period ranging from May 2018 until February ‘21. 87 eyes of 77 patients were identified, 3 eyes were lost to follow up in year one and 2 year data were obtained for 17 eyes. Vision, iop, drop dependency was measured and complications were recorded. Further surgical treatment was considered failure and the patient was then removed from the cohort.Results: Mean vision improved from LogMAR 0,45 to 0,16 stable throughout the two years. Drop dependency dropped modestly from 2,71 to 2,49 (8%) in year one and 2,35% (13,04%) in year two. IOP dropped from 19,25mHg to 14,55 mmHg (24,43%) in year one and 12,41 mmHg (36,68%) in year two. Complications included one patient with retained lens matter, 1 with recurrent uveitis, 1 iris prolapse, 1 Irvine Gass syndrome,1 had steroid response and 2 had pressure spikes. Furthermore by year 2, 1 patient was excluded due to incomplete documentation, 2 were discharged, 4 died (6 eyes), 4 patients needed further treatment with trabeculectomy and one received micropulse cyclodiode laser.Conclusions: Overall combined phacoemulsification/iStent inject W surgery is safe, effective, does not affect the overall safety profile of phacoemulsification surgery and has a place in early and moderate glaucoma. Improvement in year 2 results in comparison to year one can be explained by the removal from the study of the patients that received further treatment; and the small number of patients seen is an effect of the reduced capacity because of the COVID‐19 pandemic restrictions during that time.
The socioeconomic impact among Tunisian glaucoma patients
Authors: Jallouli Aida , Maamouri Rim , Doukh Meryem , Aoun Hichem , Ouederni Meriem , Cheour Monia 
Published: January 2024

Aims/Purpose: The purpose of our study is to evaluate the socioeconomic impact of primary open‐angle glaucoma (POAG) on Tunisian population.Methods: A cross‐sectional study was conducted in Habib Thameur Hospital, Tunisia. POAG patients who were ≥ 40 years old at the time of recruitment had minimal cataract, underwent cataract or trabeculectomy surgery at least 3 months prior and were on medical treatment. Data were collected from patients through one‐on‐one interview with questionnaire.Results: We collected 38 glaucomatous patients; the mean age of patients was 58 years old (range 46–82 years). There was a female predominance (57.89%) with a sex ratio (M/F) of 0.72. The average of intraocular pressure (IOP) was 21.6 mmHg with 21.05% of patients having an IOP over 30 mmHg. We noted that 76.31% of patients resided in urban areas and 41.2% of them were illiterate. The monthly income as claimed by patients ranged between zero and 600 Tunisian dinars (TND) with an average monthly income of 287.5 TND. Patients' monthly spending on glaucoma ranged between zero and 69.5 TND, with a mean of 35.2 TND which equalled 12.2% of their monthly income. Eighteen (47.3%) of the participants experienced anxiety and depression. Severe stage of glaucoma and reduced visual acuity were significantly associated with anxiety and depression.Conclusions: Identifying the socio‐economic impact of glaucoma can raise awareness among Tunisian patients and ophthalmologists, and may result in the optimal management of glaucoma.
Effects of cataract on peripapillary retinal nerve fibre layer and ganglion cell‐inner plexiform layer thickness measurement by cirrus optical coherence tomography
Authors: Park Chanjoon 
Published: January 2024

Aims/Purpose: To assess the effect of cataract on peripapillary retinal nerve fibre layer (pRNFL) thickness and macular ganglion cell‐inner plexiform layer (mGC‐IPL) thickness measured by Cirrus (Carl Zeiss Meditec, Dublin, California, USA) spectral domain–optical coherence tomography (OCT).Methods: Cirrus OCT was used to measure the pRNFL thickness and mGC‐IPL thickness in 44 patients (63 eyes) patients with cataract, including 43 glaucoma eyes. Cataracts were graded according to the Lens Opacities Classification System III. The study aimed to identify factors that could contribute to segmentation errors and variations in the signal strength index (SSI) or average thickness of mGC‐IPL and pRNFL.Results: The prevalence of preoperative segmentation error were higher in pRNFL measurements compared with mGC‐IPL measurements (36.5% vs. 19.0%, p = 0.046). Multivariate analysis showed that segmentation error in RNFL measurements was significantly associated with preoperative SSI. Multivariate analysis indicated that preoperative SSI was highly correlated with changes with average thickness changes of mGC‐IPL and pRNFL.Conclusions: Among eyes with cataract, the occurrence of segmentation errors was more common in measurements of the pRNFL compared to measurements of mGC‐IPL. Following cataract surgery, there was a slight increase in all thickness parameters in both mGC‐IPL and pRNFL measurements, although the differences were not statistically significant (p = 0.102 and p = 0.151, respectively). It is important to identify segmentation errors, particularly in pRNFL measurements of eyes with cataract and low SSI.