bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative analysis of the quality of life among different retinal diseases
Authors: Darriba David Blanco , Fernandez‐Vigo Jose Ignacio , Burgos‐Blasco Barbara , Amor Patricia Robles , Marzo Elena Montolío , Ávila Haizea Haizea Etxabe 
Published: January 2024

Aims/Purpose: To assess the difference and repercussions on the quality of life (QoL) among different retinal diseases such as diabetic macular oedema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age‐related macular degeneration (nAMD) and central serous chorioretinopathy (CSC).Methods: A cross‐sectional study was carried out in 241 patients, affected by DME (n = 44), RVO (n = 41), PM (n = 34) and nAMD (n = 85) receiving intravitreal injections due to the presence of macular oedema or choroidal neovascularization. The CSC patients included (n = 37) were those with persistent subretinal fluid candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning‐25 (NEI VFQ‐25). Best eye visual acuity (BEVA) was recorded through the Early Treatment Diabetic Retinopathy Study (ETDRS) scale.Results: There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (p = 0.436), despite the difference in the mean BEVA (CSC: 86.3 ± 11.9; RVO: 78.5 ± 15.5, DME: 73.3 ± 15.2, nAMD: 72.9 ± 12.6 and PM: 68.5 ± 18.1 letters respectively; p < 0.001). The lowest VFQ‐25 total score was observed in the PM patients (52.1 ± 20.9), followed by nAMD (55.3 ± 20.8), RVO (65.0 ± 22.3), DME (68.6 ± 21.0) and CSC (70.9 ± 16.2). The DME group reported the worst score for general health (38.9 ± 21.4), having the CSC patients the highest general health score. Mental health and role difficulties were lowest for PM (48.2 ± 28.8 and 48.2 ± 31.9, p < 0.007).Conclusions: This study reveals the differences in the QoL among the main retinal diseases such as DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing higher impact in PM and nAMD.Keywords: quality of life; NEI VFQ‐25; age‐related macular degeneration; diabetic retinopathy; central serous chorioretinopathy; high myopia; retinal vein occlusion.
The inflammatory potential of diet is associated with the risk of age‐related eye diseases
Authors: Vergroesen Joëlle , Thee Eric , de Crom Tosca , Jong Jessica Kiefte‐de , Voortman Trudy , Klaver Caroline , Ramdas Wishal 
Published: January 2024

Aims/Purpose: Inflammation is involved in the pathogenesis of cataract, age‐related macular degeneration (AMD) and possibly open‐angle glaucoma (OAG). We assessed whether the inflammatory potential of diet (quantified using the dietary inflammatory index; DII) affects the incidence of these eye diseases. Serum inflammation markers were investigated as possible mediators.Methods: Participants aged >45 years were derived from the Rotterdam Study. From 1991 onwards, every 4–5 years, participants underwent extensive eye examinations. At baseline, blood samples and dietary data were collected. The DII was adapted (aDII) based on data availability. Of the 7436 participants free of eye diseases at baseline, 4036 developed incident eye diseases over time (cataract = 2895, early‐intermediate AMD = 891, late AMD = 81, OAG = 169).Results: A higher aDII was significantly associated with increased inflammation. A higher neutrophil‐lymphocyte ratio (NLR) was associated with an increased risk of cataract and AMD. Additionally, complement component 3c (C3c) and systemic immune‐inflammation index (SII) were associated with increased risks of cataract and late AMD, respectively. Every point increase in the aDII was associated with a 9% increased risk of cataract (Odds ratio [95% confidence interval]: 1.09 [1.04–1.14]). The NLR and C3c partly mediated this association. We also identified associations of the aDII with risk of AMD (early‐intermediate AMD, OR [95% CI]: 1.11 [1.03–1.19]; late AMD, OR [95% CI]: 1.24 [1.02–1.53]). The NLR partly mediated these associations. The aDII was not associated with OAG.Conclusions: We observed an unfavourable association between the aDII and cataract. More importantly, we found an association between the aDII and risk of AMD. Especially the NLR, a marker of subclinical inflammation, seems to be involved. These findings are relevant for patients with AMD and substantiate the current recommendations to strive for a healthy lifestyle to prevent blindness.
Automatic characterization of Meibomian gland morphology
Authors: Novo‐Diez Andrea , Blanco‐Vázquez Marta , Arlanzón‐Lope Pablo , Valencia‐Sandonís Cristina , González‐García María J. , Fernández Itziar 
Published: January 2024

Aims/Purpose: To characterize the Meibomian gland (MG) morphology in healthy subjects with an automatic software.Methods: An automatic software was developed for image analysis in R code, consisting of 4 stages: (1) selection of the region of interest, (2) image preprocessing to obtain a binary and a skeleton image, (3) modelling of each MG to fit each MG to a piecewise linear model, and (4) quantification of the following MG features: tortuosity, MG shortening, number of MGs, deviation from a vertical line, and MG area. Meibography images of the upper eyelid were acquired using the Easy Tear View+®. A group of 156 healthy subjects were included, with a mean age and confidence interval (CI) of 43.88 (95% CI: 41.38–46.37) years, range 16–76 years. Reference intervals (RI) were calculated for each MG feature to be used as a diagnostic tool to classify a specific value as normal or non‐normal. Generalized Additive Models for Location, Scale and Shape were used to estimate the percentile curve for each morphologic feature of MG, considering the influence of age and sex.Results: Age had an influence on tortuosity, mean = 0.3 (95% CI: 0.3–0.31), RI: 0.19–0.4 <20 years, and 0.24–0.39 at 50–60 years. Age and sex had an influence in the MG shortening, mean = 63% (95% CI: 62–64%), mean RI: 58–74% <20 years; 59–84% >75 years; women RI: 56–71% <20 years; 57–82% >75 years. The rest of the variables were not affected by age or sex: number of MGs = 16.05 (95% CI: 15.28–16.82), RI: 8–27; vertical deviation = 0.37 (95% CI: 0.36–0.38), RI: 0.29–0.45, and MG area = 14% (95% CI: 14–15%), RI: 8.17–19.81%.Conclusions: Tortuosity variability decreases between 45 and 60 years of age. The MG shortening increases with age and is higher in men. These values could be useful to classify a meibography image as normal or non‐normal, helping to diagnose MG alterations in an objective way.
Morphogeometric characterization in keratoconus according to the RETICS grading system
Authors: Jaimes Claudia Patricia Tarazona , Megiddo Elinor , Gomez Carmelo , Moya Alejandro , Martinez Francisco Cavas , Alio Jorge 
Published: January 2024

Aims/Purpose: Keratoconus progression characterizes by corneal thinning resulting in irregular astigmatism and visual impairment. In the present work a computerized 3D modelling method is used to describe different morphogeometric variables in healthy corneas and keratoconus. RETICS grading system was used to characterize keratoconus with best corrected visual acuity (BCVA) as the major grading parameter. Analyzing morphogeometric variables and its correlation with visual acuity (VA) may help understand structural changes associated with visual decline in keratoconus.Methods: 124 healthy corneas and 257 eyes with keratoconus were included and classified according to the RETICS grading system as grade 1 (n = 94) when VA > 0.9; grade 2 (n = 65) when 0.6 < VA ≤ 0.9; grade 3 (n = 50) when 0.4 < VA ≤ 0.6; grade 4 (n = 31) when 0.2 < VA ≤ 0.4 and grade 5 (n = 17) when VA ≤ 0.2. Computerized 3D modelling was done and morphogeometric variables analysed: anterior surface area (ASA), posterior surface area (PSA), total area (TA), total volume (TV), anterior apex deviation (AAD), posterior apex deviation (PAD), anterior minimum thickness point deviation (AMTPD) and posterior minimum thickness point deviation (PMTPD).Results: All morphogeometric variables showed differences between normal and keratconic eyes (p < 0.001). ASA and PSA present higher values in keratoconus (p < 0.001), while TV shows lower values in the same subjects (p < 0.001). Correlation between BCVA and all variables was calculated showing a positive correlation for the ASA (p = 0.0036) and PSA (p = 0.0172), and a negative correlation for TV (p = 0.1612) and PAD (p = 0.0821).Conclusions: As keratoconus progresses and VA worsens, corneal structural changes include an increase in the PAD, in addition to an increase of both anterior and posterior corneal areas while TV tends to decrease. Morphogeometric variables represent a new parameter to characterize keratoconus and some demonstrate a statistically significant correlation with visual loss.
miRNA profiling in the aqueous humour in patients with Fuch's endothelial corneal dystrophy
Authors: Wróbel‐Dudzińska Dominika , Kosior‐Jarecka Ewa , Ćwikińska‐Haszcz Agnieszka , Czop Marcin , Kocki Janusz , Żarnowski Tomasz 
Published: January 2024

Aims: The aim of the study was to determine and compare the expression profiles of miRNA molecules in the aqueous humour (AH) of patients with Fuch's endothelial corneal dystrophy (FECD) and patients with normal corneal endothelium undergoing cataract surgery.Methods: The study consisted of 20 Caucasian patients (10 FECD and 10 control patients) who underwent comprehensive ophthalmology examination, thus routine corneal transplant or cataract surgery. 100 μL of AH were obtained from the anterior chamber at the beginning of the surgery with special care to avoid contamination with blood tears. The total RNA was isolated from the AH samples using an miRNeasy Serum/Plasma kit according to the manufacturer's instructions. The RNA concentration was determined by using NanoDrop2000c spectrophotometer. In addition, RNA analysis was performed using Agilent Bioanalyzer2100 and PicoRNA Kit according to the manufacturer's protocol. A microarray system (GeneChip miRNA 4.0 Array chip, Affymetrix) was used to determine the miRNA expression profiles. The RNA preparation and hybridization were performed according to the manufacturer's protocol, with one modification to extend the hybridization time to 42 h. The gene chips were scanned with an Affymetrix GeneChip Scanner 3000.Results: We found significant overexpression of hsa‐miR‐4532, hsa‐miR‐6800‐5p, hsa‐miR‐3621, hsa‐miR‐4270, hsa‐miR‐548ac, hsa‐miR‐328‐5p, hsa‐miR‐6771 ‐5p, hsa‐miR‐6858‐5p, hsa‐miR‐548a‐3p, hsa‐miR‐6069, hsa‐miR‐6716‐5p, hsa‐miR‐7151‐3p, hsa‐miR‐5189‐5p, hsa ‐miR‐4279, hsa‐miR‐1233‐5p, hsa‐miR‐455‐3p in patients with FECD compared to those patients with normal corneal endothelium. Reduced expression of hsa‐miR‐3613‐3p, hsa‐miR‐1298‐3p, hsa‐miR‐16‐2‐3p, hsa‐miR‐4668‐5p was observed in patients with FECD in addition to the control group.Conclusions: The analysis of miRNA expression profiles and their application as potential biomarkers will facilitate and accelerate the diagnosis of FECD, as well as enable the development of individualized molecularly targeted therapy.
The second rapid assessment of avoidable blindness survey in Palestine: A national cross‐sectional study
Authors: Mikki Nahed , Mactaggart Islay 
Published: January 2024

Aim: To assess prevalence and main causes of blindness, vision impairment and cataract surgical coverage in Palestinians aged 50 years and older.Methods: The survey was part of a larger population‐based survey using the rapid assessment of avoidable blindness (RAAB) methodology to estimate prevalence of vision impairment, blindness and disability in individuals aged 50 years and older in Palestine. It was a nationally representative, cross‐sectional, population‐based survey in Gaza Strip and West Bank. A sample size of 4224 participants aged 50 years and older was determined in 69 clusters in the West Bank and 52 clusters in the Gaza Strip. Within each cluster, 35 people aged 50 years or older were examined in their homes.Results: The total examined was 3848. Adjusted prevalence of blindness was 2.6%. This is a non‐significant decrease from 3.4% in 2008. The prevalence of blindness in Gaza (4.0%) was higher than the prevalence of blindness in the West Bank (1.8%). The prevalence was higher among females than males.Adjusted prevalence of severe vision impairment, moderate vision impairment and mild vision impairment was 1.4%, 10.2% and 11.6%, respectively. Principal cause of blindness, severe and moderate vision impairment was untreated cataract followed by diabetic retinopathy. Refractive error was the principal cause of mild vision impairment. More than 80% of vision impairment was avoidable.Unmet need for cataract surgery varied from 0.9% among blind participants to 6.5% among participants with mild vision impairment. Effective cataract surgical coverage was low in general and varied from 42.4% among blind operated participants to 25.9% among participants with mild vision impairment.Conclusions: Around 80% of vision impairment was avoidable. Untreated cataract and diabetic retinopathy were the main causes of blindness, severe and moderate vision impairment. Refractive error was the principal cause of mild vision impairment. Effective cataract surgical coverage was low.
Diplopia as the presenting symptom of a post‐transplant lymphoproliferative disorder in a bilateral inferior lim transplanted young adult
Authors: Fustel Paula Boned , García Laura Fernández , Martí M. Ángeles Ruth Bort , Gregori Enrique España 
Published: January 2024

Aims/Purpose: To present a unique case of post‐transplant lymphoproliferative disorder (PTLD) after bilateral inferior limb transplantation, which is still controversial due to the absence of precedents in the literature and the unclear risk–benefit ratio.Methods: Case report.Results: A 22‐year‐old male presented to the emergency room complaining of double vision. He had a history of bilateral inferior limb amputation 8 years ago and received a bilateral lower limb transplantation 2 years later. He had normal graft function and was receiving cytomegalovirus prophylaxis. During neurological examinations left abducens nerve (CN VI) palsy was noted. Other cranial nerves affected produced facial hypoesthesia (CN V) and mild paresis (CN VII), hearing loss and tinnitus in left side (CN VIII) and soft palate asymmetry (CN X). He was otherwise neurologically intact, alert and orientated. MRI revealed a lesion located at the facial colliculus at the floor of 4th ventricle. In the context of immunosuppression, the differential diagnosis included abscess versus PTLD. Biopsy of the lesion was performed. Morphologically atypical lymphocytic cells suggestive of B lymphoma were identified. Monoclonal rearrangement for heavy chain Igen and immunoglobulins were identified with molecular biology techniques. The histology features were consistent with a diagnosis of CNS B lineage primary lymphoma. Two days later, bilateral supracondylar amputation was performed. Following the explant, immunosuppression was withdrawn. His underlying condition was finally diagnosed as PTLD, for which he started a chemotherapeutic regimen with radical intention (methotrexate and cytosine arabinoside). The patient recovered fully and up to date, 10 years later, is doing well.Conclusions: Due to its diverse aetiologias, a proper workup must be done of the patients presenting with diplopia to the emergency room. PLTD must be a condition to always be considered in patients with history of solid organ transplant; since the early diagnosis is crucial for a successful management of this often‐fatal condition.
When atypical becomes urgent: Unleashing the ophthalmologist's role in managing unconventional macroadenomas
Authors: Martí M. Ángeles Ruth Bort , Fustel Paula Boned , Pelaez Blanca Casado , García Laura Fernández , Gregori Enrique España 
Published: January 2024

Aims/Purpose: To present an atypical macroadenoma case and its management, in which the visual monitoring was key to indicate surgical intervention.Methods: Case report.Results: A 55‐year‐old male who was admitted to our emergency department with a main complaint of bilateral central and painless visual loss of 2 days' duration. He had DM type II. BCVA OU was 0.2, with no RAPD, but bilateral dyschromatopsia (OD: 4/16 OS: 10/16). Computerized visual field testing revealed a central scotoma (OD) and temporal hemifield loss (OS). An urgent CT scan revealed the presence of a 24 × 15 × 3 mm sellar‐suprasellar mass, with a locoregional mass effect and possible extension to cavernous sinuses and optic chiasm compression. 12 h after admission, deterioration of BCVA was observed (OD: 0.05 and OS: 0.1), along with worsening of dyschromatopsia (OD: 2/16 and OS: 7/16) and campimetric deficit progression (left homonymous hemianopic pattern). The MRI revealed the presence of a 21 × 21 × 36 mm sellar mass, without signs of recent intratumoral bleeding, with solid suprasellar extension, posterior cystic degeneration, compressing optic nerve, right optic tract, optic chiasm, and invading right cavernous sinus. Due to the worsening visual function, a consensus decision was made to proceed with same‐day endoscopic transsphenoidal resection. 24 h post‐surgery, the patient showed improvement in BCVA (1.0 OU) and dyschromatopsia (OD: 10/16 and OS: 12/16).Conclusions: In our case, despite unclear compressive effect on neuroimaging, careful monitoring of visual function allowed to timely indicate surgery, as the positive outcomes reflect. Managing this pathology in tertiary hospitals goes beyond the required experience of the neurosurgical team. The time for surgery indication is a big challenge due to the lack of clear definitions to indicate surgical intervention: “impending vision loss” or “clinically significant increase in size near the visual pathway.”
Nrf2 and HuR/ELAV1 as determinant factors for VEGF expression and secretion in ARPE‐19 cells under stress stimuli
Authors: Bresciani Giorgia , Manai Federico , Govoni Stefano , Amadio Marialaura 
Published: January 2024

Aims/Purpose: The transcription nuclear factor E2‐related factor 2 (Nrf2) pathway is a key antioxidant system in the RPE, protecting it from oxidative stress and inflammation. Its dysfunction is a renowned aspect of Age‐related Macular Degeneration (AMD). As previously documented, RNA‐binding protein HuR/ELAVL1 interacts with Nrf2 mRNA, as well as many of its targets at the post‐transcriptional level. Among them, vascular endothelial growth factor (VEGF) is a crucial one, being involved in both physiological maintenance of vasculature and pathological angiogenesis. Purposes of our study were disclosing the crosstalk between Nrf2 and HuR in RPE cells subjected to stressful stimuli and understanding their regulatory effect on VEGF.Methods: Wild type, Nrf2‐ or HuR‐deficient ARPE‐19 cells were used. As stressful stimuli, MG132 (5 μM) and Bafilomycin (50 nM) for 24 h, or 4‐Hydroxynonenal (4‐HNE; 50 or 100 μM) for 6 h, were used. Cell viability was assayed by enzymatic fluorescence analysis; VEGF expression and extracellular secretion were evaluated by RT‐qPCR and ELISA, respectively.Results: When subjected to intense toxic stimuli, HuR‐deficient cells display impaired viability, although to a lesser extent compared to Nrf2‐deficient cells. In these silenced cell models, 4‐HNE seems to be more harmful than the autophagy inhibitors. Nrf2 or HuR deficiency markedly affects VEGF levels and secretion, even more than stressful conditions. Furthermore, distinctive effects of silencing either Nrf2 or HuR on the level of the other factor have been disclosed.Conclusions: Both HuR and Nrf2 are involved in the constitutive regulation of VEGF levels; contexts characterized by oxidative stress or impaired clearance induce more significant changes in RPE featured by an impairment of Nrf2 than of HuR levels. Further elucidations in how the crosstalk between these two factors regulate common targets (e.g., VEGF) may improve our understanding of RPE homeostasis and alteration, and consequently AMD pathophysiology.
Influence of dark adaptation on the perceptual threshold of electrically evoked phosphenes
Authors: Link Dietmar , Noether Eva , Freitag Stefanie , Graichen Uwe , Klee Sascha 
Published: January 2024

Aims/Purpose: Phosphenes are light phenomena in the eye that have been studied since the 18th century. They can be evoked mechanically or by electrostimulation, for example. The perception of phosphenes and their threshold, the limit of phosphene perception, has been the subject of numerous studies. In this work, the dynamics of the threshold shift of electrically evoked phosphenes during dark adaptation is recorded. Statistically it was tested whether the phosphene thresholds differ before and after dark adaptation.Methods: A study was conducted on 16 healthy subjects (7 w, 9 m, 28.5 ± 6.8 yr). Each subject sat approximately 30 cm in front of a black cloth‐covered semi‐circular screen placed on a table. On the table was a signal generator (33250A, Agilent Technologies Inc, Santa Clara, CA, USA) with a rotary control for the subject's own setting of the current intensity for the current stimulation (sinusoidal, 20 Hz) using a transcranial electrical stimulator (DC‐Stimulator PLUS, neuroConn GmbH, Ilmenau, Germany). The electrodes were a ring electrode at one eye and a rectangular electrode at the back of the head. After the subject had been instructed, and the electrodes had been attached, the subject had to set the phosphene threshold in room light conditions (125 cd/sqm) 10 times in succession (baseline B1, bright adapted). Lightproof glasses were then worn. For 40 min, each subject adjusted the threshold at intervals of 2 min. After 40 min, 10 more threshold values were recorded (baseline B2, dark adapted). Means were calculated for each subject for both baselines B1 and B2 and tested for discrimination using the Wilcoxon signed‐rank test.Results: All subjects were able to successfully complete the test. The global thresholds before and after dark adaptation were 132.3 ± 13.8 μA and 329.5 ± 38.0 μA respectively. The difference between the conditions B1 and B2 is significant (p = 0.0002). All measurement curves of the threshold progression show an increasing behaviour with a pronounced plateau after approximately 15 min.Conclusions: We successfully performed a study on the generation of phosphenes during current stimulation. The dynamics of the threshold progression from light to dark adaptation could be recorded. A significant threshold shift is shown for all subjects.