bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short‐term intraocular pressure fluctuation in primary angle closure glaucoma
Authors: Tan Shaoying , Yu Marco , Chan Poemen P. , Tang Fang Yao , Cheung Carol Y. , Tham Clement C. Y. 
Published: January 2024

Purpose: To identify the most sensitive period for detecting significant circadian and ultra‐short‐term intraocular pressure (IOP) fluctuation associated with disease progression in primary angle closure glaucoma (PACG).Methods: PACG eyes, which had been followed up for over 2 years under the CUHK PACG Longitudinal (CUPAL) Study, were recruited. Eyes with or without functional or structural glaucomatous progression were classified into ‘progressive’ or ‘stable’ groups based on serial visual field (VF) and retinal nerve fibre layer (RNFL) thickness documentations, respectively. Circadian and ultra‐short‐term IOP fluctuations were recorded by Sensimed Triggerfish® sensors with 288 readings over 30 s, at 5‐min intervals, over a 24‐h period. The circadian IOP fluctuation was represented by smoothed sensor output signals using B‐spline smoothing transform and described by functional data analysis. In each of seven activity‐related 1‐h periods during the examining day, the mean value of the amplitude‐frequency profiles of the signal fluctuations in twelve 30‐s intervals, which represent the ultra‐short‐term IOP fluctuation, was calculated by semi‐variogram/semi‐variance. The signals were compared between ‘progressive’ and ‘stable’ groups by permutation tests on functional t‐statistics.Results: Among the 25 recruited PACG eyes, 16 eyes were classified as RNFL ‘progressive’ group (the mean rate of change in global RNFL thickness: −0.199 ± 0.128 μm/month). Statistically significant differences were found during the time periods from 22:00 to 23:00 and from 07: 00 to 08:00 in gradients that reflected by the first derivative of the IOP fluctuation curve, as well as from 23:00 to 24:00 and 08:00 to 09:00 in curvatures that reflected by the second derivative of the IOP fluctuation curve, between the VF progressive and the VF stable groups (p < 0.05). Gradients differences were also found during the time periods from 24:00 to 01:00 and 02:00 to 03:00 between structural progressive and stable groups (p < 0.05). Higher signal fluctuations, in terms of amplitude‐frequency, were found during the first 1‐h period of sleeping in the RNFL ‘progressive’ group, compared to the RNFL ‘stable’ group (p = 0.028).Conclusions: Between RNFL ‘progressive’ and ‘stable’ PACG eyes, significant differences in circadian IOP fluctuation and ultra‐short‐term IOP fluctuation at the 1‐h period after falling asleep were identified. Large circadian IOP fluctuations may be associated with disease progression in PACG eyes. The first hour of sleeping may be the most sensitive period for detecting significant short‐term IOP fluctuation in PACG eyes.
Cornea on fire: PACK‐CXL in the treatment of infectious keratitis
Authors: Aiello Francesco 
Published: January 2024

Infectious keratitis is a severe eye condition that can cause permanent vision loss if not treated promptly. The current standard of care for this condition involves the use of broad‐spectrum topical antibiotic drops. However, researchers have explored photoactivated chromophore for collagen cross‐linking (PACK‐CXL) as a potential treatment option for infectious keratitis. Studies have shown that PACK‐CXL can improve the healing process in bacterial keratitis and prevent corneal melting caused by bacterial enzymatic degradation.When activated by UV light, riboflavin, the photosensitizer used in PACK‐CXL, induces changes in collagen properties, leading to a hardening and strengthening effect on the corneal stroma. However, individuals with corneal ulcers may experience greater penetration of UV light due to the compromised integrity of the cornea, which could cause endothelial cell loss and impair corneal function.The purpose of this presentation is to provide a summary of the evidence on the comparative effectiveness and safety of PACK‐CXL with or without standard therapy versus standard therapy alone for the treatment of bacterial keratitis. The latest randomized controlled trials (RCTs) will be reviewed, and their findings regarding the efficacy and safety of PACK‐CXL in treating infectious keratitis will be discussed, as well as a comparison with standard antibiotic therapy alone. Ultimately, this talk aims to inform evidence‐based recommendations for the treatment of infectious keratitis and provide clinicians with the most up‐to‐date information to make informed treatment decisions.
Retinal delivery of nanotherapeutics in a model of inherited retinal dystrophy
Authors: Velasco Sheyla , Gallego Idoia , González Lorena Olivares , Valencia Dayra , Morales Silvia , Puras Gustavo , Pedraz José Luis , Rodrigo Regina 
Published: January 2024

Inherited retinal dystrophies (IRDs) constitute a heterogeneous group of retinal diseases that cause the progressive loss of vision. They are mainly associated with photoreceptor (rods and cones) or retinal pigment epithelium (RPE) dysfunction and loss. Several therapeutic strategies are ongoing in animal models and in patients, including gene, cell, or pharmacological therapies. However, at present, there is only one effective treatment available, Luxturna.The eye presents some characteristics that facilitate the development of different therapeutic strategies. It is an immune privilege and easily accessible organ. In the case of retinal diseases, one of the biggest challenges is the effective drug delivery to the diseased area because of the existence of several physiological and anatomical barriers of the eye. Among others, the routes for drug delivery to the retina include: 1) Topical that is a non‐invasive route, but does not provide the delivery of significant levels of therapeutic agents; 2) Systemic that can deliver a high level of therapeutic agents, but the blood‐retina barrier limits those that can be delivered; and 3) Intravitreal that provides a good delivery but can induce retinal endophthalmitis, retinal detachment, increased intraocular pressure or retinal haemorrhages. Nanotechnology has reformed the field of drug delivery and revolutionized medicine. Drug Delivery Systems (DDS) protect drugs from degradation, improve their permeability across cell membranes, their bioavailability, provide stable formulation and yield sustained and controlled release of drugs. Many types of nanoparticles (range in size from 10 to 1000 nm) used as drug carriers are made of polymers, lipids, inorganic metallic components, etc. DDS can overcome the limitations associated with current ocular therapy and ensure targeted and controlled drug delivery. We will present different nanocarriers loaded with therapeutic agents for the treatment of inherited retinal dystrophies.
Persistent epithelial defects in neurotrophic keratopathy
Authors: Georgoudis Panagiotis 
Published: January 2024

One of the complications of neurotrophic keratopathy is the breakdown of the corneal epithelium. This can progress to non‐healing persistent epithelial defects (PED) which are challenging to manage and can lead to corneal ulceration, scarring and perforation.The causes of epithelial breakdown, prevention and contemporary medical and surgical management will be discussed during this talk. The use of conservative methods available to all clinical settings all they way to more sophisticated surgical methods available in tertiary referral centres, will be presented and discussed.
New insights from paediatric electrophysiology
Authors: Thompson Dorothy 
Published: January 2024

Visual electrophysiology is uniquely valuable in paediatric practice because it provides objective measures of visual pathway function. The combination of electroretinograms and visual evoked potentials to flashes and patterns enables a functional assessment of the entire pathway, from photoreceptors to striate cortex. This information can be impossible to obtain from children by other means. Electrophysiology complements structural information, often highlighting discrepant structure function relationships.Objective functional electrophysiology facilitates early diagnosis and can delineate potential treatment windows from the youngest ages. Thus visual electrophysiology findings in children contribute to natural history and deep phenotyping studies that inform clinical trials of new treatments not only for ocular disease, but also systemic diseases that involve the eye.This talk will describe ways in which ISCEV tests can be adapted and optimized for young children in clinical practice without loss of diagnostic accuracy, and how electrophysiology can distinguish phenotypes and inform genetic analysis. Examples of the value and limitations of electrophysiology in potential gene trials and other ameliorating treatments will be presented and discussed; including inherited retinal disease such as RPE65, neurodegenerations that affecting the eye such as CLN2 and iron brain disorders such as PKAN and ciliopathies such as BBS.Key words: visual electrophysiology, children, ERG, VEP, ISCEV.
Non infectious ocular surface inflammation: Paediatric GVHD
Authors: Atilla Huban 
Published: January 2024

Although ocular findings and treatment for GVHD are described in adult patients, the literature describing this condition in paediatric patients is relatively few. In children, detection of symptoms and diagnosis of ophthalmic findings are more difficult than in adults, as history taking, clinical examination and diagnostic tests such as fluorescein staining or Schirmer tests are difficult to perform due to limited cooperation. Also patients cannot specify their complaints and symptoms especially in younger age group. Follow‐up and frequent ophthalmic evaluation are important in diagnosis and management of children who had bone marrow transplantation. Even though ophthalmic findings are common in children, usually milder than adults but timely diagnosis and management are very important to decrease secondary eye complications such as corneal ulcers and vision loss and also to improve quality of life.Graft‐versus‐host disease (GVHD) is a major complication of bone marrow transplantation that is performed for haematological malignancies and diseases and seen in 50–70% of cases. It is a complex clinical disease with many organ and system involvement. Acute form is seen in the first 3 months after transplantation, systemic manifestation mainly include hepatitis and skin involvement and chronic form is mostly seen after acute GVHD. Ocular manifestations can be classified as acute and chronic and also as anterior and posterior. Most common ocular finding is dry eye with corneal involvement and seen in 40–90% of patients with chronic GVHD. Corneal vascularization, keratitis and even perforation can be seen. Conservative treatment with topical steroids, autologous serum, lubricant eye drops and ointments should be integrated with topical cyclosporine‐A that might be an effective and safe treatment option in dry eye related to chronic GVHD.
Molecular and cellular changes underlying plasticity and regeneration of intact, injured and aged cold corneal nerves
Authors: Meseguer Victor 
Published: January 2024

The peripheral nerve endings from trigeminal neurons that innervate the cornea are key neural structures to detect and encode the features of the physical and chemical external stimuli at the ocular surface. These neurons are functionally diverse and have been classified into polymodal nociceptors, mechano‐nociceptors and cold thermoreceptors. Each functional type evokes qualitative different conscious sensations. The sensory modality that is generated from a nerve ending is determined by the type and specific characteristics of the ion channels involved in stimulus transduction and encoding. Among them, TRPM8 channels transduce both cold and osmotic stimuli in corneal cold nerve terminals. These cold thermoreceptors mediate sensations of ocular surface cooling and dryness, and play an important role in the regulation of basal tearing and blinking. Morphologically, cold thermosensitive neurons display a more complex branching of their peripheral nerve endings innervating the cornea in comparison to the other functional classes of sensory neurons.With aging, TRPM8‐expressing cold sensory neurons innervating the mouse cornea experience morphological and functional alterations. These changes occur earlier and are more prominent at the nerve terminal than at the neuron cell body. A drastic reduction of the nerve terminal branching complexity in addition to lower background impulse activity is observed in cold nerves of aged mice. Similarly, after performing photorefractive keratectomy (PRK) in the adult mouse cornea, both the nerve terminal branching and background activity are reduced in a fraction of the cold nerve terminals. An altered morphological configuration along with an aberrant transducing and coding ion channels expression at corneal cold nerve terminals are likely to contribute to the discomfort sensations experienced after corneal surgery and to the age‐related abnormal tearing in the elderly.(Supported by PID2021‐124460OB‐I00 from DOI: MCIN/AEI/ 10.13039/501100011033, and CIPROM/2021/48 from the Generalitat Valenciana, Spain)
Medical and surgical management of neurotrophic keratopathy
Authors: Dua Harminder S. 
Published: January 2024

Neurotrophic Keratopathy (NK) is not a specific disease entity but a consequence of several conditions with varied aetiopathogenesis, of which a loss or reduction in corneal sensitivity is the hallmark. NK is clinically graded as Mild (stage1), Moderate (stage 2) and Severe (stage 3). The grading helps in understanding severity and planning treatment. Management can be considered in two parts. The first is the management of the underlying condition when active, for example herpes virus keratitis, bacterial ulcers and immune mediated ulcerative keratitis; and the second part, which deals with treatment of the non‐healing epithelial defect, stromal melting with or without vascularization and perforation that remains due to epithelial, stromal and corneal nerve pathology.Management of mild and moderate NK begins with the identification and elimination of any obvious underlying cause such as neuroleptic, antipsychotic, antihistamine and other systemic medications, preservatives in long term topical medications; and treatment of concurrent ocular surface infection. Tear substitutes and anti‐inflammatory agents both steroids and specific immunosuppressors like cyclosporin and lifitegrast should be used early. Antibiotics can be used prophylactically or to treat subclinical or overt infection. Medication with preservatives should be avoided. Prevention of progression to severe (stage 3) NK can be achieved with antiproteases such as citrate, tetracyclines and macrolides. Substrate re‐generating agents like Cacicol and promoters of epithelial regeneration like co‐enzyme Q10 target aspects of the underlying pathology. The introduction of recombinant human nerve growth factor (rh)NGF (Cenegermin/Oxervate) has provided specific therapy that addresses the basic defect related to corneal nerves. Insulin drops are proving to be useful and amniotic membrane extracts/amniotic fluid has also been tried. Autologous and pooled allo serum or plasma drops, which provide a variety of known and unknown factors have also proved useful but may at times aggravate the condition. Usually a combination of two or more of the above are required but rhNGF and insulin hold considerable promise for long term remission.Medical treatment is often augmented with non‐surgical interventions such as bandage contact lens, padding, punctal plugs, botulinum toxin, frost suture and glue. These are primarily designed to deal with exposure, dry eyes and reduce the abrasive effect of lid blinks, to promote healing. Useful surgical procedures include tarsorrhaphy, amniotic and conjunctival grafts, penetrating and lamellar keratoplasty and limbal stem cell transplants. Surgical interventions are designed to augment effects of the non‐surgical interventions, reduce scarring, deal with complications and restore sight. A key principle is that wound healing after any form of surgery or transplant, is poor if the corneal sensations remain impaired or absent.
Objective and independent measurement of scattering caused by the cornea and crystalline lens
Authors: Vilaseca Meritxell 
Published: January 2024

meritxell.vilaseca@upc.eduThere are several methods that provide information on the intraocular scattering. Procedures based on the observation of the lens through the slit lamp from which a gradation of the state of every cataract is assessed (e.g. lens opacities classification system III ‐ LOCS III) are the most widely used in clinics. Nevertheless, they provide information related to the back‐scattered light and not forward scattering, which is responsible for the degradation of vision. To do so, a procedure that assess retinal straylight using a device based on a psychophysical compensation‐comparison approach was proposed, in which the subject's task is a forced‐choice between two half fields to decide which one flickers more intensely. From these measurements, a psychometric function is fitted and used to determine the straylight compensation level log(s) on the basis of a few stimuli responses.As an alternative approach, some attempts have been made to use the double‐pass as a means of objectively estimating forward scattering. The double‐pass technique is a procedure that is able to capture the complete optical information of the eye, including the effect of higher‐order aberrations and intraocular scattering within a small visual angle. Artal et al. proposed the Objective Scatter Index (OSI) calculated from double‐pass images for estimating scattering with the intention to grade cataracts. This technique was also used successfully to account for scattered light in patients with keratitis and uveitis, and those undergoing refractive surgery. More recently, a new Frequency Scatter Index (FSI3) based on the analysis of double‐pass retinal images in the frequency domain has also been suggested, as a means of minimizing the impact of optical aberrations on the results obtained.Nevertheless, all of the former methods provide information on the total scattered light in the eye, which consists of the combined contributions originating from different ocular structures. In this regards, we recently proposed a technique for the objective and independent assessment of scattering caused by the cornea and the lens based on the analysis of the contrast of the third and fourth Purkinje images. The technique was preliminarily validated first by using artificial eyes with different levels of corneal and lens scattering; second, it was validated in eyes wearing customized contact lenses to simulate corneal scattering and eyes with nuclear cataracts. Finally, it was tested on a larger population of eyes with cataracts and corneal disorders to prove its clinical usefulness.In this work, we review all the above‐mentioned techniques that have been proposed for objective intraocular scattering assessment, putting especial emphasis on the last one based on Purkinje images, and compare their results and clinical performance.
Long‐term risk of glaucoma after cataract surgery in childhood
Authors: Schmidt Diana Chabané , Eriksson Frank , Bach‐Holm Daniella , Grønskov Karen , Kessel Line 
Published: January 2024

AbstractPurposeTo examine the long‐term risk of glaucoma after cataract surgery in childhood.MethodsThis study took place from January 2022 until December 2022 and included patients from a large family with hereditary childhood cataract who had cataract surgery before 18 years of age. Patients underwent an ophthalmologic examination to determine the presence of glaucoma or ocular hypertension (OHT). Patients who did not want to participate in the examination could contribute with a medical journal from their treating ophthalmologist. The risk of long‐term glaucoma was determined using survival analysis, and risk factors were assessed using a Cox proportional hazards regression model.ResultsWe included 68 patients (133 eyes) with a median age at cataract surgery of 7 years (IQR: 5–10). The median follow‐up time after cataract surgery to glaucoma/OHT or the latest ophthalmologic examination was 35 years (IQR: 15–48). Twelve patients (18 eyes) had glaucoma, and five patients (eight eyes) had OHT, resulting in 15 patients with glaucoma/OHT. The long‐term risk of glaucoma/OHT diagnosed in adulthood was 47.7% (CI: 21.8–70.9) at the age of 70 years of patients who were free of glaucoma before their 18th year. We could not confirm or dismiss an association between glaucoma/OHT and sex, age at surgery, number of ocular interventions before 18 years of age or glaucoma after cataract surgery in a first‐degree relative.ConclusionCataract surgery in childhood is associated with a high risk of late‐onset glaucoma. Regular lifelong follow‐up is important to ensure early diagnosis and prevent extensive vision loss.
A low proportion of undertriage validates the new West coast system for triage—Paediatric
Authors: Sjöstedt Hannah , Kindblom Jenny M. , Celind Jimmy 
Published: January 2024

AbstractAimThere is a lack of studies on paediatric triage systems. This study aimed to evaluate patient safety of the Gothenburg‐developed paediatric triage system West Coast System for Triage—Paediatric (WEST‐P).MethodThis study was performed at the paediatric emergency department in Gothenburg, Sweden, October 2020 to April 2021. Included patients were double‐triaged with the WEST‐P, and the established Rapid Emergency Triage and Treatment System—Paediatrics (RETTS‐p). We compared the level of urgency between both systems to identify potentially undertriaged patients. Also, we assessed the patient safety according to clinical assessment at presentation, and pre‐defined criteria.ResultsThis study included 2290 (23%) of triaged patients (44% girls, median age: 5.0 years) during the study period. A higher number of patients triaged to low urgency in WEST‐P compared to RETTS‐p (p < 0.0001) was observed, and 497 cases with low WEST‐P and high RETTS‐p urgencies identified. Of these, 29 had a clinical assessment indicating high urgency. After patient safety assessment, seven (0.4%) were determined undertriaged by the new triage system WEST‐P.ConclusionOur findings demonstrate a low risk of undertriage in the new WEST‐P. Thus, the WEST‐P has a high degree of patient safety when used in a paediatric emergency department.
SLAG—software for reconstruction of historical smelting processes based on slag properties
Authors: Kupczak Krzysztof , Warchulski Rafał 
Published: January 2024

AbstractThe publication presents the functions of the SLAG software created to recreate historical metallurgical processes. SLAG allows for determining the smelting temperature, the viscosity of the metallurgical melt, and the oxygen and sulfur fugacities during smelting. With software, both liquidus temperature and melt viscosity can be calculated using different models, covering the range of chemical compositions of historical slags as wide as possible. Based on thermodynamic calculations, SLAG allows the performance of O2 and S2 fugacity calculations in the temperature range of 1000–2000 K (727–1727°C). The range of applicability of other properties (viscosity and liquidus temperature) depends only on the limitations of individual models. Using SLAG, it is also possible to create predominance area diagrams (PADs) and diagrams that consider the viscosity's dependence on temperature for slag of a given chemical composition. Based on glass transition temperature (Tg) and melt fragility, it is also possible to reconstruct the conditions that prevailed during the various stages of historical glass manufacturing processes.