bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncommon case of basal linear deposits and its tomographic and indocyanine green angiography findings
Authors: Braham Imene Zhioua , Hachicha Ines , Mili Ilhem , Boukari Mejdi , Zhioua Raja Gmar 
Published: January 2024

Purpose: To report a rare and uncommon case of patient presenting drusen associated to basal linear deposit (BlinD) and macular vitelliform material (VM).Methods: Patient was assessed with multimodal imaging: fundus autofluorescence (FAF), indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI‐OCT). Electroretinogram (ERG) and visually evoked potentials (VEP) along with systemic evaluation were also performed.Results: A 52‐year‐old woman consulted for ophthalmological check‐up, without any complaint. Past history revealed breast cancer treated with chemotherapy and hormone therapy, currently in remission. Visual acuity was 10/10 in the right eye (RE) and 8/10 in the left eye (LE). Slit‐lamp anterior examination was unremarkable. Fundus examination revealed multiple interlaced round yellowish lesions mainly in the posterior pole associated to a pigmented macular lesion on the LE. FAF showed bilateral macular hypoautofluorescent lesions. ICGA highlighted bilateral scattered hypofluorescent spots (SHS) mainly noted in the late phase, distributed throughout the posterior pole, with partial confluence. EDI‐OCT featured the presence of drusenoid retinal pigment epithelium (RPE) elevation along with a thick and distinctive hyperreflective band between the RPE and Bruch's membrane (BM). Associated bilateral hyperreflective VM were also detected. ERG and VPE were unremarkable. Patient underwent systemic evaluation insuring absence of cancer recurrence, choroidal metastases, paraneoplastic syndrome or any systemic disease.Conclusions: BlinD is defined as a deposit located between the RPE and the BM. Recently, this entity has been correlated with SHS seen in late stages on ICGA and might be a precursor sign of age‐related macular degeneration. Associations between drusen and BlinD and between drusen and VM have been previously reported; however, the concomitance of these three features has, to our knowledge, never been reported.
The two extremes of retinal fold management
Authors: Stappler Theodor 
Published: January 2024

Aims/Purpose: Retinal folds represent a debilitating complication following retinal detachment surgery. While some patients may experience partial retinal flattening with minimal or moderate improvement of visual function, many will go on to suffer severe permanent vision loss. The indication and timing of possible reintervention is still debated, particularly for how long after initial retinal fold formation there can still be a reasonable expectation of anatomical and functional improvement.Methods: We present the cases of two patients suffering debilitating postoperative macular folds at opposite ends of the intervention window, who were referred to the Jules Gonin Hospital at different postoperative timepoints following retinal detachment surgery. Patient Nr 1 was reoperated within 20 days of the initial surgery, patient Nr 2 10 months later. Retinal folds were confirmed by preoperative OCT and pre‐ and post‐op cyclotorsion was measured on fundus photography.Results: Patient Nr 1 recovered vision from CF to 0.2 logMar within 3 months, improving to 0.0 logMar after one year. Patient No 2 recovered from HM to 0.6 after 3 months and further to 0.5 logMar after one year. Most importantly, while patient Nr 1 had no more cyclotorsion, undisturbed binocular vision already on day one postoperatively, even to the absence of metamorphopsia during follow‐up, patient Nr 2 recovered slowly, also regaining binocularity without cyclotorsion, but with lasting metamorphopsia. During the video presentation, the different retinal elasticity at these differing timepoints can be demonstrated intraoperatively as well as different strategies to induce retinal separation so that the central retina can be reattached in a new, more physiological position.Conclusions: Our cases illustrate that early intervention can lead to a virtually symptom‐free result while even delayed intervention may still be able to achieve some improvement in visual function and the avoidance of monocularity.References:Heimann H, Bopp S. Retinal folds following retinal detachment surgery. Ophthalmologica. 2011;226 Suppl 1:18–26Wong R. Longitudinal study of macular folds by spectral‐domain optical coherence tomography. Am J Ophthalmol. 2012 Jan;153(1):88–92.e1
Sunrays epiretinal membrane
Authors: Hachicha Ines , El Matri Khaled , Rim Bouraoui , Fatma Mghaieth , Limaiem Rim , El Matri Leila 
Published: January 2024

Aim: To report a unique aspect of an opalescent, symmetrical, sun rays like epiretinal membrane (ERM), assessed with swept source optical coherence tomography (SS‐OCT).Methods: Patient was assessed with multimodal imaging: colour photography and SS‐OCT with B‐scan and en face imaging.Results: A 65‐year‐old male with hypertension and diabetes history, followed in our consultation for pre‐proliferative diabetic retinopathy (DR), lost of sight for two years, presented with progressive visual decrease in his left eye (LE). Best corrected visual acuity (BCVA) of the right eye was 8/10 without any sign of DR activity on fundus examination. BCVA of the LE was limited to hand motion. Anterior segment examination was unremarkable. Fundus examination highlighted the presence of opaque dense ERM lining the posterior pole mimicking a symmetrical wheel spoke or sunrays, centred by a foveal pigmented lesion. En face SS‐OCT showed patterned retinal folds and B‐Scan SS‐OCT showed a thick hyperreflective layer above the internal limiting membrane (ILM) associated to underlying retinal surface wrinkling. We also noted thickened disorganized retinal layers, ectopic inner foveal layers (EIFL) and loss of the foveal depression. The central bouquet assessed the presence of subretinal hyperreflective vitelliform‐like deposit associated to intraretinal hyperreflective foci corresponding to pigment migration.Conclusion: This case corresponds to the final stage ERM of Govetto classification. It reveals a migration process of retinal pigment cells towards inner retinal layers. The advent of high‐resolution SS‐OCT offered a better detection of ERM stages and alterations of the central bouquet, in order to improve our pathophysiological understanding. In fact, many hypotheses on ERM development processes were suggested. Glial cells and retinal pigment epithelial cells would undergo trans‐differentiation to a myofibroblastic pre‐retinal cells through the retina, via microdefects above ILM. Accumulated myofibroblastic cells, along with extracellular matrix deposition are the main precursors of ERM.
Ozurdex insert dislocated to the anterior chamber after postration in a patient who underwent secondary implant surgery with Canabrava technique: A case report
Authors: Remacha Carla Sánchez , Simón Cristina Calvo , Borghi Luca Bueno , Fernández Miguel Castillo , Clavería Julia Aramburu , Martínez Marta Suñer , Arias Pablo Cisneros , De Rivas Marta Orejudo , Moscarda Eva Josefina Nuñez , Sánchez Adrián Moñux , Pascual Paula Casas , Puyuelo Francisco Javier Ascaso 
Published: January 2024

Aims/Purpose: To present a case report of a 64‐year‐old man with dislocation of a dexamethasone anterior chamber (AC) implant, who underwent secondary implantation with the Canabrava technique.Methods: A male patient underwent surgery for a secondary implant in the left eye using the Canabrava technique.Post‐operatively, cystic macular oedema was observed on optical coherence tomography (OCT). After 15 days, with no anatomical improvement despite treatment with Nevanac eye drops, a dose of intravitreal injection with Ozurdex® was prescribed. A few days later, the patient came to the emergency department and reported seeing a foreign body in the treated eye. On biomicroscopic examination, an Ozurdex® insert was found in the AC. When the patient was questioned again, he stated that he had been in the praying position the previous days. A new macular OCT was performed, showing resolution of the foveal oedema. Dilation of the LAA with phenylephrine was performed with cephalic manoeuvres in the supine decubitus position, achieving the repositioning of the dexamethasone implant in the vitreous chamber. Finally, an OCT of the anterior pole shows that the secondary implant is normally positioned without complications.Results: After initial treatment with Ozurdex® intravitreal implant, total resolution of the post‐operative cystic macular oedema is achieved, even with dislocation to the anterior chamber. After outpatient management of the dislocation of the implant, we were able to relocate it to the vitreous chamber without the need for surgical management of the patient.Conclusions: In the clinical case, it is demonstrated that the anti‐inflammatory effect of Ozurdex® remains active despite dislocation of the implant to the anterior chamber. Likewise, a good ambulatory technique in the supine position with directed cephalic manoeuvres may be sufficient to reposition the implant without the need for surgery.
Ocular involvement in a patient with POEMS syndrome, 2 years follow‐up with OCTA
Authors: Millas Sara Crespo , Di Lauro Salvatore , Galarreta‐Mira David 
Published: January 2024

Aims/Purpose: To report the microvascular changes in a case of POEMS syndrome over 2‐years follow‐up with OCT angiography.Methods: Case report of a 54 years old man with POEMS syndrome derived to our department from Neurology to evaluate visual acuity (VA) and fundus. OCT and OCTA (Triton, Topcon, Inc, Tokyo, Japan) was performed in each visit.Results: At the time of the first examination the patient and the VA… was 0.8 right eye (RE) and 1 left eye (LE) and fundus exploration revealed some microaneurysms (MA) and hard exudates. The OCT was normal and OCT‐A revealed some MA. In the follow‐up in 2022, the VA was 0.8 RE and 0.9 LE, in the fundus we found an increased number of MA and hard exudates, in OCT appeared some cysts in the parafoveal region and a higher number of MA in OCTA. After 2 years follow‐up, the VA was 0.9 in both eyes, and as new findings in fundus examination, some intraretinal haemorrhages and vascular proliferation in periphery in LE. In OCT persist parafoveal cysts and OCTA showed a mild increase in the number of MA. We did not found any affectation in optic nerve or signs of vasculitis.Conclusions: POEMS syndrome is a multiorganic disease with an increase production of vascular endothelial growth factor (VEGF). The ocular involvement is rare and the more common findings are optic neuropathy, macular oedema or retinal occlusive vasculitis. In this case report we made a follow‐up in the changes in OCT and OCTA. These two ancillary tests help to found microvascular changes that can be unnoticed in these patients. As far as we know, there is not others publications with a 2 years follow‐up with OCTA in POEMS syndrome.
Synchrotron‐based Fourier transform infrared microspectroscopy examined differences between the cultured and post‐operative human lens epithelial cells important for understanding posterior capsular opacification and lens regeneration
Authors: Andjelic Sofija , Kreuzer Martin , Hawlina Marko 
Published: January 2024

Aims/Purpose: To compare the bio‐macromolecular composition and the differences between the human cultured and post‐operative lens epithelial cells (LECs) on lens capsules (LCs) for a better understanding of posterior capsular opacification (PCO)—the most common complication of cataract surgery, and lens regeneration.Methods: The explants of the anterior portion of the LC containing the LECs, obtained from cataract surgery and cultivated under adherent conditions, as well as the post‐operative LC with LECs, were analysed by using synchrotron radiation‐based Fourier transform infrared (SR‐FTIR) microspectroscopy, a vibrational spectroscopic technique that allows monitoring of the entire biochemical status of the biological processes. The SR‐FTIR microspectroscopy setup installed on the beamline MIRAS at the Spanish synchrotron light source ALBA was used, where measurements were set to achieve single‐cell resolution, with high spectral stability and high photon flux.Results: We found that the differences exist between the composites of cultured and post‐operative LECs on LCs on the level of all chemical constituents: proteins, lipids, nucleic acids and carbohydrates as well as oxidative stress. The strongest differences are found in protein secondary structure contribution where the composite of primary LECs cultures on LC have more α‐helix (1652 cm−1) and post‐operative LC have more β‐sheet (1624 cm−1 and 1697 cm−1) secondary structures. The oxidative stress is more expressed in the composite of primary LECs cultures on LC and relatively less in the composite of post‐operative lens epithelium LECs on LC.Conclusions: Our results obtained by SR‐FTIR increase the knowledge about the total proteins, lipids, and nucleic acids in human primary cultures LECs while offering also evidence that SR‐FTIR is sensitive to the pathologic processes of LECs transdifferentiation. We showed that the composite of primary cultures LECs on LC have a distinct bio‐macromolecular composition compared to the composite of post‐operative LECs on LC, which gives additional information for a better understanding of PCO and lens regeneration.
Targeted fluorescence imaging using bevacizumab‐800CW within neovascular age‐related macular degeneration (AMD) patients to evaluate the upregulation of vascular endothelial growth factor (VEGF‐A) (preliminary results)
Authors: Volkmer Pia , Schmidt Iris , Westra Kim , Polman Janine , Ouwerkerk M. Stefan , Uwantege Liberata , Bolhuis Renée , Muskens Rogier , Huiskamp E. Angela , Nagengast Wouter 
Published: January 2024

Aims/Purpose: With this phase 1 study, we aim to gain insight into the feasibility of using bevacizumab‐800CW to visualize the upregulation of VEGF‐A in AMD patients for treatment optimization.Methods: First, six wet AMD patients who are currently undergoing treatment with anti‐VEGF agents were included to evaluate the optimal tracer dose and received either 4.5 or 15 mg bevacizumab‐800CW. For the ongoing analysis of targeted tracer accumulation, three additional on‐therapy and three naïve patients will be included with the optimal dose of 15 mg. Fluorescence images (Heidelberg Spectralis) were taken before, up to 60 min and 3–4 days after intravenous injection of bevacizumab‐800CW. The target‐to‐background ratios (TBR) were calculated and compared between dose groups to evaluate the optimal dose. To investigate targeted tracer uptake, images of different time points are normalized and aligned, and a fluorescence intensity line is plotted over the active lesion to locate interesting areas for further quantification.Results: The preliminary results showed a clear inflow of the tracer into the eye vasculature after administration of 15 mg bevacizumab‐800CW. The fluorescence remains visible up to 1 h after tracer administration. Visual image comparison and TBR calculation in the first six patients showed that 15 mg bevacizumab‐800CW was the optimal tracer dose. In patients who received 15 mg bevacizumab‐800CW, accumulation of fluorescence signal in a smaller area within the active lesion was seen after 3–4 days.Conclusions: For the first time, we show that bevacizumab‐800CW (4.5 mg/15 mg) can be imaged in AMD patients using a commercially available system. An increase in signal intensity 3–4 days after bevacizumab‐800CW injection predicts tracer accumulation in the diseased area indicating ongoing active disease. VEGF‐A imaging can act as a proof of concept and pave the way for a broad application to track the performance of drugs by fluorescence molecular imaging.
The association between dry eye with ocular aberrations and contrast sensitivity in 60 years old people and over
Authors: Yekta AbbasAli , Khabazkhoob Mehdi , Hashemi Hassan , Azami Mohammad , Ostadimoghaddam Hadi , Shandiz Javad Heravian , Ehsaei Asieh , Azimi Abbas , Yekta Yeganeh 
Published: January 2024

Aims/Purpose: To determine the association between dry eye with higher order aberrations (HOAs) and contrast sensitivity in 60 years old people and over.Methods: This population‐based study was conducted in Tehran, the capital of Iran, using stratified multistage random cluster sampling. All participants underwent complete ocular examination including measurement of uncorrected and best‐corrected visual acuity, refraction, slit‐lamp biomicroscopy. Zywave was used for measuring HOAs aberrations. Contrast sensitivity was measured with best correction visual acuity using the CVS1000 grating charts. Schirmer and tear break‐up time (TBUT) tests were used for evaluating dry eye in participants.Results: After applying exclusion criteria, the data of 397 individuals were analysed. A total of 415 people were invited, of whom 397 (62.8%) were females. The mean age of the participants was 68.32 ± 5.49 years. After adjusting with age and sex, in the multiple regression model that the TBUT test has a direct association with spherical aberration (p = 0.017) and an inverse association with coma, trefoil and the third, fourth and fifth order aberrations (p < 0.05). Schirmer test results also had a positive relationship with spherical aberration (p = 0.046) and an inverse relationship with coma, trefoil and the third, fourth and fifth order aberrations (p < 0.05). Contrast sensitivity had a significant association with Schirmer test result only in spatial frequency of 3CPD.Conclusions: The results of this study indicated the association between dry eyes and HOAs, and that the TBUT and Schirmer test results are of the most important factors in this relationship. Treating dry eye, can improve HOAs and quality of vision in elderly people.
Keratoconus: Ocular surface considerations, from bench to bedside
Authors: Doroodgar Farideh , Niazi Sana 
Published: January 2024

Aims/Purpose: This comprehensive systematic narrative study is aimed to describe the close interactions between the ocular surface and keratoconus with its vast spectrum of diagnostic and treatment techniques, both basic and clinical.Methods: This investigation searched PubMed, Scopus, Cochrane, Embase, and Web of Science for relevant papers published up to January 2023. The systematic review used MeSH and non‐MeSH terms. Unrestricted language and publishing schedule. After a comprehensive search, all of the search results were imported into Endnote software after a thorough search. Duplicate and less relevant citations have been eliminated in Endnote. In addition to the databases indicated, we searched Google Scholar for “Ocular surface” AND ((keratoconus) OR (“pellucid marginal degeneration”) OR (“corneal ectasia”) OR (“iatrogenic ectasia”)).Results: Treating dry eye, MGD, and blepharitis may slow KC progression and relieve symptoms. Eye rubbing and mechanical injury could spread bacteria to the eyelids, causing blepharitis. Tarsorrhaphy is the most powerful manoeuvre to help heal epithelial defects, especially in moderate and severe forms of DED. Use high‐quality eyedrops, especially preservative‐free ones, to increase tissue viscosity on the ocular surface and protect tear film to reduce epithelium injury before and after surgery. Finally, Vitamins, minerals, metal ions, and antioxidants may prevent dry eye and KC. In addition, improper air quality, wind, pollution, low humidity, watching TV, reading, and surgical procedures can cause dry eye illness, increase MMP‐9 and IL‐6 and decrease EGF during exacerbation.Conclusions: This is the first systematic narrative review to explore the mutual interaction between the ocular surface and KC and the wide spectrum of diagnostic and therapeutic options. Dry eye and tear film instability have been documented as a non‐ectatic differential diagnosis for KC and ectatic disorders. Nonetheless, KC and DED are both common topics. Future research should look into the effect of pre‐treating ocular surface health on postoperative outcome and the efficacy of the therapeutic strategy in reversing KC ocular surface changes.
Long‐term clinical course of amniotic membrane after permanent amniotic membrane transplantation
Authors: Kim TaeHwan , Noh Seungyoon , Kwon Yoon Hyung 
Published: January 2024

Aims/Purpose: To investigate the long‐term clinical outcomes of transplanted amniotic membrane in patients who underwent permanent amniotic membrane transplantation (P‐AMT) on cornea.Methods: From April 2014 to March 2021, medical records and digital photographs of 68 patients (72 eyes) who underwent P‐AMT were analysed retrospectively. The duration of complete re‐epithelization of cornea and wearing therapeutic contact lens (T‐lens) after surgery were investigated, the size of preserved amniotic membrane (AM) excluding the melted portion was analysed using the Image J program every year up to 6 years after surgery, and it was compared by dividing into a single‐layer group and a double‐layer group. In addition, when the AM melts, the cause, time, and related factors of melting were analysed.Results: The average duration to complete re‐epithelialization after surgery was 12.2 ± 11.0 days, and T‐lens were worn on average up to 8.7 ± 8.5 months after surgery. In total group, the average ratio of preserved AM annually up to 6 years after surgery was 94.9%, 94.3%, 97.8%, 96.4%, 95.8%, 91.6% respectively, and there was no significant difference between the single‐layer group and the double‐layer group. AM melting appeared in 38.9% (28 eyes) of the total group, and melting was first observed on average 16.4 ± 17.2 months after surgery. The formation and rupture of bullae was the most common cause of melting at 71.4% (20 eyes), and there were no statistically significant related factors involved in the formation of bullae.Conclusions: In the case of P‐AMT performed in various diseases of the cornea, the transplanted AM is partially melt but considered to be well preserved up to 6 years after surgery to form a stable ocular surface.
The effect of long‐term use of gadgets on the condition of the bulbar conjunctiva in young people
Authors: Hryzhymalska Olexandra , Melnyk Olha , Zhmud Tetiana , Andrushkova Olga 
Published: January 2024

Aims/Purpose: To evaluate the condition of the bulbar conjunctiva in young people by the method of impression cytology in response to long‐term use of gadgets.Methods: The research design consisted of 40 students (80 eyes) aged 18–20 years (19 ± 1.2). All students underwent general ophthalmological examinations, including blink rate per minute and impression cytology of the bulbar conjunctiva from the temporal side. Changes in the bulbar conjunctiva were evaluated according to Nelson's classification. Criterion for inclusion in the study: time spent on gadgets at least 6 h per day. Exclusion criteria: contact lens users, chronic eyelid diseases, diabetes, systemic connective tissue diseases, Sjögren's disease...).Results: Morphological and morphometric studies of the bulbar conjunctiva showed that most of the subjects (35 students, which is 87.5%) had a normal epithelial state of the front surface of the eye, which corresponds to 0–1 degrees according to Nelson, while 5 students had changes in the form of partial squamous metaplasia, which corresponded to the II degree according to Nelson and amounted to 12.5%. Blink frequency was reduced in 27 subjects, which was 67.5%. In most cases (n = 34, 85%) had a reduced blink frequency while working with gadgets, and 27 students (67.5%) had it reduced even without using digital devices.Conclusions: The results of our research showed that 12.5% of students had changes in the epithelium of the bulbar conjunctiva, corresponding to the II degree according to Nelson, which can be considered as adaptively compensatory processes, in response to long‐term use of gadgets. Therefore, it is necessary to prescribe moisturizing drops to young people, which do not contain preservatives, phosphates and buffers (for example, Thealoz duo).