bluuebunny/crossref_metadata_2025_split huggingface dataset:
TFOS lifestyle report: Effects of environmental conditions on the ocular surface
Authors: Villani Edoardo ,   the Environmental Conditions Subcommittee of the TFOS Lifestyle Workshop
Published: January 2024

This presentation summarizes the findings of the Environmental Conditions Subcommittee of the recent Workshop of the Tear Film & Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org). The tear film and the ocular surface morphofunctional unit are directly exposed to the surrounding environment. Environmental factors with potential, probable or well‐established impact on the ocular surface health include: climate factors (temperature, humidity, windspeed, altitude, dew point, ultraviolet light), outdoor and indoor pollutants (gases, particulate matter, and airborne pollutants) and allergens. These factors interact each other in complex and concurrent ways, contributing to different specific ocular surface diseases, including dry eye, ocular allergies, conjunctival and corneal degenerative conditions, injuries, and neoplastic diseases. Age and sex, race/ethnicity, geographical area, and seasonality are some of the key elements playing a relevant role in environmental factors‐related ocular surface diseases.Throughout an extensive narrative review process, this report evaluated in detail the evidence about each of those environmental conditions and the associated ocular surface diseases. Distinct environmental conditions may increase risk and/or aggravate certain conditions and may contribute to specific diseases. Indeed, a systematic review, conducted to investigate the association between outdoor pollution and dry eye signs and symptoms, found evidence supporting the risk factor role of air pollution (from NO2 and CO, but not from PM10) and soil pollution (from chromium).
TFOS lifestyle report: Effects of contact lenses on the ocular surface and adnexa
Authors: Filipe Helena Prior ,   the Contact Lenses Subcommittee of the TFOS Lifestyle Workshop
Published: January 2024

This presentation summarizes the evidence‐based findings of the Contact Lens Subcommittee of the recent Workshop of the Tear Film & Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org).Several risk factors can increase the potential for complications associated with contact lens wear, such as ignoring appropriate contact lens care, disregarding an ocular or systemic disease (especially if associated with an unhealthy ocular surface), reduced clinical surveillance and the simultaneous use of excessive alcohol, tobacco, or recreational drugs. The recent pandemic has introduced novel challenges to the wear of contact lenses, including mask associated dry eye, discomfort and fatigue with digital devices, accidental exposure to hand sanitizers and a decreased duration of contact lens wear. Adverse environments for lens wearers, such as pollution, dust, smoke, and sport or work accidents determining ocular trauma, can represent challenges for the use of contact lens, though protective in some cases. To ensure the best outcomes for contact lens wearers in adverse situations, prescription choice should consider several factors, including night driving, sports, wear at high altitude, military application, and outer space environments.This presentation synthetises the lifestyle‐related choices made by both clinicians and contact lens wearers, and underlines that, if appropriately undertaken, these can positively impact contact lens wearers quality of life. A systematic review and meta‐analysis highlight the need to better understand the influence of lifestyle factors on contact lens dropout.
LHON spectrum disorder: Phenotype and genes
Authors: Barboni Piero 
Published: January 2024

Leber hereditary optic neuropathy (LHON) is an inherited optic neuropathy primarily affecting young male with subacute bilateral visual loss. Clinically it is characterized by central scotoma, discromatopsia, and usually permanent central visual loss.This disease has a typical optic disc appearance at fundus examination of pseudoedema and microangiopathy which characterize the asymptomatic and subacute phases of the disease. Optic disc atrophy follows in the chronic phase.When the disease manifests, the preferential involvement of papillomacular fibres and macular retinal ganglion cell (RGC) damage are evident. These clinical features combined with the ophthalmoscopic pattern create the framework that make the disease unique.Primary point mutations of mitochondrial DNA (mtDNA) have been described as the genetic cause of the disease in about 90% of cases. Recently, new autosomal recessive DNA mutations have been reported in patients affected by subacute visual loss associated with a clinical picture resembling LHON.We herein describe the phenotype of 6 patients in which whole‐exome sequencing identified variants in the MECR gene in 2 probands of the same pedigree, in the NDUFAF4 gene in one patient, and mutation in the nuclear gene DNAJC30 in 3 patients. The 3 male probands with DNAJC30 mutation presented the typical LHON clinical picture with subacute loss of vision at an adult age in 2 cases and at a childhood age in one case. The pattern of visual loss with central scotoma and discromatopsia was associated with pseudoedema and microangiopathy at fundus appearance. Optical coherence tomography (OCT) analysis showed in both acute and asymptomatic family members the swelling of fibres while in the dynamic and chronic stages a progressive thinning of fibres. Visual recovery was detected in the younger patient and, partially, in one of adult patient.The 3 other patients carrying the MECR and NDUFAF4 gene variants showed a particular course of the disease characterized by a childhood onset of visual loss followed by a recurrence of visual loss at an adult age. The childhood onset was insidious in one case and subacute in the other 2 cases (about 6 years of age).OCT analysis demonstrated in the insidious case the temporal thinning of fibres and the macular RGC atrophy followed by swelling of fibres during the recurrence.In the differential diagnosis of inherited optic neuropathies with clinical presentation resembling LHON we should take into consideration the recessive form with mutations in the DNAJC30 gene which appears to overlap the mtDNA LHON disease. Moreover, clinical patterns resembling LHON with recurrence of visual loss represent another form of LHON with unique clinical presentation associated with variants in the MECR and the NDUFAF4 genes. These new clinical and genetic patterns enlarge the spectrum of LHON disease.
The effect of glaucoma surgical procedures on the corneal endothelium
Authors: Georgoudis Panagiotis 
Published: January 2024

All types of surgery in the anterior chamber can cause damage to the corneal endothelial cells and result in reduction of the endothelial cell density. This is the case for glaucoma procedure as well.During this presentation, we will review the available evidence of the effect of trabeculetomy, glaucoma drainage devices (tubes) and MIGs, on the health of the corneal endothelium, in the short and long term.
Size of the foveal blue scotoma related to the shape of the foveal pit but not to macular pigment
Authors: Schaeffel Frank 
Published: January 2024

Co‐authors: Yun Chen and Weizhong Lan.The central fovea is known to lack S‐cones. A nice psychophysical demonstration was introduced by Magnussen et al, Vision Res 2001. If the computer screen is sinusoidally modulated in brightness at about 1 Hz and is viewed through a blue filter that transmits below 480 nm, the “foveal blue scotoma” becomes visible as a small irregular black spot that follows fixation. It is highly variable among subjects. We studied the possible reasons ‐ foveal shape or macular pigment distribution. We found that the steeper the foveal slopes and the narrower the foveal pit, the larger the foveal blue scotoma. We found no correlation with macular pigment distribution or Maxwell's spot. Therefore, the foveal blue scotoma appears to be a consequence of the lack of S‐cones in the foveal center. Unlike the foveal blue scotoma, Maxwell's spot is based on macular pigment as previously proposed.
Clinical outcome of organ‐cultured preloaded DMEK compared to standard DMEK ‐ A single center study
Authors: Rickmann Annekatrin , Wahl Silke , Szurman Peter 
Published: January 2024

The use of ready‐to‐use grafts from specialized eye banks might provide a number of benefits, including graft quality control, assured availability at a certain operation time, a decreased likelihood of case cancellation, and a shorter and less sophisticated DMEK surgery, with a resulting lower risk of graft damage. However, it is critical to thoroughly establish the clinical safety of employing these preloaded tissues. Especially since most of the studies were prepared and stored under hypothermic conditions. There are only a few studies on preprepared tissues in organ culture, which are partly controversial.In this prospective study we included patients who received DMEK surgery at the Knappschaft Eye Clinic Sulzbach between 05/2021–12/2022. Patients received either a preloaded DMEK (pDMEK), prepared 5 days before surgery in the eye bank, or a conventional, directly before surgery, surgeon‐prepared DMEK (sDMEK).The preliminary data shows that preloaded DMEK is a safe procedure, but there is a trend towards more frequent rebubbling in the pDMEK group and a statistically non‐significant lower postoperative endothelial cell count compared to the sDMEK group. However, visual acuity and corneal thickness reduction were similar in both groups.
Usefulness of eye tracking systems in multiple sclerosis
Authors: Guantay Carla Daniela 
Published: January 2024

Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by inflammation and neurodegeneration. It represents the leading cause of nontraumatic disability in young adults in many places around the world.Currently, for the objective quantification of the damage of the visual pathway swept‐source OCT (SS‐OCT) is considered the most appropriate technique. Additionally, during the course of the disease multiple neurological deficiencies can appear, including eye motility disorders.Patients may develop various ocular motor disorders (OMDs) affecting visual function and significantly increasing disability. These alterations involve visual function and may decrease quality of life perceived by patients because they affect, among other functions, reading capability.OMDs, can be analysed by several recording systems, although they have not been incorporated into the practice routine clinic due to its complexity, high costs and also because the value of these alterations is probably not known.It is possible that an accurate examination of motility eye, may have a substantial impact on the diagnosis and management of those patients. OMDs has been suggested as potential biomarker of early neurological deterioration and its evaluation could contribute to obtaining progression and response to treatments, facilitating translational development of so‐called precision medicine.Eye trackers are state‐of‐the‐art tools that can obtain valuable information of OMDs in neurological degenerations. In MS, oculomotor alterations as saccadic dysmetria, saccadic intrusions, nystagmus, fixational deficits, smooth pursuit impairment, skew deviation, optokinetic and vestibulo‐ocular reflex impairments, may go unnoticed because systematic examination of the oculomotor systems do not use routinely these techniques.As mentioned, objective recordings of eye movements through eye‐tracking systems are not currently performed widely, despite that they have been described as an important adjunct in diagnosis, documentation, and management of different neurologic conditions.In addition, eye tracking is also a capable method to investigate the relationship between behaviour and neural mechanisms. Eye motion recordings provide a measure of functional preservation of the nervous system, which should be recognized to be of significant importance in assessing a disease in which disability is manifested by disruption of normal neuronal functions.In fact, it has been described that eye tracking tasks (especially saccadic tasks) are often used as an adjunct to traditional scales for cognitive assessment. In addition, eye tracking data confirmed that MS is characterized by attention deficits.In conclusion, there is a growing interest in the use of eye tracking systems as biomarkers for MS. Specifically in this work we have analysed a large series MS patients to detect if any of the anomalies that patients refer to, such as reading difficulties, are related to disorders of the ocular motor systems.
Use of OCT in the search for biomarkers in neurodegenerative diseases
Authors: Salobrar‐Garcia Elena 
Published: January 2024

Over the last 10 years, research has increasingly demonstrated that the retina, a tissue in the central nervous system that grows from the brain, is affected by various pathological processes in patients with neurodegenerative diseases.Some of the changes widely detected in these diseases are abnormal deposition of different proteins in the retinal and choroid layers, retinal glial changes, neuronal death as well as changes in the vision of these patients.OCT provides high‐resolution two‐dimensional cross‐sectional imaging and three‐dimensional volumetric measurements, making it particularly useful for analysing retinal structural abnormalities consistent with disease pathogenesis. This tool can help us to measure hallmark signs and structural‐functional biomarkers in the accessible retina to assess risk, disease progression, and therapeutic efficacy in patients with neurodegenerative diseases.In this SIS, we will review the findings found in the retina by OCT and Optical coherence tomography angiography (OCT‐A) in different neurodegenerative diseases and the use of new machine learning techniques in the search for a guide to be used in clinical practice, to assess risk, disease progression, and therapeutic efficacy in patients with neurodegenerative diseases.
Immunotherapy induced uveitis
Authors: Makhoul Dorine 
Published: January 2024

Uveitis can affect all layers of the eye and may be due to various etiologies: autoimmune, infectious, iatrogenic or masquerade syndrome. Recently, a new iatrogenic uveitis entity has been associated with cancer immunotherapy (CIT).Immune checkpoint inhibitors and targeted therapies including BRAF and MEK inhibitors are increasingly used for treatment of metastatic malignancies. There is currently 10 immune checkpoint inhibitors (ICPIs) targeting one of three ligands, leading to T‐cell activation for attack against malignant cells. These ligands include cytotoxic T‐lymphocyte antigen‐4 (CTLA‐4, ipilimumab), programmed death protein 1 (PD‐1, pembrolizumab, nivolumab), and programmed death ligand‐1 (PD‐L1, atezolizumab, avelumab, durvalumab).ICPIs overcome T‐cell inhibition and increases the activity of immune system and the loss of immune homeostasis, which can lead to autoimmune/inflammatory side effects, termed immune‐related adverse events (IRAEs). IRAEs can include ophthalmic manifestations as uveitis, which can very between anterior uveitis, intermediate uveitis, and panuveitis, but also some cases of ocular surface disorders, optic neuropathy and orbitopathy.The aim of my presentation is therefore to describe ICPI‐induced ocular IRAEs, more specifically the uveitis, detailing the anatomical specificities, potential risk factors, workup, and the management through an adapted treatment, and outcome, in relation to the outcome of the underlying tumour.
Combined cataract and vitreoretinal surgery
Authors: Modis László 
Published: January 2024

Combined cataract surgery and vitrectomy is a surgical technique used to address both cataract and vitreoretinal disorders. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This technique offers several advantages over separate surgeries, including reduced surgical time and anaesthesia exposure, as well as quicker visual rehabilitation. However, the optimal timing and approach for combined cataract surgery and vitrectomy remain controversial.Indications for combined cataract surgery and vitrectomy include various vitreoretinal conditions, such as retinal detachment, diabetic retinopathy, macular holes, and epiretinal membranes. The timing of surgery depends on the severity of the cataract and the vitreoretinal pathology, as well as the surgeon's preference. The most common surgical techniques include phacoemulsification with posterior chamber intraocular lens implantation, followed by pars plana vitrectomy. The filling of the vitreous cavity is possible with several types of tamponades, such as different gases, but in extreme cases even with silicone oil. After gas tamponade, proper positioning of the patient is of great importance.Complications associated with combined cataract surgery and vitrectomy include posterior capsule rupture, intraocular lens dislocation, postoperative inflammation, and intraocular pressure elevation. However, the overall complication rate is low, and the visual outcomes are generally favourable.In conclusion, combined cataract surgery and vitrectomy is a useful technique for managing various vitreoretinal conditions. Proper patient selection, careful surgical planning, and close postoperative monitoring are critical for achieving optimal outcomes.
TFOS lifestyle report: Effects of nutrition on the ocular surface and adnexa
Authors: Versura Piera ,   the Nutrition Subcommittee of the TFOS Lifestyle Workshop
Published: January 2024

This presentation summarizes the findings of the Nutrition Subcommittee of the recent Workshop of the Tear Film & Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org). It is now recognized that unhealthy nutrition habits, which include either under and over eating, can impair our daily wellbeing and contribute to the risk of developing several diseases. Nutrients are substances required by the body to perform its basic functions, and must be obtained from our diet. They are broadly classified into three groups: macronutrients (carbohydrates, lipids, and proteins), micronutrients (vitamins and minerals), and water. In the report each element of nutrition and its known impact on the ocular surface is discussed on the basis of scientific evidence. Vitamin deficiencies, such as vitamin A and C, have been consistently associated with ocular surface impairment, but links with other systemic nutritional deficiencies are far less established, and just hypothesized at present. The influence of factors such as age, sex, ethnicity, socioeconomical issues on nutrition, and the modulation of the gut microbiome to improve ocular surface disease are also explored. Certain systemic conditions may affect the uptake, processing and distribution of nutrients by the body, thus leading to deficiencies of micro‐ and macro‐nutrients that are important in maintaining ocular surface health.Among supplements, the omega‐3 and omega‐6 polyunsaturated fatty acids are the most extensively studied dietary supplements in ocular surface disease, with numerous randomized controlled trials, systematic reviews and meta‐analyses, mostly in patients with dry eye disease, and showing low to moderate certainty evidence for a reduction in either symptoms and signs.An overarching issue identified in the report is the relative paucity of high‐quality evidence in explaining the role of nutrition in ocular surface health and disease. Eye doctors are advised to consider the evidence prior to providing nutritional recommendations to patients with respect to treatment for an ocular surface disease.
Big data enabled keratoconus care
Authors: Li Ji‐Peng Olivia 
Published: January 2024

Keratoconus is a disorder affecting the cornea in which its normal round shape progressively thins causing a cone‐like bulge to develop. Because the cornea does most of the focusing of the eye, this change in shape causes significant problems with vision. As the disease gets worse, the cornea gets steeper, and vision continues to decline. It is a significant cause of visual loss in the UK, affecting up to 1 in 450 young people and is the commonest indication for corneal transplantation in young people. Corneal cross‐linking (CXL) is the only proven treatment to prevent keratoconus getting worse. However there is limited reports of its long term safety in large numbers and we reported one of the largest series in the world.We used data from the Early Keratoconus Clinic over the past 10 years to generate our results, looking at how many patients progressed despite treatment. What we also did that was innovative was to create personalized progression threshold definitions. We know that early progression can be quite hard to detect, and in later disease the imaging is poorly repeatable. Therefore a personalized threshold, derived from repeated scans from our dataset, will be able to pick up disease earlier, before more progressive visual loss.We used real world data from our patients to create a predictive model, a calculator, that predicts when a patient is likely to need treatment. The reason for creating this calculator is that it allows patients to better understand their risks in a visual format, gives clinicians an objective marker for an individual's risk, and also allows the hospital to plan services based on needs.We were able to also use genetic data to see how it influenced disease progression, based on the gene segments that were identified by the Institute of Ophthalmology and Moorfields. This work has resulted in an open access calculator available on https://beta.moorfieldscxl.com.This talk will also look at the opportunities and challenges of deploying artificial intelligence algorithms in the management of keratoconus, and how we can adapt our own routine practices to contribute to the development of big datasets that can further train and validate AI algorithms.