bluuebunny/crossref_metadata_2025_split huggingface dataset:
INCREASING EVIDENCE FOR THE SAFETY OF FOVEA-INVOLVING HALF-DOSE PHOTODYNAMIC THERAPY FOR CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Feenstra Helena M. A. , Diederen Roselie M. H. , Lamme Martine J. C. M. , Tsonaka Roula , Fauser Sascha , Yzer Suzanne , van Rijssen Thomas , Gkika Theodora , Downes Susan M. , Schlingemann Reinier O. , Hoyng Carel B. , van Dijk Elon H. C. , Boon Camiel J. F. 
Published: February 2023

Purpose:
A retrospective study was performed with data from the prospective randomized controlled trials, PLACE and SPECTRA, assessing the risk of foveal atrophy and the likelihood of structural and functional improvement on optical coherence tomography, after foveal half-dose photodynamic therapy in chronic central serous chorioretinopathy.

Methods:
A total of 57 chronic central serous chorioretinopathy patients received a single half-dose photodynamic therapy with a treatment spot that included the fovea. Optical coherence tomography scans and fundus autofluorescence images were analyzed for structural improvement and possible atrophy development, at baseline and at several visits after treatment. Main outcome measures were integrity of the external limiting membrane and ellipsoid zone on optical coherence tomography and hypoautofluorescence on fundus autofluorescence.

Results:
The subfoveal external limiting membrane was graded as continuous in 21 of 57 of patients (36.8%) at baseline, and the subfoveal ellipsoid zone was graded as continuous in 5 of 57 patients (8.8%) at first visit, which improved to 50 of 51 (98.0%) and 32 out of 51 (62.7%) at the final visit at 2 years, respectively (both P < 0.001). Hypoautofluorescent changes on fundus autofluorescence were present in 25 of 55 patients (45.5%) at baseline and in 23 of 51 patients (45.1%) at the final visit (P = 0.480).

Conclusion:
In patients with chronic central serous chorioretinopathy who received a single, foveal, half-dose photodynamic therapy, a significant improvement in structure and function was seen at the final follow-up. None of the patients developed foveal atrophy.
LEPREL1-RELATED GIANT RETINAL TEAR DETACHMENTS MIMIC THE PHENOTYPE OF OCULAR STICKLER SYNDROME
Authors: Magliyah Moustafa S. , Almarek Faisal , Nowilaty Sawsan R. , Al-Abdi Lama , Alkuraya Fowzan S. , Alowain Mohammed , Schatz Patrik , Alfaadhel Talal , Khan Arif O. , Alsulaiman Sulaiman M. 
Published: February 2023

Purpose:
To describe the features of retinal detachments and high myopia in patients with novel pathogenic variants in LEPREL1 and report a possible association with nephropathy.

Methods:
Retrospective study of 10 children with biallelic LEPREL1 pathogenic variants. Data included ophthalmic features, surgical interventions, and genetic and laboratory findings.

Results:
10 patients (8 females) from three families with homozygous (2) or compound heterozygous (1) variants in LEPREL1 were included. At presentation, mean age was 9.9 ± 2.6 years. Mean axial length was 28.9 ± 1.9 mm and mean refraction was −13.9 ± 2.8 diopters. Bilateral posterior subcapsular cataracts were present in eight patients (80%), with lens subluxation in five eyes of three patients (30%). Rhegmatogenous retinal detachments (RRD), associated with giant retinal tears (GRT), developed in seven eyes of five patients (50%) at a mean age of 14.14 ± 5.9 years. Six were successfully reattached with mean Snellen best-corrected visual acuity improving from 20/120 preoperatively to 20/60 at last follow-up. Urinalysis in nine patients revealed microhematuria and/or mild proteinuria in six patients (67%).

Conclusion:

LEPREL1-related high myopia confers a high risk of early-onset GRT-related RRD. The ocular phenotype may be confused with that of ocular Stickler syndrome if genetic testing is not performed. Further investigations into a potential association with renal dysfunction are warranted.
CHARACTERIZATION OF MACULAR NEOVASCULARIZATION IN BIETTI CRYSTALLINE DYSTROPHY USING MULTIMODAL IMAGING MODALITIES
Authors: Li Qian , Zhang Shengjuan , Kang Lihua , Wang Donglin , Jiao Xiaodong , Hejtmancik J. Fielding , Wang Lifei , Peng Xiaoyan 
Published: February 2023

Purpose:
To characterize the clinical features of macular neovascularization (MNV) secondary to Bietti crystalline dystrophy.

Methods:
The imaging data of 157 eyes in 79 patients with Bietti crystalline dystrophy were retrospectively reviewed. 12 individuals (19 eyes) were found to have MNVs. Multimodal retinal imaging was used to evaluate the features of MNVs and the primary chorioretinopathy.

Results:
The MNV lesions were shown as typical type 2 MNVs with subretinal hyperreflective material (SHRM), and usually detected along the borders of the retinal pigment epithelium/choriocapillaris dropout. The active MNVs were noted in earlier stages of Bietti crystalline dystrophy, while the activity was observed to be reduced in advanced cases. On spectral domain optical coherence tomography, the outer retinal structures were demonstrated to be partially preserved above the SHRMs compared with the extensive atrophy contiguously. Fibrotic scaring of the MNVs was commonly observed and arteriolarization was usually shown within the scars.

Conclusion:
MNV was demonstrated to be a common complication secondary to Bietti crystalline dystrophy. The lesions were typical type 2 MNV of varied activities possibly associated with the degrees of the primary degeneration. Choriocapillaris hypoperfusion may participate in MNV development.
The Cosine Law to Choose the Correct Forceps Shaft Length for Macular Surgery in Highly Myopic Eyes
Authors: Teixeira Anderson , Salaroli Camila , Fuganti Raphaela M. , casella Antônio Marcelo B. 
Published: February 2023

Purpose:
To demonstrate a mathematical analogy between the Pythagorean theorem using the axial a-scan measurement, i.e., the distance between the central cornea and the sclerotomy, and the lengths of the forceps in eyes of patients with all axial lengths.

Methods:
We used the Pythagorean equation (c2 = a2 + b2) to calculate the adequate shaft length of the forceps to use in macular surgery, especially in highly myopic eyes, where c2 represents the axial length (hypotenuse); b2 the sum of the corneal ray and distance between the corneal limbus and the sclerotomy (base side); and a2 the distance between the sclerotomy and the fovea (perpendicular side).

Results:
We reproduced the cosine law to estimate the distance between the sclerotomy and the fovea. The distance between the sclerotomy and the foveal area is shorter than the axial length and can become smaller based on the distance from the sclerotomy to the corneal limbus.

Conclusion:
This simple mathematical formula is useful when performing surgery in highly myopic eyes, in which there can be difficulties reaching the macular area.
GIANT RETINAL TEAR DETACHMENT
Authors: Ramamurthy Srishti , Raval Vishal , Ali Hasnat , Tyagi Mudit , Narayanan Raja , Reddy Rajeev , Das Anthony Vipin 
Published: February 2023

Purpose:
To study etiology, clinical presentation, anatomical, and functional outcomes of patients with giant retinal tear detachment at a tertiary eye institute.

Methods:
Retrospective, consecutive case series of 396 patients (396 eyes) who underwent surgery were reviewed. Factors affecting the final anatomical and functional success were determined.

Results:
Mean age was 37 years (range; 1–79 years), and 86% (n = 339) of the subjects were men. Trauma (21%) and high myopia (11%) were predisposing risk factors. Two hundred and seventy-seven eyes (70%) had giant retinal tear configuration of >180° and <270°, associated with partial retinal detachment in 282 (71%) eyes and macular detachment in 262 (66%) eyes. Primary surgery included pars plana vitrectomy (n = 240, 61%), pars plana vitrectomy with encirclage band (n = 152, 38%), or scleral buckle (n = 4, 1%). The mean follow-up duration was 15 months (median, 8.4 months; range, 3–83 months). Anatomical success after initial surgery was 64% (255 eyes), which improved to 78% (308 eyes) after undergoing a second vitreoretinal procedure for recurrent retinal detachment (53 eyes). Median visual acuity improved from 20/1,500 preoperatively to 20/400 at final follow-up (P= 0.01), and 15% of eyes achieved postoperative visual acuity of 20/60 or better. Factors associated with poor anatomical success included age <16 years (P = 0.005) and presenting visual acuity 20/400 or less (P = 0.001).

Conclusion:
Trauma and myopia constituted the major risk factors for giant retinal tear detachment in our series. Surgery for giant retinal tear detachment managed with pars plana vitrectomy with or without encirclage band and silicone oil tamponade had good anatomical and favorable visual outcomes at last follow-up.
HEALING MECHANISMS AFTER MACULAR HOLE REPAIR SUGGESTS PROCESS OF FOVEATION
Authors: Spaide Richard F. 
Published: February 2023

Purpose:
To evaluate the long-term healing of the fovea following macular hole surgery in light of the processes known to occur during the maturation of the fovea during childhood, in which there is migration of the inner retinal layers away from and the photoreceptors toward the center of the macula.

Methods:
Consecutive patients with longer than 1 year of follow-up were evaluated with spectral-domain optical coherence tomography. The interinner nuclear layer distance, which was the separation across the fovea of the midpoints of the inner nuclear layers, and the ONL (outer nuclear layer) to RPE (retinal pigment epithelium) thicknesses were measured.

Results:
There were 22 eyes of 21 patients, 16 of whom were female; the mean age was 65.6 years. Initially, after the surgery, there was closure of the hole with continuity of the inner and middle layers of the retina across the previous macular hole. Over time, there was a migration of the inner retinal layers away from and movement of the ONL toward the center of the macula. The mean interinner nuclear layer distance increased from 352 µm to 549 µm (P = 0.001), and the ONL-RPE thickness increased from 77 µm to 146 µm (P < 0.001). The mean logMAR acuity improved 6.5 lines.

Conclusion:
Healing of a macular hole after surgery seems to recapitulate the development of the macula in childhood. The process of foveation may have evolutionary benefit of optimizing macular function after injury despite the absence of effective replication of the highly specialized, postmitotic photoreceptors.
PREDISPOSING CHARACTERISTICS OF OPTICAL COHERENCE TOMOGRAPHY FOR PATIENTS WITH PERSISTENT SUBRETINAL FLUID AFTER SUCCESSFUL REPAIR OF RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Zhao Tongtao , Gu Peng , Sun Cheng , Zhang Minfang , Duan Ping 
Published: February 2023

Purpose:
To investigate the predisposing clinical parameters and characteristics of fundus imaging of patients with persistent subretinal fluid (PSF) after successful repair of rhegmatogenous retinal detachment.

Methods:
A retrospective study recruiting 57 patients was conducted. All patients underwent pars plana vitrectomy with silicone oil tamponade. Patients were divided into two groups: patients presenting PSF by the time of silicone oil removal as PSF group and patients presenting no PSF by the time of silicone oil removal as control group. All patients were followed up for 3 months or longer after primary surgery. Ophthalmic examinations, including fundus photography and optical coherence tomography, were performed.

Results:
There were significant differences between the two groups in average age, durations of preoperative symptoms, and type of retinal breaks (P < 0.05). These clinical parameters showed statistical correlations with PSF (P < 0.05). The proportions of patients presenting distinctive boundaries of the detached retina on fundus photograph and patients showing a hyperreflective line underlying the detached retina on optical coherence tomography in the PSF group were both significantly higher than the control group (P < 0.05). The macular detachment heights on optical coherence tomography in the PSF group were significantly lower than the control group (P < 0.05). These imaging characteristics also showed strong correlations with PSF (P < 0.05).

Conclusion:
This study suggests that patients with PSF have younger age, longer symptom duration, and higher incidence of retinal holes. The distinctive detachment boundary on fundus photograph, lower macular detachment height, and hyperreflective line underlying the detached retina on optical coherence tomography may be the predisposing characteristics of PSF.
RECONSTITUTION OF THE CHORIOCAPILLARIS IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY
Authors: Lee Jessica G. , Spaide Richard F. 
Published: February 2023

Purpose:
The purpose of this study was to describe findings derived from extensions of optical coherence tomography, including volume rendering and frame-averaged optical coherence tomography angiography (OCT-A), in a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE).

Methods:
This is a case report of a patient with APMPPE imaged during the acute and convalescent stages.

Results:
A 20-year-old man presented with an acute change in vision. He had multiple yellow–white placoid lesions at the level of the retinal pigment epithelium in the macula and nasal to the optic nerve in both eyes. Within 2 weeks, his visual acuity worsened to 20/80 and 20/400 in the right and left eyes, respectively. Spectral domain OCT showed focal defects in the ellipsoid and retinal pigment epithelium layers. Volume-rendering OCT-A showed inflammatory cells in the outer nuclear layer above the APMPPE lesion. Frame-averaged OCT-A revealed significant loss of capillary flow signal within capillary segments of the choriocapillaris. Ten weeks after presentation, there was resolution of the placoid changes, discontinuance of the inflammatory infiltrate in the outer nuclear layer, and significant reconstitution of flow in the choriocapillaris. The visual acuity was 20/20 in both eyes.

Conclusion:
Novel volume-rendered and frame-averaged OCT-A images in a patient with APMPPE allowed detection of inflammatory cell infiltrate in the outer nuclear layer and reversible capillary segment nonperfusion of associated APMPPE lesions. The findings suggest short-term insults to choriocapillaris function may be reversible and can be tracked with modern imaging techniques.
Rhegmatogenous Retinal Detachment with concurrent Choroidal Detachment and Macular Hole Formation after Uncomplicated Cataract Extraction and Intraocular Lens Implantation – A Case Report and Review of Literature
Authors: Tsui Jonathan C , Brucker Alexander J , Kolomeyer Anton M 
Published: February 2023

Abstract

Purpose:
To describe a case of concurrent rhegmatogenous retinal detachment, choroidal detachment, and macular hole (RRD-CD-MH) formation in a patient after uncomplicated cataract extraction and intraocular lens implantation (CEIOL). In addition, we summarize the previously reported cases of RRD-CD-MH in the literature.

Methods:
Interventional case report and literature review.

Results:
A 71-year-old white man without relevant past medical or ocular history underwent an uncomplicated CEIOL. He presented three weeks later with counting fingers vision and intraocular pressure (IOP) of 5 mmHg. On dilated fundus examination, multiple superior tears and total RRD with a serous CD was evident. Intraoperatively, a full-thickness MH was identified. The patient underwent routine RRD and MH repair, with instillation of 1000 centistoke silicone oil (SiO). The retina successfully re-attached, the CD resolved, and the IOP normalized; however, the MH did not initially close. The SiO was removed ∼4 months later and, while the MH remained open, the patient’s vision improved to 20/80. Approximately three years after the surgical repair, the MH closed spontaneously, and the vision remained at 20/80.

Conclusion:
Our patient developed an RRD-CD-MH post-uncomplicated CEIOL. The MH displayed delayed closure. The vision improved after surgical repair, and remained stable in the long-term.
Efficacy of Maribavir in Valganciclovir-Resistant Cytomegalovirus Retinitis
Authors: Tsui Jonathan C. , Huang Vincent , Kolomeyer Anton M. , Miller Charles G. , Mishkin Aaron , Maguire Albert M. 
Published: February 2023

Abstract

Purpose
To determine whether maribavir is effective at treating ganciclovir-resistant cytomegalovirus retinitis.

Methods
Retrospective case report of a lung transplant patient with bilateral cytomegalovirus retinitis documented with serum and aqueous humor studies and color fundus photographs

Results
A 72-year-old lung transplant patient with active ganciclovir-resistant cytomegalovirus was treated with intravitreal foscarnet therapy in one eye. Retinitis developed in the contralateral eye and was managed with systemic maribavir alone. Active retinitis regressed in both the eye treated with intravitreal foscarnet and the un-injected eye.

Conclusions
This patient’s results suggest that systemic maribavir is an effective treatment for treatment-resistant cytomegalovirus retinitis.
Diffuse posterior scleritis associated with HLA-B14* managed with multimodal imaging: case report and review of the literature
Authors: Raneri Marco , Fossataro Federica , Martines Francesco , Maione Giulio , Pece Alfredo 
Published: February 2023

Abstract

Purpose:
To report a case of posterior scleritis (PS) in an HLA-B*14 positive patient highlighting the crucial role of multimodal imaging and of autoimmune systemic disease screening for the diagnosis.

Methods:
Case Report.

Results:
A 73-year-old woman, complaining of ocular discomfort in right eye (RE), presented conjunctival hyperemia, keratic precipitates involving the anterior segment and four chorioretinal elevations with macular folds at fundus examination. Multimodal imaging and systemic diagnostic work-up were performed. While awaiting results, topical corticosteroid was prescribed. Four days later, worsening of exudative chorioretinal was detected. Except for erythrocyte sedimentation rate, tests were negative, while molecular typing of HLA genes was positive for HLA-B*14. Diagnosis of PS was confirmed by ultrasound examination while diagnosis of ankylosing spondylitis was made by rheumatologist. The patient was given systemic corticosteroid and one month later the posterior segment was unremarkable.

Conclusion:
HLA-B*14 may configure as a causal factor so autoimmune systemic disease screening should rule this out in management of PS, which should be diagnosed on the basis of multimodal imaging.
Three cases of acute retinal necrosis with atypical fundus findings
Authors: Chujo Shinichiro , Matsubara Hisashi , Ichio Atsushi , Matsui Yoshitsugu , Sugimoto Masahiko , Kondo Mineo 
Published: February 2023

Abstract

Purpose:
To determine the mechanism for the development of segmental granular lesions along the retinal vessels in eyes with acute retinal necrosis (ARN).

Method:
This was a retrospective analysis of the medical records of 3 eyes of 3 patients who were diagnosed with ARN that had atypical segmental granular lesions aligned along the retinal vessels.

Results:
The segmental granular lesions were present on both the retinal arteries and veins throughout the retina. Optical coherence tomography (OCT) showed that the granular lesions protruded into the vitreous cavity. Histopathological examinations confirmed that the lesions were made up of lymphocytes.

Conclusions:
We suggest that the granular lesions were formed by a mechanism similar to that of HTLV-1-associated uveitis (HAU). We also found that the granular lesions disappeared soon after vitrectomy.
Anatomical and functional outcomes of bevacizumab treatment in pediatric autosomal recessive bestrophinopathy
Authors: Mitchell Jacobs , El-Rashedy May , Fowler Nicholas , Shirkey Belinda , Kitchens John , Maldonado Ramiro S 
Published: February 2023

Abstract.

Purpose:
To report functional and anatomical outcomes of anti-VEGF treatment in eyes with autosomal recessive Bestrophinopathy (ARB) presenting in the first decade of life.

Methods:
Case series of four eyes from two siblings with compound heterozygous mutations in the BEST1 gene who were treated with eight monthly intravitreal bevacizumab (IVB) injections. Response to treatment was analyzed using fundus photography (CFP), fundus autofluorescence (FAF), optical coherence tomography (OCT), OCT angiography (OCTA), and Microperimetry (MP).

Results:
Patient-1 (male, age 9 yrs.) with visual acuity of 20/20 OD and 20/50 OS. Patient-2 (female, age 10 yrs.), with visual acuity of 20/25 OD, 20/20 OS. All eyes had multifocal subretinal deposition of lipofuscin, subretinal fluid and three had choroidal neovascularization (CNV). Lipofuscin material reabsorbed in 2/4 eyes, the CNV regressed in 3/3, a bacillary detachment resolved (1/1) but the subretinal fluid did not change. Functional improvement in visual acuity was noted but MP showed scattered areas of reduced retinal sensitivity. No ocular or systemic side effects were detected.

Conclusion:
Anti-VEGF treatment of choroidal neovascularization in eyes with ARB resulted in anatomical changes that were only clinically significant in the eye with decreased visual acuity. The hyporeflective subretinal material remained unchanged suggesting a non-exudative cause. These findings provide new insights into the management of ARB, especially in pediatric subjects with CNV.
Fungal Infection After Descemet Membrane Endothelial Keratoplasty: Incidence and Outcomes
Authors: Wong Brittany M. , Bonnet Clémence , Ghaffari Reza , Houser Kourtney , DeMatteo Jennifer , Lau Nicola , Aldave Anthony J. 
Published: February 2023

Purpose:
The aim of the study was to describe the incidence, presentation, management, and outcomes of fungal infection after Descemet membrane endothelial keratoplasty (DMEK).

Methods:
Retrospective case series of culture-proven fungal infections after DMEK reported in the literature, directly by surgeons, and to the Eye Bank Association of America from January 1, 2011, to December 31, 2020.

Results:
The domestic incidence of fungal infections, fungal keratitis, and fungal endophthalmitis after DMEK from 2011 to 2020 was 3.5, 1.3, and 2.2 per 10,000 cases, respectively, with no significant increasing trend. Thirty-four cases were identified, 14 (41.2%) published and 20 (58.8%) unpublished. Donor tissue fungal cultures were performed in 20 of the 34 (58.8%) cases and were positive in 19 of the 20 (95.0%), all but one Candida species. Recipient fungal cultures were performed in 29 of the 34 (85.3%) cases and were positive in 26 of the 29 (89.7%), all but one Candida species. Infection presented a mean of 33 ± 38 days (median 23, range 2–200, outlier 949) after transplantation: 25 (73.5%) with endophthalmitis and 9 (26.5%) with keratitis. Topical, intrastromal, intracameral, intravitreal, or systemic antifungal therapy was used in all 27 eyes with treatment data. Surgical intervention (DMEK explantation or partial removal, repeat endothelial keratoplasty, penetrating keratoplasty, and/or pars plana vitrectomy) was required in 21 of the 27 (77.8%) eyes. The corrected distance visual acuity at the last follow-up was ≥20/40 in 13 of the 27 (48.1%) eyes and counting fingers or worse in 6 of the 27 (22.2%) eyes.

Conclusions:
Fungal infection is a rare but serious complication of DMEK that results in counting fingers or worse corrected distance visual acuity in nearly a quarter of eyes.