bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in the accommodative microfluctuations with different viewing conditions and stimuli targets
Authors: Dominguez‐Vicent Alberto , Selin Paulina , Venkataraman Abinaya 
Published: January 2025

Aims/Purpose: To investigate how accommodative microfluctuations change with varying viewing conditions and stimulus targets, including different viewing distances, spatial frequencies, contrasts, and with negative contrast polarity.Methods: Powerref3 was used to measure the AMFs. Four stimulus targets consisting of five letter words were presented on an Ipad: low contrast (LC) 10%, negative contrast polarity (NC), and two high contrast 100% in different sizes. Each stimulus corresponded to a visual acuity of 6/12, the high contrast target was additionally displayed at 6/36. The targets were presented at 40 cm and 4 m. 11 participants with no ocular pathologies or binocular or accommodative disorders were measured. The 6/12 target was used as a baseline reference for comparisons against the other stimuli targets in the analysis. The different components of the AMFs, the high (1.0‐2.3 Hz), mid (0.61–0.99 Hz) and low (0‐0.6 Hz) were analysed. The root mean square (RMS) accommodation values and accommodative response were also analysed.Results: No significant difference in RMS or any of the frequency components were found for the various stimulus targets, including spatial frequency, contrast or negative contrast polarity, when compared to the reference 6/12 target. When comparing the RMS values for each stimulus condition between distances, a significant increase was seen at near for 6/12 (p = 0.027), 6/36 (p < 0.001) and LC (p = 0.002), but not for NC (p = 0.465). No significant difference in accommodative response was found between the different stimulus conditions (p = 0.427).Conclusions: The findings suggest that AMFs are not significantly affected by the various stimuli targets presented in this study. However, the viewing distance significantly affected the AMFs, with increased AMFs at near.
Bilateral aqueous misdirection following cataract surgery: A case report
Authors: Tahhan Owais 
Published: January 2025

Aims/Purpose: The purpose of the case‐report is to explore the aetiology, prevention and management where there is inadequate literature on the topic of BAM. This allows reflection on the case, its respective learning points and opportunities for future research into the prevention and screening of people with risk factors for BAM.Methods: We present a case of an 85‐year‐old female with a history of bilateral cataract surgery, who presented with blurry vision, pain, photophobia, and elevated intraocular pressure (IOP). Detailed clinical examinations, including visual acuity assessment, IOP measurement, slit‐lamp examination, and gonioscopy were performed. Management strategies, including medical therapy and surgical intervention, are discussed.Results: Upon presentation, the patient exhibited features consistent with BAM, including shallow anterior chambers, mid‐dilated pupils, and elevated IOPs. Immediate medical management with intravenous acetazolamide, topical pressure‐lowering agents, and cycloplegics was initiated. Subsequently, anterior vitrectomy was performed in both eyes, leading to the resolution of symptoms, deepening of anterior chambers, and normalization of IOPs at 6 weeks postoperatively.Conclusions: Bilateral aqueous misdirection is a rare but potentially blinding complication following cataract surgery. Prompt recognition and aggressive management, including medical therapy and surgical intervention, are crucial for achieving favourable outcomes and preserving visual function. Clinicians should maintain a high index of suspicion for BAM in postoperative patients presenting with unexplained elevated IOP and shallowing of anterior chambers, facilitating timely diagnosis and intervention.We present a case of BAM which has high educational value in its rarity. We investigate the evidence‐based risk‐factors and aetiology that apply in this case and discuss novel approaches to conservative and surgical management. Based on the literature some high‐risk cases would potentially benefit from taking preventative measures to reduce the incidence of BAM.
Effect of the spherical aberration in intraocular lenses on visual quality
Authors: Cervantes Dayan Flores , Ramírez Emilio Dorronzoro , Arevalo Vanesa Gerena , Paciencia Alfredo Morales , Haddi Inas Baoud Ould , Arias Cristina Bonnin , Sánchez Vanesa Blázquez 
Published: January 2025

Aims/Purpose: To analyze the effect of corneal spherical aberrations (z40) on the selection of extended range intraocular lenses to optimize patients’ visual quality.Methods: This is an observational, prospective, and cross‐sectional study. The sample consists of 30 patients with bilateral implantation of the study's intraocular lenses (IOLs): AcrySof® IQ Vivity™ (Alcon Laboratories, Inc, Fort Worth TX) with 22 eyes and Luxsmart® (Bausch & Lomb) with 38 eyes respectively. Each IOL has a manufacturer‐specified asphericity value, and the analysis of spherical aberrations was conducted with Pentacam HR® (Oculus Optikgeräte GmbH, Germany).Photopic visual acuity (VA) – monocular and binocular (for distant, intermediate, and near vision) – was measured using the ETDRS test and evaluated one‐month post‐surgery. A p‐value of < 0.05 was considered the criterion for statistical significance, and the correlation was performed with Spearman's test.Results: The average pupil diameter of the sample was 2.64 ± 0.39 mm, with a maximum value of 4.2 mm and a minimum of 1.90 mm. All patients experienced an improvement in postoperative VA under photopic conditions, regardless of the implanted IOL. The distant VA for the Vivity® lens was ‐0.05 LogMar and for Luxsmart® it was 0.01 LogMar; the near VA for Vivity® was 0.1 LogMar while for Luxsmart® it was 0.3 LogMar, and the intermediate VA for both lenses was 0.15 LogMar. No correlation was observed between Z40 parameters and VAConclusions: The IOL models studied, Vivity® and Luxsmart® provide optimal distance VA, although the Vivity® lens showed better results at all distances.
Isolated corneal intraepithelial neoplasia: An unheard variety
Authors: Carles‐Cerban Luis Maria , Moraña‐Borrageiros Maria Noelia , Alvarez‐Novoa‐Rodriguez‐Cadarso Andrea , Alvarez‐Rodriguez Roberto , De‐Rojas‐Silva Victoria 
Published: January 2025

Aims/Purpose: The purpose of this clinical case is to present the symptoms, as well as biomicroscopical, tomographical and histological findings of the isolated corneal intraepithelial neoplasia, a very rare variety of ocular surface squamous neoplasia.Methods: We present the case of a 78‐year‐old woman with foreign body sensation in her right eye for four months. The cornea presented, apart from crocodile shagreen, a white patch in the temporal‐inferior quadrant, separate from the limbus. This lesion showed punctate staining and contained a thin line of normal aspect. The optical coherence tomography (OCT) showed hyperreflective and thickened epithelium with sudden transition to normal cornea.On suspicion of corneal intraepithelial neoplasia, excisional biopsy was indicated, with Shields's non‐touch technique, 2 mm surgical margins and absolute‐alcohol application on the limbus.Furthermore, a review of the past 25 years literature has been performed, using the following key words: corneal intraepithelial neoplasia; ocular surface squamous neoplasia.Results: The histological result showed a corneal intraepithelial neoplasia with non‐assessable margins. One week after surgery, the defect had already been replaced by normal epithelium, and we added two cycles of co‐adjuvant topical mitomycin C (0.04%). Two years after surgery, the patient is asymptomatic and with no signs of recurrence.Regarding the review, only 10 cases of isolated corneal intraepithelial neoplasia have been described in the past 25 years. No references of crocodile shagreen concurrence have been found, whereas there is some consensus of surgery as main treatment and OCT as useful diagnostic tool.Conclusions: Isolated corneal intraepithelial neoplasia should always be included in differential diagnosis when it comes to a thickened and atypical lesion in the cornea. In this context, OCT can be useful, whereas final diagnosis and treatment should include excisional biopsy.
Submacular hemorrhage displacement with subretinal rtPA and air injection
Authors: Rego‐Lorca Daniela , Crespí‐Vilimelis Jaume , Loscos‐Giménez Irene , López‐de‐Eguileta Alicia , Díaz‐Cascajosa Jesús , Vela‐Segarra José Ignacio 
Published: January 2025

Aims/Purpose: submacular hemorrhage (SMH) is a well‐known cause of severe vision loss. Surgical treatment aims displacement of the blood away from the fovea to prevent macular photoreceptor damage. Different surgical techniques have been described for this purpose, but, until date, the best approach remains a matter of debate. Injection of subretinal rtPA and air was first described in 2013 reporting encouraging results. We describe our experience with this surgical technique.Methods: consecutive case series including patients with SMH managed with PPV and subretinal injection of rtPA and air. SMH was graded as small, large, extensive, or massive. SMH displacement was assessed one week after surgery.Results: 36 eyes of 36 patients were evaluated. Etiologies of SMH included age‐related macular degeneration (83.3%), macroaneurysm rupture (8.3%), ocular traumatism (5.6%) and Terson syndrome (2.8%). Average time between diagnosis and surgical intervention was 6.1 days. Hemorrhage size was classified as small in 8 patients (22.2%), large in 8 patients (22.2%), extensive in 16 patients (44.4%) and massive in 4 patients (11.1%). Sub‐RPE hemorrhage was noticed in 21 patients (58.3%). One week after surgery, SMH displacement was achieved in 33 patients (91.7%). Visual acuity improved in 28 patients (77.8%), remained stable in 4 patients (11.1%) and worsened in 4 patients (11.1%). Postoperative complications included vitreous hemorrhage (11.1%), macular hole (5.6%), and retinal detachment (5.6%).Conclusions: subretinal injection of air and rtPA is an effective technique for SMH displacement, facilitating rapid blood migration and, thus, reducing retinal deterioration and enabling greater visual recovery.References
Martel JN, Mahmoud TH. Subretinal pneumatic displacement of subretinal hemorrhage. JAMA Ophthalmol. 2013; 131: 1632–5.
High myopia and atrophy complication: Multimodal study and prospects
Authors: Gonzalez Corinne 
Published: January 2025

Aims/Purpose: This multimodal study of High Myopia with Atrophy areas, patchy atrophies of retina to analyze retina layers structure, focusing on outer retinal layers, particularly photoreceptor and Retinal pigment epithelium layers, their evolution, their impact on visual fonction. So the prospects of High Myopia's Atrophy complications.Methods: A total of 84 eyes from 44 patients, with High Myopia. Multimodal study includes mainly OCT, notably OCT en Face (Spectralis HRA‐OCT, spectral domain OCT), combined with Autofluorescence, IR imaging, Fluorescein (FA) and Infracyanine (ICG) angiography (SLO Spectralis HRA‐OCT) (mainly when suspicion of subretinal neovascular complication). ETDRS visual acuity (VA), complete ophthalmic examination with Fundus exam were added. Follow‐up was done every year during 8 years.Results: VA remain stable in 42% cases, impaired in 58% cases. Multimodal analyze highlight 15% stable, 85% Atrophy area increase, (patchy atrophies: 74% cases, peripapillary atrophy: 26% cases). Development of Atrophy include: increase of width, surface, perimeter of atrophic areas, thinning, fragmentation of retinal layers, particularly photoreceptor and retinal pigment epithelium layers. Combined Neovascular complication occurred in 27% cases (series of 3 IVT of Anti VEGF were done when neovascular activity was confirmed). Visual function condition depends on Topography of Atrophy, Atrophic areas, patchy atrophies too, Morphology of Atrophy, Atrophic areas, patchy atrophies too (width and length), their Evolution, and Macular Sparing. Atrophy complication of High Myopia leads to ask involvement of collagen, fibroelastic tissues physiopathology, genetic factors, way of life, key role of Age Macular Degeneration in High Myopia Elderly eyes. Those are the Prospects.Conclusions: High Myopia with ATROPHY complication is a great question to better consider follow‐up protocol, screening, particularly of and when neovascular complication sometimes here with. Multimodal analysis enables better precision, discrimination in Atrophy assessment, evolution, so, issue to preserve visual function and allows to better manage the prospects.
Cytomegalovirus retinitis in a patient with human immunodeficiency virus: A clinical case study
Authors: Bestué Ana Pueyo , Ciubotaru Olga , Pueyo‐Bestué Ignacio , Fernández‐Velasco Diego , Mallén Victor , Bermúdez Javier , Biescas Andrés , Rius Núria , Ila Carmen , Hernández‐Barahona Claudia 
Published: January 2025

Aims/Purpose: To present a clinical case of cytomegalovirus (CMV) retinitis in a patient with newly diagnosed HIV, highlighting the characteristic retinal appearance and treatment outcomes.Methods: A 52‐year‐old male with no significant medical history presented with weight loss and persistent diarrhea. Initial evaluation revealed HIV infection at AIDS stage C3, with a high viral load (2,330,000 copies/mL) and severe immunosuppression (CD4 count = 10 cells/μL). Additional findings included pancolitis, atypical pulmonary infiltrates, and pancytopenia. Ophthalmologic examination was conducted due to reported visual disturbances.Results: Ophthalmologic assessment revealed a visual acuity of 1.0 in both eyes and intraocular pressure of 10 mmHg. Fundoscopy and ultra‐wide field retinography identified lesions resembling a "cheese and tomato pizza" in the right eye, characterized by granular white‐yellow and white‐gray paravascular infiltrates, retinal opacification, and associated hemorrhages. Optical coherence tomography (OCT) showed foveal integrity but significant vitreous cellularity in the right eye and optic nerve edema.The patient was treated with Valganciclovir 900 mg every 12 hours for CMV, alongside a combination antiretroviral therapy (ART) regimen of Bictegravir, Emtricitabine, and Tenofovir, plus Atovaquone due to cotrimoxazole intolerance. Follow‐up examinations indicated a gradual improvement in retinal lesions, with the right eye showing residual peripheral nasal lesions and the left eye remaining clear.Conclusions: This case underscores the importance of early diagnosis and prompt initiation of antiviral and antiretroviral therapies in managing advanced opportunistic infections in HIV/AIDS patients. The "cheese and tomato pizza" analogy aids in the visual identification of CMV retinitis. Continuous monitoring and timely intervention are crucial for preserving vision and improving patient outcomes.References
Basic and Clinical Science Course, Retina. American Academy of Ophthalmology. 2021
Diaz Llopis M. AIDS in Ophthalmology. Lecture 1996 Spanish Society of Ophthalmology (SEO)
Comparison of intravitreal PBS injection timepoints in the mouse oxygen‐induced retinopathy model
Authors: Lappeteläinen Birgitta , Jääskeläinen Niina , Tenhunen Anni , Ekolle Xavier , Vergun Olga , Haapaniemi Anne Mari , Kolehmainen Anni , Koponen Anna Mari , Partanen Päivi , Vähätupa Maria 
Published: January 2025

Aims/Purpose: Intravitreally (IVT) administered phosphate‐buffered saline (PBS) is known to reduce neovascularization in the mouse oxygen‐induced retinopathy (mOIR) model, and often used as a vehicle control in preclinical efficacy studies. Here, the aim was to compare the effects of PBS on neovascularization and revascularization when administered at different timepoints. VEGF‐inhibitor aflibercept (Eylea®) was used as a reference control.Methods: C57BL/6JRj male and female mice were exposed to 75 % oxygen from postnatal day 7 (P7) for 5 days. At P12 the mice were returned to normoxic conditions and IVT injected with PBS or aflibercept to the right eye at P12, P13, or P14 (n = 7‐9 eyes/group). Contralateral left eye was left untreated. Retinal flat mounts collected at P17 were stained with Isolectin B4, and microscopy images covering the whole retinal flat mount were analyzed for the size of neovascular (NV) and avascular (AVA) area using a proprietary AI‐based algorithm.Results: NV or AVA area did not differ between PBS and aflibercept at P12. Aflibercept reduced neovascularization by 83 % at P13 (Mann‐Whitney test, p < 0.001) and by 65 % at P14 (unpaired t‐test, p < 0.01) when compared to PBS, while AVA was similar between groups. When compared to untreated eyes, PBS significantly reduced neovascularization at P12, and the size of AVA area at P12 and P13 (Mann‐Whitney test, p ≤ 0.001).Conclusions: Our findings show significant anti‐angiogenic effect of PBS when injected at P12, suggesting that P12 is not an optimal timepoint for IVT treatment if PBS is used as a vehicle. PBS administered at P13 or P14 did not block neovascularization while it still was inhibited by aflibercept. Further studies are needed to explore if similar effect at P12 is seen with other vehicle or neutral antibody controls.
Serum RNA profile reflects fluid status and atrophic retinal changes in neovascular age‐related macular degeneration
Authors: Heloterä Hanna , Kostanek Joanna , Liukkonen Mikko , Siintamo Leea , Watala Cezary , Blasiak Janusz , Kaarniranta Kai 
Published: January 2025

Aims/Purpose: The increasing prevalence of age‐related macular degeneration (AMD), a disease that can result in the loss of central vision, is an emerging problem worldwide due to aging societies. This creates a challenge for the healthcare system and understanding of the mechanisms of AMD pathogenesis will help in early, personalized, and efficient intervention. Current diagnostic methods rely on optical coherence tomography/angiography imaging, which identifies existing damages, but does not provide information on the mechanisms behind them. In this study, we analyzed mRNAs, lncRNA, and small ncRNAs profiles in the serum of nAMD patients and associated them with anatomical changes observed at the retinal level.Methods: RNA‐Seq analysis of human serum samples from neovascular AMD and control patients.Results: In the present work, we showed the difference in the serum RNA profile between neovascular AMD (nAMD) patients and controls. Moreover, the RNA profile of nAMD patients corresponded with anatomical changes in the retinal fluid compartments and atrophic changes and was affected by intravitreal anti‐vascular endothelial growth factor treatment.Conclusions: Therefore, serum could be used as a target for a liquid biopsy to explore anatomical changes in the eye during nAMD progression and treatment. This finding opens a new pathway in AMD studies, which are limited due to restricted access to live human target material and the limited value of animal models of human AMD.
Human versus artificial intelligence: Validation of a deep learning model for retinal layer and fluid segmentation in optical coherence tomography images from patients with age‐related macular degeneration
Authors: Santos‐Oliveira Joana , Miranda Mariana , Mendonça Ana Maria , Sousa Vânia , Melo Tânia , Carneiro Ângela 
Published: January 2025

Aims/Purpose: Artificial intelligence (AI) models have received considerable attention in recent years for their ability to identify optical coherence tomography (OCT) biomarkers with clinical diagnostic potential and predict disease progression. This study aims to externally validate a deep learning (DL) algorithm by comparing its segmentation of retinal layers and fluid with a gold‐standard method for manually adjusting the automatic segmentation of the Heidelberg Spectralis HRA + OCT software Version 6.16.8.0.Methods: A total of sixty OCT images of healthy subjects and patients with intermediate and exudative age‐related macular degeneration (AMD) were included. A quantitative analysis of the retinal thickness and fluid area was performed, and the discrepancy between these methods was investigated.Results: The results showed a moderate‐to‐strong correlation between the metrics extracted by both software types, in all the groups, and an overall near‐perfect area overlap was observed, except for in the inner segment ellipsoid (ISE) layer. The DL system detected a significant difference in the outer retinal thickness across disease stages and accurately identified fluid in exudative cases. In more diseased eyes, there was significantly more disagreement between these methods.Conclusions: This DL system appears to be a reliable method for accessing important OCT biomarkers in AMD. However, further accuracy testing should be conducted to confirm its validity in real‐world settings to ultimately aid ophthalmologists in OCT imaging management and guide timely treatment approaches.References: Pawloff, M.; Gerendas, B.S.; Deak, G.; Bogunovic, H.; Gruber, A.; Schmidt‐Erfurth, U. Performance of retinal fluid monitoring in OCT imaging by automated deep learning versus human expert grading in neovascular AMD. Eye 2023, 37, 3793–3800.
Diagnosis of birdshot chorioretinopathy without typical funduscopy spots
Authors: Funes Elisa , Munuera Inés , Merino Jacobo Yañez , Sopeña‐Pinilla Maria , Ciobotaru Olga , Bestué Ana Pueyo , Pueyo‐Bestué Ignacio , Fernandez‐Velasco Diego , Mallen Victor , Bermudez Javier 
Published: January 2025

Aims/Purpose: To present a case of birdshot chorioretinopathy (BCR) in a Spanish patient with HLA‐A29 positivity without characteristic “birdshot” spots on ophthalmoscopy.Methods: A 53‐year‐old Spanish female presented at the ophthalmological emergency department of a tertiary hospital with complaints of blurred vision in the right eye for one week. The patient had a significant ocular history of anterior uveitis, one episode of macular edema in the left eye and cataract surgery in both eyes. Corrected visual acuity was 0.8 in the right eye (OD) and 0.9 in the left eye. Funduscopic examination demonstrated peripapillary atrophy, increased cellularity in the vitreous and atrophic lesions (suspicious of old foci of chorioretinitis) in the right eye and peripapillary atrophy and atrophic lesions. Late phase fluorescein (FA) showed perivascular and optic disc leakage in OD and hyperfluorescent lesions which corresponded to areas of atrophy in OI. Laboratory evaluations were positive for human leukocyte antigen – A29 (HLA‐A29). At this point, indocyanine green angiography (ICGA) was ordered which revealed hypocyanescent lesions throughout the choroid in both eyes that were centered on the optic disc, supporting the diagnosis of BCR.Results: The patient started 45 mg of prednisone daily, followed by 3 pulses of intravenous methylprednisolone, which made the increase in vitreous cells in the right eye disappear. Prednisone was progressively decreased by 5 mg each week, until reaching 20 mg, at which time Methotrexate was started at 10 mg per week.Conclusions: This case highlights the importance of ICGA in the diagnosis of BCR, even in the absence of characteristic spots on ophthalmoscopy. Proper diagnostic work‐up, including assessing HLA‐A29 positivity, is needed to manage atypical cases.