bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periosteal graft and conjunctival pedicle flap for re‐exposed glaucoma drainage device tube
Authors: Saldianovitta Rahajeng Anugrahing , Hamid Aulia Abdul , Dewi Debby Shintiya 
Published: December 2022

AbstractPurpose: To report the management of exposed glaucoma drainage device (GDD) tube using periosteal graft.Methods: A case report of patient from ophthalmology outpatient clinic in Dr. Saiful Anwar general Hospital.Results: A 26‐year‐old male with history of steroid induced glaucoma came to ophthalmology clinic. Patient already underwent several procedures to control his intraocular pressure (IOP), including trabeculectomy and implantation of GDD. Implantation of GDD is widely used to control IOP in glaucoma patients. One month after implantation, patient experienced exposed GDD tube. Exposed GDD tube is one of the most common complications. The incidence is about 12% and tend to happen in eyes that already underwent many surgeries previously. This condition needs a further operative procedure such as adding patch graft on exposed area, in this case patient underwent conjunctival and pericardial graft. One month after additional patch graft procedure, patient felt uncomfortable sensation and redness on his right eye, even though IOP was 12 mmHg. During anterior segment examination, tube expose was found again. Patient underwent periosteal graft from his right tibial bone and conjunctival pedicle flap. After 2 months of evaluation, the graft is attached and IOP controlled at 14 mmHg.Conclusions: Periosteal graft and conjunctival pedicle flap could be one of the appropriate choices to cover re‐exposed GDD tube.
Anatomical changes in the retinal capillary plexuses assessed by optical coherence tomography angiography in diabetic patients
Authors: Fernández‐Espinosa Guisela , Orduna‐Hospital Elvira , Boned‐Murillo Ana , Sopeña‐Pinilla María , Díaz‐Barreda María Dolores , Bielsa‐Alonso Sofía , Bartolomé‐Sesé Isabel , Pinilla Isabel 
Published: December 2022

AbstractPurpose: To assess anatomical changes in the retinal superficial capillary (SCP) and deep capillary (PCP) plexuses, as well as choriocapillary (CC) in patients with diabetes mellitus (DM) without diabetic retinopathy (DR), and in DM patients with mild and moderate DR without diabetic macular edema (DME) using optical coherence tomography angiography (OCTA).Methods: Ninety eyes were included, 34 patients with long‐term DM (more than 10 years) but without DR signs, and 54 patients with mild or moderate DR (levels 35 and 43 on the ETDRS scale) without DME. All participants underwent a complete ophthalmic examination including best corrected visual acuity (BCVA) and OCTA examination using deep‐range imaging with the DRI‐Triton SS‐OCT.Results: The mean age was 63.82 ± 8.56 years and 63.00 ± 13.21 years in long‐term DM without DR and with DR, respectively. In patients with long‐term DM without DR, foveal avascular zone (FAZ) abnormalities were seen in both SCP and DCP (55% and 5%), and microaneurysms (MAs) were present in SCP and DCP (35% and 47.5%). Loss of perfusion was detected in SCP and DCP (30% and 47.5%), and ischemia was observed in SCP, DCP and CC (60%, 37.5% and 10%). In patients with mild or moderate DR without DME, OCTA also detected morphological abnormalities such as FAZ changes and MAs (79.6% and 81.11%), loss of perfusion (83.3% and 64.2%), and ischemia (66.67%, 81.1% and 18.5%) in SCP, DCP and CC respectively. Microvascular tortuosity and intraretinal microvascular anomalies (IRMAs) were detected in 48.1% and 46.3% in SCP vs 22.6% and 20.8% in DCP, respectively.Conclusions: Patients with long‐term DM without DR present morphological changes measured with OCTA, such as MAs in both retinal plexuses. The changes in the FAZ are more evident in the SCP due to the capillary anastomosis. Capillary dropout can be found in both plexuses. Patients with DR show more evident changes that include MAs, loss of perfusion and ischemia and other vascular abnormalities.
Unilateral neuroretinitis as manifestation of syphilitic disease
Authors: Martínez Marta Suñer , Clavería Julia Aramburu , Fernández Miguel Castillo , deRivas Marta Orejudo , Moscarda Eva Josefina Núñez , Arias Pablo Cisneros , El Bakkali Ismael Bakkali , Rivasés Guillermo Pérez , Ascaso Javier 
Published: December 2022

AbstractPurpose: Syphilis is a systemic sexually transmitted disease caused by the spirochete Treponema Pallidum. Ocular symptoms indicate neurological compromise, corresponding to 5%–8% of syphilis cases. The clinic is varied and involvement of practically any of the ocular structures has been described. The most frequent presentation is uveitis, which can be posterior, intermediate, anterior or panuveitis, unilateral or bilateral, granulomatous or not. It is responsible for 1%–2% of uveitis cases. This clinical experience aims to reinforce the existence of this entity and the importance of early treatment and adequate control of symptoms.Methods: A 35‐year‐old man presented blurred vision in the left eye of sudden onset of 2 days of evolution. On examination, visual acuity of right eye 1.0 and left eye 0.05 according to decimal scale. Biomicroscopy shows Tyndall, without retrokeratic precipitates or synechiae. Transparent cornea and isochoric normoreactive pupils. The eye fundus shows obliterated papillae with fibrinoid‐like material, vasculitis, scattered haemorrhages and macular folds. Right eye without alterations. He reports the possibility of a risky sexual relationship. In serological tests, IgM for Syphilis is detected. He is admitted to the Infectious Diseases service for intravenous treatment with Benzylpenicillin 4 million Ul/ 4H.Results: One month later, inflammation of the anterior pole has disappeared, but the fundus shows persistent neuroretinitis with edema of the optic nerve, macular star exudates and a focus of vasculitis in the superior temporal artery. Ozurdex is indicated. One month later, he shows visual acuity of 1 in left eye, and reduced inflammation of the optic nerve, exudates and haemorrhages.Conclusions: Ocular syphilis is an entity that is still present, as well as the importance of actively searching for it. It is a potentially serious disease that affects young adults, with a good response to treatment if the diagnosis is made early.
Microglial activation and retinal pigment epithelium alteration in a model of focal LED‐induced phototoxicity. Neuroprotection afforded by bFGF and minocycline
Authors: Ollero Juan Antonio Miralles De Imperial , Ortega Alejandro Gallego , Muñoz María Norte , Di Pierdomenico Johnny , Valiente‐Soriano Francisco Javier , Vidal‐Sanz Manuel 
Published: December 2022

AbstractPurpose: To study the microglial reaction and degeneration of the retinal pigment epithelium (RPE) and its protection with basic fibroblast growth factor (bFGF) administered alone or combined with minocycline (MC) in a model of focal light‐emitting diode (LED)‐induced phototoxicity (LIP) in mice.Methods: In dark‐adapted adult C57 mice (20–25 g), the left eye was dilated and exposed for 45 seconds to a blue LED (400 nm; 500 lux) placed 2 mm perpendicular to the corneal apex (n = 71). Mice were treated with bFGF (0.5 μg) administered alone or in combination with MC (45 mg/kg). bFGF was administered in a single intravitreal injection just after LIP and the MC was daily injected intraperitoneally, starting the day before LIP (n = 10–13 per group). Vehicle or naïve groups were used as controls (n = 6–10 each group). Retinas were immunodetected with anti‐arrestin and anti‐Iba1 antibodies to study cone outer segments (a+OS) and microglial cells (Iba1+cells) and RPEs were immunodetected with anti‐ZO1 to study RPE cells, at 3 and 7 days after LIP. The number of cones and microglial cells was studied within a pre‐fixed area (PFA) of 0.9 mm diameter at the centre of the lesion.Results: Treatment with bFGF alone or in combination with MC was effective in protecting a+OS within the PFA compared to vehicles at 7 days after LIP (p = 0.034 and p = 0.001, respectively). The combined treatment of bFGF and MC was effective in reducing the number of Iba1+cells within the PFA in the outer plexiform layer at 7 days after LIP (p = 0.0003). However, the treatments had no restorative effect on RPE cell survival or morphological integrity at 7 days after LIP (p = 0.6762).Conclusions: Administration of bFGF alone or in combination with MC increased a+OS survival and reduces Iba1+cell activation but does not reduce RPE damage.
Ultra‐wide field fluorescein angiography in intermediate and posterior uveitis: A retrospective study
Authors: Stavropoulou Theodora , Theodorakis Andreas , Papadedes Konstantinos 
Published: December 2022

AbstractPurpose: To review the diagnostic value of the Ultra‐wide field imaging system Optomap Panoramic 200A (Optos, PLC, Scotland) in patients with intermediate, posterior uveitis or panuveitis of our department and the presence of findings in the periphery of the retina compared to the conventional 7 standard field fluorescein (7SF) angiography, as well as the contribution of the findings to the change of the therapeutic approach.Methods: This is a retrospective study. A medical records electronic search using Medisoft (Medisoft Limited, UK) conducted and included 69 patients and 121 eyes with intermediate, posterior uveitis or panuveitis that underwent Ultra‐wide field fluorescein angiography imaging. Subsequently, imaging was observed for detection of vasculitis, ischemia, neovascularisation and/or choroidal lesions in areas beyond 75° that was detected by conventional fluorescein angiography. The therapeutic approach based on the presence/absence of relevant findings was also reviewed.Results: Out of 121 eyes in total, 67 were classified as intermediate uveitis, 44 as posterior uveitis and 5 as panuveitis. The presence of at least one form of peripheral angiographic finding was noted in 52 eyes, peripheral vasculitis was observed in 40 eyes and peripheral ischemia in 31 eyes. Decision to change the therapeutic approach was decided in 42 eyes overall, 31 of which presented peripheral findings and 11 lacked any. 21 eyes were noted with peripheral findings, but no change of treatment was decided. There was a statistically significant correlation between presence and absence of findings and change of treatment (p < 0.00001). No other statistically significant correlation between treatment alteration and score or specific uveitis type was found.Conclusions: Compared with conventional 7SF imaging, the Ultra‐wide field fluorescein angiography is an extremely useful diagnostic test for the detection of active disease and can significantly change the therapeutic approach in patients with intermediate, posterior uveitis or panuveitis.
The monitoring of the speed of re‐epithelization after refractive surgery performed with the method of Trans‐PRK, with the use of hydrocortisone sodium phosphate (Softacort)”
Authors: Sakellaris Dimitris 
Published: December 2022

AbstractPurpose: To exhibit the advantages of preservative‐free hydrocortisone in the postoperative treatment regimen of transepithelial photorefractive keratectomy (Trans‐PRK) for the promotion of epithelization and minimalization of early haze appearance.Methods: In this prospective, randomized controlled study, 40 patients who had undergone trans‐PRK were divided into two equal groups, the first group received hydrocortisone (Softacort®, Laboratoires Thea) 2 drops 4 times daily for 7 days and the control group received no complementary medication. Both groups were given: artificial tears 2 drops hourly for 7 days, then administered every 2 h for 21 days and tapered till 3 months post‐operation, antibiotic drops (quinolone) 4 times daily and autologous serum hourly for 7 days, and a bandage contact lens till complete epithelization of the surgical wound. Patients were monitored daily to determine the time of a complete epithelization and then on day 15 and 30 to assess any signs of early‐onset haze and visual acuity. Scheimpflug topography and anterior segment OCT were performed on day 15 and 30 as well as IOP tonometry.Results: The results showed a significant decrease in recovery days in patients treated with hydrocortisone compared to the control group (p < 0.0006) which was associated with a higher rate of early‐onset haze presentation. Both groups had satisfactory visual acuity and no significant differences in their IOP were observed.Conclusions: The use of hydrocortisone sodium phosphate drops (Softacort®) has been shown to be efficient in corneal epithelization and haze management and safe in patients after trans‐PRK.
Determination of the activation regions of three deep learning models in infrared images of glaucoma
Authors: Díaz‐Alemán Valentín Tinguaro , Perera Sandra Gómez , Batista Francisco José Fumero , Miranda Silvia Alayón , del Arco Rafael Arnay , Saavedra José Francisco Sigut 
Published: December 2022

AbstractPurpose: The main objective of this study is to characterize the activation regions of three Deep Learning models using infrared images of the optic nerve of glaucoma patients.Methods: We have retrospectively collected a sample of patients with primary and secondary open‐angle glaucoma and normal patients. The images in infrared were recorded with a spectral domain optical coherence tomography. Three previously trained models were used, VGG19, ResNet101 and the Shufflenet. Sensitivity, specificity, diagnostic accuracy in training and testing, and ROC area were calculated for all three models. The gradient‐weighted class activation map (GradCAM) was used to obtain the activation regions that highlight the most important components in the images for model prediction. The correlation coefficient between the glaucoma activation maps and between normal activation maps of the three models was calculated, and the location of the activation regions in the glaucoma and normal images was determined for each model.Results: 639 eyes of 415 patients were collected, 432 glaucomatous and 207 normal. The accuracy of the models on the test set was 96.9% (VGG19), 95.3% (ResNet101), and 93.8% (Shufflenet). The activation maps of the ResNet101 and Shufflenet models obtained a high correlation in glaucoma (0.75) and normal (0.68) cases. For the three models, the region of interest was located mainly in the inferior temporal quadrant in 65.2% of the cases (VGG19), in 52.9% (Shufflenet) and in 54.1% (ResNet101).Conclusions: In glaucoma eyes, the regions of interest assessed with the gradient‐weighted class activation maps of the three models analysed are located in more than half of the cases in the inferior temporal quadrant of the optic nerve.
Refractive management of a bilateral lens subluxation case in marfan syndrome patient
Authors: Dinnarwika Syarah Nandya , Wulandari Lely Retno , Sulistya Triana Budi , Anandita Nanda Wahyu 
Published: December 2022

AbstractPurpose: To report refractive management of bilateral lens subluxation case in Marfan Syndrome patient.Methods: Diagnosis based on a history‐taking, a physical examination, and an ancillary test. The refractive state of the patient was examined by an autorefractometer, streak retinoscopy and best‐corrected visual acuity (BCVA), before and after cycloplegic on each eye.Results: A 7‐years‐old girl diagnosed with Marfan Syndrome by the Department of Paediatric Cardiology complained for blurred vision in both eyes. Initial visual acuity of the patient was 0.027 in her right and left eyes. Anterior segment examination showed phacodenesis in both eyes. After cycloplegic refraction with enlarging pupil diameter and performed streak retinoscopy, BCVA in the right eye was 0.040 with a refractive correction of −22.00 diopters (D) and left eye was 0.021 with −20.00 D. After several follow ups, the refractive state remains highly fluctuates due to severe lens subluxation degree, which is seen through a half pupillary area. Consequently, operative approach using intracapsular lens extraction technique is considered. A month after the surgery, the distance visual acuity in right eye was 0.125 and 0.080 in left eye. With a refractive correction of +5.50 D, visual acuity became 0.500, while for the left eye became 0.125 with +5.00 D. Whereas, binocular distance visual acuity with refractive correction became 0.400. Therefore, spectacle was prescribed to achieve optimal visual acuity.Conclusions: The refractive management steps in lens subluxation associated with Marfan Syndrome case is very challenging depends on patient's condition. The intracapsular lens extraction procedure prior to spectacle prescription should be considered as a management of severe lens subluxation in patient with Marfan syndrome, in order to achieve BCVA.
Corneal morphological and structural changes measured with pentacam induced by pterygium surgery
Authors: Villalba Mateo , Argudo Alejandro Tocón , Fernández Pilar Margarita Álvarez , Sanchez Javier Benitez‐del‐Castillo 
Published: December 2022

AbstractIntroduction: Pterygium has been related to the induction of astigmatic and optical aberrations and surgery could induce a reduction in these corneal characteristics.Purpose: Study main objective was to evaluate corneal changes and optical aberrations that occura after primary pterygium surgery, and as a secondary objective, to evaluate changes depending on the used surgical technique (simple excision vs. conjunctival plasty).Methods: Data collection was performed through Scheimpflug camera system for anterior segment analysis (Pentacam®): corneal astigmatism in diopters (K) and curvature radius and corneal aberration (Root Mean Square (RMS) Low order aberrations (LOA) and RMS High Order aberrations HOA) in a total of 18 eyes of 18 patients from the Hospital Universitario de Jerez (HUJ) who need pterigion surgery. Variables measured were analysed before surgery and 3 months later.Results: Results showed that there is no statistically significant change in astigmatism after pterygium surgery, although there is a statistically significant reduction in total RMS of the anterior cornea (p = 0.02), RMS LOA of the anterior cornea (p = 0.03) and RMS HOA of total cornea (p = 0.007), anterior cornea (p = 0.03) and posterior cornea (p = 0.03). There are not statistically significant differences between both groups when comparing the surgical technique used.Conclusions: No statistically significant changes in astigmatism after pterygium surgery have been found, but there is a significant decrease in optical aberrations, especially in the anterior cornea. It cannot be concluded that one surgical technique is superior to another.
The effect of sodium glucose transporter 2 inhibitor in diabetic macular edema. A pilot study
Authors: Hernández Irene Gil , Perez Delia Hernandez , Montesa Maria Jesus Puchades , Teruel Jose Luis Gorriz , Duch‐Samper Antonio M. 
Published: December 2022

AbstractPurpose: To investigate if the oral administration of sodium‐glucose cotransporter 2 (SGLT2) inhibitors may have a relevant role modifying the diabetic macular edema (DME) in naïve eyes of diabetic patients.Methods: We conducted a single‐arm pilot study including 6 eyes from 4 patients with type 2 DM with de novo DME who had never been treated with intravitreal injections of VEGF. We performed a first visit to ensure adequate metabolic control and blood pressure of the patients. Later, we add 100 mg/day of oral canagliflozin with an increase of 300 mg of canagliflozin at second month. In this study, visual acuity (VA) and central retinal thickness (CRT, μm) prior to and at 3 months after the initiation of SGLT2 inhibitors were retrospectively compared.Results: 3 of 4 patients maintained or improved their visual acuity. Only one patient worsened their visual accuracy in both eyes at week 12, and since this case exceeded the preset limit of 5 letters, the progression of DME was considered, requiring rescue with intravitreal anti‐VEGF treatment, according to the pre‐established protocol. After 12 weeks of follow‐up, median CRT improved from 317.5 to 302 μm (mean 15.5 μm).Maximum ILM‐EPR height of edema also reduced from 482 to 438 μm (mean 42.1 μm) None of the four patients reported severe adverse effects.Conclusions: To our knowledge, this pilot study is the first to evaluate the effect of oral canagliflozin in a series of patients with DME who have not previously received intraocular therapy or undergone vitreoretinal surgery. Based on our preliminary results, we could speculate that SGLT2i inhibitors may be useful to decrease DME within 12 weeks of treatment, with improvement of visual accuracy avoiding invasive treatments. Larger clinical studies are needed to confirm this relationship.
Modulation of retinal cytokine expression by saffron in an experimental glaucoma model
Authors: Fernández‐Albarral José A. , Martínez‐López Miguel A. , Salobrar‐Garcia Elena , Martín‐Sánchez Beatriz , Felipe Diego San , López‐Cuenca Inés , Marco Eva M. , Salazar Juan Jose , de Hoz Rosa , Ramirez Jose Manuel , López‐Gallardo Meritxell , Ramirez Ana Isabel 
Published: December 2022

AbstractPurpose: To analyse the anti‐inflammatory effect of saffron extract, by regulating the expression of cytokines and chemokines involved in the neuroinflammatory process leading to retinal ganglion cell (RGC) damage, in a mouse model of unilateral laser‐induced ocular hypertension (OHT).Methods: Three groups of Albino Swiss mice treated with saffron extract were used; saffron naïve group (SNG), saffron laser group 1 day (SLG1d) and saffron laser group 3 days (SLG3d). Both eyes with OHT (treated with laser photocoagulation) and their contralateral were analysed. Retinal samples were processed and multiarray kits (MILLIPLEX MAP Mouse Cytokine/Myokine Magnetic Bead Panel) were used to quantify the expression of: IL‐1β, IL‐4, IL‐6, IL‐10, IL‐17, IFN‐ϒ, TNF‐α, Brain‐derived Neurotrophic Factor (BDNF), Vascular Endothelial Growth Factor (VEGF) and Fractalkine. Immunohistochemical analysis was performed to locate cells expressing the factors and cytokines detected in the multiplex assay.Results: After saffron treatment, no significant differences were found, at 1 and 3 days after laser‐induced OHT, between the concentration of proinflammatory cytokines (IL‐1β, IFN‐γ, TNF‐α and IL‐17), anti‐inflammatory cytokines (IL‐4 and IL‐10), BDNF, VEGF, and fractalkine in both the OHT eye and its contralateral eye, compared to saffron naïve. IL‐6 levels increased significantly in the OHT eye in SLG1d, reaching normal values at SLG3d compared to SNG. These results are contrary to those found in OHT eyes and their contralateral not treated with saffron, in which changes in cytokine levels were observed.Conclusions: Saffron is effective in regulating the production of proinflammatory cytokines, VEGF, and fractalkine induced by increased IOP, thus protecting the retina from its related damage. Saffron could be beneficial as coadjutant therapies in the treatment of glaucoma, thus helping to decrease the inflammatory process that occurs in this pathology.