bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful DWEK in persistent corneal edema secondary to subacute unexplained endotheliitis: 6‐month follow‐up
Authors: Cisneros‐Arias Pablo , El Bakkali Ismael Bakkali , Rivasés Guillermo P. , Moscarda Eva Núñez , de Rivas Marta Orejudo , Suñer Marta , Clavería Julia Aramburu , Fernandez Miguel Castillo , Pascual Paula Casas , Puyuelo Javier Ascaso , Simon Cristina Calvo , Remacha Carla Sánchez 
Published: December 2022

AbstractPurpose: To present a case of persistent corneal edema after endothelial disease of unknown cause and with a severe decrease in the endothelial count and clinical improvement after DWEK (descemetorhexis without endothelial keratoplasty).Methods: A 61‐year‐old immunocompetent male patient, with no relevant ophthalmological or systemic history, who after multiple episodes of subacute endotheliitis with retrokeratic precipitates and diffuse iridian atrophy in his right eye, showed central persistent corneal edema, secondary to a marked decrease in endothelial count and severe decrease in best‐corrected visual acuity (0.2) after several months of inflammatory stability.Results: During flare‐ups of inflammation, treatment with corticosteroids, topical ganciclovir and oral acyclovir was prescribed, with a good clinical response. Aqueous humour samples were taken during the outbreaks without yielding results for herpesviruses. The endothelial count remained low at the central level several months later, although the peripheral count was good. The fellow eye showed a normal count. It was decided to perform DWEK in the endothelial zone of retrokeratic precipitates as a diagnostic measure. The analyses of the endothelial sample FOR THE HERPESVIRIDAE FAMILY do not show results, however, a progressive improvement in corneal edema and visual acuity was observed from the first month after DWEK. He is currently stable, with mild paracentral edema and a best‐corrected visual acuity of 0.7.Conclusions: DWEK is reserved for cases of slightly advanced endothelial dystrophy, in which the central endothelial denudation causes a centripetal migration of the peripheral endothelial reserve. In this case, the clinical findings suggest a viral aetiology of the endothelial loss, therefore, DWEK was considered as a diagnostic procedure, to obtain samples for PCR and as a first step prior to DMEK. The improvement after DWEK in the area of retrokeratic precipitates without the need for a subsequent transplant suggests localized endothelial involvement in cases of endothelial loss associated with localized inflammatory precipitates.
Clinical and tomographic characteristics of anterior scleritis
Authors: Maamouri Rym , Aoun Safa Ben , Meriem Ouederni , Fatma Daoua , Zohra Aydi , Cheour Monia 
Published: December 2022

AbstractPurpose: To describe clinical, etiological and tomographic features of anterior scleritis.Methods: Retrospective case series study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis between the 1st January 2021 and the 1st January 2022. Nine patients (12 eyes) with anterior scleritis were included. All patients underwent complete ophthalmic examination including anterior segment and fundus slit lamp examination. The cases were documented with multimodal imaging including anterior segment optical coherence tomography (AS‐OCT). All patients were referred to the internal medicine department for general examination.Results: The median age of the patients was 37 years. 44% were male and 56% were female. Ophthalmic examination revealed diffuse conjunctival hyperemia and scleral vessel dilation with negative neosynephrine test in all eyes. The scleritis was bilateral in 3 patients, diffuse in 6 eyes, nodular in 5 eyes and necrotizing in 1 eye. One eye was complicated with angle closure glaucoma, 2 eyes had anterior uveitis, 1 eye had retinal vasculitis and 2 eyes were associated with posterior scleritis. AS‐OCT revealed a narrow anterior chamber and a closed angle in 1 eye, dilated scleral vessels in all eyes, thickening of the sclera in 11 eyes, dome‐shaped hyperreflective lesions corresponding to the nodules in 5 eyes and thinning of the sclera in the eye with necrotizing scleritis. Systemic disease was found in 7 patients. Main etiologies were tuberculosis in 3 patients and Behçet disease in 2 patients. The other two diagnosis were granulomatosis with polyangiitis and MacDuffie syndrome.Conclusion: In our case series Behcet disease and tuberculosis were the main diagnosis of anterior scleritis. AS‐OCT could show different features of anterior scleritis depending on the clinical presentation and could consequently help to monitor the inflammation.
Analysis of retinal displacement by wide‐field retinography in combined vitreoretinal surgery at the Urduliz hospital
Authors: Costales‐Mier Felipe , Mendívil Estibaliz Ispizua , Salinas Gotzone Barbarias , Otxoa Iker , Ortega Concepción Hernaez 
Published: December 2022

AbstractPurpose: To describe the findings of retinal displacement (RD) by autofluorescence (AF), and by Optomap imaging in patients with retinal detachment that underwent simultaneous scleral buckle (SB) and pars plana vitrectomy (PPV). Likewise, to describe the morphological findings by OCT‐SD and their association with the final visual acuity. Finally, assess the correlation of RD, depending on the use of gas or silicone oil (SO) as taponade.Methods: Retrospective analysis of a series of 17 patients, operated by PPV and CE, with gaseous tamponades and SO. Postoperative funduscopic assessment was performed using Optomap (colour retinography and AF) and macular OCT.Results: Of the 17 patients, 10 presented retinal displacement (58.82%), 9 with an inferior direction and 1 superior direction. The mean displacement distance being 0.185 mm. 80% of them were in the extramacular zone, and 20% in macular area. Superior RD was retinal redetachment case with SO as tamponade. On the OCT analysis, five patients presented alterations in the photoreceptor interdigitation zone, five patients developed an epiretinal membrane, one patient presented persistence of subretinal fluid. Half of those who suffered RD also presented alteration of photoreceptors. These were the ones with the worst VA (decimal VA 0.62 vs. 0.73 mean of all cases).Conclusions: Retinal displacement assessed by wide‐field autofluorescence retinography, can be observed both in the early and later postoperative stages. It appears frequently in the inferior direction, as it seems to be more common when SO is used (75%) compared to a gas tamponade (53.8%). In patients with combined surgery, the proportion, direction, and rate of displacement seems to be similar to series previously described where isolated PPV or isolated SB is performed with pneumatic retinopexy, with gas tamponade. When SO is used as a tamponade, our series presents a higher RD rate than in isolated procedures. Apparently, the macular defects recorded in OCT occur mainly in patients associated with RD, especially in the macular area. To our knowledge, we have not found studies that describe the association of these findings in patients undergoing simultaneous SB and PPV procedure, requiring prolonged follow‐up of these patients, as well as possibly a larger number of them, in order to corroborate these findings.
Metallic intraocular foreign body removal assisted through the extrusion line
Authors: Costales‐Mier Felipe , Maeso Alicia Traveset , Cuesta‐Lasso Marta , Aguayo Javier 
Published: December 2022

AbstractPurpose: To describe an alternative vitreoretinal surgical manoeuvre, to remove metallic intraocular foreign bodies.Methods: Two patients, at different time lines, underwent vitrectomy to remove a metallic intraocular foreign body (IOFB). A 3‐port vitrectomy was performed, a 23‐G constellation vitrectomy equipment was used in both procedures, careful core vitrectomy was first done, vitreous adhesions and vitreous detachment was carefully done, retina was partially detached at the IOFB location, vitreous adhesions were cut and released gently not to increase the retinal detachment. Liquid prefluorocarbon was placed on the macula. As the vitreous adherences were cut, the IOFB was free from all potential tractional forces, the soft silicone tip cannula was held on to its surface, and at maximal vacuum aspiration, the IOFB was brought up to the anterior chamber, switching the light pipe for forceps in the other hand, and removed out of the eye. A complete as possible vitrectomy was performed, intraocular laser around the retinal brakes was performed, an intraocular lens was placed in the ciliary sulcus with the optic within the anterior capsule, and silicone oil was used as tamponade.Results: No signs of intraocular inflammation were recorded postoperatively. Intraocular silicone oil removal was done at the third post‐operative month in both cases, retina remained attached through follow up, both patients had over 9 months follow‐up visits, visual acuity improved from initial presentation, and also improved after the silicone oil tamponade removal.Conclusions: Active aspiration through the soft silicon tip cannula can be used to reach, and assist removal of metallic intraocular foreign bodies, being this manoeuvre safe, reproducible, possibly time‐saving, and also it could potentially avoid the risk of IOFB mobilization, avoiding further damage to the retina.
Correlations between visual function and inner retinal structure in OPA1 autosomal dominant optic atrophy
Authors: Pemp Berthold , Schrittwieser Johannes , Kircher Karl , Schmidt Wolfgang , Reitner Andreas 
Published: December 2022

AbstractPurpose: To evaluate the influence of autosomal dominant optic atrophy (ADOA) on visual function and inner retinal layer thickness in patients harbouring a pathogenic variant in the OPA1 gene.Methods: We retrospectively investigated clinical data of 59 patients (118 eyes) with ADOA and genetically confirmed OPA1 variants. Visual function was evaluated by best corrected visual acuity (VA), and by mean deviation (MD) of automated static threshold perimetry. Macular ganglion cell layer (mGCL) volume and peripapillary retinal nerve fibre layer (pRNFL) thickness were measured by optical coherence tomography. The analysis was performed for all available data from both eyes in the whole sample. Furthermore, patients were stratified in 2 groups based on variant type (haploinsufficiency: 86 eyes, missense variants: 14 eyes).Results: The mean age at examination was 30.5 ± 16.1 years, VA was 0.55 ± 0.33 logMAR, MD was −4.73 ± 3.59 dB, mGCL volume was 0.60 ± 0.10 mm3, and pRNFL thickness was 63.8 ± 10.6 μm. VA correlated significantly with mGCL volume (p < 0.001) and with pRNFL thickness (p = 0.021). MD also correlated with pRNFL thickness (p = 0.017). Patient age was associated with mGCL volume (p < 0.001) and pRNFL thickness (p = 0.024), but not with VA or MD. MD was significantly lower in the missense group than in the haploinsufficiency group (−9.31 ± 4.07 dB vs. −4.03 ± 2.85 dB; p < 0.001), whereas VA did not differ between groups. Thickness of the pRNFL was also lower in the patients with missense variants, but only the nasal sector was significantly thinner (48.2 ± 12.8 μm vs. 58.2 ± 19.2 μm; p = 0.035).Conclusions: Visual function and inner retinal structure are closely associated in ADOA patients with OPA1 variants. Increasing age may be accompanied by a continuing degeneration of retinal ganglion cells, but seems to have less effect on further loss of visual function. Patients carrying missense variants show more pronounced optic atrophy and visual field defect.
A screening tool to detect chronic ocular graft versus host disease in a haematology/oncology outpatient setting
Authors: Greenan Emily , Vandenberghe Elizabeth , Conneally Eibhlin , Gabhann‐Dromgoole Joan Ní , Murphy Conor 
Published: December 2022

AbstractPurpose: To develop an effective and efficient screening tool for chronic ocular graft versus host disease (oGvHD) that could be integrated into a post‐allogeneic transplant follow‐up clinic.Methods: Consecutive patients attending the post‐allogeneic transplant follow‐up clinic were recruited. Participants completed questionnaires before ophthalmic examination to prevent bias and were considered to have chronic oGvHD if they fulfilled either the National Institute of Health or International Chronic Ocular Graft‐vs‐Host‐Disease Consensus Group diagnostic criteria. PHASE I participants completed the Ocular Surface Disease Index (OSDI) questionnaire. In this instance a threshold score of >33 was considered suggestive of chronic oGvHD. PHASE II participants completed the OSDI as part of a new algorithm in which score of >33 in the context of daily ocular lubricant usage was considered suggestive of chronic oGvHD. Those diagnosed with chronic oGvHD were recruited into a prospective study. This aimed to correlate ocular surface disease severity which was scored using the Oxford Grading schematic and OSDI results during subspecialist treatment.Results: PHASE I (n = 100) resulted in a sensitivity of 100%, specificity of 86.9%, positive predictive value (PPV) of 0.59, negative predictive value (NPV) of 1.0 and likelihood ratio (LR) of 7.3 (p < 0.0001). PHASE II (n = 68) resulted in 100% sensitivity and specificity with a PPV and NPV of 1.00 (p < 0.0001). Finally OSDI score and ocular surface disease severity was found to be strongly correlated (n = 65, 0.67, p < 0.0001).Conclusions: An algorithm including the self‐administered OSDI questionnaire and a polar ‘yes/no’ question relating to ocular lubricant usage can be used to reliably and consistently identify patients with chronic oGvHD, triggering earlier referral to ophthalmology. The OSDI score strongly correlates with disease severity and will aid ophthalmologists to accurately triage patients with oGvHD referred to their care.
The relationships between mesopic light sensitivity and macular inner and outer retinal layer thicknesses in older healthy adults
Authors: Puell María , Moreira‐Estebaranz Carolina , Remis‐Gonzalez Melisa , Cedrun‐Sanchez Juan 
Published: December 2022

AbstractPurpose: Structural and functional markers are important for the early detection of neurodegenerative diseases of the eye. This study investigates the relationships between macular layer thicknesses and mesopic light sensitivity (MLS) in older healthy eyes.Methods: Measurements were made in 38 eyes of 38 healthy individuals of mean age 67 ± 5.6 years (range 60–80 years) and good visual acuity. MLS was measured with macular integrity assessment (MAIA) microperimetry at the central 10° diameter circle. MLSs at the central subfield (1° radius) and at four regions (temporal, nasal, superior, inferior) of the parafoveal ring (3°–5° radius of eccentricity) were registered. Total, inner, and outer retinal layer (IRL and ORL) thicknesses were measured in the macular region through spectral‐domain optical coherence tomography (SD‐OCT). Relationships between MLS and the retinal thickness in the corresponding macular region were examined using forward stepwise multiple linear regression analyses.Results: ORL and IRL thickness in the inferior parafoveal ring were significant contributing factors to the inferior MLS (ORL: p < 0.0001; IRL: p = 0.0003; R2 model = 51%). Increased ORL thickness and decreased IRL thickness correlated with worse MLS. The total retinal thickness, age, sex, refractive error, axial length, retinal illuminance or visual acuity variables were not found to be significant predictors of MLS.Conclusions: ORL and IRL thicknesses predict inferior parafoveal MLS in healthy older eyes. The measurement of MLS in combination with macular layer thicknesses may be useful for detecting loss of sensitivity caused by early degenerative diseases of the retina.
Performance evaluation of cataract surgery on a virtual reality simulator
Authors: Yu Zhaohua , Popa Alexandru , Söderberg Per 
Published: December 2022

AbstractPurpose: To evaluate the cataract surgery performance of non‐experienced trainees on a virtual reality simulator.Methods: Ten medical students familiar with the anatomy and physiology of the eye, but naive to cataract surgery, were admitted to the study. Each subject was introduced to the simulator and then registered 40 simulations spanning 10 consecutive days with 4 simulations each day. Each simulation contains two phases, the capsulorhexis plus sculpting phase and the evacuation phase. The simulator automatically measured 38 variables during the simulation. All the variables were converted to performance index previously formulated by Söderberg et al. to assess the performance in both phases.Results: In the capsulorhexis plus sculpting phase the asymptote of the trainee overall performance index was, estimated as 95% CI, 0.9 ± 0.7 and a number of simulations needed to reach 90% of the asymptote was 37 ± 24, indicating that the performance asymptote of a naive trainee achieves approximately after 40 simulations. An average incidence of capsular damage was 30% for the first 10 simulations whereas 9% for the last 10 simulations. In the evacuation phase the trainee overall performance index of 1 which is equivalent to the reference performance index was reached within the first 5 simulations and quickly plateaued, and less performance variation and better performance correlated with more training on the simulator.Conclusions: A high‐level performance asymptote occurs in the capsulorhexis plus sculpting phase after 40 simulations. In the evacuation phase performance asymptote can be reached at very early stage. Evacuation is less difficult than capsulorhexis plus sculpting.
Point‐of‐care diagnostic devices for dry eye disease
Authors: Shi Yuqi , Hu Yubing , Yetisen Ali 
Published: December 2022

AbstractPurpose: Tears can be utilized as a surrogate medium for blood constituents to perform continual analyte measurements in point‐of‐care settings. This work aims to develop fluorescent tear lactoferrin sensor and implement the sensor on different point‐of‐care (POC) platforms for ocular health diagnosis through a smartphone camera‐based application.Methods: The fluorescent lactoferrin sensor was developed based on the binding with trivalent terbium (TbCl3) and its sensitivity and selectivity were examined in Tris buffer solutions and artificial tear fluid (ATF). The lactoferrin sensor was then integrated on various platforms including lateral flow detection, capillary tube detection, and contact lens detection. A smartphone camera and 3D printed readout device were applied for data collection. The smartphone application was designed and employed for data processing.Results: A relative high linearity of lactoferrin (0.0–5.0 mg/ml) in buffer solutions and ATF were achieved with a slope of 3.32 (R2 = 0.99) and 4.28 (R2 = 0.98) respectively. The linear regression for lactoferrin sensors in lateral flow sensing, capillary tube sensing and contact lens sensing platforms was 0.90, 0.93 and 0.97, respectively. Their corresponding limit of detection was yielded at 0.57, 0.12 and 0.44 mg/ml, respectively.Conclusions: This work provides various platforms for sensitively and selectively tear lactoferrin monitoring at POC platform for potential clinical applications. The region of interest and auto‐exposure adjustment for smartphone application can be developed further in future experiments. The contact lens sensor is promings to provide patients with quantitative readouts to monitor ocular diseases continually.
Juvenile glaucomas and multi locus disease causing genomic variations
Authors: Gupta Viney , Somarajan Bindu , Gupta Shikha , Singh Abhishek , Mahalingam Karthikeyan , Sharma Arundhati 
Published: December 2022

AbstractPurpose: Multilocus disease‐causing genomic variations (MGVs) and multiple genetic diagnoses (MGDs) are increasingly being recognized in individuals and families with Mendelian disorders. This can mainly be attributed to the widespread use of next generation sequencing (NGS) for the evaluation of these disorders. We conducted an NGS study of 40 juvenile onset open angle glaucoma (JOAG) families to evaluate the known and unknown gene mutations.Methods: Whole Exome sequencing was undertaken for 40 unrelated trios (proband and both parents) where the proband had JOAG. Out of these, eight were autosomal dominant, while rest were non familial.Results: Out of the 8 autosomal dominant JOAG families, MYOC mutations were detected in 3 (37.5%) and LTBP2 in 1 (12.5%). The family with LTBP2 mutation also had a MYOC mutation. One autosomal dominant family (12.5%) out of 8 had a rare EFEMP1 mutation in both affected father and daughter. The daughter also had Stickler syndrome (STL), that was later identified on observing a pathogenic COL11A1 mutation.Conclusions: These findings underline the importance of genetic evaluation in systematic phenotyping families with JOAG for MGVs and MGDs.References1. Collantes ERA, Delfin MS, Fan B, Torregosa JMR, Siguan‐Bell C, Florcruz NVG, Martinez JMD, Masna‐Hidalgo BJ, Guzman VPT, Anotado‐Flores JF, et al. EFEMP1 rare variants cause familial juvenile‐onset open‐angle glaucoma. Hum Mutat. 2021. 43(2):240–252.2. Stickler GB, Hughes W, Houchin P. Clinical features of hereditary progressive arthro‐ophthalmopathy (Stickler syndrome): a survey. Genet Med. 2001;3(3):192–6.
Evaluation of severity and time disease using new optical coherence tomography tool in multiple sclersosis patients
Authors: Ciordia Beatriz Cordón , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Palomar Elisa Viladés , Rodrigo Maria Jesus , Perié Manuel Subías , Campo Lorena Arias , Munuera Ines , Satue Maria , Garcia‐Martin Elena 
Published: December 2022

AbstractPurpose: To assess the ability of Posterior Pole new protocol in optical coherence tomography (OCT) to detect areas with significant differences on retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thicknesses in patients with multiple sclerosis (MS) versus healthy controls; in addition, to assess the correlation between RNFL and GCL thicknesses, disease duration and the Expanded Disability Status Scale (EDSS).Methods: We analysed 64 eyes of healthy controls and 100 eyes of remitting–relapsing multiple sclerosis (RR‐MS) patients by OCT Posterior Pole protocol. Analysis based on clinically definite time point (CDMS) dividing patients in two subgroups [CDMS‐1 (≤5 years) and CDMS‐2 (≥6 years)].Results: Significant differences in RNFL and GCL were found between RR‐MS group and healthy controls, and also for each CDMS subgroups on both layers. Moderate to strong correlations were found between RNFL and GCL thicknesses and CDSM; furthermore, we observed a strong correlation with EDSS 1 year after OCT exam.Conclusions: Posterior Pole protocol is a useful tool to assess MS; it can reveal differences even in early stages of the disease. RNFL thicknesses demonstrate strong correlation with disability status, while GCL correlates better with time of disease.