bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of newly referred patients with suspected angle closure: Do we need to redefine the clinical pathways?
Authors: Narayan Akshay , Nolan Winnie , Raja Aneela , Nathwani Neil , Tur Sergio Bordajandi , Thomas Rachel , Scott Andrew , Martins Alessandra , Founti Panayiota 
Published: December 2022

AbstractPurpose: To investigate outcomes of referrals for suspected angle closure and to explore whether anterior segment optical coherence tomography (AS‐OCT) can be used to tighten triaging criteria in a glaucoma virtual clinic.Methods: Retrospectively collected data. The first audit (04/2018–03/2019) identified referrals for suspected angle closure in the absence of other glaucoma‐related findings (primary angle closure suspect (PACS) referrals). All patients underwent gonioscopy. The second audit (04‐08/2019) identified consecutive patients with suspected angle closure in a virtual clinic. Management outcomes were assessed, using gonioscopy as the reference standard. Outcomes were re‐audited after changing the triaging criterion from angle width < 10° to iridotrabecular contact (ITC) in ≥1 quadrants on AS‐OCT.Results: Out of 1754 glaucoma referrals (first audit), 24.6% (431/1754) were PACS referrals. Of these, only 10.7% (42/393) had an occludable angle on gonioscopy, with 97.6% (41/42) being PACS. Of these, 78% (32/41) underwent laser peripheral iridotomy. Out of 137 referrals in the virtual clinic (second audit), 66.4% (91/137) were triaged to the face‐to‐face clinic. Of these, 31.9% (29/91) were discharged. AS‐OCT had positive and negative predictive value of 74.3% (95% confidence intervals (CI) 57.8–86.0) and 82.1% (95% CI 70.0%–90.2%), respectively, in detecting ITC in ≥1 quadrants. In the re‐audit 45.9% (45/98) of those with suspected angle closure were triaged for gonioscopy, with 24.4% (11/45) of them being discharged.Conclusions: PACS referrals represent a substantial burden to hospital‐based services and their ‘accuracy’ appears to be low. ITC in ≥1 quadrants on AS‐OCT can be useful in triaging those who need further evaluation with gonioscopy.
Acute omega‐3 fatty acid supplementation confers novel neurovascular‐protective effects on the retinal and ophthalmic arterial proteome of Cyp2c44−/− mice
Authors: Manicam Caroline , Herfurth Anna , Grus Franz , Pfeiffer Norbert , Perumal Natarajan 
Published: December 2022

AbstractPurpose: Cytochrome P450 (CYP) gene mutations are associated with the pathogenesis of glaucoma. Although the molecular mechanisms are largely unknown, omega‐3 polyunsaturated fatty acids (ω3) and the CYP‐derived lipid mediators play significant roles in the neurovascular functions of ocular vascular beds. This study explored the proteome changes attributed to inherent lack of the main murine CYP gene (Cyp2c44) and the effects of acute dietary supplementation with ω3 in the retina (R) and ophthalmic artery (OA) in vivo.Methods: Male mice with targeted deletion of the Cyp2c44 gene (KO) and their floxed littermates (WT) were gavaged daily for 7 days with 0.01 ml/g ω3 composed of menhaden fish oil. Another group in respective strains served as vehicle‐treated controls. R and OA were isolated at day 8 post‐treatment (n = 9/group) and subjected to mass spectrometry (MS)‐based proteomics and in‐silico bioinformatics analyses.Results: Acute ω3 administration elicited significant differential expressions of 56 and 18 proteins in the R and OA, respectively. The KO mice exhibited significant retinal degeneration (p = 1.82 E‐2) and compromised microtubule dynamics (p = 9.46 E‐3), while mitochondrial chain deficiency (p = 3.77 E‐8) and inhibition of molecular transport (p = 5.24 E‐5) were implicated in OA. Remarkably, ω3 supplementation in KO mice resulted in significant changes in the R proteins involved in vision functions, and heightened metabolic activity via glycolysis and AMPK signalling (CRYBB2, ALDOC, ENO2). Noteworthy, ω‐3 had a profound influence on the regulation of OA proteins involved in the inhibition of necrosis, activation of molecular transport and intercellular junctional organization (HSPA8, HK1, YWHAB).Conclusions: In gist, short‐term dietary supplementation with ω3 confers physiologically relevant beneficial effects on the ocular vascular beds via specific neuro‐vasculoprotective signalling mechanisms in the absence of Cyp2c44. The potential adjunct use of ω3 for glaucoma therapy needs further investigation.
Preliminary results of serial sessions of a newly developed at home device using low‐level light therapy for the treatment of dry eye disease
Authors: Scalzo Giovanna Carnovale , Vaccaro Sabrina , Borselli Massimiliano , Scorcia Vincenzo , Giannaccare Giuseppe 
Published: December 2022

AbstractPurpose: To evaluate objective parameters of ocular surface and ocular discomfort symptoms after the use of a new at‐home device in patients with dry eye disease (DED) owing to meibomian gland dysfunction (MGD).Methods: In this prospective study patients with mild to moderate DED owing to MGD not successfully responding to first‐line therapy (tear substitutes and eye lid hygiene) were recruited. Non‐invasive ocular surface examination was carried out by means of Keratograph 5 M (Oculus, Wetzlar, Germany) for the evaluation of: (i) tear meniscus height (TMH); (ii) non‐invasive break‐up time (NIBUT); (iii) ocular redness; (iv) meibomian gland loss (MGL). Ocular Surface Disease Index (OSDI) questionnaire was used to assess ocular discomfort symptoms. Patients were evaluated before (T0) and after 1 week of treatment consisting of 4 serial sessions (every other day) of low‐level light therapy (LLLT) with a newly‐developed at home device.Results: Seven patients (6 females and 1 male, mean age 56.86 ± 7.29 years) were enrolled and completed regularly the entire cycle of 4 home sessions without any adverse event. Mean value of NIBUT increased significantly at T1 compared to T0 (respectively 5.81 ± 2 0.85 vs. 7.64 ± 3.93 s; p = 0.035); conversely, there were not statistically significant differences for TMH, redness score and MGL. In addition, OSDI score improved at T1 compared to T0 (respectively, 20.17 ± 9.5 vs. 31.14 ± 9.83; p < 0.001).Conclusions: One week of serial sessions of a newly‐developed at home device using LLLT improved significantly tear stability and subjective discomfort symptoms in patients with DED owing to MGD. This strategy could represent a new therapeutic option in the armamentarium of MGD treatments.
Uveal effusion after trabeculectomy: Management challenges
Authors: Cheour Monia , Nouri Slim , Abid Yosra , Sassi Hela , Meriem Ouederni 
Published: December 2022

AbstractPurpose: To discuss the causes and risk factors of uveal effusion after trabeculectomy and to describe the management of this complication.Methods: This observational retrospective case series included 5 consecutive cases of uveal effusion that developed after trabeculectomy with intraoperative 5‐FU. All patients underwent ophthalmological examination including best corrected visual acuity (BCVA) measurement, anterior segment and fundus examinations. Fundus photography, B‐scan ultrasonography and Swept Source optical coherence tomography (SS‐OCT) were used to detect and monitor choroidal detachment and hypotony maculopathy. Anterior segment optical coherence tomography (AS‐OCT) was performed to assess iridocorneal angle opening and anterior chamber depth.Results: Four men and one woman were included. Mean age was 48.8 ± 15.1 y. One patient had nanophtalmia confirmed by B‐scan ultrasonography while four patients had postoperative hypotonia caused by overfiltration (3 cases) and bleb leak (1 case). All patients received corticosteroids and cycloplegics associated with a reformation of the anterior chamber and in one case we performed bleb revision. We showed resolution of the choroidal effusion, normalization of the ocular hypertension and restoration of visual acuity in all cases.Conclusions: Uveal effusion after trabeculectomy occurs in 3%–34% of cases. Its management can be challenging and requires close monitoring. Conservative management can overcome choroidal detachment, restore visual acuity and avoid aggressive surgery.References.1. Schrieber C, Liu Y. Choroidal effusions after glaucoma surgery. Current Opinion in Ophthalmology. 2015; 26(2): 134–42.2. Senthikumar VA, Michra C. Ultra‐widefield image of choroidal detachment after combined glaucoma filtration surgery. Indian J Ophthalmol. 2020; 68(8): 1669.
Implementation of a virtual screening service for hydroxychloroquine and chloroquine retinopathy: One‐year results
Authors: Ferreira Catarina , Fernandes Joana , Saraiva Eduardo , Fonseca Sofia 
Published: December 2022

AbstractPurpose: To evaluate the results of a new virtual screening service for hydroxychloroquine (HQC) and chloroquine (CQ) retinopathy.Methods: Prospective study including patients under long‐term HCQ or CQ therapy referred for screening at a single ophthalmic centre in Portugal over a one‐year period. The virtual clinic consisted of a visit for functional and structural testing, in accordance with the guidelines on HCQ retinopathy screening1,2, followed by a later review by an experienced consultant. Individualized counselling for both patients and prescribing physicians was provided on retinal toxicity risk, safe dosing, and adequate screening intervals.Results: A total of 93 patients under treatment with HCQ attended the virtual clinic. Systemic lupus erythematosus (38.7%) and rheumatoid arthritis (18.3%) were the most prevalent diagnoses. Mean daily HCQ dosing was 5.2 ± 1.6 mg/Kg, with 46.2% patients using a daily dose greater than 5 mg/Kg. Median treatment duration was 48 months (range: 1–264) and 49.5% patients had been treated for longer than 5 years. Renal disease was present in 11 patients (11.8%) and 7 (7.5%) had pre‐existing retinal conditions. Structural changes in macular optical coherence tomography and fundus autofluorescence were rarely detected (3.3%). In contrast, 16 patients (17.2%) presented with abnormal 10‐2 visual field testing. Multifocal electroretinogram was performed in 14 patients (15.1%), detecting characteristic abnormalities of drug toxicity in one patient, with a definite diagnosis of severe HCQ retinopathy. Recommendation for dose adjustment was given in 47.3% of cases, including advice to discontinue HCQ use in 7 (7.5%) patients based on risk factors.Conclusions: Retinal toxicity is a rare adverse effect of HCQ, a therapy increasingly used in the management of autoimmune disorders. Virtual clinics could be a safe and sustainable care delivery system for adequate counselling, risk assessment and early retinopathy detection.References.1. Marmor MF, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology 2016; 123:1386–1394.2. Royal College of Ophthalmologists. Hydroxychloroquine and chloroquine retinopathy: recommendations on monitoring. London: Royal College of Ophthalmologists, 2020.
Pathogenic variant c.61G > C in NLRP3 lowers NLRP3 inflammasome activation threshold in patients with keratitis Fugax Hereditaria
Authors: Kawan Sabita , Backlund Michael , Immonen Annamari , Kivelä Tero , Turunen Joni 
Published: December 2022

AbstractPurpose: To elucidate the effect of NLRP3 variant c.61G > C on interleukin‐1β (IL‐1β) secretion in keratitis fugax hereditaria (KFH), a cryopyrin‐associated periodic syndrome limited to the eye, and to probe the potential modifying role of prednisolone.Methods: Peripheral blood mononuclear cells (PBMCs) isolated from whole blood of patients with KFH and healthy controls were grown under steady‐state conditions or primed with lipopolysaccharide (LPS) with or without prednisolone, and subsequently activated with adenosine triphosphate (ATP). Cell lysates and proteins precipitated from the cell culture media were separated by SDS‐PAGE. NLRP3, procaspase‐1, and IL‐1β were visualized by western blotting. The concentration of secreted IL‐1β in the culture media was quantified by ELISA.Results: A lower threshold for IL‐1β secretion following priming of the NLRP3 inflammasome with LPS was observed in patients‐derived PBMCs, compared to healthy controls (median, 124 vs. 16 pg/ml respectively). Interestingly, in PBMCs derived from patients with frequent KFH symptoms, LPS priming alone was able to trigger substantial IL‐1β secretion (median, 522 pg/ml), whereas those of patients experiencing occasional KFH attacks showed a subtler release of IL‐1β (median, 85 pg/ml). LPS and ATP treated PBMCs from patients with KFH showed significantly diminished IL‐1β secretion with prednisolone treatment (p = 0.04). NLRP3 expression was significantly enhanced with LPS stimulation (p = 0.03) whereas procaspase‐1 expression was not affected.Conclusions: PBMCs from patients with KFH are more prone to secrete IL‐1β, confirming the presumption that the c.61G > C is a gain‐of‐function variant. Furthermore, prednisolone is confirmed as a potent drug to reduce IL‐1β secretion in KFH.
MR‐based follow‐up after brachytherapy and proton beam therapy in uveal melanoma
Authors: Tang Michael , Ferreira Teresa , Jaarsma‐Coes Myriam , Klaassen Lisa , Marinkovic Marina , Vu Khanh , Rasch Coen , Creutzberg Carien , Horeweg Nanda , Klaver Yvonne , Rodrigues Myra , Luyten Gregorius , Beenakker Jan‐Willem 
Published: December 2022

AbstractPurpose: Comparison of Magnetic Resonance Imaging (MRI) with conventional ultrasound for the follow‐up in Uveal Melanoma (UM) patients treated with brachytherapy or proton beam therapy (PBT).Methods: 26 UM patients were scanned before, 3, 6 and 12 months after ruthenium brachytherapy (n = 13) or PBT (n = 13) at 3Tesla MRI. Tumour prominence measurements were compared between MRI and ultrasound. On Perfusion weighted MR‐imaging (PWI), the relative enhancement and outflow at 2 min after peak were assessed. Treatment response was defined as a reduction of ≥0.6 mm prominence and/or ≥5% perfusion outflow was achieved.Results: Pretreatment prominences were comparable on MR and ultrasound (mean absolute difference 0.49 ± 0.46 mm), larger differences were observed at 3 and 6 months post treatment (0.88 ± 0.86 mm and 0.74 ± 0.72 mm, respectively). At 12 months post treatment, the difference was reduced to 0.55 ± 0.33 mm. Pretreatment, 76% of the UM showed a washout perfusion curve. The pretreatment average enhancement and outflow were 98% (SD:49%) and 31% (SD: 25%) respectively. At 3 months post treatment tumours showed 41% less outflow on average with more favourable perfusion curves (e.g. 68% showed a persistent or plateau curve). At 6 and 12 months post treatment, tumours continued to show less outflow (respectively, −47% and −38%) and more favourable perfusion curves (respectively, 79% and 76% with either persistent or plateau curves). These, generally favourable, perfusion changes were also observed when no reduction in prominence was yet apparent, which is why treatment response was more frequently detected on MRI as opposed to ultrasound. For example, at 3 months post treatment >80% of patients were already detected on MRI versus 46% on ultrasound.Conclusions: MRI is beneficial for the follow‐up of UM patients, especially for PBT treated patients as these generally take longer before a reduction in prominence can be observed.
Comparison of ocular aberrations and retinal image quality provided by a validated aberrometer and a new open field aberrometer for VEMoS project
Authors: Alio Jorge , Martínez‐Abad Antonio , José‐Martínez Marina , Mira‐López Paula 
Published: December 2022

AbstractPurpose: The aim of this observational study was to compare the retinal image quality and ocular aberrations provided by a validated aberrometer and by a new open field aberrometer.Methods: This is an observational and comparative study composed by healthy eyes not presenting cataract or ocular pathologies affecting media transparence or visual function. Patients underwent a measurement of ocular aberrations by a closed field aberrometer (Osiris, CSO) and by an open field aberrometer developed for VEMoS European project (OFA, CSO). Both measurements were performed by a qualified optometrist and the pupil size selected for the analysis was 4 mm. SPSS program was applied for the statistical analysis, particularly Wilcoxon test was used to compare both devices considering a significance of 0.05.Results: The study included 20 eyes of 20 patients with a mean age of 36.2 ± 9.7 years. The sphere was significantly more negative with Osiris in comparison with OFA (−0.33 ± 2.17 diopters vs. 0.29 ± 2.17 diopters, p < 0.001), the spherical aberration was also slightly lower with Osiris (0.02 ± 0.03 microns vs. 0.03 ± 0.03 microns, p: 0.045). The rest of aberrometric coefficients including the cylinder, coma, trefoil, quadrefoil and secondary astigmatism showed no significant differences between devices (p > 0.05). Moreover, the point spread function did not presented statistical differences, but a trend to obtain higher values was observed in Osiris (0.219 ± 0.127 vs. 0.189 ± 0.126, p: 0.370).Conclusions: The sphere provided by an open field aberrometer was significantly more positive comparing with a close field aberrometer probably associated to an accommodative response induced in close field aberrometers. Similarly, the spherical aberration assumed small changes between devices, which would be generated also by accommodation. The rest of parameters showed no differences between devices indicating a suitable agreement between devices for these coefficients.
Macrophage infiltration in the cornea in a mouse model of sepsis
Authors: Quirce Susana , Ramírez Kristy Tatiana Rodríguez , Vidal‐Sanz Manuel , Agudo‐Barriuso Marta 
Published: December 2022

AbstractPurpose: To analyse the effect of a systemic inflammatory insult induced by lipopolysaccharide (LPS) administration on the cornea in mice.Methods: Male and female C57BL/6J mice were injected with a single intraperitoneal injection of LPS (5 mg/kg). Intact animals were used as control. At 21 days after LPS administration animals were sacrificed with sodium pentobarbital. Corneas were dissected as flat mounts or histological sections (16 μM) and Iba1 (microglia and macrophages) and CD45 (activated microglia and macrophages) immunodetected.Results: In LPS treated animals but not in intact ones, microglia/macrophages were found in all corneal layers while in corneal flat mounts Iba1 + Cd45+ cells were observed through the corneal surface with higher density in the periphery.Conclusions: Sepsis causes infiltration and activation of microglia/ macrophages in the murine cornea that lasts up to 21 days.
Association of visual acuity and vessel density in glaucoma patients with myopia
Authors: Kim Seong Ah. , Park Chan Kee , Park Hae‐Young Lopilly 
Published: December 2022

AbstractPurpose: To evaluate correlation between vessel density (VD) and visual acuity (VA) in glaucoma patients with myopia.Methods: 65 eyes of 70 open angle glaucoma patients with myopia were included in this study. Myopia was defined as axial length > 26.0 mm. Decreased VA was defined as <20/25. Visual field (VF) 24‐2 and 10‐2 were both performed. Superficial and deep peripapillary VD (PPVD) were evaluated using radial peripapillary capillary VD and choriocapillary VD in peripapillary atrophy (PPA), respectively, of optical coherence tomography angiography (OCT‐A). Temporal and nasal superficial PPVD around optic nerve head (ONH), and the ratio of temporal to nasal PPVD were evaluated. Macular VD was evaluated using superficial and deep layer of OCT‐A. PPA with and without gamma‐zone PPA, disc torsion, and disc‐fovea distance (DFD) were evaluated.Results: 32 eyes of normal VA and 33 eyes of decreased VA were enrolled. In logistic regression analysis, thinner ganglion cell complex (GCC) (p = 0.005), lower deep PPVD (p = 0.028), and longer DFD (p = 0.049) were significantly associated with decreased VA. Worse VA was significantly associated with older age (p = 0.005), thinner GCC (p < 0.001), more decreased ratio of temporal to nasal superficial PPVD (p = 0.022), and lower deep PPVD (p < 0.001) in linear regression analysis. Worse mean deviation of VF10‐2 was significantly correlated with thinner GCC, lower temporal PPVD, and lower deep PPVD, respectively in linear regression analysis (all p < 0.001).Conclusions: Eyes with decreased VA showed lower temporal superficial PPVD, deep PPVD, and thinner GCC in patients with myopia. Decreased VA was also associated with longer DFD. Decreased VD that may be affected by scleral deformation at temporal to ONH was associated with central scotoma and decreased VA.
Quantification of vascular pathology in the retina through probability distributions of central artery and vein width equivalent
Authors: El Youssfi Asmae Igalla , Cedrun‐Sanchez Juan , Puell María , Alonso José Manuel López 
Published: December 2022

AbstractPurpose: A semi‐automated method of measuring the Central Retinal Artery Equivalent (CRAE) and Central Retinal Vein Equivalent (CRVE) has been developed. The method was used to calculate parametric probability distribution for CRAE and CRVE in healthy retinas in order to quantify possible vascular pathology degree.Methods: Using the ARIA software (MATLAB), the diameters of the retinal vessels located in a ring with radii 0.5 and 1 diameter of the optic disc were quantified. A measurement of CRAE and CRVE was obtained for two data base of healthy retinas (15 and 52 patients) measured with different retinal cameras. Subsequently, the probability distribution of CRAE and CRVE was calculated, as well as the bootstrap estimators of the mean, standard deviation, skewness, and kurtosis. MATLAB functions were used to select the parametric distribution that best fits the data. The Mahalanobis distance of each retina to healthy distribution was obtained. This classification distance was applied to healthy and glaucoma retinas.Results: The fits to theoretical distributions were good for a Generalized Extreme Value Distribution (gev) characterized by three parameters (scale, mean and standard deviation). They appear to be consistent across different databases. In retinas with glaucoma, the Mahalanobis distance allows the degree of pathology to be quantified. Moreover, the method can be used to classify the healthy retinas.Conclusions: The possible existence of parametric probability distributions for values of vascular calibres opens the possibility of quantifying the degree of vascular pathology.
Snail track a in a case with anterior segment dysgenesis caused by a novel FOXC1 variant
Authors: Jedličková Jana , Skalická Pavlína , Dudakova Lubica , Liskova Petra 
Published: December 2022

AbstractPurpose: To identify disease‐causing mutation in one proband of Czech origin with anterior segment dysgenesis (ASD) and to describe the associated phenotype.Methods: After complex ophthalmic examination of 15‐year‐old female at the Department of Ophthalmology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, DNA extraction from blood was performed. Pathogenic variants in genes associated with ASD were searched using exome sequencing. Confirmation of the presence of causal variant and segregation within the family members was performed by Sanger sequencing. Standard paternity testing was performed to confirm de novo origin of the variant.Results: Except for common finding of ASD as mild iris hypoplasia, pupil deformation in both eyes, and unilateral iridocorneal adhesions, there was a snail track lesion of the right cornea at the level of the Descemet membrane. Molecular genetic analysis revealed that the proband was a carrier of a novel heterozygous frameshifting variant in the FOXC1 gene: NM_001453.3: c.605del, p.(Pro202Argfs*113). De novo origin was confirmed by the absence of the variant in healthy parents and sister of proband, and further by the paternity testing.Conclusions: Loss of visual functions in ASD is often very acute, therefore establishing molecular diagnosis highly impacts patient management and enabling prenatal diagnostics. Further studies need to be performed to verify if there is a true association of snail tracks and pathogenic variants in FOXC1.