bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microglial alterations as a possible treatment target in retinitis pigmentosa
Authors: Almansa Inmaculada , Sanz María Miranda , Sánchez‐fideli Amparo , Trull Carmen 
Published: December 2022

AbstractPurpose: The term retinitis pigmentosa (RP) describes a group of hereditary retinopathies. The first clinical signs of RP are night blindness and loss of peripheral vision. Central vision remains preserved until advanced stages of the disease. At a cellular level, the rods are the first to degenerate. Subsequently, there is degeneration of the cones. Inflammation plays a fundamental role in RP. The microglia respond quickly to alterations, acquiring amoeboid morphology; migrating to damage focus; acquiring macrophages functions; phagocytosing cellular debris; secreting molecules that initiate tissue repair; and favouring neuroprotection. However, if the activation is excessive, the constant secretion of nitric oxide and proinflammatory cytokines lead to pathological side effects. The purpose of this work was to review published studies in order to know if the inhibition of micloglial activation may be a good option to increase photoreceptor protection.Methods: A systematic literature review was conducted, in accordance with PRISMA criteria, in different bibliographic databases: Medline, Embase, SCOPUS and Web of Science. We searched human and animal reviews, published in English in the past 10 years. Initial search terms were ‘retina’, ‘retinitis pigmentosa’, ‘retinal degeneration’ and ‘therapeutics. Duplicate studies were removed, and the remaining articles were assessed for eligibility by full‐text review.Results: Understanding the mechanisms leading to photoreceptor death is essential for the development of new treatments in RP. It has been shown increased retinal infiltration of activated microglia in many animal models of RP. Different works have studied the clinical efficacy of antioxidants, minocycline, transforming growth factor beta or tamoxifen. However, the complete efficacy in RP has not been fully established.Conclusions: Pharmacological inhibition of microglial activation may be a good therapeutic target to reduce photoreceptor cell death in RP.
Tear metabolomics. An outstanding approach to the molecular diagnosis of glaucoma
Authors: Gallego‐Martinez Alex , Martinez‐Bisbal Mari Carmen , Andres‐Blasco Irene , Marabotto Marina Dolores Botello , Hernandez‐Martinez Francisco Javier , Martinez‐Mañez Ramon , Duran Maria Dolores Pinazo 
Published: December 2022

AbstractPurpose: The open‐angle glaucoma (OAG) is the first cause of irreversible blindness worldwide, being the main risk factor the elevated intraocular pressure (IOP). The molecular mechanisms of OAG development and progression remains incomplete. Because of this, biomarkers for early diagnosis of OAG are not conclusive. We deal with understanding the metabolomics of OAG by using 1H‐ nuclear magnetic resonance (NMR) spectroscopy in tear samples for searching specific metabolites that improve early molecular diagnosis of OAG.Methods: 1H NMR monodimensional experiments were acquired from tears in 30 tear samples (OAG patients: n = 11 and healthy controls: n = 19). Additionally, 2D (TOCSY and 1H‐13C HSQC) experiments were acquired in a reduced set of samples to assign the resonances. Spectra underwent phase, baseline and chemical shift correction. The signals in the spectra were assigned, integrated and normalized to the total sum of integrals. Finally, data were analysed by multivariate statistics (PLS‐DA) to determine a model to discriminate between the controls and OAG tears. The whole data set was split into calibration (18 samples) to calculate the model and validation set (10 samples) to test the performance and the ability for disease discrimination.Results: The calculated PLS‐DA model showed a sensitivity of 100% and a specificity of 83.3% to discriminate OAG patient's tears versus control tears in the validation set. The set of metabolites participating is this discriminant model were obtained, mainly those involved in specific cellular and molecular pathways regarding the pathologic mechanisms of OAG.Conclusions: Data obtained by 1H‐NMR spectroscopy in tears confirms the validity of metabolomics as a non‐invasive approach to better OAG managing.
The use of anterior segment optical coherence tomography in infectious keratitis
Authors: Hassairi Asma , Jendoubi Fahd , Fendouli Ines , Limaiem Rim , El Matri Leila 
Published: December 2022

AbstractPurpose: To describe the anterior segment optical coherence tomography (AS OCT) findings in infectious keratitis.Methods: Forty‐five patients with confirmed microbial keratitis were included in this prospective, observational case series study. All subjects underwent ophthalmologic examination. AS OCT scanning was performed on presentation and at follow‐up.Results: 25 patients (55%) had microbial keratitis, 18 patients (40%) had herpetic keratitis and Two patients (4%) had Fungal keratitis. Twelve different patterns were identified. Thirty‐two of the 45 eyes (71%) had epithelial defect associated with sub‐epithelial infiltrates in twenty cases (44%). In 13 of these cases, hydropic changes were observed. Thirty‐six eyes (80%) showed stromal involvement. Stromal infiltrates were also seen, in twenty cases, as a diffuse or local hyper‐reflective area. Five cases (11%) were associated with uveitis: Retrocorneal hyperreflective deposits, thick inflammatory plaque attached to the endothelium and anterior chamber inflammatory cells were imaged.Conclusions: Infectious keratitis has characteristic features on AS‐OCT images. These patterns are not specific and do not orient towards the nature of the microorganisms but AS‐OCT imaging may provide useful supplementary information for diagnosing and monitoring infectious keratitis.
Glaucoma detected as minimal cross section of the nerve fibre layer at the ONH, average thickness provides comparable specificity to integrated area when comparing subjects
Authors: Soderberg Per , Yu Zhaohua , Kisonaite Konstancija 
Published: December 2022

AbstractPurpose: To determine if integrated area provides better specificity than average thickness for measurements of minimal cross‐section of the nerve fibre layer at the optic nerve head (ONH).Methods: In each of 40 non glaucomatous subjects aged 20–69 years, male/female ratio 1, the ONH was captured in 3D with Topcon OCT‐Triton with a raster scan. Subjects were recruited stratified to provide even age distribution. The ONH volumes were exported and the minimal cross‐section of the nerve fibre layer at the ONH was segmented fully automated with a custom algorithm. The minimal cross‐section around the circumference of the ONH was for half the sample estimated as average thickness (μm), PIMD‐2Pi, and for the other half as integrated area, PIMA‐2Pi (mm2). For each sample, the dependence on the estimates on age was fitted to a straight line with linear regression, providing the quantity at average age and the age loss for each quantity. Then, for each quantity, the specificity for level at average age and age loss was estimated numerically as a 95% confidence interval considering a threshold for not pathological of 0.1 of the estimated mean above the mean. Further, the difference in specificity between the two quantities was numerically estimated as a 95% confidence interval for the difference between specificities for the two quantities.Results: The specificity for not pathological was for; PIMD‐2π:average age, [0.67;0.80], PIMA‐2π:average age, [0.68; 0.82] (d.f. = 18), difference average at age, [−0.09; 0.11] (d.f. = 36), PIMD‐2π: thickness·year−1, [0.39; 0.45], PIMA‐2π: area·year−1, [0.36; 0.43] (d.f = 18), difference year−1, [−0.07; 0.03] (d.f = 36).Conclusions: When comparing subjects, there is no advantage of estimating the minimal cross‐section of the nerve fibre layer over the circumference of the ONH as integrated area as compared to average thickness, with regard to differentiating pathological from not pathological.
Fungal blebitis due to Aspergillu ustus. About the first case described in the literature
Authors: Díaz‐Barreda Mª. Dolores , Boned‐Murillo Ana , Pinilla Isabel , Rivasés Guillermo Pérez , Fernández Miguel Castillo , Pérez Itziar , Pardina Elena , Garcia Diana Perez , Martinez Juana , Ibañez Juan 
Published: December 2022

AbstractPurpose: Blebitis is the infection of the valve created in glaucoma filtering surgery. Only 4 cases have been described that refer to ophthalmic infections caused by A. ustus, the pathogen demonstrated in the cultures in this case.Methods: We present the case of a 73‐year‐old woman with a history of hypertension, dyslipidaemia, hyperuricaemia, hypothyroidism and glaucoma in both eyes under maximum topical treatment, despite which she had elevated intraocular pressure (IOP) and structural progression in the right eye (RE). Trabeculectomy with mitomycin‐C (MMC) was performed in RE. After 36 days, the patient came to the emergency department with a slightly painful red and secretions in RE. Examination revealed a whitish bleb, hyperfiltration, fibrin in the anterior chamber and mild corneal oedema. The vitreous was not found to be involved at any time. A conjunctival swab was taken and treatment was started and the patient was admitted for blebitis 3 days later. Two anterior vitrectomies were necessary, the first with collection of aqueous humour (AH) samples and intravitreal injection of vancomycin, the second, after 3 weeks, with phacoemulsification (leaving the patient in aphakia), collection of AH and vitreous samples and intravitreal injection of voriconazole with the addition of oral fluconazole.Results: Eleven weeks after the first surgery Aspergilus ustus was isolated in vitreous humour samples. After 1 year of follow‐up the patient has visual acuity (VA) of light perception in RE, ptisis bulbi, hypotonia, without pain, discomfort, signs of infection or any other symptoms. Together with her it was decided to perform enucleation.Conclusions: Blebitis is a potentially fatal complication whose risk does not decrease over the years. Being alert to warning signs and symptoms is paramount for early detection and optimal management. To our knowledge this would be the first reported case of A. ustus blebitis.
Pupilar block after cataract surgery
Authors: Martínez Marta Suñer , Alperte Juan Ibañez , Cisneros‐Arias Pablo , Claverías Julia Aramburu , Fernández Miguel Castillo , Nuñez‐Moscarda Eva , Orejudo‐Rivas Marta , Pérez‐Rivasés Guillermo , el Bakkali Ismael Bakkali , García Diana Pérez 
Published: December 2022

AbstractPurpose: To describe a case of pupillary block in a pseudophakic patient secondary to synechiae between the iris and the intraocular lens implanted in the capsular bag.Methods: 60‐year‐old woman presented severe diabetic retinopathy and cataract in her right eye. Phacoemulsification + hydrophobic monofocal intraocular lens in capsular bag was decided. The next day, we found a hemovitreous in right eye, observation was decided after performing ultrasound. As the condition did not resolve, a pars plana vitrectomy was performed. Seventeen days after the second surgery, the patient presented intense pain in her right eye, visual acuity of hand motion, IOP of 70 mm Hg, intense corneal edema, iris bombe, wide chamber and narrow in the periphery. Correct pseudophakia. Irregular pupil with mild non‐reactive miosis. Closed angle. Topical hypotensive drugs, oral acetazolamide, and IV mannitol were prescribed without response. Peripheral iridotomies were performed with good response. Mydriatics are added to force pupillary dilation.Results: The next day she presented an IOP 10. One month after the iridotomies she presented an IOP 12 and visual acuity of 0.6.Conclusions: Pseudophakic pupillary blocks rarely occur with current phacoemulsification techniques and capsular bag intraocular lens implantation. Complications inherent to surgery and patients (glaucoma, diabetes, children, previous early surgery) that predispose to a greater inflammatory context may be associated with the potential development of synechiae between the iris and the anterior intraocular lens / capsule, preventing the correct flow of the aqueous humour due to the pupillary block. In a study of the type of intraocular lens in a uveitic context, a greater association was found with hydrophobic intraocular lens than with other types. The ocation where the intraocular lens is implanted is also related, being greater in the intraocular lens in the anterior chamber or sulcus. Peripheral YAG laser iriditomies are a good therapeutic option but are not recommended intraoperatively because they can cause more complications than benefits.
Comparative analysis of corneal versus scleral tunnel incision implantation of anterior artisan Aphakia intraocular lens
Authors: Gonzalez Rocío Vega , Ruiz‐Medrano Jorge , Flores‐Moreno Ignacio , García‐Consuegra Pablo , Ruiz‐Moreno Jose María 
Published: December 2022

AbstractPurpose: To evaluate the surgically induced astigmatism (SIA), efficacy and safety of two distinct accesses for anterior Artisan Aphakia IOL implantation in patients without capsular support.Methods: Outcome data were collected for all patients who had undergone prepupillary Artisan Aphakia IOL insertion associated with pars plana vitrectomy from October 2016 and June 2022 at Puerta de Hierro‐Majadahonda University Hospital. All those with available preoperative and postoperative IOL master keratometry records were included in the analysis. The results were analysed by the incision type (corneal versus scleral tunnel).Results: Ninety‐seven eyes from 79 patients were included. Average follow up was 2 years. Forty‐five (48%) were corneal incisions and 53 (52%) were scleral tunnels. The main causes were: 33 (32%) eyes with Marfan syndrome, 27 (26%) eyes had a complicated cataract surgery and 23 (23%) eyes had luxation or subluxation of the IOL‐capsule complex. The mean surgically induced astigmatism (SIA) in the scleral tunnel group (1.28 ± 1.15 diopter [D]) was significantly lower than in the corneal incision group (2.20 ± 1.27 D) (p < 0.001). The mean BCVA was better in the scleral tunnel group (0.18 ± 0.33 logMAR) than in the corneal incision group (0.27 ± 0.53 logMAR), although the difference was not significant (p = 0.09). The rate of complications did not show differences between groups. Two eyes (2%) developed corneal decompensation. There were 20 (20.67%) cases of cistoid macular edema (11 in the scleral tunnel group and 10 in the corneal incision group). In the scleral tunnel group, there was a tendency to first day postoperative hypotonia (24.5%) (p = 0.06), in all cases it resolved with conservative measures within 1 week.Conclusions: Scleral‐incision approach is a safe technique that should be performed for anterior Artisan Aphakia IOL implantation in order to reduce SIA and improve BCVA. Intraocular pressure should be monitored throughout the first postoperative week.
lax eyelid condition and floppy eyelid syndrome prevalence in obstructive sleep apnoea syndrome patients: A systematic review and meta‐analysis
Authors: Ceccarelli Francesca , Afflitto Gabriele Gallo , Bonetti Mario Alessandri , Cesareo Massimo , Aiello Francesco , Nucci Carlo 
Published: December 2022

AbstractPurpose: The aim of this systematic review and meta‐analysis was to explore the available literature to estimate the prevalence rate of lax eyelid condition (LEC) and floppy eyelid syndrome (FES) in obstructive sleep apnoea (OSA).Methods: PRISMA guidelines were acknowledged in the conduction of this work, whose protocol has been registered in PROSPERO. Four electronic databases were searched from inception to December 24, 2020. A random intercept logistic regression model was carried out for the analysis of overall proportions, while mean difference was calculated as a measure of effect size to compare continuous variables. The estimated numbers of LEC/FES patients in OSA were calculated by multiplying the prevalence rate determined by our random‐effects model and the corresponding Benjafield's et al population prospect.1Results: We included 11 studies comprising 1225 OSA patients of whom 431 and 153 affected by LEC and FES, respectively. Our model estimated a pooled prevalence rate for LEC and FES in OSA patients of 40.2% (95%CI: 28.6–53.1%) and of 22.4% (95% CI: 13.8–34.2%), respectively. The number of LEC/FES affected individuals among OSA patients is expected to peak up to 376 and to 210 million, respectively. OSA patients appeared to have a 3.4 (95% CI: 2.2–5.2) and a 3.0 (95% CI: 1.7–5.5) increased risk of developing LEC and FES than the healthy counterpart.Conclusions: Given the strict association between LEC/FES and OSA both sleep physicians should consider the eventuality of ocular comorbidities in sleep apnoea patients and ophthalmologists should investigate the occurrence of sleep disturbances whenever any case of lid laxity is encountered.Reference1. Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pepin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature‐based analysis. Lancet Respir Med 2019; 7: 687–698.
Retinal vascular changes in response to hypoxia
Authors: Westwood Jessica , Simpkins Ciaran , Mayhook‐Walker India , Normando Eduardo Maria , Morris Daniel , Darby‐Smith Andrew 
Published: December 2022

AbstractPurpose: Increased tortuosity and engorgement of retinal vasculature are recognized physiological responses to hypoxia. This can lead to high‐altitude retinopathy (HAR), which is a pathology seen in unacclimatised individuals at altitude. It typically features asymptomatic flame haemorrhages, but incidence reports are highly variable and our understanding of the aetiological mechanisms remains incomplete. This study aimed to evaluate retinal vascular changes throughout an expedition to 4167 metres.Methods: 10 healthy participants summitted Mount Toubkal, Morocco. Fundus images were taken on a handheld camera pre‐departure, daily throughout the expedition, and one‐month post‐return. Diameter and tortuosity of four vessels was assessed, in addition to vessel density and the presence of HAR.Results: Significant (p ≤ 0.05) increases in tortuosity and diameter were observed in some vessels on high‐altitude exposure days. There was a significant increase in vessel density on summit day only.Conclusions: This is the first study to report increased vessel density and no incidence of HAR. These results are likely attributable to relatively low altitude exposure, a conservative ascent profile, and the young, healthy demographic profile of participants. However, the study is limited by its small sample size, environmental confounding factors and semi‐subjective diameter measurements. Physiological but not pathological changes were seen in this cohort, which gives insight to the state of the cerebral vasculature throughout this expedition and builds on current understanding of retinal vascular changes in hypoxia. Future work must include daily retinal images of larger sample sizes at higher altitude and take steps to mitigate against environmental confounders. This work is relevant to altitude tourists, patients with diabetic retinopathy or retinal vein occlusion, and critically ill patients at sea level.
Prevention campaign for amblyopia and other eye disorders among schoolchildren
Authors: López Carmen Miquel , Perea Juan Antonio Sánchez , Menargues Manuel Almarcha , Abellán Maria Victoria Navarro , Andreu Ester Mainar 
Published: December 2022

AbstractPurpose: This is a retrospective longitudinal observational study to detect amblyopia and other visual anomalies (refraction, strabismus, pathologies…) in 3, 4 and 5‐year‐old schoolchildren. Amblyopia is a disorder of sight in which the brain fails to fully process input from one eye and over time favours the other eye. It results in decreased vision in an eye that typically appears normal in other respects. Early detection improves treatment success. There is currently an early detection program but according to a recently published study, does not have good compliance or appropriate material.Methods: The study was carried out with children aged 4–6 years from 4 different schools, collecting 491 children with the corresponding informed consent of their parents. The study was divided into two phases, first an optometrist performed an external examination, red reflex, pupillary examination, ocular motility, cover test and photoscreening with a portable autorefractometer. And if any anomaly is detected in the second phase, it would be explored by an ophthalmologist who would also perform stereopsis tests, visual acuity, dilated refraction, eye fundus, and diagnosis and treatment.Results: 491 children were included in this study, visual anomalies were detected in 96, of which 60 were studied in our center. It was detected 47% who had refractive problems, 5% strabismus and 0% opacities. Extrapolating it to the total number of patients seen, 9% had refractive problems and 1% strabismus.Conclusions: Amblyopia has a prevalence of 6% in the population. Its treatment is relatively simple with glasses and patches at a low cost. There is a prevalence of 5%–7.5% of amblyopia in <6 years, 1%–3% strabismus in <6 years as well as 1 of 3 school failure is caused by visual problem.Paediatric check‐up or other check‐ups that these schoolchildren do not detect this type of condition. Therefore, the Campaign for the Prevention of Amblyopia and Other Visual Anomalies idea should be implemented in all the Autonomous Communities.Reference1. Eileen E Birch. Amblyopia and binocular vision. Prog Retin Eye Res. 2013; 33: 67–84.