bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL OUTCOMES OF ACUTE ENDOPHTHALMITIS AFTER INTRAVITREAL DELIVERY OF VASCULAR ENDOTHELIAL GROWTH FACTOR INHIBITORS VERSUS STEROIDS
Authors: Adams Olufemi E. , Sodhi Guneet S. , Vagaggini Tommaso , Haq Zeeshan , Curran Christian D. , Prairie Michael L. , Montezuma Sandra R. , Koozekanani Dara D. , Ryan Edwin H. , Parke DAVID WILKIN , Mittra Robert A. , Tang Peter H. 
Published: February 2023

Purpose:
To compare patients with acute endophthalmitis after intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors vs. steroids.

Methods:
Retrospective single-center, nonrandomized interventional study from 2013 to 2021.
Patients underwent vitreous biopsy before initiating treatment and were divided into the following cohorts: (1) anti-VEGF managed medically (T&I–anti-VEGF), (2) anti-VEGF managed by immediate pars plana vitrectomy (PPV–anti-VEGF), and (3) steroid therapy and managed medically or by pars plana vitrectomy (steroid).

Results:
A total of 141 patients were analyzed. The steroid cohort demonstrated significantly worse presenting (median = 2.80 logarithm of the minimum angle of resolution [logMAR]; P ≤ 0.01) and final (median = 2.30 logMAR) best-corrected visual acuity compared with T&I–anti-VEGF (presenting: median = 2.00 logMAR; final: median = 0.40 logMAR) and pars plana vitrectomy–anti-VEGF cohorts (presenting: median = 2.30 logMAR; final: median = 0.48 logMAR). There was no significant (P = 0.33) difference in the final best-corrected visual acuity between T&I–anti-VEGF and pars plana vitrectomy–anti-VEGF cohorts. There were no significant (P ≥ 0.63) differences among cohorts in best-corrected visual acuity before acute endophthalmitis diagnosis (T&I–anti-VEGF: median = 0.40 logMAR; pars plana vitrectomy–anti-VEGF: median = 0.40 logMAR; steroid: median = 0.44 logMAR). Microbial cultures revealed similar profiles for all cohorts.

Conclusion:
Acute endophthalmitis after intravitreal injection steroid therapy had worse outcomes compared with anti-VEGF therapy.
RECURRENCE OF ACUTE RETINOPATHY IN PSEUDOXANTHOMA ELASTICUM
Authors: Ramtohul Prithvi , Cabral Diogo , Cicinelli Maria Vittoria , Freund K. Bailey 
Published: February 2023

ABSTRACT

Purpose:
To report a case of recurrent acute retinopathy associated with pseudoxanthoma elasticum (PXE) and to propose a reappraisal of this entity based on multimodal imaging analysis.

Methods:
Retrospective case report. High-resolution optical coherence tomography (High-Res OCT), ultra-widefield imaging, and widefield swept-source OCT-angiography (OCTA) and en face OCT were performed.

Results:
A man in his 40s diagnosed with PXE and angioid streaks presented with two distinct episodes of acute retinopathy in his right eye during a one-year follow-up period. Acute retinopathy was characterized by rapid vision loss. High-Res OCT showed multifocal hyperreflective lesions splitting the retinal pigment epithelium/Bruch’s membrane complex and associated with focal choroidal thickening. After the first episode, OCTA confirmed the development of macular neovascularization at the site of a prior inflammatory lesion. During the second episode, multimodal images showed findings consistent with epiphenomenon multiple evanescent white dot syndrome (EpiMEWDS). On en face widefield OCT, acute retinopathy was characterized by multiple hyperreflective spots scattered at the posterior pole.

Conclusion:
Recurrence of acute retinopathy can be observed in patients with PXE and angioid streaks. Multimodal imaging shows that some lesions of PXE-associated acute retinopathy closely resemble those of punctate inner choroidopathy/idiopathic multifocal choroiditis.
Descemet Stripping Without Endothelial Keratoplasty in Early-Stage Central Fuchs Endothelial Dystrophy: Long-term Results
Authors: Vieira Rita , Castro Catarina , Coelho João , Mesquita Neves Miguel , Gomes Miguel , Oliveira Luís 
Published: February 2023

Purpose:
The purpose of this study was to report long-term results of Descemet stripping without endothelial keratoplasty (DWEK) associated with phacoemulsification in patients with early-stage central Fuchs endothelial corneal dystrophy.

Methods:
This is a retrospective study, including all patients submitted to DWEK associated with cataract surgery with a minimum follow-up of 24 months. Included patients had central confluent guttae confirmed with specular microscopy, a clear peripheral endothelium (with a peripheral endothelial count >1500 cells/mm2), and a central pachymetry <600 μm. The main end points were the presence of a clear cornea and time that was needed to achieve transparency, best-corrected visual acuity in logMAR, endothelial central cell count (ECC), and central pachymetry.

Results:
A total of 22 eyes were included with a mean follow-up of 40.8 ± 10.5 months. At baseline, mean central pachymetry was 536 ± 34 mm and 6 eyes had countable ECC (mean 1138 ± 190 cells/mm2). Twenty eyes (90.9%) achieved good corneal transparency 3.2 ± 1.1 months after surgery. There was a significant improvement in logMAR best-corrected visual acuity compared with baseline (0.13 ± 0.10 vs. 0.48 ± 0.24, respectively, P < 0.001). Endothelial central repopulation was observed in all successful cases. Twelve months after DWEK, ECC was 1449 ± 344 cells/mm2 and 1393 ± 450 cells/mm2 at the end of follow-up, without a significant decrease between this period (P = 0.081). Only 2 eyes (9.1%) did not achieve corneal transparency and were submitted to an endothelial keratoplasty.

Conclusions:
According to our results, DWEK is a safe and effective procedure in selected cases of early-stage central Fuchs endothelial corneal dystrophy. This seems to be a promising technique, delaying or avoiding endothelial transplantation.
Recurrent Keratoconus: Corneal Transplants for Keratoconus Develop Tomographic Ectatic Changes
Authors: Miura Maria , Leon Pia , Nahum Yoav , Böhm Myriam S. , Mimouni Michael , Belin Michael W. , Johns Lynette , Ciolino Joseph B. 
Published: February 2023

Purpose:
The purpose of this study was to evaluate postoperative Scheimpflug imaging changes during the first 5 years after penetrating keratoplasty (PK) in patients with keratoconus (KC).

Methods:
This retrospective, interventional case series includes 31 eyes of 31 patients who underwent their first PK with a history of KC. Postoperative Scheimpflug imaging was performed 3 months after the removal of the last suture (baseline) and then repeated 3 and 5 years after the PK. Demographic data, donor and host trephination diameter, and Scheimpflug imaging (Pentacam HR, Oculus, Germany) parameters indicative of ectasia were analyzed to evaluate postoperative graft changes that occur after PK.

Results:
The maximal keratometry (Kmax) progressed significantly between baseline (53.5 ± 6.1 D) and postoperative year 3 and year 5 [56.5 ± 6.1 diopter (D) and 58.8 ± 7.9 D, P < 0.001]. Significant changes were also observed for the anterior best fit sphere and posterior best fit sphere (P < 0.001 for 3 and 5 years compared with baseline). Kmax increased by at least 2 Ds for 74.2% of patients and up to 7 Ds or more for 25.8% of the patients. A significant inverse correlation was observed for host trephine size and progression of Kmax (r = −0.52, P = 0.01), which indicated that larger host trephination size was associated with a smaller increase in postoperative Kmax.

Conclusions:
Tomographic graft changes indicative of ectasia were observed within 3 to 5 years after PK in patients with KC. These changes were observed more frequently and sooner after corneal transplants than previously reported.
Corneal Densitometry to Assess the Corneal Cystine Deposits in Patients With Cystinosis
Authors: Biswas Susmito , Alzahrani Khaled , Radhakrishnan Hema 
Published: February 2023

Purpose:
The purpose of this study was to assess the suitability of corneal densitometry measurements obtained with Scheimpflug imaging in estimating the corneal changes caused by cystine deposits in the cornea in patients with cystinosis.

Methods:
Scheimpflug imaging (Pentacam) was performed for 14 patients with cystinosis and 16 age-matched controls. Pentacam data were used for analysis of the corneal densitometry at different zones in the cornea for patients with cystinosis and controls. Densitometry measurements were compared with the corneal crystal scores obtained from the slitlamp images for patients with cystinosis.

Results:
There was no statistically significant difference in keratometry measurements between the 2 groups (P > 0.05). Corneal thickness was found to be significantly higher in the control group when compared with the cystinosis group (P = 0.0004). The mean corneal densitometry was significantly higher in patients with cystinosis when compared with controls at most of the corneal layers and zones. The corneal densitometry readings for the right and left eyes showed moderate positive correlation with the corneal crystal score with a ceiling effect being reached at the maximum corneal crystal score of 3.

Conclusions:
Corneal densitometry obtained through Pentacam can be used as an objective estimate of the level of cystine crystals present in patients with cystinosis. The clinical estimate of corneal crystal score, although effective at low levels of crystal deposition, does not allow for accurate estimates of change when the level of crystal deposition is high leading to limited utility when assessing treatment effects. Hence, densitometry measurements can potentially be used to assess treatment efficacy of cystinosis treatments in clinical settings.
Distribution of Corneal Volume and Its Associated Factors in an Elderly Population: Tehran Geriatric Eye Study
Authors: Hashemi Hassan , Valadkhan Mehrnaz , Nabovati Payam , Yekta Abbasali , Aghamirsalim Mohamadreza , Khabazkhoob Mehdi 
Published: February 2023

Purpose:
The aim of this study was to determine the distribution of corneal volume (CV) using Pentacam and its relationship with demographic and ocular factors in an elderly population older than 60 years.

Methods:
The present report is a part of the Tehran Geriatric Eye Study. The sampling was performed using the multistage stratified random cluster sampling method. The preliminary ocular examinations were performed for all individuals including visual acuity measurement, objective and subjective refraction, and slit-lamp biomicroscopy. Finally, study participants underwent anterior segment imaging and ocular biometry using Pentacam AXL.

Results:
The mean CV was 57.92 mm3 [95% confidence interval (CI): 57.76–58.08] in the whole sample. The mean CV was 57.69 mm3 (95% CI: 57.52–57.87) after excluding diabetic patients. The mean CV was 57.79 mm3 (95% CI: 57.57–58.01) and 58.04 mm3 (95% CI: 57.83–58.26) in men and women, respectively. The mean CV was 57.96 mm3 (95% CI: 57.71–58.21), 57.84 mm3 (95% CI: 57.49–58.19), and 57.92 mm3 (95% CI: 57.7–58.13) in individuals with emmetropia, myopia, and hyperopia, respectively. The CV decreased significantly with advancing age. Moreover, the anterior chamber depth, central corneal thickness, mean keratometry, anterior corneal asphericity (Q value), and posterior corneal astigmatism were significantly directly related to CV, whereas axial length and white-to-white distance had a statistically significant inverse association with the CV.

Conclusions:
Aging is one of the important factors in reducing CV that should be considered. Some other topographic and biometric indices also have a significant relationship with CV.
Mustard Gas–Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management
Authors: Soleimani Mohammad , Momenaei Bita , Baradaran-Rafii Alireza , Cheraqpour Kasra , An Seungwon , Ashraf Mohammad Javad , Abedi Farshad , Javadi Mohammad Ali , Djalilian Ali R. 
Published: February 2023

Purpose:
Mustard gas (MG) is a potent blistering and alkylating agent that has been used for military and terrorism purposes. Ocular surface injuries are common after exposure to MG. This review provides an update on the pathophysiology, ocular surface complications, and treatment options for MG-related ocular injuries.

Methods:
Required information was obtained by reviewing various databases such as Cochrane Library, Google Scholar, and PubMed until March 2022. Data were collected by using keywords: “mustard gas” OR “sulfur mustard” AND “eye” OR “cornea” OR “ocular complication” OR “keratitis” OR “keratopathy” OR “limbal stem cell deficiency” OR “dry eye.”

Results:
Chronic intracellular toxicity, inflammation, and ischemia have been shown to play an essential role in the pathogenesis of MG injury. Ocular surface injuries can have acute, chronic, and most distinctly a delayed-onset presentation leading to various degrees of limbal stem cell deficiency. To date, no treatment has been agreed on as the standard treatment for chronic/delayed-onset MG keratopathy. Based on the authors’ experience, we propose a management algorithm for MG-related ocular surface injuries involving optimization of ocular health, anti-inflammatory therapy, and if needed surgical interventions. The management of chronic and delayed-onset presentation remains challenging.

Conclusions:
MG keratopathy is a unique form of chemical injury which can lead to a range of ocular surface pathologies. Long-term anti-inflammatory therapy even in patients with seemingly mild disease may potentially reduce the likelihood of the development of more severe delayed-onset disease.
Glaucoma management in patients with penetrating keratoplasty or keratoprosthesis
Authors: Sun Jessica A. , Manz Sarah N. , Shen Lucy Q. 
Published: February 2023

Purpose of review
Advances in surgical techniques and postoperative care have significantly improved rates of short-term complications following keratoplasty; however, glaucoma remains a highly prevalent long-term and potentially devastating complication for postkeratoplasty patients. In this review, we provide an overview of recent literature on glaucoma management in patients who have undergone penetrating keratoplasty or the Boston keratoprosthesis type I (KPro) implantation.

Recent findings
New research suggests an inflammatory cause underlying glaucoma following KPro. Accurate IOP measurement is difficult in patients postkeratoplasty; study of objective techniques such as PDCT or Tono-Pen in penetrating keratoplasty eyes and trans-palpebral Diaton tonometry in KPro eyes have shown promising results. Early glaucoma surgical intervention should be considered for patients undergoing penetrating keratoplasty and KPro.

Summary
Patients who have undergone penetrating keratoplasty or implantation of the Boston keratoprosthesis type I should be monitored frequently for elevated intraocular pressure and for other signs of glaucomatous optic nerve damage. Intraocular pressure elevation should be treated promptly either medically or surgically while minimizing risk to the corneal graft. Further research into inflammatory causes and other treatment modalities is promising for the long-term visual success in these patients.
Maternal, Infant, and Breast Milk Antibody Response Following COVID-19 Infection in Early Versus Late Gestation
Authors: Wachman Elisha M. , Snyder-Cappione Jennifer , Devera Jean , Boateng Jeffery , Dhole Yashoda , Clarke Katherine , Yuen Rachel R. , Parker Samantha E. , Hunnewell Jessica , Ferraro Renee , Jean-Sicard Sigride , Woodard Elizabeth , Cruikshank Alice , Sinha Bharati , Bartolome Ruby , Barnett Elizabeth D. , Yarrington Christina , Taglauer Elizabeth S. , Sabharwal Vishakha 
Published: February 2023

Background:
Coronavirus disease 2019 [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] infection at varying time points during the pregnancy can influence antibody levels after delivery. We aimed to examine SARS-CoV-2 IgG, IgM and IgA receptor binding domain of the spike protein and nucleocapsid protein (N-protein) reactive antibody concentrations in maternal blood, infant blood and breastmilk at birth and 6 weeks after SARS-CoV-2 infection in early versus late gestation.

Methods:
Mothers with SARS-CoV-2 infection during pregnancy were enrolled between July 2020 and May 2021. Maternal blood, infant blood and breast milk samples were collected at delivery and 6 weeks postpartum. Samples were analyzed for SARS-CoV-2 spike and N-protein reactive IgG, IgM and IgA antibodies. Antibody concentrations were compared at the 2 time points and based on trimester of infection (“early” 1st/2nd vs. “late” 3rd).

Results:
Dyads from 20 early and 11 late trimester infections were analyzed. For the entire cohort, there were no significant differences in antibody levels at delivery versus 6 weeks with the exception of breast milk levels which declined over time. Early gestation infections were associated with higher levels of breastmilk IgA to spike protein (P = 0.04). Infant IgG levels to spike protein were higher at 6 weeks after late infections (P = 0.04). There were strong correlations between maternal and infant IgG levels at delivery (P < 0.01), and between breastmilk and infant IgG levels.

Conclusions:
SARS-CoV-2 infection in early versus late gestation leads to a persistent antibody response in maternal blood, infant blood and breast milk over the first 6 weeks after delivery.
Trends and Changes in Influenza-associated Hospitalizations in Children During 25 Years in Finland, 1993–2018
Authors: Mattila Janna-Maija , Vuorinen Tytti , Heikkinen Terho 
Published: February 2023

Background:Limited long-term data are available on potential changes in the demographics and management of children hospitalized with influenza.Methods:We identified all children ≤15 years old hospitalized with virologically confirmed influenza at Turku University Hospital, Finland, during the 25-year period of July 1993–June 2018. Data on clinical variables, comorbidities and management were retrieved directly from the medical records. Population-based rates of hospitalization were calculated using official annual databases of children living in the hospital catchment area.Results:Between 1993–1998 and 2013–2018, the median age of children increased from 1.3 years to 3.3 years (P< 0.0001). The proportion of children <2 years of age decreased from 65.2% to 36.8%, whereas the proportion of children 6–15-year-old increased from 13.0% to 36.2% (P< 0.0001 for both). The population-based rates of hospitalization decreased by 49% in children 1 year of age (incidence rate ratio, 0.51; 95% confidence interval: 0.27–0.92;P= 0.018) and increased by 194% in children 6–15 years old (incidence rate ratio, 2.94; 95% confidence interval: 1.70–5.32;P< 0.0001). The median duration of hospitalization shortened from 2.0 days (interquartile range [IQR], 1.0–4.0) to 1.0 day (IQR, 1.0–2.0;P< 0.0001).Conclusions:During the 25 years, the median age of hospitalized children increased by 2 years, while the duration of hospitalization shortened.
Effect of Multimodal Preemptive Analgesia of Flurbiprofen Axetil, Nalbuphine, and Retrobulbar Block on Postoperative Pain and Enhanced Recovery in Patients Undergoing Oculoplastic Day Surgery: A Prospective, Randomized, Double-Blinded Study
Authors: Ye Zexi , Zhu Yanling , Zhang Rui , Wang Yongyi , Huang Jingxia , Gan Xiaoliang 
Published: February 2023

Purpose:
To evaluate the effect of either flurbiprofen axetil or nalbuphine combined with retrobulbar block (RB) before surgery on postoperative pain control and enhanced recovery in day-care patients undergoing orbital implantation.

Methods:
A total of 45 patients undergoing orbital implantation with general anesthesia were randomly divided into three groups: flurbiprofen axetil (1 mg/kg) combined with RB (group F), nalbuphine (0.1 mg/kg) combined with RB (group N), and placebo as normal saline with RB (group C). The primary outcome was the average pain score (numeric rating scale: 0–10) within the first 24 hours. Other outcomes including the peak pain score, paracetamol requirement, quality of recovery (QoR)-15, and adverse effects (AEs) were assessed.

Results:
The average and peak pain scores within 24 hours after surgery in group F were significantly lower than in other groups (p < 0.0167). Compared with group C, the NRS scores were significantly decreased at 2 and 4 hours in group F, and 2 hours in group N after surgery (p < 0.0167), but without significant differences at other measured time points. The time to first paracetamol oral intake displayed a significant difference among the three groups (p < 0.0167).

Conclusion:
Preemptive use of flurbiprofen axetil 1 mg/kg combined with RB is an optimal choice for multimodal analgesia for day-care patients undergoing orbital implantation in terms of efficient acute pain control, without impeding patient-enhanced recovery.
Chorio-Retinal Folds Associated With Orbital Cavernous Venous Malformations
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: February 2023

Purpose:
To determine the incidence of clinically detectable chorio-retinal folds (CRFs) with orbital cavernous venous malformations (OCVMs) and their recovery.

Methods:
Retrospective case-note and imaging review, with estimation of odds ratios in relation to the position and volume of the mass.

Results:
Records for 402 patients were reviewed, 83 (21%) having CRFs. The mean logarithm of minimum angle of resolution acuity was similar with or without CRFs (0.37 and 0.31, respectively; p = 0.46), but induced hyperopia was commoner with CRFs (76% vs. 12%; p < 0.001), exophthalmos greater (4.52 mm vs. 2.97 mm; p < 0.001), eye movement restriction commoner (37% vs. 21%; p = 0.004), and disc swelling more prevalent (42%, vs. 17%; p < 0.001). Orbital cavernous venous malformations with CRFs were almost all intraconal (98%; odds ratio 9.96; p = 0.002), and 93% (77/83) midorbital (odds ratio 6.02; p < 0.001). The median size with CRFs was twice that of those without (3.85 ml vs. 1.92 ml; p < 0.001), and two-thirds OCVMs with folds had volumes >2.5 ml (p < 0.001). The OCVM was excised in 76 of 83 (92%) of CRF group and 213 of 319 (67%) of those without (p < 0.001). The postoperative acuity was improved or unchanged in 67 of 76 (88%) eyes with folds, and 184 of 213 (83%) without CRFs (p = 0.84). The proportion recovering an acuity within 1 Snellen line (or better than) the unaffected side was 80% with CRFs and 77% in their absence (p = 0.63). Induced hyperopia persisted in 39% of all patients, with the mean being higher with CRFs (2.22D vs. 1.02D; p = 0.017).

Conclusions:
CRFs occur in ~25% of mid-intraconal OCVMs. Despite OCVM excision, 39% of operated patients retain significant residual hyperopia (54% if CRFs present before surgery), and 41% of such CRFs remain clinically detectable after surgery (with variable visual impairment). Earlier surgery might, therefore, be advisable in patients with CRFs and/or induced hyperopia.