bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of silicon oil tamponade in patients with chronic exudative retinal detachments in effective with conservative treatment
Authors: Ha Joonyoung , Han SooYeon , Yang Yunsik 
Published: January 2025

Aims/Purpose: To investigate the surgical treatment outcomes and complications of pars plana vitrectomy and silicone oil tamponade in patients with chronic exudative retinal detachment that did not respond to conservative treatment.Methods: This retrospective study included 81 eyes of 81 patients diagnosed with chronic exudative retinal detachment who underwent pars plana vitrectomy and silicone oil tamponade after failing to respond to conservative treatment with oral steroids and intravitreal or sub‐Tenon's triamcinolone injections between February 2002 and September 2023. The best‐corrected visual acuity (BCVA) before and after surgery, postoperative complications, and recurrence rates were analyzed.Results: The mean duration of silicone oil tamponade was 17.98 ± 3.16 months. Successful retinal reattachment was achieved in 68 eyes (83.95%) after the initial surgery. Of the 51 eyes that had the silicone oil removed, 14 (27.45%) experienced retinal re‐detachment and required additional silicone oil injection. After final silicone oil removal, 39 eyes (48.15%) maintained stable retinal attachment. The mean BCVA improved significantly from logMAR 1.54 ± 0.134 preoperatively to logMAR 1.155 ± 0.139 after silicone oil removal (p = 0.029). Postoperative complications included cataract (n = 30), secondary glaucoma (n = 20), epiretinal membrane and macular edema (n = 8), and emulsified silicone oil (n = 4).Conclusions: Silicone oil tamponade is an effective surgical treatment that can improve visual outcomes in patients with chronic exudative retinal detachment refractory to conservative management. Although complications can occur, they are manageable, making this approach a reasonable option when conservative treatments fail.
Restoring vision in acute retinal necrosis: A case report
Authors: de Lázaro Alejandra Antón Guzmán , Lozano Carmen Isabel García , Martín Sergio Pernas , Outeiriño Patricia Roig , Hernández Eduardo Conesa , Carretero Manuel Moriche 
Published: January 2025

Aims/Purpose: This case report outlines the management of acute retinal necrosis in a 23‐year‐old patient, highlighting challenges and strategies in restoring vision. Acute retinal necrosis (ARN) is a rare yet severe condition characterized by the rapid destruction of the retina. We present the case of a 23‐year‐old patient with no relevant past medical history who developed ARN due to herpes virus infection.Methods: A thorough ophthalmologic evaluation, including clinical examination and imaging studies, was conducted to diagnose and treat the patient's condition.Results: The patient presented with acute visual acuity decline in the right eye, leading to a diagnosis of acute retinal necrosis. Despite the complex complications, including retinal detachment, prompt intervention and multidisciplinary collaboration facilitated successful restoration of vision. The patient's evolution showed a lot of complications that turned out to great improvements.Conclusions: This case underscores the importance of early diagnosis, prompt intervention, and multidisciplinary collaboration in managing acute retinal necrosis, especially in young patients. Effective management strategies can lead to successful restoration of vision and favourable patient outcomes.
Assessing the retina with pupillometry and silent substitution
Authors: Gibertoni Giovanni , Hromov Anton , Piffaretti Filippo , Geiser Martial 
Published: January 2025

Aims/Purpose: This device aims to establish a quantitative method for evaluating photoreceptor function, encompassing intrinsically photosensitive retinal ganglion cells (ipRGCs), through a silent substitution technique. Ultimately, this technology strives to facilitate the early detection of neurological diseases, investigation of the circadian rhythm, and clinical assessment of retinal conditions such as color deficiencies and glaucoma.Methods: A new ophthalmic device using a Maxwellian layout for independent but simultaneous stimulation of both eyes was created. Each channel uses six LEDs for controlled stimuli. Scheimpflug cameras and near‐infrared light to avoid pupil constriction track the pupil dynamics (25‐35Hz). System calibration allows user‐defined protocols for characterizing pupil responses and comparisons with control groups. The device generates high‐quality stimuli for photoreceptor silencing, featuring a compact design with a 0.9 mm exit pupil, 30 mm vertex distance, and a maximum 60° field. For further control over illumination area, smaller or annulus field stops can be readily inserted.Results: The spectral uniformity exhibits an excellent spectral uniformity (98‐99%). Notably, the radiant power ratio between stimulus and baseline exhibits good stability, maintaining a variation of less than 1% over a three‐month period.Preliminary testing confirms the device's performance aligns with expectations. Chromatic pupillometry and melanopsin stimulation experiments conducted on six volunteers using a 3‐second flash yielded results consistent with established literature.Conclusions: Silent substitution is gaining traction in various research fields, including diagnostics and neurophysiology. Early results indicate the device meets requirements for silent substitution. Certification as a Class‐I CE marked medical device (EU 2017/745) facilitates further clinical research.
Asteroid hyalosis in patients with macular telangiectasia type 2
Authors: Urbancic Mojca , Divjak Darja Dobovsek , Kuncic Ajda , Hudler Petra , Debeljak Natasa 
Published: January 2025

Aims/Purpose: Asteroid hyalosis is composed of calcium and phospholipids. The prevalence of this condition is around 1 % and increases with age. Recent reports have indicated an increased occurrence of asteroid hyalosis among younger individuals suffering from retinal dystrophies, implying that degenerative processes may play a role in the onset of condition. Macular telangiectasia type 2 (MacTel) is a neurodegenerative retinal disease. The disease‐associated metabolic profiling indicates distinct alterations, such as reduced serum serine and glycine levels, as well as altered lipid metabolism. We speculated that there might be some common mechanisms in the pathogenesis of asteroid hyalosis and MacTel. Our objective was to determine the prevalence of asteroid hyalosis among MacTel patients and to assess any potential correlation with the progression stages of MacTel disease.Methods: MacTel patients had a complete ophthalmological exam followed by multimodal imaging. We recorded the presence of asteroid hyalosis and graded MacTel fundus alterations according to MacTel Research Group's classification. The prevalence of asteroid hyalosis was determined, and its correlation with MacTel stages was analyzed in our patients.Results: Data of 46 patients, 22 (47.8%) males and 24 (52.2%) females, aged 66.76 ± 9.83 years were analyzed. Eight patients had asteroid hyalosis (17.4%), with 3 cases being bilateral. Eyes with asteroid hyalosis (11 eyes) exhibited MacTel changes ranging from stage 0 to stage 6: one eye was at stage 0, two at stage 1, two at stage 2, one at stage 3, two at stage 4, two at stage 5, and one at stage 6. Our findings revealed no correlation between the presence of asteroid hyalosis and the stages of MacTel disease.Conclusions: We observed higher prevalence of asteroid hyalosis among MacTel patients compared to general population. However, we did not identify any relationship between MacTel fundus alterations and asteroid hyalosis.
The polarity effect of direct current stimulation on the vascular regulation of the inner retina
Authors: Freitag Stefanie , Link Dietmar , Klee Sascha 
Published: January 2025

Aims/Purpose: Electrical stimulation is not only a suitable method for researching the human nervous system but also for treating neuronal disorders. In ophthalmology, it is applied to patients suffering from various retinal diseases like retinitis pigmentosa. It is known that in the application of direct current stimulation (DCS), the polarity of the current determines the increase or decrease in neuronal activity and enables different therapeutic approaches. However, the polarisation‐dependent effect of the current on the vascular processes in the retina has not yet been investigated. This study examined the effect of anodal and cathodal DCS on the temporal vessels of the inner retina.Methods: The study was conducted on 24 healthy subjects (14w, 10m, mean age 25.5 ± 3.2yr) who were randomly assigned to either an anodal or a cathodal DCS group (symmetrical design). To test the effect of the DCS (800μA; ring‐shaped electrode placed surrounding the eye, square electrode placed at the occiput) on vascular regulation, the DCS was combined with visual flicker stimulation using the Dynamic Vessel Analyzer (DVA, Imedos Systems GmbH; standard protocol). Exclusion criteria were ocular and systemic diseases. We investigated two primary vessel segments (superior temporal artery (STa) and vein (STv)) located between 0.5 and 2.0 disc diameters from the optic disc. For each subject the DVA was performed two times (first baseline DVA1, followed by a 20‐minute DCS (different polarity depending on the group), and directly afterwards a second DVA2). For statistical analysis, the t‐test for paired samples was used and Bonferroni corrected.Results: The mean vascular responses (STa/STv) for the anodal DCS group were DVA1: 3.7 ± 1.7%/3.4 ± 1.6%; DVA2: 3.5 ± 1.3%/5.4 ± 3.2% and for the cathodal DCS group DVA1: 3.2 ± 2.0%/4.0 ± 2.6%; DVA2: 3.2 ± 1.4%/2.5 ± 1.3%. For the venous vascular response, we found a significant increase after anodal DCS (p = 0.019) and a significant decrease after cathodal DCS (p = 0.018).Conclusions: We were able to successfully determine the effect of different DCS polarities on the retinal vascular system. We found significant effects on the veins. The absence of effects on the arteries indicates different regulatory pathways in the retina. This should be investigated by further selective stimulation.
Delayed onset macular hemorrhage following previous intraocular tuberculosis
Authors: Cabo Ana , Garcia‐Bardera Javier , Amor Patricia Robles , Fernández‐Sáez Clara , Caride Sara Garcia 
Published: January 2025

Aims/Purpose: Mycobacterium tuberculosis, an acid‐fast‐staining bacterium, thrives in oxygen‐rich environments due to its obligate aerobe nature. Consequently, tuberculous lesions often manifest in highly oxygenated tissues. Among these tissues, the choroid stands out for its exceptionally high blood flow rate, making it a prime site for M. tuberculosis colonization. We will focus on macular hemorrhages as a complication following intraocular tuberculosis, which may have a delayed onset and arise from inactive lesions.Methods: Presentation of a clinical case.Results: We present a case involving a 58‐year‐old patient who presented to the Emergency Room with complaints of acute loss of visual acuity in her right eye. She had been immunocompromised in the past, and had a personal history of intraocular tuberculosis, which she reported had been inactive for years. On examination, her visual acuity was measured at 0.1 in the affected eye. Fundus examination revealed a macular hemorrhage surrounding a choroidal scar. There were no signs of anterior ocular involvement, vitreal inflammation, or active choroiditis. The patient was otherwise asymptomatic. Despite the lack of active lesions, a chest radiograph was performed to rule out active tuberculosis in the lungs, yielding negative results. Active tuberculosis disease was hence ruled out, as well as the need for systemic anti‐TB therapy. The patient was started on antiVEGF intravitreal injections. The patient was scheduled for follow‐up visits, and her visual acuity had improved to 0.8 in the right eye after four months.Conclusions: Choroidal neovascularization and hemorrhages are rare complications of intraocular tuberculosis, and they may arise from both active and inactive lesions. Activity can be determined by fundus examination and fluorescein angiography. Any systemic symptoms should also be recorded on the patient's history. If risen from an inactive choroidal scar, a macular hemorrhage should be treated with anti VEGF injections.
Diagnosis of a case of ocular reactivation in a patient with lymphoplasmacytic lymphoma
Authors: Muñoz Noelia Montaña , de Ulzurrun Gabriel Liaño Diez , Shadvar Samira Ketabi , Moreno Silvia Virseda , de la Torre Marta Vela , Fiz Jesús Pérez , de Andrade Pérez Marina Pardo , González Miguel Herrero , González Olga Martinez 
Published: January 2025

Aims/Purpose: Waldenstrom's macroglobulinemia (WM) is a rare hematological neoplasm characterized by lymphoplasmacytic proliferation, monoclonal immunoglobulin M (IgM) production, and bone marrow infiltration. Ocular involvement can be one of the signs of disease activity, and the purpose of this case is to present the ocular manifestations that may occur through a clinical case seen in consultation.Methods: A review was conducted of a case involving a 64‐year‐old male patient seen in the ophthalmology department of our hospital, with no known drug allergies and a personal history of Waldenstrom's macroglobulinemia diagnosed in 2018, currently in remission. The patient presented with progressive visual acuity loss in the left eye in the context of possible vitritis/chorioretinitis. He was treated with trimethoprim, sulfamethoxazole, and prednisone due to the suspicion of a possible infectious cause. Laboratory tests, serologies, a vitreous biopsy, fluorescein angiography, and ocular ultrasound were performed to determine the etiology. A few weeks later, he presented with clinical symptoms of disorientation and behavioral changes, prompting an emergency visit. A brain MRI was performed, revealing a tumoral lesion in the left frontal lobe, suggestive of cerebral lymphoma.Results: After studying and biopsying the brain lesion, the diagnosis of cerebral lymphoma was confirmed, with ocular involvement in the form of vitritis and chorioretinitis as a sign of disease reactivation.Conclusions: Waldenstrom's macroglobulinemia can manifest in various ways, and one of them can be through ocular activity signs such as uveitis (both anterior and posterior), vitritis, retinitis, and chorioretinitis. Therefore, it is necessary to conduct a thorough differential diagnosis through a complete medical history, laboratory tests, serologies, and imaging studies when suspecting a possible disease reactivation.
A novel artificial intelligence‐based classification of highly myopic eyes based on visual function and fundus features
Authors: Meng Jiaqi , Song Yunxiao , He Wenwen , Lu Zhong‐Lin , Chen Yuxi , Wei Ling , Zhang Keke , Qi Jiao , Du Yu , Lu Yi , Zhu Xiangjia 
Published: January 2025

Aims/Purpose: To develop a novel classification of highly myopic eyes using artificial intelligence (AI) and investigate its relationship with contrast sensitivity function (CSF) and fundus features.Methods: 616 highly myopic eyes of 616 patients were enrolled. CSF was measured using the quantitative CSF method. Myopic macular degeneration (MMD) was graded according to the International META‐PM Classification. Thickness of the macula and peripapillary retinal nerve fiber layer (p‐RNFL) were assessed by fundus photography and optical coherence tomography, respectively. Classification was performed by combining CSF and fundus features with principal component analysis and k‐means clustering.Results: With 83.35% total variance explained, highly myopic eyes were classified into 4 categories. The percentages of categories 1 to 4 were 14.9%, 37.5%, 36.2%, and 11.4%, respectively. CSF of the eyes in category 1 were the highest, followed by those in category 2 and then category 3, while the lowest was seen in category 4. Compared to those in category 1, eyes in category 2 presented higher percentage of MMD2 and thinner temporal p‐RNFL. Eyes in categories 3 and 4 presented significantly higher percentage of MMD ≥ 3, thinner nasal macular thickness and p‐RNFL (p < 0.05). Multivariate regression showed category 4 had higher MMD grades, thinner macular and p‐RNFL thickness compared to category 3.Conclusions: We proposed an AI‐based classification of highly myopic eyes by integrating features from both visual function and fundus. It might be an important tool to comprehensively evaluate highly myopic eyes.
Long‐term results of unilateral or bilateral injection of lenadogene nolparvovec gene therapy for leber hereditary optic neuropathy
Authors: Biousse Valérie , Yu‐Wai‐Man Patrick , Newman Nancy , Subramanian Prem , Moster Mark , Wang An‐Guor , Donahue Sean , Leroy Bart , Carelli Valerio , Vignal‐Clermont Catherine , Sadun Alfredo , Sergott Robert , Fernández Gema Rebolleda , Chwalisz Bart , Banik Rudrani , Taiel Magali , Sahel José‐Alain 
Published: January 2025

Aims/Purpose: To evaluate the efficacy and safety of intravitreal lenadogene nolparvovec gene therapy (LNGT) in patients with Leber hereditary optic neuropathy due to the m.11778G > A MT‐ND4 mutation for up to 5 years after administration.Methods: REFLECT is a randomized, double‐masked, placebo‐controlled phase 3 study. The first‐affected eye received LNGT; the other eye was randomly injected with LNGT or placebo. RESTORE is the 5‐year follow‐up study of the two phase 3 studies RESCUE and REVERSE, in which patients received an injection of LNGT in one eye and a sham injection in the other eye. REFLECT interim data at 4 years after LNGT and RESTORE final data at 5 years are presented.Results: In REFLECT, 48 patients were treated bilaterally and 50 unilaterally. The mean (standard deviation [SD ]) improvement in best‐corrected visual acuity (BCVA) from nadir to 4 years was ‐0.40 (0.32) (+20 ETDRS letters) and ‐0.34 (0.31) (+17 letters) LogMAR in the first and second‐affected eyes of bilaterally treated patients, and ‐0.38 (0.41) (+19 letters) and ‐0.27 (0.32) (+14 letters) LogMAR in the first and second‐affected eyes of unilaterally treated patients. Better BCVA improvement and higher responder rates were observed in patients treated bilaterally. In RESTORE, 62 unilaterally treated patients completed the study. At 5 years, mean (SD) change in BCVA from nadir was ‐0.44 (0.46) LogMAR (+22 ETDRS letters) for LNGT‐treated eyes and ‐0.39 (0.36) LogMAR (+20 ETDRS letters) for sham‐treated eyes. Overall, LNGT safety was favorable in REFLECT and RESTORE.Conclusions: The persistence of the LNGT effect and the favorable safety profile were confirmed 4 years after a unilateral or bilateral injection in REFLECT and 5 years after a unilateral injection in RESTORE. Bilateral LNGT provided additional benefit compared to unilateral LNGT.
The COVID‐19 pandemic and Urology – reflecting on successful initiatives and lessons in Australia
Authors: Xu Jennifer , Alberto Matthew , Woon Dixon , Bolton Damien , Ischia Joseph 
Published: January 2025

ObjectivesTo summarise the impact of the coronavirus disease 2019 (COVID‐19) pandemic on urological practice globally with a focus on Australian initiatives, as the pandemic resulted in radical changes in healthcare infrastructure and policies.MethodsWe conducted a literature review of the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE) and Web of Science medical databases. The key terms used to conduct our search algorithm comprised of ‘COVID’, ‘wait list or wait time or delay’, ‘urology’, ‘surgery’ and ‘outcomes’, and generated 231 articles. Abstracts were reviewed for relevance and 40 studies selected for full‐text review. Society position statements and government level press release statements were identified through citation tracking and additionally included.Results/discussionThe halt on elective surgical services during the pandemic was deemed necessary to curb infection rates and conserve healthcare resources. However, it resulted in extended wait times and large surgical backlogs with major downstream effects. Australia fared favourably with regards to infection rates compared to international populations consequent upon strict border control, vaccine mandates, and stringent lockdowns. However, similar trends were noted in both oncological and non‐oncological urology service reduction, resulting in significant concerns regarding the long‐term sequelae of delayed surgery and missed appointments upon patient clinical outcome. Initiatives including collaborative partnerships between public and private hospital sectors, government‐funded programmes and adoption of telehealth were successfully established as part of Australia's efforts to stabilise our healthcare system in response to the pandemic.ConclusionAustralia's pandemic efforts have highlighted the escalating imbalance between increasing demand from a growing and ageing population on an already over‐burdened system with finite resources. The additional strain of managing post‐COVID‐19 pandemic fallout in this context provides further challenges for clinicians and healthcare administrators alike. Collaboration by all stakeholders must continue in order to seek innovative solutions to maximise efficiency of healthcare service utilisation, so that quality universal healthcare provision may continue in the future.
Variation in the commissioning of specialist weight management services and bariatric surgery across England: Results of a freedom of information‐based mapping exercise across the 42 integrated Care Systems of England
Authors: Elhariry Maiar , Iyer Pranav , Isack Nadya , Sousa Bernado , Singh Pushpa , Abbott Sally , Wiggins Tom , Nirantharakumar Krishnarajah , Bellary Srikanth , Flint Stuart W. , Pournaras Dimitri J. , Hazlehurst Jonathan M. 
Published: January 2025

SummarySpecialist weight management services including bariatric surgery are commissioned within regions of England called Integrated Care Systems (ICSs) with eligibility and treatment guidelines determined as part of the National Institute for Health and Care Excellence (NICE) guidance. Reported variation in commissioning and bariatric surgery eligibility criteria has not been previously mapped. Freedom of Information (FOI) requests provide a tool, supported by legislation, to ask questions of public authorities including ICSs such that they must respond accurately. FOIs were sent to all 42 ICSs in England asking 4 questions aiming to establish whether there is variation in the commissioning of specialist weight management services and the eligibility criteria for bariatric surgery across England. Responses were presented descriptively and mapped across England. Responses were received from 41 out of 42 ICSs, with 34 reporting that they provide commissioned medical weight management programmes and 38 funding bariatric surgery. Thirteen reported using criteria that were not compliant with NICE guidance. A large area of the country centred around the East of England does not have a bariatric unit reducing access to care. There is significant geographical variation in the availability of both bariatric and specialist medical weight management services across England, with large portions of the country without local access to a service or no service at all. Where services are available, there is significant inconsistency in eligibility for bariatric surgery despite nationally available guidance.