bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the influence of genotype on the response to prostaglandin analogues, prostamides, and beta‐blockers in patients with ocular hypertension and glaucoma
Authors: Tejado Sara Carlota Labay , Toro Valeria Opazo , Hernáez Mar , Brunet Mercè , Milla Elena 
Published: January 2025

Aims/Purpose: The objective of the study is to analyse the genotype that predicts the phenotypic characteristics of a cohort of patients with glaucoma and ocular hypertension (OH), and its correlation with the individual pharmacological response to beta‐blockers (BB), prostaglandin analogues (PGA), and prostamides (PM).Methods: This is a prospective study that included 193 eyes of 109 patients with glaucoma or OH under monotherapy with BB, PGA, and PM. Five single nucleotide polymorphisms were genotyped using real‐time PCR assays: prostaglandin‐F2α receptor (rs3766355, rs3753380); cytochrome P450 2D6 (rs16947, rs769258); and beta‐2‐adrenergic receptor (rs1042714). The main variables studied were previous ocular interventions, mean deviation of the visual field (MD), baseline intraocular pressure (bIOP), and treated (tIOP), and the rate of variation of intraocular pressure (vIOP).Results: From the total of eyes, 112 were treated with PGA (58%), 59 with BB (30.6%), and 22 with PM (11.4%). 25 patients had previously undergone a glaucoma procedure. The mean bIOP and tIOP were 23.57 ± 4.8 mmHg and 19.99 ± 4.87 mmHg, respectively. Statistically significant differences were observed in tIOP between heterozygotes (HT) and homozygotes (HM) rs769258 compared to wildtype (WT) individuals (p = 0.049). For rs3753380, differences were observed in vIOP in the PGA group (p = 0.032) and in tIOP in the PM group (p = 0.03). Differences were also observed for rs1042714 in MD (p < 0.001) and vIOP (p = 0.017). Finally, a significant influence on vIOP (p = 0.019) was found for systemic treatment metabolized by CYP2D6 among those treated with BB.Conclusions: These preliminary findings suggest the potential of pre‐emptive pharmacogenetic tests as a guide to achieve personalised treatment preventing adverse reactions and improving efficacy and the clinical evolution of patients with glaucoma.
Plateau iris syndrome: A case report
Authors: Mabrouk Amira , Zahaf Amine , Lajmi Houda , Achour Besma Ben , Hmaied Wassim 
Published: January 2025

Purpose: We report the case of plateau iris syndrome (PIS) in a middle‐aged woman, controlled by medical treatment.Methods: Case reportResults: A 37‐year‐old woman, presented to our department with paroxysmal periorbital pain and progressive decline in VA in the left eye.Best corrected VA was 10/10 in both eyes.Anterior chamber(AC) was peripherally shallowed,but normal in the center bilaterally.Intra ocular pressure (IOP) was normal in OD and 38 in OS. C/d ratio was 0.3 in OD,0.4 in OS.On gonioscopy,angle was occludable in OD.In OS,it revealed convex iris,closed angle/360°,opening by indentation with double hump sign.Visual field showed no abnormalities. Bilateral laser peripheral iridotomy (LPI) was performed.Angle depth improved only in OD.The diagnosis of IPS was made.An UBM made revealed a lens volt (LV)measuring 1.11mm with an occludable angle in the OD.In the OS, LV was elevated 1.20mm, the angle was closed with peripheral anterior synechiae.Iridoplasty wasn't done.We discussed the phacoemulsification but as the patient was controlled by medical treatment and hadn't cataract, we opted to treat medically with regular controls.Conclusions: Although PIS represents a diagnostic trap,based on a cautious anamnesis and a thorough gonioscopy,the accurate diagnosis can be made.Treatment may be challenging in some cases with many considerations.
How do patients relate to preservatives in eye drops and what do they know?
Authors: Saruhanian Arevak , Andreasen Jens Rovelt , Toft‐Petersen Anne , Korsgaard Maiken , Kolko Miriam 
Published: January 2025

Aims/Purpose: The purpose of this questionnaire was to investigate how glaucoma patients relate to preservatives in eye drops and the impact on their quality of life and eye discomfort.Methods: This study was designed as a questionnaire‐based cross‐sectional study. Inclusion criteria included the present use of intraocular pressure‐lowering eye drops, > 18 years of age, and the ability to read and understand Danish. Questionnaires with self‐rated compliance of < 60% or inadequate replies were excluded. Participants were classified into two groups depending on preservative status of their eye drops: participants using only preservative‐free eye drops (PF) and participants using only preservative‐containing eye drops or a combination of both preservative‐containing and preservative‐free eye drops (PC). Further questions were asked regarding awareness of preservative status of eye drops, and willingness to pay more for preservative free options. 146 questionnaires were included in total.Results: No statistically significant differences were found between the groups concerning the Glaucoma Symptom Scale (GSS) score (PC: 66.16 + 21.49 vs. PF: 67.55 + 21.77; p > 0.05), the Glaucoma Quality of life (GQL‐15) score (PC 30.31 + 15.13 vs. 31.33 + 16.80; p > 0.05), or the eye discomfort score (PC/PF OR; 0.90, 95% CI; 0.66‐1.21, p > 0.05). We found that most of the participants in the PC group were unaware of the preservative status of their eyedrops (PC; 74%), as well as unaware of the possibility to avoid preservatives, by using a preservative‐free option (PC; 67%). However, regardless of the knowledge on preservative status most participants were willing to pay more for preservative‐free eyedrops (PC; 83%, PF; 93%)Conclusions: No significant difference in GSS, GQL‐15 or eye discomfort was observed. A severe lack of information was however observed regarding patient‐awareness on the preservative status of IOP‐lowering eye drops, as well as significant willingness to pay more for preservative‐free options.
Initial evaluation of State‐of‐the‐Art deep learning models on data of project forever
Authors: Reimann Marcel , Andreasen Jens Rovelt , Dahl Anders Bjorholm , Kolko Miriam 
Published: January 2025

Aims/Purpose: We investigated state‐of‐the‐art deep learning models trained on the dataset Artificial Intelligence for Robust Glaucoma Screening Challenge [1] on a cohort subset of Project FOREVER. In addition, we investigated how the current evaluation metrics can be applied to a real‐world screening scenario.Methods: We followed and combined the reported best‐performing model designs on the challenge dataset [1] to assess the generalizability of these models to our dataset. The entire pipeline was built using open‐source packages and model weights to ensure reproducibility. The optic disc segmentation and quality assessment were performed using AutoMorph [2]. Afterward, a vision transformer is used to classify the cropped images into non‐referable and referable glaucoma. The model is then applied to a labeled subset of participants of Project FOREVER.Results: Using AutoMorph resulted in a much smaller good‐quality training set compared to what is reported in the AIROGS challenge. It classified one‐fifth of the images as ungradable. In addition, it failed to segment the optic disc in numerous images. Overall, we achieved similar performances on our test split of the AIROGS dataset. Our results also showed that, although high specificity and sensitivity values can be reached, the precision scores of the algorithms were generally low.Conclusions: We suggest including precision as a standard metric to report when evaluating screening algorithms. Specificity and sensitivity are insufficient as they do not capture the economic aspects of the proposed models. Low precision algorithms might introduce high burdens on the healthcare systems due to a high number of false positive referrals.References
C. de Vente et al., "AIROGS: Artificial Intelligence for Robust Glaucoma Screening Challenge," in IEEE Transactions on Medical Imaging, vol. 43, no. 1, pp. 542‐557, Jan. 2024, doi: 10.1109/TMI.2023.3313786.
Zhou Y, Wagner SK, Chia MA, Zhao A, Woodward‐Court P, Xu M, Struyven R, Alexander DC, Keane PA. AutoMorph: Automated Retinal Vascular Morphology Quantification Via a Deep Learning Pipeline. Transl Vis Sci Technol. 2022 Jul 8;11(7):12. doi: 10.1167/tvst.11.7.12. PMID: 35833885; PMCID: PMC9290317.
Improved early detection of glaucoma progression
Authors: Soderberg Per , Tumer Tolga , Kisonaite Konstancija , Holm Jonatan , Yu Zhaohua 
Published: January 2025

Aims/Purpose: To establish a strategy for early detection of glaucoma progressionMethods: In the Uppsala Glaucoma Detection study (UGDS) both eyes in 89, patients with at least one glaucoma suspect eye at inclusion were measured with iterated measurements every 4 month for five years, including measurements of IOP, visual field, HTR‐CD, HRT‐NRA, OCR‐RNFLT and Gdx‐Tsnit. Typically, measurements are compared to population tolerance for evaluation. We estimated within subject variability based on the residual variance of not glaucoma suspect eyes followed over time. A critical limit for no progression in subsequent measurements within the same subject was estimated as the extreme confidence limit for the tolerance limit. We set the tolerance to 0.95 and the confidence coefficient to 0.95.Results: We estimated the within subject standard deviation for subjects to 2.2 mmHg, 0.76 dB, 2.2 x10‐2 rel., 4.7 x10‐2 mm2, 3.4 μm, 1.5 μm for IOP, MD, NRA, RNFLT and Tsnit, respectively. For a specific baseline measurement of each of the different quantities, figure before bracket, this resulted in the critical limits in brackets 17 (21) mmHg, ‐1.53 (‐2.9) dB, 0.45 (0.49) rel., 1.85 (1.76) mm2, 110 (103) μm, and 55 (52) μm, respectively.Conclusions: Estimation of the within subject variability allows estimation of critical limit for detection of progression closer to the subject specific baseline level.
Soft matter 3D printed drug‐loaded subconjunctival inserts for post‐surgical anti‐inflammatory drug delivery
Authors: Alambiaga‐Caravaca Adrián , Bernat‐Just Lucia , Luembe Esther Nginyu , Hibbitts Alan 
Published: January 2025

Aims/Purpose: The aim of this study is to develop 3D printed drug‐loaded subconjunctival inserts to reduce inflammation post‐trabeculectomy by delivering antifibrotic therapies in a controlled and targeted manner.Methods: Different gelatin derivatives were functionalized with methacrylate anhydride to create printable hydrogels. Methacrylation was confirmed by FT‐IR and quantified by 1H NMR, identifying optimal functionalization methods. Various water‐soluble co‐polymers, were incorporated to enhance the mechanical properties, stability, and biocompatibility of the hydrogels as well as a photo‐initiator. The stability of the formulations was assessed by immersing them in PBS at 37°C for up to three months. Extrusion and printability tests were conducted to select the best‐performing blends, which were then used to print different models under UV light exposure to cross‐link the blends and control drug release based on surface contact.Results: The incorporation of polymers improved the stability of the gelatin hydrogels, with controlled degradation possible between 2 and 12 weeks depending on polymer blend. Extrusion and printability tests identified lead candidates. Optimal candidates exhibited controlled drug release over a three‐month period, meeting the therapeutic goal for post‐surgical inflammation management.Conclusions: The development of 3D printed drug‐loaded subconjunctival inserts shows promise in providing targeted antifibrotic therapy post‐trabeculectomy. The optimized hydrogels exhibit improved stability and controlled drug release, potentially enhancing post‐operative outcomes and reducing intraocular pressure effectively. Further studies are warranted to evaluate the ex vivo biodistribution, the in vitro performance in cell culture and long‐term benefits of these customized drug delivery systems.References: Barroso IA, Man K, Robison TE, Cox SC, Ghag AK. Photocurable GelMA Adhesives for Corneal Perforations. Bioengieering. 2022, 9, 53.
Correlation between dyslipidaemia and glaucoma risk: Insights from a population‐based glaucoma screening (NCT 05875090)
Authors: Whitfield Rafael , Lima‐Cabrita Afonso , Lobo Vasco , Monteiro Bernardo , Marques Rodrigo , Ourique Matilde , Leal Inês , Barão Rafael , Pazos Marta , Stalmans Ingeborg Stalmans , Abegão‐Pinto Luís 
Published: January 2025

Aims/Purpose: Glaucoma, a leading cause of irreversible blindness globally, is often associated with elevated intraocular pressure (IOP). However, other risk factors may play a role, particular vascular related parameters. This investigation aimed to explore the association between glaucoma and dyslipidaemia (DL) in participants in a primary care screening pilot. NCT 05875090Methods: analysis at screening visit comparing the odds of a positive referral between participants with and without DL. Secondary outcomes were medication with statins. Positive referral was defined by IOP≥24mmHg or AI≥0.73. Descriptive and bivariate analyses were used to compare the glaucoma proportions and IOP/AI means between groups. Significance was set at p < 0.05 with 95% confidence intervals (CI).Results: Data from 839 participants (54% male, 62 ± 4 years) across 11 functional units were analysed. Many had low educational attainment (69%), diabetes (81,1%), hypertension (63,4%), and DL (66,2%). Among participants with DL, 7,38% had glaucoma positive outcome at screening. No difference in glaucoma odds was found between DL and non‐DL patients (OR 0.782; CI 0.400‐1.528), nor between DL patients medicated with statins compared to those non‐medicated (OR 2.083; CI 0.597‐7.276). Interestingly, DL may be associated with a positive referral due to high IOP (but not disc damage) when compared to non‐DL subjects (OR 0.404; CI 0.155‐1.055; p = 0.09), but further analyses with larger samples are needed.Conclusions: Analysing the association between dyslipidaemia and glaucoma revealed a significant prevalence of DL, with 7,38% meeting positive referral criteria. While the study suggests a potential difference in glaucoma based on IOP between individuals with and without DL, this finding lacks statistical significance. Further analyses, including consideration of confounders and biases, are necessary for confirmation. Continued research and clinical observation are vital for a deeper understanding of this association.
Correlation between diabetes and glaucoma risk: Insights from a population‐based glaucoma screening (NCT 05875090)
Authors: Monteiro Bernardo , Lima‐Cabrita Afonso , Lobo Vasco , Whitfield Rafael , Marques Rodrigo , Ourique Matilde , Varandas Teresa , Barão Rafael , Pazos Marta , Stalmans Ingeborg , Abegão‐Pinto Luís 
Published: January 2025

Aims/Purpose: To evaluate the association between Glaucoma referral and Diabetes in participants in a population‐based glaucoma screening using artificial intelligence (AI).Methods: Analysis of cohort characteristics at baseline contact (screening visit). Glaucoma referral was defined by intraocular pressure (IOP) ≥ 24mmHg or AI score ≥ 0.73. Diabetes information, including HbA1C, was collected from electronic medical records. Our analysis used descriptive and bivariate statistics, including chi‐square tests. Significance was p < 0.05 with 95% confidence intervals (CI).Results: Data from 837 participants were analyzed, comprising 54% males, with an average age of 62±4 years, across 11 functional units of Santa Maria Local Health Unit. A significant portion of participants had diabetes (69%), of which 8.3% were referred. AI scores were lower in diabetic patients compared to the non‐diabetic sub‐cohort (0.57 vs 0.61; p = 0,009). Intrigingly, while no correlation in the overall range of HbA1C with the AI score was detected, there was a detectable trend towards higher AI scores in decompensated diabetic patients (HbA1C > 9%;n = 10): (ρ = 0.591; CI‐0.083‐0.894; p = 0.072)Conclusions: Overall, diabetes diagnosis may influence glaucoma referral programs. AI threshold for referral may be adapted to the setting (particularly if a dual diabetic retinopathy and glaucoma screening is considered). Interestingly, AI appears to detect retinal/disc abnormalities in metabolic decompensated patients.
Prognostic impact and correlation with disease activity of three‐dimensional OCT biomarkers in Vogt‐Koyanagi‐Harada patients
Authors: Lima‐Cabrita Afonso , Vieira Diogo Fróis , Fernandes João Lourenço , Salbany João , Sousa David , Sanches João , Marques‐Neves Carlos , Leal Ines 
Published: January 2025

Aims/Purpose: Vogt‐Koyanagi‐Harada syndrome (VKH) is an autoimmune disease characterized by a chronic bilateral granulomatous panuveitis accompanied by extraocular manifestations, namely of the nervous, auditory, and integumentary systems. Retinal changes documented by optical coherence tomography (OCT) were found to have prognostic value, including detachments between retinal layers with fluid accumulation. The aim of this study was to estimate the total detachment volume (TDV) between retinal layers with fluid accumulation that characterizes the Vogt‐Koyanagi‐Harada syndrome.Methods: An OCT analysis framework was developed in Python which, after a parameter tuning process, automatically segments the 3D detachments between retinal layers and calculates the TDV. The pipeline processes each slice individually following a chain of image processing steps: image enhancement; binarization; size filter; and contour detection. To validate this strategy, this method was applied to one 3D OCT image of a patient with VKH, and the resulting masks were compared with the ground truth obtained after manual segmentation by an expert.Results: Our pipeline has revealed an Intersection of Union (IoU) score of 84%, demonstrating its ability to efficiently segment retinal detachments after a parameter tuning process. As a consequence of such capability, the relative deviation between the experimental and ground truth TDV was 8.3%.Conclusions: This semi‐automated approach offers a promising tool for clinicians to detect retinal changes in VKH patients. By enabling early and precise detection of fluid accumulation and retinal detachments, this method can enhance prognostic evaluations and potentially improve patient management and treatment outcomes. Future work should focus on validating this framework across a larger dataset and refining the processing pipeline to further improve segmentation accuracy and robustness.
Automated OCT‐angiography segmentation of the optic nerve head to distinguish optic disc edema and pseudo‐edema
Authors: Battista Marco , Oakley Jonathan , Carbonelli Michele , Coutinho Catarina , Galzignato Alice , Brotto Luigi , Amore Giulia , Mularoni Cecilia , Bosello Francesca , Erba Stefano , Nucci Paolo , Lenzetti Chiara , Gagliano Caterina , Capobianco Matteo , Dell'Arti Laura , Carelli Valerio , Bandello Francesco , La Morgia Chiara , Cascavilla Maria Lucia , Barboni Piero 
Published: January 2025

Aims/Purpose: To study the optic nerve head (ONH) dimension in symptomatic and asymptomatic patients with Leber hereditary optic neuropathy (LHON) and to correlate ONH parameters with genotype and clinical phenotype.Methods: Seventy‐eight affected patients, 175 asymptomatic carriers, and 29 age‐matched healthy controls were enrolled in the study. All patients underwent ONH optical coherence tomography (OCT) measurements by DRI OCT Triton (Topcon, Japan) and were analyzed with the Orion custom software (Volexeron, CA, USA). The following parameters were obtained for each eye: disc area, horizontal and vertical diameter; retinal nerve fiber layer (RNFL) and ONH volume. For the comparison of the different parameters the ANOVA with Bonferroni post‐hoc test was performed.Results: LHON‐affected patients appeared to have smaller ONH size parameters compared to control cases, but only the vertical disc diameter of patients with mutations 11778 and 14484 were statistically significant. Also, carrier patients with the mutation 11778 presented a statistical significantly smaller vertical disc diameter compared to controls, instead 14484 carriers presented a bigger diameter. ONH volume of all affected patients was significantly smaller. Moreover, asymptomatic 11778 carriers older than 35 years were significantly smaller. Linear regression sustained the relationship between age, volume, and RNFL, unlike between age and disc area.Conclusions: This study exposed the differences of ONH size in LHON‐affected and ‐carrier patients with different mutations: smaller disc in 11778 affected and unaffected patients and larger disc in 14484 carriers. A strong correlation was found between ONH volume both in affected patients and carriers older than 35 years old. These results highlight the importance of the 3D ONH structure as a potential biomarker to support clinicians in the characterization of symptomatic LHON patients and possibly at‐risk mutation carriers with different genetic mutations and clinical course.
Complete blindness revealing pituitary apoplexy with recovery after transsphenoidal decompression
Authors: Mabrouk Amira , Achour Besma Ben , Hmaied Wassim 
Published: January 2025

Aim/Purpose: We report the case of middle aged man,who developed sudden onset of bilateral no light perception (NLP) vision after pituitary apoplexy (PA).Transsphenoidal pituitary decompression(TPPD) was performed.Three months later,the patient regained excellent functional vision in one eye but had residual visual field loss.Methods: Case report:A 37‐year‐old man,with a history of diabetes mellitus,presented to our department for acute onset of bilateral blurry vision.Ophthalmic examination was notable for bilateral NLP,sluggishly reactive pupils.Eye movements were conserved.Fundus examination showed cup‐to‐disc ratios of 0.5 bilaterally without disc swelling.Investigations revealed an elevated prolactin and growth hormone level.A CT scan and an MRI done showed a hemorrhagic pituitary macroadenoma.TPPD was realised.On later controls,VA in the right eye(OD) had improved to 10/10 while it remained NLP in the left eye(OS).His right pupil was briskly reactive to light but sluggishly in his OS.Humphrey visual field testing of OD revealed peripheral loss of visual field.Results: PA involves the sudden expansion of a pituitary mass due to either hemorrhage or infarction.Bitemporal hemianopsia is the most common visual disturbance due to optic chiasm compression,but others presentations can be seen.NLP is rare.Headache and limitation of extraocular movements are relatively frequent.Clinical outcomes after PA vary depending on initial presentation's severity and treatment.Although TPPD can improve VA in cases of PA,the final outcome may be poorer in patients with NLP.Despite the positive outcome of both early and late surgery,literature generally supports early intervention,particularly in severe visual compromise.Conclusions: We report a case of bilateral blindness presenting after PA,with partial vision's recovery following TPPD seven days after the apoplectic event.This case highlights the possibility of functional vision's return after relatively late surgery despite initial NLP.References
Recovery of Complete Blindness and Internal Ophthalmoplegia After Transsphenoidal Decompression of Pituitary Apoplexy.Cureus2022Sep