bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient demographics and surgical outcomes of dropped nucleus in cataract surgery
Authors: Martins Pedro , Cabanas João , Cardoso Daniel , Sousa‐Neves Filipe 
Published: January 2025

Aims/Purpose: To analyse the baseline demographic/clinical characteristics and visual outcomes of patients who experienced nucleus drop during cataract surgery with subsequent need for pars plana vitrectomy (PPV).Methods: Retrospective case series of patients who underwent phacoemulsification for non‐traumatic cataract and experienced nucleus drop during surgery, with subsequent need for PPV to extract the dropped fragments. Demographic data, ocular comorbidities (such as ocular hypertension – OHT/glaucoma, pseudoexfoliation – PEX, presence of advanced white or brunescent cataract, shallow anterior chamber or previous intravitreal injections – IVI), timing of nucleus drop, intraoperative complications and post PPV visual outcomes and complications, for the study period (2018 to 2023), were collected.Results: Over the study period 33 eyes of 33 patients experienced nucleus drop. 17 (52%) were male with a mean age of 74.4 ± 9.4 (45‐92) years. Pre‐operative visual acuity ranged from light perception to 0.22 logmar. Three patients (9.1%) had previously undergone IVI and 7 (21.2%) had glaucoma or OHT; 9 (27.3%) had PEX – all but one had poor pupillary dilation ( < 5 mm). A significant proportion of patients (13, 40.4%) presented with advanced brunescent/white cataracts. Most nucleus drops occurred following a posterior capsular rupture during quadrant removal (18 cases – 54.5%) or hydro‐dissection (8 cases – 24.3%); remaining cases occurred following a radialized capsulorhexis with posterior extension or due capsular bag‐nucleus luxation to the vitreous. PPV was uneventful in most cases – one patient developed an epiretinal membrane 2 years after PPV. Visual acuity improved by an average of ‐0.96 logmar in the post‐operative period.Conclusions: PPV is the preferred management for nucleus drop after complicated cataract surgery. Current devices and surgeon expertise allow for a low risk of complications and good visual/anatomical outcomes.
Studies in the electroretinogram i‐wave: Evidence for off pathway origin and association with a myopia risk locus
Authors: Vetrivel Krishnika , Tan Jit Kai , Xu Zihe , Jiang Xiaofan , Leo Shaun , Bhatti Taha , Tariq Ambreen , Hammond Christopher , Hysi Pirro , Mahroo Omar 
Published: January 2025

Aims/Purpose: A myopia‐risk locus near the GJD2 gene has been associated with cone‐driven electroretinograms (ERGs), specifically cone‐driven OFF pathway signals. In light‐adapted ERGs to a standard flash, conventionally measured components are the a‐wave and b‐wave. A later component, the “i‐wave”, is thought to originate in retinal OFF pathways, as evidenced by pharmacological experiments in primates. We investigated this component in human ERGs, testing the hypothesis that an association would be found with the myopia risk locus.Methods: ERGs were examined from patients with rare monogenic post‐phototransduction deficits affecting only ON pathways, or both ON and OFF pathways, to explore which gave rise to the i‐wave. ERGs were then analysed from genotyped healthy adults from the TwinsUK cohort. The i‐wave amplitude was measured in the standard flash ERG by two investigators independently. We investigated association with allelic identity, adjusting for age, sex and inter‐individual relatedness. Separately, we adjusted for refractive error where this was available.Results: Patient recordings showed i‐waves persisted in absence of ON pathway signals, but were abolished when both ON and OFF pathways were impaired. Recordings and genotypes were available in 184 TwinsUK individuals (95% female). Mean (SD) age was 64.1 (9.7) years. Allelic dosage at the risk locus was significantly associated with i‐wave amplitude Refractive error was available for 175 participants. The association in these individuals remained significant both before and after adjusting for refractive error (p = 0.035 and p = 0.043 respectively).Conclusions: ERGs in patients are consistent with the human i‐wave arising from cone‐driven OFF pathways. i‐wave amplitudes associated significantly with allelic dosage at the myopia risk locus. This supports importance of cone‐driven signalling in myopia development and adds evidence that this locus affects cone‐driven OFF pathway signals.
Characterizing iPSC‐derived organoid models from the most prevalent retinal dystrophies
Authors: Navinés‐Ferrer Arnau , Gaudó Paula , Méndez‐Vendrell Pilar , Ruiz‐Nogales Sheila , Siles Laura , Pomares Esther 
Published: January 2025

Aims/Purpose: To establish novel retina cell models to investigate the mechanisms that lead to cell death in IRD.Methods: We generated induced pluripotent stems cells (iPSC) from a cohort of patients with some of the most prevalent IRDs: Retinitis Pigmentosa (RP), Stargardt Disease, Best Disease and Achromatopsia. We differentiated them into PR precursors, retinal organoids (RO) or retinal pigment epithelium cells (RPE) and analyzed the functional implications of each gene and pathogenic variant.Results: All cell models generated from 6 iPSC lines allowed for a better understanding of the molecular mechanisms of IRD. Specifically, in the Best Disease model, we determined using RPE cells that a particular dominant mutation in BEST1 is responsible for a defective closure of the bestrophin pentameric channel. The mutation responsible for RP in RHO shows rhodopsin accumulation and mislocalization, along with an increase of autophagy and ER stress. RO models with mutations in the genes PDE6A and PDE6C, causing respectively RP and Achromatopsia, suggest that expression levels of the pathogenic proteins are diminished. Finally, RPE and RO from two distinct Stargardt Disease patient lines show affectations in bisretinoid disposal, phagocytosis reduction and cell death. Interestingly, those results correlate with the severity of the phenotypes.Conclusions: We show that a wide range of mutations responsible for IRD can be studied using iPSC‐derived retinal models. This opens the door to a deeper understanding of retinal diseases and are key for the development of successful gene and cell therapies.References: Inherited retinal dystrophies (IRD) are a group of rare diseases where photoreceptor (PR) cell death leads to partial or total visual impairment. Over 300 genes have been determined to cause these dystrophies, but most of the molecular mechanisms underlying the start and development of the pathology are still waiting to be unraveled.
Retinal neurovascular coupling in long covid patients
Authors: Lindner Theresa , Pai Viktoria , Janku Patrick , Pylypenko Liudmyla , Ehm Astrid , Fritsch‐Stork Ruth , Garhöfer Gerhard , Schmidl Doreen 
Published: January 2025

Aims/Purpose: Long COVID is a multi systemic condition that occurs in some patients after acute SARS‐CoV‐2 infection. It has been hypothesized that endothelial dysfunction might be involved in the disease process. Assessment of neurovascular coupling (NVC) in the retina is a non‐invasive method to measure endothelial function. Briefly, stimulation of the retina with flicker light usually leads to a significant increase in retinal blood flow. This mechanism has been found to be disturbed in diseases that are associated with endothelial dysfunction.In this context, we investigated whether changes in NVC can be found in patients with long COVID compared to healthy subjects.Methods: We included patients who had a previously confirmed COVID‐19 infection and were diagnosed with long COVID according to WHO guidelines. Healthy subjects had no history of COVID‐19 infection and were negative for SARS‐CoV‐2 seroprevalence. To assess NVC, diffuse flicker light stimulation was performed over 60s using the Dynamic Vessel Analyzer (DVA, Imedos, Germany). We calculated the percentage increase in mean vessel diameter of arteries and veins in response to the flicker light relative to the baseline diameter size.Results: Fifteen (15) patients with long COVID and 11 healthy subjects were included in the current study. During stimulation with flicker light, the diameters of retinal arteries and veins significantly increased in patients with long COVID (3.1 ± 3.5% for arteries and 4.8 ± 2.9% for veins, p < 0.001 vs. baseline each). The same was found for healthy controls (increase in arteries: 3.4 ± 3.0%, increase in veins: 4.2 ± 1.8%, p < 0.001 vs. baseline each). No difference between the two groups in the flicker response was observed (p = 0.792 for arteries and p = 0.579 for veins).Conclusions: In our small study, NVC was not altered in patients with long COVID compared to healthy subjects. However, further studies including larger sample sizes are needed to assess vascular issues in long COVID patients to better understand the underlying pathophysiological mechanisms.
Non‐invasive variables to assess acute stress in surgical personnel: A pilot study
Authors: Beyrouti Rubén Cabrera , García Marina López , Guerra Rocío Alfayate , Quesada María Eugenia Torregrosa , Ferré Jorge Francés , Bueno María Victoria González , Aracil‐Marco Adolfo 
Published: January 2025

Aims/Purpose: To evaluate the use of non‐invasive markers of acute stress in healthcare workers during surgery.Methods: Fifteen ophthalmologists (9 men; 6 women) and one interventional radiologist were recruited. They were assessed on two different days: a) at rest, early morning, at home; b) in the hospital, at four different time points: on arrival, before hand‐washing, after completion of surgery and approximately 30 minutes later. The following measurements were taken: a) heart rate (HR) and heart rate variability (HRV, an indicator of parasympathetic activity) using a Polar HR9 monitor and the EliteHRV® app; and b) salivary cortisol using ECLIA (Cobas 411® autoanalyzer, Roche Mannheim). Data were analysed using Sigmaplot® (Pearson correlation coefficient; one‐way repeated measures ANOVA).Results: The sample consisted of individuals with a mean age of 40.4 ± 10.9 years and a mean professional experience of 10.5 ± 11.6 years. No significant correlations were found between the different variables on any of the days. However, on the day of surgery, both heart rate (HR) and salivary cortisol were significantly lower in the final measurement (HR = 67.9 ± 9.9 beats per minute; cortisol: 0.22 ± 0.10 μg/dL) compared to the preoperative values (HR = 74.6 ± 12.8 beats per minute, p = 0.004; cortisol: 0.47 ± 0.19 μg/dL, p = 0.001). In addition, heart rate variability (HRV) tended to be lower in the pre‐ and post‐intervention measurements.Conclusions: This pilot study suggests that non‐invasive measurement of variables such as HR, HRV and salivary cortisol concentration may be useful in assessing the level of acute stress experienced by healthcare professionals during surgical activity. However, further studies are needed to identify the most sensitive and specific variables for this purpose.
Actin‐related proteomic changes in age‐related, diabetic and post‐vitrectomy cataract
Authors: Karakosta Christina , Samiotaki Martina , Parayotou George , Papaconstantinou Dimitrios , Moschos Marilita 
Published: January 2025

Aims/Purpose: Actin has been implicated in lens opacification; however, the specific actin‐related pathways involved in cataracts remain unclear. In this study, actin‐related signaling pathways involved in the development of different types of cataract were evaluated.Methods: Two sample types were collected during routine cataract surgery; the anterior capsule (AC) and phacoemulsification cassette contents (PCC). Participants were divided into three groups. Age‐related cataract (ARC) group included 12 patients without a history of DM, and age > 75 years; Diabetic cataract (DC) group included 11 patients with diabetes mellitus (DM) and age < 65 years.; and Post‐vitrectomy cataract (PVC) group included 7 patients without a history of DM, who had vitrectomy surgery in the past 12 months. The sample preparation was based on Sp3 protocol (Single‐Pot, Solid‐Phase‐enhanced, Sample‐Preparation). Liquid chromatography online with tandem mass spectrometry was used for protein recognition and quantification. DIA‐NN software was applied for data analysis. Statistical analysis was performed on Perseus software.Results: In PCC samples, proteins with significant differential expression in ARC compared to DC and PVC were involved in pathways including actin binding, actin cytoskeleton reorganization, and small GTPase‐mediated signal transduction pathways. In AC samples, proteins with significant differential expression in ARC compared to DC and PVC were involved in actin binding and actin cytoskeleton reorganization pathways.Conclusions: Our findings suggested that actin‐binding pathway may be involved in ARC formation by causing abnormal lens fiber cell elongation and differentiation. The results of the present study revealed that small GTPase‐mediated signal transduction pathway exhibit lower expression in ARC than in the DC and PVC groups in PCC, and this may be linked to ARC formation through abnormal fiber cell organization, leading to lens opacification and cataract.
"Tinu‐like syndrome" as a rare adverse effect of nivolumab: A clinical case
Authors: Bestué Ana Pueyo , Pueyo‐Bestué Ignacio , Fernández‐Velasco Diego , Mallén Victor , Bermúdez Javier , Biescas Andrés , Rius Núria , Ila Carmen , Hernández‐Barahona Claudia , García‐Navarro Damian 
Published: January 2025

Aims/Purpose: By presenting this clinical case, our main purpose is to raise awareness of the growing incidence of immune‐related adverse effects (irAEs) with patients undergoing treatments such as Nivolumab.Methods: Presentation of clinical case from our Ophthalmology departmentResults: Our clinical case consists of a patient 66‐year‐old male, presenting pain in both eyes since a couple of days. On examination, in addition to reduced visual acuity (VA) of 6/10 in both eyes, bilateral cellular Tyndall grade 2 was noticed, with no other findings in the anterior or posterior segment. When inquiring into his background, he was being treated with oral corticosteroids due to grade 2 Immune‐mediated Nephritis, attributed by the Oncology service of the same center to the use of Nivolumab in the context of stage IV lung carcinoma. Analytical findings highlighted elevated inflammatory markers, as well as positivity for HLADQA1*01. After a month of topical corticosteroid and mydriatic therapy, VA and anterior segment inflammation returned to normal.Conclusions: TINU syndrome (Tubulointerstitial Nephritis and Uveitis) is a rare entity, of uncertain pathogenesis, characterized by bilateral anterior uveitis that is usually preceded months before by Tubulointerstitial Nephritis. In addition, analytical findings such as elevated beta‐2 microglobulin in urine or certain haplotypes such as the already mentioned HLADQA1*01 stand out. Although it is a condition typical of adolescents or young people, it could, as in this case, debut late as a “TINU‐like” condition, likely as an immune‐related adverse effect of Nivolumab. Therefore, it is important to be alert to ocular symptoms in the context of any immune checkpoint inhibitor treatment such as Nivolumab
Case report of cancer‐associated retinopathy in a patient with neuroendocrine carcinoma of the esophagus
Authors: Monleón Claudia Hernández‐Barahona , Raez Carmen Ila , Navarro Damián García , Plata Carlos Santana , Rufas Inés Munuera , Pérez Elisa Funes , Merino Jacobo Yañez , Sopeña‐Pinilla Maria , Ciubotaru Olga , Barón Nieves Pardiñas , Bestué Ana Pueyo 
Published: January 2025

Aims/Purpose: To present the case of a patient with Retinopathy associated with a neuroendocrine carcinoma of the esophagus and to analyze the characteristics of this paraneoplastic syndrome.Methods: A 55‐year‐old man with glaucoma and no other relevant medical history came to the emergency department with sudden vision of a “star‐shaped figure” and photopsias in his left eye (OS).Results: Visual acuity was 0.05 in his right eye (OD) and 1 in his OS. Slit‐lamp examination revealed a bilateral positive Tyndall effect. Fundoscopy of his OS showed nummular lesions in the posterior pole and along vascular arcades. Optical coherence tomography of his OS revealed hiperreflective lesions in the outer retinal layers, with some paravascular extension matching with the nummular lesions observed in the fundus. Fluorescein angiography revealed central mottling without clear vasculitis in his OD and central mottling with vasculitis over paravascular areas of the hyperfluorescence nummular lesions of his OS. The 24‐2 visual field test showed an increase in the blind spot and a nasal scotoma of the OS.Despite a normal body TAC scan and non‐detected antiretinal antibodies, gastroscopy revealed a neuroendocrine carcinoma of the esophagus after the patient reported dysphagia for gaseous liquids. He began treatment with chemotherapy, radiotherapy and steroid boluses, which partially stabilized the lesions until he eventually deceased a year and half after diagnosis.Conclusions: Cancer‐associated retinopathy should be considered in the differential diagnosis of patients with inflammatory signs and acute vision loss. Early diagnosis is crucial for the prognosis and treatment of the primary tumor.References
J.Mª Caminal‐Mitjana. Manifestaciones intraoculares del cáncer sistémico. Neurology 2000; vol.; 31 pages: 1259 – 61.
Efficacy and safety of intralesional bleomycin as a treatment in eyelid hydrocystomas
Authors: Arzola Martin , Cárdenas‐Belaunzarán Jorge , Garcia Ariel Ceriotto 
Published: January 2025

Aims/Purpose: To evaluate the efficacy and safety of intralesional bleomycin as a treatment for eyelid hydrocystomas.Methods: A prospective, longitudinal, experimental, descriptive study was carried out; 33 patients with a clinical diagnosis of eyelid hydrocystoma were evaluated. Measurements were made in length, width and depth to obtain the volume of the lesion, clinical photographs were taken and intralesional bleomycin diluted at 1 unit – 1 milliliter was applied. Afterwards, a safety questionnaire was given. Clinical photographs, volume measurement and safety questionnaire were carried out at 3, 6 and 9 weeks post‐treatment. Persistent cysts received an additional injection. A repeated measures ANOVA was performed to analyze volumetric changeResults: 33 patients were evaluated, presenting with 102 hydrocystomas. Cyst mean volume was 21.16 mm3, 62.74% showed involution after 3 weeks of intralesional bleomycin injection.After the first application of bleomycin, a decrease in the average millimeter volume of hydrocystomas of 92.2% was achieved.At this point, remaining lesions had a mean volume of 1.66 mm3. At 6 weeks 90.19% showed involution with a mean volume of 0.98 mm3 and at 9 weeks 100% showed involution. This difference was clinically and statistically significant (F = 16.75, p < 0.05).Conclusions: This study is a milestone to continue the evaluation of the effectiveness and safety of sclerosing treatments for hydrocystomas, the results obtained through intralesional injection of bleomycin are promising.We can conclude that the use of bleomycin is safe and effective as a treatment modality for hydrocystomas.References
Koumaki, D. et al (2021). Apocrine and eccrine hidrocystomas: a clinicopathological study. Acta Dermatovenerologica Alpina, Panonica, et Adriatica, 30(2), 53–56.
Trischman, T., & Scott, J. F. (2020). Comparative efficacy of hidrocystoma treatments: A systematic review. Journal of Cutaneous Medicine and Surgery, 24(5), 474–480.
Froudarakis, M., et al (2013). Revisiting bleomycin from pathophysiology to safe clinical use. Critical Reviews in Oncology/Hematology, 87(1), 90–100
Dailey, R. A., et al. (2005). Treatment of multiple apocrine hidrocystomas with trichloroacetic acid. Ophthalmic Plastic and Reconstructive Surgery, 21(2), 148–150.
Evaluating brolucizumab in neovascular AMD: Clinical outcomes from a tertiary care eye hospital
Authors: López‐Cuenca Inés , Fabozzi Lorenzo , Younis Saad , Sen Sagnik , Palmieri Filomena 
Published: January 2025

Aims/Purpose: To present real‐world clinical data on the effectiveness of brolucizumab in managing neovascular age‐related macular degeneration (nAMD), either as primary therapy or as switch therapy, in a tertiary care eye hospital in London.Methods: This research involved 37 eyes diagnosed with nAMD, all of which received intravitreal injections of brolucizumab. The main metrics assessed were changes in best corrected visual acuity (BCVA) and central retinal thickness (CRT) by optical coherence tomography (OCT), as well as the incidence of serious ocular adverse events. Additional evaluations included intraretinal fluid (IRF), subretinal fluid (SRF), subretinal hyperreflective material (SHRM), pigment epithelial detachments (PEDs), hyperreflective foci (HF), macular atrophy, and retinal pigment epithelial tears.The patients are classified into: patients not previously treated (Naïve) and patients treated with other anti‐VEGF agents.Results: The average BCVA for all patients after treatment was 0.47 ± 0.33 LogMAR, compared to a baseline of 0.50 ± 0.28 LogMAR (p = 0.372). Treatment‐naïve patients showed a non‐significant improvement in BCVA (p = 0.116). Both treatment‐naïve patients and the entire cohort exhibited a statistically significant reduction in mean CRT following the injections. Most patients showed enhancements in OCT findings, notably in the resolution of IRF, SRF, SHRM, and PEDs. Four eyes developed ocular adverse events, specifically intraocular inflammation.Conclusions: While brolucizumab did not lead to a significant improvement in BCVA, it effectively reduced CRT in both the overall study group and in treatment‐naïve nAMD patients. The study identified intraocular inflammation as a noteworthy adverse event related to brolucizumab. Therefore, careful patient selection, education, and diligent monitoring of inflammation are essential for those receiving this therapy.