bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rapid assay of granulocytic esterase in the discharge of conjunctival sac as a tool for the recognition of bacterial ocular surface inflammation
Authors: Oseka Maciej , Maciejewicz Piotr 
Published: January 2022

AbstractPurposeOcular surface inflammation (OSI) is one of the most common diseases in ophthalmic practice. Bacteria can be one of many reasons of OSI. Topical antibiotics are prescribed in many cases of OSI. There is an important reason of the increase the antibiotic resistance. An enzyme granulocystic esterase (GE) is a marker of neutral granulocytes activated during bacterial inflammation. The goal of our study was to check the usage of rapid assay of GE in the discharge coming from conjunctival sac in patients with OSI.MethodsDischarge was collected from the conjunctival sac by sterile swab for microbiological cultures and the rapid assay of GE. There is a color reaction of indoxyl with diazonium salt in the assay. The positive result gives the purple color of the test area and its intensity is dependent on the amount of GE.ResultsThe intensity of the of the rapid assay color was the highest in patients with purulent discharge. In most cases, the presence of Staphylococcus aureus and Staphylococcus epidermidis was confirmed. Very low GE activity was found in most patients without purulent discharge. There were few patients without purulent discharge but with positive results of rapid assays and microbiological cultures. There was lack of correlation between intensity of subjective and objective symptoms (except purulent discharge) and positive result of rapid assay and microbiological cultures.ConclusionsA rapid assay of GE seems to be easy tool for the recognition of bacterial etiology of ocular surface inflammation. It can help to limit topical antibiotics usage in the treatment of ocular surface inflammations and reduce the antibiotic resistance.
Dendritic cell depletion modifies corneal nerve activity and mice nociceptive behaviour
Authors: Rincon Frutos Laura , Luna Carolina , Antonio Gómez Sánchez Jose , Carmen Acosta M. , Belmonte Carlos , Seyed‐Razavi Yashar , Hamrah Pedram , Gallar Juana 
Published: January 2022

AbstractPurposeTo determine the influence of resident dendritic cells (DC) in modulating corneal sensory nerve activity and its possible implications in basal tearing and pain.MethodsC57BL/6 CD11c‐DTR mice (both sexes, 5–6 months old) were used. Short‐term (48 hr, STD) and long‐term (8 days, LTD) DC depletion was done by bilateral subconjunctival injections of diphtheria toxin (DT) under anesthesia. Naïve mice (no DT‐injections) served as control. Background and stimulus‐evoked (cooling and heating ramps) activity of cold thermoreceptor nerve terminals was recorded ex vivo. Basal tearing rate was measured using commercial phenol red threads during 30 seconds in isoflurane‐anesthetised animals. For monitoring the presence of spontaneous eye pain, the eye closure ratio (calculated by dividing the height by the width of the palpebral fissure measured in photographs) was used.ResultsSTD produced a significant decrease in heating threshold (37.7 ± 0.7°C, n = 10 versus naïve, 41.6±1.8°C, n = 4 and LTD, 42.3±1°C, n = 8; p = 0.003, ANOVA). After LTD, lower temperature values were needed to reach both cooling threshold and peak frequency during cooling ramps (30.7 ± 0.5°C, n = 17 versus naïve, 32.3 ± 0.3°C, n = 20, and STD, 32.2±0.4°C, n = 17; p = 0.005, ANOVA). Basal tearing was slightly reduced in STD (2.8 ± 0.6 mm before DT versus 1.2 ± 0.38 mm at 48 hr, n = 6; p = 0.119, paired t‐test) and signs of spontaneous pain were observed in both STD and LTD, being the eye closure ratio lower than before DT‐injections (STD: 0.92 ± 0.01 before DT versus 0.18 ± 0.02 at 48 hr, n = 23, p ≤ 0.001, paired t‐test; LTD: 0.9 ± 0.03 before DT versus 0.17 ± 0.02 at 48 hr versus 0.46 ± 0.07 at day 8, n = 3, p ≤ 0.001, RM One‐way ANOVA).ConclusionsDifferences observed in nerve impulse activity and the subsequent changes in basal tearing and signs of spontaneous pain suggest a crucial role of DC in corneal nerve activity and ocular surface homeostasis.Supported by SAF2017‐83674‐C2‐1‐R and ‐2‐R (AEI‐ERDF), PROMETEO/2018/114 and ACIF/2017/169 (Generalitat Valenciana).
A unique pre‐endothelial layer at the posterior peripheral cornea: ultra‐structural study
Authors: Akhtar Saeed , Samivel Ramachandran , Smedowski Adrian , Alkanaan Aljoharah , Masmali Ali , Kirat Omar , Khan Adnan , Almubrad Turki Almubrad 
Published: January 2022

AbstractPurposeTo investigate the ultrastructure of a unique pre‐endothelial layer (PENL) of the posterior peripheral cornea and compare their fibers to those of the limbus and sclera.MethodsTen anonymous‐donor human sclera–corneal rings (leftover after corneal transplants) were processed for electron microscopy. Semi‐thin sections were examined using an Olympus BX53 microscope, and ultrathin sections were studied using a JOEL 1400 transmission electron microscope.ResultsA unique pre‐endothelial layer (PENL) was identified at the posterior peripheral cornea a radial distance of 70 µm – 638 µm, from the Descemet’s membrane endpoint (DME). At 272 µm distance from the DME, the posterior pre‐limbal cornea contained 5 layers; basement membrane (BM), pre‐Descemet’s layer (PDL), Descemet’s layer (DM), and a pre‐endothelial layer (PENL) between the DM and endothelium (EN). As the DM runs towards the central stroma, the PENL thins out gradually and disappears at a distance of 638 µm from DME. The layer contained an electron‐dense sheath with periodic structures (narrow‐spacing fibers), wide‐spacing fibers, and numerous microfibrils. The typical elastic fibers were composed of an elastic core surrounded by microfibrils. These were present in sclera and limbus but were not observed in the PENL.ConclusionsThe present study revealed the existence of a new acellular PENL, and it can be considered as another layer of the pre‐limbal peripheral posterior cornea. Knowledge of the PENL layer may help with understanding the pathology of endothelial dystrophies and pre‐DM dystrophies. PENL fibers were similar in structure to the fibers of trabecular meshwork described previously.
Long‐term effects of trabeculectomy on visual field progression across two centres in the United Kingdom: A 10 year follow‐up
Authors: Yang Yingjia , Shah Matthew , Bobat Hannaa , Sepetis Anastasios , Shah Peter , Kirwan James 
Published: January 2022

AbstractPurposeTrabeculectomy is the most commonly performed surgical procedure for the treatment of glaucoma in the UK. The overarching aim is to achieve good IOP control, and thereby halt or slow further visual field loss. We aim to analyse whether trabeculectomy is successful in achieving long‐term visual field stability.MethodsA retrospective analysis was performed on consecutive patients who underwent a trabeculectomy between 2001 and 2010 at the Queen Alexandra Hospital in Portsmouth and the Queen Elizabeth hospital, Birmingham under the care of two specialists (JK and PS). Only eyes with at least five years of follow‐up post‐operatively, as well as visual fields before surgery and at least 5 years after were included. Patient demographics and comorbidities, intraocular pressures before and after surgery, visual field information prior to surgery and at the most recent follow‐up were collated and analysed.Results146 eyes of 110 patients met the eligibility criteria. Median follow‐up time was 10.0 years (range 5–17.5 years) and median visual field progression per year was −0.12 dB. 69% (n = 101) achieved stable visual fields post op (MD loss/year < 0.3 dB), 14% (n = 20) showed borderline/minimal progression (0.3–0.5 dB MD loss/year), 13% (n = 19) had moderate progression (0.5–1 dB loss/year), and 4% (n = 6) showed rapid progression (MD loss >1 dB/year). Median IOP reduction at final follow‐up compared to before surgery was 47% (median final IOP was 11 mmHg). Eyes that achieved good IOP control (<12 mmHg at final review, n = 96) had a median visual field progression of −0.08 dB/year. All six cases of rapid deterioration were confounded by concurrent severe systemic diseases (two cases of metastatic cancer, one case each of infective endocarditis and severe hypotension) and non‐glaucoma ocular conditions (one case each of diabetic maculopathy and advanced age‐related macular degeneration) during the follow‐up period.ConclusionsIn the majority of these cases (83%, n = 121), trabeculectomy resulted in visual field stability. Its positive effect on visual field stability is enhanced when the final IOP is less than 12 mmHg.
Trends in glaucoma surgery: an evolving landscape
Authors: Parkash Daniel , Gohil Anjali , Ansari Abdus Samad , Kulkarni Avi , Kailani Obeda 
Published: January 2022

AbstractPurposeThe introduction of microinvasive glaucoma devices (MIGS), and changes in healthcare demands in consequence to the COVID‐19 pandemic, glaucoma surgeons have been required to evolve traditional practice techniques. We aimed to study trends in glaucoma surgery over a 5‐year period.MethodsElectronic medical records for patients undergoing glaucoma surgical procedures were retrieved at our centre between January 2016 and March 2021. Data on demographics, co‐morbidities, aetiology of disease, ocular parameters and outcomes were retrieved. Changes in clinical guidelines and surgeon related preferences were compared at all time points. Trends in surgical practice including variance in the utilisation of MIGS surgery were studied.ResultsA total of 4028 operations were included. The mean age was 69.5 (SD 12.8). No significant variance in sex was seen (M:F 2061:1967). Trabeculectomies comprised of 10.2% (n = 411), glaucoma drainage devices (GDD) 2.8% (n = 111) and MIGS 22.2% (n = 895) of all operations performed. A 61.4% and 60.3% reduction in number of trabeculectomies and GDD’s was seen respectively between 2016 and 2020. There was a significant increase in the utilisation of MIGS (+293%) and combined procedures (+10%). A significant proportion of these novel procedures included endo‐cyclophotocoagulation (n = 178) and iStents (n = 642). During the COVID‐19 pandemic there appeared to be marked increase in the number of Preserflo implantations in comparison to trabeculectomies and GDD surgeries (+850% increase of Preserflo between 2019 and 2020, 9.4% and 54.6% decline for trabeculectomies and GDD’s respectively).ConclusionsMIGS is becoming increasingly established as an effective tool in the glaucoma surgeons’ armamentarium. This is due to shorter surgical time, recovery periods and cost‐effectiveness of MIGS procedures. This continues to be an evolving landscape, with the advancement of canal‐based and subconjunctival MIGS procedures.
Evaluating the diagnostic generalizability of deep learning models trained with images of the ganglion cell layer of early glaucoma
Authors: Díaz‐Alemán Valentín Tinguaro , Miranda Silvia Alayón , Fumero Batista Francisco José , Perera Sandra Gómez , del Arco Rafael Arnay , Sigut Saavedra José Francisco 
Published: January 2022

AbstractPurposeTo determine the diagnostic generalizability of two deep learning models when trained only with images of the ganglion cell layer (GCL) of mild glaucoma.MethodsWe have collected a sample from patients with primary and secondary open‐angle glaucoma and normal patients. The sample was divided into mild glaucoma (MD≤6 dB), and moderate‐advanced (MD > 6 dB). The GCL images were recorded with a spectral‐domain Optical Coherence Tomography. Two pre‐trained models were used, the ResNet101 and the Shufflenet. The sensitivity, specificity, diagnostic precision in training and test, and the ROC area were calculated for the two models with three different training conditions according to how the images were partitioned into training and test. In the first partition, mild glaucomas were used for training and moderate‐advanced for test. In the second, moderate‐advanced glaucomas were used for training and mild for test. In the third, the whole sample was used without classifying by severity. Gradient‐weighted Class Activation Mapping (GradCAM) was used to obtain saliency maps which highlight the more important components in the images for the model prediction. The correlation coefficient between the maps of the glaucoma and normal images of the two models was calculated.Results561 eyes were collected from 337 patients, 356 are glaucomatous and 200 are normal. The precision of the models in the test set in partition 1, was 90.9% (ResNet101) and 94.2% (Shufflenet). In partition 2, was 74.4% (ResNet101) and 73.5% (Shufflenet), and in partition 3 an accuracy of 94.6% was found with both models. The correlation coefficient between the GradCAM saliency maps of the models was 0.46 for glaucoma images and 0.83 for normal images.ConclusionsThe two deep learning models are able to generalize and have high diagnostic precision if they are trained only with images of the GCL of mild glaucoma. Both models show high correlation in the GradCAM saliency maps with normal images.
ASGARD – Adverse events and safety in glaucoma patients: assessing reports on eye drops
Authors: Thein Anna‐Sophie , Hedengran Anne , Arita Reiko , Cvenkel Barbara , Gazzard Gus , Heegaard Steffen , De Paiva Cintia , Petrovski Goran , Prokosch‐Willing Verena , Utheim Tor P. , Virgili Gianni , Azuara‐Blanco Augusto , Kolko Miriam 
Published: January 2022

AbstractPurposeThere are large variations in how adverse events, safety and tolerability related to intraocular pressure (IOP)‐lowering eye drops are reported. Inconsistencies and discrepancies in outcomes and methods lead to missed opportunities when comparing studies and combining results in meta‐analyses, making it difficult to translate the findings into the clinic. The purpose of this study is to establish consensus among experts on measured outcomes when conducting future clinical trials examining ocular adverse events, safety, and tolerability in patients treated with IOP‐lowering eye drops.MethodsA Delphi study of 2–4 rounds is conducted. International glaucoma and ocular surface experts are invited to participate. The importance of items is ranked using a 10‐point scale (1 as not important, 10 as very important). Background literature is used to identify relevant items to be included in the survey. Items are organized into domains, e.g. visual acuity, with subgroups regarding measurement method. A core group of 8–12 leading experts are recruited prior to generating the first questionnaire. The core group contributes to and reviews the study protocol, the questionnaire, the recruitment, and the final article.ResultsAn item is considered important when the mean value of importance is ranked ≥7 and the interquartile range of scores is ≤3. At least 30 experts are required to participate in all rounds to complete the study. Not all domains are expected to reach consensus. Consensus within 90% of the domains surveyed is considered a valid consensus status for conclusion.ConclusionsAchieving consensus on standardized methods for assessing adverse events, safety, and tolerability of IOP‐lowering eye drops will provide a valuable basis for evaluating eye drops in randomized clinical trials. This will then enable systematic reviews, which are most valuable to decision makers.
Assessing the role of cross‐linked sodium hyaluronate in improving the quality of circumpapillary OCT scans
Authors: Yap Timothy , Abdulhussein Dalia , Ahmed Faisal , Francesca Cordeiro M , Normando Eduardo 
Published: January 2022

AbstractPurposeAssessment of cross‐linked sodium hyaluronate (XLHA) in improving circumpapillary OCT scan quality and segmentation accuracyMethodsCircumpapillary OCT scans (Heidelberg Spectralis) of prospectively recruited glaucoma clinic patients were assessed. Patients were included if suboptimal image quality was suspected, based on live preview images. Exclusion criteria included severe loss of media clarity due to corneal opacification or dense cataract, adverse reaction to any constituents of the investigative eyedrop, contact lens use, eyedrop use in the preceding two hours, significant imaging artefact, or scanning and segmentation failure. Prior to repeat scanning, within‐patient eyes were randomised to receive topical application of XLHA (VisuXL) or blinking alone as a control group. The objective primary outcome measure was the mean proprietary image quality indicator (QI). Subjectively, masked clinician assessment of image preference was assessed. Global circumpapillary RNFL thickness and the improvement of segmentation errors were secondary outcomes.ResultsSixty‐seven patients (134 eyes) were eligible for analysis with a mean age (±SD) of 69.7 ± 14.4 years, of whom 57% were male and 43% female. Mean baseline QI in the XLHA group was 23.0 ± 4.95, and 23.3 ± 5.04 in the control eyes (p = 0.76). The mean change in QI was +0.28 ± 3.93 in the XLHA eyes, and +0.34 ± 4.01 in the control eyes (p = 0.93). No significant effect on RNFL thickness (p = 0.82), subjective image preference (p = 0.73) or the extent of segmentation errors (p = 0.46) was seen. Post‐hoc analysis revealed baseline QI as a predictor of repeat scan improvement across all groups, with a baseline QI less than 24.5 associated with improvement on repeat scanning (OR 4.49, 95% CI 2.06 – 9.59).ConclusionsRepeat scanning was beneficial with baseline QI below 24.5; however, no evidence was found to support the use of XLHA over blinking to improve repeat OCT scan quality.
Evaluation of the ultrastructural and in vitro flow properties of the PreserFlo® microShunt
Authors: Barberá Marta Ibarz , Bragard Jean , Fernández laura Morales , Rivero Pedro Tañá , de Liaño Rosario Gomez , Guezala Miguel Teus 
Published: January 2022

AbstractPurposeThe purpose of this study was to measure the luminal diameter of the PreserFlo® microshunt and to calculate the theoretical resistance to flow for comparison with the outcomes of the in vitro flow testing of this device.MethodsThe PreserFlo® was designed to control the flow of aqueous humor by means of its length and width according to the Hagen‐Poiseuille equation. Scanning electron microscopy (SEM) was performed to measure the internal lumen of the tube and flow testing was carried out using a constant gravity‐flow test.ResultsThe SEM images of the PreserFlo® implant showed that the luminal diameter measured 63.6 x 70.5 μm. The theoretical calculation of the resistance to flow (R) for an aqueous humor viscosity of 0.7185 was 1.3 mmHg/μL/min. Assuming a constant aqueous humor flow of 2 μL/min, the calculated pressure differential (△p) across the device was 2.6 mmHg. The experimental gravity‐flow test showed that the theoretical flow (Qtheo) and the in vitro flow (Qexp, 15.75 g/24 h) were consistent.ConclusionsThe internal diameter of the PreserFlo® implant measured by SEM fits the dimensions described by the manufacturer. The experimental and theoretical flow testing showed that the pressure drop across this device is lower than the pressure required to avoid numerical hypotony.References1. Ibarz Barberá M, Morales Fernández L, Tañá Rivero P, Gómez de Liaño R, Teus, MA (2021), Anterior‐segment optical coherence tomography of filtering blebs in the early postoperative period of ab externo SIBS microshunt implantation with mitomycin C: Morphological analysis and correlation with intraocular pressure reduction. Acta Ophthalmol. https://doi.org/10.1111/aos.148632. Sheybani A, Reitsamer H, Ahmed II. Fluid Dynamics of a Novel Micro‐Fistula Implant for the Surgical Treatment of Glaucoma. Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4789–95.3. Pinchuk L, Riss I, Batlle JF, Kato YP, Martin JB, Arrieta E, Palmberg P, Parrish RK 2nd, Weber BA, Kwon Y, Parel JM. The development of a micro‐shunt made from poly(styrene‐block‐isobutylene‐block‐styrene) to treat glaucoma. J Biomed Mater Res B Appl Biomater. 2017 Jan;105(1):211–221.4. Gardiner BS, Smith DW, Coote M, Crowston JG. Computational modeling of fluid flow and intra‐ocular pressure following glaucoma surgery. PLoS One. 2010;5(10):1–11.
Health‐related behaviours and visual impairment among people aged 50 years and older in Gegharkunik province of Armenia: rapid assessment of avoidable blindness survey
Authors: Giloyan Aida , Harutyunyan Tsovinar , Petrosyan Varduhi 
Published: January 2022

AbstractPurposeThis study assessed the prevalence of visual impairment (VI) and the association between VI and health‐related behaviours in population aged 50 years and older in Gegharkunik province of Armenia.MethodsTwenty‐four clusters with 50 people in each were sampled for the interviewer‐administered survey in Gegharkunik in 2019. Ophthalmic examination assessed presenting and pinhole corrected visual acuity using Rapid Assessment of Avoidable Blindness methodology. The structured questionnaire collected information about participants’ socio‐demographics, body mass index, self‐assessed general health status, utilisation of eye services, presence of chronic non‐communicable diseases, and health‐related behaviours (smoking, physical activity and alcohol consumption).ResultsThe mean age of participants was 64.8 (SD = 10.2), ranging from 50 to 97. Women constituted 62.4% of the sample. About 26% of participants had mild to severe VI and 2% were blind. Approximately 58% of participants were physically inactive or insufficiently active. Most of the respondents never used alcohol (62.5%), while 33.4% were moderate and 4.1% were heavy alcohol users. After adjusting for health characteristics and health‐related behaviours, being physically inactive or insufficiently active was associated with VI in the first logistic regression model. Advanced age and self‐assessed “poor” general health status were associated with VI after adjusting for demographics, health characteristics and health‐related behaviours. Moderate alcohol consumption had protective effect on VI in both models.ConclusionThe prevalence of VI in this population was higher compared to the global rate and estimates from the European region. Regular ophthalmic examination and public health interventions might reduce VI and improve health‐related behaviours among target population.