Control Eyes Research Articles

The Correlation Between Eye Strain on Visual Acuity with Refractive Error Among Children

ABSTRACT Background: Visual impairment is a significant public health problem. Computer use by children especially school-aged children is growing rapidly. In these decades, therefore, extensive viewing of the computer screen can lead to eye discomfort, fatigue, blurred vision and headaches, dry eyes, and other symptoms of eyestrain. But nowadays, in this hazardous situation, visual impairment in children has negative impacts on socio-emotional competence and academic development. Uncorrected refractive error is the leading cause of vision loss. Materials and Methods: A true experimental study that met the inclusion criteria was randomly allocated into the study group (n = 85) and the control group (n = 85) sociodemographic variable and eye health variable assessed by structured questionnaire. Convergence insufficiency symptom survey assessed. Results: The experimental group exhibited a significant reduction in eye strain level and refractive error with improvement in visual acuity. In the post-test, the experimental group showed complete to moderate recovery compared to the control group. It showed the significance difference where P < 0.001. Pearson correlation analysis was used for refractive error between the groups. Refractive error was reduced − 0.5 diopters in each participants. There is a significant change in the experimental group considered as a P value < 0.001 statistically significant, respectively. In contrast, the control group had no significant improvement in visual acuity reduction in refractive error. Conclusion: This finding concludes that the children were having eye strain, which impacts the visual acuity could be incorporated with sociodemographic variables and eye health variables with convergence insufficiency symptoms among participants.

Enhanced ferroptosis sensitivity promotes the formation of highly myopic cataract via the DDR2-Hippo pathway

Highly myopic cataract (HMC) is a leading cause of blindness among the working-age individuals, with its pathogenesis poorly understood. This study aimed to elucidate the role of ferroptosis in HMC development as well as the underlying mechanisms. In HMC lens epithelia, levels of Fe2+ and lipid peroxidation were found elevated, with increased vulnerability towards ferroptosis as revealed by transmission electron microscopy. Mechanistically, RNA sequencing of HMC lens epithelial samples identified up-regulated expression of discoidin domain receptor tyrosine kinase 2 (DDR2) as a key factor, which could enhance ferroptosis sensitivity via the Src-Hippo pathway. Specifically, DDR2 interacted with Src kinase, leading to the nuclear translocation of homologous transcriptional regulators (yes-associated protein 1 [YAP1] and WW domain containing transcription regulator 1 [WWTR1]) of the Hippo pathway, which altered the expression level of ferroptosis-related genes. Notably, highly myopic eyes of mice exhibited higher sensitivity to RSL3, a ferroptosis inducer, manifested as more severe nuclear lens opacities both in vitro and in vivo compared with the contralateral control eyes, which could be alleviated by inhibitors of either ferroptosis or DDR2. Altogether, these findings highlighted the role of DDR2 in mediating ferroptosis in HMC formation, providing a novel insight for therapeutic interventions.

Comparison of retinal vascular abnormalities in the fellow eyes of children with Coats' disease and normal subjects using ultra-widefield fundus fluorescein angiography.

To investigate retinal vascular abnormalities in the affected and fellow eyes of children with Coats' disease using Optos® ultra-widefield fundus fluorescein angiography (UWFFA) and compare the peripheral vascular abnormalities between fellow eyes and normal control eyes. Children diagnosed with Coats' disease who underwent UWFFA were retrospectively reviewed. Healthy eyes with complete UWFFA data were selected as controls. Retinal vascular abnormalities of the primary affected, fellow eyes and normal control eyes were recorded by investigating the UWFFA images. Among the 190 eyes of 95 patients with unilateral Coats' disease, 83 (87.4%) were male, and the median age was 9.00 (7.00, 12.25) years (4-18 years). 93 (97.9%) fellow eyes had peripheral capillary telangiectasia that most commonly located in the temporal periphery. 59 (62.1%) fellow eyes had microaneurysms and 19 (20.0%) had vascular leakage; 29 (30.5%) fellow eyes had peripheral vascular tortuosity and 86 (90.5%) eyes had peripheral right-angle vessels. Peripheral capillary non-perfusion (CNP) were found in 31.6% (30/95) fellow eyes. We also found that the terminal vascular patterns in the fellow eyes were mainly loop pattern, accounting for 90.5%. The incidence of capillary bed abnormalities, vascular leakage, right-angle vessels and CNP were significantly higher in fellow eyes of Coats' disease than control eyes (p<0.001, p=0.044, p<0.001, p=0.001, respectively). Regarding the terminal vascular patterns, the proportion of loop pattern in fellow eye group was significantly higher than that in control eye group (p<0.001). A total of 21 Coats' patients had follow-up UWFFA data. The average follow-up time was 13.19±10.09 (3-35) months. There was no significant change in peripheral retinal vascular abnormalities in the fellow eye of all patients between the first and last visit. Because Optos® UWFFA device is able to quickly take panoramic fundus images using mild excitation light without contacting the cornea, it allows the detection of peripheral vascular changes in the fellow eyes of children with Coats' disease. Contrary to the previous belief that Coats' disease is a "unilateral condition", our finding shows that Coats' disease appears to be a highly asymmetric bilateral disease, and the peripheral vascular abnormalities in the fellow eye remains stable in short term.

Investigation of Endothelial Cell Density after PreserFlo Implantation Compared to Contralateral Eyes without PreserFlo Implantation - A Retrospective Analysis.

Loss of corneal endothelial cells after glaucoma surgery can lead to corneal decompensation and reduced vision. This loss may be accelerated by drainage implants like PreserFlo, which allow controlled subconjunctival filtration. In a retrospective analysis, we examined its impact on corneal endothelial cell density (ECD). Data from medical records for 94 eyes were retrospectively analyzed. This included 47 PreserFlo-operated eyes and 47 contralateral control eyes. Inclusion criteria were open-angle glaucoma, laser trabeculoplasty as the only prior glaucoma surgery, and a contralateral control eye without any previous glaucoma surgeries and without any relevant diseases. Only standalone procedures and pseudophakic eyes were considered. We included 48 eyes at 2 weeks (24 operated, 24 control eyes), 72 at 3 months (36 each), 34 at 1 year (17 each), and 36 at 3 years (18 each). Preoperatively, the 47 eyes that were planned for surgery had a mean ECD of 2141 ± 527 cells/mm², and the 47 control eyes had an ECD of 2114 ± 561 cells/mm². Two weeks postoperatively, ECD decreased by 5.4% in the operated eyes and increased by 1.1% in the control eyes. After 3 months, endothelial cell loss (ECL) was 3.6% (operated) and 1.9% (controls). After 1 year, ECL was 11.7% (operated) and 5.6% (controls); after 3 years it was 7.6% (operated) and 2.9% (controls). No significant differences in ECL dynamics between the operated and control eyes were detected by the analysis of variance. Although there was a trend to accelerated ECL in operated eyes compared to controls, this difference was not significant. Overall, the Preserflo procedure appears safe as regards to its influence on endothelial cell count.

Analysis of the effect of congenital unilateral trochlear nerve paresis on retinal vascular density: a retrospective study.

To use swept-source optical coherence tomography angiography (SS-OCTA) to investigate the alterations in retinal vascular density (VD) in patients presenting with congenital unilateral trochlear nerve palsy. The medical records of patients diagnosed with congenital unilateral trochlear nerve palsy and those of a healthy control group were reviewed retrospectively. Comprehensive ocular examinations and SS-OCTA imaging were conducted. The study population was divided into three subgroups of eyes: paretic eyes, fellow eyes, and controls. All participants underwent comprehensive ophthalmic examinations, which included assessments of ocular motility, refraction under cycloplegia, and axial length measurement. Various strabismus tests-the cover-uncover test, prism and alternate cover test, Krimsky test, and Parks-Bielschowsky test-were conducted to confirm the diagnosis and evaluate the extent of the condition. A total of 34 patients and 39 healthy controls were included. Sex and age distributions were similar between groups. Significant differences were observed in central VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) between paretic eyes, fellow eyes, and control eyes. The fellow eye exhibited lower central VD compared to the paretic and control eyes. Inverse correlations between deviation angle and VD were noted in different SCP and DCP quadrants in paretic eyes. In our study cohort, there were significant changes in retinal VD in fellow eyes of patients with trochlear nerve palsy, which we speculate may be related to compensatory head position.

Analysis of the correlations between changes in posterior segment and anterior chamber segment after implantable collamer lens implantation in highly myopic patients

PurposeTo evaluate the impact of Implantable Collamer Lens (ICL) implantation on anterior chamber angle parameters and posterior segment structures in highly myopic eyes and explore potential correlations between these changes. The study aimed to assess alterations in superficial and deep vessel density (SVD, DVD), foveal avascular zone (FAZ) area, and retinal nerve fiber layer (RNFL) thickness to clarify the safety profile of ICL implantation.MethodsProspective observational study, included 36 highly myopic eyes undergoing ICL implantation in surgery group and 23 non-surgical control eyes in non-surgery group. Anterior chamber parameters were assessed using AS-OCT, and posterior segment changes, including SVD, DVD, FAZ, and RNFL, were evaluated using OCT and OCTA preoperatively and at intervals up to 3 months postoperatively. Statistical analyses included paired t-tests, Wilcoxon tests, and Spearman correlation.ResultsICL implantation significantly improved uncorrected distance visual acuity (UDVA) (p < 0.01). Anterior chamber depth (ACD) and angle parameters, such as AOD and TISA, decreased initially but stabilized by 3 months. SVD and DVD showed early postoperative fluctuations, returning to baseline by 3 months, while the FAZ area and subfoveal choroidal thickness remained stable. Significant correlations were identified between anterior segment narrowing and posterior vascular changes, particularly in the pericentral region.ConclusionsICL implantation effectively and safely corrects high myopia, with stable anterior and posterior structural changes by 3 months. Transient vascular density fluctuations correlated with anterior chamber angle alterations, highlighting the need for long-term studies to further understand these dynamics and ensure retinal safety postoperatively.Trial registrationThe study was approved by the ethics committee of Aier Eye Hospital, Jinan University (No. GZAIER2023IRB25; China Clinical Trial Record No. MR-44-24-009241).

Topography-guided, patterned, customized corneal crosslinking for non-invasive astigmatism correction.

To propose and evaluate a novel, non-invasive approach for enduring corneal astigmatism correction based on topography-guided, patterned, customized riboflavin-ultraviolet A corneal collagen crosslinking (CXL). Astigmatism was modelled on both eyes of rabbits. A randomly selected eye of each rabbit was treated by the proposed CXL procedure with another eye as control. The proposed procedure was performed by a self-built intelligent platform through delivering ultraviolet A lattice in a refined and patterned manner, based on pre-operative corneal topography. The long-term effectiveness, stability, and safety were investigated for 180 days, with topographic measurements, anterior segment optical coherence tomography (AS-OCT), and in vivo corneal confocal microscopy (IVCM). Spatially selective demarcation lines in AS-OCT images and trabecular patterned hyperdense structure with abundant needle-like processes in IVCM images were detected in the CXL eyes, revealing spatially selective crosslinking. Reductions of astigmatic magnitude (in the steep axis: 0.46 ± 0.28 vs. 2.15 ± 0.58 dioptres, P < 0.001) and high order aberration (0.38 ± 0.18 vs. 0.59 ± 0.19, P = 0.009) with increase of visual strehl ratio (0.21 ± 0.06 vs. 0.13 ± 0.03, P < 0.001) were found in the CXL eyes after CXL and maintained for 180 days, compared to inconspicuous changes in the control eyes. No obvious opacity and inflammation were observed in the CXL eyes, and transient loss of endothelial cells in the treated area was recovered in the subsequent visit. The proposed novel, non-invasive approach safely fulfilled corneal astigmatism correction with visual quality improvement as well as a decrease in high-order aberration.

Assessment of interocular symmetry of choroidal vascularity index and thickness in patients with systemic sclerosis: a prospective study.

Systemic sclerosis (SSc) affects blood vessels, internal organs, and skin. In ophthalmology, SSc impacts the choroid. The choroidal vascularity index (CVI) measures the vascular component of the choroid and may serve as a biomarker for the disease staging and prognosis. Studies have reported reduced choroidal thickness and altered CVI in SSc, which supports the theory of vascular damage. This study aimed to examine interocular symmetry in choroidal parameters among SSc patients. It has provided the insight into the disease symmetry and assessed the representativeness of examining one eye. This prospective single-center cross-sectional study included 33 patients with SSc and 40 healthy controls. The patients underwent ophthalmological examination (including refraction, visual acuity, IOP, biometry, slit-lamp biomicroscopy, dilated fundus examination, and spectral-domain optical coherence tomography) and rheumatological evaluation. Various parameters of the choroid in the macular and peripapillary regions were analyzed, including choroidal thickness, choroidal volume, and CVI. The interocular asymmetry in the choroidal parameters was quantified using signed and absolute differences. The correlation analysis between the left and right eyes was based on the intraclass correlation coefficient (ICC), Spearman's correlation coefficient, and paired Wilcoxon test. There were no significant differences in the macular and peripapillary choroidal parameters between fellow eyes in both SSc patients and controls (p > 0.05). The parameter that showed the lowest correlation among those examined was CVI-in both groups, as well as in both examined areas. The interocular correlation of choroidal parameters was stronger in the peripapillary area than in the macular area in both groups. In general, the results were confirmed in subgroup analyses stratified according to sex, SSc subtype, Scl70 antibody positivity and previous and/or active digital ulcers. There is interocular symmetry of the choroidal parameters in patients with SSc and controls included in our study. The parameters from one eye are representative of the fellow eye of a given patient. This conclusion may contribute to the design and interpretation of future studies. It also broadens our knowledge of SSc pathophysiology.

Peripapillary and Macular Microvasculature of the Retina in Primary Angle Closure Suspect

Purpose: To compare the macular and peripapillary vascular parameters between the primary angle closure suspect (PACS) eyes and normal control eyes using optical coherence tomography angiography (OCTA).Methods: In this retrospective study, 42 PACS subjects and 38 normal individuals are included. Vessel density (VD) and perfusion density (PD) of the macular area and peripapillary area, and fovea avascular zone parameter were analyzed using OCTA and compared between two groups after adjustment for the axial length.Results: There were no statistically significant differences in sex ratio, age, refractive errors and intraocular pressures between both groups. In the peripapillary area, inferior VD and PD in the outer zone were significantly lower in the PACS eyes, while the retinal nerve fiber layer thicknesses were similar between groups (&lt;i&gt;p&lt;/i&gt; = 0.032, 0.026). In the macular superficial capillary plexus, inferior VD and PD in the inner zone, inferior VD and PD, nasal VD and PD in the outer zone were significantly lower in the PACS eyes, whereas ganglion cell inner plexiform layer thickness were similar between both groups (all &lt;i&gt;p&lt;/i&gt; &lt; 0.005).Conclusions: The VDs and PDs of retinal capillaries in PACS eyes, which have no glaucomatous changes in the retinal nerve fiber layer and optic nerve disc, were significantly lower compared to normal eyes.

A Novel Rabbit Model of Meibomian Gland Dysfunction-Induced Dry Eye.

The objective of this three-phase study was to develop a model of mild to moderate evaporative dry eye to be used to evaluate tear film stability endpoints during product development. Rabbits were sedated prior to ophthalmic cautery of meibomian gland orifices. The orifices of eyelid meibomian glands were half-cauterized (to yield obstruction of every other meibomian gland orifices), fully cauterized (to yield obstruction of all meibomian gland orifices), or untreated. The primary outcome measures were model repeatability, tear film break-up time (TBUT), non-invasive tear break-up time (NIBUT), and model confirmation with daily artificial tears. Other examinations included Draize score, tear production, fluorescein staining, eschar, and histopathology. Cauterization was well tolerated in all phases. In phase I, TBUT was significantly decreased compared to baseline on days 14, 21, 28, and 35 in fully cauterized meibomian gland orifices but not in half-cauterized meibomian gland orifices. In phase II, both NIBUT and TBUT were similarly and significantly reduced in the fully cauterized meibomian gland orifices compared to the control eyes on days 7, 9, 14, and 28. In the confirmation phase, the administration of eye drops significantly improved NIBUT over the course of the study. A rabbit model of dry eye was successfully and safely created through the obstruction of meibomian gland orifices by cautery, which yielded a significant reduction in tear film stability. A quantifiable benefit of artificial tears relative to untreated control was demonstrated within the model. When the model is deployed, the utility and efficacy of therapeutic formulations can be evaluated.

Laser speckle flowgraphy reveals widespread reductions in ocular blood flow in non-exudative age-related macular degeneration.

To evaluate whether and where laser speckle flowgraphy (LSFG)-derived indices of ocular blood flow are reduced in non-exudative age-related macular degeneration (AMD) compared with age-matched control subjects. Retrospective case-control study PARTICIPANTS: 39 eyes of 24 subjects with AMD and 41 eyes of 21 healthy controls were included. Subjects with non-exudative AMD in the early, intermediate, or advanced stage underwent blood flow imaging with LSFG and were compared to age-matched control subjects. Mixed-effects models accounted for correlations between eyes in the same patient. Logistic regression evaluated the effect of ocular perfusion pressure and other factors associated with blood flow. Blood flow data was analyzed in two ways: by binary threshold for the primary analysis and through a superpixel-based method to map the territory of very low flow. Choroidal blood flow and inner retinal blood flow in AMD and control eyes. Choroidal blood flow as measured by the LSFG in arbitrary units (AU) was reduced by 33% in AMD patients vs controls (5.3±0.3 AU vs 7.9±0.5 AU respectively, P = .00005). Inner retinal blood flow was also significantly reduced in AMD (12.5±0.6 vs 15.6±0.5 AU, P = .004). Ocular perfusion pressure showed no significant difference between AMD and control groups (50±5.5 vs 53±6.7 mmHg respectively, P = .17), indicating that neither elevated intraocular pressure nor low blood pressure could account for the reduced blood flow. In most cases, the area of lowest blood flow was large and diffuse, exceeding the abnormal area affected by non-exudative AMD. Controlling for other subject and eye characteristics, an eye with 10%, 25%, or 50% below the average normal choroidal blood flow was more likely to have AMD, with an odds ratio of 2.27, 7.76, and 60.1, respectively (P = .026). Laser speckle flowgraphy showed lower choroidal and inner retinal blood flow in non-exudative AMD patients compared to age-matched controls, not explained by low perfusion pressure. Areas of reduced blood flow greatly exceeded the territory of choroidal atrophy, emphasizing its role as a risk factor for the development and potential progression of dry AMD.

In vivo implantation of the grosso shape‐memory implant for corneal shape and strength restoration

Aims: The GROSSO® implant is an ophthalmic medical device designed to reshape the ectatic cornea. The primary aim of this study is to assess for the first time the surgical implantation and safety of the device in vivo in a preclinical study done in rabbits.Methods: A 9‐9.5mm diameter circular corneal pocket located at 2/3 of the minimum corneal thickness was created by femtosecond laser in the right eye only. In 8 control eyes the pocket was manually separated while in the GROSSO® group with 12 eyes, the implant was manually inserted through the access cut while being folded with a 6‐0 vicryl suture. After insertion in the intrastromal pocket, the suture was cut and the device was atraumatically unfolded inside the pocket. Intraocular pressure, tomography, biomechanics, in vivo confocal microscopy (IVCM) were evaluated before operation and postoperatively at 1 week and 1,2,3 and 6 months. Haze and neovascularization scoring was used to assess the inflammatory reaction to the implant.Results: All surgeries were successfully completed but with a variable eccentric ablation due to the applanation which is designed in the femtolaser for the human cornea. Haze and neovascularisation did not differ between groups, with haze returning to preoperative levels at 3 months. Neovessels were detected in 5 GROSSO® and 2 control eyes at 1 month and were located outside or in the periphery of the implant and then they were treated with topical steroids resulting in vessel regression. The GROSSO® implantation did not alter the intraocular pressure or central corneal thickness compared to controls. Biomechanical strength of GROSSO® group increased relative to controls and preoperative levels, and IVCM showed minimal inflammation around the implants. The GROSSO® group had lower keratometry values at 1 month that remained stable to 6 months, while controls experienced changing keratometry up to 6 months.Conclusions: The GROSSO® medical device can be safely implanted in the corneal stroma with laser‐assisted surgery. Postoperative inflammation was present in both treatment groups and minimal and could be treated with topical steroids. There were no changes in intraocular pressure or corneal thickness in the GROSSO® group and implanted corneas became flatter and biomechanically stronger thanks to the presence of the GROSSO® medical device.

A Comparison of the corneal biomechanical properties in pseudoexfoliation glaucoma, primary open angle glaucoma, and healthy subjects using corvis scheimpflug technology

Aims/Purpose: The purpose of this study was to compare corneal biomechanical properties using Corvis Scheimpflug Technology (ST) among pseudoexfoliation glaucoma (PXG), primary open angle glaucoma (POAG), and healthy controls.Methods: Sixty eyes of 60 patients were enrolled in the study. These include 20 eyes with PXG, 20 eyes with POAG and 20 eyes of normal controls. Corneal biomechanical properties measured by Corvis ST were compared among PXG, POAG, and normal control groups. Corneal biomechanical parameters, which included deformation amplitude (DA) ratio maximum (Max) (2mm), Ambrosio relational thickness (ARTh), Integrated radius, and corneal biomechanical index (CBI), were compared and analyzed after adjusting for intraocular pressure and age.Results: There were no significant differences in age, central corneal thickness, and intraocular pressure among the PXG group, POAG group, and normal control group (p = 0.133, p = 0.797, and p = 0.983, respectively). The DA ratio Max (2mm) value was significantly higher in the PXG group compared to normal control group after adjusting for IOP and age (4.48 ± 0.07 vs. 4.22 ± 0.07, p = 0.026). The Integrated Radius value was significantly higher in the PXG group compared to the POAG group after adjusting for IOP and age (8.42 ± 0.18 vs. 7.85 ± 0.17, p = 0.072).Conclusions: PXG showed significant differences compared to POAG and normal controls in corneal biomechanical properties. Even after adjusting for intraocular pressure and age, the cornea in the PXG group exhibited greater flexibility and deformation compared to the POAG and normal control groups. These results suggest that corneal biomechanical properties may influence intraocular pressure measurement in PXG patients and may be related to optic nerve vulnerability.

Panretinal photocoagulation for the treatment of proliferative diabetic retinopathy

After the completion of DRS study in 1979, Panretinal Photocoagulation (PRP) became the gold standard for the treatment of proliferative diabetic retinopathy.Light from the laser is absorbed by the retinal pigment epithelium (RPE), and the underlying choroid and it is converted to thermal energy. Those thermal burns denature tissue protein, causing local retinal cell death, coagulative necrosis and eventually scarring. In that respect, laser photocoagulation leads to diminished oxygen demands of the areas of capillary non perfusion, and reduced expression of vasoactive factors such as vascular endothelial growth factor (VEGF) and protein kinase C (PKC) in the retina. As a result, adequate oxygen and nutrients are diverted towards the non‐ischemic retinal areas.As documented by the DRS study, after a 5‐year follow‐up period, the rates of severe visual loss were diminished by at least 50% in all eyes treated with PRP in comparison with untreated control eyes. The greatest beneficial effect was shown for treated eyes with high risk PDR characteristics (any NVD with extent greater than or equal to one‐fourth disc area without vitreous or preretinal hemorrhage, any NVD with vitreous or preretinal hemorrhage,any NVE with extent greater than or equal to one‐half disc area, with vitreous or preretinal hemorrhage). Harmful effects of PRP includes peripheral visual field loss, decrease in visual acuity, nyctalopia etc. Treatment of non‐high risk PDR cases, could also be proposed under certain circumstances such as in patients with difficulty to attend regular appointments, advanced diabetic disease in the fellow eye etc.Although anti‐VEGF agents have been approved for the treatment of PDR, PRP remains an effective therapeutic option and the choice of treatment could be made on an individualized basis. However, in high risk PDR patients with co‐existing maculopathy the addition of anti‐VEGF injections to PRP treatment is advisable.

Multifocal electroretinogram evaluation of different optical coherence tomography patterns of diabetic macular edema

Purpose To correlate macular function to morphological patterns of diabetic macular edema (DME) observed by optical coherence tomography (OCT). Patients and methods This study included 100 DME eyes and 60 control eyes. OCT patterns of DME were divided into: Type 1: diffuse retinal thickening (DRT); Type 2: cystoid macular edema (CME); Type 3: neurosensory detachment (NSD); and Type 4: the combined type that was further subdivided into: Type 4a: DRT with CME, Type 4b: DRT with NSD, and Type 4c: CME with NSD. These types were correlated with LogMAR VA and P1 wave amplitude and implicit time of multifocal electroretinogram. Results In both central ring 1 and paracentral ring 2, P1 amplitude was significantly reduced in all types of DME compared with control group. P1 amplitude was highest in Type 1, and lowest in Type 4c compared with other DME types. P1 implicit time was significantly delayed in all types, and significantly delayed in Type 4c compared with Type 1. Conclusion DRT was the best type for macular function, CME was associated with decreased P1 wave amplitude in central macular ring, NSD was associated with decreased P1 wave amplitude in the paracentral macular ring, combined CME with NSD carried the poorest visual function. From a practical point of view, combining OCT and multifocal electroretinogram testing may offer a potent method to assess the degree of retinal injury.

Impact of citicoline and coenzyme Q10 (COQUN Combo) on retinal ganglion cell survival in a experimental glaucoma model

Aims/Purpose: Treatments for glaucoma damage have focused on lowering intraocular pressure (IOP). However, despite controlled IOP, the neurodegenerative process continues. Therefore, it is necessary to study new molecules with neuroprotective properties for treatment. The aim of this study was to investigate the survival of retinal ganglion cells (RGCs) in an experimental model of ocular hypertension (OHT) following the administration of a combination of citicoline and coenzyme Q10 (COQUN Combo).Methods: Four groups of Swiss albino mice were used: vehicle control (Vehicle, n = 6), COQUN Combo control (COQUN Combo, n = 5), laser with vehicle (LG+Veh, n = 6), and laser with COQUN Combo (LG+COQUN Combo, n = 6). COQUN Combo was administered daily mixed with gelatin, 15 days prior to laser induction and 7 days post‐induction in COQUN Combo and LG+COQUN Combo groups. The Vehicle and LG+Veh groups received only neutral gelatin. OHT was induced in the left eye by laser photocoagulation of the limbal and episcleral veins, analyzing hypertensive eyes and their contralateral. IOP was measured different time points after‐laser (24h, 48h, 3, 5, and 7 days). Retinal whole‐mounts were processed with 1) Anti‐Brn3a to semi‐automatically quantify the number of Brn3a+ RGCs; and 2) Anti‐melanopsin to manually quantify the number of melanopsin+ RGCs.Results: At 24 hours post‐laser, both vehicle and COQUN Combo hypertensive eyes exhibited a significant increase in IOP. However, the increase was lower in the COQUN Combo OHT eyes (p value &lt; 0.0001). In vehicle OHT eyes, the number of Brn3a+ RGCs was significantly lower compared to the vehicle control. However, the COQUN Combo‐treated OHT eyes maintained similar values to vehicle control eyes, as did the contralateral vehicle and contralateral COQUN Combo eyes. The number of melanopsin+ RGCs was similar in all study groups.Conclusions: The COQUN Combo may be a neuroprotective strategy in glaucomatous pathology.

Detection of Retinal and Choriocapillaris Microvascular Changes in Retinal Vein Occlusion and Fellow Eyes by Optical Coherence Tomography Angiography: A Systematic Review and Meta-Analysis.

This study aims to summarize the retinal and choroidal microvascular features detected by optical coherence tomography angiography (OCTA) in the affected and fellow eyes of patients with retinal vein occlusion (RVO). A comprehensive search of the PubMed, Embase, and Ovid databases was conducted to identify studies comparing OCTA metrics among RVO, RVO-fellow, and control eyes. Outcomes of interest included parameters related to foveal avascular zone (FAZ) and fovea- and optic nerve head (ONH)-centered perfusion measurements of superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris layer. Pooled results were presented as mean differences or standardized mean differences with 95% confidence intervals. Fifty-three studies, comprising 2119 RVO, 1393 fellow, and 1178 control eyes, were included in the quantitative meta-analysis. RVO eyes exhibited larger FAZ areas, increased FAZ acircularity, and reduced macular retinal and choriocapillaris perfusion compared to RVO-fellow and control eyes (P < 0.05). RVO eyes also demonstrated significantly lower perfusion density (PD) in the inside-disk and peripapillary regions of the radial peripapillary capillary layer (RPC), as well as lower retinal and choriocapillaris PD in the 4.5 × 4.5mm2 field of view (FOV) of ONH-centered scans (P < 0.05). RVO-fellow eyes showed decreased SCP-PD and DCP-PD in theparafoveal region and the 3 × 3mm2 FOV, reduced inside-disk and 4.5 × 4.5mm2 FOV RPC-PD (P < 0.05), and a diminished choriocapillaris flow area in the 3 × 3mm2 FOV (P < 0.05). Both RVO-affected and RVO-fellow eyes exhibited retinal and choriocapillaris microvascular impairment around the fovea and ONH. OCTA represents a promising tool for comprehensively assessing vascular alterations in RVO and providing evidence of fellow eye involvement.

Bilateral meibomian gland morphological alterations in unilateral herpes simplex keratitis based on artificial intelligence analysis.

To explore whether unilateral herpes simplex keratitis (HSK) can cause morphological changes of bilateral meibomian glands (MGs) based on artificial intelligence (AI) analytical system. In the retrospective study, 29 patients with unilateral HSK and 29 participants matched in terms of age and sex were included as control group. Meibographic images of the upper eyelid using Keratograph 5M and assessed ocular surface parameters including tear meniscus height and tear break-up time. MG density and vagueness values were automatically analyzed and calculated using an AI analytical system. We compared the differences between the affected and the contralateral unaffected eyes in HSK patients, and the normal control eyes. We employed either the paired t-test or the Wilcoxon signed-rank test to compare significant difference between the affected and unaffected eyes in HSK patients or between the HSK group and control group. The MG density was 0.19±0.09 in the HSK-affected eye and 0.18±0.07 in contralateral unaffected eye, which had no significant difference (P=0.616). The MG density between the affected eye with HSK and the normal control group was statistically significant (P=0.028). There was a significant difference in MG density between the contralateral unaffected eye and the normal control group (P=0.012). However, no significant difference in vagueness value was observed between the eye with HSK and the control group or between HSK eye and contralateral eye. The MG density between the HSK-affected eye and the contralateral unaffected eye don't significantly differ, whereas there is a significant decrease in the HSK group compared to that of the normal participants. Unilateral HSV keratitis may suffer from bilateral changes of MG morphology indicating bilateral dry eye. Therefore, the fellow eye of patients with unilateral HSK should be considered a potential case of MG dysfunction, necessitating early treatment for bilateral dry eye in the clinic.

Ocular Drug Delivery of Nanoparticles for Glaucoma

The nasolacrimal channels drain the medication from the pre-corneal area, causing the majority of the ophthalmic medication to be quickly removed following topical instillation. Over the past thirty years, newer medical techniques, such as in situ gel, nanoparticle, liposome, nanosuspension, microemulsion, iontophoresis, and occuserts have been created in an effort to overcome these challenges. These methods gradually and deliberately boost the drug's bioavailability. This article discusses ocular drug delivery for ophthalmics and its ideal characteristics, and also provides an insight on the use of nanotechnology in the form of nanoparticles used for the treatment of glaucoma in the eyes, employing HPH, ultrasonication/HSH, SE, SED technique, SFM, ME technique, SD method, DE method, PM, FUD, and other techniques to offer continuous and controlled IOP inside the eye chamber, make drug more ocularly bioavailable, and address a few pharmacological difficulties in ophthalmology. The creation of new drug delivery methods is currently gaining popularity, and this can facilitate the development of medicines for diseases that endanger eyesight.

Transmission Rates of UV-A and Green Light in an ex vivo Corneal Cross-linking Model for Infectious Keratitis.

To investigate the light transmission (LT) of UV-A and green light through infected corneas saturated with riboflavin or rose bengal in an ex vivo porcine model for infectious keratitis. University of Zurich and EMPA. Laboratory study. Ex vivo porcine eyes (n=162) were divided into three groups: control eyes, eyes infected with Staphylococcus aureus, and eyes infected with Pseudomonas aeruginosa. Corneas remained either uninfected, or were infected with S. aureus, and P. aeruginosa, respectively, and were either left untreated, or were instilled with 0.1% riboflavin or 0.1% rose bengal. Corneal buttons were prepared, and corneal LT was measured at 365 nm and 522 nm using a spectrophotometer. LTs were calculated and compared. Transmission electron microscopy (TEM) was used to visualize structural damage and bacteria within infected corneas. Riboflavin-saturated corneas infected by S. aureus or P. aeruginosa (LT = 0.77% [0.41-1.87] and 0.81% [0.23, 1.46]) exhibited 3.18-fold and 3.02-fold lower LTs than uninfected corneas (LT = 2.45% [2.15, 5.89]) (both p-values < 0.001). No LT difference was found between rose bengal-saturated corneas infected by S. aureus or P. aeruginosa and uninfected corneas (all LTs = 0.01% [0.01-0.01]; both p-values = 0.08). TEM showed bacteria on corneal stroma borders and occasionally inside the stroma. Our results indicate that the amount of light arriving at the corneal endothelium is substantially reduced in infected corneas. The total fluence of clinical PACK-CXL protocols can be safely increased substantially while maintaining a low risk of corneal endothelial damage.