Eye Examination Research Articles

The Chinese keratoconus (CKC) cohort study.

The Chinese keratoconus (CKC) cohort study is a population-based longitudinal prospective cohort study in the Chinese population involving a clinical database and biobanks. This ongoing study focuses on the prevention of KC progression and is the first to involve the effect of gene‒environment interactions on KC progression. The CKC cohort is hospital-based and dynamic and was established in Zhengzhou, China; KC patients (n = 1114) from a large geographical area were enrolled from January 2019 to June 2023, with a mean age of 22.23 years (6‒57 years). Demographic details, socioeconomic characteristics, lifestyle, disease history, surgical history, family history, and visual and social function data are being collected using questionnaires. General physical examination, eye examination, biological specimen collection, and first-degree relative data were collected and analyzed in the present study. The primary focus of the present study was placed on gene, environment and the effect of gene‒environment interactions on KC progression. The follow-up of the CKC cohort study is expected to include data collection at 3 months, 6 months, and 1 year after the initial examination and then at the annual follow-up examinations. The first follow-up of the CKC cohort study was recorded. A total of 918 patients completed the follow-up by June 1, 2023, with a response rate of 82.40%. Aside from the younger age of patients who were followed up, no significant differences were found between patients who were followed up and patients who were not.

Ocular Manifestation of the Pediatric Age Group in Almarj

Children are disproportionately affected by visual disorders like refractive errors, amblyopia, and strabismus. Early intervention and vision screening are crucial. The study aims to investigate the ocular manifestation among children of the age group 4–15 years. A cross-sectional study conducted at Marj Teaching Hospital in 2024 examined 100 children with ophthalmological conditions. The examinations included slit lamp examinations, visual acuity assessments, spherical refractive error measurements, and dilated retinal exams. The study examined children aged 4-15 years old, with 59% being male and 43% female. Diagnosis revealed a range of ocular conditions, with astigmatism being the most common at 48%. There were significant differences in visual acuity between males and females (p<0.001), particularly in left eye visual acuity without glasses. There was no significant difference in visual acuity between age groups when wearing or not wearing glasses. However, there was a trend towards better right-eye visual acuity for children aged 4-10 years compared to those aged 11-15 years (p<0.001). Refractive errors with a higher prevalence of simple astigmatism in females compared to males. High hypermetropia was only present in females, suggesting some differences in refractive errors between males and females, particularly hypermetropia. The study emphasizes the significance of regular eye examinations for detecting and addressing visual impairments, and calls for further research into factors contributing to these conditions, particularly male-female differences, to improve eye health and quality of life. we highly advocate assessing the visual acuity of preschool children in order to prevent amblyopia.

Assessment of Relation between Periodontal Disease and Macular Degeneration.

Periodontal disease may result in chronic inflammation and bacteremia in some people. The study aimed to evaluate the connection between periodontal disease and macular degeneration. The specialist dental surgeon conducted the dental examination using a community periodontal index probe. An ophthalmologist performed the eye examination. Age-related macular degeneration (AMD) was identified through specific criteria such as the existence of particular types of drusen and pigmentary abnormalities. Two hundred participants were part of the study. According to the data, factors such as advanced age, limited education, low income, hypertension, cardiovascular disease (CVD), and hepatitis B surface antigen (HBsAg) presence were strongly linked to AMD in all participants. Multiple studies have indicated a connection between periodontitis in the mouth and macular degeneration in individuals under 60 years of age.

COMBINED CENTRAL RETINAL VASCULAR OCCLUSION AS THE PRESENTING FEATURE IN β-THALASSEMIA WITH IRON DEFICIENCY ANEMIA.

To report a case of β-thalassemia trait with iron deficiency anemia presenting as a combined central retinal vein and artery occlusion. Case report. A 22-year-old woman presented with sudden-onset blurry vision in the left eye of 3-day duration. Best-corrected visual acuity was 20/20 and 20/1000 in right and left eyes, respectively. Fundus examination of the left eye revealed optic disk edema, macular whitening with a cherry-red spot, markedly dilated and tortuous retinal veins, and hemorrhages both around the disk and extending into the macula and the periphery. Fundus fluorescein angiography showed delayed filling of retinal vasculature, dilated and tortuous retinal veins, and blocked fluorescence around and beyond the optic disk. Optical coherence tomography scan at presentation showed hyperreflective inner retinal layers with neurosensory detachment. Optical coherence tomography angiography showed that the vessel densities of superficial and deep capillary plexus were remarkably reduced. A diagnosis of β-thalassemia trait combined with iron deficiency anemia was made after hematologic workup. The patient was treated with a course of oral iron supplements, vasodilator (compound Xueshuantong), inhalation of a mixture of 5% carbon dioxide and 95% oxygen, and a nutritional agent (compound anisoine). Six months later, her visual acuity improved to 20/60 in the left eye with complete resolution of all clinical signs. Combined central retinal vein and artery occlusion is a rare emergency leading to acute vision loss and can manifest in patients with β-thalassemia trait with iron deficiency anemia. Prompt diagnosis and early management is important to treat underlying systemic disorders and to prevent occurrence of a similar episode in fellow eye.

The eye in forensic practice: In the dead.

Post-mortem examination of the eye provides valuable forensic information yet is often overlooked. This brief review focuses on determining the cause/manner of death and post-mortem interval. External eye findings like corneal haziness and tache noire, combined with post-mortem changes in the iris, lens, retina and vitreous humour, can help estimate time since death. Ocular biometrics (iris/retinal scans) may facilitate identification. Age-related ocular changes can provide insights. The eye offers clues into personality (corneal tattooing, trichotillomania) and cause of death (petechiae in strangulation, retinal haemorrhages in abusive head trauma). Ocular trauma and underlying eye disease may be evident. Toxicology of vitreous humour can detect drugs/poisons. As a window into systemic disease and age-related changes, the eye aids pathology interpretations and, accordingly, post-mortem examinations have value. Ocular findings should not be overlooked in forensic examinations as they provide distinct information in determining cause/manner of death and post-mortem interval.

Demographic distribution of allergic conjunctivitis in selected schools in Ovia North East Local Government Area, Benin City, Edo State

Background: The burden of allergic diseases and conjunctivitis has been on the increase, especially in developing countries, prompting several studies across varying populations to investigate the causes and prevalence of these conditions. Epidemiological studies have been concerned largely with the prevalence of allergic conjunctivitis in the adult population and little is known about its prevalence in the paediatric population. The purpose of this study was to determine the prevalence of allergic conjunctivitis among school children in Ovia North East Local government Area, Benin City. Materials and Methods: A cross-sectional study was conducted using a sample size of 300 children aged 5 to 17 years from selected schools. Case history was taken through a structured questionnaire after which the children were screened. Visual acuity was measured using the Snellen Acuity chart. Internal and external eye examinations were done using a direct ophthalmoscope, magnifying loupe and penlight respectively. Data obtained was presented in percentages and tables. Chi square test was utilized to test for association between variables. Results: A total of 190 participants were examined: 78 males and 112 females (12.9± 2.39 years). The study revealed that allergic conjunctivitis was present in 48.4% (92) of the participants, with itching being the most commonly experienced symptom. There was no association between allergic conjunctivitis and either age or gender (p<0.05). Conclusion: Allergic conjunctivitis was prevalent among children in the southern part of the country, stating the need for enlightenment among parents/guardians, use of relief methods, and recommendation of further research.

Five-year results of atropine 0.01% efficacy in the myopia control in a European population

AimsTo evaluate the efficacy and safety of 0.01% atropine eye-drops in controlling myopia progression over 5 years.MethodsExperimental, analytical, prospective, randomised and longitudinal study, in 361 right eyes from 361 children...

Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

ObjectiveTo report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.DesignCross-sectional study.SettingHomes for the aged centres in Hyderabad,...

Pregnancy and diabetic retinopathy

Background: An increase in the worldwide prevalence of diabetes, especially among younger populations, has led to a higher prevalence of pre-existing diabetes among pregnant women. The precise mechanisms underlying the development or progression of diabetic retinopathy (DR) during pregnancy are not entirely understood. This narrative review incorporates all available data to offer fresh insights into the pathogenesis and mechanisms of the pregnancy-induced development and/or progression of DR. Moreover, the author aims to offer clinical recommendations for DR both before conception and during pregnancy to appropriately counsel these susceptible patients. Methods: A literature search was performed using various combinations of the following keywords: diabetes, pregnancy, diabetic retinopathy, ocular, eye, retina, microangiopathy, mechanism, pathophysiology, hyperglycemia, hypoxia, neovascularization, growth factors, immune system, blood flow, and recommendations. The search was conducted using PubMed/MEDLINE, ISI Web of Science, Scopus, and Google Scholar, and only English articles published from January 1, 2020, to December 31, 2023, involving human participants, were considered. The International Diabetes Federation Diabetes Atlas website was searched for clinical recommendations. Results: Pregnancy-induced hyperglycemia, blood flow changes, growth factors, and the immune system play important roles in the development and progression of DR. Hyperglycemia leads to significant stress on the capillary endothelium through increased glucose flux via the polyol and hexosamine pathways, activation of protein kinase C, and increased formation of advanced glycation end-products. These pathways act in several ways that may lead to increased oxidative stress, inflammation, and vascular blockage. Thus, eye examinations are crucial before, during, and up to 12 months after pregnancy. Individuals with severe non-proliferative and proliferative DR should gradually decrease their blood glucose levels to near-normal levels over a period of 6 months before conception. Statins and medications inhibiting the renin–angiotensin system should be discontinued before pregnancy or at the initial antenatal visit if they are still being used. Retinal examinations should be performed shortly after conception and during the first trimester using tropicamide eye drops and digital imaging. Subsequent examinations should be scheduled based on DR severity at the initial examination. Conclusions: While the precise mechanism underlying the progression of DR during pregnancy remains uncertain, the available literature suggests that pregnancy-induced hyperglycemia, blood flow changes, growth factors, and the immune system play important roles in its development and progression. Pregnant women with diabetic eye manifestations benefit from the expertise of multidisciplinary teams comprising ophthalmologists, diabetologists, and gynecologists to improve both maternal and perinatal outcomes. Moreover, postpartum follow-up requires special attention.

Ocular manifestations of severe familial hypercholesterolemia

BackgroundTo study ocular manifestations of patients with severe familial hypercholesterolemia (FH). MethodsIn this population-based case-control study, patients suffering from severe familial hypercholesterolemia from the Lebanese Familial Hypercholesterolemia Registry, along with age and gender-matched healthy controls were recruited. All participants underwent a comprehensive eye examination, and patients underwent fluorescein angiography as well. Logistic regression models were used to identify any association between patients with severe familial hypercholesterolemia and abnormal eye findings, while adjusting for hypertension and pack-year smoking. The main outcome measure of this study was the development of ocular vascular abnormalities. Results28 patients and 28 controls were recruited. Patients with severe familial hypercholesterolemia had significantly greater odds of developing corneal arcus and xanthelasmas than the control group (p < 0.001). Retinal vascular abnormalities (plaques) were exclusively and more significantly present in patients with familial hypercholesterolemia (18 %). Similarly, retinal arteriosclerosis was exclusively and significantly more prevalent in the familial hypercholesterolemia group (p < 0.001, adjusted odds ratio 6.8). Stratification by LDL levels and genotypes did not show any significant change in the prevalence of any ocular finding. ConclusionIn addition to the well-established increase in incidence of corneal arcus and xanthelasmas, severe familial hypercholesterolemia patients have more prevalent retinal vascular abnormalities that include vascular plaques and arteriosclerosis.

Comparison of Air Puff Tonometer with Gold Standard Applanation Tonometer for Measurement of Intraocular Pressure in Adult Population

Detecting and treating glaucoma early is vital to prevent vision loss. Two main instruments, the Air Puff Tonometer and the Gold Standard Applanation Tonometer, are used to measure Intraocular Pressure (IOP). However, there is ongoing debate among ophthalmologists regarding the accuracy and reliability of these devices. Objective: To evaluate and contrast the measurements of intraocular pressure obtained through Air puff tonometry and Goldmann applanation tonometry. Methods: A cross-sectional comparative study was conducted upon 900 patients of Glaucoma, selected through purposive sampling technique, attending the Eye OPD of Isra University Hospital, Hyderabad. Patients with age more than 18 years, of both genders who provided consent for eye examination and treatment, were included in the study while patients with corneal disease or prior surgery, ocular trauma, or those presenting with active infection or ocular disease were excluded from the study. Results: 396 (44.0%) of patients were males and 504 (56.0%) were females. The results indicate that the mean IOP measurement for air puff tonometry (17.43 mm Hg) is significantly higher (p-value=0.0001) than the mean measurement obtained by Goldman tonometry (13.84 mm Hg). Overall, the distribution of IOP was similar for both types of tonometry, with a slightly higher proportion having high IOP values (19-22 mmHg) with Goldman tonometry compared to air puff tonometry. Conclusions: The findings of this research demonstrated a noteworthy contrast between the two techniques, where the air puff tonometry produced noticeably elevated intraocular pressure measurements in comparison to the widely accepted applanation tonometry

Colour Image Enhancement Model of Retinal Fundus Image for Diabetic Retinopathy Recognition

Diabetic retinopathy (DR) features are typically identified through ophthalmologist eye examinations, but these images often facechallenges like low contrast, non-uniform illumination, and colour inconsistency, affecting the diagnosis accuracy. Therefore, this studyintroduces two novel techniques to improve image quality. One is applying colour image processing techniques to original retinalfundus images, overcoming existing algorithm limitations. Firstly, a new colour correction algorithm was proposed based on TunedBrightness Controlled Single-Scale Retinex (TBCSSR) named Fuzzy TBCSSR Histogram Matching (fTBCSSRhm) to address the issue of colour inconsistency in the dataset. Secondly, based on hybrid particle swarm optimisation-contrast stretch (HPSOCS), the hybridof TBCSSR and HPSOCS named eTBCSSR-HPSOCS algorithm is introduced to tackle the limitations of the standard Particle SwarmOptimisation (PSO) algorithm in HPSOCS, which is prone to local optima and exhibits low convergence rates. This technique combinesthe L-component of the LAB colour model with an enhanced velocity mechanism in PSO and contrast stretching (lavHPSOCS). Its goalis to fine-tune parameters automatically, reduce over-enhancement, avoid unwanted artefacts, and preserve intricate details. This approach improves optimisation by balancing exploration and exploitation and refining velocity control. The proposed algorithm underwent both qualitative and quantitative evaluations. Tests on 100 retinal fundus images from primary datasets were performed to benchmark the algorithm against three existing approaches. The results show that the qualitative performance of the proposed enhancement is more favourable to ophthalmologist specialists than other images. Quantitatively, eTBCSSR-HPSOCS outperforms others with the lowest mean squared error (MSE) of 42.72859, the highest peak signal-to-noise ratio (PSNR) of 32.768, and entropy of 0.977.

Treatment of Meningiomas Involving the Optic Canal with Endoscopic Transnasal Decompression of the Optic Nerve

Management of patients with optic nerve sheath meningiomas (ONSMs) is controversial and the treatment strategy in this patient group is still up for discussion. Transnasal endoscopic orbital and optic nerve decompression aims to reduce the pressure in the orbit and on the optic nerve and thereby prevent vision loss. This article presents material from 7 cases of transnasal endoscopic orbital decompression. The study design is a retrospective cohort study. The aim was to include all patients with a meningioma residing along the nerve sheath and who were operated using endoscopic transnasal decompression of the orbit and if needed the optic canal at Odense University Hospital. Data from the medical records were collected and pre- and postoperative eye examinations were compared. In addition, it was recorded whether there were complications to the procedure and whether additional treatments were given. In total, 4 women and 3 men were included in the study. Four out of 7 patients experienced improvement in vision after the operation. One patient experienced unchanged vision and 2 patients experienced deterioration of vision after surgery. The current report of 7 patients with ONSM shows promising results for this surgical procedure as 4 out of 7 patients experienced improvement in their vision at follow-up examinations. The 2 patients who experienced deterioration of vision already had severely reduced vision preoperatively, which indicates that surgery should be considered before the vision becomes significantly reduced.

An Efficient Feature Selection and Extraction using Metaheuristic Technique for Diabetic Retinopathy

Diabetic retinopathy (DR) is associated with diabetes, which causes harm to the retina as a result of persistent elevated blood sugar levels, resulting in symptoms such as impaired vision. Regular eye examinations are crucial for the timely identification of any issues. The process of selecting characteristics in DR involves optimizing important features using a combination of Hybridized Weight-Optimized Particle Swarm Optimization and Whale Optimization Algorithm (HWOPSO-WOA). This leads to an enhancement in the accuracy of detection, which is crucial for appropriate diagnosis and therapy. Pre-processing encompasses the utilization of linear filters such as Sobel and Prewitt for image manipulation, mean filters for the reduction of noise, and Gaussian filters for the purpose of smoothing. Feature selection employs an objective function that considers significant performance measure, which utilizes binary encoding and conducts fitness evaluation. The methodology is utilized for the analysis of DR utilizing the Indian Diabetic Retinopathy Image Dataset. The results comprise convergence graphs, and a comparative analysis, which emphasize the greater accuracy and efficiency of the Proposed technique. Visual representations, such as fundus images with selected features, highlight the importance of the chosen features in detecting DR. The proposed HWOPSO-WOA achieves highest accuracy of 97.3% and minimal processing time 98.45seconds that outperforms the state-of-art techniques.

Chronic Serous Chorioretinopathy: A Case Study

Introduction Chronic central serous chorioretinopathy (CSCR) is characterized by persistent subretinal fluid that disrupts the outer layers of the retina and may lead to complications such as: outer retinal atrophy, increased risk of choroidal neovascularization (CNVM) and the potential for permanent vision loss. This report describes the clinical features of chronic CSCR. Case Presentation A 73-year-old male with a history of systemic steroid and inhaler use presented for a routine eye exam without visual complaints. Examination findings included normal visual acuity in both eyes and multiple areas of retinal hyper and hypopigmentation along the arcades with no macular involvement in the right eye; the left eye was unremarkable. Fundus photography and optical coherence tomography showed localized areas of outer retinal disruption and thinning near the optic nerve head and along the corresponding retinal areas of irregular pigmentation in the right eye; the left eye was unremarkable. Discussion In chronic CSCR, structural changes in the retina can lead to retinal dysfunction and permanent vision loss. Treatment options for chronic CSCR include photodynamic therapy, intravitreal anti-vascular endothelial growth factor therapy, or systemic steroid receptor blockers. Visual prognosis varies depending on the severity of the disease, age of onset, risk of CNVM and the degree of outer retinal degeneration. Conclusion Patients with chronic CSCR are at risk for permanent vision loss. The structural changes in the outer retina also increase the risk for CNVM. Hence, it is important that patients with chronic CSR receive regular eye examinations and are educated on the role of regular Amsler grid testing.

Panretinal handheld OCT angiography for pediatric retinal imaging

Comprehensive visualization of retina morphology is essential in the diagnosis and management of retinal diseases in pediatric populations. Conventional imaging techniques often face challenges in effectively capturing the peripheral retina, primarily due to the limitations in current optical designs, which lack the necessary field of view to characterize the far periphery. To address this gap, our study introduces a novel ultra-widefield optical coherence tomography angiography (OCTA) system. This system, specifically tailored for pediatric applications, incorporates an ultrahigh-speed 800 kHz swept-source laser. The system’s innovative design achieves a 140° field of view while maintaining excellent optical performance. Over the last 15 months, we have conducted 379 eye examinations on 96 babies using this system. It demonstrates marked efficacy in the diagnosis of retinopathy of prematurity, providing detailed and comprehensive peripheral retinal angiography. The capabilities of the ultra-widefield handheld OCTA system in enhancing the clarity and thoroughness of retina vascularization assessments have significantly improved the precision of diagnoses and the customization of treatment strategies. Our findings underscore the system’s potential to advance pediatric ophthalmology and broaden the scope of retinal imaging.

Molecular identification of the bacterium acute conjunctivitis by the method of sequensing gen 16S rRNA

Conjunctivitis is the most common eye disease, characterized by contextual inflammation, which can be caused by bacteria. The diagnosis of conjunctivitis is established based various factors, including the patients’s medical history, onset of eye symptoms, non-ocular symptoms, previous disease history, family medical history, allergies, and physical examination of the eyes, which may include assessments of visual acuity and vision field. Some cases of conjunctivitis require laboratory examinations to confirm the diagnosis. These may include cytological examination with Giemsa staining, Chlamydia Diagnostic Test, Nucleic acid amplification tests (NAATs) or Polymerase chain reaction (PCR), and microbiological tests. Microbiological examination helps identify the bacteria responsible for conjunctivitis and aids in treatment by prescribing antibiotics to suppress the growth of the infecting bacteria. While identification tests are not routinely performed, researchers often seek to determine the specific type of bacteria causing conjunctivitis infections, which may require several laboratory tests. Bacterial virulence plays a significant role, with genetic mutations potentially leading to severe infections of varying severity. Virulence genes encode proteins that express pathogenic properties. The species responsible for conjunctivitis can be definitively identified definitively through microbiological examination, utilizing methods such as the 16S Ribosomal RNA Sequencing (rRNA) technique, known for its accuracy and speed. This study aims to analyze the results of rRNA sequencing in cases of acute bacterial conjunctivitis caused by 16S rRNA genotyping. The research employed an exploratory metholodolot, with the results analyzed using the The Basic Local Alignment Search Tool (BLAST) tracking program database on the National Center for Biotechnology Information (NCBI) website. The findings revealed that Sphingomonas paucimobilis encoded the 16S rRNA using Universal Primary 27 F and 1492 R, obtained in a sequence size of 1351bp. The isolate demonstrated similarities to Sphingomonas paucimobilis.

Impact of diabetes on visual acuity and its association with blood glucose levels in diabetic patients attending Murtala Muhammad Specialist Hospital, Kano, Nigeria

Diabetic retinopathy is a known complication of Diabetes, underscoring the need for regular eye examinations and glycemic control. The aim of the study was to assess visual acuity (VA), and Fasting blood glucose (FBG) among diabetic patients at Murtala Muhammad Specialist Hospital Kano. It was a cross-sectional observational study consisting of 60 participants; 30 Diabetic patients &amp; 30 non-diabetic patients (controls), aged 30-60 years. Data was collected using questionnaire and FBG measured using glucometer. Data was analyzed using SPSS version 25, considering a p-value of &lt;0.05 as statistically significant. Majority of the participants were aged 51-60, with most diabetics having the disease for 1-10 years. Diabetic patients exhibited severe visual impairment (VI) in both eyes, followed by moderate VI, contrasting with controls who mostly had normal VA. Significant differences were noted between controls and diabetics in terms of duration of diabetes (DOD), VA, and FBG, but not age. While no significant gender differences were found in age, VA, or DOD within diabetic and control groups. Female diabetics had slightly higher FBG levels than males. Also, a significant relationship was observed between DOD and VI in the right eye of diabetic patients. In conclusion, this study reveals that diabetic patients had a higher frequency and more severe VI compared to controls, with significantly elevated FBG. No significant differences in age, DOD, VA, or FBG levels between genders in both groups. However, the severity of VI increased with DOD in the right eye. This emphasizes the importance of regular eye examinations and improved glycemic control to minimize the risk of VI in diabetics.

Exploring Pediatric Vision Care: Insights from Five Years of Referral Cases in the UCI Eye Mobile and Implications of COVID-19.

To analyze referral rates, patient demographics, referral indications, and the impact of socioeconomic factors on ocular health from the University of California Irvine (UCI) Eye Mobile for Children, particularly during the coronavirus disease 2019 (COVID-19) pandemic. A retrospective chart review was performed on de-identified records of children examined on the UCI Eye Mobile. GraphPad Prism 10.0.0 and Python software were used for statistical analyses. In the academic years from 2018 to 2022, 3,619 children received comprehensive eye examinations on the UCI Eye Mobile. Among them, 76 were referred to a pediatric ophthalmologist. The majority of these children were Hispanic (72.6%, 54 of 74), followed by Asian (10.9%, 8 of 74). A significant proportion (82.9%, 63 of 76) attended school districts with median incomes below that of Orange County. Statistically significant differences were found in age (P = .001; pre-COVID: 3.98 ± 1.08 years vs COVID: 5.75 ± 2.92 years) and gender (P = .023; pre-COVID female: 31 of 41 vs COVID female: 15 of 32) between the pre-COVID and COVID years. Additionally, there were significant differences in the proportion of children with hyperopia with astigmatism between the pre-COVID and COVID years (P = .044; pre-COVID: 23 of 40 vs COVID: 12 of 35). The most common indications for ophthalmologist referrals were for strabismus evaluation/treatment (28.9%, 22 of 76), followed by abnormal cup-to-disc ratio (21.1%, 16 of 76). The study highlights the pivotal role of the UCI Eye Mobile for children in identifying ocular conditions needing referrals to subspecialty care. The majority of children needing these referrals attended schools in lower economic communities. Additionally, the COVID-19 pandemic appears to have influenced the demographic and clinical characteristics. [J Pediatr Ophthalmol Strabismus. 20XX:X(X):XXX-XXX.].

Histological Findings in the Eyes of Abcc6 Knockout Rat Model of Pseudoxanthoma Elasticum.

To describe the ocular findings of murine pseudoxanthoma elasticum (PXE) models with ATP-binding cassette subfamily C member 6 (Abcc6) gene knockout. This experiment was conducted in four Abcc6-/- rats and compared with six wild-type Abcc6+/+ control rats. The animals underwent necropsy at 6 months of age. Histological examination of the eyes was performed. Histological examination of eight eyes from four Abcc6-/- rats revealed multiple nodular foci of calcification in the uvea, sclera, and conjunctiva, focally in perivascular distribution, as well as linear and nodular calcification of Bruch's membrane. Calcific foci were not associated with inflammation in the knockout rats. There was no evidence of calcification in control eyes. The Abcc6-/- rat model shows that PXE can affect multiple ocular tissues beyond the calcification in Bruch's membrane noted in human eyes. Nodular calcific foci probably correspond to comet lesions seen in patients with PXE. The presence of ectopic calcium without inflammation distinguishes it from inflammatory calcium deposition in atherosclerosis. Further studies are needed to determine why PXE does not cause inflammatory infiltration. The Abcc6-/- murine model may be suitable for studying ocular PXE pathophysiology and ectopic calcification and developing effective therapies.