Eye Pathologies Research Articles

Longitudinal Assessment of Ocular Biomarkers in Individuals With Gulf War Illness Symptoms.

Gulf War illness (GWI) is characterized by a constellation of symptoms, including, but not limited to, diarrhea, fatigue, and memory problems that affect Gulf War veterans. Currently, there are no objective biomarkers for GWI. Previous studies have identified differences in optical coherence tomography (OCT) metrics between individuals with GWI symptoms and those without. However, there are limited data on how these metrics change over time. Therefore, in this current study, we conducted a prospective case-control investigation to determine if OCT metrics show longitudinal changes in those affected by GWI. We conducted a prospective study with 100 Gulf War-era veterans at the Miami Veterans Affairs Hospital from November 2018 to February 2022. Inclusion criteria required service during 1990-1991, with both deployed and nondeployed veterans included. Exclusions were based on factors like active infection, unmanaged psychotic disorders, significant head injuries, severe neurological disorders, and eye pathologies affecting OCT imaging. All participants provided informed consent, and the study was institutional review board-approved and conducted per the Declaration of Helsinki and Health Insurance Portability and Accountability Act guidelines. GWI symptoms were assessed using the modified Kansas questionnaire, categorizing veterans into groups based on GWI symptoms presence and deployment status. Data on demographics, comorbidities, medications, and medical and ocular diagnoses were collected. Participants underwent OCT imaging at 2 time points, 1 year apart, with macular, retinal nerve fiber layer, and ganglion cell layer-inner plexiform layer (GCL-IPL) thicknesses measured. Additionally, blood samples were collected and cytokine levels measured at baseline. Data analysis involved descriptive statistics, t-tests, and multivariable regression models. Statistical analyses were performed using SPSS 28.0. Logistic regression demonstrated that post-traumatic stress disorder (odds ratio [OR]: 8.18, 95% confidence interval [CI]: 2.327-28.851, P = .001) and a lower baseline macular thickness in the outer nasal segment (OR: 0.959, 95% CI: 0.924-0.994, P = .023) remained significantly associated with GWI symptoms. The model also found that individuals with GWI symptoms were more likely to have an increase in inner temporal GCL-IPL layer thickness over a 1-year period (OR: 1.187, 95% CI: 0.974-1.447, P = .089). When analysis was conducted only among those deployed, only baseline interleukin (IL) 1a (OR = 1.24, CI = 1.019-1.52, P = .03) and interleukin-10 (OR = 0.95, CI = 0.91-0.99, P = .02) levels remained significantly associated with GWI symptoms. Baseline OCT measures, especially a thinner outer nasal macula, were associated with GWI symptoms. Longitudinally, individuals with GWI symptoms had greater thickening of their inferotemporal GCL compared to those without symptoms. When the model was re-examined in deployed veterans, OCT measures (at baseline and longitudinally) no longer remained significantly related with GWI symptoms and instead baseline levels of plasma inflammatory cytokine markers, IL1a and IL10, were most closely related to symptoms. Our longitudinal study builds on our previous retrospective and cross-sectional work on identifying ocular biomarkers in GWI. Across the studies, macular thinning at baseline and inferotemporal GCL-IPL thickening have been noted between cases and controls. Some of these findings share correlates with OCT biomarkers identified in conditions such as Alzheimer's, Parkinson's and Multiple Sclerosis. This is significant as it may help contextualize future research and help us develop better models of GWI.

Information-extreme machine learning of an ophthalmic diagnostic system with a hierarchical class structure

The paper considers the method of hierarchical information-extreme machine learning for the system of ophthalmic diagnosis of eye pathology. Since the proposed method is developed within the framework of a functional approach to modeling the cognitive processes of natural intelligence, it, unlike neuro-like structures, acquires the properties of flexibility when retraining a diagnostic system and requires an order of magnitude fewer image samples. In addition, the decision rules based on the results of machine learning within the geometric approach in the form of a binary hierarchical structure of recognition classes ensure their practical invariance to the multidimensionality of both the space of diagnostic features and the alphabet of recognition classes. The modified Kullback-Leibler information measure, which is considered as a function of the accuracy of classification solutions, is chosen as a criterion for optimizing the parameters of the machine learning system for diagnosing eye pathologies. A hierarchical information-extreme machine learning algorithm for an ophthalmic diagnostic system for six eye pathologies was developed and programmatically implemented. Based on the results of functional diagnostics, it has been experimentally proved that the constructed decision rules are error-free according to the training matrices of recognition classes of each level of the constructed binary hierarchical structure.

Optical and Electronic Expert System for Diagnosing Eye Pathology in Glaucoma

For the first time, mathematical models for evaluating biomedical images were obtained using fuzzy set methods on the basis of expert knowledge bases, thus making it possible to carry out complex qualitative diagnostics and increase the reliability and efficiency of diagnosis. A methodology for analyzing biomedical images was formed based on the fuzzy set apparatus, which allowed a fuller assessment of the level of disease for glaucoma patients. Aspects of the practical implementation of the optical–electronic system for biomedical information processing were considered. An algorithm and an optical–electronic system for biomedical image analysis are proposed, and they can be used to increase the informativeness and reliability in the diagnosis of eye pathologies and glaucoma in particular.

The effects of COVID-19 severity on health status in Kazakhstan: A prospective cohort study

On May 5, 2023, the World Health Organization announced the end of the coronavirus pandemic. Nonetheless, there are growing reports indicating that individuals who have contracted COVID-19, especially in its more severe manifestations, may endure medium-to long-term impacts of the condition.The purpose of this study was to investigate the impact of the severity of COVID-19 on the subsequent health outcomes. MethodsThe prospective cohort study ran from March to October of 2021.482 study participants were divided into two cohorts: the first cohort encompassed 118 individuals who received hospital care, while the second cohort included 364 individuals receiving outpatient care. Propensity Score Analysis was used as the probability of being hospitalized for COVID-19 in logistic regression as a covariate, to account for the influence of intervening factors that were associated with the probability of being hospitalized for COVID-19. The odds ratio (OR) was the association metric that was applied. ResultsPatients with more severe COVID-19 are more prone to infectious and parasitic diseases ORadj 6.61 (with 95 % CI 1.84–23.75), p = 0.004, more likely to show complications from the respiratory system ORadj 2.37 (with 95 % CI 1.35–4.16), p = 0.003, more frequently diagnosed eye pathologies ORadj 5.60 (with 95 % CI 1.96–15.98), p = 0.001, susceptible to hospitalization, ORadj 3.49 (1.78–6.84), p < 0.001. ConclusionOur study's findings indicate that patient with more severe COVID-19 have a higher requirement for medical attention regardless of other factors that influence the need for medical care.

The Relationship Between Gut Microbiome and Ophthalmologic Diseases: A Comprehensive Review.

The gut microbiome has been studied in recent years due to its association with various pathological pathways involved in different diseases, caused by its structure, function, and diversity alteration. The knowledge of this mechanism has generated interest in the investigation of its relationship with ophthalmologic diseases.Recent studies infer the existence of a gut-eye microbiota axis, influenced by the intestinal barrier, the blood-retina barrier, and the immune privilege of the eye. A common denominator among ophthalmologic diseases that have been related to this axis is inflammation, which is perpetuated by dysbiosis, causing an alteration of the intestinal barrier leading to increased permeability and, in turn, the release of components such as lipopolysaccharides (LPS), trimethylamine oxide (TMAO), and bacterial translocation. Some theories explain that depending on how the microbiome is composed, a different type of T cells will be activated, while others say that some bacteria can pre-activate T cells that mimic ocular structures and intestinal permeability that allow leakage of metabolites into the circulation. In addition, therapies such as probiotics, diet, and fecal microbiota transplantation (FMT) have been shown to favor the presence of a balanced population of microorganisms that limit inflammation and, in turn, generate a beneficial effect in these eye pathologies. This review aims to analyze how the intestinal microbiome influences various ocular pathologies based on microbial composition and pathological mechanisms, which may provide a better understanding of the diseases and their therapeutic potential.

Spontaneous recovery from amblyopia following fellow eye vision loss: a systematic review and narrative synthesis

BackgroundThe effectiveness of traditional amblyopia therapies is largely restricted to childhood. However, spontaneous recovery in adulthood is possible following vision loss in the fellow eye due to enucleation, injury, or disease. The twofold purpose of this study was (1) to define the incidence of recovery and (2) to elucidate the clinical features associated with greater amblyopic eye gains. MethodsA systematic review of three databases yielded 24 reports containing 110 cases of patients ≥18 years old with unilateral amblyopia and vision-limiting fellow eye pathology. ResultsOur analysis revealed that 25 of 42 of adult patients (59.5%) gained ≥2 logMAR lines in the amblyopic eye after fellow eye vision loss. The degree of improvement is clinically meaningful (median, 2.6 logMAR lines). Recovery occurs within 12 months of initial loss of fellow eye vision. Regression analysis demonstrated that younger age, worse baseline visual acuity in the amblyopic eye, and worse vision in the fellow eye independently conferred greater gains in amblyopic eye visual acuity. Recovery occurs across amblyopia types and fellow eye pathologies, although disease entities affecting fellow eye retinal ganglion cells demonstrate shorter latencies to recovery. ConclusionsAmblyopia recovery after fellow eye injury demonstrates that the adult brain harbors the neuroplastic capacity for clinically meaningful recovery, which could potentially be harnessed by novel approaches to treat adults with amblyopia.

Long term results of punctoplasty with canalicular triangular flap in punctal stenosis.

The aim was to describe the punctoplasty technique with canalicular triangular flap, and present the long-term results of the technique in patients with inferior punctal stenosis. The files of the patients who were diagnosed with punctal stenosis grade 0, 1, and 2 and underwent a canalicular triangular flap were evaluated retrospectively. The study was approved by the local ethical committee of the University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul. The demographic data, symptoms, prior interventions, punctal stenosis grading, associated eye pathologies, fluorescein clearance test, Munk score, and follow-up time were recorded. The puncta were evaluated biomicroscopically, and photographs were taken at each visit. The patients with at least 6 months of follow-up were included in the study. The loss of epiphora symptom, positive dye disappearance, and puncti ≥grade 3 opening were accepted as a success. A hundred and nine inferior puncti of 64 patients with symptoms of epiphora and punctal stenosis diagnosis were included in the study. Thirteen eyes were excluded as they were diagnosed to have punctal atresia or canalicular stenosis of a variable degree beyond punctum. The rest 96 eyes of 55 patients-65 eyes of 36 females and 31 eyes of 19 males-were included in the study as having pure punctal stenosis. The mean age of the patients was 64.3 ± 9.01 years (40-88 years). Forty-one patients had bilateral and 14 patients had unilateral punctal stenosis. Sixty-six were grade 1, and 30 were grade 2. Epiphora was the most commonly reported symptom.The mean follow-up time was 21.17 ± 10.5 months (6-46 months). In 76 (79.1%) eyes of 96, Munk score was 0 and in 15 (15.6%) eyes, Munk score was 1. Anatomical success as having puncta larger than grade 2 was recorded in 97.9%, and functional success was recorded in 94.6% of anatomically successful eyes. No restenosis was recorded in any punctum. Although the techniques of 1-snip, 2-snip, 3-snip, and 4-snip punctoplasty are performed with variable success rates in punctal stenosis patients, there is always a risk of restenosis due to the incision of the flap and unpredictability of the way the tissues will epithelize. In the canalicular triangular flap technique, the canalicular mucosal flap is preserved, and the continuity of the lacrimal mucosa with conjunctiva is provided, which utilizes appropriate re-epithelization of the wound edges, resulting in a wide punctal opening for the upper lacrimal system in the long term.

Comparative Analysis of Life Satisfaction of Patients before and after Diagnosis of Eye Pathologies

Aim: To compare the life satisfaction of patients before and after diagnosis of eye pathologies. Methods: This was a prospective cross-sectional survey amongst eye patients at Guinness Eye Centre, Onitsha, South East, Nigeria using pretested interviewer-administered structured questionnaire. Data collected included the socio -demographics and the life satisfaction scores of the patients before, and 4-6 weeks after diagnosis. Results: A total of 137 patients in the age range 18 to 88years, and with disease duration ranging from 1 to 23 years were enrolled. There was equal male to female ratio with mean age of 54.6 years. There was significant decreased mean life satisfaction scores from 25.9 before diagnosis to 24.3 after diagnosis among participants with eye pathology. Conclusion: The diagnosis of a vision threatening eye pathology is associated with lowering of life satisfaction hence the need to incorporate psychotherapy in the long term management of these patients.

Duration of Illness and Resilience as Determinants of Life Satisfaction amongst Patients with Eye Pathologies

Aim: To determine how duration of disease and resilience as determinants correlate with life satisfaction amongst eye pathology patients Methods: This was a prospective cross-sectional survey amongst eye patients at Guinness Eye Centre, Onitsha, South East, Nigeria using pretested interviewer-administered structured questionnaire. Information such as the socio -demographics, duration of disease and questions aimed at assessing the resilience and life satisfaction scores of these patients were collected. Results: A total of 137 patients in the age range 15 to 88years, and with disease duration ranging from 1 to 23 years were enrolled. Gender and age of the participants were controlled as covariate. There was significant correlation between duration of eye pathology diagnosis and life satisfaction r= -0.22, p= 0.01, and resilience and life satisfaction r= 0.30, p= 0.01. In other words as the duration of eye pathology diagnosis increases, the more likely that the patient will report lesser life satisfaction. In contrast, patients who report higher resilience were more likely to also report higher life satisfaction. Conclusion: Life satisfaction amongst eye pathology patients is significantly determined by duration of eye disease and resilience.

The Therapeutic Trip of Melatonin Eye Drops: From the Ocular Surface to the Retina.

Melatonin is a ubiquitous molecule found in living organisms, ranging from bacteria to plants and mammals. It possesses various properties, partly due to its robust antioxidant nature and partly owed to its specific interaction with melatonin receptors present in almost all tissues. Melatonin regulates different physiological functions and contributes to the homeostasis of the entire organism. In the human eye, a small amount of melatonin is also present, produced by cells in the anterior segment and the posterior pole, including the retina. In the eye, melatonin may provide antioxidant protection along with regulating physiological functions of ocular tissues, including intraocular pressure (IOP). Therefore, it is conceivable that the exogenous topical administration of sufficiently high amounts of melatonin to the eye could be beneficial in several instances: for the treatment of eye pathologies like glaucoma, due to the IOP-lowering and neuroprotection effects of melatonin; for the prevention of other dysfunctions, such as dry eye and refractive defects (cataract and myopia) mainly due to its antioxidant properties; for diabetic retinopathy due to its metabolic influence and neuroprotective effects; for macular degeneration due to the antioxidant and neuroprotective properties; and for uveitis, mostly owing to anti-inflammatory and immunomodulatory properties. This paper reviews the scientific evidence supporting the use of melatonin in different ocular districts. Moreover, it provides data suggesting that the topical administration of melatonin as eye drops is a real possibility, utilizing nanotechnological formulations that could improve its solubility and permeation through the eye. This way, its distribution and concentration in different ocular tissues may support its pleiotropic therapeutic effects.

Replace or Regenerate? Diverse Approaches to Biomaterials for Treating Corneal Lesions.

The inner structures of the eye are protected by the cornea, which is a transparent membrane exposed to the external environment and subjected to the risk of lesions and diseases, sometimes resulting in impaired vision and blindness. Several eye pathologies can be treated with a keratoplasty, a surgical procedure aimed at replacing the cornea with tissues from human donors. Even though the success rate is high (up to 90% for the first graft in low-risk patients at 5-year follow-up), this approach is limited by the insufficient number of donors and several clinically relevant drawbacks. Alternatively, keratoprosthesis can be applied in an attempt to restore minimal functions of the cornea: For this reason, it is used only for high-risk patients. Recently, many biomaterials of both natural and synthetic origin have been developed as corneal substitutes to restore and replace diseased or injured corneas in low-risk patients. After illustrating the traditional clinical approaches, the present paper aims to review the most innovative solutions that have been recently proposed to regenerate the cornea, avoiding the use of donor tissues. Finally, innovative approaches to biological tissue 3D printing and xenotransplantation will be mentioned.

Bilateral tonic pupil during a migraine attack: a case report.

Tonic pupil or Adie's pupil occurs due to parasympathetic denervation, and it is characterized by mydriasis with little or no response to light, with pupillary contraction to accommodation. It is caused by eye pathologies, such as infections, trauma, neoplasms, inflammatory diseases, and systemic diseases with autonomic dysfunction. Few cases have been reported of bilateral tonic pupils associated with migraine attacks. Our aimed to describe the case of a young female patient with a history of chronic migraine without aura, who presented acutely with bilateral pupillary mydriasis during a migraine attack, characterized as tonic pupil, and to discuss the possible causes of mydriasis during a migraine attack.

Prevalence of common and rare ophthalmic findings in adults attending a medical survey institute

PurposeTo examine the ophthalmic data from a large database of people attending a general medical survey institute, and to investigate ophthalmic findings of the eye and its adnexa, including differences in age and sex.MethodsRetrospective analysis including medical data of all consecutive individuals whose ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects examined at a single general medical survey institute.ResultsData were derived from 184,589 visits of 3676 patients (mean age 52 years, 68% males). The prevalence of the following eye pathologies were extracted. Eyelids: blepharitis (n = 4885, 13.3%), dermatochalasis (n = 4666, 12.7%), ptosis (n = 677, 1.8%), ectropion (n = 73, 0.2%), and xanthelasma (n = 160, 0.4%). Anterior segment: pinguecula (n = 3368, 9.2%), pterygium (n = 852, 2.3%), and cataract or pseudophakia (n = 9381, 27.1%). Cataract type (percentage of all phakic patients): nuclear sclerosis (n = 8908, 24.2%), posterior subcapsular (n = 846, 2.3%), and capsular anterior (n = 781, 2.1%). Pseudophakia was recorded for 697 patients (4.6%), and posterior subcapsular opacification for 229 (0.6%) patients. Optic nerve head (ONH): peripapillary atrophy (n = 4947, 13.5%), tilted disc (n = 3344, 9.1%), temporal slope (n = 410, 1.1%), ONH notch (n = 61, 0.2%), myelinated nerve fiber layer (n = 94, 0.3%), ONH drusen (n = 37, 0.1%), optic pit (n = 3, 0.0%), and ON coloboma (n = 4, 0.0%). Most pathologies were more common in males except for ONH, and most pathologies demonstrated a higher prevalence with increasing age.ConclusionsNormal ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects seen at a single medical survey institute.

Study of peripheral blur in retinal electrical activity

Aims/Purpose: The aim of this study was to evaluate changes in peripheral refraction by the use of a contact lens to control the progression of myopia. In addition, the response of electrophysiological activity in different areas of the retina with and without contact lens was also determined.Methods: We recruited 7 myopic individuals (23.71 ± 5.41 years) with refraction up to −4.50D (spherical equivalent), without eye pathologies and surgeries. Visual acuity was recorded, high and low contrast, with the updated refraction and with the Misight 1 Day contact lens. Peripheral refraction measurements were obtained using an open‐field autorefractometer. Multifocal electrophysiology measurements were performed binocularly with and without contact lens, with dilated pupil. Topography and aberrometry values were also recorded.Results: lens, peripheral refractions become significantly more myopic. The change in peripheral refraction induced at 30° Nasal is −0.66D. High Contrast Visual Acuity was always superior to Low Contrast VA in both conditions. The Misight 1 Day contact lens manifests a different behaviour along the anterior surface of the cornea. LC induces a significant increase in high‐order aberrations, especially in comatic aberrations, which increase three times their initial value.Conclusions: Regarding the electrophysiological response of the retina, with the use of the LC Misight 1 Day, it presented a greater implicit time and amplitude of the P1 component, in the superior temporal retina, these differences being statistically significant. The implicit time of the P2 component increased in the temporal retina and in the retinal area delimited by Rings 3, 4 and 5.

The limbal stem cell niche in development, insights from mouse models and children with aniridia

Congenital aniridia, a rare eye disease of underdevelopment of the eye, leads to multiple eye abnormalities and pathologies, including a progressive limbal stem cell deficiency leading to the emergence and progression of an aniridia‐associated keratopathy. A deeper understanding of the characteristics of this deficiency could help to explain the observed pattern of progression and may provide insights into future treatments of this, and other types of limbal stem cell deficiency. From imaging studies in infants and young children with aniridia but with clear corneas, early phenotypic changes are apparent at the limbal border, with vascular tissue and inflammation apparent. In the central cornea, elevated inflammation and a nerve deficit are present early in life. In a novel mouse model of aniridia with slow development of keratopathy, limbal stem cell markers are perturbed after birth in clear corneas, and exhibit a characteristic time‐dependent pattern as the onset of clinically visible keratopathy emerges and starts to progress. Changes in the stromal and subbasal corneal nerves are also visible in the model and can provide insights into the neural deficit seen in the human disease. The model is moreover ideal for the evaluation of novel compounds aiming to slow the progression of keratopathy and preserve corneal transparency.

Prevention and public awareness of myopia

Myopia has become a Public Health issue, with prevalence rates that depend on age and geographical area, reaching the highest values in Asia. Thus, a recent review on the prevalence of myopia in children, measured with cycloplegia, established that the prevalence ranges from 10% in Africa to 60% in Asia, increasing in all areas every year. These results show the importance of taking action to prevent myopia.The main factors with strong scientific evidence to prevent myopia are increasing outdoor time and decreasing near‐work activities.Public awareness is an essential factor to stop the increase in the prevalence rates of myopia. However, the increase in scientific literature does not give us information about the sensitivity of the general population on a specific topic.Through the internet search trends analysis, we can find out how much interest myopia has in the population, analysing the most concerned countries and how the related queries are being carried out and increased.Thus, if we look for the search trends with the word “myopia” as “term search” in the last 10 years, we can see how the number of searches is increasing, reaching the maximum in 2022. China, Taiwan, and Hong Kong lead the searches on the Internet, reflecting how the higher prevalence in these areas has generated a greater concern. Concerning related queries, we find a high growth in interest caused by the inclusion of myopia among the diseases of the international classification of diseases of the World Health Organization, ICD 10, with an increase of 2000% in the searches. This search suggests that people interested in myopia are looking for reliable sources to collect information. Finally, it is remarkable that in the review of the related queries, we did not find the term prevention among the most performed searches, and treatment, cure, or control are queries that are in positions 20, 21, and 26 of those searches.Compared with other of the most established eye pathologies in society, we can see as myopia is still behind them. For instance, if we compare the searches of the term myopia, with glaucoma or cataract, 61% of the web searches are related to glaucoma, 43% to cataracts, and only 16% corresponded to myopia.In conclusion, even though scientific evidence alerts us about the increase in the rates of myopia and the importance of working on its prevention, there is still a long way to reach society to generate a clear awareness of myopia and the consequences of not taking action to prevent it.

Results of surgical treatment of children with lens subluxation

AIM: To assess the effectiveness of the surgical treatment of patients with lens subluxation, who were under 18 years old.&#x0D; MATERIAL AND METHODS: This study presented an analysis of the results of surgical treatment of eight patients with lens subluxation. The operations were performed in the Department of Ophthalmology of the State Healthcare Institution of Healthcare MCMC “Bonum,” carried out in 2020–2022. The inclusion criteria were as follows: age under 18 years, Marfan-like phenotype, stages 2–4 subluxation, absence of retinal changes and other eye pathologies, and surgical treatment performed in 2020–2022. The mean age at the detection of lens subluxation was 3.9±2.0 years, and the age during primary surgery was 5.4±1.9 years. All patients underwent phacoaspiration of the subluxated lens with anterior vitrectomy, simultaneous implantation, and sclerocorneal fixation of the intraocular lens by the same surgeon using the same equipment and consumables.&#x0D; RESULTS: The ophthalmological status was mainly assessed, and a statistical difference (p 0.05) was found between pre- and postoperative indicators. Before surgery, the maximum corrected visual acuity was 0.15±0.12 (min 0.02; max 0.5); spherical equivalent, 6.8±4.7 (min -15; max +16); total astigmatism value, 3.25±1.15 (min, 1; max, 6.5); and corneal astigmatism, 2.4±0.9 (min, 1; max, 3.9). After the surgical treatment, the maximum corrected visual acuity was 0.53±0.31 (min, 0.05; max, 0.9); spherical equivalent, −0.6±1.71 D (min −3.5; max +3); total astigmatism, -1.63±0.75 D (min, -0.25; max, −2.75); corneal astigmatism, 2.4±0.7 D (min 1; max 3.5). All operations were performed without complications. The postoperative period in patients was regarded as unreactive.&#x0D; CONCLUSION: The results show that sclerocorneal fixation allows for reliable and safe fixation of intraocular lenses without capsule support. A statistically significant increase in visual acuity was found after surgery; however, for optimal functional results in the postoperative period, refractive errors and pleoptic treatment must be controlled.

LezioSeg: Multi-Scale Attention Affine-Based CNN for Segmenting Diabetic Retinopathy Lesions in Images

Diagnosing some eye pathologies, such as diabetic retinopathy (DR), depends on accurately detecting retinal eye lesions. Automatic lesion-segmentation methods based on deep learning involve heavy-weight models and have yet to produce the desired quality of results. This paper presents a new deep learning method for segmenting the four types of DR lesions found in eye fundus images. The method, called LezioSeg, is based on multi-scale modules and gated skip connections. It has three components: (1) Two multi-scale modules, the first is atrous spatial pyramid pooling (ASPP), which is inserted at the neck of the network, while the second is added at the end of the decoder to improve the fundus image feature extraction; (2) ImageNet MobileNet encoder; and (3) gated skip connection (GSC) mechanism for improving the ability to obtain information about retinal eye lesions. Experiments using affine-based transformation techniques showed that this architecture improved the performance in lesion segmentation on the well-known IDRiD and E-ophtha datasets. Considering the AUPR standard metric, for the IDRiD dataset, we obtained 81% for soft exudates, 86% for hard exudates, 69% for hemorrhages, and 40% for microaneurysms. For the E-ophtha dataset, we achieved an AUPR of 63% for hard exudates and 37.5% for microaneurysms. These results show that our model with affine-based augmentation achieved competitive results compared to several cutting-edge techniques, but with a model with much fewer parameters.

ԿՈՄՊԼԵՄԵՆՏԻ ՀԱՄԱԿԱՐԳԻ ԴԵՐԸ ԱԿՆԱՅԻՆ ՊԱԹՈԼՈԳԻԱՆԵՐԻ ԷԹԻՈՊԱԹՈԳԵՆԵԶՈՒՄ (ՏԵՍՈՒԹՅԱՆ ՎԵՐԼՈՒԾՈՒԹՅՈՒՆ)

Complement has long been recognized as a critical component of the innate immune system. It comprises proteins that play a central role in host defense against infection and in the modulation of antigen-specific immune and inflammatory responses. The complement system can be activated by three proteolytic cascades namely, the classical, the alternative, and the lectin pathways. The activation of complement components by all three pathways leads to the formation of a membrane attack complex (MAC). There are studies about complement system involvement in different ocular pathologies, like macular degeneration, glaucoma, diabetic retinopathy, and autoimmune uveitis. Dysregulation of the complement cascade has emerged as a key contributor to the pathophysiology of age-related macular degeneration and there has been a revolution in the treatment of the geographic type. The drug pegcetagoplan, which was approved by the FDA on February 17, 2023, is a C3 inhibitor that binds to C3 or C3b, disrupting further activation of the complement system. There are studies about the relationship between diabetic retinopathy and dysregulation of the complement system. Some authors found activation of C5a in the vitreous body, other authors found an increase of C9 and factor D in the vitreous body. Several studies have investigated the role of the complement system in the pathogenesis of glaucoma, especially the role of C3, C1, and complement regulatory proteins. There are studies about experimental autoimmune uveitis and the role of the complement system in the pathogenesis of ocular autoimmune disease. The studies provided the novel finding that complement activation plays a central role in the pathogenesis of ocular autoimmunity and may serve as a potential target for therapeutic intervention. Thus, summing up the results of studies conducted by various authors, we conclude that the complement system has its role in the pathogenesis of various eye pathologies. Identification of the complement system activation as a new direction of local ocular immunity in the pathogenesis of autoimmune uveitis will provide an opportunity for the development of targeted treatment regimens.

Assessment and safety of the new esthesiometer BRILL: Comparison with the Cochet-Bonnet Esthesiometer.

Corneal sensitivity can decrease by several ocular conditions, such as dry eye or refractive surgery, which favor ocular epithelial lesions and is measured using an esthesiometer. The study's primary objective was to demonstrate the efficacy and safety of the non-contact esthesiometer BRILL, which delivers air pulses to the corneal surface to assess corneal sensitivity. A single-center, prospective, controlled pilot study was carried out in adult patients with healthy eyes and or with pathology. Corneal sensitivity measurements were made in triplicate for both eyes at three consecutive visits. The esthesiometer BRILL was used in all visits, and on the last visit, the contact esthesiometer Cochet-Bonnet was also used. The results of both devices were compared by transforming them into force values. 54 subjects with a mean age of 50.43 (SD 16.55, interval 18-87), 77.78% women, were included. Comparing the forces applied by both esthesiometers in the healthy eyes, in the eyes with pathology in all the groups, and in the dry eyes showed significant differences, p = 0.03603, p = 0.00614, and p = 0.0001, respectively. The BRILL esthesiometer proved to be an effective and safe tool for non-contact assessment of corneal sensitivity with operator-independent repeatability. The measurements had a good agreement and comparable range with the Cochet-Bonet aesthesiometer measurements in healthy and dry eyes but with no interchangeable values. This portable device can help ophthalmologists and optometrists to diagnose eye pathologies that cause decreased corneal sensitivity and to assess the efficacy of therapy and disease progression.