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ABSTRACT Although several research studies have been conducted on investigating the bond stress--slip behaviour of Glass-Fibre Reinforced Polymer (GFRP) bars embedded in high strength concrete (HSC) using a pull-out method, [...]

Byline: Ye. Yuan, Timothy. Lin, Kai. Gao, Rouxi. Zhou, Nishant. Radke, Dennis. Lam, Xiulan. Zhang Purpose: Aerobic exercise (AE) has been reported to decrease intraocular pressure (IOP) in healthy subjects [...]

Purpose The purpose of this study was to report the clinicopathological features and management of the first case of bilateral synchronous conjunctival myxoma.Methods This study was a case report and literature review.Results A 66-year-old Chinese male with past ocular history of uncomplicated bilateral phacoemulsification and intraocular lens (IOLs) 3 years ago prior to presentation presented with bilateral red and swollen conjunctiva for over a year. On examination his corrected distance visual acuity (CDVA) was 25/20 in the right eye 20/20 in the left eye. Slit lamp examination revealed swollen temporal conjunctiva bilaterally which appeared as painless, well-circumscribed, salmon-pink, fleshy patches. The lesion in the right eye was subsequently excised, followed by excision of the lesion in the left eye at 3-week interval. Microscopically, histopathological examination of both excised specimens revealed hypocellular conjunctival mucosa covered by non-dysplastic epithelium, with presence of myxoid degeneration in the subepithelial stroma and immunostaining findings consistent with conjunctival myxoma. At his latest follow-up at 24 months, there were no recurrences of the conjunctival masses and the CDVA was the same as preoperatively.

There have been recent advances in basic research and clinical studies in polypoidal choroidal vasculopathy (PCV). A recent, large-scale, population-based study found systemic factors, such as male gender and smoking, were associated with PCV, and a recent systematic review reported plasma C-reactive protein, a systemic biomarker, was associated with PCV. Growing evidence points to an association between pachydrusen, recently proposed extracellular deposits associated with the thick choroid, and the risk of development of PCV. Many recent studies on diagnosis of PCV have focused on applying criteria from noninvasive multimodal retinal imaging without requirement of indocyanine green angiography. There have been attempts to develop deep learning models, a recent subset of artificial intelligence, for detecting PCV from different types of retinal imaging modality. Some of these deep learning models were found to have high performance when they were trained and tested on color retinal images with corresponding images from optical coherence tomography. The treatment of PCV is either a combination therapy using verteporfin photodynamic therapy and anti-vascular endothelial growth factor (VEGF), or anti-VEGF monotherapy, often used with a treat-and-extend regimen. New anti-VEGF agents may provide more durable treatment with similar efficacy, compared with existing anti-VEGF agents. It is not known if they can induce greater closure of polypoidal lesions, in which case, combination therapy may still be a mainstay. Recent evidence supports long-term follow-up of patients with PCV after treatment for early detection of recurrence, particularly in patients with incomplete closure of polypoidal lesions.

Frequent antivascular endothelial growth factor injections in neovascular age-related macular degeneration (nAMD) often lead to poor compliance and suboptimal outcomes. A longer-acting agent has been a pressing unmet need until recently. Brolucizumab, an antivascular endothelial growth factor agent, is a single-chain antibody fragment approved by the US Food and Drug Administration (FDA) on October 8, 2019, for treating nAMD. It delivers more molecules at equivalent volumes of aflibercept, thus achieving a longer-lasting effect. We reviewed literature published in English between January 2016 and October 2022 from MEDLINE, PubMed, Cochrane database, Embase, and Google scholar using the keywords: “Brolucizumab, real-world data, intraocular inflammation (IOI), safety, and efficacy”. Brolucizumab showed reduced injection frequency, better anatomic outcomes, and noninferior vision gains compared with aflibercept in HAWK and HARRIER studies. However, post hoc studies on brolucizumab revealed a higher-than-expected incidence of IOI, leading to the early termination of 3 studies: MERLIN, RAPTOR, and RAVEN for nAMD, branch retinal vein occlusion, and central retinal vein occlusion, respectively. Contrastingly real-world data showed encouraging outcomes in terms of fewer IOI cases. The subsequent amendment of the treatment protocol resulted in reduced IOI. Thereafter US FDA approved its use in diabetic macular edema on June 1, 2022. Based on major studies and real-world data, this review shows that brolucizumab is effective for treating naive and refractory nAMD. The risk of IOI is acceptable and manageable, but proper preinjection screening and high-vigilance care of IOI are needed. More studies are warranted to evaluate further the incidence, best prevention, and treatment measures for IOI.

Primary angle-closure glaucoma (PACG) is responsible for half of the glaucoma-related blindness worldwide. Cataract surgery with or without trabeculectomy has been considered to be the first-line treatment in eyes with medically uncontrolled PACG. While minimally invasive glaucoma surgery has become an important surgical approach for primary open-angle glaucoma, its indications and benefits in PACG are less clear. This review summarizes the efficacy and safety profile of minimally invasive glaucoma surgery in PACG to unfold new insights into the surgical management of PACG.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2008.01.017 Byline: Srinivas K. Rao, Chris K.S. Leung, Carol Y.L. Cheung, Emmy Y.M. Li, Arthur C.K. Cheng, Philip T.H. Lam, Dennis S.C. Lam Abstract: To determine the changes in corneal optical performance after posterior lamellar corneal transplantation. Author Affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China. Article History: Accepted 21 January 2008

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2005.10.012 Byline: Jian-Ping Tong (a)(b), Wai-Man Chan (a)(c), David T.L. Liu (c), Timothy Y.Y. Lai (a), Kwong-Wai Choy (a), Chi-Pui Pang (a)(c), Dennis S.C. Lam (a)(c) Abstract: To determine the aqueous levels of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in patients with active polypoidal choroidal vasculopathy (PCV) and choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and pathologic myopia. Author Affiliation: (a) Hong Kong Eye Hospital, Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, PRC (b) Zheyi Eye Center, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou, Zhejiang, China (c) Prince of Wales Hospital, Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, PRC Article History: Accepted 10 October 2005 Article Note: (footnote) Supported in part by Competitive Earmarked Research (4140/02M), Research Grant Council, Hong Kong.

Supplemental Digital Content is available in the text

Supplemental Digital Content is available in the text

To evaluate the associations of the TIE2gene with diabetic retinopathy (DR) and diabetic macular edema (DME).

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2004.11.055 Byline: Wai-Man Chan, Etrian Lim, David T.L. Liu, Ricky W.K. Law, Dennis S.C. Lam Abstract: To report the clinical course of intravitreal triamcinolone acetonide on choroidal granuloma secondary to sarcoidosis that was refractory to systemic prednisolone Author Affiliation: From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, People's Republic of China. Article History: Accepted 23 November 2004

ABSTRACTBinocular triplopia is a rare symptom and usually has a corneal or lenticular origin. Uniocular diplopia arising from ectopia lentis is quite common in Marfan syndrome. A visual phenomenon related to binocular triplopia due to strabismus was first reported in 1943 by Burian. Both monocular diplopia and binocular triplopia have been reported in concomitant strabismus. Strabismus is also common in Marfan syndrome but congenital superior oblique paresis has never been reported before. We report herein a rare case of binocular triplopia in a patient with Marfan syndrome arising from decompensation of his coexistent congenital superior oblique paresis triggered by his uniocular diplopia. This is the first report of congenital superior oblique paresis in a patient with Marfan syndrome. Though it is unlikely to have any etiological implications and is likely to be a mere coincidental simultaneous occurrence, it had a confounding effect on the clinical interpretation of the signs and symptoms posing an interesting diagnostic and management dilemma. Our case report emphasizes the necessity for careful evaluation of any patient with symptoms of triplopia. We further review and summarize all the causes of binocular triplopia published in English literature and propose an approach to its evaluation and management.

Nanostructured substrates such as nanowire arrays form a powerful tool for building next-generation medical devices. So far, human pluripotent stem cell-derived neurons—a revolutionary tool for studying physiological function and modeling neurodegenerative diseases—have not been applied to such innovative substrates, due to the highly demanding nature of stem cell quality control and directed differentiation procedures to generate specialized cell types. Our study closes this gap, by presenting electrophysiologically mature human pluripotent stem cell-derived neurons on a set of nanowires in different patterns and growth densities after only four weeks of maturation—thereof 14 to 16 days on the nanowire arrays. While cell viability is maintained on all nanowire substrates, the settling regime of the cells can be controlled and tuned by the nanowire density from a fakir-like state to a complete nanowire wrapping state. Especially, full electrophysiological integrity of the neurons independent of the settling regime has been revealed by patch clamp experiments showing characteristic action potentials. Based on these results, our protocol has the potential to open new pathways in stem cell research and regenerative medicine utilizing human stem cell-derived neurons on tailor-made nanostructured substrates.

Myopia has ever-rising prevalence in the past few decades globally. Its pathogenesis is still not adequately elucidated especially at the signal transduction level. For the environmental risk factors, there is a large body of fragmented knowledge about the visual inputs for accommodation, myopiagenesis and emmetropization, with the latter two being essentially local processes. The red-green and yellow-blue chromatic pathways, together with the underlying L–M and S–(L+M) cone opponency, seem to be the common denominator amongst them. In this review, experimental and observational evidence are summarized to delineate the interplay of them. This review may establish the pivotal role of longitudinal chromatic aberration (LCA) for a mechanistic approach to future research in myopia control. This review looks into the mechanistic processes underlying myopiagenesis and emmetropization, specifically focusing on chromatic aberration and cone opponency in vision as pivotal components. The roles of longitudinal chromatic aberration (LCA) and cone contrast in myopia onset and development are intriguing. How visual input and chromatic pathways (specifically, red-green and blue-yellow cone opponency) contribute to accommodation that may trigger emmetropization mechanisms, thereby influencing eye growth patterns are explored and discussed. In brief, this manuscript delves into the physiology of visual processing and highlights a foundational aspect of visual science that may account for a “Go” or “Stop” signaling in axial eye growth. It further proposes a metric to gauge myopia-inhibiting optical devices such as the peripheral defocus lenses, for its best iteration. Future research in the above-mentioned areas is warranted.

To investigate the effectiveness and safety of phacogoniotomy versus phacotrabeculectomy (PVP) among patients with advanced primary angle-closure glaucoma (PACG) and cataracts.

The emergence of generative artificial intelligence (AI) has revolutionized various fields. In ophthalmology, generative AI has the potential to enhance efficiency, accuracy, personalization and innovation in clinical practice and medical research, through processing data, streamlining medical documentation, facilitating patient-doctor communication, aiding in clinical decision-making, and simulating clinical trials. This review focuses on the development and integration of generative AI models into clinical workflows and scientific research of ophthalmology. It outlines the need for development of a standard framework for comprehensive assessments, robust evidence, and exploration of the potential of multimodal capabilities and intelligent agents. Additionally, the review addresses the risks in AI model development and application in clinical service and research of ophthalmology, including data privacy, data bias, adaptation friction, over interdependence, and job replacement, based on which we summarized a risk management framework to mitigate these concerns. This review highlights the transformative potential of generative AI in enhancing patient care, improving operational efficiency in the clinical service and research in ophthalmology. It also advocates for a balanced approach to its adoption.

Byline: Rita. Gangwani, David. Liu, Nathan. Congdon, Philip. Lam, Vincent. Lee, Nancy. Yuen, Dennis. Lam We evaluated the effectiveness of diode laser trans-scleral cyclophotocoagulation (TSCPC) on intraocular pressure (IOP) in [...]

Byline: Srinivas. Rao, Dennis. Lam In eyes with eccentric corneal opacities partially involving the pupillary area, using a rotational corneal autograft, can help restore vision without the immunological complications associated [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2007.02.039 Byline: Wai-Man Chan (a)(b)(c), Timothy Y.Y. Lai (a), David T.L. Liu (b), Dennis S.C. Lam (a) Abstract: To evaluate the safety and efficacy of intravitreal bevacizumab in the treatment of idiopathic choroidal neovascularization (CNV) and CNV secondary to central serous chorioretinopathy (CSC) or punctate inner choroidopathy (PIC). Author Affiliation: (a) Hong Kong Eye Hospital, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China (b) Prince of Wales Hospital, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China (c) Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, People's Republic of China. Article History: Accepted 19 February 2007