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Background: Peripheral hypertrophic subepithelial corneal opacification (PHSCO) is a corneal disease that may severely affect vision. The major goal of this study was to test the hypothesis that tear secretion, medication and systemic diseases are associated with PHSCO. Methods: This is a retrospective, case–control study conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. We analysed medical records of patients diagnosed with PHSCO. Sex, age, Schirmer's test II, general medication and medical history were assessed and compared to an age‐ and sex‐matched control group from the Gutenberg Health Study (GHS). Results: One hundred ninety‐five eyes of 112 patients with PHSCO were included. Eighty‐eight patients were female with a mean age of 55.3 ± 14.7 years (23–89 years) and 24 patients were male with a mean age of 59.3 ± 12.6 years (38–84 years). In 83 patients (74.1%) both eyes were involved. The Schirmer's test II was significantly reduced in patients with PHSCO compared to the GHS control group (p < 0.001). Patients with PHSCO were more frequently administered artificial tears and steroid eye drops (p < 0.001) and were more hyperopic than healthy controls (p = 0.01). Systemic diseases or medication did not differ markedly between PHSCO and healthy controls. Conclusion: Reduced tear secretion and more frequent use of artificial tears in patients with PHSCO suggest a link between PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is associated with systemic diseases. Interestingly, patients with PHSCO were less frequently on β‐blockers than control subjects. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate whether an obesity‐related inflammatory protein signature (OIPS) is associated with adverse cardiovascular events. Methods: The Olink Target 96 Inflammation panel was performed in 6662 participants from the population‐based Gutenberg Health Study (GHS). The OIPS was selected by a logistic regression model, and its association with cardiovascular outcomes was evaluated by Cox regression analysis. The GHS‐derived OIPS was externally validated in the MyoVasc study. Results: The identified OIPS entailed 21 proteins involved in chemokine activity, tumor necrosis factor (TNF) receptor binding, and growth factor receptor binding. The signature revealed a novel positive association of axis inhibition protein 1 with obesity. The OIPS was associated with increased risk of all‐cause and cardiac deaths, major adverse cardiovascular events, and incident coronary artery disease, independent of clinical covariates and established risk instruments. A BMI‐stratified analysis confirmed the association of OIPS with increased death in those with obesity and overweight and with increased risk for coronary artery disease in those with obesity. The association of OIPS with increased risk of all‐cause and cardiac deaths was validated in the MyoVasc cohort. Conclusions: The OIPS showed a significant association with adverse clinical outcomes, particularly in those with overweight and obesity, and represents a promising tool for identifying patients at higher risk for worse cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Intrauterine growth restriction leading to a birth weight (BW) which is too low for gestational age (GA) is a known risk factor for various altered organ morphologies and dysfunction in later life. This study aimed to determine for the first time the effects of being small (SGA) or large for gestational age (LGA) on the ocular geometry of adults born at term. Methods: All participants were examined with optical biometry (LenStar 900, Haag Streit) to compare the corneal curvature, white‐to‐white distance, anterior chamber depth, lens thickness and axial length between former moderate (BW percentile 3rd to <10th) and severe (BW <3rd percentile) SGA, controls (BW 10th‐90th percentile) and former moderate (BW >90th to 97th percentile) and severe (BW >97th percentile) LGA. Multivariable linear regression was used to analyse associations with GA, BW percentile categories, placental insufficiency, preeclampsia and breastfeeding after adjustment for age and sex. Results: In total, 589 eyes of 296 individuals born at term (aged 30.0 ± 9.4 years, 156 females) were examined, including 40 severe SGA, 38 moderate SGA, 140 with normal BW, 38 moderate LGA and 40 severe LGA. There was an association between a steeper corneal curvature with moderate (B = −0.201; p < 0.001) and severe SGA (B = −0.199; p < 0.001), with extreme SGA associated with smaller white‐to‐white (B = −0.263; p = 0.001) and a shorter axial length (B = −0.524; p = 0.031). Conclusions: Severe and moderate prenatal growth restriction in adults born at term leads to an altered ocular geometry, namely a steepening of the cornea and a smaller corneal diameter. [ABSTRACT FROM AUTHOR]

This article discusses a study on the postnatal environmental factors associated with corneal shaping in individuals born preterm and full-term. The study found that a longer stay in the incubator and increased time in the intensive care unit were linked to steeper corneal morphology, while postnatal temperature did not have a significant impact. The findings suggest that factors related to prematurity during incubator and ICU stays may affect corneal development. However, the study has limitations, such as being a single-center study and taking place several decades after birth. [Extracted from the article]

Aims: Prescribing information should follow a defined structure to help prescribers easily find required information. Often information appears in different sections of Summaries of Product Characteristics (SmPCs) in an inconsistent way. Still unknown is how this inconsistency affects absolute contraindications and how it can be improved. Thisstudy aimed to evaluate the structure of absolute contraindications in SmPCs based on absolute drug–drug contraindications (DDCI) in the section 'contraindications' and references to sections 'special warnings and precautions for use' (here as 'warnings') and 'interaction with other medicinal products and other forms of interaction' (here as 'interactions'). Methods: SmPCs of 693 commonly prescribed drugs were analysed regarding absolute DDCI in 'contraindications' sections. References to sections on 'warnings' and 'interactions' were evaluated to characterize information provided about DDCI. Results: Of 693 analysed SmPCs, 138 (19.9%) contained ≥1 absolute DDCI. Of 178 SmPCs that referred to sections on 'warnings' or 'interactions', 131 (73.6%) did not contain further information on absolute DDCI, whereas 47 (26.4%) did. Such additional information was found in sections on 'interactions' and 'warnings' in 41 (87.2%) and 9 (19.1%) SmPCs, respectively. Conclusions: Information regarding absolute DDCI was found not only in sections on 'contraindications' but also in sections on 'warnings' and 'interactions'. Information was not given with consistently straightforward phrasing and structure and so can leave uncertainty for prescribers. To improve drug safety, clear definitions and wording for absolute and relative contraindications should be provided, ideally in tables. [ABSTRACT FROM AUTHOR]

This article discusses the potential impact of low birthweight on macular morphology in individuals born at term. Previous studies have shown that low birthweight is associated with increased foveal thickness in individuals born preterm. However, it is unclear whether this effect is solely due to preterm birth or if it is also influenced by perinatal hypotrophy in individuals born small-for-gestational age (SGA). This study aimed to explore the association between fetal growth restriction in individuals born at term and various macular parameters. The results showed no significant differences in macular morphology between different birthweight groups, suggesting that macular developmental alterations are more likely a consequence of prematurity rather than perinatal growth indicated by birthweight. [Extracted from the article]

Introduction: Prematurity and retinopathy of prematurity (ROP) are associated with altered corneal shape and reduced visual acuity in childhood, but their long‐term effects on corneal shape in later life are still unclear. This study evaluated whether prematurity and related perinatal factors are associated with corneal aberrations in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a cohort study using Scheimpflug imaging of the cornea. Associations were assessed between corneal Zernike aberrations and gestational age (GA), birth weight (BW), BW percentile, ROP occurrence, ROP treatment and other perinatal factors using univariate and multivariable linear regression analyses. Results: This study involved 444 eyes of 256 individuals born preterm (aged 28.1 ± 8.4 years, 146 females) and 231 eyes of 132 individuals born full‐term (aged 29.8 ± 8.9 years, 77 females). Multivariable analyses revealed an association between corneal higher‐order aberrations and lower birth weight percentile (B = −0.001, p < 0.001) as well as ROP treatment (B = 0.120, p = 0.03). Corneal lower‐order aberrations were also associated with lower birth weight percentile (B = −0.004; p = 0.001) and ROP treatment (B = 0.838, p = 0.01) but not with ROP occurrence. Increased corneal aberrations were correlated with lower visual acuity and the spherical equivalent refractive error. Conclusions: Perinatal factors, particularly low birth weight percentile and ROP treatment lead to a more irregular corneal shape in adulthood, thereby reducing optical image quality and potentially contributing to reduced visual acuity and altered refractive error. [ABSTRACT FROM AUTHOR]

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Purpose: Changes in peripheral corneal thickness are described in various corneal diseases such as corneal ectasia. However, few data exist describing the increase in corneal thickness from central to peripheral and reporting the normal distribution of corneal thickness in rings around the corneal centre. The aim of this study was to report these cornea characteristics and investigate associated factors in a population‐based setting. Methods: The Gutenberg Health Study is a prospective, population‐based study examining participants in a 5‐year follow‐up (age range 40–80 years) using Scheimpflug imaging. Corneal thickness was assessed in each participant at the apex, as well as in the corneal centre (thinnest corneal thickness) and in rings with 2, 4, 6, 8 and 10 mm diameter around the corneal centre, and the increase in corneal thickness towards the periphery. The relationship between corneal thickness at these locations and possible associated factors was determined using linear regression models. For this purpose, general and ocular parameters were included. Results: A total of 9729 participants were included in the present analysis (4874 women, age 59.2 ± 10.8 years). Multivariable analysis showed a correlation between the increase in corneal thickness in the circles from 0 to 10 mm (diameter) and the following parameters: age (B = −0.24 µm per year, p < 0.001); body height (B = −0.04 µm, p = 0.005); smoking (B = −0.72 µm, p < 0.001); spherical equivalent (B = −0.70 µm per dioptre, p < 0.001); white‐to‐white distance (B = −0.75 µm/mm, p < 0.001); mean corneal radius (B = −3.61 µm/mm, p < 0.001); intraocular pressure (B = −0.12 µm/mmHg, p < 0.001); glaucoma (B = −1.94 µm, p < 0.001); and pseudophakia (B = 0.89 µm, p < 0.001). Conclusion: The results of the present study suggest that several general and ocular parameters are associated with peripheral corneal thickness. In the context of diagnosing glaucoma, a smaller increase in corneal thickness towards the periphery might be a new additional marker. [ABSTRACT FROM AUTHOR]

Purpose: To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C. Methods: Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes. Results: We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01). Conclusions: No statistically significant differences were found between trabeculectomy, XEN45® gelstent implantation and Preserflo® MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate long‐term results of glaucoma surgery in newborn and infants with glaucoma. Methods: Seventy‐nine eyes of 52 children (age: 3 weeks–15.3 years) with primary congenital or secondary glaucoma treated between 2015 and 2017 were included. The median follow‐up time was 3.9 years. Conventional probe trabeculotomy, 360° catheter‐assisted trabeculotomy, filtering and cyclodestructive surgery were compared. Strict criteria for surgical success were applied: Complete surgical success (IOP below target IOP, no further surgery) and incomplete surgical success (additional surgery allowed) were analyzed, and IOP at baseline and last follow‐up was compared. Results: Intraocular pressure (IOP) was significantly reduced in primary congenital (preoperative IOP: 27.8 ± 7.5 mmHg vs. postoperative IOP: 14.2 ± 4.5 mmHg) and secondary glaucoma (preoperative IOP: 29.2 ± 9.1 mmHg vs. postoperative IOP: 16.6 ± 4.7 mmHg). 90% of all eyes reached target IOP with or without medication allowing for additional surgeries. As first surgery, 360° catheter‐assisted trabeculotomy had a tendency to higher surgical success than other surgical approaches, while cyclodestructive procedures had lowest. Conclusions: We found very promising surgical results in our childhood glaucoma patient group. Surgical success in both congenital and secondary glaucoma was high. [ABSTRACT FROM AUTHOR]

We report in situ structural measurements of shock‐compressed single crystal orthoenstatite up to 337 ± 55 GPa on the Hugoniot, obtained by coupling ultrafast X‐ray diffraction to laser‐driven shock compression. Shock compression induces a disordering of the crystalline structure evidenced by the appearance of a diffuse X‐ray diffraction signal at nanosecond timescales at 80 ± 13 GPa on the Hugoniot, well below the equilibrium melting pressure (>170 GPa). The formation of bridgmanite and post‐perovskite have been indirectly reported in microsecond‐scale plate‐impact experiments. Therefore, we interpret the high‐pressure disordered state we observed at nanosecond scale as an intermediate structure from which bridgmanite and post‐perovskite crystallize at longer timescales. This evidence of a disordered structure of MgSiO3 on the Hugoniot indicates that the degree of polymerization of silicates is a key parameter to constrain the actual thermodynamics of shocks in natural environments. Plain Language Summary: The study of silicate materials at extreme pressures and temperatures provides insight on the evolution of planetary bodies evolution during solar system formation. During their accretion, rocky bodies have undergone several collisions and possibly planetary impacts that have transformed their minerals. The microscopic processes occurring during such events are not fully understood. In this study, we used high‐power lasers to generate shock waves into MgSiO3 enstatite crystals, creating conditions comparable to the deepest part of the early Earth mantle and large planetary impacts. During the shock wave transit, within few nanoseconds, we probed the structure of shocked enstatite between 14 ± 3 and 337 ± 55 GPa using intense X‐ray pulses from Linac Coherent Light Source X‐ray free electron laser facility. We found that, when shocked between 80 ± 13 GPa and the conditions of equilibrium melting (above 170 GPa), enstatite transforms into a disordered structure instead of forming bridgmanite or post‐perovskite—the expected equilibrium phases. This disordered structure is similar to MgSiO3 glass or liquid and is observed up to 337 ± 55 GPa. This study provides the first direct measurement of shocked enstatite structure and suggests that the observed disordered state is an intermediate phase on the transformation pathway of bridgmanite in natural impacts. Key Points: We performed ultrafast X‐ray diffraction of orthoenstatite crystals shock compressed up to 337 ± 55 GPa on the HugoniotA disordered structure was observed from 80 ± 13 GPa along the Hugoniot, well below the melting temperatureThe degree of polymerization strongly influences the kinetics of recrystallization in shocked silicates [ABSTRACT FROM AUTHOR]

Purpose: Using a bleb‐grading system clinically facilitates long‐term follow‐up of patients with previous glaucoma surgery. Clinical evaluation of these patients can be challenging for untrained ophthalmologists. Morphological bleb configuration might influence planning of follow‐up visits in glaucoma patients due to different and individual prognosis after trabeculectomy. In this study, we compared the MaBAGS (Mainz Bleb Appearance Grading System), a classification system for filtering blebs with other classification systems (MBGS/Moorfields Bleb Grading System, IBAGS/Indiana Bleb Appearance Grading Scale) in reference to usability and reliability and compare it to grading by bleb photographs. Methods: Forty‐two eyes of 31 patients after trabeculectomy were included. Three observers, two senior and one junior observer, graded all blebs using MaBAGS, MBGS and IBAGS during slit‐lamp examination. Bleb photographs were reviewed at least 4 weeks after clinical examination. Statistical analysis was performed to determine agreement between the observers using intraclass correlation coefficients. Results: With MaBAGS, excellent and good levels of agreement were found for vascularity indices, Seidel test and transparency. Parameters for area and height yielded moderate agreement, while indices for conjunctival mobility and microcysts failed to show satisfying levels of agreement. Using MBGS resulted in excellent and good interobserver consistency for parameters regarding subconjunctival blood, Seidel test, and central and peripheral vascularity. Height and nonbleb vascularity reached moderate levels of agreement. Agreement for area parameters was low. With IBAGS, good levels of agreement were found for height and vascularity, and moderate for extent. In all grading systems, consistency was considerably better between the two experienced observers compared to the inexperienced grader. Conclusions: MaBAGS shows good reproducibility. Using such a grading system improves precision of the description of a highly variable clinical finding. The reliability of grading by slit‐lamp examination exceeds that of grading on photographs. [ABSTRACT FROM AUTHOR]

Summary: Irvingia gabonensis kernels are a promising oleiferous source. Their total lipid content was 72.3%. C14:0 and C12:0 represented the most abundant fatty acids. Triacylglycerols with ECN 32 and 46–48 were identified for the first time by HPLC‐DAD‐ESI‐MSn. Comprehensive GC‐FID and GC‐MS analyses revealed novel insights into minor lipids like phytosterols and tocochromanols. Among the latter, γ‐tocopherol was found to be the major vitamer. β‐Sitosterol and stigmasterol were the prevailing phytosterols in the kernel fat. The high saturation level of the fat resulted in a sharp differential scanning calorimetry melting curve with a high melting temperature of 42.1 °C. The fat remained solid over a wide temperature range and still contained 66.6% solid fats at 35 °C. Consequently, kernels of the African mango provide a viable source for the recovery of solid fats applicable in the food industry as sustainable alternatives to replace palm‐based fats or hardened vegetable oils. Characterisation of lipophilic compounds and thermal behaviour of Irvingia gabonensis kernel fat applicable in the food industry as a sustainable alternative for palm‐based fats or hardened vegetable oils. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to investigate the relationship between visual acuity, peripapillary retinal nerve fibre layer (pRNFL), retinal thickness at the fovea and other factors with the neurologic status of former preterm children. Methods: In this cross‐sectional hospital based study in a maximum care tertiary centre, detailed anthropometric and ophthalmological data of former preterm children ranging from 4 to 10 years of age with a gestational age (GA) ≤32 weeks were assessed. Analyses of the correlation between pRNFL and foveal thickness, as well as visual acuity (VA) parameters at 4–10 years of age, with neurological development were evaluated at 2 years of age by Bayley Scales II of Infant Development, including Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI). Results: Data were available for 106 former preterm children. Univariate analysis revealed a correlation between PDI with pRNFL thickness (B = 0.43; p = 0.013), VA (B = −29.2; p < 0.001), GA (B = 2.7; p = 0.002), retinopathy of prematurity (ROP; B = −16.3; p < 0.001) and intraventricular haemorrhages (IVH; B = −22.9; p < 0.001) but not with strabismus or foveal thickness. In the multivariable analysis, the association remained for visual acuity and IVH, but not for pRNFL thickness or ROP. Mental Developmental Index (MDI) was associated with visual acuity (B = −34.3; p = 0.001), GA (B = 2.53; p = 0.02) and IVH (B = −15.4; p = 0.02), the latter also in the multivariable analysis. Conclusion: This study revealed an association between PDI at 2 years of age and lower visual acuity later in childhood. However, there was no correlation between retinal morphology and neurologic outcome in former preterm children after adjusting for several potential confounders. [ABSTRACT FROM AUTHOR]

GA and BW percentiles were also not associated with CRAE in a multivariable model with adjustment for age, sex, mean arterial blood pressure and arterial hypertension. Preterm birth and associated factors are linked with an increased risk for cardiovascular disease and arterial hypertension in later life (Barker 2004; Barker & Bagby 2005). Associations were assessed with linear regression analyses between GA, BW and BW percentile, ROP occurrence, ROP treatment, placental insufficiency, preeclampsia, breastfeeding, maternal smoking during pregnancy, mean arterial blood pressure (mmHg) and arterial hypertension with retinal vessel characteristics. [Extracted from the article]

Abstract: A range of double carbene adducts of digallanes(4) are prepared from an existing double digallane adduct, and their halides are subsequently exchanged, establishing the feasibility of both base and halide‐exchange reactions from digallane adducts. Furthermore, a range of digallium species are treated with transition‐metal Lewis bases, leading alternatively to oxidative addition products, species with monocoordinate Ga+ ligands, and an unusual ditopic metal‐only Lewis pair (MOLP). These results underline the manifold and unpredictable chemistry of halogallane species with Lewis bases. [ABSTRACT FROM AUTHOR]

Purpose Optical coherence tomography ( OCT) of the anterior segment allows quantitative analysis of the geometry of the iris. We performed spectral domain OCT examinations in healthy emmetropic, hyperopic and myopic subjects to investigate iris curvature and its associations. Methods In a cross-sectional study, out of 4617 eyes (2309 subjects) those with refractive errors of <−4 or >+3 dioptres were identified by objective refraction. The iris was examined using the anterior segment mode of a spectral domain 3D OCT-2000 (Topcon Inc., Japan) in the temporal meridian, and OCT scans were investigated with respect to presence and amount of convex and concave iris configuration. Ninety-three eyes of 50 subjects served as emmetropic group (−0.5 ≤ x ≤+0.5 dioptres). Previous ocular surgery was exclusion criterion. Results Six hundred and sixty-eight eyes of 398 persons [292 male (76%); age range; 18-66 years] were included in the study. In the myopic group, 105 eyes had a concave iris configuration (26%), while in the hyperopic group, no eye had this configuration (0%) and in the emmetropic group five eyes (5%). Convex iris configuration was found in 96% of hyperopic, in 85% of the emmetropic and in 67% of the myopic eyes. There was an association between concave iris configuration and myopia, younger age and male gender, and with anterior chamber angle width. Conclusion Spectral domain OCT images can be used for analysis of the iris structure and geometry. Our results are limited to the properties of the study population having an age range from 18 to 66 years and consisting mainly of men. [ABSTRACT FROM AUTHOR]

Pterygium is a benign, slowly progressing disease of bulbar conjunctival tissue growing onto the cornea. Hundred participants (1.0 %; 95% CI: 0.8-1.2%) had pterygium in only one eye while 20 participants (0.2 %; 95% CI 0.1-0.3%) had pterygium in both eyes. In summary, we report data on the prevalence of pterygium in Germany. [Extracted from the article]

Retinal artery occlusion (RAO) is a rare and severe disease potentially causing blindness. Data from the health insurance AOK Baden-Württemberg in Germany in 2016. gl Using health claims data comes with several limitations including misclassification and under/over-reporting. In summary, we report incidence of RAO in Germany for the first time using health claims data and found it to be slightly higher than the data for the US (Leavitt et al.). [Extracted from the article]

The use of a base affords pyranosides, whereas silver salts gives the corresponding bromooxepines. [ABSTRACT FROM AUTHOR]