Search

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Long-term comparative data of phacoemulsification combined with endoscopic cyclophotocoagulation (phaco-ECP) versus phacoemulsification (phaco) alone in dogs are rare. Objectives: To investigate the effects of ECP on postoperative intraocular pressure (IOP) and complications after phaco in dogs with normal IOP. Methods: Medical records of IOP, conjunctival hyperemia, corneal edema, aqueous flare, posterior synechia, intraocular fibrin, and posterior capsule opacification (PCO) formation in 15 canine eyes that underwent phaco-ECP and 36 eyes that underwent phaco alone were evaluated retrospectively. ECP was applied when either the iridocorneal angle or the ciliary cleft was narrow or closed. Results: The IOP of the phaco-ECP group persisted within the normal range postoperatively. The phaco-ECP group had a shorter period of dorzolamide use than did the phaco group. PCO was formed earlier in the phaco-ECP group than in the phaco group. The phaco-ECP group showed more severe corneal edema than the phaco group at every follow-up visit. Posterior synechia was more severe in the phaco-ECP group than in the phaco group from two weeks until the last follow-up. Conclusions: Although ECP might cause more postoperative complications such as corneal edema and posterior synechia, it could effectively reduce the incidence of IOP increase after phaco in dogs with a high risk of postoperative glaucoma. [ABSTRACT FROM AUTHOR]

Background: Choroid, ciliary body, and iris melanomas are often grouped as uveal melanoma, the most common intraocular primary malignancy. The purpose of the current study was to analyze the tumor profile of newly diagnosed cases of choroidal melanoma at a reference center in Sao Paulo, Brazil, and to investigate the frequency of eyes treated by enucleation that could have been treated with brachytherapy if available in the service. Methods: Medical records of patients referred to our service with initial diagnostic hypothesis of choroidal melanoma from July 2014 to June 2020 were analysed on demographics, diagnosis confirmation, tumor measurement by ultrasonography and established treatment. Data were evaluated on clinical and demographic characteristics as age, sex, affected eye, ultrasound parameters, and treatment management of patients with clinically diagnosed choroidal melanoma. Among the patients submitted to enucleation, we investigated how many could have been selected to receive brachytherapy. Results: From the 102 patients referred with the choroidal melanoma diagnosis hypothesis, 70 (68.62%) were confirmed. Mean measurements from the tumors in millimetres were: 9.19 ± 3.69 at height and 12.97 ± 3.09 by 13.30 ± 3.30 at basal. A total of 48 cases (68.57%) were enucleated, 8 (11.43%) were treated by brachytherapy in a different service, and 14 patients (20.00%) returned for enucleation at their original referral center. Out of the 48 patients enucleated, 26 (54.17%) could have been selected to brachytherapy treatment. Conclusions: The results indicate a late diagnosis of choroidal melanoma cases referred to our service. Most enucleated cases could have been treated with brachytherapy if it was broadly available at the national public health insurance. Further public health political efforts should focus on early diagnosis and better quality of life post-treatment for oncologic patients. [ABSTRACT FROM AUTHOR]

Previously, we developed a simple procedure of intracameral injection of silicone oil (SO) into mouse eyes and established the mouse SOHU (SO-induced ocular hypertension under-detected) glaucoma model with reversible intraocular pressure (IOP) elevation and significant glaucomatous neurodegeneration. Because the anatomy of the non-human primate (NHP) visual system closely resembles that of humans, it is the most likely to predict human responses to diseases and therapies. Here we tried to replicate the mouse SOHU glaucoma model in rhesus macaque monkeys. All six animals that we tested showed significant retinal ganglion cell (RGC) death, optic nerve (ON) degeneration, and visual functional deficits at both 3 and 6 months. In contrast to the mouse SOHU model, however, IOP changed dynamically in these animals, probably due to individual differences in ciliary body tolerance capability. Further optimization of this model is needed to achieve consistent IOP elevation without permanent damage of the ciliary body. The current form of the NHP SOHU model recapitulates the severe degeneration of acute human glaucoma, and is therefore suitable for assessing experimental therapies for neuroprotection and regeneration, and therefore for translating relevant findings into novel and effective treatments for patients with glaucoma and other neurodegenerations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the position of the haptics of the implantable collamer lens (ICL) in myopic eyes using a high-frequency ultrasound robotic scanner. Methods: This was a prospective, single-arm, observational study carried out at the Instituto Zaldivar SA (Mendoza, Argentina) in a sample of 52 eyes who have been submitted to successful ICL implantation prior to enrollment. Images of the eyes were obtained using a very-high frequency digital ultrasound robotic scanner (VHFDU) to establish the position of the ICL in the posterior chamber and its relation to the ciliary sulcus. New parameters for lens position analysis were also described. Results: In 81% of cases (42 eyes), the ICL rests on the ciliary body (CB) in both temporal and nasal sides, being slightly lower than 6% (3 eyes) those that rest on the sulcus in both sides, with significant correlations between ICL position and vault values (p< 0.05). Cases in which the ICL position was CB-CB yielded central vault values across the whole range determined within the sample, but most of the eyes where the ICL rests on both the sulcus in one side and the CB in the other yield greater central vault values. Correlation was significant between ICL position and retroposition distance on the temporal side (Spearman's rho − 0.487, p< 0.001). A significant but weaker correlation was also found between ICL position and retroiridian space (p< 0.05). Conclusion: ICL for myopia footplates tend to locate outside of the sulcus in a significant percentage of patients after successful implantation. VHFDU assessment in eyes implanted with an ICL to properly study the lens footplate position and posterior anatomical relations provides important additional information besides post-surgery vault. [ABSTRACT FROM AUTHOR]

Surgical resection is widely used to treat small tumours located in the iris and the ciliary body, due to the accessibility of these sites. By contrast, surgical removal of choroidal tumours is substantially more challenging, which is why this procedure is performed only at specialised centres. In the present article, we review the literature on surgical resection of choroidal tumours, which can be performed as endoresection (ab interno) or transscleral resection (ab externo). An important aim of this review is to describe and compare the two approaches in terms of visual outcomes, survival rates, and complications. Both approaches are indicated for the removal of large tumours (thickness > 8 mm) with small base diameters. Surgical resection of the tumour allows clinicians to obtain valuable histopathologic and cytogenetic data from the specimen and eliminates the risks associated with radiotherapy. However, both of these surgical approaches are technically challenging procedures involving the risk of severe early and late postoperative complications. [ABSTRACT FROM AUTHOR]

The Fitzpatrick Skin Type (FST) is an objective method of classifying patients based on skin color and sunburn sensitivity. The Cancer Genome Atlas (TCGA) is a method of determining the prognosis of patients with uveal melanoma based on genetic composition of the tumor. There is no literature studying the relationship of FST and TCGA groups. Retrospective cohort study on 854 patients with uveal melanoma treated at a single tertiary ocular oncology center between April 2006 and June 2020, classified based on FST on a scale of I-VI and based on genetic analysis with TCGA classification on a scale of A, B, C, and D. Outcome measures included uveal melanoma-related metastasis and death per FST and TCGA group. Patients classified as FST I (compared to FST II and III-V) had higher odds of being TCGA group D (OR 2.34, p = 0.002). Patients classified as FST III-V (compared to FST I and II) had higher odds of being TCGA group B (OR 2.26, p = 0.002). Kaplan-Meier survival analysis showed no difference in melanoma-related metastasis or death comparing FST I vs. II vs. III-V within each TCGA group at 5, 10, and 15 years. Patients classified as FST I are more likely to have a higher grade melanoma on genetic testing whereas those classified as FST III-V show lower grade melanoma. Despite differences in tumor features and genetic profile with various FST, survival analysis at 5, 10, and 15 years revealed no difference in melanoma-related metastasis or death within each TCGA group per skin tone. [ABSTRACT FROM AUTHOR]

Intraocular, ciliary body, medulloepithelioma (CBME) is a rare tumor of the nonpigmented ciliary body epithelium, typically presenting in childhood. We describe a case of CBME. Ocular examination and imaging guided diagnostic and treatment decisions. Aqueous humor (AH) liquid biopsy was collected from the affected eye at eventual enucleation. Whole genome sequencing (WGS) was employed to determine somatic copy number alterations (SCNA) in AH cell-free DNA (cfDNA). Tumor sample was analyzed using various assays to evaluate for oncogenic mutations and SCNAs. Histopathology determined diagnosis. A 5-year-old male with glaucoma and cataract in the left eye (OS) experienced worsening left eye pain and redness. There was no light perception OS and the eye was hypotonus. Anterior segment exam showed complete cataract and rubeosis iridis. Ocular B-scan ultrasound OS revealed an intraocular lesion with calcifications and retinal detachment. Orbital MRI suggested left globe hypercellularity. An infiltrative lesion involving the ciliary body was seen in the left eye on examination under anesthesia. Left eye enucleation was performed in the setting of pain, blindness, and tumor, with anterior chamber paracentesis for AH liquid biopsy collection. SCNA profile of AH cfDNA demonstrated loss of copy of chromosomes 4, 6, and 9. Tumor was negative for clinically significant mutations or SCNAs. Histopathology diagnosed malignant teratoid CBME. We present a case of CBME and include the unique SCNA profile of AH cfDNA from the enucleated eye. This case suggests utility of AH liquid biopsy in distinguishing between differential diagnoses for intraocular mass lesions. [ABSTRACT FROM AUTHOR]

Retinal cavernous hemangioma (RCavH) is an uncommon, benign, vascular tumor of venous aneurysms. It can be sporadic or inherited in an autosomal-dominant pattern as part of an oculoneurocutaneous syndrome. Some affected patients are asymptomatic, and others have symptoms related to retinal dragging and vitreous hemorrhage. In the case presented here, the tumor was located in the anterior retina overhanging the ciliary body with lens involvement and heterochromia. The differential diagnosis included traumatic hemorrhage, persistent fetal vasculature, juvenile xanthogranuloma, retinoblastoma, medulloepithelioma, and others. Fluorescein angiography documented the slow-filling cavernous aneurysms of RCavH. [ABSTRACT FROM AUTHOR]

Abstract Background Inflammatory Myofibroblastoma Tumors (IMTs) are extremely tumour rare in the intraocular. Case presentation A ciliary body tumor was found under slit lamp biomicroscopy in a 55-year-old male first diagnosed with cataract. Then this patient underwent trans-sclera resection via partial lamellar sclerouvectomy and par plans vitrectomy to remove the mass. Hematoxylin and eosin (HE) staining and immunohistochemistry findings showed that the characteristics of the tumor were consistent with IMT. Conclusions We reported a rare case of intraocular IMT, which is confirmed by H&E staining, and IHC positive staining for Vimentin, Desmin and ALK, while negative staining for SMA, S-100, ki-67, CK, CD68, and calponin.

Background: Previous morphological studies have found degenerative retinal abnormalities in experimental hypopinealism. It is important to determine the morphology and function of the iris and ciliary body in prolonged pineal gland dysfunction with melatonin deficiency. Purpose: To determine the morphology and function of the iris and ciliary body in rabbits maintained under conditions of prolonged around-the-clock illumination leading to hypopinealism and melatonin deficiency. Material and Methods: Fifty five adult rabbits (110 eyes) were used in this experimental study. Animals were divided into two groups, an experimental group of 32 animals maintained under conditions of around-the-clock illumination to induce functional hypopinealism, and a control group of 23 animals maintained under natural day/night cycle conditions. Both groups were subdivided into 5 subgroups based on the duration of the experiment: 1-2 months, 3-5 months, 8-12 months, 18-19 months, and) 26-28 months. Blood melatonin levels were assessed by an enzyme-linked immunosorbent assay. A comprehensive morphological study of rabbit iris and ciliary body specimens was conducted. Results. Blood melatonin level at night time in the experimental group was almost six-fold lower than blood melatonin level in the control group. In animals maintained under conditions of around-the-clock illumination, marked circulatory abnormalities with markedly dilated and hyperemic vessels were observed in the iris and ciliary body at time points until 12 months. In addition, at 12 to 28 months, iris and ciliary body vascular circulatory abnormalities appeared to be changed by sclerotic abnormalities. In animals exposed to around-the-clock illumination, vascular sclerotic changes appeared substantially earlier, and were much more marked, than in control animals. The mean vascular wall thickness (VWT) in iris and ciliary body specimens for the experimental group was 1.5-fold higher than that for the control group (177.5 ± 7.3×10-6 m vs 101.9 ± 4.4×10-6; р < 0.05) at 18 to 19 months, and twice higher than that for the control group (217.4 ± 8.7×10-6 m vs 107.2 ± 5.2 ×10-6 m) at 26 to 28 months. The like newly formed rough bundles of collagen fibers found in an analogue of the Schlemm canal may exert a very negative effect on hydrodynamics of the eye.

The report aims to present the case of intraocular leiomyoma. We conducted a case study on a patient who presented with an intraocular tumour. After examination, including magnetic resonance, positron emission tomography with computed tomography, B-scan, we performed surgery – enucleation of the eye globe with histological verification of tumour mass. Histological analysis of enucleated eyes proved intraocular leiomyoma. Leiomyoma is a rare intraocular tumour, which is clinically challenging to recognize; therefore, histological confirmation is most often required.

To evaluate the oncological results in local control and vision preservation at 5 years with ocular brachytherapy treatment with I-125 in the largest cohort of patients in Colombia and one of the largest in Latin America, given that the National Institute of Canerology Bogota-Colombia has an important recognition in being the only institution that performs this management in the country. In an emerging country with limited resources, where surgical management with exenteration for some neoplasms such as uveal melanomas is the treatment standard, ocular brachytherapy is becoming increasingly important. This was a retrospective review of all patients with ocular melanomas treated with intraocular low-dose-rate (HDR) I-125 brachytherapy from July 2013 to October 2022 at the National Institutes of Medicine. cancerology, Bogotá-Colombia. 51 patients with ocular melanoma were identified. The median age at diagnosis was 53 years (range = 21-62). The majority were choroidal melanomas (77%, n=39), ciliary body melanomas (19%, n=10), and two iris melanomas (4%, n=2). Average hospitalization during the procedure was 3 days. The most widely used apex radiation dose prescribed was 85Gy (±: 10.3 Gy) using the COMS plate. all patients had individualized planning based on CT, fused with fine-slice resonance, ultrasound. The mean follow-up for each patient varied from the first treated patients at 71.5 months (±: 51.8 months). 47 patients (92.1%) remained free of recurrence. 41 (80.3%) demonstrated complete tumor regression after a median period of 24 months (3-74 months). At the final examination, the visual acuity of 33 patients (64.7%) was 20/20 and 14 patients (27.4%) had a visual acuity of 20/40. Retinopathy was detected in 4 patients (7.8%). After the treatments, only two patients (3.9%) had active vascular changes at the last examination. Moderate optic neuropathy was observed in 1 patient (1.9%). Cataract development was diagnosed in 10 patients (19.6%) and 5 patients (9.8%) had bilateral cataract development. Ocular brachytherapy with I-125 for ocular melanoma is an excellent treatment strategy for properly selected patients, offers optimal local control, preserves the visual, functional and aesthetic capacity of patients, our data on oncological results support this option every time more important in developing countries such as Colombia where access to this management modality is limited. [ABSTRACT FROM AUTHOR]

Microphthalmia, mostly an autosomal dominant disorder, is a worldwide severe congenital ocular malformation that causes visual impairment. Our investigation unveiled a total of 30 genes associated with microphthalmia. Employing the CytoHubba and PPI network, we identified Bmp4 as the most pivotal hub gene. Subsequently, the conditional overexpression of Bmp4 in the retina caused highly distinctive microphthalmia, manifested by retinal disorganization with ganglion cell misalignment. Significant reduction in the number and abnormal distribution location of retinal cells in microphthalmia model mice. Elevated Bmp4 was associated with an increase in retinal apoptosis and a decrease in proliferating cells, which exacerbates the development of microphthalmia. Here we identify Bmp4 as an extremely important gene responsible for microphthalmia and the involved mechanisms. Overexpression of Bmp4 induces retinal cell ectopic expression and developmental defects, highlighting the importance of a well-balanced Bmp4 level in shaping the embryonic retina during early development. • Bmp4 is the key gene associated with microphthalmia using bioinformatics analysis. • Bmp4 overexpression contributed to defects in retinal and ciliary body development. • The proper level of Bmp4 was important for embryonic eye development. [ABSTRACT FROM AUTHOR]

RETRACTION: A.A. Seleem, and A.H. Badr, 'Comparative Study of The Ciliary Body and Iris Morphology In The Anterior Eye Chamber of Five Different Vertebrate Classes', Anatomia Histologia Embryologia 53, no. 3 (2024): e13052, https://doi.org/10.1111/ahe.13052. The above article, published online on 12 May 2024 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor‐in‐Chief, Fred Sinowatz; and Wiley‐VCH GmbH, Published by John Wiley & Sons Ltd. The retraction has been agreed after an investigation found that this article was the resubmitted version of a manuscript which had been rejected a month previously, primarily due to concerns about compliance with animal ethical best practices concerning killing. Upon submission of the second manuscript, there was no clearly identifiable indication that it was a resubmission, as required by the journal during the submission process. Without knowledge that the new manuscript was the resubmission of a rejected manuscript, the new handling editors could not benefit from the peer review history. Because of this, they did not appreciate the necessity to confirm whether the ethical concerns raised in the rejected version had been addressed in the resubmitted version. Had the handling editors seen the peer review history, they would have rejected the second manuscript prior to peer review. Additionally, the second manuscript had been edited to omit mention of the unethical practice and investigators were therefore unable to verify which methods were used in the published study, nor could they evaluate them against the accepted ethical practices for handling animals. The authors responded to our inquiry but could not provide either adequate raw data or explanations for our concerns. Therefore, the article must be retracted. The authors have been informed of the retraction and Dr. Seleem, on behalf of both authors, disagrees with this decision. [ABSTRACT FROM AUTHOR]

Osteopontin (OPN) is an extracellular matrix protein with a diverse range of functions, including roles in cell adhesion, migration, and immunomodulation, which are associated with the modulation of neuroinflammation in the central nervous system. The present study was performed to evaluate the involvement of OPN in the eyes of an experimental autoimmune uveoretinitis (EAU) model. The EAU model was developed by immunization of Lewis rats with interphotoreceptor retinoid-binding protein. The results showed the OPN level was remarkably upregulated in the eye of EAU rats on day 9 post-immunization. The level of CD44, a ligand of OPN, was increased in the ciliary body of EAU rats. Furthermore, OPN was also detected in the ciliary body and activated microglia/macrophages in the EAU retina. The results suggest that OPN was significantly upregulated in the eyes of EAU rats, and that it may be useful as an early biomarker of ocular autoimmune diseases. All animal experiments were approved by the Institutional Animal Care and Use Committee of Jeju National University (approval No. 2020-0012) on March 11, 2020.

Yacoub A Yousef,1 Mona Mohammad,1 Ibrahim AlNawaiseh,1 Reem AlJabari,1 Mario Damiano Toro,2,3 Almutez Gharaibeh,4 Robert Rejdak,5 Katarzyna Nowomiejska,5 Sandrine Zweifel,3 Teresio Avitabile,6 Magdalena Rejdak,6 Rashed Nazzal2 1Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan; 2Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszy&nacute;ski University, Warsaw, Poland; 3Department of Ophthalmology, University of Zürich, Zürich, Switzerland; 4School of Medicine, The University of Jordan, Amman, Jordan; 5Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland; 6Department of Ophthalmology, University of Catania, Catania, ItalyCorrespondence: Yacoub A YousefDepartment of Surgery (Ophthalmology), King Hussein Cancer Centre, Queen Rania St, Amman, 11941, JordanTel +96265355000Email yyousef@khcc.joMario Damiano ToroDepartment of Ophthalmology, University Hospital of Zürich, Raemistrasse 100, Zürich, 8091, SwitzerlandTel +39 3495158220Email toro.mario@email.itPurpose: Ciliary body (CB) and iris thicknesses may change with certain eye diseases as well as between different populations. Here, we report Ultrasound Biomicroscopy Measurements (UBM) of the normal thickness for the CB and the iris from a homogenous population in the Middle East.Patients and Methods: Sonomed 35-MHz (SONOMED, INC. New York, USA) images were obtained at 4 radial meridians, and the thickness was measured at 3 locations along the radial length of the iris and at the thickest part of the CB. Parameters included mean thickness, median thickness, range, and standard deviation.Results: Of 46 adult patients, 83 normal eyes were included in this analysis. The overall mean, median iris thicknesses at the iris root, midway along the radial length of the iris, and at the juxtapupillary margin in mm were 0.42, 0.41 ± 0.08, 0.52, 0.51± 0.08, and 0.72, 0.71± 0.1, respectively. The overall mean, median thicknesses of the CB and CB + ciliary processes in mm were 0.72, 0.71 ± 0.1, and 1.42, 1.37 ± 0.2 respectively. Gender, age, side, and height had no impact on iris and/or CB thickness (p> 0.05). However, the iris thickness was significantly thicker in the superior quadrant than inferiorly, and in the nasal quadrant than the temporal quadrant (p=0.04), and the CB thickness and the CB + ciliary processes thickness were significantly thicker in the superior quadrant than inferiorly (P = 0.04 and 0.02 consecutively).Conclusion: We measured in this study the normal thickness of the CB and the iris in normal eyes from homogenous population in the Middle East using ultrasound biomicroscopy. Our findings are essential for the ophthalmic community worldwide and in the Middle East region and can be used as a normative thickness data for the iris and CB in healthy eyes.Keywords: ultrasound biomicroscopy, iris, ciliary body

Myo/Nog cells, named for their expression of MyoD and noggin, enter the eye during early stages of embryonic development. Their release of noggin is critical for normal morphogenesis of the lens and retina. Myo/Nog cells are also present in adult eyes. Single nucleated skeletal muscle cells designated as myofibroblasts arise from Myo/Nog cells in cultures of lens tissue. In this report we document the presence of Myo/Nog cells in the lens, ciliary body and on the zonule of Zinn in mice, rabbits and humans. Myo/Nog cells were rare in all three structures. Their prevalence increased in the lens and ciliary body of rabbits 24 h following cataract surgery. Rabbits developed posterior capsule opacification (PCO) within one month of surgery. The number of Myo/Nog cells continued to be elevated in the lens and ciliary body. Myo/Nog cells containing alpha smooth muscle actin and striated muscle myosin were present on the posterior capsule and overlaid deformations in the capsule. Myo/Nog cells also were present on the zonule fibers and external surface of the posterior capsule. These findings suggest that Myo/Nog contribute to PCO and may use the zonule fibers to migrate between the ciliary processes and lens.

Glaucoma remains a significant problem in ophthalmology. It is characterised by increased intraocular pressure (IOP), visual field loss, and optic nerve degeneration. Despite some progress achieved in the diagnosis and treatment of the disease, millions still suffer from glaucoma (currently, according to WHO, there are more than 106 million people globally), and many patients are already in the later stages. The accompanying pain syndrome sometimes forces doctors to remove the eye. In this regard, several so-called organ-preserving operations were introduced, the purpose of which is to reduce the production of intraocular fluid (IOF) and, accordingly, eliminate the pain syndrome. Glaucoma treatment includes conservative and surgical interventions. Surgical methods for glaucoma treatment aim to improve the outflow of intraocular fluid (fistulising operations) or reduce its production (cyclodestructive procedures). This paper analyses the evolution of surgical interventions to reduce intraocular fluid production by destroying the aqueous humour-producing ciliary processes. Systematic review searches were performed using Google Scholar, Pubmed, Web of Science, Cyberleninka, and Cochrane Library databases for articles published up to 2020 using keywords related to cyclodestruction (CD), cyclophotocoagulation (CPC), and treatment of refractory glaucoma (RG).

Background. In the available literature, there are isolated publications devoted to the topic of the possible effect of laser correction by the Femto LASIK method on the myopic eye choroid. In this connection, in our opinion, the relevance of continuing research in this direction remains.The aim of this study was to examine the volume of the retina in the macular zone, the thickness of the choroid and the ciliary body using optical coherence tomography on myopic eyes after femtosecond-assisted laser in situ keratomileusis in the short term.Material and methods. 30 patients (30 right eyes) aged 20 to 35 years, suffering from mild and moderate myopia, but without pathological changes in the retina according to OCT, made up the study group. All patients underwent myopia correction using the Femto LASIK method. Before the operation, after 4 hours and the next day, they underwent the examination of the retinal volume in the macular zone, the choroidal and the ciliary body thickness using OCTResults. The analysis of the obtained results of the studied parameters showed that the ciliary body thickness and the retinal volume in the macular zone did not undergo statistically signifi cant changes and remained within the preoperative values (p > 0.05). We observed a tendency to an increase in the thickness of the choroid 4 hours after the operation, but the carried out statistical analysis did not confi rm the reliability of its changes (p > 0.05). On the next day, the choroidal thickness indices practically recovered to the preoperative level (p > 0.05).Conclusion. A study of the retinal volume in the macular zone, the thickness of the choroid and ciliary body using OCT in myopic eyes in the short term after Femto LASIK showed the absence of statistically signifi cant changes in the studied parameters, which indirectly indicates the safety of this method of laser correction for the posterior segment of the eye.

PurposeTo evaluate the long-term clinical efficacy of ultrasound cyclo-plasty (UCP) in the treatment of moderate glaucoma and molecular effects in animal experiments.MethodsAn 18-month clinical study was conducted among 32 patients with moderate glaucoma. The primary outcome was surgical success, defined as a reduction in intraocular pressure (IOP) of greater than or equal to 20% from the baseline and an IOP value of greater than 5 mmHg at the last follow-up. The secondary outcomes were related to the quality of life, complications, and mean IOP value at each follow-up. In the animal experiment, 20 New Zealand rabbits were used to establish a high-IOP model and implement UCP. The distribution of aquaporin 4 (AQP4) in the ciliary body and the tissue changes under electron microscopy were observed after surgery.ResultsThe mean patient IOP decreased from 34.9 ± 4.9 mmHg before surgery to 23.5 ± 5.2 mmHg at 18 months after UCP. No vision loss occurred in any patient. Some patients had postoperative complications, but the symptoms were mild and disappeared within 3 months after the surgery. Most patients had good postoperative quality of life. Histology showed that AQP4 remained in the ciliary muscle after UCP, and only the bilayered epithelial cells showed coagulative necrosis. Furthermore, electron microscopic observation revealed the destruction of ciliary process cells covered by ultrasound after UCP.ConclusionUCP is associated with mild postoperative reactions and the mild treatment of ciliary tissue and is a safe and effective method for reducing IOP in moderate glaucoma.

Primary open-angle glaucoma progression in those already on maximal medical therapy has traditionally been treated with trabeculectomy, a surgical procedure that carries a high degree of morbidity. In the last few decades, significant advances have been made in the field of minimally invasive glaucoma surgery (MIGS) devices, which aim to defer or prevent trabeculectomy via less arduous surgical techniques in certain types of glaucoma. Although reviews have been published examining the efficacy of various MIGS techniques, no article synthesises the comparative safety of all available devices. We performed a literature review examining the safety of MIGS devices. Fifteen devices were included, variously attempting to increase aqueous outflow through the trabecular meshwork or the suprachoroidal space, shunting into the subconjunctival space, or reducing aqueous production through ciliary body ablation. Notably, the earliest product attempting to increase outflow to the suprachoroidal space, Alcon's CyPass Micro-Stent, was withdrawn from the market due to concerns regarding increased corneal endothelial cell loss at five years post-implantation. All other devices were described as well-tolerated, with the most common adverse effects including hyphaema, intraocular pressure spikes, and device migration or obstruction. MIGS devices are purported to be uniformly safe, and many studies report no statistically significant increased complications beyond those associated with cataract surgery alone. It is important to note, however, the generally poor quality of current studies, with a dearth of randomised, or even prospective, data, and a large proportion of studies funded by device producers. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the outcomes of ultrasound cyclo plasty (UCP) for primary open-angle glaucoma (POAG) and identify the predictors of failure. Methods: This retrospective cohort study included patients with POAG who underwent UCP at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, between 2016 and 2021. The main outcome measures were the intraocular pressure (IOP), the number of antiglaucoma medications, and the presence of vision-threatening complications. The surgical outcome of each eye was based on the main outcome measures. Cox proportional hazard regression analysis was performed to identify the possible predictors of UCP failure. Results: Sixty-six eyes of fifty-five patients were included herein. The mean follow-up period was 28.95 (±16.9) months. The mean IOP decreased significantly from 23.02 (±6.1) to 18.22 (±7.0) and 16.44 (±5.3) mm Hg on the 12th and 24th months, respectively; the mean number of antiglaucoma medications decreased significantly from 3.23 (±0.9) to 2.15 (±1.5) and 2.09 (±1.6), respectively. The cumulative probabilities of overall success were 71.2 ± 5.6% and 40.9 ± 6.1% on the 12th and 24th months, respectively. High baseline IOP and the number of antiglaucoma medications were associated with a higher risk of failure (hazard ratio = 1.10 and 3.01, p = 0.04 and p < 0.01, respectively). The most common complications were cataract development or progression (30.8%) and prolonged or rebound anterior chamber reaction (10.6%). Conclusions: UCP reasonably controls the IOP and reduces the antiglaucoma medication burden in eyes with POAG. Nevertheless, the success rate is modest, with a high baseline IOP and number of medications. [ABSTRACT FROM AUTHOR]

Purpose: To describe successful intraocular pressure control of refractory glaucoma and vision preservation with an endocyclophotocoagulation (ECP) procedure by pars plana approach. Animal Studied An 8‐year‐old, female‐spayed, mixed‐breed goniodysgenic dog with glaucoma following phacoemulsification with intraocular lens placement (IOL) refractory to maximized medical therapy and Ahmed gonioimplantation in both eyes (OU). Procedures: For the first glaucoma interventional surgery, bilateral goniovalve implantation was performed following cataract surgery. A goniovalve was implanted in the left eye (OS) 2‐days post‐phacoemulsification, and 14‐days post‐phacoemulsification in the right eye (OD). Short‐term intraocular pressure (IOP) control was achieved. However, glaucoma recurred 41‐days post‐phacoemulsification OU, and an endocyclophotocoagulation by pars plana approach was performed OU to treat 300° of the ciliary body with a 23‐gauge argon laser endoscope. Results: Th ECP pars plana approach was successful in obtaining IOP‐control and vision preservation during a 15‐month follow‐up period. No intraoperative complications were encountered. Short‐term postoperative complications included intraocular inflammation with fibrin and postoperative ocular hypertension. Intraocular pressure‐control and vision preservation were maintained at the last follow‐up examination, 15 months postoperative pars plana ECP. Conclusion: Endocyclophotocoagulation by pars plana approach achieved long‐term (>1 year) IOP‐control, preserved vision, and reduced the number of anti‐glaucoma medications following failure of previous Ahmed gonioimplantation for uncontrolled glaucoma. This is the first case report of an endocyclophotocoagulation procedure by a pars plana approach for uncontrolled glaucoma following Ahmed gonioplantation. With the appropriate skill set, this novel surgical approach can be considered as a surgical intervention for glaucoma in canine patients. [ABSTRACT FROM AUTHOR]

People infected with the mosquito-borne Rift Valley fever virus (RVFV) can suffer from eye-related problems resulting in ongoing vision issues or even permanent blindness. Despite ocular disease being the most frequently reported severe outcome, it is vastly understudied compared to other disease outcomes caused by RVFV. Ocular manifestations of RVFV include blurred vision, uveitis, and retinitis. When an infected individual develops macular or paramacular lesions, there is a 50% chance of permanent vision loss in one or both eyes. The cause of blinding ocular pathology remains unknown in part due to the lack of a tractable animal model. Using 3 relevant exposure routes, both subcutaneous (SC) and aerosol inoculation of Sprague Dawley rats led to RVFV infection of the eye. Surprisingly, direct inoculation of the conjunctiva did not result in successful ocular infection. The posterior segment of the eye, including the optic nerve, choroid, ciliary body, and retina, were all positive for RVFV antigen in SC-infected rats, and live virus was isolated from the eyes. Proinflammatory cytokines and increased leukocyte counts were also found in the eyes of infected rats. Additionally, human ocular cell lines were permissive for Lrp1-dependent RVFV infection. This study experimentally defines viral tropism of RVFV in the posterior segment of the rat eye and characterizes virally-mediated ocular inflammation, providing a foundation for evaluation of vaccines and therapeutics to protect against adverse ocular outcomes. IMPORTANCE Rift Valley fever virus (RVFV) infection leads to eye damage in humans in up to 10% of reported cases. Permanent blindness occurs in 50% of individuals with significant retinal scarring. Despite the prevalence and severity of this outcome, very little is known about the mechanisms of pathogenesis. We addressed this gap by developing a rodent model of ocular disease. Subcutaneous infection of Sprague Dawley rats resulted in infection of the uvea, retina, and optic nerve along with the induction of inflammation within the posterior eye. Infection of human ocular cells induced inflammatory responses and required host entry factors for RVFV infection similar to rodents. This work provides evidence of how RVFV infects the eye, and this information can be applied to help mitigate the devastating outcomes of RVF ocular disease through vaccines or treatments. [ABSTRACT FROM AUTHOR]

Background: The oculomotor nerve (OMN) innervates the pupil, ciliary body, upper eyelid, and extraocular muscles through two divisions: a superior division that innervates the levator palpebrae superioris (LPS) and superior rectus (SR), and an inferior division that supplies the medial rectus (MR), inferior rectus (IR), inferior oblique (IO), and parasympathetic fibers to the pupil and ciliary body. We present a case of complete splitting of the cisternal segment of bilateral OMNs that was discovered incidentally on magnetic resonance imaging (MRI) in a patient who had no ocular complaints. Case report: A 69-year-old patient was found to have bilateral splitting of the cisternal segments of OMNs during an MRI for trigeminal neuralgia workup. Both nerves sprang from the midbrain as distinct roots. They were symmetric on the right and minimally asymmetric on the left. On both sides, the medial root was slightly inferiorly situated. The patient had no visual problems and continued to function normally. A review of the literature for similar cases identified no such variants; however, it did identify eight examples of OMN fenestrations produced by aneurysms (AN), six of which had no OMN palsy symptoms. Conclusion: An anatomic variant of split bilateral OMN cisternal segments is described. The superior and inferior divisions may have different brainstem origins. Although this variant is an anatomic curiosity, it may have clinical significance and explain the various presentation of compressive OMN palsies. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety of a new intraocular mitomycin c (MMC) application technique in the rabbits. Materials and Methods: Sixteen male New Zealand rabbits were used. The rabbits were divided into 4 study groups. 2µg MMC in group-A, 5µg MMC in group-B, 10µg MMC in group-C and 20 µg MMC in group-D were applied with MMC sandwich technique into right eyes of rabbits. In MMC sandwich technique, ciliary body was protected with air, and posterior pole was protected with perfluorocarbon. The left eye was used as a control group. The rabbits had one-month followed up. Intraocular pressures were measured at first week and month 1. Scotopic and photopic a-and b-wave amplitudes and implicit times were compared between control and study eyes. Multiple small slices that included the ciliary body, macula and optic nerve head were examined for the evaluation of MMC toxicity Results: Intraocular pressure did not differ between the control and study eyes. Scotopic and photopic a- and b-wave amplitudes and implicit times of group A, B, C and D eyes were similar to those of the control eyes. In all of the study groups, the histopatholologic morphologies of the ciliary body, retina and optic nerve were similar to those of control group. Furthermore, retinal layer thicknesses were similar between the MMC injected eyes and the control eyes. Conclusions: Our newly defined MMC sandwich technique permitted the use of MMC up to 20 µg concentrations without causing toxicity in the vital intraocular structures. [ABSTRACT FROM AUTHOR]

Intraocular pressure (IOP) is regulated primarily through aqueous humor production by ciliary body and drainage through uveoscleral and trabecular meshwork (TM) tissues. The goal of this study was to measure the effect of non-psychotropic cannabidiol (CBD) on aqueous humor outflow through TM and assess the effect of CBD on the TM cell signaling pathways that are important for regulating outflow. Perfused porcine eye anterior segment explants were used to investigate the effects of CBD on aqueous humor outflow. Cultured porcine TM cells were used to study the effects of CBD on TM cell contractility, myosin light chain (MLC) and myosin phosphatase targeting subunit 1 (MYPT1) phosphorylation, and RhoA activation. In the anterior segment perfusion experiments, aqueous humor outflow was increased significantly within 1 h after adding 1 µM CBD and the effect was sustained over the 5 h of measurement. Treatment of TM cells with 1 µM CBD significantly decreased TM cell-mediated collagen contraction, inhibited phosphorylation of MLC and MYPT1, and reduced RhoA activation. Our data demonstrate, for the first time, that as a potential therapeutic agent for lowering intraocular pressure, CBD can enhance aqueous humor outflow and modify TM cell signaling. [ABSTRACT FROM AUTHOR]

To summarize the design and methodology of a trial designed to evaluate the efficacy and safety of low dose laser cycloplasty (LCP) in treating malignant glaucoma. Prospective, multicentre, non-controlled clinical trial. Subjects were recruited from eight ophthalmic centers in China. The target sample size was 34. Patients aged >18 years with a clinical diagnosis of malignant glaucoma inadequately controlled on medical therapy or malignant glaucoma recurrence after topical cycloplegics withdrawal were enrolled. All patients underwent LCP under retrobulbar anesthesia or sub-Tenon anesthesia. LCP is a treatment adopting few laser points (1100–2000 mW energy, 2000 milliseconds duration) that cauterizes and remodels the ciliary body over two clock hour-positions, which may relieve the ciliary ring block. Follow-up is planned for a period of 12 months. The primary outcome is the resolution of malignant glaucoma which is defined as central anterior chamber deepening after LCP. The Malignant Glaucoma Treatment trial (MGTT) will be the first prospective trial providing evidence of a treatment for malignant glaucoma. It intends to provide clinicians an optional, easy and convenient treatment for malignant glaucoma patients. Detailed morphological and biometric information collected during the study period will also help provide experience for the outcomes of malignant glaucoma. ChiCTR1800017960. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is an autoimmune disease which causes non‐scarring type hair loss considered to target the pigmentary system. The hair follicle may not be the only site for involvement of the disease. Iris, the ciliary body, choroid and epithelium of the retinal pigment may also be affected. The aim of the present study was to compare retinal pigment epithelium (RPE) and choroidal thicknesses between patients with AA and healthy controls. Methods: The study included 44 patients with alopecia areata, and 44 healthy individuals with similar age and gender distribution. RPE and choroidal thickness measurements were performed through Spectral‐domain optical coherence tomography (SD‐OCT) (Heidelberg Spectralis® OCT). Results: There was not any significant difference between patients with AA and healthy individuals for RPE and choroidal thickness (p = 0.751, p = 0.725, respectively). However, the choroidal thickness (422 ± 79 μm) was significantly thinner in patients with poor prognostic criteria than other patients (371 ± 75 μm; p = 0.039). Conclusion: Monitoring of choroidal thicknesses through optic coherence tomography (OCT) may provide an insight for the disease prognosis in patients with AA. [ABSTRACT FROM AUTHOR]

To investigate the UBM characteristics of presumed trematode-induced granulomatous uveitis. Prospective case series. Thirty patients who presented with anterior chamber (AC) granuloma were included. UBM Imaging included Cornea, iris, AC angle, posterior chamber, ciliary body, and vitreous base. Thirty eyes were included with a mean age of 12.4 ± 2.5 years. UBM findings were retrocrneal membrane (33%), sub conjunctival nodule (10%), AC granuloma (100%); peripheral anterior synechia, granuloma-like lesion in posterior chamber; ciliary body edema with localized granuloma at specific site (100%), cataract in 30% either localized or generalized, and dot or thread-like high reflection on vitreous base in (20%). Presumed trematode-induced AC granuloma is common among children living in the rural areas of Egypt. UBM examinations can demonstrate various pathologic changes of anterior segment of the eye and provide objective evidence for the exact origin of those granulomas. [ABSTRACT FROM AUTHOR]

Purpose: To present a case of intraocular schwannoma arising from the ciliary body with description of histological and immunophenotypic characteristics. Case Report: A 32-year-old woman who was followed for glaucoma of the left eye and chronic renal failure at the stage of hemodialysis presented with buphthalmos and two weeks of blurry vision of the left eye. A magnetic resonance imaging exam was performed suspecting melanoma. Enucleation was rapidly performed. The histological examination after HE (Hematoxylin and Eiosin) and HEA50 (Hematoxylin and polychromatic solution EA 50) staining showed proliferation of mesenchymal monomorphic fusiform cells with eosinophilic cytoplasm and small oval nuclei which showed a tendency toward palisading. Some parts of the tumor were hypercellular with a fascicular arrangement (Antoni A pattern); other parts were weakly cellular with a myxoid arrangement (Antoni B pattern). Several Verocay bodies and a lot of hemorrhagic suffusions were described. Mitotic figures were very rare. Immunohistochemistry staining showed that tumor cells were positive for PS100 and vimentin. Conclusion: Although ciliary body schwannoma is extremely rare, it should be considered in the differential diagnosis of intraocular tumors. [ABSTRACT FROM AUTHOR]

Iris and ciliary body cysts constitute a significant diagnostic problem and are difficult to diagnose in routine practice on slit lamp or gonioscopy examination. The diagnosis must be established by ultrabiomicroscopy, which is not widely available, but represents the only technique capable of evaluating the anatomical relationships of the visualized ocular structures. Diagnosing ocular hypertension and pseudoplateau iris secondary to iridociliary cysts can be challenging for ophthalmologists, as it is rarely possible to perform a complete diagnostic workup. The authors of this article present a rare case of a patient with bilateral pseudoplateau iris and ocular hypertension associated with iridociliary cysts. In addition, various forms of intraocular pressure-regulating therapies recommended in treatment are reviewed. [ABSTRACT FROM AUTHOR]

Background: Ocular mucosa-associated lymphoid tissue (MALT) lymphoma involving orbit and conjunctiva usually has an indolent clinical course with "salmon patch" mass as typical presentation. This study is to report a series of rare cases and investigate the clinical and pathological features of ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis.Methods: This retrospective, observational study was conducted at Beijing Tongren Hospital. From 2018 to 2020, 3 cases of 3 eyes (2 female patients and 1 male patient) with ocular MALT lymphoma that involved uveal tissue primarily and presented as posterior scleritis were included in the study. All patients had complaints of red eyes with blurred vision. The average age was 56.33 ± 2.08 years old and the average time from initial diagnosis to pathological diagnosis was 3.00 ± 1.73 months. Ophthalmic examinations including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp microscope examinations, fundus photography, B-scan ultrasonography, ultrasound biomicroscope (UBM), optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were conducted. Systemic workups including orbital magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and blood autoimmune antibody tests were also conducted. Pathological tissue from patients were obtained through surgeries. Biopsy examinations were performed to accurately determine pathological diagnosis. All the information of clinical, imaging and pathological changes were collected and analyzed.Results: At the initial diagnosis, the BCVA of involved eyes decreased seriously while the IOP were normal. All involved eyeball showed extensive hyperemia and local thickening in the wall of eyeballs. B-scan ultrasonography showed mass with abundant blood and irregular cysts inside the eyeball wall and in the retrobulbar orbit, surrounding the ocular wall and optic nerve. UBM showed solid lesions with low and medium echo under the conjunctiva and inside the ciliary body of 2 cases. OCT showed posterior polar wavy rise of RPE and local neuroepithelial detachment in all cases. FFA and ICGA showed vascular abnormalities (patch-like strong fluorescence and fluorescence leakage) and local thickening in retina and choroid (Rectangle-like weak fluorescence below the macula). The posterior wall of the eyeball was thickened and enhanced in MRI. PET-CT also showed thickening of posterior wall of eyeballs and increased metabolic activity but there was no sign of autoimmune disease. All patients were diagnosed as MALT lymphoma through pathologic examinations of biopsy tissue.Conclusions: The onset of primary ocular MALT lymphoma in uvea is hidden. The early clinical manifestations are lack of specificity and misleading. B-scan ultrasonography has characteristic manifestations and is valuable in diagnosis. However, pathological diagnosis through tissue biopsy is irreplaceable. [ABSTRACT FROM AUTHOR]

Nephrotic syndrome is a disease that causes fluid retention in the body due to loss of protein in the blood, which can lead to serous retinal detachment (SRD) in the macula. We report a case of severe SRD in both eyes and angle closure due to ciliary body edema caused by nephrotic syndrome. A 57-year-old man was admitted to the Department of Nephrology in our hospital for a thorough examination of his generalized edema. He was diagnosed with nephrotic syndrome but proved to be refractory to steroid treatment. Due to distortion symptoms in both eyes on the 30th day of hospitalization, the patient was referred to our department. Best-corrected visual acuity (BCVA) was 0.8 in the right eye and 1.0 in the left eye. Slit lamp examination and anterior segmental optical coherence tomography (OCT) showed shallow anterior chambers in both eyes. Fundus and macular OCT demonstrated severe SRD in the posterior pole of both eyes. After observing the presence of hypoalbuminemia, we considered the possibility of SRD and angle closure due to ciliary edema that resulted from the leaks associated with the nephrotic syndrome. Thereafter, ocular findings improved in conjunction with systemic symptom improvements associated with ultrafiltration and low-density lipoprotein apheresis. On the 60th day of hospitalization, his BCVA improved to 1.2 in both eyes, SRD disappeared, and the anterior chamber depth normalized. This case demonstrates the importance of recognizing SRD and angle closure associated with ciliary body edema as complications linked with nephrotic syndrome. [ABSTRACT FROM AUTHOR]

Posterior scleritis is a relatively uncommon form of scleral inflammation of the posterior segment of the eye. Clinical manifestations include ocular pain, headache, pain with ocular movements, and loss of vision. A rare presentation of the disease is acute angle closure crisis (AACC) with elevated intraocular pressure (IOP) secondary to anterior displacement of the ciliary body. Various systemic diseases have been described to co-exist with posterior scleritis; however, psoriasis has not been associated with posterior scleritis. Here, we present a case of posterior scleritis which initially presented as AACC in a patient with pre-existing psoriasis. A 50-year-old male with a history of psoriasis under treatment presented to the emergency department with intense sudden ocular pain and loss of vision on the left eye as well as headache and nausea. A thorough medical and ocular history was taken, and a detailed examination of the anterior and posterior segment was completed including visual acuity and IOP. Initial diagnosis of AACC was made, and appropriate actions were taken with partial resolution of his symptoms. However, upon further work-up including ultrasound (B-scan) of the left eye a final diagnosis of posterior scleritis was made. The patient was treated with steroids and nonsteroidal anti-inflammatory drugs which dramatically improved his condition. Photographic evidence of initial presentation and post-treatment condition was obtained and presented in this report. Posterior scleritis is a potentially vision-threatening condition which is usually challenging to diagnose. In this report, we highlight the challenges one might come into when dealing with different manifestations of the same disease, increasing awareness. This case of posterior scleritis presenting as AACC in a patient with a history of psoriasis enhances what we already know from the literature as well as provides some new insights in the clinical manifestations of posterior scleritis in the setting of psoriasis without arthritis. [ABSTRACT FROM AUTHOR]

Mechanical properties of the anterior anatomical structures of the eye, such as the cornea and ciliary body, play a key role in the ocular function and homeostasis. However, measuring the biomechanical properties of the anterior ocular structures, especially deeper structures, such as the ciliary body, remains a challenge due to the lack of high-resolution imaging tools. Herein, we implement a mechanical shaker-based high-frequency ultrasound elastography technique that can track the induced elastic wave propagation to assess the linear and nonlinear elastic properties of anterior ocular structures. The findings of this study advance our understanding of the role of anterior ocular structures in the pathogenesis of different ocular disorders, such as glaucoma. [ABSTRACT FROM AUTHOR]

Clearance of ocular fluid and metabolic waste is a critical function of the eye in health and disease. The eye has distinct fluid outflow pathways in both the anterior and posterior segments. Although the anterior outflow pathway is well characterized, little is known about posterior outflow routes. Recent studies suggest that lymphatic and glymphatic systems play an important role in the clearance of fluid and waste products from the posterior segment of the eye. The lymphatic system is a vascular network that runs parallel to the blood circulatory system. It plays an essential role in maintenance of fluid homeostasis and immune surveillance in the body. Recent studies have reported lymphatics in the cornea (under pathological conditions), ciliary body, choroid, and optic nerve meninges. The evidence of lymphatics in optic nerve meninges is, however, limited. An alternative lymphatic system termed the glymphatic system was recently discovered in the rodent eye and brain. This system is a glial cell-based perivascular network responsible for the clearance of interstitial fluid and metabolic waste. In this review, we will discuss our current knowledge of ocular lymphatic and glymphatic systems and their role in retinal degenerative diseases. [ABSTRACT FROM AUTHOR]

Introduction: Intraocular metastasis (IM) occurred in approximately 8–10% of patients with metastatic malignancy, for whom oncological immunotherapies showed poor visual potential. However, the mechanism for that inefficiency remains unclear and requires further exploration. Methods: We established a novel mouse model of IM by intracarotid injection of cutaneous melanoma cells. We investigated disease progression using ophthalmic and histological examinations. We used combined anti-PD-1 and anti-CTLA4 antibodies for immunotherapy and evaluated the therapeutic effects in the mouse model. In addition, we characterized the immune microenvironment of tumor-infiltrating CD8+ T by fluorescence staining and assessed their cytotoxicity by flow cytometry. Results: All mice presented IM in the left eye, while the right eye was healthy. Uveal tissues with rich vascularity (e.g., the iris, ciliary body, and choroid) initiated IM at an early stage, and IM development resulted in several secondary changes, including corneal swelling, retinal detachment, and intratumoral hemorrhage. Immunotherapy could inhibit IM and prolong the time to eye rupture but did not prevent rupture ending. This inefficiency might be attributed to ocular tissues specificities that inhibited CD8+ T-cell infiltration via PD-L1 expression. PD-L1low corneal tissue resisted tumor invasion with high levels of CD8+ T-cell infiltration, whereas CD8+ T cells were deficient in PD-L1high uveal metastasis. Furthermore, we found a significantly increased PD-1+/− CD4+ and PD-1+/− CD8+ T cells infiltrating the intratumoral hemorrhage area. Although these CD8+ T cells in the IM were not exhausted and had a higher capacity of cytotoxicity (higher interferon-γ ratio) than CD8+ T cells in the blood, FasL+ PD-L1+ ocular tissue can strongly inhibit these IM-infiltrating T cells. Conclusions: Immunotherapy can inhibit the disease progression of IM. Enhancing the effects of tumor-infiltrating CD8+ T cells should be one of the highest potentials to improve the visual potential. [ABSTRACT FROM AUTHOR]

Introduction: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) is a method for intraocular pressure (IOP) reduction in patients with glaucoma; however, the specific mechanisms underlying its ability to reduce IOP remain unclear. We therefore investigated the morphological changes and mechanisms of IOP reduction after MP-TSCPC. Methods: The right eyes of 4 pigmented rabbits were treated with MP-TSCPC with power setting corresponding to those used in glaucoma patients (1 power: 2,000 mW; time: 160 s; duty cycle: 31.3%). Power settings of 1, 1/8, 1/16, and 1/32 power were applied to the right eyes. The left eyes were used as controls. A light microscope and electron microscope were used to observe morphological findings after 1 week of MP-TSCPC. IOP and IOP reduction rate were compared before and after MP-TSCPC application on days 1, 3, and 5, and at 1 week. Results: In the pre-MP-TSCPC, IOP was 16.7 ± 0.6 mm Hg. The IOP of rabbit treated with the 1 power was 3 mm Hg, with an IOP reduction rate of 80%; however, the eyes developed phthisis bulbi. The IOP was 7.0 ± 0.0 mm Hg 1 week after MP-TSCPC (IOP reduction rate: 59%) in rabbit treated with the 1/8 power. Reduction in IOP was observed, but there was significant tissue invasion to the ciliary body. The IOP was 10.3 ± 0.6 mm Hg (IOP reduction rate: 40%) 1 week after MP-TSCPC in rabbit treated with the 1/16 power, which was more effective to reduce IOP than that with the 1/8 power. Tissue invasion to the ciliary body was negligible, nonpigmented epithelial cells of the pars plicata were damaged, basal infoldings were destroyed, and repair was accompanied by proliferating tissue. No IOP reduction or tissue change was observed in rabbit treated with the 1/32 power. Conclusion: A potential mechanism for IOP reduction in pigmented rabbits is aqueous humor transport dysfunction due to damage to the nonpigmented epithelial cells of the pars plicata and destruction of basal infoldings. The power of MP-TSCPC was consistent with both morphological changes and IOP reduction. [ABSTRACT FROM AUTHOR]

Glaucoma ranks as the second most prevalent cause of global blindness. Presently, the reduction of intraocular pressure (IOP) stands as the sole efficacious method for addressing this condition. Endoscopic cyclophotocoagulation (ECP) is designed to mitigate aqueous humor production by inducing coagulation or closure of the ciliary body. Since its inception in 1990s, ECP has emerged as a pivotal modality in the therapeutic armamentarium for glaucoma. This review primarily elucidates the instrumentation employed in ECP for the treatment of glaucoma, the mechanisms underlying its efficacy in glaucoma management, and a comparative analysis of ECP in relation to other modalities for anti-glaucoma treatment. Furthermore, it examines the contemporary clinical utilization of ECP in glaucoma therapy, as well as the prevalent postoperative complications and their preventive measures. We anticipate that the role of ECP in the treatment of glaucoma will persistently evolve alongside advancements in the field. Particularly noteworthy is its expanding applicability in glaucoma therapy and its increasingly vital role in personalized comprehensive treatment approaches., Competing Interests: Declarations Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Purpose: We systematically reviewed the case report literature to identify cases of uveal metastases originating from thyroid cancer (TC), evaluate factors and indications in uveal metastases from TC, and provide clinical insights through recent case studies., Methods: Web of Science, Medline, and Scopus databases were searched for case reports or series reporting uveal metastasis from a thyroid neoplasm. Articles published in any language from inception through November 2022 were searched and screened independently by two reviewers. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist for Case Reports., Results: A total of 1049 records were screened, resulting in the identification of 46 cases from 43 studies. The mean (SD) age at uveal metastases diagnosis was 58.44 (±17.99) years with the median (interquartile range) of 56.5 (29.75) (range, 20-83 years), with 34.8% of cases (16/46) cases reported in elderly patients (>64 years). The sample consisted of 56.5% (26/46) male patients. Uveal metastases were observed in the right eye in 16 cases, the left eye in 19 cases, and both eyes in 11 cases. Choroidal involvement was present in 84.8% of cases (39/46) cases. Papillary carcinoma was the most common thyroid cancer type (34.8%, 16/46), followed by follicular carcinoma (32.6%, 15/46), and medullary carcinoma (21.7%, 10/46)., Conclusion: Uveal metastases have been observed to appear in metastatic TC, and physicians should approach ocular symptoms cautiously in cases that accompany a neck mass or a history of previous TC., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To report the intermediate-term success rate of ultrasound cyclo plasty (UCP), predictors for failure and complications in advanced glaucoma., Methods: This study included patients with advanced glaucoma who underwent UCP. The main outcome measures were intraocular pressure (IOP), the number of antiglaucoma medications, and the presence of complications. Success was defined as an IOP reduction ≥30% and IOP between 6 mmHg and 18 mmHg with no vision-threatening complications. Cox proportional hazard regression analysis was performed to identify possible predictors for failure., Results: We included 65 eyes of 58 patients in the study. The mean IOP and number of antiglaucoma medications decreased significantly from 27.60 ± 5.5 mmHg and 3.40 ± 0.9 at baseline to 17.80 ± 8.0 mmHg (35.51% reduction) and 2.43 ± 1.3 at 12 months and 17.10 ± 8.2 mmHg (38.04% reduction) and 2.41 ± 1.5 at 24 months, respectively ( p  < 0.01 for both). The success rates were 66.2% (43/65) and 72.4% (21/29), while the failure rates were 33.8% (22/65) and 27.6% (8/29) at 12 and 24 months postoperatively, respectively. The cumulative probabilities of overall success were 67.7 ± 5.8% and 33.8 ± 5.9% at 12 and 24 months, respectively. High baseline IOP and history of old glaucoma surgery were associated with a higher risk for failure (Hazard ratio = 1.10 and 5.82, p  = 0.03 and p  < 0.01, respectively). The most common complications were anterior chamber reaction (18.5%) and cataract development/progression (15.4%). Two eyes (3.1%) developed phthisis bulbi., Conclusions: Although UCP is effective in lowering IOP in eyes with advanced glaucoma, the intermediate-term success rates were moderate., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Plaque radiotherapy is an effective treatment modality for medium-sized ocular tumors such as uveal melanoma. The authors review the available literature and concisely summarize the current state of the art of ophthalmic plaque brachytherapy. The choice of radioisotope, which includes Ruthenium-106 and Iodine-125, depends on the intended treatment duration, tumor characteristics, and side effect profiles. Ophthalmic plaques may be customized to allow for the delivery of a precise radiation dose by adjusting seed placement and plaque shape to minimize collateral tissue radiation. High dose rate (HDR) brachytherapy, using beta (e.g., Yttrium-90) and photon-emitting sources (e.g., Ytterbium-169, Selenium-75), allows for rapid radiation dose delivery, which typically lasts minutes, compared to multiple days with low-dose plaque brachytherapy. The efficacy of Ruthenium-106 brachytherapy for uveal melanoma varies widely, with reported local control rates between 59.0% and 98.0%. Factors influencing outcomes include tumor size, thickness, anatomical location, and radiation dose at the tumor apex, with larger and thicker tumors potentially exhibiting poorer response and a higher rate of complications. Plaque brachytherapy is effective for selected tumors, particularly uveal melanoma, providing comparable survival rates to enucleation for medium-sized tumors. The complications of plaque brachytherapy are well described, and many of these are treatable.