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AbstractPurposeMethodsResultsConclusionsWith age, the mammalian lens forms successive layers of crystallin protein fibers which infoliate with lens growth and development. As heavy metals generally bind to tissue protein, heavy metals are posited to sequester within the lens with age. Therefore, this study aims to compare heavy metals in human crystalline lens of older adults to known physiologic blood and urine levels and assess the association between concentrations in the lens and metabolic biomarkers.Consecutive lens specimens obtained during cataract surgery by phacoemulsification were subjected to atomic spectrometry for heavy metal content. A one-sample t-test compared heavy metals in lens to known physiologic blood and urine concentrations. Linear regression models assessed the association between heavy metals and biomarkers of metabolic function. Linear discriminant analysis assessed the classification of gender and smoking status based on multiple and individual heavy metals.All heavy metal levels were elevated in lens specimens compared to blood and urine with the exception of iron (p < 0.0001). Lens titanium and copper were positively associated with blood-urea nitrogen (Titanium: β̂ = 1.14, p = 0.04, Copper: β̂ = 1.12, p = 0.03. Lens copper was positively associated with creatinine (β̂ = 1.10; p = 0.02), but negatively associated with glomerular filtration rate (β̂ = 0.89; p = 0.02). Lens chromium and lead were positively associated with albumin (Chromium: β̂ = 1.03, p = 0.03; Lead: β̂ = 1.02, p = 0.04). Lens nickel was positively associated with bilirubin (β̂ = 1.14; p = 0.03). Classification based on multiple or individual heavy metals for gender and smoking status was not statistically significant.Our results suggest the human crystalline lens accumulates heavy metals with age and demonstrate the correlation between abnormality of metabolic function and heavy metal deposition in older adult lens. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the histopathological findings of the anterior lens capsule in pediatric patients who had surgery for cataracts. Methods: This study is a prospective interventional study. Anterior capsule tissue samples that were obtained by the anterior capsulotomy method during phacoemulsification surgery were fixed and examined under a transmission electron microscope. Results: Twenty-two eyes of 19 patients who were diagnosed with congenital and juvenile cataracts were included in this study. Five patients had associated systemic diseases, including hydrocephalus, cerebral palsy, prematurity, juvenile myelomonocytic leukemia, and Down's syndrome. Electron microscopic evaluation demonstrated single-layered epithelium under the capsule, degenerated organelles with round-oval and prismatic-oval nuclei, and degenerated mitochondria and heterochromatin-rich nuclei. In the case with cerebral palsy, collagen fibrils of the connective tissue and fibroblast-like cells were observed replacing the epithelium that should be underneath the capsule in both eyes, and there was a disorganized distribution of collagen fibrils and vacuole structures in the cytoplasm of fibroblast-like cells. Conclusion: Similar histopathological findings were found in pediatric cataracts with or without systemic disease except in one cerebral palsy case. The absence of lens epithelium may have been a result of degeneration in this patient, and this can be attributed to the presence of systemic inflammation and gliosis in cerebral palsy. The absence of lens epithelium can play a role in the development of dense subcapsular fibrosis and cataract formation. [ABSTRACT FROM AUTHOR]

Purpose: To report an atypical presentation of severe toxicity, anterior chamber (AC) inflammation, and transient parafoveal formation of subretinal fluid induced by the subconjunctival injection of 5-fluorouracil (5-FU). Methods: Case presentation. Results: Seven weeks after trabeculectomy, a 40-year-old white male had a subconjunctival injection of 5-FU. Within minutes after the injection, the lens turned grey and then total white. Initially, AC was clear, and 20 min later, a severe AC reaction was detected. The patient was prescribed hourly dexamethasone eye drops and tropicamide eye drops twice daily. Two days post-injection, vision improved, AC reaction was minimal, and there was whitish fibrinous material on the anterior surface of the lens, extending up to the pupillary margin. Minimal posterior synechiae were observed, and upon dilation, the remainder of the anterior surface of the lens appeared completely clear, indicating that only the portion of the lens not covered by the iris exhibited fibrinous material and deposits. One week post-injection, vision worsened due to severe corneal toxicity. The dimensions of the whitish fibrinous material on the anterior lens capsule decreased, and macular scans revealed parafoveal subretinal fluid. Two weeks later, vision significantly improved, and the dimensions of the whitish fibrinous material on the anterior lens capsule were further decreased. The subretinal fluid had completely resolved. Conclusion: We describe a rare case of severe toxicity, AC inflammation, and transient parafoveal subretinal fluid formation caused by the 5-FU. This was treated with topical steroid treatment, and eventually some level of lens opacification persisted despite significant clearance of the AC inflammation. [ABSTRACT FROM AUTHOR]

In this chapter, Dewey's theory of law -- its nature, authority, and legitimacy -- is brought to the surface. It is argued that, from his entirely general pragmatist account of knowledge as seen through the lens of human inquiry, we find a promising theory not only of how we can make sense of getting things right in ethics but also in the law. Detours are taken to the work of James, Peirce, and Holmes, and, in the end, we find that Dewey builds on his pragmatist predecessors to offer a truly promising account and justification of the law as a series of provisional punctuation points in a democratic process of inquiry. [ABSTRACT FROM AUTHOR]

The αA-crystallin protein plays a vital role in maintaining the refractive index and transparency of the eye lens. Significant clinical studies have emerged as the αA-crystallin is prone to aggregation, resulting in the formation of cataracts with varied etiologies due to mutations. This work aims to comprehend the structural and functional role of cataract-causing mutations in αA-crystallin, particularly at N-Terminal and α-Crystallin Domains, using in-silico approaches including molecular dynamics simulation. About 19 mutants of αA-crystallin along with native structure were simulated for 100 ns and the post-simulations analyses reveal pronounced dynamics of αA-crystallin due to the enhanced structure flexibility as its native compactness was lost and is witnessed mainly by the mutants R12L, R21L, R21Q, R54L, R65Q, R116C and R116H. It is observed that αA-crystallin discloses the NTD motions as the dominant one and the same was endorsed by the linear variation between Rg and the center-of-mass of αA-crystallin. Interestingly, such enhanced dynamics of αA-crystallin mutants associated with the structure flexibility is internally modulated by the dynamic exchange of secondary structure elements β-sheets and coils (R2 = 0.619) during simulation. Besides, the observed pronounced dynamics of dimer interface region (β3-L6-β4 segment) of ACD along with CTD dynamics also gains importance. Particularly, the highly dynamic mutants are also characterized by enhanced non-covalent and hydrophobic interactions which renders detrimental effects towards its stability, and favours possible protein unfolding mechanisms. Overall, this study highlights the mutation-mediated structural distortions in αA-crystallin and demands the need for further potential development of inhibitors against cataract formation. [ABSTRACT FROM AUTHOR]

The prevalence of presbyopia and nuclear cataracts (NUC) is reported to be higher in tropical areas than that in other regions, suggesting a potential influence of high temperatures on lens health. Transient receptor potential vanilloid (TRPV) channels play a crucial role in detecting ambient temperatures across various species, with TRPV1 and TRPV4 expressed in lens epithelial cells. In this study, we investigated whether ambient temperatures affect TRPV1 and TRPV4 activity in the lens, potentially contributing to the development of presbyopia and NUC. We conducted experiments using cultured human lens epithelial cell lines under different temperature conditions. Our results revealed that the mitogen-activated protein kinase (MEK)/extracellular signal-regulated kinase (ERK) and p38 pathways, downstream molecules of TRPV1, were activated, while Src family kinase, a downstream molecule of TRPV4, was inhibited at 37.5 °C culture compared to 35.0 °C. Confocal microscope images demonstrated higher expression of TRPV1 in 3D-structured cells under high-temperature culture conditions. Additionally, in organ culture lenses, higher elasticity was observed at elevated temperatures compared to that at lower temperatures. These results suggest that high ambient temperatures may induce lens sclerosis via TRPV1 activation, potentially contributing to the development of presbyopia and NUC. [ABSTRACT FROM AUTHOR]

Refractive errors are defined as an impairment in the eye's capacity to focus light, resulting in the formation of blurred or unfocused images. These issues arise from alterations in the shape of the cornea, the length of the eyeball, or the aging of the crystalline lens. It is anticipated that the prevalence of visual impairment will increase in conjunction with global population growth. At present, a significant number of countries have not yet accorded sufficient priority to eye health within their healthcare systems. This has resulted in insufficient awareness and reluctance to seek costly specialized care. This study proposes the development of an advanced refractive eye disease detection system with the objective of improving diagnostic accuracy, disseminating disease information, and reducing financial barriers to specialist consultation. The research employs certainty factor (CF) methods and image processing with feature extraction. The initial results demonstrate the potential for identifying specific refractive eye diseases with high certainty through the analysis of symptoms and the examination of photographs of the eye. The proposed approach provides an alternative method for diagnosing refractive eye diseases, which could enhance access to refractive eye care services and reduce the economic burden on patients. [ABSTRACT FROM AUTHOR]

Purpose Materials and Methods Results Conclusion This study aims to inform about the clinical image, diagnostic possibilities, and treatment options for cats and dogs diagnosed with ocular encephalitozoonosis.Medical records of 7 dogs and 75 cats with ocular encephalitozoonosis presented at the Clinical Unit of Ophthalmology of the University of Veterinary Medicine Vienna between 08/2006 and 02/2022 have been compiled. Diagnosis was based on the presence of cataracts and positive antibody titer against Encephalitozoon cuniculi. Patient history, details on the characteristics of the cataracts, level of antibody titers, and the treatment regimen were summarized, as are the results of histological stainings of surgical samples to determine the presence of Encephalitozoon cuniculi, as well as PCR analyses to identify its sub‐strains.Our analysis of the clinical data shows that focal cortical anterior cataracts often associated with anterior uveitis and lesions in the fundus are the most prevalent manifestation of ocular encephalitozoonosis in cats and dogs.Serological testing and PCR analysis of lens material are the most important diagnostic tools. Timely phacoemulsification with adjuvant anti‐inflammatory and antiparasitic medication is the most promising therapy for Encephalitozoon cuniculi‐induced cataracts. [ABSTRACT FROM AUTHOR]

Background: We present the treatment and follow-up of a rare patient with acute retinal necrosis (ARN) with optic neuropathy as the first manifestation. Case presentation: A 57-year-old male patient first presented with reduced vision and optic neuropathy in his right eye.After 20 days, the vision in the left eye decreased, and the slit-lamp examination showed no remarkable changes in the anterior segment. The right eye showed 2 + cells and flares in the anterior chamber. The iris texture was good, the pupils were round (light reflex), the crystalline lens was slightly opaque, and the vitreous was turbid. An anterior chamber paracentesis was performed to collect aqueous humor for polymerase chain reaction testing. The PCR test showed positive detection of VZV in the right eye, while the content of VZV in the left eye was lower than the reference value. Both eyes of the patient were successively diagnosed with acute retinal necrosis (ARN) due to VZV infection. The patient was treated with topical antiviral and anti-inflammatory eye medication, oral steroids, and general antiviral drugs. After three months, the vision and condition were relatively stable. Conclusions: Clinicians should realize that accurate diagnosis and timely antiviral therapy are crucial for treating ARN. [ABSTRACT FROM AUTHOR]

Purpose: The shortage of donor corneas limits Bowman layer transplantation for keratoconus. In this study, we evaluate the clinical outcome of porcine anterior lens capsule (xenograft) transplantation in the corneal stroma of a rabbit model as substitute for Bowman layer graft that is used in stromal transplantation for advanced keratoconus. Methods: Transplantation of porcine anterior lens capsule in the corneal stroma was performed in four New Zealand white rabbits through the creation of a stromal pocket. Corneal transparency, central corneal thickness, and topographic characteristics of corneas were evaluated at different time points: pre- (0) and post- (7, 14, 21, and 28) operative days. Additionally, at the end of the study histopathological findings were evaluated. Results: In comparison to pre-operative day, transplantation of an anterior lens capsule preserved corneal transparency, central corneal thickness, and topographic characteristics remained constant throughout the study period. Histopathological analysis revealed the presence of the anterior lens capsule as a fully integrated lamellar graft without adverse effects in host stroma. Conclusion: The anterior lens capsule may be useful as a graft for intrastromal corneal trasplantation. Similarly to Bowman layer, anterior lens capsule has mechanical characteristics that facilitate corneal transplantation. In post-transplanted corneas the preservation of transparency, as well as the effect on corneal thickness, and topographic characteristics support the possibility of using anterior lens capsule as a substitute for Bowman layer graft. [ABSTRACT FROM AUTHOR]

Background: The radiation exposure of nuclear medicine personnel, especially concerning extremity doses, has been a significant focus over the past two decades. This study addresses the evolving practice of NM, particularly with the rise of radionuclide therapy and theranostic procedures, which involve a variety of radionuclides such as 68Ga, 177Lu, and 131I. Traditional studies have concentrated on common radioisotopes like 99mTc, 18F, and 90Y, but there is limited data on these radionuclides, which are more and more frequently used. This study, part of the European SINFONIA project, aims to fill this gap by providing new dosimetry data through a multicenter approach. The research monitors extremity doses to hands, eye lens doses, and whole-body doses in nuclear medicine staff handling 68Ga, 177Lu, and 131I. It examines the type of activities performed and the protective measures used. The study extrapolates measured doses to annual doses, comparing them with annual dose limits, and assesses the contribution of these specific procedures to the overall occupational dose of nuclear medicine personnel. Results: Measurements were conducted from November 2020 to August 2023 across nine hospitals. The highest whole-body, eye lens and extremity doses were observed for 68Ga. Average maximum extremity doses, normalized per manipulated activity, were found of 6200 µSv/GBq, 30 µSv/GBq and 260 µSV/GBq for 68Ga, 177Lu and 131I, respectively. Average whole-body doses stayed below 60 µSv/GBq for all 3 isotopes and below 200 µSv/GBq for the eye lens dose. The variation in doses also depends on the task performed. For 68Ga there is a risk of reaching the annual dose limit for skin dose during synthesis and dispensing. Conclusions: This study's measurement campaigns across various European countries have provided new and extensive occupational dosimetry data for nuclear medicine staff handling 68Ga, 177Lu and 131I radiopharmaceuticals. The results indicate that 68Ga contributes significantly to the global occupational dose, despite its relatively low usage compared to other isotopes. Staff working in radiopharmacy hot labs, labeling and dispensing 177Lu contribute less to the finger dose compared to other isotopes. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the occupational radiation exposure of staff during endoscopic retrograde cholangiopancreatography (ERCP), with a focus on individuals closest to the radiation source, and to identify potential increases in exposure to hands and eye lenses. Patient radiation exposure during ERCP was also assessed. Materials and methods Staff organ doses were monitored using a Philips Allura Xper FD 20 fluoroscopy system, during 24 ERCP procedures for a period of 7 months. Staff doses were measured using thermoluminescence dosemeters and electronic personal dosemeters, and patient effective doses were simulated and calculated. Results Physicians' annual organ doses ranged from 0.2 to 1.6 mSv for shoulders, 0.1 to 0.4 mSv for eye lenses, and 0.3 to 1.6 mSv for fingers. The annual organ dose of the nursing staff ranged from 0.08 to 2.4 mSv for shoulders, 0.02 to 2.3 mSv for eye lenses, and 1.2 to 5.3 mSv for fingers. The effective dose to patients ranged from 0.009 to 0.46 mSv. Conclusion Staff doses were within safe limits, but patient doses were high, emphasizing the need for improved radiation protection. [ABSTRACT FROM AUTHOR]

Background: It is widely accepted that glaucoma-induced oxidative stress expedites cataracts' process. Therefore, we examined the effects of apelin-13 against oxidative stress-induced damage in human lens epithelial cells (HLECs) and investigated the potential pathogenic mechanism of acute primary angle-closure glaucoma. Methods: This experiment included five groups: control, H2O2, apelin-13 + H2O2, ML221 + H2O2, and apelin-13 + ML221 + H2O2. ML221 was employed in rescue experiments as an APJ antagonist. HLECs were pretreated with or without apelin-13 and subsequently exposed to H2O2. HLECs' viability was assessed by CCK8. Cell apoptosis was determined using Annexin V-FITC/PI staining. The mitochondrial membrane potential was assessed by fluorescent probe JC-1. Intracellular G6PD activity, NADPH/NADP+, and GSH/GSSG ratios were detected to assess the cells' oxidative damage. Result: Apelin-13 reversed the H2O2-induced decrease in cell viability. The increased expression of G6PD and GLTU1, the G6PD, GSH/GSSG and NADPH/NADP + levels showed that apelin-13 can mitigate the H2O2-induced inhibition of the pentose phosphate pathway and dysregulation of cell redox status in the apelin-13 + H2O2 group compared with the H2O2 group. In H2O2-treated HLECs, apelin-13 can mitigate cell apoptosis, promote Bcl-2 expression, and suppress the Bax and Caspase-3 expression. In addition, H2O2 substantially reduced the mitochondrial membrane potential in HLECs, which was reversed by apelin-13. Notably, the inhibition of APJ intensified oxidative damage in H2O2-induced HLECs, demonstrating that the effects of apelin-13 were hindered by ML221. Conclutions: Apelin-13 reduced oxidative damage and apoptosis in HLECs through APJ. These results demonstrate that apelin-13 can be employed as a potential drug for glaucoma with cataracts to delay the progression of cataracts. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate long-term anatomical and functional outcomes of autologous internal limiting membrane (ILM) transplantation in refractory highly myopic macular holes (HMMHs). Methods: Retrospective interventional analysis of 13 eyes with refractory HMMH undergoing autologous ILM transplantation with gas tamponade. Best-corrected visual acuity (BCVA, Snellen), optical coherence tomography and fundus photography were scheduled at baseline and every follow-up visit (1, 3, 6, 12, 18, 24 months and the most recent). Preoperatively, we collected minimum linear diameter (MLD) and basal diameter (BD). Post-operatively, rates of external limiting membrane (ELM)/ellipsoid zone (EZ) restoration, excessive gliosis and subfoveal retinal pigmented epithelium (RPE) atrophy were evaluated. Results: Average AXL was 31.45 ± 2.07 mm and mean follow-up was 47.2 ± 31.4 months. Anatomical success was reached in 7/13 eyes (54%), while 2 cases showed persisting HMMH, 2 cases had early recurrence and 2 cases late recurrence. BCVA went from 0.19 ± 0.18 to 0.22 ± 0.20 at final follow-up (p = 0.64), improving in 5/13 eyes (38%). One eye showed continuous ELM and EZ lines, while another eye showed an irregular ELM but no EZ. Post-operatively, 5 eyes (71%) developed progressive atrophy of the subfoveal RPE, while excessive gliosis was reported in 3 eyes (43%). Furthermore, one patient developed post-operative chronic macular edema-like changes in the perifoveal area. Conclusion: Autologous ILM transplantation showed controversial anatomical outcomes and and poor visual results in refractory HMMH. Moreover, progressive subfoveal patchy atrophy and excessive gliosis are possible post-operative complications. Key messages: What is known: • Various surgical techniques have been proposed to treat refractory highly myopic macular holes (HMMHs), including autologous internal limiting membrane (ILM) flap transplantation, autologous retinal transplantation and lens capsule transplantation. • Long-term analysis of the outcomes of autologous ILM transplantation still lacks in HMMH. What is new: • Primary anatomical success was reached in 54% of cases and only 38% of eyes showed improvements in visual outcomes. • Progressive subfoveal patchy atrophy and excessive gliosis were two of the most frequent adverse effects, negatively influencing visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the performance of 10 MHz ultrasonography in detecting posterior lens capsule defects before traumatic cataract surgery. Methods: This retrospective analysis includes patients with traumatic cataracts who underwent cataract surgery. Preoperative 10 MHz ultrasonography was performed to evaluate whether the posterior lens capsule was defective or intact, and the results were compared to the intraoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa were calculated. Results: The study included 140 eyes of 140 patients. There were 68 eyes with closed-globe injuries and 72 eyes with open-globe injuries. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa of 10 MHz ultrasonography was 86.76%, 90.28%, 89.39%, 87.84%, 88.57% and 0.771, respectively. The accuracy was 86.11% and 91.18% in open-globe and closed-globe injury groups, respectively. Conclusion: The accuracy of 10 MHz ultrasonography in evaluating the posterior lens capsule in traumatic cataracts is high. Preoperative 10 MHz ultrasonography would help to make an appropriate surgical plan. [ABSTRACT FROM AUTHOR]

As GIS progressively permeates our everyday lives, it becomes increasingly significant to incorporate emotional factors into the design and use of GIS technologies. While existing methods such as self‐report and AI‐enhanced techniques prevail in collecting emotional factors, they often miss real‐time emotional nuances and synchronization with geographically referenced and other accompanying data. To bridge this gap, we introduce "Neural Sensing," a novel approach that combines Electroencephalogram (EEG) with GIS technologies to quantitatively measure emotional responses to places. This approach offers a unique lens to understand human dynamics in a hybrid physical–virtual realm, especially by delving into our mental worlds. To demonstrate the utility of Neural Sensing, we have designed a pilot empirical study to analyze emotional reactions to geographical environments. This approach broadens the domain of GIS methodologies from remote sensing and social sensing to a neural sensing approach. Through this study, we underscore the importance of the mental dimension of the hybrid physical–virtual world and encourage GIScientists to emphasize human experiences and feelings in GIS analyses. [ABSTRACT FROM AUTHOR]

The Australian Synchrotron Imaging and Medical Beamline (IMBL) uses a superconducting multipole wiggler (SCMPW) source, dual crystal Laue monochromator and 135 m propagation distance to enable imaging and computed tomography (CT) studies of large samples with mono‐energetic radiation. This study aimed to quantify two methods for CT dose reduction: wiggler source operation at reduced magnetic field strength, and beam modulation with spatial filters placed upstream from the sample. Transmission measurements with copper were used to indirectly quantify the influence of third harmonic radiation. Operation at lower wiggler magnetic field strength reduces dose rates by an order of magnitude, and suppresses the influence of harmonic radiation, which is of significance near 30 keV. Beam shaping filters modulate the incident beam profile for near constant transmitted signal, and offer protection to radio‐sensitive surface organs: the eye lens, thyroid and female breast. Their effect is to reduce the peripheral dose and the dose to the scanned volume by about 10% for biological samples of 35–50 mm diameter and by 20–30% for samples of up to 160 mm diameter. CT dosimetry results are presented as in‐air measurements that are specific to the IMBL, and as ratios to in‐air measurements that may be applied to other beamlines. As CT dose calculators for small animals are yet to be developed, results presented here and in a previous study may be used to estimate absorbed dose to organs near the surface and the isocentre. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the astigmatic power of the crystalline lens and the whole eye without phakometry using a set of linear equations and to provide estimates for the astigmatic powers of the crystalline lens surfaces. Methods: Linear optics expresses astigmatic powers in the form of matrices and uses paraxial optics and a 4 × 4 ray transfer matrix to generalise Bennett's method comprehensively to include astigmatic elements. Once this is established, the method is expanded to estimate the contributions of the front and back lens surfaces. The method is illustrated using two examples. The first example is of an astigmatic model eye and compares the calculated results to the original powers. In the second example, the method is applied to the biometry of a real eye with large lenticular astigmatism. Results: When the calculated powers for the astigmatic model eye were compared to the actual powers, the difference in the power of the eye was 0.030.130.04TD (where T represents the matrix transpose) and for the crystalline lens, the difference was 0.080.290.08TD (power vector format). A second example applies the method to a real eye, obtaining lenticular astigmatism of −5.84 × 175. Conclusions: The method provides an easy‐to‐code way of estimating the astigmatic powers of the crystalline lens and the eye. [ABSTRACT FROM AUTHOR]

Purpose: To determine if supplementing standard clinical assessments with Optical Coherence Tomography (OCT) imaging of the crystalline lens improves the accuracy and precision of lens opacity assessment and associated clinical management decisions by optometrists. Methods: Fifty optometrists registered in the UK or Éire undertook a clinical vignette study where participants graded lens opacities and made associated clinical management decisions based on the image(s)/information displayed. Three forms of vignettes were presented: (1) Slit‐lamp (SL) images of the lens, (2) SL and OCT images and (3) SL, OCT and visual function measures. Vignettes were constructed using anonymised data from 50 patients with varying cataract severity, each vignette being presented twice in a randomised order (total vignette presentations = 300). The accuracy of opacity and management decisions were evaluated using descriptive statistics and non‐parametric Bland–Altman analysis where assessments from experienced clinicians were the reference. The precision of assessments was examined for each vignette form using non‐parametric Bland–Altman analysis. Results: All (n = 50) participants completed the study, with 36 working in primary eyecare (primary eyecare) settings and 14 in hospital eyecare services (HES). Agreement was highest where vignettes contained all clinical data (i.e., SL, OCT and visual function data—grading: 51.0%, management: 50.5%), and systematically reduced with decreasing vignette content (p < 0.001). A larger number of vignettes containing imaging and visual function measures exhibited below reference (i.e., less conservative) grading compared with vignettes containing imaging data alone (all p < 0.05). HES‐based optometrists were more likely to grade lens opacities lower than clinicians working in primary eyecare (p < 0.001). Good measurement precision was evident for all vignettes, with a mean bias close to zero and limits of agreement below one grading step for all conditions. Conclusions: The addition of anterior segment OCT to SL images improved the accuracy of lens opacity grading. Structural assessment alone yielded more conservative decision making, which reversed once visual functional data was available. [ABSTRACT FROM AUTHOR]

Purpose: To introduce a method to calculate retinal irradiance caused by ophthalmoscopy. This may be used to verify the compliance of an instrument with the radiation limits set by light hazard standards. The proposed method is simpler to use and less prone to error than the methods currently found in the light hazard standards. Methods: The optical properties of the standardised human eye, specified by current light hazard standards, are used to calculate the magnification of an aerial image of the retinal surface by the combination of the optics of eye and the auxiliary lens used for ophthalmoscopy. The magnification of the aerial image is used to transform the spectral irradiance of the instrument illumination source to retinal irradiation values. The spectral irradiance of the instrument illumination source can be measured directly as the aerial image is located in the focal plane of the viewing optics of the ophthalmoscope. These spectral irradiation values are then processed using weightings specified by current light hazard standards to give a weighted irradiance which is converted directly to a retinal irradiance value. Results: A single formula is provided to calculate the retinal irradiance using the processed, measured spectral irradiance values of the illumination source. Conclusion: The new method introduced here is simpler to use, requires fewer physical measurements and is less likely to introduce measurement error than that currently found in light hazard standards. The only physical measurement that needs to be taken is the illumination source spectral irradiance measured in the viewing focal plane of the instrument. These values are weighted using given in the light hazard standards. The combined irradiance value is then converted to retinal irradiance using the formula given in this paper. [ABSTRACT FROM AUTHOR]

Purpose: To quantify the impact of varying central fluid reservoir depth, lens thickness/mass and the addition of a peripheral fenestration upon scleral lens centration. Methods: Ten young, healthy adults participated in a series of repeated‐measures experiments involving short‐term (90 min) open eye scleral lens wear. Scleral lens parameters (material, back optic zone radius, diameter, back vertex power and landing zone) were controlled across all experiments, and the central fluid reservoir depth (ranging from 144 to 726 μm), lens thickness (ranging from 150 to 1200 μm), lens mass (101–241 mg) and lens design (with or without a single 0.3 mm peripheral fenestration) were altered systematically. Scleral lens decentration was quantified using over‐topography maps. Results: On average, scleral lens centration varied by <0.10 mm over 90 min of wear. Medium and high initial fluid reservoir conditions resulted in 0.17 mm more temporal and 0.55 mm more inferior lens decentration, compared to the low fluid reservoir depth (p < 0.001). Changes in lens thickness or the addition of a peripheral fenestration did not cause clinically significant changes in centration (<0.10 mm on average) when controlling for fluid reservoir depth. Central fluid reservoir depth was the best predictor of horizontal and vertical lens decentration, explaining 62–73% of the observed variation, compared to 40–44% for lens thickness and mass. Conclusion: Scleral lens decentration remained relatively stable over 90 min of lens wear. A greater initial central fluid reservoir depth resulted in significantly more lens decentration, particularly inferiorly. Large variations in lens thickness, mass or the addition of a single peripheral fenestration did not substantially affect lens centration. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the clinical presentation, histopathologic characteristics, and management of phacolytic glaucoma. Patients and Methods: The database at the Florida Lions Ocular Pathology Laboratory was searched for surgical specimens at the Bascom Palmer Eye Institute. Patients with a diagnosis of "phacolytic glaucoma" on cytopathology between the years of 1997 and 2023 were included (n = 15). Patient demographics, anatomic site, laterality, clinical features, and ocular examination findings were obtained from available medical records. Results: The diagnosis of phacolytic glaucoma was established by light microscopic examination of cytology specimens in 15 eyes (Right = 8, Left = 6, not specified = 1). Between 1997 and 2023, there were 32 cytopathology cases with a preoperative diagnosis of phacolytic glaucoma. From this group of 15 cases, there were nine males and six females. Mean age was 64.2 years (Range: 39–87). Thirteen samples were from the anterior chamber and two were obtained from the vitreous. All 15 cases (100%) demonstrated histiocytes with engulfed foamy and/or granular presumed lenticular material. CD68 immunohistochemistry was positive within histiocytes in four cases that were stained (100%). Of the available medical records, clinical features, and ocular examination findings included: eye redness, decreased vision, eye pain, anterior chamber inflammation, dislocated or subluxed crystalline lens, cataract, and elevated intraocular pressure (average = 41.3 ± 8.67 mm Hg). Conclusions: Phacolytic glaucoma is a rare complication of mature/hypermature cataracts that presents with ocular pain, decreased vision, and anterior chamber inflammation. AC paracentesis with cytopathologic evaluation is a minimally invasive, rapid technique that can aid in the diagnosis and management of this disease. [ABSTRACT FROM AUTHOR]

Background: CircRNA plays a regulatory role in multiple life processes. Circ_0122396 could participate in the regulation of age-related cataract (ARC) progression. However, the precise molecular mechanisms of circ_0122396 In ARC remain enigmatic. Methods: Circ_0122396, microRNA (miR)-23a-3p, and matrix metalloprotease (MMP)-16 (MMP16) expression levels were detected via quantitative real-time polymerase chain reaction. Western blot was used to detect the levels of MMP16 and apoptosis-related proteins. Cell counting kit-8 analysis and 5-ethynyl-2'-deoxyuridine assay were used to assess human lens epithelial cells (HLECs) proliferation. Flow cytometry was performed to determine cell apoptosis. Levels of malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) were measured using commercial kits. Luciferase reporter assay, RNA immunoprecipitation (RIP) assay, and RNA pull-down assay were used to examine the interaction among circ_0122396, miR-23a-3p, and MMP16. Results: Circ_0122396 and MMP16 were down-regulated while miR-23a-3p was up-regulated in ARC. H2O2 constrained proliferation and GSH-PX level, promotes apoptosis and MDA level in HLECs, and overexpression of circ_0122396 attenuated these effects. miR-23a-3p was a direct target of circ_0122396, and MMP16 was a direct target of miR-23a-3p. The effect of circ_0122396 overexpression on H2O2-induced HLECs was reversed by miR-23a-3p, and MMP16 elevation overturned the impacts of miR-23a-3p in H2O2-induced HLECs. Conclusions: Circ_0122396 may regulate the progression of ARC via the miR-23a-3p/MMP16 pathway in H2O2-stimulated HLECs, which may serve as a potentially valuable biomarker and novel therapeutic target for ARC. [ABSTRACT FROM AUTHOR]

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Ultraviolet (UV) radiation‐triggered production of reactive oxygen species (ROS) is a primary contributor to apoptosis in human lens epithelial cells (HLECs), which can ultimately result in cataract formation. The nuclear factor erythroid‐2‐related factor 2 (Nrf2)‐Kelch ECH associating protein 1 (Keap1) pathway, a fundamental oxidative stress regulation mechanism, plays a crucial role in the development of cataracts. Ferulic acid (FA), recognized for its potent antioxidant properties can activate the Nrf2 signaling pathway to mitigate oxidative damage and cell apoptosis. In this study, we have demonstrated the protective effects of FA in reducing UVA‐induced oxidative damage and apoptosis in HLECs through the modulation of the Keap1/Nrf2 pathway, as evidenced by both cellular and animal experiments. HLECs and Lens were exposed to 10 J/cm2 UVA radiation with or without prior treatment with FA. We found that UVA radiation increased oxidative damage and cell apoptosis in HLECs, ultimately leading to opacification of rat lenses, while FA was able to attenuate both oxidative damage and cell apoptosis in HLECs and reduce the degree of lens opacification. FA upregulated the expression of antioxidant response factors of the Keap1/Nrf2 pathway and downregulated the expression of apoptosis‐related genes in HLECs, as demonstrated by Western blot and RT‐qPCR analyses. We also found that UVA radiation increased the degree of demethylation of the Keap1 promoter in HLECs, whereas FA reduced the level of Keap1 promoter demethylation as determined by DNA sequencing. Additionally, UVA upregulated the expression of DNA active demethylase of the Keap1 promoter in HLECs, Dnmt1, Dnmt3a, and Dnmt3b, as shown by immunofluorescence, Western blot, and RT‐qPCR, however, FA attenuated the activity of the passive demethylase TET1 in addition to the active demethylases. These results demonstrated that UVA radiation can cause oxidative damage, cell apoptosis, and rat lens opacification by increasing the demethylation of the Keap1 promoter in lens epithelial cells. Conversely, FA was shown to reduce oxidative damage, inhibit cell apoptosis, and decrease rat lens opacification by increasing the methylation of the Keap1 promoter. These findings suggest that FA could be therapeutically beneficial in preventing and mitigating cataracts induced by UVA radiation. [ABSTRACT FROM AUTHOR]

The International Commission on Radiological Protection recommended a significant reduction of the equivalent dose limit for the eye lens. Reportedly, medical staff in charge of diagnostic imaging procedures may exceed the new dose limits for the eye lens. The use of dosimeters dedicated to the eye lens remains low, and dosimeters for the neck region were often used to assess eye lens doses. However, measurements by neck badges may overestimate or underestimate the recommended eye lens doses because the height of the neck differs from that of the eye. This study aimed to evaluate the air dose distribution in the vertical plane to understand the difference between neck and eye doses. H *(10) in the height of the eye position was 52.8% lower than that in the height of the neck position in the under-table position. Thus, the equivalent eye lens dose evaluated using a neck badge dosimeter may be overestimated. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to investigate the incidence and prognosis of retinal injury in patients with lens dislocation caused by blunt eye trauma. Methods: We retrospectively analyzed 53 patients who underwent lensectomy and vitrectomy for contusive lens dislocation and had no preoperative retinal injuries. Patients were categorized according to the presence of retinal injury discovered intraoperatively. The clinical features of 53 eyes were assessed during a 3‐month postoperative follow‐up. Results: Retinal injuries were observed intraoperatively in 28 patients (52.8%), predominantly in peripheral regions, with a single retinal tear being the most common type. Total lens dislocation was more frequent than subluxation in the group with retinal injuries. The intraocular pressure (IOP) at the 3‐month follow‐up was significantly lower than the initial IOP in both groups, with no significant differences between them. The corrected distance visual acuity (CDVA) significantly improved in both groups without significant differences. Conclusion: Half of the patients without preoperative retinal injuries were found to have injuries during surgery. Total lens dislocation carried a greater risk of retinal injuries than subluxation. The improvement in CDVA after prompt retinal injury treatment did not significantly differ from that in patients without retinal injury, highlighting the importance of prompt intervention. [ABSTRACT FROM AUTHOR]

Age-related cataracts is a highly prevalent eye disorder that results in the clouding of the crystalline lens and is one of the leading causes of visual impairment and blindness. The disease is influenced by multiple factors including genetics, prolonged exposure to ultraviolet radiation, and a history of diabetes. However, the extent to which each of these factors contributes to the development of cataracts remains unclear. Our study identified 101 independent genome-wide significant loci, 57 of which are novel. We identified multiple genes and biological pathways associated with the cataracts, including four drug-gene interactions. Our results suggest a causal association between type 1 diabetes and cataracts. Also, we highlighted a surrogate measure of UV light exposure as a marker of cataract risk in adults. Here, the authors expand knowledge of the genetic architecture of age-related cataracts, exploring associated pathways and drug-gene interactions, and clarify the roles of type 1 diabetes and UV exposure in cataract etiology. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to examine the impact of cataract surgery on the corneal endothelium and central corneal thickness (CCT) in pediatric patients, and to identify the factors associated with corneal alterations. Methods: This retrospective study included consecutive children undergoing bilateral or unilateral cataract surgery and intraocular lens implantation at the Eye Hospital of Wenzhou Medical University, with or without posterior capsulorhexis and anterior vitrectomy, and an age-matched normal control group. This study aimed to assess whether changes in corneal parameters, including CCT, corneal endothelial cell density (CD), average cell area (AVE), standard deviation of size (SD), coefficient of variation (CV), percentage of hexagonal cells (6A) before and after surgery, and endothelial cell loss (ECL) differed among the bilateral cataract, unilateral cataract, and control groups. Furthermore, the potential effects of anterior vitrectomy, axial length, preoperative anterior chamber depth, surgical duration, horizontal corneal diameter, intraoperative pupil diameter (PD), and the number of corneal sutures on corneal endothelial parameters and CCT were investigated. Results: A total of 107 eyes from 107 children were included in the study. In the bilateral cataract group, CD significantly decreased, AVE and CCT significantly increased, and ECL was significantly higher than in the control group. The unilateral cataract group also exhibited a significant increase in CCT. Additionally, the number of corneal sutures was negatively correlated with CD, and PD was negatively correlated with CV in the unilateral cataract group. Conclusion: Cataract surgery in pediatric patients results in increased CCT, reduced CD, and morphological changes in corneal cells. A greater number of corneal sutures and a smaller PD increased the risk of CD reduction and elevated CV in the unilateral cataract group, underscoring the need for ophthalmologists to minimize corneal damage in these children. [ABSTRACT FROM AUTHOR]

Introduction: The morphological characteristics of eyes in fishes are highly diverse and have evolved to meet the specific visual requirements as per their habitats. These morphological features of eyes are important for researchers and ecologists. The dusky spinefoot (Siganus luridus) is a tropical teleost fish with a laterally flattened body which lives in the Mediterranean Sea. Currently, there are no histological data relating to the Siganus luridus eye. Methods: In this study, the morphology of the Siganus luridus eye was examined to enhance our understanding of its structure and its relationship to fish ecology. Detailed gross and microscopic features were recorded using light and scanning microscopy. Results: The key observations describe the main structural features of the eye of Siganus luridus, specifically, the diameter of the orbit, architecture of three tunics of eye and detailed lens description. The choroid was divided into four layers, and had a rete mirabile, consisting of numerous small blood vessels in the choroidal gland. The tapetum lucidum was observed, which is interesting since Siganus luridus is herbivore and herbivores typically lack a tapetum lucidum. Discussion: These observations shed new light on the intricate eye structure of Siganus luridus and provide valuable insights into its visual abilities and adaptations to the aquatic environment and feeding behavior. [ABSTRACT FROM AUTHOR]

Background: Apart from the conventional utilization of ICL implantation for the correction of refractive errors, its recent applications extend to correcting refractive errors post laser refractive surgery. Notably, the development of cataracts stands out as a prevalent postoperative complication, often associated with low vault. Previous cases have demonstrated successful management of cataracts with ICL through the combination of FLACS and ICL removal coupled with IOL implantation, resulting in favorable postoperative visual outcomes. Herein, we present a case of cataract with low vault ICL following LASIK and its subsequent management. Case presentation: A 46-year-old male presented with vision loss in the right eye for 9 months, and he had undergone LASIK 22 years prior and had ICL implantation in both eyes 2 years ago to correct refractive error. One day after ICL implantation, both eyes exhibited the UDVA of 1.2 and 1.0, well-positioned ICLs, and approximate vault of 150 μm and 200 μm. Six months ago, the patient became aware of blurred vision in the right eye for a duration of 3 months. Examination revealed cloudy lens cortex in the right eye. During the current review, the UDVA of the right eye was 0.6, where nasal wedge-shaped clouding was evident and worsened, while the left eye lens remained transparent. AS-OCT demonstrated the vault of 54 μm in the right eye and 83 μm in the left eye. Considering the patient's history of LASIK and the presence of right eye cataract, a monovision approach was adopted. The patient underwent FLACS combined with ICL extraction and monofocal IOL lens implantation in the right eye. At 10 days postoperatively, the patient exhibited the UDVA of 1.0. Conclusions: Our report confirms the feasibility of FLACS in managing cataracts in patients with low vault ICL following LASIK. This procedure does not pose significantly greater challenges than in typical cataract cases, although meticulous care remains essential throughout every step of the surgery, particularly during laser scanning and positioning. With adequate preoperative preparation and precise calculation of the IOL power, surgical outcomes can meet expectations fully. [ABSTRACT FROM AUTHOR]

This study presents a finite element analysis to model ocular biomechanics and the interactions between the human eye and contact lenses in the closed-eye condition. The closed-eye state, where the eyelids are fully shut, presents challenges for experimental measurements due to the invasive nature of accessing and analysing the contact lens and corneal interface, making simulation tools valuable for accurate characterisation. The primary objective of this study was to examine how CLs fold and twist and their impact on the cornea when the eye is closed. The secondary aim of this study was to assess how crucial contact lens parameters (Young's modulus, base curve, and diameter) influence corneal stress distribution and the overall fit of the lens on the eye. The findings show that increasing Young's modulus significantly reduces corneal stress and promotes uniform stress distribution, making it the most influential factor for wearer comfort and safety. While base curve and diameter variations primarily affect contact area, their impact on stress distribution is minimal. This research provides insights for improving contact lens design and enhancing safety for contact lens wearers. [ABSTRACT FROM AUTHOR]

Background: Fluoroscopy guided interventions (FGIs) pose a risk of prolonged radiation exposure; personalized patient dosimetry is necessary to improve patient safety during these procedures. However, current FGIs systems do not capture the precise exposure regions of the patient, making it challenging to perform patient‐procedure‐specific dosimetry. Thus, there is a pressing need to develop approaches to extract and use this information to enable personalized radiation dosimetry for interventional procedures. Purpose: To propose a deep learning (DL) approach for the automatic localization of 3D anatomical landmarks on randomly collimated and magnified 2D head fluoroscopy images. Materials and methods: The model was developed with datasets comprising 800 000 pseudo 2D synthetic images (mixture of vessel‐enhanced and non‐enhancement), each with 55 annotated anatomical landmarks (two are landmarks for eye lenses), generated from 135 retrospectively collected head computed tomography (CT) volumetric data. Before training, dynamic random cropping was performed to mimic the varied field‐size collimation in FGI procedures. Gaussian‐distributed additive noise was applied to each individual image to enhance the robustness of the DL model in handling image degradation that may occur during clinical image acquisition in a clinical environment. The model was trained with 629 370 synthetic images for approximately 275 000 iterations and evaluated against a synthetic image test set and a clinical fluoroscopy test set. Results: The model shows good performance in estimating in‐ and out‐of‐image landmark positions and shows feasibility to instantiate the skull shape. The model successfully detected 96.4% and 92.5% 2D and 3D landmarks, respectively, within a 10 mm error on synthetic test images. It demonstrated an average of 3.6 ± 2.3 mm mean radial error and successfully detected 96.8% 2D landmarks within 10 mm error on clinical fluoroscopy images. Conclusion: Our deep‐learning model successfully localizes anatomical landmarks and estimates the gross shape of skull structures from collimated 2D projection views. This method may help identify the exposure region required for patient‐specific organ dosimetry in FGIs procedures. [ABSTRACT FROM AUTHOR]

Background: Pseudoexfoliation syndrome (PEX) is a common age-related ocular condition characterized by the accumulation of a fibrillar, pseudoexfoliative material on the anterior segment of the eye. This study aims to investigate the histopathological characteristics of pseudoexfoliative material within different ocular structures, including the eyelid, conjunctiva, and anterior lens capsule. Methods: A total of 32 anterior lens capsules, 3 eyelid fragments, and 12 conjunctival specimens were obtained from patients clinically diagnosed with PEX during ocular surgeries at the Onioptic Hospital of Ophthalmology. The tissue specimens were subsequently processed using the classical histological technique of paraffin embedding. This process enabled the production of serial sections with a thickness of 4 microns, facilitating the microscopic examination of fine details. The sections were stained with the hematoxylin-eosin (HE) method for the observation of microscopic structures. Results: This study's findings reveal that PEX material, characterized by its fibrillar and amorphous components, is consistently present across multiple ocular structures, including the anterior lens capsule, eyelid, and conjunctiva. When stained with H&E, the PEX material typically appears as amorphous, eosinophilic deposits. Under higher magnification, these deposits exhibit a fibrillar structure, often appearing as irregular, granular, or filamentous aggregates. Conclusions: The deposit of fibrillar material in the eyelid and conjunctiva, though less commonly emphasized compared to other structures, is a significant finding that sheds light on the systemic nature of the syndrome. The consistent identification of fibrillar eosinophilic deposits across these structures highlights the systemic distribution of PEX material, reinforcing the notion that PEX syndrome is not confined to the anterior segment of the eye. [ABSTRACT FROM AUTHOR]

Posterior capsule opacification (PCO) is a common complication after cataract surgery. Residual lens epithelial cells (LECs) on the anterior lens capsule, after cataract surgery, migrate to the posterior lens capsule and undergo transdifferentiation into myofibroblast‐like cells. Those cells synthesize excessive amounts of extracellular matrix and contribute to fibrosis during PCO. Cellular senescence, a phenomenon that increases with aging, has been implicated in several fibrotic diseases. Here, we have investigated the prevalence of senescent LECs within the lens posterior capsule and the ability of advanced glycation end products (AGEs) in lens capsules to induce senescence, contributing to PCO. Aged lens capsules from pseudophakic human cadaver eyes showed the presence of senescent LECs. In human capsular bags, LECs showed an age‐dependent increase in senescence after 28 days of culture. Human LECs cultured on aged lens capsules for 3 days underwent senescence; this effect was not seen in LECs cultured on young lens capsules. Human LECs cultured on an AGE‐modified extracellular matrix (ECM‐AGEs) showed an AGE‐concentration‐dependent increase in the expression of senescence markers and reactive oxygen species (ROS) levels. Treatment with a RAGE antagonist and ROS inhibitor reduced the expression of senescence and fibrotic markers. Additionally, conditioned media from ECM‐AGEs‐treated cells induced the expression of fibrotic markers in naïve LECs. Together, these suggest that AGEs in the capsule induce senescence of LECs, which triggers the mesenchymal transition of neighboring non‐senescent LECs and contributes to PCO. [ABSTRACT FROM AUTHOR]

To evaluate lenticular biomechanical and geometric parameters in Chinese adults with myopia and identify relevant factors using Brillouin microscopy (BM) and Pentacam. The biomechanical and geometric properties of the ocular lenses of Chinese adults with myopia were quantified using BM. Anterior segment images were acquired using a Pentacam. Correlated factors including age, sex, spherical equivalent (SE), intraocular pressure (IOP), axial length (AL), white-to-white ratio (WTW), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were analyzed. We studied 65 eyes from 65 participants (mean age, 25.23 ± 6.12 years). Width of Top Plateau (WTP), Width of Bottom Plateau (WBP), Slope of Anterior Cortex (SAC), Slope of Posterior Cortex (SPC), and Height of Plateau (Height) metrics obtained using BM showed mean values of 2.597 ± 0.393 mm, 4.310 ± 0.535 mm, 1.344 ± 0.549 GPa/mm, –1.343 ± 0.480 GPa/mm, and 3.373 ± 0.048 GPa, respectively. No significant correlation was found between these parameters and sex, SE, IOP, CCT, ACA, or Height. Interestingly, WBP (r = 0.467, P < 0.001), SAC (r = 0.412, P = 0.001), and SPC (r = –0.280, P = 0.024) were significantly associated with age, and an age-related increase of WBP (slope of 35.36 ± 10.08 μm per year) was identified. Both ACD and ACV showed significant correlations with SAC (r = 0.329 and 0.380, P = 0.008 and 0.002, respectively), but not with SPC. BM provided a novel perspective on lenticular biomechanical and geometric properties in Chinese adults with myopia, which correlated with age, AL, WTW, ACD, and ACV. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to compare morphology and location of crystalline lens between acute acquired concomitant esotropia (AACE) patients and control subjects, both before and after cycloplegia. Methods: This is a prospective and observational clinical study. Morphological and locational parameters of the crystalline lens in 53 AACE patients and 32 control subjects were assessed before and after cycloplegia using CASIA2 system, which represents the latest swept-source anterior segment optical coherence tomography. Cycloplegic refraction was recorded by administering 1% atropine in patients younger than 12 years and 1% cyclopentolate in those > 12 years old. Morphological parameters included anterior radius of curvature (ARC), posterior radius of curvature (PRC), lens thickness (LTH), and equivalent diameter of lens (LED). Locational parameters comprised lens decentration (LD) and lens tilt (LT). Comparison of these parameters before and after cycloplegia were conducted between AACE and controls. Additionally, the study analyzed and compared the changes in these parameter post-cycloplegia. Results: Our findings suggest no significant difference in morphological parameters including ARC, PRC, LTH and LED between AACE patients and controls before or after cycloplegia. However, 2D-modeling data in the 0° meridian revealed that variation post-cycloplegia of LD (lens shift) in right eyes was different in AACE patients, measuring − 0.03(0.08) [median(interquartile range)] which was significantly distinct from the control group, exhibiting a measurement of 0.01(0.06) (z = − 2.373, p = 0.018). In left eyes, a similar trend was observed with lens shift in the 0° meridian being 0.02(0.06) in AACE, significantly differing from control group's measurement of − 0.02(0.08) (z = − 2.809, p = 0.005). Further, correlation analysis revealed that larger temporal shift of lens was associated with greater changes in ARC (r = 0.294, p = 0.006) and LTH (r = − 0.230, p = 0.031). Conclusions: The morphological features of the crystalline lens were similar in AACE patients and controls; however, the change of lens location by cycloplegia was observed only in AACE patients, suggesting an association with excessive accommodation. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence and associated factors of pseudoexfoliation syndrome (PEX) in an Iranian elderly population. Methods: This study, a population-based cross-sectional study conducted on individuals ≥60 years in Tehran, the capital of Iran in 2019 using a multi-stage stratified random cluster sampling. All study participants underwent complete ocular examination (including measurement of uncorrected and best-corrected visual acuity, refraction, slit-lamp biomicroscopy). The PEX was diagnosed based on the presence of white fluffy dandruff-like pseudoexfoliative material on the pupillary margin, on the anterior lens capsule, and/or the trabecular meshwork. Results: Of the 3791 invitees, 3310 participated in the TGES (response rate: 87.3%). After applying exclusion criteria, the data of 3274 individuals were analyzed for this report. The overall prevalence of PEX was 3.63% (95% CI:2.67–4.58) in this study. 81.1% of PEX cases were bilateral. The prevalence of PEX increased significantly with advancing age in a linear trend from 2.38% (95%: 1.27–3.48) in the age group 60–64 years to 6.48% (95%: 2.02–10.95) in the age group ≥80 years (OR = 1.05, p = 0.008). According to the multiple logistic regression model, advancing age (OR: 1.06, p = 0.002) and the presence of cataract (OR: 5.02, p < 0.001) were significantly associated with increased odds of PEX. Conclusion: The results showed a lower prevalence of PEX in the Iranian elderly compared to previous studies on the elderly population. Advancing age and cataracts were the only associated factors of PEX in the present study. [ABSTRACT FROM AUTHOR]

The prevention of blindness from glaucoma requires multiple treatments to lower intraocular pressure. Here, human contact lenses are modified with highly porous metal‐organic frameworks with sustained release of brimonidine for prolonged glaucoma treatment. Various metal‐organic frameworks were screened for their attachment to lenses, loading with brimonidine, and drug‐release properties. Optimized therapeutic ocular lenses conjugated with MIL‐101(Cr) frameworks maintain optical transparency and power. Coating of lenses with MIL‐101(Cr) nanoparticles reduced brimonidine washout with tears and ensured a gradual and localized release of the drug into the eyeball through the cornea. The hybrid lenses provided a 4.5‐fold better decrease in eye pressure, compared by area under the curve (AUC) value to a commercially available brimonidine tartrate solution. Therapeutic lenses did not induce any notable eye irritation or corneal damage in vivo. The newly developed hybrid lenses are expected to provide a robust platform for the therapy and prevention of various ocular diseases. [ABSTRACT FROM AUTHOR]

The Atlantic sea lamprey (Petromyzon marinus) is an anadromous species which is a detritivore for years in freshwater, before metamorphosing into a juvenile and feeding parasitically at sea. However, their migratory patterns and marine ecology are poorly characterized. In other fishes, chemical analysis of calcified structures has aided in understanding their life history, but sea lamprey lacks these structures. Recent work using eye lenses suggests an alternate approach. Lenses are stable protein structures that accrue layers on their outer edge as they grow. We used stable isotope ratios (δxY) of hydrogen, carbon, nitrogen, and oxygen to explore lens layers and compare lenses to muscle. Returning adults were collected in May 2021 from the Penobscot (Maine), Connecticut (Massachusetts), and Susquehanna (Maryland) rivers. Lenses were dissected into three layers (surface, middle, core) and analyzed separately to investigate changes over time. We used mixed-effects models to assess differences in isotope ratios among lens layers. Isotope ratios changed from the core to the surface layer and δ13C were suggestive of a change from terrestrial to marine sources and δ15N showed an increase in trophic level as individuals grew, as would be expected when transitioning from detrital sources to marine prey. However, the isotope ratios of the outer lens layer generally did not correspond with the muscle, perhaps indicating a different temporal interval. These data suggest temporal accretion of lens proteins provide a record to explore sea lamprey ecology. [ABSTRACT FROM AUTHOR]

Background We aimed to investigate the radiation dose to the eye lens (lens dose) during cerebral angiography and to evaluate the effectiveness of the lens dose reduction protocol for 3-dimensional rotational angiography (3D-RA) in reducing overall lens dose exposure. Methods We conducted a randomized, controlled clinical trial at a tertiary hospital with patients undergoing cerebral angiography. The lens dose reduction protocol in 3D-RA involved raising the table to position the patient's eye lens away from the rotation axis. The lens dose was estimated by measuring the entrance surface air kerma using a photoluminescent glass dosimeter. The lens doses of 3D-RA, overall examination, and image quality were analyzed and compared between the two groups. Results A total of 20 participants (mean age, 58±9.4 years; including 12 men [60%]) were enrolled and randomly assigned to either the conventional group or the dose reduction group. The median lens dose in 3D-RA was significantly lower in the dose reduction group compared with the conventional group (1.1 mGy vs 4.5 mGy, p<0.001). The total dose was significantly lower in the dose reduction group (median of 7.5 mGy vs 10.2 mGy, p=0.003). In the conventional group, 3D-RA accounted for 46% of the total lens dose, while in the dose reduction group, its proportion decreased to 16%. No significant differences were observed in the image quality between the groups. Conclusion The lens dose reduction protocol resulted in a significant reduction in the lens dose of the 3D-RA as well as entire cerebral angiography, while maintaining the image quality. [ABSTRACT FROM AUTHOR]

Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound. [ABSTRACT FROM AUTHOR]

Purpose: The epithelial–mesenchymal transition of human lens epithelial cells plays a role in posterior capsule opacification, a fibrotic process that leads to a common type of cataract. Hyaluronic acid has been implicated in this fibrosis. Studies have investigated the role of transforming growth factor (TGF)-β2 in epithelial–mesenchymal transition. However, the role of TGF-β2 in hyaluronic acid-mediated fibrosis of lens epithelial cell remains unknown. We here examined the role of TGF-β2 in the hyaluronic acid-mediated epithelial–mesenchymal transition of lens epithelial cells. Methods: Cultured human lens epithelial cells (HLEB3) were infected with CD44-siRNA by using the Lipofectamine 3000 transfection reagent. The CCK-8 kit was used to measure cell viability, and the scratch assay was used to determine cell migration. Cell oxidative stress was analyzed in a dichloro-dihydro-fluorescein diacetate assay and by using a flow cytometer. The TGF-β2 level in HLEB3 cells was examined through immunohistochemical staining. The TGF-β2 protein level was determined through western blotting. mRNA expression levels were determined through quantitative real-time polymerase chain reaction. Results: Treatment with hyaluronic acid (1.0 μM, 24 h) increased the epithelial–mesenchymal transition of HLEB3 cells. The increase in TGF-β2 levels corresponded to an increase in CD44 levels in the culture medium. However, blocking the CD44 function significantly reduced the TGFβ2-mediated epithelial–mesenchymal transition response of HLEB3 cells. Conclusions: Our study showed that both CD44 and TGF-β2 are critical contributors to the hyaluronic acid-mediated epithelial-mesenchymal transition of lens epithelial cells, and that TGF-β2 in epithelial-mesenchymal transition is regulated by CD44. These results suggest that CD44 could be used as a target for preventing hyaluronic acid-induced posterior capsule opacification. Our findings suggest that CD44/TGF-β2 is crucial for the hyaluronic acid-induced epithelial-mesenchymal transition of lens epithelial cells. [ABSTRACT FROM AUTHOR]

Background: Fibrosis cataract occurs in patients receiving cataract extraction. Still, no medication that can cure the disease exists in clinical. This study aims to investigate the effects and mechanisms of Entrectinib on fibrotic cataract in vitro and in vivo. Methods: The human lens cells line SRA 01/04 and C57BL/6J mice were applied in the study. Entrectinib was used in animals and cells. Cataract severity was assessed by slit lamp and Hematoxylin and Eosin staining. Expression of alpha-smooth muscle actin, fibronectin, and collagen I were examined by real-time quantitative PCR, western blotting, and immunofluorescence. Cell proliferation was evaluated by Cell Counting Kit-8. Cell migration was measured by wound healing and transwell assays. Molecular docking, Drug Affinity Responsive Target Stability, and Cellular Thermal Shift Assay were applied to seek and certify the target of Entrectinib treating fibrosis cataract. Results: Entrectinib can ameliorate fibrotic cataract in vitro and in vivo. At the RNA and the protein levels, the expression of alpha-smooth muscle actin, collagen I, and fibronectin can be downgraded by Entrectinib, while E-cadherin can be upregulated. The migration and proliferation of cells were inhibited by Entrectinib. Mechanistically, Entrectinib obstructs TGFβ2/Smad and TGFβ2/non-Smad signaling pathways to hinder the fibrosis cataract by targeting PYK2 protein. Conclusions: Targeting with PYK2, Entrectinib can block TGF-β2/Smad and TGF-β2/non-Smad signaling pathways, lessen the activation of EMT, and alleviate fibrosis cataract. Entrectinib may be a potential treatment for fibrosis cataract in clinic. [ABSTRACT FROM AUTHOR]

Interventional radiology is one of the most widely used treatment options for abdominal abnormality. Due to new dose limitations, radiation is a hazard that needs to be considered when choosing the international treatment technique. The aim of this study was to measure the effective/equivalent doses and to investigate the associated factors correlating with the doses during Transarterial Chemoembolization (TACE) and Percutaneous Transhepatic Biliary Drainage (PTBD) for radiologists, technologists and nurses involved with the treatment. This prospective study reports occupational dose per procedure of 57 cases (TACE = 42, PTBD = 15) in a Thailand hospital spanning one year. All staff included in this study wore 30 nanoDot Optically Stimulated Luminescence Dosimeter for measuring doses at 7 bodily locations. The average dose area product and cumulative doses was 151.3 Gy·cm2, 1,185.1 mGy during TACE and 21.3 Gy·cm2, 212.2 mGy during PTBD. The radiation exposure of the radiologists was significantly higher than technologists and nurses (p-value < 0.05). The lead protection equipment was a dose-reducing factor which decreased the dose up to 93%. The present study also contributes to the establishment of an individual dose location report and identifies significant correlations between associated factors and dose values. The left hand (1.2 mSv) and the left eye (1.1 mSv) showed maximum doses during the PTBD procedure. The exceeded dose over the limitation was observed in the left eye. We concluded that the dose feedback was able to increase awareness of the occupation staff. So, dose monitoring, updating education and regular training could be applied simply and effectively to improve skills, while reducing the occupational dose. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis paper introduces a practice framework for individualised positive behaviour support (PBS). The framework incorporates existing function-based PBS principles and integrates contemporary research and Australian legislation to frame practice elements through a human rights lens. It is designed to support people with disability of varied aetiologies across the lifespan in various settings (e.g. home, schools, and aged care).Existing research and literature have been reviewed, including key theories and current formulations to inform a new practice framework that reflects recommendations for applications in community settings.The PBS Pathway (PBS-P) framework promotes culturally sensitive and socially valid strategies for empowering the person and their supporters via a clear practice framework. It emphasises evidence-based practices while acknowledging the need for flexibility to meet individual needs.The PBS-P framework offers a pragmatic approach and focused lens for critical thinking and reflective applications within PBS. It promotes a universal approach across the lifespan and service settings, contributing to a shared understanding of PBS as a rights-based practice. The framework’s alignment with current legislation supports adoption within existing systems; however, successful implementation requires skilled practitioners, adequate funding, and policies to support knowledge translation.The positive behaviour support pathway framework guides individualised practices for people across the lifespan and service settings, with emphasis on data-based decision making to inform socially and culturally valid intervention planning.The framework aligns with current legislation and addresses current concerns relating to poor behaviour support practices and urgent recommendations for practices that protect and promote human rights.The positive behaviour support pathway framework guides individualised practices for people across the lifespan and service settings, with emphasis on data-based decision making to inform socially and culturally valid intervention planning.The framework aligns with current legislation and addresses current concerns relating to poor behaviour support practices and urgent recommendations for practices that protect and promote human rights. [ABSTRACT FROM AUTHOR]

Currently available intraocular lenses (IOLs) on the market often differ significantly in elastic modulus compared to the natural human lens, which impairs their ability to respond effectively to the tension of the ciliary muscles for focal adjustment after implantation. In this study, we synthesized a polyacrylamide–sodium acrylate hydrogel (PAH) through the cross-linking polymerization of acrylamide and sodium acrylate. This hydrogel possesses excellent biocompatibility and exhibits several favorable properties. Notably, the hydrogel demonstrates high transparency (94%) and a refractive index (1.41 ± 0.07) that closely matches that of the human lens (1.42). Additionally, it shows strong compressive strength (14.00 kPa), good extensibility (1400%), and an appropriate swelling ratio (50 ± 2.5%). Crucially, the tensile modulus of the hydrogel is 2.07 kPa, which closely aligns with the elastic modulus of the human lens (1.70–2.10 kPa), enabling continuous focal adjustment under the tension exerted by the ciliary muscles. [ABSTRACT FROM AUTHOR]