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Objective: This study aims to conduct an analysis glaucoma surgeries performed over a 13-year period at a tertiary hospital affiliated with the Spanish National Health System, with the goal of assessing temporal trends., Methods: This retrospective observational study scrutinized surgeries undertaken in the glaucoma unit of a tertiary center in Spain between 2010 and 2022. Data collected included surgical dates, procedure performed, whether it was standalone or combined, as well as patient demographics including age, sex, and type of underlying glaucoma. Surgeries on individuals under 18 years of age were excluded. An annual comparative analysis was performed to ascertain the evolving trends in glaucoma surgical interventions., Results: A total of 12,944 surgeries were included in the analysis, comprising 9428 isolated cataract surgeries and 2975 glaucoma procedures. Trabeculectomy, glaucoma drainage devices (GDD), and cyclodestruction, collectively referred to as traditional surgery, demonstrated a decline from 93.2% to 23.6% over the study duration. Minimally invasive glaucoma surgery (MIGS) and minimally invasive bleb surgery (MIBS) demonstrated a significant increase from 3.8% in 2010 to 74.7% in 2022, relative to the total glaucoma surgeries. Furthermore, combined surgeries manifested a noteworthy increase from 39.0% in 2010 to 44.2% in 2022, with 86.4% of combined procedures in 2022 being MIGS or MIBS., Conclusion: In recent years, there has been a noticeable change in the trend of glaucoma surgeries, with MIGS and MIBS procedures experiencing a significant increase and becoming the most commonly performed glaucoma procedures. Consequently, traditional glaucoma surgeries have decreased in frequency., 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.

Objective: To evaluate the differences in peripapillary and macular vascular parameters by optical coherence tomography angiography (OCTA) between patients with primary congenital glaucoma (PCG) and healthy controls; and to determine their diagnostic accuracy., Material and Methods: Observational, cross-sectional study including 39 eyes with PCG and 78 healthy eyes. Only one eye per patient was included. All included patients underwent a comprehensive ophthalmic examination and peripapillary and macular analysis were performed by Angioplex TM OCTA (Cirrus HD-OCT 5000) with a 4.5 × 4.5 mm optic nerve head scan and 6 × 6 mm macular scan. Global data and quadrant data from peripapillary vascular parameters and global data and circular sectors data from macular superficial plexus parameters were compared between groups. The glaucoma discrimination capability of these parameters was calculated as areas under the receiver operating characteristics curve (AUC ROC)., Results: Mean age was 14.1 ± 8.7 years for the PCG patients and 11.7 ± 6.2 years for controls (p = 0.093). All vascular peripapillary measurements (global and quadrants; all p < 0.001) and all macular measurements (p < 0.042) excepting perfusion density in the inner circle (p = 0.087), were reduced in the PCG group compared to controls. According to AUC ROC, peripapillary (all ≥ 0.706) and macular parameters (all ≥ 0.699) showed good diagnostic capacity. AUC ROC for the most discriminatory measurements corresponding to blood flux index (0.887) and whole macula vascular density (0.855) were similar (p = 0.085)., Conclusion: Peripapillary and macular vascular parameters by OCTA are decreased in patients with PCG, showing a good capacity to discriminate between normal and glaucomatous eyes., (© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Objective: The aim was to assess the influence of corneal biomechanics on intraocular pressure (IOP) measurements made with the Icare200 (IC200) rebound tonometer and the Perkins handheld applanation tonometer in patients with primary congenital glaucoma (PCG)., Materials and Methods: A total of 40 PCG patients and 40 healthy controls, age, and sex-matched, were recruited. IOP was measured with the Ocular Response Analyzer (IOPc, IOPg), IC200 and Perkins. The variables age, IOP, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), best-corrected visual acuity, spherical equivalent, medications, and glaucoma surgeries were recorded for each subject. Univariate and multivariate analysis were used to detect effects of variables on IOP measurements., Results: Mean CCT was 545.65±71.88 μm in PCG versus 558.78±27.58 μm in controls (P=0.284). CH and CRF were significantly lower in PCG group than in control group: mean CH 8.11±1.69 versus 11.15±1.63 mm Hg (P<0.001), and mean CRF 9.27±2.35 versus 10.71±1.75 mm Hg (P=0.002). Mean differences between IOP IC200-Perkins were 0.79±0.53 mm Hg in PCG versus 0.80±0.23 mm Hg in controls (P<0.001) and mean differences IC200-IOPc were -0.89±5.15 mm Hg in PCG (P<0.001) versus 1.60±3.03 mm Hg in controls (all P<0.009). Through multivariate analysis, CRF showed positive association and CH negative association with IOP measured with Perkins or IC200 in both subject groups. No association was detected for CCT, age, or sex., Conclusion: CH and CRF were identified as the main factors interfering with IOP measurements made with both tonometers in patients with PCG and healthy controls., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

We demonstrate that black holes and stars in general relativity can be destabilized by perturbations of nonminimally coupled vector fields. Focusing on static and spherically symmetric backgrounds, our analysis shows that black holes with sufficiently small mass and stars with sufficiently high densities are subject to ghost- or gradient-type instabilities. This holds for a large class of Einstein-Proca theories with nonminimal couplings, including generalized Proca models that have sparked attention for their potential role in cosmology and astrophysics. The stability criteria translate into bounds of relevance for low-scale theories of dark energy and for ultralight dark matter scenarios.

Purpose: To examine agreement between intraocular pressure (IOP) measurements made using the rebound tonometer Icare ic200 (RT200) and the Perkins handheld applanation tonometer (PAT) in patients with primary congenital glaucoma (PCG). The impacts of several covariables on measurements using the two devices were also assessed., Materials and Methods: Intraocular pressure measurements were made in a single session in 86 eyes of 86 patients with PCG (46 under anaesthesia, 40 in the office). The order was RT200 then PAT. The variables age, central corneal thickness (CCT), corneal state and anaesthesia were recorded in each patient. Data were compared by determining interclass correlation coefficients (ICC) for each tonometer and representing the differences detected as Bland-Altman plots. Effects of covariables were assessed through univariate and multivariate regression., Results: Mean IOP difference between tonometers (RT200 minus PAT) was 1.26 mmHg (95%: 0.22-2.31). Absolute agreement (ICC) was 0.73 (95% CI: 0.62-0.82). Lower and upper limits of agreement (95%) were -8.06 mmHg (95% CI: -9.87 to -6.25) and 10.59 mmHg (95% CI: 8.77-12.40), respectively. The tonometers showed systematic differences (a = -4.63 mmHg; 95% CI: -9.11 to -1.44) and proportional differences; for each mmHg increase in PAT-IOP, the RT200 reading increased by 1.28 mmHg (b = 1.28; 95% CI: 1.12-1.53). None of the variables tested as predictors were able to explain differences between the tonometers., Conclusions: Despite the good overall agreement between both tonometers, caution should be taken in high values of IOP, considering the interchangeability of its readings as systematic and proportional differences appear to exist between both methods., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

To assess the effectiveness and safety of the Preserflo Microshunt (PMS) implantation combined with cataract surgery in open-angle glaucoma (OAG) patients. Retrospective, open-label study conducted on insufficiently controlled OAG patients, who underwent a PMS implant procedure with mitomycin-C 0.2%, either alone or in combination with cataract surgery, and were followed for at least 12 months. Success was defined as an intraocular pressure (IOP) ≤ 18 mmHg and a reduction of at least 20% without (complete) or with (qualified) hypotensive medication. Fifty-eight eyes were included in the study, 35 eyes underwent PMS alone and 23 underwent PMS + Phaco. In the overall study sample, mean IOP was significantly lowered from 21.5 ± 3.3 mmHg at baseline to 14.6 ± 3.5 mmHg at month 12 (p < 0.0001). The IOP was significantly reduced in both groups; p < 0.0001 each, respectively. Ocular hypotensive medication was significantly reduced (p < 0.0001) in both groups. No significant differences were observed in IOP lowering or medication reduction between groups. At month 12, 62.1% eyes were considered as complete success and 82.8% eyes as qualified success. The most common adverse events were device close-to-endothelium, conjunctival fibrosis, and wound leakage. PMS, either alone or in combination with phacoemulsification, may be considered as a valuable option for treating OAG patients., (© 2021. The Author(s).)

Several recent proposals to embed inflation into high-energy physics rely on inflationary dynamics characterized by a strongly nongeodesic motion in negatively curved field space. This naturally leads to a transient instability of perturbations on sub-Hubble scales, and to their exponential amplification. Supported by first-principles numerical computations, and by the analytical insight provided by the effective field theory of inflation, we show that the bispectrum is enhanced in flattened configurations, and we argue that an analogous result holds for all higher-order correlation functions. These "hyper-non-Gaussianities" thus provide powerful model-independent constraints on nonstandard inflationary attractors motivated by the search for ultraviolet completions of inflation.

Purpose: To compare the diagnostic performance of circumpapillary retinal nerve fiber layer (cpRNFL) analysis versus segmented ganglion cell complex analysis both by spectral-domain optical coherence tomography (SD-OCT) in children with primary congenital glaucoma (PCG)., Methods: Participants were 40 children diagnosed with PCG and 60 healthy children. Ophthalmological data collected (for one eye per child) were cup-disc ratio (C/D) and axial length (AL). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). For the cpRNFL measurements conventional S-D OCT software was used and the capacity of each method to discriminate between normal and glaucomatous eyes was compared., Results: Mean age was 11.20 ± 3.94 years for the glaucoma patients and 10.90 ± 2.46 years for controls (p = 0.64). All measurements were reduced (thinner) in the glaucoma group, significantly so for: cpRNFL, GCL, IPL and outer-superior and outer-inferior quadrant mRNFL. According to their areas under the receiver operating characteristics curve (AUC), temporal superior cpRNFL (0.869) and outer superior GCL (0.840), IPL (0.799), and mRNFL (0.767) showed the better diagnostic capacity. No differences were observed in AUCs for the most discriminatory cpRNFL and macular measurements., Conclusion: Segmented macular layer analysis shows a good capacity to discriminate between normal and glaucomatous eyes; which is comparable to that of cpRNFL analysis in children with PCG.

The level of intraocular pressure (IOP) is the main known risk factor for the development and progression of glaucomatous optic neuropathy. Despite Goldmann applanation tonometry (GAT) being the gold standard for determining IOP since the last century, its limitations were obvious from the start and include substantial effects of several eye variables such as axial length, curvature, rigidity, and corneal thickness. These limitations have prompted the development of numerous formulas and nomograms designed to compensate for the ocular characteristics effect on GAT, but none of these methods has been entirely satisfactory. Similarly, as a result of efforts to mitigate some of the limitations of conventional tonometry, several new tonometers have appeared on the scene., (© 2015 Elsevier B.V. All rights reserved.)

Background: Several antibodies, also called serological markers, are associated with specific forms, disease behavior and phenotype of inflammatory bowel disease (IBD)., Aim: Summarize and analyze the evidence of the utility of serologic markers in IBD, making emphasis on their clinical utility and behavior between populations., Material and Methods: Relevant articles were located by computer-assisted search of PubMed (since January 1979 until December 2008)., Results: Anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear Anti-neutrophil Cytoplasmic Antibodies (pANCA) are the best studied serological markers. Assessing both ASCA and pANCA allows a better differentiation of Crohn's disease (CD) from ulcerative colitis (UC) than by using the individual tests alone. The ASCA+/pANCA- phenotype is characteristic of CD, while the ASCA-/pANCA+ phenotype is found in UC. The interest on atypical ANCA is growing as it may be a useful tool to distinguish between different IBD forms. Newer markers derived from various microbial species of the gut and glycan markers are of interest as they offer new ways to stratify patients into serologic subgroups. These serological markers may act as prognostic indicators of the severity and behavior of IBD, but more studies are necessary to determine their utility., Conclusions: There is emerging evidence that combining serological markers may increase the accuracy of diagnosis of a specific form of IBD or its behavior, but the perfect assay or combination of antibodies has not been discovered. They have several limitations, therefore clinicians must be aware of the evidence on serological markers, interpret them with caution and always correlate with the clinical picture.