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Competing Interests: The authors report no conflicts of interest.

Biological drugs, termed biologics, are medications that contain or are derived from a living organism (human, animal, or microorganism). With new biological agents being approved by the Food and Drug Administration (FDA) every year, clinicians need to know potential ocular adverse effects that are associated with these drugs. This review provides an overview of ocular adverse effects of biological medications used to treat both ophthalmic and non-ophthalmic diseases. We searched PubMed for relevant case reports, case series, reviews, and clinical trials reporting ocular adverse effects caused by biologics. This review was conducted in June 2021 and investigated the drugs listed in the most updated (April 2021) FDA Purple Book Database of Licensed Biological Products. This review focuses on monoclonal antibodies, interleukins, and receptor fusion proteins. We explore ocular side effects of 33 biological drugs, stating whether they are frequent, common, or rare., Competing Interests: Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2022.)

Purpose: To assess the efficacy of different devices and nomograms in predicting the most optimal Implantable Collamer Lens (ICL) (STAAR Surgical) size., Methods: This retrospective study includes 73 patients (142 eyes) who underwent ICL placement surgery. Anterior segment measurements were obtained by the OPD-Scan III (Marco), the Lenstar LS 900 (Haag-Streit AG/Alcon Laboratories, Inc), the Galilei G4 (Ziemer), and the VuMax ultrasound biomicroscopy device (UBM) (Sonomed Escalon). The efficacy of the four devices and four nomograms was assessed by comparing the indicated ICL sizes to the patient's postoperative vault measurements., Results: Using white-to-white (WTW) measurements obtained by the Lenstar LS 900 and Galilei G4 coupled with the U.S. Food and Drug Administration's (FDA) (also called the manufacturer's) nomogram predicted the highest percentage (33% and 43%) of the 13.7 mm ICL sizes, respectively. Using the VuMax UBM coupled with the Dougherty nomogram indicated the highest percentage (80%) of the 12.6 mm ICL size. The ICL sizes predicted by UBM using the Parkhurst nomogram were comparable to those deemed ideal according to postoperative vault measurements., Conclusions: The Parkhurst nomogram predicted the most appropriate ICL size. When using WTW measurements, the optimized WTW nomogram showed promising results, especially in eyes whose preoperative calculations suggest low postoperative vaults. Moreover, clinicians should use caution when using the FDA nomogram because it showed a propensity toward indicating oversized ICLs. [ J Refract Surg . 2022;38(2):106-111.] .

Competing Interests: The authors declare that they have no conflicts of interest to disclose.

Purpose: To assess visual outcomes over time of femtosecond laser-assisted cataract surgery compared to standard phacoemulsification cataract surgery., Design: A retrospective, single-center comparative study., Methods: Patient data including demographics, ocular biometry, pre- and postoperative visual acuity, postoperative complications, primary (uncorrected distance visual acuity over time) and secondary visual outcomes (uncorrected near visual acuity, best distance visual acuity, patient complaints, satisfaction, and postoperative surgery) were gathered and statistically analyzed. Demographic differences between patients receiving femtosecond-laser assisted cataract surgery (FLACS) versus standard phacoemulsification cataract surgery (PCS) were corrected for outcome comparison. Safety, efficacy, predictability, and stability were analyzed for each procedure and compared., Results: A total of 155 eyes in PCS and 143 eyes in FLACS were analyzed at 1 week, 3 months, and 1 year using odds ratio. The odds ratio of being 20/20 or better and 20/40 or better at the specified time periods were similar and statistically insignificant at all time periods analyzed except 20/20 or better for uncorrected distance visual acuity (UDVA) at 1 year (p=0.0001) and uncorrected near visual acuity (UNVA) at 1 week (p=0.02). In both cases, the odds of being 20/20 or better favored FLACS. Mean UDVA, UNVA, and best distance visual acuity (BDVA) were all similar and statistically insignificant between the two groups. Postoperative patient complaints, safety, efficacy, predictability, and stability between the two groups showed no statistical significance., Conclusion: Despite the odds ratio of being 20/20 or better favoring FLACS for UDVA at 1 year and UNVA at 1 week, the mean logMAR UDVA, BDVA, and UNVA were similar and statistically insignificant between the FLACS and PCS groups at 1 week, 3 months, and 1 year. Differences in visual acuity were likely due to differences other than surgical approaches. While both FLACS and PCS are appropriate approaches to cataract surgery, one does not appear to be superior when assessing longitudinal markers for visual acuity, safety, efficacy, predictability and stability., Competing Interests: Dr Phillip C Hoopes Jr reports Medical Advisory Board for RxSight, outside the submitted work. The authors report no other conflicts of interest in this work., (© 2021 Moshirfar et al.)

Purpose: To compare the inter-device agreement of anterior chamber depth (ACD), central corneal thickness (CCT), flat keratometry (K1), steep keratometry (K2), corneal astigmatism (ΔK), and white-to-white (WTW) measurements., Methods: This is a retrospective study with 73 myopic patients (142 eyes). We extracted and compared anterior segment measurements (ACD, CCT, K1, K2, ΔK, and WTW) of four devices (OPD-Scan III, Pentacam HR, Lenstar LS 900, and Galilei G4), and performed pairwise agreement comparisons between them., Results: Agreement analyses revealed that the most agreement occurred: in Pentacam HR and Galilei G4 for ACD measurements, in Pentacam HR and Lenstar LS 900 for CCT measurements, in OPD-Scan III and Galilei G4 for WTW measurements, in OPD-Scan III and Pentacam HR for K1 and K2 measurements, and OPD-Scan III and Galilei G4 for ΔK measurements., Conclusion: OPD-Scan III is interchangeable with both Galilei G4 and Lenstar LS 900 for WTW measurements. OPD-Scan III and the Pentacam-HR are interchangeable in K1, K2, and ΔK measurements. OPD-Scan III and Lenstar LS 900, and OPD-Scan III and Galilei G4 are interchangeable in K1 and ΔK measurements, respectively.

Background: Glucose metabolism is related to depression, but the relationship between blood glucose and suicide attempts in patients with major depressive disorder (MDD) remains unclear. This large-scale sample explores the relationship between suicide attempts and fasting blood glucose, in addition to sex differences in first-episode and drug naive (FEDN) MDD patients., Methods: 1718 FEDN MDD patients diagnosed for the first time were recruited, and their demographic data, clinical data, and blood glucose indicators were collected. 17-item Hamilton Depression Rating Scale (HAMD), 14-item Hamilton Anxiety Rating Scale (HAMA), and positive subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess their depression, anxiety and psychotic symptoms, respectively., Results: The depression, anxiety, psychotic symptoms and blood sugar levels of the suicide attempt group were higher than those of the non-suicide attempt group. Correlation analysis showed that blood glucose was significantly associated with suicide attempts in male and female patients. While binary logistic regression showed that blood glucose levels were significantly associated with suicide attempts in male patients, it showed that suicide attempts were not significantly associated with blood glucose levels in female patients., Limitations: The main limitations are cross-sectional design and inability to control selection bias., Conclusions: In male MDD patients, fasting blood glucose level is a potential biomarker of suicide attempt, which deserves attention to avoid suicide risk. However, in female patients, fasting blood glucose has no significant correlation to suicide attempts., (Copyright © 2021. Published by Elsevier B.V.)

Background: Recent publications suggest that left atrial (LA) myopathy is a potential source of thromboembolism, independent of atrial fibrillation., Aims: We sought to investigate whether the presence of atrial premature activity after an ischaemic stroke is associated with LA remodelling and dysfunction, and might be a surrogate marker of LA myopathy., Methods: After an ischaemic stroke or a transient ischaemic attack, patients without known atrial fibrillation or overt heart disease were included prospectively in the study. All patients had a standard workup, including ambulatory Holter electrocardiogram monitoring and transthoracic echocardiography. In some patients, transoesophageal echocardiography was also performed. Anatomical and functional LA remodelling were assessed using minimal and maximal volumes and LA emptying fraction in two-dimensional and three-dimensional echocardiography. Patients were separated into two groups according to the burden of atrial premature complexes (APCs), measured by Holter electrocardiography., Results: Among 148 eligible patients recruited from October 2015 to May 2016, 93 were included in the group with non-frequent APCs (nf-APC:<100 APCs/24hours) and 43 in the group with frequent APCs (f-APC:>100 APCs/24hours). Twelve patients had paroxysmal atrial fibrillation, and were not included in the statistical analysis. Maximal and minimal indexed LA volumes were significantly higher in the f-APC group than in the nf-APC group (P<0.01). LA emptying fraction was worse in the f-APC group than in the nf-APC group. In addition, LA appendage emptying velocity was impaired in the f-APC group, and was correlated with LA remodelling variables, especially LA emptying fraction (r=0.621)., Conclusions: After an ischaemic stroke or a transient ischaemic attack, excessive APCs are associated with LA remodelling. Thus, LA dilatation and dysfunction reflect early LA myopathy, which might itself be responsible for cardioembolic stroke., (Copyright © 2020. Published by Elsevier Masson SAS.)

Aims: Paroxysmal atrial fibrillation (PAF) is common, often silent, and can be difficult to detect. Echocardiographic parameters assessing left atrial (LA) remodelling correlated with atrial fibrosis in permanent AF, but less is known about earlier stages such as PAF. We aimed to evaluate whether 2D and 3D echocardiographic (2DE and 3DE) assessment of LA anatomy and function is able to identify patients with PAF., Methods and Results: This case-control study included 102 patients without overt heart disease, 44 patients with PAF. Anatomical remodelling was assessed using indexed maximal, minimal, and pre-atrial contraction volumes. Reservoir, conduit, and pump functions were assessed by volume and strain methods. All parameters were assessed by 2DE and 3DE and were compared between the two groups. Receiver-operating characteristic curves were constructed for each parameter for PAF prediction. PAF patients had bigger LA volumes than non-PAF group. Using 3DE, all atrial functions were impaired in the PAF group, regardless of the parameters used (all P < 0.05), whereas using 2DE, conduit function did not reach significant difference. Areas under the curve (AUCs) for 3D parameters were higher than those for equivalent 2DE parameters. PAF was best predicted by LA minimal indexed volume assessed by 2DE or 3DE (AUC 0.82 and 0.86, respectively) and 3D-LA ejection fraction and area strain (AUC = 0.82 and 0.81, respectively)., Conclusion: Anatomical and functional LA remodelling assessed by 2DE and 3DE is independently and strongly associated with PAF, suggesting that these parameters can help identify PAF., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)

After decades of development of information systems dedicated to health professionals, there is an increasing demand for personalized and non-hospital based care. An especially critical domain is cardiology: almost two third of cardiac deaths occur out of hospital, and victims do not survive long enough to benefit from in-hospital treatments. We need to reduce the time before treatment. But symptoms are often interpreted wrongly. The only immediate diagnostic tool to assess the possibility of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision making but require setting up new infrastructures. The European EPI-MEDICS project has developed an intelligent Personal ECG Monitor (PEM) for the early detection of cardiac events. The PEM embeds advanced decision making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care provider only if necessary and requiring no specific infrastructure. This solution is a typical example of pervasive computing and ambient intelligence that demonstrates how personalized, wearable, ubiquitous devices could improve healthcare.

Recently, much has been published about osteoporosis and the suspected vast numbers of patients who are undiagnosed or at risk. Various groups, including the US Preventative Services Task Force and The National Osteoporosis Foundation, have attempted to highlight the recommendations regarding who and when to screen. We know that for a screening test to be effective, not only must it predict morbidity far enough in advance that something can be done but it also must be widely available and cost effective. There are several methods of screening with varying sensitivity and specificity for identifying people at risk for osteoporotic fracture. After an examination of all available approved testing methods, it seems that dual-energy x-ray absorptiometry (DEXA) and calcaneal ultrasound best predict patients at risk for fracture. However, because of the length of time needed to demonstrate bone mineral changes and the small magnitude of these changes, DEXA seems to be the most cost-effective method to follow patients who are receiving treatment.

In western countries, heart disease is the main cause of premature death. Most of cardiac deaths occur out of hospital. Because of a continuously growing elderly population, the number of heart attacks is steadily increasing. Symptoms are often interpreted incorrectly. Victims do not survive long enough to benefit from inhospital treatments. To reduce the time before treatment, the only useful diagnostic tool to assess the presence of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision-making but require setting up new infrastructures. The pervasive solution proposed by the European EPI-MEDICS project is an intelligent Personal ECG Monitor for the early detection of cardiac events. It includes part of the patient electronic health record (EHR), embeds a web server and decision-making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care providers only if necessary, without requiring to set-up specific infrastructures. Healthcare becomes personalized, wearable and ubiquitous.