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The 2 most known cannabinoids are Δ9-tetrahydrocannabidiol (THC) and cannabidiol (CBD). Both chemicals are extracted from the cannabis plant but can also be synthetically produced, 89-Tetrahydrocannabidiol is extracted from thesubspecies of the cannabis plant known asthe marijuana plant, which contains a high concentration of THC (0.3% to 30%). Δ9-Tetrahydrocannabidiol is a major psychoactive and intoxicating component of the cannabis plant and is not recommended for use in dogs due to its toxic effect. Cannabidiol is extracted from the subspecies of the cannabis plant known as the hemp plant and must contain less than 0.3% THC. Cannabidiol is a major nonpsychoactive component of the cannabis plant, and its effect has been investigated for epilepsy, neoplasia, and osteoarthritis in dogs. Public interest in the medical use of cannabinoids for various diseases and disorders has grown in the last couple of years. The attention has extended to veterinary medicine, where veterinarians and pet owners are curious about what diseases the nontoxic CBD can be used for to treat companion animals. The use of CBD for ophthalmic diseases has also been investigated due to its anti-inflammatory and neuroprotective effects. Intraocular pressure regulation for glaucoma, corneal diseases (eg, keratitis and corneal pain), uveal diseases (eg, endotoxin-induced uveitis), and retinal/optic nerve head diseases (eg, diabetic retinopathy) are areas where CBD's effect has been investigated in humans and animals. The aim of this review is to give an update on what is known regarding the use of cannabinoids, especially CBD, for ophthalmic diseases in dogs. [ABSTRACT FROM AUTHOR]

Purpose: Diving is an intense physical activity under hyperbaric and hyperoxic conditions. The aim of this study is to evaluate the long‐term effects of diving on the thicknesses of retinal layers and retinal anatomy in professional deep and scuba divers. Methods: The study included 52 eyes of deep divers who dive to depths of more than 130 feet (ft), 49 eyes of scuba divers who dive up to 130 ft, and 66 eyes of the control group, consisting of nondiving but regularly exercising males. Measurements of macular retinal layer thicknesses, peripapillary nerve fiber layer thickness, subfoveal choroidal thickness, and peripheral retinal examinations with scleral indentation were performed and statistically compared between the groups. Results: The mean diving duration was 455.00 ± 318.88 h in deep divers and 451.67 ± 281.10 h in scuba divers. The retinal pigment epithelium (RPE) was statistically significantly thicker in deep divers than in scuba divers and the control group on the 3 mm ring of the Early Treatment Diabetic Retinopathy Study grid. Subfoveal choroidal thickness was significantly thicker in deep divers than in scuba divers (p < 0.05). RPE abnormalities showed a significant increase in both the deep and scuba diver groups (p = 0.01). Conclusion: An increased thickening of the subfoveal choroid and RPE, resembling pachychoroid pigment epitheliopathy, was detected in deep divers over a long‐term duration. [ABSTRACT FROM AUTHOR]

Objective Animals Studied Procedure(s) Results Conclusions The aim of this study was to detect and describe ocular abnormalities in a population of Turkmen horses.A total of 55 Turkmen horses (33 mares and 22 stallions) from one herd were evaluated in this study.Demographic data (Age, Sex, Coat color) were recorded. All animals underwent complete ophthalmic examination. The Schirmer tear test ‐I (STT‐I) was performed for all horses prior to other diagnostic tests. Neuro‐ophthalmic examinations (menace response, dazzle reflex, pupillary light reflex, maze test, and visual tracking) were carried out in different lighting situations (bright and dim lights). Slit lamp biomicroscopy, direct and indirect ophthalmoscopy, fluorescein staining, and tonometry were performed for each horse.The mean (standard deviation) age of horses was 5.7 (4.6) years (range of 1–17 years). In total, 18 horses (32.7%) had ocular‐related lesions. Cataract, iris hyperpigmentation and corneal edema were the most identified conditions in the horses of this study.About one‐third of studied horses had at least one ocular abnormality. No ocular abnormalities attributed to the distinct cream/gold coat color were identified, which the Turkmen horse is known for. [ABSTRACT FROM AUTHOR]

This study employs spectral-domain optical coherence tomography (SD-OCT) to examine features of central serous chorioretinopathy (CSCR), specifically pigment epithelial detachment (PED) and relevant optical coherence tomography parameters. This study conducted at the Gitam Institute of Medical Sciences and Research involved nine patients with blurred central vision. A thorough eye examination was conducted. The diagnosis of CSCR was made, and high-quality retinal scans were obtained using SD-OCT, focusing on foveal thickness, subretinal fluid (SRF) height and diameter, subfoveal choroidal thickness (SFCT), and PEDs height and diameter. This study involved nine participants with CSCR, predominantly male (77.78%), with a mean age of 42 years. Foveal thickness varied (274–740 μ, average 454.1111). Macular SRF height ranged from 34–572 μ, average 266.6667, SRF diameter 866–6100 μ, average 3,394.1111, and SFCT 401–479 μ, average 447.4444. Among CSCR patients with PEDs (66.67%), no significant difference was observed in ocular parameters compared to those with CSCR only. PED characteristics exhibited variability (height: 20–223, diameter: 89–1474). Our study highlights the utility of SD-OCT in evaluating various parameters associated with CSCR, particularly PED. The research explored various parameters, including foveal thickness, macular maximum SRF height and diameter, SFCT, and PEDs height and diameter, shedding light on the heterogeneity of CSCR presentations. [ABSTRACT FROM AUTHOR]

Aim: Uveitis is one of the leading causes of visual impairment worldwide. This study aims to delineate the demographic and clinical characteristics of uveitis patients who underwent treatment and monitoring at our facility. Material and Methods: A retrospective examination was conducted on the medical records of uveitis patients monitored at the Uvea-Behçet Unit of Karadeniz Technical University Faculty of Medicine Farabi Hospital between 1997 and 2020. Four hundred and fifty uveitis patients, whose records comprehensively met the study criteria, were evaluated for analysis. Results: Females constituted 56.2% (n=253) while males represented 43.8% (n=197) of the study group. Patients exhibited a mean age of 35.85±16.79 years. The predominant clinical presentation was a decline in visual acuity reported by 84.9% (n=382) of the patients. Idiopathic uveitis emerged as the most prevalent subtype accounting for 23.5% (n=106) of cases. Topical steroids were the primary treatment administered to 78.4% (n=353) of the study group. Six hundred eleven of a total of 900 eyes were involved. Anatomically, anterior uveitis was the most common form in all eyes, with 38.7% (n=349). Of the eyes with involvement, 59.1% (n=367) fully recovered, while 38.5% (n=239) experienced symptom management with ongoing treatment, and 2.4% (n=15) of patients were non-responsive to treatment. Conclusion: The prevalence, subtype distribution, and clinical manifestations of uveitis can exhibit regional variations. This study demonstrates the demographic and clinical characteristics of uveitis patients in the Eastern Black Sea Region. [ABSTRACT FROM AUTHOR]

Background: Demographic characteristics apparently play a critical role in the incidence and prevalence of uveitis in different societies. Numerous studies have investigated the demographic-epidemiological factors and clinical patterns of uveitis in Iran; however, no study has been conducted in the west of the country yet. Objectives: To assessed epidemiologic pattern of uveitis in patients residing in the west of Iran. Methods: This study investigated 358 files of uveitis patients referring to the specialized retina-uveitis clinics in a referral hospital in the west of Iran from March 2016 to September 2022. The demographic characteristics, clinical patterns, and complications of uveitis were evaluated in this study. Results: The uveitis patients' mean age (± SD) at the diagnosis time was 48.14 (± 11.91) years (18 - 72 years), the patients with anterior uveitis had the lowest mean age (45.47 ± 11.54 years), and the patients with panuveitis had the highest mean age (52.90 ± 10.14 years) at the diagnosis time. The prevalence of the disease was equal in both genders; however, posterior uveitis and panuveitis significantly involved males more than females (P < 0.01 and 0.01 respectively). The most common anatomical pattern of involvement belonged to anterior uveitis (34%), followed by panuveitis (23.4%), posterior uveitis (22.9%), and intermediate uveitis (19.5%). The prevalent etiology in anterior, intermediate, and panuveitis were idiopathic and Toxoplasma chorioretinitis was the most common causes in posterior uveitis (34.14%). Moreover, acute clinical course and nongranulomatous pathology were also more prevalent. The most common complications of the disease were cataracts and cystoid macular edema (CME). Also, patients with panuveitis followed by posterior uveitis had the worse visual prognosis. Conclusions: The predominant pattern of involvement in patients referring to the referral center in the west of Iran was in the form of anterior uveitis, acute in terms of clinical course, and non-granulomatous in terms of pathology. This clinical view for evaluation in a referral center differs from the pattern expected to be observed in the general population and even in general ophthalmology centers. [ABSTRACT FROM AUTHOR]

Objectives: Yasunari nodules are choroidal lesions observed in patients diagnosed with neurofibromatosis type 1 (NF-1) and characterized by relatively irregular dome-shaped, plaque-like, or patchy boundaries. The present study examines the multimodal imaging characteristics of Yasunari nodules and their value in the diagnosis of NF-1. Materials and Methods: Medical records including optical coherence tomography (OCT), enhanced depth imaging OCT, infrared reflectance (IR) imaging, OCT angiography, and color fundus images of NF-1 patients who were examined at the Department of Ophthalmology in Dokuz Eylül University Faculty of Medicine between January 2022 and December 2023 were retrospectively reviewed for the presence of Yasunari nodules. Results: A total of 54 eyes of 27 patients were included in the study. At least one choroidal nodule was detected on IR imaging in 52 eyes (96.3%). In 31 (72.1%) of the 43 eyes (79.6%) with available high-quality OCT angiography images, choroidal nodules were observed as areas showing a flow deficit in the choriocapillaris layer. Of the total 54 eyes included, Lisch nodules without choroidal nodules were observed in 2 eyes (3.7%). In 16 eyes (29.6%), Lisch nodules were not detected despite the presence of choroidal nodules. Both Lisch nodules and choroidal nodules were detected in the other 36 eyes (66.7%). Conclusion: Yasunari nodules are frequently observed in NF-1 cases and can be easily detected with multimodal imaging techniques, especially IR imaging. The ability to visualize choroidal nodules before the appearance of Lisch nodules demonstrates the importance of Yasunari nodules in the diagnosis of NF-1. [ABSTRACT FROM AUTHOR]

Introduction: Although checkpoint inhibitors (CPIs) have improved outcomes for patients with metastatic melanoma, those progressing on CPIs have limited therapeutic options. To address this unmet need and overcome CPI resistance mechanisms, novel immunotherapies, such as T-cell engaging agents, are being developed. The use of these agents has sometimes been limited by the immune response mounted against them in the form of anti-drug antibodies (ADAs), which is challenging to predict preclinically and can lead to neutralization of the drug and loss of efficacy. Methods: TYRP1-TCB (RO7293583; RG6232) is a T-cell engaging bispecific (TCB) antibody that targets tyrosinase-related protein 1 (TYRP1), which is expressed in many melanomas, thereby directing T cells to kill TYRP1-expressing tumor cells. Preclinical studies show TYRP1-TCB to have potent anti-tumor activity. This first-in-human (FIH) phase 1 dose-escalation study characterized the safety, tolerability, maximum tolerated dose/optimal biological dose, and pharmacokinetics (PK) of TYRP1-TCB in patients with metastatic melanoma (NCT04551352). Results: Twenty participants with cutaneous, uveal, or mucosal TYRP1-positive melanoma received TYRP1-TCB in escalating doses (0.045 to 0.4 mg). All participants experienced ≥1 treatment-related adverse event (TRAE); two participants experienced grade 3 TRAEs. The most common toxicities were grade 1-2 cytokine release syndrome (CRS) and rash. Fractionated dosing mitigated CRS and was associated with lower levels of interleukin-6 and tumor necrosis factor-alpha. Measurement of active drug (dual TYPR1- and CD3-binding) PK rapidly identified loss of active drug exposure in all participants treated with 0.4 mg in a flat dosing schedule for ≥3 cycles. Loss of exposure was associated with development of ADAs towards both the TYRP1 and CD3 domains. A total drug PK assay, measuring free and ADA-bound forms, demonstrated that TYRP1-TCB-ADA immune complexes were present in participant samples, but showed no drug activity in vitro. Discussion: This study provides important insights into how the use of active drug PK assays, coupled with mechanistic follow-up, can inform and enable ongoing benefit/risk assessment for individuals participating in FIH dose-escalation trials. Translational studies that lead to a better understanding of the underlying biology of cognate T- and B-cell interactions, ultimately resulting in ADA development to novel biotherapeutics, are needed. [ABSTRACT FROM AUTHOR]

PurposeCase presentationConclusionTo report a case of uveal effusion syndrome in association with primary COVID-19 infection to share our experience and insight in diagnosing and managing this unique case.A 56-year-old woman presented with angle closure glaucoma of both eyes. Further examination and imaging revealed the etiology to be related to bilateral uveal effusions and choroidal thickening in the setting of recent COVID-19 infection. The patient’s glaucoma was managed with bilateral iridotomies and medical therapy, while the precipitating uveal effusions resolved with treatment on oral steroids.While uveal effusion syndrome has been associated with COVID-19 vaccination, it has not yet been reported after primary infection. Recognition of this rare phenomenon will allow for better diagnosis and treatment in future cases. [ABSTRACT FROM AUTHOR]

Aim: To investigate the frequency and location of additional primary malignancies in a Polish cohort of uveal melanoma (UM) patients registered in a single centre database. Material and method: Retrospective data analysis of patients treated for uveal melanoma at the Department of Ophthalmology, Poznań University of Medical Sciences, Poland between 1991 and 2017. Data on the diagnosis of the additional malignancies were obtained during the follow-up visits in our Department and/or from the Greater Poland Cancer Registry. The exclusion criteria comprised no confirmed follow-up or incomplete clinical entry data. Results: Among 644 UM patients registered in the database up to 2017, the additional malignancy was diagnosed in 126 (20%) patients: 71 men, 55 women at the median age of 67 years (range: 34–94). In 48 patients (38%), the additional malignancy occurred prior to the diagnosis of UM, in 73 (58%) patients - after it. The most common locations of second cancer were skin (20 cases / 15%), breast (17 cases / 13%) and lungs (15 cases / 12%). The median follow-up was 36 months (range: 3–242). 87 patients (69%) died by the study close, 32 (37%) of them due to metastatic disease from uveal melanoma, 41 (47%) due to another cancer. Conclusions: The frequency of additional primary malignancies was higher in our cohort than reported by most of other groups. If there is a certain predisposition to a specific type of additional primary carcinoma in UM patients, the analysis of larger database is required. [ABSTRACT FROM AUTHOR]

Tebentafusp is a bispecific protein that recently underwent FDA approval for the treatment of metastatic uveal melanoma that functions by redirecting cytotoxic T cells to glycoprotein-100, a protein highly expressed in melanoma. Although clinical trials have demonstrated that rashes are common in the first few days of treatment, little is known about skin reactions that develop later in the treatment course. Herein, we describe a type IV hypersensitivity reaction and vitiligo-like depigmentation that developed six weeks into treatment and discuss the possible mechanisms underlying these reactions. The type IV hypersensitivity reaction resolved without intervention within seven weeks of onset, suggesting that tebentafusp can be safely continued in select patients who develop this cutaneous react [ABSTRACT FROM AUTHOR]

Background: Cardiac surgery has been associated with adverse ocular events. Off-pump coronary artery bypass graft surgery evades the systemic inflammatory response seen in extracorporeal circulation and is superior to on-pump surgery with regard to end-organ dysfunction and neurological outcomes. Objectives: To determine the effects of off-pump (without extracorporeal circulation) coronary artery bypass graft surgery on choroidal thickness, ganglion cell complex, and the retinal nerve fiber layer. Design: Prospective, longitudinal study. Methods: Patients who underwent off-pump surgery were examined preoperatively and postoperatively at 1 week and 6 weeks after surgery. Choroidal thickness, ganglion cell complex, and the retinal nerve fiber layer measurements were recorded, and the effects of off-pump coronary artery bypass on these parameters were assessed. Results: A total of 44 eyes of 44 patients were included in the study. There was a statistically significant increase in subfoveal choroidal thickness from 252.84 ± 56.24 µm preoperatively to 273.82 ± 39.76 µm at 1 week and 301.97 ± 44.83 µm at 6 weeks after off-pump coronary artery bypass graft surgery (p = 0.044; p ⩽ 0.001). Ganglion cell complex and retinal nerve fiber measurements showed no significant difference compared to preoperative values. Conclusion: Off-pump coronary artery bypass graft surgery showed no negative effects on ganglion cell complex and retinal nerve fiber measurements. A significant increase in subfoveal choroidal thickness was seen after off-pump surgery, which might be advantageous in patients who are at high risk or have preexisting ocular diseases that are affected by the choroid. [ABSTRACT FROM AUTHOR]

The theory of pupil-collateral disease, the combination of differentiation of ophthalmic collateral and differentiation of viscera, is applied to treat pupil-related diseases, such as diseases of the uvea, retina, macula, and optic nerve, based on the theory of collateral disease (a traditional Chinese medicine (TCM) term). The theory of pupil-collateral disease is also in accordance with the TCM principles of harmonizing the viscera, dredging qi and blood, and supplementing deficiency and reducing excess to achieve eye homeostasis. This theory originated from the Yellow Emperor 's Internal Classic, followed by the Treatise on Febrile Diseases, which was adapted from the Clinical Guidelines and Medical Records and developed in later generations. The core pathogenic mechanism of pupil-collateral disease is collateral stasis in the eyes. The characteristics of symptom can be summarized as prolonged, static, stubborn, miscellaneous, and solid. The general principle of treatment is dredging ophthalmic collateral and improving eyesight. Furthermore, considering the degree of damage to the ophthalmic meridians, sufficiency of qi and blood, and the duration of the disease, eight methods were established, including by dredging collateral by using condiment herbs, by promoting blood circulation, by cooling blood, by clearing phlegm, by using insect medicines, by warming yang, by benefiting qi, and by nourishing qi and blood. The theory of pupil-collateral disease will enrich the theoretical connotation of the theory of collateral diseases, providing a reference to improve the efficacy of treatment of eye diseases that are difficult to treat. [ABSTRACT FROM AUTHOR]

A 69-year-old woman with bilateral primary open-angle glaucoma who underwent cataract extraction with intraocular lens implantation and excisional goniotomy with the Kahook Dual Blade (KDB; New World Medical, Rancho Cucamonga, CA, USA) in both eyes one year prior was referred for evaluation of significant visual acuity loss and pain in the left eye. On initial examination, intraocular pressure in the left eye was 3 mmHg and slit lamp examination revealed normal anterior chamber depth. Gonioscopy revealed a cyclodialysis cleft that was confirmed by anterior segment optical coherence tomography. Prominent chorioretinal folds suggestive of long-standing hypotony maculopathy were observed during fundoscopic examination. The cyclodialysis cleft, thought to be created inadvertently during the KDB goniotomy, resolved after three sessions of argon laser photocoagulation and the patient's symptoms and visual acuity partially improved. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the effect of macular choroidal thickness (MCT) and peripapillary choroidal thickness (PPCT) on the classification of obese and healthy children by comparing the performance of the random forest (RF), support vector machine (SVM), and multilayer perceptrons (MLP) algorithms. Materials and Methods: Fifty-nine obese children and 35 healthy children aged 6 to 15 years were studied in this prospective comparative study using optical coherence tomography. MCT and PPCT were measured at distances of 500 µm, 1,000 µm, and 1,500 µm from the fovea and optic disc. Three different feature selection algorithms were used to determine the most prominent features of all extracted features. The classification efficiency of the extracted features was analyzed using the RF, SVM, and MLP algorithms, demonstrating their efficacy for distinguishing obese from healthy children. The precision and reliability of measurements were assessed using kappa analysis. Results: The correlation feature selection algorithm produced the most successful classification results among the different feature selection methods. The most prominent features for distinguishing the obese and healthy groups from each other were PPCT temporal 500 µm, PPCT temporal 1,500 µm, PPCT nasal 1,500 µm, PPCT inferior 1,500 µm, and subfoveal MCT. The classification rates for the RF, SVM, and MLP algorithms were 98.6%, 96.8%, and 89%, respectively. Conclusion: Obesity has an effect on the choroidal thicknesses of children, particularly in the subfoveal region and the outer semi-circle at 1,500 µm from the optic disc head. Both the RF and SVM algorithms are effective and accurate at classifying obese and healthy children. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate and report the outcome of a patient with locally recurrent uveal melanoma (UM) previously treated with brachytherapy (BT), using a second personalized globe-sparing radiotherapy approach. Material and methods: In June 2020, a 78-year-old man arrived at our institution with diplopia and suspected uveal melanoma. At the ophthalmological evaluation (B-scan and A-scan ultrasonography) a lesion in the right eye at 6–7 hours of about 5 mm thickness, with internal lacunar areas, approximately 7 mm away from the limbus, was observed. The patient underwent ruthenium plaque BT at a total dose of 110 Gy prescribed to the apex of the tumour. At the follow-up, the lesion was under control until September 2021, but it recurred with a satellite exudative detachment in the lower and temporal sectors 7–10 hours. At the B-scan the lesion had a maximum thickness of 4.6 mm. Subsequently, in a multidisciplinary discussion, one single fraction stereotactic radiosurgery was scheduled. The prescribed dose was 27 Gy in the de-novo lesion and 24 Gy in the previously irradiated site. Stereotactic radiosurgery was performed in October 2021. Results: The time interval between the 2 treatments was 15 months. Twenty months after recurrence, local tumour control was observed, and no metastases were detected on follow-up examinations. No severe acute or late toxicity was observed due to the retreatment. Conclusions: Photon stereotactic radiotherapy is a feasible, acceptably tolerated modality, and it represents an eye-preserving treatment also for patients with recurrent UM unfit for BT. [ABSTRACT FROM AUTHOR]

Simple Summary: The objective of the present study is to establish a new in vivo patient-derived xenograft (PDX) model for uveal melanoma (UM) based on the chick chorioallantoic membrane (CAM) assay. Furthermore, various implantation techniques and monitoring tools, such as different ultrasound modalities, optical coherence tomography and angiography, fluorescein angiography, image analysis, as well as fluorescent immunohistochemistry, were investigated for the assessment of the growth, vascularity, and, therefore, the viability of the implanted grafts. The results suggested an increase in the size parameters of the UM specimens and comparable data for the applied monitoring instruments, resulting in the CAM-based PDX model becoming an alternative step in translational cancer research for novel diagnostic and therapeutic experimentation in the field of ocular melanoma. Background: Patient-derived tumor xenografts (PDXs) have emerged as valuable preclinical in vivo models in oncology as they largely retain the polygenomic architecture of the human tumors from which they originate. Although animal models are accompanied by cost and time constraints and a low engraftment rate, PDXs have primarily been established in immunodeficient rodent models for the in vivo assessment of tumor characteristics and of novel therapeutic cancer targets. The chick chorioallantoic membrane (CAM) assay represents an attractive alternative in vivo model that has long been used in the research of tumor biology and angiogenesis, and can overcome some of these limitations. Methods: In this study, we reviewed different technical approaches for the establishment and monitoring of a CAM-based uveal melanoma PDX model. Forty-six fresh tumor grafts were acquired after enucleation from six uveal melanoma patients and were implanted onto the CAM on ED7 with Matrigel and a ring (group 1), with Matrigel (group 2), or natively without Matrigel or a ring (group 3). Real-time imaging techniques, such as various ultrasound modalities, optical coherence tomography, infrared imaging, and imaging analyses with Image J for tumor growth and extension, as well as color doppler, optical coherence angiography, and fluorescein angiography for angiogenesis, were performed on ED18 as alternative monitoring instruments. The tumor samples were excised on ED18 for histological assessment. Results: There were no significant differences between the three tested experimental groups regarding the length and width of the grafts during the development period. A statistically significant increase in volume (p = 0.0007) and weight (p = 0.0216) between ED7 and ED18 was only documented for tumor specimens of group 2. A significant correlation of the results for the cross-sectional area, largest basal diameter, and volume was documented between the different imaging and measurement techniques and the excised grafts. The formation of a vascular star around the tumor and of a vascular ring on the base of the tumor was observed for the majority of the viable developing grafts as a sign of successful engraftment. Conclusion: The establishment of a CAM-PDX uveal melanoma model could elucidate the biological growth patterns and the efficacy of new therapeutic options in vivo. The methodological novelty of this study, investigating different implanting techniques and exploiting advances in real-time imaging with multiple modalities, allows precise, quantitative assessment in the field of tumor experimentation, underlying the feasibility of CAM as an in vivo PDX model. [ABSTRACT FROM AUTHOR]

Background: Suprachoroidal surgery can lower intraocular pressure and medication use. There is currently no commercial suprachoroidal product on the market. Here, we report our 1 year results of a novel ciliary sulcus suprachoroidal microtube technique. Purpose: To determine the real-world efficacy of intrascleral ciliary sulcus suprachoroidal microtube technique in Black and Afro-Latinx patients with glaucoma refractory to topical ocular hypertensive medications. Methods: A retrospective non-comparative single center study of 36 Black and Afro-Latinx patients with glaucoma and pseudophakia who underwent intrascleral ciliary sulcus suprachoroidal microtube surgery for glaucoma as a stand-alone procedure at a single practice. Investigated parameters were number of medications, visual acuity (VA), intraocular pressure (IOP), mean deviation on visual field (VF) test. Success was defined as (a) IOP ⩽ 15 mmHg and or ⩾ 20% reduction in IOP and (b) a reduction in number of medications. We used paired t -test to compare baseline and follow-up parameters. Results: We reviewed a total of 36 patients who had undergone the procedure. Twenty had success with 12-month follow-up in the study. The mean number of medications decreased significantly from 4.2 ± 1.0 preoperatively to 2.4 ± 1.7 in 12 months (p = 0.021) with five patients being medication free. In addition, the IOP decreased significantly from 21 ± 8.2 to 13.5 ± 4.4 mmHg (p = 0.032). In the 20 patients who had 12-month follow-up, the VA remained stable from Log Mar 0.62 ± 0.6–0.46 ± 0.6 (p = 0.052). VF in patients with successful procedure (no further interventions) remained stable from baseline mean deviation of –16.53 ± 10.04 to –16.82 ± 9.80 dB at 6–12 months. Adverse effects were transient and included IOP spike, hypotony, hyphema, and cornea edema that were treated and resolved. Conclusions: This 12-month retrospective study demonstrated that intrascleral ciliary sulcus suprachoroidal microtube surgery can reduce IOP and medication burden in pseudophakic patients with glaucoma. However, despite several successes, surveillance should take place for IOP spikes, possible tube obstruction, and need for additional glaucoma surgery. [ABSTRACT FROM AUTHOR]

Standard ocular drug delivery methods generally are safe and effective for treating diseases of the eye. However, many routes of administration carry the risk of adverse effects due to drug exposure to anterior ocular tissues. Additionally, these delivery methods may not result in high and consistent levels of a therapeutic agent delivered to target tissues for diseases affecting the posterior segment of the eye. Injection into the suprachoroidal space (SCS) represents an alternative method of ocular drug delivery to the posterior segment. SCS injection facilitates targeted distribution to affected chorioretinal tissues for potential efficacy benefits, compartmentalization away from unaffected anterior segment tissues for potential safety benefits, and a high degree of bioavailability. Furthermore, the SCS may serve as a drug depot for long-acting drug delivery of small-molecule suspensions. Until recently, drug delivery to the SCS could be achieved only in the operating room setting with anesthetic immobilization of the eye and surgical dissection through the sclera. A novel microneedle device, the SCS Microinjector® (Clearside Biomedical, Inc) was developed to permit physicians to administer therapies safely and reliably into the SCS in the office setting. Successful use of SCS injection has been demonstrated with triamcinolone acetonide injectable suspension (Xipere®, Bausch + Lomb), a novel formulation optimized for use with the SCS Microinjector®. FDA approval of this combination drug and device for the treatment of macular edema associated with uveitis (UME) was based on outcomes from the phase 3 PEACHTREE study (NCT02595398); other important studies included its long-term observational extension (MAGNOLIA; NCT02952001) and an open-label safety study (AZALEA; NCT03097315). The SCS Microinjector® together with triamcinolone acetonide injectable suspension for use in the SCS presents an opportunity for safe and effective drug delivery for the treatment of UME and, potentially, for broader use with alternate medications to treat other ocular diseases that impact chorioretinal tissues (eg, age-related macular degeneration, diabetic retinopathy, choroidal melanoma). [ABSTRACT FROM AUTHOR]

In radiotherapy, the dose and volumes of the irradiated normal tissues is correlated to the complication rate. We assessed the performances of low-energy proton therapy (ocular PT) with eye-dedicated equipment, high energy PT with pencil-beam scanning (PBS) or CyberKnifeR -based stereotactic irradiation (SBRT). CT-based comparative dose distribution between external beam radiotherapy techniques was assessed using an anthropomorphic head phantom. The prescribed dose was 60 Gy_RBE in 4 fractions to a typical posterior pole uveal melanoma. Clinically relevant structures were delineated, and doses were calculated using radiotherapy treatment planning softwares and measured using Gafchromic dosimetry films inserted at the ocular level. Precision was significantly better with ocular PT than both PBS or SBRT in terms of beam penumbra (80%–20%: laterally 1.4 vs. ≥ 10 mm, distally 0.8 vs. ≥ 2.5 mm). Ocular PT duration was shorter, allowing eye gating and lid sparing more easily. Tumor was excellent with all modalities, but ocular PT resulted in more homogenous and conformal dose compared to PBS or SBRT. The maximal dose to ocular/orbital structures at risk was smaller and often null with ocular PT compared to other modalities. Mean dose to ocular/orbital structures was also lower with ocular PT. Structures like the lids and lacrimal punctum could be preserved with ocular PT using gaze orientation and lid retractors, which is easier to implement clinically than with the other modalities. The dose to distant organs was null with ocular PT and PBS, in contrast to SBRT. ocular PT showed significantly improved beam penumbra, shorter treatment delivery time, better dose homogeneity, and reduced maximal/mean doses to critical ocular structures compared with other current external beam radiation modalities. Similar comparisons may be warranted for other tumor presentations. [ABSTRACT FROM AUTHOR]

The visualization of choroidal vasculature and innate immune cells in the eyes of pigmented mice has been challenging due to the presence of a retinal pigment epithelium (RPE) layer separating the choroid and retina. Here, we established methods for visualizing the choroidal macrophages, mast cells, and vasculature in eyes of albino and pigmented mice using cell type-specific staining. We were able to visualize the choroidal arterial and venous systems. An arterial circle around the optic nerve was found in mice similar to the Zinn–Haller arterial circle that exists in humans and primates. Three different structural patterns of choriocapillaris were observed throughout the whole choroid: honeycomb-like, maze-like, and finger-like patterns. Choroidal mast cells were relatively few but dense around the optic nerve. Mast cell distribution in the middle and periphery was different among strains. Macrophages were found in all layers of the choroid. Thus, utilizing the simple and reliable methods described herein will allow the evaluation of transgenic and preclinical mouse models of ocular diseases that affect the choroid, including age-related macular degeneration (AMD), diabetic choroidopathy, and retinopathy of prematurity. These studies will advance our understanding of the pathophysiology, and molecular and cellular mechanisms that can be targeted therapeutically, in these diseases. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify the available literature describing the utilization of artificial intelligence (AI) as a clinical tool in uveal diseases. Methods: A comprehensive literature search was conducted in 5 electronic databases, finding studies relating to AI and uveal diseases. Results: After screening 10,258 studies,18 studies met the inclusion criteria. Uveal melanoma (44%) and uveitis (56%) were the two uveal diseases examined. Ten studies (56%) used complex AI, while 13 studies (72%) used regression methods. Lactate dehydrogenase (LDH), found in 50% of studies concerning uveal melanoma, was the only biomarker that overlapped in multiple studies. However, 94% of studies highlighted that the biomarkers of interest were significant. Conclusion: This study highlights the value of using complex and simple AI tools as a clinical tool in uveal diseases. Particularly, complex AI methods can be used to weigh the merit of significant biomarkers, such as LDH, in order to create staging tools and predict treatment outcomes. [ABSTRACT FROM AUTHOR]