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Due to population aging, lifestyle changes, coexisting medical disorders, and environmental factors, most countries have seen an increase in the prevalence of eye illnesses in recent decades. As a result of excellent knowledge on ocular disorders, patients are more likely to receive early detection and treatment, and there is a more prominent need for less invasive, more effective treatments for anterior and posterior eye disorders. Over 120 million individuals worldwide benefit from contact lens applications; however, there is room for improvement in ophthalmic therapies. Many corneal and ocular surface illnesses can be treated with therapeutic contact lenses (TCLs), which reduce pain and promote ocular healing, corneal protection, and eye drug delivery. According to studies, up to 26% of therapeutic contact lens users stop wearing contact lenses due to discomfort, such as dry eye disease. An interesting subject that is now undergoing a significant role in improving ocular lenses is materials which are highly evolving with advances in bioscience for different applications, such as drug delivery, eye wound dressing, and eye disease treatments. Silicon hydrogel and polymer acrylate-based materials are commonly used in ocular lens fabrication. With a priority on the materials science used in creating new therapeutic ocular lenses, this review offers a recently developed viewpoint on ocular lens materials to provide an outline of the upcoming outlooks and challenges in this field. [ABSTRACT FROM AUTHOR]

To evaluate the possible role of systemic inflammation in dry eye disease (DED) via systemic inflammatory marker associations with DED signs and symptoms, and an analysis of a subgroup with Sjogren's Syndrome (SS). Participant serums were analyzed using line immunoassays (LIAs) for the presence of antibodies against 34 systemic inflammatory markers. Using the 2012 American College of Rheumatology definition, the 481 participants were categorized into group 1 (SS; n = 52), group 2 (autoimmune disease not including SS; n = 66), or group 3 (control, i.e. no autoimmune disease; n = 363). 3 markers were positive in ≥10% of participants: Ro52 (19.3%), Scl-70 (15.0%), CN-1A (14.2%). 2 markers were positively associated with symptoms: PM-Scl100 (p = 0.02), Sm (p = 0.009). 5 markers were positively associated with signs: U2SnRNP A', Ro52, La, DNA, Ro60. SS participants showed significantly higher positivity for 4 markers compared to participants with no autoimmune disease: PL-7 (p = 0.02), Ro52 (p < 0.0001), La (p < 0.0001), Ro60 (p < 0.0001). SS participants showed significantly higher positivity for 3 markers compared to participants with another autoimmune disease: Ro52 (p < 0.0001), La (p = 0.002), Ro60 (p < 0.0001). This study did not show evidence of significant systemic inflammation in participants with moderate-to-severe DED, based on the markers tested. PM-Scl100 and Sm may be associated with more severe DED symptoms. U2SnRNP A', Ro52, La, DNA, and Ro60 may be associated with more severe ocular surface disease. Ro52 and PL-7 may be diagnostic markers for SS. Future research evaluating these relationships and their clinical significance is needed. [ABSTRACT FROM AUTHOR]

We compared recruitment of participants at high risk for glaucoma and other eye diseases in three community-based studies designed to improve access to eye care in underserved populations in New York City, Alabama, and Michigan. We used (1) participant data collected at enrollment (e.g. demographic, medical conditions, healthcare access, and method of hearing about study) and (2) interviews with study staff to assess effective recruitment strategies in enrolling people at high risk for eye disease. We analyzed participant data using descriptive statistics and interview data using content analysis to categorize responses to questions. In these community-based studies, all sites recruited greater proportions of populations with increased risk of eye disease compared to their estimates in the US population. High-risk characteristics varied based on the setting (i.e. Federally Qualified Health Centers or affordable housing buildings). Older adults represented 35% to 57%; 43% to 56% identified as Black; 1% to 40% as Hispanic/Latino; 20% to 42% reported a family history of glaucoma; 32% to 61% reported diabetes; and 50% to 67% reported high blood pressure. Social risk factors for under-utilization of eye care due to poverty included that 43% to 70% of participants had high school or lower education; 16% to 40% were employed; and 7% and 31% had no health insurance. From a qualitative perspective, active, personalized, culturally sensitive methods were most effective in recruiting participants. Implementing eye disease detection interventions in community-based settings facilitated recruiting individuals at high risk for glaucoma and other eye diseases. [ABSTRACT FROM AUTHOR]

Podologists are exposed to many occupational hazards, including volatile organic compounds (VOCs) from insole manufacturing and noise/vibration during nail or tissue grinding. In this study, VOCs, noise, and vibration were measured in five podiatry clinics and three offices. Questionnaires were administered to 23 podologists and 19 office workers to inquire about their pain, ocular, skin and respiratory complaints. The results showed that the podologists' exposure to the total VOC concentrations was approximately twice as high as that of the office workers. The podologists' complaints regarding pain were found to be correlated with ambient noise and hand-arm vibration levels. Ocular, skin, and respiratory complaints were also found to be correlated with total VOC concentrations. These results suggest that VOCs, noise and vibration in the working environment may impair podologists' health and that they have an intensifying effect on each other, increasing the severity of health issues. [ABSTRACT FROM AUTHOR]

First‐line options for the treatment of dry eye disease (DED) rely on artificial tears (ATs), among which cationic emulsion (CE)‐based ATs have been developed in order to mimic the healthy tear film for an improved restoration of the ocular surface homeostasis. In this review, we describe the outcomes reported in several studies, assessing the mode of action, ocular tolerance and clinical performance of a CE‐based AT. Pilot studies have revealed that CE‐based ATs can increase the volume and stability of the tear film while limiting its evaporation rate. Larger studies have demonstrated that CE‐based ATs play a significant role in the improvement of both objective and subjective DED parameters, including superior efficacy on DED symptoms compared to several other available AT formulation types. Concomitantly, CE‐based ATs have been shown to help patients to prevent or recover from corneal defects associated with refractive surgery. These positive outcomes on ocular surface epithelia are likely due to the combination of unique rheological behaviour and intrinsic anti‐inflammatory properties. Based on all clinical findings, CE‐based ATs represent a valuable treatment option for patients with various etiologies of DED including evaporative forms and would deserve evaluation of benefits in other surgical intervention types triggering DED. [ABSTRACT FROM AUTHOR]

Dry eye disease is a highly prevalent condition, which can substantially impair quality of life, work productivity, and vision. It is considered an inflammatory disease and the most common cause is meibomian gland dysfunction. Despite many treatment alternatives being available, including artificial tears, warm compresses, antibiotics, and anti‐inflammatory therapy, lasting treatment effects are rare. Over the last two decades, intense pulsed light therapy, after being well established in dermatology, has been gradually introduced to the field of ophthalmology to treat meibomian gland dysfunction. The purpose of the current article is to critically review the clinical studies assessing the use of intense pulsed light to treat meibomian gland dysfunction published to date. The vast majority of the included studies demonstrated improved symptoms and signs, although the degree of efficacy and its duration varied greatly depending on concomitant treatment, number of treatment sessions, and other factors. Several possible mechanisms of action concerning disease propagation and treatment efficacy are discussed. There is still a need for larger, randomised, longitudinal studies to define the most efficacious treatment regime and to predict which patients may benefit the most. More studies are needed on implementing biochemical analyses and machine learning algorithms. Such studies may prove beneficial in predicting treatment effects, defining optimal treatment regimens, and furthering our understanding of the mechanisms of action. [ABSTRACT FROM AUTHOR]

Background: Diabetic eye disease is a common micro-vascular complication of diabetes and a leading cause of decreased vision and blindness in people of working age worldwide.Although previous studies have shown that chemokines system may be a player in pathogenesis of diabetic eye disease, it is unclear which chemokines play the most important role.To date, there is no meta-analysis which has investigated the role of chemokines in diabetic eye disease.We hope this study will contribute to a better understanding of both the signaling pathways of the chemokines in the pathophysiological process, and more reliable therapeutic targets for diabetic eye disease. Methods: Embase, PubMed, Web of Science and Cochrane Library systematically searched for relevant studies from inception to Sep 1, 2023. A random-effect model was used and standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to summarize the associated measure between chemokines concentrations and diabetic eye disease. Network meta-analysis to rank chemokines-effect values according to ranked probabilities. Results: A total of 33 different chemokines involving 11,465 subjects (6559 cases and 4906 controls) were included in the meta-analysis. Results of the meta-analysis showed that concentrations of CC and CXC chemokines in the diabetic eye disease patients were significantly higher than those in the controls. Moreover, network meta-analysis showed that the effect of CCL8, CCL2, CXCL8 and CXCL10 were ranked highest in terms of probabilities. Concentrations of CCL8, CCL2, CXCL8 and CXCL10 may be associated with diabetic eye disease, especially in diabetic retinopathy and diabetic macular edema. Conclusion: Our study suggests that CCL2 and CXCL8 may play key roles in pathogenesis of diabetic eye disease. Future research should explore putative mechanisms underlying these links, with the commitment to develop novel prophylactic and therapeutic for diabetic eye disease. [ABSTRACT FROM AUTHOR]

In response to the growing number of diabetes cases worldwide, Our study addresses the escalating issue of diabetic eye disease (DED), a significant contributor to vision loss globally, through a pioneering approach. We propose a novel integration of a Genetic Grey Wolf Optimization (G-GWO) algorithm with a Fully Convolutional Encoder-Decoder Network (FCEDN), further enhanced by a Kernel Extreme Learning Machine (KELM) for refined image segmentation and disease classification. This innovative combination leverages the genetic algorithm and grey wolf optimization to boost the FCEDN's efficiency, enabling precise detection of DED stages and differentiation among disease types. Tested across diverse datasets, including IDRiD, DR-HAGIS, and ODIR, our model showcased superior performance, achieving classification accuracies between 98.5% to 98.8%, surpassing existing methods. This advancement sets a new standard in DED detection and offers significant potential for automating fundus image analysis, reducing reliance on manual examination, and improving patient care efficiency. Our findings are crucial to enhancing diagnostic accuracy and patient outcomes in DED management. [ABSTRACT FROM AUTHOR]

Corneal ulceration induced by Staphylococcus pseudintermedius (S. pseudintermedius) is a common clinical eye disease. Antibiotics combined with corneoconjunctival transposition (CCT) or conjunctival autografts (CA) are often used, but the recovery characteristics are still unknown. In this experiment, canine corneal ulcer models induced by S. pseudintermedius and treated with levofloxacin eye drops (LED) were created. The models were used to compare the recovery characteristics of CCT and CA, combined with LED, by clinical observation, histopathology, and cytokine expression detected by qRT-PCR analysis. The results showed that the ulcerative cornea with only LED treatment perforated after 48 h. The mRNA expression of TLR2, IL-1β, IL-6, IL-8, and TNF-α genes was significantly elevated on 14, 28, and 35 days after the surgery compared to normal (p < 0.01). On day 42, the inflammatory damage had resolved, but the corneal transparency and arrangement of collagen fibrils in the CCT group were higher than those in the CA group. The mRNA expression of EGF, FGF, TGF-β1 and VEGF genes increased significantly (p < 0.01), mostly until day 42, proving that CCT and CA surgery contributed to the corneal recovery, and relieved the inflammatory reaction, with the elimination of corneal cicatrices needing a period of reconstruction. Therefore, this study has provided, for the first time, the method for establishing a canine corneal ulcer model induced by S. pseudintermedius. More importantly, the recovery of canine ulcerative corneas with CCT or CA surgery is reported for the first time. [ABSTRACT FROM AUTHOR]

Background. The spot vision screener (SVS) has been widely used for eye health examinations of infants and young children. The purpose of this study was to evaluate the reproducibility of two SVS measurements in children with ophthalmological diseases. Methods. 29 patients aged 15 years or younger who visited our hospital for refraction examinations with SVS before and at least 60 minutes after administration of 2 drops of 1% cyclopentolate ophthalmic solution (before and after cycloplegia) were included in this study. Two SVS measurements were made before and after cycloplegia, respectively. Intraclass correlation coefficients (ICCs) and Bland–Altman analysis for spherical, spherical equivalent (SE), cylindrical, J0, and J45 values before and after cycloplegia were analyzed. Results. The mean age ± standard deviation (SD) of the 29 patients was 7.6 ± 2.4 years. There were 11 males and 18 females. The mean spherical values based on the SVS before and after cycloplegia were 0.42 ± 1.67 diopter (D), and 1.47 ± 2.23 D for the first measurement and 0.60 ± 1.74 D, and 1.42 ± 2.27 D for the second measurement, respectively. The mean cylindrical values based on SVS before and after cycloplegia were −1.45 ± 0.96 D and −1.65 ± 0.89 D for the first measurement and −1.58 ± 1.13 D and −1.66 ± 0.91 D for the second measurement, respectively. The ICCs for the first and second spherical, SE, cylindrical, J0, and J45 values before cycloplegia were 0.95, 0.98, 0.83, 0.86, and 0.86, respectively. The ICCs for the first and second spherical, SE, cylindrical, J0, and J45 values after cycloplegia were 0.99, 0.99, 0,87, 0.73, and 0.80, respectively. The Bland–Altman analysis of the first and second spherical and SE values before cycloplegia showed fan-shaped variation as hyperopia increased. Conclusions. Two consecutive SVS refraction measurements have a high degree of reproducibility for spherical and SE values but a low degree for cylindrical, J0, and J45 values. From these results, multiple measurements are required to obtain reliable results for cylindrical values. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) are 90% of diabetes cases, and its prevalence and incidence, including comorbidities, are rising worldwide. Clinically, diabetes and associated comorbidities are identified by biochemical and physical characteristics including glycemia, glycated hemoglobin (HbA1c), and tests for cardiovascular, eye and kidney disease. Objectives: Diabetes may have a common etiology based on inflammation and oxidative stress that may provide additional information about disease progression and treatment options. Thus, identifying high-risk individuals can delay or prevent diabetes and its complications. Design: In patients with or without hypertension and cardiovascular disease, as part of progression from no diabetes to T2DM, this research studied the changes in biomarkers between control and prediabetes, prediabetes to T2DM, and control to T2DM, and classified patients based on first-attendance data. Control patients and patients with hypertension, cardiovascular, and with both hypertension and cardiovascular diseases are 156, 148, 61, and 216, respectively. Methods: Linear discriminant analysis is used for classification method and feature importance, This study examined the relationship between Humanin and mitochondrial protein (MOTSc), mitochondrial peptides associated with oxidative stress, diabetes progression, and associated complications. Results: MOTSc, reduced glutathione and glutathione disulfide ratio (GSH/GSSG), interleukin-1β (IL-1β), and 8-isoprostane were significant (P <.05) for the transition from prediabetes to t2dm, highlighting importance of mitochondrial involvement. complement component 5a (c5a) is a biomarker associated with disease progression and comorbidities, gsh gssg, monocyte chemoattractant protein-1 (mcp-1), 8-isoprostane being most important biomarkers. Conclusions: Comorbidities affect the hypothesized biomarkers as diabetes progresses. Mitochondrial oxidative stress indicators, coagulation, and inflammatory markers help assess diabetes disease development and provide appropriate medications. Future studies will examine longitudinal biomarker evolution. [ABSTRACT FROM AUTHOR]

Oxidative stress plays a critical role in the development of chronic ocular conditions including cataracts, age-related macular degeneration, and diabetic retinopathy. There is a need to explore the potential of topical antioxidants to slow the progression of those conditions by mediating oxidative stress and maintaining ocular health. Selenium has attracted considerable attention because it is a component of selenoproteins and antioxidant enzymes. The application of selenium to a patient can increase selenoprotein expression, counteracting the effect of reactive oxygen species by increasing the presence of antioxidant enzymes, and thus slowing the progression of chronic ocular disorders. Oxidative stress effects at the biomolecular level for prevalent ocular conditions are described in this review along with some of the known defensive mechanisms, with a focus on selenoproteins. The importance of selenium in the eye is described, along with a discussion of selenium studies and uses. Selenium's antioxidant and anti-inflammatory qualities may prevent or delay eye diseases. Recent breakthroughs in drug delivery methods and nanotechnology for selenium-based ocular medication delivery are enumerated. Different types of selenium may be employed in formulations aimed at managing ocular oxidative stress conditions. [ABSTRACT FROM AUTHOR]

This article provides an overview of Vogt-Koyanagi-Harada (VKH) disease, an autoimmune disorder that affects multiple systems in the body. It discusses the four clinical phases of the disease and emphasizes the importance of early diagnosis and treatment. The article also explores recent studies on diagnostic criteria, imaging features, and treatment options for VKH disease. It includes brief reports on atypical cases of the disease and discusses the use of OCT angiography and adalimumab therapy in monitoring and treating VKH disease. The article highlights the need for prompt diagnosis and early intervention to prevent complications and visual impairment. It also mentions a rare case of a 2-year-old girl with VKH disease and autoimmune polyendocrinopathy candidiasis ectodermal dystrophy syndrome, a rare genetic disease. The authors encourage further research on VKH disease. [Extracted from the article]

Aim-To study the Correlation between Ocular surface disease index (OSDI0, tear film break up time (TFBUT) and Schirmers Test in case of dry Eye. Materials and Methods-Observational study was conducted at the Ophthalmology Department of a Tertiary Hospital between 6 months. commenced with the administration of the OSDI questionnaire. Subsequently, Tear Film Break-Up Time (TFBUT) and Schirmer's test were conducted, and the resulting data was subject to analysis. OSDI scores were recorded on a scale ranging from 0 to 100, with higher scores indicating greater disability. A diagnosis cut-off point for OSDI scores was established at =35.Results-suggests a positive correlation between Schirmer's test and TFBUT, indicating that as the Schirmer's test values increase, TFBUT values tend to increase as well. On the other hand, there is a negative correlation between TFBUT and OSDI, indicating that as TFBUT decreases, OSDI scores tend to increase, reflecting worse ocular surface discomfort. Conclusion- The Ocular Surface Disease Index (OSDI) questionnaire, in combination with quick and non-invasive clinical tests like the Schirmer test and Tear Film Break-Up Time (TBUT), provides a comprehensive approach to diagnose dry eye. This combined approach helps clinicians accurately diagnose and manage dry eye by considering both subjective and objective aspects of the condition. [ABSTRACT FROM AUTHOR]

Treatment with aromatase inhibitors (AIs) in patients with breast cancer can lead to dry eye disease (DED). The purpose of the study is to determine the prevalence and risk factors of DED in patients treated with AIs for breast cancer. Participants in this cross-sectional study were patients with breast cancer treated with AIs. Demographic and clinical data, including age, sex, type of cancer, stage, grade, duration of treatment and adjuvant chemotherapy and/or radiotherapy were collected. All patients underwent a detailed ophthalmic examination, as well as Tear Break up Time (TBUT) and Schirmer test, while Ocular Surface Disease Index (OSDI) questionnaires were administered. Based on the clinical findings, a diagnosis of DED was made, and prevalence was calculated. Univariate analysis of the association of different variables with DED was performed. A logistic regression analysis was done to identify risk factors for DED among study population. A total of 102 participants were included in the study. The mean age of patients was 62.4 ± 10.8 years. A total of 77 out of 102 patients (75.5%) had ductal, 16 (15.7%) lobular and 9 (8.8%) other types of breast cancer. A total of 83 patients (81.4%) received chemotherapy and 70 patients (68.6%) received radiotherapy. The mean duration of treatment was 24.4 ± 18.9 months. The prevalence of DED in the study sample was 69.6%. Patients who received radiotherapy (OR = 3.31, 95%CI = 1.30–7.82, p = 0.01) or were under treatment with AIs for more than 24 months (OR = 3.53, 95%CI = 1.47–9.21, p = 0.002) were found to have an increased risk of DED. There was a high prevalence of DED among the study population. Radiotherapy and duration of treatment with AIs were independently associated with DED. [ABSTRACT FROM AUTHOR]

We propose that the diet-derived compound ergothioneine (ET) is an important nutrient in the human body, especially for maintenance of normal brain function, and that low body ET levels predispose humans to significantly increased risks of neurodegenerative (cognitive impairment, dementia, Parkinson's disease) and possibly other age-related diseases (including frailty, cardiovascular disease, and eye disease). Hence, restoring ET levels in the body could assist in mitigating these risks, which are rapidly increasing due to ageing populations globally. Prevention of neurodegeneration is especially important, since by the time dementia is usually diagnosed damage to the brain is extensive and likely irreversible. ET and vitamin E from the diet may act in parallel or even synergistically to protect different parts of the brain; both may be "neuroprotective vitamins". The present article reviews the substantial scientific basis supporting these proposals about the role of ET. [Display omitted] • ET appears to be a vital nutrient for humans, especially for the brain. • Low levels of ET may predispose individuals to develop neurodegenerative and other age-related diseases. • Further studies are needed to uncover why ET levels decline. • This will lead to strategies to restore levels of ET to mitigate increased risk of dementia and other age-related disorders. It may also identify synergies with other therapies for Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Purpose. To determine the relationship between dyslipidemia and dry eye disease (DED), as well as its influence on tear film and meibomian glands. Methods. This cross-sectional study included 40 patients with a mean age of 35.2 ± 13.9 years without any history of dyslipidemia. DED and serum lipid profile were evaluated after 8 hours of fasting. Patients were classified according to serum lipid levels with the following cut-off values: total cholesterol (TC) (200 mg/dl), high-density lipoprotein (HDL) (40 mg/dl), low-density lipoprotein (LDL) (130 mg/dl), and triglycerides (TG) (150 mg/dl). The relationship between serum lipid levels and DED was analyzed with the following variables: dry eye questionnaire-5 (DEQ-5), first (F-NIBUT) and average (A-NIBUT) noninvasive breakup time, tear meniscus height (TMH), lipid layer grade (LLG), conjunctival bulbar redness (CBR), and upper (U-LAMG) and lower (L-LAMG) loss area of meibomian glands. Results. Regarding tear film, patients with elevated TC and LDL levels reported significantly higher DEQ-5 scores and TMH (P < 0.05), while those with lower HDL levels showed significantly higher LLG (p < 0.05). Regarding MGD, patients with elevated TC, LDL, and TG, as well as lower HDL levels showed significantly higher L-LAMG (p < 0.05). HDL was correlated with LLG (p < 0.05), while TC was correlated with TMH (p < 0.05) and L-LAMG (p < 0.05), respectively. Conclusions. Disorders in TC, HDL, LDL, and TG levels were associated with DED, having an impact on the tear film and meibomian glands, specifically in DEQ-5 scores, LLG, and L-LAMG. [ABSTRACT FROM AUTHOR]

Choroidal osteoma (CO) is a rare benign tumor usually unilateral and have a female preponderance. We report a case of a 34-year-old healthy male diagnosed with unilateral Choroidal Osteoma with an associated Choroidal Neo Vascular Membrane (CNVM). The diagnosis was confirmed based on clinical examination, typical findings on B-scan, Fundus fluorescein angiography, Indocyanine green angiography and Optical coherence tomography. The CNVM was treated with intravitreal Bevacizumab injections and showed a good response initially. There was a recurrence of CNVM over two years when patient was lost to follow-up. Treatment with intravitreal Ranibizumab bio similar injection helped to stabilize his vision. Regular follow-up is essential for timely treatment of recurrence of CNVM and optimum visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Refractive error represents a common eye disorder that can significantly impact an individual's visual function and overall well-being. There are several methods of correcting refractive errors and objective of this study was to assess the awareness of refractive surgery and the preferred methods of refractive error correction among medical students in Baghdad. Study Design: Cross sectional survey. Place and Duration of Study: University of Baghdad Al-Kindy College of Medicine from November 2022 to March 2023. Methods: Medical students from six Baghdad medical colleges with total sample size of 350 were included. Students who had undergone refractive surgeries and fifth and sixth year medical students were also excluded. Level of knowledge was categorized as; <50% (0-5) poor knowledge, 50-70% (6-8) moderate knowledge and >70% (9-12) good knowledge. Results: Among the students with refractive errors, 82% had knowledge about their refractive error. Forty percent had myopia, 12% had astigmatism, 15 % had myopia and astigmatism, 10% had hyperopia, 5% had hyperopia and astigmatism. Among them 57.8% were not willing to undergo refractive surgery due to fear of complications. Forty eight percent had poor knowledge,43.1% had moderate and only 8.26% had a good knowledge of refractive surgeries. The majority preferred eyeglasses (82.6%) followed by both eyeglasses and contact lenses. Conclusion: Students had good awareness about refractive surgery but their familiarity and knowledge about it remained poor because of complications. An overwhelming majority of students still preferred spectacles as the method for vision correction. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness of Fluorometholone 0.1% and Cyclosporine 0.05% in the treatment of vernal keratoconjunctivitis. Study Design: Quasi experimental study. Place and Duration of Study: Hayatabad Medical Complex, Peshawar from December 2020 to June 2021. Methods: This study includes 104 patients divided into 2 groups. Patients in Group A were given topical Fluorometholone 0.1% while group B were given topical Cyclosporine 0.05%. Signs and symptoms were graded from scale 0-10 at the start of treatment and then at day 7,14 and 30. Drug was considered effective if the final score was equal to or less than 3 at day 30. Results: Mean age of the patients was 9.96±2.722 years in group A and 10.02±2.790 years in group B. Mean baseline score was 6.90±0.721 in group A and 5.87±0.768 in group B. In group A, 45 (86.5%) patients showed effectiveness while in group B, 36 (69.2%) patients showed effective results. Fluorometholone gave superior results as compared to Cyclosporine in patients with severe disease i.e., baseline score ≥ 6. Systemic allergic associations were noted in44.2% patients in group A and 36.5% patients in group B. Conclusion: These findings suggest that Fluorometholone may be a preferable treatment option for vernal keratoconjunctivitis, particularly in cases of more severe disease. However, considerations regarding systemic allergic associations should also be taken into account when making treatment decisions. [ABSTRACT FROM AUTHOR]

Scleritis, an inflammatory disease of the eye affecting scleral tissue, presents unique challenges in the older adult population. Unlike their younger counterparts, older individuals manifest a distinct spectrum of the disease with different underlying etiologies, co-morbidities, altered immune function, and an increased risk of systemic side effects from medication choices. Addressing these complexities necessitates a comprehensive and multidisciplinary approach. Treatment of choice will depend on any underlying cause but generally involves non-steroidal anti-inflammatory drugs, systemic or local corticosteroids, and potentially disease-modifying anti-rheumatic drugs. Utilization of these therapeutic agents in older adults warrants careful consideration because of their potential side-effect profiles. This article critically examines the specific concerns for the use of these drugs in older patients and reviews the existing literature on their use in this specific cohort. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has seen significant progress in medical diagnostics, particularly in image and video analysis. This review focuses on the application of AI in analyzing in vivo confocal microscopy (IVCM) images for corneal diseases. The cornea, as an exposed and delicate part of the body, necessitates the precise diagnoses of various conditions. Convolutional neural networks (CNNs), a key component of deep learning, are a powerful tool for image data analysis. This review highlights AI applications in diagnosing keratitis, dry eye disease, and diabetic corneal neuropathy. It discusses the potential of AI in detecting infectious agents, analyzing corneal nerve morphology, and identifying the subtle changes in nerve fiber characteristics in diabetic corneal neuropathy. However, challenges still remain, including limited datasets, overfitting, low-quality images, and unrepresentative training datasets. This review explores augmentation techniques and the importance of feature engineering to address these challenges. Despite the progress made, challenges are still present, such as the "black-box" nature of AI models and the need for explainable AI (XAI). Expanding datasets, fostering collaborative efforts, and developing user-friendly AI tools are crucial for enhancing the acceptance and integration of AI into clinical practice. [ABSTRACT FROM AUTHOR]

The warming effect of low-level light therapy may contribute to its therapeutic mechanism which is beneficial for dry eye management. Low-level light therapy is proposed to work via cellular photobiomodulation and a potential thermal effect in dry eye management. This study examined the change in eyelid temperature and tear film stability after low-level light therapy compared to warm compress. Participants with no to mild dry eye disease were randomised into control, warm compress, and low-level light therapy groups. The low-level light therapy group was treated with Eyelight mask (633 nm) for 15 minutes, the warm compress group with Bruder mask for 10 minutes, and the control group with an Eyelight mask having inactive LEDs for 15 minutes. Eyelid temperature was measured using the FLIR One® Pro thermal camera (Teledyne FLIR, Santa Barbara, CA, USA), and clinical measures of tear film stability were evaluated before and after treatment. Thirty-five participants (mean age ± SD, 27.3 ± 4.3 years) completed the study. Eyelid temperatures for external upper, external lower, internal upper and internal lower eyelids were significantly greater in the low-level light therapy and warm compress groups immediately after treatment compared to the control group (all p < 0.001). No difference in temperature was observed between the low-level light therapy and warm compress groups at all time points (all p > 0.05). Tear film lipid layer thickness was significantly greater after treatment (mean (95% CI), 13.1 nm (5.3 to 21.0), p < 0.005) but not different between groups (p > 0.05). A single treatment of low-level light therapy increased eyelid temperature immediately after treatment, but the increase was not significantly different from warm compress. This suggests that thermal effects may in part contribute to the therapeutic mechanism of low-level light therapy. [ABSTRACT FROM AUTHOR]

This article presents a case study of a woman with primary antiphospholipid syndrome (APS), a rare autoimmune disease that affects blood vessels. The patient in the study had a condition called proliferative ischaemic retinopathy, which caused blockages in the blood vessels of her eyes. The article discusses the diagnosis and treatment of the patient, as well as the long-term stability she has experienced after seven years of follow-up. The article also emphasizes the role of eye care practitioners in diagnosing and managing vascular pathologies like APS. [Extracted from the article]

BACKGROUND: Antibody--drug conjugates (ADCs) are a novel class of drugs with rapidly expanding oncology indications across solid and hematologic malignancies. OBJECTIVES: This article provides an overview of ADCs with a high risk of ocular reactions and guidance for oncology nurses to help mitigate risk and identify toxicities for prompt management. METHODS: This review presents updated evidence, manufacturer recommendations, and clinical guidance about three ADCs with a risk of overall ocular reactions exceeding 40%, as well as strategies to prepare patients for treatment, prevent reactions, and respond to presenting ocular toxicities. FINDINGS: ADCs can cause a range of ocular reactions from mild dry eye to severe and doselimiting corneal adverse reactions and vision loss. Oncology nurses and other members of the interprofessional team can perform focused clinical assessment, provide patient education about self-management and prevention, and coordinate surrounding eye care for patients receiving treatment with ADCs. [ABSTRACT FROM AUTHOR]

This document is a response to a letter to the editor criticizing a clinical trial on the use of photobiomodulation (PBM) in patients with dry age-related macular degeneration (AMD). The authors of the response address the criticisms raised, highlighting the strict inclusion criteria and the involvement of respected experts and research institutes in the trial. They also discuss the impact of the COVID-19 pandemic on the trial and address concerns about patient distribution and the effect of PBM on drusen volume. The authors conclude that while the trial was not designed to draw conclusions about GA progression, the results support the potential benefits of PBM in modifying the disease. [Extracted from the article]

Dry eye disease (DED) is a continuing medical challenge, further worsened in the autoimmune inflammatory hyperactivation milieu of Sjögren's syndrome (SS) due to disturbances to innate and adaptive immunity with malfunctioning neuro-endocrine control. However, the pathogenetic mechanisms of SS DED are not fully established. This review summarized the available evidence, from systematic reviews, meta-analyses, and randomized clinical trials, for the efficacy and safety of the available ocular therapeutics for the management of SS DED. Relevant studies were obtained from major databases using appropriate keywords. The available largely empirical symptomatic, supportive, and restorative treatments have significant limitations as they do not alter local and systemic disease progression. Topical therapies have expanded to include biologics, surgical approaches, scleral lens fitting, the management of lid margin disease, systemic treatments, nutritional support, and the transplantation of stem cells. They are not curative, as they cannot permanently restore the ocular surface's homeostasis. These approaches are efficacious in the short term in most studies, with more significant variability in outcome measures among studies in the long term. This review offers an interdisciplinary perspective that enriches our understanding of SS DED. This updated review addresses current knowledge gaps and identifies promising areas for future research to overcome this medical challenge. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effects of 10% GlicoPro tear substitute therapy in patients with severe dry eye disease (DED). Methods: In this prospective longitudinal study, 30 individuals receiving 10% GlicoPro four times daily for DED were evaluated. The ocular surface disease index (OSDI) questionnaire, average non-invasive break-up time (A-NIBUT), non-anesthetic and anesthetic corneal esthesiometry (CE), ocular pain, and the presence of conjunctivochalasis (CCH) were used as clinical endpoints. Treatment compliance using dosing diaries and AEs was assessed. Results: A significant improvement was observed in the clinical endpoints: the ΔOSDI questionnaire was −39.27 ± 13.22 [−65 to −15] points, ΔA-NIBUT was 3.10 ± 1.31 [1 to 5] s, Δnon-anesthetic CE was 14 ± 6.35 [5 to 25] mm, and Δanesthetic CE was 13 ± 5.35 [5 to 20] mm (p < 0.001 for all comparisons). Ocular pain was reduced in 92.5% of the patients at the end of the follow-up. However, there was no change in the presence of CCH. In addition, all the patients were fully compliant with the dosing and no AEs related to the use of the 10% GlicoPro tear substitute were reported. Conclusions: The 10% GlicoPro tear substitute has the potential to achieve beneficial effects in ocular surface treatments. [ABSTRACT FROM AUTHOR]

Chronic diseases including mental disorders have been associated with suicide. This study broadens the approach by incorporating a comprehensive list of chronic diseases and a context of comorbidities and explored their associations with suicide. Data-linkage between death registry and Korean National Health Insurance data was conducted. Suicide cases (n = 64,099) between 2009 and 2013 were 1:4 matched for gender and age to an alive control (n = 256,396). A total of 92 individual diseases of 9 broad categories were identified from insurance claims data. Conditional logistic regression was applied to assess the associations, adjusting for mental and behavioral disorders and socioeconomic status. Suicide cases frequently experienced chronic diseases (90.0 %) and comorbidities (74.6 %). Chronic diseases greatly increased suicide risk and, among these, mental and behavioral disorders showed the highest suicide risk (OR = 7.53, 95 % CI = 7.32–7.74) followed by cardiovascular (OR = 3.36, 95 % CI = 3.26–3.47). For individual diseases, gastritis and duodenitis were most prevalent (68.1 %) among suicide cases but depressive disorder showed the highest risk (OR = 4.95, 95 % CI = 4.79–5.12). Suicide risk was strong in comorbid status sometimes comparable to odds for mental and behavioral disorder alone (e.g., OR for cardiovascular and eye vision-related diseases = 4.01, 95 % CI = 3.86–4.17). Differentiation of comorbidity was limited to pairs between major disease categories, neglecting the heterogeneity within categories. Chronic diseases, in particular comorbidity, showed strong associations with suicide. This suggests that those with comorbidities feel that they are pushed to the extreme line, supporting comprehensive interventions for them to address wider reasons including psychological and social problems, besides medical problems. • Mental and behavioral disorders showed the highest suicide risk followed by cardiovascular diseases. • Comorbidities were common among those who died by suicide. • Most of comorbidities were associated with an additional increase in suicide risk, compared to individual disease categories. • Some comorbid conditions without involving mental disorders had suicide risk, comparable to that for mental disorders. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the imaging repeatability of self-service fundus photography compared to traditional fundus photography performed by experienced operators. Design: Prospective cross-sectional study. Methods: In a community-based eye diseases screening site, we recruited 65 eyes (65 participants) from the resident population of Shanghai, China. All participants were devoid of cataract or any other conditions that could potentially compromise the quality of fundus imaging. Participants were categorized into fully self-service fundus photography or traditional fundus photography group. Image quantitative analysis software was used to extract clinically relevant indicators from the fundus images. Finally, a statistical analysis was performed to depict the imaging repeatability of fully self-service fundus photography. Results: There was no statistical difference in the absolute differences, or the extents of variation of the indicators between the two groups. The extents of variation of all the measurement indicators, with the exception of the optic cup area, were below 10% in both groups. The Bland–Altman plots and multivariate analysis results were consistent with results mentioned above. Conclusions: The image repeatability of fully self-service fundus photography is comparable to that of traditional fundus photography performed by professionals, demonstrating promise in large-scale eye disease screening programs. [ABSTRACT FROM AUTHOR]

Regarding clinically-concerning non-standard initial anti-tuberculous (TB) regimens, few studies have examined their prevalence, risk factors and impacts. We recruited patients with drug susceptible TB and non-standard initial anti-TB regimens (NSTB group) and matched them with patients with standard initial regimens (STB group) in a 1:1 ratio. The risk factors and outcomes were analyzed. During the 11-year study period, we analyzed 50 (3.7%) patients with NSTB from a total set of 1337 patients with drug-susceptible TB. Pyrazinamide (60%) was the drug most commonly not prescribed in the NSTB group, followed by ethambutol (34%). Multivariable logistic regression identified independent risk factors as underlying eye disease (adjusted odds ratio [aOR]: 8.869; 95% CI 2.542–30.949; p = 0.001), gout/hyperuricemia (aOR: 4.012 [1.196–13.425]; p = 0.024), and liver disease (aOR: 12.790 [3.981–41.089]; p < 0.001). The NSTB group had longer treatment durations (281 ± 121 vs. 223 ± 63 days; p = 0.003) and more occurrences of treatment interruption (26% vs. 8%; p = 0.021) than the STB group. In conclusion, NSTB occurs in around 3.7% of patients and is associated with longer treatment and more treatment interruption. The risk factors might include underlying liver and eye diseases, and gout. Further studies to improve non-standard initial regimens and prevent negative outcomes are warranted. [ABSTRACT FROM AUTHOR]

Age-related macular degeneration (AMD) is a devastating eye disease that causes permanent vision loss in the central part of the retina, known as the macula. Patients with such severe visual loss face a reduced quality of life and are at a 1.5 times greater risk of death compared to the general population. Currently, there is no cure for or effective treatment for dry AMD. There are several mechanisms thought to underlie the disease, for example, ageing-associated chronic oxidative stress, mitochondrial damage, harmful protein aggregation and inflammation. As a way of gaining a better understanding of the molecular mechanisms behind AMD and thus developing new therapies, we have created a peroxisome proliferator- activated receptor gamma coactivator 1- alpha and nuclear factor erythroid 2-related factor 2 (PGC1α/NFE2L2) double- knockout (dKO) mouse model that mimics many of the clinical features of dry AMD, including elevated levels of oxidative stress markers, damaged mitochondria, accumulating lysosomal lipofuscin and extracellular drusen-like structures in retinal pigment epithelial cells (RPE). In addition, a human RPE cell-based model was established to examine the impact of non-functional intracellular clearance systems on inflammasome activation. In this study, we found that there was a disturbance in the autolysosomal machinery responsible for clearing mitochondria in the RPE cells of one-year-old PGC1α/NFE2L2-deficient mice. The confocal immunohistochemical analysis revealed an increase in autophagosome marker microtubule-associated proteins 1A/1B light chain 3B (LC3B) as well as multiple mitophagy markers such as PTE-induced putative kinase 1 (PINK1) and E3 ubiquitin ligase (PARKIN), along with signs of damaged mitochondria. However, no increase in autolysosome formation was detected, nor was there a colocalization of the lysosomal marker LAMP2 or the mitochondrial marker, ATP synthase β. There was an upregulation of late autolysosomal fusion Ras- related protein (Rab7) in the perinuclear space of RPE cells, together with autofluorescent aggregates. Additionally, we observed an increase in the numbers of Toll- like receptors 3 and 9, while those of NOD-like receptor 3 were decreased in PGC1α/NFE2L2 dKO retinal specimens compared to wild-type animals. There was a trend towards increased complement component C5a and increased involvement of the serine protease enzyme, thrombin, in enhancing the terminal pathway producing C5a, independent of C3. The levels of primary acute phase C- reactive protein and receptor for advanced glycation end products were also increased in the PGC1α/NFE2L2 dKO retina. Furthermore, selective proteasome inhibition with epoxomicin promoted both nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and mitochondrial- mediated oxidative stress, leading to the release of mitochondrial DNA to the cytosol, resulting in potassium efflux-dependent activation of the absent in melanoma 2 (AIM2) inflammasome and the subsequent secretion of interleukin-1β in ARPE-19 cells. In conclusion, the data suggest that there is at least a relative decrease in mitophagy, increases in the amounts of C5 and thrombin and decreased C3 levels in this dry AMD- like model. Moreover, selective proteasome inhibition evoked mitochondrial damage and AIM2 inflammasome activation in ARPE-19 cells. [ABSTRACT FROM AUTHOR]

Epicanthus is a half-moon-shaped skin fold diagonally or vertically distributed in front of the medial canthus. In mild cases, it affects aesthetics, whereas in severe cases, it may obscure the patient's field of vision and even affect the functional development of the eyes in children. Until now, surgery has been the only corrective measure for epicanthus and a bewildering number of epicanthus-related surgical procedures have been reported; however, there is no standardized classification to guide inexperienced plastic surgeons in their study or case selection. Therefore, this review aimed to classify epicanthus accordingly and introduce its corresponding and appropriate surgical treatment modalities. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dry eye disease (DED) is rising globally and needs to be urgently addressed by medical professionals because it lowers patients' quality of life. There are as yet no available data in the literature about the prevalence of and risk factors for DED in the Gaza Strip, a gap that the present study seeks to address. Methods: A cross-sectional study was carried out between March and August 2022 in Gaza governorates using a proportional stratified sampling technique. Only Gazan individuals ≥ 18 years old and able to follow the instructions were included. The Ocular Surface Disease Index (OSDI) questionnaire, which has previously been translated into Arabic and validated, was applied to evaluate DED symptoms. Subjective clinical tests for DED conducted were tear meniscus height (TMH), meibomian gland dysfunctions (MGDs), Marx line (ML), conjunctival Lissamine green staining (LGS), tear film break-up time test (TBUT), corneal fluorescein staining (CFS) and Schirmer II tear test (STT). DED was defined based on an Arab-OSDI score ≥ 13 and at least one positive clinical sign. Results: A total of 426 participants were assessed from four areas (North Gaza Strip, 82; Gaza City, 147; Mid-Zone Gaza Strip, 62; South Gaza Strip, 135). The prevalence of DED in the present study was 31.5% (95% CI: 27.1, 36.1). Age > 50 years old (odds ratio [OR] = 10.45; 95% CI: 2.95, 37.05; P < 0.001), female gender (OR = 3.24; 95% CI: 1.40, 7.52, P = 0.006), menopause or pregnancy (OR = 2.59; 95% CI: 1.25, 5.35; P = 0.03) and pharmacotherapy (artificial tears; OR = 9.91; 95% CI: 2.77, 35.46; P < 0.001) were each associated with DED symptoms. South Gaza Strip (OR = 0.04; 95% CI: 0.01, 0.12; P < 0.001), unemployed (OR = 11.67; 95% CI: 1.43, 95.44; P = 0.02), non-consumption of caffeine (OR = 0.40; 95% CI: 0.19, 0.88; P = 0.02) and TMH < 0.2 (OR = 1.80; 95% CI: 1.02, 3.19; P = 0.04) were associated with TBUT < 5 s. LGS was associated with those > 50 years old (OR = 2.70; 95% CI: 1.38, 5.28; P = 0.004), previous refractive or ocular surface surgeries (OR = 2.97; 95% CI: 1.34, 6.59; P = 0.008) and CFS ≥ 1 (OR = 1.91; 95% CI: 1.07, 3.44; P = 0.03). Conclusion: Various aspects of DED were linked with different risk factors, suggesting that DED subtypes have different underlying pathophysiologies. [ABSTRACT FROM AUTHOR]

Cataract, a common eye disease, causes lens opacification, which can lead to blindness. Early cataract detection in a privacy-preserving approach has led us to investigate the concept of Federated Learning (FL) and its prominent technique, known as Federated Averaging (FedAVG). Federated learning has the potential to solve the privacy issues by allowing data servers to train their models natively and distribute them without invading patient confidentiality. This research introduces an interactive federated learning framework that permits multiple medical institutions to screen cataract from split lamp images utilising convolutional neural network (CNN) without sharing patient data, as well as grade normal, mild, moderate, and severe cataracts. The CNN is developed based on Modified-ResNet-50 and FedAVG technique could achieve relatively high accuracy. The experimental results demonstrate that the proposed modification reduces the processing time to a greater extent. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if worse visual acuity is associated with an increased risk of incident fall or mortality, independent of other relevant cofounders. This was a single-center retrospective cohort study of 428 new cases of anterior ischemic optic neuropathy (AION). Separate Cox proportional hazards models were constructed to evaluate the relationship between either logMAR visual acuity (VA) or legal blindness (20/200 or worse VA) and survival time to (1) encounter for fall, (2) mortality, and (3) a composite adverse outcome. Multivariable models were adjusted for a priori confounders. In adjusted models, a 1-unit increase in logMAR VA was associated with a significantly greater risk of an incident fall (adjusted HR 1.36, 95% CI (1.06–1.73), p = 0.014) and of mortality (adjusted HR 1.44, 95% CI (1.15–1.82), p = 0.002). Meeting criteria for legal blindness was also significantly associated with a higher risk of incident fall (HR 1.80, 95% CI (1.05–3.07), p = 0.032) and mortality (adjusted HR 2.16, 95% CI (1.29–3.63), p = 0.004). Among patients with AION, worse visual acuity or legal blindness conferred a significantly increased risk of falls and mortality, independent of coexistent comorbidities. Future studies should consider fall reduction interventions for patients with poor vision from severe eye disease such as AION. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to describe the optical coherence tomographic features of a cat with acute corneal hydrops. Animal Studied: A 4‐year‐old castrated male domestic shorthaired showing conjunctival redness, ocular discharge, and intermittent squinting of both eyes with asymmetrical disease onset. Methods: Complete ophthalmic examination and optical coherence tomography were performed. Results: On slit‐lamp biomicroscopic examination, severe intrastromal fluid pockets with profound bullae were observed in the dorsomedial region in both eyes. A diagnosis of feline acute corneal hydrops was made in both eyes. Optical coherence tomography revealed profound stromal lamellar separation representing heterogeneous reflective areas, and fluid pockets and bullae of variable size were concomitant to Descemet's membrane detachment demonstrated by a well‐defined homogeneous hyporeflective area. Upon reevaluation 30 days during healing process for both eyes, the thickened epithelia and the thinning pan‐stromal areas were identified as homogeneously hyper‐reflective epithelia and as heterogeneous hyper‐reflectivity, respectively. A thickened posterior corneal surface was shown as heterogeneous with patchy hyper‐reflectivity. Additionally, Descemet's membrane detachment in the initial presentation had two distinct forms suspicious of Descemet's membrane rupture in each eye: a break with rolled ends and a break with flat ends. Conclusion: To the author's knowledge, this study represents the first documentation of in vivo detection of Descemet's membrane detachment and presumed rupture in a cat experiencing acute corneal hydrops. These observations strongly indicate that Descemet's membrane detachment/rupture acts as a most likely risk factor in the onset of acute corneal hydrops in cats. [ABSTRACT FROM AUTHOR]

The progress of artificial intelligence algorithms in digital image processing and automatic diagnosis studies of the eye disease glaucoma has been growing and presenting essential advances to guarantee better clinical care for the population. Given the context, this article describes the main types of glaucoma, traditional forms of diagnosis, and presents the global epidemiology of the disease. Furthermore, it explores how studies using artificial intelligence algorithms have been investigated as possible tools to aid in the early diagnosis of this pathology through population screening. Therefore, the related work section presents the main studies and methodologies used in the automatic classification of glaucoma from digital fundus images and artificial intelligence algorithms, as well as the main databases containing images labeled for glaucoma and publicly available for the training of machine learning algorithms. [ABSTRACT FROM AUTHOR]

Aland island eye disease (AIED), an incomplete form of X-linked congenital stationary night blindness (CSNB2A), and X-linked cone-rod dystrophy type 3 (CORDX3) display many overlapping clinical findings. They result from mutations in the CACNA1F gene encoding the α1F subunit of the Cav1.4 channel, which plays a key role in neurotransmission from rod and cone photoreceptors to bipolar cells. Case report: A 57-year-old Caucasian man who had suffered since his early childhood from nystagmus, nyctalopia, low visual acuity and high myopia in both eyes (OU) presented to expand the diagnostic process, because similar symptoms had occurred in his 2-month-old grandson. Additionally, the patient was diagnosed with protanomalous color vision deficiency, diffuse thinning, and moderate hypopigmentation of the retina. Optical coherence tomography of the macula revealed retinoschisis in the right eye and foveal hypoplasia in the left eye. Dark-adapted (DA) 3.0 flash full-field electroretinography (ffERG) amplitudes of a-waves were attenuated, and the amplitudes of b-waves were abolished, which resulted in a negative pattern of the ERG. Moreover, the light-adapted 3.0 and 3.0 flicker ffERG as well as the DA 0.01 ffERG were consistent with severely reduced responses OU. Genetic testing revealed a hemizygous form of a stop-gained mutation (c.4051C>T) in exon 35 of the CACNA1F gene. This pathogenic variant has so far been described in combination with a phenotype corresponding to CSNB2A and CORDX3. This report contributes to expanding the knowledge of the clinical spectrum of CACNA1F-related disease. Wide variability and the overlapping clinical manifestations observed within AIED and its allelic disorders may not be explained solely by the consequences of different mutations on proteins. The lack of distinct genotype–phenotype correlations indicates the presence of additional, not yet identified, disease-modifying factors. [ABSTRACT FROM AUTHOR]

Our aim was to find the best evidence on the prevalence of idiopathic scoliosis (IS) in subjects with eye diseases (EDs) and to determine the most common visual alterations that are present. Following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), a bibliographic search up to June 2023 in the PubMed, PsycINFO, SCOPUS, and CINAHL Complete databases was performed. Observational studies were selected and the results were analyzed with prevalence odds ratio (OR). A total of six studies, including 18,396 subjects, were selected. The group of subjects with EDs was made up of 6048 individuals, of whom 655 (10.83%) had IS. The group of subjects without EDs was made up of 12,348 individuals of whom 444 (3.60%) presented with IS with an OR = 2.91, CI (95%) = [1.75, 4.83]. Blindness was assessed in a single study with an OR = 7.83, CI (95%) = [1.66, 36.90]; all three studies in the refractive error subgroup yielded an OR = 2.24, CI (95%) = [1.10, 4.58]; and the two studies that included subjects with strabismus showed an OR = 3.09, CI (95%) = [1.38, 7.00]. EDs were associated with an almost three times greater odds of having IS. We recommend the inclusion of vision testing in children with IS. [ABSTRACT FROM AUTHOR]

(1) Background: Dry eye disease (DED) is a multifactorial ocular surface disease characterized by an imbalance in ocular surface homeostasis, and tear substitutes constitute the first line of treatment. The present study aimed to evaluate the changes in the signs and symptoms of patients with DED treated with a novel tear substitute containing the GlicoPro® complex. (2) Methods: Patients with DED not successfully responding to other tear substitutes were enrolled and treated with a novel ophthalmic solution (two drops four times daily). Patients were examined before starting the study treatment (T0) and after 30 (T1) and 60 (T2) days of treatment by means of Keratograph for the evaluation of the following: (i) tear meniscus height (TMH); (ii) noninvasive Keratograph break-up time (NIKBUT); (iii) bulbar redness; and (iv) infrared meibography. The SANDE questionnaire was administered to assess ocular discomfort symptoms. Analysis of the tear content of proenkephalin and Met/Leu-enkephalin was also performed. (3) Results: At T2, a significant improvement in NIKBUT first, average, and class, TMH, and SANDE score was found. The tear content of proenkephalins was significantly higher at T1, whereas processed active Met/Leu-enkephalins increased at both T1 and T2. (4) Conclusions: Our novel tear substitute based on GlicoPro® resulted in a significant improvement in ocular discomfort symptoms, tear volume, and stability in the patients treated. The increase in active peptides processed in tears may represent the pathophysiological substrate underlying this finding. [ABSTRACT FROM AUTHOR]

The ocular surface system interacts with, reacts with, and adapts to the daily continuous insults, trauma, and stimuli caused by direct exposure to the atmosphere and environment. Several tissue and para-inflammatory mechanisms interact to guarantee such an ultimate function, hence maintaining its healthy homeostatic equilibrium. Evaporation seriously affects the homeostasis of the system, thereby becoming a critical trigger in the pathogenesis of the vicious cycle of dry eye disease (DED). Tear film lipid composition, distribution, spreading, and efficiency are crucial factors in controlling water evaporation, and are involved in the onset of the hyperosmolar and inflammatory cascades of DED. The structure of tear film lipids, and subsequently the tear film, have a considerable impact on tears' properties and main functions, leading to a peculiar clinical picture and specific management. [ABSTRACT FROM AUTHOR]

Traditional Chinese Medicine has a long history in ophthalmology in China. Over 250 kinds of Traditional Chinese Medicine have been recorded in ancient books for the management of eye diseases, which may provide an alternative or supplement to current ocular therapies. However, the core holistic philosophy of Traditional Chinese Medicine that makes it attractive can also hinder its understanding from a scientific perspective – in particular, determining true cause and effect. This review focused on how Traditional Chinese Medicine could be applied to two prevalent ocular diseases, glaucoma, and cataract. The literature on preclinical and clinical studies in both English and Chinese on the use of Traditional Chinese Medicine to treat these two diseases was reviewed. The pharmacological effects, safety profile, and drug-herb interaction of selected herbal formulas were also investigated. Finally, key considerations for conducting future Traditional Chinese Medicine studies are discussed. [ABSTRACT FROM AUTHOR]

Graft‐versus‐host disease (GVHD) is a systemic disease that can affect multiple organs as a consequence of an allogeneic haematopoietic stem cell transplant. One organ system that is often affected in GVHD is the eyes. Ocular GVHD (oGVHD) may involve various structures within the eye including the lacrimal glands, eyelids, conjunctiva, cornea, and nasolacrimal ducts, and is a source of morbidity in patients with GVHD. Common presenting features of GVHD overlap with dry eye disease (DED), including decreased tear production, epithelial disruption, and Meibomian gland dysfunction (MGD). In this review, we aim to compare oGVHD and DED to better understand the similarities and differences between the conditions, with a focus on pathophysiology, risk factors, clinical features, and treatments. [ABSTRACT FROM AUTHOR]

Adult stem cells, present in various parts of the human body, are undifferentiated cells that can proliferate and differentiate to replace dying cells within tissues. Stem cells have specifically been identified in the cornea, trabecular meshwork, crystalline lens, iris, ciliary body, retina, choroid, sclera, conjunctiva, eyelid, lacrimal gland, and orbital fat. The identification of ocular stem cells broadens the potential therapeutic strategies for untreatable eye diseases. Currently, stem cell transplantation for corneal and conjunctival diseases remains the most common stem cell‐based therapy in ocular clinical management. Lens epithelial stem cells have been applied in the treatment of paediatric cataracts. Several early‐phase clinical trials for corneal and retinal regeneration using ocular stem cells are also underway. Extensive preclinical studies using ocular stem cells have been conducted, showing encouraging outcomes. Ocular stem cells currently demonstrate great promise in potential treatments of eye diseases. In this review, we focus on the identification, characterisation, and therapeutic application of adult stem cells in the eye. [ABSTRACT FROM AUTHOR]

Purpose: The burden of ocular diseases has been gradually increasing worldwide. Various factors are suggested for the development and progression of ocular diseases, such as ocular inflammation, oxidative stress, and complex metabolic dysregulation. Thus, managing ocular diseases requires the modulation of pathologic signaling pathways through many mechanisms. Nicotinamide mononucleotide (NMN) is a bioactive molecule naturally found in life forms. NMN is a direct precursor of the important molecule nicotinamide adenine dinucleotide (NAD+), an essential co-enzyme required for enormous cellular functions in most life forms. While the recent experimental evidence of NMN treatment in various metabolic diseases has been well-reviewed, NMN treatment in ocular diseases has not been comprehensively summarized yet. In this regard, we aimed to focus on the therapeutic roles of NMN treatment in various ocular diseases with recent advances. Methods: How we came to our current opinion with a recent summary was described based on our own recent reports as well as a search of the related literature. Results: We found that NMN treatment might be available for the prevention of and protection from various experimental ocular diseases, as NMN treatment modulated ocular inflammation, oxidative stress, and complex metabolic dysregulation in murine models for eye diseases such as ischemic retinopathy, corneal defect, glaucoma, and age-related macular degeneration. Conclusion: Our current review suggests and discusses new modes of actions of NMN for the prevention of and protection from various ocular diseases and can urge future research to obtain more solid evidence on a potential future NMN treatment in ocular diseases at the preclinical stages. [ABSTRACT FROM AUTHOR]

Introduction: Chronic ocular pain, particularly prevalent in patients with dry eye disease and post-femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) surgery, presents with unclear clinical characteristics and an undefined pathogenesis. In this study, we aimed to compare clinical characteristics and tear neuropeptide concentrations in patients with dry eye disease (DED) with and without chronic ocular pain following FS-LASIK, and investigate correlations between ocular pain, clinical characteristics, and tear neuropeptide levels. Methods: Thirty-eight post–FS-LASIK patients with DED were assigned to two groups: those with chronic ocular pain and those without chronic ocular pain. Dry eye, ocular pain, and mental health-related parameters were evaluated using specific questionnaires and tests. The morphology of corneal nerves and dendritic cells (DCs) was evaluated by in vivo confocal microscopy. Function of corneal innervation was evaluated by corneal sensitivity. Concentrations of tear cytokines (interleukin [IL]-6, IL-23, IL-17A, and interferon-γ) and neuropeptides (α-melanocyte-stimulating hormone, neurotensin, β-endorphin, oxytocin, and substance P [SP]) were measured using the Luminex assay. Results: Most patients with chronic ocular pain experienced mild to moderate pain; the most common types included stimulated pain (provoked by wind and light), burning pain, and pressure sensation. More severe dry eye (P < 0.001), anxiety symptoms (P = 0.026), lower Schirmer I test values (P = 0.035), lower corneal nerve density (P = 0.043), and more activated DCs (P = 0.041) were observed in patients with ocular pain. Tear concentrations of SP and oxytocin were significantly higher in patients with ocular pain (P = 0.001, P = 0.021, respectively). Furthermore, significant correlations were observed among ocular pain severity, SP, and anxiety levels. Conclusions: Patients with DED after FS-LASIK who have chronic ocular pain show more severe ocular and psychological discomfort and higher tear levels of neuropeptides. Furthermore, ocular pain severity is correlated with tear SP levels. Trial Registration: ClinicalTrials.gov identifier: NCT05600985. [ABSTRACT FROM AUTHOR]