Search Results (32)

(1) Background: Ultra-early optical coherence tomography (OCT) changes following intravitreal injection may reflect transient mechanical compression rather than pharmacologic effects; however, this temporal profile has not been rigorously characterised with appropriate statistical methodology. (2) Methods: In this prospective observational study, 40 eyes of 40 consecutive patients (one per patient) with macular edema secondary to neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or chronic central serous retinopathy (CSR) underwent intravitreal bevacizumab (n = 35) or triamcinolone acetonide (n = 5). Goldmann applanation tonometry and spectral-domain OCT were performed at baseline, 2–5 min, 15 ± 5 min, 24 h, and 48 h post-injection. Repeated-measures ANOVA with Greenhouse–Geisser correction, linear regression, and Spearman rank correlation were applied. (3) Results: Central subfield thickness (CST) decreased markedly at 15 ± 5 min (mean −24.8 ± 11.5%; 95% CI: −28.5% to −21.1%; p < 0.001; partial η² = 0.70), with near-complete rebound by 48 h (−1.0%; p = 0.400). Peak intraocular pressure (IOP) elevation correlated with CST reduction (Spearman r_s = 0.61; 95% CI: 0.39–0.77; p < 0.001), and baseline CST predicted thinning magnitude (R² = 0.52; p < 0.001). (4) Conclusions: Ultra-early OCT thinning after intravitreal injection is consistent with transient mechanical compression. Retinal thickness measurements within 48 h post-injection should be interpreted with caution when assessing treatment response, as early anatomic reduction may not reflect pharmacologic efficacy. Full article

Continuous intraocular pressure (IOP) monitoring is crucial for glaucoma management. Currently, traditional static IOP measurements often fail to detect circadian fluctuations, leading to a clinical dilemma where “normal IOP” is observed despite persistent visual field deterioration. This study presents a wireless, passive localized surface plasmon resonance (LSPR) sensing platform integrated into flexible silicone hydrogel contact lenses. Gold nanoparticles (AuNPs), synthesized via the sodium citrate reduction method, were incorporated into the lens periphery using a “swelling-induced nano-doping” technique to transduce IOP-induced corneal strain into detectable spectral shifts. Ex vivo porcine eye investigations established a physical mapping model, confirming significant LSPR peak wavelength response trends in correlation with IOP variations (10–50 mmHg) and corneal curvature changes. Subsequent 21-day in vivo rabbit studies demonstrated excellent ocular surface biocompatibility; quantitative histopathological analysis (HE, PAS, and Ki67 staining) revealed no significant adverse alterations in corneal endothelial cell density or conjunctival goblet cell function compared to control groups (p > 0.05). Furthermore, the platform maintained high structural integrity and anterior segment tolerance under transient high-IOP conditions. While currently a proof-of-concept, these results indicate that the LSPR-active hybrid system effectively captures dynamic IOP fluctuation patterns as an optical response to acute interventions, providing a foundational engineering path for next-generation, battery-free wearable diagnostics in personalized glaucoma care without the need for built-in electronics. Full article

Background: Glaucoma requires therapies that extend beyond intraocular pressure (IOP)-lowering strategies, and baicalein (BA) offers dual IOP-lowering and neuroprotective potential. This study evaluated the pharmacokinetics of BA and its major metabolite baicalin (BG) in mouse eyes and serum after intravitreal (IVT) and oral administration to determine whether non-invasive oral dosing can achieve IVT-comparable ocular exposure. Methods: BA was administered via IVT injection (100 μM) or oral gavage (20 and 200 mg/kg) in mice, and concentrations of BA and BG in serum and ocular tissues were quantified using a validated ultra-performance liquid chromatography–mass spectrometry (UHPLC/MS) method. Results: After IVT, ocular BA peaked at 331.56 ± 17.75 ng/g at 5 min and declined to 7.13 ± 0.79 ng/g at 4 h, with minimal systemic exposure. Oral administration achieved comparable or higher peak ocular BA levels (380.43 ± 52.85 ng/g at 15 min for 20 mg/kg; 309.70 ± 24.75 ng/g at 5 min for 200 mg/kg), with markedly higher ocular area under the concentration–time curve (AUC: 2455.48 ± 667.83 h·ng/g for 200 mg/kg and 1224.88 ± 751.13 h·ng/g for 20 mg/kg) versus IVT (247.07 h·ng/g). Serum BA and BG peaked at 5 min after oral dosing, with systemic BG exposure substantially exceeding BA. Conclusions: Non-invasive oral BA dosing achieves ocular concentrations comparable to IVT injection, with significantly greater overall exposure and favorable pharmacokinetic profiles. This study provides the first demonstration in mice that non-invasive oral BA administration can replace invasive IVT delivery, establishing a strong rationale for its clinical development in glaucoma and retinal disease management. Full article

Objectives: The Eight-chop technique is a mechanically based nuclear segmentation method designed to improve surgical efficiency and reduce intraocular tissue stress during phacoemulsification. Early postoperative aqueous flare serves as an objective indicator of surgical invasiveness, whereas corneal endothelial cell density (CECD) loss represents a structural measure of endothelial injury. Although both parameters are clinically important, their relationship has not been systematically investigated in the context of this newer mechanical fragmentation approach. Methods: This prospective observational study included 118 eyes from 70 non-diabetic patients undergoing uncomplicated Eight-chop phacoemulsification. Aqueous flare was measured preoperatively and at postoperative Day 1, Day 7, Week 7, and Week 19 using laser flare photometry. CECD was evaluated preoperatively and at Weeks 7 and 19. Changes over time were analyzed using paired t-tests. Linear mixed-effects models (random intercept = patient ID) were constructed to assess predictors of CECD loss and postoperative intraocular pressure (IOP) reduction. Explanatory variables included Day 1 flare, age, preoperative CECD, nucleus hardness (Emery-Little grade), cumulative dissipated energy (CDE), and irrigation fluid volume. Results: Postoperative flare increased significantly at all time points (all p < 0.001), peaking on Day 7 (16.7 ± 9.21 photon counts/ms). CECD loss was extremely small, averaging 1.38% at Week 7 and 1.46% at Week 19. In mixed-effects models, Day 1 flare was not associated with CECD loss at Week 7 (p = 0.35) or Week 19 (p = 0.85). Significant predictors of CECD loss included Emery-Little grade (p = 0.004 at Week 7; p = 0.025 at Week 19), with borderline contributions from CDE and irrigation volume. IOP decreased significantly at Weeks 7 and 19; however, Day 1 flare did not predict IOP reduction. Conclusions: Eight-chop phacoemulsification produced uniformly low postoperative inflammation and exceptionally small corneal endothelial cell loss. Early postoperative flare did not predict CECD loss, suggesting that the Eight-chop technique provides a highly standardized, low-invasiveness surgical environment. These findings suggest that the Eight-chop technique lowers ultrasound energy requirements and may help reduce corneal endothelial stress relative to standard phacoemulsification. Full article

Background/Objectives: Glaucoma affects over 70 million people worldwide and is a major cause of irreversible blindness, with elevated intraocular pressure (IOP) as the only modifiable risk factor. Conventional techniques like Goldmann applanation tonometry (GAT) are widely used but cannot provide continuous or nocturnal monitoring, limiting the detection of pressure peaks relevant to disease progression. Emerging technologies, including home-based devices, wearable sensors, such as contact lens-based sensors (CLBS), and implantable biomedical microelectromechanical systems (bioMEMS), offer more comprehensive and continuous assessment of IOP patterns. Thus, this scoping review aimed to map the available evidence on technologies for continuous IOP monitoring, summarizing their performance and agreement with traditional tonometry. Methods: A systematic search of electronic databases was conducted to identify studies published in the last 10 years evaluating self-tonometry devices, CLBS, or implantable systems designed for continuous IOP monitoring. Two reviewers independently screened articles, applied eligibility criteria, charted relevant data, including device characteristics and agreement with GAT, and reported clinical applications. Results: Self-tonometry devices demonstrated generally good agreement with GAT while enabling patients to monitor IOP outside clinical settings. These devices provided valuable information on diurnal and nocturnal IOP fluctuations, especially in individuals with rapid progression or those undergoing postoperative follow-up. BioMEMS-based wearable and implantable sensors showed promise for continuous long-term monitoring and revealed previously unrecognized fluctuation patterns, including activity-related changes. Conclusions: Emerging IOP-monitoring technologies appear to complement standard clinical methods by offering more detailed IOP profiles. Their integration into clinical practice may support individualized risk assessment and improved management of glaucoma progression. Full article

Coral reefs exposed to chronically turbid conditions challenge conventional assumptions about the optical environments required for reef persistence and productivity. This study investigates the utility of light absorption coefficients as indicators of optical water quality in Varadero Reef, an extreme coral ecosystem located in Cartagena Bay, Colombia. Field campaigns were conducted across three seasons (rainy, dry, and transitional) along a transect from fluvial to marine influence. Absorption coefficients at 440 nm were derived for particulate (a_p(440)) and chromophoric dissolved organic matter (a_CDOM(440)) to assess their contribution to underwater light attenuation. Average values across seasons show that a_p(440) reached 0.466 m⁻¹ in the rainy season (September 2021), 0.285 m⁻¹ in the dry season (February 2022), and 0.944 m⁻¹ in the transitional rainy season (June 2022). Meanwhile, mean a_CDOM(440) values were 0.368, 0.111, and 0.552 m⁻¹, respectively. These coefficients reflect the dominant influence of particulate absorption under turbid conditions and increasing a_CDOM(440) relevance during lower turbidity periods. Mean Secchi Disk Depth (ZSD) ranged from 0.6 m in the rainy season to 3.0 m in the dry season, aligning with variations in Kd PAR, which averaged 2.63 m⁻¹, 1.13 m⁻¹, and 1.08 m⁻¹ for the three campaigns. Chlorophyll-a concentrations at 1 m depth also varied significantly, with average values of 2.3, 2.7, and 6.2 μg L⁻¹, indicating phytoplankton biomass peaks associated with seasonal freshwater inputs. While particulate absorption limits light penetration, CDOM plays a potentially photoprotective role by attenuating UV radiation. The observed variability in these optical constituents reflects complex hydrodynamic and environmental gradients, providing insight into the mechanisms that sustain coral functionality under suboptimal light conditions. The absorption-based approach applied here, using standardized spectrophotometric methods, proved to be a reliable and reproducible tool for characterizing the spatial and temporal variability of IOPs. We propose integrating these indicators into monitoring frameworks as cost-effective, component-resolving tool for evaluating light regimes and ecological resilience in optically dynamic coastal systems. Full article

Background/Objectives: To evaluate the neuromodulative effects of oral intake of a fixed combination of citicoline 500 mg plus homotaurine 50 mg plus vitamin B3 54 mg plus pyrroloquinoline quinone (CIT/HOMO/B3/PPQ) or of citicoline 800 mg alone (CIT800) on retinal ganglion cell (RGC) function in glaucoma patients by pattern electroretinogram (PERG) and to investigate the effects on quality of life and visual function. Methods: Consecutive patients with primary open-angle glaucoma with controlled IOP (<18 mmHg) receiving prostaglandin analogues as monotherapy; with two reliable visual fields (Humphrey 24-2 SITA Standard) per year in the last 2 years; and an early to moderate visual field defect (MD < −12 dB) were randomized to: arm A. topical therapy + CIT/HOMO/B3/PPQ for 4 months, followed by 4 months of topical therapy + CIT800; and arm B. topical therapy + CIT800 for 4 months, then topical therapy + CIT/HOMO/B3/PPG for 4 months. Patients were examined at month 0, 4, and 8. Complete ocular examination, visual field test, PERG, and quality of life assessment (NEI-VFQ25) were performed at each visit. Results: Forty patients were selected and completed the study, and none developed or reported an adverse event. The overall mean age was 64.2 (±7.7) years, 27 were male. At the end of the intake period of both products, patients exhibited higher P50 and N95-wave amplitudes and shorter latencies compared to baseline. The crossover analysis found that PERG parameters were better when patients received the CIT/HOMO/B3/PQQ combination with a statistically significant shorter peak time of 1.24 ms (95% CI, 0.37 to 2.10; p = 0.006) in the central P50 wave, 1.32 ms (95% CI, 0.44 to 2.22; p = 0.004) in the inferior P50 wave, and 1.70 ms (95% CI, 0.09 to 3.31; p = 0.038) in the inferior N95 wave; and a statistically significant increase of 0.35 µV (95% CI, 0.10 to 0.60; p = 0.006) in the superior N95 amplitude. The crossover analysis did not reveal any significant differences between the intake of CIT800 and CIT/HOMO/B3/PQQ in terms of visual acuity or IOP. During the intake of CIT/HOMO/B3/PQQ, a significant improvement was observed in the total mean score (p = 0.004), in the general health scale (GH, p = 0.01), in the color vision scale (p = 0.006), and in the peripheral vision scale (p = 0.001). Conclusions: The present study has shown that the addition of CIT/HOMO/B3/PQQ in early glaucoma improves PERG parameters and quality of life, likely by slowing down RGC aging and enhancing mitochondrial function more significantly than citicoline 800 mg alone. Full article

Background/Objectives: this study aims to assess the safety of ciliary sulcus-placed hydrophilic acrylic intraocular lenses (IOLs). Methods: In this retrospective cohort study, consecutive patients who underwent phacoemulsification with implantation of IOLs into the ciliary sulcus without suture fixation between 2014 and 2016 at the Meir Medical Center were included. Clinical outcomes were compared between one-piece (1P) hydrophilic acrylic IOLs (Seelens AF, Hanita Lenses, Kibbutz Hanita, Israel) and three-piece hydrophobic acrylic IOLs with PMMA haptics (3P) (MA60AC, Alcon Laboratories, USA). Results: Thirty-eight eyes met the inclusion criteria and had ciliary sulcus IOLs implanted, twenty-three eyes with 1P hydrophilic (60.52%) and fifteen (39.47%) with 3P hydrophobic IOLs. Mean follow-up was 47.36 ± 7.25 months for the 1P group and 46.54 ± 9.82 months for the 3P group (p = 0.87). The mean peak IOP was higher in the 3P group (p = 0.038). No differences in the incidence of anterior uveitis or cystoid macula edema (CME) were detected between the groups (p > 0.05). None of the patients in our study developed uveitis, bleeding episodes, or required treatment for increased intraocular pressure, and no patient was diagnosed with uveitis-glaucoma-hyphema (UGH) syndrome. Post-operative corrected distance visual acuity (CDVA) was similar between the groups (p = 0.66). Conclusions: Hydrophilic IOLs can be safely placed in the ciliary sulcus and are non-inferior to the implantation of three-piece hydrophobic IOLs in the sulcus. In our cohort, with an average follow-up of approximately four years, no UGH was diagnosed, and none of the lenses were explanted. Full article

Background/Objectives: Glaucomatous neuropathy, a progressive deterioration of retinal ganglion cells, is the leading cause of irreversible blindness worldwide. While elevated intraocular pressure (IOP) is a well-established modifiable risk factor, increasing attention is being directed towards IOP-independent factors, such as vascular alterations. Color Doppler imaging (CDI) is a prominent technique for investigating blood flow parameters in extraocular vessels. This prospective, nonrandomized clinical trial aimed to assess the impact of ab externo canaloplasty on ocular blood flow parameters in patients with primary open-angle glaucoma (POAG) at a three-month follow-up. Methods: Twenty-five eyes of twenty-five patients with early or moderate POAG underwent canaloplasty with simultaneous cataract removal. CDI was used to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs) before and after surgery. Results: The results showed a significant reduction in IOP and improvement in mean deviation at three months post-surgery. Best corrected visual acuity and retinal nerve fiber layer thickness significantly increased at each postoperative control visit. However, no significant changes were observed in PSV, EDV, and RI in the studied vessels. Conclusions: In conclusion, while canaloplasty effectively reduced IOP and medication burden, it did not significantly improve blood flow parameters in vessels supplying the optic nerve at three months post-surgery. Careful patient selection considering glaucoma severity and vascular risk factors is crucial when choosing between canaloplasty and more invasive procedures like trabeculectomy. Further larger studies are needed to comprehensively analyze this issue. Full article

Background/Objectives: This study aimed to examine the postoperative changes in the corneal biomechanical properties between solo cataract surgery and solo microhook ab interno trabeculotomy (LOT). Methods: This retrospective case–control study included 37 eyes belonging to 26 patients who underwent solo cataract surgery and 37 eyes belonging to 31 patients who underwent solo µLOT. These two groups were matched according to their preoperative intraocular pressure (IOP), axial length (AL), and age. Corneal Visualization Scheimpflug Technology (Corvis ST) was used to obtain four biomechanical parameters representing the corneal stiffness or corneal deformation at the highest concavity, including stiffness parameter A1 (SP-A1), stress–strain index (SSI), peak distance (PD), and deflection amplitude max (DefAmpMax). These parameters were compared preoperatively and 6 months postoperatively, and between the two surgical groups. Results: Preoperatively, the patients’ IOP, age, and AL, as well as their results in four Corvis ST parameters, were similar between the two groups (p > 0.05). No significant difference was observed in SP-A1; however, PD and DefAmpMax were significantly larger, and SSI was significantly smaller postoperatively in the LOT group than in the cataract group. Conclusions: Corneal stiffness was reduced, and the cornea was more deformed with LOT than cataract surgery. Full article

Background: Inherited primary open-angle glaucoma (POAG) in Beagle dogs is a well-established large animal model of glaucoma and is caused by a G661R missense mutation in the ADAMTS10 gene. Using this model, the study describes early clinical disease markers for canine glaucoma. Methods: Spectral-domain optical coherence tomography (SD-OCT) was used to assess nine adult, ADAMTS10-mutant (median age 45.6 months, range 28.8–52.8 months; mean diurnal intraocular pressure (IOP): 29.9 +/− SEM 0.44 mmHg) and three related age-matched control Beagles (mean diurnal IOP: 18.0 +/− SEM 0.53 mmHg). Results: Of all the optic nerve head (ONH) parameters evaluated, the loss of myelin peak height in the horizontal plane was most significant (from 154 +/− SEM 38.4 μm to 9.3 +/− SEM 22.1 μm; p < 0.01). There was a strong significant negative correlation between myelin peak height and IOP (Spearman correlation: −0.78; p < 0.003). There were no significant differences in the thickness of any retinal layers evaluated. Conclusions: SD-OCT is a useful tool to detect early glaucomatous damage to the ONH in dogs before vision loss. Loss in myelin peak height without inner retinal thinning was identified as an early clinical disease marker. This suggests that initial degenerative changes are mostly due to the loss of myelin. Full article

We tested five chemically and metabolically stable prostaglandin (PG) receptor agonists in a mouse model of dexamethasone-induced ocular hypertension (OHT). Whilst all compounds significantly (p < 0.05, ANOVA) lowered intraocular pressure (IOP) after twice-daily bilateral topical ocular dosing (5 µg/dose) over three weeks, the time course and magnitude of the responses varied. The onset of action of NS-304 (IP-PG receptor agonist) and rivenprost (EP4-PG receptor agonist) was slower than that of misoprostol (mixed EP2/EP3/EP4-PG receptor agonist), PF-04217329 (EP2-PG receptor agonist), and butaprost (EP2-PG receptor agonist). The rank order of IOP-lowering efficacies aligned with the onset of actions of these compounds. Peak IOP reductions relative to vehicle controls were as follows: misoprostol (74.52%) = PF-04217329 (74.32%) > butaprost (65.2%) > rivenprost (58.4%) > NS-304 (55.3%). A literature survey indicated that few previously evaluated compounds (e.g., latanoprost, timolol, pilocarpine, brimonidine, dorzolamide, cromakalim analog (CKLP1), losartan, tissue plasminogen activator, trans-resveratrol, sodium 4-phenyl acetic acid, etc.) in various animal models of steroid-induced OHT were able to match the effectiveness of misoprostol, PF-04217329 or butaprost. Since a common feature of the latter compounds is their relatively high affinity and potency at the EP2-PG receptor sub-type, which activates the production of intracellular cAMP in target cells, our studies suggest that drugs selective for the EP2-PG receptor may be suited to treat corticosteroid-induced OHT. Full article

The surface area of encapsulation around the Ahmed glaucoma valve (AGV) endplate is a critical factor in the surgical outcome as it is associated with the degree of IOP reduction. We investigated the surgical outcome of AGV implantation with an additional pericardium graft inserted adjacent to the endplate, with the intent of expanding the surface area of encapsulation. We enrolled 92 patients (92 eyes) who underwent AGV implantation. Of them, 50 patients underwent conventional surgery (termed the without-expansion group), and 42 received an additional an 8 × 6 mm pericardium graft inserted adjacent to the AGV endplate at the sub-Tenon’s space (with-expansion). The hypertensive phase was classified as mild (>21 mmHg), moderate (>25 mmHg), and severe (>30 mmHg). Six months post-surgery, the with-expansion group exhibited a lower IOP (14.90 ± 4.27 mmHg) and lower peak IOP (22.29 ± 4.95 mmHg) than the without-expansion group (17.56 ± 4.88 mmHg and 25.06 ± 6.18 mmHg, p = 0.008 and p = 0.021, respectively). The with-expansion group exhibited a relatively low rate of moderate (16.7%) and severe (4.8%) hypertensive phases compared to the without-expansion group (40.0% and 20.0%, with p = 0.014 and p = 0.031, respectively). The additional pericardium graft was associated with a reduced occurrence of moderate hypertensive phase in both univariate and multivariate analysis logistic regression analyses (p = 0.017 and p = 0.038, respectively). Endplate surface area expansion using an additional pericardium graft reduced the occurrence of moderate and severe hypertensive phases, and lower postoperative 6-month IOP could be achieved. Full article

Trabecular meshwork (TM) tissue is highly specialized, and its structural integrity is crucial for maintaining homeostatic intraocular pressure (IOP). The administration of glucocorticoids, such as dexamethasone (DEX), can perturb the TM structure and significantly increase IOP in susceptible individuals, resulting in ocular diseases such as steroid-induced glaucoma, a form of open-angle glaucoma. Although the exact mechanism involved in steroid-induced glaucoma remains elusive, increasing evidence suggests that DEX may act through various signaling cascades in TM cells. Despite uncertainty surrounding the specific process by which steroid-induced glaucoma occurs, there is growing evidence to indicate that DEX can impact multiple signaling pathways within TM cells. In this study, we examined the impact of DEX treatment on the Wnt signaling pathway in TM cells, given that Wnt signaling has been reported to play a crucial role in regulating extracellular matrix (ECM) levels in the TM. To further elucidate the role of Wnt signaling in the glaucomatous phenotype, we examined mRNA expression patterns between Wnt signaling markers AXIN2 and sFRP1 and DEX-mediated induction of myocilin (MYOC) mRNA and protein levels over 10 days in DEX-treated primary TM cells. We observed a sequential pattern of peak expression between AXIN2, sFRP1, and MYOC. Based on the study, we propose that sFRP1 upregulation could be a result of a negative feedback mechanism generated by stressed TM cells to suppress abnormal Wnt signaling activities. Full article

Decreased blood flow to the optic nerve (ON) and neuroinflammation are suggested to play an important role in the pathophysiology of glaucoma. This study investigated the potential neuroprotective effect of azithromycin, an anti-inflammatory macrolide, and sildenafil, a selective phosphodiesterase-5 inhibitor, on retinal ganglion cell survival in a glaucoma model, which was induced by microbead injection into the right anterior chamber of 50 wild-type (WT) and 30 transgenic toll-like receptor 4 knockout (TLR4KO) mice. Treatment groups included intraperitoneal azithromycin 0.1 mL (1 mg/0.1 mL), intravitreal sildenafil 3 µL, or intraperitoneal sildenafil 0.1 mL (0.24 μg/3 µL). Left eyes served as controls. Microbead injection increased intraocular pressure (IOP), which peaked on day 7 in all groups and on day 14 in azithromycin-treated mice. Furthermore, the retinas and ON of microbead-injected eyes showed a trend of increased expression of inflammatory- and apoptosis-related genes, mainly in WT and to a lesser extent in TLR4KO mice. Azithromycin reduced the BAX/BCL2 ratio, TGFβ, and TNFα levels in the ON and CD45 expression in WT retina. Sildenafil activated TNFα-mediated pathways. Both azithromycin and sildenafil exerted a neuroprotective effect in WT and TLR4KO mice with microbead-induced glaucoma, albeit via different pathways, without affecting IOP. The relatively low apoptotic effect observed in microbead-injected TLR4KO mice suggests a role of inflammation in glaucomatous damage. Full article