Search Results (989)

Background: Macular edema (ME) secondary to retinal vein occlusion (RVO) is a significant cause of vision impairment. Many patients show suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) monotherapy, prompting the exploration of alternative treatments. Faricimab is a bispecific antibody that targets VEGF-A and angiopoietin-2. We report 9-month real-world outcomes of switching to faricimab in therapy-resistant RVO-associated ME. Methods: In this retrospective study at a single tertiary center, patients with persistent or recurrent ME despite prior treatments (ranibizumab, aflibercept, or dexamethasone implant) were switched to faricimab. All eyes received a loading phase of four monthly faricimab injections, followed by a treat-and-extend regimen individualized per response. Key outcomes included best-corrected visual acuity (BCVA, logMAR), the central subfield thickness (CST, μm), and the intraretinal fluid (IRF) status on optical coherence tomography, assessed from the baseline (month 0, mo0) through the loading phase (mo1–mo3) and at month 9 (mo9). Results: Nineteen eyes (19 patients, mean age 64.8 years) were analyzed. The median BCVA improved from 0.20 to 0.00 logMAR by month 3 (p < 0.01) and was maintained at month 9. The median CST decreased from 325 μm at the baseline to 285 μm at month 3 (p < 0.01) and remained at 285 μm at month 9. IRF was present in 100% of eyes at the baseline, 26% at month 3, and 26% at month 9 (p < 0.01 for the baseline vs. month 9). Among eyes previously on anti-VEGF therapy (n = 14), the median treatment interval increased from 45.50 days at the baseline to 56.50 days at month 9 (p = 0.01; δ = 0.86). No intraocular inflammation or other adverse events were observed in this cohort over nine months. Conclusions: In this retrospective series, switching to faricimab was associated with improvements in vision and retinal anatomy that were maintained over 9 months; injection intervals were extended in a subset of eyes. These exploratory findings warrant confirmation in larger, controlled studies to define long-term effectiveness, safety, and dosing strategies. Full article

Background: This study aimed to evaluate the influence of scleral contact lens (SCL) wear on optical coherence tomography (OCT) scan quality and structural measurements in patients with keratoconus. Methods: This retrospective observational study included 28 eyes of 28 keratoconus patients. All participants underwent a comprehensive ophthalmologic evaluation, including corneal topography and spectral-domain OCT (Optopol REVO 60). Two OCT measurement sessions were performed on the same day: one without SCLs and one after a 30–75 min adaptation period with Mini Misa^® scleral lenses. Recorded parameters included corneal and epithelial thicknesses, ganglion cell–inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, and device-reported quality index (QI). Correlation analyses between topographic values, age, and OCT parameters were also conducted. Results: The mean age of participants was 32.96 ± 13.72 years. SCL wear significantly decreased anterior segment QI (6.76 ± 1.73 vs. 5.57 ± 2.34, p = 0.019) but improved posterior segment QI in both the ganglion (2.52 ± 1.03 vs. 5.76 ± 2.17, p < 0.001) and disc (2.82 ± 0.94 vs. 4.39 ± 1.87, p < 0.001) modules. Central corneal thickness remained stable, while central epithelial thickness decreased slightly (50.53 ± 6.66 µm vs. 47.59 ± 7.20 µm, p = 0.007). RNFL and GCIPL thicknesses showed no significant changes, except for minor sectoral variations. Steeper keratometry values correlated with lower QI in both conditions. Conclusions: SCLs enhanced posterior OCT scan quality while reducing anterior segment image clarity. These findings suggest that SCLs not only provide visual rehabilitation but also facilitate more reliable posterior segment imaging in keratoconus patients, despite mild interference with anterior segment OCT metrics. Further prospective studies are warranted to validate these results. Full article

Posttraumatic Stress Disorder (PTSD) is characterized by disruptions in central nervous system functioning and existential crises, yet the mechanistic links between neurobiological processes and dimensions of life meaning and identity remain underexplored. The aim of this study was to examine the relationships between stress biomarkers (serotonin, cortisol, noradrenaline, and interleukin-12 [IL-12]) and existential attitudes (measured using the Life Attitude Profile (Revised) [LAP-R]) in mining rescuers, considering PTSD duration and participant age. This cross-sectional study included 92 men aged 18–50 years, divided into three groups: no PTSD (n = 28), PTSD ≤ 5 years (n = 33), and PTSD > 5 years (n = 31). Serum levels of four biomarkers and LAP-R scores across eight domains were evaluated. Statistical analyses employed nonparametric tests, including the Kruskal–Wallis test for overall group differences (with Wilcoxon r effect sizes for pairwise comparisons, Mann–Whitney U tests for post hoc pairwise comparisons, and Spearman’s rank correlations for biomarker–LAP-R associations. Age effects were assessed in two strata: 18–35 years and 36–50 years. Kruskal–Wallis tests revealed significant group differences (p < 0.001) for all biomarkers and most LAP-R domains, with very large effect sizes (r > 0.7) in pairwise comparisons for serotonin (control median: 225.2 ng/mL vs. PTSD ≤ 5y: 109.9 ng/mL, r = 0.86; vs. PTSD > 5y: 148.0 ng/mL, r = 0.86), IL-12 (control: ~8.0 pg/mL vs. PTSD ≤ 5y: 62.4 pg/mL, r = 0.86; vs. PTSD > 5y: ~21.0 pg/mL, r = 0.69), and LAP-R scales such as Life Purpose (control: 54.0 vs. PTSD ≤ 5y: 39.0, r = 0.78; vs. PTSD > 5y: 20.0, r = 0.86) and Coherence (control: 53.0 vs. PTSD ≤ 5y: 34.0, r = 0.85; vs. PTSD > 5y: 23.0, r = 0.86). The PTSD ≤ 5y group exhibited decreased serotonin, cortisol (median: 9.8 µg/dL), and noradrenaline (271.7 pg/mL) with elevated IL-12 (all p < 0.001 vs. control), alongside reduced LAP-R scores. The PTSD > 5y group showed elevated cortisol (median: ~50.0 µg/dL, p < 0.001 vs. control, r = 0.86) and normalized IL-12 but persistent LAP-R deficits. Older participants (36–50 years) in the PTSD ≤ 5y group displayed improved existential attitudes (e.g., Life Purpose: 47.0 vs. 27.5 in 18–35 years, p < 0.001), whereas in PTSD > 5y, age exacerbated biological stress (cortisol: 57.6 µg/dL vs. 36.1 µg/dL, p = 0.003). Spearman correlations revealed stage-specific patterns, such as negative associations between cortisol and Death Acceptance in PTSD > 5y (ρ = −0.49, p = 0.005). PTSD alters biomarker levels and their associations with existential dimensions, with duration and age modulating patient profiles. These findings underscore the necessity for integrated therapies addressing both biological and existential facets of PTSD. Full article

Background: Optical coherence tomography angiography (OCTA) enables non-invasive, high-resolution visualization of the retinal microvasculature and is increasingly utilized in pediatric ophthalmology. However, its clinical application in children is limited by the absence of age-specific normative data. Methods: In this cross-sectional study, macular vessel density (VD) and foveal avascular zone (FAZ) area were assessed in 118 healthy Caucasian children aged 4 to 17 years. OCTA scans were obtained using the OCT Topcon Triton^® device with 3 × 3 mm and 6 × 6 mm macular cubes. Vascular metrics from the superficial (SCP) and deep capillary plexuses (DCP) were analyzed in relation to demographic, refractive, biometric, and structural OCT parameters. Correlation and multivariate linear regression analyses were performed to evaluate associations. Results: Age-stratified reference percentiles for macular VD and FAZ area in SCP and DCP are presented for 118 children. Key associations included: (1) Increased macular thickness correlated with higher VD in the fovea and inner ring (SCP and DCP, all p < 0.05); (2) Thicker maculas were associated with smaller FAZ areas (SCP: r = −0.72, DCP: r = −0.58, both p < 0.001); (3) Older age was linked to reduced VD in the inner macular ring and smaller FAZ area (SCP and DCP, all p < 0.001); and (4) longer axial length correlated with lower central VD (SCP: r = −0.27, DCP: r = −0.37, both p < 0.05). No significant sex-based differences were observed. Conclusions: This study provides normative OCTA data for macular VD and FAZ area in healthy Caucasian children and identifies key associations with ocular parameters. These findings support improved diagnostic accuracy and clinical decision-making in pediatric retinal evaluation. Full article

Aristotle’s theory of soul was a hot topic in the Late Middle Ages and it sparked a great series of debates with serious theological and philosophical implications. The medieval commentators of Aristotle played a crucial role in the dissemination of these debates since their explanations and commentaries on Aristotle’s theory of soul served as a springboard for further discussions. One of the most important medieval commentators of Aristotle was Albert the Great (ca 1200–1280) who dealt extensively with the topic of soul and its connection with the doctrine of intellect. Albert discussed the subject of soul not only in the Aristotelian commentaries but also in many genuine works of his which delineated Albert’s theory of soul in great detail. This paper will primarily focus on two works of Albert, De homine and Liber de natura et origine animae; it aims to provide a coherent account of Albert’s early theory of soul and to shed some light on important hermeneutical issues that derive from these two works. Full article

Background: Age-related macular degeneration is a major cause of vision loss, and improved visualization of macular neovascularization (MNV) on OCT angiography (OCTA) could enhance clinical assessment. This study aimed to establish a simple and accessible image enhancement method. Methods: We retrospectively analyzed 24 eyes from 22 patients with MNV at the Doheny UCLA Eye Centers. Grayscale-inverted OCTA images were generated using the basic “Invert” function in ImageJ 1.51 23. Each original and inverted image pair was assessed for seven MNV-related features: structure and area within 3 × 3 mm, 6 × 6 mm and 12 × 12 mm scans, and presence of polypoidal lesions. Twenty-one ophthalmologists graded visibility using a standardized five-point scale. Paired comparisons were performed using the Wilcoxon signed-rank test. Results: Grayscale inversion significantly improved the visualization of MNV structure in 6 × 6 mm scans (mean difference: +0.67 ± 1.02; p = 0.008), 12 × 12 mm scans (+0.62 ± 1.07; p = 0.013), and detection of polypoidal lesions (+0.43 ± 0.98; p = 0.030). No significant differences were found for 3 × 3 mm structure (p = 0.793) or area-related features (all p > 0.3). Conclusions: Grayscale inversion may enhance MNV visibility and polypoidal lesion detection on OCTA. As this study relied solely on subjective assessments, future work should incorporate quantitative image analysis. Full article

This paper describes for the first time a lobe–hyaloclastite felsic complex on an oceanic island of intraplate setting. In the submarine volcanic succession of the Basal Complex of La Palma (Canary Islands), two main units are identified: an older felsic formation and a conformable upper basaltic–trachybasaltic formation. The felsic formation comprises three facies associations: (1) coherent facies, represented by trachytic lobes with porphyritic, aphanitic, or glass trachytes; (2) autoclastic facies, including hyaloclastites and autobreccias; and (3) syn-eruptive resedimented facies, consisting of mono- and polymictic breccias (massive or graded), and of volcaniclastic sandstones and breccias. The internal architecture and facies relationships are consistent with sedimentation in a submarine trachytic lobe–hyaloclastite complex, which predates the basaltic–trachybasaltic formation. These felsic rocks are classified as trachytes, although they exhibit extensive hydrothermal alteration. The behavior of incompatible trace elements suggests that the variety of the trachytic rocks—porphyritic or aphanitic terms—can be attributed to fractional crystallization processes. However, the features of the incompatible trace elements and the rare earth elements indicate that these trachytes are not cogenetic with the submarine basaltic–trachybasaltic rocks of the Basal Complex of La Palma. Instead, the trachytic magmas responsible for the lobe–hyaloclastite complex formation likely represent the late evolution of a precursor basaltic magma that would have led to the formation of a basaltic submarine shield not exposed nowadays. This study also presents the first robust geochronological constraints for the submarine volcanic units of the La Palma Basal Complex, based on U–Pb on zircons and Ar–Ar on amphiboles. Given that the submarine trachytic lobe–hyaloclastite complex is the oldest lithostratigraphic unit exposed on La Palma, a minimum age of 3.10 Ma is proposed for the initiation of the island submarine growth stage. Full article

Retinal vasculature is essential for maintaining visual function by supporting metabolically active neurons. However, the retina lacks redundant blood supply, rendering it highly susceptible to vascular dysfunction. Understanding mechanisms of retinal vascular abnormalities is critical for therapies that preserve vascular and neuronal integrity, yet progress has been hindered by limited models and genetic diversity. To address this gap, we examined the retinal vasculature in multiple aged strains from the BXD recombinant inbred mouse panel, a genetically diverse, tractable, and physiologically relevant platform for uncovering novel genetic drivers and disease mechanisms. We identified BXD32 as a striking outlier with dramatically reduced vessel density. Using optical coherence tomography, optical coherence tomography angiography, and histological analyses, we comprehensively characterized retinal vasculature and structural integrity of BXD32 mice during aging. We found progressive, age-dependent vascular dysfunction and degeneration, beginning in the deep capillary plexus and advancing to the intermediate and superficial layers. These changes were accompanied by neuronal degeneration, including photoreceptor loss and thinning of the ganglion cell complex. Our findings establish BXD32 as a spontaneous and genetically tractable model of inherited retinal neurovascular degeneration and provide a foundation for future studies to identify causative genetic loci and underlying molecular mechanisms. Full article

We previously reported ocular phenotypes of 1-year-old 129S1/SvlmJ lysyl oxidase-like 1 null (Loxl1^−/−) mice. Here we sought to characterize age-dependent changes in C57BL/6J Loxl1^−/− mice in a longitudinal fashion. Retinal ganglion cell (RGC) function was assessed by electroretinography (ERG), and optic nerves were evaluated by histological analysis. Ocular biometric measurements were obtained by optical coherence tomography (OCT). We detected reduced RGC function, revealed by decreased amplitude and increased latency of ERG positive scotopic threshold responses (pSTRs) in Loxl1^−/− mice compared to age-matched wt mice. In addition, there is significant inter-eye asymmetry of RGC function, as well as age-related RGC function loss observed only in Loxl1^−/− mice. Histologically, we observed enlarged optic nerve areas in Loxl1^−/− mice compared to wt mice. Significant ocular biometric differences between two groups were detected, most notably, age-related axial elongation of the globe, accompanied by deepening of anterior chamber depth (ACD). Though eyes elongate with age in both groups, this is more pronounced in Loxl1^−/− mice, and the elongation of the globe correlated with decreased RGC function. The correlation of age-related reduction in RGC function with globe axial elongation may have implications for the association of axial myopia with glaucoma and aging in humans. Full article

Modern ophthalmic imaging methods such as optical coherence tomography (OCT) typically require expensive scanner components to direct the light beam across the retina while the patient’s gaze remains fixed. This proof-of-concept experiment investigates whether the patient’s natural eye movements can replace mechanical scanning by guiding the gaze along predefined patterns. An infrared fundus camera setup was used with nine healthy adults (aged 20–57) who completed tasks comparing passive viewing of moving patterns to actively tracing them by drawing using a touchpad interface. The active task involved participant-controlled target movement with real-time color feedback for accurate pattern tracing. Results showed that active tracing significantly increased pupil diameter by an average of 17.8% (range 8.9–43.6%; p < 0.001) and reduced blink frequency compared to passive viewing. More complex patterns led to greater pupil dilation, confirming the link between cognitive load and physiological response. These findings demonstrate that patient driven gaze guidance can stabilize gaze, reduce blinking, and naturally dilate the pupil. These conditions might enhance the quality of scannerless OCT or other imaging techniques benefiting from guided gaze and larger pupils. There could be benefits for children and people with compliance issues, although further research is needed to consider cognitive load. Full article

The use of intelligent clinical decision support systems (CDSS) has the potential to improve the accuracy and speed of diagnoses significantly. These systems can analyze a patient’s medical data and generate comprehensive reports that help specialists better understand and evaluate the current clinical scenario. This capability is particularly important when dealing with medical images, as the heavy workload on healthcare professionals can hinder their ability to notice critical biomarkers, which may be difficult to detect with the naked eye due to stress and fatigue. Implementing a CDSS that uses computer vision (CV) techniques can alleviate this challenge. However, one of the main obstacles to the widespread use of CV and intelligent analysis methods in medical diagnostics is the lack of a clear understanding among diagnosticians of how these systems operate. A better understanding of their functioning and of the reliability of the identified biomarkers will enable medical professionals to more effectively address clinical problems. Additionally, it is essential to tailor the training process of machine learning models to medical data, which are often imbalanced due to varying probabilities of disease detection. Neglecting this factor can compromise the quality of the developed CDSS. This article presents the development of a CDSS module focused on diagnosing age-related macular degeneration. Unlike traditional methods that classify diseases or their stages based on optical coherence tomography (OCT) images, the proposed CDSS provides a more sophisticated and accurate analysis of biomarkers detected through a deep neural network. This approach combines interpretative reasoning with highly accurate models, although these models can be complex to describe. To address the issue of class imbalance, an algorithm was developed to optimally select biomarkers, taking into account both their statistical and clinical significance. As a result, the algorithm prioritizes the selection of classes that ensure high model accuracy while maintaining clinically relevant responses generated by the CDSS module. The results indicate that the overall accuracy of staging age-related macular degeneration increased by 63.3% compared with traditional methods of direct stage classification using a similar machine learning model. This improvement suggests that the CDSS module can significantly enhance disease diagnosis, particularly in situations with class imbalance in the original dataset. To improve interpretability, the process of determining the most likely disease stage was organized into two steps. At each step, the diagnostician could visually access information explaining the reasoning behind the intelligent diagnosis, thereby assisting experts in understanding the basis for clinical decision-making. Full article

Glaucoma is traditionally defined as an ocular disease characterized by progressive retinal ganglion cell degeneration, in some cases with elevated intraocular pressure (IOP), and optic nerve damage. However, growing evidence indicates that glaucoma shares critical features with neurodegenerative disorders, including Alzheimer’s and Parkinson’s diseases. This study aimed to explore the systemic nature of primary open-angle glaucoma (POAG) by integrating visual function, cognitive performance, and transcriptomic profiling. We conducted a multidimensional assessment of POAG patients and age-matched controls, accounting for demographic factors. Structural parameters included retinal nerve fiber layer (RNFL) thickness, measured using optical coherence tomography (OCT), and visual field indices mean deviation (MD) and pattern standard deviation (PSD). Cognitive function was evaluated across multiple domains, encompassing visual memory, executive function, processing speed, and verbal fluency. Additionally, transcriptomic analysis was performed from conjunctival samples to identify differentially expressed genes (DEGs) and enriched pathways. POAG patients exhibited significant RNFL thinning, which correlated with both visual field loss and cognitive impairments, particularly in terms of visual memory and executive function. Transcriptomic profiling revealed a distinct gene expression signature in POAG, including upregulation of TTBK1 and CCN2 (CTGF), genes associated with tau phosphorylation and extracellular matrix remodeling. Functional enrichment analysis indicated the involvement of neurodegenerative pathways, such as glutamate signaling, calcium signaling, and cell adhesion. Our findings support the reclassification of glaucoma as a neurodegenerative disease with both ocular and cognitive manifestations. Furthermore, biomarkers such as TTBK1 and CCN2 may serve as potential targets for early detection and neuroprotective therapy. Full article

Background and Objectives: To find morphological features on optical coherence tomography (OCT) and OCT-angiography (OCTA) influencing contrast sensitivity (CS) in patients with retinitis pigmentosa (RP). Materials and Methods: Cross-sectional study enrolling 18 eyes of 18 patients with RP. They were examined with CSV1000-E (VectorVision) under mesopic conditions (logarithmic scale), spectral-domain OCT (SD-OCT, Spectralis), swept-source OCT (SS-OCT, Triton), and OCTA (Triton). Automatic thickness measurements of every retinal layer were obtained in grids of 8 × 8 and 10 × 10 cubes. Foveal avascular zone and vascular densities (VD) were also analyzed. Statistical analysis included multiple lineal regression analyses, and a correlation analysis between age, axial length, and intraocular pressure, and retinal nerve fiber layer (RNFL) thickness. Results: Mean age was 47.34 ± 13.77 years. Mean CS with 3, 6, 12, and 18 cycles/degree (c/d) was 1.48 ± 0.37, 1.51 ± 0.39, 1.00 ± 0.42, and 0.44 ± 0.39, respectively. The most related variables to 3 c/d frequency were nasal RFNL thickness (R² = 0.54) and central outer plexiform layer (OPL) (R² = 0.33). In case of 6 c/d frequency, it was central VD in deep plexus (R² = 0.66), and retinal pigment epithelium (RPE) (R² = 0.22). As for 12 c/d frequency, it was central RNFL (R² = 0.50), and central VD in deep plexus (R² = 0.26). Regarding 18 c/d frequency, it was central RNFL (R² = 0.70). Conclusions: Central and nasal RNFL thickness seem to be main predictors of CS in patients with RP, as well as VD in deep retinal plexus. Others with limited influence might be central and nasal OPL thickness, and central RPE thickness. Full article

Purpose: To compare the performance of two swept-source optical coherence tomography-based biometers in the measurement of ocular biometry and the prediction of postoperative refractive errors in eyes with short axial length (AL). Methods: A total of 48 eyes from 29 patients with AL ≤ 22 mm were included. AL, anterior chamber depth (ACD), keratometry (K), and lens thickness (LT) measured using the IOLMaster^® 700 and ARGOS^® before cataract surgery were compared. The refractive error prediction accuracy of the two devices was also compared. Results: This study included four men (7 eyes) and 25 women (41 eyes), with an average age of 70.7 ± 8.1 years (mean ± SD; range, 47–82 years). The two devices demonstrated good agreement in measurements of ocular biometry with high intraclass correlation coefficients (AL = 0.975; ACD = 0.957; K = 0.988; LT = 0.994). However, AL and ACD were significantly shorter when measured with the IOLMaster^® 700 compared to the ARGOS^® (p < 0.001 for both). There was no significant difference in mean absolute prediction errors between the two devices (p = 0.423). The IOLMaster^® 700 showed a significantly lower mean prediction error than the ARGOS^® (+0.12 ± 0.39 diopters vs. +0.20 ± 0.39 diopters, p = 0.006), although the difference was of limited clinical relevance. There were no significant differences in the percentages of eyes within ± 0.50 D (77.1% vs. 75.0%, p = 0.811) and ± 1.00 D (100% vs. 97.9%, p = 0.315) of the predicted refractive error. Conclusions: Although IOLMaster^® 700 and ARGOS^® showed good agreements in eyes with short AL, significant differences were observed in the measurements of AL and ACD. Both devices demonstrated good efficacy and comparable performance in predicting postoperative refractive errors. Full article

Non-destructive evaluation techniques using infrared and terahertz waves were employed to examine an aged violin and an inlaid dish. The results suggest that active thermography can rapidly reveal the general features of deterioration, while optical coherence tomography and THz imaging visualise cross-sectional images by scanning. These techniques are complementary and provide useful information for conservation planning. Full article