Search Results (3,661)

This study evaluated the early structural and functional effects of combined citicoline and coenzyme Q10 (CoQ10) (CitiQ10) treatment in a laser-induced ocular hypertension (OHT) model in Swiss albino mice, focusing on retinal inflammation and neuroprotection. Sixty male CD-1 mice were assigned to four groups: vehicle, CitiQ10, OHT, and OHT + CitiQ10. OHT was induced by laser photocoagulation of limbal and episcleral veins, and CitiQ10 was administered orally starting 15 days before induction. Intraocular pressure (IOP) was measured by rebound tonometry, retinal structure was assessed by spectral domain optical coherence tomography (SD-OCT), and function was evaluated using full-field electroretinography (ffERG). At 3 days post-induction, OHT eyes exhibited significant retinal nerve fiber layer (RNFL) thickening, increased vitreous particles, and early functional impairment, particularly reduced scotopic b-wave and oscillatory potentials. CitiQ10 treatment mitigated these changes, reducing vitreous particles, moderating RNFL alterations, and not exhibiting significant changes in ERG amplitudes. At 7 days post-induction, structural and functional deficits persisted but were less pronounced in treated eyes. These findings suggest that CitiQ10 treatment may attenuate early retinal damage in glaucoma, with OCT and ffERG serving as reliable monitoring tools, supporting the therapeutic potential of this approach in early stage disease. Full article

Background: Juvenile idiopathic arthritis-associated uveitis (JIA-U) is a rare condition, and assessment of the efficacy of disease-modifying antirheumatic drugs, synthetic (sDMARD) or biological (bDMARD), in randomized trials is hindered by this fact. Methods: In this prospective longitudinal study, we observed 38 children aged 1.3 to 15.2 years, with 69 eyes affected with JIA-U for 1970 overall eye examinations (6–59, median 16) irregularly scattered across 4.4–87.6 months (median 21.6) of follow-up, with on- and off-periods of DMARD use and use of topical treatments. Results: With adjustment for several time-invariant and time-varying covariates, periods of exposure to sDMARD vs. no DMARD exposure were associated with peak benefits of 15–20% lower probability of having more severe anterior chamber (AC) inflammation and a similar relative reduction in the daily use of topical corticosteroids (TCS). Periods of bDMARD exposure or of bDMARD + sDMARD exposure vs. no DMARD use were associated with peak benefits of an around 50% reduction in the probability of having more severe AC inflammation, and peak benefits of an around 60–65% reduction in TCS use. Conclusions: The observations regarding bDMARD (only) or bDMARD + sDMARD exposure are in agreement with the extent of benefits suggested for adalimumab vs. placebo (+background sDMARD) in the only existing randomized trial in this setting evaluating AC inflammation and TCS use. Full article

The current study investigates the influence of intersubject variability in ocular characteristics on the mapping of visual field (VF) sites to the pointwise directional angles in retinal nerve fiber layer (RNFL) bundle traces. In addition, the performance efficacy on the mapping of VF sites to the optic nerve head (ONH) was compared to ground truth baselines. Fundus photographs of 546 eyes of 546 healthy subjects (with no history of ocular disease or diabetic retinopathy) were enhanced digitally and RNFL bundle traces were segmented based on the Personalized Estimated Segmentation (PES) algorithm’s core technique. A 24-2 VF grid pattern was overlaid onto the photographs in order to relate VF test points to intersecting RNFL bundles. The PES algorithm effectively traced RNFL bundles in fundus images, achieving an average accuracy of 97.6% relative to the Jansonius map through the application of 10th-order Bezier curves. The PES algorithm assembled an average of 4726 RNFL bundles per fundus image based on 4975 sampling points, obtaining a total of 2,580,505 RNFL bundles based on 2,716,321 sampling points. The influence of ocular parameters could be evaluated for 34 out of 52 VF locations. The ONH-fovea angle and the ONH position in relation to the fovea were the most prominent predictors for variations in the mapping of retinal locations to the pointwise directional angle (p < 0.001). The variation explained by the model (R² value) ranges from 27.6% for visual field location 15 to 77.8% in location 22, with a mean of 56%. Significant individual variability was found in the mapping of VF sites to the ONH, with a mean standard deviation (95% limit) of 16.55° (median 17.68°) for 50 out of 52 VF locations, ranging from less than 1° to 44.05°. The mean entry angles differed from previous baselines by a range of less than 1° to 23.9° (average difference of 10.6° ± 5.53°), and RMSE of 11.94. Full article

Background and Objectives: This study evaluates the safety, tolerability, and efficacy of preservative-free Dorzolamide 2%-Timolol 0.5% (PF-DT), with a focus on improving the ocular microenvironment in a real-world transition setting. Materials and Methods: A prospective, multicenter, open-label study involving thirty patients with dry eye disease previously treated with BAK-DT was conducted. Participants were transitioned to PF-DT, and evaluated at weeks 4, 12, and 24. The primary endpoint was the Ocular Surface Disease Index (OSDI) score. Secondary outcomes included Break-Up Time (BUT), Schirmer test results, corneal staining, conjunctival hyperemia, intraocular pressure (IOP), and patient satisfaction. Results: Twenty-five patients completed the study. The OSDI improved from 21.5 to 12.5 (p < 0.001), with 60.0% of patients showing improvement and 52.0% achieving complete symptom resolution. Among eyes with corneal staining, 78.4% demonstrated a reduction of at least one grade, and 50.0% of those with conjunctival redness showed similar improvement. By week 24, 78.0% exhibited no corneal staining, and 50.0% had no conjunctival redness. BUT increased from 5.0 to 7.0 (p < 0.01), while IOP decreased by 1 mmHg (p < 0.01). Satisfaction regarding comfort (≥80%) and handling (≥50%) was high, with 88.0% preferring PF-DT. Conclusions: Transitioning to PF-DT improved ocular surface health while maintaining IOP control, supporting the benefits of preservative-free formulations in restoring microenvironment homeostasis and enhancing tolerability and patient satisfaction. Full article

Hypoxic eye diseases represent a pivotal yet often underappreciated contributor to the onset and progression of many retinal disorders. When hypoxia persists or exceeds the tissue’s compensatory capacity, it triggers pathological retinal neovascularization, blood–retinal barrier disruption, and neuronal apoptosis, ultimately resulting in irreversible visual impairment. Connexins (Cxs) form gap junction channels and hemichannels and regulate retinal cell proliferation, differentiation, and survival, thereby playing a central regulatory role in the pathogenesis of hypoxic ocular diseases. In addition to gap junctions, Cx hemichannels promote transmission of molecules between intra- and extracellular environments, further influencing retinal homeostasis under hypoxic stress. This review synthesizes recent progress in understanding connexins in localized and systemic hypoxic eye diseases. We focus on the molecular mechanisms underlying the development and progression of hypoxia-induced ocular pathology, with particular emphasis on the emerging potential of Cxs as novel therapeutic targets for hypoxic ocular diseases. Following a systematic literature search, the electronic databases PubMed and EMBASE were consulted, with the search deadline set at December 2025. The search terms employed were as follows: hypoxia, connexin, gap junctions, hemichannels. Full article

Background and Objectives: Tear film instability and corneal surface irregularity are important sources of variability in keratometric and corneal topographic measurements, particularly affecting astigmatic magnitude and axis. Accurate preoperative biometry is crucial for optimal refractive outcomes in cataract surgery. Dry eye disease (DED) may compromise the reproducibility of keratometric parameters, leading to errors in intraocular lens (IOL) power calculation. This study aimed to evaluate the impact of DED on the reproducibility of keratometric measurements and to assess the effect of a four-week treatment with lipid-containing artificial tears on these parameters in cataract patients. Materials and Methods: This cross-sectional study included 116 patients scheduled for cataract surgery, of whom 65 (56.0%) had DED and 51 (44.0%) served as controls. All patients underwent two preoperative keratometric measurements 10–20 min apart (IOL1 and IOL2). The control group proceeded to surgery the next day, while surgery in the DED group was postponed. Patients with DED received preoperative therapy with lipid-containing artificial tears. Follow-up assessments occurred one month after therapy (keratometric measurement named IOL3) and eight weeks postoperatively. Clinical evaluation included slit-lamp examination, dry eye testing according to Dry eye Workshop II (DEWS II) criteria: Ocular surface Disease Index (OSDI), Tear Break-Up Time (TBUT), Schirmer I, Oxford staining, and meibomian gland assessment), ocular biometry, and postoperative spherical equivalent measurement using an auto ref-keratometer. Nonparametric statistical analyses were applied to evaluate associations between parameters. Results: In the DED group, corneal astigmatism showed a significant difference between IOL1 and IOL2 (Wilcoxon signed-rank test {Z = 2.43; p = 0.015}). Significant changes in predicted IOL power were observed between pretreatment and posttreatment values (t = 2.57; p = 0.013) and between IOL2 and IOL3 (t = 2.23; p = 0.029), indicating improved keratometric stability following tear film therapy. No additional significant correlations were identified. Conclusions: DED adversely affects the reproducibility of keratometric measurements and may compromise IOL power selection. Preoperative identification and treatment of DED, followed by repeated biometry after tear film stabilization, are strongly recommended to enhance refractive accuracy and optimize surgical outcomes in cataract patients. Full article

Background and Objectives: Patients with Sjögren’s disease (SjD) do not experience any improvement in gastroesophageal reflux disease (GERD) symptoms after SjD treatment, and in some patients, reflux even worsens. It is important to note that GERD manifests itself through typical and atypical symptoms, the latter of which may include eye damage, as evidenced by a growing body of research. When SjD patients were prescribed medication to treat GERD, their condition improved at the same time. Therefore, we aim to investigate whether there is a link between ocular dryness and gastroesophageal reflux disease (GERD) in patients with Sjögren’s disease (SjD). Materials and Methods: Our study included 27 patients with SjD according to the 2016 American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) Sjögren’s syndrome Classification Criteria, and 28 patients with non-autoimmune sicca syndrome due to GERD (nonautoimmSicca). Results: The study involved 55 participants, 48 (87.3%) women and 7 (12.7%) men. The median age was 54 years (IQR 49–64). A total of 41 subjects (74.5%) had GERD, and 20 subjects (36.4%) tested positive for Helicobacter pylori: 13 (48.1%) and 1 (3.7%) in the SjD group, and 28 (100.0%) and 19 (67.9%) in the nonautoimmSicca group, respectively. A significant difference in asymmetric tear secretion (p < 0.001) was found between the nonautoimmSicca and SjD patients, with values of 5 (3–10) mm/5 min and 1 (0–2) mm/5 min, respectively. A low correlation was detected between sialometry results and tear secretion asymmetry (r = 0.48, p < 0.001). An increase of 1 mm/5 min in the tear secretion asymmetry between the eyes was associated with a 2.04-fold increase in the odds ratio for having GERD (95% CI 1.25–3.32, p = 0.004), and was associated with a 1.9-fold increase in the odds ratio for having GERD (95% CI 1.04–3.49, p = 0.038) in patients with SjD. The presence of Helicobacter pylori is associated with asymmetric tear secretion [95% CI 1.22 (1.05–1.41, p = 0.010)]. Conclusions: Asymmetric tear secretion between the eyes is associated with the odds of having GERD. Patients with non-autoimmune sicca syndrome due to GERD have significantly greater asymmetry in tear secretion compared to those diagnosed with Sjögren’s disease. Full article

Background: Aloe vera gel in 0.3% hyaluronate (AV/HA) could mitigate glaucoma therapy-related ocular surface disease (GTOSD). Methods: Thirty-nine patients diagnosed with GTOSD and receiving AV/HA or HA underwent ocular surface disease index (OSDI), Symptom Assessment iN Dry Eye (SANDE), National Eye Institute Visual Function Questionnaire (NEI VFQ)-25 questionnaires, and tear matrix metalloproteinase-9 (MMP-9), break-up time (BUT), corneal fluorescein staining (CFS), Schirmer test I (STI), and bulbar conjunctival hyperemia (BCH) determination. Results: After one month, AV/HA increased BUT (5 (7–4.5) to 7 (8–5.5)) and STI (12 (19.5–8) to 13.5 (20–10)), while it decreased BCH (2.2 (2.3–1.3) to 2.1 (2.2–1.2)) and CFS (3 (4–2) to 2 (3.0–1.5)) (p < 0.001). SANDE and OSDI scores were reduced from 36.18 (38.5–20.5) to 22.91 (31.5–17.21), and 29.5 (32.5–19.5) to 20 (26.5–18) (p < 0.001). HA reduced BCH from 2.75 (3.20–2.15) to 2.25 (2.30–1.90) (p = 0.014) and CFS from 3.5 (5–2.75) to 2.5 (4–2) (p = 0.014), while it increased BUT (p = 0.036). The SANDE score decreased from 28.95 (47.6–20.9) to 26.86 (36.41–19.90) (p = 0.009), whereas the OSDI decreased from 40 (49–19.5) to 29 (42–19.75) (p = 0.005). Any significant change in NEI VFQ-25 was collected. A trend for an MMP-9 immunoassay positivity reduction was observed in AV/HA (0.073). Conclusions: These findings invite considering lubricants enriched with natural anti-inflammatory agents, such as Aloe vera, as a potential adjunctive option to improve the ocular surface in glaucoma. Full article

For retinal degenerative diseases, advanced therapies such as gene therapy and retinal stem cell therapy have emerged as promising treatments, which are often delivered through subretinal injection. However, clinical subretinal injection remains challenging due to the extremely high precision requirements, lack of depth information, and the physiological limitations of manual operation, often leading to complications such as hypotony and globe atrophy. To address these challenges, this study proposes a novel ophthalmic surgical robotic system designed for high-precision subretinal injections. The robotic system incorporate a remote center of motion mechanism for its mechanical structure and employs a master–slave control system to achieve motion scaling. A microscope-integrated optical coherence tomography device is applied to provide real-time microscopic imaging and depth information. The design and performance of the proposed system are validated through simulations and experiments. Precision tests demonstrate that the system achieves an overall positioning accuracy of less than 30 $\mathsf{\mu }$m, with injection positioning accuracy under 20 $\mathsf{\mu }$m. Subretinal injection experiments conducted on artificial eye models further validate the clinical feasibility of the robotic system. Full article

Although calpain-5/CAPN5 is widely expressed in mammals, little is known regarding its functions. Pathogenic mutations of CAPN5 are causal for a devastating autoimmune eye disease, neovascular inflammatory vitreoretinopathy (NIV). To provide insight into both the physiological and pathological roles of CAPN5, it is essential to identify candidate interaction partners and possible substrates. Human SH-SY5Y neuroblastoma cells, transfected with full-length catalytically dead (Cys81Ala) CAPN5-3×FLAG, were used for anti-FLAG co-immunoprecipitation (co-IP) and quantitative proteomics using Sequential Window Acquisition of all THeoretical mass spectra (SWATH-MS). Fifty-one proteins were enriched at least four-fold, p < 0.01, relative to cells transfected with an empty FLAG vector. A high proportion (24/51) of candidate CAPN5 interaction partners are associated with protein quality control, including components of the chaperonin, chaperone, and ubiquitin–proteasome systems. Additional candidate interactors include tubulins, kinases, phosphatases, G proteins, and mitochondrial proteins. CAPN5 interactions for 14 of the candidate proteins were confirmed by co-IP and immunoblotting. Of these 14 proteins, 11 exhibited in vitro calcium-induced proteolysis following co-IP with WT CAPN5-3×FLAG. Impaired calcium-induced proteolysis of co-IP proteins was observed for the pathogenic CAPN5 variants R243L and R289W. Further studies are needed to validate the association of candidate CAPN5 interactors with proteins and complexes suggested by the SWATH-MS and co-IP results, and the possible role of CAPN5 within such complexes. The possible involvement of CAPN5 in protein quality control is relevant to NIV, as defects in protein quality control have been implicated in inherited retinal disorders. Proteomic data are available via ProteomeXchange with identifier PXD068008. Full article

Background/Purpose: Four patients independently reported episodes of seeing a dimly flickering overlay on an otherwise intact part of their binocular visual field. The aim of the study was to describe the clinical characteristics of this episodic phenomenon, which we call dim flicker. Methods: Retrospective chart review and patient evaluation of an animated reference simulation. Results: The patients described repeated episodes of a seeing a patch of rhythmically oscillating dim flicker overlaid on a circumscribed patch of their otherwise normal binocular visual field. The flicker was typically seen at low ambient light levels and disappeared in bright light or when one or both eyes were covered. Episodes lasted seconds to minutes. Some flicker patches crossed the vertical midline. The flicker was subjectively experienced as coming from one specific eye. Compared to a 7 Hz flicker simulation, patients reported differences in location, prominence, and frequency, with the latter ranging from 3 to 10 Hz. In three patients, the flicker was sometimes experienced during aerobic exercise and in two patients sometimes when they rose at night in the dark. In one patient, the flicker corresponded to an area of ischemic macular edema secondary to central retinal vein occlusion. There was no headache during or after the flicker. Associated maladies included retinal venous congestion, central serous chorioretinopathy, arterial hypertension, atrial fibrillation, and migraine with visual aura distinctly different from the dim flicker. Conclusions: Episodes of seeing an endogenous, rhythmically oscillating transparent overlay within a confined, non-expanding part of an otherwise intact binocular visual field appears to be a distinct nosological entity that can be associated with ocular and systemic vascular disease. Full article

Background/Objectives: Hemodialysis (HD) is the commonest life sustaining form of kidney replacement therapy in the world; however, this method of treatment have many adverse effects, and even a single HD session affects many organs, including the eyes. The aim of this study was to assess the effect of a single HD session on the ophthalmologic findings in patients with End-stage Renal Disease (ESRD). The second aim of the study was to examine the correlation of these changes with each other and between changes in systemic stressors related to the HD session. Methods: This was a single-center cross-sectional observational study conducted on 32 patients undergoing HD. Selected parameters of the anterior and posterior segment of the eye as well as systemic parameters were assessed before and after a single HD session. Results: Best corrected visual acuity (BCVA) improved, and lens thickness (LT), axial length (AXL), average macular thickness (MT), central MT and total vessel density (VD) of the deep capillary plexus DCP increased significantly after a single HD session. The Schirmer test results, tear break up time (TBUT), anterior chamber depth (ACD), central and average choroidal thickness (CT) decreased significantly after HD. Body weight loss was the only significant systemic change. Decrease in TBUT correlated positively with Schirmer’s test results decrease. Increase in CCT correlated positively with AXL increase. Decrease in central and average CT correlated positively with IOP decrease. Increase in central MT correlated positively with increase in average MT. Decrease in central CT correlated positively with average CT decrease. Change in VD of the SCP correlated positively with change in VD of DCP. Apart from the positive correlation between SBP change and Schirmer’s test results change, there were no correlations between systemic and ophthalmic parameters changes. Conclusions: Our study showed that HD affected the parameters of the anterior and posterior segments of the eye. Numerous correlations between these changes suggest that they are interrelated and represent the complex response of the eye to the HD process. Full article

Ocular allergy (OA) is a subtype of seasonal allergy that causes symptoms of itchiness, redness, swelling and irritation of the ocular surface and eyelids, often triggering allergy-induced eye rubbing and sustained inflammation for up to six months of the year during peak allergy season. These symptoms, coupled with reduced sleep quality, impaired daily productivity and decreased mood, highlight a significant yet underrepresented disease burden. Recent advances in tear-based multi-omics have enabled detailed characterisation of OA-associated biochemical changes on the ocular surface, highlighting human tears as a promising biospecimen for diagnostic biomarker and therapeutic target research. This review discusses emerging proteomic, lipidomic, metabolomic and miRNA findings comparing OA sufferers with healthy controls, and, where relevant, with comorbid conditions such as dry eye disease and keratoconus. Differential expression patterns across these analytes implicate key pathways involved in immune response, wound healing, angiogenesis, inflammation, oxidative stress and return to homeostasis on the ocular surface. By integrating these data into a stepwise model of OA biopathway activation, this review outlines candidate biomarkers and highlights methodological advances that may support translation of tear multi-omics into clinical tools for OA management. Full article

Background/Objectives: Meibomian gland dysfunction (MGD) has been shown to be more prevalent in patients with keratoconus (KC) in Turkey, Egypt, and Israel but has not been examined in the Palestinian Authority (PA). Therefore, this study compared the prevalence and clinical features of MGD in patients with keratoconus versus healthy controls seen in an optometry clinic in the PA. Methods: Patients with KC and healthy controls who were non-contact lens wearers were recruited. Habitual visual acuity (VA), tear break-up time (TBUT), meibography, meibomian gland (MG) expressibility (MES) and quality score (MQS), and Schirmer test were evaluated. MGD was defined by an Ocular Surface Disease Index (OSDI) Questionnaire score ≥ 13, TBUT < 10 s, and MG loss > Grade 1. Outcomes were compared using Mann–Whitney U tests, Chi-Square tests and Spearman correlation. Results: The study included 33 eyes of 17 KC (mean age: 29.2 ± 7.7, range:19–50) and 27 right eyes of 27 control participants (mean age: 34.2 ± 11.7, range:18–56). MGD was prevalent in 67% of KC and 30% of control participants. VA was significantly worse (0.8 + 0.2 vs. 1.0 + 0.0, p < 0.001), with significantly greater MG loss in the lower eyelids (p = 0.002), and shorter TBUT (4.1 ± 1.5 s vs. 5.7 ± 1.7 s, p < 0.001) in the KC group. No significant differences were found in symptoms, MES, MQS, MG loss in the upper eyelids, or Schirmer test. Conclusions: KC patients exhibited a significantly higher prevalence and severity of MGD signs compared with controls. These findings highlight the importance of comprehensive ocular surface evaluation and management in this population. Full article

Objective: This was a longitudinal study of TCF4 CTG18.1 trinucleotide repeat lengths in 17 patients (27 eyes) diagnosed with Fuchs’ endothelial corneal dystrophy (FECD), and it aimed to correlate the repeat expansion status with disease severity and progression. Design: This was a prospective cohort study looking at FECD clinical progression and TCF4 CTG18.1 repeat length expansion status over time. Methods: A total of 27 eyes from 17 patients diagnosed with FECD were recruited. Only eyes with FECD disease severity of at least Grade 4 on the modified Krachmer clinical grading scale were included; eyes that had previously undergone any form of ocular surgery prior to the first genotyping or during the duration of follow-up were excluded. CTG trinucleotide repeat genotyping was performed on peripheral blood leukocytes at two time points over an average follow-up of 10 years. Over the follow-up period, the FECD progression of each subject was examined using pachymetry, Scheimpflug imaging (Pentacam), and endothelial cell density (ECD) readings, during the baseline visit, yearly thereafter, at the time of repeat CTG18.1 genotyping, and at their latest visit. Main Outcome Measures: The clinical progression of FECD patients was assessed using central corneal thickness (CCT), ECD, and any keratoplasty performed. CTG repeat length was assessed twice over the entire follow-up period. Results: The non-expanded alleles were shown to be stable over the period of follow-up and did not develop any expanded repeats. Repeat expansion did not influence the risk of attaining Threshold Disease, although more patients in the L ≥ 40 group (CTG18.1 repeat sequence of more than or equal to 40 repeats) underwent keratoplasty. Conclusions: Through this study, we found that the CTG18.1 allele lengths of <40 repeats in peripheral blood leukocytes showed minimal change over a 10-year period, and none became an expanded repeat. Hence, a single CTG expansion assessment, performed at any point in a patient’s lifetime, is likely a good representation of genetic risk. Clinicians may use this information to better advise patients on the risk of clinical progression and the best therapeutic strategy. Full article