Search Results (596)

Background/Objectives: We evaluated the clinical features and natural course of treatment-naïve non-exudative macular neovascularization (NE MNV) associated with age-related macular degeneration in Korean patients. Methods: This retrospective longitudinal study of 21 eyes of 21 patients with NE MNV involved a chart review of best corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCT angiography parameters. Results: This study included 13 men (13/21, 61.9%) and 8 women (8/21, 38.1%), with a mean age of 71.5 ± 9.1 years. The average follow-up period was 15.1 ± 11.8 (range 6.0–49.6) months, and 14 eyes (66.7%) demonstrated exudative changes on OCT scans. The baseline BCVA was 0.15 ± 0.18 logMAR. The initial central macular thickness (CMT), subfoveal choroidal thickness, and the outer retinal layer thickness were 265.3 ± 37.1, 245.2 ± 95.2, and 86.6 ± 5.3 μm, respectively. Cox proportional hazards analysis revealed that older age (hazard ratio [HR]: 1.096, 95% confidence interval [CI]: 1.002–1.200; p = 0.045), larger baseline CMT (HR: 1.025, 95% CI: 1.002–1.049; p = 0.035), and larger baseline MNV (HR: 1.618, 95% CI: 1.035–2.529; p = 0.035) were significant risk factors for exudative changes. Conclusions: We observed the clinical features and natural course of NE MNV in Korean patients and identified that significant risk factors for exudative changes in NE MNV included old age, initially thick CMT, and larger MNV size at baseline. For eyes with NE MNV that have risk factors of exudative conversion, more frequent observation is recommended to ensure the appropriate management. Full article

Introduction: Small Bowel Obstruction (SBO) accounts for 15% of emergency department (ED) admissions. While conservative management is recommended, surgery becomes necessary when strangulation is suspected. Identifying which patients need surgery remains a challenge, as traditional imaging lacks sufficient sensitivity and specificity. This study aimed to explore radiomic features to identify potential predictors of strangulation. Methods: This retrospective study included patients admitted to a tertiary referral hospital ED between 2019 and 2023, diagnosed with Adhesion Small Bowel Obstruction (aSBO) via contrast-enhanced abdominal CT scans. Two patient groups were examined: those who underwent surgery with bowel resection and ischemic changes confirmed histologically (operative management—OM) and those successfully treated with conservative management (CM). All CT scans were reviewed blindly by a general surgeon and an experienced radiologist. Pre-obstructive loop segmentation was performed using 3D Slicer software, with slice-by-slice contouring of intestinal borders on images of suspected strangulated bowel. Radiomic features were extracted, followed by univariate and multivariate regression analysis. Results: A total of 55 patients were included: 27 CM and 28 OM. Significant differences emerged in GLCM (Gray Level Co-occurrence Matrix), GLDM (Gray Level Dependence Matrix), GLRLM (Gray Level Run Length Matrix), and GLSZM (Gray Level Size Zone Matrix), particularly involving entropy and uniformity. These metrics reflect subtle variations in gray levels not visible to the naked eye. Conclusions: Differences in entropy, uniformity, and energy align with imaging and histopathological findings, supporting the development of radiomic models and future AI-based prediction tools. Full article

Background and Objectives: The Drosophila retinal determination network comprises the transcription factor Teashirt (Tsh) and the transcription co-regulator C-terminal Binding Protein (CtBP), both of which are essential for normal adult eye development. Both Tsh and CtBP show a pattern of co-expression in the proliferating cells anterior to the morphogenetic furrow that demarcates the boundary between the anteriorly placed proliferating eye precursor cells and the posteriorly placed differentiating photoreceptor cells in the larval eye-precursor tissue, the eye–antennal disc. The disc ultimately develops into the adult compound eyes, antenna, and other head structures. Both Tsh and CtBP were found to interact genetically during ectopic eye formation in Drosophila, and both were present in molecular complexes purified from gut and cultured cells. However, it remained unknown whether Tsh and CtBP molecules could interact in the eye–antennal discs and elicit an effect on eye development. The present study answers these questions. Methods: 5′ GFP-tagging of the tsh gene in the Drosophila genome and 5′ FLAG-tagging of the ctbp gene were accomplished by the CRISPR-Cas9 and BAC recombineering methods, respectively, to produce GFP-Tsh- and FLAG-CtBP-fused proteins in specific transgenic Drosophila strains. Verification of these proteins’ expression in the larval eye–antennal discs was performed by immunohistological staining and confocal microscopy. Genetic screening was performed to establish functional interaction between Tsh and CtBP during eye development. Scanning Electron Microscopy was performed to image the adult eye structure. Co-immunoprecipitation and GST pulldown assays were performed to show that Tsh and CtBP interact in the cells of the third instar eye–antennal discs. Results: This study reveals that Tsh and CtBP interact genetically and physically in the Drosophila third instar larval eye–antennal disc to regulate adult eye development. This interaction is likely to limit the population of the eye precursor cells in the larval eye disc of Drosophila. Conclusions: The relative abundance of Tsh and CtBP in the third instar larval eye–antennal disc can dictate the outcome of their interaction on the Drosophila eye formation. Full article

Opioids are known to constrict pupils, and mobile phone-based self-administered eye scanning (MPSES) offers a potential method for monitoring opioid use in real-world settings. A clinical trial with 12 volunteers measured pupil size using MPSES under different light conditions (approx. 50 or approx. 500 lux) in the lab and over a week at home. Each participant made approximately 21 home tests, 12 in the lab without oxycodone and 16 in the lab after oxycodone intake. At the second visit the participants received a single dose of 20 mg oxycodone, and their pupil size was monitored hourly for 5 h. The pupil size after oxycodone intake was compared to drug-naïve tests performed at the lab and at home. Logistic regression models were built using measured pupil size and light conditions measured by the phone during each test, and a dichotomous variable indicating tests before or after oxycodone dosing as the outcome. The model demonstrated high classification accuracy (AUC = 0.94), with 82% true positives, 9% false positives, 91% true negatives and 18% false negatives. Misclassifications were largely due to difficulties measuring pupil size in individuals with corneal arcus, causing most of the false positive findings, and other interindividual differences. This shows that MPSES, including monitoring of ambient light conditions, can effectively detect opioid use within the 50–500 lux range. Our study paves the way for using MPSES to detect opioid use. Full article

Background/Objectives: Hydroxychloroquine (HCQ) retinopathy can be underrecognized early, as structural changes in OCT may precede symptoms and are often subtle. Early detection is crucial to prevent irreversible damage. This study evaluated longitudinal OCT changes preceding overt HCQ toxicity using ellipsoid zone (EZ) mapping. Methods: Patients on long-term HCQ underwent two macular cube scans at least one year apart using Cirrus HD-OCT. Scans were analyzed with an EZ-mapping platform and manually validated. Patients with baseline OCT signs of toxicity or co-existing macular disease were excluded based on masked expert review. Results: Three hundred and seventy-three eyes of 373 patients were included. The mean age was 57.0 ± 12.6 years, the mean HCQ dose was 379.4 ± 59.4 mg, the treatment duration was 5.6 ± 3.7 years, and the OCT interval was 3.1 ± 0.9 years. Outer retinal metrics remained stable across the cohort. The mean en face EZ attenuation increased from 3.3% to 3.9% (p = 0.24). Thirty-four eyes (9.1%) experienced an absolute increase of ≥4% (~1.5 mm²) in EZ attenuation. This increase was significantly associated with age at HCQ initiation (p < 0.001), age at the time of the first and second OCT (p < 0.001), and baseline visual acuity (p = 0.01), and demonstrated changes in other outer retinal metrics (p < 0.01). Only 3/34 eyes (8.9%) were diagnosed by the managing clinician with HCQ toxicity at the time of the second OCT. However, 26 of these eyes (76.5%) had signs of HCQ toxicity by expert review, suggesting the overall greater sensitivity of these quantitative outer retinal metrics for detecting toxicity compared with clinician review. Conclusions: Longitudinal OCT assessment revealed overall stability in outer retinal metrics in eyes on HCQ, but a subset showed increased EZ attenuation, which correlated with age at the time of HCQ initiation, baseline visual acuity, and expert OCT review. These changes may help identify at-risk eyes and eyes with early toxicity and warrant further validation as potential screening biomarkers. Full article

Artificial intelligence (AI) is revolutionarily shaping the entire landscape of medicine and particularly the privileged field of radiology, since it produces a significant amount of data, namely, images. Currently, AI implementation in radiology is continuously increasing, from automating image analysis to enhancing workflow management, and specifically, pediatric neuroradiology is emerging as an expanding frontier. Pediatric neuroradiology presents unique opportunities and challenges since neonates’ and small children’s brains are continuously developing, with age-specific changes in terms of anatomy, physiology, and disease presentation. By enhancing diagnostic accuracy, reducing reporting times, and enabling earlier intervention, AI has the potential to significantly impact clinical practice and patients’ quality of life and outcomes. For instance, AI reduces MRI and CT scanner time by employing advanced deep learning (DL) algorithms to accelerate image acquisition through compressed sensing and undersampling, and to enhance image reconstruction by denoising and super-resolving low-quality datasets, thereby producing diagnostic-quality images with significantly fewer data points and in a shorter timeframe. Furthermore, as healthcare systems become increasingly burdened by rising demands and limited radiology workforce capacity, AI offers a practical solution to support clinical decision-making, particularly in institutions where pediatric neuroradiology is limited. For example, the MELD (Multicenter Epilepsy Lesion Detection) algorithm is specifically designed to help radiologists find focal cortical dysplasias (FCDs), which are a common cause of drug-resistant epilepsy. It works by analyzing a patient’s MRI scan and comparing a wide range of features—such as cortical thickness and folding patterns—to a large database of scans from both healthy individuals and epilepsy patients. By identifying subtle deviations from normal brain anatomy, the MELD graph algorithm can highlight potential lesions that are often missed by the human eye, which is a critical step in identifying patients who could benefit from life-changing epilepsy surgery. On the other hand, the integration of AI into pediatric neuroradiology faces technical and ethical challenges, such as data scarcity and ethical and legal restrictions on pediatric data sharing, that complicate the development of robust and generalizable AI models. Moreover, many radiologists remain sceptical of AI’s interpretability and reliability, and there are also important medico-legal questions around responsibility and liability when AI systems are involved in clinical decision-making. Future promising perspectives to overcome these concerns are represented by federated learning and collaborative research and AI development, which require technological innovation and multidisciplinary collaboration between neuroradiologists, data scientists, ethicists, and pediatricians. The paper aims to address: (1) current applications of AI in pediatric neuroradiology; (2) current challenges and ethical considerations related to AI implementation in pediatric neuroradiology; and (3) future opportunities in the clinical and educational pediatric neuroradiology field. AI in pediatric neuroradiology is not meant to replace neuroradiologists, but to amplify human intellect and extend our capacity to diagnose, prognosticate, and treat with unprecedented precision and speed. Full article

Introduction: This pilot study aimed to test the feasibility of a novel vectorial image analysis method to quantify coronal microvascular displacement in different retinal plexuses in intermediate age-related macular degeneration (iAMD) over 6 months. Material and methods: A retrospective series of iAMD patients with at least 6-month follow-up was included if they had complete medical records, best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCT angiography (OCTA). En-face (coronal) vascular displacement between baseline and 6 months was assessed in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) using the Farneback motion tracking algorithm applied to consecutive OCTA scans. Results: Eighteen eyes of 18 iAMD patients met the inclusion criteria. Average coronal vascular displacement (T₀–T₆) was 13.7 ± 7.72 µm for the SCP, 15.11 ± 10.06 µm for the DCP, and 19.02 ± 12.25 µm for the CC slab. Reticular pseudodrusen (RPD) was associated with greater displacement in the DCP (p = 0.047), but not in the SCP (p = 0.980) or CC (p = 0.473). Quantitative analysis confirmed the highest DCP displacement in RPD eyes (66.7%, p = 0.02), while drusenoid pigment epithelial detachment showed the greatest reorganization in the CC (100%, p = 0.02). Discussion: Retinal vessels undergo significant tangential displacement in iAMD, suggesting a structural reorganization of the microvasculature. Such remodeling may constitute a compensatory response to ultrastructural alterations resulting in ischemia. Full article

Background and Clinical Significance: Central serous chorioretinopathy (CSCR) and hydroxychloroquine (HCQ) retinopathy can both cause outer retinal changes in systemic lupus erythematosus (SLE) patients treated with HCQ and corticosteroids. Differentiating between transient steroid-induced CSCR and irreversible HCQ toxicity is critical to avoid unnecessary discontinuation of essential therapy. Case Presentation: Three female SLE patients (ages 47, 41, and 37) on long-term HCQ (25, 9, and 6 years, respectively) and recent or ongoing low-dose prednisolone presented with unilateral OCT findings, parafoveal or pericentral photoreceptor defects, with the fellow eye unaffected. Review of clinical history and serial imaging revealed transient subretinal fluid in all cases, associated with recent corticosteroid use or dose escalation. Subsequent tapering or cessation of steroids led to resolution of the fluid, and earlier OCT scans confirmed normal outer retinal morphology, indicating that these changes were residual effects of resolved CSCR rather than HCQ toxicity. In Cases 1 and 2, the best-corrected visual acuity (BCVA) in the affected eye declined from 20/22 to 20/40 during the CSCR episode and improved to 20/30 and 20/25, respectively, after subretinal fluid resolution. In Case 3, by contrast, BCVA remained stable at 20/20 throughout the pre-, during-, and post-CSCR periods. Conclusions: Resolved CSCR can mimic HCQ retinopathy. These cases emphasize the importance of detailed medication history, serial multimodal retinal imaging, and comparison with prior and fellow-eye scans to distinguish resolved CSCR from HCQ retinopathy. Such thorough evaluation and careful differential diagnosis help ensure appropriate management—avoiding unnecessary HCQ discontinuation while protecting both ocular and systemic health. Full article

Schizophrenia is a complex disorder that affects mental organization and cognitive functions, including concentration and memory. One notable manifestation of cognitive changes in schizophrenia is a diminished ability to scan and perform tasks related to visual inspection. From the three evaluable aspects of the ocular movements (saccadic, smooth pursuit, and fixation) in particular, smooth pursuit eye movement (SPEM) involves the tracking of slow moving objects and is closely related to attention, visual memory, and processing speed. However, evaluating smooth pursuit in clinical settings is challenging due to the technical complexities of detecting these movements, resulting in limited research and clinical application. This pilot study investigates whether the quantitative metrics derived from eye-tracking data can distinguish between patients with schizophrenia under treatment and healthy controls. The study included nine healthy participants and nine individuals receiving treatment for schizophrenia. Gaze trajectories were recorded using an eye tracker during a controlled visual tracking task performed during a clinical visit. Spatiotemporal analysis of gaze trajectories was performed by evaluating three different features: polygonal area, colocalities, and direction difference. Subsequently, a support vector machine (SVM) was used to assess the separability between healthy individuals and those with schizophrenia based on the identified gaze trajectory features. The results show statistically significant differences between the control and subjects with schizophrenia for all the computed indexes (p < 0.05) and a high separability achieving around 90% of accuracy, sensitivity, and specificity. The results suggest the potential development of a valuable clinical tool for the evaluation of SPEM, offering utility in clinics to assess the efficacy of therapeutic interventions in individuals with schizophrenia. Full article

Laser beam scanning (LBS) projection systems based on MEMS micromirrors offer advantages such as compact size, low power consumption, and vivid color performance, making them well suited for applications like AR glasses and portable projectors. Among various scanning methods, raster scanning is widely adopted; however, it suffers from artifacts such as dark bands between adjacent scanning lines and non-uniform distribution of the scanning trajectory relative to the original image. These issues degrade the overall viewing experience. In this study, we address these problems by introducing random variations to the slow-axis driving signal to alter the vertical offset of the scanning trajectories between different scan cycles. The variation is defined as an integer multiple of 1/8 of the fast-axis scanning period ($1/{\mathrm{f}}_{\mathrm{h}}$) Due to the temporal integration effect of human vision, trajectories from different cycles overlap, thereby enhancing the scanning fill factor relative to the target image area. The simulation and experimental results demonstrate that the maximum ratio of non-uniform line spacing is reduced from 7:1 to 1:1, and the modulation of the scanned display image is reduced to 0.0006—below the human eye’s contrast threshold of 0.0039 under the given experimental conditions. This method effectively addresses scanning display artifacts without requiring additional hardware modifications. Full article

Understanding human perceptual strategies in high-stakes environments, such as crime scene investigations, is essential for developing cognitive models that reflect expert decision-making. This study presents an immersive experimental framework that utilizes virtual reality (VR) and eye-tracking technologies to capture and analyze visual attention during simulated forensic tasks. A360° panoramic crime scene, constructed using the Nikon KeyMission 360 camera, was integrated into a VR system with HTC Vive and Tobii Pro eye-tracking components. A total of 46 undergraduate students aged 19 to 24–23, from the National University of Singapore in Singapore and 23 from the Central Police University in Taiwan—participated in the study, generating over 2.6 million gaze samples (IRB No. 23-095-B). The collected eye-tracking data were analyzed using statistical summarization, temporal alignment techniques (Earth Mover’s Distance and Needleman-Wunsch algorithms), and machine learning models, including K-means clustering, random forest regression, and support vector machines (SVMs). Clustering achieved a classification accuracy of 78.26%, revealing distinct visual behavior patterns across participant groups. Proficiency prediction models reached optimal performance with a random forest regression ($R^2$ = 0.7034), highlighting scan-path variability and fixation regularity as key predictive features. These findings demonstrate that eye-tracking metrics—particularly sequence-alignment-based features—can effectively capture differences linked to both experiential training and cultural context. Beyond its immediate forensic relevance, the study contributes a structured methodology for encoding visual attention strategies into analyzable formats, offering valuable insights for cognitive modeling, training systems, and human-centered design in future perceptual intelligence applications. Furthermore, our work advances the development of autonomous vehicles by modeling how humans visually interpret complex and potentially hazardous environments. By examining expert and novice gaze patterns during simulated forensic investigations, we provide insights that can inform the design of autonomous systems required to make rapid, safety-critical decisions in similarly unstructured settings. The extraction of human-like visual attention strategies not only enhances scene understanding, anomaly detection, and risk assessment in autonomous driving scenarios, but also supports accelerated learning of response patterns for rare, dangerous, or otherwise exceptional conditions—enabling autonomous driving systems to better anticipate and manage unexpected real-world challenges. Full article

Paired box gene 3 (PAX3) plays an important role in craniofacial development. Mutations in this gene are associated with Waardenburg syndrome, which is a condition characterized by facial anomalies such as widely spaced inner corners of the eyes. PAX3 gene polymorphisms are associated with the relative position of the nasal root (nasion), even among healthy individuals. Facial morphology has primarily been examined using three-dimensional (3D) facial scans of soft tissues, whereas studies focusing on hard tissues remain limited. Therefore, the present study aimed to analyze 3D craniofacial morphology in hard tissues using computed tomography imaging and investigate the influence of PAX3 polymorphisms on the 3D morphology of the nasal root. The analysis was conducted on three populations: 201 healthy Japanese, 74 healthy Korean, and 142 healthy Egyptian individuals. DNA was extracted from saliva samples, and the genotypes of two PAX3 single-nucleotide polymorphisms (SNPs; rs9288572 and rs7559271) were analyzed. A multiple regression analysis of the association between these SNPs and measurements related to nasal root morphology revealed a significant association between rs7559271 and the protrusion angle of the nasion. These findings suggest that PAX3 gene polymorphisms influence the morphological development of the nasal root within the normal range of hard tissues. Full article

To describe a technique for managing acute corneal hydrops in eyes with keratoconus using dome stromal drainage with intracameral air injection under real-time three-dimensional (3D) microscope-integrated optical coherence tomography (OCT) guidance. We describe a retrospective case series of six eyes from six patients with keratoconus who developed acute corneal hydrops. All eyes underwent intracameral air injection with controlled dome puncture for stromal fluid drainage, without the use of sutures. The procedure was performed using a 3D visualization system that enables integrated and simultaneous viewing of the surgical field and intraoperative OCT scan (a 3D digitally assisted visualization system that displayed a split-screen view of the surgical field and OCT cross-sections simultaneously). Postoperative resolution of edema and improvement in clarity were documented. The resolution of corneal edema allowed for subsequent mushroom-shaped penetrating keratoplasty performed with a femtosecond laser in four eyes of four patients. All six eyes showed significant resolution of corneal edema within 2 to 4 weeks. Stromal clefts collapsed rapidly after drainage. In each case, the thick edema was reduced to a confined leucoma. No intraoperative or postoperative complications were observed. All four eyes that underwent a femtosecond laser-assisted mushroom-shaped penetrating keratoplasty showed optimal anatomical and functional success. Air-assisted dome drainage, combined with simultaneous 3D and OCT visualization, is a safe and effective technique for treating acute corneal hydrops. This technology enables real-time decision-making and enhances surgical precision, opening the door to advanced procedures that are otherwise limited by corneal opacity. Full article

Carboxymethyl cellulose (CMC) films, derived from sugarcane bagasse agricultural waste (SCB) incorporated with Betalains-nitrogen-doped carbon dots (Betalains-N–CQDs), derived from beet root waste (BR), offer a sustainable, smart and naked-eye sensor for strawberry packaging due to their excellent fluorescent and shape memory properties. These CMC-Betalains-N–CQDs aim to enhance strawberry preservation and safety by enabling visual detection of common food contaminants such as bacteria, fungi and Pb(II). Crucially, the CMC-Betalains-N–CQD film also exhibits excellent shape memory properties, capable of fixing various shapes under alkaline conditions and recovering its original form in acidic environments, thereby offering enhanced physical protection for delicate produce like strawberries. Optical studies reveal the Betalains-N–CQDs’ pH-responsive fluorescence, with distinct emission patterns observed across various pH levels, highlighting their potential for sensing applications. Scanning Electron Microscopy (SEM) confirms the successful incorporation of Betalains-N–CQDs into the CMC matrix, revealing larger pores in the composite film that facilitate better interaction with analytes such as bacteria. Crucially, the CMC-Betalains-N–CQD film demonstrates significant antibacterial activity against common foodborne pathogens like Escherichia coli, Staphylococcus aureus, and Candida albicans, as evidenced by inhibition zones and supported by molecular docking simulations showing strong binding interactions with bacterial proteins. Furthermore, the film functions as a fluorescent sensor, exhibiting distinct color changes upon contact with different microorganisms and Pb(II) heavy metals, enabling rapid, naked-eye detection. The film also acts as a pH sensor, displaying color shifts (brown in alkaline, yellow in acidic) due to the betalains, useful for monitoring food spoilage. This research presents a promising, sustainable, and multifunctional intelligent packaging solution for enhanced food safety and extended shelf life. Full article

A 51-year-old female presented to the emergency department with vertigo, visual disturbances, involuntary rapid repetitive eye movements, incoordination, and imbalance. Physical examination revealed opsoclonus, myoclonus, and bilateral limb and gait ataxia. Initial workup was negative for intracranial abnormalities, and no abnormalities were noted on blood work or cerebrospinal fluid analysis. Tumor markers were within normal limits. As part of her diagnostic workup, a positron emission tomography (PET) scan was performed, which showed a highly FDG-avid solitary 7 mm left axillary lymph node. Ultrasound-guided percutaneous biopsy revealed metastatic poorly differentiated carcinoma. Histopathological examination could not conclusively distinguish between adenocarcinoma and squamous cell carcinoma. She was diagnosed with seronegative opsoclonus-myoclonus ataxia syndrome of paraneoplastic origin from an occult primary malignancy and started on pulsatile corticosteroids and intravenous immunoglobulin (IVIG), with only moderate symptomatic improvement. Given the anatomic location and immunohistochemical staining pattern of the lymph node, the malignancy was considered as being of primary breast origin. A left axillary lymph node dissection was performed, with 1/12 nodes testing positive for poorly differentiated carcinoma. The patient experienced significant improvement in her neurological symptoms 2–3 days following resection of the solitary malignant lymph node, largely regaining her functional independence. She went on to receive adjuvant radiotherapy to the breast and axilla, as well as adjuvant hormonal therapy. Full article