Search Results (123)

Purpose: The aim of this study was to compare the one-year efficacy of three spectacle lens designs, highly aspherical lenslets (HALs), horizontally asymmetric peripheral defocus (HAPD) lenses, and standard single vision lenses (SVLs) in slowing myopia progression in school-aged children. Methods: In this prospective, non-randomized study, 57 children, aged 8–17 years, were grouped based on the type of lenses worn: HAL (n = 16), HAPD (n = 21), or SVL (n = 20). Comprehensive ophthalmologic examinations were performed at baseline, 6 months, and 12 months. Outcome measures included spherical equivalent refraction (SER), spherical refraction (SR), cylindrical refraction (CR), and axial length (AL). Data were analyzed using non-parametric tests with significance set at p < 0.05. Results: All groups showed some progression in SER and AL over 12 months. The HAL group demonstrated the smallest median SER change (−0.3 D), compared to HAPD (−0.5 D) and SVL (−0.4 D), though group differences were not statistically significant (p = 0.111). Axial elongation was significantly lower in the HAL group (0.1 mm, IQR: 0.0–0.2 mm) compared to HAPD and SVL (both 0.2 mm, p < 0.0001). CR remained stable in all groups, with no clinically meaningful changes. The HAPD groups showed no advantages over SVL in any parameter. Conclusions: Among the three lens types studied, HAL lenses were the most effective in reducing both refractive and axial myopia progression over 12 months. These findings support their use as a reliable intervention in pediatric myopia control. Full article

Background/Objectives: This study investigates adaptive changes in long-lasting pattern electroretinogram (PERG) responses in ocular hypertension (OHT) and open-angle glaucoma (OAG) patients, and in healthy subjects. Methods: Sixty consecutive individuals were recruited, including 20 OHT, 20 OAG, and 20 normal subjects. All participants underwent comprehensive ophthalmologic examination, 30–2 perimetry, and retinal nerve fiber layer imaging. Steady-state (7.5 Hz) PERGs were recorded over approximately 2 min, in response to 90% contrast alternating gratings within a large field size. The recordings were acquired into a sequence of 10 averages (packets), lasting 10 s each, following a standardized adaptation paradigm (Next Generation PERG, PERGx). Key outcome measures included PERGx parameters reflecting response amplitude and phase changes over time. Results: The PERGx grand average scalar amplitude, a surrogate of ordinary PERG, was significantly reduced in both OHT and OAG groups compared to normal subjects (p < 0.01). In contrast, minimal adaptation changes were noted in PERGx amplitude among all groups. The PERGx phase exhibited a progressive decline over time, with consistent delays of approximately 20 degrees across all groups. Angular dispersion of the PERGx phase increased significantly in OHT patients compared to normal subjects (p < 0.05). An inverse relationship was observed between PERGx angular dispersion and treated intraocular pressure, specifically in OHT patients. Conclusions: The findings suggest that both OHT and OAG eyes may exhibit temporal abnormalities in PERG adaptation, potentially indicating early dysfunction in retinal ganglion cell activity. Translational Relevance: PERGx phase changes may have significant implications for glaucoma early detection and management. Full article

Background/Objectives: The aim of this study was to evaluate the associations between optical coherence tomography angiography (OCTA)-based retinal vessel diameter (RVD) measurements, with retinal ganglion cell (RGC) function assessed by means of steady-state pattern electroretinography (ssPERG) using ganglion cell layer-inner plexiform layer thickness (GCL-IPLT) measurements and with Humphrey field analyzer (HFA) global indices in glaucoma suspects (GSs). Methods: Thirty-one eyes (20 participants) underwent a comprehensive ophthalmologic examination, ssPERG measurements utilizing the PERGLA paradigm, HFA, optical coherence tomography (OCT), and OCTA. The OCTA scans were processed using ImageJ software, Version 1.53, allowing for measurement of the RVD. Multiple linear regression models were used. Results: After controlling for age, race, central corneal thickness (CCT), and spherical equivalent (SE), a linear regression analysis found that the RVD explained the 4.7% variance in magnitude (Mag) (p = 0.169), 9.2% variance in magnitudeD (MagD) (p = 0.021), and 16.9% variance in magnitudeD/magnitude (p = 0.009). After controlling for age, CCT, and signal strength (SS), a linear regression analysis found that the RVD was significantly associated with the GCL-IPLT measurements (average GCL-IPL, minimum GCL-IPL, superior, superonasal, inferior, and inferonasal sectors) (p ≤ 0.023). An identical regression analysis where the RVD was replaced with the PERG parameters showed a significant association between the MagD and almost all GCI-IPLT measurements. RVD measurements were significantly associated with HFA VFI 24-2 (p = 0.004), MD 24-2 (p < 0.001), and PSD 24-2 (p = 0.009). Conclusions: Decreased RVD measurements were significantly associated with RGC dysfunction, decreased GCL-IPLT, and all HFA global indices in the GSs. Full article

Introduction: Recent technological progress in optical imaging—such as adaptive optics, interferometry and tomography—has greatly improved the resolution of retinal imaging. The ability to capture sequential images over time is particularly valuable for continuous monitoring and assessment of retinal diseases. Methods: This cross-sectional study involved patients with type 2 diabetes mellitus and age-matched controls from the Diabetes and Ophthalmology Department of the Emergency Military Clinical Hospital “Dr. Constantin Papilian” Cluj-Napoca between October 2023 and October 2024. These patients were assessed for inclusion and exclusion criteria and then categorized into two groups: the diabetes group and control group. Each participant underwent a comprehensive ophthalmological examination and retinal evaluation using SS-OCT (Spectralis Heidelberg Engineering, Heidelberg, Germany). The parameters measured included the superficial and deep foveal avascular zones (FAZ) in only one eye for each patient, selected based on image quality. Additionally, each patient underwent quantitative analysis of serum C-reactive protein (CRP) levels. Results: A total of 33 patients (33 eyes) featured, 13 men and 20 women. The DM group showed statistically significant higher results for CRP value compared to healthy subjects (p < 0.001). Also, both superficial and deep FAZ areas were statistically significantly higher for diabetes patients compared to the healthy controls (p < 0.05). The correlation analysis revealed that there was no significant correlation between CRP and either superficial FAZ (p = 0.809) or deep FAZ (p = 0.659). However, a significant positive moderate correlation was found between superficial FAZ and deep FAZ (r = 0.577, p = 0.015). Conclusions: Our findings showed a significantly enlarged FAZ in diabetic patients compared to healthy individuals, highlighting its potential as an early indicator of microvascular alterations in diabetes. While CRP levels were notably elevated in the diabetic group, no significant association was found between CRP and FAZ measurements, suggesting that FAZ changes may occur independently of systemic inflammatory status. Full article

Background and Objectives: Pediatric Sjögren’s syndrome is a rare autoimmune disease with a heterogeneous clinical expression and limited pediatric-specific diagnostic criteria. Ocular involvement often represents an early manifestation, yet it may go unrecognized in children due to poor symptom reporting and the underuse of objective diagnostic tools. This retrospective study evaluated six pediatric patients with Sjögren’s syndrome, integrating systemic and ocular findings with a focus on early immunological and clinical markers. Materials and Methods: All patients underwent ophthalmological assessments, including tear break-up time, Schirmer’s test, and slit-lamp examination. Results: Tear break-up time values consistently indicated tear film instability (mean RE 7.4 ± 2.5 s; LE 7.7 ± 2.3 s), while Schirmer’s test showed greater variability. Slit-lamp examination revealed inhomogeneous tear films in all patients and blepharitis in 66.7%, consistent with Meibomian gland dysfunction. Systemic features included arthralgia, Raynaud’s phenomenon, fatigue, and frequent seropositivity for ANA and anti-SSA/Ro antibodies. Minor salivary gland biopsy confirmed lymphoepithelial sialadenitis in all cases. Conclusions: These findings highlight the importance of combining laboratory and clinical markers with ophthalmological parameters to support an early diagnosis of Sjögren’s syndrome in pediatric patients. Integrating TBUT and slit-lamp evaluation with serological and histopathological data may enhance diagnostic accuracy and guide timely, targeted intervention to prevent long-term complications. Full article

Background: Traumatic optic neuropathy (TON) represents a major cause of vision loss worldwide, and treatment options are limited. Here, we study whether methylene blue (MB), a free radical scavenger, is able to prevent morphological and electrophysiological hallmarks of neuropathy in an animal model of TON. Methods: The left eyes of Wistar rats were subjected to intraorbital nerve crush (IONC) while the right ones were sham operated. The group of rats treated with MB (n = 16) received five intraperitoneal injections with 2.0 mg/kg MB in the 24 h following IONC while the control group (n = 16) received just vehicle (PBS) as a control. Twenty-one days after surgery, scotopic full field (scERG), scotopic oscillatory potentials (OP), photopic full field (phERG) and pattern (PERG) electroretinography were performed for retinal function assessment. Furthermore, the number of cell nuclei in the ganglion cell layer (GCL) was recorded in post mortem histological sections. Results: IONC induced very significant reductions in electrophysiological parameters including scotopic a- and b-wave, OPs, photopic b-wave, PhNR amplitude and N2 amplitude. In addition, it also generated a significant prolongation of the N2 implicit time, indicating a profound impact on retinal function. This was further corroborated by a very significant reduction in the number of neuronal nuclei in the GCL, suggesting an intense loss and functional impairment of retinal ganglion cells. MB treatment was able to prevent, partially or completely, all those parameters, indicating the efficiency of such approach. Conclusions: Since MB is already approved for clinical use and presents a high safety profile, it could be repurposed as a neuroprotective drug for ophthalmological applications once proper phase 2 clinical trials are accomplished. Full article

Background/Objectives: Worldwide, glaucomas are the leading cause of irreversible blindness in adults. On the ocular level, they are fairly well understood; however, the functional and structural changes that occur in the brain have become a subject of great interest lately, mostly owing to improved accessibility and effectiveness of functional magnetic resonance imaging (fMRI). This, coupled with the non-invasive nature of the methodology, has contributed to an ever-growing body of research published on the topic. In this systematic review, we gather, systematize, and compare the results and methodologies reported in the literature, as pertaining to resting-state fMRI brain changes in primary open-angle glaucoma (POAG). Methods: A systematic search in PubMed, Scopus, and Web of Science was carried out, resulting in a total of 290 records identified, with 67 assessed for eligibility and 24 selected for inclusion. Results: The main findings include worse functional parameters in the early visual centers in POAG across all methodologies, reduced functional connectivity between V1 and other parts of the visual cortex, functional aberrations in higher levels of the visual system, predominantly in the ventral stream and in extravisual networks, among others. Moreover, the majority of these changes are shown to be correlated with ophthalmological measurements. Conclusions: Although studies on this matter tend to suffer from a limited sample size and a lack of methodological standardization, we nevertheless manage to present common results and conclusions regarding the effects of POAG on brain function. Full article

(1) Background: Mopeia–Lassa reassortant ML29 virus is an investigational, reassortant virus vaccine for the prevention of Lassa fever caused by Lassa virus (LASV). (2) Methods: The vaccine virus ML29-SF was prepared in Vero cells using a serum-free culture medium under Good Manufacturing Practice. A 2-week repeat dose toxicity study was performed in guinea pigs under Good Laboratory Practice (GLP) regulations to assess the local and systemic toxicological effects. (3) Results: Following an intramuscular (IM) or subcutaneous (SC) injection of 10⁴ PFU of ML29-SF LASV vaccine at the start of the study, with a second dose 15 days later, no toxicological response attributable to the vaccine was observed. Vaccine-related effects were not observed in any in-life or post-mortem parameter evaluated, including clinical observations, injection site observations, body temperature, body weight, food consumption, ophthalmology, immunology, hematology, clinical chemistry, gross anatomical pathology, organ weights, and histopathology. An immunogenic response, as measured by the elicitation of IgG antibodies against major LASV immunogens, nucleocapsid and glycoprotein precursor, was observed in all vaccine-treated animals prior to the booster dose (Study Day 15) which endured through the end of the study (Study Day 42). There was no evidence of viral shedding in any vaccinated animal. (4) Conclusions: Overall, this single-dose vaccine was locally and systemically well tolerated even after a two-dose repeat administration, confirming the high level of safety of ML29-SF vaccination and supporting the future evaluation of this LASV vaccine, including in clinical trials. Full article

Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can provide rich three-dimensional microvascular information of fundus in ophthalmic imaging. However, various imaging artifacts may be generated during OCTA data acquisition and processing, originating from a number of factors such as multiple light scattering, tissue motion, improper device operation and signal processing algorithms. Artifacts can detrimentally affect the qualitative interpretation of clinical pathologies and quantitative evaluation of vasculature parameters. This article firstly introduces the OCTA acquisition process and sources of artifacts, and then describes four different categories of artifacts in detail, mainly including light propagation and signal intensity-related artifacts, tissue motion artifacts, improper operation artifacts, and signal processing-related artifacts. Corresponding methods for the identification and processing of these artifacts are also presented. Furthermore, this article also details some recent progress in leveraging artificial intelligence (AI) technology in the identification and suppression of artifacts, showcasing its potential as a powerful tool in OCTA artifact processing. The development of artifact suppression techniques enables OCTA to reliably evaluate fundus diseases and monitor their progression. This development facilitates broader and deeper applications of OCTA in both research and clinics of ophthalmology. Full article

Background/Objectives: The aim of the current investigation was to assess the short-term changes in retinal-choroidal vasculature and the morphological complexity of non-exudative macular neovascularization (NE-MNV) using optical coherence tomography angiography (OCTA) and spectral-domain optical coherence tomography (SD-OCT). Methods: Sixteen eyes of 12 patients with NE-MNV underwent baseline and six-month follow-up examinations, including comprehensive ophthalmological assessment and imaging. Central macular thickness, foveal avascular zone, vessel density, flow area, and choroidal vascularity index were analyzed. NE-MNV morphology was quantitatively assessed for area, vessel characteristics, and fractal dimensions. Results: Significant changes in NE-MNV morphology were noted over six months, especially in fractal dimensions, vessel junctions, and vessel length (p-values: 0.01, 0.037, and 0.036, respectively). While there was an increase in the NE-MNV area, it did not reach statistical significance. No significant changes were shown regarding the standard SD-OCT and OCTA output parameters or choroidal measurements. Conclusions: The increase in NE-MNV fractal dimensions suggests rising complexity in the neovascular network and may indicate possible implications for clinical management. The correlation between baseline and follow-up measures underscores a trend toward complexity, pointing to the necessity for closer monitoring of patients with higher NE-MNV fractal dimensions. Full article

Background: Several imaging studies have confirmed ocular involvement in systemic sclerosis (SSc). However, elastography has not yet been used for this purpose in the literature. Thus, this study aimed to evaluate ocular involvement in SSc using shear wave elastography (SWE). Methods: This study included 29 SSc patients and 30 age- and sex-matched healthy controls. All participants underwent independent ophthalmological evaluations by two ophthalmologists. Subsequently, SWE was used to evaluate the retina–choroid–sclera (RCS), optic disc (OD), optic nerve (ON), and retrobulbar adipose tissue (RBFT) of the right eye. The median shear wave elasticity (kPa) and velocity (m/s) values were automatically calculated using the ultrasound device’s integrated software. Results: The elasticity and velocity values of RBFT in SSc patients were significantly higher than those in the control group. However, no notable differences were observed in other analyzed areas. A strong association was found between digital ulcers and velocity values of the RCS, while no significant differences were noted for other parameters. Conclusions: This study revealed increased stiffness in the RBFT of SSc patients. To our knowledge, this is the first evidence suggesting that SSc can affect RBFT. Further studies are required to confirm this finding and investigate its link to the disease. Additionally, we found a strong association between digital ulcers and increased RCS stiffness. Using SWE for the first time, we have demonstrated that microcirculatory disruption in SSc extends beyond the skin and can affect multiple tissues simultaneously. Full article

Background/Aim: Among NF1-dependent tumors, the most common are optic pathway gliomas (OPGs). The objective of this study was the retrospective analysis of the course, indications for treatment, and effects of therapy for NF1-OPGs. Patients and Methods: We analyzed demographics, clinical and genetic data, imaging and ophthalmological parameters, their impact on therapeutic decisions, and the effectiveness of the therapy in 92 patients. Results: OPGs were unilateral in 55.4% of patients and bilateral in 44.6%. Post-contrast enhancement in MRI was observed in 67.4%. Oncological treatment was required in 16.3% of patients with median age 3.8 years. Factors significant in multivariate analysis contributing to the need of oncological treatment were: amblyopia and proptosis. Factors contributing to amblyopia were: strabismus, proptosis, co-occurrence of epilepsy, bilateral OPGs, and thickness of the optic nerve ≥ 8 mm. The first line of oncological treatment included vincristine + carboplatin or monotherapy with vinblastine. The use of subsequent lines of oncological treatment was necessary in 46.7% patients. Conclusions: The following conclusions, suggest modification of the approach in the management of patients with NF1-OPG, summarize the presented study: (1) perform the first MRI after the age of 1 year, (2) reduce the frequency of follow-up scans in the first year of observation in patients with isolated involvement of intraocular and/or intraorbital segments of the optic nerve, (3) refrain from administering contrast during control MRI examinations of the orbits after OPG diagnosis; (4) in patients with co-occurring psychomotor delay or treated with antiepileptic drugs, do not make decisions about oncological therapy when visual acuity deterioration is observed, without progression in optical coherence tomography (OCT), visual evoked potentials (VEP), and MRI. Full article

The measurement of electrical potentials in the human body is becoming increasingly important in healthcare as a valuable diagnostic parameter. In ophthalmology, while these signals are primarily used to assess retinal function, other applications, such as recording accommodation-related biopotentials from the ciliary muscle, remain poorly understood. Here, we present the development and evaluation of a novel implantable ring electrode for recording biopotentials from the ciliary muscle. Inspired by capsular tension rings, the electrode was fabricated using laser cutting, wiring, and physical vapor deposition coating. The constant impedance and weight over a simulated aging period of 391 days, demonstrated the electrode’s stability. In vivo testing in non-human primates further validated the electrode’s surgical handling and long-term stability, with no delamination or tissue ingrowth after 100 days of implantation. Recorded biopotentials from the ciliary muscle (up to 700 µV) exceeded amplitudes reported in the literature. While the results are promising, further research is needed to investigate the signal quality and origin as well as the correlation between these signals and ciliary muscle activity. Ultimately, this electrode will be used in an implanted device to record ciliary muscle biopotentials to control an artificial lens designed to restore accommodation in individuals with presbyopia. Full article

Background/Objectives: Childhood obesity is a significant health concern also capable of impacting ocular health. This study evaluates the effects of childhood obesity on corneal morphology, anterior chamber parameters, intraocular pressure (IOP), and corneal endothelial cell morphology. Understanding these relationships may contribute to early diagnosis and management strategies. Methods: This prospective, cross-sectional study was conducted at the Harran University Faculty of Medicine between January and December, 2024. Ninety children aged 7–17 years were included, with only the right eyes being analyzed. The participants were categorized into three groups based on body mass index (BMI) percentiles: normal weight (≤85th percentile), overweight (86–94th percentiles), and obese (≥95th percentile). All participants underwent comprehensive ophthalmological examinations, including IOP measurement with a non-contact tonometer, corneal topography assessment using a Scheimpflug camera, and endothelial cell morphology evaluation via specular microscopy. Results: IOP was significantly higher in the overweight and obese groups (p < 0.001). Central corneal thickness (CCT) also increased significantly in these groups (p < 0.05). Positive correlations were determined between BMI and IOP (r = 0.493, p < 0.001) and CCT (r = 0.345, p < 0.001). Additionally, waist circumference exhibited a strong correlation with BMI (r = 0.905, p < 0.001) and a significant association with IOP (r = 0.463, p < 0.001). No significant differences were observed among the groups in terms of other anterior chamber or endothelial parameters. Conclusions: Childhood obesity is associated with increased IOP and CCT, suggesting potential alterations in corneal biomechanics and ocular physiology. These findings highlight the importance of routine ophthalmological evaluation in obese children to detect early ocular changes and prevent long-term complications. Full article

Background: Rhegmatogenous retinal detachment (RRD) is an ophthalmological emergency that can lead to vision loss if left untreated. Pars plana vitrectomy (PPV) is the preferred procedure for most complex RRD cases with a high success rate. However, certain parameters related to the patient, disease history, or ocular presentation may influence surgical outcomes. Methods: A systematic review of studies from 2010 to 2023 was conducted using PubMed/Medline (National Library of Medicine, Bethesda, MD, USA) and Scopus (Elsevier, Netherlands). The main objective of this review is to present the most significant data published in the scientific literature over the last 10 years, focusing on the latest implications of prognostic factors affecting the success of PPV in RRD. The search included terms such as “prognostic factors”, “visual outcome”, “functional outcome”, and “rhegmatogenous retinal detachment”. The database search returned 3489 studies. The included studies had to involve participants with RRD treated mainly by PPV, a minimum of 10 participants, and at least a 6-month follow-up period. Studies were excluded if they involved patients with previous PPV treatment or trauma. After reviewing their abstracts, titles, and applying the exclusion criteria, 19 articles were selected. Because it is an ample and interesting topic, many authors explored the connection between prognostic factors involved in the management of RRD and the final visual and functional outcomes. Methodological quality was assessed using PRISMA guidelines. Results: various factors have been studied, ranging from classic ophthalmological parameters, such as refractive error, axial length, lens status, visual acuity, duration of symptoms, description of the RRD, and retinal tears, to more complex findings on optical coherence tomography. Conclusions: The factors that significantly influenced postoperative prognosis in RRD included preoperative best-corrected visual acuity (BCVA), duration of symptoms, macular status (on/off), extent of retinal detachment, presence of macular hole, and proliferative vitreoretinopathy (PVR). Disruption of the ellipsoid zone (EZ), presence of epiretinal membrane (ERM), and lack of external limiting membrane (ELM) integrity were associated with poorer outcomes following RRD surgery. Full article