Search Results (518)

Background/Objectives: Penetrating intraocular foreign bodies (IOFBs) are ocular emergencies, often leading to preventable vision loss. This case report highlights a unique presentation of a work-related penetrating IOFB that mimicked a golden hypopyon. Methods: A 35-year-old male presented to the emergency department with sudden-onset pain and vision loss in the left eye while he was cutting a tree with metallic scissors. He had a visual acuity of 20/30 in the right eye and counting fingers in the left eye. A dilated slit-lamp examination and CT scan confirmed the presence of a 6–8 mm metallic IOFB in the anterior chamber, with no involvement of the lens or the posterior segment. Surgical removal was performed. Results: The metallic IOFB was removed surgically with IOFB forceps using a single paracentesis. The patient reported resolving pain and regained baseline visual acuity of 20/20 postoperatively, which remained stable at one-month follow-up. Conclusions: This case illustrates the successful surgical management of a penetrating metallic IOFB with a unique presentation mimicking a hypopyon. Emphasis on unique presentations of IOFBs can aid in timely management, ultimately reducing the risk of complications. Full article

Multiple Sclerosis (MS) is a chronic neurological disorder affecting the central nervous system that significantly impairs postural control and functional abilities. Robotic-assisted gait training mitigates this functional deterioration. This preliminary study aims to investigate the effects of a four-week gait training with the ExoAtlet II exoskeleton on static balance control and functional mobility in five individuals with MS (Expanded Disability Status Scale ≤ 2.5). Before and after the training, they were assessed in quiet standing under Eyes Open (EO) and Eyes Closed (EC) conditions and with the Timed Up and Go (TUG) test. Center of Pressure (CoP) Sway Area, Antero–Posterior (AP) and Medio–Lateral (ML) CoP displacement, Stay Time, and Total Instability Duration were computed. TUG test Total Duration, sit-to-stand, stand-to-sit, and linear walking phase duration were analyzed. To establish target reference values for rehabilitation advancement, the same evaluations were performed on a matched healthy cohort. After the training, an improvement in static balance with EO was observed towards HS values (reduced Sway Area, AP and ML CoP displacement, and Total Instability Duration and increased Stay Time). Enhancements under EC condition were less marked. TUG test performance improved, particularly in the stand-to-sit phase. These preliminary findings suggest functional benefits of exoskeleton gait training for individuals with MS. Full article

This study aimed to evaluate the impact of preoperative anti-VEGF injections on pars plana vitrectomy (PPV) outcomes in patients with proliferative diabetic retinopathy (PDR). Material and methods: We analysed 232 eyes with proliferative diabetic vitreoretinopathy treated with posterior vitrectomy. There were 112 women and 120 men. The patients were divided into two groups of 116 eyes each. In 116 eyes (study group), an anti-VEGF injection was administered 3 to 5 days before vitrectomy. The control eyes were not injected with anti-VEGF due to systemic contraindications to anti-VEGF treatment or lack of patient consent. All participants underwent pars plana vitrectomy with silicone oil injection. The oil was removed within 2–3 months after PPV. Results: At 2 years of observation, after removal of silicone oil, visual acuity (VA) was 0.24 ± 0.27 logMAR in the study and 0.37 ± 0.45 logMAR in the control group (p = 0.003). Intraocular pressure was 16.84 ± 6.25 mmHg in the study group and 17.78 ± 6.22 mmHg in the control group (p = 0.04). The mean duration of surgery was 47.62 ± 9.87 and 50.05 ± 9.41 min in the study and control groups, respectively (p = 0.02). The size of intraoperative haemorrhage was 0.97 ± 0.86 dd in the study group and 1.51 ± 1.22 dd in the control group (p = 0.003). The frequency of surgery-induced retinal breaks was 0.34 ± 0.56 in the study group and 0.56 ± 0.76 in the control group (p = 0.003). The recurrence rate of retinal detachment was 0.05 ± 0.22 in the study group and 0.1 ± 0.31 in the control group (p = 0.15). Conclusions: Preoperative anti-VEGF therapy shortens the duration of surgery, reduces complications, and improves long-term outcomes in terms of visual acuity and maintenance of normal eye function. Full article

This paper provides a brief review of the genus Trichorondonia Breuning, 1965. A new species, Trichorondonia wenkaii sp. nov. (文凯毛郎氏天牛), is described and illustrated. Trichorondonia kabateki Viktora, 2024 is newly recorded in Hubei province, with the first description of the male. Additionally, photographs of the holotypes of three previously described species are presented. A key to the four species is given. The new species differs from T. pilosipes and T. hybolasioides in having elytra with rounded lateral apical angles and a vertex with blackish-brown pubescence medially behind the eyes. The new species can also be easily distinguished from T. kabateki by the antennae being ventrally fringed with sparse hairs only on segments 1–8, the greyish-yellow pubescence on the pronotum being unevenly distributed and particularly sparse in the posterior half, the elytra having rather thin greyish-yellow pubescence and hardly visible greyish-white pubescence, elongated blackish-brown spots on the elytral longitudinal carinae, and a small tuft of black setae at the centre of the elytral base where there is no obvious tubercle. The type specimen of the new species was collected in Dianping village, Xinhua town, Leye county, Guangxi Zhuang Autonomous Region of China, and deposited at Insect Collection, College of Agriculture, Yangtze University, Jingzhou, Hubei, China (ICYZU). Full article

Background: The retina, a light-sensitive tissue of the central nervous system that is located at the posterior part of the eye, is particularly vulnerable to alterations in oxygen levels. In various retinal diseases, such as central retinal vein occlusion, glaucoma, and diabetic retinopathy, hypoxia (a condition of low oxygen levels) is commonly observed. Müller glia, the principal glial cells in the retina, play a crucial role in supporting the metabolic needs of retinal neurons. They are also responsible for sensing oxygen levels and, in response to hypoxia, express Hypoxia-Inducible Factor 1 (HIF-1), a transcription factor that activates signaling pathways related to hypoxia. Methods: In this study, primary rat Müller glial cells were cultured and exposed to a 1% oxygen for 72 h. Following this, immunohistochemical assays were conducted to assess the effects of hypoxia on various parameters, including HIF-1α expression, cell survival, Müller glia-specific markers (CRALBP and GS), gliosis (GFAP expression), apoptosis (caspase-3 expression), cell proliferation (Ki-67 expression), and metabolic stress (indicated by the number of mitochondria per cell). Results: Under hypoxic conditions, a decrease in Müller glial survival and proliferation was observed. Conversely, there was an increase in HIF-1α expression, GFAP expression, caspase-3-positive cells, and the number of mitochondria per cell. However, no significant changes were noted in the expression of the Müller glial markers GS and CRALBP. Conclusions: In conclusion, hypoxia resulted in reduced proliferation and survival of Müller glial cells, primarily due to increased apoptosis and heightened metabolic stress. Full article

Corneal sensitivity is an important indicator of corneal health and innervation. Corneal hypoesthesia may be an early indicator of corneal diseases such as neurotrophic keratopathy. Various instruments have been used to measure corneal sensitivity, the first being the Cochet–Bonnet aesthesiometer. Over the years, new devices employing different stimuli have been developed, such as the gas-based Belmonte aesthesiometer, the Swiss liquid-jet aesthesiometer, and the most recently released corneal Brill aesthesiometer. In this review, the progress and advancement of aesthesiometers since their introduction is described. The mechanism, advantages, and disadvantages of these aesthesiometers are discussed and compared. We also report the relationship between corneal sensitivity and corneal innervation in various conditions, including diabetes mellitus, Fuchs’ endothelial dystrophy, dry eye disease, glaucoma, keratoconus, herpes simplex keratitis, post-refractive surgery, and ocular graft-versus-host disease. Through this review, we aim to highlight the importance of the assessment of corneal sensitivity and innervation in the diagnosis, treatment, and monitoring of anterior and posterior segment ocular disorders. Full article

Background: Topical statin therapy holds promise for ocular diseases, such as age-related macular degeneration, but the effective delivery to the posterior segment is limited by poor aqueous solubility, chemical instability, and ocular barriers. Cyclodextrins (CDs) can enhance statin solubility and stability; however, the behavior of CD–statin complexes in aqueous eye drops—particularly their influence on the equilibrium between the inactive lactone (ring closed) and active hydroxyacid forms (ring open)—remains unclear. This study aimed to (i) investigate how 5% and 10% (w/v) concentrations of selected CDs affect the lactone/acid equilibrium of simvastatin and atorvastatin and (ii) define formulation parameters (statin form, CD type and concentration, and pH range) for stable eye drop development. Methods: Simvastatin or atorvastatin was added to buffered solutions (pH 2.0 to pH 9.5) of RMβCD, HPβCD, γ-CD, or SBEβCD at 0%, 5%, and 10% (w/v), incubated at 23 ± 1 °C, and sampled over time for UPLC quantification of lactone and hydroxyacid forms, and rate constants for the forward and reverse reaction were calculated. Phase solubility studies were also conducted to further characterize equilibrium behavior in aqueous CD systems. Results: The lactone form was most stable at a pH of 4.5, while the hydroxyacid form prevailed at a pH ≥ 7. γ-CD and HPβCD accelerated lactone hydrolysis for both statins, whereas RMβCD exerted a stabilizing effect. Increasing the CD concentration from 5% to 10% provided minimal additional stabilization. Conclusions: These findings highlight that the precise control of the pH, an appropriate cyclodextrin choice, and the selection of the statin form are critical to developing chemically stable eye drops. Full article

Background: The biomechanical properties of ocular tissues are critical to physiological processes that span ocular development, aging, and disease. The structural integrity of these tissues is important in mediating how the eye responds to strain and stress that pose challenges to physiological homeostasis. In the posterior segment, the peripapillary sclera and lamina separate the intraocular chamber and the fluid-filled subarachnoid space. Degradation of each contribute to pathogenic progression in multiple conditions and are largely determined by the integrity and architecture of collagen fibers, especially type I collagen. Methods: We used atomic force microscopy to measure how stress induced by elevations in intraocular pressure impacts stiffness of the peripapillary sclera and glial lamina in the rat eye and whether changes in stiffness could be influenced by topical treatment of a reparative mimetic of type I collagen. Results: Four weeks of elevated intraocular pressure reduced Young’s modulus in peripapillary sclera and glial lamina, coincident with reduced anterograde transport along the optic projection to the brain. Reduction in tissue stiffness correlated with an increase in fragmented collagen. Topical application of collagen mimetic peptide during the period of elevation countered both. Conclusions: Collagen remodeling occurs in many ocular conditions that influence the peripapillary sclera and glial lamina, including glaucoma and myopia. Our results suggest that topical application of collagen mimetic peptides that intercalate with and repair collagen damaged by disease processes could serve to mitigate changes in tissue stiffness and integrity due to degraded collagen. Full article

Background/Objectives: This study assessed the reliability of the Barrett True-K formula in patients who had undergone laser-based corneal refractive surgery by comparing outcomes using measured vs. predicted posterior corneal astigmatism (PCA) within the Barrett True-K No History formula. Methods: We selected 49 eyes out of 41 patients with a history of uncomplicated laser visual correction (LVC) that underwent cataract surgery between 2020 and 2024. The Front K1 and K2, the Back K1 and K2, the anterior chamber depth, the lens thickness, the horizontal white-to-white, and the central corneal thickness were measured using Pentacam. The axial length was measured using the IOL Master 500 or NIDEK AL-Scan. These data were then imported into the freely available online Barrett True-K calculator for post-LVC eyes, and the postoperative results were compared with the predicted IOL target. The cumulative distribution of the refractive prediction error, absolute refractive prediction error, and refractive prediction error were calculated as the difference between the postoperative spherical equivalent and the expected spherical equivalent for both the predicted and measured PCA calculations. Results: The results suggest improved accuracy with the Barrett True-K formula when incorporating measured PCA values, supporting the use of corneal tomography for optimized refractive outcomes in post-LVC cataract patients. Conclusions: It is always advisable to measure the posterior corneal surface using corneal tomography in all patients who have undergone LVC to achieve better refractive outcomes after cataract surgery. Full article

Background and Objectives: Descemet stripping automated endothelial keratoplasty (DSAEK) is a widely used surgical technique for treating corneal endothelial dysfunctions such as Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). This study aimed to investigate the association between postoperative visual acuity and various corneal morphological and optical parameters, including corneal densitometry (CD) and higher-order aberrations (HOAs), measured using the Pentacam (OCULUS Optikgeräte GmbH, Wetzlar, Germany), as well as graft thickness, which was assessed by anterior segment optic coherence tomography (AS-OCT), (Optovue Inc., Fremont, CA, USA), and corneal thickness, assessed by both AS-OCT and Pentacam. Materials and Methods: This prospective, observational cohort study included 17 eyes from 13 patients who underwent DSAEK. Data on preoperative visual acuity were collected, while postoperative parameters were assessed during follow-up visits. Corneal measurements included the total corneal and corneal graft thickness, corneal densitometry in 20 defined subregions, and corneal higher-order aberrations. Associations between these parameters and postoperative visual acuity were evaluated using nonparametric statistical tests. Results: The postoperative visual acuity improved significantly (p < 0.001). Strong correlations were found between poorer visual acuity and higher CD values. The strongest correlations with visual acuity were found for CD 2–6 mm total (Rho = 0.795; p < 0.001), CD central 2–6 mm (Rho = 0.791; p < 0.001), and CD central 0–2 mm (Rho = 0.730; p < 0.001). Significant associations were also observed with anterior and posterior HOAs (Rho = 0.624, p = 0.01; and Rho = 0.556, p = 0.02, respectively). No correlation was found between visual outcomes and graft thickness measured by AS-OCT (Rho = 0.051; p = 0.85), nor with total corneal thickness measured by AS-OCT (Rho = −0.227; p = 0.38) or Pentacam (Rho = −0.369; p = 0.14). Conclusions: This study demonstrates that CD and HOAs are more strongly associated with postoperative visual acuity after DSAEK than traditionally monitored parameters such as graft or corneal thickness. The results highlight the value of detailed corneal imaging and support the use of advanced optical diagnostics in postoperative evaluation. Full article

Background: Uveitis encompasses a broad group of diseases with infectious and non-infectious etiologies, potentially leading to permanent and irreversible visual impairment. This study aimed to determine whether the etiology and anatomical location of uveitis influence the course and laterality of the disease. Methods: This retrospective observational study included patients with uveitis treated at the University Eye Clinic of “St. George” University Hospital in Plovdiv, Bulgaria, between January 2011 and December 2023. All participants underwent a comprehensive eye examination and minimal laboratory screening, with additional tests and specialist consultations performed when necessary. Uveitis cases were categorized into anterior, intermediate, posterior, and panuveitis according to anatomical location; unilateral or bilateral according to laterality; and acute, chronic, or recurrent based on disease course. Results: The study included 606 patients aged between 3 and 87 years. The etiology and anatomical location of uveitis were significantly associated with the course and laterality of the disease (p < 0.001). Anterior and posterior uveitis were mostly unilateral, with a defined cause and characterized by acute or recurring progression. Intermediate uveitis was mostly idiopathic and chronic, while panuveitis had a more uniform distribution regarding disease progression. Among cases with a determined etiology, HLA-B27-associated uveitis was the most common (32.5%), characterized by sequential involvement of both eyes and a recurrent course. Viral and toxoplasmic uveitis were more frequently unilateral. Conclusions: Our findings indicate that the etiology and anatomical location of uveitis can serve as prognostic factors for contralateral eye involvement and the progression of the inflammatory process. We found that anterior and posterior uveitis were predominantly unilateral and typically presented with an acute or recurrent course, whereas intermediate uveitis and panuveitis were more commonly chronic. In men, uveitis more often had an acute onset, while in women, it tended to follow a chronic course. Full article

Introduction: This study aimed to determine the frequency of posterior vitreous detachment (PVD) in dry and wet age-related macular degeneration (AMD) patients compared with healthy eyes via ultrawide field optical coherence tomography (UWF–OCT). Additionally, the retinal thicknesses in the central and peripheral zones of AMD patients and the control group were compared. Methods: We included 123 eyes from 83 participants with dry AMD, 123 from 87 participants with wet AMD, and 85 from 53 healthy controls. All three study groups were compared according to age, sex, best corrected visual acuity (BCVA), PVD stage, axial length, and retinal thickness in the central, perifoveal, and peripheral zones. Additional analyses included correlations between the BCVA and PVD stage and between retinal thickness and the PVD stage. Results: Complete separation of the vitreous from the macula was significantly more common in AMD patients than in the control group, as noted in 47 eyes (55.29%) in the control group, 92 eyes (74.80%) in the wet AMD group, and 93 eyes (75.61%) in the dry AMD group. The PVD stage did not significantly influence retinal thickness. BCVA in AMD patients did not correlate with the PVD stage. Conclusions: Complete PVD is more common in AMD patients than in healthy controls, as evaluated by UWF–OCT. No relationship between the PVD stage and AMD type or BCVA was observed. Full article

Purpose: Pickleball, the fastest-growing sport in the United States, has seen a rapid increase in participation across all age groups, particularly among older adults. However, the sport introduces specific risks for ocular injuries due to the unique dynamics of gameplay and the physical properties of the pickleball. This study aims to explore the mechanisms of pickleball-related eye injuries, utilizing finite element modeling (FEM) to simulate ocular trauma and better understand injury mechanisms. Methods: A multi-modal approach was employed to investigate pickleball-related ocular injuries. Finite element modeling (FEM) was used to simulate blunt trauma to the eye caused by a pickleball. The FEM incorporated detailed anatomical models of the periorbital structures, cornea, sclera, and vitreous body, using hyperelastic material properties derived from experimental data. The simulations evaluated various impact scenarios, including changes in ball velocity, angle of impact, and material stiffness, to determine the stress distribution, peak strain, and deformation in ocular structures. The FEM outputs were correlated with clinical findings to validate the injury mechanisms. Results: The FE analysis revealed that the rigid, hard-plastic construction of a pickleball results in concentrated stress and strain transfer to ocular structures upon impact. At velocities exceeding 30 mph, simulations showed significant corneal deformation, with peak stresses localized at the limbus and anterior sclera. Moreover, our results show a significant stress applied to lens zonules (as high as 0.35 MPa), leading to potential lens dislocation. Posterior segment deformation was also observed, with high strain levels in the retina and vitreous, consistent with clinical observations of retinal tears and vitreous hemorrhage. Validation against reported injuries confirmed the model’s accuracy in predicting both mild injuries (e.g., corneal abrasions) and severe outcomes (e.g., hyphema, globe rupture). Conclusions: Finite element analysis provides critical insights into the biomechanical mechanisms underlying pickleball-related ocular injuries. The findings underscore the need for preventive measures, particularly among older adults, who exhibit age-related vulnerabilities. Education on the importance of wearing protective eyewear and optimizing game rules to minimize high-risk scenarios, such as close-range volleys, is essential. Further refinement of the FEM, including parametric studies and integration of protective eyewear, can guide the development of safety standards and reduce the socio-economic burden of these injuries. Full article

Background and Objectives: Gait and posture alterations are reported in patients with diabetic foot. We evaluated whether gait and postural parameters are associated with a well-known parameter, e.g., glycated hemoglobin levels in blood, and the salivary markers 1,5-anhydro-D-glucitol (1,5-AG) and Advanced Glycation End-Products (AGEs) measured in saliva samples. Materials and Methods: Gait and postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated hemoglobin concentration and fasting glycemia. The salivary concentration of 1,5-AG and AGEs was measured using an enzyme-linked immunosorbent assay. Results: Eighty-five patients were evaluated, revealing significant associations (p < 0.05) between salivary 1,5-AG and sway path displacement along the medio-lateral axis (rho = 0.365, p = 0.017) and sway area (rho = 0.334, p = 0.031) during tandem position tests with eyes closed. Salivary AGEs were significantly associated with sway path displacement along the anterior–posterior axis (rho = 0.419, p = 0.004) and medio-lateral axis (rho = 0.436, p = 0.002) in the tests performed with eyes closed, feet close together, and foam pads, as well as with sway area (rho = 0.387, p = 0.007). The concentration of HbA1c was significantly correlated with sway path displacement along the anterior–posterior axis in the tests performed with eyes closed, feet close together, and foam pads (rho = 0.236, p = 0.043), as well as with sway area (rho = −0.236, p = 0.043). A significant difference was observed in the salivary AGE concentration between patients with previous ulcers versus those without (p = 0.035). By applying Bonferroni correction for multiple comparisons, the associations remained significant (p < 0.05) for AGE concentration in saliva and postural instability parameters. Conclusions: The results suggest a link between salivary glycemic control biomarkers, in particular AGEs and postural changes in patients with diabetic foot, indicating a new interesting filed for further studies on fall risk. Full article

Purpose: This study aimed to refine the criteria for EndoART implantation regarding posterior corneal irregularity; to improve the selection of candidates for this synthetic alternative to endothelial keratoplasty. Methods: This study analyzed the impact of posterior corneal surface elevation differences; anterior chamber depth (ACD); and preoperative corneal pachymetry on the success of EndoART implant adhesion. Patients undergoing EndoART implantation at the Medical University of Vienna were assessed using OCT to measure corneal irregularities. Postoperative outcomes, including re-bubbling rates; implant adhesion; and visual acuity changes, were monitored. Results: EndoART successfully adhered in eyes with moderate posterior irregularities (elevation differences up to 204 µm). Severe irregularities (elevation differences > 200 µm) resulted in implant detachment. No significant correlation was found between corneal pachymetry or ACD and adhesion failure. Glaucoma devices and prior penetrating keratoplasty did not significantly affect adhesion. Some cases required re-bubbling, and patients reported pain reduction and moderate improvements in visual acuity. Conclusions: This study found that EndoART implantation can be successful despite posterior corneal irregularity. EndoART represents a viable solution for patients with poor biological graft survival prognosis, including those with glaucoma or prior surgeries, expanding its potential use and addressing the global donor cornea shortage. Full article