Delayed Late-Onset Severe Progressive Corneal Flattening: A Complication 9 Years After Corneal Collagen Crosslinking.

Purpose: We describe a case of late visual deterioration with marked progressive corneal flattening 9 years after crosslinking (CXL) was performed using the Dresden protocol.

Case Presentation: This patient with bilateral keratoconus underwent epithelium off crosslinking of the left eye only in 2007. After almost a decade of stability, he developed significant progressive corneal flattening with Descemet and stromal folds without inflammation, and a large hyperopic shift.

Corneal Artificial Endothelial Layer (EndoArt): Literature Review and Our Experience.

: The objective of this study was to examine the morphological corneal changes and outcomes following the implantation of an artificial endothelial layer (EndoArt) in patients with chronic corneal oedema. : A systematic review of the literature was conducted alongside a detailed analysis of two clinical cases with chronic corneal oedema that were treated using EndoArt. Our experience with these two cases is included to provide practical insights and real-world outcomes.

Multimodal imaging and histopathological evaluation in silicone oil keratopathy.

Purpose: To describe features in silicone oil keratopathy using multimodal imaging and histopathological examination.

Methods: Case report.

Result: A 21-year-old male developed right corneal decompensation in the heavy SO (HSO)-filled eye.

Optometrist-delivered selective laser trabeculoplasty in the HES - a training protocol and early service evaluation.

Over the last decade, the delivery of glaucoma care in the UK has changed dramatically, with more non-medical ophthalmic practitioners involved in the care of glaucoma patients. Optometrists and other non-medical professionals are now involved in the delivery of laser treatments in the Hospital Eye Service (HES), but there is currently no standardised national training framework for non-medical clinicians. Moorfields Eye Hospital and UCL's Institute of Ophthalmology have developed and delivered an education and training programme for the delivery of lasers, including Selective Laser Trabeculoplasty (SLT) by non-medical ophthalmic practitioners.

The Orphan Drug for Acanthamoeba Keratitis (ODAK) Trial: PHMB 0.08% (Polihexanide) and Placebo versus PHMB 0.02% and Propamidine 0.1.

Purpose: To compare topical PHMB (polihexanide) 0.02% (0.2 mg/ml)+ propamidine 0.

Correlation of ex vivo and in vivo confocal microscopy imaging of .

Background/aims: The aim of this study was to correlate the various forms of on ex vivo confocal microscopy (EVCM) with in vivo confocal microscopy (IVCM) and findings from cultured positive cases of .

Methods: live, dead and empty cysts, and live trophozoites were prepared in vitro and inoculated into porcine cornea using a sterile 26-gauge needle and examined ex vivo using the Heidelberg Retina Tomograph II/Rostock Corneal Module. IVCM images from 12 cultured positive cases, obtained using the same instrument, were compared with EVCM findings.

The use of in vivo confocal microscopy in fungal keratitis - Progress and challenges.

Fungal keratitis (FK) is a serious and sight-threatening corneal infection with global reach. The need for prompt diagnosis is paramount, as a delay in initiation of treatment could lead to irreversible vision loss. Current "gold standard" diagnostic methods, namely corneal smear and culture, have limitations due to diagnostic insensitivity and their time-consuming nature.

Quantitative and qualitative assessment of anterior segment optical coherence tomography capture of disease state in childhood anterior uveitis.

Background/aims: Anterior segment optical coherence tomography (AS-OCT) assessment of anterior chamber inflammation is an emerging tool. We describe the performance of AS-OCT in a paediatric population.

Methods: A mixed-methods prospective study, using routine clinical assessment as reference standard, and AS-OCT, with Tomey CASIA2 or Heidelberg Spectralis HS1, as index test, with data collected on patient perceptions of imaging.

Machine Learning Algorithms to Detect Subclinical Keratoconus: Systematic Review.

Background: Keratoconus is a disorder characterized by progressive thinning and distortion of the cornea. If detected at an early stage, corneal collagen cross-linking can prevent disease progression and further visual loss. Although advanced forms are easily detected, reliable identification of subclinical disease can be problematic.

Comparison of culture, confocal microscopy and PCR in routine hospital use for microbial keratitis diagnosis.

Aims: To evaluate the sensitivity and specificity of polymerase chain reaction (PCR), in vivo confocal microscopy (IVCM) and culture for microbial keratitis (MK) diagnosis.

Methods: Retrospective review of PCR, IVCM and culture results for MK diagnosis at Moorfields Eye Hospital between August 2013 and December 2014.

Results: PCR results were available for 259 MK patients with concurrent culture for 203/259 and IVCM for 149/259.

Functional and Structural Changes Following Corneal Neurotisation in the Management of Neurotrophic Keratopathy: UK Single Centre Series.

Objective: To report the functional and anatomical outcomes including structural changes in corneal nerve density and morphology using in vivo confocal microscopy (IVCM) after corneal neurotisation in patients with neurotrophic keratopathy (NK), using a sural nerve graft.

Patients And Methods: Prospective study of patients undergoing corneal neurotisation for NK. Functional outcomes were measured through visual acuity, slit-lamp examination of corneal and conjunctival staining, tear production (Schirmer's 1 test), tear film break-up time, tear film meniscus height, quality and osmolarity, central corneal thickness and corneal sensation using Cochet-Bonnet esthesiometry.

The Utility of Corneal Nerve Fractal Dimension Analysis in Peripheral Neuropathies of Different Etiology.

Purpose: Quantification of corneal confocal microscopy (CCM) images has shown a significant reduction in corneal nerve fiber length (CNFL) in a range of peripheral neuropathies. We assessed whether corneal nerve fractal dimension (CNFrD) analysis, a novel metric to quantify the topological complexity of corneal subbasal nerves, can differentiate peripheral neuropathies of different etiology.

Methods: Ninety patients with peripheral neuropathy, including 29 with diabetic peripheral neuropathy (DPN), 34 with chronic inflammatory demyelinating polyneuropathy (CIDP), 13 with chemotherapy-induced peripheral neuropathy (CIPN), 14 with human immunodeficiency virus-associated sensory neuropathy (HIV-SN), and 20 healthy controls (HCs), underwent CCM for estimation of corneal nerve fiber density (CNFD), CNFL, corneal nerve branch density (CNBD), CNFrD, and CNFrD adjusted for CNFL (ACNFrD).

Clinical and confocal imaging findings in congenital corneal anaesthesia.

Background/aims: Congenital corneal anaesthesia (CCA) is an uncommon cause of corneal ulceration in young patients, with a reported poor visual prognosis. We correlated clinical findings in patients with CCA with corneal sub-basal nerve plexus (SBNP) morphology and dendritiform cell density (DCD) on confocal microscopy.

Methods: A prospective, case-control study was conducted at a referral clinic.

Corneal Endothelial Cell Loss after Baerveldt Glaucoma Implant Surgery.

Purpose: To evaluate risk factors for corneal endothelial cell density (ECD) loss after Baerveldt glaucoma implant (BGI) insertion.

Design: Prospective cohort study.

Participants: Seventy-two patients (72 eyes) with glaucoma.

In Vivo Confocal Microscopy Morphologic Features and Cyst Density in Acanthamoeba Keratitis.

Purpose: To correlate in vivo confocal microscopy morphologic features (IVCM-MF) and Acanthamoeba cyst density (ACD) with final best-corrected visual acuity (BCVA) in Acanthamoeba keratitis (AK).

Design: Retrospective cohort study.

Methods: Patient demographics, treatment outcome, and corresponding IVCM-MF performed at the acute stage of infection were analyzed.

Anterior Segment Optical Coherence Tomography Angiography and Optical Coherence Tomography in the Evaluation of Episcleritis and Scleritis.

: To evaluate the feasibility of using anterior segment optical coherence tomography (AS-OCT) and AS-OCT angiography (AS-OCTA) in assessing patients with episcleritis and scleritis.: Degree of vascularity [vessel density index (VDI)], measured with AS-OCTA, and sclera thickness [conjunctiva epithelium (CE), conjunctiva/episclera complex (CEC), and episclera/sclera complex (ESC)], measured with AS-OCT were compared.: A total of 37 eyes (13 episcleritis, 11 scleritis, 13 controls) were analyzed.

In Vitro Evaluation of the Inhibitory Effect of Topical Ophthalmic Agents on Viability.

Purpose: To compare the antimicrobial effect of topical anesthetics, antivirals, antibiotics, and biocides on the viability of cysts and trophozoites in vitro.

Methods: Amoebicidal and cysticidal assays were performed against both trophozoites and cysts of (ATCC 50370) and (ATCC 30461). Test agents included topical ophthalmic preparations of common anesthetics, antivirals, antibiotics, and biocides.

Longitudinal changes in corneal leucocyte density in vivo following transplantation.

Aims: To prospectively evaluate the changes in corneal leucocyte density with in vivo confocal microscopy (IVCM) following transplantation and to determine if leucocyte density post-transplant is an indicator of graft rejection risk.

Methods: IVCM imaging of cornea pre-transplant and post-transplant at 1 week, 1, 3 and 12 months. The changes in leucocyte density associated with diagnosis, vascularisation, type of keratoplasty, topical steroid and immunosuppression treatment, allograft rejection and failure within 4 years post-transplant were analysed.

keratitis: confirmation of the UK outbreak and a prospective case-control study identifying contributing risk factors.

Background/aims: keratitis (AK) is a chronic debilitating corneal infection principally affecting contact lens (CL) users. Studies were designed to test claims that the UK incidence may have increased in 2012-2014 and to evaluate potential causes.

Methods: Annualised incidence data were collected from January 1984 to December 2016.

Comparison of In Vivo Confocal Microscopy, PCR and Culture of Corneal Scrapes in the Diagnosis of Acanthamoeba Keratitis.

Purpose: Acanthamoeba keratitis (AK) is an uncommon but serious corneal infection, in which delayed diagnosis carries a poor prognosis. Conventional culture requires a long incubation period and has low sensitivity. Polymerase chain reaction (PCR) and in vivo confocal microscopy (IVCM) are available alternative diagnostic modalities that have increasing clinical utility.

XEN-45 collagen implant for the treatment of uveitic glaucoma.

Importance: The XEN-45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic glaucoma.

Background: To determine the safety and efficacy of the XEN-45 collagen implant in eyes with uveitic glaucoma.

Design: Exploratory prospective case series.

Use of Corneal Confocal Microscopy to Evaluate Small Nerve Fibers in Patients With Human Immunodeficiency Virus.

Importance: Objective quantification of small fiber neuropathy in patients with human immunodeficiency virus (HIV)-associated sensory neuropathy (HIV-SN) is difficult but needed for diagnosis and monitoring. In vivo corneal confocal microscopy (IVCCM) can quantify small fiber damage.

Objective: To establish whether IVCCM can identify an abnormality in corneal nerve fibers and Langerhans cells in patients with and without HIV-SN.

Prospective Study of the Diagnostic Accuracy of the In Vivo Laser Scanning Confocal Microscope for Severe Microbial Keratitis.

Purpose: To determine the diagnostic accuracy of in vivo confocal microscopy (IVCM) for moderate to severe microbial keratitis (MK).

Design: Double-masked prospective cohort study.

Participants: Consecutive patients presenting to Aravind Eye Hospital, Madurai, India, between February 2012 and February 2013 with MK (diameter ≥3 mm, excluding descemetocele, perforation, or herpetic keratitis).

Changes in corneal aesthesiometry and the sub-basal nerve plexus in benign essential blepharospasm.

Background: The aetiology of blepharospasm remains unclear. There is evidence that the afferent pathway is important, but this area remains under-researched.

Aim: To explore the hypothesis that the afferent arm of the blink reflex is abnormal in blepharospasm by assessing a range of measures of corneal sensory function.