Choroidal biopsies; a review and optimised approach.

The majority of choroidal tumours are diagnosed accurately with clinical examination and the additional data obtained from non-invasive imaging techniques. Choroidal biopsies may be undertaken for diagnostic clarity in cases such as small melanocytic or indeterminate lesions, identifying the primary tumour in the case of choroidal metastases or the subclassification of rarer conditions such as uveal lymphoma. There is however an increasing use of biopsy techniques for prognostication in uveal melanoma.

Proton beam radiotherapy for choroidal and ciliary body melanoma in the UK-national audit of referral patterns of 1084 cases.

Introduction: Proton beam therapy has been utilised for the treatment of uveal melanoma in the UK for over 30 years, undertaken under a single centre. In the UK, all ocular tumours are treated at one of four centres. We aimed to understand the variation in referral patterns to the UK proton service, capturing all uveal melanoma patients treated with this modality.

AutoMorph: Automated Retinal Vascular Morphology Quantification Via a Deep Learning Pipeline.

Purpose: To externally validate a deep learning pipeline (AutoMorph) for automated analysis of retinal vascular morphology on fundus photographs. AutoMorph has been made publicly available, facilitating widespread research in ophthalmic and systemic diseases.

Methods: AutoMorph consists of four functional modules: image preprocessing, image quality grading, anatomical segmentation (including binary vessel, artery/vein, and optic disc/cup segmentation), and vascular morphology feature measurement.

Introducing the 'Benign Eyelid Lesion Pathway': 1 year experience of synchronous tele-oculoplastics in a tertiary hospital.

Background: Patients with benign eyelid lesions make up a large proportion of referrals to the oculoplastic service and lend themselves well to telemedicine with assessments heavily reliant on history, observation-based examination and photographs to enable management decision-making. Our tertiary unit set up tele-oculoplastics clinics for all new patients referred for benign eyelid lesions comprising tele-consultation with antecedent patient photograph: Benign Eyelid Lesion Pathway (BELP). One year on, we describe a retrospective analysis of 974 patients looking at distinct parameters of effectiveness.

Assessment of Localised Corneal Biomechanical Deterioration With Keratoconus Progression.

To evaluate the regional corneal biomechanical deterioration with keratoconus (KC) progression as measured by the Stress-Strain Index (SSI) maps. The preoperative examinations of 29 progressive KC cases that were submitted to corneal cross-linking (CXL) were evaluated. The examinations included the tomography and the SSI measured by the Pentacam HR and the Corvis ST (Oculus, Wetzlar, Germany), respectively.

Keratoconus: A Biomechanical Perspective.

Purpose: The relevance of corneal biomechanics and the importance of including it in the clinical assessment of corneal ectasias are being increasingly recognized. The connection between corneal ultrastructure, biomechanical properties, and optical function is exemplified by a condition like keratoconus. Biomechanical instability is seen as the underlying basis for the secondary morphological changes in the cornea.

The anterior cruciate ligament in murine post-traumatic osteoarthritis: markers and mechanics.

Background: Knee joint injuries, common in athletes, have a high risk of developing post-traumatic osteoarthritis (PTOA). Ligaments, matrix-rich connective tissues, play important mechanical functions stabilising the knee joint, and yet their role post-trauma is not understood. Recent studies have shown that ligament extracellular matrix structure is compromised in the early stages of spontaneous osteoarthritis (OA) and PTOA, but it remains unclear how ligament matrix pathology affects ligament mechanical function.

Corneal Stiffness Mapping by the Stress-Strain Index Maps and Brillouin Microscopy.

The study of corneal stiffness has numerous clinical applications such as the measurement of intraocular pressure, the preoperative screening for iatrogenic ectasia after laser vision correction surgery and the diagnosis and treatment of corneal ectatic diseases such as keratoconus. The localised aspect of the microstructure deterioration in keratoconus leading to local biomechanical softening, corneal bulging, irregular astigmatism and ultimately loss of vision boosted the need to map the corneal stiffness to identify the regional biomechanical failure. Currently, two methods to map the corneal stiffness are integrated into devices that are either already commercially available or about to be commercialised: the stress-strain index (SSI) maps and the Brillouin Microscopy (BM).

Proposal of a new slit-lamp shield for ophthalmic examination and assessment of its effectiveness using computational simulations.

Purpose: This study aimed to use computational models for simulating the movement of respiratory droplets when assessing the efficacy of standard slit-lamp shield versus a new shield designed for increased clinician comfort as well as adequate protection.

Methods: Simulations were performed using the commercial software Star-CCM+. Respiratory droplets were assumed to be 100% water in volume fraction with particle diameter distribution represented by a geometric mean of 74.

Changing trends in pseudoretinoblastoma diagnoses: A 10 year review from the United Kingdom.

Aim: To study the different types and frequency of pseudoretinoblastoma (pseudoRB) lesions who present to a retinoblastoma centre due to concern that the condition may be retinoblastoma.

Methods: A retrospective chart review of 341 patients presenting sporadically to the Royal London Hospital from January 2009 to December 2018.

Results: 220 patients (65%) were confirmed to have retinoblastoma, while 121 (35%) had pseudoRB.

A Phase 1 study of ADI-PEG20 (pegargiminase) combined with cisplatin and pemetrexed in ASS1-negative metastatic uveal melanoma.

Metastatic uveal melanoma (UM) is a devastating disease with few treatment options. We evaluated the safety, tolerability and preliminary activity of arginine depletion using pegylated arginine deiminase (ADI-PEG20; pegargiminase) combined with pemetrexed (Pem) and cisplatin (Cis) chemotherapy in a phase 1 dose-expansion study of patients with argininosuccinate synthetase (ASS1)-deficient metastatic UM. Eligible patients received up to six cycles of Pem (500 mg/m ) and Cis (75 mg/m ) every 3 weeks plus weekly intramuscular ADI (36 mg/m ), followed by maintenance ADI until progression (NCT02029690).

Biomechanical Effects of tPRK, FS-LASIK, and SMILE on the Cornea.

The objective of this study is to evaluate the corneal biomechanical response to three laser refractive surgeries. Two hundred and twenty-seven patients who submitted to transepithelial photorefractive keratectomy (tPRK), femtosecond laser-assisted keratomileusis (FS-LASIK), or small-incision lenticule extraction (SMILE) were included in this study. All cases were examined with the Corvis ST preoperatively (up to 3 months) and postoperatively at 1, 3, and 6 months, and the differences in the main device parameters were assessed.

Measuring Inflammation in the Vitreous and Retina: A Narrative Review.

Uveitis consists of a group of syndromes characterised by intraocular inflammation, accounting for up to 15% of visual loss in the western world and 10% worldwide. Assessment of intraocular inflammation has been limited to clinician-dependent, subjective grading. Developments in imaging technology, such as optical coherence tomography (OCT), have enabled the development of objective, quantitative measures of inflammatory activity.

Resolution of Isolated Subretinal Abscess with Systemic Antibiotic Treatment.

Purpose: To describe clinical features and therapeutic management of a case of isolated subretinal abscess (SRA) in an immunocompetent male patient with no predisposing conditions or risk factors.

Methods: Clinical data, including medical history, clinical findings and results of systemic investigations, were retrospectively collected in a 40-year-old man diagnosed with unilateral focal SRA.

Results: Systemic investigations did not reveal any extraocular infective focus.

In Vivo Biomechanical Changes Associated With Keratoconus Progression.

Purpose: To assess the biomechanical deterioration arising from keratoconus progression .

Methods: The preoperative examinations of 32 progressive KC cases that were submitted to corneal cross-linking were evaluated. The examinations included the corneal tomography using the Pentacam HR and biomechanical parameters assessed by the Corvis ST (Oculus, Wetzlar, Germany).

The role of maternal age & birth order on the development of unilateral and bilateral retinoblastoma: a multicentre study.

Background/objectives: Retinoblastoma is a common childhood intraocular malignancy, the bilateral form of which most commonly results from a de novo germline pathogenic variant in the RB1 gene. Both advanced maternal age and decreasing birth order are known to increase the risk of de novo germline pathogenic variants, while the influence of national wealth is understudied. This cohort study aimed to retrospectively observe whether these factors influence the ratio of bilateral retinoblastoma cases compared to unilateral retinoblastoma, thereby inferring an influence on the development of de novo germline pathogenic variants in RB1.

Evaluation of corneal biomechanical behavior in vivo for healthy and keratoconic eyes using the stress-strain index.

Purpose: To evaluate the characteristics of corneal material properties in healthy individuals and keratoconic patients using the stress-strain index (SSI).

Setting: Vincieye Clinic in Milan, Italy, and Instituto de Olhos Renato Ambrósio in Rio de Janeiro, Brazil.

Design: Retrospective observational cross-sectional study.

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.

Hypertensive eye disease.

Hypertensive eye disease includes a spectrum of pathological changes, the most well known being hypertensive retinopathy. Other commonly involved parts of the eye in hypertension include the choroid and optic nerve, sometimes referred to as hypertensive choroidopathy and hypertensive optic neuropathy. Together, hypertensive eye disease develops in response to acute and/or chronic elevation of blood pressure.

Safety-Net Suture for Aphakic Descemet Membrane Endothelial Keratoplasty.

Purpose: The purpose of this research was to describe a low-cost, accessible method for reducing the risk of posterior donor dislocation in Descemet membrane endothelial keratoplasty (DMEK) performed in eyes with aphakia and a large iris defect (unicameral eyes)-the "safety-net suture."

Methods: We review 3 cases of aphakic bullous keratopathy in unicameral eyes treated successfully using DMEK aided by a simple technique to create a temporary, partial barrier between the anterior and posterior chambers. The safety-net suture technique is based on a continuous 10-0 polypropylene suture placed across the anterior chamber in a cat's-cradle pattern anterior to the trabecular meshwork.