RETINAL NEURONAL ECTOPIA: A NEW ENTITY IN THE DIFFERENTIAL DIAGNOSIS OF RETINOBLASTOMA.

Background: To present a rare retinal disorder that should be considered in the differential diagnosis of retinoblastoma.

Methods: A 2-year-old boy presented with left ocular discomfort, leukocoria, and a left divergent squint. Examination of the left eye revealed abnormalities in the anterior segment, and fundoscopy showed an irregular white calcified mass with fibrosis and traction toward the lens.

The role of intracranial pressure in glaucoma and therapeutic implications.

Despite glaucoma being the second leading cause of blindness globally, its pathogenesis remains incompletely understood. Although intraocular pressure (IOP) contributes to glaucoma, and reducing IOP slows progress of the disease, some patients progress despite normal IOP (NTG). Glaucomatous damage causes characteristic cupping of the optic nerve where it passes through the lamina cribrosa.

Instrument-based tests for quantifying aqueous humour protein levels in uveitis: a systematic review protocol.

Background: Inflammation in anterior uveitis is characterised by breakdown of the blood-ocular barrier, which allows leakage of blood constituents of higher molecular weight into the aqueous humour. In routine clinical care, increase in aqueous protein levels can be observed at the slit lamp as 'flare' and the severity can be graded using various clinical grading systems, of which the Standardization of Uveitis Nomenclature (SUN) grading system is most commonly used. Alternative instrument-based technologies are available, which can detect aqueous protein levels in an objective and quantifiable way.

Management Issues in Conjunctival Tumours: Ocular Surface Squamous Neoplasia.

Ocular surface squamous neoplasia is the most common tumour of the ocular surface. It is a spectrum of disease from intraepithelial dysplasia to invasive squamous cell carcinoma. Recent years have seen an increase in the use of topical chemotherapeutic agents to treat this condition, often as primary treatment without full-thickness biopsy.

Long-Term Outcomes of StopLoss Jones Tubes for Epiphora in Patients With Early or Multiple Loss of Lester Jones Tubes.

Purpose: Extrusion is the most common cause of failure in conventional Lester Jones tubes (LJTs). StopLoss Jones tubes (SLJTs) with distal flange are designed to reduce this complication. This study compared the survival of SLJTs with their prior LJTs and control patients with LJTs-only.

Optical coherence tomography (OCT) in unconscious and systemically unwell patients using a mobile OCT device: a pilot study.

Objective: This study aims to evaluate the feasibility of retinal imaging in critical care using a novel mobile optical coherence tomography (OCT) device. The Heidelberg SPECTRALIS FLEX module (Heidelberg Engineering, Heidelberg, Germany) is an OCT unit with a boom arm, enabling ocular OCT assessment in less mobile patients.

Design: We undertook an evaluation of the feasibility of using the SPECTRALIS FLEX for undertaking ocular OCT images in unconscious and critically ill patients.

Benefit of an electronic head-mounted low vision aid.

Purpose: To evaluate the efficacy of electronic head-mounted low vision aid (e-LVA) SightPlus (GiveVision, UK, givevision.net) and to determine which people with low vision would see themselves likely using an e-LVA like this.

Methods: Sixty participants with low vision aged 18 to 93 used SightPlus during an in-clinic study session based on a mixed methods design.

Management Issues in Conjunctival Tumours: Conjunctival Melanoma and Primary Acquired Melanosis.

Conjunctival melanoma is a rare malignant condition of the ocular surface. It is potentially lethal, with regional lymph node spread often preceding distant solid-organ metastasis. Due to its rarity and the long latency between treatment and local recurrence or the development of metastases, it is difficult to study.

Intraocular Biopsy and ImmunoMolecular Pathology for "Unmasking" Intraocular Inflammatory Diseases.

Intraocular inflammation can hide a variety of eye pathologies. In 33% of cases, to obtain a correct diagnosis, investigation of the intraocular sample is necessary. The combined analyses of the intraocular biopsy, using immuno-pathology and molecular biology, point to resolve the diagnostic dilemmas in those cases where history, clinical tests, and ophthalmic and systemic examinations are inconclusive.

Numerical Simulation of Corneal Fibril Reorientation in Response to External Loading.

Purpose: To simulate numerically the collagen fibril reorientation observed experimentally in the cornea.

Methods: Fibril distribution in corneal strip specimens was monitored using X-ray scattering while under gradually increasing axial loading. The data were analysed at each strain level in order to quantify the changes in the angular distribution of fibrils with strain growth.

Royston-Parmar flexible parametric survival model to predict the probability of keratoconus progression to corneal transplantation.

Purpose: To assess a Royston-Parmar flexible parametric survival model to generate a personalised risk profile for keratoconus progression.

Methods: We re-analysed a historic database of 2723 individuals with keratoconus. A Royston-Parmar survival model was fitted to predict the likelihood of the worse eye progressing to corneal transplantation.

Instrument-based Tests for Measuring Anterior Chamber Cells in Uveitis: A Systematic Review.

Purpose: New instrument-based techniques for anterior chamber (AC) cell counting can offer automation and objectivity above clinician assessment. This review aims to identify such instruments and its correlation with clinician estimates.

Methods: Using standard systematic review methodology, we identified and tabulated the outcomes of studies reporting reliability and correlation between instrument-based measurements and clinician AC cell grading.

Development and validation of a new intraocular pressure estimate for patients with soft corneas.

Purpose: To introduce and clinically validate a new method of estimating intraocular pressure (IOP) in patients with keratoconus and soft corneas with the aim of significantly reducing dependence on corneal biomechanics.

Setting: Vincieye Clinic, Milan, Italy, and Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil.

Design: Retrospective case series.

Macrophages promote a profibrotic phenotype in orbital fibroblasts through increased hyaluronic acid production and cell contractility.

Graves' orbitopathy (GO) is an autoimmune inflammatory disease affecting the orbit. Orbital fibroblasts are a key component in GO pathogenesis, which includes inflammation, adipogenesis, hyaluronic acid (HA) secretion, and fibrosis. Macrophages are thought to participate in the immunological stage of GO, but whether they can directly affect the fibroblasts phenotype and modulate disease progression is unknown.

Evaluating the Impact of Uveitis on Visual Field Progression Using Large-Scale Real-World Data.

Purpose: To compare rates of visual field (VF) loss in uveitis patients with glaucoma against patients with primary open-angle glaucoma (POAG) and explore the association between intraocular pressure (IOP) and rate of VF loss.

Design: Retrospective cohort study.

Methods: Anonymized VFs and IOP measurements extracted from the electronic medical records of 5 regionally different glaucoma clinics in England.

Noninferiority of Preservative-free Versus BAK-preserved Latanoprost-timolol Fixed Combination Eye Drops in Patients With Open-angle Glaucoma or Ocular Hypertension.

Unlabelled: PRéCIS:: Noninferiority of efficacy was demonstrated for a preservative-free latanoprost-timolol fixed combination compared with a BAK-containing formulation at 84 days after treatment in patients with open-angle glaucoma or ocular hypertension.

Purpose: The purpose of this study was to compare the effect on intraocular pressure and safety of preservative-free latanoprost-timolol fixed combination (T2347) to benzalkonium chloride-preserved latanoprost-timolol fixed combination in patients with open-angle glaucoma or ocular hypertension.

Methods: Phase III, randomized, parallel-group, investigator-masked study in 10 countries.

Color Vision Deficiency Among Doctors: Can We Make Useful Adaptations to the Color Codes Used in the Clinical Environment?

Color vision deficiency (formerly known as color blindness) is common as a congenital and as an acquired condition. Some professions, most famously commercial aviation, require their members to demonstrate normal color vision. In the United States and United Kingdom, no restriction is placed on the ability of the color-deficient doctor to practice medicine, although there is evidence that certain clinical discriminations are harder for such doctors.

Determination of Corneal Biomechanical Behavior for Healthy Eyes Using CorVis ST Tonometry: Stress-Strain Index.

This study aims to introduce and clinically validate a new algorithm that can determine the biomechanical properties of the human cornea . A parametric study was conducted involving representative finite element models of human ocular globes with wide ranges of geometries and material biomechanical behavior. The models were subjected to different levels of intraocular pressure (IOP) and the action of external air puff produced by a non-contact tonometer.

Corneal deformation amplitude analysis for keratoconus detection through compensation for intraocular pressure and integration with horizontal thickness profile.

Background: The Corvis ST provides measurements of intraocular pressure (IOP) and a biomechanically-corrected IOP (bIOP). IOP influences corneal deflection amplitude (DA), which may affect the diagnosis of keratoconus. Compensating for IOP in DA values may improve the detection of keratoconus.

Microstructure-based numerical simulation of the mechanical behaviour of ocular tissue.

This paper aims to present a novel full-eye biomechanical material model that incorporates the characteristics of ocular tissues at microstructural level, and use the model to analyse the age-related stiffening in tissue behaviour. The collagen content in ocular tissues, as obtained using X-ray scattering measurements, was represented by sets of Zernike polynomials that covered both the cornea and sclera, then used to reconstruct maps of collagen fibril magnitude and orientation on the three-dimensional geometry of the eye globe. Fine-mesh finite-element (FE) models with eye-specific geometry were built and supported by a user-defined material model (UMAT), which considered the regional variation of fibril density and orientation.

Forecasting future Humphrey Visual Fields using deep learning.

Purpose: To determine if deep learning networks could be trained to forecast future 24-2 Humphrey Visual Fields (HVFs).

Methods: All data points from consecutive 24-2 HVFs from 1998 to 2018 were extracted from a university database. Ten-fold cross validation with a held out test set was used to develop the three main phases of model development: model architecture selection, dataset combination selection, and time-interval model training with transfer learning, to train a deep learning artificial neural network capable of generating a point-wise visual field prediction.

Regional changes in corneal shape over a 6-month follow-up after femtosecond-assisted LASIK.

Purpose: To assess the regional changes in corneal shape after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in patients with different myopia extents.

Setting: Eye Hospital, Wenzhou Medical University, Wenzhou, China.

Design: Retrospective case series.