Medicine › Ophthalmology

Retinal and Optic Conditions

Works Count: 43865

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This cluster of papers explores the ocular manifestations of COVID-19, including its impact on the eyes, such as retinal artery occlusion, conjunctivitis, viral shedding in tears and secretions, and the expression of ACE2 receptor on the ocular surface. It also delves into specific conditions like Susac syndrome and utilizes techniques like optical coherence tomography to study these manifestations.

Keywords

COVID-19; Ocular Findings; Retinal Artery Occlusion; Conjunctivitis; Tears and Secretions; Susac Syndrome; Optical Coherence Tomography; Viral Shedding; ACE2 Receptor; Ophthalmic Manifestations

A Randomized Trial Comparing the Efficacy and Safety of Intravitreal Triamcinolone With Observation to Treat Vision Loss Associated With Macular Edema Secondary to Central Retinal Vein Occlusion

2009-09-14

Ingrid U. Scott , Michael S. Ip , Paul VanVeldhuisen +7 more

Error in Figure in: A Randomized Trial Comparing the Efficacy and Safety of Intravitreal Triamcinolone With Observation to Treat Vision Loss Associated With Macular Edema Secondary to Central Retinal Vein … Error in Figure in: A Randomized Trial Comparing the Efficacy and Safety of Intravitreal Triamcinolone With Observation to Treat Vision Loss Associated With Macular Edema Secondary to Central Retinal Vein Occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study Report 5

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Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment

1990-04-01

J. Donald M. Gass

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Ophthalmology HomeNew OnlineCurrent … Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Ophthalmology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Ophthalmology journal

Central Retinal Artery Occlusion: Visual Outcome

2005-09-01

Sohan Singh Hayreh , M. Bridget Zimmerman

Fluorescein Angiography Complication Survey

1986-05-01

Lawrence A. Yannuzzi , Kathleen T. Rohrer , Lori J. Tindel +4 more

Argon Laser Photocoagulation for Macular Edema in Branch Vein Occlusion

1986-07-01

Daniel Finkelstein

INDOCYANINE GREEN VIDEOANGIOGRAPHY OF OLDER PATIENTS WITH CENTRAL SEROUS CHORIORETINOPATHY

1996-01-01

Richard F. Spaide , Lisa S. Hall , Anton Haas +7 more

Purpose: The authors studied the indocyanine green (ICG) videoangiography findings of central serous chorioretinopathy (CSC) in older adults. Background: Central serous chorioretinopathy in older adults may be confused with the … Purpose: The authors studied the indocyanine green (ICG) videoangiography findings of central serous chorioretinopathy (CSC) in older adults. Background: Central serous chorioretinopathy in older adults may be confused with the exudative forms of age-related macular degeneration (AMD) because the two entities may have similar ophthalmoscopic and fluorescein angiographic findings. Because of its enhanced ability to image the choroidal circulation, ICG videoangiography has been used to describe certain choroidal vascular abnormalities in young adults with CSC, as well as older patients with choroidal neovascularization (CNV). The ICG videoangiography findings in CSC in older adults is largely unknown. Methods: The authors performed ICG videoangiography on 36 patients aged 50 years or older with CSC to characterize their findings. Results: The ICG videoangiography findings of the patients were consistent, revealing choroidal vascular hyperpermeability manifested by areas of hyperfluorescence that were first seen in the midphase of the angiogram. In the later phases of the angiogram, there were dispersion of the hyperfluorescence and a distinctive silhouetting of the larger choroidal vessels. Conclusions: Older patients with CSC have a unique temporal and topographic pattern of hyperpermeability that can help establish the proper diagnosis.

Walsh and Hoyt's Clinical Neuro-Ophthalmology

1989-09-01

Nancy S. Newman

Subjects covered in each volume are as follows: Volume One The Visual Sensory System The Autonomic Nervous System The Ocular Motor System The Eyelid Facial Pain and Headache Nonorganic Disease … Subjects covered in each volume are as follows: Volume One The Visual Sensory System The Autonomic Nervous System The Ocular Motor System The Eyelid Facial Pain and Headache Nonorganic Disease Volume Two Tumors The Phacomatoses Vascular Disease Volume Three Degenerative and Metabolic Diseases Infectios, Inflammatory, and Demyelinating Disease

Standard for clinical electroretinography

1989-12-01

Michael F. Marmor , G. B. Arden , Sven-Erik Nilsson +1 more

Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye

2015-04-20

Yali Jia , Steven T. Bailey , Thomas S. Hwang +7 more

Significance Retinal vascular diseases are a leading cause of blindness. Optical coherence tomography (OCT) has become the standard imaging modality for evaluating fluid accumulation in these diseases and for guiding … Significance Retinal vascular diseases are a leading cause of blindness. Optical coherence tomography (OCT) has become the standard imaging modality for evaluating fluid accumulation in these diseases and for guiding treatment. However, fluorescein angiography (FA) is still required for initial evaluation of retinal ischemia and choroidal neovascularization, which are not visible in conventional structural OCT. The limitations of FA include poor penetration of fluorescence through blood and pigment, inability to determine the depth of the pathology due to its two-dimensional nature, and some uncommon but potentially severe complications. As a noninvasive three-dimensional alternative, OCT angiography may be used in routine screening and monitoring to provide new information for clinical diagnosis and management.

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Acute retinal arterial occlusive disorders

2011-05-22

Sohan Singh Hayreh

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Vasospasm, its Role in the Pathogenesis of Diseases with Particular Reference to the Eye

2001-05-01

Josef Flammer , Mona Pache , Thérèse J. Resink

<i>Modern Aspects of the Vitreous State</i>

1961-10-01

J. D. Mackenzie , Stuart A. Rice

Meta-analysis of facial identification studies.

1986-09-01

Peter N. Shapiro , Steven Penrod

Meta-analyse de 128 etudes consacrees a l'identification du temoignage oculaire et a la reconnaissance des visages, recherchant les facteurs influencant la performance et les secteurs de recherche a approfondir dans … Meta-analyse de 128 etudes consacrees a l'identification du temoignage oculaire et a la reconnaissance des visages, recherchant les facteurs influencant la performance et les secteurs de recherche a approfondir dans ce domaine

RISKS OF INTRAVITREOUS INJECTION: A COMPREHENSIVE REVIEW

2004-10-01

Rama D. Jager , Lloyd Paul Aiello , Samir C. Patel +1 more

In Brief Purpose: To evaluate the prevalence of the most common serious adverse events associated with intravitreous (IVT) injection. Methods: A systematic search of the literature via PubMed from 1966 … In Brief Purpose: To evaluate the prevalence of the most common serious adverse events associated with intravitreous (IVT) injection. Methods: A systematic search of the literature via PubMed from 1966 to March 1, 2004, was conducted to identify studies evaluating the safety of IVT injection. Data submitted in New Drug Applications to the U.S. Food and Drug Administration for drugs administered into the vitreous were included where available. Serious adverse events reported in each study were recorded, and risk per eye and risk per injection were calculated for the following serious adverse events: endophthalmitis, retinal detachment, iritis/uveitis, intraocular hemorrhage, ocular hypertension, cataract, and hypotony. Rare complications also were noted. Results: Data from 14,866 IVT injections in 4,382 eyes were analyzed. There were 38 cases of endophthalmitis (including those reported as pseudoendophthalmitis) for a prevalence of 0.3% per injection and 0.9% per eye. Excluding cases reported specifically as pseudoendophthalmitis, the prevalence of endophthalmitis was 0.2% per injection and 0.5% per eye. Retinal detachment, iritis/uveitis, ocular hypertension, cataract, intraocular hemorrhage, and hypotony were generally associated with IVT injection of specific compounds and were infrequently attributed by the investigators to the injection procedure itself. Retinal vascular occlusions were described rarely in patients after IVT injection, and it was unclear in most cases whether these represented true injection-related complications or chance associations. Conclusion: The risk of serious adverse events reported after IVT injection is low. Nevertheless, careful attention to injection technique and appropriate postinjection monitoring are essential because uncommon injection-related complications may be associated with permanent vision loss. Adverse event data from 14,866 intravitreous injections reported in the literature were used to calculate the risk of endophthalmitis, retinal detachment, iritis/uveitis, intraocular hemorrhage, ocular hypertension, cataract, and hypotony. While the risks associated with IVT injection appear to be quite low, serious complications associated with vision loss may occur following IVT injection.

Listeriosis in Adults: A Changing Pattern. Report of Eight Cases and Review of the Literature, 1968-1978

1980-03-01

R. E. Nieman , Bennett Lorber

One hundred eighty-six cases of adult listeriosis are reviewed. Listeria infections appear to be increasing in frequency, and some of the clinical characteristics of infection have changed since the last … One hundred eighty-six cases of adult listeriosis are reviewed. Listeria infections appear to be increasing in frequency, and some of the clinical characteristics of infection have changed since the last critical review. Meningitis remains the most common form of listeriosis in adults. Prominent clinical features of meningitis include ataxia, tremors, seizures, and fluctuating consciousness. Cerebrospinal fluid findings are variable; the result of gram stain is usually negative. Nonmeningitic infections of the central nervous system are characterized by an acute onset of hemiparesis or cranial nerve palsies. Blood cultures almost invariably yield Listeria monocytogenes. Primary listeria bacteremia, previously considered rare, is being reported with increasing frequency. Patients with malignancy, those receiving immunosuppressive drugs, and pregnant women seem particularly prone to this form of listeriosis. Listeria endocarditis is increasing in frequency and clinically resembles other forms of subacute endocarditis. Most patients with listeria endocarditis have an underlying, predisposing heart lesion. Renal transplant recipients are particularly prone to develop listeriosis. Mortality in listeriosis is highest among individuals with infection of the central nervous system, those with an underlying malignancy, and those receiving immunosuppressive therapy.

TYPE-A BEHAVIOR AND CENTRAL SEROUS CHORIORETINOPATHY

1987-01-01

Lawrence A. Yannuzzi

A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type … A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type A behavioral pattern based on the Jenkins Activity Survey. The patients selected as matched controls had painless, reduced central vision and other chorioretinal diseases (Group I), or non-chorioretinal ocular conditions (Group II). The Type A behavior was significantly more frequent in study patients than in either Control Group I (X2 = 6.1 and P less than 0.025) or Control Group II patients (X2 = 17.7 and P less than 0.001). When both control groups were combined for comparison to the CSP patients, there was also a highly significant difference with regard to Type A behavior (X2 = 14.1 and P less than 0.001). A comparison of Control Group I with Control Group II revealed no significant difference in Type A behavior. Subfactor analysis of the Type A behavior pattern was also studied. The results of this clinical study were used in conjunction with experimental evidence linking catecholamines with CSP in developing a multifactorial etiologic hypothesis. The hypothesis suggests that the eyes as an organ system, and the macula as an ultimate target area, can be intermittently or continuously stimulated adversely by Type A behavior and its physiological consequences, most notably a sympathetic discharge. The multifactorial concept alludes to other potential risk factors such as age, race, sex, refractive state, or unknown tissue susceptabilities. The pathogenesis implies an inter-relationship between finely balanced components of a complex biopsychological system involving an individual's genetic endowment, his environment, and his behavioral pattern. The concept also offers new possible lines of investigation for the treatment of CSP, utilizing pharmacological regulators and for its prevention through early identification of CSP-prone individuals. A review of the pertinent cardiovasculature literature linking the Type A behavior with coronary artery disease and the significant papers in the ophthalmic literature on central serous pigment epitheliopathy are included in the discussion.

Central Retinal Artery Occlusion and Retinal Tolerance Time

1980-01-01

Sohan Singh Hayreh , H. E. Kolder , Thomas A. Weingeist

Prevalent misconceptions about acute retinal vascular occlusive disorders

2005-03-11

Sohan Singh Hayreh

THE SPECTRUM OF BLUNT INJURY TO THE CAROTID ARTERY

1994-09-01

Thomas H. Cogbill , Ernest E. Moore , Mark Meissner +7 more

Cogbill, Thomas H. MD; Moore, Ernest E. MD; Meissner, Mark MD; Fischer, Ronald P. MD; Hoyt, David B. MD; Morris, John A. MD; Shackford, Steven R. MD; Wallace, James R. … Cogbill, Thomas H. MD; Moore, Ernest E. MD; Meissner, Mark MD; Fischer, Ronald P. MD; Hoyt, David B. MD; Morris, John A. MD; Shackford, Steven R. MD; Wallace, James R. MD, PhD; Ross, Steven E. MD; Ochsner, M. Gage MD; Sugerman, Harvey J. MD; Lambert, Pamela J. RN; Moore, Frederick A. MD; Jurkovich, Gregory J. MD; Cocanour, Christine S. MD; Potenza, Bruce MD; Chang, Michael C. MD; Trevasani, Gino T. MD; Aprahamian, Charles MD; Frankel, Heidi L. MD Author Information

ISCEV Standard for full-field clinical electroretinography (2015 update)

2014-12-13

Daphne L. McCulloch , Michael F. Marmor , Mitchell Brigell +4 more

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Paracentral Acute Middle Maculopathy

2013-08-09

David Sarraf , Ehsan Rahimy , Amani A. Fawzi +7 more

With the advent of more sophisticated imaging systems, such as spectral domain optical coherence tomography (SD-OCT), disruption of the inner segment/outer segment (IS/OS) band, and thinning of the outer nuclear … With the advent of more sophisticated imaging systems, such as spectral domain optical coherence tomography (SD-OCT), disruption of the inner segment/outer segment (IS/OS) band, and thinning of the outer nuclear layer (ONL) have been identified in association with acute macular neuroretinopathy (AMN).To characterize a new SD-OCT presentation of AMN as a paracentral acute middle maculopathy and to describe multimodal imaging findings that implicate an underlying pathogenesis related to retinal capillary ischemia.Retrospective observational case series (January 1, 2012, to January 1, 2013) reviewing clinical and imaging data from 9 patients (11 eyes) with AMN at 6 tertiary referral centers. Lesions were classified as type 1 or 2 in relation to the SD-OCT location of the lesion above (type 1) or below (type 2) the outer plexiform layer (OPL) at 6 tertiary referral centers.Of the 9 patients, 5 were female and 4 were male (mean age, 47.6 years; range, 21-65 years). All patients presented with an acute paracentral scotoma and demonstrated a classic dark gray paracentral lesion with near-infrared imaging. Visual acuity ranged from 20/15 to 20/30. Six eyes (5 patients) had type 1 SD-OCT lesions, also referred to as paracentral acute middle maculopathy, and 5 eyes (4 patients) had type 2 SD-OCT lesions. Although type 1 lesions lead to inner nuclear layer (INL) thinning, type 2 lesions resulted in ONL thinning. Type 2 lesions were always associated with significant outer macular defects, including disruption of the inner segment/outer segment and outer segment/retinal pigment epithelium bands, whereas type 1 lesions spared the outer macula.Paracentral acute middle maculopathy may represent a novel variant of AMN that affects the middle layers of the macula above the OPL as diagnosed with SD-OCT imaging. Two types of AMN lesions may be seen with SD-OCT occurring above and below the OPL. Type 1 refers to hyperreflective bands in the OPL/INL region with subsequent INL thinning. Type 2 is hyperreflective bands in the OPL/ONL region with subsequent ONL thinning. Type 2 lesions may be associated with concomitant defects of the inner segment/outer segment layer. We propose that each of these lesions may be explained by occlusion of either the superficial capillary plexus (type 1) or deep capillary plexus (type 2) located in the innermost and outermost portion of the INL, respectively, immediately adjacent to each corresponding lesion type.

Pathophysiology of Hypertensive Retinopathy

1982-10-01

Mark O.M. Tso , Lee M. Jampol

Global estimates of visual impairment: 2010

2011-12-01

Donatella Pascolini , Silvio Paolo Mariotti

<h3>Abstract</h3> <h3>Background</h3> Long COVID is a post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection syndrome characterised by not recovering for several weeks or months following the acute episode. The effectiveness … <h3>Abstract</h3> <h3>Background</h3> Long COVID is a post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection syndrome characterised by not recovering for several weeks or months following the acute episode. The effectiveness of COVID-19 vaccines against long-term symptoms of COVID-19 is not well understood. We determined whether vaccination was associated with the incidence of reporting long-term symptoms post-SARS-CoV-2 infection <h3>Methods</h3> We invited individuals who were PCR tested for SARS-CoV-2 infection at participating hospitals between March 2020-November 2021 to fill an online questionnaire that included baseline demographics, details of their acute episode and information about symptoms they were currently experiencing. Using binomial regression, we compared vaccinated individuals with those unvaccinated and those uninfected in terms of self-reported symptoms post-acute infection. <h3>Results</h3> We included 951 infected and 2437 uninfected individuals. Of the infected, 637(67%) were vaccinated. The most commonly reported symptoms were; fatigue (22%), headache (20%), weakness (13%), and persistent muscle pain (10%). After adjusting for follow-up time and baseline symptoms, those who received two doses less likely than unvaccinated individuals to report any of these symptoms by 64%, 54%, 57%, and 68% respectively, (Risk ratios 0.36, 0.46, 0.43, 0.32, p<0.04 in the listed sequence). Those who received two doses were no more likely to report any of these symptoms than individuals reporting no previous SARS-CoV-2 infection. <h3>Conclusions</h3> Vaccination with at least two doses of COVID-19 vaccine was associated with a substantial decrease in reporting the most common post-acute COVID-19 symptoms, bringing it back to baseline. Our results suggest that, in addition to reducing the risk of acute illness, COVID-19 vaccination may have a protective effect against long COVID.

Ranibizumab for Macular Edema Due to Retinal Vein Occlusions

2012-02-01

Jeffrey S. Heier , Peter A. Campochiaro , Linda Yau +4 more

Standard Diagnostic Criteria for the Acute Retinal Necrosis Syndrome

1994-05-01

Gary N. Holland

SENILE MACULAR DEGENERATION: A CASE-CONTROL STUDY

1983-08-01

Leslie Hyman , Abraham M. Lilienfeld , Frederick L. Ferris +1 more

Journal Article SENILE MACULAR DEGENERATION: A CASE-CONTROL STUDY Get access LESLIE G. HYMAN, LESLIE G. HYMAN 1Department of Community and Preventive Medicine, School of Medicine, Health Sciences Center, L3-099, State … Journal Article SENILE MACULAR DEGENERATION: A CASE-CONTROL STUDY Get access LESLIE G. HYMAN, LESLIE G. HYMAN 1Department of Community and Preventive Medicine, School of Medicine, Health Sciences Center, L3-099, State University of New York at Stony BrookStony Brook, NY 11794 Reprint requests to Dr. Hyman. Search for other works by this author on: Oxford Academic PubMed Google Scholar ABRAHAM M. LILIENFELD, ABRAHAM M. LILIENFELD 2Department of Epidemiology, The Johns Hopkins University, School of Hygiene and Public HealthBaltimore, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar FREDERICK L. FERRIS, III, FREDERICK L. FERRIS, III 3Office of Biometry and Epidemiology, National Eye Institute, National Institutes of HealthBethes-da, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar STUART L. FINE STUART L. FINE 4The Wilmer Institute, The Johns Hopkins HospitalBaltimore, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 118, Issue 2, August 1983, Pages 213–227, https://doi.org/10.1093/oxfordjournals.aje.a113629 Published: 01 August 1983

Retinal Vascular Layers Imaged by Fluorescein Angiography and Optical Coherence Tomography Angiography

2014-10-15

Richard F. Spaide , James M. Klancnik , Michael J. Cooney

The retinal vasculature is involved in many ocular diseases that cause visual loss. Although fluorescein angiography is the criterion standard for evaluating the retina vasculature, it has risks of adverse … The retinal vasculature is involved in many ocular diseases that cause visual loss. Although fluorescein angiography is the criterion standard for evaluating the retina vasculature, it has risks of adverse effects and known defects in imaging all the layers of the retinal vasculature. Optical coherence tomography (OCT) angiography can image vessels based on flow characteristics and may provide improved information.To investigate the ability of OCT angiography to image the vascular layers within the retina compared with conventional fluorescein angiography.In this study, performed from March 14, 2014, through June 24, 2014, a total of 5 consecutive, overlapping B-scan OCT angiography images composed of 216 A-scans were obtained at 216 discrete positions within a region of interest, typically a 2 × 2-mm area of the retina. The flow imaging was based on split-spectrum amplitude decorrelation angiography (SSADA), which can dissect layers of vessels in the retina. These distinct layers were compared with the fluorescein angiograms in 12 healthy eyes from patients at a private practice retina clinic to evaluate the ability to visualize the radial peripapillary capillary network. The proportion of the inner vs outer retinal vascular layers was estimated by 3 masked readers and compared with conventional fluorescein angiograms of the same eyes.Outcome measures were visualization of the radial peripapillary capillary network in the fluorescein and SSADA scans and the proportion of the inner retinal vascular plexus vs the outer retinal capillary plexus as seen in SSADA scans that would match the fluorescein angiogram.In none of the 12 eyes could the radial peripapillary capillary network be visualized completely around the nerve head by fluorescein angiography, whereas the network was readily visualized in the SSADA scans. The fluorescein angiograms were matched, with a mean proportion of the inner vascular plexus being 95.3% (95% CI, 92.2%-97.8%) vs 4.7% (95% CI, 2.6%-5.7%) for the outer capillary plexus from the SSADA scans.Fluorescein angiography does not image the radial peripapillary or the deep capillary networks well. However, OCT angiography can image all layers of the retinal vasculature without dye injection. Therefore, OCT angiography, and the findings generated, have the potential to affect clinical evaluation of the retina in healthy patients and patients with disease.

Standard for clinical electroretinography (2004 update)

2004-03-01

Michael F. Marmor , Graham E. Holder , Mathias W. Seeliger +1 more

Central retinal artery occlusion.

2003-10-09

Sohan Singh Hayreh , M. Bridget Zimmerman , Alan Kimura +1 more

Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases.

1981-01-01

W R Green , C.–C. Chan , Grover M. Hutchins +1 more

The clinical and histopathologic features of 29 eyes from 29 patients with central retinal vein occlusion (CRVO) are reported. A fresh or a recanalized thrombus was observed in each eye. … The clinical and histopathologic features of 29 eyes from 29 patients with central retinal vein occlusion (CRVO) are reported. A fresh or a recanalized thrombus was observed in each eye. This study considers the temporal aspects of the cases, and it notes the different morphologic features of the occlusion. These observations explain most of the variability of the changes observed in previous reports. We believe that these different features represent the various stages in the natural evolution of such a thrombus. The interval between CRVO and histopathologic study in our series ranged from six hours to more than 10 years. Local and systemic factors were reviewed and were found to be important in the pathogenesis of thrombus formation. Local diseases with a predisposing effect on CRVO included: glaucoma, papilledema, subdural hemorrhage, optic nerve hemorrhage, and drusen of the optic nerve head. Associated systemic diseases included: hypertension, cardiovascular and cerebrovascular disease, diabetes mellitus, and leukemia with thrombocytopenia. A fresh thrombus in the CRVO was observed in three (10.3%), and a recanalized thrombus in 26 eyes (89.7%). Endothelial-cell proliferation was a conspicuous feature in 14 (48.3%) of the eyes. Chronic inflammation in the area of the thrombus, and/or vein wall or perivenular area was observed in 14 (48.3%) of the eyes. Arterial occlusive disease was observed in seven eyes (24.6%). Cystoid macular edema was found in 26 (89.7%) of the eyes.

Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography

2017-02-10

J. Peter Campbell , Miao Zhang , Thomas S. Hwang +4 more

Abstract Optical coherence tomography angiography (OCTA) is a noninvasive method of 3D imaging of the retinal and choroidal circulations. However, vascular depth discrimination is limited by superficial vessels projecting flow … Abstract Optical coherence tomography angiography (OCTA) is a noninvasive method of 3D imaging of the retinal and choroidal circulations. However, vascular depth discrimination is limited by superficial vessels projecting flow signal artifact onto deeper layers. The projection-resolved (PR) OCTA algorithm improves depth resolution by removing projection artifact while retaining in-situ flow signal from real blood vessels in deeper layers. This novel technology allowed us to study the normal retinal vasculature in vivo with better depth resolution than previously possible. Our investigation in normal human volunteers revealed the presence of 2 to 4 distinct vascular plexuses in the retina, depending on location relative to the optic disc and fovea. The vascular pattern in these retinal plexuses and interconnecting layers are consistent with previous histologic studies. Based on these data, we propose an improved system of nomenclature and segmentation boundaries for detailed 3-dimensional retinal vascular anatomy by OCTA. This could serve as a basis for future investigation of both normal retinal anatomy, as well as vascular malformations, nonperfusion, and neovascularization.

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Vision Loss after Intravitreal Injection of Autologous “Stem Cells” for AMD

2017-03-15

Ajay E. Kuriyan , Thomas A. Albini , Justin H. Townsend +7 more

Adipose tissue-derived "stem cells" have been increasingly used by "stem-cell clinics" in the United States and elsewhere to treat a variety of disorders. We evaluated three patients in whom severe … Adipose tissue-derived "stem cells" have been increasingly used by "stem-cell clinics" in the United States and elsewhere to treat a variety of disorders. We evaluated three patients in whom severe bilateral visual loss developed after they received intravitreal injections of autologous adipose tissue-derived "stem cells" at one such clinic in the United States. In these three patients, the last documented visual acuity on the Snellen eye chart before the injection ranged from 20/30 to 20/200. The patients' severe visual loss after the injection was associated with ocular hypertension, hemorrhagic retinopathy, vitreous hemorrhage, combined traction and rhegmatogenous retinal detachment, or lens dislocation. After 1 year, the patients' visual acuity ranged from 20/200 to no light perception.

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2019-nCoV transmission through the ocular surface must not be ignored

2020-02-01

Cheng‐Wei Lu , Xiufen Liu , Zhifang Jia

Chaolin Huang and colleagues1Huang C Wang YM Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24. https://doi.org/10.1016/S0140-6736(20)30183-5.)Summary Full Text … Chaolin Huang and colleagues1Huang C Wang YM Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24. https://doi.org/10.1016/S0140-6736(20)30183-5.)Summary Full Text Full Text PDF Scopus (33099) Google Scholar reported the epidemiology, symptoms, and treatment of patients infected by the 2019 novel coronavirus (2019-nCoV) in Wuhan, China. As ophthalmologists, we believe that transmission of 2019-nCoV through the eyes was ignored. On Jan 22, Guangfa Wang, a member of the national expert panel on pneumonia, reported that he was infected by 2019-nCoV during the inspection in Wuhan.2Dai X Peking University Hospital Wang Guangfa disclosed treatment status on Weibo and suspected infection without wearing goggles.http://www.bjnews.com.cn/news/2020/01/23/678189.htmlDate: Jan 22, 2020Date accessed: January 24, 2020Google Scholar He wore an N95 mask but did not wear anything to protect his eyes. Several days before the onset of pneumonia, Wang complained of redness of the eyes. Unprotected exposure of the eyes to 2019-nCoV in the Wuhan Fever Clinic might have allowed the virus to infect the body.2Dai X Peking University Hospital Wang Guangfa disclosed treatment status on Weibo and suspected infection without wearing goggles.http://www.bjnews.com.cn/news/2020/01/23/678189.htmlDate: Jan 22, 2020Date accessed: January 24, 2020Google Scholar Infectious droplets and body fluids can easily contaminate the human conjunctival epithelium.3Olofsson S Kumlin U Dimock K Arnberg N Avian influenza and sialic acid receptors: more than meets the eye?.Lancet Infect Dis. 2005; 5: 184-188Summary Full Text Full Text PDF PubMed Scopus (75) Google Scholar Respiratory viruses are capable of inducing ocular complications in infected patients, which then leads to respiratory infection.4Belser JA Rota PA Tumpey TM Ocular tropism of respiratory viruses.Microbiol Mol Biol Rev. 2013; 77: 144-156Crossref PubMed Scopus (245) Google Scholar Severe acute respiratory syndrome coronavirus (SARS-CoV) is predominantly transmitted through direct or indirect contact with mucous membranes in the eyes, mouth, or nose.5Peiris JS Yuen KY Osterhaus AD Stohr K The severe acute respiratory syndrome.N Engl J Med. 2003; 349: 2431-2441Crossref PubMed Scopus (1028) Google Scholar The fact that exposed mucous membranes and unprotected eyes increased the risk of SARS-CoV transmission4Belser JA Rota PA Tumpey TM Ocular tropism of respiratory viruses.Microbiol Mol Biol Rev. 2013; 77: 144-156Crossref PubMed Scopus (245) Google Scholar suggests that exposure of unprotected eyes to 2019-nCoV could cause acute respiratory infection. Thus, Huang and colleagues1Huang C Wang YM Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24. https://doi.org/10.1016/S0140-6736(20)30183-5.)Summary Full Text Full Text PDF Scopus (33099) Google Scholar should have analysed conjunctival scrapings from both confirmed and suspected 2019-nCoV cases during the onset of symptoms. The respiratory tract is probably not the only transmission route for 2019-nCoV, and all ophthalmologists examining suspected cases should wear protective eyewear. We declare no competing interests.

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Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection

2020-02-26

Jianhua Xia , Jianping Tong , Mengyun Liu +2 more

Abstract Objective This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS–CoV‐2‐infected patients. Methods A prospective interventional case series study was performed, and … Abstract Objective This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS–CoV‐2‐infected patients. Methods A prospective interventional case series study was performed, and 30 confirmed novel coronavirus pneumonia (NCP) patients were selected at the First Affiliated Hospital of Zhejiang University from 26 January 2020 to 9 February 2020. At an interval of 2 to 3 days, tear and conjunctival secretions were collected twice with disposable sampling swabs for reverse‐transcription polymerase chain reaction (RT‐PCR) assay. Results Twenty‐one common‐type and nine severe‐type NCP patients were enrolled. Two samples of tear and conjunctival secretions were obtained from the only one patient with conjunctivitis yielded positive RT‐PCR results. Fifty‐eight samples from other patents were all negative. Conclusion We speculate that SARS‐CoV‐2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis.

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Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong

2020-03-03

Tracy H. T. Lai , E. Tang , Sandy Chau +2 more

Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology … Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology to minimise COVID-19 infection of both healthcare workers and patients.Infection control measures implemented in our ophthalmology clinic are discussed. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts.A three-level hierarchy of control measures was adopted. First, for administrative control, in order to lower patient attendance, text messages with an enquiry phone number were sent to patients to reschedule appointments or arrange drug refill. In order to minimise cross-infection of COVID-19, a triage system was set up to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas and to encourage these individuals to postpone their appointments for at least 14 days. Micro-aerosol generating procedures, such as non-contact tonometry and operations under general anaesthesia were avoided. Nasal endoscopy was avoided as it may provoke sneezing and cause generation of droplets. All elective clinical services were suspended. Infection control training was provided to all clinical staff. Second, for environmental control, to reduce droplet transmission of COVID-19, installation of protective shields on slit lamps, frequent disinfection of equipment, and provision of eye protection to staff were implemented. All staff were advised to measure their own body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhoea. Third, universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE) were promoted.We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic. In order to minimise transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.

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Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals

2020-03-16

Ivan Seah , Rupesh Agrawal

In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2) emerged from China. This virus causes the coronavirus disease 2019 (COVID-19). … In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2) emerged from China. This virus causes the coronavirus disease 2019 (COVID-19). Since then, there have been anecdotal reports of ocular infection. The ocular implications of human CoV infections have not been widely studied. However, CoVs have been known to cause various ocular infections in animals. Clinical entities such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been documented in feline and murine models. In this article, the current evidence suggesting possible human CoV infection of ocular tissue is reviewed. The review article will also highlight animal CoVs and their associated ocular infections. We hope that this article will serve as a start for further research into the ocular implications of human CoV infections.

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Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)

2020-03-19

Li Guo , Lili Ren , Siyuan Yang +7 more

The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)-based technique, which identifies the viral nucleic … The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)-based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19.The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort.The median duration of IgM and IgA antibody detection was 5 (IQR, 3-6) days, while IgG was detected 14 (IQR, 10-18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%).The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.

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Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients

2020-03-24

Ivan Seah , Danielle E. Anderson , Adrian Eng Zheng Kang +5 more

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Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China

2020-03-31

Ping Wu , Fang Duan , Chunhua Luo +4 more

While the outbreak of coronavirus disease 2019 (COVID-19) has resulted in more than 100 000 infected individuals in China and worldwide, there are few reports on the association of severe … While the outbreak of coronavirus disease 2019 (COVID-19) has resulted in more than 100 000 infected individuals in China and worldwide, there are few reports on the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with ocular abnormalities. Understanding ocular manifestations of patients with COVID-19 by ophthalmologists and others may facilitate the diagnosis and prevention of transmission of the disease.To investigate ocular manifestations and viral prevalence in the conjunctiva of patients with COVID-19.In this case series, patients with COVID-19 treated from February 9 to 15, 2020, at a hospital center in Hubei province, China, were retrospectively reviewed for ocular manifestations. During the period of treatment, the ocular signs and symptoms as well as results of blood tests and reverse transcriptase-polymerase chain reaction (RT-PCR) from nasopharyngeal and conjunctival swabs for SARS-CoV-2 were noted and analyzed.Ocular signs and symptoms as well as results of blood tests and RT-PCR for SARS-CoV-2.Of the 38 included patients with clinically confirmed COVID-19, 25 (65.8%) were male, and the mean (SD) age was 65.8 (16.6) years. Among them, 28 patients (73.7%) had positive findings for COVID-19 on RT-PCR from nasopharyngeal swabs, and of these, 2 patients (5.2%) yielded positive findings for SARS-CoV-2 in their conjunctival as well as nasopharyngeal specimens. A total of 12 of 38 patients (31.6%; 95% CI, 17.5-48.7) had ocular manifestations consistent with conjunctivitis, including conjunctival hyperemia, chemosis, epiphora, or increased secretions. By univariate analysis, patients with ocular symptoms were more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without ocular symptoms. In addition, 11 of 12 patients with ocular abnormalities (91.7%; 95% CI, 61.5-99.8) had positive results for SARS-CoV-2 on RT-PCR from nasopharyngeal swabs. Of these, 2 (16.7%) had positive results for SARS-CoV-2 on RT-PCR from both conjunctival and nasopharyngeal swabs.In this study, one-third of patients with COVID-19 had ocular abnormalities, which frequently occurred in patients with more severe COVID-19. Although there is a low prevalence of SARS-CoV-2 in tears, it is possible to transmit via the eyes.

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Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease

2020-04-07

Lu Chen , Meizhou Liu , Zheng Zhang +7 more

Purpose To report the ocular characteristics and the presence of viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens in a patient with confirmed 2019 … Purpose To report the ocular characteristics and the presence of viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens in a patient with confirmed 2019 novel coronavirus disease (COVID-19). Participant and methods A 30-year-old man with confirmed COVID-19 and bilateral acute conjunctivitis which occurred 13 days after illness onset. Based on detailed ophthalmic examination, reverse transcription PCR (RT-PCR) was performed to detect SARS-CoV-2 virus in conjunctival swabs. The ocular characteristics, presence of viral RNA and viral dynamics of SARS-CoV-2 in the conjunctival specimens were evaluated. Results Slit lamp examination showed bilateral acute follicular conjunctivitis. RT-PCR assay demonstrated the presence of viral RNA in conjunctival specimen 13 days after onset (cycle threshold value: 31). The conjunctival swab specimens remained positive for SARS-CoV-2 on 14 and 17 days after onset. On day 19, RT-PCR result was negative for SARS-CoV-2. Conclusion SARS-CoV-2 is capable of causing ocular complications such as viral conjunctivitis in the middle phase of illness. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection. However, conjunctival sampling might not be useful for early diagnosis because the virus may not appear initially in the conjunctiva.

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Tropism, replication competence, and innate immune responses of the coronavirus SARS-CoV-2 in human respiratory tract and conjunctiva: an analysis in ex-vivo and in-vitro cultures

2020-05-07

Kenrie P. Y. Hui , Man Chun Cheung , Ranawaka A. P. M. Perera +7 more

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing a respiratory disease (coronavirus disease 2019, COVID-19) of varying severity in Wuhan, China, and subsequently leading to a … Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing a respiratory disease (coronavirus disease 2019, COVID-19) of varying severity in Wuhan, China, and subsequently leading to a pandemic. The transmissibility and pathogenesis of SARS-CoV-2 remain poorly understood. We evaluate its tissue and cellular tropism in human respiratory tract, conjunctiva, and innate immune responses in comparison with other coronavirus and influenza virus to provide insights into COVID-19 pathogenesis.

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Retinal findings in patients with COVID-19

2020-05-01

Paula M. Marinho , Alléxya A. A. Marcos , André Romano +2 more

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The unique characteristics of COVID-19 coagulopathy

2020-06-18

Toshiaki Iba , Jerrold H. Levy , Jean M. Connors +3 more

Thrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC), … Thrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC), with CAC usually showing increased D-dimer and fibrinogen levels but initially minimal abnormalities in prothrombin time and platelet count. Venous thromboembolism and arterial thrombosis are more frequent in CAC compared to SIC/DIC. Clinical and laboratory features of CAC overlap somewhat with a hemophagocytic syndrome, antiphospholipid syndrome, and thrombotic microangiopathy. We summarize the key characteristics of representative coagulopathies, discussing similarities and differences so as to define the unique character of CAC.

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Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study

2020-06-30

George Goshua , Alexander B. Pine , Matthew L. Meizlish +7 more

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The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

2021-02-17

Matthew J. Burton , Jacqueline Ramke , Ana Patrícia Marques +7 more

Eye health and vision have widespread and profound implications for many aspects of life, health, sustainable development, and the economy. Yet nowadays, many people, families, and populations continue to suffer … Eye health and vision have widespread and profound implications for many aspects of life, health, sustainable development, and the economy. Yet nowadays, many people, families, and populations continue to suffer the consequences of poor access to high-quality, affordable eye care, leading to vision impairment and blindness. In 2020, an estimated 596 million people had distance vision impairment worldwide, of whom 43 million were blind. Another 510 million people had uncorrected near vision impairment, simply because of not having reading spectacles. A large proportion of those affected (90%), live in low-income and middle-income countries (LMICs). However, encouragingly, more than 90% of people with vision impairment have a preventable or treatable cause with existing highly cost-effective interventions. Eye conditions affect all stages of life, with young children and older people being particularly affected. Crucially, women, rural populations, and ethnic minority groups are more likely to have vision impairment, and this pervasive inequality needs to be addressed. By 2050, population ageing, growth, and urbanisation might lead to an estimated 895 million people with distance vision impairment, of whom 61 million will be blind. Action to prioritise eye health is needed now. This Commission defines eye health as maximised vision, ocular health, and functional ability, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Eye health is essential to achieve many of the Sustainable Development Goals (SDGs). Poor eye health and impaired vision have a negative effect on quality of life and restrict equitable access to and achievement in education and the workplace. Vision loss has substantial financial implications for affected individuals, families, and communities. Although high-quality data for global economic estimates are scarce, particularly for LMICs, conservative assessments based on the latest prevalence figures for 2020 suggest that annual global productivity loss from vision impairment is approximately US$410·7 billion purchasing power parity. Vision impairment reduces mobility, affects mental wellbeing, exacerbates risk of dementia, increases likelihood of falls and road traffic crashes, increases the need for social care, and ultimately leads to higher mortality rates. By contrast, vision facilitates many daily life activities, enables better educational outcomes, and increases work productivity, reducing inequality. An increasing amount of evidence shows the potential for vision to advance the SDGs, by contributing towards poverty reduction, zero hunger, good health and wellbeing, quality education, gender equality, and decent work. Eye health is a global public priority, transforming lives in both poor and wealthy communities. Therefore, eye health needs to be reframed as a development as well as a health issue and given greater prominence within the global development and health agendas. Vision loss has many causes that require promotional, preventive, treatment, and rehabilitative interventions. Cataract, uncorrected refractive error, glaucoma, age-related macular degeneration, and diabetic retinopathy are responsible for most global vision impairment. Research has identified treatments to reduce or eliminate blindness from all these conditions; the priority is to deliver treatments where they are most needed. Proven eye care interventions, such as cataract surgery and spectacle provision, are among the most cost-effective in all of health care. Greater financial investment is needed so that millions of people living with unnecessary vision impairment and blindness can benefit from these interventions. Lessons from the past three decades give hope that this challenge can be met. Between 1990 and 2020, the age-standardised global prevalence of blindness fell by 28·5%. Since the 1990s, prevalence of major infectious causes of blindness—onchocerciasis and trachoma—have declined substantially. Hope remains that by 2030, the transmission of onchocerciasis will be interrupted, and trachoma will be eliminated as a public health problem in every country worldwide. However, the ageing population has led to a higher crude prevalence of age-related causes of blindness, and thus an increased total number of people with blindness in some regions. Key messagesEye health is essential to achieve the Sustainable Development Goals; vision needs to be reframed as a development issueThere is extensive evidence showing that improving eye health contributes directly and indirectly to achieving many Sustainable Development Goals, including reducing poverty and improving work productivity, general and mental health, and education and equity. Improving eye health is a practical and cost-effective way of unlocking human potential. Eye health needs to be reframed as an enabling, cross-cutting issue within the sustainable development framework.Almost everyone will experience impaired vision or an eye condition during their lifetime and require eye care services; urgent action is necessary to meet the rapidly growing eye health needIn 2020, 1·1 billion people had distance vision impairment or uncorrected presbyopia. By 2050, this figure is expected to rise to 1·8 billion. Most affected people live in low-income and middle-income countries (LMICs) with avoidable causes of vision impairment. During the life course, most people will experience vision impairment, even if just the need for reading glasses. Because of unmet needs and an ageing global population, eye health is a major public health and sustainable development concern which warrants urgent political action.Eye health is an essential component of universal health coverage; it must be included in planning, resourcing, and delivery of health careUniversal health coverage is not universal without affordable, high quality, equitable eye care. In line with the WHO World report on vision, we urge countries to consider eye care as an essential service within universal health coverage. To deliver comprehensive services including promotion, prevention, treatment, and rehabilitation, eye care needs to be included in national strategic health plans and development policies, health financing structures, and health workforce planning. Coordinated intersectoral action is needed to systematically improve population eye health, also within healthy ageing initiatives, schools, and the workplace. Integration of eye health services with multiple relevant components of health service delivery and at all levels of the health system is of central importance.High quality eye health services are not universally delivered; concerted action is needed to improve quality and outcomes, providing effective, efficient, safe, timely, equitable, and people-centred careUse of effective service coverage indicators for cataract and refractive error highlight the delivery gap between population eye health needs and the delivery of good outcomes. We urge eye health providers to take a holistic view to emphasise quality and design service delivery based on individual and population needs: a people-centred approach. Services need to be characterised by inclusiveness and equity in design and delivery, proactively addressing the needs of marginalised and vulnerable groups through targeted interventions. To encourage improved quality in cataract surgery, we support redefining a good vision outcome threshold as 6/12 or better.Highly cost-effective vision-restoring interventions offer enormous potential to improve the economic outlook of individuals and nations; a major scale up of financial investment in eye health is requiredFor 2020, we estimate that vision impairment resulted in $410·7 billion lost economic productivity; the full cost is most likely higher. Treatments for cataract and refractive error would meet more than 90% of unmet needs and are highly cost-effective. The case for countries to invest in improving population eye health is compelling and more financial resources are urgently required.Financial barriers to accessing eye care leave many people behind; eye health needs to be included in national health financing to pool the riskHealth-care costs prevent many people from accessing essential eye health services. Eye care needs to be integrated into general health system financing to remove cost barriers. To improve access for the whole population and mitigate eye care expenditure, mechanisms that pool risk are highly desirable.Technology and treatment developments offer new tools to improve eye health; thoughtful application is needed to maximise the potential to improve coverage, accessibility, quality, efficiency, and affordabilityTechnological developments such as telemedicine, mHealth, and artificial intelligence offer the potential to revolutionise eye health care in the next decade by delivering affordable, high-quality services to remote areas. However, caution is needed to ensure all populations benefit from these developments.The eye health workforce is unable to meet population needs in many countries; major expansion in service capacity is required through increased numbers, sharing tasks, strengthened training, enabling work environments, and effective leadershipMany areas have major shortages of personnel working in eye health. The available workforce needs to be distributed according to population need. Quality of training for the workforce needs to be updated, with renewed emphasis on competency. Enabling working environments need to be created, including appropriate support, supervision, and equipment. Long-standing issues of low productivity need to be systematically resolved. Mentoring and other programmes to cultivate an emerging generation of eye health leaders are needed.Reliable survey and service data are key to progress in eye health; robust indicator data are needed to shape change and drive actionTo monitor progress in delivering improved eye health within universal health coverage, a balanced set of robust indicators are needed, which we outlined in this Commission. Service data should be available and used by implementers and policy makers to drive change. We highlight the scarcity of epidemiological data in several regions, which should be addressed as a priority.Research has been crucial to advances in understanding and treating eye disease; solution-focused, contextually relevant research is urgently needed to deliver innovative prevention and treatment strategies and inform implementation of eye health within universal health coverageImplementation research is needed, particularly in LMICs, to guide effective delivery of services within universal health coverage. Discovery research is needed for specific areas that remain without efficacious interventions. The economic impact of vision impairment, and the costs and benefits of interventions are only partly understood; a coordinated global effort to systematically collect data is needed. A step-change in the capacity of LMICs to do contextually relevant eye health research and a greater commitment are needed to improve diversity and inclusion in the research community. Eye health is essential to achieve the Sustainable Development Goals; vision needs to be reframed as a development issue There is extensive evidence showing that improving eye health contributes directly and indirectly to achieving many Sustainable Development Goals, including reducing poverty and improving work productivity, general and mental health, and education and equity. Improving eye health is a practical and cost-effective way of unlocking human potential. Eye health needs to be reframed as an enabling, cross-cutting issue within the sustainable development framework. Almost everyone will experience impaired vision or an eye condition during their lifetime and require eye care services; urgent action is necessary to meet the rapidly growing eye health need In 2020, 1·1 billion people had distance vision impairment or uncorrected presbyopia. By 2050, this figure is expected to rise to 1·8 billion. Most affected people live in low-income and middle-income countries (LMICs) with avoidable causes of vision impairment. During the life course, most people will experience vision impairment, even if just the need for reading glasses. Because of unmet needs and an ageing global population, eye health is a major public health and sustainable development concern which warrants urgent political action. Eye health is an essential component of universal health coverage; it must be included in planning, resourcing, and delivery of health care Universal health coverage is not universal without affordable, high quality, equitable eye care. In line with the WHO World report on vision, we urge countries to consider eye care as an essential service within universal health coverage. To deliver comprehensive services including promotion, prevention, treatment, and rehabilitation, eye care needs to be included in national strategic health plans and development policies, health financing structures, and health workforce planning. Coordinated intersectoral action is needed to systematically improve population eye health, also within healthy ageing initiatives, schools, and the workplace. Integration of eye health services with multiple relevant components of health service delivery and at all levels of the health system is of central importance. High quality eye health services are not universally delivered; concerted action is needed to improve quality and outcomes, providing effective, efficient, safe, timely, equitable, and people-centred care Use of effective service coverage indicators for cataract and refractive error highlight the delivery gap between population eye health needs and the delivery of good outcomes. We urge eye health providers to take a holistic view to emphasise quality and design service delivery based on individual and population needs: a people-centred approach. Services need to be characterised by inclusiveness and equity in design and delivery, proactively addressing the needs of marginalised and vulnerable groups through targeted interventions. To encourage improved quality in cataract surgery, we support redefining a good vision outcome threshold as 6/12 or better. Highly cost-effective vision-restoring interventions offer enormous potential to improve the economic outlook of individuals and nations; a major scale up of financial investment in eye health is required For 2020, we estimate that vision impairment resulted in $410·7 billion lost economic productivity; the full cost is most likely higher. Treatments for cataract and refractive error would meet more than 90% of unmet needs and are highly cost-effective. The case for countries to invest in improving population eye health is compelling and more financial resources are urgently required. Financial barriers to accessing eye care leave many people behind; eye health needs to be included in national health financing to pool the risk Health-care costs prevent many people from accessing essential eye health services. Eye care needs to be integrated into general health system financing to remove cost barriers. To improve access for the whole population and mitigate eye care expenditure, mechanisms that pool risk are highly desirable. Technology and treatment developments offer new tools to improve eye health; thoughtful application is needed to maximise the potential to improve coverage, accessibility, quality, efficiency, and affordability Technological developments such as telemedicine, mHealth, and artificial intelligence offer the potential to revolutionise eye health care in the next decade by delivering affordable, high-quality services to remote areas. However, caution is needed to ensure all populations benefit from these developments. The eye health workforce is unable to meet population needs in many countries; major expansion in service capacity is required through increased numbers, sharing tasks, strengthened training, enabling work environments, and effective leadership Many areas have major shortages of personnel working in eye health. The available workforce needs to be distributed according to population need. Quality of training for the workforce needs to be updated, with renewed emphasis on competency. Enabling working environments need to be created, including appropriate support, supervision, and equipment. Long-standing issues of low productivity need to be systematically resolved. Mentoring and other programmes to cultivate an emerging generation of eye health leaders are needed. Reliable survey and service data are key to progress in eye health; robust indicator data are needed to shape change and drive action To monitor progress in delivering improved eye health within universal health coverage, a balanced set of robust indicators are needed, which we outlined in this Commission. Service data should be available and used by implementers and policy makers to drive change. We highlight the scarcity of epidemiological data in several regions, which should be addressed as a priority. Research has been crucial to advances in understanding and treating eye disease; solution-focused, contextually relevant research is urgently needed to deliver innovative prevention and treatment strategies and inform implementation of eye health within universal health coverage Implementation research is needed, particularly in LMICs, to guide effective delivery of services within universal health coverage. Discovery research is needed for specific areas that remain without efficacious interventions. The economic impact of vision impairment, and the costs and benefits of interventions are only partly understood; a coordinated global effort to systematically collect data is needed. A step-change in the capacity of LMICs to do contextually relevant eye health research and a greater commitment are needed to improve diversity and inclusion in the research community. Despite this progress, business as usual will not keep pace with the demographic trends of an ageing global population or address the inequities that persist in each country. New threats to eye health are emerging, including the worldwide increase in diabetic retinopathy, high myopia, retinopathy of prematurity, and chronic eye diseases of ageing such as glaucoma and age-related macular degeneration. With the projected increase in such conditions and their associated vision loss over the coming decades, urgent action is needed to develop innovative treatments and deliver services at a greater scale than previously achieved. Good eye health at the community and national level has been marginalised as a luxury available to only wealthy or urban areas. Eye health needs to be urgently brought into the mainstream of national health and development policy, planning, financing, and action. The challenge is to develop and deliver comprehensive eye health services (promotion, prevention, treatment, rehabilitation) that address the full range of eye conditions within the context of universal health coverage. Accessing services should not bring the risk of falling into poverty and services should be of high quality, as envisaged by the WHO framework for health-care quality: effective, safe, people-centred, timely, equitable, integrated, and efficient. To this framework we add the need for services to be environmentally sustainable. Universal health coverage is not universal without eye care. Multiple obstacles need to be overcome to achieve universal coverage for eye health. Important issues include complex barriers to availability and access to quality services, cost, major shortages and maldistribution of well-trained personnel, and lack of suitable, well maintained equipment and consumables. These issues are particularly widespread in LMICs, but also occur in underserved communities in high-income countries. Strong partnerships need to be formed with natural allies working in areas affected by eye health, such as non-communicable diseases, neglected tropical diseases, healthy ageing, children's services, education, disability, and rehabilitation. The eye health sector has traditionally focused on treatment and rehabilitation, and underused health promotion and prevention strategies to lessen the impact of eye disease and reduce inequality. Solving these problems will depend on solutions established from high quality evidence that can guide more effective implementation at scale. Evidence-based approaches will need to address existing deficiencies in the supply and demand. Strategic investments in discovery research, harnessing new findings from diverse fields, and implementation research to guide effective scale up are needed globally. Encouragingly, developments in telemedicine, mobile health, artificial intelligence, and distance learning could potentially enable eye care professionals to deliver higher quality care that is more plentiful, equitable, and cost-effective. This Commission did a Grand Challenges in Global Eye Health prioritisation exercise to highlight key areas for concerted research and action. This exercise has identified a broad set of challenges spanning the fields of epidemiology, health systems, diagnostics, therapeutics, and implementation. The most compelling of these issues, picked from among 3400 suggestions proposed by 336 people from 118 countries, can help to frame the future research agenda for global eye health. In this Commission, we harness lessons learned from over two decades, present the growing evidence for the life-transforming impact of eye care, and provide a thorough understanding of rapid developments in the field. This report was created through a broad consultation involving experts within and outside the eye care sector to help inform governments and other stakeholders about the path forward for eye health beyond 2020, to further the SDGs (including universal health coverage), and work towards a world without avoidable vision loss. The next few years are a crucial time for the global eye health community and its partners in health care, government, and other sectors to consider the successes and challenges encountered in the past two decades, and at the same time to chart a way forward for the upcoming decades. Moving forward requires building on the strong foundation laid by WHO and partners in VISION 2020 with renewed impetus to ultimately deliver high quality universal eye health care for all.

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COVID-19 and Eye: A Review of Ophthalmic Manifestations of COVID-19

2021-02-17

Mrittika Sen , Santosh G Honavar , Namrata Sharma +1 more

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life threatening respiratory distress. … The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life threatening respiratory distress. It can affect almost every organ of the body. Ophthalmologists world over are reporting various manifestations of the infection in the eye. This review was undertaken to help ophthalmologists recognize the possible manifestations and the stage of the viral disease when they commonly appear. Literature search was performed for the publications on ophthalmic manifestations of coronavirus disease-19 (COVID-19) between January 1, 2020 and January 31, 2021. 46 case reports, 8 case series, 11 cross sectional/cohort observational studies, 5 prospective interventional studies, 3 animal models/autopsy studies and 6 reviews/meta-analysis were included. Conjunctivitis is the most common manifestation and can develop at any stage of the disease. Direct effect due to virus, immune mediated tissue damage, activation of the coagulation cascade and prothrombotic state induced by the viral infection, the associated comorbidities and drugs used in the management are responsible for the findings in the eye. The viral ribonucleic acid (RNA) has been isolated from ocular tissues but the role of eye as a route for infection is yet to be substantiated. Ophthalmic manifestations may be the presenting feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of the possible associations of ocular diseases with SARS-CoV-2 in order to ask relevant history, look for specific signs, advise appropriate tests and thereby mitigate the spread of infection as well as diagnose and initiate early treatment for life and vision threatening complications.

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa

1993-06-01

Eliot L. Berson

A review of central retinal artery occlusion: clinical presentation and management

2013-03-08

Daniel D. Varma , Sudha Cugati , Andrew W.P. Lee +1 more

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Retinal Pigment Epithelium

2011-08-24

Keith M. Zinn , Michael F. Marmor

Prevalence of Anterior Segment Diseases on a Remote Island: A Telemedicine-Based Study Using the Smart Eye Camera

2025-06-25

Robin Kuroiwa , Takahiro Mizukami , Hiroki Nishimura +4 more | Cureus

Treatment Outcomes with the Optic Neuritis Treatment Trial Protocol in Typical Optic Neuritis and Prognostic Factors Associated with Final Visual Acuity: Real-Life Data

2025-06-23

Abdulkadir Can Çınar , Ayça Küpeli Çınar , A Dinç +5 more | Namık Kemal Tıp Dergisi

Morphological, vascular, and functional changes in macular telangiectasia type 2 in Egyptian patients

2025-06-23

Shaimaa Ibrahim Gafar , Hany Hamza , Ihab Abdelaziz +2 more | Scientific Reports

Little documented studies regarding analysis of macular telangiectasia type 2 in Egyptian patients. This prospective study included 24 eyes with MacTel-2, and 24 control eyes. Spectral-domain optical coherence tomography Angiography … Little documented studies regarding analysis of macular telangiectasia type 2 in Egyptian patients. This prospective study included 24 eyes with MacTel-2, and 24 control eyes. Spectral-domain optical coherence tomography Angiography (OCT-A) was performed. Staging of eyes with MacTel-2, quantification of Foveal and parafoveal vascular density and full retinal thickness were performed. In MacTel-2 eyes, the superficial capillary vessel density was significantly decreased in the temporal, superior and inferior para-foveal area (p-value = 0.004, < 0.001 and 0.002 respectively). Only temporal parafoveal deep vessel density showed significant decrease in the MacTel-2 group as compared with the normal control group (49.6% versus 54.01%, p value = 0.010). There was a statistically significant decrease in the foveal and all the para-foveal thickness as compared with normal control group (P < 0.001). One-fourth of cases were classified as stage 4 MacTel-2. The patterns of neovessels were sea-fan, tangled or dead tree network, equally distributed among the six affected eyes. A significant reduction in both foveal density and visual acuity was documented with disease progression. This study emphasizes the role of OCT-A in diagnosis, staging and identification of neovascular pattern of MacTel-2. Furethermore, this study is considered one of the few Egyptian studies in staging the disease providing correlation to visual acuity, macular thickness and vessel density affection.

Brain Rot: A Scale Development Study

2025-06-23

Ercan Yılmaz , Abdullah Aktürk | Research on Education and Psychology

In this research, it was aimed to develop a valid and reliable measurement tool to determine the brain rot levels of individuals. The research study group was formed by selecting … In this research, it was aimed to develop a valid and reliable measurement tool to determine the brain rot levels of individuals. The research study group was formed by selecting among the Alpha generation individuals who are accepted to use social media more intensively. In the scale development process, draft scale development, EFA, CFA, test-retest, and known group validity methods were used. Cronbach's Alpha and McDonald's Omega coefficients were calculated for the reliability analyses of the scale. According to the findings obtained as a result of the analyses, the scale consists of four dimensions and 18 items. The scale dimensions are cognitive load, cognitive fatigue, emulation, and depersonalization. The fit indices of the structure obtained with CFA are acceptable and good fit level. Cronbach's Alpha and McDonald's Omega coefficients calculated for the reliability of the scale are above 0.70. According to the methods of test-retest and known group validity methods, the developed scale makes measurements that are stable and can distinguish different groups. As a result of all analyses, it was determined that the developed brain rot scale is a valid and reliable measurement tool.

Manejo anestésico em um paciente com síndrome de SUSAC

2025-06-23

Gabriel Peixoto Nascimento , Dirceu Castro Pacheco , Gustavo Siqueira Elmiro +1 more | REVISTA CIENTIFICA CEREM-GO

A Síndrome de Susac (SS) é definida como uma microangiopatia oclusiva de etiologia autoimune,caracterizada pelo acometimento de arteríolas nos leitos vasculares cerebrais, retinianos e cocleares. Atríade clínica clássica manifesta-se por … A Síndrome de Susac (SS) é definida como uma microangiopatia oclusiva de etiologia autoimune,caracterizada pelo acometimento de arteríolas nos leitos vasculares cerebrais, retinianos e cocleares. Atríade clínica clássica manifesta-se por encefalopatia, déficits visuais e perda auditiva. Dada a sua relativararidade e apresentação clínica variável, a SS frequentemente representa um desafio diagnóstico,resultando em subdiagnóstico ou diagnóstico errôneo. Atualmente, a terapêutica predominante paraa SS envolve a imunomodulação com corticoterapia. O presente relato de caso descreve a evoluçãoclínica de uma paciente de 36 anos submetida a anestesia geral inalatória para colecistectomiavideolaparoscópica eletiva. Embora a monitorização invasiva da pressão intracraniana não tenha sidoimplementada, a condução anestésica demonstrou-se eficaz para a paciente em questão, evidenciandoa importância de uma avaliação clínica e neurológica detalhada no período perioperatório, mesmo emprocedimentos considerados de baixo risco neurológico.

Double Myopic Choroidal Neovascular Membranes (CNVMs): A Case Report

2025-06-22

Asli Perente , Aikaterini Giannoukaki , Doukas Dardabounis +2 more | Cureus

Objective Lens Densitometry Evaluation Using Scheimpflug Topography in Children After COVID-19 Infection

2025-06-22

Onur Kalay , Ayşe İpek Akyüz Ünsal , Erol Erkan +4 more | Meandros Medical And Dental Journal

Purpose: To explore the effects of COVID-19 on lens structure in children using Pentacam HR Scheimpflug corneal topography and lens densitometry (LD). Methods: This prospective case-control study involved patients aged … Purpose: To explore the effects of COVID-19 on lens structure in children using Pentacam HR Scheimpflug corneal topography and lens densitometry (LD). Methods: This prospective case-control study involved patients aged 7 to 18 who were scheduled for ophthalmologic examination. Pentacam densitometry zones (PDZ 1, 2, and 3) were assessed in children who had recovered from COVID-19 in the past 6 months and had no systemic diseases, with comparisons made to controls. Results: A total of 114 eyes from 57 patients were evaluated, including 29 (50.9%) children in the patient group and 28 (49.1%) in the control group. PDZ 1 values for ages 7-10, all PDZ values for ages 11-14, and PDZ 3 values for ages 15-18 were significantly higher after COVID-19 compared to those in the control group (P < 0.05). Positive correlations were observed between PDZ 1-3 values and time since recovery from COVID-19 in patients aged 11-14 (r = 0.639, 0.628, and 0.590, respectively; P = 0.014, 0.016, and 0.027). Conclusions: Vision quality is affected not only by visual acuity but also by factors such as contrast sensitivity, higher-order optical irregularities, and the clarity of the visual axis. This study reveals significant differences in lens density, particularly in the 11-14 age group, which may suggest the potential impact of COVID-19 on children's visual quality, indicating a need for further investigation.

Structural, Functional, and Cellular Analysis of a Case of Acute Zonal Occult Outer Retinopathy (AZOOR)

2025-06-21

Mattia Iuliano , Marco Lombardo , Benedetto Falsini +4 more | Biomedicines

Background: Adaptive optics transscleral flood illumination (AO-TFI) enables in vivo, non-invasive, high-resolution imaging of retinal pigment epithelium (RPE) and photoreceptor (PR) cells, paving the way for a new potential characterization … Background: Adaptive optics transscleral flood illumination (AO-TFI) enables in vivo, non-invasive, high-resolution imaging of retinal pigment epithelium (RPE) and photoreceptor (PR) cells, paving the way for a new potential characterization of retinal diseases. This study aimed to analyze RPE and PR cells in a case of acute zonal occult outer retinopathy (AZOOR) using AO-TFI. Methods: A patient affected by AZOOR underwent a comprehensive eye examination, perimetry, electroretinography (ERG), autofluorescence, and optical coherence tomography (OCT) during the acute phase (T0). After three years (T1), OCT angiography (OCTA) and AO-TFI were also performed. Voronoi analysis was utilized to quantify RPE and PR cells. Results: At T0, OCT revealed interruptions in the ellipsoid zone (EZ) of the right eye, while the structure of the left eye appeared normal. Perimetry and ERG were abnormal in both eyes. At T1, OCT indicated recovery of the EZ in the right eye, while thinning of the ONL persisted. Perimetry and mfERG values remained below normative limits. OCTA exhibited globally reduced vessel density in the inner retina of the right eye. AO-TFI demonstrated reduced PR density in affected areas despite preserved EZ, while RPE cell density appeared unaffected. Conclusion: AO-TFI enabled a detailed visualization and quantification of macular RPE and PR cells, providing valuable insights into the pathophysiology of AZOOR.

Large language models in neuro-ophthalmology diseases: ChatGPT vs Bard vs Bing

2025-06-20

Dong Hee Ha | International Journal of Ophthalmology

AIM: To investigate the capabilities of large language models (LLM) for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and -4.0, Bard, and … AIM: To investigate the capabilities of large language models (LLM) for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and -4.0, Bard, and Bing. METHODS: Each chatbot was evaluated for four criteria, namely diagnostic success rate for the described case, answer quality, response speed, and critical keywords for diagnosis. The selected topics included optic neuritis, non-arteritic anterior ischemic optic neuropathy, and Leber hereditary optic neuropathy. RESULTS: In terms of diagnostic success rate for the described cases, Bard was unable to provide a diagnosis. The success rates for the described cases increased in the order of Bing, ChatGPT-3.5, and ChatGPT-4.0. Further, ChatGPT-4.0 and -3.5 provided the most satisfactory answer quality for judgment by neuro-ophthalmologists, with their sets of answers resembling the sample set most. Bard was only able to provide ten differential diagnoses in three trials. Bing scored the lowest for the satisfactory standard. A Mann-Whitney test indicated that Bard was significantly faster than ChatGPT-4.0 (Z=-3.576, P=0.000), ChatGPT-3.5 (Z=-3.576, P=0.000) and Bing (Z=-2.517, P=0.011). ChatGPT-3.5 and -4.0 far exceeded the other two interfaces at providing diagnoses and were thus used to find the critical keywords for diagnosis. CONCLUSION: ChatGPT-3.5 and -4.0 are better than Bard and Bing in terms of answer success rate, answer quality, and critical keywords for diagnosis in ophthalmology. This study has broad implications for the field of ophthalmology, providing further evidence that artificial intelligence LLM can aid clinical decision-making through free-text explanations.

Klebsiella pneumoniae endophthalmitis following central retinal artery occlusion

2025-06-20

Hong Lei , Zheng-Gao Xie | International Journal of Ophthalmology

Conceptual Study on The Add-On Effect of Bhringaraj Yastimadhu Siddha Taila Pratimarsh Nasya in Simple Myopia

2025-06-20

Shruti Karade , Santosh S. Mulik , Sanjay Durve +2 more | Journal of Neonatal Surgery

Myopia is a major public health problem pertaining to eye that entails substantial societal, personal, educational, and economical impact. Various surveys in India have found the prevalence of myopia ranging … Myopia is a major public health problem pertaining to eye that entails substantial societal, personal, educational, and economical impact. Various surveys in India have found the prevalence of myopia ranging from 6.9% to 19.7%. Myopia progression is irreversible and methods for the correction of myopia are not without complications. Myopia closely resembles Timira involving first and second Patala in terms of symptoms, anatomical structures involved, and the pathogenesis of the disease. The study is aimed at evaluating the efficacy of the Pratimarsh Nasya procedure with Bhringaraj Yashtimadhu Siddha Taila in fresh and old myopes. The formulation owing to its neuro nourishing, anti-inflammatory and rejuvenating properties may help in stabilising or reducing the progression of myopia when used as an adjunct to standard ophthalmic care.

Susac Syndrome with Cerebral Venous Sinus Thrombosis – A Rare Association

2025-06-18

Jon C. George , Kiren George Koshy , Sruthi Nair | Neurology India

Faricimab (Vabysmo)

2025-06-18

CDA-AMC | Canadian Journal of Health Technologies

Reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class. The assessments inform nonbinding recommendations that … Reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class. The assessments inform nonbinding recommendations that help guide the reimbursement decisions of Canada’s federal, provincial, and territorial governments, with the exception of Quebec. This review assesses faricimab injection (Vabysmo) 6 mg/0.05 mL solution for intravitreal injection. Indication: For the treatment of macular edema secondary to retinal vein occlusion.

Artificial intelligence versus ophthalmology experts: Comparative analysis of responses to blepharitis patient queries

2025-06-16

Daniel Bahir , Audrey Talley Rostov , Yumna Busool +7 more | European Journal of Ophthalmology

Objective To assess the accuracy and clinical education value of responses from AI models (GPT-3.5, GPT-4o, Gemini, Gemini Advanced) compared to expert ophthalmologists’ answers to common patient questions about blepharitis, … Objective To assess the accuracy and clinical education value of responses from AI models (GPT-3.5, GPT-4o, Gemini, Gemini Advanced) compared to expert ophthalmologists’ answers to common patient questions about blepharitis, and evaluate their potential for patient education and clinical use. Methods Thirteen frequently asked questions about blepharitis were selected. Responses were generated by AI models and compared to expert answers. A panel of ophthalmologists rated each response for correctness and clinical education value using a 7-point Likert scale. The Friedman test with post hoc comparisons was used to identify performance differences. Results Expert responses had the highest correctness (6.3) and clinical education value (6.4) scores, especially in complex, context-driven questions. Significant differences were found between expert and AI responses ( P < 0.05). Among AI models, GPT-3.5 performed best in simple definitions (correctness: 6.4) but dropped to 5.5 in nuanced cases. GPT-4o followed (5.4), while Gemini and Gemini Advanced scored lower (5.0 and 4.9), especially in diagnostic and treatment contexts. Conclusions AI models can support patient education by effectively answering basic factual questions about blepharitis. However, their limitations in complex clinical scenarios highlight the continued need for expert input. While promising as educational tools, AI should complement—not replace—clinician guidance in patient care.

Possibilities of using transpalpebral tonometry for screening control of intraocular pressure in young children

2025-06-14

Е. Н. Иомдина , Nina Yu. Kushnarevich , T. Yu. Larina +1 more | Russian Ophthalmological Journal

Purpose of the work was to study the possibility of using transpalpebral tonometry (TPT) using the Tonotest device in younger children (up to and including 5 years old) for screening … Purpose of the work was to study the possibility of using transpalpebral tonometry (TPT) using the Tonotest device in younger children (up to and including 5 years old) for screening control of intraocular pressure (IOP). Material and methods . As part of the screening examination, IOP was determined in 46 children (92 eyes) aged 5 months to 5 years, divided into 2 groups. In the 1st group — 21 children (42 eyes) aged 5 months to 3 years (average 1.5 ± 1.0 years) — only Tonotest was used for tonometry, and in the 2nd group — 25 children (50 eyes) aged 3.5 to 5 years (average 4.5 ± 0.6 years) — IOP measurement was performed sequentially (in random order) by two methods — using Tonotest and a pneumotonometer (Reichert 7 AutoTonometer, USA). Results . In most cases, the children tolerated the TPT procedure well and did not complain of discomfort, pain, or any other unpleasant sensations. However, in 7 children (33 %) of the 1st group and in 5 children (20 %) of the 2nd group, behavioral characteristics did not allow measuring IOP. The IOP level according to TPT in the 1st group was 16.4 ± 2.9 mm Hg. In the 2nd group, the IOP value according to Tonotest was 15.1 ± 2.0 mm Hg, according to the pneumotonometer — 16.0 ± 2.1 mm Hg (p = 0.09). Conclusion . The possibility of using TPT for screening control of IOP in younger children (0–5 years old) is shown. Comparison of the results of IOP determination in the group of children aged 3.5–5.0 years using Tonotest and pneumotonometer showed no statistically significant differences between them. TPT using Tonotest allows to expand the possibilities of IOP monitoring in pediatric practice.

Assessing and predicting adverse events from pupil dilators used in department of ophthalmology in atertiary care hospital

2025-06-14

Roopan J , Harshitha P , Hosseini Gh.A. +2 more | Future Journal of Pharmaceuticals and Health Sciences

Background: For the overwhelming majority of diseases, medication management will enhance health-related quality of life. Inappropriate pharmaceutical usage, however, can be harmful and lead to problems with medication. A situation … Background: For the overwhelming majority of diseases, medication management will enhance health-related quality of life. Inappropriate pharmaceutical usage, however, can be harmful and lead to problems with medication. A situation or incident that interferes with intended health results, either directly or indirectly, is referred to as a pupil-related problem. When using pupil dilators for eye exams, such unfavourable outcomes are frequently observed. Every medication has side effects, and this pupil dilation medication also exhibits some of the most prevalent ones, such burning in the eye. Eye discomfort, eye irritation, elevated intraocular pressure, and impaired vision. Methods: A prospective observational study was conducted on 209 patients at the Department of Ophthalmology, AIMS, B.G. Nagara, between January and June 2024. Data were collected daily using a structured form, and ADRs were assessed using the Naranjo and WHO causality assessment scales after obtaining ethical clearance. Results: Among the 209 participants (104 males and 105 females), 196 (93.8%) experienced ADRs. A total of 556 ADRs were identified, of which 444 were short-term and 112 long-term. Short-term ADRs included 344 ocular, 98 systemic, and 2 mixed cases, while long-term ADRs comprised 83 ocular, 17 systemic, and 1 mixed case. The most common short-term ADRs were blurred vision, photosensitivity, headache, eye dryness, and burning sensation. ADRs were found to be more prevalent in patients with comorbidities and in adolescents. Conclusion: The study concludes that pupil dilators carry a high risk of ADRs, particularly in vulnerable groups. Careful monitoring and preventive strategies are essential to minimize these effects during ophthalmic procedures.

Results of the first Russian survey of retinologists “SETCHAtochkaRU”

2025-06-14

E. V. Bobykin , R.R. Fayzrakhmanov , S. Yu. Golubev +7 more | Russian Ophthalmological Journal

Disorders of the posterior segment of the eye are traditionally one of the most important medical and social problem. The rapid development in the ophthalmology field in the 20th and … Disorders of the posterior segment of the eye are traditionally one of the most important medical and social problem. The rapid development in the ophthalmology field in the 20th and 21st centuries has led to a significant improvement in the knowledge on the physiology and pathology of the light-perceiving eye structures, revolutionary achievements in the diagnosis and treatment of a wide range of retinal diseases, optic nerve, choroid and vitreous body pathology. The need for highly qualified physicians with a modern understanding of this problem led to the emergence of an ophthalmological specialization called “retinology”. Modern retinology includes various areas of diagnostics (including visualization of eye structures, electrophysiological and genetic methods), as well as drug, laser and microsurgical treatment and rehabilitation of the patients. In the rapidly developing medicine, sociological research is extremely important, allowing health care organizers to assess existing trends and make decisions determining the development direction in the field, and specialists to exchange opinions and analyze their professional activities. Retinology is no exception. Surveys of professional organizations of retinologists that have great scientific and practical significance are successfully conducted abroad, the most famous of which are the EURETINA Clinical Trends Survey and the ASRS Preferences and Trends (PAT) Survey. In Russia, such surveys have not been conducted to date. At the same time, the opportunity to learn the opinions of Russian specialists, as well as to compare domestic and foreign data is of undoubted interest. In 2024, we organized and conducted the first independent Russian survey of retinologists “SETCHAtochkaRU”, in which 585 ophthalmologists from all federal districts of the Russian Federation took part, as well as our colleagues from Belarus, Kazakhstan, Kyrgyzstan, Latvia, Lebanon, Tajikistan, Turkmenistan, Turkey and Uzbekistan. The main results of the survey are presented in this publication.

474-P: Progression of Diabetic Retinopathy in Wales during the COVID-19 Pandemic

2025-06-13

REBECCA L. THOMAS , WY Cheung , James Rafferty +6 more | Diabetes

Introduction and Objective: Between March and September 2020, routine healthcare in the UK, including diabetic retinopathy (DR) screening, was paused due to the COVID-19 pandemic. This created a natural experiment … Introduction and Objective: Between March and September 2020, routine healthcare in the UK, including diabetic retinopathy (DR) screening, was paused due to the COVID-19 pandemic. This created a natural experiment to explore the impact of extended screening intervals. Methods: Data from Diabetic Eye Screening Wales (DESW) and primary care were linked using the Secure Anonymised Information Linkage databank (SAIL). Individuals screened within 12 months pre-lockdown and rescreened between March 2020 and August 2022 were included. Results: Of 12,424 individuals with no DR pre-lockdown, 84.3% remained free of retinopathy post-lockdown, 15.8% progressed to background retinopathy, and 0.3% to referable retinopathy. Background Retinopathy (Pre-Lockdown): Of 11,694 individuals with background DR pre-lockdown, 30.8% regressed to no retinopathy, 64.9% remained with background DR, and 4.4% progressed to referable diabetic retinopathy (RDR). Of 731 individuals with RDR pre-lockdown, 3.3% had no DR post-lockdown, 36.0% regressed to background DR, and 60.7% remained at referable level. Of 24,866 individuals with no maculopathy pre-lockdown, 94% remained maculopathy-free, while 6.0% developed diabetic maculopathy. Diabetic Of 257 individuals with diabetic maculopathy pre-lockdown, 50.6% regressed to no maculopathy, while 49.4% remained unchanged. Conclusion: The risk of progression from no DR to RDR or maculopathy was low (0.3% and 6.0%, respectively). Only 10% of those referred with suggested maculopathy required treatment. This study provides further evidence that screening biennially is considered safe for those without DR Disclosure R.L. Thomas: None. W. Cheung: None. J. Rafferty: None. L. Pratt: None. J. Cherry: None. R. Reynolds: None. G. Williams: None. S.C. Bain: Research Support; Novo Nordisk A/S, Lilly Diabetes. Speaker's Bureau; Menarini, AstraZeneca. Research Support; Boehringer-Ingelheim, Abbott Diagnostics, Amgen Inc. D.R. Owens: None. Funding Health and Care Research Wales (HRG-20-1776(P))

ROQUS - Retinal OCT Quality and Usability Score

2025-06-13

Guilherme Aresta , Teresa Araújo , Georg Faustmann +1 more | Biomedical Optics Express

Tenecteplase in Central Retinal Artery Occlusion Study (TenCRAOS): Protocol for a randomized-controlled trial

2025-06-12

Stephen James Ryan , Øystein Kalsnes Jørstad , Mona Skjelland +7 more | European Stroke Journal

Rationale: Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that, without prompt reperfusion, is associated with a high risk of permanent blindness. There is currently no evidence-based, effective treatment … Rationale: Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that, without prompt reperfusion, is associated with a high risk of permanent blindness. There is currently no evidence-based, effective treatment for CRAO. Methods and design: TenCRAOS is an investigator-initiated, international, multicenter, randomized controlled, double-dummy, double-blind, phase III trial testing tenecteplase (TNK) 0.25 mg/kg + placebo versus acetylsalicylic acid (ASA) 300 mg + placebo. The target population is patients diagnosed with CRAO and a best-corrected visual acuity (BCVA) of ⩾1.0 logarithm of the minimum angle of resolution (logMAR), corresponding to a decimal BCVA of ⩽0.1 or a fraction BCVA of ⩽6/60, who can be treated within 4.5 h. Sample size: Assuming a difference in proportion of participants reaching the primary endpoint of 20% in the placebo/ASA treatment group versus 50% in the TNK/placebo group, we need 78 participants to reach 80% power to detect the difference on a 5% significance level. Outcomes: The primary outcome is the proportion of participants with BCVA of ⩽0.7 logMAR in the affected eye at 30-day follow-up, corresponding to a decimal BCVA of ⩾0.2 or fraction BCVA of ⩾6/30, representing a clinically relevant improvement of BCVA of ⩾0.3 logMAR (or 15 letters). Secondary efficacy outcomes include proportion of participants with BCVA of ⩽0.5 logMAR, corresponding to a decimal BCVA of ⩾0.32 or fraction BCVA of ⩾ 6/19, self-reported vision-targeted health status, quality of life, and modified Rankin Score at 30 and 90 days. Safety outcomes include symptomatic intracranial hemorrhage, major bleeding, and mortality. Exploratory analyses include assessment with optical coherence tomography with angiography and transorbital ultrasound. Discussion: TenCRAOS intends to assess the efficacy and safety of systemic TNK within 4.5 h of CRAO onset.

Optical Coherence Tomography (OCT) Findings in Post-COVID-19 Healthcare Workers

2025-06-12

Sanela Sanja Burgić , Mirko Resan , Milka Mavija +4 more | Journal of Imaging

Recent evidence suggests that SARS-CoV-2 may induce subtle anatomical changes in the retina, detectable through advanced imaging techniques. This retrospective case–control study utilized optical coherence tomography (OCT) to assess medium-term … Recent evidence suggests that SARS-CoV-2 may induce subtle anatomical changes in the retina, detectable through advanced imaging techniques. This retrospective case–control study utilized optical coherence tomography (OCT) to assess medium-term retinal alterations in 55 healthcare workers, including 25 individuals with PCR-confirmed COVID-19 and 30 non-COVID-19 controls, all of whom had worked in COVID-19 clinical settings. Comprehensive ophthalmological examinations, including OCT imaging, were conducted six months after infection. The analysis considered demographic variables, comorbidities, COVID-19 severity, risk factors, and treatments received. Central macular thickness (CMT) was significantly increased in the post-COVID-19 group (p < 0.05), with a weak but statistically significant positive correlation between CMT and disease severity (r = 0.245, p < 0.05), suggesting potential post-inflammatory retinal responses. No significant differences were observed in retinal nerve fiber layer (RNFL) or ganglion cell complex (GCL + IPL) thickness. However, mild negative trends in inferior RNFL and average GCL+IPL thickness may indicate early neurodegenerative changes. Notably, patients with comorbidities exhibited a significant reduction in superior and inferior RNFL thickness, pointing to possible long-term neurovascular impairment. These findings underscore the value of OCT imaging in identifying subclinical retinal alterations following COVID-19 and highlight the need for continued surveillance in recovered patients, particularly those with pre-existing systemic conditions.

Retinal Vessel Analysis shows distinct endothelial dysfunction in hospitalized COVID-19 patients (The CoViThel Study) Measuring endothelial dysfunction in COVID-19 with RVA

2025-06-11

R. Biedermann , Walthard Vilser , Silke R. Klee +7 more | Archives of Internal Medicine Research

Aims: Patients with SARS-CoV-2 infection exhibited a heterogenous disease course, ranging from asymptomatic or mild to critical ill patients. One factor contributing to the severity, is endothelial dysfunction, which is … Aims: Patients with SARS-CoV-2 infection exhibited a heterogenous disease course, ranging from asymptomatic or mild to critical ill patients. One factor contributing to the severity, is endothelial dysfunction, which is difficult to quantify in clinical routine. We hypothesized that retinal vessels may serve as a promising target to analyze endothelial dysfunction in these patients. Methods and Results: 90 COVID-19 patients were consecutively included in the study and received an examination of retinal vessels using Static Vessel Analyzer (SVA) and Dynamic Vessel Analyzer (DVA 3). Matched healthy individuals were used as a control group in this prospective cohort study. After matching there was no difference in age and gender between the two groups. We found a higher BMI in the COVID-19 group. SVA showed both wider arterial (209.1 MU (SD 18.6) vs. 181.3 MU (SD 16.4), p < 0.001) and venular (256.5 MU (SD 20.9) vs 210.8 MU (SD 24.7), p < 0.05) diameters in the COVID-19 group (p < 0.001). DSVA showed both less arterial dilatation (2.35% (SD 1.70) vs. 3.70 % (SD 1.69) and arterial constriction (-1.02% (SD 1.024) vs. -1.41% (SD 1,43) in COVID-19 patients compared to healthy controls. Subgroup analysis showed a continuous decline in arterial dilatation (p < 0.01) and constriction (p <0.05) with increasing disease severity Conclusion: Parameters of retinal microcirculation are impaired in COVID-19 patients as examined by Static and Dynamic Vessel analyzer. Further studies including longitudinal analysis are needed to further investigate diagnostic potential of the examination.

Trends in Ophthalmic Surgery Among Older Patients in Japan (Fiscal Years 2018 to 2022): A National Claims Database Study on Surgical Shifts and the COVID-19 Pandemic's Impact

2025-06-11

Yoshiaki Kabata | Cureus

Re: Gupta RR, et al. Diagnostic and Therapeutic Challenges. Retina. 2024 Feb 1;44(2):364-368. doi: 10.1097/IAE.0000000000003357

2025-06-10

Wenyu Wang , Changzheng Chen | Retina

Re: RETINA-224-1467. Response to Wang et al. regarding Gupta RR et al. Diagnostic and Therapeutic Challenges. Retina. 2024 Feb 1;44(2):364-368.

2025-06-10

Rebekah H. Gensure , Steven T. Bailey | Retina

Selected Abstracts from The Royal College of Ophthalmologists Annual Congress 2025 ACC, Liverpool, UK

2025-06-06

| Eye

Fighting steroids with steroids: a case of bilateral central retinal vein occlusion in an anabolic steroid user

2025-06-04

John S. Read , Colin Parsloe | New Zealand medical journal

Chatbots in keratorefractive surgery patient education

2025-06-04

Hinpetch Daungsupawong , V. Wiwanitkit | Journal Français d Ophtalmologie

Visión y pandemia: aproximaciones y reflexiones

2025-06-02

Anna María Fernández Poncela | Revista Científica UNTRM Ciencias Sociales y Humanidades

Se habla de los trastornos oculares producto de la pandemia, sin embargo, no se estudia de forma amplia y diversa sus causas u orígenes, tanto físicos como emocionales, así como, … Se habla de los trastornos oculares producto de la pandemia, sin embargo, no se estudia de forma amplia y diversa sus causas u orígenes, tanto físicos como emocionales, así como, sociales y psicológicos. Este trabajo es un acercamiento al tema de la disminución de la vista e incremento de sus problemáticas en tiempos de la pandemia. La hipótesis es que el aumento de problemas en la vista se origina en algunas medidas, así como, en el impacto emocional que se sintió en ese momento. Se realiza una revisión bibliográfica, se aplican entrevistas y se reflexiona sobre el tema. Como resultado se constata la existencia y el crecimiento de trastornos oculares, y como se consideran producto de la situación vivida, en especial de aspectos físicos como los hábitos de vida producto de las medidas establecidas, en cuanto a la cuestión emocional no parece haber tanta claridad. Se hacen propuestas de especialistas olvidados y renovadas miradas, con objeto de mejorar la cuestión.