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Vergence, accommodation, and visual tracking in children and adolescents evaluated in a multidisciplinary concussion clinic.

Vision Res 2021 Apr 7;184:30-36. Epub 2021 Apr 7.

Boston Children's Hospital, Boston, MA 02115, United States; Harvard Medical School, Boston, MA 02115, United States.

Many patients with concussion experience visual symptoms following injury that lead to a diagnosis of convergence insufficiency, accommodative insufficiency, or saccadic dysfunction. However, these diagnostic categories are based on aggregates of clinical tests developed from a non-concussed population and therefore may not accurately describe visual deficits in the concussed population. Thus, we sought to understand individual metrics of visual dysfunction in chronically symptomatic post-concussion patients. Read More

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A case report of reconstruction of ocular and complete upper eyelid avulsion with severe facial soft tissue injuries using anterolateral thigh free flap.

Int J Surg Case Rep 2021 Apr 1;82:105856. Epub 2021 Apr 1.

Reconstructive Microsurgery Section, Division of Plastic Surgery, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.

Introduction And Importance: Ocular injury is second mostly caused by motor vehicle accident (MVA) and often leads to severe ocular injury even to visual loss and various aesthetic problems. The outcome is determined by the magnitude of the initial damage and treatment availability. Treating ocular and facial injury due to MVA is challenging given the scope of the damage and may result in various outcomes. Read More

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Eye closure sensitivity and genetic generalized epilepsies: A prospective study of 123 cases.

Epilepsy Res 2021 Mar 29;173:106628. Epub 2021 Mar 29.

University of Health Sciences, Umraniye Training and Research Hospital, Department of Neurology, Istanbul, Turkey. Electronic address:

Purpose: To investigate the possible relationship between eye closure sensitivity (ECS) and genetic generalized epilepsy (GGE) in terms of epilepsy syndromes, photosensitivity (PS), and prognosis.

Method: One hundred and twenty-three patients diagnosed with GGE were classified according to epilepsy syndromes. Among them, ECS and PS were detected in repeated video-EEGs. Read More

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MicroRNA-431-5p encapsulated in serum extracellular vesicles as a biomarker for proliferative diabetic retinopathy.

Int J Biochem Cell Biol 2021 Apr 7:105975. Epub 2021 Apr 7.

Tianjin International Joint Research and Development Center of Ophthalmology and Vision Science, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384, China. Electronic address:

Early diagnosis and precise monitoring of the development of proliferative diabetic retinopathy (PDR) can significantly improve therapeutic strategies and help decrease blindness caused by it. Extracellular vesicles (EVs) were recently found to be involved in intercellular communications and are a potential source for the discovery of novel biomarkers. The current study aims to investigate the effectiveness of microRNAs (miRNAs) encapsulated in small EVs (sEVs) as minimally invasive biomarkers for PDR. Read More

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Perifoveal Chorioretinal Atrophy following Subretinal Voretigene Neparvovec-rzyl for RPE65-mediated Leber Congenital Amaurosis.

Ophthalmol Retina 2021 Apr 7. Epub 2021 Apr 7.

The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA;; Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address:

Purpose: To report an anatomic change observed in a series of patients who underwent subretinal injection of voretigene neparvovec-rzyl (VN) for RPE65-mediated Leber congenital amaurosis.

Design: Multi-center retrospective chart review.

Participants: Patients who underwent subretinal VN injection at each of four participating institutions. Read More

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Impact of COVID-19 Pandemic on Ophthalmology Medical Student Teaching: Educational Innovations, Challenges, and Future Directions.

Surv Ophthalmol 2021 Apr 7. Epub 2021 Apr 7.

Blanton Eye Institute, Houston Methodist Hospital, Department of Ophthalmology, Houston, Texas, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa; The Departments of Neurology and Neurological Surgery, Weill Cornell Medical College, New York City, New York, USA; The Department of Ophthalmology, Baylor College of Medicine (Adjunct Professor), Houston, Texas, USA; The UT MD Anderson Cancer Center, Houston, Texas, USA; The University of Iowa Hospitals and Clinics (Adjunct Professor), Iowa City, Iowa, US.

Graduate medical education (GME) in ophthalmology has faced and overcome many challenges over the past years and 2020 has been a game-changing year. Although the severe acute respiratory syndrome coronavirus (SARS-CoV2) pandemic disrupted medical education globally, ophthalmic educators rapidly transformed their curricula to novel and effective virtual learning formats. Thus, while the COVID-19 outbreak has been one of the most significant challenges faced in the history of medical education, it has also provided an impetus to develop innovative teaching practices, bringing with it unprecedented success in allowing medical students to continue their education in ophthalmology despite these challenges. Read More

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The daily gene transcription cycle in mouse retina.

Exp Eye Res 2021 Apr 7:108565. Epub 2021 Apr 7.

Aier School of Ophthalmology, Central South University, Changsha, China; Aier Eye Institute, Changsha, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China. Electronic address:

Many physiological retinal processes, such as outer segment disk shedding and visual sensitivity, exhibit a daily rhythm. However, the detailed transcriptome dynamics and related biological processes of the retina are not fully understood. Retinal tissues were collected from C57BL/6J male mice housed in a 12h light/12h dark (LD) cycle for 4 weeks, at Zeitgeber time (ZT) 0, 4, 8, 12, 16, and 20. Read More

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The effect of retinal scaffold modulus on performance during surgical handling.

Exp Eye Res 2021 Apr 7:108566. Epub 2021 Apr 7.

Carver Department of Biomedical Engineering, The University of Iowa, 5601 Seamans Center for the Engineering Arts and Sciences, Iowa City, IA, 52242, USA; Institute for Vision Research, The University of Iowa, USA. Electronic address:

Emerging treatment strategies for retinal degeneration involve replacing lost photoreceptors using supportive scaffolds to ensure cells survive the implantation process. While many design aspects of these scaffolds, including material chemistry and microstructural cues have been studied in depth, a full set of design constraints has yet to be established. For example, while known to be important in other tissues and systems, the influence of mechanical properties on surgical handling has not been quantified. Read More

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Clinical features, visual outcome, and poor prognostic factors in occlusive retinal vasculitis.

Can J Ophthalmol 2021 Apr 7. Epub 2021 Apr 7.

Massachusetts Eye Research and Surgery Institution, Waltham, Mass.; Ocular Immunology and Uveitis Foundation, Waltham, Mass.; Harvard Medical School, Boston, Mass.. Electronic address:

Objective: To investigate the clinical features, treatment, and visual outcome of occlusive retinal vasculitis (ORV), with a focal analysis on prognostic factors associated with poor visual outcome.

Methods: We conducted a retrospective cohort study in patients diagnosed with ORV with at least 6 months of follow-up. Demographic data, ocular features, best corrected visual acuity (BCVA), fluorescein angiography, therapy regimens, and outcomes were collected from the Massachusetts Eye Research and Surgery Institution database from 2006 to 2017. Read More

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Implementation of a 3D-printed custom mask fitter in an ophthalmology setting during the coronavirus disease 2019 (COVID-19) pandemic.

Can J Ophthalmol 2021 Mar 19. Epub 2021 Mar 19.

Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON. Electronic address:

Objective: To assess the effectiveness of a 3D-printed custom mask fitter in lieu of N95 respirators among ophthalmologists and other eye care professionals who may not be prioritized to receive N95 respirators amidst the coronavirus disease 2019 pandemic.

Methods: This was a proof-of-concept study from a tertiary eye care center in Oakville, Canada. All participants underwent the N95 Qualitative Fit Test with a custom mask fitter secured over an American Society for Testing and Materials Level 3 face mask. Read More

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Development of new therapeutic options for the treatment of uveal melanoma.

FEBS J 2021 Apr 10. Epub 2021 Apr 10.

The University of Sydney, Sydney Pharmacy School, Faculty of Medicine and Health, Sydney, NSW, 2006, Australia.

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. Important cytogenetic and genetic risk factors for the development of UM include chromosome 3 monosomy, mutations in the guanine nucleotide-binding proteins GNAQ/GNA11, and loss of the BRACA1-associated protein 1 (BAP 1). Most primary UMs are treated conservatively with radiotherapy, but enucleation is necessary for large tumours. Read More

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Effect of cataract surgery on wet age-related macular degeneration activity.

Acta Ophthalmol 2021 Apr 10. Epub 2021 Apr 10.

Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.

Background: Wet age-related macular degeneration (AMD) and age-related cataract are often coexisting causes of visual impairment. Yet, the timing of cataract surgery in wet AMD patients is controversial.

Methods: One hundred and eleven eyes of 111 patients with wet AMD underwent cataract surgery at Helsinki University Hospital in Finland during 2014-2018. Read More

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Heart rate detection by Fitbit ChargeHR : A validation study versus portable polysomnography.

J Sleep Res 2021 Apr 10:e13346. Epub 2021 Apr 10.

Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.

Consumer "Smartbands" can collect physiological parameters, such as heart rate (HR), continuously across the sleep-wake cycle. Nevertheless, the quality of HR data detected by such devices and their place in the research and clinical field is debatable, as they are rarely rigorously validated. The objective of the present study was to investigate the reliability of pulse photoplethysmographic detection by the Fitbit ChargeHR (FBCHR, Fitbit Inc. Read More

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Surfactant cocamide monoethanolamide causes eye irritation by activating nociceptor TRPV1.

Br J Pharmacol 2021 Apr 10. Epub 2021 Apr 10.

State Key Laboratory of Natural Medicines and Department of TCM pharmacology, School of Traditional Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China, 211198.

Background And Purpose: Cocamide monoethanolamide (CMEA) is commonly used as a surfactant-foam booster in cosmetic formulations. Upon contact with the eye or other sensitive skin areas, CMEA elicits sting and lasting irritation. We hypothesized a specific molecular interaction with TRPV1 by which CMEA caused eye irritation. Read More

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The role of polymorphisms rs2070744 and rs1799983 eNOS gene in patients with POAG: a systematic review and meta-analysis.

Int Ophthalmol 2021 Apr 10. Epub 2021 Apr 10.

Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Glaucoma is a progressive disease of the optic nerve that has several underlying causes, but in most cases, the cause is unknown. Given the importance of the role of nitric oxide in the occurrence of ocular nerve damage and the effect of eNOS gene polymorphic sites on protein function, to better understand the mechanism of formation of POAG, the relationship between polymorphisms rs2070744 and rs1799983 eNOS gene with POAG risk was investigated in this study using meta-analysis.

Methods: In this study, systematic review and meta-analysis of study data related to the study of polymorphisms rs2070744 and rs1799983 eNOS gene in patients with POAG using the keywords eNOS, NOS3, Gluuc8898, POAG, primary open-angle glaucoma. Read More

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Humoral immune responses to AAV gene therapy in the ocular compartment.

Biol Rev Camb Philos Soc 2021 Apr 9. Epub 2021 Apr 9.

John Van Geest Centre for Brain Repair, Department of Clinical Neuroscience, University of Cambridge, Cambridge, U.K.

Viral vectors can be utilised to deliver therapeutic genes to diseased cells. Adeno-associated virus (AAV) is a commonly used viral vector that is favoured for its ability to infect a wide range of tissues whilst displaying limited toxicity and immunogenicity. Most humans harbour anti-AAV neutralising antibodies (NAbs) due to subclinical infections by wild-type virus during infancy and these pre-existing NAbs can limit the efficiency of gene transfer depending on the target cell type, route of administration and choice of serotype. Read More

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MICOS and the mitochondrial inner membrane morphology - when things get out of shape.

FEBS Lett 2021 Apr 10. Epub 2021 Apr 10.

Department of Cellular Biochemistry, University Medical Center Göttingen, Humboldtallee 23, 37073, Göttingen, Germany.

Mitochondria play a key role in cellular signalling, metabolism and energetics. Proper architecture and remodelling of the inner mitochondrial membrane are essential for efficient respiration, apoptosis and quality control in the cell. Several protein complexes including mitochondrial contact site and cristae organising system (MICOS), F F -ATP synthase, and Optic Atrophy 1 (OPA1), facilitate formation, maintenance and stability of cristae membranes. Read More

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Age-related changes in ocular mucosal tolerance: lessons learned from gut and respiratory tract immunity.

Immunology 2021 Apr 10. Epub 2021 Apr 10.

Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 77030, USA.

The ocular surface is the part of the visual system directly exposed to the environment, and it comprises the cornea, the first refractive tissue layer, and its surrounding structures. The ocular surface has evolved to keep the cornea smooth and wet, a prerequisite for proper sight, and also protected. To this aim, the ocular surface is a bona fide mucosal niche with an immune system capable of fighting dangerous pathogens. Read More

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Visual Impairment and Objectively Measured Physical Activity in Middle-Aged and Older Adults.

J Gerontol A Biol Sci Med Sci 2021 Apr 10. Epub 2021 Apr 10.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Background: Vision loss is associated with increased falls risk and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood.

Methods: This study included 603 participants aged ≥ 50 years (mean age=73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Read More

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Adenosine integrates light and sleep signalling for the regulation of circadian timing in mice.

Nat Commun 2021 Apr 9;12(1):2113. Epub 2021 Apr 9.

Sleep and Circadian Neuroscience Institute (SCNi), Department of Pharmacology, University of Oxford, Oxford, UK.

The accumulation of adenosine is strongly correlated with the need for sleep and the detection of sleep pressure is antagonised by caffeine. Caffeine also affects the circadian timing system directly and independently of sleep physiology, but how caffeine mediates these effects upon the circadian clock is unclear. Here we identify an adenosine-based regulatory mechanism that allows sleep and circadian processes to interact for the optimisation of sleep/wake timing in mice. Read More

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Cellular FLICE-like inhibitory protein (cFLIP) critically maintains apoptotic resistance in human lens epithelial cells.

Cell Death Dis 2021 Apr 9;12(4):386. Epub 2021 Apr 9.

Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, USA.

The present study aims to understand the mechanism of the lens epithelial cell's strong anti-apoptotic capacity and survival in the mature human lens that, on the one hand, maintains lens transparency over several decades, while on the other hand, increases the risk of posterior capsule opacification (PCO). Here we compared FHL124 cells and HeLa cells, spontaneously immortalized epithelial cell lines derived from the human lens and cervical cancer cells, respectively, of their resistance to TNFα-mediated cell death. TNFα plus cycloheximide (CHX) triggered almost all of HeLa cell death. Read More

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Maternal finger-prick allogenic blood for persistent corneal epithelial defects.

BMJ Case Rep 2021 Apr 9;14(4). Epub 2021 Apr 9.

Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

This is a case of a 17-year-old patient with aniridia-related keratopathy and persistent epithelial defect (PED) treated successfully using maternal finger-prick blood (FPB). Maternal allogenic FPB treatment was initiated to the patient who was non-compliant with the use of autologous FPB. The PED was successfully managed with maternal FPB treatment with rapid and complete closure of the epithelial defect. Read More

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Diagnostic value of culture results from aqueous tap versus vitreous tap in cases of bacterial endophthalmitis.

Br J Ophthalmol 2021 Apr 9. Epub 2021 Apr 9.

Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and Biomedical Research Centre, Institute of Ophthalmology, UCL, London, UK

Objective: To investigate the concordance between aqueous and vitreous tap culture results among different types of bacterial endophthalmitis.

Methods And Analysis: This retrospective cohort analysis included all cases diagnosed with endophthalmitis at Moorfields Eye Hospital between January 2008 and March 2020. Aqueous and vitreous samples obtained simultaneously at presentation. Read More

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Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity.

Br J Ophthalmol 2021 Apr 9. Epub 2021 Apr 9.

Department of Ophthalmology, Peking University People's Hospital, Eye diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Clinical Centre of Optometry, College of Optometry, Peking University Health science center, Beijing, China

Background: Data on serum vascular endothelial growth factor (VEGF) and drug levels in patients with retinopathy of prematurity (ROP) following intravitreal injections of conbercept (IVC) are lacking.

Methods: Multicentre, prospective, non-randomised study of patients with aggressive posterior retinopathy of prematurity (APROP) or type 1 ROP who had not received other treatment. All infants received therapy in both eyes plus intravitreal IVC 0. Read More

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AI-powered effective lens position prediction improves the accuracy of existing lens formulas.

Br J Ophthalmol 2021 Apr 9. Epub 2021 Apr 9.

Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA

Aims: To assess whether incorporating a machine learning (ML) method for accurate prediction of postoperative anterior chamber depth (ACD) improves the refraction prediction performance of existing intraocular lens (IOL) calculation formulas.

Methods: A dataset of 4806 patients with cataract was gathered at the Kellogg Eye Center, University of Michigan, and split into a training set (80% of patients, 5761 eyes) and a testing set (20% of patients, 961 eyes). A previously developed ML-based method was used to predict the postoperative ACD based on preoperative biometry. Read More

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Detection of SARS-CoV-2 genomic and subgenomic RNA in retina and optic nerve of patients with COVID-19.

Br J Ophthalmol 2021 Apr 9. Epub 2021 Apr 9.

Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Purpose: Presence of SARS-CoV-2 RNA in human retinal biopsies (RBs) was previously reported by us. In this consecutive study, we analysed RB and optic nerve biopsies (ONBs) in deceased patients with confirmed COVID-19 assessing viral RNA load, possible virus replication and infectivity.

Patients And Methods: In this case series, 14 eyes of 14 deceased patients with COVID-19 were enucleated during autopsy. Read More

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Clinical outcomes following selective laser trabeculoplasty in Afro-Caribbean patients with glaucoma at high risk for progression.

Br J Ophthalmol 2021 Apr 9. Epub 2021 Apr 9.

Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Aim: To characterise clinical outcomes following selective laser trabeculoplasty (SLT) in eyes of Afro-Caribbean patients with open-angle glaucoma (OAG) at high risk for progression.

Methods: In a prospective interventional case series, patients meeting high-risk criteria (advanced disease, unilateral glaucoma blindness, inadequate intraocular pressure (IOP) on 2 medications, recent progression on medications, inability to administer, afford or tolerate medications) underwent bilateral 360° SLT and managed based on their subsequent clinical course. Patient-specific indications for SLT-IOP reduction (IOP group) or reduced reliance on medical therapy (MED group)-were recorded before treatment. Read More

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Comparison of the performance of the dry eye questionnaire (DEQ-5) to the ocular surface disease index in a non-clinical population.

Cont Lens Anterior Eye 2021 Apr 6:101441. Epub 2021 Apr 6.

Department of Optometry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address:

Objective: To compare the performance of the dry eye questionnaire (DEQ-5) with the Ocular Surface Disease Index (OSDI) and further validate the DEQ-5 questionnaire.

Methods: A population-based cross-sectional study conducted in Ghana. OSDI and DEQ-5 questionnaires were administered to participants. Read More

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