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Abstract This study aims to investigate the prevalence of visual impairments, such as myopia, hyperopia, and astigmatism, among school-age children (7–9 years) in Lubelskie Voivodeship (Republic of Poland) and apply artificial intelligence (AI) in the detection of severe ocular diseases. A total of 1049 participants (1.7% of the total child population in the region) were examined through a combination of standardized visual acuity tests, autorefraction, and assessment of fundus images by a convolutional neural network (CNN) model. The results from this artificial intelligence (AI) model were juxtaposed with assessments conducted by two experienced ophthalmologists to gauge the model's accuracy. The results demonstrated myopia, hyperopia, and astigmatism prevalences of 3.7%, 16.9%, and 7.8%, respectively, with myopia showing a significant age-related increase and hyperopia decreasing with age. The AI model performance was evaluated using the Dice coefficient, reaching 93.3%, indicating that the CNN model was highly accurate. The study underscores the utility of AI in the early detection and diagnosis of severe ocular diseases, providing a foundation for future research to improve paediatric ophthalmic screening and treatment outcomes.

Introduction: Teleophthalmology uses technology to provide remote eye care services, tackling obstacles in accessing specialized care. Optical coherence tomography (OCT) represents a technical advancement, enabling high-resolution ocular imaging. The aim of this study is to evaluate the diagnostic accuracy, feasibility, safety, and clinical utility of home monitoring OCT devices and remote OCT technology compared to standard in-office OCT in teleophthalmology settings across various eye conditions., Materials and Methods: A systematic literature search was conducted in PubMed, Cochrane Library, ScienceDirect and Google Scholar for studies on home-monitoring/remote OCT published from January 2004 to February 2024. Studies utilizing home monitoring/remote OCT in teleophthalmology for patients with eye disorders and reporting on diagnostic accuracy, safety, disease monitoring (clinical utility) or treatment response were included and synthesized narratively., Results: A total of 12 research studies involving 3,539 participants were incorporated in the analysis. The majority of home or remote OCT scans exhibited satisfactory diagnostic image quality. There was high agreement between home/remote and in-office OCT for detecting pathologies and measuring retinal thickness. Compared to in-person evaluations, home/remote OCT demonstrated excellent sensitivity and specificity, though some variability was seen across conditions and interpreters. Home OCT devices provided feasible and safe self-operation with high patient acceptability. Scan times were faster when conducted at home compared to those in the office., Conclusion: Home/remote OCT devices can effectively provide diagnostic-grade retinal imaging outside traditional settings. High diagnostic accuracy was demonstrated compared to in-office OCT. Feasibility and patient acceptability data support home OCT for remote monitoring., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dolar-Szczasny, Drab and Rejdak.)

Tea tree oil (TTO) is used in ophthalmology to maintain healthy eyelid skin and to combat parasitic eyelid infections. Keratocytes belong to the structure of the corneal stoma and enable to maintain corneal homeostasis. TTO that reaches the surface of the eye in too high concentration may disturb the functions of these cells. The aim of the study was to test what concentration of TTO is safe for corneal keratocytes in vitro without causing a toxic effect. A normal human keratocytes (HK) cell line was used in the study. Morphology was visualized by light and fluorescence microscopy, cytometric analysis of the cell cycle and cytometric and spectrophotometric viability evaluation were performed. The level of nitric oxide was tested by Griess spectrophotometric method. TTO concentrations exceeding 0.01% significantly reduced cell viability. The IC50 values were on average 0.057%. Increasing TTO concentrations stimulated HK cells to release NOx. The observed values did not exceed 1 μM. The lowest TTO concentration increased the number of HK cells in the G1 phase of the cell cycle. Increasing TTO concentrations (≥0.1%) increased the number of cells in late apoptosis. TTO at concentrations ranging from 0.1% to 0.5% significantly changed cell morphology. Fluorescence analyzes confirmed that TTO at concentrations ≥0.1% induced apoptotic cell death. TTO exerts strong effect on ocular keratocytes depending on applied concentration. Concentrations exceeding 0.1% have a toxic effect on keratocytes, which die mainly by apoptosis. The ocular surface should be protected from excessive exposure to TTO, which may damage corneal stroma cells., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD affects diagnostic accuracy and distinguish between malignant choroidal melanoma and benign choroidal nevus among ophthalmologists. Methods: In this cross-sectional study, we engaged ophthalmologists through a web-based survey distributed via the professional ophthalmology society's social media channels. The survey encompassed a series of three fundus images representing normal fundus, choroidal nevus, and choroidal melanoma. Each image underwent simulation for the three primary types of CVD-protanopia, deuteranopia, and tritanopia-alongside a non-simulated version. Results: The study included 41 participants, averaging 40 years of age (±9.2), comprising 28 (68%) men and 13 (32%) women. Significantly lower rates of identifying orange pigments were observed in simulated protanopia images compared to non-simulated ones ( p = 0.038). In simulated deutranopia images, the recognition of melanotic lesions was notably reduced compared to non-simulated images ( p = 0.048). No such limitation was observed for tritanopia. However, participants retained their ability to identify subretinal fluid and estimate tumor thickness in simulated and non-simulated images. Concerning simulated images of choroidal nevi, participants misdiagnosed nevi as choroidal melanoma in 37% of cases in simulated protanopia nevi images and 41% in simulated deutranopia nevi images. This resulted in unnecessary referrals of benign lesions as malignant, emphasizing the potential for mistaken diagnoses. Nevertheless, almost all simulated images of malignant melanoma were correctly referred for specialized oncological treatment. Conclusions: The simulated CVD conditions of protanopia and deuteranopia affected the accuracy of identifying the melanotic nature of the choroidal tumor and the presence of orange pigments. This limitation led to challenges in correctly diagnosing choroidal melanoma and choroidal nevus, resulting in extra referrals for nevus cases. However, participants were safe and could still determine the possible risk of eyes with choroidal melanoma, so most referred melanoma cases to specialized oncologists as needed.

Purpose: To assess the feasibility and the diagnostic accuracy of the new tool, DEvice© (AI, Rome, Italy), for screening patients with dry eye disease (DED)., Methods: This study was performed at the University Magna Græcia of Catanzaro. Enrolled patients were classified as affected by DED (group 1) or not (group 2) using an already validated tool (Keratograph 5M, Oculus, Germany), evaluating the noninvasive keratograph breakup time (NIKBUT), tear meniscus height (TMH), meibomian gland loss (MGL), and bulbar redness. All the patients were then examined by means of DEvice©, which allowed the measurement of the relative humidity (RH) and temperature of the ocular surface. Symptoms were scored using the Ocular Surface Disease Index (OSDI) questionnaire., Results: Overall, 40 patients (17 males and 23 females, mean age 38.0 ± 17.1 years) were included: of these, 20 belonged to group 1 and the remaining 20 to group 2. Using Keratograph 5M, significant differences between groups 1 and 2 were detected for NIKBUT-first (respectively, 4.97 ± 1.85 vs. 13.95 ± 4.8 s; p < 0.0001) and for NIKBUT-average (10.55 ± 4.39 vs. 15.96 ± 4.08 s; p = 0.0003). No statistically significant changes were detected for TMH ( p = 0.565), MGL ( p = 0.051), and bulbar redness ( p = 0.687). Using Device©, a statistically significant higher value of RH was found in group 1 compared to group 2 (respectively, 85.93 ± 10.63 vs. 73.05 ± 12.84%; p = 0.0049). A statistically significant correlation was found between RH and OSDI (r = 0.406; p = 0.009). The value RH showed a discriminating power to detect DED with an AUC = 0.782 (standard error 0.07264; 95% CI 0.6401-0.9249; p = 0.0022)., Conclusions: The DEvice© can effectively discriminate DED patients from healthy subjects. The parameter RH showed good sensitivity, making this tool ideal for a fast and noninvasive DED screening.

Aim: To investigate the efficacy and safety profile of T-shaped pars plana scleral incision technique in removing large intraocular foreign bodies, during 23-gauge pars plana vitrectomy., Methods: Retrospective interventional case series that included patients diagnosed with a large intraocular foreign body (IOFB). Possible postoperative complications were recorded 24 h, 1 month, 3 and 6 months postoperatively., Results: Thirty eyes of 30 patients (48 ± 5 years old) were enrolled. All IOFBs were successfully removed: mean diameters of 7.8 ± 2.0 mm and 2.6 ± 0.3 mm. Silicone oil and sulfur hexafluoride were used in 27 and 3 eyes, respectively. Lensectomy was performed in 27 eyes. Intraocular lens was implanted at first attempt in 12 eyes; during a second operation in 12 eyes and 6 eyes remained aphakic. At any follow-up, no signs of postoperative complications were observed. Secondary retinal detachment occurred in 12 eyes. Mean preoperative corrected distance visual acuity was 0.04, on the Snellen scale; it increased to 0.07, at last follow-up. Mean intraocular pressure was 17.97 mmHg. All eyes were preserved., Conclusion: T-shaped scleral incision could be an effective, safe and easy-to-perform standard procedure to remove large IOFBs during pars plana vitrectomy, without increasing the risk of surgical complications and additional damage to the ocular tissues., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Toro, Nowomiejska, Concilio, Motta, Rekas, Costagliola, Avitabile, Castellino, Caputo, Choragiewicz and Rejdak.)

The aim of this study was to pharmacologically induce accommodative paralysis and evaluate its effects on the bioelectrical activity of the muscular system. The study included two participant groups: those with myopia and those with normal vision (emmetropes). Electromyographic assessments were performed using the Noraxon Ultium DTS 8-K MR 3 myo Muscle Master Edition system. The muscles analyzed in this study were the temporalis, masseter, sternocleidomastoid, trapezius, abdominal muscles, biceps brachii, and the external oblique muscles of the abdomen. It is important to acknowledge that, based on the current findings, it cannot be definitively stated that the observed effects have clinical significance, and additional studies are encouraged.

This article aims to provide a comprehensive review of the biochemical changes observed in the anterior chamber of the eye in diabetic patients. The increased levels of inflammatory markers, alterations in antioxidant defense mechanisms, and elevated levels of advanced glycation end products (AGEs) in the aqueous humor (AH) are explored. Additionally, the impact of these biochemical changes on diabetic retinopathy progression, increased intraocular pressure, and cataract formation is discussed. Furthermore, the diagnostic and therapeutic implications of these findings are presented. This study explores potential biomarkers for detecting diabetic eye disease at an early stage and monitoring its progression. An investigation of the targeting of inflammatory and angiogenic pathways as a potential treatment approach and the role of antioxidant agents in managing these biochemical changes is performed.

Neuroplasticity is a complex process that is heightened during time-sensitive periods of pre- and postnatal brain development. It continues, albeit to a lesser extent, throughout adolescence and young adulthood. Congenital visual deprivation is well-known and explored in human-model behavioral research. In this study, we review existing research on neuroadaptations and neuroplasticity of the visual pathway as a result of inherited retinal diseases (IRD), focusing on data concerning congenital bilateral visual deprivation in humans published in PubMed in the past 5 years, including 18 articles. We highlight evidence about the anatomical and behavioral aspects of neuroplasticity as different brain responses to different types of visual deprivation. We also focus on various very interesting aspects of the cross-modal functional reorganization of the visual and auditory cortex as an example of brain plasticity due to combined visual and auditory loss. Our study shows that central nervous system magnetic resonance imaging (MRI) advancements have allowed researchers to report previously elusive anatomical evidence. Patients with a known mechanism of IRD-examined with high magnetic field MRI and functional MRI-have been proven to be adequate models to explore neuroadaptations of the visual pathway due to bilateral, early, and late visual deprivation.

Purpose: To evaluate and compare the visual outcomes of an enhanced monofocal intraocular lens (IOL) with two different monofocal IOLs., Setting: Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Design: Prospective, single-center, single-masked, randomized controlled clinical study., Methods: The study included patients undergoing phacoemulsification and IOL implantation. Patients were consecutively randomized by block randomization and assigned in a 1:1:1 allocation ratio to three study arms to bilaterally receive Tecnis Eyhance™ (model ICB00) or Tecnis ® monofocal 1-piece (model PCB00) or Clareon ® monofocal (model CNA0T0), respectively. Monocular and binocular (both corrected and uncorrected) visual acuities for far, intermediate and near were registered and compared among groups at 3 months. To track changes in patient quality of life, the Catquest-9SF questionnaire was administered to each patient before and after cataract extraction., Results: Ninety patients (30 for each group) were enrolled. At 3 months follow-up, statistically significant differences for intermediate visual acuities were found between the three groups. Nonstatistically significant differences were observed for distance visual acuities and the changes in Catquest-9SF scores., Conclusion: Tecnis Eyhance™ provided better results in intermediate visual outcomes without adverse effects on patients' quality of life., (© 2024. The Author(s).)

Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye's ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.

Background: We aimed to assess the status of the optic nerve and retina by optical coherence tomography (OCT) in a group of patients with idiopathic intracranial hypertension (IIH) on the basis of dynamic changes in intracranial pressure., Methods: This observational and cross-sectional study included patients affected by idiopathic intracranial hypertension with papilledema (IIHWP) and patients with idiopathic intracranial hypertension without papilledema (IIHWOP). All participants underwent an OCT examination of the macula and optic nerve head. Parameters related to intracranial pressure, including cerebrospinal fluid (CSF) opening pressure (oCSFp), CSF mean pressure (mCSFp), and pulse wave amplitude (PWA), were included in the analysis., Results: Out of the 22 subjects enlisted for the study, a total of 16 patients suggestive of IIH were finally enrolled. Papilledema was detected in nine subjects (56.2%) and seven patients were affected by IIHWOP (43.7%). The OCT examination showed a higher mean RNFL thickness in IIHWP patients in comparison to IIHWOP in both eyes ( p < 0.05 and p < 0.01, respectively). Intracranial pressure (ICP) measurements showed that IIHWP had higher values of oCSFp, mCSFp, and PWA compared to IIHWOP ( p = 0.0001, p = 0.0001, and p = 0.0001, respectively). In addition, ICP parameters significantly correlated with RNFL., Conclusions: Clinical parameters suggestive of idiopathic intracranial hypertension are associated with retina and optic nerve OCT parameters. OCT is a useful tool to detect these alterations in a non-invasive fashion.

This study aims to investigate the prevalence of visual impairments, such as myopia, hyperopia, and astigmatism, among school-age children (7-9 years) in Lubelskie Voivodeship (Republic of Poland) and apply artificial intelligence (AI) in the detection of severe ocular diseases. A total of 1049 participants (1.7% of the total child population in the region) were examined through a combination of standardized visual acuity tests, autorefraction, and assessment of fundus images by a convolutional neural network (CNN) model. The results from this artificial intelligence (AI) model were juxtaposed with assessments conducted by two experienced ophthalmologists to gauge the model's accuracy. The results demonstrated myopia, hyperopia, and astigmatism prevalences of 3.7%, 16.9%, and 7.8%, respectively, with myopia showing a significant age-related increase and hyperopia decreasing with age. The AI model performance was evaluated using the Dice coefficient, reaching 93.3%, indicating that the CNN model was highly accurate. The study underscores the utility of AI in the early detection and diagnosis of severe ocular diseases, providing a foundation for future research to improve paediatric ophthalmic screening and treatment outcomes., (© 2024. The Author(s).)