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To determine the outcomes of intravenous (IV) tocilizumab (TCZ) in patients with non-infectious uveitis who failed with conventional immunomodulatory and anti-TNFα therapies. Records of seven patients with non-infectious uveitis treated with monthly IV TCZ (4–10 mg/kg) or biweekly IV TCZ (8 mg/kg) were reviewed. Outcome measures were changes in visual acuity, anterior chamber cell and flare grade, vitreous haze, central subfield thickness (CST), and fluorescein angiography (FA) score. Ten eyes of seven patients received TCZ therapy. Median age of patients was 14 (range, 7–24) years. Median duration of TCZ therapy was 15 (range, 5–32) months. Mean CST reduced from 373 ± 101.0 μm to 298.2 ± 40.3 μm. Mean FA score reduced from 12.5 ± 4.3 to 3.6 ± 2.6. One patient developed elevated liver transaminases. IV TCZ is a potentially effective and safe therapeutic option for the management of refractory non-infectious uveitis. [ABSTRACT FROM AUTHOR]

Fibrocystic breast changes (FCCs) are benign lesions thought to be caused by an increased estrogen-to-progesterone ratio. One of the most common endocrinopathies that increases this ratio is polycystic ovarian syndrome (PCOS). Although nonproliferative FCCs do not increase the risk of breast cancer, they can make mammographic detection of malignancy in postmenopausal women more difficult. The aim of this study was to investigate the effects of PCOS on the development of postmenopausal FCCs. This retrospective cohort study used the TriNetX research network to identify two cohorts of postmenopausal women (Z78.0) older than 45, without a prior diagnosis of FCCs (N60.1) or hormone replacement therapy (Z79.890). One cohort included a diagnosis of PCOS (E28.2). The cohorts were balanced for age, race, ethnicity, and hormonally relevant comorbidities. The cohorts were then evaluated for the development of FCCs after menopause. Postmenopausal patients with PCOS were 52% more likely to develop FCCs than those without PCOS (2.2% vs. 1.4%, relative risk 1.52, 95% confidence interval 1.05, 2.22, P = 0.03). Postmenopausal women with PCOS have a higher risk of developing FCCs. Further studies are needed to improve the differentiation of benign FCCs from malignant lesions on imaging for postmenopausal women with PCOS who develop FCCs. [ABSTRACT FROM AUTHOR]

To evaluate the correlation between longitudinal changes in aqueous flare measured by laser flare photometer (LFP), best-corrected visual acuity (BCVA), and clinical grade using both Standardization of Uveitis Nomenclature (SUN) and modified SUN (MSUN) scales uveitis patients. Patients were classified according to both SUN and MSUN grading scales. LFP measurements were acquired (Kowa FM-700) at each visit. Mean change in LFP was assessed longitudinally, comparing with those in visual acuity, SUN, and MSUN grading scales. Mean change in LFP was correlated to those in BCVA (p =.018), SUN scale (p <.001), and MSUN scale (p =.008). Cases within same initial SUN (0 and 1+) and MSUN (0.5+ and 1+) grades and different longitudinal flare prognosis (decreased/unchanged/increased) had significantly different initial LFP values (all p <.05). LFP measurement is beneficial in monitoring inflammatory activity. Cases of identical clinical flare scores with different clinical prognosis may be predicted by LFP. [ABSTRACT FROM AUTHOR]

To study the efficacy and safety of suprachoroidal CLS-TA (proprietary suspension of triamcinolone acetonide) in uveitic macular edema (UME) with and without concurrent systemic corticosteroid or steroid-sparing therapy (ST). Post hoc analysis of the PEACHTREE phase 3 randomized trial. Among UME patients receiving no ST, at week 24, mean BCVA change was +15.6 letters in 68 CLS-TA patients versus +4.9 letters in 49 sham-control patients (p <.001), while mean CST change was −169.8 µm versus −10.3 µm, respectively (p <.001). Among patients receiving ST, at week 24, mean BCVA change was +9.4 letters in 28 CLS-TA patients versus −3.2 letters in 15 sham-control patients (p =.019), while mean CST change was −108.3 µm versus −43.5 µm, respectively (p =.190). No SAEs related to treatment were reported. A clinically meaningful benefit of CLS-TA was noted in UME patients, regardless of concurrent ST usage. Abbreviation and Acronyms CST = central subfield thickness; BCVA = best corrected visual acuity; ME = macular edemaI; IVT = intravitreal; AE = adverse event; FA = fluocinolone acetonide; SD-OCT = spectral-domain optical coherence tomography; NIU = noninfectious uveitis; SAE = serious adverse event; TEAE = treatment emergent adverse event; ITT = intent to treat; CI = confidence interval [ABSTRACT FROM AUTHOR]

We study the effects of weak two-photon absorption on two-dimensional (2D) solitons interaction in a silicon-based waveguide under a framework of coupled perturbed (2 + 1) D nonlinear Schrödinger equations with a pure Kerr nonlinearity and a nonstationary potential. We extend the perturbative analysis for collisions of two one-dimensional solitons in silicon waveguides to derive the theoretical expressions for the amplitude evolution of a single perturbed soliton and for the abrupt amplitude downshift of a colliding soliton due to a fast interaction between two 2D solitons in silicon lattices. The theoretical calculations are then validated by the extensive simulations of the coupled perturbed (2 + 1) D nonlinear Schrödinger model with periodic and non-periodic potentials. The simulations are implemented by using the accelerated imaginary-time evolution scheme and the split-step Fourier method. These results allow us to accurately capture the abrupt energy downshift of a colliding soliton in silicon-based two-dimensional waveguides. [ABSTRACT FROM AUTHOR]

The dissimilar lap-joint of the AA6061 to 316 stainless steel was produced by friction stir welding. Changing microstructure, joint interface, and mechanical performances via welding rate were revealed. A wave interface pattern was found at the low welding rate with a free oxide layer. The interface became flat at the high welding rate with the oxide film formation. The diffusion and intermetallic compounds (IMCs) layers were formed on the interface and their thickness decreased via increasing the welding rate. The highest joint strength was obtained at the welding rate of 75 mm/min but strongly reduced with growing the welding rate. The strength was dramatically correlated with the bonding area, diffusion thickness and interface morphology instead of the IMCs layer thickness. At the low welding rate, the joint was fractured via ductile behaviour with a lot of dimples found on the fracture surface of 316 stainless steel. [ABSTRACT FROM AUTHOR]

To compare laser flare photometry (LFP) measurements of aqueous flare with Standardization of Uveitis Nomenclature (SUN) and modified SUN grading. In this prospective study with multicenter design, uveitis patients were classified according to SUN and modified SUN grading scales. LFP was performed with Kowa FM-700 flaremeter. Mean LFP values were compared with SUN and MSUN scores. The study included 475 LFP measurements, of which 216, 48, 150, 31, 28 and 2 had 0, 0.5+, 1+, 1.5+, 2+ and 3+ flare, respectively. LFP values were significantly different between each two consecutive steps for both clinical gradings (all P <.05). Cut-off values for modified SUN grading steps were defined as 5.7, 9.7, 15.7 and 43.2 for 0/0.5+, 0.5+/ 1+, 1+/1.5+ and 1.5/2+ borders of clinical flare, respectively. LFP proves to be an objective measurement in analyzing aqueous flare comparable to both SUN and MSUN clinical grading systems. [ABSTRACT FROM AUTHOR]

To report a case of acute unilateral posterior uveitis as a rare manifestation of giant cell arteritis (GCA). A 62-year-old male presented to the clinic for evaluation of decreased vision in the right eye (OD). BCVA in OD was 20/60, and fundus examination revealed 3+ vitreous cells along with several inflammatory precipitates located in posterior vitreous and on surface of retina. Although TAB was inconclusive for GCA, the clinical diagnosis of GCA was made according to the GCA diagnostic criteria. This diagnosis was further supported by 18FDG-PET scan. The patient was started on corticosteroids, and the symptoms improved significantly after first week of treatment. At follow-up visit one month and half later, BCVA improved to 20/40 in the right eye. Although GCA is rarely present with uveitis, in case of unilateral posterior uveitis in elderly patient, it should be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Ocular involvement is a rare manifestation of tuberculosis. Four key issues historically faced by clinicians when diagnosing and treating ocular tuberculosis – diagnostic uncertainty, naturally heterogeneous presentations, limitations of existing laboratory diagnostic tools, and non-uniform treatment guidelines – continue to test today's physicians. Unparalleled scientific and clinical developments over the past century have greatly expanded the knowledge surrounding this challenging ophthalmic condition. Experience with large volumes of cases at tuberculosis-endemic centres has led to recent growth in knowledge and physician experience, perhaps more so in developing countries. Looking forward, the role of diverse new technologies, including artificial intelligence and proteomics, will advance ocular tuberculosis research. Efforts have been made to address the lack of standardized nomenclature, diagnostic uncertainty, and unvalidated, geographically variable treatment guidelines. [ABSTRACT FROM AUTHOR]

To correlate changes in subfoveal choroidal thickness (SCT) with the degree of anterior inflammatory activity in chronic Vogt-Koyanagi-Harada (VKH) disease. Anterior segment inflammation was assessed using SUN anterior chamber cell grading criteria, and SCT was measured using EDI-OCT in patients with VKH at multiple visits. ANOVA was used to compare the mean SCT for each anterior chamber cell grade. Regression analysis was used to correlate the anterior segment cell grade and the SCT. 14 patients were included in the study. A total of 432 data points consisting of SCT and anterior segment cell values were analyzed. ANOVA demonstrated significant difference between the mean SCT for different anterior chamber cell grades (p <.0001). Regression analysis demonstrated significant correlation between SCT and grade of anterior chamber cells (R2 = 0.37, p <.001). Chronic VKH is characterized by a dynamic change in SCT that correlates with anterior segment inflammatory activity. [ABSTRACT FROM AUTHOR]

A heatmap analysis of choroidal lesions in patients with punctate inner choroidopathy (PIC) or multifocal choroiditis (MFC) with or without uveitis was performed to determine if there were any distinguishing features among these uveitic entities. Retrospective review of medical records was conducted at the Byers Eye Institute, Stanford. Fundus photographs were masked and placed on a standardized template. Lesions were identified and heatmaps were generated in a standardized fashion. 30 eyes were identified with PIC or MFC. Heatmap analysis revealed three distinct patterns of fundus lesions: posterior, peripheral, and combined. All patients with PIC had the posterior pattern. Patients with MFC had the peripheral or combined pattern, and all patients with MFC with uveitis had the combined pattern. Three patterns of fundus lesions were identified in patients with PIC and MFC. PIC and MFC may represent two separate disease entities with distinct phenotypes of choroidal lesions. [ABSTRACT FROM AUTHOR]

To evaluate the effects of fluorescein fundus angiography (FFA) on semiautomated aqueous flare measurements Laser flare photometer (LFP) measurements was performed at baseline, 30 min, and 4 h after the intravenous administration of sodium fluorescein dye. FFA was performed immediately after the baseline LFP measurement. LFP values at 30 min and 4 h after FFA were compared to baseline values. Mean change in LFP measurements at 30 min and 4 hafter baseline was compared between FFA arm and controls. The mean flare measurement in the FFA and control arm dropped 6% (p value = 0.002) and 9% (p value = 0.04), respectively. Mean change in LFP measurement at 30 min and 4 h after baseline was not significant between FFA arm and controls. Administration of fluorescein dye does not increase LFP values. The decrease in the LFP measurement following FFA may be attributed to dilation drops. [ABSTRACT FROM AUTHOR]

From the Vietnamese plant Macrosolen tricolor (Lecomte) Danser, one new diarylpropanoid, named macrotricolorin A (1) together with three diarylheptanoids including bisdemethoxycurcumin (2), demethoxycurcumin (3) and curcumin (4), were isolated. Their structures were elucidated by intensive analyses of their IR, UV, HR-ESI-MS and NMR (1 D & 2 D) spectra. It is the first time that diarylalkanoids have been reported from the genus Macrosolen. Compound 1 exhibited anti-inflammatory activity against the nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW264.7 with an IC50 value of 27.54 ± 1.75 μM. [ABSTRACT FROM AUTHOR]

Keywords: Brolucizumab; retinal vasculitis; occlusive vasculitis; intraocular inflammation EN Brolucizumab retinal vasculitis occlusive vasculitis intraocular inflammation 1508 1510 3 11/18/22 20220801 NES 220801 Recent reports of retinal vasculitis (some cases were also occlusive) after brolucizumab injection has ignited a poorly understood immunogenicity alert in the form of intraocular inflammation and retinal vasculitis. Patients with retinal vasculitis rarely suffer from systemic vasculitis. First being that IOI preceded vasculitis by a few weeks, second, predominantly arterial involvement, third, all the patients had previous anti-VEGFs injections in the past (no treatment naïve patients), fourth all the affected patients were female, and lastly, vasculitis was found to be noninfectious and not related to post-procedure endophthalmitis. [Extracted from the article]

Purpose: To report a Candida endogenous endophthalmitis in a pregnant woman with a prior history of in-vitro fertilization (IVF).Methods: Case report.Results: 21-year-old healthy woman within the first trimester of her pregnancy of a successful IVF developed a focal retinitis and panuveitis. Ocular findings suggested fungal endophthalmitis. The patient was treated with pars plana vitrectomy and repeated intravitreal antifungal injections. No systemic therapy was given. Cultures showed Candida albicans. IVF procedure was the only identifiable risk factor for endogenous endophthalmitis.Conclusions: In-vitro fertilization appeared as a possible risk factor for endogenous endophthalmitis during pregnancy. In the absence of systemic fungal infection, local intravitreal antifungal injections seem to be effective options to treat endogenous candida endophthalmitis, especially in the first trimester. [ABSTRACT FROM AUTHOR]

Capparis trinervia (family Capparaceae) is a common wild plant distributed in various localities in the mountainous region of Vietnam. While essential oils have been found in the leaves and stems of C. trinervia, there are no reports to date describing the chemical composition and biological activities to guide further exploration and application of the oils. This study determined the essential oil composition of C. trinervia; 8 and 23 distinct essential oil compounds were identified from C. trinervia leaves and stems, respectively. Stigmasterol (C29H48O) was identified as the primary compound of essential oil from leaves, accounting for 75.775% of the oils, while 3,7,11,15-tetramethyl-2-hexadecen-1-ol (C20H40O) was identified as the main essential oil component in C. trinervia stems, accounting for 18.337%. This study also explored the cytotoxic effects of essential oils extracted from C. trinervia against five cancer cells lines (A549, MCF7, HeLa, HepG2 and KB). A strong cytotoxic effect on all cancer cell lines was demonstrated by 100 µg mL−1 essential oils derived from C. trinervia leaves and stems, which suggests the species is a promising candidate for use in life and public healthcare. [ABSTRACT FROM AUTHOR]

Limited data suggest that subcutaneous administration of TCZ may be less effective than intravenous dosing in patients with ocular inflammatory disease, although several patients have experienced control of their inflammation with subcutaneous delivery and this route may be better tolerated. Four patients discontinued therapy due to TCZ-associated side effects, including neutropenia, persistent dizziness and nausea, angioedema, and severe abdominal pain. Tocilizumab (TCZ; Actemra®; Roche/Genentech in the US; Chugai Pharmaceutical Co. in Japan) is a recombinant, humanized monoclonal antibody directed against the interleukin-6 (IL-6) receptor and currently approved by the Food and Drug Administration (FDA) and the European Commission to treat adults with moderately to severely active rheumatoid arthritis (RA) and pediatric patients with polyarticular Juvenile Idiopathic Arthritis (JIA) or systemic JIA. The authors concluded that intravenous TCZ can be a safe and effective treatment for patients with refractory JIA-associated uveitis and that selected patients may be successfully switched from monthly intravenous to weekly subcutaneous TCZ following a prolonged period of control. [Extracted from the article]

Ocular tuberculosis has protean clinical manifestations. Because of its varied clinical presentation, multimodal imaging is very important to characterize the disease activity, presence of inflammation, determining therapeutic response, and detection of complications. Narrative review In this review, various imaging modalities employed in the management of ocular tuberculosis including fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) have been reviewed. Not only do these imaging tools complement each other in providing a comprehensive assessment of the pathology, they also help in gaining valuable insights regarding the evolution of the disease. Fundus imaging plays a vital role in the diagnosis and management of patients with posterior uveitis due to tuberculosis. Fundus imaging may have a useful role in defining clinical endpoints for ocular tuberculosis in the future. [ABSTRACT FROM AUTHOR]

Purpose: Overview of treatment options for the most common intraocular opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), including ocular syphilis, ocular tuberculosis, toxoplasmic chorioretinitis, and viral retinitis. Method: Narrative Review. Results: Despite the huge advances in the development of combined antiretroviral therapy (cART) for the management of patients with human immunodeficiency virus (HIV) infection, opportunistic infections still represent a significant diagnostic dilemma and cause of ocular morbidity in patients with HIV. Conclusion: Although the treatment of intraocular infections in patients with AIDS may be challenging, prompt assessment of the clinical features and appropriate aggressive management of the underlying etiology are critical to avoid life and vision threatening. [ABSTRACT FROM AUTHOR]

Purpose: There is controversy regarding the diagnosis and management of ocular tuberculosis (TB) due to lack of robust evidence. The Collaborative Ocular Tuberculosis Study (COTS) was conducted in stages to enable swift, accurate data collection across 25 participating centers. Method: Data collection was facilitated by a cloud-based data aggregation platform with programmed logic based on anecdotal evidence from uveitis experts corroborated with literature review. Results: The platform enabled standardization of interpretation and collection of data from patient medical records. The pre-programmed logic also ensured the platform only prompted the entry of relevant data based on initial data entered for each unit of analysis. This enabled collection of the vast amounts of data without compromising either of the breadth nor the depth of data collection. Conclusion: The final output from this effort was an in-depth retrospective analysis to facilitate the design of future prospective investigations on ocular TB and develop best practice guidelines. [ABSTRACT FROM AUTHOR]

This document summarizes the experience of the International Uveitis Study Group (IUSG), the Intraocular Inflammation Society (IOIS), and the Foster Ocular Inflammation Society (FOIS) and can aid as a guide for the treatment of uveitis patients in the era of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Although the attainment gap between black and minority ethnic (BME) students and white students has persisted for decades, the potential causes of these disparities are highly debated. The emergence of learning analytics allows researchers to understand how students engage in learning activities based on their digital traces in a naturalistic setting. This study investigates the attainment gap by analysing the differences in behavioural engagement between different ethnic groups. Using multilevel models of academic performance, demographics, and online traces of 149,672 students enrolled in 401 modules in a distance learning setting, we confirmed the existing attainment gap. After controlling for other demographics, module characteristics and engagement, BME students were between 19% and 79% less likely to complete, pass or achieve an excellent grade compared to white students. Given the same academic performance, BME students spent 4-12% more time on studying than white students. While the attainment gap remained persistent after controlling for academic engagement, our study further highlighted the inequality of attainment between BME and white students. [ABSTRACT FROM AUTHOR]

Extracts from the rhizomes of Paris species have been used in Asia to help treat inflammation, infection, analgesia, detoxification, dysentery, etc. Analysis of the chemical components from the rhizomes of Paris vietnamensis showed that they contained polyphenols, flavons, flavonols, flavonoids, tannins and steroidal and triterpenoid saponins. In this study, P. vietnamensis was identified from the sample collected from Sapa, Laocai province, Vietnam and three steroidal glycosides from rhizomes of this species were evaluated for anticancer and antimicrobial activity in vitro. The samples were identified as belonging to P. vietnamensis species through a combination of morphological characteristics and DNA barcodes based on the nucleotide sequence of the ITS and matK. All three steroidal glycosides exhibited strong cytotoxic activity against SK-LU-1, HeLa and MKN7 cell lines with IC50 values ranging from 1.07 to 4.37 µmol L−1, and exhibited high antimicrobial activity against strains of Serratia marcescens, Escherichia coli, Lactobacillus plantarum and Bacillus subtilis. This study provides information on the antibacterial and inhibitory activities of steroidal glycosides derived from the rhizomes of P. vietnamensis collected from Sapa, Laocai province, Vietnam on cancer cell lines. Thus, P. vietnamensis could be used as an alternative to other species of the Paris genus for anticancer and antimicrobial treatment. [ABSTRACT FROM AUTHOR]

Macular edema is a leading cause of functional visual loss in retinal vascular or ocular inflammatory diseases. Because persistent macular edema can lead to irreversible retinal damage, multi-approached treatment should be considered to achieve complete resolution of macular edema. With an enhanced understanding of its pathophysiology, numerous therapeutic options have been developed for the management of macular edema over the decades. Although medical therapies account for the mainstay of treatment, surgical approaches with vitrectomy can play an important role in the management of macular edema, depending on its mechanism of fluid accumulation. The index review focuses on the efficacy of surgical therapy for macular edema secondary to various ocular diseases including diabetic retinopathy, uveitis, and retinal vein occlusion, and consequently provides the evidences that may expand the knowledge and support the employment of surgical options. [ABSTRACT FROM AUTHOR]

There has been a growing interest in how teaching might be informed by learning design (LD), with a promising method for investigating LD being offered by the emerging field of learning analytics (LA). In this study, we used a novel LA for LD methodology to investigate the implementation of LD in an online distance learning context. A key innovation is the focus on patterns of LD. Using data from the virtual learning environment, outcomes data, and self-reports, for 47,784 students, we investigated the impact of those patterns on student behaviour, pass rates and satisfaction. A second innovation involves social network analysis. Our study revealed that different patterns of LD were associated with statistically significant differences in behaviour, but not in pass rates or satisfaction. Nonetheless, the study highlights that applying LA to LD might, in a virtuous circle, contribute to the validity and effectiveness of both, and to the enhancement of online distance learning. [ABSTRACT FROM AUTHOR]

Purpose: Report global adalimumab safety and efficacy outcomes in patients with non-infectious uveitis.Methods: Adults with non-infectious intermediate, posterior, or panuveitis were randomized 1:1 to receive placebo or adalimumab in the VISUAL I (active uveitis) or VISUAL II (inactive uveitis) trials. Integrated global and Japan substudy results are reported. The primary endpoint was time to treatment failure (TF).Results: In the integrated studies, TF risk was significantly reduced (hazard ratio [95% CI]) with adalimumab versus placebo (VISUAL I: HR = 0.56 [0.40-0.76], p < 0.001; VISUAL II: HR = 0.52 [0.37-0.74], p < 0.001). In Japan substudies, no consistent trends were observed between groups (VISUAL I: HR = 1.20 [0.41-3.54]; VISUAL II: HR = 0.45 [0.20-1.03]). Adverse event rates were similar between treatment groups in both studies (854 to 1063 events/100 participant-years).Conclusions: Adalimumab lowered time to TF versus placebo in the integrated population; no consistent trends were observed in Japan substudies. Safety results were consistent between studies. [ABSTRACT FROM AUTHOR]

Introduction: Ocular tuberculosis (TB) is a rare extra-pulmonary manifestation with protean clinical manifestations. Ocular TB as a cause of potentially blinding disease has been recently recognized by ophthalmologists as well as pulmonologists. In the past decade, there has been a great leap in our understanding of the disease pathogenesis, clinical and imaging features, as well as therapeutic challenges and disease complications. Areas covered: In this expert review, an emphasis has been laid on the recent advances in ocular imaging including wide-field fundus imaging, fluorescein angiography and autofluorescence, enhanced-depth optical coherence tomography, optical coherence tomography angiography, among others, as well as progress in the field of diagnostics such as polymerase chain reaction and other nucleic acid amplification tests. Findings from the Collaborative Ocular Tuberculosis Study (COTS), a multicentric study on ocular TB, have been explained in details. Expert opinion: Due to rapid advances in the field of fundus imaging and laboratory testing, it has become possible to recognize the pathological alterations observed in ocular TB. With further research, it may be possible to generate a consensus on the diagnosis and management of this entity in the future. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo explore the efficacy of CLS-TA, a proprietary suprachoroidal injectable suspension of triamcinolone acetonide, in noninfectious uveitis (NIU) with macular edema (ME), categorized by anatomic subtype.Patients diagnosed with ME associated with NIU of any etiology and anatomic subtype were eligible for the phase 3 PEACHTREE trial of CLS-TA. Post-hoc analyses were performed, stratified by discrete anatomic subtype of uveitis (anterior, intermediate, posterior, and panuveitis.)Across all anatomic subtypes at 24 weeks, patients receiving CLS-TA at baseline and week 12 demonstrated mean increases in BCVA ranging from +12.1 to +15.9 letters, mean central subfield thickness (CST) improvement ranging from −120.1 µm to −189.0 µm, and IOP changes ranging from +0.5 to +3.1 mmHg. Overall, reports of adverse events were similar among subtypes.Irrespective of the uveitic anatomic subtype among patients treated for ME associated with NIU, a clinical benefit in participants treated with CLS-TA was demonstrated, with a comparable safety profile. [ABSTRACT FROM AUTHOR]

Language education has a rich history of research and scholarship focusing on the effectiveness of learning activities and the impact these have on student behaviour and outcomes. One of the basic assumptions in foreign language pedagogy and CALL in particular is that learners want to be able to communicate effectively with native speakers of their chosen language. Combining principles of learning analytics and Big Data with learning design, this study used a student activity based taxonomy adopted by the Open University UK to inform module design. The learning designs of four introductory and intermediary language education modules and online engagement of 2111 learners were contrasted using weekly learning design data. In this study, we aimed to explore how learning design decisions made by language teachers influenced students’ engagement in the VLE. Using fixed effect models, our findings indicated that 55% of variance of weekly online engagement in these four modules was explained by the way language teachers designed weekly learning design activities. Our learning analytics study highlights the potential affordances for CALL researchers to use the power of learning design and big data to explore and understand the complexities and dynamics of language learning for students and teachers. [ABSTRACT FROM AUTHOR]

Retinal vasculitis presents with inflammation involving the retinal vasculature as an isolated disease or in combination with other ocular or systemic conditions. This entity may be associated with a wide variety of clinical manifestations such as vascular sheathing, cotton-wool spots, retinal ischemia, and neovascularization. Often, retinal vasculitis and its complications lead to diagnostic challenges in identifying the exact etiology of the inflammation. Ancillary investigations such as fundus photography, fluorescein angiography, and more recently, adaptive optics imaging and optical coherence tomography angiography, may provide valuable information that help in establishing the exact diagnosis and initiation of appropriate therapy. In the index review, multimodal imaging features of retinal vasculitis are described. In addition, detection of vascular inflammation using novel noncontact imaging techniques has been highlighted. [ABSTRACT FROM PUBLISHER]

Purpose: To investigate the structure of vitreomacular traction (VMT), specifically, if a correlation exists between 1) the VMT type/grade and the central foveal thickness (CFT) and subfoveal and adjacent choroidal thickness, 2) the vitreomacular/foveal angle (VMFA) and the CFT and subfoveal and adjacent choroidal thickness, and 3) the diameter of vitreomacular adhesion (VMA) and CFT and subfoveal and adjacent choroidal thickness. Materials and Methods: Retrospective, multicenter image analysis study. We analyzed raster scans of the macula taken with spectral-domain optical coherence tomography (SD-OCT) of 61 eyes of 55 patients with VMT. Conventional scans of the vitreoretinal interface were analyzed to measure CFT and the degree of VMFA. Enhanced depth imaging (EDI) scans were analyzed to measure the choroidal thickness in the macula. The multivariate test of means and the t-test were used for statistical comparisons. Results: There was no statistically significant difference in CFT between focal vs broad and concurrent vs isolated type VMT. Central (p= 0.009), nasal (p= 0.004), and temporal (p= 0.007) subfoveal choroidal thickness was significantly higher in broad VMT compared to focal VMT. There was difference in both CFT (p= 0.035) and central (p= 0.005), nasal (p= 0.01), and temporal (p= 0.001) choroidal thickness between moderate and severe VMT. There was a correlation between VMFA and CFT, where a wider angle was associated with increased CFT (p= 0.026). The broader VMA was associated with increased central subfoveal (p= 0.032), nasal (p= 0.05), and temporal (p= 0.01) choroidal thickness. Conclusions: Eyes with broad VMT have thicker choroid than eyes with focal VMT, which have a more open vitreomacular angle. The angle of VMT is related to distinct CFTs. [ABSTRACT FROM PUBLISHER]

Diabetic retinopathy (DR) comprises a major challenge to the public health and economy, being the leading cause of vision loss in working-aged adults in developed countries. If left untreated, DR will eventually progress leading to devastating blinding consequences including diabetic macular edema (DME), vitreous hemorrhage and tractional retinal detachment. Ranibizumab is a humanized monoclonal antibody fragment that targets the vascular endothelial growth factor (VEGF). It has been approved by the US FDA for the treatment of DME and DR in patients with DME. Given its proven efficacy and favorable safety profile, it has been widely used as one of the preferred therapeutic option for DME in modern clinical practice. This review provides a comprehensive overview on the safety and efficacy of ranibizumab in the management of DR and its associated sight-threatening microvascular complications. [ABSTRACT FROM AUTHOR]

A transitional economy has been characterized as experiencing a large amount of economic and social change. SMEs can be considered as the vehicle for entrepreneurship development in such a context. The purpose of this paper is to further the investigation of the favourability of the transitional environment on SMEs and entrepreneurship in Vietnam. Using a new approach, we analyse the transitional economy discourse via examining government policies, international organization reports and academic articles on Vietnam. Our findings suggest that, in Vietnam, compared to an overall normative framework developed from a wide literature review, the settings generally support a vibrant transitional entrepreneurship development and SMEs. However, more needs to be done to build up favourable sociocultural setting and effective business support systems in the country. Implications for the relevant stakeholders and suggestions for future research in the East Asian and Central and Eastern Europe regions are also provided. [ABSTRACT FROM AUTHOR]

Purpose: To compare the frequencies of attacks before and after immunomodulatory therapy (IMT) with mycophenolate mofetil (MMF) in recurrent punctate inner choroidopathy (PIC) and to report fundus autofluorescence (FAF) findings. Methods: Eight patients who had at least two recurrent episodes of increased activity before MMF and 12 months of documented clinical course before and after MMF were included. The frequencies of attacks before and after MMF were compared. FAF images evaluated. Results: Before MMF, the 8 patients experienced 19 attacks of recurrent disease activity; during MMF therapy, 3 (38%) patients experienced 6 recurrent episodes. The attack frequencies were 1.09 ±± 0.75 before and 0.23 ±± 0.32 during treatment ( p == .036). Among the 6 patients who had FAF, surrounding hyperautofluorescent halo was detected in 4 and recurrence occurred in 2 who did not show any changes on the intensity during treatment. Conclusion: In the index study, the employment of MMF has decreased frequency of attacks in recurrent PIC. FAF may be employed to monitor and predict the response to treatment. [ABSTRACT FROM AUTHOR]

Purpose: To describe the bioactivity of an intercellular adhesion molecule inhibitor (efalizumab) in a patient with refractory uveitic macular edema. Methods: A 55-year-old man presented with idiopathic autoimmune uveitis and associated macular edema, which could not be controlled by regional and systemic corticosteroid and selected immunomodulatory therapy. Efalizumab was administered as subcutaneous injections. Results: After 37 weekly injections of efalizumab, the uveitic macular edema was successfully eliminated. Six months following discontinuation of efalizumab, there were no signs of recurrent inflammation. Conclusion: Further investigation of the role of intercellular adhesion molecule inhibitors in the management of uveitic macular edema is indicated. [ABSTRACT FROM AUTHOR]

Background. The prevalence and significance of higher than normal cardiac troponin I (cTnI) levels in asymptomatic chronic hemodialysis (HD) patients remains a source of discussion. The aim of the present study was to evaluate the prevalence of higher than normal cTnI levels in asymptomatic HD patients, as determined by the last generation of immunoassay, and to perform further cardiological investigations in those patients with persistently elevated cTnI levels. Methods. All chronic HD patients in our center who had exhibited no symptoms of coronary artery disease (CAD) during the previous four weeks were screened. cTnI levels were determined before dialysis in all patients using the last generation AccuTnI™ assay (UniCel DxI 800, Beckman Coulter). The cTnI levels of those patients with elevated cTnI at the screening evaluation were then measured monthly for six months. We were thus able to identify a group of patients with persistently elevated cTnI levels (> 3 consecutive months) who subsequently underwent cardiac echography and dipyridamole-exercise (D-E) thallium testing. If stress myocardial ischemia was detected, a coronary angiography was then performed. Results. Fifty patients (32 males) were included: mean age 62.8 ± 13.6 years, 20 (40%) with a history of CAD, and 21 (42%) diabetic. At the initial screening, the mean cTnI concentration was 0.05 ± 0.06 μg/L and the cTnI levels were higher than normal (> 0.09 μg/L) in six patients (12%). In the follow-up, the cTnI normalized immediately in two patients but remained persistently elevated (range, 0.10-0.48 μg/L) in four (8%). These four patients (all males, one diabetic) had a mean age of 70.2 ± 6.6 years, and all had heart failure with a history of severe CAD with previous myocardial infarction (n = 4), coronary stenting (n = 3), and/or bypass (n = 2). D-E thallium imaging showed reversible myocardial ischemia in all. The stress ischemia involved one to four cardiac segments and was slight to moderate in three patients and severe in the diabetic patient. A coronary angiogram was performed in all patients, and showed lesions of variable severity: severe three-vessel CAD with severe systolic dysfunction in two patients (including the diabetic), and non-critical/peripheral coronary stenosis in the other two. Conclusions. Among the asymptomatic HD patients in our center, we identified four (8%) with persistently elevated cTnI levels, as determined using the last generation AccuTnI™ assay. All of them had a history of severe CAD with heart failure and exhibited reversible myocardial ischemia upon D-E thallium imaging; coronary angiography revealed coronary lesions of variable severity. Overall, our data indicate that persistent low-grade cTnI elevation occurs in HD patients having longstanding severe cardiac disease, but, from our data, it is difficult to reach a conclusion as to the best clinical approach for this group of patients. [ABSTRACT FROM AUTHOR]

Purpose: To report an atypical case of chorioretinopathy in a patient with bilateral renal transplantations. Methods: A 55-year-old female was referred for management of birdshot chorioretinopathy. Ophthalmologic examination revealed bilateral yellowish, chorioretinal lesions with adjacent hemorrhages. Results: Angiography demonstrated lesions with hyperfluorescence, leakage, and diffuse macular edema. OCT showed intraretinal edema. Laboratory evaluation revealed IgG antibodies for Bartonella hensalae. Treatment with oral ciprofloxacin led to regression of lesions, resolution of macular edema, and improvement in visual acuity. Conclusion: Multifocal chorioretinal lesions associated with B. hensalae can be atypical ophthalmic manifestations of cat-scratch disease (CSD), which may occur in immunosuppressed patients. Recognition of underlying disease and appropriate therapy can lead to improved outcomes. [ABSTRACT FROM AUTHOR]

We report the case of a 62-year-old man without prodromal symptoms who developed a hemolytic-uremic syndrome (HUS) one week after the diagnosis of an acute bacteremic urinary infection (UTI). In this patient, the E. coli isolated in blood cultures was a non-O157:H7 Shigatoxin-producing strain that could subsequently be identified as O138:H-. This is a strain that is normally found in pigs and that has never been isolated in humans previously. UTI-related HUS is a rare event, as until now, only 14 pediatric and 3 adult cases have been reported. Indeed, this new case, besides its interesting microbiological aspects, should heighten our awareness of UTI-related HUS as a rare but real condition, not only in young children but also in adult patients. This should emphasize the necessity to search actively for other sources of Shigatoxin-producing E. coli in patients presenting with HUS without gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of ciliary body melanoma that masqueraded as chronic uveitis.Methods: A patient experienced persistent unilateral panuveitis and elevated intraocular pressure. Inflammation and pressure worsened after cataract extraction and lens implantation. Diagnostic vitrectomy was non-revealing.Results: Repeat vitrectomy and lens implant removal revealed a ciliary body mass, suggestive of melanoma. Ultrasonography and clinical evaluation by the retinal oncologists supported this diagnosis. The uveitis persisted despite aggressive medical treatments, including methotrexate. Proton beam irradiation of the melanoma led to resolution of uveitis and restoration of normal intraocular pressure.Conclusion: Ciliary body melanoma can present as chronic uveitis and refractory glaucoma. [ABSTRACT FROM AUTHOR]

#ENDTB" call for action.[4],[5] Ocular tuberculosis (OTB) is a relatively unrecognized form of extra-pulmonary TB that can be the first or only presentation of TB infection.[6] The disease causes significant ocular morbidity with recurrent episodes of ocular inflammation and can be potentially blinding if left untreated. Collaborative ocular tuberculosis study consensus guidelines on the management of tubercular uveitis-report 2: guidelines for initiating antitubercular therapy in anterior uveitis, intermediate uveitis, panuveitis, and retinal vasculitis. Tuberculosis (TB) has been an unrelenting public health problem for decades mainly due to the prominent gap between the estimates of incident case load and the actual number of cases reported.[[1], [3]] This gap is largely due to the limitations of the existing diagnostic tests among other considerations, prompting calls from WHO for efforts to reduce missed cases with TB under its "FIND. Collaborative ocular tuberculosis study consensus guidelines on the management of tubercular uveitis-report 1: guidelines for initiating antitubercular therapy in tubercular choroiditis. [Extracted from the article]

Throughout the decades, tuberculosis (TB) has always been on the differential diagnosis of (infectious) anterior, intermediate, posterior, and pan-uveitis. However, it is difficult for ophthalmologists and uveitis specialists to manage patients with uveitis and presence of serologic findings that may suggest previous exposure or infection (i.e., QuantiFERON Gold) without pulmonary symptoms or radiographic finding. At times, it has been challenging for uveitis specialists and ophthalmologists to convince ID colleagues to start anti-tubercular therapy (ATT) in such cases even though the ocular findings are very suggestive of tubercular ocular infections. [Extracted from the article]

Purpose: To report a case of sclerochoroidal calcifications and describe the appearance of these lesions using optical coherence tomography with enhanced depth imaging (EDI-OCT) technology. Design: Case Report Methods: An 85-year-old patient who presented with bilateral retinal lesions suspected to be metastases was evaluated with slit-lamp biomicroscopy, funduscopy, fluorescein angiography, B-scan ultrasonography (U/S), and EDI-OCT. Results: B-scan U/S demonstrated echo-dense consolidations in the choroid bilaterally with acoustic shadowing consistent with sclerochoroidal calcifications. EDI-OCT revealed hyper-reflective lesions with decreased reflectivity posterior to the lesion. Conclusions: Sclerochoroidal calcifications should be included in the differential of choroidal masses, given their unique appearance on EDI-OCT. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of intraocular non-Hodgkin lymphoma (NHL) manifesting as persistent intermediate uveitis, facial mass, and Bell palsy. Design: Retrospective, interventional case report. Methods: A 51-year-old patient with persistent intermediate uveitis for 4 years is diagnosed with intraocular NHL after developing Bell palsy and a facial mass. Initial diagnostic vitrectomy was inconclusive. Results: Subsequent treatment with cyclophosphamide, adriamycin, vincristine, prednisone, and rituximab resulted in regressed facial mass and improved visual acuity. Conclusion: NHL can manifest as latent Bell palsy and facial mass in addition to the more common symptoms of uveitis. Intraocular NHL should be suspected in any patient of any age with persistent uveitis. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) anterior uveitis and corneal endotheliitis are the most common ocular diseases caused by CMV infections in immunocompetent patients. The incidence of CMV corneal endotheliitis is relatively high in middle-aged men. CMV corneal endotheliitis presents with mild anterior chamber inflammation, corneal edema, keratic precipitates, and elevated intraocular pressure. It resembles Posner–Schlossman syndrome and Fuchs uveitis because of the elevated intraocular pressure. Without proper diagnosis and treatment, it may progress to bullous keratopathy or glaucoma, necessitating keratoplasty or glaucoma surgery. Therefore, early diagnosis and treatment are important for a good prognosis. Aqueous humor analysis can facilitate the diagnosis of CMV corneal endotheliitis, and early antiviral treatment can decrease the risk of corneal compensation or glaucomatous optic atrophy. In this article, we review the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of CMV corneal endotheliitis along with the evidence for early clinical diagnosis and active antiviral treatment. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To assess the diagnostic performance of two chatbots, ChatGPT and Glass, in uveitis diagnosis compared to renowned uveitis specialists, and evaluate clinicians’ perception about utilizing artificial intelligence (AI) in ophthalmology practice.Six cases were presented to uveitis experts, ChatGPT (version 3.5 and 4.0) and Glass 1.0, and diagnostic accuracy was analyzed. Additionally, a survey about the emotions, confidence in utilizing AI-based tools, and the likelihood of incorporating such tools in clinical practice was done.Uveitis experts accurately diagnosed all cases (100%), while ChatGPT achieved a diagnostic success rate of 66% and Glass 1.0 achieved 33%. Most attendees felt excited or optimistic about utilizing AI in ophthalmology practice. Older age and high level of education were positively correlated with increased inclination to adopt AI-based tools.ChatGPT demonstrated promising diagnostic capabilities in uveitis cases and ophthalmologist showed enthusiasm for the integration of AI into clinical practice. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Accurate diagnosis and timely management are vital for favorable uveitis outcomes. Artificial Intelligence (AI) holds promise in medical decision-making, particularly in ophthalmology. Yet, the diagnostic precision and management advice from AI-based uveitis chatbots lack assessment.We appraised diagnostic accuracy and management suggestions of an AI-based chatbot, ChatGPT, versus five uveitis-trained ophthalmologists, using 25 standard cases aligned with new Uveitis Nomenclature guidelines. Participants predicted likely diagnoses, two differentials, and next management steps. Comparative success rates were computed.Ophthalmologists excelled (60–92%) in likely diagnosis, exceeding AI (60%). Considering fully and partially accurate diagnoses, ophthalmologists achieved 76–100% success; AI attained 72%. Despite an 8% AI improvement, its overall performance lagged. Ophthalmologists and AI agreed on diagnosis in 48% cases, with 91.6% exhibiting concurrence in management plans.The study underscores AI chatbots' potential in uveitis diagnosis and management, indicating their value in reducing diagnostic errors. Further research is essential to enhance AI chatbot precision in diagnosis and recommendations. [ABSTRACT FROM AUTHOR]