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Adrià Arboix,1 Joan Massons,1 Josefina Alió2 1Division of Cerebrovascular Diseases, Department of Neurology, Hospital Universitari del Sagrat Cor, University of Barcelona, 2Department of Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain Abstract: The oldest old population (>85 years of age) represents the faster growing segment of the elderly in developed countries. Cardioembolic infarction (CI) accounts for 14%–30% of all cerebral infarcts and is the most severe ischemic stroke subtype with the highest in-hospital mortality. Also, CI is associated with a low frequency of symptom-free patients at hospital discharge and presents a non-negligible risk of early embolic recurrence. Moreover, cardioembolic stroke is the acute cerebrovascular event most commonly found in very old subjects. However, some clinical aspects of the natural course of the disease in very old patients are still poorly defined. The present report presents an updated review of relevant aspects of CI related to clinical manifestations, biological characteristics, prognostic implications, and treatment strategies, which may contribute to improving the quality of care and outcome of acute cardioembolic stroke in very old patients. The most relevant aspects of CI are discussed based on the data published in the literature and the authors' experience in the management of stroke patients, collected from the hospital-based "Sagrat Cor Hospital of Barcelona Stroke Registry". The following aspects are commented on: epidemiologic data and risk factors, clinical characteristics, cardiac workup studies, special cardioembolic clinical features, outcome, thrombolytic therapy, antithrombotic treatment, and indications for future research lines. Cardioembolic stroke is an important topic in the frontier between cardiology and vascular neurology. The impact of CI on the patients' health and quality of life, health care systems, and society in general merits an in-depth review of current clinical issues, advances, and controversies. Keywords: cardioembolic infarction, epidemiology, risk factors, secular trends, stroke registry, very old patients

Neurotrophic keratitis or keratopathy (NK) is a degenerative corneal disease induced by impairment of the trigeminal nerve function. This condition may lead to persistent epithelial defects, corneal ulceration, and perforation. The diagnosis of NK requires a careful investigation of any ocular and systemic condition associated with the disease and ocular surface and corneal sensitivity examinations. In the past, several medical and surgical procedures were used to treat this condition with different clinical effectiveness. Cenegermin is a recombinant human nerve growth factor (rh-NGF) that supports corneal reinnervation. Different clinical trials have demonstrated the safety and efficacy of topical cenegermin in patients with moderate to severe neurotrophic keratitis. In this review, we report the literature on clinical results regarding the treatment of NK with cenegermin since its approval by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) in 2017 and 2018, respectively., 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 reviewer IA declared a past co-authorship with the author JA to the handling editor., (Copyright © 2024 Roszkowska, Spinella, Calderone, Sindoni, Wowra, Kozak, Sajak-Hydzik and Aliò.)

Background: Presbyopia is a common progressive vision disorder characterised by an inability to focus on near objects. The emergence of newer treatment options in addition to spectacles or contact lenses highlights the importance of assessing patient/user preferences., Methods: People with presbyopia and healthcare professionals (HCPs) took part in a moderated, structured discussion of specific questions on a virtual advisory-board platform. The objective was to better understand unmet needs and the experience of living with the condition. Closed and open questions were included., Results: Nine individuals (age 40 to 70 years) with presbyopia participated, from Australia, China, France, Italy, Ireland, Japan and the US. One ophthalmologist and one optometrist represented the perspective of HCPs. Over two weeks, 621 posts were entered on the platform. There was widespread agreement that the often stated association between age and presbyopia was unfortunate. Some participants had developed presbyopia at 30-45 years of age. What is more, the association with age was seen as implying a natural process, reducing the incentive to treat. Instead there was a call for an action-oriented view of presbyopia as a condition which may be effectively treated in the future. All participants experienced dealing with presbyopia as burdensome, affecting quality of life to varying degrees. When considering new treatments, convenience was the most important factor. The option to administer drops when needed was considered favourable, but short-acting treatments may not reduce inconvenience compared with spectacles. Participants viewed a therapy that targets the underlying cause of the condition favourably compared with symptomatic treatment. Side effects would severely reduce the appeal of drops. For clinical trials in presbyopia, patient-reported outcomes should be mandatory and need adequately to capture quality of life. Studies in presbyopia must be designed to minimise the inconvenience to participants in order to counter the risk of high drop-out rates., Conclusions: The interactive format provided insights into living with presbyopia, particularly the negative impact on quality of life, subjects' openness to new therapies, and the need to move away from considering the condition an unavoidable and intractable consequence of ageing., (© 2022. The Author(s).)