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PurposeMethodsResultsConclusionStandardized data collection is needed to improve research for rare diseases. In this manuscript, we describe our experience establishing the Prospective Ocular Tumor Study (POTS).The ongoing POTS captures all patients with an ocular tumor seen on the Ocular Oncology Service at Mayo Clinic Rochester and collects patient demographics, tumor features, treatment, and outcomes. This manuscript reports data collected from July 2019-July 2024.During a 5-year time period, 1,766 patients enrolled in the database, with 975 (55%) females, 1,732 (98%) white race, and mean age 61.5 years. The most frequent tumor types were choroidal melanoma (n = 610 [34%]), choroidal nevus (n = 575 [32%]), iris nevus (n = 95 [5.3%]), iris melanoma (n = 46 [2.6%]), and vitreoretinal lymphoma (n = 46 [2.6%]).The POTS is a valuable source of detailed, longitudinal data on rare ocular tumors. Expanding standardized data collection across multiple centers will facilitate improved outcomes research in ocular oncology. [ABSTRACT FROM AUTHOR]

Purpose: To assess inflammatory changes in the anterior vitreous (AV) using a swept source anterior segment optical coherence tomography (SS-ASOCT) and to correlate them with uveitis features and clinical grading of intraocular inflammation. Methods: 140 eyes from 96 patients were included in this observational, cross-sectional study: 40 ACTIVE uveitis, 40 INACTIVE uveitis and 60 CONTROLS. All eyes underwent intraocular inflammation clinical grading (anterior chamber (AC) cells counting and vitreous haze evaluation) and AV imaging with SS-ASOCT. Cells seen in the AV on OCT were manually counted using imageJ. Vitreous reflectivity variation was indirectly measured by calculating the vitreous/iris pigment epithelium (VIT/IPE) relative intensity. These OCT-based parameters were compared across the groups and correlated with inflammation clinical grading. Results: The mean [SD] number of AV OCT cells was significantly higher (both p < 0.001) in ACTIVE uveitis (12[9.8]) compared to INACTIVE uveitis (4.5[3.5]) and CONTROLS (4[3.1]). In ACTIVE uveitis the number of AV OCT cells was significantly and positively correlated with the AC cells (p = 0.04), the VIT/IPE relative intensity (p = 0.0002), the uveitis anatomical classification (INTERMEDIATE UVEITIS, p = 0.02) and the vitreous haze clinical grading (p < 0.0001). The mean[SD] VIT/IPE relative intensity of the AV increased from CONTROLS (0.12[0.01]) to INACTIVE uveitis (0.15[0.01]) to ACTIVE uveitis (0.17[0.02]), but with no statistically significant differences. Conclusions: We were able to visualize and objectively evaluate changes occurring in the AV in eyes with uveitis by means of a commercially available SS-ASOCT. OCT-cells in the AV could represent an adjunctive tool in the objective evaluation of intraocular inflammation. [ABSTRACT FROM AUTHOR]

Diabetes can involve several ocular structures -- including the cornea, lens, and retina -- and cause vascular and neural changes in these tissues. Although retinopathy is the most common ocular complication of diabetes, uveopathy can also be observed. This includes vascular, neural, muscular, and basement membrane changes. The main clinical manifestations of diabetic uveopathy are anterior uveitis and abnormal pupillary dynamics. Fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography are ideal for the imaging of vascular changes of the iris and choroid, while dynamic pupillometry is a simple screening tool to detect neuropathy. Additionally, ultrasound biomicroscopy can provide clear images of the ciliary body. Iris abnormalities, primarily angiopathy and neuropathy, can appear as alterations in vascular diameter, neovascularization, and abnormal pupillary dynamics. Choroidal abnormalities primarily affect blood vessels, including alterations in vascular diameter, microaneurysm formation, and neovascularization. The abnormal manifestations in the ciliary body include a decrease in vessel count, alterations in their diameter, isolated angiomatous dilatation, and diffuse thickening of the basal membrane of the pigment epithelium. [ABSTRACT FROM AUTHOR]

Purpose: To report visual and refractive outcomes and intraoperative and postoperative complications after pars plana vitrectomy (PPV) with retropupillary implantation of an iris clip intraocular lens (IOL). Methods: This is a retrospective case series of patients who underwent secondary retropupillary intraocular lens insertion combined with pars plana vitrectomy to treat aphakia secondary to a dislocated nucleus lens (group A); or IOL dislocation (group B). Patient demographics, preoperative visual and refractive outcomes, intraoperative factors, postoperative visual and refractive outcomes, and complications within the follow-up period ranging from 6 months up to 3 years postoperative, were recorded. Results: In total, 57 eyes of 50 patients were included with a follow-up range of 6 months to 3 years. The overall mean age was 77.0 years (range 28 to 99 years), with 26/50 (52%) of patients being male. There were 13/57 (22.8%) patients in group A and 44/57 (77.2%) patients in group B. The single most common identifiable cause for lens dislocation was pseudoexfoliation, which was seen in 13/57 (22.8%) of eyes. The mean improvement in visual acuity (baseline and final follow) was 0.72 logMAR (1.09 logMAR to 0.37 logMAR) in all patients, 1.12 logMAR (1.64 logMAR to 0.52 logMAR) in group A, and 0.60 logMAR (0.91 logMAR to 0.31 logMAR) in group B. In 46 eyes (80.7%), postoperative refractive errors were within ±1.00 dioptres (D) of the target refraction, with a mean difference of 0.36D from target refraction. Complications included corneal edema (35.1%), hyphema (26.3%), anterior chamber inflammation (26.3%), vitreous hemorrhage (14%), elevated intraocular pressure (IOP, 12.3%) and cystoid macular edema (CME, 5.3%). All these complications were managed with topical medical therapy and did not require further surgical intervention. One eye from group A was the only eye that developed retinal detachment (RD) or endophthalmitis. No patients had IOL dislocation in the postoperative follow-up period, which ranged from 6 months to 3 years. Conclusions: Retropupillary implantation of an iris clip IOL with pars plana vitrectomy is an efficient, predictable, and stable surgical option for aphakic eyes without capsular support. Postoperative corneal edema, hyphema, and anterior chamber inflammation are common but usually resolve without the need for further surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: To study the prevalence, clinical presentation, treatment, and follow-up of ocular (dermal) melanocytosis (ODM) and its association with choroidal melanoma (CM) in Asian Indian patients. Methods: This was a retrospective case series of patients with ODM conducted in a quaternary eye care center. Results: Of the total 1.48 million patients during the study period, we identified 213 patients with ODM with a prevalence rate of 0.014%. Median age at presentation was 13 years (range 0–76 years). Unilateral presentation of ODM was noted in 87% cases. ODM involved the sclera in 100% cases, the iris in 23%, the choroid in 20%, the eyelid in 29%, and V1 and V2 dermatomes in 53% cases. Nineteen patients (9%) were found to have CM, with 1.3 times increased risk of CM compared to the Caucasian population. The most common tumor location was in the inferior quadrant (n = 8, 44%). The mean tumor thickness was 8.3 ± 2.8 mm with a mean basal diameter of 14.0 ± 4.3 mm. Primary treatment of CM included plaque brachytherapy (n = 6), enucleation (n = 9), and few patients refused for treatment (n = 3). During a mean follow-up period of 21 months, one patient died because of lung metastasis. Conclusion: Although rare, choroidal melanoma does occur in the presence of ODM with an increased risk in Asian Indians compared to the Caucasian population. Patients with ODM should be examined periodically for early detection of CM. [ABSTRACT FROM AUTHOR]

Colored contact lenses have gained popularity among young individuals owing to their ability to alter the appearance of the wearer's eyes. However, conventional lenses containing chemical dyes are susceptible to detachment of the pigment layer, which can lead to corneal damage. In this research, a novel cellulose‐based structural color contact lens (SCCL) is presented that enhances aesthetic appeal via a cholesteric liquid crystal (CLC) layer. Methacrylate‐functionalized hydroxypropyl cellulose (HPCMA) molecules self‐assemble into CLC and are cross‐linked within the lens mold, resulting in the colored iris region of the contact lens. By employing multistep polymerization techniques, lenses with composite colors and intricate shapes are fabricated. Moreover, by incorporating bioderived antimicrobial peptides into the structurally colored region of the lens, SCCLs are achieved with good biocompatibility, controlled drug release, and broad‐spectrum antibacterial activity. The results of in vivo experiments using an animal model indicate that the SCCLs perform well in the treatment of bacterial keratitis. It is believed that these drug‐loaded structurally colored contact lenses will lead to various advancements in ocular medical devices and provide antibacterial protection against infectious keratitis in the future. [ABSTRACT FROM AUTHOR]

Ultrasound biomicroscopy (UBM) is the standard for diagnosing plateau iris, but its limited accessibility in routine clinical settings presents challenges. While anterior segment optical coherence tomography (AS-OCT) is more convenient, its effectiveness in detecting plateau iris is limited. Previous research has demonstrated that combining UBM and AS-OCT image pairs through neural style transfer has improved classification accuracy. However, obtaining paired images is impractical in everyday practice. In this study, we propose a novel semi-supervised approach that eliminates the need for paired images. A generative model learns to distinguish plateau and non-plateau features from UBM images. AS-OCT images are input into the generator, which attempts to transform them into corresponding UBM images. The model's performance is measured by loss values, representing the difficulty of transforming AS-OCT images, which are then used to predict plateau iris. The classification baseline, which applies AS-OCT solely without the style-transfer of UBM information, obtained 52.72% sensitivity, 60.82% specificity, and 57.89% accuracy for external validation; in contrast, the classification with neural style transfer of the image pairs respectively obtained 94.54%, 100.00%, and 98.03%, whereas the semi-supervised approach using loss values classification obtained 93.10%, 93.13%, and 93.12%, respectively. This semi-supervised transfer learning model presents a novel technique for detecting plateau iris with AS-OCT. [ABSTRACT FROM AUTHOR]

Introduction: The diagnosis of metastatic iris tumor is made by a fine-needle aspiration biopsy of part of the solid component of the tumor and tumor cells seeded in the anterior chamber; however, sometimes the diagnosis is not made due to insufficient sample volumes. We report a case of metastatic iris tumor in which measurement of tumor marker levels in the aqueous humor together with fine needle aspiration cytology contributed to the diagnosis. Case Report: An 80-year-old Japanese woman was referred to our hospital because of an iris mass. Six months before the initial visit, the patient was diagnosed with adenocarcinoma of the cecum. Slit-lamp microscopy revealed an elevated iris mass. Fine-needle aspiration cytology suggested adenocarcinoma. The carcinoembryonic antigen (CEA) level in the anterior chamber was 5,716.1 ng/mL, and serum CEA level measured on the same day were 678.5 ng/mL. These data indicated CEA levels synchronously elevated in both anterior chamber and serum. Based on aspiration cytology and high CEA levels of anterior chamber, she was diagnosed with metastatic iris tumor derived from adenocarcinoma of the cecum. One month after the initial visit, right eye irradiation was performed for metastatic iris tumor. Conclusions: Measurement of tumor marker levels in the aqueous humor, together with fine needle aspiration cytology of the tumor, contributes to the diagnosis of metastatic iris tumors. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the impact of iris nevus on the incidence and prognosis of uveal melanoma (UM). Methods: A retrospective cohort study was conducted involving 1128 UM cases and 4356 healthy controls. Participants were categorized based on iris nevus presence and grade: grade 0 (no iris nevus), grade 1 (single iris nevus), grade 2 (multiple iris nevi), and grade 3 (partial or complete darkening of the iris). Propensity matching score method was employed to control for age and sex differences, while the χ 2 test was used to compare the existence rate and grade of iris nevus between groups. Univariate ANOVA evaluated differences among various iris nevus grades, the Kaplan–Meier method analyzed the prognosis of patients with different iris nevus grades, and multivariate Cox proportional risk regression analysis was conducted to evaluate the relationship between clinical data and prognosis. Results: A total of 5484 subjects were analyzed. UM patients exhibited a higher prevalence and grade of iris nevus (all P < 0.001) after propensity matching. Patients with iris nevus in the affected eye did not show a worse prognosis (P = 0.414). However, those with partial or complete iris darkening or multiple nevi had a poorer prognosis compared to those with a single or no iris nevus (all P < 0.05). Iris nevus presence and grade in the healthy eye had no prognostic impact (P = 0.726 and P = 0.825, respectively). The multivariate COX proportional risk model showed that tumor diameter (P < 0.001), age (P = 0.020), and grade of iris nevus in the affected eye (P = 0.009) were independent risk factors for a worse prognosis. LSD analysis revealed that patients with partial or complete darkening of the iris had larger tumor diameters than those without iris nevus (P = 0.013), single nevus (P = 0.015), and multiple nevus (P = 0.023). Discussion: Our findings indicate a higher proportion and grade of iris nevus in UM patients compared to controls, and a worse prognosis for UM patients with higher-grade iris nevi in the affected eye. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study is to investigate the effect on choroidal parameters of drug withdrawal in patients taking α1 adrenergic receptor antagonist (ARA) inhibitors. Methods: In total, 32 eyes of 32 patients under alpha-lytic therapy, and 32 eyes of 32 control subjects, both scheduled for cataract surgery in the fellow eye, were included. EDI-OCT was performed in all patients and subfoveal choroidal thickness (SFCT), luminal choroidal area (LCA), stromal choroidal area (SCA), total choroidal area (TCA), and choroidal vascularity index (CVI) during the preoperative visit were compared with data approximately 1 month after alpha-lytic withdrawal. The same assessments were performed in the control group. Results: SFCT and LCA were significantly reduced in the patients 1 month after alfa-lytic therapy withdrawal (p < 0.05), whereas in the control group, no changes in choroidal parameters were observed. Conclusions: The data proved that α1ARA inhibitors affected choroidal vessels, whereas no modification of choroidal stroma was observed. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the efficacy and safety of performing phacoemulsification using the eight-chop technique with iris hooks in patients with small pupils. Methods: The iris hooks and control groups each included 65 eyes. Cataract surgeries were performed using the eight-chop technique. The operative time, phaco time, aspiration time, cumulative dissipated energy, and volume of fluid used were measured. Best-corrected visual acuity, corneal endothelial cell density (CECD), and intraocular pressure (IOP) were measured preoperatively and postoperatively. Results: In total, 130 eyes of 107 patients (mean age, 75.9 ± 7.1 years; 58 men, 72 women) with cataracts were evaluated. The mean operative time, phaco time, aspiration time, cumulative dissipated energy, and volume of fluid used were 10.6 min, 20.7 s, 101.1 s, 7.8, and 38.0 mL, respectively, in the iris hooks group and 4.6 min, 16.2 s, 72.1 s, 7.0, and 28.9 mL, respectively, in the control group. The decrease in CECD at 19 weeks postoperatively was 2.1% and 1.2% for the iris hooks and control groups, respectively. In both groups, IOP decreased significantly (all p < 0.01) at 7 and 19 weeks postoperatively. No intraoperative complications were found in either group. Conclusions: The eight-chop technique using iris hooks resulted in a small postoperative reduction in CECD and excellent values for intraoperative outcome measures. In addition, those cataract surgeries were very short, efficient, and safe, without complications. The eight-chop technique using iris hooks could provide an ideal solution for patients with small pupils. [ABSTRACT FROM AUTHOR]

Purpose: To report an atypical presentation of severe toxicity, anterior chamber (AC) inflammation, and transient parafoveal formation of subretinal fluid induced by the subconjunctival injection of 5-fluorouracil (5-FU). Methods: Case presentation. Results: Seven weeks after trabeculectomy, a 40-year-old white male had a subconjunctival injection of 5-FU. Within minutes after the injection, the lens turned grey and then total white. Initially, AC was clear, and 20 min later, a severe AC reaction was detected. The patient was prescribed hourly dexamethasone eye drops and tropicamide eye drops twice daily. Two days post-injection, vision improved, AC reaction was minimal, and there was whitish fibrinous material on the anterior surface of the lens, extending up to the pupillary margin. Minimal posterior synechiae were observed, and upon dilation, the remainder of the anterior surface of the lens appeared completely clear, indicating that only the portion of the lens not covered by the iris exhibited fibrinous material and deposits. One week post-injection, vision worsened due to severe corneal toxicity. The dimensions of the whitish fibrinous material on the anterior lens capsule decreased, and macular scans revealed parafoveal subretinal fluid. Two weeks later, vision significantly improved, and the dimensions of the whitish fibrinous material on the anterior lens capsule were further decreased. The subretinal fluid had completely resolved. Conclusion: We describe a rare case of severe toxicity, AC inflammation, and transient parafoveal subretinal fluid formation caused by the 5-FU. This was treated with topical steroid treatment, and eventually some level of lens opacification persisted despite significant clearance of the AC inflammation. [ABSTRACT FROM AUTHOR]

Background: Gout is an inflammatory metabolic disorder characterized by the accumulation of monosodium urate in extracellular spaces, especially joints. Its clinical characteristics include arthritis, nephrolithiasis, nephropathy, and tophi. Ocular tophi have been observed in the lateral canthus, upper eyelid, orbit, iris, anterior chamber, subconjunctival space, and cornea. Good visual acuity requires a transparent cornea with healthy endothelial function and stromal layer organization. Reduced corneal transparency in gout patients may be a result of uric acid accumulation in the stroma or endothelial dysfunction. Aims and Objectives: This study aimed to investigate corneal endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in gout patients compared to healthy individuals. Materials and Methods: A retrospective comparative study was conducted on 70 eyes of 35 gout patients and 70 eyes of 35 healthy subjects without gout or any other systemic disease. Detailed ophthalmologic examination was followed by specular microscopy where ECD, average cell area (ACA), coefficient of variation (CV), hexagonality ratio (HEX), and CCT values were recorded and analyzed in gout patients and healthy subjects. Results and Analysis: Mean ECD and HEX values were lower in the gout group than in the control group (P = 0.004 and P = 0.002). CV, standard deviation, ACA, maximum cell area, and CCT values were significantly higher in the gout group than in the control group (P = 0.001, P < 0.001, P = 0.007, P = 0.002, and P = 0.001). A significant positive correlation was found between uric acid levels and CCT (r = 0.355, P = 0.003). Conclusions: The study and monitoring of corneal morphology in gout patients and the correlation between corneal thickness and serum uric acid levels over time may provide insights into disease progression and modifications in drug therapy. Hence, ophthalmic evaluation should be incorporated in the comprehensive management of gout, especially in patients with unexplained ocular symptoms. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare endothelial features by in-vivo confocal microscopy (IVCM) in Chinese eyes with chronic or recurrent anterior uveitis (AU) with and without cytomegalovirus (CMV). Methods: A double-masked, cross-sectional case-control study at a tertiary eye clinic. Results: Thirty eyes of 30 subjects were analyzed. Fifteen eyes (50%) were CMV positive, while fifteen eyes were negative for herpes simplex virus, varicella zoster virus and CMV. Absence of pseudoguttata was the strongest, independent risk factor for CMV (OR 34.53, 95% CI: 1.84-648.02, p = 0.018), followed by severe iris depigmentation (OR 31.45, 1.02-965.81, p = 0.048) and low corneal endothelial cell density (ECD) (OR 14.79, 1.14–191.30, p = 0.039) on univariable regression. All three remained statistically significant after adjustment. The combination of absence of pseudoguttata and low ECD on IVCM achieved a similar predictive value as iris depigmentation examination. Conclusion: Absence of pseudoguttata on IVCM was an independent predictor of positive CMV detection after adjusting for iris depigmentation and corneal endothelial cell density. The addition of this feature to severe iris depigmentation and low corneal ECD can increase the positive predictive value of detecting CMV. IVCM was a useful non-invasive tool to predict CMV in patients with chronic or recurrent AU. Key message: What is known: • Early detection of CMV can guide use of CMV-specific treatment for better clinical outcomes. • The gold standard of polymerase chain reaction (PCR) detection of viral DNA in aqueous fluid involves an invasive procedure with known risk of false negative results. What is new: • Absence of pseudoguttata on the non-invasive in-vivo confocal microscopy (IVCM) is an independent risk factor for CMV detection in aqueous fluid. • Performing IVCM in patients with chronic or recurrent anterior uveitis can increase the positive predictive value of detecting CMV via aqueous tapping, hence stratifying patients with a higher risk of CMV involvement to receive a more invasive investigative procedure. [ABSTRACT FROM AUTHOR]

This article presents an iris‐mimicking polymeric microparticle with randomly generated silica film cracks to be utilized as a wet‐phase micro security taggant. The microparticles are designed to replicate the capillary patterns in the human iris, providing high data capacity and stability, making them ideal for authentication. Furthermore, the microparticles integrate a QR code within the pupillary zone of the iris, enabling pupillary authentication to enhance two‐factor identification and elevate overall security levels an unprecedented feature absent in conventional iris recognition systems. The resulting artificial iris‐mimicking microparticles have high coding efficiency and unique characteristics and can be authenticated in the wet phase, making them suitable for use as micro security taggants. [ABSTRACT FROM AUTHOR]

Objective Procedures Results Conclusion To describe the case of a 12‐year‐old male African lion (Panthera leo) presented with ocular discharge, corneal edema, and buphthalmos of the right eye.Ocular ultrasonography showed an intraocular mass involving the iris and ciliary body. Enucleation was performed.Subsequent histopathological analysis revealed a pleomorphic pigmented neoplastic cell population infiltrating, expanding and effacing the iris and ciliary body and occupying the ciliary cleft. The histopathological and immunohistochemical features were consistent with a diffuse iris melanoma (DIM).DIM is the most common primary intraocular neoplasm of domestic cats, but rarely reported in large felids. The prognosis in large felids is unknown and warrants identifying additional cases and careful monitoring of affected individuals. [ABSTRACT FROM AUTHOR]

Assessing handling qualities is crucial for ensuring the safety and operational efficiency of aircraft control characteristics. The growing interest in Urban Air Mobility (UAM) has increased the focus on electric Vertical Takeoff and Landing (eVTOL) aircraft; however, a comprehensive assessment of eVTOL handling qualities remains a challenge. This paper proposed a handling qualities framework to assess eVTOL handling qualities, integrating pilot compensation, task performance, and qualitative comments. An experiment was conducted, where eye-tracking data and subjective ratings from 16 participants as they performed various Mission Task Elements (MTEs) in an eVTOL simulator were analyzed. The relationship between pilot compensation and task workload was investigated based on eye metrics. Data mining results revealed that pilots' eye movement patterns and workload perception change when performing Mission Task Elements (MTEs) that involve aircraft deficiencies. Additionally, pupil size, pupil diameter, iris diameter, interpupillary distance, iris-to-pupil ratio, and gaze entropy are found to be correlated with both handling qualities and task workload. Furthermore, a handling qualities and pilot workload recognition model is developed based on Long-Short Term Memory (LSTM), which is subsequently trained and evaluated with experimental data, achieving an accuracy of 97%. A case study was conducted to validate the effectiveness of the proposed framework. Overall, the proposed framework addresses the limitations of the existing Handling Qualities Rating Method (HQRM), offering a more comprehensive approach to handling qualities assessment. [ABSTRACT FROM AUTHOR]

Introduction: Bilateral acute iris transillumination (BAIT) is characterized by acute bilateral onset of intense pigment dispersion in the anterior chamber, diffuse iris transillumination, and mydriatic atonic pupils, accentuated pigment deposition in the angle of anterior chamber, and elevated intraocular pressure (IOP). Herein, we report an unusual case of a Chinese patient with BAIT presented to our hospital with no iris transillumination defect. Case Presentation: A 37-year-old male patient presented to our settings with bilateral photophobia, redness, and blurry vision. The symptoms began acutely following a respiratory illness, for which he was treated with moxifloxacin. The patient demonstrated a profound thick layer of pigment deposition on the anterior surface of the lens, corneal endothelial pigment dusting, and trabecular meshwork hyperpigmentation. He was previously diagnosed with acute anterior uveitis with accentuated IOP rise, and was subsequently treated with topical corticosteroids, cycloplegic, and IOP-lowering medications. Despite aggressive medical treatment, IOP remained refractory. The retinal nerve fiber layer severely restricted in both eyes (OU). He was then referred to our glaucoma consultant practice. Although low-energy Selective Laser Trabeculoplasty (SLT) (Quantel, USA) was then performed, it elicited no favorable response, a result that was different compared to previous reports on Caucasian patients. Finally, we performed binocular trabeculectomy combined with mitomycin application, resulting in the optimal IOP control. Conclusion: BAIT in Chinese patients has atypical characteristics, which can highly contribute to misdiagnosis and therapeutic delay with significant consequences. Simultaneously, it is essential to differentiate BAIT from iridocyclitis and pigment dispersion syndrome. [ABSTRACT FROM AUTHOR]

Background: The aim of this retrospective study was to compare the surgical and refractive outcomes using the Carlevale IOL (FIL SSF; SOLEKO) with those of the retropupillary-fixated Artisan IOL (Aphakia Model 205; OPHTEC), implanted through a 6 mm sclerocorneal tunnel incision in both groups. Methods: This study included 51 consecutive eyes (25 Carlevale and 26 Artisan IOLs). Due to complex preoperative conditions (e.g., dislocated polymethylmethacrylat IOL, luxated Cataracta rubra), all patients underwent lens explantation using a standardized 6 mm sclerocorneal tunnel incision and a 23 G or 25 G pars plana vitrectomy. Visual acuity (VA), spherical equivalent, refractive prediction error (PE), incision-suture time, and complication rates were recorded preoperatively and during the follow-up period. Results: The average follow-up period was 40.9 ± 5.7 days. VA improved by 0.28 ± 0.39 logMAR (p < 0.0001) in the Carlevale group and by 0.36 ± 0.47 logMAR (p < 0.0001) in the Artisan group. The improvement was comparable between both groups (p = 0.921). The deviation of the PE was −0.67 ± 0.56 in the Carlevale group and 0.34 ± 0.71 in the Artisan group (p < 0.0001). The mean incision-suture time was 42.5 ± 5.8 min in the Carlevale group and 28.2 ± 6.4 min in the Artisan group. Anterior chamber and vitreous hemorrhages were the most common complications, occurring in 12% in the Carlevale group and 17.2% in the Artisan group. Conclusions: The use of the Carlevale IOL, implanted using a sclerocorneal tunnel technique, presents a valid option for treating complex lens dislocations. The scleral fixation of the Carlevale IOL minimizes risks associated with iris fixation, such as chronic inflammation and pupil distortion, making it particularly suitable for patients with damaged irises. [ABSTRACT FROM AUTHOR]

Despite the tight link between the visibility of the iris and pupil, the perceived effects of these two have been studied largely in isolation. We demonstrate, across two experimental studies, that the effects of perceived pupil size are dependent on the visibility of the iris. In a first study, our participants donated more and had more positive impressions of portraits of non-human primates when these were manipulated to appear having larger pupils. Post-hoc inspection of our data suggested that the difference was greater for species with more conspicuous irises. In a second study, we concomitantly manipulated iris brightness and pupil size. Brighter irises and larger pupils elicited greater donations. Participants rated photographs with brighter irises as cuter, more attractive and friendlier, but only when they had dilated pupils. Our results have methodological implications for studies manipulating eye appearance, and help interpret results from previous studies. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion To provide a historical overview of the various efforts to change eye colour for purely cosmetic reasons, along with the associated potential risks and harms.Literature and online search.Eye drops containing adrenaline were used during World War II on involuntary inmates of concentration camp Auschwitz‐Birkenau. Prostaglandin drops, used in glaucoma therapy since 1996, can increase iris pigmentation as an undesired side effect. Commercial drops, available since 2011, are not effective and potentially dangerous. Iris implants, commercially available since 2011, led to serious complications like corneal decompensation, uveitis and glaucoma, and for this reason, implants had to be removed, leaving some patients almost blind. Also commercially in use since 2011 are laser treatments to make brown eyes blue. Among the possible complications are anterior uveitis and (pigmentary) glaucoma. Corneal tattooing has existed for almost 2000 years. Complications of modern, intrastromal keratopigmentation include corneal perforation, bacterial infection, allergic or toxic reaction to pigment, migration of pigment, and functional complications like visual field limitation and light sensitivity. Personal identity and self‐esteem are likely contributing factors to undergo this potentially harmful cosmetic eye surgery. In addition to the earlier discussed complications, the artificial layer of colour can obscure ocular pathology of the cornea or iris. As the majority of individuals undergoing these procedures are relatively young, problems may arise in the future when they will need cataract or other eye surgeries.Permanently changing eye colour in healthy eyes for purely cosmetic reasons is a risky procedure. [ABSTRACT FROM AUTHOR]

Background/Objectives: To compare the clinical outcome of suture and sutureless iris fixation techniques for dislocated intraocular lenses (IOLs). Methods: Retrospective cohort study including patients who underwent surgery for late IOL dislocation over a 10-year period. IOL repositioning was achieved either by suturing the original IOL to the iris using the Siepser slipknot technique or by replacing it with a retropupillary sutureless iris claw IOL. Data collected during surgery included the type of dislocation, the need for anterior or posterior vitrectomy, duration of surgery, and intraoperative complications. Six months after surgery we assessed the eye and iris anatomy; refraction, astigmatism, and visual acuity; endothelial cell damage; and rate of postoperative complications. Results: Included in the study were 60 patients: 32 underwent IOL relocation and 28 underwent IOL exchange. Pseudoexfoliation (43.7% and 39.3%) and retinal surgery (34.4% and 28.6%) were identified as the main possible causes for IOL dislocation. The mean duration of the surgery was 62.9 ± 14.9 min for the Relocation group, and was 42.7 ± 11.4 min for the Exchange group (p < 0.001), with similar low intraoperative complication rates (6.25% and 7.14%, respectively). The studied parameters showed no differences between the two groups postoperatively, except for corneal astigmatism which was 1.31 ± 0.45 D in the Relocation group and was 1.89 ± 0.86 D in the Exchange group (p < 0.001). Conclusions: Both suture and sutureless iris fixation techniques for dislocated IOLs yielded similarly favorable outcomes in this study. IOL relocation resulted in less postoperative astigmatism, while IOL exchange offered the advantage of shorter surgical time. [ABSTRACT FROM AUTHOR]

Purpose: Uveitis-Glaucoma-Hyphema (UGH) syndrome results from contact between the intraocular lens (IOL) and the iris or ciliary body, leading to uveal structure erosion and blood-aqueous barrier breakdown. Treatment involves various drugs, with IOL removal often being necessary. Diagnosis relies on clinical signs, but imaging techniques like ultrasound biomicroscopy (UBM) or anterior segment optical coherence tomography (AS-OCT) are crucial. AS-OCT accurately depicts IOL position and potential contact, emerging as a primary alternative to UBM in the diagnosis. Our study aimed to correlate AS-OCT findings with clinically detectable iris atrophy in pseudophakic patients with IOL-iris chafing and UGH syndrome. Methods: The study retrospectively analyzed patients diagnosed with UGH syndrome presenting at the Ocular Immunology Unit of Reggio Emilia, Italy, from January 2019 to August 2023. Patients' data were collected. Ophthalmological exams and imaging were performed. The peephole sign in AS-OCT images was evaluated. Statistical analyses were conducted, with a significance level of p ≤ 0.05. Results: The study reviewed 22 eyes of 22 patients with UGH syndrome. Four eyes were excluded, leaving 18 patients (8 females, 10 males). Common misdiagnoses included idiopathic anterior uveitis (55.5%) and herpetic anterior uveitis (16.7%). All patients had iris transillumination defects, mostly focal (77.8%). AS-OCT revealed IOL chafing in all the eyes, with peephole sign correlation. More peephole signs occurred with IOL in the sulcus (p-value = 0.08). Conclusion: The study recommends AS-OCT for UGH syndrome confirmation and UBM when IOL-iris chafing is not observed on AS-OCT scans. [ABSTRACT FROM AUTHOR]

Purpose: Ocular cysticercosis, caused by Taenia solium larvae, presents significant public health challenges, especially in regions with poor sanitation. Traditional imaging techniques often fail to detect anterior segment cysticercosis accurately, necessitating the exploration of more advanced diagnostic modalities like Ultrasound Biomicroscopy (UBM). Patients and Methods: A retrospective observational analysis was conducted on 18 eyes from 14 patients with cysticercosis involving the anterior segment. UBM imaging was performed using a Sonomed VuMax HD ultrasound biomicroscopy machine with a 50 MHz probe. Results: In the study, 18 eyes from 18 patients were analyzed, revealing 12 cases of conjunctival cysticercosis, 4 of anterior chamber cysticercosis, and 2 of iris cysticercosis. Patients averaged 37.89 (± 16.2) years, with a male predominance. Conjunctival cysts appeared as clear masses, occasionally eliciting inflammatory reactions. Iris involvement caused thinning near the angle, while anterior chamber cysts could displace the lens, leading to iris bombe in some instances. Conclusion: UBM emerges as a valuable diagnostic tool for anterior segment cysticercosis, providing detailed imaging superior to traditional methods. Its cost-effectiveness and accessibility make it particularly valuable, especially in resource-constrained settings. Future research should focus on validating UBM's diagnostic accuracy and exploring its role in monitoring disease progression and treatment response. [ABSTRACT FROM AUTHOR]

This review explores the Neapolitan pizza baking process in a traditional wood‐fired oven, employing visual color analysis and IR thermal scanning to detail heat exchange mechanisms. During cooking, the oven floor temperature in the pizza area decreased proportionally to the pizza's mass, whereas the free area maintained a constant temperature of 439 ± 3°C. An IR thermal camera indicated that the oven dome temperature reached approximately 480°C with a weak flame and 500°C with a strong flame. The pizza's bottom achieved a maximum temperature of 100 ± 9°C, facilitated by the Pizzaiolo's skill in lifting and rotating the pizza for uniform cooking. Top temperatures varied: up to 180°C for white pizza and 84°C and 67°C for tomato and Margherita pizzas, respectively. IRIS electronic eye analysis revealed more browning and blackening on the pizza's top compared to its bottom, with peaks of about 26% and 8% for white pizza, respectively. Rapid baking is pivotal in Neapolitan pizza‐making, necessitating precise heat and mass transfer management to influence sensory attributes. European Commission Regulation No. 97/2010 mandates wood‐fired ovens for true Neapolitan pizza, but environmental concerns prompted the Associazione Verace Pizza Napoletana to certify gas or electric ovens when wood‐fired ovens are impractical. Operating costs vary: liquefied petroleum gas ovens are the costliest, with costs ranging from €5.38 to €6.19/h, whereas natural gas and electric ovens have operating costs between €2.70 and €4.10/h. At €0.15/kg, firewood is the most economical, supporting traditionalist views. However, natural gas and electric ovens present competitive costs under stringent antipollution laws, making them viable alternatives. [ABSTRACT FROM AUTHOR]

Background: To report the clinicopathological features and epidemiology of iris melanoma in Queensland, Australia. Methods: This was a retrospective study of 86 patients with iris melanoma treated between 2001 and 2022 at the Queensland Ocular Oncology Service, Brisbane, Australia. Main outcome measures included demographics, clinical and phenotypic features, age‐adjusted incidence and relative survival. Results: Eighty‐six patients (63% female) were included. Mean age was 54 years (range 17–82 years). The majority of patients (97%) were Caucasian, with blue eyes, fair skin and Fitzpatrick Skin Type I or II. Demographic features and clinical history showed a tendency for high ultraviolet radiation (UVR) exposure in the cohort. Histopathology was available in 69 cases (82%), and of these, 77% tumours were of spindle cell origin, with low‐risk genetic profiles. Patients were followed for a mean of 8 years (median 7, range 1–21 years) after diagnosis, and only one case of metastasis was documented. Conclusions: The association of iris freckles, history of UVR exposure and dermatologic findings supports the role of UVR in iris melanoma. Occupation and avocation history, as well as evaluation of iris freckles may offer an easily accessible way of stratifying the risk of an individual for development of UVR‐related uveal melanoma. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the pupil size (at the iris plane) under photopic (PPH) and scotopic (PS) conditions after phacoemulsification with intraocular lens (IOL) implantation. Methods: This retrospective observational cohort study included 190 virgin eyes from 190 patients who underwent cataract surgery with IOL implantation. Data collected with Aladdin (Topcon), AS-OCT MS-39 (CSO), and iTrace (Tracey) were SimK, mean pupillary power at 6 mm (MPP), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), lens rise (LR), PPH and PS before and after surgery at 30 days, dysfunctional lens index, and opacity grade. The position of the postoperative iris plane (PIP) was measured manually with MS-39, and a multivariate regression formula was developed to predict it. Statistical analysis was performed using Statistical Package for Social Science (SPSS) (IBM). Results: The mean and standard deviations were 42.61 ± 3.20 D for MMP at 6 mm, 3.35 ± 0.37 mm for ACD, 3.89 ± 0.18 mm for PIP (P < 0.01), 4.55 ± 0.42 mm for LT, 0.43 ± 0.24 mm for LR, and 25.91 ± 3.03 mm for AL. The mean preoperative and postoperative topographic pupil magnification was 12% and 14.22%, respectively (P < 0.01). Despite an increase in magnification, the postoperative pupil was smaller than the preoperative one both for scotopic and photopic conditions: The larger the preoperative pupil, the more it tends to reduce in the postoperative period. Conclusions: Analysis of the preoperative topographic pupil alone is not sufficient for a correct indication of the optical zone and total diameter of IOL to be implanted but must be correlated with biometric data. The topographic pupil, therefore, undergoes a change in magnification from the preoperative period to the postoperative period. Furthermore, the real pupil presents a modification and, in most cases, tends to be smaller postoperatively in both photopic and scotopic conditions. [ABSTRACT FROM AUTHOR]

Introduction: This retrospective chart review aims to report a combined surgical approach of intraocular lens (IOL) fixation and gonioscopy-assisted transluminal trabeculotomy (GATT) for the treatment of subluxated IOLs and glaucoma or ocular hypertension. Methods: Charts of patients who underwent IOL fixation combined with GATT between November 2019 and July 2023 were reviewed. The main outcome measure was surgical success, defined as a well-centered IOL and an IOP of 18 mmHg or lower and either a 30% IOP reduction or a reduction in medications as compared to baseline. Complications and the need for reoperation were recorded. Results: Eleven patients who underwent GATT with IOL fixation were included. The mean age was 80.45 years (range: 73–90). IOL subluxation was associated with pseudoexfoliation in all cases. Seven patients underwent scleral fixation, and four underwent iris fixation. The mean follow-up was 15.36 (range: 2.7–26.6) months. The success rate was 72.73%. The mean baseline IOP was 20.63 ± 6.56 mmHg on 2.81 ± 1.53 medications. Four patients were on oral carbonic-anhydrase inhibitor (CAI) before surgery. The mean IOP at the end of the follow-up was 13.86 ± 3.5 mmHg on 1.36 ± 1.57 medications, and none were on oral CAIs. No intraoperative complications occurred, and transient hyphema and vitreous hemorrhage were the most common postoperative complications. All patients had a well-centered IOL. No patients needed additional surgery for IOL position or IOP control. The mean corrected distance visual acuity was 0.634 ± 0.62 logMAR at baseline and 0.36 ± 0.38 at the end of follow-up. Conclusions: GATT can be combined with IOL fixation to the sclera or iris to effectively reduce IOP and medication usage. [ABSTRACT FROM AUTHOR]

Chromatophoromas are neoplasms arising from pigment cells in vertebrates. Iridophoromas are a type of chromatophoroma that are reported in several teleost species. There are multiple case reports of this diagnosis in betta fish (Betta splendens), but all previously reported cases originated from the skin. This is the first report of an intra-ocular iridophoroma. An adult betta fish had buphthalmia of the right eye and enucleation was performed. The fish survived surgery but was found dead 2 days later. The eye and entire body were examined histologically, and the right eye was also examined ultrastructurally. Histologically, the uveal tract of the right eye was unilaterally and markedly expanded by a neoplasm that expanded and obliterated the iris and choroid and regionally invaded the cornea and sclera. The neoplasm was composed of spindle cells that contained pale green, birefringent, crystalline granules (iridophores). Transmission electron microscopy revealed that neoplastic cells contained a single elongated nucleus and one or more thin cytoplasmic bundles of reflecting plates that were oriented parallel to the basal lamina, further confirming the diagnosis of iridophoroma. This is the first reported case of an iridophoroma arising from the uveal tract. Most cases of iridophoromas and other chromatophoromas in fish are reported as benign. However, there are no established histological criteria of malignancy in these neoplasms. Despite the bland cellular morphology, most reported cases of iridophoromas and other chromatophoromas in bettas (including this case) had substantial tissue invasion and/or destruction. This suggests that iridophoromas and chromatophoromas in bettas may have local invasion, consistent with malignancy, despite bland cytological features. [ABSTRACT FROM AUTHOR]

The idea of developing a robot controlled by iris movement to assist physically disabled individuals is, indeed, innovative and has the potential to significantly improve their quality of life. This technology can empower individuals with limited mobility and enhance their ability to interact with their environment. Disability of movement has a huge impact on the lives of physically disabled people. Therefore, there is need to develop a robot that can be controlled using iris movement. The main idea of this work revolves around iris recognition from an eye image, specifically identifying the centroid of the iris. The centroid's position is then utilized to issue commands to control the robot. This innovative approach leverages iris movement as a means of communication and control, offering a potential breakthrough in assisting individuals with physical disabilities. The proposed method aims to improve the precision and effectiveness of iris recognition by incorporating advanced segmentation techniques and fuzzy clustering methods. Fast gradient filters using a fuzzy inference system (FIS) are employed to separate the iris from its surroundings. Then, the bald eagle search (BES) algorithm is employed to locate and isolate the iris region. Subsequently, the fuzzy KNN algorithm is applied for the matching process. This combined methodology aims to improve the overall performance of iris recognition systems by leveraging advanced segmentation, search, and classification techniques. The results of the proposed model are validated using the true success rate (TSR) and compared to those of other existing models. These results highlight the effectiveness of the proposed method for the 400 tested images representing 40 people. [ABSTRACT FROM AUTHOR]

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PurposeCase reportConclusionTo report the occurrence of unilateral, neonatal-onset congenital glaucoma in a child with Rubinstein–Taybi Syndrome (RTS).A 15-day-old male with features of RTS was presented with an enlarged corneal diameter, corneal haze, and peripheral corneal vascularization of the left eye. Ultrasound biomicroscopy of his left eye revealed iris atrophy, iridocorneal adhesions, and iris adhesions to a partially absorbed cataractous lens. Genetic evaluation of the child and the parents revealed a novel de novo heterozygous pathogenic variant in exon 5 of the CREBBP gene (NM_004380.3:c.1390C>T). A diode laser cyclophotocoagulation was performed to control the IOP in the left eye.Unilateral neonatal-onset congenital glaucoma due to iridocorneal adhesions can be a rare presentation of Rubinstein–Taybi Syndrome. [ABSTRACT FROM AUTHOR]

Objective Animals Studied Procedure Results Conclusion To map the disease locus for familial ocular melanosis (OM) in the Cairn Terrier.Cairn Terriers with OM and normal control dogs.A genome‐wide association study (GWAS) was performed using 63 OM‐affected and 31 control Cairn Terriers, followed by haplotype analysis. A significantly associated single‐nucleotide polymorphism was genotyped in a larger group of OM‐affected and control Cairn Terriers. The coding and splice‐site regions of genes mapping within the confidence interval were sequenced.A ~9.2 Mb region of chromosome 11 was significantly associated with OM. Haplotype analysis narrowed the region to 1.49 Mb. Genotyping of a SNP within the region showed 86% of OM‐affected dogs were homozygous or heterozygous for the risk allele, whereas 78% of unaffected dogs were homozygous for the nonrisk allele. Sequencing of the coding regions and splice sites of four genes (c9orf72, IFNK, the 5′ end of MOB3B, and the 3′ end of LINGO2) and of a microRNA (MIR876) did not detect any genetic variants unique to OM‐affected dogs.OM in Cairn Terriers maps to a 1.49 Mb region of chromosome 11. This accounts for 86% of OM cases in our DNA bank. A second locus may account for the OM phenotype in the remaining 14% of cases. Sequencing of coding regions and splice sites of positional candidate genes and a microRNA did not reveal any genetic variants unique to affected dogs. Further studies are required to elucidate the DNA variant causal for OM in Cairn Terriers and to understand the disease mechanism. [ABSTRACT FROM AUTHOR]

Purpose: We report our experience of diagnosing and managing metastatic adenocarcinoma of the lungs with primary manifestation to the iris and the ciliary body with the purpose to raise clinical suspicion for systemic malignancy in the presence of undetected ocular mass along with other ocular manifestations. Observations: An 82‐year‐old male presented with a deterioration of vision and intense pain in the right eye since the day before. With his right eye, he suddenly discerned hand movements only. Intraocular pressure in the right eye was increased. Slit–lamp biomicroscopy revealed a ciliary injection and hemorrhagic mass overlying the temporal half of the iris. The L‐9 ultrasound biomicroscopy (UBM) scan documented the tumor completely infiltrating the iris and the ciliary body. We suspected a metastatic eye lesion. CT chest imaging showed a solid expansive formation of the right lung. At the Oncology Department, a fine needle aspiration biopsy was performed under the control of MSCT, which confirmed lung adenocarcinoma. Conclusions and Importance: Although very rarely, pathological changes in the uvea may indicate a metastatic occurrence that needs to be considered in the differential diagnosis. It is important to undergo a wide ophthalmological examination, which in this case included a standardized A‐scan echography and UBM, which confirmed the suspicion of a tumor lesion, followed by cooperation with other medical professionals in order to discover a primary diagnosis. [ABSTRACT FROM AUTHOR]

A 74-year-old Chinese man underwent extracapsular cataract extraction in his right eye and developed a translucent iris membrane 4 months later. He was treated with two intracameral 5-FU injections and membranectomy at 2 weeks apart. At one year following the second membranectomy, the patient maintained a clear cornea without residual or recurrent membrane, an endothelial cell density of 1072 cell/mm2, a visual acuity of 20/50 and a normal intraocular pressure. Our technique of using dispersive and cohesive viscoelastics in protecting the corneal endothelium from intracameral 5-FU, helped preserve corneal endothelial cells and maintain corneal clarity at one year after surgery. [ABSTRACT FROM AUTHOR]

Background: Alpha-1 adrenergic receptor antagonists (α1-ARAs) are frequently used in treatment of Hypertension and symptomatic benign prostatic hypertrophy (BPH). Numerous studies have demonstrated the association between α1-ARAs like Tamsulosin and increased surgical risks for patients undergoing cataract surgery. This study aims to identify and study the effects of α1-ARAs on iris parameters and the subsequent operative challenges encountered during cataract surgery. Methods: A cross-sectional, prospective study involving 30 patients on α1-ARAs planned for cataract surgery and equal number of age and sex matched controls were subjected to evaluation of changes on iris parameters and subsequent challenges in cataract surgery. Results: The study group had statistically significant lesser pupil diameter. Iris thickness at sphincter muscle region (SMR) was similar between groups (P = 0.53). Significantly lower values of iris thickness at dilator muscle region (DMR) found in treated subjects (P = < 0.001). There was statistically significant difference between DMR/SMR ratio of two groups (P < 0.001). Multiple regression analysis revealed longer duration of α1-ARAs treatment correlated with reduced DMR/SMR ratio (P = 0.001; r = 0.47). Conclusion: α1-ARAs have implications for pupil size regulation and surgical procedures involving the eye. Tamsulosin is more potent than alfuzosin in inducing IFIS. Systemic α1-ARAs lower values of DMR thickness, DMR/SMR ratio and reduces pupillary diameter. Therefore, ophthalmologists, primary care physicians, urologists, and patients should be aware of the potential difficulties that these drugs pose for cataract surgery. [ABSTRACT FROM AUTHOR]

Purpose: To describe features of a syphilitic vascularized iris mass on multimodal imaging and its resolution after penicillin treatment. Methods: Observational case report and literature review of syphilitic iris masses. Results: A 43-year-old woman presented with a unilateral vascularized tan iris mass in the setting of bilateral panuveitis that occurred along with bilateral papillitis, cystoid macular edema and retinal vasculitis. Laboratory work-up confirmed a diagnosis of syphilis. Ultrasound biomicroscopy (UBM) of the iris mass showed parapupillary hyperechoic full-thickness iris stromal thickening with small intrinsic circular lumens without cyst or ciliary body extension, while the anterior segment optical coherence tomography (AS-OCT) demonstrated a hyperreflective mass with deep iris extension and partial hyporeflective rim. Following treatment, the mass fully resolved without residual sequela. A review of literature identified 11 additional cases of syphilitic iris masses in the English literature from 1915 to present. Their presentations and clinical courses were reviewed herein. Conclusions: This report characterizes a syphilitic iris mass on slit-lamp photography, iris fluorescein angiography, UBM and AS-OCT; depicts key characteristics of syphilitic iris masses; and highlights the need for close inspection of the iris mass as an uncommon sign of ocular syphilis. [ABSTRACT FROM AUTHOR]

Purpose: Distinguishing an iris melanoma from an iris nevus can be challenging as few clinical features other than documented growth are helpful in making the diagnosis. In this study, we compared the presenting intraocular pressure (IOP) and cup-to-disc ratio (CDR) between affected and unaffected eyes in patients with iris melanoma and iris nevus. Patients and methods: This was a single-institution retrospective case series of patients treated for iris melanoma and iris nevus from January 2013 to October 2022. Thirty-nine subjects with iris melanoma and forty age-matched patients with iris nevus were included. We analyzed the difference in IOP, CDR, and diagnosis of glaucoma between affected and unaffected eyes in patients with iris melanoma and control iris nevus cohort. Results: The average IOP for eyes with iris melanoma and iris nevus was 18.8± 6.1 mmHg and 14.6± 3.5 mmHg (P< 0.001), respectively. The average CDR was 0.36± 0.27 and 0.24± 0.14 (P=0.02), respectively. The average IOP of the contralateral unaffected eye in iris melanoma patients was 16.3± 3.5 mmHg, significantly less than the affected eye (P=0.03). The average CDR of the contralateral unaffected eye in iris melanoma was 0.25± 0.15, which was trending towards being less than the affected eye (P=0.05). There was no difference in the average IOP (P=0.89) or average CDR (P=0.49) between the affected and unaffected eye in patients with iris nevus. Conclusion: We demonstrate that patients with iris melanoma are more likely to have greater IOP and CDR in the affected eye compared to the unaffected eye, and a diagnosis of unilateral glaucoma than eyes with iris nevus. Patients with iris melanoma had greater IOP asymmetry between the affected and unaffected eye. Therefore, IOP and CDR asymmetry may suggest a diagnosis of iris melanoma. [ABSTRACT FROM AUTHOR]

Lymphatic dysfunction is characterized by the sluggish movement of lymph fluids. It manifests as a "Lymphatic Rosary" in the iris which is often due to dehydration and inactivity. Detecting these signs early is crucial for diagnosis and treatment. Therefore, there is a need for an automated, accurate, and efficient method to detect lymphatic rosaries in the iris. This paper presents a novel approach for detecting a lymphatic rosary using advanced image processing techniques. The proposed method involves iris segmentation to isolate the iris from the eye, followed by normalization to standardize its structure, and concludes with the application of the modified Daugman method to identify the lymphatic rosary. This automated process aims to enhance the accuracy and reliability of detection by minimizing the subjectivity associated with manual analysis. The proposed approach was tested on various iris images and the results demonstrated impressive accuracy in detecting lymphatic rosaries. The use of different iris code bit representations allowed for a robust detection process, showcasing the method's effectiveness by achieving an accuracy of 94.5% in identifying the presence of a lymphatic rosary across different stages. The novel image processing technique outlined in this paper offers a promising solution for the automated detection of lymphatic rosaries in the iris. The approach not only improves diagnostic accuracy but also provides a standardized method that could be widely implemented in clinical settings. This advancement in iris diagnosis has the potential to play a significant role in the early detection and management of lymphatic dysfunction. [ABSTRACT FROM AUTHOR]

The article describes the case of a 19-month-old male with bilateral microphthalmia and left coloboma of the iris evaluated in the outpatient Genetics Clinic. Topics discussed include a strong family history of psychiatric and neurodevelopmental disorders in the maternal lineage, genetic causes of colobomas and microphthalmias, and a published report of a patient with a 16p13.11 duplication and coloboma.

Purpose: Special properties and recent advances in the synthesis and biomolecular functionalization of gold nanoparticles (GNPs) have led to the evolution of their use in biomedical applications such as photon radiotherapy. Simulation-based studies on the effect of various parameters that govern the dose enhancement due to utilizing GNPs have facilitated the progress of knowledge in this field. Due to their flexibility and easier accessibility compared with experimental works, simulations have the potential to be considered for pre-clinical tests and, therefore, should be close to the realistic conditions as much as possible. Materials and methods: To this aim, the present work investigates the effect of the presence of GNPs that are accumulated in the cytoplasm of the constituent cells in healthy tissues of a human eye phantom, inspired by the published experimental results which report that non-target tissues also receive the drugs containing GNPs. The GNPs' concentrations are assumed to decrease by moving from the tumor toward the depth of the phantom through a suggested pattern. The MCNPX Monte Carlo code is used for the simulations. Results: The results show that for four concentrations tested, the dose enhancement factor in the shallower layer reaches 6, and decreases to 1.2 in the last layer. The dose enhancements are also examined for critical structures of the iris, cornea, sclera, and lens, showing maximum deviations of about 3 to 200% compared with the absence of GNPs in the healthy tissue. Considering the reported doses to the lens by clinical institutions, the effect of penetration of GNPs to deep layers on treatment time is also investigated. Conclusions: The results show that the penetration of GNPs from the tumor toward healthy tissues strongly controls the dose enhancement over the various eye structures and emphasizes the importance of modeling the GNPs' distribution in the medium on the overall dose enhancement. Considering the current challenges in the clinical use of GNPs, more effort needs to be made to reach an effective endpoint in treatment. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the factors affecting footplate position and its influence on vault characteristics after implantable collamer lens (ICL) implantation. Setting: Hunan Provincial People's Hospital, Changsha, China. Design: Retrospective case series. Methods: This study included 124 patients (124 eyes). Ultrasound biomicroscopy (UBM) was performed to assess the iris and ciliary body morphologies and observe the footplate position. Using multiple linear regression, the relationship between various ocular and ICL parameters and the vault as well as the factors affecting the footplate distance (FD) were analyzed. Based on the FD, 3 groups were formed: group 1 (<500 mm), group 2 (500 to 1000 mm), and group 3 (>1000 mm). The distribution of the vault range postoperatively was observed for the 3 groups. Results: Ciliary sulcus angle and FD significantly affected the vault (adjusted R² = 0.190, F = 6.763, P < .001), with FD being the most important factor influencing the vault (b = -0.383, P < .001). Postoperative UBM revealed that the footplate was located at different positions in the posterior chamber, with the majority (52%) being located on the ciliary body. The mean size of the 4 footplate orientations was 0.88 ± 0.24 mm. Multiple linear regression analysis revealed that ciliary body thickness (CBT), iris curvature (IC), and ICL iris contact length (IRCL) significantly influenced the FD (adjusted R² = 0.373, F = 11.432, P < .001). The vault range differed significantly among the 3 groups (X² = 32.33, P < .001). Conclusions: Different postoperative ICL footplate positions significantly affect the vault. CBT, IC, and IRCL can alter the position of the footplate from the expected position. This study provides reference for ICL size selection and vault prediction. [ABSTRACT FROM AUTHOR]

Feature extraction plays a vital role in the segmentation of regions of interest in medical images. While histograms offer a reliable method for analyzing color properties, the challenge of defining the pigment spot color has motivated the search for a practical feature for extraction. Consequently, analyzing the image using histograms and the HSV (Hue, Saturation, Value) color space led to the groundbreaking discovery of a reliable color feature and an exciting opportunity for pigment spot extraction. This study utilized 131 pigment spot images from the Miles Research datasets. The Region of Interest (ROI) was determined using a histogram color-based saturation intensity component, revealing new findings of thresholds ranging from 0.70 to 0.90. The results indicate that the proposed method achieved a Detection Rate (DR) of 37.1% (49 images), a False Acceptance Rate (FAR) of 14.5% (19 images), and a False Rejection Rate (FRR) of 48.4% (63 images). While the detection rate shows room for improvement, the proposed method significantly reduces the FAR to 14.5%, compared to 64.8% and 65.3% in color-based segmentation and simple color detection, respectively. This newfound feature contributes to improved accuracy and efficiency in medical image analysis, facilitating better patient diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

There are various techniques available for constructing a custom ocular prosthesis. The present technique report describes a digital workflow for constructing an ocular prosthesis using computed tomography integrated with digital technologies. The outer region of the healthy eyeball was segmented to produce the top surface of the prosthesis, while the contour and bottom surface were segmented from the tissue bed of the anophthalmic socket. The iris position was determined by tracing the optical nerve and confirmed by superimposing the patient's facial scan onto the soft tissue model of the computed tomography. Using these parameters, a standard tessellation language file for the ocular prosthesis was generated and 3D printed. The iris was then printed via UV technology using digital photographs of the patient's contralateral eye; characterization of the sclera and the final layer of clear acrylic resin were done conventionally. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to quantify anterior chamber parameters to provide potential risk indicators for evaluating the progression of primary angle‐closure suspect (PACS) eyes to acute primary angle closure (APAC) and the degree of intraocular pressure elevation in patients with APAC utilizing anterior segment optical coherence tomography (AS‐OCT). Methods. Tomey CASIA2 AS‐OCT was used to quantitatively measure various anterior chamber parameters, including anterior chamber depth (ACD), anterior chamber volume (ACV), lens thickness (LT), lens vault (LV), iris‐trabecular contact index (ITC), iris thickness (IT), iris volume (IV), iris curvature (IC), iris area (IA), and iris thickness (IT), in APAC eyes (30 eyes) and contralateral PACS eyes (30 eyes) of 30 patients. The differences in these parameters between the two groups and their relationship with intraocular pressure were analyzed. Results. Compared to the PACS group, the APAC group exhibited significantly smaller IA and IC, and significantly larger pupil diameter (PD) and ITC (P < 0.05). There were no statistically significant differences in ACV, ACD, ACW, ACA, LV, IV, and IT750/2000 between the two groups. In APAC eyes, multivariable linear regression analysis showed a significant negative correlation between intraocular pressure and IV (β = −1.85; 95% confidence interval: −2.77 to −0.93; P = 0.001), while no correlation was found in PACS eyes. In all 60 eyes, LT showed a negative correlation with ACV, ACD, ACA, and nasal IT750, and a positive correlation with LV and nasal IC. Conclusion. AS‐OCT has multiple advantages in evaluating various anterior chamber parameters in patients with glaucoma. IA may serve as a predictive indicator of the progression of eyes from PAC or APAC. A significant negative correlation was found between intraocular pressure and IV during APAC attacks. LT can be considered a predictive factor for the occurrence of primary angle‐closure disease. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyze the incidence of pseudophakic macular edema (PME) and the role of contributing risk factors following prepupillary or retropupillary implantation of iris-claw lenses. Methods: This retrospective cohort study included patients who underwent iris-claw intraocular lens implantation over a 16-year period at the University Hospital of Santiago de Compostela, Spain. The presence of risk factors for PME was recorded, and surgical outcomes included visual acuity, macular OCT scans, and description of complications. Results: A total of 148 eyes from 147 patients were included. Seventy-nine eyes (54.4%) underwent prepupillary iris-claw lens implantation and 69 eyes (46.6%) underwent retropupillary implantation. The mean age of the patients was 68.9 ± 17.2 years. The incidence of PME post-surgery was 23.0% (26.6% prepupillary and 18.8% retropupillary), and the mean time between surgery and diagnosis was similar for both locations (4.8 and 4.7 months, respectively). PME recurred in 33% of the patients, reaching a high rate of 72.7% when the lens location was prepupillary. The mean best-corrected visual acuity was 0.66± 0.55 logMAR preoperatively and 0.38± 0.50 logMAR postoperatively. Postoperative complications occurred in 29 patients (19.6%). Conclusion: PME following iris-claw lens implantation tends to be more frequent and recurrent when the location is prepupillary. Planning for iris-claw lens surgery should consider the risk factors for the development of PME. [ABSTRACT FROM AUTHOR]

Carotid-cavernous fistula (CCF) is a rare condition involving an abnormal communication between the carotid artery and the cavernous sinus. We present a unique case of posttraumatic unilateral CCF initially misdiagnosed as a corneal melt with iris prolapse and orbital cellulitis. The patient, a 25-year-old male, experienced swelling, bleeding, and sudden vision loss in the affected eye following a fall. Imaging confirmed a direct CCF, and the patient underwent endovascular coiling, evisceration, and prosthetic replacement. Partial loss of levator palpebrae superioris muscle function was observed postprocedure. This case underscores the diagnostic challenge of CCF and highlights the significance of early and accurate diagnosis for appropriate management. [ABSTRACT FROM AUTHOR]

Background: To compare intraocular pressure (IOP) and anterior segment parameters between eyes with unilateral primary angle closure glaucoma (PACG) and their fellow eyes with primary angle closure (PAC) or primary angle closure suspect (PACS). Methods: Subjects underwent anterior segment imaging using 360‐degree swept‐source optical coherence tomography (SS‐OCT, CASIA Tomey, Nagoya, Japan) and ocular investigations including gonioscopy and IOP measurement. Each SS‐OCT scan (divided into 8 frames, 22.5 degrees apart) was analysed and an average was obtained for the following anterior segment parameters: iridotrabecular contact (ITC), angle opening distance (AOD750), iris thickness and curvature, anterior chamber width, depth and area (ACW, ACD and ACA) and lens vault (LV). Results: Among 132 unilateral PACG subjects (mean age: 62.91 ± 7.2 years; 59.1% male), eyes with PACG had significantly higher presenting IOP (24.81 ± 0.94 vs. 18.43 ± 0.57 mmHg, p < 0.001), smaller gonioscopic Shaffer grade (2.07 ± 0.07 vs. 2.31 ± 0.07, p < 0.001) and a greater extent of peripheral anterior synechiae (PAS, 1.21 ± 0.21 vs. 0.54 ± 0.16 clock hours, p = 0.001). PACG eyes also exhibited increased ITC, ITC area, greater LV and smaller AOD750, ACD and ACA (all p < 0.05). Using the forward stepwise regression model, an increase in 1 mmHg in presenting IOP before laser peripheral iridotomy (LPI) increases the odds of having PACG by 9% (95% confidence interval 5%–14%). Conclusions: PACG eyes have higher presenting IOP, smaller anterior segment parameters, greater extent of PAS, and larger LV compared to their fellow eyes with angle closure. Narrower anterior chamber dimensions and higher presenting IOP before LPI may increase risk of chronic elevated IOP and glaucomatous optic neuropathy after LPI. [ABSTRACT FROM AUTHOR]

Background: Equine primary iris cysts are usually incidental findings but, if associated with clinical signs, may require intervention. The use of laser (Nd:Yag or diode) has been reported but requires specialised equipment. Transcorneal aspiration has not been previously evaluated in the standing horse. Objectives: To review outcomes of standing transcorneal aspiration of primary iris cysts (STAPIC) in horses. Methods: Horses were identified from electronic patient records from 2018 to 2024 across four collaborating centres. Clinical presentation and outcomes were identified and reported using descriptive statistics. Results: Eighteen horses were identified. Behavioural signs reported included 'spooking' and changes in rideability often associated with jumping. Single large unilateral cysts were present in 11 horses, bilateral cysts in three horses and multiple unilateral cysts in four horses. Following treatment, one horse developed uveitis and fibrin in the anterior chamber associated with needle contact with the iris stroma due to movement, and a second horse developed fibrin within the anterior chamber. Both conditions resolved with anti‐inflammatory medication and administration of tissue plasminogen activator. No other adverse effects were reported. Follow‐up was available from all horses (median: 6 months, interquartile range [IQR]: 4–11 months) with no recurrence, although one horse developed an iris cyst in the contralateral eye after 3 years. All owners reported improvement in clinical signs, with 61% reporting no further signs. Conclusions: STAPIC is an effective and easily accessible alternative for treating iris cysts in horses rarely associated with complications. [ABSTRACT FROM AUTHOR]

Background: Chemical injuries of the eye may produce extensive damage to the ocular surface epithelium, cornea and anterior segment resulting in permanent unilateral or bilateral visual impairment. In addition to causing ocular surface injury, alkalis readily penetrate into the eye, damaging the corneal stroma and endothelium as well as other anterior segment structuressuch as iris, lens and ciliary body. Objective: To study the epidemiology Of Ocular Chemical Injuries. Methods: This prospective study was conducted among all patients who will presented with ocular chemical injuries to Government Rajaji Hospital between the period October 2012 to November 2013. Result: The mean age of the patient who sustained ocular chemical injuries was 29.05 years. Most of the people who sustained ocular chemical injuries are domestic workers (22.5%) and students (22.5%). Urban people (65%) are prone for chemical eye injuries. Semi urban people (31.7%) and rural people (3.3%) form the minority group in this study. Most literates (76.7%) [College education-36.7%, school education-40%]are prone for chemical injuries. The Right eye was relatively more commonly affected (50%) than the lefteye (30%). In our study, there were 12 cases with bilateral injury (20%). Most of the ocular chemical injuries are accidental (61.7%), work place (21.7%) eye injuries come under second category in our study. Conclusion: Most chemical eye burns are mild injuries with no lasting adverse effects. Immediate irrigation of the eye is the most important part of treatment. Prophylactic efforts should be increased in order to bring down the incidence of burns. Injuries caused by assault were more severe and people proportionately lost more eyes. [ABSTRACT FROM AUTHOR]