Superficial ocular vascular changes after orbital decompression in patients with thyroid ophthalmopathy measured by anterior segment OCT angiography; an observational study.

Thyroid eye disease (TED) is a common ophthalmologic manifestation of thyroid dysfunction. Despite various imaging techniques available, there hasn't been a widely adopted method for assessing the anterior segment vasculature in TED patients. Our study aimed to evaluate alterations in ocular surface circulation following orbital decompression surgery in TED patients and investigate factors influencing these changes. Using anterior segment optical coherence tomography-angiography (AS-OCTA), we measured ocular surface vascularity features, including vessel density (VD), vessel diameter index (VDI), and vessel length density (VLD), both before and after decompression surgery, alongside standard ophthalmic examinations. Our AS-OCTA analysis revealed a significant decrease in most of the temporal vasculature measurements six weeks post-surgery (p < 0.05). However, differences in the nasal region were not statistically significant. These findings indicate notable changes in ocular surface circulation following orbital decompression in TED patients, which may have implications for intraocular pressure (IOP) control and ocular surface symptoms management. AS-OCTA holds promise as a tool for evaluating the effectiveness of decompression surgery and assessing the need for further interventions.

Effects of Dietary Fiber Level and Forage Particle Size on Growth, Nutrient Digestion, Ruminal Fermentation, and Behavior of Weaned Holstein Calves under Heat Stress.

This experiment was designed to investigate the effects of feeding diets with different fiber content and forage particle size on the performance, health, nutrient digestion, rumen fermentation, and behavioral and sorting activity of Holstein dairy calves kept under elevated environmental temperature. Sixty weaned Holstein female calves (age = 96.7 ± 7.62 days old; body weight = 82.4 ± 10.4 kg) were randomly assigned to one of 4 treatments arranged in a 2-by-2 factorial design in a 70-day experiment. Dietary forage content (moderate, 22.5%; or high, 40.0% on DM basis) and alfalfa hay particle size (short, 4.39 mm; or long, 7.22 mm as geometric mean) were the experimental factors, resulting in the following combinations: (1) high-fiber (HF) diets with forage-to-concentrate ratio of 40:60 and long particle-sized alfalfa hay (LPS; HF-LPS); (2) HF diets with short particle-sized alfalfa hay (SPS; HF-SPS); (3) moderate-fiber (MF) diets with forage-to-concentrate ratio of 22.5:77.5 with LPS (MF-LPS); and (4) MF diets with SPS (MF-SPS). The temperature-humidity index averaged 73.0 ± 1.86, indicating that weaned calves experienced a moderate extent of heat stress. Fiber level and AH particle size interacted and affected dry matter intake, with the greatest intake (4.83 kg/d) observed in MF-SPS-fed calves. Final body weight was greater in calves receiving MF vs. HF diets (164 vs. 152 kg; p < 0.01). Respiration rate decreased when SPS vs. LPS AH was included in HF but not MF diet. Lower rectal temperature was recorded in calves fed MF vs. HF diet. Digestibility of dry matter and crude protein was greater in calves fed MF than HF diets, resulting in lower ruminal pH (6.12 vs. 6.30; p = 0.03). Fiber digestibility was greater in calves fed SPS compared with those fed LPS alfalfa hay. Feeding HF compared with MF diet increased acetate but lowered propionate molar proportions. The inclusion of SPS vs. LPS alfalfa hay decreased lying time in HF diet (920 vs. 861 min; p < 0.01). Calves fed MF vs. HF diets spent less time eating but more time lying, which is likely indicative of better animal comfort. Dietary fiber level and forage particle size interacted and affected sorting against 19 mm particles, the extent of which was greater in HF-SPS diet. Overall, dietary fiber level had a stronger effect than forage particle size on the performance of weaned calves exposed to a moderate degree of heat stress as feeding MF vs. HF diet resulted in greater feed intake, final body weight, structural growth measures, nutrient digestion, as well as longer lying behavior. The inclusion of SPS alfalfa hay in MF diets increased feed consumption.

Pediatric orbital subperiosteal abscess outbreak in Iran: characteristics and causes.

PURPOSE: To evaluate demographics, characteristics, and management of pediatric patients with subperiosteal abscesses (SPA) secondary to orbital cellulitis and discuss the etiology of a dramatic rise in SPA. METHODS: Data were gathered by retrospective chart review of patients admitted to a tertiary referral eye hospital (Farabi Eye Hospital) diagnosed with orbital cellulitis with subperiosteal abscess from October 2022 to March 2023 (six months). Data on demographic information, clinical examination, radiographic evidence of sinusitis, orbital cellulitis, SPA, surgical and non-surgical management taken, isolated bacteria, and duration of hospital stay were gathered. RESULTS: 24 patients were admitted during these six months, with a diagnosis of orbital SPA secondary to paranasal sinusitis, confirmed by an orbital Computed Tomography (CT) scan. The age range was 11 months to 16 years. 75% of patients were male. All patients had a history of flu-like illness before developing orbital cellulitis. All patients had concurrent sinusitis, and 18 underwent initial surgical abscess drainage. The ethmoid sinus was the most involved, and most patients had a medially located SPA. Abscess volume ranged from 0.78 to 7.81 cm3 (mean: 3.52 cm3). One patient had concurrent central retinal artery occlusion due to orbital cellulitis. CONCLUSIONS: In this study, we report a dramatic increase in the incidence of SPA referred to our hospital. Larger abscess volumes and an increased number of cases that needed initial surgical drainage are also of note. An influenza outbreak in the autumn and winter, undiagnosed Corona Virus Disease 2019 (COVID-19) infection, increased antimicrobial resistance due to excessive off-label use of antibiotics during the COVID-19 pandemic, and more virulent bacterial infections are the most probable hypotheses to justify this observation.

Anaplastic Large Cell Lymphoma With Intraocular or Ocular Adnexal Involvement: A Case Report and Systematic Review.

PURPOSE: To review the existing literature on patients with anaplastic large cell lymphoma (ALCL) affecting the globe and/or ocular adnexa, and to present a report documenting the clinical course of a patient with ALCL that involved their globe and ocular adnexa. METHODS: PubMed, Scopus, and Google scholar were systematically searched for all cases of ALCL involving intraocular or adnexal ocular structures from inception to May 2023. Moreover, a new reported case added to the cases found in searches. RESULTS: The review identified 1680 studies, with 8 meeting inclusion criteria. A total of 9 patients were included with a mean age of 29.7 years (median: 30.0, range: 1.3-48). Primary ALCL was present in 5/9 (55.6%) patients. The most common ophthalmic manifestations included periorbital swelling (5/8), chemosis (5.8), and decreased vision (5/7). Misdiagnoses were initially made in 3 patients, and the lag time to correct diagnosis from 3 weeks to 3 months. CD30 expression was positive in all cases, and 6/9 patients were positive for anaplastic lymphoma kinase, resulting in 6/9 patients being diagnosed with anaplastic lymphoma kinase-positive ALCL. In terms of management modalities, chemotherapy was administered in 8/9 patients, while radiation therapy was utilized in 4/9 patients, and 2 underwent autologous stem cell transplantation. Five (55.6%) patients succumbed to ALCL while 4 (44.4%) were alive and disease-free at the last follow-up. The median times from the initial presentation of ALCL to death, ophthalmic presentation to death, and diagnosis to death were 4.12 months (range: 1.1-168.0), 2.62 months (range: 1.1-144), and 4.00 months (range: 0.10-168), respectively. The median follow-up duration was 21.0 months (range: 1.1-168.0). CONCLUSIONS: ALCL involving the globe and ocular adnexa is a rare and highly malignant tumor that can mimic benign clinical conditions. Early biopsy and aggressive treatment with chemotherapy regimens such as CHOP and radiation therapy may be useful.

Corneal biophysical changes after upper eyelid blepharoplasty and ptosis surgery: a review.

Upper eyelid surgeries, such as blepharoplasty and ptosis correction, are commonly performed procedures worldwide. This review examines the effects of these surgeries on ocular properties and visual function. A search of the PubMed and Google Scholar databases was conducted to identify relevant articles published after 2000. The results demonstrate that the ocular and adnexal organs function as a unified visual system, with changes in one component affecting the functions of others. Eyelid surgery can alter ocular properties and functions by modifying retinal lighting and ocular optics. These alterations can affect intraocular pressure estimation, corneal curvature, corneal epithelial thickness, refractive power of the cornea, and intraocular lens calculation. Additionally, eyelid surgery can exacerbate dry eye symptoms and impact contrast sensitivity, which is a significant factor in visual quality. Therefore, understanding these interactions is crucial before performing eyelid surgery and during follow-up. This review summarizes recent literature on the effects of upper eyelid surgery on corneal properties and visual function, emphasizing the importance of considering these factors when planning or undergoing such procedures.

Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence.

PURPOSE: This study aimed to evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP). METHODS: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal bevacizumab from 2012 to 2019. Medical records of patients were evaluated. RESULTS: Mean gestational age (GA) and birth weight of patients were 28 ± 2 weeks and 1121 ± 312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64 ± 13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97%) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). The presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factors predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis. CONCLUSION: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Awareness of risk factors for treatment failure and recurrence may help clinicians to schedule more vigilant approach in susceptible cases.

Current diagnostic tools and management modalities of Nocardia keratitis.

Nocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology, etiology, diagnosis and management of Nocardia keratitis. Nocardia asteroides is the most frequently reported from Nocardia keratitis. Pain, photophobia, blepharospasm and lid swelling are mainly clinical manifestations. Usual risk factors for Nocardia keratitis are trauma, surgery, corticosteroids, and contact lens wear. Several antibiotics were used for treatment of Nocardia infection but according to studies, topical amikacin is the drug of choice for Nocardia keratitis. Topical steroid should not prescribe in these patients. In conclusion, although Nocardia keratitis is rare, early diagnosis and treatment are essential to prevent any scar formation and preserve a good visual acuity.

Ocular flare-up in patients with systemic lupus erythematosus following discontinuation of hydroxychloroquine.

In this report, we describe two patients with systemic lupus erythematosus (SLE) who manifested with posterior segment flare-up approximately three months after cessation of hydroxychloroquine (HCQ). They were stable systemically with no history of hypertension or nephropathy at the time of referral. Our first patient presented with bilateral retinal vein occlusion, while evidence of choroidal involvement such as vascular leakage and wedge-shaped filling delay was present in indocyanine green angiography of both patients. HCQ is well known to have a role in the treatment of SLE for its immunomodulatory and antithrombotic effects. Although reports of systemic flare-up of SLE following HCQ cessation exist in the literature, this is the first report of ocular flare-up in such settings.

Dry Eye Disease: Emerging Approaches to Disease Analysis and Therapy.

Dry eye disease (DED) is among the most common ocular disorders affecting tens of millions of individuals worldwide; however, the condition remains incompletely understood and treated. Valuable insights have emerged from multidisciplinary approaches, including immunometabolic analyses, microbiome analyses, and bioengineering. Furthermore, we have seen new developments in clinical assessment approaches and treatment strategies in the recent past. Here, we review the emerging frontiers in the pathobiology and clinical management of DED.

Effect of Stress, Depression and Type D Personality on Immune System in the Incidence of Coronary Artery Disease.

BACKGROUND: Psychoneuroimmunology (PNI) is the study of the interaction between psychological processes and the nervous and immune systems of the human body. The impact of psychological factors on the immune system and the role of this system in Coronary Artery Disease (CAD) are confirmed. Coronary Heart Disease (CHD) is arisen due to the failure of blood and oxygen to the heart tissues. AIM: The present study aimed to describe psychoneuroimmunological processes which contribute to CAD and CHD progression. METHOD: Such psychological risk factors like stress, depression and type D personality were investigated here. Psychoneuroimmunological pathways of all three mentioned risk factors were described for CAD. RESULTS: The studies review indicated that stress could be accompanied with myocardial ischemia and help to rupture. The depression involves in the transfer of stable atherosclerotic plaque to unstable, and type D personality is effective in the initial stages of a CAD. CONCLUSION: As more information on cardiovascular immunity becomes available, this will provide a better understanding and thus act as the foundation for the potential development of new treatment strategies for treatment of cardiovascular disorders.

Affective and cognitive theory of mind in borderline personality disorder: The role of comorbid depression.

Disturbed interpersonal relationships and misreading of others' intentions are core symptoms of borderline personality disorder (BPD). Despite these impairments, some studies have found an enhanced theory of mind (ToM) in BPD patients. Taking this into consideration, the current study attempts to further understand these discrepancies by separating ToM into two domains: affective and cognitive. Moreover, the study considered the role of comorbid symptoms of depression in these patients. Subjects were 21 patients with BPD, 23 patients with BPD and comorbid major depressive disorder (MDD), and 25 healthy controls (HC). ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assessed the affective and cognitive aspects of ToM, respectively. In addition, all participants were evaluated with the Beck Depression Inventory (BDI). Results showed that in both BPD groups (i.e., BPD without MDD and BPD with MDD) affective ToM scores were higher than in the HC group; however, in the cognitive ToM, the HC group performed better than the both BPD groups. Also, overall the BPD group with MDD had decreased ToM skills. Finally, BPD groups received greater scores on the BDI as compared to the HC group.

Variation in antioxidant enzyme activities, growth and some physiological parameters of bitter melon (Momordica charantia) under salinity and chromium stress.

In general, salinity and heavy metals interfere with several physiological processes and reduce plant growth. In order to evaluate of three levels of salinity (0, 4 and 8 ds m(-1)) and three concentration of chromium (0, 10 and 20 mg kg(-1) soil) in bitter melon (Momordica charantia), a plot experiment was conducted in greenhouse at university of Shahrood, Iran. The results revealed that chromium treatment had no significant affect on fresh and dry weight, but salinity caused reduction of fresh and dry weight in growth parameter. Salinity and chromium enhanced antioxidant enzymes activities like catalase (CAT), guaiacol peroxidase (GPX) and sodium content in leaves. However salinity and chromium treatments had no effect on potassium, phosphorus in leaves, soluble carbohydrate concentration in leaves and root, but decreased the carotenoid content in leaves. On increasing salinity from control to 8 ds m(-1) chlorophyll a, b and anthocyanin content decreased by 41.6%, 61.1% and 26.5% respectively but chromium treatments had no significant effect on these photosynthetic pigments.

Salinity effects on compatible solutes, antioxidants enzymes and ion content in three wheat cultivars.

In order to study effects of different salinity levels on antioxidant enzyme activities, catalase (CAT), ascorbate peroxidase (APX) and guaiacol peroxidase (GPX) associated with compatible solutes, proline and carbohydrate and mineral nutrient content in shoots, sodium and potassium, in three wheat cultivars an experiment was conducted as completely randomized 3 x 4 factorial design with three replicates in a greenhouse. Three wheat cultivars (Pishtaz, Kavir and Hamon), that differ in their salt tolerances, were grown in four different salinity levels (S0 = control, S1 = 100, S2 = 200 and S3 = 300 mM NaCl). Twenty days after wheat cultivars subjected to salt stress, data showed salinity stress induced increase in the antioxidant enzyme activities. Among the cultivars, salinity stress decreased leaf-APX but increased the activities of leaf-GPX in Pishtaz cultivar. Our results showed a positive correlation between praline accumulation and Leaf-APX (r2 = 0.56), Leaf-GPX (r2 = 0.63) and Leaf-CAT (r2 = 0.73). In these cultivars, in their shoots Na+ showed an increase in concentration with salinity that approximately matches a decrease in K+ concentration. It seems that Na+ concentrations in the shoot may have had a more significant effect on plant antioxidant enzyme activities and compatible solutes such as proline and carbohydrates. These results indicated which in wheat under salinity stress antioxidant enzymes and compatible solutes help to plant adaptation. In this study we found a positive correlation between Na+ concentration in the shoots and the antioxidant enzyme activities and compatible solutes in the leaves.