Automatic segmentation of corneal dystrophy on photographic images based on texture analysis.

PURPOSE: To develop an automatic algorithm to analyze dystrophic lesions on photographic images of corneal dystrophy. METHODS: The dataset included 32 images of corneal dystrophy. The dystrophic area was manually segmented twice. Manually labeled dystrophy areas were compared with automatically segmented images. First, we manually removed the light reflex from the image of the cornea. Using an automatic approach, we extracted the brown color of the iris. Then, the program detected the circular region of the pupil and the corneal surface. A whitish dystrophy area was defined based on the image intensity on the iris and the pupil. The sliding square kernel was applied to clearly define the dystrophic region. RESULTS: For the manual analysis and the twice automatic approach, the Dice similarity was 0.804 and 0.801, respectively. The Pearson correlation coefficient was 0.807 and 0.806, respectively. The total number of distinct dystrophic areas showed no significant difference between the manual and automatic approaches according to the Wilcoxon signed-rank test (p < 0.0001, both). CONCLUSIONS: We proposed an automatic algorithm for detecting the dystrophy areas on photographic images with an accuracy of approximately 0.80. This system can be applied to detect and predict the progression of corneal dystrophy.

Oral-Facial-Digital Syndrome Type IX with Subfoveal Drusenoid Deposit.

We describe a patient with oral-facial-digital syndrome (OFDS) with the following anomalies: cleft lip, cleft palate, micrognathia, hypertelorism, nasal septum deviation, thumb polydactyly in the right hand, and partial agenesis of the corpus callosum. In addition, the patient had optic disc coloboma in the left eye and subfoveal drusenoid deposit in the right eye, features of OFDS type IX. Subfoveal drusenoid deposit has not been previously reported in OFDS type IX. Evaluation of the fundus is necessary for diagnosis of OFDS.

Photochemical Retinopathy induced by blue light emitted from a light-emitting diode Face Mask: A case report and literature review.

RATIONALE: Skin photobiomodulation involves the use of low doses of light of a specific wavelength to reduce skin inflammation and promote tissue repair. Recently, a face mask using a light-emitting diode (LED) to induce photobiomodulation has been widely introduced in the market. However, a short wavelength of high-energy blue light can cause retinal damage. We would like to report a rare case of photochemical retinopathy after using a blue LED face mask. PATIENT CONCERNS: A 37-year-old woman presented with complaints of distorted vision. The patient was exposed to blue light from an LED face mask 1 month before presentation. DIAGNOSIS: Color fundus photography revealed a yellowish chorioretinal lesion and optical coherence tomography revealed retinal pigment epithelium destruction in the parafoveal area. Fluorescein angiography revealed leakage from the lesion at the parafovea. The patient was diagnosed with blue LED-induced photochemical retinopathy. INTERVENTIONS: Intravitreal bevacizumab was injected in the right eye. OUTCOMES: After 4 weeks, dysmorphopsia was improved. LESSONS: This case report demonstrates that retinal damage can occur in humans due to prolonged exposure to blue light. Therefore, it is important to be wary of eye exposure and ensure the eyes are covered during LED face mask use.

Relationship between early structural changes at cornea incision sites and surgical outcomes after phacoemulsification.

AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography (AS-OCT). METHODS: We evaluated 80 eyes of 59 patients who underwent phacoemulsification with a clear corneal incision. All incisions were evaluated 1wk, 1, and 3mo postoperatively using AS-OCT and analyzed regarding angle, length of the incision, maximal corneal thickness at the incision, and if present, corneal endothelial gap length and incision gap area. The patients were divided into two groups according to whether or not an endothelial gap was present at 1wk postoperatively (endothelial gap, group 1; no endothelial gap, group 2). We analyzed the difference in patient and surgical factors between the two groups, and compared the surgical outcome and the refractive outcome. RESULTS: An endothelial gap was observed in 56 (70.0%) of 80 eyes at 1wk postoperatively but not at 3mo postoperatively. The mean patient age was significantly higher in group 1 than in group 2. The longer the length of the corneal incision and the steeper the incision angle, the greater the length and area of the endothelial gap. In group 1, the mean change in mean keratometry of the anterior cornea was significantly greater than in group 2, and the spherical equivalent (SE) and mean numerical error indicated significant myopic changes at 1wk postoperatively. CONCLUSION: The risk of an endothelial gap increases with patient age and a long corneal incision and steep incision angle. The presence of an endothelial gap after surgery may affect the early postoperative corneal curvature and SE.

Effects of scleral collagen crosslinking with different carbohydrate on chemical bond and ultrastructure of rabbit sclera: Future treatment for myopia progression.

BACKGROUND: Myopia is the most common ocular disorder and is mainly caused by axial elongation of the sclera. If the stiffness of sclera increased, it can inhibit myopia progression. The aim of this study is to compare the effect of the collagen crosslinking with different types and concentrations of carbohydrates on chemical bond and ultrastructural change of rabbit sclera. METHODS: Nine New Zealand white rabbits were treated with five, sequential sub-Tenon injections of 0.15 mL solutions of ribose, sucrose, and glycogen of 0.1, 0.2 and 0.4 M concentration at the right eye over 14 days. Ten weeks after the last injection, the rabbits were sacrificed and chemical bond and ultrastructural changes were compared with those of the untreated left sclera using Raman spectroscopy, atomic force microscopy (AFM), and histology. RESULTS: Raman spectroscopy of the control and cross-linked rabbit sclera tissue revealed different types of collagen interactions. Raman shift of 919 cm-1 (C-C stretching and vibration of the proline ring in collagen) was the highest in ribose, followed by sucrose and glycogen. Total energy intensity was also highest in ribose, followed by sucrose and glycogen, and showed a tendency to increase at higher concentrations. AFM revealed interlocking arrangements of collagen fibrils. The collagen fibril diameter was 105.6 ± 21.2 nm, 109.4 ± 28.8 nm, 113.1 ± 30.8 nm and 137.6 ± 25.3 nm for control group, 0.4 M glycogen, sucrose, and ribose, respectively. Histology indicated increased density of the collagen bundle and no increase in inflammatory cell recruitment compared to control at high concentrations of ribose. CONCLUSIONS: Scleral crosslinking using glycation increased the scleral biomechanical rigidity and these results were particularly pronounced in ribose. Scleral crosslinking using glycation may be a promising method for inhibiting high myopia progression.

Successful treatment of conjunctival lymphangiectasia accompanied by corneal dellen using a high-frequency radiowave electrosurgical device.

A 62-year-old man presented with a 1-month history of right eye pain unresponsive to artificial tears and topical steroids. At presentation, bullous yellowish fluid collection was noted in the nasal conjunctiva. Corneal thinning and opacity were observed at the 3 o'clock position of the cornea. High-frequency radiowave ablation and biopsy were performed at the affected area. Conjunctival lymphangiectasia was confirmed by excisional biopsy. An improvement in the degree of corneal dellen and chemosis was evident 1 week after ablation. Use of a high-frequency radiowave electrosurgical device may be a simple and effective treatment option for symptomatic conjunctival lymphangiectasia.

Clinical characteristics and ophthalmologic findings of pituitary adenoma in Korean patients.

PURPOSE: To investigate the clinical characteristics of and ophthalmic findings in Korean patients diagnosed with a pituitary adenoma. METHODS: The medical records of 534 patients diagnosed with a pituitary adenoma at Kyung Hee University Hospital between January 2007 and December 2016 were retrospectively reviewed. RESULTS: Mean patient age was 47.9 ± 16.2 years. The most common symptoms at the time of presentation were headache (26.2%) and visual disturbance (12.4%). The referral rate to the ophthalmology department was 18.44% and patients most often presented to the neurosurgery department. Optic chiasm compression was identified in 23.4% of patients (54.4% of patients referred to ophthalmology, 15.0% of patients not referred to ophthalmology). Normal visual field (57%) was the most common visual field feature followed by bitemporal hemianopsia (17.8%). Optic chiasmal compression without visual field defects was found in 36.1% of patients. Tumor volume was positively correlated with visual field pattern standard deviation (PSD, p = 0.020) and best-corrected logMAR visual acuity (p = 0.000) and negatively associated with tumor volume and visual field mean deviation (MD, p = 0.000). Best-corrected visual acuity (p = 0.000), MD (p = 0.001), and PSD (p = 0.028) significantly improved after surgery. CONCLUSIONS: Pituitary adenoma patients do not always have ocular symptoms at their first presentation, even when optic chiasm compression and visual field deficits are present. Therefore, collaboration with an ophthalmologist is important when evaluating pituitary adenoma patients.

Clinical Course and Prognostic Factors of Acquired Third, Fourth, and Sixth Cranial Nerve Palsy in Korean Patients.

PURPOSE: This study aimed to evaluate the clinical course and prognostic factors of acquired third, fourth, and sixth cranial nerve (CN) palsy grouped according to etiology. METHODS: This study involved a retrospective review of the medical records of 153 patients who were diagnosed with acquired paralytic strabismus from January 2004 to July 2015. Outcomes, recovery rates, and time to recovery were investigated according to the affected CN: CN3, CN4, and CN6 palsies. The patients were classified into four groups based on etiology: idiopathic, traumatic, neoplastic, and vascular. RESULTS: The mean age of the patients was 59.8 ± 14.5 years and the mean follow-up period was 10.8 months. Out of the 153 patients, 63 (41.2%) had CN3 palsy, 35 (22.9%) had CN4 palsy, and 55 (35.9%) had CN6 palsy. The most common causes were vascular related (54.9%), followed by idiopathic (28.1%), trauma (8.5%), and neoplasm (5.88%). About 50% of the patients recovered within six months. Among the four etiologic groups, the idiopathic group showed the best prognosis because about 50% of the patients in this group recovered within three months. This was followed by the vascular, traumatic, and neoplastic groups. Cox proportional hazard analysis revealed a significant association between the baseline prism diopter and recovery rate. CONCLUSIONS: The prognosis and natural history of paralytic strabismus vary depending on its cause. The vascular group had the best recovery rate and shortest recovery time, whereas the neoplastic group required the longest time to recover.

Spontaneous corneal perforation in Terrien's marginal degeneration in childhood: A case report.

RATIONALE: Terrien's marginal corneal degeneration (TMD) is characterized by progressive peripheral corneal thinning. It appears primarily above the age of 40 years and is rare at younger ages. Spontaneous corneal perforation in TMD is a rare, but serious complication that may occur in childhood. PATIENT CONCERNS: This review presents the case of a 16-year-old girl presented with blurred vision in the right eye on awakening in the morning. Slit-lamp examination revealed superior corneal thinning with a corneal perforation. DIAGNOSES: The best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/20 in the left eye. Intraocular pressures were 5 and 18 mm Hg in the right and left eyes, respectively, measured using a noncontact tonometer. Slit-lamp examination revealed superior corneal thinning with superficial pannus. A 1-mm corneal perforation was observed at the 11 o'clock position. The anterior chamber of the right eye was flat and the Seidel test result was positive. The left eye showed no apparent abnormality on slit-lamp examination. Corneal topography showed 4.3 D of against-the-rule astigmatism, and anterior segment optical coherence tomography revealed superior corneal thinning. We diagnosed it as childhood onset TMD. INTERVENTIONS: Multilayered amniotic membrane transplantation was performed over the perforation site and a bandage contact lens was placed. OUTCOMES: At 1 week postoperatively, the BCVA of the right eye improved to 20/32, the amniotic membrane graft was well-attached, and the anterior chamber remained deep. At 2 months postoperatively, the BCVA was 20/25 and the anterior chamber depth was maintained. LESSONS: Spontaneous corneal perforation due to TMD is rare, but may occur in childhood. The possibility of corneal perforation should be considered even in childhood and good surgical results can be obtained with amniotic membrane transplantation.

An atypical presentation of functional visual loss: A case report.

RATIONALE: Functional visual loss (FVL) can manifest as various symptoms. Decreased distant visual acuity is the most common symptom and visual field defect is the second most common symptom. Hemianopsia is rarely reported. In an atypical situation of FVL, it is important to prove that no organic pathology exists, through detailed history taking and appropriate examinations. PATIENT CONCERNS: This review presents the case of a 48-year-old male patient presented with decreased bilateral visual acuity and visual field defect after a traffic accident 3 weeks ago. Visual field test showed atypical features of FVL in which visual field change from binasal hemianopsia to left homonymous hemianopsia. DIAGNOSIS: The best corrected visual acuities (BCVA) were 20/63 in both eyes and binasal hemianopsia was observed on a Humphrey visual field test. Brain computed tomography (CT) scan and magnetic resonance imaging (MRI) showed no abnormalities in the brain and optic chiasm. Two weeks after presentation, however, the patient's visual field defect changed from binasal hemianopsia to left homonymous hemianopsia. We diagnosed it as FVL due to conversion disorder. INTERVENTION AND OUTCOMES: We decided to cooperate with a psychiatrist for cognitive behavioral therapy and the patient is under observation. LESSONS: Binasal hemianopsia and homonymous hemianopsia are rare; however, it may occur simultaneously in 1 patient with FVL. The possibility of FVL should be considered when there is atypical visual field defect and no organic abnormalities are observed. Repeated Humphrey field test and VEP may be helpful in diagnosis of FVL.

Physicochemical and surface properties of acrylic intraocular lenses and their clinical significance.

To analyze and compare several commercially available acrylic intraocular lenses (IOLs) with particular regard to their clinical significance, we examined the physicochemical and surface properties of four currently available acrylic IOLs using static water contact angle, atomic force microscopy (AFM), Raman spectroscopy, and differential scanning calorimetry (DSC) measurements. The hydrophobic acrylic IOLs, ZA9003, and MA60BM, had contact angles ranging from 77.9° ± 0.65° to 84.4° ± 0.09°. The contact angles in the hydrophilic acrylic (970C) and heparin-surface-modified (HSM) hydrophilic acrylic IOLs (BioVue) were 61.8° ± 0.45° and 69.7° ± 0.76°, respectively. The roughness of the IOL optic surface differed depending on the type of IOL (p < 0.001). The surface roughness of BioVue had the lowest value: 5.87 ± 1.26 nm. This suggests that the BioVue IOL may lead to reduced cellular adhesion compared to the unmodified IOLs. All IOLs including those composed of acrylic optic materials from different manufacturers showed distinct Raman spectra peaks. The glass transition temperatures (Tg) for the hydrophobic acrylic IOLs were between 12.5 and 13.8 °C. These results suggest that the intraoperative and postoperative behavior of an IOL can be predicted. This information is also expected to contribute greatly to the industrial production of reliable biocompatible IOLs.

The Effects of Distance Between the Corneal Apex and the Inner and Outer Corneal Wound Edges on Corneal Astigmatism After Cataract Surgery.

PURPOSE: To compare the effects of the distance from the inner and outer corneal incision wounds to the corneal apex on the changes in corneal astigmatism after cataract surgery. METHODS: Seventy-two eyes with anterior corneal astigmatism less than 2.50 diopters (D) were evaluated. The distance between the incision wound and the corneal apex was measured using the Pentacam (Oculus Optikgeräte, Wetzlar, Germany) Scheimpflug image and the Image J program (National Institutes of Health, Bethesda, MD). Patients were subgrouped into the inner incision distance close (less than 4,816.44 µm) and far (4,816.44 µm or greater) groups based on the median value of inner incision distance and the outer incision distance close (less than 6,131.77 µm) and far (6,131.77 µm or greater) groups based on the median value of outer incision distance. RESULTS: In the inner incision distance group, the mean change in anterior, posterior, and total corneal astigmatism at 1 week and anterior astigmatism at 1 month were statistically significantly greater in the inner incision close group than in the inner incision far group. In the outer incision distance group, the mean change in anterior corneal astigmatism at 1 week was statistically significantly greater in the close group than in the far group. Surgically induced astigmatism (SIA) of the posterior cornea showed a statistically significant increase in the inner incision close group compared to the inner incision far group 1 month postoperatively, whereas there were no significant differences in the outer incision distance groups. Inner incision distance significantly correlated with the mean change in anterior and posterior corneal astigmatism and posterior SIA at 1 week postoperatively. CONCLUSIONS: Corneal astigmatism was affected more by inner incision distance than outer incision distance, and a larger change in the posterior SIA was noted with decreasing inner incision distance. During cataract surgery, the position of the inner corneal incision should be considered rather than the outer incision. [J Refract Surg. 2017;33(7):460-468.].

The Long-term Clinical Outcome after Corneal Collagen Cross-linking in Korean Patients with Progressive Keratoconus.

PURPOSE: To evaluate the long-term clinical effectiveness and safety of corneal collagen cross-linking (CXL) in progressive keratoconus compared with untreated contralateral eyes. METHODS: In this retrospective study, nine eyes of nine patients with progressive keratoconus who received CXL (treatment group) and nine untreated contralateral eyes with keratoconus (control group) were included. All patients were followed for at least 5 years and assessed with best-corrected visual acuity, maximum keratometry, mean keratometry, corneal astigmatism, and corneal thickness. Clinical data were collected preoperatively and at 1, 3, 6, 12, 24, 36, 48, and 60 months, postoperatively. RESULTS: Mean best-corrected visual acuity improved significantly from 0.58 ± 0.37 logarithm of minimum angle of resolution preoperatively to 0.39 ± 0.29 logarithm of minimum angle of resolution at 5 years after corneal CXL (p = 0.012). There was significant flattening of the maximum keratometry and mean keratometry from preoperative values of 63.39 ± 10.89 and 50.87 ± 6.27 diopter (D) to postoperative values of 60.89 ± 11.29 and 49.54 ± 7.23 D, respectively (p = 0.038, 0.021). Corneal astigmatism decreased significantly from 7.20 ± 1.83 D preoperatively to 5.41 ± 1.79 D postoperatively (p = 0.021). The thinnest corneal thickness decreased from 434.00 ± 54.13 to 365.78 ± 71.58 µm during 1 month after treatment, then increased to 402.67 ± 52.55 µm at 5 years, which showed a statistically significant decrease compared to the baseline (p = 0.020). In the untreated contralateral eyes, mean keratometry increased significantly at 2 years compared with the baseline (p = 0.043). CONCLUSIONS: CXL seems to be an effective and safe treatment for halting the progression of keratoconus over a long-term follow-up period of up to 5 years in progressive keratoconus.

Paradoxical development of neovascular glaucoma following carotid angioplasty and stenting.

This report describes a very rare ocular complication of carotid intervention. A 74-year-old patient presented with left-sided weakness and was diagnosed with right cerebral border-zone infarctions caused by severe stenosis of the right proximal internal carotid artery. Staged carotid intervention (balloon angioplasty followed by stenting) was successfully performed. However, neovascular glaucoma developed following carotid angioplasty and stenting. We concluded that although carotid angioplasty and stenting improves vision in patients with ischemic oculopathy, it can rarely induce paradoxical visual deterioration such as development or aggravation of neovascular glaucoma.

Instrument-Free Synthesizable Fabrication of Label-Free Optical Biosensing Paper Strips for the Early Detection of Infectious Keratoconjunctivitides.

We introduce a surface-enhanced Raman scattering (SERS)-functionalized, gold nanoparticle (GNP)-deposited paper strip capable of label-free biofluid sensing for the early detection of infectious eye diseases. The GNP biosensing paper strip was fabricated by the direct synthesis and deposition of GNPs on wax-divided hydrophilic areas of a permeable porous substrate through a facile, power-free synthesizable, and highly reproducible successive ionic layer absorption and reaction (SILAR) technique. To maximize localized surface plasmon resonance-generated SERS activity, the concentration of the reactive solution and number of SILAR cycles were optimized by controlling the size and gap distance of GNPs and verified by computational modeling with geometrical hypotheses of Gaussian-estimated metallic nanoparticles. The responses of our SERS-functionalized GNP paper strip to Raman intensities exhibited an enhancement factor of 7.8 × 10(8), high reproducibility (relative standard deviation of 7.5%), and 1 pM 2-naphthalenethiol highly sensitive detection limit with a correlation coefficient of 0.99, achieved by optimized SILAR conditions including a 10/10 mM/mM HAuCl4/NaBH4 concentration and six SILAR cycles. The SERS-functionalized GNP paper is supported by a multivariate statistics-preprocessed machine learning-judged bioclassification system to provide excellent label-free chemical structure sensitivity for identifying infectious keratoconjunctivitis. The power-free synthesizable fabrication, label-free, rapid analysis, and high sensitivity feature of the SILAR-fabricated SERS-functionalized GNP biosensing paper strip makes it an excellent alternative in point-of-care applications for the early detection of various infectious diseases.

Microfluidic-based non-enzymatic glycation enhances cross-linking of human scleral tissue compared to conventional soaking.

We evaluated nano-structural and chemical changes in human scleral collagen caused by non-enzymatic glycation using AFM, Raman spectroscopy, and microfluidics. Twenty 8 × 2 mm2 scleral strips (n = 5, each) were divided into four groups of pure sclera tissues (control group) and sclera tissues with incubation (1 hr in BSS and ribose) and preservation (23 hr in 90% ethanol) for 7 days (BSS + DR7 group) and 30 days (BSS + DR30 group) at room temperature, and 7 days in a microfluidic chip (BSS + DR + µF7 group). The BSS + DR7 and BSS + DR30 groups were incubated in a mixture of balanced salt solution (BSS) and 0.2 M D-ribose in PBS, pH 7.4 containing 0.1% sodium azide, while the BSS + DR + µF7 group was incubated in the same solutions supplied by two inlet reservoirs from a microfluidic chip. The scleral tissues incubated in the microfluidic environment showed a clear irregular parallel arrangement of collagen fibrils with tangled fibrils. A Raman shift was observed at 919 cm-1 in the glycation groups. Non-enzymatic glycation led to an increased in the density of scleral stromal collagen. Our method using non-enzymatic glycation in a microfluidic environment successfully induced collagen cross-linking. These in vitro results suggested that glycation can be used to strengthen connective tissues. SCANNING 38:421-426, 2016. © 2016 Wiley Periodicals, Inc.

A Case of Orbital Metastasis of Uterine Leiomyosarcoma With Intracranial Extension Presenting With Proptosis.

A 57-year-old woman presented with protrusion of the OS 2 months in duration and decreased vision 1 month in duration. The patient was diagnosed with uterine leiomyosarcoma approximately 3 years before presentation. Lung and liver metastases were diagnosed by biopsy 1 year prior to this visit. CT revealed a solid mass with central necrosis in the left lateral orbit that resulted in orbital shifting, bony destruction, and intracranial extension. The diagnosis was left orbital metastatic leiomyosarcoma, and the patient died 2 months after receiving the diagnosis.

Investigation of biochemical property changes in activation-induced CD8+ T cell apoptosis using Raman spectroscopy.

The study was to investigate the changes in biochemical properties of activated mature CD8+ T cells related to apoptosis at a molecular level. We confirmed the activation and apoptosis of CD8+ T cells by fluorescence-activated cell sorting and atomic force microscopy and then performed Raman spectral measurements on activated mature CD8+ T cells and cellular deoxyribose nucleic acid (DNA). In the activated mature CD8+ T cells, there were increases in protein spectra at 1002 and 1234 cm -1 . In particular, to assess the apoptosis-related DNA spectral signatures, we investigated the spectra of the cellular DNA isolated from resting and activated mature CD8+ T cells. Raman spectra at 765 to 786 cm -1 and 1053 to 1087 cm -1 were decreased in activated mature DNA. In addition, we analyzed Raman spectrum using the multivariate statistical method including principal component analysis. Raman spectra of activated mature DNA are especially well-discriminated from those of resting DNA. Our findings regarding the biochemical and structural changes associated with apoptosis in activated mature T cells and cellular DNA according to Raman spectroscopy provide important insights into allospecific immune responses generated after organ transplantation, and may be useful for therapeutic manipulation of the immune response

Label-free biochemical analytic method for the early detection of adenoviral conjunctivitis using human tear biofluids.

Cell culture and polymerase chain reaction are currently regarded as the gold standard for adenoviral conjunctivitis diagnosis. They maximize sensitivity and specificity but require several days to 3 weeks to get the results. The aim of this study is to determine the potential of Raman spectroscopy as a stand-alone analytical tool for clinical diagnosis of adenoviral conjunctivitis using human tear fluids. A drop-coating deposition surface enhanced Raman scattering (DCD-SERS) method was identified as the most effective method of proteomic analysis in tear biofluids. The proposed DCD-SERS method (using a 2-µL sample) led to Raman spectra with high reproducibility, noise-independence, and uniformity. Additionally, the spectra were independent of the volume of biofluids used and detection zones, including the ring, middle, and central zone, with the exception of the outer layer of the ring zone. Assessments with an intensity ratio of 1242-1342 cm(-1) achieved 100% sensitivity and 100% specificity in the central zone. Principal component analysis assessments achieved 0.9453 in the area under the receiver operating characteristic curve (AUC) as well as 93.3% sensitivity and 94.5% specificity in the central zone. Multi-Gaussian peak assessments showed that the differences between these two groups resulted from the reduction of the amide III α-helix structures of the proteins. The presence of adenovirus in tear fluids could be detected more accurately in the center of the sample than in the periphery. The DCD-SERS technique allowed for high chemical structure sensitivity without additional tagging or chemical modification, making it a good alternative for early clinical diagnosis of adenoviral conjunctivitis. Therefore, we are hopeful that the DCD-SERS method will be approved for use in ophthalmological clinics in the near future.

Molecular and chemical investigations and comparisons of biomaterials for ocular surface regeneration.

This study investigated and compared the ultrastructural and chemical properties of representative biomaterials for ocular surface regeneration: a human amniotic membrane (AM) in a basal plate, a human AM in reflected chorion, a preserved AM, and a human corneo-scleral tissue. Assessments of the morphological differences in the extracellular matrices were evaluated by hematoxylin-eosin, Masson's trichrome (for total collagen), and picrosirius-red (for newly synthesized collagen) staining. Assessments of the changes in the molecular structures and chemical compositions of the biomaterials for ocular surface regeneration were evaluated by Raman spectroscopy. A placental AM (52 %) was a dense and thick collagenous structure compared to a reflected AM (23 %). The spectroscopy did not obtain any structural information for a preserved AM. The cornea group (100 %, control) and sclera group (104 %) showed the collagen lamellae and interfibrillar spacing, and a slight inflammatory reaction with more fibrous and granulomatous tissues. There was a formation of newly synthesized collagen in a placental AM, while there were few collagen components in a reflected AM. Human AM tissues showed consistent Raman spectra and the characteristic collagen bands, similar to the corneal and scleral tissues. Therefore, these findings suggest that human placental AM and reflected AM are structurally suitable for scleral and corneal surface regeneration, respectively, while human placental or preserved AM and reflected AM are molecularly and chemically suitable for corneal and scleral surface regeneration, respectively.