Medicine and Pharmacology

Abstract: There is a dearth of research on the readiness of the multiple stakeholder groups needing to adopt competency-based education (CBE) reform in a single optometry program context. This study assessed and compared readiness for transition to CBE across four stakeholder groups—students, educators, regulators, and employers—in Nigerian optometry training on six domains: knowledge, skills, institutional/system readiness, regulatory alignment, workforce relevance, and change readiness. A structured questionnaire (36 items, three-point format) was administered to students (n = 656), educators (n = 26), regulators (n = 3), and employers (n = 16). Scores were computed as a Readiness Index (0–100%), with group differences tested using Kruskal-Wallis and Mann-Whitney U tests. All four groups scored above the scale midpoint. Educators reported significantly higher readiness than students (86.9% vs. 77.3%; H = 14.03, p = 0.003); differences between students and regulators (87.5%) or employers (84.9%) were not significant after Bonferroni correction. The lowest-scoring domain across all groups was institutional/system readiness, particularly among students (mean = 2.20/3.00), and student readiness varied significantly by training institution. Nigerian optometry stakeholders broadly support CBE adoption in principle, but institutional and system-level preparedness lags behind attitudinal support, indicating that reform will require deliberate investment in institutional infrastructure.

Abstract: Purpose: To evaluate the ability of computer vision models to detect myopia from standard colour fundus photographs and to compare their diagnostic performance with that of experienced ophthalmologists. Methods: A total of 324 retinal fundus images were labelled as myopic or non-myopic using cycloplegic subjective refraction. Images were acquired with a non-mydriatic 45° fundus camera and split into training, internal validation (80 images), and independent testing sets (50 images). YOLOv8 and YOLOv11 variants were trained for binary classification. Performance was evaluated using standard diagnostic metrics, with bootstrap confidence intervals and Holm–Bonferroni correction. Five ophthalmologists independently classified the test set, and their consensus was compared with model predictions using DeLong and McNemar tests. Results: On internal validation, YOLOv8-xl achieved the highest sensitivity (0.983) and MCC (0.646). YOLOv11 models showed greater variability, with the extra-large variant displaying degenerate behaviour. On the independent test set, YOLOv8-n achieved an AUC of 0.860 versus 0.753 for YOLOv11-s, with no significant difference (p = 0.174). Clinical consensus reached an AUC of 0.832 and did not differ from YOLOv8-n (p = 0.725). McNemar testing showed no difference between YOLOv8-n and clinicians (p = 1.000), while YOLOv11-s differed significantly (p < 0.001). Limitations include the small, class-imbalanced dataset and the limited number of ophthalmologists. Conclusions: YOLOv8 models can detect myopia from standard fundus photographs with performance comparable to experienced ophthalmologists, supporting their potential as complementary screening tools.

Abstract: Age-related macular degeneration (nAMD) is a significant cause of visual impairment globally.1 This single-centre retrospective study evaluated real-world outcomes of faricimab in patients with neovascular age-related macular degeneration (nAMD) who responded suboptimally to other anti-VEGF treatment. Patients with nAMD who were switched to faricimab between September and December 2022 with a minimum of 12 months’ follow-up were included. Main outcomes were best-corrected visual acuity (BCVA), central subfield thickness (CST), and treatment intervals at 12 and 18 months. A total of 136 eyes received at least one intravitreal faricimab injection, of which 71 eyes (62 patients) with sufficient follow-up data were included in the analysis. Median BCVA changed from 68 ETDRS letters (IQR 57-74) to 66 (55-75, p=0.119) at 12 months and 67 (56-73, p=0.009) at 18 months. Median CST changed from 296 µm (IQR 270-339) at baseline to 273 µm (245-313, p=0.0001) at 12 months and 263 µm (240-300, p<0.000) at 18 months. 5.6% of eyes had a dry macula at baseline, compared to 26.8% (p=0.002) and 31.7% (p=0.001) at 12 and 18 months, respectively. Mean treatment interval changed from 5.2 ± 1.6 weeks at baseline, to 7.4 ± 2.8 weeks (p<0.0000) at 12 months, and 7.5 ± 3.1 weeks (p<0.0000) at 18 months. Adverse events included one case of hypertensive anterior uveitis and one post-injection hypotony. Switching to faricimab for nAMD achieved stable vision, improved anatomical outcomes and extended treatment intervals over 18 months.

Abstract: Despite a growing range of effective monotherapies for childhood myopia control, a subset of children continues to show suboptimal control, prompting interest in combination therapy. This narrative mini-review summarises recent evidence on combining pharmacological, optical, and device-based treatments to slow myopia progression, with emphasis on axial length (AL) as the benchmark of efficacy. The most studied combination is low-dose atropine plus orthokeratology (OK), with multiple studies and meta-analyses reporting greater slowing of AL elongation than OK alone, particularly in younger children and faster progressors. Emerging evidence supports combining low-dose atropine with other refractive interventions, such as Defocus-incorporated multisegment (DIMS) and highly aspherical lenslets (HAL), and dual-focus soft contact lenses, although findings vary by study design, atropine dose, and cohort characteristics. Repeated low-level red light (RLRL) therapy combined with OK or DIMS spectacles has also shown improved AL outcomes in some studies, but retinal safety signals and rebound after cessation require careful monitoring. Combination therapy may be most appropriate for fast progressors, notably those with greater than 0.2 mm over 12 months or for inadequate responders to monotherapy, with stepwise escalation guided by AL response, safety, and adherence. Further long-term, randomised trials with standardised endpoints and responder definitions are needed.

Abstract: Retinal degeneration is associated with mitochondrial dysfunction, oxidative stress, and disruption of metal homeostasis within the retinal pigment epithelium (RPE). Dysregulation of redox-active metals has been implicated in age-related macular degeneration (AMD), but whether targeted intracellular metal modulation preserves retinal structure and function remains unclear. This study explores the effect of metal ion modulation on retinal structure and visual function. Telomir-Zn, a first-in-class intracellular metal modulator, depletes labile Fe²⁺, potently inhibits multiple JmjC KDMs, and induces epigenetic reprogramming. In a zebrafish model combining impaired DNA repair and mitochondrial dysfunction (Sen57^wrn−/−ND6^−/+), Telomir-Zn reduced oxidative stress, preserved retinal architecture, improved visual behaviors, and partially normalized telomeric content and CpG methylation patterns. Complementary studies in human ARPE-19 RPE cells showed attenuation of iron/copper-induced ROS and calcium dysregulation, with reciprocal zinc accumulation and labile Fe²⁺ depletion. These findings establish targeted metal modulation and multi-KDM inhibition as a novel strategy to mitigate oxidative-epigenetic stress and preserve retinal structure/function in degenerative disease, supporting further development for AMD.

Abstract: Purpose: To report a child with severe treatment resistant juvenile idiopathic arthritis associated uveitis (JIAU), a condition that typically presents as chronic anterior uveitis, although severe panuveitis with retinal vasculitis may rarely occur.Methods: We describe the clinical course, treatment response, and challenge, dechallenge, and rechallenge sequence in a child with severe refractory JIAU treated with combined infliximab and tofacitinib therapy.Results: The patient showed marked improvement in ocular inflammation, macular edema, and visual acuity following addition of tofacitinib to ongoing infliximab therapy. Inflammation recurred after holding infliximab despite continuation of tofacitinib and improved again following reintroduction of infliximab.Conclusion: This challenge, dechallenge, and rechallenge sequence suggests that neither infliximab nor tofacitinib alone provided adequate disease control, whereas their combination was associated with sustained suppression of ocular inflammation. Combined tumor necrosis factor alpha and Janus kinase inhibition may represent a rescue therapeutic option for carefully selected patients with severe refractory JIAU, although its long term safety and efficacy require further evaluation.

Abstract: Background/Objectives: Diabetic retinopathy (DR) is a leading cause of visual im-pairment in United States adults. Artificial intelligence (AI) screening systems using non-dilated fundus photography in primary care settings offer a convenient alternative to dilated screening, but image quality remains a critical limitation. No studies have as-sessed how primary care photographer experience affects gradability of non-dilated images in AI-assisted screening. We hypothesized that medical assistant (MA) photog-raphers’ gradability rates (GR) would improve with experience. Methods: We retrospectively reviewed 1354 DR screenings performed from 05/12/2021-12/28/2022 across 10 Temple Primary Care Clinics using the Canon CR-2 AF camera and EyeNuk’s EyeArt system. 30 MA photographers captured images; MAs with < 10 screenings were excluded. GR were calculated for each photographer. Linear and polynomial regression analyses assessed associations between number of photographs and GR. For MA photographers with >90 screenings, GR was further evaluated over time in blocks of ten consecutive screenings. Results: Eleven MA photographers met inclusion criteria. Linear regression showed no significant association between number of photographs and percentage of gradable images (F = 0.259, p = 0.7784). Three MAs conducted at least 91 screenings. Linear re-gression analysis of successive screenings showed no significant association with average GR (F = 0.684, p = 0.4323). Conclusions: Image gradability did not improve with increasing MA photographer experience. Repeated practice alone appears insufficient to achieve high GR. Standard-ized competency-based training, refresher sessions, or robotic fundus photography may be needed to optimize image quality in AI-assisted DR screening programs in a primary care setting.

Abstract: Purpose:To model treat and extend (TREX) therapy as a threshold-search problem and compare common extension and shortening rules using durability distributions derived from published studies. Design: Computational modelling study using Monte Carlo (MC) simulation and Pareto multi-objective optimisation analysis of TREX rules. Subjects: 10,000 simulated eyes per durability distribution. Methods: Each simulated eye was assumed to have a fixed maximum dry interval (T_max), defined as the longest injection interval maintaining disease stability. Four TREX search rules were evaluated: +2/−2, +4/−4 with midpoint refinement, +4/−2, and a midpoint bracketing strategy. Deterministic pathways were enumerated for each T_max from 4 to 16 weeks. Durability priors were derived from published maintenance interval data from TENAYA/LUCERNE, the FARIT study, and a real-world aflibercept 2 mg cohort, with intermediate weekly survival values interpolated using a piecewise constant hazard interpolation. Monte Carlo simulation of 10,000 eyes was used to estimate visits to maintenance interval, cumulative overshoot, and maximum single overshoot. Pareto analysis identified dominated and non-dominated strategies. Main outcome measures: Number of visits to find maintenance interval, cumulative and maximum overshoot beyond a disease-controlling interval. Results: Under TENAYA/LUCERNE priors, +4/−2 required the fewest visits to maintenance, while +2/−2 had the lowest overshoot. The midpoint strategy achieved similar efficiency to +4/−2 with lower overshoot. Across all three durability distributions, +4/−4 was consistently dominated. The Pareto-optimal set varied by durability prior: midpoint performed favourably under longer-durability distributions but carried greater overshoot risk under shorter-durability priors. Conclusion: TREX rule choice involves explicit trade-offs between search efficiency and overshoot. Pareto analysis provides a structured framework for comparing extension strategies and tailoring rule choice to expected durability and clinical risk tolerance.

Abstract: Background: To investigate the effects of biologic and targeted synthetic therapies on retinal microvascular parameters assessed by optical coherence tomography angiography (OCTA) in patients with axial spondyloarthritis (axSpA). Methods: This cross-sectional study included 159 eyes of 82 patients with radiographic or non-radiographic axSpA receiving tumor necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i), or Janus kinase inhibitors (JAKi) for at least one year. All patients had low disease activity at the time of examination (BASDAI < 3). Comprehensive ophthalmic evaluation and swept-source OCTA imaging were performed. The superficial capillary plexus vessel density and foveal avascular zone (FAZ) areas in both the superficial (SCP) and deep capillary plexus (DCP) were assessed. Statistical analyses were adjusted for age, sex, smoking status, history of uveitis, treatment duration, and ocular variables. Results: Significant differences were observed among treatment groups in the deep foveal avascular zone (DCP-FAZ) area (P = 0.0060). Post-hoc analyses revealed larger DCP-FAZ values in patients treated with TNFi compared with IL-17i (P = 0.0010), and in those treated with IL-17i compared with JAKi (P = 0.0151). No significant differences were found in superficial FAZ area or superficial capillary plexus vessel density between treatment groups. Patients receiving JAKi were older and had shorter treatment duration compared with the other groups. Smoking status was associated with a significantly smaller deep FAZ area (P = 0.0019), whereas superficial FAZ measurements remained unaffected. A weak positive correlation was observed between intraocular pressure and deep FAZ area (r = 0.18, P = 0.0237), and treatment duration was positively correlated with deep FAZ size (rho = 0.16, P = 0.0454). Conclusions: Different classes of biologic and targeted synthetic therapies are associated with distinct retinal microvascular characteristics in patients with axSpA. The observed differences in deep FAZ measurements suggest that treatment-specific effects on retinal microcirculation may persist despite low systemic disease activity. OCTA may serve as a valuable non-invasive tool for detecting subclinical vascular alterations and monitoring ocular microvascular involvement in axSpA. Further longitudinal studies are required to clarify the clinical significance and long-term implications of these findings.

Abstract: The goal of study was to identify bacterial species isolated from canine non-healing ulcers and evaluate temporal changes in resistance patterns. Corneal microbiology samples were collected from 228 non-healing ulcers of 221 dogs between January 2019 and February 2023. Samples were cultured aerobically and isolates were identified using MALDI-ToF mass spectrometry. Antibiotic susceptibility testing was performed using Kirby-Bauer disc diffusion according to current CLSI guidelines. Acquired resistance patterns were compared between 2019–2020 and 2021–2023, and multidrug-resistant (MDR) and possible extensively drug-resistant (XDR) isolates were characterized. Bacterial growth was observed in 71% (163/228) of samples, yielding 170 isolates. The most frequently isolated species were Staphylococcus epidermidis (21%), Staphylococcus pseudintermedius (18%), Staphylococcus capitis (15%), and other coagulase-negative staphylococci (14%). Overall susceptibility was highest to combinations involving neomycin-polymyxin-bacitracin (neopolybac). A statistically significant increase in overall bacterial resistance (P = 0.000008) and acquired resistance (P = 0.000504) was observed from 2019–2020 to 2021–2023. Methicillin-resistant Staphylococcus spp. comprised 61% of staphylococcal isolates, with an increase from 47% (2019–2020) to 70% (2021–2023). Over half the isolates (53%) were multidrug-resistant. Topical antibiotic regimens containing neomycin-polymyxin-bacitracin provided the broadest coverage. Increasing resistance, particularly methicillin resistance in staphylococci, highlights the concern about the development of highly resistant bacteria which can potentially increase crossover infections between humans and dogs.

Abstract: Background: The rabbit (Oryctolagus cuniculus) is a currently indispensable pre-clinical model for fundamental discovery and translational research in glaucoma surgery. While not fully representative of the human eye, the rabbit often serves as the first robust assessment of a new chemical entity in an anatomically and physiologically relevant setting. In later stages of development, the rabbit is also a critical model for regulatory-facing Good Laboratory Practice (GLP) graded pre-clinical safety studies. However, while guidelines exist for human glaucoma surgeries in terms of patient profile vs surgery type and success criteria, there is limited collated information available on how rabbit glaucoma filtration surgeries are designed, use and mode of administration of anti-metabolite Mitomycin C (MMC) and post-operative antibiotic and anti-inflammatory dosing regime. These disparities limit cross-comparability in studies and encourage sub-optimal study design and incomplete reporting. Methods: This review investigated and collated current procedural and reporting practices based on 100 peer-reviewed rabbit glaucoma filtration surgery publications from the years 2011-2025. Publications meeting acceptance criteria were segmented into pre-operative design (ethical approval, rabbit characteristics, study duration), intra-operative (surgery type, surgical approach, use of MMC) and post-operative follow up (antibiotics, anti-inflammatories, analysis and adverse events). Results: It was found that there were clear preferences in animal model selection, study design and intra-/post-operative anti-fibrotic/inflammatory treatment regimes. Additionally, there were several areas identified where reporting was ambiguous or omitted. E.g. rabbit age, post-operative treatments, adverse events. The levels of omission were 16-30% and represent areas for improvement and highlight the need for ongoing review in pre-clinical research.

Abstract: Background: Symptomatic vitreous floaters are generally considered benign and self-limiting, especially in young individuals. However, persistent symptoms can sig-nificantly impair vision and quality of life, even when best-corrected visual acuity (BCVA) is preserved. Long-term data on pars plana vitrectomy (PPV) for floaters in young patients remain limited. Methods: This retrospective observational study included patients under 50 years old affected by persistent symptomatic vitreous floaters for at least 24 months who underwent PPV over 10 years at a single tertiary referral center. All eyes had undergone a stand-ardized 25-gauge vitrectomy. If posterior vitreous detachment (PVD) was absent, it was induced. Next, the vitreous base was shaved, the peripheral retina was inspected, and endolaser was applied as indicated. Air tamponade was used at the surgeon’s discretion and was always applied for retinal breaks. Results: Eighty-nine eyes were included. Mean age at surgery was 37.0 ± 7.0 years, with 59.6% of patients under 40 years old. The median duration of symptoms before surgery was 32 months (27–48). Preoperative BCVA was preserved in almost all eyes and re-mained stable postoperatively, with a mean change of +0.03 logMAR. The median fol-low-up was 60 months (58–72). No cases of rhegmatogenous retinal detachment, new-onset glaucoma, or visually significant cataract needing surgery were observed. Postoperative complications included endophthalmitis in one eye, macular hole in one eye, and permanent visual field defects in two eyes due to optic nerve touch during PVD induction. Importantly, no eye required reintervention for recurrent symptomatic floaters. Conclusions: Symptomatic vitreous floaters may persist for years in some young patients. Surgery may be considered when symptoms are significant. In this series, complete PPV with PVD induction provided stable BCVA and anatomical outcomes, with no reinter-vention for recurrent visually disturbing floaters. However, serious complications show that this elective procedure carries real risks.

Abstract: The study evaluated the resistance of human corneal and scleral tissues to collagenase-mediated degradation after riboflavin/ultraviolet-A collagen crosslinking (CXL), alone or combined with N-acetylcysteine (NAC) and Polygonum cuspidatum dry extract (Polydatin). Twenty-four human donor eyes unsuitable for transplantation provided 12 corneal buttons and 12 scleral strips, which were allocated to untreated controls, CXL alone, NAC/polydatin alone, and combined pre- and/or post-CXL treatment groups. Samples underwent accelerated CXL (9 mW/cm², 5.4 J/cm²) and were subsequently exposed to collagenase solution. Degradation time and protein release were assessed. Untreated corneal and scleral tissues were completely digested after 7 ± 2 and 16 ± 2 days, respectively. CXL significantly increased resistance to enzymatic degradation, extending digestion time to 14 ± 2 days in corneal tissue and 24 ± 2 days in scleral tissue (p < 0.01). The combination of NAC and polydatin administered before and after CXL further enhanced tissue stability, prolonging degradation time to 21 ± 1.8 days for corneas and 30 ± 2 days for sclerae (p < 0.001 vs. controls). These findings suggest that NAC and Polydatin may potentiate the extracellular matrix–stabilizing effects of CXL and warrant further investigation for corneal ectasia and progressive myopia.

Abstract: This study investigated retinal proteomic alterations associated with type-1 diabetes mellitus (T1DM) using two mouse models of diabetic retinopathy (DR): the genetic Ins2akita/+ (Akita) model and streptozotocin (STZ)-induced diabetes. Retinas were collected from Akita (n=4) and STZ-induced diabetic mice (n=6) 15–16 weeks after diabetes onset and compared with age-matched controls. Quantitative mass spectrometry identified 7,933 proteins in Akita retinas and 7,399 proteins in STZ retinas. Differentially expressed proteins were identified using adjusted p-values and log₂ fold-change, ranked by Man-hattan distance, and visualized with volcano plots and heatmaps. The top 20 dysregulat-ed proteins in each model were subjected to canonical pathway analysis. Both models demonstrated upregulation of inflammatory and angiogenesis-associated proteins, in-cluding LRRC58, coronin-2A, S100-A4, and COL4A2, supporting a pro-inflammatory and vascular remodeling microenvironment. However, there were distinctive changes in some proteins between the two models. For example, Crystallins were downregulated in the STZ model but upregulated in the Akita model. Canonical pathway analysis revealed ac-tivation of platelet-related signaling pathways, enrichment of lipid metabolic networks, and significant alterations in extracellular matrix organization. These findings indicate coordinated inflammatory, metabolic, and structural remodeling in DR and identify can-didate molecular pathways for further investigation and therapeutic targeting.

Abstract: Background: Optical coherence tomography (OCT) and OCT angiography (OCTA) retinal imaging in inherited retinal dystrophies (IRD) has been limited to the posterior pole and central midperiphery (up to about 16.5x16.5 mm). Two novel commercially available swept-source (SS) OCT/-OCTA devices provide the possibility of wide-field (WF) evaluation of retinal and choroidal structures including the vasculature in a single examination. Methods: A limited series of 16 IRD patients could be examined with a BMizar (400kHz, 24x20 mm scan width) and a Dream OCT (200 kHz, 26x21 mm scan width) in addition to the normal clinical examination protocol. This series included patients with retinitis pigmentosa, cone-rod dystrophy, macular dystrophy and autosomal recessive bestrophinopathy. Results: WF-SS-OCT/-OCTA enabled the detection of retinal, choroidal and choriocapillaris alterations in the macular and midperiphery in a single examination session. Even small foveal lesions and a small silent macular neovascularization could be detected on WF screening. Regional alterations of choroidal and choriocapillaris flow patterns were identified. These were mostly in correspondence with areas that appeared clinically affected, but unexpected lesions were identified as well. Occlusion of peripheral retinal vessels was seen in retinitis pigmentosa, though flow could be detected in retinal vessel which were difficult to distinguish on fundus images. In one patient with nystagmus WF-SS-OCT/-OCTA could be performed, whereas standard OCT volume scan could not be obtained. Conclusions: Both WF-SS-OCT/-OCTA devices provide detailed insights in structural and vascular retinal and choroidal alterations in a single short examination. Larger series of IRD patients examined with WF-SS-OCT/-OCTA promise to provide novel insights into the pathology of IRDs and will help to understand differences in the development of IRDs between humans and research animals.

Abstract: Purpose: To establish a geometric framework for scleral fixation planning in secondary intraocular lens (IOL) implantation that accounts for corneal ellipticity and meridional orientation, and to analyze the limitations of fixed limbus-distance marking. Methods: The limbal boundary is modeled as an ellipse defined by horizontal and ver-tical white-to-white (WTW) diameters. A target circumferential scleral locus is defined concentrically relative to an anatomical reference center. Fixation points are determined as a function of meridional orientation θ using an explicit radial model of the elliptical limbus and an orientation-dependent limbal offset. The framework is analyzed for two-, three-, and four-point fixation configurations, including the effect of uniform circumferential displacement. Results: A constant limbus-distance strategy implicitly assumes rotational invariance of limbal geometry. When the cornea is elliptical, this assumption produces predictable meridional deviations from the intended circumferential scleral locus for vertical and oblique fixation. An orientation-dependent limbal offset preserves geometric symmetry across all meridians and maintains fixation points on a consistent target locus independent of angular configuration. Under representative biometric conditions, maximal geometric deviations from the intended scleral locus approached approximately 0.58 mm when a constant limbus-distance strategy was applied. Conclusions: Scleral fixation planning can be formalized as a geometric problem gov-erned by limbal ellipticity and meridional orientation. An explicit orientation-dependent model provides a technique-independent basis for reproducible fixation planning and reduces reliance on fixed-distance heuristics.

Abstract: Background/ Objectives: Meropenem is a broad-spectrum carbapenem antibiotic with demonstrated efficacy against multidrug-resistant Gram-negative pathogens. Alt-hough its use as an ophthalmic formulation is off-label, growing clinical evidence sup-ports its application in severe ocular infections such as keratitis and endophthalmitis. However, the intrinsic instability of meropenem in aqueous solutions and the absence of standardized ophthalmic preparations limit its routine use. Furthermore, no stability studies are currently available for meropenem 50 mg/mL eye drops stored in polypro-pylene (PP) dropper bottles under freezing and subsequent refrigerated conditions. The aim of this study was to evaluate the physicochemical and microbiological stability of a 50 mg/mL meropenem ophthalmic solution prepared in hospital pharmacy and packaged in PP containers. Methods: Eye drops were aseptically prepared and stored at −20 ± 2 °C for up to 42 days, followed by refrigerated storage (5 ± 3 °C) after thawing for up to 7 days. Chemical stability was assessed using a validated stability-indicating HPLC method in accordance with ICH guidelines and was defined as 90–110% recovery of the initial concentration. Physical stability (appearance, pH, particulate matter) and micro-biological stability were also evaluated under simulated in-use conditions. Results: The HPLC method demonstrated excellent linearity, precision, and accuracy. Meropenem concentrations remained within the predefined acceptance limits throughout the 42-day study period under freezing conditions, with no significant changes in pH, color, or par-ticulate formation. After thawing, a progressive decrease in drug concentration was ob-served under refrigerated conditions, falling below 90% of the initial concentration within 24–48 hours. A concomitant color change from colorless to yellow was also detected, consistent with β-lactam ring hydrolysis. Despite this degradation, no significant changes in physical parameters other than color were observed, and microbiological testing con-firmed sterility for up to 7 days under refrigerated conditions. Conclusions: Meropenem drops 50 mg/mL in PP dropper bottles is physicochemically and microbiologically stable for 43 days (42 days under frozen conditions plus 1 day, in-use conditions, after opening and under refrigeration).

Abstract: Introduction - This study analyzes the ipsilesional hemifields in patients with hemianopia and Biofeedback Training (BT). Methods - Prospectively, BT stimulated the paracentral ipsilesional hemifields. BT was compared to a control group using C 10-2 program 68 points on the MAIA microperimetry (Centervue, Padova, Italy). Five weekly BT sessions of 20 minutes delivered. 34 subjects enrolled, 28 in treatment, 6 into control group. Outcomes: General retinal sensitivity (RS), average of the central two columns, the paracentral column of the blind hemifield, ipsilesional hemifield, and the whole ipsilesional and blind hemifields. Paired t-tests used for statistical analysis. Results - Control and treatment groups were equal demographically. In control group, no difference found pre-and-post BT. Baseline RS on the ipsilesional hemifield was 21.4 ± 4.5, lower than the normal cut-off value of 25 dB (p < 0.001). BT improved RS from 14.0 ± 4.2 (1.6, 20.9) to 15.0 ± 4.8 (3.8, 27.5), p= 0.01, paracentral two columns, 16.3 ± 5.3 (2.2, 24.5) to 17.8 ± 5.6 (3.8, 30.7), p = 0.01, central column in ipsilesional hemifield, 20.7 ± 5.4 (2.2, 29.1) to 21.8 ± 4.8 (7.3, 30.7), p = 0.05, and ipsilesional hemifield, 21.42 ± 4.8 (2.5, 28.5) to 22.39 ± 4.24 (7.5, 29.4), p=0.01.Discussion - Ipsilesional hemifields were abnormal and BT improved RS, benefiting patients with hemianopia.

Abstract: Transforming Growth Factor-beta (TGF-β) promotes lens epithelial-mesenchymal transition (EMT) and fibrosis, contributing to anterior subcapsular cataract (ASC) formation. Transgenic mice overexpressing TGF-β1 in lens have been studied for over three decades, and yet the impact of active TGF-β1-overexpression on the lens epithelial transcriptome is undefined. We have addressed this knowledge gap by examining the gene expression landscape of these unique lens epithelia. High-throughput RNA-sequencing was performed on isolated lens epithelia from three-week-old TGF-β1-overexpression transgenic mice from two independent lines, OVE853 and OVE918, and wild-type mice. Downstream analyses included comparisons with lens datasets (e.g., cataract-surgery model) and investigations using various resources/tools (e.g., Gene Ontology, CompBio, iSyTE). Compared to wild-type murine lens epithelia, 384 differentially expressed genes (DEGs) were commonly identified in lens of both transgenic lines. Candidates involved in EMT, inflammatory response, extracellular matrix organization, and mechano-sensation were elevated, while those involved in lipid metabolism, Wnt-suppression, Bmp- and Notch-activation were reduced. Comparative analyses with temporal transcriptomes on a mouse cataract-surgery model identified overlapping pathological pathways, and some elevated genes, for example endoplasmic reticulum stress genes, were in agreement with human ASC data. A major discovery was the identification of several novel TGF-β1-targets. All our data is made user-friendly accessible through iSyTE.

Abstract: Fundus fluorescein angiography (FFA) is the gold standard for assessing diabetic retinopathy (DR) severity, but whether different contrast diffusion times affect staging remains unclear. Following two clinical DR staging criteria, we established DR staging models on FFA images respectively adopting Swin-Transformer and ConvNeXt architectures and investigated the impact of FFA diffusion time on staging performance. A total of 7,508 FFA images were annotated according to both staging criteria, and divided into venue, recirculation, and late phase. Single-phase and combined-phase images were used for multi-class and binary classification tasks respectively. Model performance was evaluated using accuracy, precision, recall, and F1-score. A generalized linear model with Bonferroni correction was adopted for inter-phase statistical comparisons. Experimental results demonstrated ConvNeXt architecture outperformed Swin-Transformer in overall accuracy. No statistically significant impact of diffusion time images on staging performance was observed for either model (P > 0.05). Although staging accuracy numerically declined across successive phases, the differences were not significant, possibly attributed to reduced contrast and obscured lesions caused by hyperfluorescent leakage in late phase. Our findings verify that different contrast diffusion times have only a marginal, non-significant impact on DR staging accuracy, offering theoretical guidance for intelligent DR diagnosis using FFA images.