A Second-Generation (44-Channel) Suprachoroidal Retinal Prosthesis: A Single-Arm Clinical Trial of Feasibility.

Purpose: To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years. Design: Prospective, single-arm, unmasked interventional clinical trial. Participants: Four participants, with advanced RP and bare-light perception vision. Methods: The 44-channel suprachoroidal retinal prosthesis was implanted in the worse-seeing eye. Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation. Main Outcome Measures: Serious adverse event (SAE) reporting, visual response outcomes, functional vision outcomes, and quality-of-life outcomes. Results: All 4 participants (aged 39-66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants' daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. Emotional well-being was not impacted by device implantation or usage. Conclusions: The completed clinical study demonstrates that the suprachoroidal prosthesis raises no safety concerns and provides improvements in functional vision, activities of daily living, and observer-rated quality of life. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Human Anterior Segment Perfusion Organ Culture.

The human anterior segment perfusion organ culture is an ex vivo model system for studying the human conventional outflow pathway with reference to pressure regulation. In this model, anterior segments dissected from human donor eyes can be fixed to a modified petri dish and perfused with media along with various study agents at the physiological flow rate of 2.5 µL/min. The model mimics the one-way flow of aqueous humor in human eyes and can be used to evaluate the effects of various drugs on eye pressure in real time. Using this model, cells and tissues of the anterior segment can be maintained for up to 28 days, enabling histological and molecular evaluations.

Guardians of the ocular surface: lessons learned from a challenging case of Langerhans cell histiocytosis with eyelid involvement

ABSTRACT Langerhans cell histiocytosis comprises a heterogeneous range of clinical manifestations secondary to clonal proliferation of histiocytes, characterized by the accumulation of these cells in various organs and tissues. The ophthalmological component commonly involved is the orbit. Herein, we report a rare case of Langerhans cell histiocytosis with eyelid involvement, which resulted in severe ocular surface complications, which subsequently significantly impacted the patient's quality of life. This case report highlights the fact that despite being rare, Langerhans cell histiocytosis should be included in the differential diagnosis of eyelid lesions. Furthermore, a multidisciplinary approach with a systemic overview is crucial for managing the ocular complications.

Comparison of the refractive prediction errors of artificial intelligence formula with 3 conventional formulas and 11 combination methods in cataract surgery on eyes with short axial length

ABSTRACT Purpose: To compare the refractive prediction error of Hill-radial basis function 3.0 with those of 3 conventional formulas and 11 combination methods in eyes with short axial lengths. Methods: The refractive prediction error was calculated using 4 formulas (Hoffer Q, SRK-T, Haigis, and Hill-RBF) and 11 combination methods (average of two or more methods). The absolute error was determined, and the proportion of eyes within 0.25-diopter (D) increments of absolute error was analyzed. Furthermore, the intraclass correlation coefficients of each method were computed to evaluate the agreement between target refractive error and postoperative spherical equivalent. Results: This study included 87 eyes. Based on the refractive prediction error findings, Hoffer Q formula exhibited the highest myopic errors, followed by SRK-T, Hill-RBF, and Haigis. Among all the methods, the Haigis and Hill-RBF combination yielded a mean refractive prediction error closest to zero. The SRK-T and Hill-RBF combination showed the lowest mean absolute error, whereas the Hoffer Q, SRK-T, and Haigis combination had the lowest median absolute error. Hill-radial basis function exhibited the highest intraclass correlation coefficient, whereas SRK-T showed the lowest. Haigis and Hill-RBF, as well as the combination of both, demonstrated the lowest proportion of refractive surprises (absolute error >1.00 D). Among the individual formulas, Hill-RBF had the highest success rate (absolute error ≤0.50 D). Moreover, among all the methods, the SRK-T and Hill-RBF combination exhibited the highest success rate. Conclusions: Hill-radial basis function showed accuracy comparable to or surpassing that of conventional formulas in eyes with short axial lengths. The use and integration of various formulas in cataract surgery for eyes with short axial lengths may help reduce the incidence of refractive surprises.

Intraocular pressure modulation with thermal stimuli

ABSTRACT Purpose: This study aimed to determine whether early-stage intraocular pressure can be modulated using a thermal face mask. Methods: In this prospective clinical study, healthy participants were randomized on a 1:1:1 allocation ratio to three mask groups: hypothermic (G1), normothermic (G2), and hyperthermic (G3). After randomization, 108 eyes from 108 participants were submitted to clinical evaluations, including measurement of initial intraocular pressure (T1). The thermal mask was then applied for 10 minutes, followed by a second evaluation of intraocular pressure (T2) and assessment of any side effects. Results: The hypothermic group (G1) showed a significant reduction in mean intraocular pressure between T1 (16.97 ± 2.59 mmHg) and T2 (14.97 ± 2.44 mmHg) (p<0.001). G2 showed no significant pressure difference between T1 (16.50 ± 2.55 mmHg) and T2 (17.00 ± 2.29 mmHg) (p=0.054). G3 showed a significant increase in pressure from T1 (16.53 ± 2.69 mmHg) to T2 (18.58 ± 2.95 mmHg) (p<0.001). At T1, there was no difference between the three study groups (p=0.823), but at T2, the mean values of G3 were significantly higher than those of G1 and G2 (p<0.00). Conclusion: Temperature was shown to significantly modify intraocular pressure. Thermal masks allow the application of temperature in a controlled, reproducible manner. Further studies are needed to assess the duration of these effects and whether they are reproducible in patients with pathologies that affect intraocular pressure.

Reduced on-line speech gesture integration during multimodal language processing in adults with moderate-severe traumatic brain injury: Evidence from eye-tracking.

BACKGROUND: Language is multimodal and situated in rich visual contexts. Language is also incremental, unfolding moment-to-moment in real time, yet few studies have examined how spoken language interacts with gesture and visual context during multimodal language processing. Gesture is a rich communication cue that is integrally related to speech and often depicts concrete referents from the visual world. Using eye-tracking in an adapted visual world paradigm, we examined how participants with and without moderate-severe traumatic brain injury (TBI) use gesture to resolve temporary referential ambiguity. METHODS: Participants viewed a screen with four objects and one video. The speaker in the video produced sentences (e.g., "The girl will eat the very good sandwich"), paired with either a meaningful gesture (e.g., sandwich-holding gesture) or a meaningless grooming movement (e.g., arm scratch) at the verb "will eat." We measured participants' gaze to the target object (e.g., sandwich), a semantic competitor (e.g., apple), and two unrelated distractors (e.g., piano, guitar) during the critical window between movement onset in the gesture modality and onset of the spoken referent in speech. RESULTS: Both participants with and without TBI were more likely to fixate the target when the speaker produced a gesture compared to a grooming movement; however, relative to non-injured participants, the effect was significantly attenuated in the TBI group. DISCUSSION: We demonstrated evidence of reduced speech-gesture integration in participants with TBI relative to non-injured peers. This study advances our understanding of the communicative abilities of adults with TBI and could lead to a more mechanistic account of the communication difficulties adults with TBI experience in rich communication contexts that require the processing and integration of multiple co-occurring cues. This work has the potential to increase the ecological validity of language assessment and provide insights into the cognitive and neural mechanisms that support multimodal language processing.

Cost-effectiveness and cost-utility of community-based blinding fundus diseases screening with artificial intelligence: A modelling study from Shanghai, China.

BACKGROUND: With application of artificial intelligence (AI) in the disease screening, process reengineering occurred simultaneously. Whether process reengineering deserves special emphasis in AI implementation in the community-based blinding fundus diseases screening is not clear. METHOD: Cost-effectiveness and cost-utility analyses were performed employing decision-analytic Markov models. A hypothetical cohort of community residents was followed in the model over a period of 30 1-year Markov cycles, starting from the age of 60. The simulated cohort was based on work data of the Shanghai Digital Eye Disease Screening program (SDEDS). Three scenarios were compared: centralized screening with manual grading-based telemedicine systems (Scenario 1), centralized screening with an AI-assisted screening system (Scenario 2), and process reengineered screening with an AI-assisted screening system (Scenario 3). The main outcomes were incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR). RESULTS: Compared with Scenario 1, Scenario 2 results in incremental 187.03 years of blindness avoided and incremental 106.78 QALYs at an additional cost of $ 490010.62 per 10,000 people screened, with an ICER of $2619.98 per year of blindness avoided and an ICUR of $4589.13 per QALY. Compared with Scenario 1, Scenario 3 results in incremental 187.03 years of blindness avoided and incremental 106.78 QALYs at an additional cost of $242313.23 per 10,000 people screened, with an ICER of $1295.60 per year of blindness avoided and an ICUR of $2269.35 per QALY. Although Scenario 2 and 3 could be considered cost-effective, the screening cost of Scenario 3 was 27.6 % and the total cost was 1.1 % lower, with the same expected effectiveness and utility. The probabilistic sensitivity analyses show that Scenario 3 dominated 69.1 % and 70.3 % of simulations under one and three times the local GDP per capita thresholds. CONCLUSIONS: AI can improve the cost-effectiveness and cost-utility of screenings, especially when process reengineering is performed. Therefore, process reengineering is strongly recommended when AI is implemented.

A single molecule carrier for ocular posterior segment diseases.

Eye drops are envisaged as the most promising non-invasive formulation for the treatment of the ocular posterior segment diseases, while it is hindered by a series of complex ocular barriers, both static and dynamic in nature. In this context, we propose a single molecule nanomedicine based on host-guest chemistry to achieve highly efficient drug delivery targeted to ocular posterior segment. Sulfonated azocalix[4]arene (SAC4A) serves as the single molecule carrier, owing the multiple features of small size (24.0 Šin length, 21.2 Šin width, 14.8 Šin height with a Van der Waals volume of 930 Å3), negative charge, hydrophilicity, loading universality and hypoxia-triggered release. As a proof-of-concept, an eye drop formed by the complexation of SAC4A with sunitinib (SUN) is prepared to treat wet age-related macular degeneration (wAMD). SAC4A successfully transports SUN to the ocular posterior segment (the amount of SUN reaching the retinal-choroid tissue in the SUN@SAC4A group was 2.47 times larger than that in the SUN group at 30 min), significantly enhancing its anti-choroidal neoangiogenesis effect of SUN to wAMD, which played a key role in the treatment. We believe that the single molecule nanomedicine paradigm is highly amenable for treating various ocular posterior segment diseases in the future.

Integrated miRNA sequencing and experimental validation Unveil that low-level laser enhances vascular endothelial cell proliferation, migration, and lumen formation via miR-90/VEGFA.

The hydroxyapatite orbital implantation is widely used to treat orbital malformation, but delayed postoperative angiogenesis can hinder conjunctival wound healing, potentially leading to implant exposure and prolapse. Low-intensity laser therapy (LLLT) is recognized for its ability to promote tissue regeneration, reduce inflammation, and alleviate pain. This study aims to explore the specific mechanism of miRNAs-VEGFA pathway regulation in early vascularization after orbital implant placement induced by LLLT. A hydroxyapatite orbital implant model was established and treated with LLLT. Vascular tissues surrounding the ocular prosthesis were extracted for high-throughput sequencing to identify differentially expressed miRNAs. miRNAs predicted to bind with VEGFA were selected for validation. GO and KEGG analyses were performed to reveal the functional enrichment of target genes regulated by these miRNAs. Dual luciferase assay, qRT-PCR, and Western blotting were used to verify the targeting relationship between miR-90 and VEGFA. The effects of miR-90 on rabbit microvascular endothelial cell function were assessed through CCK-8 assay, scratch test, and tube formation assay. High-throughput sequencing revealed 32 differentially expressed miRNAs, with 8 upregulated and 24 downregulated. miR-90 was predicted to have a high binding score and expression abundance with VEGFA and was confirmed to regulate VEGFA expression. In vitro functional tests showed that miR-90 inhibited rabbit microvascular endothelial cell proliferation, migration, and tube formation. This study is the first to demonstrate that LLLT regulates ocular prosthesis angiogenesis via the miR-90/VEGFA pathway, providing a new target for treating vascular-dependent diseases.

The Weight on Sight: Exploring the Links Between Obesity and Ocular Diseases.

Obesity is a significant public health concern with escalating levels worldwide creating a variety of socioeconomic challenges and imposing a serious risk factor for a range of complications which include diabetes, hypertension, cardiovascular disease, and stroke, all of which are primary causes of early death. Furthermore, there is growing evidence connecting obesity to the development of several ocular disorders. Excessive weight is a common denominator in the aetiology of many ocular pathologies such as diabetic retinopathy, idiopathic intracranial hypertension, cataract, high intraocular pressures, age-related macular degeneration, and retinal vascular diseases through the association with diabetes, hypertension, and dyslipidemia. This review highlights the risks weight gain and a sedentary lifestyle imposes on patients' ocular health and aims to inform the public and raise awareness about the consequences obesity has on sight. This review explores articles available on Ovid-MEDLINE (Medical Literature Analysis and Retrieval System Online) and PubMed regarding the impact of obesity on ocular health and the pathogenesis of obesity-linked ocular diseases.

The Aryl Hydrocarbon Receptor: A Crucial Mediator in Ocular Disease Pathogenesis and Therapeutic Targeting.

The aryl hydrocarbon receptor (AHR) is a pivotal nuclear receptor involved in mediating cellular responses to a wide range of environmental pollutants and endogenous ligands. AHR plays a central role in regulating essential physiological processes, including xenobiotic metabolism, immune response modulation, cell cycle control, tumorigenesis, and developmental events. Recent studies have identified AHR as a critical mediator and a potential therapeutic target in the pathogenesis of ocular diseases. This review provides a thorough analysis of the various functions of AHR signalling in the ocular environment, with a specific emphasis on its effects on the retina, retinal pigment epithelium (RPE), choroid, and cornea. We provide a detailed discussion on the molecular mechanisms through which AHR integrates environmental and endogenous signals, influencing the development and progression of age-related macular degeneration (AMD), retinitis pigmentosa, uveitis, and other major ocular disorders. Furthermore, we evaluate the therapeutic potential of modulating AHR activity through novel ligands and agonists as a strategy for treating eye diseases. Understanding the molecular mechanisms of AHR in ocular tissues may facilitate the development of AHR-targeted therapies, which is crucial for addressing the pressing clinical demand for novel treatment strategies in ocular diseases.

Design of eye phantom for optical coherence tomography angiography study.

Tissue phantoms play an important role in validating biomedical imaging techniques. For optical imaging systems such as optical coherence tomography, creating layers of phantoms with different refractive indices is important. This paper explored various phantom materials to create eye-mimicking phantoms. The phantom also included microfluidic channels to mimic vasculature. To verify the optical properties of the created phantom, the transmission and reflection spectroscopy was performed using a photoluminescent spectrometer studying the complete visible and near infrared spectrum. We created a 3D model to house multiple layers that mimicked the retina at one end and the contact lens at the other, representing the anterior segment of the eye. A realistic retinal layer-mimicking, which, among other things, may pave the way for new combined imaging modalities.

When noise becomes signal: a study of blink rate using an eye tracker.

PURPOSE: Although blink rate is considered important for digital eye strain and dry eye conditions, its assessment has been mostly manual. This study aimed at quantifying blink rate automatically using the Eyelink 1000 Plus eye tracker and comparing it with manual counting. Additionally, blink rate was correlated with reading eye movements and reading speed. METHODS: Thirty participants (mean age 26.8±3.5 years; 19 females) were enrolled. An on-screen reading task for 3 minutes duration, was repeated 3 times with a 2-minute break between the repetitions. During this task, eye movements and blinks were measured through the Eyelink 1000 Plus eye tracker. The blink was also counted manually by the examiner in real time from a video feed. RESULTS: The blink rate obtained by the eye tracker (median [Q1, Q3]:11.7 [6.8,15.5] blinks/min) and manual counting (11.6 [7.1, 15.4] blinks/min) were comparable (p>0.5). No significant correlations were observed between the blink rate and any of the reading eye movement parameters except saccadic amplitude (Spearman's rho, rs =0.506). No statistically significant correlation was found between the blink rate and reading speed. CONCLUSION: The Eyelink 1000 Plus eye tracker gives a comparable blink rate compared to that obtained through manual counting. A positive correlation between the blink rate and saccade amplitude could indicate a coupled interaction between the two mechanisms to minimize visual loss during reading. The option of using this tracker to investigate blinks in dry eye and binocular vision disorders can be further explored.

Phospholipid Nanoemulsion-Based Ocular Lubricant for the Treatment of Dry Eye Subtypes: A Multicenter and Prospective Study.

INTRODUCTION: Dry eye disease (DED) is a multifactorial condition of the ocular surface (OS) characterized by loss of tear film homeostasis, ocular discomfort, and vision disturbances. Most available ocular lubricants target the aqueous deficiency of the tear, restoring only this layer, leaving the tear lipid stratum deficient, as occurs in most patients with evaporative DED. An innovative propylene glycol-hydroxypropyl guar enriched with a phospholipid nanoemulsion (PG-HPG-PH-N) is indicated to restore deficiencies in both the lipid and aqueous layers of the tear film, and its composition was designed to increase lubricant retention on the OS. The purpose of this study was to evaluate, through the Ocular Surface Disease Index (OSDI) and clinical assessment, the treatment of patients who had DED due to aqueous deficiency arising from mixed or evaporative DED subtypes with a PG-HPG-PH-N ocular lubricant at a reduced frequency of twice a day, in a prospective, multicenter, and single-arm study. METHODS: Patients were screened from days - 7 to 0, and from day 1 (baseline and first day of treatment) to day 28 of treatment with this lubricant. After visit 1 (screening visit, days - 7 to 0), designed as pre-treatment OS assessment, patients returned to their research center on days 14 and 28 of treatment for a complete assessment, including anamnesis, the OSDI, corrected visual acuity, tear breakup time (TFBUT), OS staining evaluation, tolerability index, and environmental exposure questionnaire. RESULTS: Seventy patients were enrolled in this study (60 women, 10 men), with a mean age of 45 (range 27-64) years. TFBUT results showed an improvement in tear film stability as vital dyes sodium fluorescein and lysamine green showed a decrease in corneal staining after 14 and 28 days of treatment. No significant adverse events were reported, demonstrating the good tolerability of the lubricant. CONCLUSIONS: The PG-HPG-PH-N nanoemulsion can be considered to be a safe and effective ocular lubricant for treating DED due to aqueous deficiency, both mixed and evaporative subtypes. TRIAL REGISTRATION: Brazilian National Research Ethics Commission (ReBEC registration number 16055).

Prediction in reading: A review of predictability effects, their theoretical implications, and beyond.

Historically, prediction during reading has been considered an inefficient and cognitively expensive processing mechanism given the inherently generative nature of language, which allows upcoming text to unfold in an infinite number of possible ways. This article provides an accessible and comprehensive review of the psycholinguistic research that, over the past 40 or so years, has investigated whether readers are capable of generating predictions during reading, typically via experiments on the effects of predictability (i.e., how well a word can be predicted from its prior context). Five theoretically important issues are addressed: What is the best measure of predictability? What is the functional relationship between predictability and processing difficulty? What stage(s) of processing does predictability affect? Are predictability effects ubiquitous? What processes do predictability effects actually reflect? Insights from computational models of reading about how predictability manifests itself to facilitate the reading of text are also discussed. This review concludes by arguing that effects of predictability can, to a certain extent, be taken as demonstrating evidence that prediction is an important but flexible component of real-time language comprehension, in line with broader predictive accounts of cognitive functioning. However, converging evidence, especially from concurrent eye-tracking and brain-imaging methods, is necessary to refine theories of prediction.

Retina in Clinical High-Risk and First-Episode Psychosis.

BACKGROUND AND HYPOTHESIS: Abnormalities in the retina are observed in psychotic disorders, especially in schizophrenia. STUDY DESIGN: Using spectral-domain optical coherence tomography, we investigated structural retinal changes in relatively metabolic risk-free youth with clinical high-risk (CHR, n = 34) and first-episode psychosis (FEP, n = 30) compared with healthy controls (HCs, n = 28). STUDY RESULTS: Total retinal macular thickness/volume of the right eye increased in FEP (effect sizes, Cohen's d = 0.69/0.66) and CHR (d = 0.67/0.76) compared with HCs. Total retinal thickness/volume was not significantly different between FEP and CHR. Macular retinal nerve fiber layer (RNFL) thickness/volume of the left eye decreased in FEP compared with HCs (d = -0.75/-0.66). Peripapillary RNFL thickness was not different between groups. The ganglion cell (GCL), inner plexiform (IPL), and inner nuclear (INL) layers thicknesses/volumes of both eyes increased in FEP compared with HCs (d = 0.70-1.03). GCL volumes of both eyes, IPL thickness/volume of the left eye, and INL thickness/volume of both eyes increased in CHR compared with HCs (d = 0.64-1.01). In the macula, while central sector thickness/volume decreased (d = -0.62 to -0.72), superior outer (peri-foveal) sector thickness/volume of both eyes increased (d = 0.81 to 0.86) in FEP compared with HCs. CONCLUSIONS: The current findings suggest that distinct regions and layers of the retina may be differentially impacted during the emergence and early phase of psychosis. Consequently, oculomics could play significant roles, not only as a diagnostic tool but also as a mirror reflecting neurobiological changes at axonal and cellular levels.

Isolated Pancreatic Metastasis in a Patient With Orbital Rhabdomyosarcoma: A Report of a Rare Case.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents and its occurrence in adults is extremely rare. There are three major subtypes of RMS of which alveolar RMS (ARMS) has the worst prognosis and tends to metastasize to unusual locations such as the pancreas. We present a case of a 19-year-old male with a rapidly enlarging right orbital mass, the imaging of which revealed it to be an infiltrative lesion with extension into the nasal cavity, ethmoid sinuses, and intracranial involvement. Histopathology confirmed the diagnosis of ARMS. A staging CT scan showed an enlarged and hypoenhancing pancreas; the histopathology test confirmed ARMS metastasis. It is important to consider pancreatic involvement in patients with ARMS, as it may be misinterpreted with other pathologies such as pancreatitis and pancreatic lymphoma. Metastasis to the pancreas can significantly alter the clinical approach and staging, underscoring the need for accurate diagnosis and staging in these patients.

A dataset of color fundus images for the detection and classification of eye diseases.

The retina is a critical component of the eye responsible for capturing visual information, making the importance of retinal health for clear vision. Various eye diseases, such as age-related macular degeneration, diabetic retinopathy, and glaucoma, can severely impair vision and even lead to blindness if not detected and treated early. Therefore, automated systems using machine learning and computer vision techniques have shown promise in the early detection and management of these diseases, reducing the risk of vision loss. In this context, to facilitate the development and evaluation of machine learning models for eye disease detection, we introduced a comprehensive dataset which was collected during a span of eight months from Anawara Hamida Eye Hospital & B.N.S.B. Zahurul Haque Eye Hospital using Color Fundus Photography machine. The dataset has two categories of data: color fundus photographs and anterior segment images. The color fundus photographs categorized into nine classes: Diabetic Retinopathy, Glaucoma, Macular Scar, Optic Disc Edema, Central Serous Chorioretinopathy (CSCR), Retinal Detachment, Retinitis Pigmentosa, Myopia, Healthy and anterior segment images has one class: Pterygium. This dataset comprises 5335 primary images. By providing a rich and diverse collection of color fundus photographs, this dataset serves as a valuable resource for researchers and clinicians in the field of ophthalmology for the automatic detection of nine different classes of eye diseases.

A comparative study on the lipid layer thickness analysis of medical staff before and after work.

Background & Aims: To study the change of the lipid layer thickness analysis in medical staff (MS) before and after work, and to explore the significance of measuring lipid layer thickness (LLT) respectively in four quadrants. Methods: Ocular Surface Disease Index (OSDI) questionnaire and video display terminal using time for 55 MS were collected (the informed consent was obtained from all patients). Noninvasive tear break-up time, LLT, tear meniscus height (TMH), meibomian glands (MG) dropout, and blink pattern before and after work (worked for more than 4 h) of 110 eyes were measured by Gaush iDea Ocular surface analyzer. Lid margin abnormalities were evaluated by the slit-lamp microscopy. Results: The average OSDI score of 55 MS was 25.68 ± 14.91. The average LLT of 110 eyes after work (65.12 ± 3.63 nm) was significantly reduced compared to before work (66.54 ± 4.16 nm), p < 0.05. The LLT in the superior quadrant was significantly thinner than that in the other three quadrants, p < 0.01. The average LLT was positively correlated with the LLT in the inferior (r = 0.822, p < 0.001), nasal (r = 0.261, p < 0.001), and temporal quadrant (r = 0.372, p < 0.001), while was negatively correlated with the MG dropout in lower lid (r = -0.209, p = 0.002). There was a significant correlation between the LLT in the inferior quadrant and the VDTt (r = -0.173, p = 0.01). The LLT of inferior quadrant were positively related to the TMH (r = 0.149, p = 0.027) and negatively related to MG dropout in lower lid (r = -0.162, p = 0.017). Conclusion: The LLT significantly decreases after work in MS. The distribution of the lipid layer on the ocular surface is uneven. It is unreasonable for current detection instruments to measure the inferior quadrant LLT alone to represent average LLT.

Enhancing ensemble classifiers utilizing gaze tracking data for autism spectrum disorder diagnosis.

PROBLEM: Diagnosing Autism Spectrum Disorder (ASD) remains a significant challenge, especially in regions where access to specialists is limited. Computer-based approaches offer a promising solution to make diagnosis more accessible. Eye tracking has emerged as a valuable technique in aiding the diagnosis of ASD. Typically, individuals' gaze patterns are monitored while they view videos designed according to established paradigms. In a previous study, we developed a method to classify individuals as having ASD or Typical Development (TD) by processing eye-tracking data using Random Forest ensembles, with a focus on a paradigm known as joint attention. AIM: This article aims to enhance our previous work by evaluating alternative algorithms and ensemble strategies, with a particular emphasis on the role of anticipation features in diagnosis. METHODS: Utilizing stimuli based on joint attention and the concept of "floating regions of interest" from our earlier research, we identified features that indicate gaze anticipation or delay. We then tested seven class balancing strategies, applied seven dimensionality reduction algorithms, and combined them with five different classifier induction algorithms. Finally, we employed the stacking technique to construct an ensemble model. RESULTS: Our findings showed a significant improvement, achieving an F1-score of 95.5%, compared to the 82% F1-score from our previous work, through the use of a heterogeneous stacking meta-classifier composed of diverse induction algorithms. CONCLUSION: While there remains an opportunity to explore new algorithms and features, the approach proposed in this article has the potential to be applied in clinical practice, contributing to increased accessibility to ASD diagnosis.