The effect of blue-light filtering intraocular lenses on the development and progression of macular atrophy in eyes with nAMD.

PURPOSE: To assess the effect of blue-light filtering (BLF) intraocular lenses (IOLs) on the development and progression of macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). DESIGN: Retrospective clinical cohort study. METHODS: nAMD patients with anti-vascular endothelial growth factor (VEGF) injections who underwent uneventful cataract surgery between 2007 and 2018 with follow-up until June 2023. Subsequent MA rates were compared between subjects who received a BLF IOL or a non-BLF IOL. All OCT scans were manually reviewed in a masked manner regarding patient baseline variables and IOL status by an experienced research technician. Using the Heidelberg software, the area of MA was manually evaluated and calculated (mm2) by the program. The overall risk of developing new-onset MA and the effect of IOL type on disease progression were assessed. Death was included as a censoring event. RESULTS: Included were 373 eyes of 373 patients (mean age 78.6±6.7 years at surgery, 67.4% females). 206 eyes were implanted with BLF IOLs and 167 with non-BLF IOLs with comparable follow-up times (3164±1420 days vs. 3180±1403 days, respectively, P=0.908), and other baseline parameters (age, gender, corrected distance visual acuity, macular thickness, cumulative number of anti-VEGF injections). Nine pre-existing and 77 new-onset MA cases were detected, with similar distribution between BLF and non-BLF eyes (P=0.598 and P=0.399, respectively). Both univariate Kaplan-Meier (P=0.366) and multivariate Cox regression analysis adjusted for age and gender showed that BLF-IOLs were comparable to non-BLF IOLs regarding hazard for new-onset MA (HR 1.236, 95% CI 0.784-1.949, P=0.363). Final MA area at the last visit was 5.14±4.71mm2 for BLF IOLs and 8.56±9.17mm2 for non-BLF IOLs (P=0.028), with the mean annual MA area increase of 0.78±0.84mm2 and 1.26±1.32mm2, respectively (P=0.042). CONCLUSIONS: BLF IOLs did not show added benefit over non-BLF IOLs in terms of MA-free survival but were associated with less progression over time in a cohort of nAMD patients.

Choroidal arterial abnormality in central serous chorioretinopathy.

PURPOSE: To evaluate the choroidal arterial abnormality in central serous chorioretinopathy (CSC). METHODS: Fifty-two eyes from 52 patients with CSC were retrospectively evaluated. Arterial and venous ultrawide-field indocyanine green angiography were merged after color and transparency adjustments to compare the choroidal arterial and venous vasculature. Specifically, we evaluated whether the choroidal arteries directly fill the pachyvessel without interconnection of choriocapillaris (arterial pachyvessel; aPV). Then, the clinical characteristics of patients with and without arterial pachyvessel were compared. RESULTS: Pachyvessel under subretinal fluid was detected in 47 of 52 eyes (90.4%). An arterial pachyvessel was detected in eight of 52 eyes (15.4%). Of those eight eyes with arterial pachyvessel, seven (87.5%) showed sustained staining through the venous phase, suggesting they are arteriovenous shunt, while one eye (12.5%) showed diminished fluorescence in the venous phase, suggesting this pachyvessel was purely an artery. Patients with arterial pachyvessel experienced more CSC recurrences (non-aPV group: 2.09 ± 1.44 times vs. aPV group: 3.25 ± 1.28 times; p = 0.039) and pachychoroid neovasculopathy (PNV) development (non-aPV group: 2.3% vs. aPV group: 37.5%, p = 0.009). CONCLUSION: The presence of arterial pachyvessel in eyes with CSC may represent choroidal circulatory imbalance and focal shear stress to Bruch's membrane, leading to a chronic nature and PNV development.

Nanoribbon Yarn with Versatile Inorganic Materials.

Nanomaterial-based yarns have been actively developed owing to their advantageous features, namely, high surface-area-to-volume ratios, flexibility, and unusual material characteristics such as anisotropy in electrical/thermal conductivity. The superior properties of the nanomaterials can be directly imparted and scaled-up to macro-sized structures. However, most nanomaterial-based yarns have thus far, been fabricated with only organic materials such as polymers, graphene, and carbon nanotubes. This paper presents a novel fabrication method for fully inorganic nanoribbon yarn, expanding its applicability by bundling highly aligned and suspended nanoribbons made from various inorganic materials (e.g., Au, Pd, Ni, Al, Pt, WO3, SnO2, NiO, In2O3, and CuO). The process involves depositing the target inorganic material on a nanoline mold, followed by suspension through plasma etching of the nanoline mold, and twisting using a custom-built yarning machine. Nanoribbon yarn structures of various functional inorganic materials are utilized for chemical sensors (Pd-based H2 and metal oxides (MOx)-based green gas sensors) and green energy transducers (water splitting electrodes/triboelectric nanogenerators). This method is expected to provide a comprehensive fabrication strategy for versatile inorganic nanomaterials-based yarns.

Micro-/Nanohierarchical Structures Physically Engineered on Surfaces: Analysis and Perspective.

The high demand for micro-/nanohierarchical structures as components of functional substrates, bioinspired devices, energy-related electronics, and chemical/physical transducers has inspired their in-depth studies and active development of the related fabrication techniques. In particular, significant progress has been achieved in hierarchical structures physically engineered on surfaces, which offer the advantages of wide-range material compatibility, design diversity, and mechanical stability, and numerous unique structures with important niche applications have been developed. This review categorizes the basic components of hierarchical structures physically engineered on surfaces according to function/shape and comprehensively summarizes the related advances, focusing on the fabrication strategies, ways of combining basic components, potential applications, and future research directions. Moreover, the physicochemical properties of hierarchical structures physically engineered on surfaces are compared based on the function of their basic components, which may help to avoid the bottlenecks of conventional single-scale functional substrates. Thus, the present work is expected to provide a useful reference for scientists working on multicomponent functional substrates and inspire further research in this field.

Ultra-Widefield-Guided Swept-Source OCT Findings of Peripheral Vitreoretinal Abnormality in Young Myopes.

PURPOSE: To evaluate the ultra-widefield fundus photography (UWF-FP)-guided swept-source OCT (SS-OCT) images of peripheral vitreoretinal abnormality (PVRA) in young asymptomatic myopes. DESIGN: Cross-sectional, single-center study. PARTICIPANTS: A total of 1966 eyes of 983 consecutive patients aged 18 to 42 years with refractive error in the spherical equivalent of < 0 diopters (D) who visited KEYE Eye Center, Seoul, Republic of Korea, for refractive surgery. METHODS: The prevalence of PVRA and their characteristics, including shape, location, presence of pigmentation, membrane, retinal breaks, and detachment, were evaluated. A logistic regression analysis was done to evaluate the risk factors of PVRA and the risk of retinal breaks or detachment among eyes with PVRA. RESULTS: Among 1966 eyes, 317 (16.1%) had PVRA, and 182 (57.4%) and 135 (42.6%) had focal and linear lesions, respectively. The risk of PVRA was increased with axial length of the eyes (odds ratio [OR], 1.238, 95% confidence interval [CI], 1.112-1.379, P < 0.001), corneal astigmatism (OR, 1.320, 95% CI, 1.148-1.519, P < 0.001), presence of discrete margins of different retinal reflectivity (DMDRR; indicating outer retinal disruption from abnormal vitreoretinal traction) (OR, 1.751, 95% CI, 1.334-2.300, P < 0.001), and posterior vitreous detachment (PVD) at the posterior pole of the retina (OR, 1.833, 95% CI, 1.352-2.485, P < 0.001). Among eyes with PVRA, patient age (OR, 1.063, 95% CI, 1.008-1.121, P = 0.025), linear lesions (OR, 15.234, 95% CI, 7.891-29.407, P < 0.001), and multiple lesions (OR, 3.432, 95% CI, 1.780-6.620, P < 0.001) were independently associated with the presence of retinal breaks or detachment. CONCLUSIONS: The follow-up for PVRA among young myopes should be personalized on the basis of their ocular characteristics, including asymmetric ocular expansion (axial length and astigmatism) and vitreoretinal interface status. The treatment plan for PVRA eyes should emphasize the greater risk of retinal breaks and detachment with increasing age and the presence of linear and multiple lesions. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Correction: A wearable colorimetric sweat pH sensor-based smart textile for health state diagnosis.

Correction for 'A wearable colorimetric sweat pH sensor-based smart textile for health state diagnosis' by Ji-Hwan Ha et al., Mater. Horiz., 2023, 10, 4163-4171, https://doi.org/10.1039/d3mh00340j.

Recent Advances in Sensor-Actuator Hybrid Soft Systems: Core Advantages, Intelligent Applications, and Future Perspectives.

The growing demand for soft intelligent systems, which have the potential to be used in a variety of fields such as wearable technology and human-robot interaction systems, has spurred the development of advanced soft transducers. Among soft systems, sensor-actuator hybrid systems are considered the most promising due to their effective and efficient performance, resulting from the synergistic and complementary interaction between their sensor and actuator components. Recent research on integrated sensor and actuator systems has resulted in a range of conceptual and practical soft systems. This review article provides a comprehensive analysis of recent advances in sensor and actuator integrated systems, which are grouped into three categories based on their primary functions: i) actuator-assisted sensors for intelligent detection, ii) sensor-assisted actuators for intelligent movement, and iii) sensor-actuator interactive devices for a hybrid of intelligent detection and movement. In addition, several bottlenecks in current studies are discussed, and prospective outlooks, including potential applications, are presented. This categorization and analysis will pave the way for the advancement and commercialization of sensor and actuator-integrated systems.

A wearable colorimetric sweat pH sensor-based smart textile for health state diagnosis.

Sweat pH is an important indicator for diagnosing disease states, such as cystic fibrosis. However, conventional pH sensors are composed of large brittle mechanical parts and need additional instruments to read signals. These pH sensors have limitations for practical wearable applications. In this study, we propose wearable colorimetric sweat pH sensors based on curcumin and thermoplastic-polyurethane (C-TPU) electrospun-fibers to diagnose disease states by sweat pH monitoring. This sensor aids in pH monitoring by changing color in response to chemical structure variation from enol to di-keto form via H-atom separation. Its chemical structure variation changes the visible color due to light absorbance and reflectance changes. Furthermore, it can rapidly and sensitively detect sweat pH due to its superior permeability and wettability. By O2 plasma activation and thermal pressing, this colorimetric pH sensor can be easily attached to various fabric substrates such as swaddling and patient clothing via surface modification and mechanical interlocking of C-TPU. Furthermore, the diagnosable clothing is durable and reusable enough to neutral washing conditions due to the reversible pH colorimetric sensing performance by restoring the enol form of curcumin. This study contributes to the development of smart diagnostic clothing for cystic fibrosis patients who require continuous sweat pH monitoring.

Long-term Clinical Outcomes After Trifocal Intraocular Lens Implantation: A Retrospective Observational Study.

PURPOSE: To evaluate the long-term stability of the AcrySof IQ PanOptix TFNT00 intraocular lens (IOL) (Alcon Laboratories, Inc). METHODS: This was a retrospective review of 1,065 eyes (745 patients) who underwent implantation of a PanOptix IOL. A total of 296 eyes (mean age: 58.62 ± 5.63 years and preoperative refractive error: -0.68 ± 3.01 diopters [D]) met inclusion criteria for this study. The objective refraction, uncorrected distance and near visual acuity (UDVA and UNVA), and corrected distance visual acuity (CDVA) were evaluated at postoperative months 1, 2, 6, 12, 24, and 36. RESULTS: The refractive error was -0.20 ± 0.36 D at 1 month, -0.20 ± 0.35 D at 2 months (P = .503), -0.10 ± 0.37 D at 6 months (P < .001), -0.02 ± 0.38 D at 12 months (P < .001), 0.00 ± 0.38 D at 24 months (P < .001), and 0.03 ± 0.39 D at 36 months (P < .001). Multivariate analysis showed long-term, independent associations for young age (beta = -0.122; P = .029) and changes in mean keratometry (beta = -0.413; P < .001). A greater refractive change was associated with a greater change in UNVA (r = 0.134; P = .026) but not with UDVA (r = -0.029; P = .631) or CDVA (r = -0.010; P = .875). CONCLUSIONS: Implantation of the PanOptix IOL yields stable clinical outcomes for visual acuity and refractive error for the first 3 years. A slight hyperopic shift, causing decreased near visual acuity, is anticipated for younger patients. [J Refract Surg. 2023;39(4):236-241.].

Water-resistant free-standing DNA-complexed films with antioxidant and H2O2-responsive activity.

Water-insoluble DNA complexes are suitable for producing free-standing DNA films due to their low water sensitivity, which prevents their rapid degradation in aqueous environments. Here, we proposed two types of free-standing films that exhibit low dissolution rates in water: low molecular weight chitosan (LCS)-DNA films and phosphatidylcholine (PC)-cetyltrimethylammonium (CTMA)-DNA films. The structure and binding characteristics of the LCS-DNA and PC-CTMA-DNA complexes were investigated with UV-Vis spectroscopy and via the fluorescent characteristics of daunorubicin bound to them. A simple drop-casting method was then adopted for both complexes to fabricate free-standing films. An increase in antioxidant activity and water-resistance of the LCS-DNA DNA film was observed when the molar ratio of LCS to DNA was increased, but the dissolution rate of the LCS-DNA film was also dependent on the ionic strength of the dissolving solution. Fourteen days were required to dissolve the LCS-DNA film in deionized water, whereas immediate dissolution was observed in 1× phosphate-buffered saline (PBS). Deformation of the PC-CTMA-DNA film was accelerated by H2O2, such that the PC-CTMA-DNA film was degraded after 21 days of immersion in 1× PBS with H2O2. Due to the low dissolution rate in water and antioxidant activity, the free-standing LCS-DNA film should be able to store and protect embedded clinical materials, such as proteins and intercalating drugs, from moisture and enable localized delivery of treatments to designated sites. Also, the free-standing PC-CTMA-DNA film could be a biocompatible candidate for use as a membrane or sensor for detecting the levels of reactive oxygen species.

Nanotransfer-on-Things: From Rigid to Stretchable Nanophotonic Devices.

The growing demand for nanophotonic devices has driven the advancement of nanotransfer printing (nTP) technology. Currently, the scope of nTP is limited to certain materials and substrates owing to the temperature, pressure, and chemical bonding requirements. In this study, we developed a universal nTP technique utilizing covalent bonding-based adhesives to improve the adhesion between the target material and substrate. Additionally, the technique employed plasma-based selective etching to weaken the adhesion between the mold and target material, thereby enabling the reliable modulation of the relative adhesion forces, regardless of the material or substrate. The technique was evaluated by printing four optical materials on nine substrates, including rigid, flexible, and stretchable substrates. Finally, its applicability was demonstrated by fabricating a ring hologram, a flexible plasmonic color filter, and extraordinary optical transmission-based strain sensors. The high accuracy and reliability of the proposed nTP method were verified by the performance of nanophotonic devices that closely matched numerical simulation results.

Accuracy of Nine Formulas to Calculate the Powers of an Extended Depth-of-Focus IOL Using Two SS-OCT Biometers.

PURPOSE: To evaluate the accuracy of nine formulas to calculate the power of a new extended depth-of-focus intraocular lens (EDOF IOL), the AcrySof IQ Vivity (Alcon Laboratories, Inc), using measurements from two optical biometers, the IOLMaster 700 (Carl Zeiss Meditec AG) and Anterion (Heidelberg Engineering GmbH). METHODS: After constant optimization, the accuracy of these formulas was analyzed in 101 eyes: Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane, Olsen, RBF 3.0, and SRK/T. Both standard and total keratometry from the IOLMaster 700 and standard keratometry from the Anterion were used for each formula. RESULTS: Constant optimization provided slightly different values for the A-constant, which ranged between 118.99 and 119.16, depending on the formula and the optical biometer. According to the heteroscedastic test, within each keratometry modality the standard deviation of the SRK/T was significantly higher compared to that of the Holladay 1, Kane, Olsen, and RBF 3.0 formulas. The SRK/T formula provided less accurate results also when the absolute prediction errors were compared by Friedman test. According to McNemar's test with Holm corrections, statistically significant differences were found within each keratometry modality between the percentage of eyes with a prediction error within ±0.25 diopters obtained with the Olsen formula compared to the Holladay 1 and Hoffer Q formulas. CONCLUSIONS: Constant optimization remains a mandatory step to achieve the best outcomes with the new EDOF IOL: the same constant should not be used for all formulas and for both optical biometers. Different statistical tests revealed that older IOL formulas have lower accuracy compared to newer formulas. [J Refract Surg. 2023;39(3):158-164.].

Nanoscale three-dimensional fabrication based on mechanically guided assembly.

The growing demand for complex three-dimensional (3D) micro-/nanostructures has inspired the development of the corresponding manufacturing techniques. Among these techniques, 3D fabrication based on mechanically guided assembly offers the advantages of broad material compatibility, high designability, and structural reversibility under strain but is not applicable for nanoscale device printing because of the bottleneck at nanofabrication and design technique. Herein, a configuration-designable nanoscale 3D fabrication is suggested through a robust nanotransfer methodology and design of substrate's mechanical characteristics. Covalent bonding-based two-dimensional nanotransfer allowing for nanostructure printing on elastomer substrates is used to address fabrication problems, while the feasibility of configuration design through the modulation of substrate's mechanical characteristics is examined using analytical calculations and numerical simulations, allowing printing of various 3D nanostructures. The printed nanostructures exhibit strain-independent electrical properties and are therefore used to fabricate stretchable H2 and NO2 sensors with high performances stable under external strains of 30%.

Multidimensional Honeycomb-like DNA Nanostructures Made of C-Motifs.

Thanks to its remarkable properties of self-assembly and molecular recognition, DNA can be used in the construction of various dimensional nanostructures to serve as templates for decorating nanomaterials with nanometer-scale precision. Accordingly, this study discusses a design strategy for fabricating such multidimensional DNA nanostructures made of simple C-motifs. One-dimensional (1D) honeycomb-like tubes (1HTs) and two-dimensional (2D) honeycomb-like lattices (2HLs) were constructed using a C-motif with an arm length of 14 nucleotides (nt) at an angle of 240° along the counterclockwise direction. We designed and fabricated four different types of 1HTs and three different 2HLs. The study used atomic force microscopy to characterize the distinct topologies of the 1D and 2D DNA nanostructures (i.e., 1HTs and 2HLs, respectively). The width deviation of the 1HTs and height suppression percentage of the 2HLs were calculated and discussed. Our study can be provided to construct various dimensional DNA nanostructures easily with high efficiency.

Aberrant glial activation and synaptic defects in CaMKIIα-iCre and nestin-Cre transgenic mouse models.

Current scientific research is driven by the ability to manipulate gene expression by utilizing the Cre/loxP system in transgenic mouse models. However, artifacts in Cre-driver mouse lines that introduce undesired effects and confound results are increasingly being reported. Here, we show aberrant neuroinflammation and synaptic changes in two widely used Cre-driver mouse models. Neuroinflammation in CaMKIIα-iCre mice was characterized by the activation and proliferation of microglia and astrocytes in synaptic layers of the hippocampus. Increased GFAP and Iba1 levels were observed in hippocampal brain regions of 4-, 8- and 22-month-old CaMKIIα-iCre mice compared to WT littermates. Synaptic changes in NMDAR, AMPAR, PSD95 and phosphorylated CaMKIIα became apparent in 8-month-old CaMKIIα-iCre mice but were not observed in 4-month-old CaMKIIα-iCre mice. Synaptophysin and synaptoporin were unchanged in CaMKIIα-iCre compared to WT mice, suggesting that synaptic alterations may occur in excitatory postsynaptic regions in which iCre is predominantly expressed. Finally, hippocampal volume was reduced in 22-month-old CaMKIIα-iCre mice compared to WT mice. We tested the brains of mice of additional common Cre-driver mouse models for neuroinflammation; the nestin-Cre mouse model showed synaptic changes and astrocytosis marked by increased GFAP+ astrocytes in cortical and hippocampal regions, while the original CaMKIIα-Cre T29-1 strain was comparable to WT mice. The mechanisms underlying abnormal neuroinflammation in nestin-Cre and CaMKIIα-iCre are unknown but may be associated with high levels of Cre expression. Our findings are critical to the scientific community and demonstrate that the correct Cre-driver controls must be included in all studies using these mice.

Visual outcomes of epiretinal membrane removal after diffractive-type multifocal intraocular lens implantation.

BACKGROUND: To assess visual outcomes of epiretinal membrane (ERM) removal in multifocal intraocular lens (MIOL)-implanted eyes, according to ERM stage. METHODS: Retrospective chart reviews were undertaken in patients with diffractive-type MIOL implants, each undergoing pars plana vitrectomy and ERM removal between February 2018 and November 2020 at Gyeongju St. Mary's Eye Clinic and KEYE Eye Center. Assessments focused on monocular uncorrected and corrected values of distant visual acuity (UDVA and CDVA) and uncorrected near visual acuity (UNVA) at postoperative 12 months according to the stage of ERM. RESULTS: The present study included a total of 49 MIOL-implanted eyes from 49 enrollees, 25 undergoing pars plana vitrectomy for ERM removal (11 eyes with Stage 2 and 14 eyes with Stage 3), and 24 acting as age-matched controls. There was a significant difference in UDVA and UNVA between control and Stage 3 ERM (UDVA; 0.01 ± 0.04 for control, and 0.07 ± 0.08 for stage 3 ERM, p = 0.035, UNVA; 0.03 ± 0.05 for control, and 0.13 ± 0.16 for Stage 3 ERM, p = 0.029). There were no significant differences in CDVA between groups (p = 0.121, ANOVA test). CONCLUSIONS: Eyes with Stage 3 ERM did not achieve visual acuity comparable to control eyes, suggesting the necessity of an early intervention for ERM in eyes with diffractive type MIOL. A meticulous preoperative retinal evaluation for ERM development is mandatory when planning diffractive-type MIOL implantation.

Analysis of uncorrected near visual acuity after extended depth-of-focus AcrySof® Vivity™ intraocular lens implantation.

A newly developed extended-depth-of-focus AcrySof® Vivity™ intraocular lens (IOL), which has a wavefront-shaped anterior surface, has shown a promising outcome in minimizing dysphotopsia, the biggest issue after diffractive type IOL implantation. On the contrary, relatively low uncorrected near visual acuity (UNVA) has been raised as a demerit of this IOL. However, there is only limited information about the UNVA after Vivity implantation. In the present study, we compared the uncorrected distant and intermediate visual acuity (UDVA and UIVA) and UNVA according to the range of refractive error (RE) from 91 eyes from 91 patients implanted with Vivity IOL. Then we assessed the biometric factors for their association with UNVA from 66 eyes with a RE within ± 0.25 D. The UDVA was worst in eyes with RE < -0.50 D (0.17 ± 0.21), which was significantly worse than in any other group (P < 0.001 for every analysis). The UIVA was worst in eyes with RE of 0.25 to 0.50 D (0.35 ± 0.07 D), which was significantly worse than in eyes with RE of -0.50 to -0.26 D (P = 0.020) and in eyes with RE of -0.25 to -0.01 D (P = 0.028). The UNVA was worst in eyes with RE of 0.25 to 0.50 D (0.40 ± 0.14 D), which was significantly worse than in eyes with RE of -0.50 to -0.26 D (P = 0.022), which suggests that the extent of monovision should be limited up to -0.50 diopter. On univariate analysis for UNVA in eyes with a RE within ± 0.25 D, the anterior chamber depth (R = 0.257; P = 0.037) and pupil size (R = 0.451; P < 0.001) had a statistically significant relation to UNVA, while multivariate analysis showed the pupil size (ß = 0.451; P < 0.001) as the sole indicator, suggesting eyes with a small pupil size might receive a UNVA benefit.