Prediction of neovascular age-related macular degeneration recurrence using optical coherence tomography images with a deep neural network.

Neovascular age-related macular degeneration (nAMD) can result in blindness if left untreated, and patients often require repeated anti-vascular endothelial growth factor injections. Although, the treat-and-extend method is becoming popular to reduce vision loss attributed to recurrence, it may pose a risk of overtreatment. This study aimed to develop a deep learning model based on DenseNet201 to predict nAMD recurrence within 3 months after confirming dry-up 1 month following three loading injections in treatment-naïve patients. A dataset of 1076 spectral domain optical coherence tomography (OCT) images from 269 patients diagnosed with nAMD was used. The performance of the model was compared with that of 6 ophthalmologists, using 100 randomly selected samples. The DenseNet201-based model achieved 53.0% accuracy in predicting nAMD recurrence using a single pre-injection image and 60.2% accuracy after viewing all the images immediately after the 1st, 2nd, and 3rd injections. The model outperformed experienced ophthalmologists, with an average accuracy of 52.17% using a single pre-injection image and 53.3% after examining four images before and after three loading injections. In conclusion, the artificial intelligence model demonstrated a promising ability to predict nAMD recurrence using OCT images and outperformed experienced ophthalmologists. These findings suggest that deep learning models can assist in nAMD recurrence prediction, thus improving patient outcomes and optimizing treatment strategies.

Effect of Focal Laser Photocoagulation on the Ganglion Cell Complex Thickness in Acute Central Serous Chorioretinopathy.

This study investigated the changes in the ganglion cell complex (GCC) of patients with acute central serous chorioretinopathy (CSC) following focal laser photocoagulation (FLP) and sought to determine its correlation with visual acuity (VA). Our retrospective study was conducted on 30 patients diagnosed with acute CSC between January 2015 and April 2022, who underwent FLP within 3 months of symptom onset. The study assessed GCC changes by measuring the thickness of its inner retinal layers-retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) using optical coherence tomography (OCT). GCC thickness was compared between the affected and unaffected eyes and a healthy control group. VA was also assessed at baseline and at 1, 3, and 6 months post-treatment. VA showed significant improvement from 0.20 ± 0.14 at baseline to 0.10 ± 0.12 logMAR at 6 months post-treatment (p = 0.003). There was no significant change in GCC thickness over the 6-month period. No significant differences in GCC thickness were observed when comparing CSC eyes with fellow eyes or with normal controls at any time point. Final VA was significantly related only to baseline VA, with no correlation found with other factors, including RNFL, GCL, and IPL thickness. In summary, for patients with acute CSC undergoing FLP, our findings indicate that there is no significant change in GCC thickness detectable by OCT before and after the resolution of subretinal fluid (SRF), despite improvements in VA post-laser treatment. This suggests that any potential impact of FLP on GCC thickness may be minimal and not discernible with the current measurement methods, such as OCT, emphasizing that VA improvements may be primarily associated with alterations in the outer retina rather than the inner retina. Further studies with extended follow-up durations are warranted to evaluate any potential long-term changes in GCC.

Longitudinal changes in the ganglion cell complex thickness in acute central serous chorioretinopathy using spectral-domain optical coherence tomography.

In this retrospective longitudinal cohort study, we investigated the temporal changes in the peripapillary retinal nerve fiber layer (pRNFL) and inner retinal thickness in patients with acute central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (SD-OCT). We followed up with these patients for 6 months, and during this period, the thickness of the pRNFL and the ganglion cell complex (GCC) in CSC patients were compared with the eyes of normal healthy individuals. The study also examined the correlation between the pRNFL thickness, GCC thickness, and visual acuity. The research sample consisted of 67 patients (43 male and 24 female) with an average age of 49.72 ± 9.87 years. The initial findings showed no significant differences in the pRNFL and GCC thickness between the study and fellow eye, study and normal healthy eyes, and fellow and normal healthy eyes. There was no significant difference in the pRNFL and GCC thickness when comparing the study eye with the fellow eye for 6 months. In the study eye, no significant difference was observed when comparing the initial GCC and pRNFL thickness with those at 1, 3, and 6 months. Visual acuity improved significantly from 0.18 ± 0.23 logMAR to 0.04 ± 0.06 logMAR (p < 0.001). The GCC and pRNFL thickness did not significantly affect visual acuity. In conclusion, acute CSC patients did not show significant changes in the pRNFL and inner retinal thickness, suggesting that the GCC and pRNFL do not substantially influence the short-term visual prognosis in these patients.

Anesthesia Choice and Its Potential Impact on Endoluminal Functional Lumen Imaging Probe Measurements in Esophageal Motility Disorders.

BACKGROUND AND AIMS: The widespread use of peroral endoscopic myotomy (POEM) has revolutionized the management of esophageal motility disorders (EMDs). The introduction of an endoluminal functional lumen imaging probe (EndoFLIP) can serve as a complimentary diagnostic tool to assess the mechanical properties (i.e., pressure, diameter, distensibility and topography) of the esophagus. During EndoFLIP measurements, different anesthesia techniques may induce variable degrees of neuromuscular blockade, potentially affecting esophageal motility and altering the results of EndoFLIP metrics. Our study aimed to compare the impact of using total intravenous anesthesia (TIVA) versus general anesthesia with inhalational anesthetics (GAIA) on diagnostic EndoFLIP measurements. METHODS: We conducted a retrospective study of all adult patients (≥18 years) undergoing EndoFlip during the POEM procedure at our institution between February 2017 and February 2022. We obtained the differences in pressure, diameter, and distensibility index using propofol-based TIVA vs sevoflurane-based GAIA with a 30ml and 60ml balloon. The differences were divided into terciles and compared between diagnoses using univariate comparisons and logistic regression models. RESULTS: 49 patients were included (39% Type 1 achalasia, 43% Type 2 or 3 achalasia, and 18% jackhammer esophagus (JE)). Compared to spastic disorders (Type 2, 3 and JE), Type 1 had lower values of pressure differences at 60 mL in univariate (3.75 vs 15.20 p=0.001) and multivariate (aOR 0.89 95%CI 0.82-0.978) analyses. Compared to Type 1, Type 2 and 3 had higher rates of pressure differences at 60 mL in univariate (9.85 vs 3.75 p=0.04); and nearly reached significance in multivariate analysis (1.09 95%CI 1-1.20). Compared to Type 1, JE demonstrated higher values in pressure differences at 60 mL (27.7 vs 3.75 p<0.001) CONCLUSION: Esophageal pressure, as measured by EndoFLIP, was significantly reduced when patients were sedated with sevoflurane-based GAIA. The use sevoflurane-based GAIA for diagnostic EndoFLIP may potentially lead to the misclassification of spastic disorders as Type I achalasia. Therefore, propofol-based TIVA should be considered over sevoflurane-based GAIA for sedation during the diagnostic test.

Loss of Consciousness in a 34 Yo Male Related to Marijuana.

Nontraumatic exertional syncope can be an ominous event reflecting profound arterial hypotension, cerebral hypoperfusion, and transient loss-of consciousness that occurs most commonly in patients with underlying cardiovascular disease. In contradistinction, transient loss-of-consciousness in "healthy adults" is typically vasovagal syncope related to exaggerated orthostatic cardiovascular responses attributed to a hyper-reactive autonomic nervous system. In the present report, a 34 yo male presents to the hospital emergency department (ED) for a sudden loss of consciousness and fall ultimately related to cardiac syncope ascribed to chronic recreational marijuana use complicated by coronary vasospasm.

Developing and Evaluating an AI-Based Computer-Aided Diagnosis System for Retinal Disease: Diagnostic Study for Central Serous Chorioretinopathy.

BACKGROUND: Although previous research has made substantial progress in developing high-performance artificial intelligence (AI)-based computer-aided diagnosis (AI-CAD) systems in various medical domains, little attention has been paid to developing and evaluating AI-CAD system in ophthalmology, particularly for diagnosing retinal diseases using optical coherence tomography (OCT) images. OBJECTIVE: This diagnostic study aimed to determine the usefulness of a proposed AI-CAD system in assisting ophthalmologists with the diagnosis of central serous chorioretinopathy (CSC), which is known to be difficult to diagnose, using OCT images. METHODS: For the training and evaluation of the proposed deep learning model, 1693 OCT images were collected and annotated. The data set included 929 and 764 cases of acute and chronic CSC, respectively. In total, 66 ophthalmologists (2 groups: 36 retina and 30 nonretina specialists) participated in the observer performance test. To evaluate the deep learning algorithm used in the proposed AI-CAD system, the training, validation, and test sets were split in an 8:1:1 ratio. Further, 100 randomly sampled OCT images from the test set were used for the observer performance test, and the participants were instructed to select a CSC subtype for each of these images. Each image was provided under different conditions: (1) without AI assistance, (2) with AI assistance with a probability score, and (3) with AI assistance with a probability score and visual evidence heatmap. The sensitivity, specificity, and area under the receiver operating characteristic curve were used to measure the diagnostic performance of the model and ophthalmologists. RESULTS: The proposed system achieved a high detection performance (99% of the area under the curve) for CSC, outperforming the 66 ophthalmologists who participated in the observer performance test. In both groups, ophthalmologists with the support of AI assistance with a probability score and visual evidence heatmap achieved the highest mean diagnostic performance compared with that of those subjected to other conditions (without AI assistance or with AI assistance with a probability score). Nonretina specialists achieved expert-level diagnostic performance with the support of the proposed AI-CAD system. CONCLUSIONS: Our proposed AI-CAD system improved the diagnosis of CSC by ophthalmologists, which may support decision-making regarding retinal disease detection and alleviate the workload of ophthalmologists.

Long-Term Changes in Retinal Nerve Fiber Layer Thickness after Vitrectomy for Epiretinal Membrane Using Optical Coherence Tomography Images.

This study investigated the long-term effects of epiretinal membrane (ERM) surgery on peripapillary retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) images. We included 30 patients with idiopathic ERM who underwent a vitrectomy for ERM removal with internal limiting membrane peeling. The patients were followed up for 5 years after surgery, and their medical records were reviewed for best-corrected visual acuity (BCVA) and OCT parameters. The study population comprised 24 females (80.0%), and the mean age was 65.4 ± 7.2 years. The baseline BCVA significantly improved from 0.28 ± 0.24 to 0.12 ± 0.09 logMAR (p < 0.001) 1 year after surgery and continued to improve for 5 years after surgery. The peripapillary RNFL thickness initially increased after surgery and then gradually decreased. The peripapillary RNFL thicknesses of the global and temporal sectors showed significant reductions 2 years after surgery, whereas those of the nasal sectors did not significantly change. The peripapillary RNFL thickness was thinner in the global and temporal areas of the operated eyes than in those of the fellow eyes 4 and 5 years after surgery. In conclusion, peripapillary RNFL thicknesses decreased in the global and temporal areas after ERM surgery, whereas peripapillary RNFL thicknesses in the nasal sectors did not change significantly during the long-term follow-up.

Prediction of Visual Acuity in Pathologic Myopia with Myopic Choroidal Neovascularization Treated with Anti-Vascular Endothelial Growth Factor Using a Deep Neural Network Based on Optical Coherence Tomography Images.

Myopic choroidal neovascularization (mCNV) is a common cause of vision loss in patients with pathological myopia. However, predicting the visual prognosis of patients with mCNV remains challenging. This study aimed to develop an artificial intelligence (AI) model to predict visual acuity (VA) in patients with mCNV. This study included 279 patients with mCNV at baseline; patient data were collected, including optical coherence tomography (OCT) images, VA, and demographic information. Two models were developed: one comprising horizontal/vertical OCT images (H/V cuts) and the second comprising 25 volume scan images. The coefficient of determination (R2) and root mean square error (RMSE) were computed to evaluate the performance of the trained network. The models achieved high performance in predicting VA after 1 (R2 = 0.911, RMSE = 0.151), 2 (R2 = 0.894, RMSE = 0.254), and 3 (R2 = 0.891, RMSE = 0.227) years. Using multiple-volume scanning, OCT images enhanced the performance of the models relative to using only H/V cuts. This study proposes AI models to predict VA in patients with mCNV. The models achieved high performance by incorporating the baseline VA, OCT images, and post-injection data. This model could assist in predicting the visual prognosis and evaluating treatment outcomes in patients with mCNV undergoing intravitreal anti-vascular endothelial growth factor therapy.

IL-11 induces NLRP3 inflammasome activation in monocytes and inflammatory cell migration to the central nervous system.

The objective of this study is to examine IL-11-induced mechanisms of inflammatory cell migration to the central nervous system (CNS). We report that IL-11 is produced at highest frequency by myeloid cells among the peripheral blood mononuclear cell (PBMC) subsets. Patients with relapsing-remitting multiple sclerosis (RRMS) have an increased frequency of IL-11+ monocytes, IL-11+ and IL-11R+ CD4+ lymphocytes, and IL-11R+ neutrophils in comparison to matched healthy controls. IL-11+ and granulocyte-macrophage colony-stimulating factor (GM-CSF)+ monocytes, CD4+ lymphocytes, and neutrophils accumulate in the cerebrospinal fluid (CSF). The effect of IL-11 in-vitro stimulation, examined using single-cell RNA sequencing, revealed the highest number of differentially expressed genes in classical monocytes, including up-regulated NFKB1, NLRP3, and IL1B. All CD4+ cell subsets had increased expression of S100A8/9 alarmin genes involved in NLRP3 inflammasome activation. In IL-11R+-sorted cells from the CSF, classical and intermediate monocytes significantly up-regulated the expression of multiple NLRP3 inflammasome-related genes, including complement, IL18, and migratory genes (VEGFA/B) in comparison to blood-derived cells. Therapeutic targeting of this pathway with αIL-11 mAb in mice with RR experimental autoimmune encephalomyelitis (EAE) decreased clinical scores, CNS inflammatory infiltrates, and demyelination. αIL-11 mAb treatment decreased the numbers of NFκBp65+, NLRP3+, and IL-1ß+ monocytes in the CNS of mice with EAE. The results suggest that IL-11/IL-11R signaling in monocytes represents a therapeutic target in RRMS.

Assessing the effectiveness of portable HEPA air cleaners for reducing particulate matter exposure in King County, Washington homeless shelters: Implications for community congregate settings.

Over four thousand portable air cleaners (PACs) with high-efficiency particulate air (HEPA) filters were distributed by Public Health - Seattle & King County to homeless shelters during the COVID-19 pandemic. This study aimed to evaluate the real-world effectiveness of these HEPA PACs in reducing indoor particles and understand the factors that affect their use in homeless shelters. Four rooms across three homeless shelters with varying geographic locations and operating conditions were enrolled in this study. At each shelter, multiple PACs were deployed based on the room volume and PAC's clean air delivery rate rating. The energy consumption of these PACs was measured using energy data loggers at 1-min intervals to allow tracking of their use and fan speed for three two-week sampling rounds, separated by single-week gaps, between February and April 2022. Total optical particle number concentration (OPNC) was measured at 2-min intervals at multiple indoor locations and an outdoor ambient location. The empirical indoor and outdoor total OPNC were compared for each site. Additionally, linear mixed-effects regression models (LMERs) were used to assess the relationship between PAC use time and indoor/outdoor total OPNC ratios (I/OOPNC). Based on the LMER models, a 10 % increase in the hourly, daily, and total time PACs were used significantly reduced I/OOPNC by 0.034 [95 % CI: 0.028, 0.040; p < 0.001], 0.051 [95 % CI: 0.020, 0.078; p < 0.001], and 0.252 [95 % CI: 0.150, 0.328; p < 0.001], respectively, indicating that keeping PACs on resulted in significantly lower I/OOPNC. The survey suggested that keeping PACs on and running was the main challenge when operating them in shelters. These findings suggested that HEPA PACs were an effective short-term strategy to reduce indoor particle levels in community congregate living settings during non-wildfire seasons and the need for formulating practical guidance for using them in such an environment.

Short-term effect of intravitreal brolucizumab injections in patients with neovascular age-related macular degeneration on retinal nerve fiber layer thickness.

This study reported the short-term effects of intravitreal brolucizumab (IVB) on peripapillary retinal nerve fiber layer (RNFL) thickness in patients with neovascular age-related macular degeneration (nAMD). This retrospective observational case series included patients with nAMD treated with other anti-vascular endothelial growth factor (anti-VEGF) agents and subsequently switched to IVB because of poor response to those other agents on spectral domain optical coherence tomography (SD-OCT). Best-corrected visual acuity (BCVA), intraocular pressure, funduscopy, and SD-OCT were assessed at baseline, 2 weeks, 1 month, and 3 months after injection. Twenty-two patients were included in the study. In the IVB group, BCVA significantly improved 3 months after injection compared with baseline (0.45 ± 0.25 vs. 0.38 ± 0.25, p = 0.012). During the 3-month follow-up, compared with baseline, RNFL thicknesses of the global, superior temporal, inferior temporal, inferior nasal, nasal, and superior nasal sectors did not change substantially in the IVB group. However, temporal RNFL thickness significantly decreased at 1 month (p = 0.045), and the significance was lost at 3 months (p = 0.378). The central macular thickness of treated eyes significantly decreased compared with the baseline at every follow-up visit. IVB in patients with nAMD had morphological and functional visual gain effects without RNFL thinning during the short-term follow-up.

Severe Adverse Events of Periocular Acupuncture: A Review of Cases.

Acupuncture is recognized as a component of alternative medicine and is increasingly used worldwide. Many studies have shown the various effects of acupuncture around the eyes for ophthalmologic or nonophthalmologic conditions. For ophthalmologic conditions, the effect of acupuncture on dry eye syndrome, glaucoma, myopia, amblyopia, ophthalmoplegia, allergic rhinoconjunctivitis, blepharospasm, and blepharoptosis has been reported. Recently, several studies on dry eye syndrome have been reported and are in the spotlight. However, given the variety of study designs and reported outcomes of periocular acupuncture, research is still inconclusive, and further studies are required. In addition, although a systematic and reliable safety assessment is required, to the best of our knowledge, there have been no reports of a literature review of ocular complications resulting from periocular acupuncture. This review collected cases of ocular injury as severe adverse events from previously published case reports of periocular acupuncture. A total of 14 case reports (15 eyes of 14 patients) of adverse events published between 1982 and 2020 were identified. This review article provides a summary of the reported cases and suggestions for the prevention and management of better visual function prognosis.

Long-term changes in the choroidal thickness in patients with unilateral central retinal vein occlusion.

The purpose of this study was to investigate the long-term changes in the choroidal thickness in central retinal vein occlusion (CRVO) following anti-vascular endothelial growth factor (VEGF) treatment. This retrospective study included 41 eyes from 41 patients with treatment-naïve unilateral CRVO. We compared the best-corrected visual acuity (BCVA), subfoveal choroidal thickness (SFCT), and central macular thickness (CMT) of CRVO eyes with those of fellow eyes at baseline, 12 months, and 24 months. Baseline SFCT was significantly higher in CRVO eyes than in fellow eyes (p < 0.001); however, there was no significant difference in the SFCT between CRVO eyes and fellow eyes at 12 months and 24 months. When compared with baseline SFCT, SFCT significantly decreased at 12 months and 24 months in CRVO eyes (all p < 0.001). In patients with unilateral CRVO, SFCT in the CRVO eye was significantly thicker than in the fellow eye at baseline, and after 12 months and 24 months, there was no difference from the fellow eye.

Sustained alternate-day fasting potentiates doxorubicin cardiotoxicity.

Fasting strategies are under active clinical investigation in patients receiving chemotherapy. Prior murine studies suggest that alternate-day fasting may attenuate doxorubicin cardiotoxicity and stimulate nuclear translocation of transcription factor EB (TFEB), a master regulator of autophagy and lysosomal biogenesis. In this study, human heart tissue from patients with doxorubicin-induced heart failure demonstrated increased nuclear TFEB protein. In mice treated with doxorubicin, alternate-day fasting or viral TFEB transduction increased mortality and impaired cardiac function. Mice randomized to alternate-day fasting plus doxorubicin exhibited increased TFEB nuclear translocation in the myocardium. When combined with doxorubicin, cardiomyocyte-specific TFEB overexpression provoked cardiac remodeling, while systemic TFEB overexpression increased growth differentiation factor 15 (GDF15) and caused heart failure and death. Cardiomyocyte TFEB knockout attenuated doxorubicin cardiotoxicity, while recombinant GDF15 was sufficient to cause cardiac atrophy. Our studies identify that both sustained alternate-day fasting and a TFEB/GDF15 pathway exacerbate doxorubicin cardiotoxicity.

Incidence of Retinal Artery Occlusion and Related Mortality in Korea, 2005 to 2018.

Importance: It remains unclear whether comorbidities in patients with retinal artery occlusion (RAO), a rare retinal vascular disorder, differ by subtype and whether mortality is higher. Objective: To examine the nationwide incidence of clinically diagnosed, nonarteritic RAO, causes of death, and mortality rate in patients with RAO compared with that in the general population in Korea. Design, Setting, and Participants: This retrospective, population-based cohort study examined National Health Insurance Service claims data from 2002 to 2018. The population of South Korea was 49 705 663, according to the 2015 census. Data were analyzed from February 9, 2021, to July 30, 2022. Main Outcomes and Measures: The nationwide incidence of any RAO, including central RAO (CRAO; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code, H34.1) and noncentral RAO (other RAO; ICD-10 code, H34.2) was estimated using National Health Insurance Service claims data from 2002 to 2018, with 2002 to 2004 as the washout period. Furthermore, the causes of death were evaluated and the standardized mortality ratio was estimated. The primary outcomes were the incidence of RAO per 100 000 person-years and the standardized mortality ratio (SMR). Results: A total of 51 326 patients with RAO were identified (28 857 [56.2%] men; mean [SD] age at index date: 63.6 [14.1] years). The nationwide incidence of any RAO was 7.38 (95% CI, 7.32-7.44) per 100 000 person-years. The incidence rate of noncentral RAO was 5.12 (95% CI, 5.07-5.18), more than twice that of CRAO (2.25 [95% CI, 2.22-2.29]). Mortality was higher in patients with any RAO than in the general population (SMR, 7.33 [95% CI, 7.15-7.50]). The SMR for CRAO (9.95 [95% CI, 9.61-10.29]) and for noncentral RAO (5.97 [95% CI, 5.78-6.16]) showed a tendency toward a gradual decrease with increasing age. The top 3 causes of death in patients with RAO were diseases of the circulatory system (28.8%), neoplasms (25.1%), and diseases of the respiratory system (10.2%). Conclusions and Relevance: This cohort study found that the incidence rate of noncentral RAO was higher than that of CRAO, whereas SMR was higher for CRAO than noncentral RAO. Patients with RAO show higher mortality than the general population, with circulatory system disease as the leading cause of death. These findings suggest that it is necessary to investigate the risk of cardiovascular or cerebrovascular disease in patients newly diagnosed with RAO.

Detecting Macular Disease Based on Optical Coherence Tomography Using a Deep Convolutional Network.

Neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC) are two of the most common macular diseases. This study proposes a convolutional neural network (CNN)-based deep learning model for classifying the subtypes of nAMD (polypoidal choroidal vasculopathy, retinal angiomatous proliferation, and typical nAMD) and CSC (chronic CSC and acute CSC) and healthy individuals using single spectral-domain optical coherence tomography (SD-OCT) images. The proposed model was trained and tested using 6063 SD-OCT images from 521 patients and 47 healthy participants. We used three well-known CNN architectures (VGG-16, VGG-19, and ResNet) and two customized classification layers. Additionally, transfer learning and mix-up-based data augmentation were applied to improve robustness and accuracy. Our model demonstrated high accuracies of 99.7% and 91.1% in the nAMD and CSC classification and retinopathy (nAMD and CSC) subtype classification, including normal participants, respectively. Furthermore, we performed an external test to compare the classification accuracy with that of eight ophthalmologists, and our model showed the highest accuracy. The region determined to be important for classification by the model was confirmed using gradient-weighted class activation mapping. The model's clinical criteria were similar to that of the ophthalmologists.

Longitudinal Change of Choroidal Thickness after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane.

This study aimed to investigate changes in choroidal thickness after pars plana vitrectomy (PPV) with and without air tamponade in patients with idiopathic epiretinal membrane (ERM). We retrospectively reviewed 61 patients with ERM who underwent a 25-gauge transconjunctival sutureless PPV. The patients were divided into two groups: the air tamponade group (30 eyes) and the nontamponade group (31 eyes). Subfoveal choroidal thickness (SFCT) was analyzed over 12 months. No significant differences were seen between the two groups at baseline. For all patients, the SFCT was significantly thicker at 1 month after surgery and significantly thinner at 6 and 12 months after surgery than preoperative values. In the subgroup analysis, there was no significant difference in SFCT 3 months after surgery compared with the preoperative values in both groups, but SFCT was significantly lower 6 months after surgery in both groups. In conclusion, our results showed that choroidal thickness temporarily increased after surgery and then gradually decreased until 12 months after the PPV for ERM.

Reproducibility efforts as a teaching tool: A pilot study.

The "replication crisis" is a methodological problem in which many scientific research findings have been difficult or impossible to replicate. Because the reproducibility of empirical results is an essential aspect of the scientific method, such failures endanger the credibility of theories based on them and possibly significant portions of scientific knowledge. An instance of the replication crisis, analytic replication, pertains to reproducing published results through computational reanalysis of the authors' original data. However, direct replications are costly, time-consuming, and unrewarded in today's publishing standards. We propose that bioinformatics and computational biology students replicate recent discoveries as part of their curriculum. Considering the above, we performed a pilot study in one of the graduate-level courses we developed and taught at our University. The course is entitled Intro to R Programming and is meant for students in our Master's and PhD programs who have little to no programming skills. As the course emphasized real-world data analysis, we thought it would be an appropriate setting to carry out this study. The primary objective was to expose the students to real biological data analysis problems. These include locating and downloading the needed datasets, understanding any underlying conventions and annotations, understanding the analytical methods, and regenerating multiple graphs from their assigned article. The secondary goal was to determine whether the assigned articles contained sufficient information for a graduate-level student to replicate its figures. Overall, the students successfully reproduced 39% of the figures. The main obstacles were the need for more advanced programming skills and the incomplete documentation of the applied methods. Students were engaged, enthusiastic, and focused throughout the semester. We believe that this teaching approach will allow students to make fundamental scientific contributions under appropriate supervision. It will teach them about the scientific process, the importance of reporting standards, and the importance of openness.

The effect of intravitreal brolucizumab on choroidal thickness in patients with neovascular age-related macular degeneration.

In this study we evaluated the effect of intravitreal brolucizumab injections on choroidal thickness in patients with neovascular age-related macular degeneration (nAMD) who previously showed an incomplete response to anti-vascular endothelial growth factor treatment. A total of thirty-four eyes from 34 patients were included in this study. The patients received an average of 2.4 ± 1.1 brolucizumab injections with the mean follow-up period of 4.9 ± 2.0 months. After their first brolucizumab treatment, the central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were significantly decreased from 431.6 ± 190.0 µm and 193.9 ± 75.1 µm to 274.6 ± 109.4 µm (P < 0.001) and 169.4 ± 71.1 µm (P < 0.001), respectively. However, there were no improvements in visual acuity. Patients were divided into three subgroups according to the number of brolucizumab treatments: one, two, and three or more injections. In all three subgroups, the CFT and SFCT were significantly reduced compared to baseline at all time points of brolucizumab injections. In conclusion, choroidal thickness was significantly reduced after intravitreal brolucizumab injections as a switching treatment in patients with nAMD.