Abstract: Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. AMD most commonly affects older individuals and is characterized by irreversible degeneration of the retinal pigment epithelium and neurosensory retina. Currently, there are limited treatment options for dry AMD outside of lifestyle modification and nutrient supplementation. Risuteganib [Luminate (ALG-1001), Allegro Ophthalmics, CA, USA] is an intravitreally administered inhibitor of integrin heterodimers αVβ3, αVβ5, α5β1, and αMβ2. It is currently undergoing clinical trials for the treatment of dry AMD and diabetic macular edema (DME). Preclinical studies have shown that risuteganib has an effect on the pathways for angiogenesis, inflammation, and vascular permeability. Ongoing clinical trials have had promising results showing improvements in patient best corrected visual acuity (BCVA) and reduced central macular thickness measured by optical coherence tomography (OCT). There is a pressing need for treatments for dry AMD and while risuteganib appears to have a potential benefit for patients, more data are needed before one can truly evaluate its efficacy. This narrative review provides a concise summary of the most up to date data regarding the proposed mechanism of action of risuteganib in the treatment of nonexudative AMD and DME as well as the results from recent phase 1 and phase 2 clinical trials.

Abstract: Several factors drive the need for increased efficiency in telemedicine screening programs directed toward diabetic retinopathy: continually increasing prevalence of diabetes worldwide, growing awareness among physicians and patients of the importance of early detection of retinal damage, and emerging technology in artificial intelligence that enables rapid identification of vision-threatening fundus features. In this context, optimizing workflows in teleretinopathy programs becomes a priority. Recent work has revealed opportunities for improvement in areas of logistics, in particular in finding the best way to get diabetic patients in front of screening cameras as conveniently as possible, as this improves compliance and, ultimately, achieves the widest reach for detection programs. The present review discusses particular aspects of mobile screening programs in which specialized retinal cameras are deployed in a van or similar type of vehicle so that they can reach patients anywhere in order to reduce barriers to access. The rationale for implementing such programs and practical considerations are presented, along with a view toward future expansion of screening and integration with artificial intelligence platforms. Lacking standardization of format and quality control among smartphone-linked approaches at present, translation of eye clinic-based photographic techniques to community-based screening offers a means of expanding the scope of impactful screening programs without the need for adoption of significantly new technology.

Abstract: The objective of the paper is to provide a general view for automatic cup to disc ratio (CDR) assessment in fundus images. As for the cause of blindness, glaucoma ranks as the second in ocular diseases. Vision loss caused by glaucoma cannot be reversed, but the loss may be avoided if screened in the early stage of glaucoma. Thus, early screening of glaucoma is very requisite to preserve vision and maintain quality of life. Optic nerve head (ONH) assessment is a useful and practical technique among current glaucoma screening methods. Vertical CDR as one of the clinical indicators for ONH assessment, has been well-used by clinicians and professionals for the analysis and diagnosis of glaucoma. The key for automatic calculation of vertical CDR in fundus images is the segmentation of optic cup (OC) and optic disc (OD). We take a brief description of methodologies about the OC and disc optic segmentation and comprehensively presented these methods as two aspects: hand-craft feature and deep learning feature. Sliding window regression, super-pixel level, image reconstruction, super-pixel level low-rank representation (LRR), deep learning methodologies for segmentation of OD and OC have been shown. It is hoped that this paper can provide guidance and bring inspiration to other researchers. Every mentioned method has its advantages and limitations. Appropriate method should be selected or explored according to the actual situation. For automatic glaucoma screening, CDR is just the reflection for a small part of the disc, while utilizing comprehensive factors or multimodal images is the promising future direction to furthermore enhance the performance.

Abstract: The most prominent causes of loss of vision in individuals over 50 years include age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR). While it is important to screen for these diseases effectively, current eye care is not properly doing so for much of the population, resulting in unfortunate visual disability and high costs for patients. Innovative functional testing can be unified with other screening methods for a more robust and safer screening and prediction of disease. The goal in the creation of functional testing modalities is to develop highly sensitive screening tests that are easy to use, accessible to all users, and inexpensive. The tests herein are deployed on an iPad with easily understood and intuitive instructions for rapid, streamlined, and automatic administration. These testing modalities could become highly sensitive screenings for early detection of potentially blinding diseases. The applications from our collaborators at AMA Optics include a cone photostress recovery test for detection of AMD and diabetic macular edema (DME), brightness balance perception for optic nerve dysfunction and especially glaucoma, color vision testing which is a broad screening tool, and visual acuity test. Machine learning with the combined structural and functional data will optimize identification of disease and prediction of outcomes. Here, we review and assess various tests of visual function that are easily administered on a tablet for screening in primary care. These user-friendly and simple screening tests allow patients to be identified in the early stages of disease for referral to specialists, proper assessment and treatment.

Abstract: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and juvenile idiopathic associated uveitis (JIA-U) is the most frequently noted extra-articular manifestation. JIA-U can present asymptomatically and lead to ocular complications, so regular screening and monitoring are needed to prevent potentially sight-threatening sequelae. Topical glucocorticoids such as prednisolone acetate are usually the first line of treatment for anterior uveitis associated with JIA-U, but long-term use may be associated with cataract, ocular hypertension and glaucoma. Disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate allow tapering of the corticosteroids to prevent long-term complications. Biologic therapies have been increasingly used as targeted therapies for JIA-U, particularly monoclonal antibodies targeting the proinflammatory cytokine TNF-α such as adalimumab and infliximab. One recent, multicenter, prospective, randomized clinical trial provided evidence of the efficacy of adalimumab with methotrexate for JIA-U compared to methotrexate alone. Another clinical trial studying the interleukin-6 inhibitor tocilizumab for JIA-U showed promise in tapering topical corticosteroids. Additionally, JAK inhibitors are emerging biologic therapies for JIA-U in patients refractory to TNF-α inhibitors, with a clinical trial assessing the efficacy of baricitinib for JIA-U underway. While clinical trials on these novel biologics are limited, further investigation of these agents may provide additional therapeutic options for JIA-U.

Abstract: Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries. There are many categories of eyelid surgeries, the most common of which include blepharoplasty, ptosis surgery, and eyelid reconstruction. In many cases, these procedures are combined, and there are many different techniques for each type of operation. Upper eyelid blepharoplasty usually includes the excision of skin, preseptal orbicularis oculi muscle, and orbital fat. Common methods of lower eyelid blepharoplasty are the skin-muscle flap, the skin flap, and the transconjunctival. Ptosis surgery is mainly divided into three types: transcutaneous, transconjunctival, and sling surgery. Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction. Different types and methods of surgery have their own advantages and disadvantages, and postoperative complications may occur. Therefore, postoperative complications of eyelid surgeries, such as dry eye symptoms, should be taken into serious consideration. Relevant literature involving these complaints can be found in PubMed by searching the terms “dry eye”, “eyelid”, “surgery”, and other related keywords. Moreover, various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index (OSDI), tear film breakup time, Schirmer test, fluorescein staining, and lissamine green staining after various eyelid surgeries. As dry eye disease is prevalent in the general population, it is more urgent to figure out what we can learn from these complaints. Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.