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Negative dysphotopsia (ND) refers to the subjective perception of an arc-shaped darkness or shadow in the temporal field of vision. This condition occurs after uneventful cataract surgery with an in-the-bag intraocular lens (IOL). To address this issue, supplementary implantation of conventional three-piece IOLs in the sulcus or dedicated supplementary Rayner Sulcoflex® IOL have been used successfully. The aim of this retrospective case series was to assess the effectiveness of resolving ND using a supplementary 1stQ AddOn® (Medicontur) IOL. The 1stQ AddOn® has a different design and optic size compared to the Rayner Sulcoflex®. Patients experiencing severe and persistent ND underwent supplementary implantation of the 1stQ AddOn® IOL. The primary outcome measure was the resolution of dysphotopsia. Nine eyes received the 1stQ AddOn® IOL, with complete symptom resolution observed in 6 eyes, partial improvement in 1 eye, and no change in 2 eyes. This indicates that supplementary implantation of the 1stQ AddOn® IOL can effectively and safely treat ND, performing equally well as the Rayner Sulcoflex®. The positive impact of sulcus-fixated supplementary IOLs seems to be related to the interaction between the central optic and the pupil margin.

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Extracellular RNAs present in biofluids have emerged as potential biomarkers for disease. Where most studies focus on blood-derived fluids, other biofluids may be more informative. We present an atlas of messenger, circular, and small RNA transcriptomes of a comprehensive collection of 20 human biofluids. By means of synthetic spike-in controls, we compare RNA content across biofluids, revealing a 10,000-fold difference in concentration. The circular RNA fraction is increased in most biofluids compared to tissues. Each biofluid transcriptome is enriched for RNA molecules derived from specific tissues and cell types. Our atlas enables an informed selection of the most relevant biofluid to monitor particular diseases. To verify the biomarker potential in these biofluids, four validation cohorts representing a broad spectrum of diseases were profiled, revealing numerous differential RNAs between case and control subjects. Spike-normalized data are publicly available in the R2 web portal for further exploration.

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PURPOSE: To describe the structural and functional characteristics of oxalate retinopathy. METHODS: Five patients with molecularly confirmed primary hyperoxaluria (PH) Type 1 underwent multimodal retinal imaging (spectral-domain optical coherence tomography, white light, and HRA multispectral imaging) and functional testing, including color vision testing, Goldmann perimetry, and International Society for Clinical Electrophysiology of Vision standard electrophysiological testing. RESULTS: Four distinct retinal phenotypes are presented. One patient with a c.[33dupC]; c.[731T>C] mutation showed bilateral perifoveal retinal pigment epithelium hyperplasia. The fundus in the four other patients, all of whom share an identical homozygous c.[33dupC] mutation, ranged from normal to bilateral widespread distribution of retinal crystals and confluent macular retinal pigment epithelium hyperplasia with subfoveal fibrosis. All patients who had developed end-stage renal disease showed some sign of retinopathy, more severe with earlier onset. CONCLUSION: Retinopathy in PH Type 1 shows considerable interindividual variation. No correlation between genotype and retinal phenotype was detected. Oxalate crystals at the level of the retinal pigment epithelium seem to be irreversible. A proposed clinical grading system of oxalate maculopathy, based on a literature review, may provide clinicians with a tool to better predict visual function and prognosis.

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PURPOSE: Rubella virus (RV) has a central role in the etiopathogenesis of Fuchs' uveitis syndrome (FUS). We aim to offer new insights by comprehensive analysis of recent laboratory and epidemiologic data. METHODS: We conducted a literature search for laboratory data and papers on etiopathogenesis. RESULTS: Aqueous humour samples of FUS patients show immunoreactivity to RV, in a specific and sensitive manner. Identification of RV genome confirm intraocular infection in a subset of FUS patients. Epidemiologic findings further support causality. The clinical spectrum of RV-associated uveitis is similar but not identical to FUS. FUS eyes exhibit a predominance of CD8 + T cells, high IFN-? and IL-10 levels. CONCLUSIONS: RV is the leading cause of FUS. Cytokine-based findings mirror a viral etiology and chronic low-grade inflammation. RV-associated FUS represents a common pathway of intraocular RV inoculation after congenital or acquired infection. Other causes, including HSV and CMV, may lead to FUS.

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HYPOTHESIS: The tuberosities of the proximal humerus relate geometrically to the humeral head in an anteroposterior symmetry. MATERIAL AND METHODS: Twenty-eight cadaveric shoulders were scanned with computed tomography and reconstructed digitally in 3 dimensions. On both tuberosities, 5 facets were identified. An orthogonal planar system using the center of the humeral head as its origin was created to calculate the coordinates of the centre of each facet. The angular position of the center of each facet was measured with reference to the sagittal plane. The inclination of each facet was measured to the axial plane. RESULTS: The presence of 5 distinct facets with a different inclination was confirmed (lesser tuberosity: inferior facet: 77.8° [sd 7.8°]; superior facet: 50.3° [sd 9.3°] - greater tuberosity: superior facet: 20.4° (sd 5.6°); middle facet: 48.6° (sd 5.2°); inferior facet: 92.7° [sd 7.7°]). The angular position of the centers of the facets was less variable (lesser tuberosity: inferior facet: 22.6° [sd 4.3°]; superior facet: 39.2° [sd 4.4°] - greater tuberosity: superior facet: 89.9° [sd 5.9°]; middle facet: 131.6° [sd 6.1°]; inferior facet: 155.1° [sd 6.8°]). CONCLUSION: Our study contributes to the knowledge of the anatomy of the proximal humerus, more specifically of the position of the rotator cuff insertion in relation to the humeral head. These insights are useful in the development of shoulder trauma prostheses.

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