Institut de Recherche en Opthalmologie

HighlightsWhat are the main findings?Modern high-resolution anterior segment tomographers are capable of extracting surface height data from the corneal front and back surfaces and from the epithelium–stroma interface.The higher refractive index of the corneal epithelium suggests that the cornea should be considered as a dual-layer structure to account for potential inhomogeneity in the epithelial thickness.What is the implication of the main finding?Model surfaces, such as floating best-fit spheres or conoids, could be fitted to the height map data within a specific region of interest to determine relevant surface characteristics such as curvatures, asphericities, and apex positions.Based on a dataset with bilateral repeat measurements in a cataractous population, we were able to confirm that the extracted surface characteristics seem to be very robust. However, surface asphericity should be extracted from a larger region of interest to ensure more robust data.We investigated the repeatability of the MS-39 in determining power vector components—the spherical equivalent (SEQ) and astigmatic powers (C0 and C45) and asphericity (Q)—of corneal epithelium, stroma, and endothelium in a large patient cohort. In this retrospective cross-sectional single-centre study, we evaluated a dataset containing 600 MS-39 anterior segment tomography measurements from 200 eyes (three repeat measurements each) taken prior to cataract surgery. The exported measurements included height map data for the epithelium, stroma, and endothelium surface. Model surfaces (spherocylinder (SphCyl), cylindrical conoid (CylConoid), and biconic (Biconic), all in the 3/6 mm zone) were fitted using nonlinear iterative optimisation, minimising the height difference between the measurement and model. The mean (MEAN) and standard deviation (SD) for each sequence of measurements were derived and analysed. In the 3 mm and 6 mm zone, the MEAN SEQ was 53.47/53.56/53.57 and 53.21/53.54/53.54 D for SphCyl/CylConoid/Biconic for the epithelium, −4.47/−4.51/−4.51 and −4.45/−4.50/−4.50 D for the stroma, and −6.23/−6.26/−6.26 and −6.18/−6.29/−6.30 D for the endothelium. With the three surface models and the 3/6 mm zone, the SD for SEQ/C0/C45 was in the range of 0.04 to 0.11/0.05 to 0.13/0.04 to 0.11 D for epithelium; 0.01 to 0.02/0.01 to 0.05/0.01 to 0.06 D for stroma; and 0.01 to 0.02/0.02 to 0.07/0.03 to 0.07 D for endothelium. Fitting floating model surfaces with astigmatism to map data of the corneal epithelium, stroma, and endothelium seems to be a robust and reliable method for extracting equivalent power and astigmatism using all the datapoints within a region of interest.

As Federated Learning (FL) expands, the challenge of non-independent and identically distributed (non-IID) data becomes critical. Clustered Federated Learning (CFL) addresses this by training multiple specialized models, each representing a group of clients with similar data distributions. However, the term ''CFL'' has increasingly been applied to operational strategies unrelated to data heterogeneity, creating significant ambiguity. This survey provides a systematic review of the CFL literature and introduces a principled taxonomy that classifies algorithms into Server-side, Client-side, and Metadata-based approaches. Our analysis reveals a distinct dichotomy: while theoretical research prioritizes privacy-preserving Server/Client-side methods, real-world applications in IoT, Mobility, and Energy overwhelmingly favor Metadata-based efficiency. Furthermore, we explicitly distinguish ''Core CFL'' (grouping clients for non-IID data) from ''Clustered X FL'' (operational variants for system heterogeneity). Finally, we outline lessons learned and future directions to bridge the gap between theoretical privacy and practical efficiency.

Information about corneal biomechanics is crucial for achieving satisfactory outcomes after surgical corneal interventions, e.g., for astigmatic keratotomies, but also to identify corneas that are at risk for postoperative complications such as corneal ectasia. Hitherto, approaches to characterize corneal biomechanics in an in vivo setting have yielded only minor success, demonstrating the unmet medical need for a diagnostic technique to measure ocular biomechanics. This review shall explain the mechanism of Brillouin spectroscopy and summarize the current scientific knowledge for ocular tissue. PubMed research of relevant experimental and clinical publications, as well as reporting of own experience using Brillouin spectroscopy. Brillouin spectroscopy can measure different biomechanical moduli with a high spatial resolution. Currently, available devices are able to detect focal corneal weakening, e.g., in keratoconus, as well as stiffening after corneal cross-linking. Also, the mechanical properties of the crystalline can be measured. Corneal anisotropy and hydration, together with the dependence on the angle of the incident laser beam in Brillouin spectroscopy, are challenges in the precise interpretation of measured data. A clear advantage in the detection of subclinical keratoconus compared to corneal tomography, however, has not been shown yet. Brillouin spectroscopy is a technique to characterize biomechanical properties of ocular tissue in vivo. Published results confirm ex vivo data of ocular biomechanics; however, further improvements in the acquisition and interpretation of measured data are required until this technique can be used in a clinically viable setting.

The purpose of this Monte-Carlo study is to investigate the effect of using a thick lens model instead of a thin lens model for the intraocular lens (IOL) on the resulting refraction at the spectacle plane and on the ocular magnification based on a large clinical data set. A pseudophakic model eye with a thin spectacle correction, a thick cornea (curvatures for both surfaces and central thickness) and a thick IOL (equivalent power PL derived from a thin lens IOL, Coddington factor CL (uniformly distributed from -1.0 to 1.0), either preset central thickness LT = 0.9 mm (A) or optic edge thickness ET = 0.2 mm, (B)) was set up. Calculations were performed on a clinical data set containing 21 108 biometric measurements of a cataractous population based on linear Gaussian optics to derive spectacle refraction and ocular magnification using the thin and thick lens IOL models. A prediction model (restricted to linear terms without interactions) was derived based on the relevant parameters identified with a stepwise linear regression approach to provide a simple method for estimating the change in spectacle refraction and ocular magnification where a thick lens IOL is used instead of a thin lens IOL. The change in spectacle refraction using a thick lens IOL with (A) or (B) instead of a thin lens IOL with identical power was within limits of around ±1.5 dpt when the thick lens IOL was placed with its haptic plane at the plane of the thin lens IOL. In contrast, the change in ocular magnification from considering the IOL as a thick lens instead of a thin lens was small and not clinically significant. This Monte-Carlo simulation shows the impact of using a thick lens model IOL with preset LT or ET on the resulting spherical equivalent refraction and ocular magnification. If IOL manufacturers would provide all relevant data on IOL design data and refractive index for all power steps, this would make it possible to perform direct calculations of refraction and ocular magnification.

H6 family homeobox 1 (HMX1) regulates multiple aspects of craniofacial development, and mutations in HMX1 are linked to an ocular defect termed oculoauricular syndrome of Schorderet–Munier–Franceschetti (OAS) (MIM #612109). Recently, additional altered orofacial features have been reported, including short mandibular rami, asymmetry of the jaws, and altered premaxilla. We found that in two mutant zebrafish lines termed hmx1mut10 and hmx1mut150, precocious mineralization of the proximal vertebrae occurred. Zebrafish hmx1mut10 and hmx1mut150 report mutations in the SD1 and HD domains, which are essential for dimerization and activity of hmx1. In hmx1mut10, the bone morphogenetic protein (BMP) antagonists chordin and noggin1 were downregulated, while bmp2b and bmp4 were highly expressed and specifically localized to the dorsal region prior to the initiation of the osteogenic process. The osteogenic promoters runx2b and spp1 were also upregulated. Supplementation with DMH1—an inhibitor of the BMP signaling pathway—at the specific stage in which bmp2b and bmp4 are highly expressed resulted in reduced vertebral mineralization, resembling the wildtype mineralization progress of the axial skeleton. These results point to a possible role of hmx1 as part of a complex gene network that inhibits bmp2b and bmp4 in the dorsal region, thus regulating early axial skeleton development.

Patients operated in childhood for early esotropia may suffer from persistent strabismus, whether residual, recurrent, or consecutive, usually with a more complex oculomotor imbalance than in primitive strabismus. The clinical data are fundamental, in particular, (1) the basic accommodation-free deviation, (2) the horizontal far/near incomitance, (3) the cyclovertical incomitances and/or A or V pattern, and (4) the motility restrictions. In complicated cases, magnetic resonance tomography of the orbits showed the anomalies of the eye and muscle position. The intraoperative findings have to be taken into account, such as (1) the position of the eyes and (2) the muscle extensibility in antagonistic muscle pairs. Twenty-seven patients, aged 16 to 62, were included in the present retrospective study. All of them had repeat surgery between 2013 to 2018, 15 for residual esotropia and 12 for consecutive exotropia. In five of the eight patients with posterior fixation sutures on the medial recti, the residual exo or estropia was moderate and could be corrected with a recession or tuck of the lateral recti. In the three other patients with pronounced esotropia, revision of the posterior fixation sutures was carried out. In 19 patients (11 esotropia and 8 exotropia) with only prior conventional surgery, the surgical choice for the residual deviation went electively to the muscles that were most responsible for the motor imbalance, without using posterior fixation sutures. In 4 of these 19 patients, the deviation was small due, in particular, to residual incomitances. For any persistent cyclovertical incomitance, the overacting oblique muscles were recessed, and, in four patients with an A or V pattern, the lateral rectus insertions shifted to the horizontal meridian in the same procedure. The two main difficulties are to assess (1) the imbalance of the active and passive muscle force and (2) the surgically induced incomitances.

Correction to: Novel PDE6B Mutation Presenting with Retinitis Pigmentosa – A Case Series of Three PatientsKlin Monbl Augenheilkd 2019; 236(04): 562-567DOI: 10.1055/a-0811-5480

PurposeTo investigate how corneal hydration affects the Brillouin frequency of corneal stroma.MethodsFrom a simple analytical model considering the volume fraction of water in corneal stroma, we derived the dependence of Brillouin frequency on hydration and hydration-induced corneal thickness variation. The Brillouin frequencies of fresh ex vivo porcine corneas were measured as their hydration was varied in dextran solution and water. Healthy volunteers (8 eyes) were scanned in vivo repeatedly over the course of 9 hours, and the diurnal variations of Brillouin frequency and central corneal thickness (CCT) were measured.ResultsThe measured dependence of Brillouin frequency on hydration, both ex vivo and in vivo, agreed well with the theoretical prediction. The Brillouin frequencies of human corneas scanned immediately after waking were on average ∼25 MHz lower than their daytime average values. For stabilized corneas, the typical variation of Brillouin frequency was ± 7.2 MHz. With respect to CCT increase or swelling, the Brillouin frequency decreased with a slope of −1.06 MHz/μm in vivo.ConclusionsThe ex vivo and in vivo data agree with our theoretical model and support that the effect of corneal hydration on Brillouin frequency comes predominantly from the dependence of the tissue compressibility on the water. Corneal hydration correlates negatively with the Brillouin frequency. During daytime activities, the influence of physiological hydration changes in human corneas is < ± 10 MHz. The sensitivity to hydration may potentially be useful in detecting abnormal hydration change in patients with endothelial disorders.