Mehenaz Hanbazazh

Background: Optic neuritis (ON), a common manifestation of demyelinating disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), often leads to significant visual impairment. Although high-dose corticosteroids are a first-line therapy, many patients experience incomplete recovery. Apheresis therapies, including plasma exchange (PLEX) and immunoadsorption (IA), are being increasingly used as rescue treatments, but their efficacy and safety are debated. Methods: We conducted a systematic review and meta-analysis of studies evaluating PLEX and IA for acute ON in patients with demyelinating diseases. Four databases were searched up to January 2025. The included studies reported visual or neurological outcomes in patients with MS, NMOSD, MOGAD, or idiopathic ON. The primary outcomes were treatment response and visual acuity changes (logMAR). The study quality was assessed using RoB 2, ROBINS-I, or JBI tools. Random effects models were employed for the meta-analysis. Results: Twelve studies (800+ ON attacks) were analyzed. Both PLEX and IA demonstrated significant visual improvement, with a pooled mean logMAR reduction of -1.11 (95% CI: -1.70 to -0.53). Early intervention correlated with better outcomes. MOGAD-ON patients showed the highest response rates, while delayed treatment in NMOSD-ON patients was linked to poorer vision. Adverse events were rare and mild. Conclusion: PLEX and IA are effective and safe second-line therapies for steroid-refractory ON, particularly when initiated early. These findings support the prompt use of apheresis in eligible patients to optimize visual recovery.

To investigate the trends of hospital admissions concerning diseases of the eye and adnexa in Australia in the past 2 decades. This is a descriptive ecological study on the population level that examined hospitalization data for the duration between 1998 and 2021 in Australia. Hospitalization data were extracted from the National Hospital Morbidity Database. The chi-squared test was utilized to assess the difference in admission rates between the years 1998 and 2021. Hospital admission rate for diseases of the eye and adnexa increased by 1.20-fold (from 852.32 [95% confidence interval [CI] 848.16–856.47] in 1998 to 1873.72 [95% CI 1868.48–1878.96] in 2021 per 100,000 persons, P < .01). The most common cause of hospitalization for diseases of the eye and adnexa was disorders of the lens (65.7%), followed by disorders of the choroid and retina (15.6%), followed by disorders of the eyelid, lacrimal system, and orbit (7.7%). Hospital admission rate among males increased by 1.25-fold (from 737.67 [95% CI 732.18–743.16] in 1998 to 1657.19 [95% CI 1650.19–1664.20] in 2021 per 100,000 persons). Hospital admission rate among females increased less sharply by 1.03-fold (from 965.37 [95% CI 959.14–971.59] in 1998 to 1964.35 [95% CI 1956.80–1971.90] in 2021 per 100,000 persons). There are clear gender and age roles in the epidemiology of hospital admissions related to eye and adnexa disorders. Lens disorders were the most common cause of hospital admission. The admission rate increase during the past decades could be due to increases in life expectancy, lifestyle changes, and improvements in screening protocols.

Objective To study in a masked fashion whether an objective histological feature associated with keratoconus (KCN) occurs in donor corneas in eyes originally receiving a corneal graft for KCN. Methods Two ocular pathologists performed a retrospective masked histological analysis of slides from donor buttons recovered from 21 eyes with a history of KCN undergoing repeat penetrating keratoplasty (failed-PK-KCN), 11 eyes that underwent their first PK due to KCN (primary KCN), and 11 eyes without history of KCN which underwent PK for other conditions (failed-PK-non-KCN). Breaks/gaps in Bowman’s layer served as the pathological feature indicative of recurrent KCN. Results Breaks in Bowman’s layer were present in 18/21 (86%) of the failed-PK-KCN group, 10/11 (91%) of the primary KCN group, and in 3/11 (27%) of the failed-PK-non-KCN group. Pathological evidence suggests that the prevalence of breaks is significantly higher in grafted patients with a history of KCN than non-KCN controls (OR: 16.0, 95% CI 2.63 to 97.2, Fisher’s exact test p=0.0018) with a conservative Bonferroni criterion of p Conclusions This study provides histological evidence that breaks and gaps in Bowman’s layer, consistent with those found in primary KCN, may develop within the donor tissue in eyes with a history of KCN.

Purpose: To document a unique case of a corneal/conjunctival epithelial inclusion cyst located in the orbicularis oculi muscle with a comprehensive review of variant conjunctival cysts and simulating conditions. Methods: Clinicopathologic case report with detailed histopathologic and immunohistochemical evaluation for cytokeratins combined with a tabulation of mimicking lesions and relevant literature citations. Results: A 59-year-old man experienced severe blunt left periorbital trauma that resulted in a limbal partial-thickness corneal wound with an associated epithelial abrasion and a full-thickness eyelid laceration extending from the superior fornix to the margin. Several months after surgical repair of the eyelid a cyst appeared in the superior pretarsal skin. Histopathologic and immunohistochemical investigations supplied data suggesting that the cyst had a high probability of a corneoscleral limbal stem cell origin. Distinctive features of the lesion are contrasted with those of allied or simulating cysts. Conclusions: Stem cells are now believed to be located at the corneoscleral limbus, in the inferior fornix, in the medial canthal region, and at the eyelid margin where transitions from conjunctival epithelium to epidermal epithelium occur. Due to their replicative, hardy and robust nature, stem cells displaced to alien environments are most likely to survive and produce cysts. The cyst’s corneal-type cytologic characteristics, the absence of goblet cells, and the expression of a broad spectrum of cytokeratin biomarkers in the current case give support to the proposal that limbal stem cells in the region of the corneal laceration were displaced to the eyelid orbicularis muscle and were responsible for this most extraordinary cyst. Comparison with other epithelial cystic linings lends further evidence for this conclusion.

To explore the value of molecular technologies in the pathologic evaluation, diagnosis, and treatment of retinoblastoma and uveal melanoma. Review of the peer-reviewed literature on the molecular p...

O1 Regulation of genes by telomere length over long distances