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Article ; Online: Microbiome and Inherited Retinal Degenerations.

Douglas, Vivian P / Douglas, Konstantinos A A / Iannaccone, Alessandro

2023 Volume 193, Issue 11, Page(s) 1669–1674

Abstract: Inherited retinal degenerations (IRDs) represent a genetically and clinically heterogeneous group of progressive and visually debilitating disorders that can lead to irreversible visual loss. Our understanding of IRD pathogenesis at both the genetic and ... ...

Abstract	Inherited retinal degenerations (IRDs) represent a genetically and clinically heterogeneous group of progressive and visually debilitating disorders that can lead to irreversible visual loss. Our understanding of IRD pathogenesis at both the genetic and cellular levels has increased tremendously over the past two decades, but the exact pathogenic mechanisms remain incompletely understood. Enhanced understanding of the pathophysiology of these diseases can result in new treatment targets. Alterations in the human gut microbiome play a key role in the pathogenesis of many ocular and nonocular diseases, such as age-related macular degeneration, neurologic and metabolic disorders, and autoimmune conditions. The gut microbiome regulates the susceptibility of mice to develop experimental autoimmune uveitis, a model for autoimmune disease of the posterior portion of the eye elicited by the systemic response to retinal antigens. Because of the mounting evidence in favor of a role for local and systemic inflammatory and autoimmune-mediated components to IRD pathogenesis, this review presents the current knowledge of gut microbiome in IRDs and discusses the association between possible changes in gut microbiome and pathogenesis of these diseases, with special attention to their possible contribution to the inflammatory underpinnings of IRDs.
Language	English
Publishing date	2023-04-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2943-9
ISSN	1525-2191 ; 0002-9440
ISSN (online)	1525-2191
ISSN	0002-9440
DOI	10.1016/j.ajpath.2023.03.005
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Article ; Online: Optical coherence tomography angiography in neuro-ophthalmology.

Douglas, Vivian Paraskevi / Douglas, Konstantinos A A / Torun, Nurhan

Current opinion in ophthalmology

2023 Volume 34, Issue 4, Page(s) 354–360

Abstract: Purpose of review: Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging technique, which provides depth resolved visualization of microvasculature of the retina and choroid. Although OCTA has been widely used for the ... ...

Abstract	Purpose of review: Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging technique, which provides depth resolved visualization of microvasculature of the retina and choroid. Although OCTA has been widely used for the evaluation of a number of retinal diseases, its use in the field of neuro-ophthalmology has been less studied. In this review, we provide an update on the utility of OCTA in neuro-ophthalmic conditions. Recent findings: Peripapillary and macular microvasculature analyses have indicated that OCTA can be a promising tool for early detection of a number of neuro-ophthalmic diseases, differential diagnosis, and monitoring of disease progression. Recent studies have demonstrated that structural and functional impairment can develop at early stages in some conditions such as in multiple sclerosis and Alzheimer's disease even in the absence of overt clinical symptoms. Furthermore, this dye-less technique can be a valuable adjunct tool in the detection of complications commonly seen in some congenital entities such optic disc drusen. Summary: Since its introduction, OCTA has emerged as an important imaging approach shedding light on unrevealed pathophysiological mechanisms of several ocular diseases. The use of OCTA as a biomarker in the field of neuro-ophthalmology has recently gained considerable attention with studies supporting its role in clinical setting while larger studies are warranted for correlating these findings with traditional diagnostic procedures and clinical features and outcomes.
MeSH term(s)	Humans ; Tomography, Optical Coherence/methods ; Ophthalmology ; Angiography/methods ; Retina ; Retinal Diseases/diagnostic imaging ; Fluorescein Angiography/methods ; Retinal Vessels
Language	English
Publishing date	2023-04-18
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1049383-9
ISSN	1531-7021 ; 1040-8738
ISSN (online)	1531-7021
ISSN	1040-8738
DOI	10.1097/ICU.0000000000000955
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Article: Subthreshold Exudative Choroidal Neovascularization (CNV): Presentation of This Uncommon Subtype and Other CNVs in Age-Related Macular Degeneration (AMD).

Douglas, Vivian Paraskevi / Garg, Itika / Douglas, Konstantinos A A / Miller, John B

Journal of clinical medicine

2022 Volume 11, Issue 8

Abstract: Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in people over the age of 50 worldwide. Exudative or neovascular AMD is a more severe subset of AMD which is characterized by the presence of choroidal ... ...

Abstract	Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in people over the age of 50 worldwide. Exudative or neovascular AMD is a more severe subset of AMD which is characterized by the presence of choroidal neovascularization (CNV). Recent advancements in multimodal ophthalmic imaging, including optical coherence tomography (OCT) and OCT-angiography (OCT-A), have facilitated the detection and characterization of previously undetectable neovascular lesions and have enabled a more refined classification of CNV in exudative as well as nonexudative AMD patients. Subthreshold exudative CNV is a novel subtype of exudative AMD that typically presents asymptomatically with good visual acuity and is characterized by stable persistent or intermittent subretinal fluid (SRF). This review aims to provide an overview of the clinical as well as multimodal imaging characteristics of CNV in AMD, including this new clinical phenotype, and propose effective approaches for management.
Language	English
Publishing date	2022-04-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11082083
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Article ; Online: The epidemiology of pediatric dry eye disease in the United States: An IRIS® registry (Intelligent Research in Sight) analysis.

Douglas, Vivian Paraskevi / Hall, Nathan / Ross, Connor / Douglas, Konstantinos A A / Elze, Tobias / Miller, Joan W / Lorch, Alice C / Traish, Aisha S

The ocular surface

2024 Volume 32, Page(s) 106–111

Abstract: Purpose: Dry-eye disease (DED) is a chronic progressive ocular surface disorder with limited studies in the pediatric population. The Academy of Ophthalmology's IRIS® Registry was leveraged to investigate the prevalence of DED in the pediatric ... ...

Abstract	Purpose: Dry-eye disease (DED) is a chronic progressive ocular surface disorder with limited studies in the pediatric population. The Academy of Ophthalmology's IRIS® Registry was leveraged to investigate the prevalence of DED in the pediatric population (PDED, patients <18 years old) and the demographic differences of DED between pediatric and adult patients (ADED). Methods: Retrospective cohort study. Patients with DED between January 1st, 2013 and December 31st, 2019 (N = 4,795,979) were included. Descriptive statistics, Pearson's chi-squared tests and two-sample proportions tests were conducted to compare key demographic distributions between the ADED and PDED cohorts. Results: The average age at onset for ADED patients was 61.06 (±14.75) years and for PDED patients was 12.51 (±3.86). The overall tests for independence and the individual tests of proportions of each category were statistically significant for all demographic characteristics (p < 0.001). Characteristics with the largest discrepancies between patients of PDED and the IRIS Registry pediatric patient pool (PIRIS) included female sex (58.08 % vs. 50.60 %), male sex (41.58 % vs. 48.78 %) and Asian race (6.02 % vs. 3.11 %) respectively. Within the PDED cohort, females were at higher risk of PDED (58 % vs. 42 %). PDED was more prevalent in children with refractive errors (76 %) and eyelid/conjunctival disorders (41 %). Characteristics with the largest discrepancies between PDED and ADED patients included female sex (58.08 % vs. 68.12 %), male sex (41.58 % vs. 31.55 %) and Caucasian race (50.24 % vs. 67.06 %) respectively. Conclusions: Significant differences in the PDED cohort are demonstrated in this study. PDED was more prevalent in the female sex and Caucasian race compared to PIRIS and was more commonly associated with refractive errors and eyelid/conjunctival disorders.
MeSH term(s)	Humans ; Male ; Retrospective Studies ; Female ; Registries ; Dry Eye Syndromes/epidemiology ; United States/epidemiology ; Child ; Adolescent ; Prevalence ; Middle Aged ; Adult ; Child, Preschool ; Aged ; Young Adult ; Age Distribution
Language	English
Publishing date	2024-01-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Multicenter Study
ZDB-ID	2208578-6
ISSN	1937-5913 ; 1542-0124
ISSN (online)	1937-5913
ISSN	1542-0124
DOI	10.1016/j.jtos.2024.01.012
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Article ; Online: Overlap between ophthalmology and psychiatry - A narrative review focused on congenital and inherited conditions.

Kiely, Chelsea / Douglas, Konstantinos A A / Douglas, Vivian Paraskevi / Miller, John B / Lizano, Paulo

Psychiatry research

2023 Volume 331, Page(s) 115629

Abstract: A number of congenital and inherited diseases present with both ocular and psychiatric features. The genetic inheritance and phenotypic variants play a key role in disease severity. Early recognition of the signs and symptoms of those disorders is ... ...

Abstract	A number of congenital and inherited diseases present with both ocular and psychiatric features. The genetic inheritance and phenotypic variants play a key role in disease severity. Early recognition of the signs and symptoms of those disorders is critical to earlier intervention and improved prognosis. Typically, the associations between these two medical subspecialties of ophthalmology and psychiatry are poorly understood by most practitioners so we hope to provide a narrative review to improve the identification and management of these disorders. We conducted a comprehensive review of the literature detailing the diseases with ophthalmic and psychiatric overlap that were more widely represented in the literature. Herein, we describe the clinical features, pathophysiology, molecular biology, diagnostic tests, and the most recent approaches for the treatment of these diseases. Recent studies have combined technologies for ocular and brain imaging such as optical coherence tomography (OCT) and functional imaging with genetic testing to identify the genetic basis for eye-brain connections. Additional work is needed to further explore these potential biomarkers. Overall, accurate, efficient, widely distributed and non-invasive tests that can help with early recognition of these diseases will improve the management of these patients using a multidisciplinary approach.
MeSH term(s)	Humans ; Ophthalmology ; Genetic Testing ; Psychiatry
Language	English
Publishing date	2023-11-25
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2023.115629
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Article ; Online: Ophthalmic manifestations of dementing disorders.

Douglas, Vivian Paraskevi / Douglas, Konstantinos A A / Cestari, Dean M

Current opinion in ophthalmology

2021 Volume 32, Issue 6, Page(s) 515–520

Abstract: Purpose of review: Dementia is a term for loss of memory, language, problem-solving, and other thinking abilities, which significantly interferes with daily life. Certain dementing conditions may also affect visual function. The eye is an accessible ... ...

Abstract	Purpose of review: Dementia is a term for loss of memory, language, problem-solving, and other thinking abilities, which significantly interferes with daily life. Certain dementing conditions may also affect visual function. The eye is an accessible window to the brain that can provide valuable information for the early diagnosis of people who suffer from Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies as well as from more rare causes of dementias, such as Creutzfeldt-Jacob and Huntington's diseases. Herein, we present the ocular manifestations of neurocognitive disorders focusing on the neuro-ophthalmic ones and further discuss potential ocular biomarkers that could help in early detection of these disorders. Recent findings: Ophthalmic examination along with the recent developments in in-vivo testing have provided a strong foundation of useful knowledge about brain disorder in neurodegenerative diseases without the need for invasive studies. Currently, a number of visual measures, such as visual acuity, contrast sensitivity, pupil response, and saccades in addition to various ophthalmic tests, such as electroretinogram, visual evoked potential, optical coherence tomography (OCT), and OCT-angiography have been widely used and evaluated as potential biomarkers for different stages of dementia. Summary: Ophthalmologic and neuro-ophthalmic evaluation is evolving as an important part of the early diagnosis and management of people with dementia. A particular focus on ocular biomarkers in dementing illnesses has arisen over the past few years and there are several promising measures and imaging tools that have been proposed as potential biomarkers for these diseases.
MeSH term(s)	Alzheimer Disease ; Brain ; Evoked Potentials, Visual ; Humans ; Huntington Disease ; Parkinson Disease
Language	English
Publishing date	2021-08-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049383-9
ISSN	1531-7021 ; 1040-8738
ISSN (online)	1531-7021
ISSN	1040-8738
DOI	10.1097/ICU.0000000000000807
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Article ; Online: Hemorrhagic Papilledema Secondary to Craniopharyngioma.

Douglas, Vivian Paraskevi / Douglas, Konstantinos A A / Chwalisz, Bart K

JAMA ophthalmology

2020 Volume 138, Issue 10, Page(s) e200880

MeSH term(s)	Adult ; Craniopharyngioma/complications ; Craniopharyngioma/diagnosis ; Eye Hemorrhage/diagnosis ; Eye Hemorrhage/etiology ; Eye Hemorrhage/physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Papilledema/complications ; Papilledema/diagnosis ; Papilledema/physiopathology ; Pituitary Neoplasms/complications ; Pituitary Neoplasms/diagnosis ; Visual Fields/physiology
Language	English
Publishing date	2020-10-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2701705-9
ISSN	2168-6173 ; 2168-6165
ISSN (online)	2168-6173
ISSN	2168-6165
DOI	10.1001/jamaophthalmol.2020.0880
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Article ; Online: Optic nerve sheath meningioma.

Douglas, Vivian Paraskevi / Douglas, Konstantinos A A / Cestari, Dean M

Current opinion in ophthalmology

2020 Volume 31, Issue 6, Page(s) 455–461

Abstract: Purpose of review: Optic nerve sheath meningiomas (ONSMs) are rare benign tumors of the anterior visual pathway which present with slowly progressive and painless vision loss and account for approximately 2% of all orbital tumors. This article provides ... ...

Abstract	Purpose of review: Optic nerve sheath meningiomas (ONSMs) are rare benign tumors of the anterior visual pathway which present with slowly progressive and painless vision loss and account for approximately 2% of all orbital tumors. This article provides an overview as well as an update on the ONSMs with regards to cause, epidemiology, clinical presentation, diagnosis, and management in adults and pediatric population. Recent findings: The clinical presentation and prognosis of ONSMs can vary and largely depend on the location of tumor as well as the histologic type. Overall, the diagnosis is based on clinical presentation, examination, and neuroimaging findings. Nevertheless, delays in diagnosis or misdiagnosis are not uncommon and can result in higher morbidity rates. Recent advances in diagnostic as well as more effective and less-invasive treatment options are discussed in this review. Summary: ONSMs are a rare cause of slowly progressive and inexorable visual loss. Although ONSM diagnosis depends on the characteristic clinical and radiologic findings, prompt diagnosis, and appropriate management is critical for favorable visual outcomes. Thus, current focus is optimizing diagnostic as well-treatment methods for patients with ONSMs.
MeSH term(s)	Humans ; Meningioma/diagnosis ; Meningioma/therapy ; Neuroimaging ; Optic Nerve Neoplasms/diagnosis ; Optic Nerve Neoplasms/therapy ; Prognosis ; Vision Disorders/etiology
Language	English
Publishing date	2020-09-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049383-9
ISSN	1531-7021 ; 1040-8738
ISSN (online)	1531-7021
ISSN	1040-8738
DOI	10.1097/ICU.0000000000000700
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Article ; Online: Ocular Manifestations of COVID-19 (SARS-CoV-2): A Critical Review of Current Literature.

Douglas, Konstantinos A A / Douglas, Vivian Paraskevi / Moschos, Marilita M

In vivo (Athens, Greece)

2020 Volume 34, Issue 3 Suppl, Page(s) 1619–1628

Abstract: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in the city of Wuhan in December of 2019 and since then more than 5,000,000 people have been infected, with approximately 338,000 deaths worldwide. The ... ...

Abstract	The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in the city of Wuhan in December of 2019 and since then more than 5,000,000 people have been infected, with approximately 338,000 deaths worldwide. The virus causes the coronavirus disease 2019 (COVID-19), which is characterized by fever, myalgia and cough, with severe acute respiratory syndrome being the most fearsome complication. Nevertheless, the vast majority of cases present mild symptoms or none. Central nervous system and cardiovascular manifestations have been reported. The range of ocular manifestations, either as a result of the infection or as a result of the treatment, has not yet been discussed. In this study, a systematic review of current literature relevant to COVID-19 was performed with focus on modes of transmission, ocular manifestations related to infection and medications, as well as the control of infection in ophthalmic practice.
MeSH term(s)	Abducens Nerve Diseases/etiology ; Antiviral Agents/adverse effects ; Antiviral Agents/therapeutic use ; Betacoronavirus/physiology ; Biomarkers ; COVID-19 ; China ; Conjunctival Diseases/blood ; Conjunctival Diseases/etiology ; Contact Lenses/adverse effects ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Coronavirus Infections/therapy ; Coronavirus Infections/transmission ; Equipment Contamination ; Eye Diseases/etiology ; Eye Diseases/prevention & control ; Humans ; Hyperemia/blood ; Hyperemia/etiology ; Immunization, Passive/adverse effects ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Keratoconjunctivitis/etiology ; Lacrimal Apparatus Diseases/blood ; Lacrimal Apparatus Diseases/etiology ; Leukocyte Count ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/transmission ; Retinal Diseases/chemically induced ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Antiviral Agents ; Biomarkers
Keywords	covid19
Language	English
Publishing date	2020-05-29
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.11952
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Article ; Online: Subthreshold Exudative Choroidal Neovascularization (CNV)

Vivian Paraskevi Douglas / Itika Garg / Konstantinos A. A. Douglas / John B. Miller

Journal of Clinical Medicine, Vol 11, Iss 8, p

Presentation of This Uncommon Subtype and Other CNVs in Age-Related Macular Degeneration (AMD)

2022 Volume 2083

Abstract	Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in people over the age of 50 worldwide. Exudative or neovascular AMD is a more severe subset of AMD which is characterized by the presence of choroidal neovascularization (CNV). Recent advancements in multimodal ophthalmic imaging, including optical coherence tomography (OCT) and OCT-angiography (OCT-A), have facilitated the detection and characterization of previously undetectable neovascular lesions and have enabled a more refined classification of CNV in exudative as well as nonexudative AMD patients. Subthreshold exudative CNV is a novel subtype of exudative AMD that typically presents asymptomatically with good visual acuity and is characterized by stable persistent or intermittent subretinal fluid (SRF). This review aims to provide an overview of the clinical as well as multimodal imaging characteristics of CNV in AMD, including this new clinical phenotype, and propose effective approaches for management.
Keywords	subthreshold exudative choroidal neovascularization ; CNV ; age-related macular degeneration ; AMD ; occult CNV ; classic CNV ; Medicine ; R
Subject code	616
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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