European Society of Ophthalmology Congress of the European Society of Ophthalmology (SOE) 2023 15-17 June, 2023, Prague, Czech Republic Abstracts Scientific Programme Committee Wagih Aclimandos, United Kingdom, Chairman Thomas Fenech, Malta, Programme Co-ordination Susanne Albrecht, Sweden, Multidisciplinary Nikolaos Bechrakis, Germany, Oncology and Pathology Susanne Binder, Austria, Retina Jan-Tjeerd de Faber, The Netherlands, Paediatrics and Strabismus Shlomo Dotan, Israel, Neuro-ophthalmology Christoph Hintschich, Germany, Oculoplastics Graham Holder, United Kingdom & Singapore, Electrophysiology Friedrich Kruse, Germany, Cornea and External Eye Carlos Pavésio, United Kingdom, Uveitis Marie-José Tassignon, Belgium, Cataract and Refractive Liz Tomlin, United Kingdom, Multidisciplinary Carlo Enrico Traverso Italy, Glaucoma Congress Committee Wagih Aclimandos, United Kingdom, President Jan-Tjeerd de Faber, The Netherlands, Immediate Past-President Thomas Fenech, Malta, Secretary General Pavel Rozsíval, Czech Republic, Local Representative Electronic production of the abstract book by pharma service, a business unit of documedias GmbH. Copyright to all poster data resides with the respective authors. Permission should be sought for any re-use of these data. Individual authors are solely responsible for the content of their contribution. Every effort has been made to faithfully reproduce the abstracts as submitted. However, no responsibility is assumed by the organisers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in the medical sciences, we recommend that independent verification of diagnoses or drug dosages should all be made. All material is correct at the time of print.

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS FP01: Retina FP01-1 Quality of life after pars plana vitrectomy, scleral buckle, or pneumatic retinopexy for rhegmatogenous retinal detachment: a meta-analysis C. Zajner1, B. Leung1, M. Malvankar1, P. Hooper1, T. Sheidow1 1University of Western Ontario, Medicine & Dentistry, London, Canada Purpose: Comparisons of the surgical and anatomic results of rhegmatoge- nous retinal detachment surgery have been investigated previously. A system- atic evaluation of the available evidence comparing quality of life outcomes of either pars plana vitrectomy, scleral buckling, pneumatic retinopexy has not been evaluated to date. The outcome of this study was to analyze whether pars plana vitrectomy, scleral buckling, or pneumatic retinopexy for the treat- ment of rhegmatogenous retinal detachment result in differing quality of life outcomes. Methods: In February of 2022, a comprehensive search of MEDLINE, EMBASE, CINHAL, and Cochrane Library was conducted for studies on patients treated surgically for rhegmatogenous retinal detachment and in- cluded follow-up measurements of quality of life outcomes. Meta-analysis was completed using STATA v. 14.0. Results: Thirteen studies with a sample range between 25 to 176 (total n=1063) published between 2004 to 2020 were identified. Meta-analysis found a better correlation between higher quality of life outcomes with scleral buckling than with pars plana vitrectomy (SMD = 0.62, CI: [0.31, 0.93]). We also found no difference in quality of life outcomes between pneumatic retinopexy and pars plana vitrectomy (SMD = 0.08, CI: [-0.07, 0.22]). There was insufficient data available for an analysis comparing scleral buckling with pneumatic retinopexy. Conclusions: This meta-analysis of a limited number of studies identified scleral buckling as resulting in better quality of life outcomes for patients when compared to pars plana vitrectomy. Pneumatic retinopexy did not show a difference in quality of life outcomes compared to pars plana vitrectomy. The study was limited by the small number of available studies for analysis. Overall, these results emphasize that quality of life outcomes between differ- ent types of rhegmatogenous retinal ought to be considered by ophthalmolo- gists in determining which procedure to perform. FP01-2 Real-world outcomes of intravitreal bevacizumab using a treat-and-extend regime for cystoid macular oedema secondary to central retinal vein occlusion D. Gildea1, B. Tang1, C. Baily1, A. Ryan1 1Royal Victoria Eye & Ear Hospital, Ophthalmology Department, Dublin, Ireland Purpose: The purpose of this study was to report the real-world treatment out- comes using a treat-and-extend intravitreal bevacizumab protocol in cystoid macular oedema (CMO) secondary to central retinal vein occlusion (CRVO). Methods: We conducted a retrospective case series of consecutive adult pa- tients with CMO secondary to CRVO treated with bevacizumab, using a treat- and-extend protocol, who presented between 1stJanuary 2019 and 31stDecem- ber 2021. Patients underwent Ultra-widefield fundus fluorescein angiography (UW-FFA) within 3 months of presentation, were followed up for a minimum of 6 months and had a clinical examination including best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at every visit. The primary outcome measure was mean change in BCVA. Results: 33 eyes of 33 patients were included in the study. The mean change in BCVA from baseline was +24.5 (Median 18, SD 21.5) letters, with a mean follow-up duration of 18.5 (SD 8.9) months. The mean number of injections was 9.5 (SD 1.9) in year 1 and 7.8 (SD 2.8) in year 2. 12.1% of patients suc- cessfully completed treatment. 87.9% of patients were still requiring active treatment, with a maximum interval achieved of 4-weekly in 18.2%, 6-weekly in 42.4%, 8-weekly in 6.1%, 10-weekly in 15.2%, and 12-weekly in 6.1%. The mean maximum interval achieved of those requiring ongoing treatment was 6.8 (SD 2.4) weeks. Multiple regression analyses showed that a higher base- line BCVA was negatively associated with mean visual acuity gain (P<0.001) and positively associated with final BCVA (P<0.001). Conclusion: The use of intravitreal bevacizumab in a treat-and-extend regi- men is effective in treating CMO secondary to CRVO, in a real-world setting. FP01-3 The DAVIO trial: a phase 1, open-label, dose- escalation study of a single injection of EYP-1901 (vorolanib in Durasert® platform) demonstrating reduced treatment burden in wet AMD M. Munk1,2, S. Patel3, P. Storey4, M. Barakat5, V. Hershberger6, W. Bridges7, D. Eichenbaum8, D. Lally9, M. Roy10, J. Duker10, D. Paggiarino10 1Augenarzt-Praxisgemeinschaft Gutblick AG, Ophthalmology, Bern, Switzerland, 2Feinberg School of Medicine, Northwestern University, Ophthalmology, Chicago, United States, 3West Texas Retina Consultants, Abilene, TX, United States, 4Austin Retina, Austin, TX, United States, 5Retinal Consultants of Arizona, Phoenix, AZ, United States, 6Florida Eye Associates, Melbourne, FL, United States, 7Asheville Eye, Asheville, NC, United States, 8Retina Vitreous Associates of Florida, St. Petersburg, FL, United States, 9New England Retina Consultants, Springfield, MA, United States, 10EyePoint Pharmaceuticals, Watertown, MA, United States Purpose: Undertreatment of wet age-related macular degeneration (wAMD) with anti–vascular endothelial growth factor (anti-VEGF) therapies may ac- count for a significant proportion of unsatisfactory visual outcomes in the real world. The DAVIO trial was a phase 1, multicenter, open-label, dose-esca- lation trial evaluating the safety of EYP-1901, a sustained-delivery therapy supplying the tyrosine kinase inhibitor vorolanib in a bio-erodible form of Durasert® given via intravitreal injection. Methods: Previously treated eyes with wAMD received EYP-1901 with up to 48 weeks of follow-up. The primary endpoint was the rate of ocular and sys- temic adverse events (AEs). Secondary endpoints included best-corrected vi- sual acuity (BCVA) and optical coherence tomography (OCT) measurements. Results: Seventeen eyes received 440 µg (n=3), 1,060 µg (n=1), 2,060 µg (n=8), or 3,090 µg (n=5) of EYP-1901. Investigator-reported AEs were mostly mild in nature and related to the intravitreal injection procedure; no reported AEs were related to EYP-1901. 4 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS Results: The mean age at the first examination was 17.8 years (range 2 to 42 years). The mean age of symptoms onset was 1,99 years (range 6 weeks to 5 years). In 6 patients the disease was caused by biallelic mutations in the RPE65 gene, in 4 patients in the CEP290 gene and in 3 patients in the CRB1 gene. Biallelic mutations in the GUCY2D, LCA5, RPGRIP1 and CLN3 genes were the cause of the disease in one patient each. As for probands suffering from LCA/EOSRD and examined elsewhere two were documented carriers of pathogenic variants in the CEP290gene, two in the CRB1gene and one in theGUCY2D gene. Three patients with biallelic mutations inRPE65 underwent gene therapy. Conclusions: A thorough characterization of clinical findings in rare retinal disease is important for the possibility of enrolling patients in clinical trials and for current and future targeted therapies. Acknowledgements: This work has been supported by grant from the Agency for Health Research of the Czech Republic:NU20-07-00182 and EJPRD19-234 Solve-RET FP01-8 Using 3D-MRI imaging to quantitatively analyze the shape of eyeballs with high myopia and to investigate relationships between myopic traction maculopathy and posterior staphyloma X. Chen1, X. Guo1, Y. Wang1 1Beijing Friendship Hospital, Capital Medical University, Department of Ophthalmology, Beijing, China Purpose: To quantitatively analyze the shape of eyes with high myopia using high-resolution three-dimensional (3D) magnetic resonance imaging (MRI) and investigaterelationships betweenmyopic traction maculopathy (MTM) andthe morphological changes ofposterior staphyloma (PS). Methods: This prospective study enrolled 105 patients with high myopia at Beijing Friendship Hospital. All participants underwent a comprehensive oph- thalmic examination. MTM was divided into different types by optical coher- ence tomography, and ocular shapes were categorized by 3D-MRI. Results: A total of 105 patients (105 eyes) were studied, with a mean age of 60.4 ± 13.3 years and mean axial length of 28.71 ± 2.78 mm. Spheroidal shape was observed in 35 eyes (33.3%), ellipsoidal shape in 11 eyes (10.5%), conical shape in 17 eyes (16.2%), nasally distorted shaped in 18 eyes (17.1%), temporally distorted shape in 16 eyes (15.2%), and barrel shape in 8 eyes (7.7%). PS was identified in 84 eyes (80%), and the proportions for the elliptical, conical, nasal torsion, temporal torsion and barrel shapes were 27.9%, 23.1%, 12.9%, 9.5%, 17.1% and 9.5%, respectively. In eyes without PS, MTM accounted for 23.8%, while with PS the proportion increased to 53.8%. The proportion of MTM in spheroidal was lowest, and nasal and temporal tor- sion shapes were highest. 45.5% of the nasal torsion shapes were with MTM, and for nasal torsion shape were 83.3%. Conclusions: Not all highly myopic eyes are deformed. Spheroid was the predominant ocular shape. Eyes with PS display more severe myopic macu- lopathy. Moreover,nasallyand temporally distorted eyes present significantly high percentage of MTM. FP01-9 Investigation of the role of LRP5 in hereditary eye diseases: Zebrafish disease model F. Yaylacıoğlu Tuncay1,2, S. Yousaf2, H.A Burgess3, R.B Hufnagel2 1University of Health Sciences, Gülhane Medical Faculty, Medical Biology, Ankara, Turkey, 2National Institutes of Health, National Eye Institute, Ophthalmic Genetics and Visual Function Branch, Bethesda, United States, 3Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Developmental Biology, Bethesda, United States Purpose: The LRP5gene encodes a transmembrane protein involved in Norrin/β-catenin signaling pathway which has a fundamental role in the reti- nal vascular development. Some variants reported in LRP5 are associated with diseases affecting the eye, such as Osteoporosis Pseudoglioma Syndrome (OPPG), Familial Exudative Vitreoretinopathy (FEVR), or Retinopathy of prematurity (ROP). Despite several clinical and preclinical research in the lit- erature, the mechanisms of eye pathologies related to LRP5 variants are still unclear. The purpose of this study was to evaluate whether zebrafish can be used as a model organism for investigating the mechanisms underlying LRP5-related eye diseases. Method: Lrp5sa11097 zebrafish line, carrying c.851C>A mutation in lrp- 5causing a premature stop codon in exon 5 at amino acid position 284, was crossed with transgenic (Tg[fli1:EGFP]AB) zebrafish line which has a report- er gene to visualize blood vessels. The survival rate, gross morphology, the structural and functional integrity of the retina and retinal vasculature were compared between lrp5 knock-out (KO) and wild-type (WT) zebrafish. Results: Lrp5 KO zebrafish larvae showed decreased survival rates when compared to WT. During the larval period only head size showed a significant difference between KO and WT. However, lrp5 KO adult zebrafish demonstrated significantly smaller eye size in addition to head size. The analysis of retinal vasculature in adult zebrafish showed closer and more branched retinal vessels in lrp5KO when compared to WT. The dark-flash response assay showed no detectable functional visual defect in lrp5KO larvae. Conclusion: This study was the first that revealed Lrp5-related eye patholo- gies in zebrafish. Lrp5 mutant zebrafish could be further evaluated to under- stand the role of LRP5 in the retinal vascular pathologies. Besides, lrp5mu- tants may provide useful models to study small-eye-related problems such as axial hypermetropia and nanophthalmos. 6 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS FP02-4 FP02-5 Treatment with lenadogene nolparvovec gene therapy results in sustained visual improvement in m.11778G>A MT-ND4-LHON patients: the RESTORE study V. Biousse1, P. Yu-Wai-Man2, N.J. Newman1, V. Carelli3, M.L. Moster4, C. Vignal-Clermont5, T. Klopstock6, A.A. Sadun7, R.C. Sergott4, M. Taiel8, J.-A. Sahel9 1Emory University School of Medicine, Departments of Ophthalmology, Neurology and Neurological Surgery, Atlanta, United States, 2Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, University of Cambridge, Department of Clinical Neurosciences, Cambridge, United Kingdom, 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy, 4Wills Eye Hospital and Thomas Jefferson University, Departments of Neurology and Ophthalmology, Philadelphia, United States, 5Rothschild Foundation Hospital, Department of Neuro Ophthalmology and Emergencies, Paris, France, 6Friedrich Baur Institut, Munich, Germany, 7Doheny Eye Institute, UCLA School of Medicine, Los Angeles, United States, 8GenSight Biologics, Paris, France, 9Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France Purpose: Two phase 3 clinical studies, RESCUE and REVERSE, assessed the efficacy and safety of an intravitreal injection of lenadogene nolparvovec gene therapy in patients with Leber hereditary optic neuropathy (LHON) due to the m.11778G>A mitochondrial DNA mutation in MT-ND4. Recruited patients were followed up for a period of 5 years post-treatment as part of the long- term RESTORE study. Methods: In RESCUE and REVERSE, all patients were treated with lenado- gene nolparvovec in one eye with a sham injection in the other eye. After 96 weeks, patients were invited to participate in RESTORE for another 3 years, corresponding to 5 years post-treatment administration. Quality of life was monitored using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Results: Of the 72 patients who completed RESCUE or REVERSE, 62 par- ticipated in RESTORE. Patients were mostly male (79.0%) with a mean (stan- dard deviation [SD]) age of 37.1 (15.3) years. Five years after treatment, the bilateral improvement from nadir observed at 2 years was maintained with an absolute mean change (SD) in BCVA from nadir of -0.44 (0.46) LogMAR (+22.0 EDTRS letters equivalent) for lenadogene nolparvovectreated eyes and -0.39 (0.36) LogMAR (+19.5 EDTRS letters equivalent) for shamtreated eyes. At 5 years, BCVA for most patients (80.7%) were on chart (i.e., ≤1.6 LogMAR). A clinically relevant response from nadir was observed in 71.0% of patients. Overall, quality of life improved in a clinically meaningful way with a mean gain of 7 points from baseline for the VFQ-25 composite score. The safety profile was favorable, similar to that observed in the first 2 years after treat- ment. Conclusion: Long-term follow-up of MT-ND4-LHON patients who were uni- laterally treated with lenadogene nolparvovec demonstrated a sustained im- provement of BCVA in both eyes with an improvement of quality of life up to 5 years after treatment. Indirect comparison of lenadogene nolparvovec gene therapy versus natural history in m.11778G>A MT-ND4 Leber Hereditary Optic Neuropathy patients N.J. Newman1, M.L. Moster2, V. Carelli3, P. Yu-Wai-Man4, V. Biousse1, P.S. Subramanian5, C. Vignal-Clermont6, A.-G. Wang7, S.P. Donahue8, B.P. Leroy9, R.C. Sergott2, T. Klopstock10, A.A. Sadun11, G. Rebolleda Fernández12, B.K. Chwalisz13, R. Banik14, M. Taiel15, J.-A. Sahel16 1Emory University School of Medicine, Departments of Ophthalmology, Neurology and Neurological Surgery, Atlanta, United States, 2Wills Eye Hospital and Thomas Jefferson University, Department of Neurology and Ophthalmology, Philadelphia, United States, 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy, 4Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, University of Cambridge, Department of Clinical Neurosciences, Cambridge, United Kingdom, 5Sue Anschutz- Rodgers University of Colorado Eye Center, University of Colorado School of Medicine, Aurora, United States, 6Rothschild Foundation Hospital, Department of Neuro Ophthalmology and Emergencies, Paris, France, 7Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Department of Ophthalmology, Taipei, Taiwan, 8Vanderbilt University, and Vanderbilt Eye Institute, Vanderbilt University Medical Center, Department of Ophthalmology, Neurology, and Pediatrics, Nashville, United States, 9Department of Ophthalmology and Center for Medical Genetics, Ghent University Hospital, and Department of Head & Skin, Ghent University, Ghent, Belgium, 10Friedrich Baur Institut, Munich, Germany, 11Doheny Eye Institute, UCLA School of Medicine, Los Angeles, United States, 12Alcala University, Department of Ophthalmology, Madrid, Spain, 13Massachusetts Eye & Ear, Harvard Medical School, Department of Ophthalmology, Boston, United States, 14Icahn School of Medicine at Mount Sinai, Department of Ophthalmology, New York, United States, 15GenSight Biologics, Paris, France, 16Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France Purpose: To compare the visual acuity of MT-ND4 Leber hereditary optic neuropathy (LHON) patients treated with lenadogene nolparvovec in clinical trials to the spontaneous evolution of visual acuity in an external control group of untreated MTND4 LHON patients. A previous analysis was performed on treated patients from three phase 3 stud- ies. This updated analysis incorporates a fourth trial, REFLECT, in which pa- tients received lenadogene nolparvovec unilaterally or bilaterally. Methods: Visual acuity data of 174 MT-ND4 LHON patients intravitreally injected in one or both eyes were pooled from four phase 3 trials: REVERSE, RESCUE, RESTORE and REFLECT. The external control group included 208 age-comparable (≥ 15 years old) untreated m.11778G>A MT-ND4 LHON patients from 11 natural history studies. Results: Both cohorts were predominantly male patients (81.2%) with a me- dian age at onset of vision loss of 26.0 years. Eyes treated with lenadogene nolparvovec had better visual acuity at all timepoints when compared to natu- ral history eyes. Mean [95% confidence interval (CI)] difference versus natural history was 0.30 [0.39; 0.22] LogMAR (+15 EDTRS letters) at last observation (p<0.01) with a maximal follow-up of 3.9 years after treatment. When adjusting for covariates, the estimated mean [95% CI] difference was 0.43 [0.53; 0.33] LogMAR (+21.5 EDTRS letters) versus natural history at last observation (p<0.0001). 8 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

adjusting for age and gender were built to assess the relationship between cor- neal biomechanical properties and myopia, axial length (AL) and lens thick- ness (LT). Results: One hundred and fifty-six eyes (out of 78 children) were enrolled of which 100 had a spherical equivalent ≤ -0.50 and were classified as myopes. The mean±standard deviation age was 14.18±2.60 years, being significantly higher in the myopes (p=0.004). The proportion of myopes increased with age (p=0.019). LT presented a significant but weak negative correlation with in- traocular pressure (r=-0.227, p=0.005). Almost half of myopes had a positive family history of myopia. Myopia was associated with higher amplitude of whole eye movement (p<0.001). Longer AL and thinner lenses were associ- ated with a more deformable corneal behavior. Conclusion: In this sample of Portuguese children, AL and LT, but not myopic status, were related with corneal biomechanical behavior. Longitudinal studies are warranted to elucidate the role of corneal biomechanics in the screening and follow-up of ocular diseases in children. FREE PAPER PRESENTATIONS FP02-9 Spontaneous consecutive exotropia Ö. Bursali1, B. Çakir1, K. Gündoğdu1, S. Özmen1 1Sakarya University Education and Research Hospital, Ophthalmology Department, Sakarya, Turkey Purpose: To investigate the ophthalmological characteristics of cases with spontaneous consecutive exotropia. Method: The medical records of cases with the diagnosis of strabismus, be- tween 2012 and 2022 were scanned retrospectively. The cases with consecu- tive exotropia, without any ocular surgery or botox injection, were included in the study. The age at presentation of the esotropia and the consecutive exotro- pia were extracted from the notes. The initial and final detailed examinations of all patients were documented. Results: The study included 9 cases (2 females and 7 males) out of 3500 files. The rate of spontaneous exotropia development in 1750 patients with esotropia was 0.05%. The mean age ± standard deviation of cases was 11 ± 3.64 years. The presentation age of esotropia was 2.11± 0.99 years. The mean age at the time of appearance of exodeviation was 9.50 ±2.87 years. The mean period of spontaneous conversion to exotropia was 6.33±3.70 years after hyperopia correction. The mean spherical equivalent refraction was +5.00 ± 1.46 diopters (D) (range +2.50 to +7.00 D), and +5.00 ±1.38 D (range 2.50to +6.75 D) for right and left eyes, respectively. Only two of the nine cases had binocular vision. Conclusion: All the cases had a refractive spherical equivalent of at least +2.50 D. The initial age at presentation of the esotropia, in all cases, was younger than three years. Lack of binocular vision was remarkable in most cases. Keywords: consecutive; exotropia; spontaneous; hyperopia FP02-10 Myopia, axial length and lens thickness: a corneal biomechanical analysis of older children and adolescents A. Ferreira1,2, J.H. Marques1, A. Marta1,3, C. Castro1, P.M. Baptista1, D. José1, P. Sousa1, I. Neves1, P. Menéres1,3, I. Barbosa1,3 1Centro Hospitalar Universitário do Porto, Department of Ophthalmology, Porto, Portugal, 2Faculty of Medicine of the University of Porto, Department of Biomedicine - Unit of Anatomy, Porto, Portugal, 3Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal Objectives: To compare the corneal biomechanics of myopes with non- myopes in a sample of Portuguese children. In addition, we sought to evaluate their habits and background as well as to assess the potential relationship of axial length and lens thickness with their corneal biomechanical properties. Methods: Observational cross-sectional study assessing healthy children (8 to 18 years old) conducted at a tertiary university hospital center (Centro Hospitalar Universitário do Porto, Porto, Portugal). Demographic and clini- cal data were retrieved from medical records and participants’ and parents’ interview. After this interview, ocular biometry and corneal biomechanics were assessed using ZEISS IOL Master 700 (Carl Zeiss Meditec, Jena, Germany) and Corvis ST (Oculus, Wetzlar, Germany), respectively. Linear mixed-effects models 10 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

the initial learning curve did not significantly influence efficacy. In one patient it was not possible to implant the device. Two patients had transient hyphaema which resolved by one week. Conclusions: Surgeon experience during the initial learning curve for Hydrus had no apparent effect on efficacy or safety at 3 months. The study was limited by lack of corneal endothelial cell measurements however 5-year data from the HORIZON study indicated a high level of corneal safety even with long- term presence of the implant. FP03-7 Structure function relationship in glaucoma using anatomically corrected OCT images L. Schmetterer1, L. Chi1, D. Wong1, J. Chua1 1Singapore Eye Research Institute, Singapore, Singapore Purpose: To investigate whether the structure function relationship in glau- coma can be improved by anatomical compensation of circumpapillary reti- nal nerve fiber layer (RNFL) thickness profiles for multiple demographic and anatomical factors. Methods: In this cross-sectional study, 353 eyes from patients with early glau- coma (visual field [VF] mean deviation, ≥−6 dB) underwent Cirrus spectral- domain optical coherence tomography (OCT) imaging and Humphrey 24-2 VF tests. Compensated RNFL thickness profile was corrected for age, refrac- tive error, optic disc (ratio, orientation, and area), fovea (distance and angle), and retinal vessel density. Focal associations between VF losses at the individual VF test locations, origi- nal RNFL, and compensated RNFL thickness measurements were determined using nerve fiber trajectory tracings. Linear mixed models were used to model focal VF losses at each VF test location. Results: The highest baseline correlation with VF losses was 0.30 (95% con- fidence interval [CI], 0.21-0.39) in the superior arcuate sector. Applying the compensated RNFL data increased the correlation substantially to 0.43 (95% CI, 0.34-0.51; P<0.001). Twenty-two (43.1%) VF locations had a Spearman’s correlation value of 0.25 or greater with focal VF loss using the compensated RNFL approach com- pared with 7 VF locations (13.7%) using the original RNFL model. Conclusions: Compensating for demographic and anatomical characteristics in RNFL thickness profiles substantially improves the modelling of focal early VF losses, suggesting that structure-to-function maps accounted for demo- graphic and anatomic variances may help unmask localized structural and functional loss in early glaucoma. FREE PAPER PRESENTATIONS (PDA) group and control group. Subjects in the PDA group were given a copy of our Chinese POAG PDA, which was developed by our team. Subjects were then instructed to read through the PDA at home. All the subjects in the PDA and control were required to complete a ques- tionnaire at baseline, and repeated at 3 and 6 months follow up to determine change in disease knowledge, medication adherence, and decision conflict. The questionnaires included: 1. Glaucoma knowledge; 2. 8-item Morisky medication adherence scale (MMAS-8); 3. 10-item glaucoma medication adherence self-efficacy scale (GMASES-10); and; 4. 16-item decision conflict scale (DCS). The difference of changes between the two groups was analyzedwith one-way analysis of covariance (ANCOVA),fitting the baseline data as a covariate. Results: Totally, 156 subjects participated in this study, including 77 in the control group and 79 in the PDA group. Compared to the control group,PDA group showed around 1 point more improvement in disease knowledge at both 3 and 6 months (both p < 0.05), 2.5[95%CI(1.0, 4.1)] and 1.9[95%CI(0.2, 3.7)] points more improvement in GMASES-10 at 3 and 6 months respective- ly, and reduction in DCS by 8.8 [95%CI (4.6, 12.9)] points more at 3 months and 13.5 [95%CI (8.9, 18.0)] points more at 6 months. No difference was detected in MMAS-8. Conclusion: PDA led to improvement in disease knowledge and self-confi- dence in medication adherence, and reduced decision conflict compared to control group for at least 6 months. FP03-6 Safety and efficacy of the Hydrus Microstent during the initial learning curve A. Tatham1, S. Deol1, K. Cheng1, J.L. Ang1, S.-L. Young1, S. Dhillon1, T. Rane-Malcolm1 1University of Edinburgh, Centre for Clinical Brian Sciences, Edinburgh, United Kingdom Purpose: To examine the safety and efficacy of Hydrus Microstent during the learning curve of surgeons new to the procedure. Method: A retrospective study including a consecutive series of the first 38 Hydrus procedures performed by 3 surgeons. Two were experienced cataract and glaucoma surgeons with previous experience of MIGS but not Hydrus and 1 a glaucoma fellow. Patients were followed for a minimum of 3 months, with the primary out- comes, percentage and absolute change in IOP at time of listing for surgery compared to the visit after and closest to 3 months post-op. The relationship between order of surgery and IOP reduction was examined using regression analyses. Results: 37 eyes were treated with combined phacoemulsification-Hydrus. Mean IOP at baseline was 20.5±6.5 mmHg (range 11 to 35mmHg), using an average of 2.0 topical medications for glaucoma. Average mean deviation (MD) was -9.9±7.4dB. Peak IOP prior to surgery was 26.3±5.8 mmHg. Average IOP at 3 months was 14.8±3.6 mmHg, significantly lower than base- line (P<0.001). 29 of 38 eyes (81.6%) had ≥20% reduction in IOP on the same or fewer medications. The average reduction in IOP was 23.3±27.1% (5.7±6.7 mmHg), with an average reduction of 1.4±1.2 medications. Eyes with higher baseline IOP had significantly greater reductions in IOP with Hydrus (0.9, 95% CI 0.7 to 1.1 mmHg, greater reduction in IOP per 1mmHg higher baseline IOP, P<0.001). Baseline MD and surgeon experience during 12 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS FP04: Cornea, Ocular Surface FP04-1 Addressing the use of different topographic and tomographic devices for keratoconus management in optometry and ophthalmology practices, a comparison of the Medmont-E300, Revo-NX and Pentacam-AXL L. Angelo1, A. Gokul1, C.N. McGhee1, M. Ziaei1 1The University of Auckland, Auckland, New Zealand Purpose: To evaluate the repeatability and agreement of a Placido disc-based videokeratoscope (Medmont-E300 topographer) typically used in primary care with spectral-domain optical coherence tomography (Revo-NX) and Scheimpflug corneal tomography (Pentacam-AXL) typically used in second- ary-care. Method: A prospective study where one eye from each subject was random- ized to have central and thinnest corneal thickness (CCT, TCT) and maximum, mean, steep and flat keratometry (Kmax, Kmean, Ksteep and Kflat), measured with all three devices. Three measurements were completed per device to as- sess intra-observer repeatability. Results: 110 eyes from 110 patients with keratoconus were analyzed. Repeatability was best with the Pentacam for CCT, Kmax, Kmean, Ksteep and Kflat parameters (precision=9.21,0.8,0.38,0.52,0.58). The Medmont had better repeatability than the Revo with Kmax, Kmean, Ksteep and Kflat (pre- cision=1.41,1.35,1.43,1.59). Revo had the best repeatability with TCT (precision=3.81). The intraclass cor- relation coefficient was ˃0.94 for all parameters in all devices. Agreement was generally poor between devices. However, there was good agreement between Pentacam and Medmont Kflat measurements (p˃0.05). Conclusion: Repeatability of keratometry parameters with the Pentacam and Medmont were greater than the Revo, suggesting a lower threshold for change for anterior corneal changes. There was poor agreement between devices. The Revo had the greatest repeatability for TCT, suggesting a lower threshold for assessing thinning in disease progression and corneal-crosslinking safety. The Pentacam provided the best overall compromise between keratometry and pachymetry repeatability. FP04-2 Keratoconus: intrastromal ring segments implantation in the topographic axis versus the comatic axis - a comparative study Á. Silva1, T. Monteiro1, A. Oliveira2, C. Cruz1, R. Silva1, M. Sampaio1, M. Pereira1, R. Leite1, F. Vaz1 1Hospital de Braga, Ophthalmology, Braga, Portugal, 2Universidade do Minho, Braga, Portugal Purpose: Compare visual, refractive and topographic outcomes after ICRS implantation in patients with keratoconus, considering the coincidence of the topographic and coma axes. Methods: A retrospective cohort study was designed. Sixty-one eyes with keratoconus were submitted to ICRS implantation at Hospital de Braga be- tween 2011 and 2016. Two groups were created: group 1 if coincident axes (K1 and comatic axis ≤30º) and group 2 if non-coincident axes (>30º). Several variables were evalu- ated: uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction (sphere, cylinder, and spherical equivalent), topography (asphericity, coma, K1, K2, maximum K and keratometric cylinder) and cor- neal paquimetry, pre and postoperatively. The follow-up was 6 months. Results: We examined 61 eyes: 20 female, 41 male, 24 eyes with coincident axes, 37 with non-coincident axis. Medium age was 33.25 (SD=10.5), without significant differences between groups. Postoperatively, there was an improvement in visual outcomes: increased lev- els ofUCVA (β=0.16) and BCVA (β=0.15)). Topographic variables improved with surgery: a significant decrease in anterior K1 and K2(β=-2.51), anterior Kmax (β=-2.88 and keratometric cylinder (β=-1.19) was observed. Coma (β =-0.75) and asphericity (β=0.39) also improved. Refractive parameters revealed a reduction in sphere (β=2.09), cylinder (β=1.57) and spherical equivalent (β=2.88). No statistically significant differ- ences were seen between the groups regarding refractive, visual and topo- graphic parameters (p>0.05). No vision threatening complications were re- ported. Conclusions: ICRS implantation is effective in improving visual, refractive and topographic outcomes in patients with keratoconus, with a good safety profile, apparently without significant differences when considering the coin- cidence of the topographic and comatic axes. 14 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS The preoperative CDVA improved from 1.44 ± 0.31 logMAR to 0.44 ± 0.06 logMAR (P < 0.001). The preoperative CCT increased from 335.35 ± 11.24 µm to 477.35 ± 4.31 µm (P < 0.001). Conclusion: FML implantation is a safe, economical (does not require labora- tory support), and reliable technique. This study showed that FML contains living stem cells and keratocytes, therefore it initiates the regeneration of cor- neal tissue, which leads to increased corneal thickness, and improved visual acuity. FP04-6 Fresh human myopic lenticule intrastromal implantation for keratoconus using SMILE surgery in a long-term follow-up study: ultrastructural analysis by transmission electron microscopy F. Semiz1, A.s. Lokaj1, C.E. Semiz2, Z.A. Demirsoy3, N.H. Musa1, G.I. Semiz4, G. Tanriverdi5, O. Semiz1 1Eye Hospital,Pristina,Kosovo, ophthalmology, Prishtina, Albania, 2Gazi University, Faculty of Medicine, Ankara, Turkey, 3Yeditepe University, Faculty of Medicine, Istanbul, Turkey, 4Bahcesehir University, Faculty of Medicine, Istanbul, Turkey, 5Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey Purpose: To investigate new intrastromal histological structures that develop after myopic human lenticular implantation in keratoconus with femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery using trans- mission electron microscopy. Methods: Sixty eyes with advanced keratoconus indicated for corneal trans- plantation were included in this study. Fresh myopic lenticular implants were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea, untreated keratoco- nus, and treated keratoconus following 1, 2, and 3 years of surgery. These five lenticular samples were examined under the electron microscope and compared. Results: Disorganized and thinned collagen fibers were observed in the stro- ma with degenerative stromal cells (telocyte-like cells and keratocytes) in the keratoconic cornea. Apoptotic bodies and cell debris were easily observed near the disorganized fibers. In contrast, the myopic refractive error of the control and treatment groups demonstrated well-organized parallel lamellar structures. Healthy keratocytes and telocyte-like cells were observed in samples obtained 1, 2, and 3 years after lenticular implantation. Thus, telocyte-like cells may be activated by appropriate stimuli, such as stem cells, and be involved in stromal regeneration. Conclusions: Fresh myopic intrastromal lenticular implantation is a safe, eco- nomical, and reliable technique that leads to increased corneal thickness, im- proved visual acuity, and the regeneration of healthy keratocytes and telocyte- like cells that are involved in stromal regeneration. ClinicalTrials.gov Identifier: NCT04591587 FP04-7 Long-term effect of intense pulsed light combined with low-level light therapy in the treatment of Meibomian Gland Dysfunction J. Leite1, B. Ribeiro1, J.H. Marques1, A. Marta1, P.M. Baptista1, D. José1, P. Sousa1, P. Menéres1,2, I. Barbosa1,2 1Centro Hospitalar Universitário do Porto, Porto, Portugal, 2ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal Purpose: To evaluate the efficacy of intense pulsed light (IPL) combined with low-level light therapy (LLLT) in the treatment of meibomian gland dysfunc- tion (MGD). Methods: Prospective, double-arm, non-randomized study. Patients with MGD were consecutively assigned to either IPL combined with LLLT (group 1, Eye-Light® + My-Mask® by Expansione Group, Italy) or IPL therapy alone (group 2, E>Eye® by ESW vision, France). Evaluations at baseline and at 1st, 6th, 12th and 18th month after treatment. Outcomes were the variation of the validated Dry Eye Related Questionnaire (OSDI-12) and automated analysis of the ocular surface (IDRA® Ocular Surface Analyzer SBM Sistemi, Italy) such: non-invasive tear break-up time (NIBUT), blink rate (BR), meniscus height (MH) and lipid layer thickness (LLT). Schirmer’s test (ST), tear film osmolarity (TFO) and superficial fluo- rescein corneal staining lesions (SFCSL) were also evaluated. Results: Sixty-two patients (124 eyes) were included: 31 in group 1 and 31 in group 2, 30.6% were male, with a mean age of 65.7±10.1 years. Comparing baseline with 18th month of follow-up, both groups showed a sig- nificant improvement in the Ocular Surface Disease Index (OSDI) (p<0.001) and decrease in NIBUT (group 1, p=0.789; group 2, p=0.133); In BR and MH, there was a significant improvement in group 1 (p<0.001 and p=0.040, respectively) but not in group 2 (p=0.618 and 0.701, respectively); Both groups had a significant improvement in LLT (p<0.001) and in ST (group 1, p<0.001; group 2, p=0.029); an increase in group 1 (p<0.001) and a de- crease in group 2 (p=0.005) occurred in TFO; No differences in SFCSL in both groups (group 1, p=0.240; group 2, p=0.081). During the follow-up, 6 eyes (group 1) and 16 eyes (group 2) were referred for retreatment. Conclusions: IPL is an effective and safe treatment choice for MGD. Both groups showed benefits. The benefits of combined therapy seem to be more persistent and wider, improving the aqueous layer of the tear film. 16 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS FP05: Oculoplastics, Retina, Uveitis Conclusion: A non-surgical approach is tempting for the patient. However, recurrences might be inoperable and finally untreatable. The primary surgical approach in operable cases should be prioritized. Radio- and immunotherapy should be kept for non-operable patients. FP05-4 Quantifying functional vs. cosmetic blepharoplasty procedures following dermatochalasis referral D. Hu1, P. Rizzuto1 1Warren Alpert Medical School of Brown University, Ophthalmology, Providence, United States Purpose: Indications for blepharoplasty (bleph) may be categorized as “func- tional” or “cosmetic”. In the US, patients electing to proceed with functional blephs must demonstrate significant compromise of daily living activities due to visual impairment in order to qualify for insurance coverage. Patients who do not meet these requirements can elect to pay for the bleph, as it is con- sidered cosmetic. The purpose of this study is to characterize the nature of the dermatochalasis evaluation (eval), indications for surgery, and subsequent functional vs. cosmetic bleph. Method: A retrospective chart review was conducted from a single oculoplas- tic surgeon in the US. CPT (diagnosis code) was used to identify patients seen for dermatochalasis eval between 1/2019-1/2023. The primary outcome mea- sure was whether the patient elected to proceed with functional or cosmetic bleph. Additional variables collected include age (stratified 20-39, 40-59, and 60+ years) and gender. Results: 608 patients were seen for an eval between 2019-2023. 243 (40%) patients then elected to proceed with surgery. Of these, 196 (81%) patients received cosmetic bleph. 47 (19%) patients received functional bleph. Neither age nor gender were reliable predictors of whether patients elected to proceed with surgery (p>0.5). Of patients who did receive surgery, age was a signifi- cant predictor of whether the bleph was functional vs. cosmetic (p<0.001), and gender was not (p=0.364). Conclusion: The data show that the majority (60%) of evals did not lead to bleph. The rate of eval leading to surgery may be partially explained by a discrepancy in the understanding of insurance coverage between patient, re- ferring provider, and surgeon. False expectations of insurance coverage for both the eval and subsequent surgery may result in an excess number of evals and associated out-of-pocket expenses for patients. Both patients and referring providers should be aware of the insurance requirements for functional blephs. FP05-2 Recovery of the ratio of closure time during blink time in lacrimal passage intubation Y. Kim1, H. Lew1 1CHA Bundang Medical Center, Ophthalmology, Gyeonggido, Korea, Republic of Purpose: We aim to find a novel blink parameter in nasolacrimal duct ob- struction (NDO) patients and analyze parameters that could reflect subjective symptoms and objective indicators at the same time through a blink dynamic analysis. Methods: A retrospective study was conducted with 34 patients (48 eyes) who underwent lacrimal passage intubation (LPI) and 24 control groups (48 eyes). All patients’ blink patterns were measured using an ocular surface interfer- ometer before and after LPI, including total blink (TB) and partial blink (PB) and the blink indices blink time (BT), lid closing time (LCT), closure time (CT), lid opening time (LOT), interblink time (IBT), closing speed (CS), and opening speed (OS). The tear meniscus height (TMH) was measured and the questionnaire “Epiphora patient’s Quality of Life (E-QOL)”, including daily activity re- striction as well as static and dynamic activities, was completed. Results: Compared to CT and the ratio of CT during BT (CT/BT) in control (89.4 ± 20.0 msec, 13.16 %), those in NDO’s were longer (140.3 ± 92.0 msec, 20.20 %). They were also related to TMH. After LPI, CT, and CT/BT were recovered to 85.4 ± 22.07 msec, 13.29% (p<0.001). CT and CT/BT showed a positive correlation with the E-QOL score, particularly with dynamic activi- ties. Conclusion: CT and CT/BT, which are objective indicators associated with subjective symptoms of patients, are considered new blink indices for the evaluation NDO patients with Munk’s score. FP05-3 Periocular basal cell- and squamous cell carcinoma - when surgery would have been the best option K. Chaloupka1 1University Hospital Zurich, Eye Clinic, Zurich, Switzerland Purpose: Basal cell- (BCC) and squamous cell cancer (SCC) are the most frequent malignant tumors in the periocular area. Treatment options include surgery, radio- and immunotherapy. As tempting a non-surgical approach might be, the long term results show disasters recurrences when treated first with radiotherapy or immunotherapy. We present several patients with non-operable recurrences and discuss the chosen options including the pros and cons. Method: We review the history of patients with recurrences of BCC/SCC and compare a primary surgical approach with the chosen non-surgical approach. Results: Nine patients (six male, three female, aged 58-81y) in a 12 months period present with non-operable non-curative recurrences after primary non- surgical treatments of periocular. 18 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS FP05-7 Digital exclusion, social deprivation and clinical outcomes of patients undergoing hyperacuity home monitoring J. Mendall1, M. Islam2,3, L. Bachmann4,5, K. Wong6, S. Sansome2,3, S. Kang6, J. Huemer6 1University College London Medical School, London, United Kingdom, 2NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom, 3UCL Institute of Ophthalmology, London, United Kingdom, 4Medignition AG, Zurich, Switzerland, 5University of Zurich, Medical Faculty, Zurich, Switzerland, 6Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom Purpose: To measure the risk for digital exclusion and the social deprivation in- dex among participants in a home monitoring programme using the Alleye app for retinal disease. To examine the association of these parameters with clinical outcomes and programme adherence to investigate digital exclusion. Methods: Secondary analysis of 89 patients with diabetic maculopathy and retinal vein occlusions at Moorfields Eye Hospital participating in an Alleye home monitoring programme between June 2020-October 2022. Postcodes were used to determine the Digital Exclusion Risk Index (DERI) and the Index of Multiple Deprivation (IMD) for London. Clinical information from the clinic information system and Alleye app usage data were extracted for each patient. Associations between the DERI/IMD, clinical parameters and app use were examined in multivariable regression models. Results: Mean DERI was 2.56 (SD 0.36), IMD was 6.25 (SD 2.79), visual acuity in the better eye at study entry was 83.3 letters (SD 7.9), and mean follow-up was 344.4 days (SD 260.1). During the observation period, 36% received an intravitreal injection (IVI) and visual acuity fell by at least 10 let- ters in around 1 in 4 patients. In 87.5% of patients requiring IVI, use of the app increased. We found no association with clinical parameters and programme adherence for DERI or IMD. Conclusion: This home monitoring programme for mostly diabetic patients included people with a high digital exclusion risk and high social deprivation. Interestingly, there is no association between these parameters, clinical course and monitoring adherence, suggesting that patients with high digital exclusion risk and significant social deprivation may benefit from such a programme. FP05-8 Cannabidiol reduces para-cellular permeabilty in a model of the human inner blood-retinal barrier through PPARγ receptors P. Richardson1, R. Khan1, I. Iskandar1 1University of Nottingham, GEM School of Medicine, Derby, United Kingdom Purose: The aim of this study was to investigate the role of cannabidiol (CBD) in a 2-D transwell model of the inner blood retinal barrier (iBRB) using 3 hu- man primary retinal cell lines. Methods: Human retinal vascular endothelial cells (HuREC), astrocytes (HuRAstro) and pericytes (HuRPeri) were co-cultured on 0.1µm pore tran- swell inserts. Different combinations of the 3 cell types were compared to provide the optimal cell configuration, and integrity of the iBRB was measured by Transepithelial electrical resistance (TEER) with measurements before and at intervals after 10µM CBD added to the apical lumen. PPARγ antagonism was investigated by co-administration of 10µM GW9662 to the apical lu- men. The mean percentage change from baseline (3 samples in each 6 replicate experiments) was compared by one-way ANOVA with Dunnett’s corrections using GraphPad software. Results: The highest baseline TEER was achieved when HuREC and HuRPeri were co-cultured on the apical surface and HuRAstro on the baso-lateral sur- face of the insert. TEER was increased at 1, 2, 3 and 24 hours with 10µM CBD (149.6%, 142.8% 158% and 117.1% respectively); significantly higher than the vehicle control and GW9662 alone (p=0.0001 at all points) and greater than CBD + GW9662 at 2, 3 and 24 hours (p=0.0001). At 1 hour there was no significant difference in TEER between CBD with or without GW9662. Conclusion: This is the first study to demonstrate CBD can increase iBRB properties in a 2-D transwell cell culture model using human cell lines. Co- culture of REC and Retinal pericytes is a more physiological configuration as direct contact allows ‘Peg’ formation between the 2 cells. Increased iBRB integrity by CBD was mediated in part by the transcription factor PPARγ receptors. As there was incomplete and delayed inhibition with GW9662 there may be other pathways through which CBD can operate. Conditions with a breakdown of the iBRB leading to macular oedema would benefit from further study with CBD. FP05-9 Ocular autoimmune diseases & lessons from uveitis H. Bayazed1 1College of Medicine- University of Zakho- Kuristan Region, Biomedical Science, Zakho / Kurdistan Region, Iraq Purpose of presentation: It is not well understood how the ocular immune privilege is bridged in face of different systemic autoimmune diseases. However, ocular immune response in systemic autoimmune diseases may manifest with different arrays of eye disorders isuch as uveitis. This presentation may cover and provide an overview of the altered ocular microenvironment in face of different autoimmune-mediated diseases with a concentration on uveitis as a challenging medical disorder to achieve a faster diagnosis and a more effective treatment for patients. Recent findings: During the 20th century, Immuno-ophthalmology emerged as a subspecialty bridging ophthalmologists and immunologists. Literature reviews declare that the eye may be overwhelmed either as a bystander of unrelated autoimmune-mediated diseases or in certain instances the eye per se is the specific target affected by a certain inflammatory process such as uve- itis. Uveitis can present as an isolated entity or associated with other systemic autoimmune diseases and continues to be a diagnostic conundrum attributed to its heterogeneous presentation. However, suspicion of autoimmune-related uveitis with ocular or systemic manifestations should be considered challenging and clinically complex cases. Recent studies are focusing ON the pathogenesis of ocular inflammatory dis- ease following autoimmune-mediated diseases and identifying new targets for immunotherapy that will not only improve efficacy but also minimize adverse effects from traditional therapy. 20 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FREE PAPER PRESENTATIONS FP06-3 The use of a video-based telemedicine software for consultations and interactive visual acuity measurement after cataract surgery L. Pelosini1, S. Sansome1, L. Sharief1 1King’s College Hospital NHS Foundation Trust, Ophthalmology, London, United Kingdom Purpose: This study assessed the feasibility, safety, accuracy, and patient sat- isfaction in the use of a novel telemedicine software for video consultations and interactive visual acuity measurement following routine cataract surgery. Methods: This prospective cohort study assessed the use of video consulta- tion in 65 patients two weeks after routine cataract surgery. We compared this cohort with face-to-face consultations two weeks after cataract surgery. The remote consultation included a subjective assessment of the patient’s symptoms and compliance with medications, a visual evaluation of the ex- ternal eye, an assessment of photos of the anterior segment obtained with a smartphone and sent via the software, a digital analysis of hyperemia and a remote interactive measurement of ETDRS visual acuity during the video consultation. Results: Patients selected for video consultation were younger (median 73 years versus 85 years) with better general health conditions and were familiar with computer and smartphone devices. The video consultation allowed a reli- able assessment of symptoms, compliance with medication, and examination of the external eye in all cases. 4% of patients seen by video consultation required a clinic review due to intolerance to postoperative medications. There was no adverse effect in the group assessed by video consultation when they were assessed at the final review 5 weeks after surgery. 97% of patients were satisfied with the video assessment. Conclusion: This study showed that the video consultation was effective, safe, accurate, and satisfactory in this cohort of patients following routine cataract surgery. There were no adverse effects/complications missed in the group subject to video consultation at two weeks versus the patients reviewed in the clinic at two weeks. The novel process of integrating remote video consultation to routine medical care has the advantage of reducing hospital attendance and the cost of travel- ing for patients. FP06-4 Vitreous loss fire drills – ophthalmic simulation improves trainee surgical M. Khalil1, D. Lockington1 1Gartnavel General Hospital, Ophthalmology, Glasgow, United Kingdom Purpose: Ophthalmic trainees have reported limited exposure and low confi- dence regarding the management of cataract complications such as posterior capsule rupture (PCR)/vitreous loss (VL). We wished to evaluate the impact of a simulation-based educational training event on these concerns. Method: A mandatory educational “vitreous loss fire drill” was arranged for ophthalmic trainees in West of Scotland region, including a pre-course knowl- edge transfer video, and 4 practical simulation stations including performing an anterior vitrectomy, inserting a 3-piece lens, corneal wound suturing, and communication skills training and debriefing. A pre and post course question- naire of self-reported competence and confidence was undertaken (Likert scale 1-10). Results: 28 ophthalmic trainees participated (mean age 30 years; 54% male). All junior trainees (ST1-3) scored <6 in confidence and competence in all pre-course questions. All participants reported significant improvements following the “fire drill”, with median reported competence for anterior vitrectomy increasing from 2 to 7 (p<0.00001); 3-piece IOL techniques (3 to 7; p<0.00001) and corneal wound suturing (5 to 7; p<0.00001). Median reported confidence improved for performing anterior vitrectomy (4.5 to 8; p<0.00001); 3-piece IOL techniques (3.5 to 8; p<0.00001) and corneal wound suturing (6 to 8; p<0.00001). Conclusion: We have shown that a “PCR/VL fire drill” significantly improves trainee surgical competence and confidence in related surgical tasks, and re- duced concerns. Simulation-based activities enables development of essential skills and could be expanded for other intra-operative surgical complications. Such events should not be limited to trainees alone, but could form part of mandatory train- ing in the future. FP06-5 Results of uveitic cataract surgery in children at department of ophthalmology of First Faculty of Medicine of Charles University and General University Hospital in Prague O. Dušek1, M. Fichtl1, P. Sklenka1, M. Hlozanek2, J. Dvořák1, M. Michaličková1, M. Brichova1, P. Svozílková1, A. Klímová1, J. Heissigerová1 1Department of Ophthalmology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic, 2Department of Ophthalmology, 2nd Faculty of Medicine, Charles University and Motol University Hospital in Prague, Prague, Czech Republic Purpose: The purpose of the study is to present the results of cataract surgery in pediatric patients with chronic uveitis (CU) at our clinics. Methods: Retrospective analysis in period 2/2018-3/2021. The group includ- ed 8 patients (6 girls and 2 boys) with CU (7 children anterior uveitis and juvenile idiopathic arthritis and 1 child panuveitis and Blau syndrome). The standard surgical procedure included lens phacoemulsification with im- plantation of artificial intraocular lens (IOL) into the bag, posterior circular capsulorhexis and anterior vitrectomy. It was extended in some cases by ad- ditional procedures. Intracameral cefuroxime and subconjunctival dexametha- sone were administered into all eyes. All IOLs were monofocal, hydrophobic and acrylic. The nonparametric Mann-Whitney test was used to evaluate differences in best-corrected central visual acuity (BCVA). A significant p-value was p <0.05. Results: The average age of the children at the time of surgery was 7.5 years (5-12 years). Systemic treatment: 4 children methotrexate, 3 children myco- phenolate mofetil, 6 children adalimumab, 2 children corticosteroids (CS) and 1 child tocilizumab. Cataract surgery was performed in 10 eyes under general anesthesia. The sur- gery was performed in the absence of uveitis activity lasting at least 3 months. Perioperatively intravenous pulses of CS were administered with following conversion to an oral form. 22 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

FP06-10 Awareness and knowledge regarding diabetic retinopathy among non ophthalmic medical personnel of a tertiary care teaching hospital: a cross sectional study D. Surya1, S. Bhat2, S. Rao3 1Yenepoya University, Ophthalmology, Mangalore, India, 2Nitte University, Ophthalmology, Mangalore, India, 3Nitte University, Internal Medicine, Mangalore, India Background: Diabetic retinopathy (DR) is a microangiopathy and a blind- ing complication of Diabetes Mellitus (DM). It occurs due to poor control of DM and lack of knowledge about the complications of DM. Early referral of patients with diabetes to an ophthalmologist could help in the early detection, management and prevention of blindness due to DR. Awareness of DR among non ophthalmic medical personnel is essential for prompt timely referral to an ophthalmologist. Aim: This study was conducted to assess the awareness and knowledge of diabetic retinopathy among resident non ophthalmic personnel in a tertiary care centre. Methods: A hospital-based, cross sectional study was conducted using a pre- tested questionnaire. All the resident non ophthalmic medical personnel, at the medical college and hospital were recruited. Questionnaire was distributed to all the participants. The questionnaire contained questions to determine awareness of retinopathy and its risk factors, screening protocols and manage- ment. Data obtained was analyzed using the using SPSS Version 23.0 soft- ware. Results were expressed in form of percentages and proportions. Results: A total of 157 residents were recruited. Only 86 participants (mean age of 25years) completed the questionnaire. 83% of participants were aware of DR. Only 76% were aware that regular retinal examinations are required in both type 1 and 2 DM and 75% were not aware what the treat- ment for DR is. Conclusion: Although a large proportion of medical personnel are aware that diabetes can affect the eyes, there is little knowledge of its risk factors and prevention including screening protocols and treatment. Improving their knowledge will go a long way in guiding their patients. Implementation of awareness programme in their curriculum may improve their knowledge about the importance of prevention of DR related blindness. Awareness levels of medical personnel are vital in planning strategies to prevent blindness due to DR in Diabetes. FREE PAPER PRESENTATIONS Methods: We reviewed and compared the differences between the reports from Global burden of disease (GBD) and Lancet Committee in terms of the magnitude and distribution of the need depending on how the problem, popu- lation and regions are defined and how the data is collected and interpreted. We also reviewed the result of the Rapid Assessment of Avoidable Blindness (RAAB) surveys. Results: The magnitude of the problem is so high, and the World Health Organization (WHO) has identified that unaddressed near vision impairment (NVI) affects more than 500 million people globally.However, there is also huge difference between difference sources. Conclusion: There is need to find consensus in definitions and robust epide- miological data for quantify and monitor need to near vision glasses. There is also a huge need to the cost effective interventional and predictive studies that could address this predominant cause of visual impairment. Furthermore, there is a need to methodological framework for future studies on new inter- ventions and how to predict end users’ compliance with these interventions. FP06-9 A standardised preoperative risk stratification system to facilitate safer training and reduce complications of cataract surgery: considering outcomes with surgeon and patient perceptions C.N. McGhee1, S. Namkung1, J. Zhang1, J.V Han1 1University of Auckland, Ophthalmology, New Zealand National Eye Centre, Auckland, New Zealand Purpose: To further validate a cataract risk stratification system: to enable safer training of eye surgeons and improved patient outcomes; to evaluate surgeon perceptions; and to explore patient attitudes towards ophthalmology trainee involvement in surgery. Methods: Prospective cohort study: preoperative risk stratification of con- secutive cases (M=500) in a public teaching hospital setting. Identification of higher-risk cases and recommendation to allocate these cases to senior sur- geons. Primary outcome: intraoperative complication rates relative to adherence to risk recommendations. A face-to-face, 16-question patient questionnaire was independently administered to assess patient perspectives of trainee involve- ment. A structured, anonymised, electronic 21-question survey of a sample of eye surgeons assessed knowledge and views of risk stratification systems. Results: The stratification system scoring recommendations were adhered to in 98% of cases. Overall intraoperative complication rate was 5.4% (4.4% in those adhering to guidelines) with no statistical difference between surgeon levels. Post-op. mean best-corrected visual acuity was 6/7.5, cystoid macular oedema occurred in 3.6%. The patient questionnaire (N=84) revealed a num- ber of viewpoints for discussion but 90% supported trainee surgeon involve- ment in surgery. The surgeon questionnaire (N=66) revealed 77.3% thought risk stratification useful, however, 56.1% had not used any stratification sys- tem. Reservations included: weighting of risk factors; scoring cataract density; increased clinic time; potential to reduce trainee experience. Conclusions: This risk stratification system identifies high risk cases and re- duces complication rates, allowing safer training. Most patients held positive views towards trainee involvement with minor reservations. Surgeons thought risk stratification useful, but further education in relation to acceptability, ad- vantages and minimal drawbacks is required to improve uptake 24 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

the eGFR, it correlated negatively with macular thickness and positively with retinal nerve fibre layer in the same 3 quadrants, namely; the temporal, nasal and inferior regions. There is statistically significant positive correlation be- tween albumin/ creatinine ratio and central subfield thickness. SELDAI score correlated positively with macular thickness. The correlation was statistically significant. Further analysis was done to the subgroup of patients with neurological affec- tion. There was statistically significant higher mean macular thickness among cases with CNS affection than cases without affection (273.35 versus 256.51). In addition, all patients with neurological symptoms had reduced nerve fiber layer thickness in at least 1 clock hour sector. There is statistically significant lower global RNFL thickness, superior and temporal quadrants RNFL thickness in the subgroup of patients with neuro- logical SLE manifestations. OCT measurements can be a potential biomarker in lupus nephritis and neuropsychatric lupus patients. FREE PAPER PRESENTATIONS FP07-3 Systemic intravascular large B-cell lymphoma presenting with bilateral multiple serous detachments followed by rapid systemic deterioration leading to death H. Abdou1,1, B. Kapoor1 1University Hospitals of Leicester, Leicester, United Kingdom Purpose: To study a case of rare subtype of Lymphoma presenting with bilat- eral multiple serous detachments succeeded by fatal systemic deterioration. Methods: A patient in his 6th decade of life presented to eye caualty with re- duced vision. A clinical picture suggestive of bilateral Vogt Koyanagi Harada (VKH) syndrome was found and oral steroid was started. In few days, the patient was admitted to the hospital with a stroke and treated with throm- bolysis. He was discharged after clinical improvement. Eye review showed improvement in the interim, and possible choroidal masses were found later. Lymphoma was suggested as a possibility. The patient has developed other strokes with progressive neurological symptoms. He had extensive investiga- tions which were inconclusive. Sadly, the patient has passed away and post mortem autopsy confirmed intravascular large B-cell lymphoma which is a rare subtype of Lymphoma. Results: The patient had unusual presentation of intraocular lymphoma re- sembling VKH with no medical history at presentation. However, developing new medical symptoms and signs not correlating raised questions about VKH diagnosis. The challenge of performing vitreous biopsy in an unstable patient added to the complexity. Also, having had a recent dose of COVID vaccine was a red herring to investigate for vaccine -related thrombosis. Revisiting the diagnosis of VKH soon when associated with unexpected medi- cal symptoms, was an important learning point from this case. Conclusion: In summary, masquerading lymphoma can be very challenging to diagnose, and multidisciplinary team input is highly needed. intravascular large B-cell lymphoma is a rare subtype of Lymphoma which has been re- ported with ocular associations in a very small number of case reports in the literature. FP07-4 Ocular coherence tomography findings in systemic lupus patients with and without lupus nephritis M. Shahin1,2,3, E. Awad1, A. Awad1, G. Abdelateef1, H. Mabed1 1Mansoura University, Mansoura, Egypt, 2Horus University, New Domiette, Egypt, 3Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia This is an observational case series (30 patients). The aim of this study is to determine OCT findings for patients with and without lupus nephritis and correlation with other systems affection. Mean age of the studied cases was 33.97 years ranging from 18 to 56 years. Median duration of systemic lupus was 3.5 ranging from 1 to 9 years and median duration of lupus nephritis was 3.5 months. Albumin / creatinine ratio, 24-hour protein in urine and serum creatinine positively correlated with macular thickness. The correlation between them and the macular thickness was statistically sig- nificant. Both serum creatinine and albumin/creatinine ratio negatively cor- related with retinal nerve fibre layer thickness in the temporal & nasal and inferior quadrants. The correlations were statistically significant. Regarding 26 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS R APID FIRE PRESENTATIONS RF01: Contact Lenses, Education, Ocular Surface, Oncology & Pathology RF01-2 Treatment of aphakia in babies with contact lenses K. Jankovic Terzic1 1Ophthalmology Practice ‚Okoioko‘, Belgrade, Serbia Aphakia in babies is best treated with contact lenses. Fitting should be done as soon as possible after the surgery and ideally with the contact lens for pro- longed wear. Method: Retrospective overview of the medical documentation from October 2016 to dec 2021 (38 months). Only patients prescribed with contact lenses have been taken into consideration. Results: In total 53 babies with 84 aphakic eyes have been examined. All have had congenital cataract apart from two (2) who have had secondary cataract after the eye trauma. Age at the moment of cataract operation was between 10 days and 18 months (average 4,2 months). All babies have been operated at the Eye clinic, Clinical center in Belgrade. Fitting with contact lens has been done empirically, 30 days to 11 months post cataract surgery (average 2.4 months). 46 were prescribed with Silsoft Super Plus (elastoflicon A, Bausch Lomb) and 7 babies were prescribed with the Oculolens soft individual (Contaflex GM advance 58, Opticus) contact lens. Initial power was from + 32 Dsph to + 18 Dsph, depending on the age and the axial length. 42 have been referred to pediatric ophthalmologist for the treat- ment of amblyopia. Detailed education of parents has been conducted by the skilled and experienced nurse. By the end of 2020. Silsoft Super Plus was not available for the Serbian nor EU market. From this period onward, parents have been individually purchasing this lens from USA market or have been using available aphakic lenses locally. Three (3) patients have undergone secondary implantation of IOL, 3 have been using glasses only and four (4) patients have not returned for the follow-up. Conclusion: Initial correction of aphakia in babes with contact lenses is manageable even without keratometry. Regular follow up and treatment of amblyopia is needed. For successful wear as well as decrease of possible com- plications it is important to educate and support parents. RF01-3 Ophthalmology clinic appointment non-attendance in New Zealand: analysis of 169,854 non-attended clinic appointments from 2009-2018 S. Misra1, R. Hossain1, S. Guest2, F. Breeze1, J. McKelvie1 1The University of Auckland, Department of Ophthalmology, Auckland, New Zealand, 2Waikato District Health Board, Hamilton, New Zealand Purpose: Clinic appointment non-attendances consume a significant propor- tion of healthcare resources and are associated with poor health outcomes. This study evaluates ophthalmology clinic appointment non-attendances across New Zealand (NZ) and calculates the rates of non-attended first and follow-up appointments. Methods: A nationwide retrospective study was performed from 2009-2018 of all public-funded ophthalmology clinic appointment non-attendances us- ing NZ Ministry of Health datasets. The NZ Deprivation Index (NZDep) was used to evaluate regional socioeconomic disparities. Rates of non-attended first-specialist-assessment (FSA) and follow-up appointments/100,000-ap- pointments/year were calculated. Results: There were 2,803,350 (94.3%) attended and 169,854 (5.7%) non- attended ophthalmology clinic appointments from 2009-2018. Ethnicities in- cluded NZ-Europeans (n=85,431, 50.3%), Māori (n=41,893, 24.7%), Pasifika (n=26,155, 15.4%), Asian (n=10,313, 6.1%), and Other (n=6,062, 3.6%). Māori and Pasifika were nearly 2.5-fold more likely to not attend compared to NZ-Europeans. Disparities in socioeconomic status existed with 61% of patients residing in the two most deprived quintiles (NZDep=7-10). The nationwide overall mean rate of FSA appointment non-attendance was 487/100,000 appointments/year and non-attendance at follow-up visits was 564/100,000 appointments/year. Conclusion: This is the first nationwide analysis of non-attendance for oph- thalmology clinic appointments. Similar rates of FSA and follow-up appoint- ment non-attendance existed within each region but geographic variability nationally. Identifying population groups more likely to not attend their appointment can aid in optimising service delivery, reduce health inequity, and improve health outcomes. RF01-4 Self-reporting visual function: impact of personality traits and social determinants L. Havstam Johansson1, M. Zetterberg1 1Sahlgrenska Academy at University of Gothenburg, Department of Neuroscience/Ophthalmology, Mölndal, Sweden Purpose: To investigate if self-reported visual function in a 70-year-old population were influenced by social determinants, psychological aspects or vision. Methods: Participants (born 1944) were asked a question about their own visual function (N=560): the population who misjudged their own vision ca- pacity (N=48) was studied. Group A (N=18) consisted of participants having low presenting visual acuity at the ophthalmic examination (<0.5 decimal, >0.3 logMAR) and reported having a good vision ability. Group B (N=30) included persons having normal vision (presenting visual acuity ≥0.5 decimal, ≤0.3 logMAR) but reported low vision. Social determinants questions involved marital status, education, household economy as well as question of smoking and alcohol consumption. Ophthalmic examination included near visual acuity test, both presenting distance visual acuity as well as BCVA, visual field test and contrast sensitivity test. Psychometric test conducted the Neuroticism-Extraversion-Openness Five Factor Inventory, Sense of Coherence scale (SOC) and the Montgomery- Åsberg Depression Rating Scale. Statistical tests used were Chi-Square test, Mann-Whitney U-test and Logistic regression. Results: The population who made the wrong assumptions about their vi- sion ability had lower alcohol consumption (p=0.024) and lower household economy (p=0.034) compare to the control group. Group A were mostly women (p=0.002) with unrefractive errors and more visual field defects compare to the controls (p=0.041). Group B lived without partner or spouse (p=0.036), had low educational level (p=0.012), were dissat- 28 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS According to the DAS-28 score, which shows RA disease activity, RA pa- tients with similar severity of disease, according to their systemic treatment; those who received hydroxychloroquine treatment were determined as group 1, those who received methotrexate treatment as group 2, and those who re- ceived leflunomide treatment were defined as group 3. In addition, ocular surface changes of the patients, ocular surface disease in- dex (OSDI) questionnaire, Schirmer 1 test, tear break-up time (BUT), tear meniscus height (TMH), Oxford scoring according to staining of the ocular surface with fluorescein, conjunctival impression cytology (CIC) evaluating the stage of squamous metaplasia and goblet cell density were statistically compared between the groups. Results: 49 patients with a mean age of 57.9±10.2 years, 39 were female, and 10 were male. The mean follow-up period for RA was 12.1±7.8 years, and the number of patients according to the groups was 19 in group 1, 15 in group 2, and 14 in group 3, respectively. The OSDI questionnaire scores for the groups were 34.8±14.4, 35.2±14.4, and 46.03±14.3, respectively. Schirmer 1 test was 8.5±2.6 in group 1, 9.06±4.1 in group 2, and 7.8±2.6 in group 3 (p>0.005). BUT was measured as 6.4±1.9, 5.5±2.3, and 5.3±2.4 in the groups. The Oxford score was 0.94±0.97, 0.94±0.85, and 1.5±1.15 according to the staining of the ocular surface with fluorescein. According to the Nelson staging of CIC, it was 1.3±0.82 in group 1, 1.7±1.06 in group 2, and 1.7±1.3 in group 3. Conclusion: There was no statistical difference was observed between the groups in ocular surface evaluation tests and pathological examinations. RF01-8 The relationship between risk of obstructive sleep apnea and dry eye disease R. Aldina1,2, F. Yanuar1, Z. Afif1,3, H. Holipah1 1Universitas Brawijaya, Faculty of Medicine, Malang, Indonesia, 2Dr. Saiful Anwar General Hospital, Ophthalmology, Malang, Indonesia, 3Dr. Saiful Anwar General Hospital, Neurology, Malang, Indonesia Purpose: Dry Eye Disease (DED) may lead to decreased visual function, chronic tissue changes, eyelid, conjunctival, and corneal abnormality. Several studies pointed out the relationship between DED and obstructive sleep apnea (OSA). In patients with OSA, oxidative stress, hypoxia, and ocular surface inflammation increase, leading to a decrease in the functions of meibomian glands, goblet cells, corneal sensitivity, and tear production as a response to the stimulations from the lacrimal glands. The loss of conjunctival meibomian glands and goblet cells are implications of damage to the tear film quality, which results in DED. The relationship between risk factors of OSA and DED has yet been sufficiently clear to this point and, even, controversial among the published studies to date. Therefore, this study attempted to identify the relationship between the two. Method: This is a population-based cross-sectional study. Data were obtained from the database of Biomarker Smarthealth Research in Mendalanwangi, Sidorahayu, and Cepokomulyo Villages, which are located in Malang Regency, having risks of OSA (based on the STOP-BANG questionnaire), above ≥40 years old, involving a total of 518 participants. The available data were then processed according to the variables and went through DED exami- nations. This study employed the purposive sampling method. Result: In this study, moderate risk of OSA suggests a significant influence on the occurrence of DED with an odds ratio (OR) 1.66 (p<0.05). In addi- tion, moderate risk of OSA predisposes ADDE-type and Mix-type DED with OR 2.85 and 1.23 (p<0.05). High risk of OSA correlates with the occurrence of ADDE-type DED with OR 2.37 (p<0.05). The age group >60 years old shows a correlation with Mix-type DED with OR 2.09 (p<0.05). Women have a higher predisposition to ADDE-type with OR 2.58 (p<0.05). Conclusion: Moderate risk of OSA influences the occurrence of DED, both ADDE-type and Mix type; whereas high risk of OSA only correlates with ADDE-type. Older age plays a role in the occurrence of Mix-type DED and women have a higher tendency to present with ADDE- type. Keywords: ADDE, EDE, Mix, Metabolic Syndrome, population-based RF01-9 Corneal epithelial thickness correlation with Dry Eye symptom severity: a cross-sectional study B. Barbosa Ribeiro1, J. Heitor Marques1,2, P.M. Baptista1,2, P. Sousa1, S. Pires1, P. Menéres1,2, I. Barbosa1,2 1Centro Hospitalar Universitário do Porto, Ophthalmology, Porto, Portugal, 2ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal Purpose: To study the correlation between corneal epithelial thickness and the severity of symptoms in patients with Dry Eye Disease (DED). Method: We conducted a cross-sectional study from the outpatient clinic of a tertiary hospital. Adult patients with a clinical diagnosis of dry eye dis- ease were eligible for participation. Each patient underwent Swept Source Optical Coherence Tomography (OCT) Corneal Epithelial Thickness Mapping (by Heidelberg Anterion®) and automated ocular surface analysis (by IDRA® Ocular Surface Analyzer SBM Sistemi, Italy). Schirmer’s test, tear film osmolarity (by TearLab® Osmolarity System) and Dry-Eye Related Questionnaire (OSDI-12) were evaluated separately. Patients were classified accordingly to OSDI-12 in group 1 (mild disease) and group 2 (moderate to severe disease). Results: This study enrolled 200 eyes (of 100 subjects): 65 in group 1 and 135 in group 2. Median (range) OSDI and Schirmer’s test in group 1 were 7 (22) vs. 46 (79), p<0.001 and 15 (25) vs. 11 (34) mm, p=0.007 in group 2. Eyes from group 2 showed higher mean epithelial thickness (48.4 vs. 47.1, p=0.027) and lower mean stromal thickness (522.0 vs. 546.6, p<0.001) than group 1. Mean maximum epithelial thickness was higher in group 2 – 62.7 (11.5) vs. 58.5 (7.8) µm, p=0.009 in group 1 - and it was located inferiorly in most patients. Overall, the OSDI score was positively correlated with mean epithelial thick- ness (r=0.188, p=0.008) and epithelial variability index (r=0.277, p=0.004) and negatively correlated with mean stromal thickness (r=-0.313, p<0.001). Patients in group 2 showed higher epithelial variability index (4.5 vs. 3.2, p<0.001). Conclusion: Our study suggests that patients with more severe symptoms have thicker corneal epithelia, thinner stroma, and higher epithelial variability index. Since it considers each subject’s epithelial thickness, it may be a predic- tor of Dry Eye Disease severity. We’re currently working on new evidence to confirm these results. 30 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

cedure usually gives excellent results in preventing recurrence, maintaining the structural integrity of the anterior segment, and maintaining good visual function. RAPID FIRE PRESENTATIONS RF01-14 Anterior segment ischemia following intra-arterial chemotherapy for stage E retinoblastoma: report of four cases D. Hadjistilianou1, A. Pagliara1, G. Guidetti1, S. De Francesco1, C. Menicacci1 1University of Siena, Ophthalmology, Referral Center for Retinoblastoma, Siena, Italy Purpose: To report two new cases of anterior segment ischemia following intra-arterial chemotherapy alone and two cases after intra-arterial and intra- vitreal chemotherapy in retinoblastoma stage E1. Method: Observational case series of four patients with stage E1 retinoblas- toma. The clinical records of patients diagnosed with retinoblastoma were ret- rospectively reviewed. We obtained anterior segment and fundus photography (Panocam). We document the effects of anterior segment ischemia by MRI and histological examination. Results: We registered anterior segment ischemia in 4 cases out of 304 who underwent intra-arterial chemotherapy; two of them have been treated also with intra-vitreal chemotherapy. All of them developed iris atrophy or subat- rophy, cataract and neovascular glaucoma. Conclusion: Only four cases of anterior segment ischemia after intra-arterial chemotherapy are reported in literature. We present two new cases of anterior segment ischemia following intra-arterial chemotherapy alone and two cases after intra-arterial and intra-vitreal chemotherapy. This is a possible complica- tion that should be considered by the clinician in patients that undergo first- or second-line IAC. RF01-15 Surgical treatment of iris lesions D. Rasic1, D. Vasovic1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia Purpose: The most frequent iris lesions seen in routine clinical practice are nevocellular nevi, iris melanocytomas, “suspicious” nevocellular nevi–mela- nocytic neoplasia of uncertain malignant potential, and iris melanoma. Due to their localization, iris lesions are easily observed by clinical ophthalmo- logical examination. They grow slowly and usually require only documented and regular monitoring. However, if necessary, surgical excision is one of the preferred therapeutic modalities with good results. Method: Forty-nine patients were surgically treated and monitored for iris lesions at the University Eye Hospital Clinical Center of Serbia. In patients who underwent surgery, the entire lesion was removed, and the iris and/or pu- pil was reshaped (iridoplasty and/or pupilloplasty). Simultaneous or (rarely) subsequent cataract surgery using phacoemulsification in combination with artificial intraocular lens implantation has also been performed. Results: The most common histopathological findings included melanoma and melanocytic neoplasia with uncertain malignant potential, several nevo- cellular nevi, melanocytomas, and one iris varix. Excellent tumor control was maintained throughout patient follow-up while maintaining good visual acuity and vision quality in each case. Conclusion: Iris lesions are easily accessible for clinical ophthalmological examination and are relatively easy to recognize and monitor. In some cases, surgical removal of these lesions is the preferred treatment option. This pro- 32 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF02-4 Swept source anterior segment optical coherence tomography findings in negative dysphotopsia following cataract surgery E.C. Yesilkaya1, S. Keleş Yeşiltaş1 1University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey Purpose: To evaluate the anterior segment morphology of patients reporting negative dysphotopsia after cataract surgery with swept source anterior seg- ment optical coherence tomography (SS AS-OCT). Methods: This is a retrospective case-control study. The study group included patients with permanent negative dysphotopsia, and the control group includ- ed age- and sex-matched, uneventful postoperative cataract patients with the same in-the-bag acrylic monofocal intraocular lens implantation. All patients underwent SS AS-OCT at 6 month postoperatively. Anterior chamber width (ACW), pupil diameter (PD), lens vault (LV), nasal and temporal iridocorneal angle (ICA), anterior opening distance from 500 µm (AOD500) and iris thickness (IT) from 1000 µm were compared. Results: Eight eyes of 8 patients (62.5% female) in the negative dysphotopsia group and 18 eyes of 18 patients (56% female) in the control group were analysed. The mean age in negative dysphotopsia group was 59.2 and control group was 64.3 (p=0,16). The SS AS-OCT findings for the negative dysphotopsia and control groups, respectively, were as follows: The mean (SD) ACW (mm) was 12.47 (±0.29) and 12.31 (±0.62) (p=0,53); PD (mm) was 4.49 (±0.44) and 5.26 (±1.03) (p=0,18); LV (µm) was 603.83 (±185.7) and 668.2 (±261.3) (p=0,54); nasal ICA was 36.6°(±7.1) and 41.8°(±6.5) (p=0,15); temporal ICA was 33.7° (±7.3) and 43.9°(±8.2) (p=0,02); nasal AOD500 (mm) was 1.29 (±0.2) and 1.35 (± 0.3) (p=0,69); temporal AOD500 was 1.24 (±0.3) and 1.40 (±0.3) (p=0,49); nasal IT from 1000 µm was 460.7 (±105.6) and 467.8 (±108.7) (p=0,97); tem- poral IT from 1000 µm was 440.2 (±97.5) and 397.7 (±99.2) (p=0,34). Conclusions:Thepresent study shows that; PD, LV, nasal and temporal ICA and AOD500 values were lower in the negative dysphotopsia group than in the normal control group, this difference was statistically significant only for the temporal ICA. These findings might have clinical implications for the treat- ment of negative dysphotopsia. RF02-5 Telehealth postoperative day one monitoring for uncomplicated cataract surgery: a retrospective review during the COVID-19 pandemic G. Mcknight1, A. Harbour2, L. Jordan3 1Center for Sight, Anterior Segment, Pensacola, United States, 2Florida State University, College of Medicine, Pensacola, United States, 3Florida State University College of Medicine, Pensacola, United States Purpose: To investigate the use of telehealth on postoperative day one (POD1) after uncomplicated cataract surgery in lieu of the standard in-office visit for routine monitoring of postoperative complications. Methods: Patients reviewed served as their own controls, as their first surgery received the standard POD1 in-office visit, and their second surgery received a telehealth call with a symptom screening questionnaire by an experienced oph- thalmic technician. In-office visits resumed at one week for both groups. The main outcome measures were corrected distance visual acuity (CDVA) at one month postoperatively, interventions, and postoperative complications. The COVID-19 pandemic shed light on telehealth as a tool to promote social distancing while still providing medical care. Telehealth has now become an alternative to in-person visits for many fields of medicine. As many elective surgeries were postponed and in-office visits were limited, COVID-19 provid- ed the uniqueopportunity to compare outcomes in the setting of an outpatient community ophthalmology clinic of uncomplicated cataract surgeries with a POD1 in-office visit versus cataract surgery with a POD1 telehealth visit. Results: 122 eyes of 61 adult uncomplicated cataract surgery patients were included. The mean age at the time of operation was 70.85 years ± 6.97 (SD) (range 56 to 84 years) for the in-office group, and 71.28 years ± 6.87 (SD) (range 56 to 84 years) for the telehealth group. Average logMAR CDVA at one-month was 0.09 ± 0.12 (SD) in the in-office group and 0.10 ± 0.13 (SD) in the telehealth group, which was statistically insignificant (p = 0.64). The number of postoperative complications and/or interventions when con- trolling for previous ocular pathology was also statistically insignificant (p = 0.90). Conclusions: A telehealth visit one day after uncomplicated cataract surgery is a safe alternative to the in-office visit for the purpose of routine monitoring for postoperative complications. RF02-6 Radiation induced changes in lens structure and its comparison with non-exposed individuals E. Grisle1, G. Laganovska2, A. Zemītis1, I. Markeviča1 1Pauls Stradiņš Clinical University Hospital, Ophthalmology, Riga, Latvia, 2Pauls Stradiņš Clinical University Hospital, Riga, Latvia Aim: It is suggested that exposure to higher doses of radiation can cause mi- gration of human lens epithelium cells towards the posterior cortex of the lens and not the nucleus, inducing formation of posterior cortex cataract. This re- search was carried out to evaluate radiation caused changes in lens structure and its effects on cataract formation. This research is particularly important given the political situation in the World today. Methods: This study was carried out in a patient group aged 55 – 70 years of age. Three groups of patients were compared: 50 healthy individuals, 50 Chernobyl clean-up workers (who worked in the theritory but not inside/on the reactor) and 11 Chernobyl clean-up workers (who worked on the roof or inside the reactor). The thickness of posterior lens cortex was compared between these groups. All measurements were performed with Heidelberg Anterion and the data were analysed using software Jamovi. Results: Tukey Post-Hoc Test showed that there is a statistically significant difference in posterior lens cortex thickness between healthy individuals and people who worked in Chernobyl city (p<0,001). However, there was no sta- tistically significant difference in this measurement between Chernobyl clean- up workers who worked on the roof of the reactor and people who worked only in the city (p=0,459). There was no significant difference between total lens thickness between neither of the groups (p>0,05). Conclusions: Exposure to increased amount of radiation can induce signifi- cant changes in patient health and cause differences in cataract lens morphol- ogy. Therefore it is important for our society to do our best to prevent any possible nuclear accidents. 34 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

Conclusions: In our large cohort study, the use of pupil expansion devices in cataract surgery was associated with an increased risk of major postoperative complications. Effective anti-inflammatory treatment and follow-up are war- ranted in eyes operated with a pupil expansion device. RF02-12 The ideal near vision test: a survey of international expert opinion E. Watts1,2, M. Katibeh3,2, N.M. Bolster4,2, A. Bastawrous4,2 1Tennent Institute of Ophthalmology, Glasgow, United Kingdom, 2Peek Vision, Berkhamsted, United Kingdom, 3Aarhus University, Department of Ophthalmology, Aarhus, Denmark, 4London School of Hygiene and Tropical Medicine, International Centre for Eye Health, London, United Kingdom Purpose: 509.7 million people are estimated to have near vision impairment due to uncorrected presbyopia (age-related near vision impairment). Quick and accurate testing of near vision allows identification of unmet need. The purpose of the survey was to assess whether currently existing near vision tests were satisfactory, whether a new digital near vision test could improve service, and what characteristics an ideal near vision test would have. Methods: Between October and December 2020, a survey was sent to a se- lection of 16 international experts working in the context of vision screening. Participants included optometrists, ophthalmologists, public health research- ers and software test developers working in global ophthalmology, from six continents. A subset of respondents were followed up with in-depth inter- views. Results: The most commonly described purposes of the near vision test were: to identify threshold for onward referral to an optometrist/refraction- ist (14/16), for prescription of ready readers (14/16), and to allow population survey data collection (13/16). 11/16 of respondents thought the test should be a single optotype chart. If single optotype, tumbling “E” was the most popular optotype (9/16). Most respondents (9/16) thought the chart should be present- ed one letter at a time with a surrounding border. Conclusions: The most popular test design was a single optotype Tumbling “E” test, showing individual optotypes in a bounding box. These results have since been used to guide development of PeekNV, a new digital test of near visual acuity and impairment. RAPID FIRE PRESENTATIONS Methods: Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospec- tive study. The included patients were 56–79 years old, wanted spectacle independence, and had preoperative myopic refraction between − 1.0 and − 2.25 diopters (D) and astigmatism between − 0.75 and − 1.75 D. The treatment status of these patients was defined as trifocal IOL (n= 82). SMILE was performed on patients who were dissatisfied after cataract sur- gery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifo- cal IOL implantation. Results: The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from − 2.08 ± 0.28 [− 2.25 to − 1.0] preoperatively to − 0.25 ± 0.20 − 0.5 to 0] 1 year postoperatively (p< 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52–0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05–0.1] logMAR at 1 month postoperatively (p< 0.001), 0.09 ± 0.02 [0.05–0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05–0.1] logMAR at 12 months postoperatively (p< 0.001). Patient satisfaction measures after SMILE (read- ing, night driving, and using a computer) were significantly improved. Conclusion: SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complica- tions and increases patient satisfaction. clinicaltrials.gov (NCT04693663) RF02-11 Use of pupil expansion devices is associated with an increased risk of post cataract complications A. Achiron1 1Tel Aviv Medical Center, Tel Aviv, Israel Purpose: To assess the risk for uveitis, pseudophakic cystoid macular edema (PCME), andposterior capsular opacification (PCO) associated with the use of pupil expansion devices in cataract surgery. Methods: This study included 39,460 eyes operated without a pupil expan- sion device and 699 eyes operated with the device. Odds ratios for uveitis and PCME when using a pupil expansion device were calculated using univariate and multivariate regression analysis, having age, gender, diabetes, pseudoex- foliation, and pupil expansion device as independent variables. Multivariate Cox regression controlling for age and gender was used to estimate hazard ratios (HR) for Nd:YAG laser capsulotomies. Results: Postoperative uveitis and PCME were reported in 3.9% and 2.7% of the eyes operated with a pupil expansion device compared to 2.3% and 1.3% operated without the device (p=0.005 and p=0.002, respectively). In univariate regression analysis, eyes with pupil expansion devices showed a higher risk of postoperative uveitis or PMCE after cataract surgery (OR 1.88, 95%CI 1.39-2.55, p&lt;0.001). In multivariate regression analysis, the risk for PMCE was greater among dia- betic patients and in eyes with a pupil expansion device than in those without (OR 1.50, 95%CI 1.24- 1.83, P&lt;0.001; OR 1.90, 95%CI 1.16-3.11, P=0.01). In Cox regression analysis adjusted for the patient&#39;s age and gender, the use of a pupil expansion device was associated with higher Nd:YAG laser capsulotomy rates (HR 1.316, 95%CI 1.011-1.714, P=0.041). 36 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS R APID FIRE PRESENTATIONS RF03: Retina RF03-1 Evaluation of ganglion cell layer and retinal nerve fiber layer in flight personnel B. Isik1 1Biruni University Hospital, Istanbul, Ophthalmology, Istanbul, Turkey Purpose: The aim of this study was to evaluate and compare ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thicknesses in flight person- nel and healthy controls. Methods: In this prospective study, 36 pilots and cabin crew (study group) and 43 healthy controls (control group) were enrolled. RNFL thicknesses in the superior, inferior, nasal, and temporal quadrants of the optic disc and GCL thicknesses in the superior and inferior areas of the macula were measured by the help of Cirus HD OCT-5000 unit (Carl Zeiss, Jena, Germany). Results: No significant differences were detected in terms of sex and age be- tween the two groups (P=0.3 and 0.2, respectively). The average cup disc ra- tio, vertical cup disc ratio, average RNFL thickness and RNFL thicknesses of superior, nasal, temporal and inferior quadrants of the optic disc did not differ between the two groups (all P>0.05). No significant difference in the minimum, average and superior GCL thick- nesses were documented (all P>0.05). The GCL thickness of the inferior quad- rant of the macula was significantly thinner in the pilots and cabin crew group (P=0.03). Conclusion: From the results of this study, it was concluded thatGCL thick- ness of the inferior quadrant significantly decreased in the study group. This change might be related with long term and recurrent high altitude, low oxy- gen and high ultraviolet radiation exposure. RF03-2 Evaluation of differentiation status of stimulated adipose MSCs towards RPE phenotypes in co-culture conditions G.K. Srivastava1 1IOBA, Universidad de Valladolid, Valladolid, Spain Purpose: Adipose derived mesenchymal cells (hADMSCs) are very promis- ing to retina repair via the neuroprotection and/or the damaged retinal cell re- placement. Retinal pigment epithelial cell layer (RPE) needs cell replacement in late stages of the disease such as AMD. Method: In this research study, the hAD-MSCs were co-cultivated with mitomycin (MMC) inactivated RPE cells along with drugs/factors and their combinations (VIP, NIC, ATRA, VIP+NIC, VIP+ATRA, NIC+ATRA and VIP+NIC+ATRA) in standard culture conditions in trans‐well system of 6‐ well plates in which both cells were not in direct physical contact. Western blot technique was used to analyse differentiation status of hAD‐ MSCs by measuring amount of expression of MSCs‐specific marker Thy‐1 (CD90) and RPE marker proteins (RPE65, Ezrin, CK8/18, Tyrosinase, MerTK, MiTF, Pax6) in the hAD‐MSCs under each stimulated condition. Induction of epithelial characteristics of RPE in stimulated hAD‐MSCs was evaluated by analyzing the expression of RPE specific epithelial proteins e.g. cytokeratin 8/18 (CK8/18),ZO1 and pan‐cytokeratin (PCK). Results: Results of significant comparative changes, increase or decrease, of all the markers in the hAD‐MSCs under stimulated and unstimulated con- ditions are summarized in Table. WB results and summary Table showed expression of MSCs‐specific marker Thy‐1(CD90) decreased significantly in stimulated hAD‐MSCs. This significant decrease was more prominent especially in case of combinations of factors. Expression of RPE65, Ezrin, CK8/18, Tyrosinase, MerTK, MiTF, Pax6 proteins increased significantly in stimulated hAD‐MSCs in comparison to unstimulated hAD‐MSCs. Conclusion: The hADMSCs in indirect co-culture with inactivated RPE cells along with factors were found to differentiate towards RPE phenotypes to different extent, when stimulated by different combinations of factors. Combinations of factors were found better in stimulating the differentiation in comparison to individual factors. RF03-3 Subretinal hyper reflective material (SHRM) morphology in neovascular age-related macular degeneration (AMD): a case-control study D. Alex1, A. Giridhar1, M. Gopalakrishnan1 1Giridhar Eye Institute, Department of Retina, Cochin, India Purpose: To evaluate the association of morphological features of subreti- nal hyperreflective material (SHRM) with visual acuity, geographic atrophy (GA), and scar formation in eyes with neovascular age-related macular de- generation (neovascular AMD) and to compare with controls of neovascular AMD without SHRM. Methods: Retrospective analysis of 157 wet AMD eyes with SHRM and 50 eyes without SHRM treated with Anti-VEGF. Baseline Spectral Domain-OCT characteristics (SHRM location, height, width, area, reflectivity, border defini- tion) were collected and were correlated with visual acuity (VA) at baseline, 3,6,12 months and looked for development of scar and geographical atrophy (GA) and were compared to the control group. Results: When compared to the control, baseline parameters with a significant predictive value of 12-month visual acuity were the presence of SHRM, foveal involvement of SHRM, high reflective SHRM, well-defined SHRM borders, and thick SHRM. VA was decreased with greater SHRM height, width, and area (P < 0.001). Decreasing reflectivity of SHRM lesions and disappearance of SHRM correlated with better VA at 12 months (P < 0.05). At 12 months, scar and GA were present more often in eyes with persistent SHRM than in eyes with SHRM that resolved and those without SHRM in the control group. Conclusion: SHRM can be considered as a surrogate OCT biomarker in pre- dicting the final visual outcomes in neovascular age-related macular degen- eration. Baseline parameters predicting poorer vision at 12-month follow-up were the presence of SHRM involving the fovea, well-defined SHRM borders, greater SHRM height, width, area, and persistence of SHRM with Anti-VEGF therapy. 38 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS Most ocular study eye adverse events were considered mild to moderate. Intraocular inflammation and infectious endophthalmitis rates per injection were 0.20% (excluding four events in 2018 attributed to drug impurity) and 0.034%, respectively. Rates of new-onset exudative age-related macular de- generation (eAMD) were 12.2% PM, 6.7% PEOM and 3.1% sham over 24 months. Conclusions: Pegcetacoplan slowed GA lesion growth and was well tolerated through Month 24. Rates of eAMD were higher with pegcetacoplan versus sham. RF03-8 Early real-world outcomes following intravitreal Faricimab for wet age-related macular degeneration (nAMD) in a multi-ethnic UK cohort A. Al-Gilgawi1, A. Green2, P. Ramakrishnan1, A. Ghulakhszian1, D. Ramcharan1, C. Dinah1,3 1London North West University Healthcare NHS Trust, Ophthalmology, London, United Kingdom, 2West Hertfordshire Hospitals NHS Trust, London, United Kingdom, 3Imperial College London, Brain Sciences, London, United Kingdom Purpose: Faricimab is the first bispecific agent to be approved for the man- agement of nAMD. Benefit in a real world ethnically-diverse cohort is not yet determined. We report early real-world outcomes in patients treated with Faricimab for nAMD. Methods: Consecutive patients presenting with nAMD or not responding to standard of care were initiated on Faricimab between July and December 2022. Functional and structural parameters 4 weeks after first Faricimab injec- tion are presented in this interim analysis. Results: 37 (mean age 79; 59% female; 32% Black, South Asian or Other) eyes were included. 20 eyes were switched from previous anti-VEGF therapy; the mean number of previous injections in this cohort was 33.95 (±30.8). Eylea was the most recent therapy in 65%, Lucentis in 20% and Beovu in 15%. 50% of eyes were switched for persistent CNV activity despite maximal treatment, 40% for inability to extend beyond 4-8 weeks and 10% for other reasons. Mean improvement in LogMAR BCVA 4 weeks after the first injection was -0.04 (±0.08), p=0.02. CSFT and PED height showed a mean reduction of -19.6 (±24.6) p=0.002 and -31.7 (±26.9) p<0.0001 respectively at 4 weeks post first injection. 17 eyes were naïve to any anti-VEGF treatment. Mean BCVA at baseline was LogMAR 0.61; mean central subfield thickness (CSFT) at baseline was 426.5µm; mean macular volume (MV) at baseline was 9.24µm and eyes with subretinal (SRF), intraretinal fluid (IRF) and SRF+IRF at baseline were 94%, 65%, 58.8% respectively. Mean change in BCVA was -0.16 (p=0.19), mean change in CSFT was -108.9 (p=0.0001), mean change in MV was -0.88 (p=0.002). Proportions of those with SRF or IRF both dropped by 35%. No intraocular inflammation or endophthalmitis was observed. Conclusion: Our results indicate a potential benefit of Faricimab therapy in a multi-ethnic cohort with nAMD. Longer term real-world analyses are required to assess efficacy and durability. RF03-9 The optical density of subretinal fluid in the differential diagnosis of chorioretinal disorders C. Durmaz Engin1, M. Kayabasi2, S. Koksaldi2, S.C. Ipek3, A.O. Saatci2 1Buca Seyfi Demirsoy Education and Research Hospital, Ophthalmology, Izmir, Turkey, 2Dokuz Eylul University, Ophthalmology, Izmir, Turkey, 3Bodrum Gozakademi Medical Center, Ophthalmology, Mugla, Turkey Purpose: To investigate the diagnostic role of optical density ratio (ODR) in chorioretinal disorders with different pathophysiological mechanisms that present with subretinal fluid (SRF). Method: Patients with acute central serous chorioretinopathy; CSCR (n=49), Vogt Koyanagi Harada’s disease; VKH (n=34) and choroidal hemangioma (n=17) were included. Spectral-domain optical coherence tomography (SD- OCT) images were analyzed using ImageJ by three independent readers. The ODRs were calculated using “region of interest (ROI)” and “entire region (TOTAL)” selection methods from the SRF to the vitreous, retinal pigment epithelium (RPE), and retinal nerve fiber layer (RNFL) reflectivity ratios. Correlation analysis between age, central macular thickness (CMT), lesion size, and ODRs were obtained. Results: The measurement of optical density was highly reproducible (intra- class correlation coefficient> 0.9). The optical density of the SRF, vitreous, RNFL, and signal strength were comparable (p=0.360, p=0.247, p=0.105 and 0.628, respectively), even though the mean age was significantly different be- tween disease groups. While there was no difference in SRF OD measurements between two meth- ods (p=0.401), there was a significant difference for vitreous OD measure- ments (p=0.016) for all participants. The ANOVA test of ODR(ROI) ,ODR(TOTAL), ODR-RPE (ROI) and ODR-RNFL (ROI) revealed no significant difference between acute CSCR, VKH disease and choroidal hemangioma groups (p>0.05 for all). The Pearson correlation analy- sis revealed a significant negative correlation between SRF height (p < 0.05) and CMT (p < 0.01) with ODR(ROI). Conclusion:The optical density ratio measurements appear to be highly re- peatable and thus may serve as a reliable SD-OCT parameter for chorioretinal disorders. Despite their distinct pathophysiology, the ODRs of SRF in acute CSCR, VKH disease, and choroidal hemangioma were not found to be statisti- cally different. RF03-10 Pathogenic implication from retinal events following COVID-19 infection X. Li1 1Xiamen Eye Center of Xiamen University, Retina, Xiamen, China Purpose: Coronavirus disease 2019 (COVID-19) infection had affected not only respiratory tract but also many other organs. In the retina, COVID-19 is associated with vascular events. The aim of this study was to report the retinal findings following omicron variants covid-19 infection and a better understanding of pathological retinal changes may help elucidate mechanisms of systemic thrombo-occlusive com- plications in patients affected by COVID-19. 40 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS tensity with surrounding edema, which prompted a workup for possible septic emboli versus occult malignancy. Subsequent blood cultures led to the detec- tion and diagnosis of Streptococcus gordonii endocarditis. It was subsequently revealed that the patient had self-extracted his molar two months prior to the onset of symptoms. Conclusions: Endocarditis has been associated with Roth spots and inflam- matory findings of the posterior segment. However, CRAO caused by vegetal septic embolism is rare. To our knowledge, this represents the first reported case of endocarditic CRAO with Streptococcus gordonii confirmed as the causative microbe. Retinal vascular occlusion in a young patient with no dis- tinct risk factors should prompt a comprehensive dental history and infectious workup, with consideration given to early transesophageal echocardiography. R APID FIRE PRESENTATIONS RF04: Glaucoma, Uveitis RF04-1 Esterman virtual reality visual fields in patients with glaucoma M. Sharma1, E. Savatovsky1, A. Grajewski1, E. Bitrian1 1Bascom Palmer Eye Institute, Miami, United States Purpose: Visual field damage has been shown to be related to impaired driv- ing performance.The Esterman visual field test, traditionally performed using standard automated perimetry (SAP), is a method to detect visual field deficits that would affect driving performance. The purpose of this study is to compare Esterman visual field test results using standard automated perimetry (SAP) to results obtained from a virtual reality visual field headset (VRVF). Methods: Patients with mild to severe glaucoma ranging from 14 to 90 years were included. Subjects performed Esterman visual field tests on both VRVF and SAP. Order of testing was randomized. Duration of testing and the Esterman efficiency score (EES), defined as the number of points correctly identified divided by the number of total points displayed during the test, were recorded for each test. Results: 22 subjects were included in the study with ages ranging from 14-78 years old. Eleven had mild glaucoma and 11 had moderate to severe glauco- ma. Mean Esterman efficiency score (EES) using SAP was 85 and mean EES using VRVF was 76. Mean duration of SAP testing was 281 seconds while mean duration of VRVF testing was 299 seconds. Patients reported a more pleasant experience with the head mounted VRVF device. Conclusion: Glaucoma has been found to be a leading reason for driver’s license issues at a higher age. The Esterman visual field test performed using standard automated perimetry (SAP) can be useful in driver’s license screen- ings; however, lack of portability and inability to accommodate multiple pa- tients at once in current testing environments creates challenges of using SAP to implement the Esterman test. Virtual reality visual field devices can be used in clinical practice to provide comparable results to standard automated perimetry for the Esterman visual field test, offering a portable and virtual alternative to SAP. RF04-2 Comparison of calculated and measured ocular perfusion pressures (OPP) W.-D. Ulrich1, C. Ulrich1, K. Kotliar2, K.-D. Wernecke3 1OphthaOphthalmological Office MVZ Polimed. HBS gGmbH Halberstadt, Halberstadt, Germany, 2Biomedical Engineering, Aachen, University of Applied Sciences, Aachen, Germany, 3Sostana GmbH Berlin, Berlin, Germany Purpose: With the Ocular Pressure Flow Analyzer (OPFA) ocular perfusion pressure (OPP) can be measured noninvasively on both eyes simultaneously without dilation of the pupils to compare OPFA data of measured and calcu- lated (surrogate) OPP. 42 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF04-5 RF04-7 Systematic review of clinical practice guidelines for the diagnosis and management of open angle glaucoma Correlation between Hemoglobin A1c with normal-tension glaucoma in rural population J. Galvez-Olortegui1,2, S. Bernales-Urbina1,3, R. Bouchikh-El Jarroudi1,4, R. Mollo-Bautista1,5, I. Silva-Ocas1, C. Burgueño-Montañes1,2, T. Galvez-Olortegui1,3,6 1Scientia Clinical and Epidemiological Research Institute, Evidence Based Ophthalmology Unit (Oftalmoevidencia), Trujillo, Peru, 2Hospital Universitario Central de Asturias, Ophthalmology Service, Oviedo, Spain, 3Glaucoma - Centro de Excelencia, Lima, Peru, 4Hospital Universitari Germans Trias i Pujol, Servicio de Oftalmología, Barcelona, Spain, 5Hospital Nacional 2 de Mayo, Servicio de Oftalmología, Lima, Peru, 6Hospital Nacional Guillermo Almenara Irigoyen, Departamento de Oftalmología, Lima, Peru Purpose: To assess the Clinical Practice Guidelines (CPG) for the diagnosis and management of open angle glaucoma (OAG). Methods: A systematic review of CPGs for the diagnosis and management of OAG, published between January-2017 and November-2022, was carried out. A search in databases (Pubmed/Medline, Scopus, Web-of-Science, Embase), metasearch engines (Tripdatabase, Epistemonikos), CPG developer organiza- tions, ophthalmology associations and CPG repositories/databases was per- formed. CPGs in English/Spanish were selected, and 5 authors assessed them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. Individual assessment by domain (AGREE-II), over- all evaluation, and its use with or without modifications was carried out for each CPG. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes of each CPG was performed. Results: 6 CPGs were appraissed (National Institute for Health and Care Excellence-NICE 2022, European Glaucoma Society-EGS 2021, Preferred Practice Patterns-PPP 2020, Sistema Nacional de Salud Español-SNS 2017, Ministry of Health Malaysia-MaHTAS 2017 and EsSalud Peru 2021). Most CPG scored high in domain 4 (clarity of presentation). NICE, SNS and IETSI, scored high in domain 3 (rigour of development). The EGS guide and the MaHTAS scored low in domain 3 (due to absence of available informa- tion), but scored high in domain 4. All the CPGs used GRADE system for making recommendations. In the meta- synthesis, variability was found in risk factors such as diabetes, ethnicity, hy- potensives drugs (Latanoprostene in the PPP, not available in Spain or Peru), IOP correction algorithms use(EGS), Selective Laser Trabeculoplasty (SLT) indication for initial treatment (EGS, NICE, MaHTAS), and minimally inva- sive glaucoma surgery indications(MIGS). Conclusions: NICE, SNS and IETSI CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. S. Prayitnaningsih1, B.S. Pratama1, H. Holipah2, A.A. Hamid1, Z. Afif3, B.B. Siswanto4, A. Santoso4 1Universitas Brawijaya, Ophthalmology Department, Malang, Indonesia, 2Universitas Brawijaya, Public Health Department, Malang, Indonesia, 3Universitas Brawijaya, Neurology Department, Malang, Indonesia, 4Universitas Indonesia, Cardiology Department, Jakarta, Indonesia Purpose: To evaluate the correlation between Hemoglobin A1c (HbA1c) with normal-tension glaucoma (NTG). Method: Cross-sectional population-based study taken from 3 villages involved 128 or 256 eyes, that devided into three groups consisted of nor- mal, prediabetes and diabetes groups. All subjects underwent age, sex, body weight, and height assessments. HbA1c levels were measured by ELISA from subjects‘ blood. Normal IOP measured by Tonopen confirmed the diagnosis of NTG. Mean Defect (MD) of visual field evaluated by Automated Humphrey Perimetry, Retinal Nerve Fiber Layer (RNFL) thickness and vertical cup-to-disc ratio (CDR) measured by Optical Coherence Tomography (OCT). The relationship between variables was tested by using the logistics regression test. Results: There was a relationship between high HbA1c level (≥7%) and NTG (p = 0,03; OR = 3,33), RNFL (p = 0,04; OR = 2,22), and CDR (p = 0,05; OR = 2,05). If the subjects have diabetes, the risk of NTG is three times higher, the risk of RNFL thinning is two times higher, and the risk of large CDR is two times higher than normal HbA1c. Results show statistically significant relationships between BMI with NTG and MD, systole with NTG, and age with NTG, MD, and CDR. Conclusion: Subjects with high HbA1c levels have an increased risk of NTG. Correlation between age, systole, and BMI with NTG were also identified. RF04-8 To evaluate the outcomes of Ahmed Glaucoma Valve (AGV) in pediatric patients C. Castro1, A. Figueiredo1, R. Reis1, I. Sampaio1, M.J. Menéres1 1Centro Hospitalar Universitário do Porto, Porto, Portugal Purpose: To evaluate the outcomes of Ahmed Glaucoma Valve (AGV) in pe- diatric patients. Methods: Case series of patients under 18 years-old, with glaucoma, sub- mitted to AGV implantation, between 2010 and 2021, in Centro Hospitalar Universitário do Porto, a tertiary center in Portugal. Type of glaucoma, previ- ous surgeries, pre- and postoperative intraocular pressure (IOP), surgical com- plications and need for additional IOP lowering agents or glaucoma surgeries, were recorded. Results: Thirteen eyes (11 patients) underwent AGV implantation. Median follow-up time was 10 [1.5-11] years. Mean age at the time of surgery was 12.3±3.0 [7-17] years-old, and 64% were boys. Six eyes had congenital glau- coma, 2 had aphakic glaucoma, 2 had Sturge-Weber syndrome, 2 had uveitic glaucoma and 1 had glaucoma secondary to a congenital hemangioma. 44 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

In terms of disease recurrence, the rate of reactivation on adalimumab was 0.62 flare-ups/patient-year, with 4 patients developing flare-ups in the initial 6-month treatment period. Four patients experienced adverse events, which included single episodes of: oral and genital thrush, bleeding gums, headache and nausea, and pain on adalimumab injection. Conclusion: This case series demonstrates that adalimumab is effective and safe after 6 months of treatment in the majority of refractory scleritics. We hope that our findings can add valuable data that will further support routine implementation of adalimumab in patients with refractory scleritis. RF04-13 Retinal mapping in idiopathic intermediate uveitis before and after topical steroid treatment in adult population H. Akil1, Y. Ansari1 1John Radcliffe Oxford University NHS Trust Hospitals, Eye Department, Oxford, United Kingdom Purpose: To analyze retinal thickness (RT) changes in patients with inter- mediate uveitis using The Heidelberg Spectralis optical coherence tomogra- phy (OCT), color-coded retinal thickness map before and after topical steroid treatment. Method: Retinal maps were statistically analyzed for 26 patients with newly diagnosed intermediate uveitis before after topical steroid therapy. Twenty four eyes of 24 patients (only one eye) were followed until resolution of in- flammatory activity (follow up in two weeks time and 4 weeks after the first follow up). Resolution occurred in all subjects within 6 weeks after the initial diagnosis. At each visit, thickness maps were generated. None of the patients had cystoid macular oedema. All patients were imaged by spectral-domain 840-nm OCT over a 6 × 6-mm field of view. The spatial distribution of reti- nal thickness was mapped and analyzed using the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Results: The retinal thickness was found to be significantly decreased in eyes with intermediate uveitis after topical steroid eye drops with a mean change of 39 ± 6.7 μm (mean ± SD, Bonferroni correction,α= 0.0125). Conclusion: Eyes diagnosed with idiopathic intermediate uveitis demonstart- ed a decrease in retinal thickness map after topical steroid eye drops. Retinal thickness map could be beneficial as imaging marker in monitoring treatment response of patients with idiopathic intermediate uveitis. RAPID FIRE PRESENTATIONS We report on a well-documented case with 4 years of follow-up where a pre- sumptive diagnosis of bilateral ampiginous choroiditis was made on a 48 years old female. Methods: Clinical case review. Case report: She presented initially with bilateral panuveitis with a best corrected visual acuity (BCVA) of 20/30 in her RE and 20/40 in her LE. Fundoscopy revealed vitritis and numerous retinal whitish placoid lesions with macular involvement in the LE. OCT showed increased retinal and cho- roid thickness with irregularity and hyperreflectivity of the external retina. An extensive workup to exclude several inflammatory and infectious condi- tions was done. OCT-A revealed a type 2 neovascular choroidal membrane in the LE. On the RE FA revealed leakage inferior to the fovea which cor- responded to hypocyanescence in ICG. On the LE progressive staining of the placoid lesions was observed which corresponded to marked hypocyanes- cence in ICG. Autofluorescence revealed placoid hypoautofluorescent lesions with dotted hyperautofluorescent margins. The extension of the placoid lesions and BCVA have been relatively preserved thus far in the follow-up period due to intensive treatment with imunosupres- sive drugs and antiVEGF injections in the LE. After being started on oral cor- ticosteroids, the patient moved on to corticosteroid sparing imunosupressive drugs (first cyclosporin and later methothrexate) and now is controlled with a monoclonal antibody (adalimumab). Conclusions: Ampiginous choroiditis is a primary inflammatory chorioreti- nopathy which requires intensive clinical monitoring and treatment in order to prevent disease progression and preserve BCVA. RF04-12 Adalimumab in the treatment of refractory non- infectious scleritis: 6-month outcomes E. Bober1, K. Frain1, M. Fotuhi1, J. Virgo2, E. Hindle3, J. Ma4, J. Luis1, P. Addison1, N. Okhravi1, W. Tucker1, M. Westcott1, C. Pavesio1, R. Lee1, I. Yeung1 1Moorfields Eye Hospital, Uveitis Department, London, United Kingdom, 2Guys & St Thomas‘ NHS Foundation Trust, Medical Eye Unit, London, United Kingdom, 3Moorfields Eye Hospital, Pharmacy Department, London, United Kingdom, 4West Hertfordshire Teaching Hospitals NHS Trust, Rheumatology Department, London, United Kingdom Purpose: Adalimumab is not routinely used in the treatment of refractory scleritis due to scarce scientific evidence in medical literature that would jus- tify its high cost. The aim of this case series was to assess efficacy and safety of adalimumab after 6 months of treatment in the subset of scleritics previ- ously refractory to conventional immunosuppressive agents. Method: Our retrospective analysis included 15 adults with refractory non- infectious scleritis initiated on adalimumab between September 2014 and October 2021 at our tertiary referral centre. Data was collected from clinic let- ters accessed from the electronic records system. Patients’ baseline character- istics and 6-month outcomes were analysed to determine the steroid-sparing effect, time to first scleritis flare-up since commencement of adalimumab, and presence of any adverse events during the follow-up period. Results: The fraction of patients on ≤10mg of daily oral prednisolone on ini- tiation of adalimumab vs at 6 months was 46.7% and 93.3%, respectively. A Wilcoxon matched-pairs signed rank test indicated that the prednisolone dose at 6 months of adalimumab was statistically significantly lower than the dose on initiation of therapy (p <0.0005). 46 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS R APID FIRE PRESENTATIONS RF05: Neuro-ophthalmology RF05-1 VRDN-001, a full antagonist antibody to IGF-1 receptor, in Thyroid Eye Disease (TED): results from Phase 1/2 clinical study R. Turbin1, B. Katz2, K. Cockerham3, R. Tang4, N. Nijhawan5, S. Ugradar6, D. O’Shaughnessy2, R. Summerfelt2, A. She2, R. Douglas7 1Rutgers New Jersey Medical School, Dept of Ophthalmology, New Jersey, United States, 2Viridian Therapeutics Inc, Waltham, United States, 3Stanford Department of Ophthalmology at Byers Eye Institute, Stanford, United States, 4Eye Wellness Center– Neuro-Eye Clinical Trials, Inc., Bellaire, United States, 5Oshawa Clinic, Oshawa, Canada, 6The UCLA Stein Eye Institute, Los Angeles, United States, 7Cedars Sinai Medical Center, Los Angeles, United States Purpose: IGF-1R antagonism reduces TED-related inflammation and propto- sis. VRDN-001, a full antagonist antibody to IGF-1R, is being evaluated in a phase 1/2 RCT (NCT05176639) at 3-20 mg/kg. We present results from the first cohort (10 mg/kg) of TED patients. Methods: Adults with active moderate-to-severe TED with clinical activity score (CAS) ≥4 were randomized to 2 infusions 3 weeks apart of either 10 mg/kg VRDN-001 or placebo (3:1). Safety and efficacy through 12 weeks were assessed. Results: Baseline characteristics were similar between VRDN-001 (n=6) and placebo (n=2). At 6 weeks, overall responder rate (% of patients with ≥2 mm reduction in proptosis and ≥2 point reduction in CAS) was 83% (5/6; VRDN- 001) vs. 0% (placebo); proptosis responder rate (% of patients with ≥2 mm reduction) was 83% (5/6; VRDN-001) vs. 50% (1/2; placebo). At 12 weeks, 80% (4/5) of VRDN-001 responders had maintained both overall and proptosis response. Mean proptosis reduction was 2.4 mm (VRDN-001) vs. 1.0 mm (placebo) at 6 weeks and remained consistent for VRDN-001 at 12 weeks (2.2 mm). MRI analysis at both 6 and 12 weeks showed proptosis improvement for all 4 VRDN-001 patients with scans available and no improvement in both placebo patients. CAS decreased to 0 or 1 for 83% (5/6; VRDN-001) vs. 0% (placebo) at 6 weeks and was maintained for 80% (4/5) at 12 weeks. Mean reduction in CAS was 4.3 (VRDN-001) vs. 1.5 (placebo) at 6 weeks and remained con- sistent for VRDN-001 at 12 weeks (4.2). Of the 4 VRDN-001 patients with diplopia, complete resolution occurred for 3 by 6 weeks and all by 12 weeks. AEs were mostly mild, with no severe or serious AEs reported. Conclusion: Two infusions of 10 mg/kg VRDN-001 were well tolerated in this cohort of TED patients. The rapid, clinically meaningful improvement across all efficacy measures by 6 weeks was sustained through 12 weeks. These results were achieved with a lower dose and fewer treatments than in prior RCTs of other anti-IGF-1R antibodies. RF05-2 Optic nerve head vascular changes and optic neuropathy in carriers of LHON-causing mitochondrial mutations C. Quigley1, K. Stephenson1, P. Kenna1, L. Cassidy1 1Royal Victoria Eye and Ear Hospital, Dublin, Ireland Purpose: In LHON the incitement to vision loss is not fully understood, as many carriers of the associated mitochondrial mutations do not manifest vi- sion loss. Optic nerve blood supply may have a role. Method: A group of LHON-affected, and their asymptomatic maternal rela- tives underwent examination including testing of visual acuity and visual- evoked-potential testing, and optic nerve imaging including optic coherence tomography angiography. A control sample was used to derive a normal confidence interval (CI) for perpipapillary vessel density (VD), using the software imagej to derive VD and R to analyse data. Results: We included four LHON-affected patients (four males, median age 21, interquartile range (IQR) 17-31), eleven asymptomatic carrier relatives (ten females, median age 56, IQR 45-63), and ten controls with normal eyes (seven females, median age 48, IQR 37-56). The normal 95% CI for peripapil- lary VD was found to be 6.7-16.7% (n=20 eyes). Of the LHON-affected (n=6 eyes), one eye had reduced VD at 4.1%, and of the asymptomatic relatives (n=19 eyes), three eyes had reduced VD at 6% in each eye. Raised VD was found unilaterally in two asymptomatic relatives, at 17%, one of whom also had reduced VD in the contralateral eye. In those eyes with reduced peripapillary VD, visual acuity was variable. In the LHON-affected individual and one of the asymptomatic carriers, VA was reduced to 1.6 LogMAR and 2.4 LogMAR respectively, and in the other as- ymptomatic carriers, VA was normal at 0.0 LogMAR. In these asymptomatic carriers with normal VA but reduced VD, VEP was prolonged in one carrier to 130 milliseconds. Conclusion: Reduced peripapillary vessel density may be observed to a vari- able extent in those affected by LHON and also in their asymptomatic rela- tives, where it can be associated with signs of optic neuropathy, even in the absence of visual acuity reduction. RF05-3 The incidence and prognosis of asymptomatic Idiopathic Intracranial Hypertension (IIH) diagnosis at the Ottawa Hospital T. Gholamian1, M. Quinn1, D. Albreiki1 1University of Ottawa, Ophthalmology, Ottawa, Canada Purpose: A subset of patients with IIH are asymptomatic and do not present with symptoms of increased ICP. The objective of this study is to understand if incidental IIH diagnoses is a predictor for better outcomes from a symptom- atic and visual outcome perspective. Methods: This is a retrospective chart review of all patients who received a diagnosis of IIH at the Eye Institute between the dates of 31-Aug-2000 and 31-08-2022. The demographics data, referring health care professional, visual symptoms, systematic symptoms, visual signs, visual fields data, OCT RNFL data, GCIPL data, and neuroimaging findings were collected. Descriptive sta- tistics were performed. 48 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF05-6 Visual dysfunction in relation to cobalt toxicity in mouse model B. Obied1, S. Richard1, A. Zahavi2, O. Girshevitz3, H. Sheffer4, N. Goldenberg-Cohen5 1Technion Institute of Technology, Medicine, Haifa, Israel, 2Sackler Faculty of Medicine, Tel Aviv University, Medicine, Tel Aviv, Israel, 3Bar-Ilan University, Faculty of Engineering and Institute of Nanotechnology and Advanced Materials, Tel Aviv, Israel, 4Bnai Zion Medical Center, Department of Pathology, Haifa, Israel, 5Bnai Zion Medical Center, Department of Ophthalmology, Haifa, Israel Purpose: Exposure to cobalt may results in toxic effects. The aim of the study was to explore the pathophysiology of cobalt toxicity related visual impair- ment. Methods: 104 wild type mice (WT, C57Bl6) were injected with cobalt-chlo- ride in 3 different routes:single intravenous (IV) injection (high, medium, and low concentrations); single intravitreal (IVT) injection, or daily repeated in- traperitoneal (IP) injections (high dose/3 days, medium dose/14 days, and low dose/55 days). Immunodeficient transgenic NOD SCID Gamma mice (NSG, n=13), were also injected IVT or IP, euthanized after 7d or 3d, respectively. WT IP injected mice underwent repeated ERG examinations. Macroscopic, histological, immunohistochemistry, and apoptosis staining were performed for eyes and brain. Cobalt levels were measured in the blood, urine and tears by particle induced x-ray emission analysis (PIXE). IVT inject- ed mice underwent magnetic resonance imaging (MRI) which was performed after 7 and 14 days of cobalt injection. Results: IV injection of cobalt in high/medium concentrations was lethal in all 8 mice. Low concentration IV injections were tolerated. PIXE results showed complete cobalt elimination from the blood by 2 hours. ERG records showed decreased b-wave amplitude. Apoptosis involved all retinal layers, but mainly the ONL. There was thinning of the retina, with preservation of RGCs. The inflammatory reaction was mainly microglial affecting mainly the INL. Histological and immunohistochemistry analysis showed intensive activation of microglia in the dura and optic nerves as well. IVT injection induced de- creased signal intensity in the optic nerve on MRI. Conclusions: Our study demonstrated extensive involvement of the retina and optic nerves in cobalt induced toxicity, the later was also demonstrated on MRI. It also caused severe cerebral inflammatory reaction. ERG demonstrated post-synaptic dysfunction. High levels of cobalt detected in the blood are as- sociated with optic neuritis. R APID FIRE PRESENTATIONS RF06: Cornea RF06-1 Evaluation of keratoconus with the ophthalmometric slit lamp M.-M. Gellrich1, S.J Linke2,3, J. Steinberg2,3 1Ophthalmological Practice, Kellinghusen, Germany, 2University Hospital Hamburg-Eppendorf, Hamburg, Germany, 3Zentrum Sehstärke, Hamburg, Germany Purpose: The surfaces of the cornea, its thickness and refraction can be evalu- ated with tomographic devices. We investigated whether corneal geometry can be characterized quantitatively by the slit lamp and also compare our findings to changes in biomicroscopy. Methods: In 20 eyes with keratoconus and 20 normal eyes we carried out the tick test, which indicates tilt between the two corneal surfaces (A small light source projects obliquely at the level of the corneal equator onto the patient’s eye. The tick sign is positive if - under slit lamp observation - the 2. Purkinje reflex veers downwards at least 0.2 mm). Also we looked for the presence of iron lines or Vogt’s striae. Furthermore in 33 eyes with keratoconus central corneal thickness was cal- culated from the visible width (w) of an 45° optical section through the pupil center and correlated to pachymetric measurements (m). Finally the central corneal curvature was calculated from the size of the 1st Purkinje image of a stripe-figure with 4.5 mm width projected at a distance of 6 cm onto the pupil centre. Results: Mean P2-deviation in the keratoconus group was much higher with 0.29 + 0.12 mm than in the control group with 0.04 + 0.03 mm (p< 0.001). In the keratoconus group the tick sign was present in 17 eyes while iron lines were present in 6 eyes and Vogt’s striae in 5 eyes. Linear regression revealed the following formula for corneal pachymetry with the slit lamp: m = 1,75 w (R² = 0,9977). The size of the 1st Purkinje image could also be determined when the figures of Javal’s ophthalmometer are too much distorted to be evaluated. Conclusion: Few ophthalmologists are aware that - before the era of biomi- crocopy - Allvar Gullstrand invented the slit lamp for ophthalmometric pur- poses. In keratoconus patients the renaissance of this original concept enables the general ophthalmologist without access to corneal tomography to carry out follow up examinations based on quantitative data collected with the slit lamp only. 50 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF06-5 Examination of corneal stromal regeneration by immunofluorescence after Keratoconus treatment F. Semiz1, A. Syla Lokaj1, N. Hima Musa1, Z.A. Demirsoy2, G.I. Semiz3, C.E. Semiz4, O. Semiz1 1Eye Hospital, Ophthalmology, Prishtina, Albania, 2Yeditepe University, Faculty of Medicine, Istanbul, Turkey, 3Bahcesehir University, Faculty of Medicine, Istanbul, Turkey, 4Gazi University, Faculty of Medicine, Ankara, Turkey Purpose: To examine both the patient‘s cornea and the implanted lenticule with the immunofluorescence method after the lenticule was implanted with a SMILE in a patient with Keratoconus. Methods: Forty-five eyes with advanced KC indicated for corneal transplan- tation were included in this study. Fresh myopic lenticular implants were placed in all eyes with SMILE surgery. After two and three years of surgery, small pieces of both the patient‘s cornea and the implanted lenticule were re- moved from the normal corneal stroma, untreated KC, and treated KC. These samples were examined and compared by immunofluorescence. Results: The fragments were analyzed by the immunofluorescence method. Well-organized parallel layered structures were seen in all samples taken, and healthy keratocytes and regenerative cells and stem cells, and telocytes were observed. Conclusion: Fresh myopic intrastromal lenticular implantation is a safe, reli- able technique that leads to increased corneal thickness, improved visual acu- ity, and the regeneration of healthy keratocytes and telocytes, and it contains stem cells and telocytes that are involved in stromal regeneration. ClinicalTrials.gov Identifier: NCT04591587 RF06-6 Diabetic corneal neuropathy and nephropathy, in patients with and without peripheral neuropathy: a systematic review and meta-analysis S. Misra1, H. Wadhwa1, C. McGhee1 1The University of Auckland, Department of Ophthalmology, Auckland, New Zealand Purpose: The aim of the current study was to evaluate corneal microstruc- tural changes and nephropathy in patients with diabetic peripheral neuropathy (DPN+) and without (DPN-) in each of Type 1 (T1DM) and Type 2 diabetes (T2DM). Method: A systematic review of studies that quantified corneal sub-basal nerve parameters using laser scanningin vivo corneal confocal microscopy (CCM) and DPN+ in those with diabetes was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) state- ment. CCM parameters examined were corneal nerve fibre density (NFD), nerve branch density (NBD) and nerve fibre length (NFL). Meta-analysis was done in RevMan 5.4. Results: 49 studies met inclusion criteria- 20 were included in this meta-anal- ysis (11 for T1DM, 9 for T2DM) with further data pending from 29 studies. This comprised 999 patients T1DM (314,313,372; DPN+,DPN-,controls) and 913 with T2DM (455,265,193; DPN+,DPN-,controls). Compared to T2DM, T1DM patients had larger differences in NFD (8.37±1.18 vs 3.50±0.61), NBD (9.86±1.63 vs 2.44±0.92) and NFL (4.15±0.34 vs 1.65±0.18) between DPN+ and DPN- groups. T1DM patients also had larger differences than T2DM patients in NBD (-17.49±3.60 vs -3.46±0.77) and NFL (-3.40±0.76 vs -2.77±0.29) between DPN- and controls, but insignificant difference, in NFD (-5.48±1.15 vs 5.56±1.31). eGFR was not significantly different between DPN+ and DPN- in T1DM (p=0.06) and T2DM (p=0.50). When comparing DPN- to controls, eGFR was reduced by 4.27ml/min (p=0.02) in T2DM. Conclusion: Corneal sub-basal nerve changes and nephropathy precede pe- ripheral neuropathy in both T1DM and T2DM but more in T1DM. In the presence of peripheral neuropathy, corneal neuropathy is associated with ne- phropathy more in patients with type 2 than type 1 diabetes. Future studies should refrain from grouping patients of different diabetes types together. CCM may be useful for monitoring progression of diabetic neuropa- thy and nephropathy. RF06-7 Correlation of corneal endothelial parameters with advanced glycation end products in diabetes mellitus patients B. Peterfelde1,2, Z. Svikle1, D. Petersone3, J. Janceva1,2, R. Nagobade1,2, E. Briede2, K. Agiseva2, J. Valeinis3, J. Sokolovska1, K. Baumane1,2 1University of Latvia, Faculty of Medicine, Riga, Latvia, 2Riga East University Hospital, Department of Ophthalmology, Riga, Latvia, 3University of Latvia, Faculty of Physics, Mathematics and Optometry, Riga, Latvia Purpose: To analyze the association between advanced glycation end-prod- ucts and corneal endothelial structural parameters in type 1 (T1D) and type 2 (T2D) diabetes mellitus patients. Methods: 95 eyes (95 patients, 73.7% female, median age 65 years (49.0- 71.5)) were included in this cross-sectional study. There were 50 patients with- out diabetic retinopathy (DR) (80% T2DM, median diabetes duration 15 years (8.0-25.0)) and 45 patients with DR (44.4% T2DM, median diabetes duration 25 years (18.0-31.0)). Corneal endothelial cell analysis was performed using Konan CellCheck20 specular microscope. Images were processed in auto trace mode and quantified for cell den- sity (CD), coefficient of variation (CV), hexagonality (HEX), pachymetry (Pachy).AGEs risk groups (0 - normal, 1 - mild, 2 - moderate, 3 - high) were determined using a skin autofluorescence AGE reader (Diagnoptics). Statistical analysis was performed using Rstudio: Wilcoxon, Kruskal-Wallis, Fisher, Chi square tests. Results: Correlation was found between: 1. CD and patient age (r=-0.381), diabetes type (p=0.036) T1D median (Q1- Q3) CD=2747 (2502-2836) mm2, T2D CD=2523 (2347-2667) mm2; 2. CV and AGEs risk group (p=0.008); 3. Pachy and DR group (p=0.008). There was no significant correlation between: 1) CD and AGEs risk group (p=0.052), diabetes duration (r=-0.002), albumin- to-creatinine ratio (ACR; r=-0.013), DR group (p=0.68); 2. CV and patient age (r=0.257), diabetes type (p=0.19), diabetes duration (r=0.13), ACR (r=0.14), DR group (p=0.42); 3. HEX and patient age (r=-0.11), AGEs risk group (p=0.58), diabetes type (p=0.26), diabetes duration (r=-0.15), ACR (r=-0.23), DR group (p=0. 39); 4. Pachy and patient age (r=-0.17), AGEs risk group (p=0.20), diabetes type (p=0.21), diabetes duration (r=0.18), ACR (r=0.03). Conclusions: Quantitative evaluation of corneal endothelial cells and AGEs levels can be used as an non-invasive biomarkers of corneal and vascular health. 52 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF07-3 Juvenile idiopathic arthritis associated uveitis (JIA-U): demographic and clinical predictors of ocular involvement and visual prognosis G. Cavaco Tardão1, P. Carreira1, F. Moraes1, R. Carreira1, V. Fraga2, T. Loureiro1, F. Fraga1, A. Vide Escada1, M.J. Santos2, A. Cardoso1, N. Campos1 1Hospital Garcia de Orta, Ophthalmology, Almada, Portugal, 2Hospital Garcia de Orta, Rheumatology, Almada, Portugal Purpose: To characterize a Portuguese population of patients with Juvenile Idiopathic Arthritis (JIA) and to evaluate possible associations between clini- cal factors and ocular involvement. Design: Retrospective, observational cross-sectional study. Method: Patients diagnosed with JIA in the previous 20 years in Hospital Garcia de Orta were included. Data were assessed from Reuma.pt database. Associations between demographic (age and sex), clinical (articular involve- ment, extra-articular manifestations, biological therapy), laboratory data (anti-nuclear antibodies, anti-CCP antibodies, rheumatoid factor, HLA-B27, c-reactive protein, erythrocyte sedimentation rate) and ocular involvement were assessed. Statistical analysis was performed using Chi-square for categorical variables and Mann-Whitney test for continuous variables. P-value < 0.05 was consid- ered statistically significant. Results: 91 patients were included, 11 (12%) with previous episodes of uve- itis. There was a statistically significant preponderance of early age at JIA diagnosis (mean 4.73 vs. 9.58 years, p-value=0.008), anti-nuclear antibodies positivity (p-value=0.01), and oligoarticular subtype (p-value=0.04) in the uveitis group. Ocular complications occurred in 36% of patients (n=4): cata- racts (n=2), band keratopathy (n=1) and posterior synechiae (n=1). The occurrence of complications was corelated with a shorter period between JIA diagnosis and the first JIA-U episode (mean 0.67 vs. 4.88 years, p=0.012) but not with age at JIA diagnosis or articular involvement. There was an eryth- rocyte sedimentation rate (ESR) elevation in the12 months before uveitis (mean 40.5 mm/hr, 13-83). Conclusion: These results are concordant with literature. The occurrence of JIA-U shortly after JIA diagnosis was shown to be a potential risk factor for ocular complications. ESR could be a potential biomarker for JIA-U, but larg- er multicentric studies are needed to corroborate this finding. RF07-4 Transposition surgery outcomes and effectiveness in correction of pattern deviations D. Dizdar Yigit1, C. Gurez2, A. Inal2 1Marmara University Hospital, Ophthalmology, Istanbul, Turkey, 2Beyoglu Eye Training and Research Hospital, Ophthalmology, Istanbul, Turkey Purpose: The aim of this study is to compare surgery results before and after rectus transposition operations which were indicated due to pattern strabismus. Method: The files of patients who had strabismus surgery between January 2021 and June 2022 were reviewed. 48 eyes of 38 patients with pattern eso- tropia or exotropia were included in this single center, retrospective study. The patients with systemic or ocular diseases other that refractive errors were ex- cluded. The angle of deviations (AD) before surgery, postoperative one month and 6 months were noted. AD measurements were made while the patient’s head were positioned in chin down, primary and chin up position. Successful outcome was defined as ocular alignment equal or under 10 prism diopters (PD) and also if the pattern deviation was corrected. Results: The mean age of 38 patients (18 males,20 females) included in this study was 27,32±18,38 years. 32 of them had exotropia (84%) and 6 of them had esotropia while 28 (74%) of them had V pattern and 10 (26%) had A pat- tern deviation. The mean AD of the patients before surgery in superior gaze, primary position and inferior gaze were 42,63±14,18 PD; 32,42±12,66 PD and 22,95±15,98 PD, respectively. The mean AD after 6 months was 4,84±9,27 PD in primary position and the pattern deviations were corrected in 84,2% of cases. Most frequently performed operation was lateral rectus recession with supraposition (78,9%) for exotropia with V pattern. Only two of the cases with residual pattern deviations required reoperation. Conclusion: Transposition of rectus muscles is an effective way for treatment of pattern deviations. While correcting the deviation in primary position, the ocular alignment in superior and inferior gaze can be effectively obtained. RF07-5 Our experience with ocular trauma in pediatric population A. Nadarevic Vodencarevic1, A. Međedović1, V. Jusufović1, M. Halilbašić1, Z. Mušanović1, A. Pilavdžić1 1University Clinic Center Tuzla, Tuzla, Bosnia and Herzegovina Introduction: Ocular trauma is very serious condition that could lead to vi- sion loss and vision impairment in children. Currently there is no known study of pediatric ocular trauma in Bosnia and Herzegovina. Purpose is to study the epidemiology, mechanism, causes and outcome of serious ocular trauma requiring hospital admission at University Clinic Center Tuzla, in children below 16years of age. Methods: Each file was studied to find out the demographic data, mechanism and cause of injury. The definitions and classifications of ocular trauma in our study were modified from the Ocular Trauma Classification Group guidelines and Birmingham Eye Trauma Terminology Presenting and final visual acuity were recorded along with details of anterior and posterior segment evaluation. All patients were followed up to 6 months. Results: This study included a total of 37eyes from 37 patients. Most injuries occurred in boys while playing outside without parent supervision. There were differences between rural and urban children. Most of the injuries occurred in rural locations of Tuzla Canton. Conclusion: We emphasize that in this major study of pediatric eye injuries in Bosnia and Herzegovina the majority of pediatric eye injuries were outside of the home and most of them were preventable. We believe strongly that is necessary to work more on health education, adult supervision and application of appropriate measures to reduce the incidence and severity of trauma. This is the first study to provides a detailed insight into epidemiology and socio-economic characteristics of pediatric patients hospitalized for ocular injuries. 54 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS R APID FIRE PRESENTATIONS RF08: Cornea, Ex ternal Eye RF08-1 Surgical outcomes of the artificial endothelial layer “Endoart®” implantation, in patients with chronic corneal edema M. Omiadze1, R. Omiadze1, M. Dvali2, N. Labauri3, D. Ofer4, G. Mekvabishvili2, S. Tsiklauri1, T. Mamageishvili3 1Caucasus Medical Centre, Tbilisi, Georgia, 2Akhali Mzera, Tbilisi, Georgia, 3Davinci Eye Clinic, Tbilisi, Georgia, 4EyeYon Medical, Tel Aviv, Israel Purpose: To evaluate short term clinical safety and efficacy study of the EndoArt® implantation in patients with chronic corneal edema, which is a synthetic biocompatible artificial endothelial layer. Methods: 17eyes of 17patients with chronic corneal edema , 14 pseudophakic bullous keratopathy and 1 Fuchs disease, received EndoArt® implantation in three different clinics.Central corneal thickness, change in best corrected dis- tance visual acuity (BCDVA) from baseline, and complications were assessed and analyzed in6-9months postoperatively. Results: 17eyes showed marked reduction in CCT measured by anterior seg- ment OCT (mean 246μm) improvement of BCVA (mean 0.11).Complications include implant graft decentration, detachment, pain due to transient IOP el- evation, conjunctival hyperemia. Conclusion: The EndoArt® demonstratingsimplicity of the surgical proce- dure, while exhibiting corneal thickness and pain reduction, and improved VA over time. Although no severe adverse events were observed, further studies should be conducted to investigate the safety and efficacy of the novel device. RF08-2 Deep anterior lamellar keratoplasty versus penetrating keratoplasty for macular corneal dystrophy S. Al-Swailem1, A. AlAraj2, A. AlAmeer3 1King Khaled Eye Specialist Hospital, Research Department, Riyadh, Saudi Arabia, 2College of Medicine, Qassim University, Department of Ophthalmology, Buraidah, Qassim, Saudi Arabia, 3King Abdullah bin Abdulaziz University Hospital, Ophthalmology Division, Surgery Department, Riyadh, Saudi Arabia Purpose: To compare the postoperative outcomes of deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PKP) for macular corneal dystrophy (MCD). Methods: A Single-center, retrospective, interventional case series. A chart review was performed of 100 patients (157 eyes) who underwent pri- mary DALK (DALK group) and PKP (PKP group) for histopathologically confirmed MCD for whom at least 12 months of follow-up was available. Between-group comparisons were performed of visual acuity (VA), graft sur- vival, and postoperative complications. Results: There were 22 eyes in the DALK group and 135 in the PKP group. The mean postoperative follow-up was 7.2 ± 6.20 years for the DALK group and 9.7 ± 4.1 years for the PKP group. Postoperative best-corrected visual acu- ity (BCVA) of 20/40 or better was achieved in 90.9% of the DALK group and 76.3% of the PKP group (P=0.12). At last visit, graft survival was 95.5% (21 eyes) and 91.1% (123 eyes) in DALK and PKP groups, respectively (P=0.69, log-rank test). Corneal graft rejection episodes occurred in 1 (4.5%) DALK graft and 19 (14.1%) PKP grafts. Microbial keratitis and cataract occurred in 6 (4.5%) and 15 (11.1%) PKP eyes. One (4.5%) eye in the DALK group had cataract and none of the DALK cases developed microbial keratitis. Clinically significant recurrence was observed in 4 (2.9%) PKP eyes and 1 (4.5%) DALK eye (P=0.69), respectively. Conclusion: DALK is a viable option for MCD without Descemet membrane involvement. DALK had comparable medium-term visual and survival out- comes to PKP. DALK has the advantage of lower open sky intraoperative complications and lower graft rejection episodes. RF08-3 Successful treatment of myopic lenticular implantation by changing the corneal Q value, using the Smile module in patients with high hyperopia and astigmatism F. Semiz1, A.s. Lokaj1, O. Semiz1, N.H. Musa1, G.I. Semiz2, Z.A. Demirsoy3, C.E. Semiz4 1Eye Hospital, Ophthalmology, Prishtina, Albania, 2Bahcesehir University, Faculty of Medicine, Istanbul, Turkey, 3Yeditepe University, Faculty of Medicine, Istanbul, Turkey, 4Gazi University, Faculty of Medicine, Ankara, Turkey Purpose: To show that allogeneic lenticular implants removed by Smile sur- gery from patients with myopic refractive error in the cornea were implanted in high hyperopia patients with high astigmatism, changing the shape of the cornea (Q value), increasing visual acuity, intermediate and near vision, and decreasing high astigmatism. Methods: Forty eyes of 30 patients between the ages 20 to 50 with and cor- neal thickness minimum of 450 µm and a maximum of 550 µm were included in this study. Fresh corneal lenticular implantation as an allogenic implant that we took from myopic patients (-4.50 D) to implant in hyperopic patients (+4.0 D to +6.50, astigmatism between +1.0 D and +3.0 ) according to Corneal corneal topography. The stromal pocket diameter was 8 mm, 2 mm super inci- sion, and 130-µm cap thickness Results: After the myopic lenticular implantation, patients were followed for 1 year the uncorrected distance visual acuity increased from 0.70 ± 0.08 log- MAR preoperatively to 0.04 ± 0.02 [0.05–0.1] logMAR at 12 months post- operatively (p < 0.001).Qvalue decreased from − 0.50 ± 0.04 preoperatively to − 0.78 ± 0.05 1 year postoperatively. Preoperative UNVA (35 cm) J6 and postoperative UNVA (35 cm) J2.Preoperative UNVA (70 cm) J5 and postop- erative UNVA (70 cm) J3. Conclusion: Intrastromal myopic lenticular implantation is a safe and ef- fective treatment method in patients with high hyperopia and astigmatism. Patients were an increase in distance visual acuity, intermediate and near vi- sion. ClinicalTrials.gov Identifier: NCT04616144 56 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF08-7 In vitro evaluation of the antimicrobial activity of antiseptics against clinical Acinetobacter baumannii strains isolated from combat wounds of the eye and eyelids H. Nazarchuk1, T. Denysko2, O. Nazarchuk2, N. Bahniuk2, V. Bebyk2 1National Pirogov Memorial Medical University, Vinnytsya, Ophthalmology, Vinnytsya, Ukraine, 2National Pirogov Memorial Medical University, Vinnytsya, Microbiology, Virology and Immunology, Vinnytsya, Ukraine Health care-associated infections (HCAIs) are among the most prominent medical problems around the world. In the context of increasing antibiotic resistance globally, the use of antiseptics as the main active agent and poten- tiator of antibiotics for the treatment of purulent-inflammatory complications of traumatic wounds, burns, surgical wounds can be considered to tackle op- portunistic infections and their prevention during war. Purpose: This study presents a comparative investigation of the antimicro- bial efficacy of antiseptics used for surgical antisepsis and antiseptic treatment of skin, mucous membranes and wounds against multidrug-resistant clinical isolates ofAcinetobacter baumannii as a wound pathogen of critical priority (according to the WHO). Methods: Clinical strains ofA.baumannii (n=42) were isolated from patients with infectious complications of combat burn wounds of eye and eyelids, re- ceived during war conflict in Ukraine. The activity of antiseptics was deter- mined using double serial dilutions against clinical antibiotic-resistant strains (42 isolates, 74%) determined by the disc diffusion method. Results: The highest activity against clinical strains of A.baumannii among the studied antiseptics was found in decamethoxine (0.1% and 0.02%) and octenidine (0.1%)It was found thatstrains of A.baumannii, which have natural and acquired resistance to antimicrobial drugs, remain susceptible to modern antiseptics. Antiseptic drugs based on decamethoxine, chlorhexidine, octeni- dine, polyhexanide, povidone-iodine 10% and 2% provide effective bacteri- cidal activity againstA. baumannii within the working concentrations of these drugs. Conclusion: Modern surfactant-active antiseptics (decamethoxine, chlorhexi- dine, octenidine, polyhexanide) povidone-iodine (10%, 2%) provide effective antimicrobial activity against planktonic multidrug-resistant A. baumannii clinical strains colonizing combat wounds and burns. R APID FIRE PRESENTATIONS RF09: Oculoplastics RF09-2 Clinical outcomes of mixed injection of steroid and botulinum neurotoxin A in the upper eyelid retraction patients with Graves’s ophthalmopathy Y. Kim1, H. Lew1 1CHA Bundang Medical Center, Ophthalmology, Gyeonggido, Korea, Republic of Purpose: We aimed to find the clinical outcomes of mixed injection of ste- roid and botulinum neurotoxin A (BoNT-A) on the upper eyelids in the GO (Graves’s ophthalmopathy) patients and to analyze the clinical factors accord- ing to the response after injection. Method: 37 eyes from 23 patients were enrolled for upper eyelid retraction (UER) with GO. They were taken orbital computed tomography scan (CT) and measured the cross-section area of the orbit and each extra ocular muscle at the apex. A mixed injection consisted of triamcinolone (40mg/ml), dexa- methasone (5mg/ml), 5-FU and BoNT-A (2.5 unit) 0.1cc each transconjunc- tivally. After the injection, the photographs were analyzed based on MRD1, IPF and lid lag at down gaze by Image J program. And the patients were divided into two groups; Responders (decreased amount of MRD1 after injection was more than 1mm) versus Non-responders. Any side effects were monitored during the follow up (11.0±11.6months). Results: After injection, CAS decreased from 3.0±0.8 to 1.4±0.5 and MRD1 decreased from 5.0±0.9mm to 4.5±1.3mm in the total patients. Responders accounted for 60.9% of the patients. The difference of IPF and MRD1 before and after injection were 0.60±1.1mm and 0.90±0.90mm in the responders, while that of IPF and MRD1 were -0.57±0.88mm and -0.15±0.75mm in non- responders. Pre-injection IPF and FT4 in the responders were significantly higher (p<0.05). The cross-sectional area of EOM (153.5±18.0mm2) and the lateral rec- tus muscle (37.6±9.7mm2) were bigger in the responders than in non- responders(132.0±27.9mm2, 29.8±8.1mm2). At the last follow up, the treat- ment effect on IPF maintained as 1.2±3.4mm and on MRD1 as 1.2±3.4mm in the responders. Conclusion: Mixed injection comprising steroid and BoNT-A would be effec- tive, especially for the patients who is at the hyperthyroid condition and whose IPF is big. And increased EOM cross-sectional area on CT up to 150mm2 could be another favorable indicator of mixed injection in UER with GO. 58 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS R APID FIRE PRESENTATIONS RF10: Electrophysiology, Retina RF10-1 Evaluation of the eye in myopic adolescents by electrophysiological and structural tests B. Yıldırım1, M. Şahin Hamurcu1 1Ankara City Hospital, Ophthalmology Clinic, Ankara, Turkey Purpose: Even with 20/20 best corrected visual acuity(BCVA) structural and functional changes may occur in the retina and optic nerve depending on the refraction error in myopic adolescents. It was aimed to evaluate these chang- es with pattern electroretinography (pERG), optical coherence tomography (OCT), optical coherence tomography angiography (OCTA). Methods: 100 eyes of 50 children (aged 10-18) without myopic degenerations were included in the study prospectively. All patients have a BCVA of 20/20 bilaterally. Patients were divided into 3 groups according to the cycloplegic refraction. Height, weight, blood pressure (BP), pulse, intraocular pressure (IOP), spherical equivalent, axial length were measured for all. Retinal nerve fiber layer (RNFL), central macular, choroidal thicknesses were measured by OCT; vascular densities of superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris, peripapillary capillary plexus were measured by OCTA. PERG measurement was performed. SPSS 21.0 was used for analysis, p<0.05 was accepted as significant. Results: Age, height, weight, BP, pulse, IOP showed no difference between groups. P50 implicit time was longer and N95 amplitude was lower in myo- pic groups in PERG. No significant difference was found in P50 amplitudes. RNFL was found to be thinner in myopia except temporal quadrant. There was no difference in central macular thickness and choroidal thickness between the groups. Significant loss of SCP and DCP were detected in myopic groups.No signifi- cant difference was found in the peripapillary plexus, except from the tem- poral quadrant. In addition to the literature a statistically significant positive correlation was found between deep retinal capillary plexus density and P50 amplitudes. Conclusion: In axial myopic adolescents,changes in retinal vascular density and electroretinogram responses correlate with each other and begin before myopic degenerations and vision deteriorations. OCTA and ERG may be used in follow-up of myopia progression. RF10-2 Improving the diagnostic ability of multifocal electroretinogram in macular telangiectasia type 2 A.A. Ledolter1, M. Ritter1, G.E. Holder2,3, U. Schmidt-Erfurth1, A.M. Palmowski-Wolfe4 1Medical University of Vienna, Ophthalmology, Vienna, Austria, 2National University Hospital & National University of Singapore, Ophthalmology, Singapore, Singapore, 3University College London, Institute of Ophthalmology, London, United Kingdom, 4University Hospital of Basel, Ophthalmology, Basel, Switzerland Purpose: In a previous study (Ledolter et al. 2022), the multifocal electro- retinogram (mfERG) in patients with macular telangiectasia type2 (MacTel) showed inner retinal dysfunction in areas with MacTel-related retinal pathol- ogy. That analysis has now been extended to determine whether the sensitiv- ity of mfERG can be increased by evaluating individual mfERG components including N2 as well as including analysis of the central mfERG hexagon. Method: Thirty-five eyes of 18 patients with MacTel and 20 controls under- went mfERG. The scalar product (SP) was calculated for three mfERG com- ponents: N1, P1 and N2 for each of 103 mfERG responses. Optical coherence tomography (OCT) was performed. MfERG hexagons corresponding topo- graphically to the retinal changes seen on OCT (MacTel area) were analyzed and compared to the corresponding hexagons in controls. A Wilcoxon test was used for statistical analysis. A bootstrapped area under the receiver operating characteristic (AUROC) was calculated to predict the groups. Results: MfERG responses of the central 15° were analyzed. P1 and N2 of the central hexagon response (N52) and of the adjoining temporal (N51) and nasal (N53) hexagon responses showed the strongest difference in patients com- pared to controls. The greatest difference was observed in the central hexagon response (N52) (p=0.001 for both P1 and N2 and p=0.01 for N1). The central hexagon response (N52) had an AUC value of 0.86 for P1. Pooling P1+N2 did not further improve the AUC (0.84). Conclusion: P1 and N2 components of the mfERG responses are more af- fected than the N1 component confirming inner retina involvement in MacTel (bipolar and ganglion cells) and to a lesser degree photoreceptor involvement. This supports the concept of Müller cell involvement in the disorder. The in- clusion of analysis of the central mfERG responses improved the sensitivity of the mfERG to detect focal macular dysfunction in MacTel and confirms the value of mfERG as a biomarker in this disease. RF10-3 Deep learning neural networks for the classification of retinal disorders using full-field electroretinography (ffERG) T. Gholamian1, H. Liu1, R. Karanjia1, H.-A. Nguyen1, D. Abou Assali1, M. Anwar1, S. Coupland1 1University of Ottawa, Ophthalmology, Ottawa, Canada Purpose: Deep neural networks have recently been successful in tasks such as image classification using ophthalmological images, but there has been no studies thus far that have examined their use utilizing full-field electroretino- grams (ffERGs) data. The objective of this study is to assess the diagnostic accuracy of a deep learning neural network in the detection and classification of disease using ffERG. 60 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

RAPID FIRE PRESENTATIONS RF10-7 Independent predictive factors of anatomical and functional success in rhegmatogenous retinal detachment C.N. Cruz1, A. Silva1, K. Sousa1, G. Calvão-Santos1, L. Mendonça1, N. Gomes1 1Hospital de Braga, Ophthalmology, Braga, Portugal Purpose: Rhegmatogenous retinal detachment (RRD) is a major cause of ocular morbidity and requires urgent treatment. Current surgical techniques provide high rates of anatomical success, but functional outcome remains un- certain. Here we attempt to identify factors associated with anatomical and functional outcomes in RRD surgery. Methods: Retrospective, cohort study including 496 eyes from 496 patients submitted to RRD surgery from 2012 to 2017 in Hospital de Braga. Data in- cluded best corrected visual acuity (BCVA), macula status (on/off), presence of myopia (≤ -3 diopters); phakia status and previous RRD. Time to surgery, surgical technique, and deleterious factors (hemovitreous, macular hole and retinal dialysis) were also obtained. Anatomical success was defined as com- plete application of the retina at the end of follow-up. Functional success was defined as a BCVA<0.4 logMAR. All subjects were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. Results: Mean age at diagnosis was 61 years. Seventy-eight percent present- ed macula-off and 23% macula-on. Preoperative and 12 months BCVA was 2.0±1,2 and 0,2±0,4 logMAR, respectively. Isolated PPV was carried in 92% and median time to surgery was 4 days. Anatomical success was obtained in 87% and was associated with the presence of myopia. Functional success was observed in 64% and was negatively associated with the presence of deleteri- ous factors. The presence of macula-off, ILM peeling, and silicone oil tam- ponade were associated with worse surgical outcomes. Preoperative CDVA and time to surgery revealed significative association as predictive factors in univariate analysis but not in the multivariate model. Conclusion: The presence of certain clinical and surgical factors can be used to predict functional and surgical success in RRD surgery. Given its substan- tial visual morbidity, the definition of independent predictive factors for RRD surgical correction is fundamental for a personalized care. 62 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-07 Quantification of droplet aerosol generation during phacoemulsification and pars plana vitrectomy M. Moustafa1, H. Kaneshayogan1, Z. Liu2, J. Haywood2, D. Partridge2, J. Park1, E. Herbert1, I. Sian1 1Taunton and Somerset NHS Foundation Trust, Ophthalmology, Taunton, United Kingdom, 2University of Exeter, Exeter, United Kingdom Purpose: To quantify the number of droplet aerosols sized between 0.12- 8.00μm that are generated during phacoemulsification cataract surgery in hu- man cadaveric eyes, using 2.2mm and 2.75mm incisions, and if aerosol pro- duction is reduced by coating the corneal surface with hydroxypropyl meth- ylcellulose (HPMC), and to quantify aerosol production during the different steps of 23-gauge pars plana vitrectomy. Methods: A printed optical particle spectrometer (POPS) was used to measure droplet aerosol generation during surgery on human cadaveric eyes for phaco- emulsification surgery with either 2.2mm or 2.75mm main incision; both with and without usage of HPMC and during various stages of 23-gauge pars plana vitrectomy. Results: The maximum measured mean particle number concentration (PNC) without HPMC was 88/cm3 which reduced to 66/ cm3 with HPMC using 2.2mm corneal incisions ( P<0.05). With 2.75mm corneal incisions the maxi- mum measured mean PNC without HPMC was 493/cm3 which reduced to 61/ cm3 with HPMC (P<0.05). No droplet aerosol generation was detected during pars plana vitrectomy apart from during air infusion through a leaking trocar valve (mean PNC of 123/cm3). Conclusion: This is the first study to quantify size and number of droplet aerosol production during phacoemulsification and vitrectomy surgery in ca- daveric human eyes. The amount of droplet aerosols produced during cataract surgery can be reduced by using a 2.2mm incision and using HPMC to coat the cornea. Droplet aerosols may be generated during vitrectomy surgery during air infusion, in the setting of a leaking trocar valve. EP-CAT-08 The effects of music and television on intraoperative hypertension in cataract surgery: a prospective, randomized controlled trial T. Cheng1, S. Kodali1, M. Curley1, A. Barmettler1 1Albert Einstein College of Medicine/Montefiore Medical Center, Ophthalmology, Bronx, United States Purpose: Patients undergoing ophthalmic surgery routinely experience anxi- ety and stress. Music has been shown to diminish anxiety for cataract surgery, but the role of television (TV) has not been examined. The aim of this study is to evaluate the effects of music versus TV on anxiety and hypertensive events in cataract surgery. Methods: Patients undergoing cataract surgery were randomized to one of three groups: music (classical), TV (home improvement), or control (ambient noise) for 20 minutes prior to surgery. Blood pressure (BP), heart rate (HR), and anxiety level (Visual Analog Scale [VAS]) were measured before and 20 minutes after the start of the intervention. The incidence of intraoperative hy- pertensive events (IOE), defined as SBP ≥ 160 or DBP ≥ 100 with HR ≥ 85, was recorded. Results: Of 409 total patients, 138 were randomized to the music arm, 133 to the TV arm, and 138 to the control arm. There were no significant differ- ences in baseline characteristics between the three groups, with respect to age, sex, or pre-operative blood pressure. The music and TV groups had signifi- cantly lower anxiety levels (VAS) after the intervention compared to controls (p <0.05), with music showing the greatest decrease in VAS (Med=0, [IQR -2 to 0]). No significant reduction in BP or HR was observed in either intervention group. Patients undergoing first-time cataract surgery in the music and TV groups had significantly less intraoperative hypertensive events than those in the control group (2 [2.4%] and 0 [0%] vs 6 [7.9%], p<0.05). Conclusion: This is the first prospective, randomized study to examine the ef- fects of listening to music, watching TV, and a control prior to cataract surgery. Each showed significantly decreased subjective anxiety levels in those under- going either first or second eye cataract surgery. Music and TV also decreased the incidence of intraoperative hypertensive events in patients undergoing first-time cataract surgery. EP-CAT-10 Intraocular foreign body removal combined with lensectomy: case report E. Medina1,2, L. Strucinska1,2, A. Zemitis1,2, G. Laganovska1,2 1Riga Stradins University, Department of Ophthalmology, Riga, Latvia, 2Pauls Stradins Clinical University Hospital, Department of Ophthalmology, Riga, Latvia Introduction: Intraocular foreign bodies (IOFB) are a major cause of morbid- ity and even blindness in young population. IOFB can lodge and damage any structure of the eye depending on its way through the eye. The most frequent defects caused by foreign body (FB) are traumatic cataract, retinal and subreti- nal hemorrhages, retinal detachment and endophthalmitis. Visual prognosis after treatment depends on different factors such as the time of diagnosis, treatment options, size and location of the trauma, tissue damage and inflammation. Case presentation: A 32-year-old man sustained injury of the left eye with a metal foreign body after repairing pipes at home without using protective equipment. On admission best-corrected visual acuity (BCVA) was 0,15 and intraocular pressure (IOP) was 12 mmHg. Under slit-lamp examination, a full- thickness corneal wound with localized corneal edema at the nasal lower area was revealed. Also, the clouding of the lens and lens masses were present in anterior cham- ber. Ultrasound of the left eye was done but the FB was not reliably visualized therefore CT scan of the orbits was done, which confirmed IOFB inside the lens. Extraction of IOFB was done using forceps and aspiration-irrigation was used to remove traumatic lens opacification. Intraocularlens was implanted in the posterior capsular bag. Three corneal sutures with Nylon 10/0 were used to close the wound. BCVA on discharge was 0,2 and IOP 13 mmHg. Patient was prescribed eye drops Sol. Levofloxacin 6x per day and Sol. Dexamethasone- Chloramphenicol 4x per day. On 5-months follow-up visit the patient’s BCVA was 0,7 and IOP was within normal limits. Discussion: Intraocular penetrating injuries require detailed and scrupulous examination of all eye structures. Early diagnosed damage can be treated ad- equately and therefore serious complications of IOFB such as endophthalmi- tis, visual impairment and disability can be prevented especially in patients of working age. 64 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-14 EP-CAT-17 Family case of Weill–Marchesani syndrome A. Corduneanu1, L. Bucinscaia2 1Nicolae Testemitanu SUMPh, Department of Ophthalmology, Chisinau, Moldova, Republic of, 2Republican Clinical Hospital Timofei Moșneaga, Department of Ophthalmology, Chisinau, Moldova, Republic of Presentation of the case of 2 patients, female, first degree relatives (mother, daughter) with progressive decrease of visual functions, who were examined and underwent surgical treatment in the Ophthalmology department of the Republican Clinical Hospital “Timofei Moșneagă”. In all cases, a progressive decrease of visual acuity occurred in childhood. In case of daughter examination, a pupillary block has been found, iris bombe, anterior synechiae, secondary glaucoma and pseudophakia in the right eye and subluxation of the IOL in the vitreous body in the left eye. She underwent laser-iridotomy on the right eye, which had positive results. IOP decreased. After that anterior synechiolysis has been performed. Reposition of the IOL with scleral fixation has been performed on the left eye. In mother’s case, an inferior subluxation of the lenses on both eyes has been found. She underwent surgical treatment on both eyes – extraction of the lens with IOL implantation with scleral fixation. In both cases short stature, brachycephaly and brachydactyly has been ob- served. In mother’s case stiffness in the elbow joint and interphalangeal joints has been observed. EP-CAT-16 Assessment of results of Lentis Comfort IOL implantation S. Dimova1, D. Mitova1, T. Mitov1 1Trakia University Stara Zagora, Stara Zagora, Bulgaria Objective: To assess visual acuity and patient satisfaction after Lentis Comfort intraocular lens (IOL) implantation. Methods: The review followed 171 eyes of 133 patients implanted with Lentis Comfort (LS-313 MF15) IOL. The patient’s visual acuity was evalu- ated for far, intermediate and near (0.3, 0.5 and 5 meters), refractive error, con- trast sensitivity were recorded. Patients were provided with a questionnaire to assess the severity of photopsia, spectacle dependence, and satisfaction with visual function. Results: Uncorrected distance visual acuity (UDVA)was 0.08 ± 0.12 (log- MAR) and uncorrected near visual acuity (UNVA) was 0.13 ± 0.16 logMAR. Contrast sensitivity (FACT 100) was 20/20 for distance and 20/25 for near. All patients expressed high level of satisfaction with the lens and reported no photopsia. Conclusion: Lentis Comfort IOL performed well for far and intermediate dis- tance, most of the patients did not require glasses for their daily near distance needs. Keywords: Oculentis Comfort; IOL, EDOF Correlation between Metabolic syndrome components with lens thickness: populational study in Malang District, Indonesia H. Purnamasari1, A. Sulistiyowati1, S. Prayitnaningsih1, R. Rosandi2, H. Holipah3 1University of Brawijaya, Ophthalmology, Malang, Indonesia, 2University of Brawijaya, Endocrinology, Malang, Indonesia, 3University of Brawijaya, Public Health, Malang, Indonesia Purpose: Metabolic syndrome (MS) might induce escalation of oxidative stress, inflammation, and endothelial dysfunction which might impair the lens structure and trigger cataract. Previous study has shown that lens thickness was related to incidence of cataracts, and this study was to determine which component of the metabolic syndrome that consists of body mass index, blood pressure, diabetes mellitus, and dyslipidemia, has the most influence on lens thickness. Method: This is an analytic observational study with a cross-sectional design. The sample was citizens from Malang district, Indonesia, with risk factors for suffering from metabolic syndrome of those who are over 40 years old, overweight, active or passive smokers, having a history of hypertension or diabetes. The independent variables measured include body mass index (BMI), systolic blood pressure (systole), diastolic blood pressure (diastole), fasting blood sug- ar level (FBS), HDL cholesterol (HDL), and triglycerides (TG). Lens thick- ness is the dependent variable measured in cycloplegic conditions, and was previously confirmed that there were no ocular abnormalities such as cataract, pseudofakia, afakia, or congenital abnormalities. Results: 116 participants were identified as MS and 155 as non-MS. Linear regression analysis show that lens thickness was affected significantly by sys- tole (coefficient 4.30, SE 1.61, p<0.05) and FBS (coefficient 1.36, SE 0.59, p<0.05). Only these two components of MS that have a considerable effect on the lens thickness, however outside from these variables, age >60 years was also proved to affect lens thickness significantly (coefficient 229.11, SE 76.34, p<0.05). Conclusion: Systole is the component of MS that primarily affects lens thick- ness, and might play a role in the presence of cataract. I suggest to conduct more study to determine the effect of systole on cataract formation. EP-CAT-18 Improving theatre efficiency for bilateral cataract operations in a high-flow hub J. Ashby1, O. Kousha2, W. Meldrum2, G. Christie2, J. Ellis2 1University of Glasgow, School of Medicine, Glasgow, United Kingdom, 2Ninewells Hospital, Department of Ophthalmology, Dundee, United Kingdom Purpose: Cataract is the most frequently performed surgical intervention in the UK with 452,000 performed in England in 2018/2019. Demand is rising due to an ageing population, with an added severe disruption to services from the pandemic. Immediate Sequential Bilateral Cataract Surgery (ISBCS) is safe and effective and recommended by RCOphth and the National Institute for Health and Care Excellence [NG77], yet <1500 ISBCS operations were performed in 2021/2022 and <1% of NHS patients undergo ISBCS. 66 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-23 Use of mechanic dilatator in small pupils during routine cataract surgery A. Janeková1, R. Zugar1, J. Pašta2,1 1Eye Center Prague, Prague, Czech Republic, 2Military Hospital Prague, Prague, Czech Republic Purpose: To investigate outcomes and complications of using a mechanic pu- pil dilatator (Malyugin ring) during cataract surgery in small pupils. Methods: Retrospective case- series reviewing. Best corrected distance visual acuity was recorded before and after the surgery. Patients were asked about concomitant medication. Measuring of pupil diameter at the beginning and at the end of the surgery was done by computer analysis. Total time of surgery was recorded. Signs of intraocular inflammation, iris defects and intraocular pressure were monitored. Results: Total 42 eyes (7 women, 32 men) operated between 5/2021 and 5/2022 were included. In 18 eyes of 9 patients the ring was used during sur- geries of both eyes, 11 eyes (11 patients) underwent planned surgery of just one eye and in 13 eyes the device was used in second operated eye based on first eye surgery experience. Totally 3 surgeons performing surgeries used ring in 15, 13 and 14 cases re- spectively. 32 men patients were using systemic alpha-1- antagonists, in 5 eyes pseudoexfoliation syndrome was present and 2 eyes suffer from posterior synechiae. Average time of implantation of the ring was 1:53 minutes (from 58 seconds to 3:10 minutes). Average explantation time of the ring was 32 seconds (from 20 seconds to 1:35 minutes). Average time of the surgery was 17:43 minutes (median 15:20 minutes). There were 2 cases of posterior capsule rupture during surgery. Corrected dis- tance visual acuity before surgery was 0.54 LogMar and 0,15 LogMar after the surgery. No inflammation signs and elevation of intraocular pressure were observed at the first check-up. In 3 cases pigment dispersion was recorded. Conclusion: Malyugin ring help to maintain sufficient mydriasis during sur- gery time. No complications connected to ring use or manipulation were re- corded during surgery. The Malyugin ring is one of the options of pupil expan- sion techniques which could be safely used in patients with poor dilated pupil. EP-CAT-24 Late postoperative opacification of a hydrophobic acrylic intraocular lens AcryNovaTMPC 610Y M. Otrošinová1, J. Novák1 1Pardubice Regional Hospital, Ophthalmology Department, Pardubice, Czech Republic Purpose: Intraocular lens (IOL) opacification may cause severe visual im- pairment. The pathogenesis remains unclear. The aim is to report the case of late postoperative opacification of a hydrophobic acrylic intraocular lens AcryNovaTMPC 610Y and its clinical consequences and laboratory character- istics. Method: Lens replacement was indicated for an 82-year-old patient, 9 years after uncomplicated bilateral cataract surgery, in 2005. Opacification led to a significant reduction in best corrected distance visual acuity (to 0.63) and con- trast sensitivity. The relative opacity of the lens material was 21% (OCULUS Pentacam HR). One explanted IOL was analysed using anterior segment OCT in vitro and spectroscopic method EDX (Energy-dispersive X-ray spectros- copy). Macroscopical photo documentation, light and electron microscopic analysis were also done. Results: Best corrected distance visual acuity (BCDVA) after the surgery im- proved to 1.00. We did not find signs of non-homogeneity (i.e. micro glisten- ing – vacuoles) in the material with the aid of SEM upon 20 000x enlargement. Using the EDX method we did not record the presence of calcium or phospho- rus, and therefore calcification of the material was excluded. Anterior segment OCT of AcryNova hydrophobic lenses with symptoms of opacification shows homogeneous light dispersion (scattering effect), in contrast with lenses from transparent PMMA or hydrophobic acrylate. In the explanted IOL we have documented structural changes of primarily hydrophobic material leading to features of hydrophilic one. Conclusion: Some batches of AcryNovaTMPC 610Y may have been produced from material of poor quality which is the cause of its structural changes and its progressive opacification. Susceptibility of the IOL to opacification is caused by a multifactorial combination of material and processing properties as well as individual conditions of the patient. EP-CAT-25 Corrective replacement of calcified hydrophilic acrylic intraocular lens LENTIS Mplus M. Otrošinová1, J. Novák1 1Pardubice Regional Hospital, Ophthalmology Department, Pardubice, Czech Republic Purpose: To present the case of a patient with LS-313 MF30 (Lentis Mplus, Oculentis) intraocular lens (IOL) opacification, in which due to symptoms of visual disturbances IOL exchange was necessary. Method: We describe our experience of postoperative opacification of multi- phocal Lentis Mplus IOL, onset 6 years after cataract surgery. Nowadays diag- nostic imaging methods were used. The literature was reviewed to summarize the diagnosis, classification, use of diagnostic aids, and the current treatments for IOL opacification. Results: A 82-year-old man presented with decreased visual acuity and blurred vision 6 years after phacoemulsification with continuous curvilinear capsu- lorhexis (CCC) and in-the-bag IOL implantation. After the slit lamp examina- tion, patient was investigated with Scheimpflug camera(OCULUS Pentacam HR)and anterior segment spectral domain OCT(Optovue, Avanti RTVue XR), which confirmed the diagnosis of IOL opacification. Patient underwent IOL exchange surgery in both eyes, first in left eye and then in right eye. Conclusion: Since the global market demand and supply of multifocal IOLs have increased markedly, it is possible that cases with opacification may con- tinue to increase over the next few years. Clinicians must be aware of the potential for opacification of this IOL design, despite hydrophobic surface modification. 68 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-29 Selective laser capsulotomy in pediatric cataract surgery S. Stoyanova1, A. Topov1 1Acibadem City Clinic Tokuda Hospital, Ophthalmology, Sofia, Bulgaria Purpose: To demonstrateselective laser capsulotomy and thestabilityof the anterior capsule, proper positioning and accurate sizing during cataract sur- gery in children. Methods: This caseconcerns a 6-month-old child with congenital cataract, diagnosed by standard methodology. The intervention was performed under general anesthesia, mechanical dilatation of the pupilwith the use or iris retrac- tors due to the impossibility though the means of medication. We used a specific solution of trypan blue to stain the anterior capsule, a 4.2 mm selective laser capsulotomy was performed because of the small size of the eye. This step was followed by an eventful standard irrigation-aspiration of lenticular masses. Results: The selective laser capsulotomyachieves anterior chamber stability, correct anterior capsulotomy positioning, accurate sizeand improves capsule- elasticity and completeness. Conclusion: The use of laser capsulotomy in children in cataract surgery leads to improved safety during the intervention, reduces the risk of inaccuracy of the capsulotomy size, leads to subsequent adequate and correct treatment in time to prevent amblyopia. EP-CAT-30 Visual outcomes after bilateral implantation of a Miniwell proxa EDOF IOL S. Bharti1 1Bharti Eye Foundation, Cataract & Refractive Surgery, New Delhi, India Purpose: To evaluate the visual performance, patient satisfaction and clini- cal outcomes after bilateral implantation of Miniwell Proxa EDOF IOL with cataract surgery in Indian eyes. Method: 20 eyes of 10 patients in the age group of 55 to 70 years with de- mand of spectacle independent vision for distance and reading were included in this study. All eyes underwent Slit lamp examination, OCT for Cornea and Macula, apart from routine clinical examination for cataract. eyes with any ocular pathology and with astigmatism more than 1D were excluded. IOL power was measured with Optical biometry ( AL Scan, Nidek, Japan) using Barrett Universal 2 formula. Both eyes were operated either same day or within a week apart under topical anaesthesia with Femtosecond laser (Zeimer, Switzerland) creating a temporal incision,5.5 mm capsulorrhexis and six nuclear segments. None of the eyes had any complications during surgery. They were examined on day 1, 7, 30 and 90 postoperatively for visual acuity for distance and near. Results: 11 patients were females and 9 patients were males. The mean pre- operative BCVA was 20/60. Post operative uniocular distance UCVA was 20/40 a1 month and was 20/30 at 3 months. Binocular postoperative uncorrected visual acuity was 20/30 at 1 month and 20/25 at 3 months. Binocular near visual acuity was N 8 at 1 month and N6 at 3 months. 1 month postoperatively 70% of eyes had a cylinder value <-0.5 which re- mained same up to 3 months postoperatively. 3 months postoperatively 40 % (8) eyes had emmetropic spherical equivalent. Discussion: This is the initial results of use of near dominant EDOF IOL im- plant in both eyes of a patient. This the first study of use of near dominant EDOF IOL in both eyes of a patient needing good near vision for reading but not much of computer work. Conclusion: Bilateral implantation of Miniwell Proxa EDOF IOL in a patient provide good functional vision for distance and near in patients. EP-CAT-31 A case of non-expulsive traumatic total iridodialysis? V. Miranda1, M.J. Matias1, C. Pestana Aguiar1, J. Alves Ambrósio1, A. Gomes Rocha1, I. Lopes Cardoso1 1Centro Hospitalar de Entre o Douro e Vouga (CHEDV), Ophthalmology, Santa Maria da Feira, Portugal Introduction: Traumatic aniridia is a condition where the whole iris is torn from the ciliary body after blunt force trauma. While in surgically naïve eyes this condition usually accompanies other injuries such as commotio retinae, lens dislocation and scleral/limbal rupture, in eyes with previous ocular sur- gery the surgical wound is likely the weakest point through which the high IOP is released and sometimes the iris is expulsed. Several cases of expulsive iridodialysis without IOL dislocation have been reported following clear corneal phacoemulsification. We report on a possible case of non-expulsive traumatic total iridodialysis. Methods: Clinical case review. Case reports: An 87 y.o. pseudophakic male on anticoagulation drugs pre- sented after cranioencephalic traumatism due to a fall. He had a best corrected visual acuity (BCVA) of hand motion in his left eye (LE) and normal eye movements. Slit lamp exam revealed subconjunctival haemorrhage, hyphema, and a complete absence of iris tissue with visible ciliary processes and IOL in the capsular bag, without pseudophacodonesis. Fundus exam was difficult due to media opacity and echography documented vitreous haemorrhage (VH). The fellow eye exam was unremarkable but it was noticed that the patient had a blue colored and slightly atrophic iris. At 2 weeks post-trauma there was complete reabsorption of hyphema but he still maintained significant VH even at 1.5 months post-trauma. The patient un- derwent pars plana vitrectomy to clear the VH with good result and a final BCVA of 20/25. Conclusions: We present a case of traumatic total iridodialysis in a pseudo- phakic patient. While we can’t indisputably exclude that the iris was, at least partially, expulsed through the prior cataract wound which then self-sealed, we found no evidence of it such as episcleral pigmentation or presence of iris remnants in the ocular surface. We therefore hypothesize that the remnant and probably necrotic iris tissue was completely reabsorbed. 70 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-36 Retro pupillary iris claw lens implantation in aphakia– Is it a viable alternative? S. Farooq1, A. Kochar1, N. Ali Khan1 1SP Medical College and Associated Groups of Hospitals, Ophthalmology, Bikaner, India Purpose: To evaluate the Indications, surgical outcomes and complications of implantation of Retro pupillary Iris Claw intra ocular lens (RPIC –IOL). Method: This is aprospective, interventional, hospital based study.This study- included 42 patients with various indications for RPIC-IOL implantation at a tertiary care centre from September 2020 to August 2021. Informed con- sent was obtained and the study followed the guidelines of the Declaration of Helsinki. A comprehensive preoperative assessment was done. All the patients underwent RPIC-IOL fixation by a single experienced surgeon using the same standard technique.The patients were examined on postoperative day 1st, 7th day, at one month and three months. Statistical Analysis: P-value <0.05 was taken as significant. Data entry was done in Microsoft excel. Medcalc 12.2.1.0 version software was used for all statistical purpose. Results: The most common indication was posterior capsular tear in 23 pa- tients (54.76%). When BCVA was compared pre- and post-operatively at 3 months,Pvalue was found to be <0.001, and a significant increase in BCVA was noted in 39 patients between pre- and post-operative values. The mean postoperative IOP at 3 months was 14.21+2.14 mmHg with a range of 10–20 mmHg. Most common postoperative complication was distorted pu- pil (35.71%). Conclusion: RPIC-IOL implantation is a viable option for management of aphakia in complicated cases. The technique is safe with short learning curve and good functional outcomes. Keywords: Retro pupillary, Iris claw lens, Aphakia EP-CAT-37 Is surgical eye care becoming an environmental scare? S. Savur1, S. Kaup1, D. Davis1, K. Divyalakshmi1 1Yenepoya Medical College, Ophthalmology, Mangalore, India Purpose: Healthcare is one of the major contributors of greenhouse emis- sions. It is estimated that one-quarter to half of all hospital waste is produced in the operating room. Recycling of surgical waste is uncommon, even though there are many recyclable materials. The objective of this study was to determine the amount of waste produced in different ophthalmic surgical procedures over a period of one month, in order to gauge the probable adverse environmental impact. Method: We conducted a waste audit of all ophthalmic surgeries, from one unit of a moderately busy tertiary care hospital over a period of one month. Waste was categorized into 3 streams: clinical waste, general wastes and sharps. The mean weight of waste per case was obtained by dividing total weight of waste produced by total number of cases in each category. Result: The total waste produced from 24 different ophthalmic surgeries over a period of one month in ophthalmic unit was 18.704 kgs. Out of this, 12.270 kg comprised of clinical waste and 5.725 kg of general waste. The mean waste production per case was highest for vitrectomy (2.420kg), followed bymanual small incision cataract surgery (MSICS) (0.796 kg) and phacoemulsification (0.668kg). The general waste per case, out of the total waste generated was 35% (235gms ) and30.9% (246gms) in phacoemulsification and MSICS re- spectively. The average waste generated per case per month is 0.779kg. Conclusion: Eye surgeries contribute to a significant amount of waste genera- tion and contribute towards green house emission. EP-CAT-38 Subjective vision-related quality of life and visual performance of 3 intraocular lenses: an enhanced monofocal, extended-depth-of-focus and trifocal L. Kapitanovaite1, D. Zaliuniene1, R. Zemaitiene1 1Lithuanian University of Health Sciences Medical Academy Faculty of Medicine, Department of Ophthalmology, Kaunas, Lithuania Purpose: To compare subjective vision-related quality of life (QoL), visual performance and spectacle independence of 3 intraocular lenses (IOLs): en- hanced monofocal, extended depth of focus (EDOF) and trifocal. Method: 40 patients without ocular comorbidities undergoing cataract sur- gery with implantation of an enhanced monofocal (Tecnis Eyhance), EDOF (Tecnis Symfony) or trifocal (Alcon Panoptix) IOL were included. 3 months postoperatively the following parameters were analyzed: uncorrected visual acuity (VA) (logMAR) for distance (6 meters), intermediate (66 cm) and near (40 cm) distance, halometry (Halo v1.0 programme), halo and glare percep- tion, QoL (National Eye Institute Visual Functioning Questionnaire-25) and spectacle independence. Results: Post-operative distance and intermediate VA were similar be- tween IOLs (p=0.92, p>0.05). Near VA was significantly better for Panoptix than other IOLs (p<0.05). Halometry results were similar for Eyhance and Symfony IOLs (p=0.72) but showed worse results for Panoptix IOL (p=0.01). Patients with Eyhance and Symfony IOLs had less subjective halos and glare perception than Panoptix IOL group (respectively p=0.005, p=0.018). Subjective visual disturbance correlated with halometry results (p<0.001). None of the patients reported the need to use spectacles for distance. 50% of Panoptix IOL group occasionally needed spectacles for intermediate distance (p=0.052). Near-distance correction demand was highest and constant for 75% of Eyhance IOL group (p=0.273). QoL questionnaire results showed high and similar results for all IOL groups (93.1±6.9) (p=0.247). Conclusion: Spectacle independence is successfully achieved with Symfony and Panoptix IOLs for all distances, while with Eyhance IOL spectacles are usually needed for near-distance. Panoptix IOL induces most objectively seen photic phenomenon, which are also noticed by the patients. Overall patients were highly satisfied with the outcomes of the surgeries and chosen IOL. 72 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-42 Trifocal IOLs implantation in cataract patients that have experienced previous laser vision correction M. Piovella1, B. Kusa1 1Piovella Global Center For Ophthalmology, Ophthalmology, Monza, Italy Purpose: To evaluate visual performances of trifocal IOLs AT LISA tri 839 MP and AT LISA tri toric 939MP trifocal IOLs (Carl Zeiss Meditec AG - Jena - Germany) in patient that experienced previous laser vision correction. Methods: Only eyes with regular cornea were included in this study: 36 eyes of 21 patients mean age: 56.57 ± 8.76 years. Preop SE was -0.91 ± 3,31 BCDVA 20/21.40 ± 3,18. Postop were measured: distance (5m) near (40cm) and intermediate (80 cm) VA, corneal topography and aberrometry, contrast sensitivity and defocus curve and quality of vision. Follow-up examinations were performed at day 1 2 7 30 90 180 360 and yearly. Results: At six months BCDVA was 20/20,65 ± 2,51. SE was -0,20 ± 0,45. Residual astigmatism was 0,02 ± 0,42.83% of eyes after trifocal IOLs implan- tation achieved postop refractive results within ± 0.75 diopters. Conclusion: Trifocal IOLs provided good visual performances also with pa- tients that experienced laser vision correction decades ago. To be selected for surgery eyes biometry needed to be applied with no difficulties and hav to demonstrate no significant differences related the perfect IOLs power also af- ter multiple attempts. EP-CAT-43 Paulus Aeginetus, a Byzantine physician of the 7th century and his contribution to ophthalmology G. Balanikas1, D. Peirounides1, S. Diafas1, I. Voudouragaki1, E. Papadopoulou1, N. Makris2, D. Christodoulou3, ‘Society of History of Ophthalmology Scholars’ 1Aristotle University of Thessaloniki, A’ Ophthalmologic Clinic, AHEPA Hospital, Thessaloniki, Greece, 2Ophthalmiatreio Athinon, A’ Ophthalmologic Clinic, Athens, Greece, 3Aristotle University of Thessaloniki, Department of Medicine, Laboratory of History of Medicine, Thessaloniki, Greece Purpose: This presentation is to exhibit the work of the Βyzantine physician Paulus Aeginetus and especially his contribution to treating ophthalmic condi- tions such as cataract, glaucoma, trauma, and other diseases. It is believed that he was born on the Greek island of Aegina c. 625 A.D. Methods: A classic medical text of the middle Byzantine period was a valu- able source for medieval medical knowledge, but very little was known about its author. The work is ‘The Seven Books of Paulus Aegineta’ or ‘Epitome Medicae’ This work is a compendium of ancient and byzantine medical knowledge, and it was the basis for the development of the knowledge of late Arabic Medicine. This presentation was based mainly on the Sixth book of this 3-volume com- pendium of English Edition in 1834, published by Francis Adams, which in- cludes the Ophthalmologic issues. Results: ‘πιτομαί ἰατρικαί’ is the original title of Paulus Aegineta’s work. Three manuscripts from Paulus›s work are kept in the Megisti Lavra mon- astery of Mount Athos library. This library was established around 963 A.D. by St. Athanasius, founder of the conventus life of Mt. Athos. Fragments of Paulus’s work are also in the monastery of Iviron on Mt. Athos. Paulus Aeginetus was the only physician of the ancients who described the cataract operation. He also described burns of the eyelids by drugs and the subsequent creation of a symblepharon (Συμβλέφαρον). Conclusion: Paulus Aegineta’s life is entirely unknown, but his monumental work gives us a rich encounter with Medicine not only during the 7th century but also before and after him and is one of the main sources of medical knowl- edge for the upcoming generations of physicians. The 6th book of this work includes several ophthalmological conditions such as eyelid disorders, chalazion, pterygium, trichiasis, cataract, glaucoma, and the diagnosis, medications, and treatment for them. Paulus Aeginetus (625- 690 A.D.) was considered one of the great compilers of Medical Knowledge. EP-CAT-44 Central macular thickness changes following laser posterior capsulotomy measured by optical coherence tomography D. Vasovic1, D. Rasic1, I. Marjanovic1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia Purpose: Neodymium-doped yttrium aluminum garnet (Nd: YAG) laser treat- ment is considered the gold standard for posterior capsule opacification (PCO) treatment. However, it can lead to complications such as increased intraocular pressure (IOP), retinal hemorrhage, iritis, vitreous prolapse, corneal injury, vitritis, pupil blockage, hyphema, retinal detachment, IOL dislocation, exac- erbation of endophthalmitis, and cystoid macular edema. Our study aimed to access changes in the central macular thickness (CMT) at different time points following Nd: YAG laser capsulotomy using optical coherence tomography (OCT). Method: This study included 112 eyes (59 males and 53 females) from pseu- dophakic patients with PCO. Patients with other anterior or posterior segment pathologies were excluded from this study. The CMT values were measured at baseline, one week, one month, 3 and 6 months following Nd: YAG cap- sulotomy. The preoperative and postoperative measurements were compared. SPSS 21.0 was used for statistical analysis, and a difference was considered significant if p<0.05. All values are expressed as means ± SD. Results: The mean age of all patients was 76±9.12 years. After treatment, best-corrected visual acuity was significantly higher than baseline values (p<0.05). On the other hand, significant changes related to age, gender, total laser shots, total laser energy, and time between cataract surgery and Nd: YAG laser cap- sulotomy was not observed (p>0.05). The mean CMT values at baseline, one week, one month, 3 and 6 months fol- lowing Nd: YAG laser capsulotomy were 256.11 ± 16.001, 267.69 ± 17.012, 266.08 ± 16.015, 260.08 ± 16.015, 257.08 ± 16.015 µm, respectively. Cystoid macular edema developed in 2 patients (1.78%). Conclusion: Significant changes in CMT values following Nd: YAG laser capsulotomy was not observed compared to the baseline. However, cystoid macular edema remains one of the possible causes of visual reduction follow- ing Nd: YAG laser capsulotomy. 74 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-49 EDOF IOL for bilateral cataract in young patient with previous PRK D. Ibrahim1 1American Medical Complex, Erbil, Iraq Purpose: To report a case and surgical results of unknown reason bilateral cataract in young patient with history of refractive surgery (PRK) seven years ago. Method: Private ophthalmology practice. Report of case: A 32-year-old male patient arrived at the author clinic com- plaining from blurry vision in both eyes. He underwent photorefractive kera- tectomy PRK surgery for mild myopia & astigmatism about 7 years ago by author. The PRK procedure was uncomplicated and both eyes were stable with 10/10 visual acuity in both eyes after 3 months of surgery. On routine follow up every 6 months for three years the patient did not suffer from any problem except intermittent dryness managed by lubricant eyedrops. Patient come back on January 2021 complaining from poor VA in both eyes in last six months. With examination the diagnosis was bilateral nuclear cataract. performing full evaluation (VA, BCVA, TONOMETRY, CORNEAL TOMOGRAPHY, OCT, BIOMETRY.) The decision was cataract surgery with EDOF toric IOL for both eyes. The refraction was (OD: -6.50 sph-1.75 * 50) and (OS: -6.25 sph- 0.75* 98). VA was 0.3 OU. The challenge was choosing the right IOL power, so after doing calculation with Haigis-L formula and Barrett true-k formula we choose +21 D with 1.50 cylinder for right eye and +22 D with 1.00 cylinder for left eye. After one- month of surgery the refraction was (OD: -0.25 sph-0.25 * 80) and (OS: 0.00 sph-0.50* 67). UCVA was 10/10 in both eyes with good independent glasses VA for near vision with both eyes. Conclusion/take home message: A history of patient’s refractive surgery will help to avoid refractive ‘surprises’ after cataract surgery. In young patient it is better to choose the most glasses independent IOL with less aberrations and halos. Measurements of the posterior corneal surface are mandatory as the corneal refractive index changes. To choose the right IOL power it’s neces- sary to apply at least two formulas of the third generation (Barrett True-K, Haigis-L… etc). ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Contact Lenses EP-COL-01 The impact of advanced surface moisturizing technologies on on-eye performance and comfort with contact lenses O. Ucakhan-Gunduz1, T. Celik Buyuktepe2, M. Arslanturk Eren3 1Ankara University School of Medicine, Department of Ophthalmology, Ankara, Turkey, 2Unye State Hospital, Department of Ophthalmology, Ordu, Turkey, 3Trabzon Kanuni Training and Research Hospital, Department of Ophthalmology, Trabzon, Turkey Purpose: To comparatively evaluate the on-eye performance and comfort with two lotrafilcon B contact lenses manufactured using different surface moisturizing technologies in lens wearers with daily digital platform use lon- ger than 3 hours. Methods: Twenty-nine asymptomatic habitual contact lens wearers were ran- domly assigned to wear either AirOptix Aqua or AirOptix HydraGlyde contact lenses for 1 month each in a randomized, double-masked crossover study. The Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8) scores, biomicroscop- ic examination, tear function tests, and blink rates were recorded at baseline, and at the end of month-1 and month-2. To assess comfort scores with the two lenses, the patients completed a questionnaire that includes questions to score the first impressions and experiences (visual acuity, comfort, dryness) with each lens and a Likert-Type questionnaire. Results: The mean age of patients was 25.5±7.2 years. Tarsal papillary grade was significantly lower, tear-film break up time was higher with AirOptix HydraGlyde lenses compared to AirOptix Aqua (p<0.05) lenses. There were no significant differences between the two lenses in terms of slit lamp findings, Schirmer`s test, blink rates, or CLDEQ-8 scores (p>0.05). AirOptix HydraGlyde lenses performed significantly better in terms of blurred vision, end-of-day comfort, dryness and tiredness (p<0.05). Although more than 80% of patients agreed or strongly agreed that both lenses provided excellent visual acuity and comfort, higher percentage of patients preferred to continue with AirOptix HydraGlyde contact lenses at the end of the study. Conclusion: AirOptix HydraGlyde lenses with advanced surface moisturizing technology were superior in terms of end-of-day and end-of-month comfort and visual quality which are common complaints related with contact lens discomfort. Technological advances in silicone hydrogel lens surface treatments seem to be helpful in improving contact lens comfort in lens wearers with moderate daily exposure to digital devices. 76 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Cornea EP-COR-01 Desperate measures for desperate times - a case of simultaneous bilateral keratoplasty for mooren’s ulcer S. Patil1 1Dr D. Y. Patil Hospital, Ophthalmology, Kolhapur, India A 65 year old male patient with uncontrolled diabetes first time presented in 2019 with complaints of pain, redness, watering in both eyes. On slit lamp examination it was 360 degree peripheral ulcerative keratitis, with corneal thinning and overhanging edge with iris incarceration in right eye and left eye inactive PUK. All rheumatological laboratory tests were negative, so it was diagnosed as Mooren’s ulcer. Treated with right eye tectonic keratoplasty and left eye with conjunctival resection with Cynoacrylate glue and bandage contact lens. Patient lost subsequent follow ups and presented with Right eye failed graft and left eye worsening of condition. Right eye regraft done under immunosup- pressant and also referred to rheumatologist for adjusting immunosuppressant dose. On further follow up left eye worsening so that eye also treated with tectonic keratoplasty. Patient was doing well after surgery improved vision but again lost follow ups and again came with both eyes failed grafts. So patient posted for right eye 3rd tectonic keratoplasty and left eye re-glue and BCL. Proper consent was taken, but on operation table it is found that only glue and bandage contact lens was not able to give enough tectonic support to left eye, so decision was changed and we decided aggressively to do tectonic keratoplasty for left eye also in same sitting. Discussion: There are only few case reports published in literature for simul- taneous bilateral keratoplasty. Conclusion: 1. Despite absence of underlying immune condition it often requires systemic immunosuppressants to get control of inflammation, 2. As bilateral mooren’s is aggressive condition, aggressive treatment is re- quired, 3. Hand in hand cooperation of both ophthalmologists and rheumatologist is mandatory to deal with such kind of situation, 4. At times we have to change our preoperative plans on operation table and take agressive action, 5. Need for strict follow up after any keratoplasty slould be explained. EP-COR-03 In vivo confocal microscopy analysis of corneal subbasal nerve plexus before and after surgical treatment of rhegmatogenous retinal detachment by pars plana vitrectomy (PPV) vs PPV/Scleral Band(BE) F.M. Hermoso Fernandez1, A. Romero Titos1, C. Gonzalez Gallardo1, M. Cruz Rojo1 1Hospital Universitario Clinico San Cecilio, Ophthalmology, Granada, Spain Purpose: To evaluate in vivo confocal microscopy (IVCM) features of corneal subbasal nerve plexus (SNP) before and after surgical treatment of rhegmatogenous retinal detachment using fully automated software ACCMetrics. Methods: Observational prospective study, including 6 patients were in PPV/ BE and 4 patients in the PPV group. IVCM exams of SNP were performed using Heidelberg Retina Tomograph. Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), corneal nerve total branch density (CTBD), corneal nerve fiber area (CNFA), corneal nerve fiber width (CNFW), and corneal nerve fractal dimension (CNFrD) were analysed before surgery and 3 months after treatment using fully automated software ACCMetrics. Results: The mean value of corneal nerve fibers density (CFND) in PRE- VPP group was 15,63±10,82 compared to 15,62±3,6 in POST-VPP. The mean value of CNFD in PRE-VPP/BE group was 8,331±5,1 compared to 9,37±5,2 in POST-VPP/BE group, there was a non significative increase of 1,04±6,14 in POST-VPP/BE. The mean value of corneal nerve fibers length (CNFL) in POST-VPP was 0,12±4,2 less than in PRE-VPP; this value was in POST-VPP/ BE 0,38±3,85 less than in PRE-VPP/BE group, both p>0,05. Conclusion: The present study represents the first pilot evaluation of corneal SNP before and after rgehmatogenous retinal detachment surgery. Our first results doesn’t confirm any significant change in the corneal SNP parameters but the results may suggest a higher reduction of CNFL in VPP/BE group. A higher sample size will be necessary to increase the significance level of the study. EP-COR-04 2 case presentations of Cogan’s syndrome with different ocular manifestations L. Kambulyan1 1Yerevan State Medical University, Yerevan, Armenia We would like to describe typical and unusual presentations of Cogan’s syn- drome. Cogan’s syndrome is a rare autoimmune disease. There are 2 forms of Cogan’s syndrome. The diagnosis of classic Cogan’s syndrome is made on the basis of non-syphilitic interstitial keratitis, acute-onset sensorineural hearing loss and vestibular symptoms such as Meniere’s disease, and progressive hear- ing loss up to deafness within 2 years. Diagnosis of atypical Cogan’s syndrome can also be made when the classic pattern of autoimmune-type vestibule-auditory symptoms is associated with inflammatory eye disease other than interstitial keratitis or when the interval between onset of ophthalmologic and the onset of vestibule-auditory symp- toms is more than 2 years.It most commonly affects young adults between 20-30 years old but can be seen at any ages. 78 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-COR-08 Halting a hot therapeutic Penetrating Keratoplasty (PKP) in a patient with corneal melting and impending perforation I. Gardeli1, N. Ktistakis1, K. Mouriki1, R. Datseri1, M. Orfanidou2 1General Hospital of Athens Georgios Gennimatas, Cornea Department, Athens, Greece, 2General Hospital of Athens Georgios Gennimatas, Microbiology Department, Athens, Greece Purpose: To present the management of a compelling case of gram-negative microbial corneal ulcer, accompanied by corneal melting and impending per- foration. Methods: A 39-year-old otherwise healthy female contact lens wearer without any previous ocular history was referred the emergency department with pain and redness in her left eye (OS) ongoing for 5 days. She was already receiving treatment for her condition, but without any improvement. Slit lamp biomi- croscopy of OS yielded conjunctival hyperemia with corneal melting. Corneal ulceration was evident near the limbus, measuring 6,6mm high and 5mm wide, accompanied by significant melting at the center of the lesion, stromal infiltration, and generalized corneal edema. Pentacam Central Corneal Thickness maps displayed thinning at 43 and 81 μm. Anterior Chamber (AC) was deep, with significant inflammation (Tyndall +4), and a 3mm high hypo- pyon. B-scan ultrasound displayed no signs of intraocular inflammation. All topical and systemic medications were discontinued for 6 hours as preparation for corneal scraping collection for culture. We switched treat- ment to Amikacin instilled every 15 minutes as a loading dose and then to hourly. Moreover, vancomycin was added. Owing to a strong suspicion of Pseudomonas being the offending agent intravenous (iv) Ceftazidime 2gr x3 was incorporated into the regimen. Results: On a 5-day follow-up corneal melting subsided, the hypopyon had minimized, and the anterior chamber reaction had downgraded to +2. Corneal scraping cultures yielded Pseudomonas. Therefore, we kept the same regimen while closely monitoring the patient. Epithelization of the ulcer was initially evident 5 days later and the patient was discharged. Conclusions: Post-discharge, she was followed in outpatient, scheduled for Deep Anterior Lamellar Keratoplasty (DALK) since the endothelium and Descemet membrane were left intact. By these means we avoided a therapeu- tic penetrating keratoplasty and the risks that it entitles. EP-COR-09 Results of corneal cross-linking for post-LASIK ectasia: a prospective study R. Gaster1, J.B. Margines1, X. Li2, Y. Rabinowitz1 1Cornea Eye Institute, Beverly Hills, United States, 2Lundquist Institute, Torrance, United States Purpose: Post-LASIK ectasia (PLE) leads to visual loss, corneal warpage and may require corneal transplantation. Corneal cross-linking (CXL) halts progression of PLE and may improve visual function. This prospective study determines the safety and efficacy of CXL for PLE. Method: Of 97 eyes of PLE patients who underwent CXL, 59 eyes were eval- uated at 1 year, 42 eyes at 2 years, 30 eyes at 3 years, 20 eyes at 4 years and 17 eyes at 5 years post-CXL. Main outcome measures were uncorrected distance visual acuity (UCVA), best-corrected distance visual acuity (BCVA), maximum keratometry (Kmax) and minimum pachymetry. Results: LogMAR UCVA improved at most postop time points, but not sig- nificatntly. LogMAR BCVA improved at most postop time points, but only significantly at 1 year post-CXL. Kmax decreased significantly at 1, 3 and 4 years post-CXL. Minimum pachymetry decreased significantly at all post- CXL time points. Conclusion: CXL for patients with PLE is safe and efficacious in halting pro- gression of disease. Visual function is maintained or may improve post-CXL. Patients with PLE should be encouraged to stop progression of the disease by early CXL. EP-COR-10 Evaluation of ciclosporine effectiveness in severe dry eye disease using anterior segment optical coherence tomography I. Fendouli1, A. Hassairi1, R. Saidane1, F. Jendoubi1, R. Limaiem1, L. El Matri1 1Faculty of Medicine of Tunis, University of Tunis, B Department of Ophthalmology, Hedi Raies Institute, Tunis, Tunisia Purpose: The aim of our study is to assess the efficacy of topical ciclosporin in severe dry eye disease (DED) patients. Patients and method: We conducted a prospective study including six pa- tients followed for various Severe dry eye syndromes. Treatment resorted to ciclosporin 0.05% (Restasis®) in addition to hyaluronic acid. Efficacy of treat- ment was assessed from symptomatolgy using OSDI, slit lamp examination, visual acuity, possible complications. Anterior segment optical coherence to- mography was performed to study tear film thickness (TFT), tear meniscus area (TMA) and height (TMH) for each patient, before and after treatment. Results: Etiologies in severe DED were various in our series involving Lyell syndrome (1 patient), Gougerot Sjogren syndrome (3 patients), Ocular Cicatricial Pemphigoid (1 patient) and Graft versus Host Disease (1 patient). Ciclosporin allowed the regression of functional and physical signs with most of the time improvement of visual acuity. There was a statistically significant difference in TFT, TMA and TMH before and after treatment. Our best results were obtained with Gougerot Sjogren syndrome. Discussion: Ciclosporin in topical form has an immunomodulatory role with- out systemic effect. This molecule acts by its anti-inflammatory, immunosup- pressive and regulating action of apoptosis. It may represent an alternative to local corticosteroid therapy in case of failure or corticoid-dependence. Several studies highlighted the effectiveness of the molecule in moderate or severe dry syndromes, especially Gougerot Sjogren syndrome. Conclusion: Cyclosporine is an innovative immunosuppressive agent, used for many years in the treatment of several auto-immune or inflammatory dis- eases. Its indications in ocular surface pathologies are susceptible to expand. A study with larger cohorts ought to be conducted in severe DED in order to better identify them. 80 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS ing hours) and 4-Hrly for next 12 days. We evaluated BK recovery clinically and with cornea OCT, anterior chamber (AC) reactions, corneal haze and pain (on a 10-point scale) 12 hours and 1, 3, 5 and 14 days after treatment. A sepa- rate drug retention study (DRS) over time in DDCL was performed. Results: The baseline corneal-infiltration (i.e., BK severity) values were com- parable for Groups 1 (18 cases) and 2 (17 cases) (P = 0.92). After 12 hours, the scores improved in both groups and continued to improve throughout the follow-up period; the improvements were more pronounced in Group 2 than in Group 1 (all P <0.05). Complete recovery occurred on Days 14 and 5 in Groups 1 and 2, respectively. Furthermore, the AC reaction resolved by Day 3 in Group 2. The baseline pain scores were also comparable between Groups 1 and 2 (P = 0.52) and decreased throughout the follow-up period (all P <0.05); the decrease was more pro- nounced in Group 2. DRS established an extended drug-corneal availability for up to 4-Hours. Conclusion: Novel DDCLs augment the drug-lesion interaction time by pro- longing corneal antimicrobial availability, which hastens corneal healing in BK. Thus, a DDCL may decrease the antibiotic regimen and improve patient tolerance, eliminating the necessity for a loading dose. EP-COR-15 A phase-2 study on novel endothelial keratoprosthesis in chronic endothelial dysfunction: interim trial reports L.R. Daniel Raj Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cornea & Ocular Surface Diseases, Tiurnelveli,, India Purpose: To evaluate the safety and effectiveness of implanting a novel syn- thetic corneal endothelial substitute (endothelial keratoprosthesis) in cases of chronic endothelial dysfunction. Methods: A prospective open-label clinical safety & efficacy evaluation. Cases of chronic corneal edema due to endothelial dysfunction, not associated with systemic diseases like Herpes Simplex or prior corneal surgeries were subjected to a central 6 mm synthetic endothelial implantable substitute after a central 7.0mm descemetorhexis & attached under gas similar to endothe- lial keratoplasty. Pre & post-op central pachymetry (in mic.), vision (ETDRS characters), pain scores were analyzed in addition to re-bubbling rates & toxic reactions due to implants or any adverse events. Results: 12 cases were enrolled. The longest follow-up is 8 months and low- est is 6 months. Vision at baseline was 9.75+/-1.7 ETDRS characters, which improved to 41.75+/-8.7 by Month-1, and retained after 6-mon. at 55.59+/- 7.1. Mean Central pachymetry reduced from 715 mic, to 504 mic by Mon-1 & maintained at 492.5 mic by Month-4. Pain, out of a scale of 1 -100, at presen- tation was 90.5+/-2.3 & 68.25+/-4.03 at 1- Mon, further improved by Mon-4 (p=0.0001). No immunologic reactions to the synthetic implants or any other adverse reactions to the surgeries were noticed. None of the implants were explanted. 3 cases needed re-bubbling (D7, D7, D12 & 21). For one subject who died after 6 months, post-mortem HPE reports revealed dense fibrous adhesions of the implant edges to the cornea, favoring long-term retention of the device. Conclusion: Endothelial keratoprosthesis improved vision, reduced chronic edema caused by endothelial dysfunction & was not associated with adverse events or implant toxicities until month 6, & are continuously been monitored for safety. Endothelial keratoprosthesis could be an alternative to EK proce- dures with no risks of associated rejection events. EP-COR-16 Corneal endothelial toxicity following over-dosed concentrated optical Nepafenac: a case report L.R. Daniel Raj Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cornea & Ocular Surface Diseases, Tiurnelveli, India Purpose: To report an unusual and extensive corneal endothelial toxicity due to over-dosed high concentration topical NSAIDS (Nepafenac 0.3% eye drops QID) in post-cataract surgery. Methods: A pharmacovigilance case report from a Tertiary Eye Care Institution. A 58-year-old female underwent uneventful micro-phacoemulsi- fication with hydrophobic IOL surgery in her LE with an improved vision of 20/20 till the 3rd POD. Post-operative medications prescribed were a topical fixed combination of Moxifloxacin 0.5% with Dexamethasone 0.1% QID and topical 0.3% Nepafenac suspension OD. Results: On POD-3 presented with severe corneal edema, pain & vision of CF-2M, immediately following application of Nepafenac 0.3% eye drops. Diagnosed as endothelial toxicity due to concentrated topical Nepafenac (0.3%) which she was using QID, instead of advised OD dosing after ex- cluding other possibilities. Underwent FS-DSAEK 3 months post cataract surgery. Ocular topical NSAIDs are known to cause several ocular surface toxicities, perhaps this is the first case of endothelium compromise of its over-dosed concentrated forms. The probable mechanisms are either diffusion into the AC through a partially open cataract incision or trans-corneal absorption. Conclusion: This case is reported as a pharmacovigilance measure to empha- size the rational use of concentrated topical NSAIDS by cataract surgeons. Patients need thorough counseling on post-operative medications, their dos- age, and possible drug toxicities after cataract surgery, to avoid such disastrous complications, even though very rare & unusual in occurrence. EP-COR-17 Corneal stroma regeneration with cellular therapy: confocal study M. El Zarif1,2, K. Abdul Jawad2, J.L Alió1,3 1Miguel Hernandez University, Ophthalmology, Elche, Spain, 2Optica General, Research, Saida, Lebanon, 3Vissum Grupo Miranza, I+D+I, Alicante, Spain Purpose: Recently we described a new surgical approach by regenerative medicine using autologous adipose-derived adult stem cells (ADASCs) and decellularized corneal tissue with advanced keratoconus. We report herein the confocal microscopy in vivo evolution of the injected ADASCs into the human cornea along one-year follow-up into keratocytes, as well as the evolution of the corneal decellularized or ADASCs-recellularized human donor corneal laminas in advanced keratoconus. Methods: Confocal microscopy was performed in an experimental, prospec- tive consecutive series of cases. Fourteen patients were randomly distributed into 3 experimental groups. Group-1 patients underwent implantation of autologous ADASCs. Group-2 patients received decellularized donor corneal stromal lamina. Group-3, patients received implantation of the recellularized lamina with ADASCs. Implantation was performed in a femtosecond-assisted. 82 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Practice size or location was not associated with the number of newly di- agnosed cases. Optometrists with greater experience were more likely to prescribe RGP lenses and co-manage patients with ophthalmologists. Topographic unit ownership suggested an increased likelihood of prescribing RGP lenses but did not alter referral patterns. Conclusion: Our survey provides an indication of current practice and high- lights the important role of optometrists in the diagnosis and management of patients with keratoconus. Our results identify substantial variability in diag- nostic and referral patterns, and we propose that patients would benefit from the development of standardised guidelines for referral and co-management with ophthalmologists. EP-COR-21 Barriers, including systemic, demographic and socio-economic factors, to accessing tertiary keratoconus care L. Angelo1, A. Gokul1, H. Wadhwa2, C.N. McGhee1, M. Ziaei1 1The University of Auckland, Auckland, New Zealand, 2Waikato District Health Board, Hamilton, New Zealand Purpose: Determine the barriers to gaining access to the crosslinking service in Auckland particularly among Māori and Pacific Peoples. Methods: Data from patient records at Auckland District Health Board was collected prospectively over 12 months. Parameters included age, gen- der, BMI, ethnicity, NZ Deprivation score of residence (NZDep; area-based measure of socioeconomic status, 1=low deprivation - 10=high deprivation), disease severity (maximum keratometry and thinnest corneal thickness), at- tendance, distance travelled to clinic, car ownership, employment, and visual outcomes. Results: 454 subjects with keratoconus had a mean age of 24.1±0.8years, mean BMI of 33.0±9.7 and 43% were female. Pacific People consisted 40.2% of the population, Māori 27.2%, Europeans 21.2%, Asian 9.9% and MELAA 1.3%.Mean distance travelled was 12.5±9.5km, NZDep was 6.8±2.6 and at- tendance was 69.0±42.5%. Lowest attendance was in Pacific People and highest was in Asians (58.88% vs 90%,p=0.02). Mean worst-eye visual acuity at attendance was 0.75±0.47log- MAR(6/35). Unemployment was associated with worse best-eye visual acuity at FSA (p=0.01) and follow-up (p<0.05). Māori and Pacific People had the highest NZDep (p<0.001), presented younger (p=0.02), had higher disease severity (p<0.001) and worse visual acuity (p<0.001). Conclusion: A low rate of attendance was seen in this patient cohort attending a keratoconus clinic. Pacific People and Māori presented younger with worse disease severity and visual acuity but also had the highest non-attendance rate. Our results suggest that deprivation, ethnicity, and unemployment were found to be active barriers to clinic attendance. EP-COR-22 Engineering disease microenvironment of pterygium to elucidate the roles of cell-matrix interaction in cellular dysfunction during disease progression J. Chung1 1Soonchunhyang University College of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of Purpose: Cells can mechanosense the mechanical properties of their micro- environment and convert them into chemical signals to regulate various cel- lular functions such as proliferation, apoptosis, differentiation, and migration, known as mechanotransduction. We aim to understand the underlying molecu- lar mechanism of pterygium pathogenesis. Methods: Transcriptome analyses using human pterygium epithelial cells and fibroblasts isolated from primary pterygium tissue. Quantitative polymerase chain reaction (PCR) and wound scratch test were performed to compare char- acteristics between pterygial and normal conjunctival cells. Traction force microscope (TFM) analysis and migration ability in different matrix stiffness conditions (matrix stiffnesses to mimic normal (~2.5 kPa) and pterygial (~60 kPa) tissue) were compared between pterygial and normal con- junctival cells. Results: Transcriptome profiles showed significantly upregulated cell adhe- sion and migration-associated signaling pathways in the pterygial cells and which were validated by qPCR (MMP, integrin alpha) and wound scratch as- says. TFM analyses revealed that pterygium cells showed significantly higher levels of mechano-sensitiveness to their microenvironment and underwent mechanotransduction. Cells cultured on a stiff matrix exhibited increased growth, elongation, and numbers of vinculin, and furthermore, the same cell behaviors were signifi- cantly increased in both pterygium-derived cells. Conclusions: These results indicate both pterygium-derived fibroblasts and epithelial cells are much sensitive to the mechanical properties of their micro- environment suggesting that fibrotic nature of pterygium tissues could play a significant role in regulation of pterygium cell migration and pathogenesis. These findings may offer insight into the important roles of cell-matrix in- teractions in pterygium pathophysiology, which could provide a valid tool to develop potential therapeutic candidates. EP-COR-25 Acute bilateral toxic endothelitis in binge alcohol consumption: a case series R. Dcruz1, A. Roy2 1Ahalia Eye Institute, Glaucoma, Malappuram, India, 2LVPEI, Cornea, Vijayawada, India Endothelitis has a vast range of etiologies including infective, chemical-in- duced, drug-induced, systemic and toxic causes. Toxic endothelitis second- ary to alcohol binge consumption is rare and is reported less frequently in literature. We report a series of three cases with bilateral defective vision due to corneal edema and endothelitis following alcohol, binge drinking. Specular micros- copy revealed a decreased endothelial count along with polymegathism and pleomorphism. All cases showed dramatic improvement with frequent topical steroid application alone. 84 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Finally, with the purpose of faster and non painful recovery an Amniotic Membrane Transplant was made using a 10-0 Nylon to secure amniotic mem- brane to conjunctiva. Two layers were used, the first one with the epithelial side up and the second one with epithelial aspect face to the cornea. A treat- ment with therapeutic contact lens plus topical 0.1% Dexamethasone and 0.5% Moxifloxacin three times per day were prescribed. Conclusion: EDTA chelation is one of the most extended options used to treat Band Keratopathy. After removal of epithelium usually a therapeutic contact lens is placed to support the growth of new epithelium. However, that is only a physical support without biological regenerative prop- erties. Amniotic membrane not only provides a wide range of growth factors but also decreases the inflammatory response and risk of infection with a rela- tively simple procedure. Because of the previously exposed, patients can get a faster and non painful recovery after the surgery which is crucial in this pathology since most of the cases are bilateral. In this case, our patient gets an asymptomatic full recovery by the first month postoperative gaining three lines of vision. EP-COR-30 Deep anterior lamellar keratoplasty following Gundersen flap surgery: a two-step approach for Acanthamoeba keratitis G. Camburu1,2, N. Salgari3,1,4, C. Bovone5,1,4 1Ospedali Privati Forlì ‚Villa Igea’, Ophthalmology, Forlì, Italy, 2University of Medicine and Pharmacy ‚Carol Davila’, Bucharest, Romania, 3University of Ferrara, Translational Medicine, Ferrara, Italy, 4Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy, 5University of Ferrara, Morphology, Surgery and Experimental Medicine, Ferrara, Italy Purpose: We report the successful management of Acanthamoeba kera- titis through Gundersen flap surgery followed by Deep Anterior Lamellar Keratoplasty. This study reviews the surgical management and outcomes of a patient with severe Acanthamoeba keratitis not responsive to empiric anti- biotic therapy. Methods: A 35-year old female presented with severe corneal ulceration as- sociated with intense conjunctival hyperemia, neovascularization and thick purulent discharge. She had a history of contact lens wear. No clinical re- sponse was observed with standard empiric antibiotic therapy, Hexamidine di- isetionate 0.1% coll q.i.d and PHMB 0.02% coll q.i.d. Gundersen flap surgery was performed and topical antimicrobial therapy was continued resulting in clinical resolution of the infection and inflammatory response. Upon clinical resolution, 9mm DALK was successfully performed. Results: The surgery was uneventful and vision improved. Conclusions: For Acanthamoeba keratitis, a two-step approach involving conjunctival flap surgery followed by deep anterior lamellar keratoplasty can achieve infection control and improve surgical outcomes, thereby, potentially lowering the risk for corneal graft rejection and subsequent graft failure. EP-COR-31 A case of keratitis caused by infection of Acinetobacter lwofii in a patient with ulcerative colitis A. Moscalciuc1, M. Iacubitchii2, A. Corduneanu2 1Republic Clinical Hospital Timofei Mosneaga, Ophthalmology, Chisinau, Moldova, Republic of, 2SUMPh Nicolae Testemitanu, Ophthalmology, Chisinau, Moldova, Republic of Purpose: To report a case of keratitis caused by Acinetobacter lwofii in a pa- tient with ulcerative colitis using oral steroids for an extended period of time. Case summary: A 32-year-old male patient, using oral prednisolone for an extended period of time for ulcerative colitis, with significant visual impair- ment, ocular pain, conjunctival injection, and discharge in his right eye was consulted in emergency room. Prior, he was given topical antibiotics - tobramycin 0,3%, ciprofloxacin 0,3% q.i.d. and topical diclofenac 0,1% t.i.d for 3 weeks without any improvement. On slit-lamp examination, a 6.0 × 7.5-mm dense round stromal infiltrate with an overlying epithelial defect, hypopion and endothelial plaque was observed. The bacteriological culture revealed A. lwofii. According to the susceptibility result, the patient was treated with topical 0.5% levofloxacin hourly and intracamerular vancomycin 1.0 mg/0.1ml. The corneal ulcer healed gradually with corneal opacity remaining after 12 weeks of treatment. Conclusions: This study reports a case of a rarely ocular involvement with Acinetobacter lwofii in a patient using oral steroids for an extended period of time. EP-COR-32 Bilateral subconjunctival haemorrhage. More than meets the eye? W.W.A. Ng1, K.H.A. Lau1 1National Healthcare Group Eye Institute, Singapore, Singapore Purpose: To share an uncommon presentation of disseminated Kaposi sar- coma presenting with bilateral subconjunctival haemorrhage. Methods: Case report with photo-documentation. Results: A 34-year-old Malay man, with poorly controlled HIV infection, chronic hepatitis C, secondary syphilis, and childhood asthma, was diagnosed with COVID-19 and admitted for isolation following 3 days of respiratory symptoms and a positive PCR test. He also complained of red and teary eyes for a month’s duration. Multiple sub- conjunctival hemorrhages were seen bilaterally. Lower lid eversion revealed violaceous vascular masses hidden in the inferior fornices extending up to the bulbar conjunctiva. Further lesions in the left upper gum, stomach, duodenum and rectum were found. There was generalized lymphadenopathy correspond- ing to hyper-attenuating enlarged lymph nodes on CT scan. Biopsies of the stomach lesions and inguinal lymph node were positive for Kaposi sarcoma. After compliance with antiviral treatment and improvement in HIV viral load, Paclitaxel was started. Conjunctival lesions showed good resolution with treatment. Despite reports linking kaposi sarcoma with COVID-19 infection, the timeline of events suggests HHV-8 viral reactivation due to COVID-19 infection is unlikely in our patient. 86 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS were referred to the service following an eye examination by an optometrist. The fifth sibling also underwent a clinical assessment as the clinician was suspicious of keratoconus due to high prevalence in their siblings. A standard clinical examination including history, unaided vision (UVA), corneal tomog- raphy (Pentacam AXL) was conducted. Results: The five siblings were aged 5, 7, 8, 10 and 12 years. The second and third oldest were female, and the remaining, male. The two oldest siblings had moderate keratoconus with an oval-cone pattern. UVA in right and left eyes was 6/120, 6/19 and 6/30, 6/19, respectively. Both were waitlisted for bilateral CXL. The other siblings had mild keratoconus, demonstrating an asymmet- ric bowtie, inferior steepening and reduced corneal thickness bilaterally, but 6/7.5 or better UVA. All siblings reported eye-rubbing with only one reporting atopy. No other family history was noted. Conclusion: This case series represents an unusually high occurrence of kera- toconus among siblings. The fact that all five siblings had either frank or sub- clinical keratoconus highlights the need to investigate siblings, particularly younger siblings, for the disease in Māori and Pacific Peoples, among whom keratoconus is known to have a higher prevalence. This may allow for earlier detection and treatment with CXL, preventing moderate to severe vision loss. EP-COR-36 Severe keratitis with endophthalmitis N. Yesilirmak1 1Ankara Yildirim Beyazit University, Ankara Bilkent City Hospital, Department of Ophthalmology, Department of Neuroscience, Ankara, Turkey Objective: The incidence of severe keratitis with endophthalmitis is approxi- mately 0.5% in the population. Mostly the source is fungal infection and the prognosis is very poor. Surgical intervention and enucleation are required in more than 70% of cases. Initial visual acuity (VA) is considered the main factor determining the prognosis. In this case report, we presented a patient with severe keratitis and endophthalmitis whose stability was achieved with- out surgery. Method: Case report. Results: The 80-year-old male patient was referred to our clinic with the di- agnosis of severe keratitis with endophthalmitis in the right eye. The VA was light perception in the right eye and 20/20 in the left eye. Biomicroscopic examination revealed total corneal ulcer in the right eye, shallowness and hy- popyon in the anterior chamber, vitreous opacities and bands on ultrasound. Corneal scraping and vitreous sample were taken and intravitreal, subcon- juntival and topical fortified voriconazole + amphotericin B + vancomycin + ceftazidime treatments were administered. In the first week, it was observed that the vitreous opacities decreased and the corneal lesion started to shrink. Topical fortifying treatment was gradually decreasing with the arrival of the culture(-), amniotic membrane was applied and renewed as needed, and lat- eral tarsorrhaphy was performed and then removed at the 3rd week. In the 8th week, the keratitis area disappeared and was replaced by scar tissue and vascularization, however VA did not increase. Conclusion: Although the lesions regressed and surgery was not needed in our case, VA did not increase, which proves the negative effect of initial VA on prognosis. As a result, it has been shown that even though there was no growth in culture with this case, continuing with the agents whose efficacy we have observed and application of amniotic membrane and tarsorrhaphy can provide stability without going to surgery even in such cases with poor prognosis. EP-COR-37 Smile for the treatment of residual refraction error and presbyopia after Photorefractive Keratectomy (PRK) and LASIK F. Semiz1, A.s. Lokaj1, N.H. Musa1, C.E. Semiz2, Z.A. Demirsoy3, G.I. Semiz4, O. Semiz1 1Eye Hospital, Ophthalmology, Prishtina, Albania, 2Gazi University, Faculty of Medicine, Ankara, Turkey, 3Yeditepe University, Faculty of Medicine, Istanbul, Turkey, 4Bahcesehir University, Faculty of Medicine, Istanbul, Turkey Purpose: We aimed to investigate the improvement in visual acuity, presby- opia, and patient satisfaction after small-incision intrastromal myopic lenti- cule implantation using (the SMILE module) with residual hyperopic refrac- tion after PRK And LASIK surgery. Methods: This included 54 eyes of 22 patients (aged 43 to 52 years). Postop PRK and Lasik included hyperopic residual refraction. Patients had residual hyperopia between +1.0 and +3.25 D and Astigmatism between +0.75 and +1.75 D. The cap thickness was set to 130 µm from the corneal surface and a 2.0-mm incision. The pocket was dissected using a blunt spatula washed with normal saline and a 7.70 mm intrastromal pocket was prepared with SMILE Module and a Myopic lenticule implanted. Results: Patients were followed for 12 months. No reaction, infection, epithe- lial defects, punctate keratitis, or signs of allogeneic rejection were observed in any of the patients. The UDVA increased from 0.70 ± 0.06 logMAR preop- eratively to 0.05 ± 0.02 logMAR 12 months postoperatively (p< 0.001). And UNVA had an increase in J 2 one year after preop J 7. Conclusion: SMILE module is a reliable method for treating residual refrac- tion and presbyopia after PRK and Lasik, as it provides results in the shortest time without complications and increases patient satisfaction. ClinicalTrials.gov Identifier: NCT04793893 EP-COR-38 Correlation of corneal curvature and central corneal thickness with refractive errors in school age children population T.K. Wardani1, N.W. Anandita1, L.R. Wulandari1 1Universitas Brawijaya, Ophthalmology, Malang, Indonesia Purpose: To determine and investigate the correlation between corneal cur- vature, central corneal thickness (CCT) with refractive errors, age and gender among school age children population in Malang district, Indonesia. Methods: A population based consecutive cross sectional study was conducted in 13 orphanages in Malang district, Indonesia. This study involved 772 eyes of 386 respondents who met the inclusion criteria included in this study. After receiving approval and informed consent, following examinations were performed for all the respondents, measuring best-corrected visual acuity by Logarithmic Visual Acuity Chart (LVRC), corneal curvature by handheld autorefractometer, central corneal thickness (CCT) by handheld pachymetry devices. All patients underwent a complete slit-lamp examination. Correlation between corneal curvature, central corneal thickness (CCT) with refractive errors, age, and gender was studied using One-Way ANOVA, Pearson, and Independent t-test correlation coefficient. 88 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

Results: All patients were followed for five years. No reaction, infection, epi- thelial defects, punctate keratitis, deep lamellar keratitis, or signs of allogeneic rejection were observed in any of the patients. Q value improved from − 0.82 ± 0.04 preoperatively to − 0.60± 0.05 five years postoperatively (p< 0.001). The pre-operative CDVA improved from 1 ± 0 logMAR to 0.55 ± 0.09 log- MAR (P< .001). The preoperative CCT increased from 398 ± 13.29 µm to 481.10 ± 8.12 µm (P< .001). Conclusion: The intrastromal lenticule implantation procedure was clinically effective in improving corneal shape (increasing Q value) and vision in pa- tients with keratoconus. The addition of fresh myopic lenticule increased cor- neal thickness while transforming the cone into an ellipsoid shape. EP-COR-44 Calcific band keratopathy M. Rotnáglová1, E. Tihelková1 1Gemini oční Klinika a.s., Průhonice, Czech Republic Introduction: The case report is about an 83-year-old female patient with calcific band keratopathy. Methods: A patient with history of atrophic form of age related macular dys- trophy, glaucoma, after cataract surgery, with zonular keratopathy, was re- ferred to our clinic by the district ophthalmologist because of several months of pain in both eyes, especially in the right eye, significant photophobia. The patient almost did not open her eyes in daylight for the last six months, in the last months she was repeatedly treated with ATB + KS, but after these treat- ments there was only a slight decrease in the difficulties. Initial BCVA in both eyes was hand movement, after application of local an- aesthetics was 0.05, corneal findings of zonular keratopathy with epithelial integrity disorder in the center, other findings on the anterior segment were normal, funduscould not be seen. In the operating room after abrasion of the corneal epithelium on the right eye, a layer of calcium deposits was gradually dissolved and abraded using 3% EDTA. After the procedure, a contact lens was fitted and local antibiotic therapy was administered 5 times a day. At regular follow-ups, the cornea is reepithelialized and the fundus shows an advanced stage of dry form of age related macular degeneration. Conclusion: Despite the fact that we did not expect a visual benefit in the patient due to the presence of the atrophic form of ARMD, the removal of the calcific band keratopathy using EDTA had a significant subjective benefit for the patient, and the elimination of pain and photophobia resulted in an improved quality of life. ELECTRONIC POSTER PRESENTATIONS EP-COR-42 Mystery of corneal dystrophy - a rare case of granular dystrophy S. Patil1, S. Joshi2, H. Joshi2 1Dr D.Y. Patil Hospital, Ophthalmology, Kolhapur, India, 2H.V. Desai Eye Hospital, Ophthalmology, Pune, India A case of 11 year old girl and 13 year old boy brought by their mother to hospital with complaints of whitish opacity in both eyes which was gradually progressing, painless and associated with diminution of vision, photophobia and glare. No other ocular complaints and no similar complaints in family but there is 2 nd degree consanguineous marriage. Birth history and antenatal history uneventful. Slit lamp examination shows white crumb like opacities with clear intervening spaces, posteriorly going upto midstroma extending to periphery sparing limbus. Necessary investigations like B scan to rule out any posterior segment pathology,anterior segment OCT to see extent of depth of opacity and plan surgery accordingly. The first male child posted for left eye DALK, then after a week a female child also posted for left eye DALK. Both corneal buttons sent for histopathological examination as well as special stains like congo red and mason trichrome, of which Masson trichrome stain was came positive. Postoperatively started on antibiotic and steroid eye drops and now doing well. Postoperative Anterior segment OCT done to see thickness of graft Discussion: Granular dystrophy is rare epithelial stromal dystrophy autosomal dominant linked to TGFB1 gene on chromosome number 5.Histopathologicaly diagnosed by special stains like mason trichrome. Conclusions: 1. Early intervention leads to better visual prognosis. 2. Manual Deep anterior lamellar keratoplasty, helps in baring of descemets membrane reduction chances of endothelial rejection post operatively. 3. As it is lamellar keratoplasty earlier the visual recovery and suture related complications are eliminated, and; 4. Counselling about consanguineous marriages reduces chances of inherit- able diseases. EP-COR-43 Changes in corneal Q value (corneal shape) after intrastromal lenticule implantation in advanced keratoconus N. Hima Musa1, F. Semiz1, A. Syla Lokaj1, O. Semiz1, C. Ece Semiz2, G. Idil Semiz3, Z. Alp Demirsoy4 1Eye Hospital, Ophthalmology, Pristina, Albania, 2Gazi University Medicine Faculty, Ankara, Turkey, 3Bahcesehir University Medicine Faculty, Istanbul, Turkey, 4Yedi Tepe University Medicine Faculty, Istanbul, Turkey Purpose: To investigate Corneal Q value changes after Fresh myopic lenticu- lar implantation in keratoconus with femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery. Methods: Fifty eyes with advanced keratoconus indicated for corneal trans- plantation were included in this study. Fresh myopic lenticular implants were placed according to corneal topography in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive er- rors of the cornea. 90 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-COR-48 Unilateral ectasia with sudden onset and rapid progression in an adult patient with history blepharitis and atopy P. García Carrero1, E. Puertas Martínez1, B. Sarmiento Torres1, C. Mata Beltrán1, S. Arroyo San Víctor1, V.A. Damas Casani1, D. Burón Pérez1, D. Rojas-Correa1, A. García Louro1 1University Hospital 12 Of October, Madrid, Spain Keratoconus is a bilateral and asymetric corneal disease which results in pro- gressive thinning of the cornea. Environmental factors promote its emergence and progression. A 55 year old man, with a history of allergy and atopy and a normal ophthal- mology examination 2 months earlier (irrelevant refraction and opitmal visual acuity), came to the ophtalmology emergencies complaining of a 1 month history of blurred vision in his left eye and itching, increased secretions and foreign body sensation in both eyes (BE). On examination, we verified a best corrected visual acuity (BCVA) in the right eye (RE) of 0.8 and count fingers in the LE. In the slit lamp, signs of severe blepharitis, allergic conjunctivitis and gutta were found in BE, while in the LE an inferior corneal thinning associated with iron lines and possible Munson’s sign was observed. As a corneal ectasia was suspected, artificial tears were prescribed and after 2 weeks a review was performed in the anterior segment section. A LE keratom- etry (+49.25 at 170º,cylinder -12.25x80º) and sheimpflug topography (Oculus Pentacam®) was performed. He presented a mean K of 45.2D, a maximum K of 60.7D, a thinnest corneal thickness of 415 micrometers, a posterior eleva- tion (PE) of +119 microns and a high-risk crab claw pattern consistent with de novo ectasia on LE, while parameters were normal on the RE. Treatment to stabilize the tear film with descending corticosteroid eye drops, palpebral hygiene and oral doxycycline, was prescribed and avoid eye rubbig was recomended. One month later, an endothelial count was performed in LE with 1768 cells and a Pentacam® was repeated, evidencing progression with an increase of 1.5D and PE of +17 microns for which crosslinking was carried out. Currently follow-up with serial topography reveals stability. Environmental factors affecting ocular surface cancause unilateral sudden on- set and rapid progression of keratoconus in adulthood, requiring early treat- ment for its stabilization. EP-COR-49 Dry human amniotic membrane-derived matrix for the treatment of persistent corneal epithelial defects L. Pelosini1, H. Manzar1, S. Sansome1, L. Sharief1 1King’s College Hospital NHS Foundation Trust, Ophthalmology, London, United Kingdom Purpose: To present the use of dry human amniotic membrane-derived matrix (AMDDM) in the treatment of persistent corneal epithelial defects (PEDs) Methods: Retrospective review of 45 patients (63 to 94 years) treated at Queen Mary’s Hospital, King’s College Hospital NHS Foundation Trust with AMDDM (Omnigen) for PEDs. The main outcome measures were time to heal the corneal epithelial defect, the safety of the procedure (safety was de- fined as lack of complications and no need for further intervention), the final visual acuity (VA), and the patient’s comfort. Results: A total of 45 cases (26 females and 19 males) were followed up for up to six months following the resolution of the corneal pathology. The major- ity of patients presented non-healing epithelial defects secondary to neuro- trophic keratitis (63%) and the remaining patients had persistent defects due to infective causes (13% herpetic keratitis, 24% bacterial keratitis). The mean time to heal was 29 days (range 18 to 48 days), the mean time for removal of the bandage contact lens was 18 days (range 14 to 26 days), the safety of the procedure was demonstrated in 44 cases not requiring further procedure, 1 case required tectonic corneal graft due to microbial keratitis. The total time for resolution of the pathology to discontinue the topical anti- microbial therapy was 32 days (range 29-49 days). The VA remained stable from baseline at the first assessment of the corneal epithelial defect in 67% of patients and improved by an average of 2 Snellen lines in 27% of patients, the vision resulted in the loss of an average of 2 Snellen lines from baseline in 6% patients. All patients reported improved comfort following the AMDDM. Conclusions: The use of dry human amniotic membrane-derived matrix re- sulted in an acceleration of the time to heal the corneal defect in all cases, the procedure resulted safe and led to an improved level of comfort in all patients. EP-COR-50 Treatment of corneal infection by an antibiotic drug eluting contact lens C. Adams1 1Glint Pharmaceuticals, Cambridge, United States Moxifloxacin is a fourth-generation fluoroquinolone, commonly used by oph- thalmologists due to its increased activity against Staphylococcus aureus as well as gram negative organisms compared to earlier fluoroquinolones such as ofloxacin and ciprofloxacin. For this reason, moxifloxacin is often a first- line choice by ophthalmologists for the treatment and prevention of anterior ophthalmic infections. To treat ocular infection more effectively than standard eye drops Glint Pharmaceuticals has developed a moxifloxacin releasing con- tact lens. A safety study was performed on 20 subjects with healthy eyes. The protocol design was a contralateral study with 5 mg/ml antibiotic (USP Moxifloxacin and 0.5% Providone (PVP)) Tocopherol sterile bandage contact lens (senofil- con A) labeled ACL5 (antibiotic contact lens) versus a Tocopherol bandage contact lens (senofilcon A) labeled TCL (tocopherol contact lens. Both lenses were plano with a base curve of 8.8. The lenses were worn continuously for 48 hours. Primary study objectives were: 1. Confirm that the 5 mg/ml antibiotic (USP Moxifloxin) sterile bandage con- tact lens (senofilcon A) ACL5 has no adverse results on eyes; 2. Confirm patient comfort with wearing ACL5 as compared to the control lens (TCL) over time. Study results: All participants completed the study without adverse events and or discomfort over a 48-hour period. Based on the study results clini- cal developed of ACL5 will proceed with a larger cohort with clinical grade infection. 92 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS surface and with a small opening - 3 mm superior incision at 90° and side cut angle 50°. The pocket was dissected using a blunt spatula. The lenticule was held with lenticule forceps and gently inserted into the pocket through the 3 mm superior incision. Result: The patients were followed up for one year. There were no complica- tions. Q value decreased from -0.53±0.04 preoperatively to -0.81 ±0.05 one year postoperatively (p<0.001). Postoperative uncorrected vision increased to 4 lines in 7 eyes and improved to 5 lines in 9 eyes. Patient satisfaction has increased. Conclusion: Intrastromal lenticule implantation is a feasible and no-compli- cation treatment method in aphakic patients. By changing the Q value, both vision improvement and patient satisfaction were observed. EP-COR-54 Case report of three degenerations in one eye S. Kechyants1, L. Kambulyan2, A. Hovakimyan3 1Yerevan State Medical University, Malayan Eye Center, Yerevan, Armenia, 2Yerevan State Medical University, Yerevan, Armenia, 3Yerevan State Medical University, Malayan Eye Center, Cornea- Uveitis Department, Yerevan, Armenia We would like to submit an atypical case presentation of three different types of degenerations in one eye. Corneal degenerations are changes or gradual deteriorations in the tissue of the cornea. They can negatively impact the func- tion of the cornea, limiting its ability to help the eye focus properly. Corneal degenerations can be caused by disease or by aging. In most cases, degenera- tions have nothing to do with genetics. Age-related degenerations are known as “involutional” corneal degenerations, while degenerations caused by disease or exposure to certain conditions are “non-involutional.” The symptoms of corneal degeneration can vary depend- ing on the type of degeneration. In most cases, patients experience both cosmetic and sight-related symptoms. Treatments for corneal degeneration can vary depending on the exact diagno- sis. Our case report represents a patient with three degenerations in the left eye and one degeneration in the right eye. The patient was admitted to the eye clinic with complaints of poor vision and visited for only a prescription for glasses. During slit lamp examination, we discovered crocodile shagreen in the right eye and crocodile shagreen, Salzmann’s nodular degeneration, and Terrien’s marginal degeneration in the left eye. We did a literature review and didn’t find cases like this, where three different types of degenerations occurred simultaneously. EP-COR-56 Mooren`s ulcer case presentation in elderly patient H. Sargsyan1, Z. Sargsyan1 1Yerevan State Medical University after Mkhitar Heratsi, Ophthalmology, Yerevan, Armenia Mooren`s ulcer is progressive, painful, superficial corneal ulceration, start- ing at a corneal margin and spreading circumferentially and centripetally: A 73-year-old female patient applied to Malayan Eye Center complaining of photophobia, pain, redness, and tearing in her left eye. No systemic disease was found, a limbal conjunctival injection with 90% stromal lysis was re- vealed in the left eye. The patient reported no other illness and was completely healthy. The following treatment was prescribed: antibiotic eye drops q.i.d., cycloplegic eye drops q.i.d., corticosteroid eye drops t.i.d., sodium chloride 5% eye drops q.i.d., lubricant eye drops q.i.d., doxycycline 100 mg p/o b.i.d., subtenon`s injection of betamethasone 0.5 ml. After seven days the corneal ulcer was in the same size and no positive dynamics was observed, so a subtenon`s injec- tion of betamethasone 1.0 ml was performed, and an oral immunosuppressant drug: azathioprine (imuran) 50mg/day was added. After two weeks, due to no positive dynamics, a surgical intervention was performed: amniotic membrane transplantation and conjunctival resection, as well as in addition to the prescribed drugs, oral glucocorticosteroid tablets were added: metipred 32 mg/day, and also imuran 100 mg/day, doxycycline tablets 50 mg/day b.i.d. After two weeks, the ulcer started to heal, stromal lysis became 60%, metipred was decreased to 24mg/day whereas the other drugs remained the same. Two months after the first visit, the eye was completely healed, the corneal epithelial layer was intact․ Thus, Mooren’s ulcer remains a diagnosis of exclu- sion with uncertain pathophysiology. One should always look for associated scleritis, limbal involvement, to rule out other causes of peripheral ulcerative keratitis, including infectious, collag- enous and degenerative processes. Advances have been made in the treatment, but significant percentage of cases still remain refractory to available therapies and result in severe visual morbidity. EP-COR-57 Malignant glaucoma after DSAEK caused by trapped gas bubble behind the iris M. Sarnat-Kucharczyk1, Ł. Drzyzga1, E. Mrukwa-Kominek1 1Medical University of Silesia, Department Ophthalmology, Faculty of Medical Sciences in Katowice, Katowice, Poland Purpose: The aim is to describe a case of a 67-year-old female with malignant glaucoma after Descemet Striping Automated Keratoplasty (DSAEK) due to a trapped gas bubble behind the iris and to present a problem-solving pathway in the management of this complication and the intraocular pressure (IOP) rise. Methods: Uncomplicated DSAEK in the right eye was performed in a 75-year-old female with Fuchs’ endothelial keratopathy. At the end of the sur- gery anterior chamber in 80% was filled with a mixture of SF6 and air. Results: 12 hours after uncomplicated surgery patient complained about se- vere ocular pain and headache. IOP was 50 mmHg. In slit lamp examination anterior chamber (AC) was very shallow with peripheral iridocorneal contact and reduced gas bubble to 10% of the AC. 94 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Methods: Selective literature search in books and journal articles in close co- operation with Institute of Experimental Ophthalmology, Saarland University Homburg/Saar (Germany) and Department of Ophthalmology, University of New South Wales at Prince of Wales Hospital, Sydney (Australia). Results: Ida Mann was one of the first female clinician-scientists to conduct pioneering research in ophthalmology. On the foundations of a strong basic science knowledge base and early adoption of the new technology of her era (including the slit lamp, contact lenses, toxicology and cancer medicine), she built an impressive career as an academic ophthalmologist. Her achievements are all the more remarkable given the then strong resistance for women to entering medicine as a career, even from her own family: She passed the matriculation examination in 1914. She finished her exams in 1941, was appointed Margaret Ogilvie Reader in Ophthalmology in Oxford in 1941, managing her activities in research, teaching and medical practice she was granted a personal chair at the University of Oxford in 1944, being the first female professor at Oxford. She was a private advisor to Winston Churchill during WWII. In 1949 she moved to Australia where she continued doing research and practicing medicine almost until her passing. Conclusions: Through her outstanding contributions and achievements in ophthalmology and medicine she achieved international recognition in an era before the internet. In recognition of her numerous contributions she received honorary degrees, prizes and medals from many countries. She was appointed as Dame Ida Mann of the order of the British Empire on June 14, 1980 for her services to the welfare of Aboriginal people. EP-EDU-03 Audit ensuring quality of care for patients seen only once and discharged from Moorfields Eye Hospital clinics, using a telemedicine questionnaire as a follow up consultation A.I. Marinescu1, C. Hall2 1Moorfields Eye Hospital, General Ophthalmology, London, United Kingdom, 2University Hospitals Sussex, Brighton, United Kingdom Purpose: To consider patient reported outcomes from 3 audits, using a tele- medicine questionnaire, of 3 different General Ophthalmology clinics. Patients selected have been seen only once and discharged with or without treatment. In many cases we don’t hear from these patients again unless referred back by their GP. This new audit was developed for this specific group. Method: 174 patients were surveyed by an ophthalmologist (Fellow or junior doctor) by telephone using a standard seven question survey and the results were analysed. The questionnaire covered presenting symptoms, severity, diagnosis and ex- planation, improvement, completion of treatment, asking if the patient was told what to do if condition worsened and waiting time. The doctor had discretion to take action if required. Results: Reported severity of symptoms – very bad 22 (12.6%), bad 26 (15%), medium 48 (27.6%), mild 37 (21.2%), no symptoms 41 (23.6%) Improvement: 96 patients (55%) said better or much better 68 patients (39%) said condition the same. 7 (5%) patients said worse and 3 (1%) no symptoms Did not take treatment: 2 patients (0.1%) Not knowing what to do if symptoms worsened: 42 patients (24.1%) Diagnosis not explained: 2 patients (0.1%) Waiting time: 142 (81.6%) patients were happy with the waiting time Conclusion: It proves the value of regular audit cycles covering this type of consultation to ensure care quality is maintained and enhanced and allows for benchmarking between sites. To ensure that all advice given is also written in the consultation letter and consider giving other explanatory material during the consultation. To include specific advice on what to do if the condition worsens. The patients reporting worse had conditions such as floaters, retinal haemor- rhages, corneal scar, blunt trauma and dry eyes. In two cases patients were directed to A&E. The patients reporting no change generally had chronic conditions, dry eyes, floaters, myopic degeneration, corneal scars. EP-EDU-04 Can Indie dogs be trained as guide dogs for the blind? J. Elliott1, R. Sharma2, D. Verma3, A. Hanley2 1University of Nottingham, Nottingham, United Kingdom, 2University Hospitals Derby & Burton, Derby & Burton, United Kingdom, 3NHS (retired), Goa, India Breeding and training guide dogs is a rigid and costly process. They are bred and reared for key behaviours such as minimal distraction, docility, trainability, low aggression and lack of fear. Indie dogs are strays and are plentiful in India, posing a public health risk and animal welfare concern. The Indie dog could be suitable as a guide dog due to high intelligence, having learnt to survive in difficult environments. They have strong immune systems and lack the predis- position to certain genetic conditions found in some European breeds. A pilot study on two Indie puppies has been done under the aegis of National Association for Blind Goa and Welfare for Animals Goa. Muskie and Aramis were street dogs, rescued by a co-author at three weeks old, fully vaccinated, neutered/spayed and fostered in his home. Their intelligence was assessed by teaching them skills with a reward feedback mechanism. They were tested for intelligent disobedience, a crucial guide dog skill, where a dog independently disobeys a command in a dangerous situation. A literature review has been written to investigate dog behaviour, breed and importance of a puppy’s early life experiences. Another study in Kochi is proposed, which will test 15 Indie puppies using games and social interaction with Blind volunteers to assess behavioural suitability. If successful, recommendations will be made to train these puppies as guides. The pilot study found the puppies to be highly intelligent but further studies are needed with larger samples and a scientific assessment of suitability. The review found that breeding guide dogs increases the chance of desirable be- havioural traits, but a complex interplay of genetic and environmental factors shape a dog’s personality. There is no evidence that Indie puppies would not make good guide dogs. A selection tool would help identify the puppies with the highest chances of suc- cess. This would help solve the stray dog crisis and avoid expensive breeding of guide dogs. 96 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-EDU-08 EP-EDU-09 Hypotensive and hypertensive athalamia after bilateral glaucoma surgery. Importance of differential diagnosis J. Torres1, M. Montero-Rodríguez1, E. Gutiérrez-Díaz1, M.D. Lago-Llinas1, B. De-Lucas-Viejo1 112 de Octubre Universitary Hospital, Ophthalmology, Madrid, Spain Case study: 82-year-old patient with primary bilateral open-angle glaucoma in maximum treatment, and cataract in both eyes (BE). His medical history included branch thrombosis in the right eye (RE) 20 years ago, atrial fibrillation under treatment with Sintrom Ò, and polymyalgia rheu- matica. Combined surgery with Preserflo Microshunt implantation is indicated in both eyes. The RE surgery was performed first, which failed after three weeks; therefore, it was decided to review it at the time of performing the left eye (LE) surgery. Both surgeries were uneventful. In the immediate postoperative period, visual acuity is less than 0.1, present- ing a grade 2 athalamia in BE. The IOP of the RE is 2 mmHg and that of the LE is 13 mmHg. A wide filtration bleb is evident in RE, and flat in LE. The fundus revealed nasal and inferior serous choroidal detachment (CD) in the RE, and thrombosis of the central retinal vein in the LE. It is classified as hyperfiltration in RE, and glaucoma with vitreociliary block in LE. We per- formed a YAG capsulohyaloidotomy in the LE, with good formation of the an- terior chamber, and cyclopentolate and topical corticosteroids were prescribed in the BE, and oral corticosteroids at a dose of 1 mg/Kg/day. The evolution of both eyes was adequate. The CDs resolve at 10 weeks in RE, currently presenting an IOP of 6 mmHg. Likewise, the IOP in the LE is 10 mmHg, and the patient is being treated with antiangiogenic agents. Discussion: The management of athalamia is essential in the postoperative period of glaucoma surgery. Intraocular pressure, the shape of the blister and the fundus of the eye are crucial when diagnosing its cause, and its manage- ment will depend on this. On the other hand, bilateral surgery has its advantages, but also its risks. Among them is the threat of bilateral vision loss, as in this case, where the complications are different in each eye, aggravated by the fact that a thrombo- sis is presenting in a single functional eye. Carl Wilhelm Von Zehender, a pioneer in ophthalmic microsurgery, founder and editor of “Klinische Monatsbleätter für Augenheilkunde,” and a great educator G. Balanikas1, D. Peirounides1, S. Diafas1, E. Papadopoulou1, P. Rasoglou2, M. Angelou3, ‘Society of History of Ophthalmology Scholars’ 1Aristotle University of Thessaloniki, A’ Ophthalmologic Clinic, AHEPA Hospital, Thessaloniki, Greece, 2Ophthalmica Institute, Cataract and Refractive Surgery, Thessaloniki, Greece, 3Ophthalmiatreio Athinon, A’ Ophthalmologic Clinic, Athens, Greece Purpose: Carl Wilhelm v. Zehender was born in Bremen in May 1819. He studied medicine in Goettingen, Jena, Prague, Paris, and Vienna. During this period, he developed a friendship with Albrecht v.Graefe. In 1863 the first edition of “Klinische Monatsblaetter für Augenheilkunde” was published as a review. This presentation will unfold the details of his life and academic work. Method: In 1863, the first edition of “Klinische Monatsblaetter für Augenheilkunde” was published. In the pages of this medical review, the evo- lution of Ophthalmology in Germany is present with the progress in diagnos- ing and treating many ocular conditions. We used this volume for this presentation to compose the epoch, the envi- ronment, the personality, and the work of Carl Wilhelm von Zehender, the founder, and reformer of Ophthalmology in Germany. Results: Carl Wilhelm von Zehender was a pioneer of German Ophthalmology and a great teacher. He established the Heidelberg Ophthalmological Society, and from the pages of “Klinische Monatsblaetter für Augenheilkunde,” and his work at Rostock University educated several young physicians. We reviewed Volume XXVII, published in Stuttgart by Verlag von Ferdinand Enke in 1889, including scientific announcements, examining methods, com- plications after surgical procedures, etc. The book contains plates to enrich the articles, anatomical engravings, and even a color lithographic plate of oph- thalmoscopic findings. Conclusions: In the second half of the 19th century, Ophthalmology was es- tablished as a separate surgical specialty. Carl Wilhelm von Zehender was a man who led in this. His writings and experience were valuable for this decision. He worked hard to build the Ophthalmologic Clinic of Rostock University and was a founding member of the Heidelberg Ophthalmological Society. Von Zehender invented two ophthalmoscopes in 1854 and an auto- ophthalmoscope in 1863. All these reveal the genius and the inspiring route of Carl Wilhelm von Zehender in Medicine. 98 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Ex ternal Eye EP-EXE-01 Case report: orbital compartment syndrome in the setting of periorbital necrotizing fasciitis R. Hollinger1,2, A. Zaldivar2, J. Nadayil2, D.M. Aloise2, J. Dalton3, M. Brink4,2 1London School of Hygiene and Tropical Medicine, London, United Kingdom, 2Florida International University Herbert Wertheim College of Medicine, Miami, United States, 3University of Pittsburgh Medical Center, Pittsburgh, United States, 4Center for Excellence in Eye Care, Miami, United States Introduction: Periorbital necrotizing fasciitis is a rare, but rapidly progres- sive, vision-threatening infection of the tissues surrounding the eye. This un- usual case presentation highlights the necessity of prompt treatment to prevent permanent vision loss secondary to orbital compartment syndrome. Case presentation: A 55-year-old female presented to the emergency depart- ment with left periorbital edema and ophthalmoplegia one day after recov- ering from four days of sore throat. She denied history of trauma. CT scan revealed an intact globe and inflammatory changes without abscess, consistent with orbital cellulitis. Upon admission, her initially intact vision rapidly declined. She developed fulminant orbital compartment syndrome with a tense globe and difficulty opening her lids; intraocular pressure (IOP) was above 50 mmHg. Lateral canthotomy with cantholysis of the lower eyelid was performed to prevent permanent vision loss. Post-procedure IOP was 24 mmHg. Intravenous van- comycin and ceftazidime, acetazolamide, brimonidine, and Maxitrol ointment were given to prevent infection and IOP elevation. The next morning, erythema surrounded the left eye with increasing swelling and pain. Ice packs and intravenous solumedrol were provided to relieve in- flammation. Periocular bullae were noted. By 13:00, IOP exceeded 50 mmHg and lateral canthotomy with cantholysis of the upper lid was performed. Post-procedure IOP was 34 mmHg. Cultures grew Streptococcus pyogenes, with a final diagnosis of necrotizing fasciitis of the left orbit. Patient was ad- mitted to the intensive care unit for management of sepsis and transferred for surgical debridement upon stabilization. Discussion: This rare clinical presentation of orbital compartment syndrome secondary to S. pyogenes necrotizing fasciitis, including disease course and therapeutic management, represents an important consideration for clinicians when developing differential diagnoses. EP-EXE-02 The multiple ocular manifestations of a neglected newly diagnosed multibacillary leprosy with grade II disability S. Purnamasari1,2, O. Sofia1,2 1Universitas Brawijaya, Faculty of Medicine, Malang, Indonesia, 2Dr. Saiful Anwar General Hospital, Ophthalmology, Malang, Indonesia Purpose: To describe multiple ocular manifestations of a newly diagnosed multibacillary leprosy with grade II disability. Method: A case report. Result: A 71-year-old woman complained of visual loss with protruding solid intraocular material and redness on the left eye about one week. There were also decreased visual acuity and redness on the right eye. Incomplete closure on both eyes were reported the past 30 years. The ophthalmologic examina- tion revealed the visual acuity of the left eye was no light perception and the right eye was 6/24. Conjunctival and peri corneal injections, ocular discharge, and significant intraocular structures prolapse were observed in the left eye. Corneal hypoesthesia and madarosis on both eyes, peripheral ulcerative kera- titis, neurotropic ulcer, and dry eye on the right eye were also noted. The Dermatovenereology consultation revealed the systemic abnormalities such as claw hand, ulnar nerve thickening on both upper extremities, and hy- poesthesia on both upper and lower limbs. The acid fast bacteria were identi- fied from both earlobes skin scraping specimens with +3 bacterial index and 75% morphological index. The patient was diagnosed with LE severe corneal ulcer with iris and lens prolapse, RE peripheral ulcerative keratitis, RLE lagophthalmos, and multi- bacillary leprosy with grade II disability newly diagnosed. Evisceration of the left eye under general anesthesia was performed due to corneal perforation with iris and lens prolapse after initiated the multidrug therapy for leprosy. Conclusion: The advanced ocular complications manifested at the time of leprosy diagnosis found in this case are corneal ulcer with perforation, iris and lens prolapse, peripheral ulcerative keratitis, neurotropic ulcer, corneal hypoesthesia, lagophthalmos, and madarosis. The classic leprosy deformities in endemic area were left untreated and causing the preventable monocular blindness. Keywords: leprosy, ocular manifestation, corneal perforation, blindness EP-EXE-03 Challenges in the treatment of Ligneous conjunctivitis: a report of two cases with long term follow up A. Alhemidan1, A. Abdelaal1 1Prince Sultan Military Medical City, Department of Ophthalmology, Riyadh, Saudi Arabia Purpose: Ligneous conjunctivitis is a membranous or pseudomembranous conjunctivitis that causes pronounced thickening of tarsal and palpebral con- junctival surfaces. The ocular manifestations are a consequence of congenital severe plasminogen deficiency a disorder with accompanying recurrent mem- brane formation in several mucous membranes all over the body. Treatments is challenging with universal regrowth of the membrane following excision in the absence of adequate topical and systemic therapy. 100 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-EXE-06 EP-EXE-07 Reactivation of a 19-year inactive severe thyroid-associated orbitopathy post SARS-CoV-2 vaccine: a case report M. Karhanova1,2, J. Schovanek3,4, E. Kriegova5, A. Petrackova5 1University Hospital Olomouc, Department of Ophthalmology, Olomouc, Czech Republic, 2Faculty of Medicine and Dentistry, Palacky University Olomouc, Department of Ophthalmology, Olomouc, Czech Republic, 3University Hospital Olomouc, Czech Republic, Europe, Department of Internal Medicine III, Olomouc, Czech Republic, 4Faculty of Medicine and Dentistry, Palacky University Olomouc, Department of Internal Medicine III, Olomouc, Czech Republic, 5Faculty of Medicine and Dentistry, Palacky University Olomouc, Department of Immunology, Olomouc, Czech Republic Purpose: We present a rare case of reactivation of thyroid-associated orbi- topathy (TAO) after SARS-CoV-2 vaccine in a patient with a 19-year history of inactive disease. We also discuss possible immunological context. Case report: A 74-year-old woman presented in March 2022 with clinical signs and symptoms of TAO (preseptal edema and erythema of eyelids, con- junctival hyperemia, retrobulbar pain, and pain on eye movement) and with a new onset of diplopia. Her eye problems began in early January 2022, ap- proximately 2-3 weeks after the second dose of the SARS-CoV-2 vaccine (Pfizer-BioNTech). The diagnosis of Graves disease was made more than 20 years ago. She un- derwent thyroidectomy in 1999 for developing moderate to severe TAO, im- munosuppressive treatment, and bilateral orbital decompression in 2003. Since the disease was inactive, the patient had no diplopia and was satisfied with the result of the treatment. TAO reactivation was diagnosed based on the clinical signs and MRI findings (confirmed activity). The endocrino- logical status was stable, and no residuum of the thyroid gland was found. Phenotyping of circulating immune cells revealed higher expression of the chemokine receptor CCR4 on T cells associated with Th2 immune response and higher expression of the check-point inhibitor CTLA-4 on T-cells, which leads to inhibition of T-activated lymphocytes. Immunosuppressive treatment was indicated (methylprednisolone, cumula- tive dose 4.5g), and the patient recovered fully. Three months later, the CCR4 and CTLA-4 expression on T-cells and distribution of immune cell subpopula- tions was within normal values. Conclusion: The possible association between COVID-19 vaccination and TAO is currently known, however reactivation of TAO after almost 20 years is very rare. Clinicians should remain vigilant for recurrence or aggrava- tion in all patients with a history of TAO. Supported by MH CZ, grant nr. NU21J-01-00017. All rights reserved. Supported by MH CZ – DRO (FNOL,00098892). Pseudomonas putida blepharoconjunctivitis: case report I. Juliao1, F. Stival2, L. Stival3 1Instituto de Olhos de Goiânia, Goiânia, Brazil, 2Instituto de Olhos de Goiânia, Oculoplastics, Goiânia, Brazil, 3Instituto de Olhos de Goiânia, Cornea and External Eye, Goiânia, Brazil Case presentation: A 47 years old female presented with complaints of epiph- ora, hyperemia, and mucopurulent discharge of the right eye for 11 months. Her past ocular history included dacryocystorhinostomy of the right eye and previous penetrating corneal trauma, with subsequent surgery 25 years ago. She denied former contact lens use, recent hospitalization, and systemic dis- eases. Examination revealed hyperemic bulbar and palpebral conjunctiva, edema of eyelids, and mucopurulent discharge of the right eye. There was no in- volvement of cornea and no palpable lymph nodes. A chronic blepharocon- junctivitis diagnosis was made, and a swab culture revealed the growth of Pseudomonas putida. CT scan of orbits showed thickening of the conjunctiva of the right eye and dacryocystography evidenced obstruction at the level of the Krause’s valve. Treatment consisted of topical gentamicin, vancomycin, and a single oral dose of Azithromycin. The symptoms gradually improved until resolution within eight weeks of treatment. The control swab culture exam was negative. Discussion: Pseudomonas putida is a gram-negative bacteria of the Pseudomonas species, recognized as a sporadic cause of systemic infections in hospitalizations, and infrequently, of keratitis. Ocular infection rarely oc- curs without predisposing factors, such as immunocompromised status, cor- neal trauma, and contact lens use. The first case reporting spontaneous ocular infection by P. putida highlighted it as a possible emerging ocular pathogen, a topic of particular relevance since P. putida is reported as a contaminant of daily practice ophthalmic solu- tions. In our search, we did not find any case of P. putida infection related to lacri- mal system obstruction, which possibly played a role as a predisposing factor to this long-lasting unilateral blepharoconjunctivitis. This report may provide further evidence of the clinical behavior of this pathogen. EP-EXE-08 Neonatal conjunctivitis with an unusual etiological agent M. Sobrinho1, S. Leite2, M. Calegari1, L. Pegorin1 1Pontifical Catholic University of Campinas, Campinas, Brazil, 2São Leopoldo Mandic School of Medicine, Campinas, Brazil A 3-day-old baby girl was admitted to our service with mucopurulent secre- tion in the right eye for about 48 hours, with worsening in the last 24 hours. Ocular examination: OD: mucopurulent secretion, hyperemia of the bulbar conjunctiva hyperemia of the tarsal conjunctivae, upper eyelid edema. Hospitalization was carried out for laboratory tests and intravenous antibiotic therapy with Ceftriaxone (single dose of 125mg), in addition to instillation of Tobramycin 0.3% eye drops q.i.d.. Her parents were treated Azithromycin 500mg per day for 05 days. 102 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Glaucoma EP-GLA-01 Comparison of latanoprost 0.005% and travoprost 0.004% in patients with primary open angle glaucoma and ocular hypertension G. Hoxha1 1University Clinical Center of Kosovo, Ophthalmology, Pristina, Albania Purpose: To compare the hypotensive effect of latanoprost 0.005% and tra- voprost 0.004% solutions in primary open-angle glaucoma or ocular hyper- tensive patients. Method: In this prospective, multicenter, clinical trial, 100 patients received latanoprost once daily in the evening (n = 50), or travoprost once daily in the evening (n = 50). Efficacy was compared across treatment groups over 6 months. Results: Mean IOP at the first visit in latanoprost 0.005% group was 26.2 mmHg (SD ± 1.9 mmHg), and in travoprost 0.004% group was 26.3 mmHg (SD ± 1.9 mmHg). Mean IOP at the fifth visit (after 6 months) in latanoprost 0.005% group was 17.5 mmHg (SD ± 1.2 mmHg) and in travoprost 0.004% group was 18.4 mmHg (SD ± 1.5 mmHg). There was statistically significant difference of IOP in both eyes on fifth visit by groups. Both latanoprost 0.005% and travoprost 0.004% showed similar hypotensive effect with the first one being slightly more potent in reducing the IOP. EP-GLA-02 Incidence and therapy of the elevation of intraocular pressure after intravitreal and/or sub-tenon administration of various steroidal agents A.A. Wykrota1, U. Löw1, A.D. Abdin1, C. Munteanu1, B. Seitz1 1Saarland University Medical Center, Department of Ophthalmology, Homburg/Saar, Germany Purpose: For the treatment of macular edema, in addition to the use of anti- vascular endothelial growth factors, also steroids are used. Side effects include among others cataract formation and elevation of intraocular pressure (IOP). The aim of this retrospective study was to elicit the IOP elevation after admin- istration of steroidal agents, the time of onset, and the efficacy of administered eye pressure-lowering therapies. Methods: We included 428 eyes with a postoperative (n = 136), diabetic (n = 148), uveitic macular edema (n = 61), and macular edema after retinal vein occlusion (n = 83). These patients were treated with one or more diverse ste- roidal agents once or multiple times. These drugs included: triamcinolone ace- tonide (TMC) as intravitreal injection (TMC IVI) or sub-tenon (TMC ST), as well as dexamethasone (DXM) and fluocinolone acetonide (FA) intravitreally. An increase of IOP of ≥25 mmHg was designated as pathological. Results: Of 428 eyes, 168 eyes (39.3%) had IOP elevation to a mean of 29.7 (SD±5.6) mmHg, which occurred at a median of 5.5 months. Steroids most often leading to rise of IOP, with statistical significance of p<0.001, included DXM (39.1% of all eyes getting this drug), TMC IVI (47.6%), TMC ST com- bined with DXM (51.5%), DXM with FA (56.8%), and TMC IVI with DXM (57.4%). IOP rise was treated as follows: 119 conservatively (70.8%), 21 sur- gically (12.5%; cyclophotocoagulation 8.3%, filtering surgery 1.8%, drug car- rier removal 2.4%), and 28 eyes received no therapy (16.7%). Sufficient IOP regulation was achieved in 82 eyes (68.9%) with local therapy. In 37 eyes (31.1%) with persistently elevated IOP, topical therapy had to be continued. Conclusions: IOP increases after any type of steroid application are not a rar- ity. Regular IOP checks are necessary after each steroid administration, with possible initiation of conservative and/or surgical therapy if necessary. It is important to actively inform the patient about this side effect preoperatively. EP-GLA-05 Factors affecting adherence to glaucoma medication: patient’s perspective K. Singh1, D. Jain2, A. Singh1, V. Verma3 1Guru Nank Eye Centre and MAMC, Ophthalmology, Delhi, India, 2Postgraduate Institute of Child Health, Ophthalmology, Noida, India, 3Assam University, Statistics, Assam, India Purpose: Adherence to anti glaucoma medication is the key factor in achiev- ing target Intraocular pressure to prevent glaucoma progression.To determine factors affecting medication adherence in glaucoma patients. Methods: A cross-sectional study was conducted on 200 patients attending glaucoma services in a tertiary referral hospital of North India. Adherence to medication was determined subjectively by questionnaire and objectively by counting the number of used bottles at end of a month or during refill, whichever was earlier. Patient related parameters in adherence towards glau- coma medication were studied based on demography, knowledge, attitudes and practices (KAP). The statistical techniques of bivariate and multivariate logistic regression were adopted to test the objective. Results: Population was statistically homogeneous based on gender and in- come. A large proportion of patients hadbilateral disease (87%) and were on two or more medications (62.5%). Adherence to anti glaucoma medication was 68%, with 58% having knowledge about glaucoma. Deterrents to drug adherence were identified as forgetfulness (71%), unavail- ability of drugs (19%) or funds to purchase the same (26%), polypharmacy (21%), and side effects (5%). Dependence on an escort by 44% and pres- ence of living spouse emerged as key aspects, highlighting the need of family counselling. Disease misconceptions (53%) were prevalent and drug instillation practices unsatisfactory (57%). Suboptimal counselling was highlighted with the need to demonstrate how to put drugs. Conclusions: The study offers insight into patients’ perspectives regarding the lifetime use of anti-glaucoma medications and focuses on key issues linked to drug non-adherence. 104 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-10 EP-GLA-11 Relationship of ocular hemodynamic parameters, intracranial pressure and structural changes in glaucoma V. Bakstytė1, E. Šimienė1, A. Stoškuvienė1, V. Petkus2, A. Ragauskas2, I. Janulevičienė1 1Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Ophthalmology, Kaunas, Lithuania, 2Kaunas University of Technology, Health Telematics Science Institute, Kaunas, Lithuania Purpose: To predict the course of primary open-angle glaucoma (POAG) using hemodynamic parameters, intracranial pressure (ICP) and structural changes. Method: Participants diagnosed with POAG (50-67 years) were randomly se- lected from the Department of Ophtalmology, Lithuanian university of health sciences. Prospective study included 34 patients (17 in each group), they were divided according to the mean deviation into early (up to -6 dB) and advanced (from -6 dB to -27.57 dB) POAG groups. OCT images were taken using an swept-source optical coherence tomography instrument. Orbital doppler device was used for non-invasive ICP measure- ments. Colour Doppler imaging was used for retrobulbar blood flow measure- ments in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCA). The results were collected using MS Excel 2010 program. The obtained data were processed with the “ImageJ” program and using the statistical analysis program SPSS 25.0 package. The chosen level of statistical significance was (p < 0.05). Results: According to the area under the ROC curve, diagnostic significance of thicknesses to predict the course of glaucoma was estimated in optic nerve head (ONH) retina (R) 1 and 7 sectors, retinal nerve fiber layer (RNFL) 11, 12, 1, 2, 4, 6, 7, 10 sectors, superior (S) and inferior quadrants, ganglion cell layer (GCL) 3 sector and of ONH vessel density (VD) was found in all layers of inferior temporal (IT) sector. The mean ICP was 7.85 mmHg ± 2.63 mmHg in the early and 7.71 mmHg ± 2.43 mmHg in the advanced POAG group (p > 0.05). No significant difference was found between the groups in retrobulbar blood flow in peak systolic velocity (PSV), end-diastolic velocity (EDV) and resis- tance index (RI) (p > 0.05). ICP was significantly associated with ONH VD in choriocapillary layer of superior temporal sector. The moderate correlations which coincidence with the most significant ONH thicknesses and VD loss were found between OA EDV and R 1, RNFL 12, GCL 3 sectors, OA RI and R 1, RNFL 1, 6 sectors and S quadrant, GCL 3 sector, CRA RI and RNFL 12 sector, OA PSV and deep plexus layer IT, CRA EDV and choriocapillary layer IT, CRA RI and superficial plexus layer IT, SPCA RI and avascular retina layer IT sectors. Conclusion: Clinical application of OCT-A, ICP and retrobulbar blood flow measurements algorithm may help predict the course of POAG and prevent irreversible vision loss. Further longitudinal studies are needed to evaluate the importance of these results. Anterior chamber angle status at the time of neovascular glaucoma diagnosis J. Wang1, M. Qiu1 1The University of Chicago, Ophthalmology & Visual Science, Chicago, United States Purpose: Many medical and surgical therapies exists for neovascular glau- coma (NVG), but their efficacies largely depend on the anterior chamber angle anatomy, with open angles more responsive to medical or angle-based thera- pies as compared to synechially closed angles. However, little data on this topic exists, so this case series was created to describe the angle status of NVG eyes on presentation. Methods: A retrospective chart review was performed for all NVG patients from 2010-2022 with a gonioscopy at the time of presentation. Complete angle closure was defined as having >75% peripheral anterior synechiae (PAS), partial angle closure as having 1-75% PAS, and open angles as having 0% PAS. Results: Of 206 NVG patients, 134 (68 men, 66 women, mean 65.6 years) had a gonioscopy and were included in the analysis. Underlying etiologies included PDR (N=70), RVO (N=40), chronic RD (N=10), RAO (N=9), OIS (N=3), radiation retinopathy (N=1), and idiopathic (N=1). Presenting IOP was 33mmHg in 32 eyes (23.9%), 44mmHg in 43 eyes (32.1%), and 49mmHg in 59 eyes (44%) with open, partially closed, and com- pletely closed angles, respectively. Presenting VA ranged from 20/20 to LP, 20/25 to NLP, and 20/60 to NLP in the three groups respectively. The proportion of eyes that were phakic and that presented to the emergency room setting (instead of outpatient clinic setting) were 47% and 6%, 47% and 19%, and 64% and 24% in open, partially closed, and completely closed angles, respectively. Conclusion: This case series describes the angle status amongst patients pre- senting with NVG. While there is a trend towards higher IOPs and worse BCVAs in eyes with increasing degrees of angle closure, all groups exhibited a wide range of IOPs and BCVAs. Eyes with closed angles also trended towards being phakic, presenting to the ED, and being new patients. Future prospective studies are needed to deter- mine the optimal treatment plan in NVG eyes, which may differ according to the angle anatomy. EP-GLA-12 Childhood glaucoma-clinical algorithm E. Maksimova1, T. Mitov1, D. Mitova1 1St Petka Eye Clinic Varna, Branch Haskovo, Trakia University Stara Zagora, Varna, Bulgaria Purpose: The aim of the investigation is to elaborate the right surgical ap- proach for different forms of childhood glaucoma. Methods: Retrospective analysis of 12 cases of childhood glaucoma for a period of three years; meta-analysis of the literature. Case by case analysis was done including IOP, corneal diameter, axial length, cup to disc ratio, type of operation, complications and success rate. All patients were followed for at least three years. Deep sclerectomy was the operation of choice for congenital forms and trabeculectomy –for uveitic glau- coma cases. 106 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS with a suspension of biodegradables no-loaded microspheres (Ms) at 0-2- 4-8-12-16 and 20 weeks (Ms20/10 cohort); 45 rats received Msloadedwith dexamethasone at baseline and week 4 (MsDexa cohort); 43 rats received Ms co-loaded with dexamethasone and fibronectine at baseline (MsDexaFibro cohort), in the anterior chamber of the eye. These 4 cohorts of experimental animals were comparted to 43 healthy rats (healthy cohort). IOP, functional- ity of neuroretina by electroretinography (ERG), structure of neuroretina and vitreous interface by optical coherence tomography (OCT) were analyzed. Results: The EVS cohort showed the steepest and strongest increase in IOP, whereas the Ms models had a more progressive increase. Each model showed a specific retinal damage and vitreous signal in OCT. The EVS cohort experi- enced the highest vitreous intensity and percentage loss in ganglion cell layer, MsDexa in the retinal nerve fiber layer and MsDexaFibro in total thickness of the retina at 24 weeks of the study. Ganglion cells’ signal using ERG was big- ger in the glaucomatous cohorts compared to healthy rats. Conclusions: Modulable degeneration was generated using models by the injection of biodegradable Ms. The biodegradable Ms models simulated ac- curately the neurodegeneration seen in human chronic glaucoma. Our results reinforced the multifactorial condition of glaucoma according to several noxa. EP-GLA-16 Influence of sex on chronic glaucoma neurodegeneration in rats over 6-month follow-up I. Munuera1, T. Martínez1, M. Subías1, L. Arias1, M.J. Vicente1, Á. Tello1, V. Mallén1, D. Fernández1, A. Pueyo1, A. Aragón2, M.J. Rodrigo1 1Miguel Servet University Hospital, Ophthalmology, Zaragoza, Spain, 2Complutense University, Pharmaceutics and Food Technology, Madrid, Spain Purpose: To evaluate if sex influences on retinal neurodegeneration in rats with chronic glaucoma, steroid-induced glaucoma and healthy controls over 24 weeksof follow-up. Methods: A total of 220 Long-Evang rats (87 males/133 females) were evalu- ated. Glaucoma was induced using 4 models: sclerosing the episcleral veins (9 males/ 14 females), injecting into theeyeanterior chamber poly(lactic-co- glycolic acid) microspheres (Ms) non-loaded (9 males/14 females), Ms loaded with dexamethasone (20 males/23 females) and co-loaded with dexametha- sone-fibronectin (18 males/ 28 females). As controls, 85 healthy animals were analysed (31 males/ 54 females). Intraocular pressure (IOP) was measured biweekly using a rebound tonometer (Tonolab®). Neuroretinal function was analysed using dark- and light-adapted electro- retinography (ERG Roland consult RETIanimal®) at 0, 12 and 24 weeks; and structure using optical coherence tomography (OCT Spectralis,Heidelberg Engineering®) at 0, 8, 12, 18 and 24 weeks. Results: Males had higher IOP (p<0.05) in all cohorts. In both sexes and all chronic glaucoma models neuroretinal thickness decreased over time com- pared to healthy controls (p<0.05). Males showed a higher percentage of reti- nal nerve fiberlayer thickness loss in chronic and steroid models. However fe- males receiving Msdexamethasone-fibronectin experienced larger fluctuations in thickness, and the highest loss rate by mmHg. Malesalso exhibited worse neuroretinal functionality in chronicglaucoma models. Conclusions: Female rats with chronic glaucoma and steroid-induced glaucoma experienced lower IOP levels, lower neuroretinal structural loss and had pre- served neuroretinal functionality compared to males. Neuroretinal degeneration was influenced by sex and by the ocular hypertension-inducing model used. EP-GLA-17 Immune analysis of vitreous humor in rats using optical coherence tomography I. Munuera1, M. Subías1, T. Martínez1, L. Arias1, D. Fernández1, V. Mallen1, M.J. Vicente1, Á. Tello1, A. Aragón2, L. Pablo1, M.J. Rodrigo1 1Miguel Servet University Hospital, Ophthalmology, Zaragoza, Spain, 2Complutense University, Pharmaceutics and Food Technology, Madrid, Spain Purpose: To study immune response by characterizing vitreous opacities us- ing optical coherence tomography (OCT) and computational analysis in dif- ferent glaucoma models. Methods: Glaucoma models were generated in rats, based on episcleral veins sclerosis (n= 25) and injection of biodegradable microspheres non loaded (n=25), loaded with dexamethasone (n=45) or co-loaded with dexamethasone and fibronectin (n= 43) and compared to healthy animals (n=43). Intraocular pressure, neuroretinal structure and vitreous interfaceusing OCTwere evalu- ated over 6 months. Vitreous images were exported as AVI videos (n=463). A bioinformatics anal- ysis was designed, which characterized the opacities according to size, into isolated (10µ2), non-activated (10-50µ2), activated (50-250µ2) and complexed (>250µ2) cells. Total area, mean number of opacities, intensity, eccentricity and orientation of each vitreous opacity were analyzed, and a histological study performed. Results: All glaucoma models presented greater vitreous intensity and num- ber of opacities with dynamic fluctuations in the percentage of activated cells, compared to healthy rats (p<0.05). The episcleral veins sclerosis model pre- sented the highest intensity, total area and mean number of vitreous opacities. Both steroid-induced models showed lower intensity and an anti-inflammato- ry profile with higher population of non-activated cells (p<0.05). The smallest opacities (10µ2, isolated cells) appear to be the first to respond to noxa, as they were the most rounded (recruitment), showed the highest mean intensity (intracellular machinery) and the greatest change in orientation (mo- tility). Vitreous opacities were identified as hyalocyte-like Iba-1+ microglial cells. Discussion: Immune changes in glaucoma could be analyzed using OCT im- aging. Immune response differed according to the glaucoma model induced. Vitreous immunity could be a biomarker of onset, progression and monitoring of future immune-targeting therapies for glaucoma. EP-GLA-18 Assessment of quality of life in patients with primary open-angle glaucoma R. Maamouri1, M. Doukh1, Z. Gharbi1, S. Nouri1, M. Ouederni1, M. Cheour1 1Hospital Habib Thameur, Ophthalmology, Tunis, Tunisia Purpose: To evaluate the quality of life of patients with primary open angle glaucoma (POAG) using the questionnaire ‘National Eye Institute Visual Function Questionnaire’ (NEI-VFQ-25). Methods: Were included POAG patients who were ≥ 40 years old at the time of recruitment and had minimal cataract or underwent cataract or trabeculec- tomy surgery at least 3 months prior and were on medical treatment. 108 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-21 Relationship between risk of obstructive sleep apnea syndrome with normal tension glaucoma B.S. Pratama1, Z. Afif2, H. Holipah3, A.A. Hamid1, S. Prayitnaningsih1 1Universitas Brawijaya, Ophthalmology Department, Malang, Indonesia, 2Universitas Brawijaya, Neurology Department, Malang, Indonesia, 3Universitas Brawijaya, Public Health Department, Malang, Indonesia Purpose: To evaluate the correlation between the risk of obstructive sleep apnea syndrome (OSAS) and normal-tension glaucoma (NTG) Method: A total of 128 respondents or 256 eyes underwent age, sex, body weight, and height assessments. The independent variables measured were OSAS risk measured using the STOP-Bang questionnaire, systolic-diastolic blood pressure, and body mass index (BMI). The dependent variables that measured were NTG status, mean defect (MD) measured with Perimetry as well as retinal nerve fiber layer (RNFL) thick- ness, and vertical cup-to-disc ratio (CDR) measured with optical coherence tomography. The relationship between variables was tested using the logistics regression test. Results: There was no relation between STOP-Bang scores and NTG, MD, RNFL, or CDR although when we stratified the sample to obese (BMI ≥30 kg/ m²) respondents, it was found that high OSAS risk had a significant effect on CDR (p = 0.02; OR = 4.22). If the respondents have a high OSAS risk, the risk of large CDR is four times higher than those with mild OSAS risk. Results show statistically significant relationships between BMI and either NTG or MD, systole blood pressure and NTG, as well as age and either NTG, MD, or CDR. Conclusion: In obese respondents, high OSAS risk increased the risk of large CDR. Association between either age, systole blood pressure, or BMI and NTG were also identified. EP-GLA-22 Screening fundus photography predicts and reveals risk factors for glaucoma conversion in eyes with large optic disc cupping H.J. Choi1,2 1Seoul National University College of Medicine, Ophthalmology, Seoul, Korea, Republic of, 2Seoul National University Hospital Healthcare System Gangnam Center, Ophthalmology, Seoul, Korea, Republic of Purpose: This study aimed to investigate the risk factors for glaucoma con- version and progression in eyes with large optic disc cupping without retinal nerve fiber layer defect (RNFLD). Methods: Five hundred forty-two eyes of 271 subjects who had a vertical cup-to-disc ratio (CDR) ≥ 0.6 without RNFLD were enrolled. Characteristics for optic disc configuration (including CDR, vertical cupping, ISNT rule, disc ovality, peripapillary atrophy [PPA]-to-disc area [DA] ratio, and lamina cribrosa pore visibility) and blood vessels (including central retinal vessel trunk [CRVT] nasalization, bayoneting of vessels, baring of circumlinear ves- sels, history of disc hemorrhage [DH] and vessel narrowing/sclerotic change) were evaluated. A Cox proportional hazards (PH) model was fitted to assess the risk for glau- coma conversion and RNFLD progression after controlling for the confound- ing effects of covariates. To develop a scoring system for assessing the risk of glaucoma conversion, baseline factors were included in the multivariable Cox PH model. Results: From a median follow-up of 11.3 years, 26.6% of eyes (n = 144) developed RNFLD within a median of 5.1 years. Baseline factors, including vertical CDR ≥ 0.7 (hazard ratio [HR] = 2.12), vertical cupping (HR = 1.93), ISNT rule violation (HR = 2.84), disc ovality ≥ 1.2 (HR = 1.61), PPA-to-DA ratio ≥ 0.4 (HR = 1.77), CRVT nasalization ≥ 60% (HR = 1.77), vessel nar- rowing/sclerotic change (HR = 2.13), DH history (HR = 5.60), and baseline intraocular pressure ≥ 14 mmHg (HR = 1.70) were significantly associated with glaucoma conversion (all Ps < 0.05). An HR-matched scoring system based on initial fundus photography predicted glaucoma conversion with specificity of 90.4%. Conclusion: Careful examination of the optic nerve head and vascular struc- tures can help to predict the risk of glaucoma conversion in eyes with large optic disc cupping. EP-GLA-23 General and disease specific quality of life in glaucoma patients: a qualitative study E. Kanonidou1, D. Balatsoukas1, D. Paliouras2 1General Hospital of Thessaloniki Hippokrateion, Ophthalmology, Thessaloniki, Greece, 2Hellenic Open University, Thessaloniki, Greece Purpose: To assess visual impairment and quality of life (QOL),relationship between visual function and health-and vision-related QOL, and identify fac- tors significantly impacting QOL for glaucoma patients. Method: Participants were 169 patients (PAOG),73 men/96 women,mean age 70.43±9.01 years. One-on-one interviews were performed from January to April 2019. Data collected included demographics,clinical examinations and treatment status. QOL data collected utilized Greek version of MOS SF-36 and NEI VFQ-25. Written informed consent was obtained from all subjects. Results: The higher health-related QOL scores for both questionnaires,the fewer difficulties experienced by patients.Glaucoma patients had significant- ly lower scores of both SF-36 (physical health 34.60±12.99, mental health 32.06±1218) and NEI VFQ-25 (77.75±1555). The domains mostly affected were driving (30.53±4087),general health (4689±2532), general vision (68.11±15.84), mental health (75.27±19.96), role difficulties (77.73±29.58) and peripheral vision (78.55±23.51). Increasing se- verity of glaucoma correlated significantly with worsening QOL(p=0.001). Strong correlation was found between SF-36 and NEIVFQ-25 (p<0.0001). SF-36 was significantly correlated with gender (p<0.0001), number of co- morbid diseases (p=0.005 for physical health), number of non-glaucoma medications (p=0,005 for physical health) and visual field defect of better eye (p=0.012 for physical and p=0.021 for mental health). NEI VFQ-25 was significantly correlated with gender (p<0,0001), number of anti-glaucoma medications (p=0.014), number of instillations of topical anti- glaucoma medication/day (p=0.046), visual acuity and visual field defect of better eye (p<0,0001). Conclusion: Combination of demographic data, clinical examination and QOL questionnaires may help clinicians better ascertain impact of disease severity on glaucoma patients’ QOL. This information may help in patient education, treatment compliance and selection of treatment options. 110 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-27 comparing surgical outcomes of cataract surgery alone versus combined surgery in pseudoexfoliative glaucoma R. Dcruz1, A. Rao2 1Ahalia Eye Institute, glaucoma, Malappuram, India, 2LVPEI, Glaucoma, Bhubaneswar, India Purpose: Pseudoexfoliation glaucoma(XFG) is often associated with higher complication rates and less surgical success. Studies comparing long term outcome of cataract surgery alone versus combined surgery in pure cohort of XFG is lacking in literature. This study aims to compare the long-term surgical outcomes of cataract surgery alone versus combined surgery in XFG in terms of intraocular pressure(IOP) reduction. Design: Retroprospective comparative case series. Methods: All patients with XFG who underwent either cataract surgery alone (group1-either phacoemulsification-PHACO/SICS, n=35) or combined surgery (Group 2-phacotrabeculectomy, PHACOT or SICS +trabeculectomy,n=47) from 20132019 by a single trained surgeon, were screened and recalled for a detailed clinical examination, including Humphrey visual field analyzer at 3 monthly intervals for a minimum of 2 years. Results:A total of 81 eyes of 67 patients with XFG were included in this study. (group 1-35eyes and group2-46 eyes each). Both groups achieved 26-40% IOP reduction from pre-operative IOP levels, p<0.001, with cataract surgery alone achieving >23% IOP reduction at final follow up. Surgical success rates were similar in both groups (complete success 66% in group1 and 55% in group2, p=0.4), and qualified success 17% in group 1 versus 24% in group2, p=0.8). Group 2 eyes had more post-operative transient and late complications than group1.Kaplan-Meier analysis showed a marginally better survival rate for group1 (75% (55-87%) than group 2, 66% (50-78%), at 2 years which was not significantly different. Conclusion: Cataract surgery can be as effective as combined surgery in mod- erate XFG eyes. The final visual acuity, IOP profile, and complication rates are comparable between the two procedures. EP-GLA-28 Not every cupping in disc with visual visual defect mean Glucoma M. Kesba1, V. Reci2 1Mataria Teaching Hospital, Cairo, Egypt, 2Univeristy Clinic for Eye Diseases, Ophthalmology, Skopje, Republic of North Macedonia 34 years old male patient come to the clinic for renewal his glasses and fol- low, there no history Hypertension or diabetes or any systemic disease, he was diagnosed as Glucoma patient since 2018 and take Glucoma medical ttt eye drops since he was diagnosed as Glucoma and stopped it since 6 month by himself. Ophthalmic examination: Free anterior segment in both eyes Clear cornea in both eyes van herick grading 4 in both eyes Pupil: round regular reactive in both eyes Fundus Iop: right eye 12, left eye 14 Normal macula in right eye CD 0.6 Left eye funds CD: 0.7 Lt Elevation from para macular region till optic disc in left eye, Previous investigations 2018: 2018 oct nerve fiber layer show Right eye within normal value Left eye focal defect affecting 3 clocks 2018 visual field show Right eye normal visual field Left eye sever visual field changes (upper actuate Scotoma 2022 investigations show: Oct nerve fiber layer: Right eye: within normal RNFL thickness in all quadrants, with normal border area and vertical C/D ratio = 0.62, associated with normal GCL analysis. Left eye: focal decrease of the RNFL involving the lower quadrant and borderline thickness of the RNFL involving the nasal quadrant, with normal border area and vertical C/D ratio = 0.73, associated with focal affection of the lower GCL. Visual field: Normal visual field findings on the right. Severe left visual field changes . Oct macula: Right normal macula Left para macular Retinoschisis with optic dis pit Conclusion: Optic Disc Pit With Peripapillary Retinoschisis Misdiagnosed as Glaucoma EP-GLA-29 Microshunt-Preserflo implant study of efficacy and safety with 2-year follow-up M.D. Lago Llinas1, D. Buron Perez1, E. Gutierrez Diaz1, M. Montero Rodriguez1, J.L. Torres Peña1, B. De Lucas Viejo1, A. Bengoa Gonzalez1 1Universitary Hospital 12 de Octubre, Ophthalmology, Madrid, Spain Purpose: Present our experience with Microshunt-Preserflo implant in the treatment of glaucoma by minimally penetrating surgery. Material and methods: We analyzed a sample of 54 operated eyes in our cen- ter. They have an average age of 72.5 years and females predominate (53.7%). 77.7% of our patients are Caucasian. The most frequent type of glaucoma is the primary open-angle glaucoma (61.1%), followed by pseudoexfoliative glaucoma (9.2%). 48.1% of the cases were performed standalone. Presurgical intraocular pressure (IOP) is 17.5mmHg with a mean use of 2.4 antiglaucomatous drugs. In the surgical technique we used 0.2% Mitomycin C for 2 minutes. IOP control is performed by Goldman applanation tonom- etry. Results: Postoperative IOP at 6 months is 14.6mmHg with 0.7 antiglaucoma- tous drugs, at 12 months IOP is 16.7mmHg with 0.6 drugs and at 2 years of follow-up IOP is 15.5 mmHg with 0.6 antiglaucomatous drugs. 10 cases post- surgical reoperations are required, 2 caused by endothelial contact of the de- vice, 2 due to vitreous obstruction and 6 due to excessive conjunctival fibrosis that resulted in increased IOP. No other postoperative complications occurred. There were no cases with permanent hypotonia or extrusions of the device. 112 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-33 XEN® stent implantation: efficacy and safety at 2 years Á. Silva1, C. Cruz1, N. Lopes1, R. Silva1, M. Sampaio1, M. Pereira1, R. Leite1, F. Vaz1 1Hospital de Braga, Ophthalmology, Braga, Portugal Purpose: To evaluate the efficacy and safety of XEN® implantation in the treatment of glaucoma, with a follow-up of up to 2 years. Methods: This retrospective study included patients with glaucoma that un- derwent XEN® implantation with or without combined phacoemulsification. Changes in IOP and number of IOP-lowering medications, surgical success rate (IOP ≤ 18 mmHg and ≥ 30% reduction) and incidence of complications during the 2-year follow-up were evaluated. Cases that required additional glaucoma surgery were also reported and automatically classified as complete surgical failure (excluding needling). Results: Thirty-four eyes of 30 patients were included. Most cases (70,6%) underwent isolated XEN® implantation. Most cases were primary open-angle glaucoma (44,1%) followed by pseudoexfoliative glaucoma (35,3%). Preoperatively, mean IOP was 26,26 +- 8,84 mmHg, dropping to 16,34 +- 7,00 mmHg at 6-months, 15,07 +- 3,24 mmHg at 1-year, and 16,12 +- 4,77 at 2-years postoperatively, corresponding to a reduction of 37,2%, 40,7% and 34,4%, respectively (p<0,001). The number of IOP-lowering medica- tions was 2,82 +- 1,11 preoperatively and dropped to 1,06 +- 1,34 at 2-years (p=0,001). Surgical success was achieved at 2-years in 55,6%, and 38,9% achieved com- plete surgical success (same criteria, without medications). Four eyes (11,8%) were classified as complete surgical failure and 11 eyes (32,4%) underwent needling due to bleb failure. Most common complications were IOP spikes ≥ 30 mmHg (17,6%) and hyphema (20,6%). Conclusion: XEN® implantation is an effective and safe alternative to signifi- cantly reduce IOP and the number IOP-lowering medications over a period of at least 2 years. The high incidence of bleb failure requiring needling reinforces the need for longer follow-up in order to determine the long-term surgical success rate. EP-GLA-34 Morbidity caused by exfoliative glaucoma in Finland L. Uimonen1,2, N. Hautala1,2, A. Falck1,2 1University of Oulu, Research Unit of Clinical Medicine, Oulu, Finland, 2Oulu University Hospital, Department of Ophthalmology and Medical Research Center, Oulu, Finland Purpose: To investigate the incidence and the prevalence of exfoliative glaucoma (XFG) in the catchment area of the Oulu University Hospital in Finland, and the morbidity related to XFG. Methods: The population of Northern Ostrobothnia was 372 639 in 2000, and 413 830 in 2020. During the years 2000-2020, a total of 1520 patients with XFG living in the catchment area of the Oulu University Hospital (Northern Ostrobothnia) were diagnosed and followed up for XFG. The clinical diagnosis of glaucoma is based on typical defects in the nerve fiber layer, the optic disc and/or the visual field (2 of the 3 criteria required, Finnish Current Care Guideline for Glaucoma), and all subjects had pseudoexfoliation detected in biomicroscopy. Results: Of the study patients, 37% were men. 29% had been diagnosed be- fore year 2000, 38% were diagnosed during 2000-2009 and 33% during 2010- 2020. The mean age at the diagnosis of XFG was 71 ± 8.9 (SD), range 40-92 years. Women were somewhat older than men, 72 ± 8.9 years vs. 69 ± 8.7 years, respectively. At onset, 67% of the patients had unilateral XFG, and 33% bilateral. 64% of the patients had been followed up for 5 years or longer, and 36% had a shorter follow-up or a single visit. At the end of the individual follow up, 50% had bi- lateral disease. The mean follow-up time was 13 ± 8.1 years. 45% of subjects deceased before 31.12.2022 at a mean age of 86 ± 7.1 years. According to these figures the incidence of XFG was 15/100 000/year in 2000-2009, and 11/100 000 in 2010-2020, and the prevalence 170/100 000 during the study period. The true incidence and prevalence may be higher, but not lower, as some individuals may not have been referred to the hospital or have not been diagnosed in the first place. Conclusions: XFG affects elderly people, and it commonly becomes bilateral by time. It is more common in women than men, and at the time of diagnosis women are 3 years older than men. EP-GLA-35 Association between Serum Creatinine and Hypertension with Normal Tension Glaucoma (NTG) R.H. Khuluqi1, H. Holipah2, A.A. Hamid1, S. Prayitnaningsih1 1Universitas Brawijaya, Ophthalmology Department, Malang, Indonesia, 2Universitas Brawijaya, Public Health Department, Malang, Indonesia Purpose: To evaluate the association between Serum Creatinine and Hypertension with Normal Tension Glaucoma (NTG). Methods: This Cross-Sectional Population-Based Study involved 122 sub- jects taken from 3 villages. History taking and physical examination were car- ried out to determine age, gender, height and weight. Independent variable consist of Serum creatinine evaluated using Cobas e501 automatic analyzer, and hypertension measured using digital sphygmomanometer. The dependent variables consist of NTG, mean defect (MD), retinal nerve fiber layer thick- ness (RNFL), and vertical cup-to-disc ratio (CDR). A perimetric examination was performed to determine MD, and an optical coherence tomography scan was performed to determine RNFL, and CDR. NTG was obtained based on these three parameters. The association between variables is then tested by using logistic regression test. Results: Hypertension was not significantly associated with NTG, MD, RNFL, and CDR. Serum creatinine was not significantly associated with NTG, MD, RNFL, and CDR, although there was a significant difference in serum creatinine levels between large CDR group and normal CDR group (p=0.008). As secondary outcomes, we revealed an association between increased age and NTG (p=0.041, OR = 3.93). Association between aged 50-59 years with abnormal MD (p= 0.039, OR= 5,977), and those aged ≥60 years with Large CDR (p= 0.024, OR= 6,822) were also confirmed. Conclusion: Subjects with hypertention and increased level of Serum Creatinine had no risk of developing NTG. The association between age and glaucoma parameters was also identified. 114 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

EP-GLA-40 Long term success rate of selective laser trabeculoplasty (SLT) following failed incisional glaucoma surgery L. Ali Aljasim1, A. Albazei2 1King Khaled Eye Specialist Hospital, Glaucoma, Riyadh, Saudi Arabia, 2King Khaled Eye Specialist Hospital, Ophthalmology, Riyadh, Saudi Arabia Purpose: Trabeculectomy (Trab) & deep sclerotomy (DS) success rate around 80%, and failure rate increases over the years, following which patients either put back on medication or surgery will be repeated. SLT tried following failed glaucoma surgery, success rate was modest and short lived. Method: Retrospective review of all cases underwent SLT following failed Trab or DS in our institute, calculating initial success; as 20% reduction of IOP, or reduction in their medication with maintaining target IOP for 6month with no further intervention, then late failure was defined as any glaucoma in- tervention needed later (adding medication or undergoing glaucoma surgery), repeating SLT was not considered as failure. Results: 112 eyes suffered from glaucoma , 46 POAG, 37 pseudoexfoliation & 24 pigmentary glaucoma, with mild disease in 15%, moderate in 22% & sever in 63%, all underwent incisional glaucoma surgery, 106 Trab (4 had bleb revision) & 6 had DS. 92months later (6-360) another intervention needed, glaucoma was uncontrolled in 38%, or intolerant to medications in 62%, so SLT was done. Initial success rate was 69.6%, with IOP reduced from 21.3±5.7 to 16.9±5.8mmHg 6months after SLT, and number of medication reduced from 3.2±2.3 to 2.8±1.4 IOP maintained around 17.3±6.9mmHg, with the use of 2.9 ± 1.4 glaucoma medications over a period of 17.3±19.6 months (some cases followed up for 5-7years), over the years 27.6% of the cases needed further intervention (late failure). Failed SLT cases had more medications added (n=39) or underwent glaucoma surgery (n=24). Conclusion: SLT has a good initial success rate following failed glaucoma incisional surgery, and failure over years was relatively low, which will delay further surgical interventions SLT is a low-risk procedure, that should be offered for the patients with uncon- trolled glaucoma or intolerant of their glaucoma medications even after failed incisional glaucoma surgery. ELECTRONIC POSTER PRESENTATIONS In patients without CH (n=34 [50.7%]) at baseline, mean times to onset (50.1 days) and duration (41.4 days, n=13) were similar to those with CH at baseline (n=33 [49.3%]; onset, 65.8 days; duration, 42.9 days [n=14). In the BIM/TIM arm 19 of 212 (9.0%) patients had CH; the mean onset of CH was 61.7 days with a resolution (in 10 [52.6%] patients) duration of 21.8 days, and 9 (47.4%) had no CH reported at baseline. Conclusion: CH was expected to emerge as a treatment-related AE in a therapy combining both a ROCKi and prostaglandin, as both agents have been associ- ated with CH in previous studies. The severity of CH in MERCURY-3 was mild and resolved (in those that achieved this) around a month after onset. This characterisation of treatment-related CH, in conjunction with emerging real-world experience with NET/LAT, helps to contextualise the risk and ex- pected severity and duration of CH in patients treated with NET/LAT. EP-GLA-39 Outcomes of micropulse transscleral laser therapy (MP-TLT) in glaucoma patients - a comparison of two treatment protocols in a six-months observation period W. Maruszczyk1, K. Gontarz1,2, M. Nocoń-Bratek1, M. Bogocz1,2, M. Dorecka1,2, E. Mrukwa-Kominek1,2 1Prof. K. Gibinski University Clinical Center, Medical University of Silesia in Katowice, Department of Ophthalmology, Katowice, Poland, 2Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Department of Ophthalmology, Katowice, Poland Purpose: The purpose of the study was to compare the efficacy of MP-TLT performed with two protocols in patients with glaucoma over a six-months observation period. Methods: Patients with various stages of glaucoma and insufficiently con- trolled intraocular pressure despite maximally tolerable antiglaucoma ther- apy were selected to the study. We included 8o adult patients with various glaucoma subtypes, without prior glaucoma surgeries except SLT, LPI, and / or uneventful cataract phacoemulsification. Patients were assigned to two groups. All of them underwent MP-TLT in 2021 and had at least 6-months of follow-up. Patients were treated with the Micropulse P3 device powered by the CYCLO G6 (Iridex, Mountain View, CA, USA) at 2500 mW, with a duty cycle of 31.3%, using different treatment duration time. The first group had a duration of 50 seconds per hemisphere (five 10-sec- ond sweeps), while the second 80 seconds per hemisphere (four 20-second sweeps). Both hemispheres were treated. Patients were followed up 1 day, 2 weeks, 1, 3 and 6 months after surgery. On each visit we assessed the IOP, BCVA and the number of antiglaucoma medications. The qualified success was determined as an IOP between 6-21 mmHg and ≥20% reduction of IOP from the baseline without additional sur- geries, with or without the use of anti-glaucoma medications. Results: The mean IOP before the procedure was 19.62 ± 3.59 mmHg and 19.15 ± 5.08 mmHg in group 1 and 2, respectively, and in month 6 was 15.6 ± 3.29 mmHg and 16.32 ± 3.49 mmHg in group 1 and 2, respectively. Average IOP reduction was 17.91 ± 19.72 % and 10.77 ± 23.73 % in group 1 and 2, respectively. Qualified success was 40% and 37.5% in group 1 and 2, respectively. In the study population, the distribution of success was the same for both protocols (p=1.0, Fisher’s exact test) at 6 months. Conclusions: MP-TLT appears to be a safe and effective treatment for glau- coma using both protocols. Further studies are required. 116 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-44 A retrospective study of the clinical efficacy and safety of the PreserFlo MicroShunt K.Y. Phoong1, G. Nandakumar1, G. Majeed1, M. Elhanan1, M. Hakim1, S. Liu2,1, V. Shankar1 1East Lancashire Healthcare Trust, Ophthalmology, Blackburn, United Kingdom, 2University of Manchester, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom Purpose: The Preserflo Microshunt is a minimally invasive shunt inserted which lowers intraocular pressure (IOP) through the formation of a filtering bleb. This study aims to quantify the efficacy of the Preserflo in lowering IOP and evaluate its safety profile. Method: A retrospective, single-centre cohort study of 100 consecutive eyes followed up for at least 3 months post Preserflo implantation within a period of two years. The primary outcome measures were IOP control with or without the need for IOP-lowering medication and surgical success rates as per the World Glaucoma Association guidelines.[1] Secondary outcome measures were the incidence of complications and rein- terventions to determine the safety profile of the procedure. Results: A total of 100 procedures were performed on 94 patients, with a mean age of 72.5 ±13.6 years. Primary open-angle glaucoma was the leading cause of glaucoma, accounting for 62% of cases. From the pre-op cohort’s baseline IOP of 30.2 ± 12.1 mmHg, 57 eyes were followed up to one year, achieving a significant reduction in IOP to a mean of 14.4 ± 6.41 mmHg (p<0.01). 63.2% of patients met the complete success criteria and 87.7% achieved qualified successes. The use of anti-glaucoma medication was reduced significantly from 3.10 ± 0.94 to 0.81 ± 1.14 (p<0.01). Complications encountered were eight cases of hyphaemas, four cases of hypotony, two cases of corneal oedema, four cases of macular oedema, one vitreous haemorrhage, two cases of scarring and one shunt extruding through the conjunctiva. Conclusion: The Preserflo Microshunt is an effective and minimally invasive option for managing glaucoma surgically. The procedure was successful in achieving significant reductions in IOP and reducing the need for antiglau- coma medication in the majority of patients. While some complications and reinterventions were required in a minority of cases, the overall safety profile of the procedure is very strong. EP-GLA-45 Prevalence of glaucomatous appearing discs in patients undergoing artificial intelligence screening for diabetic retinopathy H. Chawla1, C. Hicks1, L. Assi1, J. Epling1, L. Al Dujaili1, J. Weiss1 1Louisiana State University School of Medicine, Ophthalmology, New Orleans, United States Purpose: Artificial intelligence (AI)-based image analysis allows high-vol- ume screening for diabetic retinopathy (DR), identifying referable patients by disease severity. However, replacing manual screening with platforms opti- mized for a single condition decreases the ability to detect additional ocular diseases such as glaucoma. The purpose of this retrospective cross-sectional study was to determine the prevalence of optic disc changes suspicious for glaucoma (OCSG) in a representative population of diabetic patients who un- derwent AI-based DR screening. Methods: High-resolution images were retrieved for 677 consecutive auto- mated DR screening exams. These were reviewed independently by two oph- thalmology resident readers for evidence of OCSG which included increased vertical cup to disc ratio (VCDR), beta-zone peripapillary atrophy, optic disc hemorrhage, vessel bayonetting, rim thinning, and/or central vessel nasaliza- tion. The prevalence of OCSG was reported and compared between subjects designated as referable for DR versus non-referable for DR. Results: In total, 823 eyes in 413 subjects were included. The classification reliability of ophthalmology resident graders was moderate to substantial compared to a glaucoma specialist. The total OCSG prevalence was 5.8% to 20.6%, with no statistically significant difference between patients designated referable versus non-referable on AI-based diabetic retinopathy screening. Conclusions: This pilot study demonstrated a significant prevalence of OCSG in diabetic patients undergoing AI-based retinopathy screening. Reliance on single-disease screening modalities may risk missing OCSG which would warrant further workup if detected on manual screening. These findings em- phasize the need for AI-based platforms capable of screening for multiple high-prevalence ophthalmic conditions. EP-GLA-46 Outcomes of inferotemporal XEN gel stent implantation E. Browning1, R. Shetty1 1Florida Eye Specialists- Jacksonville, Glaucoma, Jacksonville, United States Purpose: The purpose of this study was to determine the efficacy and safety of inferotemporal placement of the XEN gel stent. Method: A retrospective study was performed on twenty patients who un- derwent stand-alone XEN gel stent implantation in the inferotemporal quad- rant via ab-externo approach without conjunctival incision or tenonectomy. A mixture of 40 µg of Mitomycin C (0.1 cc of 0.04% solution) and preservative free lidocaine (0.1 cc) was injected subconjunctivally posterior to the bleb. Follow-up ranged from postop day one to seven months. Factors analyzed in- cluded number of medications, intraocular pressure (IOP), need for additional procedures, and complications. Results: At the most recent follow-up visits, mean IOP had a reduction of 47%, from 20.35 mmHg preoperatively to 10.68 mmHg (p < 0.001), and the number of medications reduced by 81%, from 4.05 preoperatively to 0.75 (p < 0.001). Complications included bleb leak (one eye), persistent cystoid macular edema (one eye), and postop day one hypotony with grade 1 anterior chamber shallowing (one eye). One patient required additional tube shunt surgery after failed bleb needling. There were no patients with blebitis, stent exposure, per- sistent hypotony, or bleb dysesthesia. Conclusion: Newer literature is emerging illustrating the viability of an in- ferior approach to XEN gel stent implantation. Our results show ab-externo inferotemporal approach is efficacious and safe. 118 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-GLA-50 Results of micropulse cyclophotocoagulation in patients with early open-angle glaucoma A. Rakova1, I. Ioshin2, A. Tolchinskaya2 1FSBI “Clinical Hospital”, Ophthalmology, Moscow, Russian Federation, 2FSBI “Clinical Hospital”, Moscow, Russian Federation Pupose: To evaluate the possibilities of transscleral micropulse cyclophoto- cogulation in patients with early stages of glaucoma. Material and methods: 38 patients with early stages of primary open-angle glaucoma underwent micropulse cyclophotocogulation as the primary proce- dure. For the operation, modified laser parameters were used on the SUPRA 810 device (Quantel Medical, France). The laser parameters were at 2.0 W for a duration of 100 s per hemisphere at a 31.3% duty cycle, fluense was 121,8 J/m2. Best corrected visual acuity (BCVA) before surgery averaged 0.88. The follow-up period averaged 17±11 months (from 6 to 30 months). The Kaplan- Meier scale was used to assess the cumulative success of laser treatment after surgery. Results: The postoperative period was uneventful. A month after the micro- pulse cyclophotocogulation, was noted hypotensive effect averaged 41.5%. The mean pre-operative intraocular pressure was 25.5 ± 5.5 mm Hg and the mean post-operative intraocular pressure at 12 months was 16.0 ± 3.5 mm Hg (hypotensive effect -31%). No changes in BCVA were detected during the ob- servation period. IOP reduction was achieved in all cases. The parameters of the state of the ONH (OST, perimetry) remained stable, or their improvement. The mean number of intraocular pressure-lowering medications used preop- eratively was 2.4 ± 1.1; the mean number of medications used at the 12-month post-operative visit was 1.4 ± 1.0. Conclusion: Micropulse cyclophotocogulation in patients with early stages of glaucoma leads to a pronounced stable hypotensive effect during the follow up period, avaraged 31%(up to 21% to 50%). An improvement in the quality of life was noted due to the refusal or reduction in the number of instilla- tions. To develop practical recommendations on the indications and regimens of micropulse cyclophotocogulation in the early stages of glaucoma, further monitoring of patients is carried out. ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Neuro-ophthalmology EP-NEO-01 THE optic nerve OCT analyses in traumatic optic neuropathy N. Moyseyenko1, H. Leskiv1, A. Dziubak1 1Ivano-Frankivsk National Medical University, Ophthalmology, Ivano-Frankivsk, Ukraine The case of 52 years old patient that found visual disorders due to craniocere- bral injury and chest injury with clavicle fracture. Methods: OCT of optic nerve was made twice in 2 days and in 3-month after injury. Results: In 3 months after the injury, the average thickness of the layer of nerve fibers in the right eye was 100 mm, compared to 141 mm on the third day after the injury, and decreased by 41 mm, 41%, in the left eye - from 142 mm to 91 mm, by 36%. The volume of excavation of the right eye on the third day after the injury was 0.08 mm3, on the third month - 0.19 mm3, that is, it increased by 0.11 mm3, 58%. In the left eye, the excavation volume on the third day after the injury was 0.15 mm3, on the third month - 0.76 mm3, that is, it increased by 0.61 mm3, 80%. The area of the neuroretinal band of the right eye on the third day after the injury was 1.95 mm2, on the third month - 1.15 mm2, that is, it decreased by 0.8 mm2, 41%. In the left eye, the area of the neuro-retinal belt was 1.64 mm2, on the third month - 1.29 mm2, that is, it decreased by 0.35 mm2, 21%. Spectral analysis of the macular cube three months after the injury showed the spread of a zone with a reduced thickness of the ganglion cell layer (p<0.05) over the entire upper temporal segment in comparison with the previous pe- riod. Conclusion: Traumatic optic neuropathy leads to dystrophic disorders in the form of a progressive decrease in the thickness of the layer of nerve fibers and ganglion cells of the retina, as well as to changes in the architecture of the optic nerve head. EP-NEO-03 Non-functional pituitary tumor presenting with an unusual visual field defect C. David1, R. Mangahas1 1Jose B. Lingad Memorial General Hospital, Ophthalmology, San Fernando, Pampanga, Philippines Background: Pituitary adenomas are classified as either functional or non- functional, depending on their hormone-secreting capabilities. These tumors can cause visual loss by compressing the optic chiasm. Such compression produces the characteristic bitemporal hemianopia. Asymmetric growth of tumors and different optic chiasm configurations can contribute to uncommon visual field disturbances. Objectives: To present a case of a pituitary tumor presenting with an unusual visual field defect, and describe how the anatomical relationship of the sella turcica with the chiasm can cause such defects. 120 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS The classical loss of temporal fields have been reported in various studies. We looked at data from various neurosurgical centres in the world looking at data about the recovery rate of visual field to help our patients understand the pace of recovery of visual field following trans-sphenoidal surgeries. Method: Literature search of patients who presented with symptoms of pitu- itary apoplexy who had undergone trans-sphenoidal decompression or those treated medically. Data regarding early surgery (within 72 hours), severity of presentation, and level of vision loss were gathered. Results: Majority of patients had CNIII palsy. Early surgeries lead to better symptom control and earlier visual recovery of patients. Patients generally recovered vision if they presented shortly after symptom onset. Patients who presented following months of chiasmal compression did not recover their vision as much as the early surgery group. Diffusor tensor imaging following surgical approach showed early axonal signal recovery. In the months to years following surgery remyelination and diffuse axonal thickness was measured although the recovery was not complete. Conclusion: Oculomotor palsies in cases of apoplexy developed in a definef sequence- mydriasis, gaze limitation, and ptosis. These will improve in re- verse order. 90% of patients who undergo early surgery will recover 90% of visual function and visual field. EP-NEO-07 Radial nerve fiber layer (RNFL) and choroidal macular thickness (CMT): markers of severity in Multiple Sclerosis (MS) patients M. Cerdà-Ibáñez1, L. Manfreda Domínguez2, A. Duch-Samper2 1FISABIO Oftalmología Médica (FOMCV), Valencia, Spain, 2Hospital Clínico Universitario de Valencia, Valencia, Spain Purpose: To investigate whether vascular changes (choroidal thickness and macular vascular plexus) as well as changes in the thickness of retinal nerve fibre layers and retinal ganglion cells occur over one year in patients with multiple sclerosis. Methods: We analysed 104 eyes of MS patients (divided into 2 groups: pa- tients with primary progressive MS and subject with relapsing-remittent MS). Patients were also divided according with their disability (low disability and high disability). Anatomical parameters: RNFL and ganglion cell layer (GCL) were studied using optical coherence tomography. Vascular parameters were also analysed: CMT (studied by OCT) and vascular macular plexus with OCT- angiography (OCTA). Any subject has optic neuritis history. Results: RNFL was thinner with the highest degree of disability and in pa- tients with PPMS. MCT showed significant decreased in the group, which has moderate severe disability and showed a decrease in the group that their dis- ability worsened during the year of the study. Retinal macular plexus showed no difference in any group. Conclusions: The study of the RNFL and MCT are objective and valuable indicators in these patients, especially with regard to the progression of their disability and to remark the worst subtypes of the disease. EP-NEO-08 “Parinaud syndrome”: a case report J.M. Villalva1, M.L.D. Fermin1 1FEU-NRMF, Ophthalmology, Quezon City, Philippines Childhood intracranial tumors are rare, with only 3-4% in East Asia.The clinical presentations often vary depending on the size, location, and invasiveness of the tumor. These children usually present with non-specific signs and symptoms causing delays in the diagnosis of these patients. This significant delay poses a great challenge to physicians to maintain a high index of suspicion by having a more aggressive approach for earlier diagnosis and intervention. This is a case of an 11-year-old male who presented with a progressive head- ache accompanied by limited upgaze in both eyes. The patient complained of generalized headache, throat pain, and low-grade fever, and was initially diag- nosed with Acute Tonsillopharyngitis. Due to persistent headache and an epi- sode of projectile vomiting, patient sought a consult with an Ophthalmologist where prescription glasses were given, which did not afford relief. Due to worsening symptoms, the patient sought another consult and was di- agnosed with Urinary Tract Infection. A few days later, another episode of projectile vomiting associated with headache, diplopia, and seizure occurred which prompted admission. Cranial MRI revealed a heterogeneously enhanc- ing mass at the pineal region. An emergency ventriculoperitoneal shunt was done. The patient underwent adjuvant radiotherapy, chemotherapy, and an in- cision biopsy. Despite optimal therapy, the patient passed away as a result of multi-organ failure. Detailed history taking, comprehensive physical examination, and appropri- ate radiological evaluation along with a multidisciplinary team are impera- tive in the prognosis of children with rare intracranial malignancies. Tumor markers may aid in determining the type of intracranial tumors, and avoid the morbidity and mortality associated with an upfront neurosurgical intervention. Adjuvant chemo and radiotherapy along with excision of residual tumor is still the recommended treatment modality for better prognosis and survival. EP-NEO-09 Dural carotid-cavernous fistula fed from contralateral side complicated with CRVO successfully treated with endovascular embolization I. Simkiene1,2, M. Kurminas3, D. Palionis3, A. Cimbalas1 1Vilnius University Hospital Santaros Clinics, Department of Eye Diseases, Vilnius, Lithuania, 2Vilnius University Faculty of Medicine, Vilnius, Lithuania, 3Vilnius University Hospital Santaros Clinics, Department of Radiology, Vilnius, Lithuania Purpose: To describe a rare case of an endovascular embolization of chronic dural carotid-cavernous fistula (CCF) complicated with central retinal vein occlusion (CRVO). Methods: A retrospective case report. Results: A 68 year old women with hypertension presented with mild left orbital pain, redness and proptosis of 5 days duration. She had a similar but milder episode 1.5 year ago, which resolved spontaneously. She had no history of a head or ocular trauma. BCVA was 0.2 (Snellen) due to exposure keratitis. Proptosis was present (Hertel OD 15mm, OS 26mm), on left eye fundus exam tortuous vessels were present. CT angiography showed enlarged medial and inferior rectus and mild venous congestion. 122 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Conclusion: Making a prompt diagnosis of GCA is essential in order to start treatment without delay and therefore prevent the ocular morbidity associated with this disease. EP-NEO-13 Biometry extraction and probabilistic anatomical atlas of the Anterior Visual Pathways using dedicated high-resolution 3D MRI E. Pravatà1, A. Diociasi2, R. Navarra3, L. Carmisciano2, M.P. Sormani2, L. Roccatagliata2, A. Chincarini4, A. Ossola5, A. Consigli5, C. Gobbi6, C. Zecca6 1Neurocenter of Southern Switzerland, Neuroradiology, Lugano, Switzerland, 2University of Genova, Department of Health Sciences, Genova, Italy, 3Institute for Advanced Biomedical Technology (I.T.A.B.), Chieti, Italy, 4Istituto Nazionale di Fisica Nucleare (INFN), Genova, Italy, 5Neurocenter of Southern Switzerland, Opthalmology, Lugano, Switzerland, 6Neurocenter of Southern Switzerland, Neurology, Lugano, Switzerland Purpose: Anterior visual pathways (aVP) damage may be linked to diverse in- flammatory, degenerative and/or vascular neuro-ophtalmological conditions. However, a standardized methodological framework to extract corresponding magnetic resonance imaging (MRI) biomarkers is currently unavailable. Therefore, we developed a software algorithm for processing 3D high-resolu- tion MRI data to generate a probabilistic anatomical atlas of the normal aVP and its intraorbital (iOrb), intracanalicular (iCan), intracranial (iCran), optic chiasm (OC), and tract (OT) subdivisions. Method: By using a 3T MRI scanner and a dedicated imaging protocol, we acquired 3D sub-millimetre (0.6mm3) “CISS” images from 24 healthy partici- pants. aVP labels were obtained by manual segmentation of each aVP subdivi- sion. Label straightening and normalization with cross sectional area (CSA) preservation were obtained using in-house scripts. A probabilistic atlas (“aVP-24”) was generated by averaging L and R sides of all subjects. Leave-one-out cross-validation with respect participants’ in- terindividual variability was performed employing the spatial similarity in- dex (DSI). Spatially normalized representations of the aVP subdivisions were generated. Results: CSA values overlapped before and after normalization, demonstrat- ing preservation of the aVP cross-section. Volume, length, CSA, and ellipticity index (Ei) biometrics were extracted. The aVP-24 morphology followed pre- vious descriptions from the gross anatomy. Atlas spatial validation DSI scores of 0.85 in 50% and 0.77 in 95% of participants indicated good generalizability across the subjects. Conclusion: The proposed MRI standardization framework allows for previ- ously unavailable, geometrically unbiased biometric data of the entire aVP and provides the base for future spatial-resolved, group-level neuro-ophtoal- mology investigations. EP-NEO-14 Atipical forms of traumatic optic neuropathy N. Moyseyenko1, A. Dziubak1 1Ivano-Frankivsk National Medical University, Ophthalmology, Ivano-Frankivsk, Ukraine Purpose: To present Two case of traumatic optic neuropathy (TON) with atypical symptoms. Methods: OCT of optic nerve was made twice in 2 days and in 3-month after injury. Results: Case A. The injury was obtained as a result of a blow to the chest and a frac- ture of the clavicle. Within three months after the trauma, there was a deterioration of vision in both eyes to 0.6, a slowing of the reaction of the right pupil to light. OCT on the third day after the injury showed a thickening of the layer of nerve fibers in both eyes to 215 mm and a decrease in the thickness of the layer of ganglion cells in the right eye to 281 mm. Three months after the injury, the thickness of the nerve fiber layer decreased to 55 mm, and the ganglion cell layer decreased to 285 mm in both eyes. Right-sided hemianopsia was atypical for TON. Case B. He received damage to the optic nerve as a result of surgical bite cor- rection. He applied on the fifth day after the operation, when the vision in the right eye was 0, without the sensation of light, in the left eye - 0.8. As a treatment, pulse therapy with corticosteroids was started. On the third day of treatment, he noticed that he was able to count fingers on his right eye, and after 2 weeks, the visual acuity of the right eye became 0.3, on the left eye - 0.8 However, according to OCT, bilateral multi-chamber detachment of the pig- ment epithelium in the macular area was revealed against the background of functional vision recovery. EP-NEO-15 Some aspects of neuro-ophthalmological examinations in the diagnosis of visual disorders L. Žorić1 1Clinic for Eye Diseases, UKC, Faculty of Medicine, UPKM, Neuro-Ophthalmology, Belgrade, Serbia Patients with various vision disorders are referred to neuro-ophthalmologist perhaps more often than to ophthalmologist who deal with other ophthalmic disorders. This happens mainly in diseases that do not have a prominent oph- thalmological finding. Due to the specificity of neuro-ophthalmological work, a certain disease is more often suspected, which is further investigated, mostly using electrophys- iological and imaging methods. In this presentation brief descriptions of several neuropathies and retinopa- thies are given. 124 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-NEO-19 Visual and neuroretinal study in patients with fibromyalgia A. Pueyo-Bestué1, M.J. Vicente1, A. Tello1, V. Mallén1, D. Fernández1, T. Martinez1, M. Subías1, L. Arias1, I. Munuera1, E. García-Martín1 1Miguel Servet University Hospital, Ophtalmology, Zaragoza, Spain Purpose: To study visual parameters, retinal nerve fiber layer and macular ganglion cell layer (GCL) in patients with Fibromyalgia (FM) over 5 years and compare them with controls. Methods: Eighty patients with FM and thirty-eight age and sex-matched healthy controls participated in the study. Only one eye per subject was ran- domly selected and included. Visual acuity (VA) with ETDRS chart, contrast sensitivity vision (CSV) with Pelli Robson, color vision with Farnsworth and Lanthony D15 tests and retinal evaluation using Spectral domain Optical co- herence tomography (SD-OCT), were conducted in all of the subjects. Visual function parameters, ganglion cell layer (GCL) and retinal nerve fi- ber layer (RNFL) thickness were re-evaluated after 5 years. Patients were classified into three different groups based on their phenotype and associa- tion between progressive ophthalmologic changes and disease severity was analysed. Results: After 5 years of follow up, patients suffered from fibromyalgia presented variations in neuroretina thickness and in visual function param- eters. They showed sectorial progressive decrease in RNFL and GCL thick- ness. Changes in GCL thickness were associated with disease severity. They showed worse low contrast VA and low frequency CSV. Correlations between structural changes and disease severity scores were only observed in the atypi- cal and biologic phenotypes. Conclusions: In patients with FM has been detected retinal neurodegenera- tion and visual dysfunction. The study of RNFL, CGL and visual parameters could be a non-invasive and useful tool for monitoring FM. EP-NEO-20 Ability of optical coherence tomography in the early detection of Alzheimer’s disease A. Pueyo-Bestué1, D. Fernández1,1, A. Tello1, V. Mallén1, M.J. Vicente1, T. Martinez1, L. Arias1, M. Subías1, I. Munuera1, B. Cordon1, E. Vilades1, B. Cameo1, M.I. Fuertes1, E. García-Martín1 1Miguel Servet University Hospital, Ophtalmology, Zaragoza, Spain Purpose: Toevaluate visual parameters, retinal nerve fiber layer and macular ganglion cell layer (GCL) in patients with Alzheimer’s disease (AD) and com- pare them with controls, in order to develop non-invasive biomarkers for the early diagnosis of this disease. Methods: Twenty-five eyes of AD patients and 80 eyes of age and sex-matched healthy controls participated in the study. The group of AD patients presented a mean age at diagnosis of 65.26± 8.54 years and a mean disease progression of 5.85± 9.55 years. Visual acuity (VA) was measured with ETDRS chart. Fast macular and N-site axonal protocols with Spectral domain Optical coher- ence tomography (Spectralis OCT, Heidelberg) and EDTRS and TSNIT proto- cols with Swept-Source Optical coherence tomography (Triton OCT, Topcon) were performed in all the subjects to study the retinal layers thicknesses. Results: AD patients presented reduction in visual function parameters and thinning in neuroretina measurements. They showed worse low contrast VA, being the largest difference with healthy controls at 100% ETDRS contrast level (p<0.001). Patients showed sectorial decrease in RNFL and GCL thick- ness. Studying the optic nerve, a significant reduction was observed in all sectors with Triton OCT, especially in the total thickness (269.67 µm in AD versus 285.32 µm in controls, p<0.001), and in the inferior nasal sector (291.83 µm in AD versus 315.84 µm in controls, p<0.001). With Spectralis OCT, the reduction observed in the optic nerve was not sig- nificant. Regarding macular thickness, there was a decreased thickness in all regions of GCL using Triton OCT (p<0.001) and in the N2, S1 and T2 sectors, GCL and inner plexiform layer using Spectralis OCT (p<0.001). Conclusions: A decrease in visual acuity and a thinning of retinal layers in AD patients was detected, greater with Triton OCT. The analysis of retinal layers with OCT could be used as a useful and non-invasive tool in the early diagnosis of AD. EP-NEO-21 Evaluation of the retinal anatomy and visual function assessment in people with protanomally and deuteranomally A. Pueyo-Bestué1, A. Tello1, D. Fernández1, M.J. Vicente1, V. Mallén1, T. Martinez1, M. Subías1, L. Arias1, I. Munuera1, E. García-Martín1 1Miguel Servet University Hospital, Ophtalmology, Zaragoza, Spain Purpose: To determine whether subjects with normal color vision within the same age and gender distribution have differences in the retinal nerve fiber layer (RNFL) thickness, macular area, retinal ganglion cell complex, and reti- nal layers that contain photoreceptors (bastons and cones), as well as visual acuity, contrast sensitivity, and color visión; compared with subjects with color blindness. Methods: 50 color-blind and 50 control subject’s eyes were used in this cross- sectional and observational investigation. Visual function (visual acuity, con- trast sensitivity and color vision) and neuroretinal structure were assessed in all subjects using optical coherence tomography (OCT). Results: The retinal nerve fiber layer, ganglion cell layer, and retinal thickness were all noticeably thinner in the color blindness group. Additionally, layers that contain photoreceptor nuclei showed significant thinning (between the outer limiting layer and the Bruch membrane and between the outer plexiform layer and the outer limiting membrane). Conclusions: The RNFL and various retinal layers (ganglion cell and pho- toreceptor layers) were discovered to have dramatically reduced thicknesses, proving that color blindness is linked to thinning of the retinal and RNFL thicknesses as well as the retinal layers that contain photoreceptor nuclei. Therefore, it appears that an OCT study with retinal segmentation is a marker of color blindness that is useful in clinical practice in cases of diagnostic un- certainty. This study may be helpful in assessing the efficacy of future medi- cines like gene therapy. 126 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-NEO-25 Right homonymous hemianopia due to arteriovenous malformation of ambient cistern-left thalamus spletzer martin grade III: a case report U. Haidar1, R. Prihatningtias2 1Diponegoro University, Ophthalmology Department, Semarang, Indonesia, 2Diponegoro University, Neuro-Ophthalmology Subdivision, Ophthalmology Department, Semarang, Indonesia Introduction: Homonymous hemianopia is a visual fields defect due to the lesion in retrochiasmal, anywhere from contralateral optic tract to occipital cortex. AVMs are responsible for visual impairment in young population. Case: A 23 years old female complained the visual field defect in the tem- poral RE and the nasal LE since 7 years ago, along sudden onset with severe headache. Current examination shows the VA both eyes are 20/20. No anterior and posterior segment abnormalities. The OCT found GCL-IPL 68 (RE) and 71 (LE) shows thinning in nasal quadrant RE and temporal quadrant LE. The HVFA showed the right homonymous hemianopia. The 3D TOF and MRV showed nidus with size AP1.9xLL1.9xCC1.7 cm on the left parietal region with feeding artery from left posterior cerebry artery, left communicating posterior artery, and draining vein into internal cerebral sinus which is spletzer martin grade 3 class B. The DSA showed nidus 1.5 cm, eloquent, and feeder in Galen venous which is SM grade 3. Therefore, the neurosurgery is giving advice for Gamma Knife Radiosurgery (GKRS) to resolve the AVM. Discussion: Discovering a visual defect in relatively younger patient is a warning sign. AVM is a rare causative. A prevalence was 0.01 to 0.50 percent of the general population ranges 20 to 40 years old. The cause of visual field loss in AVM due to compression or infarction of the visual pathway, as well as haemorrhage from AVM. The circulatory error and the malformation are leading to hypoperfusion and functional defects.This patient is classified SM grade 3. So, neurosurgery plans GKRS. The target is nidus obliteration to deprive the risk of intracranial haemorrhage, usually occurs in 1 to 5 years. The obliteration approximately from 60 to 70% with doses of 15-16 Gy up to 90% or more with doses of 20-25 Gy. Conclusion: This case illustrates right homonymous hemianopia associated to AVM in the ambient cistern of the left thalamus in young female which is remarkable case. EP-NEO-26 FALCON: a prospective natural history study of patients with Autosomal Dominant Optic Atrophy (ADOA) Y. Liao1, B. Ticho2, F. Wang2, K. Saluti2, E. Gaier3, S. Gross2 1Stanford University, Stanford, United States, 2Stoke Therapeutics, Bedford, United States, 3Harvard University, Boston, United States ADOA is the most common inherited afferent neuro-ophthalmic disorder. Patients typically present in the first decade of life and up to 46% of patients progress to legal blindness. Up to 90% of cases are caused by a heterozygous mutation in the nuclear gene OPA1, often leading to haploinsufficiency of OPA1 protein. Though ubiquitously expressed, reduced OPA1 protein levels preferentially impairs mitochondrial function in retinal ganglion cells lead- ing to apoptosis and progressive, irreversible vision loss. The natural history ofOPA1-related neurodegeneration in ADOA is poorly understood. FALCON is a multicenter, prospective natural history study of patients with ADOA who are ≥8-≤60 years (y) old and have a causative heterozygousOPA1 gene variant. The study includes ~45 patients (~15 (8-17y), ~20 (18-40y), and ~10 (41-60y)) and is comprised of clinical and ocular assessments at baseline, 6, 12, 18, and 24 months (m). Primary endpoints include changes from baseline to 24m in best-corrected visual acuity using Early Treatment Diabetic Retinopathy Study optotypes; visual field changes (as assessed by automated, static perimetry), peripapillary retinal nerve fiber layer, and macular ganglion cell layer (ganglion cell com- plex) thicknesses as assessed by optical coherence tomography. Secondary endpoints include changes in aforementioned endpoints at 6, 12, and 18m; contrast sensitivity; and retinal electrical activity. Exploratory end- points include flavoprotein fluorescence. These results will characterize ADOA clinical progression in absence of treat- ment to define vision loss magnitude and neuropathological, functional, and structural manifestations. Results will also identify endpoint(s) that change the most to inform clinical trial design. There are currently no approved treat- ments for ADOA. Comparative assessment of candidate outcomes measures and a comprehensive understanding of the ADOA clinical progression are es- sential to develop and test new potential therapies. EP-NEO-27 Leber’s idiopathic stellate neuroretinitis: case report L. Mammadova1 1National Ophthalmology Center named after acad. Z. Aliyeva, Retina Department, Baku, Azerbaijan In 1916, Leber’s idiopathic stellate neuroretinitis (LISN) was described by Theodore Leber as a rare disease characterized by optic disc swelling associ- ated with a macular star. This fundus appearance can have multiple causes but the etiology of Leber’s idiopathic stellate neuroretinitis remains unknown. A 20 year-old man consulted for a progressive decline in visual acuity and a blurred vision in his rightt eye. Corrected Visual acuity of the rihg eye was hand movement, Funduscopy of the left eye revealed a stellate maculopathy with loss of foveolar depression and a swelled optic disc. Laboratory inves- tigations were normal. No infectious nor inflammatory etiology was found. Brain imaging was normal. Patient received 4 days of intravenous methyl- prednisoloneat 10mg/kg/D for 4 days in a row and an oral relay was started with a progressive degression over 2 weeks. The evolution after treatment was satisfactory, the visual acuity 3 weeks after the intravenous injection of corticoids increased to 6/12. Leber’s idiopathic stellate neuroretinitis (LISN) is a disorder characterized by disc oedema, peripapillary and macular hard exudates and, often, the pres- ence of vitreous cells. The changes in the optic nerve are the primary cause of reduced vision in this condition. The more common treatable causes must be excluded wich are cat scratch disease (CSD) and vascular disease. 50% of cases have no identifiable cause and are labeled idiopathic neuroretinitis. There is no consensus regarding optimal treatment. The prognosis of Leber’s idiopathic stellate neuroretinitis is good in most cases. In conclusion, in any patient presenting with an optic disc oedema associated with stellate maculopathy, it is important to rule out all potentially treatable differential diagnoses before retaining the diagnosis of Leber’s idiopathic stel- late retinopathy. Complementary examinations must be oriented according to the data of the clinical examination. 128 Congress of the European Society of Ophthalmology (SOE) 15 - 17 June, 2023, Prague, Czech Republic - Abstract Book

referred to the hospital to complete the examination. The study was completed with a macular optical coherence tomography (mOCT) that was normal in BE, an OCT of the peripapillary fiber layer where was observed a decrease in temporal thickness in RE and in nasal quadrant in LE with a decreased mean thickness in BE. Priority cranial computed tomography (CT) and CT angiography were per- formed, where a partially thrombosed giant right carotid aneurysm was de- tected with a mass effect on the adjacent brain structures. Also, was done a cerebral arteriography where aneurysms were observed in both carotids and in the right posterior cerebral artery and a Doppler ultrasound of the supra-aortic trunks that was normal. Due to the risk-benefit balance, the management was conservative. The ophthalmologist plays an important role in the diagnosis of these lesions as they can cause a ophthalmological alteration as first symptom, furthermore it can manifest as an atypical campimetric alteration depending on the mag- nitude of the lesion. EP-NEO-35 Perioperative ischemic optic neuropathy O. Đokić1, D. Vasović2, L. Žorić3 1Fa