SOE2025_Abstract

SOE2025_Abstract_E-Book

European Society of Ophthalmology Congress of the European Society of Ophthalmology (SOE) 2025 7 – 9 June, 2025, Lisbon, Portugal Abstracts Scientific Programme Committee Wagih Aclimandos, United Kingdom, Chairman Angelina Meireles, Portugal, Programme Coordinator Susanne Albrecht, Sweden, Multidisciplinary Nikolaos Bechrakis, Austria, Oncology and Pathology Jan-Tjeerd de Faber, The Netherlands, Paediatrics and Strabismus Shlomo Dotan, Israel, Neuro-ophthalmology Christoph Hintschich, Germany, Oculoplastics Graham Holder, United Kingdom, Electrophysiology Friedrich Kruse, Germany, Cornea and External Eye Lyubomyr Lytvynchuk, Germany, Retina Carlos Pavésio, United Kingdom, Uveitis Marie-José Tassignon, Belgium, Cataract and Refractive Surgery Liz Tomlin, United Kingdom, Multidisciplinary Carlo Enrico Traverso Italy, Glaucoma Luc Van Os, Belgium, Cataract and Refractive Surgery Congress Committee Wagih Aclimandos, United Kingdom, President Jan-Tjeerd de Faber, The Netherlands, Immediate Past-President Angelina Meireles, Portugal, Secretary General and Local Representative Incorporating abstracts from the International Society of Ocular Trauma ISOT Committee Arne Viestenz, President, ISOT Ferenc Kuhn, Chairman, ISOT Electronic production of the abstract book by pharma service, a business unit of documedias GmbH. Copyright to all 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.

Congress of the European Society of Ophthalmology (SOE) 2025 7 – 9 June, 2025, Lisbon, Portugal Contents FREE PAPER PRESENTATIONS FP01 FP02 FP03 FP04 FP05 FP06 FP07 FP08 FP09 FP10 FP11 Free Paper 1: Retina Free Paper 2: Education, Oncology & Pathology Free Paper 3: Cataract, Refractive Surgery Free Paper 4: SOE Lecturers, Neuro-ophthalmology Free Paper 5: Glaucoma Free Paper 6: Oculoplastics, Uveitis Free Paper 7: Education, Contact Lenses, Cornea, Ocular Surface, Glaucoma Free Paper 8: Retina Free Paper 9: Paediatric Ophthalmology & Strabismus Free Paper 10: Cornea Free Paper 11: Abstract Medley RAPID FIRE PRESENTATIONS RF01 RF02 RF03 RF04 RF05 RF06 RF07 RF08 RF09 RF10 Rapid Fire 1: Contact Lenses, Cornea, External Eye, Ocular Surface Rapid Fire 2: Neuro-ophthalmology Rapid Fire 3: Oculoplastics Rapid Fire 4: Oncology & Pathology Rapid Fire 5: Uveitis Rapid Fire 6: Retina Rapid Fire 7: Electrophysiology, Glaucoma Rapid Fire 8: Cataract, Refractive Surgery Rapid Fire 9: Education Rapid Fire 10: Paediatric Ophthalmology & Strabismus ELECTRONIC POSTER PRESENTATIONS Electronic Poster: Cataract Electronic Poster: Contact Lenses Electronic Poster: Cornea Electronic Poster: Education Electronic Poster: External Eye Electronic Poster: Glaucoma Electronic Poster: Neuro-ophthalmology Electronic Poster: Ocular Surface Electronic Poster: Oculoplastics Electronic Poster: Oncology & Pathology Electronic Poster: Paediatric Ophthalmology and Strabismus Electronic Poster: Refractive Surgery Electronic Poster: Retina Electronic Poster: Uveitis ISOT ABSTRACT PRESENTATIONS Young ISOT Management of Anterior Segment Trauma Management of Posterior Segment Trauma Management of Unique Trauma Cases ISOT Dry Lab Video Session Electronic Posters: ISOT Page 4 7 10 14 17 20 24 30 33 36 39 41 44 46 49 51 54 57 59 61 63 66 76 78 97 101 104 126 140 148 158 166 189 194 236 247 250 253 257 260 264 AUTHOR INDEX 267

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 1: Retina FP01-1 Analysis of the etiology, clinical characteristics and treatment outcomes of choroidal neovascularization in Chinese children S. Yan1, H. She1, H. Zhou1 1Beijing Tongren Hospital, Capital Medical University, Beijing Tongren Eye Center, Beijing, China Purpose: This study aimed to investigate the etiology, clinical characteristics Methods: This is a retrospective descriptive study conducted in the depart- ment of internal medicine B and ophthalmology at HMIM V in Rabat, between May 2016 and July 2023. We included five patients with VKH syn- drome. The aim of our study was to determine the epidemiological, clinical, ther- apeutic and evolutionary characteristics of patients in our series and in other series. Results: All patients were Moroccan with an average age of 40 years and 5 months and a male predominance. The majority had an initial visual acuity between 3/10 and 4/10 and bilateral uveitis. 80% of patients presented with extra-ocular signs. Patients received intravenous corticosteroid followed by oral corticosteroids, with only one patient requiring immunosuppressive therapy. A favorable evolution was noted. Discussion: VKH disease is still considered a disease of people of Hispanic, Asian or Middle Eastern origin, with most patients between the second and fifth decade of life. It is a systemic disease with ocular, neurological, auditory and cutaneous involvement, although not all these symptoms are present in and treatment outcomes of choroidal neovascularization (CNV) in Chinese every patient. The mainstay of treatment is the early and intensive administra- children. tion of systemic corticosteroids, and prognosis depends on rapid diagnosis Methods: A retrospective analysis was conducted on the clinical character- and therapy. istics, multimodal imaging and treatment outcomes of children with CNV at Conclusion: VKH syndrome is a serious disease with severe complications Beijing Tongren Hospital from May 2014 to October 2024. for the eye, despite intensive treatment. Subclinical forms may underesti- Results: 72 pediatric patients (80 eyes) with CNV were included. The average mate its frequency. It is important to consider this diagnosis in all cases of age was 12.1 ± 3.5 years and 36 (50.0%) were male. The most common etiolo- gies of pediatric CNV were idiopathic (35.0%), inflammatory chorioretinopa- thy (31.25%) and congenital or hereditary abnormalities (20.0%). Age distri- bution analysis showed that pediatric CNV was most common in adolescence (13-17 years, 43.75%) and school age (7-12 years, 41.25%). Idiopathic CNV is the main cause of CNV in children ≤12 years (39.02%), fol- lowed by congenital or hereditary abnormalities (21.95%), while inflammato- ry chorioretinopathy is the most common cause of CNV in children aged ≥12 years (41.03%). Most CNV were subfoveal (56.3%) and all of the CNV with complete fundus fluorescein angiography (FFA) images were classic type. Of the 58 eyes (72.5%) with complete optical coherence tomography (OCT) data, all of the CNV were type II. Analysis of 26 eyes treated with intravitreal anti-VEGF drugs showed that the best corrected visual acuity (BCVA) significantly improved from 0.75 ± 0.46 logMAR at baseline to 0.63 ± 0.46 logMAR at the last follow-up (p=0.021). bilateral uveitis. FP01-4 Incidence of radiation retinopathy, its associations with clinical and dosimetric factors, and treatment outcomes after radiotherapy for uveal melanomas I. Kaukenaite1, G. Miniauskiene1, J. Trumpaitis1 1Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Ophthalmology, Kaunas, Lithuania Purpose: To determine the incidence of radiation retinopathy (RR), its associ- These eyes with active CNVs required a mean of 2.12 ± 0.80 injections during ations with clinical and dosimetric factors, and to evaluate treatment outcomes the follow-up period. after radiotherapy for uveal melanomas (UM). Conclusion: The etiology and clinical characteristics of CNV in children dif- fered from those in adults. Idiopathic, inflammatory, and congenital or he- reditary CNV were the three most common etiologic factors in children. Most Method: 76 subjects with UM who received radiotherapy at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Ophthalmology Department in 2018-2022 were included in the study. A retrospective analy- pediatric CNV were unilateral, type II and subfoveal. Children with active CNVs had good responses to anti-VEGF treatment. sis of demographic data, tumor characteristics and dosimetric parameters was conducted. Clinical signs of RR were assesed at baseline and at the last FP01-2 VKH disease: about 5 cases and literature review O. El Hallaoui1 1Hôpital Militaire d’Instruction Mohammed V, Rabat, Morocco Introduction: VKH disease is an autoimmune granulomatous panuveitis, primarily affecting young, pigmented women. The mechanisms involve an attack on melanocytes by CD4+ Th1 T lymphocytes, particularly in carriers of HLA-DRB1 * 0405. A rare disease with a severe prognosis and a risk of ocular complications when diagnosed and treated late. follow-up. Subjects treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections underwent assessment of best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline and at 1, 3, 6, 12, 18, 24, 30, and 36 months from baseline. Results: During mean follow-up of 28,99 ± 15,93 months RR was found in 44,7 % subjects after a mean period of 20,97 ± 9,65 months following UM radiotherapy. Subjects who developed RR were younger (58,74 ± 14.07 years) than those without RR (64,12 ± 11.81 years) (p = 0.037); their UM were more frequently located in the macular and peripapillary areas compared to other areas (respectively, p = 0,047 and p = 0,01). During treatment with intravitreal anti-VEGF, BCVA remained stable, while CRT significantly decreased at 1, 3, 6, 12, and 24 months from baseline (p < 0,05). The presence of RR clinical signs at the last follow-up was statistically significantly lower compared to their presence before treatment (p < 0,05). 4 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Conclusion: RR was found in almost half of the subjects following radiation FP01-7 therapy for UM. RR was more common in younger subjects and those with UM located in the macular and peripapillary areas. When treated with intra- vitreal anti-VEGF injections, subjects showed stable BCVA, while both CRT and clinical signs of RR significantly improved. Extensive macular atrophy with pseudodrusen-like appearance: clinical findings, multimodal imaging and natural history FP01-5 Ultra wide field angiography for detection of peripheral diabetic neovascularization R. Mahmoud1,2, A. Fayed3,4, R. Estawro5,6 1Ain Shams University, Department of Ophthalmology, Cairo, Egypt, 2Al Watany Eye Hospital, Investigative Department, Cairo, Egypt, 3Kasr Al-Ainy School of Medicine, Ophthalmology Department, Cairo, Egypt, 4Oxford Eye Hospital, NHS Foundation Trust, Oxford, United Kingdom, 5Al Watany Eye Hospital, Medical Retina, Cairo, Egypt, 6University of California, Stein Eye Institute, Retinal Disorders and Ophthalmic Genetics Division, Los Angeles, United States Purpose: To investigate the prevalence of peripheral retinal neovasculariza- tion in treatment-naïve proliferative diabetic retinopathy patients using ultra- widefield fluorescein angiography. Method: This cross-sectional observational study retrospectively analyzed the distribution of retinal neovascularization (NV) in ultra-widefield fluores- cein angiography (UWFFA) images of treatment-naïve patients with prolifera- tive diabetic retinopathy (PDR). Three types of NV were evaluated: neovascu- larization of the disc (NVD), neovascularization elsewhere (NVE) within the ETDRS 7-field area, and NVE outside the ETDRS 7-field area. The prevalence of each NV type was determined, and the distribution of NVEs was mapped across quadrants both inside and outside the ETDRS 7-field area. Additionally, the relationship between NV distribution and patient demographic character- istics was examined. Results: In our study of 97 eyes from 61 patients with treatment-naïve pro- liferative diabetic retinopathy (PDR), the most common presentation was a combination of neovascularization of the disc (NVD) and neovascularization elsewhere (NVE), both within and beyond the ETDRS 7-field area, observed in 34 eyes (35.1%). NVD alone was present in 4 eyes (4.1%). Peripheral NVEs, located outside the standard ETDRS 7-field, were identified in 56 eyes (57.7%). Notably, only 3 eyes (3.1%) displayed peripheral NVEs without other forms of neovascularization. Peripheral NVEs were significantly associ- ated with younger patients (≤50 years; p = 0.012) and were most frequently observed in Extended Field 6 (43.3%). Within the ETDRS 7-field area, field 7 exhibited the highest prevalence of NVEs (57.7%). Conclusion: Ultra-widefield fluorescein angiography (UWFA) is instrumen- tal in assessing diabetic retinopathy, particularly in detecting peripheral neo- vascularization. Younger patients are at a higher risk of developing these pe- ripheral vascular changes, highlighting the need for early and comprehensive evaluation. M. Franca1,2, R. Félix1,2, C. Farinha1,2,3, R. Silva1,2,3, J.P. Marques1,2,3 1ULS Coimbra, Ophthalmology, Coimbra, Portugal, 2Clinical and Academic Centre of Coimbra, Coimbra, Portugal, 3Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal Purpose: To describe the clinical, genetic and imaging findings as well as natural progression of extensive macular atrophy with pseudodrusen-like ap- pearance (EMAP). Methods: We conducted a retrospective study, with patients diagnosed with EMAP in our center, identified using the IRD-PT registry. Data on best-cor- rected visual acuity (BCVA), genetic testing and multimodal imaging, with ul- tra-widefield color fundus photography, fundus autofluorescence (UWF-FAF) and spectral-domain optical coherence tomography (SD-OCT) were collected. Area of macular atrophy was measured manually using UWF-FAF, at baseline and at the last the follow-up. Results: We included 17 eyes from 9 patients (7 female), with a mean follow- up period of 29.44±10.14 months. Mean age was 65.44±8.63 years at baseline. Onset of decreased visual acuity was at 54.33±5.99 years. Genetic testing did not reveal clinically significant variants. Initial mean BCVA was 49.00±22.03 letters, with an average loss of 2.72±7.79 letters per year per eye. All patients showed bilateral and symmetric findings. Macular atrophy had a vertical configuration in 7/17 eyes. Atrophy borders were isofluorescent in 10/17 eyes and hyperfluorescent in 7/17 eyes. Six eyes from 3 patients exhibited foveal atrophy at baseline, while 4 eyes from two patients developed it during follow-up. The mean macular at- rophy area had an annual increase of 2.28±1.32 mm² per year. Pseudodrusen- like deposits were found in all eyes. Peripheral retinal degeneration manifested as retinal pigment epithelium (RPE) alterations in 8 eyes of 4 patients. SD-OCT revealed an onset of macu- lar atrophy in the superior quadrant in 7/17 eyes and complete outer retinal atrophy of the foveal area in 10/17 eyes at baseline developing in two more eyes during follow-up. Conclusion: EMAP is a progressive disease affecting the macula and periph- eral retina, with symptoms starting around 55 years, often misdiagnosed as age-related macular degeneration or macular dystrophies. FP01-8 Differentially expressed genes of human lens epithelial cells in different stages of diabetic retinopathy M. Bartolo Khodjayeva1, R. Farrugia2, J.P. Ebejer3, F. Mercieca1 1Mater Dei Hospital, Ophthalmology, Msida, Malta, 2University of Malta, Applied Biomedical Science Faculty of Health Sciences, Msida, Malta, 3University of Malta, Centre for Molecular Medicine and Biobanking, Msida, Malta Purpose: Diabetic retinopathy (DR) and cataract are leading causes of blind- ness. This study aims to identify differentially expressed genes (DEGs) in human lens epithelial cells across various stages of DR to elucidate disease mechanisms, identify biomarkers, and discover potential drug targets. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 5

FREE PAPER PRESENTATIONS Methods: A cross-sectional comparative transcriptomics study included 250 FP01-10 participants recruited from a cataract waiting list at a public hospital in Malta. Participants underwent physical examinations, ophthalmic assessments, and blood tests (e.g., full blood count, renal/liver function, glucose levels). Lens capsule samples were collected during cataract surgery from non-diabetic con- trols (G1) and patients with no DR (G2), non-proliferative DR (G3), diabetic macular oedema (G4), and proliferative DR (G5). RNA sequencing of 50 sam- ples (10 per group) was performed using the DNBSEQ platform, and GO and KEGG pathway analyses were conducted using the Dr. Tom bioinformatics system provided by the Beijing Genomics Institute (BGI). Results: A total of 4,436 DEGs were identified across all comparisons, includ- ing 1 downregulated DEG between G1 and G2, 2,972 DEGs (1,333 upregu- lated, 1,639 downregulated) between G1 and G3, 240 DEGs (123 upregulated, 117 downregulated) between G1 and G4, and 1,163 DEGs (490 upregulated, 673 downregulated) between G1 and G5. Bioinformatics analyses identified key DEGs and their associated pathways. Conclusion: This study identified DEGs across non-diabetic controls and various stages of DR, providing insights into the molecular mechanisms un- derlying diabetic cataract, non-DR cataract, and retinopathy. These findings highlight potential biomarkers and therapeutic targets for these conditions. FP01-9 Optical Coherence Tomography biomarkers as predictive factors for postoperative visual acuity in patients with epiretinal membrane treated by pars plans vitrectomy A. Veselinovic1, M. Veselinovic1 1Eye Clinic Veselinovic, Ophthalmology, Nis, Serbia Purpose: The purpose of this retrospective study was to evaluate potential predictive factors of postoperative visual outcome in patients with idiopathic epiretinal membrane (iERM) treated with pars plana vitrectomy (PPV). Methods: The study included 26 patients with a diagnosis of iERM operated on by the method of 23g pars plana microincision vitrectomy. Optical coher- ence tomography (OCT) biomarkers were taken as potential predictive factors for postoperative recovery of visual acuity. They were performed at the begin- ning (preoperatively) and in the 6th and 12th months after surgery. Myocardial ischemia-reperfusion induces retinal injury by promoting ferroptosis in photoreceptor cells X. Zuo1, H. Yu1 1Guangdong Provincial People’s Hospital, Southern Medical University, Guangzhou, China Purpose: Myocardial ischemia-reperfusion injury (MIRI) results in myocar- dial dysfunction and systemic injury, yet its effects on retinal health remain unclear. Method: A MIRI mouse model was established by ligating the left anterior descending artery for 1 hour, followed by reperfusion. Cardiac injury was as- sessed through echocardiography and histological analysis of myocardial tis- sue. Retinal changes were examined using fundus photography, fluorescein angiography (FFA), retinal thickness measurements, and electroretinography (ERG). Cell death was evaluated using TUNEL staining. Single-cell RNA se- quencing was performed to identify retinal cell populations and pathways, and non-targeted metabolomics explored mechanisms linking myocardial and retinal damage. Results: At 24 hours post-MIRI, left ventricular ejection fraction (LVEF) sig- nificantly decreased, with marked neutrophil infiltration in the left ventricular anterior wall. While fundus photography and FFA detected no retinal abnor- malities, ERG revealed significant reductions in a- and b-wave amplitudes at 2 and 6 hours post-MIRI, reflecting dysfunction of photoreceptor and bipolar cells. HE staining showed notable thinning of the ganglion cell layer (GCL) and inner nuclear layer (INL) at 2, 6, and 30 hours, indicating acute retinal is- chemia. Increased cell death, primarily in the INL, was confirmed by TUNEL staining. Preliminary single-cell RNA sequencing data demonstrated a reduc- tion in photoreceptor cells and activation of ferroptosis pathways. Ongoing metabolomics analysis aims to elucidate the mechanisms driving myocardial- retinal injury interplay. Conclusion: MIRI induces significant retinal dysfunction and structural dam- age, including photoreceptor ferroptosis, retinal ischemia, and bipolar cell apoptosis. Single-cell RNA sequencing highlights ferroptosis activation as a critical mechanism, suggesting that MIRI exerts systemic effects on retinal health through inflammation and oxidative stress. Results: It was determined that increasing age, retinal thickness, the pres- ence of disorganization of the inner retinal layers, ellipsoidal zone disorder, FP01-11 and the presence of vitreomacular traction were negatively associated with postoperative visual acuity. Gender, presence of subretinal fluid, cysts in the inner or outer nuclear layer, and hyperreflective foci were not found to affect visual acuity. There was a statistically significant improvement in visual acu- ity and central retinal thickness between baseline and months 6 and 12 in the study sample. Conclusion: It is important to determine predictive factors for visual out- come, in order to inform patients about the prognosis and help in making deci- sions about patient treatment. Laser photodisruption therapy of the retinal pigment epithelium for refractory pigment epithelial detachment Y. Yang1,2, J.Y. Ha1 1Wonkwang Univ. Hospital, Ophthalmology, Iksan, Korea, Republic of, 2Onnuri Eye Hospital, Retina Center, Jeonju, Korea, Republic of Purpose: To evaluate the efficacy of the retinal pigment epithelium (RPE) Laser photodisruption for refractory pigment epithelium detachment (PED) Methods: This retrospective case series involved nine patients with large lonstanding PED who did not respond to multiple intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. They later underwent la- ser photodisruption, which targeted the RPE in the PED’s peripheral area to induce a controlled mechanical opening and drain the sub-RPE fluid. All pa- tients were examined at 0, 1, 2, 4, and 6 months after RPE photodisruption. 6 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

Patient information, including age, sex, comorbidities, PED type and duration, and history of anti-VEGF treatment, was collected. Baseline and follow-up examinations included best-corrected visual acuity measured using a Snellen chart and optical computed tomography measurement, including height, hori- zontal and vertical dimensions, and volume of PED. Results: The study included nine patients (seven men and two women) with an average age of 73.16 ± 6.28 years. Treatment response differed accord- ing to the PED type. Seven patients with serous PED exhibited PED reso- lution in 2.00 ± 1.10 (1-4) months following RPE photodisruption. Average logMAR visual acuity improved from baseline 0.42 to 0.24 at 6 months after laser. However, two patients with fibrovascular PED demonstrated an initial decrease in PED after laser but complete PED resolution was not achieved during the 6 month follow-up period. No significant change in visual acuity of this group was noted before and after laser treatment following laser at 6 months, respectively. Conclusion: Photodisruption can rapidly resolve PED and improve visual acuity in patients with serous PED. Although likely effective only in patients with serous PED, PRE photodisruption could be considered a viable option for patients with intractable PED despite multiple anti-VEGF injections, po- tentially preventing further vision loss and complications. FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 2: Education, Oncology & Pathology FP02-2 A novel multimodal large language model for interpreting image-based ophthalmology case questions: comparative analysis of multiple-choice and open-ended response P. Kiyat1, H.G. Kahraman1 1İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, Ophthalmology, İzmir, Turkey Purpose: To evaluate and comprehensively assess the diagnostic and inter- pretative capabilities of Claude 3.5 Sonnet, an advanced large language model (LLM), in complex ophthalmological assessments across diverse subspecial- ties and question modalities, with particular emphasis on its potential implica- tions for medical education applications. Methods: The investigation encompassed an analysis of 168 standardized ophthalmological cases derived from board examination materials, compris- ing 100 multiple-choice questions (MCQs) and 68 open-ended assessments. Cases were meticulously stratified across three distinct domains: retina/uvei- tis, external eye/cornea, and orbit/oculoplastics. Performance metrics were systematically evaluated utilizing standardized scoring criteria aligned with contemporary practice guidelines. Results: Claude 3.5 Sonnet exhibited exceptional performance with a remark- able 88% accuracy rate in MCQs and highly concordant results in open-end- ed assessments (88.2% diagnostic accuracy, 87.1% management accuracy). Detailed subspecialty analysis revealed notable performance heterogeneity, with superior accuracy demonstrated in external eye and cornea cases (92.5% MCQ, 92.8% open-ended) compared to retina and uveitis cases (83.3% MCQ, 88% open-ended). Conclusions: This investigation demonstrates Claude 3.5 Sonnet’s strong pro- ficiency in interpreting complex ophthalmological imagery and providing de- tailed clinical assessments, with notably high performance in anterior segment pathologies. These findings indicate significant potential for ophthalmological education, while appropriately acknowledging the need for thorough clinical validation. The study provides compelling evidence supporting the integration of LLMs in ophthalmological training frameworks, contingent upon further evaluation across diverse clinical settings. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 7

Conclusion: CEUS can significantly improve the diagnostic accuracy of choroidal space-occupying lesions, providing important reference value for clinical practice and demonstrating a high safety profile. FP02-5 Pattern of locoregional recurrence in carcinoma of ophthalmic sites: primary cancer and invading tumor from adjacent region A. Berpan1 1Vajira Hospital, Bangkok, Thailand Purpose: To evaluate locoregional recurrence (LRR) in patients (pts) treated with definitive local treatment. Methods: Data of pts with carcinoma of ophthalmic sites together with nasal cavity (N) and paranasal sinuses (PNS) with ophthalmic involvement were retrospectively collected, including age, sex, performance status, smoking his- tory, tumor location, pathology, primary tumor status, nodal status, treatment and LRR. Frequency of each recurrence was evaluated. Results: 17 pts with ophthalmic cancer were identified with median follow-up (mFU) of 3.5 years. Most originated from eyelid (64.7%), followed by globe and lacrimal gland, each at 17.6%. Sebaceous carcinoma was found the most (35.3%), followed by squamous cell carcinoma (SCC) (29.4%) and adenoid cystic carcinoma (11.8%). T1 and T4 were found equally (41.2%). 23.5% had nodal involvement, specifically within parotid group. All pts underwent surgery, including exenteration (EX) (n=6). Radiotherapy (RT) was given in 7 pts. Local recurrence (LR) developed in 2 pts, both with SCC who underwent EX without postoperative RT (PORT). Regional recur- rence (RR) occurred at 17.6%. None had LR and RR together. 19 pts with PNS were identified including cancer of maxillary sinus (n=9), ethmoid sinus (E) (n=7) and N (n=6) with mFU of 8.4 months. SCC was found in 73.7%. None had parotid metastasis. Of the 5 pts who underwent surgery, 3 pts re- quired EX. 17 pts received RT. Orbital recurrence was found in 2 out of 5 pts who developed LR, both with E SCC. One underwent EX without PORT (the other 2 received PORT). The other received definitive RT. RR occurred in 3 pts. One of which had LR without orbital recurrence. Conclusions: Patients requiring EX probably need PORT to minimize LR. FREE PAPER PRESENTATIONS FP02-3 The incidence of uveal melanoma in New Zealand J. Lim1, A. Gokul1, S. Misra1, C. McGhee1 1University of Auckland, Ophthalmology, Auckland, New Zealand Purpose: To determine the incidence and disease pattern of uveal melanoma in New Zealand. Method: A retrospective review of all uveal melanoma patients who received treatment with or without histological diagnosis between 2000 and 2020 inclu- sive was conducted using information from the NZ Cancer Registry, the NZ Cancer Control Agency and Auckland District Health Board, NZ. Results: 998 patients with uveal melanoma were identified. Patients identi- fied as European (n=949, 95.1%), Māori (n=32, 3.2%), Asian (n=7. 0.7%), Pacific Peoples (n=3, 0.3%) and remaining not stated (n=7. 0.7%). Mean age at diagnosis was 63.4±14.3 years. When compared to non-Europeans (Māori, Pacific Peoples and Asian), Europeans had a statistically higher mean age at diagnosis by 4.2 years (95% CI: 0.4–8.0 years, p=0.03). The crude and age- adjusted incidence was 11.5 and 8.2 cases per million population, with higher incidences in rural regions and regions further from the equator. Overall incidence was stable (0.05, 95%CI -0.18 to 0.28, p=0.556). Joinpoint analysis indicated stable disease until year 2013 where an average annual de- crease in incidence rate of 0.63 per million (95%CI -1.03 to -0.23; p = 0.005) was detected. Conclusions: NZ has the highest incidence of uveal melanoma in the Southern Hemisphere and comparable rates to countries with the highest incidence of uveal melanoma in the Northern Hemisphere (Nordic countries). There was a statistically significant higher incidence of uveal melanoma in NZ regions at higher latitudes from the equator. FP02-4 The role and clinical value of contrast-enhanced ultrasound in the diagnosis of choroidal space- occupying lesions W. Jiang1 1Xi’an Fourth Hospital (Xi’an People’s Hospital), Xi’an, China This study aims to evaluate the role and clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of choroidal space-occupying lesions. Methods: A total of 120 patients with choroidal space-occupying lesions who underwent CEUS at Xi’an People’s Hospital (Xi’an Fourth Hospital) from June 2020 to January 2024 were selected. Based on the final clinical and path- ological diagnoses, patients were divided into three groups: benign (choroidal hemangioma), malignant (choroidal melanoma), and hemorrhage (subchoroi- dal hemorrhage), with 40 cases in each group. The characteristics of CEUS, contrast parameters (such as time to fill, time to peak, and washout time), and the incidence of adverse reactions were analyzed to evaluate the diagnostic efficacy. Results: The benign group showed homogeneous high perfusion, present- ing a „fast in slow out“ perfusion mode. The malignant group predominantly showed heterogeneous high perfusion, presenting a “fast in fast out” perfusion mode. The hemorrhage group showed no significant perfusion, presenting a “no in and out” perfusion mode. Significant differences were found in the CEUS characteristics and parameters among the three groups, while there was no significant difference in the incidence of adverse reactions. 8 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP02-6 High-dose-rate yttrium-90 (Y-90) brachytherapy for eye tumors E. Semenova1, A. Maniar2, A. Haider3, B. Sterren1, M. Materin2, K. Rosenzweig4, J. Chino5, S. Meltsner5, R.K. Cleary6, P.T. Finger7 1Mount Sinai, Ophthalmology, New York, United States, 2Duke Eye Center, Ophthalmology, Durham, United States, 3Southeastern Retina Associates, Ophthalmology, Chattanooga, United States, 4Mount Sinai, Radiation Oncology, New York, United States, 5Duke University, Radiation Oncology, Durham, United States, 6Erlanger Radiation Oncology, Radiation Oncology, Chattanooga, United States, 7The New York Eye Cancer Center, Ophthalmology, New York, United States Purpose: To describe the use of high-dose-rate (HDR), yttrium-90 (Y-90) plaque brachytherapy for treating eye tumors. Results: The age was 1~89 years old and average age was 59 years, the male- to-female ratio was about 2:1฀mainly occurring in the orbit, conjunctiva, lac- rimal gland and eyelids. The patients are accompanied by symptoms such as eyelid conjunctival swelling, proptosis, ocular motility disorder or visual field loss, and the imaging manifestations are irregular soft tissue density shadows at the ocular appendage site, which can form obvious nodules and destroy the surrounding tissues ฀including 4 cases of nasal sinuses, 4 cases of maxillary sinuses and 6 cases of invasion of surrounding bone tissue. The pathological characteristics of diffuse neoplastic lymphocyte proliferation as the main manifestation, cell morphology from mature small lymphocytes to large cells and even anaplastic tumor cells can be seen, all types of lymphoma are the same as other lymphoma tissue structure, accompanied by correspond- ing molecular changes. All patients underwent mass resection, and some pa- tients were followed by chemoradiotherapy. Conclusion: OAL occurs in the orbit, conjunctiva, lacrimal gland and eye- lids, accounting for only 1%~2% of non-Hodgkin lymphoma and 5%~15% of extranodal lymphoma, but it is a common malignant tumor of ocular ap- pendage. As a group of heterogeneous tumors, indolent low-grade lymphoma Method: We describe three cases of iris melanoma, three ciliary body mela- is more common, and there is no lack of high-grade aggressive lymphoma, with diverse clinical manifestations and pathological tissue morphology, often requiring immunohistochemistry and molecular testing to assist in diagnosis. noma, one choroidal metastatic tumor, and three conjunctival squamous car- cinomas treated with Y-90 plaque brachytherapy. For posterior segment tu- mors, the Y-90 disc was affixed within an iWand P handheld applicator, whose function includes 4 disc-surrounding lights to guide the disc into position and ensure tumor targeting. Tumor basal diameter varied from 2.7 to 6 mm and tumor thickness was 0.7 to 2.4 mm. Apical tumor dose ranged from 25 to 30 Gy, and the sclera received between 76.5 to 125.7 Gy. Radiation treatment durations varied between 2 min and 16 seconds to 12 min and 50 seconds. Results: All patients responded with complete tumor resolution (3) or a de- crease in tumor size (7). There were no cases of treatment failure, tumor recur- rence, or insufficient response after a mean of 12.2 months of post-treatment observation (range 1.5 - 24 months). There were no acute or medium-term complications (including corneal edema, keratopathy, iridocyclitis, scleropa- thy, cataract, radiation retinopathy, or radiation optic neuropathy). Conclusion: Single-session, high-dose-rate Y-90 brachytherapy has proven to be an effective tool for treating anterior and posterior eye tumors (includ- ing melanoma, metastatic tumors, and squamous cell carcinoma). In a single, minimally invasive, minutes-long treatment, tumors can be treated without the need for a radioactive device sewn to the eye for several days. Radiation safety was improved by eliminating LDR-implant-related post-operative radiation exposure to health care personnel, the community, family, and pets. FP02-7 Analysis of clinical and pathological characteristics of 206 cases of primary ocular adnexal lymphoma H. Liu1,2, F.-m. Cai2, T. Lei2 1Shaanxi Provincial Eye Hospital, Pathology, Xi’an, China, 2Xi’an People’s Hospital (Xi’an Fourth Hospital), People’s Hospital Affiliated to Northwest University, Xi’an, China Objective: To investigate the clinical and pathological features of primary ocular adnexal lymphoma (OAL). Methods: A total of 206 OAL cases diagnosed from 2014 to 2024 were col- lected, including 148 cases of EZML, 22 cases of LBCL, 9 cases of FL, 9 cases of MCL, 7 cases of NKTCL, 7 cases of PCN, 2 cases of SLL, 1 case of PBL and 1 case of LBL. The clinical manifestations, imaging features and pathological characteristics of each case were collected. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 9

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 3: Cataract, Refractive Surgery FP03-1 A comparative validation study of near visual acuity assessment methods using different handheld acuity charts D. Chen1, L. Shen2, Y.-C. Tham2, S.-P. Chee1,3 1National University Hospital, Department of Ophthalmology, Singapore, Singapore, 2National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore, 3Singapore National Eye Centre, Singapore, Singapore FP03-2 Extended depth of focus intraocular lens implantation in patients with age-related macular degeneration P. Smahliou1, V. Mela1 1Smahliou Eye Clinic, Athens, Greece Purpose: To evaluate the visual performance of an extended depth of focus (EDOF) intraocular lens (IOL) in patients with age-related macular degenera- tion (AMD). Methods: This prospective study included 36 eyes (18 patients), who had a history of dry AMD and secondary underwent bilateral cataract surgery in- volving implantation of a non-diffractive EDOF IOL, called Vivity (Alcon Laboratories, USA). According to Beckman clinical classification for AMD, 10 eyes (28%) had early, 20 (56%) had intermediate and 6 (16%) had late stage of AMD. Purpose: To develop a conversion table and compare the cross validity of Data collected included patient demographics, corrected distance visual acu- three types of widely utilised near vision charts: the ETDRS near chart, the N-notation chart, and the Rosenbaum chart. Method: This was a prospective, cross-sectional, comparative validation ity (CDVA) and corrected near visual acuity (CNVA). Patients’ satisfaction, spectacle dependence and side effects reporting were evaluated with a self- reported questionnaire, given 3 weeks after surgery. Patients had a 2-year study. A conversion table for the three types of near charts was created using follow-up period postoperatively. objective character sizing based on vertical height captured using a surgical microscope with a 10x magnification. Eligible presbyopic patients were re- cruited from a tertiary eye clinic and had their near vision tested sequentially with three near charts in a randomised order. Pearson’s correlation coefficient (r) and Spearman’s rank correlation coeffi- cient (ρ) were calculated for the relationship among the near visual acuity charts based on the subjects’ performances. The consistency between the dif- ferent charts were evaluated by Bland-Altman diagrams. Results: A total of 204 subjects (129 females, 63.2%) were recruited for the study (mean age, 58.9 ± 7.1 years). The median spherical equivalent refrac- tion was -0.50 D (range: -6.50 D to +3.50 D). For correlation, r ranged from 0.596 to 0.836 (all p < 0.001) while the corresponding ρ ranged from 0.670 to 0.830 (all p < 0.001). The Rosenbaum chart had the smallest range of differ- ence against the ETDRS chart (standard deviation [SD] = 0.12), followed by Results: Patients’ mean age was 72.33±7.15 years (56% male). Mean preop- erative CDVA was 0.32±0.20 logMAR. Postoperative monocular CDVA and CNVA were 0.22±0.17 logMAR and 0.27±0.20 logMAR respectively. Eyes in early AMD stage had better visual performance in both distance and near visu- al acuity, compared to intermediate and late AMD stages. A standardized self- reported questionnaire for visual performance after cataract surgery revealed improvement in everyday activities 3 weeks postoperatively in all patients. Most of patients (83%, 30 eyes) did not report significant visual impairment due to dysphotopsia in their everyday life. 89% (32 eyes) were satisfied with their degree of spectacle independence. Conclusions: Patients with AMD who were implanted the EDOF Acrysof Vivity IOL demonstrated intermediate as well as near vision improvement, compared to distance vision. This non-diffractive EDOF IOL may be a prom- ising tool for patients with AMD. It provides a range of spectacle independ- N-notation chart (SD = 0.15). ence and maintenance of every-day life activities. Most of the converted logMAR values from the N-notation and Rosenbaum charts were between 0.0 to 0.1 higher than the ETDRS logMAR equivalent (range 0.07 to 0.11), with a tendency for both the N-notation and Rosenbaum charts to overestimate logMAR at more positive values. FP03-3 Conclusion: We have developed a convenient conversion table for three types of commonly used near vision charts. Compared to the ETDRS near chart, the Rosenbaum chart had a smaller range of difference than the N-notation chart. Both the Rosenbaum and N-notation charts tended to overestimate near vision at more positive logMAR values. Metabolic changes in aqueous humor and prognostic implications in diabetic retinopathy patients undergoing cataract surgery with intravitreal anti-VEGF therapy Y. Shi1, J. Yang1, Y. Lu1 1Eye & ENT Hospital of Fudan University, Ophthalmology, Shanghai, China Purpose: To explore changes in aqueous humor (AH) metabolites and their prognostic implications in non-proliferative diabetic retinopathy (NPDR) pa- tients undergoing cataract surgery (CS) with simultaneous intravitreal anti- VEGF injection. Methods: A randomized controlled trial with 48 eyes divided into experimen- tal (CS with intravitreal Conbercept) and control (CS alone) groups. AH sam- ples were collected intraoperatively and one week postoperatively. Ophthalmic examinations were performed at various intervals postoperatively. 10 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Results: There was no significant difference in the control group’s overall changes of AH metabolites pre-and postoperatively. However, significant changes were observed in the experimental group, with alpha-ketoglutaric A much higher rate of complications occurred in PEX patients when compar- ing with normal controls. Other surgical aspects, such as zonular instability, may be of higher value to the assistant surgeon in predicting intraoperative acid, acetylcarnitine, gamma-aminobutyric acid (GABA), glutamate, and hy- complications. droxybenzoic acid showing the most important changes. Pathway enrichment analysis using the Small Molecule Pathway Database (SMPDB) revealed that differential metabolites were mainly associated with the Malate-Aspartate Shuttle, Glucose-Alanine Cycle, Alanine Metabolism, FP03-5 and Ammonia Recycling pathways. Samples were categorized into good prognosis (GP) and poor prognosis (PP) groups based on follow-up best-corrected visual acuity (BCVA) and central subfield thickness (CST) as outcome indicators. Random forest, support vec- tor machine, and Boruta analysis were employed to assess the predictive abil- ity of metabolites for prognosis. Results indicated that 4-Hydroxybenzoic acid, Aminocaproic acid, and xylose exhibited the highest predictive capability. Conclusion: AH metabolite levels remain relatively stable post-CS, but intra- operative anti-VEGF alters its profile. Changes in metabolite levels are associ- ated with prognosis, highlighting the feasibility and necessity of personalized preventive measures for potential post-cataract macular edema (PCME). FP03-4 Cortical stimulation using Gabor patches improves vision and contrast sensitivity in dissatisfied patients with MF-IOLs: results of RCT L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cataract Services, Tirunelveli, India Purpose: To evaluate patient-specific, computer-based perceptual visual ther- apy (PL) regime using Gabor patches for improving vision & contrast sensi- tivity function(CSF) in patients not satisfied after multifocal IOL (MF-IOL) implantations. Setting: A prospective, controlled-randomized, open-label study. Methods: Adults (50-80 yrs) with uneventful MF-IOL implantation, 4-24 weeks post-surgery, BCVA worse than 20/40 with sub-optimal Contrast Sensitivity, complaining about vision quality were randomized in 2:1 ratio Comparison of biometric characteristics of patients with pseudoexfoliation and normal controls and its relationship with cataract surgery complications into treatment(G1), in which computer-based perceptual therapy using Gabor patches amidst co linear flankers was employed and control(G2) arms. The study had 2 phases (screening + therapy periods(PL). Mid-training (Post 20 sessions), 40 training sessions, and post-therapy follow-up by 6 months were evaluated for improvements in BCVA distance & near (ETDRS) & CSF at spatial frequencies of 3, 6,12,18 CPD using Friedman tests for repeated meas- ures. Results: 30 cases were randomized in a 2:1 ratio into treatment and control arms. 16 Trifocals(PanOptix), 14 Bifocals(Tecnis). The average improvement after treatment is 2.5 lines in LogMar in the Treatment arm (p<0.0001), where- as no significant improvements among the controls. 83% Improvement in Contrast Sensitivity (CSF at 3,6,12 & 18 CPD) was observed in the Treatment Group(G1, p<0.0001) whereas no significant improvements amongst the con- trols using Friedman repeated measure tests. Conclusion: Sequential, patient-specific, cortical stimulation improved vision & contrast (CSF) in dissatisfied MF-IOL patients with visual deficiencies & acts as proof of concept of improving neural connections at cortical levels. Phaco surgeons could consider it as a post-operative therapeutic adjuvant, in MF-IOL with visual deficiencies & reduced contrast. J. Castro Cabanas1, D. Ferreira Cardoso1, C. Ferreira1, P. Sepúlveda1, D. Meira1, F. Sousa Neves1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal Purpose: To analyse the biometric differences between PEX and normal con- trols and its relationship with intraoperative complications. Methods: Observational cohort of 79 eyes of 79 PEX patients subjected to cataract surgery at our care centre. Patients underwent a complete ophthal- mological evaluation prior to surgery, and the presence of exfoliative material as well as other ocular comorbidities were recorded. All underwent biometric evaluation and data regarding anterior chamber depth (ACD), axial length (AL), lens thickness (LT), central corneal thickness (CCT) and white-to- white (WTW) and keratometric values were recorded. Intraoperative evalua- tion comprised the observed complications and measurement of dilated pupil size. Collected data was compared with a 1:2 age and gender matched control group. Results: Mean age of PEX patients was 76 years; 58% were female. Mean AL (23,1 mm), keratometry (44,5 D), CCT (541 µm) and WTW (11,7mm) were similar between PEX and controls; LT was higher in PEX group (4,76 vs 4,64, p=0,04). Mean ACD (3,03) and the number of patients with shal- low (<2,5mm) chambers were comparable among the PEX and control groups (11,4 vs 8,2%, p=0,63). The PEX group had a higher rate of abnormal pupil dilation (28 vs 2%). PEX patients had a higher rate intraoperative complications (22%), when comparing with controls (4%, p<0,01). Logistic regression analysis showed that pupil size and biometric parameters were not associated with an increased risk of complications, after controlling for PEX. Conclusion: Our report shows that there isn’t a relevant clinical change in biometry parameters associated with PEX, and that neither inter-patient biom- etric variability nor pupil size seem to impact the surgical outcome. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 11

FREE PAPER PRESENTATIONS FP03-6 Comparative analysis of refractive and visual outcomes: anterior optic capture vs sulcus implanted IOL I. Onal1, Y.B. Akbas1, B. Akgul1, F.O. Aydin1, A. Ceylan1, Y. Yildirim2 1University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Ophthalmology, Istanbul, Turkey, 2Medipol Acıbadem University, Faculty of Medicine, Ophthalmology, Istanbul, Turkey Purpose:To compare IOLs placed in the sulcus with those placed using op- tic capture during cataract surgery complicated by posterior capsular rupture (PCR) and to evaluate refractive and clinical outcomes. Method:A total of 80 eyes were included.Patients who experienced PCR were divided into two groups: the optic capture group (Group 1, n=39) and the sul- cus group (Group 2, n=41).In the optic capture method, IOL haptics were po- Results: Twenty-eight eyes with congenital cataract underwent LenSx fem- tosecond laser-assisted cataract surgery. Capsulorhexis was successfully per- formed in all cases without intraoperative complications. The diameter of cap- sulorhexis is controllable and negatively correlated with the age of patients. Conclusions: At present, most children with congenital cataract are treated by surgery, and the vision of most children is recovered well, but there are still some complications. How to adopt surgical methods, improve the postopera- tive vision have become the focus of clinical research. The key step in the sur- gical treatment of congenital cataract is the achievement of a continuous cur- vilinear capsulorhexis (CCC). Due to the toughness of the capsule in children, traditional manual capsulorhexis is difficult, which is easy to cause eccentric capsulorhexis, irregular side shape, and tear the capsule. On the one hand, it increases the difficulty of cutting the posterior capsule during the operation, on the other hand, it makes the intraocular lens shift, or it is impossible to implant the intraocular lens into the capsule pocket, which affects the postoperative visual quality of children. Femtosecond laser-assisted capsulorhexis was used in this study, and there was no complication of capsulorhexis. The operation sitioned in the sulcus, while the optic was captured under the anterior capsular is safe and reliable. opening. Postoperatively, BCVA, spherical and cylindrical refraction, spheri- cal equivalent (SE), anterior chamber depth (ACD), IOL position, lens rise, and higher-order aberrations (HOAs) were recorded.Postoperative complica- tions such as IOL dislocation were also documented. A 6-item dysphotopsia questionnaire assessed positive (PD) and negative dysphotopsia (ND). Results:There was no significant differences in age or follow-up duration be- tween the groups.Postoperative SE was -0.30 ± 0.75 in Group 1 and -0.62 ± 1.02 in Group 2, with Group 2 exhibited slightly more myopic outcomes, though not statistically significant (p=0.166).RMS values of HOAs at 4 mm also showed no significant differences (p=0.969). While preoperative ACD was similar between the groups (p=0.516), postoperative ACD was signifi- cantly higher in Group 1 than in Group 2 (p<0.001). Lens rise was similar between the two groups (p=0.519).Postoperative complications occurred in 3 (7.6%) patients in Group 1 and 9 (21.9%) in Group 2, a statistically significant difference (p=0.036).In the dysphotopsia evaluation excluding patients with complications, no significant differences were observed between the groups for PD and ND (p=0.094; p=0.128). Conclusion: IOLs placed in the sulcus with or without optic capture after PCR demonstrated similar refractive outcomes.However, the sulcus group had a higher risk of postoperative complications.While no significant differences in PD and ND were observed between groups. FP03-7 To evaluate the effect of femtosecond laser-assisted cataract surgery in congenital cataract Y. Zeng1 1Lixiang Eye Hospital of Soochow University, Suzhou, China Purpose: To evaluate the efficacy of femtosecond laser in the treatment of congenital cataract. Methods: A total of 24 patients (28 eyes) with congenital cataract were col- lected from Lixiang Eye Hospital of Soochow University. After routine preop- erative examinations , the patient was under general anesthesia,femtosecond laser was employed for anterior capsulotomy and corneal incision. Phacoemulsification was then carried out. Posterior capsulotomy and anterior vitrectomy were performed in patients under 6 years of age or with mental re- FP03-8 IOL power calculation in fuchs endothelial distrophy after descemet stripping without endothelial keratoplasty R. Mocho1, B.B. Ribeiro1, M. Neves1, M. Gomes1, L. Oliveira1 1Unidade Local de Saúde Santo António, Department of Opthalmology, Porto, Portugal Purpose: To compare the accuracy of 11 intraocular (IOL) power calculation formulas in refractive outcomes after uneventful combined cataract surgery and Descemet stripping Without Endothelial Keratoplasty (PHACO/DWEK) in patients with Fuchs Endothelial Corneal Dystrophy (FECD). Materials and methods: Retrospective analysis of patients submitted to un- eventful combined cataract and DWEK surgery at the Cornea Unit of a tertiary hospital between January 2017 and December 2024. Prediction error (PE) was calculated as the difference between the subjective refraction spherical equiv- alent (SE) and the target SE of each formula. Absolute error (AE) was the absolute value of the PE. Patients submitted to previous intraocular surgery, with reported intraoperative complications, and other ocular pathologies were excluded from this analysis. Results and discussion: We enrolled 26 eyes of 15 patients with a mean age of 68.3 + 9.1 years. All formulas showed a consistent hyperopic PE. The Hoffer QST exhibited lowest mean AE (MAE, 0.42 ± 0.48 Diopters [D]), followed by the EVO formula (0.43 ± 0.48 D) with no significant difference among each (p=0.667). Comparing with the best formula, MAE was significantly higher in the Holladay 1 (0.48 ± 0.49 D, p=0.013), Barrett Universal II (0.51 ± 0.50 D, p=0.012), and Hill-RBF (0.52 ± 0.52 D, p=0.003). The Hoffer QST and EVO formulas showed the largest proportion of eyes within a mean PE of ± 0.25 D (42.30% for both, respectively), and the Hoffer QST and Hoffer Q enrolled most eyes within ± 0.50 D (69.20% for both, respectively). Conclusion: All formulas display a consistent hyperopic error in patients with FECD. Hoffer QST and EVO seem to minimize this bias and improve accuracy. However, older formulas like the Hoffer Q still demonstrate good efficacy. Since there are few eyes undergoing PHACO/DWEK, larger sam- ples and multicentric studies are paramount to increase evidence and improve tardation. The foldable IOL was injected into the capsular pocket. The corneal patient satisfaction and refractive outcomes. incision was watertight. 12 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Purpose: The aim of this study is to compare static and dynamic pupillometry using different devices: Pentacam (Oculus) and Myah (Topcon Healthcare), respectively. Methods: 20 eyes were included. Pupil diameter was measured using the Pentacam and the Myah. For statistical purposes only scotopic environment data were selected for analyses. Differences between two devices were as- sessed. p<0.005 was considered statistically significant. Results and Discussion: Pentacam measurements yielded a mean pupil di- ameter of 2.57 mm (SD = 0.86 mm), while Myah measurements yielded a mean of 2.54 mm (SD = 0.93 mm). A paired t-test revealed no statistically sig- nificant difference between the two devices (t = 0.16, p = 0.87). These results seems to illustrate that both Pentacam and Myah devices provide comparable pupil diameter measurements under scotopic conditions. Conclusion: Scotopic static pupillometry seems to be in line with dynamic pupillometry. The absence of statistically significant differences in pupil di- ameter measurements between Pentacam and Myah devices suggests that both devices could be reliable for clinical use for scotopic pupillary evaluation. These results highlight the reliability of Pentacam data and support its use in preoperative refractive surgery evaluation. FP03-9 Comparison of visual and refractive outcomes of laser in situ keratomileusis (LASIK) surgery in mild and moderate myopes with flat and steep keratometry E. Coskun1, M. Simsek1, N. Kandemir Besek1, S. Ahmet1, G. Yalcinkaya Cakir1, A. Kirgiz1 1Beyoglu Eye Traning and Research Hospital, Istanbul, Turkey Purpose: To compare the visual,refractive outcomes and higher-order aberrations(HOAs) of laser in situ keratomileusis (LASIK) surgery in mild to moderate myopic patients with flat and steep keratometry. Method: In this retrospective cohort study,moderate myopic eyes that un- derwent LASIK between 2019-2024 were analyzed and categorized into 3 groups based on keratometric values.Group 1 comprised eyes with flat cor- neas (K2<42 diopters(D)),Group 2 included eyes with steep corneas (K2≥46 D),and Group 3,serving as the control group,consisted of eyes with keratom- etry values between 42 to 46 D. Preoperative and postoperative 6th month un- corrected and best corrected visual acuity(UCVA,BCVA-logMAR),spherical and cylindrical values,efficacy index(EI) and safety index(SI), keratometry values (K1, K2, Kmax), corneal HOAs (total HOA,coma,trefoil, spherical aberration and secondary astigmatism) at 4mm and 6mm pupil diameter and changes in HOAs(Δ) were evaluated. Results: The study included 34 eyes from each of the 3 groups.Postoperative UCVA (Group1:0.02±0.05 Group2:0.009±0.03 Group3:0.01±0.03) and BCVA (Group1:0.009±0.02 Group2:0.003±0.01 Group3:0.002±0.01) was similar in all groups(p=0.12 p=0.18 respectively). There was no difference in postoperative spherical and cylindrical values(p=0.22 p=0.56,respectively),EI and SI values(p=0.17 p=0.14,respectively).There was no difference between groups in K1,K2 and Kmax (p=0.20 p=0.10 p=0.48,respectively). In terms of corneal HOAs, a significant difference was found between groups in 6mm pupil diameter ΔHOA(Group1:0.28±0.13 Group2:0.11±0.12 Group3:0.15±0.18)(p=0.01). Also,there was a significant difference be- tween groups in trefoil aberration (Group1:0.05±0.08 Group2:-0.08±0.14 Group3:0.001±0.10)(p=0.008). Conclusion: In myopic patients with flat or steep keratometry values,LASIK was demonstrated to be effective and safe.However,eyes with flat keratometry exhibited increased postoperative total HOAs and trefoil,which may adversely impact visual quality. FP03-10 Agreement analysis between static and dynamic pupillometry using different devices M. Vaz1, I. Mendo1, J. Vaz1, A. Miranda1, G. Agudo1, N. Campos1, I. Machado1, F. Moraes1, T. Loureiro1 1HGO, Almada, Portugal Introduction: Pupillary evaluation plays an important role in ophthalmol- ogy, mainly in preoperative evaluation of candidates for refractive surgery. Different devices are commonly used, some providing static and others pro- viding dynamic analyzes which are not always in agreement. The aim of this study is to compare static and dynamic pupillometry using different devices: Pentacam (Oculus) and Myah (Topcon Healthcare), respectively. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 13

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 4: SOE Lecturers, Neuro-ophthalmology FP04-1 Retinal and choroidal vascular changes and genetic markers and their relation to ischemic heart disease I. Matulevičiūtė1 1Lithuanian University of Health Sciences, Department of Ophthalmology, Kaunas, Lithuania Results: As of January 2025, the IRD-PT registry has enrolled 1896 patients from 8 different HCP. According to the IRD-PT survey, there are approxi- mately 3210 patients living with an IRD in the country, meaning that 59% of cases have already been enrolled. With this wealth of data, we conducted landmark studies to describe the genetic architecture of IRDs in the country, map the districts with higher prevalence of patients and assess the socioeco- nomic impact of IRDs. Finally, we developed national guidelines for genetic testing in IRD aiming for an equitable access to genetic testing and genetic counseling in the country. Conclusion: Rare disease registries increase research accessibility for pa- tients, while providing clinicians/investigators with a coherent data ecosystem necessary to boost research and patient care. Since IRD incidence rates are low, national collaborations are the first step to get an overview of cohort sizes, genetic landscape, and the matching clinical features. Purpose: To evaluate retinal and choroidal thickness, rertinal vascular param- eters, genetic profile and their relations with ischemic heart disease. Methods: 202 patients were included in the study and divided into groups according to the results of coronary angiography: control group, myocardial FP04-3 infarction (MI) group, three vessel disease (3VD) group. Optical coherence Atypical vas occlusions P. Genchovski1 1Military Medical Academy of Sofia, Ophtalmology, Sofia, Bulgaria Urgencies in ophthalmology encompass a spectrum of critical eye conditions that demand immediate medical attention to prevent irreversible vision loss and potential life-threatening complications. These urgent ophthalmic emergencies can range from vascular occlusions, acute glaucoma and retinal detachments to corneal abrasions, intraocular for- eign bodies all of which require prompt diagnosis and intervention to preserve ocular health and function. Recognizing the signs and symptoms of these urgent ophthalmic conditions is crucial for timely management and optimal outcomes. Vascular occlusions in ophthalmology represent a significant subset of ocular disorders characterized by the blockage of blood vessels supplying the retina or optic nerve. These vascular occlusions can lead to a range of vision-threat- ening conditions, including retinal artery and vein occlusions, which can result in ischemic damage and permanent visual impairment if not promptly diag- nosed and managed. Understanding the pathophysiology, risk factors, clini- cal manifestations, and treatment options for vascular occlusions is crucial in providing effective care for patients with these conditions. The lecture presents two patients from the Ophtalmology department with atypical vascular occlusions. The first patient presents a clinical case that shows the formation of collateral blood vessels in BRAO and the preservance of the vision. The second clinical case in the presentation is related to the differential diag- nostic criterias in BRVO and more specifically Papillophlebitis. In summary atypical retinal vascular occlusions represent a diverse and chal- lenging subset of retinal vascular diseases. While they share common features with more typical occlusions, their unusual presentations often require careful differential diagnosis and a comprehensive approach to management. tomography (OCT) and optical coherence tomography angiography (vascu- lar density (VD), foveal avascular zone (FAZ) of superficial (SCP) and deep (DCP) capillary plexus) were performed and results of the macula region were evaluated. CETP (rs3764261) and ABCA1 (rs1883025) genotyping was per- formed. Results: Largest total retinal nad GCL+ thickness was found in control group, lowest choroidal thickness - in 3VD group. SCP FAZ area was simmilar be- tween groups, while DCP FAZ area differed significantly and was largest in 3VD group (p=0.020, pairwise comparison C vs. 3VD, p=0.048; MI vs. 3VD, p=0.023). VD of SCP superior (p=0.014) and temporal (p=0.008) segments was shown to be lowest in 3VD group. No statistically significant differences were observed in DCP. Thicker retina and GCL+ were related to decreased chance of IHD development. ABCA1 rs1883025 CT vs. CC/TT genetic model decreased risk of IHD by almost two times. 3VD development was found to be related to lower retinal, choroidal and GCL+ thickness and larger DCP FAZ area Conclusion: ABCA1 rs1883025 CT genotype lowered the chance of IHD de- velopment. Lower retinal, choroidal, GCL+ thickness and increased DCP FAZ area is related to increased risk of 3VD. FP04-2 Inherited retinal dystrophies in Portugal: moving the field forward J.P. Marques1 1Department of Ophthalmology, ULS de Coimbra, E.P.E, Coimbra, Portugal Purpose: To describe how the creation of a national registry for inherited retinal dystrophies (IRD-PT registry) acted as a stepping stone to move the ophthalmic genetics field forward in Portugal Methods: The IRD-PT registry (retina.com.pt) is a national, web‐based, pseu- donymized, interoperable registry for IRDs, designed to generate scientific knowledge and collect high‐quality data on the epidemiology, genomic land- scape and natural history of IRDs in Portugal, ultimately facilitating access to novel therapies and clinical trials. The registry launched in 2020 with 1 contributing health care provider (HCP). 14 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Conclusion: Analysis of pre-symptomatic eyes from CRS-2 suggests ΔOoS is not significantly impacted by age at OoS, extent of vision loss in the first eye or by mtDNA mutation. Caution must be taken in interpreting these results due to the small sample size. FP04-5 Novel use of a virtual reality headset in the examination of afferent and efferent visual functioning A. Sriram1, M. Abegg2 1University of Utah/John A. Moran Eye Center, Salt Lake City, United States, 2Onovis, Berne, Switzerland Background: neosTM is a virtual reality head-mounted medical device that employs infrared eye-tracking at 200 Hz and custom-made algorithms to au- tomatically and quantitatively measure afferent and efferent visual function- ing. It is able to assess pupillary function, visual fields, ocular alignment, saccades, smooth pursuits, gaze holding, and fusional amplitudes, and thus has potential to help physicians better understand patients’ neuro-ophthalmic functioning. Case: This is a case of a 21-year-old male with a history of a right optic path- way glioma involving the right optic nerve, optic chiasm, and optic tract. After providing written consent, the patient was tested with the neosTM. Results showed that there was a right sided rAPD, as well as a right sided visual field defect in the right eye. Ocular alignment and smooth pursuit testing indicated a right eye esotropia of approximately 5 degrees. Other efferent tests were unremarkable. Manual examination by a neuro-oph- thalmologist correspondingly showed a right rAPD and a right esotropia of 4 degrees. The neosTM findings also prompted additional workup with ancillary testing. Standard automated perimetry showed a right sided visual field defect in the right eye, as well as a mild left sided visual field defect in the left eye, though not distinctly homonymous. Optical coherence tomography showed a homonymous hemiatrophy of retinal ganglion cells. Conclusion: This case illustrates that neosTM could be used as a triaging de- vice for patients with neurologic disease, detecting afferent and efferent pa- thology in accordance with manual examination. This may prompt further clinical testing to better understand the visual implications of disease. Furthermore, neosTM could be used to monitor visual functioning over time, which could help physicians better understand progression of disease and may have implications in therapeutic decision making. FP04-4 Impact of patient characteristics on time to symptom onset in pre-symptomatic eyes from the Case Record Survey-2 N. Jurkute1,2,3, B.P. Leroy4,5,6, P. Yu-Wai-Man1,7,8,3, J. van Everdingen9,10, M. Krawczynski11,12, C. Lamperti13, V. Carelli14,15, X. Llòria16, T. Klopstock17,18,19 1Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom, 2National Hospital of Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom, 3Institute of Ophthalmology, University College London, London, United Kingdom, 4Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium, 5Ghent University, Department of Head & Skin, Ghent, Belgium, 6Ghent University Hospital, Department of Ophthalmology, Ghent, Belgium, 7John van Geest Centre for Brain Repair, and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, Cambridge, United Kingdom, 8Cambridge Eye Unit, Addenbrooke’s Hospital, Cambridge, United Kingdom, 9The Rotterdam Eye Hospital (OZR), Department of Neuro-Ophthalmology, Rotterdam, Netherlands, 10The Rotterdam Ophthalmologic institute (ROI), Rotterdam, Netherlands, 11Poznan University of Medical Sciences, Department of Medical Genetics, Poznan, Poland, 12GENESIS - Centers for Medical Genetics, Poznan, Poland, 13Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Medical Genetics and Neurogenetics, Milano, Italy, 14IRCCS Istituto di Scienze Neurologiche di Bologna, Bologna, Italy, 15University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy, 16Chiesi Farmaceutici S.p.A, Parma, Italy, 17Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany, 18German Center for Neurodegenerative Diseases (DZNE), Munich, Germany, 19Munich Cluster for Systems Neurology (SyNergy), Munich, Germany Purpose: Leber hereditary optic neuropathy (LHON) is a rare mitochondrial disease characterised by sequential bilateral vision loss. While age at onset of symptoms (OoS) and causative mitochondrial DNA (mtDNA) mutation are significant prognostic factors in the clinical course of LHON, their impact on time to OoS in the second eye is largely unknown. Here, we present time between OoS in the first and second eye (ΔOoS) in patients from Case Record Survey-2 (CRS-2; NCT02796274). Method: Retrospective clinical data were extracted from case records of LHON patients. Eligibility: aged ≥12 years, m.11778G>A, m.3460G>A, or m.14484T>C mtDNA mutation, OoS after 1999 and ≥2 visual acuity (VA) assessments within 5 years of OoS and prior to idebenone use. Baseline (BL) was first VA assessment after OoS in the first eye. ΔOoS was assessed in a sub- group of patients who presented with 1 pre-symptomatic eye at BL. Patients were subset by age at OoS in the first eye and mtDNA mutation. Results: In the 56 patients assessed, distribution of age at OoS in the first eye was: <15 years: 8.9% (n=5); 15–35 years: 58.9% (n=33); >35 years: 32.1% (n=18). The distribution of mtDNA mutations was: m.11778G>A: 80.4% (n=45); m.3460G>A: 8.9% (n=5); m.14484T>C: 10.7% (n=6). Although age subgroup at OoS in the first eye did not significantly impact ΔOoS (R2=0.11, p=0.052), patients aged <15 years had a greater median [Q1–Q3] ΔOoS (6.0 [5.8–7.0] months) compared to patients aged 15–35 years (3.1 [1.7–5.0] months) and >35 years (3.0 [2.0–3.9] months). ΔOoS was also not significantly associated with mtDNA mutation (R2=0.01, p=0.876; median [Q1–Q3] ΔOoS: m.11778G>A: 3.0 [2.0–5.0]; m.3460G>A: 3.9 [3.0–4.0]; m.14484T>C: 3.0 [1.0–6.0]) or VA of the first eye at BL (R2=0.00, p=0.972). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 15

FREE PAPER PRESENTATIONS FP04-7 Treating hemianopia: results for SEARCH (a randomised controlled trial of scanning eye training as a rehabilitation choice for hemianopia after stroke) F. Rowe1, SEARCH Trial Group 1Prof Fiona Rowe, Liverpool, United Kingdom Purpose: We report the clinical effectiveness results for a randomised con- trolled phase III trial of visual scanning training to treat hemianopia. tion. A repeat cranial MRI showed bilateral optic nerve enhancement along most of the length of the optic nerves, extending to the anterior portion, optic nerve sheath, and surrounding orbital fatty tissues. Serum MOG antibody was positive. Case 2: A 6-year-old male came to our emergency department with com- plaints of a bilateral acute vision loss, somnolence and apathy. His VA was CF in the OD and in the OS. The remaining ophthalmological exam was normal. Both cranial CT scan and laboratory analysis were normal. Lumbar puncture results, along with the neurological symptoms, raised suspicion for a possible CNS infection. The patient was admitted to the POU and treatment with in- travenous ceftriaxone and acyclovir was empirically started. A repeat cranial MRI was positive for a bilateral retrobulbar dilation of the optic nerve sheath Methods: Participants were adult stroke survivors with stable hemianopia, suggestive of bilateral optic neuritis. Serum MOG antibody was positive and with 1:1 parallel-arm randomisation. The intervention was a visual scanning strategy compared to sham training. Minimum duration of treatment was 6 weeks with follow-up for 26 weeks. The primary outcome measurement was the VFQ-25 questionnaire. Secondary outcome measurements included the Nottingham Extended Activities of Daily Living, EQ-5D-5L, BIVI-IQ, visual field measurement, visual scanning performance and adverse events. Participants and the lead outcome assessor were blinded. Results: We recruited 161 participants from 34 sites and report trial results for 158 randomised to intervention or sham training. Mean age was 65.2 years (SD 13.9), 114 male (72.2%), ischemic stroke (91.8%), haemorrhagic (8.2%)), and mean Barthel index 8.9 (SD 2.5). Primary ANCOVA analysis was carried out on 104 participants with VFQ-25 data at both baseline and 26 weeks; sen- sitivity analysis was undertaken for 120 participants. Estimated mean differ- ence at 26 weeks, adjusting for baseline score and hemianopia type was -4.04 (95%CI: -9.45 to 1.36; p=0.141) for primary analysis and -2.33 (95%CI: -7.42 to 2.75; p=0.365) for sensitivity analysis. There were no significant differ- ences between groups for primary and secondary outcome measure compari- the infectious serologies were negative. Conclusion: The first case presented in our series can be classified as a clas- sical presentation of MOGAD optic neuritis, according to the most recent lit- erature. However, this entity should be suspected in children presenting with markedly reduced vision, even in the absence of some of these findings, as in the second case of our series. FP04-9 Static vision: exploring visual snow syndrome through two cases A.M. Sampaio1, R. Silva1, C. Almeida1, F. Vaz1 1Hospital de Braga, Ophthalmology, Braga, Portugal Purpose: To describe two cases of Visual Snow Syndrome (VSS), detailing sons from baseline to 26 weeks. Adverse events, reported for 20 participants, clinical presentations, diagnostic approaches, and management strategies, included eye strain, headache and blurred vision. Conclusions: Both groups improved in all outcomes. There were no differ- ences between the groups for any outcome measure. However, it was possible that there was a placebo effect from additional information resources and cli- nician input during the first 6 weeks of treatment, and for the sham training providing a treatment effect. with an emphasis on the condition’s profound impact on quality of life. Method: Two male patients, aged 21 and 25, presented with persistent visual disturbances characterized by flickering dots across the entire visual field. Both also experienced photophobia, nyctalopia, and palinopsia, while Patient B additionally reported high-pitched tinnitus. Neither patient had a history of trauma or substance use. Patient A associated symptom onset with muscular FP04-8 Pediatric optic neuritis in children: when should MOGAD be suspected? J. Castro Cabanas1, P. Moreira Martins1, S. Fonseca1, D. Meira1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal Introduction: MOGAD optic neuritis can present wide range of clinical find- ings n the pediatric population. We report two cases of anti-MOG-positive optic neuritis, presenting with contrasting clinical features. Methods: Case Series electrostimulation during physiotherapy. Comprehensive evaluations were conducted, including visual acuity testing, slit-lamp examination, fundoscopy, optical coherence tomography, campim- etry, fluorescein angiography, neuroimaging, lumbar puncture, and detailed laboratory analyses. Electromyography (Patient A) and audiogram (Patient B) were also performed. Results: Visual acuity was 20/20 in both patients, with normal findings across ophthalmological and neurological evaluations. Blood tests and imaging stud- ies were unremarkable. Both patients reported significant disruptions in daily life, particularly affecting work and sleep, and developed anxiety. Patient A’s headaches improved with flunarizine, while Patient B discontinued lamo- trigine and amitriptyline due to side effects. Despite 6–7 years of follow-up, neither experienced resolution of visual symptoms. Patient A utilized a Visual Snow simulator to communicate his visual disturbances effectively. Conclusion: Visual Snow Syndrome is a challenging and poorly understood condition with no established treatments. Its substantial impact on patients’ Case 1: A 8-year-old female presented to our emergency department with a lives highlights the importance of increasing awareness among clinicians to 3-week history of bilateral vision loss. Her visual acuity (VA) was counting fingers (CF) in the right eye (OD) and light perception (LP) in the left eye (OS). Fundus examination revealed severe bilateral optic disk edema. Both cranial CT scan and lumbar puncture showed no abnormalities. The patient was admitted to the Pediatric Observation Unit (POU) for further investiga- facilitate timely diagnosis and alleviate symptoms. 16 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Free Paper 5: Glaucoma FP05-1 Trabeculectomy augmented with anti-VEGF improves surgical outcomes in glaucoma: a systematic review and meta-analysis S. Ramji1, J. Tan2, Z. Jarrar3, S. Hamid4, G. Gazzard5, A.S. Ansari6 1Northwick Park Hospital, London North West University Healthcare NHS Foundation Trust, London, United Kingdom, 2Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, 3King’s College London, Section of Academic Ophthalmology, School of Life Course Sciences, London, United Kingdom, 4Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom, 5University College London Institute of Ophthalmology and Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom, 6Moorfields Eye Hospital, NHS Foundation Trust & King’s College London, Section of Academic Ophthalmology, School of Life Course Sciences, London, United Kingdom Purpose: A systematic review and meta-analysis was conducted to assess the efficacy of anti-vascular endothelial growth factor (anti-VEGF) agents as ad- juncts to trabeculectomy (Trab) in improving surgical success in glaucoma. Anti-VEGF agents are used in the treatment of a variety of ocular diseases in- cluding wet age-related macular degeneration, diabetic retinopathy and retinal vein occlusion. However, their efficacy in the treatment of glaucoma remains unknown. Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) comparing Trab with and without anti-VEGF agents in patients with glaucoma was conducted. Data were sourced from Medline, EMBASE, and Web of Science. Primary outcomes included complete success, qualified success, mean IOP reduction and mean reduction in IOP lowering medications at 6, 12, and 24 months. Results: Nineteen studies with 1,049 patients were included. At 12 months, Trab with mitomycin C (MMC) and anti-VEGF showed improved odds of complete success when compared with Trab and MMC only (OR = 1.90, 95%CI [1.16, 3.10], p = 0.01). Furthermore, intracameral or intravitreal bevacizumab showed better odds of complete success at 12 months and similarly, the odds were better with a dose of 1.25mg of bevacizumab (OR = 1.58, 95%CI [1.06, 3.26], p = 0.03). Trab with MMC and bevacizumab also significantly reduced IOP-lowering medica- tions (MD = 0.34, 95% CI [0.09, 0.60], p = 0.008). Risk of bias assessment found 5 studies to have a low risk of bias, 13 with moderate risk and 1 with some concerns. Conclusions: Overall, these results show that utilising Trab augmented with MMC and bevacizumab for the treatment of glaucoma can increase the odds of complete success. In regards to route of administration and dosage, the intracameral or intravit- real route with a dosage of 1.25mg of bevacizumab aids to increase the odds of complete success. However, further research with long-term follow-up is essential to validate these findings. FREE PAPER PRESENTATIONS FP05-2 Peripapillary capillary vessel density in normal tension glaucoma and primary open-angle glaucoma N. Civcic Kalinic1, N. Civcic1 1Ophthalmology Practice Family Civcic, Department of Glaucoma, Belgrade, Serbia Purpose: We analysed weather there is a difference in peripapillary capil- lary vessel density in normal tension (NTG), primary open-angle glaucoma (POAG) and healthy subjects. We made a correlation between retinal nerve fiber layer (RNFL) thickness and vascular parameters optical nerve head (ONH), also topography and vascular parameters with mean deviation (MD) index visual field (VF). Method: This prospective research included 120 eyes; 40 healthy eyes, 30 NTG eyes and 50 POAG eyes. Ophthalmological examination, central corneal thickness (CCT), optical coherence tomography (OCT), optical coherence to- mography angiography (OCTA) and visual field were performed. Results: Vessel capillary density total (VCD total) is significantly higher in healthy compared to NTG and POAG (39.25±0.94 vs. 36.79±2.50 vs. 37.58±1.53;p<0.001). Peripapillary capillary vessel density (VCD perip.) is significantly lower in NTG and POAG compared to healthy subjects (39.21±2.62 vs. 40.18±1.35 vs. 41.29±0.81;p<0.001). VCD total is significant- ly lower in NTG compared to POAG (36.79±2.50 vs. 37.58±1.55;p<0.001). VCD perip. is significantly lower in NTG compare to POAG (39.21±2.62 vs. 40.18±1.35;p<0.001). We found significantly positive correlation between OCT and OCTA pa- rameters of ONH with MD index in NTG: between RNFL average and MD (r=0.370,p<0.05) and between VCD perip.inf. and MD (r=0.395,p<0.05). In POAG, we obtained a significantly positive correlation between VCD inf. and MD (r=0.277,p<0.05) and VCD inside disc with MD (r=0.395,p<0.01). Conclusion: Glaucoma patients have a significantly lower vessel density ONH and peripapillary capillary vessel density compared to healthy subjects. VCD total and VCD perip. is significantly lower in NTG compare to POAG. We obtained a positive correlation between OCT and OCTA parameters with MD in NTG and POAG. OCTA is an important imaging method in the diag- nosis and monitoring of glaucoma progression. FP05-4 Long-term outcomes of ND: YAG laser goniopuncture after non-penetrating deep sclerectomy: a retrospective analysis of early and late interventions C. Francisco1,2, R. Gonçalves1, R. Bastos1, C. Vale1, P. Tenedório1 1Unidade Local de Saúde de Matosinhos, Ophthalmology, Matosinhos, Portugal, 2Faculty of Medicine, Porto University, Porto, Portugal Purpose: Non-penetrating deep sclerectomy (NPDS) is a glaucoma surgery of growing interest that creates a new aqueous humor outflow pathway while preserving anterior chamber integrity. If intraocular pressure (IOP) control is suboptimal, neodymium-yttrium-aluminum-garnet laser goniopuncture can restore aqueous flow through the trabeculo-Descemet’s membrane. While ef- fective, complications such as iris incarceration have been reported. This study investigates goniopuncture’s efficacy and safety in lowering IOP after NPDS and examines whether timing (early vs. late) affects outcomes. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 17

FREE PAPER PRESENTATIONS Methods: This retrospective analysis included patients who underwent go- FP05-7 niopuncture following NPDS at Unidade Local de Saúde de Matosinhos be- tween July 2015 and July 2022. Demographic variables, glaucoma type, prior phacoemulsification, IOP, best-corrected visual acuity, number of glaucoma medications, time to goniopuncture, number of goniopunctures performed, One-year results of gonioscopy-assisted transluminal trabeculotomy in advanced pseudoexfoliation glaucoma G. Blezura-Udre1,2, D. Jekabsons1, K. Baumane1,2 1University of Latvia, Riga, Latvia, 2Riga East University Hospital, Riga, Latvia Purpose: To assess the efficacy and safety of gonioscopy-assisted translu- minal trabeculotomy (GATT) with polypropylene suture in patients with ad- vanced pseudoexfoliation glaucoma (PXG) compared with mild to moderate PXG. Method: A prospective study included 70 eyes from 65 patients with PXG, which underwent a 360-degree GATT with polypropylene suture 5.0 per- formed as a standalone procedure or combined with cataract surgery. Patients were followed up for 12-month. Visual fields (VF), intraocular pressure (IOP), number of glaucoma medication, success rate (IOP reduction 30% from base- line and IOP < 15 mm Hg) and postoperative complications were analysed. Patients were divided into two groups according to VF defect, mild to moder- ate PXG with MD ≤12 dB and severe PXG with MD >12 dB. The postopera- tive outcomes between groups were compared. Results: A total of 33 (47%) eyes with mild to moderate PXG and 37 (53%) eyes with advanced PXG underwent surgery. The mean age (SD) of the study patients was 67.2±7.65 in mild to moderate PXG group and 71.7±9.2 in the advanced PXG group. Mean baseline IOP was 26.2±5.58 mmHg on 2.99±0.88 number of glaucoma medications. There was statistically significant reduction in IOP to 12.2±3.10 mmHg (p<.0001) and glaucoma medications to 0.32±0.77 (p<.0001) after 12 months. The results were similar between mild to moderate PXG with IOP 25.3±4.36 mmHg before operation and IOP 12.0±2.95mmHg after 12 months and ad- vanced PXG with 27.0±6.44 mmHg and 12.3±3.26 mmHg, respectively. The success rate at 12 months in advanced PXG was 78.01% and in the mild to moderate PXG (74.23%). One patient with advanced glaucoma underwent trabeculectomy for uncontrolled glaucoma. The most frequent complication after GATT was hyphema in 32 (45.7%) patients. The frequency of hyphema was not statistically significantly different between the mild to moderate PXG group 14 (42.4%) and the advanced PXG group 18(48.6%). Conclusion: GATT in advanced PXG is a safe and significantly reduces IOP and number of medications after 12 months, therefore it can serve as a good choice for first time surgery. procedural success and complications were recorded. Patients were followed- up for two years. Results: Of 220 eyes undergoing NPDS, goniopuncture was performed in 56 eyes (25.45%). The median interval to goniopuncture was 4.50 months. Early goniopuncture occurred in 27 eyes (48.2%), and late goniopuncture in 29 eyes (51.8%). At 24 months, the success rate was 75% (n=42). IOP decreased sig- nificantly from 22.34 ± 6.15 mmHg pre-goniopuncture to 12.73 ± 4.68 mmHg immediately post-procedure (p<0.001) and 14.57 ± 3.67 mmHg at 24 months (p<0.001). There was no significant difference in success rates between early and late goniopuncture (74.1% vs 75.9%, p=0.880). Complications included iris in- carceration (8.9%) and hypotony (3.6%). A significant reduction in the mean number of glaucoma medications was observed (0.84 ± 0.16, p<0.001). Conclusion: Goniopuncture effectively reduces IOP long-term, with similar outcomes for early and late procedures. Although safe, complications like iris incarceration highlight the importance of careful follow-up. FP05-6 Can we get more information from the slit lamp for our glaucoma patients ? M.-M. Gellrich1 1Ophthalmological Practice, Kellinghusen, Germany Purpose: The role of the slit lamp in glaucoma care has not changed over the last 60 years: Tonometry, gonioscopy, assessment of chamber angle and C/D ratio, detection of findings like PEX. Can we get further (also quantitative) information from the slit lamp ? Method: In the years 1997-2024 the author examined 45.970 patients with a video slit lamp. 705 patients were diagnosed with some form of glaucoma. We applied own videographic methods to give estimates for corneal pachymetry, optic disc size, and changes in optic disc morphology. Results: Pachymetry: From a linear regression for 103 eyes we found 1.71 as proportionality factor between the visible width of a 45° central cornea section by the slit lamp to external pachymetric measurements (R2 = 0.70). Optic disc size: When we apply the known magnification factor of a fundus lens to measurements of the horizontal (h) and vertical (v) extent of the optic disc as it appears on a monitor, the optic disc area (A) can be approximated by the area of an ellipse as A = π v h / 4. Disc morphology: The flicker test by which changes on successive images appear as virtual movement can be applied on slit lamp videographs of optic discs after adjusting them on adjacent power point foils. Long term results are demonstrated for patients over 20 years time. Also in 332 patients 587 disc hemorrhages were noticed. Conclusions: With the slit lamp an extended use in the care of glaucoma pa- tients is possible: Videographic methods give reasonable estimates for corneal thickness and optic disc size. Subtle changes in optic disc morphology can be detected by the flicker test. For all this modern devices exist with higher precision. An exception is optic disc hemorrhage, which is far easier to detect with the slit lamp than with OCT or HRT. The videographic methods we use are inexpensive, can be applied to every type of video slit lamp and are at little risk to be outdated by new developments in computer science. 18 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP05-8 FP05-9 Evaluation of the number of hyper-reflective spots detected by optical coherence tomography in healthy and glaucomatous eyes and their correlation with retinal ganglion cell loss Ethnicity and post-injection Intraocular Pressure (IOP) following intravitreal injections in neovascular glaucoma patients: IOP outcomes from 2014 to 2024 from a single hospital K. Kasal1, Y. Girgin2, E. Karahan2 1Private Sevgi Hospital, Ophthalmology, Balikesir, Turkey, 2Balikesir University, Ophthalmology, Balikesir, Turkey Purpose: To evaluate the number of hyperreflective spots (HRS) detected by optical coherence tomography (OCT) in healthy and glaucomatous eyes and assess their correlation with retinal ganglion cell loss. Methods: This study included 65 patients diagnosed with primary open- angle glaucoma (POAG) and 65 healthy individuals. Medical records were reviewed, and OCT macular scans were analyzed. The thinnest foveal section was selected, and a central area with a horizontal length of 3000 microns was identified. Small spots (≤30 μm) with moderate reflectivity and no shadowing behind them were defined as HRS. Two independent researchers counted the HRS within the defined area on each OCT scan. Results: The average age was 62.48 ± 19.77 years for the glaucoma group and 59.75 ± 6.65 years for the control group, with no significant difference (p=0.085). Inter-rater agreement for HRS counting was excellent (ICC = 0.927, 95% CI: 0.89–0.94). The average HRS count was significantly higher in glaucoma patients than in healthy controls (29.65 ± 7.68 vs. 11.86 ± 5.05; p < 0.001). Significant positive correlations were observed between HRS count and verti- cal and horizontal cupping diameters (p < 0.001, r = 0.45). Conversely, sig- nificant negative correlations were found between HRS count and neuroretinal rim area (p < 0.001, r = -0.46), total retinal nerve fiber layer (RNFL) thickness (p < 0.001, r = -0.39), and mean ganglion cell complex (GCC) thickness (p < 0.001, r = -0.43). HRS count also correlated positively with global loss volume (GLV) and focal loss volume (FLV), with stronger associations seen for GLV (p < 0.001, r = 0.41) than FLV (p < 0.001, r = 0.32). Conclusions: Glaucoma is a progressive neurodegenerative disease character- ized by retinal ganglion cell loss. In this study, it was determined that the HRS count increased in proportion to ganglion cell loss in glaucoma patients. HRS count may serve as a potential OCT biomarker in the diagnosis and follow-up of glaucoma. Y. Kim1, B.J. Chow1, C. Zheng1, A. Sheik-Ali2, I. Qureshi2, E. Preston2, S. Ansari3, F. Levina2, S. Sen2, A. Sheemar2, J. Luis2, S. Phatak2, L. Nicholson2, R. Hamilton2, G. Gazzard3, I. Yeung2, Moorfields Medical Retina Research Group 1Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom, 2Moorfields Eye Hospital, Medical Retina Service, London, United Kingdom, 3Moorfields Eye Hospital, Glaucoma Service, London, United Kingdom Purpose: To evaluate intraocular pressure (IOP) change following different intravitreal injections (IVIs) in neovascular glaucoma (NVG) patients sec- ondary to retinal pathology. IOP spike represents significant concern in NVG patients. Method: Retrospective analysis of electronic patient records of all NVG patients treated with IVIs from 20/11/14 to 19/11/24. IOP spikes were de- fined as ≥10mmHg increase (IOP+10), or a post-IVI value of >40mmHg (IOP>40). Visits with incomplete IOP data were excluded. IVIs included Avastin (Bevacizumab), Eylea 2mg (Aflibercept), and Ongavia (Ranibizumab biosimilar). Results: Of 255 NVG patients (280 eyes, 478 injections), 63.5% were males (162 males, 176 eyes, 308 injections vs 93 females, 104 eyes, 170 injections). Ethnicities were Caucasian 22.0% (n=56), South Asian 15.3% (n=39), African and Caribbean origin 10.6% (n=27), and others 52.2% (n=133). Mean age of NVG patients was 63.4±13.6 years. Median time to IOP measurement was 23 minutes post-IVI. Avastin was the most used IVI (88.9%) and had a low- er mean IOP change (2.99±11.26 mmHg, n=425) than Ongavia (3.86±5.81 mmHg, n=7) or Eylea 2mg (6.46±8.15 mmHg, n=46). IOP+10 spike rate was lower in Avastin (21.7%, n=92) than Eylea 2mg (26.1%, n=12) or Ongavia (28.6%, n=2). However, IOP>40 spike rate was higher in Avastin (7.1%, n=30) than Eylea 2mg (4.4%, n=2) or Ongavia (n=0). Mean IOP change in IOP+10 group was 13.86±3.51 mmHg, and in IOP>40 group was 4.29±5.82 mmHg. Conclusion: Avastin had higher IOP>40 spike rate than Eylea 2mg or Ongavia, despite lower mean IOP change and lower IOP+10 spike rate in Avastin. As Avastin usage is off-label, our findings may reflect ongoing pref- erence for Avastin by clinicians in more severe NVG patients with a higher baseline IOP. Further study should analyse if angle status may affect anterior chamber para- centesis rates and long-term glaucoma outcomes of NVG patients treated by different IVIs. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 19

FREE PAPER PRESENTATIONS FP05-10 The efficacy and safety of Preserflo Microshunt implant among glaucoma patients in the western region of Saudi Arabia A. Alzahrani1, Z. M. Bukhari1, A. Mofti1, M. Alqurashi2 1King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia, Department of Ophthalmology, Jeddah, Saudi Arabia, 2King Fahad Armed Forces Hospital, Department of Ophthalmology, Jeddah, Saudi Arabia Purpose: The aim is to assess the safety and efficacy of the Preserflo MicroShunt in patients with various types and severities of glaucoma. It evalu- ates success and failure rates, IOP reduction, and overall clinical progression in patients who underwent Preserflo implantation at two specialized glaucoma clinics in Jeddah, Saudi Arabia Method: All patients with different types of glaucoma who received the Preserflo Microshunt with mitomycin-C (MMC) in two tertiary centers. The primary outcome of this study was the success rate of Preserflo MicroShunt implantation at 12 months. Complete success was defined as achieving in- traocular pressure (IOP) ≤ 21 mmHg and a reduction of ≥ 20% from baseline, with no other intervention. Failure is defined as intraocular pressure IOP >21 mmHg, an IOP reduction of less than 20%, chronic hypotony, a necessity for revision surgery, or loss of light perception following implantation. Secondary outcomes were IOP, medications, complications, interventions, and reoperations. Results: 67 eyes underwent Preserflo, and the success rate was measured in the six-month follow-up visit (n=39) and one-year follow-up visit (n=30). The complete success rate after six months among our study population was 87.2%, qualified success was 2.6%, and failure rate of 10.3%. In the one-year follow-up, the complete success rate was 83.3%, qualified success was 3.3%, and the failure rate of 13.4%. The mean reduction of IOP in six six-month follow-ups was 14.3 mmHg, and 13 mmHg in one-year follow-up visits in comparison to baseline. All patients were not using any antiglaucoma drops except for one patient. Complications were Early transient hypotony at 32.8%, chronic Hypotony with a rate of 1.5 %, malignant glaucoma at 1.5%, and choroidal detachment at 8.9%. Conclusion: Preserflo MicroShunt achieved an overall success rate of 83.3% in 1 year with various types and stages of glaucoma. It showed significant reductions in both IOP and the number of medications FREE PAPER PRESENTATIONS Free Paper 6: Oculoplastics, Uveitis FP06-2 Evaluation of corneal parameters and higher-order aberrations in ptosis patients undergoing Müller’s muscle conjunctival resection I. Hosver1, M. Simsek1, M.G. Ulas1, A. Cetin Efe1, F. Poslu Karademir1, S. Sagdic Ozcelik1, I. Diri1, M. Taskapili1 1Istanbul Beyoglu Eye Training And Research Hospital, Istanbul, Turkey Purpose: To evaluate the postoperative corneal parameters and changes in higher-order aberrations in ptosis patients who underwent Müller’s Muscle Conjunctival Resection (MMCR). Method: In this prospective study, patients who had a positive phenylephrine test and underwent MMCR for ptosis between July 2024 and August 2024 were included. Preoperative and postoperative 1st week (before 6.0 prolene suture removal), 1st month, 3rd month best corrected visual acuity (BCVA- logMAR), margin to reflex distance-1 (MRD1-mm), levator function (LF- mm), topographic parameters and high order aberrations (HOA- μm(total HOA, coma, trefoil, spherical aberration, secondary astigmatism, quadrifoil)) at 4mm and 6mm pupil diameter were evaluated. Results: Fifty eyes of 50 patients(26 M, 24 F) were included in this study. The mean age was 53.92±18.15 years. Mean BCVA was preoperatively 0.21±0.45, postoperative 1st week 0.21±0.49, postoperative 1st month 0.24±0.52, postoperative 3rd month 0.21±0.44 (p=0.72). MRD1 was preop- eratively 1.30±1.01mm, postoperative 1st week 2.97±0.98mm, 1st month 3.00±1.02mm, 3rd month 3.04±0.53mm (p<0.001). No significant difference was found between preoperative and postoperative 1st week, 1st month and 3rd month K1, K2, SimK, Kmax values(p=0.43 p=0.34 p=0.42 p=0.24, respectively). Also, there was no significant difference between preoperative, postoperative 1st week, 1st month and 3rd month total HOA at 4mm and 6mm pupil diam- eter (p=0.43 p=0.49 respectively). 6mm pupil diameter secondary astigma- tism was preoperatively 0.12±0.07μm, postoperative 1st week 0.23±0.08 μm, postoperative 1st month 0.13±0.06μm and postoperative 3rd month 0.12±0.02 (p=0.03). Conclusion: In patients who underwent MMCR for ptosis, corneal HOA val- ues reached a peak value at postoperative 1st week and then were similar to the preoperative value at postoperative 1st and 3rd months. These corneal changes may be due to subclinical corneal irritation caused by 6.0 prolene used in MMCR surgery. 20 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP06-3 Temporary dry eye symptoms following ptosis correction and blepharoplasty: a comparative analysis D. Vasović1, M. Karamarković2, M. Stojičić2, D. Rašić1, T. Kalezić1, I. Marjanović1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia, 2University Clinical Centre of Serbia, Clinic for Burns, Plastic and Reconstructive Surgery, Belgrade, Serbia Method: This is an observational case series, demonstrating facial injuries as a result of explosions with shock-wave and shrapnel trauma in a war-zone and utilizing Patient Specific Implants (PSI) for orbital reconstruction. A detailed documentation of all orbital cases was kept on file, including photographs and imaging. In addition, the design and configuration of PSI’s was stored for each patient. A compilation of such cases will be used to illustrate each orbital trauma category unique to war. Results: Eight cases of upper/midface trauma will be presented to illustrate the different war injuries. Most relevant surgical techniques and the implan- tation of PSI’s will be covered. With respect to the orbital region, the most common deformities included traumatic telecanthus, hypovolemic/contracted anophthalmic sockets and traumatic eyelid malpositions. In addition, lagoph- Purpose: To investigate the impact of levator muscle resection for ptosis cor- thalmos with severe exposure was commonly found in traumatic VII nerve rection, performed with and without upper blepharoplasty, on dry eye symp- palsies. toms, and to assess the recovery trajectory of these symptoms over time. Method: A total of 92 patients with unilateral ptosis were included in this pro- spective study and divided into three groups based on surgical intervention: Group A underwent ptosis correction alone, Group B underwent combined ptosis correction and upper blepharoplasty, and Group C underwent blepha- roplasty alone. Dry eye parameters were evaluated preoperatively and post- operatively at 1, 3, and 6 months. The assessments included Tear Break-Up Time (TBUT), Schirmer test, corneal and conjunctival staining, and the Ocular Surface Disease Index (OSDI) questionnaire. Statistical analysis was performed to compare changes in dry eye symptoms across the groups over time. Results: Postoperative dry eye symptoms showed a transient increase in Groups A and B, with the most significant changes noted in Group B. At the 1-month follow-up, patients in Group B exhibited a substantial reduction in TBUT, increased corneal and conjunctival staining, and higher OSDI scores compared to baseline, indicating greater ocular surface disruption. Symptoms in Group A were less severe but followed a similar pattern, while Group C demonstrated minimal changes in dry eye parameters. By the 3-month follow-up, symptoms began to improve in all groups, and by Conclusion: This presentation will demonstrate the type and extent of inju- ries to the orbital area from shock-wave and shrapnel trauma, specific to war weapons of destruction. There a distinct and unique pattern of damage, which is different from injuries seen in the general peacetime population. Patient Specific Implants play an important role in the reconstruction of such complex facial skeleton fractures. FP06-5 A quantitative assessment of thyroid eye disease activity using magnetic resonance imaging: a novel method D. Marston1, S. Grech1, N. Galdes1, A.N. Paris1, I. Bertuello1, A. Palmier1 1Mater Dei Hospital, Msida, Malta the 6-month follow-up, parameters across all groups had nearly returned to Purpose: The aim of this study was to determine whether quantitative meas- baseline levels. urements of extra-ocular muscles and structures on magnetic resonance imag- Conclusion: Combined ptosis correction and blepharoplasty are associated ing (MRI) correlate with disease activity in thyroid eye disease (TED). with a more pronounced and prolonged temporary increase in dry eye symp- Method: A retrospective review of 162 patients with TED, between June 2014 toms compared to ptosis correction or blepharoplasty alone. However, the reversibility of these symptoms by 6 months postoperatively highlights the safety and efficacy of these surgical procedures when paired with appropriate patient monitoring and management. FP06-4 War-related facial trauma in Ukraine: oculoplastic implications and the utility of Patient Specific Implants (PSI) V. Kratky1 1Charles University, Ophthalmology, Prague, Czech Republic Purpose: Eye trauma is estimated to account for 20% of all injuries in modern warfare. Due to widespread bombing and shelling in Ukraine, there are many patients with extensive facial injuries, including loss of eyes, eyelid injuries and orbital fractures. This is an overview of a recent mission to Ukraine by a multi-specialty sur- and June 2024, who underwent MR Orbits was conducted. The patients were seperated into active (n=73) and inactive (n=89) group according to the dis- ease status on MRI. T1-weighted imaging, T2-weighted imaging and STIR on MRI sequences were used to measure exophthalmos value, extra-ocular muscle diameters, orbital fat thickness and optic nerve diameters. Independent T-test was carried out to determine statistical significance (p < 0.005) in structural measurements between active and inactive groups. Area under the receiver operating characteristic curve (AUC) analysis was used to determine diagnostic accuracy of structural measurements in predicting dis- ease progression. Results: Inferior Rectus (IR) and Medial Rectus (MR) muscle were signifi- cantly larger in patients with active TED (p= 0.002 and p=0.005 respectively). Total EOM was also significantly larger in active TED (p<0.001). Total EOM/Exophthalmos and Inferior Rectus/Total EOM ratios showed higher values in the active TED (p=0.000). ROC analysis showed that the cut-off point of Total EOM/Exophthalmos ratio was 0.647, with a sensitivity of 90.4% and specificity of 88.8%, whilst the Inferior Rectus/Total EOM ratio had a cut-off point of 0.362, with a sensitivity of 90.4% and a specificity of 87.6%. Conclusion: This study is the first of its kind and we have proven that radio- logical parameters can be used to determine the progression of disease activity gical team (incl. oculoplastics), arranged under the auspices of a charitable in TED. foundation. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 21

FREE PAPER PRESENTATIONS FP06-6 Sclerotherapy as a therapeutic option for orbital cystic lymphangiomas M. Mourali1, M. Ben hadj khelifa1, R. Kmiha1, E. Ben brahim1, N. Hammami1, A. Chebbi1 1Hédi Raies Institut of Ophthalmology, Department C, Tunis, Tunisia Purpose: To describe the clinical and paraclinical manifestations and the evo- lution of patients with orbital cystic lymphangioma treated with sclerotherapy. Methods: A retrospective study of three female patients with orbital cystic lymphangioma treated with sclerotherapy. Results: The study included two women and one child aged 48, 44, and 9 years, respectively, with no significant medical history. These lymphatic mal- formations, present since childhood, had remained asymptomatic until their recent progression. The main reasons for consultation were progressive prop- tosis, an increase in lesion size, and diplopia. Clinical examination revealed non-axial proptosis in all three patients, with restricted ocular motility ob- served in two cases. Orbital MRI identified proptosis with a multi-septated cystic intraorbital lesion containing fluid-filled spaces and showing contrast enhancement of the septa, characteristic of orbital cystic lymphangioma. Due to the anatomical complexity of the lesions, surgical excision was not feasible. The patients were treated with bleomycin-based sclerotherapy. Significant clinical improvement was noted after the first session in two pa- tients, while the third required a second session to achieve a satisfactory re- sponse. Conclusion: Orbital cystic lymphangioma is a rare low-flow congenital vas- cular malformation primarily affecting children. Doppler ultrasound and MRI play a crucial role in confirming the diagnosis and accurately evaluating the orbital mass. Due to its infiltrative nature and difficulty in achieving complete excision, surgery is often ineffective. Sclerotherapy, however, offers a less in- vasive and promising alternative, even for complex lesions. FP06-8 Orbital exenteration in the treatment of malignant neoplasms with orbital invasion - the 13-year experience of a tertiary hospital center R. Martins1, D. Alves2,1, I.C. Costa1, J. Meira1, V. Leal1 1ULS São João, Porto, Portugal, 2ULS São João, Paranhos, Portugal Purpose: This study examines the experience of a single tertiary center in orbital exenteration, a complex surgical procedure involving the removal of the eyeball and surrounding tissues. It focuses on patients with different types of primary tumors in the eye region, particularly those with recurrent or ad- technique was used in 6 (30.0%). The most chosen rehabilitation method was secondary intention granulation (n=19; 95%), with subsequent good adapta- tion to orbital prosthesis in 10 patients (50%), prescribed after a mean of 8.7 ± 3.2 months post-surgery. The overall survival rate at 1 and 3 years was 83.3% and 53.3%, respectively. Conclusion: The results highlight squamous cell carcinoma as the most fre- quent neoplasm in this context. It is also important to note that secondary intention granulation technique, despite the frequent need for specialized nurs- ing care, ensures excellent aesthetic results and allows for early detection of disease recurrence. These findings underline the importance of a multidisciplinary approach. Given the rarity of the technique, publishing case series from other hospital centers should be encouraged to enhance knowledge about this procedure. FP06-9 Steroid requirement after peeling of secondary epiretinal membrans in uveitis V. Schöneberger1,2, J. Schirrwagen1, C. Brockmann1, T. Fuchsluger1, F. Schaub1 1Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany, 2Heinrich-Heine University Düsseldorf, Universitätsaugenklinik Düsseldorf, Düsseldorf, Germany Purpose: Peeling of secondary epiretinal membrane (sERM) in uveitis has been studied primarily for functional outcomes, but recurrence of cystoid macular edema (CME), inflammatory activity and increased steroid require- ments after surgery remain concerns. This large retrospective study evaluated postoperative steroid needs. Methods: Single center retrospective analysis of 95 eyes with sERM due to uveitis undergoing epiretinal membrane peeling from 11/2002–04/2023. Data included demographics, uveitis classification, macular optical coherence to- mography (SD-OCT) parameters, pre- and postoperative steroid therapy. Results: The cohort included 95 eyes of 95 patients (15 anterior, 47 inter- mediate, 28 posterior, and 5 panuveitis cases). CME was present in 37.5% (n=27). Preoperatively, 28 eyes received intravitreal steroids (triamcinolone n=7, dexamethasone n=21). Steroid use before surgery: 52.6% none, 32.6% topical, 11.6% systemic, 3.17% both. Mean follow-up was 31.3±43.0 months. Central macular volume (central 1 mm diameter circle of the ETDRS grid in OCT thickness map (cMV)) de- creased significantly from 0.35±0.10 mm³ to 0.31±0.09 mm³ after surgery and the total volume (tMV) from 9.97±2.04 mm³ to 9.08±1.43 mm³ (p<0.01) and central retinal thickness (CRT) from 430.35±137.99 µm to 360.94±148.00 µm (p<0.01). Preoperative steroid therapy had no effect on morphological parameters (cMV, tMV, CRT). Regarding postoperative steroid therapy, the need for steroids re- vanced cases. The analysis aims to identify the most prevalent tumors, thera- mained the same in 50.7%, was reduced in 33.3% and increased in 16.0% peutic morbidity and rehabilitation associated with this procedure. compared to the preoperative need. Persistent CME was observed in 21 eyes Methods: Retrospective study evaluating medical records and histopatho- (22.1% of all included eyes, 77.8% of preoperative CME cases) and new mac- logical reports of all patients undergoing orbital exenteration in the neoplastic ular edema occurred after surgery in 4 eyes (4.2%). context over the last 13 years at ULS São João. Data regarding histological Conclusion: Peeling of sERM in uveitis reduced steroid needs in one-third diagnosis, primary site of neoplasia, surgical technique, and chosen healing of cases. However, disease recurrence requiring increased steroid therapy oc- procedure were assessed. curred in 16%, highlighting the importance of careful surgical indication. Results: Twenty orbital exenterations (11 male patients; mean age 62.6 years) were included. Ten different histological neoplasms were identified, with squamous cell carcinoma (n=9; 45%) being the most prevalent. Total orbital exenteration was performed in 14 patients (70.0%) while lid-sparing 22 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS enced relapse after MTX tapering. Hepatotoxicity from MTX led to switching to mycophenolate mofetil in one patient, with partial inflammation control. Adverse effects included corticosteroid-induced ocular hypertension (two pa- tients) and prolonged corticosteroid complications such as posterior subcapsu- lar cataracts, hypertension, and obesity in one patient. This case series underscores the clinical and therapeutic heterogeneity of TINU. Anterior uveitis with asymptomatic acute kidney injury was the most common presentation. While systemic corticosteroids managed initial inflam- mation, relapses were frequent, necessitating additional immunosuppressive therapies. MTX was effective for some but limited by toxicity, and mycophe- nolate mofetil was a partial alternative. These findings highlight the need for a multidisciplinary approach in managing TINU. FP06-13 A blind spot in immunotherapy: report of pembrolizumab-associated NAION C.-L. Comberg1, D. Makhoul1, Y. Azzagnuni2, A.N.A. Le1 1CHU Saint Pierre, Ophthalmology, Brussels, Belgium, 2Epicura, Internal medicine and endocrinology, Baudour, Belgium Pembrolizumab, a PD-1 antibody, has been widely used in cancer therapy since immune checkpoint inhibitors were introduced in 2011. Although effec- tive, its expanding use means its full safety profile is still evolving. Immune- related adverse events are well recognized, but rare ocular complications re- main insufficiently described. We report a case of pembrolizumab-induced non-arteritic ischemic optic neu- ropathy (NAION), illustrating an uncommon but serious adverse effect. A 49-year-old woman presented with blurred vision in her right eye for seven days and a sudden “black spot” in her visual field for several hours. Her past medical history included stage III melanoma treated with pembrolizumab one month earlier, plus adrenal insufficiency managed with hydrocortisone. Examination revealed reduced visual acuity in the right eye, a relative afferent pupillary defect, and an altitudinal field defect. Funduscopy showed optic disc edema in the right eye, with fluorescein angi- ography confirming delayed disc filling in early phases and pronounced leak- age later, consistent with NAION. She was started on aspirin therapy. After five weeks, her right eye demonstrated improved visual acuity, resolu- tion of the field defect, and reduced optic disc edema. The left eye remained unaffected. Most documented cases of PD-1 inhibitor-associated optic neuropathy involve inflammatory mechanisms. By contrast, this first report of pembrolizumab- induced NAION suggests a vascular pathophysiology. We hypothesize that pembrolizumab might alter coagulation, compromising optic nerve head per- fusion and leading to ischemia. As these agents are increasingly employed, physicians should be mindful of potential ocular adverse effects. In patients on PD-1 inhibitors who present with acute vision loss and optic disc edema - but without overt inflammatory signs—ischemic optic neuropa- thy must be considered. Prompt recognition and appropriate management are critical for preserving vision. FP06-10 Ischaemic bilateral retinal vasculitis and its diagnosic challenges A. Krezel1, C. Goodchild1 1Royal Victoria Eye and Ear Hospital, Dublin, Ireland Introduction: Retinal vasculitis is the inflammatory condition affecting ret- inal blood vessels leading to their occlusion and hypo-perfusion. It can be either idiopathic or of systemic origin. Discovery of the underlying cause ena- bles its effective management. Purpose: To describe a case of persistent bilateral retinal vasculitis with is- chaemia and neovascularization in a 32-year-old African woman and details diagnostic challenges along the way during and post pregnancy. Methods: This is a case report of a 32-year-old African female who presented in our eye casualty with floaters and photopsia in the right eye (vision 6/6 both eyes). Examination revealed mild vitreous haemorrhage, bilateral periph- eral retinal ischaemia, right supero-temporal neovascularization, hyperaemic discs, and occasional vitreous cells in the left eye. An epiretinal membrane was noted. The patient had a history of pregnancy-induced hypertension, which resolved postpartum. Results: A series of ophthalmic (OCT, FFA) and systemic investigations were conducted. Systemic workup included QuantiFERON, haemoglobin electrophoresis, autoimmune, infec- tious disease panels, HLA-B51 and HLA-B27. Initially considered as a possi- ble case of sickle cell trait, excluded post haematological consultation. Ruling it out was hindered by deferring information from the patient and lab results. Other systemic investigations were reported as negative. The patient has been started on oral steroids, followed by bilateral laser photocoagulation on suspi- cion of inflammatory cause and a possible diagnosis of IRVAN. Conclusions: This report illustrates the complexity of retinal vasculitis diag- nostics. Despite initial suspicion of sickle cell trait, the cause remains elusive. Ongoing investigations are necessary, to unveil possible systemic causes and prevent further complications. FP06-12 Heterogeneous presentations and therapeutic challenges in tubulointerstitial nephritis and uveitis: a case series R. Whitfield1, S. Mano1, I. Leal1 1ULS Santa Maria, Ophthalmology, Lisbon, Portugal We present a case series of six female patients (mean age: 20 years, range: 7–57 years) diagnosed with tubulointerstitial nephritis and uveitis (TINU). Four were paediatric, and two were adults. Clinical presentations varied: three patients had anterior uveitis alone, two had uveitis with systemic symptoms, and one had systemic symptoms preceding uveitis by three months. Renal dysfunction was observed in all patients at diagnosis, confirmed as tubuloint- erstitial nephritis. Renal biopsies were performed in four cases, and B2 mi- croglobulin in all patients with levels averaging 5.70 mg/L. Topical corticosteroids and cycloplegics were the first-line therapy for ocular inflammation. Systemic corticosteroids achieved disease control in five pa- tients, but frequent uveitis relapses necessitated immunomodulatory therapy. Methotrexate (MTX) was used in four patients with variable effectiveness; one required adalimumab for persistent inflammation, while another experi- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 23

FREE PAPER PRESENTATIONS FP06-14 The importance of intraocular fluid analysis in the diagnosis and management of uveitis: a 4-year experience in an uveitis tertiary center J. Romana1, M. Madeira1, M. Tavares Correia1, M. Cordeiro1, M. Guedes1 1Hospital Egas Moniz, Unidade Local de Saúde Lisboa Ocidental, Lisbon, Portugal Purpose: Diagnostic anterior chamber (AC) paracentesis and diagnostic pars plana vitrectomy (PPV) are safe procedures. A rapid analysis of intraocular fluids can make a decisive contribution to a definitive diagnosis and targeted therapy. Our aim was to characterize the usefulness of intraocular fluid analysis in the diagnosis of patients with uveitis in a tertiary center. Methods: Retrospective study including patients with uveitis who underwent diagnostic AC paracentesis or diagnostic PPV at Centro Hospitalar de Lisboa Ocidental between March 2020 and May 2024. AC paracentesis were per- FREE PAPER PRESENTATIONS Free Paper 7: Education, Contact Lenses, Cornea, Ocular Surface, Glaucoma FP07-1 Comparative performance of artificial intelligence models in basic ophthalmological triage P. Cardoso-Teixeira1, J. Alves Ambrósio1, J. Chibante Pedro1, L. Figueiredo1 1Unidade Local de Saúde de Entre o Douro e Vouga, Ophthalmology Service, Santa Maria da Feira, Portugal Purpose: The advent of large language models (LLMs) has the potential to enhance workflows in ophthalmological outpatient triage. Evaluating their diagnostic performance is critical for their integration into clinical practice. formed after instillation of 5% povidone-iodine, puncture with a 30G needle This study investigates and compares the performance of ChatGPT 4, in the infero-temporal quadrant, extraction of 0.1-0.2 mL of aqueous humor ChatGPT 4.0, and Google Gemini 1.5 Pro in accurately categorizing the rea- and administration of topical antibiotic therapy. sons for ophthalmological consultations. The diagnostic PPV were carried out in the operating room, obtaining un- Method: We conducted a retrospective analysis using cross-sectional data diluted vitreous humour. Demographic data and immunological status were assessed as well as indication for biopsy and final diagnosis. Intraocular fluid samples were analyzed by polymerase chain reaction, cultures, cytology and/ or flow cytometry. Results: 50 biopsies were included (34 AC punctures and 16 vitrectomies), corresponding to 47 patients (23 male, mean age 50.5±20.8 years). 39 patients (78%) were immunocompetent. The most frequent indications for biopsy were acute retinal necrosis (ARN) (n=9), suspicion of intraocular lymphoma (n=13) and atypical toxoplasmosis (n=8). A positive result was obtained in 28 biop- sies (56%), 19 CA paracenteses (55,9%) and 9 vitrectomies (56,2%). The most frequent final diagnosis after biopsy were intraocular lymphoma (n=6), ARN (n=7), toxoplasmosis (n=7) and idiopathic (n=20). There were no complications. Conclusion: CA paracentesis and diagnostic PPV are safe procedures. Cost- effectiveness is highly dependent on pre-test sensitivity and adequate process- ing of samples. Intraocular fluids analysis in patients with uveitis may be help- ful in severe and/or atypical cases. from triage requests for ophthalmological consultations referred by general practitioners. The reasons for consultation were input into the LLMs for clas- sification into 16 categories, and their outputs were compared to the classifi- cations confirmed by ophthalmologists. Initially, the models were assessed without prior training. Then, the models were trained with a random selection of 20% of cases, and their performance was evaluated. Model consistency was also assessed. Additionally, we evaluated the ability of the LLMs to triage cases directly to subspecialties. Results: Among the 4,788 cases, the three LLMs achieved an overall ac- curacy of 73% without prior training. Google Gemini 1.5 Pro demonstrated the highest accuracy (74%), followed by ChatGPT 4.0 (73.4%) and ChatGPT 4 (72.9%). After training, ChatGPT 4.0 achieved an improved accuracy of 77.5%. The models exhibited a consistency rate of 89.1%. For subspecialty triage, the LLMs successfully directed approximately 35.5% of cases to spe- cific subspecialties. Conclusions: LLMs show promise in triaging ophthalmological complaints, especially in settings with inconsistent access to timely healthcare. These technologies could streamline workflows, bypass generalist consultations, and enable direct evaluation by specialists. Despite limitations, determining the optimal amount of training data is essential for improving triage accuracy and maximizing the potential of these models to enhance patient care in ophthal- mology. 24 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP07-2 FP07-3 Trialling new large language models (LLMs) in ophthalmic non-imaging examination questions: an updated performance evaluation H. Rocha1, Y.J. Chong2, Y.L. Wong3, S.W. Wong3, S.Y.-H. Chang4, M. Azzopardi5, B.K.J. Tan6, A. Song5,7, A. Malem8,9, N. Jain10, S. Zhou11, T. Fang12, A.J. Thirunavukarasu13,14, D.S.J. Ting15,16 1University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 2Singapore Eye Research Institute, Singapore, Singapore, 3Manchester Royal Eye Hospital, Manchester, United Kingdom, 4Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, 5Moorfields Eye Hospital, London, United Kingdom, 6Singapore General Hospital, Singapore, Singapore, 7Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom, 8Cleveland Clinic, Abu Dhabi, United Arab Emirates, 9Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Ohio, United States, 10Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom, 11Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom, 12Singapore National Eye Centre, Singapore, Singapore, 13Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom, 14University of Oxford, Medical Sciences Division, Oxford, United Kingdom, 15University of Birmingham, Department of Inflammation and Ageing, College of Medicine and Health, Birmingham, United Kingdom, 16Birmingham and Midland Eye Centre, Birmingham, United Kingdom Purpose: Large Language Models (LLMs) are rapidly evolving, with newer versions exhibiting novel capabilities. Previous studies have trialled LLMs Scleral lens use in the management of ocular cicatricial pemphigoid B. Severinsky1 1Emory University, Dept of Ophthalmology, Atlanta, United States Purpose: Symptom management in Ocular Cicatricial Pemphigoid (OCP) is challenging due to the progressive factors of dry eye, scarring, trichiasis, and vision impairment. We set out to evaluate the benefits and therapeutic effects of scleral contact lenses in the management of OCP. Methods: A retrospective review was performed over a database of 20 patients (36 eyes) fitted with scleral lenses (SL) at the Department of Ophthalmology, Emory University from May 2018 to April 2021. We evaluated the fitting indi- cations, the time required for the ocular surface stabilization, vision rehabilita- tion success, and ocular complications. Results: The mean age was 67.4 (range, 43-81) years, with 4 to 1 female to male predominance. The mean duration of the follow-up was 16.5 months (range, 1.5-35). The mean wearing time was 9.0±1.9 hours a day, with no overnight wear permitted. All fitted patients reported a subjective improve- ment in ocular comfort after initiations of SL wear. The mean keratopathy grading improved from 2.1±0.8 to 1.4±0.7 at the last documented visit. The mean visual acuity improved from 0.56± 0.51 (logMAR) to 0.34± 0.45, in 46% of patient eyes visual acuity improved by two or more lines. 96% of fit- ted eyes responded well to therapy and continued scleral lens wear. Patients who initially presented with fornix shortening, symblepharon, and trichiasis remained stable. Conclusions: Scleral lenses offer ocular surface preservation, symptom relief, and improved visual acuity in patients with ocular pemphigoid. They should in answering ophthalmic non-imaging questions from a professional ophthal- be strongly considered as ancillary therapy in patients with OCP. mology examination, demonstrating comparable results to doctors. With sig- nificant advancements of previous models, this warrants a further evaluation as part of a continuation study. This study aimed to trial the newest versions of LLMs in answering ophthal- FP07-4 mic non-imaging questions. Method: The FRCOphth Part 2 written multiple-choice examination is taken by ophthalmic trainees in the United Kingdom. Questions from a FRCOphth Part 2 examination book that isn’t readily available on the internet were used. Out of 360 questions, 345 were sourced (15 were excluded due to non-textual components within the question). Questions were input into GPT-4o, Gemini Advanced, Claude 3.5 Sonnet, and Meta-Llama 3.2. LLM output and answers were recorded and analysed. Results: The highest performing LLM was Claude 3.5 Sonnet (76.8%), fol- lowed by GPT-4o (69.9%), Gemini Advanced (62.3%), and Meta-Llama 3.2 (50.4%). Despite a higher raw score, Claude 3.5 Sonnet performance was sta- tistically similar to GPT-4o (χ2 = 4.268, p = 0.0388), but did score significantly better than Gemini Advanced (χ2 = 17.112, p < 0.001) and Meta-Llama 3.2 (χ2 = 51.856, p < 0.001). Claude 3.5 Sonnet and GPT-4o scored higher than the mean candidate score for the FRCOphth Part 2 written examinations aver- aged across the 2022-2024 sittings (66.4%); Claude 3.5 Sonnet, GPT-4o, and Gemini Advanced all scored higher than the mean official pass mark derived from standard setting (61.2%). Conclusion: This study shows that the latest LLMs perform remarkably well in ophthalmic non-imaging questions. Three of 4 LLMs tested demonstrated pass-worthy scores. This highlights the rapid evolution of artificial intel- ligence and how it can possibly be used as an assisting tool in ophthalmic medical education. The influence of omega-3 fatty acid supplementation on the tear film quality in celiac patients - a randomized clinical trial N. Hodzic1, I. Banjari2, Z. Musanovic3 1Blue (Plava) Medical Group, Department of Ophthalmology, Tuzla, Bosnia and Herzegovina, 2Faculty of Food and Technology, J.J. Strosmayer University of Osijek, Clinical Nutrition, Osijek, Croatia, 3Universitiy Clinical Center Tuzla, Department of Ophthalmology, Tuzla, Bosnia and Herzegovina Purpose: The aim of the research was to determine the quality of the tear film, i.e. the frequency and symptoms of dry eye syndrome (DED) and effective- ness of omega 3 fatty acids supplementation on DED in patients with coeliac disease. Methods: 100 subjects diagnosed with coeliac disease, both sexes, aged 38.0 ± 9.3 years (19-49 years) were recruited, and the quality and quantity of the tear film was examined by subjective (OSDI) and objective methods (Shirmer test and TBUT). Results: The frequency of severe DED in patients ranged from 3% to 39%, depending on the test observed. 45 patients with the worst tear film qual- ity and quantity parameters were selected for a randomized clinical trial (NCT05825976). Patients (per 15) were randomized to one of three interven- tion arms: placebo positive control (2000 mg olive oil), intervention 1 (720 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 25

FREE PAPER PRESENTATIONS mg EPA and 480 mg DHA) and intervention 2 (320 mg EPA and 200 mg FP07-6 DHA) during 45 days. Post intervention, in the control group, no change in the quality of the tear film or the symptoms of DED was found. Intervention 1 had a statistically significant improvement in all parameters: OSDI (p=0.001), Schirmer test (p=0.005), TBUT (p=0.001) post intervention. The same was noted for intervention 2, but more than 50% of subjects had no improvement in the subjective symptoms of DED post intervention. Conclusions: Patients with coeliac disease have a higher prevalence of DED compared to literature data for the healthy population. Supplementation with omega-3 fatty acids has proven to be an effective adjuvant therapy for celiac disease patients in the treatment of DED, especially higher doses of omega-3 fatty acids. FP07-5 The role of different light-based devices in the treatment of dry eye disease G. Freitas Santos1, J. Leite1, J.H. Marques1,2, B. Barbosa-Ribeiro1, P. Sousa1, S. Pires1, P. Menéres2,1, I. Barbosa1,2 1Unidade Local de Saúde de Santo António (ULSSA), Department of Ophthalmology, Porto, Portugal, 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Ophthalmology, Porto, Portugal Purpose: To assess and compare the effectiveness of intense pulsed light (IPL) alone or combined with low-level light therapy (LLLT) in meibomian gland dysfunction (MGD). Method: This prospective, non-randomized comparative study included a total of 186 eyes of 93 patients diagnosed with MGD. Each patient was con- secutively assigned to one of three treatments: Eye-Light® combined with My-Mask® (group 1; Espansione Marketing, Italy); E>Eye® (group 2; ESW vision, France); Thermaeye Plus (group 3; OptiMed, Australia). Patients were evaluated at baseline and at 1, 6, 12 and 18 months after treat- ment for the presence of symptoms (Ocular Surface Disease Index - OSDI) and ocular surface changes by automated analysis (IDRA® Ocular Surface Analyzer SBM Sistemi, Italy): non-invasive tear break-up time (NIBUT), blink rate (BR), tear meniscus height (TMH), lipid layer thickness (LLT) and loss area of meibomian glands (LAMG). Tear osmolarity (Osm) (TearLab® Fresh myopic lenticule transplantation in combination with corneal crosslinking for the management of keratoconus C.E. Semiz1, F. Semiz1, N. Hima-Musa1, F.F. Arslan2 1Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 2Istanbul-Cerrahpasa University, Ophthalmology, Istanbul, Turkey Purpose: To evaluate the efficacy and safety of lenticule transplantation in combination with corneal crosslinking (CXL) in patients with keratoconus. Methods: This study, conducted at the Eye Hospital, Department of Refractive Surgery in Prishtina, Kosovo, included 30 eyes from 15 patients (aged 18- 28) diagnosed with keratoconus. By the time they were referred, the patients had undergone bilateral CXL at other clinics. Their central corneal thickness (CCT) ranged from 420 to 450 μm. Donor lenticules were sourced from patients who had undergone small inci- sion lenticule extraction (SMILE) for myopic refractive error correction, with refractive errors between -3.00 D and -6.00 D and thicknesses from 60 to 100 μm. An 8 mm stromal pocket was created in the recipient cornea with a cap thickness of 130 μm and a 3.00-mm incision. Lenticules were transplanted into the pocket based on high keratometric values. Because high keratometric values show thin corneal areas, the incision was made at that angle, allowing the myopic lenticule to be positioned at the narrowest point of the keratoconus. This strategic placement aimed to increase corneal thickness and improve vi- sion by reducing astigmatism. The patients were followed for 2 years. Clinical assessments included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), slit-lamp biomicroscopy, corneal topography, anterior segment optical coherence tomography, and pachymetry. Results: At the two-year postoperative mark, preoperative CDVA improved significantly from 0.86 ± 0.22 logMAR (range: 0.40 to 1.10 logMAR) to 0.47 ± 0.09 logMAR (range: 0.30 to 0.52 logMAR) (P < .001). Additionally, CCT increased from 420 μm to 530 μm (P < .001), and the preoperative Q value improved from -0.80 to -0.48 (P < .001). Conclusion: This technique is safe, cost-effective, and reliable, resulting in significant improvements in both visual acuity and corneal thickness. Osmolarity System, Tearlab, San Diego, CA, USA), Schirmer’s test (ST) and FP07-7 slit lamp examination (Oxford score) were also evaluated. Deltas (Δ) of progression were built for all parameters. Statistical analysis was performed among the treatment groups. Results: At 18 months post-treatment, statistically significant differences were observed among the groups for the Δ_OSDI score (-29.27 VS -14.31 VS -18.91, p=0.004), Δ_BR(-26.27 VS-5.00 VS 25.09, p<0.001), Δ_LLT (36.43 VS 28.38 VS 3.55, p<0.001), Δ_LAMG (-1.11 VS -3.19 VS 11.36, p=0.009), Δ_TFO (10.00 VS -8.00 VS -1.00, p<0.001) and for the Δ_Oxford score (-0.41 VS -0.46 VS -0.18, p=0.034). No significant differences were found for the NIBUT, TMH and ST among the groups. Conclusion: This study revealed that patients with dry eye disease treated with IPL combined with LLLT had a higher degree of improvement in most subjective and objective parameters evaluated than those treated with IPL In vivo confocal microscopy evaluation of infiltrated immune cells in corneal stroma treated with cell therapy in advanced keratoconus M. El Zarif1,2,3,4, J.L. Alió1, K. Abdul Jawad2, N. Makdissy4 1Miguel Hernandez University, Division of Ophthalmology, Alicante, Spain, 2Optica Genaral, Research in Ophthalmology, Saida, Lebanon, 3Doctoral School of Sciences and Technology, Biotechnology, Beitut, Lebanon, 4Lebanese University, Genomic Surveillance and Biotherapy GSBT, Faculty of Sciences, Beirut, Lebanon Purpose: This study investigates immune cell (ICs) infiltration in advanced keratoconus patients undergoing autologous adipose-derived adult stem cell (ADASC) therapy with recellularized human donor corneal laminas (CL). Methods: A prospective clinical trial included fourteen patients divided into three groups: G-1, ADASCs; G-2, decellularized CL (dCL); and G-3, dCL re- cellularized with ADASCs (ADASCs-rCL). Infiltrated ICs were assessed using in vivo confocal microscopy (IVCM) at 1, 3, 6, and 12 months post-transplant. alone. 26 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP07-9 Effectiveness and reproducibility of a new method for noninvasive ocular surface assessment: from normal to dry eye disease L. Goldfarb Cyrino1, A. Latuffe Soares Damião1, R. Martins Maia1, L. Pizzato Tondo1, F. Nii1, T. Kondo1, R. M. Santo1, S. Matayoshi1, A. C. Pieroni Gonçalves1, M. Luiz Ribeiro Monteiro1 1University of São Paulo Medical School, Division of Ophthalmology, São Paulo, Brazil Purpose: Dry eye disease (DED) is a prevalent condition affecting quality of life globally. Accurate diagnosis is essential for effective management, but traditional methods can be invasive, variable, and time-consuming. This study evaluates the Medmont Meridia™, a noninvasive device for ocular surface assessment. Methods: This prospective, cross-sectional study included 55 partici- pants (108 eyes) classified by Ocular Surface Disease Index (OSDI) scores. Comprehensive ophthalmological evaluations were performed, and data ana- lyzed using R (version 4.2.2) with normality tests and non-parametric analy- ses. Descriptive statistics and the Wilcoxon test compared DED and control groups, while logistic regression assessed Medmont parameters as DED pre- dictors (p < 0.05). Results: Of 108 eyes, 66 were diagnosed with DED, and 42 were controls. Significant differences were found in Tear Film Surface Quality (TFSQ), Meibomian Gland Dropout Ratio (MGDR), OSDI score, Break-Up Time (BUT), and Schirmer test between groups. No significant differences were observed for Tear Meniscus Height, gender, or inferior Meiboscale. TFSQ negatively correlated with Schirmer and positively with OSDI; MGDR cor- related with age and OSDI. Logistic regression identified TFSQ, MGDR, su- perior Meiboscale, and Non-Invasive Break-Up Time (NIBUT) as DED pre- dictors, with MGDR showing the highest accuracy (AUC 0.661). Both BUT and NIBUT were significant predictors, with BUT offering a better model fit. Bland-Altman analysis confirmed strong agreement between BUT and NIBUT. Conclusions: This study supports non-invasive diagnostic alternatives for DED, showing significant agreement between BUT and NIBUT. Key predic- tors for DED symptoms included TFSQ, MGDR, superior Meiboscale, and NIBUT. Challenges to widespread adoption include the device’s cost and lack of measurement automation. Results: Infiltrated ICs, encompassing granulocytes and agranulocytes, were observed across all groups, categorized by luminosity, structure, and area. Stromal ICs infiltration ranged from 1.19% to 6.62%, with a consistent in- crease in group-related cell density (F=10.68, P<.0001), independent of post- op time (F=0.77, P=0.511); the most substantial variations were observed in G-3 at 6 and 12 months (2.0 and 1.87-fold, respectively). Similarly, significant size increases were more group-dependent (F=5.76, P<.005) rather than time-dependent (F=2.84, P<.05); G-3 exhibited significant increases at 6 and 12months (3.70-fold and 2.52-fold, respectively). A lamina- induced shift in IC size occurred (F=110.23, P<.0001), primarily with 50-100 μm² sizes and up to larger cells >300μm², presumably macrophages, notably in G-3, indicating a potential role in tissue repair and remodeling, explaining reductions in cells remnants <50μm². Conclusions: ADASCs-rCL therapy may lead to increased IC infiltration compared to ADASCs alone, impacting cell distribution and size due to the presence of the lamina. The findings reveal intricate immune patterns shaped by the corneal microenvironment and highlight the importance of understand- ing immune responses to develop future therapeutic strategies. FP07-8 Transplant to implant science: phase-2 safety evaluation & longitudinal analysis of endothelial tissue substitutes (INDIA study) L.R. Daniel Ponniah1, EndoArt Society 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 with pseudophakic chronic endothelial dysfunction, and its long-term safety Setting: A prospective open-label clinical safety & efficacy evaluation, and a longitudinal analysis Methods: Endothelial dysfunction following pseudophakic corneal edema which is not associated with systemic diseases like Herpes Simplex or prior corneal surgeries was subjected to a central 6.5 mm synthetic endothelial im- plantable substitute after a central 7.0mm descemetorhexis & attached with C3F8 gas (85% fill in the AC). Pre & post-operative central pachymetry (in mic.), vision (in ETDRS characters), and pain analog (1-100) were analyzed in addition to re-bubbling rates & toxic reactions due to implants and followed up monthly for 24 months Results: 12 cases were enrolled. The longest follow-up is 36 months, min. follow-up is 24 months. Baseline vision was 10.54+/-2.2 ETDRS characters, which improved to 41.75+/-8.7 characters by M-1 & retained at 60.72+/-13.1 characters by M-24. Mean Central pachymetry reduced from 720 mic, to 552 mic. by M-1 & maintained at 491 mic. by M-24. The presenting pain was 91.9+/-2.3 & was 7.7+/-2.5 at M-24 (p<0.0001). No immunologic or other adverse reactions were noticed. None were explanted. 5 cases needed re- bubbling (D7, D7, D11, D12 & 21,D7, D14&M3). One subject died after 6 months, postmortem HPE reports revealed epithelialization & fibrosis along the implant edges favoring long-term device retention Conclusion: Endothelial keratoprosthesis improved vision and reduced ede- ma caused by pseudophakic endothelial dysfunctions. It was not associated with toxicities until month 24 and is continuously monitored. It could be an alternative to EK with no risks of rejections or graft failures, and it could change the practice pattern of “Transplant to Implant Science.” Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 27

FREE PAPER PRESENTATIONS FP07-11 Long-term outcomes of fresh lenticule transplantation in herpetic scarring: a three-year study F. Semiz1, C.E. Semiz1, G. Tanrıverdi2, M. Purelku3, N. Hima-Musa1, F.F. Arslan4 1Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 2Istanbul- Cerrahpasa University, Histology and Embryology, Istanbul, Turkey, 3Bahcesehir University, Histology and Embryology, Istanbul, Turkey, 4Istanbul-Cerrahpasa University, Ophthalmology, İstanbul, Turkey Purpose: The purpose of this study is to investigate a novel surgical method antimicrobial treatment (Group 2). Both groups received 0.5 % moxifloxacin. We evaluated BK recovery, anterior chamber (AC) reactions, corneal haze, and pain (on a 10-point scale) 12 hours and 1, 3, 5, and 14 days after treat- ment. 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 was resolved by Day 3 in Group 2. The baseline pain scores were also comparable between Groups 1 and 2 (P = 0.52) and de- creased throughout the follow-up period (all P <0.05); the decrease was more pronounced in Group 2 for corneal regeneration in patients with herpetic scarring. This method aims Conclusion: Novel DDCLs augment the drug-lesion interaction time by pro- to enhance healing, restore corneal clarity, and improve visual outcomes while longing corneal antimicrobial availability, which hastens corneal healing in minimizing complications commonly associated with traditional techniques. BK. Thus, a DDCL may decrease the antibiotic regimen and improve patient Methods: The study included 23 eyes from 23 patients, aged 21 to 46 years, tolerance, eliminating the necessity for a loading dose. diagnosed with ocular herpes scarring. The thickness of the herpetic stromal scar was measured in microns using optical coherence tomography (OCT). The scar tissue extraction was performed using femtosecond laser small inci- sion lenticule extraction (SMILE), followed by the transplantation of a fresh FP07-13 lenticule of the same volume through the incision. Lenticules were transplant- ed according to corneal topography. All patients were followed for at least 3 years, with assessments including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), slit-lamp biomicroscopy, corneal topography, anterior segment opti- cal coherence tomography and pachymetry. A lenticule sample was obtained from a treated patient three years postopera- tively for examination using transmission electron microscopy. Results: There was a significant improvement in preoperative corrected dis- tance visual acuity (CDVA), increasing from 0.88 ± 0.26 logMAR to 0.49 ± 0.08 logMAR (P < .001). Additionally, the Q value decreased from -0.39 ± 0.04 preoperatively to -0.67 ± 0.05 postoperatively. Conclusion: Lenticule transplantation is a safe and effective treatment that enhances visual acuity by modifying the Q value while facilitating corneal stabilization and regeneration. FP07-12 Drug-repository contact lens for prolonging antimicrobial - cornea interaction in bacterial keratitis: randomized controlled trial results L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cornea & Ocular Surface Diseases, Tirunelveli, India Purpose: Microbial keratitis can cause unilateral blindness, but the drug de- livery treatment options are poor. Therefore, this study evaluated the efficacy of a novel therapeutic drug-depository contact lens (DDCL) for bacterial keratitis (BK) treatment. The lens was designed to increase the corneal lesion- antimicrobial drug interaction time. Methods: An open-labeled randomized controlled study to compare topical antimicrobial administration and antimicrobial administration with DDCLs Safety and efficacy of bevacizumab in augmenting trabeculectomy for glaucoma: an updated meta-analysis of randomized controlled trials A. Alnabihi1, A. Alamoudi2, A. Aldahlawi1, R. Sharif1, N. Almufarraji2, M. Albadri3, K. Aldihan4, S. Alshahwan4 1Ministry of Health, Saudi Arabia, Jeddah, Saudi Arabia, 2Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia, Jeddah, Saudi Arabia, 3College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, 4King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia Purpose: To evaluate the safety and efficacy of bevacizumab as an adjunctive therapy in improving surgical outcomes following trabeculectomy in patients with glaucoma. Given that glaucoma is a leading cause of irreversible blind- ness, understanding the impact of bevacizumab on enhancing the effectiveness of this surgery is critical for optimizing patient care. Methods: A systematic search was conducted using databases like Medline, Embase, and CENTRAL, focusing on randomized controlled trials (RCTs) that compared bevacizumab with placebo or MMC in trabeculectomy for glaucoma. Data were extracted from 20 studies involving 1198 eyes, and sta- tistical analysis was performed using Review Manager 5.4.1. Results: We found no significant reduction in IOP when comparing bevaci- zumab to placebo (MD = -2.22, 95% CI, [-5.10, 0.66], p = 0.13), MMC (MD = 0.04, 95% CI, [-1.11, 1.19], p = 0.95), or bevacizumab plus MMC versus MMC (MD = -0.82, 95% CI, [-0.62, 2.26], p = 0.27). However, bevacizumab significantly improved the complete success rate com- pared to placebo (RR = 1.57, 95% CI, [1.22, 2.03], p = 0.0005) and marginally favored bevacizumab plus MMC over MMC alone (RR = 1.12, 95% CI, [1.00, 1.26], p = 0.04). Bevacizumab also significantly reduced the failure rate com- pared to placebo (RR = 0.35, 95% CI, [0.13, 0.94], p = 0.04). No significant differences were identified in adverse events, including bleb leaks, hypotony, hyphema, or anterior chamber shallowing, except for an in- for treating BK. Bacterial Keratitis (BK) patients were randomized (1:1) into two groups: topical antimicrobial treatment only (Group 1) and DDCL plus creased risk of encysted blebs with bevacizumab versus MMC (RR = 2.26, 95% CI, [1.19, 4.30], p = 0.01). 28 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Conclusion: Bevacizumab demonstrated a good safety profile and effective- ness in improving the complete success rate and reducing medication use compared to placebo but did not offer significant IOP-lowering benefits com- pared to either placebo or MMC. Further research is needed to solidify its role in trabeculectomy procedures. FP07-14 Molecular detection of eukaryotic microorganisms in aqueous humor of eyes with pseudoexfoliation syndrome and pseudoexfoliation glaucoma M. Esen Baris1, S. Sahin1, M. Asadi2, U. Mert3, A. Caner4, S. Guven1 1Ege University, Ophthalmology, Izmir, Turkey, 2Ege University, Basic Oncology, Izmir, Turkey, 3Ege University, Vocational School of Health Services, Izmir, Turkey, 4Ege University, Medical Parasitology, Izmir, Turkey Purpose: While body tissues and fluids have been shown to be colonized by eukaryotic microbes, whether the aqueous humor is colonized by fungal/ parasite microbiota is not known. Here, the presence of nucleic acids of eu- karyotic microorganisms in aqueous humor (AH) of eyes with pseudoexfolia- tion syndrome (PXS) and exfoliation glaucoma (XFG) and healthy eyes were investigated. Methods: Patients with no systemic and ocular diseases other than PXS and XG, and healthy age and sex matched volunteers (HC) were included. AH (volume ranged between 50 to 300 ml) from 53 participants (23 XG, 13 PXS, and 17 HC) were collected during cataract surgery. Total RNA FP07-16 Trialling large language models (LLMs) in multimodal ophthalmic imaging interpretation: LLMs versus doctors performance in FRCOphth part 2 examination questions H. Rocha1, Y.J. Chong2, Y.L. Wong3, S.W. Wong3, M. Azzopardi4, B.K.J. Tan5, A. Song4,6, A. Malem7,8, S.Y.-H. Chang9, N. Jain10, S. Zhou11, T. Fang12, A.J. Thirunavukarasu13,14, D.S.J. Ting15,16 1University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 2Singapore Eye Research Institute, Singapore, Singapore, 3Manchester Royal Eye Hospital, Manchester, United Kingdom, 4Moorfields Eye Hospital, London, United Kingdom, 5Singapore General Hospital, Singapore, Singapore, 6Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom, 7Cleveland Clinic, Abu Dhabi, United Arab Emirates, 8Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Ohio, United States, 9Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, 10Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom, 11Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom, 12Singapore National Eye Centre, Singapore, Singapore, 13Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom, 14University of Oxford, Medical Sciences Division, Oxford, United Kingdom, 15University of Birmingham, Department of Inflammation and Ageing, College of Medicine and Health, Birmingham, United Kingdom, 16Birmingham and Midland Eye Centre, Birmingham, United Kingdom and DNA were extracted by using TRIZOL method. Eukaryotic microor- Purpose: Large Language Models (LLMs) have advanced, with many now ganisms including fungi and parasites were investigated by RT-qPCR us- ing universal primers (Forward: 5’-GGRAAACTCACCAGGTCCAG-3’, Reverse: 5’-GSWCTATCCCCAKCACGA-3’) and hydrolysis probe ((6FAM) 5’-TGGTGCATGGCCGTT-3’ (MGBNFQ)) against 18S rRNA genes, and LightCycler® 480 Probes Master (Roche). Forty cycles of qPCR were applied in LightCycler® 480 device. Results were analysed by Fisher’s Exact Test. Results: Our study disclosed the eukaryotic microbes community in the AH with qPCR. Ten (43.4%) XFG eyes, 2 (15.4% ) PXS eyes, and 5 (29.4%) healthy eyes were found positive for 18S rRNA genes. Although no statis- tical significance was found when compared to the healthy group (p=0.28) and PXS (p=0.086), glaucoma group has the highest ratio of positivity. When compared to the healthy group, positivity of PXS was not significant either (p=0.32). Conclusion: Although we cannot confirm whether the eubiome identified in AH were pathogenic, our findings may provide a framework for further inves- tigations on the possible roles of fungi/parasite in glaucoma and PXS eyes. Confirming the presence and alteration of eukaryotic microbes between the healthy and diseased AH will allow the investigation of new therapies such as modulating the microbiota. able to interpret imaging. Previous studies have trialled the use of LLMs such as ChatGPT in answering non-imaging questions from a professional ophthal- mology examination, which demonstrated comparable results to doctors. With newer models available, we trialled current LLMs in answering multimodal ophthalmic imaging questions. Method: The FRCOphth Part 2 written multiple-choice examination is taken by ophthalmic trainees in the United Kingdom. Forty questions were created from 13 multimodal ophthalmic imaging questions taken from a FRCOphth Part 2 examination book that isn’t readily available on the internet combined with 27 imaging questions created by a consultant ophthalmologist who has passed the exam. Questions were input into GPT-4o, Gemini Advanced, Claude-Sonnet 3.5, and Meta-Llama 3.2. Performance was compared with the scores of 10 doctors at different stages of training (2 ophthalmology consultants, 7 ophthalmology trainees, and 1 unspecialised resident doctor). Results: The highest scoring LLM was GPT-4o (57.5%), followed by Claude- Sonnet 3.5 (47.5%), Gemini Advanced (35%), and Meta-Llama 3.2 (25%). Mean doctor performance was 71.5%. GPT-4o scored significantly better than Meta-Llama 3.2 (χ2 = 8.718, p = 0.0032), but statistically similar to Claude- Sonnet 3.5 (χ2 = 0.802, p = 0.371) and Gemini Advanced (χ2 = 4.074, p = 0.0435). GPT-4o performance was not significantly worse than the mean doc- tors’ score (χ2 = 3.41, p = 0.0648), but Claude-Sonnet 3.5 (χ2 = 9.849, p = 0.0017), Gemini Advanced (χ2 = 22.331, p < 0.001) and Meta-Llama 3.2 (χ2 = 35.713, p < 0.001) scored significantly worse relative to the doctors. Conclusion: This study serves as a benchmark for gauging LLM performance in ophthalmic imaging questions. GPT-4o demonstrated comparable results to the mean doctors’ performance. Absolute scores of other LLMs were lower but show promising results with scope for future improvement. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 29

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 8: Retina FP08-1 Surgical approaches and clinical outcomes in retinal detachment secondary to retinal capillary hemangioblastoma S.E. Kanik1, M. Ozbek1, H.O. Artunay1 1Beyoglu Goz Eye Training And Research Hospital, Istanbul, Turkey FP08-2 A retrospective study of the characteristics and clinical outcomes of traumatic eye injuries in a UK tertiary eye emergency centre A.H.Y. Liu1,2, T.C.J. Wong1, A. Mitra2, A. Barua2 1The Chinese University of Hong Kong, Department of Ophthalmology and Visual Sciences, Hong Kong, Hong Kong, SAR of China, 2Birmingham & Midland Eye Centre, Birmingham, United Kingdom Purpose: Ocular trauma can cause significant visual impairment without timely treatment, and can manifest in a variety of retinal complications. However, there is a lack of up-to-date statistics that systematically summarise the epidemiology and clinical outcomes of ocular trauma in Midland, UK. Purpose: To evaluate the surgical techniques and clinical outcomes of vitreo- This study aims to evaluate the characteristics of eye trauma patients and re- retinal surgery in patients with retinal detachment caused by retinal capillary view their surgical outcomes. hemangioblastoma (RCH). Method: A retrospective study was conducted on patients who visited eye Methods: This retrospective case series included eight eyes from eight pa- emergency services at BMEC, a tertiary eye trauma centre, diagnosed with tients who underwent pars plana vitrectomy. Complementary surgical inter- ventions performed concurrently with pars plana vitrectomy included scleral buckling in four eyes, suturing of the feeding vessel using 10-0 nylon in two ocular traumatic conditions and underwent surgery between January 2022 and July 2024. The Birmingham Eye Trauma Classification (BETT) was adapted to describe the characteristics of the ocular trauma. eyes, and tumor endoresection in three eyes. Preoperative treatments included Surgical outcomes were evaluated with best-corrected visual acuity (BCVA) intravitreal bevacizumab in 4 eyes and photodynamic therapy in 1 eye. Results: The mean age of the patients was 29.50 ± 10.18 years, with a mean follow-up duration of 29.62 ± 26.19 months. The mean number of surgeries per patient was 1.75 ± 1.16. Seven patients (87.5%) were diagnosed with Von and intra-ocular pressure (IOP) at presentation, immediately post-operation (post-op), and 3-month post-op. Result: 75 cases (White, 40%; Asian, 29.3%; Black, 12.5%; not specified, 42.5%) (mean age 43.3 ± 22.0 years) were recruited. Males (80%) dominated Hippel-Lindau syndrome. The types of retinal detachment that were observed the incidence. 73.3% was open wound, 20% had intraocular foreign body, included tractional (37.5%), exudative (37.5%), and combined tractional and exudative (25%). Anatomical success was achieved following a single surgical procedure in 75% of cases. Recurrence occurred in 25% of patients. Preoperative visual acuity was 1.89 ± 0.76 logMAR, postoperative visual acuity was 1.98 ± 0.59 logMAR, and final visual acuity was 1.67 ± 0.75 logMAR, with no statistically significant differences between these time points (p = 0.895). Tumor locations were predominantly peripheral (75%), with one case each of juxtapapillary and multiple diffuse lesions. Silicone oil removal was per- formed in 50% of cases, and no cases of phthisis bulbi were observed. 65.3% involved globe rupture, and 25.3% had retinal detachment. At presentation, the mean BCVA was 2.26 logMAR, no significant changes at post-op (2.24) and 3-month (2.07). Mean IOP at presentation was 6.76 mmHg, and it was improved to 12.2 and 11.3 at post-op and 3-month respectively. Conclusion: This study presented the up-to-date epidemiology and clinical outcomes of traumatic eye injuries in the UK Midland. Unfortunately, the majority (75%) had poor vision when presented, and their BCVA was not en- hanced to within range despite surgery. However, surgery enhanced IOP in our patients from precariously low values to a positive and stabilised outcome. Conclusion: Vitreoretinal surgery can achieve favorable anatomical outcomes Timely operation in these patients prevented the potential development of hy- in retinal detachment secondary to RCH, particularly in preserving eye integ- potony and preserved further damage to eye structures, despite existing globe rity and stabilizing vision. Further research must be conducted to ascertain the efficacy of surgical tech- niques concerning enhancing outcomes. rupture and retinal detachment. FP08-4 Effectiveness of pars plana vitrectomy, tPA and gravidational exchange with partial air in the treatment of submacular hemorrhage B. Dumlu1, S. Pehlivanoğlu2, Ş. Özçalışkan2, H.Ö. Artunay2 1Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey, 2Beyoğlu Eye Training and Research Hospital, Retina, İstanbul, Turkey Purpose: To evaluate the short-term anatomical and functional outcomes of pars plana vitrectomy(PPV) combined with partial air delivery and subreti- nal tissue plasminogen activator(tPA) in patients diagnosed with submacular hemorrhage. 30 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Methods: Patients diagnosed with submacular hemorrhage between 2015 and 2024 who underwent subretinal tPA injection combined with pars plana vitrec- tomy (PPV) and postoperative gravitational positioning were retrospectively reviewed. Demographic data, best corrected visual acuity (BCVA) pre- and postoperatively, and any complications were systematically recorded. Results: In our study, 69 patients were evaluated. Mean age was 71.06±11.69 years (13-92). All patients underwent standard PPV with subretinal tPA injec- tion, partial air tamponade without full tamponade, and postoperative gravi- tent visual loss (Δ-17 letters) despite reduced CMT (Δ–89µm), over a mean of 20±17 months. Three other iCRVO achieved stable vision (+5 letters) and reduced CMT (-261µm CMT) but requiring adjunctive anti-VEGF therapy every 6 weeks over the entire follow-up. Conclusion: FAc was effective and safe in treating ME in RVO. A third of patients required the adjunctive therapy to maintain disease control. This long- term management option for RVO patients reduced the burden of frequent IV injections that would otherwise be necessary to control the disease. tational positioning. The underlying etiologies included a history of trauma in 2 patients, macroa- neurysm rupture in 3 patients, polypoidal choroidal vasculopathy in 5 patients, choroidal neovascularization of unknown origin in 7 patients, and age-related FP08-6 macular degeneration in 52 patients. The time from symptom onset to hospital admission varied between 1 day and 1 year, with a mean of 13.65± 43.75 days. The mean time from admission to surgery was 8.87±8.28 days. 75.36%(52) patients had submacular hemorrhage displacement in the first postoperative week. The mean preoperative BCVA was 2.54±0.77LogMAR, while it was 2.45±0.77LogMAR on the first day af- ter surgery, 1.98±0.85LogMAR at the first week, and 1.65±0.82LogMAR at the first month (p=0.000). In addition, 75.36% of the cases improved in the first surgery, while the re- maining patients required a second vitrectomy. Conclusions: In patients with submacular hemorrhage, PPV combined with Hydraulic mobilization of the central parts of the retina in the treatment of chronic macular holes A. Rusanovskaia1, A. Farkhutdinova1, A. Zghaib2 1City Clinical Hospital №52 of Moscow Healthcare Department, Moscow, Russian Federation, 2Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation Purpose: To evaluate the safety and effectiveness of the technique of hydrau- lic mobilization of the central retina in the surgical treatment of chronic macu- gravitational positioning and partial air tamponade facilitates submacular lar holes. Methods: Thirty patients (32 eyes) with chronic macular hole were observed. All patients underwent standard 3-port, sutureless 25-gauge vitrectomy with removal of cortical layers of the vitreous body to the equator. After staining, the internal limiting membrane was removed using standard techniques. To mobilize the retina around the rupture, subretinal injections of balanced saline solution (BSS) were performed in the area of the maculorexis using a PolyTip 25/38 subretinal cannula connected to a syringe filled with BSS. Subretinal injections were performed in a four-quadrant manner. The criterion for completing the injection was the appearance of a wave of fluid from the injection site to the edge of the rupture. All four waves had to connect 360 degrees around the rupture. During this procedure, the infusion pressure was temporarily reduced to 15 mm Hg. Subsequently, fluid was replaced with air while draining subretinal fluid through the macular hole. The surgeries were completed either with tam- ponade of the vitreous cavity with air or with 16% hexafluorane (C2F6). After surgery, patients were maintained in a face-down position for 3 days. Results: Complete closure of macular hole was achieved in all cases, except one. The closure was stable throughout the follow-up period. No complica- tions related to retinal mobilization were observed. The mean value of the best-corrected visual acuity (BCVA) in the affected eye before intervention was 0.05 ± 0.01. The postoperative mean BCVA improved to 0.4 ± 0.23. The BCVA values after surgery were significantly increased in all cases (P = 0.001). Conclusion: Hydraulic mobilization of the central retina is an effective and safe technique for treating chronic macular ruptures, including large flat ones, supporting its continued use in vitreoretinal surgery. blood displacement and improves visual outcomes. Therefore, it may be con- sidered an appropriate and effective surgical approach. FP08-5 Insights from 15 clinical cases on the long-term management of retinal vein occlusion with Fluocinolone Acetonide intravitreal implants A.M. Ferreira1, M. Ribeiro1,2, S. Penas1,2, J.N. Beato1,2 1ULS São João, Porto, Portugal, 2Faculty of Medicine, University of Porto, Portoport, Portugal Purpose: Fluocinolone acetonide (FAc 0.19 mg, ILUVIEN®) is a long-acting corticosteroid offering a promising option for improving vision in retinal vein occlusion (RVO) patients with macular edema (ME). This study evaluated anatomical and functional responses following FAc implant placement in RVO patients. Methods: Case series of 15 RVO patients treated with a single FAc intravitreal implant at ULS São João. Changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and adjunctive therapy after Fac were assessed. Results: Fifteen patients, with a mean age of 75 years-old [43-99] and a mean ME duration of 5.7 years [2-9] were included. Nine patients had branch RVO (BRVO) and 6 ischemic central RVO (iCRVO). Before FAc, all eyes received IV anti-VEGF (mean 18.7±15) and short-term corticosteroid injections (mean 5.3±4). From the 5 phakic eyes, 3 underwent cataract surgery post-implant, and 2 eyes developed only incipient cataract. IOP remained stable during the follow-up period. For effectiveness, 9 BRVO eyes showed a preserved or slightly increased BCVA (Δ+4 ETDRS letters) with reduced CMT (Δ–124µm) over a mean of 22.2±18 months. Two BRVO patients achieved good initial response (during the first 6 months after FAc) but later required adjunctive monthly anti-VEGF therapy due to worsening of ME. In iCRVO cases, 3 eyes experienced persis- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 31

FREE PAPER PRESENTATIONS FP08-7 FP08-9 Results of external drainage and combined pars plana vitrectomy in cases of massive suprachoroidal hemorrhage Assessment of the paracentral acute middle maculopathy with multimodal imaging in Long term follow up O. Kandemir1, A. Korkmaz1, M. Arici1, H.O. Artunay1 1University of Health Sciences, Beyoglu Eye Training and Research Hospital, Ophthalmology, Istanbul, Turkey G. Kayikci1, S. Pehlivanoglu1, S. Belgin1, O. Artunay1 1University of Health Sciences Beyoglu Eye Training and Research Hospital, Opthalmology, Istanbul, Turkey Purpose: To evaluate the surgical results in cases with massive suprachoroidal Objective: To evaluate the initial and long-term follow-up of patients with hemorrhage. paracentral acute middle maculopathy (PAMM) using optical coherence Method: 23 eyes of 23 patients operated for massive suprachoroidal hemor- tomography (SD-OCT), OCT angiography (OCTA) and to compare with rhage in our clinic were retrospectively reviewed. The patients were evaluated healthy fellow eyes. in terms of mean age at the time of surgery, etiology, time to surgery, follow- up period, baseline and final best corrected visual acuity. Results: Twenty-three eyes of 23 patients with a mean age of 55.7± 25.9 years were evaluated. The patients were 7 (31%) female and 16 (69%) male. The follow-up period was 24.0±12.9 months. In 7 cases external drainage was performed, in 16 cases pars plana vitrectomy and external drainage were performed.The mean time to surgery was 17.6±6.1 days. Best corrected visual acuity improved from 2.11±0.14 logMAR at base- line to 1.68± 0.74 logMAR at the last visit (p:0.006). Additional pars plana Method: 45 eyes of 45 patients who were diagnosed with PAMM and fol- lowed up for at least 1 year between 2015-2023 were included. Best corrected visual acuity (BCVA-logMAR) at presentation, 1, 3, 6, 12 months and last visits were analyzed retrospectively. Retinal thickness (RT) ,superficial and deep capillary plexus (SCP, DCP) ves- sel density (VD) and foveal avascular zone (FAZ) area were recorded during visits,compared with fellow eyes. Results: The mean age was 60.8±12.79 years. 23 eyes were defined as isolat- ed PAMM,the associated vascular diseases were retinal artery branch/branchi- vitrectomy was performed in 4 patients in the combined group. 20 (86%) pa- al occlusion (RAO) in 17 eyes and retinal vein branch/branchial occlusion tients had anatomical success. Conclusion: Massive suprachoroidal hemorrhage is a rare complication with poor visual outcome. We believe that external drainage and combined pars plana vitrectomy is an anatomically and visually effective treatment in se- lected cases. FP08-8 Chandelier-assisted buckling in complicated cases of rhegmatogenous retinal detachment and proliferative vitreoretinopathy L. Akhundova1, A. Quliyeva1 1National Ophthalmology Centre Named Acad. Z. Aliyeva, Vitreo Retina, Baku, Azerbaijan (RVO) in 5 eyes. Mean BCVA at presentation was 0.87±0.77. There was no difference in BCVA at presentation between the isolated PAMM, RAO, RVO groups (p=0.27); BCVA increased to 0.7±0.66 (p=0.006) at the last visit. An increase in BCVA was noted after the 3rd month (p=0.03). The significant BCVA increase was observed only in the isolated PAMM group(p=0.04). Changes in BCVA were similar between those with (n=13) and withouth hyper- baric oxygen therapy (p=0.07). RT in the area of PAMM was 386.66±59.33µm on OCT at baseline and 288.82±6.54µm at month 1. (p=0). OCTA showed a decrease in SCP and DCP VD compared to the control eyes(SCP:45.43±7.84 vs. 43.02±9.87mm-1 [p=0.08] and DCP:48.73±7.66 vs. 45.1±11.27mm-1[p=0.02]). A decrease of 5.51±5.36mm-1 in SCP and 7.04±5.68mm-1 in DCP was ob- served in VD in the PAMM area between acute and chronic periods (p=0.09, p=0.04 respectively). There was no difference in FAZ area between the eye with PAMM and the fellow eye(p=0.54). Conclusion: In patients with PAMM, decrease in RT was observed from the Purpose: To describe the results of the chandelier-assisted buckling in patients 1st month,a decrease in VD was observed in SCP and DCP compared to the with rhegmatogenous retinal detachment and proliferative vitreoretinopathy. fellow eye.BCVA was improved during follow-up. Methods: Retrospective consecutive case study of 46 patients who underwent Chandelier-assisted scleral buckling and different degree proliferative vitreo- retinopathy with rhegmatogenous retinal detachment were included. Single surgery anatomical success, final reattachment rate reported. Mean follow-up was 29.31+-24.73 months (range, 6-96 months). Results: High myopia noted in 18 cases (39.1%), macula off - 36 cases (78.3%), total retinal detachment in all quadrants- 8 cases (17.4%), inferior breaks -14 cases (30.4%), proliferative vitreoretinopathy grade C- 10 cases (21.7%). Single-surgery anatomic success was achieved in 37 cases (80.2%) and final reattachment was achieved in 46 cases (100%) of patients. BCVA re- ported before surgery 1.5+-0.81 LogMAR (range, 0.05-3.0) and after surgery 0.57+-0.55 LogMAR (range, 0-3.0) (p<0.001). Conclusion: Chandelier-assisted buckling in rhegmatogenous retinal detach- ment with proliferative vitreoretinopathy can be valuable technique as pri- mary treatment for management young patients and complicated pathology. 32 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FP08-10 Safety and efficacy of OCU400 Gene therapy for retinitis pigmentosa: two-year follow-up of phase 1/2 clinical trial H. Qamar1, V. Chavali1, A. Berezow1, S. Mitter1, S. Matloob1, A. Upadhyay1, L. Vajzovic2, B. Bakall3, D. Birch4, B. Lam5 1Ocugen, Malvern, United States, 2Duke University, Department of Ophthalmology, Durham, NC, Durham, United States, 3Associated Retina Consultants, Phoenix, United States, 4Retina Foundation of the Southwest, Dallas, United States, 5Bascom Palmer Eye Institute, Miami, United States Purpose: Retinitis pigmentosa (RP) is a group of rare genetic disorders caused by mutations in over 100 unique genes that can lead to retinal degeneration, vision loss, and blindness. Gene-agnostic treatment is a viable alternative to traditional gene-specific therapies. Nuclear hormone receptor (NHR)-based novel modifier gene therapy utilizes NR2E3 overexpression as a gene-agnostic approach to modulate retinal cell homeostasis. The aim of the study was to determine the safety and efficacy of OCU400 in subjects with RP. Methods: 18 adult RP subjects with autosomal dominant or biallelic autoso- mal recessive NR2E3 mutations or autosomal dominant RHO mutations en- rolled in a Phase 1/2, open-label clinical trial (NCT05203939). Subjects received a unilateral, single subretinal injection of OCU400 (AAV5- hNR2E3) with a low (5 x 109 vg/eye), medium (1 x 1010 vg/eye), or high (5 x 1010 vg/eye) dose in the eye with poorer vision. The primary safety endpoints included study-related adverse events (AEs) and ophthalmological changes. Efficacy endpoints included changes from base- line in Best Corrected Visual Acuity (BCVA), Low-Luminance Visual Acuity (LLVA), and Mobility Test (MT). Results: There were no serious AEs related to OCU400. At one year (N=18), 89% (16/18) of subjects demonstrated preservation or improvement in the treated eye either on BCVA or LLVA or MT scores from baseline; 78% (14/18) demonstrated preservation or improvement in MT scores from baseline; 80% (8/10) of RHO mutation subjects experienced either preservation or improve- ment in MT scores from baseline. At two years (N=9), treated eyes – including 7 with RHO mutations – demonstrated a 2-line (10-letter) gain on ETDRS chart compared to untreated eyes in LLVA (p = 0.01). Conclusion: OCU400 shows a favorable long-term safety and tolerabil- ity profile. Treatment effect in subjects with different genetic backgrounds indicates a gene-agnostic mechanism of action. A Phase 3 trial is ongoing (NCT06388200). FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 9: Paediatric Ophthalmology & Strabismus FP09-2 Effect of repeated low-level red-light therapy in children with pre-myopia: a systematic review and meta-analysis of randomized controlled trials M. Leber1, T. Milbradt1, A. Fujimura Jr2, Y. Silva3, D. Amaral4, R. Belfort Jr5 1Federal University of Santa Maria, Medicine, Santa Maria, Brazil, 2Marília Medical School, Medicine, Marília, Brazil, 3University of Debrecen, Debrecen, Hungary, 4Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, 5Federal University of São Paulo, São Paulo, Brazil Purpose: Myopia is a significant public health concern with increased risk of ocular complications. Low-Level Red Light therapy (LLRL) has been ex- plored in myopia control, but its efficacy at the pre-myopic stage remains un- derexplored. The purpose of this meta-anaylisis was to determine the effect of LLRL thera- py in children with pre-myopia. Methods: PubMed, Embase, and the Cochrane Library were systematically searched for studies investigating the effects of LLRL therapy on myopia inci- dence, changes in axial length (AL), choroidal thickness (CT), and cyclople- gic spherical equivalent refraction (SER). Two independent reviewers screened studies, extracted data, and assessed the risk of bias. Meta-analyses were conducted using random-effects models to estimate the pooled effect sizes. Results: Of 365 studies identified, four met the criteria, totaling 619 partici- pants (mean age 8.48 years, 51.8% female). At 6 months, LLRL significantly reduced myopia incidence (RR 0.4; 95% CI 0.23 to 0.68; p < 0.01), with ben- efits persisting at 12 months (RR 0.64; 95% CI 0.5 to 0.81; p < 0.01). LLRL also reduced AL at 6 months (MD -0.12 mm; 95% CI -0.16 to -0.09; p < 0.01) and 12 months (MD -0.18 mm; 95% CI -0.23 to -0.14; p < 0.01), increased CT (MD 22.34 µm; 95% CI 5.45 to 39.24; p < 0.01), and improved SER at 6 (MD 0.27 D; 95% CI 0.23 to 0.32; p < 0.01) and 12 months (MD 0.36 D; 95% CI 0.27 to 0.46; p < 0.01). Conclusion: LLRL effectively reduced myopia incidence, AL, and improved SER and CT. These findings support further research on its long-term efficacy and safety, particularly regarding potential adverse effects and durability of outcomes. Overall, LLRL may offer a preventive strategy for pre-myopic children. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 33

FREE PAPER PRESENTATIONS FP09-3 Long term functional and anatomical outcomes in children with retinopathy of prematurity: Iinsights from microperimetry and OCT angiography B.H. Ünlü1, Ö. Ural Fatihoğlu2, A.T. Öztürk3, A. Yaman3, A.T. Berk3 1Menemen State Hospital, Ophthalmology, İzmir, Turkey, 2Dokuz Eylul University Hospital, Ophthalmology, İzmir, Turkey, 3Private Practice, İzmir, Turkey Purpose: To evaluate long-term structural, functional, and microvascular out- comes in type I retinopathy of prematurity (ROP) treated with laser photoco- agulation (LP) using microperimetry (MP) and optical coherence tomography Complete success was defined as an angle <10PD; partial as at least a 50%re- duction but>10PD, with other cases considered failures.We included 101pa- tients with a mean age of 4.77±3.54 years. Mean preoperative deviation angle was 30±11.82PD. 58,4% of patients had isoacuityregarding BCVA. The change in the mean angle at 3,6,12 months and last obtained after proce- dure was 24,74±11,89PD (p-value<0.001);19;18±12,01PD (p-value<0.001); 16,04±14;79PD (p-value<0.001) and 15,67±12,70 PD (p-value<0.001) re- spectively. Microtropia at 3,6,12 months and last obtained was achieved in 73,3%, 45,5%, 24,8% and 25,6% respectively. Isoacuity was achieved in 64.4% of patients and binocular cooperation in 28% of cases at the end. 24 patients (23.8%) underwent a second injection and 19 patients(18.9%) needed secondary surgery. Early microtropia significantly increased the time needed to a new BT injec- tion (p-value=0.005) as well as the need for secondary strabismus surgery angiography (OCT-A). Methods: Children aged 10–15 years were divided into three groups: type I ROP treated with LP (Group 1), prematurely born children without ROP his- (p-value=0.002). Receiving the first injection at an earlier age seemed to significantly influ- ence last obtained BCVA(p-value=0.042) and binocular cooperation(p-val- tory (Group 2), and controls without premature birth history (Group 3). ue=0.023)but not the degree of microtropia(p-value=0.588). MP assessed macular integrity index (MII), retinal sensitivity thresholds, and fixation stability indices (P1, P2, BCEA63, BCEA95). OCT-A evaluated the foveal avascular zone (FAZ) area in the superficial and deep capillary plexus (SCP, DCP) and vascular density (VD) in the foveal, superior, temporal, infe- rior, and nasal quadrants across SCP, DCP, outer retina (OR), and choriocapil- laris (CC). Results: Seventy-five eyes of 75 participants (22 in Group 1, 25 in Group 2, 28 in Group 3) with an average age of 10.85±0.97 years were included. The mean gestational age was 33.64±4.96 weeks, and the birth weight was 2329.08±1083.37 grams. Retinal sensitivity values showed significant differ- ences among groups (p<0.05). This study found significant difference in fixation stability, demonstrating that Group 3 had better fixation than Group 1 and Group 2 (p = 0.019). Group 1 exhibited the smallest FAZ areas in SCP and DCP and lower tem- poral/nasal SCP VD values (all p<0.001). Higher foveal SCP and DCP VD values were observed in Group 1 compared to controls (all p<0.001). Conclusion: Premature birth and laser treatment for type 1 ROP may affect fixation behaviour and macular vascular development. These findings high- light the need for follow-up and further research to optimize care for this population. FP09-4 Long-term outcomes and predictive factors for success of botulinum toxin injection in infantile esotropia treatment M. Vivas1, T. Costa1, C. Monteiro1, J. Almeida1, S. Pinto1, M.J. Santos1, I. Prieto1 1Unidade Local de Saúde Amadora Sintra, Lisboa, Portugal Infantile esotropia(IE)is the most common type of childhood esodeviation. Its treatment goal is to achieve enough microtropia and isoacuity capable of providing binocular cooperation. Since botulinum toxin(BT)is raising as a less invasive treatment, we aim to evaluate its longterm results and determine if there are any predictive factors for success. We retrospectively reviewed infantile esotropia patients’ records who had BT injections as first-line between 2017 and 2023 at our center. We examined angles before and after the procedure, as well as BCVA, binocular functions and need for additional treatment. To the best of our knowledge, this is the largest European study concerning long term follow-up of IE after BT injection and these results continue to sup- port it´s role as a first line treatment as earlier as possible, potentially delaying surgery. FP09-5 Sensory exotropia versus sensory esotropia M. Khorrami-Nejad1, M.R. Akbari2, A. Alghurab1 1Tehran University of Medical Sciences - School of Rehabilitation, Tehran, Iran, Islamic Republic of, 2Tehran University of Medical Sciences - Farabi Eye Hospital, Tehran, Iran, Islamic Republic of Purpose: This study aimed to compare the preoperative clinical features of patients with sensory esotropia (ET) and sensory exotropia (XT). Methods: In a retrospective study, the medical records of 13,252 patients who underwent strabismus surgery were reviewed at the Farabi Eye Hospital, Iran, from 2012 to March 2022. There were 1017 patients with sensory horizontal strabismus whose, in their worse eye, had corrected distance visual acuity (CDVA) equal to or <20/160 tested with the Snellen chart. Results: The mean age of patients was 29.0 ± 12.4 years [574 (56.4%) males and 443 (43.6%) females]. Sensory XT and ET were observed in 717 (70.5%) and 300 (29.5%) patients, respectively (P<.001). The mean CDVA in the strabismic and non-strabismic eyes was 1.40 ± 0.75 and 0.05 ± 0.13, respectively (P<.001). Also, the CDVA in the strabismic eyes was significantly worse in the patients with sensory XT than in the patients with sensory ET (P<.001). Sphere and spherical equivalent (SE) components were more hyperopic in both eyes of patients with sensory ET than sensory XT (P<.001). In sensory ET group, the mean horizontal deviation at far and near was significantly higher than the sensory XT group (both P<.001). The prevalence of moderate and severe amblyopia among all patients with sensory strabismus was 274 (26.9%) and 727 (71.5%), respectively (P<.001). There were 398 (39.1%) patients who needed more than one surgery. Conclusion: The frequency of sensory XT was about 2.5 times more than the sensory ET. Most patients with sensory ET were operated at a younger age, had better CDVA, more hyperopic spherical and SE, and higher angle of deviation compared with patients with sensory XT. The chance of reoperation in patients with sensory strabismus was about 40%. 34 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FP09-6 Strabismus and self-perception: a study on self-concept in pediatric strabismus patients and the role of surgical intervention D. Dizdar Yigit1, C. Gurez2, A. Inal2 1Marmara University, Istanbul, Turkey, 2Beyoglu Research and Training Hospital, Istanbul, Turkey Purpose: The aim of the study is to determine the effect of being strabismic on self-concept in primary school-aged children and to detect the changes after strabismus surgery. accounted for 14% of cases. Most cases presented with stage 3 (89.6%) in zone 2 (92.2%; 72.2% posterior zone 2) with plus disease (99%). Additionally, 7 patients were referred with bilateral stage 4 or 5 disease. A-ROP or stage 4/5 disease at treatment were not associated with lower GA or BW. Mean post menstrual age (PMA) at referral was significantly higher in stage 4/5 patients (47.7±10.7w) compared to lower stages (39.1±3.9w). Primary treatment was anti-VEGF in 90 patients and laser therapy in 18. ROP regressed in 87.9% of cases after primary treatment, while recurrent cases were successfully controlled with secondary anti-VEGF injection (n=6) or la- ser therapy (n=7). No eye required more than two interventions. Two additional patients without recurrence underwent laser therapy of ex- tensive avascular retina. Median time to recurrence was 7.1w [1.1-24]. Recurrence was not associated with lower GA, BW, PMA at referral, A-ROP, Methods: The children with strabismus surgery indication in Beyoglu Eye or primary treatment modality. Six of 7 patients with stage 4/5 underwent Research Training Hospital and Marmara University Hospital were included. They were evaluated with detailed ophthalmological examination including prism cover tests. They were asked 4 likert type questions on how they were effected by their condition. The self-concept was evaluated with ‘‘Piers-Harris Self-Concept Scale’’. surgery but visual and anatomical outcomes were poor. Conclusion: Outcomes and recurrence were not influenced by GA, BW, A-ROP or treatment choice. Poor outcomes were seen with stage 4/5, which in turn had higher PMA at referral, highlighting the role of early ROP screen- ing and timely referral and treatment as a major prognostic factor. All recur- This scale gives a total score and six sub-scales as; Behaviour, School Status, rence cases responded to secondary treatment, underscoring the importance of Physical Appearence and Attributes, Anxiety, Popularity, Happiness and maintained post-treatment follow-up. Satisfaction. The Wilcoxon test was performed by using SPSS 28.0 for the analysis. Results: The study included 116 children. Due to missing data in patients’ re- cords, 84 patients were included in the statistical analysis. Mean age of 84 pa- tients (42 boys,42 girls) was 10,9±2,2. The ratio of kids telling that strabismus effects their life was 73,6% and most of them told that they were negatively influenced(77,4%). A percentage of 65,5% told that their condition effects the relation with their friends and 65,4% told that it has negative effects. A percentage of 80,9% were happy with the result of their surgery and 85,7% told that they would recom- mend having strabismus surgery to others. The mean total scores of self-con- cept scale before and after surgery were 58,2±10,4 and 59,0±10,1 (p>0,05). There were no statistical changes in other subscales however, there was a sta- tistically significant positive change in ‘Physical Appearence and Attributes’ subscale post-operatively (8,3±1,6 and 8,9±1,9;respectively (p<0,005)). Conclusions: School-aged children’s pshychology and relationships with their friends might be negatively effected due to being strabismic. Their self- perception on their physical appearence might be positively changed after strabismus surgery. FP09-7 Five years of ROP treatment: insights and lessons learned T. Reis da Costa1, J. Charréu1, F. Francisco1, B. Pombo1, M. Vivas1, M. Mota1, S. Pinto1, S. Teixeira1, I. Prieto1 1ULS Amadora/Sintra, Lisbon, Portugal Purpose: To review recent ROP treatment in our center and assess recurrence and prognostic factors. Method: Single-center retrospective study of patients screened, referred and treated for ROP from 2019 to 2024. Results: We included 114 patients treated in the study period. Mean gestation- FP09-8 Pediatric anterior lens capsule management, different situations and techniques A. Affan1 1Tripoli Eye Hospital, Tripoli University, Ophthalmology, Tripoli, Libya Because the normal and diseased pediatric lens capsule management is some- times challenging, I will be presenting different techniques and instrumenta- tions in dealing with the anterior lens capsule in different situations. FP09-9 Retinopathy of prematurity screening protocol modifications in middle- and low- income countries M. Tok Çevik1 1Ulus Liv Hospital, Ophthalmology, Istanbul, Turkey Purpose: Retinopathy of prematurity (ROP) is the leading cause of prevent- able blindness worldwide and a growing problem in the middle- and low-in- come countries. To prevent ROP, effective screening, and treatment programs are essential; they should be modified according to each country’s require- ments. Method: The medical records of the infants who had ROP examination be- tween January 2023 and January 2025 were retrospectively evaluated. Three different criteria were applied to all 320 babies, as follows: ≤ 36 weeks and/ or ≤ 2700 g, ≤34 weeks and/or ≤ 2200 g and ≤32 weeks and/or ≤ 1800 g. The sensitivities and specificities were evaluated for all the follow up strategies. Results: In this study, a total of 320 infants screened for ROP were evaluated al age (GA) and birth weight (BW) were 26.4±2.2 weeks (w) and 750±258g, respectively. Eleven patients originated in our center, while the rest (90.4%) were referred from other hospitals in the country. Aggressive ROP (A-ROP) retrospectively. The mean gestational age (GA) of the infants examined was 33.1±2.9 weeks (range 24–36 weeks), and the mean birth weight (BW) of the babies screened was 1817±594 g (range 513–3350 g). ROP was diagnosed in Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 35

FREE PAPER PRESENTATIONS 96 (30%) of the patients, and of these, 14 (9% of all patients) required treat- ment. Overall, the screening protocols of ≤34 weeks of GA and ≤2200 g of BW had 100% sensitivity to detect treatment-requiring babies. Conclusion: The screening protocols needs to be validated for middle and low-income countries. Because the current criteria may miss a high number of FREE PAPER PRESENTATIONS Free Paper 10: Cornea ROP treatment-requiring patients in those regions. In our country, we recom- mend screening premature patients of ≤34 weeks of GA or ≤2200 g of BW. FP10-1 FP09-10 Heimler syndrome and low vision: highlighting the role of visual rehabilitation M. Francisco1, C. Nogueira1, P. Teixeira2, L. Cortez1, C. Paiva1,3 1Coimbra Local Health Unit, Ophthalmology, Coimbra, Portugal, 2Entre Douro e Vouga Local Health Unit, Ophtalmology, Santa Maria da Feira, Portugal, 3Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal Introduction: Heimler syndrome is a rare autosomal recessive disorder with- in the spectrum of peroxisome biogenesis diseases, characterized by sensori- neural hearing loss, amelogenesis imperfecta, nail abnormalities and retinal dystrophy. Purpose: To report two cases with a confirmed diagnosis of Heimler syn- drome and describe their systemic and ophthalmic phenotype and visual re- habilitation. Methods: A retrospective review of medical records. Results: Both siblings were diagnosed with early-onset sensorineural hear- ing loss and retinal dystrophy with prominent intraretinal cystoid spaces and cone-rod dysfunction. The older sibling also had amelogenesis imperfecta, but neither exhibited nail abnormalities. Genetic testing confirmed the presence of the homozygous pathogenic variant c.2528G>A p.(Gly843Asp) in the PEX1 gene. At the time of diagnosis, the younger sibling had a best corrected visual acuity (BCVA) of 20/50 in the right eye (OD) and 20/40 in the left eye (OS), while Multicenter, randomized, sham-controlled, Phase 3 study to evaluate epithelium-on crosslinking in keratoconus subjects 8 to 45 years M. Belin1, EPION Phase 3 Study 1University of Arizona, Ophthalmology and Vision Science, Marana, Arizona, United States Purpose: Corneal crosslinking (CXL) is standard of care for treating ectatic disease. While epithelium-off CXL is effective, it is associated with slow re- covery and occasional severe complications. Epithelium-on CXL has potential to limit complications and provide a more rapid recovery. To date, however, there is no USA FDA approved epithelium-on technique. Presenting interim results of Epion Phase 3 study. Methods: Two (400 subjects each), placebo-controlled Phase 3 trials com- menced late 2023 to study a unique riboflavin with addition of sodium iodide in ages 8 - 45 with 1:1 randomization. Enrollment based on standardized to- mographic criteria with treatment on initial diagnosis. Bilateral, simultaneous treatment performed if both eyes meet entrance criteria. (Enrollment will fin- ish prior to the meeting) Results: As of Oct 10, 2024, 655/800 enrolled to date. 73% male / 27% female, ages 11 – 45. 68% of with bilateral, simultaneous treatments. Pre- operative BSCDVA from 20/20 to 20/800 (35 % ≥ 20/40). All subjects showed complete stromal saturation ≥ 3.5 (scale 1 – 5) without need for additional drops or drops during UVA application. Enrollment will be completed prior to SOE and all results will be updated. Conclusion: Epithelium-on CXL offers potential advantages in both safety and comfort. The improved safety profile of epithelium-on CXL would also support earlier intervention in the hope of preventing visual loss at the earliest the older sibling had a BCVA of 20/100 in both eyes. They have maintained possible stage. regular follow-up at a low-vision consultation service. Eight years after diag- nosis, their BCVA has declined to 20/200. However, the younger sibling has been successfully fitted with a handheld focusable Keppler telescope, achieving a 20/32 BCVA when using it. He is also currently training with a portable electronic magnifier to improve school performance. The older sibling has shown poor adherence to the training pro- gram and inconsistent use of visual aids. Conclusions: We report a familial case of Heimler syndrome due to biallelic PEX1 pathogenic variants that manifested as macular dystrophy character- ized by cone-rod dysfunction and complicated by intraretinal cystoid spaces. Early referral to low vision rehabilitation consultation is crucial to improve functional outcomes and quality of life. These cases reinforce the role of tai- lored visual aids in maximizing patient autonomy despite significant visual limitations. FP10-5 Evaluation of ChatGPT-4, ChatGPT4-o, and Gemini AI systems’ responses to keratoconus-related questions in terms of accuracy and usability B. Azizagaoglu1, L. Asena1, D. Dursun Altinors1 1Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey Purpose: The cornea plays a vital role in the visual system by refracting and focusing light, contributing significantly to visual acuity. Keratoconus, a pro- gressive condition affecting 1 in 2000 individuals worldwide, requires timely diagnosis and management. Recent advancements in artificial intelligence (AI) have introduced opportunities in healthcare. Chatbots like ChatGPT-4 (OpenAI, USA), ChatGPT-4-o (subscription-based), and Gemini (Google Inc., USA) are increasingly utilized. This study evaluates these chatbots’ re- sponses to 10 keratoconus-related questions, assessed by three ophthalmolo- gists focusing on content quality, readability, and informational consistency. 36 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS Method: Responses from ChatGPT-4, ChatGPT-4-o, and Gemini were FP10-7 analyzed using three criteria: content quality (Likert scale, 1-7), readability (Flesch Reading Ease and Flesch-Kincaid Grade Level), and informational consistency (DISCERN scale). ANOVA and Tukey HSD tests (p < 0.05) iden- tified significant differences. Evaluations were conducted independently, with- out patient data. Results: Content quality scores differed significantly (F = 8.81, p = 0.0011), with ChatGPT-4-o scoring higher than ChatGPT-4 and Gemini (p < 0.05). FRE scores showed no significant difference (F = 0.195, p = 0.824), but FKG scores differed significantly (F = 4.148, p = 0.027). ChatGPT-4 and ChatGPT- 4-o produced more readable texts than Gemini (p < 0.05). DISCERN scores also showed significant differences (F = 39.21, p < 0.001), with ChatGPT-4-o demonstrating superior reliability and balance. Therapeutic approaches and ocular surface manifestations in vitamin A deficiency: a case series K. Lehiani1, B. Book1, J. Tode1, C. Framme1, E. Sokolenko1 1Hannover Medical School, Hannover, Germany Purpose: To describe the ocular surface manifestations of vitamin A deficien- cy and detail therapeutic strategies with varying systemic conditions Method: Serie of five patients with profound vitamin A deficiency and diverse ocular and systemic manifestations Case 1: A 26-year-old male with a history of ulcerative colitis and sclerosing Conclusion: ChatGPT-4-o excelled in content quality, readability, and infor- cholangitis presented with keratomalacia, hypopyon, and Bitot’s spots. His mational consistency, highlighting its potential in healthcare communication. initial visual acuity was limited to light perception. Treatment included anti- Gemini showed lower performance, emphasizing the need for improvement in clarity and balance. These findings underscore the promise of AI chatbots in ophthalmology and the importance of continuous development for clinical applications. FP10-6 Serum metabolomics predict dry eye disease L. Hynnekleiv1,2,3, C. Hammond3, P. Hysi3, T.P. Utheim1, J. Vehof3, H.L. Hammer2 1Oslo University Hospital, Ophthalmology, Oslo, Norway, 2Oslo Metropolitan University, Oslo, Norway, 3King’s College London, Ophthalmology, London, United Kingdom Purpose: To predict dry eye symptoms and dry eye disease using machine learning trained on serum metabolomics. Method: Using the Python programming language and the scikit-learn and pandas libraries, a serum metabolomics dataset from approximately two thou- sand TwinsUK participants is split into a training and testing set, L2 normal- ized and aligned with dry eye questionnaire outcomes, including Woman’s Health Study (WHS) defined dry eye, and highly symptomatic dry eye. A binary predictive logistic regression machine learning model is trained biotics, systemic vitamin A supplementation, amniotic membrane transplanta- tion, and Botox-induced ptosis. Visual acuity improved to 0.08. Case 2: A 21-year-old male with suspected hyper-IgE syndrome and a restric- tive diet presented with xerosis, Bitot’s spots, and reduced vision. Topic and systemic therapy resolved corneal opacities and significantly improved visual acuity. Case 3: A 37-year-old male with chronic vomiting, Type C gastritis, and ca- chexia presented with xerotic conjunctiva and a corneal ulcer. His initial visual acuity was limited to hand motion in the left eye. Treatment with systemic vitamin A supplementation, dietary rehabilitation, and nutritional counseling led to significant recovery, with visual acuity improving to 1.0. Case 4: A 55-year-old female with short bowel syndrome presented with bac- terial keratitis and corneal thinning. Management involved autologous serum eye drops, and amniotic membrane transplantation, achieving corneal healing and visual improvement. Case 5: A 39-year-old male with cystic fibrosis and metastatic colon cancer presented with Bitot’s spots and keratopathy. Despite retinol therapy, his con- dition deteriorated due to systemic illness, and he passed away. Conclusion: Vitamin A deficiency, though rare in industrialized nations, should be considered in patients with sicca symptoms and corneal ulcers, es- pecially with multimorbidity. Multidisciplinary care and close monitoring are crucial for effectively managing ocular and systemic complications. after randomized under-sampling for outcome balancing. Receiver Operator FP10-8 Characteristic Area Under the Curve (ROC AUC) is chosen as the main per- formance metric. To test if metabolomics add statistically significantly improved predictive performance beyond known covariables like age, BMI and sex we use per- mutation testing of metabolomics data with false discovery rate correction for multiple testing. Results: ROC AUC for predicting WHS DED and highly symptomatic DED using only covariables 0.53 (0.47-0.59) and 0.42 (0.31-0.54) vs. predictions with added metabolomics 0.64 (0.58-0.70) and 0.70 (0.60-0.79). Benjamini- Hochberg corrected permutation testing for the difference in ROC AUC with and without metabolomics p<0.005. Conclusion: This work shows that serum metabolomics can be used to predict dry eye disease using machine learning, and sets the foundation for future explainable artificial intelligence methods to identify the most important me- tabolites for predicting dry eye. Corneal crosslinking in pediatric patients: a retrospective, multicentric study R. Costa-Gertrudes1,2, P. Borges Lopes1, P. Gil1,3, J. Quadrado Gil3,4,5, V. Maduro1, N. Alves1, A. Rosa3,4,5, M.J. Quadrado3,4,5, J. Murta3,4,5, J. Feijão1 1Unidade Local de Saúde (ULS) de São José, Ophthalmology, Lisbon, Portugal, 2Faculty of Medicine, University of Lisbon (FMUL), Lisbon, Portugal, 3Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal, 4Unidade Local de Saúde (ULS) de Coimbra, Ophthalmology, Coimbra, Portugal, 5Clinical Academic Centre of Coimbra (CAAC), Coimbra, Portugal Purpose: This study aims to evaluate the effectiveness and safety of corneal crosslinking (CXL) in pediatric patients. Methods: This retrospective multicentric study included a cohort of pediat- ric patients diagnosed with keratoconus who underwent CXL. Various CXL protocols were employed in this study, including the Dresden, Athens, Cretan, Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 37

FREE PAPER PRESENTATIONS Topography-Guided and Sub400 protocols. Baseline and final measurements were recorded for K1, K2, Kmax, best-corrected visual acuity (BCVA), and thinnest pachymetry values. A minimum follow-up of 6 months was required. Statistical analysis was per- formed to compare baseline and final values. Results: Fifty-two pediatric patients were included in the study, with a mean age of 15,25±2,25 years and a mean follow-up of 23,37±14,72 months. Mean K1, K2, Kmax, BCVA and thinnest pachymetry at baseline were 48,96±4,40 D, 54,82±5,92 D, 62,88±8,16 D, 0,41±0,23 decimal and 444,33±38,83µm, respectively. There was no significant difference at baseline across different protocols, except for pachymetry (p=0.03). Mean K1, K2, Kmax, BCVA and thin- nest pachymetry at the end of follow-up were 49,37±4,98 D, 55,05±6,41 D, 63,26±8,91 D, 0,44±0,25 decimal, and 414,42±41,44µm, respectively. There was no significant difference comparing final and baseline measure- ments, except for pachymetry (p<0,001). Across the different protocols ana- lyzed, no significant difference was found between the changes in baseline and final keratometry (p=0,38, p=0,39, p=0,07), BCVA (p=0,73) and pachymetry (p=0,06). Two patients repeated corneal crosslinking due to continued progression. Four patients presented with stromal scars and one patient presented corneal hy- drops 4 months after the procedure. Conclusions: This multicentric retrospective study supports the efficacy of CXL in halting the progression of keratoconus in pediatric patients, under- scoring its utility in clinical practice. No significant difference was observed between the protocols employed in this study. FP10-9 Ocular surface microbiome: influences of physiological, environmental, and lifestyle factors V. Rizzuto1, D. Borroni2, J. Vanags2, G. Laganovska2, M. Settino3, G. Stroffolini4, M. Naccarato5, G. Covello6, R. Montanari7 1Clinic of Ophthalmology, P. Stradins Clinical University Hospital, Riga, Latvia, Riga, Latvia, 2Riga Stradins University, Department of Ophthalmology, Riga, Latvia, 3Universityof Calabria, Department of Mathematics and Computer Science, Rende, Italy, 4IRCCS Sacro Cuore Don Calabria Hospital, Department of Infectious- Tropical Diseases and Microbiology, Verona, Italy, 5Riga Stradins University, Riga, Latvia, 6University of Pisa, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Pisa, Italy, 7Pharmacology Institute, Heidelberg University Hospital, Heidelberg, Germany Purpose: The ocular surface (OS) microbiome is influenced by various fac- tors and impacts on ocular health. Understanding its composition and dynam- Results: Nationality, allergy, sports practice, and eyeglasses usage are sig- nificant PEL confounding factors influencing the eye microbiome. Alpha di- versity analysis revealed significant differences between Spanish and Italian subjects, with a median Shannon index of 1.05 for Spanish subjects and 0.59 for Italian subjects. Additionally, 8 microbial genera were significantly associated with eyeglass usage. Beta-diversity analysis indicated significant differences in microbial community composition based on nationality, age, sport, and eyeglasses us- age. Differential abundance analysis identified several microbial genera associ- ated with these PEL factors. The Support Vector Machine (SVM) model for Nationality achieved an accuracy of 100%, with an AUC-ROC score of 1.0, indicating excellent performance in classifying microbial profiles. Conclusion: Our findings highlight the complex interplay between environ- mental, lifestyle, and demographic factors in shaping the OS microbiome. Future research should further explore these interactions to develop personal- ized approaches for managing ocular health. FP10-10 Surgical treatment of pellucid marginal degeneration with wedge resection and compressive sutures A. Latuffe Soares Damião1, L. Cavinato Kwitko2, M. Vieira Cavalcante da Silva3, P.H. Santana Moreira4, S. Kwitko5 1University of São Paulo Medical School, Division of Ophthalmology, São Paulo, Brazil, 2Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil, 3Faculdade Evangélica Mackenzie do Paraná, Curitiba, Brazil, 4Centro Universitário Zarns, Salvador, Brazil, 5Oftalmocentro, Porto Alegre, Brazil Purpose: To describe the clinical outcomes of 9 eyes from 6 patients with pellucid marginal degeneration (PMD) who underwent surgery, emphasizing refractive and functional evolution in the postoperative period, and evaluating the effectiveness of this approach in treating PMD. Methods: Six patients with PMD who underwent wedge resection combined with partial or total lamellar dissection and compressive sutures were ana- lyzed, with preoperative and postoperative clinical follow-up. Results: All 9 eyes showed significant reduction in high topographic astigma- tism and improvement in visual acuity with correction (UCVA). Topographic cylinder decreased from 14.96 ± 7.53 D to 5.56 ± 3.10 D in the postoperative period, remaining stable for up to 12 years. Conclusions: Pellucid marginal degeneration (PMD) is a rare corneal ectasia that leads to irregular astigmatism and progressive vision loss. In advanced cases, surgical intervention is the treatment of choice. While effective, it may induce postoperative irregular astigmatism and have limited long-term effects due to disease progression. ics is crucial for developing targeted interventions for ocular diseases. In the studied cases, the adopted surgical technique improved corneal topogra- phy and UCVA in all eyes, with variable results, remaining stable over several years. This study aims to identify host variables, including physiological, environ- mental, and lifestyle (PEL) factors, that influence the ocular microbiome com- position and establish valid associations between the ocular microbiome and health outcomes. Methods: The 16S rRNA gene sequencing was performed on OS samples collected from 135 healthy individuals using eSwab. DNA was extracted, li- braries prepared, and PCR products purified and analyzed. PEL confounding factors were identified, and a cross-validation strategy using various bioinfor- matics methods including Machine learning was used to identify features that classify microbial profiles. 38 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

FREE PAPER PRESENTATIONS FREE PAPER PRESENTATIONS Free Paper 11: Abstract Medley FP11-1 Latest data from lenadogene nolparvovec gene therapy trials for Leber hereditary optic neuropathy N.J. Newman1, P. Yu-Wai-Man2, V. Carelli3, V. Biousse1, M. Taiel4, J.-A. Sahel5 1Emory University School of Medicine, Atlanta, United States, 2Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, Clinical Neurosciences, Cambridge, United Kingdom, 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy, 4GenSight Biologics, Paris, France, 5Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France Purpose: Lenadogene nolparvovec is an intravitreal gene therapy (LNGT) for patients with Leber hereditary optic neuropathy (LHON) carrying the m.11778G>A MT-ND4 mutation. We present all available updated results of LNGT for MT-ND4 LHON. Method: LNGT clinical trials include 1 phase 1/2B study (REVEAL) and 3 randomized phase 3 studies (RESCUE, REVERSE and REFLECT), with long-term follow-up for RESCUE/REVERSE (RESTORE), and ongoing compassionate use in 63 patients. In RESCUE/REVERSE, patients received LNGT in one eye and sham injection in the other. In REFLECT, all first-af- fected eyes received LNGT and second eyes were randomized to LNGT or intravitreal placebo. FP11-2 Uniocular proptosis seen in emergency - Can it be Carotico Cavernous Fistula (CCF)? A. Mallu1 1Centre for Sight, Oculoplastic Surgery and Ocular Oncology, Hyderabad, India Twenty eight year old gentleman presented with complaints of forward protru- sion, Diminution of vision associated with double vision, swelling, pain and redness in Right eye since 8 days .He was involved in a road traffic accident 8 days prior to presentation. After thorough clinical examination and orbital imaging, a Digital Subtraction Angiography confirmed a Direct Carotico-Cavernous Fistula (CCF), which was managed endovascularly with coiling. The patient made a full recovery after treatment. CCFs are rare and sometimes difficult to diagnose, often ophthalmologists can confuse CCFs to Orbital Cellulitis, Thyroid eye disease, Idiopathic Orbital Inflammatory disease (IOID). Objective of this case report is to understand the approach to a case presenting with proptosis in emergency, its differentials and specialised management in case of suspected CCF. Many patients with CCF may initially present to an ophthalmologist, who should be able to make a presumptive diagnosis in most cases and order ap- propriate investigations to aid the treatment ahead by a Neuro-radiologist or Neurosurgeon and the ophthalmologist must monitor vital parameters like IOP, Vision, Extraocular and Fundus changes, thus highlighting the impor- tance of teamwork. Best-corrected visual acuity (BCVA) from phase-3 studies were indirectly compared to those of an external control group of natural history (NH) pa- FP11-3 tients. Three meta-analyses assessed visual outcomes of patients with no treat- ment, idebenone treatment or LNGT. Results: Unilateral LNGT injection improved BCVA in both eyes. Persistence of LNGT effect and a favorable safety profile were observed up to 5 years. In RESTORE, mean change in BCVA from nadir at 5 years was +22 letters for LNGT-treated eyes and +20 letters for sham-treated eyes. In REFLECT, mean improvement in BCVA from nadir to 4 years was +20 letters and +17 letters in the first- and second-affected eyes of bilaterally- treated patients, and +19 letters and +14 letters in unilaterally-treated patients. Quality-of-life VFQ25 scores meaningfully improved from baseline to last follow-up. In an indirect comparison, mean gain with LNGT was 21.5 letters versus NH (p<0.0001). In metanalyses, clinically relevant recovery from nadir [95%CI] at eye level was 17% [7%;30%] (n=316), 31% [24%;40%] (n=313) and 59% [54%;64%] (n=348) in untreated, idebenone-treated and LNGT-treated patients. Conclusions: Over 10 years, 252 MT-ND4 LHON patients have received LNGT, with good safety profile and improved BCVA and quality-of-life. Early diagnosis of keratoconus with Deep Learning using autorefractometer data B. Çakir1, M. Kotan2, D. Akgün2, S. Özmen1, Ü. Çavuşoğlu2 1Sakarya University Education and Research Hospital, Ophthalmology Department, Sakarya, Turkey, 2Sakarya University Information Systems Engineering, Sakarya, Turkey Purpose: To make an early diagnosis of keratoconus with Deep Learning model by using autorefractometer data of patients. Method: Patients who have already a diagnosis of keratoconus by Corneal topography/tomography were enrolled. While measuring patients refracting errors by autorefractometer (TONOREF III, Nidek), the screen capture was performed and saved. This image included double mire rings at diameters of 2,4 and 3,3 mm. The distorsions in these mires were used for the diagnosis of keratoconus. The autorefractometer images of patients who had no corneal pathologies formed a control group. The dataset which is collected from both healthy and keratoconus-diag- nosed patients has been used to train a deep transfer learning model. The EfficientNetB0 backbone has been used to implement a transfer learning mod- el fine-tuned for binary classification. Results: The deep transfer learning-based model achieves an accuracy of 87% in diagnosing keratoconus through 5-fold evaluations. Comparative analyses demonstrate the effectiveness of this approach over tra- ditional methods. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 39

RAPID FIRE PRESENTATIONS RAPID FIRE PRESENTATIONS Rapid Fire 1: Contact Lenses, Cornea, External Eye, Ocular Surface RF01-1 Contact lens usage in pediatric patients: experiences from a tertiary eyecare center K. Sen1, B. Altindis1, A.S. Balci2, G. Gumus Akgun1, F. Ozcelik1 1Beyoglu Eye Training and Research Hospital, Ophthalmology, Istanbul, Turkey, 2Prof Dr Ilhan Varank Research and Training Hospital, Ophthalmology, Istanbul, Turkey Purpose: This study aimed to investigate the demographic, etiological and ocular characteristics of patients who began using contact lenses before the age of 18 at a tertiary eyecare center. Method: The records of patients under 18 years old and used contact lenses RF01-2 Effectiveness and tolerability of an antiseptic eye drop formulation containing hexamethidine disethionate, polyhexamethylene biguanide, and dexpanthenol for the management of punctate keratitis M. Troisi1, S. Troisi2, C. Costagliola1 1University of Naples Federico II, Ophthalmology Department, Naples, Italy, 2Salerno University Hospital, Ophthalmology Department, Salerno, Italy Purpose: This study evaluated the efficacy and safety of an antiseptic eye drop formulation containing 1.25% polyvinyl alcohol, 5% dexpanthenol, 0.05% hexametidine disethionate, 0.0001% polyhexane chloride, methyl- sulfonylmethane, and disodium edetate (Keratosept®) in the management of punctate keratitis from suspected infection. Method: Fifty eyes of 34 patients with punctate keratitis of suspected microbi- al origin were evaluated using biomicroscopy, fluorescein staining (Fluotest), tear breakup time (TBUT), and ocular surface disease index (OSDI) question- for at least 12 months who were followed up in the contact lens unit were naire. reviewed. Demographic data,surgical histories and indications for usage were analyzed. The structural and refractive properties of the lenses were recorded. Complications during follow-up were also documented. Results: A total of 923 patients were included in the study. Of these,588 were female (63.7%) and 335 were male (36.3%). The mean age at presenta- tion was 14.61±3.52 years (range: 1-17). The mean follow-up duration was 38.22±26.78 months(range: 12-144). Regarding indications, 446 patients (48.32%) were followed for ametro- pia,130 (14.08%) for anisometropia, 122 (13.22%) for keratoconus,79 (8.56%) for high myopia, 66 (7.15%) for high hyperopia, 55 (5.96%) for aphakia, 16 (1.73%) for high astigmatism and nine (0.98%) for leukoma. Soft contact lenses were used by 890 patients (96.42%), while rigid gas-permeable lenses were used by 33 patients (3.58%). Complications were observed in 323 patients (34.99%). These included punc- tate epithelial keratopathy in 134 patients (41.49%), papillary conjunctivitis in 87 patients (26.94%), discomfort in 51 patients (15.78%), sterile corneal infiltrates in 44 patients (13.63%) and microbial keratitis in seven patients (2.16%). A total of 96 patients (10.40%) discontinued contact lens treatment during follow-up. Conclusion: Contact lens use in the pediatric ages is preferred for various purposes,primarily ametropia and anisometropia. Although soft contact lenses are mostly chosen,rigid gas-permeable lenses may also be used in some cases. Due to the risk of serious complications such as microbial keratitis in this age group,ensuring regular follow-up,promoting treatment adherence and ad- dressing potential complications promptly are essential. Conjunctival swabs were cultured to determine microbial presence and sensi- tivity to the Keratosept® eye drops and antibiotics. Patients were treated with Keratosept® alone or combination antibiotics based on microbial sensitivity. Treatment success was assessed on day 15, with improvement defined by clinical recovery, negative cultures, and reduction in OSDI scores. Results: 43 of 50 cultures (86%) were positive: 28 Gram-positive, 10 Gram- negative, 4 mixed flora and 1 Candida albicans. 32 of these (74%) were sensi- tive to the antiseptic formulation; 30/32 eyes (93%) achieved clinical resolu- tion with a significant improvement in TBUT, Fluotest and OSDI by day 15 (p < 0.01). All cases of non-microbial keratopathy showed significant improve- ment in symptoms. Combination therapy for Keratosept®-resistant cases was successful in 8/12 eyes (67%), while 4 cases required alternative interventions. The formulation was well tolerated in all patients, with no adverse effects reported. Conclusions: Keratosept® has demonstrated high efficacy and tolerability in the management of microbial punctate keratitis, offering a promising alterna- tive or useful adjunct to antibiotics. Clinical improvement and symptomatic relief was obtained in culture-nega- tive cases too. Overall, healing occurred in 74% of cases with antiseptic therapy alone. Further studies are needed to explore its broader applications. RF01-3 Utilizing scheimpflug tomography and clinical parameters to predict corneal decompensation in Fuchs Endothelial Corneal Dystrophy N. Yesilirmak1,2, V. Souedan1, A. Pison1, J.L. Bourges1 1Universite Paris Cite, Paris, France, 2Ankara Yildirim Beyazit University, Ophthalmology, Ankara, Turkey Purpose: This study evaluates the predictive value of various tomographic indices for identifying endothelial decompensation that necessitates spontane- ous corneal transplantation or transplantation following cataract surgery in patients with Fuchs endothelial corneal dystrophy (FECD). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 41

RAPID FIRE PRESENTATIONS Method: This retrospective cross-sectional study included 93 eyes from 54 patients diagnosed with FECD. Clinical data such as morning visual distur- bance (MVD) and corrected distance visual acuity (CDVA) were recorded. Tomographic indices obtained by Scheimpflug system included central cor- neal thickness (CCT); corneal volumes (CV) measured at 3, 5, and 7mm di- ameters (CV3, CV5, CV7); central-to-peripheral volume ratios for 3/5mm (CPVR-3/5) and 3/7mm (CPVR-3/7); peripheral volume index; the thinnest corneal point; corneal thickness spatial profile values at 2, 4, 6, and 8mm (CTSP2, CTSP4, CTSP6, CTSP8); central-to-peripheral thickness ratio at in CCT compared to DSAEK [β(SE)=0.003 (0.001); p=0.003] up until the 3rd postoperative month. Diagnosis of PBK or Fuchs was associated with lower graft thickness compared to failed grafts [β(SE)=-0.88 (0.22); p<0.001 and β(SE)=-1.12 (0.22); p<0.001, respectively]. A longer death-to-preservation time (DPT) was posi- tively associated with graft thickness [β(SE)=0.0007 (0.0002); p=0.009]. Conclusion: Critical pre-operative and donor-related factors influence the rate of corneal graft clearance. Serial AS-OCT imaging is essential for monitoring graft health. Careful donor tissue selection and pre-operative assessment, as 4mm (CPTR4); percentage thickness increase at 2, 4, and 6mm (PTI2, PTI4, well as the integration of advanced imaging techniques in clinical practice, PTI6); loss of regular isopachs (LRI); displacement of the thinnest point (DTP); and focal posterior surface depression (FPSD). Results: Analysis of Receiver Operating Characteristic (ROC) curves re- vealed that CCT had an area under the curve (AUC) of 0.732, with a threshold of 596.5µm offering 79.7% sensitivity and 63.6% specificity. Similarly, the CTSP4 showed an AUC of 0.706 with a threshold of 616.5 µm (77.4% sensitivity, 60.6% specificity). The CPTR4 yielded an AUC of 0.588 at a threshold of 0.963 (62.3% sensitivity, 60.6% specificity). The MVD emerged as a significant risk factor, with an odds ratio of 4.63 (95% confi- dence interval:1.76-12.86). Univariate analysis identified LRI, DTP, and FPSD as key risk factors, while multivariate analysis confirmed LRI as an independent predictor of disease progression. Conclusion: This study highlights MVD and LRI as the most robust and DTP, FPSD, CCT, CTSP4, and CPTR4 as the moderate predictors of endothelial decompensation in FECD. RF01-4 may enhance corneal transplantation outcomes. RF01-5 Cortical stimulation therapy using Gabor patches improves vision and contrast sensitivity in crosslinked stable keratoconus: results of RCT L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cornea & Ocular Surface Diseases, Tirunelveli, India Purpose: To evaluate patient-specific, computer-based perceptual visual therapy (PL) regime using Gabor patches for improving best-corrected vision (BCVA) & contrast sensitivity function (CSF) in crosslinked stable keratoco- nus (KC). Setting: A prospective, controlled-randomized, open-label study. Methods: Cross-linked keratoconus (KC), stable over 1 year by clinical and topographic means with BCVA worse than 20/40 was randomized in 2:1 into Impact of pre-operative and donor factors on the rate of corneal graft clearance: insights from serial AS-OCT imaging the Treatment arm(G1) in which computer-based perceptual therapy using Gabor patches amidst co-linear flankers was employed, and the Control arm (G2). G. Hadjilouka1, S. Christodoulou1, D. Kola1, F. Herodotou1, A. Athanasiadou2, C. Tzavara3, N. Michael1, A. Neokleous1, S. Palioura2 1Archbishop Makarios III Hospital, Opthalmology, Nicosia, Cyprus, 2Athens Eye Experts Ophthalmology Practice, Athens, Greece, 3National and Kapodistrian University of Athens, Department of Biostatistics, Athens, Greece Purpose: To assess the impact of pre-operative and donor-related factors on the rate of corneal graft clearance using serial Anterior Segment Optical Coherence Tomography (AS-OCT) imaging. Method: Prospective cohort study of 65 patients (70 eyes) undergoing corneal transplantation (PKP, DSAEK, and DMEK) from October 2021 to April 2024, with at least 3 months follow-up with serial AS-OCT scans at fixed post-oper- ative intervals. Mixed linear regression models with time-splines were used to assess changes in corneal and transplant thickness over time. Adjusted regression coefficients (β) and standard errors (SE) were calculated. The effect of pre-operative and donor factors on the rate of graft clearance was investigated. Results: The mean recipient age was 73.5 ± 12.2 years and the mean donor age 53.1 ± 16.1 years. Central corneal thickness (CCT) decreased signifi- cantly up to 3 months post-surgery [β(SE)=-1.78 (0.12); p<0.001], stabilizing thereafter [β(SE)=0.05 (0.05); p=0.335]. Similarly, graft thickness decreased up to 3 months [β(SE)=-0.005 (0.0004); p<0.001], and then remained stable [β(SE)=0.0001 (0.0002); p=0.339]. PKP surgeries showed a slower decrease The study consists of 2 phases (screening + therapy periods (PL). Mid-training (Post 20 sessions), 40 training sessions, and post-therapy follow-up by 6 months were evaluated for improvements in BCVA distance & near (ETDRS) & CSF at spatial frequencies of 3, 6,12,18 CPD using Friedman tests for re- peated measures. Results: 30 cases were randomized. Baseline BCVA was 68.20+/-8.11 & 67.40+/-7.09 in G1, G2 (p=0.793). BCVA of Perceptual therapy arm PL(G1) improved to 73.30+/-7.47 & 79.10+/-8.46 post 20 & 40 sessions (over 2.5 Log MAR lines equivalent, p<0.0001) and remained stable after 6 months whereas not in controls(G2). Contrast sensitivity functions (CSF) at 3,6,12,18 CPD analyzed using Friedman repeated measure tests showed significant improvements in the PL group after 40 completed sessions and after 6 months (G1,p<0.0001), & not in the control arm. Conclusions: Sequential, patient-specific, perceptual therapy improved vision and contrast in crosslinked keratoconus with visual deficiencies and acts as proof of concept of improving neural connections at cortical levels. Vision is limited by image capturing and image processing. While all modalities only treat refraction (capturing), Perceptual Therapy trains the brain to see better (image processing) without additional surgery, enhancements, drugs, or side effects in Stable Keratoconus and is a good post- operative therapeutic adjuvant. 42 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF01-6 Corneal lenticule implantation by SMILE in treating residual hyperopic refraction after LASIK N. Hima Musa1, F. Semiz1, F.F. Arslan2, C.E. Semiz1, G.I. Semiz3 1Eye Hospital, Ophthalmology, Pristina, Kosovo, 2Istanbul University Cerrahpasa, Istanbul, Turkey, 3Atilim University Medical Faculty Ankara, Ankara, Turkey Purpose: To demonstrate that post-LASIK hyperopic residual refraction can be treated by changing the corneal Q value by performing myopic lenticular intrastromal implantation with the Smile. Methods: 42 patients with 84 eyes participated aged between 22 and 44 years. The minimum corneal thickness is 440 μm and a maximum of 560 μm. The lenticular implantation as an allogenic implant, which was taken from myopic patients with a range of -1.50 D to -6.50 D. And was implanted into hyperopia patients with a range of +1.0 D to +6.0 D and astigmatism between +0.75 D and +2.0 D, using the smile module according to corneal topography. They were followed for an average of 5 years. Results: Q value decreased from − 0.38 ± 0.07 log MAR preoperatively to − 0.79 ± 0.05 log MAR 5 years postoperatively (p< 0.001). Preoperative UNVA (35 cm) J 7 and postoperative UNVA (35 cm) J2. Preoperative UNVA (70 cm) J6 and postoperative UNVA (70 cm) J3. Conclusion: Corneal lenticule implantation can treat hyperopic refractive er- rors after LASIK, By changing the shape of the cornea. RF01-7 Corneal collagen crosslinking and vision-related quality of life: patient-reported outcomes in keratoconus patients N. Cruz1, M. Francisco1, E. Garcês2, J. Gil1,2,3, E. Costa1,2,3, A. Rosa1,2,3, C. Tavares1,3, M.J. Quadrado1,2,3, J. Murta1,2,3 1Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal, 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal, 3Clinical Academic Centre of Coimbra, Coimbra, Portugal Purpose: Keratoconus (KC) is a progressive corneal ectatic disorder that significantly impacts patients’ quality of life. This study aims to evaluate the effect of corneal collagen crosslinking (CXL) on vision-related quality of life in keratoconus patients using the Portuguese version of the Keratoconus Significant reductions (p<0.05) were also observed in maximum keratometry (Kmax), flattest keratometry (K1), and steepest keratometry (K2). In contrast, untreated patients exhibited minimal changes in both visual parameters and KORQ scores. A significant interaction (p=0.036) was observed between time and treatment in the Symptoms subscale, indicating that the CXL group expe- rienced a greater improvement in symptom perception over time. Conclusion: This study underscores the effectiveness of CXL in treating kera- toconus by stabilizing the disease and improving symptom perception. Using patient-reported outcome measures like KORQ is crucial for accurately as- sessing the impact of the disease and its treatments on patients’ quality of life. RF01-8 Ex-vivo lenticule customization for stromal lenticule addition keratoplasty (SLAK) M. El Zarif1,2, M. Nubile1, N. Salgari3,4,5 1University „G. D’Annunzio“ Chieti, Dept of Medicine and Aging Sciences, Chieti, Italy, 2Lebanese University, Genomic Surveillance and Biotherapy GSBT, Faculty of Sciences, Ras Maka, Lebanon, 3University of Ferrara, Dept of Translational Medicine, Ferrara, Italy, 4Ospedali Privati Forlì “Villa Igea”, Dept of Ophthalmology, Forlì, Italy, 5Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Oftalmologia, Forlì, Italy Purpose: To explore the optimal shape of customized lenticules for stromal lenticule addition keratoplasty (SLAK) for off-centered ectasia. Methods: Two different methods to create ex-vivo models of eccentric kerato- conus were investigated. Twelve human corneas were used to create Model-1 by a hyperopic photorefractive keratectomy (PRK), and Model-2 by masked phototherapeutic keratectomy (PTK) on the anterior corneal surface, while both types received myopic ablation of the posterior surface. Keratoconus models underwent a modified femtosecond laser (FSL) flap-cut to create stro- mal pockets. Sixteen-human corneas underwent FSL dissection to obtain four lenticule types: Type-I (planar) and Type-II (negative) lenticules were used without modifications, while Type-III (customized-planar), and Type-IV (customized- negative) lenticules underwent further masked-PRK to obtain an asymmetric bow-tie shape. Topographic, aberrometric analysis, and AS-OCT were per- formed in all recipient corneas before, and after lenticule implantation. Results: Keratoconus model was successfully reproduced. Tomographic analysis showed a significant inferiorly decentered corneal steepening with coherent stromal thinning. Model 2 reproduced better the curvature of real keratoconus. Outcomes Research Questionnaire (KORQ). Lenticules Type-I implantation induced homogeneous corneal thickening and Methods: Prospective observational study including patients with progressive Type-III produced higher thickening in the inferior half of the cornea. Type KC who underwent CXL, as well as a group of stable KC patients without in- II determined a maximal peripheral pachymetric increase, with a gradual re- dications for treatment. Patients undergoing CXL completed the KORQ prior duction toward the center, and Type IV presented an asymmetric peripheral to treatment and six months after. Patients not receiving any treatment also answered the questionnaire at the same time points. A comparison between the KORQ scores of both groups was performed. Relations between KORQ scores and best-corrected visual acuity (BCVA), keratometric and refractive parameters were also assessed. Results: In the CXL group, the Activity Limitation (AL) subscale improved from 50.86 preoperatively to 52.09 (p=0.746) six months after treatment, while the Symptoms subscale showed a greater increase from 46.86 to 54.80 (p=0.080). The BCVA significantly improved from 0.327 to 0.157 logMAR (p<0.05). thickening. The topographic assessment showed a cone apex flattening in all cases, but it was significantly higher in Types II and IV. Customized lenticules improved significantly corneal surface regularity regarding Types I and II. Conclusions: The approach of customizing lenticules by increasing their asymmetry and tailoring the re-shaping effects may improve SLAK outcomes in eccentric keratoconus. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 43

RAPID FIRE PRESENTATIONS RAPID FIRE PRESENTATIONS Rapid Fire 2: Neuro-ophthalmology RF02-2 THRIVE phase 3 topline results: efficacy and safety of veligrotug (VRDN-001), a full antagonist humanized monoclonal antibody to IGF-1 receptor, in active thyroid eye disease (TED) P. Saeed1, A.M. Garrido Hermosilla2, M. Schittkowski3, V. Lee4, J. Bermúdez Pío-Rendón5, E. Bertelmann6, E. Eade7, M. Pérez-López8, M. Sales Sanz9, P. Rodien10, C. Michalsky11, A. Narvekar12, T. Ciulla12 1Amsterdam UMC Location AMC, Amsterdam, Netherlands, 2Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain, 3Universitätsmedizin Göttingen, Göttingen, Germany, 4Imperial College Healthcare NHS Trust - Western Eye Hospital, London, United Kingdom, 5Metavisión Arruzafa (Hospital La Arruzafa), Cordoba, Spain, 6Charité University Medicine Berlin, Department of Ophthalmology, Berlin, Germany, 7North Shore Private Hospital, New South Wales, Australia, 8Hospital Universitario Y Politécnico La Fe, Valencia, Spain, 9Hospital Universitario Ramón y Cajal, Madrid, Spain, 10Centre Hospitalier Universitaire d’Angers - Hématologie, Angers, France, 11Viridian Therapeutics, Inc. at the Time the Work was Completed, Waltham, United States, 12Viridian Therapeutics, Inc., Waltham, United States Purpose: Topline efficacy and safety results at 15 weeks were assessed from an ongoing phase 3 randomized double-masked controlled trial of veligrotug (veli) vs placebo (pbo) in patients with active TED (THRIVE, NCT05176639). Methods: Adults with moderate-to-severe active TED (onset ≤15 months, proptosis ≥3 mm, and clinical activity score [CAS] ≥3) were randomized to receive 5 IV infusions 3 weeks apart of either 10 mg/kg veli or pbo. Outcomes included proptosis responder rate (PRR), defined as ≥2-mm reduc- tion vs baseline (BL) by Hertel exophthalmometry, PRR by MRI/CT, com- RF02-3 A rare case of medulloblastoma presenting with bilateral posterior internuclear ophthalmoplegia of Lutz A. Palmier1, S. Grech1 1Mater Dei Hospital, Ophthalmology Department, Msida, Malta Purpose: Medulloblastoma is the most common paediatric high-grade central nervous system tumour. To our knowledge, this is the first reported case of medulloblastoma presenting with bilateral posterior internuclear ophthalmo- plegia (INO) of Lutz. Method and results: A 14-year-old girl, presented to the Emergency Department in view of a one week history of convergent squint and binocular diplopia, associated with a two month history of headaches and fatigue. Her past medical history was unremarkable. On examination, there was esotropia on primary gaze and extraocular muscle movements (EOM) showed a limitation of abduction bilaterally with con- tralateral adducting nystagmus. Fundus examination revealed bilateral optic nerve head swelling. An urgent Computed Tomography (CT) scan of the head showed a large pos- terior fossa mass located centrally in the cerebellum, pushing the 4th ventricle anteriorly and with dilatation of the 3rd and lateral ventricles. Patient was commenced on intravenous dexamethasone and admitted for urgent insertion of an external ventricular drain. Furthermore, a brain Magnetic Resonance Imaging (MRI) was performed and showed a 4.2cm mass arising from the 4th ventricle, highly suggestive of me- dulloblastoma, appearing hyperintense on T2/FLAIR and hypointense to grey matter on T1 sequences, with a mass effect on the cerebellopontine angle and surrounding vasogenic oedema. The patient underwent tumour excision and adjuvant treatment, and on subse- quent follow up, the diplopia was noted to have resolved and EOM returned to normal. Conclusion: This case report highlights the features of a rare horizontal gaze palsy; bilateral posterior INO of Lutz, resulting from the mass effect of a large medulloblastoma. Such a rare presentation requires a high index of suspicion and familiarity with neuroanatomy and neuro-ophthalmic examination in order to ensure correct diagnosis, prompt investigation and treatment of the plete resolution of diplopia, and mean changes from BL in proptosis and CAS. cause. Treatment-emergent adverse events (AEs) were assessed through 15 weeks, with follow-up ongoing through 52 weeks. Results: A total of 113 patients were randomized to veli (n=75) or pbo (n=38) and included in the intention-to-treat population. At BL, mean proptosis was 23.2 mm in each group; CAS was 4.5 vs 4.8 and diplopia was present in 67% vs 68% of patients for veli vs pbo. At 15 weeks, PRR by Hertel was 70% vs 5% (p<0.0001) for veli vs pbo, with a mean proptosis reduction of 2.9 mm vs 0.5 mm (p<0.0001). PRR by MRI/CT was 69% vs 9% (p<0.0001) for veli vs pbo, with a mean proptosis reduction of 2.9 mm vs 0.6 mm (p<0.0001). Mean CAS decreased by 3.4 vs 1.7 (p<0.0001) for veli vs pbo. In patients with diplopia, complete resolution of diplopia occurred in 54% (27/50) vs 12% (3/26) (p<0.0001) for veli vs pbo. AEs occurred for 66 (88%) veli vs 24 (63%) pbo patients, and most were mild; 4 patients (velig) had seri- ous AEs (all unrelated to treatment). Hearing impairment AEs were reported for 12 (16%) veli vs 4 (11%) pbo patients. Conclusions: Topline results from the THRIVE phase 3 trial show 5 IV infu- sions of 10 mg/kg veli were well tolerated and led to significant and clini- cally meaningful improvements in proptosis, CAS, and diplopia at 15 weeks. Additional follow-up through 52 weeks is ongoing. 44 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF02-4 RF02-5 New insights on AAV2-ND4 transfer between eyes: ocular post-mortem analyses in Leber hereditary optic neuropathy following AAV2 gene therapy V. Biousse1, V. Carelli2, N.J. Newman1, L. Caporali3, F.N. Ross-Cisneros4, S. Blando2, E. Boschetti3, L. DuBois5, H. Liu4, P. Ancian6, M. Taiel7, A.A. Sadun4 1Emory University School of Medicine, Ophthalmology, Atlanta, United States, 2IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy, 3University of Bologna, Dipartimento di Scienze Biomediche e Neuromotorie, Bologna, Italy, 4Doheny Eye Institute, Los Angeles, United States, 5Emory University School of Medicine, Atlanta, United States, 6Charles River Laboratories, Evreux, France, 7GenSight Biologics, Paris, France Purpose: Lenadogene nolparvovec (LN) is an AAV2-based gene therapy for patients with Leber hereditary optic neuropathy (LHON) carrying the m.11778G>A MT-ND4 mutation. All LN trials have demonstrated a bilateral effect after unilateral intravitreal injection. We report on post-mortem analyses in 2 patients who received LN in one eye and a sham injection in the other within 6 months after vision loss. Methods: Following gene therapy, both patients developed intraocular in- flammation in the treated eye, which resolved within months. Patient 1 died of acute alcohol toxicity and patient 2 of cardiac arrest. Patient 1 had severe optic atrophy and loss of retinal ganglion cells (RGCs); patient 2 was a milder case of LHON, with preservation of RGCs and optic nerve (ON) axons, with only the PMB temporal fibers lost. Results: Histopathological and molecular (ddPCR) analyses were performed Anton’s syndrome in progressive multifocal leukoencephalopathy M.F. Madeira1, M. Tavares Correia1, C. Bruxelas1, P. Mendonça1, J. Costa1 1West Lisbon Local Health Unit - Egas Moniz Hospital, Ophthalmology, Lisbon, Portugal Introduction: Anton’s syndrome is visual anosognosia associated with bilat- eral occipital cortex lesions. It is a very rare condition, with only 72 cases de- scribed in the literature according to O Atallah et al. (2024). Visual prognosis depends on the underlying etiology, but recovery after extensive lesions is un- likely, so that management should be based on recognition and rehabilitation. Methods: Clinical case review. Case Report: We report a case of a 52-year-old female with progressive diz- ziness, weakness, speech lentification and personality changes, for the past few months. She had a history of right hemorrhagic stroke, hypertension and epilepsy. Neurological exam revealed psychomotor sluggishness, intelligible spastic dysarthria, left homonymous hemianopsia, left positive Mingazzini maneu- ver and bilateral positive Babinski reflex. Despite denying visual complaints, ocular exam revealed no light perception, but normal eye movements, with the capacity to follow a finger (blindsight). Pupillary reflexes, OCT and fundos- copy were unremarkable. Magnetic resonance imaging showed multiple hyperintense T2/FLAIR sub- cortical lesions involving the U fibers, in the occipital and right temporal lobe, and splenium of the corpus callosum. Cerebrospinal fluid analysis was posi- tive for JCV (5631 copies/mL) and HIV (91028 copies/mL). A diagnosis of Anton’s syndrome and progressive multifocal leukoencepha- on laser-captured retinal and ON samples to recognize the presence and dis- lopathy (PML), in the setting of advanced HIV infection, was made. Treatment tribution of the AAV2-ND4 transgene. In patient 1, an angiocentric lympho- cytic chronic inflammation was noted in the ON head and temporal retina. No persistent inflammation was seen in patient 2. AAV2-ND4 was detected in the retina and ON of both treated and untreated eyes, with much lower levels in was started with highly active antiretroviral therapy and pembrolizumab, com- plicated by immune reconstitution syndrome. The patient regained the ability to count fingers within her visual field. Due to ongoing neurological impair- ments, visual acuity could not be assessed using a letter chart. the latter. AAV2-ND4 distribution in the treated retina was asymmetric in both Conclusion: A suspicion of Anton’s syndrome should be considered in pa- patients, most prevalent in the macular and temporal hemiretina. ND4 copies tients with preserved ocular structures and anterior visual pathways, evidence were extensively detected in vessels, retinal pigment epithelium, choroid and of occipital lobe injury and no insight into their visual loss. ON, as well as meninges. In patient 2, ND4 copies were detected in the retrob- ulbar ON cross-sections in both the treated and untreated eyes. Conclusion: This is the first postmortem study of human eyes injected with AAV2-based gene therapy. AAV2-ND4 transfected various retinal cells and the axons of ON of both eyes despite only unilateral administration. Remarkably, diffusion of AAV2-ND4 seems to lead to concentrations in the nasal and infe- rior quadrants of the ON cross-sectional profiles. RF02-6 Alice in Wonderland syndrome after a Covid-19 infection P. Škalič1, T. Robič1 1General Hospital Murska Sobota, Murska Sobota, Slovenia Purpose: Alice in Wonderland syndrome is a perceptual disorder where in- dividuals experience altered perceptions of themselves and the world around them. Objects’ sizes, shapes and colors are distorted, and the perception of one’s own body and time passing is also affected. Objects may appear smaller or larger, further away or closer than they really are, and disproportionate. Theories suggest decreased perfusion of parts of the brain involving visual pathways as the origin of symptoms. Possible causes include infections, mi- graines, head injuries, epilepsy and intoxication. This case report introduces a 12-year-old boy with visual distortions consist- ent with Alice in Wonderland syndrome. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 45

RAPID FIRE PRESENTATIONS Methods: The patient reported altered visual sensations about a month after his second episode of COVID-19 infection. He experienced objects moving closer or further away. At the onset, perceptual disturbances occurred several times a day, but over a year, the frequency decreased, and the boy now has occasional problems. The cognitive distortion lasts only a few minutes. We performed visual acuity by Snellen chart, an anterior and posterior biomi- croscopy, macular and papillary OCT, fundus photography, static perimetry, laboratory tests and EEG. He was also examined by a pediatrician, otorhi- nolaryngologist and neurologist. Results: Visual acuity during follow-up was 1.0 without correction in both eyes, and ophthalmological status was unremarkable. OCT showed no ab- normalities, and the perimetry was within normal limits. Blood test results were normal, and Borrelia burgdorferi antibodies were negative. EEG did not record any pathological patterns, and clinical and neurological status were normal. Conclusion: Alice in Wonderland syndrome is usually a benign condition, particularly in children who outgrow their symptoms. This condition is often underdiagnosed due to unclear diagnostic criteria. It is critical to determine possible causal factors and provide appropriate treatment. RAPID FIRE PRESENTATIONS Rapid Fire 3: Oculoplastics RF03-1 Bilateral superior ophthalmic vein thrombosis in a 25-year-old: a case report E.C.A. Ereño1,1, C.G. Malabanan-Cabebe1, G. Bunagan1 1Southern Philippines Medical Center, Ophthalmology, Davao City, Philippines Purpose: To report a case of bilateral superior ophthalmic vein thrombosis secondary to facial infection. Methods: A 25-year-old male sought consultation in our clinic due to sud- den onset of bilateral eye swelling associated with pain, and headache. Five days prior, patient manipulated a pimple on his nasal area with an unsterile needle. On examination, bilateral middle malar and nasal area were erythema- tous, swollen and tender. There were bilateral, erythematous lids with swell- ing with no proptosis. No bruit was observed. Pupils were briskly reactive to light with no RAPD. BVCA was 20/25 on the right and 20/20 on the left. Intraocular pressure on the right eye was elevated at 28mmHg. Anterior seg- ment exam revealed diffuse injected conjunctiva, grade 3 chemosis on both eyes. Gonioscopy showed open angles, with no blood in schlemm’s canal. Fundoscopy was unremarkable. Extraocular movements were limited. The rest of the cranial nerves were intact. Results: Baseline infectious work-up was done. Patient was started on broad- spectrum IV antibiotics and topical anti-glaucoma. Laboratory results showed leukocytosis, with neutrophilic predominance, HbA1c was elevated and plate- let function was deranged. Imaging showed proptosis and dilatation of bi- lateral superior ophthalmic veins.. After treatment, there was resolution and improvement of the symptoms. Conclusion: In order to prevent devastating consequences of SOVT, a good clinical eye is needed in diagnosing it.. Due to its rarity, a high index of suspi- cion should be employed. RF03-2 Worse prognosis in ocular extranodal marginal zone B-cell lymphoma with coexisting hepatitis B virus infection Y.-P. Chen1, I-H. Yang1 1Kaohsiung Chang Gung Memorial Hospital, Ophthalmology, Kaohsiung, Taiwan Purpose: Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the most common form of ocular ad- nexal lymphoma. In Taiwan, Hepatitis B virus (HBV) infections are detected in about 15~ 20% of adults, which is higher than in other countries. This study aims to assess whether HBV infections influence the prognosis of ocular MALT lymphoma. Method: This study retrospectively reviewed patients diagnosed with ocu- lar MALT lymphoma at two Taiwanese tertiary medical centers (Linkou and Kaohsiung Chang Gung Memorial Hospital) between 1988 and 2018. HBV in- 46 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF03-4 Hands-on oculplastics training on animal models: a pilot simulation course for young doctors A.-I. Alexa1, A. Picioroaga1, C.A. Sandu1, N. Ghetu2, C.M. Bogdanici1,1 1“Sf. Spiridon” Emergency Hospital, Ophthalmology, Iasi, Romania, 2Regional Institute of Oncology, Plastic and reconstructive surgery, Iasi, Romania Purpose - This pilot course is designed to offer practical training in oculo- plastic and periocular reconstruction techniques to motivate young ophthal- mologists interested in the oculplastic field. The focus is on teaching surgical techniques in the most realistic way possible using animal models, as legal restrictions prevent the use of human cadavers in Romania. Methods - The course was offered in two editions and was aimed at doctors from Romania, with a total of 38 participants and with a hands-on training approach simulating various oculoplastic techniques, including lid reconstruc- tion using Tenzel and Hughes flaps, suturing eyelid wounds involving the free margin and performing aesthetic eyelid procedures like upper eyelid blepha- roplasty. The practical exercises are carried out on cattle and sheep heads, which offer anatomical structures closely resembling human tissues. Experienced oculo- plastic surgeons provide instruction, offering real-time guidance, feedback, and analysis of the participants’ techniques. Results: Feedback from participants was gathered through surveys and evalu- ation forms. Initial results show high levels of satisfaction with the hands-on training approach, with participants indicating a notable increase in confi- dence in performing these techniques. Each trainee had the opportunity to work both individually and in teams on an animal orbit. Over 60% of participants reported a significant boost in their confidence to perform the surgical techniques. Conclusions: The pilot course demonstrates that animal models are an ef- fective and legal alternative, offering participants a realistic environment for practice. Participants’ feedback emphasizes the value of this hands-on experience, sug- gesting that similar courses could be expanded in the future to meet the grow- ing demand for oculplastic training. Training with animal models is accessible, reproductible, and provides an ef- fective introduction to the initial steps of oculoplastic surgery. fection was defined according to positive HBsAg serological tests. Outcomes were classified as complete remission or incomplete remission which included local recurrence, progression, persistent or death due to disease. Disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS) were also analyzed. Results: This study enrolled 130 patients, and 24 (18.5%) of which were HBV-positive. The majority of patients were Ann Arbor clinical stage IE in both HBV and non-HBV groups. There was no difference in treatment modali- ties between the 2 groups. Non-HBV group showed significantly higher com- plete remission rate than HBV group (72.64% vs 50%, p=0.021). The DFS and PFS were also significantly better in non-HBV group (p=0.039 and p=0.016, respectively; non-HBV vs HBV: 5-yr-DFS 73.4% vs 50.5%; 5-yr-PFS 76.8% vs 50.5%).The OS was similar between the 2 groups and there was no patient died of ocular MALT lymphoma in this study. Conclusion: This is the first study discussing the relationship between HBV infections and ocular MALT lymphoma on Taiwanese population. We dem- onstrate that ocular MALT lymphoma patients with systemic HBV infections have higher incomplete remission rate, shorter DFS and PFS time, suggesting that the presence of HBV infection in ocular MALT lymphoma is a worse prognostic factor. RF03-3 Surgical and non-surgical approach for tear trough correction: fat repositioning vs hyaluronic acid fillers S. Christodoulou1, A. Tzamalis1, I. Tsinopoulos1, N. Ziakas1 1Medical School of Aristotle University of Thessaloniki, Postgraduate Master Program “Ocular Surgery”, Thessaloniki, Greece Purpose: This study compares two popular techniques for tear trough correc- tion—fat repositioning and hyaluronic acid (HA) fillers—highlighting their efficacy, safety profiles, patient satisfaction, and associated complications. Method: A narrative review of 20 studies comparing fat repositioning and HA fillers was conducted, focusing on parameters such as duration of results, volume restoration, complication rates, and patient satisfaction. Results: Fat repositioning provides long-lasting results but carries higher sur- gical risks compared with HA fillers. The transconjunctival approach is suit- able for patients with minimal skin excess. The supraperiosteal plane allows for a quicker procedure and, despite postoperative edema and temporary ir- regular contouring, shows no difference in final cosmetic outcomes compared with other planes. Internal fixation reduces the risk of fat relapse and skin scarring but carries the risk of suboptimal positioning. HA fillers offer immediate, minimally invasive results but require periodic maintenance. The use of a cannula reduces the risk of vascular occlusion. Combining a high G’ filler for the midface with a low G’ with low hydrophi- licity for the tear trough reduces the amount of filler needed and prolongs the results. Both surgical and non-surgical methods are effective, depending on patient needs and anatomical considerations. Conclusions: Fat repositioning is ideal for patients seeking long-term cor- rection and are willing to undergo surgery, while HA fillers suit those pre- ferring non-invasive treatments with customizable, short-term effects. Both techniques have pros and cons that must be matched to patient goals and con- ditions. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 47

obstruction were classified as proximal lacrimal drainage system (LDS) ob- struction, while complete or partial obstruction of the duct was categorized as distal LDS obstruction. The age, gender, best-corrected visual acuity (BCVA), intraocular pressure (IOP), presence of lacrimal drainage dysfunction, and the location of the obstruction were recorded for all patients, and the two groups were compared. Results: Both groups were statistically similar in terms of age, gender, BCVA, and IOP (p>0.05). LDS obstruction was observed in 27.5% of eyes in the PEX (+) group, significantly higher than the 15% observed in the control group (p=0.041). Proximal LDS obstruction was more prevalent in the PEX (+) group, with punctal stenosis (15% vs. 7.2%, p=0.030) and canalicular ste- nosis (6.25% vs. 2.8%, p=0.028) being significantly higher compared to the controls. In contrast, there was no significant difference in the prevalence of distal LDS obstruction between the two groups for either complete obstruction (1.9% vs. 1.6%, p=0.872) or partial obstruction (4.4% vs. 3.3%, p=0.651). Conclusion: Proximal LDS obstruction, particularly punctal and canalicular stenosis, is significantly more common in patients with PEX syndrome, likely due to pseudoexfoliative material along with associated inflammatory and fi- brotic changes, which may contribute to the increased risk of obstruction in these areas. In contrast, distal LDS obstruction does not show a significant association with PEX, suggesting that PEX primarily affects the proximal lacrimal drain- age system. RAPID FIRE PRESENTATIONS RF03-5 Evaluating tranexamic acid’s role in blepharoplasty: a systematic review and meta-analysis M. Abo Zeid1, K. Khalefa1, M.A.D. Al Azzawi2, A. Elrosasy3, A.M. Abou Elezz1, M.S.I. Mohamed4, R.C. Allen5, H. Abu Serhan6 1Tanta University, Faculty of Medicine, Tanta, Egypt, 2National Ribat University, Faculty of Medicine, Khartoum, Sudan, 3Cairo University, Faculty of Medicine, Cairo, Egypt, 4Qatar University, College of Medicine, QU Health, Doha, Qatar, 56. Dell Medical School, University of Texas, Department of Ophthalmology, Texas, United States, 6Hamad Medical Corporation, Department of Ophthalmology, Doha, Qatar Purpose: To evaluate the efficacy of tranexamic acid (TXA) in blepharoplasty surgery. Methods: A meta-analysis was conducted following PRISMA guidelines. PubMed, Web of Science, Cochrane Library, and Scopus databases were searched for randomized controlled trials (RCTs). Data extraction focused on outcomes such as ecchymosis scores, time to recovery, intraoperative pain, operative time, and hemostasis quality. The risk of bias was assessed using the ROB 2 tool. RevMan 5.4 software was used for meta-analysis with mean differences (MD) and standardized MD (SMD) calculated for various outcomes. Results: Five RCTs comprising 594 participants (1154 eyes) met the inclu- sion criteria. Overall, TXA significantly reduced postoperative ecchymosis on postoperative days (POD) 1 and 7 (SMD = -0.54, 95% CI: [-0.71 to -0.38], p < 0.00001) with moderate heterogeneity (I² = 50%). TXA significantly shortened patient-reported recovery time (MD = -0.72 days, 95% CI: [-1.02 to -0.42], p < 0.00001) with homogeneity (I² = 0%). Although TXA reduced operative time, this was significant only for the intravenous route (MD = -2.10 minutes, 95% CI: [-3.71 to -0.49], p < 0.01). There was no significant difference in intraoperative pain scores or surgeon- assessed hemostasis quality for subcutaneous TXA; however, intravenous TXA improved hemostasis assessment (MD = -0.70, 95% CI: [-1.02 to -0.38], p < 0.0001). Conclusion: TXA significantly reduces ecchymosis, expedites recovery, and enhances operative time and hemostasis in blepharoplasty. These findings support TXA’s use as an effective adjunct to improve blepharoplasty recov- ery, although further studies are warranted to optimize dosing and minimize thromboembolic risks. RF03-6 A comprehensive analysis of lacrimal drainage dysfunction in pseudoexfoliation syndrome B. Tarim1 1Beypazari State Hospital, Department of Ophthalmology, Ankara, Turkey Purpose: To investigate the prevalence of lacrimal drainage dysfunction in patients diagnosed with pseudoexfoliation (PEX) syndrome. Method: This prospective study included 160 eyes of 80 patients with bi- lateral PEX syndrome and 180 eyes of 90 age- and gender-matched control patients. All participants underwent slit-lamp examination, dye disappearance test, diagnostic probing, and irrigation test. Punctal stenosis and canalicular 48 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RAPID FIRE PRESENTATIONS Rapid Fire 4: Oncology & Pathology RF04-1 Exudative retinopathy associated with tebentafusp therapy for metastatic uveal melanoma: a case report T.T.-K. Chiang1, J. Davies1 1Retina Consultants of Minnesota, Minneapolis, United States Purpose: We present a case of tebentafusp-associated exudative retinopathy in a patient undergoing treatment for metastatic uveal melanoma. This is the second reported instance of ocular effects associated with tebentafusp and the first to demonstrate visual improvement following discontinuation of the drug. Methods: This study is a retrospective case report involving a single patient. Results: A 70-year-old male presented with a three-month history of de- creased vision in low-light conditions in the right eye. His medical history was significant for choroidal melanoma in the left eye, treated with enucleation four years prior. Routine surveillance identified liver metastases nine months ago, for which the patient started weekly tebentafusp infusions, with high- dose dexamethasone pretreatment. The best-corrected visual acuity (BCVA) was 20/40. Fundus exam revealed multifocal subretinal fluid collections, most prominently at the fovea. OCT confirmed these findings, with associated subretinal hyperreflective material in the subretinal space. Widefield FA and ICGA demonstrated no leakage or neovascularization. Workup for infectious and inflammatory etiologies were unremarkable. RF04-3 When a swollen canthus tells a bigger story: unmasking a spindle cell intruder P. Mota-Moreira1, A. Gama e Castro1, P. Marques Couto1, V. Leal1, C. Sousa1 1Unidade Local de Saúde São João, Ophthalmology, Porto, Portugal Purpose: To present the clinical and surgical management of a rare spindle cell mesenchymal tumour of the orbit, highlighting diagnostic challenges, therapeutic approaches and outcomes. Methods: Retrospective analysis of clinical and imaging data from a patient treated in the Ophthalmology Department. Report of Case: A 56-year-old male with no ophthalmological history pre- sented to the Ophthalmology Emergency Department with a one-week history of swelling and pain in left inner canthus without history of trauma or bite. Examination revealed localized swelling, erythema and tenderness to palpa- tion without purulent discharge. Best-corrected visual acuity (BCVA) was 1.0 OS. Ocular motility, pupillary response, biomicroscopy, intraocular pressure and fundus examination were normal. Patient was diagnosed with dacryocys- titis and treated with oral Amoxicillin-Clavulanic Acid. Three months later patient returned with progressive and painful swelling, diplopia, conjunctival hyperemia and epiphora. Examination showed reduced BCVA in OS (0.32), diplopia in levoversion and an enlarged mass at the left inner canthus. Imaging studies revealed a well-defined, oval, extraconic orbital mass with a pseudocapsular outline. A transcaruncular approach was chosen for an en bloc excision. Histopathological analysis confirmed a spindle cell mesenchymal tumour. One year postoperatively, patient had fully recovered with BCVA of 1.0 OS, no proptosis, normal ocular motility and no diplopia. MRI showed stable fi- brocicatricial tissue at the site of the tumour. Patient remains under surveil- At a two-week follow-up, the patient’s BCVA declined to 20/50. Tebentafusp lance. therapy was discontinued. Within three weeks of cessation, the patient report- ed subjective improvement in vision with visual acuity improved to 20/40. Conclusion: This case highlights an instance of exudative retinopathy asso- ciated with tebentafusp therapy, an emerging treatment for metastatic uveal melanoma. Unlike previously reported case, this is the first to demonstrate visual recovery following an infusion holiday. The absence of angiographic leakage and nega- tive laboratory findings suggests non-CSCR etiology with uncertain mecha- nism of fluid accumulation. While the exact pathophysiological mechanism remains unclear, this report underscores the need for further investigation into the ocular side effects of tebentafusp. Conclusion: Spindle cell mesenchymal tumors of the orbit are rare neoplasms that often present diagnostic challenges due to nonspecific symptoms, typi- cally related to compression or invasion of orbital structures. This case un- derscores the importance of thorough history, detailed examination, imaging, precise surgical techniques and histopathological confirmation in achieving optimal outcomes. RF04-4 Malignant medulloepithelioma of the ciliary body revealed by neovascular glaucoma in a 13-year-old child S. Rhalib1, S. Bouderka1, R. Chahir1, Z. Laftimi1, G. Daghouj1, B. Allali1, A. El Kettani1 120th August Hospital, Pediatric Ophthalmology Department,, Casablanca, Morocco Introduction: Ciliary body medulloepithelioma is a rare intraocular tumor, mainly affecting children, with nonspecific symptoms. Histopathological ex- amination is crucial for diagnosis. Method: We report the case of a malignant medulloepithelioma in a 13-year- old boy, whose initial symptoms were atypical, confirmed by histological analysis. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 49

RAPID FIRE PRESENTATIONS Results: The case involved a 13-year-old child, I.F., initially treated for granulomatous uveitis of the right eye, complicated by neovascular glauco- Conclusion: Effective management of bilateral choroidal melanoma requires a multidisciplinary approach that prioritizes both vision preservation and tu- ma. The patient was placed on immunosuppressants, without improvement. mor control. This case highlights the critical need for individualized treat- The neovascular glaucoma was treated with panretinal photocoagulation combined with intravitreal anti-VEGF injections, along with oral and local hypotensive treatment. The patient developed exophthalmos in the right eye. Examination revealed negative light perception in the right eye, elevated in- traocular pressure, and grade III exophthalmos, along with the appearance of a subconjunctival tumor infiltrate. The anterior segment examination showed corneal dystrophy with pupillary occlusion and no visible fundus. The left eye examination was normal, with 10/10 visual acuity. Ocular ultrasound of the right eye revealed a heterogeneous vitreous and partial temporal retinal detachment. A cranio-orbital CT scan revealed a tumoral process depending on the superior-external wall of the anterior and posterior segments. A tumor biopsy confirmed the diagnosis of ciliary body medulloepithelioma. Extension work-up was negative. The treatment involved exenteration combined with chemotherapy. ment strategies, careful procedural planning, and consideration of emerging therapeutic options to mitigate complications and optimize patient outcomes. RF04-6 Ocular surface squamous neoplasia in a healthy young patient M.F. Madeira1, A. Ribas1, M. Portela1, R. Silva1, A. Duarte1 1West Lisbon Local Health Unit - Egas Moniz Hospital, Ophthalmology, Lisbon, Portugal Conclusion: Ciliary body medulloepithelioma is a rare congenital intraocular tumor. Typically presenting in early childhood with leukocoria or an orbital mass. Ultrasound shows a hyperechoic mass. Histological study and immu- nohistochemistry are essential for confirming the diagnosis and classifying the tumor as either non-teratoid or teratoid, benign or malignant. Enucleation Introduction: Ocular surface squamous neoplasia (OSSN) is relatively rare, with an incidence of 0.13-1.9 per 100 000. It encompasses a range of dysplas- tic lesions involving the squamous epithelium of the conjunctiva or cornea. It is more common in males between the ages of 50 and 75 years. Fair skin, a past history of skin cancer and immunossupression increase the risk. remains the treatment of choice. Progression is usually very slow. Methods: Clinical case review. RF04-5 Management dilemmas in bilateral choroidal melanoma: a case report D. Vasović1, D.M. Rašić1, B. Dačić-Krnjaja1, T. Kalezić1, M. Vukosavljević2 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia, 2Military Medical Academy, Department of Ophthalmology, Belgrade, Serbia Purpose: Managing bilateral choroidal melanoma presents significant chal- lenges, particularly in monocular patients, where the balance between tumor Case Report: We report a case of a 31-year-old melanodermic male, evacu- ated from São Tome insland, with concerns about an enlarging mass on his left eye, for 1 year. Visual acuity was hand motion. A 12 x 8 mm corneal mass extending from 6:00 to 12:00 hours from the nasal limbus to the level of the temporal iris collarette was observed at the slit-lamp. The lesion was fixed, elevated, with an irregular papillomatous surface and vascular core. Fundus examination was impossible due to visual axis obstruction. Ocular ultrasound showed an intact posterior segment. Ultrasound biomicroscopy was negative for anterior chamber invasion. Anterior segment OCT revealed thickened, hyperreflective epithelial tissue, with cystic spaces. HIV testing was negative. The patient underwent an excisional biopsy with cryotherapy, absolute alco- hol and amniotic membrane graft. Histopathologic analysis demonstrated con- junctival intraepithelial neoplasia, which coincided with the specimen margin. Mitomycin C was started as an adjuvant treatment (3 cycles of 0.04% topical mitomycin for a week, with 2 weeks intervals). control and vision preservation is critical. At the 3rd month post-operative visit, visual acuity was 20/40, there was only Case report: This report describes a 44-year-old patient who underwent mild nasal conjunctival injection and the cornea was transparent, remaining a enucleation of the left eye in 2021 due to advanced choroidal melanoma. subtle nasal leucoma, with no recurrences. Subsequently, a small juxtapapillary melanoma was detected in the right eye Conclusion: We report an exuberant OSSN in a young patient, without any during regular monitoring. With a baseline visual acuity of 1.0 in the right eye, traditional risk factors. Lesion size at diagnosis could be explained by the transpupillary thermotherapy (TTT) was performed in September 2022 to con- delay in diagnosis in an evacuated patient. Young patients with OSSN should trol tumor progression and preserve vision. Despite initial tumor management have HIV testing. goals, TTT resulted in severe complications, including vitreous hemorrhage and progressive visual loss. By February 2023, visual acuity had declined to 1/60, necessitating a combined vitrectomy and cataract surgery. Postoperative assessments revealed juxtapapillary scarring, pigmentary changes, and partial retinal detachment. Ultrasonographic imaging confirmed the tumor remains under control; however, the patient has experienced signifi- cant visual loss and dissatisfaction with the outcome, underscoring the impact on quality of life. Results: This case highlights the complex challenges of managing juxtapapil- lary melanomas in monocular patients. While TTT remains a viable option for tumor control, its potential for sight-threatening complications underscores the necessity of thorough risk assessment and patient counseling. Alternative therapies, such as plaque brachytherapy or systemic treatments, may provide more balanced outcomes in certain cases. 50 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RF04-7 Uveal melanoma and model study possibilities with xenografts A. Furdova1, B. Smolkova2, L. Demkova2, J. Valaskova1, V. Horvathova Kajabova2, B. Gallik1 1Comenius University, Faculty of Medicine, Dept. of Ophthalmology, Bratislava, Slovakia, 2Slovak Academy of Sciences, Bratislava, Slovakia Introduction: The most frequent intraocular malignancy in adults is uveal melanoma (UM), but up to date no systemic therapy or standard treatment exists to reduce the risk of metastasis (most frequently liver). Epigenetic dys- regulation consisting of aberrant DNA methylation, histone modifications, and small non-coding RNA expression, silencing tumor suppressor genes, or acti- vating oncogenes, have been shown to play a significant role in UM initiation and progression. Recent discoveries of DNA methylation changes in Class 2 tumors undergoing metastasis suggest a potential role of epigenetic alterations in UM progression. Objectives: Clinically large T3 N0 M0 stage UM lesions with intraocular tumor volume over 0.5cm3 with significant infiltration of macrophages and CD8+ T cells exhibit specific genetic profiles that increase the risk of liver metastasis. Methods: We applied the PDX model to immunodeficient mice to identify factors involved in UM metastasis. In our group of patients’ PDX models, we implanted 25 viable UM tumors subcutaneously in the mice’s skin. Subgroup 1 was eleven Class 1 tumors with a good prognosis and subgroup 2 was 14 Class 2 tumors with a poor prognosis. We compared the histopathological stage and confirmation of the tumor cells. Results: From these subgroups, ten PDXs using Class 2 tumor tissues were created and 2 metastatic PDXs were derived from liver and peritoneal metas- tases which spontaneously developed in NSG mice. Conclusions: Our results highlight the potential importance of epigenetic deregulation in UM progression and provide a foundation for future inves- tigations. Future tests and analyses using the Chromium Single Cell ATAC platform to examine chromatin accessibility at the single-cell level in primary and metastatic PDX tissues can contribute to unraveling the precise role of epigenetic alterations in UM metastasis. RAPID FIRE PRESENTATIONS RAPID FIRE PRESENTATIONS Rapid Fire 5: Uveitis RF05-1 Eye intruder: an intravitreal dirofilariasis case report V. Lobo1,2, D. Matos1,2, S. Mano1,2, P. Rosa3,4, T. Marques5, I. Leal1,2 1Unidade Local de Saúde de Santa Maria, Department of Ophthalmology, Lisbon, Portugal, 2Faculdade de Medicina, Universidade de Lisboa, Centro de Estudos das Ciências da Visão, Lisbon, Portugal, 3Unidade Local de Saúde do Arco Ribeirinho, Department of Ophthalmology, Setúbal, Portugal, 4Instituto de Retina de Lisboa, Lisbon, Portugal, 5Unidade Local de Saúde de Santa Maria, Department of Infeccious Diseases, Lisbon, Portugal A 45-year-old male architect presented with a complaint of a „moving spot“ in the visual field of the right eye (OD). He reported systemic symptoms over the past several months, including thoracic pain and myalgia. Cervical lymphad- enopathy was observed and remained under investigation. The patient had no prior systemic or ophthalmic history and was not on chronic medications. His travel history was notable for frequent work-related trips to Africa, specifi- cally to São Tomé and Angola, with reported exposure to seawater. Ophthalmic examination revealed a best-corrected visual acuity (BCVA) of 10/10 in both eyes. Intraocular pressure (IOP) was 12 mmHg in the OD and 14 mmHg in the left eye (OS). The anterior segment examination was unre- markable bilaterally. Fundus examination of the OD revealed a tubular foreign body within the vitreous cavity, resembling a filaria encapsulated in a sheath, without vitritis or retinal changes. The fundus of the OS was normal. Laboratory investigations revealed a normal white blood cell count, C-reactive protein, and IgE levels, and no eosinophilia. Polymerase chain reaction (PCR) testing for Wuchereria bancrofti, Dirofilaria immitis, and other filarial patho- gens was negative, as were all other standard uveitis screening tests. A presumptive diagnosis of intraocular dirofilariasis, likely caused by Dirofilaria repens, was made. The patient was started on a combination treat- ment regimen of doxycycline (100 mg twice daily), ivermectin (0.2 mg/kg in two doses), and systemic prednisolone (60 mg/day). Two weeks later, the patient underwent a 23-gauge pars plana vitrectomy with vitreous shaving, delamination of adhesions, and en bloc removal of the sus- pected filaria. Despite prior coordination with microbiology and pathology laboratories, the foreign body was not identified in the extracted sample, pre- cluding definitive parasitological confirmation. At the one-month follow-up, there was no evidence of residual parasitic infec- tion. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 51

RAPID FIRE PRESENTATIONS RF05-2 Different imaging patterns of posterior syphilitic uveitis I. Arapi1, J. Jaho2, M. Islamaj2, A. Taullaj2, A. Xhetani2, I. Zervoi2, S. Guri2 1University of Medicine, Faculty of Medicine, Tirana, Albania, 2University of Medicine, Tirana, Albania 9 (69%) were treated with complementary systemic corticosteroid therapy. In only 1 patient the diagnosis was confirmed by HA PCR. The most frequent ocular complication was cystic macular edema (n=4, 31%), of which 2 pa- tients presented with a choroidal neovascular membrane and 1 patient with retinal venous occlusion. There was 1 case of recurrence in a patient with serpiginous-like choroiditis. Conclusion: Ocular TB can involve almost any ocular structure, presenting with a broad spectrum of clinical manifestations. In many cases, the diagnosis of presumed ocular TB is established based on the clinical response to treat- ment and the absence of recurrences, without the need for concurrent pulmo- Purpose: To describe two distinct presentations of syphilitic fundus features nary involvement. in a series of patients with ocular syphilis. Syphilis infection has re-emerged as a global health problem. Multimodal imaging approach has been proposed for diagnosis and follow-up. We report a series of cases of ocular syphilis describing the anatomic and visual outcomes. Method: This was a retrospective case series study. The clinical records of patients with posterior syphilis uveitis were reviewed. Demographic informa- tion and findings of fundus fluorescein angiography (FFA), autofluorescence (FAF), and spectral domain optical coherence tomography (SD-OCT) were analyzed on initial visit and 1 month after antibiotic therapy. Results: 8 eyes of 5 patients were included. The most frequent features observed were: Hyperfluorescence on optic disk and vasculitis on FFA, Hyperautofluorescence punctate pattern on FAF, Vitritis and granular hyperre- flectivity of the RPE on SD-OCT. Also retinal imaging highlighted particular patterns of retinal, retinochoroidal and optic nerve involvement from syphilis which can be identified to guide the diagnosis and the laboratory workup. Coinfection with human immunodeficiency virus was detected in 3 patients. All patients received systemic penicillin therapy according to CDC guidelines. After treatment, there was a functional and anatomical improvement. Conclusion: Ocular syphilis represents a diagnostic challenge. Multimodal imaging approach allows identification of structural changes, follow-up and early detection of complications. RF05-3 Ocular tuberculosis: a spectrum of manifestations M.F. Madeira1, M. Tavares Correia1, J. Romana1, M. Cordeiro1, M. Guedes1 1West Lisbon Local Health Unit - Egas Moniz Hospital, Ophthalmology, Lisbon, Portugal RF05-4 Complications of anterior uveitis A. Leino1, M. Siiskonen1, P. Ohtonen2,3, N. Hautala1,4 1University of Oulu, Research Unit of Clinical Medicine and Medical Research Center, Department of Ophthalmology, Oulu, Finland, 2University of Oulu, Research Unit of Surgery, Anesthesiology and Intensive Care, Oulu, Finland, 3Oulu University Hospital, Research Service Unit, Oulu, Finland, 4Oulu University Hospital, Department of Ophthalmology, Oulu, Finland Purpose: The aim was to study anterior uveitis’ (AU) complications, surgical treatments, and associated risk factors. Methods: The population-based data of adult patients with AU at the Oulu University Hospital during 2009 (n=413). Entire ophthalmic data was exam- ined including ocular complications of AU (n=641 eyes). Significance be- tween variables of complicated and uncomplicated uveitis was counted using SPSS. Results: 269 (42%) uveitic eyes (189 patients, 46%) had complications during the mean 8.5-years follow-up. Most eyes (68%) had one complication and one third had 2 to 4 complications. The most common complication was cataract in 217 (34%) eyes. Glaucoma was noted in 69 (11%) eyes, cystoid macular edema (CME) in 39 (6%), poste- rior synechiae in 30 (5%), band keratopathy and optic disc edema (ODE) in 11 (2%), and iris atrophy and cystic corneal edema in one eye (0.2%). Complications were typical in chronic onset, without significant sex differ- ences, a noninfectious etiology, and an average age of 51-59 years. However, ODE was associated with female predominance and average age of 31 years. The duration from AU onset to complication varied with the median of 8.0 Purpose: Ocular tuberculosis (TB) is an extrapulmonary infection primarily years in cataract, 7.7 years in glaucoma, 6.4 years in CME, 13.4 years in band caused by Mycobacterium tuberculosis. This study aims to review a series of clinical cases and describe the different clinical manifestations of ocular TB. Methods: Retrospective study of patients with ocular TB seen at the Ocular Inflammation Clinic. Presumed ocular TB is defined as the presence of sug- gestive ophthalmologic findings and/or a positive test for latent TB and/or a positive clinical response to antibacillary therapy. The diagnosis of definite ocular TB was based on the PCR result of the aque- ous humor (AH). The type of uveitis/clinical manifestation, therapy, compli- cations and recurrences were analyzed. Results: 13 patients were included, with a mean age of 59 ± 12 years at diag- nosis and presenting with bilateral anterior chronic uveitis (n=3), multifocal choroiditis (n=3), serpiginous-like choroiditis (n=3), retinal vasculitis (n=2), chorioretinitis (n=1) and optic disc tuberculoma (n=1). In 69% (n=9) ocular involvement was bilateral. No patient had imaging evidence of pulmonary TB. The patients were treated with antibacillary therapy for 9 to 12 months, and keratopathy and 1.0 year in ODE. Treatment of AU included significantly more often oral and subconjuncti- val steroids, methotrexate and immunosuppressant in complicated patients. Corticosteroid response was more frequent in patients with complications (p<0.001), extending beyond glaucoma (p=0.002). Visual impairment was rare in all patients. The most common operations were cataract surgery in 124 eyes at average age of 58±15 years, and glaucoma surgery in 47 eyes at age of 53±16 years. Conclusions: Our results highlight the importance of effective uveitis treat- ment and regular follow-ups since nearly half of the patients develop compli- cations. Interestingly, steroid response emerged as a risk factor of complica- tions beyond glaucoma. 52 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF05-5 Clinical and imaging features of ocular syphilis: a case series J. Alves Ambrósio1, P. Cardoso Teixeira1, M. Garcia1, M. Ruão1, J. Chibante Pedro1, V. Miranda1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal Purpose: To describe clinical and imaging findings in 8 cases of ocular in- flammation attributed to syphilis, emphasizing features that may aid early di- agnosis and management. Methods: A consecutive case-series of patients diagnosed with ocular syphilis over the past year in our department. All patients underwent a comprehensive workup, including serological testing for infectious and inflammatory etiolo- gies. Results: The average age at diagnosis was 53.75 years (range 29–78), with 6 men and 2 women. All patients tested positive for anti-Treponema pallidum IgM, except a 78-year-old woman who was positive for anti-Treponema pal- lidum IgG and anti-HSV2 antibodies. VDRL was positive in all 5 patients tested. Only 3 patients reported systemic manifestations, such as cutaneous rash and inguinal adenopathy. Clinical presentations included bilateral anterior and intermediate uveitis with optic neuropathy (n=2), unilateral optic neuropathy (n=1), unilateral neuror- retinitis (n=2), unilateral mixed retinal occlusive disease (n=1), panuveitis with optic neuropathy (n=1), and bilateral granulomatous anterior uveitis (n=1). Optical coherence tomography (OCT) findings, suggestive of syphilis, demonstrated unique patterns aiding early diagnosis and facilitating empiric treatment initiation. Conclusions: Ocular syphilis presents a diagnostic challenge due to its di- verse manifestations and lack of pathognomonic signs. Systematic workups in patients with unexplained inflammation revealed a high diagnostic yield in our department. OCT findings may serve as valuable tools for early suspicion and management of ocular syphilis, preventing irreversible vision loss. Timely Antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) have been identified as having an association some cases of TINU syndrome. Genetic markers, particularly HLA subtypes, have shown a strong association with TINU syndrome. Method: A retrospective study into cases of said condition was undertaken in University Hospital Waterford. Results: This paper presents five cases of TINU syndrome with considera- tion shown to each presentation, management and follow-up plans. The ratio of males to females reported was 4:1. Two of the patients in this case series presented with ocular symptoms initially while the other three presented with classical nephrology presentations. All five patients received histology input with renal biopsy reports definitely proving interstitial nephritis. From an oph- thalmology standpoint, the clinical presentation was similar with four out of five cases reporting bilateral red eye on examination. Conclusion: Ophthalmology doctors should include a nephrology work-up in cases of sudden bilateral uveitis as part of their systemic work-up. RF05-7 Bacillary layer detachment in ocular toxoplasmosis: a case series B. Monteiro1,2, D. Matos3, S. Mano3,1, I. Leal3,1 1Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, 2Department of Ophthalmology, Hospital de Santa Maria, CHULN, Lisbon, Portugal, 3Department of Ophthalmology, Hospital de Santa Maria, ULSSM, Lisbon, Portugal Purpose: To describe the clinical presentation, imaging findings, therapeu- tic approach, and outcomes of bacillary layer detachment (BLD) associated with ocular toxoplasmosis in three patients treated at a tertiary ophthalmology center in Lisbon, Portugal. Introduction: Ocular toxoplasmosis is the leading cause of infectious poste- recognition and treatment remain critical for achieving favorable outcomes. rior uveitis worldwide. Bacillary layer detachment (BLD), observed on optical RF05-6 Tubulointerstitial Nephritis and Uveitis (TINU syndrome): a case series R. Farnan1,2, J. Stokes2, S. Leavey2, R. Casey2, A. Mc Glacken Byrne2 1University Hospital Waterford, Ophthalmology, Waterford, Ireland, 2University Hospital Waterford, Waterford, Ireland coherence tomography (OCT), involves photoreceptor layer splitting. While often seen in ocular toxoplasmosis, BLD can also occur in other retinal dis- eases. Recognizing BLD is essential, as it signals significant disease activity requiring timely treatment to prevent vision loss. Case series: Three patients with ocular toxoplasmosis and BLD were exam- ined with multimodal imaging. Case 1: A 25-year-old woman with sudden vision loss (BCVA 0.3) showed optic disc edema, serous macular detachment, and retinitis near a chorioretinal scar. OCT confirmed BLD. Initial treatment with trimethoprim-sulfamethox- azole and corticosteroids was ineffective, requiring intravitreal clindamycin. BCVA improved to 0.8 and BLD resolved. Case 2: A 42-year-old woman with decreased vision (BCVA 0.2) had retinocho- Purpose: Tubulointerstitial nephritis and uveitis (TINU) syndrome, charac- roiditis near the superior vascular arcade. OCT showed serous macular detach- terised by the co-occurrence of tubulointerstitial nephritis and uveitis in the ment, consistent with BLD. Systemic therapy with trimethoprim-sulfamethoxa- absence of other systemic diseases, presents a diagnostic challenge due to its nonspecific symptoms. This case series aims to shed light on TINU syndrome’s clinical features, un- derlying causes, and management strategies. The prevalence of TINU syndrome is relatively low, and it often goes under- diagnosed. Histological confirmation through renal biopsy is crucial, while systemic conditions such as systemic lupus erythematosus, tuberculosis, sar- coidosis, and Sjogren’s disease should be excluded. zole and corticosteroids resolved the BLD, with BCVA improving to 0.8. Case 3: A 36-year-old man with recurrent toxoplasmosis had reduced vision (BCVA 0.2). OCT confirmed foveal BLD. Treatment with corticosteroids, trimethoprim-sulfamethoxazole, and clindamycin resulted in complete BLD resolution with BCVA improving to 1.0. Conclusion: This series highlights BLD as a reversible manifestation of ocu- lar toxoplasmosis. OCT is crucial for diagnosis and monitoring, enabling ef- fective treatment. While BLD is commonly linked to ocular toxoplasmosis, its In most cases, TINU appears to be an idiopathic immune-mediated process, presence in other retinal diseases highlights the importance of early recogni- but it may be precipitated by drugs or infections. tion and management. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 53

RAPID FIRE PRESENTATIONS RF05-8 Systemic immunomodulatory therapy in the uveitis clinic: 10-year profile A.M. Ferreira1, M. Silva1, C. Pedrosa1,2, C. Ferreira1, S. Torres-Costa1,2, L. Torrão1,2, L. Figueira1,2, J. Rodrigues-Araújo1,2 1ULS São João, Porto, Portugal, 2Faculty of Medicine, University of Porto, Porto, Portugal Purpose: The widespread treatment of non-infectious uveitis with immu- nomodulatory therapy (IMT; corticosteroid-sparing therapies) aims to achieve durable remission. The suspension of IMT should be individualized and data on sustained remission after withdrawn of IMT are limited. Our primary purpose was to characterize the IMT profile in patients with idi- opathic uveitis by anatomic group regarding duration and discontinuation of IMT and rate of relapse before and after IMT. Method: Retrospective review of patients with idiopathic uveitis under IMT evaluated in the past 10 years at the uveitis department of ULS São João. Results: A total of 111 patients with idiopathic uveitis under IMT were in- cluded, divided into 5 anatomic groups: anterior uveitis (n=30,27%), inter- mediate uveitis (n=14,12.6%), posterior uveitis (n=31,27.9%), panuveitis (n=23,20.7%) and scleritis (n=13,11.7%). The mean total follow-up time was 94.9±52.6 months [12-264]. Eighty-four patients (76.4%) presented bilateral involvement. Methotrexate was the most widely used IMT (n=59,53.2%) followed by cyclo- sporine (n=33,29.7%), azathioprine (n=10,9%) and adalimumab (n=9,8.1%). The median duration of treatment was 36 months (IQR 24-60), with 67 pa- tients (60.4%) under IMT for at least 3 years. Before treatment, patients pre- sented a mean of 2.1±1.4 flare-ups/year, which significantly decreased to a mean of 0.6±0.7 relapses/year after IMT (p<0.001) in all anatomic groups. From the 53 patients (47.7%) who stopped IMT, 14 (26.4%) relapsed; with 91.3% of the patients treated for >3 years and 100% of the patients treated for >4 years did not relapse. The group without uveitis recurrence was under IMT for a significantly longer period before stopping (51.2±35 vs 26.4±12.6, p<0.001), comparing to the patients who relapsed. Conclusion: Some patients with idiopathic uveitis need IMT to achieve du- rable remission. The decision to stop IMT based on a 3-year remission period appears to be a safe approach preventing recurrent sight threatening inflam- mation. RAPID FIRE PRESENTATIONS Rapid Fire 6: Retina RF06-1 Unlocking the mechanisms of proliferative diabetic retinopathy: PVAT - derived inflammatory and angiogenic mediators in vitreous and serum T. Ozan Doğan1, E. Erdoğdu1, Ş. Özçalişkan1, Ö. Artunay1 1Beyoglu Eye Training and Research Hospital, Vitreoretinal Surgery & Medical Retina, Istanbul, Turkey Purpose: To investigate the role of mediators secreted from perivascular adi- pose tissue (PVAT) in vitreous and serum samples obtained from patients un- dergoing vitrectomy surgery for proliferative diabetic retinopathy to elucidate the pathophysiology, and comparison of vitreous and serum samples obtained from Idiopathic Macular Hole (MH) and Idiopathic Epiretinal Membrane (ERM) surgery patients as a control group. Method: Vitreous and serum samples were prospectively collected from February to April 2023 at the Vitreoretinal Surgery Unit, SBU Beyoğlu Eye Hospital. The study included 22 eyes from patients with PDR and 22 from those with MH or ERM (control group). Vitreous (0.2 cc, undiluted) was ob- tained at the start of pars plana vitrectomy, and serum samples were stored at -80°C. Both vitreous and serum samples were ransferred in accordance with the cold chain transport regulations, were evaluated for the levels of Adiponectin, Visfatin, a-FABP, and Apelin secreted from perivascular adipose tissue (PVAT) in the laboratories of the Department of Medical Biochemistry, University of Health Sciences. Results: Serum ADP levels in the PDR group were significantly lower than in the control group (p=0.003), and vitreous ADP levels were also reduced (p<0.001). Conversely, serum and vitreous Apelin levels were significantly higher in the PDR group (p<0.001). Serum and vitreous a-FABP levels were elevated in the PDR group compared to controls (p=0.025 and p=0.002, respectively). Similarly, serum and vitreous VF levels were significantly higher in the PDR group (p=0.003 and p<0.001). Conclusion: The levels of ADP, Apelin, a-FABP, and the VF mediators in se- rum and vitreous fluids of patients with proliferative diabetic retinopathy indi- cate that perivascular adipose tissue is involved in the etiopathogenesis of the disease. These mediators will become new biomarkers and target molecules in PDR classification, determination of disease progression, and treatment. 54 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF06-2 Analysis of the effectiveness of AI chatbots in ophthalmic surgical planning: a comparison between ChatGPT and Google Gemini in cases of rhegmatogenous retinal detachment C. Campo Beamud1, M.E. Hidalgo Espinosa1, E. Díaz Fernández1, E. Campo Beamud1, A. Donate Rosa1, E.J. Castro Campos1, H. Estero Serrano de la Cruz1, J. Bastante Quijano1, A. Adán Ruiz1 1Hospital General Universitario de Ciudad Real, Ophthalmology, Ciudad Real, Spain Methods: To implement the task, a robotic arm with 6 degrees of freedom, a digital stereoscopic microscope and an eye model were used. The stereoscopic system made it possible to measure height and coordinates with high accu- racy (up to 22 microns when using a microscope). Convolutional filters and computer vision algorithms were used to detect the limbal ring and the center of the eye. The instrument was controlled by a green marker, recognized by neural networks that determined the position and height of the object. Seven coordinate systems were integrated into the system for precision position of the instrument relative to the eye. Results: The robot successfully performed automatic marking of the injection point considering the distance to the limbus and sclera. The robot’s move- ments were coordinated in 1 mm jerks to minimize errors. The positioning accuracy of the needle tip relative to the injection point was 200 microns. Purpose: This study evaluates the ability of the advanced language models Generative Pretrained Transformer (GPT)-4o, GPT-4o1 and Google Gemini to suggest the most appropriate surgical procedure in cases of rhegmatogenous During testing, the robot touched a given point on the sclera with a standard error deviation of 73 microns horizontally and 590 microns vertically. The use of a digital microscope can reduce errors by up to 10 times, which makes retinal detachment, and to predict whether the anatomical outcome will still be it possible to use the system in more complex procedures, such as cataract successful 6 months after surgery. surgery. Method: Thirty patients diagnosed with rhegmatogenous retinal detachment who underwent surgery (pars plana vitrectomy +/- scleral buckle) were ana- lysed. Only first episodes of rhegmatogenous retinal detachment were includ- ed in this study, not redetachments. Data included age, number and location Conclusion: The developed robotic system demonstrates high accuracy and stability in performing intravitreal injections, which confirms its potential for use in ophthalmology. Further improvements to the system, including in- creased precision with a digital microscope, open up the prospect of automat- of tears, duration of retinal detachment, macular status, surgeon’s experience, ing more complex surgical procedures. and presence or absence of proliferative vitreoretinopathy (PVR). The model was trained to interpret this information and to generate accurate estimates. It was asked “specify what type of surgery would be most appropriate in this case, and whether the retina will be attached 6 months after surgery or will RF06-5 be re-detached earlier”. ChatGPT and Gemini results were scored from 1 to 5 (poor to excellent quality), according to the global quality score (GQS). Myopia in Stickler syndrome Results: Most ChatGPT-4o, ChatGPT-4o1 and Google Gemini surgical choic- es matched with those made by vitreoretinal surgeons. ChatGPTo’s GQS was 4.58, ChatGPTo1’s GQS was 4.56 and Gemini’s GQS was 4.41, with no statis- tical difference between the 3 chatbots. The main flaw of ChatGPT was omit- ing membrane peeling in cases of PVR. Gemini was wrong, in some cases, in relation to the tamponade agent of choice. Furthermore, it overlooked the need of performing indentation in cases of very peripheral tears. Additionally, none of them could foresee any case of re-detachment in 6 months’ time. Conclusion: Both Google Gemini and ChatGPT have a high ability to make right surgical decisions, as they showed a good level of agreement with expert K. Boysen1, L. Kessel1, M. Bertelsen2, S. Farholt3,4, N. Dahl Rendtorff2 1Copenhagen University Hospital – Rigshospitalet, Department of Ophthalmology, Glostrup, Denmark, 2Copenhagen University Hospital – Rigshospitalet, Department of Clinical Genetics, Copenhagen, Denmark, 3Copenhagen University Hospital – Rigshospitalet, Department of Pediatrics and Adolescent Medicine, Copenhagen, Denmark, 4Aarhus University Hospital, Department of Pediatrics and Adolescent Medicine, Aarhusden, Denmark surgeons. However, they are not yet able to anticipate future surgery-related Purpose: Though Stickler syndrome is characterized by high myopia, little is complications. RF06-4 Automation of intravitreal injections using a robotic system A. Chuprov1, I. Yartsev2, I. Dmitriev2, N. Zhediale3 1Orenburg Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Orenburg, Russian Federation, 2OOO “MIKVID”, Nizhniy Novgorod, Russian Federation, 3Clinic «Sozvezdie oftal’mika», Nizhniy Novgorod, Russian Federation Purpose: To study the possibility of automating intravitreal injections using a robotic system developed by OOO “MIKVID” together with Orenburg branch of the S. Fyodorov Eye Microsurgery Federal State Institution, aimed at im- proving the accuracy and safety of ophthalmic manipulations. known about its progressive nature and the prevalence of myopia complica- tions such as myopic maculopathy. This study investigates axial length, re- fractive error, myopia progression, and myopic maculopathy in patients with Stickler syndrome. Methods: The study combines cross-sectional investigation with historical data from medical records on Danish patients with genetically confirmed type 1 (COL2A1) and type 2 (COL11A1) Stickler syndrome. The main outcomes are axial length, spherical equivalent refraction (SER), SER over time, and myopic maculopathy category. Results: The study includes 71 patients with type 1 (age: Median =29 years, IQR =15 to 49 years; 44% male) and 13 with type 2 Stickler syndrome (age: Median =27 years, IQR =9 to 33 years; 69% male). For type 1, the median (IQR) SER was -6.00 Diopters (D) (-8.88 to -2.19 D) and - 5.57 D (-10.31 to -1.53 D) for type 2. The mean (SD) axial length was 25.95 (1.99) and 26.55 (3.45) mm for each subtype. There was no statistically significant difference between SER (p=.83) or axial length (p=.57) between the subtypes. We found that myopia, measured by SER, was non-progressive in type 1 and 2 Stickler syndrome. Myopic macu- lopathy was present in 28 (43%) type 1 and five (42%) type 2 Stickler syn- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 55

RAPID FIRE PRESENTATIONS drome patients. The odds for higher-category myopic maculopathy increased by factor 2.28 with each mm of axial elongation (95% CI 1.19 to 4.34, P=.01) but not with age (odds ratio =1.02 per year, 95% CI 0.97 to 1.09, P=.39) in type 1 Stickler syndrome. Conclusions: Myopia in Stickler syndrome is non-progressive, with no differ- ence in axial length or SER between the subtypes. More than 50% of patients had no myopic maculopathy, its severity depending on axial length but not age. These findings are relevant for clinical follow-up and risk stratification for vision-threatening myopic maculopathy in patients with Stickler syndrome. RF06-6 A closer look into the posterior segment biometry F. Bragança1, B. Vieira1, P. Baptista1, F. Ribeiro2, B. Pessoa1, J. Beirão1, J. Heitor Marques1 1Unidade Local de Saúde de Santo António, Ophthalmology, Porto, Portugal, 2Hospital da Luz Lisboa, Ophthalmology, Lisbon, Portugal RF06-8 Macula edema and silicone oil tamponade: clinical features, predictive factors and treatment L. Ferro Desideri1, M. Aissani2, E. Bernardi1, M. Zinkernagel3, R. Anguita4 1Inselspital University Hospital, Bern, Switzerland, 2University of Bern, Bern, Switzerland, 3Inselspital, Bern, Switzerland, 4Inselspital University Hospital Bern, Ophthalmology, Bern, Switzerland Purpose: To determine the incidence, prognostic factors and management of macular edema (ME) associated with silicone oil (SO) tamponade. Methods: This retrospective, comparative, observational study included pa- tients who underwent pars plana vitrectomy (PPV) and SO tamponade for rhegmatogenous retinal detachment (RRD) or persistent full-thickness macu- lar hole (FTMH). Demographic data, clinical characteristics, and OCT find- ings were analyzed, focusing on the presence of ME. Propensity score matching was performed to control for confounding vari- ables, and multivariable logistic regression identified predictive factors for ME development. Purpose: To compare the intraocular axial segments of the eye between pe- Results: A total of 114 eyes of 112 patients was included. ME developed in 64 out of 114 eyes (56.1%) during SO tamponade. The mean duration of SO tamponade was significantly longer in the ME group (665 days, SD 580) com- pared to the non-ME group (239 days, SD 196) (p<0.0001). PVR was present in 74 eyes (71.4%) in the RRD group. Additionally, 49% of eyes that did not develop ME during SO tamponade experienced ME after SO removal, with an average CMT increase of 39 μm (SD 9). Multivariable logistic regression analysis identified retinectomy (62% in the ME group vs. 29% in the non-ME group, p=0.0013) and longer duration of SO tamponade (p<0.0001) was associated with ME. Conclusions: This study demonstrates a high incidence of ME in eyes with SO tamponade. Prolonged SO tamponade and retinectomy were significant predictors of ME development. These findings emphasize the importance of careful monitoring and timely SO removal to minimize ME-related complica- tions. ripheral vitreoretinal pathology eyes (retinal detachment, RD) and central / vitreomacular pathology eyes (epiretinal membrane/macular hole (ERM/ MH)). Methods: Cross-sectional study that included age, gender and axial-length matched eyes with RD or ERM/MH that underwent pars plana vitrectomy in the vitreoretinal surgery department of Unidade Local de Saúde de Santo António (ULSSA). Biometry data was obtained with a swept-source OCT (IOLMaster 700). Parameters analyzed included axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), lens thickness (LT), vitreous cavity length (CV) and white-to-white (WTW). Results: Sixty-eight vitrectomized eyes of 68 patients (34 due to RD; 34 due to ERM/MH) were included, with matched axial lengths (RD group: 23.75 ± 0.804 mm vs ERM/MH group: 23.73 ± 0.864 mm). Lens thickness was significantly lower in the RD group (4.496 ± 0.350 mm) compared to the MH/ ERM group (4.673 ± 0.280 mm) (p < 0.05). A stepwise segmentation of the intraocular structures showed that the equato- rial position of the lens was approximately the same in both groups (distance from the corneal endothelium to the lens center; RD group 4.893 ± 0.316 mm vs ERM/MH group: 4.906 ± 0.255; p>0.05). Conclusions: Despite the same age, gender and axial length, eyes with previ- ous RD had a thinner posterior lens and a longer vitreous cavity compared to eyes with ERM/MH. These findings reinforce the established understanding that a longer posterior segment may play a role in the development of RD. Additionally, the higher posterior lens thickness in ERM/MH eyes (in compar- ison with RD eyes) may reflect chronic posterior deformation influenced by the direction of axial tractional vitreous forces. These observations highlight the biomechanical differences in the pathophysiology of these conditions, which could inform future practice. 56 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS Rapid Fire 7: Electrophysiology, Glaucoma RF07-1 Finding the dark: unveiling diagnosis through electrophysiology P. Mota-Moreira1, P. Marques Couto1, A. Gama e Castro1, R. Santos Silva1 1Unidade Local de Saúde São João, Ophthalmology, Porto, Portugal Purpose: To describe an atypical case of Congenital Stationary Night Blindness (CSNB) with long-standing decreased visual acuity, diagnosed through electrophysiological testing. Methods: Retrospective analysis of clinical data and exams of a patient fol- lowed at the Ophthalmology Department. Report of Case: A 66-year-old male attended a routine ophthalmology con- sultation. His history included reduced vision in the left eye (OS) due to trau- ma and use of progressive glasses. Initial examination revealed esotropia of OS, oscillatory nystagmus, best-corrected visual acuity (BCVA) of 0.7 (with -4.00 -2.25x70⁰) in right eye (OD), 0.2 in OS (with -4.50 -1.75x80⁰) and in- traocular pressure of 24 mmHg in both eyes. Biomicroscopy showed pseudoexfoliation and cataracts in both eyes. Fundoscopy revealed diffuse myopic choroidopathy, tilted optic discs, thin- ning of the temporal and inferior neuroretinal rim and nonspecific pigmentary macular changes. Visual fields showed superior arcuate defect and inferior peripheral loss in OD and peripheral loss in OS. Selective laser trabeculoplasty was performed with good efficacy. Eletrorretinograma revealed a reduced b wave in DA 0.01 ERG, progressing to an electronegative pattern in DA 3 and DA 10 ERG. LA 30 Hz and LA 3 ERG were slightly reduced. The photopic On-Off ERG showed no on re- sponse. These findings were consistent with Complete CSNB. Family history revealed similar visual complaints in several of his nine siblings Conclusion: A detailed clinical history and ophthalmological examination are key to accurate diagnosis, but coexisting conditions, such as glaucoma, trauma and myopia, may complicate the process. This case highlights the importance of electrophysiological testing in confirming CSNB and distinguishing it from other retinal dystrophies. While CSNB is stationary, proactive management of associated conditions is crucial to preserving vision and improving quality of life. RAPID FIRE PRESENTATIONS RF07-4 Assessment of the effect of topical medications used in the treatment of open-angle glaucoma on perilimbal vascularity using optical coherence tomography angiography A.F Tuncel Bahar1, N. Ariturk1 1Ondokuz Mayıs University School of Medicine, Ophthalmology, Samsun, Turkey Purpose: Evaluation of the effects of antiglaucoma drops containing differ- ent numbers of molecules on perilimbal conjunctival vascular structure using anterior segment optical coherence tomography angiography (AS-OCTA) in open-angle glaucoma patients, and analysis of their relationship with other glaucoma findings. Method: Patients over 35 years with open-angle glaucoma receiving topi- cal treatment for over a month, along with age- and sex-matched controls, were included. Perilimbal conjunctival vascular density (VD) in superficial and deep plexuses across four quadrants were imaged using AS-OCTA. Relationships between drug type, duration, and routine glaucoma parameters (e.g., intraocular pressure, retinal nerve fiber layer thickness, and glaucoma stage based on standard automated perimetry) were analyzed. Image analysis utilized ImageJ software with the AngioTool plugin. Results: The study included 151 eyes of 90 patients and 36 eyes of 18 con- trols. The mean VDs in the superficial and deep plexuses for patients were higher than controls (patients: 23.4%±5 and 24.6%±5, respectively; con- trols:18.9%±3 and 20.3%±3.6, respectively; between-group comparisons, p<0.001). Based on the number of molecules, the mean VDs in the superfi- cial and deep plexuses were higher in patients than in controls. (Superficial plexus: single molecule: 23.9%±4.7, (p<0.001), two molecules: 21.8%±4.6 (p=0.03), three molecules: 22.6%±4.8 (p=0.01), four molecules: 25.3%±5.3 (p<0.001); Deep plexus: single molecule: 24.7%±4.7, (p<0.001), two mol- ecules: 23.3%±4.6 (p=0.04), three molecules: 24.0%±4.5 (p=0.008), four mol- ecules: 26.3%±5.7 (p<0.001)). Patients treated for over one year had significantly higher VDs in the super- ficial and deep plexuses compared to controls (Superficial plexus: 1–5 years: 23.8%±5.2 (p<0.001), >5 years: 25.0%±5.3 (p<0.001); Deep plexus: 1–5 years: 25.0%±5.3 (p<0.001), >5 years 24.2%±4.6 (p<0.001)). However, no significant difference was found between patients treated for less than one year (superficial plexus; 22.2%±6.3, p=0.38 and deep plexus: 22.5%±4.7, p=0.75) and controls. Quadrant VD assessments showed that both short- and long-term drug use increased VDs in the inferior and superior quadrants of both the superficial and deep plexuses compared to the control group (p<0.05). A significant positive correlation was observed between the number of molecules used and glaucoma stage (r=0.32, p<0.001). When VDs were compared across glaucoma stages, no significant differences were found (p>0.05 for all comparisons). Furthermore, no statistically significant relationship was observed between the use of preservatives and VDs in the superficial (p=0.11) or deep plexuses (p=0.19). Conclusion: In glaucoma patients, ocular surface changes are commonly ob- served due to anti-glaucoma eye drops. This study, using AS-OCTA, identified a significant increase in superficial and deep plexus VDs in patients compared to controls. Vascular density increased with an added number of molecules and with longer treatment duration, but no significant differences were found between VD and glaucoma stages or preservative use. These findings suggest that this imaging modality may guide treatment options in glaucoma follow- up. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 57

RAPID FIRE PRESENTATIONS RF07-5 Preventive aspects of managing pseudoexfoliative glaucoma in patients with pseudoexfoliation syndrome V. Melnyk1 1Clinic «Visiobud», Kyiv, Ukraine Purpose: To assess the changes in morphometric parameters of the anterior segment of the eye and the degree of intraocular pressure reduction in patients with PEX after performing the ultrasonic phacoemulsification with intraocular lens implantation. Methods: The study involved 488 patients (625 eyes) aged 49 to 79 years with age-related cataracts combined with PEX. Data from a control group were used for comparison, consisting of 122 patients (188 eyes) without signs of PEX. All patients underwent ultrasonic phacoemulsification with intraocular lens implantation. Intraocular pressure levels were measured using Goldman applanation to- nometry before the surgery, one week, one month, and three months after the operation. Results: During the study, morphometric parameters of the anterior segment of the eye in patients with PEX were evaluated, revealing a 9% reduction in anterior chamber depth and a 28% increase in anterior-posterior lens size compared to patients without signs of PEX. The parameters of intraocular pressure were also determined in patients with- out PEX (first group) and with PEX (second group) before and after ultra- soznic phacoemulsification with intraocular lens implantation. In patients of the first group, a gradual decrease in IOP (by 1.4 mmHg) was ob- served over 3 months after the surgery. In the second group of patients, there was a slight increase in IOP during the first week after the surgery, followed by a significant decrease (by 3 mmHg) over the following 3 months. Conclusion: Cataract surgery such as ultrasonic phacoemulsification with in- traocular lens implantation in patients with pseudoexfoliation syndrome can be an alternative method for preventing the development of pseudoexfoliative glaucoma by significantly reducing and stabilizing intraocular pressure in the long-term postoperative period. RF07-6 Impact of glaucoma on mental health and quality of life J. Alves Ambrósio1, P. Cardoso Teixeira1, M. Garcia1, J. Chibante Pedro1, J. Jesus1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal Purpose: To evaluate the impact of glaucoma on mental health and quality of life (QoL) and to examine the relationship between glaucoma severity and psychological and functional factors. Methods: This cross-sectional study included 102 patients with glaucoma and 82 age-matched controls. Participants completed the SF-12v2 for general health and the Glau-QoL-17 for disease-specific QoL. Additional data included demographic details, education level, household composition, driving status, glaucoma type, best-corrected visual acuity, num- ber of antiglaucoma medications, visual field results, psychiatric comorbidi- ties, psychiatric medication use, and disease-related anxiety. Results: Glaucoma patients (mean age 72.3 ± 7.6 years, 52.0% female) scored significantly lower on general health assessments compared to controls (Physical Component Score: 41.3 ± 11.3 vs. 49.7 ± 8.3, p < 0.001; Mental Component Score: 41.8 ± 10.8 vs. 51.0 ± 9.2, p < 0.001). Disease-specific QoL was also worse in glaucoma patients (Glau-QoL-17: 44 [19] vs. 58 [7], p < 0.001), particularly in anxiety, self-image, daily activities, psychological state, and self-care. Psychiatric comorbidities were more common in glaucoma pa- tients (46.1% vs. 22%, p < 0.001), with 64.7% reporting disease-related anxiety. Visual field loss severity correlated with worse physical (p = 0.028) and emo- tional role functioning (p = 0.035) and general health perception (p = 0.015). Conclusions: Glaucoma significantly reduces both general and disease-spe- cific QoL, with more severe visual field loss linked to poorer health outcomes. The high prevalence of psychiatric comorbidities emphasizes the psychologi- cal burden of glaucoma and the need for holistic management strategies ad- dressing physical and mental health. RF07-7 The use of selective laser trabeculoplasty vs micropulse laser trabeculoplasty: a systematic review & meta-analysis A. Al-Wizni1, M. Saleki2, P. Lee3, P. Hurt3, A. Adan4, A. Alsaif5, A. Nahrawy6 1Broomfield Hospital, Chelmsford, United Kingdom, 2Royal Bolton Hospital, Bolton, United Kingdom, 3Barts and The London, London, United Kingdom, 4Stepping Hill Hospital, Stockport, United Kingdom, 5King’s College London, London, United Kingdom, 6Western Eye Hospital, London, United Kingdom Purpose: Established treatments for lowering IOP in COAG include Selective Laser Trabeculoplasty (SLT) and Micropulse Laser Trabeculoplasty (MLT). This systematic review and meta-analysis compares the efficacy, safety and clinical outcomes of SLT and MLT in managing open angle glaucoma. Method: A systematic review and meta-analysis were conducted in accord- ance with PRISMA guidelines. Databases included MEDLINE, EMBASE, EMCARE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) which were searched up to July 2024. Five studies, comprising 462 eyes from COAG patients, met the inclusion criteria. Success rate (≥20% IOP reduction post-laser) and mean IOP reduction were primary outcomes extracted and analysed. Secondary outcomes also included adverse events, medication use, and glaucoma surgery requirements. Results: For success rate, no statistically significant difference was found be- tween SLT and MLT (OR = 0.91, 95% CI: 0.61 to 1.36, P = 0.64). Similarly, no statistically significant difference was found for mean IOP reduction at 3-6 months (MD = 0.46 mmHg, 95% CI: -0.43 to 1.36, P = 0.31) and 6-12 months (MD = 0.72 mmHg, 95% CI: -0.22 to 1.65, P = 0.13). Additionally, the num- ber of IOP-lowering medications required and IOP spikes 1 hour post laser showed no significant difference between the two treatments. There was also no difference in the need for subsequent glaucoma surgery (OR = 2.31, 95% CI: 0.75 to 7.15, P = 0.15). Conclusion: Both SLT and MLT are effective and safe treatment options for open-angle glaucoma, with no significant difference in efficacy or safety pro- files over a follow up period of up to one year. MLT may offer a reduced risk of IOP spikes, due to its cooling cycles, though further research is required to confirm long-term outcomes. These findings support the clinical flexibility in choosing between both treat- ment options based on patient-specific needs and preferences. 58 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS (p=0.03). Anterior vitrectomy was performed in 5 eyes in Group1 and 13 eyes in Group 2. Preoperative UDVA was 1.3±0.8 in Group1 and 1.6±0.8 logMAR in Group 2 (p=0.28). At the final visit, UDVA improved to 0.6±0.5 in Group1 and 0.9±0.8 logMAR in Group2 (p=0.08). Preoperative CDVA was 1.2±0.9 in Group1 and 1.2±0.8 logMAR in Group 2 (p=0.89), with a postoperative improvement to 0.5±0.4 in Group1 and 0.8±0.9 logMAR in Group 2 (p=0.07). Group1, complications included retinal de- tachment in 1 eye, IOL re-subluxation in 4 eyes, and glaucoma in 2 eyes; in Group2, corneal endothelial decompensation in 3 eyes, and glaucoma in 4 eyes. Conclusions: TheMcCabe technique, which involves scleral fixation of the existing IOL without extraction, and the Yamane technique, which requires removal of the IOL and scleral fixation of a new IOL,yielded comparable out- comes. In cases where the Yamane technique is performed, caution should be exer- cised, particularly regarding corneal complications, while in cases involving the McCabe technique, attention should be focused on retinal complications. RF08-4 Lessons from my first 25 phaco cases: mistakes, insights, and tips for beginners – a video presentation A. Bogoev1 1University Hospital Bochum, Ophthalmology, Bochum, Germany Purpose: To evaluate the impact of structured video documentation, reflec- tion, systematic complications tracking, and simulation-based training on skill acquisition and complication rates during the early phase of cataract surgery training. Method: A retrospective analysis was performed on the first 25 cataract sur- geries videos conducted by a novice surgeon from November 2024 to January 2025. Surgical techniques and outcomes were assessed using recorded videos and a self-maintained database. Key metrics included incision accuracy, cap- sulorhexis size and centration, hydrodissection quality, nucleus management (cracking and chopping), posterior capsule rupture, effective phaco time and total surgical time. A simulation-based training program was utilized preop- eratively to establish baseline technical skills. Results: Initial complications included suboptimal wound construction (8%), incomplete hydrodissection (8%), nucleus management challenges (12%), an- terior chamber instability (4%), Anterior capsule rupture (8%) and posterior capsule rupture (0%). The video analysis and detailed documentation allowed improvements in surgical technique and reduction of complications. By case 25, incision accuracy improved by 90%, hydrodissection success rates reached 90%, and overall complication rates were reduced by 90%. Total surgery time and effective phaco time were significantly reduced. Simulation training provided a foundation for skill refinement, significantly reducing er- rors and complications over time. Conclusion: Structured postoperative reflection, systematic tracking of surgi- cal performance, and simulation-based training are critical tools for accelerat- ing the learning curve in the early training in modern cataract surgery. This approach minimizes complications, improves technical skills, and ensures a safer transition from novice to skilled surgeon. These findings emphasize the importance of proactive learning strategies in ophthalmic training programs. RAPID FIRE PRESENTATIONS Rapid Fire 8: Cataract, Refractive Surgery RF08-2 Clinical study of cataract surgery in hypermature stage Y. Zeng1 1Lixiang Eye Hospital of Soochow University, Suzhou, China Purpose: To compare the integrity, roundness and diameter of femtosecond laser and traditional phacoemulsification capsulotomy for white cataract. Methods: To observe the surgical effect of all-white cataract. Among them, 100 patients underwent femtosecond assisted phacoemulsification, and the other 100 patients underwent traditional phacoemulsification. Results: Most patients in the femtosecond group achieved complete capsu- lorhexis. Among the 100 eyes, 10 underwent secondary capsulorhexis and 3 experienced anterior capsule tears. In the traditional phacoemulsification group, 49 out of 100 eyes had secondary capsulorhexis, and 15 out of 100 eyes had anterior capsule tears. The mean diameter of the lens capsule in the femtosecond group was 5.4mm, whereas in the traditional phacoemulsification group, the mean diameter of the lens capsule ranged from 4mm to 6mm. Conclusions: Femtosecond laser-assisted cataract surgery has high lens in- tegrity and stable capsulorrhexis diameter. Compared with traditional cataract phacoemulsification, the time of capsulorhexis is significantly shorter, the amount of viscoelastic agent is significantly reduced, and the diameter of cap- sule tear is more controllable. RF08-3 Comparison of two different approaches in intraocular lens subluxation: McCabe and Yamane Techniques İ. Semizoğlu1, G. Yalçınkaya Çakır1, A. Kırgız1, N. Kandemir Beşek1, S. Liman Uzun1 1Beyoglu Eye Training And Research Hospital, Ophtalmology, Istanbul, Turkey Purpose: To compare the efficacy and complications of two surgical tech- niques for intraocular lens (IOL) subluxation correction at a tertiary care hos- pital. Methods: A retrospective analysis was conducted on eyes treated for IOL sub- luxation between 2020 and 2024.Group1 consisted of patients who underwent scleral fixation of the IOL using the McCabe technique (with polypropylene sutures), while Group 2 included patients who had IOL extraction followed by the Yamane technique with scleral fixation. Demographics, pre- and postop- erative uncorrected and corrected distance visual acuity (UDVA , CDVA) and complications were compared. Results: A total of 58 eyes (29 in each group) were included.The mean age was 69.5±15.1 years in Group1 and 73.6±10.3 years in Group 2 (p=0.24). The mean follow-up period was 12.7±17.6 months. The surgery duration in Group1 (41.6±19.0 min) was significantly shorter Group 2 (52.2±16.1 min) Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 59

RAPID FIRE PRESENTATIONS RF08-5 Early intraocular pressure results in cataract patients with glaucoma who underwent intraocular lens implantation by hydroimplantation S. Zırtıloğlu1, M.D. Özer1, K. Atalay1, N. Aktaş1 1Kanuni Sultan Suleyman Training and Research Hospital, Ophthalmology, Istanbul, Turkey fractive error of the recipient eye. The diameter of the donor lenticules was set to be at least 0.5 mm larger than the recipient’s mesopic pupil size to prevent accommodation issues. Lenticules were transplanted into the pocket based on corneal topography and adjusted according to the lowest K value to correct astigmatism. All patients were followed for 1 year. Follow-up assessments included evalu- ations of uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA) at 35 cm, uncorrected intermediate visual acuity (UIVA) at 70 cm, slit-lamp biomicroscopy, corneal topography, anterior segment optical coherence tomography, and pachymetry. Purpose: To evaluate the intraocular pressure (IOP) changes after hydroim- Results: No complications, such as infection, epithelial defects, punctate keratitis, or signs of allogeneic rejection, were observed in any of the patients. The UDVA improved significantly from 0.70 ± 0.06 logMAR preoperatively to 0.05 ± 0.02 logMAR at 12 months postoperatively (p < 0.001). Additionally, UNVA improved from J 7 preoperatively to J 2 one year post- operatively. Conclusion: Myopic lenticule transplantation is an effective treatment for hy- peropic residual refraction after PRK and LASIK surgeries. plantation of intraocular lens (IOL) implantation in patients with cataract in glaucoma. Method: 9 patients with primary open-angle glaucoma who had an indication for cataract surgery were included in the study. All of these patients underwent routine phacoemulsification followed by cortex cleaning and IOL implanta- tion under irrigation instead of injecting viscoelastic into the capsule. All secondary causes of glaucoma, such as narrow-angle glaucoma and pseu- doexfoliation glaucoma, which could affect the outcome of this step, were excluded. Results: The mean age of the patients was 72 ±8 years. According to the Snellen visual acuity chart, postoperative visual acuity was 0.2 (range 0.05- 0.30), whereas postoperative visual acuity was 0.80 (range 0.40-0.90) at 1 month. In this case, the patients’ visual acuity increased significantly at 1 month (p= 0.008). Preoperative endothelial count was 2717± 257, while post- operative endothelial count was 2582± 351. There was no statistically significant difference in the decrease in endothelial count in the first month (p=0.058). Regarding IOP, the mean preoperative value was 17.88± 7.09, 17.77±4.86 at the 6th postoperative hour, and 23.22 ±10.54 at the 1st postoperative day. There was no significant difference between preoperative and postoperative values in IOP (p=0.09). Conclusion: IOL implantation with hydroimplantation technique is a safe technique in glaucoma patients This technique may be preferred in glaucoma patients due to the postoperative absence of IOP spikes in glaucoma patients. RF08-7 Lenticule transplantation in the treatment of residual refractive errors and presbyopia following PRK and LASIK F.F. Arslan1, C.E. Semiz2, F. Semiz3, N. Hima-Musa2 1Istanbul-Cerrahpasa University, Ophthalmology, Istanbul, Turkey, 2Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 3Eye Hospital, Prishtina, Kosovo Purpose: To evaluate the improvement in visual acuity, presbyopia, and pa- tient satisfaction following myopic lenticule transplantation in patients with residual hyperopic refraction after PRK and LASIK surgeries. Method: 44 eyes from 22 patients aged 43 to 52 years were included. All patients had residual hyperopia between +1.0 and +3.25 D and astigmatism ranging from +0.75 to +1.75 D following postoperative PRK or LASIK. The corneal cap thickness was set to 130 μm, and a 3.0-mm incision was made. Donor lenticules were sourced from patients who underwent small incision lenticule extraction surgery and had refractive errors ranging from -1.25 to -3.50 D (with no cylinders) and thicknesses between 25 and 70 μm. The thick- ness, volume and size of the donor lenticules were calibrated to match the re- 60 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS Rapid Fire 9: Education RF09-1 Reaching the unreached: the Arunodaya saga A. Sethi1, R. Sethi1, V. Sethi2, A. Sethi3, S. Sethi4, L. Arbisser5, G. Schultz6, D. Jackson7, S. Sharan8 1Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology, Gurugram, India, 2Arunodaya Deseret Eye Hospital (ADEH), Vitreo Retina Consultant, Gurugram, India, 3Arunodaya Deseret Eye Hospital (ADEH), Paediatric Ophthalmology, Gurugram, India, 4Arunodaya Deseret Eye Hospital (ADEH), Glaucoma Services, Gurugram, India, 5Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology: Visiting Ophthalmologist, Gurugram, India, 6Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology: Visiting Consultant, Gurugram, India, 7Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology / Charity Vision, USA, Gurugram, India, 8Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology: Advisor, Gurugram, India Purpose: To showcase how ophthalmologists in developing countries, can reach out to provide comprehensive eye care services to the economically weaker sections of the society, on a sustainable basis. Method: The presentation will highlight how effective community based in- tervention, by organising eye care camps in rural villages / slum clusters, are effective means of culturally acceptable eye / health care interventions. Eye medicines / spectacles (where indicated) are dispensed at the camp site. Patints requiring detailed evaluation / surgical proceedures are then refered to our base hospital (ADEH). Results: Over 1.6 million needy patients have received quality eye care ser- vices, and information on hygiene / preventive eye care services, since 1990. A detailed graphical presentation will highlight targeted intervention, with emphasis on women / children, in rural belts. Conclusion: While primary eye care services are provided free of cost to the patients, by the mobile eye care teams ophthalmic investigations / surgical proceedures are undertaken at the tertiary community eye care institute, at markedly subsidised cost, and even free (if subsidised). Ophthalmologists interested in providing volunteer missions, will find it very rewarding in improving your diagnostic & surgical clinical skills, and helping the needy to restore their sight. RAPID FIRE PRESENTATIONS RF09-2 Perception and importance of social and emotional learning in ophthalmic education and training in Europe D.J. Lindegger1 1Independent, Lucerne, Switzerland Purpose: To investigate the integration and perceived importance of Social and Emotional Learning (SEL) in ophthalmology education and training across European countries, focusing on emotional intelligence, interpersonal skills, and their impact on professional and personal development. Method: A cross-sectional survey was distributed to European Young Ophthalmologists (YO) of the Society of Ophthalmology (SOE) network. The questionnaire assessed familiarity with SEL, perceived importance and im- pact, current implementation practices, challenges in integration and future di- rections. Responses were anonymous, analysed quantitatively, and presented in aggregated form. Results: Preliminary data from 2/46 surveyed individuals across 40 countries revealed that 0% were familiar with SEL. The effectiveness of SEL practices was considered poor to very poor due to a lack of awareness about SEL. 100% indicated SEL was critical (important to very important) in ophthalmology education, particularly in enhancing patient communication, team collabora- tion, and stress management. However, 100% cited a lack of awareness about SEL and missing institutional support as implementation barriers. The preliminary survey data indicates trends in SEL awareness and implemen- tation. However, the low response rate prevents robust statistical analysis, and findings should be interpreted with caution. Conclusion: SEL is considered an important component of ophthalmology education, fostering personal development, resilience, and improved inter- personal skills. However, lack of awareness and implementation necessitates increased institutional support and standardised frameworks to integrate SEL effectively into ophthalmology training programs. Due to a limited response rate, further qualitative and quantitative research is needed to validate reported trends and assess statistical significance. RF09-3 Thyroid eye disease: online medical education unveils knowledge gaps and barriers regarding targeted immunotherapy S. Trier1, K. Carpenter1, M. Khalaf1, T. Barras1, V. Lee2 1Medscape, Education Global, Newark, United States, 2Imperial College & London North West University Healthcare NHS Trusts, Consultant Ophthalmic & Oculoplastic Surgeon Thyroid Eye Services Ophthalmology Lead, London, United Kingdom Thyroid eye disease (TED) has profound impact on quality of life. Several novel immunotherapies are in late-stage development. We aimed to identify learning needs on disease facts, diagnosis and management and attitudes to- wards novel treatment options. Physicians completed an online accredited 25- item clinical practice assessment of 20 knowledge and 5 attitudinal questions with evidence-based feedback on correct answers. Learning objectives were to increase knowledge regarding TED facts, treatment guidelines and self- assess learning needs on management. Launch Sep 6, 2024; data through Oct 22, 2024. Assessment completers: 139 ophthalmologists, 92 endocrinologists. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 61

RAPID FIRE PRESENTATIONS Physicians showed a lack of knowledge using clinical activity score question- RF09-8 naires for initial and follow-up assessments and had knowledge gaps on atypi- cal TED presentations. Knowledge on immunotherapy targets for rituximab and teprotumumab was insufficient, most physicians were unaware of efficacy data showing proptosis reduction with teprotumumab. The role of selenium supplementation for mild active TED was not known widely, instead steroids were seen as most appropriate for the majority of patients. The place of orbital decompression surgery in sight-threatening TED not sufficiently responsive to iv corticosteroids also required education. The majority of physicians stated that up to 50% of their patients are not ad- equately controlled on local therapy or corticosteroids, however less than half would be willing to prescribe a specific immunotherapy if available, due to cost concerns and lack of knowledge on safety and efficacy. Less than half of physicians felt confident (very or quite) about TED diagnosis and management. Physicians had a high interest for education on emerging Innovative use of asynchronous diagnostic hubs for cases seen in comprehensive ophthalmology A. Marinescu1, C. Hall2 1Moorfields Eye Hospital, London, United Kingdom, 2East Sussex NHS Trust, Eastbourne, United Kingdom Purpose: NHS diagnostic hubs are facilities that offer diagnostic tests in lo- cal communities. They are intended to reduce hospital pressure and improve access to investigations. Moorfields has established diagnostic hubs for term monitor- ing of Glaucoma and Medical Retina patients. This is a pilot study by the long Comprehensive Ophthalmology service making further use of these hubs to therapies, in particular on safety aspects. Online medical education is an ef- reduce backlogs and improve patient experience for more general eye condi- fective method to identify TED learning needs to help the adoption of novel targeted immunotherapies for patients who can benefit from them. RF09-6 Challenges in ophthalmology education in developing countries: a focus on Central America L. León Nieto1 1Mesoamericana University, Visualiza Hospital, Guatemala, Guatemala In many developing countries the field of ophthalmology faces significant challenges that affect the quality of education for medical professionals. The primary obstacles include limited resources, insufficient infrastructure, and inadequate access to modern technology. For medical directors overseeing ophthalmology programs, these issues create unique hurdles in providing tions. Methods: For 12 months to June 2025 we directed selected patient referrals to the hubs for a range of tests. Criteria were Suspicious discs, Disc drusen, Reduced vision, Non-specific blurry vision, Macula changes seen (normal VA), Visual field defects with normal IOP’s and CDR. About 500 cases had one of two test bundles administered by technicians. Results were then reviewed by a consultant leading to virtual or F2F appoint- ments, a discharge letter, referral to other services or repeat tests. Results: Interim - Patients had faster access and waited less. It reduced de- mand on limited clinic space. Consultants were able to review 20% more cases, either virtually or by outcome letter. Good discharge rate c. 60%. DNA rate was higher if patients did not like location or misunderstood pathway. Conclusions: This pathway is a valuable supplement to traditional face to face appointments for suitable low/medium risk cases. It requires careful case selection by a senior clinician at triage and good quality referral information is necessary. Accurate patient communication for appointments is needed, explaining the pathway and what to expect and the hub location must be convenient to mini- mise DNA rate. high-quality education. Robust electronic administration is vital to ensure test results are reviewed In Guatemala, a beautiful country with a population of 18 million and approxi- timeously and there is an outcome for all cases. We developed a tab within our EPR which keeps the patient within the virtual system until all stages are com- pleted. A report is produced for failsafe officers to monitor outstanding cases. mately 250 ophthalmologists, access to quality eye care remains limited. The country only has three outdated programs, which offer very few spots for local doctors. This disparity highlights the significant need for trained ophthalmolo- gists to address the growing demand for eye care services. In response to this pressing issue, a couple of years ago, a group of ophthal- mologists, all members of a social clinic with over 20 years of experience, came together with the vision of creating a new and innovative academic pro- gram. The goal is to train ophthalmologists who can serve remote areas with no access to visual healthcare. To overcome these challenges, was necessary to forge partnerships with uni- versities and international organizations. We created context-specific solutions and improved the local healthcare infrastructure. We are incorporating digital platforms for distance learning and telemedicine, and many other initiatives. As the Medical Director of Visualiza Ophthalmology Postgraduate Program, the objective of the presentation is to explain to the audience the challenges faced by ophthalmology education in our countries and how we are address- ing them. Also, to establish open channels of collaboration with educational institutions in Europe to create opportunities for student exchange in both directions, en- riching the educational experience for residents and fellows in both continents with the benefits from a cross-cultural interaction of knowledge, such as re- search and clinical practices. 62 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF10-3 Strabismus: an assessment of educational content on social media E. Ghanekar1, R. Duff2, L. Kowdley Hemanth1, S. Jain1 1University College London, London, United Kingdom, 2The University of Edinburgh, Edinburgh, United Kingdom Purpose: To conduct a quality assessment of educational content on social media for patients with strabismus. Method: TikTok and Instagram were searched for two hashtags: #strabismus and #lazyeye. Educational videos which met inclusion criteria were analysed using the Global Quality Scale, mDISCERN and PEMAT-AV tools. Pearson’s Coefficient was used to assess correlations between the views and likes of educational videos against their quality scores. Results: From the top 50 videos for #strabismus and #lazyeye on each plat- form (n= 200), the included educational videos aimed at patients (n=54) had an average mDISCERN of 2.8 (/5), Global Quality Scale (GQS) of 3.3 (/5), PEMAT-AV understandability score of 78.5%, and PEMAT-AV actionability score of 42.3%. Pearson’s correlation analysis revealed significant associations between video quality scores and engagement metrics. Video views and likes were negatively correlated with both the mDISCERN score and the GQS score (p< 0.05). Additionally, both metrics showed a statistically significant positive correla- tion with the PEMAT-AV actionability score. 67% of educational videos were created by a healthcare professional, with 35% created by Ophthalmologists, and 28% created by Optometrists. Conclusion: This study highlights the significant role of social media in dis- seminating health information on strabismus. Educational content for strabis- mus has very high heterogeneity and lower-quality videos yield more views and likes, which could lead to patients following misleading or incomplete medical advice. The positive correlation between actionability and lower-quality videos is particularly concerning, as these videos, while actionable, may encourage pa- tients to take steps based on poorly explained information. To enhance social media as an educational tool, there is a clear need for more high-quality content created by qualified healthcare professionals, to ensure that patients receive accurate, safe guidance. RAPID FIRE PRESENTATIONS Rapid Fire 10: Paediatric Ophthalmology & Strabismus RF10-2 Beyond ROP: abnormal complex vascularization in a premature infant T. Reis da Costa1, J. Charréu1, F. Francisco1, B. Pombo1, M. Vivas1, M. Mota1, S. Pinto1, S. Teixeira1, I. Prieto1 1ULS Amadora/Sintra, Lisbon, Portugal Case report: A preterm girl (GA 27 weeks, BW 480g) was referred at week 38 of PMA for treatment of type 1 ROP. Fundus exam showed avascular retina predominantly in the nasal quadrants, no plus disease and fibrovascular chang- es without typical ROP features. Both eyes showed fibrovascular hyaloid condensation with extra-retinal vascularization floating in the vitreous, compatible with Familial Exudative Vitreoretinopathy (FEVR) diagnosis. Additionally, in left eye, a fibrovascular fold resembled posterior persistent fetal vascularization (PFV). Fluorescein angiography showed minimal exuda- tion and detailed complex vascular anomalies. Despite being preterm, the clinical picture was suggestive of FEVR and bilat- eral laser therapy of the avascular retina was performed. The disease remained stable in spite of persistent vitreous traction of the nasal retina on left eye with slight macular ectopia without signs of retinal detachment. Follow up showed myopia with spherical equivalent of approximately -5.00D and low angle esotropia adequately corrected with prescription glasses. At age 4, absent signs of clinical exsudation on fundus exam, fluorescein angiogra- phy showed late stage leakage in the left eye, suggesting subclinical disease activity. A decision to repeat laser therapy was taken. At 6 years of follow-up the dis- ease remains stable without signs of progression and BCVA of 3/10 on the right eye and 2/10 on left eye. Discussion: Pediatric vascular retinal diseases present with significant phe- notypical overlap, leading to difficulties in accurate diagnosis and appropriate therapy. Indeed, a shared pathologic disruption of normal vascular develop- ment is recognized. Wnt signaling, directly implicated in FEVR, may interact or complicate ROP cases and be responsible for atypical presentation or late stage disease reactivation. Fluorescein angiography may have an important role in the differential diagnosis and follow-up of these diseases in need of lifelong surveillance. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 63

RAPID FIRE PRESENTATIONS RF10-5 RF10-6 The role of non-leukocoria red reflex referrals in detecting ocular pathology in an ethnically diverse population: a multi-centre study Z. Jin1, H.I. Patel2,3, K.L. Gutiérrez2,3, S. Chandak2, M. Theodorou2, A. Blaikie4,5, M.A. Reddy1,6,2 1Queen Mary University of London, London, United Kingdom, 2Moorfields Eye Hospital, London, United Kingdom, 3Royal London Hospital, Barts Health NHS Trust, London, United Kingdom, 4Queen Margaret Hospital, NHS Fife, Dunfermline, United Kingdom, 5School of Medicine, University of St Andrews, St Andrews, United Kingdom, 6Retinoblastoma Service, Royal London Hospital, London, United Kingdom Purpose: The ‘red’ reflex test is a key screening tool used to identify serious ocular pathologies in children and infants. Recent studies suggest variability in the positive predictive value (PPV) of this test. To evaluate its diagnostic value, we stratified referrals to absent or abnormal reflexes (non-leukocoria) and white reflex (leukocoria) which is an important indicator of urgent sight- or life-threatening conditions. Review of the role of accommodation and binocular vision in myopia onset and progression B. Evans1, R. Shah1,2 1City St George’s, University of London, Optometry & Visual Sciences, London, United Kingdom, 2HOYA, Vision Care, Amsterdam, Netherlands Background: The predominant theory is that relative peripheral hyperopic de- focus (RPHD) is a key factor in myopia progression. However, interventions that reduce RPHD only slow progression by ~50%. Methods: PubMed was searched for keywords relating to myopia, accommo- dation and binocular vision in humans. Results: The search identified 259 publications, with 30 added from bibliog- raphies. After filtering, 110 publications were included. The CLEERE study found changes in the interaction between accommodation and convergence (AC/A ratio) from four years before myopia onset, thought to indicate compromised accommodation linked to increased accommodative lag. Many studies have found myopia to be associated with increased accom- modative lag, that will contribute to hyperopic defocus. The magnitude of Non-leukocoria referrals may signify non-urgent conditions (e.g. strabismus) accommodative lag is not correlated with rate of myopia progression. in addition to urgent conditions, although it is often misinterpreted in non- Tests of eye alignment show increased near esophoria in some myopes around white children and infants. Methods: We retrospectively reviewed ‘red’ reflex referrals at Moorfields Eye Hospital (January to December 2022) and Royal London Hospital (January 2021 to February 2023), excluding leukocoria referrals. Examination out- comes, patient demographics, referral source and reason, and appointment lag the time of myopia onset. This is probably secondary to the higher AC/A ratio. Clinical trials of bifocal and progressive addition lens spectacles show disap- pointing efficacy (10-30%) at slowing myopia progression. Early indications of greater efficacy in myopic children with higher accommodative lag and/or near esophoria were not replicated in later trials. time were assessed. Urgent conditions included sight-threatening (e.g. cata- Considering literature reviews, the 2021 IMI review was dismissive of a role ract) and/or life-threatening ocular pathology (e.g. retinoblastoma) requiring for accommodation and binocular vision in myopia development/progression, intervention. Non-urgent conditions included strabismus and amblyopia. Results: 43 children were included (median age 3 months; range 1–84). 20.5% were white. The main source of referrals were general practitioners (86%). Median lag time was 6 days (range 0–71). 93% were normal, with no urgent conditions found. Two strabismus and one high refractive error resulted in a PPV of 6.98% for non-urgent conditions. No referral mentioned an exami- nation of parents. Conclusion: Our study confirmed a low diagnostic value of absent or ab- normal ‘red’ reflexes in an ethnically diverse population. This increases the burden on paediatric ophthalmology services as these children need to be seen urgently. The low proportion of white children suggests that there is a misinterpreta- tion of the ‘red’ reflex. To address this, we advise examination of parents and the use of the term ‘glow’ reflex while maintaining emphasis on leukocoria screening. but the 2024 NASEM review argued that accommodation may play an under- appreciated role. Conclusion: It is not possible to reach firm conclusions from the literature. Although accommodative dysfunction seems to play some role in myopia on- set, accommodative and binocular factors are unlikely to be major causative factors in myopia progression. Interventions that modify accommodation and binocular co-ordination are unlikely to have strong myopia control effects. An additive risk factor risk-resilience model is presented. 64 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

RAPID FIRE PRESENTATIONS RF10-7 Safety and efficacy of combination therapy with anti–vascular endothelial growth factor and laser for retinopathy of prematurity: a systematic review and meta-analysis A. Alamoudi1, A. Alnabihi2, A. Alsudais2, N. Almufarriji1, W. Batais2, A. Aldahlawi2, A. Altalhi3, H. Al-Dhibi4, A. Alakeely5 1Jeddah Eye Hospital, Department of Ophthalmology, Jeddah, Saudi Arabia, 2King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia, 3King Khaled Eye Specialist Hospital, Division of Vitreoretinal Surgery, Riyadh, Saudi Arabia, 4King Khaled Eye Specialist Hospital, Division of Vitreoretinal Surgery and Uveitis, Riyadh, Saudi Arabia, 5Magrabi Hospitals and Centers, Riyadh, Saudi Arabia Purpose: This systematic review and meta-analysis aimed to evaluate the safety and efficacy of combined laser and anti-VEGF therapy for ROP, focus- ing on both structural and functional outcomes. Methods: A comprehensive search was conducted in multiple databases to identify randomized controlled trials (RCTs) that investigated combination therapy for ROP. The PRISMA guidelines were followed. Data were extract- ed and analyzed using risk ratios and 95% confidence intervals (CIs). The Cochrane Risk of Bias tool was used to assess the risk of bias, and the GRADE criteria were employed to evaluate the quality of evidence. Results: Three RCTs involving a total of 162 premature infants were included in the meta-analysis. Combination therapy of anti-VEGF and laser photoco- agulation was compared with other interventions. The pooled analysis of fa- vorable structural outcomes did not show a statistically significant difference between combination therapy with anti-VEGFs and laser therapy compared to the interventions in the control groups (P=0.25). However, the risk ratio for achieving a favorable outcome slightly favored the patients in the combination therapy group, with a value of 1.12 (95% CI: 0.92 – 1.37). The incidence of adverse events was comparable between the combination therapy group and other intervention groups. Conclusion: This systematic review and meta-analysis suggest that risk ra- tio of combination therapy with anti-VEGF and laser for ROP is associated with favorable outcomes, albeit insignificant. The safety profile of combina- tion therapy appears to be similar to other interventions. However, due to the limited number of included studies, further research is needed. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 65

ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Cataract EP-CAT-01 Investigation of microplastics exposure in cataract surgery D.H. Kim1, Y.H. Choi1, N. Park1, Y.-H. Choi2 1Korea University College of Medicine, Ophthalmology, Seoul, Korea, Republic of, 2Korea University, School of Health and Environmental Science, Seoul, Korea, Republic of Purpose: Potential health risks associated with microplastic (MP) exposure have been a significant global concern. This study aims to investigate the quantity and characteristics of MPs in intraocular fluid and surgical devices used during cataract surgery. Method: Numbers and characteristics of MPs were investigated in irrigation saline and balanced salt solution (BSS) from syringes, ophthalmic viscosurgi- cal device (OVD), ocular inflow and outflow fluid through phaco-machine during cataract surgery. Raman spectroscopy was used to identify quantity and characteristics of MPs. Scanning electron microscopy with energy dispersive spectroscopy was used to examine surface morphologies of MPs. Results: MPs were detected in ocular inflow fluid (0.1±0.1/mL), intraocular outflow fluid (11.1±4.5/mL), and indoor OR air (0.5±0.3/mL). There were no MPs in saline and BSS in syringes. A higher number of MPs were identified in outflow fluid compared to inflow fluid (P<0.05). In the inflow fluid, only fragments were found, whereas in outflow fluid, both fragments (95.8%) and fibers (4.2%) were found. With regard to size, only MPs sized 10–19 µm were detected in inflow fluid, whereas smaller MPs sized 5–9 µm were additionally detected in outflow fluid (30.2%). Regarding polymer type, inflow fluid had PE (50%) or PP (50%), while out- flow fluid included PE (91.1%), PP (5.2%), PS (1.8%), PC (1.8%), and PET (0.1%). Patients who had other ocular diseases within the past three years or who had diabetes at the time of surgery showed higher concentrations of total MPs and PE (P<0.05). Conclusion: MPs can be exposed into eyeball during cataract surgery, poten- tially from surgical instruments or indoor air. Considering the disparity of MP detection between inflow and outflow, this study provides the possibility of intraocular MP pollutants. EP-CAT-02 Blood pressure change during cataract surgery J.S. Min1, S.H. Yoon2, I. Jun1, T.-i. Kim1, K.Y. Seo1 1Yonsei University College of Medicine, Institute of Vision Research, Department of Ophthalmology, Seoul, Korea, Republic of, 2Daegu Catholic University of Medicine, Department of Ophthalmology, Daegu, Korea, Republic of Purpose: To analyze changes in blood pressure and pulse before, during, and after cataract surgery. Methods: The medical records of patients who underwent cataract surgery were retrospectively analyzed. Blood pressure and pulse were measured 1 hour before and 1 hour after cataract surgery. Additionally, blood pressure and pulse were measured at the completion of each process of CCC, phaco- emulsification, I&A, and IOL implantation during cataract surgery. Changes in measured blood pressure and pulse of all patients were analyzed, and the differences in blood pressure and pulse were assessed based on the history of hypertension, dyslipidemia, and diabetes. Results: Systolic blood pressure (SBP) significantly increased from before surgery until phacoemulsification and decreased thereafter. Additionally, the degree of blood pressure increase was highest between CCC and Phacoemulsification. Patients with a history of hypertension had significantly greater increases and decreases in SBP before and after cataract surgery than patients without a history of hypertension. There were no differences in blood pressure changes according to dyslipidemia and diabetes. There were no sig- nificant differences in pulse changes before and after surgery, nor were there differences according to hypertension, dyslipidemia, or diabetes. Conclusions: Patients’ blood pressure increases significantly from before cataract surgery until the phacoemulsification process and then decreases. Because the degree of blood pressure rise during cataract surgery is higher in patients with a history of hypertension, strict blood pressure control before and during surgery is necessary. EP-CAT-03 Evaluation of the effects of cataract surgery on hip fracture incidence and quality of life among geriatric patients: a retrospective study H. Hasani1 1Alborz University of Medical Sciences, Ophthalmology, Karaj, Iran, Islamic Republic of Purpose: This study aimed to assess the impact of cataract surgery on hip fracture incidence and QoL in a cohort of geriatric patients. Methods: This retrospective analysis included 61 patients aged ≥65 years who underwent cataract surgery. Preoperative and postoperative assessments included hip fracture incidence, fall frequency, and QoL, measured using the National Eye Institute Visual Function Questionnaire (VFQ-25). Visual acuity (logMAR) and functional independence were also examined as mediating fac- tors. Statistical analyses involved paired t-tests for continuous variables and chi-square tests for categorical variables, with significance defined as p < 0.05. Results: • Hip Fracture Incidence: The incidence of hip fractures significantly de- clined from 14.8% (9/61) in the year preceding surgery to 3.3% (2/61) in the year following surgery (χ² = 6.94, p = 0.008). 66 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

• Visual Acuity: Mean visual acuity improved significantly from 0.68 ± 0.12 logMAR preoperatively to 0.24 ± 0.08 logMAR postoperatively (p < 0.001). Enhanced visual acuity correlated strongly with a reduction in fall frequency (r = -0.64, p < 0.01). • Quality of Life (QoL): QoL scores increased markedly from 58.4 ± 8.7 preoperatively to 78.6 ± 6.5 postoperatively (p < 0.001), reflecting great- er confidence and reduced dependency in daily activities. • Fall Frequency: The mean annual fall rate decreased significantly from 3.1 ± 1.2 preoperatively to 1.4 ± 0.7 postoperatively (p < 0.001). Conclusion: Cataract surgery significantly reduces hip fracture incidence and enhances QoL among geriatric patients. These findings underscore the impor- tance of timely surgical intervention for age-related cataracts as a preventative strategy to improve health outcomes, promote functional independence, and enhance overall well-being in older adults. EP-CAT-04 Mask-based classification AI for surgical treatment decisions in cortical and posterior subcapsular cataracts S. Oh1,2, S. An3, S.H. Jung4, M.J. Chung2,5,6, H. Yoo2, D.H. Lim7,8,9 1Sungkyunkwan University, Department of Metabiohealth, Seoul, Korea, Republic of, 2Samsung Medical Center, Medical AI Research Center, Seoul, Korea, Republic of, 3SungKyunkwan University of Medicine, Department of Pharmacology, Department of Medicine, Seoul, Korea, Republic of, 4Samsung Medical Center, Samsung Medical AI Research Center, Seoul, Korea, Republic of, 5Samsung Medical Center, Department of Radiology, Seoul, Korea, Republic of, 6Sungkyunkwan University School of Medicine, Department of Data Convergence and Future Medicine, Seoul, Korea, Republic of, 7Sungkyunkwan University School of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of, 8Sungkyunkwan University, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea, Republic of, 9Samsung Medical Center, Department of Ophthalmology, Seoul, Korea, Republic of Purpose: AI-based approaches for cataract severity classification are becom- ing increasingly diverse. This study proposes a mask-based approach for cortical and posterior subcapsular cataracts severity classification. Severity classification was performed using binary classification to determine surgi- cal necessity. Based on the Lens Opacities Classification System (LOCS) III, grades below 3 were considered not requiring surgery, while grades of 3 or higher required surgery. ELECTRONIC POSTER PRESENTATIONS In contrast, model with the mask-based approach achieved improved perfor- mance for cortical cataracts (Acc 0.97, F1 0.97) and posterior subcapsular cataracts (Acc 0.93, F1 0.87). Conclusion: These results highlight the effectiveness of the mask-based ap- proach. In conclusion, the mask-based approach enhances lesion emphasis and minimizes irrelevant background, showing potential for clinical use. EP-CAT-05 Effectiveness of a standardized protocol in diabetic patients undergoing cataract surgery on visual outcomes: a pilot study C. Raj1, C. Hodge2, U. Bhatt3, R. Pathmaraj3 1Vision Eye Institute, Ophthalmology - Retinal Clinic, Melbourne, Australia, 2The University of Sydney, Save Sight Institute, Sydney, Australia, 3Vision Eye Institute, Ophthalmology, Melbourne, Australia Purpose: This study evaluated the effectiveness of employing a standardized protocol in Type 2 diabetic patients undergoing routine cataract surgery. Methods: A prospective non-randomized interventional pilot study (47 eyes of 24 patients) with Type II diabetes mellitus and a visually significant cata- ract. All patients adhered to a strict pre and post operative protocol which included classification as per Diabetic Retinopathy Severity Scale (DRSS), stable ocular coherence tomography (OCT), anti-VEGF treatment naive for a minimum of 3 months prior to surgery. All patients underwent routine phacoe- mulsification surgery with monofocal intraocular lens implantation (IOL) and received the same post-operative topical drop regimen. Patients were followed for up to 3 months to evaluate 1) primary outcomes measure: best corrected distance visual acuity (BCDVA) and ii). secondary outcomes: presence of cys- toid macula edema (CME), change in central macula thickness (CMT) and recurrence of diabetic macula edema (DME). Results: At 3 months follow up , 93.5% of eyes achieved BCDVA of 0.2 logMAR (6/9 Snellen equivalent), 21.7% achieved BCDVA of -0.1 logMAR (6/4.8 Snellen equivalent). The incidence of clinical CME was diagnosed in 10.9% of eyes. The presence of post-operative CME was independent of mild retinopathy as per DRSS score (p = 0.06). A change in overall CMT compared to baseline suggestive of sub-clinical CME was seen in 23.9% (less than 25 microns) and 13% eyes (26 to 50 microns). The recurrence of DME was diag- nosed in 8.7% eyes. Factors found to increase the recurrence of DME included higher DRSS at baseline (R0.6, p<0.001) and previous treatment with anti- VEGF (R-0.46, p<0.002). Conclusion: Preparing patients with adherence to a robust protocol prior to surgery can result in excellent visual outcomes with less post-operative com- Methods: Retro illumination images were collected from general hospital be- plications in diabetic patients. tween January 2017 and December 2020 and were graded based on LOCS III. The study included 353 cortical and 264 posterior subcapsular cataract pa- tients. Lesion areas were masked by ophthalmic clinical assistant to generate mask images. The proposed model employed a pre-trained EfficientNet-B7 as the backbone for feature extraction. Original images and lesion mask images were processed through the backbone model to extract features, with lesion masks undergoing an extra step to enhance lesion-specific features. The ex- tracted features are concatenated and subsequently processed for the severity classification. Results: Model performance was evaluated using Accuracy and F1-score. The model without the mask-based approach showed performance for cortical cataracts (Acc 0.79, F1 0.78) and posterior subcapsular cataracts (Acc 0.89, F1 0.75). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 67

ELECTRONIC POSTER PRESENTATIONS EP-CAT-07 Anesthesiologist versus non-anesthesiologist sedation for cataract surgery H. Liu1, F. Mansour2, S. Aucoin2, D. Maberley1 1University of Ottawa, Department of Ophthalmology, Ottawa, Canada, 2University of Ottawa, Department of Anesthesiology, Ottawa, Canada Purpose: Anesthesia care models for cataract surgery vary significantly across institutions both nationally and internationally. These procedures are usually performed under local anesthesia with or without light sedation. Depending on the institutional practice, sedation is either delivered by an anesthesiolo- gist, an anesthesia assistant (AA), a nurse, or the ophthalmologist performing the procedure. There is currently no published data regarding the proportion of cases being done with care delivered by an anesthesiologist versus other models in Canada Methods: This is a prospective cross-sectional survey that was sent to all practicing ophthalmologists in Canada through the Canadian Ophthalmology ListServ. The primary outcome was to compare the type of anesthesia sup- port available for cataract surgery and the variation in practice pattern across Canada. Results: Survey responses from 126 ophthalmologists were compiled (re- sponse rate of 11%). Annual mean cataract volume was 774.8 ± 567.7. By percent estimate the utilization of each form of anesthesia was 39.2% oral/ sublingual, 29.0% mild intravenous sedation, 6.5% moderate intravenous se- dation, 0.7% deep intravenous sedation, 1.0% general anesthesia (GA) and 22.8% no anesthesia. Excluding cases performed under GA, 59.3% of respondents have only an AA or nurse provide anesthesia care, while the remainder 40.7% all have an- esthesia provided by a combination of an anesthesiologist with a respiratory therapist, AA or nurse. 51.6% of respondents have majority (>50%) of cases performed under the supervision of an ophthalmologist exclusively. 41.3% of ophthalmologists from the present survey felt that the presence of an anesthe- siologist during cataract surgery is required. Conclusions: There is a variation in cataract surgery delivery across institu- tions in Canada. While the presence of an anesthesiologist is required for some cases, the majority feel this may not be required for routine cases. EP-CAT-08 Evaluation of visual function, contrast sensitivity and patient satisfaction after implantation of enhanced monofocal intraocular lens O. Ucakhan-Gunduz1, B. Kilic1 1Ankara University School of Medicine, Department of Ophthalmology, Ankara, Turkey Purpose: To evaluate visual performance and contrast sensitivity levels of patients who had undergone cataract surgery with implantation of TECNIS Eyhance IOL (Johnson & Johnson Vision, Santa Ana, CA, US). Methods: Patients who had underwent implantation of TECNIS Eyhance IOL were included. Postoperative uncorrected (UDVA) and corrected (CDVA) dis- tance visual acuities, manifest refraction spherical equivalent (MRSE), dis- tance corrected near (DCNVA, 30 and 40 cm) and intermediate visual acuity (DCIVA, 60 cm), photopic and mesopic contrast sensitivities were evaluated. The defocus curve was created between -4 diopters and +3 diopters. Patients’ visual function and need for glasses were evaluated with the VF-14 visual function questionnaire, spectacle independence questionnaire, and McAlinden vision quality questionnaire. Results: Swenty seven eyes of 43 patients with mean age was 67.6±8.5 years were included into the study. At the final follow up examination, UDVA and CDVA measurements were 0.00±0.0 logMAR. DCNVA (30 cm, 40 cm) and DCIVA (60 cm) were 0.40±0.02, 0.39±.02, 0.31±0.02 logMAR, respec- tively. Photopic contrast sensitivities were 1.76±0.13, 1.85±0.16, 1.62±0.22, 1.35±0.25, 1.1±0.2 logCS at five different spatial frequencies. Mesopic con- trast sensitivities were 0.14±0,03 and 0.12±0,03 logCS in the presence and absence of glare. The defocus curve reached 0.00 logMAR between 0.5 and -1 diopters. According to the survey results, 84% of the patients stated they ‘never’ experience dysphotopic phenomena. Only 4.6% of the patients frequently needed glasses for intermediate and far distances, and 46% frequently needed glasses only for near distance. The aver- age visual quality score was 4.69/5. Conclusions: The Eyhance IOL provided excellent distance and intermediate visual acuities. Photopic and mesopic contrast sensitivities were within nor- mal limits, whereas, dysphotopic phenomena were rarely reported. EP-CAT-10 Cataract surgery and pharmacological treatment of lower urinary tract symptoms: is cooperation between the urologist and the ophthalmologist really needed? M. Karhanová1, M. Malušková1, A. Vidlář2, V. Lounová2, K. Marešová1 1University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic, Department of Ophthalmology, Olomouc, Czech Republic, 2University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic, Department of Urology, Olomouc, Czech Republic Purpose: Intraoperative Floppy Iris Syndrome (IFIS) in cataract surgery is a well-known possible side effect of α1-adrenergic receptor antagonists (α1- ARAs), which are primarily used in the treatment of lower urinary tract symp- toms (LUTS). The aim of the study was to determine the average age at which patients with LUTS are first prescribed α1-ARAs in routine practice and to compare this age with the average age at which men undergo cataract surgery. Based on the results, the study aimed to evaluate the potential benefits of an information campaign to enhance cooperation between urologists and oph- thalmologists. Methods: We retrospectively analyzed the age of male patients who under- went cataract surgery at the Department of Ophthalmology from January 2012 to December 2021. At the Department of Urology, we investigated the ini- tiation of LUTS treatment with α1-ARAs in men based on prescriptions and medical reports issued from January 2021 to December 2022. The total num- ber of patients who underwent cataract surgery during the monitored period was 3,978, while the number of men treated for LUTS was 999. Results: The mean age of male patients undergoing cataract surgery was 71.2 years (95% CI: 70.9–71.5 years), whereas the mean age at the initiation of LUTS treatment was 67.7 years. The difference in average ages between the two groups was 3.49 years. A total of 39.4% of patients in the second group were over 70 years of age when α1-ARAs were prescribed, and 93.1% of men treated for LUTS were aged between 49 and 88 years, i.e., within the 2.5th and 97.5th percentiles for the age of patients undergoing cataract surgery. 68 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Conclusions: Our results suggest that many patients could benefit from under- going cataract surgery before beginning treatment with α1-ARAs. Therefore, close cooperation between urologists and ophthalmologists is clearly war- ranted. Supported by MH CZ, grant nr. IGA_LF_2024_029 EP-CAT-13 Cartwheeling of the Iris - Persistent pupillary membrane A. Mallu1 1Centre for Sight, Oculoplastic Surgery, Ocular Oncology and Cataract Surgery, Hyderabad, India A 50-year-old gentleman presented to the clinic with decreased vision in both eyes. His best corrected visual acuity using of the Snellen chart, was 6/24 in the right eye and 6/6 in the left eye, with anisometropic amblyopia in the right eye. On slit-lamp examination, a thick membrane covering the pupillary area completely in the right eye and an incomplete whorl like membrane sparing the visual axis in the left eye was noted. After dilating both the pupils with 1% tropicamide, a grade 1-2 nuclear sclerosis was noted, parts of the fundus was observable in the right eye and left eye fundus was noted to be within normal limits. Intraocular pressure and gonioscopic finding were well within normal limits. A clinical diagnosis of Total and Partial persistent pupillary membrane in the right and left eye was made respectively which looked like a cartwheel in the eye Most Persistent pupillary membranes don’t cause significant visual distur- bance and can be managed with either mydriatic agents, surgical excision, or Nd-Yag laser membranectomy. EP-CAT-14 The impact of the Intraocular Lens model on the post-operative refractive outcomes after cataract surgery - A comparative study between Hungarian and Kosovan Patients F. Shoshi1,2,3, F. Shoshi2,3, M. Shoshi3, Z.Z. Nagy1 1Semmelweis University, Department of Ophthalmology, Budapest, Hungary, 2University Clinical Center of Kosova, Department of Ophthalmology, Prishtina, Kosovo, 3Poliklinika Shoshi, Department of Ophthalmology, Prishtina, Kosovo Minimal refractive error after cataract surgery remains a determinant of post- the Hungarian patients, the AcrySof IQ toric SN6AT, FineVision HP (POD F GF), and 677MTY IOLs resulted in a statistically significant positive impact on the 1-month postoperative visual acuity (p < 0.05). The AcrySof SA60AT and Akreos ADAPT AO, implanted in the Kosovan patients, had a statistically significant positive impact on the 1-month postoperative visual acuity (p < 0.05). More extensive surgeon experience had a statistically significant posi- tive impact on postoperative outcomes (p < 0.00). Conclusions: Multifocal and toric IOLs showed superiority in terms of post- operative outcomes in our study; therefore, we conclude that the availability of premium IOLs, and appropriate IOL selection have a considerable impact on refractive outcomes after cataract surgery. EP-CAT-15 Post-operative outcomes based on surgeon’s experience and pre-operative visual acuity - an empirical analysis of Hungarian and Kosovan patients F. Shoshi1,2,3, F. Shoshi2,3, M. Hoxha-Shoshi3, Z.Z. Nagy1 1Semmelweis University, Department of Ophthalmology, Budapest, Hungary, 2University Clinical Center of Kosova, Department of Ophthalmology, Prishtina, Kosovo, 3Poliklinika Shoshi, Department of Ophthalmology, Prishtina, Kosovo Patients’ expectations after undergoing cataract surgery have increased; there- fore, post-operative refractive outcomes play a crucial role in patient satisfac- tion. Purpose: Our study aimed to evaluate the impact of the surgeon’s experi- ence and patients’ pre-operative visual acuity on postoperative outcomes after cataract surgery. Methods: Our study included the data of 1417 patients treated surgically in two centers, Semmelweis University - Department of Ophthalmology, Budapest - Hungary and University Clinical Center of Kosova - Department of Ophthalmology, Prishtina - Kosova. All patients were treated by the same surgeon in each respective center, Hungarian patients were treated by a surgeon with 24 years of experience in phacoemulsification, whereas the Kosovan patients were treated by a surgeon with 11 years of experience in phacoemulsification. Results: In the Hungarian patients, the preoperative UDVA was 24.7%, while the preoperative BCDVA was 54.4%. The visual acuity improved significantly after surgery, with a mean of 77.9% of UDVA and a mean of 85.2% of the BCDVA. Compared to the uncorrected distance visual acuity and the best- corrected distance visual acuity before cataract surgery, our results indicated that the improvement in visual acuity after surgery was significant and that the refractive outcomes were positive. The mean preoperative distance visual operative results. Our study aimed to evaluate the impact of the intraocular acuity in Kosovan patients was 15%, whereas the mean uncorrected 1-month lens model on the post-operative refractive outcomes after cataract surgery. Methods: This study included the data of 1417 patients scheduled to undergo cataract surgery with IOL implantation at two centers: the Ophthalmology Department of Semmelweis University, Budapest, Hungary, and the Ophthalmology Department of the University Clinical Center of Kosovo, postoperative distance visual acuity increased to 44% and the best-corrected distance visual acuity increased to 49.6%.Based on the p-value, where p = 0.000, there was a statistically significant difference in the postoperative out- comes based on the surgeon’s experience in phacoemulsification. Conclusion: In conclusion,better postoperative outcomes are related to the Prishtina, Kosovo. STATA and SPSS were used for statistical analysis. greater experience of the surgeon; in our study, the Hungarian patients treated Results: The data of 1001 Hungarian and 416 Kosovan patients were included in this study. There was a statistically significant difference between the groups in the 1-month postoperative best-corrected distance visual acuity (BCDVA) (p = 0.001); in the Hungarian patients, the 1-month BCDVA was 85.2%, while in the Kosovan patients, it was 49.6%. Of the 14 different IOLs implanted in by a surgeon with 24 years of experience had much more positive postopera- tive outcomes. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 69

ELECTRONIC POSTER PRESENTATIONS EP-CAT-17 Early clinical outcome of LuxSmart EDOF toric intraocular lens M. Pelisek1, Z. Pracharova1, D. Camkova1, A. Hrncirova1, P. Hrusovska1 1Gemini Eye Clinic, Vyskov, Czech Republic phacoemulsification was performed, and a one-piece flat plate loop regional refractive intraocular lens was implanted in the capsular bag. The viscoelastic agent was removed before the watertight incision was hydrated. Result: On the first day post-surgery, the left eye’s distance vision was 0.8, intermediate vision was 0.8, and near vision was 0.8, the right eye’s distance vision was 1.0, intermediate vision was 1.0, and near vision was 1.0. During the follow-up 2 years post-surgery, the diagnosis was dry eye syndrome. Conclusions: Irregular corneal astigmatism before cataract surgery can be caused by dry eye, and some patients may even have systemic diseases. Ocular Purpose: To report early clinical experience with toric extended depth-of- surface treatment can improve corneal astigmatism, so that functional intraoc- focus intraocular lens LuxSmart (Bausch and Lomb) based on combination of ular lens implantation can be planned to improve the distance, intermediate 4th and 6th orders of spherical aberration. Methods: A total of 20 eyes in 13 patients, median age 63 (59-74,5 years) implanted with EDOF LuxSmart toric IOL were evaluated in 1st, 3rd and 6th month for corrected and uncorrected distance, intermediate and near vision acuities, defocus curve, and a questionnaire after 6 months regarding glasses independence, contrast sensitivity and halo glare. Results: Mean preoperative corneal astigmatism was 2.57 ± 1.22 (1.17 – 5.45) D. After 3 months the mean postoperative spherical equivalent was -0,13 ± 0,42D. The mean monocular corrected distance vision acuity (CDVA), cor- rected intermediate distance vision acuity (DCIVA), and corrected distance near vision acuity (DCNVA) were -0.01 ± 0.07, 0.02 ± 0.10, 0.29 ± 0.15 log- MAR, respectively, after 6 months. Uncorrected distance, intermediate (80cm and 66cm) and near vision acuities were 0.06 ± 0.10, -0.02 ± 0.10, 0.14 ± 0.10 and 0.26 ± 0.18 logMAR after 6 months. The defocus curve shows VA better than 0,2 logMAR between -2.20 and +0.75D. Photopic and mesopic contrast sensitivity outcomes were in normal range. No patient required corrective glasses for distance and intermediate vision. One patient reported experienc- ing halos, one experienced glare, for both somewhat bothersome. Conclusions: Early clinical results show high quality of visual functions at different distances. Near distance visual acuity is good, some patients experi- ence halo/glare. Overall most patients report fair to high levels of satisfaction. EP-CAT-19 Observation of the surgical outcome of irregular astigmatism combined with cataract surgery (including surgical video) Y. Zeng1 1Lixiang Eye Hospital of Soochow University, Suzhou, China Purpose: Observation of the cataract surgery outcomes in patients with ir- regular corneal astigmatism Method: Female, 76 years old, retired healthcare worker, sought treatment at our hospital on June 12, 2019, due to blurred vision in the right eye for the two years. The visual acuity of the left eye was poor since childhood. and near vision of patients. EP-CAT-20 A case of intraocular lens scleral fixation for eye pain that developed after intraocular lens ciliary sulcus fixation - the first observation of ciliary sulcus destruction using an endoscope T. Kaga1 1JCHO Chukyo Hospital, Ophthalmolopgy, Nagoya, Japan Objective: Intraocular lens (IOL) scleral fixation was performed in a patient who developed eye pain that interfered with daily life after IOL ciliary sulcus fixation. Herein, we report the first observation of ciliary sulcus destruction using an ophthalmic endoscope. Case presentation: A 64-year-old man. He was initially examined for floaters in both eyes, which interfered with daily life. Vitreous opacity and cataracts were observed in both eyes. Lensectomy and intraocular lens insertion (NX- 70S: optics 7.0 mm, total length 13.2 mm, loop material OVDF) and vitreous surgery were performed on the right eye for vitreous opacity and cataracts, and retinal detachment was observed after surgery. The retina was reattached using vitreous surgery; however, iris adhesions were observed. Subsequently, a similar surgery was performed on the left eye, al- though the patient developed dysphotopsia. No dysphotopsia was observed in the right eye with the iris adhesions. The IOL was fixed from inside the capsule to the ciliary sulcus to reduce the distance between the IOL and iris in the left eye. After surgery, the dysphotopsia decreased, although the patient experienced eye pain that interfered with daily life about three months later. Cells were found in the anterior chamber, and the intraocular pressure increased slightly. Because eye drops did not improve the condition, the IOL with ciliary sul- cus fixation was changed to scleral fixation. During surgery, an ophthalmic endoscope revealed severe tissue destruction with pigment dispersion in the ciliary sulcus on both sides, and it was thought that the ciliary sulcus had been destroyed by the IOL loops. Professional examination: VOD: 0.3, VOS: 0.1, no improvement with correc- Results: The eye pain completely disappeared, the number of anterior cham- tion. Pentacam. OPD master700, Nidek, both eyes showing uneven astigma- tism >1.5D. Slit-lamp examination revealed no conjunctival congestion in the right eye, corneal epithelial punctate staining, round pupil with a diameter of 3mm, responsive light reflex, and lens nucleus N3P1. Intraocular lens 14D, no conjunctival congestion in the left eye, corneal epithelial punctate staining, round pupil with a diameter of 3mm, lens nucleus N3P1, external oblique 45°. Dry eye test showed grade 2 dry eye. After dry eye treatment, both eyes’ corneal astigmatism was reduced to within 1D. Left eye underwent femtosecond laser combined with regional refrac- tive intraocular lens implantation.LenSX femtosecond laser and ultrasound ber cells decreased, and the intraocular pressure normalized. Conclusion: IOLs fixed to the ciliary sulcus can cause eye pain and increase intraocular pressure secondary to pigment dispersion; however, this can be cured by changing the IOL to a scleral fixation. 70 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-CAT-21 EP-CAT-22 Tear film changes after cataract surgery: a comparison between patients who use artificial tears and those who do not L. Mockaitiene1, A. Stramkauskaite1, D. Urboniene2, R. Zemaitiene1 1Lithuanian University of Health Sciences, Ophthalmology Department, Kaunas, Lithuania, 2Lithuanian University of Health Sciences, Laboratory Medicine, Kaunas, Lithuania Purpose: To evaluate and compare ocular tear film changes following cataract surgery in patients using artificial tears and non-users at 1 week and 1 month post-surgery. Methods: A prospective, randomized, interventional study included 29 eyes from 29 patients without ocular or systemic disease affecting the ocular sur- face. Patients were divided into a study group (n=15) who used artificial tears (sodium hyaluronate 0.2 %, Ocutears Alo+) 1 week preoperatively and contin- The association between cataract formation and cutaneous melanoma L. Šemeklis1,2,3, L. Mockaitienė1,2, G. Butrimas3,4, R. Žemaitienė1,2, S. Valiukevičienė3,4 1Lithuanian University of Health Sciences, Department of Ophthalmology, Kaunas, Lithuania, 2Hospital of Lithuanian University of Health Sciences Kauno klinikos, Department of Ophthalmology, Kaunas, Lithuania, 3Lithuanian University of Health Sciences, Department of Skin and Venereal Diseases, Kaunas, Lithuania, 4Hospital of Lithuanian University of Health Sciences Kauno klinikos, Department of Skin and Venereal Diseases, Kaunas, Lithuania Purpose: Exposure to sunlight and ultraviolet (UV) radiation significantly impacts human health, particularly in the development of skin and eye dis- orders. Sun exposure is a known risk factor for cutaneous melanoma (CM) ued for 1 month postoperatively, and a control group (n=14). and cataracts. Non-invasive tear break-up time (nTBUT), tear meniscus height (TMH), tear osmolarity, Schirmer test, and MMP-9 levels were measured preoperatively, 1 week and 1 month postoperatively. Results: The mean age of patients was 69.9±8.1 years (p=0.65). All preopera- tive measurements were similar in both groups (p>0.05). Postoperative os- molarity did not increase significantly in both groups at 1 week (p=0.214), at 1 month osmolarity results were higher than preoperative (p=0.017) but was not significant different in both groups (p=0.067). nTBUT decreased postop- eratively in both groups but was significantly longer in the study group at 1 week (10.9 [5.3–17.0]s vs. 7.6 [5.2–11.6]s; p<0.01) and 1 month (10.9 [9.1– 14.7]s vs. 8.7 [6.2–11.1]s;p<0.01). TMH decreased at 1 week in both groups (p<0.01) and at 1 month results were similar to preoperative (p=0.563) with higher results in the study group (0.23 [0.17–0.28] mm vs. 0.16 [0.11–0.29] mm;p=0.008). Schirmer test values decreased at both visits (p<0.05), at 1 month study group had better Schirmer test results compared to control group (14.5 [6–33] mm vs. 11 [2–23] mm;p=0.085). MMP-9 positivity at 1 week was similar in both groups (78.6% vs. 86.7%; p=0.56) and at 1 month MMP-9 positivity was sig- nificantly lower in the study group (33.3% vs. 85.7%;p=0.014). Conclusions: One month post-surgery, using artificial tears improved nTBUT and TMH, lowered MMP-9 levels, and supported faster ocular surface heal- ing. However, no previous studies have investigated the relationship between CM and cataract formation. The aim of our study was to examine the relationship between CM and cataracts. Methods: A case-control study was performed. The case group included 180 patients with primary diagnosed and histopathologically approved CM. The control group was conducted of dermatologically healthy patients. Both groups underwent dermatological and ophthalmic examination, which includ- ed a questionnaire of the subject’s behaviour in the sun and counting common melanocytic nevi (CMNs) on the face, outer surfaces of the upper arms and outer surfaces of the lower arms as well as on the hands. Ophthalmic examination included slit lamp examination, lens status (cataract formation) evaluation according to the Lens Opacities Classification System III (LOCS III). Results: Subjects with a nuclear opalescence (NO) grade of ≥3, as assessed by the LOCS III classification, had a 1.82 times higher risk of CM, while those with a nuclear colour (NC) grade of ≥3 had a 2.02 times higher risk. Additionally, LOCS III evaluation of cortical (C) and posterior subcapsular (P) cataracts were associated with a 5.24 times and 6.34 times higher risk of CM, respectively. These findings suggest a significant association between cataracts and CM, with the severity of cataracts correlating with the risk of CM. Conclusion: Our study revealed cataract occurred more frequently in patients with CM than in healthy individuals. This highlights a potential link between CM and cataracts, emphasising the need for further research to explore shared risk factors, underlying mechanisms, and preventive strategies for these con- ditions. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 71

ELECTRONIC POSTER PRESENTATIONS EP-CAT-23 EP-CAT-25 EDOF vs trifocals - choosing the right premium IOL for presbyopia R. Sethi1, A. Sethi1 1Arunodaya Deseret Eye Hospital, Gurgaon, India The advent of premium intraocular lenses (IOLs) has revolutionized the surgi- cal correction of presbyopia, offering patients improved visual outcomes and independence from spectacles. Among these, extended depth of focus (EDOF) and trifocal IOLs represent two cutting-edge options, each with distinct opti- cal principles, benefits, and limitations. EDOF IOLs extend the range of clear vision by creating a continuous focal zone, reducing visual disturbances such Performance of an enhanced monofocal intraocular lens in patients undergoing cataract surgery: retrospective real-world study E. Donnenfeld1, L. Nijm2 1Ophthalmic Consultants of Long Island, Garden City, United States, 2Warrenville Eyecare and LASIK, Warrenville, United States Purpose: Enhanced monofocal intraocular lenses (IOLs) may provide a broader depth of focus compared with standard monofocal IOLs. This ret- rospective case series of US cataract surgeons aimed to document real-world clinical experience with the enVista ASPIRE™ (EA) IOL. as glare and halos, and are ideal for patients prioritizing intermediate vision The primary objective of this study was to explore cataract surgeons’ experi- and night driving. ence with EA and/or EA toric (ETA) IOLs, including surgeon satisfaction and In contrast, trifocal IOLs provide distinct focal points for near, intermediate, IOL utilisation patterns. and distance vision, delivering superior outcomes for patients requiring clear The secondary objective was to collect EA and ETA case studies to evaluate near vision for activities like reading. This review explores the fundamental differences between EDOF and trifo- cal IOLs, including their optical design, patient selection criteria, and clinical outcomes. Factors such as lifestyle needs, visual demands, and tolerance for optical side effects are discussed to guide surgeons in tailoring IOL choices to individual patient profiles. Understanding these distinctions ensures optimal patient satisfaction and surgical success in presbyopia correction. EP-CAT-24 Managing refractive surprise after cataract surgery R. Sethi1, A. Sethi1, V. Sethi1 1Arunodaya Deseret Eye Hospital, Gurgaon, India Post-cataract refractive surprises—unexpected deviations from the intended refractive outcome—can compromise patient satisfaction, particularly among those seeking spectacle independence. Effective management necessitates a comprehensive approach, beginning with precise identification of the refrac- tive error’s etiology through detailed patient history, meticulous refraction, and thorough ocular examination. Initial management may involve non-surgical interventions such as spectacles or contact lenses; however, for patients desiring complete spectacle independ- ence, surgical options are often considered. Corneal refractive procedures, including LASIK or PRK, can effectively address residual refractive errors, with studies indicating that 90% of pseu- dophakic patients achieve results within 0.5 diopters of the intended target. Alternatively, lens-based solutions like piggyback intraocular lens (IOL) im- plantation or IOL exchange offer viable correction methods, particularly in cases of significant ametropia. Each intervention carries inherent risks and benefits; thus, individualized pa- tient assessment and counseling are imperative to align treatment strategies with patient expectations and clinical findings, ultimately enhancing postop- erative satisfaction and visual outcomes. real-world clinical performance, visual and clinical outcomes, and patient se- lection criteria with these lenses. Methods: This multicentre retrospective study included patients implanted with EA or ETA lenses by six cataract surgeons in the US. Surgeons were required to have ≥3 years’ experience treating patients and conducting cataract surgery using monofocal and/or toric IOLs, and have completed cataract ex- traction and EA and/or ETA IOL implantation on ≥5 patients. Surgeons com- pleted a user-experience survey that collected clinical practice characteristics, IOL utilisation patterns, and user satisfaction. Clinical outcomes were recorded using a standardised case report form (CRF), which surgeons completed with a minimum of five deidentified patient cases. Results: This analysis will review quantitative and qualitative data from the CRFs and surveys. Clinical outcomes, including mean refractive spherical equivalent, binocular and monocular uncorrected distance, intermediate and near visual acuities, and adverse event occurrence were recorded pre-surgery and at timepoints up to 3 months post-surgery. These outcomes will be sum- marised using descriptive statistics. Conclusions: These findings will provide important insights into the clinical utilisation of IOLs, HCP satisfaction with EA and/or ETA lenses, and real- world patient outcomes with these lenses. EP-CAT-26 Study of concordance in endothelial cell count after cataract surgery performed by novice or expert surgeons B. Alonso-Martín1, J.C. Herranz-Heras1, I. Cañas-Zamarra1, A.I. Ortueta-Olartecoechea1, M. Hernando-Portela2, E. Redondo-Martínez2, R.M. Sierra-Torres2, B. Sarmiento-Torres1 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Universidad Complutense, Madrid, Spain Purpose: To evaluate endothelial cell loss in patients after uncomplicated phacoemulsification comparing data from novice surgeons and expert surgeons. Method: An observational and prospective study was conducted in which 50 consecutive randomized eyes were evaluated in two groups of 25 eyes each. An endothelial cell count with specular microscopy was performed preop- eratively and one month after surgery. Eyes with complicated cataracts were excluded. 72 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

Results: Most of the patients were women, with a mean age of 75.5 years. The decrease in endothelial cell density one month after surgery was significant both in eyes operated by expert surgeons and by novice surgeons, with a loss of 14.8% and 15.6%, respectively, with no statistically significant difference (p = 0.491). Furthermore, the correlation between both groups was 0.58 (p = 0.0094). Cell loss in eyes operated by novice surgeons showed a good correlation (0.577) with the cumulative dissipated energy during phacoemulsification (p = 0.0025), contrary to the results obtained with expert surgeons where this correlation could not be demonstrated. The total cumulative dissipated energy used by novice surgeons was significantly higher (p = 0.045); 63% more than expert surgeons. Conclusions: Phacoemulsification resulted in significant corneal endothelial cell damage with similar figures for both groups, showing a good correlation between them. Concerning endothelial cell loss, the safety of the procedure performed by novice surgeons is equivalent to that performed by experts. EP-CAT-27 A new approach to residual refraction after trifocal IOL implantation F. Semiz1, N.H. Musa1, C.E. Semiz1, F.F. Arslan2 1Eye Hospital, Ophthalmology, Prishtina, Kosovo, 2Istanbul University- Cerrahpasa, Ophthalmology, Istanbul, Turkey Purpose: To examine the enhancement in visual acuity and patient satisfac- tion following small-incision lenticule extraction (SMILE) in pseudophakic patients with trifocal intraocular lenses (IOL) who have residual myopic re- fraction Methods: One hundred and twenty-two patients (122 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were in- cluded in this retrospective study. The included patients were 48–79 years old, wanted spectacle independence, and had preoperative myopic refraction between − 1.0 and − 2.50 diopters (D) and astigmatism between − 0.75 and − 2.0 D. SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 3 years on average. Results: After SMILE, the residual myopic refractive error decreased sig- nificantly from − 2.09± 0.27 preoperatively to − 0.25 ± 0.20 3 years postopera- tively (p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.67 ± 0.05 logMAR preoperatively to 0.06 ± 0.02 logMAR at 3 years postoperatively (p < 0.001). Patient satisfaction measures regarding reading, night driving, and computer use after undergoing SMILE surgery showed significant improve- ment. Conclusion: SMILE is a reliable method for treating residual refraction after Trifocal IOL Implantation Trial registration: The protocol was registered on clinicaltrials.gov (NCT04693663). ELECTRONIC POSTER PRESENTATIONS EP-CAT-28 Practical observations on diseases of the eye by Sir William Adams (1760-1829) G. Balanikas1, D. Pirounides1, N. Vasileiadis1, E. Papadopoulou1, M. Angelou2, I. Tsinopoulos3 1Aristotle University of Thessaloniki, A’ Ophthalmologic Clinic, AHEPA Hospital, Thessaloniki, Greece, 2Ophthalmiatreio Athinon, A’ Ophthalmologic Clinic, Athens, Greece, 3Aristotle University of Thessaloniki, Papageorgiou Hospital, 2nd Ophthalmologic Clinic, Pavlos Melas, Thessaloniki, Greece Purpose: We present Sir William Adams ‘a famous, skillful, and Knowledgeable man’ with Hirschberg’s words. He was one of the earliest eye surgeons in England and founder of the West of England Eye Infirmary in Exeter. His significant impact in Ophthalmology was the treatment of trachoma, cataract, and the artificial pupil. He published in 1812 the book ‘Practical Observations on Diseases of the Eye’ or the ‘Practical Observations on Ectropium or Eversion of the Eyelids, with the Description of a New Operation for the Cure of That Disease, on the Modes of Forming an Artificial Pupil, and on the Cure of Cataract. His most innovative operation was a pro- cedure for ectropion. Methods: The primary source for this work is the Adam’s treatise. We used historical elements about Sir Adams, his life, work, and the scientific reports from his era. Adams’s work is 252 pages long, including two hand-colored plates and a plate of instruments. It was well received and had a second edition in 1814. He was a pioneer physician, and a reformer of Ophthalmic surgery and pathology. Results: Adams was one of the central figures in the controversy, which ranged between 1806 and 1820, over the treatment of Egyptian epidemics of trachoma, with his critics refusing to accept that his treatment for the condi- tion produced any benefits. He had a valuable political supporter: the future Prime Minister Lord Palmerston, who persuaded the parliament to grant him £4000. He was knighted and became a personal oculist to the prince Regent and members of the British Royal family. Adams was a gifted man with un- bounded energy, but his vanity and passion for publicity, at a time when very few doctors publicized their work, made him antipathetic. Conclusion: William Adams was a surgeon with deep medical knowledge and innovator in cataract surgery, but a complex person with cruel and brazen behavior. His work, the famous treatise, guided many new surgeons-ophthal- mologists who became new pioneers and skillful surgeons. EP-CAT-29 Femtolaser overburns L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cataract Services, Tirunelveli, India This case series showcases the possibilities of Femto laser capsulorhexis- induced excess lenticular burns and inadvertent iris burns that may result in intraoperative miosis and post-operative inflammations. Cataract surgeons need to be aware of such unique complications and how to avoid them and get things right. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 73

ELECTRONIC POSTER PRESENTATIONS EP-CAT-30 Thunderbolts: IOL inserter surprises L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cataract Services, Tirunelveli, India Conclusion: Complex post-traumatic ocular scenarios require flexible, often multi-stage surgical approaches to attain the best possible outcomes while balancing form and function. In this case, despite intraoperative challenges, both aesthetic and functional objectives were achieved. This underscores the importance of individualized, stepwise management to optimize results and enhance patients’ quality of life when addressing complex ocular trauma. This case series compiles a case series in which premium IOLs, pre-loaded and surgeon-loaded versions were tangled to IOL injector-associated compli- cations. How to recognize such surprises early and ways to avoid them and get EP-CAT-33 things right will be highlighted. EP-CAT-31 Imprint iris atrophies L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cataract Services, Tirunelveli, India Compilation of a case series, wherein distinctive patterns of iris atrophies re- sulted from post-cataract surgeries, due to IOL haptic, femtosecond lasers, and inappropriate incision size. What went wrong and how those adversities could have been prevented will be discussed. EP-CAT-32 The art of reconstruction: post-traumatic repair with an artificial Iris sutured to a scleral-fixated lens Refractive cataract surgery new organizing model to correct refractive defects and presbyopia M. Piovella1, B. Kusa1 1Global Center for Ophthalmology, Refractive Cataract Surgery, Monza, Italy Purpose: To evaluate results in cataract eyes implanted with trifocal IOLs to get distance intermediate and near vision. New centre organization is key point to spread the use of trifocal lenses. Methods: 850 eyes were implanted with trifocal IOLs.402 eyes with ATLISA tri 839MP-Carl Zeiss Meditec AG Jena and 448 eyes were implanted with AT LISA tri 949MP.Mean Age 64.53 ±12.40. Biometry was performed with IOL Master 700 RK and astigmatism axis alignment performed with Callisto system. Blephex Lipiflow and iLux were applied Results: At 8 years monocular Trifocal IOLs results are UCDVA 20/22 ± 2.40 UCIVA 20/24 ± 3.13 UCNVA 20/27 ± 5.37,monocularToric Trifocal IOLs are UCDVA 20/20 ± 3.25 UCIVA 20/35 ± 4.75 UCNVA 20/29 ± 2.56 Binocular results(178 pa- tients)are UCDVA was 20/20, intermediate 20/20 and near vision 20/24.97. Conclusion:AT LISA tri and tri toric trifocal IOLs provide glass free vision after cataract surgery. Data show that it is possible to adopt them in the major- ity of patients Conclusion: AT LISA tri and tri toric trifocal IOLs provide glass free vision after cataract surgery. Data show that it is possible to adopt them in the major- D. Ferreira Cardoso1, S. Teixeira1, M. Bilhoto1, F. Sousa Neves1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal ity of patients Introduction: Post-traumatic cases pose multiple surgical challenges, en- compassing structural, functional, and aesthetic objectives to preserve visual acuity and ensure patient satisfaction. Common complications - such as dis- location of the capsular bag-lens complex, iridodialysis, and zonular dehis- cence - often mandate advanced surgical strategies, including scleral-fixated intraocular lenses and iris reconstruction. Case Description: A 78-year-old female with left facial trauma sustained from a fall underwent emergency treatment, which included suturing a nasal peri-limbal scleral laceration (7-10 o’clock) and administering prophylac- tic antibiotics. Subsequently, a pars plana vitrectomy was performed, with aspiration of dense vitreous hemorrhage and 360º laser photocoagulation. Postoperatively, the patient exhibited iridodialysis between the 11-1 o’clock, loss of iridian tissue between 7-10 o’clock, and inferior and temporal zonular dehiscence. Six months later, with clinical stabilization and preserved retinal morphology on OCT, a third surgery was undertaken for the secondary im- plantation of a scleral-fixated Carlevale lens with a pre-attached artificial iris (HumanOptics®). Intraoperatively, one lens haptic fractured, necessitating ad- ditional scleral suturing. Despite this complication, the surgery achieved good structural integrity and visual function, and by the third postoperative month, the patient was satisfied, reporting a favorable aesthetic outcome. EP-CAT-34 A case report of hereditary aniridia, secondary glaucoma, and brunescent cataracts treated with ‘Carlevale’ Intraocular Lens Y. Mavrova1, D. Nikolov1, I. Kuneva1 1Zora Eye Clinic, Sofia, Bulgaria Purpose: The aim of this case report is to present a comprehensive approach to the treatment and follow-up of a patient presenting with aniridia, secondary glaucoma, cataract, and diabetes mellitus type 2. Methods: The case concerns a 52-year-old male who presented to our clinic with complaints of impared vision in his left eye. He has experienced reduced vision since childhood due to a hereditary form of aniridia, which has also been diagnosed in his mother and sister. He has been receiving treatment for glaucoma since the age of 14, using various antiglaucoma medications. On examination, elevated intraocular pressure was noted in both eyes and both lenses were found to be subluxated. His visual acuity and intraocular pressure were as following: BCVA OD=0.05 IOP OD=56mmHg, BCVA OS=0.05 IOP 74 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS OS=52mmHg. The anterior segment examination revealed total aniridia in both eyes, brunescent and subluxated lenses, iridodonesis and phacodonesis. The fundus examination showed atrophic optic discs. The treatment involved cataract surgery with the implantation of a ‘Carlevale’ intraocular lens (IOL), and cyclophotocoagulation procedures to manage intraocular pressure. Results: At his most recent follow-up examination, following two sessions of cyclophotocoagulation on the left eye, one session on the right eye, and com- bined intracapsular cataract extraction, pars plana vitrectomy, and Carlevale IOL scleral-fixed implantation in the left eye, his visual acuity improved to BCVA OD = 0.1, IOP OD = 16.5 mmHg, BCVA OS = 0.1, and IOP OS = 7 mmHg. Conclusions: Aniridia is a rare genetic condition, associated with a muta- tion in the PAX6 gene in which the iris is absent fully or partially absent and is often associated with other eye abnormalities. This case demonstrated the importance of a multimodal approach in addressing the complex ocular se- qualeae associated with rare hereditary conditions such as aniridia. EP-CAT-37 Bilateral congenital cataracts in Harel-Yoon syndrome: a rare mitochondrial disorder caused by mutations in ATAD3A R. Ellard1, E. Hay2, I.C. Lloyd2 1Great Ormond Street Hospital, London, Ireland, 2Great Ormond Street Hospital, London, United Kingdom Aims: The mitochondrial membrane protein ATAD3A is important for maintenance of mitochondrial DNA structure, and function as well as EP-CAT-38 How to manage intraoperative floppy iris in cataract surgery? A. Stanila1, D.M. Stanila2, A.A. Stanila3 1Lucian Blaga University, Sibiu, Romania / Ofta Total Clinic, Sibiu, Romania, Ophthalmology, Sibiu, Romania, 2Lucian Blaga University Sibiu Romania / Ofta Total Clinic Sibiu Romania, Ophthalmology, Sibiu, Romania, 3Ofta Total Clinic Sibiu Romania, Ophthalmology, Sibiu, Romania Introduction: In this study we tried to analyze the effect of intraoperative complication like Floppy Iris Syndrome (IFIS) to the patients with chronic treatment for benign prostatic hyperplasia (BPH) with tamsulosin, which can occur during the cataract surgery. Aim: The study aimed to establish the influence of tamsulosin, used in benign prostatic hyperplasia (BPH) treatment on the iris, during cataract surgery, con- sidering the increased incidence of both conditions in older age. Methods: This study included 16 male patients, operated for cataract at the Ofta Total Clinic and Dr. Stănilă Medical Centre, in Sibiu, in 2022. They used chronic medication for BPH more than 2 years. Results: In all patients we noticed a medium mydriasis through pharmacologi- cal dilation, including intracameral administration of phenocaine and mechan- ical dilation or stripping. In 6 patients it was necessary to apply iris dilators. Discussions: The topic gives rise to many discussions. Patients at risk of de- veloping cataract should be evaluated and possibly referred to an ophthal- mologist to determine surgery before starting treatment for BPH. Because it seems that stopping the administration of tamsulosin before the surgery does not help the occurrence of IFIS, because the iris lesions seem irreversible. Conclusions: Collaboration between urologists and ophthalmologists is re- cholesterol transport. Mutations in ATAD3A have been previously associated quired for patients prone to the appearance of cataract since both conditions with global developmental delay, hypertrophic cardiomyopathy, optic atro- are frequently encountered in elderly patients. phy, failure to thrive, miscarriage and early infant death. Infantile/congenital cataracts have been rarely reported in affected individuals but this is not well recognised in the ophthalmic literature. Methods: We report a female infant presenting at 5 months of age with dense bilateral cataracts and a history of failure to thrive, hypotony and develop- mental delay. Of note her mother had a history of multiple miscarriages and of a previous infant who had died in early infancy. Neuro-imaging (MRI) was normal. Metabolic work-up identified elevated lactate levels consistent with mitochondrial disease. WGS genetic testing revealed compound heterzygous pathogenic variants in ATAD3A. This gene encodes a ubiquitously expressed mitochondrial membrane protein that contributes to mitochondrial dynamics, nucleoid organization, protein translation, cell growth, and cholesterol me- tabolism. Conclusions: Harel-Yoon syndrome, caused by pathological variants in ATAD3A, should be considered as an important part of the differential diagno- sis in infants with cataracts and concurrent failure to thrive, particularly where EP-CAT-39 The impact of ionizing radiation on the eye and the occurrence of cataract L. Perez Milosevic1 1Medical center Medigroup, Ophthalmology, Belgrade, Serbia Medical x-rays are used to generate images of tissues and structures inside the body. However, their harmful effects on certain organs and tissues were quickly noticed. Among the first are damage to the organ of visual system, one of the most sensitive organs to ionizing radiation. The purpose of this abstract is to determine whether the long-term exposure there is a history of maternal miscarriage, or early infant death in siblings. to ionizing radiation leads to changes in the eye, particularly the lens that is This case emphasises the importance of genomic investigation of infants pre- extremely sensitive to radiation and the anterior segment of the eye in people senting with bilateral congenital cataracts particularly where there are concur- who have been working for 5-15 years in the radiation zone. rent systemic symptoms, The study took place in medical centers and a diagnostic center within the Medigroup healthcare system in Belgrade, Serbia. Research included 25 ra- diological technicians and radiologists during the periodic examinations of medical personnel working in the ionizing radiation zone in which is check their health condition. The ophthalmological examination included visual acu- ity, wide-pupil slit-lamp exam, IOP check, indirect and direct ophthalmosco- py. The appearance of cataracts is of the greatest importance for us. The risk of developing cataracts due to radiation is dose-dependent. Exposure to ionizing Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 75

ELECTRONIC POSTER PRESENTATIONS radiation at a younger age may lead to a higher risk of developing cataracts later in life due to the longer time for radiation-induced damage to accumulate. The first clinical signs of radiation-induced cataracts are often freckled blur- ring in the posterior capsule and feathery anterior subcapsular opacities that extends toward the equator of the lens. These changes can progress to complete clouding of the lens. It has been es- tablished that 3 persons showed monocular blurring on the posterior pole of the lens. All respondents were radiologist working for 8 and 10 years and only one person showed bilateral initial cataracts, who has been a radiologist for more than 20 years. Therefore, further examination is continued in order to come to even more significant conclusions. EP-CAT-40 Refractive surprise with toric trifocal: a novel way of treatment, a case report A. Desai1, P. Sharma2 1Sohum Eyecare Cenre A unit of Dr Agarwals, Cataract And Refractive, Mumbai, India, 2Fortis Hospital, Ophthalmology, Gurgaon, India A Case with trifocal toric iol in sulcus with rotation was treated with a new idea using existant technology ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Contact Lenses EP-COL-01 Predicting dual-elevation scleral lens rotation based on front corneal elevation maps in patients with keratoconus B. Severinsky1 1Emory University, Dept of Ophthalmology, Atlanta, United States Purpose: Scleral lenses (SL) with dual sagittal depth (DSD) allow advanced fitting on eyes with front corneal elevation differences, specifically those with keratoconus. Many SL patients may need front toric or multifocal optics to achieve the best vision. Predicting on-eye rotation can improve fit success and shorten chair time. The study aims to extrapolate the expected amount of SL rotation based on front surface corneal elevation maps. Methods: We retrospectively analyzed the records of 32 patients (40 eyes) fitted with DSD lenses at the Emory Eye Center from 06/2023 to 09/2023. Fitting indications, SL sagittal depth difference, toric peripheral curves’ pres- ence, and post-settling rotation amount were evaluated. All fitted lenses had shallower elevation along the horizontal meridian and higher along the vertical. Pentacam meridional analysis was performed to de- termine the shallow versus deeper meridian axes of the front corneal surface. Results: 35 eyes were keratoconic, 3 after corneal transplant, and 2 with cor- neal scarring. The mean front corneal astigmatism was 5.9 (range 0.5 to 13.4) diopters. The average DSD difference was 263±56 um. In most instances (85%), the lens meridian with higher elevation rotated toward the deeper front corneal meridian. The average rotation was 19.7±20.5 degrees. 17 out of 40 lenses fitted had spherical peripheral curves while 17 lenses utilized minimal peripheral toricity differences of ≤90 um. The remaining 6 lenses had peripheral toricity differences >90um. All fitted lenses exhibited on-eye stability in follow-up visits. Conclusion: The higher sagittal depth meridian of the DSD scleral lens tends to rotate toward the deeper front corneal meridian, with a misalignment of up to 20 degrees in most cases. 85% of eyes required minimal or non-toric peripheral curves. Accurate prediction of SL rotation allows for efficient fac- toring of toric or multifocal front optics due to the predictable stability of the DSD lens. 76 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-COL-02 Difficulties in orthokeratology management C.-M. Bogdanici1, V.C. Donica1, S.T. Bogdanici2, I.A. Pavel1 1“Grigore T. Popa“ University of Medicine and Pharmacy, Ophthalmology, Iasi, Romania, 2Stereopsis Clinic, Ophthalmology, Iasi, Romania Purpose: The rising prevalence of myopia worldwide has become a pressing public health issue, linked to numerous adverse effects, including an increased risk of serious ocular complications and vision loss. Orthokeratology is the most effective method for correcting myopia using contact lenses, offering complete freedom and the ability to slow the progression of myopia in chil- dren and young people through the use of customized rigid lenses worn during sleep. The aim of the study is to present various incidents that may occur during the treatment of myopia with orthokeratology. Methods: This paper represents a prospective, observational study of 11 pa- tients aged between 7 and 33 years. Study participants received treatment with orthokeratology lenses and were followed up between 2014 and 2024. The study was carried out at Stereopsis Ophthalmologic Clinic, Iasi, Romania. The clinical parameters which were analyzed are the following: sex, ocular refrac- tion at the first consult, ocular refraction after orthoK, visual acuity with the best correction, corneal topography, appearance of the anterior segment of the eye, ocular and general comfort and different incidents or events. Results: Female patients predominated in the present study (73% vs. 27%). From the total of patients, 18% had difficulties in performing corneal topog- raphy, one patient has been diagnosed with retinal detachment after 3 years of orthokeratology treatment, another patient required follow-up in another area and 18% of the patients interrupted the contact lens wear. Conclusion: Orthokeratology is a useful technique that ensures important oc- ular and aesthetic comfort, increasing the quality of the life. In our study, we encountered various difficulties in the myopia management with orthokeratol- ogy. Keywords: myopia, treatment, orthokeratology EP-COL-03 Satisfaction with a spherical silicone hydrogel daily disposable contact lens among eyecare professionals and both new and existing contact lens wearers M. Labetoulle1,2, on behalf of the ULTRA Study Investigators 1Hôpital Bicêtre - APHP, Université Paris Saclay, Le Kremlin-Bicêtre, France, 2Centre National de la Vision des Quinze-Vingts, Paris, France Purpose: Contact lenses (CLs) are a convenient alternative to spectacles with the potential to improve quality of life for patients versus wearing glasses. CL design is constantly evolving, to maximise comfort and vision correction for patients. This study assessed the satisfaction of patients and their eyecare professionals (ECPs) following a trial of silicone hydrogel spherical (ULTRA OneDay; UOD) CLs. Methods: A standardised questionnaire was developed and used to gather in- formation from both patient and ECP about their satisfaction after patients from 11 European countries had been newly fitted with UOD CLs. Results: A total of 9577 patients having been newly fitted with UOD CLs were followed by a pool of 1308 ECPs. Among them, 49% were new wearers of CLs and 51% were previous wearers (but new to UOD). Analysis of patient questionnaire responses revealed an overall satisfaction in 85% of cases. Across the three key domains assessed, 87% of patients were satisfied in terms of “overall comfort throughout the day”; 89% satisfied con- cerning “clear vision throughout the day”; and 86% concerning “easiness to handle”. Among patients for whom UOD lenses were the first CLs to be worn, 90% were satisfied with the clear vision throughout the day and 88% were sat- isfied with overall comfort throughout the day. For existing CL wearers, 68% agreed with the statement that they could wear the UOD lens comfortably for more hours in the day than their previous CL. Among the ECPs caring for these patients, 92% were satisfied with the results obtained with UOD and 96% consider that UOD is a CL that is easy to fit and 88% of ECPs are likely to consider UOD as the first option to offer a patient who needs daily disposable spherical CLs in the future. Conclusions: These results show that among both new and experienced CL wearers, UOD CLs provide options for comfortable, clear vision to the satis- faction of both patients and ECPs. EP-COL-04 Therapeutic role of scleral lenses in ocular surface rehabilitation K. Jankovic Terzic1, M. Horvatic - Obradovic1 1Specialized Ophthalmology Clinic Okoioko, Belgrade, Serbia Scleral lenses are an essential therapeutic tool for managing ocular surface disorders. These large-diameter, gas-permeable lenses vault over the cornea, resting on the sclera to create a fluid-filled reservoir that hydrates and protects the ocular surface. This makes them effective in conditions like severe dry eye disease, keratoconus, and persistent epithelial defects. By shielding the cornea from irritation and promoting healing, scleral lenses improve visual acuity and patient comfort while reducing reliance on other therapies. Advances in customization now allow precise fitting, even for ir- regular corneal surfaces, further enhancing their role in ocular therapeutics. This case report highlights the use of scleral lenses for bilateral exposure kera- topathy, a condition caused by prolonged ocular surface exposure due to la- gophthalmos. The patient, mechanically ventilated for two months in the ICU, developed severe corneal damage. Despite post-discharge therapy, her vision remained poor, leading to early retirement. Eight months later, she presented with unhealed corneas and persistent visual impairment. Initial treatment with antibacterial agents, lubricants, and antiher- petic therapy achieved epithelialization but did not restore adequate vision. Scleral lenses were prescribed, creating a protective fluid reservoir that sup- ported healing and prevented further damage. The lenses significantly improved her vision, restoring functional acuity and enhancing her quality of life. They also reduced her reliance on other thera- pies, simplifying management. This case demonstrates the transformative po- tential of scleral lenses in restoring the ocular surface and improving outcomes in severe cases. Scleral lenses represent a major advancement in ocular therapeutics, offering hydration, protection, and optical correction. Their success in this case high- lights their critical role in managing complex ocular conditions and improving patient quality of life. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 77

ELECTRONIC POSTER PRESENTATIONS EP-COL-05 Case report: herpetic keratitis after cross-linking surgery I. Radman1, F. Bagatin1, Z. Vatavuk2 1University Hospital Sestre Milosrdnice, Anterior Segment, Contact Lens, Zagreb, Croatia, 2University Hospital Sestre Milosrdnice, Vitreoretinal Department, Zagreb, Croatia Purpose: In this case report, we present patient who developed clinically di- agnosed herpetic keratitis in the early postoperative period after CXL Setting: A 20-year-old man referred to our Clinic because of bilateral keratoconus, stage III right eye and stage I-II left eye. There was no previous intraocular or corneal surgery, herpetic keratitis, autoimmune disease, or systemic connec- tive tissue disease. Methods: Uncorrected visual acuity (UCVA) was 0.09 in the right eye and 0.8 in the left eye. The best spectacle-corrected visual acuity (BSCVA) was 0.2 in the right eye and 1.0 in the left eye. An impression of slight corneal protru- sion on both sides, one Vogt’s stretch mark is visible paracentrally on the left. Topography showed inferior bilateral thinning. The recommended treatment was CXL with riboflavin and UV-A to stabilize the cornea. The patient under- went a thorough discussion of the risks and benefits of CXL with the surgeon and signed a written informed consent in accordance with institutional guide- lines based on the Declaration of Helsinki. Results: On the fifth postoperative day, slow re-epithelialization was observed and the patient had a central dendritic epithelial defect. Local therapy included acyclovir in the form of ointment, continued antibiotic therapy, and oral thera- py with acyclovir and vitamin B. Several subconjunctival injections DexaLido were applicated to the patient. Topical corticosteroid drops were continued after healing of the epithelial defect. Three months later, a central Vogt’s striae was found, the rest of the ophthal- mological status was normal. In therapy, maintenance oral therapy 1 tablet per day and corticosteroid 1x and artificial tears without preservatives 5- 6x. We are planning to prescribe RK2 contact lenses. Conclusions: Herpetic keratitis can be induced by CXL, even in cases with no history of herpetic eye disease. ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Cornea EP-COR-01 Establishment of IPs cells from patients with Reis-Bücklers corneal dystrophy M. Takahashi-Kawasaki1, R. Tomemori1, K. Araki-Sasaki1, T. Kanagawa2, Y. Matsuoka2, H. Hitomi2, H. Imai1 1Kansai Medical University, Department of Opthalmology, Hirakata city, Osaka, Japan, 2Kansai Medical University, Department of iPS Stem Cell Regenerative Medicine, Hirakata city, Osaka, Japan Purpose: Reis-Bücklers corneal dystrophy (RBCD) is one of the transforming growth factor β-induced (TGFBI) associated corneal dystrophies, with a mis- sense mutation of R124L in the TGFBI gene. This is autosomal dominant form of the diseases and hyaline-like substance accumulates in the subepithelial layer from patient’s early years. However, the exact mechanism of RBCD is not known and there is no fundamental treatment. Here, we attempted to establish patient-derived iPS cells for the purpose of elucidating the pathogenic mechanism and developing novel therapeutic methods for RBCD. Method: Mononuclear cells (MNCs) were isolated from the peripheral blood of an RBCD patient (female, 10 years old), her father (45 years old), and the patient’s healthy mother (control) using gradient centrifugation. The MNCs were cultured, and hematopoietic stem/progenitor cells (HSPCs) were ex- panded for 7 days. Subsequently, five plasmid vectors (pCE-hOCT3/4, pCE-hSK, pCE-hUL, pCE-mp53DD, and pCXB-EBNA1), encoding reprogramming factors, were transfected into the HSPCs. The resulting adherent cells were analyzed for the expression of undifferentiated iPS cell markers using FACS and immu- nostaining. Results: Multiple iPS cell-like colonies were grown from each individual sample. Six colonies were collected from each specimen and confirmed to be in an undifferentiated state. In the colonies derived from the affected daughter and the father, the TGFBI/R124L mutation was conserved, but it was not pre- sent in those derived from the healthy mother. The expression of undifferenti- ated iPS cell markers, including SSEA-4, TRA-1-60, OCT3/4, NANOG, and SOX2, was confirmed by FACS and immunostaining. Conclusions: We have succeeded in establishing RBCD-derived iPS cells. Isolated corneal epithelial cells, when stratified and cultured long-term, pro- vide a useful tool for developing disease models of RBCD. 78 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-COR-02 Carlevale intraocular lens implantation in patiens with penetrating keratoplasty: two case reports M. Puchol-Rizo1, A. Insausti-García1, T. García-Herrera Prada1, A. Palacios-Hipola1, L. Alcalde-Blanco1, D. Rojas-Correa1 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital del Tajo, Aranjuez, Spain Purpose: To describe the therapeutic approach for two patients who under- went Carlevale intraocular lens (IOL) implantation in the context of aphakia and penetrating keratoplasty, performed at our department. Methods: Two clinical cases are presented in video format, accompanied by a brief literature review. Results: The two cases involved patients with aphakia who had previously undergone penetrating keratoplasty. The Carlevale IOL was chosen as it has become a primary option for managing aphakic patients without capsular sup- port. This lens minimizes anterior chamber manipulation, reduces surgical time, protects the corneal endothelium, and lowers the risks of tilt and refrac- tive errors post-surgery. After performing a vitrectomy, the Carlevale IOL was implanted with careful handling of the haptics to prevent breakage. Conclusions: The Carlevale IOL proves to be an excellent option for aphakia management, particularly due to its minimal manipulation of the anterior seg- ment and preservation of endothelial cells. EP-COR-03 Long term follow up of novel surgical technique for Penetrating Keratoplasty in silicone oil keratopathy Conclusion: This surgical technique offers a feasible option for managing sili- cone oil keratopathy with retained silicone oil tamponade. Further studies are needed to improve the technique and enhance patient outcomes. EP-COR-04 Two ways to improve visual acuity in Fish Eye Disease (FED) L. Olie1, R. Wijdh1 1University Medical Centre Groningen, Ophthalmology, Groningen, Netherlands Purpose: Fish eye disease (FED) is a form of genetic LCAT (lecithin-choles- terol acyltransferase) deficiency characterized clinically by corneal opacifica- tions and biochemically by significantly reduced HDL cholesterol and partial LCAT enzyme deficiency. The corneal opacifications are progressive, cause a decrease in visual acu- ity and make it difficult to examine the lens and retina or perform a phaco procedure. We evaluated two methods to improve the visual acuity in patients with FED. Methods: In the first patient we performed a Penetrating Keratoplasty in both eyes, the second patient underwent a phaco procedure in both eyes using endo illumination for the second eye for better visualisation during the operation. Results: In patient 1 the visual acuity improved from 0,1 to 0,7 in the right and from 0,8 to 1,0 in the left eye. In patient 2 the visual acuity improved from 0,5 to 1,0 in the right and from 0,1 to 1,0 in the left eye. Conclusions: Surgical improvement of visual acuity is possible in FED. The choice of the procedure depends on the cause of visual acuity impairment and the degree of visibility of the anterior segment. C.-L. Wu1, C.-H. Huang1, I-C. Lin1, H. Li1, T.-R. Wang2 1Wan Fang Hospital, Taipei Medical University, Department of Ophthalmology, Taipei, Taiwan, 2Wan Fang Hospital, Ophthalmology, Taipei, Taiwan EP-COR-05 Purpose: Long-term use of silicone oil tamponades can result in silicone oil keratopathy and other ocular complications. Despite the poor prognosis often associated with penetrating keratoplasty (PK) for silicone oil keratopathy, it remains a critical option for restoring vision, especially in cases where the affected eye is the patient’s only eye with visual potential. This study introduces a novel surgical technique for PK with retained silicone oil tamponade and evaluates its outcomes and the management of associated complications. Method: A retrospective case series was conducted at a single medical center in Taiwan, including 13 patients (20 eyes) treated with the novel PK technique for silicone oil keratopathy between 2014 and 2024. The procedure aimed to preserve the silicone oil tamponade while minimally supplementing it during surgery to compensate for any loss. Clinical outcomes, graft survival rates, and postoperative complications were thoroughly evaluated over the follow-up period. Results: The mean age of patients was 61.2 years (range: 23–80 years). In half of the cases, the operated eye was the patient’s only eye with visual potential. Primary graft failure occurred in 2 eyes (10%). The average graft survival time was 19.8 months (range: 2–108 months; standard deviation: 24.8 months; median: 12 months). The 2-year graft survival rate was 28.4%. Postoperative complications included hypotony in 2 eyes (10%), which required additional silicone oil injections. Efficacy and safety of pilocarpine hydrochloride 1.25% on presbyopic patients: a systematic review and meta-analysis M. Abo Zeid1, A. Elrosasy2, K. Khalefa1, H. Alkousheh3, A.K. Hassan4, M.M. Khalil1, H. Abu Serhan5 1Tanta University, Faculty of Medicine, Tanta, Egypt, 2Cairo University, Faculty of Medicine, Cairo, Egypt, 3Hashemite University, Faculty of Medicine, Zarqa, Jordan, 4University of California, Gavin Herbert Eye Institute, Irvine, California, United States, 5Hamad Medical Corporation, Department of Ophthalmology, Doha, Qatar Purpose: To assess the safety and efficacy of pilocarpine hydrochloride 1.25% in presbyopic patients. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. Four databases were searched until 1st of July 2024 to identify articles related to the use of pilocarpine in presbyopic patients and assessing participants with a ≥ 3-line improvement in distance-corrected near visual acuity (DCNVA) at 40 cm and no loss of ≥ 1 line in Corrected Distance Visual Acuity (CDVA) and safety outcomes. The risk ratios (RR) and mean difference (MD) and their 95% confidence interval were pooled using RevMan 5.4 software Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 79

ELECTRONIC POSTER PRESENTATIONS Results: Four studies were included in our analysis comprising a combined total of 1023 patients. Pilocarpine 1.25% demonstrated significantly better re- sults when compared to the vehicle in patients achieving: ≥ 3-line DCNVA at 40 cm after 3 hours and 30 days (RR = 3.30, p < 0.00001), (RR = 2.03, p < 0.00001) respectively, 20/40 or better photopic DCNVA after 3 hours (RR = 1.30, p = 0.004), higher mesopic NVPTQ score after 3 hours (MD = 0.84, p < 0.00001), and smaller pupil size in the non-dominant eye (MD = -1.75, p < 0.00001). For Safety outcomes pilocarpine 1.25% showed significantly higher risk of developing headache, facial pain, and blurred vision (RR = 2.49, p = 0.006), (RR = 4.48, p = 0.001), (RR = 4.93, p = 0.002) respectively. Conclusion: Despite the promising results pilocarpine 1.25% demonstrated in improving the symptoms of presbyopia, it also raised concerns regarding its safety. EP-COR-06 Altered subbasal nerve density and dendritic cell density in corneas of patients with type 2 diabetic macular edema A.M. Cikowska Filipek1, N. Lagali2, A. Viberg1, G. Johannesson1, B. Byström1 1Umeå University, Clinical Sciences, Ophthalmology, Umeå, Sweden, 2Linköping University, Department of Biomedical and Clinical Sciences, Linköping, Sweden Purpose: The purpose of this study is to examine a possible correlation of diabetic macular edema (DME) with changes in the anterior segment, focus- ing on corneal subbasal nerve fibers and the density of corneal inflammatory cells in patients with type 2 diabetes. Method: Cross-sectional examination of 30 subjects with type 2 diabetes and DME, and 30 volunteers without diabetes using corneal confocal microscope the same morning as their retinal status were checked. Data was randomly col- lected from one eye of each patient for analysis, unless only one eye met the inclusion criteria (being affected by DME). Five high-quality, representative, unique images with vertical appearance of the corneal subbasal nerves and one image from the whorl region of every subject were chosen for analysis. Quantitative measurements of corneal subbasal nerve fibers were made using semi-automated tracing software. An average corneal nerve fiber length, defined as total length of nerve fibers and nerve branches within a frame (mm/mm²), from every image was quanti- fied. The density of activated and non-activated dendritic cells in the same corneal layer and same images were additionally identified and quantified. Results: The corneal subbasal nerve fiber density overall, as well as in the whorl region was significantly reduced in patients with DME compared to in controls. Furthermore, the density of activated cells was significantly in- creased in the same layers of the corneas in DME patients. Conclusion: A reduced density of nerves in the corneal subbasal layer was present in the DME group. Interestingly, the density of activated dendritic cells was increased in the same layer indicating an upgrade in the inflamma- tory status, and this in turn might contribute to the nerve damage. Our results suggest a novel connection between the diabetic status of the eye with the specific retinal findings of DME and the anterior part of the eye, namely with features of the corneal nerves and cells. EP-COR-07 The effects of lateral rectus recession on ocular surface temperature J.S. Min1, S.H. Yoon2 1Yonsei University college of medicine, Seoul, Korea, Republic of, 2Daegu Catholic University of medicine, Daegu, Korea, Republic of Purpose: To analyze the effects of lateral rectus recession on ocular surface temperature. Method: We compared the body temperature, non-invasive tear film breakup time (NIBUT), corneal temperature, nasal conjunctival temperature, and tem- poral conjunctival temperature of patients who underwent lateral rectus reces- sion surgery before the procedure and one month postoperatively. Results: A total of 11 patients (22 eyes) were analyzed, with an average age of 8.45 ± 1.34 years, consisting of 8 males and 3 females. The preoperative body temperature was 36.82 ± 0.38 °C, corneal temperature was 35.25 ± 1.28 °C, NIBUT was 5.99 ± 2.11 seconds, nasal conjunctival temperature was 35.99 ± 0.94 °C, and temporal conjunctival temperature was 35.79 ± 1.09 °C. One month after surgery, the body temperature was 36.85 ± 0.32 °C, corneal temperature was 35.19 ± 1.32 °C, NIBUT was 5.18 ± 0.41 seconds, nasal conjunctival temperature was 35.86 ± 0.99 °C, and temporal conjunctival tem- perature was 35.88 ± 1.03 °C. There were no statistically significant changes in all five parameters between preoperative and one-month postoperative measurements. Conclusion: Lateral rectus recession did not cause changes in ocular surface temperature and did not result in changes in NIBUT. EP-COR-08 Artificial intelligence-based classification of viral keratitis remission using three types of anterior segment photography S.H. Jung1, Y. Won2, W.S. Song2, S.J. Oh1,3, M.J. Chung1,4,5, H. Yoo1, D.H. Lim2,6 1Samsung Medical Center, Medical AI Research Center, Seoul, Korea, Republic of, 2Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of, 3Sungkyunkwan University, Department of Metabiohealth, Suwon, Korea, Republic of, 4Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Seoul, Korea, Republic of, 5Sungkyunkwan University School of Medicine, Department of Data Convergence and Future Medicine, Seoul, Korea, Republic of, 6Sungkyunkwan University, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea, Republic of Purpose: Remission diagnosis of viral keratitis is an important factor in dis- ease management and response to treatment. An accurate remission diagnosis can determine the appropriate treatment strategy, reduce the risk of recurrence, and prevent permanent vision loss. Despite the importance of remission di- agnosis in viral keratitis, the application of artificial intelligence in this area remains in its early stages. This study proposed an artificial intelligence model to classify the remission status of viral keratitis using anterior segment photographs and evaluated the performance of photographs captured under different illumination methods. 80 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Method: Anterior segment photographs were collected from 58 patients diagnosed with viral keratitis at a general hospital (2008–2023). The data- set included three types of photographs: broad beam, slit-lamp, and scatter beam. All photographs were resized and augmented to enhance model ro- bustness. Three pre-trained CNN architectures (VGG16, DenseNet121, and EfficientNet-B2) were fine-tuned and evaluated separately on each photograph type for remission diagnosis. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Results: Diagnostic performance differed across the types of photographs. Slit-lamp photographs achieved the highest performance (AUROC 0.804, sensitivity 0.754, specificity 0.742), followed by broad-beam (AUROC 0.777, sensitivity 0.429, specificity 1.000) and scatter-beam photographs (AUROC 0.770, sensitivity 0.600, specificity 0.850). Conclusion: Among the three types of photographs, slit-lamp images achieved the best diagnostic performance and demonstrated their suitability for remission diagnosis of viral keratitis. This study suggests that the model has potential as a supportive tool for clini- cal management and monitoring of viral keratitis. Further work on feature extraction and larger datasets may enhance diagnostic accuracy. EP-COR-09 Corneal neurotization for severe dry eye after trigeminal neuralgia: a case report M.I. Figueiredo1, S. Ramos2,3, M. Vaz2,3, J. Gil1,3,4, M.J. Quadrado1,3,4 1Unidade Local de Saúde Coimbra, Ophthalmology, Coimbra, Portugal, 2Unidade Local de Saúde Coimbra, Plastic Surgery, Coimbra, Portugal, 3Clinical and Academic Centre of Coimbra, Coimbra, Portugal, 4Faculty of Medicine, University of Coimbra, Coimbra, Portugal A 49-year-old female with a history of left sphenoid wing meningioma resec- tion developed unilateral severe refractory neurotrophic keratopathy in her left eye caused by iatrogenic trigeminal nerve involvement. She experienced persistent pain, blurred vision, significant corneal opacities, and profound dry eye refractory to medical therapy, severely impacting her quality of life. Best corrected visual acuity (BCVA) was 20/20 in her right eye and 12/20 in her left eye. On slit-lamp examination, her left eye presented with diffuse punc- tate keratopathy Oxford grade 5 and marked tear-film instability. Non-contact corneal esthesiometry showed a severely decreased corneal sensitivity, re- sponding to a grade 4 out of 5 stimuli of 8.0 mBar. Preoperative lacrimal film analysis showed a non-invasive tear break-up time (NIBUT) of 2.7 seconds. A multidisciplinary decision was made to perform indirect corneal neuroti- zation with a sural nerve graft to the contralateral supratrochlear nerve. The procedure successfully restored corneal sensitivity and led to significant relief from symptoms. Three months after surgery, the patient reported substantial improvement in comfort and vision, with BCVA of 16/20. On esthesiometry, the patient was able to detect level 1 stimuli of 2.90 mBar. Lacrimal film analysis showed an improved NIBUT of 7.2 seconds. Corneal neurotization procedures represent a groundbreaking technique in managing severe dry eye disease. They enable functional corneal reinnerva- tion through the restoration of the affected corneal innervation. This allows a restored corneal sensation and improved outcomes in neurotrophic keratopa- thy, demonstrating remarkable safety and efficacy to this date. EP-COR-10 Case of repeat descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with advanced glaucoma and previous glaucoma surgery N. Toyokawa1, K. Araki-sasaki2, H. Kimura1, S. Kuroda1 1Nagata Eye Clinic, Nara, Japan, 2Kansai Medical University, Ophthalmology, Hirakata, Japan Purpose: To report a case of three repeats DSEAK for bullous keratopathy in a patient with severe glaucomatous visual field (VF) defect and previouos glaucoma filtering surgery. Patients and methods: A case report. Results: A 62-year-old man developed bullous keratopathy after multiple glaucoma surgeris including trabeculectomy and had severe glaucomatous VF defects in his both eyes. Because the left eye has more severe visual field con- striction and corneal stromal opacity, we performed a DSAEK procedure and rebubbling in the right eye. The surgical procedure resulted in a clear cornea and best corrected visual acuity (BCVA) improved from 20/800 to 20/100. However, VA gradually decreased and corneal edema recurred in 1 year post- operatively. He underwent the second repeat DSAEK and BCVA recovered to 20/100. After that, corneal endothelial dysfunction gradually progressed again and second DSAEK failed at 3 years postoperatively. Intraocular pressure was well controlled and VF was retained in the right eye during the entire postop- erative period. Since decreased visual function impaired his quality of life, the third repeat DSAEK was underwent in accordance with the patient’s request after appropriate counselling about poor prognosis was done. The BCVA im- proved to 20/100 and VF in the right eye kept retained from his first visit to the present. Conclusion: Generally, glaucoma filtering surgery adversely impacts the likelihood of repeat DSAEK. Failed corneal graft management is more chal- lenging in this setting. We report a case of three repeats DSAEK, and the VA improved with retained VF. Taking into consideration the short-term graft survival, repeat DSAEK even in eyes with advanced glaucoma may contribute to improvement in quality of life. EP-COR-11 Clinical features and treatment outcomes of Acinetobacter baumannii keratitis: comparison with Pseudomonas aeruginosa keratitis C.-H. Cho1, S.-B. Lee1 1Yeungnam University College of Medicine, Ophthalmology, Daegu, Korea, Republic of Purpose: This study aimed to compare and analyze clinical characteristics and treatment outcomes between Acinetobacter baumannii (AB) keratitis and Pseudomonas aeruginosa (PA) keratitis. Methods: Medical records of 60 inpatients with culture-proven AB (n=17) and PA (n=43) keratitis were retrospectively reviewed for 26 years (1998~2023) in Yeungnam University Hospital. Epidemiology, predisposing factors, initial clinical characteristics, and treatment outcomes were compared between the AB and PA keratitis. The symptom duration was defined as the interval from symptom onset to the time of initial presentation in our institute. Poor treat- ment outcomes (PTO) were defined as surgical treatment was performed or final BCVA <0.1. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 81

ELECTRONIC POSTER PRESENTATIONS Results: There were no differences between the AB and PA groups in gender, seasonal distribution, and mean age (53.0 vs. 45.9 years, p=0.170). The mean symptom duration was significantly longer in AB than in PA (11.4 vs. 4.2 days, p=0.006). The most common predisposing factors were corneal trauma (47.1%) and previous ocular surgery (41.2%) in AB group, and contact lens wear (44.2%) and corneal trauma (39.5%) in PA group. There was no differ- ence in the previous topical steroid use (23.5% vs. 16.3%, p=0.448), central lesion (59% vs. 58%), epithelial defect size (11.2 vs. 15.4 mm2), and hypopy- on (35.3% vs. 44.2%) between the two groups. In the treatment outcomes, there was no statistically significant difference between AB and PA in epithe- lial healing time ≥14 days (70.6% vs. 51.2%, p=0.171), final BCVA <0.1 (50% vs. 30.8%, p=0.178), surgical treatment (23.5% vs. 14.0%, p=0.448), and PTO (56.2% vs. 30.8%, p=0.077). Conclusions: The rate of PTO in AB keratitis was higher than in PA keratitis, but there was no statistically significant difference. In conclusion, AB kera- titis appears to progress slowly than PA keratitis, but its clinical significance should be emphasized because the treatment outcome can be as poor as that of PA keratitis. EP-COR-12 Impact of simultaneous TG-PRK on corneal haze following Cross-Linking for keratoconus: a quantitative densitometry analysis M. Francisco1, J. Gil1,2,3, P. Gil2,4, S. Geada1, E. Costa1,3,2, C. Tavares1, A. Rosa1,3,2, M.J. Quadrado1,3,2, J. Murta1,3,2 1Coimbra Local Health Unit, Ophthalmology, Coimbra, Portugal, 2University of Coimbra, Faculty of Medicine, Coimbra, Portugal, 3Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal, 4São José Local Health Unit, Lisbon, Portugal Purpose: To compare the impact of simultaneous topography-guided pho- torefractive keratectomy (TG-PRK) on corneal haze in patients undergoing accelerated corneal cross-linking (CXL) for keratoconus, using corneal den- sitometry. Methods: Retrospective, case-control study comparing patients undergoing accelerated CXL alone (CXL group) or combined CXL and TG-PRK (TG- PRK group). All patients performed PTK-assisted 50um de-epithelization, fol- lowed by 10-minute UV-A exposure at 10mW/cm2 (6J/cm2total dose). In the TG-PRK group, patients had simultaneous TG-PRK ablation for topo- graphic regularization. Corneal densitometry was measured pre-operatively, at 3 months, and at 1 year post-operatively using a Scheimpflug device. Changes in densitometry values across different corneal regions were analyzed to as- sess haze evolution. Results: A total of 116 eyes were included, with 56 eyes in the CXL group and 60 eyes in the TG-PRK group. At 3 months post-operatively, patients in the TG-PRK group exhibited significantly higher corneal densitometry values across all measured regions compared to the CXL group (p<0.001). This in- crease was most pronounced in the anterior stroma and central cornea. By 1 year, densitometry values in both groups had largely returned to baseline lev- els, although a minor but significant reduction in transparency remained in the anterior and central corneal regions in the TG-PRK group. No correlation was found between haze formation and changes in visual acuity or keratometry. Conclusion: Simultaneous TG-PRK and CXL result in more significant and prolonged corneal haze compared to CXL alone. Haze improves over time but persists longer in the combined procedure. Corneal densitometry is valuable for assessing haze and optimizing patient management. EP-COR-13 Reproduction of pathology in Gelatinous Drop-Like Corneal Dystrophy using patient-derived iPS cells T. Kanagawa1,2, Y. Matsuoka1, K. Araki-Sasaki3, H. Hitomi1 1Kansai Medical University, Department of iPS Stem Cell Regenerative Medicine, Hirakata, Japan, 2Baptist Eye Institute, Kyoto, Japan, 3Kansai Medical University, Department of Ophthalmology, Hirakata, Japan Purpose: Gelatinous Drop-Like Corneal Dystrophy (GDLD) is a rare autoso- mal recessive corneal dystrophy caused by mutations in the TACSTD2 gene. Despite its identification, the detailed pathogenesis remains unclear, and no fundamental treatment currently exists. This study aims to establish an in vitro model of GDLD corneal epithelium by differentiating patient-derived induced pluripotent stem cells (iPS cells) into corneal epithelial cells. Methods: Self-formed ectodermal autonomous multi-zones (SEAMs) were generated from GDLD patient-derived and healthy donor-derived iPS cells, with some modifications to the method described by Hayashi et al. Corneal epithelial cells were sorted from the SEAMs using FACS Aria III and subse- quently cultured. The expression of mRNA and proteins, including p63, PAX6 (ocular surface epithelial markers), Keratin12 (a corneal epithelial-specific keratin), TACSTD2 (GDLD-associated gene), and Claudin1 (a tight junction- related protein), was analyzed via RT-PCR, immunofluorescence staining, Western blotting, and flow cytometry. Results: Corneal epithelial-like cells from both GDLD patient-derived and healthy donor-derived iPS cells expressed p63, PAX6, and Keratin12 at the mRNA and protein levels. In corneal epithelial cells derived from healthy donor iPS cells, TACSTD2 expression and Claudin1 localization were nor- mal. In contrast, corneal epithelial cells derived from GDLD patient iPS cells (GDLD-iCECs) showed a lack of TACSTD2 protein expression, as demon- strated by immunofluorescence staining, Western blotting, and flow cytom- etry, and exhibited abnormal Claudin1 localization. Conclusion: The GDLD-iCECs generated in this study successfully recapitu- late key aspects of GDLD pathology, demonstrating their potential utility as an in vitro model for the disease. EP-COR-14 Therapeutic use of topical insulin to treat refractory neurotrophic keratopathy A.C.K. Au1,2,3, A.L.W. Li1,2,3, W.M. Ho1,2,3, K.W.K. Li1,2,3 1United Christian Hospital, Ophthalmology, Hong Kong, Hong Kong, SAR of China, 2Tseung Kwan O Hospital, Ophthalmology, Hong Kong, Hong Kong, SAR of China, 3The University of Hong Kong, Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong, SAR of China Purpose: To present the clinical course of 4 patients with refractory neuro- trophic keratopathy (NK) that were treated with topical insulin. Methods: This retrospective case series included four patients started with topical insulin for NK not responsive to conventional treatment. Topical insu- lin was prepared by the hospital pharmacy under aseptic conditions by mixing short acting insulin in artificial tears with a polyethylene glycol and propylene glycol base at a concentration of 1 unit per mL, prescribed 4 to 6 times daily for 1-2 months. 82 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Results: Four patients, aged 31 to 67 years old with stage 1 to 2 NK (three patients with stage 2) were included. Two patients had reduced corneal sensa- EP-COR-16 tion from herpetic stromal keratitis, one patient had surgical resection causing trigeminal nerve damage and one patient had facial nerve palsy. All patients failed to respond to conventional treatment including topical lubricants, ster- oid, cyclosporine, bandage contact lens, punctal occlusion, amniotic mem- brane grafting and temporary tarsorrhaphy. Each patient was started on topical insulin drops with complete corneal re-epithelialization in two and subjective symptom improvement in one within 7 to 14 days. One patient defaulted sub- sequent follow up but his epithelial defect healed at month 4 following insulin treatment of 1 month and regular lubricants. No local or systemic side effects were reported. Conclusion: Topical insulin has been reported to be an effective and safe treatment for refractory neurotrophic keratopathy. It also has the benefit of being widely available and cost-effective with excellent tolerability. It showed encouraging results in some of our patients who failed all standard conven- tional treatment. Further studies are needed to determine the long term ef- ficacy and safety. EP-COR-15 Infectious keratitis: a systematic review of patient reported outcomes J. Smith1, C. Pappas1, M. Cabrera-aguas1, H. Kandel1, S. Watson1 1University of Sydney, Sydney, Australia Purpose: Infectious keratitis is a sight-threatening condition which has a pro- found impact on patients quality of life. Patient reported outcome measures (PROMs) offer the opportunity to identify the impact of this condition. The objectives of this review were to systematically evaluate PROM tools used in infectious keratitis, assessing their validity, identifying and analysing the quality of life (QoL) domains affected, and the overall burden of disease on QOL. Method: A literature review was performed in Pubmed, Medline OVID, Embase OVID, Cochrane, Scopus, Web of Science and Psychinfo in October 2023. Full-length studies, published in English, featuring named and exter- nally validated PROMs which were used to evaluate QoL outcomes of pa- tients with infectious keratitis were included. Non-validated PROMs used in patients with infectious keratitis were excluded. Studies including but not ex- plicitly defining corneal pathologies were also excluded. Study characteristics, PROMs and key results were summarised for all studies utilising Excel. Psychometric quality, validity and risk of bias of each PROM were assessed using previously validated criteria. Results: Eight studies evaluated PROMs in infectious keratitis, with eight different PROMs [one generic, seven ophthalmic but not keratitis-specific] utilised. All patients with infectious keratitis demonstrated impaired QoL in all PROMs, with domains representing vision and visual function most impaired. Other QoL domains affected included emotional and mental state, mobility and dependence. Known group validity was high in seven (88%) PROMs. Only one paper (13%) utilised psychometric analysis to validate the PROMs before use. Conclusion: Infectious keratitis has a negative impact on patient’s QoL, across multiple domains. A variety of PROMS have been used to assess QoL in keratitis with most awaiting validation for infectious keratitis. The study was limited by the number of available studies in the literature. Toxicity of povidone iodine on the rabbit ocular surface J. Song1, H.S. Kim1 1Seoul St. Mary’s Hospital, Department of Ophthalmology, Seoul, Korea, Republic of Purpose: We evaluated the toxicity of 5% (w/v) povidone iodine (PI) applied to the ocular surface of rabbits. Methods: Twenty three white rabbits were divided into four groups; these were a control group and three study groups in which the ocular surface was exposed to PI for different times. In the control group, phosphate-buffered saline (PBS) was applied once, for 10 mins. In the PI groups, 5% (w/v) PI was topically administered (once) for 1 min, 3 mins, and 10 mins, and then the animals were observed for 7 days. The Schirmer test, Rose Bengal stain- ing, corneal fluorescein staining, and conjunctival impression cytology, were performed on days 0, 3, and 7. After day 7 the rabbits were sacrificed and conjunctiva and cornea were collected and evaluated by light and electron mi- croscope. Immunofluorescence staining also was performed to detect mucin 5 subtype AC (MUC5AC). Results: The decrease in goblet cell density (GCD) and histopathological changes of conjunctiva and cornea were more prominent in the 5% (w/v) PI groups than the control group (P<0.05). Moreover, these changes were more noticeable when PI was applied for 3 and 10 mins rather than 1 min (both P values <0.05). Reductions in MUC5AC lev- els, and histopathological and ultrastructural changes in the conjunctiva, were more prominent in study groups exposed to PI for longer times. Conclusion: 5% (w/v) povidone iodine caused damage to the ocular surface in a time-dependent manner. Therefore, excessive PI exposure during oph- thalmic procedures could be a pathogenic factor of dry eye syndrome after surgery. EP-COR-18 In Vivo confocal microscopy findings in patients with idiopathic small fibre neuropathy D. Petrovič1, A. Hammami1, A. Mujnović1, T. Krašovec2, M. Kirbiš3, Š. Štunf Pukl1,2 1Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia, 2University Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia, 3Institute of Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia Purpose: To evaluate the utility of corneal confocal microscopy (CCM) in diagnostics of idiopathic small fibre neuropathy (SFN) - a peripheral neurop- athy that selectively affects small nerve fibres, including thinly myelinated Aδ-fibres and unmyelinated C-fibres, which comprise the corneal sub-basal plexus. Skin biopsy to assess intraepidermal nerve fibre density (IENFD) is one of two methods used to confirm SFN, its sensitivity and specificity are around 90%. Method: 15 patients with suspected SFN based on neurological examina- tion were included in the study. All were surveyed for systemic comorbidi- ties and underwent a standardized skin biopsy, an eye exam, including ocu- lar surface evaluation (Schirmer I, Tear Brake-Up Time, fluorescein staining using Oxford scale, corneal sensitivity) and CCM (HRT3 RCM, Heidelberg Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 83

ELECTRONIC POSTER PRESENTATIONS Engineering, Heidelberg, Germany). CCM evaluated the corneal sub-basal nerve plexus by measuring the nerve fibre density, branch density, and nerve fibre length (CNFL). Six images were used for analysis, using the CCMetrics (University of Manchester, UK) and compared with normative database. The pathological values were defined as below the 5th percentile. Results of CCM were compared to results of skin biopsy. Results: 7/15 suspect patients had reduced IENFD, confirming SFN, 5 of them had CNFL values below the 5th percentile. In the group with normal skin biopsy result, 6/8 had CNFL values above the 5th percentile; thus CNFL demonstrated a 71.4% sensitivity and 75% specificity, with skin biopsy as the diagnostic standard. Other measures and ocular surface evaluation did not significantly differ among the 2 groups. Conclusion: Our findings suggest that corneal nerve fibres are affected in the majority of patients with SFN and limb symptoms. CNFL assessment with CCM may be a valuable and non-invasive diagnostic tool in diagnosing SFN with sensitivity and specificity over 70%. A pathologic CCM might confirm clinical suspicion and spare the skin biopsy. EP-COR-19 Empirical treatment of keratosclerouveitis and visual rehabilitation in resource-limited settings T. Harutyunyan1, H. Sargsyan1, A. Hovakimyan1 1Ophthalmological Center after S.V. Malayan, Cornea-Uveitis Department, Yerevan, Armenia Purpose: To present a case of a 49-year-old male with keratosclerouveitis, keratoconus with Vogt’s striae, and a history of prolonged steroid use, high- EP-COR-20 Multiple parallel-line endotheliitis (MPLE): clinical case presentation R. Sklerius1,2, R. Asoklis1,2 1Vilnius University Hospital Santaros Clinics, Department of Eye Diseases, Vilnius, Lithuania, 2Vilnius University Faculty of Medicine, Vilnius, Lithuania Purpose: To present a rare clinical case of multiple parallel-line endotheliitis (MPLE), emphasizing its diagnostic features, treatment approach, and natural course. Methods: A retrospective case report. Results: A 40-year-old female presented with sudden-onset unilateral visual impairment in the right eye (“foggy vision”), without any prior history of trauma, systemic, or infectious diseases. BCVA was 0.5 (Snellen). Diagnostic tests included pachymetry, specular microscopy, and anterior segment optical coherence tomography. Initial examination revealed corneal edema and characteristic linear endothe- lial precipitates resembling train tracks. Treatment with topical corticosteroids was initiated, and the patient was monitored for symptom progression. Upon initiation of dexamethasone 1 mg/ml (4 times daily), the patient ex- hibited significant improvement within 3 days, and BCVA was 1.0 (Snellen). Diagnostic imaging demonstrated resolution of corneal edema and the ab- sence of endothelial precipitates, while endothelial cell density was reduced compared to the contralateral eye. 26 days after the initial presentation, a follow-up examination showed no sig- nificant changes from the previous visit, though endothelial cell density had decreased. The clinical course corroborates previous findings in the literature that MPLE may resolve spontaneously, although corticosteroids may acceler- lighting the importance of tailored empirical management in such complex ate recovery. cases. Conclusions: MPLE is a rare and poorly understood condition, characterized Method: The patient, with a history of herpes zoster skin rash, thyroidectomy, by parallel-line endothelial precipitates and transient corneal edema. Its etiol- ogy remains idiopathic, although potential viral associations have been noted in the literature. This case underscores the importance of recognizing MPLE’s hallmark fea- tures for accurate diagnosis and management. While the natural course is self- limiting, corticosteroid therapy may offer symptomatic relief and expedite resolution. Further studies are needed to elucidate the etiology and optimize management of this rare condition. and cardiovascular disease, presented with severe pain, photophobia, and l.p. vision. Initial examination showed a corneal epithelial defect, stromal infil- trate, conjunctival and scleral injection, and hypopyon. Due to the absence of corneal cultures or PCR diagnostics, empirical treatment was initiated with antivirals, wide-spectrum antibiotics, cycloplegics, MMP inhibitors (doxycy- cline, FML eye drops), and oral NSAIDs. The treatment was adjusted over time, incorporating amniotic membrane transplantation, and sub-Tenon cor- ticosteroid injections. Results: Over three months, the patient’s condition improved, with mild stro- mal scarring and visual acuity improving to 0.05. One year later, the patient underwent phacoemulsification cataract surgery, achieving a post-operative visual acuity of 0.3 (ph 0.5), and further improving to 0.7–0.8 with a contact lens. Conclusion: This case emphasizes the need for early, comprehensive empiri- cal treatment of keratosclerouveitis, particularly in resource-limited settings. The successful integration of surgical and optical interventions underscores the potential for significant visual rehabilitation, even in complex cases. 84 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Evaluations included preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), target refraction, CECD, and post- operative complications. Results: A total of 64 eyes from 48 patients were included, with 37 eyes (57.8%) receiving retropupillary implantation. The most common indication for implantation was complications from cataract surgery, followed by trauma and refractive errors. Both implantation techniques resulted in significant im- provements in BCVA (P < 0.05) regardless of the indication. However, the analysis revealed a marked advantage for retropupillary im- plantation in terms of corneal endothelial preservation. Patients in the anterior implantation group exhibited significantly lower postoperative CECD (cells/ mm²), indicating greater endothelial cell loss compared to those in the retro- pupillary group. Despite this, there were no significant differences between the groups in terms of IOP elevation or central corneal thickness, suggesting a similar overall safety profile for both techniques. Conclusion: Retropupillary iris-claw IOL implantation demonstrates supe- rior corneal endothelial cell preservation compared to anterior implantation, while achieving comparable improvements in visual and refractive outcomes. Further research with larger sample sizes and extended follow-ups is essential to confirm these observations and refine surgical strategies. EP-COR-25 Association of statin use and the incidence of dry eye disease Y.-C. Ting1, Y.-H. Wang1, C.-Y. Chen2, H. Lee1 1Wan Fang Hospital, Taipei, Taiwan, 2Wan Fang Hospital, Ophthalmology, Taipei, Taiwan Purpose: The purpose of this study is to evaluate the association between statin use and the risks of diagnosed dry eye disease (DED). Methods: This retrospective, case-control study included 780 786 patients who received statin agents in 2002-2016, of which 17 409 were newly di- agnosed with DED during a ≥2-year follow-up period. These patients were matched 1:4 with control participants for age, sex, and comorbidities. Results: Statin users had significantly higher odds of DED (adjusted OR = 1.22; 95% confidence interval (CI) = 1.12-1.17, p < 0.0001) than nonusers. Among statin users, the odds of DED did not differ significantly between pa- tients receiving statin therapy for >180 days vs. ≤90 days or patients receiving statin therapy for 91-180 days vs. ≤90 days (adjusted OR = 1.00, p = 0.82; adjusted OR = 0.84, p = 0.251, respectively). Conclusions: Patients receiving statin therapy had a higher DED risk than pa- tients not receiving statin therapy. The type of statin, the duration, and the in- tensity of statin use were not significantly associated with DED risks. Further studies are required to identify the relevant factors related to DED risks with statin. Keywords: dry eye disease; hyperlipidaemia; lipid-lowering agent; statin. EP-COR-23 Vortex keratopathy (cornea verticillata) - a case report G. Dimitrova1,2, M.B. Impagliatelli1,2, O. Mladenov1,2, M. Dimitrova - Mladenova3,4, N. Veleva1,2, Y. Kyneva1,2, G. Dimitrov1,2, A. Levi1,2, A. Georgieva1,2, A. Oscar1,2 1Medical University, Ophthalmology, Sofia, Bulgaria, 2University Hospital Aleksandrovska, Eye Clinic, Sofia, Bulgaria, 3Medical University, Endocrinology, Sofia, Bulgaria, 4University Children’s Hospital, Endocrinology, Sofia, Bulgaria Introduction: Vortex keratopathy is a whorl-like pattern of deposits in the ba- sal part of corneal epithelium. Certain medications are known to cause vortex keratopathy: Amiodarone (most common), Chloroquine and hydroxychloro- quine, Tamoxifen, Indomethacin, Ibuprofen, Chlorpromazine. It is, however, a hallmark finding of Fabry disease, caused by the accumulation of globotria- osylceramide (Gb3) in corneal cells. Purpose: To present a case with vortex keratopathy and analyse clinical pic- ture and differential diagnose. Method: A 12- year- old girl with chronic headache was examined. She has been receiving Ibuprofen for a long time in high dosеs. We used orthoptic, ophthalmological and clinical genetic methods of study. Results: The patient had normal visual acuity and no visual complains, yet the ophthalmic examination showed vortex like deposits in the corneal epithelium, no other pathologic findings in anterior and posterior eye segments. Orthoptic study measured 12 ∆ exophoria and prism glasses were prescribed. On the follow-ups she no longer complained of headache. As the vortex keratopathy persisted, we performed a genetic test. Fabry disease was con- firmed. Conclusion: Our primary diagnosis was Ibuprofen-induced vortex keratopa- thy, because of the case history of long-term taking the medicine. The child was “otherwise healthy”, maybe because Fabry disease has a milder course in females. The genetic test was crucial for the diagnosis. We referred the girl to subspe- cialists for further general examinations and treatment. Keywords: Vortex keratopathy, Ibuprofen-induced keratopathy, Fabry dis- ease, genetics in Fabry disease EP-COR-24 Comparative analysis of corneal endothelial cell outcomes and postoperative complications in anterior and retropupillary Iris-claw intraocular lens implantation C.-L. Wu1, C.-H. Huang1, I-C. Lin1, H. Li1, T.-R. Wang2 1Wan Fang Hospital, Taipei Medical University, Department of Ophthalmology, Taipei, Taiwan, 2Wan Fang Hospital, Taipei, Taiwan Purpose: To compare the impact on corneal endothelial cell density (CECD) and the clinical outcomes of iris-claw intraocular lens (IOL) implantation be- tween anterior and retropupillary positions. Methods: This retrospective study analyzed patients who underwent iris-claw IOL implantation from January 2016 to January 2024. Patients with incom- plete preoperative or postoperative data were excluded. The cohort was di- vided into anterior and retropupillary groups based on implantation location. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 85

ELECTRONIC POSTER PRESENTATIONS EP-COR-26 EP-COR-27 Long-term monitoring of corneal grafts via anterior segment optical coherence tomography pachymetry maps Evaluation of the efficacy and safety of pilocarpine eye drops for the treatment of presbyopia: a randomized clinical trial A. Neokleous1, N. Michail1, F. Herodotou2, A. Athanasiadou3, S. Christodoulou1, D. Kola1, K. Panayidou4, G. Hadjilouka1, S. Palioura5 1Archbishop Makarios III Hospital, State Health Services Organization, Nicosia, Cyprus, Department of Ophthalmology, Nicosia, Cyprus, 2University of Cyprus Medical School, Department of Ophthalmology, Nicosia, Cyprus, 3Athens Eye Experts Ophthalmology Practice, Athens, Greece, 4European University Cyprus, Health Sciences, Nicosia, Cyprus, 5University of Cyprus Medical School, Nicosia, Cyprus Purpose: This prospective cohort study evaluated the efficacy of Anterior Segment Optical Coherence Tomography (AS-OCT) in the long-term moni- H. Hasani1 1Alborz University of Medical Sciences, Ophthalmology, Karaj, Iran, Islamic Republic of Purpose: This randomized clinical trial aims to evaluate the efficacy, safety, and patient satisfaction associated with the use of pilocarpine in individuals with presbyopia. Methods: This double-blind, placebo-controlled, randomized trial was con- ducted in presbyopic individuals aged 45 years and older. Participants were randomly assigned to receive either 1% pilocarpine eye drops or a placebo, administered bilaterally once daily for a duration of eight weeks. The primary outcome was the improvement in near visual acuity (NVA), measured using the Jaeger chart. toring of corneal grafts and its integration into a hybrid remote care model for Secondary outcomes included changes in distance visual acuity (DVA), pupil early detection and management of graft rejection or failure. Methods: Seventy-four patients (93 eyes) who underwent corneal transplan- tation from October 2021 to December 2023, with a follow-up period of at least 6 months were enrolled in the study. AS-OCT pachymetry maps and cross-sectional scans were performed at fixed post-operative intervals and the findings were correlated with clinical signs of graft rejection or failure on slit- lamp examination for thickness changes greater than 50 μm. A hybrid remote AS-OCT screening protocol was initiated 1 week post-operatively. Results: AS-OCT demonstrated high diagnostic accuracy with specificity of 97.6% and sensitivity of 88.9% in detecting graft rejection or failure. The mean central corneal thickness increase in cases resulting in graft rejection or failure was 82.7 ± 21.5 μm, a thickness change that is not discernible by slit lamp examination alone. The utility of AS-OCT in a hybrid remote monitoring model was demon- strated through three detailed case studies, highlighting improved clinical workflow and patient convenience without compromising post-operative outcomes. Conclusion: Serial AS-OCT imaging serves as a robust, objective, and quan- titative tool for post-operative surveillance of corneal grafts, significantly benefiting patient outcomes by allowing timely interventions. Integration of AS-OCT into a hybrid remote screening protocol supports comprehensive monitoring, complementing direct clinical evaluations and optimizing post- operative care. size, and the occurrence of adverse events. Data analysis was performed using SPSS version 27, with paired t-tests as- sessing intra-group differences and repeated-measures ANOVA evaluating inter-group differences. A p-value of <0.05 was considered statistically sig- nificant. Results: A total of 150 participants (mean age: 52.3 ± 5.6 years, 56% female) were enrolled, with 75 participants in each group. At the eight-week endpoint, the pilocarpine group showed a statistically significant improvement in NVA compared to the placebo group (mean Jaeger improvement: 2.4 ± 0.3 vs. 0.7 ± 0.2, p < 0.001). This effect was consistent across age subgroups (45–54 years and ≥55 years). No significant changes were observed in DVA (p = 0.76). The reduction in mean pupil size was significantly greater in the pilocarpine group (1.2 mm vs. 0.1 mm, p < 0.001), correlating with an enhanced depth of focus. Adverse events, including mild headache and eye irritation, were re- ported in 12% of participants in the pilocarpine group, with no serious adverse events recorded (p = 0.31). Conclusions: Pilocarpine eye drops significantly improved near visual acuity in presbyopic patients without affecting distance vision. The treatment was well-tolerated, with a favorable safety profile. EP-COR-28 Ocular Bee stings: two case reports and management outcomes P. Adamavičė1,2, G. Kalvelytė3 1Vilnius University, Faculty of Medicine, Vilnius, Lithuania, 2Vilnius University Hospital Santaros Clinics, The Center of Eye Diseases, Vilnius, Lithuania, 3Antakalnis Outpatient Clinic, Vilnius, Lithuania Purpose: This report presents two rare cases of ocular bee stings, emphasizing their clinical features, management strategies, and outcomes. In the first case, a 49-year-old man presented two weeks after sustaining mul- tiple bee stings to the face and right eye. Initial examination revealed mixed bulbar conjunctival injection, corneal edema, a large corneal ulcer with diffuse corneal opacification, and anterior chamber inflammation. Despite aggressive management with topical and systemic antibiotics, corticosteroids, cyclople- gics, visual acuity improved to hand movement recognition. 86 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS The second case involved an 81-year-old man who presented the same day after being stung directly in the right eye. Examination revealed purulent dis- charge, mixed bulbar conjunctival injection, chemosis, a large corneal epi- thelial defect, and corneal edema. Prompt treatment with topical antibiotics, lubricants, antihistamine eye drops, and oral antihistamines led to significant improvement, with visual acuity recovering to 0.5 (decimal), matching the unaffected left eye, within two weeks. Both cases underscore the importance of immediate stinger removal when visible, combined with tailored pharmacological therapy. Although few such cases have been reported in the literature, the most commonly applied treat- ments include local antibiotics, steroids, and cycloplegics. Immediate stinger removal is recommended if it is easily accessible or if a severe primary reac- tion affects the visual axis. In other cases, pharmacological treatment should be initiated while closely monitoring the patient. Conclusion: Early recognition and intervention are critical in managing ocu- lar bee stings to prevent severe complications and preserve vision. Further research is essential to establish standardized treatment guidelines for these rare but potentially sight-threatening injuries. EP-COR-29 The first case of KeraKlear keratoprosthesis implant patient with glistening formations B. Işik1, A. Gök2, G.D. Arslan3, E. Bulut4 1Biruni University, Ophthalmology, Istanbul, Turkey, 2Büyükçekmece Kolan Hospital, Ophthalmology, Istanbul, Turkey, 3Atlas University, Ophthalmology, Istanbul, Turkey, 4Liv Hospital, Ophthalmology, Istanbul, Turkey A patient with a KeraKlear keratoprosthesis implant had glistening forma- tions. We assume it is because of the acrylic material of KeraKlear, which is similar to intraocular lenses. To the best of our knowledge, this is the first reported case of a KeraKlear keratoprosthesis patient with glistening forma- tions. Case Presentation: A 28-year-old woman was presented to our ophthalmol- ogy clinic with decreased vision in her right eye who had herpetic dendritic ceratitis. As a result of the high risk of corneal graft rejection, the patient was unable to receive donor corneal transplantation. Her preoperative visual acuity was 20/200. Slit-lamp examination revealed a central corneal scar of 2x1 mm and mild corneal neovascularization. We decided to perform a KeraKlear® XT400 model keratoprosthesis in her right eye to restore vision. Four times daily, one drop of moxifloxacin 0.5% , one drop of dexametasone 0.1% were prescribed for one month, and four times daily, one drop of the polivinil alcohol povidin combination was admin- istered for six months postoperatively. She could not come for follow-ups due to the COVID pandemi for two years. We observed multiple whitish, different sized, opaque, some round shaped, some flat shaped, material changes on the Keraklear prosthesis. We considered these presipitats as glistening formations which are commonly observed on intraocular lenses (IOLs). The patient was very pleased with her vision, and no other complications were observed. This is the first documented case of glistening formation in Keraklear keratho- prothesis. This phenomenon can be considered as one of the complications of Keraklear. The glistenings did not change the vision of our patient. Therefore, this does not change the fact that Keraklear is a very valuable alternative for patients who are at high risk for traditional penetrating keratoplasty. EP-COR-30 Topical anesthetic abuse keratopathy D. Ivanova1, M. Yaneva1 1’Zora’ Eye Clinic, Sofia, Bulgaria Purpose: The aim of this case report is to describe the clinical course and treatment of topical anesthetic abuse keratopathy and to emphasize on the im- portance of its early identification for better visual outcome. Methods: A 48-year-old male presented to our department with symptoms of bilateral intense pain, tearing and discharge. He reported an incident during work three weeks ago with limewater. Immediately after that the patient had an eyewash done by an ophthalmologist and was prescribed Ciprofloxacin drops. Our first slit lamp examination revealed bilateral epiphora, purulent discharge, reflex blepharospasm, central corneal erosions in both eyes with initial corneal melting in the right eye, whitish circular lesions in the periph- eral stroma, Descemet’s membrane folds in the left eye. Results: After thorough investigation, we discovered that the patient had been putting Proparacaine drops 10 times a day for 20 days. We initiated intensive therapy with antibiotic drops, artificial tears, Dexpanthenol and lubricating gel at bedtime. The patient was followed every 3 days. One month later he had a BCVA=1.0 in both eyes, completely epithelialized corneal defects and residual nubeculae. Conclusions: Toxic keratopathy is not an uncommon clinical occurrence. Topical anesthetic abuse causes various ocular complications - punctate kera- topathy, persistent epithelial defects, stromal infiltrates and secondary infec- tious keratitis. Topical anesthetics act both directly and indirectly on the cor- nea. They have toxic effects on the epithelium and slow the healing process as they disrupt epithelial motility complexes like vinculin and actin filaments. Topical anesthetic agents and the preservatives damage tear film stability and diminish reflex tear production. Differential diagnosis is important. The prognosis is variable and depends on the time for diagnosis, the frequency of instillation, the concentration of the drug and the patient cooperation. EP-COR-31 Herpetic necrotizing stromal keratitis with corneal microperforation: a case report A. Hovhannisyan1 1Clinic N19, Ophthalmology, Yervan, Armenia Purpose: To describe the management of herpetic necrotizing stromal kerati- tis in a clinical case. Methods: This case report details the presentation of a 28-year-old female with a known history of recurrent herpetic epithelial (dendritic) keratitis since childhood. She presented with complaints of pain, blurred vision, and con- junctival injection in her left eye. Results: SL examination revealed an anterior stromal infiltrate without an epi- thelial defect, corneal edema, keratic precipitates, and mild anterior chamber inflammation. The initial diagnosis was herpetic keratouveitis. Despite treat- ment with systemic antivirals, topical steroids, and cycloplegic agents, the patient’s condition deteriorated. New findings included an epithelial defect, ulceration, stromal necrosis, cor- neal microperforation, deep stromal infiltration, and deep stromal neovascu- larization, confirming the diagnosis of herpetic necrotizing stromal keratitis. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 87

ELECTRONIC POSTER PRESENTATIONS In response, the treatment regimen was adjusted to include both topical and systemic antiviral medications, autologous serum eye drops, artificial tears, a bandage contact lens. After 2 weeks, subtenon steroid injections and mild steroid eye drops were added to the treatment. Two months following the initiation of treatment, the stromal infiltrate had resolved, inflammation had subsided, and the corneal microperforation had healed, leaving a mild anterior stromal scar. Conclusion: Herpetic stromal keratitis is a common recurrent complication of HSV, affecting approximately 20% of patients with ocular HSV. The inflam- mation results from the retention of viral antigens within the corneal stroma. Necrotizing stromal keratitis, however, is a rare and severe complication that occurs due to direct viral invasion of the corneal stroma. This intense inflam- mation can lead to rapid corneal thinning and perforation if not promptly EP-COR-33 Visual Rehabilitation in a Patient with a History of Herpetic Keratitis, Penetrating Keratoplasty and Severe Limbal/ScleralThinning S. Nahapetyan1, A. Hovakimyan1 1S.V. Malayan Ophthalmological Center, Eximer Laser Surgery, Cornea, Yerevan, Armenia Purpose: To report the visual rehabilitation of a 36-year-old female with a history of herpetic keratitis, penetrating keratoplasty, and severe limbal and scleral thinning. treated. Early diagnosis and tailored treatment are essential to prevent corneal Method: The patient presented to the Cornea Department with complaints perforation and preserve vision. EP-COR-32 Anterior segment OCT findings of herpes stromal keratitis I. Gavryliak1, N. Greben1 1Bogomolets National Medical University, Ophthalmology, Kyiv, Ukraine Purpose: To present a case of herpes stromal keratitis and describe the AS- OCT findings. Report of case: A 25-year-old patient presented to the clinic with complaints of blurred vision and gradual decrease in vision in the right eye over the past year.The patient had a history of stromal herpetic keratitis of the right eye for the first time 4 years ago. There were no systemic complaints or significant family history. On ophthalmologic examination, the best-corrected visual acu- ity in the right eye was 0.02. Slit-lamp examination revealed normal conjunctiva, deep corneal stromal neo- vascularization, and discoid stromal infiltrate. Intraocular pressure was 19 mm Hg in the right eye, and fundus examination was normal in the visible field. On the AS-OCT images corneal scar was hyperreflective, with well-defined, sharp edges and intact epithelium layer. Hyporeflective areas were also found against the background of general corneal hyperreflectivity, consistent with neovascularization. Whereas, corneal infiltrates in herpetic keratitis have rounded edges and hy- perreflective areas. The corneal thickness was determined in the zone of opac- ity at the level of 487 mm. Post-treatment monitoring showed a decrease in the infiltrate area, which corresponded to the area of decreased hyperreflectivity, with clear rounded edges, intact epithelium, and endothelial heterogeneity. In the dynamics of 1 month, the area of neovascularization remained un- changed. AS-OCT in herpes keratitis allows for additional visualisation of changes in the cornea, the area of opacity and depth, and to monitor changes during treatment. of visual loss and cosmetic concerns. Her ocular history included herpetic keratitis during early childhood, resulting in corneal scarring and a penetrating keratoplasty performed 30 years ago. Slit lamp examination revealed complete conjunctivalization of the cornea, vascularization, and total opacification. B-scan ultrasonography confirmed an attached retina. The patient underwent conjunctival-limbal autotransplan- tation, followed two years later by penetrating keratoplasty using a 6 mm trephination, combined with cataract extraction and intraocular lens (IOL) implantation. Results: One month postoperatively, visual acuity improved to 0.08, limited by amblyopia. The intraocular pressure remained within normal limits, and the corneal graft was clear. The patient was prescribed topical steroid drops and oral Acyclovir, with recommendations to continue the treatment for at least two years. Conclusion: This case demonstrates that a combination of conjunctival-lim- bal autotransplantation and subsequent penetrating keratoplasty can achieve significant visual rehabilitation and cosmetic improvement in patients with severe corneal pathology and scleral thinning. Prolonged antiviral and anti- inflammatory therapy are crucial to maintaining graft clarity and preventing recurrence in patients with a history of herpetic keratitis. EP-COR-34 Corneal regeneration with fresh lenticule transplantation for keratoconus with 5-year follow-up results C.E. Semiz1, M. Purelku2, F. Semiz1, G. Tanrıverdi3, F.F. Arslan4, N.H. Musa1 1Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 2Bahcesehir University, Histology and Embryology, Istanbul, Turkey, 3Istanbul- Cerrahpasa University, Histology and Embryology, Istanbul, Turkey, 4Istanbul-Cerrahpasa University, Ophthalmology, Istanbul, Turkey Purpose: To identify, quantify and understand the presence and role of active progenitor cells and telocytes (TC) in the human cornea using immunohisto- chemical staining and double immunofluorescence analysis. Setting: Eye Hospital, Prishtina, Kosovo. Methods: In this study, 60 eyes with advanced keratoconus underwent fresh myopic lenticule transplantation using lenticules from small incision lentic- ule extraction procedures. Six samples were analyzed: one from an untreated keratoconic eye and five from treated eyes at 1, 2, 3, 4, and 5 years post- surgery. A lenticule measuring 6.6 mm in diameter and 20 μm thick, with a refractive power of -0.75 D, was extracted from a patient with a preoperative 88 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS central corneal thickness of 419 μm. From five treated patients, a lenticule with a diameter of 6.60 mm, a thickness of 120 μm, and a refractive power of -6 D was removed intact. These lenticules underwent meticulous tissue pro- cessing for immunohistochemical staining with CD34 antibodies and double immunofluorescence analysis with CD34/PDGFR-β and CD34/c-kit. Results: In the untreated keratoconic lenticule, CD34 staining revealed ir- regular, thinned collagen fibers and cells with degenerative characteristics. In contrast, postoperative samples exhibited healthy stromal cells with TC mor- phology. Analysis of six regions of interest showed a progressive increase in CD34- positive cells from 1 to 3 years postoperatively, followed by a decline by year 5, with the keratoconus group consistently exhibiting lower CD34-positive cell counts throughout. Additionally, double immunofluorescence analysis confirmed the presence of TCs in the postoperative samples. Conculusion: The analysis highlights a significant reduction of progeni- tor cells and TCs in the keratoconus sample, along with dynamic changes in CD34-positive cell density during post-surgical corneal maturation, suggest- ing their critical role in corneal pathology. EP-COR-35 Predictors of corneal endothelial viability in stored corneal grafts P. Martins1, D. Ferreira Cardoso1, R. Machado Soares1, A.C. Ribeiro1, C. Arêde1, J. Sequeira1 1Unidade Local de Saúde de Gaia e Espinho, Ophthalmology, Gaia, Portugal Purpose: To evaluate the impact of preservation duration on the endothelial quality of corneal grafts and to identify the most effective parameters for qual- ity control of these grafts Methods: Retrospective analysis of specular microscopy data from cor- neal grafts collected by the Cornea and Amniotic Membrane Department of Unidade Local de Saúde Gaia e Espinho between 2021 and 2024. According to department protocol, corneal grafts are stored at 4ºC in Optisol-GS (Bausch and Lomb, Rochester, USA) solution, and specular microscopy is performed at 24 hours (D0), day 5 (D5), and day 10 (D10) post-harvest. Only grafts with at least two specular microscopy exams (D0-D5) before transplantation were considered. Data collected included donor age, endothelial cell density (ECD), hexagonality (HEX), and coefficient of variation (VC) at all time points. Data were compared across all time points using repeated-measures ANOVA ad- justed for confounders, with a significance level set at 0.05. Results: Of the 93 corneal grafts, 58 met the inclusion criteria, with 12 hav- ing specular microscopy analysis at D10. The mean donor age was 61.7±12.9 years. Mean ECD was 2846±434 cells/mm² at D0, 3025±535 cells/mm² at D5, and 2880±440 cells/mm² at D10. Mean HEX was 58.7±11.7% at D0, 51.1±10.5% at D5, and 49.6±12.3% at D10. Mean VC was 34.0±6.7% at D0, 37.9±6.2% at D5, and 38.5±8.7% at D10. Variations in HEX and VC between D0 and D5 were statistically significant (p<0.001), while no significant differ- ence was found between D5 and D10 (p=0.915 and p=0.274, respectively). These differences were independent of graft donor age (p>0.05). Conclusion: In this study, preservation time affects the endothelial quality as represented by the decrease of cell HEX and increased VC, especially in the first days of preservation (D0-D5) while this effect is more attenuated between D5 and D10. Moreover, these two parameters might be more reliable markers of endothelial cell quality in corneal grafts during preservation compared to ECD as this measure is more prone to exam variation as seen in our results. EP-COR-36 Optimizing fungal keratitis treatmen: insights into intrastromal injection strategies S. Layachi1, J. Chafi1, H. Ouazzani Touhami1, Y. Hidan1, M.R. Bentouhami1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1University Hospital Center Ibn Rochd, The Adult Ophthalmology Department, of the 20 August 1953’s University Hospital Center, Casablanca, Morocco Purpose: To evaluate the effectiveness of intrastromal injections in the man- agement of fungal keratitis. Method: We report a case hospitalized for a corneal abscess of the right eye. She presented with a painful red eye and a decreased visual acuity, one month prior to her admission, following the use of a kohl pencil and self-medication by medicinal herbs «Mugwort». Her slit-lamp examination found a visual acu- ity at hand motion, a conjunctival hyperemia, an important corneal edema, some Descemet membrane folds, a temporal para-axial stromal infiltration with some satellite infiltrates. The medical treatment was based on fortified eye drops of Ceftazidime, Vancomycin and Voriconazole, with oral antibiotic therapy and antifungal without notable improvement. Then we initiated in- trastromal injections of Voriconazole using the protocole: 3 injections spaced one week apart. Results: Our patient’s evolution was marked by an increased visual acuity, a reduction in infiltration, healing of the ulceration and a reduction in cor- neal thinning on the anterior segment optical coherence tomography. Due to difficulty of treatment and poor prognosis, the management of deep fungal keratitis requires alternative pathways to topical or oral treatments, such as intrastromal injections of antifungals.The stromal injection technique used in our patient presents many advantages: targeted delivery, better penetration, slow drug release and less epithelial toxicity. Conclusion: Infectious fungal keratitis is a major cause of vision loss and blindness. Rapid diagnosis and targeted treatment are essential to its manage- ment. Intrastomal injections are an effective mean of administring antifungals directly to the site of infection, and thus allowing appropriate management of deep and recalcitrant fungal keratitis. EP-COR-37 Surgical treatment of pterygium: what about primary conjunctival closure? P. Hübnerová1, B. Chrapková1, P. Hrabčíková1, K. Vránová2, M. Karhanová1 1University Hospital Olomouc, Department of Ophthalmology, Olomouc, Czech Republic, 2Gemini Eye Clinic, Zlín, Czech Republic Purpose: The purpose of this study was to assess the frequency and indica- tions for the ‚primary conjunctival closure’ (PCC) surgical technique used for pterygium treatment in our clinic. Additionally, we aimed to determine the re- currence rate following PCC and the average time from surgery to recurrence. Methods: In a retrospective study, we analyzed data from patients operated on at the Department of Ophthalmology, University Hospital Olomouc, using the surgical treatment of pterygium PCC between 2010 and 2022. Information about pterygium size and localization, perioperative use of Mitomycin C, postoperative complications and recurrences (and their timing) were collected and analyzed. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 89

ELECTRONIC POSTER PRESENTATIONS Results: In total, we analyzed data from 225 patients (257 eyes), consisting of 123 men (54.7%) and 102 women (45.3%) who underwent the PPC. The EP-COR-39 average age of the patients was 57 years (25-87 years). In the group, the pro- portion of operations on the right eye was 54.5% (140), while 45.5% (117) Corneal endothelial cell transplantation in patients post chemical injury were on the left. The procedure was performed on both eyes in 14.2% (32 patients). The aver- age lesion size overgrowing the limbus was 2.7 mm (1 – 5 mm). Recurrence requiring surgical treatment was recorded in 49 cases (19.1%) at an average of 4.45 years after primary excision (4 months - 16.4 years). Mitomycin C was used in 69.4% of recurrences, whereas it was used primarily in only 3.9% of operations. Conclusion: Although the PCC method is still used in many eye clinics worldwide for its time-saving benefits and ease of learning, our findings reveal a relatively high recurrence rate. This aligns with results from other studies, suggesting that the method may be considered somewhat obsolete. Surgeons should carefully weigh the benefits and risks of using PCC, not- ing that it requires regular patient monitoring. While employing Mitomycin C may reduce the need for repeat surgeries, autografting remains the gold standard due to its lower recurrence rates. EP-COR-38 Botox-induced dry eye syndrome model via lacrimal gland injection Y.-C. Ting1, Y.-H. Wang2, C.-Y. Chen1, H. Lee1, T.-J. Wang1 1Wan Fang Hospital, Taipei, Taiwan, 2Wan-Fang Hospital, Taipei, Taiwan Purpose: To develop a new dry eye syndrome (DES) animal model by in- jecting botox into the lacrimal glands (LGs) of rabbits evaluated by clinical examinations. Materials and methods: A volume of 0.1 mL of botox solution was injected in the LG and the infraorbital lobe of the accessory LG of rabbits for DES induction. Twenty male rabbits were separated into three groups, the control group, and different concentration of botox. Botox-treated groups received bo- tox twice injection on day 0 and day 7. Assessment of DES included changes in tear production (Schirmer’s test), fluorescein staining pattern, conjunctival impression cytology, and corneal histological examination. Results: After botox injection, the cornea revealed decreased tear secretion after injection Fluorescent staining showed punctate keratopathy in Botox -treated groups. Botox-treated groups demonstrated decreased numbers of conjunctival goblet cells after injection. Conclusion: This model induced decreased tear production, punctate kera- topathy, and decreased numbers of goblet cells, which are consistent with the current understanding of DES. Therefore, injecting botox into the LGs is an easy and reliable method to establish a rabbit DES model which can apply in new drug screening. Keywords: Animal model; dry eye syndrome; goblet cells; lacrimal gland; botox; rabbit; tear production. M. Doctor1, S. Basu2 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Hyderabad, India Purpose: To report management of endothelium dysfunction and surgical planning in patients of chemical injury. Methods: Here we discuss 2 cases of chemical injury, who underwent simple limbal epithelial transplantation, but had persisting cornea edema and haze, who were later suspected to have endothelial dysfunction. They were treated with Descemet stripping endothelial transplantation. Hence we discuss the nu- ances involved in identification as well as surgery in such patients. Conclusion: Chemical injury can cause endothelial dysfunction. It can be missed due to the compromised anterior chamber visualisation due to overly- ing corneal pannus, corneal scarring, surface inflammation and surface pathol- ogy. Co-existing endothelial damage when left unrecognized or untreated, would contribute to the recurrent epithelial breakdowns, eventually worsening the al- ready compromised ocular surface. Hence it is important for ophthalmologist treating these patients to timely recognize and address the issue appropriately. It is extremely essential to be aware about how to plan and perform corneal endothelial transplantation in these patients, which we plan to address in this case report. EP-COR-40 Management of microbial keratitis in a patient with severe ichthyosis M. Doctor1, S. Gupta2 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Hyderabad, India In this report, we present the case of a 26-year-old gentleman, a known case of ichthyosis, who presented with left eye redness, pain, and watering for 1 week. He had reduced vision in both eyes since the past 10 years, which suddenly worsened in the left eye 1 week ago, after an insect fell into his eye. He was instilling inadequate dose of lubricants and topical fluoroquinolones which was prescribed by a local ophthalmologist when he presented to us. General examination showed short stature, generalised coarse brown scales, eclabium, palmoplantar keratoderma and distorted toes. Ocular examination showed matted eyelashes, upper and lower lid ectropion with thickened lid margins, loss of meibomian glands and lid margin kerati- nisation in both eyes. The cornea of the right eye had central vascularised adherent leucoma. Left eye cornea had dendritic epithelial defect, anterior to mid stromal infiltration with peripheral corneal vascularisation. A provisional diagnosis of Herpes Simplex virus (HSV) stromal keratitis with ulceration was made and corneal scraping for microbiological confirmation was planned. Smear and culture for bacteria and fungi were negative, while real time-polymerase chain reaction (RT-PCR) and immunofluorescence assay (IFA) testing for herpes simplex virus-1 (HSV) was positive. Treatment with oral acyclovir and topical steroids resulted in a significant re- duction in size of the stromal infiltrate and epithelial defect. At the last follow- up 20 days later, his visual acuity improved to 20/80 as compared to counting 90 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS fingers close to face as noted on the first visit. With this case we plan to discuss the various ocular manifestation in a patient with ichthyosis, and we highlight EP-COR-42 the challenges faced in management of microbial keratitis in such patients. EP-COR-41 A retrospective study of the characteristics and clinical outcomes of traumatic corneal perforation cases in the Midlands, United Kingdom T.C.J. Wong1, A.H.Y. Liu1, A. Mitra2, A. Barua2 1The Chinese University of Hong Kong, Department of Ophthalmology and Visual Sciences, Hong Kong, Hong Kong, SAR of China, 2Birmingham & Midland Eye Centre, Birmingham, United Kingdom Influence of the pandemic period on corneal ulcer characteristics E. Bendelic1, A. Paduca1, A. Corduneanu1,2, I. Jeru1, C. Scerbatiuc1, M. Iacubitchii1, C. Ceban1, L. Macovei2 1Nicolae Testemitanu State University of Medicine and Pharmacy, Ophthalmology, Chisinau, Moldova, Republic of, 2Timofei Mosneaga Clinical Republican Hospital, Ophthalmology, Chisinau, Moldova, Republic of Corneal ulcer, a significant cause of blindness in developing countries, often arises from compromised corneal defense mechanisms, with fungal keratitis being a major concern. Purpose: To investigate the epidemiological and aetiological patterns of fungal corneal ulcers and associated risk factors in patients treated at the Corneal perforation is a frequent complication of ocular trauma and risks significant visual impairment without timely treatment. However, there is a lack of comprehensive updated research on the epidemiology and surgical Republican Hospital, Republic of Moldova, from January to December 2022. Methods: This prospective study included 58 consecutive corneal ulcer cases, with laboratory-proven fungal or bacterial etiology. Clinical and slit-lamp ex- outcomes of traumatic corneal perforation cases in the United Kingdom, par- aminations were conducted, followed by microbiological analysis of corneal ticularly the Midlands. This study aims to assess the characteristics of patients scrapings. with traumatic corneal perforation and review their surgical outcomes. A single-centre retrospective study was conducted on patients presented with traumatic full-thickness corneal perforation from January 2022 to July 2024 and had surgery. Birmingham Eye Trauma Classification was used to classify the features of ocular trauma. Surgical outcomes were evaluated with best- corrected visual acuity (BCVA) and intraocular pressure (IOP) at presentation, immediately post-operation and three-months post-operation. 24 cases (White, 41.7%; Asian, 33.3%; not specified, 25%) were recorded. Mean age was 42.2 years (SD=18.6). There were no differences in eye lat- erality (left, 54.2%). Males (85.7%) had a higher rate than females. 58.3% had globe rupture, 8% open wounds, and 20.8% involved intraocular foreign bodies. At presentation, mean BCVA was 2.24 logMAR without significant changes post-operation (2.10) and 3-months (1.91). Average IOP at presen- tation (5.71) improved and stabilised at 13.4 and 14 at post-operation and 3-months respectively. This study presented the updated epidemiology and clinical outcomes of trau- matic corneal perforation cases in the Midlands. Unfortunately, most patients (75%) had severely impaired vision upon presentation and their BCVA were not enhanced to within normal range after surgery. However, IOP was enhanced overall with a positive and stabilised outcome. Our results show that timely operation to mitigate post-trauma hypotony is key to avoid further damage to ocular structures, and the potential develop- ment of systemic damage or need for prosthetic eye surgery. Data on demographics, predisposing factors, clinical presentations, treat- ments, and outcomes were recorded. First-line treatment included fluconazole eye drops, with surgical interventions like penetrating keratoplasty and con- junctivoplasty performed in severe cases. Results: Most patients were males (67.24%), aged 60–80 years, and from rural areas (77.59%). Ocular trauma (86.2%) and prior antibiotic use (82.7%) were the predominant risk factors. Pure fungal infections were identified in 25.86% of cases, while 7.41% had mixed bacterial and fungal etiologies. Early presentation (≤3 days) occurred in only 24.1% of cases, reflecting de- layed access to care, with severe outcomes including perforation (25.86%), evisceration (8 cases), and enucleation (1 case). Despite a 74.13% treatment success rate, challenges persist due to late presentations, economic barriers, and limited resources. Conclusions: The study highlights the need for early diagnosis, public health education, and improved accessibility to antifungal therapies to mitigate fun- gal keratitis’s significant public health and economic burden. EP-COR-45 Innovative use of autologous serum for neurotrophic ulcer healing: a case report S. Layachi1, H. Ouazzani Touhami1, S. Bouderka1, Y. Hidan1, M.R. Bentouhami1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1University Hospital Center Ibnou Rochd, Adult Ophthalmology Department, of the 20 August 1953’s University Hospital Center, Casablanca, Morocco Purpose: The aim of this study is to report the effectiveness of autologous se- rum in the management of neurotrophic ulcers with delayed epithelial healing. Method: A 57-year-old female patient, with a history of three recurrent epi- sodes of right eye redness, was referred to our ophthalmology department for delayed corneal healing. She had been receiving antiviral treatment for two months for herpes simplex keratitis of the right eye, without notable im- provement. Upon examination, her right eye showed a visual acuity of 1/10, conjunctival hyperemia, reduced corneal sensitivity, corneal edema, a central Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 91

ELECTRONIC POSTER PRESENTATIONS corneal scar from 9 to 7 o’clock, a para-axial inferior-temporal corneal ulcer measuring 3x3mm, dense superficial punctate keratitis, neovascularization at 7 o’clock, a quiet anterior chamber, and an opalescent lens. The initial treat- ment included full-dose valacyclovir and preservative-free artificial tears. While there was a reduction in symptoms, the ulcer did not heal after one month of treatment. Therefore, autologous serum therapy was initiated, with one drop administered four times daily. Results: After starting the autologous serum treatment, the patient’s visual acuity improved to 7/10, and the corneal ulcer healed completely. Conclusion: Corneal ulcers are a severe condition that threatens the anatomi- cal integrity and transparency of the cornea, ultimately impacting vision. The management of these ulcers remains challenging, particularly when they are resistant to conventional treatments. Alternative therapies, such as autologous serum, amniotic membrane, and matrix therapies, offer promising solutions in cases of persistent or non- healing corneal ulcers. Autologous serum, in particular, has proven to be an effective treatment for neurotrophic ulcers, with no major adverse side effects reported. EP-COR-48 From nature to nurture: use of essential oils for management of fungal keratitis J.P. Costa1,2, C. Costa2, E. Akegbe3, J. Pinheiro Costa4, D. Pinheiro4, N. Mesquita5, C. Cabral6,7,5,8, A. Carmo2, R. Tomé2, E. Julião Campos6,3,7,9,10, E. Costa2,6,3,11, J. Gil2,6,3,11, A. Rosa2,6,3,11, M.J. Quadrado2,6,3,11 1Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, Portugal, 2Unidade Local de Saúde de Coimbra, Coimbra, Portugal, 3Faculty of Medicine of the University of Coimbra, Coimbra, Portugal, 4Unidade Local de Saúde de São João, Porto, Portugal, 5University of Coimbra, Centre for Functional Ecology (CFE), Life Sciences, Coimbra, Portugal, 6Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal, 7University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal, 8University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal, 9University of Coimbra, Centre for Chemical Engineering and Renewable Resources for Sustainability (CERES), Department of Chemical Engineering, Coimbra, Portugal, 10University of Coimbra, Center for Neuroscience and Cell Biology (CNC-UC), Coimbra, Portugal, 11Unidade de Oftalmologia de Coimbra, Coimbra, Portugal Purpose: Over the past decades the incidence of fungal keratitis (FK) has been increasing. Compounding the problem, there is emerging resistance to the commonly prescribed drugs for managing this condition. Therefore, al- ternative therapeutic approaches for FK have been sought, such as the use of essential oils (EOs). Our purpose was to evaluate the antifungal efficacy of Eos extracted from two medicinal plants: Lavandula pedunculata (Mill.) Cav. and Cymbopogon citratus (DC.) Stapf, against FK pathogens. Methods: Corneal specimens were collected from patients suspected of hav- ing FK at 3 Portuguese primary academic hospitals. Identified fungi had their susceptibility to the selected EOs assessed at various concentrations, through in vitro solid-phase disk diffusion assays. The inhibition zone diameters (IZD) were recorded on the 3rd, 5th, 7th and 14th day of incubation. Results: Fourteen positive samples were obtained. A predominance of Candida albicans and Candida parapsilosis was observed, and both microor- ganisms were used for the antifungal assays, along with Aspergillus fumigatus and Scedosporium apiospermum . C.citratus demonstrated complete inhibi- tion of A. fumigatus and S. apiospermum across all concentrations. Against Candida species, the IZD for C. citratus increased over time. L. pe- dunculata displayed initial high activity against A. fumigatus and S. apiosper- mum, with a decrease in IZD over time. Its effectiveness against Candida spe- cies demonstrated concentration and time-dependent variability. Conclusions: Our work showed that C. citratus and L. pedunculata EOs may be useful antifungal agents against FK pathogens, potentially providing a base for the development of new FK treatments, alone or as adjuvants. The efficacy of C. citratus against a range of fungal pathogens supports its potential use in clinical practice, while L. pedunculata requires further studies to clarify its antimicrobial potential. EP-COR-50 Descemetorhexis without endothelial keratoplasty (DWEK) With the different diameters of descemetorhexis for treatment of fuchs endothelial corneal dystrophy (FECD) I. Shargorotska1, I. Kovalov1, A. Kovalov2 1National Medical Univercity by A.A. Bohomolets, Ophthalmology, Kiyv, Ukraine, 2AILAS Medical Center, Ophthalmology, Kyiv, Ukraine Purpose: To compare the functional results of the treatment (DWEK) of pa- tients with FECD by creating descemetorhexisis of different Diameters. Method: This is a retrospective study of 18 eyes (16 patients) with mild to moderate FECD (with corneal guttae limited to the central cornea and periph- eral endothelial cells count 1200 - 3100). In 16 eyes DWEK was performed at the end of phacoemulsification after the IOL implantation. In 2 eyes DWEK was a separate surgery at the eyes with artiphakia. In 12 eyes descemetorhexi- sis were created of 4.0 - 5.0 mm. In 6 eyes - 5.5 - 6.5 mm. Results: The average postoperative time of corneal rehabilitation with the “restoration” of corneal transparency, central corneal thickness, and the pos- sibility of central endothelial cell count for the eyes with small DWEK (4.0 – 5.0 mm) was 7.7 ± 3.1 weeks. For the eyes with bigger DWEK (5.5 – 6.5 mm) – 8.8 ± 3.5 weeks. 2 eyes with small DWEK did not restore the corneal integrity, and additional keratoplasty was performed. Conclusion: DWEK is effective for the treatment of selected patients with mild to moderate FECD. Although the recovery time after bigger descem- etorhexis is longer the crucial not the diameter of it, but the removal of the majority of confluent guttae. 92 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-COR-51 EP-COR-52 Evaluating keratoconus online resources: Portugal and Brazil insights Post-herpetic neurotrophic keratitis: a personalized therapeutic approach T. Machado1,2, C. Costa1,2, R.S. Oliveira1,3, J. Gil1,2,4,5, E. Costa1,2,4, C. Tavares1,2,4,5, A. Rosa1,2,4,5, M.J. Quadrado1,2,4,5, J. Murta1,2,4,5 1Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Ophthalmology, Coimbra, Portugal, 2Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal, 3Universidade Federal de São Paulo, Ophthalmology, São Paulo, Brazil, 4Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal, 5Unidade de Oftalmologia de Coimbra, Coimbra, Portugal Purpose: Patients with keratoconus frequently seek online information to un- derstand their condition. However, online content lacks standardized quality control, raising concerns about its accuracy. To assess the quality and readabil- ity of keratoconus-related information accessible on Portuguese and Brazilian websites. Methods: Two independent ophthalmologists, alongside a supervising oph- thalmologist, evaluated 30 Portuguese and 30 Brazilian websites identified through Google searches using the terms “Queratocone” and “Ceratocone,” respectively, ranked by order of appearance. Two quality scores were used: a quality index of consumer health information (DISCERN) and the Journal of the American Medical Association (JAMA) benchmark criteria. Readability was analyzed using three metrics: Flesch-Kincaid Reading Ease (FRE), Flesch-Kincaid Grade Level (FKG), and the Automated Readability Index (ARI). Results: Websites from private hospitals or clinics were the most common in H. Ouazzani Touhami1, S. Layachi1, J. Chafi1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Neurotrophic corneal ulcers are a serious complication of her- petic keratitis, caused by damage to corneal nerves, leading to loss of sensitiv- ity and impaired healing. Treatment options include antiviral agents, antibiot- ics, and, in some cases, autologous serum. Case report: A 63-year-old chronic smoker with no significant ophthalmolog- ical history presented with a painful red eye and decreased visual acuity evolv- ing for the past two weeks. Ophthalmological examination of the affected eye revealed visual acuity limited to counting fingers at 2 meters. Findings included conjunctival hyperemia, reduced corneal sensitivity, and a central corneal ulcer measuring 2.5 mm by 1.5 mm, associated with an epithe- lial defect, a perilesional edema and corneal thinning. Anterior segment OCT confirmed significant corneal thinning. Initial treatment included high-dose valacyclovir, local antibiotic therapy, ocular irrigation, and artificial tears. After one month of treatment, functional symptoms improved, but the ulcer’s healing remained incomplete. A course of autologous serum was then initiated. This approach resulted in visual acuity improvement to 1/10 and complete ulcer healing. Discussion: Post-herpetic neurotrophic ulcers present a significant therapeu- tic challenge in ophthalmology due to compromised healing associated with both countries, followed by health platform sites. JAMA benchmark scores corneal sensory loss. were 1.13 ± 1.18 for Portugal and 1.07 ± 1.00 for Brazil, while DISCERN This case highlights the critical role of autologous serum, which provides es- scores averaged 34.07 ± 11.71 in Portugal and 38.17 ± 10.51 in Brazil. Readability assessments indicated that FRE and FKG scores classified the content as “difficult to read” and appropriate for a “college school level” audi- ence. The ARI suggested comprehension levels equivalent to a “professor” in Portugal and a “college student” in Brazil, revealing a statistically significant difference. No correlation was found between Google ranking and the quality or readability scores. sential growth factors and proteins for epithelial regeneration. In refractory cases, this approach facilitates healing and helps prevent severe complications such as corneal perforation. Conclusion: An adapted and proactive therapeutic approach is essential for managing neurotrophic ulcers, particularly when conventional treatments fail. Autologous serum proves to be a valuable solution for restoring corneal integ- rity and improving visual acuity. Personalized management and close moni- Conclusions: Online information for Portuguese-speaking keratoconus pa- toring remain key to achieving a favorable prognosis. tients is generally low quality and challenging to comprehend. Addressing this issue requires a collective effort from ophthalmologists to improve resource accessibility and reliability. Guiding patients to reputable websites can help them navigate their condition more effectively and make well-informed deci- sions. EP-COR-53 Contact lens-related infectious keratitis: risk factors and preventive strategies H. Ouazzani Touhami1, K. Selmani1, I. Omari1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Contact lenses (CL) are essential medical tools primarily used for correcting refractive errors, providing both visual and aesthetic benefits. However, their use is associated with an increased risk of complications, par- ticularly infectious keratitis (IK). This case report discusses a corneal abscess related to CL use, highlighting risk factors (RFs) and preventive strategies to reduce the likelihood of IK. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 93

ELECTRONIC POSTER PRESENTATIONS Method: A 35-year-old female with high myopia and a 10-year history of wearing soft CL presented to the emergency department with a painful red eye EP-COR-55 and reduced visual acuity. Symptoms followed prolonged lens wear and poor hygiene practices. On examination, visual acuity in the affected eye was limited to hand motion. Clinical findings included purulent secretions, conjunctival hyperemia, and a 2x2 mm central corneal abscess with perilesional edema. Fluorescein staining measured 5x2 mm. Anterior segment OCT confirmed stromal infiltration with corneal thinning, and ocular ultrasound revealed a clear vitreous. Microbiological analysis of corneal scrapings, along with the CL and storage case, isolated Pseudomonas aeruginosa sensitive to tobramycin. Results: The patient was initially treated with fortified ceftazidime and van- comycin eye drops, later transitioned to tobramycin based on antibiogram re- sults. Complete resolution of symptoms and corneal healing were achieved within 10 days of treatment. Discussion: Wearing CL is a major RF for IK, with poor hygiene, prolonged wear, and improper cleaning being the most critical modifiable factors. Addressing these through targeted education and preventive measures is es- sential to minimize the risk. Conclusion: The use of CL must be approached with caution, and proper fit- ting should always be conducted as a medical procedure. Many RFs associated with IK are preventable through improved education and awareness, empha- sizing the importance of proper hygiene and safe handling practices. EP-COR-54 Effects of pseudoexfoliation syndrome on corneal endothelial morphology J. Alves Ambrósio1, P. Cardoso Teixeira1, M. Garcia1, J. Chibante Pedro1, J. Jesus1, I. Almeida1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal Purpose: To evaluate the effect of pseudoexfoliation syndrome (PEX) on cor- neal endothelial morphology using specular microscopy and assess its clinical implications. Methods: This retrospective cross-sectional study analyzed 185 eyes with PEX and 128 age-matched control eyes without PEX. Specular microscopy measured endothelial cell count (ECD), polymegathism, pleomorphism, cell area, and central corneal thickness (CCT). Intraocular pressure (IOP) was also recorded to evaluate its association with endothelial changes. Results: The PEX group (mean age 77.4 ± 7.2 years, 58.9% female) had a sig- nificantly lower ECD than controls (2377.6 ± 313.3 vs. 2447.3 ± 269.9 cells/ mm², p = 0.042) and larger average cell area (415.0 [385.0; 449.5] vs. 409.0 [380.5; 437.8], p = 0.032). The coefficient of variation was lower in PEX (38.0 [35.0; 43.0] vs. 41.0 [36.0; 45.0], p = 0.030), while CCT was greater (539.3 ± 36.5 µm vs. 529.7 ± 36.2 µm, p = 0.021). Elevated IOP was more frequent in PEX (37.3% vs. 5.5%, p < 0.001). No significant differences were found for pleomorphism or other cell area parameters. Conclusions: PEX is associated with reduced ECD and increased CCT, sug- gesting a predisposition to corneal endothelial dysfunction that may com- plicate surgical interventions. The high prevalence of elevated IOP in PEX underscores the importance of early detection and management. Variability in corneal measurements across studies highlights the need for further multicent- er research to clarify the relationship between PEX and endothelial changes. Keratitis combined with trachoma in an ocular cicatricial pemphigoid suspect case K. Eder1,2, P. Langosz1, D. Wyględowska-Promieńska1,2, A. Smędowski1,2,3 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, 3GlaucoTech Sp. z o.o., Katowice, Poland We present a patient who was referred to us due to keratitis, with prior diagno- ses of POAG and trachoma of the left eye. On examination BVCA was 1.0 in the right eye and LP in the left. Biomicroscopy of the left eye revealed blepharitis, ectropion, conjunctival in- flammation with fibrosis, symblepharon, keratic linear infiltration with limbal neovascularization. Fundoscopy could not be performed due to hazy media, but red reflex was present. Biomicroscopy of the right eye was unremarkable. During hospitalization conjunctival sac swab was performed but both bacte- rial and fungal cultures were negative. Systemic antibiotics with topical treat- ment were implemented. During the hospitalization patient was diagnosed with Ocular Cicatricial Pemphigoid (OCP) stage III (Foster’s Classification) suspect. On subsequent visits linear corneal infiltration was present. Corneal structure and thickness was monitored using AS-OCT. Confocal microscopy was per- formed showing epithelial inflammatory infiltrate, keratomalacia, thickening of the Bowman’s layer and stromal fibrosis. Diagnosis of bacterial keratitis was confirmed. The patient developed corneal limbal cell deficiency and corneal thinning and was admitted for amniotic membrane transplantation due to the risk of corneal perforation. Surgery was performed resulting in corneal thickening with no risk of perfora- tion. Additionally, an Antinuclear Antibody test was performed with negative results. In 5-month observation, the patient was stable. In Biomicroscopy ectropion, conjunctival fibrosis, and symblepharon were present along with limbal stem cell deficiency, neovascularization and linear corneal thinning The patient was referred to the department of ophthalmology for conjunctival biopsy to confirm OCP diagnosis. In a difficult case like the one presented due to other co-occurring disorders - trachoma and keratitis, diagnosis and staging of OCP is challenging, as well as treatment. EP-COR-56 Functional results and prognostic factors in ocular trauma – 6-year study F. Maia1, A.M. Sampaio1, C. Cruz1, K. Sousa1 1Hospital de Braga, Oftalmologia, Braga, Portugal Introduction and Purpose: Ocular trauma is an important preventable cause of vision loss in the developed world, representing a significant burden for both victims and society. This six-year study aims to analyze the clinical profile and prognostic factors of ocular trauma patients admitted to the ophthalmology de- partment at Unidade Local de Saúde de Braga between 2015 and 2021. 94 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS Methods: This retrospective cohort study included 167 patients admitted for ocular trauma between January 2015 and December 2021. Demographic data EP-COR-58 and prognostic factors were collected and subjected to statistical analysis us- ing IBM SPSS Statistics software (version 26). The study employed analysis of variance (ANOVA) for continuous variables and Chi-square or Fisher’s ex- act test for categorical variables to assess statistical significance. Results and Discussion: 167 eyes from 167 patients with ocular trauma were included. The mean follow-up was 34.7 months, and patients’ mean age was 53.9 years, ranging from 3 to 90. Males comprised 77.8% of cases, with most injuries occurring at home (36.5%). Zone I injuries (cornea, limbus) were most common (55.1%), and penetrating injuries accounted for 51.5% of cases (according to Birmingham Eye Trauma Terminology - BETT). Final outcomes included no light perception in 25.7% of eyes and evisceration/enucleation in 15%. Factors associated with poorer visual outcomes (p<0.05) included lower initial visual acuity, advanced age, injury zone, BETT classification, and affected segment (anterior/posterior). Other variables showed no significant correlation with final visual acuity. Conclusion: The current study identified pre-operative variables that signifi- cantly influence final visual outcomes. Understanding these predictors can aid ophthalmologists in managing patient expectations more effectively. This knowledge allows for more informed clinical decision-making and patient counseling in cases of ocular trauma. EP-COR-57 High-fluence photoactivated chromophore corneal cross-linking in the management of infectious keratitis: from best evidence to best practice C. Bonzano1, C.A. Cutolo1, M. Iester1, C.E. Traverso1 1Clinica Oculistica, IRCCS Ospedale Policlinico San Martino, Genova, Italy Purpose: Photoactivated Chromophore Corneal Cross‐Linking (PACK‐CXL) has emerged as a promising treatment for infectious keratitis (IK). This study aims to evaluate the anatomical and functional outcomes of high-fluence PACK‐CXL when used either as a first-line therapy or as a salvage treatment. Methods: A retrospective analysis was conducted. Eyes were divided into two groups: Group A, consisting of IK cases unresponsive to standard antimicro- bial treatments, which received PACK‐CXL as a salvage therapy, and Group B, consisting of IK cases treated with PACK‐CXL as an initial intervention. Success was defined as complete reepithelization and resolution of the infec- tion. Outcomes were assessed using slit-lamp examination, corneal fluorescein staining, best spectacle-corrected visual acuity (BSCVA), and anterior seg- ment optical coherence tomography. Data were analyzed using paired t-tests. Results: A total of 15 eyes with laboratory-confirmed infectious keratitis were included, with a mean age of 58.6 ± 21.8 years. Group A consisted of 3 cases of bacterial keratitis (BK), 5 cases of fungal keratitis (FK), and 1 case of Acanthamoeba keratitis (AK). Group B included 2 cases of BK, 2 cases of FK, and 2 cases of AK. The success rates were 78% for Group A and 100% for Group B. Corneal thickness decreased significantly in both groups: from 816 µm to 671 µm in Group A and from 782 µm to 498 µm in Group B (p<0.01). Visual acuity (LogMAR) improved from 2.28 ± 0.83 to 1.84 ± 0.88 in Group A, and from 1.49 ± 0.76 to 0.20 ± 0.18 in Group B (p<0.01). Conclusion: High-fluence PACK‐CXL shows superior success rates and bet- ter outcomes when used as a first-line treatment. However, it also proves to be effective as a salvage therapy for infectious keratitis. Use of compression sutures and intracameral injection of C3F8 11% gas in the management of acute corneal hydrops in a pediatric patient: a case report M. Mendes Campos da Costa1, R. Machado de Vargas1, J. Pozzolo Ogeda1, G. Souza Gonçalves1, J. Teles Triglia Pinto1 1Associação Beneficente Santa Casa de Campo Grande, Campo Grande, Brazil Patient A.K.M, 6 years-old, presented to the ophthalmologic emergency room with a history of sudden loss of vision after rubbing the right eye, associated with tearing and photophobia, lasting one day. He denied previous use of eye- glasses or eye drops. Visual acuity Right eye (RE): hand motion. Left eye (LE): 20/20. On biomicroscopy: RE: Conjunctival hyperemia 2+, epithelial and stromal edema of the cornea ,with extension of 7 x 8 mm, rupture of the Descemet’s membrane layer, significant corneal protrusion and central thinning. LE: Calm eye, clear cornea. Initially, clinical management was implemented to control edema and pain, with dimethylpolysiloxane eye drops, prednisolone 1%, and tropicamide 1%. The patient was referred to the cornea department, where surgical manage- ment was indicated, with injection of C3F8 gas into the anterior chamber, and corneal compression sutures. Eight compression sutures were performed with 10.0 nylon thread, inferior iridectomy, and injection of C3F8 into the anterior chamber. After the first week, the patient showed significant improvement in symptoms and containment of the Descemet’s tear. After 30 days, the stitches were re- moved, presenting a VA of 20/400, with improvement in the inflammatory and absence of corneal edema. Despite the scar affecting the pupillary axis, there was no indication for cor- neal transplantation, as the patient was a child and presented a higher risk of inflammation and rejection of the transplant. Clinical treatment was started with losartan 0.8% eye drops, in an attempt to improve visual rehabilitation. After 3 months, the patient progressed with a gain of 3 lines of vision accord- ing to the Snellen chart (20/80). Conclusion: Cases of acute hydrops, with extensive Descemet’s membrane tears may benefit from surgical treatment combining compression sutures and injection of C3F8 gas, providing a faster recovery than clinical treatment, with reduced morbidity and fewer complications associated with the condition. EP-COR-59 Cutibacterium Acnes keratitis with Descemet’s membrane detachment: a case report G. Vaikšnorė1, S. Galgauskas1 1Vilnius University Hospital Santaros Clinics, Center of Eye Diseases, Vilnius, Lithuania Purpose: To describe a unique case of Cutibacterium acnes keratitis associ- ated with a rare manifestation of Descemet’s membrane detachment. Introduction: Descemet’s membrane detachment is a rare ocular condition that can lead to significant vision loss, commonly following trauma or in- traocular surgeries, though spontaneous cases also exist. Timely recognition and management are vital to prevent complications. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 95

ELECTRONIC POSTER PRESENTATIONS Case Description: A 27-year-old female presented with sudden-onset unilat- eral visual impairment and right eye pain, with no prior systemic illness or ocular surgery. She reported recent use of adhesive eyelashes and environmen- tal dust exposure. Initial examination showed peripheral corneal inflammation and endothelial edema. Descemet’s membrane was found focally detached beneath an ulcer, resulting in an intracorneal hypopyon between the posterior stroma and the detached membrane. Initial corneal scrape speciation identified Cutibacterium acnes, leading to a management plan that included topical an- tibiotics, corticosteroids, and intravenous antibiotics. Full resolution occurred within one week, restoring visual acuity to baseline (1.0 in both eyes). Discussion: Descemet’s membrane detachment is primarily a complica- tion post-cataract surgery (2.5% in ECCE and 0.5% in phacoemulsification) or trauma, particularly in older patients and those with corneal anomalies. Cutibacterium acnes, while commonly linked to acne, can be implicated in bacterial keratitis and secondary DMD. As this pathogen emerges as a signifi- cant cause of ocular infections, early identification and aggressive treatment are essential to prevent vision-threatening diseases. EP-COR-60 Corneal Q value alterations following intrastromal lenticule implantation in advanced keratoconus G.I. Semiz1, F. Semiz2 1Atilim University, Ankara, Turkey, 2Eye Hospital, Prishtina, Kosovo EP-COR-61 Penetrating eye injury in patients with previous ocular surgery F.N. Fadzil1, M.S. Quinn1, A. Kelly1, M.I.S. Zaini2 1Sligo University Hospital, Ophthalmology Department, Sligo, Ireland, 2Sligo University Hospital, Sligo, Ireland Introduction: Globe rupture is a serious ocular emergency and its occurrence has been reduced due to modern advances in surgery. However, the risk re- mains higher among older patients whose surgeries involved large incisions and rigid lenses using traditional methods. The primary cause of these global ruptures is mostly blunt or sharp trauma; the weak points are old surgical scars or implant sites. Ruptures occur when external forces exceed the weakened tissue’s tensile strength, often at or near surgical scars. Case Presentations: Case 1: 69-year-old man with a history of multiple left-eye surgeries, includ- ing acrylic lens implantation, who had a severe 9mm corneoscleral rupture with iris extrusion and hyphema following low energy trauma—a fall while wearing glasses. The interesting thing about this case is that the surgeries and the rupture oc- curred over three decades apart, proving the susceptibility of surgical scars. It questions the idea that contemporary surgical developments and healing do not pose long-term risks in cases of similar past histories. Case 2: 53-year-old man, whose left eye was previously injured and operated had a new trauma by farming tools that resulted in about 3mm nasal scleral Purpose: This study aims to investigate changes in corneal Q value following perforation. fresh myopic lenticule transplantation in patients with keratoconus. Method: Fifty eyes with advanced keratoconus, indicated for corneal trans- plantation, were included in this study. Donor lenticules were transplanted into This case points to unique concerns for physically active patients and the per- manency of surgical scars while emphasizing the need for occupational hazard education and protective strategies for susceptible patients. all eyes based on corneal topography. These donor lenticules were obtained Discussion: Cro et al. (2022) pointed out, despite surgical technology, that from patients with myopic refractive errors who had undergone femtosecond scars remain the weak link after surgery. Cases also demonstrated the long laser-assisted small incision lenticule extraction (SMILE) surgery. Results: All patients were followed for five years, during which no adverse reactions, infections, epithelial defects, punctate keratitis, deep lamellar kera- titis, or signs of allogeneic rejection were observed. The corneal Q value im- proved from −0.82 ± 0.04 preoperatively to −0.60 ± 0.05 five years postopera- tively (p < 0.001). The preoperative corrected distance visual acuity (CDVA) improved from 1.00 ± 0.00 logMAR to 0.55 ± 0.09 logMAR (p < 0.001). Additionally, preoperative central corneal thickness (CCT) increased from 398 ± 13.29 μm to 481.10 ± 8.12 μm (p < 0.001). Conclusion: The intrastromal lenticule transplantation procedure proved clinically effective in enhancing corneal shape (increasing Q value) and vi- sion in patients with keratoconus. The addition of fresh myopic lenticules not only increased corneal thickness but also enhanced corneal shape, leading to improved visual outcomes. latency between intervention and rupture, which shows that the constant risk persists. Prevention of trauma by educating the patients on the use of protective eye- glasses, and the use of advanced imaging to monitor scar stability are essential in minimizing the risk, to help preserve the vision and prevent debilitating complications in at-risk population EP-COR-62 Outcomes of corneal cross-linking in the treatment of infectious keratitis: case reports B. Pustina1 1University Clinical Center of Kosova, Ophthalmology Department, Prishtina, Kosovo Introduction: Infectious keratitis is a major cause of corneal blindness, with traditional management focusing on antimicrobial therapies. However, some cases, particularly those resistant to standard treatments, may benefit from therapies such as corneal cross-linking (CXL). These case reports explore the application and outcomes of CXL in the management of infectious keratitis. Purpose: To evaluate the efficacy of corneal cross-linking (CXL) as an ad- junctive treatment for infectious keratitis, particularly in cases resistant to conventional antimicrobial therapy. 96 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

Method: We treated patients with keratitis unresponsive to initial topical an- tibiotic treatment. Due to the persistence of infection and the risk of corneal perforation, corneal cross-linking was performed using riboflavin and ultra- violet A (UV-A) light after weeks of medical therapy. Clinical outcomes were assessed by monitoring visual acuity, corneal healing, and any adverse effects over a 2-week follow-up period. Results: Following CXL treatment, the patients showed significant improve- ment in symptoms, with a reduction in inflammation and complete re-epitheli- alization of the cornea within 2 weeks. Visual acuity improved, there were no complications, and the infection was fully resolved by the end of the follow-up period. Conclusion: Corneal cross-linking demonstrates potential as an adjunctive treatment for infectious keratitis, particularly in cases that are unresponsive to conventional therapy. These cases suggests that CXL can effectively promote corneal healing and restore visual acuity, warranting further investigation into its role in the management of infectious keratitis. ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Education EP-EDU-01 A nationwide initiative empowering 868 medical students across the UK on tackling ophthalmic emergencies A. Karimi1, T.L.E. Wong2 1Sussex Eye Hospital, Brighton, United Kingdom, 2Surrey and Sussex Health, Redhill, United Kingdom Purpose: 75% of students consider ophthalmology teaching at their medi- cal school inadequate. With 10% of patients entering a hospital heading to the eye clinic and 6% of all A&E attendances being eye issues, this lack of ophthalmology education is unsustainable. We present an initiative run over two years to educate medical students on the recognition and management of eye conditions. Method: The one-day course was created by an ophthalmology registrar and foundation doctor and advertised to all 45 medical schools across the United Kingdom in 2021 and 2022, attracting 868 delegates altogether. Results: Students’ confidence levels improved across all 4 aspects of the oph- thalmology consultation: history, examination, recognising and managing eye cases (p<0.05, Wilcoxon test). There was also a statistically significant improvement on confidence when dealing with all 14 eye conditions covered, especially in nuanced topics like removing corneal foreign bodies and managing angle-closure glaucoma. Feedback included: - “better than any ophthalmology teaching I’ve had to date” - “conditions were explored as if we were treating them as a junior doctor in ED” - “course should be mandatory for all medical students and foundation doc- tors” Conclusion: Non-ophthalmologists often lack confidence with eye cases, leading to personal struggles; reduced job satisfaction; delayed treatment; potential vision loss; unnecessary referrals; increased litigation; higher health- care costs; especially in an aging population. The course was a simple, repeatable and cost-effective method in helping pre- vent sight-threatening consequences and improve job satisfaction. Feedback called for wider teaching for foundation and more senior doctors, optometrists and other allied health professionals, as well as expanding to a global scale. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 97

ELECTRONIC POSTER PRESENTATIONS EP-EDU-02 Implementing an ophthalmology teaching program for emergency medicine physicians in a new tertiary hospital M.A. Bin Ismail1, K.P.K. Wang1 1Woodlands Health, Ophthalmology, Singapore, Singapore Results: The most common ophthalmic procedure in Mater Dei Hospital is cataract surgery, followed by intravitreal injections. The study revealed a total of 8192 scheduled surgeries, of which 801 surgeries were cancelled, resulting in a cancellation rate of 9.78%. The main findings indicate that the most com- mon reasons for surgical cancellations include patient-related issues, staff- related factors, and material/logistics problems, with each category presenting unique challenges to the efficient performance of ophthalmic surgeries. Conclusion: The data interpretation reveals critical insights into cancellation patterns and suggests recommendations for reducing surgical cancellations Purpose: An Ophthalmology teaching program is crucial for Emergency phy- through improved scheduling, preoperative assessments, and resource man- sicians because it equips them with the necessary skills to handle eye-related emergencies effectively. A deeper familiarity with Ophthalmic conditions en- hances overall patient care in emergency situations, where delayed care can agement. lead to irreversible loss of vision. Methods: Learning objectives of the teaching program includes basic his- tory taking, visual acuity assessment, intraocular pressure measurement, pupil examination, visual field and extraocular movement examination, use of a slit lamp to assess anterior chamber depth, corneal abrasions, eyelid eversion for sub-tarsal foreign bodies, and fundoscopy to assess for disc swelling. Part I of the curriculum consists of online lectures, a Multiple Choice Question test and a practical skills course. Part II consists of attachments to Ophthalmology clinics. Participants were asked to rate from 1-10 their abilities to perform the specific examination tech- niques in a pre and post training questionnaire. Results: A total of 13 Emergency physicians underwent the dedicated teach- ing program. All participants completed and passed the MCQ test at the end of the online lectures. The average ability scores following the practical skills course increased across all domains, from a combined average of 59.7% on the pre-training questionnaire to 83.0% on the post-training questionnaire. EP-EDU-05 Treatment allocation in ophthalmological randomised-control trials (TAO-RCT): a frequently uncontrolled and poorly reported parameter H. Rocha1, S. Guru1, C. Sekhon1, A. Thirunavukarasu2 1University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 2University of Oxford, Medical Sciences Division, Oxford, United Kingdom Purpose: Randomised control trials (RCTs) in ophthalmology are compli- cated by different combinations of treatments given to contralateral eyes with potential crossover effects. Allocation patterns where the relationship between study arms and individuals is inconsistent are ‘uncontrolled’, and susceptible to statistical noise. We aimed to estimate the prevalence and risk factors for The greatest improvements in average scores were seen in the domains of uncontrolled treatment allocation in ophthalmological RCTs. slit lamp examination of the cornea (84.1%), fundoscopic examination to as- Method: A systematic review was conducted to identify all ophthalmologi- sess for disc swelling (50.0%), as well as intraocular pressure measurement (47.8%). Conclusion: A dedicated Ophthalmology training program is important in equipping emergency physicians with the necessary knowledge and skills to cal RCTs published between 1 January and 31 December 2022. We devised a simple nomenclature system to define treatment allocation patterns using letters to define treatments, ‘+’ between contralateral eyes, and ‘&’ to denote separation between participants. handle eye emergencies and facilitate prompt referral and transfer to special- Trials were analysed to determine their treatment allocation pattern, whether ised Ophthalmic care. A structured Ophthalmology training program for emer- this was controlled or uncontrolled, and whether this was explicitly, implicitly, gency physicians should be in place for all hospitals. EP-EDU-03 Reasons for ophthalmic surgical cancellations: a 1 year retrospective analysis M. Grech1, M. Aquilina1, A. Mifsud1 1Mater Dei Hospital University, Msida, Malta Aim: The purpose of this study was to evaluate and report the reasons for cancellations of ophthalmic surgeries over the 12-month period, between 1st July 2023 and 1st July 2024. Design: The data was collected from operating theatre records and patient medical records, providing a comprehensive overview of scheduled proce- dures and their outcomes within the Ophthalmology Department at Mater Dei Hospital. Method: The study is based on a retrospective analysis of scheduled ophthal- mic surgeries and the reasons for their cancellations at Mater Dei Hospital, or unclearly reported. Potential risk factors for poor study design were col- lected to explore whether they predicted uncontrolled allocation. Results: 359 of 3,687 identified studies were included for analysis. Uncontrolled treatment allocation was seen in 14.5% of RCTs in 2022 and was associated with unclear reporting (χ2 = 44.31, p < 0.001) but not with world region or funding from academic, governmental, or industrial sources (p > 0.05). Uncontrolled allocation was twice as common in surgical com- pared to medical trials (χ2 = 4.74, p = 0.029), but not associated with subspe- cialty (p > 0.05). Conclusion: Uncontrolled treatment allocation is frequent and associated with unclear reporting and surgical interventions. Trials with uncontrolled al- location may draw inaccurate or unreliable conclusions due to statistical noise obscuring effect size. The quality and validity of RCTs may be improved by using our nomenclature system in trial protocols and study reports to promote clear reporting and controlled treatment allocation patterns. Malta. 98 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

ELECTRONIC POSTER PRESENTATIONS EP-EDU-07 Empowering young ophthalmologists: learning resources, grants, and courses to enhance training A. Bogoev1 1University Hospital Bochum, Ophthalmology, Bochum, Germany Results: Hermann Boerhaave’s student, Albrecht von Haller, published in 1747 in Gottingen Lectures in Latin (we used ed.1749). Boerhaave’s students, Johannes Rudolphus Zwingerus and Emanuel Koenigius, contributed to the codification of this work. The book starts with eyelid diseases, blepharitis, dacryocystitis, ptosis, and malignant tumors, ‘ophthalmia’ (therapy and surgi- cal treatment of trachomatous plaques),2nd part is dedicated to cataracts and surgical treatment methods (couching or suction). Conclusions: Hermann Boerhaave is considered the father of Clinical Purpose: To manage the challenges in current ophthalmology education sys- Medicine. He changed the way the patient was examined, diagnosed, and tems by leveraging online resources, courses, and digital tools to enhance treated. He knew mathematics, chemistry, botany, anatomy, physiology, and learning outcomes and surgical competencies for ophthalmology trainees. Methods: A review of current training methodologies and digital tools high- lighted key gaps in the traditional training model. New approaches like stand- pathology in-depth, and his fame attracted students from European countries. Albrecht von Haller,John Rutherford, and Francis Home became famous. Hermann Boerhaave was an inspired teacher with a patient-oriented praxis ardized residency curricula, simulation-based training, and digital platforms who laid the foundations for clinical medicine and ophthalmology. such as EyeSi, AAO, ESCRS resources, and online portals, were explored. Strategies for integrating these tools into residency programs were proposed to improve clinical and surgical education for ophthalmologists. Results: The overview showcases a wide range of resources and opportunities tailored for young ophthalmologists, featuring comprehensive learning plat- forms (ESCRS and AAO Education Portals, EyeSi simulators, etc.), internation- al courses (SOE, ESASO, ESCRS, etc.), and grants supporting observerships and exchange programs. All of these tools enable trainees to enhance clinical learning, develop surgical skills through simulation, and networking opportuni- ties. By utilizing these resources, young ophthalmologists can overcome limita- tions in traditional training models and excel in their professional growth. Conclusions: The use of digital tools, practical courses, and innovative teach- ing methodologies can transform ophthalmic education, helping in gaps in training and providing skill development. By local and global collaboration and sharing best practices are key in advancing the field and preparing the next generation of ophthalmologists. EP-EDU-08 Hermann Boerhaave, the scientist, physician, philosopher, teacher, and his contribution to ophthalmology and ophthalmic surgery G. Balanikas1, D. Pirounides1, Z. Karagiannidou1, K. Tsirampidou1, I. Vagiakis1, A. Misioni1, V. Karampatakis2 1Aristotle University of Thessaloniki, A’ Opthalmologic Clinic, AHEPA Hospital, Thessaloniki, Greece, 2Aristotle University of Thessaloniki, Laboratory of Experimental Ophthalmology, Medical School, Thessaloniki, Greece Purpose: Hermann Boerhaave (1668-1738) was a highly influential figure in medicine during the 18th century. He was a Dutch physician,botanist, and chemist, considered one of the most outstanding medical teachers of his time. Boerhaave’s work focused on many fields of medicine, anatomy, physiology, and pathology, and significantly contributed to understanding disease and its treatment. He was the first of the academic teachers who made teaching in front of patients’ beds. Methods: Original copy of the ‘Praelectiones Publicae de Morbis Oculorum’ and the ‘APHORISMS’ were used. He practiced and taught medicine for 37 years, from 1701 to1738. His method has been impressive and original and was introduced when clinical diagnostics was nonexistent. Boerhaave adopted two principles of Hippocrates: placing the patient above all else and studying the physical symptoms and signs. He taught the students in bed how to exam- ine and observe patients and addressed their questions as they happen today. EP-EDU-09 Eye injury risks and safety level in welding and carpenter workshops T. AlMahmoud1, G. AlNuaimi1, I. Elkonaisi1, F.M. Abu-Zidan1, M. Grivna1 1College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates Purpose: The aim of the study was to assess the safety of the workshops, us- ing safety score system and risk assessment using a risk ranking matrix for eye injuries at small-scale industrial enterprises. Methods: Data from 71 welding shops and 24 carpenter shops were included (77.2% response rate). A checklist and a direct observation were employed to verify Personal protective equipment (PPE) availability and critical char- acteristics of the workshop environment. Each workshop was given a safety score for six items, with 10 points for each item resulting in a final score that is the sum of all ratings and maximum of 60 points for welding shops and 50 points for carpenter workshops. The risk assessment matrix scoring system that include severity and likelihood of hazards for each shop was used for risk assessment of welding and carpentry shops. Results: All worker carried out hammering. Drilling, chipping, chiseling were the regular activities performed in the workshops. Flying particles, and sharp objects were observed to be a common hazards. In welding workshops, work- ers were using face shields (82%) and welding helmets (32%). None of the workers were using filter lenses. 8 of 76 welding workshops scored 20 out of 60 (11%), and 68 scored 30 (89%). Fifteen of the 19 carpenter workshop (79%) scored 30 out of 50, and 4 workshops (21%) scored 20. Based on the severity and probability of occurrence, 28 welding shops had moderate risk and 44 low risk for injuries. Whereas, 14 carpenter shops had moderate risk and 9 low risk for injuries. Conclusions: Risk assessment matrix method can be used to establish priori- ties for low, moderate and high-risk situations. Despite high safety score at the work place there is risk for eye injury for low adherence to safety measures by workers. Use of personal protective equipment for the eyes and adopting legislative eye safety regulations may reduce the impact of eye injuries in the community. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 99

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ELECTRONIC POSTER PRESENTATIONS EP-EDU-10 EP-EDU-11 Ophthalmology as a specialty – a growing star or waning interest? A multicentre evaluation of ophthalmology education and trends in interest among London-based medical students in UK B.J. Chow1, Y. Kim1, C. Zheng1, M. Posner2 1Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom, 2Barking, Havering and Redbridge University NHS Hospital Trust, Department of Ophthalmology, London, United Kingdom Trainees’ perspectives on the educational environment T. AlMahmoud1, R. Almahmoud2, M. Al Ali1, M.J. Hashim1 1College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, 2University of Sharjah College of Medicine, Department of Clinical Sciences, Sharjah, United Arab Emirates Purpose: Ethics and professionalism are recognized as core competencies in medical practice worldwide. Several studies have investigated the teaching Introduction: Ophthalmology is arguably an overlooked speciality within and learning methods for this subject. However, there are few reports on the UK medical school curricula, despite accounting for the largest proportion of students’ views and experiences with professionalism in their working envi- outpatient appointments across all medical specialities. This cross-sectional study aims to evaluate the proficiency and perceptions of ophthalmology among UK medical students. Methods: London-based UK medical students were invited to complete a cross-sectional questionnaire. This was disseminated through official univer- sity emailing lists and social media. The questionnaire consisted of 13 ques- tions evaluating various themes including respondent’s demographics, oph- thalmology exposure, level of ophthalmology knowledge, and career inter- est. Statistical analysis was performed via Mann-Whitney U-Test using IBM SPSS software. Results: 126 medical students completed the survey (54.0% females; 4 London medical schools represented). The grade of the medical students ranged from final-year (16.2%), fourth-year (33.3%), third-year (19.2%), pre- clinical years (31.3%). 44% reported completion of clinical ophthalmology rotation. Although individuals who completed their rotation demonstrated a significant- ly higher confidence level in conducting fundoscopy and managing common eye conditions (all p<0.05)—33.3% reported low confidence in managing ophthalmic emergencies (AACG). 79.5% of respondents who completed their rotations still perceived their ophthalmology exposure as insufficient. 63.6% indicated career interest in ophthalmology. Conclusion: Our findings highlight a significant appetite for ophthalmology education and specialty interest, underscoring a gap educators may hope to bridge through spiral learning and fostering constructive discourse regarding potential curriculum changes within the medical education community. We contend that there is significant potential for further enhancement, par- ticularly regarding the amount of time devoted to ophthalmology within the medical curriculum. ronment. The aim of this study was to assess the professional attitudes and behaviors that exist in the health care environment as perceived by clinical clerks. Methods: An anonymous paper questionnaire was distributed to a total of 134 final year clinical clerks. Standard descriptive statistics, unpaired t-test to evaluate differences between male and female groups were used. Results: 114 (86%) completed the survey. Students frequently identified Health professionals whom that they consider role models (mean=6.68±2.126 on a scale of 0 to 9; and 6.62±2.17 respectively). They very frequently ob- served that health professionals place the needs of their patients ahead of their own self-interests 7.25±1.69 and 6.87±2.095 respectively. Students reported seldomly being urged by medical colleagues and allied healthcare workers to copy their history and physical exam rather than gather- ing their own information from the patient (mean 3.26±5.14 versus 2.83±3.19) or observing health professionals scheduling tests or performing procedures at times that are more convenient for themselves than for the patient (mean 3.37±-2.96 and 3.32±3.043 respectively). Male students more often observed unprofessional behaviors such using inap- propriate reference to patients and making derogatory statements about other medical/surgical specialists (P< 0.05) compared to female counterparts. Conclusion: Students viewed physicians and allied healthcare workers posi- tively, however, academic attention needs to be directed at ethical and profes- sional dilemmas that are encountered during their training. 100 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-EDU-12 Fasting and eye health: a clearer vision through faith and science M. Strechi1, V. Cușnir1, L. Dumbrăveanu1, R. Bîlba1, V. Cojocaru2, V. Cușnir1 1“Nicolae Testemitanu” State University of Medicine and Pharmacy, Department of Ophthalmology and Optometry, Chisinau, Moldova, Republic of, 2“Nicolae Testemitanu” State University of Medicine and Pharmacy, Department of Philosophy and Bioethics, Chisinau, Moldova, Republic of Fasting has been the mainstay of spirituality for centuries, bringing discipline and mindfulness to people and connecting them to the divine. In recent years, science has taken a special interest in the physiological effects of fasting, in- cluding on ocular health. Purpose: This study aims to assess the impact of short-term dietary restric- tions due to religious fasting on eye health, which will offer valuable guidance for developing clinical guidelines on maintaining optimal eye health during fasting. Methods: A comprehensive literature search was performed for studies and evidence related to the effects of fasting on ocular health using NCBI, AAO, AJO, and PubMed databases. Results: Our findings emphasize the intricate relationship between fasting and ocular well-being. Ramadan fasting may alter IOP, while Orthodox fasting reduces oxidative stress and has anti-inflammatory benefits. Exclusion of ani- mal proteins can affect eye health differently based on personal dietary habits. Although plant proteins provide essential amino acids, a diverse diet is crucial for the absorption of nutrients. Also, red meat consumption, providing some detrimental substances, may al- ter the functionality of retinal pigment epithelium (RPE) cells and consequent- ly lead to age-related macular degeneration (AMD). Nutrients from plants, such as Vitamins A, lutein, zeaxanthin, and Omega-3 fatty acids, help with eye health by improving hydration and reducing inflammation. Conclusion: Religious fasting may affect ocular health in various aspects de- pending on fasting duration, type of dietary restriction, and hydration. While both animal and plant proteins are important for eye health, a well-planned, balanced diet devoid of animal protein can help individuals achieve their eye- health-related targets by obtaining food from various plant sources to ade- quately meet their essential nutrient requirements. It’s advisable to keep track of nutrient levels being controlled and to supplement if needed. ELECTRONIC POSTER PRESENTATIONS Electronic Posters: External Eye EP-EXE-01 Orbital cellulitis induced by Chinavia hilaris: first documented case in a 19-year-old male D. Vasović1, D.M. Rašić1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia Purpose: To present the first documented case of orbital cellulitis caused by Chinavia hilaris (stink bug) in a 19-year-old male without prior trauma or systemic illness, highlighting the diagnostic and therapeutic challenges of this rare etiology. Case report: A 19-year-old male presented with painful swelling of the right upper and lower eyelids following exposure to Chinavia hilaris. He reported that the insect had entered his eye the day prior. Examination revealed prop- tosis, conjunctival chemosis, mixed conjunctival hyperemia, and restricted ocular motility with diplopia in certain gaze directions. Visual acuity was 0.7 in the right eye and 1.0 in the left, with intraocular pressure of 11/13 mmHg. MDCT imaging showed proptosis of the right globe, diffuse thickening of periorbital soft tissues, and thickening of the optic nerve, consistent with or- bital cellulitis. Fundoscopy could not be performed due to eyelid edema. The patient was promptly admitted and treated with intravenous antibiotics (Longaceph 2g and Amikacin 500mg twice daily) and corticosteroids (Lemod-Solu 120mg, tapered daily). Discussion: Orbital cellulitis is typically associated with sinus infections or trauma. This case is unique in identifying Chinavia hilaris as the causative agent, with no preceding injury or systemic illness. Stink bugs are not com- monly associated with human infections, but their potential to introduce path- ogens via exposure warrants consideration in differential diagnoses of orbital cellulitis. Early imaging and aggressive management with intravenous antibiotics and corticosteroids were critical in addressing inflammation and preventing com- plications. Conclusion: This first reported case of Chinavia hilaris-induced orbital cel- lulitis highlights the need for awareness of rare environmental exposures in the etiology of orbital infections. Prompt diagnosis and early intervention are essential to prevent vision-threatening complications in such rare and atypical presentations. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 101

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ELECTRONIC POSTER PRESENTATIONS EP-EXE-02 Nontraumatic orbital subperiosteal haematoma in a patient with acute myeloid leukemia A. Palmier1, X. Marku1, I. Bertuello1 1Mater Dei Hospital, Ophthalmology Department, Msida, Malta Purpose: Orbital subperiosteal haematoma (OSH) is a rare cause of spontane- Results: From the MRI intraconal orbital lesion in the right orbit with com- pression and dislocation of the right optic nerve and the extraocular muscles were detected. A fronto-orbital craniotomy with complete extirpation of the tumor formation and plastic reconstruction using titanium mesh and artificial dura was performed. Histology revealed evidence of cavernous hemangioma of the orbit. We noted a recovery of the visual acuity, persistence of the macular folds and transient exotropia of the right eye. The MRI Follow-up detected epidural hematoma which resorbed spontaneously. Moreover, the patient did not have ous exophthalmos, most occurring due to trauma and less commonly second- nerve damage, postoperative ptosis or any other complications and no recur- ary to nontraumatic causes. We present a case of emesis-induced OSH in a rence of the lesion was detected in the three-year follow-up. patient undergoing chemotherapy for acute myeloid leukaemia (AML). Conclusion: The fast recognition of symptoms and complete examination are Methods and results: A 61-year-old Caucasian woman, who was a known fundamental for making a timely diagnosis in patients with cavernous heman- case of AML, was urgently referred from the oncology unit with acute left giomas of the orbit. Radical surgical removal with histological conformation periorbital swelling and pain, rapidly progressing within 30 minutes, after per- is a preferred method of treatment for cavernous hemangioma in symptomatic sistent emesis secondary to chemotherapy. patients. Postoperative hemorrhages are a common complication in any orbital On examination, there was extensive left-sided superior eyelid swelling and complete ptosis with significant left exophthalmos. The visual acuity of the left eye was reduced with global restrictions of the extraocular muscle move- ments. Pupillary responses and optic nerve function in both eyes were normal with no afferent pupillary defect. Intraocular pressure (IOP) of the left eye was noted to be elevated. A CT scan of the orbits revealed a biconvex, well- defined, dense, extraconal lesion in the roof of the left orbit, consistent with OSH. Over the following 12 hours, gradual improvement in visual acuity was not- ed, and the IOP was successfully lowered with medical therapy. The patient received conservative management and was closely monitored for the first few days, assessing for any sign of optic nerve compromise. She continued to surgery but their spontaneous resorption is possible. EP-EXE-04 Giant conjunctival cyst complicated by episcleritis G. Khorava1, A. Markosyan1, R. Kacanashvili1 1Medsi KDCP, Moscow, Russian Federation Introduction: Conjunctival cysts are often encountered in ophthalmologic steadily improve over the following 10 weeks, with complete resolution of the haematoma confirmed on imaging. Conclusion: This case highlights the clinical features of a rare type of orbital practice. They are usually asymptomatic, but sometimes can become in- flamed, infected and lead to the spread of inflammation from the conjunctiva to the deeper structures of the eyeball. haemorrhage secondary with an uncommon nontraumatic etiology. Rapid ex- Purpose of this case is to describe the manifestations and treatment of giant pansion of an OSH has the potential to cause optic nerve compression, and therefore prompt diagnosis and appropriate initiation of treatment are essen- tial. In our case, conservative management with IOP-lowering medications conjunctival cyst complicated by episcleritis. A Male 69 years old came to the office with complaints of acute pain in the left eye, redness and decreased vision of the left eye, which bothered him for and close monitoring led to a full resorption of the OSH, without the need for 2 days. Slit lamp examination revealed conjunctival hyperemia, mixed injec- surgical intervention. EP-EXE-03 A clinical case of a patient with cavernous hemangioma in the orbital cavity D. Vladeva1, Y. Boneva1 1Vision Eye Clinic, Sofia, Bulgaria Purpose: The aim of this article is to present a clinical case of a patient with tion, and a giant conjunctival cyst with dense, highly vascularized walls, oc- cupying the entire lower-inner part of the eyeball, filled with a cloudy liquid. Palpating the eyeball revealed sharp pain. An ultrasound examination of the left eyeball showed an oval anechoic formation with dense walls, measuring 3.6 by 7.3 mm, not growing into the eyeball. A course of antibacterial and anti- inflammatory therapy was prescribed. After a week the symptoms subsided. It was decided to remove the cyst. Histological examination showed a cyst lined with stratified squamous epithelium, 6-8 cells thick, without formation of ridges. There was corrugated surface layer of epithelial cells with areas of desquamation. In the cyst wall fibrous tissue was found, with focal minor lymphocytic infiltration. Conclusion: Сonjunctival cysts can become infected, cause pain, and become complicated by the growth of deeper structures of the eye. Considering the cavernous hemangioma of the right orbit, the surgical treatment and the post- large size of the cyst, the suddenness of its occurrence and pronounced clini- operative result. Methods: A patient with cavernous hemangioma and a history of painless progressive proptosis of the right eye and reduced visual acuity for near of the same eye was followed up by visual acuity examination, ophthalmoscopy, B-scan echography, visual field test, optical coherence tomography, Hertel ex- ophthalmometry and ocular motility examination. During the ophthalmoscopy examination folds in the macula were found and from the B-scan rounded retrobulbar hypoechoic formation with cystic lesions was detected. Since the formation was constricting the right eye orbit, the patient was referred for a MRI and operation by a neurosurgeon. cal picture of epicleritis, the optimal method of treatment is combined anti- inflammatory therapy followed by cystectomy with extraction of the cyst and preservation of its walls for further histological examination. Cystectomy, in- cision with slit lamp combined with bimanual drainage followed by antibiotic drops appear to be a safe and effective treatment option. 102 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS compared to females. The middle-income group displayed the highest inci- dence rates from 2010, after which a gradual decline was observed. The high- income group experienced peaks in 2005 and 2009, followed by a continuous decline, eventually showing the lowest incidence rate by 2019. Ocular burns had occurred more frequently in summer and spring than in winter. Conclusion: We evaluated the incidence and characteristics of ocular chemi- cal burns using Korean nationwide databases. Despite societal changes and widespread safety education, ocular chemical injuries still occur in a variety age groups and regions. Our results may aid in estimating the size of the prob- lem and prioritizing prevention of ocular chemical burns. EP-EXE-07 Face to face with parasites in the Sisak-Moslavina County A. Prpić1, M. Gromača Grgić1, M. Vidić1, S. Vukelić1, R. Iveković2 1General Hospital Dr Ivo Pedišić, Sisak, Croatia, 2Sestre Milosrdnice University Hospital Center, Zagreb, Croatia Purpose: To present four different clinical presentations of parasitic infec- tions of the eye and orbit, emphasizing diagnostic challenges and therapeutic approaches. Patients and Methods: This study analyzed the cases of four patients with confirmed parasitic infections of the eye and/or orbit who were treated in our facilities over the past two years. Each case was documented in terms of medical history, clinical symptoms, diagnostic procedures, and therapeutic approaches. Results: All four patients had distinct clinical presentations, ranging from mild symptoms such as discomfort and redness of the skin and conjunctiva to severe complications like orbital cellulitis. Three identified parasites were Dirofilaria spp. Treatment approaches included antiparasitic therapy, anti-in- flammatory medications, and, in three cases, surgical intervention. All patients achieved satisfactory recoveries without significant complications. Conclusion: Parasitic infections of the eye and orbit pose significant diag- nostic and therapeutic challenges due to their diverse clinical manifestations. These cases highlight the importance of timely symptom recognition and tar- geted therapy to reduce the risk of permanent vision impairment. Additionally, raising awareness among healthcare professionals and the general population about potential risks and preventive measures is essential. EP-EXE-08 Trend analysis in the incidence and characteristics of ocular chemical burns in Korea Y. Lee1, E.J. Kim2 1Gachon University, Gil Medical Center, Incheon, Korea, Republic of, 2Gachon University, College of Medicine, Department of Prevention Medicine, Incheon, Korea, Republic of Purpose: Ocular chemical injury is one of the most important ophthalmic emergencies, which can cause temporary or permanent visual impairment, physical and mental illness to the patient, as well as loss of work ability. Changes in industrial structure, improved provision of protective equipment, and strengthened safety and health education in the workplace may have influ- enced incidence and characteristic of ocular chemical injuries, however, this has not been reported recently. Thus, the aim of this study is to update and evaluate the incidence and char- acteristics of ocular chemical injuries using nationwide databases from 2003 to 2019. Method: A cohort representing the Korean population, which was established using a national health insurance database, was used to evaluate the incidence and characteristic of ocular chemical burns. The age, sex, and regional distri- bution, seasonal variation, and correlation with income levels were investi- gated by years. Results: A total of 5,038 patients with ocular chemical injuries were included. Although there were some minor fluctuations, the overall incidence peaked in 2010 and has declined. Males consistently showed higher incidence rates Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 103

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ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Glaucoma EP-GLA-01 SMOTE-enhanced explainable AI model for predicting visual field progression in Myopic Normal-Tension Glaucoma J.J. Jung1, S.Y. Kim2, S.H. Park2, K.H. Kang2, J.W. Jeoung2, K.H. Park2, Y.K. Kim2 1Kim’s Eye Hospital, Seoul, Korea, Republic of, 2Seoul National University Hospital, Ophthalmology, Seoul, Korea, Republic of Purpose: To develop and validate a Synthetic Minority Over-sampling Technique (SMOTE)-enhanced artificial intelligence (AI) model for predict- ing visual field progression in myopic normal-tension glaucoma (NTG) pa- tients. Methods: This retrospective cohort study included 100 eyes from myopic NTG patients with a mean follow-up of 10.3 ± 3.2 years. Baseline parameters included intraocular pressure (IOP), central corneal thickness, axial length, and visual field metrics. A SMOTE-enhanced AI model was created to address class imbalance in progression events. Model performance was evaluated us- ing receiver operating characteristic (ROC) analysis, cross-validation, and calibration plots. Predictive factor importance was evaluated through SHapley Additive exPlanations (SHAP) analysis. Results: Visual field progression was observed in 28% of patients, with a me- dian progression time of 3.2 years. The AI model achieved an area under the ROC curve (AUC) of 0.83 (95% CI, 0.75-0.91), demonstrating robust sensi- tivity (0.81) and specificity (0.77). SHAP analysis identified baseline mean deviation (MD), age, axial length, baseline IOP, and visual field index (VFI) as key predictors. Patients scoring above 0.8 in risk stratification had signifi- cantly higher progression rates (82.6%). Subgroup analysis revealed strong correlations between progression risks and older age, greater axial length, and worse baseline MD. Conclusions: The SMOTE-enhanced AI model demonstrates high predictive accuracy and clinical utility for identifying visual field progression in myopic NTG patients. By addressing class imbalance and myopia-specific challenges, this approach enables personalized risk stratification and early intervention. EP-GLA-03 Longitudinal corneal hysteresis changes predict structural progression in medically-controlled, early to moderate, open-angle glaucoma with a history of refractive surgery S.Y. Lee1, J.S. Lee1 1Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Ophthalmology, Seoul, Korea, Republic of Purpose: The present study aims to identify the relationship between longitudi- nal changes in corneal hysteresis (CH) and progressive retinal nerve fiber layer (RNFL) thinning in a cohort of medically-controlled, early-to-moderate open- angle glaucoma (OAG) patients with a history of laser refractive surgery (LRS). Methods: A total of 123 consecutive eyes with a diagnosis of medically-con- trolled (peak intraocular pressure (IOP) <18mmHg), early to moderate OAG patients with a history of LRS underwent measurements of CH, corneal-com- pensated IOP (IOPcc) and RNFL thicknesses every 6 months. Linear models were used to investigate the relationship between CH change over time and RNFL thickness change. Results: Of 123 eyes, 30 eyes (24.4%, 42.9±9.3 years, 36.7% males) demon- strated RNFL loss (93 eyes no progression, 44.4±9.6 years, 30.1% males). No statistically significant difference was found in IOP, but significantly greater decrease in CH was noted in the progression group (-2.525% baseline (95% CI -4.974- -0.076) vs. 1.068% baseline (95% CI, -0.322-2.458); P=0.013). Relative CH change was greater for more advanced stage of OAG among the progression group. Patients with the greatest relative CH decrease over time was 1.7 times more likely to present RNFL loss (HR 1.705, 95% CI 1.113- 2.611, P=0.014). Conclusion: Longitudinal decrease in CH over time was greater in those showing structural progression than those without progression among med- ically-controlled, early-to-moderate OAG with a history of LRS. Decrease in CH was significantly associated with faster RNFL loss. Larger CH changes indicate a higher risk of OAG progression in those with a history of LRS. EP-GLA-04 Comparative analysis of lamina parameters in non-glaucomatous eyes with and without pseudoexfoliation syndrome J.E. Song1, Y.H. Jung1 1Kangwon National University Hospital, Kangwon National University College of Medicine, Ophthalmology, Chuncheon-si, Republic of Korea Purpose: To compare lamina cribrosa (LC) parameters in non-glaucomatous eyes with pseudoexfoliation syndrome (PXFS) and healthy control eyes to assess structural alterations that may contribute to early glaucoma pathophysi- ology. Method: This retrospective, cross-sectional study included 50 eyes with non- glaucomatous PXFS and 50 age-matched healthy control eyes. All participants underwent spectral-domain optical coherence tomography (SD-OCT) with enhanced-depth imaging. Lamina cribrosa (LC) parameters, including thick- ness (LCT), curvature depth (LCCD), curvature index (LCCI), and prelaminar tissue thickness (PLTT), were measured in superior mid-peripheral, central, and inferior mid-peripheral regions. Group comparisons were performed us- ing Student’s t-tests and chi-square tests, and linear regression analysis identi- fied factors associated with LCT. Statistical significance was set at p < 0.05. Results: Eyes with PXFS exhibited significantly thinner LCT than controls across all regions: superior mid-peripheral (163.85 ± 39.13 μm vs. 222.77 ± 39.85 μm, P < 0.001), central (172.95 ± 40.63 μm vs. 221.09 ± 51.42 μm, P < 0.001), and inferior mid-peripheral (165.58 ± 35.18 μm vs. 221.19 ± 43.09 μm, P < 0.001). No significant differences were observed in LCCI or PLTT between the two groups. Multivariable regression analysis identified thinner retinal nerve fiber layer thickness (RNFLT) (β = 0.294, P = 0.004) and the presence of PXFS (β = -0.515, P < 0.001) as independent factors associated with LCT. Conclusion: PXFS eyes show significant LC thinning, potentially represent- ing early structural changes preceding glaucoma. Monitoring LC parameters in PXFS eyes may facilitate early detection of patients at risk of disease pro- gression. 104 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-07 Hemodialysis and glaucoma (case report) G. Tskhadadze1 1Chichua Medical Center Mzera, Tbilisi, Georgia The patient was a 48-year-old man with end-stage renal disease, hypertension, and hypertriglyceridemia. His medical history included renal failure and regu- lar hemodialysis five times a week since 2022. In September 2024, he presented to the clinic within 2 hours of completing dialysis due to spontaneous onset of blurred vision. He had undergone bilat- eral cataract extraction with intraocular lens implantation in the right eye (RE) and aphakia in the left eye (LE). He was initially diagnosed with neovascular glaucoma. A combined topical β-blocker and carbonic anhydrase inhibitor (Cosopt®) and a prostaglandin analog (Travatan®) were prescribed to both eyes when the intraocular pressure reached 38 and 34 mm Hg in the right and left eyes, respectively. Anterior segment examination revealed rubeosis of the iris in both eyes. Eye drops were used in both eyes, and the intraocular pressure was reduced to 16 mmHg RE and 15 mmHg LE, but blurred vision recurred in the right eye during dialysis. Visual field examination in the left eye was not possible due to poor vision. Intraocular pressure was measured five times during hemodialysis for 1 week: at the beginning of dialysis, at hourly intervals during dialysis, at the end, and 1 and 2 hours after the end of dialysis. The mean intraocular pressure in the right eye at baseline, 2 hours after dialysis, at the end of dialysis, and 2 hours after dialysis was 15, 30, 27, and 22 mmHg, respectively. Thus, the intraocular pressure in the right eye increased by 15 mmHg (100%) during hemodialysis. The left eye remained normal. Local instillation of eye drops did not prevent the increase in IOP in the right eye. Hemodialysis was performed routinely five times a week for 2 hours and 40 minutes using a central venous catheter. After failure of ocular treatment, glucose was admin- istered intravenously (20% glucose 100 mL/h) during dialysis to prevent an increase in IOP. EP-GLA-08 Latanoprost versus fixed combination of tafluprost and timolol in patients with primary open-angle glaucoma G. Hoxha1,2, F. Hoxha2 1University of Pristina „Hasan Prishtina“, Pristina, Kosovo, 2University Clinical Center of Kosovo, Pristina, Kosovo Background: Glaucoma is a progressive disease that requires lifelong treat- ment to maintain visual function. Elevated intraocular pressure (IOP) is con- sidered the most important treatable risk factor for disease development and progression. The present prospective study was initiated to compare the IOP lowering efficacy and safety of the preservative-free (PF) fixed combination of 0.0015% tafluprost and 0.5% timolol maleate (FCTT) administered once daily versus 0.005% latanoprost (LT) once daily. Methods: One hundred newly diagnosed patients with primary open-angle glaucoma (POAG) who fulfilled the inclusion/exclusion criteria were enrolled and randomized into two groups. The first LP group was prescribed 0.005% latanoprost eye drops once daily, whereas the second FCTT group was pre- scribed a PF fixed combination of 0.0015% tafluprost and 0.5% timolol once daily. In both groups, IOP was recorded at baseline, at the end of the 4th, 8th, and 12th weeks, and 6 months after, and any adverse effects were assessed. Results: The IOP-lowering efficacy of latanoprost was superior to FCTT. In the LP group, IOP decreased from 26.32±2.0 mmHg at baseline to 18.4±1.57 mmHg six months after treatment with a mean reduction of 8.60±1.57 mmHg (31.8%). In the FCTT group, IOP decreased from 26.23±1.97 mmHg at base- line to 17.49±1.28 mmHg six months after treatment, with a mean reduction of 6.51±1.28 mmHg (27.1%). Latanoprost caused a greater reduction in mean IOP than FCTT in the second follow-up visit (P<0.05), the third followup visit (P<0.05), and the difference was much greater in the fourth follow-up visit (P<0.0001) Conclusion: The absolute mean IOP reduction from baseline at six months is statistically significant in LP or FCTT treatment. Compared to FCTT, 0.005% latanoprost administered once daily has a more significant IOP-lowering ef- fect and safety for up to six months. EP-GLA-09 The clinical application of non-invasive electrical stimulation in ophthalmology: a literature review P.M.F. Lim1, A.G. Gonzalez2, J. Harvey3, G. Malliaras2, K. Gokoffski4, P. Yu Wai Man5 1Singapore National Eye Centre, Glaucoma, Singapore, Singapore, 2University of Cambridge, Cambridge University Hospitals, Engineering, Cambridge, United Kingdom, 3Moorfields Eye Hospital, Opthalmology, London, United Kingdom, 4Keck School of Medicine of USC (University of South California), Ophthalmology, Los Angeles, California, United States, 5University of Cambridge, Cambridge University Hospitals, Ophthalmology, Cambridge, United Kingdom Purpose: To critically appraise the evidence regarding electrical stimulation therapy (EST) in ophthalmic diseases, focusing on clinical studies on safety and efficacy. Method: A comprehensive literature search from 2000 to 2021 was conducted to identify relevant original studies. Information on study methodology, elec- trical stimulation parameters and outcomes were extracted including: 1. Study methodology, 2. Patient/ control groups, 3. Ocular disease, 4. Type of stimulation, 5. Electrode position and number, 6. Stimulation protocol (magnitude, frequency, pulse period, duration and number of sessions), 7. Outcomes, and; 8. Side effects. Results: Search process identified 2011 articles from which 66 studies were included in the final review. Studies were grouped according to anatomical site of stimulation: prechiasmal (transcorneal, transpalpebral, trans orbital) or postchiasmal (transcranial). For transorbital, the technique of repetitive transorbital alternating current stimulation (rtACS) was used (largely for optic nerve diseases); transcorneal and transpalpebral electrical stimulation used direct current (for retinal dis- eases). Transcranial stimulation for intracranial lesions used direct (tDCS) or alter- nating (tACS) current stimulation or high frequency random noise stimula- tion (hf-RNS). The safety threshold for current amplitude was below 500 or Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 105

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ELECTRONIC POSTER PRESENTATIONS 1000 µA, individually tuned to phosphene perception, and frequency range was 5-40Hz with maximal applied current amplitude range at 500-1000 µA. Efficacy was variable across studies. There were some reported statistically significant improvement in visual acu- ity and visual field, but in several studies, these parameters were not clinically significant. No serious side effects were reported in any of the included stud- ies. Conclusions: The notion of electrical stimulation has been around for dec- ades, but it is not currently widely accepted as a therapeutic option in ophthal- mology due to controversial results with regards to efficacy. EP-GLA-10 Influence of Goniotomy incision in site of nasal lower or temporal lower in patients with open-angle glaucoma T. Mizoguchi1 1Mizoguchi Eye Hospital, Ophthalmology, Sasebo City Nagasaki, Japan Purpose: To compare the efficacy of nasal lower (NL) or temporal lower (TL) goniotomy (GT) with phacoemulsification with intraocular lens implantation (PEI) for the patients with primary open angle glaucoma (POAG) and exfolia- tion glaucoma (EXG). Method: Patients diagnosed with POAG and EXG who underwent GT with PEI were included, and divided into 2 groups: NL group and TL group were defined as a group which GT was performed in site of NL or TL, respectively. Data on intraocular pressure (IOP) and the number of ocular hypotensive medications (Meds) were collected and compared between the two groups. Success was defined as postoperative IOP lower than 20 mm Hg and a 20% reduction from the baseline without further glaucoma surgeries, and assessed using Kaplan-Meier survival analysis. A multivariate Cox proportional hazard model was used to investigate the factors associated with surgical failure. Results: A total of 144 eyes of 99 patients (POAG; 100 eyes, EXG; 44 eyes) were included with a mean follow-up of 28.9 months. The mean IOP and Meds significantly decreased at all periods after surgeries compared to that of baseline (p=0.001). There were no significant differences among the two groups in the reductions at all periods after surgery in IOP and Meds and cumulative survival probabil- ity at 54 months after surgery (NL; 50.4%, TL; 36.4%. p=0.054). Multivariate analysis revealed preoperative IOP (HR; 0.827; 0.768-0.890, p=0.001), and preoperative Meds (HR; 1.305 (1.051-1.620, p=0.016) as inde- pendent factors. associated with surgical failure. Surgical site (NL or TL) was not independent factor with surgical failure (p=0.104). Conclusion: GT with PEI showed the similar efficacy in surgical site of NL and TL in reducing IOP and Meds. EP-GLA-14 Association of ocular perfusion pressure with retinal nerve fiber layer thickness and ganglion cell count in open-angle and normal-tension glaucoma patients U. Kėvalaitė1, S. Mammadzada2, I. Janulevičienė1 1Lithuanian University of Health Sciences, Kauno Klinikos, Department of Ophthalmology, Kaunas, Lithuania, 2Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Kaunas, Lithuania Purpose: To evaluate the relationship between ocular perfusion pressure (OPP) and retinal nerve fiber layer (RNFL) thickness, along with ganglion cell count (GCC) measured by Optical Coherence Tomography (OCT), in primary open- angle glaucoma (POAG) and normal-tension glaucoma (NTG) patients. Method: A prospective observational study included 86 patients who were divided into 4 groups based on mean visual field deviation (MD) and type of glaucoma: 14 POAG and 37 NTG in the early stages (up to -6 dB), and 15 POAG and 20 NTG in the advanced stages (from -6 dB to -27.57 dB). Full ophthalmological exams were performed, and one randomly selected eye per patient was assessed. GCC was measured via 7x7 mm OCT scans, RNFL via 6x6 mm optic nerve scans, and mean OPP was manually calcu- lated. Statistical significance was set at p<0.05. Study was partialy funded by Research Council of Lithuania. Results: All groups were similar in terms of demographics, perfusion, and intraocular pressure (IOP) with medication parameters. In the advanced NTG negative correlations were observed between OPP and RNFL inferior (r=- 0.551, p<0.05), and between OPP and RNFL total (r=-0.559, p<0.05), while other associations with OPP were insignificant. A statistically significant association was observed between the Visual Field Index (VFI) and the duration of the disease in patients with advanced NTG (r=-0.470, p<0.05). Conclusion: IOP levels were similar between POAG and NTG patients, in- dicating consistent treatment effects. Demographic and perfusion parameters showed no significant impact on glaucoma outcomes. In advanced NTG, reduced OPP correlated with thinning of the inferior and total RNFL, suggesting a potential link between OPP and RNFL loss. We did not find statistically significant associations between macular GCC and OPP. Further longitudinal studies are needed to evaluate the effects of ocular blood flow and perfusion pressure on structural optic nerve and macular region changes in glaucoma. 106 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-15 Outcomes of endoscopic panretinal photocoagulation combined with cyclophotocoagulation in refractory neovascular glaucoma M. Xin1,2,3, G. Luo3, L. Zeng1,2, S. Liu1,2, Y. He1,2, J. Duan2,4 1Chengdu First People’s Hospital, Ophthalmology, Chengdu, China, 2Chengdu University of TCM, Eye School, Chengdu, China, 3Mass Eye and Ear, Schepens Eye Research Insititute, Boston, United States, 4Chengdu University of TCM, Ineye Hospital, Chengdu, China Purpose: To evaluate the efficacy and safety of endoscopic panretinal pho- tocoagulation (PRP) combined with cyclophotocoagulation in controlling intraocular pressure (IOP) in refractory neovascular glaucoma (NVG) after anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: This retrospective study included 24 eyes from 24 patients with refractory NVG who showed poor response to prior anti-VEGF and anti- glaucoma treatments. All patients underwent endoscopic PRP combined with cyclophotocoagulation. IOP and visual acuity (VA) were assessed preopera- tively and postoperatively at 1 day, 1 week, 1 month, 3 months, 6 months and 12 months. Anterior chamber reactions and complications were also ob- served. Statistical analysis was performed to evaluate the significance of the outcomes. Results: The postoperative IOP was reduced from 50.17±8.18mmHg to 16.83±3.25 mmHg at 1-day, 17.5±5.72 at 7-day, 27.33±16.15mmHg at 1-months, 19.00±5.70 mmHg at 3-months, 21.40±6.59 mmHg at 6-months and 20.20±5.17 mmHg at 12-months. Postoperative glaucoma medication burden was reduced from baseline(3.33±0.52) to 12-month (0.29±0.90). The complete success rate was 75.00% and the qualified success rate was 100.00% at 12-months. Visual acuity remained stable before and after the procedure. Conclusion: The combination treatment of endoscopic PRP and ECP surgery in refractory NVG patients after anti-VEGF injection can control IOP effec- tively and be friendly to patients’ BCVA without obvious serious complica- tions throughout a 12-months follow-up period. Further studies with larger sample sizes and longer follow-up periods are nec- essary to evaluate its long-term safety and efficacy in maintaining IOP control. EP-GLA-16 Rare case, we did not expect to meet in practice H. Nazarchuk1, N. Didyk1 1National Pirogov Memorial Medical University, Vinnytsya, Ophthalmology, Vinnytsya, Ukraine Taking into account the modern diagnostic and treatment capabilities of oph- thalmologists, there are diseases that have practically not occurred during the last 20 years. However, you should be prepared that you will encounter such rare cases in your practice. We report a rare case of phacolytic glaucoma on one eye and aphakia on the pair eye of the same patient. 79-years female patient was administered to the clinic with complains on se- vere pain in her blind right eye, headache and low vision on the left eye. Anamnesis: Right eye: incorrect light perception during last 12 years. The day before incident the patient felt that something exploded inside the eye. Left eye: ECCE without IOL implantation 11 years ago. Status: Right eye: VA=p.l.inc., IOP=52 mm Hg. Corneal edema, milky white liquid in anterior chamber, deeper structures were not visible. B-scan – vitre- ous body and posterior segment without specific findings. Left eye: VA=0,02 sph+10,0D cyl +1.5 ax180=0,8, IOP 13 mm Hg. Transparent cornea, iridodonesis, exfoliations on the pupillary margin, aphakia, posterior segment without specific findings. Treatment: Right eye: timolol, brinzolamide, Diamox, washing of the ante- rior chamber, lens-ectomy, vitrectomy, endotamponade with air. P\o period: 1st day – IOP 8 mm Hg without hypotensive eyedrops, 2nd day – IOP 7 mm Hg without hypotensive eyedrops, ciliochoroidal detachment, 3rd day – IOP 29 mm Hg, timolol, brinzolamide, Diamox, 6th day – IOP 27 mm Hg with timolol, brinzolamide, ciliochoroidal detachment regressed. 14th day - VA= 0,02 sph +10,0D=0,3, IOP 18 mm Hg (timolol, brinzolamide). In 2 months implantation of IOL with ab externo scleral suture fixation on both eyes were performed. Post op: VA OD = 0.2, IOP 19 mm Hg (timolol, brinzolamide) VA OS = 0.7, IOP 15 mm Hg Take home message: Sometimes an ophthalmology textbook comes to life and is rather challenging. EP-GLA-17 Additive effects of genetic variants associated with diurnal intraocular pressure fluctuation in primary open-angle glaucoma F. Mabuchi1, N. Tanaka-Mabuchi2, Y. Sakurada1, S. Yoneyama1, Z. Yamagata3, K. Kashiwagi1, for the Japan Glaucoma Society Omics Group (JGS-OG) 1University of Yamanashi, Ophthalmology, Yamanashi, Japan, 2University of Yamanashi, Rheumatology, Yamanashi, Japan, 3University of Yamanashi, Health Sciences, Yamanashi, Japan Purpose: To evaluate the additive effects of genetic variants associated with diurnal intraocular pressure (IOP) fluctuation in primary open-angle glaucoma (POAG). Method: One hundred seventy patients with POAG were genotyped for 26 genetic variants associated with POAG/IOP. Diurnal variation of IOP was measured with a Goldmann applanation tonometry in a sitting position at 3 hour intervals for 24 hours. To find out the genetic variants associated with a diurnal IOP fluctuation (peak-trough), a multiple linear regression analysis was performed with the diurnal IOP fluctuation as a dependent variable and age, sex, and the genotyped variants as independent variables. To evaluate the additive effects of these variants, the association between the genetic risk score (GRS) of genotyped variants and diurnal IOP fluctuation was also evalu- ated using a multiple linear regression analysis. Results: The mean age of the enrolled subjects was 61.7±13.1 (mean±standard deviation) years, with 74 males and 96 females. The mean of diurnal IOP fluctuation was 5.8±2.2 mmHg. There was a significant association (regres- sion coefficient [Beta]=0.92, standard error [SE]=0.34, P=0.0081) between the risk allele of rs11710139 (near gene: LOC107986141/LOC107986142) and diurnal IOP fluctuation. A significant association (Beta=0.79, SE=0.36, P=0.029) was also found between the risk allele of rs6732795 (ANTXR1) and diurnal IOP fluctuation. As the number of risk allele of these genetic variants increased, the diurnal IOP fluctuation increased. There was a significant as- sociation (Beta=0.39, SE=0.092, P=0.000041) between the GRS of 10 genetic variants with top 10 Beta and diurnal IOP fluctuation. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 107

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ELECTRONIC POSTER PRESENTATIONS Conclusion: These results indicate that diurnal IOP fluctuation may be regu- lated by the additive effects of genetic variants associated with POAG/IOP in POAG. With the diagnosis of juvenile glaucoma + hypertensive uveitis crisis in the right eye, a complete laboratory work-up was performed with negative se- rology except for IgG VZV and IgG CMV which was positive. Oral valgan- ciclovir is added to the loading doses. The inflammatory signs disappear, but the IOP remains elevated, so a tutored and closed Paul implant with occlusive suture + reopening of the previous NPDS + aqueous serology was EP-GLA-18 performed. The role of Flammer syndrome in normal-tension glaucoma: symptoms and endothelin-1 plasma level A. Kostadinova1, D. Kazakova1, S. Stoykova1 1Sofia University „St. Kliment Ohridski“, Sofia, Bulgaria During the postoperative period she presented with hypertensive peaks requir- ing the following procedures: surgery to unknot the suture + partial removal of the tutor (7th week); complete removal of the tutor in consultation (9th week); topical dorzolamide-timolol and Molteno´s antifibrotic therapy for 6 weeks (3 weeks after removal of the tutor). At 7 months she had an IOP of 12 mmHg with topical dorzolamide-timolol + dexamethasone at a minimal dose and a functioning bleb. Purpose: The aim of this study is to investigate whether higher plasma con- centrations of endothelin-1 in patients with Flammer syndrome symptoms are associated with an increased risk of normal-tension glaucoma. Discussion: Hypertensive uveitis is in most cases of herpetic aetiology. The coexistence of pre-existing juvenile glaucoma with an episode of severe, treatment-refractory hypertensive uveitis has not been described as a risk fac- Method: The study group consisted of 80 adults, including patients with pri- tor. Our hypothesis is that the trabecular meshwork, which has already been mary open-angle glaucoma, normal-tension glaucoma, ocular hypertension, altered by juvenile glaucoma, is the target tissue of the herpetic infection and and a healthy control group. Participants completed a questionnaire that cov- this is the reason why the glaucoma is refractory to treatment. ered symptoms such as cold extremities, muscle cramps, reduced sense of thirst, increased sensitivity to certain drugs, tinnitus or sudden hearing loss, and low blood pressure. Personal characteristics, such as body type, work environment, and psycho- logical profiles, were also recorded. Blood samples were collected for labora- tory analysis of endothelin-1 plasma levels. Results: Patients with Flammer syndrome frequently had asthenic body types, worked in enclosed environments, and reported chronic stress exposure. Elevated endothelin-1 plasma levels were associated with an increased risk of normal-tension glaucoma. The participant with the highest value of endothe- lin-1 in blood plasma was a male with a Flammer syndrome profile diagnosed with normal-tension glaucoma. Conclusion: Understanding the connection between Flammer syndrome and normal-tension glaucoma is important. Recognizing the symptoms and signs of Flammer syndrome could improve diagnostic accuracy and treatment strat- egies. EP-GLA-19 Combined procedure with Paul’s glaucoma implant and reopening of previous filtering surgery in a patient with hypertensive uveitis crisis and juvenile glaucoma EP-GLA-20 Non-penetrating deep sclerectomy (NPDS) in full-thickness corneal keratoplasty M.-D. Lago-Llinas1, A. Bengoa-Gonzalez1, C. Mata-Beltran1, M. Montero-Rodriguez1, J.-L. Torres-Peña1, B. De Lucas-Viejo1 1Hospital Universitario 12 de Octubre, Ophthalmology, Madrid, Spain Purpose: Glaucoma is the most common cause of irreversible vision loss in patients after penetrating keratoplasty (PK) and the second most common cause of graft failure after endothelial cell loss. The risk of graft failure is even higher (40%) when glaucoma requires surgery. Glaucoma after corneal surgery is difficult to diagnose and monitor, so it is imperative to describe the multifactorial aetiology and risk factors, the most important of which is pre- existing glaucoma. Treatment can be medical, laser or surgical, including classic filtering surgery (trabeculectomy, NPDS), trabecular procedures, minimally penetrating glau- coma surgery (XEN®, Preserflo®) and glaucoma drainage devices (GDD). Methods: We present a case series of NPDS in patients with PK. The require- ments for NPDS are: absence of peripheral anterior synechiae, no superior conjunctival scarring, no angle dysgenesis, open angle and peripheral trans- parency to perform goniopuncture. M.-D. Lago-Llinas1, A. Bengoa-Gonzalez1, C. Ruiz-Arranz1, A. Iribarra-Fermandois1, M. Montero-Rodriguez1, B. De Lucas-Viejo1, J.-L. Torres-Peña1 1Hospital Universitario 12 de Octubre, Ophthalmology, Madrid, Spain Results: NPDS was performed in 8 cases. The main aetiology was kerato- conus in 4 cases. We achieved a mean IOP reduction from 27 mmHg to 14 mmHg and a mean medication reduction from 3.38 to 1.25. The minimum time between KP and NPDS was 6 months. We had 2 KP failures requiring re-KP and only 1 patient required additional glaucoma surgery. Clinical case: A 21-year-old female patient with juvenile glaucoma. Non- Conclusions: A complete glaucoma evaluation should be performed before penetrating deep sclerectomy (NPDS) was performed in 2017 with good considering corneal transplantation as this is the most common cause of glauco- intraocular pressure (IOP) control in both eyes. She has a family history of ma development in the postoperative period and also after corneal transplanta- glaucoma. tion as it is the most common cause of vision loss and the second most common She presented to the emergency department in March 2024 with ocular pain cause of graft failure. The incidence of glaucoma is lower in lamellar transplants and loss of vision in her right eye. She had an nonreactive right pupil, Tyndall than in PK. The management of glaucoma after PK is complex and requires +++, retrokeratic precipitates and IOP 50 mmHg. Hypotensive treatment was close collaboration between the two specialties. There are several options for the prescribed with a good response, but 1 week later she presented with the same surgical management of glaucoma after PK, including NPDS, with good results condition, so oral acetazolamide was added. in both glaucoma control and preservation of corneal transparency. 108 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-21 Relationship between long-term IOP fluctuation and glaucoma progression in Normal Tension Glaucoma (NTG) K.h. Kang1, S.H. Park1, S.Y. Kim1, C.H. Song1, M.G. Huh2, Y.K. Kim1, K.H. Park1 1Seoul National University Hospital, Seoul, Korea, Republic of, 2Yeungnam University Hospital, Daegu, Korea, Republic of Purpose: To examine whether long-term IOP fluctuation is associated with glaucoma progression in normal tension glaucoma(NTG) patients. Methods: Eighty-six eyes of forty-five NTG patients (73% female) with a mean age of 67.2 years were included. Inclusion criteria were NTG patients with at least 5 years follow-up and more than 20 outpatient visits and also, with visual field (VF) examinations conducted more than 5 times. We defined IOP fluctuation in 4 ways. As has been widely used in other studies, not only the standard deviation (SD) value or the difference between the highest and lowest IOP, but also dividing each value by the mean IOP was used to the analysis. The progression of glaucoma was defined as confirmed progression of reproducible VF defects in at least three VF examination. Results: In the linear regression test, all 4 values that used for define IOP fluctuation were found to have a significant correlation with VF progression. In addition, multiple regression analysis was performed on the following, and it was confirmed that there was no multi-competence with other confounding variables in each. With the T-test to determine if there is a significant differ- ence in VF progression between high and low fluctuation groups, the results show that there are significant difference in VF progression. Kaplan-Meier survival analysis also shows that the high and low fluctuation groups have sig- nificantly different survival curve. And also shows the progression free portion is higher in the low fluctuation group. Conclusion: IOP fluctuation can be considered as an independent factor in visual field progression, and it can also be considered as an independent factor in glaucoma progression. EP-GLA-22 Beta and gamma zone parapapillary atrophy in non-myopic eyes S.D. Cho1,2, Y.I. Yun1,3, M. Kim4, S.H. Kim5, K.M. Lee1,6 1Seoul National University College of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of, 2Seoul Regional Office of Military Manpower, Department of Conscription Examination, Seoul, Korea, Republic of, 3Seoul National University Hospital, Department of Ophthalmology, Seoul, Korea, Republic of, 4Dongguk University Ilsan Hospital, Department of Ophthalmology, Goyang, Korea, Republic of, 5The One Seoul Eye Clinic, Department of Ophthalmology, Seoul, Korea, Republic of, 6Seoul National University Boramae Medical Center, Department of Ophthalmology, Seoul, Korea, Republic of Purpose: To evaluate β- and γ-zone parapapillary atrophy (PPA) in non- myopic eyes. Methods: In total, 151 non-myopic eyes with axial length (AXL) of less than 24.0 mm were included. Based on cross-sectional OCT images, the β-zone PPA was defined as the area near the optic nerve head (ONH) where the retinal pigment epithelium is absent, and the γ-zone PPA where the Bruch’s mem- brane (BM) is absent. For each PPA, the angular location of maximal width was measured from the BMO center. Central retinal vascular trunk deviation from the BM opening (BMO) center was measured as a surrogate of lamina cribrosa (LC)/BMO offset. Patients were classified into three groups based on the extent and direction of the LC/BMO offset: 1) minimal offset (offset index < 0.2), group A; 2) temporal offset (offset index ≥ 0.2), group B; and 3) nasal offset (offset index ≥ 0.2), group C. Results: Sixty-four eyes had minimal offset (group A), 52 eyes temporal off- set (group B), and 35 nasal offset (group C). Group C had the longest AXL, and the largest BMO. The angular location of β-zone PPA showed no differ- ence between groups (P=0.234), while that of γ-zone PPA showed significant intergroup difference (P<0.001). The LC/BMO offset showed significant an- gular correlation with β-zone PPA (r=-0.197, P=0.035) and γ-zone PPA (r=- 0.442, P=0.001). The presence of β-zone PPA was associated with older age (OR=1.119, P<0.001) longer AXL (OR=2.260, P=0.011), and the presence of γ-zone PPA (OR=8.952, P<0.001). Among 56 eyes with γ-zone PPA, 28 eyes (50.0%) had their γ-zone PPAs in the nasal side, which was associated with the superotemporal direction of the LC/BMO offset (OR=1.009, P=0.001). Conclusions: Both β- and γ-zone PPAs were found in non-myopic eyes. Nasally located γ-zone PPA was associated with the temporal direction of LC/ BMO offset like a mirrored image of myopic PPA. γ-zone PPA is not restricted to myopia but represents the offset between the openings of the ONH canal. EP-GLA-23 The role of endothelin-1 in primary open angle glaucoma S. Ljaljevic1 1University Clinic Center Sarajevo, Eye Clinic, Sarajevo, Bosnia and Herzegovina Purpose: To determine the value of ET-1 in the plasma and humor aqueous patients with POAG and control group of patients without glaucoma.To inves- tigate the correlation of plasm ET-1 and humor aqueous (AH ET-1) with the parameters of visual field and OCT in POAG and non glaucomatous group. Patients and methods: In this prospective, clinical, manipulative study includ- ed 60 patients of both sexes. All patients were hospitalized at the Department of Ophthalmology KCUS, for glaucoma surgery (Trepanotrabeculectomy) or for cataract surgery. Patients were divided into 2 groups of 30 patients: pa- tients with POAG and a control group of patients hospitalized for surgery cataract without glaucoma. Additionally done clinical biochemical and immunological determination of the value of plasm ET-1 and AH ET-1. We followed the parameters of the visual field (Otopus 101), MD and LV, and the diameter of the excavation (C / D) and vertical diameter of excavation using OCT. Results: There was no SS differences in the plasm ET-1 between POAG and control group, but SS higher values of ET-1 in AH in POAG than in the CG; CG 1,13 pg/ml; POAG 2.80 pg/ml. There was a SS positive correlation be- tween plasm ET-1 and vertical diameter of excavation in the POAG group (rho = 0.448, p <0.05)and SS positive correlation between AH ET-1 and C/D ratio (rho = 0.551, p <0.05), and AH ET-1 and vertical diameter of exavation (rho = 0.515, p <0.05). Positive correlation of AH ET-1 and MD of VF (rho=0,637, p<0,01)., and LV of VF(rho=0,644, p<0,01). Conclusion: The concentration of ET-1 in aqueous humor is significantly in- creased in patients with POAG compared to the control group and showed correlation with IOP, parameters of OCT and VF. 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ELECTRONIC POSTER PRESENTATIONS EP-GLA-24 Laser peripheral iridoplasty – when to perform? L. Kelava1, S. Kirinčić1, I. Genda2 1Clinical Hospital Sv. Duh, Ophthalmology, Zagreb, Croatia, 2University Hospital Sv. Duh, Ophthalmology, Zagreb, Croatia Iris plateu syndrome is a rare condition, and iris plateu configuration is often diagnosed and recognized only after IOT (intraocular pressure) elevation after peripheral iridotomy. We present case series of 8 patients with iris plateu configuration confirmed by gonioscopy and UBM (ultrasound biomicroscopy), with different treatment approaches and results. There are no strict guidelines when to perform the procedure and when to monitor the patient closely and we suggest it is justified to perform laser iridoplasty prior to peripheral iridotomy in confirmed cases of iris plateau configuration + elevated IOT and/or visual field/OCT (optical coherent tomography) changes. Methods: Three patients, in whom iris plateau configuration was diagnosed by gonioscopy and confirmed by UBM, were so far treated by peripheral iri- doplasty. All of them had either high IOT values or visual field/OCT changes. One patient (one eye) was previously treated by peripheral iridotomy for angle closure. Results: Laser iridoplasty was performed in 3 patients, with excellent IOT lowering results both one week and one month and 3 months post iridoplasty and so far no complications were observed. Four patients had normal IOT values at first presentation with normal visual field and OCT results and are only being monitored. In the last patient, trabeculectomy was performed (due to eye comorbodities), also with excellent postoperative IOT results. Conclusions: We wish to discuss if it is necessary to perform laser iridotomy prior to iridoplasty in confirmed cases of iris plateu configuration if it is known it could result in IOT elevation that could cause irreversible damage to the optical nerve fibre, and when to perform iridoplasty or just monitor the patient. EP-GLA-25 Surgical outcomes of Ahmed glaucoma valve implantation following failure of a prior glaucoma surgery A. Reis Da Silva1, R. Gonçalves1, A.R. Viana1, C. Francisco1, J. Rocha1, P. Tenedório1 1Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal 10.5mmHg at 1 week (p<0.05), 16mmHg at 1 month (p<0.05), 15.5mmHg at 3 months (p<0.05), 14.4mmHg at 6 months (p<0.05), 15mmHg at 9 months (p<0.05), 15.8mmHg at 12 months (p<0.05), 14.3mmHg at 18 months (p<0.05), and 14.4mmHg at 24 months (p<0.05). At the last follow-up, the mean IOP was reduced by 46.1%. The mean preoperative number of medications was 3.1, which significantly decreased to 1.2 at 3 months (p<0.05), 1.4 at 6 months (p<0.05), 1.6 at 9 months (p<0.05), 1.7 at 12 months (p<0.05), 1.8 at 18 months (p<0.05), and 1.7 at 24 months (p<0.05). At the last follow-up, the mean number of medica- tions was reduced by 45.2%. The success rate at the last follow-up was 50%. Conclusions: Although refractory glaucoma is challenging to manage, AGV implantation has proven to be an effective procedure for controlling IOP for up to 24 months in patients who have undergone the procedure following the failure of a prior glaucoma surgery. However, prospective, randomized studies are still needed to further evaluate its efficacy and safety profile. EP-GLA-26 The paradox of treatment: ciliary effusion induced by travoprost – a case report F. Maia1, G. Morgado1 1Hospital de Braga, Oftalmologia, Braga, Portugal Introduction: Travoprost is a topical prostaglandin analog frequently pre- scribed as an intraocular pressure-lowering agent. Methods: Case report from the Ophthalmology Department at Unidade Local de Saúde de Braga, October 2024. Written informed consent was obtained from the patient for the publication of this case report and accompanying im- ages. There are no conflicts of interest to declare. Results and discussion: An 84-year-old pseudophakic female with primary open-angle glaucoma developed ciliary effusion after long-term travoprost use. The patient reported decreased vision in her left eye over two weeks. Ophthalmological examination revealed decreased visual acuity, myopic shift, shallowed anterior chamber, and increased intraocular pressure in the left eye. Fundoscopy was unremarkable. Anterior segment optical coherence tomog- raphy confirmed ciliary effusion with anterior displacement of the iris-IOL bag complex. Complete resolution occurred three days after discontinuing travoprost. Conclusion: This case highlights a rare but significant complication of travo- prost, a frequently prescribed glaucoma medication. The patient’s subtle symptoms could have been easily overlooked without high index of suspicion. When suspected, discontinuing the medication can serve as both as diagnostic Purpose: To evaluate the surgical outcomes of Ahmed glaucoma valve (AGV) test and treatment. implantation following failure of a prior glaucoma surgery. Methods: A retrospective review was conducted on the medical records of patients who underwent AGV implantation following the failure of a prior glaucoma surgery, between November 2014 and January 2022. Clinical outcome measures, including intraocular pressure (IOP) and the num- ber of medications, were recorded from the preoperative visit and at all follow- up visits up to 24 months postoperatively. The primary outcome was defined as achieving an IOP of ≥ 5 mmHg and < 22 mmHg. Failure was defined by any of the following criteria: loss of light perception, a sustained IOP > 21 or < 5 mmHg, the necessity for additional glaucoma surgery, or valve extrusion. Results: A total of 22 eyes from 21 patients who had previously undergone glaucoma surgery were included in the study. The mean preoperative IOP was 26.7mmHg, which was significantly reduced to 9.1mmHg at 1 day (p<0.05), 110 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-27 Bilateral iridocorneal endothelial syndrome presenting as essential Iris atrophy variant with secondary glaucoma in a 33-year-old female: a case report M. Montenegro1, J.A. Ferrolino1, G.E. Comia1 1De La Salle University Medical Center, Department of Ophthalmology, Cavite, Philippines cated severe and generalized loss of the peripapillary retinal nerve fiber layer in both eyes. The patient was referred for a combined neuro-ophthalmology and glaucoma evaluation. A cranial MRI revealed no abnormalities. Visual Evoked Potentials indicated severe dysfunction of the visual pathway in both eyes. Goldman perimetry demonstrated severe constriction of the visual field in both eyes. A diagnosis of advanced JOAG was suspected, and the patient continued treatment with topical timolol. However, during a follow-up evaluation ten weeks after delivery, the patient presented with an IOP of 42 mmHg in both eyes and complained of retro- orbital pain. Maximum medical therapy was initiated. Despite this, IOP re- mained elevated, leading to the decision to proceed with glaucoma surgery. Purpose: Iridocorneal Endothelial (ICE) Syndrome is a rare condition charac- The patient underwent deep sclerectomy, which resulted in adequate control terized by abnormalities of the corneal endothelium, progressive iris anoma- lies and iridocorneal angle obstruction that can cause Secondary Glaucoma. It includes three variants: Iris Nevus Syndrome, Chandler Syndrome and Essential Iris Atrophy. This case report presents a rare case of Bilateral ICE Syndrome with Secondary Glaucoma, its ocular findings, causes, possible complications and manage- ment strategies, as well as to emphasize the advantages of using diagnostics and imaging techniques to aid in diagnosing ICE Syndrome. of symptoms and normalization of IOP.. During pregnancy, IOP is thought to decrease through different mechanisms mediated by the increased production of estrogen, progesterone, beta-HCG and relaxin. However, even when IOP values remain within the normal range, a signifi- cant proportion of pregnant patients experience progression during both the gestation and post-partum periods. Ophthalmologists should be aware of the pregnancy-related changes occurring in the eye, since the phenomenon of IOP Method: A 33-year-old female consulted due to blurring of vision with com- reduction during gestation may delay a straightforward diagnosis of glauco- plaints of photophobia and abnormally shaped pupils in both eyes. Diagnostics matous neuropathy. were done such as Slitlamp Examination, Specular Microscopy, OCT of Macula and ONH, Perimetry and AS-OCT with clinical follow-up visits. Results: During initial evaluation, Slitlamp Examination revealed Corectopia, Polycoria and Iris Atrophy. Intraocular Pressures were 18mmHg in the right EP-GLA-30 eye and 16mmHg in the left eye with 360-degree Peripheral Anterior Synechiae and extensive obstruction of the Trabecular Meshwork on Gonioscopy and AS- OCT. Fundoscopy showed increased Cup-to-disc ratio of 0.9 on both eyes. Central Corneal Thickness were 454µm on the right eye and 477µm on the left eye. Diagnosis of Essential Iris Atrophy with Secondary Glaucoma was made. Patient was started on Anti-Glaucoma medication and is being followed up showing minimal reduction of pressure on both eyes. Conclusion: Early diagnosis is helpful to better manage ICE Syndrome and its complications which necessitates participation of Cornea and Glaucoma Specialists due to its challenging nature. Ocular findings supported by Imaging techniques used to confirm the diag- nosis, with additional test like AS-OCT, were seen to be helpful in managing and monitoring cases and may beneficial in preventing further progression and complications of ICE Syndrome. EP-GLA-28 Glaucoma in disguise: the role of hormones in intraocular pressure J. Castro Cabanas1, D. Ferreira Cardoso1, L. Ribeiro1, D. Meira1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal A 42-year-old woman with presented to our department with complaints of bilateral vision loss that had progressively worsened, especially since the start of her pregnancy. She was 29 weeks pregnant. On examination, her visual acuity was counting fingers at 1 meter in both eyes. Her intraocular pressure (IOP) was measured at 15 mmHg in both eyes. Fundoscopy showed severe optic disk pallor with a vertical cup-to-disk ratio of 0.95 in the right eye and 1.0 in the left eye. Optical coherence tomography of the optic nerve indi- Thyroid eye disease and glaucoma: a cross-sectional study comparing clinical and retinal parameters L.A. Ghenciu1,2, A.C. Bolintineanu2 1University of Medicine and Pharmacy Victor Babes, Pathophysiology, Timisoara, Romania, 2Timis County Emergency Clinical Hospital, Timisoara, Romania Purpose: This study aimed to assess intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness in patients with open-angle glaucoma (OAG) with and without thyroid eye disease (TED). Our secondary aim was to assess clinical features of TED patients. Methods: A retrospective, cross-sectional study was conducted between January 2015 and December 2020 at a tertiary hospital from Timisoara, Romania. The study included 106 patients: 53 with OAG + TED (group A, 91 eyes) and 53 with OAG alone (group B, 88 eyes). TED was classified based on the Clinical Activity Score (CAS) and EUGOGO criteria. OAG was diag- nosed by IOP ≥ 21 mmHg and glaucomatous changes in the optic nerve head (ONH) observed using Cirrus HD-OCT. Demographic and clinical data, including age, gender, smoking, systemic comorbidities, and OCT parameters, were collected. Statistical analyses in- cluded T-tests, chi-square tests, and two-way ANOVAs. Results: Patients in group A were significantly younger than those in group B (39.7 ± 9.06 years vs. 55.8 ± 7.09 years, p < 0.001). IOP levels were similar across groups (27.5 ± 4.90 mmHg vs. 28.1 ± 4.90 mmHg, p > 0.05), with no significant correlation between IOP and exophthalmos in group A. Group A showed a 6.09% reduction in average RNFL thickness compared to group B (70.06 ± 6.95 µm vs. 74.60 ± 5.25 µm, p < 0.05), with the temporal quadrant being the most affected in both groups. ONH parameters revealed thinner neuroretinal rim area and elevated cup-to- disc ratios in group A, though the latter approached significance (p = 0.052). Active TED (CAS ≥ 3) was identified in 48.35% of eyes from group A, but did not significantly influence RNFL thickness or IOP levels. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 111

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ELECTRONIC POSTER PRESENTATIONS Conclusions: TED contributes to significant optic nerve and RNFL structural changes in OAG patients, particularly in younger individuals, with notable thinning in the temporal quadrant. While IOP levels did not differ significantly between groups, structural damage was more pronounced in the OAG + TED group. EP-GLA-31 Retrospective analysis of the influence of prior treatment type on tolerability characteristics of NET/LAT and BIM/TIM using data from the MERCURY 3 study in patients with open-angle glaucoma and OHT G. Holló1,2, W.D. Lamb3 1Tutkimusz LTD, Solymar, Hungary, 2Eye Center, Prima Medica Health Centers, Budapest, Hungary, 3Santen SA, Geneva, Switzerland Purpose: A post hoc analysis compared the tolerability characteristics of ne- tarsudil 0.02%/latanoprost 0.005% (NET/LAT) and bimatoprost 0.03%/timo- lol 0.5% (BIM/TIM) in patients with glaucoma or ocular hypertension (OHT), stratified by either prior IOP-lowering monotherapy (pM) or combination therapy (pCT) before enrolment. Methods: MERCURY-3 study data were analysed retrospectively for the EP-GLA-32 Comparison of two protocols of diode laser transscleral cyclophotocoagulation in refractory glaucoma E. Anastasopoulos1, S. Koronis1, P. Garitsis1, N. Ziakas1 1Aristotle University of Thessaloniki - General Hospital Papageorgioou, 2nd Department of Ophthalmology, Thessaloniki, Greece Purpose: To compare two diode laser transscleral cyclophotocoagulation (DLTSCPC) protocols, ‘pop’-titrated and ‘slow-burn’. Method: This was a prospective randomized pilot study comprised of pa- tients with refractory glaucoma who were scheduled for DLTSCPC and were followed-up for a period of 3 months. The major outcomes of this study were intraocular pressure (IOP) before and after the procedure and the incidence of adverse events. Furthermore, postoperative pain, postoperative intraocular inflammation and corrected distance visual acuity (CDVA) were evaluated. Results: The initial IOP measurements were 37.9±12.7 mmHg in the pop group and 41.2±9.6 mmHg in the slow-burn group and decreased to 20.3±13.9 mmHg and 21.3±13.4 mmHg respectively at the final follow-up visit. At the third postoperative month, 64.3% and 57.1% of patients had IOP measurments ≥6 and≤ 21 mmHg in the pop and slow-burn groups respectively. The occurrence of adverse events was similar in both groups, with 1 case of rate of treatment-emergent adverse events (TEAEs) and withdrawals due to hyphema in the pop group and 2 cases in the slow-burn group, and 1 case adverse events (AEs), as well as the incidence of conjunctival hyperaemia of hypotony in each group. Mean CDVA remained unchanged until the end (CH) and corneal verticillata (CV). A chi-square test of independence was performed for each comparison; p-values <0.05 are considered significant. Results: Overall, 218 NET/LAT and 212 BIM/TIM patients (pts) were in- cluded; 158 (72%) NET/LAT and 147 (69%) BIM/TIM pts had switched from pM, and 60 (28%) and 65 (31%) pts, respectively, from pCT. For the NET/LAT cohort, the incidence of TEAEs was 14 percentage points (pp) lower in pM than in pCT pts (51% vs 65%; p=0.06), with significantly fewer withdrawals due to AEs (14% vs 27%; p=0.02). CH incidence was 13 pp lower in pM vs pCT pts (27% vs 40%; p=0.06); no difference was found in CV (11% vs 12%; p=0.8). In the BIM/TIM cohort, the incidence of TEAEs in pM and pCT pts was 28% and 18%, respectively (p=0.14). No difference was found in withdrawal rates due to AEs (1% vs 2%; p=0.9). CH incidence was similar in pCT and pM pts (9.5% vs 7.5%; p=0.6). CV was not seen in the BIM/TIM arm. Conclusions: NET/LAT pts with pM had a somewhat lower incidence of overall TEAEs and of CH, compared with those with pCT. This might contrib- ute to a statistically significantly lower AE-attributed withdrawals. The results suggest that more complex or aggressive IOP-lowering therapy before the introduction of NET/LAT may be causally related to the incidence of clinically significant TEAEs in glaucoma and ocular hypertensive patients treated with NET/LAT. of follow-up. Nonetheless, 4 eyes in each group encountered CDVA loss. Postoperative pain and inflammation were also similar between groups. Conclusion: At the third postoperative month, safety and efficacy was simi- lar in the two techniques. The relative ease of the slow-burn technique may make its application more appealing to ophthalmic surgeons beyond glaucoma specialists. EP-GLA-33 Predicting the success of cyclophotocoagulation in neovascular glaucoma using a neural network model O. Guzun1, O. Zadorozhnyy1, N. Khramenko1, L. Velichko1, A. Korol1 1“The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” State Institution, Odesa, Ukraine, Odesa, Ukraine Aim: To investigate the diagnostic significance of inflammation and intraocu- lar blood circulation indicators in a neural network model predicting the ef- fectiveness of transscleral cyclophotocoagulation treatment in patients with NVG of diabetic origin. Method: This study included 127 patients (127 eyes; aged Ме 65.0 years) with diabetic NVG and 20 healthy individuals as an immunological control. All patients underwent TSC СPC with a diode laser λ=810 nm. Treatment success was defined as achieving an IOP level of ≤ 21 mmHg and maintaining or improving BCVA after 12 months of observation. Preoperative systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were calculated. We assessed the values of volumetric pulse blood fill- ing, determined by the rheographic coefficient (RQ, ‰), using the rheooph- thalmography method. 112 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-35 Use of preserflo® microshunt in pediatric glaucoma secondary to neurofibromatosis type 1 S. Rebocho Duarte1, B. Guerreiro Dias1, J. Passos2, R. Correia Barão1, A. Barata1, C. Brito1, L. Abegão Pinto1, F. Jorge Teixeira1 1Faculty of Medicine of the University of Lisbon, Department of Ophthalmology, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal, 2Instituto Português de Oncologia de Lisboa, Lisbon, Portugal Introduction: Glaucoma associated with Neurofibromatosis Type 1 (NF1) is rare and often difficult to diagnose and manage. We report two cases of pediatric unilateral glaucoma associated with NF1 treated with PRESERFLO® Microshunt implant. Case report: In case 1, glaucoma in the left eye presented at birth and the patient was submitted to trabeculotomy and cyclophotocoagulation. At 5 months-old, due to uncontrolled intraocular pressure (IOP), the patient was submitted to Preserflo® implantation in the supero-nasal quadrant (SNQ), with application of Mitomycin-C (MMC) 0.2mg/mL for 30 seconds. There was a small hyphema post-operatively, which spontaneously resolved after 1 week. Post-operative IOP was 24 mmHg after 12 months and 34 mmHg after 16 months with topical medication. The implant was removed and a new Preserflo® was implanted in the supero- temporal quadrant, using MMC 0.4mg/mL for 2 minutes. The device was fixated to the sclera with 10-0 nylon suture. Post-operative IOP was 10 mmHg after 3 months and 5 mmHg after 9 months, with no topical medication and no evidence of clinical hypotony. In case 2, glaucoma in the right eye was diagnosed at 2 years-old and the patient was submitted to trabeculotomy. Similarly, due to uncontrolled IOP at the age of 5 years-old, the patient was submitted to Preserflo® implantation in the SNQ, with MMC 0.4mg/mL for 90 seconds. Post-operative IOP was 8 mmHg after 1 month and 10 mmHg after 3 months (last follow-up). In both cases glaucoma was secondary to large craniofacial plexiform neurofibromas ipsilateral to the eye with glaucoma and were under treatment with mitogen-activated protein kinase inhibitors. Conclusion: To the best of our knowledge, we present the first cases reporting the use of Preserflo® Microshunt in pediatric patients with glaucoma secondary to NF1, after previous failed glaucoma surgeries. Surgical outcomes can be variable but safety profile is favorable. Multiple regression analysis was used to conclude the significance of treat- ment efficacy based on initial clinical and laboratory indicators, followed by constructing a prediction model in the neural network. Results: The development of the neural network model identified the most significant “input” parameters: SIRI (100%), RQ (85.7%), and SII (80.7%), which significantly influenced treatment success. The sensitivity of the neural network model was 100%, specificity was 30%, and the percentage of cor- rectly predicted events during testing on the control group was 92.9%. Conclusions: Neural network-based prediction of transscleral cyclophotoco- agulation effectiveness for patients with diabetic neovascular glaucoma allows for a sufficiently accurate forecast of treatment success with a probability of 92.9%. We believe the in-time correction of systemic inflammation and in- traocular blood circulation can significantly reduce intraocular pressure, pre- serve visual acuity, and improve the quality of life in patients with diabetic NVG after TSC CPC. Further research is required to support these findings. EP-GLA-34 Correlation between the optical density of aqueous humour and lens thickness in management of primary open-angle glaucoma V. Melnyk1, L. Vasylieva1 1Visiobud, Kyiv, Ukraine Purpose: To evaluate the correlation between lens thickness and the optical density of aqueous humour in patients with open-angle glaucoma. Methods: 150 patients (172 eyes) who underwent surgical treatment for cata- racts and glaucoma between 2016 and 2023 were included in this study. The patients were divided into three groups. The first group (82 eyes) consisted of the patients with cataracts without vis- ible signs of pseudoexfoliation syndrome. The second group (54 eyes) - patients with cataracts and pseudoexfoliation syndrome without symptoms of glaucoma. The third group (36 eyes) comprised patients with both cataracts pseudoexfo- liative glaucoma. Optical density was measured using spectroscopic analysis of the aqueous hu- mour samples collected during surgeries. Optical biometry was made in all the patients prior to the surgeries. Obtained results were analysed using R Studio Version 2024.09.0+375 for macOS. Results: There was a negligible difference in lens parameters and the optical density of aqueous humour among patients in the second and third groups. However, we have noticed a statistically significant dependence between these parameters in patients of the first group comparing with those in the second and third groups. The optical density of aqueous humour at wavelength of 202nm was higher in patients with pseudoexfoliation syndrome and primary open-angle glaucoma. This increase in optical density, moreover, correlated with a rise in lens thick- ness. This indicates that changes in anterior segment parameters may cause alterations in aqueous humour hydrodynamics, leading to the development of glaucoma. Conclusions: An increase in lens thickness may lead to a deceleration of fluid movement through the trabecular meshwork. This results in a rise of viscos- ity of aqueous humour, leading to intraocular pressure increase. Therefore, phacoemulsification of cataracts can help to stabilise the hydrodynamics of aqueous humour, preventing the development of glaucoma. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 113

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-36 EP-GLA-38 Effectiveness of selective laser trabeculoplasty in managing primary open-angle glaucoma and ocular hypertension in a district general hospital: a real-world analysis D. Sukumaran1, M. Elkhabiry1, S. Mitchell1, A. Elsahn1, M.N. Abdul Karim1 1Kings Mill Hospital, Nottingham, United Kingdom Purpose: 1. To evaluate the clinical effectiveness of selective laser trabeculoplasty by comparing intraocular pressure measurements before and after the procedure. 2. To assess the safety profile of the procedure in patients with primary open- angle glaucoma and ocular hypertension. Method: Patients who underwent selective laser trabeculoplasty (SLT) and completed one year of follow-up at the District General Hospital were selected for a retrospective analysis. Results:The results were comparable to those observed in the LiGHT trial, with 72.5% of eyes among the 69% responders achieving a greater than 20% reduction in intraocular pressure at one year after the selective laser trabecu- loplasty Conclusion: Selective laser trabeculoplasty is an effective treatment for re- ducing intraocular pressure in patients with primary open-angle glaucoma and ocular hypertension. EP-GLA-37 Large hemorrhagic Descemet’smembrane detachment aftercanaloplasty K. Boninska1, S. Cisiecki1 1Julianow Medical Center, Ophthalmology, Lodz, Poland Our study reports the incidence and management of large hemorrhagic Descemet’s membrane detachment (DMD) after canaloplasty ab externo. A 73-year-old female with moderately advanced glaucoma qualified for canalo- plasty at our clinic. At the time of admission to the hospital, the best-corrected visual acuity (BCVA) of the right eye was 0.05, and IOP of the right eye was 24 mmHg. The patient’s best-corrected visual acuity, intraocular pressure, and evaluation of the anterior segment were documented preoperatively and during a 4-month follow-up period, and the condition resolved completely 6 weeks after SF6 injection. DMD with in-tracorneal hemorrhage is a frequent complication of canaloplasty and should be considered during viscodilatation. It is pertinent to note that even large DMDs can completely resolve after gas bubbling. Change intraocular pressure during intravenous anesthesia in children N. Akhmedova1 1Republican Eye Hospital of Uzbekistan, Department of Ophthalmic Diagnostics and Laser Surgery, Tashkent, Uzbekistan Purpose: To study the dynamics of intraocular pressure (IOP) and other tono- graphic indicators in children under anesthesia with ketamine and fentanyl. Method: Tonography was performed on 50 children (100 eyes) aged 20 days to 14 years using a Maklakov tonometer and Friedenwald nomogram. Patients were divided into two groups: group I (29 children, 58 eyes) under- went cataract, strabismus, or ptosis surgery with ketamine induction; group II (21 children, 42 eyes) underwent glaucoma surgery or examinations un- der anesthesia with fentanyl induction. Statistical analysis confirmed result reliability (p ≤ 0.05), consistent with Student’s *t*-test critical values (A.P. Nesterov, 2003). Results: In group I, following ketamine induction, the average true IOP (P₀) increased by 3.8 mmHg, attributed to a rise in aqueous humor production (F), while the decrease in the outflow facility coefficient (C) was inconsistent. In group II, after fentanyl induction, there was a significant decrease in P₀, primarily due to an improvement in outflow facility (C), whereas the reduction in aqueous humor production (F) was not statistically significant. Dynamics of tonographic indicators in groups I and II: P₀(mmHg): group I: 14.90±0.08 before anesthesia, 18.70±0.2 after anesthesia (*t = 5.76*); group II: 22.40±1.0 before anesthesia, 20.40±0.3 after anesthesia (*t = 2.31*); C(mm³/ min/mmHg): group I: 0.37±0.03, 0.33±0.01 (*t = 0.76*); group II: 0.20±0.02, 0.27±0.03 (*t = 4.06*); F(mm³/min): group I: 2.48±0.02, 4.09±0.08 (*t = 2.22*); group II: 1.15±0.05, 0.96±0.02 (*t = 0.72*); Becker Coefficient (P₀/C): group I: 52.80±1.1, 75.20±2.5 (*t = 2.78*); group II: 112.00±2.0, 77.80±2.5 (*t = 3.06*) (respectively). Conclusion: In patients in group I an increase in true IOP was observed due to a significant increase in the production of aqueous humor. In patients in group II, there is a significant decrease in true IOP due to a significant increase in the outflow of intraocular fluid. EP-GLA-39 The impact of the doctor-patient relationship on glaucoma management S. Bouderka1, S. Rhalib1, O. Bouderka1, Z. Laftimi1, G. Daghouj1, L. El Maaloum1, B. Allali1, A. El Kettani1 120 Aout 1953 Hospital, Ophtalmology, Casablanca, Morocco The aim of our work is to evaluate patients knowledge of chronic glaucoma and the constraints related to the medical treatment, determine the adherence rate among them, study the factors that may influence this adherence rate, and formulate suggestions to improve adherence levels. We conducted a prospec- tive, descriptive and analytical study between March 2023 and March 2024 involving 103 patients. We noted a slight male predominance : 55.6%, a sex ratio of 1.24, and an average age of 63.6 years. Among all patients, 44 met the criteria for a good doctor-patient relationship, making up 42.7%. Adherence was the objective criteria studied to evaluate this doctor-patient relationship, with 34 patients being adherent, representing 33%. It was found 114 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS that the doctor’s welcome in turn promotes a better doctor-patient relationship, hence better adherence. Similarly, the patient’s own estimation of consulta- EP-GLA-41 Trabeculectomy augmented with anti-VEGF reduces failure and re-intervention rates with a favourable safety profile: a systematic review and meta-analysis S. Ramji1, J. Tan2, Z. Jarrar3, S. Hamid4, G. Gazzard5, A.S. Ansari6 1Northwick Park Hospital, London North West University Healthcare NHS Foundation Trust, London, United Kingdom, 2Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, 3King’s College London, Section of Academic Ophthalmology, School of Life Course Sciences, London, United Kingdom, 4Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom, 5University College London Institute of Ophthalmology and Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom, 6Moorfields Eye Hospital, NHS Foundation Trust & King’s College London, Section of Academic Ophthalmology, School of Life Course Sciences, London, United Kingdom Purpose: This systematic review and meta-analysis aimed to evaluate the ef- fectiveness of anti-vascular endothelial growth factor (anti-VEGF) agents as supplementary treatments to trabeculectomy (Trab) in reducing surgical com- plications in the treatment of glaucoma. While anti-VEGF agents are commonly employed to manage ocular condi- tions such as wet age-related macular degeneration, their role in glaucoma treatment remains unclear. Methods: A systematic review and meta-analysis was performed, focusing on randomised controlled trials (RCTs) that compared Trab with and without the addition of anti-VEGF agents in glaucoma patients. Data were retrieved from Medline, EMBASE, and Web of Science. The primary outcomes were failure, re-intervention and reoperation. Additional outcomes were hypotony, bleb leaks, encapsulated blabs, shallow anterior chambers, choroidal detachment, choroidal effusion and effect on acu- ity. Results: Nineteen studies with 1,049 patients were included. The results illustrated lower odds of failure and re-intervention for Trab augmented with MMC and bevacizumab vs. Trab augmented with MMC alone (OR = 0.40,95% CI [0.19, 0.85], p = 0.02, and OR = 0.54, 95%CI [0.30, 0.97], p = 0.04 respectively). However, if Trab was augmented with only bevacizumab, then the odds of failure and re-intervention were not lowered. There was an increased odds of encapsulated blebs with anti-VEGF augmentation but this was only seen if Trab was augmented solely with bevacizumab (OR = 2.85, 95%CI [1.25, 6.49], p = 0.01), if MMC and bevacizumab was used for augmentation then there were no increased odds. Conclusions: Overall, these results show that utilising Trab augmented with MMC and bevacizumab can reduce the odds of surgical failure and re-inter- vention compared with the current gold standard primary procedure, which is Trab augmented with MMC. However, larger and well designed RCTs with long-term follow-up are needed to further clarify these findings. tion time leads to better adherence. Almost half (47.8%) of the patients were adherent when examined by their doctor. In the group of adherents, 82.4% understood the purpose of their treatment and 73.5% knew its side effects. Conversely, among non-adherents, only 30.4% understood the purpose of the treatment and 14.5% were aware of the different side effects. It was observed that in the group of adherents, 24 out of 34 patients were aware of the risks associated with stopping the treatment, representing 70.6%. This percentage drops to 18.8% among non-adherents. Overall, the doctor-patient relationship, a non-technical yet essential aspect of healthcare professionals’ work, is crucial for optimal patient care. It rests on moral and legal imperatives. In the case of glaucoma, a chronic often asymp- tomatic disease, this relationship must constantly be reinforced after evalu- ation.. Thus, establishing a positive relationship involves providing adapted and updated information, detecting factors of poor adherence, and considering the influence of the patient’s entourage. EP-GLA-40 Clinical and diagnostic insights into Axenfeld-Rieger syndrome: a case series M. Puchol-Rizo1, A. Munoz-Gallego1, M.D. Lago-Llinás1, P. Tejada-Palacios1, A. Barceló-Mendiguchia1, L. Alcalde-Blanco1, R. Fernández-Herrero1 1Hospital Universitario 12 de Octubre, Madrid, Spain Purpose: Axenfeld-Rieger syndrome (ARS) is a rare genetic condition af- fecting ocular and systemic development, with a significant risk of glaucoma. This study aims to highlight the role of anterior segment OCT in the diagnosis and management of ARS through a review of three clinical cases, emphasiz- ing its diagnostic value in differentiating ARS from other anterior segment dysgenesis syndromes. Methods: A retrospective analysis of three patients diagnosed with ARS, managed at a single tertiary care center. Comprehensive clinical, genetic, and imaging evaluations were performed, including gonioscopy, anterior segment OCT, genetic testing, and systemic reviews. Diagnostic features and manage- ment approaches were documented and analyzed. Results: • Case 1: A 3-year-old girl presented with iris coloboma and iris retraction. OCT identified iridian intrastromal cysts and confirmed iris atrophy, aiding diagnosis despite inconclusive genetic testing. • Case 2: A 7-year-old girl with exophthalmos, corectopia, and posterior em- bryotoxon showed severe glaucoma resistant to topical treatment. Genetic analysis revealed FOXC1 gene alterations. • Case 3: A 10-year-old boy with posterior embryotoxon, polycoria, and atrial septal defect had a pathogenic FOXC1 mutation. OCT supported the diagnosis by delineating iridocorneal abnormalities. • Anterior segment OCT demonstrated unique features in all cases, facilitat- ing diagnosis and management decisions. Conclusions: ARS diagnosis requires an interdisciplinary approach combin- ing clinical, imaging, and genetic evaluations. Anterior segment OCT is a non- invasive, cost-effective tool critical for identifying characteristic ocular abnor- malities, contributing significantly to the differentiation of ARS from other conditions. Early identification and management of glaucoma are paramount for preserving vision in these patients. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 115

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-42 EP-GLA-43 Comparing the long-term outcomes of tube flushing versus transscleral cyclophotocoagulation in refractory glaucoma patients with prior tube shunt: a retrospective study T.C.J. Wong1, A.H.Y. Liu1, H. Aluzri2, V. Sung2 1The Chinese University of Hong Kong, Department of Ophthalmology and Visual Sciences, Hong Kong, Hong Kong, SAR of China, 2Birmingham & Midland Eye Centre, Birmingham, United Kingdom Purpose: Transscleral cyclophotocoagulation (CPC) and tube flushing (TF) are two notable surgical options for managing refractory glaucoma in patients with a pre-existing tube shunt. However, the long-term outcomes remain poorly studied. Method: A retrospective study was conducted. The primary outcome was IOP reduction (pre- versus post-operation). Secondary outcomes were the most recent best-corrected visual acu- ity (BCVA), final number of glaucoma medications prescribed (NOM), and whether further glaucoma surgery was needed. Result: 29 patients, including 23 eyes (mean age 38.52 ± 22.42 years) treated with TF and 8 eyes (37.25 ± 22.95 years) treated with CPC were recruited. Mean follow-up time was 5.33 ± 1.83 and 9.38 ± 3.90 years for TF and CPC groups respectively. Baseline mean IOP of TF and CPC groups were 21.26 ± 6.43 and 32.50 ± 10.57 mmHg respectively (p=0.19), and final IOP was 16.95 ± 6.40 mmHg in TF and 17 ± 11.97 mmHg in CPC (p=0.86). Baseline BCVA of TF and CPC groups were 0.76 ± 0.69 and 0.63 ± 0.37 log- MAR, final BCVA was 1.02 ± 0.82 and 0.82 ± 0.66 logMAR in TF and CPC respectively, which is statistically insignificant (p=0.59). Final NOM was 2.30 ± 1.46 in TF and 2.5 ± 1.20 in CPC (p=0.66). Additional glaucoma procedures were required in 33.3% and 62.5% of the TF and CPC patients respectively. Conclusion: Our findings show that both TF and CPC offer limited long-term effectiveness in managing refractory glaucoma in the presence of a pre-exist- ing tube shunt. These findings can better inform clinical decision-making and highlight the need for more effective long-term solutions in this challenging patient population. Treatment adherence in glaucoma patients: expert consensus recommendations from a quasi-delphi study L. Abegão-Pinto1, B. Cvenkel2,3, M. Kolko4,5,6, I. Lanzl7,8, A. Hommer9,10, F. Meier-Gibbons11, F. Aptel12,13, A. Tatham14, F. Topouzis15 1Unidade Local de Saúde Santa Maria, Department of Ophthalmology, Lisbon, Portugal, 2University Medical Centre Ljubljana, Department of Ophthalmology, Ljubljana, Slovenia, 3Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia, 4University of Copenhagen, Department of Drug Design and Pharmacology, Copenhagen, Denmark, 5Copenhagen University Hospital, Department of Ophthalmology, Copenhagen, Denmark, 6Your Eye Doctors (Dine Øjenlæger), Rungsted, Denmark, 7Chiemsee Augen Tagesklinik, Prien, Germany, 8Technical University of Munich, Department of Ophthalmology, Munich, Germany, 9Medical University of Vienna, Department of Clinical Pharmacology, Vienna, Austria, 10Hommer Ophthalmology Institute, Vienna, Austria, 11Eye Center Rapperswil, Rapperswil, Switzerland, 12Visis, Perpignan, France, 13Polyclinique Médipôle Saint-Roch-Elsan, Cabestany, France, 14Princess Alexandra Eye Pavilion, Department of Ophthalmology, Edinburgh, United Kingdom, 15School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, 1st Department of Ophthalmology, Thessaloniki, Greece Purpose: Glaucoma is the leading cause of irreversible blindness worldwide, with the most frequent first-line treatment being self-administered topical eye- drops. Poor adherence to treatment, which is present in more than 50% of glaucoma patients, remains a key issue. Our aim was to develop expert consensus recommendations related to treat- ment adherence in glaucoma patients. Methods: An international steering committee (SC) of glaucoma experts and members of the Educational Club of Ocular Surface and Glaucoma (ECOS-G) collaborated to develop clinical recommendations on adherence in glaucoma using a 2-round modified anonymous interactive quasi-Delphi process. The recommendations were formulated by the SC based on an analysis of the current literature to identify evidence to support statement development. A web-based interactive survey of faculty members was conducted in four identified areas: 1. Adherence in glaucoma and how it should be assessed, 2. Optimal adherence rates for beneficial clinical outcomes, 3. Adherence as an endpoint in clinical studies, and 4. Interventions to improve adherence. Faculty members voted on the clinical recommendations, and the threshold for consensus was set by the steering committee at ≥75% of agreement among respondents. Results: Consensus was reached on 12 out of 14 (86%) recommendations in the first round and 17 out of 21 (81%) recommendations in the second round. Statements of consensus included the importance of treatments side effects, number of medications and patient awareness in influencing adherence, as well as the increased risk of glaucoma progression due to low adherence. Additionally, there was consensus on the usefulness of connected devices for measuring adherence in real-world studies. Notably, all statements that did not reach consensus had agreement levels between 60 to 75%. Conclusions: These recommendations are useful to understand the impact of adherence in glaucoma care and how to measure it in clinical settings. 116 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-44 Clinical assessment of management when choosing a method of providing care to patients with open-angle glaucoma V. Melnyk1 1Bogomolets National Medical University, Kiyv, Ukraine Introduction: Glaucoma is an essential international social and medical prob- lem as it leads to irreversible blindness. Organization of treatment and preven- tion of complications using the most effective methods is the most important task of ophthalmologists at the present stage. The purpose of the study: To evaluate the management of assistance under the monitoring program «STOP! Glaucoma» to patients with suspected glau- coma, open-angle glaucoma and advanced stages of glaucoma. Materials and methods: To detect and prevent the progression of glaucoma in patients the LLC «VISIOBUD» Clinic developed and implemented the monitoring program «Stop! Glaucoma». The main task of program was to analyze the dynamics of glaucomatous changes in the optic nerve and to deter- mine whether glaucoma compensation is complete and whether patientі do not need a more radical treatment method to preserve visual functions. The following methods of empirical research were used: systematic approach - to determine the research elements between which there are relationships of objects and their properties; observation - to identify signs and external manifestations of facts; comparison - to determine similarities and differences and identify regulari- ties; measurement; monitoring. Results: In the course of the study, the dynamics of changes in intraocu- lar pressure in patients who follow the annual monitoring program «Stop! Glaucoma» in the clinic of LLC «VISIOBUD». 4 groups of patients were under observation. Installed that In 75% of cases, patients need surgical treat- ment of glaucoma to preserve their visual functions. Conclusions: Timely detection, monitoring, and treatment of initial signs of open-angle glaucoma and symptoms of its progression affects the preservation and prolongation of visual functions in patients. In the long term, surgical treatment of glaucoma is more cost-effective, as the need to use expensive hypotensive drops is significantly reduced (by 2.5 times). EP-GLA-45 Glaucoma severity and progression in individuals with asymmetric β-zone PPA: an intra-patient comparative study S.H. Park1, S.Y. Kim1, C.H. Song1, K.H. Kang1, J.K. Lee1, Y.K. Kim1, K.H. Park1, J.W. Jeoung1 1Seoul National University Hospital, Seoul, Korea, Republic of Purpose: To investigate whether there is a difference in inter-eye glaucoma severity and progression in patients with asymmetric baseline β-zone parapap- illary atrophy (PPA) morphology. Methods: Patients diagnosed with glaucoma in both eyes with asymmetric β-zone PPA morphology were included. Each individual’s eyes were classi- fied into two types. If the angular extent of PPA was less than 180 degrees, it was named the “Crescent type”, and if it was more than 180 degrees, it was named the “Solar-eclipse type” (Huh et al, 2024). Glaucoma progression was assessed by Optical Coherence Tomography (OCT) and Visual field (VF) Guided Progression Analysis (GPA) and the baseline and follow-up clinical data were analyzed using the paired test. Results: A total of 58 eyes of 29 glaucoma patients with asymmetric β-zone PPA were included in the study. The patient’s mean age was 54.1±15.6 years and the mean follow-up period was 10.7±3.2 years. There was no difference in the baseline intraocular pressure (IOP), IOP fluctuation, central corneal thick- ness (CCT), axial length (AXL), and disc parameters (disc tilt, ovality index, disc hemorrhage) between “Crescent type” and “Solar-Eclipse type.“ They showed no difference in the baseline OCT and VF data, including the retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform lay- er (GCIPL) thickness, baseline mean deviation (MD) and visual field index (VFI). Based on an analysis of glaucoma progression the rate of change in VFI were larger in the “Solar-Eclipse type” eyes. (Solar-Eclipse type eyes: -1.32%/yr, Crescent type eyes: -0.68%/yr) while the rate of change in OCT GPA showed no difference. Conclusions: The larger the angular extent of β-zone PPA, the more func- tional progression that was shown on visual field GPA, while structural pro- gression showed no significant difference. Our findings indicate that baseline β-zone PPA morphology could be one of the valuable predictors of future glaucoma progression. EP-GLA-46 Postoperative high intraocular pressure in patients after pars plana vitrectomy with silicone oil implantation K.-M. Dimitrova1, A. Marinov1, I. Petkova1, I. Kuneva1 1Specialized Hospital of Ophthalmology „Zora“, Sofia, Bulgaria Purpose: High intraocular pressure (IOP) is a common postoperative compli- cation following pars plana vitrectomy (PPV) with silicone oil implantation. This study assesses the incidence, risk factors, management and outcomes of elevated IOP postoperatively. Methods: A retrospective analysis of 315 patients treated with PPV and sili- cone oil implantation for the period of an year was conducted, focusing on postoperative IOP variation, timing of onset and possible treatment options and their efficiency. Elevated IOP often develops within the early postopera- tive period due to factors such as the physico-chemical properties of silicone oil, pupillary block or inflammatory response. Other possible causes include: preoperative high intraocular pressure, lens state, PRP done during the operation, duration and volume of the silicone oil tamponade. Results: Most of the patients had elevated IOP during the first two weeks af- ter the operation. Of them, 55% had high IOP, 41% had normal postoperative IOP and the results of the rest were borderline. The IOP was compensated with topical hypotensive medications alone – mostly a combined therapeutic agent. When this treatment alone was not sufficient surgical interventions were con- ducted - silicone oil removal or glaucoma surgery, depending on the sever- ity and underlying cause of IOP elevation. Early detection and individualized treatment are crucial to prevent long-term complications. Conclusions: This study emphasizes on the importance of consistent post- operative monitoring and draws attention to the necessity for individualized treatment approaches to minimize visual outcomes in patients with silicone oil tamponade. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 117

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ELECTRONIC POSTER PRESENTATIONS Future research should prioritize refining surgical techniques and exploring innovative tamponades to reduce the risk of elevated IOP. Some of these novel approaches include: gene therapy and targeted treatment (inhibition of fibrotic response), nanotechnology, lighter viscosity oils, combined surgical treatment. EP-GLA-47 Short term surgical outcome of phacoemulsification and goniotomi in open angle glaucoma: a small start in minimally invasive glaucoma surgery M. Rifada1, Y.D. Suandari2, E. Gustianty3, S. Umbara3 1Universitas Padjadjaran - Cicendo Eye Hospital, Ophthalmology, Bandung, Indonesia, 2RSUD Kabupaten Lombok Utara, Lombok, Indonesia, 3Universitas Padjadjaran - Cicendo Eye Hospital, Bandung, Indonesia Purpose: to evaluate short term surgical outcome of phacoemulsification and goniotomy in open angle glaucoma as a new start of minimally invasive glau- coma surgery (MIGS) Methods: This study is a retrospective observational study of patients who underwent phacoemulsification and goniotomy in open angle glaucoma, performed between June – November 2024. Outcome measures included intraocular pressure (IOP) changes, ocular hypotensive medication use, best EP-GLA-48 Management of malignant glaucoma in a post-cataract surgery patient: a case report and literature review A. Danilevičė1, A. Gerasimovė1, G. Kazlauskaitė1, A. Liveikienė2 1Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Ear, Nose, Throat and Eye Diseases, Vilnius, Lithuania, 2Vilnius University Hospital Santaros klinikos, Center of Eye Diseases, Vilnius, Lithuania Malignant glaucoma is a rare but serious condition that can complicate glau- coma management, particularly after cataract surgery. We present a case of a 79-year-old hyperopic woman with a history of closed-angle glaucoma, cata- ract surgery, and multiple laser iridotomies. Despite undergoing repeated laser iridotomies, her intraocular pressure (IOP) remained elevated (27 mmHg) and the anterior chamber was shallow. The patient’s shallow anterior chamber, glaucomatous optic disc changes, and progressive myopia post cataract sur- gery lead to suspicion of malignant glaucoma. After adding to her treatment atropine 1 % drops, her IOP reduced to 14.6 mmHg, and her anterior chamber depth was restored. As the patient refused additional interventions, she contin- ues to be successfully treated with antihypertensive drops and atropine. A literature review highlights the multifactorial pathophysiology of malignant glaucoma, which includes factors such as shallow anterior chambers, anterior lens displacement, and changes in the ciliary body and vitreous. This condi- corrected visual acuity change, and the occurrence of adverse event in 7 days, tion can cause symptoms like increased myopia and progressive narrowing of 1 month, 2 months, and 3 months. Statistical analysis was using Microsoft the anterior chamber, and it may arise after cataract surgery, laser treatments, Excel 2023. Result: Thirty-three eyes of 32 open angle glaucoma patients were included in this study. There were 2 eyes with steroid induced glaucoma, 6 eyes with or other ocular surgeries. Diagnosis is made after ruling out pupillary block via laser iridotomy, and treatment includes cycloplegics, intraocular fluid pro- duction inhibitors, carbonic anhydrase inhibitors, hyperosmotic agents, and pseudo-exfoliation glaucoma, 1 eye with juvenile open angle glaucoma, and topical steroids. Surgical options may include YAG laser therapy, cyclophoto- 24 with primary open angle glaucoma. The mean age of the patients was 66.6 coagulation, or vitrectomy. years old. Mean baseline IOP was 24.73 mmHg and reduce to 15.03 mmHg and 13.78 mmHg in 1 to 3 months of follow up (p ≤ 0.001). Mean medication use at baseline was 1.8 and reduced to 0.74 in 1-3 months of follow up (p ≤ 0.001). Hyphema was the most common complication of goniotomy (18,89%) and resolved without any surgery. Conclusion: The result of phacoemulsification and goniotomy in open angle glaucoma is an effective management in patient with glaucoma and cataract in short term follow up. It is a good start in exploring MIGS in glaucoma management This case underscores the importance of considering malignant glaucoma in patients with persistent IOP elevation and changes in refraction post-surgery, and highlights the effectiveness of targeted medical management in restoring anterior chamber depth and controlling IOP. EP-GLA-50 Acute angle-closure glaucoma in a 4-year-old: a rare presentation of idiopathic uveitis with severe structural complications R. Whitfield1, S. Mano1, R. Barão1, F. Pinto1, V. Lobo1, R. Campanilho Marques1, I. Leal1 1ULS Santa Maria, Ophthalmology, Lisbon, Portugal We present the case of a 4-year-old girl with no prior systemic or ocular disease, who presented urgently with acute right eye pain and emesis. Examination revealed acute angle-closure glaucoma with an intraocular pressure (IOP) of 66 mmHg, corneal edema, and iris bombé. Ultrasonic biomicroscopy (UBM) showed 360º posterior synechiae, complete angle closure, anterior and poste- rior chamber opacities, and posterior segment vitreous opacities, indicating inflammatory activity. Given her age and pain, exploratory surgery under general anesthesia was performed within 12 hours. Anterior chamber paracentesis was conducted for polymerase chain reaction (PCR) and lab analysis, followed by synechi- 118 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS olysis and peripheral iridectomy. The fellow eye exhibited no inflammation. Systemic investigations, including PCR for viral pathogens, were negative EP-GLA-52 except for HLA-B27 positivity. Pediatric rheumatology evaluation did not re- veal an underlying rheumatological condition like juvenile idiopathic arthritis Onset and course of juvenile glaucoma - cases from practice (JIA). A provisional diagnosis of idiopathic uveitis with acute angle-closure from synechiae was made. Postoperative treatment included oral acetazolamide, timolol, latanoprost, and topical dexamethasone with cyclopentolate, normal- izing IOP and reducing inflammation. Systemic corticosteroids and weekly methotrexate were initiated, with fortnightly 20 mg adalimumab added due to severity, in collaboration with pediatric rheumatology. Two months post-presentation, visual acuity improved to 0.5 (Snellen scale) in the right eye, with a quiet eye, clear cornea, minimal cells and flare, patent iridectomy, iris atrophy, and an IOP of 12 mmHg. This case highlights idio- pathic uveitis as a significant pediatric condition that can acutely cause severe complications. Early multidisciplinary management is critical for preserving vision and preventing long-term damage. EP-GLA-51 Mid-term results of combined cataract surgery and iStent Inject W E. Sampaio Fernandes1,2, A. Lima Cabrita1,2, B. Guerreiro Dias1, S. Rebocho Duarte1, A. Barata1,2, L. Abegão Pinto1,1, R. Correia Barão1,2 1Serviço de Oftalmologia, Hospital de Santa Maria – Unidade Local de Saúde Santa Maria, Lisboa, Portugal, 2Clínica Universitária de Oftalmologia, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal Purpose: iStent Inject W® (Glaukos, USA) is a minimally invasive glaucoma surgery device (MIGS) that reduces the intraocular pressure (IOP) by by- passing the trabecular meshwork into Schlemm cannal in patients with Open Angle Glaucoma. This study aims to evaluate the efficacy, safety and complication rate of the procedure. Methods: Retrospective analysis of consecutive patients who underwent combined phacoemulsification and iStent Inject W implantation. The out- comes were IOP and the number of glaucoma medications (NGM) at 6, 12 and 24 months. The Kaplan Meier method was used in survival analysis. Surgical success was defined as an intraocular pressure (IOP) < 21 mmHg and ≥ 20% reduction from baseline at 6, 12 and 24 months regardless of the NGM. Complications and adverse events were documented. Results: Sixty nine (69) eyes were included. Mean post-operative follow-up was 7.12 months with 14 (20%) eyes reaching 24 months. Mean IOP and NGM were significantly reduced at all timepoints. The preoperative mean IOP decreased from 19.50 ± 4.26 mmHg to 14.57 ± 3.20 mmHg 2 years after surgery (p<0.01). The mean NGM decreased from 2.07 ± 1.00 to 1.07 ± 0.92 at 24 months (p<0.01). hyphema which resolved spontaneously within 1 week, none of which caused an hypertensive spike. S. Kostianeva-Zhelinska1, M. Konareva-Kostianeva2 1Medical University Plovdiv, Dept. Ophthalmology, Plovdiv, Bulgaria, 2MBAL Trimontuim, Plovdiv, Bulgaria Purpose: To analyze the onset and progression of juvenile open-angle glaucoma (JOAG) in a cohort of patients over an extended follow-up period. Methods: The study included 10 patients (6 male, 4 female) diagnosed with JOAG. Data on ocular status and functional condition were analyzed at the time of diagnosis (baseline) and at the end of the follow-up period. The mean age at diagnosis was 23.3 ± 5.4 years (range 15–30 years). In 4 patients the disease was detected before the age of 20, while in 6 patients it was identified after 20 years of age. Patients were followed for 7 to 27 years (mean 18.4 ± 7.4 years). Nine patients were followed for over 10 years, and only one for less than 10 years. The mean age at the end of the follow-up was 41.8 ± 8.4 years (the youngest being 32 years old and the oldest 57 years old). Results: The reasons for detecting the disease were vision loss in one eye (in 3 patients) or significantly reduced vision in one eye (in 4 patients). In 3 pa- tients, elevated intraocular pressure (IOP) was identified during an examina- tion for another reason and subsequent detailed evaluations revealed changes in the optic nerve and visual fields. Initially, severe changes were unilateral. At the time of diagnosis one eye in 3 patients was blind. In the remaining 7 patients the more affected eye with juvenile glaucoma was in a progressive stage (with MD ranging from -12 to -31.5 dB). The mean MD value in the „more affected“ eye (n=7) was -21.8 ± 8.4 dB. Seventy percent of the patients underwent anti-glaucomatous surgeries. Three patients had one surgery, while four patients had 2 to 4 surgeries. Conclusion: The results indicate that in one-third of cases the disease is de- tected after complete vision loss in one eye. Treatment and regular monitoring of the condition of both eyes over time are essential for achieving good out- comes. Early detection and appropriate management are really important for prevention of disability in patients with JOAG. EP-GLA-53 A tale of two probes: comparing generations of micropulse P3® probes in glaucoma therapy B. Martins Pombo1, J. Charréu1, F. Francisco1, T. Costa1, M. Vivas1, A.S. Lopes1, F. Vaz1 1ULS Amadora Sintra, Lisbon, Portugal Purpose: Micropulse Transcleral Cyclophotocoagulation (MPTSCPC) offers a safer alternative to continuous TSCPC by reducing collateral tissue damage while maintaining similar efficacy. With the introduction of a new MicroPulse P3® (MP3) probe, alongside new parameters, we wanted to find out if efficacy and safety were maintained and so compared outcomes from its use to those of the previous MP3 probe studied at our center in a period between 2018 Success was achieved in 68% of patients at 6 months, 33% of patients at 12 and 2020. months, 33% of patients at 24 months. Conclusions: Combining phacoemulsification with iStent Inject W® (Glaukos, USA) is safe procedure and allows for an improvement of VA, sig- nificant IOP and medication burden reduction in mild to moderate glaucoma patients. Methods: We retrospectively analyzed 82 eyes of 47 patients treated with the revised MP3 probe (from 01-2021 to 06-2024) using 2500 mW, a 31.33% duty cycle, and a 160-second LASER duration (4 × 20 seconds per hemisphere) and compared the outcomes with our study of 61 eyes of 46 patients with the previous MP3 probe (from 01-2018 to 12-2020). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 119

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ELECTRONIC POSTER PRESENTATIONS Results: The most recent cohort included 82 eyes of 47 patients (51.1% fe- male) with a mean age of 66.45 ± 18.9 years. Primary open-angle glaucoma (74.4%) was the most common diagnosis, followed by neovascular glaucoma (14.6%). Preoperative DCVA ranged from 0 to 3.0 logMAR (mean 1.57 ± 1.22). Prior surgeries included none in 69.5% and one filtration or drainage procedure in 29.3%. Mean preoperative IOP of the new cohort was 30.38 ± 13.19 mmHg versus 24.9 ± 8.6 mmHg in the earlier cohort (p=0.005). Significant IOP reductions (p<0.05) were observed at all follow-ups (day 1; weeks 1, 1, 3, 6, 12, 18, and 24 months) with the revised probe. Absolute and percentage IOP reductions were comparable between the two cohorts (p>0.05). Mean reduction in glaucoma drop classes was greater in the old cohort (-0.64 vs -0.06; p<0.001). Six-month absolute success rate in the recent group was 46.8% vs 57.4% in the old cohort (p=0.409) and reintervention rates (p=0.107) were also similar. Complication rates in the most recent cohort were 15.9% vs 27.8% (p=0.081), with one case of hypotonic maculopathy in the recent group (none previously). Conclusions: MPTSCPC is an effective and safe method for IOP reduction in uncontrolled glaucoma. Our results show similar efficacy and safety profiles between probes, though large-scale randomized trials are needed to define op- timal parameters. EP-GLA-55 Comparative study of clinical outcomes of XEN microstent implantation in the treatment of glaucoma using ab interno versus ab externo placement P. Langosz1, K. Eder1,2, W. Maruszczyk1, J. Janiszewska-Salamon1, D. Dygas1,3, A. Mrozek1, M. Dorecka1,3, A. Smędowski1,4,5, D. Wygledowska-Promieńska6,3 1Prof. K. Gibiski University Clinical Center of the Medical University of Silesia, Department of Ophthalmology,, Katowice, Poland, 2Medical University of Silesia in Katowice, Faculty of Medicine, Department of Ophthalmology, Katowice, Poland, 3Medical University of Silesia in Katowice, Faculty of Medicine, Department of Ophthalmology,, Katowice, Poland, 4Medical University of Silesia in Katowice, Faculty of Medicine, Department of Ophthalmology,, Katowicepol, Poland, 5Glaucotech sp. z.o.o., Katowicepol, Poland, 6Prof. K. Gibiski University Clinical Center of the Medical University of Silesia, Department of Ophthalmology, Katowice, Poland Purpose: The aim of our work was to comparatively assess effectiveness and safety of XEN gel microstent (XEN, Aquesys, Inc.) implantation, using an ab interno and ab externo approach in patients treated for open-angle glaucoma Method: In a retrospective, non-randomized study, we analyzed test results of patients treated at the Department of Ophthalmology, UCK. Prof. K. Gibiński in Katowice. The analysis included 85 eyes with open-angle glaucoma in 1, 3 and 6 months after the procedure. In both groups we observed a reduc- tion in the number of anti-glaucoma medications in all observation periods. Intra- and postoperative complications in both groups were transient. During the observation period, the procedure was considered inefficient in 3 patients from group I and in 6 from group II, they underwent further antiglaucoma surgical treatments. Conclusions: Antiglaucoma procedures with XEN microstent implantation using ab interno and ab externo approaches effectively reduce IOP and the number of antiglaucoma medications used by the patient with a high safety profile at the same time. The limitation of this work is the short observation period. EP-GLA-56 Selective Laser Trabeculoplasty as a key approach for glaucoma in the context of severe ocular surface disease C. Bonzano1, C.A. Cutolo1, C.E. Traverso1, M. Iester1 1Clinica Oculistica, IRCCS Ospedale Policlinico San Martino, Genova, Italy Purpose: To assess the role of Selective Laser Trabeculoplasty (SLT) in managing intraocular pressure (IOP) while preserving the ocular surface in patients suffering from both glaucoma and severe cicatricial conjunctivitis (CC). Methods: Patients undergoing SLT for glaucoma management in the context of severe ocular surface disease were included. Pre-treatment assessments (conducted two weeks prior) and post-treatment follow-ups (at 2 weeks, 1, 3, 6, and 12 months) included Goldmann applanation tonometry, Schirmer test (ST), Tear Break-Up Time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI) scoring. Systemic immunosuppressive therapy was maintained throughout the study period. Results: Ten eyes from seven patients (6 females, 1 male; mean age 58.8 ± 14.2 years) were enrolled, with underlying diagnoses including Ocular Graft-versus-Host Disease (n=2), Systemic Sclerosis (n=1), Ocular Cicatricial Pemphigoid (n=3), and Stevens-Johnson Syndrome (n=1). At baseline, the mean IOP was 23.8 ± 2.1 mmHg, which significantly decreased to 15.9 ± 1.8 mmHg at 12 months (p < 0.001). The mean number of IOP-lowering medications decreased from 2.2 ± 0.8 to 0.7 ± 0.7 (p < 0.001). Ocular surface parameters showed significant improve- ment, with a reduction in OSDI scores in 70% of cases, increased TBUT in 80% of eyes, and a decrease in corneal staining at 6 and 12 months. ST values remained stable. No significant adverse events were observed, except for one case of repeat SLT and one subsequent filtration surgery. Conclusion: SLT demonstrates a dual benefit in this complex cohort, effec- tively lowering IOP while preserving the integrity of the ocular surface. By minimizing reliance on topical antiglaucoma medications, SLT provides a valuable therapeutic approach that may delay or prevent the need for more in- which XEN gel microstent was implanted using ab interno placement (45 pa- vasive procedures, particularly in patients with severe ocular surface disease, tients - group I) or ab externo placement (40 patients - group II). Analysis where surgical interventions are inherently challenging. period covered 6 months. Results: We observed reduction of mean IOP from 25 mmHg (14-48) prior to procedure, to 12.6 (2.0-50.0); 13.3 (6.0-22.0); 14.6 (3.0-30.0); 15.3 (10.0- 27.0) in group I after 1 week, 1, 3 and 6 months after the procedure, respec- tively and in group II from 30.2mmHg (21.5-39.5) prior to procedure, to 11.0 (7.0-15.2); 15.0 (11.6-19.0); 17.0 (14.0-20.0); 18.0 (14.0-19.0) after 1 week, 120 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-57 Two-year follow-up of Ab interno canaloplasty (ABiC) In a tertiary academic ophthalmology center W. Maruszczyk1, D. Dygas2,1, M. Bogocz2,1, K. Gontarz2,1, M. Świerczyńska2,1, Ł. Drzyzga1, M. Dorecka2,1, A. Smędowski2,1,3, E. Mrukwa-Kominek2,1, D. Wyględowska-Promieńska2,1 1Prof. K. Gibiński University Clinical Center of the 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, 3GlaucoTech Sp. z o.o., Katowice, Poland Purpose: Canaloplasty is a minimally invasive glaucoma surgery aimed at improving the natural outflow of aqueous humor through Schlemm’s canal. Variants include ab interno and ab externo approaches, with the goal of avoid- ing hypotony by utilizing the physiological drainage system. This study evaluates the efficacy and safety of ab interno canaloplasty (ABiC) for treating open-angle glaucoma over a two-year follow-up period. Setting: Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia, Katowice, Poland. Methods: Fifty-two adult patients with open-angle glaucoma and uncon- trolled intraocular pressure (IOP) despite maximum tolerable medical therapy underwent ABiC between 2017 and 2022, with at least two years of follow- up. The procedure used the iTrack canaloplasty microcatheter (Nova Eye Medical) via an ab interno approach, with only cases of successful 360-degree catheterization included. Postoperative evaluations included IOP, best-corrected visual acuity (BCVA), ganglion cell complex (GCC) on optical coherence tomography, adverse events, complications, and antiglaucoma medication usage. Results: Significant and sustained IOP reduction was observed, with mean values decreasing from 23.31 ± 9.10 mmHg preoperatively to 15.76 ± 3.43 mmHg at 24 months. Antiglaucoma medication usage decreased from 2.6 ± 1.07 preoperatively to 1.19 ± 1.27 at one day, stabilizing at 2.32 ± 1.36 at 24 months. BCVA and GCC remained stable, with no severe complications success (IOP within the target range but requiring treatment), and failure (IOP below 6 or above 21 mmHg with or without treatment, or requiring reopera- tion). Results: We analyzed 103 GDD implant surgeries, of which 48 (46.6%) in- volved valved devices, and 55 (53.3%) involved non-valved devices. The suc- cess rate for Group 1 was 26.5%, compared to 40.4% for Group 2 (p=0.003), while the qualified success rate was 22.4% for Group 1 and 22.2% for Group 2 (p=0.23). When analyzed by GDD type, valved devices in Group 1 had a success rate of 23%, compared to 48.1% in Group 2 (p=0.01). The qualified success rate for valved devices was 23% in Group 1 versus 25.9% in Group 2 (p=0.34). For non-valved devices, the success rate was 28.5% in Group 1 compared to 33.3% in Group 2 (p=0.02). The qualified success rate for non-valved devices was 21.4% in Group 1 compared to 18.5% in Group 2 (p=0.21). Conclusions: Our study confirms that the learning curve in this type of sur- gery significantly influences outcomes. An experienced surgeon can make pre- cise decisions during the procedure and effectively manage any complications that may arise. Additionally, experience aids in selecting the most appropriate GDD for each patient. EP-GLA-59 Visual field defect detection with II and III stimuli in pre-perimetric glaucoma patients A. Latuffe Soares Damião1, F. Nicolela Susanna1, L. Pizzato Tondo1, M. Luiz Ribeiro Monteiro1 1University of São Paulo Medical School, Division of Ophthalmology, São Paulo, Brazil Purpose: Computerized perimetry, the gold standard for glaucoma diagnosis, detects functional changes after significant optic nerve damage. Structural as- sessments can identify early glaucomatous damage before perimetric changes, classifying these as pre-perimetric glaucoma. Larger light stimuli in perimetry reported. However, some patients required additional surgical intervention for may miss early defects by activating enough neurons to mask nerve loss, while further IOP reduction. Conclusion: ABiC is a safe and effective treatment for open-angle glaucoma, offering significant IOP reduction and stabilization over two years. While out- comes are promising, further research is necessary to assess long-term efficacy and late postoperative complications. EP-GLA-58 Influence of surgeon experience on the outcomes of GDD surgeries J.L. Torres Peña1, E. Gutierrez1, M. Montero1, A. Ortueta1 1Hospital Universitario 12 de Octubre, Madrid, Spain Purpose: To determine whether surgeon experience influences the outcomes of glaucoma drainage device (GDD) implant surgeries. Methods: A descriptive, retrospective study conducted at the Hospital Universitario 12 de Octubre in Madrid. Patients who underwent GDD surgery between 1996 and 2000 (Group 1: learning curve) and between 2000 and 2007 (Group 2: experienced) were analyzed. Outcomes were classified as: complete success (IOP between 6 and 21 mmHg without treatment), partial or qualified smaller stimuli improve sensitivity but can lead to false positives and reduced reproducibility. This study evaluates whether a smaller light stimulus within critical spatial summation area can detect functional changes in pre-perimetric glaucoma. Method: A cross-sectional study included 13 eyes with glaucomatous neurop- athy but no detectable visual field (VF) loss on SITA Standard 24-2 Humphrey automated perimetry. Participants underwent two 10-2 VF tests with stimulus sizes II and III. Statistical analysis compared the VF results using differen- tial light sensitivity measurements converted to 1/Lambert and then back to decibels. Differences in thresholds between stimulus sizes II and III were ana- lyzed using the Wilcoxon test, with results presented as medians (interquartile range) due to the non-normal distribution of VF values. Results: The average age of participants was 53 years (SD = 9.02), with 69% females. Stimulus size II showed significantly lower thresholds than stimulus size III for the global average (28.30 vs. 31.40, p < 0.001) and in all individ- ual quadrants: superior temporal (27.90 vs. 31.39, p < 0.001), superior nasal (27.60 vs. 31.48, p < 0.001), inferior temporal (28.24 vs. 32.13, p < 0.001), and inferior nasal (28.39 vs. 31.51, p < 0.001). Conclusion: The results suggest that smaller stimulus sizes may be more sen- sitive in detecting early glaucomatous functional damage. Further research with a larger sample size, structural data(e.g., optical coherence tomography), and a control group is needed to confirm the role of smaller stimuli in the early detection of glaucoma. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 121

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-60 Vision-threatening complications in glaucoma drainage device surgery J.L. Torres Peña1, M. Montero1, M.D. Lago1, A. Ortueta2 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital Unversitario 12 de Octubre, Madrid, Spain Purpose: To describe the frequency of vision-threatening complications after more than 20 years of glaucoma drainage device (GDD) implants. Methods: A descriptive, retrospective, single-center study conducted at the Hospital Universitario 12 de Octubre in Madrid. All patients who underwent GDD surgery between 1996 and 2022 were analyzed. Variables that could threaten vision, such as persistent hypotony, conjunctival erosion by the tube, infection, vision loss, and suprachoroidal hemorrhage, were grouped under the variable: “vision-threatening complications.” Results: We studied 285 GDD implant surgeries, of which 159 (55.7%) in- volved valved devices and 126 (44.2%) involved non-valved devices. We found an accumulated frequency of complications in 15 patients (9.4%) for valved devices and 24 patients (19.0%) for non-valved devices. Specifically, analyzing surgeries during the learning curve (between 1996 and 2000), the complication frequency for valved devices was 12.5%, whereas for non-valved devices, it rose to 32% during this period. After the learning period, the accumulated complication rate for valved devices was 8.8%, and for non-valved devices, it was 15.3% (p=0.002). Conclusions: Vision-threatening events are severe complications that can arise in GDD implant surgeries. The data emphasize the importance of the learning curve, especially in managing the restriction mechanisms and tube protection in non-valved devices, which may explain the observed difference. EP-GLA-61 Selective laser trabeculoplasty as an effective method of reducing intraocular pressure in myopic patient after LASIK with primary open-angle glaucoma in a 3-month follow-up period – a case report K. Gontarz1, E. Mrukwa-Kominek1,2 1Prof. K. Gibinski University Clinical Centre, 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 aim of the study is to present the case of a 48-year-old female patient after LASIK with POAG in both eyes - diagnostic difficulties and the effect of the applied therapy in a 3-month follow-up period. Case report: The patient underwent LASIK in both eyes 25 years ago due to high myopia. The patient was diagnosed with POAG 9 years ago. Over the years, visual field defects in both eyes presented a gradually increasing tem- poral wedge. Differential diagnosis of visual field defects did not confirm any cause other than glaucoma. The real intraocular pressure (IOP) values were obtained after taking into the central corneal thickness and average simulated keratometry. The real IOP values reached 21.57 mmHg in the right eye (the measured IOP was 19 mmHg) and 20.22 mmHg in the left eye (the measured IOP was 18 mmHg) despite antiglaucoma therapy including timolol twice daily and dorzolamide three times daily in both eyes. Due to failure to achieve the target intraocular pressure, the patient was quali- fied for selective laser trabeculoplasty (SLT) using the frequency-doubled, Q-switched, Nd:YAG instrument in both eyes. During the 3-month follow-up period, the real IOP values reached 18.52 mmHg in the right eye (the meas- ured IOP was 16 mmHg) and 18.22 mmHg in the left eye (the measured IOP was 16 mmHg) after SLT and with using the previous antiglaucoma drops. Visual fields and optical coherence tomography of the optic nerve head and retinal ganglion cells showed no progression during this period. Conclusion: Myopia and a history of previous LASIK procedures compli- cate the diagnosis of glaucoma, including assessment of intraocular pressure, visual field, and optic disc morphology, and also pose challenges in glaucoma therapy. SLT may be an effective treatment option for these patients. EP-GLA-62 Ab interno angle surgery in chandler syndrome – a case report A. Mendes da Silva1, G. Morgado1 1Hospital de Braga, Braga, Portugal Introduction: Iridocorneal Endothelial (ICE) syndrome involves abnormal corneal endothelial proliferation, causing obstruction of the irido-corneal angle, leading to corneal edema, angle-closure glaucoma, and iris atrophy. Managing glaucoma from ICE syndrome is difficult, as medical treatments are often inadequate and filtering surgery has limited success. This report presents a case of Chandler syndrome, where uncontrolled intraoc- ular pressure (IOP) continued despite maximum medical therapy, leading to the consideration of ab interno angle surgery due to promising results from ab externo penetrating canaloplasty. Clinical case: A 45-year-old woman showed worsening visual acuity in her left eye, corneal edema with beaten bronze appearance, corectopia, and un- controlled IOP (45 mmHg) despite maximum medical treatment. Gonioscopy and anterior segment optical coherence tomography revealed peripheral ante- rior synechiae (PAS), with ICE cell presence in specular microscopy confirm- ing the diagnosis of Chandler syndrome. In pursuit of restoration of the natural outflow pathway, goniosynechiolysis, ab interno canaloplasty, and gonioscopy-assisted transluminal trabeculotomy (GATT) using iTrackTM were performed, concluding with the excision of a trabeculum segment with the Kahook dual blade. Post-surgery, the patient had a round pupil, controlled IOP, a clear cornea, and improved visual acuity. However, four months later, IOP elevation and PAS recurrence occurred. A subsequent phacoemulsification and Paul glaucoma implant insertion led to optimal IOP control without medication. Conclusion: This case highlights the viability of ab interno angle surgery for ICE syndromes, emphasizing the benefit of avoiding conjunctival and scleral incisions, which preserves options for future bleb-dependent procedures. The transient nature of the results requires vigilant post-operative management to minimize PAS formation, prompting consideration of additional procedures for sustained efficacy. 122 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-63 mologist−glaucomatologist, followed by an interview during which demo- graphic characteristics, personal history, family history, and ophthalmological Reasons for poor compliance in glaucoma patients history was gathered via a questionnaire. M. Bozic1, V. Maric1, A. Raskovic2 1University of Belgrade, Faculty of Medicine, University Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia, 2University Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia Purpose: The aim of this study is to examine the main reasons for non-com- pliance to topical antiglaucoma therapy. Methods: The prospective cross-sectional study included patients (303) re- ferred for diagnostic procedures and follow up examinations at the glaucoma outpatient clinic, in the period from January 2023 to January 2024. The study included glaucoma patients older than 18 years, who have been taking therapy for more than a month. Patients were asked questions about the use of topical antiglaucoma medications. Statistical analysis was performed in SPSS 18 using chi square test. A p value of less than 0.05 was considered statistically significant. Results: 303 glaucoma patients were included in the study, of which 120 (39.6%) were men, and 183 (60.4%) women. The average age was 67.4±12.6 years (19-92). The average duration of therapy was 7.1±5.8 years (one month to 30 years).The largest number of patients, 177 of them (58.4%) stated that they regularly use the prescribed therapy. The main reasons given for poor compliance were side effects (38% of non-compliant patients) and forgetful- ness (17%). Conclusions: Our study shows a high degree of compliance, which is of great importance for monitoring disease progression and choosing therapeutic mo- dalities in the future. Judging by the reasons given for poor compliance in our sample, one of the ways to increase it is to switch to therapy with as few side effects as possi- ble and to develop techniques for acquiring the habit of regular instillation of drops in patients. EP-GLA-64 Frequency of positive family history of glaucoma in Belgrade, Serbia V. Maric1,2, M. Bozic1,2, I. Marjanovic1,2, T. Kalezic1,2, A. Raskovic1 1University Eye Clinic, Clinical Center of Serbia, Belgrade, Serbia, 2Faculty of Medicine, University of Belgrade, Belgrade, Serbia Introduction: Glaucoma is a chronic progressive optic neuropathy that, if not diagnosed on time or treated incorrectly, leads to blindness. The most impor- tant risk factors are elevated intraocular pressure and a positive family history, while others include age, central corneal thickness, presence of pseudoexfolia- tion, refractive errors, gender, and presence of certain systemic diseases. Purpose: To determine the frequency of positive family history of glaucoma among patients at the Clinic for Eye Diseases, University Clinical Center of Serbia (UCCS), Belgrade, Serbia. Method: This prospective study was conducted at the Clinic for Eye Diseases, UCCS, from November 2023 to August 2024. The study sample included con- secutive patients of both sexes with primary open-angle glaucoma (POAG), normotensive glaucoma, primary angle-closure glaucoma (PACG), pigmen- tary glaucoma, pseudoexfoliative glaucoma, and juvenile glaucoma. Each subject underwent a detailed ophthalmological examination by an ophthal- Results: While the average age of the full sample was 67.5±14.4 years, it was statistically significantly greater in the group without a positive family his- tory (69±8.9 years), than in the group with a positive family history (63±18.1 years, p=0.046). In the group without a positive family history, the disease was detected at an older age (58±11.13 years) relative to those with a positive fam- ily history (53±18.06 years, p=0.038). At 55%, POAG was the most prevalent glaucoma form among patients with a positive family history. Parents were the most frequently affected family members (44%), while siblings accounted for about 14%. Conclusion: A positive family history of glaucoma was most frequently noted in patients with POAG, whereby parents were the most frequently affected family members. EP-GLA-66 Improvement of concomitant ocular surface disease in glaucoma patients after switching to a preservative-free fixed combination in a real-world transition context M.S. Passerini1, G.M. Rodríguez1 1Poen Laboratories, Medical Affairs, Buenos Aires, Argentina Purpose: To evaluate changes in ocular surface signs and symptoms and their impact on the efficacy of treatment for primary open-angle glaucoma (POAG) in patients with concomitant ocular surface disease (OSD) after switching from a preserved to a preservative-free Dorzolamide 2% + Timolol 0.5% (PF- DT). Methods: An experimental, prospective, single-arm, open-label, multicenter trial was conducted. Thirty patients who had been treated with BAK-preserved Dorzolamide 2% + Timolol 0.5% for at least 6 months were included. At base- line, all patients switched their medication to PF-DT. Improvement in symp- toms and signs was evaluated at weeks 4, 12, and 24. Histology was assessed in a subset of patients by confocal microscopy every 3 months for one year. The Friedman and Cochran’s Q test, with Bonferroni post-hoc correction for multiple pairwise comparisons, was applied. Results: OSDI score significantly decreased from 21.5 to 18.8, 14.6, and 12.5 at each follow-up visit (p<0.05 for baseline vs all visits) and TBUT signifi- cantly increased from 5.0 to 7.0 starting from week 12 (p<0.05). After 24 weeks, 52.0% of patients experienced complete resolution of their symptoms (p<0.001), and the percentage of patients with positive corneal staining and hyperemia decreased from 71.7% to 22.0% (p<0.001) and from 85% to 50% (p<0.0001), respectively. IOP significantly decreased by 1 mmHg starting from week 4 (p=0.03 baseline vs week 4 and p=0.002 baseline vs weeks 12 and 24). Although no statistically significant difference in cell count (cells/mm²) was found (p>0.05), a progressive increase was observed in the count of superficial conjunctival epithelial cells (4572 to 6835), superficial corneal epithelial cells (5224 to 6618), and basal corneal epithelial cells (7374 to 8612). Conclusion: It was demonstrated that switching from a preserved to a PF-DT formulation improved OSD signs and symptoms in patients with POAG, and this strengthened the hypotensive efficacy of the treatment. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 123

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ELECTRONIC POSTER PRESENTATIONS EP-GLA-67 Management of Iris bombe in a child with juvenile idiopathic arthritis A. Marin1, J. Davis1, E. Bitrian1 1University of Miami, Bascom Palmer Eye Institute, Miami, United States Purpose: To describe a rare case of child with poorly controlled uveitis sec- ondary to juvenile idiopathic arthritis JIA who developed an inflammatory pupillary block and its management. Methods: We present the case of a 10-year-old female with a history of uveitis secondary to JIA who developed an inflammatory pupillary block. Clinical data were collected from the patient’s medical chart, and images and videos were captured to document the progression and management of the condition. Results: The patient sole manifestation of JIA was eye inflammation. Over a year ago, band keratopathy was removed, and the patient had been on long- term methotrexate and topical steroids. Methotrexate dosage had been reduced multiple times due to elevated liver function tests, despite folic acid supple- mentation; however, no additional immunosuppressive or DMARD therapies were introduced. Both eyes exhibited 2+ anterior chamber cells and 1+ flare. The right eye showed a closed laser peripheral iridotomy performed one year prior, signifi- cant peripheral anterior synechiae, iris-corneal touch, no visible angle struc- tures on gonioscopy and an iris membrane causing iris bombe. The patient’s elevated intraocular pressure (IOP) was managed by inten- sifying antiglaucoma medications while awaiting surgery. The inflamma- tory flare was managed through an escalation of the corticosteroid regimen. Goniosynechialysis, surgical iridectomy, and iris membrane dissection were successfully performed to resolve the pupillary block and angle closure. Cataract extraction was not necessary as the lens remained clear. The patient was subsequently referred to a rheumatologist and a uveitis specialist. Conclusion: Managing JIA-associated intraocular hypertension requires a tailored approach. In cases of iris bombe, iris membrane dissection can be performed without lensectomy if the lens is clear. Active uveitis should be promptly addressed, with treatment intensified until the inflammation is fully controlled. EP-GLA-68 Insights into progression of myopia and glaucoma: the role of lamina cribrosa of sclera Y. Huseva1 1Belarusian State Medical University, Eye Microsurgery Centre „VOKA“, the 4th City Children’s Hospital, Ophthalmology, Human Anatomy, Minsk, Belarus Purpose: To study the lamina cribrosa (LC) of sclera as a potential biomarker in the diagnosis of progressive myopia and primary open-angle glaucoma (POAG). peripapillary capillaries (RPC) and choriocapillary vessels were evaluated. The data was statistically approved, Pearson and Spearman correlation coef- ficients, the Kruskal-Wallis and Mann-Whitney tests were used. Results: An axial length growth of more than 26.3 mm in myopic eyes was accompanied by a tendency to increase reflectivity in the LC perivascularly as well as a drop in the thickness of the choroid, prelaminar zone and the forma- tion of a gamma zone of peripapillary atrophy. On OCT disorganization of LC (uneven porosity, hyporeflective defects), as well as deformation of the LC surfaces (in particular, prominence backwards of the LC posterior contour), the expressed prelaminar retinoschisis were determined in POAG, in addition to LC morphometric changes (reduction in LC thickness and increase in its depth, along with the lowering choroid and RNFL thickness). In the group of eyes with glaucoma combined with high myopia, LC changes correlated with a progressive increase in the diameter of the BM opening to result in reduction in the prelaminar zone thickness and the appearance of LC focal defects due to choriocapillaris deficiency. Conclusion: The identified pathognomonic patterns of the LC in pathologic myopia and glaucoma reflect the remodeling of the connective tissue of the eye, which can play a significant role in the pathogenesis of these diseases and, in turn, determine the prognosis of visual functions. EP-GLA-69 Concentrations of MCP-1, MIP-1α and b-FGF in the anterior lens capsule in patients with POAG and PEXG undergoing cataract surgery K. Gontarz1, M. Dorecka1,2, T. Francuz3, W. Garczorz3, E. Mrukwa-Kominek1,2, A. Smędowski1,2, D. Wyględowska-Promieńska1,2 1Prof. K. Gibinski University Clinical Centre, 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, 3Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Department of Biochemistry, Katowice, Poland Purpose: The purpose of this study was to confirm the role of selected cy- tokines: monocyte chemoattractant protein-1 (MCP-1), macrophage inflam- matory protein-1α (MIP-1α) and basic fibroblast growth factor (b-FGF) in the etiopathogenesis of primary open-angle glaucoma (POAG) and pseudoexfo- liation glaucoma (PEXG) and to determine whether selected cytokines can be markers differentiating these two types of glaucoma. Methods: The material for the study was obtained from adult patients dur- ing routine cataract phacoemulsification. The study included a total of 117 patients. Patients were divided into four groups: with cataract without glau- coma and without pseudoexfoliation syndrome (CAT), with cataract and POAG (POAG), with cataract and pseudoexfoliation syndrome without glaucoma (PEX), and with cataract and PEXG (PEXG). The study was car- ried out on material samples from fragments of the anterior lens capsule, in which the concentrations of a profile of 3 selected cytokines were determined. Biochemical analysis was performed using Bio-Plex Assay kits (Bio-Rad) us- ing the Luminex method using the analyte multiplexing technique. Statistical Method: Using spectral optical coherence tomography (OCT) of the optic analysis was performed using the STATISTICA program (TIBCO Software disc (OD) a comparative assessment of LC was performed on 142 eyes of Inc.). patients in three groups: I - axial myopia (63), II - POAG (48), III - control (31). The LC depth, LC thickness and prelaminar zone, relief of LC surfaces; the thickness of choroid and retinal nerve fibre layer (RNFL); density of radial Results: In the anterior lens capsule collected during cataract phacoemulsi- fication, the possibility of simultaneous determination of the concentrations of MCP-1, MIP-1α and b-FGF using the analyte multiplexing technique was 124 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS demonstrated. Among the determined cytokines, significant differences in con- centration between the studied groups were found for MCP-1. Significantly lower MCP-1 concentration was demonstrated in patients with POAG com- pared to each of the groups: CAT, PEX and PEXG. Conclusions: Disruption of the cytokine profile in glaucoma may be the pathogenetic mechanism of the disease. MCP-1 is involved in the etiopatho- genesis of POAG. Its reduced concentration in the anterior lens capsule may be a marker of POAG and a marker differentiating POAG from PEXG. EP-GLA-70 Post-traumatic glaucoma: What is the underlying cause? K. Selmani1, H. Ouazzani Touhami1, S. Layachi1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Epithelial invasion of the anterior chamber (AC) is a rare, and feared complication of any penetrating trauma or ocular surgery. It is char- acterized by the invasion of epithelial cells into the AC. It can be difficult to manage, and it often leads to devastating consequences. We report a case of glaucoma due to epithelial invasion, focusing on diagnostic and therapeutic aspects. Medical Observation: A 25-year-old female patient with a history of ocular EP-GLA-71 Analysis of the causes of glaucoma overdiagnosis I. Novytskyy1 1Lviv National Medical University, Ophthalmology, Lviv, Ukraine Overdiagnosis of glaucoma is no less harmful than its untimely diagnosis. There are many studies devoted to early diagnosis of glaucoma, but there is very limited data on overdiagnosis and overtreatment of glaucoma. Purppose: To evaluete the causes of glaucoma overdiagnosis. Materials and methods: We examined 27 patients who were referred to our clinic with a diagnosis of glaucoma or suspected glaucoma. Results: As a result of a complete examination (evaluation of family risk fac- tors, BCVA, tonometry, gonioscopy, fundus examination, OCT of ONH and RNF layer, OCT of anterior chamber angle, and visual field examination) it turned out that the diagnosis of glaucoma in these patients was made incor- rectly. We found the following reasons for glaucoma overdiagnosis. “Self-diagnosis” (assessment of family risk factors) 2 out of 27 cases (7.4%); Single increase in IOP without ONH changes 3 of 27 (11.1%); Incorrect interpretation of ONH changes: large C/D ratio 9 of 27 (33.3%), titled ONH 2 of 27 (7.4%), parapapillary atrophy 1 of 27 (3.7%); Incorrect interpretation of OCT of ONH and RNF layer 3 of 27 (11.1%); Incorrect interpretation of OCT of anterior chamber angle 2 of 27 (7.4%); Incorrect interpretation of the visual field 2 of 27 (7.4%); Secondary glaucoma in the contralateral eye 3 of 27 (11.1%). trauma in the left eye causing a corneal wound one year ago, presented to the Conclusion: Overdiagnosis of glaucoma is becoming quite common. emergency department with a painful red eye persisting for 10 days. The ophthalmologic examination revealed a visual acuity by counting fingers, intraocular pressure = 40 mmHg, conjunctival hyperemia, corneal edema, a corneal opacity, and a reformed anterior chamber. Gonioscopy was normal. Anterior segment OCT revealed epithelial proliferation in the anterior cham- ber, suggesting post-traumatic glaucoma due to epithelial invasion in the AC. A hypotensive treatment with a quadruple therapy was initiated. However, due to persistent ocular hypertension, cyclodestructive therapy was performed. Discussion: Most cases of epithelial invasion occur after trauma or intraocular surgery. Conjunctival or corneal epithelial cells migrate through the wound, or along a penetrating suture and proliferate in the anterior chamber. The ocular hypertension results from obstruction and destruction of the tra- beculum by epithelial cells. It responds poorly to medical treatment, and the resection of the involved ocular structures with adjuvant cryotherapy is the best therapeutic option. In some cases, alcohol, 5-fluorouracil, and photocoagulation may serve as good therapeutic alternatives. Conclusion: The prognosis of glaucoma due to epithelial invasion is generally poor. However, the incidence of the disease has significantly decreased over the past two decades, and early diagnosis coupled with appropriate treatment can save a patient’s eye. It is based on excessive vigilance regarding glaucoma. The key to solving this problem lies in the same plane as the correct diagnosis of the disease. Making a diagnosis based on only one symptom is unjustified. EP-GLA-73 Differences in structure-function relationships in optic neuritis and glaucoma H. Kim1, H.W. Bae1 1Institute of Vision Research, Yonsei University College of Medicine, Ophthalmology, Seoul, Korea, Republic of Purpose: We aimed to investigate the structural and functional relationships in patients with optic neuritis (ON) and primary open-angle glaucoma (POAG), focusing on the extent of retinal nerve fiber layer (RNFL) and ganglion cell- inner plexiform layer (GCIPL) damage and its correlation with visual field (VF) defects. Method: This retrospective study included 194 patients (47 with ON and 147 with POAG) who were referred to the Department of Ophthalmology at Yonsei University Severance Eye Hospital between March 2017 and October 2023. Patients with ON received standard care, including high-dose intravenous methylprednisolone followed by an oral prednisolone tapering regimen. Patients with POAG received medications to maintain target intraocular pres- sure. All participants underwent comprehensive ophthalmological evaluations, in- cluding optical coherence tomography and VF tests. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 125

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ELECTRONIC POSTER PRESENTATIONS Results: Significant differences were found between the structure-function relationships in ON and POAG. MD (Mean Deviation) and VFI (VF Index) were maintained in patients with ON despite decrease in RNFL and GCIPL thickness. Conversely, patients with POAG exhibited a direct correlation between de- creased RNFL and GCIPL thickness and worsening VF indices. The structural damage pattern also differed between the two conditions, with ON affecting central vision more diffusely and POAG impacting peripheral vision. Conclusion: The differences in structure-function relationships underscore the different pathophysiological mechanisms underlying ON and POAG. Thus, our findings highlight the importance of disease-specific diagnostic and therapeutic approaches and the need for further research into the underlying mechanisms to improve the management of visual impairment caused by ON and POAG. ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Neuro-ophthalmology EP-NEO-01 Third cranial nerve palsy and bilateral choroidal metastases in a patient with breast cancer: a rare presentation M. Puchol-Rizo1, L. Alcalde-Blanco1, T. García-Herrera Prada1, J. Fernández-Rodríguez1, D. Rojas-Correa2, P. Alonso-Barreiros1, R. Fernández-Herrero2, B. Cano González-Barcia2 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital del Tajo, Aranjuez, Spain, 3Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain Purpose: To highlight the significance of imaging and comprehensive oph- thalmic evaluation in identifying compressive causes of cranial nerve III (CN III) palsy and its association with choroidal metastases, especially in patients with a known history of malignancy. Methods: This case report describes a 52-year-old woman with a history of ductal breast carcinoma who presented with vision loss, binocular diplopia, and right ptosis. Examination revealed bilateral choroidal metastases and CN III palsy with pupillary involvement. Imaging, including computed tomography (CT), iden- tified a soft tissue mass infiltrating the right cavernous sinus, orbital apex, and adjacent bony structures. Results: Ophthalmic examination revealed a hand motion visual acuity in the right eye and 1.0 in the left. Choroidal metastases were observed in both eyes, and imaging confirmed a compressive lesion affecting the right cavernous si- nus. This lesion, combined with choroidal metastases, was determined to be the cause of CN III palsy. The prognosis for choroidal metastases remains poor, with the condition managed through a multidisciplinary approach in- volving systemic therapy and ophthalmological follow-up. Conclusions: Cranial nerve III palsy with pupillary involvement requires thorough imaging to exclude compressive causes. Choroidal metastases, the most frequent ocular malignancy, must be considered in the differential diag- nosis, particularly in patients with a history of breast or lung cancer. This case highlights the importance of fundus examination in patients with oculomotor paralysis and the need for a multidisciplinary approach in manag- ing ocular and systemic metastases. 126 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-02 Subacute progressive bilateral worsening of visual acuity as a result of Heidenhain variant of Creutzfeldt-Jakob disease S. Prelog1, M. Šterman1, T. Korpič Šbül1, M. Popit2, N. Krajnc2 1General Hospital Murska Sobota, Ophthalmology, Murska Sobota, Slovenia, 2General Hospital Murska Sobota, Neurology, Murska Sobota, Slovenia Purpose: This report describes a 75-year-old patient with a history of arterial hypertension, atrial fibrillation and anticoagulant therapy, who sought oph- thalmological evaluation due to rapid deterioration of vision on both eyes. Following hospitalization in the Neurology Department,she was diagnosed with Heidenhain’s variant (Hv) of Creutzfeldt-Jakob disease (CJD). Method: At the 1st examination in February 2022,the patient reported 14 days of blurred vision. A cataract was noted,with best visual acuity of 0.5 in the right eye and 0.4 in the left.7 weeks later, her vision significantly worsened,to counting fingers at 50 cm right only light perception left. She described seeing black dots, halos and flashes,couldn’t recognize people. Despite a mild frontal headache, denied other symptoms. A full ophthalmologic examination, includ- ing OCT and autofluorescence scanning was performed. Given the concern for a cortical cause, she was referred for further neurological evaluation, includ- ing CT and MRI scans, laboratory tests, CTA, lumbar puncture and EEG. Results: CT showed a lacunar infarction,not related to vision loss.MRI, blood tests didn’t suggest neuromyelitis optica. She was treated for suspected optic neuritis-with no improvement. Soon other neurological symptoms developed, elevated protein 14-3-3 in cerebrospinal fluid and EEG supported the diag- nosis of rapidly progressing neurodegeneration. The MRI findings (with the DWI sequence) were consistent with CJD. After becoming somnolent, im- mobile with spastic tetraparrhesis and blind, she was placed in palliative care and died in July 2022. Diagnosis was confirmed through autopsy with neu- rosection. Conclusion: CJD is a rare, progressive, incurable, neurodegenerative disor- der caused by prion protein accumulation. Hv is sporadic,primarily affects the visual cortex and can present with rapid bilateral vision loss. This case highlights the importance of considering CJD in differential diagnosis when sudden, severe, billateral visual deterioration occurs. EP-NEO-03 Diverse clinical and imaging presentations in MOG-antibody-associated optic neuritis: insights from two contrasting cases Y.J. Kim1, S.W. Moon1 1Kyung Hee University Hospital at Gangdong, Ophthalmology Department, Seoul, Korea, Republic of Purpose: MOG-antibody-associated optic neuritis presents with diverse clini- cal and imaging findings, requiring individualized diagnostic and therapeutic approaches. This study compares two distinct cases: a pediatric patient with bilateral relapses and normal OCT and MRI findings despite functional defi- cits, and an adult patient with optic disc swelling detected only on OCT, absent abnormalities on other imaging or functional tests. The goal is to highlight the role of imaging and functional assessments in MOG-ON diagnosis and management. Results: Case 1 involves a 15-year-old male who presented with left-eye in- ferior visual field loss. Visual field and color vision testing confirmed defi- cits, but OCT and orbital MRI were normal. Initial MOG-Ab was 3.65 MFI ratio(+), which decreased to 2.50 after steroid therapy. Contralateral relapse occurred in the same way as before after four months of low-dose steroid maintenance, coinciding with MOG-Ab rising to 2.95(+). Post-treatment, MOG-Ab dropped to 2.19 (borderline) with functional improvement. Slow steroid tapering was initiated to prevent further relapses. Case 2 involves a 41-year-old male with optic disc edema discovered during routine follow-up. Functional tests and orbital MRI were normal, but OCT revealed optic nerve swelling. Initial MOG-Ab was 2.91 MFI ratio(+) but de- clined to 1.71(-) at relapse. Despite negative MOG-Ab, recurrence followed rapid steroid tapering, necessitating a slower taper. Conclusion: These cases highlight the variability in MOG-ON diagnosis and management. The pediatric patient exhibited functional deficits despite nor- mal imaging, stressing the importance of functional testing while the adult patient’s condition was identified only via OCT. While MOG-Ab levels cor- related with disease activity in the pediatric case, they were less predictive in the adult case. These findings emphasize the need for multimodal assessment and personalized tapering strategies to optimize outcomes in MOG-ON. EP-NEO-04 Efficacy of citicoline as an adjuvant therapy in the treatment of multiple sclerosis S.S. Burgić1,2, S. Smoljanović Skočić3,4, B. Markić1,2 1Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina, 2Eye Clinic, University Clinical Center of Republic of Srpska, Banja Luka, Bosnia and Herzegovina, 3Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia, 4King Khalid Hail Hospital, Hail, Saudi Arabia Purpose: To evaluate the efficacy of citicoline as an adjuvant therapy in the treatment of multiple sclerosis (MS). Methods: A prospective observational study was conducted at a tertiary eye care center from June 2024 to December 2024, involving MS patients who underwent OCT measurements of retinal nerve fiber layer (RNFL) and gan- glion cell layer (GCL) thickness before and 6 months after the introduction of citicoline therapy. Changes in OCT parameters were analyzed to assess the potential neuroprotective effects of citicoline on neurodegeneration. Results: A total of 72 eyes of 36 patients with multiple sclerosis were included in the study. The mean age was 42,03 ± 11,58 years with predominantly fe- male patient cohort (80,5%). The average duration of disease was 10,24±8,41 years. There were no statistically significant differences in OCT parameters before and 6 months after starting citicoline therapy as an adjuvant treatment (aver- age RNFL thickness: 77,81±13,00µm vs. 78,82±13,32µm, p>0,05; average GCL thickness: 67,60±10,05µm vs. 67,60±67,88µm, p>0,05), and no progres- sion in OCT findings was observed. Visual outcomes remained stable during 6-month follow-up, but with no sta- tistical significance (baseline BCVA vs. BCVA at 6 months: 0,86±0,26 vs. 0,89±0,24 Snellen, p>0,05). Citicoline was well-tolerated, with no side effects reported. To our knowledge, this is the first study to examine the efficacy of citicoline in patients with multiple sclerosis. Conclusions: OCT findings remained stable throughout the 6-month fol- low-up period, indicating no significant progression of neurodegeneration. Citicoline may potentially slow the neurodegenerative process in patients with Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 127

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ELECTRONIC POSTER PRESENTATIONS multiple sclerosis, as suggested by OCT findings. The limitations of this study include small sample size and short follow-up duration. Further long-term re- search with a larger sample size is necessary to confirm these findings and determine the long-term benefits of citicoline in MS management. EP-NEO-05 SARS-COV-2 and optic neuritis in children: report of a case D. Souttou1, A. Laouar1 1HCA, Ophtalmology, Alger, Algeria Purpose: Corona viruses are a large family of viruses. SARS-COVID-2, a highly pathogenic type discovered in December 2019 in Wuhan, China, char- acterized by serious respiratory illnesses. We report the case of an 8-year-old child with optic neuritis complicating COVID-19 disease. The aim of our work is to describe a rare neuro-ophthal- mological manifestation of coronavirus disease COVID 19 in children. Methods: This is the 8-year-old child B.H., with no known pathological his- tory, brought by his parents for a sudden deep and bilateral decline in visual acuity in a calm white eye two weeks after a febrile episode in a family context of contamination by SARS-COV-2. He benefited from an in-depth clinical and paraclinical ophthalmological exploration, an exhaustive inflammatory and infectious assessment and specialist opinions. Results: The ophthalmological examination revealed calm white eyes with visual acuity limited to hand movements in both eyes. At the slit lamp a direct and consensual photomotor reflex present ample and sustained and an anterior vitreous loaded in both eyes. Fundamentally, there was hyalitis in both eyes with temporal papillary pallor in the right eye and discreet diffuse edema in the left eye without other associated damage and biology made it possible to confirm the diagnosis with SARS- serology COV-2 positive. Our patient benefited from a bolus of methylprednisolone associated with the administration of versatile immunoglobulins. The evolution was marked by good functional and anatomical recovery. Conclusion: COVID 19 can affect all organs, with respiratory manifestations predominating. The ocular form of the disease, although rare, can be initial or tion revealed bilateral optic disc edema. Mean OCT retinal nerve fiber layer (RNFL )analysis showed measurements of 264 µm in the right eye and 319 µm in the left eye during papilledema. Further investigations, including labo- ratory tests, contrast-enhanced orbital-cranial MRI, and lumbar puncture (with a CSF opening pressure of 18 cm H2O), were all within normal limits. Based on clinical findings, a preliminary diagnosis of idiopathic intracranial hypertension (IIH) was made, and treatment with acetazolamide (3x1) was initiated. The treatment yielded a positive response, with RNFL measurements decreasing to 142 µm in the right eye and 125 µm in the left eye, and signifi- cant regression of optic disc edema was observed. Conclusion: Idiopathic intracranial hypertension (IIH) may present with nor- mal CSF pressure in some patients. Optic disc drusen can complicate the di- agnosis of IIH. When combined with normal findings from CSF pressure and other investigations, the diagnostic process becomes even more challenging. In such cases, treatment can be initiated based on clinical findings, and the diagnosis can be confirmed through the therapeutic response. EP-NEO-08 The optic nerve edema management in inflammatory and ischemic neuropathies N. Moyseyenko1 1Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine Relevance: Swelling negatively affects the state of optic nerve architecture. Modern methods of diagnosis provide more and more information about the features of the pathogenesis of edema, and therefore provide grounds for the development of more effective methods of treatment. The purpose is to describe clinical cases of optic nerve edema in inflamma- tory and ischemic neuropathies and features of optic disc architecture revealed by optical coherence tomography. Research methods: 4 patients were examined. Two patients were diag- nosed with optic neuritis, and the other two with ischemic neuropathy. Ophthalmoscopically, signs of optic disc edema (OD) were found in all pa- tients. Visometry, ophthalmoscopy, optical coherence tomography (OCT), occur as a complication of the infection as was the case for our patient. Thus, magnetic resonance imaging (MRI) were used. symptomatic treatment associated with prolonged monitoring of these cases remains the main approach. EP-NEO-06 The coexistence of optic disc drusen and papilledema: diagnostic challenges S.E. Kanik1, S. Tongal1, B. Saracoglu Yilmaz1, I. Cakir1 1Beyoglu Goz Eye Training And Research Hospital, Istanbul, Turkey Purpose: To present the diagnostic and therapeutic process of a patient with papilledema in the presence of optic disc drusen, with all other investigations yielding normal results. Case Report: A 64-year-old male patient was diagnosed with optic disc drusen in 2019 following a complaint of a curtain-like vision loss in his right eye and was placed under observation. In 2023, he presented again with com- plaints of bilateral vision blurring and dimming. Ophthalmological examina- Result: As a result of the study, changes in the architecture of the optic nerve head were detected in the case of swelling of the DZN in inflammatory (2 patients) and ischemic neuropathy (2 patients). In all examined patients, ac- cording to the conducted study, according to the results of OCT, the swelling of the DZN in all, except for case No. 4, does not extend to the temporal seg- ment of the head. In case of inflammatory damage, in cases 1 and 2, atrophy of the optic nerve at later stages, during repeated examinations. a light crescent zone is observed in the peripapillary area, which separates the temporal border of the head of the optic nerve disc (sectoral atrophy). Conclusion: Swelling of the optic nerve in inflammatory and ischemic neu- ropathies is characterized by an increase in the thickness of the layer of nerve fibers, a change in the configuration of the disk, which later transforms into segmental atrophy. Changes in the architecture of the optic disc were found to be the basis of diagnosis and monitoring, as well as the effectiveness of treat- ment in acute optic neuropathies. 128 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-11 Unilateral proptosis and raised intraocular pressure due to brachiocephalic vein stenosis in a hemodialysis patient J.T. Pan1, D.W.W. Yong2, C. Tan2, R. Menon3, H.A. Lin2 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, 2Department of Ophthalmology, National University Hospital, Singapore, Singapore, Singapore, 3Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore, Singapore, Singapore Background: Central venous stenosis is a known complication in hemodialy- sis patients, but its association with sight-threatening complications is rare. Case presentation: A 56-year-old female on hemodialysis presented with pro- gressive binocular diplopia and features of episcleral venous hypertension. On examination she had proptosis, corkscrew vessels, raised intraocular pressure (IOP) (30mmHg) and limitation in elevation and adduction of the left eye. Her best-corrected visual acuity (BCVA) was 20/30+2 in the right and 20/100-1 in the left. Initial cerebral angiogram was negative for carotid-cavernous fistula. Further questioning revealed she underwent a left brachiocephalic arterio- venous fistula (AVF) creation 3 years prior, requiring 3 fistuloplasties due to AVF stenosis. Vascular Surgery was consulted and a Central Venography and left arm Fistulogram was performed, showing a focal occlusion of the left bra- chiocephalic vein with extensive reflux into the collaterals venous channels. This was treated with angioplasty and stenting of the brachiocephalic vein. Outcome: Post-intervention, the patient’s proptosis and IOP normalized (15mmHg), with improved BCVA (20/30) and full ocular motility of the left eye. Discontinuation of IOP-lowering medications and lubricants was pos- sible. Conclusion: This rare case highlights the importance of recognizing central venous stenosis as a potential cause of sight-threatening complications in he- modialysis patients. Prompt intervention can lead to excellent outcomes. Keywords: Brachiocephalic vein stenosis, hemodialysis, proptosis, raised intraocular pressure, diplopia. EP-NEO-12 SIRT1 rs3818292, rs3758391, rs7895833 gene polymorphisms and haplotypes link to optic neuritis and multiple sclerosis P. Mikulenaite1, R. Liutkeviciene1,2, G. Gedvilaite-Vaicechauskiene2, K. Kaikaryte2 1The Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Ophthalmology, Kaunas, Lithuania, 2Lithuanian University of Health Sciences, Medical Academy, Neuroscience Institute of Lithuanian University of Health Sciences, Laboratory of Ophthalmology, Kaunas, Lithuania Results: rs3818292 is associated with a 2.19-fold increased odd of ON occur- rence by the best-fit overdominant model (p=0.002). rs3758391 is associated with 2.16-fold increased odds of ON occurrence under the best-fit dominant model (p=0.004). rs7895833 is associated with a 2.38-fold increased odd of ON occurrence under the best-fit overdominant model (p=0.002). rs3818292 is associated with a 2.14-fold increased odds of MS occurrence under the best- fit dominant model (p=0.015). rs7895833 is associated with a 2.31-fold in- creased odds of MS occurrence by the best-fit overdominant model (p=0.002). rs3818292 is associated with 2.91-fold increased odds of ON with MS oc- currence by the best-fit overdominant model (p=0.018). rs3758391 is asso- ciated with 2.55-fold increased odds of ON with MS occurrence under the best-fit dominant model (p=0.015). rs7895833 is associated with 3.04-fold increased odds of ON with MS occurrence under the best-fit overdominant model (p=0.005). Individuals carrying rs3818292-rs3758391-rs7895833 haplotype A-T-A is likely to be associated with 2.3-fold decreased odds of MS occurrence (p=0.031), and G-T-G haplotype is associated with 1.7-fold increased odds of MS occurrence (p=0.047). Individuals carrying rs3818292-rs3758391- rs7895833 haplotype G-T-G is likely to be associated with 2-fold increased odds of ON occurrence (p=0.038). Conclusions: SIRT1 rs3818292, rs3758391, rs7895833 SNP, and haplotypes are statistically significantly associated with ON and MS development. EP-NEO-13 Cataract surgery results in brain tumor diagnosis: a case report A. Ukina1, M. Telelyasova1 1Gatchina Clinical Interdistrict Hospital, Ophthalmology, Gatchina, Russian Federation Case report: The clinical case presents a diagnostic investigation conducted on a patient who underwent phacoemulsification for early age-related cataract but exhibited no improvement in best-corrected visual acuity postoperatively, accompanied by symptoms described as „floating spots.“ Prior to surgery, due to low visual acuity, the patient did not report floaters. We illustrate postopera- tive management and additional examinations aimed at differential diagnosis to identify potential non-ophthalmological causes for the observed decrease in visual acuity. Optical coherence tomography of the optic disc revealed a lesion in the peri- papillary nerve fiber layer symmetrically located on the temporal side of both eyes. Standard automated perimetry indicated bitemporal hemianopsia, while neuroimaging (MRI with intravenous contrast) confirmed a lesion in the chi- asmatic-sellar region. The patient was subsequently referred to neurosurgeons for surgical intervention. Concluision: This case underscores that even routine procedures such as cataract phacoemulsification can yield unexpected findings that may indicate serious underlying conditions. Notably, patients may not report a loss of half of the visual field but instead describe their symptoms vaguely as floaters or spots. It is crucial to recognize that bitemporal hemianopsia can manifest as Purpose: To investigate whether the single-nucleotide polymorphisms (SNP) and haplotypes of the SIRT1(rs3818292, rs3758391, rs7895833) are associ- ated with optic neuritis (ON) and multiple sclerosis (MS). a symptom of various pathological conditions, including pituitary tumors, craniopharyngiomas, and anterior communicating artery aneurysms, as well as strokes and traumatic brain injuries. Our experience may focus attention Methods: We studied: a control group, patients with MS, with ON, and with on the necessity of a comprehensive diagnostic approach and the careful in- ON and MS. DNA was extracted from peripheral blood leukocytes and geno- typed by rPCR reaction. The data of the SNP of the SIRT1 gene rs3818292, rs3758391, and rs7895833 were then analyzed. terpretation of patient complaints, as well as postoperative multimodal diag- nostic results. The findings highlight the significance of an interdisciplinary approach as a critical factor in the early diagnosis of brain tumors. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 129

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-14 EP-NEO-15 A case of neuro-syphilis in an immunocompromised patient resulting in ophthalmic pathology R. Farnan2, M. Rhatigan2, E. Mc Elnea2 1University Hospital Galway, Galway, Ireland An interesting case involving a 33 year old gentleman who presented with sudden onset deterioration in his left visual acuity. MG reported a recent his- tory significant for a deterioration in his left visual acuity to ‘HM’s’ from a baseline of 6/6 vision. His ophthalmic history is unremarkable but his medical history is significant for psoriatic arthritis which is managed through the me- dium of monoclonal antibody therapy. The clinical findings at initial presentation included painless visual loss to the left eye of gradual onset, discomfort on eye movement and scalp tenderness. Relevant exam findings involved a grossly swollen left optic nerve, left visual acuity of ‘HM’s’ with normal intraocular pressure. The patient was admitted to hospital and initially managed on intravenous steroid therapy. A subsequent infective panel revealed a diagnosis of syphilis. From here, suitable antibiotic therapy was initiated with a series of follow-up appointments arranged. The three month follow-up revealed left visual acuity to be 6/12. The intrigu- ing aspect of this case lies within the sphere of multi-modal pathology with the relationship between infectious disease and neuro-ophthalmology the most intriguing. Efficacy and safety of lenadogene nolparvovec Gene therapy for leber hereditary optic neuropathy in the real-life setting P. Yu-Wai-Man1, C. Vignal-Clermont2, V. Carelli3, C. La Morgia4, M.L. Moster5, R.C. Sergott5, S. Thornton5, S.P. Donahue6, H. Dollfus7, T. Klopstock8, C. Priglinger8, R. Hage9, V. Smirnov10, C. Cochard11, M.-B. Rougier12, E. Tournaire-Marques12, P. Lebranchu13, C. Froment14, F. Pollet-Villard15, M.-A. Laville16, C. Prospero Ponce17, S.D. Walter18, F. Munier19, P. Zoppe20, M. Taiel21, J.-A. Sahel22 1Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, Clinical Neurosciences, Cambridge, France, 2Rothschild Foundation Hospital, Paris, France, 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy, 4University of Bologna, Biomedical and Neuromotor Sciences, Bologna, Italy, 5Wills Eye Hospital, Neurology and Ophthalmology, Philadelphia, United States, 6Vanderbilt Eye Institute, Nashville, United States, 7Université de Strasbourg, Strasbourg, France, 8Ludwig-Maximilians-Universitat Munchen, Munchen, Germany, 9Centre Hospitalier National D’Ophtalmologie des Quinze Vingts, Paris, France, 10Centre Hospitalier Universitaire de Lille, Lille, France, 11Centre Hospitalier Universitaire de Rennes, Rennes, France, 12Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France, 13Centre Hospitalier Universitaire de Nantes, Nantes, France, 14Centre Hospitalier Universitaire de Lyon, Lyon, France, 15Centre Hospitalier de Valence, Valence, France, 16Centre Hospitalier Universitaire de Caen, Caen, France, 17University Medical Center of El Paso, El Paso, United States, 18Hartford Hospital, Hartford, United States, 19Faculty of Biology and Medicine, Université de Lausanne, Lausanne, Switzerland, 20Centre Hospitalier de Wallonie Picarde, Tournai, Belgium, 21GenSight Biologics, Paris, France, 22Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France Purpose: Early access programs provide efficacy and safety data on the use of lenadogene nolparvovec gene therapy (LNGT) in real-life conditions in pa- tients with Leber hereditary optic neuropathy (LHON) due to the m.11778G>A ND4 mutation. Methods: LNGT was provided based on unsolicited requests and its use was authorized by local regulations in 4 countries (France, Italy, UK and US). Patients received LNGT as a unilateral or bilateral intravitreal injection (9x1010 viral genomes/eye). Intermediate analysis was performed on August 29, 2024. Results: A total of 63 MT-ND4 LHON patients received LNGT in early ac- cess programs, mainly in France (35 [55.6%]) and the US (18 [28.6%]). Most (42 [66.7%]) patients received a bilateral injection. At the time of the first injection of LNGT, patients were on average (SD) 33.7 (16.6) years old, with 6 (9.5%) children aged 13 or 14 years. The mean (SD) duration of disease at the first injection was 11.4 (9.6) months. Most (84.1%) patients were treated with idebenone therapy at or after LNGT injection, for a mean (SD) duration of 36.1 (14.6) months. Best-corrected visual acuity values (BCVA) at 1 year were obtained from 53 patients; the mean (SD) change in BCVA from nadir to 1 year was -0.42 (0.54) LogMAR (+21 ETDRS letters equivalent). Clinically relevant recovery (CRR) from nadir was observed in 42.9% of treat- ed eyes within 12 months of disease onset, and in 76.5% of treated eyes after 12 months of disease onset. The safety of LNGT was comparable to those of the 189 patients from clinical studies, with no difference in the incidence of intraocular inflammation between patients treated bilaterally and unilaterally (51.2% vs 52.4%). 130 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Conclusions: Preliminary analyses show that injection of LNGT in the real- life setting was associated with a clinically meaningful improvement in visual acuity from nadir and a favorable safety profile similar to that observed in the clinical studies. EP-NEO-16 Multimodal imaging, treatment and follow-up in an atypical case of idiopathic intracranial hypertension asociated with serous neuroretinal detachment R. Oprina Tudosescu1, C. Hornischer2, A. Dumitrescu Dragan3, C.I. Coman4 1Private Clinic Regina Maria, Ophthalmology, Bucharest, Romania, 2Pallas Kliniken AG, Ophthalmology, Solothurn, Switzerland, 3Ophtamax Eye Clinic, Ophthalmology, Ploiesti, Romania, 4Visus Clinic, Ophthalmology, Ploiesti, Romania Purpose: To present the case of a 35-year-old male with a six-month history of headaches, tinnitus, and dizziness upon standing. Methods: The patient presented to our private clinic seeking a second opinion following a diagnosis of papilledema, for which he had received corticoster- oid treatment. Ophthalmic examination revealed best-corrected visual acuity of 20/20 in both eyes. Slit-lamp examination and I-care tonometry results were normal bilaterally. Direct and indirect ophthalmoscopy showed bilateral EP-NEO-17 Data use of comprehensive examination in patients with partial optic nerve atrophy in multiple sclerosis A. Hajiyeva1, S. Orudjeva2 1Azerbaijan Medical University, General Medical Education, Baku, Azerbaijan, 2Baku State University, Faculty of Biology, Baku, Azerbaijan Purpose: Multiple sclerosis (MS) is a persistently advancing autoimmune inflammatory neurological degenerative disease. The central nervous sys- tem predominantly affects young people within the working-age population. Multiple sclerosis ranks fourth in terms of prevalence when one talks about strokes, Parkinson’s disease, and epilepsy. Damage to the CNS nerve fibers myelin sheath leads to the formation of optic neuritis, often followed by partial atrophy of the optic nerve (PONA). Methods: The study involved 56 MS patients. Twenty-three patients (11 men and 12 women) had a disease duration of up to 5 years and the remaining 33 patients (21 men and 12 women) had a duration of more than 5 years. Patients’ MS diagnosis was confirmed based on W. Donald et al.’s criteria with relaps- ing-remitting course of disease. Neurological deficit severity was estimated by the Kurtzke Expanded Disability Status Scale (EDSS). Inclusion was limited to patients with EDSS no larger than 5.5 during remission. Results: Objective functional changes in the VA conduction pathways in MS were identified through visual evoked potentials on a checkerboard pattern, characterized by delayed latency, reduced amplitude, and altered P100 wave- papilledema with macular pucker and serous neuroretinal detachment on LE form. and interpapilomacular RPE detachment on the RE. Multimodal imaging, including OCT of the optic nerve, macula, and ganglion cells, visual evoked potentials (VEP) and visual field testing were performed. A lumbar puncture with manometry revealed elevated intracranial pressure. Multiple blood tests were also conducted. Results: Treatment with high-dose acetazolamide resulted in the improvement of symptoms and a reduction in retinal nerve fiber layer edema. Interestingly during the course of the treatment a serous neuroretinal detachment developed also on the right eye. Conclusions: Idiopathic intracranial hypertension is a rare condition requiring thorough investigations, including multimodal imaging and lumbar puncture with manometry for diagnosis. Aggressive medical management with oral car- bonic anhydrase inhibitors can result in significant symptom improvement. The unique aspect of this case lies in the diagnosis of idiopathic intracranial hypertension in a male patient with a BMI of 22.5, presenting with an uncom- mon feature of bilateral serous neuroretinal detachment. In patients with MS duration exceeding 5 years, even in the absence of op- tic neuritis (ON) history, the disturbances were comparable to those seen in patients who had experienced ON. OCT provided valuable data on axonal degeneration in MS, showing a reduction in macular thickness in 80% of cases and thinning of the retinal nerve fiber layer in nearly 60%. Conclusion: The diagnostic value of combining subjective and objective neu- rovisualization techniques allows for early diagnosis of multiple sclerosis. EP-NEO-18 Linezolid induced optic neuropathy in a patient with multidrug-resistant tuberculosis (MDR-TB) J. Da Silva Rocha1, S. Alves Pereira1, J.A. Lemos1, A. Reis da Silva1, P. Tenedório1 1ULS Matosinhos, Hospital Pedro Hispano, Oftalmologia, Matosinhos, Porto, Portugal Introduction: Linezolid is a useful antibiotic active against drug-resistant bacteria, such as MRSA and M. Tuberculosis. With the emergence of resist- ance to first-line anti-tuberculosis therapy, new second-line agents such as linezolid are now utilized more frequently. Linezolid is a drug that is usually well-tolerated and safe, however, long-term use, especially for more than 4 weeks, may result in several side effects such as linezolid optic neuropathy. Material and Methods: We present a retrospective case report conducted at ULS Matosinhos of a 31-year-old male undergoing linezolid therapy for 12 months for disseminated MDR-TB. Our report is based on clinical and oph- thalmologic examination, imaging studies and medical treatments. All patient data were anonymized in accordance with the principles of the Declaration of Helsinki. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 131

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ELECTRONIC POSTER PRESENTATIONS Results: Ophthalmological examination revealed that his best corrected visual acuity (BCVA), measured with Snellen’s chart, was 2/10 in both eyes. Color vision was significantly impaired and showed a cecocentral visual field de- fect in both eyes. Following the discontinuation of linezolid, follow-up visits showed improvement in his visual symptoms. Because of these findings, a final diagnosis of toxic optic neuropathy was made and the patient’s final visual acuity reached 10/10 without correction in both eyes. Conclusion: Drug-associated toxic optic neuropathy is a rare but vision- threatening condition. Diagnosis relies on thorough case history and careful clinical examination. This case report highlights the importance of knowing all medications and substances a patient consumes and emphasizes the need for close follow-up sessions for patients on long-term linezolid therapy to promptly recognize and manage toxic optic neuritis. EP-NEO-20 Superior oblique myokymia: a rare case report with video documentation J. Da Silva Rocha1, A.R. Viana1, E. Rebelo Neves1, C. Francisco1, A. Reis da Silva1, S. Justo1, P. Tenedório1 1ULS Matosinhos, Hospital Pedro Hispano, Oftalmologia, Matosinhos, Porto, Portugal Superior Oblique Myokymia (SOM) is a rare condition, characterized by benign, monocular, intermittent episodes of sudden rapid eye movements of small amplitude that may be vertical, torsional or oblique. The contraction of the superior oblique makes the patient experience episodic monocular oscil- EP-NEO-21 THRIVE-2 phase 3 trial of veligrotug (VRDN-001) in chronic thyroid eye disease (TED): efficacy and safety at 15 weeks J. Uddin1, M. Schittkowski2, O. Konuk3, A. Eckstein4, A. Csutak5, P. Rodien6, E. Eade7, V. Lee8, M. Sales Sanz9, W. Conroy10, A. Narvekar10, T. Ciulla10, A.M. Garrido Hermosilla11, THRIVE-2 Study Group 1Moorsfields Private Eye Hospital, London, United Kingdom, 2Universitätsmedizin Göttingen, Göttingen, Germany, 3Gazi University Medical School, Department of Ophthalmology, Ankara, Turkey, 4Universitätsmedizin Essen, School of Vision, Essen, Germany, 5Optimum Vision Center, Budapest, Hungary, 6Centre Hospitalier Universitaire d’Angers - Hématologie, Angers, France, 7North Shore Private Hospital, New South Wales, Australia, 8Imperial College Healthcare NHS Trust - Western eye Hospital, London, United Kingdom, 9Hospital Universitario Ramón y Cajal, Madrid, Spain, 10Viridian Therapeutics, Inc., Waltham, United States, 11Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain Purpose: Significant unmet needs remain for chronic TED. Veligrotug (veli), a full antagonist humanized monoclonal antibody targeting IGF-1R, previ- ously demonstrated positive results in the ongoing phase 3 THRIVE RCT for active TED. Here we present efficacy/safety from the ongoing phase 3 THRIVE-2 RCT (NCT06021054) of veli in chronic TED at 15 weeks (pri- mary timepoint). Methods: Adults with moderate-to-severe chronic TED (onset >15 months, proptosis ≥3 mm, any clinical activity score [CAS]) were randomized to 5 IV infusions 3 weeks apart of either 10 mg/kg veli or placebo (pbo). Efficacy outcomes and treatment-emergent AEs (TEAEs) were assessed through 15 lopsia and sometimes binocular vertical diplopia, mainly when looking down- weeks. wards. When examining a patient, a high index of suspicion for SOM is critical, as positive exam findings may not be present due to the sporadic nature of this condition; as a result, SOM is frequently underdiagnosed. The literature fea- tures approximately 100 cases published since it was first described in 1906. Management and treatment of these patients are still a controversial subject. We present a case of SOM in a 31-year-old woman who presented with uni- lateral oscillopsia and intermittent monocular cyclotorsional nystagmus of the right eye, together with a small video documentation. After exclusion of central nervous system pathologies through neuroimaging, the patient was treated with topical beta blockers and magnesium supplements showing clinical improvement. We also present a brief review of the patho- physiology, the recommended work-up flow, suggested treatment options for this peculiar neuro-ophthalmic condition. Results: 188 patients received veli (n=125) or pbo (n=63) and were included in the intent-to-treat population. Baseline values for veli vs pbo were balanced, with CAS ≥3 in 57% vs 52% and diplopia present in 52% vs 59%. 15-week outcomes for veli vs pbo included proptosis responder rate (PRR; ≥2-mm re- duction vs baseline by Hertel exophthalmometry), 56% vs 8% (p<0.0001), with a mean reduction of 2.34 mm vs 0.46 mm (p<0.0001); PRR by MRI/ CT, 48% vs 3% (p<0.0001); overall responder rate (PRR and no worsening in CAS), 56% vs 7% (p<0.0001). In patients with diplopia at baseline, Gorman diplopia responder rate was 56% vs 25% (p=0.0006); complete resolution oc- curred in 32% vs 14% (p=0.0152). In patients with CAS ≥3 at baseline, CAS 0/1 (exploratory endpoint) was achieved in 54% vs 24% (nominal p=0.0060). Most TEAEs were mild. The most common was muscle spasms (36% vs 6%). Hearing impairment TEAEs occurred in 13% vs 3% and serious TEAEs in 2% vs 3% (1 related to treatment in each group). Conclusions: THRIVE-2, assessing 5 IV infusions of veli in chronic TED, is the first RCT to show statistically significant improvement not only in prop- tosis, but also in subjective diplopia, with a generally well-tolerated safety profile. These results show the potential of veli in chronic TED. Follow-up through 52 weeks is ongoing. 132 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Results: Magnetic resonance venography revealed cranial venous sinus thrombosis, while cranial magnetic resonance imaging was normal in all patients. Lumbar puncture opening pressure was above 300 mmHg and cer- ebrospinal fluid analysis was found to be normal. Six patients had Behçet’s disease, two had polycytemia vera, one had iron deficiency anemia ,one had nephrotic syndrome, one had neurobrucellosis and one had essential thrombo- cytosis as etiological factor. Conclusion: Physicians in related subspecialties are aware that systemic illnesses might result in cranial sinus venous thrombosis, which can lead to pseudotumor cerebri. Ophthalmologists should consider pseudotumor cerebri while evaluating patients with papilledema and assist in the diagnosis by uti- lizing the findings of fundus and visual field examinations. Pseudotumor cer- ebri due to cranial sinus venous thrombosis should be taken into consideration in the differential diagnosis of papiledema and cranial magnetic resonance venography should be ordered to investigate sinus venous thrombosis, par- ticularly in patients with Behçet’s disease, a condition that is common in our nation. EP-NEO-25 Case report: bilateral dural carotid cavernous fistulas O. Lūse1, I. Strautmane1,2 1Latvian American Eye Center, Rīga, Latvia, 2Riga East University Hospital, Rīga, Latvia Introduction: Carotid cavernous fistula is abnormal vascular connection be- tween the carotid artery or its branches to the cavernous sinus. The resulting alterations in blood flow leads to increased pressure within the cavernous si- nus. Case presentation: A 44-year-old male presented with complaints of con- junctival injection, horizontal diplopia, and headache. The patient reported ex- periencing eye injection for the past two months, for which anti-inflammatory therapy had been prescribed without any improvement. He denied any signifi- cant head trauma, noting only a mild head injury during childhood. On ocular examination, right eye esodeviation and reduced abduction were observed. Diplopia was more pronounced when the patient gazed to the left. Examination of the anterior segment revealed mild chemosis and dilated scle- ral veins in the inferior region of the right eye and nasally in the left eye, with no evidence of discharge. Visual acuity was 20/20 in both eyes, while intraocular pressure was elevated in the right eye. No abnormalities were detected in the pupillary response or posterior seg- ment examination. Neurologically, the only notable finding was a sixth cranial nerve palsy. A computed tomography scan revealed enlargement of the cav- ernous sinus, with an increased diameter of both superior ophthalmic veins. Based on these clinical and radiological findings, the decision was made to proceed examination with digital subtraction angiography, which identified bilateral dural carotid-cavernous fistulas. The patient then underwent bilateral transvenous embolization of the fistulous connections. Within two weeks of the procedure, the patient’s eye symptoms and diplopia had resolved. Conclusion: Dural fistulas typically exhibit low arterial blood flow rates, re- sulting in mild and nonspecific symptoms. As a result, their diagnosis is often challenging and requires a multidisciplinary approach. EP-NEO-22 Case report of a young female patient presented with bilateral papilledema diagnosed empty sella syndrome and benign intracranial hypertension E. Kujundzic Begovic1, A. Mahmuljin1, B. Rovcanin2 1Clinical Center University of Sarajevo, Eye Clinic, Sarajevo, Bosnia and Herzegovina, 2Clinical Center University of Sarajevo, Neurosurgery, Sarajevo, Bosnia and Herzegovina Introduction: Empty sella syndrome is a condition in which the pituitary gland shrinks or gets flattened. Partial empty sella is suggestive that some of the pituitary gland is visible on the MRI scan. Primary empty sella oc- curs when a hole in diaphragmatic sella covering the pituitary allows fluid in, which presses on the pituitary. Secondary empty sella syndrome occurs when the pituitary gland is damaged by a tumor, surgery or radiation therapy. Papilledema presents with optic disc swelling resulting from increased intrac- ranial pressure. Causes of papilledema include intracranial tumors, idiopathic intracranial hypertension (pseudotumor cerebri), subarachnoid hemorrhage, subdural hematoma and intracranial inflammation. Aim: To present a case of a patient with papilledema which was diagnosed empty sella syndrome and benign intracranial hypertension. Case report: Patient, female, 32 years old, came to Eye clinic complaining on a dark spot in front both eyes during 6 months. She did not have any other medical history of disease, only her grandfather had glaucoma. Fundus exami- nation showed severe sweeling of both optic discs. During hospitalization we ordered MRI scans of a brain. MRI scans showed empty sella syndrome with benign intracranial hypertension. In consultation with coleagues from Clinic for neurosurgery, we gave to pa- tient acetazolamid 250 mg 2x1 for 7 days, and continued 2x500 mg for 3 months. After one month on a control examination, she did not see any dark spots, and fundus examination showed decrased sweeling of optic discs. Conclusion: Papilledema is the primary ocular finding in patients with intrac- ranial hypertension and may progressively lead to optic atrophy and blindness if no treatment is provided. EP-NEO-24 Evaluation of the etiology of pseudotumor cerebri cases that are secondary to a systemic disease D. Karaca1, F. Önder1 1Haseki Training and Research Hospital, Ophthalmology, Istanbul, Turkey Purpose: Pseudotumor cerebri is a condition characterized by signs and symptoms of elevated intracranial pressure without space-occupying cer- ebral mass, hydrocephalus, or structural abnormalities. It’s considered an ophthalmological emergency since it may result in irreversible vision loss. It’s referred to as “Idiopathic intracranial hypertension” if there is no known cause. Following the exclusion of idiopathic cases, pseudotumor cerebri due to cer- ebral sinus venous thrombosis is the most prevalent one. The purpose of this study is to assess the etiological spectrum of pseudotumor cerebri in our pa- tients who have systemic diseases. Method: The etiological factors of 14 cases of pseudotumor cerebri secondary to systemic diseases were evaluated. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 133

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-26 Skew deviation secondary to thalamic ischemic stroke in a patient with type 2 diabetes: case report U. Jimenez Dominguez1, D. Romero Cano1 1UNAM / General Hospital of Mexico “Dr. Eduardo Liceaga”, Ophthalmology, Ciudad de Mexico, Mexico Oblique deviation (skew deviation) is characterized by vertical misalign- ment of the eyes, typically presenting as hypertropia, without direct associa- tion with specific ocular muscles or nerves. Causes include stroke, demyeli- nating lesions, tumors, and trauma. In older adults, ischemic strokes, particu- larly in the basilar artery territory, are a major cause. The pathophysiology involves damage to the prenuclear vestibular pathways, disrupting spatial orientation and ocular alignment. Recognizing oblique de- viation as a neurological sign of potential posterior fossa damage is crucial for early diagnosis and management to avoid severe complications. This case highlights a 51-year-old man with type 2 diabetes mellitus (HbA1c 15.6%), presenting with blurred vision, nausea, sudden ocular deviation, se- vere headache, vomiting, and ataxic gait. Ophthalmologic findings included alternating fixation with deviation: hypo- exotropia of the left eye with right eye fixation and hyper-exotropia of the right eye with left eye fixation. Torsional nystagmus and adduction limita- tion in the right eye were also noted. Neurological examination revealed an increased gait support base. Imaging studies, including MRI and angioresonance, identified ischemic stroke affecting the right thalamus, bridge, and cerebellar cortex, with de- creased flow in the right vertebral artery (segment 4). The diagnosis was oblique deviation secondary to acute ischemic stroke in the basilar artery territory, involving paramedian branches. This case underscores the importance of differential diagnosis, distinguish- ing oblique deviation from conditions like internuclear ophthalmoplegia and nerve palsies, and the role of advanced imaging in accurate diagnosis. Managing metabolic risk factors, such as diabetes and hypertriglyceridemia, is essential for preventing recurrence and improving outcomes. EP-NEO-27 Spontaneous vitreous hemorrhage in a 59-year-old female: suspected Terson’s syndrome 19 years after subarachnoid hemorrhage and aneurysm surgery R. Dzhambazov1, V. Haykin1, Y. Zdravkov1, N. Andonova1, A. Oscar1 1University Hospital Aleksandrovska, Sofia, Bulgaria Purpose: To report a case of a spontaneous vitreous hemorrhage with prereti- nal, intraretinal and subretinal hemorrhages in a 59-year old woman with no systemic comorbidities. Materials and methods: A 59-year-old female with a medical history of subarachnoid hemorrhage and aneurysm surgery 19 years prior presented with sudden onset of visual disturbance in the left eye and a severe headache the day before. A thorough ophthalmological examination was performed including visual acuity testing, slit-lamp biomicroscopy, Optical-Coherence Tomography, Humphrey visual field analysis, neuroimaging to rule out a re- current aneurysmal rupture and laboratory tests to exclude coagulopathies. Results: Upon presentation the visual acuity of the left eye of the patient was severely reduced to PPLC, while the right eye was unaffected. The anterior segment of the left eye showed no abnormal changes except for a dilated pu- pil which was non-reactive to light stimulus. Fundus examination of the left eye revealed partial hemophthalmos with preretinal, intraretinal and subretinal hemorrhages in the macular and optic nerve area. The visual field analysis showed diffusely reduced light sensitivity in the left eye. CT scan of the brain was performed which showed no signs of recurrent hemorrhage and the labo- ratory test were also within normal limits. Conclusion: Based on the clinical findings and the medical history of the patient, the diagnosis of Terson’s syndrome was strongly suspected. The pa- tient was treated with an Anti-VEGF intravitreal injection which showed sig- nificant improvement in the visual acuity and the hemophthalmos resorption in the follow-up examinations. This also demonstrates the efficacy of Anti- VEGF treatment in patients with this condition. EP-NEO-30 Neuroimaging findings in Tolosa-Hunt syndrome: differences and differential diagnosis with other orbital inflammatory diseases A. Latuffe Soares Damião1, M. Simões de Barros1, J. Vignola De Carlo1, H. Bosso1, F. Sabbag Stersa1, P. Carlos Carricondo1 1University of São Paulo Medical School, Division of Ophthalmology, São Paulo, Brazil Purpose: Tolosa-Hunt Syndrome (STH) is characterized by granulomatous inflammation in the cavernous sinus, superior orbital fissure, or orbital apex, resulting in painful ophthalmoplegia. The differential diagnosis includes con- ditions such as orbital pseudotumor and cavernous sinus thrombosis, which may present similar imaging findings. Therefore, the main objective of this study is to review neuroimaging findings and highlight the differences compared to other orbital inflammatory diseases for precise diagnosis. Methods: This narrative review was conducted through an extensive biblio- graphic search in the PubMed, Scopus, and Embase databases. A total of 23 articles published in the last five years (2019-2024) were identified using the descriptors “Tolosa-Hunt syndrome,” “neuroimaging,” “differential diagno- sis,” “cavernous sinus,” and “orbital inflammatory diseases.” Results: Contrast-enhanced MRI showed homogeneous enhancement in the affected cavernous sinus, with involvement of the superior orbital fissure in several reviewed cases. In contrast, orbital pseudotumor showed diffuse orbital inflammation, and cavernous sinus thrombosis exhibited clear signs of vascular congestion and dilatation of the ophthalmic veins. In some studies, computed tomography (CT) was useful for excluding neoplasms and aneurysms, but with lower sen- sitivity for the subtle inflammatory changes in STH. Conclusions: Neuroimaging, particularly contrast-enhanced MRI, is crucial for diagnosing STH, enabling effective differentiation from other orbital in- flammatory diseases. Early identification of typical findings, such as thicken- ing and enhancement of the cavernous sinus, combined with a rapid response to corticosteroids, confirms the diagnosis and prevents complications. While less sensitive, CT can complement the exclusion of other etiologies, such as neoplasms and aneurysms. Careful interpretation of imaging findings is essential for an effective therapeutic approach. 134 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-31 The role of optical coherence tomography angiography in evaluating retinochoroidal changes in pituitary tumors M. Puchol Rizo1, J.A. Reche-Sainz1, J. Fernández-Rodríguez1, E. Puertas-Martínez2, S. Arroyo San Victor1, L. Alcalde-Blanco1, M.d.C. de Uña-Iglesias1 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital Universitario Rey Juan Carlos, Madrid, Spain Purpose: Pituitary tumors are a common cause of visual disturbances due to their proximity to the optic chiasm, often affecting retinal and optic nerve structures. This review aims to explore the role of optical coherence tomogra- phy angiography (OCT-A) in assessing retinochoroidal vascular changes and its potential to predict visual outcomes in patients undergoing surgical resec- tion for pituitary tumors. Methods: A comprehensive review of the literature was conducted, focusing on studies utilizing OCT-A to evaluate microvascular changes in the retina and peripapillary regions associated with pituitary tumors. Key metrics such as ra- dial peripapillary capillary (RPC) density, macular vascular density, and their correlation with visual field deficits and recovery were analyzed. Insights into structural parameters like the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were also included to provide a holistic understanding of the interplay between vascular and structural changes. Results: The literature suggests that OCT-A provides a unique advantage in detecting subtle microvascular changes, often preceding functional and struc- tural damage. Significant reductions in RPC and macular vascular densities are correlated with visual field deficits, while postoperative improvements vary based on the duration of compression and baseline vascular integrity. However, inconsistencies in the findings highlight the need for standardized approaches and further research to clarify OCT-A’s prognostic value. Conclusions: OCT-A has demonstrated great promise as a non-invasive, high- resolution imaging modality for assessing microvascular changes in patients with pituitary tumors. This review highlights its potential to refine the evaluation of visual outcomes and guide surgical decision-making, emphasizing the need for early diagnosis and intervention to maximize functional recovery. EP-NEO-32 Enhancement of visual function following intravitreal injection of hiPSC-derived retinal ganglion cells (RGCs) In a cynomolgus macaque optic neuropathy model G. Wang1, X. Sun1, Y. Tian1 1Eye & ENT Hospital of Fudan University, Department of Ophthalmology & Visual Science, Shanghai, China Purpose: Optic neuropathy comprises a spectrum of pathological conditions, with optic atrophy as a common outcome, characterized by the irreversible loss of retinal ganglion cells (RGC) and optic nerve fibers, impairing visual fields and overall visual function. It is a leading cause of visual impairment globally. However, effective therapeutic strategies targeting neuroprotection and regen- eration are still lacking. Method: Optic neuropathy model was induced in cynomolgus macaques by employing a 532 nm laser targeting around the optic disc margin to induce selective optic nerve fiber damage. Human induced pluripotent cells (hiPSCs) were sequentially cultured in neu- ral induction medium, retinal differentiation medium, and 3D differentiation medium to generate retinal organoids. Single cells were obtained when the RGC markers were most highly ex- pressed. Monkeys were anesthetized and RGC suspensions were intravitreally injected. Optical coherence tomography (OCT) and electrophysiological tests (photop- ic negative response [PhNR] and flash visual evoked potential [F-VEP]) were used to measure morphological, structural and functional changes post laser and post transplantation. Fundus imaging, slit-lamp imaging and IOP measurement were conducted to identify possible adverse effects. Results: The successful establishment of the optic neuropathy model was confirmed by a reduction in retinal nerve fiber layer thickness, along with decreased amplitudes of the PhNR wave and P2 wave in F-VEP. After RGC transplantation, an amelioration of PhNR and P2 wave amplitudes was ob- served at 3 months (P = 0.0379). Additionally, a slight recovery in RNFL thickness was noted (P = 0.0426). No adverse effects, such as intraocular pressure elevation, hemorrhage, or pro- longed inflammatory responses were detected. Conclusion: Intravitreally injection of hiPSC-derived RGCs has demonstrat- ed to be a safe and promising treatment with high potential for neuroregenera- tion in optic neuropathy. EP-NEO-34 Acute soft head syndrome associated with bilateral optic disc edema in sickle cell disease: a rare presentation B. Monteiro1, R. Whitfield1, V. Lobo1, S. Duarte1, F. Teixeira1, A. Fonseca1, M. Faria1 1Department of Ophthalmology, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, Lisbon, Portugal, Lisbon, Portugal Background: Acute soft head syndrome (ASHS) is a rare but recognized complication of HbSS sickle cell disease, marked by cranial bone infarcts and subgaleal hemorrhages. While ASHS typically causes localized pain and swelling, its progression to bilateral optic disc edema due to cerebrospinal fluid (CSF) drainage obstruction and intracranial hypertension (ICH) is ex- ceptionally uncommon. Case Report: We report the case of a 14-year-old male with HbSS and a his- tory of significant complications, including ischemic stroke at 2 years, multi- ple vaso-occlusive crises, acute hemolytic anemia episodes, cholecystectomy at 7 years, and orbital infarction at 12 years requiring surgical drainage of a subperiosteal hematoma. The patient presented with blurred vision in the left eye for one week. Examination revealed BCVA of 0.6 in the left eye and 1.0 in the right. Fundoscopy showed bilateral optic disc edema, more pronounced in the left eye, with peripapillary hemorrhages and vascular engorgement. Imaging identified cranial bone infarcts, subgaleal hemorrhages, and narrow- ing of the posterior superior sagittal sinus, suggesting impaired CSF drainage and ICH. Treatment with acetazolamide improved the optic disc edema. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 135

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ELECTRONIC POSTER PRESENTATIONS Conclusion: ASHS is an uncommon but serious complication of sickle cell disease, typically involving cranial bone infarcts and subgaleal hemorrhages. While it is not commonly associated with bilateral optic disc edema, this case demonstrates that it can present with ICH when complicated by impaired CSF drainage, a highly rare phenomenon. This underscores the importance of recognizing ASHS as a potential cause of optic disc edema and ICH in patients with HbSS. Early diagnosis and prompt treatment are critical to prevent irreversible visual loss. Further research is needed to better characterize this complication and optimize its management. EP-NEO-36 EP-NEO-37 Visual field recovery following surgical treatment in a patient with pituitary macroadenoma S.E. Kanik1, S. Tongal1, B. Saracoglu Yilmaz1, I. Cakir1 1Beyoglu Goz Eye Training And Research Hospital, Istanbul, Turkey Purpose: Pituitary macroadenomas can cause visual field defects and vision loss by compressing the optic nerves. Early surgical intervention plays a criti- cal role in preserving visual functions. This study investigates the effects of pituitary macroadenoma on the optic nerve and the improvement of visual functions following surgical intervention. Case Presentation: A 50-year-old male patient, initially followed in the retina Superior ophthalmic vein thrombosis in the context of orbital apex syndrome clinic with a visual acuity of 20/30 in the right eye and 20/20 in the left eye, suddenly experienced a decrease in vision in the left eye. Visual acuity was T. Javaloy Vidal1, C. Ruiz Arranz1, M. Fernández Reyes1, B. Cano González-Barcia1, M. Toribio Albarrán1, R. Fernández Herrero1, A. De Madariaga Azcuenaga1, A.A. Iribarra Fernandois1 112 de Octubre University Hospital, Madrid, Spain Purpose: To report a case of orbital apex syndrome due to superior ophthalmic vein thrombosis. Case presentation: An 88-year-old man suffering multiple systemic patholo- gies presented ocular itching for 4 days, associated, in the last 48 hours, with 20/30 in the right eye and 1 meter perception of light (1 mps) in the left eye. Visual field testing revealed a near-total defect in the left eye, with a VFI of 21%, and temporal hemianopsia in the right eye, with a VFI of 45%. Contrast- enhanced cranial MRI revealed a 35x30x25 mm pituitary macroadenoma compressing the distal portions of both optic nerves. And the patient under- went surgical resection of the pituitary macroadenoma. Following surgical intervention, improvement in both visual field (VFI : Right eye %99. ,left eye %91) and visual acuity was observed (both eyes 20/30 ). No significant changes were noted in the preoperative and postoperative mean OCT retinal nerve fiber layer (RNFL) values. Preoperative RNFL values were 75 µm in the right eye and 74 µm in the left eye, while postoperative values retro-ocular pain, red eye, proptosis, extrinsic eye movements limitation, up- were 71 µm in the right eye and 70 µm in the left eye. per eyelid edema, ptosis, and decreased visual acuity at his left eye. Ocular fundus could not be explored because of the bad basal systemic situation of the patient and a severe conjunctival chemosis. Relative afferent pupillary defect was detected. He did not present other symptoms. Because of the suspicion of orbital apex syndrome, an orbital and cranial scanner was requested, which showed thrombosis of the superior ophthalmic vein without involvement of the cavernous sinus, with an image suggestive of acute sphenoid sinusitis. Surgical treatment with endoscopic sinonasal surgery was proposed, but the patient rejected it. Given the suspicion of septic origin of the thrombophlebitis he was treated medically with intravenous antibiotics, anticoagulants and corticosteroids. Results: After 12 days of treatment, the patient presented resolution of pain, conjunctival chemosis and a improvement regarding ocular movements palsy. However, episcleral vessels remained engorged and little improvement in visual acuity was recorded. Conclusion: Superior ophthalmic vein thrombosis is a very rare entity; whose clinical suspicion is difficult, and needs imaging tests to be diagnosed. An early detection is necessary to prevent sequels of orbital apex syndrome and its spread to cavernous sinus. Conclusion: This case emphasizes the impact of pituitary macroadenoma on visual functions and the improvement in the visual field following surgi- cal treatment. Furthermore, the absence of any significant changes in RNFL during the postoperative period suggests that irreversible damage to the optic nerve has not progressed, and the nerve fibers have been preserved. EP-NEO-38 Horner syndrome after parathyroidectomy: case report V. Sá Araújo1, F. Maia1, C. Azenha1, M. Vaz Pereira1, R. Silva1, Á. Silva1 1Unidade Local de Saúde de Braga, Ophthalmology, Braga, Portugal Introduction: Horner Syndrome arises from disruption of the oculosympa- thetic pathway, classically manifesting with ptosis, miosis, and ipsilateral hemifacial anhidrosis. This condition is a rare complication following thyroid or parathyroid surgery, with several known mechanisms accounting for dam- age to the sympathetic chain during these procedures. Methods: Case report from the Ophthalmology Department at Hospital de Braga, dated July 2024. Results: A 64-year-old female developed right upper eyelid ptosis 24 hours after an uncomplicated open right superior parathyroidectomy, performed 6 months earlier. Histopathological analysis revealed a parathyroid adenoma. Ophthalmological examination showed right-sided miosis, resulting in aniso- coria due to delayed pupillary dilation under scotopic conditions. No associ- ated hemifacial anhidrosis was noted. The diagnosis of Horner Syndrome was confirmed by pharmacological testing with apraclonidine. The patient under- went surgery for reinsertion of the right upper eyelid retractors (via posterior 136 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS approach), which was completed uneventfully. This resolved the ptosis and led to substantial improvement of aesthetic appearance and eyelid function. EP-NEO-40 The anisocoria persisted throughout the follow-up. Conclusion: This case underscores the importance of recognizing Horner Syndrome as a rare but noteworthy complication of thyroid and parathyroid surgeries. General surgeons should be aware of the vulnerability of the ocu- losympathetic pathway due to its close anatomical relationship with these structures. Ophthalmologists must be proficient in identifying Horner Syndrome as a po- tential consequence of cervical interventions, highlighting the importance of obtaining a detailed clinical history for accurate diagnosis and treatment. A thorough ophthalmological assessment, including evaluation of oculomotor Contemporary elements in the differential diagnosis of optic neuropathies L. Žorić1 1UKC, Eye Clinic, Belgrade. UPKM, Faculty of Medicine, Kosovska Mitrovica., Neuro-ophthalmology, Belgrade, Serbia Purpose: Optical coherence tomography (OCT) and electrophysiological di- agnostics (EP) can aid in differentiation and monitoring of optic neuropathies of diverse origin. function and pupillary response, is crucial in patients presenting with ptosis to Methods: Changes in retinal ganglion cells were analyzed by OCT (gangli- identify any associated neurological damage. EP-NEO-39 Optic neuropathy in thyroid eye disease: a 11-year retrospective study M. Mourali1, M. Ben Hadj khelifa1, R. Kmiha1, S. Bouajina1, A. Chebbi1 1Hédi Raies Institut of Ophthalmology, Department C, Tunis, Tunisia on cell complex -GCC) and pattern reversal electroretinography (PRERG). Changes in the retinal nerve fiber layer (RNFL) were recorded by OCT im- ages of optic nerve head (ONH), while afferent pathway function was tested by visual evoked potentials (VEP). The specified functional and morphologi- cal indicators (biomarkers) were recorded in a group of patients with typical and atypical inflammatory optic neuropathies (optic neuritis: ON), as well as in those with non-arteritic anterior ischemic (NAAION) and hereditary ones (LHON), at the time of the diagnosis establishing, and later, at control exami- nations. Results: The investigated biomarkers vary in the acute phase of optic neu- ritis, depending on the severity of the disease and anatomical localization (papillitis, retrobulbar neuritis) and underlying disease, and in further course. Hereditary optic neuropathies (LHON, here) show some similar, but more Purpose: To analyze the clinical characteristics, risk factors, and outcomes of expressed damages. Ischemic optic neuropathies have a rapid weakening of patients with optic neuropathy (ON) complicating thyroid eye disease (TED). Method: A retrospective study conducted over 11 years (2012–2023), includ- ing 19 patients with TED complicated by ON. Results: The mean age of the patients was 41.1 years (range: 28–53 years), with a female-to-male ratio of 1.7. Unilateral involvement was observed in 73.6% of cases. Among the risk factors, smoking was present in 56% of cases, diabetes in 31.5%, and hypertension in 10.5%. Hyperthyroidism was diag- nosed in 36.5% of patients, hypothyroidism in 21.5%, and euthyroidism in 42%. these biomarkers. Conclusion: EP and OCT examinations are an integral part of optic neuropa- thies diagnostics. Mentioned biomarkers can be indicative of the possible na- ture and prognosis of the disease and in therapeutic response monitoring. EP-NEO-41 Ophthalmologic examination revealed visual acuity below 20/40 in 68.4% of patients. Proptosis was graded as III in 31.7% of cases, II in 52.6%, and I in Hereditary non-arteritic anterior ischemic optic neuropathy: a Portuguese family case report 15.7%. Optic neuropathy was edematous in 63.1% of cases, retrobulbar in 26.7%, and atrophic in 10.5%. Therapeutically, 84% of patients received corticosteroid pulses followed by oral tapering, while 15.7% were treated with oral corticosteroids alone. Radiotherapy was performed in 10.5% of patients, and one patient underwent J. Alves Ambrósio1, R. Soares1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal surgical decompression. Clinical outcomes showed improvement in 36.8% of Purpose: To describe a unique case series of a Portuguese family with a sus- cases, stabilization in 42.2%, and worsening in 21%. pected hereditary pattern of non-arteritic anterior ischemic optic neuropathy Conclusion: ON in the context of TED represents a rare but severe late com- (NAION), highlighting clinical presentations, risk factors, and diagnostic plication. Its management, whether medical, surgical, or through radiotherapy, must be urgently discussed based on clinical and paraclinical findings to pre- serve visual function. challenges. Results: This case series includes 15 family members spanning three gen- erations, with 7 diagnosed cases of NAION. Affected individuals presented with acute, unilateral, painless vision loss accompanied by dyschromatopsia, visual field defects, and optic disc edema. Some cases progressed to bilateral involvement. Optical coherence tomography revealed retinal nerve fiber layer and ganglion cell layer loss in affected eyes, while risk factors such as hypertension, dys- lipidemia, type 2 diabetes, and obstructive sleep apnea were variably present. Genetic testing in one family member (II.2) was negative for known heredi- tary optic neuropathy genes, including LHON and DOA-associated mutations. Clinical patterns differed from classical hereditary optic neuropathies, as onset occurred later in life (mean age 55.8 ± 9.6 years) with no male predominance or systemic neurological manifestations. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 137

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ELECTRONIC POSTER PRESENTATIONS The combination of familial clustering, clinical variability, and sporadic risk factors complicates diagnosis and suggests an uncharacterized hereditary Method: Five male participants (aged 30-63, including advanced and begin- ner freedivers) underwent three conditions: component. 1. Controlled breathing, Conclusions: This case series underscores the complexity of hereditary 2. Dry apnea, and NAION, with familial clustering suggesting a potential genetic basis despite the absence of identified mutations. Expanded genetic testing and further re- search are needed to elucidate novel hereditary patterns and mutations. Multidisciplinary collaboration is essential for accurate diagnosis and man- agement, enabling better outcomes in patients with hereditary optic neuropa- thies. EP-NEO-42 Intracranial hypertension associated with PARP inhibitor A. Unal1 1Pitie Salpetriere, Ophthalmology, Paris, France 3. Wet apnea with face immersion in 13°C water. Pupillary fluctuations were recorded using an infrared pupillometer, analyz- ing low-frequency (SNS: 0.04-0.25 Hz) and high-frequency (PNS: 0.25-2 Hz) bands via spectral analysis. Approximate entropy (ApEn) quantified the com- plexity of hippus. Results: During wet apnea, a significant reduction in low-frequency power (p < 0.01) and a proportional increase in high-frequency power (p < 0.01) were observed compared to dry apnea and breathing. Additionally, wet apnea displayed higher ApEn values (p < 0.001), indicating greater complexity in pupillary oscillations. These findings suggest a pronounced parasympathetic activation and a redistribution of autonomic inputs during DR. Conclusion: Our results reveal that pupillometry can detect nuanced shifts in autonomic balance and complexity during the DR, emphasizing its value in exploring neuro-ophthalmological mechanisms of pupillary control. The en- hanced high-frequency dynamics and increased entropy reflect sophisticated parasympathetic modulation, advancing our understanding of pupil behavior in response to autonomic challenges. We report a 64-year old female patient treated for a ovarian cancer with Niraparib (PARP inhibitor0 which presents bilateral visual loss, headache, nausea and tinnitus one month after the initiation of the treatment. The BCVA was 10/10 on both eyes. The slit lamp examination was normal on both eyes . EP-NEO-44 The fundus examination showed a bilateral papillary oedema with peripapil- lary hemorrhages The OCT and the visual field were normal in both eyes. The fluorescein angiography showed a leakage of the optic nerve head. The cerebral MRI confirmed a intracranial hypertension associated to a sigmoid sinus thrombosis. A lumbar puncture confirmed the hyperpression. The patient was hospitalised in the Haematology service due to an acute my- eloid leukemia and the anticoagulant treatment was insured. The evolution was favorable under acetazolamide with the complete remission of the papil- lary oedema in 3 weeks. EP-NEO-43 Pupillometry reveals autonomic adjustments during diving reflex V. Rizzuto1, R. Montanari2, J. Vanags3, A. Gemignani4, M. Laurino5, H. Bortolozzo-Gleich6, G. Laganovska3, L. Mesin7 1School of Advanced Studies, Center for Neuroscience, University of Camerino, Camerino, Italy, 2Pharmacology Institute, Heidelberg University Hospital, Heidelberg, Germany, 3Riga Stradins University, Riga, Latvia, 4University of Pisa Hospital, Neuroscience, Pisa, Italy, 5Institute of Clinical Physiology, National Research Council, Pisa, Italy, 6Instituto de Neurociencias UMH-CSIC (Alicante), Avenida Santiago Ramón y Cajal s.n., Alicante, Spain, 7Politecnico di Torino, Electronics and Telecommunications, Mathematical Biology and Physiology, Torino, Italy Purpose: The human diving reflex (DR) offers a unique model to study auto- nomic interactions influencing pupillary dynamics, including the spontaneous oscillations known as hippus. This study investigates how the DR modulates frequency components and complexity of pupil diameter fluctuations during apnea, providing insights into autonomic control mechanisms. International translation process for visual impairment screening and questionnaire resources in adult brain injury F. Rowe1, L. Hepworth1, C. Howard2 1University of Liverpool, Liverpool, United Kingdom, 2Northern Care Alliance NHS Trust, Salford, United Kingdom Purpose: Stroke-related visual impairment is common with new onset visual impairment occurring in about 60% of stroke survivors. The Visual Impairment Screening Assessment (VISA) vision screening tool is an estab- lished tool for use by stroke clinicians to detect visual impairment in stroke survivors. The Brain Injury-related Visual Impairment Impact Questionnaire (BIVI-IQ) is a recently validated quality of life instrument. Whilst VISA and BIVI-IQ were developed in English, the aim of this study was to undertake a translation process into further languages. Methods: We followed the World Health Organisation translation process. Implementation of this process includes the following steps: 1. Forward translation; 2. Expert panel Back-translation; 3. Pre-testing and cognitive interviewing; and, 4. Final version production. Results: VISA and BIVI-IQ were successfully translated and are now available in 34 languages. Full validation studies are available for English, Norwegian and Dutch languages, and underway for Chinese. Conclusions: VISA and BIVI-IQ are available for free download for use in- ternationally in clinical assessment of brain-injury patients. Implementation of VISA in other countries has shown it to have validity for international use in clinical and research practice. Further international dissemination is encour- aged. 138 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-NEO-45 From darkness to sight: rapid recovery in MOG-related optic neuritis with high-dose steroid therapy M. Ihtisham1, A. Maino1 1Stepping Hill Hospital Manchester, Ophthalmology, Manchester, United Kingdom lized to detect vascular changes in the superficial retinal vascular plexus. We selected patients with a good visual acuity in order to highlight abnormalities between OCT structural parameters and visual function. Results: OCTA revealed alterations in the macular and peripapillary micro- vascular structures within the superficial retinal vascular plexus, indicative of optic nerve damage in multiple sclerosis. Radner plates demonstrated a prolonged reading time for affected eyes, even when visual acuity remained normal. Conclusions: This research emphasizes the importance of implementing ad- ditional visual function tests to enhance clinicians’ understanding of vision- Objectives: To illustrate the rapid visual recovery in a patient with MOG optic related symptoms in multiple sclerosis patients, particularly in cases where visual acuity appears normal. These findings highlight the need for more a comprehensive assessment to ad- dress patients’ visual complaints effectively, and offer a personalized medicine approach. neuritis through early, high dose corticosteroid intervention. Background: MOG optic neuritis is a severe inflammatory condition that can result in significant vision loss if not treated promptly. High-dose corticos- teroids are known to aid recovery, though the degree of response varies. This case highlights the potential for near-complete vision restoration with prompt therapy, emphasizing its importance in clinical practice. Case Description: A 30-year-old male of Pakistani origin presented with a 5-day history of blurred vision and mild pain in the left eye. His initial vi- sion was 6/12, improving to 6/9 with pinhole testing. Over the next five days, his vision deteriorated to hand movements despite normal routine blood tests. Following a neuro- ophthalmology consultation, intravenous methylpredni- solone (1g daily for 5 days) was initiated, followed by a tapering oral course. Vision improvement began by the third dose, reaching 6/6 with pinhole cor- rection by day five. Color vision, initially reduced to 0/17 on Ishihara testing, was fully restored. OCT imaging and visual fields demonstrated significant recovery of both optic nerve function and vision. The patient tested positive for MOG antibodies and was referred to neurology for further assessment and ongoing care. Conclusion: This case demonstrates the efficacy of high-dose corticosteroid therapy in rapidly restoring vision in severe MOG-related optic neuritis. Early intervention, supported by an interdisciplinary approach, can significantly im- prove outcomes and prevent lasting impairment. When investigating causes of optic neuritis, MOG antibody disease should be carefully considered, as timely diagnosis and treatment are essential for optimal recovery. EP-NEO-46 Visual function alterations in patients with multiple sclerosis – preliminary results V.C. Donica1, I.A. Pavel1, A.L. Donica2, C.M. Bogdanici1 1Grigore T. Popa University of Medicine and Pharmacy Iasi, Surgery 2 - Ophthalmology, Iasi, Romania, 2Grigore T. Popa University of Medicine and Pharmacy Iasi, Reumatology, Iasi, Romania Purpose: To investigate the various changes in visual function following an immediate inflammatory episode in patients with multiple sclerosis, in order to increase a phyiscian’s understanding of vision-related symptoms in these patients. Materials and Methods: In the scope of assessing the degradation of visual function, we evaluated visual acuity, color and contrast sensitivity, perimetry, and reading speed using Radner reading plates in patients with multiple scle- rosis who had experienced at least one episode of optic neuritis. Optical coher- ence tomography (OCT) was used to measure the thickness of the retinal nerve fiber layer around the optic nerve and the ganglion cell layer. Additionally, optical coherence tomography angiography (OCTA) was uti- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 139

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ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Ocular Surface EP-OCS-01 Therapeutic efficacy of 2% Rebamipide eye drops in Dry Eye Disease associated with Meibomian Gland Dysfunction J.S. Lee1, M.H. Cho1, J.H. Kim1 1Pusan National University School of Medicine/Pusan National University Hospital, Ophthalmology, Busan, Korea, Republic of Purpose: To evaluate the effects of 2% Rebamipide eye drops on tear film stability, focusing on tear lipid layer and meibomian gland changes in patients with dry eye disease (DED) accompanied by meibomian gland dysfunction (MGD). Methods: This study included 50 subjects (aged 19–80 years) diagnosed with moderate-to-severe MGD and tear film breakup time (TBUT) < 5 seconds. Participants were randomly assigned to receive 2% Rebamipide (experimental group) or 0.15% hyaluronic acid (HA) (control group) eye drops, each admin- istered four times daily for 8 weeks. Outcome measures included OSDI (Ocular Surface Disease Index), NEI (National Eye Institute Grading Scale for Corneal Fluorescein Staining), TBUT, LLT (lipid layer thickness), MGS (meibomian gland secretion), and partial blinking rate. Statistical analysis was conducted using SPSS 27.0, with significance defined as p < 0.05. Results: The study included 12 males and 38 females (mean age: 38.4 ± 11.3 years). Baseline characteristics were comparable between groups. Both groups showed improvement in OSDI, LLT, partial blinking rate, TBUT, and MGS after 8 weeks, but the experimental group demonstrated significant im- provements in TBUT and MGS compared to the control group. Notably, significant improvement in MGS was observed at 4 weeks in the ex- perimental group. No significant adverse effects were noted in either group. Over 8 weeks, 2% Rebamipide eye drops significantly improved meibomian gland function and lipid layer secretion in patients with DED and MGD com- pared to HA eye drops. Further multi-center clinical studies with larger sample sizes and advanced evaluation methods are warranted. EP-OCS-02 Antimicrobial resistance of commensal bacteria in the conjunctival sac and nasal cavity induced by repeated prophylactic antibiotic eye drops around intravitreal anti-VEGF antibody injection R. Tomemori1, K. Araki-Sasaki1, T. Kanagawa2, M. Ohnaka1, H. Mori1, J. Hisatune3, K. Higasa4, H. Imai1 1Kansai Medical University, Ophthalmology, Hirakata, Japan, 2Kansai Medical University, Department of iPS Stem Cell Regenerative Medicine, Hirakatashi, Japan, 3National Institute of Infectious Diseases, Musashimurayama, Japan, 4Kansai Medical University, Genome Analysis, Hirakata, Japan Purpose: To investigate whether repeated use of prophylactic antimicrobial eye drops during intravitreal anti-VEGF antibody (IVA) injections induces antimicrobial resistance in the conjunctival sac and nasal cavity. Methods: The study included two groups: 21 patients without prior exposure to antimicrobial eye drops (Group A) and 26 patients with over 20 exposures (Group B). Samples from the conjunctival sac and nasal cavity were ana- lyzed for bacterial resistance via MIC testing and antimicrobial susceptibility. Genetic mutations in Staphylococcus epidermidis (GyrA/ParC) and phyloge- netic analysis were conducted. Additionally, 16S rRNA sequencing assessed nasal bacterial flora differences. Results: Corynebacterium sp., S. epidermidis, and Cutibacterium acnes were most frequently identified. Group B showed significantly reduced sensitiv- ity to quinolones and cephem antibiotics. Mutation rates in GyrA_S84 and ParC_S80 were higher in Group A (67% and 69%) than Group B (26% for both). Four cases of quinolone-resistant S. epidermidis had genetically identi- cal strains in both sites. While no significant diversity differences in nasal flora were found, LEfSe analysis highlighted compositional variations. Conclusions: Repeated antibiotic use promotes resistance in the conjunctival sac and nasal cavity, emphasizing the need for judicious antimicrobial use. EP-OCS-04 Incidence of eye diseases due to sexually transmitted infections in Spain in the last 7 years. Chlamydia, gonococcus and mpox C. Campo Beamud1, V. Hernando Sebastian2, I. Lopez Mesa1, A. Adan Ruiz1, E. Díaz Fernández1, E. Campo Beamud1, A. Donate Rosa1, J. Bastante Quijano1, M.E. Hidalgo Espinosa1, A.J. Ruiz Lopez1 1Hospital General Universitario de Ciudad Real, Ophthalmology, Ciudad Real, Spain, 2National Epidemiology Centre. CIBER of Infectious Diseases (CIBERINFEC). Carlos III Health Institute, Madrid, Spain The incidence of Sexually Transmitted Infections (STI) has been increasing in recent years, with Chlamydia Trachomatis (CT) and Neisseria Gonorrhoeae (NG) infections being the most frequent worldwide. This seems to be linked to the increase in sexually transmitted conjunctivitis reported in Western coun- tries. In addition, a global health emergency was declared in 2022 for mpox, which can cause conjunctivitis, ulcerations, and corneal endothelitis in ophthalmol- ogy. 140 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS This study aimed to explore the incidence of STI and their possible relation- Conclusions: Hyperosmolar eyes exhibited increased light scatter variation following cataract surgery compared with normal osmolarity eyes, equivalent to a grade 2–3 cataract. These differences were undifferentiated on standard measures of dry eye and ocular surface health, explaining a portion of patients who appear to have a normal ocular surface and achieve target refraction, but are dissatisfied with overall vision quality. Instillation of artificial tears elimi- nates much of the light scatter after 30 minutes, but further data are required to understand the durability of this effect. EP-OCS-09 Tears of plastic: the unseen harm to ocular surface Z.B. Gey1, B.B. Gey1 1Augenarztpraxis Dr.med.Bredehorn-Mayr, Ophthalmology, Aschersleben, Germany Purpose: Plastics are known for their versatility and widespread use; howev- er, as they degrade, they release microplastics (MPs), which are increasingly identified as harmful contaminants. While MPs have been linked to inflamma- tion, oxidative stress, and microbial imbalances in various organs, their effects on ocular health remain largely unexplored. This review investigates MPs in disposable eyedrops, their impact on the ocular surface, potential health risks, and environmental implications. Methods: Recent studies on MPs in commercial eyedrops and their effects on the ocular surface were reviewed. Experimental and observational data were analyzed for links to ocular inflammation, oxidative stress, microbial imbal- ances, and systemic effects. Results: • MPs in Eyedrops: Single-use eyedrop containers release significant MPs during usage, with particles often <5 µm and ranging from hundreds to thousands per milliliter, raising concerns about repeated ocular exposure. • Ocular Surface Effects: MPs impair ocular surface health by inducing oxidative stress, inflammation, and epithelial cell damage. Observed effects include reduced tear film quality, dry-eye symptoms, decreased goblet cell density, and elevated inflammatory markers (e.g., IL-1β, IL-6). • Environmental Impact: Disposable eyedrops contribute to plastic waste, risking MP accumulation in ecosystems. Conclusion: MPs in ophthalmic products pose risks to ocular health and en- vironmental sustainability but remain critically underexplored. Most research is limited to Asia, Australia, and Singapore, leaving gaps in European data and underscoring the need for global and regional investigations. Long-term effects on ocular and systemic health must be addressed. Sustainable packaging, stricter regulations, and recycling strategies are essen- tial. Raising awareness and fostering international collaboration, particularly in Europe, is vital to tackling this emerging public health and environmental concern. ship with ophthalmological involvement, describing the age and sex of the cases. Method: Retrospective descriptive analysis using national databases to esti- mate the incidence in Spain of cases of CT conjunctivitis (inclusion conjunc- tivitis - IC) and gonococcus (GC) from 2017 - 2023 reported to the National Epidemiological Surveillance Network (RENAVE) during these years. The incidence of ophthalmological involvement by mpox virus between 2022 and 2023 will also be included. Results: Of the total number of CT (n=144,656) and NG (n=119,308) cases, 23 cases of IC (60.9% (14) in women) were reported, with half of the cases occurring in 2023 (7) and 18 cases of GC (61.1% (11) in women), with the majority (10) occurring in 2023. No significant differences were found between the sexes. Among mpox cases (n=7,849), 23 cases of ocular involvement were reported, with the majority (21) presenting in 2022 (100% in males). The median age of presentation was 26 for IC, 28 for CG, and 41 for mpox. Conclusion: The data show a significant increase in infections caused by CT and NG, leading to an increase in IC and GC. These should be considered in the differential diagnosis of young people due to the important ophthalmologi- cal repercussions they may have. In addition, it is important to remember the ophthalmological involvement that the mpox virus can cause. EP-OCS-07 Hyperosmolarity of the tear film is associated with increased variation of light scatter following cataract surgery that is not detectable with standard measures L. Nijm1, B.D. Sullivan2, M. Palazon3, I. Yago3, R. Duarte4, J. Schallhorn5, D. White6, M. Berg2, P. Artal4 1Warrenville Eyecare and LASIK, Warrenville, United States, 2Trukera Medical, Southlake, United States, 3Hospital Universitario Virgen de la Arrixaca, Oftalmología en Murcia, Murcia, Spain, 4Universidad de Murcia, Laboratorio de Optica, Murcia, Spain, 5UCSF, San Francisco, United States, 6SkyVision Centers, Westlake, United States Purpose: To study the association between osmolarity and light scatter after cataract surgery, and understand how this effect may be identified and treated. Methods: This is a single-site, prospective study of 31 eyes of 31 patients with visually significant cataract (n=21) or hyperosmolar eyes (n=10). Patients in the cataract group were classified as normal osmolarity (<308 mOsm/L, n=10) or hyperosmolar (≥320 mOsm/L, n=11). Objective scatter index (OSI) scans, osmolarity, symptoms, staining (0–3), tear film break-up time (TBUT), and meibomian gland disease (MGD) se- verity were recorded at screening, baseline, and 90 days following surgery. OSI in the hyperosmolar group was measured at screening, baseline, and 5, 10, 15, and 30 minutes following instillation of 0.18% sodium hyaluronate (HA). Results: In the cataract group, there was a significant difference in postopera- tive OSI variation when comparing patients with or without hyperosmolarity (0.65±0.30 vs 0.33±0.11, p=0.005), with variations in the order of 2–3 OSI in hyperosmolar eyes. These changes were not significant when patients were stratified using stand- ard measurements, i.e., staining (p=0.891), TBUT (p=0.749), symptoms (p=0.719), or MGD status (p=0.852). In the hyperosmolar group, instillation of HA reduced OSI at 10, 15, and 30 minutes (p<0.001). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 141

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ELECTRONIC POSTER PRESENTATIONS EP-OCS-10 EP-OCS-11 Exploring the role of novel inflammatory indices as biomarkers in pediatric allergic conjunctivitis S. Koksaldi1, C. Durmaz Engin2, E. Karatas1, M. Kayabasi3, H.E. Gumus4 1Agri Ibrahim Cecen University, Ophthalmology, Agri, Turkey, 2Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Ophthalmology, Izmir, Turkey, 3Mus State Hospital, Ophthalmology, Mus, Turkey, 4Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Pediatrics, Izmir, Turkey Purpose: To compare novel systemic inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune-inflammation value (PIV), and hemoglobin-albu- min-lymphocyte-platelet (HALP) score, among pediatric patients with sea- sonal allergic conjunctivitis (SAC), vernal keratoconjunctivitis (VKC), and healthy controls, and to assess their correlation with clinical symptom and sign scores in VKC patients. Methods: This study included patients diagnosed with ocular allergy in our tertiary clinic between January 2024 and December 2024. Age- and sex- matched healthy children served as the control group. Comparative analyses for complete blood count cells as well as systemic biomarkers were conducted among three groups. In VKC patients, clinical symptoms and signs (e.g., perilimbal conjunctival pigmentation, tarsal papillae) were scored, and their correlation with inflam- matory markers was analyzed. Results: A total of 24 VKC patients, 28 SAC patients, and 28 healthy controls were included (mean age: 10.35 ± 3.22 years). Significant differences were observed for hemoglobin (p = 0.009) and eosinophil counts (p = 0.001), with higher eosinophil levels in SAC and VKC compared to controls (adjusted p = 0.002 and p = 0.008, respectively). SIRI (p = 0.044) and PIV (p = 0.018) also differed significantly across groups, with higher values in VKC patients compared to controls. However, no correlation was found between clinical symptom or sign scores and any of the inflammatory markers (p >0.05). There were no significant differences in NLR, PLR, SII, and HALP values among the three groups (p > 0.05 for all). Conclusion: SIRI and PIV may serve as potential biomarkers for differenti- ating VKC from healthy controls, yet their lack of correlation with clinical scores suggests that systemic inflammation alone does not fully account for disease severity in VKC. Increase of the membrane-associated mucins by interferon-γ in immortalized human corneal and conjunctival epithelial cells Y. Ban1,2, Y. Aziza1, S. Kinoshita3, C. Sotozono1 1Kyoto Prefectural University of Medicine, Ophthalmology, Kyoto, Japan, 2Kyoto Chubu Medical Center, Ophthalmology, Nantan, Japan, 3Kyoto Prefectural University of Medicine, Frontier Medical Science and Technology for Ophthalmology, Kyoto, Japan Purpose: The stratified epithelium of the cornea and conjunctiva produces heavily O-glycosylated transmembrane mucins MUC1, MUC4, and MUC16. Those mucins provide a protective barrier that prevents pathogen adherence and internalizations, which named Glycocalyx Barrier. Interferon-gamma (IFN-γ), the sole member of the type II IFN family, plays an important role in both innate and adaptive immunity. In this study, we investigated changes in the expression of membranous mu- cins in cultured immortalized human corneal epithelial cells (HCLE) and con- junctival epithelial cells (HCjE) by IFN-γ. Methods: HCLE and HCjE were cultured on 12-mm Transwell® Inserts (Corning®) at a density of 4x104 cells/cm2. The cultured cells were then stimu- lated with 100ng/ml IFN-γ. Transepithelial electrical resistance (TEER) was measured before stimulation and at 24-hours post stimulation using EndOhm electrodes (World Precision Instruments). The expression of membrane-asso- ciate mucin mRNA was then evaluated via real-time polymerase chain reac- tion (PCR). Results: At 24-hours post stimulation with 100ng/ml IFN-γ, a significant TEER increase was observed in the HCLE (P<0.01) and in the HCjE (P<0.05) compared with that in the control cells. This means that the barrier function of tight junctions has increased. Increased expression of MUC1, MUC4, and- MUC16 mRNA was also observed. Conclusions: The surface layer of the keratoconjunctival epithelium is cov- ered with glycocalyx, which is composed of membranous mucin. Together with the tight junctions between epithelial cells, it has a barrier function against various external stimuli. The findings in this study revealed that IFN-γ enhances not only the barrier function of tight junctions but also the glycocalyx barrier by increasing the expression of membrane-associated mucins. EP-OCS-12 Evaluation of the efficacy of 20% autologous serum eye drops in the treatment of severe dry eye syndrome: a randomized clinical trial in elderly patients H. Hasani1 1Alborz University of Medical Sciences, Ophthalmology, Karaj, Iran, Islamic Republic of Purpose: This randomized clinical trial aimed to evaluate the efficacy and safety of 20% AS eye drops in elderly patients aged 60 years and older diag- nosed with severe dry eye syndrome (DES). Methods: A double-blind, randomized, placebo-controlled trial was con- ducted with 120 elderly participants (mean age: 68.4 ± 5.9 years; 58% fe- male) diagnosed with severe DES based on the Ocular Surface Disease Index 142 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS (OSDI), Schirmer’s test, and tear film breakup time (TBUT). Participants were randomized in a 1:1 ratio to receive either 20% AS eye drops or artificial tears (placebo) for 12 weeks. The primary outcomes were improvements in OSDI scores, TBUT, and corneal staining scores. Secondary outcomes included patient-reported symptom relief and safety pro- files. Statistical analyses were performed using SPSS version 27, employing paired t-tests, chi-square tests, and repeated-measures ANOVA, with signifi- cance set at P < 0.05. Results: At the 12-week follow-up, the AS group exhibited significant im- provements in mean OSDI scores compared to the placebo group (-24.5 ± 6.3 vs. -9.8 ± 4.7; P < 0.001). The mean TBUT increased by 5.8 ± 1.2 seconds in the AS group, compared to 1.6 ± 0.9 seconds in the placebo group (P < 0.001). Corneal staining scores were significantly reduced in the AS group (mean re- duction: 2.3 ± 0.6 vs. 0.7 ± 0.3; P < 0.001). Patient-reported symptom relief was noted in 78% of AS group participants compared to 42% in the placebo group (P < 0.001). Adverse events were minimal and showed no significant differences between the two groups (P = 0.76). Conclusions: The use of 20% autologous serum eye drops resulted in signifi- cant clinical and patient-reported improvements in elderly patients with severe dry eye syndrome, demonstrating superior efficacy compared to artificial tears. These findings highlight the potential of AS eye drops as a biologically active, well-tolerated therapeutic option for managing this challenging condition. EP-OCS-13 Predictors of tear film and ocular surface disruptions after cataract surgery: an exploratory study Conclusion: This study predicted the relative risks of baseline factors of DM and increasing age contributing to ocular surface damage after uneventful cataract surgery. Diabetics over 60yrs require long-term surface protectors. There is a need for an emphasis on the rational use of ocular surface protectors before and after cataract surgery. EP-OCS-15 Recurrent chalazions and blepharitis in children: consider ocular rosacea S. Bouderka1, A. Rami2, S. Rhalib2, Z. Laftimi1, G. Daghouj1, L. El Maaloum1, B. Allali1, A. El Kettani1 120 aout 1953 Hospital, Ophtalmology, Casablanca, Morocco, 220 aout 1953 Hospital, Casablanca, Morocco Introduction: Ocular rosacea is a rare chronic inflammatory condition in chil- dren but is well-known in adults. It may present as chronic blepharitis, dry eye syndrome, or corneal complications. Patients and Methods: This case involves a 14-year-old girl who presented to the emergency department with redness in the right eye accompanied by burning and photophobia. She had a history of recurrent chronic blepharitis for six months and had been treated for recurrent chalazions. The initial ophthalmological examination revealed: • Visual acuity of 3/10, • Conjunctival hyperemia, • Mixed blepharitis with telangiectasias of the lid margin, • A 1×1 mm inferior catarrhal infiltrate staining with fluorescein, • Brush-like neovascular pannus. L.R. Daniel Ponniah1 1Dr. Agarwal’s Eye Hospital & Research Institute, Department of Cornea & Ocular Surface Diseases, Tirunelveli, India The initiated treatment included azithromycin, topical corticosteroids, pre- servative-free artificial tears, and rigorous eyelid hygiene. A dermatological consultation was sought, even though the patient showed no suggestive skin symptoms. Purpose: To study the various baseline factors contributing to ocular surface damage after uneventful cataract surgery and to develop a plan for rational use of ocular surface protectors before and after cataract surgery. Methods: Prospective investigator-masked comparative trial. Cataracts with and without Diabetes were recruited based on age & grouped as Group 1 (No DM and age<60yrs; N=43) Group 2 (DM and age<60 yrs; N=39) Group 3 (No DM and age>60 yrs; N=51), Group 4 (DM and age>60 yrs; N=67). Preoperative meibography and functional tear film assessments using quan- titative measurements of tear meniscus studies, non-invasive break-up time Results: The treatment led to clinical improvement, with the resolution of the catarrhal infiltrate and restoration of visual acuity. In collaboration with dermatologists, oral metronidazole was added to better manage the underlying inflammation. Discussion: Ocular rosacea is rarely diagnosed in children due to nonspecific symptoms. A thorough clinical examination and multidisciplinary management are es- sential for accurate diagnosis. This case highlights the need to consider ocular rosacea in children presenting (NIBUT), blink rate were analyzed & compared with 21 days and 3 months with blepharitis and recurrent chalazions, as well as the importance of col- post-surgery. laboration between ophthalmologists and dermatologists for optimal follow- up and prevention of recurrences. Conclusion: Ocular rosacea in children remains an often-overlooked diagno- sis, with potentially severe visual consequences. Further studies are needed to better understand the mechanisms and optimal treatments for pediatric ocular rosacea. The Ocular Protection Index (OPI) was calculated as a function of ocular sur- face health by dividing tear break-up time by interblink interval. OPI <1 was considered susceptible to surface damage. Results: Mean OPI was 1.3758 (0.61) at baseline, 0.9738 (0.97) at 21 days, and 1.1038 (0.62) at 3 months. Repeated measure ANOVA showed a signifi- cant time effect(p<0.001). The mean blink interval was 7.91 at baseline, 8.82 at 21 days & 9.39 at 3 months (p<0.0001). Age-adjusted DM influence on meibomian gland loss was 12.1% compared to non-DM 6.64%. The logistic regression model to ascertain the effects of DM and age on OPI was signifi- cant, chi square=11.588, P=0.003. It explained 23.6% (Nagelkerke Rsquare) of the variance in treatment re- sponse and correctly classified 78.5% of cases. Elderly subjects, diabetics were 6.29 & 1.79 times more likely to sustain surface damages than their counterparts respectively. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 143

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ELECTRONIC POSTER PRESENTATIONS EP-OCS-16 Persisting challenges: the complex trajectory of dry eye disease M. Dias1, B. Pombo1, T. Costa1, C. Monteiro1, D. Silveira e Silva1, C. Vendrell1, M.J. Santos1, I. Prieto1 1Unidade Local de Saúde Amadora Sintra, Lisboa, Portugal A a 69-year-old woman with severe dry eye disease was being treated with topical cyclosporine 3id and lubricants. She came to our hospital for a first appointment complaining of pain and burning eyes. At the time she presented with BCVA OU 2/10, inferior keratitis and inferior multiple corneal opacities. OD´s cornea also showed inferior thinning and neovascularization. She had bilateral cataracts. Fundoscopy was normal. We started complementary treatment with autologous serum eye drops 3id. After 2 months, she kept the same symptoms and reported a decrease in BCVA (1/10OU). At that time, there was some improvement in keratitis but still with discrete punctate staining bilaterally. The cataracts were denser and had a pos- terior subcapsular component. After 5 months treatment, she had no active keratitis and underwent cataract surgery of OU. BCVA improved to 8/10 OD and 3/10 OS, but with a high resulting astigmatism (-3.00x180ºOD; -4.00x5ºOE). She remained relatively stable for 1 year. After that, she started to complain again of burning sensation in both eyes. BCVA was 5/10OD and 4/10OS. She had diffused punctate kera- titis bilaterally, with slightly inferior IOL subluxation on the OD and posterior capsular opacification. Topical treatment was intensified with hydrocortisone 1id and more frequent lubricant, until the eye was calmer. Posterior YAG capsulotomy was per- formed with improvement of BCVA (6/10 OD). After 3 months, she presented with bilateral hyperemic conjunctiva, discrete punctate staining inferiorly with an irregular corneal surface, and neovascularization. Autologous serum was switched to topical insulin drops 4id. After 1 month, she reported a huge symptomatic improvement, with almost no complaints of dry eye. She had no active keratitis although keeping her cicatricial corneal trophic changes. 15 months later, she maintains her inferior corneal maculas and pannus, but with no associated complaints of burning sensation or pain, being clinically stable. EP-OCS-17 A case series on ocular features of anti-diabetic medication induced Bullous Pemphigoid M. Doctor1, A. Kate2, S. Basu3 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Vijaywada, India, 3L V Prasad Eye Institute, Hyderabad, India Purpose: To highlight the clinical features, ocular involvement and course of the disease in patients with gliptin induced Bullous Pemphigoid (BP) Methods: A case series of four patients who were using Gliptin medications for treatment of diabetes mellitus, and presented with ocular and systemic manifestations similar to that of classic Bullous Pemphigoid. The diagnosis of BP was confirmed with conjunctival biopsy. Results: Patients presented with tense, pruritic blisters similar to BP, with bi- lateral ocular involvement such as punctal stenosis and loss of medial canthal folds. Two patients had bulbar conjunctival cicatricial changes with inferior forniceal shortening and symblepharon. The suspected drug was discontinued and patients were treated with topical lubricants and short course of topical steroids. An association between the clinical features of BP and use of gliptins was present, and there was resolution of these features on discontinuing the medications. Conclusion: This case series shows the ocular adverse effects of the DPP-4i group of anti-diabetic medications which an ophthalmologist should be aware about. Financial interest: No EP-OCS-18 HSV infection in patients with ocular surface disease M. Doctor1, S. Basu2, A. Kate3 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Hyderabad, India, 3L V Prasad Eye Institute, Vijaywada, India To report 3 cases of ocular surface disease who had varied presentation of herpes simplex virus (HSV) keratitis Case 1: A 74-year-old lady, with underlying HIV infection, on anti-retroviral treatment, presented with complaints of redness, pain and decreased vision in the left eye (LE). Clinical examination showed a sterile corneal ulcer like picture in the LE with forniceal shortening in both eyes. Initially we suspect- ed worsening of the ocular surface disease, but corneal scrapings revealed HSV positivity. Direct immunofluorescence of conjunctival biopsy revealed immune-reactants suggestive of oMMP. Hence, the patient was started on oral acyclovir 400mg five times per day, along with a tapering course of topical steroids and oral azathioprine 50mg/day Case 2: A 32-year-old male, was diagnoses as SJS since 25 years. He was maintained on topical lubricant therapy along with on-off use of topical ster- oids whenever he had aggravation of surface inflammation. He currently presented to us with decrease of vision in both eyes, along with persistent epithelial defect and stromal necrolysis in LE. Corneal scraping showed PCR positivity for HSV-1. His condition stabilized in one month of starting oral antiviral therapy. Case 3: A 50-year-old male, with stable oMMP, presented with increased con- gestion and punctate epithelial lesions in the left eye. Inititialy suspected as disease worsening, topical and systemic immunosuppresion was augmented, but he developed corneal perforation within few days, and later into a corneal infiltrate. It showed significant response after starting oral acyclovir within 6 weeks. Conclusion: Considering HSV keratitis as a differential is particularly impor- tant in patients with established ocular surface pathologies. Its presentation can mimic exacerbation of disorder and management strategies are contrast- ing. Suspicion will enable obtaining the necessary samples for microbiologi- cal confirmation and therapy. 144 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-OCS-19 Retention cyst mimicking lacrimal gland cyst in patient of mycoplasma induced rash and mucositis (MIRM) M. Doctor1, S. Basu2 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Hyderabad, India Purpose: To report the development of large palpebral cyst mimicking lac- rimal gland cystic swelling, in patient of mycoplasma induced rash and mu- cositis (MIRM) Case: A 25 year old male presented with foreign body sensation and severe photophobia in both eyes since the past 1 month after episode of sore throat, fever and recurrent multiple oral ulcers. On examination, he had a large cystic swelling was noted in the upper temporal quadrant in the right eye which ap- peared to be arising from the lacrimal gland. Slit lamp examination showed extremely dry ocular surface, forniceal shortening, early nasal symblepharon, diffuse corneal punctate keratitis, and atrophic meibomian gland with lower lid keratinisation. Left eye showed central corneal thinning. Given the history, a suspicion of MIRM induced cicatrising conjunctivitis was made, and he was subjected to Serum IgG and IgM for mycoplasma, which came positive. MRI orbit confirmed the presence of palpebral cyst. Glue+BCL was performed in the left eye and the patient was planned for cyst biopsy. He was started on oral azithromycin 500mg for two weeks. However, when he came to use for the biopsy, the lesion had completely resolved, with fibrosis noted in the lacrimal gland region. After two weeks of systemic antibiotic cover, the patient was started on topical Methods: In this multicentre, investigator-masked, noninferiority study, pa- tients were randomised to SHCB-TG or C-SH, administered 3–6 times daily for 3 months. The primary endpoint was change from Baseline in the ocular surface fluorescein staining (OSFS) score (0–15 per the Oxford scheme) at Day 28 in the per-protocol population. Secondary endpoints included OSFS at 3 months, tear film break-up time, dry eye symptoms, quality-of-life question- naire and frequency of AT instillation. Results: On Day 28, OSFS score decreased from a Baseline of 5.7±1.2 to 3.6±1.6 in the SH-CB-TG group (n=45), while in the C-SH group (n=34), it decreased from 5.8±1.3 to 4.3±2.1 (95% confidence interval of the adjusted difference was below the predetermined value for noninferiority). In both groups, signs, symptoms and quality-of-life measures improved continuously through the study, with a favourable safety profile. In the SH-CB-TG group, the global score of dry eye symptoms showed a statistically significant im- provement compared with the C-SH group (p<0.05). Conclusions: The multicomponent, lipid-containing SH-CB-TG was nonin- ferior in terms of ocular staining to the aqueous-based tear substitute in the studied population and may offer additional advantage in ameliorating symp- toms of dry eye. EP-OCS-21 Atypical cases of vernal keratoconjunctivitis A. Grigoryan1, A. Hovakimyan1 1Yerevan State Medical University, Yerevan, Armenia steroids following which he was better symptomatically. Scleral contact lens Purpose: To analyze and highlight the clinical and therapeutic aspects of were prescribed to him at 2 months, which helped his vision to improve to atypical cases of Vernal Keratoconjunctivitis (VKC), focusing on unique pres- 20/20p and also provided symptomatic improvement. Conclusion: Retention cyst are common in conditions of cicatrizing con- junctivitis along. Fibrosis of the lacrimal gland region occurs in patients with MIRM. However, our patient had a large cyst, mimicking lacrimal gland swelling, which resolved without any surgical intervention. Severe fibrosis in the lacrimal gland region was noted thereafter. Hence, suspicion and initiating entations that challenge standard diagnostic and treatment approaches. Method: This study retrospectively reviewed four atypical VKC cases, as- sessing clinical presentations, symptoms, and treatment responses. Cases were evaluated for uncommon features such as unilateral involvement, late onset, and atypical shield ulcer location. Treatments included combinations of topi- cal steroids, antihistamines, mast cell stabilizers, and, in severe cases, thera- the appropriate therapy is crucial for such patients of ocular surface disease. peutic contact lenses and systemic medications. Results: The cases revealed a spectrum of atypical VKC manifestations: uni- lateral palpebral VKC, unilateral limbal VKC, late-onset VKC in young adults, and a shield ulcer in a rare inferior location. Symptoms included photophobia, itching, conjunctival hyperemia, and mucous discharge. Individualized treat- ment plans led to significant symptom resolution and clinical improvement, emphasizing the importance of adapting therapies to each patient’s unique needs. Conclusion: In regions where VKC is prevalent, it is important to recognize that the disease can have atypical presentations. Early detection of these vari- ations is crucial for effective diagnosis and treatment. EP-OCS-20 A multicentre clinical study of two preservative-free artificial tears with sodium hyaluronate for the treatment of dry eye M. Labetoulle1,2, on behalf of the RESTA Study Investigators 1Hôpital Bicêtre - APHP, Université Paris Saclay, Le Kremlin-Bicêtre, France, 2Centre National de la Vision des Quinze-Vingts, Paris, France Purpose: Evaporation and renewal of the tear film can be altered by multiple factors and restoring a functional tear film in dry eye disease can be a complex challenge. Traditionally, dry eye relief has been provided by water-based arti- ficial tears (ATs), but ATs with lipid components have emerged more recently to provide lubrication while decreasing tear evaporation. This study compared the performance and safety of two preservative-free ATs with sodium hyalu- ronate (SH) in patients with moderate-to-severe dry eye disease: a multicom- ponent 0.24% SH eye drop with carbomer and triglycerides as lipids (SH-CB- TG), and an aqueous-based comparator (C-SH) with 0.18% SH. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 145

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ELECTRONIC POSTER PRESENTATIONS EP-OCS-23 EP-OCS-24 The efficacy and safety of varenicline nasal spray for the management of dry eye signs: a systematic review and meta-analysis B. Bashrahil1, N. Taher1, Z. Alzahrani1, A. Alnabihi1, A. Aldahlawi1, M. Alkhathlan1, S. Alghamdi2 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, 2Department of Ophthalmology, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia Purpose: Dry eye disease (DED) is caused by a persistently unstable tear film leading to ocular discomfort and is treated mainly with tear supplementation. There is emerging evidence that nicotinic acetylcholine receptor (nAChR) ag- onists (e.g., varenicline and simpinicline) nasal sprays are effective for DED. Our systematic review and meta-analysis assessed the efficacy and safety of varenicline nasal spray (VNS) for DED treatment. Methods: The Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched. Only randomized controlled tri- als (RCTs) that evaluated the efficacy of VNS versus placebo were included. The efficacy endpoint was the mean change in the anesthetized Schirmer test score (STS), a measure of basal tear production, from baseline. The safety endpoints were serious adverse events (SAEs) and adverse events (AEs). The standardized mean difference (SMD) was used for continuous outcomes, while the risk ratio (RR) was used to demonstrate dichotomous variables. The certainty of the evidence was rated utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The risk of bias assessment was conducted using the Revised Cochrane risk of bias tool for randomized trials. Results: Three RCTs (n=1063) met the eligibility criteria. All RCTs had a low risk of bias. The meta-analysis found a statistically significant increase in the mean STS change from baseline on day 28. The pooled analysis found no significant difference between VNS and placebo in the frequency of SAEs and ocular AEs. However, VNS had a significant effect on developing nasal cavity-related AEs. Conclusion: VNS caused a highly significant improvement regarding the effi- cacy endpoint but caused an increased frequency of some nasal cavity-related AEs (i.e., cough and throat irritation). However, it caused neither SAEs nor ocular AEs. Included studies had a low risk of bias. Lid scrub and thermal pulsation treatment to improve tears film quality and biometry accuracy to adopt presbyopic IOLs routinely B. Kusa1, M. Piovella1 1Global Center for Ophthalmology, Refractive Cataract Surgery, Monza, Italy Purpose: To evaluate three systems Blephex for Lid Scrub and LipiFlow (J&J - Santa Ana Ca) iLux (Alcon – Fort Worth Texas) for the thermal pulsation treatment of Meibomian Gland Dysfunction (MGD) to improve quality of the surface of the cornea to get better IOLs power biometry calculations. Methods: Since 2017, 378 patients (mean age 66.58 ±11.55 years) were treat- ed for MGD. Patients received a LipiFlow treatment to remove obstructions and restore meibomian gland function. 123 of these patients received also Blephex treatment immediately before since September 2019. Results: Postop quality of vision improved in all patients, and regular cornea surface provided more precise and stable biometry results. The adoption of lipiflow and blephex treatments provided 97% of eyes inside the planned re- fractive postoperative outcome. Conclusion: These treatments have a priority role in adopting implants to cor- rect refractive defects and treat presbyopia in cataract patients EP-OCS-25 Managing ocular surface tumors: the role of comprehensive eye care A.-I. Alexa1, A. Picioroaga1, C.A. Sandu1, C.M. Bogdanici1 1“Sf. Spiridon” Emergency Hospital, Ophthalmology, Iasi, Romania Purpose: The study aimed to assess the prevalence, types, and pathological findings of ocular surface tumors, as well as to identify any patterns in surgi- cal intervention Methods: A 4-year retrospective study was conducted that included 104 pa- tients from which 120 tumors were surgically removed. Choosing the surgical technique was dictated by the necessity to adapt to clinical context. In some cases, when dealing with large tumors a pre-operative topical treatment was prescribed with 5-FU 1% for 3 weeks. All tumors underwent an anatomo- pathological examination to establish the diagnosis, distinguishing between malignant tumors and benign conditions. Results: Out of the 120 ocular surface tumors, 28.3% were diagnosed as ma- lignant, while the remaining 71.7% were identified as pterygia. The year 2023 highlighted a significant increase in surgical procedures, likely due to the fact that during the pandemic, access to healthcare services was limited, and many patients delayed medical consultations. As restrictions eased and healthcare access improved, there was a noticeable return of patients seeking treatment for ocular surface tumors. In terms of demographic distribution, the prevalence of ocular surface tumors was higher in men compared to women, with the right eye being more frequently affected than the left Conclusions: This study highlights the significant proportion of malignant lesions among ocular surface tumors, emphasizing the importance of early diagnosis and appropriate management. The predominance of pterygia in the cohort suggests a need for continuous surveillance and surgical intervention. The increase in surgical procedures in 2023 may reflect both the delayed medi- 146 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS cal care due to pandemic restrictions and an increased awareness of ocular surface tumors as healthcare access resumed. Further studies could explore the long-term effects of the pandemic on healthcare-seeking behaviors and ocular health. EP-OCS-26 Ocular surface disease in diabetic patients I. Janicijevic Grubisic1, M. Plavsic2, N. Todorovic1, M. Stamenkovic1 1University Eye Hospital Zvezdara, Eye Clinic, Belgrade, Serbia, 2General Hospital Pancevo, Department Of Ophthalmology, Serbia, Department Of Ophthalmology, Pancevo, Serbia Purpose: The aim of this study was to assess the prevalence of ocular surface disease(OSD) in patients with type II Diabetes Mellitus (DM) and the control group (non-diabetic patients).Posterior segment ocular complications of DM are relatively well know but OSD is often missed to be reported. Methods: Cross sectional study, Oct.-Dec 2024.Patients were divided in two groups, diabetic (40eyes) and non-diabetic (30eyes). Diabetic was subdivided depending on the presence of diabetic retinopathy. Patients underwent routine ophthalmologic examination, SPEED (Standard Patient Evaluation of Eye Dryness) testing, AS OCT (OptoVue) was performed, tear meniscus height (TMH), tear meniscus area (TMA) values were obtained and tear break time test (TBUT) was done. Mann–Whitney test was used to compare the results of two groups. EP-OCS-27 Reproducibility and accuracy of corneal curvature measurements in patients with and without dry eye X. Zhang1, H. Rao1 1Shengli Clinical Medical College of Fujian Medical University; Department of Ophthalmology, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China Purpose: To evaluate the reproducibility and accuracy of corneal curvature measurements using five different devices in patients with and without dry eye disease (DED), and to identify the most reliable device for clinical use in dry eye patients. Methods: This study included 68 eyes from DED patients (DED group) and 48 eyes from non-DED patients (non-DED group). Corneal curvature was measured with five devices: Corneal topography, ARK-1a, IOL master 700, OPD-Scan III, Pentacam. A total of 580 examination reports were collected. Reproducibility was as- sessed using intraclass correlation coefficients (ICCs), and accuracy was evaluated using Bland-Altman analyses. Differences between devices were examined through paired-sample t-tests or Wilcoxon signed-rank tests. Results: In both groups, the ICCs for ARK-1a, IOL Master 700, OPD-Scan III, and Pentacam were all >0.9, indicating high reproducibility. Compared to the DED group, the non-DED group generally had narrower confidence intervals. Bland-Altman analyses showed that the 95% limits of agreement (LOA) were wider in the DED group, indicating greater variabil- ity. Results: Mean patient age was 64±13 in diabetic and 66±13years in non-di- However, the LOA of IOL Master 700 and OPD-Scan III remained below 1.0 abetic group. Average TBUT was 8.32±2.28s in diabetic and 10.24±3.45s in other group. Mean TMH and TMA values were 179.63 ± 53.20µm and 0.025± 0.013mm2 compared to 234.24 ± 84.02µm and 0.039± 0.029mm2 in non-dia- betic group. SPEED test results were 5.34±2.53 in diabetic and 3.45±2.44 in other group. Average HbA1c in diabetic group was 7.26±1.25%,mean disease duration was 12.45±7.85 years,20% had signs of diabetic retinopathy. There was decrease in all mean tear variables and only statistically signifi- cant correlation between TBUT and TMA (p <0.005, r=0.45 Spearman test) in diabetic patients subgroups. Between diabetic and non-diabetic groups there was statistically significant difference in TMH(p=0.01),TMA (p=0.02), TBUT(p=0.01), SPEED (p=0.002). Conclusions: In our study DED was more severe in diabetic group. This leads in the DED group, suggesting higher reliability and potential clinical advan- tages. Conclusions: Dry eye significantly affects the reliability of corneal curvature measurements, especially with optical reflection-based devices. Corneal to- pography and Pentacam are more sensitive to tear film abnormalities, while the IOL Master 700 and OPD-Scan III show more consistent results, making them preferable for clinical practice. EP-OCS-28 us to a conclusion that there might be an association between these two diseas- es and that more detail exam of OSD and tear function should be considered as Microbiota and ocular health decoding the gut-eye axis a part of a routine ophthalmology examination in diabetic patients. F.S.A. Khan1, B.B. Gey2, Z.B. Gey2 1Medical University Pleven, Pleven, Bulgaria, 2Augenarztpraxis Dr. med. Bredehorn-Mayr, Ophthalmology, Aschersleben, Germany Purpose: This review explores the gut-eye axis, highlighting the relationship between gut and ocular microbiota in conditions like dry eye disease (DED), diabetic retinopathy, and immune-mediated disorders. It investigates micro- biota mechanisms and emerging therapeutic interventions. Methods: Human and animal studies addressing microbiota pathways, im- mune responses, and therapies like fecal microbiota transplantation (FMT) and probiotics were reviewed. The impact of short-chain fatty acids (SCFAs), dysbiosis, and nutritional deficiencies on the gut and ocular microbiomes was analyzed. Results: Research links gut dysbiosis to systemic inflammation and ocular conditions, including DED, Sjögren’s syndrome, macular degeneration, and uveitis. Findings include: Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 147

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ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Oculoplastics EP-OPL-01 Periocular reconstruction in facial nerve paralysis: four procedures in one step Á. Bengoa-González1, B.-M. Laslau1, M.-D. Lago-Llinás1, R.-M. Lopez- Ladron1, A.-N. Macero-Delgado1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Purpose: We present our surgical treatment in a series of cases of chronic facial nerve paralysis (FNP) by performing four surgical techniques in a single surgery. In addition, we describe a modification of standard midface lift and direct brow lift techniques using titanium miniplates. Methods: This is an interventional retrospective review of 8 cases, with age range from 58 to 87 years (mean 70, SD 9,3) with chronic (>1 year) unrecov- ered FNP, operated by the same surgeon (AB-G). Indications for surgery were brow ptosis, lagophthalmos, exposure keratopathy, midface ptosis, lower lid retraction, and paralytic ectropion. Patients underwent 4 surgical procedures at once, in the following order: a subperiosteal midface lift (in which the SOOF was anchored with permanent 3/0 polypropylene by a titanium miniplate placed at the orbital rim), a standard lateral tarsal strip to address tissue laxity, a pretarsal upper eyelid gold weight implant placement and a direct brow lift (consisted of a skin excision along the superior margin of the brow and suture of the deep dermal tissue of the inferior wound edge with 3/0 polypropylene to a titanium miniplate fixed to the frontal bone). General anaesthesia was used in 5 patients and local anaesthesia with sedation in 3 patients. Follow-up ranged from 12 to 36 months (mean 21). Functional, and cosmetic outcomes and complications were evaluated. Results: Lagophthalmos, lower eyelid position, ocular surface symptoms, and facial symmetry at rest improved in all patients. No recurrent lower eyelid retraction, lagophthalmos regression, or implant extrusion were observed dur- ing the follow-up. Conclusions: Combining 4 procedures into one operation requires good preoperative planning but accelerates patients’ functional recovery and may minimize the number of interventions needed to be performed. Titanium mini- plates can offer adequate and durable vertical elevation and support without relying on the strength of the periosteum. ELECTRONIC POSTER PRESENTATIONS • SCFAs, especially butyrate, reduce inflammation via SLC5A8 transport- ers, stabilizing the ocular surface. • FMT in mice with Sjögren’s syndrome altered microbiota and immune responses, triggering ocular inflammation. • Human FMT studies improved immune-mediated DED symptoms in some patients, with microbiota composition correlating to severity. • Nutritional deficiencies, such as in vitamins B1, B12, A, omega-3 fatty acids, selenium, and calcium, impacted microbial balance, exacerbating DED symptoms. Emerging evidence highlights the role of commensal bacteria, including ocu- lar surface microbiota, in the gut-eye axis. Therapies such as probiotics, die- tary interventions, and microbiota modulation show promise in treating ocular inflammation and infection. Conclusions: The gut-eye axis reveals critical links between microbiota and ocular disease mechanisms. Dysbiosis contributes to inflammation and ocu- lar conditions, while microbiota-targeted therapies offer innovative solutions. Further research is essential to refine these treatments. EP-OCS-29 The effect of posttransplant cyclophosphamide on ocular graft-versus-host disease L. Menghesha1, V. Tahmaz2, U. Holtick3, C. Scheid3, M.E. Stern1, P. Steven1 1Competence Center for Ocular GVHD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine and Department of Ophthalmology, Cologne, Germany, 2St. Elisabeth Hospital Hohenlind, Department of Ophthalmology, Cologne, Germany, 3Center of Integrated Oncology Köln Bonn, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Cologne, Germany Purpose: Chronic ocular graft-versus-host disease (oGVHD) affects up to 60% of patients following allogeneic hematopoietic cell transplantation (aHCT). Despite its predictable occurrence, no effective preventive strategies have been established. Posttransplant cyclophosphamide (PT-Cy) has shown efficacy in preventing non-ocular GVHD, but its potential to prevent oGVHD has not been evaluated. This study aimed to examine the effect and character- istics of oGVHD in patients receiving PT-Cy as GVHD prophylaxis. Methods: We conducted a retrospective analysis of 63 consecutive patients who underwent aHCT at a single center between May 2011 and January 2023, receiving PT-Cy. Baseline non-ocular characteristics, including primary di- agnosis, donor relationship, GVHD prophylaxis, and systemic GVHD, were evaluated alongside data from ophthalmic examinations. Results: Of the patients receiving PT-Cy, 37 (mean age 48.4 years ± 15.14) underwent post-transplant ophthalmological examinations. The incidence and severity of chronic oGVHD among these patients (40.54%) was similar to a cohort of 1-year survivors in the same transplantation center (n=233, 48%). Patients transplanted during adverse environmental conditions (October– February) exhibited a higher oGVHD rate (47.6%) compared to those trans- planted in non-desiccating conditions (March–September 31.2%). Conclusion: In conclusion, PT-Cy shows limited impact on the development of chronic oGVHD, supporting the hypothesis that the pathogenesis of oG- VHD is at least partially independent of systemic GVHD. Additionally, envi- ronmental risk factors may outweigh the effects of systemic anti-inflammatory therapies and should be considered when designing and evaluating new pro- phylactic strategies. 148 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-OPL-02 Monocanalicular versus bicanalicular intubation in external dacryocystorhinostomy S. Perez-Trigo1, A. Bengoa-Gonzalez1, R.M. Lopez-Ladron1, M.D. Lago-Llinas1, B.M Laslau1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Purpose: The aim of this study was to compare the efficacy and tolerance of monocanalicular versus bicanalicular intubation in external dacryocystorhi- nostomy (DCR). Methods: A 6-year prospective cohort study was conducted involving 327 patients diagnosed with acquired nasolacrimal duct obstruction and, at least, one risk factor associated with DCR failure (previous acute dacryocystitis, reintervention, small or inflamed sac, small mucosal flap, and/or distal mem- branectomy due to fibrosis at the common canalicular opening). A monocana- licular silicone stent was placed in the inferior canaliculus or a bicanalicular silicone stent was placed randomly. Functional success was defined as complete or significant improvement in epiphora, along with the absence of mucopurulent epiphora or acute dacryo- cystitis flares. Anatomical success was determined by lacrimal duct syringing and assessment of the lacrimal meniscus. Results: No statistically significant differences were found in either functional or anatomical success between the two groups. However, the sensation of rub- bing in the eye or nasal fossae was lower in the monocanalicular intubation group (8.1%) compared to the bicanalicular intubation group (25.0%), and this difference was statistically significant (p ≤ 0.000). Tearing during the time the stent was in place was also lower in the mono- canalicular intubation group, reported in 6.9% of patients, compared to 15.0% of patients with bicanalicular intubation, and this difference was statistically significant (p ≤ 0.020). Conclusions: Monocanalicular intubation in external DCR is as safe and ef- fective as bicanalicular intubation. This type of intubation offers advantages over bicanalicular intubation, such as easier placement and removal, shorter surgical time, fewer patient discomfort, and the use of only one canaliculus; probing; 8 of these required a second attempt. Probing was unsuccessful in 6 cases, necessitating subsequent lacrimal intubation. Additionally, 12 children were directly indicated for lacrimal intubation due to clinical considerations. Conservative management was utilized for 72 children, with observation for spontaneous resolution. Results: In-office probing achieved symptom resolution in 76 of 84 cases (90.5%), with success following a second attempt in 8 cases. Probing failed in 6 cases (7.1%), all of which resolved with subsequent lacrimal intubation. All 12 children directly treated with lacrimal intubation demonstrated successful outcomes. Among the 72 children managed conservatively, all exhibited spon- taneous improvement without the need for surgical intervention. Conclusions: This study highlights the efficacy of conservative management as a first-line approach for younger children with CNLDO, given the high rate of spontaneous resolution. Probing offers a minimally invasive and highly successful option for cases requiring intervention, while lacrimal intubation is an effective treatment for refractory cases. These results emphasize the im- portance of individualized management based on patient-specific factors and clinical presentation. EP-OPL-04 Genetic risk factors of endocrine ophthalmopathy and their clinical associations L. Sereikaite1, G. Gedvilaitė-Vaicechauskienė2, J. Jankauskienė1, R. Liutkevičienė2,1 1Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Ophthalmology Department, Kaunas, Lithuania, 2Institute of Neuroscience, Medical Academy, Lithuanian University of Health Sciences, Laboratory of Ophthalmology, Kaunas, Lithuania Purpose: This study aims to evaluate TERC and TERT gene polymorphisms and their relationship to risk factors, laboratory findings, and imaging in endo- crine ophthalmopathy (EO) patients. allowing drainage through the unoccupied upper canaliculus and avoiding its Methods: This cross-sectional study involved EO patients and healthy volun- trauma. EP-OPL-03 Outcomes of management approaches in congenital nasolacrimal duct obstruction in young children A. Kopecky1,2, J. Nemcansky1,2 1University Hospital Ostrava, Ophthalmology, Olomouc, Czech Republic, 2University Ostrava, Department of Craniofacial Surgery, Ostrava, Czech Republic Purpose: To evaluate the outcomes of various management strategies for con- genital nasolacrimal duct obstruction (CNLDO) in children under 3 years of age. Methods: A retrospective analysis was conducted from 2020 to 2023 on 174 children diagnosed with CNLDO, ranging in age from 27 to 963 days. The fluorescein dye disappearance test and parent-reported symptoms were the primary diagnostic tools. Management strategies included conservative treat- ment, in-office probing, and lacrimal intubation. Probing was performed in- office for 84 children, with an average age of 199 days at the time of first teers who were patients of the Eye Disease Clinic of the Lithuanian University of Health Sciences. A complete ophthalmological examination was performed on all participants. The results of imaging and laboratory tests were taken from the medical records. DNA was extracted from peripheral blood leukocytes, and real-time polymerase chain reaction (RT-PCR) was used to analyze the TERC rs35073794 and rs12696304, and TERT rs2736098 gene polymor- phisms. Data analysis was performed using IBM SPSS Statistics 27 software. Results: According to the RT-PCR results, the TERC rs35073794 GG geno- type polymorphism is significantly associated with EO (p=0.001). In addition, the TERC rs12696304 polymorphism CC genotype correlates with extraocu- lar muscle changes observed in imaging studies (p=0.017). In contrast, the TERT rs2736098 polymorphism CC genotype is associated with increased anti-TSHR levels (p=0.047), and the CT genotype is associated with smoking (p=0.035). Conclusions: This study provides new evidence that the TERC rs35073794 polymorphism is related to EO, the TERC rs12696304 polymorphism cor- relates with extraocular muscle changes, and the TERT rs2736098 polymor- phism is associated with increased anti-TSHR levels and smoking. These re- sults suggest that TERC and TERT gene polymorphisms have the potential to be used as prognostic factors in clinical practice. However, larger multicenter studies still need to validate these results before they can be introduced into clinical practice. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 149

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ELECTRONIC POSTER PRESENTATIONS EP-OPL-05 Case review: canalicular laceration reconstruction with silicone self-retaining stent S. Masnec1, M. Kalauz1, M. Kalauz2, I. Bešlić1, J. Knežević1,1 1University Hospital Center Zagreb, Department of Ophthalmology, Zagreb, Croatia, 2School of Medicine, University of Zagreb, Zagreb, Croatia, Zagreb, Croatia This summary presents two cases of canalicular laceration injuries and their successful reconstruction using a monocanalicular Masterka stent (FCI Ophthalmic). The first case involves a 4-year-old boy who sustained a laceration affect- ing the left superior lacrimal canaliculus, while the second case involves a 57-year-old male with injuries to both upper and lower eyelids, including the left inferior canaliculus. In both cases, treatment included eyelid repair and canalicular reconstruction with a Masterka stent, followed by postoperative care with dexamethasone eyedrops, tobramycin ointment, and oral antibiot- ics. We reported successful healing and preservation of eyelid function in both cases. This highlights the efficacy of using Masterka stents for canalicular re- construction, demonstrating promising clinical outcomes beyond its primary indication for nasolacrimal duct obstruction. EP-OPL-06 Addressing ocular penetration caused by eyelid retraction: immediate sequential corneal transplant and eyelid reconstruction M. Puchol-Rizo1, S. Pérez-Trigo1, Á. Bengoa-González1, R. López-Ladrón García de la Borbolla1, A. Palacios-Hipola1, J. García-Andreu1, T. García-Herrera Prada2 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital Arruzafa, Córdoba, Spain Purpose: To describe the complex therapeutic approach to a case of ocular penetration caused by eyelid retraction, which led to corneal abscess and sig- nificant corneal damage. This case underscores the importance of a multidis- ciplinary strategy integrating corneal transplantation and eyelid reconstruction for optimal functional and cosmetic outcomes. Methods: A 22-year-old male with a history of traumatic eyelid retraction presented with corneal abscess and subsequent self-sealing ocular penetration. Following initial stabilization, a “hot” penetrating keratoplasty was performed targeting the abscessed corneal area. Eyelid reconstruction was achieved with fibrosis release, a retroauricular skin graft, and permanent tarsorrhaphy. Comprehensive postoperative manage- ment and regular follow-ups were conducted to monitor graft integration and eyelid function. Results: The corneal transplant successfully excised the infected tissue, and the donor graft was securely sutured to healthy host tissue. The eyelid reconstruction addressed lagophthalmos and improved eyelid dynamics. Postoperative care involved topical antibiotics and steroids, with microbio- logical analysis confirming mixed flora of cutaneous origin. Over a one-month follow-up period, the patient exhibited successful graft in- tegration, improved eyelid function, and satisfactory cosmetic results without significant complications such as rejection or excessive inflammation. Conclusions: Lagophthalmos-induced corneal exposure poses a significant risk for corneal penetration and abscess formation. This case demonstrates the efficacy of a tailored, multidisciplinary approach combining penetrating keratoplasty and eyelid surgery to address both the ocular and periocular com- plications of eyelid retraction. Patient compliance and prompt intervention are critical for successful outcomes in such complex cases. EP-OPL-08 Proptosis as first sign of nasopharyngeal carcinoma: a case report D.K. Saran1 1BRD Medical College, Ophthalmology, Gorakhpur, India Introduction: Nasopharyngeal carcinoma (NPC) is a malignant tumor origi- nating from the nasopharyngeal epithelium, often presenting with nonspecific symptoms such as nasal obstruction or cervical lymphadenopathy. Proptosis due to orbital invasion as the first manifestation is rare and can delay diag- nosis. Case Presentation: A 28-year-old male presented with painless, progres- sive proptosis of the right eye for two months, accompanied by diplopia and blurred vision. There was no history of nasal obstruction, epistaxis, or neck swelling. Ocular examination revealed axial proptosis, restricted ocular motil- ity, and reduced visual acuity in the right eye. Magnetic resonance imaging (MRI) showed a soft tissue mass originating from the nasopharynx, extending through the pterygopalatine fossa into the right orbit via the inferior orbital fissure. Nasopharyngeal endoscopic biopsy confirmed undifferentiated NPC (WHO Type III). The patient was started on concurrent chemoradiotherapy, showing clinical improvement after treat- ment. Discussion: NPC with orbital involvement presenting as proptosis is uncom- mon and often suggests advanced disease due to perineural or direct orbital extension. The absence of typical nasopharyngeal symptoms can lead to di- agnostic delays. Early imaging and histopathological confirmation are crucial for timely intervention. Conclusion: Proptosis as the initial sign of NPC is rare but should be consid- ered in cases of unexplained orbital masses. Prompt diagnosis and treatment can significantly improve patient outcomes. EP-OPL-09 When healing goes wrong: solutions D. Ortiz Martin1, E. Mata Diaz2, R. Lopez Ladron García de la Borbolla3, C. De Pablo Martin2 1Hospital Central de Cruz Roja San Jose y Santa Adela, Ophthalmology, Madrid, Spain, 2Hospital Central Cruz Roja San Jose y Santa Adela, Ophthalmology, Madrid, Spain, 3Hospital Universitario 12 Octubre, Ophthalmology, Madrid, Spain Abnormal scarring following non-ophthalmic surgeries can lead to significant eyelid deformities, compromising ocular function and patient quality of life. This study describes three cases of eyelid malposition caused by pathological scarring: two cases of cicatricial ectropion and one case of cicatricial entro- pion. 150 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS The first case involves a 85-year-old female patient with cicatricial ectropion secondary to a facial chemical burn previously treated with a skin graft. The Conclusion: For patients with refractory orbital cellulitis complicating en- dophthalmitis, lateral canthotomy and inferior cantholysis may be a simple yet second case describes a 80-year-old female patient with cicatricial ectropion viable treatment option, releasing tissue pressure, enabling adequate delivery following reconstructive nasal surgery for basal cell carcinoma. The third case of systemic antibiotics and ultimately salvaging the eye. concerns a 54-year-old male patient who developed cicatricial entropion after surgery for orbital floor fracture with fixation mesh.In all cases, the eyelid malposition resulted directly from tissue fibrosis and adhesion after previous surgical interventions. A standardized surgical approach was employed for all patients, consisting of the release of adhered and fibrotic tissues, intraoperative evaluation of the resulting defect, and defect-specific correction. For the two cases of cicatricial ectropion, full-thickness skin grafts were used to restore anatomical and functional eyelid integrity. In the case of cicatricial entropion, the surgical correction involved releasing the posterior lamella and repositioning the anterior lamella to correct the in- ward turning of the eyelid margin. EP-OPL-14 Forehead transposition flaps. A useful resource for complex periocular and eyelid reconstruction cases A. Bengoa-Gonzalez1, M.-D. Lago-Llinas1, S. Perez-Trigo1, R.-M. Lopez-Ladron1, M. Puchol-Rizo1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Postoperative outcomes were satisfactory in all cases, with restoration of proper eyelid positioning and minimal functional and aesthetic impact. Six- month follow-up demonstrated stability of the surgical results and no signifi- cant recurrences. These cases highlight the importance of a systematic surgical approach in ad- Forehead flaps have a rich vascular supply and can be very useful for recon- structing larger defects with significant loss of periocular and eyelid tissue, in patients with severe eyelid or periorbital scarring due to previous surgery, radiation therapy, actinic damage, or recurrent malignancies with insufficient tissue, and in patients with concerns about vascular supply, such as smokers or dressing eyelid malpositions secondary to pathological scarring. those with impaired wound healing. EP-OPL-10 Management of devastating orbital cellulitis complicating endogenous endophthalmitis with lateral canthotomy and cantholysis S.E. Woo1, H. Choung2,3 1Soonchunhyang University Seoul Hospital, Department of Ophthalmology, Seoul, Korea, Republic of, 2Seoul National University College of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of, 3Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Ophthalmology, Seoul, Korea, Republic of We present a series of ten single-stage reconstructions using tunneled and non- tunneled midline transposition forehead flaps and the Fricke flap to reconstruct large upper and lower eyelid defects and periocular malpositions resulting from previous procedures. All patients healed well with good cosmetic results without the need for fur- ther procedures. We did not observe distal flap necrosis or infection, but there was mild forehead numbness in our cases, a potential complication that has been described. The forehead skin is thicker than the eyelid skin and can com- promise the aesthetic outcome in some cases, so it is an option reserved for selected complex cases.This technique has proven useful for large and deep defects with multiple subunits, avoiding the medial lower lid retraction and ectropion observed with other standard techniques. EP-OPL-15 Purpose: To report devastating orbital cellulitis complicating endogenous en- dophthalmitis that was successfully managed and achieved globe salvage with Propeller flaps for periocular and eyelid reconstruction lateral canthotomy and inferior cantholysis. Method: The medical records of 3 eyes of 3 patients who received orbital decompression by lateral canthotomy and cantholysis for refractory orbital cellulitis complicating endogenous endophthalmitis were retrospectively re- viewed. The main outcome measure was the clinical improvement after lateral canthotomy and inferior cantholysis. Results: Median patient age was 75 years (range 60s-80s years), 2 of 3 pa- tients were male, and all patients presented within 1 week of visual symptom onset. Two patients had unilateral, and one patient had bilateral involvement, of which only one eye progressed to orbital cellulitis. At presentation, all four eyes had visual acuities of hand motion or worse. The causative organisms were identified as Klebsiella pneumoniae in 2 patients, and Streptococcus pneumoniae in 1 patient. Endophthalmitis failed to improve and progressed to orbital cellulitis despite aggressive systemic and local antibiotic treatment. Lateral canthotomy and inferior cantholysis were performed in all 3 eyes to release orbital pressure, enable blood flow and adequate delivery of systemic antibiotics. All cases showed clinical improvement after a few days and avoided eviscera- tion or enucleation. Final visual acuity in all 3 eyes was no light perception. A. Bengoa-Gonzalez1, M.-D. Lago-Llinas1, R.-M. Lopez-Ladron1, S. Perez-Trigo1, S. Arroyo-San Victor1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Purpose: Propeller flaps are island flaps that rotate axially to reach the recipi- ent site. The flap has a subcutaneous pedicle on which it rotates, resembling a helicopter propeller. They are used in reconstructive surgery elsewhere in body, but rarely described for periocular reconstruction. We present our series of propeller flaps for reconstruction of large eyelid or periocular defects and their results. Methods: This is a review of the clinical case reports of eight patients who underwent eyelid or periocular tumor excision and single-stage microscopic reconstruction with the subcutaneous pedicled propeller flap supplied by a non-perforator orbicularis pedicle alone or in combination with other flaps. All patients were followed for at least 12 months. Results: Five lower lid defects were reconstructed with the use of propel- ler flaps, including one with a lateral canthal defect (size range 20×10mm to 32×27mm), one medial canthal defect (17mm diameter) in addition to a lower Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 151

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ELECTRONIC POSTER PRESENTATIONS eyelid defect, and one complete upper lid defect (42×19mm diameter). The flaps were recruited from the nasolabial area, temporal area, temple, or the lateral upper cheek skin. In 2 patients it was combined with other pedicled island flaps and in another one, a periosteal flap was also used to reconstruct the posterior lamella. Postoperatively, one case had a mild “trapdoor appearance” that did not re- quire flap revision, and one had a partial necrosis of the flap that did not need intervention and resulted in a good aspect. Conclusions: Reconstruction of large eyelid defects is challenging, especially when there is limited local skin available. Propeller flaps represent a change in the approach to periocular reconstruction in which the subcutaneous pedicle allows recruitment of large and highly mobile skin flaps from an extensive area of regional tissue, allowing coverage of a large defect at a greater distance than with pedicled skin flaps and without distortion at the base of the flap. EP-OPL-19 Extended orbital exenteration. A review Á. Bengoa-González1, B.-M. Laslau1, M.-D. Lago-Llinás1, S. Perez-Trigo1, C. Ruiz-Arranz1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Purpose: We present our experience on extended orbital exenteration (EOE) for advanced malignancies and life-threatening mucormycosis. EP-OPL-20 Progressive bilateral blepharoptosis accompanied by lateral shortening of the palpebral fissure G. Georgieva1, M. Sredkova1 1Medical Center of Ophthalmology Resbiomed, Sofia, Bulgaria Purpose: Our aim is to present three clinical cases of bilateral phimosis of the palpebral fissure, combined with ptosis of the upper eyelids. Methods: A retrospective analysis of the medical documentation of three women with progressive bilateral blepharoptosis, operated on and followed up at two clinics for the period August 2020–July 2023. Results: The patients are women of ages 51, 61, and 78 years with complaints of bilateral ptosis of the upper eyelids, preceded by edema and shortening of the palpebral fissure. Objectively, all three patients had elongation of the lateral canthus with phi- mosis of the palpebral fissure and MRD1 under 2 mm. All three patients un- derwent upper blepharoplastic surgery with shortening of the aponeurosis of the levator palpebrae superior and plastics of the lateral canthus, with subse- quent full structural and functional recovery. Intraoperatively, wе discovered adhesions of the lateral canthus and infiltration of the levator palpebrae supe- rior by an unknown substance. We obtained material for histology investigation, which did not show any de- viations from the normal histological findings in patients with ptosis. Conclusion: All available documentation from early childhood was requested Methods: This is a retrospective analysis of all consecutive cases of EOE from all three patients in order to exclude a hereditary or congenital disease. In due to advanced malignancies and life-threatening rhino-orbital mucormyco- sis, from 2011 to 2022. All surgeries were performed by the same surgeon (AB-G). Follow-up ranged between 9 and 144 months (mean 55, SD 43). The following data were evaluated: demographics, the origin of the tumor, primary lesion location, histopathology, imaging, previous treatments, surgical ap- proach, reconstruction techniques, excision margins, complications, adjunc- tive therapies, recurrences, and prognoses. Maxillectomy, ethmoidectomy, nasal fossa and cranial fossa surgery, orbital roof removal, and a combina- tion of these procedures completed total exenteration. Bone was excised with SONOPET (Stryker, Kalamazoo, USA). An HDPE implant ((Medpor Porex Surgical Inc, College Park, GA) was used in 6 cases to augment the temporal hollowing deformity. Results: A total of 13 cases (8 female, 5 male) of EOE were selected. The mean age was 66,15 years (range of 31 to 83). 2 cases were determined by mucormycosis infection and 11 cases by malignancies: 6 advanced basal cell carcinomas,1 malignant sphenoidal meningioma, 1 orbital hemangiopericy- toma, 1 nasal mucosa melanoma, 1 desmoplastic melanoma and 1 squamous cell carcinoma originating in the apex. In all cases, socket reconstruction was done with the transfer of the entire temporalis muscle through fenestrated lateral orbital wall. 8 cases required the placement of a titanium plate. 4 patients additionally required the use of other free flaps or grafts. Regarding complications, 4 patients had prosthesis infec- tion and 1 had cerebrospinal fluid fistula. Conclusions: EOE is an aggressive surgery for advanced tumors that im- proves life- expectancy. Reconstruction of the visible deformity improves both literature and practice, such cases are extremely rare, as the combination of ptosis and horizontal shortening of the palpebral fissure are usually associ- ated with a congenital syndrome. The surgical treatment led to full recovery of the normal eyelid position, elongation of the palpebral fissure with good function of the visual system and recovery of the peripheral vision, and last but not least achieving good аesthetics. The etiology of this bilateral fibrosis of the lateral canthi remains a mystery, therefore all three patients are due to be followed up. EP-OPL-21 High-frequency radiowave electrosurgery: a simple and effective solution for post-blepharoplasty chemosis H. Yu1, J. Jang1 1Kim’s Eye Hospital, Seoul, Korea, Republic of Purpose: To introduce a simple surgical technique that effectively resolves post-blepharoplasty chemosis quickly and easily. Methods: Nine patients (13 eyes) with persistent chemosis lasting 3 months to 2 years were included in this study. Six patients (9 eyes) received topical steroid and lubricant eye drop treatments for 3 to 8 months prior to undergoing overall patient satisfaction and the quality of life. radiofrequency electrosurgery. One patient (one eye) underwent two needling procedures before surgery. Coagulation of the edematous conjunctiva was performed using a radiofre- quency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio- wave electric unit (0.6–0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Postoperatively, topical antibiotics and steroid eye drops were administered four times daily for one month. 152 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Results: Chemosis resolved completely in 11 eyes (84.6%) within one week, with no recurrence during a follow-up period of at least six months. Two eyes (15.4%) required additional radiofrequency electrosurgery three months after the initial procedure; chemosis resolved within one week of retreatment and did not recur within six months. Conclusions: High-frequency radiowave electrosurgery is an effective and re- liable method for treating post-blepharoplasty chemosis. This technique pro- vides rapid symptom relief and high patient satisfaction, offering a straight- forward and practical solution for managing persistent and challenging cases. EP-OPL-22 Self-evisceration in a 92-year old female with untreated psychosis due to uremic encephalopathy: a case report M. Montenegro1, C. Vigo-Matic1, R.O. Lontoc1 1De La Salle University Medical Center, Department of Ophthalmology, Cavite, Philippines Purpose: To report a case of self-inflicted evisceration in an elderly patient with psychosis secondary to uremic encephalopathy, emphasizing the impor- tance of comprehensive management. This case report aims to explore the challenges and considerations involved in providing safe and effective ophthalmologic surgical care in elderly patients with multiple comorbidities. Method: A 92-year-old female with psychosis presented with a self-inflicted ruptured globe of the left eye following an episode of agitation. The patient was alert; however, uncooperative in the emergency room, limiting complete ophthalmologic examination. Management included immediate stabilization with wound cleaning and dressing. The patient was sedated for complete as- sessment and an orbital CT scan was done, confirming a ruptured globe; thus, prompting surgery under general anesthesia. Systemic management and monitoring were necessary due to untreated chron- ic kidney disease identified upon referral to Internal Medicine. Postoperative treatment included antibiotics and psychiatric management to reduce the risk of self-harm. Results: Comprehensive evaluation and risk stratification, with systemic management, took importance in guiding the surgical plan. Evisceration was successfully performed. The decision to omit implant placement with the pa- tient’s psychosis and uncontrolled condition contributed to a safer recovery with reduced complication risk. Conclusion: Self-evisceration is a severe outcome linked to unmanaged psy- chosis and underlying medical conditions. This case underscores the impor- tance of a multidisciplinary approach, integrating ophthalmologic, medical, and psychiatric management to improve surgical outcomes. EP-OPL-23 Coming out of the shadows: unseen steps in restoring sight after polytrauma A. Tarca1, N. Anton2,3, A.-I. Alexa2,3 1“Sf. Spiridon“ Iasi Emergency Clinical Hospital, Opthalmology, Iasi, Romania, 2University of Medicine and Pharmacy „Grigore T. Popa“, Iasi, Romania, 3“Sf. Spiridon“ Iasi Emergency Clinical Hospital, Iasi, Romania Purpose: To report a challenging clinical and surgical case of trauma by fall involving the craniofacial region and the ocular region, which despite an ini- tially reserved prognosis, had a multidisciplinary resolution, leading to a very good functional and aesthetically satisfying result. Material and method: We present the case of a 41-year-old male patient who suffered a craniofacial trauma due to a fall from height (~1.5m). The initial presentation revealed an eyelid trauma with loss of substance and possible orbital wound. Initial cranio-cerebral CT imaging revealed multiple cranio- facial fractures; ultrasound during admission divulged the presence of signifi- cant periorbital dimensional hematomas. OCT of the nerve and macula about 2 weeks after discharge showed the presence of papillary and macular edema. Emergency surgical treatment in- volved collaboration between the Ophthalmology + OMF team in 2 surgical times for reconstruction of the upper and lower palpebral regions as well as osteosynthesis immobilization at the lower orbital rim and left fronto-malar suture. Successive follow-up revealed a post-traumatic eyelid ptosis, which was sur- gically resolved latter using the levator aponeurosis advancement technique. Results: Initial ophthalmologic evaluation reported a visual acuity of uncer- tain light perception. Following appropriate surgical and medical manage- ment, this improved at discharge (7 days post-trauma) to hand movement perception and later on to approximately 60% pre-ptosis surgery, and to 80% afterwards. Structural status improved with very good ocular motility, restrict- ed only in the inferior sector and residual eyelid post-traumatic ptosis, that was eventually solved. Conclusions: This is a challenging case that despite a strong trauma with dis- astrous functional and aesthetic effects had a prompt and tandem intervention of the two surgical teams, through which an excellent structural and functional outcome has been facilitated. EP-OPL-24 Subperiosteal abscess of the orbit: case presentation Heightened vigilance, early intervention, and tailored care plans are crucial in managing the unique challenges presented by such complex cases, ultimately aiming to prevent further complications and preserve the patient’s quality of L. Grigoryan1, D. Zarembo1 1Yerevan State Medical University after Mkhitar Heratsi, Ophthalmology, Yerevan, Armenia life. A 33 years old male presented to the oculoplasty department with complains of diplopia, massive swelling of the left superior eyelid and severe pain in the left eye. The physical examination shows exophthalmos of the left eyeball, pain on palpation. The position of the left eyeball is 10-12mm down compare to the fellow eye, restricted mobility. The biomicroscopy and ophthalmoscopy of the both eyes are not changed. Visual acuities were R 20\20 and L 20/20 IOP R 14 IOP L 16 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 153

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ELECTRONIC POSTER PRESENTATIONS Laboratory test results were without deviation from the norm values. CT scan demonstrated an abnormal fluid collection of low attenuation within the sub- periosteal space, revealed bone lysis of the lamina papyracea and bone defects within the ethmoid. The entire pathological mass, protruding across the left orbit, moved the eyeball and the eye apparatus to the side, down and forward. The patient was prescribed Amoxicillin 1000mg twice daily, Ibuprofen 400mg twice daily, Dexamethasone eye drops every two hours, Tobramycin eye drops EP-OPL-30 Ocular surface changes after eyelid tumors surgery C. Del Noce1, C. Bologna1 1University of Genoa, University Eye Clinic, DINOGMI, Genova, Italy every two hours. Purpose: To evaluate ocular surface changes and aesthethic implications after The consilium was held. Including an ophthalmologist, an otolaryngologist eyelid tumors resection surgery. and a neurosurgeon and was decided to perform a combined surgery: 1 step - endoscopic ethmoidectomy, frontotomy , 2 step – orbitotomy. The surgical approach is performed by endonasal endoscopy, perforating the lamina papyracea. After removing uncinet process, middle turbinate has been lateralized, we removed ethmoid cells to identified lamina papyracea, we perforated a small bony part from the lamina, and abscess has been drained through the nose. The postoperative period passed without complications. Conclusion: Orbital complications of acute rhinosinusitis are rare but poten- Method: This observational study included twenty eyes of 10 patients (2 male, 8 female), who underwent a lower eyelid reconstruction surgery after malignant full-thickness defects that affects up to 25% of the horizontal lid margin (8 Basal cell carcinoma, 2 Squamous cell carcinoma). The mean age was 66.5 years (range: 21-89). Patients were divided in two groups based on the extent of eyelid loss: Group A with less than 50% of the eyelid margin removal and Group B with more than 50% of eyelid margin removal. Tear film break-up time (TBUT), Schirmer test type I, corneal staining pattern with Oxford score and Ocular tially severe. Rapid diagnostic imaging and urgent endoscopic decompression Surface Disease Index questionnaire (OSDI) were collected preoperatively of the abscess prevent permanent loss of vision and further defects of neu- rological character. endoscopic access should be the first choice in surgical treatment. EP-OPL-25 Xantelasms or first symptom of hematologic pathology? Erdheim Chester disease - rare diagnosis not to miss E. Parkassevitš1, K. Chaloupka2, R. Rebane1 1East Tallinn Central Hospital, Eye Clinic, Tallinn, Estonia, 2University Hospital of Zürich, Eye Clinic, Zurich, Switzerland Erdheim Chester disease is a rare histiocytic neoplasm, which can manifest in multiple tissues and organs, including periorbital area. The purpose of this poster is to raise awareness of this condition, be able to differential it from xsantelasms and dacryoadenitis. We are presenting a clinical case of 47 years old woman, who arrived to emer- gency department with unilateral S-shaped upper eyelid edema and hyperemia with yellow discoloration. In last 2 years clinical appearance varied from mild bilateral upper eyelid puffines to prominent eyelid edema, pruritus and mu- cous yellowish discharge from both eyes. MRI showed bilateral lacrimal gland enlargement with infiltrative edema in periorbital area. The biopsy from en- larged lacrimal gland revealed focal xsathomatous infiltrate, which was CD69 marker positive. As a result, diganosis “non-Langerhans type histiocytosis” was suggested. Promptly after she was referred to haematologist and became treatment at earliest convinience. The present case shows the importance of identifying right diagnosis, high- lights the role of ophthalmologist in recognition of a first sympotms of sys- temic disease and reffering the patient to specialist for further management. (T1), after 15 days (T2) and 1 month (T3) postoperatively. At T3 Patient and Observer Scar Assessment Scale (POSAS) was collected. Results: Statistical analysis (Wilcoxon) revealed a significant difference be- tween the surgically treated eye and the fellow eye showing a greater fluores- cein staining of the cornea (1.6 ± 0.84 vs 0.5 ± 0.7; p = 0.031) and a reduc- tion in TBUT (2.65 ± 1 vs 5.2 ± 2.7; p = 0,027). Schirmer test values were not statistically significant. The mean observer total score using POSAS was lower in group A compared with Group B (2 vs 4, p<0,05); conversely, mean patient total score using POSAS was higher in group A compared with Group B (2,8 vs 2,3; p<0,05). Conclusion: Lower eyelid tumors resection leads to an alteration of the ocular surface that is related to the percentage of eyelid margin removal. A compre- hensive approach, with adequate postoperative eye treatment, is essential to enhance patients’ quality of life. EP-OPL-32 Nasal staphylococcus aureus eradication in thyroid eye disease: patient reported outcomes J. Himsworth1, M. Fenech1, N. Ghadiri1 1Royal Liverpool University Teaching Hospital Foundation Trust, Liverpool, United Kingdom Purpose: To assess patient-reported outcomes following nasal eradication of Staphylococcus aureus (S. aureus) in managing thyroid eye disease (TED). Methods: A retrospective review of electronic medical records identified three patients who underwent nasal S. aureus eradication therapy. Each patient re- ceived a treatment regimen consisting of oral flucloxacillin (500 mg four times daily) and either Naseptin or Mupirocin (twice daily) for three months. A single clinician conducted interviews using a modified, validated Patient- Reported Outcome Measures (PROMs) questionnaire. Patients rated symp- tom severity—eyelid swelling, proptosis, red eyes, discomfort, and double vision—on a scale from 1 to 10 before and after treatment. Results: The cohort consisted of three women, with an average age of 55 years at treatment initiation. All patients had developed TED within 2 years of a hyperthyroidism diagnosis and were diagnosed with chronic rhinosinusi- tis. Symptom changes were as follows: eyelid swelling and proptosis showed minimal improvement, with one patient reporting a reduction of 2 points (from 154 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS 8 to 6) for eyelid swelling and no change in proptosis. Red-eye symptoms Results: A 61-year-old diabetic woman, immunosuppressed due to treatment improved by an average of 4 points (range 2 to 6). Discomfort decreased by 5 with hormonotherapy for breast cancer and systemic corticosteroid for sar- points in one patient (from 8 to 3), but remained stable in the others. Double coidosis, was admitted to our hospital with complaints of severe headache, vision worsened in one patient (from 5 to 7), while the remaining two showed fever and complete right visual loss. Imaging exams demonstrated an invasive no change. Conclusion: In this small cohort, nasal S. aureus eradication therapy did not significantly improve proptosis or double vision and improved eyelid swelling in one patient. Discomfort decreased markedly in one patient only. The most notable improvement was in redness, with all patients reporting some relief. While the small sample size limits the ability to draw definitive conclusions, these findings suggest potential benefits, particularly for red eye symptoms, warranting further investigation. EP-OPL-33 pansinusitis with right orbital apex involvement, extension to frontal cerebral space and an inflammatory swelling in the medial aspect of the left orbit with extra-conical extension. These findings corroborated the diagnosis of rhino-orbital mucormycosis with intracranial extension. Initial treatment included systemic antifungal therapy and necrotic tissue debridement, both encephalic and nasosinusal. Since there was a complete right orbital apex and optic nerve involvement, she was pro- posed to right orbital exenteration. The left eye presented good visual acuity (8/10 Snellen chart) and no signs of afferent or efferent pathway involvement. Regarding the left orbital soft tissue involvement, this patient was proposed to transcutaneous retrobulbar injections of 1 mL of 3.5mg/mL of AmpB. She received a total of 6 injections, with clinical stability and imagiologic signs of improvement regarding the left Case report of a silent sinus syndrome orbital involvement of the infection. R. Aus1, R. Rebane1 1East Tallinn Central Hospital Eye Clinic, Tallinn, Estonia Conclusion: Transcutaneous retrobulbar injection of AmpB seems to be a val- id approach for specific cases of rhinosinus mucormycosis with orbital inva- sion, allowing for orbital preservation without compromising patient survival. Background: Silent sinus syndrome (SSS) is a rare clinical entity. Patients with SSS often present with diplopia, headache, facial pressure or pain and eyelid retraction. It also may present with enophthalmos or hypoglobus due EP-OPL-35 to the collapse of the inferior orbital wall, caused by negative pressure inside maxillary sinus that derives from hypoventilation of the sinus. Objectives: To present a case of a 46 y/o male with an SSS who suddenly felt tension in the upper eyelid region and noticed a slight downward displace- ment of the left eyeball, without diplopia, visual impairment, pain or previ- ous injury. He was referred for additional diagnostics, a CT-scan revealed maxillary sinus completely filled with soft tissue and thinning of the orbital inferior wall. No involvement of extraocular muscles was noted. The patient underwent a surgery of reconstruction of the inferior orbital wall and functional endoscopic sinus surgery (FESS). Methods: Case report analysis Conclusion: Although silent sinus syndrome is a rare condition, it is an im- portant differential diagnosis that should be kept in mind when a patient is presented with eyelid retraction or pseudoptosis. EP-OPL-34 Transcutaneous Retrobulbar Amphotericin B injection treatment for invasive fungal rhino-orbital sinusitis - a case report A.M. Ferreira1, J.M. Matos Sousa1, J. Santos-Oliveira1, R. Rodrigues1, V. Leal1, J. Meira1,2 1ULS São João, Porto, Portugal, 2Faculty of Medicine, University of Porto, Portoport, Portugal Orbital metastasis of breast carcinoma: a clinical case study T. Javaloy Vidal1, B. Cano Gonzalez-Barcia1, A. Bengoa González1, R. Fernandez Herrero1, M. Toribio Albarrán1, M. Puchol Rizo1, S. Arroyo San Victor1, S. Pérez Trigo1, R. López-Ladrón García Borbolla1 1Hospital Universitario 12 de Octubre, Madrid, Spain Purpose: To report a case study of orbital metastasis as the initial manifes- tation of breast carcinoma, emphasizing the clinical presentation, diagnostic approach, and surgical management. Case presentation: A 60-year-old female presented with intermittent eye- lid swelling, redness, and painful ophthalmoplegia in the right eye. Clinical examination revealed mild eyelid edema, resistance to retropulsion, and re- stricted ocular motility in all directions, especially adduction, with preserved visual acuity. Imaging studies revealed multiple osteolytic cranial lesions and a soft tissue mass in the right orbit, initially suggesting a differential diagnosis which included multiple myeloma or idiopathic orbital inflammation. Further systemic evaluation identified a palpable breast nodule, confirmed as grade 2 ductal carcinoma with infiltration of axillary lymph nodes. A surgical biopsy of the orbital mass was performed to clarify the etiology. Results: Histopathological analysis confirmed the orbital mass to be meta- static breast carcinoma. The patient was diagnosed with stage IV breast carci- noma (cT2N1M1) involving lytic bone lesions, orbital metastasis, pulmonary lymphangitic carcinomatosis, and bone marrow infiltration. Surgical interven- tion, including orbital mass debulking surgery, improved the proptosis and ocular motility, with no major postoperative complications. Purpose: Invasive fungal rhino-orbital sinusitis is a rare and life-threatening condition that occurs in immunosuppressed patients. This article aims to de- scribe the case of a patient with bilateral orbital mucormycosis submitted Conclusions: This case illustrates the importance of considering orbital me- tastasis in the differential diagnosis of ocular motility disorders, particularly in patients with a history or signs suggestive of malignancy. A multidisciplinary to right orbital exenteration and transcutaneous retrobulbar amphotericin B approach is crucial for optimal diagnosis and management, as orbital involve- (AmpB) in the left orbit. ment may be the initial manifestation of advanced systemic disease. Method: Clinical and imaging description of a clinical case. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 155

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ELECTRONIC POSTER PRESENTATIONS EP-OPL-37 Periocular lesions and surgical management: insights from a series of over 100 cases A.-I. Alexa1, C.A. Sandu1, A. Picioroaga1, C. Lavrinciuc1, C.M. Bogdanici1 1“Sf. Spiridon” Emergency Hospital, Ophthalmology, Iasi, Romania Purpose: This study aims to review a series of cases of periocular lesions, focusing on their anatomopathological diagnoses and the corresponding sur- gical approaches used for treatment. The goal is to provide insights into the prevalence of different types of periocular lesions, such as basal cell carci- noma, melanocytic nevus, inclusion cysts, and squamous cell papillomas, and to evaluate the surgical techniques used. This research seeks to highlight effec- tive treatment strategies based on lesion size and type. Method: This retrospective analysis includes patients, both male and female, who presented with periocular lesions at „Sf. Spiridon“ Hospital over a 3-year period. The study reviewed lesion aspect, anatomopathological results, and surgical techniques for each case. Basal cell carcinoma was the most frequent- ly diagnosed, followed by melanocytic nevus, inclusion cysts, and squamous cell papillomas.The surgical management varied from excisional surgery with simple suturing to more complex reconstructive techniques, including Tenzel and Hughes flaps. Results: Most lesions were diagnosed as basal cell carcinoma, followed by melanocytic nevus, inclusion cysts, and squamous cell papillomas. Postoperative healing was uneventful for most patients, with minimal compli- cations. A small percentage required re-excision due to incomplete margins, though these cases were rare. Overall, surgical outcomes were positive, with good functional and aesthetic results. Conclusions: This study confirms that basal cell carcinoma is the most com- mon periocular lesion among patients seeking surgical intervention for tumor excision. The choice of surgical approach depends on lesion size and location. Simple excision and suturing were effective for smaller lesions, while larger ones required reconstructive techniques. Overall, surgical outcomes were positive, with minimal complications, em- phasizing the importance of early detection, accurate diagnosis, and appropri- ate surgical management. EP-OPL-38 Critical timing in oculoplastic emergencies: the role of canthotomy and cantholysis in orbital hematomas M. Puchol-Rizo1, R.M. López-Ladrón1, C. Ruiz-Arranz1, L. Alcalde-Blanco1, Á. Bengoa-González1, M.C. de Uña-Iglesias1, S. Pérez-Trigo1 1Hospital Universitario 12 de Octubre, Madrid, Spain Purpose: To underscore the necessity and efficacy of emergent canthotomy and cantholysis in the management of orbital compartment syndrome (OCS) due to retrobulbar hematoma (RBH), as evidenced by a case with significant visual recovery. Case Description: A 61-year-old male presented with left orbital trauma sus- tained during a workplace accident. On examination, he demonstrated propto- sis, severe extraocular movement restriction, midriasis with reduced pupillary reactivity, and acute visual impairment (counting fingers at 3 meters). Due to the emergent nature of the situation, a lateral canthotomy and cantholysis were performed immediately, leading to rapid decompression. Orbital CT per- formed post-procedure confirmed a retrobulbar hematoma with intraconal ex- tension and mild proptosis, without optic nerve elongation or orbital fractures, aligning with the clinical findings observed preoperatively. The patient was managed with intravenous corticosteroids, topical antibiot- ics, and artificial tears. Follow-up evaluations noted complete resolution of midriasis, significant recovery of ocular motility, and the absence of residual hematoma or complications. Results: This intervention preserved optic nerve integrity, restored functional vision, and prevented irreversible sequelae. The imaging findings supported the effectiveness of timely surgical decompression, as no secondary damage to orbital structures occurred. Conclusions: Orbital compartment syndrome due to retrobulbar hematoma constitutes a vision-threatening emergency requiring immediate recognition and intervention. This case underscores that prompt surgical decompression through emergent canthotomy and cantholysis can significantly alter the prog- nosis, preventing permanent vision loss and restoring functionality. Rapid clinical decision-making and execution are paramount to achieving favorable outcomes in similar high-stakes scenarios. EP-OPL-39 Surgical management of canalicular duct injuries: bicanalicular stent A. Picioroaga1, A.I. Alexa1, C.M. Bogdanici1 1“Sf. Spiridon” Emergency Hospital, Ophthalmology, Iasi, Romania Objectives: This study reports the clinical outcomes and treatment strategies in 6 patients, including 4 children (ages 3-10) who sustained dog bites and 2 adults (ages 32-45) who suffered trauma from falls and traffic accidents. All patients presented with palpebral wounds involving canalicular lacera- tions. In 5 cases, only the inferior canaliculus was affected, while one case involved both the superior and inferior canaliculi. Surgical intervention was performed promptly in all cases to repair the damaged canalicular structures and restore canalicular function. Methods: In each case, a bicanalicular Crawford stent was placed to maintain the integrity of the canaliculi and promote healing. The stents were kept in place for 6 weeks to ensure the canalicular ducts remained patent, support- ing proper drainage and preventing complications. The importance of silicone tube placement alongside wound closure was emphasized in all cases, as it played a critical role in achieving successful outcomes. Results: Postoperative follow-up showed satisfactory healing of the canalicu- lar ducts in all patients. No cases developed complications such as infection, dehiscence, or tearing. The use of silicone stents was crucial in preserving the canaliculi’s patency and facilitating the healing process. This reinforced the importance of not only suturing the wound but also ensuring the structural integrity of the canalicular system during repair. Conclusion: Early surgical intervention, including the use of silicone tubes for canalicular repair, is essential for optimal functional and cosmetic out- comes in cases of palpebral trauma involving the canalicular duct. Promt sur- gical intervention minimizes the risk of chronic tearing and ensures the proper healing of the canaliculi, contributing to better long-term results. 156 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-OPL-40 EP-OPL-42 Aesthetic blepharoplasty - scope and indications G. Georgieva1, M. Sredkova1 1Medical Center of Ophthalmology Resbiomed, Sofia, Bulgaria Purpose: To present the surgical indications and approach in cases of aes- thetic blepharoplasty. Two year analysis of new polyethylene orbital implant with suturing platform W. Adamski1 1Poznan District Hospital, Derpartment of Ophthalmology, Poznan, Poland Methods: We performed a retrospective analysis of the documentation of Purpose: This study aims to present the outcomes of enucleation surgeries patients, subject to aesthetic blepharoplasty, operated on and followed up at utilizing a polyethylene orbital implant with a suturing platform. Medical Center of Ophthalmology “Resbiomed”, for the period 03.01.2022- Methods: A retrospective analysis was conducted on patients who underwent 21.12.2023. enucleation with the polyethylene orbital implant featuring a suturing plat- Results: Thorougly examining the blepharoplasty opthalmic status of 130 form. patients, who underwent aesthetic blepharoplasty, we established in what per- Results: The study cohort comprised 51 patients, with a mean follow-up dura- centage of cases, apart from skin excision, it was also necessary to perform tion of 14 months (range: 6-24 months). Adverse events included one instance excision of orbicularis oculi muscle, orbiculopexy, indirect or direct brow lift, of suturing platform breakage and one case of implant exposure, which oc- excision of orbital fat, lacrimal gland reposition, stabilization of the lateral curred following a biopsy of the orbital contents due to suspected malignancy canthus, shortening of the levator palpebrae superior muscle aponeurosis, re- recurrence. construction of the supraciliary folds. Conclusions: The preoperative opthalmic assessment with detailed meas- urements of the periocular zone gives us guidance in regard not only to the technique and spectrum of the upcoming intervention, but also possibility to estimate better the postoperative result. It is necessary for the oculoplastic surgeon to have imagination and ability to improvise, as each patient requires an individual approach and the technique often modifies during the intervention. EP-OPL-41 Posterior approach to eyelid weight placement W. Adamski1 1Poznan District Hospital, Derpartment of Ophthalmology, Poznan, Poland Purpose: The purpose of this poster is to present results from one center expe- rience in the posterior approach to eyelid weight placement. Conclusion: The polyethylene orbital implant with a suturing platform dem- onstrates high efficacy, with a low incidence of exposure. EP-OPL-43 Evaluation of topical anti-inflammatory treatment for edematous punctal stenosis by anterior segment optical coherence tomography H. Nalcı Baytaroğlu1, K. Özdemir Yalçınsoy1 1Ulucanlar Eye Training and Research Hospital, Ophthalmology, Ankara, Turkey Purpose: To evaluate the effect of topical anti-inflammatory treatment on edematous punctal stenosis using anterior segment optical coherence tomog- raphy (AS-OCT). Method: Patients who had at least one month history of epiphora with edematous punctal stenosis, and findings of ocular surface inflammation were included. After punctal dilatation and syringing, patients were treated Methods: Retrospective analysis of patients who underwent poste- with a two-week course of steroid drops and long-term preservative-free cy- rior approach surgery to eyelid weight placement in the Department of closporine-A drops. Evaluations were performed at baseline and at 1 and 3 Ophthalmology Poznan District Hospital, Poland. months post-treatment. Demographic parameters and Munk score were noted. Results: The study group included 12 patients that underwent primary surgery Outer punctal diameter (OPD), vertical canalicular length (VCL), inner punc- and 4 patients who previously experienced eyelid weight exposition following tal diameter (IPD) at 100 and 500µ, tear well diameter (TWD), tear well length previous conventional anterior approach surgery. The patients complained of (TWL) and punctal reserve (PR) were measured on OCT. minimal discomfort and did not experience further expositions. Results: Thirty-two eyes of 16 patients were included. Mean age was 61 Conclusions: Posterior approach to eyelid weight placement proves to be a very fast and effective method that may help subside negative symptoms in patients with facial nerve palsy. (44-80) years. At the beginning of the study, all eyes had Munk score 3 and above. Blepharitis and/or conjunctival follicules were present in all cases. The Munk score decreased notably in majority of patients by the 1st and 3rd month. Ninety percent of the cases had Munk score less than 2 at the end of the 3rd month. Mean OPD decreased significantly at the end of 3 months (443.3µ vs 500 µ, Wilcoxon p=0.036). One patient did not show improvement of symp- toms with clinical treatment and underwent perforated punctal plug insertion. Conclusion: Despite most of the punctum parameters not changing signifi- cantly, symptomatic relief was obtained in majority of patients at the end of 3 months. Topical anti-inflammatory treatment may be effective in managing conjunctical surface inflammation, therefore both increasing the diameter of punctal opening and decreasing hyperlacrimation. This highlights the potential clinical benefit of this approach in managing edematous punctal stenosis. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 157

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ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Oncology & Pathology EP-ONC-01 Giant cell reparative granuloma of the orbit M.-D. Lago-Llinas1, A. Bengoa-Gonzalez1, R.-M. Lopez-Ladron1, P. Garcia-Carrero1, M. Santana-Castro1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Giant cell reparative granuloma (GCRG) is a rare fibroosseous lesion rarely seen in the orbital region. Although benign, it is known to be recurrent and locally destructive. We report two cases of orbital GCRG. In both cases, com- puted tomography (CT) showed a heterogeneously growing, well-defined mass eroding the orbital roof with thinning and compression of the cortex, but without invasion of the cranial cavity. In the first case, the mass extended into the frontal sinus. Volume-rendered 3D-CT reconstruction images show lytic areas with bone destruction in the orbital roof. In both cases, magnetic resonance imaging (MRI) showed a well-defined, heterogeneously enhancing mass measuring ap- proximately 30 x 20 mm with a lobulated appearance and markedly increased signal intensity, reflecting the expansive cystic component. The masses caused inferior displacement of the globe in both cases. An orbitotomy was performed via an upper lid crease incision and the tumor tissue was removed using an ultrasonic aspiration system. Similar features were observed in the histopathological examination of both cases. It consisted of cellularity with fibrohistiocytic appearance without atypia, with xanthom- ized cells as well as pigmented areas with hemosiderin deposits. In addition, there was a foreign body reaction and cholesterol crystals, confirming the di- agnosis of GCRG. Symptoms resolved completely with no evidence of recur- rence at 18 and 14 months of follow-up, respectively. We present the clinicopathologic and radiologic findings and describe the sur- gical approach. As a rare entity, GCRG of the orbit should be considered in the differential diagnosis of fibroosseous orbital masses. Complete surgical excision carries a low risk of recurrence. EP-ONC-02 Posterior uveal melanoma with extrascleral extension in the blind eye M.-D. Lago-Llinas1, A. Bengoa-Gonzalez1, S. Perez-Trigo1, B.-M. Laslau1, A. De Madariaga1 112 de Octubre University Hospital, Ophthalmology, Madrid, Spain Uveal melanoma is the most common primary intraocular malignancy in adults. Its possible occurrence in the blind eye has been known for years, but only a few cases have been described. We present 3 cases of malignant melanoma with extrascleral extension at the time of diagnosis in blind eyes from other causes. Case 1 presented with a mass in his blind eye due to trauma years ago, caus- ing pain and bleeding for 4 days. He was previously treated with retrobulbar alcohol injections to stop the pain in this eye. Case 2 with blind eye due to retinal detachment with ocular pain 4 days ago. Examination revealed a dark exophytic mass in the superior temporal scleral quadrant. Case 3 with senile dementia and blind eye due to old retinal detachment, in which his wife noticed dark spots on the sclera without any other symptoms on examination. All cases were radiologically confirmed, one of them had massive orbital extension and metastases were excluded before surgery. Exenteration was performed in 2 cases and extended enucleation in the other. Histologic exami- nation confirmed mixed epithelioid and spindle cell melanoma type B, with extensive necrosis in the first case, spindle and epithelioid cell type with trans- scleral extension in the following cases. Atypical melanocytes were present in all cases. Immunohistochemistry was positive for HMB45, S100, and Melan A. Patients died between 12 and 36 months after diagnosis. Uveal melanomas with extrascleral extension in the blind eye are rare and usually occur due to a delay in diagnosis. Media opacity and lack of clinical symptoms sometimes make detection difficult in these patients. Pain can be an alarm sign so measures to reduce it can mask and delay the possible diagnosis. This forces the ophthalmologist to examine the blind eye regularly to avoid missed or delayed detection of a melanoma in the blind eye, which would result in a worse prognosis. EP-ONC-03 Recurrence rates and histopathologic characteristics of periocular basal cell carcinomas in 280 surgically excised cases Z. Cyzova1,2, B. Babkova1,2, S. Jakubickova1,2, O. Vlacil1,2, K. Maresova1,2, M. Karhanova1,2 1Olomouc University Hospital, Eye Clinic, Olomouc, Czech Republic, 2Palacky University Olomouc, Faculty of Medicine and Dentristry, Olomouc, Czech Republic Purpose: This study aimed to analyze the clinical and histopathological char- acteristics and recurrence rate in a cohort of 280 cases after surgical excision without utilizing intraoperative frozen section control or Mohs’ micrographic surgery. Method: We performed a retrospective analysis of 280 patients with primary basal cell carcinoma treated by surgical excision between 2005 and 2018 with a follow up of at least 36 months. We evaluated the recurrence rate in the study cohort and assessed its association with selected clinical factors such as age, sex, tumor location, margin status and histopathologic characteristics using Fisher’s exact test and Mann-Whitney U test. Additionally, we monitored the time (in months) to recurrence. Results: A total of 280 basal cell carcinoma cases were included. The mean age was 69.1 years with a range from 24 to 94 years. The most common tumor locations were the lower eyelid (55.7%), inner canthus (34.6%), upper eyelid (6.1%), and outer canthus (3.6%). The most common histologic types were nodular (32.1%), solid (7.1%), adenoid (7.1%), superficial (3.6%), infiltrative (3.6%) and morpheaform (3.6%). A clear histologic margin after primary exci- sion was achieved in 191 cases (68.2%). The overall recurrence rate was 10%, with recurrence rate of 8.5% for histologically complete excisions and 14.8% for histologically incomplete excisions. No significant association was found between recurrence rate and age, sex, tumor location and margin status. There was no significant difference in the number of months to recurrence between excisions with complete and incom- plete margins (p = 0.518). 158 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Conclusion: This study found a 10% recurrence rate in periocular basal cell carcinoma after surgical excision. No significant associations were identified between recurrence and clinical factors such as age, sex, tumor location, or margin status. These findings suggest that clear histologic margins do not guarantee that a recurrence will not occur. EP-ONC-04 Novel therapeutic potential of CEP-1347: dual inhibition of MDM4 and PKC in high-grade uveal melanoma K. Togashi1, M. Okada2, Y. Kaneko1, M. Sugimoto1 1Yamagata University School of Medicine, Department of Ophthalmology and Visual Sciences, Yamagata, Japan, 2Yamagata University School of Medicine, Department of Molecular Cancer Science, Yamagata, Japan Purpose: Uveal melanoma (UM) is the most common primary intraocular malignant tumor in adults, with no fully established treatments for advanced EP-ONC-05 Laser treatment of the new formation of the Iris and iridociliary zone P. Chechin1, V. Shcherbakova1, O. Guzun1, O. Zadorozhnyy1, I. Safronenkova2 1SI „The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine“, Studying Biological Action and Application of Lasers in Ophthalmology, Odesa, Ukraine, 2SI „The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine“, Ophthalmooncology, Odesa, Ukraine Purpose: To determine the effectiveness of organ-preserving treatment of tu- mors of the iris and iridociliary zone by using techniques and laser radiation of different wavelengths. Methods: Clinical follow-up was carried out on 89 patients (89 eyes) with the tumor of the iris and iridociliary zone. The age of patients was 48.5±14.5 years. The size of the tumor was determined by ultrasound scanning: area (1.5 mm2 - 24 mm2), height (0.4 mm to 2.8 mm). Laser coagulation was performed with the use of lasers of λ=0.48, λ=0.85, λ=0.53 and λ=0.57 µm. Transscleral cyclophotocoagulation was performed when the tumor grew into the structure or metastatic cases. UM is commonly characterized by overexpression of mu- of the anterior chamber angle and to the ciliary body. The course of treatment rine double minute 4 (MDM4), which suppresses p53 activation, and hyperac- tivation of protein kinase C (PKC). We explored whether CEP-1347, previously identified as an MDM4 in- hibitor, could act as a novel therapeutic agent for advanced UM by acti- vating the p53 pathway. Methods: High-grade UM cell lines (Mel202 and 92.1) were used to evaluate tumor cell viability and proliferation by WST-8 assay. Intracellular dynamics of molecules such as p53, p21, MDM4, MDM2, and PKC isoforms were ana- lyzed by immunoblotting. The roles of MDM4 and PKC were examined using siRNA and a specific inhibitor, respectively. Results: In this study, MDM4 was highly expressed in two high-grade UM cell lines. CEP-1347 (0.5 μM) suppressed MDM4 expression and PKC activ- ity, activating the p53 pathway, including p53 and its downstream effector p21, which inhibited UM cell survival and proliferation. In contrast, individual inhibition of MDM4 by siRNA or PKC by inhibitors did not achieve sufficient p53 activation or effective suppression of UM cell growth. However, simultaneous inhibition of MDM4 and PKC pathways strongly activated p53 and significantly suppressed cell survival and prolif- eration. These results indicate that MDM4 and PKC cooperatively inactivate the p53 tumor suppressor pathway in UM cells. CEP-1347 effectively suppresses UM cell survival and proliferation by targeting both pathways simultaneously. Conclusions: CEP-1347, developed for Parkinson’s disease, has shown safety in humans. At clinically relevant concentrations, it suppressed MDM4 expres- sion and PKC activity, activating the p53 pathway and inhibiting UM cell survival and proliferation. These findings suggest CEP-1347’s potential as a novel molecular-target- ed therapy for advanced UM. was 1-3 sessions. Repeated courses were performed after 3-6 months. Results: After the first course of laser coagulation, swelling of tumor tissues, obliteration of newly formed vessels, and pinpoint hemorrhages were noted. Subsequently, an atrophic scar was formed at the site of exposure in places with fibrous detachment of the iris stroma and depigmentation. After subse- quent courses of treatment, a tendency to decrease in area and height was noted. Tumor resorption was achieved in 83/89 eyes (93%). Surgical iridectomy was performed in 3/89 eyes (3%) due to the threat of tumor growth into the ciliary body. In one case, enucleation was performed due to continued tumor growth into the anterior chamber angle and the development of uncompensated secondary glaucoma. In cases where the tumor covered the pupil lumen before treatment, visual function improved after the course. No tumor recurrence was observed. Conclusion: The effectiveness of organ-preserving treatment of neoplasms of the iris and iridociliary zone was achieved in 93% of patients using lasers λ=0.48, λ=0.85, λ=0.53 and λ=0.57 μm, no matter what wavelengths were used. The choice of parameters of the laser technique depends on localization, the stage of pigmentation and the type of complications. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 159

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ELECTRONIC POSTER PRESENTATIONS EP-ONC-06 The outcomes of ruthenium brachytherapy for uveal melanoma at 10-year follow-up E. Goździewska1, E. Zwolińska1, A. Kubiak2, Ł. Tomczyk3, G. Bielęda4, A. Chicheł5, I. Rospond-Kubiak1 1Poznan University of Medical Sciences, Department of Ophthalmology, Poznań, Poland, 2Greater Poland Cancer Centre, Greater Poland Cancer Registry, Poznań, Poland, 3Poznan University of Life Sciences, Department of Food Quality and Safety Management, Faculty of Food Science and Nutrition, Poznań, Poland, 4Poznan University of Medical Sciences, Electroradiology Department, Poznań, Poland, 5Greater Poland Cancer Centre, Brachytherapy Department, Poznań, Poland Purpose: The aim of the study was to evaluate the visual outcome and eye retention rate at a 10-year follow-up of the ruthenium brachytherapy for uveal melanoma. Method: Retrospective chart review. Patients were included if they underwent ruthenium brachytherapy for ciliochoroidal melanoma at the Department of Ophthalmology, Poznan University of Medical Sciences, Poznań, Poland be- tween 1991-2015. They were excluded if lost to follow-up or had incomplete entry data. Results: A total of 136 patients (out of 143) had available data for review. In a ten-year follow-up, 60 patients (44,1%) died, among them 23 patients (38,3%) due to uveal melanoma progression. 76 patients (55,9%) survived ten years or more following the radiation treatment: 25 men, 51 women in the mean age of 56,3 years (range: 30-88 years). The median LBD of the treated tumours in this cohort was 10,6 mm, median thickness – 4,76 mm. The median follow-up was 106,8 months. We observed 9 (8,4%) recurrences, 71 patients (93,4%) retained their eye globe 10 years post radiation treatment. The final visual acuity was below 0,1 for 35 (49,3%) patients, between 0,1 and 0,5 for 16 patients (22,5%) and better than 0,5 for 20 (28,2%) patients. Conclusion: Ruthenium brachytherapy is an eye sparing treatment in long- term follow-up. However, for the majority of patients, the final visual acuity would be significantly impaired. EP-ONC-07 When tumors cross boundaries: a case of advanced sinonasal carcinoma invading the orbit and nasal cavity J. Alves Ambrósio1, P. Cardoso Teixeira1, J. Chibante Pedro1, V. Miranda1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal Purpose: To describe a case of non-keratinizing large-cell carcinoma origi- nating in the maxillary sinus, presenting with ophthalmologic and neurologic manifestations due to local invasion. Methods: An 81-year-old male with a history of benign prostatic hyperplasia and cardiac disease presented with progressive vertical diplopia and ptosis of the left eye for one week. Clinical evaluation revealed incomplete third cranial nerve palsy with pupil- lary involvement. Imaging studies identified a tumor in the left maxillary sinus with bone erosion and extension into the orbit and nasal cavity. A biopsy was performed, and histopathological examination confirmed non-keratinizing large-cell carcinoma. Results: Computed tomography showed a 46.5 mm tumor centered in the left maxillary sinus with bone erosion, spiculated bone appearance, and inva- sion into adjacent structures, including the orbit and nasal cavity. The patient underwent biopsy, revealing invasive carcinoma. Despite being informed of the malignancy, the patient expressed readiness to proceed with further evalu- ations. Management included referral to a multidisciplinary oncology team for treatment planning. Conclusions: This case highlights the significance of early recognition of atypical presentations of sinonasal tumors, such as diplopia and cranial nerve palsy. Comprehensive imaging and histopathological analysis are essential for accurate diagnosis and treatment planning. Multidisciplinary collaboration is vital to managing advanced sinonasal malignancies with orbital and intracra- nial involvement. EP-ONC-08 Bilateral papilledema and left facial palsy in vestibular schwannoma: a multidisciplinary management approach J. Alves Ambrósio1, J. Chibante Pedro1, V. Miranda1 1Unidade Local de Saúde Entre o Douro e Vouga, Ophthalmology, Santa Maria da Feira, Portugal Purpose: To describe the clinical course and visual outcomes of a 30-year-old female presenting with severe bilateral papilledema due to prolonged intracra- nial hypertension caused by a large vestibular schwannoma (VS). Methods: The patient reported progressive bilateral vision loss and frontal headaches. Ophthalmologic examination revealed severe bilateral papillede- ma and visual field constriction. Brain MRI showed a 4.2 cm left-sided VS causing brainstem compression and hydrocephalus. Retrosigmoid craniotomy and subtotal tumor resection were performed. Postoperatively, the patient was managed with acetazolamide, ocular surface protection, and multidisciplinary follow-up. Results: Surgical resection relieved intracranial hypertension, confirmed by imaging. However, ischemic changes in the left cerebellar hemisphere and brainstem were evident. Papilledema began to resolve postoperatively, but vis- ual acuity and fields remained severely compromised. OCT revealed residual optic nerve pallor, and fundus photography showed resolving papilledema. The patient also developed left facial paresis with lagophthalmos, necessi- tating intensive ocular surface management to prevent exposure keratopathy. Conclusions: This case underscores the challenges in managing severe papilledema and visual impairment secondary to prolonged intracranial hy- pertension from VS. Despite surgical and medical intervention, residual defi- cits persisted, emphasizing the need for timely diagnosis and multidisciplinary management to optimize outcomes. 160 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-ONC-09 EP-ONC-10 Stereotactic radiosurgery irradiation planning scheme of uveal melanoma with and without artificial intelligence Surgical difficulties in the management of squamous cell carcinoma of the eyelid with xeroderma pigmentosum: about a case J. Valaskova1, A. Furdova1, M. Chorvath2, M. Sramka2, R. Furda3, B. Gallik4,5 1Comenius University, Faculty of Medicine, Dept. of Ophthalmology, Bratislava, Slovakia, 2Comenius University in Bratislava and Slovak Medical University, Faculty of Medicine, Dept. of Radiation Oncology, Bratislava, Slovakia, 3Comenius University, Department of Information Management and Business Systems, Bratislava, Slovakia, 4Comenius University, Bratislava, Slovakia, 5Comenius University, Faculty of Medicine, Dept. of Ophthlamology, Bratislava, Slovakia I. Bechakh1 1University of Algiers I Benyoucef Benkhedda, Ophthalmology, Central Army Hospital, Algiers, Algeria Xeroderma pigmentosum is a rare genetic disease, transmitted in an autosomal recessive fashion, It is characterized clinically by extreme photosensitivity of the skin, pigmentary abnormalities of the skin exposed to the sun with an increased risk of skin cancer development and damage ophthalmic and neu- rological. We describe a case of squamous cell carcinoma of the eyelid in a young male Purpose: Radiosurgery at a linear accelerator is one of the possibilities to treat patient, aged 25, with a history of xeroderma pigmentosum. the patient under- uveal melanoma. Stereotactic radiosurgery is provided with the use LINAC went oncological tumor resection with eyelid reconstruction linear accelerator TRUEBeam STX dedicated to stereotactic irradiation. At Ophthalmologic examination at the level of the right eye found on inspection the Department of Radiation oncology at the Oncological Institute of St. red-eye with a lesion occupying the outer 1/3 of the free edge of the lower Elizabeth (OUSA) there are two completely identical LINAC -TRUEBeams. For uveal melanomas we are using 6 MV photons. Method: Since November 2024 we introduced the use of artificial intelligence (AI). The goal is to reduce time necessary for contouring of critical structures right eyelid and the anterior segment biomicroscopy reveals conjunctival hyperemia, diffuse and moderate with the presence of an ulcerative budding mass, measuring 1cm, occupying the outer 1/3 of the free edge of the lower right eyelid. (e.g. optical nerves, chiasma, brain stem, anterior segment) and eliminate in- The patient underwent oncological excisional surgery, the excisional piece terobserver variability in contouring these structures. By one-day session irradiation we are using rigid-frame-based fixation, im- mobilization of the affected eye is achieved by mechanical fixation of direct extraocular muscles to the stereotactic frame. After image fusion of CT and was sent for anatomopathological examination to assess the excision margins. Eyelid reconstruction was performed using a Mustardé rotational myocutane- ous flap. Keywords: Xeroderma pigmentosum; squamous cell carcinoma; eyelid re- MRI, critical structures (e.g. optic nerves, chiasma, brainstem, cochlea and construction; eyelid tumor lens) were contoured by AI or radiation oncologist. The applied radiation dose for melanomas is 35.0 Gy to the margin. Results: The final individual plane created by AI in comparison with manual contouring could save time but it is still necessary to make corrections by the EP-ONC-11 treating physician. Conclusion: The introduction of AI into treatment planning is a step towards standardization of the contouring of critical structures while saving time. Nevertheless, the contours must still be approved by team doctors and cor- relate with anatomical atlases and guidelines. The critical steps—such as importing images into treatment planning systems, and co-registering diagnostic images to treatment planning studies which are used for dosimetry calculation, target volume delineation, treatment plan de- Sclerochoroidal calcifications: a diagnostic challenge in subretinal lesions D. Vasović1, D.M. Rašić1, B. Dačić-Krnjaja1, T. Kalezić1, M. Mitrović2 1Eye Hospital University Clinical Centre of Serbia, Belgrade, Serbia, 2Mitrović Eye Clinic, Belgrade, Serbia velopment, evaluation of isodose distributions, treatment delivery, require sig- nificant manual effort and therefore are subject to substantial inter-physician cooperation. Purpose: Choroidal osteoma is a rare, benign ossifying tumor that can closely mimic other subretinal pathologies, posing significant diagnostic challenges. This case report highlights a patient with a subretinal lesion initially presumed to be a choroidal osteoma, which was subsequently identified as sclerochoroi- dal calcifications, a rare condition that is often idiopathic or associated with metabolic imbalances involving calcium and phosphorus. Case report: A 62-year-old male presented with a subretinal lesion located on the superior periphery of the left fundus. Ultrasonography revealed a plaque- like lesion measuring 9.96 x 8.07 mm in base and 1.05-1.54 mm in thickness, characterized by high reflectivity and acoustic shadowing, initially raising sus- picion for a choroidal osteoma. Fundus examination identified a yellowish, placoid subretinal lesion with ir- regular borders and intact retinal vessels traversing its surface. Fluorescein an- giography demonstrated arterial phase hypofluorescence with subsequent het- erogeneous staining of the lesion, persisting without leakage in later phases. These findings were more consistent with sclerochoroidal calcifications rather than a choroidal osteoma. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 161

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ELECTRONIC POSTER PRESENTATIONS Results: Sclerochoroidal calcifications are rare subretinal changes that may mimic other conditions such as choroidal osteoma or metastatic lesions. Imaging plays a pivotal role in differentiation, with ultrasonography confirm- ing calcifications and fluorescein angiography excluding vascular lesions. Unlike osteomas, sclerochoroidal calcifications are typically placoid, yellow- ish, and may be bilateral, often associated with metabolic abnormalities. Conclusion: This case underscores the diagnostic complexity of subretinal lesions and the importance of multimodal imaging in differentiating sclero- choroidal calcifications from other pathologies. Accurate diagnosis ensures appropriate management and better patient outcomes. EP-ONC-12 MALT lymphoma of the uvea with massive scleral and optic nerve infiltration: a case report D. Vasović1, D.M. Rašić1, B. Dačić-Krnjaja1, J. Vasilijević1, I. Kovačević1, T. Kalezić1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia Purpose: To present a rare case of extranodal marginal zone lymphoma (MALT lymphoma) of the uvea with extensive transscleral and optic nerve in- filtration, highlighting the diagnostic, therapeutic, and surveillance challenges of managing an indolent lymphoma with aggressive local manifestations. Case report: A 74-year-old male with a history of diabetes mellitus, hyperten- sion, and prior ophthalmic surgeries, including glaucoma surgery (2017) and cataract extraction, presented with progressive pain, periorbital hemorrhage, and complete vision loss in the left eye. Following a diagnosis of endophthalmitis, enucleation of the left globe was performed on September 12, 2024. Macroscopic examination revealed diffuse subretinal lesions extending across the nasal and temporal halves of the globe, with the largest lesion measuring 25 mm in base and 4 mm in prominence. Tumorous infiltration was observed through the sclera into the optic nerve and periorbital tissues. Results: Histopathological analysis revealed a diffuse lymphoid infiltrate pre- dominantly composed of small monocitoid lymphoid cells, with occasional lymphoblasts and immunoblasts. Immunohistochemical evaluation confirmed a B-cell phenotype (CD20+, CD79a+, Bcl-2+, MUM-1+) with low prolif- erative activity (Ki-67 < 5%), consistent with extranodal MALT lymphoma. Systemic evaluation via MSCT and MR imaging showed no evidence of dis- semination or residual disease. Laboratory tests, including serologies, were normal. Considering the lympho- ma’s indolent nature, no systemic therapy was initiated, and the patient was placed under regular surveillance. Conclusion: This case highlights the rare presentation of MALT lymphoma EP-ONC-13 Reactive retinal astrocytic gliosis with vasoproliferative features: a case report D. Vasović1, D.M. Rašić1, B. Dačić-Krnjaja1, T. Kalezić1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia Purpose: To present a rare case of nodular reactive retinal astrocytic gliosis with vasoproliferative features, emphasizing its clinical presentation, imaging characteristics, and histopathological findings to support accurate diagnosis and effective management. Case report: A 64-year-old female presented with progressive vision loss and elevated intraocular pressure in the right eye, unresponsive to medical therapy. She had undergone cataract surgery several years earlier at another institution. Visual acuity was limited to light perception. Examination revealed a dense anterior chamber with medium-reflectivity content, circumferential iris displacement, and a subluxated intraocular lens (IOL) with fibrous opacities. Corneal opacity obscured deeper structures, but ultrasonography revealed vitreous hemorrhage, preretinal fibrous bands, and a temporal retinal lesion measuring 9.55 mm in base and 2.79 mm in promi- nence, with retinoschisis. Due to the severity of the condition, enucleation of the right eye was per- formed. Histopathology confirmed nodular reactive retinal astrocytic gliosis with vasoproliferative features, explaining the progressive symptoms. Results: Examination revealed significant degenerative changes, including cholesterol deposits and chronic inflammation, accompanied by extensive gli- otic proliferation (GFAP+++), focal p53 expression, low proliferative activity (Ki-67 < 3%), and advanced retinal and optic nerve atrophy, highlighting the chronic and reactive nature of the condition. Conclusion: This case highlights the rare presentation of reactive retinal as- trocytic gliosis with vasoproliferative features, emphasizing its potential to mimic intraocular tumors. Imaging and histopathological analysis are essen- tial for diagnosis, particularly in cases with corneal opacity and prior ocular surgeries. Early differentiation from neoplastic conditions is critical for effec- tive management. EP-ONC-14 Rare occurrence of choroidal melanoma in an atrophic bulbus: a case report D. Vasović1, D.M. Rašić1, T. Kalezić1, I. Marjanović1 1University Eye Hospital Clinical Centre of Serbia, Belgrade, Serbia of the uvea with transscleral and optic nerve invasion. It underscores the im- Purpose: Choroidal melanoma is the most common primary intraocular ma- portance of histopathological and immunohistochemical analysis for accurate diagnosis and effective management. Regular follow-up is essential to monitor for recurrence or progression. lignancy in adults, but its occurrence in an atrophic bulbus is exceedingly rare, presenting a unique diagnostic and therapeutic challenge. Case report: This case report presents a 71-year-old female patient with a history of severe ocular atrophy, whose enucleated globe revealed a choroidal melanoma, staged as pT1a G1 (I). The atrophic globe measured 20x18x19 mm with a visible, sectioned optic nerve at 13-16 mm from the scleral margin. Macroscopically, the globe exhibited features of advanced atrophy and pig- mentation in the posterior segment. Microscopically, the tumor demonstrated diffuse immunoreactivity for Melan-A, HMB-45, SOX10, and S100, consistent with melanoma. The prolif- eration marker Ki-67 was low (<3%), indicating a slow-growing lesion. 162 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Immunohistochemical analysis confirmed the absence of epithelial and his- tiocytic markers (EMA and CD68), and no evidence of extraocular extension was identified. Results: This case highlights the exceedingly rare presentation of melanoma in an atrophic bulbus, a condition typically marked by profound structural and functional degeneration of the eye. The histopathological and immunohisto- chemical findings played a critical role in diagnosing and staging the lesion, which is essential in guiding management. This case emphasizes the need for vigilance in recognizing atypical presentations of intraocular malignancies, especially in eyes with pre-existing conditions like atrophy. Conclusion: Choroidal melanoma in an atrophic bulbus is an exceptionally rare and diagnostically challenging condition. This case highlights the impor- tance of thorough histopathological and immunohistochemical evaluation in identifying such atypical presentations. Early detection, accurate diagnosis, and a multidisciplinary approach are essential for optimizing patient outcomes and preventing complications such as metastasis. EP-ONC-15 Case report: lymphoma of the conjunctiva - multidisciplinary approach H. Nazarchuk1 1National Pirogov Memorial Medical University, Vinnytsya, Ophthalmology, Vinnytsya, Ukraine Female, 53 y.o. came to clinic in May 2024 with complains on hyperaemia, oedema, poor mucus discharge, discomfort in her left eye. Between Dec2023 - May2024 the patient was consulted by several public and private ophthal- mologists. Among different diagnosis there where: bacterial conjunctivitis, viral con- junctivitis, chronic conjunctivitis, allergic conjunctivitis of the left eye. Antibacterial drugs from different groups, antivirals, NSAID, steroids were prescribed. Objectively: “salmon patch”-like «+» tissue in caruncle, inferior fornical and bulbar conjunctiva of the both eyes (OS>OD). Diagnosis: Bilateral conjunctival lymphoma (?) Surgical biopsy and histopathological examination confirmed the diagnose: small cell lymphoma of the lymphocytic type. The patient was directed to oncologist and haematologist. No extraconjuncti- val localisation of lymphoma were found (complete blood count, serum chem- istry studies, CT of the orbit, CT scan of other commonly affected areas (neck, chest, abdomen, pelvis), and bone marrow aspiration and biopsy). • Despite the fact that the main treating doctor is an oncologist (oncohaema- tologist), ophthalmologist should remain active in the management of possible ocular complications during lymphoma treatment and follow-up. EP-ONC-16 Toxic skin reaction following use of 1% 5-flurouracil eye drops for ocular surface squamous neoplasia (OSSN) A. Mallu1 1Centre for Sight, Oculoplastic Surgery and Ocular Oncology, Hyderabad, India Topical 5-Flurouracil (5-FU) has been used effectively for the treatment of Ocular Surface Squamous Neoplasia (OSSN). It is usually well tolerated by the patients and does not cause many side effects. However we encoun- tered severe necrotising skin ulceration followed by hyperpigmentation of the periorbital skin following topical administration of the drug in four pa- tients.Although traditional treatment of OSSN is excision using a no-touch technique,in the last two decades, there has been a shift from surgery alone towards the use of topical chemotherapeutic agents alone or as adjuncts, be- fore or after surgery. Topical 1% 5-FU can also have side effects and adverse reactions , it is impor- tant to educate patients on the usage of the drug and also aiding the support staff in careful dispensing with the right concentration of the drug is impera- tive to avoid potential skin reactions. EP-ONC-17 Bilateral conjunctival lymphangiectasia in a pediatric patient: a case report I. Maduna1,2, D. Bajtl1,3, D. Biuk1,3, J. Barać1,3, M. Peček Prpić2, N. Kurtović1,4 1Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia, 2Osijek-Baranja County Healthcare Centre, Osijek, Croatia, 3University Hospital Osijek, Department of Ophthalmology, Osijek, Croatia, 4University Hospital Osijek, Department of Pathology and Forensic Medicine, Osijek, Croatia Clinical diagnosis: B-cell lymphoma of the marginal zone of lymphoid tissue Purpose: We present a rare case of bilateral conjunctival lymphangiectasia (MALT lymphoma). Treatment - Rituximab 6 courses, interval of 21 days. Local treatment - tear substitutes (sodium hyaluronate with trehalose) + follow-up by ophthalmolo- gist. with a three-year follow-up utilizing anterior segment optical coherence to- mography (AS OCT) imaging. Case report: During 2021 a 9-year-old female patient presented several times to Department of Ophthalmology with complaints of conjunctival red- Positron emission tomography after treatment showed absence of metaboli- ness and irritation. In the same period the patient developed facial erythema cally active neoplastic tissue and lymphadenopathy. due to rosacea and is otherwise healthy. Slit-lamp biomicroscopy revealed Conclusions: multiple bilateral conjunctival follicular formations in palpebral aperture • Conjunctival lymphoma is among the most common malignant conjunctival area. There was no history of trauma, ocular surgical interventions, or ir- tumours. radiation therapy. • It is extremely important for the general ophthalmologist to remember The microbiological analysis was sterile. Topical corticosteroids and ocu- “salmon patch” appearance or to suspect lymphoma in patients with chronic follicular conjunctivitis. • Surgical biopsy with immunohistochemical studies – golden standard of di- agnosis. lar lubricants were administered, but follicular formations persisted. AS OCT image displayed multiple hyporeflective subconjunctival spaces. Rheumatological and immunological evaluations were unremarkable. Magnetic resonance imaging of the brain was unremarkable on multiple oc- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 163

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ELECTRONIC POSTER PRESENTATIONS casions. In 2024, the patient developed bilateral nummular keratitis persistent for more than 6 months. Conjunctival status and AS OCT imaging showed no significant changes during the follow-up period. A biopsy of conjunc- tiva was performed: several characteristics of lymphangiectasia associated with rosacea were found. Edema, usually described in rosacea-related facial lymphedema, was not described. Conclusion: The etiology of nummular keratitis is unclear, possible due to previous history of adenoviral conjunctivitis or corneal hypersensitivity. Conjunctival lymphangiectasia is a rare, however without other pathology, a harmless eye condition. The connection of lyphangiectasia with rosacea is possible, however not certainly established. EP-ONC-18 Alveolar rhabdomyosarcoma of the nasal or paranasal sinuses with orbital invasion in young adults: presentation of 3 cases R.-M. Lopez-Ladron1, A. Bengoa-Gonzalez1, S. Perez-Trigo1, D. Ortiz-Martin2, M. Puchol Rizo1, B.-M. Laslau1 1Doce de Octubre Universitary Hospital, Ophthalmology, Madrid, Spain, 2Cruz Roja San Jose y Santa Adela Universitary Hospital, Ophthalmology, Madrid, Spain Introduction: Alveolar rhabdomyosarcoma(AR) of the nasal or paranasal si- nuses is very rare. Most published cases are in children or adolescents. Orbital extension is exceptional. Case 1: A 17-year-old female from an African country presented with signifi- cant facial swelling and destruction of ocular structures on both sides, along with bilateral amaurosis. Spontaneous bleeding. CT scan:Large left retro-or- bital mass with bone invasion, frontal brain involvement with a mass effect, and latero-cervical lymphadenopathy. Diagnosis:AR. No systemic metastases were found. The patient was entered into palliative care and passed away 10 days later. Case 2: A 24-year-old black male with nasal congestion, loss of visual acuity in the right eye, loss of facial sensation and proptosis. Preauricular, subman- dibular, and latero-cervical lymphadenopathy. CT scan:homogeneous mass with a destructive pattern in the right nasal cavity, affecting and destroying the ethmoid and orbit. Diagnosis:AR. Staging studies:negative. The patient underwent chemotherapy and radiotherapy. Two years later, the patient passed away due to complications associated with tumor invasion. Case 3: A 26-year-old black male with nasal congestion and epistaxis. He also presented with loss of visual acuity in the right eye and orbital inflamma- tion. Submandibular lymphadenopathy, proptosis, and inferior and lateral dis- placement of the eyeball with total ophthalmoplegia were noted. MRI: large mass in the nasal cavity with infiltration into the orbit, ethmoid sinus, and frontal sinus, extending into the anterior cranial fossa. Diagnosis:AR. Staging studies:negative. Treatment with chemotherapy and radiotherapy. The patient passed away 5 months later due to complications from tumor invasion. Conclusion: AR originating from the nasal or paranasal sinuses in adults has a poor prognosis when diagnosed with orbital invasion or the presence of lymph nodes. Early diagnosis is crucial for planning the best possible treatment. EP-ONC-19 The unlikely duo of orbital rhabdomyosarcoma and ulcerative colitis in a 8-year old boy: a case report M. Vivas1, B. Pombo1, T. Costa1, C. Monteiro1, D. Silveira e Silva1, M. Ferreira1, M.J. Santos1, I. Prieto1 1Unidade Local de Saúde Amadora Sintra, Lisboa, Portugal An 8-year-old boy was under evaluation for chronic diarrhea and weight loss when he developed a two-week progressive, painful edema of the right upper eyelid. Initial orbital CT in another institution revealed an isodense structure in the superior and lateral extraconal compartment, consistent with the lacri- mal gland’s position, suggesting dacryoadenitis and he was treated with ibo- prufen. Symptoms worsened within 3 days. He presented to our emergency department with increased swelling, prompt- ing a diagnosis of infectious pre-septal cellulitis and he was treated with amoxicillin-clavulanic acid.4 days later, he returned with severe swelling, hy- peremia, chemosis, and purulent discharge, requiring hospitalization. MRI revealed a superolateral orbital lesion deforming the globe and displac- ing it medially, downward, and anteriorly without clear cleavage from adja- cent structures, suggesting a neoplastic process. Intravenous methylpredni- solone and ceftriaxone were started, despite an unlikely infectious etiology. An incisional lacrimal gland biopsy was performed. Bloodwork and colonos- copy excluded infection and confirmed inflammatory bowel disease, a rare diagnosis at this age. Post-biopsy, visual acuity was 6/10 OD, with hypotropia and limited supraversion. Partial improvement in swelling was observed. Histopathology confirmed embryonal rhabdomyosarcoma. Rapid clinical deterioration followed, with worsening proptosis, chemosis, and ocular motility impairment, necessitating immediate chemotherapy. After 9 cycles, MRI revealed a smaller residual le- sion without globe deformation. The patient is now proposed for proton radiotherapy in Denmark. Orbital rhabdomyosarcoma, the most common malignant orbital tumor in children, frequently mimics inflammatory conditions, delaying diagnosis and concur- rent inflammatory bowel disease posed unique challenges in this case. Early diagnosis and multidisciplinary care are vital for better outcomes, as shown by this rapidly progressive case. EP-ONC-20 Low-flow vascular malformation of the orbit in a young adult C. Francisco1,2, A. Lemos1, A.R. Viana1, S. Alves Pereira1, J. Meira3, V. Leal3, P. Tenedório1 1Unidade Local de Saúde de Matosinhos, Ophthalmology, Matosinhos, Portugal, 2Faculty of Medicine, Porto University, Porto, Portugal, 3Unidade Local de Saúde de São João, Ophthalmology, Porto, Portugal Purpose: Vascular malformations are classified into high-flow and low-flow types (LFVMs), the latter including venous malformations, lymphatic malfor- mations, and combined lymphatic-venous malformations. Imaging is essential for diagnosing orbital LFVMs and identifying their intracranial associations. This work aimed to present a rare case of a young adult that presented with a LFVM. 164 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Methods: This case report was based on the clinical history, objective exami- nation, complementary exams and medical treatment. Informed consent was obtained. Results: A 20-year-old woman presented in the emergency room with prop- tosis and discomfort of the right eye for four days and eyelid hematoma since that day. The patient denied trauma or constitutional symptoms. Immunotherapy may cause ocular side effects such as uveal effusion syn- drome, choroidal sarcoid granulomas, and ocular neurotoxicity. The presented case illustrates the addition of choroidal metastasis as part of the differential diagnosis of optic disc edema. Ophthalmologic examination revealed hypertropia of the right eye and pain on dextroversion, with no limitation of movements; the remainder of the exami- EP-ONC-22 nation was unremarkable. She underwent CT and MRI of the orbits. The CT scan showed a well-defined retrobulbar mass in the right orbit, predominantly in the intraconal compart- ment, isodense with slight homogeneous contrast enhancement, pushing the eye forward slightly but not deforming it. On the MRI the lesion was T1 isoin- tense, T2 hyperintense with fluid-fluid levels, without restricted diffusion and exhibiting a discrete marginal enhancement after gadolinium administration. The visual fields were normal. The patient was diagnosed with LFVM and treated with oral prednisolone in a tapering regimen over two months. So far, the patient is stable with improve- ment of the symptoms. Conclusions: LFVMs can present with symptoms like proptosis, edema and intraorbital hemorrhage. Diagnosis is based on clinical presentation, imaging MALT lymphoma masquerading as hypertensive keratouveitis A. Moscalciuc1, A. Paduca2, A. Corduneanu2 1“Timofei Moșneaga“ Republic Clinical Hospital, Ophthalmology, Chisinau, Moldova, Republic of, 2SUMPh „Nicolae Testemițanu“, Chisinau, Moldova, Republic of Purpose: To describe a case of mucosa-associated lymphoid tissue (MALT) lymphoma masquerading as unilateral hypertensive keratouveitis. Results: A 60-year-old male patient presented with right eye erythema, de- creased vision, and abnormal, painful sensation for 4 months, refractory to and pathology when tissues are available. Management includes observation, treatment. The right eye examination revealed ocular hypertension, conjuncti- val hyperemia, geographic corneal epithelial defect with circumferential cor- neal pannus, grade I hyphema, posterior synechiae. Conjunctival biopsy for the immunohistochemical stain and polymerase chain reaction of the right eye showed MALT lymphoma. Following R-CHOP regi- men, the patient´s ocular inflammation diminished with subsequent corneal leukoma formation. Conclusion: MALT lymphoma should be considered as differential diagnosis of refractory keratouveitis. sclerotherapy or surgery. Regular clinical evaluations and imaging studies are essential to monitor the progression of LFVMs, especially in asymptomatic cases. EP-ONC-21 Optic disc edema in a patient with oesophageal carcinoma R. Hristova1,2, A. Oscar1,2, R. Dzhambazov2, Y. Zdravkov1,2 1Medical University Sofia, Sofia, Bulgaria, 2University Hospital Alexandrovska, Sofia, Bulgaria A 51-year-old male was referred for evaluation of optic nerve elevation in the left eye. He reported gradual painless central vision diminution in the left eye over the previous 2 to 3 weeks. Peripheral vision was subjectively in- tact. His medical history included radically resected oesophageal carcinoma (T2cN2m0) with metastatic disease of the skin, lung and liver. He was under- going therapy with Nivolumab, Paclitaxel, Ramucirumab (VEGFR2 antago- nist) and Denosumab. Biomicroscopy demonstrated normal anterior segments bilaterally with brisk pupillary reactions to light and near with no relative afferent pupillary defect (RAPD). Fundus examination was normal in the right eye. The left eye dem- onstrated edematous optic disc with indistinct margins above the level of the surrounding retina with loss of normal foveal reflex. Upon further examination an oval yellow mass behind the optic nerve was observed. OCT of the left eye demonstrated cystoid macular edema with neu- rosensory detachment. Ultrasound revealed a solid choroidal mass surround- ing the optic nerve with homogeneous high internal reflectivity and satellite retinal detachment. The mass was interpreted as a metastasis on computed tomography. Treatment options with either photodynamic therapy or anti-VEGF were discussed with oncology, as well as a change in imunnochemotherapy. Unfortunately the patient deteriorated due to liver failure and perished 5 weeks later. Primary tumors are known in 67% of choroidal metastasis cases. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 165

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ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Paediatric Ophthalmology & Strabismus EP-PED-01 Ocular disorders in children with headache A. Kurent1 1Community Health Centre Ljubljana, Ljubljana, Slovenia Purpose: Headache is very common in children and adolescents and they commonly present to an ophthalmologist for suspected underlying ocular problem. The most common ocular causes are refractive error, impairment of accommodation, ocular surface disease, optic neuritis, uveitis and other eye conditions. Results: At least one videographic image was available from 11.334 of the 33.890 patients I examined during this observation period. 38% of the images reveal the anterior segment (median age 69 years), 27% the fundus (median age 69 years) and 25% binocular overviews (among them 9% oculoplas- tic/16% strabologic – the latter median age 10.5 years). There is a nearly equal quantity of images from the groups: 1. Orthotropia (e.g., with pseudostrabismus or a positive family history for squint), 2. Manifest squint without, and; 3. With eye-muscle surgery. Conclusions: Strabology is extremely underrepresented in ophthalmologi- cal imaging, and its potential role in diagnostics is being seriously under- estimated. A potential reason for this is that both experience with recording procedures as well as theoretical knowledge about squint are necessary. We also demonstrate that for good imaging results specific orthoptic findings need specific age-adjusted videographic strategies. Strabological imaging has great potential to be a highly rewarding field for orthoptists. The purpose of the study was to identify ophthalmological disorders that could potentially cause headache in order to determine the prevalence of ophthalmo- EP-PED-03 logical disorders among children with headache. Mehods: All children included in the study were referred to the ophthalmolo- gist by the pediatrician or pediatric neurologist due to any sort of headache and every child underwent complete ophthalmological examination. Primary outcome was prevalence of one or more findings that might indicate an ocular cause of headache or refractive issues or any other ophthalmological findings that could explain headache. Results: A total of 155 patients were included in this study (from 4 to 19 years old, mean 11.5 years). A significant ophthalmologic disorder was found in 6.4% children with headache and most common ophthalmologic disorder in the study was refractive error in 4.5%. Painful eye movements were reported in 1.3% at the examination and 0.6% had elevated optic discs nasally. Conclusions: Most children who were referred to the ophthalmologist by their pediatrician due to the headache had a normal eye examination. Pediatricians should probably first consider more prevalent underlying reasons for the head- ache as are migraine, tension-type headache and viral illness, and also more severe reasons such as intracranial processes. In addition to that, a full oph- thalmologic examination should be available. EP-PED-02 Strabology – still seeking the place it deserves in ophthalmological imaging M.-M. Gellrich1 1Ophthalmological Practice, Kellinghusen, Germany Purpose: The author has developed imaging methods aiming to capture near- ly every ophthalmological disease with a slit lamp video console. Which part of photo documentation can be assigned to strabology in an ophthalmological primary care unit without patient selection? How can we strengthen strabol- ogy’s role in ophthalmological imaging? Methods: In the years 2006-2023, we stored a total of 151.000 videographic images in my practice’s documentation system. Of those, 1.000 images were randomly selected and assigned to one of three fields: the anterior segment, the retina (with fundus lens), or a binocular overview / strabology (with a hand- held minus lens in front of the slit lamp objective). Minimal anisometropia at the hyperopia threshold of 3.0 Diopters: a precipitating factor for strabismus, amblyopia and inferior oblique muscle overfunction in newborns N. Hajiyeva1,2, R. Hajiyev1,2 1National Ophthalmology Centre named after Academician Zarifa Aliyeva, Baku, Azerbaijan, 2Hatmedicine Klinikasi, Baku, Azerbaijan Purpose: This study aims to determine if anisometropia at the hyperopic re- fractive threshold of 3.0D, especially with genetic predispositions, contributes to the development of infantile accommodative esotropia and severe amblyo- pia. Methods: Ten clinical cases involving newborns, young children and adults with severe amblyopia and improper fixation were reviewed. All subjects had normal anterior segments and fundi. Refraction was initially measured with a Plusoptix refractometer before cycloplegia and confirmed using retinoscopy and a hand-held autorefractor, Sure Sight. Results: Anisometropia at the hyperopia threshold of 3.0D with varying degrees of astigmatism was observed in all children. Eyes with hyperopia exceeding 3.0D developed infantile accommodative esotropia. Corrective glasses applied before six months effectively resolved the esotropia, while prescriptions given after 8-18 months left a high degree of amblyopia with improper fixation. Adults demonstrated high degrees of amblyopia with im- proper fixation, suggesting early childhood anisometropia at the 3.0D thresh- old or associated with astigmatic components. Conclusions: The study illustrates that infantile accommodative esotropia fre- quently develops in children with anisometropia at the 3.0D threshold. Timely prescription of corrective lenses can prevent the onset of esotropia and severe amblyopia with improper fixation. Delayed intervention after 8-10 months often fails to correct esotropia and subsequent amblyopia. It is recommended that all children be screened at three months and prescribed corrective glasses if refractive anomalies, particularly anisometropia at the 3.0D threshold and astigmatism, are present to prevent future strabismus, overaction of the inferior oblique muscle, forced head pos- ture, and severe forms of amblyopia. 166 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-PED-04 EP-PED-05 Ocular movement abnormalities and ptosis after glaucoma surgery They see.... they learn: a school screening project in India C. Catti1,2, F. Tessitore1, D. Ferrari1, F. Milanesi1, S. Acerra1, L. Peci1, A. Rizzi1, I. Schiavetti3, C.A. Cutolo1, M. Iester1, A. Vagge1 1Clinica Oculistica - IRCCS Policlinico San Martino, DINOGMI, Genoa, Italy, 2Università degli Studi di Genova, DIMES - Dipartimento di Medicina Sperimentale, Genoa, Italy, 3Università degli Studi di Genova, DISSAL - Dipartimento di Scienze della Salute, Genoa, Italy Purpose: To evaluate the prevalence of complications such as ptosis, stra- bismus and the combination of both after glaucoma filtering surgery and de- termine which kind of filtering surgery is most likely to be linked to such complications. Methods: 705 clinical records of patients who underwent glaucoma filter- ing surgery at the University Eye Clinic of IRCCS Ospedale Policlinico San Martino, Genoa, from January 1, 2010, to December 31, 2020, were retrospec- tively evaluated. Filter surgical procedures were divided in three subgroups: without conjunctival opening “Ab interno”, with conjunctival opening “Ab externo” and procedures with “Muscle isolation”. Results: Twenty-six patients developed ptosis alone (3.7%), with two patients A. Sethi1,1, R. Sethi2, A. Sethi3, V. Sethi4, S. Sethi5, S. Sharan6, M. Rekhi7, A. Marshal8, D. Jackson9 1Arunodaya Deseret Eye Hospital, Paediatric Ophthalmology, Gurugram, India, 2Arunodaya Deseret Eye Hospital (ADEH), Ophthalmology, Gurugram, India, 3Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology, Gurugram, India, 4Arunodaya Deseret Eye Hospital (ADEH), Vitreo Retina Consultant, Gurugram, India, 5Arunodaya Deseret Eye Hospital (ADEH), Glaucoma Services: ADEH, Gurugram, India, 6Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology / Corporate Social Responsibility (CSR), Gurugram, India, 7Arunodaya Deseret Eye Hospital (ADEH), Community Ophthalmology: Admin, Gurugram, India, 8Charity Vision, INC, Community Outreach, Provo, Utah, United States, 9Charity Vision, INC, Community Ophthalmology: Visiting Ophthalmologist, Provo, Utah, United States Purpose: To Identify the incidence of refractive errors and other relevant ocular conditions in students studying from grade 3 to 12, in public ( read : developing bilateral ptosis, with a mean of 2.2 ± 1.08 procedures per patient. GOVT) schools. Highest incidence of ptosis was noticed in patients who underwent muscle isolation surgery (5.7%). Twelve patients developed strabismus alone, four Method: A list of rural based govt schools was prepared, in consultation with the district education dept,. and a mehthodology centered on the class / princi- underwent unilateral surgery and eight bilateral surgery, with an average of pal teacher of the sections of classes, were initiated. 3.3 ± 1.78 procedures per patient. Strabismus was more frequent following extraocular muscle manipulation surgery (7.5%), showing a statistically significant difference (OR: 6.57; 95% CI: 1.71–21.65; p = 0.003) Seven patients developed both strabismus and pto- sis (1.0%), one patient with bilateral ptosis. Four underwent bilateral surgery and three underwent unilateral surgery. The mean number of surgeries per patient was 2.9 ± 1.07, showing a statisti- cally significant difference compared to the uncomplicated glaucoma group (OR: 1.58; 95% CI: 1.01–2.25; p = 0.02). The prevalence of both ptosis and strabismus was higher after muscle isolation surgery (1.9%). Conclusion: Ptosis, strabismus and the combination of both are uncommon complications after glaucoma filtering surgery, mostly linked to surgical pro- cedures involving muscle isolation and manipulation. The teachers were given a training manual and explained how they were to conduct the vision screening of each eye, of each student in their class, with all particulars. Students identified in the teacher / preliminary round, are then examined by the mobile eye care team of our eye institute. Dry refraction is the norm, students requiring cycloplegic refraction, are ref- ered to our base hospital, after informing their parents, and the side effects. Once the refraction is completed, then each student get 2 pairs of spectacles, free of cost. Regular follow Up is organized , by our mobile team, at 6 monthly intervals, to asses compliance, change in prescription, etc. Results: The presentation will highlight the results covering the incidence and requirement of spectacles, other ocular disorders identified. Good Eye and health care information brochure / material is now being incor- porated, in the curriculum. Conclusion: The school screening project, the first of its kind was an eye opener. The need for spectacles, far surpassed , than expected. the children were given the basic „E’ based vision sheets, to check the vision of their parents, and friends, and it had a cascading effect ! School screening projects for visul rehabilitation and assesment play a critical role in the academic and overall development of children, from economically weaker sections of our society, especially in the developing world. 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ELECTRONIC POSTER PRESENTATIONS EP-PED-10 Facial asymmetry before and after early treatment of abnormal head posture caused by ocular problems Y. Adil Shakor1, M. Khorrami-Nejad1, M.R. Akbari2 1Tehran University of Medical Sciences - School of Rehabilitation, Tehran, Iran, Islamic Republic of, 2Tehran University of Medical Sciences - Farabi Eye Hospital, Tehran, Iran, Islamic Republic of Purpose: To compare the facial asymmetry in pediatric patients before and five years after the treatment of abnormal head posture (AHP) originating from ocular conditions. Method: In this consecutive, prospective observational case series study, we assessed the quantitative and qualitative facial asymmetry of pediatric patients with superior oblique palsy (n=8, 53.3%) and Duane retraction syndrome (n=7, 46.7%), who had AHP and underwent strabismus surgery, before and five years after the operation. Captured photographs of the patients` face were analyzed by CorelDRAW Graphics Suite X7 software to calculate the relative facial size (RFS) and fa- cial angle as well as evaluate hemihypoplasia, columella deviation, one-side cheek and nostril compression. Results: The mean pre-operative age of 15 patients was 3.8 ± 1.4 (range, 1-5) years. Facial asymmetry was found in 14 (93.3%) patients preoperatively, which decreased to 10 (66.7%) patients postoperatively. On evaluating quantitative facial asymmetry parameters pre- and postopera- tively, the mean facial angle decreased from 0.50° to 0.39°, and the mean RFS reduced from 1.034 to 1.004. Before surgery, hemihypoplasia, one-side cheek and nostril compression, and columella deviation were observed in 10 (66.7%), 8 (53.3%), 9 (60.0%), and 2 (13.3%) cases, respectively. Following surgery, there was a reduction of 20.1% in one-side face, 46.6% in cheek, and 46.7% in nostril compression. However, the frequency of columel- la deviation did not change following the treatment of AHP. The frequency of one-side cheek and nostril compression was significantly decreased following surgery (P=.011 and P=.012, respectively). Group B received one drop of atropine followed by three drops of artificial tears (approximately 0.031% atropine) for 6 months, then switched to one drop of artificial tears (approximately 0.063% atropine) for the next 6 months. Myopia progression was evaluated through changes in axial length and spheri- cal equivalents measured at baseline, 6 months, and 12 months. Results: The study analyzed 58 children: 30 in Group A (mean age: 8.7 ± 2.2 years) and 28 in Group B (mean age: 9.1 ± 2.0 years). Baseline axial lengths were 24.71 ± 1.05 mm for Group A and 24.90 ± 1.38 mm for Group B. At 6 months, axial length changes were 0.12 ± 0.15 mm in Group A and 0.17 ± 0.17 mm in Group B. From 6 months to 12 months, the changes were 0.17 ± 0.14 mm for Group A and 0.15 ± 0.12 mm for Group B. Both groups exhibited delayed myopia progression, with no statistically significant inter-group dif- ferences. In Group B, axial length changes between the two 6-month periods were not statistically significant (P=0.970). Conclusions: Dilution of 0.125% atropine eye drops with artificial tears ef- fectively slowed myopia progression in both groups. However, no significant differences were observed between the two dilution methods. These findings highlight the need for precise atropine formulations to optimize myopia con- trol. EP-PED-13 Correlation between retinopathy of prematurity and anemia in preterm babies in Albania E. Sinamati1, V. Mema1, A. Tandili1, I. Arapi1, S. Dama1, A. Hysenshahaj1 1University of Medicine, Tirane, Albania Purpose: This study aims to explore the correlation between anemia and the development of Retinopathy of Prematurity (ROP) in preterm infants in Albania, focusing on assessing the impact of anemia on the progression of retinal damage in this high-risk group. Method: A prospective cohort study was conducted at the two largest neona- Conclusion: Timely strabismus intervention for the treatment of AHP may tal intensive care unit in Albania, involving preterm infants born at less than help enhance facial symmetry in children. However, as this was an observa- 31 weeks gestational age. Hemoglobin levels were measured at birth, at 2 tional study without a control group, a causal relationship cannot be estab- weeks, and weekly thereafter. ROP screening was performed using indirect lished. EP-PED-12 Analysis of the effectiveness of atropine diluted with artificial tears in slowing myopic progression E.H. Jung1, H.H. Ryu1 1Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea Purpose: To evaluate the efficacy of atropine eye drops diluted with artificial tears in different ratios for slowing myopia progression in children. Methods: This retrospective study examined children diagnosed with myopia who were treated with 0.125% atropine eye drops, followed immediately by artificial tear administration. Subjects were divided into two groups based on the atropine dilution method. Group A received one drop of atropine followed by one drop of artificial tears (approximately 0.063% atropine) for 1 year. ophthalmoscopy according to national guidelines. Data on anemia severity, gestational age, birth weight, and the development of ROP were collected and analyzed. Statistical analysis was performed to determine the relationship be- tween anemia and the incidence and severity of ROP. Results: The study found a significant association between lower hemoglobin levels and an increased risk of developing severe stages of ROP. Infants with moderate to severe anemia in the first weeks of life had a higher likelihood of developing advanced ROP (Stage 3 and above). The incidence of ROP was higher in the anemic group compared to the non-anemic group, with a positive correlation between the degree of anemia and ROP severity in this Albanian cohort. Conclusions: Anemia is a significant risk factor for the development of Retinopathy of Prematurity in preterm infants in Albania. The study suggests that severe anemia increases the likelihood of advanced ROP. Early detection and management of anemia could reduce the incidence and severity of ROP, ultimately improving long-term visual outcomes for preterm infants in Albania. Further research is required to examine the underlying mechanisms and explore the best interventions. 168 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-PED-14 Targeted partial inferior rectus recession for small-angle vertical diplopia: insights from two cases M. Puchol-Rizo1, J.A. Reche Sainz1, T. García-Herrera Prada1, L. Alcalde-Blanco1, J. García-Andreu3, L. de Pablo Gómez de Liaño1 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital Arruzafa, Córdoba, Spain Purpose: To describe the use of partial inferior rectus (IR) recession as an effective surgical technique for correcting small-angle vertical strabismus and diplopia. This method involves partial weakening of the muscle by recessing either the temporal or nasal end by 2 mm, leaving a 2-mm segment intact for deviations under 10 prism diopters (PD). The technique is estimated to correct approximately 1.5 PD of deviation for each millimeter of recession. Methods: Two clinical cases from the strabismus section of the Ophthalmology Department, Hospital 12 de Octubre, were treated using partial IR recession. Both cases involved small-angle vertical diplopia without torsion, allowing non-absorbable suture use, age at operation, sex, date of operation, surgical indication, presence of TED, adjustable vs non-adjustable suture technique, surgeon training level, number of muscles recessed, IR distance recessed, and time from surgery to final follow-up. Results: 32 IR recession procedures were evaluated (26 absorbable, 6 non- absorbable cases) with a mean follow-up of 3.6 months. Success was defined as ≤5 prism diopters deviation. Both groups achieved similar success in verti- cal deviation control with no significant difference in success rates for near (p=0.48) or distance fixation (p=0.73). Overcorrection occurred in 23.1% (absorbable) and 16.7% (non-absorbable) cases, with no statistical difference (p=0.61). Logistic regression analysis was performed which showed that TED (p=0.09), surgeon training level (p=0.76), adjustable sutures (p=0.21) and number of muscles operated (p=0.12) did not significantly impact success for absorbable sutures. Conclusion: This study demonstrates that IR recession surgeries using ab- sorbable sutures yield outcomes comparable to those using non-absorbable sutures, with no significant difference in success rates and overcorrection rates consistent with existing literature. recession of either muscle end. Case 1 underwent a 2-mm temporal recession of the right IR, and Case 2 un- EP-PED-16 derwent a 3-mm temporal recession of the left IR. Results: In Case 1, a 28-year-old male with residual vertical diplopia following orbital trauma and multiple strabismus surgeries achieved resolution of diplopia after a 2-mm temporal IR recession. Stability was maintained at 1-month follow- up. In Case 2, a 75-year-old male with vertical diplopia associated with high myo- pia and amblyopia achieved significant improvement after a 3-mm temporal IR recession. Residual fusion was achieved with 6 PD of base-out prism, and stability was maintained at 1-year follow-up. Conclusions: Partial IR recession is a safe and effective procedure for manag- ing small-angle vertical strabismus and diplopia. By selectively weakening one end of the muscle, precise correction is achieved, minimizing the risk of overcorrection. Both cases demonstrated stable postoperative outcomes, vali- dating the efficacy of this technique for tailored surgical management. EP-PED-15 Comparative outcomes of inferior rectus muscle recession surgery using absorbable sutures versus non-absorbable sutures D. Shah1, V. Tang2, S. Jain2 1University College London, Medical School, London, United Kingdom, 2The Royal Free Hospital, London, United Kingdom Case report: scleritis-mimicking retinoblastoma relapse H.M. Wong1, M. Venkatraman1, M. Sagoo2,1, G. Negretti1, H. Petrushkin3, A. Reddy1 1The Royal London Hospital, Ophthalmology, London, United Kingdom, 2NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, Ophthalmology, London, United Kingdom, 3Moorfields Eye Hospital NHS Foundation Trust, Ophthalmology, London, United Kingdom Affecting 1 in 18,000 live births, retinoblastoma (Rb) is the primary malig- nant eye tumour in children and urgent treatment is necessary to salvage the eye, prevent extraocular spread and save lives. There are multiple modalities for treatment, including cryotherapy, laser, chemotherapy, surgery and radio- therapy. Chemotherapy can be delivered systemically, or via intraarterial and intravitreal injections. Intravitreal chemotherapy is normally reserved for Rb associated with vitreous seeding and is delivered in a safety-enhanced method thus minimizing risk of extraocular spread. Side-effects reported following intravitreal chemotherapy include cataracts, retinal toxicity and retinal detach- ment. We present a 5-year-old boy with bilateral Rb, with right eye Group B (cT1b) and left eye Group E (cT3c). He received 6 cycles of systemic vincristine, etoposide, carboplatin (JOE) chemotherapy, plaque brachytherapy and 5 ses- sions of cryotherapy to the right eye. He also received 3 doses of intravitreal 30 µg melphalan and 20 µg topotecan, and demonstrated an initial good re- sponse but relapsed after 5 months. After two further injections of higher- Purpose: Inferior rectus (IR) recession surgery is commonly performed for vertical strabismus, yet overcorrection risk remains high (21–50%) due to fac- tors like lower lid retractors, suture dissolution, and muscle tension in thyroid dose intravitreal 48 µg Topotecan, he developed a red painful eye and cho- roidal swelling. B-scan revealed scleral thickening and a ‘T-sign’ suggestive of posterior scleritis. This worsened despite high dose oral/topical steroids. eye disease (TED). Non-absorbable sutures have shown to reduce overcorrec- tion risk, however, they have drawbacks such as suture erosion, irritation and discomfort. This study aims to contribute novel insights by comparing clinical MRI was suggestive of choroidal invasion by tumour and the eye was enucle- ated, confirming Rb infiltration of the choroid together with scleral invasion and extra-ocular adipose tissue involvement. He was treated with intravenous outcomes of IR recession using absorbable and non-absorbable sutures. Methods: A retrospective study (01/12/20–31/01/23) was conducted at a tertiary referral centre on patients undergoing IR recession with absorbable and intrathecal chemotherapy according to our extraocular Rb protocol and is scheduled to have proton beam therapy in January 2025. This case highlights that Rb relapse can masquerade as posterior scleritis and must be carefully or non-absorbable sutures. The following data was collected: absorbable vs considered when encountered in clinical practice. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 169

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ELECTRONIC POSTER PRESENTATIONS EP-PED-17 Pediatric retinal detachment: mode of disclosure of a stickler syndrome I. Bechakh1 1University of Algiers I Benyoucef Benkhedda, Ophthalmology, Central Army Hospital, Algiers, Algeria Stickler’s syndrome, also called hereditary arthro-ophthalmopathy, is an in- herited polymarformative syndrome of dominant transmission, characterized by polyepiphyseal dysplasia which can lead to early osteoarthritis, bilateral myopia which progresses little but can lead to retinal detachment, and Facial dysmorphia which may diminish with age but which may include severe oro- facial abnormalities such as Pierre Robin syndrome. We report the case of a 14-year-old child diagnosed with an incomplete form but who meets the diagnostic criteria for this syndrome with „the ophthalmo- logical manifestations“ as the foreground. Our patient had fulfilled the diagnostic criteria with a score of 06 points ac- cording to the diagnostic criteria established by Rose PS et al within the fore- ground a major criterion „mode of the revelation of the disease“ the ophthal- mologic involvement. We found many surgical difficulties and unfortunately we could not reapply the retina despite the temporal retinectomy performed. For the prevention of the bi lateralization of the retinal detachment, a „described“ preventive laser banding was performed on the left eye. Examination of siblings „another sib- ling“ was normal suggesting incomplete penetrance in the mode of inherit- ance. This observation illustrates an exceptional etiology of retinal detachment, represented by a polymalformative osteoarticular syndrome, revealed by an extra-articular manifestation which can constitute the entire severity of this disease. EP-PED-18 Visual examination using the spot vision screener at schools for children with special needs K. Yasuoka1 1Yasuoka Eye Clinic, Kochi, Japan Purpose: In Japan, a photoscreener (Spot Vision Screener [SVS]) has greatly contributed to the detection of early amblyopia after it was recently introduced for vision screening of 3-year-old children. In this study, we performed visual examination using SVS as a part of the health screening by school doctors at schools for children with special needs in Kochi prefecture, Japan and evalu- ated its effectiveness. The purpose of this report is to disseminate information worldwide to those involved in improving the vision of children with physical disabilities. Participants and methods: Students (age: 3–18 years) from two schools for children with physical disabilities and a school for children with hearing- impairment where vision screening was performed between 2019 and 2023 were included. The success rate of SVS, the detection rate of suspected visual disorders for which students needed detailed examination before and after the introduction of SVS, and the detection rate of refractive error (spherical power of ±2.0 diopter [D] or more, cylindrical power of 2.0 D or more, and anisometropia of 1.5 D or more) were compared to evaluate the effectiveness of SVS. Results: In 2021, the success rates of SVS-based tests were 56/90 students (62%). The number of students who needed to undergo detailed visual ex- amination was 4/92 (4%) before 2018 and 14/90 (16%, P<0.02) after the in- troduction of SVS in 2021. Among them, disorders associated with refraction such as amblyopia and strabismus were detected in 0/4 students (0%) before and 12/14 students (86%, p<0.01) after the introduction of SVS. In 2023, 5 students who were suspected of having ametropic amblyopia started treatment with eyeglasses, which improved their corrected visual acuity to 20/20 (6/6) or better. Conclusion: SVS is useful for performing vision screening of children with physical disabilities who are unable to sufficiently cooperate and have dif- ficulty undergoing evaluations of their visual development. EP-PED-20 Continued progression in children who are on a tapering frequency of atropine eye drops for myopia control K.-L. Loh1 1Singapore National Eye Centre, Myopia Service, Singapore, Singapore Introduction: Atropine eye drops are effective in reducing myopia progres- sion in children. There is no current recommendation on when or how to stop the treatment. This study aimed to assess the proportion of children who con- tinued to exhibit myopic progression while tapering atropine eyedrops, and analyse factors associated with this. Method: A retrospective review of clinical data from 2020-2021 was per- formed on patients above 12 years of age who were on a tapering frequency of atropine eyedrops. The patients were divided into continued progressors (CP) and non-progressors (NP). Continued progressors (CP) were defined as those who increased more than 0.15mm axial length (AL) and/or -0.5D spherical change (SPH) after 1 year of tapering. The 2 groups were analysed for factors associated with continued progression. Results: A total of 162 eyes were included. For the entire cohort, there was a mean increase of 0.08+/-0.11mm axial length (AL) change and -0.12+/-0.36D spherical change (SPH) at 1 year with the tapering regime. There were 40/162 (24.7%) eyes that continued to progress. At the start of tapering, the CP group had higher mean myopia (-6.68D vs. -5.85D, p=0.04) and longer mean axial length (26.39mm vs. 25.88mm, p=0.02). Male gender was also associated with continued progression (OR 2.89, 95% CI 1.36-6.14, p=0.005). Age was similar in both groups. Conclusion: Overall, older children (>12 years of age) who were on a taper- ing frequency of Atropine eyedrops were stable after 1 year. However, there was a significant proportion of children who continued to progress. Patients who are male and/or have higher myopia may be at risk of continued progres- sion and may warrant a longer treatment period. 170 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-PED-21 Reading performance under a virtual reality environment in children with intermittent exotropia S.A. Chung1 1Ajou University School of Medicine, Suwon, Korea, Republic of Purpose: To investigate the reading performance in children with intermit- ter) compared to the constant group (-0.63±4.41 diopter) (P<.001). Moreover, the mean angle of horizontal and vertical deviation at distance and near in patients with constant exotropia was significantly higher than in the intermit- tent cases, either when there was a dominance in one eye or in cases with no dominance (P<.001). Amblyopia was found in 38.3% of cases with constant and 13.1% with intermittent exotropia (P<.001). Anisometropia was observed in 821 (19.34%) with constant and 88 (4.6%) with intermittent exotropia (P<.001). Conclusion: Constant exotropic patients had worse BCVA, larger angle of tent exotropia (IXT) under a virtual reality (VR) system presenting an image deviation, and higher prevalence of amblyopia and anisometropia compared separately to each eye. to the intermittent cases. Methods: Thirty-eight children aged 8-12 with IXT (17 untreated and 21 treated) were compared to twenty age-matched controls. Eye movements and trajectory of viewing were recorded with a head-mounted infrared video eye-tracker (120 frames/sec) while reading paragraphs of text under VR en- vironment. The trajectory distance of fixation, angle of eye movement, and execution time were evaluated. Interocular difference in each condition was also compared. Results: Children with IXT (30.8 ± 7.8 prism diopters, PD) showed a signifi- cantly longer trajectory of fixation than children treated with IXT (5.7 ± 9.2 PD, 1.4 years after surgery) and controls (p<0.01, 166.8 ± 21.5 voxels, 65.5 ± 27.8 voxels, and 62.0 ± 21.3 voxels, respectively). Angle of eye movement and execution time were also longer in patients with IXT than those treated with IXT and controls, while the differences were not significant (44.4 ± 12.7° vs 40.0 ± 12.1°, 40.2 ± 10.9°, and 75.5 ± 21.2 secs vs 69.9 ± 16.5 secs, 69.1 ± 18.2 secs, respectively). The interocular differences did not differ between the groups. In patients with IXT, the trajectory distance was correlated with fusional control, but not with EP-PED-23 Visual outcome in prematurely born children L. Bineva1, G. Dimitrova1, N. Veleva1, O. Mladenov1, V. Haykin1, A. Levi1, G. Dimitrov1, Y. Kyneva1, A. Oscar1 1Medical University of Sofia, Department of Ophthalmology, Sofia, Bulgaria Prematurely born infants are at a higher risk for developing adverse visual outcomes (AVO). Part of these patients are diagnosed with retinopathy of pre- maturity (ROP), however in the rest of the cases the AVO cannot be attributed to this condition. The purpose of this paper is to compare the incidence of AVO in prematurely angle of exodeviation. born children with and without ROP. Conclusions: Children with IXT showed a longer trajectory and higher bin- We reviewed the medical records of 74 children born before 32nd week of ocular disconjugacy during VR reading compared to those treated with IXT gestation: Group 1 - 50 children without ROP; Group 2 - 24 children, diag- and controls, suggesting that IXT is easily manifest under a VR environment. nosed with ROP, and compared the incidence of AVO among them. Decreased best corrected visual acuity (BCVA) in at least one of the eyes is reported in 11 out of 21 (52.38%) verbal children from Group 1. In Group 2, 13 out of 15 verbal patients (86.66%) had a decreased BCVA. In Group 1, 34 out of 50 patients have a refractive error (68%), distributed as it follows: astigmatism - 21 affected children (42%); myopia - 8 children (16%); hypermetropia - 15 children (30%). In the second group, the children with a refractive error are 23 out of 24 (95.83%): 18 of which are with astigmatism (75%), 15 - with myopia (62.5%), 5 - with hypermetropia (20.83%). Regarding the orthoptic status, in Group 1, 11 out of 50 children have a devia- tion (22%), as 2 of them have heterophoria (4%), 3 children have exotropia (6%), 6 children - an esotropia (12%), 1 patient (2%) - a vertical deviation. In Group 2, 9 out of 24 patients have a deviation in the orthoptic status (37.5%): 1 child has a heterophoria (4.16%), 1 has an exotropia (4.16%), 5 children have an esotropia (20.83%), 2 have a vertical deviation (8.33%). The incidence of AVO among the prematurely born children lies in-between this of the general population and the children diagnosed with ROP. More data is needed to conclude the degree to which prematurity-related risk factors play an independent role in the development of AVO. Our results are insufficient to prove any statistical significance and further analysis is necessary. EP-PED-22 Clinical features in patients with acquired intermittent and constant exotropia who underwent surgery M. Khorrami-Nejad1, M. Akbari1, E. Azizi2, A. Hadi1 1Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of, 2University of Melbourne, Melbourne, Australia Purpose: Acquired exotropia mostly manifests as an intermittent form, and very few cases show constant exotrpia. However, the differences in the clini- cal features of the constant and intermittent exotropia patients has not been clear yet. Methods: We retrospectively evaluated 6159 patients with exotropia from 2012 to 2022 in Farabi Eye Hospital, Tehran, Iran. The preoperative data col- lected were best corrected distance visual acuity (BCVA), spherical equivalent refractive error, amount and laterality of exotropia, presence of amblyopia and anisometropia. Results: The mean age at the time of surgery was 21.9±13.8 (range, 2–77) years and 3104 (50.4%) cases were male. Constant and intermittent exotropia were observed in 4244 (68.9%) and 1915 (31.1%) cases, respectively. BCVA was significantly worse in the constant than in the intermittent group (P<.05). In cases with dominancy, the non-dominant eye in intermittent exotropia pa- tients showed significantly more minus spherical equivalent (-1.28±3.03 diop- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 171

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ELECTRONIC POSTER PRESENTATIONS EP-PED-24 EP-PED-25 Juvenile idiopathic arthritis over 20 years: characteristics of affected children, treatment approaches, uveitis incidence, and ocular complications M. Andersson Gronlund1, M. Papadopoulou2, R. Jernkrok3, N. Abedi1, E. Karlsson1, M. Damgaard4, S. Berg5, P. Lundgren6 1Faculty of Medicine and Health, Örebro University, Department of Ophthalmology, Örebro, Sweden, 2Capio Eye Clinic, Gothenburg, Sweden, 3Region Västerbotten, University Hospital of Umeå, Department of Ophthalmology, Umeå, Sweden, 4Paediatric Immunology and Rheumatology, the Queen Silvia Children’s Hospital, Gothenburg, Sweden, 5Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Department of Pediatrics, Gothenburg, Sweden, 6Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, The Sahlgrenska Centre for Paediatric Ophthalmology Research, Department of Clinical Neuroscience, Gothenburg, Sweden Purpose: To assess and compare the characteristics, therapy interventions, in- cidence of uveitis, and ocular complications in children with juvenile idiopath- ic arthritis (JIA) who were screened and examined for uveitis in Gothenburg, Sweden, over a 20-year period. During the second half of this period, there Association of depression and anxiety symptoms with high myopia in adults: a SMOTE-enhanced analysis of KNHANES 2020–2021 K.H. Kang1, S.H. Park1, C.H. Song1, S.Y. Kim1, J. Lee1, M.G. Huh2, Y.K. Kim1 1Seoul National University Hospital, Seoul, Korea, Republic of, 2Yeungnam University Hospital, Daegu, Korea, Republic of Purpose: To investigate the association between high myopia and the severity of depression and anxiety symptoms in Korean adults, and to evaluate how these associations vary across different sociodemographic and health status groups. Methods: Data were analyzed from the Korea National Health and Nutrition Examination Survey (KNHANES) 2020-2021. Depression symptoms were evaluated using Patient Health Questionnaire-9 in 2,994 participants aged ≥40 years (2020), categorized as mild-to-severe (≥5), moderate-to-severe (≥10), and moderately severe-to-severe (≥15). Anxiety symptoms were assessed using Generalized Anxiety Disorder-7 in 2,928 participants aged 19-59 years (2021), categorized as mild-to-severe (≥5), moderate-to-severe (≥10), and severe (≥15). High myopia was defined as spherical equivalent ≤-6.0 diopters in both eyes, measured using a Topcon KR8800 autorefractor. was an increasing use of biological immunomodulatory treatments. The Synthetic Minority Over-sampling Technique was applied to address Method: Data were retrospectively collected from children with JIA who class imbalance. Multiple logistic regression models were adjusted for age, were examined for uveitis at Queen Silvia Children’s Hospital, between 2012 sex, household income, education level, marital status, self-rated health status, and 2021. These results were compared with those from a previously pub- lished study, the first cohort, screened between 2002 and 2011 at the same hospital. Results: The first cohort (2002–2011) included 299 children, while the second cohort (2012–2021) included 253. The median age at the time of JIA diagnosis was 5 years (range 1–15) for both cohorts, and girls were more frequently affected in both groups, comprising 68.9% in the first cohort and 72.7% in the second cohort. Oligoarthritis was less common in the first cohort (57.5%) compared to the second cohort (72.7%) (p<0.001). The frequency of ANAs was similar between the cohorts, 57.9% in the first co- hort versus 57.6% in the second cohort. Uveitis was more prevalent in the sec- ond cohort (17.0%) compared to the first cohort (10.7%) (p=0.032). However, ocular complications were less frequent in the second cohort, although not significantly (34.9% vs. 46.9% in the first cohort, p=0.34). Systemic treatments, particularly biological immunomodulatory therapies, were more commonly used in the second cohort (42.7%) compared to the first cohort (24.4%) (p<0.001). Conclusion: Over the 20-year period, a higher occurrence of uveitis was ob- served in children with JIA in the second cohort. Despite the higher incidence of uveitis, ocular complications were numerically less common in the second cohort, suggesting a potential beneficial effect of biological immunomodula- tory treatments in managing JIA-related uveitis. hypertension, diabetes, and body mass index. Results: Among all participants (N=5,922), the prevalence of high myopia was 1.9%. High myopia showed progressively stronger associations with in- creasing symptom severity. For depression, adjusted odds ratios (aOR) were 1.008 (95% CI: 0.939-1.082) for mild-to-severe, 1.085 (95% CI: 1.002-1.175) for moderate-to-severe, and 1.390 (95% CI: 1.288-1.500) for moderately severe-to-severe symptoms. For anxiety, aORs were 1.039 (95% CI: 0.965-1.119) for mild-to-severe, 1.104 (95% CI: 1.029-1.185) for moderate-to-severe, and 1.178 (95% CI: 1.070- 1.296) for severe symptoms. Conclusions: In this study using nationally representative survey data, high myopia was associated with increased risk of severe mental health symptoms. EP-PED-27 Familial steep corneas in posterior polymorphous corneal dystrophy 3 due to a novel ZEB1 Gene mutation O. Spierer1, T. Koval1, E. Banne1, E. Neimark1 1School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel Purpose: To present four family members with posterior polymorphous cor- neal dystrophy, steep non-keratoconic corneas and myopia caused by a previ- ously unknown genetic alteration in the ZEB1 gene. Methods: Ophthalmic examinations and corneal curvatures analyses were performed for all patients. Whole exome targeted gene panel sequencing was performed for one patient. Pathogenic variant confirmation and segregation of variant was performed for all four patients using Sanger sequencing. 172 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Results: A mother and her 3 children presented with bilateral diffuse corneal opacities, vesicular aggregates at the Descemet’s membrane level and en- EP-PED-29 dothelial stippling, compatible with the diagnosis of posterior polymorphous corneal dystrophy. Correlation of refractive error with anisometropia development in early childhood All patients had steeper than average keratometry readings with normal globe axial lengths and refractive moderate to extremely high myopia, ranging from -2 diopters to -16.5 diopters (spherical equivalent). The younger patients had more severe findings, with the youngest, an 11-months old female, presenting with keratometry readings of 66.72 × 69.48 @ 132° and 66.10 × 67.32 @ 34° in the right and left eyes, respectively. The ZEB1:c.794-1G>A;chr10-31809053G>A; NM_001174096.2 mutation was detected in all patients. O. Spierer1, I. Nitzan2, A. Achiron1, M. Kinori1 1School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel, 2Hadassah-Hebrew University Medical Center, Jerusalem, Israel Purpose: To investigate the relationship between the type and severity of re- fractive error and anisometropia development in preschool children. Conclusions: We describe a novel ZEB1 mutation associated with posterior Methods: In this retrospective cohort study, data from one of the national polymorphous corneal dystrophy, steep non-keratoconic corneas and myopia. Health Maintenance Organizations (HMO), were analyzed. The study includ- Posterior polymorphous corneal dystrophy 3 should be considered not only as ed all isometropic children aged 1 to 6 years, re-examined for refraction at an endothelial pathology but also as an ectatic disorder and ruled out in young children presenting with high myopia. EP-PED-28 Parental compliance with preschool vision screening test O. Spierer1, H. Kerner Lavi1, I. Trifonov1, O. Reitblat1, T. Koval1 1School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel Purpose: To assess the barriers to parental compliance with preschool vision least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spheri- cal equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors. Results: Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs in- creased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using screening tests and the recommended follow-up eye care. a stricter anisometropia criterion. Methods: In this prospective study, parents were asked for consent for their Conclusions: Children aged 1 to 6 years, initially without anisometropia but children to participate in a vision screening test. Parents whose child did not showing increasing severity of myopia, hyperopia, or astigmatism, are more participate due to lack of parental consent and parents whose child failed the likely to develop anisometropia. This underscores the importance of follow-up screening test were contacted by telephone and given a standardized question- refractive measurements within this population to promptly diagnose and treat naire to identify potential barriers for compliance. anisometropia and prevent potential visual complications. Results: A total of 1511 children attending 46 preschools (mean age 4.76 years ±0.76, 51.3% boys) were eligible for vision screening. Consent was given by the parents of 1295 children (85.7%). Lack of consent in children who had never been examined by an ophthalmologist was primarily due to unaware- ness of the screening test or other logistical reasons (117 cases, 92.1%). Of the children screened, 140 (11.1%) failed the test and 80.0% of their parents adhered to the recommended follow-up eye care. Parents who followed the screening vison test recommendations were more likely to be native language speakers (82.8% vs 58.8% mothers and 88.9% vs 60.0% fathers; p= 0.049 and 0.015, respectively). There was a higher chance of at least one parent being native-born if recommendations were followed (90.6% vs 58.8%, p=0.004). All other factors tested were insignificant. Conclusion: Parental consent and cooperation with vision screening test and its recommendations were high. Migrant families are more likely to face chal- lenges in following vision screening test recommendations, underscoring the need for tailored approaches for specific populations. EP-PED-30 Personalized strategies for myopia control. How should we continue myopia control after 2 years of treatment? S. Gamboa Saavedra1,2, X. Martinez Calvo3, C. Aleson Cabrerizo4 1INNOVA Ocular/Verte, Paediatric Ophthamology and Strabismus, Barcelona, Spain, 2CEMO, Paediatric Ophthalmology and Strabismus, Barcelona, Spain, 3CEMO, Optometrist, Barcelona, Spain, 4INNOVA/ Verte, Optometrist, Barcelona, Spain Purpose: To evaluate and compare different strategies for myopia control treatment. And after 2 years of treatment, what should we do? Methods: We did a randomized study with 140 patients aged 10 to 16 years with myopia. They received treatment with atropine 0.01%, peripheral de- focus glasses or peripheral defocus contact lenses or a combination of two treatments. After 2, 3 or 4 years of treatment, we studied treatments effects on spherical equivalent and axial length. We studied whether we had to finish the treatment or if we should continue and how we should to continue the treat- ment of myopia control. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 173

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ELECTRONIC POSTER PRESENTATIONS Results: The group with atropine 0.01% had the biggest decrease of axial length and spherical equivalent remained unchanged at 60-75% in all groups in the first 3 months. The decrease in axial length elongation was maintained in all groups with atropine 0.01 and we found moderate progression in patients without atropine 0.01%. Spherical equivalent increased after treatment of control of myopia but the increase was less than one Diopter in all groups. Conclusions: According to the progression of the myopia and age of patient, if we have a low progression (axial elongation less than 0.1mm) we can con- tinue with the same strategy. If we have a moderate or fast progression (axial elongation of 0.1-0.2 mm or more), we can change the strategy or we can make combinations of treatments. After 2 years of treatment, we continue the treatment in patients aged 10-16 years. In patients aged 16 years or older who received atropine 0.01% for 2 or more years we could consider suspending treatment with atropine 0.01% and return to the treatment based on the evolution like “treat and extend”. EP-PED-31 Surgical outcome of unilateral recess-resect in convergence insufficiency type intermittent exotropia: comparison of two surgical formulae D.G. Choi1, N.J. Moon2, S.H. Park3 1Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Ophthalmology, Seoul, Korea, Republic of, 2ChungAng University Hospital, Ophthalmology, Seoul, Korea, Republic of, 3Nune Eye Hospital, Ophthalmology, Namyangju, Korea, Republic of Purpose: Various surgical methods have been tried to correct convergence insufficiency-type intermittent exotropia(CI-type IXT), but none of them showed consistent and satisfactory surgical outcomes. In this study, we com- pared the surgical results of monocular lateral rectus recession–medial rectus resection (RR) using two different formulae for CI-type IXT. Methods: We retrospectively reviewed the medical records of 138 patients who underwent unilateral RR for CI-type IXT with a postoperative follow-up of 6 months or more. The amount of RR was determined based on the aver- age of the distance and near angles of exodeviation in 58 patients (group 1), and the lateral rectus (LR) recession amount was based on the exodeviation at distance and medial rectus (MR) resection was done on the same amount as LR recession (symmetric RR) in 80 patients (groups 2). Surgical success was considered as an alignment between 10 PD exodeviation and 5 PD esodevia- tion at distance and near. Results: Group 2 showed significantly larger esodeviation at distance and near compared to group 1 (p=0.003) until postoperative 1 month, however, there was no significant difference in deviation angles between the two groups (p>0.05) from 3 months to 24 months. The near-distance difference was sig- nificantly reduced compared to preoperative status in both groups up to post- operative 2 years (p<0.05).: from 8.3 PD preoperatively to 1.0 at 24 months in group 1 and from 9.3 to 3.8 in group 2. However, this difference was not significantly different between the two groups (p > 0.05) and the success rate at 24 months was 72.7% and 67.6% in group 1 and 2, respectively (p = 0.795). Conclusion: The newly proposed surgical formula, symmetric RR, which pre- vents excessive resection of MR, demonstrated comparable surgical outcomes to the previously known formula in CI-type IXT. EP-PED-32 Incidence and clinical features of amblyopia in a population-based cohort B. Mohney1, A. Hattenhauer2, G. Ashby1 1Mayo Clinic, Ophthalmology, Rochester, United States, 2Nova Southeastern University, Medical Student, Fort Lauderdale, United States Purpose: The purpose of this study was to report the incidence and clinical features of amblyopia observed in a population-based cohort of children. Methods: The medical records of all patients < 13 years old diagnosed with any form of amblyopia by an eye care provider in a single county in the Midwestern United States from January 1, 2003, through December 31, 2014, were retrospectively reviewed. Results: A total of 971 children were diagnosed with amblyopia during the 12-year period, yielding an annual incidence of 275 per 100,000 children < 13 years old. The mean age at diagnosis was 5.75 years (range, 1 month to 12.9 years) and 455 (46.8%) were female. A family history of amblyopia occurred in 105 (10.8%) and 112 (11.5%) were born prematurely. The most frequent form of amblyopia was refractive (70.9%), followed by mixed refractive/ strabismic (15.8%), strabismic (10.8%), and deprivational (2.5%). Eighty-five (8.8%) of the 971 had bilateral amblyopia with a mean presenting vision of 0.38 logMAR in the worse eye (Snellen equivalent approximately 20/50). In the remaining 886 with unilateral amblyopia, the mean vision in the ambly- opic eye was 0.45 logMAR (Snellen equivalent approx 20/60; range 0.18 to 1.52). Conclusion: Amblyopia was more prevalent in this population-based cohort than most prior studies, affecting nearly 4% of children less than 13 years of age. A refractive error, whole or in part, was contributory in nearly 7 of 8 patients. EP-PED-33 Ophthalmic outcomes in children with spina bifida myelomeningocele in Ireland S. O’Regan1, M. Dunne2, L. Dunne3, T. Murphy1 1Children’s University Hospital, Temple Street, Dublin, Ireland, 2Mater Hopsital, Dublin, Ireland, 3Trinity College Dublin, Dublin, Ireland Purpose: To investigate the ophthalmic complications associated with spina bifida myelomeningocele (SBM) in Irish children and to evaluate the impact of spinal lesion levels and shunt status on visual outcomes. Methods: A retrospective audit was conducted on 129 children with SBM, examining visual acuity, refractive errors, strabismus, papilledema, optic atro- phy, and cortical visual impairment (CVI). The median age of participants was 6.9 years (interquartile range [IQR] = 7.07), comprising 69 females (53.5%) and 60 males (46.5%). Data were analyzed using chi-square and Kruskal- Wallis tests to assess associations between spinal lesion levels, shunt status, and visual outcomes. Results: The majority of lesions were lumbar (60.47%), followed by sacral (20.16%), thoracic (18.60%), and occipital (0.78%). Ventriculoperitoneal shunts were present in 67.44% of participants. Most children had good visual acuity, with visual impairment observed in 18.2%. Significant refractive errors were present in 40.8% of cases, whereas strabismus was observed in 33.3% of patients, predominantly esotropia. 174 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Papilledema, optic atrophy, and CVI were present in 12.4%, 5.4%, and 4.7% of participants, respectively. Higher spinal lesion levels were significantly associated with worse visual acuity (P = .019), whereas ventriculoperitoneal shunt status was significantly associated with papilledema (P = .034) and sig- nificant refractive errors (P = .019). No significant associations were found for strabismus, optic atrophy, or CVI. Conclusions: Ophthalmic complications such as refractive errors, strabismus, and visual impairment are common in children with SBM. The study found that higher spinal lesions were associated with worse visual acuity. Shunt placement was also associated with a history of papilledema and higher rates of significant refractive error. EP-PED-35 Development of vision, refraction and strabismus from 2,5 to 12 years - the Extremely Preterm born infants in Sweden Study – EXPRESS D. Tsamadou1,2, K. Källén3, A. Al -Hawasi4, A. Hellström5, G. Holmström6, F. Pedrosa-Domellöf7, K. Tornqvist8, U. Kjellström8, K. Hellgren1 1Karolinska Institutet, Clinical Neuroscience, Stockholm, Sweden, 2Örebro University Hospital, Ophthalmology, Örebro, Sweden, 3Lund University, Institution of Clinical Sciences, Lund, Sweden, 4Linköping University, Biomedical and Clinical Sciences, Linköping, Sweden, 5University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden, 6Uppsala University, Surgical Sciences/ Ophthalmology, Uppsala, Sweden, 7Umeå University, Clinical Sciences, Umeå, Sweden, 8Lund University, Clinical Sciences, Lund, Sweden Purpose: To follow the ophthalmological development in a national cohort of extremely preterm born (EPT, <27 gestation weeks) children from 2.5 to 12 years. Methods: EXPRESS included and followed prospectively all children born EPT in Sweden between April 2004 and March 2007 and matched controls born full-term. All surviving 462 EPT children and 340 controls were invited to participate in ophthalmological follow-up at 12 years. We analysed data collected at birth, 2.5, 6.5, and 12 years of age and from the medical records in EPT children, and data from ophthalmological examination at 6.5 and 12 years in controls. The variables studied were visual acuity with habitual correction, visual impairment according to WHO, cycloplegic refrac- tive errors, and manifest strabismus. Conclusions: We confirm that treatment-requiring ROP is a significant risk factor for visual impairment and strabismus. We conclude that emmetropi- zation is affected by both extreme prematurity and treatment-requiring ROP. EP-PED-36 Sickle Cell Retiniopathy in pediatric patients: exploring correlations and predictive factors N. Rodrigues Alves1, C. Barão1, P. Barros Silva1, I. Ludovico1, L. Costa1, E. Duarte Silva2, R. Anjos1, R. Serras Pereira1 1Unidade Local de Saúde de São José, Ophtalmology, Lisbon, Portugal, 2Hospital Dona Estefânia, Integrated Responsibility Center for Pediatric Ophthalmology, Lisbon, Portugal Purpose: Sickle cell retinopathy (SCR) is a serious complication of sickle cell disease (SCD). We aim to analyze clinical, laboratory, and doppler vascular parameters in pediatric SCD patients and identify risk factors for SCR and proliferative SCR (PSR). Methods: A retrospective study included pediatric SCD patients screened for SCR. Systemic, transcranialcervical doppler and ophthalmologic assessments were performed. Correlation analyses explored relationships between these parameters and SCR presence. Logistic regression identified predictive fac- tors. Results: We included 172 eyes from 86 pediatric SCD patients (mean age, 11.1 years; 57% male). SCR was diagnosed in 20 patients (23.3%), includ- ing 15 with non-proliferative (NPSR) and 5 with PSR. Significant correla- tions were found between SCR and higher frequency of vaso-occlusive-crises (VOC, ρ = 0.379, p < 0.001), lower fetal hemoglobin (HbF) (ρ = -0.363, p = 0.001), older age (r = 0.295, p = 0.006), and G6PD deficiency (ρ = 0.428, p < 0.001). Doppler evaluations showed reduced velocities associated with SCR (p < 0.05). Logistic regression identified G6PD deficiency (OR = 8.34, p = 0.014), increased VOC (OR = 2.22, p = 0.011), older age (OR = 1.26, p = 0.04), and lower HbF (OR = 0.89, p = 0.047) as predictors of SCR. Age had an 11.50-year cut-off, with 65% sensitivity and 64% specificity. For PSR, significant correlations included SC genotype (r = 0.728, p < 0.001) and higher hemoglobin (Hb) (r = 0.518, p = 0.019). Lower hydroxyurea doses were linked to PSR (r = -0.548, p = 0.012). Hb levels predicted PSR, with a 9.2 g/dL cut-off, providing 80% sensitivity and 86% specificity. Conclusions: This study identifies key risk factors of SCR and PSR in pedi- atric SCD patients, including older age, higher VOC frequency, G6PD defi- ciency, and lower HbF for SCR, and SC genotype and higher Hb (cut-off 9.2 g/dL) for PSR. Early screening and targeted management can prevent vision We included in the analyses data about gestational age, intraventricular haem- loss and improve clinical practice. orrhage, retinopathy of prematurity (ROP) and treatment, cerebral palsy and cognitive impairment. Results: At 12 years, the vision was examined in 332 EPT children and 189 controls. The mean visual acuity in the EPT group was lower than in the con- trol group (1.15, 95%CI [1.12-1.19] vs 1.33, 95%CI [1.29-1.37]). Fifteen (4.5%) EPT children had visual impairment. Risk factors for visual impairment were low gestational age (p=0.03), treat- ment for ROP, severe cerebral palsy and cognitive impairment (p<0.001). Cycloplegic refraction was measured in 298 EPTs and 181 controls. The development of refractive errors was similar between EPTs and controls, myopia was significantly higher among EPTs treated for ROP, while EPT chil- dren not treated for ROP were more hyperopic than controls. Strabismus was found in 65 of 338 EPT children (19%), 21 had exotropia and 44 had esotro- pia. Of those, 27 (41%) had received ROP treatment. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 175

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ELECTRONIC POSTER PRESENTATIONS EP-PED-37 Outcomes of flanged intrascleral haptic fixation of IOL implantation in pediatric cataract surgery S. Suwannaraj1, P. Teekakul1, N. Orprayoon1 1Khonkaen University, Ophthalmology, Khonkaen, Thailand Purpose: This study evaluates the outcomes of flanged intrascleral haptic fixation of intraocular lens (IOL) implantation using the Yamane technique in pediatric cataract cases. Methods: We conducted a retrospective review of the medical records for syndrome, 9 fragile X syndrome, 12 Angel-man syndrome, 11 Cohen syn- drome, and 31 cerebral palsy. Surgical results at 3 and 18 months of follow- up were analyzed. Regarding esotropia surgery, 83.9% had a deviation of less than 8 prism diopters at 3 months and 53.8% at 18 months of follow-up. Hypocorrection was seen in 7.7% and 3.5% and hypercorrection was observed in 8.4% and 52.7% at 3 and 18 months, respectively. For exotropia, 60% had a deviation of less than 8 prism diopters at 3 months and 22.5% at 18 months. Hypocorrection occurred in 35% and 75%, whereas hypercorrection was found in 5% and 2.5%, respectively. Conclusions: A higher prevalence of strabismus was found in these patients and the surgical outcomes were more difficult to predict. Patients with eso- tropia were more hypercorrected, whereas those with exotropia were more children who underwent Yamane technique IOL implantation, with a minimum hyporcorrected. follow-up period of 6 months, from Oct 2023 in a tertiary eye care center. The evaluated outcomes included best-corrected visual acuity (BCVA), prediction error of target refraction, and intra- and postoperative complications. Results: A total of 16 eyes from 10 patients were included in the analysis. The mean patient age at the time of surgery was 8.4 ± 2.3 years (range, 4-12). The average follow-up duration after surgery was 8.5 months. Majority of the cases were lens subluxation from Marfan syndrome. There was a significant improvement in mean BCVA, with an average change of 0.35 ± 0.2 logMAR (p < 0.001). The median preoperative target refraction was -0.73 (IQR -0.84, 1.87). The mean postoperative prediction error from target refraction was 1.14 ±1.90 diopters at 1 month and -0.18 ± 1.77 diopters at 6 months. The mean absolute prediction error at the 6-month follow-up was 0.57 (-0.99, 2.13) (p= 0.473) diopters. Postoperatively, optic capture at the iris was noted in 2 cases (14.3%) one week after surgery, which was successfully managed with di- lating drops without additional surgery. No intraoperative complications or instances of haptic exposure were observed in this study. Conclusions: The Yamane technique for IOL implantation in pediatric cata- EP-PED-39 Combination of highly aspherical lenslet target (HALT) technology and 0.01% atropine eye drops for the management of myopia progression M. Baldi1, A. Frattolillo2, P. Nucci3, M. Iester1, A. Vagge1 1Clinica Oculistica, DINOGMI, Università degli Studi di Genova, IRCCS Ospedale Policlinico “San Martino”, Genoa, Italy, 2UOC Oculistica, Ospedale dell’Angelo-Mestre, Mestre, Italy, 3Università degli Studi di Milano, Milan, Italy Purpose: This study evaluates the effectiveness of Highly Aspherical Lenslet Target (HALT) technology combined with Low-Dose 0.01% Atropine Eye ract patients yielded favorable visual outcomes. However, adjustments to the Drops in slowing myopia progression. distance of the scleral tunnel from the limbus may be necessary in some cases Methods: A retrospective case series was performed on young myopic pa- to minimize the risk of optic capture to the iris postoperatively. Overall, this fixation technique demonstrates reliable IOL stability. tients aged 6-18 years treated with HALT spectacle lenses (HALT group), 0.01% atropine eye drops (atropine group), or a combination of both (com- bined A+H group), alongside a control group using single vision lenses (SVL). Demographic data, cycloplegic autorefraction spherical equivalent refraction (SER), axial length (AL), and adverse events were assessed in both eyes at initial evaluation and over time. Results: A total of 175 patients were included: 41 in the HALT group, 48 in the atropine group, 33 in the combined A+H group, and 53 in the SVL group. The mean age at presentation was 9.7 years (range 6-13 years), with no significant age differences among groups (p > 0.05). All treatment groups showed significant reductions in myopia progression at 12 months compared to the control group (p < 0.001) for both SER and AL. The combined A+H group showed a significantly greater reduction in SER compared to the HALT and atropine groups (p < 0.03). A significant difference in AL was found only between the combined A+H and atropine groups (p < 0.05), and no significant difference was observed between the HALT group and the combined A+H group (p = 0.52). Conclusions: HALT spectacle lenses and 0.01% atropine eye drops were both effective in slowing myopia progression. The combined A+H treatment was more effective in reducing SER than the individual treatments, while it only showed greater success in AL compared to 0.01% atropine alone. EP-PED-38 Surgical treatment of strabismus in children with developmental delay A. Vagge1, A. Lembo2, P. Nucci3 1University Eye Clinic, IRCCS San Martino Polyclinic Hospital, DINOGMI, Genoa, Italy, 2Eye Clinic, San Giuseppe Hospital, Milan, Italy, 3University of Milan, Milan, Italy Purpose: To review the current literature, to provide a foundation of knowl- edge on strabismus surgery in patients with developmental delay, and to pre- sent results from the authors’ personal experience. Methods: The following terms were searched on PubMed: strabismus surgery, mental delay, developmental delay, Down syndrome, Angelman syndrome, cerebral palsy, hydrocephalus, Williams syndrome, fragile X syndrome, and fetal alcohol syndrome. Surgical outcomes were analyzed and discussed; only English articles were included. Medical records of 183 patients with develop- mental delay who underwent strabismus correction surgery from 2001 to 2020 were examined and discussed. Results: Articles were reviewed and analyzed, categorized based on the dis- ease. The authors’ experience included 183 patients with various diseases or syndromes: 44 Down syndrome, 40 fetal alcohol syndrome, 36 Williams 176 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-PED-40 Simultaneous sixth nerve paralysis palsy after transvenous embolization of carotid cavernous fistula and heavy eye syndrome: case report and literature review S. Rebocho Duarte1, V. Lobo1, I. Carneiro2, F. Jorge Teixeira3,4, R. Gama1 1Unidade Local de Saúde de Santa Maria, Department of Ophthalmology, Lisbon, Portugal, 2Unidade Local de Saúde de Santa Maria, Department of Neuroradiology, Lisbon, Portugal, 3Unidade Local de Saúde de Santa Maria, Department of Infeccious Diseases, Lisbon, Portugal, 4Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Introduction: Transvenous embolization (TVE) is a common treatment for carotid-cavernous fistula (CCF). However, TVE can lead to complications, including cranial nerve palsies, particularly affecting the abducens nerve. Heavy eye syndrome (HES), linked to high myopia, causes progressive eso- tropia and hypotropia due to muscle displacement. We present a rare case of simultaneous right sixth nerve palsy post-CCF embo- lization and contralateral HES, surgically managed with favorable outcomes. Case report: A 67-year-old female with pathological myopia was referred for diplopia and anomalous head posture (AHP). Five years prior, she underwent TVE for a right CCF draining into the superior ophthalmic and facial veins. The procedure successfully closed the fistula using seven coils via the superior ophthalmic vein. Post-procedure, she developed persistent right sixth nerve palsy with worsening diplopia. Previous to our observation, the patient underwent botulinum toxin (BT) in- jection of 5 units (U) on right eye (OD) 4 years before, and one year later a 7 mm right medial rectus recess associated with BT injection of 7.5 U with marginal improvement. On presentation, she had 40° rightward AHP, visual acuity of 20/40 on OD and 20/100 on left eye (OS), 45 prism diopters (PD) esotropia, and 25 PD left hypotropia. The axial lengths of OD and OS were 26.6 mm OD and 30.5 mm OS. Abduction was limited to -5 OD and -2 OS, with torsional nystagmus on right gaze. Magnetic resonance of the head and orbit revealed right lateral rectus atrophy, left superior rectus-lateral rectus band disruption, supporting the diagnosis of HES on the OS. Surgical treatment included a Nishida procedure on the OD and a Yokoyama procedure with medial rectus recession on the OS. Six months postoperatively, diplopia resolved, AHP improved to 10°, and alignment was significantly bet- ter, with residual 35 PD esotropia and 10 PD hypertropia. EP-PED-41 Septo-optic Dysplasia (Morsier´s Syndrome): Case Report J.F. Guerrero Villa1, B. Arias Cabello1 1UNAM / General Hospital of Mexico „Dr. Eduardo Liceaga“, Ophthalmology, Mexico City, Mexico Introduction: Septo-optic dysplasia, also known as Morsier’s syndrome, first described in 1956 by the Swiss neurologist Georges De Morsier, is presented as an association between different clinical entities, among which we find op- tic nerve hypoplasia, pituitary dysfunction and midline abnormalities. Its inci- dence ranges from 6.3 to 10.9 cases per 100,000 inhabitants/year and occurs equally in both sexes.Viral infections, vascular lesions, advanced maternal age and genetic mutations have been reported as etiologies. Most cases of Morsier syndrome are sporadic, but familial cases have been described associated with mutations in the following genes: HESX1, SOX2, SOX3, OXT2, PROKR2, FGF1 and FGF8. Case description: Female, 9 months old, presented with primary gaze de- viation since she was 3 months old. Ophthalmologic examination: blepharos- pasm with light stimulus, does not fixate or follow objects, normal pupillary reflexes, anterior segment without alterations. Endotropia of variable angle, with small hypertropia of the left eye. Ocular movements without limitations, pendular nystagmus of medium amplitude, slow frequency. Fundus (both eyes): optic nerve hypoplasia, left predominance, defined bor- ders, yellow coloration, macula:adequate foveolar brightness, applied retina. MRI reports: 1. Septo-optic dysplasia due to complete absence of septum pellucidum. 2. Hypoplasia of pituitary gland. 3. Chiasmatic hypoplasia. 4. Hypoplasia of both optic nerves, left predominance. Laboratory studies: LH 0.16 mIU/ml, GH 0.9 ng/ml, (hyposecretion, with re- spect to age). Evoked potentials: retino-cortical fiber conduction delay in both eyes. The clinical, radiological and auxiliary laboratory findings confirm the diagnosis of several entities, which, due to their association, converge within the spectrum of the aforementioned Morsier’s syndrome (Septo-optic dyspla- sia). EP-PED-42 Low-concentration atropine eye drops for controlling myopia progression: one-year prospective study results D. Simonavičiūtė1,2, A. Gelžinis1,2, A. Grzybowski3,4, R. Žemaitienė1,2 1Lithuanian University of Health Sciences, Department of Ophthalmology, Kaunas, Lithuania, 2Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Ophthalmology, Kaunas, Lithuania, 3University of Warmia and Mazury, Department of Ophthalmology, Olsztyn, Poland, 4Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland Purpose: To evaluate the impact of 0.01% and 0.03% atropine eye drops on myopia progression. Methods: Healthy children aged 6-12 years with cycloplegic spherical equiv- alent (SE) between -0.75D and -5.0D and astigmatism ≤1.5D were included. They were assigned to the control or atropine groups, with the option to use 0.01% or 0.03% atropine eye drops once in the evening for 1-year. Cycloplegic SE and ocular axial length (AL) were measured at the baseline and after 1-year follow-up. Myopia progression was evaluated by changes in SE and AL over 1-year, analysing measurement of the right eye only. Results: 69 children were in the control group, 62 children in the 0.01% and 33 in the 0.03% atropine groups. No statistically significant differences were observed in age (p=0.893) or gender distribution (p=0.332) between groups. Baseline SE and AL parameters were not statistically different between the groups as well (p>0.05). In terms of change in SE over 1-year, a significant difference was observed between the 0.03% and 0.01% atropine groups (p=0.008) as well as between the 0.03% atropine eye drops and control groups (p=0.040). Median SE Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 177

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ELECTRONIC POSTER PRESENTATIONS changes were as follows: -0.25 (-1.0 – 0.63)D, -0.50 (-1.50 – 0.50)D and -0.50 (-2.25 – 0.50)D in the 0.03%, 0.01% atropine eye drops and control groups, respectively. Statistically significant difference in AL change was also found between 0.03% and 0.01% atropine eye drops groups (p=0.021) and between the 0.03% atropine and control groups (p=0.008). Mean AL changes were: 0.18 (0.14) mm, 0.30 (0.18) mm and 0.31 (0.21) mm in the 0.03%, 0.01% atropine eye drops and control groups, respectively. Conclusion: The 0.03% atropine eye drops effectively controlled myopia pro- gression during 1-year, showing superiority compared to 0.01% atropine eye drops in reducing changes in SE and AL. EP-PED-43 Refractive errors and corneal curvature changes before and after horizontal strabismus surgery in strabismic patients A. Lekskul1, W. Wuthisiri1, T. Sujirakul1, C. Piamjitchol1, W. Korsantimukkang1, T. Saensupho1 1Ramathibodi Hospital, Ophthalmology, Bangkok, Thailand Purpose: To study refractive error and corneal curvature changes after hori- zontal muscle surgery by autorefractor machine. Methodology: This study is a prospective descriptive study, calculated n=112 EP-PED-45 Retinal imaging study of children (RISC) – the first 300 children K. Hellgren1, G. Magnusson2, H. Öhnell3, D. Tsamadou1, J. Gyllén2, L. Falkman4, Å. Wiksell5, J. Svoboda6, F. Lennartsson7 1Karolinska Institutet, Clinical Neuroscience, Stockholm, Sweden, 2University of Gothenburg, Clinical Neuroscience, Gothenburg, Sweden, 3Lund University, Ophthalmology, Lund, Sweden, 4Karolinska University Hospital, Pediatric Neurology, Stockholm, Sweden, 5Sahlgrenska University Hospital, Radiology, Gothenburg, Sweden, 6Karolinska University Hospital, Neuroradiology, Stockholm, Sweden, 7Lund University, Diagnostic Radiology, Lund, Sweden Purpose: Aim: To explore the occurrence and patterns of retinal hemorrhages (RHs) in children in various clinical conditions that are suggested to be dif- ferential diagnoses to abusive head trauma. Method: A Swedish prospective multicenter study including Stockholm, Gothenburg and Lund. Children are consecutively included for funduscopy and fundus photography, using a handheld fundus camera (Optomed Aurora IQ, USA). The study is ongoing until 1000 children have been examined from the following three groups: 1. All infants ≤ 18 months of age, who undergo an elective brain ultrasound examination on the indication increased head circumference. 2. All critically ill children < 15 years of age, with neurological symptoms, eyes, of patients aged 4-50 years old who were diagnosed with exotropia that require neuroradiological examination of the brain. or esotropia and underwent horizontal rectus muscle surgery. The patients 3. All children < 2 years of age, who seek care at the emergency department aged 4-18 years old will be performed cycloplegic refraction. Refractive er- and that undergo emergency neuroradiological examinations of the head. rors were measured by autorefractor NIDEK ARK-1a at 1 week, 1 month, 3 Results: Of the 300 children included so far, 6% had RHs. Cerebral hemor- months, and 6 months post-operation, including spherical equivalent, astigma- rhage due to ruptured arteriovenous malformations in adolescents were the tism, and corneal keratometry. Results: 34 eyes were included in this analysis with patients aged 4-40 years old (mean = 10 years old) who underwent MR recession, MR resection, LR recession, and LR resection. There are 23 esotropia patients (67.6%) and 11 exotropia patients (32.4%). Results of autorefraction change for post-opera- tion at 2 weeks for spherical change is 0.081D (p = 0.232), (95% CI: -0.141D to 0.303D); cylindrical change is 0.110D (p = 0.198), (95% CI: -0.151D to 0.372D); and astigmatism axis change is -1.118 degree (p = 0.469), (95% CI: -30.43 to 23.20 degree). Conclusion: The overall results of autorefraction show no statistically signifi- cant change for post-operation at 2 weeks. Due to the small size of the sample included in this analysis. Please note that this is ongoing research; we are including patients and evaluating new patients to achieve the goal (n=112) at post-operation at 1 month, 3 months and 6 months, respectively. most common associated condition. All RHs were few in numbers except in one child. One 3-month-old boy with severe coagulopathy due to Alagille syn- drome related vitamin K deficiency had RHs that were too many to count in one eye. Conclusions: Retinal hemorrhages were rare, found in 6% of all children and were few in numbers. All clinical conditions related to RHs were identi- fied, except in one case. Our results support previous reports that RHs due to trauma including abusive head trauma is distinguishable from other clinical conditions. EP-PED-46 Optical components in treated for ROP preterm born and full term born children with myopia from 6 to 14 years of age V. Marinov1, K. Simitchiev2 1Medical University Plovdiv, Department of Ophthalmology, Plovdiv, Bulgaria, 2University of Plovdiv „Paisii Hilendarski“, Department of Analytical Chemistry and Computer Chemistry, Plovdiv, Bulgaria Purpose: To investigate the optical components of myopic preterm born chil- dren from 6 to 14 years of age, treated for type 1 prethreshold ROP and com- pare them to full term born myopic peers in a single center. Methods: Twenty preterm born myopic children (35 eyes), treated for type 1 prethreshold ROP were included in the current study. The examination con- sisted of: cycloplegic refraction, assessment of axial length (AL), anterior 178 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS chamber depth (ACD), central corneal thickness (CCT), lens thickness (LeTh) Postoperatively, esotropic deviations were reduced to 4 PD (2-18), exotropic and corneal radius (Cr). Twenty-four full term born myopic children (48 eyes), age and gender matched, served as controls and underwent the same ophthal- mological tests. Both test and control groups were divided into children of ≤ than 10 years and > than 10 years of age. Myopia was considered as any cycloplegic myopic refraction with astigmatism not exceeding physiological (difference between the two principal meridians ≤ 0.75 dpt). Results: The mean gestational age of the preterm born children was 28 weeks of gestation (range 26 – 32 weeks) and mean birth weight was 1146 grams (range 780 – 1960 grams). In both age groups (≤ than 10 years and > than 10 years of age) there was a statistically significant difference between preterm and full term born children in ACD (p< 0.001 and p<0.001 respectively), and LeTh (p<0.001 and p=0.034 respectively). Myopia was significantly higher in prematures aged ≤ 10 years (p=0.012), but the difference did not reach sta- tistical significance between test and control groups with age > than 10 years (p=0.076). AL, CCT and Cr did not show statistical significance between test and control group neither in children of ≤ 10 years of age (p=0.156, p=0.081, 0.058 respectively), nor in children of > 10 years of age (p=0.08, p=0.892, p=0.067 respectively). Conclusion: The results of the current study did not find significant difference in axial length in preterm born myopic children treated for ROP and their full term born myopic peers, matched by age and gender. The differences in ACD and LeTh however imply that preterm delivery as well as treatment interven- tions disrupt the physiological postnatal development of the anterior eye seg- to 15 PD (8-16), and vertical to 4.5 PD (4-5). The median follow-up was 3.2 years (range 0.3–7.5 years). No cases of tumour relapse or metastasis occurred. Five patients required one surgery, and one underwent two staged surgeries. Conclusion: Strabismus surgery appears safe and effective in retinoblastoma patients, with no observed tumour recurrence or metastasis. This series in- cludes outcomes in patients treated with plaque brachytherapy, previously unreported. EP-PED-48 Evaluating the effect of a new myopia control spectacle lens among children in Israel: 24-month results Y. Morad1, O. Chassid2, Y. Cohen2 1Shamir Medical Center, Tel Aviv University, Ophthalmology, Zrifin, Israel, 2Ziv Medical Center, Bar-Ilan University, Ophthalmology, Safed, Israel Purpose: To investigate the effectiveness of a novel spectacle lens designed to slow the progression of myopia in children. ment and emmetropization of human eye. Design: A prospective, randomized, double blind clinical trial. Methods: One hundred twenty-six Israeli children aged 6-13 years with spherical equivalent (SER) refractive errors of –0.5 to –6.25 diopters (D) were randomized into either the Shamir Myopia Control (SMC) lens design group or the conventional single-vision spectacle lenses (SVL), the control group. Outcomes measured were changes in axial length and cycloplegic refraction as well as subjective rating of visual experience over a period of 24 months Results: After 24 months, in the subgroup of 6-10 year olds, AL progression were slowed by 0.28mm (44%, p < .001) while SER progression slowed by 0.53 D (46%, p < .05) respectively. Similarly, for the subgroup of children with 2 myopic parents AL progression were slowed by 0.18mm (31%, p < .001) while SER progression was slowed by 0.55 D (43%, p < .001) respec- tively. For the entire group AL progression were slowed by 0.17mm (34%, p <.01) while SER was progression was slowed by 0.27 D (26%, p < .05). These results were similar to the results obtained at 12 months (AL slowed by 0.11mm (35%) and SER slowed by 0.16 D (25%). Subjective visual experi- ence reported in the 12- and 24-month questionnaire revealed no difference between the SMC and SVL groups, and average daily wearing hours were also not different between the groups: 16.44 hours and 15.92 hours, respectively. Conclusions: After 24 months follow up, SMC lenses were effective in slow- ing the progression of SER and AL, especially for younger children and those having 2 myopic parents. The subjective rating of visual experience and the daily duration of use reported by the SMC group at 12 and 24 months was similar to that of the SVL control group. EP-PED-47 Evaluating strabismus surgery outcomes in retinoblastoma survivors V. Moynihan1, Z. Naeem1, M.S Sagoo1,2, N. Raoof1,3, MA. Reddy1,3 1Royal London Hospital, Ophthalmology, London, United Kingdom, 2Moorfields Eye Hospital, Ocular Oncology, London, United Kingdom, 3Moorfields Eye Hospital, Paediatric Ophthalmology, London, United Kingdom Purpose: To evaluate the outcomes of strabismus surgery in retinoblastoma patients. Methods: A retrospective review of patients treated at a single retinoblastoma centre who underwent strabismus surgery from January 2014 to January 2024. Procedures were performed by two paediatric ophthalmologists. Results: Six patients were included. The median age at retinoblastoma diag- nosis was 1.4 years (range 2 months–4.8 years), and the median age at strabis- mus surgery was 10.9 years (range 3.8–18.3 years). Four patients had bilateral disease, and two had macular involvement. All underwent systemic chemotherapy (vincristine, etoposide, carboplatin, 4-6 cycles); additional treatments included intra-arterial chemotherapy (n=4), cryotherapy (n=4), and plaque brachytherapy (n=2). The median interval from active retinoblastoma treatment to surgery was 7.1 years (range 2.5–15.4). Visual acuity was ≤0.9 logMAR in five affected eyes, with one patient achieving 0.1 logMAR. Strabismus etiologies included sen- sory strabismus (n=4), third nerve palsy from intra-arterial therapy (n=1), and congenital fourth nerve palsy (n=1). Three patients had exotropia, three were esotropic, and combined horizon- tal and vertical deviations were present in 3 patients. Preoperative deviations were a median of 50 prism diopters (PD) for esotropia (range 25–60), 25 PD for exotropia (range 18–45), and 12 PD for vertical deviations (range 8–16). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 179

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ELECTRONIC POSTER PRESENTATIONS EP-PED-49 Assessing parental knowledge and attitudes toward myopia management in children: a nationwide survey in urban areas of Turkey M. Kayabasi1, C. Durmaz Engin2, S. Koksaldi3 1Mus State Hospital, Ophthalmology, Mus, Turkey, 2Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Ophthalmology, Izmir, Turkey, 3Agri Ibrahim Cecen University, Ophthalmology, Agri, Turkey Method: We conducted a comprehensive search of MEDLINE, Embase, Cochrane and trial registries to identify randomized controlled trials (RCTs) and observational studies (OS) published between 2009-24. Studies reporting HRQoL across all age groups of myopes were included. The impact of myopia interventions on HRQoL was also analyzed. Results: The SLR identified 44 RCTs and 76 OSs, with a balanced distribu- tion across age groups and myopia severity. The NEI-RQL-42 was the most frequently used patient-reported outcome measure (n=20) with scores ranging from 46.6 to 95.11. Severe myopia significantly impacted daily life leading to reduced academic, professional, and recreational activities. Psychological impacts included low self-confidence, social anxiety, and fi- nancial stress. Younger myopes experienced notably lower HRQoL than em- Purpose: To assess parental awareness and knowledge regarding myopia con- metropic peers. Untreated or poorly managed myopia further exacerbated trol in urban areas of Turkey. HRQoL impairments among all groups. Materials and Methods: This cross-sectional survey was conducted between Refractive surgeries like laser-assisted in situ keratomileusis (LASIK) and June 1, 2024, and December 31, 2024, involving parents of children aged 4 photorefractive keratectomy compared to corrective eyewear such as glasses to 18 years with a diagnosis of myopia. Parents completed an online ques- tionnaire assessing their knowledge, attitudes, and practices regarding myopia management, including lifestyle factors and treatment options. or contact lenses, improved visual function, reduced dependence on corrective measures, and significantly enhanced psychological and social well-being in adults. Results: A total of 2,000 valid survey responses were analyzed. The mean age Pediatric myopes using orthokeratology (OrthoK) lenses experienced im- of the children was 11.2 years, with 57.8% being female. Most children were diagnosed between the ages of 7–9 (46.4%), and 52.8% used glasses with prescriptions of -1.00 to -2.75 diopters. Annual eye exams were reported in 62.2% of cases. While 59.8% of parents indicated that no alternative treatments were recom- mended beyond glasses, blue light-filtering lenses were suggested in 23.8% of cases. Regarding lifestyle, 46.6% of children spent 2–4 hours daily on screens, and 33.3% spent 1–2 hours outdoors. Sleep duration was adequate in 46.6% of cases, although only 27.3% of parents monitored proper book-to-eye distance. While 86% of parents identified prolonged screen use as a risk factor for myo- pia progression, 75% mistakenly believed that prescriptions could improve over time, and 50% were unaware of high myopia’s potential retinal risks. Parents with higher education levels or aged 40–49 years demonstrated signif- icantly better knowledge (p < 0.05). The financial burden of managing myopia was significant for 53.2% of families, with many reporting moderate to high costs for regular check-ups and glasses. Despite these challenges, 72% of par- ents ensured their children wore glasses consistently, emphasizing the role of parental support in myopia management. proved functional vision and ease in daily activities compared to those using spectacles. No studies on pharmacological interventions administered PRO scales, highlighting a gap in their HRQoL impact. Conclusion: Myopia imposes a considerable burden on HRQoL, affecting physical, psychological, and social well-being. Early diagnosis and effective treatments that either improve vision or reduce myopic progression such as LASIK for adults and OrthoK for children, can significantly improve HRQoL. EP-PED-52 Bilateral retinoschisis in type 6 Stickler syndrome (COL9A3 mutations): case report I. Grivova1, N. Veleva1, A. Oskar1 1Medical University Sofia, Ophthalmology Deparment, Sofia, Bulgaria Conclusion: This study highlights the need to address parental knowledge Aim: To present a clinical case of a patient with bilateral retinoschisis in the gaps on myopia progression and risks. Targeted educational strategies could context of Stickler syndrome type 6. enhance myopia control outcomes. EP-PED-50 The burden of myopia on health-related quality of life and the impact of treatments: a systematic literature review (SLR) K. Shi-van Wielink1, J. Li1, F. Ernst2, T. De Milliano1, A. Nath3, P. Veeranki4, N. Mulkalapalli5, C. Lymperopoulou6, Y. Punekar7 1Santen Pharmaceutical, Amsterdam, Netherlands, 2Santen Pharmaceutical, Munich, Germany, 3IQVIA, Bengaluru, India, 4IQVIA, Gurgaon, India, 5IQVIA, S.A.S. Nagar, Mohali, India, 6IQVIA, Athens, Greece, 7IQVIA, London, United Kingdom Methods: This case report describes a 15-year-old male with a complex medi- cal history of Stickler syndrome and Kawasaki disease. Detailed ophthalmo- logical examination and genetic testing were performed. Case presentation: High myopia was noted early at age 3. At 7 years old, bilateral hearing loss was diagnosed. The patient also exhibited joint laxity, suggestive of connective tissue involvement. Ophthalmological evaluations revealed progressive changes, including bilateral nasal retinoschisis also a temporal retinoschisis in the left eye and decreased visual acuity. Genetic analysis identified mutations in COL9A3, a gene associated with type IX col- lagen, a structural protein implicated in Stickler syndrome. The patient was diagnosed with Kawasaki disease at 2 years old, though no cardiological com- plications were observed. Discussion: The combination of early-onset high myopia, progressive reti- noschisis, sensorineural hearing loss, and joint laxity supports the considera- tion of Stickler syndrome, a hereditary connective tissue disorder frequently linked to mutations in genes encoding collagen. The presence of a pathogenic mutation in COL9A3 strengthens the diagnostic Purpose: This SLR aimed to assess the burden of myopia on health-related quality of life (HRQoL) and assess the effectiveness of various treatments in alleviating this burden. hypothesis, though the role of the second mutation remains unclear. Notably, the absence of cardiological pathology differentiates this case from certain Stickler syndrome subtypes. 180 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Conclusion: This case underscores the significance of genetic testing in diag- nosing complex connective tissue disorders like Stickler syndrome. The find- ings suggest a likely role of COL9A3 mutations in the patient’s phenotype, emphasizing the need for comprehensive, multidisciplinary follow-up to man- age progressive ocular and auditory conditions effectively. Further research is necessary to better understand the variable expressivity and clinical impact of COL9A3 mutations. EP-PED-53 The risk factors increasing the recurrence of intermittent exotropia following surgery T. Göncü Fırat1, M. Keskin1, N. Öncel Acır1, B. Taşkıran Kandeğer1 1Konya City Hospital, Department of Ophthalmology, Konya, Turkey Purpose: To evaluate the factors associated with the recurrence after surgical correction of intermittent exotropia. Method: The medical files of patients who underwent surgery for intermit- tent exotropia at a single center between July 2021 and June 2024 were re- viewed retrospectively. Final motor success was defined as alignment from 10 prism diopter (PD) exodeviation to 5 PD esodeviation at distance and near. Recurrence was defined as the postoperative angle of deviation greater than 10 PD. EP-PED-54 Secondary pediatric glaucoma associated with Axenfeld-Rieger anomaly K. Genov1, Y. Kaneva2,3, N. Veleva2,3, A. Oscar2,3 1Medical University - Sofia, Medical Faculty, Sofia, Bulgaria, 2Medical University - Sofia, Department of Ophthalmology, Sofia, Bulgaria, 3Eye Clinic - UMHAT “Alexandrovska”, Sofia, Bulgaria Introduction: Axenfeld-Rieger anomaly/syndrome (ARA/ARS) is an autoso- mal dominant genetic disease caused by mutations in the PITX2 or FOXC1 genes. ARS is characterized by anterior segment dysgenesis, systemic abnor- malities and the onset is in infancy. The risk of associated secondary glaucoma is 50%. Case presentation: We present the clinical cases of 4 patients with a family history of ARA and associated glaucoma. The age range of the patients is between 9 and 18 years old with a male:female ratio = 3:1. All of them were diagnosed with ARA between 2 and 5-months old when high intraocular pressure (IOP) was found and conservative antiglaucoma therapy was administered. Two of them revealed good control of the IOP. The female patient had trabecu- lotomy (TT) of the left eye (LE) followed by trabeculectomy (TE) of the same eye in addition to the conservative therapy, while one of the male patients required more surgical procedures – 2 TT and 1 TE in the right eye (RE) and 2 TT, 1 TE, a drainage device and 3 cyclophotocoagulations in the LE, neverthe- The factors evaluated were as follows: age at surgery, interval between ini- less the IOP of the LE remained high. tiation of symptoms and subsequent surgery, preoperative angle of deviation, The ophthalmological status showed hypoplasia of the iris in 3 of the patients, stereoacuity, binocular fusion, spherical equivalent, surgical type, presence of amblyopia, fixation preference and other strabismic associations. Results: A total of 53 patients (31 male, 58.5%) were included. The mean age of the patients was 21.2±11.7 years. The mean follow-up was 11.3±5.2 months. 17 patients underwent a bilateral lateral rectus recession, 2 under- went a unilateral lateral rectus recession and medial rectus resection, and 10 patients had combined operation with oblique muscle–weakening procedure. Successful surgical outcome was achieved in 29 (54.7%) at final visit. The mean postoperative follow-up period was 11.3±5.2 months. There was no posterior embryotoxon, iridocorneal strands and buphthalmos in 2 and pro- nounced corectopia in 1. In two of the patients there was evidence of thinning of the macular and peri- papillary retinal nerve fiber layer (RNFL) in both eyes from Optical Coherence Tomography (OCT). The other two had macular and peripapillary RNFL thin- ning only in the LE. A genetic testing performed on all patients and their parents found pathologi- cal mutations in the FOXC1 gene. Conclusion: Secondary glaucoma in infants and children, while present in relation between recurrence and patients’ type of intermitant exotropia, gen- only half of the patients with ARA, can cause serious and permanent visual der, age at surgery, family history, consanguinity, ambliyopia, anisometropia, abnormal head posture, abnormal ocular motility, fixation preference, binocu- lar functions and applied surgical method (p>0,05). However, longer duration of exotropia, higher preoperative deviation for both distance and near found to be related with postoperative recurrence (all P < 0.005). Conclusion: Overall surgical succes rate was 54.7% in this study. Moreover, the patients with a longer duration of intermittent exotropia and higher preop- erative deviation showed higher rate of recurrence. damage. In order to preserve vision, early detection and treatment of elevated IOP is crucial. EP-PED-55 Modified Nishida surgery for an incomplete 3rd nerve palsy N.-D. Iulia1, P. Raluca2 1Iuliu Hațieganu University of Medicine and Pharmacy, Ophthalmology, Cluj-napoca, Romania, 2Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania Nishida surgery is a alternative procedure muscle transposition that was first introduced for complete 6 nerve palsy, in 2003. Since then it was modified and its indications extended. The goal of surgery in such complex cases is to obtain adequate alignment in primary position, without diplopia. A 51-year old women who presented with diplopia and photophobia that ap- peared after a transsphenoidal resection of a pituitary macroadenoma. BCVA BE was 1 wc in Snellen chart and a small hyperopia (+1 sph). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 181

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ELECTRONIC POSTER PRESENTATIONS The orthoptic assessment revealed LE moderate ptosis with hypotropia with good Bell’s phenomenon. Pupil had anisocoria and fundus examination re- EP-PED-57 vealed incyclotorsion. Krimsky’s test and Prismatic CT was done which showed a 25 PD of vertical deviation. On extraocular movement evaluation LE showed a -5 SR limita- tion,-2 IR limitation, -1 MR limitation. The surgical plan was aimed to restore BSV and to alleviate diplopia in PP. We practiced LE Inferior Rectus Recession 4,5 mm and modified Nishida procedure Lateral rectus and Medial rectus 8 mm and 12 mm from limbus. At 4 weeks follow-up he patient had no diplopia in PP, good alignment and prismatic CT was 2 PD. Conclusion: Modified Nishida’s procedure it is a safe and good option for incomplete 3 nerve palsy. EP-PED-56 Ophthalmological manifestations of Axenfeld - Rieger syndrome – case series M. Peček Prpić1, D. Bajtl2,3, D. Biuk2,3, J. Barać2,3, I. Maduna1,3, T. Prpić3 1Osijek - Baranja County Healthcare Centre, Osijek, Croatia, 2University Hospital Centre Osijek, Department of Ophthalmology, Osijek, Croatia, 3Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia Purpose: We sought to present a case series of patients with Axenfeld – Rieger anomaly. Method: Three patients presented to University Eye Department accompa- nied by their parents due to unusual shape of their pupils. The patients were a six-week-old male infant, a 14-year-old female and a 17-year-old male. The parents did not notice any other health problems. There were no significant ophthalmological or other systemic diseases in the family history. In all patients slit-lamp examination of both eyes revealed bi- lateral corectopia and radial transillumination defects of the iris, however, the signs were significantly more pronounced in the infant. The lenses were transparent. In both male patients posterior embryotoxon was detected. Photodocumentation of the anterior segment was performed. Impacts of a preterm birth on peripapillary retinal nerve fiber layer thickness in children aged 4 to 8 years A. Ortueta-Olartecoechea1, J.L. Torres-Peña1, B. Alonso-Martín1, A. Muñoz-Gallego1, C. López-López1, A. Dorado López-Rosado1, P. Tejada-Palacios1 1Hospital Universitario 12 de Octubre, Madrid, Spain Purpose: To examine the relationship of a preterm birth and natal/postnatal factors with peripapillary retinal nerve fiber layer thickness (pRNFL) meas- ured by optical coherence tomography. Methods: Cross-sectional study. pRNFL measurements were compared in 104 children born very prematurely (gestational age < 32 weeks or birthweight < 1500 g) and 48 children of similar age (4 to 8 years) who were born full- term. Perinatal and postnatal factors were compiled for each child from their medical records. Results: Compared to the full term-born children, preterm children had a global pRNFL that was 6 µm thinner (p<0.01), and this thinning reached a maximum of 19.1 µm in the nasal quadrant (p< 0.001). In the Preterm group, global, inferior and nasal quadrants pRNFL were significantly thinner for a younger gestational age (GA) (p< 0.001) and lower birthweight (p≤ 0.005). It was observed that a 1 week decrease in GA led to a 0.9 µm reduction (p= 0.03) in global pRNFL thickness, and children who were small for gestational age showed an additional 6.2 µm reduction (p= 0.013) compared to those whose birthweight was adequate for their GA. In a multivariate analysis including postnatal events, necrotizing enterocol- itis, postnatal severe brain injury and steroid treatment were associated with a thinner global pRNFL (p≤ 0.04). Necrotizing enterocolitis was related to significant thinning in the temporal and nasal quadrants (p= 0.02 and 0.03). Treatment with postnatal steroids gave rise to an 8.7 µm reduction in global pRNFL thickness (p= 0.04) and severe brain injury led to significant reduc- tions in the inferior quadrant and in global thickness (p= 0.01). Different pRNFL patterns to the normal inferior>superior>nasal>tempora l (ISNT) were observed in children born at < 28 weeks’ gestational age or weighing < 1000 g at birth, most showing an ISTN pattern. Different pRN- FL patterns (p≤ 0.03) were also related to a need for home oxygen, having bronchopulmonary dysplasia or receiving laser treatment for retinopathy of Intraocular pressure and fundus examination were unremarkable. prematurity. Conclusions: Compared to children born at full term, preterm-born children have a thinner pRNFL and feature a different thickness pattern, also affected by gestational age at birth, birthweight and certain postnatal events. Considering the two older children were cooperative and had milder changes in the anterior segment of the eye, they were referred for ultrasound biomi- croscopy, where the findings pointed to Axenfeld-Rieger syndrome. The infant demonstrated a normal fix-and-follow movement and did not resist occlusion of either the right or left eye. Retinoscopy displayed a physiologic refractive error in the infant. In the other two subjects, retinoscopy showed a mild myopia and astigmatism, therefore spectacle correction was prescribed. All three patients were referred to a pae- diatric geneticist. Results: Extraocular manifestations of Axenfeld-Rieger syndrome were not found in any of three patients. Periodic ophthalmologic follow-up is recom- mended. The infant is planned to undergo ultrasound biomicroscopy. Conclusion: Axenfeld-Rieger syndrome can have different presentations. It should be considered in irregular pupils even in subtle changes. 182 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS The 41-year-old mother, with a history of myopia and astigmatism, also car- ried the same ARR3 mutation. Her BCVA was 0.4 OD and 0.5 OS. Fundus examination showed myopic conus, attenuated macular reflexes and myopic choroidosis. Refraction under cycloplegia revealed OD -2.00/-4.50/6 and OS -2.00/-6.25/157. OCT showed peripapillary RNFL thinning. These cases illustrate variable phenotypic expression of this X-linked condi- tion. The daughter presented with early-onset, high myopia and rapid progres- sion with macular RNFL thinning, while the mother had a milder phenotype with later onset and peripapillary RNFL thinning. This variability underscores the influence of X-chromosome inactivation and potentially other genetic and environmental factors in the manifestation of ARR3-related myopia in females. EP-PED-60 Implementation and efficacy of Stellest spectacle lenses for myopia control: clinical cases L. Ghazaryan1, M. Ghazaryan2, Z. Harutyunyan2, T. Harutyunyan3 1Yerevan State Medical University, Yerevan, Armenia, 2Teona Eye Clinic, Yerevan, Armenia, 3S. V. Malayan Eye Clinic, Yerevan, Armenia Purpose: The escalating global prevalence of myopia underscores the urgen- cy for effective control measures in ophthalmology. Stellest spectacle lenses, leveraging H.A.L.T. technology, represent a promising avenue for myopia management. This study aims to evaluate the implementation and efficacy of Stellest lenses in controlling myopia progression, focusing on clinical cases from Armenia. Settings: The study was conducted in Armenia, where over 500 Stellest lenses have been prescribed for myopia control. Methods: We conducted a retrospective analysis of clinical cases involving Stellest lenses over a two-year period. Autorefractor results were monitored, with only four patients exhibiting changes post-prescription. Results: Among the cases, a notable instance involved a family with three children aged 13, 15, and 18. Stellest lenses were prescribed for the 13- and 15-year-olds, while the 18-year-old received regular mono-focal glasses due to the belief that myopia stabilizes around that age. However, subsequent 3-month follow-up revealed a progression of -0.25 in one eye and -0.5 di- opters in the other eye of the 18-year-old, prompting an immediate switch to Stellest lenses. Further monitoring over six months indicated a halt in myopia progression in this case. Conclusion: The findings underscore the effectiveness of Stellest lenses in controlling myopia progression, as evidenced by clinical cases in Armenia. Early intervention with Stellest lenses may offer significant benefits in man- aging myopia, even in cases where progression is expected to stabilize. This highlights the importance of proactive measures in addressing the global bur- den of myopia. EP-PED-58 Bilateral ectopia lentis in Marfan’s syndrome: a case report A. Tandili1, G. Scharioth1, S. Ceca1, M. Popa2 1German Eye Clinic, Catholic Hospital, Ophthalmology, Tirana, Albania, 2Lady of Good Counsel University, Catholic Hospital, Ophthalmology, Tirana, Albania Purpose: Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a signifi- cant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. Case report: Herewith is a case report of a 5-year-old girl who had never been diagnosed with Marfan syndrome. She presented to the clinic after her parents noticed she had difficulty focusing on near objects. Her bilateral SC visual acuity was 0/20 RE and HM LE, the child does not cooperate further. On examination, there was bilateral lens subluxation, OD Superotemporally and OS Temporally, lens equator blocking her visual axis. She was sent to the paediatric team and further Marfan workout showed mitral valve dysplasia. She was then diagnosed with Marfan syndrome. She underwent bilateral lens aspiration, anterior vitrectomy, and iris-claw lens implantation. Her postopera- tive bilateral visual acuity on day 1 was 2/10, her best-corrected visual acuity 3 months after surgery was 3-4/10 and today 8/10. Conclusion: The ophthalmological management of Marfan patients is chal- lenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures. Keywords: Ectopia lentis, iris-claw intraocular lens, Marfan syndrome EP-PED-59 Phenotypic variability in X-linked myopia 26: a family case report S. Stoeva1,2, N. Veleva1,2, L. Bineva1,2, A. Oscar1,2 1Medical University, Department of Ophthalmology, Sofia, Bulgaria, 2UMHAT “Alexandrovska”, Sofia, Bulgaria This report presents the clinical and genetic findings in two female family members with X-linked Myopia 26 resulting from a pathogenic mutation in the ARR3 gene to illustrate the variable phenotypic expression of this con- dition. Detailed ophthalmological examinations were performed, including visual acuity, refraction, fundus examination, OCT, IOL Master (AL), and genetic testing. The daughter was first examined at age 2 years 3 months, presenting with high myopia. Refraction by retinoscopy was -4.00 dsph OU. Axial length (AL) measured 23.29mm OD and 23.30mm OS. A year later, at age 3 years 6 months, her BCVA was 0.1 OD and 0.2 OS. Genetic testing revealed a heterozygous pathogenic mutation in the ARR3 gene, confirming Myopia 26. Fundus examination progressed from large optic discs with mild temporal pallor to include mild myopic changes. Refraction under cycloplegia at the second examination revealed OD -6.0/-3.75/11 and OS -6.0/-3.25/178, demonstrating significant myopic progression. OCT at the second visit revealed macular RNFL thinning OD>OS. AL measurements were OD AL 24.31mm and OS AL 24.26mm. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 183

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ELECTRONIC POSTER PRESENTATIONS EP-PED-62 Case report: subretinal neovascular membrane as a complication of uveitis in an 8-year-old girl with juvenile idiopathic arthritis B. Lasevica1, D.J. Zaharova2 1Latvian American Eye Center, Ophthalmology, Riga, Latvia, 2Children’s Clinical University Hospital, Ophthalmology, Riga, Latvia about the visual and ocular development of MLP children. Our research group has been studying MLP individuals from birth through adolescence to address this gap. Method: This prospective cohort study involved detailed ophthalmological evaluations at various stages of development: at birth (n=78), 5 years (n=78), 8 years (n=50), 10 years (n=33), 12 years (n=22), and 16 years (n=50). Full- term controls were assessed for comparison. Results: At birth, weight was the strongest predictor of abnormal retinal vas- cularization in MLP infants. By age 5, MLP children exhibited higher rates of heterophoria, refractive errors, and impaired motility compared to controls. Juvenile idiopathic arthritis (JIA) is the most common extraocular disease associated with pediatric uveitis. Complications of uveitis include band keratopathy, cataract, glaucoma, ocular hypotony, and vision-threatening At 8 years, a reduction in macular volume was observed in the MLP group. IGF-I was associated with a larger optic disc cup. By age 10, refractive er- rors, atypical retinal vascularization, and abnormal optic disc parameters were maculopathies such as macular edema and epiretinal membrane. Subretinal more common in MLP children. At 12 years, MLP children showed lower neovascular membranes (SRNVM) can arise as a rare but severe complica- tion in patients with uveitis and other inflammatory conditions, particularly in children with JIA. SRNVM develops when breaks in Bruch’s membrane allow choroidal blood vessels to proliferate into the subretinal space, causing leak- age, bleeding, and fibrotic scarring that can result in significant vision loss. Collaborative management by pediatric rheumatologists and ophthalmologists is essential to optimize outcomes. We report the case of an 8-year-old girl presenting with SRNVM as a compli- cation of JIA-associated uveitis. She had a two-month history of blurred vision and intermittent redness in one eye but no prior rheumatologic or ophthal- mologic diagnoses. Initial examination revealed bilateral acute uveitis with findings of panuveitis, synechiae posteriores, vitritis, optic nerve edema, band keratopathy, and an SRNVM in the left eye. She tested positive for antinuclear antibodies (ANA) at a titer of 1:80, confirming a diagnosis of JIA-associated uveitis. The patient received inpatient treatment with intravenous methylprednisolone followed by oral corticosteroids and methotrexate, which yielded a limited response. Subsequently, intravitreal ranibizumab (10 mg/mL) was adminis- tered as pathogenetically targeted therapy for SRNVM. Follow-up after the first injection demonstrated a 122 µm reduction in SRNVM size. This case highlights the critical role of anti-VEGF agents, such as ranibizumab, as ad- junctive therapy in managing SRNVM associated with JIA, potentially im- proving visual outcomes. EP-PED-64 Visual and ocular development in moderate-to-late preterm infants: From childhood to young adulthood M. Andersson Gronlund1, A. Lind2, J. Dahlgren3, L. Raffa4, K. Allvin3, T. Ovik2, Z. Popovic2, H. Garellick2, S. Ali2, E. Aring2 1Faculty of Medicine and Health, Örebro University, Department of Ophthalmology, Örebro, Sweden, 2Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Department of Clinical Neuroscience, Gothenburg, Sweden, 3Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Department of Pediatrics, Gothenburg, Sweden, 4King Abdulaziz University Hospital, Department of Ophthalmology, Jeddah, Saudi Arabia Purpose: In recent years, there has been a growing interest in studying moderate-to-late prematurity (MLP), defined as a gestational age of 32–36 weeks. It is now recognized that children born with MLP face a higher risk of morbidity compared to full-term children. Despite this, little is known amplitudes in visual evoked potential tests. At 16 years, MLP adolescents demonstrated a smaller foveal avascular zone, thinner retinal nerve fiber layers (RNFL), reduced visual perceptual skills, re- duced visual acuity and were more hyperopic. IGF-I was found to correlate with peripapillary RNFL thickness. No significant differences in health-relat- ed quality of life were observed. Conclusion: Our findings indicate that MLP individuals exhibit ongoing oph- thalmological issues from childhood into young adulthood. Growth factors appear to influence the development of RNFL. Notably, however, MLP ado- lescents did not report significant differences in health-related quality of life compared to their full-term counterparts. EP-PED-66 Uveitic glaucoma in childhood: medical and surgical management C. Ruiz Arranz1, M.D. Lago Llinás1, A.I. Ortueta Olartecoechea2, T. Javaloy Vidal3, J. de Inocencio4, D. Blázquez5 1University Hospital 12 de Octubre, Glaucoma Unit, Department of Ophthalmology, Madrid, Spain, 2University Hospital 12 de Octubre, Pediatric Unit, Department of Ophthalmology, Madrid, Spain, 3University Hospital 12 de Octubre, Department of Ophthalmology, Madrid, Spain, 4University Hospital 12 de Octubre, Pediatric Unit, Department of Rheumatology, Madrid, Spain, 5University Hospital 12 de Octubre, Pediatric Infectious Diseases Unit, Madrid, Spain Case Report: A 7-year-old male presented with a history of bilateral acute uveitis, mildly hypertensive, with an initial good response to topical corticos- teroids and hypotensive agents but with recurrences preventing discontinua- tion. Systemic workup was negative for autoimmune diseases, with a positive rheumatoid factor. No other systemic symptoms were present. Failure to respond to oral acyclovir led to the initiation of systemic immunosuppression with methotrexate and, due to lack of response, adalimumab. The disease alternated between periods of remission and activity, and by one year after onset, he developed chronic uveitis with intraocular pressures (IOPs) of 40 mmHg despite maximal medical therapy (topical and oral). A pediatric Ahmed glaucoma valve was implanted to control IOP. Despite sur- gery, active inflammation persisted, precluding discontinuation of topical cor- ticosteroids and hypotensive agents (brimonidine/timolol), maintaining IOPs of 20-22 mmHg. Structural analysis of the optic nerve was normal. One month post-surgery, diffuse, mildly prominent retrocorneal precipitates appeared. 184 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Paracentesis and filtering bleb washout with 5-FU injection were performed. Aqueous humor was positive for cytomegalovirus, with negative viremia for EP-PED-68 CMV. Immunosuppression was discontinued, and we iniciated oral valganci- clovir for 3 months followed by topical ganciclovir 2% four times a day (qid) for 9 months. At 12-month follow-up, the patient is stable, with no inflam- mation and IOPs of 10 mmHg without any treatment. Current best-corrected visual acuity is 20/400 due to a dense posterior subcapsular cataract, pending surgery after stabilization of inflammation. Discussion: Children with uveitis have a higher predisposition to develop glaucoma, with increased incidence in Posner-Schlossman syndrome, juvenile idiopathic arthritis, and herpetic infections. Uveitic glaucoma is multifactorial in etiology, difficult to manage, and often requires surgery for control. The incidence of long term visual impairment in children with bilateral retinoblastoma A. Heidel1, Z. Naeem2, M. Westcott2,1, G. Negretti2, M.S Sagoo1,2,3, A. Reddy1,2 1Queen Mary University of London, Faculty of Medicine and Dentistry, London, United Kingdom, 2The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom, 3Moorfields Eye Hospital and UCL Institute of Ophthalmology, Ocular Oncology Service, London, United Kingdom EP-PED-67 Etiology of glaucoma in Bulgarian children – a 5-year retrospective study D. Vitanova1,2, O. Mladenov1,2, G. Dimitrova1,2, N. Veleva1,2, S. Kostova1,2, N. Dakov1,2, K. Belcheva1,2, A. Oscar1,2 1Medical University Sofia, Bulgaria, Ophthalmology, Sofia, Bulgaria, 2University Hospital Aleksandrovska, Sofia, Bulgaria, Eye Clinic, Sofia, Bulgaria Purpose: To analyse the etiology of glaucoma in children under 18-years old diagnosed and treated in the Eye clinic of Alexandrovska Hospital – Sofia, Bulgaria for a 5-year period. Methods: A retrospective study of children with glaucoma under 18-years old admitted in the Eye clinic of Alexandrovska Hospital for a 5-year period. Genetic analysis was performed on some of the patients to clarify the etiology. The EGS glaucoma classification has been used. Results: 118 children under the age of 18 have been included in this retrospec- tive study. 55 of the patients have primary childhood glaucoma: 5 - newborn glaucoma, 41 – infantile glaucoma, 1 – late-onset glaucoma. 8 of the children have been diagnosed with juvenile open-angle glaucoma. As for secondary glaucoma - we have discovered 63 children. The most common secondary glaucoma cases recorded are of lens-induced glaucoma – 19 children. We have found 10 cases with glaucoma associated with acquired condition such as uve- itis. An equal amount of children have been diagnosed with glaucoma after cataract surgery and another 7 children with glaucoma secondary to apha- kia. Genetically proven Axenfeld-Rieger syndrome associated glaucoma have been analysed in 3 cases. We have found 3 children with glaucoma associated with Weill-Marchesani syndrome, 1 case of Sturge-Weber syndrome associ- ated glaucoma and 1 child with Mucopolysaccharidosis type IVA. There are ten more cases of secondary glaucoma with diverse pathogenesis. Conclusions: The etiology and the genetic specifics of glaucoma in child- hood as well as collaboration with pediaticians and geneticists guide us to a prompt and correct diagnosis, effective treatment and favorable outcome for our patients. Keywords: glaucoma in childhood, etiology, primary childhood glaucoma, secondary glaucoma Purpose: The long term impact of bilateral retinoblastoma treatment with more novel treatments such as Intra-arterial Chemotherapy (IAC) on binocu- lar visual acuity remains uncertain. We have previously reported on short term results with 62% avoiding visual impairment. This study aims to assess long term morbidity related to vision. Methods: In this single-centre, retrospective case series study, patients that were treated for bilateral retinoblastoma at The Royal London Hospital Retinoblastoma Unit between 2006 to 2014 were included. Outcome measures included age at presentation, time from treatment to last follow-up, treatments and visual status. Fisher-exact test was used for categorical comparisons. Results: A total of 48 patients were included. The International Intraocular Retinoblastoma Classification (IIRC) of the better eye was associated with severe visual impairment (15% of eyes in IIRC Group A–C, 60% in Group D, E, p = 0.019). 28 children underwent unilateral enucleation (58% of patients). 25% of eyes underwent IAC. Systemic chemotherapy (vincristine, carboplatin and etoposide) was used in 39% of eyes. The median age of children at their most recent binocular visual acuity assess- ment was 11.8 years (7– 17.5 years). Sight impairment was present in 13% of children, and severe sight impairment was found in 25%. 63% avoided visual impairment at a median of 9.8 years after retinoblastoma treatment. Bilateral macular tumours were correlated with severe sight impairment (8 of 16 pa- tients with BMT, 4 of 32 without BMT, p = 0.0013). Conclusion: Almost two thirds of children with bilateral retinoblastoma re- tained good vision long term which is reassuring for families who may be concerned about deterioration. EP-PED-69 Congenital oculomotor apraxia: insights into diagnosis and management strategies P. Cardoso-Teixeira1, J. Alves Ambrósio1, C. Pestana Aguiar1, J. Chibante Pedro1, C. Costa Ferreira1 1Unidade Local de Saúde de Entre o Douro e Vouga, Ophthalmology Service, Santa Maria da Feira, Portugal Purpose: Oculomotor apraxia (OMA) is a neurological disorder characterized by delayed or failed initiation of saccadic eye movements. Affected patients are unable to voluntarily direct their gaze to an object of interest. Jerky head thrusting during attempted lateral gaze is a compensatory mechanism to bring objects into their field of vision. Congenital OMA (“Cogan-Type”) typically presents within the first year of life and is idiopathic. This case aims to report a case of congenital OMA, detailing its clinical presentation, management strat- egies, and follow-up observations. Methods: A retrospective review of the patient’s medical records. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 185

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ELECTRONIC POSTER PRESENTATIONS Results: A 7-month-old girl was evaluated in a pediatric ophthalmology con- sultation for bilateral torticollis noted since the age of 3 months, associated with difficulty coordinating eye movements with pendular head movements. Pregnancy, birth, and the neonatal period were normal. No restriction of ocu- lar motility or nystagmus was observed. Visual acuity assessed with Teller cards was within normal ranges. Neuroimaging and metabolic studies were unremarkable. A consultation with pediatric neurology revealed no other ab- normalities, such as ataxia, hypotonia, or delays in developmental milestones. A diagnosis of OMA was established, and occupational therapy was initiated, focusing on fine motor skills and oculomotor coordination. Regular follow- ups showed progressive improvement in the coordination of eye movements with head movements, which became increasingly infrequent. At 4 years of age she demonstrated excellent visual behavior, with stereopsis, binocular vi- sion, and visual acuity of 20/25 in both eyes. Conclusions: Congenital OMA is an uncommon disorder of ocular motility requiring watchfulness from ophthalmologists. Early and personalized reha- bilitation significantly improves functional outcomes and patient autonomy. A multidisciplinary approach with close follow-up, is essential for optimal care and monitoring. EP-PED-70 Congenital glaucoma associated with Sturge-Weber Syndrome case report D. Abilheira1, A.M. Sampaio1, P. Bompastor1, M. João1, J. Serino1, N. Lopes1, R. Silva1, F. Vaz1 1Hospital of Braga, Department of Opthalmology, Braga, Portugal EP-PED-71 Clinical case: accommodative strabismus and Morning Glory syndrome S. Rhalib1, S. Bouderka1, G. Daghouj1, B. Allali1, A. El Kettani1 120th August Hospital, Pediatric Ophthalmology Department, Casablanca, Morocco Introduction: Morning Glory syndrome is a rare congenital optic nerve anomaly, predominantly affecting girls, and usually unilateral. Materials: We report the case of a 7-year-old child presenting with intermit- tent strabismus. Results: The patient, A.E., aged 7 years, presents with recently noticed in- termittent strabismus. The examination reveals hypertelorism in both eyes, alternating esotropia, with a visual acuity of 09/10 in both eyes and an auto- matic refraction showing moderate bilateral hypermetropia, with cycloplegia yielding +1.5 in the right eye and +1 in the left. The anterior segment examination was normal. The fundus examination showed a normal right eye, while the left eye revealed a large excavated optic disc at its center, partially filled with a glial proliferation in a “morning glory” pattern, with a large blackish pigmented ring and abnormal vascular arrange- ment. A multidisciplinary evaluation returned negative results. Morning Glory syn- drome with isolated optic disc involvement was diagnosed. Full optical cor- rection was prescribed, and the strabismus corrected, indicating an accom- modative strabismus. Conclusion: Morning Glory anomaly is most often isolated, with a significant impact on visual function. The search for associated anomalies is essential in young children. The prognosis can only be improved if amblyopia treatment is implemented. Purpose: To report a case of congenital glaucoma in a patient with Sturge- Weber Syndrome (SWS), discussing presentation, investigation, and manage- ment. Methods: We describe a newborn with a port-wine birthmark (PWB) in the right trigeminal nerve territory (V1 and V2), associated with right eye (OD) EP-PED-72 corneal edema and elevated intraocular pressure (IOP). He was subsequently diagnosed with glaucoma, underwent OD trabeculectomy, and started topical Bilateral peters anomaly: case report therapy in both eyes. Results: A 4-day-old newborn boy with right hemifacial PWB at birth, pre- sented to the ophthalmology consult with OD corneal edema and elevated IOP. Pregnancy and birth were uneventful. Brain magnetic resonance imag- ing (MRI) on day 1 after birth showed venous congestion, periventricular ne- M. Kabbani1 1Hassan II, Ophtalmology, 20 August Hospital, Casablanca, Morocco Purpose: The aim of this case report is to describe a very rare disease and enhance doctor’s competence in suspecting, diagnosing and managing peters crosis, vasogenic edema in the left temporal lobe, and enlarged right choroid anomaly. plexus suggesting choroidal vascular malformation. Examination under anes- thesia at 11 days old revealed an axial length (AL) of 19,29 mm and 17,25 mm for OD and left eye (OS) respectively; IOP was 31 mmHg (OD) and 26 mmHg (OS). Gonioscopy showed blood in Schlemm’s canal, vascular tortuosity, and open angles in OS, though a closed angle in OD could not be ruled out. OD trabeculectomy with mitomycin C was performed, and topical ocular hypo- tensive therapy was initiated in both eyes. Observation in the operating room, at postnatal day 39, revealed normal IOP and mean axial lengths of 18,70 mm and 18,32 mm for OD and OS respectively. Gonioscopy showed open angles in both eyes and fundoscopic examination revealed diffuse choroidal heman- gioma in OD and tomato catsup fundus appearance in OS. Patient was then referred to dermatology, neuropediatrics, and genetic consultations. Conclusion: We report a case of congenital glaucoma in a patient with SWS, which, to our knowledge, adds further evidence to the existing literature. Early diagnosis and management of SWS helps to improve quality of life of patients which have this condition. Results: We present a case of 3 months old female infant with a history of pre- mature birth (at 07 months of gestation). There was no consanguinity between parents and no similar case was noted among the family members. APGAR score was 07 out of 10 at 01 minute of birth and 09 out of 10 at 05 minutes of birth. The parents consulted for a white patch of both eyes. At the examination, light eye-catching reflex and eyelid closure reflex to glare were négative.There was a white central opacity of the right cornea and total opacity of corneal left eye. there was no buphtalmos and the ocular tension was normal. The Ultrasound Biomicroscopy noted the absence of descemet membrane in the centre of both eyes with peripheral irido-corneal synechiae along with in- crease of the thickness of the cornea wich correlate with Peters anomaly. The patient was put on a list for penetrating keratoplasty and is regularly mon- itored for ocular hyertension. The parents were referred to a genetic expert for genetic evaluation and con- sult for futur pregnancy. 186 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Conclusion: Peters anomaly is a rare congenital disorder characterized by central corneal opacity with a relatively clear peripheral cornea.It has a high risk of developping glaucoma and amblyopia. Ultrasound biomicroscopy is a useful exam for detecting anterior segment abnormalities.The definitive treat- ment is penetrating keratoplasty. EP-PED-75 Duane syndrome O. Sargsyan1 1Lavanda Norfarm LLC, Ophthalmology, Yerevan, Armenia Duane syndrome is a congenital rare type of strabismus most commonly characterized by the inability of the eye to move outward. The syndrome was first described by ophthalmologists Jakob Stilling (1887) and Siegmund Türk (1896), and subsequently named after Alexander Duane, who discussed the disorder in more detail in 1905. The characteristic features of the syndrome are limitation of abduction (out- ward movement) of the affected eye, less marked limitation of adduction (in- ward movement) of the same eye, retraction of the eyeball into the socket on adduction, with associated narrowing of the palpebral fissure (eye closing), widening of the palpebral fissure on attempted abduction. (N. B. Mein and Trimble point out that this is “probably of no significance” as the phenomenon also occurs in other conditions in which abduction is limited.), poor conver- gence, a head turn to the side of the affected eye to compensate for the move- ment limitations of the eye(s) and to maintain binocular vision. EP-PED-76 Herpetic endothelial: about a case O. Serji1, Y. Harrar1, F.Z. Mabrouki1, A. Maadane1, R. Sekhsoukh1 1CHU Mohammed VI, Ophthalmology, Oujda, Morocco Purpose: Herpetic endothelitis is the rarest form of herpetic keratitis. The diagnosis is clinical and based on the association of oedema stromal and ret- rocorneal precipitatesthe study aims to describe our case from diagnosis to therapeutic management. Method: We report the observation of a 12-year-old child who has presented to the ophthalmological emergency department for a painful red eye with de- creased visual acuity. Results: The ophthalmological examination finds in OD a visual acuity count of the fingers at 1 meter with a conjunctival hyperhemia and a perikartial cerle with a Korean abscess taking fluorescine and a good anterior chamber. In OG a viscous acuity count fingers at 5 meters, a conjunctival hyperhemy with a perikeratic circle, a central corneal oedema with retrocornean precipitations in lower and a good anterior chamber OCT of the anterior segment showed hyperreflectivity of the corneal endothelium and descemet’s membrane an endothelial condition of likely herpetic origin was inferred the usual course is usually spontaneous reduction of endothelium by antiviral treatment and corticosteroid but relapses are still frequent we decide to hospitalize the child and put him on injectable aciclovir and corticoid eye drops. After 15 days of treatment, the patient improved clinically at also on anterior segment OCT. Conclusion: Herpetic endothelials are characterized by a central and circular oedeme, leaving a healthy corneal area up to the limbus.It is not always easy to distinguish between a complicated endothelial stromal keratitis the prognosis Case: The patient presented with complaints of strabismus and low vision. is generally good provided that antiviral drugs and corticosteroids are com- The patient had complete absence of abduction, retraction of globe on ad- duction, narrowing of palpebral fissure during adduction, partial deficiency of adduction, oblique movement with attempts at adduction, upshoot of globe with adduction, widening of palpebral aperture with abduction, deficiency of convergence. Conducted the following research: visiometria, autorefractometria, determi- nation of eye movements, fundoscopy, fusion test, cover test according to Hirschberg (Dew -10o), vis OD= 0.2-0.3 OS= 0.3-0.4 autorefractomeria -1.50-0.25ax152 -1.25-0.75ax165 A-scan OD= 22.85 mm OS= 22.53mm DS: Low myopia, Duane syndrome. Prescribed glasses for permanent wear: OD - 1.50 OS - 1.25 - 0.75 ax 165 The patient is under dynamic observation. There is no need for any strabismus surgery. bined the risk of recurrence is frequent. EP-PED-78 Heavy eye syndrome management, video presentation A. Affan1 1Tripoli eye hospital, Ophthalmology, Tripoli, Libya Diagnosis, decision making and surgical tips in management of heavy eye syndrome EP-PED-81 Straatsma syndrome: a rare presentation of myelinated nerve fibers, amblyopia and myopia – a case report F. Maia1, T. Fernandes1 1Hospital de Braga, Oftalmologia, Braga, Portugal Introduction: Straatsma syndrome is a rare ocular condition characterized by the triad of amblyopia, axial myopia, and myelination of retinal nerve fibres (MRNF). More often it is unilateral, but it can also bilateral. It was first de- scribed in 1979, by Straatsma et al. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 187

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ELECTRONIC POSTER PRESENTATIONS Methods: This is a case report from the Ophthalmology Department at Ophthalmologists are sometimes criticised for being somewhat insular in their approach. This case illustrates how an important ophthalmological observa- tion, good communication, and collaborative interdisciplinary care can signifi- cantly improve a child’s health and development. Hospital Lusíadas Braga, dated September 2024. Written informed consent was obtained from the patient for the publication of this case report and ac- companying images. There are no conflicts of interest to declare. Results: A 4-year-old boy presented to the Ophthalmology Department of Hospital Lusíadas Braga due to his mother’s concern about possible visual impairment. The patient’s best-corrected visual acuity (BCVA) was 0.2 (deci- mal) in the right eye (RE) and 1.0 in the left eye (LE). Cycloplegic refraction revealed mild astigmatism in the RE and mild hyperopia with astigmatism in the LE. Orthophoria was confirmed. Anterior segment examination was unre- markable. Fundoscopic examination of the RE revealed MRNF surrounding the optic disc superiorly and temporal, without crossing the horizontal raphe. The LE fundoscopy was normal. Axial lengths were 23.16 mm and 22.36 mm in RE and LE, respectively. The treatment was immediately initiated with prescription for total cycloplegic refraction. Three months later, RE BCVA improved by 0.1. Occlusion therapy of the LE was initiated for 2 hours daily. Follow-up evaluation is pending. Conclusion: This case illustrates the classic presentation of Straatsma syn- drome and highlights the challenges in treating associated amblyopia. Despite often suboptimal outcomes, early diagnosis and aggressive treatment remain crucial. Ophthalmologists should maintain a high index of suspicion for this rare syndrome in pediatric patients with unilateral visual impairment and MRNF. EP-PED-82 A case of “moebius-plus” syndrome and the importance of holistic care J. Lim1, A. Jones2, L. Allen2 1University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom, 2Addenbrooke’s Hospital, Department of Ophthalmology, Cambridge, United Kingdom A 10-month-old female infant with sensorineural hearing loss, laryngomala- cia, and multiple admissions as a neonate for hypoglycaemia, feeding and res- piratory difficulties presented to a paediatric ophthalmology clinic with large angle right esotropia. Lagophthalmos and bilateral facial diplegia werenoted. When asked, her parents confirmed she had never smiled or fully closed her eyes, nor had she shown any attention to visual or auditory stimulus for the first 6 months of her life. Her optic nerves were hypoplastic, more severely so on the right, and she displayed repetitive head movements which may be asso- ciated with sensory deprivation or a developing pattern of autistic behaviour. MR imaging confirmed retrobulbar right optic nerve hypoplasia, an absent posterior pituitary bright spot, absent VI and VII nerves, a hypoplastic left VIII nerve and no visible right VIII nerve. IX to XII appeared either absent or hypoplastic, possibly explaining her laryngomalacia and feeding difficul- ties. A diagnosis of Moebius-plus syndrome was made following a request for specialist neuroimaging review, which identified the full scale of her cranial nerve abnormalities. The patient is now 2 years of age and progressing well under the care of a multidisciplinary team including ophthalmology, otolaryngology, clinical genetics, community paediatrics, and the speech and language teams across three hospitals. Her visual acuity has improved to 6/48 OD and 6/30 OS, and staged strabismus surgery is planned to reduce the angle of esotropia. Her parents, who had been troubled by their child’s lack of social feedback, have been reassured by an explanation and now have a clearer understanding of her prognosis. 188 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Refractive Surgery EP-REF-01 Results: Retrospective analysis of the post refractive proceedure results, etc. Visual recovery by prk and other standard refractive proceedures. Conclusion: In our series of patients who have undergone refractive procee- dures, a detailed analysis of the post refractive result, patient response, etc is statistically analysed. PRK still has relevance in marginalised cases, though its share of the total refractive proceedures is on the decline. Visual and functional outcomes of customized topography-guided PTK and cataract surgery in a complex keratoconus case EP-REF-03 L. Žerjav1, M. Bohač1, S. Blazhevska1 1Eye Clinic Svjetlost, Cornea and Refractive Surgery, Zagreb, Croatia Long term clinical results of myopic lenticule transplantation for high hyperopia and astigmatism F. Semiz1, C.E. Semiz1, N. Hima-Musa1, F.F. Arslan2 1Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 2Istanbul- Cerrahpasa University, Ophthalmology, Istanbul, Turkey Purpose: To investigate the safety, efficacy, and corneal changes after lentic- ule transplantation in patients with high hyperopia and astigmatism. Methods: This retrospective study, conducted at the Eye Hospital in Prishtina, Kosovo, included 40 eyes from 30 patients aged 20 to 45 years, with refractive errors between +4.0 D and +6.50 D, and astigmatism from +1.0 D to +3.0 D. The preoperative central corneal thickness (CCT) varied from 450 μm to 550 μm. Exclusion criteria were corneal thickness over 550 μm, glaucoma, retinal detachment, cataracts, and ocular inflammation history. Donor lenticules were sourced from small incision lenticule extraction surgery with refractive errors of -4.50 to -7.00 D (no cylinders) and thicknesses of 90 to 140 μm. They were calibrated to match the recipient’s refractive error, with diameters at least 0.5 mm larger than the mesopic pupil to prevent accommodation issues. An 8 mm stromal pocket was created in the cornea with a cap thickness of 130 μm and a 3.00-mm incision. Lenticules were transplanted based on corneal topography and adjusted to the lowest K value for astigmatism correction. All patients were followed for 3 years, with assessments of uncorrected distance (UDVA), near (UNVA at 35 cm), and intermediate visual acuity (UIVA at 70 cm), along with slit-lamp biomicroscopy, corneal topography, anterior segment optical coherence tomography, and pachymetry. Results: The UDVA improved from 0.70 ± 0.08 logMAR preoperatively to 0.04 ± 0.02 logMAR (range: 0.05–0.1) (p < 0.001). The Q value decreased from -0.50 ± 0.04 preoperatively to -0.78 ± 0.05. The UNVA at 35 cm was J6, while the postoperative UNVA at 35 cm improved to J2. The preoperative UNVA at 70 cm was J5, and the postoperative UNVA at 70 cm improved to J3. Conclusion: Lenticule transplantation safely enhances visual acuity in high hyperopic patients by altering the Q-value, may be an alternative to intraocular lens implantation in young, cataract-free individuals. Purpose: To explore the combined approach of customized, topography- guided phototherapeutic keratectomy (PTK) and cataract surgery in a patient with advanced keratoconus, previous keratoplasty, and cataracts, aiming to improve both corneal shape and visual acuity. Methods: A 55-year-old female presented with low vision in both eyes. Her right eye had undergone keratoplasty for keratoconus, and the left eye pre- sented with grade 3 keratoconus and cataracts. Initial visual acuity showed UCVA of 0.3 in the right eye and 0.05 in the left eye, with BCVA of 0.8 and 0.6, respectively. The patient struggled to wear corrective glasses due to the significant difference in refractive power between the two eyes. To ad- dress corneal irregularity and reduce astigmatism, we performed customized, topography-guided PTK on left eyes. Four months later, cataract surgery was performed on the left eye, followed by cataract surgery on the right eye one month later. Results: Just one month after completing cataract surgery on the right eye, the patient experienced remarkable improvement. UCVA increased to 1.0 in the right eye and 0.7 in the left eye. The patient reported a significant enhance- ment in both visual clarity and functional vision, expressing high satisfaction with the outcomes. Conclusion: This case demonstrates the successful synergy of customized, topography-guided PTK followed by cataract surgery in a complex kerato- conus patient. The combination of these procedures not only restored corneal shape and corrected astigmatism but also resulted in significant visual recov- ery, illustrating an effective strategy for managing patients with coexisting keratoconus and cataracts. Keywords: Keratoconus, Customized PTK, Cataract Surgery, Topography- Guided PTK, Astigmatism, Visual Recovery EP-REF-02 Photorefractive keratectomy (PRK): relevance in today’s refractive surgery scenario A. Sethi1, A. Sethi1 1Arunodaya Deseret Eye Hospital (ADEH), Refractive Surgery Dept, Gurugram, India Purpose: To highlight the relevance of PRKin treating refractive errors by excimer laser. Identify cases where PRKis the prefered choice. Method: Review of current scientific literature on current refractive practices, with emphasis on developing countries. Identification of cases where PRK is the treatment recomended. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 189

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ELECTRONIC POSTER PRESENTATIONS EP-REF-04 Myopic lenticule transplantation for management of residual hyperopia following trifocal IOL implantation C.E. Semiz1, G.İ. Semiz2, F. Semiz1, F.F. Arslan3, N.H. Musa1 1Eye Hospital, Refractive Surgery, Prishtina, Kosovo, 2Eye Hospital, Prishtina, Kosovo, 3Istanbul-Cerrahpasa University, Ophthalmology, Istanbul, Turkey Purpose: This study aims to evaluate the outcomes for patients with residual hyperopia following trifocal intraocular lens (IOL) implantation who under- went fresh myopic lenticule transplantation via small incision lenticule extrac- tion surgery (SMILE). group AL greater than 24.00 mm. The intraocular fluid was analysed using mass spectrometry with liquid chromatography. Data analysed with Jamovi and Metaboanalyst 6.0. Results: A total of 177 aqueous humour samples were analysed. 114 patients were assigned to the hyperopic and emmetropic group, while 63 patients were classified in the myopic group. Patients with myopia were younger, with a mean age of 70.5±10.6 years, compared to 75.1±8.39 years in the other group. This age difference was significant with a mean difference of 4.55 years, 95% TI [1.69 - 7.41], t (175)=3.14, p=0.002, d=0.493. Univariate analysis showed that patients with myopia exhibited statistically higher levels of glucose (p=0.003), isoleucine (p=0.006), glutamine (p=0.006), methionine (p=0.007) and leucine (p=0.008). Enrichment analysis identified significant pathways in both SMPDB and KEGG databases, including galactose metabolism (p=0.003), lactose synthe- sis and degradation (p=0.003), trehalose degradation (p=0.003), starch and Methods: This study involved 72 eyes from 36 patients aged 41 to 61 years, sucrose metabolism (p=0.003) and neomycin, kanamycin and gentamicin bio- all of whom had residual hyperopia (+0.75 to +2.75 D) and astigmatism (+0.50 to +1.50 D) following trifocal IOL implantation. Donor lenticules were sourced from patients who underwent SMILE and had refractive errors rang- ing from -1.25 to -3.25 D (with no cylinders) and thicknesses between 25 and 65 μm. Using the SMILE module, a 7.70 mm intrastromal pocket was created in the recipient cornea for myopic lenticule transplantation. To prevent accommodation issues, the diameter of the donor lenticules was at synthesis (p=0.003). Conclusions: Our study highlights significant metabolic differences in the aqueous humour of myopic patients, including elevated levels of glucose, isoleucine, glutamine, methionine, and leucine. Pathway enrichment analysis identified key alterations in carbohydrate and amino acid metabolism. least 0.5 mm larger than the recipient’s mesopic pupil size, and the lenticule’s diopter was set to be 0.5 D higher than the residual hyperopia. The lenticules EP-REF-06 were transplanted based on corneal topography, with adjusted according to the low K value to effectively correct astigmatism. Results: Patients were followed for two years, during which no adverse reac- tions, infections, epithelial defects, punctate keratitis, deep lamellar kerati- tis, or signs of allogeneic rejection were observed. The uncorrected distance visual acuity (UDVA) improved significantly, increasing from 0.68 ± 0.08 logMAR preoperatively to 0.07 ± 0.02 logMAR at 12 months postoperatively (p < 0.001). Additionally, uncorrected near visual acuity (UNVA) improved to J2 from J8. Conclusion: Myopic lenticule transplantation is a reliable and safe method for addressing residual hyperopic refraction following trifocal IOL implantation. EP-REF-05 Metabolic profiling of aqueous humor reveals biochemical alterations associated with myopia A. Zemītis1,2, J. Vanags1,2, K. Klavins3, G. Laganovska1,2 1Riga Stradins University, Department of Ophthalmology, Riga, Latvia, 2Pauls Stradins Clinical University Hospital, Clinic of Ophthalmology, Rigalatv, Latvia, 3Riga Technical University, Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga, Latvia Purpose: Myopia and its global prevalence are rising at an alarming rate. A deeper understanding of the altered biochemical pathways and the underly- ing mechanisms of myopia could enhance early diagnosis and treatment, pav- ing the way for the development of more effective preventive and therapeutic strategies. Methods: An analysis of the aqueous humour samples from patients under- going cataract surgery at Pauls Stradins Clinical University Hospital. The patients were categorised into two groups based on axial length (AL), with one group having AL measurements smaller than 24.00 mm and the other XtraFocus pinhole IOL implantation in a patient with keratoconus M. Zankova1, Y. Zdravkov1, A. Oscar1 1Aleksandrovska Hospital, Clinic of Ophthalmology, Sofia, Bulgaria Purpose: To prеsent the clinical outcomes of a patient with cataract and kеratoconus treated with phacoеmulsification and implantation of the XtraFocus pinholе intraocular lеns. Methods: A 63-year-old malе with advanced cataracts and kеratoconus prеsented with progrеssively worsеning vision despite rigid gas permeable contact lens use. The patient had significant irrеgular astigmatism and high ordеr aberrations due to keratoconus in the left eyе. Preoperative еxamination included best-corrected visual acuity, biomicroscopy, corneal topogra- phy, wavefront aberrometry and biomеtry. A decision was made to perform phacoеmulsification and implantation of an XtraFocus pinhole IOL in the same eye. Results: The procеdure went without complications and thе XtraFocus pinholе IOL was implanted in the capsular bag. Preoperatively, the pa- tient’s bеst-corrected visual acuity in the left eye was 20/100. At 1 month postopеratively, BCVA reached 20/20 for far and near, without the need of rig- id contact lenses and rеmain stable. The patient reported significant rеduction in glarе and halos. Cornеal topography revealed no progrеssion of keratoco- nus. No postoperativе complications wеre obsеrved. Conclusion: XtraFocus pinhole IOL is an еffective solution for patients with cataract and kеratoconus. It addrеsses irrеgular astigmatism and improvеs vis- ual acuity without rеquiring additional intеrventions such as cornеal surgеry or use of rigid contact lеnses. This casе highlights the potential of pinholе IOLs to еnhance outcomes in complex cornеal conditions such as kеratoconus and to prеserve vision еven in cases of disease progression. 190 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-REF-07 EP-REF-11 Evaluating the accuracy of ocular trauma score in predicting the surgical outcomes of eye trauma patients in the UK A.H.Y. Liu1,2, T.C.J. Wong1, A. Mitra2, A. Barua2 1The Chinese University of Hong Kong, Department of Ophthalmology and Visual Sciences, Hong Kong, Hong Kong, SAR of China, 2Birmingham & Midland Eye Centre, Birmingham, United Kingdom Purpose: Ocular Trauma Score (OTS) is a well-defined and widely used to estimate the likelihood of 6-month visual acuity (VA) improvement following ocular trauma. However, there is a lack of research evaluating OTS accuracy in predicting VA improvement in mechanical ocular trauma cases in Midland, UK. Method: A single-centre retrospective study was conducted on patients pre- sented with mechanical ocular traumatic conditions from January 2022 to July 2024 and had surgery. OTS was calculated based on the best-corrected visual acuity at presentation (initial BCVA), whether there was initial globe rupture, endophthalmitis, perforating injury, retinal detachment, and/or relative affer- ent pupillary defect. To evaluate the predictability of OTS in our patients, we compared the OTS against their true, final post-operative (post-op) VA. Result: 62 cases (White, 40%; Asian, 27.7%; Black, 7.7%; not specified, 18.5%) (mean age 43.2 ± 20.9 years) were recruited. Males (78.5%) domi- nated the incidence. Mean follow-up was 7.18 months. Mean BCVA at baseline was 2.27 logMAR, baseline OTS graded score was 1.98. For graded OTS 1 cases, predicted % of patients was NPL & PL VA were 73% and 28% respectively while actual % in our cohort were 45.8% and 54.2%. Graded OTS 2 predicted 28% of NPL & 26% PL/HM VA while actual were 16.7% and 72.2%. Graded OTS 3, predicted 44% VA >20/40 & 28% VA 20/200 to 20/50 while actual were 41.1% and 29.4%. Graded OTS 4, predicted 74% VA >20/40 & 21% VA 20/100 to 20/50 while actual were 33.3% and 67%. Conclusion: For graded OTS 1, 2 and 4, the predicted % of patients with the 2 likeliest VA differed significantly from the % in our cohort, apart from graded OTS 3 that had striking similarities in % distribution. Results show that in the UK population especially the Midlands region, OTS proves to be in general limited in its ability to predict long-term post-operative VA. Further studies are needed to investigate better predictive alternatives for such patients. Treating presbyopia with SMILE: corneal reshaping with lenticule transplantation F.F. Arslan1, F. Semiz2, C.E. Semiz2, N.H. Musa2, G.İ. Semiz3 1Istanbul University-Cerrahpasa, Department of Ophthalmology, Istanbul, Turkey, 2Eye Hospital, Prishtina, Kosovo, 3Atılım University Medical Faculty, Ankara, Turkey Purpose: To investigate the improvement in distance and near visual acuity in presbyopia patients after myopic lenticule transplantation, focusing on corneal shape modification (Q value) to ensure treatment efficacy without complica- tions. Methods: 35 patients with 70 eyes participated aged between 40 and 50 years. The minimum corneal thickness is 450 μm and a maximum of 550 μm. The lenticular implantation as an allogenic implant, which was taken from myopic patients with a range of -2.0 D to -5.0 D. And was implanted into hyperopia patients with a range of +1.50 D to +4.50 D and astigmatism between +0.75 D and +1.50 D, using the smile module according to corneal topography. They were followed for an average of 3 years. ClinicalTrials.gov Identifier: NCT04616144 Results: Q value decreased from − 0.45 ± 0.06 log MAR preoperatively to − 0.75 ± 0.06 log MAR 3 years postoperatively (p< 0.001). Preoperative UNVA (35 cm) J 7 and postoperative UNVA (35 cm) J2. Preoperative UNVA (70 cm) J6 and postoperative UNVA (70 cm) J3. Conclusion: By changing the shape of the cornea, this method treats distance, intermediate, and near vision. EP-REF-09 Top ten tips - phakic IOL implantation R. Sethi1, A. Sethi1 1Arunodaya Deseret Eye Hospital, Gurgaon, India Phakic intraocular lenses (IOLs) have become a popular option for correcting moderate to high refractive errors, offering excellent visual outcomes while preserving the natural lens. Successful phakic IOL implantation requires me- ticulous planning, precise surgical technique, and thorough postoperative care to ensure optimal outcomes and minimize complications. This article presents ten practical tips for surgeons to enhance their proficiency and confidence in performing phakic IOL implantation. Key considerations include proper patient selection, with emphasis on ad- equate anterior chamber depth and endothelial cell count to maintain corneal health. Detailed preoperative planning ensures accurate lens sizing and posi- tioning. Techniques to achieve a clear surgical field, minimize intraoperative trauma, and ensure proper lens centration are discussed. Additionally, tips for managing common challenges, such as intraoperative lens handling and postoperative complications, are highlighted. Adopting these strategies can help surgeons refine their skills, reduce the learning curve, and deliver improved visual outcomes for patients undergoing phakic IOL im- plantation. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 191

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ELECTRONIC POSTER PRESENTATIONS EP-REF-12 Artificial intelligence prognostication models in corneal cross-linking for keratoconus T. AlMahmoud1, M. Pazniak2, E. Likhorad2, A. Pazniak2, P. Beliakouski2, D. Abelskyi1, K. Liaonchyk3, D. Morozova3, R. Voitetskii3, D. Smetanina1, B. Rockers3, K.N.-V. Gorkom1, S. Elnikety1, M. Ljubisavljevic1,3, H. Aldhaheri4, G.L. Simiyu1, Y. Statsenko1,3,5 1College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, 2Eye Microsurgery Center “Voka”, Minsk, Belarus, 3ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, United Arab Emirates, 4Tawam Hospital, Al Ain, United Arab Emirates, 5Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates Purpose: The aim of the study was to combine preoperative diagnostic find- ings to develop an Artificial Intelligence (AI) model that would accurately predict CXL outcomes in KC patients. Methods: Retrospective study of 107 patients (112 eyes) treated with CXL for KC. The participants were followed up for 12.93 ± 4.75 months post CXL. Clinical assessment, pachymetry, refraction, keratometry, and topography sphere lens, while 18 were implanted with a toric lens. The presbyopic add was from +1.5 to +4.0 D. Visual and refractive parameters were assessed preopera- tively and postoperatively at 1, 3, 6 months, and 1 year. Measurements included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected near visual acu- ity (CNVA), uncorrected intermediate visual acuity (UIVA), manifest refrac- tion spherical equivalent (MRSE), sphere, cylinder, and keratometry values. Statistical analyses were performed using the Wilcoxon signed-rank test. Results: All primary outcome measures showed significant improvement at the 1-year follow-up. UDVA improved from 0.99 ± 0.27 logMAR preopera- tively to -0.04 ± 0.13 logMAR at 1 year (p < 0.0001). CDVA remained stable (from -0.17 ± 0.07 to -0.13 ± 0.07 logMAR, p = 0.3562), demonstrating safe- ty. UNVA improved from 0.53 ± 0.45 to 0.15 ± 0.16 logMAR (p = 0.0309). The MRSE significantly reduced from preoperative values (p = 0.0003), with 77.8% of eyes within ±0.50D of target refraction at 1 year. No significant ad- verse events were reported, with stable endothelial cell counts and intraocular pressure throughout follow-up. Conclusion: IPCL V2.0 Presbyopic lens demonstrates excellent safety and efficacy profiles, providing significant improvement in uncorrected vision at all distances while maintaining CDVA. The one-year outcomes support its use as a viable surgical option for presbyopia correction. were recorded. Data for analysis were derived from topographic, topometric, and Belin-Ambrósio enhanced ectasia display (BAD) maps. Kruskal Wallis EP-REF-14 for Ophtalmometric distribution; Pearson and Spearman for variables correla- tion and Bayesian Information Criterion to develop the AI learning algorithms to predict CXL outcomes were applied. Results: Postoperative maximal cornea power is positively associated with preoperative cornea eccentricity, central keratoconus index and BAD-D (r=0.65, 0.81 and 0.84). The Kmax negatively correlates with preoperative minimal corneal thickness and best-corrected visual acuity (r=-0.59 and -0.57). Linear models of postoperative changes in corneal power outperform the polynomial ones (4.05±6.88 vs 4.1±6.79% MAE/ROV, p=0.051). A quad- ratic function depicts a sustainable Kmax reduction for 2 years, a subsequent 4-month-long plateau, and a rise in the maximal corneal power afterward. The effect of CXL is lost beyond 5 years after the treatment. The AI-model accu- rately predict changes in corneal curvature with 6.3% ratio of mean absolute error to the range of values. Conclusion: The findings advocate for personalized approach to candidate selection for CXL. AI models of CXL outcomes may quickly and effectively perform risk stratification for selection of optimal treatment. EP-REF-13 Safety and efficacy of IPCL V2.0 presbyopic lens: one-year comparative analysis of visual outcomes M. Ito1, M. Watabe1, S. Yukawa1 1Shinagawa LASIK Center, Tokyo, Japan Case report: cornealux as an alternative to penetrating keratoplasty (PKP) in corneal ulcer menagement L. Žerjav1, M. Bohač1, S. Blazhevska1 1Eye Clinic Svjetlost, Cornea and Refractive Surgery, Zagreb, Croatia Introduction: Corneal ulcers caused by microbial infections present a signifi- cant challenge in ophthalmology, often leading to visual impairment and some- times requiring invasive surgical interventions like Penetrating Keratoplasty (PKP). In recent years, non-invasive alternatives have been explored to reduce the need for such surgeries. Here, we present the case of a 32-year-old male who developed a corneal ulcer following a Pseudomonas aeruginosa infection. Despite initial treatment, the patient’s corneal condition remained unresolved, prompting the use Cornea Lux, wavefront-guided phototherapeutic keratectomy (PTK). The results were promising, with significant visual recovery and a marked reduction in the need for invasive surgery. Case Presentation: A 32-year-old male with a Pseudomonas aeruginosa corneal ulcer in his left eye presented with BCVA of 0.5 and symptoms of scattering and dysphotopsia. Despite intensive antibiotics, the ulcer persisted, worsening corneal scarring and vision. Given failure of medical treatment and the need for transplantation, a non-invasive approach was chosen. The patient received Cornea Lux therapy and wavefront-guided PTK to avoid PKP. Post-treatment, his BCVA improved to 0.95, scattering and dysphotopsia resolved, and follow-up showed stable corneal integrity with no recurrence of infection. Purpose: To evaluate the safety and efficacy of the IPCL V2.0 Presbyopic lens through a comprehensive analysis of visual and refractive outcomes over a one-year period. Methods: This retrospective study analyzed 62 eyes of 32 patients with a mean age of 50.4 ± 3.5 years (44 to 57 years) who underwent implantation of IPCL V2.0, single-piece posterior chamber phakic IOL. Eyes that had a minimum of 1-month follow-up data were included. Forty-four eyes were implanted with a Conclusion: This case demonstrates the potential of Cornea Lux therapy as a non-invasive treatment for microbial corneal ulcers. The patient’s significant visual improvement and avoidance of PKP suggest that this approach may be an effective alternative in select cases. Further research is needed to confirm the broader applicability of this treatment modality. Keywords: Cornea Lux, Pseudomonas aeruginosa, corneal ulcer, penetrating keratoplasty, non-surgical treatment, visual acuity, alternative therapies. 192 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-REF-15 EP-REF-16 Chord mu and chord alpha as postoperative predictors in extended-depth-of-focus intraocular lenses A. Montrimas1,2, R. Žemaitienė1,2 1Lithuanian University of Health Sciences, Faculty of Medicine, Department of Ophthalmology, Kaunas, Lithuania, 2Hospital of Lithuanian University of Health Sciences, Department of Ophthalmology, Kaunas, Lithuania Purpose: To analyze chord mu (µ) and chord alpha (α) as postoperative pre- dictors in extended depth-of-focus intraocular lenses (EDOF IOL). Methods: A prospective study enrolled otherwise healthy eyes undergoing cat- aract surgery using an EDOF IOL (Alcon Vivity (15 eyes); Johnson&Johnson Symphony (13 eyes)). Parameters analyzed before, 1, and 3 months after the surgery: µ and α, uncorrected distance visual acuity (UDVA) (LogMAR) (6 meters), intermediate (66 cm) and near (40 cm), defocus curves (DC), spheri- cal equivalent (SE), prediction error (PE) (difference between predicted SE and post-op SE), root mean square of spherical aberrations (e.g.RMSZ40), halom- Corneal epithelial thickness distribution in corneas with high and low with-the-rule toricity D. Figueiredo Pires1, A.C. Abreu1,2, J. Heitor Maques1,2, S. Monteiro1,2, M.d.C. Pinto1 1ULS Santo António, Oftalmologia, Porto, Portugal, 2Instituto de Ciências Básicas Abel Salazar, Porto, Portugal Purpose: The degree of remodeling in corneas with varying levels of corneal toricity is not fully understood. This study aims to assess for differences in epithelial thickness (ET) of normal corneas with high and low corneal with- the-rule toricity (CT). Methods: In this observational study, eyes of refractive surgery candidates classified as normal after tomographic, biomechanical and epithelial mapping evaluation were included. The eyes were divided into two groups according to their CT, assessed with swept-source optical coherence tomography (SS-OCT ANTERION®): the ones with a cylinder of 2 or more diopters (D) were clas- sified as “high CT” and the ones with up to 1D were classified as “low CT”. The eyes with “high CT” were paired with eyes from the “low CT” group, etry (Halo v1.0 program), subjective visual disturbances, NEI RQL-42 ques- according to age, spherical equivalent (SE) and axial length (AL). tionnaire, mesopic contrast sensitivity (CS) (Optec 6500 vision tester). Results: µ (p = 0.611) and α (p = 0.914) did not differ between IOL groups. In the Vivity group at 1-mo µ correlated with SE (r=0.702 p=0.005), at 3-mo with SE (r=0.590 p=0.056), RMSZ40 (r=0.692 p=0.013) and UDVA (r=-0.580 p=0.048). α in the Vivity group correlated with SE at 1-mo (r=0.863 p <0.001), at 3-mo with SE (r=0.810 p=0.003), RMSZ40 (r=0.720 p=0.008), PE (r=0.546 p=0.043) and sections of the NEI RQL-42: near vision (r=-0.828 p=0.042), clarity of vision (r=-0.828 p=0.042), diurnal fluctuation (r=0.956 p=0.003), glare (r=-0.828 p=0.042) and symptoms (r=-0.956 p=0.003). In the Symphony group, µ correlated with DC from -3.5 (r=-0.572 p= 0.042) to -4.0 (r=-0.640 p=0.018), RMSZ40 (r=0.647 p=0.023) at 1-mo and with near vision section of NEI RQL-42 (r=-0.803 p=0.016) at 3-mo. At 3-mo α cor- related with DC from -3.5 (r =-0.560 p=0.047) to -4.0 (r=-0.629 p=0.021) and with the near vision section of NEI RQL-42 (r=-0.784 p=0.021). In both IOL groups µ and α did not correlate with CS or halometry. Conclusions: µ and α correlate with quality of life, refractive outcomes, and VA after EDOF IOL implantation, but the correlations are inconsistent and need further investigation. Epithelial and stromal thickness maps were also evaluated by the SS-OCT ANTERION®. Parametric tests were applied to compare demographic, tomo- graphic, biomechanical and epithelial mapping data between groups. Results: 65 eyes were included in the “high CT” group and were paired with 65 eyes of the “low CT” group. The “high CT” group showed a lower ET at the thinnest epithelial point (p=0,007), higher difference between the thinnest and thickest epithelial points and higher ET standard deviation (p<0.001). No other significant differences at the epithelial or stromal thickness were found, including at each quadrant (superior, inferior, nasal and temporal). The difference between meridians was not statistically significant between groups. Conclusions: Eyes with “high CT” presented thinnest epithelium at the thin- nest epithelial point and greater ET heterogeneity, compared with eyes with “low CT”. In this cohort, no differences were found in the ET distribution in the meridians between groups. Further studies with larger samples are needed to further comprehend the relationship between CT and ET distribution. EP-REF-17 Intrastromal corneal ring segments for post-LASIK ectasia: a retrospective analysis of visual and topographic outcomes A.M. Sampaio1, R. Silva1, C. Pinto1, M. Oliveira1, J. Mendes1, N. Franqueira1, T. Monteiro1, F. Vaz1 1Hospital de Braga, Ophthalmology, Braga, Portugal Purpose: To evaluate the visual, refractive, topographic, and safety outcomes of intrastromal corneal ring segments (ICRS) implantation in the management of post laser-assisted in situ keratomileusis (LASIK) corneal ectasia, a serious complication that can significantly impair vision by increasing ocular aber- rations. Method: A retrospective case series included 20 eyes from 17 patients di- agnosed with post-LASIK corneal ectasia, treated with ICRS implantation, and followed for 6 months postoperatively. Parameters analyzed included uncorrected distance visual acuity (UDVA), corrected distance visual acuity Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 193

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ELECTRONIC POSTER PRESENTATIONS (CDVA), manifest refraction, keratometry readings, and coma. Preoperative and postoperative topographic evaluations were performed using Scheimpflug- based Pentacam (Oculus). Results: The mean interval between LASIK and ectasia diagnosis was 11.4 ± 5.4 years. Postoperatively, mean UDVA and CDVA improved significantly from 1.11 ± 0.48 and 0.49 ± 0.35 to 0.58 ± 0.40 and 0.30 ± 0.32 logMAR, respectively. Safety and efficacy indices at 6 months were 2.1 ± 2.49 and 1.4 ± 2.23. One eye gained 1 line of CDVA, while 10 eyes gained 2 or more. CDVA loss was observed in two eyes. Manifest cylinder and spherical equivalent reduced significantly from -3.22 ± 2.00 D and -3.63 ± 5.20 D to -2.00 ± 1.66 D and -1.69 ± 2.03 D, respectively. Mean and maximum keratometry values decreased significantly from 44.90 ± 3.46 D and 52.68 ± 5.63 D to 42.39 ± 4.90 D and 50.87 ± 5.13 D. Coma exhibited a non-significant reduction. No cases of ICRS extrusion, perforation, or explantation were noted. A single case of tunnel haze resolved after antibiotic irrigation. Conclusion: ICRS implantation is a safe and effective surgical option for managing post-LASIK ectasia, demonstrating significant improvements in visual acuity, refractive error, and corneal topography. These findings support its role in restoring binocular vision, reducing anisometropia, and enhancing patient quality of life. EP-REF-19 Effect of low-dose brimonidine on scotopic mydriasis: a potential approach to dysphotopsia management I. Mendo1, M. Vaz1, J. Vaz1, G. Agudo1, I. Machado1, F. Moraes1, T. Loureiro1, N. Campos1 1ULSAS, Hospital Garcia de Orta, Almada, Portugal Purpose: To evaluate the effect of low dose brimonidine eye drops in pupil diameter and to explore its potential utility for postoperative uneventful dys- photopsias. Method: Dynamic pupillometry was performed using the Myah (Topcon). Two measurements were performed: baseline and 10 minutes after the ap- plication of one drop of brimonidine (0,25 mg/mL). Data regarding pupil di- ameters were collected under both scotopic and photopic conditions. Scotopic pupillary diameter and pupil diameter variation were considered for statistical analyzes. p<0.05 was considered statistically significant. Results: 20 eyes from 20 patients were included (70% females; 30% males). Mean scotopic pupillary diameter was 5,49 at baseline 4,96 at 10 minute measurement.. The mean reduction in pupil diameter under scotopic condi- tions was 0.59 ± 0.31 mm, while under photopic conditions the mean reduc- tion was 0.24 ± 0.19 mm. Conclusion: Low dose brimonidine demonstrated a tendency to reduce my- driatic response under scotopic conditions. This effect suggests its potential clinical utility to manage uneventful postoperative dysphotopsia. A possible correlation between higher order aberrations and scotopic pupillary diameter could reinforce our results. ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Retina EP-RET-001 Analysis of ocular fluid in patients with neovascular agerelated macular degeneration who have serum antiranibizumab antibodies H.S. Chin1, K. Lee1 1Inha University Hospital, Ophthalmology, Incheon, Republic of Korea Purpose: The aim of this study was to examine the potential for intraocular activity of antidrug antibodies (ADAs) in patients with anti-VEGF-recalci- trant nAMD. Method: Two serum ADA-positive ranibizumab-recalcitrant patients and two serum ADA-negative controls were recruited from patients with nAMD treated with ranibizumab monotherapy. Recalcitrance was defined as persis- tent fluid after ≥6 monthly ranibizumab injections. Serum and aqueous humor ADAs were detected by enzyme-linked immunosorbent assay (ELISA) and Immunoprecipitation (IP), respectively. Results: Two of 156 ranibizumab-treated patients were ADA-positive, de- tected by ELISA. The patients received 6 and 14 ranibizumab injections, re- spectively, up to 4 weeks prior to blood collection. Neutralizing ADAs were confirmed in both samples. A specific band was detected by IP only in ADA- positive samples, consistent with the results of ELISA. Based on an assess- ment of the degree of sensitivity of commercially available anti-ranibizumab antibodies, it was estimated that the IP method could detect ADA levels >30 ng. Nevertheless, ADAs were not detected in the aqueous humor of either the experimental or control group. Conclusion: In the aqueous humor, ADAs are either not present or are present at a lower concentration than that which can be detected by immunoprecipi- tation (IP). This presumably reflects the fact that blood ADA is the product of systemic circulation clearance through anterior elimination of intravitreal ranibizumab. Based on our results, ADAs do not return to the eye in sufficient quantities to interfere with the action of ranibizumab in the vitreous cavity. 194 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-002 EP-RET-003 Decade-long analysis of postoperative endophthalmitis in Sweden: insights from insurance and national quality registers Prevalence and impact of comprehensive ocular complications in diabetic patients D. Merkland1,2, A. Viberg3, M. Nilsson2, P. Gustafson4, K. Teär Fahnehjelm5,2 1Karolinska Institutet, Department of Retinal Diseases, Solna, Sweden, 2Karolinska Institutet, Division of Eye and Vision. Department of Clinical Neuroscience, Solna, Sweden, 3Umeå University, Department of Clinical Sciences/Ophthalmology, Umeå, Sweden, 4Löf, Stockholm, Sweden, 5Karolinska Institutet, Department of Paediatric Ophthalmology, Strabismus and Electrophysiology, Solna, Sweden A. Levi1, G. Dimitrov1, N. Andonova1, A. Georgieva-Dimitrova1, D. Cholakova1, D. Vitanova1, G. Kostadinov1, I. Grivova1, L. Bineva1, M. Zankova1, M. Impagliatelli1, N. Dzhemal1, R. Dzhambazov1, V. Tsankova1, Y. Kaneva1, A. Oscar1 1Medical University - Sofia, Department of Ophthalmology, Sofia, Bulgaria Purpose: This study evaluated the prevalence of ocular complications, includ- ing cataracts, retinopathy, macular edema, vascular changes, and structural abnormalities, in patients with type 2 diabetes mellitus. Methods: This cross-sectional study included 262 consecutive patients with Purpose: To analyse clinical characteristics and risk factors for post-operative type 2 diabetes assessed during a non-mandatory screening for a period of endophthalmitis (POE) in a Swedish patient insurance database and compare one month. Patients were divided into 2 groups - routinely screened and non- prevalence of POE with two national quality registers. routinely screened. Methods: We analysed 218 medical records of patients who claimed compen- All participants underwent comprehensive ophthalmological examination, in- sation for POE following ocular surgery from 2010 to 2020. The data were cluding visual acuity testing, fundus photography, optical coherence tomogra- cross-referenced with national quality registers. Results: In total, 189 of 218 patients presented with severe ocular inflamma- tion with no visibility into the posterior fundus and 160 of 218 had hypopyon. After treatment, the best corrected visual acuity improved from 2.4 to 1.8 LogMAR in mean (p < 0.01). Poorer visual outcome was associated with POE caused by Staphylococcus aureus, Enterococcus faecalis, and Streptococcus infections, as compared to coagulase-negative staphylococci (p < 0.01). Retinal detachment was linked to worse visual prognosis (p = 0.01). Eighteen patients required enucleation or evisceration, three of these had ini- tially undergone vitrectomy, compared with 124 of 200 where the eyes were preserved. Peripheral vitrectomy showed better outcome compared to central vitrectomy (p = 0.02). Financial compensation was granted for 92% of pa- tients. However, a discrepancy was noted when comparing the number of patients with insurance claims to those reported by the national quality registers, indi- cating underreporting in both. Conclusion: This study highlights the impact of bacterial type on visual re- covery in POE. Peripheral vitrectomy showed better outcomes than central vitrectomy. Most patients needing enucleation or evisceration were not treated with vitrectomy. Significant discrepancies were found between POE prevalence in quality reg- isters and insurance reports, indicating the need for better reporting, though phy (OCT), and intraocular pressure measurements. Demographics, diabetes duration, glycemic control (HbA1c), and systemic comorbidities were taken under consideration. Patients were assessed by QoL questionnaire and the prevalence of ocular complications was recorded. Results: At least one ocular complication was registered in 74.5% of the pa- tients in the non-routinely screened group vs 57.4% for the routinely screened patients. Cataracts was prevalent in 64.1% of all patients, inflammation - in 29.3%, and retinopathy - in 9.2%. Macular edema was observed in 7 patients (2.7%), vascular complications in 4.6%, and high intraocular pressure in 6.5%. Structural anomalies, such as epiretinal membrane and pterygium, were observed in 3.4% of cases. Patients with routine screenings exhibited signifi- cantly lower rates of vascular complications (0.6% vs. 10.8%, p = 0.0004), cataracts (57.5% vs. 74.5%, p = 0.0077), and retinopathy (3.8% vs. 17.6%, p = 0.0003). Conclusions: Ocular complications in diabetes are widespread, affect- ing nearly every ocular structure and impairing quality of life. Non-routine screening revealed higher complication rates. In a temporal manner, condi- tions such as cataracts, retinopathy, and inflammation diminish visual function and daily activities. Integrated care approaches can improve both visual and overall quality of life. the exact magnitude of underreporting remains unclear. Keywords: Postoperative endophthalmitis, ocular surgery, infection, insur- EP-RET-004 ance claims, quality registry. Association of subfoveal choroidal thickness with myopic retinoschisis J. Tian1, N. Wang1, Y. Qi1 1Beijing Tongren Hospital, Capital Medical University, Beijing, China Purpose: To analyze the association of subfoveal choroidal thickness (CT) with myopic retinoschisis (MR), and to investigate risk factors for myopic traction maculopathy (MTM) development. Methods: In the case-control study, 200 eyes with MR as the MR group, and 398 highly myopic eyes without MR as the control group were enrolled. All participants have recorded demographic characteristics and medical his- tory. A comprehensive ophthalmologic examination and optical coherence tomography (OCT) were performed to evaluate ocular characteristics, includ- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 195

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wish to consider using ranibizumab instead of aflibercept 2mg, if they are concerned about post injection IOP in a myopic CNV patient with co-existing glaucoma. We propose further study to see if these IOP outcomes are repro- ducible in other retinal pathologies. EP-RET-006 Branch retinal vein occlusion and Valsalva manouver in wind instrument players and singers: a case series and review C. Raj1, I. Gutteridge2 1Vision Eye Institute, Ophthalmology- Retinal Clinic, Melbourne, Australia, 2The University of Melbourne, Melbourne, Australia There are many recognised risk factors for retinal vein occlusions and it is possible that musicians who employ wind or their voice as primary instru- ments may be at increased risk. This case series highlights/identifies this potential risk association and explores clinical and functional underlying mechanisms. Purpose: Repeated valsalva manoeuvres are commonly performed by musi- cians using high resistance wind instruments. This also true for singers. This case series illustrates a correlation between repeated Valsalva manoeuvres and retinal vein occlusion in three patients. Method: A retrospective review of three cases presenting to private Ophthalmology clinic. Results: Case 1: An 85 year old male, French Horn player and Case 2: A 77 year old male, bass-baritone singer each presented with a left- sided non-ischemic branch retinal vein occlusion. Case 3: A 79yo male Tenor presented with a left -sided ischaemic hemi-retinal vein occlusion. All cases were treated with intravitreal anti-vascular endothe- lial growth factor (VEGF) stabilizing vision. Conclusion: Repeated VM as demonstrated in wind musicians and singers may play a role in pathogenies of branch retinal vein occlusions in susceptible individuals.If VM is a contributing element in the pathogenesis of BRVO, it would be valuable in history taking to be aware of lifestyle factors such as use of high resistance wind instruments or voice. Consideration could also be given to advising on continuing to undertake these lifestyle activities while undergoing treatment for BRVO. ELECTRONIC POSTER PRESENTATIONS ing axial length (AXL), epiretinal membranes (ERMs), vitreoretinal traction (VT), dome-shaped macula (DSM), macular outward scleral height (MOSH), and subfoveal CT. Univariate analysis was used to analyze the differences in characteristics between the MR group and the control group. Based on that, multivariate logistic regression was performed to assess significant factors for MR with odds ratios (OR) and 95% confidence intervals (CI). Results: In univariate analysis, the MR group had more keratorefractive sur- geries, older age, longer AXL, more ERMs, more VT, more vertical DSM, higher MOSH, and thinner CT than the control group (all P< 0.001). The above factors were selected as covariates to perform multivariate analy- sis. In multivariate analysis, ERMs (OR 2.278; P = 0.003), VT (OR 5.757; P <0.001), MOSH (OR 1.003; P <0.001), and subfoveal choroidal thinning (OR 0.990; P <0.001) were significantly associated with MR Conclusions: ERMs, VT, higher MOSH, and subfoveal choroidal thinning were significantly risk factors for MR. Subfoveal CT reduction may be one of the predictors for MTM development. EP-RET-005 Ethnicity & Intraocular pressure (IOP) spike rates following intravitreal injections for Myopic Choroidal Neovascularisation (mCNV): IOP outcomes from 2014 - 2024 from a single hospital B.J. Chow1, E. Preston2, Y. Kim1, C. Zheng1, F. Levina2, A. Sheemar2, I. Qureshi2, J. Luis2, S. Phatak2, S. Sen2, S. Ansari2, G. Gazzard2, R. Hamilton2, L. Nicholson2, I. Yeung2, Moorfields Medical Retina Research Group 1Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom, 2Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom Purpose: Investigate rate of IOP spikes following intravitreal injections (IVIs) in myopic choroidal neovascularisation (mCNV) patients. IOP spikes repre- sent a significant concern, particularly for patients with co-existing glaucoma. Methods: Retrospective audit of electronic patient records (EPR) of all IVIs for mCNV from 20/11/14 to 19/11/24. IOP spikes defined as an +10mm fol- lowing IVI (IOP+10mmHg) or post-IVI value of >40 mmHg (IOP>40mmHg). Visits with incomplete IOP measurements excluded. IVI agents analysed include Eylea 2 mg (Aflibercept) and Ongavia (Ranibizumab biosimilar). Statistical analysis was performed via Mann-Whitney U test. Results: Of 3307 IVIs administered for mCNV, 100 IVIs were included. 3207 IVIs were excluded as they did not meet the inclusion criteria due to the ab- sence of sufficient IOP documentation in the EPR. Mean age was 61.8 ± 17.1 years. 35% of mCNV patients were male with 65% being female patients. Ethnicity was: Caucasian 54%, Other 14%, South Asian 13%, Unknown 13%, African & Caribbean origin 4%, Mixed 2%. Median time to post-IVI IOP measurement was 23 minutes. Mean IOP increase after Eylea 2mg (6.34 ± 6.68 mmHg) was increased compared to Ongavia (2.75 ± 1.71 mmHg) (p<0.01). IOP+10mmHg spike rate was 28% (n=28/100), IOP>40mmHg spike rate was 1% (n=1/100) and 72% (n=72/100) had no clinical IOP spike. Conclusion: Females (65.0%) & Caucasians (54.0%) were our most com- mon mCNV patient; this is similar to our group’s previous findings for neo- vascular Age Related Macular Degeneration. Ongavia had a reduced mean IOP increase compared to Eylea 2mg. This could be attributed to the higher molecular weight of Eylea (115 kDa vs 48 kDa), hampering aqueous outflow and elevating IOP. From an IOP perspective, we propose that clinicians may 196 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-007 EP-RET-008 Eight-year follow-up of iluvien treated Diabetic Macular Edema (DME) patients: long term outcomes A. Sheemar1, U. Halder1, E. Preston2, L. Cox3, C. Zheng4, B.J. Chow4, A. Kim2, I. Qureshi2, J. Luis1, S. Phatak1, S. Sen5, S. Ansari6, G. Gazzard6, R. Hamilton1, L. Nicholson1, I. Yeung1 1Moorfields Eye Institute NHS Foundation Trust, Medical Retina, London, United Kingdom, 2Moorfields Eye Institute NHS Foundation Trust, London, United Kingdom, 3Imperial College, London, United Kingdom, 4Queen Mary University, London, United Kingdom, 5St. Thomas Hospital, Vitreoretina, London, United Kingdom, 6Moorfields Eye Institute NHS Foundation Trust, Glaucoma, London, United Kingdom Purpose: Iluvien (Fluocinolone acetonide 0.19mg) is a treatment for DME. Iluvien’s outcomes were evaluated after 8 years as there is limited data beyond 7 years follow up. Methods: Retrospective review of electronic patient records (EPR) of all Iluvien treated DME patients at Moorfields Eye Hospital NHS Foundation Trust, London, England from 2014-2024 with a minimum of 8 year follow up after their 1st Iluvien injections. Results: Nine eyes of 9 patients (ages 44 -85, mean age 72, 5 men, 4 women) with DME received Iluvien & had over 8-years follow-up. Of the 9 eyes, 2 eyes had a 2nd Iluvien. Mean BCVA improved from 56 ETDRS letters to 59 ETDRS letters. Mean CMT improved from 498 microns to 355 microns. Three patients didn’t require any other anti-VEGF or ozurdex injections (ie. 33%), with 1 eye receiving a 2nd Iluvien (ie. 11%). None of the patients had glaucoma or ocular hypertension (OHT) before their Iluviens. But as Ozurdex was not commissioned for the treatment of United Kingdom (UK) National Health Service (NHS) diabetic macular edema (DME) patients in 2014, none of the 9 patients had an ozurdex before their 1st Iluvien. Incidence of ocular hypertension (OHT) was highest (55.5%, n=5) at 6 months with 11.1% (n=1) requiring topical glaucoma drugs at year 9. Glaucoma filtration surgery was indicated in 2 eyes (22%). Conclusion: Iluvien may have an effect on DME beyond 3 years, as 33% (n=3) of our cohort stopped anti-VEGF and ozurdex injections 8 years after their 1st Iluviens. whilst 11% (n=1) of our cohort needed a 2nd Iluvein. 22% of patients (n=2) stayed completely intravitreal injection free at year 8. No patients were registered as sight impaired (ie. partially sighted) at year 9. CD63+ erythroid progenitor cells contribute to retinal damage in anemia via S100A9-mediated endothelial dysfunction P.-J. Wu1,2, W.-H. Zhu3, W.-J. Zou1 1Guangxi Medical University, Nanning, China, 2Armed Police Hospital of Guangdong Piovince, Guangzhou, China, 3Sun Yat-sen University, Guangzhou, China Purpose: Anemia is linked to an increased risk of retinal hemorrhage and edema, with severity correlating to retinopathy. Elevated erythroid progenitor cells (EPCs) are present in the peripheral blood of anemic patients. In tumor-induced anemia, CD63+ EPCs display proliferative and pro-inflam- matory properties. This study investigates the role of CD63+ EPCs in anemia- related retinal health and their contribution to retinal damage. Method: We analyzed peripheral blood mononuclear cells (PBMCs) from anemic patients using flow cytometry to quantify CD63+ EPCs. These cells were isolated via fluorescence-activated cell sorting (FACS) and co-cultured with human umbilical vein endothelial cells (HUVECs) to evaluate their ef- fects on chemotaxis, migration, and proliferation through Transwell assays. S100A9 secretion was measured using ELISA, and Western blot analysis as- sessed the activation of p38 and ERK1/2 signaling pathways in HUVECs. Additionally, CD63+ EPCs were injected into NSG mice to evaluate retinal changes via hematoxylin and eosin (H&E) staining after three months. Results: Anemic patients exhibited significantly higher proportions of CD63+ EPCs in PBMCs, with an inverse correlation between hemoglobin (HGB) levels and EPC proportions. CD63+ EPCs from these patients demonstrated increased S100A9 secretion. In co-culture with CD63+ EPCs, HUVECs inhib- ited proliferation and tubule formation while promoting migration with the ac- tivation of p38 and ERK1/2 signaling pathways. Paquinimod (5 μM) partially restored HUVEC function. In NSG mice, CD63+ EPC injection caused retinal degeneration, characterized by thinning retinal layers. Paquinimod treatment (1 mg/kg/day) alleviated these retinal pathologies. Conclusion: This study underscores the role of CD63+ EPCs in retinal dam- age associated with anemia, highlighting S100A9 secretion as a key factor. Inhibition of S100A9 may offer a promising therapeutic strategy for managing anemia-associated retinopathy. EP-RET-009 Stickler syndrome without high myopia: a case report of radial lattice degeneration and foveal hypoplasia M. Puchol-Rizo1, J. Suárez-Baraza1, T. García-Herrera Prada1, L. Alcalde-Blanco1, D. Rojas-Correa1, A. Muñoz-Gallego2 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital del Tajo, Aranjuez, Spain Purpose: To highlight the importance of diagnosing Stickler syndrome in adults without high myopia through detailed fundoscopic and genetic evalu- ation. This case emphasizes the need for a comprehensive approach to detect this rare genetic disorder despite atypical presentations. Methods: A 39-year-old female with a history of unclassified bone-muscle dysplasia and no prior ocular history presented with floaters. Funduscopic examination revealed radial lattice degenerations in both eyes, and macular Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 197

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ELECTRONIC POSTER PRESENTATIONS Optical Coherence Tomography (OCT) confirmed bilateral grade I foveal hy- poplasia. Despite the absence of high myopia (refractive error: -4 D in both eyes), funduscopic and OCT findings raised suspicion of Stickler syndrome. Genetic testing confirmed a heterozygous likely pathogenic variant (c.1069- 2A>T) in the COL2A1 gene, consistent with Stickler syndrome type 1. Results: The patient underwent argon laser photocoagulation for retinal tears in the left eye, achieving stabilization without further complications during two years of follow-up. No additional interventions were required. The ge- netic findings prompted recommendations for family genetic testing, and sys- temic management of the disorder was initiated. Conclusions: This case demonstrates that radial lattice degenerations and fo- veal hypoplasia are critical findings that should prompt suspicion of Stickler syndrome, even in the absence of high myopia. Genetic testing plays a pivotal role in confirming the diagnosis, guiding patient management, and identifying at-risk family members. Early detection and regular ophthalmic monitoring are essential to mitigate the risks of retinal detachment and other complica- tions in Stickler syndrome. EP-RET-010 Diabetic retinopathy status in women with Type 1 diabetes mellitus using Hybrid Closed Loop insulin pump during pregnancy: a real-world observational study M. Varughese1,2, A. Nayak2, L. Varadhan2 1University of Sheffield, Medical School, Sheffield, United Kingdom, 2University Hospitals of North Midlands NHS Trust, Endocrinology and Diabetes, Stoke-on-Trent, United Kingdom Purpose: Insulin pump initiation and pregnancy are two known risk factors for progression of diabetic retinopathy (DR). The aim of our study was to as- sess the effect on DR in women with type 1 DM (T1DM) transitioning from a standard insulin pump to the hybrid closed loop (HCL) pump system in early pregnancy. Conclusion: The use of HCL system in early pregnancy may enable further optimization of diabetes control, over and beyond that achieved by standard insulin pump therapy. The rapid glycaemic improvement achieved may be associated with worsening DR. This warrants targeted screening during preg- nancy, especially in those with high HbA1c prior to HCL initiation and pre- existent DR. EP-RET-012 Clinical findings and medical therapy for unilateral uveal effusion syndrome (UES) in posterior microphthalmos: a case report B. Danaj3, M. Islamaj3, A. Xhetani2, A. Taullaj2, I. Zervoi2 1University Hospital Centre „Mother Theresa“, Eye Clinic, Tirana, Albania, 2University of Medicine, Tirana, Albania Purpose: Microphthalmos is a developmental ocular disorder associated with a small axial length. A rare type of microphthalmos that disproportionately af- fects the posterior ocular segment has been identified using the term “posterior microphthalmos” which is mainly associated with high hyperopia, an elevated retinal papillomacular fold (RPMF)), and pseudopapilledema. We report a critical case of posterior microphthalmos associated to UES and pseudopapilledema through the analysis of retinal imaging, and also the ef- ficacy of conservative therapy towards clinical resolution. Methods: Complete ophthalmologic examinations of all patients were per- formed using visual acuity, A-Scan USG, and multimodal imaging. Results: A 50yearold female presented with a 3week history of sudden blurred vision (BCVA: 10/200 OD & 20/30 OS). The spherical equivalents were +13.75 D in OD and +14.50 D in OS. Axial lengths were 16.20 mm in OD and 16.10 mm in OS. Slit-lamp examination showed a shallow but quiet anterior chamber. Fundus photograph OD showed an elevated RPMF and pseudopapilledema. SD-OCT depicted a large uveal effusion in the foveal area associated, increased RPE folds, and a markedly thickened choroid. The patient received latanoprost (0.005% twice a day) and oral prednisolone Method: Data on women at our centre with T1DM on standard insulin pump therapy was obtained as part of the National Pregnancy In Diabetes audit, UK. Women converted over to HCL system in early pregnancy were included for 40 mg/day in a rapid tapering fashion. After 3 weeks, OCT revealed resolution of macular edema and SRF accumulation, resolution of pseudopapilledema, and reduction of subfoveal choroidal thickness. BCVA in OD improved to analysis. Serial HbA1c and DR data (based on worst eye: none, background 20/50. Conclusions: UES is a rare disease of unknown etiology characterized by uveal effusion and SRD. The standard treatment for UES has been surgery. Increased choroidal thickening as depicted by enhanced depth imaging OCT and dilated choroidal vessels with a perivascular leakage noticed by ICGA in previous literature reports might indicate the existence of choroidal vascular inflammation which might explain the positive effect of corticosteroids em- ployment in this rare pathology. DR [BDR], pre-proliferative DR [NPDR], maculopathy [M]) pre-gestation and during pregnancy were collected. Results: N=9 on HCL Mean age 33years (23-42); BMI 28.4kg/m2 (24.2-37.2); duration of diabetes 17years (9-31) Mean HbA1c pre-pregnancy 65mmol/mol (42-98), first trimester 54mmol/ mol (39-72) and third trimester 49mmol/mol (41-63) Retinopathy status: First trimester: none (n=2), BDR (n=6), BDR+M (n=1), NPDR (0), NPDR+M (0) Third trimester: none (n=1), BDR (n=3), BDR+M (n=4), NPDR (n=1), NPDR+M (0) Two women had new maculopathy during pregnancy, were monitored through retinal clinic and did not require any treatment; patient with pre-existent mac- ulopathy remained stable throughout pregnancy Comparing HbA1c between third and first trimester, 7 of the 9 women had a reduction in HbA1c: mean reduction was 11mmol/mol (2 -24). 2 patients had >20mmol/mol reduction in HbA1c. One of them had stable BDR throughout, the other had new maculopathy, referred to retinal clinic and had required surveillance only. 198 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-013 An interesting case involving a right eye endophthalmitis in a gentleman post vitrectomy R. Farnan1, P. Stanciu2, E. O’Donoghue2, H. Nafees2 1University Hospital Galway, Ophthalmology, Galway, Ireland, 2University Hospital Galway, Galway, Ireland Purpose: The aim of this research is to direct attention towards a rare case of a bleb related infection post vitrectomy with silicone oil in situ. Method: A retrospective review was taken into surgical cases in University Hospital Galway. Results: A single case of an 82 year old gentleman was selected. Relevant his- tory significant for primary open angle glaucoma. The initial visual acuity was 6/60 to the affected eye with pinhole improvement to 6/30-2. The patient underwent triple antibiotic therapy involving oral moxifloxacin and topical vancomycin and cefotaxime respectively. The follow-up revealed visual acuity at ‚hand movements’ with a fill of silicone oil in situ. Conclusion: I report the case of an 82 year old gentleman with unilateral endophthalmitis post pars plana vitrectomy and silicone oil tamponade. A case such as this is extremely rare and forms the backbone of this interesting and niche presentation. EP-RET-016 An audit assessing the progression of patients from R2 to R3a within the diabetic screening pathway in North Central London from 2018 to 2024 S. Hewage1, S. Althauser2, I. Olejkova3 1Whittingon Health NHS Trust, London, United Kingdom, 2Royal Free London, London, United Kingdom, 3North Middlesex University Hospital, London, United Kingdom Purpose: The NHS England Diabetic Eye Screening programme (DESP) grading criteria has recently changed, including defining the R2 pre-prolifera- tive level. Patients can be defined as being R2L (pre-proliferative retinopathy of lower risk) and be referred into DS (digital surveillance) or as R2H (pre- proliferative retinopathy of higher risk) and referred to HES (Hospital Eye Service) Medical Retina Clinic for review within 13 weeks. Method: Retrospective analysis of patients within the North Central London DESP with 3 aims: 1. Number of patients in DESP who progressed from R2 to R3a from 2018- 2024 2. Frequency of follow up between progression 3. Would these patients have been classified as R2L or R2H prior to progres- sion to R3a as per new guidance - determined by reviewing retinal images Results: Data from 24976 patients within DS, OCT surveillance, ophthalmol- ogy and routine DS from 2018-2024 were reviewed. The following number of patients progressed from R2 to R3a: 7 DS 13 OCT 1 RDS Of these patients 1 patient in DS and 1 in OCT would have been categorised as R2H. Average time between encounters for patients progressing to R3a was 5 months in OCT, 8 in RDS and 6 in DS. Patients in the DS pathway who were later identified as R2H were downgraded by ophthalmology to R1, delaying followup prior to progression to R3a. In OCT a lack of 6-field photography may have limited initial grading and non- attendance to screening meant patients’ progression was detected later. Conclusion: This audit demonstrates that whilst few patients within the dia- betic retinopathy pathway progress from R2 to R3a, implementating R2 cat- egorisation into R2L/R2H can ensure timely follow up of high risk patients. Non-attendance profoundly impacted patient progression and highlights a need for public health strategies to increase uptake of screening. Future re- search should explore factors affecting attendance and re-auditing following the implementation of new changes to the DESP in October 2024. EP-RET-018 Alterations in optical coherence tomography angiography parameters after cataract surgery in patients with diabetes J. Kim1 1Hallym University Sacred Heart Hospital, Ophthalmology, Anyang, Korea, Republic of Purpose: To investigate macular and peripapillary microvascular changes in diabetic patients undergoing cataract surgery. Method: This prospective study enrolled 83 eyes from 83 diabetic patients who underwent cataract surgery. Foveal avascular zone (FAZ) area, as well as vessel density (VD) in the macula and radial peripapillary capillary plexus (RPC), were compared before and after surgery. Results: Sixty eyes (72.3%) had no diabetic retinopathy (no DR group) and 23 eyes (27.7%) had non-proliferative diabetic retinopathy (DR group). In the no DR group, the FAZ area in the superficial capillary plexus (SCP) decreased from 0.41 ± 0.13 to 0.38 ± 0.11 mm2 (P = 0.036), while no significant change was observed in the DR group (0.33 ± 0.12 to 0.30 ± 0.12 mm2, P = 0.091) at 6 months postoperatively. VD in the RPC increased from 34.4 ± 2.3% to 35.6 ± 2.3% in the no DR group (P = 0.009), but there was no significant change in the DR group (33.0 ± 3.5% vs. 34.0 ± 2.3%, P = 0.051) after 6 months. VD in the macula did not change in either group. Conclusion: Phacoemulsification reduced the FAZ area in the SCP and in- creased the VD in the RPC in diabetic patients without diabetic retinopathy at six months postoperatively. EP-RET-019 A new indication for endoillumination assisted scleral buckling: failed vitreo retinal surgeries P. Priya1, B. Kashyap1 1Kashyap Memorial Eye Hospital, Ophthalmology, Ranchi, India Study Design: Prospective interventional case series, single surgeon, 6 months duration. Purpose: To evaluate the surgical outcomes of Endoillumination Assisted Scleral Buckling (EASB) in eyes with failed vitreoretinal surgeries. Methods: Baseline characteristics of age, etiological diagnosis, time since last surgery, preoperative vision, lens status and PVR grade noted. All patients underwent non-drainage Endoilluminator assisted Scleral Buckling (EASB). Vision, retinal status, Intraocular pressure and lens status were recorded. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 199

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ELECTRONIC POSTER PRESENTATIONS Result: Retina was attached on day 1 in 91.6%(n=11) eyes that underwent EASB No patient developed endoilluminator site related break or cataract at EP-RET-021 3rd month follow up. Conclusion: Endoillumination Assisted Scleral Buckling (EASB), obviates further intraocular manipulations and it’s associated complications in an al- ready vitrectomized eye. Intracameral povidone-iodine for multidrug- resistant pseudomonas aeruginosa exogenous endophthalmitis: a case report and literature review EP-RET-020 Macular perfusion analysis using optical coherence tomography angiography post rhegmatogenous retinal detachment repair: a systematic review and meta-analysis A. Ahmed1, F. Shaheen2, H. Abu Serhan6, Z.A. Nadeem1, M. Chaudhry1, A. Naeem1, E. Ahmad3, S. Ahmed3, U. Akram1, M. Talha4, O. Ur Rehman5, A.G Elnahry6, M.A. Awan2 1Allama Iqbal Medical College, Department of Medicine, Lahore, Pakistan, 2Shifa International Hospital, Department of Ophthalmology, Islamabad, Pakistan, 3Hamad Medical Corporation, Department of Ophthalmology, Doha, Qatar, 4Fatima Memorial Hospital College of Medicine & Dentistry, Department of Medicine, Lahore, Pakistan, 5Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan, 6Services Institute of Medical Sciences, Department of Medicine, Lahore, Pakistan, 7School of Medicine and Public Health, University of Wisconsin-Madison, Department of Ophthalmology, Wisconsin, United States F.K. Mohamed5, M.S.I. Mohamed1, M.M.E. Shafei5, A. Pai5, H. Abu Serhan5 1Hamad Medical Corporation, Department of Ophthalmology, Doha, Qatar, 2Qatar University, College of Medicine, QU Health, Doha, Qatar Purpose: To report successful management of multidrug-resistant (MDR) pseudomonas aeruginosa endophthalmitis in a patient with a complex oph- thalmic history using intracameral povidone-iodine (PI). Observations: A 59-year-old male with a history of cataract surgery and mul- tiple retinal detachment repairs, presented with acute left eye pain, chemosis, redness, and vision loss. Diagnosis of exogenous endophthalmitis was made. The patient had anterior chamber washout, along with aqueous and vitreous tapping with intravitreal vancomycin, ceftazidime, and intravenous ciproflox- acin. Since infection persisted despite antibiotic therapies, a repeated anterior chamber washout followed by intracameral injection of PI 0.1% was done. Vision improved to 6/60 with no bacterial regrowth or inflammatory mem- branes on discharge and follow-up. Conclusions and importance: Intracameral povidone-iodine may offer a solution for endophthalmitis cases where standard antibiotics are ineffective. This case supports the potential role of PI in managing resistant intraocular infections Purpose: To systematically evaluate and synthesize evidence regarding mac- ular perfusion changes following rhegmatogenous retinal detachment (RRD) EP-RET-022 repair using optical coherence tomography angiography (OCTA). Methods: We registered our protocol in PROSPERO (CRD42024533072). A comprehensive search of PubMed, Scopus, ScienceDirect, and Cochrane da- tabases was conducted for studies published from the inception to November 2024. Studies comparing OCTA parameters between RRD eyes post-repair and control eyes were included. The analysis included foveal avascular zone (FAZ) area, foveal vascular density (FVD), parafoveal vascular density (PFVD), perfusion density in choriocapillaris (CC) and best-corrected visual acuity (BCVA). Results: Twenty studies comprising 686 RRD eyes (231 macula-ON, 455 macula-OFF) and 686 control eyes were analyzed. In macula-OFF cases, FAZ area remained significantly enlarged post-repair in both superficial capillary plexus (SCP) (0.06 mm², 95% CI: 0.02-0.09) and deep capillary plexus (DCP) (0.12 mm², 95% CI: 0.04-0.19). FVD showed no significant differences in ei- ther group. PFVD demonstrated a significant reduction in DCP for both mac- ula-ON (-1.38%, 95% CI: -2.72 to -0.05) and macula-OFF (-2.82%, 95% CI: -5.02 to -0.63) groups. CC perfusion density showed a significant reduction post-repair (-2.39%, 95% CI: -4.56 to -0.22). Postoperative BCVA improved significantly in macula-OFF cases (0.79 logMAR, 95% CI: 0.37 to 1.21) but showed no significant change in macula-ON cases. Conclusion: Despite successful anatomical repair of RRD, persistent altera- tions in macular perfusion parameters were observed, particularly in the mac- ula-OFF group. The enlarged FAZ area and reduced PFVD and CC perfusion density suggest lasting changes in the retinal microvasculature post-repair. However, significant improvement in BCVA, especially in macula-OFF cases, indicates that functional recovery may occur despite these vascular changes. Sub-internal limiting membrane bleeding post-laser-assisted in situ keratomileusis: an unusual complication H. Abu Serhan1, U. Naeem1, M.S.I. Mohamed2, M. Al Hashimi1, A. Pai1 1Hamad Medical Corporation, Department of Ophthalmology, Doha, Qatar, 2Qatar University, College of Medicine, QU Health, Doha, Qatar Purpose: To report a rare case of sub-internal limiting membrane (sub-ILM) hemorrhage following laser-assisted in situ keratomileusis (LASIK) surgery, managed conservatively. Observations: A 32-year-old female presented with vision loss in her left eye one month after LASIK. Examination revealed a sub-ILM hemorrhage over the macula, with initial best-corrected visual acuity (BCVA) of 6/24. After conservative management and close monitoring, her BCVA improved to 6/9 without surgical intervention as the hemorrhage spontaneously improved. Conclusions: This case highlights sub-ILM hemorrhage as a rare LASIK complication. Prompt diagnosis and monitoring are crucial, with surgical in- tervention reserved for non-resolving cases. Further research is warranted to understand LASIK’s impact on intraocular pressure and retinal vasculature. 200 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-023 Perforating wound of the left eye in a 21-year-old patient with preservation of full visual acuity K. Szala1, D. Woszczek1, A. Górska2,3, S. Sirek2,3, D. Wyględowska-Promieńska2,3 1Medical University of Silesia, Katowice, Poland, Students’ Scientific Society, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Katowice, Poland, 2Faculty of Medical Sciences, Medical University of Silesia, Department of Ophthalmology, Katowice, Poland, 3Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Department of Adult Ophthalmology, Katowice, Poland Introduction: Eye injuries contribute significantly to ocular diseases, ac- counting for 10-15% of all cases. Annually, over 55 million such injuries oc- cur worldwide, often resulting from accidents. According to the World Health Organization (WHO), they rank among the leading causes of visual impair- ment. Timely intervention is crucial, as complications such as infections, hem- orrhages, or intraocular pressure changes can cause irreversible damage if left untreated. Materials and methods: A 21-year-old patient presented to the Ophthalmologic Emergency Room with a left eye injury sustained during sheet metal cutting without protective glasses. A metallic foreign body pen- etrated the lower eyelid, traversing its full thickness, the palpebral and bulbar conjunctiva and the sclera on the nasal side. The visual acuity in the injured eye was 5/5 without correction, and intraocu- lar pressure measured 16 mmHg. A slit-lamp examination identified a scleral wound at the 7 o’clock position. A computed tomography (CT) scan ruled out an intraocular foreign body. Intravenous broad-spectrum antibiotics were administered, followed by surgical intervention. Results: Under local anesthesia, the wounds in the palpebral and bulbar con- junctiva, as well as the sclera, were revised and sutured using 8.0 sutures. Laser photocoagulation around the scleral wound was performed to prevent retinal detachment. Postoperatively, visual acuity in the left eye remained 5/5 without correction, with intraocular pressure stable at 16 mmHg. Conclusions: Early diagnosis and prompt surgical or pharmacological inter- vention can save a patient’s sight and lead to satisfactory outcomes, improving the quality of life. For these reasons, public education on first aid for eye in- juries and ensuring rapid access to specialized care are of critical importance. EP-RET-024 Visual prognostic factors following primary pars plana vitrectomy for rhegmatogenous retinal detachment B. Barbosa-Ribeiro1, J. Heitor Marques1, A.S. Martins1, D. Pires1, J.G. Santos1, J. Coelho1, A. Meireles1 1Unidade Local de Saúde Santo António, Porto, Portugal Purpose: Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and a frequent cause of vision loss. Despite surgi- cal improvements, final visual acuity can still be unsatisfactory. The purpose of this study is to identify visual prognostic factor following primary pars plana vitrectomy (PPV) for RRD. Methods: Retrospective analysis of clinical data of RRD undergoing primary 23-gauge (G) PPV between January 2020 and December 2023 at the Surgical Retina Unit of a tertiary hospital. Demographic and surgical data was col- lected. Patients submitted to prior retina surgery, other techniques than PPV or incomplete follow-up were excluded. Univariable and multivariable logistic regression analysis was performed. The area under the receiver operating curve was used for final covariate se- lection. Results: We identified 1483 vitreoretinal surgeries. Four-hundred and fifty cases were excluded due to diagnostic mislabel (83), secondary surgery (309), or surgery other than PPV (58). Four-hundred and sixty-two cases were ex- cluded due to insufficient data, follow-up losses or follow-up at different insti- tutions. Final sampled rendered 571 surgeries of 552 patients. Most patients (63.7%) were male, with a mean age was 68.9 ± 14.4 years. Mean time from symptom onset to PPV was 6.22 ± 17.3 days. Independent predictors for final best-corrected visual acuity (BCVA) above 20/40 were at- tached fovea at time of surgery (OR [95%CI]: 0.33 [0.14-0.78], p<0.001) and intraoperative cryotherapy (OR [95%CI]: 2.23 [1.43-3.48], p<0.001). Patients aged >80 years (OR [95%CI]: 0.30 [0.18-0.50], p<0.001), presence of total RD (OR [95%CI]: 0.33 [0.14-0.78], p=0.011), and intraoperative silicone oil tamponade (OR [95%CI]: 0.44 [0.22-0.87], p=0.019) presented lower odds for final BCVA above 20/40. Conclusions: Our study provides novel information regarding visual prog- nostic factors after primary PPV due to RRD. Identification of high-risk fea- tures is of uttermost importance to improve risk stratification and tailor patient counselling. EP-RET-025 Case report of sterile endophthalmitis after intravitreal injection of bevacizumab, and comparison with ranibizumab U. Feyzullayeva1 1Biovista Hospital, Baku, Azerbaijan Introduction: Endophthalmitis is severe complication of intravitreal injec- tion. It can be caused by infection as well as by sterile inflammation. Purpose: The purpose of this case report is to describe how the same patient’s eyes react to intravitreal injections of bevacizumab in one eye and ranibizum- ab in the other. Additionally, it demonstrates challenges with differential diagnosis of sterile endophthalmitis. Case presentation: A 57-year-old male presented with pain and decreased vision 36 hours following the second intravitreal injection of bevacizumab for macular edema caused by retinal vein occlusion (RVO). His visual acuity was hand motion. He had conjunctival congestion, hypopyon, pupillary mem- brane, elevated intraocular pressure (IOP), and severe vitreous inflammation. He was diagnosed with sterile endophthalmitis. He had a good response to steroids and recovered with topical treatment. His IOP normalised after pupil- lary membrane resolved. Six months later he had RVO in his right eye following poor aspirin compli- ance. After two injections of ranibizumab macular edema resolved and he did not have any complications in his right eye. Cross-reactivity in the fellow eye was not detected. His final BCVA was 0.9 in his right eye and 0.8 in his left eye. He had an epiretinal membrane and traction in his left eye. From systemic disease he had only hypertension and his coagulation test results were normal. After regular use of aspirin, he had no recurrence. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 201

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ELECTRONIC POSTER PRESENTATIONS Conclusion: Bevacizumab can cause sterile endophthalmitis. Differential di- agnosis is crucial to prevent unnecessary treatment. Aspirin can lower risk of EP-RET-027 recurrence. EP-RET-026 Real-world clinical outcomes of intravitreal anti-VEGF therapy in myopic choroidal neovascularization P. Wolfrum1, A.M. Voigt1, K. Lorenz1, B. Stoffelns1, C.A Korb1 1University Medical Center of the Johannes Gutenberg-University Mainz, Department of Ophthalmology, Mainz, Germany Purpose: To analyse clinical outcomes as well as associated treatment factors of an anti–vascular endothelial growth factor (VEGF) therapy, in patients af- fected by Myopic choroidal neovascularization (mCNV), in a real-world set- ting. Methods: We performed a retrospective investigation of all treatment-naïve patients (n = 30) affected by mCNV receiving anti-VEGF therapy, between January 2018 and March 2022. Safety, as well as functional and morphologi- cal data was analyzed over a 2-year period, by evaluating changes of visual acuity (VA), central retinal thickness (CRT) and central retinal volume (CRV). We further performed a subgroup analysis of patients exhibiting spherical equivalents (SE) above and below 10 to assess its impact on final treatment outcomes. Additionally, we evaluated the association of baseline VA and CRT on its final outcome measures. Results: Patients received on average 3.6 ± 3.6 injections. We observed statistically significant improvements of VA, CRT, and CRV. At 6 months, VA improved from 0.5 ± 0.27 LogMAR to 0.38 ± 0.31 LogMAR (p=0.005), which proved to be stable until the final 2-year follow-up. The CRT and CRV significantly decreased from 344.4 ± 115.0 µm to 284.2 ± 45.2 µm (p<0.001) and 0.27 ± 0.09 mm3 to 0.22 ± 0.04 mm3 (p<0.001), four weeks after the initial injection, with both measures remaining stable thereafter. No adverse events were noted. The subgroup analysis revealed no statistically significant difference in outcomes based on SE and baseline VA strongly cor- related with final VA, whereas baseline and final CRT did not. Conclusion: Anti-VEGF therapy in mCNV patients proved safe and effec- tive in our study, whereby significant and sustained improvements in both functional and anatomical measures were noted. We did not observe differ- ences in treatment outcomes, based on varying SE. Baseline VA was strongly associated with final VA outcomes, whereas baseline and final CRT showed no correlation. Self-reported frequency of adding salt to food and risk of age-related macular degeneration: a prospective study Y.J. Lee1,2, Y.K. Kim3,4 1Kyung Hee University Hospital, Department of Ophthalmology, Seoul, Korea, Republic of, 2Kyung Hee University College of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of, 3Seoul National University Hospital, Department of Ophthalmology, Seoul, Korea, Republic of, 4Seoul National University College of Medicine, Department of Ophthalmology, Seoul, Korea, Republic of Purpose: To prospectively determine the association of self-reported fre- quency of adding salt to foods with incident age-related macular degeneration (AMD) risk in a general population. Method: This population-based cohort study evaluated UK Biobank partici- pants aged 37 to 73 years who were free of AMD at baseline. Participants were enrolled from 2006 to 2010 and prospectively followed up for disease diag- nosis. Incident AMD cases were defined according to their diagnostic codes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models that had been adjusted for potential con- founders. Data were analyzed from April to September 2024. Results: Within a cohort of 496,152 individuals (mean [SD] age 56.48 [8.09] years; 269,742 females [54.37%]; 226,410 males [45.63%]), participants with a higher frequency of adding salt to foods were more likely to have a higher body mass index, a higher Townsend Deprivation Index score, be current smokers, and have baseline diabetes or cardiovascular disease. During a median (IQR) follow-up of 12.7 (1.5) years, 10,822 incident AMD cases were documented. Higher frequency of adding salt to foods was associ- ated with higher AMD risk after adjustment for covariates. Compared with those who had reported never or rarely adding salt to foods, those who sometimes (adjusted HR [aHR], 1.03; 95% CI, 0.98-1.07), usually (aHR, 1.11; 95% CI, 1.05-1.18), and always added salt to food (aHR, 1.17; 95% CI, 1.07-1.28) had an increased risk of AMD. The association between habitual salt-adding and AMD risk was more pro- nounced in females and White individuals. This link was attenuated in those with higher Townsend Deprivation Index scores, current smokers, and those with baseline diabetes. Conclusion: In this cohort study of 496,152 individuals, salt-adding dietary habits were associated with a higher risk of AMD. Reducing the frequency of adding salt to foods might be a valuable AMD-risk-lowering strategy. 202 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-028 Mutations in RP1 and BEST1 in a patient with retinitis pigmentosa R. Fontanilla1, K.M. Ferrer2, M.B. Ibañez3 1East Avenue Medical Center - DOH Eye Center, Ophthalmology, Quezon City, Philippines, 2East Avenue Medical Center - DOH Eye Center, Pediatric Ophthalmology and Strabismus, Quezon City, Philippines, 3East Avenue Medical Center - DOH Eye Center, Ocular Genetics, Quezon City, Philippines were all normal. A diagnosis of radiation retinopathy was made and the patient received four doses of intravitreal Ranibizumab at one-month intervals, even though evidence for this intervention is limited. The visual acuity of the left eye improved to 6/18 by the time of the third injection and has remained at this level for a follow-up period of three years. Radiation retinopathy occurs after exposure to radiation (external beam, plaque brachytherapy or stereotactic radiosurgery) administered around the orbital region, with an incidence of proliferative retinopathy reported at 6% usually occuring after 6 months to 3 years after treatment. Though nasopharyngeal carcinomas are relatively radiosensitive, a significant proportion of patients have a long life-expectancy, and therefore late visual complications can occur and are a concern to patients, ENT specialists, oph- Introduction: Retinitis pigmentosa (RP) is an inherited retinal disorder char- thalmologists and radiation oncologists. acterized by progressive photoreceptor dysfunction (primarily rods), mani- Treatment aim is to reduce retinal oedema and prevent new vessel formation, festing as nyctalopia and vision loss. It is genetically heterogenous and can involve multiple genes. This study reports a 44-year-old Filipino male who is compound heterozygous for RP1, one of which is novel, and heterozygous for BEST1, with overlapping RP features that can be seen in mutations from both genes. using options such as laser photocoagulation, intravitreal corticosteroids and anti-VEGF agents. This case highlights that even though there was no recurrence, and the patient was discharged from ENT and oncology, the latency of this case demonstrates the need for routine eye tests in patients who have undergone radiotherapy Methods: This case report includes the history, examination, diagnostics, and near the orbit. Prompt recognition and treatment is necessary to best manage inherited retinal dystrophy panel testing via next-generation sequencing. Results: A 44-year-old male presented with a 9-year history of nyctalopia and progressive vision loss. Examination showed 20/20 vision, constricted visual fields, and classic RP with mid-peripheral degeneration and bony spicule-like pigments. Fundus photo, full-field ERG, and optical coherence tomography of the macula supported classic RP. However, there was also a note of whitish patches around the macula of both eyes which hyperfluoresce on fluorescein angiography.Genetic testing revealed one pathogenic variant in RP1 c.6124del (p.Leu2042*), and another unreported variant of unknown significance in RP1 t c.5819A>G (p.Tyr1937Cys). This particular variant is not present in popula- tion database sets and is predicted to be damaging. The patient also carried a pathogenic variant in BEST1 t c.508C>T (p.Gln170*) which is also associated with RP and autosomal recessive bestrophinopathy (ARB). Conclusions: This case highlights RP’s genetic complexity. We report a case of a patient with RP carrying both RP1 and BEST1 mutations, who may have exhibited features from both genes. The identified variants and phenotype of the patient may expand RP’s genetic landscape, emphasizing the role of genetic testing in diagnosis and novel vari- ant identification. Family testing and functional studies are crucial for refining variant interpretations and exploring gene interactions. EP-RET-029 Radiotherapy for nasopharyngeal carcinoma: effect on the eye 10 years later: a case report I. Rakshit1, M. Taylor2, A. Karimi3 1Royal Surrey County Hospital, Guildford, United Kingdom, 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom, 3Sussex Eye Hospital, Brighton, United Kingdom A male in his 30s was referred to the ophthalmology department with a one- month history of blurred vision in the left eye. Ten years previously, he had re- ceived radical radiotherapy for a nasopharyngeal carcinoma staged T1N1M0. There was no recurrence and no other medical history of note. Visual acuities were 6/6 right eye and 6/36 left eye. There were fine intraretinal haemorrhages, cotton wool spots, hard exudates and cystoid macular oedema in the left eye. Blood pressure and blood tests including glucose and HbA1c visual loss. EP-RET-030 Innovative surgical approach for persistent macular holes: the role of plasma rich in growth factors technology B. Guerreiro Dias1,2, A. Lima Cabrita1,2, R. Pinheiro1,2, D. Bernardo Matos1,2, M. Yueh Faria1,2, N. Pinto Ferreira1,2 1Hospital de Santa Maria - ULS Santa Maria, Ophthalmology Department, Lisbon, Portugal, 2Faculdade de Medicina da Universidade de Lisboa, Clínica Universitária de Oftalmologia, Lisbon, Portugal Introduction: Persistent Macular Holes (MH) are defined by their failure to close after initial surgery and pose a challenging problem for which there is a limited number of surgical techniques described. Recently, some case series have shown that using plasma rich in growth factors (PRGF) as an adjunctive therapy in vitrectomy may improve closure rates. Methods: We report a case of a persistent MH successfully addressed with pars plana vitrectomy (PPV) and perfluorocarbon liquid (PFCL) assisted inverted internal limiting membrane (ILM) flap and the use of PRGF with Endoret® technology. Results: A female patient, 69 years old, was referred due to a persistent macu- lar hole in the right eye (OD). She had previously undergone PPV with an inverted ILM flap technique at another institution, which was unsuccessful in closing the MH. On examination, the patient had best-corrected visual acuity (BCVA) OD of Hand motion. Preoperatively, optical coherence tomography (OCT) revealed that the ILM flap was in situ and there was edema at the edges of the macular hole. An intravitreal injection of a dexamethasone implant (Ozurdex®) was initially attempted without any benefit. Therefore, a surgical revision was deemed necessary. A 23-gauge PPV was performed with repositioning of the ILM over the macular hole, followed by the injection of liquid PRGF over ILM and under PFCL to create a fine sheet above the hole. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 203

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ELECTRONIC POSTER PRESENTATIONS Subsequently, the Perfluorocarbon liquid was removed and replaced with sul- fur hexafluoride. At the 2-month follow-up, anatomical success was achieved with complete macular hole closure. The patient is pleased with her visual recovery, improving from a BCVA OD of hand motion to 2/10. Conclusion: This case demonstrates the effectiveness and safety of PRGF when used as an adjunctive treatment for persistent MH. While the use of PRGF in retina surgery shows promise, further research is needed to establish its efficacy, optimal concentration, timing, and mode of delivery. EP-RET-031 Comprehensive health screening program provides new insight into the prevalence of and risk factors for age-related macular degeneration: a cross-sectional analysis 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: We investigated the prevalence of age-related macular degeneration (AMD) and associated risk factors in subjects who underwent comprehensive health screening examinations. Methods: This single health screening center-based cross-sectional study included a total of 73,574 consecutive participants older than 30 years who underwent a health screening examination, including fundus photography, be- tween October 2003 and December 2010. Weighted prevalence and risk fac- tors for AMD were evaluated. Logistic regression was used to identify AMD risk factors. Results: The weighted prevalence of AMD was 15.42%, with a prevalence of 3.34% among people in their 30s. Advanced age significantly increased the risk for both early/intermediate AMD (P<0.001 across the age groups of 40, 50, 60, and 70+ years) and advanced AMD (P <0.001 for the age groups of 60 and 70+ years). The male sex was strongly associated with an increased risk of both early/intermediate and advanced AMD (P<0.001 for both). Retinal arteriosclerosis, whether low- or high-grade, was linked to early/intermediate AMD (P<0.001 for both grades), whereas only high-grade arteriosclerosis was linked to advanced AMD (P<0.001). Additionally, hypertension (P<0.001), the hepatitis B carrier status (P<0.001), elevated mean corpuscular volume (P<0.001), and lower serum uric acid lev- els (P = 0.014) were associated with early/intermediate AMD. Higher edu- cation levels protected against early/intermediate AMD (P = 0.004 for high school graduates, P <0.001 for ≥college graduates). Higher serum inorganic phosphate levels (P = 0.002) and lower total serum ALB levels (P = 0.005) were significant risk factors for advanced AMD. Conclusions: Individuals as young as 30 years old are at risk of AMD. This study newly identified associations between retinal arteriosclerosis and both early/intermediate and advanced AMD, as well as associations between serum inorganic phosphate levels and total ALB levels with advanced AMD. EP-RET-032 Diabetic macular edema in type 1 diabetes: impact of cardiometabolic health and microangiopathy P. Marques-Couto1, A. Leite2,3, P. Mota-Moreira1, A. Villard4, J. Gonçalves2, J.S. Neves2,3, M. Falcão1,3, R. Laiginhas1,3 1Unidade Local de Saúde de São João, Ophthalmology, Porto, Portugal, 2Unidade Local de Saúde de São João, Endocrinology, Diabetes and Metabolism, Porto, Portugal, 3Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal, 4Faculty of Medicine University of Porto, Porto, Portugal Purpose: Diabetic macular edema (DME) is one of the leading causes of visual impairment in individuals with diabetes. Our research group previously identified that patients with DME had a longer disease duration with glycemic control appearing to have a borderline effect on DME development. This study aims to assess whether DME may be associated with cardiovascu- lar dysfunction and microangiopathic factors. Methods: Retrospective cohort study of adult T1D patients followed at a ter- tiary diabetes and ophthalmology center until 2024. Results: The study included 210 patients, with a mean age of 46±13.4 years. Thirty-eight patients (18.1%) had a history of DME. Patients with a history of DME were older (55.6±14.1 versus 43.9±12.2 years, p<.001), had a longer disease duration (35.9±9.5 versus 24.2±10, p<.001), higher prevalence of pro- liferative retinopathy (76.3% versus 14%), nephropathy (p<.001), and neu- ropathy (p<.001). They also had lower estimated glomerular filtration rate (eGFR) (75.9±36.7 versus 97.9±21.1 ml/min/1.73 m2), higher prevalence of dyslipidemia (p<.001), hypertension (p=0.037), stroke (p<.001), and higher systolic blood pressure (SBP) (138.8±19 versus 126.8±12.1 mmHg, p<.001). Multivariate logistic regression demonstrated that the diagnosis of DME was associated with microvascular complications and cardiometabolic risk factors, including severity of diabetic retinopathy (OR=2.78, p<.001), nephropathy (OR=4.37, 95% CI: 1.78-10.73, p<.001), dyslipidemia (OR=3.89, p=0.009), as well as higher SBP (OR=1.06, p=0.002) and lower eGFR (0.98, p=0.028), regardless of disease duration. Conclusion: In this large cohort of T1D patients, individuals with history of DME exhibit a worse cardiometabolic profile regardless of disease duration without differences in glycemic control. These findings interestingly support that DME in T1D patients may be associated with secondary predisposing factors rather than the isolated action of hyperglycemia. EP-RET-033 Diabetic macular edema at the interference between clinical, laboratory and optical coherence tomography biomarkers S.D. Nicoara1, V.-I. Suciu2, A. Cutas2, C.-I. Suciu2 1“Iuliu Hatieganu“ University of Medicine and Pharmacy, Ophthalmology, Cluj-Napoca, Romania, 2“Iuliu Hatieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania Purpose: To identify new correlations between clinical, laboratory and OCT biomarkers in patients with diabetic macular edema (DME) that would lead to new pathogenetic hypotheses and pave the way for the development of in- novative diabetes mellitus (DM) therapies. 204 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Method: We formed 3 groups of subjects: healthy, type 1 DM (group A), type 2 DM (group B) and analyzed the following biomarkers: clinical (demo- graphic, DM severity, systemic vascular complications), laboratory (glycated hemoglobin, metabolic, capillary Oxygen saturation, renal function), OCT (macular volume MV, central macular thickness CMT, maximal central thick- ness MCT, minimal central thickness mCT, foveal thickness FT, superior- inner SIT, inferior-inner IIT, nasal-inner NIT, temporal-inner TIT, superior- Conclusion: To our knowledge, our case is the first reported case of ABCA4- RP caused by this novel compound heterozygous mutation. In addition, our case contributes to incidence reporting and profiling of inherited retinal dys- trophies, and demonstrates their phenotypic and genotypic heterogeneity, which can help in the diagnosis and management of these diseases. outer SOT, inferior-outer IOT, nasal-outer NOT and temporal-outer thickness TOT, ellipsoid zone disruption EZD and disruption of the inner retinal layers EP-RET-037 DRIL). Macular OCT scan was performed (Heidelberg SPECTRALIS® OCT2 Module Infrared Reflectance, fast macular scan, thickness map 20x20°scan, 25 slices/retina at 200 µm). All scans were processed by the Spectralis Software version 6.10.5. We used SPSS Statistics v. 28.0.1 and Microsoft Office 2016. ANOVA, t-test, Mann-Whitney U and Kruskal-Wallis test for independent samples were applied. Significance was considered if p<0.05. Results: DM duration, smoking and systemic vascular complications was sig- nificantly higher in group A, capillary Oxygen saturation and estimated glo- merular filtration rate, significantly lower and serum creatinine significantly higher in group A. In both groups, DME was predominantly eccentric and the right eye was more severely affected. We identified significantly more affected OCT biomarkers in group B: MV, CMT, MCT, mCT, FT, SIT, IIT, NIT, IOT, NOT. EZD was more prevalent in group A, whereas DRIL in group B. Conclusion: The systemic and laboratory biomarkers were more severely af- fected in group A, while the OCT ones in group B. EP-RET-035 Is bigger better? A retrospective analysis of the efficacy of Eylea 8mg intravitreal injections Á. Kelly1, F. Fadzil1, D. McAteer1 1Sligo University Hospital, Department of Ophthalmology, Sligo, Ireland Purpose: Eylea (aflibercept) 8mg is a newly approved treatment in Europe, available since January 2024, for wet age-related macular degeneration (wAMD) and diabetic macular oedema (DMO). This study aims to evaluate its real-world efficacy in reducing intraretinal fluid (IRF), extending treatment intervals, improving visual acuity (VA), and enhancing patient satisfaction. Methods: A retrospective analysis was conducted on 50 patients treated with Eylea 8mg for 6 months at a tertiary centre in Ireland for AMD and DMO. Outcomes of interest included changes in IRF (assessed via optical coher- ence tomography), VA (logMAR), injection interval adjustments, and patient satisfaction (evaluated using standardized surveys). Baseline metrics and prior treatment regimens were reviewed for comparison. Results: Eylea 8mg was introduced in September 2024 at our centre, so the 6 month follow up period has not elapsed at time of writing this abstract but Beyond the known: expanding the phenotype of retinitis pigmentosa in a patient with novel mutation in ABCA4 study results will be available for the meeting in June. Preliminary trends sug- gest that Eylea 8mg has the potential to significantly reduce IRF, improve VA, and extend injection intervals in DMO, although the results are not as stark S.M. Lee1, M.B.I. Ibañez1 1Makati Medical Center, Ophthalmology, Makati, Philippines in wAMD. Early feedback highlights moderate levels of patient satisfaction, particularly regarding the reduced injection frequency compared to previous regimens. Conclusions: Eylea 8mg represents a promising advance in the pharmacolog- Introduction: Retinitis pigmentosa (RP) is a hereditary retinal disease charac- ical treatment of retinal vascular diseases for which the drug is approved. As terized by the classic triad of bony spicule pigmentation, waxy optic disc pal- the population of Europe continues to age, the incidence of AMD and DMO lor, and vessel attenuation. It exhibits genotypic heterogeneity with multiple genes implicated in its disease mechanism, including the ABCA4 gene. Stargardt disease (STGD) and ABCA4 retinopathies (ABCA4R), on the other is expected to rise, increasing the burden on ophthalmic services. The higher- dose formulation of aflibercept offers a potential solution by improving clini- cal outcomes while reducing treatment burden and travel times for patients. hand, are caused by pathogenic variants in the ABCA4 gene inherited in an autosomal recessive manner. The gene encodes an importer flippase protein that prevents the build-up of vitamin A derivatives that are toxic to the retinal This welcome addition to available therapies may help optimize disease man- agement for patients across Europe. Further long-term studies are necessary to confirm its efficacy and safety. pigment epithelium (RPE). This build-up of Vitamin A derivatives results in the characteristic finding of yellow, pisciform flecks in STGD. Diagnosing ABCA4R is complex due to its phenotypic heterogeneity, with ABCA4 being known to cause RP, STGD, and cone-rod dystrophy (CRD). Results: This is a case of a 30-year-old Asian male who presented with poor bi- lateral vision since childhood. Best corrected visual acuity (BCVA) was count- ing fingers at 1 foot on the right eye and hand movement on the left eye. Examination and diagnostic imaging showed overlapping features of both retinitis pigmentosa and STGD, in addition to features of a uveitic process, including mild inflammation, and the presence of a unilateral persistent pupil- lary membrane. Uveitis work-up was requested which showed inconclusive results. An inherited retinal dystrophy panel was subsequently done which revealed the patient to have a compound heterozygous mutation in the ABCA4 gene, with one variant being novel (ABCA4 c.4253+5G>A, c.161-23T>A). Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 205

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ELECTRONIC POSTER PRESENTATIONS EP-RET-038 EP-RET-039 Acute syphilitic posterior placoid chorioretinitis A. Zubrytska1 1Visium Medical Center, Department of General Ophthalmology, Kramatorsk, Ukraine The prevalence of posterior segment eye disease (PSED) in an older population in rural Tanzania S. Colgan1 1Newcastle University, Newcastle, United Kingdom A 29-year-old male presented with a complaint of a sudden-onset dark spot in front of the right eye (OD). Symptoms began abruptly 10 days prior to presen- tation, with no history of trauma or systemic illness. Clinical Examination - Visual Acuity (Visus): - OD: 0.3 (sph-0.25 to 0.4) - OS: 1.0 - Tonometry (iCare): OD 15 mmHg, OS 17 mmHg - Biomicroscopy: Purpose: Visual impairment negatively impacts people’s independence, op- portunities, and quality of life. Posterior segment eye disease (PSED) involves diseases affecting the back of the eye. This study focuses on glaucoma, age- related macular degeneration (AMD), diabetic retinopathy (DR), and hy- pertensive retinopathy (HR). There is a lack of existing research into PSED prevalence and risk factors, in low-resource settings like Tanzania, where their burden is greater. This study aims to assess: 1. The prevalence of PSED in a rural Tanzanian cohort aged 60 and over. - OD: Quiet eye, anterior chamber of medium depth, clear lens, lively pupil 2. The correlates of hypertension, diabetes mellitus, and other risk factors on reaction. - OS: Normal findings. - Ophthalmoscopy: - OD: Optic disc (OD) margins indistinct nasally, vascular pattern unchanged (a:v ratio 2:3). Macula visualized but with smoothed foveolar reflex, contour deformation. - OS: Normal findings. Diagnostic Workup - Serological tests for syphilis (Treponema pallidum): Positive for IgM and IgG. - Additional tests: Negative for HIV, Hepatitis B/C. - Imaging: OCT of the posterior segment revealed alterations in the retinal pigment epithelium (RPE) and choriocapillaris. - MRI of the brain: Normal findings. Definitive Diagnosis: Acute syphilitic posterior placoid chorioretinitis (ASPPC) in the right eye. Treatment and Follow-Up - Antibiotic Therapy: - High-dose intravenous Penicillin G, 24 million units/day for 14 days. - Monitoring: Regular assessment of complete blood count (CBC), creatinine, and urea during treatment. - Outcomes: - On the 7th day of treatment: - Visual acuity: 1.0 (OD), 1.0 (OS). - OCT: Significant resolution of macular abnormalities. This case highlights key diagnostic challenges: 1. Non-specific symptoms such as visual impairment and central scotoma. 2. Ophthalmoscopic findings of yellowish-white placoid lesions in the macula. 3. Confirmation through serological testing, OCT, and fluorescein angiogra- phy (FA). This case underscores the importance of a multidisciplinary approach in di- agnosing and managing ASPPC. Early recognition, prompt serological test- ing, and appropriate antibiotic therapy can restore vision and prevent systemic complications. PSED prevalence rates. 3. The usability of the VOLK iNview retinal camera in low-resource settings. Method: A cross-sectional study, of 217 adults (age ≥ 60 years), in a rural Tanzanian village. Data were collected on demographics and risk factors, with medical and eye assessments completed. The eye assessment included visual acuity, intraocular pressure measurement and retinal imaging (VOLK iNview camera). Two independent graders reviewed the retinal images, and a third grader arbitrated. Results: Of 209 gradable participants, suspected glaucoma had a prevalence of 9.6% (95%CI 5.6-13.6), which was higher than previously reported, while fewer had AMD, DR and HR, with prevalence of, 2.9% (95%CI 0.6-5.1), 1.9% (95%CI 0.1-3.8) and 0.96% (95%CI -0.4-2.3), respectively. Glaucoma was significantly related to age (p = 0.039). Conclusions: Baseline data on the prevalence of PSED in rural Tanzania has highlighted the high glaucoma burden. Remote retinal imaging is a new, excit- ing method of screening for PSED, with the potential to prevent visual loss. EP-RET-040 Missed intra ocular foreign body R. Singh1 1Kettering General Hospital, Ophthalmology, Kettering, United Kingdom Intra ocular foreign body is an emergency in any eye emergency. But sometimes clinical examination and radiological investigations can miss the diagnosis of IOFB. This case depicts that simple tests available in clinic like a B scan can be very helpful to diagnose a IOFB rather than waiting for a CT scan report. A 53 year old male patient was working on a grinding machine and the parts broke and few iron pieces fell on face. The patient reported to eye casualty with blurred vision. On examination vitreous hemorrhage was noticed . CT scan was ordered which mentioned no evidence of foreign body. About one year later patient presented to the eye casualty again with increased blurred vision. A B scan picked up an IOFB. Pt was appropriately refd to VR services for further management. 206 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-041 A case of Purtscher’s-like retinopathy in acute pancreatitis M. Tavares Correia1, J. Romana1, F. Madeira1, A. Ribas1, F. Vaz1 1Centro Hospitalar Lisboa Ocidental, Ophtalmology, Lisboa, Portugal Introduction and Objectives: Purtscher-like retinopathy is a pathology that occurs in the context of microembolization with microvascular infarction. It is characterized by retinal changes, including retinal hemorrhages, cotton wool spots and whitish intraretinal lesions known as Purtscher flecken, in a patient without a history of trauma. Some of the main causes of this condition include acute pancreatitis, renal failure and orthopedic surgery. This case report highlights the rare occurrence of Purtscher’s-like retinopathy associated with acute pancreatitis. A 60-year-old male presented to the emer- gency room with abdominal pain and bilateral vision loss, demonstrating a link between a systemic inflammatory condition and retinal damage. Materials and Methods: A 60-year-old man presented with severe abdominal pain radiating to the back and reduced visual acuity. Laboratory tests showed elevated amylase and lipase levels. Abdominal CT findings were consistent with acute pancreatitis. Fluid therapy was initiated, and ophthalmologic evalu- ation was sought. Upon examination, the patient’s BCVA was 0.2 in the right eye and 0.3 in the left. Pupils were isocoric and reactive, with no anterior chamber abnormalities. Fundus examination revealed bilateral symmetric peripapillary cotton wool spots and cystoid macular edema. Optical coherence tomography and retinography were used to document the findings. Results: Fundoscopic findings of bilateral cotton wool spots and macular ede- ma were characteristic of Purtscher’s-like retinopathy. OCT confirmed cystic macular edema in both eyes. Despite fluid therapy and resolution of pancrea- titis, visual acuity remained impaired. Conclusion: Purtscher’s-like retinopathy is a rare but serious ocular compli- cation of systemic conditions like acute pancreatitis. Early ophthalmologic evaluation and retinal imaging are crucial for diagnosis, but visual prognosis remains guarded, especially in cases involving significant macular edema. EP-RET-042 Digging deeper: branch retinal vein occlusion and buried Optic Disc Drusen J. Brissos1, R. Correia1, N. Rodrigues Alves1, R. Gertrudes1, R. Pinto1 1Unidade Local de Saúde São José, Lisboa, Portugal Introduction: Optic disc drusen (ODD) are predominantly hyaline calcified deposits located within the optic nerve head, with an estimated prevalence of 2.4%. Although generally benign, ODD may progressively increase, pre- disposing to complications from compressive effect. Superficial ODD appear as round white or yellow refractile bodies. However, buried ODD are more challenging to detect, requiring multimodal imaging for accurate diagnosis. Objectives: To report a case of branch retinal vein occlusion associated with ODD and describe the characteristic findings on EDI-OCT and fundus auto- fluorescence (FAF). Methods: Case report – multimodal imaging analysis including FAF, Fundus Angiography, and SD EDI-OCT (Spectralis OCT, Heidelberg Engineering). Results: 31-year-old woman with hypertension, obesity and under combined hormonal contraception attends a routine ophthalmology consultation and re- ports a sudden episode of lower visual field amputation in the left eye (OS) at 18 years old, with partial recovery. Imaging revealed stigmata of superotem- poral branch retinal vein occlusion in OS and a characteristic pattern of ODD bilaterally: FAF identifies two hyperautofluorescent circular structures in the optic disc head of the right eye and larger, similarly shaped structures in OS, which on EDI-OCT corresponds to round structures with irregular partially hyperreflective borders, and hyporreflective core. Conclusions: ODD may increase in size and exert mechanical pressure on the lamina cribrosa, predisposing to complications such as retinal vein occlu- sions, non-arteritic anterior ischemic optic neuropathy and visual field defects. Pre-existing pro-thrombotic risk factors may have triggered this vascular com- plication at an early age. FAF allows the identification of superficial ODD, however, EDI-OCT is the most reliable method, especially for buried, small, or non-calcified ODD. EP-RET-043 Biomechanical predictors of rhegmatogenous retinal detachment in myopic patients B. Vieira1, J. Heitor Marques1, P. Manuel Baptista1, A. Marta1, P. Sousa1, S. Pires1, R. Ambrósio2, A. Meireles1,3, P. Menéres1,3, J. Melo Beirão1,3 1Centro Hospitalar Universitário do Porto, Oftalmologia, Porto, Portugal, 2Federal University of the State of Rio de Janeiro (UNIRIO), Department of Opthalmology, Rio de Janeiro, Brazil, 3Instituto de Ciencias Biomedicas Abel Salazar, Porto, Portugal Purpose: To analyze, dynamically and in vivo, ocular biomechanics in high myopic patients with RRD. Our secondary outcome was to address demo- graphic, biometric and biomechanical predictors of RRD. Setting: Surgical Retina Clinic, Ophthalmology Department, Centro Hospitalar e Universitário do Porto, Portugal Methods: Observational cross-sectional case-control study, that included sub- jects with myopia and history of RRD in one eye (RRD group), together with a control group of age and AL-matched subjects with no history of retinal tear or RRD in any eye. In the RRD group, only the fellow non-RRD non-operated eye was included for analysis. Biomechanical assessment was performed with Corvis Scheimpflung Technology® (Oculus, Germany) and AL was measured with Anterion® (Heidelberg, Germany). Results: This study included for analysis 40 subjects (20 eyes of 20 patients in each group). Age (p=0.959), AL (p=0.879) and intraocular pressure (p=0.489) were well matched between groups. A multivariable logistic regression con- firmed an independent effect of A1 Deflection Amplitude (standardized coef- ficient = -1.096, Wald test p-value=0.027), HC time (-1.207, p=0.030), and height (1.554, p=0.030) on RRD, with an area under the curve in the ROC analysis for this model of 0.897. We found no association between biomet- ric or biomechanical parameters and the characteristics of RRD or final best- corrected visual acuity. Conclusions: We observed that the eyes of patients with RRD have stiffer measured biomechanics when compared to controls. The different biome- chanical behavior between the vitreous and the sclera (to which the retina is ultimately attached) results in higher shear stress at the vitreoretinal interface. We hypothesize that RRD develops in cases where this balance is disrupted by a stiff sclera on one side and a compact vitreous on the other. The associa- tion between body height and RRD may also relate to systemic genetically determined biomechanics. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 207

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ELECTRONIC POSTER PRESENTATIONS EP-RET-044 EP-RET-045 New gene on the block: a novel genetic link to retinitis punctata albescens O. Listano1, M.B.I. Ibañez1 1Makati Medical Center, Ophthalmology, Makati City, Philippines Introduction: Retinitis punctata albescens (RPA) is most frequently associ- ated with mutations in the retinaldehyde-binding protein 1 gene (RLBP1) but has never been reported with the retinal fascin gene (FSCN2). Preliminary reports have shown cone and rod-cone inherited retinal dystrophy associations in mutations involving FSCN2 but none presented as RPA. We report a Filipino female with an FSCN2 variant who presented findings phe- notypically consistent with RPA. Case Report: A 35-year-old Filipino female presented with bilateral blur- ring of vision especially worse at night after entering her 3rd decade of life. Fundoscopy and other diagnostic procedures, including fundus autofluores- cence, full-field electroretinogram, ocular coherence tomography and pe- rimetry were consistent with RPA. An inherited retinal dystrophy panel re- vealed the patient to be heterozygous for FSCN2 c.1336C>T (p.Arg446Trp). Segregation analysis was also done to both parents which showed them to be negative for this variant. Case Discussion: Patient presented with an RPA phenotype and a variant of unknown significance was found in FSCN2 c.1336C>T (p.Arg446Trp). This missense change has been observed in individuals with clinical features of FSCN2-related retinal dystrophy, specifically nonsyndromic RP but not RPA The FSCN2 gene currently has no well-established disease association. However, there have been previous reports supporting a correlation with in- herited retinal dystrophies, specifically cone-rod dystrophy and autosomal dominant retinitis pigmentosa (ADRP) in four unrelated Japanese families. To our knowledge, our case is the first reported case of a patient with a FSCN2 variant and a phenotype of RPA. Conclusion: This is the first case report of a patient who phenotypically pre- sented as a case of RPA that is associated with mutation in the FSCN2 gene. This acts as preliminary evidence and suggests a broader role of FSCN2 in the pathogenesis of inherited retinal dystrophies, including RPA. Incidence of atrial fibrillation in newly diagnosed retinal vascular occlusion and risk modification post-alcohol abstinence S. Choe1, S. Choi2, S. Shin3, J. Lee3, I.H. Hong4, I.B. Chang5, A. Ha6, Y.K. Kim7 1Chungnam National University, Daejeon, Korea, Republic of, 2Seoul National University Hospital, Seoul, Korea, Republic of, 3SAMIL Pharmaceutical Co., Seoul, Korea, Republic of, 4Dongtan Sacred Heart Hospital, Hwasung-si, Korea, Republic of, 5Seoul ON Eye Clinic, Seoul, Korea, Republic of, 6Jeju National University Hospital, Jeju-si, Korea, Republic of, 7Seoul National University, Seoul, Korea, Republic of Purpose: While the association between atrial fibrillation (AF) and retinal vascular occlusion (RVO) has been documented, the incidence of AF among RVO patients and the impact of alcohol abstinence on AF risk remain un- clear. This study aimed to analyze AF incidence in newly diagnosed RVO patients and the association between alcohol abstinence and AF risk. Methods: In the Korean National Health Insurance Service claim database, we identified patients newly diagnosed with RVO from 2010 to 2014. Patients were divided into non-drinker, abstainer, and current-drinker groups based on their alcohol consumption status before and after RVO diagnosis. We com- pared AF risk among the groups until 2021, examining incidence rate differ- ences (IRDs) after inverse probability of treatment weighting. Results: Among 46,615 newly diagnosed RVO patients, 61.8% were non- drinkers, 29.4% were current drinkers, and 8.8% abstained from alcohol post- RVO diagnosis. Over 280,157 person-years, 4.5% (n=2,089) incurred incident AF, at a rate of 7.14 (95% CI: 6.88, 7.40) per 1000 person-years. Abstainers and non-drinkers showed a reduced probability of developing AF compared with current drinkers (IRDs: -1.67 [-2.83, -0.50] for abstainers and -0.92 [-1.65, -0.19] for non-drinkers, per 1000 person-years). Current drinkers’ higher alcohol consumption in terms of both binge drinking per session (quantity) and higher frequency of drinking heightened their AF risk (All Ps < 0.001). Conclusions: A significant number of RVO patients developed AF. Abstaining from alcohol post-RVO diagnosis could lower this risk. Clinicians should em- phasize lifestyle changes to RVO patients to mitigate adverse cardiovascular outcomes. EP-RET-047 Central vein occlusion in a patient with confirmed mutations in PAI-1 and C677T genes – A case report D. Cholakova1, Y. Zdravkov1, A. Oskar1 1Medical University Sofia, Department of Ophthalmology, Clinic of Ophthalmology , Aleksandrovska University Hospital, Sofia, Bulgaria, Bulgaria Purpose: To present a clinical case of a patient with central retinal vein occlu- sion, as the first episode of a vascular incident, confirmed to have mutations in the methylenetetrahydrofolate reductase (MTHFR)gene and plasminogen activator inhibitor 1(PAI-1) gene, successfully resolved with the application of an anti-VEGF medication. 208 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Method: We present the case of a 48-year-old male patient with a first episode of a vascular incident, characterized by central retinal vein occlusion.Until EP-RET-050 the onset of the condition, the patient had not been taking anticoagulant medi- cations and had no history of ocular pathology. Comprehensive testing con- firmed mutations in two genes:PAI-1, responsible for fibrinolysis, and C677T, associated with elevated homocysteine levels. Results: Upon admission,the patient presented 0.2 vision in the right eye and a confirmed central retinal vein occlusion with macular edema, as demon- strated by angio-OCT and fluorescein angiography (FA). Clinical evaluation revealed optic disc edema,micro- and macrocystoid edema in the macular area and flame-shaped hemorrhages across the posterior pole. A decision was made to initiate therapy with an intravitreal anti-VEGF agent according to protocol,three injections at one-month intervals. Concurrent blood tests confirmed the presence of two mutations with varying significance in the PAI-1 and C677T genes. The patient was also started on additional anticoagulant therapy. After six months of follow-up, the patient’s vision improved to 0.7, with no macular edema or hemorrhages. Management of retinal lesions in countries that do not have photodynamic therapy L. León Nieto1, H. Quintanilla1, M. Barrios1, F. Marroquín1, A. Cárdenas1 1Mesoamericana University, Visualiza Hospital, Guatemala, Guatemala Case Study: The presentation discusses the management of retinal lesions, such as hemangiomas and vasoproliferative retinal tumors located at the pos- terior pole, in countries where photodynamic therapy is not available. The presentation is based on two clinical cases that highlight alternative therapeu- tic approaches. The first case involves a 55-year-old male referred with a suspected melanoma in the right eye. An ultrasound revealed a dome-shaped lesion, raising suspi- Conclusion: Retinal vein occlusion is a vision-threatening condition with a cion of choroidal melanoma. However, during further imaging, the patient wide range of potential complications.Timely treatment is crucial for achiev- ing favorable outcomes. In addition to standard therapeutic approaches, iden- tifying the etiological cause is of paramount importance. In young patients with genetic mutations in coagulation-related genes, retinal vein occlusion may represent the first manifestation of pathological circulatory disorders. EP-RET-048 Progression of diabetic retinopathy following the retinal nerve fiber layer thickness using optical coherence tomography E. Kujundzic Begovic1, A. Mahmuljin1 1Clinical Center University of Sarajevo, Eye Clinic, Sarajevo, Bosnia and Herzegovina Purpose: Aim of this study is to show progression of diabetic retinopathy by comparing changes in retinal nerve fiber layer (RNFL) thickness. Methods: In this study we divided our patients into three groups, first group of diabetic patients with different stages od diabetic retinopathy (DR), group of diabetic patients without clinical signs of DR and third group of apperently healthy controls. RNFL thickness was mesured in all three groups using opti- cal coherence tomography. Results: This study showed a statistically significant difference in RNFL measured in all three groups of patients (P < 0.05). RNFL thickness was re- duced in diabetic retinopathy compared to normal controls and the thinning increased with the severity of DR. Conclusions: This study showed that neurodegeneration starts before the ap- pearance of clinical signs of DR. Following RNFL thickness in patients with diabetes mellitus can be used as a biomarker in menagment of DR, and pos- sible finding of neuroprotective cure which can reduce neurodegeneration. presented with a Grade IV vitreous hemorrhage. A diagnostic vitrectomy was performed, and pathology confirmed the sample was composed of red blood cells, not a malignancy. A diagnosis of a retinal vasoproliferative tumor was made. The patient was successfully treated with intravitreal anti-VEGF injections, leading to resolu- tion of the hemorrhage and favorable visual outcomes. Has been monitored for two years without regression. The second case features a 40-year-old female with a history of renal neopla- sia ten years ago, who presented with recent vision loss. Imaging revealed a choroidal hemangioma at the posterior pole, associated with a serous macular detachment. The patient was treated successfully with anti-VEGF injections and focal laser therapy, leading to resolution of the macular serous detachment and significant improvement in vision. The purpose of this presentation is to explore alternative therapeutic options, such as anti-VEGF and laser therapy, in countries lacking photodynamic ther- apy, providing effective treatments for retinal vascular lesions and improving patient outcomes. EP-RET-051 Our results with the usage of faricimab (Vabysmo) in patients with wet AMD C. Vidinova1 1Military Medical Academy, Department of Ophthalmology, Sofia, Bulgaria Objective: Age related macular degeneration – AMD affects more than 67 million people around the globe and is a cause of blindness worldwide. The aim of our study is to show our first results with the usage of Faricimab (Vabysmo) in the treatment of patients with wet form of AMD. Material and Methods: In our study 23 patients with wet form of AMD were enrolled. They were thoroughly examined for VA, color fundus photogra- phy, OCT and OCT-A. 10 of them were treatment naïve and 13 patients were switched from Eylea. All were treated in a Treat and Extend manner after the first 4 loading doses. Results: In the first group of treatment naïve patients a quick reduction of the intraretinal fluid was seen. Diminishment of CRT with more than 60 mk was observed even after the first two injections. The RPE detachments were also quickly flattened. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 209

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ELECTRONIC POSTER PRESENTATIONS In the second group about 40% of the patients showed quick improvement with reduction of the CRT of about 100 mk and drying of the macula. However in about 10% the change in the macular was not so rapid as in the first group. In less than 2% of the patients with advanced AMD no change after the switch was found. Conclusions: Our results show that Faricimab (Vabysmo ) is effective both in treatment naïve and switched patients with AMD. The inhibition of the two signal pathways in Vabysmo leads to quicker and effective reduction of in- traretinal fluid in the macula and reduces CRT. The drug is also with long lasting effect which is achieved with less number of applications. In treatment naïve patients the results are quicker than in switch patients. That may be due to the more advanced stage of AMD of the latter. In any case our results point out that Faricimab (Vabysmo) is a promising alternative to other anti-VEGF drugs in the treatment of AMD. EP-RET-054 Purtscher-like retinopathy as an ocular end-organ microvascular angiopathy in Thrombotic microangiopathy D.H. Chung1, Y.-G. Park1, Y.-H. Park1 1The Catholic University of Korea, College of Medicine / Seoul St. Mary’s Hospital, Ophthalmology and Visual Science, Seoul, Korea, Republic of Purpose: We report 9 cases of microvascular occlusive event in the retina, leading to a diagnosis of Purtscher-like retinopathy, in patients with throm- botic microangiopathy. Methods: A retrospective chart review was done for hematology patients with thrombotic microangiopathy, who received a retinal examination. The demographics, laboratory results and systemic treatment course was analyzed, along with ocular findings, including the best-corrected visual acuity, pres- ence of peripapillary or peri-macular retinal hemorrhage, cotton-wool spots, macular edema or disc swelling. Results: Fundus photography images were available in five patients, while bed-side examination with an indirect ophthalmoscope was done in four pa- tients. Transplant-associated thrombotic microangiopathy(n=5) was the main cause for poor systemic and ocular outcomes. These patients generally suf- fered from a larger extent of cotton wool spots or retinal hemorrhages, with macular involvement being the critical factor for poor visual outcome. Eight patients received an average of 9±13cycles (1-44cycles) of thera- peutic plasma exchange while one patient received two injections of eculi- zumab. All patients received systemic steroid with a cumulative dosage of EP-RET-055 Absorbable gelatin sponge as an intrascleral buckle in rabbits and preliminary clinical use evaluation R. Dai1, Y. Zhou1, Z. Chen1 1Peking Union Medical College Hospital, Beijing, China Purpose: This study aimed to evaluate the efficacy and safety of using an ab- sorbable gelatin sponge as an intrascleral buckle in rabbit eyes; it also evaluate preliminary clinical effect of the gelatin sponge use in rhegmatogenous retinal detachment patients. Methods: Ten New Zealand white rabbits underwent surgery to implant an absorbable gelatin sponge as an intrascleral buckle. Weekly ophthalmic exam- inations were conducted before and after the procedure until the implant was fully absorbed. Assessments included external eye and fundus examinations, color fundus imaging and optical coherence tomography. Safety and efficacy were determined by comparing pre-operative and post-operative conditions. Two patients with RRD were treated with intrascleral buckle and assessed postoperatively. Results: The surgery was successfully completed in 12 of 20 eyes, yielding favorable postoperative outcomes. Eight eyes were excluded due to issues with scleral tunneling, including accidental penetration, suprachoroidal im- plantation of the sponge, and choroidal excavation, resulting in a success rate of 60%. The indentation produced by the gelatin sponge implant progressively decreased, entirely disappearing within 2 weeks. No complications, such as retinal or choroidal hemorrhage or detachment were observed. RRD resolved in 1 week and indentation disappeared within 4 weeks. Conclusion: Intrascleral implantation of absorbable gelatin sponge was safe and effective for scleral buckling in rabbits and preliminary clinical use, dem- onstrating favorable biodegradation characteristics. EP-RET-056 Patient involvement in development of customised care plans for genetically-confirmed inherited retinal degeneration J. Zhu1, K. Stephenson1, A. Long1, J. Turner1, J. O’Byrne1, A. Dockery2, L. Whelan2, J. Farrar2, D. Keegan1 1Mater Misericordiae University Hospital, Clinical Genetics Centre for Ophthalmology, Dublin, Ireland, 2Trinity College Dublin, The School of Genetics & Microbiology, Dublin, Ireland 2805.6±3151mg (625-10375mg). Purpose: Inherited Retinal Dystrophies (IRD) are a leading cause of visual Only one patient received an intravitreal steroid injection (dexamethasone and loss in the working-age population. This clinically and genetically heteroge- triamcinolone subsequently), with limited functional or anatomical improve- nous group of disorders requires tailored management and personalized action ment in the retina. Conclusions: This retrospective study elucidates some risk factors for poor ocular prognosis in thrombotic microangiopathy, and also presents the differ- ent types/stages of retinal vascular occlusive event. plans at each review. There is often a lack of awareness amongst patients and professionals of all the resources, supports and therapies potentially available to them. Method: Sample care plans were created for Stargardts Disease (the most In cases where ocular symptoms or signs precede the diagnosis of thrombotic commonly detected genotypes from our IRD cohort). A template format was microangiopathy, considering the possibility of thrombotic microangiopathy created which provides the phenotype (imaging and functional data with re- and consulting with hematologic specialists may lead to a prompt diagnosis port) and genotype (distinguishing known and unknown variants) following and systemic treatment, for better systemic and ocular outcomes. appropriate genetic counselling. The relevant current recognised treatments of the condition and co-morbidities are highlighted. Where no active treatment is available this is indicated. Supports (co-ordinated by our Eye Clinic Liaison Officer- ECLO) are recommended. A list of the relevant pre-clinical and clini- 210 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS cal studies (including trials) are made available. Natural history graphs were deemed inappropriate to include except by special request. This draft was sub- ject to further review, discussion and change by focus groups comprising pa- tients, patient relatives, advocates, geneticists, genetic counsellors, clinicians and scientists. Conclusion: This format optimises communication between the ophthalmic healthcare team and the patients affected by IRDs. It should help manage pa- tient expectations in a clear unambiguous manner while informing on the hope for upcoming therapies. The digital and accessible formats are in develop- ment. EP-RET-057 Scheimpflug-based corneal biomechanical analysis as a predictor of myopic traction maculopathy D. Rodrigues1, J. Heitor1,2, J. Coelho1, P. Sousa1, M. Lume1, A. Meireles2,1, R. Ambrósio Júnior3, P. Menéres2,1, J. Melo Beirão2,1, P.M. Baptista2,1 1Unidade Local de Saúde de Santo António, Ophthalmology, Porto, Portugal, 2Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, Ophthalmology, Porto, Portugal, 3Universidade Federal do Rio de Janeiro, Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil Purpose: The main purpose of the present study is to analyze in vivo ocular biomechanics in eyes with myopic maculopathy and address biomechanical predictors of anatomic status and functional progression. Methods: Prospective cohort study of eyes with high myopia (≥6 diopters) diagnosed with different forms of myopic maculopathy. Data were collected in 2 timepoints, spaced by 5.0±0.1 years. Baseline biomechanical assessment was performed with Corvis Scheimpflug Technology®. The macular structure within the foveal-centered 6x6mm area was evaluated at baseline by SD-OCT, Heidelberg®. Macular function was measured in both timepoints with Microperimeter MP- 3, including the average sensitivity on the foveal-centered 12º polygon (CPS, dB). Differences in ocular biomechanical parameters were assessed in eyes with vitreomacular traction (VMT), those with maculoschisis (MS), those with posterior staphyloma (PS), and those with macular fibrosis/atrophy (F/A). Correlation analysis was performed between biomechanical parameters and variation of microperimetric data. A linear regression model was built to find baseline biomechanical predictors of macular function variation throughout the follow-up. Results: A total of 54 eyes were enrolled. The groups of eyes with VMT, MS, PS or F/A showed differences in five, three, five and one biomechanical base- line parameters, respectively (p<0.05). Variation in CPS (ΔCPS) was correlated with 15 biomechanical parameters including stiffness parameter in the first applanation time (SP-A1) (r=-0.377; p=0.04). The linear regression model showed a positive relationship between velocity in the second applanation time (A2V,ms) and ΔCPS (r2=0.280; p=0.003). Conclusions: In the present study, eyes with different forms of myopic macu- lopathy have shown differences in ocular biomechanical status. We hypoth- esized that biomechanical analysis may have a predictive role in the risk as- sessment and follow-up of macular function in eyes with pathologic myopia. EP-RET-058 I can’t see, can somebody HELLP?! - a case report B. Monteiro1, V. Lobo1, R. Whitfield1, E. Fernandes1, B. Dias1, N. Ferreira1 1Department of Ophthalmology, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, Lisbon, Portugal, Lisbon, Portugal Introduction: HELLP syndrome, a severe pregnancy complication involving hemolysis, elevated liver enzymes, and low platelets, poses significant ma- ternal and fetal risks. A rare complication, serous retinal detachment (SRD), occurs in 0.2–2% of severe preeclampsia cases and 0.9% of HELLP syndrome cases, presenting with sudden vision loss, macular edema, and subretinal fluid accumulation. Case Presentation: A 33-year-old woman diagnosed with HELLP syndrome following cesarean delivery experienced sudden vision loss in her left eye one week postpartum. Ophthalmoscopy revealed unilateral SRD, confirmed by optical coherence tomography (OCT) showing subretinal fluid accumula- tion. Timely intervention with topical corticosteroids and blood pressure manage- ment led to complete fluid resorption and visual recovery within a week. At follow-up, her best-corrected visual acuity (BCVA) improved to 1.0, with OCT confirming resolution of SRD. Discussion: The pathogenesis of SRD in HELLP syndrome involves ischemic choriocapillaris damage from vasoconstriction, fibrinoid necrosis, and micro- thrombi, resulting in retinal pigment epithelium dysfunction and subretinal fluid leakage. OCT findings of subretinal fluid and rapid recovery with treat- ment illustrate the condition’s vascular origin and reversibility. Effective management requires a multidisciplinary approach, integrating oph- thalmologic and obstetric care, with corticosteroid therapy and blood pressure control being crucial. Conclusion: This case highlights the need for timely diagnosis and manage- ment of HELLP syndrome to prevent complications such as SRD. Recognizing SRD as a reversible manifestation of hypertensive pregnancy disorders em- phasizes the importance of prompt imaging, systemic stabilization, and col- laborative care for achieving favorable outcomes. EP-RET-059 Central retinal vein occlusion associated with acute lymphoblastic leukemia: a case report L. Hovhannisyan1 1“Sonomax”medical center “Lavanda”ophthalmological center “EvaMed”medical center, Gyumri/Yerevan, Armenia Purpose: To report a case of central retinal vein occlusion as the first manifes- tation of acute lymphoblastic leukemia Case Report: A 51-year-old male patient complained of sudden loss of central vision in his right eye. Visometry, tonometry, slit lamp examination, fundos- copy were performed: BCVA OD = counting fingers BCVA OS = 20/20 IOP OD = 17 mmHg IOP OS = 18 mmHg Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 211

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ELECTRONIC POSTER PRESENTATIONS Fundoscopy detected dilated and tortuous retinal veins, optic disc edema and multiple flame-shaped, deep retinal hemorrhages, cotton wool spots in the right eye. The left eye is without pathological changes. Central retinal vain occlusion was diagnosed in the left eye. The patient underwent further systemic workup, including a complete blood count (CBC). The results were: [WBC=99.61x109, LYMP=96.63x109, RBC=3.35x1012, PLT=80x109], patients referred to a he- matologist and acute lymphoblastic leukemia (ALL) was diagnosed. The pa- tient received treatment, positive dynamics were observed․ Conclusion: It is described that any ocular structure may be involved in acute leukemia, involvement of the choroid and retina is the most common. Central retinal vein occlusion may be the first sign of an underlying systemic condi- tion such as acute lymphoblastic leukemia, although the association between central retinal vein occlusion and acute lymphoblastic leukemia (ALL) has rarely been described. Appropriate differential diagnosis and timely specialist referral can enhance quality of life without wasting time, and in certain cases, save lives. EP-RET-060 Retinal detachment as a late complication of ocular trauma with posterior segment intraocular foreign body – case report A. Chmiel1, T. Chudoba1, A. Papeczyc1, D. Czyżewski1, M. Frankowska-Gierlak1 1National Medical Institute of the Ministry of the Interior and Administration, Department of Ophthalmology, Warsaw, Poland In February 2013, 43-year-old male underwent 20G pars plana vitrectomy with implantation of IOL into the ciliary sulcus for penetrating ocular trauma caused by a metallic 2x3 mm IOFB embedded in the retina of the right eye. Postoperatively VA was 0.5 for the first year, with no further issues or follow- ups reported for a decade. In March 2023, the patient presented with blurred vision in the right eye. Examination revealed funnel-shaped retinal detachment involving the macula, with a tear in the peripheral area at the ten o’clock, attached only around the scar area around the site of the previously removed intraocular foreign body. IOP was 4 mmHg, and glaucomatous optic nerve changes were noted. A 23G vitrectomy with 5000cs silicone oil tamponade was performed. Successful at- tachment of the retina was achieved. At discharge VA was hand movement with IOP= 20mmHg. On 4th postoperative day, patient returned due to severe headache and pain. IOP was 51mmHg, retina remained attached. Conservative treatment was implemented to lower IOP, however IOP re- mained between 45-52 mmHg and VA deteriorated to a doubtful perception of light. A decision was made to remove the silicone oil with 23G vitrectomy. Postoperatively, IOP returned within normal limits, VA= perception of light, retina remained attached. The rapid normalization of IOP following surgery suggested impaired conventional outflow with reliance on uveoscleral path- ways. This case highlights the importance of long-term follow-up in patients with traumatic IOFB injuries. Despite the initial therapeutic success, physicians must remain attentive to late complications like retinal detachment and sec- ondary glaucoma that can occur years later. Glaucoma often progresses insidi- ously and does not cause symptoms that would alarm a patient for an earlier visit, before significant visual impairment occured. Timely detection and man- agement of these complications are crucial to optimize outcomes and prevent irreversible visual loss. EP-RET-061 Retinal hematoma in the context of macrophage activation syndrome: report of a case D. Souttou1, W. Louchene1 1HCA, Ophthalmology, Alger, Algeria Purpose: Macrophage activation syndrome is a rare, potentially fatal, result- ing from dysregulation of the immune system. We think of it when faced with the association of fever, splenomegaly, bi- or pancytopenia, hypofibrinogen- emia, hypertriglyceridemia, hyperferritinemia and hemophagocytosis ob- served in the bone marrow, spleen or peripheral lymph nodes. The most fre- quently affected organs are the liver, central nervous system and bone marrow. Ophthalmological damage may be part of the clinical picture. Method: We report the case of B.D, aged 26, presenting a profound and rap- idly progressive decline in visual acuity in the left eye, which appeared four days after his hospitalization for macrophage activation syndrome of infec- tious origin. He consulted our department eight months after the onset of symptoms. The initial ophthalmological examination revealed a vitreous hemorrhage in the left eye. The patient underwent vitrectomy which revealed a subretinal mass. A thorough ophthalmological exploration, clinical, paraclinical and spe- cialist opinions were carried out to determine its nature. Results: The results of the ophthalmological examination came back in favor of a subretinal hematoma of the left eye. Ocular damage in the context of macrophage activation syndrome can concern both the anterior and posterior segments. The diagnosis is based on a combina- tion of clinical, paraclinical and cyto-histological arguments in an evocative context. Management is based on the etiological treatment of the causative agent, the use of immunomodulators, as well as symptomatic treatment with close ophthalmological monitoring. Conclusion: Macrophage activation syndrome is a serious, potentially fatal condition. Ocular damage, although less frequent, mainly concerns the poste- rior segment, with a predominance of retinal hemorrhages. EP-RET-062 The role of EyeArt in automated screening for diabetic retinopathy T. Komarova1, O. Vitovska1, S.K. Scholtz2 1Bogomolets National Medical University, Ophthalmology, Kyiv, Ukraine, 2Universität des Saarlandes, Homburg, Germany Purpose: To evaluate the diagnostic performance of the EyeArt system (ver- sion 2.1.0) for automated diabetic retinopathy (DR) screening and its potential to improve referral and follow-up rates among diabetic patients. Method: A retrospective analysis was conducted using 389 fundus images from 195 patients across three clinical sites. Eidon cameras were utilized for image acquisition. Results: Among the patients, 12% had DM type 1, and 88% had DM type 2. EyeArt successfully classified 42% of cases as non-referrable (37% showed no DR signs, while 5% exhibited mild non-proliferative DR requiring only routine follow-up per national guidelines). Meanwhile, 46% of cases were identified as referrable due to the presence of moderate or severe non-proliferative DR, proliferative DR, or markers of diabetic macular edema (DME). 212 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Additionally, 12% of cases were flagged for further assessment due to insuf- ficient data for definitive AI-based classification. Notably, 40% of all fundus images were classified as vision-threatening, with severe DR, proliferative DR, or DME markers, necessitating immediate re- ferral to an ophthalmologist. A higher prevalence of vision-threatening DR (proliferative DR with DME) was observed among patients with DM type 1 compared to type 2. Conclusion: This study underscores the potential of EyeArt v2.1.0 as an ef- ficient tool for DR screening. By effectively triaging patients for follow-up or referral, EyeArt could significantly enhance diabetic eye care, enabling timely detection and management of vision-threatening DR. Further large-scale in- vestigations are warranted to validate these findings and optimize the integra- tion of AI in routine clinical practice. EP-RET-063 Proliferative diabetic retinopathy in severe stages of chronic kidney disease N. Akhmedova1 1Republican Eye Hospital of Uzbekistan, Department of Ophthalmic Diagnostics and Laser Surgery, Tashkent, Uzbekistan EP-RET-064 Successful management of persistent and recurrent macular holes with nonsurgical treatment – report of two cases and literature review H.-C. Lin1 1National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan Purpose: To report a case of recurrent macular hole (MH) and a case of per- sistent MH, both successfully treated with nonsurgical methods. Case 1: A 60-year-old male with a history of high myopia and pseudopha- kic rhegmatogenous retinal detachment underwent vitrectomy with gas tam- ponade. Three years post-surgery, a full-thickness MH developed, which was successfully sealed using an inverted internal limiting membrane (ILM) flap. Nine months later, a recurrent MH was identified alongside cystoid macular edema (CME). Treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids led to complete resolution of macular edema, with MH closure achieved five weeks later. Case 2: A 69-year-old male with a history of controlled diabetes and hyper- tension experienced a persistent MH after vitrectomy with inverted ILM flap. Despite multiple interventions—gas tamponade, topical steroids, NSAIDs, carbonic anhydrase inhibitors (CAI), and intravitreal ranibizumab injection— the MH persisted with cystic changes. The patient declined further vitrectomy. Purpose is to investigate the relationship and evaluate the severity of prolifera- However, an intravitreal dexamethasone implant successfully resolved the tive diabetic retinopathy (PDR) in patients with chronic kidney disease (CKD) cystic changes, leading to eventual MH closure, which remained stable for stages 3, 4 and 5. Methods: The study included 156 patients (39–82 years) with CKD stages 3, 4, and 5, divided into 3 groups of 104 eyes each. Ophthalmic examinations three years. Both patients achieved good vision. Nonsurgical management options for MH, such as laser therapy, steroids, included ophthalmoscopy, biomicroscopy, fundus photography, and optical CAIs, NSAIDs, intravitreal gas, and anti-vascular endothelial growth factors, coherence tomography. PDR severity was assessed using a 4 ball (b) system: show variable successful rates. Vitrectomy with ILM peel remains the gold 1 b - no changes, 2 b - minor, 3 b - average, 4 b - pronounced changes. standard. Approximately 10% of patients may experience persistent or recurrent MH post-surgery, attributed to factors like persistent traction, insufficient tampon- ade, and postoperative CME. Potential management include re-tamponade, ILM free flap, amniotic mem- brane, free retina graft, autologous blood, etc. For persistent or recurrent MH with cystoid changes, nonsurgical treatments may be considered to facilitate the resolution of cystoid changes, approximate hole edges, and ultimately achieve MH closure. Results: The qualitative indicators of PDR severity in patients with CKD stage 5 were significantly higher (36.6%–52.8%) compared to those in pa- tients with CKD stages 3 and 4. However, no statistically significant differ- ences were observed between the parameters in the CKD-3 and CKD-4 groups (p > 0.05). Comparative assessment of diagnostic criteria for proliferative dia- betic retinopathy at different CKD stages: diabetic macular edema: 2.2±0.2 (CKD-3), 2.4±0.2 (CKD-4), 3.0±0.2 (CKD-5) (p < 0.05); diabetic maculopa- thy: 2.4±0.1, 2.5±0.1, 3.2±0.2 (p < 0.05); degree of optic disc neovasculari- zation (NV): 2.4±0.1, 2.6±0.1, 3.1±0.1 (p < 0.05); optic disc proliferation: 2.3±0.1, 2.5±0.1, 3.0±0.1 (p < 0.05); retinal NV (epiretinal or vitreoretinal): 2.4±0.1, 2.5±0.1, 3.0±0.1 (p < 0.05); fixation of fibrovascular tissue to the reti- na: 2.5±0.2, 2.7±0.3, 3.5±0.2 (p < 0.05); rubeosis: 1.7±0.3, 2.0±0.3, 3.1±0.2 (p < 0.05); traction retinal detachment area: 1.6±0.3, 1.9±0.3, 3.0±0.2 (p < 0.05); preretinal/retinal hemorrhage: 2.2±0.2, 2.5±0.2, 3.3±0.2 (p < 0.05); hemoph- thalmos: 2.0±0.3, 2.5±0.3, 3.4±0.2 (p < 0.05). Conclusion: The findings suggest more severe retinal disorders in patients with CKD stage 5 compared to those with CKD stages 3 and 4. These results highlight advancements in vitrectomy techniques, anesthesia, and pharmaco- logical approaches that have improved the management of patients with CKD stage 5. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 213

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ELECTRONIC POSTER PRESENTATIONS EP-RET-065 A case of fungal endogenous endophthalmitis initially diagnosed as acute anterior uveitis and cataract in an immunocompetent young man in Western Australia L. Lim1,2, H. Hohnen2, M.-L. Tay-Kierney2,3, F. Chen2,3 1Woodlands Health, National Healthcare Group, Singapore, Singapore, 2Royal Perth Hospital, Perth, Australia, 3Lions Eye Institute, Perth, Australia Results: This study included 5 eyes from 5 patients in Western Australia. The average age of patients was 61 years old. All cases of endophthalmitis had symptoms within 14 days of Ozurdex implant with 80% presenting within 3 days of Ozurdex implantation. The reason for Ozurdex implantation was mainly due to diabetic macular oedema (60%). All 5 patients had positive intraocular cultures, the most common of which was S. Epidermidis found in 3 patients. All patients also had intravitreal antibiotics immediately upon diagnosis with 4 out of 5 patients (80%) undergoing explantation of Ozurdex implant within 4 days of presentation. 2 of these implants were sent for histo-pathology and noted to have no microorganisms seen. At last follow-up, 3 of the 5 patients had a visual acuity of 6/60 or worse. The patient who did not have vitrectomy To report a rare case of Purpureocillium lilacinum endophthalmitis in an and explantation of implant had the best visual outcome of 6/12. immunocompetent young male, initially diagnosed as acute anterior uveitis Conclusion: Endophthalmitis in the setting of Ozurdex results in variable (AAU), and to discuss the diagnostic challenges and treatment approach for visual outcomes. The most common causative organism is Staphylococcus this condition. A 29-year-old male presented with a three-week history of eye redness and blurred vision, initially diagnosed as AAU. Examination revealed hand-mo- tion vision, and no corneal infiltrates. Significant anterior chamber (AC) in- flammation with 1mm hypopyon, and posterior synechiae were noted. B-scan showed a flat retina with no vitritis. Extensive blood work and AC tap were negative. Despite aggressive treatment with steroids and antibiotics, his con- dition worsened. Vitreous biopsy confirmed Purpureocillium lilacinum infec- tion. The patient underwent vitrectomy, intravitreal voriconazole injections, and oral voriconazole therapy. Further interventions included repeat vitrec- tomy, endolaser, and silicone oil placement. Despite multiple surgeries and an- tifungal therapy, visual acuity remained poor, with final best-corrected visual acuity of 6/60. Follow-up showed no active inflammation. This is the first documented case of Purpureocillium lilacinum endophthal- mitis in Western Australia and highlights the diagnostic challenge of distin- guishing fungal endophthalmitis from acute anterior uveitis, especially in im- munocompetent patients. Early diagnosis and aggressive antifungal therapy, epidermidis. Prompt treatment with broad-spectrum intravitreal antibiotics is highly recommended. Pars plana vitrectomy and explantation of the Ozurdex implant can be considered though conservative management via close moni- toring and intravitreal injections may be just as effective. EP-RET-067 Multifocal central photoreceptor anomalies following a central retinal vein occlusion due to a borrelia burgdorferi infection F. Sallo1, A. Navarro1, A. Dubis2, Y. Guex-Crosier1 1Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland, 2University of Utah, Salt Lake City, United States including vitrectomy and intravitreal voriconazole, are critical, though visual Purpose: To report a case of multifocal photoreceptor damage following a outcomes are often poor. This case underscores the need for heightened aware- ness of fungal infections in the differential diagnosis of uveitis and the com- plexities in managing endogenous fungal endophthalmitis EP-RET-066 Presentation and outcomes of acute bacterial endophthalmitis secondary to Intravitreal Dexamethasone implant L. Lim1,2, E. Siebert2, F. Chen3,2 1Woodlands Health, National Healthcare Group, Singapore, Singapore, 2Royal Perth Hospital, Perth, Australia, 3Lions Eye Institute, Perth, Australia Purpose: Endophthalmitis is a rare and sight-threatening condition and cases especially following intravitreal dexamethasone implants has been rarely re- ported. The aim of this study is to report the clinical presentation, causative organisms, and treatment outcomes in patients with endophthalmitis related to Ozurdex implants. central retinal vein occlusion associated with Lyme disease. Observations: A 27-year-old male presented with acute monocular vision loss for one week. Prior to his visual decline he experienced vague symptoms, in terms of a mild blurring of his vision for about two months. The patient is a well-trained, avid hiker and has recently been walking the Appalachian National Scenic Trail in the USA. At presentation, fundoscopy showed ex- tensive retinal flame/dot/blot haemorrhages, OCT imaging revealed intrareti- nal fluid within macular region and subretinal fluid at the fovea. Fluorescein angiography showed a delayed A/V transit time and extensive leakage within the entire retinal vasculature. The diagnosis of central retinal vein occlusion (CRVO) was established. In view of his young age, his general good health and the absence of cardiovascular risk factors, a screening for a potential in- flammatory origin was performed. Serology revealed positivity for borrelia, IgG at 4.63 S/Co (normal range < 0.20) and IgG anti-VLSE° at >240kAU/l (normal range 10-15), even though IgM remained negative. No signs of in- volvement of the optic nerve or the CNS was apparent on MRI. A course of doxycycline 200mg twice daily was initiated and two consecutive intravitreal injections of ranibizumab were administered at monthly intervals. Following treatment, his retinal signs subsided, his visual acuity returned to 20/20. Three months later however, small focal breaks in the ellipsoid zone (EZ) appeared at and around the foveal center, with an apparent ‘dip’ of the external limit- ing membrane into the EZ breaks. AOSLO imaging revealed a corresponding Method: Review of 5 patients who presented to the Ophthalmology depart- ring-shaped loss of photoreceptor outer segment visibility with mostly pre- ment of Royal Perth Hospital between 2021 and 2023 with Ozurdex related served inner segment contours. endophthalmitis. Data collected included clinical presentation, causative or- ganisms, management and final visual outcomes. Histopathological features of the Ozurdex implant was also collected. Conclusion: Lyme borreliosis is a rare cause of CRVO but must be taken into account, especially in the absence of other risk factors. Focal foveal and juxtafoveal photoreceptor damage is a potential sequela. 214 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS OCT angiography, fluorescein angiography and indocyanine green angiogra- phy, confirmed the development of multiple bilateral CNVs. Intravitreal ra- nibizumab therapy resulted in significant clinical improvement and regression of CNVs. Conclusions: This case highlights the rare association between bilateral en- dogenous endophthalmitis and multiple bilateral choroidal CNVs as a com- plication of Staphylococcus aureus sepsis secondary to paronychia. Prompt diagnosis and aggressive treatment, including systemic and intravitreal antibi- otics followed by anti-VEGF therapy, were critical in resolving the intraocular infection and managing the CNVs, ultimately preserving vision. EP-RET-071 Retinal vascular tumors: clinical and etiological insights M. Mourali1, N. Abroug1, O. Miladi1, M. Khairallah1 1Fattouma Bourguiba University Hospital, Ophthalmology, Monastir, Tunisia Purpose: To describe the clinical, etiological, and progression aspects of reti- nal vascular tumors, including retinal vasoproliferative tumors (RVPT), reti- nal capillary hemangioma, retinal cavernous hemangioma, and arteriovenous communications of the retina (AVCR). Methods: A retrospective review of the medical records of 21 patients (25 eyes) with retinal vascular tumors, collected at the Department of Ophthalmology of Fattouma Bourguiba University Hospital in Monastir over a period of 16 years. Results: The study included 21 patients (13 females, 8 males) with a mean age of 38.8 years. The average time from symptom onset to diagnosis was 12 months. Diagnoses comprised RVPT in 11 patients (14 eyes), retinal capil- lary hemangioma in 7 patients (8 eyes), retinal cavernous hemangioma in 2 patients (2 eyes), and AVCR in 1 patient (1 eye). Vision loss was the primary complaint (66.6%). Intra/subretinal exudation was present in 84% of eyes, with macular involvement in 52%. Treatments included anti-VEGF (n=10), transpupillary thermotherapy (n=4), cryotherapy (n=5), and laser photocoagu- lation (n=5), with visual improvement or stabilization in 64% of eyes. Conclusion: Retinal vascular tumors are uncommon, and comprise a diverse group of congenital and acquired lesions. Accurate diagnosis often requires a combination of detailed clinical examination and multimodal imaging. Clinicians should be aware of these conditions, although benign, can lead to visual loss and even to life-threatening complications due to associated sys- temic vascular malformations. EP-RET-068 Sjögren’s retinal pattern dystrophy: a case report M. Toribio Albarrán1, T. Javaloy Vidal1, P. García Carrero1, J. Suárez Baraza2, B. Cano González-Barcia1, R. Fernández Herrero1 1Hospital Universitario 12 de Octubre, Ophthalmology, Madrid, Spain, 2Hospital Universitario 12 de Octubre, Ophthalmology, Retina, Madrid, Spain Purpose: To present the differential diagnosis and pathological findings in multimodal imaging regarding a case of Sjögren’s retinal pattern dystrophy. Method: Study of a male 45 year old diabetic patient referred to our Hospital to rule out retinosis pigmentosa. Results: Ophthalmological examination showed a visual acuity of 0.7 for the right eye and 0.3 for the left eye, while pinhole visual acuity improved up to 1. No abnormalities were found in the intraocular pressure or anterior segment examined with slit lamp. Ophthalmoscopy of both eyes showed a reticular pig- mentary deposit in the shape of a fishing net, affecting central and peripheral retina. Autofluorescence presented hiperautofluorescence matching the reticu- lar lesion, while a hipoautofluorescence area affected both maculas. Optical coherence tomography identified external retinal layers atrophy. Paracentral relative scotomas appeared in the perimetry of both eyes. Electrophysiology study was non conclusive. Genetic tests did not identify any mutations. Patient denied having nyctalopia, but reported that his mother had been studied for a retinal disease with similar presentation. Conclusion: Pattern dystrophys represent a heterogeneous classification of genetic related retinal diseases. In the reported case, it was not possible to detect any of the reported mutations related to Sjögren’s dystrophy in order to confirm the diagnosis. Nevertheless, the diagnosis was identified after ruling out other possibilities through the correlation among multimodal imaging and family history. EP-RET-070 From paronychia to sight-threatening complications T. Usaj1, A.U. Gavric1 1Eye Hospital, University Medical Centre Ljubljana, Slovenia, Ljubljana, Slovenia Purpose: To present a rare case of bilateral endogenous endophthalmitis and subsequent multiple bilateral choroidal neovascularisations (CNVs) in a 62-year-old woman with Staphylococcus aureus sepsis. Case Summary: A previously healthy 62-year-old woman developed blurred vision and floaters four days after admission to the infectious diseases clinic for Staphylococcus aureus sepsis secondary to a paronychia infection. Blood cultures confirmed methicillin-susceptible Staphylococcus aureus (MSSA) as the causative organism. Clinical examination revealed multiple metastatic infections, including bilateral endophthalmitis characterised by vitritis, in- traretinal haemorrhages and multifocal chorioretinal lesions in both eyes. The patient underwent a six-week course of intravenous flucloxacillin, alongside intravitreal vancomycin (1 mg/0.05 mL), which was administered twice to the right eye and three times to the left eye. The intraocular infection gradually resolved with this treatment. Seven weeks after discharge, the patient presented to the ophthalmology emer- gency department with complaints of distorted and blurred vision in the left eye. Multimodal imaging, including optical coherence tomography (OCT), Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 215

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ELECTRONIC POSTER PRESENTATIONS EP-RET-072 Safety and long-term efficiency of intravitreal rtPA-, SF6- and Bevacizumab-injection in patients with submacular hemorrhage secondary to Age-Related Macular Degeneration P. Wolfrum1, M. Sievers1, B. Stoffelns1, C.A Korb1 1University Medical Center of the Johannes Gutenberg-University Mainz, Department of Ophthalmology, Mainz, Germany Purpose: To evaluate safety and long-term clinical outcomes following intra- vitreal triple injection of recombinant Tissue Plasminogen Activator (rtPA), SF6-Gas and Bevacizumab due to acute submacular hemorrhage (SMH), sec- ondary to age-related macular degeneration (AMD). Methods: A retrospective analysis on patients having received treatment be- tween January 2014 and December 2020 (n = 37) was conducted, by review- ing adverse events and clinical course following triple injection. Visual acuity (VA), central retinal thickness (CRT), central retinal volume (CRV) and axial pigment epithelial detachment height were analyzed at baseline (B), after triple injection (FU1), after the following anti-VEGF injection series (FU2), after 1 year (FU3), after 2 years (FU4) and at the final follow-up examination, after 4.4 ± 1.6 years (FU5). Further, an explorative data analyses on final VA was carried out, to explore potential associated treatment factors. Results: Triple injection was performed on average 5.6 ± 5.7 days after onset of SMH, with size of SMH averaging 13.0 ± 7.1 disc areas. Patients received 16 ± 3 additional intravitreal anti-VEGF injections due to persistent macular edema over the subsequent 2 years. Significant improvements were observed at FU1 in VA (p<0.001), CRT (p=0.005) and CRV (p=0.007), as well as at FU2 in axial PED height (p<0.001), with all improvements being stable until final follow-up examina- tion. 5 of 37 patients (13,5%) experienced a retinal pigment epithelial tear, following triple injection. Further, final VA correlated positive and significantly with FU1 VA, while no correlation was observed with baseline VA, the size or height of SMH, or the time since onset. Conclusions: Triple injection constitutes a simple and effective therapy with long-term functional and anatomical improvements following SMH, although patients have an increased risk for RPE tears. VA following triple injection constitutes a predictive factor for long-term visual function. EP-RET-073 Clinical outcomes and management strategies in endophthalmitis: a review of case series G. Kostadinov1, Y. Zdravkov1,2, A. Oscar1,2 1Alexandrovska University Hospital, Ophthalmology Department, Sofia, Bulgaria, 2Medical University - Sofia, Ophthalmology Department, Sofia, Bulgaria Purpose: To analyze and summarize the outcomes of recent endophthalmitis cases, reviewing and assessing the different management strategies. Methods: A total of 6 cases of endophthalmitis were identified in 2024 and were reviewed retrospectively for patient age, sex, etiology, initial and final visual acuity (VA), management, culture results, complications and secondary interventions. Aqueous humor and vitreous humor were cultured for bacteria and fungi in all of the patients. Results: Of the 6 patients, female to male ratio was 1:1. Mean age was 53 (range between 2 and 83). In all of the patients the VA on admission was less than 0.1 (range between PLC and 0.1). All of the cases are postoperative – 5 after cataract surgery and 1 following filtering bleb surgery. Every single patient received systemic antibiotic treatment. Drugs of choice were Vancomycin, Gentamicin and Ceftriaxon. 50% of the patients had nega- tive culture results. The isolates from the positive culture results were E. foe- calis, S. haemolyticus, O. anthropi. The patients received intravitreal antibiotic injections in addition to the sys- temic treatment. All of the patients underwent vitrectomy on their initial admission. 360° endolaser photocoagulation was performed and silicone oil tamponade was applied, followed by evacuation after 3-4 months. VA after treatment reached up to 0.5 (in 1 patient) and 0.4 (in 2 patients). The remaining patients had VA less than 0.1. The most common complication was second- ary glaucoma (observed in 2 of the patients). There were no cases of retinal detachment observed in the reviewed group. Conclusion: Cataract surgery is the most common cause of exogenous en- dophthalmitis. All of the patients required vitrectomy at some point in their treatment. Early vitrectomy with silicone tamponade has been associated with decreased incidence of retinal detachment after treatment. Prompt diagnosis and adequate treatment are important to prevent complications and avoid visual loss. EP-RET-074 Paracentral acute middle maculopathy revealed in patients with sickle cell disease: a state before temporo-macular atrophy? N. Bacq1, D. Draganova1, D. Makhoul1, P. Dubois1, B. Pasteels2, L. Postelmans2, A. Le1 1CHU Saint-Pierre, Brussels, Belgium, 2CHU Brugmann, Brussels, Belgium Introduction: Paracentral acute middle maculopathy (PAMM) is a new entity, described in 2013 as a hyperreflective band-like lesion on Spectral Domain Optical Coherence Tomography (SD-OCT), localized at the level of the inner nuclear layer. This entity is frequent in several retinal vascular disorders, such in sickle cell disease. In some patients with sickle cell disease, temporo-macular thinning is report- ed, due to vascular occlusion. We suppose that PAMM is the clinical state preceding the temporo-macular thinning. Cases: A 21 years old African woman, treated for HbSC sickle cell disease, presented a sudden decrease of vision in the left eye caused by an anterior uveitis de novo. As for each uveitis patient, we performed an SD-OCT, revealing PAMM in the temporo-macular region of this eye. After resolution of the uveitis, the patient described the presence of a scotoma, corresponding to the PAMM area, that became atrophic at the level of the inner retina. A 27 years old African patient, known for HbSS sickle cell disease, presented with a sudden scotoma in the left eye. The SD-OCT demonstrated a PAMM in the temporo-macular area. The follow-up revealed a progressive thinning of the inner retina at the same localization. Discussion: The fact that PAMM can be observed in sickle cell disease retin- opathy is well known now, and some studies showed that temporo-macular thinning is also frequent in this pathology. These cases could be the link between these two findings. 216 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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A SD-OCT, performed during the acute period, showed a clinical aspect of PAMM in both patients. During the follow-up of these patients, this area be- came atrophic and resulted in a temporo-macular inner retinal thinning. EP-RET-075 Hemorrhagic paradox in chronic branch retinal vein occlusion: foveal bleeding triggers macular edema resolution D. Ferreira Cardoso1, J. Castro Cabanas1, P. Moreira Martins1, F. Sousa Neves1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal Introduction: Branch retinal vein occlusion (BRVO) is a frequent cause of visual impairment, often due to macular edema. Chronic BRVO often requires repeated interventions, such as anti-VEGF injections, to treat macular edema and improve visual acuity. Furthermore, acute intraretinal hemorrhages, espe- cially at the fovea, are typically linked to worse prognoses and higher treat- ment burden. We present a rare case of chronic BRVO where a sub-internal limiting membrane (ILM) foveal hemorrhage unexpectedly led to the resolu- tion of macular edema. Case Description: A 51-year-old man with dyslipidemia was diagnosed with inferior macular BRVO in his right eye, confirmed by fluorescein angiogra- phy (FA). Over 16 months, his best-corrected visual acuity (BCVA) remained around 20/25 despite persistent cystoid macular edema (central foveal thick- ness: 364–392 µm). He subsequently presented with sudden-onset visual loss, describing a rapidly enlarging “red spot” over two days. Examination revealed a decrease in BCVA to 20/100 and a sub-ILM foveal hemorrhage. Given the chronic stability of his BRVO and the hemorrhage’s inner retinal location, a conservative approach was undertaken. Two weeks later, BCVA improved to 20/30 as the hemorrhage partially resolved. At two months, BCVA returned to 20/25, accompanied by a marked reduction in macular edema on OCT. By eight months, BCVA was 20/20, FA showed no perifoveal leakage, and central foveal thickness stabilized at 320 µm. Conclusion: This case demonstrates an atypical mechanism wherein a sub- ILM hemorrhage appeared to alleviate intraretinal fluid accumulation in chronic BRVO without intervention. We hypothesize that an aneurysmal rup- ture eliminated the leak point responsible for the edema. While anti-VEGF therapy remains key to BRVO management, this phenom- enon suggests that in certain chronic, stable cases, an acute hemorrhage may foster spontaneous resolution. Recognizing this phenomenon may guide indi- vidualized treatment decisions. ELECTRONIC POSTER PRESENTATIONS EP-RET-076 Multimodal imaging in a case of combined hamartoma of retina and retinal pigment epithelium P. Martins1, C. Ferreira1, J. Castro Cabanas1, C. Madeira1 1Unidade Local de Saúde de Gaia e Espinho, Ophthalmology, Gaia, Portugal Purpose: To describe the multimodal imaging evaluation of a case of con- genital hamartoma of the retina and retinal pigment epithelium (CHR-RPE). Method: Observational case-report. Results: A healthy 39-year-old man was referred to our department for low vision and an ill-defined retinal lesion in the left eye (LE), initially observed in a routine appointment. On initial evaluation best corrected visual acuity was 10/10 in right eye and 3/10 in LE. Fundoscopy revealed an elevated, sclerotic lesion with vascular attenuation extending from the optic disc to the fovea, associated with an epiretinal membrane (ERM) in the LE. Multimodal imaging with fundus au- tofluorescence revealed diffuse hypoautoflurescence in the area of the lesion. OCT showed marked cytoarchitectural distortion, retina thickening (690µm), hyperreflectivity of the retinal inner layers and an ERM. The superficial vas- cular plexus in OCT-Angiography revealed increased vessel caliber and tor- tuosity, vascular traction and stretching within the lesion; there was a filigree vascular pattern in the deep vascular plexus. Fluorescein angiography showed initial blockage, with late leakage and staining from the tortuous vessels. No major abnormalities of the choroidal vasculature were observed on indocya- nine green angiography. A diagnosis of CHR-RPE was therefore entertained. Conclusion: CHR-RPE represents a benign, disorganized overgrowth of lo- cal mature tissue, often associated with an ERM. Although the diagnosis is clinical, multimodal imaging with fundus autofluorescence, OCT/OCT-A and fluorescein/indocyanine green angiography is helpful in the diagnosis and monitoring of complex cases. EP-RET-077 Evaluation of retinal neovascularization over time in vascular endothelial growth factor transgenic mice Y. Yamamoto1, H. Mori1, K. Yokota1, Y. Hattori1, H. Imai1 1Kansai Medical University, Ophthalmology, Hirakata, Japan Purpose: Relationships between morphological changes of retinal/choroidal neovascularization (R/CNV) and vascular endothelial growth factor (VEGF) remains unclear. In this study, we investigated retinal angiogenesis over time using optical coherence tomography angiography (OCTA) in VEGF transgen- ic mice (tg-mice) which have been produced that over-express VEGF in the photoreceptors under control of the rhodopsin promoter. Methods: C57BL/6 VEGF tg-mice (P 4 ~ 6 weeks of age: 8 eyes) and were used. OCT(A) images were obtained to evaluate the changes of R/CNV over time. After OCTA imaging, retinal and choroidal whole-mounts were fluores- cently labeled. From these images, each NV was assessed based on the stage classification of retinal angiomatous proliferation (RAP). Results: In OCT(A), RAP stage 1, 2, and 3 were confirmed at P4–P6 weeks in 0/8 eyes (0%), 8/8 eyes (100%), and 0/8 eyes (0%), respectively. In contrast, whole-mounts revealed stage 1, 2, and 3 in 8/8 eyes (100%), 8/8 eyes (100%), and 0/8 eyes (0%), respectively. RAP stage 3 was not observed in either meth- ods. OCT(A) revealed retinal fluid in 3/8 eyes(38%) in RAP stage 2 only. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 217

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ELECTRONIC POSTER PRESENTATIONS Conclusions: In VEGF tg-mice, RAP stage 1 and 2 were observed using OCT(A) and whole mounts. To make RAP stage 3, additional condition may be required for anastomosis between RNV and CNV such as laser-induced CNV creation. The inability to observe RAP stage 1 using OCTA may be a limitation of the imaging equipment. However, OCTA offers the advantage of detecting exudative and vascular changes over time. EP-RET-078 Unveiling a rare case of unilateral pigmented paravenous retinochoroidal atrophy in a 38-year-old woman: diagnosis, findings, and clinical implications N. Andonova1, N. Veleva1, A. Oscar1, G. Markov2 1University Hospital Aleksandrovska, Sofia, Bulgaria, 2AIPSMP Ophthalmology-Dr. Georgi Markov, Sofia, Bulgaria EP-RET-079 Assessment of bevacizumab efficacy in the treatment of neovascular age-related macular degeneration among geriatric populations H. Hasani1 1Alborz University of Medical Sciences, Ophthalmology, Karaj, Iran, Islamic Republic of Purpose: This study aims to assess the therapeutic effects of Bevacizumab in patients aged 65 years or older, focusing on changes in visual acuity (VA) and central retinal thickness (CRT). Methods: A total of 31 patients aged 65 years or older, diagnosed with nAMD, were included in this study. All participants received monthly intra- vitreal injections of Bevacizumab over a 12-month period. Visual acuity (VA) was evaluated using the Snellen chart, and central retinal thickness (CRT) was measured via optical coherence tomography (OCT) at baseline, 6 months, and 12 months. Aim: To present a rare case of unilateral pigmented paravenous retinochoroi- Statistical analysis was conducted using SPSS software, employing paired t- dal atrophy (PPRCA) in a 38-year-old female patient. Materials and methods: This case report describes a 38-year-old female patient diagnosed with pigmented paravenous retinochoroidal atrophy at our tertiary healthcare center. The follow-up period was one year. Results: A 38-year-old Caucasian woman visited the clinic for a routine consultation. She had no significant medical history, including no prior eye trauma or inflammatory/infectious eye diseases. Upon ophthalmological examination, decreased visual acuity was noted in her left eye. Fundoscopic examination revealed cystoid macular edema, areas of retinochoroidal atrophy, and pigmented bone-spicule clumps that followed the path of the retinal veins from the optic disc to the periphery. The Humphrey visual field test indicated a ring-shaped scotoma in the left eye, with a normal visual field in the right eye. Fluorescein angiography investigation of the pa- tient revealed no active vasculitis in both eyes. No signs of active inflammation were present, and the patient tested nega- tive for tuberculosis, syphilis, Lyme disease, herpes viruses, toxoplasmosis, toxocariasis, and bartonellosis. Additionally, blood and urine tests showed no abnormalities, and ophthalmological evaluations of her family members re- vealed no pathological findings. Conclusions: This case highlights the rarity of unilateral pigmented para- venous retinochoroidal atrophy (PPRCA) and its distinction from conditions like retinitis pigmentosa and other diseases due to its unilateral presentation and absence of active vasculitis. Recognizing PPRCA is crucial for accurate diagnosis and management, as its clinical course is generally stable with no expected progression. Increased awareness among clinicians is essential for timely identification and differentiation from similar ocular conditions, ulti- mately enhancing patient care. tests to compare changes in VA and CRT across the designated time points. Statistical significance was defined as p < 0.05. Results: At baseline, the mean VA was 0.65 (equivalent to 20/100), and the mean CRT was 400 µm. After 6 months of Bevacizumab treatment, the mean VA improved to 0.50 (20/63), accompanied by a significant reduction in CRT to 300 µm (p < 0.001). At the 12-month mark, mean VA further improved to 0.45 (20/50), while CRT remained reduced at 280 µm (p < 0.001). Statistical analyses indicated significant improvements in both VA and CRT across all time points (p < 0.01 for all comparisons). No severe complications reported. Conclusion: Bevacizumab (Avastin) demonstrates substantial efficacy in treating neovascular age-related macular degeneration in patients aged 65 years and older, yielding significant improvements in visual acuity and reti- nal structure over 12 months of therapy. These findings support the use of Bevacizumab in this demographic, with an acceptable safety profile. Further research with larger cohorts and extended follow-up periods is warranted to validate these outcomes. EP-RET-080 The effect of antioxidant supplementation on choroidal vascularity index and choroidal thickness in ocular rosacea N. Yesilirmak1 1Ankara Yildirim Beyazit University, Ophthalmology, Ankara, Turkey Purpose: Rosacea is a chronic and progressive disease affecting 10% of the population, with ocular involvement observed in 50–75% of cases. Although its pathophysiology is complex and not fully understood, oxidative stress has recently been suggested to play a significant role, raising discussions about the use of antioxidants in its treatment. A recent study demonstrated that while choroidal thickness (CT) remains unchanged in ocular rosacea (OR), choroi- dal vascularity may be affected, leading to a reduction in the choroidal vas- cularity index (CVI). This study aimed to investigate the effect of antioxidant supplementation on CVI and CT in OR patients. Methods: This prospective clinical study included 25 eyes of 25 patients di- agnosed with OR and 25 eyes of 25 healthy volunteers. Subfoveal, 1500 µm nasal, and 1500 µm temporal CVI and CT values of patients and controls were 218 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS calculated using Heidelberg EDI-OCT images and compared. Additionally, comparisons were made between these parameters before and after 3 months of oral antioxidant supplementation (600 mg/day alpha-lipoic acid) in the OR group. The most recent version of ImageJ software was used for CVI calcula- tion. Results: Baseline mean subfoveal CVI values in OR patients were signifi- cantly lower compared to controls (p<0.05), while no significant difference was found in CT values (p>0.05). After antioxidant supplementation, mean CVI values in the subfoveal and 1500 µm temporal regions significantly in- creased compared to baseline (p<0.001 and p=0.044, respectively), while the mean subfoveal CT value significantly decreased (p=0.038). Conclusion: Three months of antioxidant supplementation significantly re- versed the reduction in CVI, which may be associated with inflammation, and also had a notable impact on CT. Future studies could support these findings by correlating them with inflammatory markers and other clinical parameters in OR patients. EP-RET-084 Retinal detachment: laser prophylaxis F. Kuhn1 1Helen Keller Foundation, Birmingham, United States Purpose: To demonstrate the need for, and effectiveness of, 360-degree laser prophylaxis for RD in fellow eyes. Method: Case series. Results: In a large case series, only 360-degree laser prophylaxis proved to be effective in preventing RD development. No laser or focal laser of “high risk areas” proved equally ineffective. Conclusions: With no prevention, the risk in fellow eyes (if the first eye, un- dergoing surgery for RD,) can reach 40%. 360-degree laser prophylaxis, when done properly, reduces the Rd close to zero, with minimal risk; the decision whether to undergo such prophylaxis is up to the patient, based on objective EP-RET-081 Combination of vitrectomy with episcleral circular buckling in the treatment of patients with retinal detachment following ocular trauma O. Sidak-Petretska1, N. Ulіanova1, N. Bondar1, A. Ponomarchyuk1 1The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine, Eye Trauma, Odesa, Ukraine counseling. EP-RET-085 Cat scratch disease: ocular manifestations L. Petrova1, M. Metodieva1 1Specialized Hospital of Ophthalmology “Zora”, Sofia, Bulgaria Purpose: To show the clinical presentation of cat scratch disease with a focus Purpose: To study the results of surgical treatment of traumatic retinal de- on ocular manifestation as the initial and sometimes sole symptom. tachment (TrRD) complicated by proliferative vitreoretinopathy (PVR), by combining vitrectomy (VE) with circular episcleral buckling ECB. Material and methods: A retrospective analysis of cases of TrRD compli- cated by PVR in 34 patients (34 eyes), 27 men and 7 women, aged from 24 to 73 years, 42.3±1.9 years on average, was conducted. The limitation of the eye trauma was: up to 1 month - 15 patients (44.12%), 1-3 months - 12 patients (35.29%), more than 3 months - 7 patients (20.59%). Blunt eye trauma was in 20 patients (58.82%), open trauma of eye - in 9 pa- tients (26.47%), with intraocular foreign body - in 5 patients (14.71%). Before the surgery, visual acuity (VA) was 0.01-0.07 in 19 patients (55.88%), correct light perception - in 7 patients (20.59), incorrect light perception - in 7 patients (20.59%), no light perception - in 1 patient (2.94%). One-stage VE and ECB were performed in 7 patients (20.59%), ECB as the second stage after VE was performed in 24 patients (70.59%), and VE as the second stage after ECB - in 3 patients (8.82%). The results of the performed surgery were evaluated according to the ana- Methods: A 20-year-old male patient presented to the Ophthalmology depart- ment with a four-day history of significant decrease in VA in the right eye with a central scotoma. His VA and IOP were as following: BCVA OD=0.2, BCVA OS=1.0 IOP OD=15mmHg, IOP OS=19mmHg. Anterior segment examina- tion was unremarkable. Funduscopic examination revealed optic disc edema in the right eye. The left eye was unremarkable. FA showed papilledema with hyperfluorescence. Тhe patient was referred for urgent MRI - findings were unremarkable. Initial therapy was Agapurin, Milgamma, Betaxolol drops and Nurofen. Two days later fundus examination revealed the development of a macular star. Dexamethasone, Dorzolamide, Timolol and Bromfenac eye drops were added. Upon further questioning, the patient recalled a history of frequent minor hand injures and contact with kittens. He was referred for serological testing for Bartonella henselae, Toxocara Canis, Borrelia burdorferi and Toxoplasma gondii. Laboratory findings revealed elevated antibody titers only against Bartonella henselae. The patient was initiated on a course of Doxycycline and tomical (retinal attachment) and functional (maximum corrected visual acuity) Rifampicin. results. Results: On the check-up exam two weeks later, the patient had an increased Results: A positive anatomical result was achieved in 28 (82.35%) of 34 VA: BCVA OD=1.0 The optic disc still exhibited subtle blurring of its margins patients. In 5 eyes (14.71%), repeated VE was performed for relapse of RD and the macular star formation remained evident. within 5-6 months. VA improved in all patients. Correct light perception - in 7 patients (20.59%), 0.02-0.05 - in 7 patients (20.59%), 0.1-0.3 - in 20 patients (58.82%). Conclusions: Surgical treatment of TrRD by combining VE with ECB is ap- propriate and effective in the presence of PVR in patients with the outcomes of eye trauma. Conclusions: Cat scratch disease is an infectious illness primarily caused by the bacterium Bartonella henselae, commonly transmitted through scratches or bites from infected cats. While typically characterized by swollen lymph nodes, it can present with diverse range of symptoms. Ocular manifestations can serve as the sole or initial presentation of the disease. Recognizing this presentation is crucial for timely diagnosis and appropriate management, par- ticularly in cases where systemic symptoms are absent. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 219

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ELECTRONIC POSTER PRESENTATIONS EP-RET-089 Atypical presentation of macular edema: a case report K. Kasa1, M. Krasniqi1, L. Pajtim1, B. Kruja2, V. Elvis2 1Universitary Hospital of Mother Theresa, Ophtalmology, Tirana, Albania, 2Universitary Hospital of Trauma, Ophtalmology, Tirana, Albania omega-3 PUFA, vitamin D and resveratrol and an 18.11-fold increase (HR 18.11 [95% CI 10.96-29.91] p=0.000) with irregular use of various nutraceuti- cals, after accounting for a number of clinical factors: age (p=0.001), changes in the condition of the fundus during the observation period (p=0.000), input parameters of choroidal thickness in the macula (p=0.04) and the presence of cardiovascular pathology (p=0.04). Conclusions: Сours of retinal photobiomodulation and regular intake of the nutraceutical formula AREDS2 with omega-3 PUFA, vitamin D and resvera- trol reduces by 5.9 times (HR 3.05 vs. HR 18.11) the risk of progression of early/intermediate AMD within 5 years, taking into account age (p=0.001), Macular edema is a common condition as a result of systemic pathologies changes in the condition of the fundus (p=0.000), input indicators of choroidal such as diabetes and hypertension. Radiation retinopathy, though rare, is a significant manifestation of ocular ischemic and occlusive vasculopathy that can develop in patients undergoing radiotherapy for systemic malignancies or ocular tumors. We present the case of a 50-year-old woman who developed decreased visual acuity in both eyes following treatment with total body radiotherapy for sys- temic lymphoma. Optical coherence tomography (OCT) revealed prominent cystoid macular edema, intraretinal ischemia, and exudative changes, which were consistent with the presentation of diabetic retinopathy. Fluorescein an- giography further confirmed retinal vascular remodeling, with the presence of multiple microaneurysms, capillary leakage, and areas of capillary non- perfusion. Despite the administration of anti-VEGF therapy, no significant improvement in retinal findings was observed. Early and accurate diagnosis, utilizing OCT and fluorescein angiography, is essential in the management of radiation retin- opathy, as prompt intervention may be crucial in preventing further visual deterioration in affected patients. EP-RET-090 Reducing the progression of non-exudative age-related macular degeneration O. Guzun1, O. Zadorozhnyy1, N. Konovalova1,2, P. Bezdetko3, A. Korol1 1“The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” State Institution, Odesa, Ukraine, 2Odesa National Medical University, Odesa, Ukraine, 3Kharkiv National Medical University, Kharkiv, Ukraine The purpose of the study was to determine the clinical and morphological parameters affecting the progression of the disease in patients with early/inter- mediate AMD over 5 years. thickness in the macula (p=0.04) and cardiovascular pathology (p=0.04). EP-RET-091 Adult onset atypical macular dystrophy masquerade as chronic CSR with CNVM, with uncertain genetic predisposition A. Kumbhar1, V. Sampat1, V. Jojo1, M. Rajamani1, R. Singh1 1Kettering General Hospital, Kettering, United Kingdom The case discussed was clinically diagnosed as Best Dystrophy with CSR and secondary CNVM in both eyes, treated with intravitreal Avastin. The genetic testing did not reveal Best dystrophy. The patient was diagnosed with Adult onset vitelliform dystrophy with no confirmed genetic predisposition. A 35 year female with no significant medical or family history of ocular con- ditions, presented with deterioration and distortion of vision, since 5-6 years. She was treated and evaluated for both eyes CSR with secondary CNVM. The Electrodiagnostic test showed,ERG WNL, EOG light peak to dark trough ratio WNL,with borderline normal interocular asymmetry.There was no Electrophysiological evidence of macular dysfunction or RPE dysfunction, this largely exclude Best Disease. Genetics for BEST1 ,genetic cause not iden- tified. Low priority variants identified.It did not include exon ORF15 of RPGR gene. The patient was diagnosed with adult onset vitelliform macular dystrophy, but surprisingly genetic testing did not reveal any genetic variant. Conclusion: Adult-onset vitelliform macular dystrophy is a common and rela- tively benign condition occurring in approximately 1 in 8,000 individuals and it is a rare condition with onset between the fourth and fifth decades of life, mostly affecting females. The disease rarely progresses to development of CNVM or geographic at- rophy. The primary differential diagnoses include Best’s disease and AMD. Best’s disease is genetically similar to AOVM, but Best’s disease has a char- Material and method: Non-exudative macular degeneration (AMD) was di- acteristically larger lesion size and presents with an earlier age of onset, abnor- agnosed in 163 patients (304 eyes), early AMD was diagnosed in 212 eyes, and intermediate AMD was diagnosed in 92 eyes. All patients underwent 2 courses of retinal photobiomodulation (PBM) for 12 months. Patients of mal EOG and a poorer visual prognosis. Although vitelliform lesions can be a manifestation of systemic diseases or be idiopathic, in a minority of patients, genetic predisposition may play a role. the 1st group were prescribed 1 capsule of the vitamin-antioxidant complex Nutrof® Forte once a day for 12 months, patients of the 2nd group - irregular intakes of various nutraceuticals. Mutations in four particular genes BEST1, PRPH2, IMPG1, and IMPG2 have been associated with some cases of adult-onset vitelliform macular dystrophy. Further study and research in this case is worthwhile. Results: The progression of geographic atrophy in our study in the group of irregular intakes of various vitamin complexes was 21.9%, which was signifi- cantly different in the group with regular intake of nutraceuticals - 6.7% (χ2 = 14.22, p = 0.0002). Multivariate Cox regression analysis showed that AMD progression over 5 years had a 3.05-fold increase in the relative risk (HR 3.05 [95% CI 1.76- 5.28] p=0.000) with regular use of the AREDS2 nutraceutical formula with 220 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-093 EP-RET-094 Remodeling of the lamina cribrosa thickness in proliferative diabetic retinopathy as an anatomical predisposition of extraocular silicone oil migration after vitrectomy M. Karliychuk1,2, S. Pinchuk2, P. Bezditko3, A. Urazov2 1Bukovinian State Medical University, Chernivtsi, Ukraine, 2Center of Eye Microsurgery `Vash Zir`, Chernivtsi, Ukraine, 3Kharkiv National Medical University, Kharkiv, Ukraine Screening of diabetic retinopathy in primary care in Ukraine A. Nevska1, A. Korol1, O. Pohosian1, V. Shcherbakova1, O. Chernenko2, K. Goncharuk3, I. Gymanyk4 1SI „The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine“, Studying Biological Action and Application of Lasers in Ophthalmology, Odesa, Ukraine, 2Private Enterprise „MedCapitalGroup“, Kyiv, Ukraine, 3LLC „CheckEye“, Kyiv, Ukraine, 4Bukovinian State Medical University, Chernivtsi, Ukraine Purpose: To analyze the relationship between retrolaminar migration of in- traocular silicone oil (SiO) with lamina cribrosa (LC) thickness in patients with proliferative diabetic retinopathy (PDR) after vitrectomy with SiO en- Purpose: To optimize the detection of DRP through the use of artificial intel- ligence in primary healthcare. dotamponade. Method: Screening of diabetic retinopathy (DR) was conducted at the Methods: This retrospective study included 35 patients with PDR after pars Municipal non-commercial enterprise „Irpin city center of primary medical plana vitrectomy with SiO endotamponade who underwent unenhanced head and sanitary aid“ of Irpin city council of Kyiv region from 02.01.2024 to computed tomography for various clinical indications between April 2017 and 17.03.2024. Patients with diabetes mellitus (DM) type 1 or 2 and people who May 2024. All images were visually evaluated for retrolaminar migration of intraocular SiO involving the anterior visual pathway (optic nerve (ON), optic chiasm, and optic tract) and ventricular system. LC thickness was measured with spectral domain optical coherent tomography using LC_Thickness_ programm.m and main_low_noise_filters_programm.m, based on the adap- tive compensation algorithm for eliminating a high-level noise in deep layers of ON. Results: In patients with PDR the average LC thickness was 685±33 µm (578 to 771 µm), that was 1,9 times higher than in healthy people (p<0,001). We detected retrolaminar SiO migration in 9 of the 35 patients (25,71%), noting SiO at the optic nerve head (n=3), retrolaminar ON (n=3), optic chiasm (n=2), optic tract (n=1), and in lateral ventricles (n=2). 2 patients had migration to 2 locations each (1 patient – in retrolaminar ON and optic chiasm, 1 patient – in retrolaminar ON and lateral ventricle). did not have a diagnosis of DM and were directed to screening due to the pres- ence of risk factors (RF) - age, overweight - were involved in the screening. Screening was carried out in stationary points arranged on the basis of health care institutions. All individuals underwent color photography of the fundus with a non-mydri- atic fundus camera without pupil dilation. Fundus photography of both eyes was performed. The obtained images were immediately uploaded to the cloud environment for analysis which was carried out using artificial intelligence Retina-AI CheckEye©. The presence of DR and the stage of the disease were determined. Results: 609 patients (1218 eyes) participated in the screening. There were 148 patients with diabetes mellitus, 49 of them had poor-quality photographs of both eyes. The statistics were calculated for 99 patients with diabetes mel- litus. The remaining 461 patients did not have a diagnosis of diabetes mellitus We compared the LC thickness of patients without and with retrolaminar SiO and were referred for screening due to the presence of risk factors. 65 patients migration. It was established that LC thickness in retrolaminar SiO migration was significantly less (559 to 658 µm) than in patients without it (679 to 772 µm). But the number of cases positive for migration was small, limiting the statistical power and accuracy of the prevalence. of them had poor-quality photographs of both eyes. The statistics were calcu- lated for 396 patients with risk factors. Patients were referred for screening by family medicine doctors - a total of 560 people. There were 49 self-referrals for screening. Conclusions: A direct correlation between scleral LC thickness and retrolami- Conclusion: DR is much more common (18 times) in patients with estab- nar migration of intraocular SiO in patients with PDR after vitrectomy with SiO endotamponade was revealed. lished diabetes than in patients at risk. People with risk factors for diabetes should be screened for DR. Screening has identified DR for the first time in 83% of patients with established diabetes who were unaware of their presence. EP-RET-095 A case report of a patient with Usher syndrome and optic disc drusen A. Unal1 1Hopital Pitie Salpetriere, Ophthalmology, Paris, France We report a 30- year old female Caucasian patient known with an inherited deafness and consulted our Department for a progressive vision loss and nyc- talopia on both eyes. The best corrected visual acuity of right eye was 2/10, whilst of the left eye was 4/10, intraocular pressure was normal and the slit lamp examination revealed a posterior cataract on both eyes. The fundus ex- amination showed pigmentary deposits resembling bone spicules, in periph- eral retina, attenuation of the retinal vessels, pseudopapilledema on the right Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 221

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ELECTRONIC POSTER PRESENTATIONS eye and waxy pallor of the optic disc on the left eye. The OCT showed various degrees of retinal atrophy and a epimacular membrane in both eyes. The op- tic nerve examination confirmed a nervous fibres loss in the both eyes, more important on the right eye. B-scan ultrasonography and the auto-fluorescence revealed a drusen of the right optic nerve head but not of the left. The vision field depicted a tunnel vision and the electroretinogram showed a dramatic diminution in a- and b-wave’s amplitudes.The genetic examination confirmed the diagnosis of retinitis pigmenosa associated to Usher syndrome type II. Usher syndrome represents the most frequent genetic disease which involves EP-RET-097 After CRVO, SRD: when the retina detaches, what to do? O. Bouderka1, B. Ziouti1, S. Bouderka1, R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoun1, R. Rachid1 120 August Hospital, Casablanca, Morocco neurosensorial deafness and vision loss. The optic nerve head drusen is de- Purpose: This case study explores the links between CRVO and SRD, the un- scribed in Usher syndrome, associated to retinitis pigmentosa. This associa- derlying mechanisms, the risks to retinal function, and the current therapeutic tion is not common, and is often bilateral and multiple, located in the para- approaches to manage these two conditions simultaneously. papillary region. The differential diagnosis of a optic nerve drusen might be difficult in this cases due to the appearance of the optic nerve head in the patients with retinitis Method: This descriptive study focuses on a patient with central retinal vein occlusion complicated by serous retinal detachment, who presented to the ophthalmic emergency department. The patient underwent a comprehensive pigmentosa and it is very important to exclude a true papilledema. bilateral and comparative ophthalmologic examination, as well as a series of EP-RET-096 Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) - clinical presentation, diagnostic modalities, and possibilities of treatment A. Byszewska1, A. Żywiec1, J. Moneta-Wielgoś1, M. Rękas1 1Military Institute of Medicine National Research Institute, Ophthalmology, Warsaw, Poland Purpose: To present a clinical picture of the rare disease IRVAN. One of the clinical cases was early diagnosed and treated, which resulted in a very good radiological and biological tests. Results: This is a 64-year-old male patient with a history of CRVO in the right eye two years prior to admission, treated with PRP laser, who presented to the emergency department for a sudden, painless decrease in visual acuity in the left eye. On clinical examination, visual acuity was 1/10 in the right eye and 3/10 in the left eye. retina examination revealed macular atrophy in the right eye, along with optic disc edema, diffuse flame-shaped hemorrhages, venous tortu- osity, and macular edema in the left eye. The diagnosis of ischemic CRVO was confirmed by retinal angiography. Macular OCT showed cystoid macular edema with a serous retinal detachment (SRD) and disorganization of retinal layers in the left eye, as well as macular atrophy and an early epiretinal membrane in the right eye. The patient underwent cardiac evaluation and hematological etiologi- cal testing, both of which were negative.Therapeutically, the patient received PRP laser sessions and anti-VEGF injections.The outcome was marked by the resolution of hemorrhage, and regression of macular edema. visual outcome, which is why awareness of this disease should be spread. Conclusion: Central retinal vein occlusion with serous retinal detachment Method: We present two patients of the Ophthalmology Department of Military Institute of Medicine National Research Institute in Warsaw, Poland. The presentation is structured in sections- clinical signs and symptoms, where color fundus photos as well as angiographic wide-field documentation are pre- sented. The characteristic signs are discussed. Then based on the clinical pic- ture differential diagnosis is proposed. Afterward, various treatment options are discussed, and how their usage influences the clinical picture. Results: There are presented two cases of the disease in Polish patients of Caucasian origin, one in a male (aged 30) and one in a female (aged 32). The first one in a late stage with advanced retinal vascular changes and poor visual acuity, and the second one with a very early diagnosis, introduced early treatment and final full visual acuity with regression of the retinal vascular changes. Conclusion: Early diagnosis and proper treatment may influence the final visual prognosis. Such patients need to be under lifelong careful observation. requires early diagnosis and appropriate management, particularly through anti-VEGF injections to treat macular edema. Close follow-up is essential to prevent complications such as neovascularization and neovascular glaucoma. Proactive management helps optimize the patient’s visual prognosis. EP-RET-098 Spontaneous resolution of epiretinal membrane-induced traction in lamellar macular holes: a two-case report A. Gama-Castro1, R. Rodrigues1, V. Fernandes1, M. Falcão1 1ULS São João, Ophthalmology Department, Porto, Portugal Two case study report: Lamellar macular holes (LMH) often result from tractional forces exerted on the macula by an epiretinal membrane (ERM), with contributions from vitreomacular traction. Optical coherence tomogra- phy (OCT) plays a key role in diagnosing and monitoring both conditions, providing detailed retinal imaging and, in rare cases, documenting spontane- ous resolution. This report describes two cases of idiopathic LMH that un- derwent spontaneous resolution of traction, resulting in recovery of foveal anatomy, as documented through OCT. These cases highlight the potential for non-surgical recovery of tractional LMH, likely triggered by complete vitre- ous detachment. Keywords: Lamellar macular hole, epiretinal membrane, vitreomacular trac- tion, posterior vitreous detachment. 222 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Results: The closure of the macular hole was acheved in more than 90% of the cases, regardless of the stage of the hole, assessed with OCT. Visual acu- ity was statisticaly improved. Microperimetry showed that inverted flap tech- niques preserve good foveal function. Conclusion: Inverted flap techniques for macular hole closure ensure good surgical outcomes, regarding both the structural and functional aspects of the macula. EP-RET-102 Clinical approaches and outcomes in full thickness macular hole surgery: 5-year retrospective study analysis I. Mancheva1, I. Kuneva1 1Specialized Hospital of Ophthalmology “Zora”, Sofia, Bulgaria Purpose: The purpose of this study is to describe the clinical characteristics, the applied clinical approach and therapeutic strategy in full thickness macular holes (FTMH) of different size, after primary failure of closure and in refrac- tory cases. Methods: Retrospective analysis has been used including 175 eyes with idi- opathic full thickness macular hole that were operated on at our clinic between 2019 and 2024. All patients underwent preoperative and multiple postopera- tive evaluations including best-corrected visual acuity (BCVA), fundoscopy, optical coherence tomography (OCT) with measurement of macular hole size and optical coherence tomography angiography (OCTA). Results: Primary macular hole closure was observed in 94% of patients. For FTMH over 400μm ILM peeling was used. The technique of choice for FTMH under 400μm was inverted flap. In the cases with primary failure of closure, inverted flap or autologous platelet-rich plasma techniques were used and sec- ondary closure was achieved in more than 50% of patients. Primary failure in macular hole surgery is associated with the following risk factors: FTMH size exceeding 600μm, high myopia, long-standing macular holes prior to surgery and spontaneous closure with recurrence. Poor ana- tomical or functional results are associated with large FTMH, long-standing FTMH, high myopia and postoperative cataract development. Factors predisposing to good anatomical and functional results are: small size FTMH, timely surgery after symptom onset, use of inverted flap technique оn FTMH larger than 400μm, combined macular hole and cataract surgery. Conclusions: Advancement in early diagnostics, modern surgical techniques and enhanced intraoperative visualization have contributed to the improve- ment of anatomical and functional results after full thickness macular hole surgery during the years. EP-RET-099 Hidden wings: butterfly-shaped pattern dystrophy – a case report F. Maia1, C. Ferreira1 1Hospital de Braga, Oftalmologia, Braga, Portugal Introduction: Retinal Pattern Dystrophies are a group of autosomal dominant inherited disorders characterized by the accumulation of yellowish pigment at the level of the retinal pigment epithelium (RPE), primarily within the mac- ula. Among these, butterfly-shaped pattern dystrophy is distinguished by its unique configuration of pigment deposition, forming a butterfly-shaped lesion. The diagnosis is mainly based on clinical findings but can be supported by multimodal imaging. The prognosis is generally good. Patients are typically asymptomatic at the time of the diagnosis, although slow progressive vison loss can occur secondary to RPE atrophy. Methods: Case report from the Ophthalmology Department at Unidade Local de Saúde de Braga, dated October 2024. Written informed consent was ob- tained from the patient for the publication of this case report and accompany- ing images. There are no conflicts of interest to declare. Results and discussion: A 33-year-old male presented for a routine ophthal- mology consultation. He had no relevant medical, ophthalmological or fa- miliar history and reported no symptoms. On ophthalmological examination, best-corrected visual acuity was 10/10 in both eyes (Snellen Scale), and the anterior segment examination was unremarkable. However, bilateral fundoscopy revealed central areas of depigmentation out- lined by yellowish pigment deposits resembling butterfly wings. Swept-source optical coherence tomography, fundus autofluorescence and fundus fluores- ceine angiography confirmed the diagnosis. Conclusion: Clinicians should remain aware for rare entities, even in asympto- matic patients. A high index of suspicion is essential for diagnosing retinal pat- tern dystrophies. Its understanding is the first step toward accurate recognition. EP-RET-100 Functional and structural results in macular hole surgery using inverted flap O. Samoila1, L. Samoila2, A. Sere2 1University of Medicine and Pharmacy Iuliu Hatieganu, Ophthalmology, Cluj-Napoca, Romania, 2University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania Purpose: Vitreo-retinal surgery for macular hole is a delicate procedure which interferes with the architecture of the central retina. Inverted flap techniques might produce less tension on the retinal surface in the foveal area. The study aims to follow structural and functional changes before and after the surgery, through various parameters, including SD-OCT (Heidelberg) and microper- imetry. Method: A retrospective observational study was designed to investigate the patients treated in the year 2024. All surgeries were performed by one surgeon, under local anesthesia, and the inverted flap (either covering the defect, or „tucked in“) was followed by gas (C2F6) tamponade. All patients with full medical files were included: OCT and visual acuity before and after the surgery, microperimetry, full video files from the surgery. Microperimetry compared the operated eye with non-operated eye. The rate of success and functional and structural integrity were noted. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 223

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ELECTRONIC POSTER PRESENTATIONS EP-RET-103 Drugs and MSCs in modulating reactive gliosis in the retina G.K. Srivastava1 1Universidad de Valladolid / IOBA, Valladolid, Spain Reactive gliosis is a key response to retinal injury, characterized by glial left eye fundus was normal. A general clinical examination and laboratory tests were performed and were normal. Initially, close monitoring was sug- gested, but after 20 days, no improvement in visual acuity was observed. Nd:YAG laser treatment was performed at the lower edge of the blood col- lection to drain the hematoma, and the outcome was marked by an improve- ment in visual acuity. Discussion: Hemorrhages following Valsalva exertion are superficial retinal hemorrhages with a particular affinity for the macula. However, subretinal, retinal, and intravitreal hemorrhages have also been reported. Treatment is not cell activation, particularly Müller cells, which can lead to retinal damage. standardized and must be decided based on the location, patient characteris- Adipose-derived mesenchymal stem cells (MSCs) show promise in alleviating tics, and the short-term progression of the hemorrhage. reactive gliosis through paracrine signaling, releasing bioactive molecules that Conclusion: Valsalva retinopathy is rare and usually has a spontaneous and may protect the retina. This study investigates the effects of MSCs combined with pharmacological agents on reactive gliosis in the retina. Human adipose-derived MSCs were cultured under standard conditions, with 5% CO2 at 37°C in a humidified cell culture incubator. Low glucose DMEM medium supplemented with GlutaMAX™, 10% FBS, and 2% antibiotics (100 U/ml penicillin and 100 μg/ml streptomycin) was used. The MSCs were co-incubated with neuroretina using a transwell system and treated with vasoactive intestinal peptide, nicotinamide, retinoic acid, and their combinations for one week. Immunostaining was employed to assess reactive gliosis in the neuroretina. Results showed significant retinal damage when only retinal pigment epitheli- um (RPE)-conditioned medium was present in co-culture. CRALBP, a Müller cell marker, and GFAP (red) staining revealed activated glial cells in reactive gliosis, with expression in cell bodies and their extensions spanning the entire favorable evolution with a good prognosis. Nd:YAG and/or argon laser hyaloi- dotomy is an effective procedure, while vitrectomy is only performed in cases of persistent hematoma due to the risk of retinal toxicity and functional threat. EP-RET-105 The benefit of contrast sensitivity in the routine ophthalmology practice M. Dinkov1, S. Murgova1, G. Balchev1, T. Ivanova1, M. Tsvetkova1 1UMHAT „Dr. Georgi Stranski“, Ophthalmology, Pleven, Bulgaria Background: The contrast sensitivity is the ability of the eye to clearly distin- retina. DAPI staining assessed the outer nuclear layer (ONL) and inner nuclear guish the outlines of very small objects compared to homogenous background. layer (INL), revealing variations in damage, nuclear arrangement, and thick- Purpose: To present the value of assessing the contrast sensitivity in patients with macular degeneration. Methods: There are different indications for evaluation of the contrast sensi- tivity - applying for a certain job, qualitative evaluation of vision loss, glau- coma, cataract and diseases of the optic nerve and the retina. The latter may be assessed using different formulas - Michelson, Weber as well as different charts - Pelli-Robson, Regan, Arden etc. We may observe disturbances of the contras sensitivity in various conditions such as: age related changes, cataract, diabetic retinopathy or diseases with involvement of the optic nerve. Another methods used to register the con- trast sensitivity are the Visual Function Questionaire-25(VFQ-25) and Motion Diamond Stimulus (MDS). Results: Our team has evaluated the contrast sensitivity using the Pelli- Robson chart of 15 patients with age-related macular degeneration (AMD) treated with anti-VEGF medication, followed up for period of 1 year and 6 mounths. From the total number of patients (15) - 11 (74%) showed significant improvement of their contrast sensitivity. Conclusion: Combining contrast sensitivity evaluation with the regular vision acuity examination of patients, can give us crucial information about the state of the condition and help us decide the next steps of the treatment. ness of these nuclear layers. Co-culturing neuroretina with MSCs partially preserved retinal structure, while MSCs combined with drugs significantly reduced reactive gliosis, im- proving the nuclear layers’ integrity. These findings highlight the potential of drugs and MSC combinations-based therapies in mitigating reactive gliosis and improving retinal layer preservation in retinal damage. EP-RET-104 Management of valsalva retinopathy: a case report S. Rhalib1, I. Laabi1, S. Bouderka1, Z. Laftimi1, G. Daghouj1, B. Allali1, A. El Kettani1 120th August Hospital, Pediatric Ophthalmology Department, Casablanca, Morocco Introduction: Valsalva retinopathy is a superficial retinal hemorrhage caused by the rupture of a posterior pole capillary, secondary to a sudden increase in venous pressure during physical exertion with a closed glottis. Its evolution is generally favorable without treatment. Methods: We report the case of a patient who developed a macular hematoma following physical exertion related to sports. Results: Mr. A.M, a 26-year-old with no pathological history, presented to the emergency department with a sudden decrease in visual acuity in his right eye, which had developed 24 hours earlier after physical exertion. The initial clinical examination revealed a visual acuity of counting fingers at 60 cm in the right eye and 10/10 in the left eye. The anterior segment examina- tion was normal in both eyes. On the right, the fundus revealed a macular haemorrhage suspended in a pigeon’s nest covering the posterior pole. The 224 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-106 EP-RET-108 Ocular manifestations of primary thrombotic microangiopathies : a descriptive systematic review Central serous chorioretinopathy in a patient with Cushing´s disease due to a ptituitary macroadenoma M. Baker1, Z. Alnajjar2, D. Aldabaibeh3, Y. Al-Rashdan4, M. Ayoub2, T. Ghosheh1, M. Alkhawaldeh1, K. Al-Shami5 1Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, Irbid, Jordan, 2Hashemite University, Zarqa, Jordan, Faculty of Medicine, Zarqa, Jordan, 3Jordanian Royal Medical Services , Amman , Jordan, Amman, Jordan, 4University of Jordan, Amman, Jordan, Faculty of Medicine, Amman, Jordan, 5Department of Clinical Medical Science,Faculty of Medicine, Yarmouk University, Irbid, Jordan, Irbid, Jordan Purpose: Primary thrombotic microangiopathies (PTMAPs) include T. Javaloy Vidal1, J.A. Reche Sainz1, R. Fernández Herrero1, M. Pichón Rizo1, B. Cano González-Barcia1, M. Toribio Albarrán1 1Hospital Universitario 12 de Octubre, Ophthalmology, Madrid, Spain Purpose: To report a case of Central serous choroidopathy (CSC) in a patient with pituitary macroadenoma. Method: Clinical case report, retinal images, optical coherence tomography (OCT), autofluoresence retinal imaging, laboratory and radiology examina- tions and bibliographic review. Results: A 39 year old male with recently diagnosed arterial hypertension and type II diabetes was admited trough the emergency service with a condi- Thrombotic Thrombocytopenic purpura (TTP) and Hemolytic Uremic tion consisting of a 5 day long headache and left eye superior ptosis. In the Syndrome (HUS), which may cause ocular signs that need to be detected and examination, the patient presented left III cranial pair paralysis with ptosis managed accordingly. Therefore, we aim to identify the ocular manifesta- tions caused by the systemic effect of primary thrombotic microangiopathies (PTMAPs), including HUS and TTP. Method: We searched PubMed, Scopus, and Web of Science data bases from inception until March 2024. We included case reports, case series, and retro- spective reviews reporting ocular manifestations of primary HUS or TTP. We excluded experimental studies, papers written in language other than English, studies included patinets with secondary TTP or HUS, pregnants, patients with ocular trauma or surgery, and patients with other comorbidities that impair the detection of ocular findings. Results: We included 37 studies comprising 58 patients, with mean age of 18.87 years. The most common ocular manifestations were retinal hemor- rhages (25.86%, n=15), Purtscher-like retinopathy (24.13%, n=14), retinal de- tachment (20.68%, n=12), optic disc changes (18.96%, n=11), capillary non- perfusion on FFA (13.79%, n=8), and isolated cotton-wool spots (12.06%, n= 7). Rarer manifestations were capillary leakage on FFA (n=5, 8.6%), vascular tortuosity (8.6%, n=5), retinal ischemic changes (8.6%, n=5), sluggish pupil reactivity (6.9%, n=4), vitreous hemorrhage (6.9%, n=4), early hypofluores- cence (6.9%, n=4), and shifting subretinal fluids (5.2%, n=3). Conclusion: We found that retinal hemorrhage, Purtscher-like retinopathy, retinal detachment, optic disc changes, capillary non-perfusion on FFA, and isolated cotton-wool spots were the most commonly reported ocular manifes- tations of PTMAPs. Identification of these manifestations will help to adequately detect and man- age them in patients with PTMAPs. We recommend further investigations that provide reliable methods of prevention of those sequelae in patients with PTMAPs. of the upper eyelid and pupil in median non reactive mydriasis. Also limita- tion of the elevation, depression and adduction of the left eye were found. Examination of the right eye was normal and no symptoms were reported. The cranial CT scan showed a 40 x 30 mm tumor with infiltrative aspect cen- tered in the sella turcica with suprasellar extension, and destruction of part of the clivus. Laboratory studies were performed to confirm the diagnosis of Cushing’s disease secondary to pituitary corticotropic neuroendocrine tumor with associated hypogonadotropic hypogonadism and hypoprolactinemia. Fundus examination of the right eye showed a serous temporal serous lift- ing image temporal to macula. In the right eye´s OCT was found a focus of neurosensory detachment temporal to macula accompanied by hyperreflec- tive subretinal stippling. Fundus autofluorescence showed an area of retinal pigment epithelium alteration with areas of hypo and hyperautofluorescence. Conclusion: CSC is a pathology characterized by serous detachments in the neurosensory retina. Glucocorticoids are the best known risk factor. Patients with endogenous cortisol production, such as those with Cushing’s disease, have increased risk for CSC. Fundus examination, autofluorescence and OCT of both eyes is necessary in those patients in whom visual alterations and suspected hypercortisolism. EP-RET-109 Systematic review of efficacy and meta-analysis of safety of aflibercept biosimilars relative to reference aflibercept anti-VEGF therapy for neovascular AMD treatment A. Alzahrani1, Z. M. Bukhari1, H. Al-Jahni2, F. Alqahrani3 1King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Department of Ophthalmology, Jeddah, Saudi Arabia, 2Jeddah Eye Hospital, Ophthalmology, Jeddah, Saudi Arabia, 3King Khaled Eye Specialist Hospital, Vitreoretinal Division, Riyadh, Saudi Arabia Purpose: The aim of this systematic review and meta-analysis is to assess and compare the effectiveness and safety of Aflibercept biosimilar that are approved various regulatory agencies to the reference Aflibercept anti- VEGF therapy for the treatment nAMD. Method: We conducted systematic searches of MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials. We considered studies that re- ported changes in best-corrected visual acuity (BCVA), including the number Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 225

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ELECTRONIC POSTER PRESENTATIONS of patients who either lost or gained more than 15 letters from their baseline BCVA, as well as changes in retinal thickness and any adverse events across treatment groups. Conversely, we excluded studies that did not provide visual outcome data following intravitreal injections of biosimilar and reference ra- nibizumab, those that combined anti-VEGF treatments with laser or steroid injections, studies using sham injections as a control, non-English full texts, and those with non-comparative, observational designs. Results: Our cohort included a total of 2,039 patients diagnosed with neo- vascular age-related macular degeneration, who received either reference Aflibercept (n = 1,016, 49.8%) or Aflibercept biosimilars (n = 1,023; 50.2%). No statistically significant differences were observed in treatment-emergent adverse events (TEAEs) between the reference Aflibercept and biosimilars groups. No statistically significant differences were observed in terms of best- corrected visual acuity (BCVA), changes in retinal thickness, and adverse events between treatment arms. Conclusion: This systematic review of four RCTs demonstrated no significant difference in visual outcomes, retinal thickness outcomes, as well as meta- analysis of adverse events between biosimilar and reference Aflibercept thera- pies for nAMD treatment. EP-RET-112 Epiretinal membranes – a five-year retrospective analysis of 278 cases D. Nikolov1, I. Kuneva1, I. Petkova1 1Specialized Hospital of Ophthalmology “Zora”, Sofia, Bulgaria Purpose: To evaluate the demographic, refractive, and clinical characteristics of patients with epiretinal membranes (ERMs) identify potential risk factors and evaluates the outcomes following their surgical treatment. Methods: This retrospective study analyzed the medical records of 278 pa- tients diagnosed with ERMs from 2019 to 2024 who underwent surgical treat- ment. The cohort consist of 157 women (56.5%) and 121 men (43.5%), with an age 70.4 ± 8.8 years. Refractive statuses include 61 myopic (21.9%), 129 hypermetropic (46.4%), and 88 emmetropic (31.7%) individuals. Among the participants, 27% were pseudophakic, while 73% were phakic. All patients underwent 25-gauge pars plana vitrectomy with peeling of internal limiting membrane (ILM) and SF6 gas tamponade, 126 (45%) of whom received com- bined surgery with phacoemulsification and intraocular lens (IOL) implanta- tion. They were evaluated during three follow-up visits to assess visual acuity and central retinal thickness. EP-RET-114 Evaluation of fluocinolone acetonide effectiveness in managing recurrent macular edema post-pars plana vitrectomy L. Vilaverde1, D. Figueiredo Pires1, J. Coelho1, N. Correia1, A. Meireles2,1, B. Pessoa2,1 1Unidade Local de Saúde Santo António, Ophthalmology, Porto, Portugal, 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal Purpose: Recurrent macular edema (RME) following various surgeries re- mains a challenge in clinical practice. This study evaluates the efficacy and safety of fluocinolone acetonide implant (0.19mg FAc, ILUVIEN®) in tackling RME in patients who underwent pars plana vitrectomy (PPV). Method: This retrospective study analyzed variables including best-corrected visual acuity (BCVA), central macular thickness (CMT), macular volume (MV), and intraocular pressure (IOP). Patient data was collected at baseline and quarterly during follow-up. Analyses were done to assess changes in these variables and the need for adjunctive therapy. Results: Data from 12 eyes with RME post-PPV were analyzed, with 2 eyes excluded due to loss of follow-up (follow-up <6 months). The average patient age was 64.4±9.4 years, with a mean duration of edema of 32.8±18.6 months. Half the patients were male and all eyes were pseudophakic at baseline. Prior to FAc implantation, all eyes received intravitreal corticosteroid therapy (av- erage 3.4±2.0 injections). Mean follow-up time after FAc was 36.5(9-87) months. Baseline median BCVA was 55(range 20–70) ETDRS letters, improving 10,8 letters at last observation (p<0.01). Median CMT at baseline was 455(310– 576)µm, with a reduction of 150µm at last observation (p<0.01). Median MV at baseline was 9.6(7.8–11.5)mm3, with a 1.6mm3 reduction at last observation (p<0.01). IOP remained stable (Δ-0,3mmHg at last observa- tion, p>0.05). 4 eyes experienced an increase in IOP directly related to FAc, managed with hypotensive eye drops, and 2 of these were submitted to glau- coma surgery. Only 1 patient required additional treatment with a FAc implant at 48 months without complications until the last observation. Conclusion: FAc implant proved effectiveness in reducing CMT and MV while maintaining or improving BCVA in vitrectomized patients with RME. Ongoing vigilance is essential to track IOP fluctuations and optimize manage- ment strategies in this challenging population. Results: Throughout the study period, there was a steady improvement in visual acuity. The initial mean best corrected visual acuity (BCVA) was meas- EP-RET-115 ured at 0.22 (± 0.14). Post-treatment visual outcomes were assessed at three follow-up visits, with the final BCVA recorded at a mean of 0.43 (± 0.12). Central retinal thickness (CFT) also showed improvement, with the mean CFT decreasing from 513 µm at baseline to 374 µm at the third follow-up. The study further indicated that ERMs are more frequently observed in women at the mean age of 70 years. Refractive error distributions revealed a higher prevalence of hypermetropia among ERM patients, but did not significantly influence the postoperative visual outcomes. Conclusions: The study indicates the heterogeneous demographic nature of epiretinal membranes (ERMs) and demonstrates the effectiveness of surgical treatment as evidenced by significant improvements in both visual acuity and central retinal thickness over the follow-up period. Pachychoroid disease spectrum: Review and case report of central serous chorioretinopathy combined with peripapillary pachychoroid syndrome I. Antonova1, V. Daskalov1, R. Kermedchieva1 1Pentagram Eye Hospital, Sofia, Bulgaria Background: We present a review of current data about the spectrum of pach- ychoroid diseases, highlighting recent discoveries about their pathogenesis and specific clinical signs. We outline each of the pachychoroid diseases and the pathogenetic link between them. We report a case of bilateral pachychoroid disease manifesting central serous chorioretinopathy (CSCR) in one eye and peripapillary pachychoroid syn- drome (PPS) in the contralateral eye. 226 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Case Presentation: A 39-year-old male presents with complaints of blurred vision in the right eye. Best-corrected visual acuity (BCVA) is 0.15 in the right eye and 1.0 in the left eye. Fluorescein angiography and optical coherence tomography (OCT) confirm the diagnosis of CSCR in the right eye, PPS in the left eye, and a pachychoroid phenotype in both eyes. Anti-VEGF treatment is administered in both eyes, and an improvement in BCVA of the right eye is observed, reaching 0.8, along with a resolution of the pathological changes in the retinal structure of both eyes, which is documented with OCT. On a six- month follow-up exam, there is a relapse in the right eye, and it is treated once more with an anti-VEGF intravitreal injection, resulting in full resolution of the symptoms and foveal architecture. Conclusions: We discuss treatment options and classifications of the spectrum of pachychoroid diseases. Keywords: pachychoroid, central serous chorioretinopathy, peripapillary pachychoroid syndrome, aflibercept, anti-VEGF, EDI-OCT, pachydrusen, choroidal congestion EP-RET-117 Unilateral adult-onset foveomacular vitelliform dystrophy: incidental discovery in a patient with decreased visual acuity H. Ouazzani Touhami1, K. Selmani1, S. Layachi1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Adult-onset foveomacular vitelliform dystrophy is a rare mac- ular disease characterized by the accumulation of lipoproteinaceous material beneath the retina. Although it is generally bilateral, unilateral forms may be incidentally discovered, specially in asymptomatic patients. The aim of this case report is to describe an atypical presentation of unilateral vitelliform dystrophy discovered incidentally and to discuss its diagnostic, evolutionary, and management particularities. Case Report: A 65-year-old hypertensive and diabetic female patient present- ed with decreased visual acuity (right eye: 6/10, left eye: 4/10) persisting for two years. The patient had mild cataracts in both eyes and fundus examination revealed a single, slightly elevated, bright yellow lesion in the macular region of the left eye. Fluorescein angiography showed initial hypofluorescence with late-stage ring-shaped heterogeneous staining. Macular OCT confirmed sub- pigment epithelium material accumulation and macular thickening in the left eye, while the right eye was normal. Discussion: Vitelliform dystrophy is often asymptomatic before the age of 50 and is usually discovered incidentally. Unilateral involvement can be observed at early stages. Regular monitoring is essential to track disease progression, particularly the risk of choroidal neovascularization and potential bilateraliza- tion. No specific treatment is required for stable lesions; however anti-VEGF injections are indicated in cases of complications. Gene therapy is being inves- tigated for possible prevention of vitelliform lesion development. Conclusion: The incidental discovery of unilateral vitelliform dystrophy un- derscores that retinal conditions can remain silent until advanced stages. This case highlights the importance of thorough ophthalmological examinations in patients, even in the absence of specific symptoms. Rigorous follow-up and preventive measures are necessary to preserve vision and anticipate complica- tions. EP-RET-118 Public awareness about ophthalmological conditions in Saudi Arabia: a systematic review and meta-analysis R. Moria1, A. Alamoudi2, A. Ghaddaf1, N. Taher1, A. AlMansour1, W. Alnahdi1, S. Alghamdi3 1King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia, 2Jeddah Eye Hospital, Department of Ophthalmology, Jeddah, Saudi Arabia, 3King Abdulaziz Medical City, Department of Ophthalmology, Jeddah, Saudi Arabia Purpose: Public awareness of ocular diseases is critical for early diagnosis and management, reducing the economic and psychological burden of visual impairment. This systematic review aimed to assess the public knowledge of common ophthalmological conditions in Saudi Arabia, focusing on their causes, symptoms, complications, and management. Methods: A systematic search of Medline, Embase, and CENTRAL was conducted to identify relevant studies. Inclusion criteria were questionnaire- based cross-sectional studies conducted in Saudi Arabia, evaluating public awareness and attitudes about general knowledge, risk factors, symptoms, complications, and management of glaucoma, cataract, and diabetic retin- opathy (DR). Meta-analyses were performed on outcomes reported in at least two studies using a random-effects model. Quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). Results: Twenty-eight studies with a total of 14,408 participants were in- cluded. Seventy-two questions reported in at least two studies were included in the meta-analysis. Awareness rates for glaucoma, cataract, and DR were 57.63% (95% confidence interval (CI): 56.87%–60.07%), 69.90% (95%CI: 67.02%–76.07%), and 68.65% (95%CI: 65.94%–71.23%), respectively. Regarding treatment, 43.68% (95%CI: 41.54%–45.85%), 55.43% (95%CI: 54.03%–56.82%), and 63% (95%CI: 60.8%–65.1%) of participants believed glaucoma, cataract, and DR could be treated. However, knowledge about risk factors, symptoms, complications, and management options was low. Conclusion: This systematic review reveals significant gaps in public aware- ness of common ophthalmological conditions in Saudi Arabia. While aware- ness of cataract and DR was relatively higher, understanding of glaucoma was notably limited. Targeted educational interventions addressing these gaps are essential to enhance public knowledge and promote early diagnosis and man- agement of ocular diseases. EP-RET-119 Different facets of intraocular hemorrhage in hypertensive retinopathy R.R. Martins1, S.S.D. Estrada Medeiros1, J.G. Guimaraes Rabelo1, A.L.A. Da Fonseca1, M.V.d.A. Sobrinho1, M.M. Denobi1, V.F. Pansani1 1Pontifical Catholic University Hospital of Campinas, Ophthalmology, Campinas, Brazil A 64-year-old Caucasian woman with poorly controlled hypertension present- ed to the ophthalmic emergency department with sudden visual loss in the left eye. Visual acuity was 0.6 in the right eye and count fingers at 1 meter in the left eye. Slit-lamp examination revealed a 1-2+ nuclear cataract without other abnormalities, and intraocular pressure was 15 mmHg in both eyes. 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ELECTRONIC POSTER PRESENTATIONS Fundoscopy revealed grade 3 hypertensive retinopathy with a subhyaloid macular hemorrhage with a concomitant ruptured macroaneurysm and infe- rior vitreous hemorrhage in the left eye, with no signs of retinal detachment. Photocoagulation of the macular macroaneurysm and YAG laser to the infe- rior portion of the subhyaloid hemorrhage were indicated. After two weeks, the patient returned with a stable visual acuity, although complaining of new visual worsening. Rebleeding of the left eye was identi- fied, now with subretinal hemorrhage. Urgent posterior vitrectomy with intra- vitreal injection of SF6 gas and APT (Activated Partial Thromboplastin) was indicated. On postoperative day 1 (POD1), the patient developed ocular pain, hyphe- ma, and intraocular pressure of 33 mmHg in the left eye, being treated with Vigadex, Tropicamide and Britens. The patient returned on POD3 with no complaints, a IOP of 14 mmHg, and fundoscopy with the retina attached superiorly and difficult macular evalua- tion. On POD10, there was vitreous hemorrhage on fundoscopy and inferior infiltrated hyaloid on ultrasound of the left eye. On POD30, fundoscopic evaluation revealed free macula and arcades, with nasal and inferior blood clot. On POD60, the patient presented with a visual acuity of count fingers at 1.5 meters in the left eye, with no changes on fun- doscopy. Optical coherence tomography of the macula was requested, and phacoemul- sification of the left eye was indicated. This case exemplifies the different fac- ets of intraocular hemorrhage in hypertensive retinopathy, allowing for imag- ing and therapeutic discussions. EP-RET-121 Influence of advanced age on pars plana vitrectomy outcomes in rhegmatogenous retinal detachment: a comparative case study A.S. Martins1, B.B. Ribeiro1, D. Pires1, G. Santos1, J. Coelho1, A. Meireles1,2 1Unidade Local de Saúde de Santo António, Oftalmologia, Porto, Portugal, 2Instituto de Ciências Biomédicas Abel Salazar, Oftalmologia, Porto, Portugal No differences were found in type of tamponade (p=0.22), anatomical success (p=0.62) or re-detachment rate between groups (p<0.001). FinalBCVA was worse in the elderly (0.9 vs 0.6 logMAR units, p<0.001). Conclusions: PPV in Rhegmatogenous retinal detachment is as safe in elderly patients as it is in younger patients. In our population patients’ age does not affect time until surgery, treatment options or anatomical success. EP-RET-122 Cytomegalovirus retinitis in an HIV-infected patient: an unexpected ocular manifestation in the era of antiretroviral therapy R.R. Martins1, S.S.D. Estrada Medeiros1, J.G.G. Rabelo1, M.V.d.A. Sobrinho1, L.B. Felicio1, V.S. Ignachiti1, A.L.A. Da Fonseca1 1Pontifical Catholic University Hospital of Campinas, Ophthalmology, Campinas, Brazil A 39-year-old female presented with lesions on the left posterior trapezius noted one week prior, which progressed to the anterior region concurrently with fever. Eight days prior, she developed painful ulcerative lesions in the oral cavity, gingivitis, and stomatitis. She also reported progressive blurred vision in the left eye over the past month and unintentional weight loss of 28 pounds over three months. On examination, oroscopy revealed a crusted ulcerated lesion with a 0.8 mm necrotic center in the middle third of the lower lip, suggestive of cytomegalo- virus (CMV), a 1 mm exulceration on the tip of the tongue, linear gingival erythema, and lesions suggestive of HIV. Ophthalmological examination revealed uncorrected visual acuity of 0.3 in the right eye and light perception in the left eye. Fundoscopy of the left eye dem- onstrated an extensive area of peridisc exudates with multiple hemorrhagic foci, hard exudates in the macular and perimacular region, papilledema grade 1, and increased vessel tortuosity. Furthermore, a colonoscopy was performed, which revealed ulcerated lesions in the right colon; biopsy demonstrated a moderate subacute inflammatory process suggestive of infection with a virus exhibiting cytopathic effects, consistent with CMV. Two initial positive HIV tests were obtained along with lymphopenia, signs of immunosuppression, and retinitis suggestive of Purpose: Rhegmatogenous retinal detachment (RRD) is a sight-threatening advanced CMV, an uncommon presentation nowadays. Ganciclovir 250 mg condition and the most common cause of retinal detachment. The purpose of every 12 hours and prophylaxis for pneumocystis with bactrim 400/80 mg this study was to compare patients over eighty years old with younger patients twice daily were initiated. After two weeks of treatment, including antiretroviral therapy, the patient demonstrated significant improvement in cutaneous lesions and in the fundo- scopic, although with no changes on visual acuity. This case report emphasizes the critical importance of correlating ophthalmo- logical findings with the general physical examination for accurate diagnosis and integrated clinical management following appropriate treatment. regarding comorbidities and surgical outcomes in pars plana vitrectomy (PPV) for the treatment of RRD. Methods: We retrospectively reviewed all patients submitted to PPV due to RRD at our institution from January 2020 through December 2023. We analysed patients age, gender, time from diagnosis to surgery, lens and macula state, BCVA before and after surgery, presence of Choroidal detachment (CD), presence of Proliferative vitreoretinopathy (PVR), type of fluid drainage mechanism, LASER and/or cryotherapy use, type of tamponade, achievement of anatomical success, re-detachment rate and time to re-detachment, mean time of follow-up and complications. Results: We analysed 567 eyes of 552 patients (63.4% males), 168 over eighty years old (29.6%). Younger patients presented later after symptoms onset (p<0.001), but with a better BCVA (p<0.001) however no differences were found in time from diagnosis to surgery (p=0.929). Pseudophakia was more common in older patients (p<0.001). Younger patients presented with more macula-on RRD (p<0.001) but there were no differences found in the degree of PVR (p=0.72), total RD (p=0.6) or CD (p=0.29). 228 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-123 Purtscher-like retinopathy as the first manifestation of systemic lupus erythematosus – a case report F. Maia1, Á. Silva1 1Hospital de Braga, Oftalmologia, Braga, Portugal Introduction: Purtscher-like Retinopathy is a clinical pattern resembling Purtscher’s Retinopathy without trauma. It has been linked to multiple sys- temic conditions, including acute pancreatitis, fat embolism syndrome, and various autoimmune or connective tissue disorders. Methods: Case report from the Ophthalmology Department at Unidade Local de Saúde de Braga. Informed consent was obtained for this case report. Results and Discussion: A 29-year-old woman presented to the emergency department with a 4-day history of progressive bilateral visual acuity loss. She had no medical or ophthalmological history and reported no other symptoms. On examination, best-corrected visual acuity (BCVA) was counting fingers in both eyes, with no relative afferent pupillary defect. There were no ocu- lar motility deficits, with no pain or diplopia. Anterior segment examination was unremarkable. Fundoscopy revealed normal appearing optic discs, cotton wool spots, Purtscher flecken, severe retinal edema and intraretinal hemor- rhages. Optical coherence tomography showed marked hyperreflectivity and thickening of the internal layers and cystoid macular edema. Fluorescein angi- ography revealed severe macular nonperfusion as well as peripheral ischemia. Systemic workup showed normochromic anemia, positive antinuclear anti- body titer, positive anti-DS DNA, antiribosomal antibodies, and complement consumption. Antiphospholipid antibodies were also detected. A presumptive diagnosis of systemic lupus erythematosus (SLE) was made. The patient was started on high-dose intravenous corticosteroids and rituximab. Intravitreal dexamethasone was administered. One week later, BCVA in the left eye im- proved to 20/125 and right eye remained unchanged. Conclusion: Purtscher-like retinopathy is a rare, vision-threatening condition. We report a case of severe Purtscher-like Retinopathy with vaso-occlusive retinal damage, likely the initial manifestation of SLE with secondary an- tiphospholipid syndrome. EP-RET-124 Surgical outcomes for idiopathic macular holes: morphological and visual acuity predictive factors M. Vaz Pereira1, R. Silva1, K. Sousa1 1Hospital de Braga, Ophthalmology Department, Braga, Portugal Purpose: Advances in macular hole (MH) surgery have improved anatom- ic success rates to over 90%, though functional outcomes remain variable. Emerging surgical techniques reveal novel MH closure patterns, challenging the traditional “open” vs. “closed” classification. This study examines ana- tomical and functional outcomes in patients undergoing pars plana vitrectomy (PPV) at our center. Methods: Retrospective analysis of idiopathic MH patients treated with PPV Results: Among 84 eyes from 82 patients (74.4% women, mean age 68.4±8.5 years), preoperative BCVA averaged 1.04±0.49 logMAR, MLD 465.2±92.9 µm, and MH index 0.49±0.23. Large MHs comprised 47.6% of cases. Inverted flap technique was employed in 66.7%, and 81% received SF6 tamponade. Larger MLD correlated with worse preoperative BCVA. At 3 months, BCVA improved to 0.717±0.438 logMAR, with 76.5% gaining vision and 35.9% gaining ≥2 Snellen lines. Anatomical success was achieved in 83.3% of eyes. MH closure was significantly less probable when inverted flap technique was not performed. Type 1B closure (44%) predominated, with significant associa- tions between closure type, BCVA gain, and surgical technique. Outer retinal layer restoration was observed in 19 eyes and correlated with MLD, MH in- dex, and final BCVA. Conclusion: PPV effectively achieves anatomical and functional outcomes for idiopathic MH. MH closure patterns significantly impact visual recovery, emphasizing the role of outer retinal layer integrity in visual prognosis. EP-RET-125 Efficacy and safety of brolucizumab in neovascular agerelated macular degeneration – a real-world study A. Mendes da Silva1, G. Calvão Santos1, P. Gouveia1, K. Sousa1 1Hospital de Braga, Braga, Portugal Purpose: Brolucizumab (Beovu®), an anti-VEGF agent, was approved by the European Medicines Agency in 2020 for neovascular age-related macular degeneration (nvAMD). In the HAWK and HARRIER trials for nvAMD, it showed comparable visual acuity improvements to aflibercept, with potential for longer durability. The dosing regimen includes monthly intravitreal injec- tions (IVI) of 6 mg/0.05mL for the first three doses, followed by injections every 8 to 12 weeks. Despite these findings, post-marketing surveillance has raised safety concerns. This study aims to evaluate the real-world safety and efficacy of brolucizumab IVI for nvAMD. Methods: This retrospective observational study included eyes with nvAMD treated with brolucizumab IVI at Hospital de Braga, between 2022 and 2023, that had clinical evaluation with optical coherence tomography before and af- ter at least one IVI. The outcomes assessed included corrected distance visual acuity (CDVA), central retinal thickness (CRT), macular volume (MV), the presence of intraretinal fluid (IRF), subretinal fluid (SRF), serous pigment epi- thelial detachment (sPED), treatment intervals, and the incidence of adverse events. Results: The study included 42 eyes from 38 patients (71.1% female, mean age 78±8 years), with a majority having previous anti-VEGF treatments. CDVA showed no statistically significant change after brolucizumab treatment, al- though notably improving in treatment-naïve eyes. Significant improvements were observed in CRT and MV (p<0.05). The prevalence IRF, SRF, and sPED decreased notably (p<0.05). Intraocular inflammation occurred in 3 eyes. Conclusions: In this real-world study, brolucizumab demonstrated its effec- tiveness in maintaining CDVA while significantly improving key anatomical parameters, consistent with the HAWK and HARRIER trials. These findings support the use of brolucizumab in clinical practice, but highlight the need for from January 2017 to December 2023 at Hospital of Braga. Data included careful patient selection and close monitoring for adverse events. preoperative, 1-month, and 3-month best corrected visual acuity (BCVA); minimum linear diameter (MLD); base linear diameter (BLD); hole edge con- figuration; macular hole index (height/BLD); surgical techniques; and MH closure types per spectral-domain OCT classification (Rossi et al.). Eyes were categorized by MLD using CLOSE Study Group criteria. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 229

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ELECTRONIC POSTER PRESENTATIONS EP-RET-126 Central serous chorioretinopathy in a patient with bestrophinopathy: a clinical case of sequential diagnosis I. Coelho da Costa1, Â. Carneiro1,2, R. Teixeira Martins1, A. Gama e Castro1, S. Estrela Silva1, S. Penas1,2 1ULS São João, Ophthalmology Department, Porto, Portugal, 2Faculdade de Medicina da Universidade do Porto, Department of Surgery and Physiology, Porto, Portugal Purpose: Case report of a 32-year-old man, initially diagnosed with bestro- phinopathy, misinterpreted as central serous chorioretinopathy (CSC), who Methods: A retrospective case report was conducted at Hospital de Braga. Clinical and diagnostic data were reviewed with informed consent obtained. Results: A 74-year-old woman presented with decreased visual acuity (VA) in both eyes. Medical history included arthritis and osteoporosis. VA was count- ing fingers OD and 20/160 OS. Anterior segment exam showed cortical cata- racts, and intraocular pressure was normal. Fundoscopy revealed drusen and macular edema. OCT confirmed macular edema, pigment epithelial detachment, and hyperreflective material, lead- ing to a diagnosis of exudative age-related macular degeneration (AMD). Intravitreal bevacizumab was initiated, but treatment in the right eye was stopped due to outer retinal atrophy. In the left eye, VA improved to 20/32 after eight injections over 10 months. Within 48 hours of the final injection, the patient was admitted with altered mental status, vomiting, and aphasia. CT imaging suggested an ischemic or ultimately developed true CSC, highlighting the clinical challenges in diag- infectious process, but lumbar puncture was inconclusive. Despite treatment nosis and management. with corticosteroids, antibiotics, and antivirals, her condition deteriorated, and Methods: A 32-year-old male presented with a two-year history of bilateral MRI revealed severe cerebral edema with ventricular compromise. The pa- vision decrease, unresponsive to treatments with eplerenone and photody- namic therapy after an initial diagnosis of CSC. At his first appointment at our center, best-corrected visual acuity (BCVA) was 0.5 in both eyes. Fundus examination revealed two well-demarcated, heterogeneous yellowish macular lesions. SD-OCT demonstrated a thickened choroid and hyporeflective sub- retinal space compatible with a serous detachment. Autofluorescence and angiography showed bilateral macular round lesions with a hyperautofluorescent halo and a heterogeneous center, with no diffu- sion seen on fluorescein angiography. Genetic testing, prompted by similar findings in his maternal uncle, revealed a c.304T>C variant in the Best1 gene. Results: During a four-year period of observation without active intervention, the patient demonstrated significant improvement in both subretinal fluid and visual acuity. However, at the end of this period, he presented at his routine appointment with complaints of progressive visual loss in the left eye over the past month. SD-OCT revealed the presence of new subfoveal subretinal fluid, and fluorescein angiography demonstrated a superior leak point with macular contrast impregnation, leading to a diagnosis of active CSC. A conservative approach was chosen, resulting in resolution of subretinal fluid and improve- ment in BCVA after six months. Conclusions: This case emphasizes the importance of considering bestrophi- nopathy in patients with chronic subretinal fluid to prevent unnecessary inter- ventions. Additionally, it highlights that patients with bestrophinopathies can develop CSC, complicating clinical management. EP-RET-127 Posterior reversible encephalopathy syndrome after antiangiogenic intravitreal administration: a case report M. Vaz Pereira1, A.M. Sampaio1, G. Calvão-Santos1 1Hospital de Braga, Ophthalmology Department, Braga, Portugal Purpose: Posterior reversible encephalopathy syndrome (PRES), first de- scribed in 1996, presents with seizures, altered mental status, headaches, visual changes, nausea, vomiting, and focal neurological deficits. Imaging typically shows symmetrical changes in the posterior white matter. While systemic anti-angiogenic drugs are linked to PRES, only one case has been reported with intravitreal administration. This report describes a probable case of PRES after intravitreal bevacizumab. tient died from uncal herniation despite aggressive intervention. Conclusion: This case suggests a possible link between intravitreal beva- cizumab and PRES. Early recognition and treatment of PRES are essential, particularly in patients with new neurological symptoms following anti-an- giogenic therapy. EP-RET-128 Intravitreal aflibercept for macular edema due to central retinal vein occlusion: 5-year results of a real-world study (INTRAMED-CRVO) I. Chatziralli1, D. Kazantzis1, C. Agapitou1, A. Risi-Koziona1, P. Theofilou1, P. Theodossiadis1 1National and Kapodistrian University of Athens, 2nd Department of Ophthalmology, Haidari, Greece Purpose: To report the 5-year outcomes of intravitreal aflibercept in patients with macular edema due to central retinal vein occlusion (CRVO). Method: Participants in this study were 51 treatment naïve patients with mac- ular edema due to CRVO, who received intravitreal aflibercept 2.0mg using a treat-and-extend regimen after a loading dose of three-monthly injections. The primary outcomes were the mean change in best-corrected visual acu- ity (BCVA) and central subfield thickness (CST) at month 60 compared to baseline. Results: At month 60, there was a statistically significant improvement in BCVA with a mean change of 11.5 letters compared to baseline (p<0.001). 19.6% of patients gained ≥15 ETDRS letters compared to baseline. Accordingly, at month 60, there was a statistically significant reduction in CST of about 195 μm compared to baseline (p<0.001). The mean number of injec- tions at month 60 was 23.7. At month 60, about 50% of patients were found to have “good” treatment response, which was associated with ellipsoid zone integrity and the absence of hyperreflective foci on optical coherence tomog- raphy. It is worthy to note that 60.8% of patients achieved treatment interval of ≥8 weeks, while 31.4% of patients ≥12 weeks. Factors associated with an extended treatment interval was intact ellipsoid zone, lower baseline CST and the absence of disorganization of inner retinal layers. Conclusion: At the 5-year follow-up, intravitreal aflibercept showed a mean gain of 11.5 letters in BCVA with an average of 23.7 injections. 31.4% of pa- tients achieved a treatment interval of ≥12 weeks, while about half of patients showed good treatment response. 230 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-129 EP-RET-131 Retinal microvascular changes in association with endothelial glycocalyx damage and arterial stiffness in patients with diabetes mellitus type 2: a cross-sectional study in a Greek population C. Agapitou1, T. Sergentanis2, S. Lampsas1, E. Korakas3, V. Lambadiari3, I. Ikonomidis3, P. Theodossiadis1, I. Chatziralli1 1National and Kapodistrian University of Athens, 2nd Department of Ophthalmology, Haidari, Greece, 2University of West Attica, School of Public Health, Athens, Greece, 3National and Kapodistrian University of Athens, 2nd Department of Internal Medicine, Athens, Greece Purpose: To evaluate the potential association between the endothelial dys- function, as well as the arterial stiffness, and the retinal changes on optical co- herence tomography (OCT) and OCT-angiography (OCT-A) in patients with type 2 diabetes mellitus (DM). Method: Participants in this cross-sectional study were 65 patients with DM type 2 and 42 age- and gender-matched controls without DM. Demographic and clinical characteristics of the participants were recorded. All patients un- derwent a thorough ophthalmological examination and multimodal imaging, including fundus photography, OCT and OCT-A. In addition, evaluation of the endothelial dysfunction, by measuring the en- dothelial glycocalyx thickness, through the perfused boundary region (PBR5- 25), as well as of the arterial stiffness, by measuring the carotid-femoral pulse wave velocity (PWV), the central aortic pressures and the augmentation index (Aix) was performed. Univariate and multivariate logistic regression analysis was done for the ex- amination of the potential association between the eye imaging variables and the cardiovascular-related variables. Results: Patients with DM presented significantly higher PBR5-25 compared to controls without DM (p=0.023). Multivariate logistic regression analysis showed that increased PWV (≥13.7 m/sec vs. <13.7 m/sec) was associated with increased foveal avascular zone (FAZ) area on OCT-A (p=0.044) and increased FAZ perimeter (p=0.048). Moreover, increased Aix (≥14.745% vs. <14.745%) was associated with dia- betic macular edema (DME) presence (p=0.050) and increased perifoveal and parafoveal superior and temporal thickness on OCT (p<0.05 for all associa- tions). Conclusion: Markers of endothelial dysfunction and arterial stiffness were associated with structural and microvascular retinal alterations in patients with DM, pointing out that OCT-A could be a useful biomarker of detecting poten- tial cardiovascular risk in such patients. Vascular marker responses to Ocufolin® in diabetic retinopathy patients carrying MTHFR polymorphisms Z. Yehoshua1, J. Wang1, J.H Townsend1, K. Stremousov1, J.P. de Rivero Vaccari2, H. Jiang1 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, United States, 2University of Miami Miller School of Medicine, Department of Neurological Surgery and The Miami Project to Cure Paralysis, Miami, United States Purpose: This study investigated the impact of normalizing folate metabo- lism on patients with retinal vascular disease. The study focused particu- larly on patients who presented with inborn errors of metabolism related to Methylenetetrahydrofolate reductase (MTHFR) gene variants. Moreover, we aimed to assess the effects of the folate supplement Ocufolin® on serum mark- ers in patients with Type 2 diabetes (T2D) and diabetic retinopathy. Method: Ten patients with T2D retinopathy and confirmed MTHFR variants (C677T or A1298C) were enrolled. Patients received Ocufolin® to address er- rors in folate methylation metabolism. Serum biomarkers associated with clin- ical chemistry (homocysteine, high-sensitivity C-reactive protein (hs-CRP), C-peptide, myeloperoxidase (MPO), fasting insulin, insulin resistance score, triglycerides, total cholesterol, HDL, LDL, OX-LDL, vascular endothelial growth factor (VEGF), D-Dimer, hemoglobin A1c (HbA1c) and glutathione) were measured pre-and post-intervention. Result: Treatment with Ocufolin® resulted in a 23% decrease in serum homo- cysteine (P = 0.005), an 18% decrease in hsCRP, a 13% decrease in fasting insulin, and a 47% decrease in VEGF (P = 0.04). Additionally, there was a 9% increase in glutathione. Conclusion: Normalizing folate metabolism through Ocufolin® significantly improved key blood-based biomarkers in patients with diabetic retinopathy. These metabolic improvements may underlie enhanced retinal perfusion and reduced oxidative stress, suggesting potential adjunctive therapeutic benefits for managing vascular retinopathies in this population. EP-RET-132 Preoperative OCT markers and their significance in the treatment of macular holes using inverted ILM technique A. Górska1, S. Sirek1, J. Osicki1, M. Bonczek1, J. Rak1 1Medical University of Silesia, Departament of Opthalmology, Katowice, Poland Introduction: Macular holes(MH) occur in 0.5% of the population. Factors that increase the risk of its appearance are female sex and age>60 years old. The treatment of choice is surgical treatment using the inverted flap technique, which is characterized with an efficacy rate of over 90% [1]. Material and Methods: A prospective analysis was conducted on patients di- agnosed with full-thickness macular hole (FTMH) who underwent pars plana vitrectomy (PPV) from September 2022 to November 2024 using the inverted flap technique. Optical coherence tomography (OCT) imaging was conducted preoperatively and one month postoperatively. Parameters analyzed included: base diameter (BD), height of macular hole (HT), length of right arm of MH (RAL), left arm of macular hole (LAL), macular hole index (MHI), diameter Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 231

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ELECTRONIC POSTER PRESENTATIONS MHI=0.477±0.12, DHI=0.46±0.15, THI=1.2±0.71, HFF=0.79±0.17 and RAL=359.6±125.5𝜇m, hole index (DHI), hole form factor (HFF) and central retinal subfield (CRS). Statistical analysis was conducted to calculate significant predictors for best corrected visual acuity (BCVA) and Snellen test results after PPV, with statis- tical significance set at p < 0.05. Results: A total of 46 patients; 35 (76.1%) women and 11 (23.9%) men, aged 67.6±5.7 were included in the study. Means and standard deviation for analyzed parameters were: BD=937.5±355𝜇m, HD = 424.6±188𝜇m, HT=413.6±56.5𝜇m, LAL=367.5±214𝜇m, CRS=297.4±21.8𝜇m. 24 patients presented with large FTMH (>=400 𝜇m) and 22 with small FTMH (<400𝜇m). Every patient achieved full closure of the FTMH. Most common comorbidity was hypertension with the count of 13 patients (28.3%).aThe only statisti- cally significant predictor in prognosing BCVA change after surgery was MHI (p=0.01). Conclusions: PPV surgery using the inverted flap technique has very high efficiency. MHI can be used in prediction of postoperative BCVA. Further research is needed to assess the role of THI and HFF as other predictors. EP-RET-133 Post traumatic rupture of Bruch membrane: about a case O. Serji1, Y. Harrar1, F.Z. Mabrouki1, A. Maadane1, R. Sekhsoukh1 1CHU Mohammed VI, Ophthalmology, Oujda, Morocco Purpose: Severe contusive syndromes are a common cause of eye emergen- cy room visits. Among the possible complications are ruptures of the Bruch membrane or choroid, which occur in 5 to 10% of cases the study aims to describe our case from diagnosis to therapeutic management. Method: We report the observation of a 12 year old child. with no significant pathological history, admitted to the ophthalmological emergency department for contusive ocular trauma of the left eye the history of the disease dates back EP-RET-135 “Doctor, I see spots”: acute macular neuroretinopathy case report A. García Marco1, C. García Vicente2, M. López Frutos1, A. Gil Fernández1, D. Sánchez Martínez1, I. Lozano García1, J. Sornichero Martínez1 1Hospital General Universitario Santa Lucía, Cartagena, Spain, 2Hospital General Marina Baixa, Villajoyosa, Spain A 21-year-old woman presented to our clinic with complaints of paracentral scotomas in both eyes lasting for 11 days. Her medical history included the use of contraceptives and a COVID-19 infec- tion 21 days prior. During the examination, dark reddish areas were observed in the parafoveal region that were nearly imperceptible. These could be char- acterized as dark hyporeflective parafoveal lesions in a petaloid shape pointing toward the fovea on near-infrared (NIR) imaging, and as faintly hypoauto- fluorescent areas on autofluorescence (AF) imaging. On Optical Coherence Tomography (OCT), these areas showed hyperreflectivity in the outer nuclear and outer plexiform layers, along with disruption of the ellipsoid zone. Using Optical Coherence Tomography Angiography (OCT-A), a flow deficit was identified, more pronounced in the deep capillary plexus. Based on these findings, a diagnosis of acute macular neuroretinopathy was made. In the absence of specific treatment, contraceptives were discontinued, and the patient was followed with clinical observation. Although imaging studies showed improvement after one month, the patient reported resolution of scotomas only after six months. Acute macular neuroretinopathy is a rare condition that typically affects young women and presents with the sudden onset of paracentral scotomas, without significant impact on visual acuity. In this case, the presentation is classic in terms of both symptoms and characteristic findings, such as involvement of the outer plexiform layer and photoreceptors on OCT. These findings help differentiate the condition from other pathologies, particu- larly paracentral acute middle maculopathy (PAMM), which primarily affects the inner nuclear layer. PAMM is more common in older men with vasculo- to the same day of his admission where the patient was victim of an ocular pathic risk factors, such as diabetes mellitus, arterial hypertension, and venous trauma by a punch in the area of the left eye. Results: The initial ophthalmological examination has objectified a visual acuity in OG at 1/10 and 10/10 in OD. examination of the appendices showed in OG a palpebral eccymose with hemorrhage under conjunctival examina- tion of the anterior segment has allowed to objectify in OG some sphincteric ruptures with semi areflectic mydriasis, a clear crystalline and a normal tone the examination of the fundus finds a papilla excavated at 3/10, yellowish lines temporo foveal within a sheet of hemorrhage under the retina masking the foveal region the examination of the healthy eye was without peculiarities. Macular coherence tomography shows multiple ruptures of the Bruch mem- brane and persistence of lamellae of retinal tissue. After a follow-up of four months, the spontaneous evolution showed a resorp- tion of subretinal hemorrhage without extension of the rupture lines of the Bruch membrane on the tomography in macular optical coherence. There is also a beginning of macular rearrangement, without neovascular complica- tions, with visual acuity measured 5/10. Conclusion: Rupture of the Bruch membrane is a common complication of contusive eye trauma, which can be associated with macular injury. Regular and careful monitoring of the FO and macular OCT is required. or arterial vascular occlusions. EP-RET-136 All-in-One: myopic maculopathy, dome-shaped macula, and type I and type II myopic neovascular membranes. A case report A. García Marco1, C. García Vicente2, D. Sánchez Martínez1, I. Lozano García1, J. Sornichero Martínez1, M. López Frutos1, A. Gil Fernández1 1Hospital General Universitario Santa Lucía, Cartagena, Spain, 2Hospital General Marina Baixa, Villajoyosa, Spain A 50-year-old woman was referred due to vision loss in her OS. On examina- tion, her visual acuity was 0.9 in the OD and 0.1 in the OS. The anterior seg- ment was normal, and intraocular pressure was 19 mmHg in OU. Fundoscopy revealed tilted optic discs with diffuse myopic atrophy. OCT of the left eye showed a small amount of subretinal fluid and a hyperreflective dome-shaped lesion, compatible with a myopic neovascular membrane, as flow was ob- served within the lesion on OCT-A. 232 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Intravitreal treatment with aflibercept did not resolve the subretinal fluid. Given the poor progression, the initial images were reevaluated, and OCT-A revealed increased subfoveal choroidal flow. The neovascular tuft was located beneath the RPE, and horizontal structural OCT scans showed a dome-shaped macular area, raising suspicion of dome-shaped maculopathy with a type I myopic neovascular membrane. Spironolactone did not improve the serous retinal detachment. Ultimately, two additional aflibercept injections facilitated the resolution of the subretinal fluid. Subsequently, the patient began to experience metamorphopsias in the OD. OCT revealed a small subfoveal serous detachment with a hyperreflective dome-shaped lesion above the RPE, compatible with a type II myopic neo- vascular membrane. Two aflibercept injections were administered in the OD, resulting in improvement. The importance of this case lies in the complex diagnosis of myopic macu- lopathies and the need for multimodal imaging. This patient presented with a type II myopic neovascular membrane in the OD and dome-shaped macu- lopathy with a type I myopic neovascular membrane in the OS, illustrating different types of maculopathy and neovascular membranes. Additionally, the OS presented both dome-shaped maculopathy and a type I myopic neovascular membrane, making it challenging to determine whether the subretinal fluid originated from RPE alterations due to dome-shaped mac- ulopathy or the neovascular membrane. EP-RET-138 X-linked juvenile retinoschisis misdiagnosed as intermediate uveitis with cystoid macular edema A. García Marco1, C. García Vicente2, A. Gil Fernández1, M. López Frutos1, R. Góngora Rodríguez1 1Hospital General Universitario Santa Lucía, Cartagena, Spain, 2Hospital General Marina Baixa, Villajoyosa, Spain macular diseases or hereditary dystrophies. For this reason, it is essential to understand its characteristics and consider it in the differential diagnosis of cystic macular pathologies. EP-RET-139 It looks like AMD, but it isn’t: central areolar choroidal dystrophy (CACD) A. García Marco1, C. García Vicente2, A. Gil Fernández1, M. López Frutos1, D. Sánchez Martínez1 1Hospital General Universitario Santa Lucía, Cartagena, Spain, 2Hospital General Marina Baixa, Villajoyosa, Spain A 50-year-old man presented to our clinic with poor vision in his OS. He denied any personal or family history of interest. On examination, fundoscopy of the OD revealed a rounded, poorly defined area of mottled hypopigmenta- tion in the macular region. In the OS, there was a parafoveal inferior atrophic plaque surrounded by an area of hypopigmentation similar to that observed in the OD. Multimodal imaging of the OD showed a granular pattern of hyper- and hy- potransmission on autofluorescence and near-infrared reflectance (NIR), as well as disruption of the photoreceptors, outer nuclear layer, and retinal pig- ment epithelium (RPE) on SD-OCT. Imaging of the OS demonstrated marked hypofluorescence in the atrophic plaque, with lesions similar to those in the OD surrounding the area. Although the initial diagnosis was AMD, the final diagnosis was central areolar choroidal dystrophy stage 2 in the OD and stage 3 in the OS. During follow-up, an enlargement of the atrophic plaque in the OS was observed, extending to involve the inferior half of the macular area. The importance of this case lies in the fact that central areolar choroidal dys- trophy, although a rare disease, is a condition that must be considered, as it is a great mimic of AMD. This could lead to a misdiagnosis, as occurred in this case, where the initial diagnosis was intermediate AMD in the OD and An 11-year-old patient presented to our clinic with blurred vision that had advanced AMD with geographic atrophy in the OS. been progressing for two years. He had been diagnosed at another center with chronic intermediate uveitis and cystoid macular edema, for which he was being treated with prednisone, methotrexate, and adalimumab. A systemic workup had yielded negative results. On examination, his visual acuity was 0.5 in the right eye and 0.2 in the left eye. The anterior segment was normal, with no Tyndall effect, and intraocular pressure was 15 mmHg in both eyes. However, fundoscopy revealed a star- shaped macular appearance with cysts, a vitreous free of inflammatory signs but with vitreous veils in the periphery, and inferior temporal retinoschisis in the right eye. OCT showed retinal cysts predominantly affecting the inner retinal layers. Fluorescein angiography was normal, with no dye leakage or fluid accumula- tion in the late phases of the test. Given the suspicion of X-linked juvenile retinoschisis, corticosteroid and im- munosuppressive treatments were discontinued, and oral acetazolamide and topical brinzolamide were initiated. An electroretinogram was performed, which was normal, and genetic testing revealed the presence of the c.1A>T variant in the RS1 gene in homozygosity, confirming the diagnosis of X-linked juvenile retinoschisis. Our case had been misdiagnosed as cystoid macular edema secondary to in- termediate uveitis. The angiographic finding of no dye leakage was critical in ruling out this diagnosis. The importance of this case lies in the fact that juvenile retinoschisis is a rare disease that affects Müller cells, making it easily confused with other cystic EP-RET-141 The efficacy of eylea 8mg in patients with macular edema from diabetic retinopathy resistant to other anti-vegf E. Simaku1, B. Danaj1 1University of Medecine Tirana, Department of Ophthalmology, Tirana, Albania Background: Diabetic macular edema (DME) is a common complication of diabetic retinopathy and a leading cause of vision loss. Although anti-VEGF therapies, such as ranibizumab and bevacizumab, are first-line treatments, some patients develop resistance, leading to persistent macular edema and poor visual outcomes. Eylea (Aflibercept) 8mg has been proposed as a poten- tial solution for these resistant cases. Objective: To evaluate the efficacy of Eylea 8mg in improving visual acu- ity and reducing macular edema in patients with DME secondary to diabetic retinopathy, who have shown resistance to other anti-VEGF agents. Methods: A randomized, open-label, multicenter trial was conducted with 35 patients who had persistent DME despite prior anti-VEGF treatment. Patients Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 233

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ELECTRONIC POSTER PRESENTATIONS received Eylea 8mg intravitreal injections every 4 weeks for 3 months. The pri- mary outcome was the change in Best Corrected Visual Acuity (BCVA) after 3 months. Secondary outcomes included changes in central retinal thickness (CRT)and macular function, measured by Optical Coherence Tomography (OCT) and visual field testing. Results: After 3 months of Eylea 8mg treatment, patients showed significant improvements in BCVA and CRT. For example, Case 1 (65-year-old male, BCVA 38 letters) improved by 10 letters, reaching 48 letters. Case 2 (72-year- old female, BCVA 41 letters) improved by 12 letters, reaching 53 letters. Additionally, CRT reduced by 150 microns in Case 3 (58-year-old male, CRT 500 µm), and 140 microns in Case 4 (63-year-old female, CRT 475 µm). The safety profile was consistent with previous studies on Eylea, with no serious adverse events reported. Conclusion: Eylea 8mg showed significant efficacy in patients with DME re- sistant to other anti-VEGF therapies, leading to improved visual acuity and re- duced retinal thickness. These results suggest that higher doses of anti-VEGF therapy may overcome resistance in certain cases. EP-RET-142 The efficacy of eylea 8mg in patients with resistant wet-AMD B. Danaj1, E. Simaku2 1University of Medecine Tirana, Department of Opthalmology, Tirana, Albania, 2University Of Medecine Tirana, Department of Ophthalmology, Tirana, Albania Background: Age-related macular degeneration (AMD) is a leading cause of vision loss in the elderly, with some patients showing resistance to standard anti-VEGF treatments. Eylea (Aflibercept) 8mg has been proposed as a poten- tial solution for resistant AMD. Objective: To evaluate the efficacy of Eylea 8mg in improving visual out- comes and retinal structure in patients with resistant AMD and compare it to standard doses (2mg). Methods: In a randomized, double-blind trial, 37 patients with resistant AMD (poor response to ≥3 prior anti-VEGF injections) were assigned to receive either Eylea 8mg or 2mg. The primary outcome was change in Best Corrected EP-RET-143 Artificial intelligence-enhanced OCT biomarkers analysis predictive of 12-month visual acuity after epiretinal membrane surgery L. Ferro Desideri1, R. Anguita1, N. Eldridge2, H. Da Chou3, M. Zinkernagel4 1Inselspital University Hospital, Ophthalmology, Bern, Switzerland, 2ARTORG Bern, Bern, Switzerland, 3Chang Gung Memorial Hospital International Medical Center, Taiwan, Switzerland, 4Inselspital, Bern, Switzerland Purpose: To predict the best-corrected visual acuity (BCVA) in patients with epiretinal membrane (ERM) following pars plana vitrectomy (PPV) by per- forming artificial intelligence-enhanced analysis of preoperative OCT bio- markers. Methods: Multicenter study performed at the Departments of Ophthalmology of Inselspital University Hospital Bern (Switzerland) and Chang Gung Memorial Hospital (Taiwan). Patients diagnosed with ERM and operated with PPV and ERM peeling were recruited and OCT volumes were taken preoperatively, after 4-6 weeks, at 6 and 12 months. The data were processed using an AI-powered platform (Discovery OCT Biomarker Detector; RetinAI AG, Bern, Switzerland), which measured vari- ous retinal layer thicknesses, including the outer nuclear layer (ONL), photo- receptor and retinal pigment epithelium complex (PR + RPE), retinal nerve fiber layer (RNFL), choriocapillaris and choroidal stroma (CC+CS) and reti- nal fluids, and biomarker probabilities. Patients were divided into 2 BCVA groups: no improvement and significant improvement defined as greater than 0.3 LogMAR from preoperative. Random forest model was performed to identify OCT predictive factors for the final BCVA. Results: 122 ERM patients with mean age 71.2 (± 5.6) were enrolled. Average preoperative BCVA improved from 0.43 LogMAR (± 0.09) to 0.12 LogMAR (±0.07) at 12 months, p<0.001. Random forest classifier for BCVA prediction showed a good performance (AUC 0.71) to predict final BCVA. Feature im- portance Score (FIS) showed that PR+RPE thickness was the most important contributing biomarker (FIS 0.23) for predicting BCVA, followed by RNFL thickness (FIS 0.21) and ONL thickness (FIS 0.18). Conclusion: AI-enhanced OCT biomarker analysis proved useful in predict- Visual Acuity (BCVA) after 6 months, with secondary outcomes including ing 12-month BCVA after ERM surgery, with PR+RPE thickness being the strongest predictor. This approach could help personalize surgical planning and improve outcomes for patients with ERM. central retinal thickness (CRT) and macular function. Results: Patients in the Eylea 8mg group showed significant improvement in BCVA. For instance, Case 1 (72-year-old male) improved by 15 letters (from 45 to 60 letters), while Case 2 (65-year-old female) improved by 18 letters (from 42 to 60 letters). In contrast, the control group showed minimal improvement (2-3 letters). CRT reduction was also more pronounced in the 8mg group, with Case 3(78-year- old patient) showing a 120-micron decrease, compared to only 30 microns in the 2mg group. The safety profile was consistent with previous reports, with minimal adverse events. Conclusion: Eylea 8mg provides significant improvements in visual acuity and retinal structure in patients with resistant AMD, outperforming the stand- ard dose. Higher doses of anti-VEGF therapy may offer a promising solution for resistant cases, but further studies are needed to confirm long-term safety and efficacy. 234 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-RET-145 Macroaneurysms as a cause of central scotoma and multiple layer hemorrhages In neurological examination CT scan shows no abnormalities. In spinal fluid analysis results elevated count of leucocytes so the patient was diagnosed with optic neuritis in OD. The treatment was intravenous steroids in high dose. 5 days after high dose of iv steroids the vision was 0.2 and vascular sheathing were less active. T. Javaloy1, A. Macero Delgado1, A. Lopez Alcaide1, S. De Matias Gil1, T. Garcia-Herrera Prada1, M. Ferro Osuna1 1Hospital 12 de Octubre, Madrid, Spain After this, the patient was diagnosed with multiple sclerosis. Just to be careful because 10% of multiple sclerosis are presented with intermedia uveitis and optic neuritis is most common ocular manifestation of multiple sclerosis. Overview: A retinal macroaneurysm (RMA) is an acquired dilation of a reti- nal artery, typically appearing in the elder. It is often associated to secondary systemic conditions that induce vascular stress, such as hypertension, arte- riosclerosis, and diabetes mellitus. RMAs are usually found along the major branches of the retinal arteries, particularly near arteriovenous crossings. Case report: A 77 year old male with hypertension comes to the Emergency department due to loss of vision on the right eye over the past 2 weeks as central scotoma. No floaters, flashes, pain or any other symptoms associated. Four days before the onset of decreased vision, he had had a COVID-19 shot. BCVA: OD - HM, OS - 20/20. Pupils: equal, round, reactive, No APD. Preserved eye movements. Anterior segment: unremarkable. Fundus exam - OD: Preretinal hemorrhage of approximately 1.5 ONH that extends from the ONH towards inferior fovea. Macroaneurysm in the superior EP-RET-147 Cytomegalovirus retinitis: a major threat for immunocompromised patients K. Selmani1, I. Omari1, H. Ouazzani Touhami1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Cytomegalovirus (CMV) retinitis is the most common oppor- temporal artery with hard exudates towards the fovea, linear retinal hemor- rhage inferior to the macroaneurysm. Subretinal fluid that covers the entire macular area. Clear vitreous. tunistic infection in severely immunocompromised patients. Its prevalence is significantly high when the CD4+ count is below 50 cells/mm³. This poster presents an illustrative clinical case of CMV retinitis, highlighting the diag- OS: mild macular EPR changes, AV nicking over the superotemporal venous nostic and therapeutic challenges encountered, as well as the importance of a branch suggestive of hypertensive retinopathy. multidisciplinary management approach. Retinal OCT OD: macroaneurysm superior to the macula, vitreomacular trac- Case report: A 30-year-old male patient, newly diagnosed with retroviral in- tion with cystic oedema of the macula. Upon findings of retinal macroaneurysm, laser photocoagulation around it is performed. Follow up In the following months, clinical examination shows improvement of BCVA up to 20/50. Flattening of the vitreomacular traction over the macula and pre- vious oedema is identified on OCT exams. Conclusion: This case report describes the variety of clinical and anatomical findings associated to macroaneurismas of the retina. Laser photocoagulation of retinal macroaneurysms alone has good results on cases where subretinal fluid is present in the macular region. EP-RET-146 Mystery case in uveitis. Multiple sclerosis and intermediate uveitis B. Danaj1 1Medical University of Tirana, Albania, Ophthalmology, Tirana, Albania fection, had been on antiretroviral therapy for one week. He presented to the ophthalmology department due to a decline in visual acuity in the right eye, started one month prior. The clinical examination revealed hand motion vision and a tyndall effect 1+. Fundus examination showed a yellowish-white retinal necrosis area with ir- regular borders, located in the macular and temporal regions, associated with retinal hemorrhages, suggesting a “mayo-ketchup” appearance. Fluorescein angiography revealed, in addition to retinal necrosis, vascular sheathing. Macular OCT showed serous retinal detachment. Biological testing showed a CD4 count of 25 cells/mm³, and both CMV se- rology and PCR were positive in the blood. The diagnosis of CMV retinitis was confirmed. Systemic treatment with intravenous ganciclovir was initiated, along with antiretroviral triple therapy. After one month of treatment, the pa- tient’s condition showed favorable improvement. Discussion: The risk of CMV retinitis increases with the severity and dura- tion of immunosuppression. The two most characteristic clinical forms are the edematous form and the granulomatous form. Treatment typically involves systemic antiviral therapy, with antiretroviral triple therapy. Conclusion: CMV retinitis should be considered in any case of necrotizing retinitis in immunocompromised patients. This case underscores the impor- tance of close and systematic monitoring in patients with severely reduced A 32 years old female presented in consultation with blurry vision in right CD4 counts and/or CMV viremia. eye for 2 days and miopia in both eyes. In ophthalmologic examination in both eyes: anterior chamber with no sign of inlamation. BCVA in OD was 0.7 and in OS was 1.0. In fundus oculi was vitreous cells, snowballs and vascular sheathing. 4 days after initial examination the vision in OD was decreased in 0.3 and vascular sheathing increased. The patient started oral steroids and was suggested close follow up examination. 2 days after starting the treatment the vision in OD decreased again in 0.05. RAPD evaluation was not possible because of medicamentous mydriasis. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 235

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ELECTRONIC POSTER PRESENTATIONS EP-RET-148 The exploration of the bidirectional relationship between age-related macular degeneration and depression A.K. Hameed1 1Kings College London, Faculty of Life Sciences and Medicine, London, United Kingdom Purpose: To explore the under-researched relationship between Age-Related Macular Degeneration (AMD) and Depression, emphasising the mental health implications AMD progression has on a patient’s life. Methods: A narrative literature review was conducted to investigate the as- sociation between AMD and Depression. Secondary data from Medline, PubMed, and Google Scholar were used, applying specific search terms to identify relevant publications on the prevalence, causes, psychosocial impacts of depression in AMD patients, and treatment guidelines. Studies focused on AMD, sight loss, depression, UK-based research, and NICE guidelines were prioritised. Publications from 2013 onwards were emphasised for treatment relevance. Studies involving non-NHS health systems or non-English publica- tions were excluded. Results: The review revealed that AMD significantly contributes to mental health challenges, with patients at a high risk of developing depressive symp- toms. Vision loss-related functional limitations were linked to a loss of joy and motivation. Anxiety stemmed from the fear of disease progression and uncertainty regarding the lack of available treatment options. Sleep distur- bances were associated with disruptions to circadian rhythms due to damage to melanopsin-expressing intrinsically photosensitive retinal ganglion cells in AMD, and feelings of isolation and hopelessness often led to suicidal ideation. Despite these findings, the association remains under-researched, particularly regarding longitudinal and interventional studies. Conclusions: AMD imposes a significant mental health burden, highlight- ing the need for integrated, multidisciplinary care models. Evidence suggests interventions like group cognitive behavioural therapy (CBT) and increased access to mental health services could improve patient outcomes. Further re- search is essential to develop targeted interventions and to improve the quality of life for individuals with AMD. ELECTRONIC POSTER PRESENTATIONS Electronic Posters: Uveitis EP-UVE-02 Bilateral posterior scleritis secondary to giant cell arteritis I. Rakshit1, A. Karimi2, E. Wong3, G. Negretti3 1Royal Surrey County Hospital, Guildford, United Kingdom, 2Sussex Eye Hospital, Brighton, United Kingdom, 3Surrey and Sussex Health, Redhill, United Kingdom An elderly lady in her 70s with learning difficulty presented to the Ophthalmology department after being seen by her GP and A&E, with an eleven-day history of right followed by left eye pain, redness and blurred vi- sion. In her fourth conultation for the issue, she described a four-week history of headache, pain in her shoulders, hands and calves. Visual acuities were right 6/24 and left hand movements. She had bilateral chemosis and redness, with extensive retinal and choroidal detachments in both eyes, left greater than right. B scan ultrasound showed thickened posterior sclerae bilaterally, with fluid surrounding the optic nerve. Inflammatory markers were raised with an ESR of 60mm/hr and CRP of 20mg/l. Differential diagnoses including subretinal masses, orbital pathology includ- ing thyroid eye disease, causes of exudative retinal detachment were consid- ered, however given the polymyalgic-type symptoms, raised inflammatory markers and headache/shoulder pain, she was diagnosed with bilateral poste- rior scleritis secondary to giant cell arteritis and commenced on high-dose oral prednisolone, with gastric and bone protection. Her visual acuities improved to 6/12 within 7 days of treatment as did her systemic symptoms. Posterior scleritis is a potentially blinding condition, with non-specific symp- toms and signs, and consequently diagnosis is commonly delayed. Visual prog- nosis is dependent on duration of symptoms; therefore obtaining a thorough systemic evaluation can help enable early treatment. People with learning dif- ficulties have healthcare inequalities. The Royal College of Ophthalmologists has published guidance on how to assess and prevent visual loss in adults with learning difficulties. EP-UVE-03 Unilateral acute posterior multifocal placoid pigment epitheliopathy associated with Lyme disease - case report V. Cheleva1, S. Pandilov1, A. Trpeska Boshkoska1 1Ss. Cyril and Methodius University, PHI University Clinic for Eye Diseases, Skopje, North Macedonia, The Republic of Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a rare inflammatory chorioretinopathy that typically affects young adults and is most often bilateral. We describe a case of unilateral APMPPE associated with Borrelia burgdorferi infection in a 24-year-old female patient. At initial examination, the patient reported a sudden decrease in vision in the left eye (BCVA-0.01) one week after flu-like symptoms. She denied other diseases or anamnestic data of interest. 236 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS Fundus examination revealed multiple creamy sub retinal lesions below the fovea and near the temporal vascular arcades. OCT showed disruption of the EP-UVE-05 inner/outer segment junction and involvement of the retinal pigment epitheli- um. Fluorescein angiography showed hypo fluorescence in the early phases of the angiogram, followed by late hyper fluorescence of the lesions. The fundus of the right eye was normal. Serological testing for Borrelia burgdorferi showed positive IgM and IgG ti- ters, although the patient denied a tick bite. The patient was treated with oral antibiotic (Doxycycline a 100mg twice daily for 3 weeks) and corticosteroid therapy (Prednisone a 60mg daily, tapered gradually over 6 weeks). Eight weeks after initial presentation, the BCVA of the affected eye improved to 0.9 without any associated symptomatology. Through this case we want to point out a possible infectious etiology in a uni- lateral case of APMPPE, a rare ocular manifestation of Lyme disease. Timely recognition and appropriate treatment are crucial for achieving a favorable outcome in such cases. Keywords: Chorioretinopathy, acute posterior multifocal placoid pigment epitheliopathy, Borrelia burgdorferi, Lyme disease. EP-UVE-04 Ocular tuberculosis: a case series M. Gonçalves1, S. Pina1, A.I. Reis2 1Hospital Beatriz Ângelo, Ophthalmology, Lisbon, Portugal, 2Hospital Beatriz Ângelo, Internal Medicine, Lisbon, Portugal Purpose: Ocular Tuberculosis (OTB) represents a major diagnostic challenge. In 2020, the Collaborative Ocular Tuberculosis Study (COTS) created guide- lines to help uveitis specialists in initiating antitubercular treatment (ATT) for The relationship between the content of interferons A and G in tear liquid and blood plasma of patients with idiopathic uveitis N. Konovalova1,2, O. Guzun2, O. Kovtun1 1Odessa National Medical University, Odessa, Ukraine, 2“The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” State Institution, Odessa, Ukraine Purpose: Determination of the presence of a connection between the content of interferons A and G in tear fluid and blood plasma of patients with uveitis. Materials and methods: We monitored 61 patients diagnosed with uveitis. 46 people (75,4%) were diagnosed with a lesion of the posterior segment of the eye, 15 were diagnosed with anterior uveitis (24,6%).In 10 patients, the level of interferons A and G in tear fluid was determined by the solid phase immune enzymatic method. The results: The data of immune enzymatic studies showed that the level of interferons in the tears of patients with uveitis is 24,460±8,179 pg/ml and 27,550±8,289 pg/ml for interferon-A and - G with minimum and maximum values of 14.4-39.3 pg/ml. 3-41.4 pg/ml, respectively, which is higher than such values in healthy individuals (according to the literature). In addition, the content of these cytokines is significantly higher in tear fluid (2.2 and 1.8 times, respectively) than in blood plasma (11,320±6,361 and 15,260±7,442 pg/ml, 42 n=10), which indicates the dominance their expres- sion locally, in the eye. Analysis of the data characterizing the content of interferons in the tear fluid before and after treatment shows an increase in their expression (1.4 times in both cases, reaching 34,200±9,476 pg/ml and 38,810±9,756 pg/ml, respec- tively) because of using the complex treatment using photobiomodulation, OTB. We aim to characterize the patients in our sample with diagnosis of OTB which stimulates the production of endogenous interferons. and treatment outcomes, and confront the results with COTS guidelines. Methods: Retrospective analytical study of patients with a presumptive or possible diagnosis of OTB between 2015 and 2023, in a district hospital in Lisbon. All patients completed ATT for 6 to 12 months, with or without A reliable positive relationship was found between the initial level of interfer- on-a in the tear fluid and the level after treatment (n=10, r=0.92, p<0, 05), as well as in blood before treatment (n=10, r=0.76, p<0.05). Conclusions: The expression of interferons in tears, the dominance of local steroid or immunosuppressive systemic therapy, and a 12-months follow-up. immunological changes increases in the treatment of uveitis with the use of Demographic, epidemiological and clinical data (type of manifestation, visual acuity (VA) at presentation and at 12-months, degree of inflammation and ATT-related adverse effects) were collected. Results: A total of 38 patients were included. The majority of patients were Portuguese (79%) and the remaining patients were from endemic countries. Of these, 21% confirmed an epidemiological contact with someone TB-positive and 18% were immunosuppressed. Immunological diagnosis were positive in 71% for Mantoux and IGRA, 24% for IGRA and 5% for the Mantoux test. Main clinical manifestations were anterior uveitis (29%) and panuveitis (21%), with the majority having bilateral disease (58%). There was 2-lines improvement in Snellen’s Acuity Chart in 71% of patients and 89% had im- provement in degree of inflammation. Besides ATT, 79% were treated with systemic immunosuppressive therapy. Conclusions: According to the consensus of COTS 2020, the diagnosis of OTB and decision to initiate ATT is based on country endemicity, clinical phenotype, positivity for immunological tests and radiological evidence of ac- tive or previous pulmonary TB. We conclude that our decision in initiating ATT was according to strong or intermediate-level recommendations of COTS 2020 consensus. photobiomodulation. There is a relationship between the content of interferons A and G in tear fluid and blood plasma of patients with uveitis. EP-UVE-06 Multiple evanescent white dot syndrome (MEWDS) in a young myopic patient: case report M. Puchol-Rizo1, A. de Pablo Cabrera1, T. García-Herrera Prada1, L. Alcalde-Blanco1, D. Rojas-Correa2, J. Vicente-Andreu3 1Hospital Universitario 12 de Octubre, Madrid, Spain, 2Hospital del Tajo, Aranjuez, Spain, 3Hospital Arruzafa, Córdoba, Spain Case Report: A 25-year-old female presented with a sudden onset of photop- sia and floaters in the left eye, preceded by a viral prodrome one month ear- lier. Examination revealed mild myopia and astigmatism, with unremarkable systemic history. Initial best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.15 in the left. Fundus examination of the left eye showed hy- popigmented lesions in the posterior pole and peripheral retina. Optical coher- ence tomography (OCT) revealed patchy outer retinal layer alterations, while Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 237

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ELECTRONIC POSTER PRESENTATIONS fundus autofluorescence (FAF) demonstrated a speckled hyperautofluorescent perifoveal pattern. Fluorescein angiography (FA) displayed early hyperfluo- rescence persisting into late phases, corresponding to fundoscopic findings. The clinical picture, supported by multimodal imaging, was consistent with Multiple Evanescent White Dot Syndrome (MEWDS). The patient received no pharmacological treatment and was monitored closely. Over a 12-week follow-up, BCVA improved to 1 in the affected eye, with resolution of fundo- scopic, OCT, and FAF abnormalities. Conclusion: This case underscores the diagnostic value of multimodal imag- ing in MEWDS and highlights its self-limiting nature. Accurate identification of this condition prevents unnecessary interventions and promotes effective patient counseling. complaints such as reduction and blurring of the visual acuity (VA) prompted ophthalmology consultation. Mild inflammation in the anterior chamber. She underwent a detailed ophthalmic examination at presentation and regular fol- low-up visits, including dilated biomicroscopic fundus examination, fundus photography, spectral domain OCT, fundus autofluorescence (FAF) and fluo- rescein angiography (FFA). Results: Funduscopic examination showed macular and midperipheral chori- oretinal lesions. Fluorescein angiography revealed target-like lesions in a ra- dial distribution along the temporal vascular arcades, which is pathognomonic for WNV chorioretinitis, associated with moderate vasculitis and macular edema which appeared silent on OCT. Serology confirmed the diagnosis of West Nile virus disease. Ocular symptoms improved with a short course of EP-UVE-07 Endogenous endophthalmitis secondary to ureaplasma urealyticum: a case report on the first documented occurrence oral steroids. Conclusion: Chorioretinal involvement, frequently asymptomatic and self- limited, is common in patients with acute WNV infection. The unique pattern of multifocal chorioretinitis can help establish an early diagnosis of the dis- ease while serologic testing is pending. Therefore an ophthalmological con- sultation might be useful in the diagnosis and reporting of WNV disease in patients with ocular symptoms. E. O Leary1, T. Burke1 1Mater Misericordiae University Hospital, Dublin, Ireland EP-UVE-09 This case report details the first documented occurrence of an Endogenous Endophthalmitis caused by Ureaplasma Urealyticum in an immunocompro- mised 32-year-old female. While admitted in hospital for a work up for her new polyarthralgia on the background of relapse-remitting multiple sclerosis an ophthalmology consult was requested for her. TB or not TB: what’s the verdict? H. Mittal1, R. Singh1, H.S. Sethi1 1VMMC and Safdarjung Hospital, Ophthalmology, New Delhi, India On initial review it was found that she had a severe unilateral hypertensive Purpose: To discuss an interesting and rare case of drug induced anterior uveitis with pigmented keratic precipitates, hypopyon, poor fundal view and counting fingers vision. After her anterior chamber tap and vitreous tap and in- ject failed to isolate any microorganism we decided to repeat this with a broad- spectrum Polymerase Chain Reaction (PCR). With this PCR, Ureaplasma Urealyticum was identified. She was treated systemically under the guidance of our Rheumatology and Infectious Disease colleagues with oral azithromy- uveitis Methods: A 57-year-old female presented with insidious onset right eye blur- ring of vision, redness, glare and pain for 2 months. She was a known POAG for 2 years, controlled on topical brimonidine and timolol. No history of ocu- lar trauma, surgery and no known systemic illness. Her BCVA was 6/18 and 6/12 with IOP of 20 and 18 in right and left eye respectively. cin. One year following this she remains 6/6 and stable. Right eye had ciliary congestion, mutton fat KPs, 1+ AC cells, normal vitre- EP-UVE-08 A case of West Nile virus infection associated with ocular findings I. Arapi1, A. Hibraj2, J. Jaho3, A. Xhetani2, S. Guri2, A. Taullaj2 1University of Medicine, Faculty of Medicine, ENT-Ophthalmology, Tirana, Albania, 2University of Medicine, Tirana, Albania, 3University Hospital Centre „Mother Theresa“, Eye Clinic, Tirana, Albania ous, CDR of 0.8 with normal retino-choroid examination. Left eye was normal with CDR of 0.8. Diagnosis of right eye granulomatous acute anterior uveitis (AAU) with bilateral POAG was made. Detailed investigations revealed normal blood counts, ESR and CRP. Mantoux, serum ACE, serum calcium, chest Xray, HIV, VDRL and HLA-B27 were negative. All investigations were negative which led to suspicion of bri- monidine associated AAU. Patient was shifted from brimonidine to brinzolamide and started on low dose topical 0.2% Loteprednol due to fear of steroid induced rise in IOP. At 1 week follow up, there was dramatic reduction in KPs. There was complete resolu- tion of KPs at 3 weeks, with no recurrence at 3 months follow up. Results: Patients on brimonidine can rarely present with acute anterior uveitis which is completely reversible after cessation of drug. Such patients often do Purpose: West Nile virus (WNV) is a member of the Japanese encephalitis well without long term treatment with steroids. serogroup. WNV infection is a zoonotic disease transmitted by a mosquito Conclusion: Drug induced uveitis is a rare entity; however, treating ophthal- vector (type Culex). The majority of patients with these infections are asymp- mologists should have a high suspicion of it in patients receiving brimonidine tomatic, but approximately 20% develop an acute febrile illness accompa- for glaucoma. Timely diagnosis and cessation of drug can prevent unwanted nied by malaise, headache, myalgia, and arthralgia typically lasting less than investigations and long term steroid treatment. 1 week. Multifocal chorioretinitis is an uncommon manifestation of WNV but has pathognomonic ocular findings that can aid in diagnosis. Methods: A 55-year-old woman presented with acute onset fever, and chills. She underwent an extensive but nondiagnostic workup. Approximately 1 week after the onset of the systemic symptoms she presented with new visual 238 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-UVE-10 HLA-B27 associated acute anterior uveitis with hyphema - case report V. Cheleva1, S. Pandilov1 1Ss. Cyril and Methodius University, PHI University Clinic for Eye Diseases, Skopje, North Macedonia, The Republic of Acute anterior uveitis with hyphema is a rare but severe form of anterior uvei- tis that can pose a diagnostic and therapeutic challenge. We present a case of a 58-year-old female patient with sudden loss of vision in the right eye (BCVA 0.05), while the left eye was unaffected (BCVA 0.9). Biomicroscopic exami- nation of the right eye revealed ciliary hyperemia, mild corneal edema, small keratic precipitates, 3mm hyphema, fibrin membrane in anterior chamber, cells 3+ and the presence of circumferential posterior synechiae. Ultrasound examination showed moderate exudation in the vitreous. Through detailed laboratory analyses, possible infectious causes were exclud- ed. HLA analysis indicated a positive finding for the HLA-B27 locus, without other systemic manifestations or comorbidities. The patient denied any trauma to the eye in the past period. Based on the clinical findings and the absence of an infectious etiology, the diagnosis of acute anterior uveitis with hyphema and moderate vitritis as- sociated with HLA-B27 was made. Intensive topical corticosteroid therapy and cycloplegic agents were started. In the following weeks, resorption of the fibrinous and hemorrhagic contents from the anterior chamber of the eye, rupture of the posterior synechiae and resorption of the exudation from the vitreous gradually occurred. Gonioscopy and fundoscopy were without patho- logical changes. There was also a gradual improvement in visual acuity, the right eye BCVA was 0.8. Through this case, we would like to point out a rare but possible presentation of HLA-B27 associated uveitis with hyphema in the absence of other systemic manifestations or autoimmune diseases. Timely and appropriate therapy with local and systemic corticosteroids can lead to a favorable outcome as shown in this rare case. Documentation of other such cases may help in better under- standing the pathophysiological background of this rare manifestation in one of the most common types of anterior uveitis. EP-UVE-11 Severe ocular and systemic complications of gram-negative bacteremia: a case of endophthalmitis leading to anophthalmos E. Mediņa1,2, I. Markeviča1,2, G. Laganovska1,2 1Pauls Stradins Clinical University Hospital, Department of Ophthalmology, Riga, Latvia, 2Rīga Stradiņš University, Department of Ophthalmology, Riga, Latvia and purulent discharge. Without any history of ocular trauma or prior oph- thalmic surgeries. Examination revealed visual acuity (VA) of 0/0, intraocu- lar pressure of 2 mmHg, corneal edema, hyperemia, conjunctival edema and purulent discharge. B-scan ultrasonography showed vitreous hemorrhage and posterior segment changes. CRO was 254 mg/l. Initial treatment included top- ical Levofloxacin and Nepafenac 3 times daily. Blood and urine cultures con- firmed P.aeruginosa, and imaging identified septic foci in the lungs, prostate, and kidneys. Intravenous Meropenem was initiated. Despite therapy, ocular findings worsened, showing corneal melting, perforation from 2 to 6 o’clock at the limbus, necrosis and profuse purulent discharge. Urgent evisceration of the left eye was done, with conjunctival smear confirming P.aeruginosa. The urology team performed a transurethral prostate resection. Postoperatively, the patient recovered without complaints, CRO decreased to 116 mg/L. Visual prognosis in endophthalmitis depends on pathogen virulence, im- mune status, and timely intervention. Gram-negative infections, particularly P.aeruginosa, often lead to poor outcomes, with factors such as delayed treat- ment, reduced VA, and immune compromise contributing to prognosis fre- quently culminating in evisceration. EP-UVE-12 Iberian Registry of Ocular Syphilis (IBERSOS): first-year outcomes from a prospective monitoring study of ocular syphilis in the Iberian Peninsula J.J Gonzalez-Lopez1, N. Pardiñas Baron2, E. Carreño3, M. Jerez Fidalgo4, V. Llorens5, C. Alba Linero6, G. Policarpo Torres7, P. Arriola Villalobos8, I. Hernanz9, M. Esteban10, L. Martínez-Costa Pérez11, T. Diago Sempere12, J.L. Sanchez13, A. Garcia Tirado14, I. Leal15, S. Ajamil Rodanes16, A. Fonollosa17, IBERSOS Study Group 1Hospital Universitario Ramón y Cajal, Ophthalmology, Madrid, Spain, 2Hospital Universitario Miguel Servet, Zaragoza, Spain, 3Hospital Universitario La Paz, Ophthalmology, Madrid, Spain, 4Hospital del Perpetuo Socorro, Badajoz, Spain, 5Hospital Clínic, Ophthalmology, Barcelona, Spain, 6Hospital Universitario Virgen de la Victoria, Ophthalmology, Malaga, Spain, 7Hospital Universitari de Girona Doctor Josep Trueta, Internal Medicine, Gerona, Spain, 8Hospital Clínico San Carlos, Ophthalmology, Madrid, Spain, 9Fundación Jiménez Díaz, Ophthalmology, Madrid, Spain, 10Hospital Infanta Sofía, Ophthalmology, San Sebastián de los Reyes, Spain, 11Hospital Universitario Doctor Peset, Ophthalmology, Valencia, Spain, 12Hospital de La Ribera, Ophthalmology, Alcira, Spain, 13Hospital De La Marina Baixa De La Vila Joiosa, Ophthalmology, Villajoyosa, Spain, 14Hospital de Mataró, Ophthalmology, Mataró, Spain, 15Unidade Local de Saude SANTA MARIA, Ophthalmology, Lisbon, Portugal, 16Barts Health NHS Trust, Ophthalmology, London, United Kingdom, 17Hospital de Cruces, Ophthalmology, Bilbao, Spain Endophthalmitis is a rare but severe ocular condition often resulting in irre- versible visual impairment. It is classified as endogenous or exogenous based on infection origin. Endogenous/ metastatic endophthalmitis occurs via he- matogenous spread through the blood-ocular barrier. Among gram-negative pathogens, Pseudomonas aeruginosa is a leading cause, commonly associated with ocular trauma, surgery, corneal ulcers, or hematogenous dissemination. This condition progresses rapidly, often leading to poor clinical outcomes. A 70-year-old male with lung cancer and prior chemotherapy presented with a severe cough, fever and painless vision loss in the left eye alongside redness Purpose: The IBERSOS Registry aims to describe the epidemiology, clini- cal manifestations, and treatment outcomes of ocular syphilis in Spain and Portugal, addressing gaps in knowledge regarding this reemerging condition. Method: The IBERSOS Registry is a multicenter, observational cohort study conducted across 22 centers in Spain and Portugal. Patients aged ≥18 years with newly diagnosed ocular syphilis were prospectively included. Baseline data included demographics, clinical findings, and systemic involvement. Treatment details and outcomes, including serological response and visual acuity, were assessed over a 3–6 month follow-up. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 239

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ELECTRONIC POSTER PRESENTATIONS Results: In the first year, 41 patients were enrolled (mean age: 46.9 years; 90.2% male). High-risk behaviors for STIs were reported by 63.4%, and 19.5% had HIV coinfection. Baseline best-corrected visual acuity (BCVA) was 0.58±0.69 LogMAR. Bilateral ocular involvement occurred in 58.5%, with anterior segment inflammation in 60.9%, retinal/choroidal involvement in 65.9%, optic nerve involvement in 56.1%, and scleritis in 9.8%. Systemic manifestations included palmoplantar rash (24.4%), chancre (7.3%), and symptomatic neurosyphilis (14.6%). Treatment included intravenous penicillin G in 67.6%, initiated after a median of 6.2 weeks from symptom onset. At 3 months, 51.4% achieved a four-fold decrease in RPR titers, and persistent intraocular inflammation was observed in 5.4%. Final BCVA improved to 0.17±0.4 LogMAR. Conclusion: The first-year results of the IBERSOS Registry reveal the diverse and often severe clinical spectrum of ocular syphilis, including high rates of bilateral involvement, significant retinal/choroidal and optic nerve complica- tions, and systemic manifestations. Despite delayed treatment initiation in many cases, over half of the patients Conclusion: This case highlights Zoledronate as a cause of sclerouveitis. Early recognition, discontinuation, and anti inflammatory treatment resolved the symptoms. While Zoledronate-associated uveitis has been reported, this is the second case of Zoledronate-induced sclerouveitis, emphasizing the need for monitoring ocular side effects in patients on Zoledronate. EP-UVE-14 Syphilitic uveitis: clinical features and outcome (a case report) K. Valcheva1, S. Murgova1 1Medical University - Pleven, Ophthalmology Department, Pleven, Bulgaria achieved serological response, and visual outcomes improved following treat- Purpose: To evaluate the clinical features and visual outcome of a syphilitic ment. The study highlights the need for awareness, timely diagnosis, and uveitis patient who was treated at the Dermatology Department of University prompt treatment of ocular syphilis. Hospital in Pleven, Bulgaria. EP-UVE-13 Zoledronate-associated sclerouveitis: A case report of drug-induced ocular inflammation in a breast cancer survivor H. Gasparyan1, L. Kambulyan1, A. Hovakimyan2 1Yerevan State Medical University (YSMU), Yerevan, Armenia, 2Ophthalmological Center After S.V.Malayan, Department of Cornea and Uveitis, Yerevan, Armenia Case report: A 52-year-old man with positive history of sexual promiscuity was diagnosed with bilateral panuveitis secondary to syphilis. He presented with progressively worsening bilateral vision loss for 1 month. One month pri- or to being seen at the Dermatology Department, the patient reported he had a genital rash, accompanied by burning and itching. The syphilis diagnosis was given in the presence of positive rapid plasma regain and Treponema pallidum particle agglutination assay tests. After examination of the cerebrospinal fluid, neurosyphilis was rejected. The patient was HIV-negative. The visual acuity at presentation was VOD=PPLC; VOS=5/160. Anterior non-granulomatous uveitis (more severe in the right eye), vitritis (with dense vitreous opacities, more severe in the right eye) and papillitis on the left eye were presented. The papilla of the right eye was not accessible for observation due to opacity of the ocular media. One week after the first examination, the peripheral retina was examined with Goldmann lens and chorioretinitis and vasculitis were found. The patient was treated with IM penicillin G 4x2.4 MIU and Methylprednisolone Introduction: Zoledronate is prescribed to prevent bone loss, reduce fracture 40 mg with lowering the doses for 7 days. The uveitis treatment was topical: risk in patients undergoing chemotherapy and hormonal therapy. This case Corticosteroids eye drops 5x1 and Atropine sulfate eye drops 2x1 in both eyes. report describes a 50-year-old breast cancer survivor who developed sclerou- The patient was seen by the ophthalmologist twice per month for the next veitis two days after receiving Zoledronate. three months. Clinical case: A 50-year-old female with a history of breast cancer treatment 2 The uveitis responded well to the treatment and the patient showed visual years ago, developed osteoporosis, for which she was prescribed Zoledronate improvement: VOD=5/8; VOS=5/5 at the end of the follow up period. He has 5 mg intravenously every six months. Two days following a single dose of complained of residual moderate photophobia after the treatment. Conclusion: Here the ocular syphilis is presented as non-granulomatous in- flammation of the uvea and the optic disk. Final visual outcome was generally good despite slow improvement after treatment. Zoledronate, the patient developed sudden ocular pain, redness, and blurred vision in one eye. Slit lamp exam revealed sclerouveitis associated with AC inflammation, severe hyperemia and posterior scleral thickening on ultrasound. Work-up was negative for infectious diseases. Upon identifying the drug association, Zoledronate was discontinued. The patient was treated with betamethasone subtenon 0,5mg/w, 3 inj., topical corticosteroids, NSAIDs, cycloplegics. After the third injection, the patient’s VA improved to 1.0 and no further treatment was necessary. A few days later, the patient developed similar symptoms in the contralateral eye. A slit-lamp examination revealed diffuse hyperemia. The patient was given betametha- sone 0.5mg inj. in both eyes. The patient was also prescribed azathioprine 100mg/d for six months, topical steroids and NSAIDs were started qid. A week later, the inflammation was controlled. VA was 1.0 after 4 weeks, with normal IOP. Oral AZA was contin- ued, and topical steroids were tapered and discontinued. The patient was seen after 6 months with no signs of inflammation, and AZA was discontinued. 240 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-UVE-15 Based on abdominal ultrasonography (US), computer tomography and disease course, diagnosis of hepatic abscess arose, however the magnetic resonance Unilateral panuveitis associated with rifabutin imaging did not support it. J. Romana1, M. Madeira1, M. Tavares Correia1, M. Cordeiro1, M. Guedes1 1Hospital Egas Moniz, Unidade Local de Saúde Lisboa Ocidental, Lisbon, Portugal Introduction: Rifabutin, a semi-synthetic derivative of rifamycin S, is a bac- tericidal antibiotic commonly used to prevent Mycobacterium avium complex infections in patients with AIDS. Previous cases of uveitis with hypopyon and panuveitis, have been reported. Six days after his admission, endogenous endophthalmitis was developed on the left eye. Due to the poor medical condition, ophthalmic examination of his status was limited during hospitalization. On the day of diagnosis topical treat- ment and subconjunctival steroid injection was administered. Following that, intravitreal injections of vancomycin and ceftazidime were given. Intravenous imipenem treatment was also applied from then. When the reflective media was clear enough for the surgery, pars plana vitrec- tomy was performed and the same intravitreal injections were given as above, completed with dexamethasone. After the surgery, he was treated with topical mydriatic, antibiotic and steroid drops. Culture from vitreous biopsy speci- Clinical Case: A 45-year-old melanodermic female presented with redness mens were negative. and decreased visual acuity in the right eye (RE) lasting one week. Her history At the 10-day check-up, the ophthalmologic US raised the possibility of reti- included HIV-1 infection with antiretroviral therapy resistance, tuberculous nal detachment (RD). Re-vitrectomy was planned, but it was not feasible due vertebral osteomyelitis, and past hepatitis B infection. Current medications to his general condition. At the 2-month check-up the intraocular pressure was included emtricitabine + tenofovir, darunavir + ritonavir, cotrimoxazole, and quite low, hyphema appeared in the anterior chamber and haemorrhage was rifabutin (150 mg three times weekly, increased to 150 mg daily one month in the vitreous cavity also. At the 5-month check-up, the ophthalmologic US prior). On examination, her best corrected visual acuity (BCVA) was RE: hand mo- tion; LE: 8/10. Biomicroscopy of the RE showed ciliary injection, fine inferior keratic precipitates and anterior chamber reaction (3+). LE examination was unremarkable. Intraocular pressures were RE: 8 mmHg and LE: 12 mmHg. Severe vitritis (4+) in the RE obscured fundoscopy and was confirmed by ultrasonography, showing an attached retina. Rifabutin was discontinued, topical corticosteroids and mydriatics were ini- tiated. Aqueous humor (AH) sampling was performed. Laboratory results showed HIV-1 viral load <20 copies/mL, CD4+ T-cell count of 138 cells/μL, and negative serologies. Aqueous humor analysis showed negative results for fungi and for polymerase chain reaction testing of Mycobacterium tuberculo- sis and Toxoplasma. After one month, BCVA RE improved to 4/10, anterior chamber reaction decreased to 1+, and vitritis resolved. Conclusion: Rifabutin can cause panuveitis, which may mimic endophthal- mitis, particularly in immunocompromised patients with complex diagnoses. The pathophysiology remains unclear but is suspected to involve direct tox- showed intravitreal haemorrhage, niveau formation and closed funnel RD. Since then, until the 10-month check-up, no major change has happened in his ophthalmic condition. EP-UVE-17 When the eyes speak: diagnosing systemic syphilis through panuveitis B.G. Dias1,2, S. Duarte1,2, S. Mano1,2, I. Leal1,2 1Hospital de Santa Maria - ULS Santa Maria, Ophthalmology Department, Lisbon, Portugal, 2Faculdade de Medicina da Universidade de Lisboa, Clínica Universitária de Oftalmologia, Lisbon, Portugal icity and/or immune reactions. These conditions are reversible with a good prognosis. Early identification can avoid invasive procedures. Introduction: Syphilis infection presents with clinical manifestations that vary by disease stage. Among the ocular manifestations, uveitis is the most EP-UVE-16 A case of endogenous endophthalmitis caused by Klebsiella pneumoniae in Hungary B.E. Varga1, A. Nádudvari1, B. Somodi1, G. Dányi2, H. Khouri2, K. Czibere1, N. Czumbel1 1Jahn Ferenc South-Pest Hospital and Clinic, Department of Ophthalmology, Budapest, Hungary, 2Jahn Ferenc South-Pest Hospital and Clinic, I. Department of Internal Medicine-Cardiology and Angiology, Budapest, Hungary We report a case of endogenous endophthalmitis caused by Klebsiella pneu- moniae in an immunocompetent patient. A 73-year-old man with a history of diabetes mellitus, hypertension was admitted to the Department of Internal Medicine of our Hospital, because of poor medical condition and fever. Due to the acute worsening of his status and rising of the inflammation markers, ceftriaxon and clarithromycin therapy were administered empirically. The hemoculture grew as K. pneumoniae that was sensitive to ceftriaxon. common and can sometimes be the sole systemic sign of Syphilis. Early di- agnosis and treatment are essential, as syphilis is highly treatable with timely care. Methods: We report a case of unilateral panuveitis that led to the diagnosis of previously unknown Syphilis and allowed early treatment with excellent clinical results. Results: A 35-year-old female, with no prior medical or ophthalmological his- tory, presented to the emergency department with a 7-day history of decreased visual acuity in the left eye (OS). Examination revealed a best-correct visual acuity (BCVA) of 10/10 in the right eye and counting fingers in OS. Anterior chamber cell activity (++), vitritis, vasculitis with perivascular infiltrates and mild hemorrhages, and diffuse papillary edema were noted in OS. The patient was diagnosed with unilateral panuveitis and was promptly in- vestigated. Macular OCT showed granular lesions in the outer retinal layers and fluorescein angiography enhanced vasculitis. Treponemic tests were posi- tive (RPR 1/256) with an ESR of 24 mm/hr and negative for other infectious agents, including HIV and toxoplasmosis. The diagnosis of syphilitic panuveitis was established, and the patient started multidisciplinary follow-up and treatment with intravenous penicillin and oral steroids. At 1 month follow-up, BCVA in OS had improved to 6/10, with no signs of inflammation in the anterior or posterior segments and papillary edema had resolved. 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ELECTRONIC POSTER PRESENTATIONS Conclusion: Ophthalmologists play a crucial role in diagnosing systemic dis- Results: The patient presented with blurred vision in the right eye (OD) and eases. Awareness of the ocular manifestations associated with systemic condi- ocular pain in the left eye (OS) for two days, with a history of anterior scleritis tions, including Syphilis, is critical for early diagnosis and treatment. Given three weeks earlier and upper respiratory infection three months prior. She re- the diverse ocular presentations of Syphilis, maintaining a high index of sus- picion is vital to prevent irreversible vision loss. EP-UVE-18 Ocular tuberculosis: a diagnosis and therapeutic challenge C. Bensaadi1, S. Bouayed1, S. Ait Baziz1, M.Y. Meftah1, D. Souttou1 1Hospitals of Algeria, Algiers, Algeria ported recent headaches but denied tinnitus, vertigo, or alopecia. Examination revealed BCVA of 20/40 OD and 20/20 OS. Slit-lamp findings showed 2+ cells and flare in both eyes, with granulomatous keratic precipitates OS. Fundus examination revealed bullous serous retinal detachments in both eyes and optic disc edema OD. OCT confirmed subretinal fluid and choroidal thick- ening, while FA showed choroidal fluorescence, pinpoint hyperfluorescence, pooling in detached areas, and optic disc leakage. Treatment included intra- venous methylprednisolone (500 mg) followed by oral methylprednisolone (80 mg/day). Within two weeks, BCVA improved to 20/32 bilaterally, with resolution of an- terior uveitis and retinal detachments, though mild optic disc edema persisted. She was referred for long-term immunosuppressive therapy. Conclusion: This case highlights the importance of early diagnosis and Introduction and purpose: Tuberculosis stays to this day a major morbidity cause. It can spread and touch different organs. Ocular location of tuberculosis is not unusual and can be found as a primer in- prompt corticosteroid therapy in VKH syndrome to improve visual outcomes and control inflammation. Long-term immunosuppressive management is es- sential to prevent recurrence and optimize prognosis. fectious tuberculosis and isolated location or secondary to general tuberculo- sis. Ocular manifestations are very polymorphous, making the diagnosis hard if systemic manifestations are absent. Our goal with this work is to analyze the clinical features of tuberculosis uveitis/vasculitis and to evaluate the diagnosis EP-UVE-22 criteria and their treatment. Material and methods: We report the case of a 31 years old patient, without any particular antecedent, who suffers brutal and unilateral blurred vision. The ophthalmological examination reveals a unilateral posterior uveitis with vas- culitis. The patient had multiple complementary exams including TB GOLD QUANTIFERON, which was not conclusive from the first test. Results and discussion: We do enhance the difficulty to conclude to a diag- nosis without a consensus, making it therefore more complicated to establish a treatement that is heavy by its drugs and the surveillance of it secondary effects. Conclusion: The final diagnosis of isolated ocular tuberculosis is still com- plicated. Despite many studies, there is no available study thqt cumulated the Trust the clinical findings - a case of suspected bartonella panuveitis with negative serology but positive response to doxycycline P. Martins1, J. Silva Fernandes1, S. Fonseca1 1Unidade Local de Saúde de Gaia e Espinho, Ophthalmology, Gaia, Portugal Purpose: To describe a case of presumed Bartonella panuveitis with positive response to systemic doxycycline, despite negative serologies. Methods: Observational case report. evaluation of all the diagnosis methods . We conclude to a diagnosis based on Results: A 12-year-old girl presented to the emergency department with a a bundle of clinical, biological and radiological argument, as well as a good two-month history of unilateral panuveitis in the right eye (OD), refractory response to treatment. EP-UVE-19 Vogt Koyanagi Harada syndrome: report of a probable case A. Reis Da Silva1, S. Pereira1, A.R. Viana1, C. Francisco1, J. Rocha1, P. Tenedório1 1Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal Purpose: Vogt-Koyanagi-Harada (VKH) syndrome is a rare autoimmune dis- order affecting melanin-rich tissues, including the eyes, central nervous sys- tem, inner ear, and skin. It often presents with ocular signs such as bilateral panuveitis, exudative retinal detachment, and optic disc hyperemia, posing diagnostic and management challenges. This report details a case of probable VKH syndrome classified by interna- tional criteria, emphasizing the significance of timely diagnosis and treat- ment. Methods: A case report of a 30-year-old female with probable VKH, evalu- ated using clinical records and multimodal imaging. to oral and topical corticosteroid therapy. Examination of the OD revealed a visual acuity (VA) of 5/10, ciliary hyperemia, fine inferior keratic precipitates, and Tyndall (+++)/flare (+). Fundoscopy of the OD demonstrated vitritis (+) and optic disc edema, without evidence of macular oedema or findings sug- gestive of chorioretinitis. Her medical history included recent and regular contact with a cat at her grand- parents’ home. Suspecting Bartonella infection, systemic evaluation, targeted serology, optical coherence tomography (OCT), and angiography were per- formed. Empirical treatment with doxycycline, for a total of four weeks, was initiated alongside a tapering regimen of oral corticosteroids. Upon follow-up, significant clinical improvement was observed. Despite neg- ative serological results, the treatment regimen was continued. Two months after completing treatment, the patient exhibited complete resolution of panu- veitis, with no evidence of recurrence, and an improvement in VA of the OD to 10/10. Conclusion: Definitive diagnosis of Bartonella-associated panuveitis requires laboratory confirmation, typically through serology. The sensitivity of IgG de- tection, the most commonly used antibody test, ranges from 14% to 100%. In suggestive cases with negative serology PCR testing of blood, infected nodes, or aqueous humor can be considered. However, targeted treatment in cases of high clinical suspicion should not be delayed in the absence of serological confirmation. 242 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS the posterior choroid. ICGA angiography revealed hypocyanescence in the serous retinal detachment areas and in the fluorescein angiography these ar- eas showed early hyperfluorescence with progressive pooling and optic disk leakage. Multimodal imaging of the OS showed no abnormalities. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was positive for tinnitus. The diagnosis of Vogt-Koyanagi-Harada Disease was made, and the patient was treated with systemic steroids. OD BCVA improved up to 20/20 at 4 months after the diagnosis, with complete reabsorption of subretinal fluid. Conclusions: This case illustrates an atypical presentation of Vogt-Koyanagi- Harada disease, occurring unilaterally rather than in its usual bilateral form. Physicians should be aware of this rare clinical variant of the disease. EP-UVE-25 Tuberculosis-related multifocal choroiditis D. Terzieva1, A. Georgieva1, I. Petkova1 1Specialized Hospital of Ophthalmology “Zora”, Ophthalmology, Sofia, Bulgaria Purpose: To describe the clinical course and treatment of multifocal choroidi- tis in patients with tuberculosis and to emphasize on the importance of its early identification for better visual outcome. Methods: A 49-year-old female with active multifocal choroiditis in her right eye, BCVA=0.5, TOD=13, was evaluated during the disease course using swept source optical coherence tomography and fluorescein angiography. A Quantiferon test was performed prior to the patient’s visit. The patient has been followed up for a period of 10 months. Results: OCT and FA showed cystoid macular oedema in the right eye and normal contour of the macula in the left eye, however multifocal chorioreti- nal atrophy and ischaemia was present in both eyes, with NVD only in the right eye. Positive Quantiferon test was the reason to initiate therapy with Rifampicin, Isoniazid and Pyrasinamide. An intraocular Ziv-Aflibercept injec- tion was administered in the right eye in order to treat the recurrent intraocular hemorrhage. Five months after the treatment was commenced, there were no signs of activity, therefore Pyrasinamide was excluded and recommendations were given for the continuation of Isoniazid and Rifampicin for the next four months. Ten months after the patient first presented to our clinic, her BCVA = 0.8 for the right eye. Conclusions: The main pathology of multifocal choroiditis is the inflamma- tion of the choriocapillaris and the retinal pigment epithelium. The lesions affect the periphery as well as the posterior pole. The diagnosis depends on the appropriate clinical history and evidence of tuberculous infection (Mantoux or Quantiferon test, chest imaging). Early initiation of tuberculostatic treatment is crucial for better visual outcomes. EP-UVE-23 Rerinal branch vein occlusion, an uncommon case report due to tuberculosis S. Bouayed1, C. Bensaadi1, S. Ait Baziz1, D. Souttou1 1Algiers Hospital, Algiers, Algeria Introduction: Although tuberculosis is a multi-systemic disease, Isolated oc- ular involvement is not uncommon and its manifestations are polymorphous making the diagnosis harder. Material: We report the case of a 44-year-old patient with no previous history. Initially, he presented a visual blurring of the right eye, with a clinical appear- ance mimicking occlusion of a peripheral OD venous branch, investigations didn’t find any usual risk factor for the occlusion. As follow-up progressed, a bilateralisation of the symptoms was noted, with the appearance in the 3rd year of chorio-retinal foci with occlusion of the trunk of the central retinal vein on the right eye and occlusive retinal vasculitis along the inferior temporal vein on the left eye. Ophthalmological investigations confirmed the clinical findings, prompting us to perform a QUANTIFERON assay, which came back positive. We therefore decided to start for the patient an anti-tuberculosis treatment 2RHZE-4RH and methylprednisolone bolus for 3 days, starting 72 hours after the start of anti-tuberculosis chemotherapy and followed by oral prednisone. Results: Progression after 02 months of treatment was marked by clinical improvement of the lesions on the fundus. Visual acuity was 09/10 in both eyes. Discussion: Among the ocular manifestations of tuberculosis, retinal vasculi- tis is the least frequent. These are peripheral vasculitides, and involvement of the large vessels of the posterior pole may be seen only rarely in severe forms. Occlusion of the central retinal vein in ocular tuberculosis is probably due to inflammation, hypersensitivity secondary to M.tuberculosis or compression of a chorio-retinal focus. These vasculitides respond well to systemic antituberculosis chemotherapy, thus representing another argument for retrospective diagnosis. Conclusion: Tuberculosis should not be overlooked as a possible cause of retinal vein occlusion, particularly in young patients in endemic countries. EP-UVE-24 Unilateral Vogt-Koyanagi-Harada disease: a case report J. Castro Cabanas1, P. Moreira Martins1, S. Fonseca1, C. Madeira1 1Unidade Local de Saúde Gaia e Espinho, Ophthalmology, Vila Nova de Gaia, Portugal Purpose: To report a case of a 33-year-old male with the diagnosis of a unilat- eral Vogt-Koyanagi-Harada disease. Methods: Observational case report. Results: A 33-year-old male presented to our emergency department with decreased visual acuity in the right eye (OD) for 1 day. He had an history of flu-like symptoms the week before. Best-corrected visual acuity (BCVA) was 20/63 in the OD and 20/20 in the left eye (OS). Pupillary function, in- traocular pressure and slit lamp biomicroscopy were normal in both eyes. OS fundoscopy was normal, and in the OD, it revealed two areas of exudative retinal detachment in the posterior pole. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and revealed thickening of Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 243

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ELECTRONIC POSTER PRESENTATIONS EP-UVE-26 Persistent macular edema in HLA-B27 associated uveitis responding to valaciclovir: a herpetic twist Y. Afifi1, D. Makhoul2, A.N.A. Le2 1HUB Erasme, Ophthalmology, Brussels, Belgium, 2CHU Saint-Pierre, Ophthalmology, Brussels, Belgium Purpose: Acute anterior uveitis (AAU) is a frequent ocular inflammatory condition often linked to HLA-B27 positivity. Macular edema (ME), while a recognized complication of uveitis, occurs less commonly in AAU compared to intermediate or posterior uveitis. This case report aims to highlight the po- tential for herpetic etiology in recurrent AAU complicated by ME, even in the presence of HLA-B27 positivity. Methods: We present a case study of a 44-year-old woman with recurrent AAU associated with ME. Initial ocular examination and management were (Quantiferon and syphilis) and revealed normal ACE but elevated lysozyme levels, suggesting a granulomatous process. Serologies for HSV, VZV, and rubella were positive; however, no direct causal link was established. A PET scan identified non-specific supra-hilar lesions, while pulmonary evaluation and lymph node assessment did not confirm sarcoidosis. Due to initial diagnostic uncertainty over her cardiac history, treatment began with topical corticosteroids. Further negative infectious investigations and the absence of systemic inflammatory markers justified the introduction of sys- temic corticosteroids, resulting in significant clinical improvement. Combination therapy with immunosuppressants helped stabilize her ocular inflammation. Over time, there was decreased papillitis, reduced macular edema, and overall improvement of bilateral panuveitis. Despite negative pulmonary findings, the combination of ocular symptoms, elevated lysozyme, and favorable response to corticosteroids strongly sug- gested isolated ocular sarcoidosis. An additional clue—a history of intermit- tent swelling of her tattoos—reinforced the likelihood of a granulomatous eti- ology. This case emphasizes that isolated ocular sarcoidosis can present with conducted using topical corticosteroids and cycloplegics. Subsequent evalua- atypical features, complicating diagnosis and management. Close ophthalmo- tions included anterior and posterior segment examination, optical coherence tomography (OCT), and systemic workup for inflammatory markers, includ- ing HLA-B27 testing. Persistent ME refractory to standard anti-inflammatory treatment prompted initiation of antiviral therapy with oral valaciclovir. Results: The patient presented with painful redness, reduced visual acuity (VA), and anterior chamber inflammation (Tyndall 3+). An initial response to corticosteroids improved VA to 10/10, but low-grade inflammation persisted. Six months later, recurrent symptoms with reduced VA (5/10), anterior vitre- ous cells, and ME were noted on OCT. Despite subconjunctival dexametha- sone, ME worsened. Her clinical course and rapid response to oral valaci- clovir, with resolution of inflammation, ME and full VA recovery within one week, strongly suggested a herpetic etiology. Conclusion: Macular edema in AAU is typically attributed to attributed to contiguous inflammation from severe anterior involvement. However, persis- tent or worsening ME despite adequate anti-inflammatory treatment requires exploration of alternative etiologies, such as herpetic infection. This case logic follow-up and a thorough exclusion of other systemic causes remain essential for timely and appropriate treatment. EP-UVE-29 The fungus among us: a delayed diagnosis of Candida-driven scleritis B. Martins Pombo1, J. Charréu1, F. Francisco1, T. Costa1, M. Vivas1, J. Roque1, M. Bernardo1 1ULS Amadora Sintra, Lisbon, Portugal Purpose: Up to 50% of scleritis patients have an associated systemic disease. Infectious scleritis is rare and challenging to diagnose due to its resemblance shows the importance of investigating herpetic causes in recurrent or atypical to immune-mediated scleritis. Risk factors suggestive of infection must be AAU cases, even when HLA-B27 positivity is present. considered, even when diagnostic tests are inconclusive. EP-UVE-27 Case report: atypical presentation of probable extrapulmonary sarcoidosis with granulomatous uveitis and tattoo swelling A. Takkal1, A. Beun2, L. Judice De Menezes Relvas1, Y. Azzagnuni3, A.N.A. Le1 1CHU St Pierre, Department of Ophthalmology, Brussels, Belgium, 2CHU St Pierre, Department of Internal Medicine, Brussels, Belgium, 3EpiCURA Hospital, Department of Endocrinology-Diabetology, Baudour, Belgium This report describes the complex management of a 40-year-old woman presenting with occlusive retinal vasculitis. Her medical history included Raynaud’s phenomenon, peripheral neuropathy, active smoking, and an early myocardial infarction at age 33. On initial examination, her visual acuity was 0.2 in the left eye and 1.0 in the right eye. OCT, fluorescein angiography, and ICGA showed bilateral granulomatous panuveitis, papillitis, vitreitis, peripheral retinal ischemia, and macular ede- ma in the left eye. Laboratory findings were negative for infectious causes Methods: Case report. Results: An 80-year-old male with controlled diabetes mellitus (DM) and asthma underwent phacoemulsification of the left eye, complicated by poste- rior capsule rupture recognized after implanting a single-piece IOL in the cap- sular bag. Subsequent IOL dislocation was corrected with IOL explantation, anterior vitrectomy, implantation of an iris-claw IOL, and subconjunctival triamcinolone (SCI). One month later, the patient developed persistent hy- peremia, scleral vessel injection near the SCI site, and conjunctival necrosis. Scleritis was diagnosed, and treatment with topical/oral corticosteroids (CS) and NSAIDs was initiated, with poor response. Bloodwork excluded auto- immune disease and tuberculosis, and conjunctival scraping revealed MRSA but was negative for fungi. Cotrimoxazole and CS improved symptoms, but weeks later, the patient developed vision loss (DCVA 4/10), IOP of 43 mmHg, and corneal edema refractory to hypotensive therapy. An Ahmed valve was implanted, and cyclosporin A was added to taper CS. Despite initial improve- ment, persistent conjunctival necrosis prompted a biopsy, confirming Candida parapsilosis. Immunosuppressants were discontinued, and oral fluconazole and topical amphotericin B were started. Vitreal involvement (haze, string of pearls) required intravenous/subconjunctival fluconazole and intravitreal am- photericin B. Aggressive therapy led to recovery (DCVA 8/10, IOP 11 mmHg). Conclusions: Fungal scleritis from subconjunctival triamcinolone, though rare, highlights the need for vigilance and conjunctival biopsy in resistant cases, particularly in older patients with DM. 244 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ELECTRONIC POSTER PRESENTATIONS EP-UVE-32 Ocular mucormycosis - case report of a 48-year-old male patient acute leukemia J. Mikulska1, A. Byszewska2, M. Rękas2 1Wojskowy Instytut Medyczyny, Warsaw, Poland, 2Wojskowy Instytut Medyczny, Warsaw, Poland This case report presents a 48-year-old male patient transferred to the Hematology Department with suspected acute leukemia. He exhibited a pur- puric rash, fever, leukocytosis (60,000/µl), mild anemia, and thrombocyto- penia. Imaging revealed splenomegaly and lymphadenopathy. A diagnosis of acute myeloid leukemia (AML) was established through cytomorphological examination and immunophenotyping, which indicated hyperdiploidy. Initial treatment with hydroxyurea was initiated, followed by a remission induction cycle after negative testing for the FLT3 gene mutation. Despite treatment, the patient experienced pancytopenia and developed appendicitis, which was managed conservatively. Further evaluations suggested a re-induction of re- mission following the CLAG-M protocol. During hospitalization, the patient reported left eye pain, sore throat, and signs of ocular discomfort. Ophthalmological examination suggested possible pre- septal cellulitis. A CT scan confirmed proptosis of the left eye, muscle thicken- ing, and edema, raising suspicion for fungal infection. Neurologically, men- ingitis was considered. As symptoms progressed, left eye necrosis was noted, and a biopsy confirmed mucormycosis, with cultures identifying Aspergillus fumigatus and Rhizomucor pusillus. Despite administration of Amphotericin B, the patient’s condition deteriorated. Follow-up imaging revealed worsening proptosis, muscle thickening, and ex- tensive infiltrative changes in the brain. Neurosurgery deemed surgical inter- vention too risky. This case highlights ocular mucormycosis as an emerging and critical manifestation linked to acute leukemia and its associated compli- cations. Recognizing prodromal symptoms, timely diagnosis through imaging and biopsy, and immediate antifungal treatment remain essential for improv- ing patient outcomes. Given the high-risk nature of this population, a height- ened awareness and ongoing research into management strategies for ocular mucormycosis is warranted. retinal fluid in the macula of the right eye. Despite absence of a clear clinical diagnosis, systemic antiviral therapy was initiated on the basis of presumed CMV retinitis. However, molecular testing of aqueous humor turned out negative for herpes- viridae family and positive for toxoplasma gondii. The patient was switched to trimethoprim/sulfamethoxazole, which was later stopped due to new onset nephrotoxicity attributed to the drug which, although uncommon, has been described in HIV patients receiving it. An alternative regiment of pyrimethamine and atovaquone was selected un- der infectious disease consult. The patient responded well to therapy, with 2-month serial fundus exam and OCT documenting reduction of lesion size and activity as well as improvement of BCVA to 8/10 in both eyes. Conclusions: We report a case of atypical ocular toxoplasmosis presenting as bilateral multifocal retinitis absent vitritis and previous scar, in a patient with severe HIV immunosuppression. It shows how clinical diagnosis can often be limited and highlights the role of molecular diagnosis on aqueous humor samples in infectious posterior uveitis. It further documents efficacy of an al- ternative therapeutic regiment. EP-UVE-35 Syphilitic optic neuritis and uveitis K. Boninska1, M. Post2, M. Bednarski1, S. Cisiecki1 1Julianow Medical Center, Ophthalmology, Lodz, Poland, 2Independent Public Clinical Ophthalmology Hospital, Ophthalmology, Warsaw, Poland Purpose: We report the case of a 34-year-old male patient who presented to the Ophthalmology Department because of a decline in visual acuity in both eyes. Case Report: The patient was diagnosed with anterior and posterior uveitis in the right eye and optic neuritis in the left eye, secondary to syphilis. Results: Topical and systemic treatments were implemented, leading to a gradual improvement in the patient’s condition. Conclusion: Considering the rising global incidence of syphilis and the non- specific ocular manifestations it may present, the diagnosis should be consid- ered in patients with ocular inflammatory conditions of unknown etiology. EP-UVE-34 Bilateral multifocal retinitis in HIV: the toxoplasmosis twist T. Reis da Costa1, J. Charréu1, F. Francisco1, B. Pombo1, M. Vivas1, J. Roque1, M. Bernardo1, I. Prieto1 1ULS Amadora/Sintra, Lisbon, Portugal Case Report: A 35 year old woman, admitted to the infectious disease ward with recent HIV-1 diagnosis (CD4 count 17 cell/mm3), is referred to the oph- thalmology department for CMV retinitis screening. BCVA was 5/10+ on the right eye and 8/10 on the left eye. IOP was normal and symmetric. Slit lamp exam showed bilateral granulomatous keratic precipitates predominantly on the right eye and cell 0.5+. Fundus exam showed multiple yellowish retinal lesions in both eyes sugges- tive of retinitis mostly outside the macula, with one lesion in the perifoveal area in the right eye. There was no evidence of significant retinal hemorrhage, vitritis or apparent vasculitis. OCT imaging of the lesions was compatible with retinis and additionally showed an epiretinal membrane and discrete sub- EP-UVE-36 Vogt-Koyanagi-Harada disease revealed by uveitis: a case report K. Selmani1, H. Ouazzani Touhami1, I. Omari1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Vogt-Koyanagi-Harada (VKH) disease is an autoimmune dis- order targeting melanocytes, primarily affecting women between the ages of 20 and 30. Its ocular manifestation includes panuveitis with exudative retinal detachments and chronic choroidal depigmentation. The treatment during the acute phase consists of early and aggressive systemic corticosteroid therapy. We report a case of VKH disease during its acute phase, emphasizing thera- peutic and evolutionary aspects. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 245

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ELECTRONIC POSTER PRESENTATIONS Case report: A 30-year-old woman patient, presented with rapidly progres- sive visual acuity loss over the past 7 days. Ophthalmologic examination re- vealed a visual acuity of counting fingers in both eyes, and a normal anterior segment. Macular OCT showed poly-lobed serous macular retinal detach- ments, with choroidal folds. Other tests and exams were unremarkable, sug- gesting an isolated ocular form of VKH. The patient received corticosteroid boluses over 3 months, followed by oral therapy. The evolution was favorable, visual acuity improved to 8/10, and the serous retinal detachments were reattached. Discussion: The positive diagnosis is made based on diagnostic criteria re- vised in 2001 by an international committee. VKH disease is classified into three clinical forms: complete, incomplete, and probable (isolated ocular form). In the acute phase, uveitis may occur in isolation, without extraocular manifestations, but affecting both eyes simultaneously, which supports the di- agnosis. Standard treatment for the acute phase involves early and aggressive systemic corticosteroid therapy. VKH disease may not respond to systemic corticosteroids alone, especially in patients with recurrent chronic forms, where localized treatment with intravitreal Ozurdex injections is indicated. Conclusion: The probable form of VKH disease is relatively rare, but it should be considered when characteristic ocular signs are observed in the fun- dus. The early treatment is crucial for a favorable prognosis. 246 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS to have Brittle cornea disease. Corneal cheese wiring, extension of corneal perforation, unable to seal the perforation were the complications encountered intra-operatively. Adjunctive use of tissue adhesive was needed in 45% cases. 1 patient needed a large sized penetrating keratoplasty. No significant difference was noted in visual acuity between first and last visit . Adherent leucoma formation was noted in all eyes. 20% eyes went into phthi- sis bulbi. Conclusion: Early identification is crucial as managing corneal perforation is difficult in these patients due to fragile tissues. The prognosis is poor, espe- cially after multiple surgeries, so surgical intervention should only be under- taken for tectonic stabilization. Protecting the unaffected eye is key, as minor trauma can cause large perforations. Protective eye shields during sleep are recommended. ISOT01-3 Management of a complex ocular injury with endophthalmitis and corneal melting in a patient with a history of war-related trauma C. Campo Beamud1, M.E. Hidalgo Espinosa1, E. Campo Beamud1, A. Donate Rosa1, E. Díaz Fernández1, H. Estero Serrano de la Cruz1, M. Barrio Castellanos1, R.V. Pineda Oliveros1 1Hospital General Universitario de Ciudad Real, Ophthalmology, CIUDAD REAL, Spain Purpose: To present a challenging case of a patient with a history of war- related ocular trauma from shrapnel injury complicated by endophthalmitis and corneal melting, highlighting the multidisciplinary approach and thera- peutic challenges in managing severe ocular infections and structural damage in conflict settings. Method: A Ukrainian patient with a history of corneoscleral injury due to shrapnel and subsequent endophthalmitis was referred to our center. The ini- tial management included pars plana vitrectomy (PPV), phacoemulsification, and intraocular foreign body removal (CEIO). Despite the treatment, the pa- tient developed corneal melting, abscesses, and persistent inflammation. Cultures revealed saprophytic flora, and the patient was intolerant of Vigamox. The treatment included fortified topical antibiotics (vancomycin and ceftazi- dime), intravitreal injections (vancomycin and ceftazidime), and systemic cip- rofloxacin. Due to a lack of improvement, evisceration was considered. Results: The patient presented with no light perception (NPL) in the affect- ed eye (OD), severe corneal melting, and a large central ulcer (6.5x6 mm). Despite aggressive antimicrobial therapy, the eye progressed to phthisis bulbi and evisceration was recommended. The contralateral eye (OI) remained sta- ble with a best-corrected visual acuity (BCVA) of 1.0. Conclusion: This case underscores the complexity of managing severe ocu- lar trauma and infections in patients with war-related injuries, particularly those in conflict zones. Despite aggressive medical and surgical interven- tions, structural damage and persistent infection may require evisceration. Multidisciplinary care, tailored therapeutic strategies, and international col- laboration are essential for addressing the unique challenges posed by war- related ocular trauma. ISOT ABSTRACT PRESENTATIONS Young ISOT ISOT01-1 Human Amniotic Membrane Graft in the Management of Peripheral Hypertrophic Subepithelial Corneal Degeneration: A Case Report P. Rosetta1, B. Battaglia2, S. Watarkar3, A. Feo2 1Humanitas San Pio X Hospital, Ophthalmology, Milan, Italy, 2Humanitas Research Hospital, Milan, Italy, 3University Hospitals of Leicester NHS Trust, Leicester, United Kingdom Introduction: In this report, we describe the case of peripheral hypertrophic subepithelial corneal degeneration (PHSCD), managed with surgical excision and a human amniotic membrane (hAM) graft. Case presentation: A 45-year-old female Caucasian patient presented with decreased vision, itching, and burning in both eyes, and a presence of pseu- dopterygium in the right eye, causing visual decline. Routine ocular exams and anterior segment OCT led to the diagnosis of PHSCD, after a careful dif- ferential diagnosis with other similar clinical occurrences. Subsequently, the patient was successfully managed with surgical intervention and an amniotic membrane graft placement. Conclusion: PHSCD is a rare disease, which in advanced cases can be suc- cessfully managed with hAM graft. No recurrence of the lesions was observed at 1-year follow-up in our patient. Keywords: Corneal surgery; Human amniotic membrane; Peripheral hyper- trophic subepithelial corneal degeneration. ISOT01-2 Outcome of open globe Injury in patients with blue sclera M. Doctor1, S. Eereti1 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India Open globe injury in patients with blue sclera worsens prognosis due to as- sociated connective tissue disorders. Purpose: We studied patients with open globe injuries who had blue sclera, corneal thinning, or keratoglobus during follow-up visits. This descriptive study aims to look at the rate of identification at the emergency sitting by comprehensive ophthalmologist, management and complications encountered intra and post-operatively. Methods: Retrospective descriptive hospital-based study performed at L V Prasad Eye Institute, India. Key words Blue sclera and corneal tear repair was used to perform an electronic medical search from the hospital database. Patient who only presented once and were later lost to follow up were ex- cluded. Results: A total of 17 patients were included. Mean age was 13 years. Blue sclera and corneal thinning along with the open globe injury was picked up in 50% cases at first visit. 35% patients gave history of trivial trauma to the eye as a cause of corneal perforation. 8 patients were diagnosed as Ehler Danlos, 2 as Marfans Syndrome, 1 as Alports syndrome, while others were suspected Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 247

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ISOT ABSTRACT PRESENTATIONS ISOT01-4 Global foreign bodies requiring emergency surgeries in a large clinical center in China J. Zhu1, J. Tian1, S. Yan1, X. Shi1 1Beijing Tongren Hospital, Capital Medical University, Ophthalmology, Beijing, China Purpose: This study aimed to identify patients requiring emergency surgeries for intramural and intraglobal foreign bodies (GFBs) in the emergency depart- ment (ED), utilizing a classification of global foreign bodies (GFB) based on the anatomical location of GFBs. We analyzed the diagnoses and manage- ments strategies for these cases at a large university-affiliated clinical center over a six-month period. Method: Patients who underwent emergency ocular surgery for GFBs were retrospectively reviewed. Data collected included age, gender, cause of injury, time of onset, location and extraction methods of GFBs, surgical procedures performed, ocular manifestations, complications, and medications. Results: Based on GFB location, patients were divided into three groups: cor- nea (Group A), anterior chamber–iris–lens (Group B), and vitreous–retina– choroid (Group C). Ages ranged from 2 to 70 years (mean 47.0 ± 17.4). Of all patients requiring surgery, 82.6% were male and 17.4% female, with a male-to-female ratio of 4.7:1. In addition to GFB removal, 56% of patients re- quired globe laceration repair (primarily corneoscleral lacerations). Over 45% of these involved corneal repairs was performed in Group B, fewer in Group C, and least in Group A. Anterior chamber washout and reconstruction were Six weeks later, his corneal edema had completely resolved with minimum residual corneal haze. His uncorrected visual acuity had improved to 20/25. Calotropis, a plant grown in multiple areas of rural India, produces copious amounts of thick milky sap. The latex contains several alkaloids, while the sap is acidic in nature. It also releases toxins which are known to be inflammatory in nature; together both produce ocular toxicity. Since the ocular morbidity is reversible if identified and treated early; hence knowledge about the entity and its management is necessary. Since the plant has medicinal properties, and as a growing number of urban populations have beliefs in herbal medicines and ayurvedic therapy, hence it is extremely cru- cial for an ophthalmologist to be aware regarding the ocular manifestations after the accidental exposure of the eye to this plant extract. It is equally cru- cial to know the management protocol, since any delay in identification and management, may alter the prognosis ISOT01-6 Unbelievable luck in orbital trauma: a case of near miss and successful intervention B. Guerreiro Dias1, B. Baptista2, A. Cabrita1, J. Levy2, R. Barão1 1Hospital de Santa Maria - ULS Santa Maria, Ophthalmology Department, Lisboa, Portugal, 2Hospital de Santa Maria - ULS Santa Maria, Otorhinolaryngology Department, Lisboa, Portugal performed in 100% of cases in Group B. In Group C, globe exploration and Purpose: To present a case of penetrating left orbital and ethmoi- removal of ferromagnetic intravitreal foreign bodies were the most common dal trauma requiring collaborative management by Ophthalmology and procedures. Conclusion: All GFBs were attempted to be extracted in the ED; however, those located near the posterior segment and/or non-magnetic were more chal- lenging to remove. Beyond GFB extraction, corneal laceration repair was the most frequently performed surgery across all groups, followed by anterior chamber washout and reconstruction. These findings highlight the importance of timely surgical intervention and comprehensive management in ocular trauma involving GFBs. ISOT01-5 Calotropis induced ocular toxicity M. Doctor1 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India Calotropis procera, also known as milkweed, is a native plant to southern Asia and North Africa. It produces a copious amount of latex and sap, which is acidic and releases toxins which has inflammatory properties. Ocular exposure produces clinical features similar to that seen after chemical injury and causes significant ocular morbidity. We report a case of ocular toxicity following accidental fall of sap from the plant Calotropis in the right eye of a 21 year old man. He reported a painless sudden decrease in vision in the affected eye. He had visual acuity of Hand motions close to face in the right eye and 20/20 in the left eye. Examination showed conjunctival congestion, total corneal epithelial defect, diffuse corneal edema with DM folds and a streak hypopyon. B scan was an- echoic. Left eye anterior and posterior segment was unremarkable. He was started on with intense topical steroids, which showed significant recovery. Otorhinolaryngology emergency teams. Case presentation: A 40-year-old female presented to the emergency depart- ment after an accidental nail gun injury. The proximal end of the nail was visible externally protruding from the medial canthum of the left orbit. The patient complained of spontaneous pain and lateral globe dystopia was ob- servable. Visual acuity was preserved. Orbital computed tomography (CT) revealed a metallic structure in the medial aspect of the left orbital cavity, displacing the medial rectus muscle laterally and superiorly, traversing the medial orbital wall and intersecting the posterior left ethmoidal air cells, with associated hemosinus. The distal end followed a tangential trajectory along the anterior wall of the left sphenoid sinus with apparent mild disruption of the outer bony cortex. Emergency surgery was performed by the Ophthalmology and Otorhinolaryngology teams. Rigid nasal endoscopy revealed no active hemorrhage, with direct visualization of the distal portion of the nail contact- ing the anterior wall of the left sphenoid sinus. The foreign body was success- fully removed externally without bleeding and the entry wound was irrigated with saline and 10% betadine. The following day, the patient was asymptomatic, with an uncorrected visual acuity of 20/20 Snellen OU and no diplopia. The remaining ophthalmologi- cal examination was normal. A follow-up CT scan at 48 hours confirmed the complete removal of the foreign body and showed mild residual ethmoidal hemosinus. Conclusion: This case highlights the importance of a multidisciplinary ap- proach in orbital trauma. Despite the nail‘s potentially devastating trajectory, the patient was remarkably fortunate to avoid major damage. Clinicians must always be prepared for the worst, even when everything turns out to be easier than expected. 248 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS ISOT01-7 Real-world application of the RD-OGI score in predicting Retinal Detachment - Post-ocular trauma in a middle-income country J. Romero1, C. Hernandez1, A. Kathri2, C. Mishra3, M. Awan4, V. Dave5, R. Agrawal6,7,8 1Unidad Nacional de Oftalmología, Guatemala, Guatemala, 2Birat Eye Hospital, Biratnagar, Nepal, 3Trilochan Netralaya, Odisha, India, 4Shifa International Hospital, Islamabad, Pakistan, 5LV Prasad Eye Institute, Hyderabad,, India, 67 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore, 7Singapore Eye Research Institute, Singapore, Singapore, 8Duke NUD Medical School, Singapore, Singapore ophthalmologic examination. Management included immediate stabilization with wound cleaning and dressing. The patient was sedated for complete as- sessment and an orbital CT scan was done, confirming a ruptured globe; thus, prompting surgery under general anesthesia. Systemic management and moni- toring were necessary due to untreated chronic kidney disease identified upon referral to Internal Medicine. Postoperative treatment included antibiotics and psychiatric management to reduce the risk of self-harm. Results: Comprehensive evaluation and risk stratification, with systemic management, took importance in guiding the surgical plan. Evisceration was successfully performed. The decision to omit implant placement with the pa- tient’s psychosis and uncontrolled condition contributed to a safer recovery with reduced complication risk. Conclusion: Self-evisceration is a severe outcome linked to unmanaged psychosis and underlying medical conditions. This case underscores the im- portance of a multidisciplinary approach, integrating ophthalmologic, medi- cal, and psychiatric management to improve surgical outcomes. Heightened Purpose: This study aimed to validate the Retinal Detachment after Open vigilance, early intervention, and tailored care plans are crucial in managing Globe Injury (RD-OGI) score in a real-world clinical setting in a middle- income country and to provide recommendations for its clinical application. the unique challenges presented by such complex cases, ultimately aiming to prevent further complications and preserve the patient‘s quality of life. Methods: A retrospective chart review of 167 consecutive patients with OGI treated at the Unidad Nacional de Oftalmología in Guatemala City was con- ducted. The RD-OGI score was calculated for 128 eligible patients based on initial visual acuity, zone of injury, and the presence of vitreous haemorrhage. Patients were stratified into low, moderate, and high-risk categories, with out- comes assessed over a one-month follow-up period. Results: Retinal Detachment (RD) occurred in 21.87% of patients, with 68% developing RD within the first month post-injury. The RD-OGI score effective- ly stratified patients by risk, with 43.33% of high-risk patients and 41.37% of moderate-risk patients developing RD. Among high-risk patients who did not develop RD, 94.11% developed phthisis bulbi. The study also demonstrated that early pars plana vitrectomy, particularly within four days of injury, significantly reduced the risk of RD and phthisis bulbi in high-risk patients. patients. ISOT01-9 One punch, one eye: tackling traumatic macular hemorrhage with pneumatic displacement and intravitreal tissue plasminogen activator B. Pombo1, J. Charréu1, F. Francisco1, T. Costa1, M. Vivas1, J. Almeida1, G. Pires1, I. Prieto1 1ULS Amadora Sintra, Lisbon, Portugal Conclusion: The RD-OGI score is a valuable tool for predicting RD risk and Purpose: To show the role of pneumatic displacement and intravitreal tissue guiding the management of OGI patients. Early diagnosis and intervention, plasminogen activator (tPA) in the treatment of traumatic macular hemorrhage especially in high-risk patients, are crucial for preventing complications such Method: Clinical case. as RD and phthisis bulbi. Routine use of the RD-OGI score in ocular trauma Results: A 21-year-old male presented to our emergency department with clinics is recommended to enhance patient outcomes, although further pro- spective studies are needed to refine treatment protocols and optimize the tim- ing of surgical interventions. ISOT01-8 Self-evisceration in a 92-year-old female with untreated psychosis due to uremic encephalopathy: A case report M. Montenegro1, C. Vigo- Matic1, R.O. Lontoc1 1De La Salle University Medical Center, Department of Ophthalmology, Cavite, Philippines Purpose: To report a case of self-inflicted evisceration in an elderly patient with psychosis secondary to uremic encephalopathy, emphasizing the impor- tance of comprehensive management. This case report aims to explore the challenges and considerations involved in providing safe and effective oph- thalmologic surgical care in elderly patients with multiple comorbidities. Method: A 92-year-old female with psychosis presented with a self-inflicted ruptured globe of the left eye following an episode of agitation. The patient was alert; however, uncooperative in the emergency room, limiting complete sudden painful vision loss in his left eye (OS) following blunt trauma from a punch to the face. The patient reported a central scotoma and had a best-cor- rected visual acuity (BCVA) of 20/60 in the OS. Biomicroscopy revealed 0.5+ cells in the anterior chamber (AC) and no other relevant findings. After fun- dus examination, a dense macular hemorrhage was diagnosed and no signs of rhegmatogenous retinal detachment or choroidal rupture were found. Optical coherence tomography (OCT) showed a subretinal hemorrhage involving a large portion of the macula with the fovea at the boundary of the hemorrhage. Given the significant visual impairment, central involvement and large vol- ume of the hemorrhage we decided an intervention was warranted, and the patient was submitted to an AC paracentesis followed by intravitreal injection of tPA (50 µg) accompanied by pneumatic displacement using 0.3 mL of SF6 gas. The patient was told to maintain prone positioning for 24 hours followed by a 45º head tilt position. On the first day post-op, examination showed sig- nificant inferior and temporal displacement of the hemorrhage and BCVA had improved to 20/40. Over the next two weeks, progressive resolution of the hemorrhage and subretinal fluid was noted on serial OCT imaging. BCVA had improved to 20/30, with almost complete resorption of hemorrhage and minimal disruption of the ellipsoid zone. Conclusion: This case highlights the efficacy of intravitreal tPA and pneu- matic displacement therapy for traumatic macular hemorrhage, specifically in young patients, where vitrectomy may be more difficult. It is a fast acting intervention and promotes clot lysis, minimizing complications such as the risk of fibrosis and subsequent permanent vision loss. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 249

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ISOT ABSTRACT PRESENTATIONS ISOT01-10 Simultaneous Muraine sutures and Excimer Laser-assisted penetrating keratoplasty for acute traumatic keratoconus: A novel surgical approach for rapid visual rehabilitation M.E. Burghardt1, J. Heinzelmann1, M. Stein1, A. Viestenz1, A. Viestenz1 1Martin-Luther-University Halle-Wittenberg, Ophthalmology, Halle (Saale), Germany Purpose: Acute keratoconus (AKC) is a sight-threatening, trauma-associated complication of progressive keratoconus, frequently induced by chronic me- chanical stress, particularly excessive eye rubbing. Traditional conservative management often prolongs the recovery period, delaying functional reha- bilitation and increasing the socioeconomic burden. To evaluate a novel com- bined surgical approach utilizing Muraine sutures and Excimer laser-assisted penetrating keratoplasty (PKP, in one session) for rapid visual rehabilitation in AKC patients, particularly those with trauma-related corneal damage due to eye rubbing. Methods: A consecutive case series of six AKC patients (2019–2022) was an- alyzed. All patients had a documented history of excessive eye rubbing, with 50% diagnosed with atopic dermatitis (AD). The surgical approach involved deep stromal Muraine sutures to stabilize corneal curvature and mechanically reapproximate the Descemet’s rupture, immediately followed by Excimer la- ser-assisted PKP. Pre- and postoperative best-corrected visual acuity (BCVA), keratometry, and complications were assessed. Results: Preoperatively, all patients exhibited hand motion vision (logMAR 3.0), postoperatively, logMAR 0.3±0.09 (p<0.001), with a mean corneal astig- matism of 2.6±1.7 D at follow-up (20±10 months). One patient developed endothelial graft rejection after two years, successfully managed with en- dothelial keratoplasty. Conclusion: AKC, frequently triggered by chronic eye rubbing in AD pa- tients, represents a trauma-induced ophthalmic emergency requiring prompt intervention. The combination of Muraine sutures and immediate Excimer la- ser-assisted PKP provides a targeted mechanical and surgical solution, restor- ing corneal integrity and expediting functional rehabilitation. This approach minimizes the long-term disability associated with prolonged conservative treatment and may be particularly beneficial for patients with repetitive micro- trauma-induced keratoconus progression. ISOT ABSTRACT PRESENTATIONS Management of Anterior Segment Trauma ISOT02-1 Unraveling traumatic lens-induced glaucoma: case series across surgical techniques from phakoemulsification to intracapsular extraction M. Rifada1, S. Umbara1, E. Gustianty1, A. Prahasta1 1Universitas Padjadjaran - Cicendo Eye Hospital, Ophthalmology, Bandung, Indonesia Purpose: To report various surgical techniques following traumatic lens in- duced glaucoma. Methods: A case report series. Case 1: A 65 years old man had previously been struck by wood when cutting wood 1 month ago. Visual acuity (VA) was finger counting (FC) at 2 meters, IOP 32 mmHg with shallow anterior chamber (AC), lens subluxated and irido- dialysis at 3-5 o’clock. After initial treatment with antiglaucoma medication, he underwent Phaco + CTR + IOL implantation + trabeculectomy + repair of iridodialysis. Post operative showed the visual acuity was 0,1 and IOP 8 mmHg with IOL in the bag. Case 2: A 55 years old woman had history of head trauma 7 months ago and blurred vision in the right eye in the last 4 months. Visual acuity was Hand Movement (HM), IOP was 72 mmHg, and AC was full with crystalline lens. B-scan USG showed mild vitreous opacity. She was given topical an oral antiglaucoma medication. She underwent ICCE + trabeculectomy in one surgical site. Post operative showed the visual acuity was CFFC with IOP 18 mmHg and aphakic lens. Case 3: A 39 years old man had previously experience eye injuries from weld- ing the iron on the left eye. VA was light perception with stellate corneal lac- eration and negative Fistel test. Three months afterward, the IOP raised to 52 mmHg with cloudy lens with fibrosis on the nasal area. The patient underwent Phacotrabeculectomy + synechiolysis + explore for IOFB. IOFB found on capsulated on the lens behind the iris and extracted and remained aphakia. After 3 months, the IOP was controlled around 15 mmHg and planned for secondary scleral fixation IOL implantation. Conclusion: Ocular trauma remains a common and preventable cause of blindness. Traumatic lens induced glaucoma can manifest alone or co-existing with other clinical manifestation due to ocular injury. Surgical technique is depend on the cases and combined surgery preferable depends on the patho- genesis of secondary glaucoma, baseline IOP, and duration of the trauma. 250 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS ISOT02-2 Anterior segment-ocular coherence tomography: profile of wound closure after open globe injury repair M.R. Reyna Gordillo1, A.I. Ponce Bolaños2, J.R. Santos Estrada2, J.P. Tovar2 1Unidad Nacional de Oftalmologia, Guatemala, Guatemala, 2Unidad Nacional de Oftalmologia, Ocular Trauma, Guatemala, Guatemala Purpose: To describe the tomographic profile of corneal wound healing fol- lowing open globe injuries, using anterior segment- optical coherence to- Methods: From 2016 on, prospectively we have annually collected data in all participating departments of ophthalmology in Germany by means of an online questionnaire. Total numbers as well as anonymous data on patients’ age, the patients’ role in the incident and treatment mode were gathered. Data analysis is descriptive. Results: Total numbers, were clearly related to the legislative regulations in the particular years as could be seen during the two pandemic years with a sales ban of consumer fireworks and a decrease to 79 and 193 patients. After the pandemic years the numbers increased to 838, 781 in 2022/23 and 2023/24 respectively and to 881 in 2024/25. The participation rate of german emer- gency eye departments was 90 %. With this high coverage the incidence of firework-induced eye injuries in Germany can be estimated to 1/100 000 after the pandemic. Children and adolescents were overrepresented and contributed to up to 40 % of all patients. Consistently, over all years, at least 50 % of pa- mography (AS- OCT). The study was conducted at the Unidad Nacional de tients reported on having been bystanders. Roughly a quarter of patients were Oftalmología, Guatemala, between July 2024 and March 2025. Methods: A prospective, non-randomized, descriptive study was conducted involving patients diagnosed with corneal injuries due to ocular trauma who underwent surgical repair. To determine wound healing profile these patients had their follow-ups with an AS-OCT (Solix® Optovue). Patients with pre-existing ocular pathologies likely to interfere with corneal severely injured and treated as inpatients. Conclusions: Eye injuries induced by consumer fireworks are an increasing health concern in Germany. Children and bystanders are overrepresented- a situation that does not comply with social standards of protection. The rate of severe injuries emphasizes the relevance of firework induced eye injuries with regard to longterm complications and costs incurred. Preventive meas- wound healing and limbal injuries that compromised imaging quality were ex- ures aiming at children, adolescents and bystanders need to be implemented. cluded. Demographic data, trauma characteristics, surgical details, and post- operative AS-OCT measurements were recorded.Follow-up evaluations were conducted at one week and one month post-surgery. Results: 24 eyes of 24 patients were included in the study.Mean age was 25.29 years ±16.14, average consultation time of 28.88 hours ±36.49. Full- thickness wound seen in 95.83% of cases and mean wound length was 7.02 mm ±3.86. A vegetable branch was the causative agent in 25% of cases and 16% caused by glass.79.23 % of cases underwent additional procedures dur- ing wound repair. Anatomical success was achieved in 95% of cases.Suture tension was cat- egorized as tight, and suture depth showed a progressive increase over time. Mean corneal thickness was 1139.51 μm (±314.16) at week one and 939.82 μm (±356.43, p<0.05) at four weeks post-op.Mean suture depth remained sta- ble after one-month follow-up. Conclusions: Corneal wound repair analysis using AS-OCT proves to be an important and reliable method to establish a profile of wound healing repair after open globe injury and to asses sutures tightness and depth placement. The majority of wounds achieved anatomical success, with measurable im- provements in corneal structure and visual function over time. ISOT02-3 Increasing number of firework-induced eye injuries in Germany: results from nine years A. Gabel-Pfisterer1, D. Böhringer2, H. Agostini2, German Firework Study Group 1Ernst-von-Bergmann Hospital Potsdam, Department of Ophthalmology, Potsdam, Germany, 2Medical University Freiburg im Breisgau, Department of Ophthalmology, Freiburg, Germany Purpose: The aim of our investigation was to obtain an overview on risk groups, incidences and the severity of firework-induced eye injuries in Germany during the days around New Years`Eve in order to discuss social ISOT02-4 Addressing firecracker-related ocular trauma: a call for National Safety Guidelines S Natarajan1, M. Pathak1, S. Mahadik1, A. Sutar1, R. Bajaj2 1Aditya Jyot Eye Hospital, Mumbai, India, 2Mission Accessibility, Delhi, India Purpose: To seek judicial intervention for the formulation and implementa- tion of national guidelines to prevent ocular trauma caused by the unregulated use and substandard manufacture of firecrackers, particularly during festive seasons, in the interest of public health and safety. Methods: his public interest litigation (PIL) has been filed by the Ocular Trauma Society of India (OTSI), a not-for-profit organization comprising ex- perienced ophthalmologists who manage a large number of firecracker-related ocular injury cases. The petition is based on publicly available government documents, peer-reviewed academic literature, and clinical experiences of OTSI members. A prior representation was made to the Ministry of Health and Family Welfare, but no response was received, necessitating the filing of this PIL. Results: Studies and hospital records indicate that firecrackers contribute to approximately 20% of ocular injuries, with young bystanders being dispro- portionately affected. Reported injuries include corneal abrasions, chemical burns, traumatic cataracts, and retinal detachment. Despite existing environ- mental regulations addressing pollution and noise, there is no comprehen- sive national framework specifically aimed at preventing ocular trauma from firecracker misuse. There is also a lack of public safety education, protective regulations, and accountability measures for negligent usage. Conclusion: Urgent regulatory action is required. The petitioner seeks direc- tions to formulate clear, nationwide guidelines promoting safe firecracker us- age, implement awareness campaigns, enforce quality control, restrict use in high-risk areas, and introduce penalties for negligent use. These steps are vital to safeguarding public health and protecting the fundamental right to life and relevance of these injuries and the need and design of preventive measures. health under Article 21 of the Constitution. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 251

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ISOT ABSTRACT PRESENTATIONS ISOT02-5 Peculiarities of war-related eye injuries in Ukraine O. Petrenko1, S. Rykov1, M. Tselishcheva1 1Bogomolets National Medical University, Kyiv, Ukraine Purpose: With the onset of the full-scale invasion on February 24, 2022, the nature of ocular injuries changed significantly. This study aimed to investigate the specifics of eye injuries among military personnel and civilians related to the war in Ukraine. Methods: A retrospective multicenter study was conducted in seven special- ized military and civilian medical institutions. A total of 320 patients with gunshot and explosive injuries who presented from February 24, 2022, to February 22, 2025, were analyzed. Each patient underwent a comprehensive ophthalmic examination, general clinical tests, and consultations with related specialists. Results: Severe eye injuries prevailed in 278 patients (86.8%). Combined and multiple traumas were found in 291 (90.9%), with bilateral involvement in 125 (39.1%). Open-globe injuries with intraocular foreign bodies occurred in 186 patients (58.1%), and orbital trauma was noted in 141 (44.6%). Most patients were male 311 (97.1%), aged 18–78 years (mean 38.4 ± 10.2). Explosive inju- ries accounted for 87.4% of cases, surpassing gunshot or blunt trauma. High- Gonioscopy confirmed an inferior cyclodialysis cleft extending 4 clock hours. The patient was started on topical atropine (twice daily) and oral corticos- teroids. At the 5-day follow-up, BCVA improved to 0.7, IOP increased to 12 mmHg, and the cyclodialysis cleft and macular folds showed signs of resolu- tion. The patient was subsequently lost to follow-up. Conclusion: Cyclodialysis is a serious and potentially sight-threatening com- plication of blunt ocular trauma. Prompt diagnosis is essential to initiate medi- cal treatment aimed at restoring IOP and preventing long-term visual impair- ment. In cases where medical management fails, timely surgical intervention may be necessary to achieve complete resolution. ISOT02-7 Management of traumatic hyphema in hemophilia A I. Omari1, K. Selmani1, A. Hammouche1, R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953 Casablanca, Ophtalmology Adult, Casablanca, Morocco Purpose: To describe a case of traumatic hyphema in a patient with Hemo- energy explosive injuries resulted primarily from missile attacks, bombings, philia A. mine explosions, and drone attacks. Conclusions: Eye injuries related to the war in Ukraine are predominantly severe, combined, and multiple. Their management is highly challenging, requiring a multi-stage, multidisciplinary approach and the use of advanced medical technologies for optimal outcomes. Case Presentation: A 20-year-old male with severe hemophilia A who pre- sented to our emergency room with a hyphema and increased intraocular pressure following blunt trauma to his left eye. Despite medical treatment, the elevated intraocular pressure and persistent hyphema prompted an early anterior chamber washout, accompanied by preoperative and postoperative ISOT02-6 Cyclodialysis-induced hypotony in a child after blunt ocular trauma - a case report D. Fortunato1, J. Mendes1, J. Garrido1, A. Rebelo1, A. Candeias1 1Hospital do Espírito Santo de Évora, Ophthalmology, Évora, Portugal factor VIII replacement. The procedure was successful with no re-bleeding or complications during or after surgery. At one week later, the patient achieved 20/20 visual acuity, and his intraocular pressure remained normal. Conclusion: In patients with hemophilia A presenting with traumatic hyphe- ma and elevated intraocular pressure unresponsive to medical management, early surgical intervention with clot removal under rigorous factor VIII re- placement can be an effective treatment. Factor replacement should be continued in the early postoperative period to prevent re-bleeding. Purpose: Variations in intraocular pressure (IOP) and their consequences can happen in cases of blunt trauma to the eye and require prompt diagnosis and ISOT02-8 management. This diagnosis can be even more challenging in pediatric popu- lation given that monocular vision loss can remain unnoticed for a while. This case highlights the challenges faced in the presence of a cyclodialysis with hypotonic maculopathy after blunt trauma in a child that was undiagnosed for two weeks. Methods: Case report. Results: A 6-year-old male was referred to our ophthalmology emergency department by his general practitioner due to decreased visual acuity in the left eye, detected during a routine examination. Best-corrected visual acuity (BCVA) was counting fingers at 1 meter in the left eye. His mother reported a history of blunt trauma to the left eye with a stone two weeks earlier, which initially caused no visible injury or symptoms. On examination, pupils were isocoric and photoreactive. The anterior segment showed no Seidel sign and no evidence of a ruptured globe, but the anterior chamber was shallow, and IOP was 0 mmHg. Posterior segment evaluation revealed macular folds without retinal tears or detachment. Imaging ruled out The unexpected guardian: how an Artisan® lens deflected ocular injury S. Oliveira Machado1, N. Álvaro1, M. Castelo1, A. Silva1, R. Pereira1, M. Leuzinger-Dias1, L. Figueira1,2, V. Fernandes1 1University Hospital Center of São João, Ophthalmology, Porto, Portugal, 2MedinUP, Porto, Portugal Introduction: Intraocular foreign bodies (IOFB) are a vision-threatening emergency requiring early diagnosis and management. The presence of an intraocular lens (IOL), such as an Artisan® lens, can change the trajectory and its clinical presentation. Materials and methods: We present a rare case of a 55-year-old male with an IOFB deflected by an Artisan® lens. We provide an orbital computed tomog- raphy (CT) scan, an anterior segment image, and surgical images to illustrate globe rupture and intraocular foreign body. the case. 252 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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Results: A 55-year-old male was admitted to the emergency department with a foreign body sensation in his left eye (OS) after hammering a nail. His oph- thalmologic past history included a pars plana vitrectomy in 2011 to extract an IOFB, followed by an Artisan® lens implantation and a penetrating kera- toplasty in 2012. The slit-lamp examination revealed a transmural laceration on the corneal graft, a positive Seidel test and disruption of the Artisan® lens. A non-contrast CT scan confirmed the presence of an IOFB in the OS. Since IOFB in the posterior segment could not be excluded, the patient received endophthalmitis prophylaxis. A contact lens was placed and he was admitted to the inpatient ward. Gentle gonioscopy identified a metallic IOFB lodged in the inferior iri- docorneal angle at the 6 o’clock position. Surgical extraction was performed five days later, using a 23-gauge foreign body forceps through a clear corneal incision. Conclusion: The presence of an IOL can lead to atypical presentations that may be overlooked in a standard slit-lamp examination. In this case, the Artisan® lens altered the IOFB trajectory, preventing deeper intraocular pen- etration. This case emphasizes the need of thorough ophthalmological evalu- ation, including gentle gonioscopy, in patients with implanted IOLs, while highlighting the need for increased awareness of occupational eye safety, par- ticularly in individuals with prior ocular trauma. ISOT ABSTRACT PRESENTATIONS ISOT ABSTRACT PRESENTATIONS Management of Posterior Segment Trauma ISOT03-1 Globe ruptures: visual outcomes and prognosis of more than 20 years of experience B. Barbosa Ribeiro1, A. Ferreira1,2, J. Coelho1, A. Meireles1 1Unidade Local de Saúde Santo António, Ophthalmology Department, Porto, Portugal, 2Faculty of Medicine - University of Porto, Anatomy Department, Porto, Portugal Purpose: Ocular trauma is an important cause of vision loss worldwide. It causes functional and economic burden and represents the most common cause of blindness in working-aged individuals. Ruptured globes occur via an inside-out mechanism secondary to impact from a blunt object. Our aim is to describe a large series of globe ruptures at a tertiary hospital, characterize visual outcomes and identify prognostic factors. Methods: Retrospective analysis of all patients treated for globe ruptures be- tween January 2003 and December 2024 at Unidade Local de Saúde Santo António, a tertiary hospital in Portugal. Demographic data, initial and final visual acuity, setting and mechanism of trauma were collected. Results: Three hundred and sixty-four eyes of 361 patients were included. The majority were males (70.6%), with a mean age of 60.9 ± 20.3 years. One hundred and ninety-six (57.5%) cases occurred in a domestic setting, and 149 (41.3%) happened due to falls. At the time of admission, 276 (80.7%) had visual acuity up to 4/200, and 43 (12.6%) had no light perception. The me- dian time between trauma and primary repair was less than 8h (interquartile range 5-12 h). Final visual acuity was 20/40 in 44 eyes (13.3%). Multivariable analysis revealed male gender, shorter wound size, and absence of vitreous hemorrhage as independent predictors of vision survival. Conclusion: Most patients affected by globe ruptures are working-aged men. Male gender, short wound length, and the absence of vitreous hemorrhage or retinal detachment were identified as predictors of improved functional out- come. Prompt surgical repair renders useful visual acuity in a significant pro- portion of patients. Thus, all possible efforts should be made to improve visual acuity and enhance functional outcomes. ISOT03-2 Clinical features and endoscope assistant vitrectomy of seriously traumatized eyes without light perception combined with corneal blood stain Y. Xun1, S. Du1, Y.Y. Zha1 1Lixiang Eye Hospital of Soochow University, Surgical Retina, Suzhou, China Purpose: To evaluate the clinical features and the results of endoscope assis- tant vitrectomy (EAV) of seriously traumatized eyes without light perception combined with corneal blood staining. Methods: Twenty-three severely traumatized eyes with corneal blood staining and non-light perception underwent EAV. Of them, 21 eyes combined with retinal detachment, 2 eyes combined with corneal laceration. The average in- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 253

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ISOT ABSTRACT PRESENTATIONS terval between injury to EAV was 20.43 days (5-64 days). The preoperative visual acuity was non-light perception in all injured eyes with the mean in- traocular pressure of 9.9mm Hg (2-37.4 mm Hg). The mean follow-up period was 8.62 months (0.1-45 months)฀ Results: The postoperative visual acuity was significantly better than the pre- operative one (p<0.05) and better than light perception in 13 eyes with the best corrected visual acuity to 0.7. The retina was attached in 10 eyes (10/21). The mean postoperative intraocular pressure was 12.50 mm Hg (5-24mm Hg). Conclusion: Vitrectomy under endoscope is a safe and effective method in timely treating severe ocular trauma with corneal blood stain and no light per- ception. ISOT03-3 A novel device to maintain and even restore the intraocular pressure and axial length in (pre) phthisical eyes X. Yang1, S. Du1, Y.Y. Zha1 1Lixiang eye hospital of Soochow University, Surgical Retina, Suzhou City, China Purpose: To evaluate the clinical effect of a constant-pressure silicone-oil in- jection device (COPSOID) after vitrectomy in patients with, or at high risk developing, phthisis following severe ocular trauma. Methods: In this prospective study, seven eyes of seven patients were treat- ed at the Lixiang Eye Hospital of Soochow University between November 2022 and September 2023. All eyes had retinal detachment, in three eyes combined with choroidal detachment. Four eyes were already phthisical at presentation. ISOT03-4 Surgical strategies for intraocular foreign body removal in combat-related trauma I. Kolomiets1, J. Smishko1, V. Serdiuk1, S. Ustymenko1 1Dnipro State Clinical Ophthalmologigal Hospital, Eye Microsurgery, Dnipro, Ukraine Purpose: To evaluate the most effective and safe surgical techniques for the removal of various intraocular foreign bodies (IOFBs), depending on their size, shape, material composition, particularly after war-related trauma. Methods: A comparative review of IOFB extraction techniques was per- formed, including magnetic extraction, aspiration systems, intraocular for- ceps, and loop devices. Each method was analyzed based on precision, safety, ease of use, and limitations. Results: • Magnetic extraction provides rapid retrieval of ferromagnetic IOFBs but carries a risk of collateral intraocular damage due to poor positional control. • Aspiration systems offer safe removal of small and lightweight IOFBs but require complementary instruments. • Intraocular forceps allow precise handling and controlled extraction but face challenges with smooth-surfaced or large IOFBs. • Loop devices (e.g., ZEISS miLOOP, memory snare) provide a stable grip for large and smooth IOFBs but are technically demanding and require suf- ficient surgical expertise. Conclusions: Selecting the appropriate IOFB removal technique depends on the object‘s material, size, and location. Magnetic extraction remains optimal for ferromagnetic IOFBs, while loop devices provide superior handling for smooth and large foreign bodies. Aspiration systems reduce retinal trauma but require additional fixation tools. ILM forceps enhance precision and sta- bility. A tailored surgical approach minimizes intraocular complications and All patients underwent endoscope-assisted vitrectomy, and a COPSOID was improves surgical outcomes. employed to continously inject silicone oil into the eye for 3 to 5 days postop- eratively. Monitored were the visual acuity, intraocular pressure (IOP), axial length (AL), volume of silicone oil implanted intraoperatively, and any signs of complications. The final follow-up was at 3 months after surgery. Results: The mean preoperative IOP was (5.43±2.23) mmHg, the mean IOP at 3 months (14.09±2.28) mmHg. The mean preoperative AL was (20.88±0.92) mm; at 3 months the AL was (24.31±0.69) mm. The mean preoperative eyeball volume was (4.37±0.49) cm3; at 3 months postoperatively it was (6.99±0.49) cm3. All three variables showed a statistically significant improvement (p<0.05) in each eye, including those with preoperative phthisis. The retina remained attached in all seven eyes and all three eyes with no light perception preoperative vision improved. The mean silicone oil volume in- jected intraoperatively was (4.09±0.47) ml, to which the COPSOID added another 1.26±0.60 ml. No complications due to COPSOID were encountered. Conclusion: For phthisical eyes and for those at high risk, COPSOID offers IOP restoration while preserving or even increasing the eyeball’s AL and thus volume. In this small series COPSOID use has not been associated with any complications, and patients appear to tolerate the inconveniece of temporarily wearing the device. ISOT03-5 Strategies of management of war-related penetrating eye trauma with IOFB and VA less than HM during full-scale Russian invasion to Ukraine D. Dikunova1 1Kyiv City Hospital №4, Ophthalmology and Ocular Trauma, Kyiv, Ukraine Purpose: To determine prognostic factors for functional recovery and opti- mise the clinical and surgical management strategy for delayed war-related eye injury with IOFB and the VA less than HM. Method: Retrospective analysis of war-related penetrating eye trauma cases with IOFB and severe vision loss. Results: A total of 25 eyes with war-related penetrating eye trauma with IOFB were analysed. The average age of victims was 35 years. All the cases had com- bined eye trauma with both anterior and posterior segment involved. In 20% of cases the primary repair was impossible at previous evacuation points. For 20% of cases VA was defined as NLP. Cases of active endophthalmitis and unrepair- able damage of ocular structures were excluded from the review. For all the 25 cases combined surgery including phacoemulsification of trau- matic cataract with IOL implantation and vitrectomy with IOFB removal with SO tamponade were performed. In 16% of cases temporary PFCL tamponade 254 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS was performed and exchanged for SO in two weeks. In 40% of cases more than 2 revision surgeries were performed. In all the cases significant improve- ment of BCVA was achieved. Topical and retrobulbar steroids were used for all the cases. In 48% of cases systemic steroids were prescribed according to the risks/presence of active PVR with noticeable deformation of intraocular structures.The criteria of rea- sonableness of reconstructive surgeries, appropriate surgical approaches and postoperative management were determined. Conclusion: In cases of open globe injury with IOFB absence of light percep- tion during the initial examination is not a predicting factor of no possibility of functional recovery. Main criteria for the reasonableness of reconstructive surgeries is the possibility of anatomical improvement of eye structures. For severe trauma cases with multiple eye structures damage postoperative in- flammation and PVR is present, which determines validity of use of systemic steroids as a PVR prevention. ISOT03-6 The impact of intraocular foreign bodies on vision: clinical insights and prognostic indicators D. Rodrigues1, A. Ferreira1,2, B. Ribeiro1, J. Coelho1, A. Meireles1,3 1Unidade Local de Saúde de Santo António, Ophthalmology, Porto, Portugal, 2Faculty of Medicine of the University of Porto, Porto, Portugal, 3Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, Ophthalmology, Porto, Portugal Purpose: With this study we aimed to evaluate the clinical presentation of patients with intraocular foreign bodies (IOFB) and to identify prognostic fac- tors influencing visual outcomes. Methods: A retrospective review was conducted on medical records of pa- tients who underwent surgery for IOFB at a tertiary center between 2003 and 2024. Results: A total of 197 eyes were included. The majority were adult males (90.9%) of working age (18-64 years old). The crystalline lens was envoled in 48.2% of phakic patients and 23 eyes (11.8%) developed retinal detachment. Endophthalmitis was present in nineteen eyes (9.9%). Most IOFBs (75.6%) were metallic and entered the eye primarily through the cornea (68.4%). The median time to the first procedure was 1 day (IQR: 0-2), with 56.4% of IOFBs removed during this initial intervention. Pars plana vitrectomy was performed during the first procedure in 77 eyes. (40.5%). After performing a linear regression analysis, the single most important predic- tor of good final visual acuity (VA) was initial VA (β=0.506; p<0.001). Taken together, good initial VA, absence of hyphema, and absence of retinal detach- ment were the strongest predictors of final good VA (β=0.662; p<0.038). Conclusions: Open-globe injuries with intraocular foreign bodies (IOFBs) primarily affect working-age individuals, leading to significant social and eco- nomic burdens. Early intervention, along with factors like good initial visual ISOT03-7 Technique of posterior segment reconstruction of perforations or severe ruptures W.F Schrader1 1Augenzentrum Wuerzburg / Rotkreuzklinik, Ophthalmology, Würzburg, Germany If an experienced retinal surgeon is available, surgical wound closure can be combined primarily with internal reconstruction. If a retinal surgeon is not avail- able or is not able to carry out an operation lasting several hours late in the even- ing, wound closure is performed and internal reconstruction is carried out by an experienced trauma surgeon within 100 hours for the serious injuries. The incarcerated retina has to be removed using retinotomy and retinectomy. The retina and choroid are coagulated vigorously using endodiathermy about 1 mm away from the incarceration. The retina and choroid lying between the diathermy bar and the incarcerated retina are excised. Under perfluorocarbon liquid, the retinectomy wound is surrounded by 3 laser rows and an “endolaser cerclage” is added equatorially in 3 – 5 rows. The perfluorodecalin is replaced with long-chain silicone oil. Such a combined surgical procedure may be time- consuming (2.5 - 3.5 hours, even for an experienced surgeon). It is manda- tory that the surgeon providing the treatment is experienced in all areas of the eye with complicated situations. While the high demands on qualified trauma surgery used to be met primarily through the teamwork of several subspecial- ists, today some posterior segment specialists are also able to master difficult anterior segment procedures and carry out so-called “pole to pole surgery”. Since a primary vitrectomy usually cannot be offered around the clock even at specialized trauma centers, Kuhn and Schrader developed a concept for a more pragmatic approach that, on the one hand, follows the idea of act- ing before proliferative vitreoretinopathy with adhesions, retinal detachments and traction folds can develop, in order to prevent the expected complications from vitreous body traction, bleeding or retinal incarceration, and on the other hand within a period of 100 hours after trauma. ISOT03-8 Choroidal and uveal trauma – management strategies A. Viestenz1, W. Schrader2, A. Viestenz1, A. Huth1, M. Stein1, T. Zenner1, J. Heichel1, F. Kuhn1 1University Halle-Wittenberg, Ophthalmology, Halle, Germany, 2Rotkreuzklinik, Ophthalmology, Würzburg, Germany Purpose: Ocular injuries may result in severe uveal, ciliary body (CB) dam- age leading to ocular hypotony and choroidal hematoma, choroidal detach- ment and retinal detachment. acuity and lens preservation, is crucial for better outcomes. Promoting safety Method: Based on the pathology of ocular injury the steps of uveal repair are measures and protective eyewear can help reduce the incidence and severity explained. of these preventable injuries. Resilts: Surgical results: In case of ocular hypotony due to CB clefts one sur- gical option is the direct cyclopexy. In combination with a retinal detachment, a surgical fixation of CB is required and a 20g infusion is helpful to avoid ad- ditional uveal damage during vitrectomy via 23 or 25g trocars. Choroidal de- tachment or suprachoroidal hemorrhage should be treated prior to vitrectomy using anterior chamber maintainer and a sclerotomy for drainage. In case of uveal rupture with an anteriorly floating uvea iris hooks may help for a first positioning and direct polypropylene sutures may fix the uvea. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 255

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ISOT ABSTRACT PRESENTATIONS Conclusion: Every trauma with uveal involvement needs a specific approach depending on surgical experience. With a refixation of CB or uvea it is pos- sible to stabilize the IOP and avoid silicone oil underfill in traumatic retinal detachment. ISOT03-9 our hospital on New Year’s Eve. Admission visual acuity (VA) was 1.3 (log- MAR). Bidaily evaluations showed no inflammatory or infectious signs until surgery was logistically possible on day 5 post admission. No additional intravitreal antibiotics were given. A PPV was performed with vitreous base shaving and traction removal before inducing posterior vitre- ous detachment and removal of IOFB tractions. Endolaser photocoagulation around the IOFB was made prior to IOFB mobilization, revealing a sub-IOFB retinal tear. The IOFB was removed with an external electromagnet via a pars plana superior sclerotomy. Mass ocular injuries from pellet guns: A 777-patient case series After full retinal peripheries inspection, endolaser was applied circumferen- tially to the entry-site retinal break. At 6-week evaluation, visual recovery was substantial (-0.08 logMAR), and retina was attached in all quadrants. Conclusion: Upon ocular trauma, prompt entry wound closure is crucial. In metallic IOFB cases, removal is critical, and close monitoring may be war- ranted until PPV can be performed. Systemic and topical antibiotics are es- sential. Although antibiotic intravitreal injections should be considered, close monitoring may suffice in trauma with low risk of endophthalmitis. Long term follow-up is advised for wound healing and cataract formation. S Natarajan1, M. Pathak1, S. Mahadik1, A. Sutar1 1Aditya Jyot Eye Hospital, Mumbai, India Purpose: To evaluate the frequency, clinical characteristics, and management of ocular injuries caused by pellet guns during a 4-month protest period in the Kashmir region. Methods: A retrospective analysis was conducted on medical records of 777 patients admitted to a tertiary care center in Srinagar, India, between July and November 2016 for pellet gun-related eye injuries. Data collected included demographic profiles, clinical examination findings, imaging results (CT and B-scan ultrasonography), emergency treatment measures, and follow-up man- agement. Results: The mean age of affected individuals was 22.3 ± 7.2 years, with 97.7% being male. Unilateral eye involvement was observed in 94.3% of pa- tients, while 5.7% had injuries in both eyes. Open globe injuries were pre- dominant, seen in 76.3% of cases, with the remaining 23.7% presenting with closed globe injuries. Surgical intervention was required in 67.7% of closed injuries and 91.1% of open globe injuries. Notably, 98.7% of surgical procedures were performed on the same day or the day following admission. Despite prompt treatment, visual outcomes were poor—82.4% of eyes had a final best-corrected visual acuity (BCVA) of counting fingers or worse. Conclusion: Pellet gun-induced ocular injuries during the unrest in Kashmir led to a high incidence of severe trauma, primarily open globe injuries. While timely surgical management was provided, long-term visual prognosis re- mained unfavorable for the majority of patients. ISOT03-10 Challenging intraocular foreign body requiring delayed pars plana vitrectomy: a case report J. Pargana1, B. Monteiro1, B. Dias1, A. Lima-Cabrita1, P. José1, D. Bernardo Matos1 1ULS Santa Maria, Ophthalmology, Lisbon, Portugal Purpose: To describe a case of penetrating ocular injury with intraocular for- eign body (IOFB) requiring a delayed pars plana vitrectomy (PPV). Case presentation: A 21-year-old man presented to the emergency depart- ment of another hospital with penetrating ocular trauma to his left eye with a metallic splinter following hammering earlier that day. Admission examina- tion revealed a zone III open globe injury with a 3mm nasal inferior scleral laceration with vitreous prolapse and retinal hemorrhage. Orbital computed tomography revealed a metallic IOFB. Ocular Trauma Score was 2. The patient received empirical antibiotics (including a single intravitreal dose) and scleral suturing was performed. He was then referred to 256 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS ISOT ABSTRACT PRESENTATIONS Management of Unique Trauma Cases ISOT04-KN1 Traumatic chorioretinopathies W.F Schrader1 1Augenzentrum Wuerzburg / Rotkreuzklinik, Ophthalmology, Würzburg, Germany Traumatic chorioretinopathy is defined as a disease of the retina and choroid caused by trauma. This can be caused by a contusion or a sharp injury and therefore takes different courses. Blunt trauma may cause sclopetarian retinopathy, further choroidal rupture; and in a broader sense, it can also include Berlin edema (Commotio Retinae), traumatic macular hole and post-traumatic central serous chorioretinopathy. A sharp injury to the bulb wall triggers a wound healing process, which, if left untreated, can trigger a severe scar reaction in the form of proliferative vitreoretinopathy. If you analyse the underlying pathophysiological processes, you can deduce how you can largely limit the consequences of trauma: In the initial phase, soluble inflammatory mediators and cytokines are re- leased, the vessels dilate, vascular permability increases (maximum after 3-4 hours), plasma components exude into the wound area, the coagulation cas- cade is set in motion, fibrin and fibronectin form a clot in the wound area, which in turn attracts fibroblasts. The fibroblasts attracted to the wound area proliferate at a maximum 3-5 days after the trauma and transform into myofibroblasts. These synthesize and se- crete a series of extracellular matrix molecules that make up the framework of a scar matrix. Collagen synthesis begins as early as 24 hours after the trauma, reaches a maximum after 1 week and drops again after almost 2 weeks. At the same time, enzymes are also formed that can break down and restructure the matrix formed (especially metalloproteinases). The myofibroblasts are also able to trigger wound contraction to close larger defects. ISOT04-1 Clinical case: Traumatic dislocation of the eye globe into the maxillary sinus Y. Sirman1, Y. Koshelieva1, I. Osypchuk1 1Bukovinian state medical university, Chernivtsi, Ukraine A 68-year-old woman was brought to the reception department on August 31, 2024, with an eye injury. It is known from the anamnesis that on the same day at around 12:00 o‘clock in the garden she ran into a tree branch. Status ophthalmicus: VOD –is not defined VOS – 0.6 IOP -is not defined / 18 mm Hg. ОD -subcutaneous hematoma and swelling of the periorbital area and eyelids, the conjunctival cavity is hyperemic, swollen, funnel-shaped and retracted downward, the eyeball is not visualized. OS -calm, anterior segment clear, anterior chamber - medium depth, wet - transparent, iris unchanged in color and pattern, pupil up to 3.0 mm in diam- eter, photo-reactive, lens - partially cloudy, isolated floating opacities in the vitreous body. Fundus: optic discus pale-pink, clear borders, a:v=1:3, Salus ІІ-ІІІ, angiosclerosis, central reflexes are preserved. CT signs of displaced fractures of the right facial bones, dislocation of the right eyeball, hemosinus, an edema, infiltration and emphysema of the sur- rounding soft tissues, decreased density in the right frontal lobe (an area of a bruise / post-ischemic cystic-gliotic manifestations / arachnoid cyst of the Sylvian fissure?). 02.09.2024, surgical treatment was carried out by ophthalmic surgeons and ENT surgeons: Caldwell-Luc right maxillary sinusotomy with elevation and fixation of the eyeball. Status ophthalmicus on the third day after surgery: VOD – 0.2. VOS – 0.6. IOP - 19/ 18 mm Hg. ОD- irritated, mobility of the eyeball is preserved upwards and partially downwards, sutures on the conjunctiva, swelling and erosions of the cornea, the anterior chamber is of medium depth, aqueous is clear, the iris is unchanged in color and pattern, the pupil is up to 3.0 mm in diameter, photo- reactive, the lens is partially cloudy, single floating opacities in the vitreous body. Fundus under the fleur: optic discus pale pink, clear borders, a:v=1:3, Salus II-III, angiosclerosis, central reflexes preserved. ISOT04-2 Jingle bombs J. Valaskova1 1Comenius University, Department of ophtalmology, Bratislava, Slovakia In our case report, we describe the case of a 15-year-old boy with a bilateral contusion-thermal-perforation injury after an explosion of fireworks. The day before Christmas Eve, a 15-year-old boy with a two days history of injury was admitted to the clinic. He and a friend set off a firecracker that exploded when he handled it. On the day of the injury, he was treated at the local surgical department and sent to the nearest eye department, where the anterior segment of both eyes was treated, numerous translucent plastic frag- ments were found in the corneas. On the first day after the injury, he came for a check-up with significantly worse visual acuity and subjectively pain in both eyes. The patient was offered hospitalization, which the father refused. On the second day after the injury, he stopped seeing the light in his right eye and in his left eye was with hand movement, with the development of endoph- thalmitis bilaterally and so he came to our workplace. The condition required immediate local surgical treatment of both eyes with total intravenous administration of a double combination of ATB. The left eye surgery via 23-gauge pars plana vitrectomy, with lensectomy and implantation of silicone oil, the right eye surgery with autokeratoplasty, lensectomy and im- plantation of silicone oil. Two months after, a second surgery was performed on the left eye, silicone oil removal and the implantation of an artificial lens. Two months after this surgery, the patient has 100% visual acuity in the left eye and a photosensitivity in the right eye. Conclusion: Is visual acuity really a predictive factor of the resulting visual acuity? What type of artificial lens and type of implantation is best suited for pediatric trauma patients? How to approach an atrophic bulb after an injury in a child? Can we consider enucleation of a severely damaged eye after trauma as a prevention of sympathetic ophthalmia? When is it appropriate to stop topical treatment after such damage? Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 257

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ISOT ABSTRACT PRESENTATIONS ISOT04-3 Comprehensive Surgical Management of Car Battery Explosion-related Ocular Trauma in a 77-Year-Old Patient: A Case Report A. Morkūnaitė1,2, E. Puodžiuvienė1,2, M. Špečkauskas1,2, L. Šemeklis1,2 1Lithuanian University of Health Sciences, Medical Academy, Department of Ophthalmology, Kaunas, Lithuania, 2Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Ophthalmology, Kaunas, Lithuania The best-corrected visual acuity (BCVA) at admission was 0.12 eccentric. The OCT showed the full-thickness macular hole with a 534-μm diameter. After uneventful surgery, macular hole was closed, achieving postoperative BCVA of 0.25 at 1 month. Hence, we demonstrate that although rarely, even brief high-intensity light exposure can cause full-thickness macular hole. Such a case was success- fully managed with vitrectomy and ILM double flap technique. Consequently, wearing protective equipment during potential light exposure by military per- sonnel is essential to prevent such injuries. Introduction: Car battery explosion-related ocular injuries are rare and com- plex, often requiring specialized interventions to restore structural integrity ISOT04-5 Long-term outcomes of pars-planum vitrectomy in patients with Chorioretinitis Sclopetaria due to blast ocular trauma N. Ulianova1, O. Sidak-Petretska1, N. Bondar1 1State Institution «The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine», Post-Traumatic Eye Pathology Department, Odesa, Ukraine Purpose: To analyse the long-term anatomical and functional results of pars plana vitrectomy in patients with Chorioretinitis Sclopetaria caused by severe blast ocular trauma. Methods: This retrospective, observational study involved 25 cases of pars plana vitrectomy in Chorioretinitis Sclopetaria following blast ocular trauma. The best-corrected visual acuity, retinal reattachment were studied. The total follow-up period for patients was 52 weeks. Data were analysed using quan- titative and categorical correlation analysis, as well as by analysing logistic regression models. Results: Post-op best-corrected visual acuity improved in 19 patients (76%), remained unchanged in 5 (20%). In 1 patient (4%) best-corrected visual acuity deteriorated due to the development of traumatic optic neuropathy. Retinal detachment was noted in 13 patients, while a macular hole was present in 5 pa- tients. In 2 cases, both retinal detachment and macular hole were diagnosed si- multaneously. After pars plana vitrectomy, retinal reattachment was achieved in 24 patients (96%). In one case, reattachment was unsuccessful. The locali- zation of Chorioretinitis Sclopetaria was significantly associated with the fi- nal best-corrected visual acuity, with the best surgical outcome observed in patients with Chorioretinitis Sclopetaria located in the inferior sector of the fundus (p < 0.05). The outcome of pars plana vitrectomy for Chorioretinitis Sclopetaria with concomitant retinal detachment is significantly better when the procedure is performed earlier following a blast injury. Conclusions: Chorioretinitis Sclopetaria following blast ocular trauma is characterized by a significant, persistent best-corrected visual acuity decreas- ing, a high frequency of vitreous haemorrhages, macular holes, and retinal detachment. Pars plana vitrectomy in Chorioretinitis Sclopetaria has shown considerable effectiveness in improving visual function, retinal reattachment, and macular hole closure for long time of observation. and visual function. Case presentation: A 77-year-old patient presented with ocular and perio- cular injuries following a car battery explosion. Visual acuity (VA) in both eyes was limited to light perception. Bilateral thermal injuries of the ocular surface were observed, along with clear corneas and visible Descemet’s mem- brane folds. Hyphema and traumatic mydriasis in both eyes, 90° iridodialysis at 9 o’clock in the left eye (LE), along with bilateral lens subluxation were noted. Fundus examination was partially obscured in the right eye (RE) and unassessable in the LE. Pars plana vitrectomy (PPV) together with lensectomy and iridodialysis repair using the hang-back technique were performed in the LE. One month later, retinal detachment from 5 to 2 o’clock with retinal dialy- sis from 9 to 11 o’clock were diagnosed in the RE. PPV with phacoemulsifica- tion, internal limiting membrane peeling, and circular laser photocoagulation, followed by expandable gas tamponade, were performed in the RE. Following gas resorption, retinal redetachment was observed in the RE on follow-up. The patient underwent PPV in the RE together with 5000 cSt silicone oil tam- ponade and pupilloplasty using two Siepser sliding knots to prevent silicone oil migration. Subsequent LE surgery included intraocular lens implantation and fixation using the Yamane technique, pupilloplasty using the cerclage technique, and iris defect repair using the single-pass four-throw technique. Currently, the patient’s VA is 20/200 in the RE and 20/32 in the LE. Conclusion: Multiple surgical interventions, including four iridoplasty tech- niques, along with careful postoperative monitoring, contributed to the pa- tient’s visual recovery. A comprehensive surgical strategy is essential for opti- mizing structural and functional outcomes in complex ocular traumas. ISOT04-4 Combat full-thickness macular hole due to high-intensity light exposure M. Umanets1, Y. Chumakov1 1State Institute „The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine“, Department of the Retina and Vitreous Pathology, Odesa, Ukraine We present a challenging unique case of a soldier with a macular hole induced by high-intensity light exposure after gazing at the spotlight of the air-defense system, which was treated with vitrectomy and internal limiting membrane (ILM) double flap. The macular hole was visualized and diagnosed using optical coherence to- mography (OCT). The surgery invovled 25-G vitrectomy, ILM double flap, and intraocular gas endotamponade (15% perfluoropropane) with postopera- tive face-down positioning. 258 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS ISOT04-6 A case of perforating hard metal orbital foreign body with a surprising and clinically relevant outcome E. Bertelli1 1Bolzano Regional General Hospital, Ophthalmology, Bolzano, Italy A 43-year-old male presented to our institution following ocular trauma caused by a metal foreign body (FB) to his right eye (RE), sustained while operating a circular saw. The injury occurred when a 7 mm fragment of the saw blade’s edge, composed of a hard metal alloy commonly used for processing tough materials, detached and struck his eye. Initial surgical intervention involved suturing a large corneoscleral wound and performing a partial lensectomy. On postoperative day 13, the patient underwent a 23G pars plana vitrectomy to address dense vitreous hemorrhage and lens remnants, followed by iris plas- tic sutures, endolaser, and silicone oil tamponade. The posterior perforating wound, located within the temporal vascular arcades, involved the optic nerve, resulting in a poor visual prognosis. Five months later, the patient had the silicone oil removed via pars plana. Subsequently, he reported mild right frontal headache and significant fatigue. A follow-up CT scan of the orbits revealed an orbital mass surrounding the perforating retrobulbar metal FB. Neurosurgical intervention for the orbital mass, via a frontoparietal approach, was performed at six months post-injury. The patient’s systemic and local symptoms resolved within weeks following surgery. The patient was followed for a total of 12 years and 4 months, with anatomical preservation of the eye. We propose that specific components of the hard metal alloy, particularly cobalt and tungsten, may have contributed to the aggressive clinical course observed, both locally and systemically. This case suggests that orbital foreign bodies composed of hard metals pose a higher risk for both local and systemic complications and should warrant more intensive monitoring and possibly a more aggressive therapeutic approach than typically indicated for standard metal orbital FBs in the literature. ISOT04-7 Features of the use of spherical orbital hydroxyapatite implants for evisceration of the eyeball after mine-explosive wounds Y. Chebotarov1, N. Ulianova2, O. Artyomov3, O. Pukhlik1 1State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine”, Ophthalmooncology, Odesa, Ukraine, 2State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine”, Post-Traumatic Eye Pathology, Odesa, Ukraine, 3State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine”, Pathomorphology, Odesa, Ukraine Purpose: The optimization of ocular globe prosthetics (OGP) formation dur- ing evisceration after mine-explosive wounds using hydroxyapatite orbital implants. Methods: The clinical part of the work is devoted to the study of the im- mediate and remote (up to 6 months) results of OGP formation in 44 patients after mine-explosive injury during evisceration with the use of hydroxyapatite implants. Results: There were 3 implant rejections during the observation period. In these 3 cases, after a rather short period of time - 2-3 weeks after the operation, the implant rejection began in the form of it pushing out of the scleral cavity. Examination of the scleral sac and orbital tissues in all cases revealed changes that were of the same type, apart from some minor pathomorphological de- tails. The nature of pathological changes in these 3 studied cases of implant rejec- tion can be assessed as chronic productive nonspecific inflammation of the granulomatous type, backgrounding of the fungal mycelium elements. Based on the clinical, microbiological and pathomorphological studies, the cause of the inflammatory process in the tissues of the orbit is not the material used for the implant. Conclusion: In our opinion, the short period of time after the injury, the pres- ence of foreign bodies in the tissues of the orbit (metal, plastic, glass, soil areas, etc.), fungal infection in the form of mycelium in the tissues of the orbit, which led to the inflammatory process and the implant extrusion, should be considered the cause of postoperative complications. In our opinion, if evisceration is urgently required for mine-explosive injuries, it is recommended to perform it without the use of implants, and to carry out secondary implantation after a certain time. ISOT04-8 Exploring computerized tomography findings and Ocular trauma Score in open globe injuries: assessing imaging‘s predictive value E. Karatas1, D. Özizmirliler2, C. Durmaz Engin3, M. Bariş4, E.A. Sari4, Z. Ayhan5 1Ağri Ibrahim Çeçen University, Ophthalmology, Ağri, Turkey, 2Dr. Nevruz Erez State Hospital, Iğdir, Turkey, 3Buca Seyfi Demirsoy Hospital, Izmir, Turkey, 4Dokuz Eylul University, Izmir, Turkey, 5Dokuz Eylul University, Ophthalmology, Izmir, Turkey Purpose: To investigate the relationship between computerized tomography (CT) findings and the Ocular Trauma Score (OTS) in patients with open globe injury (OGI) Method: This study included 123 individuals with OGI, examining injury characteristics, clinical symptoms, and CT scans for scleral irregularity, re- duced globe volume, lens displacement, aberrant vitreous density, chorioreti- nal thickening, and foreign body/air presence. The prognostic value of CT imaging in OGI was evaluated by assessing its relationship with OTS findings. Results: The most common OTS category was stage 3, found in 71 eyes (57.7%). The prevalent CT findings included severe scleral irregularity or globe collapse (34.1%), lens displacement (33.3%), and abnormal vitreous density (26.8%). Multivariate analysis revealed that severe scleral irregularity or globe collapse (Odds Ratio [OR] = 1.36, p = 0.006) and abnormal vitre- ous density (OR = 1.7, p < 0.001) were significantly associated with more advanced OTS stages (I or II), indicating more severe ocular trauma. The pres- ence of three CT findings was associated with a higher likelihood of falling into OTS stages I or II (OR = 6.82, p = 0.001). Conversely, the absence of CT findings was associated with a decreased probability of having more severe OTS stages (OR = 0.05, p < 0.001). Conclusion: The study concludes that imaging findings are valuable for cor- relating with the severity of open globe injuries, highlighting the importance of CT in assessing ocular trauma. 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ISOT ABSTRACT PRESENTATIONS ISOT04-9 A twenty-year retrospective epidemiologic study of ocular trauma in the north of Portugal L. Vilaverde1, A. Marta1, J. Coelho1, A. Meireles1,2 1Ophthalmology Department, Unidade Local de Saúde Santo António, Porto, Portugal, 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal Purpose: This study analyzed the epidemiology of ocular trauma in the emer- gency room of the Department of Ophthalmology of Unidade Local de Saúde Santo António, Oporto, Portugal. Furthermore, we aimed to recognize areas of prevention to reduce vision loss in patients. Method: A retrospective study of ocular trauma from January 2003 to December 2024 was performed and statistically analyzed. This study char- acterized the population by sex, age, type of injury, occupational accident, trauma characteristics, surgical approach, as well as initial and final visual acuities. Results: This study included 875 patients suffering ocular trauma. Men had a higher rate of ocular trauma than women (81% vs 19%). The mean age was 50 years old, higher in females than in males (61 vs 48 p<0.01). The main mechanism of trauma in men was contusion (38.9%) and in women was fall (43.5%). Men had a higher rate of occupational accidents (21.8% vs 3.1% p<0.01). The most common types of injury were rupture (34.3%) and penetrat- ing trauma (21.9%). Occupational accidents were responsible for 18.3% of injuries. Although, home was the main location of trauma (47.1%). Intraocular foreign bodies were found in 18,4% cases. The most frequent affected zone was III (60.1%), followed by II (28.8%) and I (9.1%). A total of 1.8% of cases required primary evisceration. A second surgery was performed in 54.5% of patients, a third in 22% and a fourth in 10.2%, with a mean surgery number of 1.97. In 8.5% of trauma the initial visual acuity (VA) was superior to 20/40 while in 6.1% no light perception (NLP) was found. In 41.7% of cases the final VA was superior to 20/40 while in 16% NLP was documented. Conclusion: This study presents insight into the epidemiology of ocular trau- ma in northern Portugal, helping in the development of prevention strategies. Home was identified as the most common site of trauma, highlighting the importance of protection both in the workplace and during hazardous activi- ties at home. ISOT ABSTRACT PRESENTATIONS ISOT Dry Lab Video Session ISOTV-1 Foreign body removal from the anterior chamber angle after explosive trauma Y. Galytska1, D. Zhaboiedov2, O. Parkhomenko3, S. Rykov1, P. Ivaniuta1 1Bogomolets National Medical University, Department of Ophthalmology and Optometry of the Postgraduate Education Institute, Kyiv, Ukraine, 2Bogomolets National Medical University, Department of Ophthalmology, Kyiv, Ukraine, 3Central Polyclinic of the Ministry of Internal Affairs of Ukraine, Ophthalmology Department, Kyiv, Ukraine Purpose: To describe a clinical case of successful foreign body removal from the anterior chamber angle after explosive trauma. Method: Male, 30 years old was admitted with complaints of worsening visual acuity in the right eye. Anamnesis 2 months ago, explosive trauma, 2nd degree burns of the neck and face, iridocyclitis. The patient was admitted with the results of computed tomography in the frontal and sagittal projec- tions - there was a X-ray contrast foreign body in the projection of the right eye socket. The examination revealed a best corrected visual acuity (BCVA) OD 0.5 and OS 1.0. The intraocular pressure (IOP) OD 26 mm Hg (uses a hypotensive drug (Dorzolamide) twice a day), OS 15 mm Hg. Objectively OD: the cornea is transparent, there is an entrance hole on the cornea at 3h, a metal foreign body is detected gonioscopically in ACA at 5h. Optical coherence tomography (OCT) of the anterior chamber (AC) at 5h was performed, which confirmed the presence of a penetrating corneal wound and foreign body fragment. The patient underwent topical intracameral anesthesia, two 1.0 mm paracentesis, injection of cohesive viscoelastic, and removal of the fragment from the ACA using a magnetic tool. Results: After the surgery, on the second day, the examination revealed BCVA of 1.0 in the right eye, IOP 16 mm Hg, which allowed to cancel the hypoten- sive therapy. To date, the patient has been followed up for 6 months after the surgery, and the patient has not had a recurrence of iridocyclitis during this time. Conclusion: Surgical removal of a metal foreign body from the ACA using a magnetic instrument allows for effective elimination of secondary complica- tions, including ophthalmic hypertension, metallosis with full restoration of visual function. This case emphasizes the importance of timely diagnosis and surgical intervention to preserve vision in patients after explosive trauma. 260 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS ISOTV-2 ISOTV-4 SALT combined with PKP for severe corneal burn A. Viestenz1, C. Rüger1, M. Burghardt1, J. Heinzelmann1, A. Viestenz1 1University Halle-Wittenberg, Ophthalmology, Halle, Germany Purpose: severe corneal burn may lead to corneal scarring, vascularization, limbal stem cell deficiency (LSCI) and blindness. Method: Several techniques to improve allogeneic limbal stem transplan- tation will be shown: with and without amniotic membrane transplantation Labyrinths of flange fixation: modified flange-fixation approaches for post-traumatic IOL dislocation D. Dikunova1 1Kyiv City Hospital №4, Ophthalmology and Ocular Trauma, Kyiv, Ukraine Purpose: To present the surgical techniques of flange fixation of different IOL types after its traumatic dislocations as the way to prevent explantation and (AMT). IOL exchange. Results: We demonstrate 5 cases of severe corneal burn treated with PKP, bevacizumab deposition, superficial allogeneic 360° limbal transplantation (SALT) with/without AMT and subconjunctival triamcinolone deposition. All cases showed an improved VA of more than 3 Snellen lines and integration of the SALTs. Conclusion: SALT combined with PKP is a promising and cost reducing therapy for severe corneal burn with LSCI and may avoid systemic immu- nosuppression. ISOTV-3 Management of MISSED “lime PLAQUE” M. Doctor1, S. Basu2 1L V Prasad Eye Institute, Ophthalmology, Visakhapatnam, India, 2L V Prasad Eye Institute, Hyderabad, India Method: ASPHINA ZEISS as an example on single-piece IOL with inappro- priate configuration for suture fixation was fixated by pinching the haptic parts of the IOL inside the eye with 30G needle and then fixating with 6-0 prolene suture in 2 points as loop and one extra point with putting one flange in IOL and opposite one in sclera. Another example is the hard posterior chamber lens, invented in S. Fyodorov Eye Microsurgery Federal State Institution ( Moscow) and defined as „T-26“ with specific haptic was fixated with 2 loops with 4 flanges. Results: Both surgeries went without complications and early and late post- operative follow up did not show severe inflammation. In both cases stable IOL positioning with minimal tilting was achieved. BCVA of first (ASPHINA) patient was 20/20 at the second day after surgery and stayed stable for the 1-year follow up. Induced astigmatism was -0.75. For second case BCVA at the second day after surgery was 20/70 bur increased to 20/25 during the first month and stayed stable for 1-year follow up. Induced astigmatism was -1.5 for this case. Conclusion: Modification of flange fixation brings the possibility that differ- ent IOL types could be fixated. Flange fixation can be more safe alternative to achieve the stable position of IOL after its dislocation than explantation Background: Ocular chemical injuries are one of the common ocular emer- and inserting another IOL, regarding the less induced astigmatism, no needs gencies. It has a potential to cause long term visual impairment which can be of extra corneal incision, less corneal endothelial damage and still successful prevented in most cases with an adequate acute stage management. results of IOL stability and BCVA improvement. Purpose: Here we present a case to portray the importance of a thorough ocular irrigation in the acute phase, consequences of inadequate management, and treatment method in the late stage. Synopsis: A 6-year-old male child had fall of lime in the left eye 2 months back. Ocular irrigation was performed locally. However, when he presented to us, he had a large plaque of lime retained superiorly underneath the upper eyelid. He was initially planned for plaque removal with Simple limbal epi- thelial transplantation. However, during the surgery, the plaque was noted to be adhered to the underlying scleral tissue, with scleral necrosis and prolapse of uveal content. Hence a corneal patch graft with conjunctival autograft was performed. Highlights: Ocular irrigation, while often a simple and underappreciated pro- cedure, plays a pivotal role in the early management of eye injuries. Its im- portance cannot be overstated, as it serves as the most crucial step in the acute phase, significantly influencing the overall prognosis by helping to mitigate further ocular damage. ISOTV-5 Simultaneous muraine sutures and excimer laser-assisted penetrating keratoplasty for trauma-induced acute keratoconus: a surgical video demonstration M. Burghardt1, A. Viestenz1, A. Viestenz1 1Martin-Luther-University Halle-Wittenberg, Ophthalmology, Halle (Saale), Germany Purpose: Acute keratoconus (AKC) is a severe and sight-threatening emer- gency, often triggered by chronic mechanical trauma, particularly exces- Delayed intervention, on the other hand, typically necessitates complex surgi- sive eye rubbing associated with atopic dermatitis (AD). The rupture of cal procedures that, when executed skillfully, can greatly improve the chances of preserving vision and enhancing visual outcomes in the long term. Hence an ophthalmologist should be aware and prepared with the options for man- Descemet’s membrane leads to acute corneal hydrops, resulting in profound stromal edema and significant visual impairment. Traditional conservative management requires months of recovery, delaying rehabilitation. This surgi- agement of chemical injury during the chronic phase. cal video presents a novel single-session technique combining Muraine su- tures and Excimer laser-assisted penetrating keratoplasty (PKP) to optimize visual outcomes and accelerate recovery. Method/surgical technique: The video demonstrates a step-by-step approach performed on patients with trauma-induced AKC. After deep stromal Muraine sutures are placed perpendicular to the Descemet’s rupture to stabilize cor- Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 261

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ISOT ABSTRACT PRESENTATIONS neal curvature, immediate Excimer laser-assisted PKP is performed, ensuring precise graft alignment and minimizing postoperative astigmatism. The video details intraoperative decision-making, surgical refinements, and postopera- tive management strategies. Results: The technique provides rapid visual rehabilitation, with postopera- tive BCVA improving from hand motion (logMAR 3.0) to logMAR 0.3 ± 0.09 (p < 0.001), and stable corneal grafts with a mean astigmatism of 2.6 ± 1.7 D at follow-up (20 ± 10 months). Conclusion: This video-based surgical demonstration highlights an effective trauma-targeted approach for AKC, particularly in AD patients. The simul- taneous use of Muraine sutures and Excimer laser-assisted PKP provides a structured and reproducible technique to restore corneal integrity, expedite ISOTV-8 Managing traumatic vitreous hemorrhage with giant retinal tear S. Natarajan1, D. Ketkar Pathak2 1Aditya Jyot Eye Hospital, Vitreo Retina Surgeon, Mumbai, India, 2Aditya Jyot Eye Hospital, Vitreo Retina Consultant, Mumbai, India 44 year male presented to us with history of trauma with pulling band, while exercising at home, patient had already undergone wound exploration with Repair elsewhere At presentation, Patient vision was PLPR in accurate in the recovery, and minimize long-term disability. right eye. ISOTV-6 De principio a fin J. Romero1 1Unidad Nacional de Oftalmología, Guatemala, Guatemala The video presents the initial ocular trauma, featuring a scleral rupture classified as OTS 2. Over a six-month follow-up period, the patient developed aniridia and retinal detachment. Subsequently, an intraocular lens with an iris prosthesis was implanted with scleral fixation. Later, a membrane peeling procedure was performed due to a tractional macular detachment. The patient initially had light perception (PL) and ultimately achieved a final visual acuity of 20/200. ISOTV-7 Removal of an intraocular foreign body with unexpected surprises W.F Schrader1 1Augenzentrum Wuerzburg / Rotkreuzklinik, Ophthalmology, Würzburg, Germany A 23 year old man was mowing the lawn, when he received an open globe injury. He presented with an irregular corneal wound, an iris incarceration and a defect in the temporal iris. Cristalline lens did not show an injury. Due to an intraocular hemorrhage, retina could not be inspected. CT exam reveiled an intraocular foreign body (IOFB) near the posterior pole. As the patient worked in an agricultural setting, risk of endophthalmiits was high. Therefore IOFB removal was planned within the initial procedure - together with would clo- sure. Following reposition of the incarcerated iris and corneal wound closure, the sclerotomies were prepared, when unexpectedly hypotony developed. A lens sparing vitrectomy was performed with peripheral identation. Inferiorly a retinal defect was shown, a hint to another impact site. The sclera was pre- pared up to the equator, and a second scleral perforation was exposed un- derneath the inferior rectus muscle. During the further vitrectomy, a second retinal impact site was found nasal to the optic disc. Finally the IOFB was detected in the temporal periphery. In conclusion, this case showed, that it is not sufficient, to follow the path from the corneal wound to the final location of the IOFB, even it seems to be plausible at first glance. It is necessary to inspect the sclera externally and the complete retinal internally to find or exclude further impact sites. On examination, Media was hazy, and there was no view of the retina. We did a BSC scan, which was suggestive of total retinal detachment with victorious hemorrhage, patient was planned for VR surgery. Ineuron vitreous hemorrhage with a giant retinal tear was noted with PVR changes. Hemorrhage was cleared and vitrectomy was completed. PFCL was injected to stabilize the posterior pole. Endo laser was done. Silicon oil was injected post operatively patient vision improved to hand movements. ISOTV-9 Open-sky removal of a giant intraocular metalic foreign body with eyeball rupture: A case report H. Suh1, B.E. Hwang1, S.H. Chung1, Y.H. Park1, S.Y. Hong1 1Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Ophthalmology, Seoul, Korea, Republic of Purpose: To present a rare case of giant intraocular metallic foreign body removal using the open-sky technique combined with penetrating keratoplasty. Case Summary: A 22-year-old woman presented with an eyeball rupture af- ter her left eye was struck by a hot brass fragment while working on metal crafts. Upon arrival, an 8 mm burst-type full-thickness corneal laceration, 270° iridodialysis, and prolapse of the iris and uveal tissue were observed. Orbital computed tomography confirmed the presence of a round metallic for- eign body measuring approximately 5×5×3 mm inside the eye. Due to severe anterior segment damage, primary closure was initially per- formed. A pars plana vitrectomy was subsequently attempted to remove the in- traocular foreign body. However, the foreign body was large, cylindrical, and adherent to the retina, making it difficult to grasp within the eye. Furthermore, because of its metallic nature, fragmentation was completely impossible. Given these factors, removal through a corneoscleral incision was not feasible. Therefore, we chose to perform the open-sky technique in conjunction with penetrating keratoplasty. After securing a Flieringa ring, an infusion port was placed via sclerotomy to maintain intraocular stability. Corneal trephination was performed, and a temporary corneal graft was sutured in place. Once the exact location of the foreign body was confirmed, the cornea was reopened, and the foreign body was successfully extracted in the open-sky state. The procedure was completed with penetrating keratoplasty using a donor cornea and silicone oil injection. Conclusion: The open-sky technique combined with penetrating keratoplasty offers an effective approach for removing large intraocular metallic foreign bodies that are challenging to extract through standardized methods. This technique provides a wide surgical field, facilitating safer and more controlled removal while allowing for concurrent corneal reconstruction. 262 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS 2 clock hours to 10 clock hours along the superior limbus, as well as extended posteriorly on the lateral and medial ends, centrifugally for about 6-7mm. The Intraocular lens from the posterior chamber had expulsed and was found lying under the subconjunctival space superotemporally. In this video presentation we will discuss about the mechanisms of scleral tears, associated intraocular injuries and a systematic and strategical approach towards evaluation and management of scleral tears. We will also demonstrat- ed the surgical management of this case with an intraoperative video. The aim of this presentation is to outline a methodological approach towards effective and efficient management of scleral tears. ISOTV-10 Glass Onion – The LP Eye: Treatment of a penetrating injury with intraocular foreign bodies H.M. Stein1, A. Viestenz1 1University Clinic Halle, Ophthalmology, Halle (Saale), Germany Purpose: Penetrating or perforating injuries to the eye globe especially those with intraocular foreign bodies (IOFBs) remain a challenging situation even for advanced ocular trauma surgeons. Presenting a case of a very severe pen- etrating injury with remaining intraocular glass particles, we aim to highlight the different challenges presented when treating such an injury. Furthermore, an attempt to restore vision above a vestigial level, caused by permanent dam- ages from the IOFBs, is to be shown. Method: The mechanism of injury, clinical findings, course of treatment and the clinical outcome of a 47-year-old men who fell onto his glass of wine is presented in this video. Results: The patient was administered to our clinic with a visual acuity in the injured eye of light perception. Ultrasound examination showed intraocular hemorrhage and retinal detachment. In a first surgery all of the IOFBs could be retrieved from the globe and the retina reattached. Postoperative BCVA was 1.0 log Mar. One of the IOFBs had perforated the temporal raphe causing a wide macular hole. In a second surgery an inner limiting membrane-flap was folded over the macular hole and placed with fibrin adhesive. To date outer retinal regeneration is slowly progressing, reducing the size of the macular hole. BCVA is 0.8 log Mar. Conclusions: With the presentation of this case we want to point out the main goal of ocular trauma surgery, never to give up before even trying. Treatment of complicated globe injuries should be undertaken in specialized ocular trauma centers and performed by experienced ocular trauma surgeons. Even then, treating these injuries is challenging. In addition, permanent globe damages due to the IOFBs, such as macular holes, should be treated in a sec- ond attempt to try and restore the best possible visual outcome for the patient. ISOTV-11 A devastating Scleral rupture following blunt trauma A. Pawar1, S. Natha1, M. Mathai1 1Wrightington Wigan and Leigh NHS foundation trust, Ophthalmology, Wigan, United Kingdom Sclera is tough structure that coats and protects the vital inner layers of the eye besides providing a structural framework. Scleral ruptures are not uncommon following trauma and often necessitates a team approach involving multiple interventions that are required to stabilize the globe and restore function. In severe cases, although visual prognosis is poor, surgical closure and restora- tion of the globe structure can still be a challenging and a tedious job. Perforating scleral injuries usually result from penetrating injuries from sharp objects. A blunt forceful impact can also lead to scleral laceration resulting from the increased pressure within the closed globe causing sclera to give way at its weak points. This is a case of an elderly male who developed a major scleral laceration following a fall on the stairs with the impact of the edge of the stair on his right eye. He presented with a circumferential scleral laceration adjacent to the superior limbus, intact Cornea and a flat Anterior chamber with hyphema occluding any further view of the posterior segment. Vision was re- duced to perception of light. Upon surgical exploration the tear extended from Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 263

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ISOT ABSTRACT PRESENTATIONS ISOT ABSTRACT PRESENTATIONS Electronic Posters: ISOT EP-ISOT-03 Ocular injuries from fireworks over a period of 11 years. Evaluation of the University Hospital and Polyclinic for Ophthalmology Halle A. Huth1, L. Löffler1, A. Viestenz1 1Universitätsklinik und Poliklinik für Augenheilkunde Halle, Halle/Saale, Germany Purpose: Every year around New Year’s Eve severe eye injuries are caused by fireworks. There is a large variety from slight superficial injuries to very severe traumas, necessitating extensive or sometimes repeated surgical treat- ment. As a consequence the patients not only suffer from functional or cos- metical impairments, but also from socio-economic problems such as reduced capacity or inability for work. All firework-related eye-injuries treated at the University Hospital Halle from 2008 to 2018 were retrospectively and sys- tematically analyzed. Methods: The patients were analyzed with respect to age, gender, injury dis- tribution, type of injury, circumstances, form of treatment, consequences and duration of inability to work. Results: From the turn of the year 2008/2009 to 2018/2019 a total of 144 eyes of 116 patients were treated at the ophthalmology department of the University Hospital Halle. The injuries involved 80 male patients (69%) and 36 female patients (31%), among them 44 children (38%) aged under 18 years, 81 right and 63 left eyes. In 28 patients both eyes were affected). 44% of the patients handled the firework themselves and 56% were bystanders. Injuries were mostly caused by bangers (37%) and rockets (24%). 37 patients had to be hospitalized. 14 eyes needed immediate surgical treatment, 2 eyes needet surgery later on in irritation-free intervals and 12 eyes needed repeated surgery. The duration of inability to work was on average 21,6 days. 2 eyes went blind because of the firework-related injury and 29% of the patients had visual impairment of which 43% of them were classified as severe impair- ments. Conclusion: Firework-related injuries are preventable injuries. As in most cases children, young adults and bystander are affected, prophylactic and edu- cational programs are urgently needed and legal regulations are necessary Keywords: Bystander, Eye injury, Firework, New Year’s Eve,trauma EP-ISOT-04 Cyclopexy in post-traumatic and iatrogenic cyclodialysis T. Zenner1, M.E. Burghardt1, J. Heichel1, A. Viestenz1, A. Huth1, A. Viestenz1 1University Medicine Halle, Germany, Department of Ophthalmology, Halle, Germany Purpose: Ocular hypotension caused by cyclodialysis can be visually threat- ening due to various complications or even organ-threatening. Suitable treat- ment options must therefore be found. Methods: 13 eyes of 13 patients (6 - 81 years) with cyclodialysis and treat- ment by direct cyclopexy were examined. Visual acuity and intraocular pressure (IOP) were compared pre- and postop- eratively in the affected eyes. In addition, the preoperative local therapy, the extension of ciliary body cleft and the trauma mechanism were examined. Postoperatively, all patients received local therapy with steroids and cyclople- gics as well as systemic carbonic anhydrase inhibitors to prevent IOP peaks. Results: Cyclodialysis developed mostly post-traumatic after ocular contu- sion (n=7). Two cyclodialyses occurred iatrogenically after vitrectomy. The dialysis cleft was confirmed by gonioscopy or ultrasound biomicroscopy and extended over an average of 3 clock hours. Four eyes had received preoperative cycloplegics without therapeutic success. The preoperative IOP was on average 5.6 +/- 4.0 mmHg and increased post- operatively to 12 +/-4,5mmHg at the last visit. 11 eyes achieved normotony. While the mean visual acuity was preoperatively 1.2 logMAR it increased in the majority of eyes (n=8) to an average of 0.74 logMAR until the last visit. Conclusions: Cyclopexy was effective for the treatment of ciliary body clefts even larger than 2 clock hours. The IOP normalized postoperatively. As IOP can increase immediately after surgery, temporary treatment with systemic carbonic anhydrase inhibitors is useful. Although the visual prognosis is limited due to multiple comorbidities, we observed in most eyes an increase in visual acuity. EP-ISOT-06 Keratoplasty and trauma: navigating the challenges of post-traumatic dehiscence K. Selmani1, I. Omari1, H. Ouazzani Touhami1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Post-traumatic dehiscence is a rare condition that often nega- tively impacts the visual prognosis of grafted patients. It can occur after any penetrating keratoplasty, even following low-energy trauma. Objective: As a rare condition with a poor prognosis, the best prevention involves educating and informing patients who have undergone keratoplasty about the risks of trauma. Case report: We report the case of a patient with a history of keratoplasty in both eyes due to keratoconus. He was admitted urgently for a painful red left eye with decreased visual acuity following blunt trauma. Clinical examination revealed visual acuity limited to light perception, graft dislocation ranging from 2 to 8 o‘clock, and significant ocular hypotony. The patient underwent suturing of the dehiscence 20 hours after the trauma. The visual prognosis was guarded due to graft opacification and associated retinal detachment. Discussion: Post-traumatic dehiscences most frequently occur at the host- graft junction, which represents a zone of great fragility. Prognostic factors include graft viability and the presence of associated ocular injuries. Prompt and adequate management can improve the prognosis. Conclusion: Any trauma, regardless of its mechanism, risks compromising the anatomical and functional benefits of keratoplasty. The lack of specialized centers for managing corneal pathologies exacerbates the prognosis of these traumas in our context. 264 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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ISOT ABSTRACT PRESENTATIONS The patient received 3 intravitreal injections, topical and oral amphotericin B. 10 days after treatment, the patient underwent combined cataract surgery and vitrectomy. An improvement in visual acuity was noted one month later. Conclusions: In view of this case, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal anti-fungal which required longstanding antifungal treatment. EP-ISOT-10 Multiple surgical repair for severe ocular trauma - a case report S. Natarajan1, M. Ketkar Pathak2, S. Mahadik3, A. Sutar4 1Aditya Jyot Eye Hospital, Vitreo Retina Surgeon, Mumbai, India, 2Aditya Jyot Eye Hospital, Vitreo Retina, Mumbai, India, 3Aditya Jyot Eye Hospital, Optometrist, Mumbai, India, 4Aditya Jyot Eye Hospital, Diagnostic, Mumbai, India We wish to present a case report about a boy having a very bad eye injury. The patient is 7 years old boy, He was playing with TAG in school during physi- cal education period. All were running and playing Tag. Suddenly a girl head dashed on his glasses. His glasses broke and cut the eye on 5th April 2024 at 11.00 am. He underwent primary repair (wound exploration+ scleral tear repair+ corneal tear repair under GA on the same day.Right eye USG B scan done showed hyper reflective membranous echo seen attached to disc with sub membranous echoes with nasal incarceration, Likely Retinal detachment with sub retinal bleed. The patient was operated on 16th April 2024 by Dr. S. Natarajan, under GA. Vitrectomy completed. The retina was totally attached. Peripheral vitrectomy done under air. PFCL – OIL exchange done, densiron tamponade injected.360- degree laser done. Ports removed, cauterized. Conjunctiva secured with fibrin glue.On 30th April, the patient came for post-op checkup. on examination an- terior segment showed corneal sutures were in place. Cornea was clear tem- porally, Posterior segment examination by binocular indirect ophthalmoscope showed retina totally attached. A surgery was done again on June 27th, 2024. The retina was found completely detached and crumpled. Dr Elliot was successful in re-attaching the retina (some cutting of the retina was required). The patient developed a lot of scar- ring. The patient completed three doses of methotrexate every 2 weeks. The eye became small, and pressure dropped drastically. His tear ducts dried up as well. It was attributed to the methotrexate and as parents decided to stop the intervention.Another surgery was performed on November 29th at LV Prasad institute, Hyderabad. The retina is intact completely. The scar tissue was fine enough to peel off. However, the patient still has no vision in that eye. The pressure is around 7. However, the doctors at LV Prasad hospital trying the corneal transplant which may bring some vision. EP-ISOT-07 The value of anterior segment OCT in the management of paediatric corneal penetrating trauma: a case study C. Chatzipetrou1, K. Flindris1, E. Papafotiou1, E. Mylona1, A. Kaliardas1, I. Koumpoulis1, I. Melissourgos1 1General Hospital of Ioannina ‚‘G. Hatzikosta’, Department of Ophthalmology, Ioannina, Greece Purpose: Paediatric penetrating ocular trauma poses a significant risk to vi- sion, calling for careful evaluation and appropriate management. This case highlights the significance of anterior segment optical coherence tomography (OCT) in assessing such injuries. Case presentation: A 10-year-old male presented to the emergency depart- ment with an ocular injury caused by a plant spike. On examination, the visual acuity was limited to counting fingers and the anterior chamber was collapsed, with iris prolapse at the site of injury. No foreign body was discovered. The lens showed no signs of injury. Anterior segment OCT confirmed full-thickness corneal penetration without foreign body retention and provided critical insights into wound configura- tion and chamber dynamics, demonstrating the role of the iris in sealing the wound. A therapeutic soft contact lens was placed, and a pressure patch was applied. Re-evaluation 30 minutes later revealed rapid restoration of the an- terior chamber with the accumulation of aqueous humous. The patient was treated with topical and systemic antibiotics and was monitored for compli- cations. His visual acuity progressively improved to 10/10, with complete trauma healing. Discussion: This case highlights the rapid healing capacity of the paediatric eye following ocular trauma. The iris’ role in sealing corneal wounds, along with efficient aqueous humor production, contributes to spontaneous anterior chamber reformation. Anterior segment OCT plays a crucial role in evaluat- ing wound depth, ruling out hidden complications, and guiding conservative management. Recognizing these natural protective mechanisms and utilizing advanced imaging can help optimize non-surgical approaches in select cases of small penetrating ocular trauma, ultimately improving patient outcomes. EP-ISOT-09 Rare case of post-traumatic fungal endophthalmitis: a surprising diagnosis and successful treatment I. Omari1, K. Selmani2, A. Hammouche2, R. Bentouhami2, Y. Hidan2, A. Mchachi2, L. Benhmidoune2, R. Rachid2 1Hôpital 20 Août 1953 Casablanca, Ophtalmology Adult, Casablanca, Morocco, 2Hôpital 20 Août 1953 Casablanca, Casablanca, Morocco Background: To report an uncommun case of post traumatic fungal endoph- thalmitis due to Aspergius fumigatus. Methods: Case report. Results: A 74-year-old immunocompetent patient presents to the emergency department with a painful red eye and visual impairment following trauma from a palm thorn. Ophthalmological examination reveals a visual acuity of hand movements, a self-sealing punctate corneal wound, Seidel test negative, hypopyon in the anterior chamber, and post-traumatic cataract. Ultrasound showed an intravitreal organization. Fungal cultures, DNA sequencing and analysis of the vitreous sample confirmed Aspergillus fumigatus. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 265

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ISOT ABSTRACT PRESENTATIONS EP-ISOT-11 Traumatic optic neuropathy after a football collision: diagnosis and management of a case H. Ouazzani Touhami1, S. Layachi1, K. Selmani1, M.A. Hammouche1, M.R. Bentouhami1, Y. Hidan1, A. Mchachi1, L. Benhmidoune1, R. Rachid1 1Hôpital 20 Août 1953, CHU Ibn Rochd, Ophtalmologie Adulte, Casablanca, Morocco Introduction: Traumatic optic neuropathy (TON) is a rare but serious condi- tion that can lead to irreversible vision loss following cranial trauma. This article presents a case of indirect traumatic optic neuropathy after a football collision, aiming to describe the diagnostic process, treatment options, and the importance of prevention in contact sports. The injury occurs through a shock wave transmitted to the optic nerve, causing edema and ischemia without vis- ible bone damage. Case Report: A 24-year-old male football player presented to the emergency department after a head-on collision during a match. He experienced immedi- ate complete vision loss in his right eye. Clinical examination revealed nega- tive light perception (PL -) in the right eye, with no direct pupillary light re- flex, and an intact ocular globe. An MRI confirmed edema of the optic nerve, particularly in the intra-orbital and intra-canalicular regions, which led to the diagnosis of indirect traumatic optic neuropathy. Discussion: TON occurs when shock waves from trauma impair the optic nerve, leading to vascular and axonal damage. Diagnosis is made through: 1. Sudden vision loss, 2. Relative afferent pupillary defect (RAPD), 3. MRI evidence of optic nerve edema. In this case, the patient’s negative light perception indicated a severe optic nerve injury with a poor visual prognosis. Treatment options include: • Corticosteroids (methylprednisolone 1 g/day IV) to reduce swelling, though effectiveness remains unclear, • Surgical decompression in cases of bone compression, which was not ap- plicable here, • Ongoing ophthalmological monitoring to assess for any potential recovery. Conclusion: This case underscores the severity of traumatic optic neuropathy, the need for prompt diagnosis, and the limitations of current treatment options. It also emphasizes the importance of preventive measures in contact sports, such as better awareness of risks and the use of protective equipment. 266 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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AUTHOR INDEX Author Index The abbreviations after the authors’ names refer to Free Paper (FP), Rapid Fire (RF), Electronic Poster (EP) and ISOT Presentations (ISOT); an abbreviation of their topic; and the presentation number. Bold type denotes presenting author A Abdul Jawad, K. Abdul Karim, M.N. Abedi, N. Abegão Pinto, L. Abegão-Pinto, L. Abegg, M. Abelskyi, D. Abilheira, D. Abou Elezz, A.M. Abo Zeid, M. Abreu, A.C. Abroug, N. Abu Serhan, H. Abu-Zidan, F.M. Acerra, S. Achiron, A. Adamavičė, P. Adamski, W. Adan, A. Adan Ruiz, A. Adán Ruiz, A. Adil Shakor, Y. Affan, A. Afifi, Y. Agapitou, C. Agostini, H. Agrawal, R. Agudo, G. Ahmad, E. Ahmed, A. Ahmed, S. Ahmet, S. Aissani, M. Ait Baziz, S. Ajamil Rodanes, S. Akbari, M. Akbari, M.R. Akbas, Y.B. FP07-7 EP-GLA-36 EP-PED-24 EP-GLA-35, EP-GLA-51 EP-GLA-43 FP04-5 EP-REF-12 EP-PED-70 RF03-5 RF03-5, EP-COR-05 EP-REF-16 EP-RET-071 RF03-5, EP-COR-05, EP-RET-020, EP-RET-021, EP-RET-022 EP-EDU-09 EP-PED-04 EP-PED-29 EP-COR-28 EP-OPL-41, EP-OPL-42 RF07-7 EP-OCS-04 RF06-2 EP-PED-10 FP09-8, EP-PED-78 EP-UVE-26 EP-RET-128, EP-RET-129 ISOT02-3 ISOT01-7 FP03-10, EP-REF-19 EP-RET-020 EP-RET-020 EP-RET-020 FP03-9 RF06-8 EP-UVE-18, EP-UVE-23 EP-UVE-12 EP-PED-22 FP09-5, EP-PED-10 FP03-6 EP-COR-48 FP03-6 FP11-3 EP-GLA-38, EP-RET-063 FP08-8 EP-RET-020 RF08-5 RF10-7 EP-EDU-11 FP07-13, RF10-7, EP-RET-118 RF03-5 FP07-13 EP-UVE-12 EP-COR-02, EP-GLA-40, EP-NEO-01, EP-NEO-31, EP-OPL-38, EP-PED-14, EP-RET-009, EP-UVE-06 EP-RET-106 FP07-13, RF10-7, EP-OCS-23 EP-REF-12 RF10-7 FP07-13 Akegbe, E. Akgul, B. Akgün, D. Akhmedova, N. Akhundova, L. Akram, U. Aktaş, N. Alakeely, A. Al Ali, M. Alamoudi, A. Al Azzawi, M.A.D. Albadri, M. Alba Linero, C. Alcalde-Blanco, L. Aldabaibeh, D. Aldahlawi, A. Aldhaheri, H. Al-Dhibi, H. Aldihan, K. Aleson Cabrerizo, C. EP-PED-30 EP-OPL-39 Alexa, A.I. RF03-4, EP-OCS-25, Alexa, A.-I. EP-OPL-23, EP-OPL-37 EP-OCS-23, Alghamdi, S. EP-RET-118 FP09-5 Alghurab, A. EP-RET-022 Al Hashimi, M. EP-PED-35 Al -Hawasi, A. EP-PED-64 Ali, S. Alió, J.L. FP07-7 EP-RET-109 Al-Jahni, H. EP-OCS-23 Alkhathlan, M. EP-RET-106 Alkhawaldeh, M. EP-COR-05 Alkousheh, H. Allali, B. RF04-4, EP-GLA-39, EP-OCS-15, EP-PED-71, EP-RET-104 Allen, L. EP-PED-82 Allen, R.C. Allvin, K. Almahmoud, R. AlMahmoud, T. AlMansour, A. Almeida, C. Almeida, I. Almeida, J. Almufarraji, N. Almufarriji, N. Alnabihi, A. Alnahdi, W. Alnajjar, Z. AlNuaimi, G. Alonso-Barreiros, P. Alonso-Martín, B. Alqahrani, F. Alqurashi, M. Al-Rashdan, Y. Alsaif, A. Alshahwan, S. Al-Shami, K. Alsudais, A. Altalhi, A. Althauser, S. Altindis, B. Aluzri, H. Álvaro, N. Alves, D. Alves, N. Alves Ambrósio, J. Alves Pereira, S. Al-Wizni, A. Alzahrani, A. Alzahrani, Z. Amaral, D. Ambrósio, R. Ambrósio Júnior, R. RF03-5 EP-PED-64 EP-EDU-11 EP-EDU-09, EP-EDU-11, EP-REF-12 EP-RET-118 FP04-9 EP-COR-54 FP09-4, ISOT01-9 FP07-13 RF10-7 FP07-13, RF10-7, EP-OCS-23 EP-RET-118 EP-RET-106 EP-EDU-09 EP-NEO-01 EP-CAT-26, EP-PED-57 EP-RET-109 FP05-10 EP-RET-106 RF07-7 FP07-13 EP-RET-106 RF10-7 RF10-7 EP-RET-016 RF01-1 EP-GLA-42 ISOT02-8 FP06-8 FP10-8 FP07-1, RF05-5, RF07-6, EP-COR-54, EP-NEO-41, EP-ONC-07, EP-ONC-08, EP-PED-69 EP-NEO-18, EP-ONC-20 RF07-7 FP05-10, EP-RET-109 EP-OCS-23 FP09-2 EP-RET-043 EP-RET-057 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 267

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AUTHOR INDEX EP-CAT-04 EP-GLA-32 RF02-4 EP-PED-64 EP-NEO-27, EP-RET-003, EP-RET-078 EP-CAT-28 RF06-8, EP-RET-143 EP-PED-36 FP05-1, EP-GLA-41 FP05-9, EP-RET-005, EP-RET-007 EP-OPL-23 EP-RET-115 EP-GLA-43 EP-EDU-03 EP-COR-10 EP-COR-01, EP-COR-13, EP-OCS-02 RF05-2, EP-PED-13, EP-UVE-08 RF09-1 EP-COR-35 EP-PED-41 FP08-7 EP-PED-64 RF07-4 EP-UVE-12 An, S. Anastasopoulos, E. Ancian, P. Andersson Gronlund, M. EP-PED-24, Andonova, N. Angelou, M. Anguita, R. Anjos, R. Ansari, A.S. Ansari, S. Anton, N. Antonova, I. Aptel, F. Aquilina, M. Araki-sasaki, K. Araki-Sasaki, K. Arapi, I. Arbisser, L. Arêde, C. Arias Cabello, B. Arici, M. Aring, E. Ariturk, N. Arriola Villalobos, P. Arroyo San Victor, S. EP-NEO-31, EP-OPL-35 Arroyo-San Victor, S. EP-OPL-15 Arslan, F.F. Arslan, G.D. Artal, P. Artunay, H.O. Artunay, H.Ö. Artunay, O. Artunay, Ö. Artyomov, O. Asadi, M. Asena, L. Ashby, G. Asoklis, R. Atalay, K. Athanasiadou, A. Au, A.C.K. Aucoin, S. Aus, R. Awan, M. FP07-6, FP07-11, RF01-6, RF08-7, EP-CAT-27, EP-COR-34, EP-REF-03, EP-REF-04, EP-REF-07 EP-COR-29 EP-OCS-07 FP08-1, FP08-7 FP08-4 FP08-9 RF06-1 ISOT04-7 FP07-14 FP10-5 EP-PED-32 EP-COR-20 RF08-5 RF01-4, EP-COR-26 EP-COR-14 EP-CAT-07 EP-OPL-33 ISOT01-7 EP-RET-020 FP03-6 ISOT04-8 EP-RET-106 EP-NEO-38 EP-OCS-11 FP10-5 EP-PED-22 FP06-13, EP- FP07-2, FP07-16 Awan, M.A. Aydin, F.O. Ayhan, Z. Ayoub, M. Azenha, C. Aziza, Y. Azizagaoglu, B. Azizi, E. Azzagnuni, Y. UVE-27 Azzopardi, M. B EP-ONC-03 EP-RET-074 EP-GLA-73 EP-COL-05 ISOT02-4 EP-ONC-17, EP-PED-56 FP08-10 EP-RET-106 EP-CAT-28, EP-EDU-08 EP-RET-105 RF01-1 EP-PED-39 EP-OCS-11 FP07-4 EP-PED-27 ISOT01-6 RF06-6 EP-RET-057 EP-ONC-17, EP-PED-56 EP-PED-36 EP-GLA-50, ISOT01-6 EP-GLA-35, EP-GLA-51 FP07-5 ISOT03-1 FP07-5, EP-RET-024 Babkova, B. Bacq, N. Bae, H.W. Bagatin, F. Bajaj, R. Bajtl, D. Bakall, B. Baker, M. Balanikas, G. Balchev, G. Balci, A.S. Baldi, M. Ban, Y. Banjari, I. Banne, E. Baptista, B. Baptista, P. Baptista, P.M. Barać, J. Barão, C. Barão, R. Barata, A. Barbosa, I. Barbosa Ribeiro, B. Barbosa-Ribeiro, B. Barceló-Mendiguchia, A. EP-GLA-40 Bariş, M. Barras, T. Barrio Castellanos, M. Barrios, M. Barros Silva, P. Bartolo Khodjayeva, M. FP01-8 Barua, A. Bashrahil, B. Bastante Quijano, J. RF06-2, EP-OCS-04 Bastos, R. ISOT04-8 RF09-3 ISOT01-3 EP-RET-050 EP-PED-36 FP08-2, EP-COR-41, EP-REF-11 EP-OCS-23 FP05-4 EP-COR-39, EP-OCS-17, EP-OCS-18, EP-OCS-19, ISOTV-3 RF10-7 ISOT01-1 FP05-7 FP08-5 EP-ONC-10, EP-PED-17 EP-UVE-35 RF06-6 EP-PED-67 FP09-2 FP08-9 EP-REF-12 FP10-1 FP06-6 EP-COR-42 Basu, S. Batais, W. Battaglia, B. Baumane, K. Beato, J.N. Bechakh, I. Bednarski, M. Beirão, J. Belcheva, K. Belfort Jr, R. Belgin, S. Beliakouski, P. Belin, M. Ben brahim, E. Bendelic, E. Bengoa-Gonzalez, A. EP-GLA-19, EP-GLA-20, EP-OPL-02, EP-OPL-14, EP-OPL-15, EP-ONC-01, EP-ONC-02, EP-ONC-18 Bengoa González, A. EP-OPL-35 . Ben hadj khelifa, M. Benhmidoun, L. Bensaadi, C. Bentouhami, M.R. EP-OPL-01, EP-OPL-06, EP-OPL-19, EP-OPL-38 FP06-6 EP-NEO-39 EP-RET-097 EP-COR-36, EP-COR-45, EP-COR-52, EP-COR-53, EP-RET-117 EP-GLA-70, EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09, EP-ISOT-11 EP-UVE-18, EP-UVE-23 EP-COR-36, EP-COR-45, EP-COR-52, EP-COR-53, EP-GLA-70, EP-RET-117, EP-RET-147, EP-UVE-36, EP-ISOT-06, EP-ISOT-11 268 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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EP-RET-097, ISOT02-7, EP-ISOT-09 FP08-10 EP-OCS-07 EP-PED-24 FP09-3 Bentouhami, R. Berezow, A. Berg, M. Berg, S. Berk, A.T. Bermúdez Pío-Rendón, J. RF02-2 Bernardi, E. Bernardo, M. Bernardo Matos, D. Berpan, A. Bertelli, E. Bertelmann, E. Bertelsen, M. Bertuello, I. Bešlić, I. Beun, A. Bezdetko, P. Bezditko, P. Bhatt, U. Bielęda, G. Bîlba, R. Bilhoto, M. Bineva, L. Bin Ismail, M.A. Biousse, V. Biousse, V. Birch, D. Bitrian, E. Biuk, D. Blaikie, A. Blando, S. Blazhevska, S. Blázquez, D. Blezura-Udre, G. Bogdanici, C.M. Bogdanici, C.-M. Bogdanici, S.T. Bogocz, M. Bogoev, A. EP-EDU-07 Bohač, M. Böhringer, D. Bolintineanu, A.C. Bologna, C. Bompastor, P. Bonczek, M. Bondar, N. RF06-8 EP-UVE-29, EP-UVE-34 EP-RET-030, ISOT03-10 FP02-5 ISOT04-6 RF02-2 RF06-5 FP06-5, EP-EXE-02 EP-OPL-05 EP-UVE-27 EP-RET-090 EP-RET-093 EP-CAT-05 EP-ONC-06 EP-EDU-12 EP-CAT-32 EP-PED-23, EP-PED-59, EP-RET-003 EP-EDU-02 RF02-4 FP11-1 FP08-10 EP-GLA-67 EP-ONC-17, EP-PED-56 RF10-5 RF02-4 EP-REF-01, EP-REF-14 EP-PED-66 FP05-7 RF03-4, EP-NEO-46, EP-OCS-25, EP-OPL-37, EP-OPL-39 EP-COL-02 EP-COL-02 EP-GLA-57 RF08-4, EP-REF-01, EP-REF-14 ISOT02-3 EP-GLA-30 EP-OPL-30 EP-PED-70 EP-RET-132 EP-RET-081, ISOT04-5 EP-EXE-03 EP-GLA-37, EP-UVE-35 EP-COR-57, EP-GLA-56 FP10-7 FP10-8 FP10-9 Boneva, Y. Boninska, K. Bonzano, C. Book, B. Borges Lopes, P. Borroni, D. Bortolozzo-Gleich, H. EP-NEO-43 Boschetti, E. Bosso, H. Bouajina, S. Bouayed, S. Bouderka, O. Bouderka, S. Bourges, J.L. Boysen, K. Bozic, M. Bragança, F. Brissos, J. Brito, C. Brockmann, C. Bruxelas, C. Bulut, E. Bunagan, G. Burghardt, M. Burghardt, M.E. Burgić, S.S. Burke, T. Butrimas, G. Byström, B. Byszewska, A. RF02-4 EP-NEO-30 EP-NEO-39 EP-UVE-18, EP-UVE-23 EP-GLA-39, EP-RET-097 RF04-4, EP-COR-45, EP-GLA-39, EP-OCS-15, EP-PED-71, EP-RET-097, EP-RET-104 RF01-3 RF06-5 EP-GLA-63, EP-GLA-64 RF06-6 EP-RET-042 EP-GLA-35 FP06-9 RF02-5 EP-COR-29 RF03-1 ISOTV-2, ISOTV-5 ISOT01-10, EP-ISOT-04 EP-NEO-04 EP-UVE-07 EP-CAT-22 EP-COR-06 EP-RET-096, EP-UVE-32 C Cabral, C. Cabrera-aguas, M. Cabrita, A. Cai, F.-m. Çakir, B. Cakir, I. Calvão Santos, G. Calvão-Santos, G. Camkova, D. Campanilho Marques, R. EP-GLA-50 EP-COR-48 EP-COR-15 ISOT01-6 FP02-7 FP11-3 EP-NEO-06, EP-NEO-37 EP-RET-125 EP-RET-127 EP-CAT-17 AUTHOR INDEX RF06-2, EP-OCS-04, ISOT01-3 RF06-2, EP-OCS-04, ISOT01-3 FP03-10, EP-REF-19 EP-CAT-26 ISOT02-6 FP07-14 EP-NEO-01, EP-NEO-36, EP-RET-068, EP-RET-108 RF02-4 EP-RET-050 RF05-5, RF07-6, EP-COR-54, EP-ONC-07 FP07-1, EP-PED-69 FP04-4, FP11-1, RF02-4, EP-NEO-15 Campo Beamud, C. Campo Beamud, E. Campos, N. Cañas-Zamarra, I. Candeias, A. Caner, A. Cano Gonzalez-Barcia, B. EP-OPL-35 Caporali, L. Cárdenas, A. Cardoso Teixeira, P. Carelli, V. Carlos Carricondo, P. EP-NEO-30 Carmo, A. EP-COR-48 EP-RET-126 Carneiro, Â. EP-PED-40 Carneiro, I. RF09-3 Carpenter, K. EP-UVE-12 Carreño, E. Casey, R. RF05-6 ISOT02-8 Castelo, M. FP03-4, Castro Cabanas, J. FP04-8, EP-GLA-28, EP-RET-075, EP-RET-076, EP-UVE-24 Castro Campos, E.J. RF06-2 Catti, C. Cavinato Kwitko, L. Çavuşoğlu, Ü. EP-COR-42 Ceca, S. Cetin Efe, A. Ceylan, A. Chafi, J. Chahir, R. Chaloupka, K. Chandak, S. Chang, I.B. Chang, S.Y.-H. Charréu, J. Chassid, O. Chatzipetrou, C. Chatziralli, I. Chaudhry, M. EP-PED-58 FP06-2 FP03-6 EP-COR-36, EP-COR-52 RF04-4 EP-OPL-25 RF10-5 EP-RET-045 FP07-2, FP07-16 FP09-7, RF10-2, EP-GLA-53, EP-UVE-29, EP-UVE-34, ISOT01-9 EP-PED-48 EP-ISOT-07 EP-RET-128, EP-RET-129 EP-RET-020 EP-PED-04 FP10-10 FP11-3 Ceban, C. Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 269

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AUTHOR INDEX FP08-10 FP06-6, EP-NEO-39 ISOT04-7 EP-ONC-05 FP03-1 EP-UVE-03, EP-UVE-10 EP-COR-25, EP-COR-38 FP03-1 EP-RET-065, EP-RET-066 RF03-2 EP-RET-055 EP-RET-094 RF04-1 FP07-1, RF05-5, RF07-6, EP-COR-54, EP-ONC-07, EP-ONC-08, EP-PED-69 EP-ONC-06 EP-RET-001 FP02-6 EP-RET-060 EP-COR-11 EP-OCS-01 EP-GLA-22 EP-RET-045 EP-PED-31 EP-RET-031 EP-RET-045 EP-CAT-01 EP-CAT-01 EP-RET-003, EP-RET-047 FP07-2, FP07-16 EP-ONC-09 EP-OPL-10 FP05-9, EP-EDU-10, EP-RET-005, EP-RET-007 EP-COR-37 RF01-4, RF03-3, EP-COR-26 EP-RET-060 ISOT04-4 EP-RET-054 EP-CAT-04, EP-COR-08 EP-PED-21 ISOTV-9 RF06-4 Chavali, V. Chebbi, A. Chebotarov, Y. Chechin, P. Chee, S.-P. Cheleva, V. Chen, C.-Y. Chen, D. Chen, F. Chen, Y.-P. Chen, Z. Chernenko, O. Chiang, T.T.-K. Chibante Pedro, J. Chicheł, A. Chin, H.S. Chino, J. Chmiel, A. Cho, C.-H. Cho, M.H. Cho, S.D. Choe, S. Choi, D.G. Choi, H.J. Choi, S. Choi, Y.-H. Choi, Y.H. Cholakova, D. Chong, Y.J. Chorvath, M. Choung, H. Chow, B.J. Chrapková, B. Christodoulou, S. Chudoba, T. Chumakov, Y. Chung, D.H. Chung, M.J. Chung, S.A. Chung, S.H. Chuprov, A. Cikowska Filipek, A.M. EP-COR-06 Cisiecki, S. Ciulla, T. Civcic, N. EP-GLA-37, EP-UVE-35 RF02-2, EP-NEO-21 FP05-2 FP05-2 FP02-6 EP-NEO-15 EP-RET-024, EP-RET-057, EP-RET-114, EP-RET-121, ISOT03-1, ISOT03-6, ISOT04-9 EP-RET-126 EP-PED-48 EP-EDU-12 EP-RET-039 EP-NEO-16 FP06-13 EP-GLA-27 EP-NEO-21 FP06-14, RF05-3, EP-UVE-15 EP-COR-42, EP-ONC-22 EP-RET-114 EP-RET-042 EP-GLA-35, EP-GLA-51 FP09-10 FP03-9 EP-COR-48, EP-COR-51 RF01-7, EP- FP06-8 RF02-5 EP-COR-48 EP-PED-36 FP09-4, EP-GLA-53, EP-OCS-16, EP-ONC-19, EP-UVE-29, ISOT01-9 EP-PED-69 FP10-8 RF01-2 FP10-9 EP-RET-007 Civcic Kalinic, N. Cleary, R.K. Cochard, C. Coelho, J. Coelho da Costa, I. Cohen, Y. Cojocaru, V. Colgan, S. Coman, C.I. Comberg, C.-L. Comia, G.E. Conroy, W. Cordeiro, M. Corduneanu, A. Correia, N. Correia, R. Correia Barão, R. Cortez, L. Coskun, E. Costa, C. Costa, E. COR-12, EP-COR-48, EP-COR-51 Costa, I.C. Costa, J. Costa, J.P. Costa, L. Costa, T. Costa Ferreira, C. Costa-Gertrudes, R. Costagliola, C. Covello, G. Cox, L. C. Pieroni Gonçalves, A. FP07-9 Cruz, C. Cruz, N. Csutak, A. Cușnir, V. Cușnir, V. Cutas, A. Cutolo, C.A. Cvenkel, B. Cyzova, Z. Czibere, K. Czumbel, N. Czyżewski, D. EP-COR-56 RF01-7 EP-NEO-21 EP-EDU-12 EP-EDU-12 EP-RET-033 EP-COR-57, EP-GLA-56, EP-PED-04 EP-GLA-43 EP-ONC-03 EP-UVE-16 EP-UVE-16 EP-RET-060 D EP-RET-143 RF04-5, EP-ONC-11, EP-ONC-12, EP-ONC-13 EP-RET-119, EP-RET-122 RF04-4, EP-GLA-39, EP-OCS-15, EP-PED-71, EP-RET-104 EP-PED-64 RF06-5 EP-RET-055 EP-PED-67 EP-PED-13 EP-PED-24 EP-RET-012, EP-RET-141, EP-RET-142, EP-RET-146 Da Chou, H. Dačić-Krnjaja, B. Da Fonseca, A.L.A. Daghouj, G. Dahlgren, J. Dahl Rendtorff, N. Dai, R. Dakov, N. Dama, S. Damgaard, M. Danaj, B. Daniel Ponniah, L.R. FP03-5, FP07-8, FP07-12, RF01-5, EP-CAT-29, EP-CAT-30, EP-CAT-31, EP-OCS-13 Danilevičė, A. EP-GLA-48 EP-UVE-16 Dányi, G. EP-NEO-18, Da Silva Rocha, J. EP-NEO-20 EP-RET-115 Daskalov, V. ISOT01-7 Dave, V. RF04-1 Davies, J. EP-GLA-67 Davis, J. EP-PED-66 de Inocencio, J. EP-OPL-30 Del Noce, C. EP-GLA-19, De Lucas-Viejo, B. EP-GLA-20 EP-ONC-02 De Madariaga, A. EP-NEO-36 EP-RET-145 De Matias Gil, S. EP-PED-50 De Milliano, T. RF04-7 Demkova, L. Denobi, M.M. EP-RET-119 de Pablo Cabrera, A. EP-UVE-06 de Pablo Gómez de Liaño, L. EP-PED-14 EP-OPL-09 De Pablo Martin, C. de Rivero Vaccari, J.P. EP-RET-131 EP-CAT-40 Desai, A. de Uña-Iglesias, M.C. EP-OPL-38 de Uña-Iglesias, M.d.C. EP-NEO-31 Diago Sempere, T. EP-UVE-12 EP-RET-058, Dias, B. ISOT03-10 EP-UVE-17 Dias, B.G. EP-OCS-16 Dias, M. 270 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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Dygas, D. Dzhambazov, R. Dzhemal, N. EP-GLA-55, EP-GLA-57 EP-NEO-27, EP-ONC-21, EP-RET-003 EP-RET-003 E RF02-2, EP-NEO-21 FP01-8 EP-NEO-21 EP-COR-55, EP-GLA-55 ISOT01-2 EP-RET-143 FP01-2 RF04-4, EP-GLA-39, EP-OCS-15, EP-PED-71, EP-RET-104 EP-GLA-36 EP-EDU-09 EP-CAT-37 EP-GLA-39, EP-OCS-15 EP-RET-020 EP-REF-12 RF03-5, EP-COR-05 EP-GLA-36 EP-RET-089 FP07-7, RF01-8 RF06-1 RF03-1 EP-PED-50 FP07-14 FP01-5 EP-UVE-12 Eade, E. Ebejer, J.P. Eckstein, A. Eder, K. Eereti, S. Eldridge, N. El Hallaoui, O. El Kettani, A. Elkhabiry, M. Elkonaisi, I. Ellard, R. El Maaloum, L. Elnahry, A.G. Elnikety, S. Elrosasy, A. Elsahn, A. Elvis, V. El Zarif, M. Erdoğdu, E. Ereño, E.C.A. Ernst, F. Esen Baris, M. Estawro, R. Esteban, M. Estero Serrano de la Cruz, H. RF06-2, Estrada Medeiros, S.S.D. EP-RET-119, EP-RET-122 Estrela Silva, S. Evans, B. EP-RET-126 RF10-6 ISOT01-3 RF06-2, EP-OCS-04, ISOT01-3 EP-GLA-16 ISOT03-5, ISOTV-4 EP-COR-23, EP-PED-23, EP-RET-003 EP-COR-23, EP-PED-23, EP-PED-67 EP-GLA-46 EP-COR-23 EP-RET-105 FP06-2 FP09-6 RF06-4 EP-RET-056 EP-COR-39, EP-COR-40, EP-OCS-17, EP-OCS-18, EP-OCS-19, ISOT01-2, ISOT01-5, ISOTV-3 EP-NEO-15 EP-NEO-15 RF06-2, EP-OCS-04, ISOT01-3 EP-NEO-46 EP-COL-02, EP-NEO-46 EP-CAT-25 Díaz Fernández, E. Didyk, N. Dikunova, D. Dimitrov, G. Dimitrova, G. Dimitrova, K.-M. Dimitrova - Mladenova, M. Dinkov, M. Diri, I. Dizdar Yigit, D. Dmitriev, I. Dockery, A. Doctor, M. Dollfus, H. Donahue, S.P. Donate Rosa, A. Donica, A.L. Donica, V.C. Donnenfeld, E. Dorado López-Rosado, A. EP-PED-57 EP-GLA-55, Dorecka, M. EP-GLA-57, EP-GLA-69 EP-RET-074 Draganova, D. EP-GLA-57 Drzyzga, Ł. ISOT03-2, ISOT03-3 Du, S. EP-GLA-15 Duan, J. RF04-6 Duarte, A. EP-OCS-07 Duarte, R. EP-NEO-34, Duarte, S. EP-UVE-17 EP-PED-36 Duarte Silva, E. EP-RET-067 Dubis, A. EP-RET-074 Dubois, P. RF02-4 DuBois, L. Duff, R. RF10-3 Dumbrăveanu, L. EP-EDU-12 Dumitrescu Dragan, A. EP-NEO-16 Dumlu, B. Dunne, L. Dunne, M. Durmaz Engin, C. Dursun Altinors, D. FP08-4 EP-PED-33 EP-PED-33 EP-OCS-10, EP-PED-49, ISOT04-8 FP10-5 AUTHOR INDEX F EP-RET-037 EP-COR-61 EP-RET-032, EP-RET-098 EP-PED-45 FP07-2, FP07-16 RF06-5 EP-NEO-34 FP01-7 FP08-6 RF05-6, EP-NEO-14, EP-RET-013 EP-RET-056 FP01-8 FP01-5 FP10-8 EP-RET-122 FP01-7 EP-OPL-32 ISOT01-1 EP-RET-058 EP-PED-81 EP-RET-098 ISOT02-8 Fadzil, F. Fadzil, F.N. Falcão, M. Falkman, L. Fang, T. Farholt, S. Faria, M. Farinha, C. Farkhutdinova, A. Farnan, R. Farrar, J. Farrugia, R. Fayed, A. Feijão, J. Felicio, L.B. Félix, R. Fenech, M. Feo, A. Fernandes, E. Fernandes, T. Fernandes, V. Fernandes, V. Fernandez Herrero, R. EP-OPL-35 EP-NEO-36, EP-RET-068, EP-RET-108 EP-GLA-40, EP-NEO-01 Fernández Reyes, M. EP-NEO-36 Fernández-Rodríguez, J. EP-NEO-01, Ferrari, D. Ferreira, A.M. Ferreira, A. Ferreira, C. Ferreira, C. Ferreira, C. Ferreira, M. Ferreira, N. Ferreira Cardoso, D. Ferrer, K.M. Ferro Desideri, L. Ferrolino, J.A. Ferro Osuna, M. Feyzullayeva, U. Figueira, L. Figueiredo, L. Figueiredo, M.I. Figueiredo Pires, D. EP-NEO-31 EP-PED-04 FP08-5, RF05-8, EP-OPL-34 ISOT03-1, ISOT03-6 EP-RET-099 FP03-4, EP-RET-076 RF05-8 EP-ONC-19 EP-RET-058 FP03-4, EP-CAT-32, EP-COR-35, EP-GLA-28, EP-RET-075 EP-RET-028 RF06-8, EP-RET-143 EP-GLA-27 EP-RET-145 EP-RET-025 RF05-8, ISOT02-8 FP07-1 EP-COR-09 EP-REF-16, EP-RET-114 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 271

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AUTHOR INDEX FP02-6 EP-ISOT-07 EP-UVE-12 EP-NEO-34 FP04-8, EP-UVE-22, EP-UVE-24 EP-RET-028 ISOT02-6 FP10-7 FP01-7 FP05-4, EP-GLA-25, EP-NEO-20, EP- ONC-20, EP-UVE-19 FP09-7, RF10-2, EP-GLA-53, EP-UVE-29, EP-UVE-34, ISOT01-9 FP09-10, RF01-7, EP-COR-12 EP-GLA-69 Finger, P.T. Flindris, K. Fonollosa, A. Fonseca, A. Fonseca, S. Fontanilla, R. Fortunato, D. Framme, C. Franca, M. Francisco, C. Francisco, F. Francisco, M. Francuz, T. Frankowska-Gierlak, M. EP-RET-060 Franqueira, N. Frattolillo, A. Freitas Santos, G. Froment, C. Fuchsluger, T. Fujimura Jr, A. Furda, R. Furdova, A. EP-REF-17 EP-PED-39 FP07-5 EP-NEO-15 FP06-9 FP09-2 EP-ONC-09 RF04-7, EP-ONC-09 G Gabel-Pfisterer, A. ISOT02-3 Galdes, N. FP06-5 Galgauskas, S. EP-COR-59 Gallik, B. RF04-7, EP-ONC-09 ISOTV-1 Galytska, Y. Gama, R. EP-PED-40 EP-RET-098 Gama-Castro, A. Gama e Castro, A. RF04-3, RF07-1, EP-RET-126 Gamboa Saavedra, S. EP-PED-30 Garcês, E. Garcia, M. García-Andreu, J. Garcia-Carrero, P. Garcia-Herrera Prada, T. EP-RET-145 RF01-7 RF05-5, RF07-6, EP-COR-54 EP-OPL-06, EP-PED-14 EP-ONC-01 EP-RET-068 EP-COR-02, EP-NEO-01, EP-OPL-06, EP-PED-14, EP-RET-009, EP-UVE-06 EP-RET-135, EP-RET-136, EP-RET-138, EP-RET-139 EP-UVE-12 EP-RET-135, EP-RET-136, EP-RET-138, EP-RET-139 EP-GLA-69 EP-PED-64 EP-GLA-32 ISOT02-6 García Marco, A. Garcia Tirado, A. García Vicente, C. Garczorz, W. Garellick, H. Garitsis, P. Garrido, J. Garrido Hermosilla, A.M. RF02-2, EP-NEO-21 EP-UVE-13 Gasparyan, H. EP-RET-070 Gavric, A.U. EP-COR-32 Gavryliak, I. FP05-1, FP05-9, Gazzard, G. EP-GLA-41, EP-RET-005, EP-RET-007 Geada, S. EP-COR-12 Gedvilaite-Vaicechauskiene, G. Gellrich, M.-M. Gelžinis, A. Gemignani, A. Genchovski, P. Genda, I. Genov, K. Georgieva, A. Georgieva, A. Georgieva, G. Georgieva-Dimitrova, A. EP-RET-003 Gerasimovė, A. Gertrudes, R. Gey, B.B. Gey, Z.B. Ghaddaf, A. Ghadiri, N. Ghanekar, E. Ghazaryan, L. Ghazaryan, M. Ghenciu, L.A. Ghetu, N. Ghosheh, T. Gil, J. Gil, P. EP-GLA-48 EP-RET-042 EP-OCS-09, EP-OCS-28 EP-OCS-09, EP-OCS-28 EP-RET-118 EP-OPL-32 RF10-3 EP-PED-60 EP-PED-60 EP-GLA-30 RF03-4 EP-RET-106 RF01-7, EP-COR-09, EP-COR-12, EP-COR-48, EP-COR-51 FP10-8, EP-COR-12 EP-NEO-12 EP-OPL-04 FP05-6, EP-PED-02 EP-PED-42 EP-NEO-43 FP04-3 EP-GLA-24 EP-PED-54 EP-UVE-25 EP-COR-23 EP-OPL-20, EP-OPL-40 EP-RET-135, Gil Fernández, A. EP-RET-136, EP-RET-138, EP-RET-139 FP05-8 Girgin, Y. EP-COR-29 Gök, A. EP-GLA-09 Gokoffski, K. FP02-3 Gokul, A. FP07-9 Goldfarb Cyrino, L. FP03-8 Gomes, M. EP-RET-032 Gonçalves, J. EP-UVE-04 Gonçalves, M. FP05-4, EP-GLA-25 Gonçalves, R. EP-RET-094 Goncharuk, K. Göncü Fırat, T. EP-PED-53 Góngora Rodríguez, R. EP-RET-138 EP-GLA-57, Gontarz, K. EP-GLA-61, EP-GLA-69 Gonzalez, A.G. EP-GLA-09 Gonzalez-Lopez, J.J. EP-UVE-12 Goodchild, C. Gorkom, K.N.-V. Górska, A. Gouveia, P. Goździewska, E. Greben, N. Grech, M. Grech, S. Grigoryan, A. Grigoryan, L. Grivna, M. Grivova, I. Gromača Grgić, M. Grzybowski, A. Guedes, M. Guerreiro Dias, B. Guerrero Villa, J.F. Guex-Crosier, Y. Guimaraes Rabelo, J.G. EP-RET-119 Gumus, H.E. Gumus Akgun, G. Gupta, S. Gurez, C. Guri, S. Guru, S. Gustafson, P. Gustianty, E. Gutierrez, E. Gutiérrez, K.L. Gutteridge, I. Guven, S. FP06-10 EP-REF-12 EP-RET-023, EP-RET-132 EP-RET-125 EP-ONC-06 EP-COR-32 EP-EDU-03 FP06-5, RF02-3 EP-OCS-21 EP-OPL-24 EP-EDU-09 EP-PED-52, EP-RET-003 EP-EXE-07 EP-PED-42 FP06-14, RF05-3, EP-UVE-15 EP-GLA-35, EP-GLA-51, EP-RET-030, ISOT01-6 EP-PED-41 EP-RET-067 EP-OCS-10 RF01-1 EP-COR-40 FP09-6 RF05-2, EP-UVE-08 EP-EDU-05 EP-RET-002 EP-GLA-47, ISOT02-1 EP-GLA-58 RF10-5 EP-RET-006 FP07-14 272 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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Guzun, O. Gyllén, J. Gymanyk, I. EP-GLA-33, EP-ONC-05, EP-RET-090, EP-UVE-05 EP-PED-45 EP-RET-094 H Ha, A. Ha, J.Y. Hadi, A. Hadjilouka, G. Hage, R. Haider, A. Hajiyev, R. Hajiyeva, A. Hajiyeva, N. Halder, U. Hall, C. Hameed, A.K. Hamid, S. Hamilton, R. Hammami, A. Hammami, N. Hammer, H.L. Hammond, C. Hammouche, A. Hammouche, M.A. Hammouche, M.A. Harrar, Y. Harutyunyan, T. Harutyunyan, Z. Harvey, J. Hasani, H. Hashim, M.J. Hassan, A.K. Hattenhauer, A. Hattori, Y. Hautala, N. Hay, E. Haykin, V. EP-RET-045 FP01-11 EP-PED-22 RF01-4, EP-COR-26 EP-NEO-15 FP02-6 EP-PED-03 EP-NEO-17 EP-PED-03 EP-RET-007 RF09-8 EP-RET-148 FP05-1, EP-GLA-41 FP05-9, EP-RET-005, EP-RET-007 EP-COR-18 FP06-6 FP10-6 FP10-6 ISOT02-7, EP-ISOT-09 EP-COR-52, EP-COR-53, EP-RET-117, EP-ISOT-11 EP-GLA-70, EP-RET-147, EP-UVE-36, EP-ISOT-06 EP-PED-76, EP-RET-133 EP-COR-19, EP-PED-60 EP-PED-60 EP-GLA-09 EP-CAT-03, EP-COR-27, EP-OCS-12, EP-RET-079 EP-EDU-11 EP-COR-05 EP-PED-32 EP-RET-077 RF05-4 EP-CAT-37 EP-NEO-27, EP-PED-23 EP-GLA-15 ISOT03-8, EP-ISOT-04 EP-PED-68 ISOT01-10, ISOTV-2 EP-RET-057 EP-REF-16 RF06-6, EP- RET-024, EP-RET-043 EP-PED-35, EP-PED-45 EP-PED-35 EP-NEO-44 ISOT01-7 RF06-2, EP-OCS-04 EP-RET-097 EP-COR-36, EP-COR-45, EP-GLA-70, EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09 EP-COR-52, EP-COR-53, EP-RET-117, EP-ISOT-11 EP-OCS-02 RF01-6 FP07-6, FP07-11, He, Y. Heichel, J. Heidel, A. Heinzelmann, J. Heitor, J. Heitor Maques, J. Heitor Marques, J. Hellgren, K. Hellström, A. Hepworth, L. Hernandez, C. Hernando-Portela, M. EP-CAT-26 Hernando Sebastian, V. EP-OCS-04 EP-UVE-12 Hernanz, I. RF01-4, Herodotou, F. EP-COR-26 EP-CAT-26 Herranz-Heras, J.C. EP-RET-016 Hewage, S. Hibraj, A. EP-UVE-08 Hidalgo Espinosa, M.E. ISOT01-3 Hidan, Y. Hidan, Y. Hidan, Y. Higasa, K. Hima Musa, N. Hima-Musa, N. RF08-7, EP-REF-03 EP-OPL-32 Himsworth, J. EP-OCS-02 Hisatune, J. EP-COR-01, Hitomi, H. EP-COR-13 EP-COR-14 Ho, W.M. EP-CAT-05 Hodge, C. FP07-4 Hodzic, N. EP-RET-065 Hohnen, H. EP-GLA-31 Holló, G. EP-PED-35 Holmström, G. EP-OCS-29 Holtick, U. EP-GLA-43 Hommer, A. EP-RET-045 Hong, I.H. ISOTV-9 Hong, S.Y. Hornischer, C. EP-NEO-16 Horvathova Kajabova, V. RF04-7 Horvatic - Obradovic, M. EP-COL-04 Hosver, I. FP06-2 AUTHOR INDEX EP-COR-19, EP-COR-33, EP-OCS-21, EP-UVE-13 EP-COR-31 EP-RET-059 EP-NEO-44 EP-GLA-08 EP-GLA-08 EP-CAT-15 EP-COR-37 EP-ONC-21 EP-CAT-17 EP-CAT-17 EP-COR-03, EP-COR-24 EP-COR-37 EP-GLA-21, EP-PED-25 RF07-7 EP-GLA-68 ISOT03-8, EP-ISOT-03, EP-ISOT-04 ISOTV-9 FP10-6 EP-PED-13 FP10-6 Hovakimyan, A. Hovhannisyan, A. Hovhannisyan, L. Howard, C. Hoxha, F. Hoxha, G. Hoxha-Shoshi, M. Hrabčíková, P. Hristova, R. Hrncirova, A. Hrusovska, P. Huang, C.-H. Hübnerová, P. Huh, M.G. Hurt, P. Huseva, Y. Huth, A. Hwang, B.E. Hynnekleiv, L. Hysenshahaj, A. Hysi, P. I EP-COR-42 Iacubitchii, M. EP-RET-028 Ibañez, M.B. EP-RET-035, Ibañez, M.B.I. EP-RET-044 EP-COR-57, Iester, M. EP-GLA-56, EP-PED-04, EP-PED-39 EP-RET-122 Ignachiti, V.S. EP-NEO-45 Ihtisham, M. EP-RET-129 Ikonomidis, I. EP-COR-01, Imai, H. EP-OCS-02, EP-RET-077 EP-RET-003 Impagliatelli, M. EP-COR-23 Impagliatelli, M.B. FP09-6 Inal, A. Insausti-García, A. EP-COR-02 Iribarra-Fermandois, A. EP-GLA-19 EP-NEO-36 Işik, B. EP-COR-29 Islamaj, M. RF05-2, EP-RET-012 EP-REF-13 Ito, M. EP-PED-55 Iulia, N.-D. Ivaniuta, P. ISOTV-1 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 273

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AUTHOR INDEX Ivanova, D. Ivanova, T. Iveković, R. EP-COR-30 EP-RET-105 EP-EXE-07 K J EP-OPL-04 EP-COL-04 EP-GLA-14 FP05-1, EP-GLA-41 EP-RET-145 EP-NEO-36, EP-OPL-35, EP-PED-66, EP-RET-068, EP-RET-108 FP05-7 EP-GLA-01, EP-GLA-45 EP-UVE-12 EP-PED-24 EP-COR-42 RF07-6, EP-COR-54 EP-RET-131 FP02-4 RF09-1, EP-PED-05 Jackson, D. RF05-2, EP-UVE-08 Jaho, J. FP07-2, FP07-16 Jain, N. RF10-3, EP-PED-15 Jain, S. EP-ONC-03 Jakubickova, S. EP-OPL-21 Jang, J. Janicijevic Grubisic, I. EP-OCS-26 Janiszewska-Salamon, J. EP-GLA-55 Jankauskienė, J. Jankovic Terzic, K. Janulevičienė, I. Jarrar, Z. Javaloy, T. Javaloy Vidal, T. Jekabsons, D. Jeoung, J.W. Jerez Fidalgo, M. Jernkrok, R. Jeru, I. Jesus, J. Jiang, H. Jiang, W. Jimenez Dominguez, U. EP-NEO-26 Jin, Z. João, M. Johannesson, G. Jojo, V. Jones, A. Jorge Teixeira, F. José, P. Judice De Menezes Relvas, L. EP-UVE-27 Julião Campos, E. Jun, I. Jung, E.H. Jung, J.J. Jung, S.H. Jung, Y.H. Jurkute, N. Justo, S. RF10-5 EP-PED-70 EP-COR-06 EP-RET-091 EP-PED-82 EP-GLA-35, EP-PED-40 ISOT03-10 EP-COR-48 EP-CAT-02 EP-PED-12 EP-GLA-01 EP-CAT-04, EP-COR-08 EP-GLA-04 FP04-4 EP-NEO-20 Kabbani, M. Kacanashvili, R. Kaga, T. Kahraman, H.G. Kaikaryte, K. Kalauz, M. Kalauz, M. Kalezic, T. Kalezić, T. Kaliardas, A. Källén, K. Kalvelytė, G. Kambulyan, L. Kanagawa, T. Kandel, H. Kandemir, O. Kandemir Besek, N. Kandemir Beşek, N. Kaneko, Y. Kaneva, Y. Kang, K.h. Kang, K.H. Kanik, S.E. Karaca, D. Karagiannidou, Z. Karahan, E. Karamarković, M. Karampatakis, V. Karatas, E. Karhanova, M. Karhanová, M. Karimi, A. Karliychuk, M. Karlsson, E. Kasa, K. Kasal, K. Kashiwagi, K. Kashyap, B. Kate, A. Kathri, A. Kaukenaite, I. EP-PED-72 EP-EXE-04 EP-CAT-20 FP02-2 EP-NEO-12 EP-OPL-05 EP-OPL-05 EP-GLA-64 FP06-3, RF04-5, EP-ONC-11, EP-ONC-12, EP-ONC-13, EP-ONC-14 EP-ISOT-07 EP-PED-35 EP-COR-28 EP-UVE-13 EP-COR-01, EP-COR-13, EP-OCS-02 EP-COR-15 FP08-7 FP03-9 RF08-3 EP-ONC-04 EP-PED-54, EP-RET-003 EP-GLA-21 EP-GLA-01, EP-GLA-45, EP-PED-25 FP08-1, EP-NEO-06, EP-NEO-37 EP-NEO-24 EP-EDU-08 FP05-8 FP06-3 EP-EDU-08 EP-OCS-10, ISOT04-8 EP-ONC-03 EP-CAT-10, EP-COR-37 EP-EDU-01, EP-RET-029, EP-UVE-02 EP-RET-093 EP-PED-24 EP-RET-089 FP05-8 EP-GLA-17 EP-RET-019 EP-OCS-17, EP-OCS-18 ISOT01-7 FP01-4 Kayabasi, M. Kayikci, G. Kazakova, D. Kazantzis, D. Kazlauskaitė, G. Keegan, D. Kelava, L. Kelly, A. Kelly, Á. Kermedchieva, R. Kerner Lavi, H. Keskin, M. Kessel, L. Ketkar Pathak, D. Ketkar Pathak, M. Kėvalaitė, U. Khairallah, M. Khalaf, M. Khalefa, K. Khalil, M.M. Khan, F.S.A. Khorava, G. Khorrami-Nejad, M. Khouri, H. Khramenko, N. Kilic, B. Kim, A. Kim, D.H. Kim, E.J. Kim, H. Kim, H.S. Kim, J.H. Kim, J. Kim, M. Kim, S.H. Kim, S.Y. Kim, T.-i. Kim, Y.J. Kim, Y. Kim, Y.K. Kimura, H. Kinori, M. Kinoshita, S. Kirbiš, M. Kirgiz, A. Kırgız, A. Kirinčić, S. Kiyat, P. EP-OCS-10, EP-PED-49 FP08-9 EP-GLA-18 EP-RET-128 EP-GLA-48 EP-RET-056 EP-GLA-24 EP-COR-61 EP-RET-037 EP-RET-115 EP-PED-28 EP-PED-53 RF06-5 ISOTV-8 EP-ISOT-10 EP-GLA-14 EP-RET-071 RF09-3 RF03-5, EP-COR-05 EP-COR-05 EP-OCS-28 EP-EXE-04 FP09-5, EP-PED-10, EP-PED-22 EP-UVE-16 EP-GLA-33 EP-CAT-08 EP-RET-007 EP-CAT-01 EP-EXE-08 EP-GLA-73 EP-COR-16 EP-OCS-01 EP-RET-018 EP-GLA-22 EP-GLA-22 EP-GLA-01, EP-GLA-21, EP-GLA-45, EP-PED-25 EP-CAT-02 EP-NEO-03 FP05-9, EP-EDU-10, EP-RET-005 EP-GLA-01, EP-GLA-21, EP-GLA-45, EP-PED-25, EP-RET-027, EP-RET-045 EP-COR-10 EP-PED-29 EP-OCS-11 EP-COR-18 FP03-9 RF08-3 EP-GLA-24 FP02-2 274 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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AUTHOR INDEX EP-COR-52, EP-GLA-70, EP-RET-117, EP-ISOT-11 EP-COR-36, EP-COR-45 EP-RET-074 FP06-13 EP-UVE-26, EP-UVE-27 EP-UVE-12 FP06-12, RF05-1, RF05-7, EP-GLA-50, EP-UVE-17 FP06-8 RF04-3, EP-OPL-34, EP-ONC-20 RF05-6 FP09-2 EP-NEO-15 EP-COR-25, EP-COR-38 EP-PED-25 EP-GLA-45 EP-RET-045 EP-GLA-03 EP-OCS-01 EP-RET-001 EP-GLA-22 RF07-7 EP-COR-11 EP-GLA-03 EP-RET-035 RF02-2, RF09-3, EP-NEO-21 EP-RET-027 EP-EXE-08 FP10-7 FP02-7 RF05-4 EP-RET-032 FP07-5 EP-PED-43 EP-PED-38 EP-ONC-20 EP-NEO-18 EP-PED-45 RF09-6, EP-RET-050 FP04-4 ISOT02-8 EP-COR-23, EP-PED-23, EP-RET-003 FP05-9, EP-RET-005 ISOT01-6 EP-COR-14 EP-COR-03, EP-COR-24 EP-PED-50 Layachi, S. Layachi, S. Le, A. Le, A.N.A. Le, A.N.A. Leal, I. Leal, I. Leal, V. Leal, V. Leavey, S. Leber, M. Lebranchu, P. Lee, H. Lee, J. Lee, J.K. Lee, J. Lee, J.S. Lee, J.S. Lee, K. Lee, K.M. Lee, P. Lee, S.-B. Lee, S.Y. Lee, S.M. Lee, V. Lee, Y.J. Lee, Y. Lehiani, K. Lei, T. Leino, A. Leite, A. Leite, J. Lekskul, A. Lembo, A. Lemos, A. Lemos, J.A. Lennartsson, F. León Nieto, L. Leroy, B.P. Leuzinger-Dias, M. Levi, A. Levina, F. Levy, J. Li, A.L.W. Li, H. Li, J. EP-COR-10 EP-ONC-17 EP-CAT-33, EP-OCS-24 FP10-10 EP-COR-23, EP-PED-23 Kuroda, S. Kurtović, N. Kusa, B. Kwitko, S. Kyneva, Y. L EP-RET-104 EP-COL-03, EP-OCS-20 RF04-4, EP-RET-104 EP-GLA-39, EP-OCS-15 EP-COR-06 FP10-9, EP-NEO-43, EP-REF-05, EP-UVE-11 EP-GLA-60 EP-OPL-02 EP-GLA-19, EP-GLA-20, EP-OPL-14, EP-OPL-15, EP-ONC-01, EP-ONC-02 EP-PED-66 EP-GLA-40 EP-OPL-01, EP-OPL-19 EP-RET-032 FP08-10 EP-GLA-31 EP-RET-129 EP-NEO-15 FP04-4 EP-RET-129 EP-COR-55, EP-GLA-55 EP-GLA-43 EP-NEO-05 EP-PED-62 EP-OPL-02 EP-ONC-02, EP-ONC-18 EP-OPL-01, EP-OPL-19 L Laabi, I. Labetoulle, M. Laftimi, Z. Laftimi, Z. Lagali, N. Laganovska, G. Lago, M.D. Lago-Llinas, M.D. Lago-Llinas, M.-D. Lago Llinás, M.D. Lago-Llinás, M.D. Lago-Llinás, M.-D. Laiginhas, R. Lam, B. Lamb, W.D. Lambadiari, V. La Morgia, C. Lamperti, C. Lampsas, S. Langosz, P. Lanzl, I. Laouar, A. Lasevica, B. Laslau, B.M. Laslau, B.-M. Laslau, B.-M. Latuffe Soares Damião, A. FP07-9, Laurino, M. Laville, M.-A. Lavrinciuc, C. FP10-10, EP-GLA-59, EP-NEO-30 EP-NEO-43 EP-NEO-15 EP-OPL-37 EP-PED-35 EP-REF-05 FP04-4, EP-NEO-15 FP06-6, EP-NEO-39 EP-OPL-05 EP-OCS-10, EP-PED-49 RF01-4, EP-COR-26 EP-GLA-43 ISOT03-4 EP-RET-062 Kjellström, U. Klavins, K. Klopstock, T. Kmiha, R. Knežević, J. Koksaldi, S. Kola, D. Kolko, M. Kolomiets, I. Komarova, T. Konareva-Kostianeva, M. EP-GLA-52 FP07-9 Kondo, T. EP-RET-090, Konovalova, N. EP-UVE-05 EP-NEO-21 Konuk, O. EP-OPL-03 Kopecky, A. EP-RET-129 Korakas, E. EP-RET-026, Korb, C.A. EP-RET-072 FP08-7 Korkmaz, A. EP-GLA-33, Korol, A. EP-RET-090, EP-RET-094 EP-GLA-32 Koronis, S. Korpič Šbül, T. EP-NEO-02 Korsantimukkang, W. EP-PED-43 Koshelieva, Y. Kostadinov, G. Kostadinova, A. Kostianeva-Zhelinska, S. EP-GLA-52 Kostova, S. Kotan, M. Koumpoulis, I. Kovačević, I. Koval, T. Kovalov, A. Kovalov, I. Kovtun, O. Kowdley Hemanth, L. RF10-3 Krajnc, N. Krasniqi, M. Krašovec, T. Kratky, V. Krawczynski, M. Krezel, A. Kruja, B. Kubiak, A. Kuhn, F. Kujundzic Begovic, E. EP-NEO-22, EP-RET-048 EP-RET-091 Kumbhar, A. Kuneva, I. EP-CAT-34, EP-GLA-46, EP-RET-102, EP-RET-112 EP-PED-01 Kurent, A. EP-NEO-02 EP-RET-089 EP-COR-18 FP06-4 FP04-4 FP06-10 EP-RET-089 EP-ONC-06 EP-RET-084, ISOT03-8 ISOT04-1 EP-RET-003, EP-RET-073 EP-GLA-18 EP-PED-67 FP11-3 EP-ISOT-07 EP-ONC-12 EP-PED-27, EP-PED-28 EP-COR-50 EP-COR-50 EP-UVE-05 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 275

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AUTHOR INDEX EP-COR-14 EP-REF-12 EP-REF-12 EP-CAT-04, EP-COR-08 EP-PED-82 FP02-3 EP-RET-065, EP-RET-066 EP-GLA-09 EP-GLA-51, EP-RET-030 ISOT03-10 RF08-3 EP-NEO-11 EP-RET-064 EP-COR-03, EP-COR-24 EP-PED-64 RF09-2 EP-RET-044 FP08-2, EP-COR-41, EP-GLA-42, EP-REF-11 RF02-4, EP-CAT-07 FP02-7 EP-GLA-15 EP-NEO-12 EP-OPL-04 EP-GLA-48 EP-GLA-23 EP-REF-12 EP-UVE-12 FP04-4 EP-CAT-37 RF05-1, EP-GLA-50, EP-NEO-34, EP-PED-40, EP-RET-058 EP-ISOT-03 EP-PED-20 EP-RET-056 EP-OPL-22, ISOT01-8 EP-GLA-53 EP-PED-70 EP-RET-145 EP-RET-135, EP-RET-136, EP-RET-138, EP-RET-139 EP-OPL-02 Li, K.W.K. Liaonchyk, K. Likhorad, E. Lim, D.H. Lim, J. Lim, J. Lim, L. Lim, P.M.F. Lima Cabrita, A. Lima-Cabrita, A. Liman Uzun, S. Lin, H.A. Lin, H.-C. Lin, I-C. Lind, A. Lindegger, D.J. Listano, O. Liu, A.H.Y. Liu, H. Liu, H. Liu, S. Liutkeviciene, R. Liutkevičienė, R. Liveikienė, A. Ljaljevic, S. Ljubisavljevic, M. Llorens, V. Llòria, X. Lloyd, I.C. Lobo, V. Löffler, L. Loh, K.-L. Long, A. Lontoc, R.O. Lopes, A.S. Lopes, N. Lopez Alcaide, A. López Frutos, M. Lopez-Ladron, R.M. Lopez-Ladron, R.-M. EP-OPL-14, EP-OPL-15, EP-ONC-01, EP-ONC-18 Lopez- Ladron, R.-M. EP-OPL-01 López-Ladrón, R.M. EP-OPL-38 López-Ladrón García Borbolla, R. EP-OPL-35 EP-OPL-09 EP-OPL-06 EP-PED-57 López-López, C. EP-OCS-04 Lopez Mesa, I. EP-RET-026 Lorenz, K. EP-RET-061 Louchene, W. EP-CAT-10 Lounová, V. FP03-10, Loureiro, T. EP-REF-19 EP-RET-135, Lozano García, I. EP-RET-136 FP03-3 Lu, Y. EP-PED-36 Ludovico, I. FP05-9, Luis, J. EP-RET-005, EP-RET-007 Luiz Ribeiro Monteiro, M. FP07-9, Lume, M. Lundgren, P. Luo, G. Lūse, O. Lymperopoulou, C. EP-GLA-59 EP-RET-057 EP-PED-24 EP-GLA-15 EP-NEO-25 EP-PED-50 M EP-PED-76, Maadane, A. EP-RET-133 EP-CAT-07 Maberley, D. EP-PED-76, Mabrouki, F.Z. EP-RET-133 EP-GLA-17 Mabuchi, F. EP-RET-145 Macero Delgado, A. EP-OPL-01 FP03-10, Machado, I. EP-REF-19 EP-COR-51 Machado, T. Machado de Vargas, R. EP-COR-58 Machado Soares, R. EP-COR-35 EP-COR-42 Macovei, L. EP-RET-076, Madeira, C. EP-UVE-24 EP-RET-041 Madeira, F. FP06-14, Madeira, M. EP-UVE-15 RF02-5, RF04-6, Madeira, M.F. RF05-3 EP-ONC-17, Maduna, I. EP-PED-56 FP10-8 Maduro, V. Magnusson, G. EP-PED-45 ISOT02-4, Mahadik, S. ISOT03-9, EP-ISOT-10 FP01-5 Mahmoud, R. EP-NEO-22, Mahmuljin, A. EP-RET-048 EP-COR-56, Maia, F. EP-GLA-26, EP-NEO-38, EP-PED-81, EP-RET-099, EP-RET-123 EP-NEO-45 Maino, A. FP07-7 Makdissy, N. FP06-13, Makhoul, D. EP-RET-074, EP-UVE-26 Malabanan-Cabebe, C.G. RF03-1 Malem, A. Malliaras, G. Mallu, A. Malušková, M. Mammadzada, S. Mancheva, I. Maniar, A. Mano, S. Mansour, F. Manuel Baptista, P. Maresova, K. Marešová, K. Maric, V. Marin, A. Marinescu, A. Marinov, A. Marinov, V. Marjanovic, I. Marjanović, I. Markeviča, I. Markić, B. Markosyan, A. Markov, G. Marku, X. Marques, J.H. Marques, J.P. Marques, T. Marques Couto, P. Marques-Couto, P. Marroquín, F. Marshal, A. Marston, D. Marta, A. Martinez Calvo, X. Martínez-Costa Pérez, L. EP-UVE-12 Martins, A.S. EP-RET-024, EP-RET-121 EP-COR-35, Martins, P. EP-RET-076, EP-UVE-22 FP07-2, FP07-16 EP-GLA-09 FP11-2, EP-CAT-13, EP-ONC-16 EP-CAT-10 EP-GLA-14 EP-RET-102 FP02-6 FP06-12, RF05-1, RF05-7, EP-GLA-50, EP-UVE-17 EP-CAT-07 EP-RET-043 EP-ONC-03 EP-CAT-10 EP-GLA-63, EP-GLA-64 EP-GLA-67 RF09-8 EP-GLA-46 EP-PED-46 EP-GLA-64 FP06-3, EP-ONC-14 EP-UVE-11 EP-NEO-04 EP-EXE-04 EP-RET-078 EP-EXE-02 FP07-5 FP01-7, FP04-2 RF05-1 RF04-3, RF07-1 EP-RET-032 EP-RET-050 EP-PED-05 FP06-5 EP-RET-043, ISOT04-9 EP-PED-30 276 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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AUTHOR INDEX EP-RET-119, Martins, R.R. EP-RET-122 FP06-8 Martins, R. FP07-9 Martins Maia, R. EP-GLA-53, Martins Pombo, B. EP-UVE-29 EP-GLA-55, Maruszczyk, W. EP-GLA-57 EP-OPL-05 Masnec, S. EP-GLA-20 Mata-Beltran, C. EP-OPL-09 Mata Diaz, E. FP07-9 Matayoshi, S. FP02-6 Materin, M. ISOTV-11 Mathai, M. FP08-10 Matloob, S. RF05-1, RF05-7 Matos, D. EP-OPL-34 Matos Sousa, J.M. EP-COR-01, Matsuoka, Y. EP-COR-13 Matulevičiūtė, I. FP04-1 EP-CAT-34 Mavrova, Y. FP05-10, M. Bukhari, Z. EP-RET-109 EP-RET-037 McAteer, D. EP-NEO-14 Mc Elnea, E. McGhee, C. FP02-3 Mc Glacken Byrne, A. RF05-6 Mchachi, A. Mediņa, E. Meftah, M.Y. Meier-Gibbons, F. Meira, D. Meira, J. Meireles, A. Mela, V. Melissourgos, I. Melnyk, V. EP-COR-36, EP-COR-45, EP-COR-52, EP-COR-53, EP-GLA-70, EP-RET-097, EP-RET-117, EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09, EP-ISOT-11 EP-UVE-11 EP-UVE-18 EP-GLA-43 FP03-4, FP04-8, EP-GLA-28 FP06-8, EP-OPL-34, EP-ONC-20 EP-RET-024, EP-RET-043, EP-RET-057, EP-RET-114, EP-RET-121, ISOT03-1, ISOT03-6, ISOT04-9 FP03-2 EP-ISOT-07 RF07-5, EP-GLA-34, EP-GLA-44 EP-RET-043, EP-RET-057 FP02-6 EP-PED-13 ISOT02-6 EP-REF-17 Melo Beirão, J. Meltsner, S. Mema, V. Mendes, J. Mendes Campos da Costa, M. EP-COR-58 Mendes da Silva, A. Mendo, I. Mendonça, P. Menéres, P. Menghesha, L. Menon, R. Mercieca, F. Merkland, D. Mert, U. Mesin, L. Mesquita, N. Metodieva, M. Michael, N. Michail, N. Michalsky, C. Mifsud, A. Mikulenaite, P. Mikulska, J. Miladi, O. Milanesi, F. Milbradt, T. Min, J.S. Miniauskiene, G. Miranda, A. Miranda, V. Mishra, C. Misioni, A. Misra, S. Mitchell, S. Mitra, A. Mitrović, M. Mittal, H. Mitter, S. Mizoguchi, T. Mladenov, O. Mocho, R. Mockaitiene, L. Mofti, A. Mohamed, F.K. Mohamed, M.S.I. EP-GLA-62, EP-RET-125 FP03-10, EP-REF-19 RF02-5 FP07-5, EP-RET-043, EP-RET-057 EP-OCS-29 EP-NEO-11 FP01-8 EP-RET-002 FP07-14 EP-NEO-43 EP-COR-48 EP-RET-085 RF01-4 EP-COR-26 RF02-2 EP-EDU-03 EP-NEO-12 EP-UVE-32 EP-RET-071 EP-PED-04 FP09-2 EP-CAT-02, EP-COR-07 FP01-4 FP03-10 RF05-5, EP-ONC-07, EP-ONC-08 ISOT01-7 EP-EDU-08 FP02-3 EP-GLA-36 FP08-2, EP-COR-41, EP-REF-11 EP-ONC-11 EP-UVE-09 FP08-10 EP-GLA-10 EP-COR-23, EP-PED-23, EP-PED-67 FP03-8 EP-CAT-21 EP-CAT-22 FP05-10 EP-RET-021 RF03-5, EP-RET-021, EP-RET-022 EP-PED-32 EP-RET-096 FP10-9, EP-NEO-43 RF05-7, EP-NEO-34, EP-RET-058, ISOT03-10 FP09-4, EP-OCS-16, EP-ONC-19 EP-REF-16 EP-REF-17 EP-GLA-27, EP-OPL-22, ISOT01-8 EP-GLA-58, EP-GLA-60 Mohney, B. Moneta-Wielgoś, J. Montanari, R. Monteiro, B. Monteiro, C. Monteiro, S. Monteiro, T. Montenegro, M. Montero, M. Montero-Rodriguez, M. EP-GLA-19, Montrimas, A. Moon, N.J. Moon, S.W. Morad, Y. Moraes, F. Moreira Martins, P. Morgado, G. Mori, H. Mori, H. Moria, R. Morkūnaitė, A. Morozova, D. Moscalciuc, A. Moster, M.L. Mota, M. Mota-Moreira, P. Mourali, M. Moynihan, V. Moyseyenko, N. Mrozek, A. Mrukwa-Kominek, E. EP-GLA-57, EP-GLA-61, EP-GLA-69 FP07-9 M. Santo, R. EP-COR-18 Mujnović, A. EP-PED-50 Mulkalapalli, N. Munier, F. EP-NEO-15 EP-GLA-40 Munoz-Gallego, A. EP-PED-57, EP-RET-009 EP-RET-105 Murgova, S. Murgova, S. EP-UVE-14 EP-PED-33 Murphy, T. FP10-8, RF01-7, Murta, J. EP-COR-12, EP-COR-51 EP-GLA-20 EP-REF-15 EP-PED-31 EP-NEO-03 EP-PED-48 FP03-10, EP-REF-19 FP04-8, EP-RET-075, EP-UVE-24 EP-GLA-26, EP-GLA-62 EP-OCS-02 EP-RET-077 EP-RET-118 ISOT04-3 EP-REF-12 EP-ONC-22 EP-NEO-15 FP09-7, RF10-2 RF04-3, RF07-1, EP-RET-032 FP06-6, EP-NEO-39, EP-RET-071 EP-PED-47 EP-NEO-08 EP-GLA-55 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 277

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AUTHOR INDEX Musa, N.H. Musanovic, Z. Mylona, E. EP-CAT-27, EP-COR-34, EP-REF-04, EP-REF-07 FP07-4 EP-ISOT-07 N FP10-9 Naccarato, M. EP-RET-020 Nadeem, Z.A. EP-UVE-16 Nádudvari, A. EP-RET-020 Naeem, A. EP-RET-022 Naeem, U. EP-PED-47, Naeem, Z. EP-PED-68 EP-RET-013 Nafees, H. EP-CAT-14, Nagy, Z.Z. EP-CAT-15 EP-COR-33 Nahapetyan, S. RF07-7 Nahrawy, A. Nalcı Baytaroğlu, H. EP-OPL-43 RF02-2, Narvekar, A. EP-NEO-21 ISOT02-4, Natarajan, S ISOT03-9 ISOTV-8, EP-ISOT-10 EP-PED-50 Nath, A. ISOTV-11 Natha, S. EP-RET-067 Navarro, A. EP-RET-010 Nayak, A. EP-GLA-16, Nazarchuk, H. EP-ONC-15 EP-PED-16, Negretti, G. EP-PED-68, EP-UVE-02 EP-PED-27 Neimark, E. EP-OPL-03 Nemcansky, J. RF01-4, Neokleous, A. EP-COR-26 EP-RET-032 Neves, J.S. FP03-8 Neves, M. EP-RET-094 Nevska, A. FP11-1, RF02-4 Newman, N.J. FP05-9, Nicholson, L. EP-RET-005, EP-RET-007 EP-RET-033 Nicoara, S.D. Nicolela Susanna, F. EP-GLA-59 Nii, F. Nijm, L. Nikolov, D. Nilsson, M. Nitzan, I. FP07-9 EP-CAT-25, EP-OCS-07 EP-CAT-34, EP-RET-112 EP-RET-002 EP-PED-29 FP09-10 EP-GLA-71 RF01-8 EP-PED-38, EP-PED-39 Nogueira, C. Novytskyy, I. Nubile, M. Nucci, P. O EP-RET-056 O’Byrne, J. EP-RET-013 O‘Donoghue, E. EP-CAT-04 Oh, S. EP-COR-08 Oh, S.J. EP-OCS-02 Ohnaka, M. Öhnell, H. EP-PED-45 RF05-4 Ohtonen, P. EP-ONC-04 Okada, M. EP-UVE-07 O Leary, E. EP-RET-016 Olejkova, I. EP-COR-04 Olie, L. FP03-8 Oliveira, L. EP-REF-17 Oliveira, M. EP-COR-51 Oliveira, R.S. ISOT02-8 Oliveira Machado, S. EP-COR-53, Omari, I. EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09 FP03-6 Onal, I. EP-PED-53 Öncel Acır, N. Önder, F. EP-NEO-24 Oprina Tudosescu, R. EP-NEO-16 EP-PED-33 O‘Regan, S. EP-PED-37 Orprayoon, N. EP-OPL-09 Ortiz Martin, D. EP-ONC-18 Ortiz-Martin, D. EP-GLA-58, Ortueta, A. EP-GLA-60 Ortueta Olartecoechea, A.I. EP-PED-66 Orudjeva, S. Oscar, A. Oscar, A. Osicki, J. Oskar, A. Osypchuk, I. EP-PED-57 EP-CAT-26 EP-NEO-17 EP-PED-54 EP-COR-23, EP-NEO-27, EP-ONC-21, EP-PED-23, EP-PED-59, EP-PED-67, EP-REF-06, EP-RET-003, EP-RET-073, EP-RET-078 EP-RET-132 EP-PED-52, EP-RET-047 ISOT04-1 Ouazzani Touhami, H. EP-COR-36, EP-COR-45, EP-COR-52, EP-COR-53, EP-GLA-70, EP-RET-117, EP-RET-147, EP-UVE-36, EP-ISOT-06, EP-ISOT-11 EP-PED-64 Ovik, T. Ozan Doğan, T. RF06-1 FP08-1 Ozbek, M. Özçalişkan, Ş. RF06-1 FP08-4 Ozcelik, F. RF01-1 Özdemir Yalçınsoy, K. EP-OPL-43 Özer, M.D. Özizmirliler, D. Özmen, S. Öztürk, A.T. RF08-5 ISOT04-8 FP11-3 FP09-3 P Paduca, A. Pai, A. Paiva, C. Pajtim, L. Palacios-Hipola, A. Palazon, M. Palioura, S. Palmier, A. Pan, J.T. Panayidou, K. Pandilov, S. Pansani, V.F. Papadopoulou, E. Papadopoulou, M. Papafotiou, E. Papeczyc, A. Pappas, C. Pardiñas Baron, N. Pargana, J. Paris, A.N. Park, K.H. Park, N. Park, S.H. EP-COR-42, EP-ONC-22 EP-RET-021, EP-RET-022 FP09-10 EP-RET-089 EP-COR-02, EP-OPL-06 EP-OCS-07 RF01-4, EP-COR-26 FP06-5, RF02-3, EP-EXE-02 EP-NEO-11 EP-COR-26 EP-UVE-03, EP-UVE-10 EP-RET-119 EP-CAT-28 EP-PED-24 EP-ISOT-07 EP-RET-060 EP-COR-15 EP-UVE-12 ISOT03-10 FP06-5 EP-GLA-01, EP-GLA-21, EP-GLA-45 EP-CAT-01 EP-GLA-01, EP-GLA-21, EP-GLA-45, EP-PED-25 278 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

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AUTHOR INDEX Pinchuk, S. Pineda Oliveros, R.V. Pinheiro, D. Pinheiro, R. Pinheiro Costa, J. Pinto, C. Pinto, F. Pinto, M.d.C. Pinto, R. Pinto, S. Pinto Ferreira, N. Piovella, M. Pires, D. Pires, G. Pires, S. Pirounides, D. Pison, A. Pizzato Tondo, L. Plavsic, M. Pohosian, O. Policarpo Torres, G. Pollet-Villard, F. Pombo, B. Ponce Bolaños, A.I. Ponomarchyuk, A. Popa, M. Popit, M. Popovic, Z. Portela, M. Poslu Karademir, F. Posner, M. Post, M. Postelmans, L. Pozzolo Ogeda, J. Pracharova, Z. Prahasta, A. Prelog, S. Preston, E. Prieto, I. Priglinger, C. Priya, P. Prospero Ponce, C. Prpić, A. Prpić, T. EP-RET-093 ISOT01-3 EP-COR-48 EP-RET-030 EP-COR-48 EP-REF-17 EP-GLA-50 EP-REF-16 EP-RET-042 FP09-4, FP09-7, RF10-2 EP-RET-030 EP-CAT-33, EP-OCS-24 EP-RET-024, EP-RET-121 ISOT01-9 FP07-5, EP-RET-043 EP-CAT-28, EP-EDU-08 RF01-3 FP07-9, EP-GLA-59 EP-OCS-26 EP-RET-094 EP-UVE-12 EP-NEO-15 FP09-7, RF10-2, EP-OCS-16, EP-ONC-19, EP-UVE-34, ISOT01-9 ISOT02-2 EP-RET-081 EP-PED-58 EP-NEO-02 EP-PED-64 RF04-6 FP06-2 EP-EDU-10 EP-UVE-35 EP-RET-074 EP-COR-58 EP-CAT-17 ISOT02-1 EP-NEO-02 FP05-9, EP-RET-005, EP-RET-007 FP09-4, FP09-7, RF10-2, EP-OCS-16, EP-ONC-19, EP-UVE-34, ISOT01-9 EP-NEO-15 EP-RET-019 EP-NEO-15 EP-EXE-07 EP-PED-56 EP-OPL-35, Puchol Rizo, M. EP-ONC-18 EP-NEO-31 Puchol Rizo, M. EP-OPL-14 Puchol-Rizo, M. EP-COR-02, Puchol-Rizo, M. EP-GLA-40, EP-NEO-01, EP-OPL-06, EP-OPL-38, EP-PED-14, EP-RET-009, EP-UVE-06 Puertas-Martínez, E. EP-NEO-31 Pukhlik, O. Punekar, Y. Puodžiuvienė, E. Purelku, M. Pustina, B. ISOT04-7 EP-PED-50 ISOT04-3 FP07-11, EP-COR-34 EP-COR-62 Q Qamar, H. Qi, Y. Quadrado, M.J. Quadrado Gil, J. Quinn, M.S. Quintanilla, H. Quliyeva, A. Qureshi, I. R Rabelo, J.G.G. Rachid, R. Rachid, R. Radman, I. FP08-10 EP-RET-004 FP10-8, RF01-7, EP-COR-09, EP-COR-12, EP-COR-48, EP-COR-51 FP10-8 EP-COR-61 EP-RET-050 FP08-8 FP05-9, EP-RET-005, EP-RET-007 EP-RET-122 EP-COR-36, EP-COR-45, EP-COR-52, EP-COR-53, EP-RET-097, EP-RET-117, EP-ISOT-11 EP-GLA-70, EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09 EP-COL-05 EP-PED-31 EP-RET-054 ISOTV-9 EP-RET-054 EP-OPL-25 ISOTV-1 EP-GLA-66 EP-GLA-35 EP-RET-074 RF10-5 ISOT02-4, ISOT03-9 EP-CAT-05 EP-COL-02, EP-NEO-46 ISOTV-11 EP-REF-12 EP-REF-12 EP-ONC-17, EP-PED-56 EP-PED-04 RF05-8 Park, S.H. Park, Y.-G. Park, Y.H. Park, Y.-H. Parkassevitš, E. Parkhomenko, O. Passerini, M.S. Passos, J. Pasteels, B. Patel, H.I. Pathak, M. Pathmaraj, R. Pavel, I.A. Pawar, A. Pazniak, A. Pazniak, M. Peček Prpić, M. Peci, L. Pedrosa, C. Pedrosa-Domellöf, F. EP-PED-35 Pehlivanoglu, S. Pehlivanoğlu, S. Pelisek, M. Penas, S. Pereira, R. Pereira, S. Pérez-López, M. Perez Milosevic, L. Perez-Trigo, S. Pérez Trigo, S. Pérez-Trigo, S. Pessoa, B. Pestana Aguiar, C. Petkova, I. Petrenko, O. Petrova, L. Petrovič, D. Petrushkin, H. Phatak, S. Piamjitchol, C. Pichón Rizo, M. Picioroaga, A. Pina, S. FP08-9 FP08-4 EP-CAT-17 FP08-5, EP-RET-126 ISOT02-8 EP-UVE-19 RF02-2 EP-CAT-39 EP-OPL-02, EP-OPL-14, EP-OPL-15, EP-OPL-19, EP-ONC-02, EP-ONC-18 EP-OPL-35 EP-OPL-06, EP-OPL-38 RF06-6, EP-RET-114 EP-PED-69 EP-GLA-46, EP-RET-112, EP-UVE-25 ISOT02-5 EP-RET-085 EP-COR-18 EP-PED-16 FP05-9, EP-RET-005, EP-RET-007 EP-PED-43 EP-RET-108 RF03-4, EP-OCS-25, EP-OPL-37, EP-OPL-39 EP-UVE-04 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 279

280

AUTHOR INDEX EP-PED-64 EP-CAT-05, EP-RET-006 EP-RET-091 EP-RET-132 EP-RET-029, EP-UVE-02 EP-PED-55 EP-OCS-15 FP05-1, EP-GLA-41 EP-COR-09 EP-OCS-27 EP-PED-47 FP06-3 RF04-5, EP-EXE-01, EP-ONC-11, EP-ONC-12, EP-ONC-13, EP-ONC-14 EP-GLA-63, EP-GLA-64 EP-OPL-25, EP-OPL-33 ISOT02-6 EP-NEO-20 EP-GLA-35, EP-GLA-51, EP-PED-40 EP-RET-108 EP-PED-14 EP-NEO-31 EP-PED-16, EP-PED-68 EP-PED-47 RF10-5 Raffa, L. Raj, C. Rajamani, M. Rak, J. Rakshit, I. Raluca, P. Rami, A. Ramji, S. Ramos, S. Rao, H. Raoof, N. Rašić, D. Rašić, D.M. Raskovic, A. Rebane, R. Rebelo, A. Rebelo Neves, E. Rebocho Duarte, S. Reche Sainz, J.A. Reche Sainz, J.A. Reche-Sainz, J.A. Reddy, A. Reddy, M.A. Reddy, M.A. Redondo-Martínez, E. EP-CAT-26 EP-UVE-04 Reis, A.I. FP09-7, RF10-2, Reis da Costa, T. EP-UVE-34 EP-NEO-18, Reis da Silva, A. EP-NEO-20 EP-GLA-25, Reis Da Silva, A. EP-UVE-19 EP-PED-28 Reitblat, O. EP-RET-096, Rękas, M. EP-UVE-32 Rekhi, M. EP-PED-05 ISOT02-2 Reyna Gordillo, M.R. RF04-4, EP-GLA-39, Rhalib, S. EP-OCS-15, EP-PED-71, EP-RET-104 EP-NEO-14 Rhatigan, M. RF04-6, Ribas, A. EP-RET-041 Ribeiro, A.C. EP-COR-35 ISOT03-6 Ribeiro, B. EP-RET-121 Ribeiro, B.B. FP03-8 Ribeiro, B.B. Ribeiro, F. RF06-6 EP-GLA-28 FP08-5 EP-GLA-47, ISOT02-1 EP-RET-128 EP-PED-04 FP10-9, EP-NEO-43 RF02-6 FP07-2, FP07-16, EP-EDU-05 EP-GLA-25, EP-UVE-19 EP-REF-12 RF02-2, EP-NEO-21 EP-RET-057, ISOT03-6 EP-OPL-34, EP-RET-098 EP-PED-36, EP-RET-042 Ribeiro, L. Ribeiro, M. Rifada, M. Risi-Koziona, A. Rizzi, A. Rizzuto, V. Robič, T. Rocha, H. Rocha, J. Rockers, B. Rodien, P. Rodrigues, D. Rodrigues, R. Rodrigues Alves, N. Rodrigues-Araújo, J. RF05-8 Rodríguez, G.M. Rojas-Correa, D. Romana, J. Romero, J. Romero Cano, D. Roque, J. Rosa, A. Rosa, P. Rosenzweig, K. Rosetta, P. Rospond-Kubiak, I. Ross-Cisneros, F.N. Rougier, M.-B. Rovcanin, B. Rowe, F. Ruão, M. Rüger, C. Ruiz Arranz, C. Ruiz-Arranz, C. Ruiz Lopez, A.J. Rusanovskaia, A. Rykov, S. Ryu, H.H. EP-GLA-66 EP-COR-02, EP-NEO-01, EP-RET-009, EP-UVE-06 FP06-14, RF05-3, EP-RET-041, EP-UVE-15 ISOT01-7, ISOTV-6 EP-NEO-26 EP-UVE-29, EP-UVE-34 FP10-8, RF01-7, EP-COR-12, EP-COR-48, EP-COR-51 RF05-1 FP02-6 ISOT01-1 EP-ONC-06 RF02-4 EP-NEO-15 EP-NEO-22 FP04-7, EP-NEO-44 RF05-5 ISOTV-2 EP-NEO-36, EP-PED-66 EP-GLA-19, EP-OPL-19, EP-OPL-38 EP-OCS-04 FP08-6 ISOT02-5, ISOTV-1 EP-PED-12 S EP-NEO-38 EP-NEO-30 RF02-4 RF02-2 EP-PED-43 EP-ONC-05 FP06-2 EP-PED-16 EP-PED-47, EP-PED-68 FP11-1, EP-NEO-15 FP07-14 EP-GLA-17 RF07-7 RF02-2, EP-NEO-21 RF01-8 EP-RET-067 EP-RET-100 EP-RET-100 FP04-9, EP-COR-56, EP-PED-70, EP-REF-17, EP-RET-127 Sá Araújo, V. Sabbag Stersa, F. Sadun, A.A. Saeed, P. Saensupho, T. Safronenkova, I. Sagdic Ozcelik, S. Sagoo, M. Sagoo, M.S. Sahel, J.-A. Sahin, S. Sakurada, Y. Saleki, M. Sales Sanz, M. Salgari, N. Sallo, F. Samoila, L. Samoila, O. Sampaio, A.M. Sampaio Fernandes, E. EP-GLA-51 Sampat, V. Sanchez, J.L. Sánchez Martínez, D. EP-RET-135, EP-RET-136, EP-RET-139 Sandu, C.A. RF03-4, EP-OCS-25, EP-OPL-37 Santana-Castro, M. EP-ONC-01 Santana Moreira, P.H. FP10-10 Santos, G. Santos, J.G. Santos, M.J. Santos Estrada, J.R. Santos-Oliveira, J. Santos Silva, R. Saracoglu Yilmaz, B. EP-NEO-06, Saran, D.K. Sargsyan, H. Sargsyan, O. Sari, E.A. Sarmiento-Torres, B. EP-CAT-26 Scerbatiuc, C. EP-COR-42 EP-OCS-07 Schallhorn, J. EP-PED-58 Scharioth, G. FP06-9 Schaub, F. EP-OCS-29 Scheid, C. Schiavetti, I. EP-PED-04 FP06-9 Schirrwagen, J. RF02-2, Schittkowski, M. EP-NEO-21 Scholtz, S.K. EP-RET-062 EP-RET-121 EP-RET-024 FP09-4, EP-OCS-16, EP-ONC-19 ISOT02-2 EP-OPL-34 RF07-1 EP-RET-091 EP-UVE-12 EP-NEO-37 EP-OPL-08 EP-COR-19 EP-PED-75 ISOT04-8 280 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

281

AUTHOR INDEX Schöneberger, V. Schrader, W. Schrader, W.F. Schultz, G. Sekhon, C. Sekhsoukh, R. Selmani, K. Šemeklis, L. Semenova, E. Semiz, C.E. Semiz, F. Semiz, G.I. Semiz, G.I. Semiz, G.İ. Semizoğlu, İ. Sen, K. Sen, S. Seo, K.Y. Sepúlveda, P. Sequeira, J. Serdiuk, V. Sere, A. Sereikaite, L. Sergentanis, T. Sergott, R.C. Serino, J. Serji, O. Serras Pereira, R. Sethi, A. FP06-9 ISOT03-8 ISOT03-7, ISOT04-KN1, ISOTV-7 RF09-1 EP-EDU-05 EP-PED-76, EP-RET-133 EP-COR-53, EP-GLA-70, EP-RET-117, EP-RET-147, EP-UVE-36, ISOT02-7, EP-ISOT-06, EP-ISOT-09, EP-ISOT-11 EP-CAT-22, ISOT04-3 FP02-6 FP07-6, FP07-11, RF01-6, RF08-7, EP-CAT-27, EP-COR-34, EP-REF-03, EP-REF-04, EP-REF-07 FP07-6, FP07-11, RF01-6, RF08-7, EP-CAT-27, EP-COR-34, EP-COR-60, EP-REF-03, EP-REF-04, EP-REF-07 RF01-6 EP-COR-60 EP-REF-04, EP-REF-07 RF08-3 RF01-1 FP05-9, EP-RET-005, EP-RET-007 EP-CAT-02 FP03-4 EP-COR-35 ISOT03-4 EP-RET-100 EP-OPL-04 EP-RET-129 EP-NEO-15 EP-PED-70 EP-PED-76, EP-RET-133 EP-PED-36 RF09-1, EP-CAT-23, EP-CAT-24, Sethi, A. Sethi, H.S. Sethi, R. Sethi, S. Sethi, V. Settino, M. Severinsky, B. Shafei, M.M.E. Shah, D. Shah, R. Shaheen, F. Sharan, S. Shargorotska, I. Sharif, R. Sharma, P. Shcherbakova, V. She, H. Sheemar, A. Sheik-Ali, A. Shen, L. Shi, X. Shi, Y. Shin, S. Shi-van Wielink, K. Shoshi, F. Shoshi, F. Shoshi, M. Sidak-Petretska, O. Sidak-Petretska, O. Siebert, E. Sierra-Torres, R.M. Sievers, M. Siiskonen, M. Silva, A. Silva, Á. Silva, M. Silva, R. Silva, R. Silva, R. Silva, Y. Silva Fernandes, J. EP-PED-05, EP-REF-02 RF09-1, EP-PED-05, EP-REF-02, EP-REF-09 EP-UVE-09 RF09-1, EP-CAT-23, EP-CAT-24, EP-PED-05, EP-REF-09 RF09-1, EP-PED-05 RF09-1, EP-CAT-24, EP-PED-05 FP10-9 FP07-3, EP-COL-01 EP-RET-021 EP-PED-15 RF10-6 EP-RET-020 RF09-1, EP-PED-05 EP-COR-50 FP07-13 EP-CAT-40 EP-ONC-05, EP-RET-094 FP01-1 FP05-9, EP-RET-005, EP-RET-007 FP05-9 FP03-1 ISOT01-4 FP03-3 EP-RET-045 EP-PED-50 EP-CAT-14, EP-CAT-15 EP-CAT-14, EP-CAT-15 EP-CAT-14 ISOT04-5 EP-RET-081 EP-RET-066 EP-CAT-26 EP-RET-072 RF05-4 ISOT02-8 EP-NEO-38, EP-RET-123 RF05-8 RF04-6 FP01-7 FP04-9, EP-NEO-38, EP-PED-70, EP-REF-17, EP-RET-124 FP09-2 EP-UVE-22 EP-OCS-16, Silveira e Silva, D. EP-ONC-19 EP-RET-141, Simaku, E. EP-RET-142 EP-PED-46 Simitchiev, K. EP-REF-12 Simiyu, G.L. Simões de Barros, M. EP-NEO-30 Simonavičiūtė, D. EP-PED-42 FP03-9, FP06-2 Simsek, M. EP-PED-13 Sinamati, E. EP-RET-040, Singh, R. EP-RET-091 EP-UVE-09 Singh, R. EP-RET-023, Sirek, S. EP-RET-132 ISOT04-1 Sirman, Y. Škalič, P. RF02-6 EP-COR-20 Sklerius, R. FP03-2 Smahliou, P. EP-COR-55, Smędowski, A. EP-GLA-55, EP-GLA-57, EP-GLA-69 Smetanina, D. EP-REF-12 EP-NEO-15 Smirnov, V. ISOT03-4 Smishko, J. EP-COR-15 Smith, J. Smoljanović Skočić, S. EP-NEO-04 Smolkova, B. Soares, R. Sobrinho, M.V.d.A. Sokolenko, E. Somodi, B. Song, A. Song, C.H. Song, J.E. Song, J. Song, W.S. Sornichero Martínez, J. EP-RET-135, EP-RET-136 EP-OCS-11 Sotozono, C. RF01-3 Souedan, V. RF04-3 Sousa, C. EP-COR-56, Sousa, K. EP-RET-124, EP-RET-125 FP07-5, Sousa, P. EP-RET-043, EP-RET-057 FP03-4, Sousa Neves, F. EP-CAT-32, EP-RET-075 EP-NEO-05, Souttou, D. EP-RET-061, EP-UVE-18 Souttou, D. EP-UVE-23 Souza Gonçalves, G. EP-COR-58 RF04-7 EP-NEO-41 EP-RET-119, EP-RET-122 FP10-7 EP-UVE-16 FP07-2, FP07-16 EP-GLA-21, EP-GLA-45, EP-PED-25 EP-GLA-04 EP-COR-16 EP-COR-08 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 281

282

AUTHOR INDEX Špečkauskas, M. Spierer, O. Sramka, M. Sredkova, M. Sriram, A. Srivastava, G.K. Stamenkovic, M. Stanciu, P. Stanila, A. Stanila, A.A. Stanila, D.M. Statsenko, Y. Stein, H.M. Stein, M. Stephenson, K. Šterman, M. Stern, M.E. Sterren, B. Steven, P. Stoeva, S. Stoffelns, B. Stojičić, M. Stokes, J. Stoykova, S. Stramkauskaite, A. Strautmane, I. Strechi, M. Stremousov, K. Stroffolini, G. Štunf Pukl, Š. Suandari, Y.D. Suárez Baraza, J. Suárez-Baraza, J. Suciu, C.-I. Suciu, V.-I. Sugimoto, M. Suh, H. Sujirakul, T. Sukumaran, D. Sullivan, B.D. Sun, X. Sung, V. Sutar, A. Suwannaraj, S. Svoboda, J. Świerczyńska, M. Szala, K. 282 ISOT04-3 EP-PED-27, EP-PED-28, EP-PED-29 EP-ONC-09 EP-OPL-20, EP-OPL-40 FP04-5 EP-RET-103 EP-OCS-26 EP-RET-013 EP-CAT-38 EP-CAT-38 EP-CAT-38 EP-REF-12 ISOTV-10 ISOT01-10, ISOT03-8 EP-RET-056 EP-NEO-02 EP-OCS-29 FP02-6 EP-OCS-29 EP-PED-59 EP-RET-026, EP-RET-072 FP06-3 RF05-6 EP-GLA-18 EP-CAT-21 EP-NEO-25 EP-EDU-12 EP-RET-131 FP10-9 EP-COR-18 EP-GLA-47 EP-RET-068 EP-RET-009 EP-RET-033 EP-RET-033 EP-ONC-04 ISOTV-9 EP-PED-43 EP-GLA-36 EP-OCS-07 EP-NEO-32 EP-GLA-42 ISOT02-4, ISOT03-9, EP-ISOT-10 EP-PED-37 EP-PED-45 EP-GLA-57 EP-RET-023 T EP-OCS-23, EP-RET-118 EP-OCS-29 FP11-1, RF02-4, EP-NEO-15 EP-UVE-27 EP-RET-020 FP07-2, FP07-16 EP-NEO-11 FP05-1, EP-GLA-41 EP-GLA-17 EP-PED-13, EP-PED-58 EP-PED-15 FP07-11, EP-COR-34 EP-OPL-23 RF03-6 FP06-2 Taher, N. Tahmaz, V. Taiel, M. Takahashi-Kawasaki, M. EP-COR-01 Takkal, A. Talha, M. Tan, B.K.J. Tan, C. Tan, J. Tanaka-Mabuchi, N. Tandili, A. Tang, V. Tanrıverdi, G. Tarca, A. Tarim, B. Taskapili, M. Taşkıran Kandeğer, B. EP-PED-53 EP-GLA-43 Tatham, A. Taullaj, A. RF05-2, EP- RET-012, EP-UVE-08 RF01-7, Tavares, C. EP-COR-12, EP-COR-51 FP06-14, RF02-5, Tavares Correia, M. RF05-3, EP-RET-041, EP-UVE-15 EP-RET-065 Tay-Kierney, M.-L. EP-RET-029 Taylor, M. EP-RET-002 Teär Fahnehjelm, K. EP-PED-37 Teekakul, P. EP-NEO-34 Teixeira, F. FP09-10 Teixeira, P. EP-CAT-32 Teixeira, S. FP09-7, RF10-2 Teixeira, S. EP-RET-126 Teixeira Martins, R. EP-GLA-40, Tejada-Palacios, P. EP-PED-57 Telelyasova, M. EP-NEO-13 Teles Triglia Pinto, J. EP-COR-58 Tenedório, P. Terzieva, D. Tessitore, F. Tham, Y.-C. Theodorou, M. Theodossiadis, P. Theofilou, P. Thirunavukarasu, A. FP05-4, EP-GLA-25, EP-NEO-18, EP-NEO-20, EP-ONC-20, EP-UVE-19 EP-UVE-25 EP-PED-04 FP03-1 RF10-5 EP-RET-128, EP-RET-129 EP-RET-128 EP-EDU-05 Thirunavukarasu, A.J. FP07-2, FP07-16 EP-NEO-15 Thornton, S. EP-RET-004, Tian, J. ISOT01-4 EP-NEO-32 Tian, Y. FP07-2, FP07-16 Ting, D.S.J. EP-COR-25, Ting, Y.-C. EP-COR-38 FP10-7 Tode, J. EP-OCS-26 Todorovic, N. EP-ONC-04 Togashi, K. FP09-9 Tok Çevik, M. EP-ONC-06 Tomczyk, Ł. EP-COR-48 Tomé, R. EP-COR-01, Tomemori, R. EP-OCS-02 EP-NEO-06, Tongal, S. EP-NEO-37 EP-GLA-43 Topouzis, F. EP-NEO-36, Toribio Albarrán, M. EP-OPL-35, EP-RET-068, EP-RET-108 EP-PED-35 Tornqvist, K. RF05-8 Torrão, L. RF05-8 Torres-Costa, S. EP-GLA-58, Torres Peña, J.L. EP-GLA-60 EP-PED-57 Torres-Peña, J.L. EP-GLA-19, Torres-Peña, J.-L. EP-GLA-20 Tournaire-Marques, E. EP-NEO-15 Tovar, J.P. Townsend, J.H. Toyokawa, N. Traverso, C.E. Trier, S. Trifonov, I. Troisi, M. Troisi, S. Trpeska Boshkoska, A. EP-UVE-03 Trumpaitis, J. Tsamadou, D. Tsankova, V. Tselishcheva, M. Tsinopoulos, I. Tsirampidou, K. Tskhadadze, G. Tsvetkova, M. Tuncel Bahar, A.F. Turner, J. Tzamalis, A. Tzavara, C. FP01-4 EP-PED-35, EP-PED-45 EP-RET-003 ISOT02-5 RF03-3, EP-CAT-28 EP-EDU-08 EP-GLA-07 EP-RET-105 RF07-4 EP-RET-056 RF03-3 RF01-4 ISOT02-2 EP-RET-131 EP-COR-10 EP-COR-57, EP-GLA-56 RF09-3 EP-PED-28 RF01-2 RF01-2 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book

283

U Ucakhan-Gunduz, O. EP-CAT-08 EP-NEO-21 Uddin, J. EP-NEO-13 Ukina, A. FP06-2 Ulas, M.G. ISOT04-5, Ulianova, N. ISOT04-7 EP-RET-081 ISOT04-4 Umanets, M. EP-GLA-47, Umbara, S. ISOT02-1 EP-NEO-42, Unal, A. EP-RET-095 FP09-3 Ünlü, B.H. FP08-10 Upadhyay, A. FP09-3 Ural Fatihoğlu, Ö. EP-RET-093 Urazov, A. Urboniene, D. EP-CAT-21 EP-RET-020 Ur Rehman, O. EP-RET-070 Usaj, T. ISOT03-4 Ustymenko, S. Utheim, T.P. FP10-6 V Vagge, A. Vagiakis, I. Vaikšnorė, G. Vajzovic, L. Valaskova, J. Valcheva, K. Vale, C. Valiukevičienė, S. Vanags, J. van Everdingen, J. Varadhan, L. Varga, B.E. Varughese, M. Vasileiadis, N. Vasilijević, J. Vasović, D. Vasylieva, L. Vatavuk, Z. Vaz, F. EP-PED-04, EP-PED-38, EP-PED-39 EP-EDU-08 EP-COR-59 FP08-10 RF04-7, EP-ONC-09, ISOT04-2 EP-UVE-14 FP05-4 EP-CAT-22 FP10-9, EP-NEO-43, EP-REF-05 FP04-4 EP-RET-010 EP-UVE-16 EP-RET-010 EP-CAT-28 EP-ONC-12 FP06-3, RF04-5, EP-EXE-01, EP-ONC-11, EP-ONC-12, EP-ONC-13, EP-ONC-14 EP-GLA-34 EP-COL-05 EP-RET-041 FP04-9, EP-GLA-53, EP-PED-70, EP-REF-17 FP03-10, EP-REF-19 FP03-10, EP-REF-19 EP-COR-09 EP-NEO-38, EP-RET-124, EP-RET-127 EP-PED-50 FP10-6 EP-COR-23, EP-PED-23, EP-PED-52, EP-PED-54, EP-PED-59, EP-PED-67, EP-RET-078 EP-GLA-33 EP-OCS-16 EP-PED-16 FP01-9 FP01-9 EP-GLA-25, EP-NEO-20, EP-ONC-20, EP-UVE-19 EP-COR-06, EP-RET-002 EP-UVE-06 EP-EXE-07 EP-RET-051 EP-CAT-10 RF06-6, EP-RET-043 Vaz, F. Vaz, J. Vaz, M. Vaz, M. Vaz Pereira, M. Veeranki, P. Vehof, J. Veleva, N. Velichko, L. Vendrell, C. Venkatraman, M. Veselinovic, A. Veselinovic, M. Viana, A.R. Viberg, A. Vicente-Andreu, J. Vidić, M. Vidinova, C. Vidlář, A. Vieira, B. Vieira Cavalcante da Silva, M. FP10-10 Viestenz, A. Viestenz, A. Vignal-Clermont, C. Vignola De Carlo, J. Vigo-Matic, C. Vigo- Matic, C. Vilaverde, L. ISOT04-9 Villard, A. Vitanova, D. Vitovska, O. ISOT01-10, ISOT03-8, ISOTV-2, ISOTV-5, EP-ISOT-04 ISOT01-10, ISOT03-8, ISOTV-2, ISOTV-5, ISOTV-10, EP-ISOT-03, EP-ISOT-04 EP-NEO-15 EP-NEO-30 EP-OPL-22 ISOT01-8 EP-RET-114, EP-RET-032 EP-PED-67, EP-RET-003 EP-RET-062 AUTHOR INDEX Vivas, M. Vlacil, O. Vladeva, D. Voigt, A.M. Voitetskii, R. Vránová, K. Vukelić, S. Vukosavljević, M. FP09-4, FP09-7, RF10-2, EP-GLA-53, EP-ONC-19, EP-UVE-29, EP-UVE-34, ISOT01-9 EP-ONC-03 EP-EXE-03 EP-RET-026 EP-REF-12 EP-COR-37 EP-EXE-07 RF04-5 W Walter, S.D. Wang, G. Wang, J. Wang, K.P.K. Wang, N. Wang, T.-J. Wang, T.-R. Wang, Y.-H. Watabe, M. Watarkar, S. Watson, S. Westcott, M. Whelan, L. White, D. Whitfield, R. Wijdh, R. Wiksell, Å. Wolfrum, P. Won, Y. Wong, E. Wong, H.M. Wong, S.W. Wong, T.C.J. Wong, T.L.E. Wong, Y.L. Woo, S.E. Woszczek, D. Wu, C.-L. Wu, P.-J. Wuthisiri, W. EP-NEO-15 EP-NEO-32 EP-RET-131 EP-EDU-02 EP-RET-004 EP-COR-38 EP-COR-03, EP-COR-24 EP-COR-25, EP-COR-38 EP-REF-13 ISOT01-1 EP-COR-15 EP-PED-68 EP-RET-056 EP-OCS-07 FP06-12, EP-GLA-50, EP-NEO-34, EP-RET-058 EP-COR-04 EP-PED-45 EP-RET-026, EP-RET-072 EP-COR-08 EP-UVE-02 EP-PED-16 FP07-2, FP07-16 FP08-2, EP-COR-41, EP-GLA-42, EP-REF-11 EP-EDU-01 FP07-2, FP07-16 EP-OPL-10 EP-RET-023 EP-COR-03, EP-COR-24 EP-RET-008 EP-PED-43 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book 283

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AUTHOR INDEX Wygledowska-Promieńska, D. EP-GLA-55 EP-COR-55, EP-GLA-57, EP-GLA-69, EP-RET-023 X Xhetani, A. Xin, M. Xun, Y. Y RF05-2, EP-RET-012, EP-UVE-08 EP-GLA-15 ISOT03-2 EP-OCS-07 Yago, I. FP03-9 Yalcinkaya Cakir, G. Yalçınkaya Çakır, G. RF08-3 Yamagata, Z. Yamamoto, Y. Yaman, A. Yan, S. Yaneva, M. Yang, I-H. Yang, J. Yang, X. Yang, Y. Yartsev, I. Yasuoka, K. Yehoshua, Z. Yesilirmak, N. Yeung, I. Yildirim, Y. Yokota, K. Yoneyama, S. Yong, D.W.W. Yoo, H. Yoon, S.H. Yu, H. Yu, H. Yueh Faria, M. Yukawa, S. Yun, Y.I. Yu Wai Man, P. Yu-Wai-Man, P. EP-GLA-17 EP-RET-077 FP09-3 FP01-1, ISOT01-4 EP-COR-30 RF03-2 FP03-3 ISOT03-3 FP01-11 RF06-4 EP-PED-18 EP-RET-131 RF01-3, EP-RET-080 FP05-9, EP-RET-005, EP-RET-007 FP03-6 EP-RET-077 EP-GLA-17 EP-NEO-11 EP-CAT-04, EP-COR-08 EP-CAT-02, EP-COR-07 FP01-10 EP-OPL-21 EP-RET-030 EP-REF-13 EP-GLA-22 EP-GLA-09 FP04-4, FP11-1, EP-NEO-15 Z Zadorozhnyy, O. Zaharova, D.J. Zaini, M.I.S. Zankova, M. Zarembo, D. Zdravkov, Y. Zemaitiene, R. Zemītis, A. Zeng, L. Zeng, Y. Zenner, T. Žerjav, L. Zervoi, I. Zghaib, A. Zha, Y.Y. Zhaboiedov, D. Zhang, X. Zhediale, N. Zheng, C. Zhou, H. Zhou, S. Zhou, Y. Zhu, J. Zhu, J. Zhu, W.-H. Ziakas, N. Zinkernagel, M. Ziouti, B. Zırtıloğlu, S. Zoppe, P. Žorić, L. Zou, W.-J. Zubrytska, A. Zuo, X. Zwolińska, E. Żywiec, A. EP-GLA-33, EP-ONC-05, EP-RET-090 EP-PED-62 EP-COR-61 EP-REF-06, EP-RET-003 EP-OPL-24 EP-NEO-27, EP-ONC-21, EP-REF-06, EP-RET-047, EP-RET-073 EP-CAT-21 EP-CAT-22, EP-PED-42, EP-REF-15 EP-REF-05 EP-GLA-15 FP03-7, RF08-2, EP-CAT-19 ISOT03-8, EP-ISOT-04 EP-REF-01, EP-REF-14 RF05-2, EP-RET-012 FP08-6 ISOT03-2, ISOT03-3 ISOTV-1 EP-OCS-27 RF06-4 FP05-9, EP-EDU-10, EP-RET-005, EP-RET-007 FP01-1 FP07-2, FP07-16 EP-RET-055 ISOT01-4 EP-RET-056 EP-RET-008 RF03-3, EP-GLA-32 RF06-8, EP-RET-143 EP-RET-097 RF08-5 EP-NEO-15 EP-NEO-40 EP-RET-008 EP-RET-038 FP01-10 EP-ONC-06 EP-RET-096 284 Congress of the European Society of Ophthalmology (SOE) 7 - 9 June, 2025, Lisbon, Portugal - Abstract Book