The aim of this study is to evaluate the changes related to diabetic retinopathy (DR) (no changes, small or moderate changes) in patients with glaucoma and diabetes using artificial intelligence instruments: Support Vector Machines (SVM) in combination with a powerful optimization algorithm—Differential Evolution (DE). In order to classify the DR changes and to make predictions in various situations, an approach including SVM optimized with DE was applied. The role of the optimizer was to automatically determine the SVM parameters that lead to the lowest classification error. The study was conducted on a sample of 52 patients: particularly, 101 eyes with glaucoma and diabetes mellitus, in the Ophthalmology Clinic I of the “St. Spiridon” Clinical Hospital of Iaşi. The criteria considered in the modelling action were normal or hypertensive open-angle glaucoma, intraocular hypertension and associated diabetes. The patients with other types of glaucoma pseudoexfoliation, pigment, cortisone, neovascular and primitive angle-closure, and those without associated diabetes, were excluded. The assessment of diabetic retinopathy changes were carried out with Volk lens and Fundus Camera Zeiss retinal photography on the dilated pupil, inspecting all quadrants. The criteria for classifying the DR (early treatment diabetic retinopathy study—ETDRS) changes were: without changes (absence of DR), mild forma nonproliferative diabetic retinopathy (the presence of a single micro aneurysm), moderate form (micro aneurysms, hemorrhages in 2–3 quadrants, venous dilatations and soft exudates in a quadrant), severe form (micro aneurysms, hemorrhages in all quadrants, venous dilatation in 2–3 quadrants) and proliferative diabetic retinopathy (disk and retinal neovascularization in different quadrants). Any new clinical element that occurred in subsequent checks, which led to their inclusion in severe nonproliferative or proliferative forms of diabetic retinopathy, was considered to be the result of the progression of diabetic retinopathy. The results obtained were very good; in the testing phase, a 95.23% accuracy has been obtained, only one sample being wrongly classified. The effectiveness of the classification algorithm (SVM), developed in optimal form with DE, and used in predictions of retinal changes related to diabetes, was demonstrated.

Pregnancy is a condition often characterized by changes that occur in different parts of the body. Generally, the eyes suffer several changes during pregnancy that are usually transient but may become permanent at times. This may occur due to the release of placental hormones and those of maternal endocrine glands and fetal adrenal glands. Due to hormonal influences, physiological ocular changes during pregnancy have been shown in Caucasian women, so corneal sensitivity, refractive status, intraocular pressure, and visual acuity may change during pregnancy. Within this review, all studies that referred to physiological aspects and to changes of ocular pathology of pregnancy, the effect of the pregnancy on pre-existing (diabetic retinopathy, neuro-ophthalmic disorders) eye disorders, postpartum ocular changes, the intraocular pressure and the effect of hypotensive ophthalmic medicine during pregnancy, the connection between pregnancy and the neuro-ophthalmic pathology, as well as the role of anesthesia were analyzed.

(1) Background: Exposure to different sources of stress can have a significant effect on both psychological and physical processes. (2) Methods: The study took place over a period of 34 days and included a total of 40 animals. Regarding the exposure to chronic stressors, we opted for physiological, non-invasive stressors, e.g., running, swimming, and changes in the intensity of light. An unforeseen stress batch was also created that alternated all these stress factors. The animals were divided into five experimental groups, each consisting of eight individuals. In the context of conducting the open field test for behavioral assessment before and after stress exposure, we aimed to investigate the impact of stress exposure on the affective traits of the animals. We also monitored body mass every two days. (3) Results: The control group exhibited an average increase in weight of approximately 30%. The groups exposed to stress factors showed slower growth rates, the lowest being the running group, recording a rate of 20.55%, and the unpredictable stress group at 24.02%. The anxious behavior intensified in the group with unforeseen stress, in the one with light variations, and in the running group. (4) Conclusions: Our research validates the animal model of intermittent light exposure during the dark phase as a novel method of inducing stress. The modification of some anxiety parameters was observed; they vary according to the type of stress. Body mass was found to increase in all groups, especially in the sedentary groups, likely due to the absence of cognitive, spatial, and social stimuli except for cohabitation.

Aim: To construct neural models to predict the progression of glaucoma in patients with sleep apnea. Materials and Methods: Modeling the use of neural networks was performed using the Neurosolutions commercial simulator. The built databases gather information on a group of patients with primitive open-angle glaucoma and normal-tension glaucoma, who have been associated with sleep apnea syndrome and various stages of disease severity. The data within the database were divided as follows: 65 were used in the neural network training stage and 8 were kept for the validation stage. In total, 21 parameters were selected as input parameters for neural models including: age of patients, BMI (body mass index), systolic and diastolic blood pressure, intraocular pressure, central corneal thickness, corneal biomechanical parameters (IOPcc, HC, CRF), AHI, desaturation index, nocturnal oxygen saturation, remaining AHI, type of apnea, and associated general conditions (diabetes, hypertension, obesity, COPD). The selected output parameters are: c/d ratio, modified visual field parameters (MD, PSD), ganglion cell layer thickness. Forward-propagation neural networks (multilayer perceptron) were constructed with a layer of hidden neurons. The constructed neural models generated the output values for these data. The obtained results were then compared with the experimental values. Results: The best results were obtained during the training stage with the ANN network (21:35:4). If we consider a 25% confidence interval, we find that very good results are obtained during the validation stage, except for the average GCL thickness, for which the errors are slightly higher. Conclusions: Excellent results were obtained during the validation stage, which support the results obtained in other studies in the literature that strengthen the connection between sleep apnea syndrome and glaucoma changes.

Background and Objectives: The incidence and prevalence of cancers are increasing worldwide, with special emphasis placed on prevention, early detection, and the development of new therapeutic strategies that strongly impact patient outcomes. Limited data are available about emergency care’s role in treating patients with cancer. This study aims to determine the burden of end-stage and first-time diagnosis of cancer on emergency care in a high-turnover emergency care center. Materials and Methods: A retrospective observational study was conducted to identify patients requesting emergent aid for cancer-related symptoms in the Emergency Department of “St. Spiridon” Hospital from Iasi (Romania) between 1 October 2022 and 30 September 2023. The proportion and demographic characteristics of end-stage patients and those who received a first-time diagnosis during the emergency visit were evaluated. Risk analysis was performed to understand these patients’ care needs (such as medical care, surgical care, specialty consults, intensive care, ward admission, and other hospital transfers) and immediate care outcomes (such as in-hospital mortality and home discharge). Results: 2318 patients with cancer requested emergent care (patient presentation rate of 3.08%), of which 444 (19.15%) were diagnosed for the first time, and 616 (26.57%) were at the end-stage. First-time diagnosed patients had a significantly different distribution of cancer types (p < 0.001), were more likely to need any form of medical care, to require a specialty consultation, or to be admitted to a ward (OR 2.65, 95% CI: 2.12–3.32; p < 0.001; OR 3.28, 95% CI: 2.48–4.35, p < 0.001; OR 2.09, 95% CI: 1.70–2.59; p < 0.001, respectively) but were less severe, while end-stage patients were more likely to address repeatedly to the emergency room (OR 1.86, 95% CI: 1.32–2.59; p = 0.001) and had higher odds of needing intensive care, assisted ventilation and death (OR-4.63, 95% CI: 1.10–19.45, p = 0.04; OR 2.59, 95% CI: 1.57–4.28; p < 0.001, and OR 4.06, 95% CI: 1.73–9.54; p = 0.001, respectively). Conclusions: The emergency department often carries the weight of diagnosing patients with cancer and treating patients with end-stage disease. These data highlight the importance of prehospital care, particularly for cancer screening and palliative care, and the importance of fostering multidisciplinary collaboration in the emergency room with oncologists, geriatricians, and palliative care specialists to improve patient outcomes.

Sleep apnea syndrome (SAS) is a condition characterized by recurrent episodes of total or partial collapse of the upper respiratory tract associated with daytime drowsiness that cannot be explained by other factors. SAS is a pathology that can cause ophthalmological damage both directly through the pathophysiological mechanism characteristic of the disease on the ocular system, and indirectly by promoting the development of other pathologies (cardiovascular, metabolic), which are a risk factor for ocular morbidity in the absence of sleep apnea syndrome. The aim of this paper is to highlight the ocular symptoms determined by sleep apnea syndrome (SAS), by analyzing literature over the past 20 years. Method: A mini-review that collected data from Pub Med Central, ResearchGate, GoogleScholar, DovePress, ScienceDirect, Elsevier, related to the ocular implications given by sleep apnea syndrome, with or without continuous positive airway pressure (CPAP) treatment. The study included articles that identified a number of eye conditions associated with sleep apnea, such as: dry eye syndrome and impaired ocular surface, glaucoma, non-arteritic anterior ischemic optic neuropathy, floppy eyelid syndrome, keratoconus, central serous chorioretinopathy, central vein occlusion, corneal neovascularization, and age-related macular degeneration. Sleep apnea syndrome is a pathology that can cause the onset or worsening of varying degrees of severity eye diseases by its pathophysiological mechanism, with a different impact on the quality of the individual’s life. On one hand, the purpose of this review is to identify studies in literature that associate sleep apnea syndrome with eye alterations; on the other hand, to inform the Romanian medical staff in different fields of the patients’ guidance diagnosed with SAS to an ophthalmology clinic since early and mild symptoms, so that these patients benefit from an ophthalmological approach and monitoring, in an attempt to diagnose and treat eye diseases in time and prevent their worsening.