Retinal Cases and Brief Reports最新文献

{"title":"Surgical approach to subretinal washout biopsy for primary vitreoretinal lymphoma (PVRL).","authors":"Jordan Vassileff Chervenkoff, Giancarlo Dell'Aversana Orabona, Edward Pringle, D Alistair H Laidlaw","doi":"10.1097/ICB.0000000000001773","DOIUrl":"https://doi.org/10.1097/ICB.0000000000001773","url":null,"abstract":"<p><strong>Introduction: </strong>We describe a case of primary vitreoretinal lymphoma (PVRL) masquerading as vitritis with subretinal lesions. We employed a subretinal washout and aspiration approach in addition to the standard vitreous biopsy.</p><p><strong>Methods: </strong>An anterior chamber tap followed by a dry vitreous biopsy were performed. Infusion was then switched on and a complete 25G right pars plana vitrectomy was then completed. To obtain further sampling material, balanced salt solution (BSS) was injected subretinally with a 41G extendible needle which was then aspirated and sent for cytohistopathological analysis. Subsequently, a fluid-air exchange was performed for tamponade. No laser retinopexy was performed.</p><p><strong>Results: </strong>Our patient had a positive vitreous and sub-retinal washout cytology with a mixed population of cells with smaller enlarged lymphocyte-like cells. A further polymerase chain-reaction (PCR) showed a clonal IGK gene rearrangement, indicating a clonal B-cell population. Further sample testing was positive for the MyD88 L265P gene mutation. No intracranial or leptomeningeal involvement was present on MRI head. At three months, her vision improved to 6/7.5 (20/25 or 0.1 LogMAR) with a pinhole in both eyes.</p><p><strong>Conclusion: </strong>Primary vitreoretinal lymphoma is an aggressive malignancy with a high mortality rate. A prompt diagnosis and treatment are essential. In the presence of subretinal lesions, subretinal fluid aspiration may increase the sensitivity in diagnosing PVRL. Additionally, it may aid visual acuity recovery long-term.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MOUND-LIKE EPIRETINAL MATERIAL: ITS SHORT-TERM CHANGES AND ASSOCIATION WITH POSTERIOR VITREOUS DETACHMENT MOUND-LIKE EPIRETINAL MATERIAL.","authors":"Issei Tetsumura, Shuichiro Aoki, Tatsuya Inoue, Kohdai Kitamoto, Takahiro Arai, Keiko Azuma, Ryo Obata","doi":"10.1097/ICB.0000000000001570","DOIUrl":"10.1097/ICB.0000000000001570","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to describe clinical characteristics of a retinal finding termed mound-like epiretinal material (MOLEM) and distinguish it from epiretinal proliferation, a similar epiretinal finding previously described in various pathologic studies.</p><p><strong>Methods: </strong>Five eyes from five patients were retrospectively identified from medical records. Clinical findings and images, including fundus photographs and optical coherence tomography, were reviewed.</p><p><strong>Results: </strong>All eyes displayed mound-like material with uniform and low-to-moderate reflectivity on an otherwise intact retinal surface detected on optical coherence tomography. No eyes presented with concurrent pathology typically observed in cases of epiretinal proliferation, such as lamellar/full-thickness macular hole, epiretinal membrane, vitreomacular traction, or uveitis. Two eyes exhibited central serous chorioretinopathy, but there was no association of MOLEM with serous retinal detachment. In three of five eyes, MOLEM appeared simultaneously with posterior vitreous detachment. Some lesions underwent irregular transformations over months and occasionally disappeared. While all cases were monitored without intervention, no visual decline or complications attributed to MOLEM were detected.</p><p><strong>Conclusion: </strong>Mound-like epiretinal material represents a novel clinical finding, characterized by transient morphological changes without symptoms and a potential association with posterior vitreous detachment. It may occur in eyes lacking macular diseases linked with epiretinal proliferation, a similar yet distinct lesion. The incidence, etiology, and clinical significance of MOLEM warrant further investigation by accumulating comparable cases, although the lesion appears benign and self-limiting.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"396-404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SEVERE RECURRENCE AND RETINAL INFLAMMATORY INFILTRATION AFTER CESSATION OF IMMUNOSUPPRESSION FOR MULTIFOCAL CHOROIDITIS AND PANUVEITIS.","authors":"Jeannette Ossewaarde-van Norel, Richard F Spaide","doi":"10.1097/ICB.0000000000001564","DOIUrl":"10.1097/ICB.0000000000001564","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to describe a severe recurrence of intraocular inflammation, following the cessation of immunosuppression, previously administered for multifocal choroiditis and panuveitis.</p><p><strong>Methods: </strong>This was a retrospective chart review.</p><p><strong>Results: </strong>A 27-year-old woman with multifocal choroiditis and panuveitis initially was treated with IV and oral corticosteroids and photodynamic therapy because of an active macular neovascularization in both eyes. Mycophenolate was soon started, and the recurrences during tapering of the oral corticosteroids in the first months were treated with periocular corticosteroids and anti-vascular endothelial growth factor injections as they became available. After a decade of immunosuppression without recurrences, the patient, having relocated, discontinued mycophenolate upon the advice of a new ophthalmologist who diagnosed her with punctate inner choroidopathy. This led to a severe recurrence in both eyes, characterized by new inflammatory lesions, ellipsoid zone loss, and widespread inflammatory cell infiltration into the outer retina. Intravitreal triamcinolone injections resulted in the resolution of subretinal and intraretinal inflammatory lesions and ellipsoid zone defects.</p><p><strong>Conclusion: </strong>The abrupt discontinuation of immunosuppression in a patient with multifocal choroiditis and panuveitis was associated with a rebound phenomenon, characterized by multilevel inflammatory activity in the posterior pole. This rebound phenomenon may offer clues as to the inflammatory targets in multifocal choroiditis and panuveitis.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"289-293"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CONCENTRIC MACULAR RINGS SIGN IN COMBINED HAMARTOMA OF RETINA AND RETINAL PIGMENT EPITHELIUM.","authors":"Lívia da Silva Conci, Renata Martins Maia, Rodrigo Pessoa Cavalcanti Lira, Leandro Cabral Zacharias, Eduardo Cunha de Souza, Sergio Luis Gianotti Pimentel, Carol Shields","doi":"10.1097/ICB.0000000000001563","DOIUrl":"10.1097/ICB.0000000000001563","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to describe two cases of concentric macular rings sign in patients with combined hamartoma of the retina and retinal pigment epithelium.</p><p><strong>Methods: </strong>Case report involving clinical examination, spectral domain optical coherence tomography, and optical coherence tomography angiography.</p><p><strong>Results: </strong>The first patient was a 26-year-old woman with clinical diagnosis of neurofibromatosis type 2. The best corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. She presented a subtle grayish lesion in the macular region of the right eye. On macular spectral domain optical coherence tomography, there was a thickened and disorganized retina, suggestive of combined hamartoma of the retina and retinal pigment epithelium. In addition, at the parafoveal region, there was a dentate pattern in the outer plexiform layer and Henle fiber layer on cross-sectional spectral domain optical coherence tomography. Optical coherence tomography angiography showed no foveal avascular zone in the right eye, and Optos ultra-widefield revealed a concentric macular rings sign in this eye. The second patient was a 14-year-old adolescent boy, with diabetes mellitus type 1. His best corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. He had a subtle whitish lesion in the macular region of the right eye, with spectral domain optical coherence tomography findings suggestive of combined hamartoma of the retina and retinal pigment epithelium. Similar to the first case, there was a dentate pattern in the outer plexiform layer and Henle fiber layer observed on spectral domain optical coherence tomography. In the right eye, blue reflectance images exhibited the concentric macular rings sign, and optical coherence tomography angiography showed absent foveal avascular zone.</p><p><strong>Conclusion: </strong>Combined hamartoma of the retina and retinal pigment epithelium may be related to changes in the outer plexiform layer and Henle fiber layer interface and may present the concentric macular rings sign.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"333-337"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVOLUTION OF AUTOIMMUNE RETINOPATHY IN STIFF PERSON SYNDROME: A CASE REPORT.","authors":"Grace E Nipp, Richmond Woodward, Andrew Gross, Jordan Deaner, Dilraj S Grewal","doi":"10.1097/ICB.0000000000001580","DOIUrl":"10.1097/ICB.0000000000001580","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report a case of autoimmune retinopathy as the presenting feature of stiff person syndrome and assess its evolution.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 35-year-old man presented with progressive, chronic vision loss. On initial examination, visual acuity measured 20/20 in the right eye and 20/50 left eye. Humphrey Visual Field testing demonstrated decreased foveal threshold in both eyes. Mild subfoveal ellipsoid zone loss was noted on optical coherence tomography. Five years later, the patient presented with painful lower extremity muscle spasms and stiffness and complained of increasing vision loss with difficulty distinguishing colors. Optical coherence tomography showed marked progression of ellipsoid zone loss. Scotoma was demonstrated on Humphrey visual field, and electroretinography demonstrated reduced responses consistent with bilateral severe maculopathy. Serum testing showed autoantibodies to the glutamic acid decarboxylase 65-kDa isoform (GAD65) at a high titer and a diagnosis of autoimmune retinopathy in the setting of stiff person syndrome was made. A systemic workup for malignancy was negative. The patient was treated with IV immune globulin and transitioned to rituximab with improvement in systemic symptoms.</p><p><strong>Conclusion: </strong>Unlike previous cases of autoimmune retinopathy in the setting of stiff person syndrome, vision symptoms and optical coherence tomography changes presented years before the onset of muscle spasms. Etiologies such as SPS should be on the differential of unexplained retinopathy, even in the absence of systemic symptoms, especially when paraneoplastic etiologies are ruled out.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"297-303"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CO-OCCURRING USHER SYNDROME TYPE 1 AND RENAL FAILURE.","authors":"Hong Le, Helen Anderson, Glydel Lopez, Julie Bayer-Vile, Hind Al-Saif, Natario Couser","doi":"10.1097/ICB.0000000000001575","DOIUrl":"10.1097/ICB.0000000000001575","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to describe a patient with a rare co-occurrence of Usher syndrome type 1C and renal disease, suspected to be secondary to Alport syndrome.</p><p><strong>Method: </strong>This was a case report and literature review of cases with Usher syndrome and renal failure. Clinical examination, color fundus photography, visual field tests, electroretinography, and whole-exome sequencing were used to diagnose and document the patient's clinical presentation.</p><p><strong>Results: </strong>An 18-year-old female patient with a known history of congenital hearing loss and chronic renal failure presented with progressive night and peripheral visual impairment, suspicious for an inherited retinal disease. Visual field testing, fundus examination, and electroretinography findings supported the diagnosis of Usher syndrome. Whole-exome sequencing identified a novel homozygous frameshift variant (c.238del) in USH1C gene. Whole-exome sequencing also identified a homozygous COL4A3 variant of unknown significance, which may be responsible for concomitant Alport syndrome.</p><p><strong>Conclusion: </strong>By presenting this rare case of co-occurring Usher syndrome Type 1 and renal failure, the authors highlight the importance of conducting further investigations that could reveal an additional underlying etiology when these entities are present.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"379-385"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MULTIPLE CHOROIDAL NEOVASCULARIZATIONS IN CHOROIDAL OSTEOMA TREATED WITH ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS: A 6-YEAR FOLLOW-UP CASE REPORT.","authors":"Yi Xuan, Min Wang","doi":"10.1097/ICB.0000000000001565","DOIUrl":"10.1097/ICB.0000000000001565","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to report a case of multiple choroidal neovascularizations (CNVs) secondary to choroidal osteoma injected with a total of 13 anti-vascular endothelial growth factor drugs over a long-term follow-up of 6-year period.</p><p><strong>Methods: </strong>This was a case report.</p><p><strong>Results: </strong>A 29-year-old woman presented with a peripapillary choroidal osteoma in her left eye with the best-corrected visual acuity of 20/25. After 2 years of follow-up, two foci of CNV (one was at the infranasal of the optic disc and the other was near the subtemporal vascular arch) and massive subretinal hemorrhage developed overlying the osteoma, causing decreased best-corrected visual acuity of 20/33. The patient was treated with four consecutive intravitreal injections of conbercept, and the two CNVs regressed with the best-corrected visual acuity recovered to 20/25. While 17 months later, the third CNV lesion locating at the fovea appeared and nine more injections of aflibercept were given during which repeated recurrence of it occurred. At the last follow-up, 6 years from baseline, all the three CNV foci were controlled, with the final best-corrected visual acuity of 20/33.</p><p><strong>Conclusion: </strong>Multiple CNVs may appear simultaneously at different locations in one osteoma, and prompt treatment with intravitreal anti-vascular endothelial growth factor may be a good option to control the progression and recurrence of these CNVs. Long-term follow-up and multimodal imaging are vital in the management of CO-associated CNV.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"328-332"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PEMBROLIZUMAB-RELATED BILATERAL OCULAR HYPOTONY ASSOCIATED WITH CILIARY DETACHMENTS AND MACULAR EDEMA: A TREATMENT-RESISTANT SIDE EFFECT.","authors":"Louise Bec, Charles Khouri, Christophe Chiquet","doi":"10.1097/ICB.0000000000001571","DOIUrl":"10.1097/ICB.0000000000001571","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to report a case of bilateral ocular hypotony associated with ciliary detachments and macular edema as an uncommon troublesome side effect of pembrolizumab (an immune checkpoint inhibitor) treatment.</p><p><strong>Methods: </strong>A 56-year-old man with a history of metastatic axillary melanoma (bone, lung, spleen, and lymph node lesions) treated with pembrolizumab complained of visual deterioration at his first-year anti-programmed-cell death-1 follow-up visit. VA in both eyes was 20/32. The patient presented with bilateral ocular hypotony (7 mmHg in the right eye and 3 mmHg in the left eye), ciliary detachments, and macular edema. Several treatments were sequentially tried, including systemic steroid therapy, subconjunctival injections of triamcinolone, an intravitreal dexamethasone implant, and leaving some cohesive viscoelastic agent during cataract surgery.</p><p><strong>Results: </strong>None of the treatments tried were effective in reducing the ocular hypotony, and stopping pembrolizumab was not an option due to its efficacy in controlling the cancer.</p><p><strong>Conclusion: </strong>Pembrolizumab treatment carries a risk of ocular hypotony which can be bilateral, presenting a challenging risk-benefit dilemma, particularly if pembrolizumab is effective in controlling the cancer.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"405-409"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ACCUMULATIVE EFFECT OF INTRAVENOUS PROSTAGLANDIN E1 OVER 19 YEARS TO TREAT THE OCULAR ISCHEMIA IN HIGH MYOPIA.","authors":"Robert D Steigerwalt","doi":"10.1097/ICB.0000000000001577","DOIUrl":"10.1097/ICB.0000000000001577","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to present the clinical history of the use of IV prostaglandin E1, a potent vasodilator of the peripheral vascular system, to treat ischemia in high myopia. This was originally reported in 2009.</p><p><strong>Methods: </strong>Three patients with high myopia and progressive visual loss were included. They all had documented ocular ischemia and were placed under treatment with IV prostaglandin E1 for the ischemia.</p><p><strong>Results: </strong>All three had central and peripheral visual improvement which initially lasted from 10 to 14 days after each treatment. Prostaglandin E1 was well tolerated by all three. One abandoned treatment after 4 months because she did not want to be part of an experiment. A second patient had irregular treatments which became ineffective after 15 years. The third has had regular treatments for the last 19.5 years maintaining a good visual acuity allowing an independent life. He has been able to extend the intervals between treatments from 3.5 to 4 months. He had occasional hypotensive episodes when the medicine was increased especially during the summer.</p><p><strong>Conclusion: </strong>High myopia can be associated with severe central and peripheral visual loss. This can be due to ischemia and can lead to no light perception in severe cases if not treated. The author presents the use of IV prostaglandin E1 as a possible treatment which could be tried in these cases.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"386-389"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHORIORETINAL ANASTOMOSIS AND RETINAL DETACHMENT WITH LASER PHOTOCOAGULATION-TREATED INCONTINENTIA PIGMENTI.","authors":"Spencer S Burt, J Peter Campbell, Benjamin K Young","doi":"10.1097/ICB.0000000000001554","DOIUrl":"10.1097/ICB.0000000000001554","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to describe a case of incontinentia pigmenti in which chorioretinal anastomosis occurred after laser photocoagulation, which was ultimately complicated by tractional and rhegmatogenous detachment.</p><p><strong>Methods: </strong>This was an observational case report.</p><p><strong>Results: </strong>A 2-month-old was referred to ophthalmology for a rash characteristic of incontinentia pigmenti due to concern for ocular involvement and was found to have peripheral avascular retina with early neovascularization. Following several rounds of panretinal photocoagulation, a chorioretinal anastomosis was noted on follow-up fluorescein angiography in the left eye. Subsequently, a tractional retinal detachment formed and was treated initially with a lens sparing pars plana vitrectomy, endolaser, and scleral buckle. Despite treatment, it progressed to a combined tractional/rhegmatogenous detachment and was deemed inoperable.</p><p><strong>Conclusion: </strong>Chorioretinal anastomosis is a rare complication of laser photocoagulation.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":" ","pages":"363-365"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}