Case Reports in Ophthalmology最新文献

{"title":"Acetazolamide-Induced Bilateral Uveal Effusions and Secondary Angle Closure: A Case Report.","authors":"Kaela Braue, Keith Martin, Ortal Fogel Tempelhof","doi":"10.1159/000551289","DOIUrl":"10.1159/000551289","url":null,"abstract":"<p><strong>Introduction: </strong>Acetazolamide-induced uveal effusion and secondary angle closure is a rarely reported but clinically significant phenomenon. The reaction is idiosyncratic and independent of dosage or prior exposure.</p><p><strong>Case presentation: </strong>A 52-year-old patient developed severe bilateral uveal effusions, acute angle closure, and myopic shift 24 h after commencing acetazolamide for altitude sickness prophylaxis. The case demonstrates unusually severe posterior involvement after a single prophylactic dose, with dramatic recovery following initiation of intravenous methylprednisolone.</p><p><strong>Conclusion: </strong>Given the widespread use of acetazolamide in ophthalmology and other medical disciplines, clinicians must be aware of potentially sight-threatening drug reactions. Prescription of acetazolamide for altitude sickness prophylaxis represents a unique risk, as patients are likely to be travelling to remote destinations. First-time dosing should occur where urgent medical assessment is readily accessible.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"396-401"},"PeriodicalIF":0.6,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811434","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}

{"title":"Laser Iris Depigmentation Resulting in Markedly Elevated Intraocular Pressure and Herpes Simplex Keratitis with Corneal Scarring: Case Report.","authors":"Wasim Jaber, Malachy Nemet, Michael Waisbourd","doi":"10.1159/000551226","DOIUrl":"10.1159/000551226","url":null,"abstract":"<p><strong>Introduction: </strong>Laser iris depigmentation (LID) is a cosmetic procedure designed to alter eye color by reducing iris pigment using an Nd:YAG laser. While this procedure is increasingly popular, it carries risk of serious, sight-threatening complications. This report highlights two cases that emphasize these potential complications.</p><p><strong>Case presentation: </strong>Two patients presented after undergoing multiple sessions of LID performed abroad. They exhibited similar symptoms, including blurry vision, nausea, and eye pain. Case 1 had intraocular pressure (IOP) of 34 mm Hg in both eyes and later developed herpes simplex keratitis, which resulted in corneal scarring. Case 2 presented with IOP of 60 mm Hg in one eye. Both patients were admitted for topical IOP-lowering treatment and received systemic administration of acetazolamide and mannitol, resulting in normalized IOP levels. However, in the first patient, corneal scarring led to a marked decline in visual acuity.</p><p><strong>Conclusions: </strong>LID may be associated with serious, sight-threatening complications, including significant increases in IOP and corneal scarring. It is crucial for both patients and healthcare providers to be fully aware of these potential risks, which may outweigh the potential esthetic benefits of the procedure, and to actively monitor postoperatively for any signs of these adverse effects.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"312-317"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688544","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}

{"title":"Combined Hamartoma of the Retina and Retinal Pigment Epithelium: The Contribution of Optical Coherence Tomography in Redefining Its Development and Natural History - A Case Series.","authors":"Andrea Lembo, Francesco Pichi, Alessandra Cernuschi, Luca Marelli, Doris Hadjstilanou, Paolo Nucci","doi":"10.1159/000551030","DOIUrl":"10.1159/000551030","url":null,"abstract":"<p><strong>Introduction: </strong>Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is a rare, benign retinal tumor typically diagnosed in childhood and traditionally believed to involve the full thickness of the retina and the retinal pigment epithelium (RPE) from early stages. With the advent of optical coherence tomography (OCT), increasing evidence suggests that the primary origin of these lesions may lie within the inner retinal layers, with progressive outward extension over time. However, reports documenting very early-stage CHRRPE confined to the inner retina remain scarce.</p><p><strong>Case presentation: </strong>We report two pediatric cases of early-stage CHRRPE diagnosed at a tertiary referral center. A 4-year-old and a 10-year-old boy presented with unexplained reduced visual acuity associated with anisometropic amblyopia or strabismus. Fundoscopic findings were subtle or barely detectable, with no evident pigmentation, fibrosis, or exudation. Multimodal imaging, particularly OCT, revealed increased retinal thickness, loss of normal foveal depression, and disorganization of the inner retinal layers up to the outer plexiform layer, while the outer retina and RPE were preserved. OCT angiography showed distortion of the superficial and deep capillary plexuses in one case. These tomographic features were consistent with CHRRPE and allowed exclusion of other differential diagnoses, including foveal hypoplasia and malignant retinal tumors.</p><p><strong>Conclusion: </strong>These cases illustrate the earliest OCT-detectable phenotype of CHRRPE, supporting the concept that the lesion originates within the inner retina and progressively extends toward the outer retinal layers. Our findings highlight the critical role of OCT in identifying subtle CHRRPE variants in children with otherwise unexplained amblyopia or strabismus and contribute to a better understanding of the developmental origin and natural history of this rare entity.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"345-356"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721730","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}

{"title":"Severe Periocular Inflammatory Reaction Mimicking Necrotizing Fasciitis following Hyaluronic Acid Microinjections: A Case Report and Literature Review.","authors":"Tehila Shlomov, Nir Erdinest, Yossi Eshel, Zvi Gur","doi":"10.1159/000551132","DOIUrl":"10.1159/000551132","url":null,"abstract":"<p><strong>Introduction: </strong>Hyaluronic acid (HA) fillers are widely utilized in esthetic medicine for facial rejuvenation, including in the periocular region. Although generally considered safe, severe inflammatory responses can occur. This report describes a case of a 42-year-old woman who developed a significant periocular reaction following HA microinjections, clinically resembling necrotizing fasciitis.</p><p><strong>Case presentation: </strong>The patient, with no significant medical or ophthalmic history, presented to the emergency department with acute periocular swelling, redness, and an inability to open her right eye 3 h after HA microinjections. Clinical examination revealed marked periorbital edema, chemosis, and restricted ocular motility in the right eye. The severity of the presentation initially suggested necrotizing fasciitis. A CT scan indicated preseptal cellulitis without post-septal involvement. Treatment with intravenous antibiotics, systemic corticosteroids, antihistamines, and topical therapies led to significant improvement.</p><p><strong>Conclusion: </strong>This case highlights the need to recognize severe inflammatory reactions following periocular HA injections, which may mimic life-threatening conditions. Timely intervention and systematic evaluation are essential for achieving favorable outcomes.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"357-364"},"PeriodicalIF":0.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763540","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}

{"title":"Monotherapy with PHMB 0.08% as \"Switch Treatment\" in Complex Cases of Acanthamoeba Keratitis: A Report of Two Cases.","authors":"Eleftherios Chatzimichail, Isabel Stasik, Alexandra Steinemann, Frank Blaser, Zisis Gatzioufas","doi":"10.1159/000551097","DOIUrl":"10.1159/000551097","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to describe the favorable clinical outcomes of 2 patients with acanthamoeba keratitis (AK) following penetrating keratoplasty (PK), successfully managed with polyhexamethylene biguanide (PHMB) 0.08% monotherapy.</p><p><strong>Cases presentation: </strong>Both patients developed recurrent AK after PK, confirmed by microbiological testing and polymerase chain reaction (PCR). Standard dual therapy with PHMB 0.02% and propamidine isethionate 0.1% was either ineffective or poorly tolerated due to ocular surface toxicity. Transition to PHMB 0.08% monotherapy resulted in marked clinical improvement, resolution of keratitis, and substantial visual recovery. At follow-up examination 9 months postoperatively for case 1 and 12 months postoperatively for case 2, both patients demonstrated clear corneal grafts with no signs of AK recurrence.</p><p><strong>Conclusion: </strong>PHMB 0.08% as monotherapy proved effective in managing recurrent AK after keratoplasty, achieving favorable anatomical and visual outcomes without recurrence during our follow-up period. These findings suggest that PHMB 0.08% monotherapy may serve as a viable alternative to conventional dual therapy, particularly in cases complicated by treatment intolerance or treatment failure. Further studies with larger cohorts and extended follow-up are warranted.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"327-332"},"PeriodicalIF":0.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688595","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}

{"title":"Leber Hereditary Optic Neuropathy in the Elderly: A Case Report.","authors":"Haoran Li, Jonathan Micieli","doi":"10.1159/000551146","DOIUrl":"10.1159/000551146","url":null,"abstract":"<p><strong>Introduction: </strong>Leber hereditary optic neuropathy (LHON) is a mitochondrial disorder typically affecting young males, with rare reports of late-onset disease. Among the three primary LHON mutations, m.14484T>C is generally associated with a relatively favorable visual prognosis. However, the disease in elderly patients carrying this mutation remains poorly characterized. This case represents the oldest reported patient to date with LHON due to the m.14484T>C mutation.</p><p><strong>Case presentation: </strong>An 89-year-old man presented with a 4-month history of painless, bilateral vision loss. The patient had a 30-pack-year smoking history and daily alcohol intake but no family history of vision loss. His best-corrected visual acuity was counting fingers at 1 foot in both eyes, with color vision loss and bilateral elevated hyperemic optic disks. OCT demonstrated relatively preserved GCIPL thickness and pRNFL elevation, and visual fields showed diffuse loss. MRI of the brain and orbits was unremarkable. Laboratory evaluation, including serum B12, was normal. Genetic testing revealed the m.14484T>C mutation in mitochondrial DNA, confirming the diagnosis of LHON. At 3-month follow-up, fundus exam showed mild disk pallor bilaterally, reduced pRNFL elevation, diffuse GCIPL thinning, and stable vision and visual field.</p><p><strong>Conclusion: </strong>This case represents the oldest reported patient to date with LHON due to the m.14484T>C mutation. Despite the mutation's typical association with better visual outcomes, the patient experienced progressive vision loss with no recovery. This case underscores the importance of considering LHON in elderly patients with bilateral optic neuropathy and highlights the potential impact of age and environmental exposures on disease expression and prognosis.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"305-311"},"PeriodicalIF":0.6,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621787","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}

{"title":"Yoga Causing Vertebrobasilar Ischemia with Neuro-Ophthalmic Presentation: A Case Report.","authors":"Marina Shenouda, Elayna Bruce, Sanjana Jaiswal, Elizabeth O Arogundade, Zsolt Garami, Andrew G Lee","doi":"10.1159/000551028","DOIUrl":"10.1159/000551028","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case of a woman experiencing blurry vision and dizziness consistent with vertebrobasilar insufficiency (VBI) during yoga, confirmed with dynamic transcranial Doppler ultrasound. This is the first case identifying yoga as a cause of vertebrobasilar ischemia leading to neuro-ophthalmic findings and documenting the use of dynamic imaging to confirm vertebrobasilar ischemia during symptomatic positioning.</p><p><strong>Case presentation: </strong>A 56-year-old female with a past medical history of attention-deficit/hyperactivity disorder, dysthymia, allergic rhinitis, vertigo, and abnormal uterine bleeding presented to neuro-ophthalmology clinic for evaluation of transient painless bilateral \"shadowing\" of vision over the past year. The patient's symptoms began 2 years prior with vertigo. She was treated with Epley maneuvers which resolved the vertigo. A year later, she experienced an acute vision change, described as a shadow or blurriness in the center of her vision lasting 10 min. At the time, she was unable to identify a trigger. She was referred to the neuro-ophthalmology clinic for further evaluation of her visual episodes, which often occurred during yoga and were accompanied by dizziness, especially in the \"upward-facing dog\" pose. She subsequently underwent a dynamic transcranial Doppler ultrasound during head-turning maneuvers and yoga poses which showed posterior cerebral artery reduction in velocity, indicating vertebral artery compression. She was counseled on starting aspirin and avoiding triggers for VBI, including yoga and chiropractic manipulations.</p><p><strong>Conclusion: </strong>Neck hyperextension or rotation may lead to vertebrobasilar ischemia. Physicians should consider yoga as a potential cause of neck hyperextension leading to vertebrobasilar ischemia. This case represents the first report of yoga with a neuro-ophthalmic presentation of VBI confirmed by dynamic imaging.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"365-370"},"PeriodicalIF":0.6,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763538","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}

{"title":"Two Novel Variants in MT-RNR1 Gene Associated with Hereditary Optic Neuropathy: A Case Report.","authors":"Sara KamaliZonouzi, Jonathan Micieli","doi":"10.1159/000551049","DOIUrl":"10.1159/000551049","url":null,"abstract":"<p><strong>Introduction: </strong>Hereditary optic neuropathies are primarily disorders of mitochondrial dysfunction leading to the metabolic failure of the highly energy-dependent retinal ganglion cells. Beyond the canonical variants found in <i>OPA1</i> or the mitochondrial genome, a growing subset of patients exhibits progressive optic atrophy of unknown origin. Identifying these variants is critical, as they might lead to a diagnostic delay. We report 2 cases with previously unreported MT-RNR1 variants, potentially contributing to a hereditary optic neuropathy.</p><p><strong>Case presentations: </strong>A 55-year-old woman with painless progressive optic neuropathy presented with bilateral central scotomas and temporal optic disc pallor. Nutritional, inflammatory, and demyelinating causes were excluded. Genetic testing revealed <i>MT-RNR1:m.1019A>G</i> variant, potentially contributing to a hereditary optic neuropathy. A 59-year-old woman with similar bilateral temporal pallor and symmetric retinal nerve fiber layer thinning was found to harbor <i>MT-RNR1:m.1183T>C</i> variant.</p><p><strong>Conclusion: </strong><i>MT-RNR1</i> gene variant was the possible cause of vision loss in these patients with mild vision loss and a clinical picture consistent with a hereditary optic neuropathy. Herein, we describe two novel variants and associated clinical features. This case report introduces a previously unrecognized genetic variant, potentially contributing to a hereditary optic neuropathy.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"387-395"},"PeriodicalIF":0.6,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811460","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}

{"title":"Choroidal Osteoma with Focal Choroidal Excavation Masquerading as Active Vogt-Koyanagi-Harada: A Case Report.","authors":"Hanan A Alshalan, Shaima Alharazi, Nora A Alyousif","doi":"10.1159/000550373","DOIUrl":"10.1159/000550373","url":null,"abstract":"<p><strong>Introduction: </strong>Choroidal osteoma is a rare, benign ossifying tumor of the choroid that can present with clinical features overlapping those of inflammatory choroidal lesions. In patients with a history of Vogt-Koyanagi-Harada (VKH) disease, distinguishing between inflammatory relapse and non-inflammatory choroidal pathology can be particularly challenging. This case report highlights the diagnostic pitfalls associated with choroidal osteoma in the setting of prior VKH and underscores the importance of comprehensive multimodal imaging to ensure accurate diagnosis and appropriate management.</p><p><strong>Case presentation: </strong>A 39-year-old female with a 14-year history of VKH disease, who had been stable off immunosuppressive therapy since 2016, presented in early 2024 with a 7-week history of cloudy vision in the right eye. She was initially diagnosed with a recurrent posterior VKH relapse and treated with high-dose intravenous corticosteroids followed by an oral taper, resulting in symptomatic improvement. However, further multimodal imaging - including wide-field fundus photography, optical coherence tomography (OCT), fundus autofluorescence, OCT angiography, fluorescein angiography, enhanced depth imaging OCT (EDI-OCT), and B-scan ultrasonography - revealed a yellow-orange, minimally elevated subretinal lesion associated with focal choroidal excavation. These findings were consistent with choroidal osteoma and confirmed by EDI-OCT and B-scan ultrasonography.</p><p><strong>Conclusion: </strong>This case illustrates a rare instance of choroidal osteoma masquerading as a posterior relapse of VKH disease. It emphasizes the critical importance of differentiating inflammatory from non-inflammatory choroidal lesions in patients with a history of uveitis. Careful interpretation of multimodal imaging is essential to avoid misdiagnosis, prevent unnecessary immunosuppressive treatment, and reduce associated risks, ultimately leading to improved patient outcomes.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"223-229"},"PeriodicalIF":0.6,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462693","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}

{"title":"Acute Macular Hole Formation after Posterior Vitreous Detachment Induction in Epiretinal Membrane Surgery: A Case Report.","authors":"Jun Young Park","doi":"10.1159/000550899","DOIUrl":"10.1159/000550899","url":null,"abstract":"<p><strong>Introduction: </strong>We report a case of acute macular hole (MH) formation that occurred immediately following posterior vitreous detachment (PVD) induction during epiretinal membrane (ERM) surgery, and to highlight the significance of intraoperative foveal hemorrhage as an early indicator of this complication.</p><p><strong>Case presentation: </strong>A 47-year-old Asian female presented with blurred vision in the left eye. Preoperative examination revealed an ERM with associated macular distortion. The patient underwent cataract surgery combined with pars plana vitrectomy, including induction of PVD, ERM, and internal limiting membrane peeling. A small foveal hemorrhage was noted immediately after PVD induction. On postoperative day 1, OCT revealed a full-thickness MH with foveal hyperreflective lesion and posterior shadowing, consistent with foveal hemorrhage. Despite in-office intravitreal gas injection, the MH persisted and required a second vitrectomy with additional gas tamponade. Follow-up OCT confirmed successful closure of the MH, with gradual restoration of the photoreceptor and outer plexiform layers.</p><p><strong>Conclusion: </strong>Acute MH formation can occur immediately after PVD induction during ERM surgery, even in the absence of overt vitreomacular traction or direct macular trauma. Intraoperative foveal hemorrhage should alert the surgeon to the possibility of impending MH formation.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"17 1","pages":"300-304"},"PeriodicalIF":0.6,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621802","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}