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ObjectiveEndoscopic dacryocystorhinostomy (DCR) is a widely performed and safe procedure for the treatment of nasolacrimal duct obstruction manifested as epiphora or dacryocystitis. Current success rates are above 90%. Data on causes for failure of the procedure are sparse. We investigated the influence of several preoperative parameters on surgery outcome and to establish that parameters are linked with failure.MethodsA retrospective analysis of the medical records of all consecutive patients who underwent endoscopic DCR in the Tel-Aviv Medical Center, a tertiary referral center, between January 2010 and August 2016 were retrospectively examined and data on the occurrence of surgical failure and reasons for failure were retrieved.ResultsA total of 165 patients (183 eyes) were included. The overall success rate for the surgery was 94.7%. The parameters that correlated significantly with failure were coexisting diabetes mellitus (P = 0.037), allergy to medications (P = 0.034), and prior ocular surgery (P = 0.043). There was no correlation between the surgical failure rates and facial trauma, previous nasal or lacrimal surgery, or the usage of a stent.ConclusionEndoscopic DCR is a safe and effective surgical procedure. Diabetes mellitus, allergies, and previous ocular surgery may lead to surgical failure. Patients with these risk factors should be aware of increased failure rates.

Background/Objectives: Spontaneous macular hole closure is a rare phenomenon, with lamellar hole epiretinal proliferation (LHEP) frequently implicated as a potential mechanism. This study aims to analyze the presence of LHEP in patients with full-thickness macular holes (FTMHs) or lamellar macular holes (LMHs) that closed spontaneously without intervention. Methods: A retrospective longitudinal analysis of optical coherence tomography (OCT) scans was conducted for 73 patients diagnosed with FTMH or LMH in a single institution. Patients with documented spontaneous hole closure were further analyzed for the presence of LHEP, other OCT findings, and clinical characteristics. Results: Of the 73 patients, eight (11%) exhibited spontaneous closure of their macular holes. LHEP was identified in all cases, regardless of hole type (FTMH or LMH). Associated OCT features on diagnosis included VMT in one eye (13%), partial or complete posterior vitreous detachment in seven eyes (88%) and epiretinal membrane in eight eyes (100%). During hole closure, an outer nuclear layer bridge was noted in six eyes (75%). Various extents of outer retinal recovery were noted following closure. After closure, five holes (63%) remained closed without further intervention, while three (38%) reopened and required surgical intervention. Conclusions: Spontaneous macular hole closure is strongly associated with the presence of LHEP, highlighting its potential role in retinal repair mechanisms. While in most patients the spontaneous closure is permanent, surgical intervention may be necessary in cases of hole recurrence.

Purpose To assess the value of increased perifoveal retinal vascular tortuosity in optical coherence tomography angiography (OCTA) images as a biomarker of early hypertensive retinopathy and compare its clinical sensitivity and accuracy with traditional morphological changes used for Scheie classification. Methods OCTA images of 81 eyes (40 eyes from 20 hypertensive subjects and 41 eyes from 21 control subjects) were obtained retrospectively. Hypertensive retinopathy changes in randomized eyes were graded according to the Scheie classification, and perifoveal vessels were traced in a masked fashion. Tortuosity values of the perifoveal vessels were then calculated along with interobserver agreement in determining the morphometric values. Results There were no differences in perifoveal venular tortuosity between the hypertensive and control groups (Mean = 1.13 ± 0.04 vs. 1.13 ± 0.03), but significant differences existed for arterioles (Mean = 1.14 ± 0.05 vs. 1.11 ± 0.04). Tortuosity measurements demonstrated a significant interobserver agreement ( p  < 0.001), while Scheie ratings had a poor interobserver agreement ( p  = 0.735). There was a significant difference in Scheie classification between the hypertensive and control groups (Mean = 1.06 ± 0.54 vs. 0.50 ± 0.43, p  = 0.005). Conclusions OCTA-based perifoveal retinal arteriolar tortuosity may be a potential reliable biomarker with certain advantages for detecting early hypertensive retinopathy than morphological changes used for the Scheie classification. This may have broad applications and establish important parameters in utilizing OCTA for screening protocols, considering the importance of early detection of systemic hypertension. Key messages What is known • The existing Scheie classification schema for hypertension is subjective in nature with challenges in consistent identification of early hypertensive changes in the retina. What is new • Perifoveal arteriolar tortuosity differs significantly between early hypertensive and control patients. • Arteriolar tortuosity may be a potential biomarker that is useful in identifying patients who have early hypertensive changes in the retina.

AimsTo determine the role of inferior meatus pathologies as an underdiagnosed cause of epiphora.MethodsThis study was conducted in the oculoplastic institution of Tel Aviv medical center—a regional referral center. A retrospective review of files of patients presenting to the lacrimal clinic with nasolacrimal duct obstruction between October 2010 and September 2016. Cases in which a pathology of the inferior meatus was identified and treated are presented in this article.ResultsDuring this time frame, we preformed 186 endoscopic dacryocystorhinostomy surgeries. Out of those, eight patients (4.3%) were diagnosed and treated for pathology causing an obstruction of the inferior meatus. Seven of our patients were females; the mean age was 24 years. A wide range of pathologies were found: cysts, dacryoliths, membranes obstructing the inferior meatus, and concheal obstruction. All patients went through endoscopic treatment targeted at the cause of obstruction. During follow-up (average 35 months) only two patients remained symptomatic and were referred for an endonasal endoscopic dacryocystorhinostomy.ConclusionsInferior meatus obstruction is an underdiagnosed cause of epiphora. Multiple pathologies may co-exist in the same patient. In select cases of NLDO, diagnosis and treatment can be done endoscopically, avoiding the need for dacryocystorhinostomy.

We present a novel model for the problem of ranking a collection of documents according to their semantic similarity to a source (query) document. While the problem of document-to-document similarity ranking has been studied, most modern methods are limited to relatively short documents or rely on the existence of \"ground-truth\" similarity labels. Yet, in most common real-world cases, similarity ranking is an unsupervised problem as similarity labels are unavailable. Moreover, an ideal model should not be restricted by documents' length. Hence, we introduce SDR, a self-supervised method for document similarity that can be applied to documents of arbitrary length. Importantly, SDR can be effectively applied to extremely long documents, exceeding the 4,096 maximal token limits of Longformer. Extensive evaluations on large document datasets show that SDR significantly outperforms its alternatives across all metrics. To accelerate future research on unlabeled long document similarity ranking, and as an additional contribution to the community, we herein publish two human-annotated test sets of long documents similarity evaluation. The SDR code and datasets are publicly available.

We present MetricBERT, a BERT-based model that learns to embed text under a well-defined similarity metric while simultaneously adhering to the ``traditional'' masked-language task. We focus on downstream tasks of learning similarities for recommendations where we show that MetricBERT outperforms state-of-the-art alternatives, sometimes by a substantial margin. We conduct extensive evaluations of our method and its different variants, showing that our training objective is highly beneficial over a traditional contrastive loss, a standard cosine similarity objective, and six other baselines. As an additional contribution, we publish a dataset of video games descriptions along with a test set of similarity annotations crafted by a domain expert.

Recently, there has been growing interest in the ability of Transformer-based models to produce meaningful embeddings of text with several applications, such as text similarity. Despite significant progress in the field, the explanations for similarity predictions remain challenging, especially in unsupervised settings. In this work, we present an unsupervised technique for explaining paragraph similarities inferred by pre-trained BERT models. By looking at a pair of paragraphs, our technique identifies important words that dictate each paragraph's semantics, matches between the words in both paragraphs, and retrieves the most important pairs that explain the similarity between the two. The method, which has been assessed by extensive human evaluations and demonstrated on datasets comprising long and complex paragraphs, has shown great promise, providing accurate interpretations that correlate better with human perceptions.