Eye最新文献

Background: Retinopathy of prematurity (ROP) is one of the leading causes of preventable childhood blindness worldwide. There has been a rapid increase in neonatal units in Tanzania leading to increased survival of preterm babies, which lead to increasing number of babies at risk of ROP. ROP screening started in Tanzania for the first time in Muhimbili National Hospital in Dar es Salaam in late 2019. This study determines the prevalence and factors associated with ROP in Muhimbili hospital from June 2020 to February 2021.

Methods: A prospective cohort study was conducted among 193 preterm newborns with ≤34 weeks gestational age and ≤2000 g birth weight. ROP screening was performed using an indirect ophthalmoscope and 20D Volk lens on dilated fundus. Prevalence was determined as the proportion of babies with ROP. Cox regression model was used to assess the contribution of risk factors to the occurrence of ROP.

Results: The prevalence of ROP was 29% (56/193), and of type 1 ROP was 8.8%. Majority had zone two (73.2%) and 41.1% had stage two disease. Aggressive ROP constituted 8.9%. Significant factors for ROP development were gestational age <32 weeks (hazard ratio 6.8, p value 0.00), birth weight <1500 g (hazard ratio 2.1, p value 0.02), Apgar score <7 (hazard ratio 1.9, p value 0.03), RDS (hazard ratio 3.3, p value 0.01) and oxygen supplementation for >1 week (hazard ratio 0.74, p value 0.03). Surfactant use had a protective effect (hazard ratio 0.2, p value 0.03).

Conclusion: Prevalence of ROP is fairly high in our setting. Screening is essential to prevent visual morbidity and blindness resulting from ROP in the country.

Objectives: To review the trend of microbial isolates for postoperative endophthalmitis (POE) in the United Kingdom (UK) and determine the sensitivity to current empirical intravitreal antibiotic treatment.

Methods: We conducted a long term multicentre consecutive case review of POE across 3 geographically distant tertiary eye centres in the UK: Sunderland Eye Infirmary (2000-2022), Oxford Eye Hospital (2016-2022), and Southampton General Hospital (2016-2022). Data on the microbial samples taken and results including sensitivities to antibiotics agents given were collected. Poisson regression was used to analyse microbial trends and outcomes were considered statistically significant at a level of p < 0.05.

Results: 179 consecutive eyes of 177 patients with POE met our inclusion criteria. The most common primary procedure was phacoemulsification and IOL insertion followed by intravitreal injections. 104 (58.1%) were culture positive and most were Gram-positive bacteria (85, 81.7%). The microbial trend consistently showed Staphylococcus epidermidis and unspecified coagulase-negative Staphylococci to be the most prevalent pathogens. Poisson regression showed no statistically significant change in any of the bacterial isolates over our study period. Antibiotic sensitivity data was available for 74% of the culture positive samples (77/104). All Gram-positive bacteria (68/68, 100%) and most (8/9, 88.9%) Gram-negative bacteria were sensitive to the empirical antibiotics (Vancomycin and Ceftazidime/Amikacin) given at presentation.

Conclusions: Most of the bacterial isolates causing POE in the UK are Gram-positive bacteria, and the trend has remained stable over more than two decades. Current empirical treatment with intravitreal Vancomycin and Ceftazidime/Amikacin provides effective broad coverage for the vast majority of cases.

The cornea serves to protect the eye from external insults and refracts light to the retina. Maintaining ocular homeostasis requires constant epithelial renewal and an efficient healing process following injury. Corneal wound healing is a dynamic process involving several key cell populations and molecular pathways. Immediately after a large corneal epithelial injury involving limbal stem cells, conjunctival epithelial cells migrate toward the center of the wound guided by the newly formed electrical field (EF). Proliferation and transdifferentiation play a critical role in corneal epithelial regeneration. Corneal nerve endings migrate through the EF, connect with the migrating epithelial cells, and provide them with multiple growth factors. Finally, the migrated epithelial cells undergo differentiation, which is also regulated by corneal nerve endings. All these processes require energy and effective cellular cross-talk between different cell lines and extracellular matrix molecules. We provide an overview of the roles and interactions between corneal wound regeneration components that may help develop fascinating new targeted therapeutic strategies to enhance corneal wound healing with less injury-related corneal opacity and neovascularization.

Background: To assess the association between patients with normal tension glaucoma (NTG) and the risk of obstructive sleep apnoea (OSA) using the STOP-Bang questionnaire.

Methods: A population-based cross-sectional analysis was performed using data from the Korean National Health and Nutrition Examination Survey from 2019 to 2021. An overall of 8832 subjects ≥ 40 years of age were investigated. Patients with NTG and controls completed the STOP-Bang questionnaire, a validated tool for identifying high-risk patients for OSA. The patients were divided into low-, intermediate-, and high-risk groups based on their scores.

Results: The mean STOP-Bang scores were 2.04 ± 0.02 in the control group and 2.42 ± 0.10 in the NTG group, with significant differences between groups (p < 0.001). In univariate logistic regression models, both intermediate-risk (Odds ratio (OR), 1.42; 95% Confidence intervals (CI), 1.05-1.91) and high-risk (OR, 1.71; 95% CI, 1.22-2.40) for OSA groups revealed a significant relationship regarding NTG compared to low-risk for OSA group. When adjusted for all confounding factors, the high risk for the OSA group was significantly associated with NTG (OR, 1.54; 95% CI, 1.06-2.24).

Conclusions: Our results indicate that high-risk OSA, as measured using the STOP-Bang questionnaire, correlates with NTG. Therefore, patients who scored two or more on the STOP-Bang questionnaire and were male, had a BMI > 35 or a neck circumference > 40 cm, or those who scored five or more and were classified as high risk should be carefully monitored because of the significantly higher likelihood of an association with NTG.