Eye最新文献

Background: Cataract remains a significant public health issue, particularly for middle-aged and older adults. This study investigates the Disability-Adjusted Life Years (DALYs) attributed to cataract among people aged 55 and older from 1990 to 2021, providing insights for public health recommendations.

Methods: Using data from the Global Burden of Disease (GBD) database, this study examines the global burden of cataract caused by four risk factors: household air pollution from solid fuels (HAPFSF), smoking, high body-mass index (BMI), and high fasting plasma glucose (FPG) in individuals aged 55 and older. The ARIMA model was used to forecast trends from 2021 to 2040, and data processing was conducted using R and Python software.

Results: The paper analyses the impact of each risk factor, showing how the burden of cataract disease varies across different SDI regions and age groups. It also evaluates the combined effects of these risk factors and assesses their respective contributions to cataract burden in different SDI regions.

Conclusions: The study highlights the need to continue promoting smoking cessation measures and strengthening dietary management to reduce obesity rates. It also suggests replacing solid fuels with clean energy in underdeveloped areas, and enhancing health lifestyle education in developed regions to lower high blood glucose levels, thereby reducing the incidence of cataract.

Background: The MOLES scoring system was developed to help non-experts estimate the likelihood of malignancy in melanocytic choroidal tumours according to mushroom shape, orange pigment, large size, enlargement, and subretinal fluid. If only imaging is assessed, as in telemedicine, a choroidal melanoma (CM) may be scored as a naevus if subretinal fluid and orange pigment are not evident and if sequential imaging is not available. In such a telemedicine environment it might be safest to modify the MOLES score to assume lesion enlargement has occurred if the thickness and/or diameter exceed 3 mm or 7.5 mm, respectively.

Methods: Clinical records and multimodal imaging of patients with clinically diagnosed small CM (with no histopathological analysis) treated with ruthenium-106 (Ru-106) plaque brachytherapy were retrospectively reviewed. Sensitivity of the original and revised MOLES in estimating likelihood of malignancy were evaluated.

Results: The cohort comprised 142 patients (mean age 60 ± 13.6 years) with small CM. Mean tumour thickness and largest basal diameter (LBD) were 1.9 ± 0.5 mm (range 0.4-2.5 mm) and 7.5 ± 1.9 mm (range 3.5-15 mm), respectively. The MOLES score was ≥3 in 97.9% and 100% of small CM according to the original and modified scoring systems, respectively. No cases had MOLES score <2, indicating that 100% of patients would have been referred for specialist assessment.

Conclusions: The revised MOLES score increases sensitivity in diagnosing CM from 97.9% to 100% and is therefore a useful aid to patient management.

Background/objectives: Diplopia is an infrequent manifestation of GCA, but may precede other visual disturbances such as transient or permanent vision loss. The literature-pooled prevalence of diplopia in GCA patients stratified by cranial nerve (CN) involvement was assessed.

Methods/literature reviewed: The protocol was registered prospectively (PROSPERO: CRD420251071956). MEDLINE, Embase, and Cochrane CENTRAL databases were searched from inception to April 17, 2025. Studies were included if they reported on the proportion of diplopia events in patients with GCA. Literature screening, data extraction, and risk of bias (ROB) assessments were performed independently and in duplicate. A non-pairwise, random-effects meta-analysis was performed.

Results: 50 studies were included, encompassing 21,680 patients with GCA and 664 diplopia events. Overall, the pooled prevalence of diplopia in GCA patients was 7.15% (95% CI = 5.52-9.22%). The pooled prevalence of diplopia in GCA patients with CN III involvement was 0.96% (95% CI = 0.35-2.60%). The pooled prevalence of diplopia in GCA patients with CN IV involvement was 0.30% (95% CI = 0.07-1.26%). The pooled prevalence of diplopia in GCA patients with CN VI involvement was 1.41% (95% CI = 0.54-3.62%). Excluding studies with high risk of ROB, the pooled prevalence of diplopia in GCA patients was 7.14% (95% CI = 5.44-9.33%).

Conclusion: Overall, 7.15% of patients with GCA experience diplopia, more frequently reported due to abducens nerve palsy compared to oculomotor and trochlear nerve palsies. Accordingly, new-onset binocular diplopia in adults may warrant consideration of GCA and further investigation. Future prospective studies should aim to better characterise underlying aetiologies and assess whether early recognition of diplopia translates to improved visual prognosis.

Introduction: The prevalence of incidental intraocular malignancy in eye removal cases due to phthisis bulbi remains poorly understood. This retrospective study evaluates the prevalence of unsuspected intraocular malignancies in eye removal specimens.

Methods: Retrospective study of 1897 evisceration and enucleation specimens submitted for histopathological examination in the UK between 2014 and 2023 submitted to Department of Eye Pathology (DEP), a laboratory within the National Specialist Ophthalmic Pathology Service (NSOPS).

Results: Among 664 cases meeting inclusion criteria, the incidence of unsuspected malignancy was 0.75% (n = 5). All cases involved evisceration, with malignancies including melanoma, squamous cell carcinoma in situ, and undifferentiated spindle cell tumours, involving one case of malignancy of a corneal button. One case changed to suspected malignancy intraoperatively due to the findings noted during evisceration. Preoperative clinical assessments, including B-scan ultrasonography, failed to detect malignancies in these cases, highlighting the importance of comprehensive preoperative evaluation.

Conclusion: These findings underscore the need for histological examination in end-stage eyes to identify hidden malignancies and inform treatment decisions. While the overall risk of unsuspected intraocular malignancy remains low, this study reinforces the necessity of considering enucleation when intraocular tumours cannot be reliably excluded preoperatively. This data also emphasises the importance of informed consent and shared decision-making, incorporating the small but material risk of malignancy into pre-operative discussions with patients.