International Ophthalmology最新文献

Purpose: To evaluate the correlation between the Triglyceride-Glucose (TyG) index and newly diagnosed cases of central retinal artery occlusion (CRAO) in patients.

Methods: The research involved 51 patients diagnosed with central retinal artery occlusion (CRAO) and a control group consisting of 50 healthy volunteers matched for age and sex. Following a thorough ocular examination, various blood biochemistry and hematological parameters were documented. The TyG index was derived from fasting plasma glucose and triglyceride values.

Results: The average age was 66.1 ± 8.9 years for individuals with CRAO and 64.9 ± 7.6 years for those in the control group. Significant differences in TyG values were observed between the CRAO and control groups, with the CRAO group exhibiting higher values (8.74 ± 0.17 vs. 8.49 ± 0.22, p<0.001). Upon multivariate analysis, the TyG index emerged as an independent predictor of CRAO (Odds Ratio= 1.84, 95% confidence interval = 1.19 - 4.23; p < 0.001). In receiver operating characteristics analysis, the area under the curve for the TyG index was 0.789. A TyG index exceeding 8.58 predicted CRAO with 78% sensitivity and 68% specificity.

Conclusion: The current study demonstrated a notable association between increased TyG index and central retinal artery occlusion (CRAO). Thus, the TyG index could serve as a valuable predictive marker for assessing the risk of CRAO.

Objective: To describe the anterior segment optical coherence tomography (ASOCT) features of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN) and correlate these findings with histopathology.

Methods: Retrospective study of 16 eyes with nuOSSN with clinical images, ASOCT scans, and histopathology.

Results: The mean age at presentation was 55 years (median, 58 years; range, 25 to 81 years). Systemic predisposing factors included human immunodeficiency virus infection (n = 2, 13%) patients and xeroderma pigmentosum (n = 1, 6%). Bulbar conjunctiva was the most common epicenter (n = 10, 63%), with limbal and corneal extension seen in 16 (100%) and 14 (88%) eyes. In addition to epithelial thickening, typical of OSSN, scleral thinning, limbal thinning, and corneal thinning were seen in 5 (31%), 10 (63%), and 7 (44%) eyes of nuOSSN, respectively. Corneal stromal opacification with normal overlying epithelium was seen in 10 (63%) cases, corresponding to the 'wedge sign' on ASOCT in all 10 cases. This corresponded to stromal invasion of OSSN on histopathology in all eyes. The wedge sign had a sensitivity of 77%, specificity of 100%, positive predictive value of 100%, negative predictive value of 50%, and an accuracy of 81% for stromal invasion compared with the gold standard of histopathological examination.

Conclusion: The ASOCT features of nuOSSN differ from classic OSSN. nuOSSN is associated with adjacent areas of scleral/limbal/corneal thinning. Corneal stromal opacification is seen as a wedge sign on ASOCT and corresponds to corneal stromal tumor invasion on histopathology. Areas of scleral/limbal/corneal thinning, along with the 'wedge sign' on ASOCT, confirmed nuOSSN with stromal invasion in 63% of patients in this retrospective study.

Purpose: This review aims to systematically review the available evidence on neuroprotective agents for optic neuritis, evaluating their effectiveness and safety.

Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. To collect the studies, we searched electronic databases including MEDLINE, Cochrane Library, and EMBASE in May 2023. A pre-established protocol of the systemic review was registered in the International Prospective Register of Systematic Reviews, ID Number: (CRD42023448479).

Results: Regarding the global loss of RNFL, a statistical significance was observed in favor of erythropoietin compared to placebo (MD = - 5.40, 95%CI, - 7.27-- 3.53). The overall difference in VEP latency recovery was insignificant (MD = - 0.63, 95%CI, - 5.95-4.69). The distinctness in visual acuity measured in logMAR in the memantine group was significant (MD = - 0.25, 95%CI, - 0.33-- 0.16). Two of the included studies had no major adverse events, however, the likelihood of major adverse events was significant overall in the other studies (RR = 2.28, 95%CI, 1.16 to 4.47). The erythropoietin group had 12 cases of major adverse events with a RR = 2.35.

Conclusion: Evaluating neuroprotective agents for ON produced mixed findings. Although erythropoietin was effective in reducing the thinning of RNFL, it did not lead to improved visual acuity results. On the other hand, our analysis found that memantine significantly improved VA compared to placebo. Notably, the experimental groups had more frequent adverse events, particularly with erythropoietin. Thus, caution is advised when contemplating the use of these agents.

Glaucoma, an optic nerve disease resulting in blindness if left untreated, is a difficult condition in healthcare in view of its diagnostic difficulties. Past approaches are based on assessment of the fundus images and the size of the cup and the disc, thickness of the rim and other abnormalities present in the eyes. Multifaceted developing AI prospects have potential to improve glaucoma identification. This research aims at implementing the best of feature learning on UNet +  + and Capsule Network (CapsNet) for better diagnostic results. For semantic segmentation, UNet +  + is used to accurately outline ODs and OCs-significant features in glaucoma diagnosis. CapsNet further performs this by capturing hierarchical structures and proves to be more sensitive towards the glaucomatous changes than the conventional Convolutional Neural Networks. To get improved image quality and features, a standard pre-processing method, such as Histogram Equalization and Contrast Limited Adaptive Histogram Equalization (CLAHE), are used in this paper to preprocess retinal images. The proposed hybrid model is then trained and tested on ten benchmark sets and achieves high accuracy in optic disc and cup segmentation and better performance in glaucoma detection than other presented approaches. Performance evaluation suggests good diagnostic ability which opens up the possibility of an automated system that helps clinicians diagnose early glaucoma. This application of UNet +  + and CapsNet shows the current possibility of glaucoma diagnosis using a new and more efficient method and a relatively small but powerful potential to prevent blindness by diagnosing glaucoma at an early stage. However, the study notes that the application of AI has revolutionized ophthalmic health care.

Purpose: To compare the Scheimpflug-Placido Topographer (SP-T; Sirius^®) and anterior-segment Swept-Source Optical Coherence Tomography (asSS-OCT; ANTERİON^®) for high order corneal aberrations in healthy subjects and patients diagnosed with stage 1 and 2 keratoconus.

Methods: The 125 eyes of 125 patients were included in the study and were divided into four groups based on their stage of keratoconus (KC) and the presence or absence of corneal cross-linking (CXL). The first group (KC1 group, n = 33) consisted of patients with stage 1 KC who underwent CXL, while the second group (ncKC1 group, n = 33) comprised patients with stage 1 KC who did not receive CXL. The third group (KC2 group, n = 26) included patients with stage 2 KC who underwent CXL, and the final group (control group, n = 33) consisted of healthy subjects. Root mean square (RMS) HOA (High-order aberration), horizontal trefoil (TrA), spherical aberration (SpA) and horizontal coma were compared between the SP-T and asSS-OCT to determine differences and agreement.

Results: A notable difference was observed between the devices in the control group for RMS HOA, horizontal TrA, and coma (p = 0.001, p = 0.026 and p < 0.001, respectively). In the KC1 group, a proportional bias was identified with regard to horizontal coma and RMS HOA (p = 0.025 and p = 0.043). For SpA, a proportional and fixed bias was observed in both the ncKC1 and control groups.

Conclusions: In the KC2 group, all parameters were in agreement, proving interchangeability between the SP-T and asSS-OCT devices. However, horizontal coma and HOA in KC1, as well as SpA in the control and ncKC1 groups, did not demonstrate this agreement. The interchangeability between devices may change according to the KC stage or CXL status.

Background: Allergic conjunctivitis is a common ocular disease characterized by inflammation of the conjunctiva, often associated with environmental allergens. CD4 + T cells and signal lymphocyte activation molecule (SLAM) expression has been implicated in the pathogenesis of allergic conjunctivitis, but their roles and interactions remain unclear.

Methods: This prospective cross-sectional observational study enrolled 100 participants, 50 with allergic conjunctivitis and 50 healthy controls, to investigate the relationship between peripheral blood CD4 + T cells, SLAM expression, and allergic conjunctivitis. Participants were evaluated using the Aston university allergy questionnaire (AUAQ), ocular surface disease index (OSDI), and dry eye questionnaire (DEQ-5). Peripheral blood mononuclear cells were isolated and analyzed for SLAM expression on CD4 + T cells using flow cytometry. Total serum IgE levels were measured using ELISA.

Results: The allergic group demonstrated significantly higher AUAQ, OSDI, and DEQ-5 scores compared to the control group, indicating a more severe allergic and ocular surface disease burden. Flow cytometry analysis revealed a significant increase in SLAM expression on CD4 + T cells in the allergic group (22.6% ± 5.3%) compared to the control group (15.2% ± 4.7%) (p < 0.001). Total serum IgE levels were also significantly higher in the allergic group (255.3 ± 131.2 IU/mL) compared to the control group (36.7 ± 19.8 IU/mL) (p < 0.001). Spearman's rank correlation analysis indicated significant correlations between AUAQ and OSDI scores (R = 0.38, p < 0.001), and between TBUT and OSDI scores (R = 0.21, p = 0.008), suggesting that reduced tear film stability is associated with more severe ocular surface symptoms.

Conclusion: The study findings suggest a significant association between allergic symptoms, ocular surface disease, and immunological markers in individuals with allergic conjunctivitis. The increased SLAM expression on CD4 + T cells and elevated total serum IgE levels in the allergic group may play a pivotal role in the pathophysiology of allergic conjunctivitis. These insights could inform the development of targeted therapies that address both the allergic and ocular surface components of the disease, potentially improving management and outcomes for patients with allergic conjunctivitis.

Purpose: Acquired vitelliform lesions are mainly progressive retinal pigment epithelium alterations and lipofuscin accumulation in the macular region. They may occur due to many different etiologies including vitreoretinal interface disorders. While vitreomacular traction can cause vitelliform lesions, the lesions then may also cause photoreceptor atrophy. We aimed to demonstrate the reabsorption of acquired vitelliform lesions after 25-gauge pars plana vitrectomy to treat patients with vitreomacular traction syndrome.

Methods: Nine eyes of eight patients, who were diagnosed with vitreomacular traction syndrome accompanied by acquired vitelliform lesions, were included in this institutional study. Patients with symptoms such as metamorphopsia, distorted vision of any kind or a decrease in visual acuity underwent 3-port 25-gauge pars plana vitrectomy and internal limiting membrane peeling with air or sulphur hexafluoride used as the endotamponade agent. During each preoperative and postoperative visit, the patients underwent a detailed ophthalmological examination. The differences in the median best-corrected visual acuity (BCVA) between the preoperative, postoperative second week, first,third and sixth months, first year and last follow-up were statistically compared using the Wilcoxon signed-rank test.

Results: The median (interquartile range IQR) preoperative BCVA was 0.40 0.30-0.45 LogMAR. During the second postoperative week, when intravitreal gas reabsorption occurred, the size of the vitelliform deposits decreased, and a median BCVA of 0.30 0.20-0.35 LogMAR was observed (p = 0.014). During the first month control vitelliform lesions were completely reabsorbed, and the BCVA was 0.20 0.15-0.35 LogMAR (p = 0.016).

Conclusion: The presence of vitelliform lesions alongside vitreoretinal interface problems may indicate the need for early surgical intervention to address potential photoreceptor damage due to additive photoreceptor stress results of traction and deposit accumulation.

This review seeks to evaluate anterior segment optical coherence tomography (AS-OCT) in the diagnostic procedure and management of Descemet's membrane detachment (DMD) in cataract surgery. DMD may present diagnostic challenges, particularly in pronounced corneal edema where traditional methods such as slit lamp biomicroscopy may be inadequate in evaluating the corneal layers. The role of AS-OCT in providing high-resolution images in the preoperative, intraoperative, and postoperative phases of cataract surgery is analyzed with a focus on its role in the early diagnosis of DMD and in evaluating the extent, morphology, and topographic localization of DMD allowing for immediate intervention during surgery and precise pneumodescemetopexy procedures where conservative treatment has failed. This review explores the integration of AS-OCT into the standard perioperative diagnostic workflow, highlighting its potential role in the prevention, accurate diagnosis, and prompt management of DMD, a complication of cataract surgery that, while low in incidence, can be highly disruptive when it occurs. The emerging role of artificial intelligence (AI) in AS-OCT analysis of anterior segment conditions and surgical procedures is discussed, though refinement of AI algorithms is warranted.

Introduction: Rhegmatogenous retinal detachment (RRD) is a vision-threatening complication of viral retinitis, at times compounded by proliferative vitreoretinopathy (PVR) at the junction of the necrotic and unaffected retina.

Methods: Retrospective review of eyes with 'junctional PVR' in RRD after viral retinitis. We define junctional PVR as presence of stiffness, transverse traction, epiretinal membrane and/or pucker at the junction of normal and necrotic retina.

Results: Five eyes of four patients with a mean age at presentation of 46.5 ± 10.96 years were included. Immunosuppression due to Human immunodeficiency virus (HIV) was the underlying condition in all the cases. Posterior hyaloid removal and epiretinal membrane removal at the junctional PVR was performed in all cases. Favourable outcomes were observed in seven sites where epiretinal membrane (ERM) removal with inner limiting membrane (ILM) peeling was performed; however, one site developed localised RRD requiring re-surgery. The mean logMAR best-corrected visual acuity (BCVA) improved from 1.84 before surgery to 0.64 during the last follow-up. All patients had undergone 23 G vitrectomy and silicone oil tamponade 1500 Centistokes (cSt) was used in all patients for a mean duration of 6.8 months.

Conclusion: Management of posterior hyaloid coupled with ERM removal and localised ILM peeling may be used to address junctional PVR in the eyes with RRD after viral retinitis.