International Ophthalmology最新文献

Purpose: This study aims to evaluate the accuracy of intraocular lens (IOL) power calculation formulas-including Kane, Emmetropia Verifying Optical (EVO) 2.0, SRK/T, Hoffer Q, Haigis standard, Haigis optimized, Holladay 1, Olsen, Barrett Universal II-in primary angle-closure glaucoma (PACG) eyes undergoing cataract surgery combined with goniosynechialysis (GSL).

Methods: Preoperative biometric data were obtained using the OA-2000. The preoperative anterior chamber depth (ACD) was categorized into two subgroups: < 2.50 mm and 2.50 to 3.50 mm. The predictive accuracy of the formulas was assessed using the mean prediction error (PE), mean absolute error (MAE), median absolute error (MedAE), and proportions of eyes within ± 0.25D, ± 0.50D, ± 0.75D, and ± 1.00D. Differences in absolute error among the various formulas were examined utilizing the Friedman test. In the case of a significant result, post hoc analysis was conducted employing the Wilcoxon test with Bonferroni correction.

Results: A total of 141 eyes of 141 PACG patients were included in the analysis. The standard deviations of the PE, ranked from lowest to highest, were as follows: Holladay 1 (0.67), Kane (0.69), EVO 2.0 (0.71), SRK/T (0.71), Hoffer Q (0.72), Haigis standard (0.74), Haigis optimized (0.76), Olsen (0.77), Barrett Universal II (0.79). Statistically significant differences in absolute refractive errors among the formulas were observed (P = 0.001). Kane formula demonstrated the lowest MedAE (0.34), and the highest percentages of eyes within ± 0.25D (35.46%) and ± 1.00D (89.36%), while EVO 2.0 had the highest percentages within ± 0.50D (65.25%). In the ACD < 2.50 mm subgroup, MedAE differed significantly among formulas (P = 0.001). The Holladay 1 formula had the lowest MedAE (0.33), followed by Kane (0.34), EVO 2.0 (0.37). In the 2.50 ≤ ACD < 3.50 mm subgroup, refractive errors showed no statistically significant differences. Additionally, the percentages within ± 0.25D, ± 0.50D, ± 0.75D, and ± 1.00D demonstrated no significant differences in both subgroups (all P > 0.05).

Conclusion: Among the nine formulas, Kane, Holladay 1, and EVO 2.0 demonstrated superior refractive outcomes in PACG eyes.

Purpose: Description of retinal phenotype by structural and functional testing, ornithine plasma levels and mutational data of OAT gene in patients with Gyrate Atrophy (GA).

Methods: Ophthalmologic examination, fundus photography (CFP), autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), Goldmann perimetry (GP), full-field electroretinogram (ffERG) and chromatic perimetry (CP) testing were performed. Ornithine plasma levels were measured. Sanger sequencing mutational analysis of the coding exons and exon-intron junctions of the OAT gene were analyzed.

Results: Twelve eyes of seven Mexican patients with GA were included. CFF showed peripheric patches of chorioretinal atrophy; FAF revealed peripheric oval areas of hypoautofluorescence; SD-OCT exhibited outer retinal tubulations in 58%, cystoid macular edema in 50%, epiretinal membrane in 42%, foveoschisis and staphyloma in 17%, and hyperreflective deposits in 100% of the eyes; GP showed constricted visual fields in 100% of the eyes; ffERG revealed preserved photopic response in 17% and preserved scotopic response in 17% of the eyes; CP exposed a deficit in generalized response of rods and cones in 100% of the eyes. Mean ornithine plasma levels were 509.5 µmol/L. One patient with genetic confirmation of GA had normal ornithine plasma levels (48 µmol/L). Molecular findings in OAT gene detected two novel pathogenic variants: c.796 C > T (p.Gln266*) and c.721_722dupCC (p.Asp242ArgfsTer6).

Conclusion: This study provides new information regarding functional and structural diagnosis in patients with GA, expands the understanding of retinal phenotype in patients with GA, reports two novel mutations and presents the first case of GA confirmed by genetic testing with normal ornithine levels.

Objective: To assess serum inflammatory biomarker levels in patients with different subtypes of diabetic macular edema (DME).

Methods: We retrospectively analyzed 50 eyes from 37 treatment-naïve DME patients who underwent intravitreal injection therapy between June and December 2023. Based on the morphological characteristics of macular edema in optical coherence tomography (OCT), the eyes were categorized into the cystoid macular edema (CME) group (n = 25) and diffuse retinal thickening (DRT) group (n = 25). Additionally, 25 eyes with diabetes retinopathy but without DME served as the control group. Comprehensive clinical data were reviewed, including best-corrected visual acuity (BCVA), central macular thickness (CMT), macular cube volume (VOL) and hematological examination. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated.

Results: NLR and SII levels were significantly higher in the CME group compared to the DRT group and control group (all P < 0.01). The optimal ROC cutoff value of NLR for CME was 2.27, with 88.0% sensitivity and 68.0% specificity. The optimal ROC cutoff value of SII for CME was 447.33, with 84.0% sensitivity and 60.0% specificity. After initial intravitreal injection therapy, BCVA and VOL significantly improved in each group (all P < 0.01). However, no significant correlation was found between systemic inflammatory marker levels and postoperative changes in BCVA, CMT and VOL (all P > 0.05).

Conclusion: Our study suggests that elevated NLR and SII levels are significantly associated with CME. Elevated serum inflammatory biomarkers may indicate a higher incidence of CME in these patients.

Purpose: This study aimed to examine the association of diabetes with anatomical and functional outcomes of epiretinal membrane surgery.

Methods: Consecutive patients who underwent epiretinal membrane surgery between 2017-2021 at Helsinki University Hospital, Finland. Here we examined the association of diabetes, glycemic control, and requirement for insulin medication with surgical outcomes at 1-month.

Results: Included were 214 eyes of 214 patients, with a mean age of 71.2 ± 8.2 years. Among patients with diabetes (n = 45), neither significant differences were observed in anatomical outcomes (- 47.8 ± 72.7 μm vs. - 38.3 ± 103 μm for foveal thickness, p = 0.566 and - 41.6 ± 61.8 μm vs. - 41.7 ± 85.7 μm for central subfield macular thickness, p = 0.996) nor in best-corrected visual acuity (BCVA) gain (0.06 ± 0.22 vs 0.12 ± 0.30 LogMAR units, p = 0.214) compared to those without diabetes. In a multivariate analysis adjusted for age, gender, the existence of preoperative macular cysts, and topical nonsteroidal anti-inflammatory drugs (NSAIDs) use, the results remained consistent. The last preoperative HbA1c levels did not correlate with changes in foveal (Pearson's r = 0.218, p = 0.264) or central subfield macular thickness (r = 0.365, p = 0.056), or with BCVA gain (r = -0.177, p = 0.386). Insulin therapy for diabetes did not associate with the outcomes (p > 0.05 for anatomical and functional comparisons).

Conclusions: In a cohort of patients who underwent epiretinal membrane surgery, neither the presence of diabetes, nor glycemic control and the use of insulin medication associated with the outcomes.

Purpose: The study aims to investigate an outbreak of acute haemorrhagic conjunctivitis (AHC) reported in North India.

Methods: All patients presenting to the outpatient clinic department with signs and symptoms (symptoms onset within 36 h) of AHC were enrolled in the study. The conjunctival swab samples were tested for the presence of enteroviruses and adenoviruses. Detailed clinical features of all positive patients were noted. Representative enterovirus-positive samples were sequenced for viral; protein 1 (VP1) gene for type identification. The sequences were analysed by the Basic Local Alignment Search Tool (BLAST) software and enterovirus genotyping tool v1.0. A maximum likelihood tree was constructed using MEGA11.

Results: Out of 133 samples tested, 75.1% (n = 100) samples were positive for enterovirus by real-time PCR. The average duration of onset was 16.9 h. Subconjunctival haemorrhage was observed in 67% of the patients, while 30% of cases had conjunctival chemosis. The causative agent of the current outbreak was identified as Coxsackievirus A24v G-IV. A sequence homology of 96-99% and pairwise distance divergence of 2.9% was observed between study sequences and recent sequences of China outbreak. Mutation analysis showed four common mutations (T281C, A311G, T332C, and T395C) with those of Chinese sequences, however no new mutations were identified in current study sequences, suggesting a close relatedness to CVA24 sequences from China.

Conclusions: Coxsackievirus A24v continues to be an important agent of Acute Haemorrhagic conjunctivitis in North India. In view of its highly contagious nature, effective and timely public health measures are required to limit its spread.

Purpose: Herpes Zoster Ophthalmicus (HZO) is a disease commonly affecting the elderly and immunocompromised. Over the last several years, a trend towards decreasing incident age, albeit with varying clinical features, has been observed. This temporal trend towards the younger age group necessitates a detailed evaluation to determine possible causes of its occurrence in this population.

Method: This is a hospital-based retrospective study. 154 datasheets were initially identified. After excluding non-relevant data sheets (88), 56 relevant and complete records were subjected to comprehensive analysis in adherence to the inclusion criteria.

Results: Most commonly affected age group was < 40 years, with the mean age being 38. Conjunctivitis was the most frequent occurrence seen in 82.05%. Keratitis was seen in varying forms as, epithelial (64.44%), stromal (15.3%) & nummular (3.57%). Anterior uveitis in 35.89%, posterior uveitis (retinitis, neuro-retinitis) in 7.69% of cases, posterior segment involvement (rhegmatogenous retinal detachment, optic atrophy) in 8.8%, secondary glaucoma in 28.2%, optic neuritis in 5.3% while orbital apex and cavernous sinus involvement were seen in one case.

Conclusion: This study reflects a temporal shift in the incidence of HZO towards the younger age group. The proportion of younger patients with HZO is increasing with some male preponderance. Identifiable factors contributing to potential risk, recurrence, and chronicity of HZO are related to demographics, immune status, dietary, environmental associations, vaccination status, and previous history of recurrences. Reported outcomes can be valuable in understanding the evolving patterns of HZO and improving patient care, public health and vaccination policies.

Purpose: to evaluate the clinical outcomes of a hybrid refractive/extended depth-of-focus intraocular lens (Lucidis; Swiss Advanced Vision, SAV-IOL SA, Neuchâtel, Switzerland) in glaucoma patients and to compare the contrast sensitivity results as regards to method of glaucoma control.

Methods: This retrospective multicenter study included 28 patients with visually impairing cataract and controlled early to moderate primary open angle glaucoma who underwent phacoemulsification and Lucidis intraocular lens implantation during the period from June 2021 to July 2023. Medical records were reviewed for baseline characteristics, severity, adequacy and method of control of glaucoma, details of cataract surgery and postoperative findings. Clinical outcomes were analysed at 3 months postoperatively and included uncorrected and best corrected near, intermediate and distance visual acuities, manifest refraction, contrast sensitivity, and patient satisfaction (adapted from the Catquest-9SF questionnaire).

Results: 42 eyes of 28 patients were included, with a male to female ratio of 1:1.8. There was a highly significant improvement in postoperative uncorrected and best corrected near, intermediate, and distance visual acuities (p < 0.001). Mean postoperative contrast sensitivity was 1.56 ± 0.11 log and there was no significant difference between medically and surgically controlled glaucoma (P = 0.08). There was a highly significant correlation between preoperative mean deviation and postoperative contrast sensitivity (p < 0.001). 26 (92.9%) patients were very satisfied. One (2.4%) eye developed dysphotopsia and no serious complications occurred throughout the study.

Conclusions: Lucidis IOL is effective and safe in patients with cataract and early to moderate POAG requesting spectacle independence. Adequate glaucoma control, regardless the method of control, and better preoperative mean deviation ensure good clinical outcomes.

Trial registration: ZU-IRB#11,295-28-11-2023, 28/11/2023 'retrospectively registered'.

Purpose: This study aimed to investigate the possible mechanisms by which ANGPTL4 is involved in the pathogenesis of choroidal neovascularization (CNV) and subretinal fibrosis.

Methods: Differentially expressed genes in retinal pigmented epithelium (RPE)-choroid-sclera complex tissues from nAMD patients and control individuals were identified via the GEO database, followed by GO and KEGG analyses. A Venn diagram was used to identify EndMT-related DEGs. A logistic regression model was constructed to screen for prognostic genes. Laser-induced CNV mouse models were established and validated with FFA and OCTA. The expression of ANGPTL4 and EndMT-related markers in the RPE-choroid-sclera complex was measured via RT‒qPCR and Western blotting. TGF-β2-induced HUVECs were used as EndMT cell models, and specific siRNAs targeting ANGPTL4 (si-ANGPTL4) were designed and screened. The effects of ANGPTL4 knockdown on the migration and invasion of HUVECs were also examined. Laser-induced CNV mouse models were constructed, and an intravitreal injection of cholesterol-modified si-ANGPTL4 was used to knock down ANGPTL4. FFA, OCTA and immunofluorescence staining were used to observe CNV formation and subretinal fibrosis, and the expression of ANGPTL4 and EndMT-related markers was determined.

Results: ANGPTL4 expression was significantly increased in mice with CNV and colocalized with IB4. In TGF-β2-induced EndMT, ANGPTL4 was also upregulated, and its knockdown led to the inhibition of EndMT and cell migration and invasion, while its overexpression promoted the EndMT process. ANGPTL4 knockdown reduced the formation of CNV and subretinal fibrosis in mice with CNV by suppressing EndMT.

Conclusions: ANGPTL4 may promote CNV and subretinal fibrosis through EndMT, suggesting that ANGPTL4 may be a novel potential target for nAMD therapy.