Journal of Current Ophthalmology最新文献

Purpose: To apply one- and left-handed phacoemulsification from the inferior nasal site for a case of rheumatoid peripheral ulcerative keratitis complicated by peripheral corneal thinning, which presented difficulties for standard two-handed cataract surgery.

Methods: A case report.

Results: The patient was an 80-year-old Japanese woman with the progression of peripheral ulcerative keratitis in the periphery of both eyes and a history of rheumatoid arthritis. Both eyes exhibited peripheral ulcerative keratitis, with the right eye particularly affected around the entire circumference of the cornea, except for the inferior nasal site. The disease subsided with the use of soft contact lenses and betamethasone and cyclosporine administration. The cataract progressed to a mature stage, and the density of corneal endothelial cells decreased to approximately 600/mm². A right-handed surgeon, positioned at the lower left corner of her face, performed phacoemulsification using a one- and left-handed technique, without performing paracentesis, through a sclerocorneal incision from the inferior nasal site of her right eye. Postoperatively, her best-corrected visual acuity improved to 20/25 from hand motion.

Conclusions: A patient with almost total circumferential thinning of the cornea, which appeared to be a challenge for standard cataract surgery, could undergo successful cataract surgery with the selection of an appropriate incision site and technique. The findings of this case report may provide valuable insights for the development of safe surgical strategies for cataract surgery in cases characterized by severe, almost circumferential peripheral thinning of the cornea.

Purpose: To critically evaluate the current evidence on the influence of lifestyle factors on glaucoma risk and progression. Glaucoma, a leading cause of irreversible vision loss globally, poses a significant clinical challenge. The pathogenesis of glaucoma is multifactorial, involving mechanisms beyond intraocular pressure (IOP). Effective treatments for reducing IOP exist, yet progressive vision loss remains a common occurrence among glaucoma patients, underscoring the need for further research. Age, ethnicity, family history, and high myopia are recognized risk factors; however, they are difficult to modify. In contrast, lifestyle factors such as physical activity, smoking, and diet may offer opportunities for risk reduction, but the relationships between these factors and glaucoma are not yet well understood.

Methods: A narrative review of literature was conducted by searching multiple databases, including PubMed, Google Scholar, Scopus, and the Cochrane Library, focusing on peer-reviewed studies published between August 2009 and October 2024. An extensive range of keywords, such as glaucoma, intraocular pressure, lifestyle factors, diet, sleep pattern, alcohol consumption, smoking, anxiety, stress, body mass index, and caffeine, were employed individually and in combination to ensure a comprehensive search.

Results: Lifestyle factors, such as mindfulness-based stress reduction, cognitive-behavioral therapy, and sleep apnea management, may be efficacious in reducing intraocular pressure fluctuations and neuroinflammatory damage. In addition, a healthy diet, body mass index, and regular physical activity may contribute to reduced glaucoma risk.

Conclusions: This review underscores the potential of lifestyle modifications as a complementary strategy in glaucoma management. Further research is necessary to explore evidence-based associations between lifestyle factors and glaucoma.

Purpose: To characterize the global patterns and map previous and emerging trends in ophthalmic imaging technology for glaucoma diagnosis through bibliometric analysis.

Methods: This cross-sectional study examined ophthalmic imaging technology for glaucoma diagnosis research evolution and theme trends from 2015 to 2024, using bibliometric analysis of Web of Science Core Collection data.

Results: From 2015 to 2024, a total of 8192 articles were published. There has been a significant surge in research interest in ocular imaging technology for glaucoma diagnosis over the past decade. The Journal of Glaucoma published the most manuscripts (674 publications), and Investigative Ophthalmology and Visual Science produced the highest citations (13,950 citations). The United States (2404 publications and 49,729 citations), the University of California System (569 publications, 13,147 citations), and Weinreb, Robert N. (226 publications, 7083 citations) were the most productive and impactful country, institution, and author, respectively. The co-occurrence cluster analysis of the top 100 keywords forms eight clusters: (1) advanced computational techniques, (2) anterior segment imaging, (3) imaging applications, (4) neuroprotection and retinal research in glaucoma, (5) optical coherence tomography and structural analysis, (6) vascular and choroidal analysis in glaucoma, (7) accuracy of medical imaging diagnostic tests, and (8) visual field assessment and disease progression. Further discussions into the subtopics were provided to assist researchers to determine the range of research topics and plan research direction.

Conclusions: Publications and citations on research related to ocular imaging technology for glaucoma diagnosis have increased over the past decade. The study illuminates the trends, global collaboration, fundamental knowledge, research hotspots, and emerging frontiers in this field.

Purpose: To analyze the trends, patterns, and dynamics of ophthalmology and optometry research in Africa, focusing on publication trends, authorship patterns, collaborative networks, and citation analysis.

Methods: A comprehensive bibliometric analysis was conducted using the Scopus database to identify publications in ophthalmology and optometry from inception to 2023. Data on publication trends, most active source titles, research themes, geographic distribution, collaborative networks, funding sponsors, authorship patterns, and citation analysis were extracted and analyzed.

Results: The results revealed a steady increase in publications in ophthalmology and optometry research in Africa, with a notable acceleration observed from 2011 onwards. The British Journal of Ophthalmology emerged as the most active journal source, highlighting the dominance of international journals in African ophthalmic research. South Africa emerged as the leading contributor to research efforts, with significant contributions from international collaborations. Naidoo was found to be the most influential on the continent. However, a disparity in authorship representation was noted, with most influential non-African authors. Citation analysis highlighted the prominence of papers addressing global issues, raising questions about equitable attribution of citations to African researchers.

Conclusions: This study provides valuable insights into the landscape of ophthalmology and optometry research in Africa, highlighting both progress and challenges. While the increasing publication output reflects growing interest and recognition in the field, efforts are needed to address disparities in authorship representation and research funding. By fostering collaboration, promoting local capacity-building, and ensuring equitable recognition of African researchers, we can work towards a more inclusive and impactful research ecosystem that advances eye health outcomes for the continent's diverse populations.

Purpose: To evaluate the safety and efficacy of increased environmental oxygen using a novel oxygen chamber during corneal cross-linking (CXL) in patients with keratoconus (KCN).

Methods: This prospective interventional pilot study included 20 eyes from 15 patients with documented progressive KCN. Patients underwent epithelium-off accelerated CXL (irradiance of 9 mW/cm² for 10 min) in two different environments. The study group received CXL using an oxygen chamber providing a high-oxygen environment (60%), while the control group underwent CXL under ambient oxygen conditions (21%). Outcome measures included visual and topographic outcomes, demarcation line depth, endothelial cell count, and dry eye evaluation. Follow-up visits were conducted up to 6 months post-CXL.

Results: Seventeen eyes completed the follow-up (study: 10 and control: 7). At 1-month postoperation, the study group exhibited a significantly deeper demarcation line, particularly at the inferior 3 mm location (250.8 μm vs. 169.3 μm, P = 0.03). At 6 months post-CXL, keratometry values improved more in the study group, with K₁ and K_m showing a significant decrease from baseline (P = 0.046 and 0.047, respectively). Best-corrected visual acuity and refraction remained stable in both groups throughout the 6-month follow-up (P > 0.05). The endothelial cell count decreased less in the study group compared to the control group (-136.1 ± 52.3 vs. -288.9 ± 100.9, P = 0.16).

Conclusion: The findings of this pilot study show that the novel oxygen chamber can safely and effectively enhance CXL outcomes by creating a hyperoxic environment.

Purpose: To report the case of late-onset retinoblastoma (Rb) in a 13-year-old male masquerading as pars planitis.

Methods: Case report.

Results: The patient presented with an 8-month history of progressive visual loss in his right eye and a nonremarkable history of blunt trauma. He had been diagnosed with the impression of pars planitis versus organized vitreous hemorrhage in another center and was referred to us 6 months later. Fundus examination with indirect ophthalmoscopy at our center revealed a fundus mass with diffuse vitreous seeding. Hence, the diagnosis of late-onset Rb was made, and complete regression of the tumor was achieved using intra-arterial and intravitreal chemotherapy.

Conclusions: In conclusion, Rb as a "masquerading syndrome" should be considered in the differential diagnosis of patients with atypical presentation of inflammatory diseases. Although these cases usually result in enucleation, with the help of new targeted treatment modalities, favorable outcome might be achievable despite the initial delay in diagnosis.

Purpose: To investigate factors contributing to retreatment after antivascular endothelial growth factor (anti-VEGF) therapy in patients with retinopathy of prematurity (ROP).

Methods: All relevant publications released up to November 2022 from PubMed, Google Scholar, and Scopus were evaluated. An Excel checklist was developed for data extraction, including author names, publication year, sample size, mean gestational age (GA), birth weight (BW), zone of ROP, total and zone-specific retreatment incidence, and the percentage of aggressive posterior ROP eyes. The primary outcome was the incidence of retreatment (IR). The mixed methods appraisal tool was used to assess the quality of the papers.

Results: The total IR was 19% (95% confidence interval (CI): 15%-23%). Among children treated with anti-VEGF agents, the highest IR occurred with intravitreal ranibizumab (IVR, 0.25 mg) (27%, 95% CI: 19%-35%) and intravitreal aflibercept (IVA, 0.4 mg) (27%, 95% CI: 6%-47%), followed by intravitreal conbercept (IVC, 0.25 mg) (16%, 95% CI: 13%-20%). The lowest IR was observed in children treated with intravitreal bevacizumab (IVB, 0.625 mg) (11%, 95% CI: 7%-14%). In the IVR group, the chance of retreatment increased by 7% for every 1-week increase in GA and 5% for every 100 g of BW. In general, the IR was significantly higher in Zone I ROP in comparison with Zone II. For patients with Zone I ROP who received IVR, the IR was 0.36 (95% CI: 0.09-0.62), while for those who underwent IVB, it was 0.06 (95% CI: 0.01-0.11). The difference between the two groups was statistically significant (P = 0.03). The IR for retreatment in patients with Zone II ROP was 0.13 (95% CI: 0.01-0.26) for IVR and 0.00 (95% CI: 0.00-0.01) for the IVB subgroup (P = 0.03).

Conclusions: While anti-VEGF therapy is effective for ROP treatment, there are significant differences in IR among different agents. IVB treatment appears to yield the most consistent results compared to other agents.

Purpose: To evaluate the effect of ambient light on transient changes in refraction and ocular biometry after near work.

Methods: This single-blind, randomized clinical trial included 87 participants randomly assigned to three groups based on ambient light levels: Group 1 (100-200 lux), Group 2 (300-400 lux), and Group 3 (500-700 lux). Each participant performed 1 h of computer-based text reading at 40 cm. Objective refraction and ocular biometric parameters, including axial length (AL), keratometry, anterior chamber depth (ACD), and lens thickness, were measured before and immediately after the task.

Results: The mean ± standard deviation change in spherical equivalent (SE) was -0.72 ± 0.57 diopter in Group 1, -0.39 ± 0.34 diopter in Group 2, and -0.11 ± 0.33 diopter in Group 3 (P < 0.001). AL increased in all groups, with the largest change in Group 1 (45.16 ± 21.60 μm), followed by Group 2 (26.78 ± 13.19 μm) and Group 3 (17.83 ± 9.76 μm) (P < 0.001). Changes in keratometry (P = 0.08), ACD (P = 0.693), and lens thickness (P = 0.999) were not statistically different across the groups. Correlation analysis showed the highest association between SE and AL change in Group 1 (r = -0.703). The multiple generalized estimating equation model revealed a significant association between changes in SE and AL (β = -0.019), lens thickness (β = -0.001), and baseline SE (β = -0.485) in Group 1; AL (β = -0.009) and baseline SE (β = -0.735) in Group 2; and AL (β = -0.016) and baseline SE (β = -0.72) in Group 3.

Conclusions: Near visual tasks induce transient myopic shifts and biometric changes, primarily through axial elongation and increased lens power. This effect is influenced by ambient light, with myopic shift intensifying as light levels decrease.

Purpose: To highlight the role of multicolor imaging to differentiate between the two cases presented, macular telangiectasia type 2 (MT 2) and tamoxifen retinopathy (TR) which have very similar phenotypical properties and can often present a diagnostic dilemma.

Methods: Retrospective analysis of 2 cases, MT 2 and TR, presenting to a tertiary eye care center in Eastern India.

Results: Both the cases show crystalline deposits and similar optical coherence tomography findings. However, MT 2 shows increased reflectance at the perifoveal region on multicolor imaging, while TR shows the same at the foveal region.

Conclusion: Differentiating early TR and MT 2 can be challenging, and multicolor imaging, especially blue reflectance, can be very helpful in solving the dilemma and clinching the diagnosis.