Journal of Current Ophthalmology最新文献

Purpose: To report a case of posttraumatic retinal pigment epithelium (RPE) tear complicated with exudative retinal detachment that underwent spontaneous resolution.

Methods: Case report.

Results: A 61-year-old healthy female presented with sudden-onset loss of vision in the left eye for 5 days following blunt trauma. She had undergone left upper eyelid and eyebrow laceration repair elsewhere. A comprehensive ophthalmic examination revealed a subfoveal RPE tear with exudative retinal detachment in the left eye. There was spontaneous healing of RPE tear and complete resolution of exudative retinal detachment 2 weeks following the initial presentation.

Conclusions: RPE tear is an extremely rare complication following blunt trauma. The size of the RPE tear can play an important role in determining the final visual prognosis in such cases.

Purpose: To determine the distribution of macular thickness and macular volume in an elderly healthy population 60 years of age and above and their determinants.

Methods: The sampling was performed using a multistage stratified random cluster sampling method on the geriatric population 60 years of age and above in Tehran, Iran. All participants underwent optometric examinations, slit-lamp examination, and optical biometry. Retinal imaging was performed by spectral-domain optical coherence tomography.

Results: The means ± standard deviation and 95% confidence interval of central macular thickness (CMT), average macular thickness (AMT), and macular volume were 221 ± 33 (218-223) μm, 267 ± 29 (265-269) μm, and 8.36 ± 0.44 (8.33-8.39) mm³, respectively. The CMT was significantly lower in females than males (β: -5.77; P = 0.002). The AMT was significantly lower in females than males (β = -10.32; P < 0.001) and was significantly directly related to intraocular pressure (β = 0.63; P = 0.038). The macular volume was significantly lower in females than males (β = -0.13; P < 0.001) and decreased with age (β = -0.01; P < 0.001). In addition, the macular volume had a significant inverse and direct relationship with axial length (β = -0.04; P = 0.011) and keratometry (β = 0.03; P < 0.001).

Conclusions: Macular thickness in the Iranian geriatric population was slightly less than the populations studied in other countries. The role of sex should also be taken into account in the interpretation of macular thickness findings.

Purpose: To evaluate indications, clinic characteristics, and outcomes in a series of patients who underwent explantation of phakic intraocular lens (pIOL).

Methods: Retrospective case series of patients who underwent iris-claw pIOL explantation in our institution from 2018 to 2022. Indications for explantation and visual and refractive outcomes were analyzed.

Results: Twenty-three eyes of 14 patients underwent pIOL explantation with a mean time to explantation of 11.7 ± 3.4 years. The mean age at explantation was 46.0 ± 3.9 years. Sixteen Artisan and seven Artiflex IOL were explanted. The main indication for explantation was endothelial cell loss (n = 14) and morphometric significant alterations of endothelial cells other than endothelial cell count decline (n = 5). The mean corrected vision after explantation was 0.4 ± 0.4 logMAR, and around 70% of intervened patients achieved visual acuity of at least 0.3 logMAR (0.5 in decimal scale).

Conclusions: In our group series, the main reason for the removal of pIOL was endothelial cell loss. This complication should be monitored and followed, so that early actions, namely IOL explantation, can be performed to avoid the development of deterioration requiring corneal transplantation. In fact, loss of follow-up, found in several cases for many years, continues to be a serious problem.

Purpose: To estimate the prevalence of age-related macular degeneration (AMD) and determine its risk factors in Iran.

Methods: A comprehensive electronic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar, with no restrictions on time or language of publication. Eleven studies meeting the eligibility criteria were included. Six studies with a total sample size of 9930 were included in the meta-analysis to calculate the overall prevalence of AMD in Iran. Meta-analysis was performed using Stata/MP version 15.0. Risk of bias assessment was carried out based on the Newcastle-Ottawa Scale.

Results: All participants in the studies were over 40 years old. The pooled prevalence of AMD was estimated to be 9.9% (95% confidence interval [CI]: 6.3%-13.5%). After accounting for publication bias, this estimated decreased to 6.4% (95% CI: 4%-10.2%). Smoking (odds ratio [OR]: 1.781; 95% CI: 1.152-2.756), hypertension (HTN) (OR: 1.512; 95% CI: 1.119-2.044), diabetes mellitus (DM) (OR: 1.545; 95% CI: 1.088-2.194), and hyperlipidemia (OR: 1.512; 95% CI: 1.055-2.165) were identified as AMD risk factors.

Conclusion: Based on the results of the present review, the prevalence of AMD in the Iranian population over 40 years of age is estimated to be 6.4%, and having a history of smoking, HTN, DM, and hyperlipidemia are identified as risk factors of AMD in Iran. Further original studies are needed to draw more accurate conclusions.

[This corrects the article on p. 115 in vol. 34, PMID: 35620380.].

Purpose: To assess the incidence and clinical profile of hemifacial spasm (HFS) and the association between HFS and systemic diseases.

Methods: This retrospective study was carried out on 85 patients with HFS, presenting at a tertiary eye care center in South India. Demographic and clinical details were recorded for all patients. Of these, the patients who had undergone magnetic resonance imaging (MRI) of the brain were analyzed for primary and secondary HFS.

Results: The mean age of the patients was 56.11 ± 12.51 years. The age at onset of HFS was 54.9 ± 12.7 years. The disease duration was 9.51 ± 7.28 years. Male:female ratio was 1:1.17. The right side was involved in 31 patients (36.47%) and the left side in 54 patients (63.52%). MRI was performed in 54 (63.52%) patients and showed neurovascular conflict in 22 (40.74%) patients and space-occupying lesions in 2 (3.70%) patients. Forty-nine (57.64%) patients had primary HFS, while five (5.88%) patients had secondary HFS due to old facial palsy in 3 and space-occupying lesions in two patients. Twenty (23.52%) patients received botulinum toxin A with a good response. Type of HFS had a significant association with hypertension (P = 0.046) while no significant association was present between laterality of HFS and systemic diseases (P > 0.05 each). Multivariate analysis showed a marginally significant association between type of HFS and hypertension (P = 0.057).

Conclusions: Primary HFS was the main type of HFS with female dominance and predilection for the left side. Hypertension had a relationship with HFS that needs to be investigated further for its causal nature.

Purpose: To assess the possible association between MIR200B variations and sight-threatening diabetic retinopathy (STDR).

Methods: A total number of 141 diabetes mellitus patients were enrolled in the study and divided into two groups including 76 patients diagnosed with STDR assigned to the case group, and 65 subjects without STDR considered in the control group. Peripheral blood specimens were used to extract the DNA content, and the primary MIR200B encoding sequence was amplified using a polymerase chain reaction. Then, the amplified DNA was sequenced by the Sanger method. The sequences were compared to the MIR200B reference sequence to find sequence variations. RNAfold, miRVaS, and Mfold bioinformatics web servers were employed to predict the potential effects of the identified variations on RNA structure.

Results: Two MIR200B gene variants were identified. Although both variations were found more frequent in cases than controls, statistical analysis of allelic and genotypic features did not reach statistical significance.

Conclusions: In silico analysis showed mild changes in MIR200B secondary structure and increased free energy in the presence of one of the identified variants (g.1167183G>A; rs72563729). Increasing the sample size in future studies may help a more accurate interpretation of the allelic association of MIR200B variations with STDR.

Purpose: To analyze the United States Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database, which contains reports of adverse events involving medical devices, and characterize the most common adverse events of femtosecond (FS) laser-assisted in situ keratomileusis (LASIK).

Methods: The MAUDE database was queried on May 19, 2022, for adverse events involving the ophthalmic FS laser reported from January 2012 to April 2022. Reports unrelated to LASIK procedures were excluded. Data extraction was performed on these reports, including the type of adverse event and whether surgery was successfully completed. Frequency analysis was performed using the Statistical Package for the Social Sciences.

Results: From the 3491 reported adverse events involving the FS laser system, 1136 met the inclusion criteria. Of the 672 cases where outcomes were reported, 476 were successfully completed and 196 were aborted. The most common intraoperative complications were incomplete cut (42.8%), thinner than intended flap (17.6%), and difficulty lifting the flap (12.0%). FS-related complications included opaque bubble layer (2.3%), air bubbles in the anterior chamber (2.4%), and vertical gas breakthrough (4.1%). Other device-related intraoperative complications included suction loss (10.2%), difficulty docking (2.4%), and laser malfunction (2.0%). The most common postoperative complications were diffuse lamellar keratitis (DLK) (7.8%) and rainbow glare (4.6%).

Conclusion: The most common intraoperative FS-assisted LASIK complication in the MAUDE database was an incomplete flap. The most common postoperative complication was DLK. This study is the first to investigate FS-assisted LASIK adverse events in the MAUDE database. It can raise awareness of real-world surgical complications and help ophthalmologists better counsel and treat patients.

Purpose: To assess the correlation between the worldwide burden of vision impairment (VI) and fine particulate matter (PM) 2.5.

Methods: In this retrospective cross-sectional study, global and national prevalence and disability-adjusted lost year (DALY) numbers and rates of total VI, glaucoma, cataract, and age-related macular degeneration (AMD) were obtained from the Global Burden of Disease database. The global and national levels of PM2.5 levels were also extracted. The main outcome measures were the correlation of PM2.5 levels with total VI and three ocular diseases in different age, sex, and socioeconomic subgroups.

Results: In 2019, the worldwide prevalence of total VI and exposure level of PM2.5 was 9.6% (95% uncertainty interval: 8.0-11.3) and 42.5 μg/m³, respectively. The national age-standardized prevalence rates of total VI (r _p = 0.52, P < 0.001), glaucoma (r _p = 0.65, P < 0.001), AMD (r _p = 0.67, P < 0.001), and cataract (r _p = 0.44, P < 0.001) have a positive correlation with PM2.5 levels. In addition, the national age-standardized DALY rates of total VI (r _p = 0.62, P < 0.001), glaucoma (r _p = 0.62, P < 0.001), AMD (r _p = 0.54, P < 0.001), and cataract (r _p = 0.45, P < 0.001) significantly correlated with PM2.5 levels. The correlations remained significant in different age, sex, and sociodemographic subgroups.

Conclusion: National prevalence rates of VI and three major ocular diseases correlate significantly with PM2.5 exposure levels, worldwide.