Journal of Current Ophthalmology最新文献

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.

Purpose: To report 5 cases of nonhuman immunodeficiency virus (non-HIV) ocular syphilis in immunocompetent patients in this era.

Methods: Retrospective analysis of five cases of retinochoroiditis was done using hospital records over 5 years. Patients were tested for venereal disease research laboratory, HIV and confirmed by treponemal pallidum hemagglutinin assay/fluorescent treponemal antibody absorption. Fundoscopy, fundus fluorescein angiography, and B-scan were done when needed. Appropriate treatment with benzathine penicillin and systemic steroids was instituted in each patient.

Results: First case had panuveitis; second presented with angle-closure glaucoma and neuroretinitis; third case showed recurrent uveitis; fourth one had occlusive vasculitis and retinal detachment, and last case had anterior uveitis with chorioretinal lesions and epiretinal membrane. Marked improvement of vision was seen in four cases, barring one case with retinal detachment.

Conclusions: Non-HIV syphilis-related retinochoroiditis is a masquerader that requires a high index of suspicion, even in immunocompetent individuals. This case series highlights the necessity of including syphilis testing in the workup of atypical uveitis cases, irrespective of systemic manifestations. Furthermore, increased public health awareness and education are critical to address the resurgence of syphilis and prevent its ocular complications.

Purpose: To evaluate the baseline optical coherence tomography (OCT) and OCT angiography (OCTA) characteristics of patients with branch retinal vein occlusion (BRVO) who developed retinal atrophy following the resolution of macular edema (ME). A secondary objective is to assess the relationship between these baseline imaging parameters and final visual acuity (VA).

Methods: This retrospective cohort study analyzed 65 eyes of 65 patients diagnosed with BRVO-related ME. All patients received three loading doses of intravitreal anti-vascular endothelial growth factor treatment based on their ME and VA status; intravitreal injections were administered. Patients were divided into two groups; Group 1 included eyes with complete resolution of ME with retinal atrophy, and Group 2 included eyes without retinal atrophy. Group 1 patients were further divided into those with good and poor VA.

Results: The baseline central retinal thickness (CRT) was significantly higher (P = 0.041), and the baseline and final central choroidal thickness (CCT) were significantly lower in the retinal atrophy group (Group 1) compared to the nonatrophy group (Group 2) (P = 0.024 and P < 0.001, respectively). The baseline quadrantal superficial capillary plexus vascular density (SCP VD) (%) was lower in the atrophic group, while the baseline quadrantal deep capillary plexus VD (DCP VD) (%) was significantly higher in retinal atrophy patients with good VA. The presence of ischemia on fluorescein angiography was significantly more frequent in patients with poor VA (P = 0.039). A positive correlation was also found between baseline DCP VD (%) in the perifoveal region and final VA.

Conclusions: Higher baseline CRT, lower baseline CCT, and lower quadrantal SCP VD were found in BRVO patients with retinal atrophy. However, higher DCP VD and less ischemia at baseline are predictive of better visual outcomes even in the presence of retinal atrophy. These findings may highlight the prognostic value of OCT and OCTA parameters in the treatment of BRVO.

Purpose: To assess the progression rate from dry age-related macular degeneration (dAMD) to advanced AMD and possible risk factors.

Methods: Demographics, medical and ocular conditions, baseline eye examinations, optical coherence tomography features, and progression rates to advanced AMD were collected.

Results: We included 74 eyes from 47 dAMD patients, with a mean age of 74.58 ± 8.29 years and 38.30% males. During a follow-up period of 8.9 ± 0.4 years, 40 eyes (54.05%) progressed to advanced AMD, with 25 eyes (33.78%) developing neovascular AMD (nAMD) and 22 eyes (29.72%) progressing to geographic atrophy (GA). Patients progressing to advanced AMD were older (77.8 ± 6.5 vs. 73.8 ± 9.5, P = 0.03). A higher incidence of open-angle glaucoma (OAG) was noted in progressing eyes (32.5% vs. 8.8%, P = 0.01), along with thinner baseline central macular thickness (CMT) (247.93 ± 32.55 vs. 268.67 ± 16.75, P = 0.007). Smokers with OAG had a higher tendency to develop nAMD (P < 0.05). Females with lower best-corrected visual acuity (BCVA) were more likely to develop GA (P < 0.001).

Conclusions: The progression rate to advanced AMD was 54.05% over 8.9 ± 0.4 years. Advanced age, reduced baseline CMT, and lower BCVA were linked to progression. OAG and smoking were associated with higher nAMD, while females had a higher risk of GA.