Journal of Current Ophthalmology最新文献

Purpose: To analyze the advantages of the new advanced three-dimensional (3D) heads-up microscopy system in vitreoretinal surgery compared to a standard optical microscope, by evaluating postoperative tissue trauma, defined by the extent of swelling of the arcuate nerve fiber layer (SANFL).

Methods: Sixty-four consecutive eyes affected by macular pucker or macular hole underwent macular peeling using a traditional optical microscope (Leica F40) or a 3D heads-up microscopy system (NGENUITY 3D Visualization System). Infrared, blue autofluorescence imaging, and spectral-domain optical coherence tomography (OCT) were performed preoperatively and 2 weeks, 1 month, and 3 months after surgery. The presence of SANFLs was checked postoperatively on infrared and blue autofluorescence fundus imaging, and the extent of each SANFL was measured on OCT near-infrared fundus images.

Results: The presence and the extension of SANFLs were comparable in the two groups (P > 0.05), with a regression over time that was similar in the two groups. The change of the peripapillary retinal nerve fiber layer thickness in the various sectors also appeared to have a similar trend with no statistically significant differences in the two groups (P > 0.05).

Conclusion: NGENUITY system is comparable in terms of visual and anatomical results, offering perspectives for the integration of new advanced visualization technologies.

Purpose: To determine the effect of upper eyelid blepharoplasty (UEB) surgery on corneal biomechanical parameters 4 months after the procedure.

Methods: In this prospective longitudinal study, numerous corneal biomechanical parameters were evaluated before and 4 months after UEB surgery. All parameters were measured by the Corneal Visualization Scheimpflug Technology (Corvis ST, CVS, Oculus Optikgeräte GmbH, Germany) device.

Results: The study included 35 eyelids of the right eyes of 35 patients with dermatochalasis who underwent UEB, with a mean age of 56.9 ± 8.9 (range, 40-75) years. With a Bonferroni corrected significance level of P < 0.001 to account for multiple comparisons, significant increases were observed in the first applanation (A1) and second applanation (A2) times and the highest concavity (HC) time following the UEB surgery. Intraocular pressure (IOP) and biomechanical-compensated IOP (bIOP) also showed a significant increase. Other corneal biomechanical parameters did not show significant differences following the UEB procedure (P > 0.001).

Conclusions: UEB surgery resulted in significant changes in A1 and A2 applanation times, HC time, IOP, and bIOP. These findings suggest that altered eyelid pressure after UEB surgery can impact specific corneal biomechanical properties. It is advisable for practitioners to evaluate postoperative IOP measurement carefully in patients undergoing UEB surgery due to its potential impact on corneal biomechanical properties.

Purpose: To assess the relationship between graft-host junction (GHJ) profile and corneal astigmatism and higher-order aberrations (HOAs) in postpenetrating keratoplasty (post-PKP) eyes.

Methods: A retrospective observational cross-sectional study was carried out at the Corneal Department of the Farabi Eye Hospital from April 2019 to March 2020. The objective of the study was to review the clinical records of 32 eyes belonging to 25 patients who had undergone PKP. The classification of the eyes was based on the most frequent alignment pattern observed in the eight GHJ sections using anterior segment optical coherence tomography (AS-OCT). The three classifications included the well-apposed junction, mal-apposed junction, and equally apposed junction.

Results: A total of 256 GHJ sections were analyzed in 32 AS-OCT images, comprising 24 keratoconus and 8 nonkeratoconus eyes. Among them, 10 eyes (31.25%) exhibited well-apposed junctions, 15 eyes (46.8%) had mal-apposed junctions, and 7 eyes (21.8%) displayed equally apposed junctions. The most prevalent type of mal-apposition observed was protrusion, accounting for 67 sections (25.3%). The mal-apposed group displayed a significantly higher mean spherical equivalent (SE) (P = 0.01) and postoperative astigmatism (P < 0.001), whereas there was no significant difference in total HOAs between the mal-apposed group and the other groups (P = 0.58).

Conclusions: Significant associations were observed between the alignment pattern of GHJ after PKP and both SE and keratometric astigmatism. Conversely, no significant association was found between the alignment pattern of GHJ and HOAs.

Purpose: To investigate the epidemiological characteristics of dry eye disease (DED) in Asian populations and among females.

Methods: This study utilized the literature-derived database on DED risk factors, which includes data from 119 studies, and followed an evidence-based medicine retrieval strategy, searching globally for studies on risk factors for DED. Specifically, we focused on the Asian and Asian female populations. A descriptive statistical analysis was conducted on the definitions and prevalence of DED as provided in the database.

Results: The study included a total of 139,556 participants, of which 74,258 were females. The overall prevalence of DED in Asians was found to be 23.9%, and it was observed to increase with age. Specifically, the prevalence was 16.2% in the group aged <30 years, and it increased to 26.7% in the group aged over 70 years. Among females, the prevalence of DED was higher at 28.1% compared to males at 20.1%. Furthermore, the prevalence of DED in females also increased with age, ranging from 39.9% in the group aged <40 years to 42.2% in the group aged over 60 years. The prevalence of DED between 2016 and 2022 was 35.3%, which indicated a significant increase of 14.6% compared to the period between 2008 and 2015. Notably, there were variations in the prevalence of DED across different regions and levels of development.

Conclusions: This study reveals a common occurrence of DED among Asians and women. The prevalence rates vary among different countries, regions, development levels, and sample sizes, and there is an observed upward trend with the increase in survey year and age.

Purpose: To report the longitudinal changes on optical coherence tomography (OCT) in a patient with torpedo maculopathy (TM).

Methods: Retrospective observational study.

Results: A 37-year-old male, without any ocular symptoms, on dilated fundus examination showed a characteristic torpedo-shaped, flat, horizontally oriented, ovoid-shaped, hypopigmented chorioretinal lesion, temporal to the foveal center. At the most recent visit, after 6 years, the lesion exhibited changes on OCT, including the collapse of the subretinal cleft, the thinning of the retinal pigment epithelium (RPE) layer and inner choroidal layers, and the increased visibility of the underlying choroid and inner retinal excavation. The fundus autofluorescence demonstrated an increase in hypoautofluorescence in the center of the torpedo lesion, which was surrounded by a hyperautofluorescent boundary.

Conclusion: This appears to be the first report of longitudinal changes in a classic case of TM, demonstrating changes in the RPE, inner choroidal, and outer retinal layers over time.

Purpose: To investigate the neuroprotective effect of riluzole through matrix metalloproteinase-2 (MMP-2) and MMP-9 in rats, in an experimental glaucoma model.

Methods: A total of 28 Wistar albino rats, 3-4 months old, weighing 250-300 g, were divided into four groups; Group I (control), Group II (glaucoma), Group III (glaucoma + corn oil + dimethyl sulfoxide (DMSO), and Group IV (glaucoma + corn oil + DMSO + riluzole). A glaucoma model was created by episcleral vein cauterization in the left eyes of Group II, III, and IV subjects. After the formation of the model, daily intraperitoneal riluzole (5 mg/kg) administration was started. At the end of 7 weeks, retinal tissues were taken and some parts of them were stained with hematoxylin and eosin for histopathological examinations. In the other part, MMP-2 and MMP-9 expressions were determined using real-time quantitative PCR and immunohistochemical techniques.

Results: As a result, a statistically significant increase in intraocular pressures (IOP) was found in Groups II, III, and IV when compared with the control eyes after 7 weeks (P < 0.001). There was a decrease in IOP in the riluzole group compared to the glaucoma group. Expression levels in both genes decreased slightly with riluzole administration. In the histopathological evaluation of the groups, it was observed that there were no significant differences between the findings of degeneration in ganglion cells, hemorrhage, and differentiation in layers.

Conclusions: MMP-2 and MMP-9 exhibited decreased expression levels in both Group III (glaucoma + corn oil + DMSO) and Group IV (glaucoma + corn oil + DMSO + 5 mg/kg riluzole) compared to the glaucoma groups in Group II. Given that both Group III and Group IV received injections of corn oil + DMSO, this conclusion was drawn.

Purpose: To identify the potential genetic factors responsible for retinal capillary hemangioblastoma (RCH) and Type II granular corneal dystrophy (GCDII), with autosomal dominant inheritance. We used whole-exome sequencing (WES) in an Iranian family to identify the possible genetic etiology of RCH and GCDII with other manifestations of von Hippel-Lindau (VHL) disease.

Methods: This study included one Iranian family for WES in index patients and Sanger sequencing in all available individuals.

Results: Clinical presentations of these patients included RCH, GCD, central nervous system hemangioblastoma as well as pancreatic cyst. WES disclosed a heterozygous known pathogenic variant c.371G>A (p.R124H) in exon 4 of gene TGFBI.

Conclusions: For the first time, our research identified the potential involvement of TGFBI: c.371G>A (p.R124H) in an Iranian family with RCH, GCDII, and other symptoms of VHL disease. In the future, TGFBI could offer a new understanding and a promising therapeutic approach for both GCDII and VHL diseases simultaneously. Before using the variant in genetic counseling, it is recommended to conduct functional analysis using appropriate animal models to understand its pathogenesis mechanism.

Purpose: To describe the epidemiological profile, clinical characteristics, and visual outcome of pediatric ocular trauma in Tunisia.

Methods: In this retrospective cohort study, we reviewed the charts of 398 children younger than 16 years of age, presenting to the Emergency Department "B" of Hedi Rais Institute of Ophthalmology, for ocular trauma. The study period was between January 1, 2013, and January 1, 2019. The final best-corrected visual acuity (BCVA) was measured at the end of the follow-up period, which was 6 months. We used the Chi-squared test to compare the two groups of final visual acuities (good vs. poor visual outcome) for different prognostic factors. The ocular trauma score (OTS) and the pediatric OTS (POTS) were calculated for each child. We used the Cohen's kappa coefficient to evaluate the agreement between our final visual acuities using OTS and POTS.

Results: The mean age was 7.95 years with a sex ratio (males to females) of 5.32. Closed-globe injury (CGI) was found in 321 eyes, while 101 eyes had open-globe injury (OGI). Injuries were bilateral in 24 children. The majority of injuries occurred at home. The predominant mechanism of injury was fall in CGI and tree branch in OGI. Initial and final BCVA were predominantly ≤0.3 logMAR in both CGI and OGI. OTS category 3 and POTS category 2 were the most common. Factors associated with poor prognosis included delay to consultation >24 h (P = 0.0001); initial BCVA >1 logMAR (P = 0.0001); OGI (P = 0.001); size of injury ≥5 mm (P = 0.01); zone III in OGI (P = 0.032); endophthalmitis (P = 0.001); OTS 1 and 2 (P = 0.01); POTS 1 (P = 0.0001); and the following associated lesions: cataract (P = 0.006), retinal detachment (P = 0.03), and intraocular foreign body (P = 0.03). We found that both OTS (P = 0.001) and POTS (P = 0.003) were predictive of the final BCVA, with a moderate agreement between them (Cohen's kappa = 0.56).

Conclusions: Studying the epidemiological profile and identifying the risk factors for poor visual outcome of pediatric ocular trauma are necessary to implement preventive measures. A thorough clinical evaluation and close patient follow-up are crucial for identifying these risk factors. Both OTS and POTS were predictive of the final visual outcome. POTS has the advantage of bypassing the initial visual acuity which may be difficult to assess in children.

Purpose: To investigate ophthalmic manifestations in coronavirus disease 2019 (COVID-19) patients admitted to a designated COVID-19 center in Northern India during the period from April 13, 2020, to April 13, 2022. This aims to provide a comprehensive understanding of ocular involvement in the context of the pandemic.

Methods: This is a hospital-based prospective observational study. All COVID-19-positive (reverse transcriptase polymerase chain reaction positive - via pharyngeal and nasal swabs) patients, who were admitted to our hospital, were included in the study. Upon receiving ophthalmology referrals, patients were seen in the COVID-19 ward, with data collected on demographic distribution, presenting ocular symptoms, and specific ocular findings.

Results: Out of 3278 patients admitted to our center, 287 developed ocular symptoms. The study revealed a mean age of 63.8 ± 13.9 years, with males constituting 61.3% of the cases. The mean logMAR best-corrected visual acuity was found to be 0.30 ± 0.60. The mean duration between COVID-19 diagnosis and development of the first ophthalmic symptom was 10.4 ± 9.8 days. The predominant ocular symptoms included redness, discharge, and watering. Anterior segment manifestations were predominant, with conjunctivitis being the most prevalent ocular pathology (74.21%), followed by episcleritis (9.41%) and subconjunctival hemorrhage (7.31%). Conjunctivitis presented bilaterally in 41.5% of these patients, emphasizing its significance in the spectrum of COVID-19 ocular manifestations.

Conclusions: This research contributes substantial evidence regarding ophthalmic manifestations in COVID-19 patients. Ophthalmologists should remain vigilant, considering the potential for ocular symptoms to precede respiratory manifestations. The study emphasizes the need for comprehensive patient assessments and preventive measures in ophthalmic practices.

Purpose: To compare meibomian gland (MG) loss and MG dysfunction (MGD) in patients with mild versus moderate-severe thyroid eye disease (TED).

Methods: Consecutive patients with TED and no other causes of dry eye disease underwent meibography and meiboscore of each eyelid were graded as 0 (no MG loss), 1 (<33% loss), 2 (33%-66% loss), and 3 (>66% loss), with a total score of 0-6. MG expression score (0-3), eyelid margin signs of MGD, lipid layer thickness (LLT), ocular surface disease index (OSDI), tear secretion, noninvasive tear break-up time (NITBUT), and tear meniscus height (TMH) were also assessed by a masked observer.

Results: Included were 21 eyes (21 patients) with mild and 19 eyes (19 patients) with moderate-severe TED. The two groups were not different except for a higher frequency of smoking (P < 0.01). Eyes with moderate-severe TED showed a higher upper eyelid meiboscore (P = 0.03), MG expression score (P < 0.01), and tear film osmolality (P = 0.02) as well as lower LLT (P = 0.03). Total meiboscore had a significantly positive correlation with OSDI (r_s = 0.37) and tear film osmolality (r_s = 0.50) as well as a negative correlation with NITBUT (r_s = -0.55), TMH (r_s = -0.44), and LLT (r_s = -0.38). While older age, male gender, smoking, and longer duration of disease were significantly associated with the higher (≥3) meiboscore in univariate analysis, none remained significant in multivariate analysis.

Conclusion: MG loss and MGD were significantly more severe in moderate-severe than mild TED.