Journal of Ophthalmic & Vision Research最新文献

Purpose: To investigate the relationship between deviation control and accommodative load in patients with intermittent exotropia (IXT).

Methods: A total of 35 patients with IXT aged 5-21 years (average, 10.46 $\pm$ 4.42 years) with a best-corrected visual acuity of 20/20 or better were included in this study. All examinations, including binocular and monocular refraction, deviation angle, near stereoacuity, and deviation control, were done in patients with the best optical correction.

Results: Of the 35 patients, 16 (45.7%) were male and 19 (54.3%) were female. The results indicated a statistically significant difference in the average distance and near deviation angles between good, relatively good, and poor deviation control levels (P = 0.012). The results also showed that the likelihood of deterioration in deviation control increased significantly with deviation angle (P = 0.012). The accommodative load of the right and left eyes at distance and near fixation did not differ significantly across the three levels of deviation control. Based on the results of univariate logistic regression, no statistically significant relationship was observed between accommodative load (both the right and left eyes at distance and near) and deviation control level. However, there was a significant difference between the accommodative loads of the left and right eyes at near and distance (P $<$ 0.001).

Conclusion: In patients with IXT, deviation control decreased with deviation angle, and accommodative load increased in near fixation compared to distance fixation, but differences were not significant across the three deviation control groups (good, relatively good, and poor).

Optical coherence tomography (OCT) diagnostic technology is increasingly being integrated into clinical practice and is evolving rapidly. Performing a meta-analysis of these advancements can provide valuable insights to clinicians and healthcare decision-makers and help identify gaps that need further research and development. We conducted a systematic review and network meta-analysis (NMA) comparing the diagnostic accuracy of three key OCT-derived parameters in identifying early glaucoma: peripapillary retinal nerve fiber layer (RNFL) thickness, macular metrics, and optic nerve head (ONH) characteristics. We systematically searched PubMed, Embase, Web of Science, and Scopus for studies published from January 2004 through March 2024, and identified 47 eligible studies. These studies comprised 12,723 eyes from 8177 participants, including patients with mild primary open-angle glaucoma, pre-perimetric glaucoma (PPG), and ocular hypertension, as well as healthy controls. Our NMA summarized the existing evidence on the diagnostic performance of these parameters. The highest diagnostic accuracies for glaucoma detection were observed for average and inferior RNFL parameters, both achieving an accuracy of 0.77 and macular GLV parameter with an accuracy of 0.76. These were followed by inferotemporal GCIPL and two ONH parameters-rim area and cup-to-disc ratio-each with an accuracy of 0.75. In conclusion, the overall diagnostic accuracy was comparable across all three categories of OCT parameters. The results also suggest the potential benefits of combining two or three of these parameters in a single report, along with the application of artificial intelligence. This approach could significantly enhance the diagnostic accuracy of OCT in detecting glaucoma at its earliest stages, ultimately improving patient outcomes through earlier intervention.

Purpose: To evaluate the 1-year effectiveness of selective laser trabeculoplasty (SLT) in patients with pseudoexfoliative glaucoma (PEXG).

Methods: This prospective, single-arm, non-randomized interventional study involved 40 eyes from 40 patients with PEXG with no history of glaucoma surgery and laser trabeculoplasty. All participants underwent a single session of 360º SLT. Follow-up visits were conducted at 2 hours, 1 day, 1 week, and at 1, 2, 3, 4, 5, 6, and 12 months after the procedure. The intraocular pressure (IOP), the number of anti-glaucoma medications (NOM), and the 1-year success rate were investigated as primary outcome measures; while the incidence of adverse effects was considered the secondary outcome. Treatment success was defined as a $\ge$ 20% decrease in IOP compared to baseline.

Results: The baseline IOP was 22.19 $\pm$ 2.08 mmHg, and the mean NOM was 3.12 $\pm$ 0.55 before the SLT procedure. The mean IOP was significantly lower at all follow-up visits than at baseline, whereas the mean NOM remained unchanged throughout the follow-up period. The mean IOP values at 1, 3, 6, and 12 months after SLT were 18.02, 16.92, 16.47, and 15.31 mmHg, respectively. The overall 1-year success rate was 85%, with an average IOP reduction of 31.0% relative to baseline. The most common adverse event following SLT was mild anterior chamber inflammation, which occurred in 32.5% of eyes.

Conclusion: The SLT procedure could significantly reduce IOP in patients with PEXG with minimal adverse effects. The 1-year outcomes were favorable, suggesting that SLT may serve as an effective primary or complementary treatment for PEXG.

Purpose: To investigate differences in corneal and ocular aberrations between hyperopic, emmetropic, and myopic eyes.

Methods: This cross-sectional study included 84 eyes from 84 healthy participants (age range 18-35 years), who were equally divided into three refractive error groups of hyperopia, emmetropia, and myopia. Following comprehensive optometric examinations, corneal and ocular aberrations were measured using Pentacam and Zywave imaging systems, respectively. Aberrations were measured for a pupil diameter of 5 mm. Root-mean-square (RMS), Zernike coefficients, and compensation factor (CF) between total ocular and corneal aberrations were calculated for statistical analysis.

Results: The mean spherical equivalent was +1.96 $\pm$ 1.64, -0.17 $\pm$ 0.19, and -2.46 $\pm$ 1.56 diopters in hyperopic (H), emmetropic (E), and myopic (M) eyes, respectively. The amount of corneal Zernike coefficients Z₄ ^-2 in the hyperopic eyes (H: 0.015 $\pm$ 0.040) was significantly higher than that of emmetropic eyes (E: -0.018 $\pm$ 0.054) and myopic eyes (M: -0.003 $\pm$ 0.038) with a P-value of 0.029. The RMS of corneal total coma (H: 0.228 $\pm$ 0.097, E: 0.183 $\pm$ 0.086, M: 0.164 $\pm$ 0.083, P-value: 0.009, respectively) and RMS of ocular fifth-order (H: 0.045 $\pm$ 0.018, E: 0.036 $\pm$ 0.020, M: 0.032 $\pm$ 0.016, P-value: 0.002) showed a significant difference between refractive error groups, with higher value in hyperopic eyes compared to the two other groups. There was no significant difference in CF for RMS and Zernike coefficients among the refractive error groups.

Conclusion: Hyperopic eyes showed a higher RMS value for ocular fifth-order and corneal coma aberrations compared to the emmetropic and myopic eyes.

Purpose: Blocking the interaction between vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR2) is recognized as an effective strategy for treating neovascular age-related macular degeneration (nAMD). The present research aimed at designing and modelling an anti-VEGF peptide based on ranibizumab for potential application in inhibiting the VEGF/VEGFR2 interaction.

Methods: Effective amino acids in the interaction between VEGF and ranibizumab were analyzed using Swiss-PdbViewer (SPDBV), PyMOL, and Chimera software. The effective area in this interaction was determined and applied as a basis to design a peptide. Then, this sequence (containing 25 amino acids) was subjected to random mutagenesis, and the binding affinity of the resulting peptides was analyzed using the ClusPro software. Subsequently, GROMACS v5.0.6 was employed for molecular dynamics (MD) simulations to evaluate the stability of target-ligand complexes. Ultimately, the peptide exhibiting the highest affinity was grafted into the kB1 and MCoTI-II frameworks to enhance the stability.

Results: This modification resulted in improved peptide-VEGF binding affinity, demonstrating the potential of in silico design for creating effective anti-angiogenic peptides in antiangiogenic therapies.

Conclusion: The findings from this study provide a basis for designing and validating peptide inhibitors against VEGF.

Purpose: To compare the outcomes of combined phacoemulsification and viscocanalostomy with versus without intrascleral implantation of Ahmed glaucoma valve (AGV) tube remnants in patients with primary open-angle glaucoma (POAG) and cataract.

Methods: A randomized clinical trial involving 60 patients with cataract and POAG was carried out. The case group underwent phacoemulsification and viscocanalostomy together with intrascleral implantation of AGV tube remnants, while the control group underwent the same procedures without any implant. The two groups were compared in terms of best-corrected visual acuity (BCVA), intraocular pressure (IOP), cup-to-disc ratio, number of ocular hypotensive medications, surgical success rate, and scleral lake size.

Results: Sixty patients were enrolled and equally divided into two groups. Postoperative IOP, BCVA, and cup-to-disc ratio did not differ significantly between the groups (P = 0.196, P = 0.724, and P = 0.443, respectively). Despite comparable IOP outcomes, the case group required a significantly higher number of ocular hypotensive medications at the final follow-up (P = 0.043). Anterior segment optical coherence tomography (AS-OCT) revealed significantly larger scleral lake dimensions in the case group in terms of length, height, surface area, and perimeter (all P $\le$ 0.001).

Conclusion: Our study found no significant difference in success rates or postoperative IOP control between combined phacoemulsification and viscocanalostomy with or without silicone implants. Although the case group demonstrated larger scleral lake dimensions on AS-OCT, this anatomical difference did not translate into superior IOP outcomes and was associated with a higher requirement for postoperative ocular hypotensive medications. The clinical significance of increased scleral lake size in the presence of an implant remains uncertain, and longer-term follow-up is warranted.

This letter responds to the letter titled "Neuro-Ophthalmologic Complications of SARS-Cov-2 Infections and Vaccinations," published in J Ophthalmic Vis Res 2024;19:140-141 with DOI: https://doi.org/10.18502/jovr.v19i1.15451.

Purpose: To report the outcomes of lensectomy, anterior vitrectomy, and iris-claw lens implantation in patients with spherophakia- or microspherophakia-related glaucoma.

Methods: In this retrospective case series, we focused on patients with isolated microspherophakia or microspherophakia associated with various syndromes and mild to moderate angle-closure glaucoma who had undergone lensectomy, anterior vitrectomy, and iris-claw lens implantation.

Results: We analyzed a total of 12 eyes of 6 patients with a mean age of 19 $\pm$ 6 years and a mean postoperative follow-up of 66 $\pm$ 12 months. All patients had lenticular myopia, and the mean refraction improved from $-$ 7.26 $\pm$ 0.67 diopters (D) to $-$ 1.18 $\pm$ 1.04 D after surgery. The mean corrected visual acuity improved from 0.92 $\pm$ 0.57 logMAR before surgery to 0.17 $\pm$ 0.15 logMAR at the last follow-up (P = 0.001). The mean intraocular pressure (IOP) decreased from 21.2 $\pm$ 3.9 mmHg on 1.9 $\pm$ 0.7 anti-glaucoma medications at baseline to 15.0 $\pm$ 1.5 mmHg (P = 0.006) on 0.8 $\pm$ 0.7 medications (P = 0.006) at the last follow-up.

Conclusion: Lensectomy and iris-claw lens implantation in our cases not only decreased the IOP and reduced the number of glaucoma medications, but also improved the best-corrected visual acuity. Removal of the abnormally shaped lens likely contributed to these changes.

Purpose: To report the relationship between urbanization and the incidence of intraocular cancers in Iran.

Methods: In this retrospective ecological study, data were extracted from the Statistical Center of Iran, the Meteorological Organization, and the Iranian National Population-based Cancer Registry (INPCR, 2006-2016). The urbanization index (UI) was calculated using principal component analysis, and weighted multiple linear regression was used to assess the relationship between the UI and the age-standardized incidence rate (ASIR) of intraocular cancers.

Results: Six hundred and fifty-four intraocular cancer cases with a gender ratio (male-to-female) of 1:13 were recorded. The mean total 11-year ASIR of intraocular cancers was 0.093 per 100,000 population. The mean ASIR showed a decrease of 0.051 per 100,000 from 2006 to 2016 (P = 0.022). Retinoblastoma (66.1%) and uveal melanoma (24.6%) were the most commonly diagnosed intraocular cancers, and their ASIR declined between 2006 and 2016. Once adjusted for environmental pollutants, an increase in the area-based UI was significantly associated with lower total ASIR of intraocular cancers in males ( $\beta$ = -0.14).

Conclusion: Urbanization was associated with a reduction in ASIR of intraocular cancers, which can be attributed to improved access to eye care facilities for timely diagnosis. However, given that the INPCR cases were verified only by histology, future research should be conducted on hospital-based registries using multiple data sources to address confounders and exposure factors and prevent underestimation of incidence rates.