Journal of Ophthalmic & Vision Research最新文献

Purpose: To investigate the effect of tinted filters on contrast threshold (CT) and visual evoked potentials (VEPs) in patients with retinitis pigmentosa (RP).

Methods: In this cross-sectional study, RP patients with best corrected visual acuity better than 1 log MAR were evaluated. The CT was measured using the Freiburg Acuity and Contrast Test, and pattern reversals were analyzed for both time and frequency components. The effects of gray (15% light transmission, 410 nm cutoff), brown (18% light transmission, 410 nm cutoff), and yellow (27% light transmission with a 470 nm cutoff) tinted filters were evaluated and compared.

Results: Eighteen participants (mean age 32.78 $\pm$ 7.35 years; 72.2% male) were evaluated. The mean CT of Weber was 3.46 $\pm$ 3.2%. Yellow filters decreased CT (mean difference [MD]: -0.597%, P = 0.054). Brown filters did not produce a significant change in the CT (MD: 0.233%, P = 0.620), while the gray filters caused a significant increase in the CT (MD: 1.423%, P = 0.004). Mode frequency (Fmod) decreased with gray filters (MD: -2.33%, P = 0.004). The latency and amplitude of VEPs improved with yellow filters (P $<$ 0.05) but worsened with gray filters (P $<$ 0.05). Additionally, the spherical equivalent showed an inverse correlation with CT in patients with RP (r = -0.997, P $<$ 0.001).

Conclusion: Using tinted filters as a low-vision aid can modify contrast sensitivity and both frequency and time domains of VEPs in patients with RP. Yellow filters appear to improve visual function, whereas gray filters may worsen it.

Purpose: To evaluate the influence of preoperative ocular and systemic variables on intraocular pressure (IOP) change following phacoemulsification cataract extraction with intraocular lens (CEIOL) implantation in eyes without glaucoma.

Methods: This retrospective cohort study included adults who underwent standalone CEIOL at a single academic center between 2017 and 2020. Preoperative demographic, ocular, and systemic health data were extracted from electronic health records using an informatics-based approach and validated by chart review. Eyes with glaucoma or other preoperative ocular conditions known to affect IOP were excluded. Postoperative IOP data were collected for up to 2 years and censored at the time of any subsequent diagnosis or treatment likely to influence IOP. A linear mixed-effects model was used to assess associations between IOP change and preoperative ocular (e.g., IOP, axial length, central corneal thickness) and systemic variables (e.g., diabetes, body mass index [BMI], smoking status), accounting for inter-eye correlation.

Results: A total of 1992 eyes from 1755 patients were included. Higher preoperative IOP ( $\beta$ = -0.563, P $<$ 0.001) and female gender ( $\beta$ = -0.229, P = 0.005) predicted greater postoperative IOP reduction. Longer axial length ( $\beta$ = 0.201, P $<$ 0.001), diabetes mellitus ( $\beta$ = 0.291, P = 0.019), thicker cornea ( $\beta$ = 0.008, P $<$ 0.001), and higher BMI ( $\beta$ = 0.022, P = 0.005) were associated with a relative increase in postoperative IOP.

Conclusion: Both ocular and systemic variables significantly influenced postoperative IOP change following CEIOL in non-glaucomatous eyes. Understanding these associations may improve clinical decision-making and help tailor IOP-related counseling for patients undergoing cataract surgery.

Purpose: To describe the link between negative emotions-depression, anxiety, and stress-and eye movement during photorefractive keratectomy (PRK).

Methods: This comparative case series was conducted on 53 PRK candidates and involved completing the Depression, Anxiety, and Stress Scale (DASS-21) before surgery. Eye movement, measured as the radial distance between the pupil and laser center during each shot, was analyzed. Average distance indicated centralization accuracy, while standard deviation (SD) indicated precision. Stress, depression, anxiety, and their relationship with eye movement during PRK were studied.

Results: The mean and SD of eye movements were not significantly correlated with depression, anxiety, stress, or the total DASS-21 score. A weak negative correlation was observed between the preoperative spherical equivalent (SE) and stress (r = -0.305, P = 0.004), anxiety (r = -0.401, P $<$ 0.001), and total DASS-21 scores (r = -0.324, P = 0.002). Lastly, a weak positive correlation was found between ablation time and the SD of eye movement (r = 0.473, P $<$ 0.001).

Conclusion: The DASS-21 questionnaire showed no link between negative emotions and eye movement. Additionally, longer ablation times correlated with greater SD of eye movement.

Intraocular lymphoma (IOL) is a rare form of non-Hodgkin lymphoma that primarily presents in two distinct types. The first type, known as primary intraocular lymphoma (PIOL), is mainly recognized as a subtype of primary central nervous system lymphoma (PCNSL). Recent classifications have emphasized the primary ocular sites affected, with vitreoretinal lymphoma emerging as the most common variant linked to PCNSL. Despite its rarity, the incidence of PIOL is rising among both immunocompromised and immunocompetent populations. Most cases of PIOL are identified as diffuse large B-cell lymphoma, although rare T-cell variants have also been reported. Secondary intraocular lymphoma (SIOL) originates from metastatic spread of non-CNS lymphomas to the ocular structures, including the retina, uvea, vitreous body, Bruch's membrane, and optic nerve. Diagnosis of IOL is challenging for ophthalmologists and pathologists, as it can easily mimic other ocular conditions. Advancements in laboratory diagnostics, such as immunocytochemistry, flow cytometry, and the evaluation of interleukin ratios (specifically IL-10:IL-6 $>$ 1), along with polymerase chain reaction (PCR) amplification for clonality, have enhanced diagnostic accuracy. Multimodal imaging approaches and molecular analyses can serve as valuable indicators of visual prognosis, recurrence rates, and the likelihood of progression to central nervous system involvement. Given that misdiagnosis or delayed diagnosis can result in serious treatment delays and potentially life-threatening outcomes for patients with IOL, this review seeks to provide a comprehensive understanding of the clinical manifestations of IOL and the diagnostic methods employed.

Purpose: To evaluate the systemic immune-inflammation index (SII) and unconjugated bilirubin levels in patients with pseudoexfoliation syndrome (PEX) and compare them with those of healthy individuals (controls).

Methods: The PEX group (n = 48) and the control group (n = 88) were retrospectively evaluated. The results of ophthalmic examinations and routine laboratory parameters were analyzed, and the SII was calculated as follows: SII = platelet count $\times$ (neutrophil/lymphocyte).

Results: The neutrophil-to-lymphocyte ratio (NLR) (P = 0.04) and SII (P = 0.03) were higher, and unconjugated bilirubin levels (P = 0.03) were significantly lower in the PEX group than in the control group. Univariate regression analysis showed that the unconjugated bilirubin levels (OR = 0.26; 95% CI, 0.07 to 0.95; P = 0.04) and SII (OR = 1.01; 95% CI, 1.00 to 1.01; P = 0.04) were correlated with PEX. Multivariate logistic regression analysis revealed that the correlation between bilirubin levels (OR = 0.02; CI, 0.01 to 0.25; P = 0.002) and SII (OR = 1.01; CI, 1.00 to 1.02; P = 0.001) remained statistically significant when adjusted for age, gender, and Charlson comorbidity index score.

Conclusion: High SII and low bilirubin values in patients with PEX were found to be correlated.

Purpose: To evaluate the effect of wearing an N95 mask on intraocular pressure.

Methods: This cross-sectional study enrolled 34 medical staff volunteers. After baseline eye examinations, all participants were asked to wear an N95 mask for 1 hour. Then, O ${}_2$ saturation, pulse rate, and blood pressure were evaluated, and sequential IOP measurements were performed using both iCare and Goldmann applanation tonometers. All measurements were taken again 1 hour after the mask was removed. Finally, all information was collected for statistical analysis.

Results: A total of 34 participants (68 eyes) with a mean $\pm$ SD age of 38.97 (12.41) years were included. The mean value of IOP/GAT increased significantly by 1.20 mmHg after wearing the mask (12.50 to 13.70 mmHg, P-value $<$ 0.001) and then decreased significantly by 1.27 mmHg after removing the mask (13.70 to 12.43 mmHg, P-value $<$ 0.001). The mean O ${}_2$ saturation increased significantly from 96.4 with the mask to 97.05 after mask removal (P-value $<$ 0.001). Although the mean pulse rate decreased by about 1.5 units after removing the mask, the difference was not significant. The mean blood pressure decreased after removing the mask; however, the change was not statistically significant. Additionally, no significant relationship was found between the change in IOP and O ${}_2$ saturation.

Conclusion: The use of N95 face masks could substantially increase IOP and reduce O ${}_2$ saturation.

Purpose: To investigate the association between glaucoma and various mental health disorders and to examine whether there were indications of effect measure modification of this association in Black compared to Non-Black populations.

Methods: The study included 65,140 individuals from the Medical Expenditure Panel Survey database, with an in-depth focus on 15,016 patients suffering from glaucoma or specific mental health disorders. We included patients aged 18 and above diagnosed with glaucoma or specific mental health disorders based on International Classification of Diseases codes from 2017 to 2020.

Results: Out of the 65,140 patients, 1492, 6359, 5756, 786, and 209 were diagnosed with glaucoma, anxiety, major depressive disorder (MDD), bipolar disorder, and schizophrenia, respectively. Of the 1492 glaucoma patients, 196 (13.2%) were diagnosed with anxiety, 183 (12.2%) with MDD, 20 (1.3%) with bipolar, and 15 (1%) with schizophrenia. The unadjusted OR (95% CI) was calculated for the association between glaucoma and anxiety (OR = 1.36 [1.17-1.58]) P $<$ 0.001), glaucoma and MDD (OR = 1.4 [1.20-164], P $<$ 0.001), glaucoma and bipolar (OR = 1.08 [0.69-1.6], P = 0.71), and glaucoma and schizophrenia and (OR = 3.08 [1.82-5.21], P $<$ 0.001). After adjustment for confounding factors, the association between glaucoma and anxiety, glaucoma and MDD, and glaucoma and schizophrenia remained statistically significant. Furthermore, for this association after interaction analysis, the interaction term of glaucoma and race with MDD (OR = 1.02 [0.6-1.5], P = 0.9), anxiety (OR = 0.64 [0.39-1], P = 0.069), and schizophrenia (OR = 2.8 [0.9-8.6], P = 0.9) didn't yield a significant evidence of effect measure modifications in Black compared to Non-Black groups after Bonferroni correction.

Conclusion: There was a statistically significant association between glaucoma and MDD, anxiety, and schizophrenia. However, for this association, there was no significant evidence of effect measure modifications in Black compared to Non-Black populations.

Purpose: To determine the optimal cut-offs for Pelli-Robson (PR) and Spaeth/Richman contrast sensitivity (SPARCS) test scores for diagnosing glaucoma and to compare PR and SPARCS scores (total and individual quadrants) for assessing contrast sensitivity in patients with glaucoma.

Methods: This study was a single-center, cross-sectional, two-group analysis of 87 glaucomatous eyes and 87 non-glaucomatous control eyes. We assessed visual acuity, refraction, intraocular pressure (IOP), cup disc ratio (CDR), and anterior chamber depth in these patients. The PR score for central contrast sensitivity was obtained, and the SPARCS scores were generated for four outer zones and the central region.

Results: The mean IOP [SD] was significantly higher in the glaucoma group (19.3 [5.2] mm Hg) compared with the control group (17.5 [3.6] mm Hg; P = 0.008). The mean CDR [SD] was significantly higher in the glaucoma group compared with the control group (0.73 [0.14] vs. 0.46 [0.12]; P $<$ 0.001). The mean [SD] PR score (1.48 [0.17] vs. 1.23 [0.19]; P $<$ 0.001) and total SPARCS score (78.2 [5.1] vs. 62.4 [11.2]; P $<$ 0.001) were significantly higher in the control group compared with the glaucoma group. The optimal cut-off for identifying glaucoma was 1.35 for the PR score and 70 for the total SPARCS score. At this value of SPARCS score, the sensitivity for identifying glaucoma was 83.9% (95% CI, 74.5 to 90.9), specificity was 96.6% (95% CI, 90.3 to 99.3), positive predictive value (PPV) was 96.1% (95% CI, 88.9 to 99.2), and negative predictive value (NPV) was 85.7% (95% CI, 77.2 to 92.0). The area under the curve (AUC) value was significantly higher for the total SPARCS score compared with the PR score (0.92 vs. 0.83; P = 0.001). All individual SPARCS scores (superior nasal, superior temporal, central, inferior nasal, and inferior temporal) had lower AUC, sensitivity, specificity, PPV, and NPV values compared with the total SPARCS score.

Conclusion: At the optimal cut-offs, the total SPARCS score offers significantly better diagnostic test properties for identifying glaucoma compared with the PR score.

Hyperreflective choroidal foci (HCF) are a finding on optical coherence tomography that may serve as a biomarker in various retinal and choroidal pathologies. These discrete hyperreflective spots, identified in various layers of the choroid, have been linked to inflammatory, vascular, and degenerative conditions. This review examines the clinical significance, histopathological correlation, and implications of HCF in various diseases, including diabetic retinopathy, age-related macular degeneration, Stargardt disease, choroideremia, Vogt-Koyanagi-Harada disease (VKH), idiopathic posterior uveitis, retinitis pigmentosa, and central serous chorioretinopathy (CSR), as well as non-pathological states. Although further studies are required to validate the findings in each pathology described herein, HCF may be used as a background prognostic marker of disease progression and therapeutic response, albeit with caution.