Journal of Ophthalmic & Vision Research最新文献

Purpose: To compare the frequency of dermatological manifestations between patients with pseudoexfoliative glaucoma and those with primary open-angle glaucoma.

Methods: A cross-sectional study was done on all consecutive pseudoexfoliative glaucoma (PEXG) and primary open-angle glaucoma (POAG) patients evaluated in a tertiary eye hospital during the study period. Eligible patients were referred to the dermatology department for complete skin, hair, nail, and mucosal examinations.

Results: Twenty-one patients in the PEXG group and 26 patients in the POAG group were included in this study. The most common skin manifestations in the study were seborrheic dermatitis, dry skin, and cherry angioma. The frequency of lentigines was significantly higher in the PEXG patients than in the POAG group (P = 0.013). More than half of the study population had seborrheic dermatitis (57.1% and 61.5% in the PEXG and POAG groups, respectively); however, the difference between the groups was not statistically significant (P = 0.775). Similarly, the frequencies of skin dryness, cherry angioma, nevus, psoriasis, contact dermatitis, itching, seborrheic keratoses, notalgia paresthetica, and vitiligo in the two groups were not statistically significantly different (P $>$ 0.1 for all comparisons). There was no significant association between the frequency of the investigated skin manifestations and patients' age, visual acuity, intraocular pressure, and cup-to-disc ratio.

Conclusion: Integumentary system disorders are pervasive in glaucoma patients, and dermatologic evaluation in glaucoma patients should be considered for diagnostic and therapeutic purposes.

Purpose: To evaluate the 3nethra aberro auto refractometer device as an alternative tool for quick and reliable measurement of refractive errors and to compare it with the gold standard subjective refractive error measurement.

Methods: Refractive errors were measured using both subjective refraction and the 3nethra aberro handheld autorefractometer. The refractive measurements were converted into equivalent vector notations of spherical equivalent and Jackson cross-cylinder measurements J0 & J45. The resultant power vectors were compared with subjective measurements.

Results: This clinical study comprised 60 subjects (22 male and 38 female; with a mean age of 34 $\pm$ 16 years). Data, when compared with the subjective refraction measurements, resulted in 90% of power vectors values in both left and right eyes being the same in the 3nethra aberro handheld autorefractometer and the subjective measurement. The refractive error measurements also had an agreement of 70% and 90% when the range of diopter was between $\pm$ 0.25 and $\pm$ 0.5D, respectively. When the Bland-Altman's plot analysis was performed, about 98% of data lied within the $\pm$ 2 standard deviation variation. An average correlation between the two methods of error measurement was 0.74, and the paired t-test showed P $>$ 0.05 for all the power vectors except for the spherical equivalent in the right eye.

Conclusion: The 90% agreement between the error measurements done by two methods indicates that the 3nethra aberro handheld autorefractometer can function as an alternative for the time-consuming subjective refractive error measurement.

Purpose: To assess the adverse drug reactions (ADR) of tetracaine among patients referred to an eye emergency department in the southeast of Iran.

Methods: In this case series study, we assessed 31 eyes of 24 patients who were referred due to adverse effects of ocular anesthetics during2017-2020. We collected the data, including age, sex, job, how the medicine was obtained, symptoms, examination results, and ADR.

Results: Of 24 patients, 22 (91.7%) were male. The mean (standard deviation) age of the patients was 32.6 (1.9) years. Twenty-two patients obtained the medicines without a prescription and a general practitioner prescribed the medicine to two patients. In the first interview, the most common symptoms were: photophobia, reduced vision, ocular pain, and redness. The main signs of persistent epithelial defect, patchy or diffuse corneal stromal infiltration, ring infiltration, and Descemet's folds were noticed in the examinations. Finally, 51.6% (n =16) of the eyes had decreased vision, 45.2% (n =14) had corneal opacity, 16.1% (n = 5) had elevated intraocular pressure that needed long-term anti-glaucoma therapy, and 6.5% (n = 2) had corneal pannus. Corneal perforation and phthisis bulbi were the final results in one eye.

Conclusion: ADR related to the use of ophthalmic topical anesthetics could cause sight-threatening severe morbidities. It seems that some general practitioners are not careful regarding the prescription of these kinds of medicine. Moreover, the over-the-counter availability of tetracaine eye drops should be managed.

Purpose: To compare the results of the current gold standard, laser interferometry, and keratometry by the IOL-Master, with a newly developed Galilei G6 using raytracing software Okulix for intraocular lens (IOL) power calculations.

Methods: For comparison of the IOL-power calculation of both devices, we analyzed the difference between the actual one-month postoperative subjective refraction and the theoretically calculated target refraction before cataract surgery. The IOL was selected according to the IOL Master recommendation aiming for emmetropia after surgery.We analyzed the differences of the measurements of the basic biometric data in 205 healthy eyes by each device.

Results: Our study included 205 healthy, unoperated eyes from 117 patients (61 women, 56 men) aged 20 to 75 years. Twenty-two eyes of cataract patients were also included in this retrospective study design. The mean difference between the prediction of the postoperative refraction and the refraction actually achieved was 0.03 D for the IOL Master and -0.23 D for the Galilei G6. The difference was not statistically significant (P = 0.059). The difference between the IOL power calculation of the IOL Master and the calculation of the G6 was not statistically significant (P = 0.064). The difference between the predicted refraction of the G6 and the refraction achieved after one month was also not statistically significant (P = 0.12) and neither was the difference between the predicted refraction of the IOL Master and the achieved refraction (P = 0.39). The mean axial length was calculated as 24.21 $\pm$ 0.80 mm using the IOL Master and 24.27 $\pm$ 0.82 mm using the Galilei G6 device. The mean value regarding anterior chamber depth (ACD) of the IOL master was 3.46 $\pm$ 0.23 mm and for the Galilei was G6 3.51 $\pm$ 0.25 mm. When comparing the white to white (WTW) values of the IOL master, it showed mean values of 12.32 $\pm$ 0.31 and Galilei showed mean values of G6 12.21 $\pm$ 0.28. All of these differences (between Galileo and IOL Master measurements) were statistically significant (P $<$ 0.001).

Conclusion: Both the laser interferometry/keratometry performed by the IOL Master and the interferometry/raytracing biometry strategy performed by the Galilei G6 demonstrated equal results when executing the IOL power calculation before cataract surgery in eyes with no prior ocular surgery.

Purpose: To study whether rituximab and bortezomib combination therapy is more effective than rituximab monotherapy in the treatment of non-paraneoplastic autoimmune retinopathy (npAIR).

Methods: Retrospective case series involving six patients with npAIR, taking either rituximab and bortezomib combination therapy (three cases) or rituximab monotherapy (one case and two historical patients).

Results: Patients on both treatment regimens showed stability in most of the visual function parameters during the one year of follow-up. Combination therapy resulted in improvement of scotopic combined rod and cone a-wave and b-wave amplitudes in all eyes where they were available (four eyes); however, rituximab monotherapy resulted in only two eyes with stable scotopic combined rod and cone a-wave and b-wave amplitudes, while four eyes showed a decrease in both a- and b-wave amplitudes. The average improvement in b-wave amplitude (50.7% $\pm$ 29.4% [range, 25-90%]) was higher than the average improvement in a-wave amplitude (35.7% $\pm$ 9.74 [range, 25-63%]). No severe adverse effects were reported.

Conclusion: Rituximab and bortezomib combination therapy may not be more effective than rituximab monotherapy in npAIR patients for most of the visual function parameters; however, this combination therapy may be more effective in improving scotopic combined rod and cone a- and b-wave amplitudes. This may indicate the higher efficacy of combination therapy when there is involvement of the inner retina.

[This corrects the article DOI: 10.18502/jovr.v17i3.11583.].

Purpose: To compare the efficacy of subconjunctival injection of an anti-connective tissue growth factor antibody (anti-CTGF) versus mitomycin-C (MMC) and placebo in reducing scar formation in a rabbit model of trabeculectomy.

Methods: A total of 14 rabbits were included. Nine rabbits underwent trabeculectomy with subconjunctival injections of either anti-CTGF antibody, MMC, or balanced salt solution (BSS), each administered in three eyes, before peritomy. The anti-CTGF group received a repeated dose of the antibody five days after surgery. All nine rabbits were euthanized on day 14; the globes were stained with hematoxylin & eosin, Masson's Trichrome, and immunohistochemistry for detecting alpha-smooth muscle (α-SMA) actin. RNA extraction was performed on five eyes of the remaining rabbits which included one eye without any surgery, one eye 5 hr after trabeculectomy without any injection, one eye five days after trabeculectomy without any injection, and two eyes five days after trabeculectomy with administration of MMC and BSS, respectively.

Results: The mean bleb area in the anti-CTGF, MMC, and control groups was 3.8 $\pm$ 1.45, 5.9 $\pm$ 1.4, and 3.5 $\pm$ 1.9 mm², respectively. Collagenous tissue was found to occupy the bleb area by 13.7%, 13.5%, and 18.5%, respectively. This ratio was significantly higher in the BSS group (P = 0.04). The expression of CTGF mRNA after 5 hr and five days in eyes undergoing trabeculectomy were significantly more pronounced as compared to the unoperated eye. The mean H-SCORE of α-SMA-immune reactive cells calculated as the grade of staining multiplied by the percentage of immune stained cells was 14.6, 10.22, and 140.58 in the anti-CTGF, MMC, and control groups, respectively. While the control eyes had a significantly higher score (Ps $<$ 0.001), the anti-CTGF and MMC groups were comparable (P = 0.87).

Conclusion: Based on the results of this animal study, the anti-CTGF antibody injection resulted in a significant reduction in collagenous tissue and myofibroblast cells after trabeculectomy.

Trabeculectomy remains the most commonly performed surgery for medically uncontrolled glaucoma. Its success in primary open angle glaucoma is approximately 82% in the initial year after surgery and 64% at the end of five years. Lower success rates have been found in secondary glaucomas like neovascular glucoma, uvietic glaucoma, post-traumatic glaucoma, and for repeat surgeries. To illustrate improvement of the efficacy of trabeculectomy, enhancement with cyclodialysis has been introduced. This involves the creation of a cyclodialysis cleft in a controlled manner to allow additional suprachoroidal drainage of the aqueous. Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an additional pathway for aqueous humor drainage. However, such a cleft often closes on its own due to associated inflammation caused by the filtration surgery. Deep sclerectomy is a non-penetrating surgery that involves dissection of a scleral patch and excision of a block of scleral tissue, retaining a thin membrane for aqueous drainage. In this study, we introduce a novel surgical technique of combining trabeculectomy with a limited deep sclerectomy and a cyclodialysis in two pseudophakic patients who developed secondary glaucoma after vitreo-retinal surgery with silicone oil insertion. In this technique the excised scleral tissue obtained after deep sclerectomy was utilized as a spacer to maintain the patency of the cyclodialysis cleft.