Journal of Ophthalmic & Vision Research最新文献

Coronavirus disease 2019 (COVID-19) is a current pandemic caused by SARS-CoV-2 that has vastly affected the whole world. Although respiratory disease is the most common manifestation of COVID-19, the virus can affect multiple organs. Neurotropic aspects of the virus are increasingly unfolding, in so far as some respiratory failures are attributed to brainstem involvement. The neuro-ophthalmic manifestations of COVID-19 and the neuro-ophthalmic side effects of vaccination were reviewed. The major findings are that the SARS-CoV-2 infection commonly causes headaches and ocular pain. It can affect the afferent and efferent visual pathways by ischemic or inflammatory mechanisms. Optic nerve may be the origin of transient or permanent visual loss from papillophlebitis, idiopathic intracranial hypertension, or optic neuritis. Cerebrovascular strokes are not uncommon and may lead to cortical visual impairment or optic nerve infarction. SARS-CoV-2 may affect the pupillomotor pathways, resulting in tonic pupil (Adie's syndrome) or Horner's syndrome. Cranial neuropathies including third, fourth, sixth, and seventh nerve palsies have all been reported. Rhino-orbital mucormycosis superinfections in COVID-19 patients receiving steroids or other immunosuppressive therapies may result in unilateral or bilateral visual loss and ophthalmoplegia. Autoimmune conditions such as Guillain-Barré, Miller-Fisher syndrome, and ocular myasthenia have been reported.

Purpose: To describe a new method of treatment of corneal perforation with extensive corneoscleral melt.

Case report: A 42-year-old man presented with moderate-sized (3.5 mm) corneal perforation with extensive corneo-limbo-scleral ulceration following bare sclera excision of pterygium. No prior use of antimetabolites or postoperative beta radiation noted. We considered retrocorneal sclera patch supported cyanoacrylate application. The sclera was thinned to one-third thickness and a patch (4.5 $\times$ 4.5 mm) was punched. The sclera patch was placed on the iris, behind the corneal perforation, adequately covering it from inside. A minimal amount of adhesive was applied on the retrocorneal sclera patch and margin of corneal perforation. The ulcerating sclera was covered with double layered amniotic membrane. Topical antibiotic, steroid, and cycloplegic drops were instilled thrice daily. Corneal perforation healed and no recurrence occurred during the 18 months' follow-up.

Conclusion: Retrocorneal scleral patch supported cyanoacrylate is effective for corneal perforation with corneo-scleral melt.

Purpose: To demonstrate novel treatments for patients with high juvenile xanthogranuloma (JXG) eyelid lesion burden.

Case report: A 14-year-old girl was referred to the oculoplastic surgery service for management of worsening extensive bilateral eyelid and adnexal lesions in the setting of JXG. The patient underwent intra-lesional steroid injections, serial excisions, and reconstruction with skin grafts. She was subsequently treated with CO ${}_2$ laser-assisted topical steroid application, which resulted in lesion regression.

Conclusion: A novel multimodal approach to treatment of severe periocular JXG, incorporating surgical debulking, skin autograft, CO2 laser, and intra-lesional steroids, can be effective for lesion control.

Purpose: Mutations in TCP-1 ring complex (TRiC) have been associated with Leber Congenital Amaurosis (LCA). TRiC is involved in protein folding and has 8 essential subunits including CCT5. Herein, we studied the retina of TRiC mutant zebrafish to evaluate the possible role of impaired actin and tubulin folding in LCA.

Methods: The cct5 ${}^{tf212b}$ retina was histologically studied using Toluidine Blue staining as well as TUNEL, BrdU-labeling, and Phalloidin assays. Retinal organisation was assessed by quantification of the cellularity utilising DAPI.

Results: Laminar organization of cct5 ${}^{tf212b}$ retinas was intact. Enhanced apoptosis throughout the cct5 ${}^{tf212b}$ retina was not compensated by higher proliferation rates, leaving the cct5 ${}^{tf212b}$ retina smaller in size. Quantification of retinal layer cellularity demonstrated that specifically the numbers of the amacrine and the retinal ganglion cells were depleted, suggesting that the cct5 ${}^{tf212b}$ retina was not uniformly affected by the reduced actin folding.

Conclusion: Whereas the current literature suggests that LCA is predominantly affecting retinal photoreceptor cells and the retinal pigment epithelium, cct5 ${}^{tf212b}$ analyses demonstrated the important role of folding of actin by TRiC, suggesting that cct5 ${}^{tf212b}$ is a useful tool to specifically analyze the role of F-actin filaments in the context of LCA.

Purpose: To evaluate the epidemiological features of open globe injury (OGI) in a tertiary ophthalmic center in the south of Iran.

Methods: The medical files of pediatric patients diagnosed with OGI between March 2014 and March 2019 were reviewed retrospectively. Demographic data, laterality, time of injury, cause of trauma, location and mechanisms, complications, and the involved tissues, visual acuity, type of operation, and antibiotic therapy were all analyzed. Data were processed using the SPSS.

Results: In total, 110 eyes of 108 patients were included. Ages $<$ 7 years comprised 49.1%, 7-12 years 26.4%, and 13-18 years 24.5% of cases. Of the 108 patients, 76 (70.3%) were males. No significant difference between right versus left eyes was seen. The incidence of OGI was lowest in winter and highest in spring, and it had more prevalence on the weekends. Sharp objects were the most common cause of OGI in ages $<$ 7 years, while blunt objects, accidents and falls, and guns and fireworks were more prevalent in older children. Home was the most common place of injury overall. The most common type of injury was penetrating trauma. Upon arrival, most of the children had a visual acuity $<$ 0.1 decimal. Primary wound closure was the most prevalent type of surgery done predominantly within 24 hr from admission time.

Conclusion: Ages $<$ 7 years and male gender were the most common age and sex of pediatric OGI, respectively, and sharp objects were the predominant etiology. Early management and primary repair are essential for prevention of complications such as endophthalmitis and amblyopia.

Purpose: To investigate and optimize the accuracy of aphakic refraction (AR) techniques for secondary intraocular lens (IOL) power calculation in aphakic children.

Methods: Thirty-three aphakic eyes of 18 patients who were candidates for secondary IOL implantation were enrolled in the present study. Axial length (AL) measured by optical biometry was used in the biometric formula (SRK-T, Holladay II, and Hoffer-Q). AR and spherical equivalent (SE) were used in two AR-based formulas (Ianchulev, Leccissotti). True power was calculated based on postoperative SE at three months' follow-up.

Results: Regarding the postoperative SE, 13 (40%) eyes were within $\pm$ 1.00 diopters (D) and 22 (66%) were within $\pm$ 2.00 D. Median absolute error (MedAE) was predicted to be 4.4 and 7.3 D with the use of Ianchulev and Leccissotti formulas, respectively. The corresponding value was 0.8 D with the biometric formula. All eyes were deemed to have myopic refraction when using the AR-based formulas except one eye with the Ianchulev formula. The coefficient of our modified formula was 1.7 instead of 2.01 in the Ianchulev formula. MedAE with the use of new formulae was 0.5 D and was comparable with the true IOL power (P = 0.22).

Conclusion: Both Ianchulev and Leccissotti formulas resulted in a significant myopic surprise in aphakic children aged between 4.5 and 14 years. The modified formula proved to determine a more accurate SE that is comparable with biometric formulas.

Purpose: To estimate the incidence and identify the factors affecting retinopathy of prematurity (ROP) in a rural tertiary hospital in Thailand.

Methods: This retrospective chart review included all infants screened for ROP. The study included all infants with gestational age (GA) $\le$ 30 weeks or birth weight (BW) $\le$ 1,500 gr or selected larger infants with an unstable clinical course. Retinal findings were classified according to the revised International Classification of ROP. Data were analyzed using univariate and multivariable logistic regression analyses.

Results: Of the 113 screened infants, the incidences of any ROP and ROP requiring intervention were 17.7% and 8.8%, respectively. In univariate analysis, lower GA, lighter BW, total days of supplemental oxygen, days of continuous positive airway pressure (CPAP), presence of apnea, and intraventricular hemorrhage (IVH) were associated with the development of any ROP. In the stepwise multivariable logistic regression analysis, lighter BW, male gender, and bronchopulmonary dysplasia (BPD) were significant risk factors for the development of any ROP. Lower GA and being either a twin or triplet were significant risk factors for ROP requiring intervention. However, no antenatal condition was identified as a risk factor for ROP.

Conclusion: The incidence of ROP in rural tertiary hospitals was relatively high as compared with previously published data from urban tertiary hospitals. Lighter BW, male gender, and BPD were significantly associated with the development of ROP in a local context. Epidemiological studies are necessary to prevent ophthalmic morbidities.