Journal of Ophthalmic & Vision Research最新文献

Purpose: To evaluate the effects of intravitreal ziv-aflibercept injections (IVZ) on subfoveal choroidal thickness (SCT) as well as on central macular thickness (CMT) and on best corrected visual acuity (BCVA) changes in eyes with center-involved diabetic macular edema (CI-DME).

Methods: Fifty-seven eyes of 36 patients with CI-DME were included in this prospective interventional case series. Structural optical coherence tomography (OCT) and enhanced depth imaging OCT were performed at baseline followed by three monthly 1.25 mg IVZ injections. Changes of SCT, CMT, and BCVA at each follow-up session were assessed. The association between baseline SCT and its monthly changes with final visual and anatomical outcomes were also assessed.

Results: CMT at baseline, and at the first, second, and third month follow-up sessions were 396 $\pm$ 119, 344 $\pm$ 115, 305 $\pm$ 89, and 296 $\pm$ 101 μm, respectively (P-value $<$ 0.001). SCT at baseline, and at months one, two, and three were 236 $\pm$ 47, 245 $\pm$ 56, 254 $\pm$ 54, and 241 $\pm$ 54 μm, respectively (P-value $>$ 0.99). Corresponding figures for BCVA were 0.58 $\pm$ 0.29, 0.47 $\pm$ 0.31, 0.4 $\pm$ 0.24, and 0.37 $\pm$ 0.23 LogMAR, respectively (P-value $<$ 0.001). There was a statistically significant positive correlation between BCVA and CMT changes following IVZ injections (P-value $<$ 0.001). However, there were no significant correlations between SCT changes and visual acuity (VA) and CMT changes following IVZ injections.

Conclusion: IVZ improved visual outcomes and macular thickness profiles in patients with CI-DME. However, IVZ had no significant effect on SCT. Baseline SCT and its monthly changes had no association with visual and anatomical outcomes.

Purpose: In this study, we describe different orbital space-occupying lesions (SOLs) from a referral center in Iran.

Methods: In this retrospective case series, all records of "orbital tumors" with a definite histopathologic diagnosis at a referral center in Iran were reviewed from April 2008 to May 2020.

Results: A total of 375 orbital SOLs were included. The study population consisted of 212 (56.5%) female and 163 (43.5%) male subjects with overall mean age of 31.09 $\pm$ 21.80 years. The most common clinical presentation was proptosis and the superotemporal quadrant was the most frequent site of involvement. Extraconal lesions (276 cases, 73.6%) outnumbered intraconal lesions (99 cases 26.4%). The great majority of SOLs (344, 91.7%) were primary, while 24 (6.4%) were secondary and 7 (1.9%) were metastatic. Benign lesions (309, 82.4%) were much more common than malignant SOLs (66, 17.6%). Overall, dermoid cysts and malignant lymphoma were the most prevalent benign and malignant orbital SOLs, respectively. The malignant to benign lesion ratio was 0.46 in children ($\le$18 years), 0.81 in middle-aged subjects (19-59 years), and 5.9 in older ($\ge$60 years) cases. The most common type of malignancy was rhabdomyosarcoma in children, lymphoma in middle-aged subjects, and invasive basal cell carcinoma in older age group.

Conclusion: Over the 12-year study period, benign, primary, extraconal orbital SOLs were more frequent than malignant, secondary, and intraconal lesions. The ratio of malignant lesions increased with age in this cohort of patients.

Ophthalmology is one of the major imaging-intensive fields of medicine and thus has potential for extensive applications of artificial intelligence (AI) to advance diagnosis, drug efficacy, and other treatment-related aspects of ocular disease. AI has made impressive progress in ophthalmology within the past few years and two autonomous AI-enabled systems have received US regulatory approvals for autonomously screening for mid-level or advanced diabetic retinopathy and macular edema. While no autonomous AI-enabled system for glaucoma screening has yet received US regulatory approval, numerous assistive AI-enabled software tools are already employed in commercialized instruments for quantifying retinal images and visual fields to augment glaucoma research and clinical practice. In this literature review (non-systematic), we provide an overview of AI applications in glaucoma, and highlight some limitations and considerations for AI integration and adoption into clinical practice.

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.