Journal of Ophthalmology最新文献

Purpose: Dry eye disease (DED) is a multifactorial disorder affecting millions worldwide. Inflammation plays a central role in DED. The aim of this review is to critically evaluate the literature concerning the efficacy and safety of lifitegrast, a small molecule immunomodulator that blocks the action of lymphocyte function-associated antigen-1. Methods: Studies were identified using PubMed and ClinicalTrials.gov. Fourteen studies met the inclusion criteria, six of which were randomized controlled trials. The articles were assessed regarding the effect of lifitegrast on symptoms and signs of DED, its usefulness compared to other treatments, and potential adverse events. Results: The analysis demonstrated positive effects of lifitegrast on subjective and objective parameters of DED in the selected studies. However, despite promising results, the included studies did not provide enough evidence to conclude that lifitegrast could outperform other treatments of DED. No major side effects were reported. Conclusions: Based on the current literature, we conclude that lifitegrast could improve various parameters of DED. Still, larger controlled trials are required to establish additional benefits of this medication beyond those of other DED treatments.

Purpose: The effect of the Rho-kinase inhibitor ripasudil on the retinal optic nerve fiber layer (RNFL) remains unclear. We aimed to determine this effect in patients with primary open-angle glaucoma (POAG) using optical coherence tomography (OCT) measurements and linear mixed analysis. Methods: This study prospectively included outpatients from a single center with POAG without a history of vitreoretinal or glaucoma surgery from December 2014 to June 2020, in whom the circumpapillary RNFL thickness (cpRNFLT) was measured more than three times before and after ripasudil initiation, without additional medication or surgery during the period. Measurements were performed using OCT in the follow-up mode. The cpRNFLT change rates were compared before and after treatment using linear mixed models with adjustments for intraocular pressure (IOP) changes. Results: Thirty eyes of 20 patients (12 males and eight females) were included. Upon ripasudil prescription, the average cpRNFLT was 60.2 ± 2.1 μm. The average IOP was 15.1 ± 0.5 and 13.5 ± 0.5 mmHg, respectively, before and after treatment initiation, with a difference of -1.6 ± 0.3 mmHg. Analysis of 343 cpRNFLT measurements using linear mixed models revealed that the cpRNFLT change rate was -0.91 ± 0.15 and -0.40 ± 0.14 μm/year, respectively, before and after treatment onset, with an increase of 0.51 ± 0.21 μm/year. After adjusting for IOP changes, the improvement in cpRNFLT change rate was 0.33 ± 0.23 μm/year, albeit not statistically significant. Conclusion: The cpRNFLT change rate significantly increased after ripasudil administration, whereas the contribution of the IOP decline was not significant.

Purpose: To investigate the correlation between corneal biomechanical characteristics and refractive status in adolescents aged 5-13 years. Methods: A cross-sectional study involved 339 children aged 5-13 with a spherical equivalent (SE) range from -6.00 to +2.00 diopters. Axial length (AL) was measured by IOL Master, corneal biomechanical parameters by Corvis ST, and anterior segment parameters by Pentacam. According to SE of right eye, the subjects were divided into moderate myopia, mild myopia, and emmetropia group. The correlation between AL and SE and corneal biomechanical parameters was analyzed. The corneal biomechanical parameters of the three groups were also compared. Results: The A2V value in the moderate myopia group was significantly lower than that in both the mild group and emmetropia group (p < 0.001). PD in the moderate group was higher than that in the mild group (p < 0.05), while PD in mild myopia was higher than that in emmetropia (p < 0.05). The SSI in the emmetropia group was significantly higher than that in the other two groups (all p < 0.001), and the SSI in the mild group was higher than that in the moderate group (p < 0.01). The A2V value in the 11-13 years old group was lower than that in the 5-7 years old group (p < 0.001) and 8-10 years old group (p < 0.01). PD in the 11-13 years old group was significantly higher than that in the 8-10 years old group (p < 0.001), and PD in the 8-10 years old group was significantly higher than that in the 5-7 years old group (p < 0.01). The SSI in the 5-7 years old group was significantly higher than that in the 8-10 years old group (p < 0.001), and the SSI in the 8-10 years old group was significantly higher than that in the 11-13 years old group (p < 0.05). AL was positively correlated with PD and negatively correlated with SSI and A2V. SE was positively correlated with A2V and SSI and negatively correlated with PD. Conclusions: Corneal stiffness seems to decrease with the increase of SE. The changes of SSI, PD, and A2V were statistically significant and can be predictors of myopia progression in adolescents aged 5-13 years.

Severe dry eye disease (DED) is an inflammatory condition characterized by a lack of sufficient moisture or lubrication on the surface of the eye, significantly impacting the quality of life and visual function. Since detrimental immune response is crucially responsible for the development and aggravation of DED, therapeutic agents which modulate phenotype and function of eye-infiltrated inflammatory immune cells could be used for the treatment of severe DED. Due to their potent immunomodulatory properties, mesenchymal stem cells (MSCs) represent potentially new remedies for the treatment of inflammatory eye diseases. The majority of MSC-sourced bioactive factors are contained within MSC-derived exosomes (MSC-Exos), nano-sized extracellular vesicles which, due to their nanosize dimension and lipid envelope, easily by pass all biological barriers in the body and deliver their cargo directly into the target immune cells. MSC-Exos contain a variety of bioactive proteins (growth factors, immunoregulatory molecules, cytokines, and chemokines) lipids, and microRNAs (miRNAs) which affect viability, proliferation, phenotype, and function of eye-infiltrated immune cells. Accordingly, MSC-Exos may modulate the progression of inflammatory eye diseases, including DED. Therefore, in this review article, we summarized the current knowledge regarding molecular and cellular mechanisms which were responsible for trophic, anti-inflammatory, immunoregulatory, and regenerative properties of MSC-Exos in the treatment of severe DED. For this purpose, an extensive literature review was carried out in February 2024 across several databases (Medline, Embase, and Google Scholar), from 2000 to the present. Eligible studies delineated molecular and cellular mechanisms responsible for the MSC-Exos-based modulation of immune cell-driven eye inflammation in DED, and their findings were analyzed in this review. Results obtained in these studies demonstrated beneficial effects of MSC-Exos in the treatment of severe DED, paving the way for their future clinical use in ophthalmology. Trial Registration: ClinicalTrials.gov identifier: NCT04213248, NCT06475027, NCT06543667, NCT05738629.

Purpose: We sought to compare the effect of cyclosporine 0.1% after various pretreatments in patients with dry eye disease. Methods: Two hundred seventy-four eyes of 137 patients diagnosed with dry eye disease were retrospectively enrolled. Thirty patients (Group 1, 60 eyes) were not pretreated, while 68 patients (Group 2, 136 eyes) were pretreated with fluorometholone 0.1%, and 39 patients (Group 3, 78 eyes) were pretreated with cyclosporine 0.05% before treatment with cyclosporine 0.1%. The Ocular Surface Disease Index Questionnaire (OSDI) score, Schirmer I test result, noninvasive tear film break-up time (NItBUT), corneal staining score, matrix metalloproteinase-9 (MMP-9) grade, meibography result, meibum quality and expressibility scores, and tear meniscus height were examined before treatment and at 1, 2, and 3 months after treatment. Results: All dry eye signs and symptoms of all Groups at 1, 2, and 3 months were significantly improved compared to those before treatment with cyclosporine 0.1% (p < 0.05). Notably, the OSDI score, Schirmer I test result, NItBUT, corneal and conjunctival fluorescein score, and MMP-9 grade in Group 3 were significantly improved compared to those in Groups 1 and 2 at 1, 2, and 3 months after treatment with cyclosporine 0.1% (p < 0.05). The percentages of cases with treatment discontinuation in Groups 1, 2, and 3 were 20.0%, 7.4%, and 10.0%, respectively. Conclusion: Pretreatment with cyclosporine 0.05% can augment the anti-inflammatory effect of cyclosporine 0.1%. Pretreatment with a steroid or a lower concentration of cyclosporine can increase compliance in patients using a cyclosporine 0.1% eye drop.

Purpose: To analyze patients' quality of life (QOL) after laser vision correction (LVC) from a worldwide literature review. Methods: Studies of prospective or cross-sectional design which evaluated QOL in patients after LVC and compared that to preoperative values or a matched group of emmetropes were included. The Web of Science, PubMed, Scopus, and ProQuest were searched for relevant articles published until February 2024. The fixed- or random-effects models were used to estimate the weighted mean difference (WMD) for postoperative QOL changes. Meta-regression was conducted for adjusting the effects of potential confounders. Results: A total of 11 peer-reviewed articles (1753 patients) were included in the study. LVC improved QOL of patients at one (SMD = 0.38, 95% CI: 0.15, 0.60), three (SMD = 1.03, 95% CI: 0.55, 1.50), and six months after surgery (SMD = 0.71, 95% CI: 0.30, 1.11). In meta-regression analysis, QOL improvement was lower in older patients compared to younger ones (β = -0.06, 95% CI: -0.11, -0.01). Also, no statistically significant difference was noted while comparing QOL in post-laser refractive surgery patients and emmetropes (SMD = -0.44, 95% CI: -0.95, 0.07). Conclusion: Patients undergoing LVC experience significant improvements in QOL, particularly in younger subjects, and achieve comparable QOL to individuals with emmetropia.

Background: This study aims to analyze the prevalence and severity of posterior capsule opacification (PCO) and glistening in a new hydrophobic biaspheric monofocal intraocular lens (IOLs) 24 months after implantation. Methods: By means of a ambispective, observational, case-control design, a total of 297 eyes from 200 cataract surgery patients were included in the study (118 females and 82 males; mean age: 72.31 ± 9.87 years, ranging from 35 to 92) and examined at the Hospital Universitario y Politécnico la Fe, Valencia (Spain). Data corresponding to patients implanted with either Asqelio (Study IOL) or Clareon (Control IOL) monofocal IOLs at least 24 months prior to study visit were analyzed. Prevalence and intensity of PCO and IOL glistening were determined and graded for both groups by a single masked observer. Refractive outcomes by autorefractometry, visual acuity, and wavefront aberrations determined by ray tracing were also measured and compared. Results: Prevalence of PCO in patients implanted with the Study IOL 24 months after implantation was 4.0%, lower than that for the Control IOL. Intensity of PCO in both groups was low. One lens in each group presented a Grade 1 glistening after 24 months from implantation. Differences in visual acuity between Study and Control Groups were not significant (p=0.260 and 0.115 for UDVA and CVA, respectively). Residual spherical aberration was significantly lower in the Study Group than that in the Control Group (p=0.007). Conclusion: Prevalence of PCO was considerably lower for Asqelio IOL than for the Control IOL and reports available in the literature for other hydrophobic IOLs. Prevalence of glistening was minimal in both study and control IOLs. Trial Registration: ClinicalTrials.gov identifier: NCT04971863.

Purpose: To evaluate the two-year fundus examination outcomes of term infants undergoing eye screening. Methods: Retrospective review of our data of term infants at a tertiary care center (Ankara Bilkent City Hospital) from October 2021 to October 2023. All screened infants underwent red reflex test and dilated posterior segment examination. Abnormal ocular findings were documented using smartphone-based imaging system. Results: A total of 5527 full-term babies were enrolled to the study. Abnormal ocular findings were observed in 1031 newborns (18.6%), the most common of which were retinal white lesions in the peripheral retina (13%) (n = 720) and posterior segment hemorrhages (4.3%) (n = 243). Other findings included congenital hypertrophy of the retinal pigment epithelium (n = 14), choroidal nevus (n = 11), idiopathic peripheral retinal scar (n = 9), chorioretinal coloboma (n = 6), optic nerve coloboma (n = 4), familial exudative vitreoretinopathy (n = 4), optic nerve large cup (n = 2), optic nerve hypoplasia (n = 2), retinal calcification (n = 2), optic nerve pit (n = 2), morning glory disc anomaly (n = 1), vascular loop on the optic disc (n = 1), retinoblastoma (n = 1), X-linked retinoschisis (n = 1), congenital toxoplasmosis (n = 1), thread-shaped white lesion (n = 1), combined hamartoma of the retina and the retinal pigment epithelium (n = 1), foveal hypoplasia (n = 1), retinal dystrophy (n = 1), and astrocytic hamartoma (n = 1). Conclusions: Detailed eye examinations of term infants can reveal a range of ocular and/or systemic abnormalities that would not be caught through pupillary red reflex test. Smartphone-based fundus imaging is a simple and effective method for documenting findings.

Introduction: This study aimed to compare ocular torsion measurements to investigate normative objective cyclotorsion values in a population of healthy, full-term and preterm children. Materials and Methods: The participants enrolled in this study had an age range of 3-12 years and were divided into two groups, full-term (gestational age (GA) > 37 weeks) and preterm without retinopathy of prematurity (ROP) (GA ≤ 37 weeks). The disc-center-fovea angle (DFA) was used to evaluate ocular torsion using two different imaging modalities: optical coherence tomography (OCT) with a 55-degree field of view (FV) and conventional fundus photography (CFP) with a 45-degree FV. The values measured from both right and left eyes were combined to obtain a single value to compensate for the effect of head tilt during measurement. Results: A total of 86 full-term and 145 preterm children were enrolled in this study. The DFAs measured using OCT and CFP were -11.57° ± 5.27° and -12.07° ± 5.66° in the full-term group and -10.64° ± 5.40° and -11.25° ± 4.80° in the preterm group, respectively. There were no significant differences between the results obtained from OCT and CFP in the two groups (p=0.109 and p=0.512, respectively). There was a strong correlation between OCT and CFP in all patients, with a Pearson's correlation coefficient of 0.74 and an intraclass correlation coefficient (ICC) of 0.74 (both p < 0.001). Multivariate regression analysis showed that the average axial length (AXL) was associated with DFA. Conclusions: This study found a significant correlation between DFA measured using OCT and CFP, making either measurement modality feasible in pediatric populations. There was no significant difference in the DFA between full-term and preterm children. AXL demonstrated an association with the DFA.

Background: To describe the clinical patterns and visual outcomes of pediatric uveitis at a tertiary referral center in East China. Methods: Retrospective case series. Clinical records of patients with pediatric uveitis who presented between January 2014 and July 2021 were reviewed. Results: The children included (n = 283; 146 females, 137 males) had a mean age at presentation of 10.6 ± 3.5 years. There was a predominance of chronic (62.9%), noninfectious (81.3%) disease, and anterior uveitis was the most common uveitis type (54.8%). Idiopathic chronic anterior uveitis (17.3%) and juvenile idiopathic arthritis (JIA)-associated anterior uveitis (16.3%) were the most common noninfectious types; ocular toxocariasis (14.8%) and viral retinitis (1.4%) were the most common infectious etiologies. Ocular complications were observed in 53.0% of patients during follow-up. Systemic immunosuppressive therapy was administered to 66.8% of patients, 67.2% of whom required immunosuppressive drugs and/or biological agents (127/189 children). Surgical treatment was conducted in 38 (13.4%) patients. Improvement or preservation of visual acuity was observed in 95.2% of patients for whom follow-up visual acuity was recorded (179/188 patients). Conclusions: Pediatric uveitis was predominantly chronic and noninfectious, with anterior involvement. Systemic therapy was required by most patients, and most eyes showed improved visual acuity.