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Inhaled Corticosteroid Exposure and Risk of Cataract in Patients with Asthma and COPD: A Systematic Review and Meta-Analysis. 哮喘和慢性阻塞性肺病患者吸入皮质类固醇暴露与白内障风险:系统综述和荟萃分析。
IF 1.9 4区 医学 Q2 Medicine Pub Date : 2023-10-19 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8209978
Osman Savran, Charlotte Suppli Ulrik

Purpose: Both systemic and inhaled corticosteroids may increase the risk of cataract in patients with both chronic obstructive pulmonary disease (COPD) and asthma. Our aim was to assess the degree of association between cataract and corticosteroid exposure in patients with asthma and COPD.

Methods: A systematic literature review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The odds ratio estimates were extracted from each article. A random effects model was applied for estimate pooling in separate meta-analyses according to study design. Meta-regression was performed to assess the dose-response relationship between corticosteroid exposure and the risk of cataract development.

Results: A total of 19 studies met the criteria for inclusion in this review, of which 12 studies provided effect estimates for pooled analyses. All but one of the included observational studies reported a significant association between use of corticosteroids and cataract development in cohorts of asthma and/or COPD patients. Pooled analyses revealed on average a doubled risk of cataract in corticosteroid-exposed asthma and COPD patients. Studies have shown that daily high-dose inhaled corticosteroid (ICS) ≥ 1000 μg is associated with a significant risk of developing cataract and by that predispose to subsequent cataract surgery, although one study showed that systemic corticosteroids increase cataract risk more than ICS.

Conclusion: ICS treatment in asthma and COPD patients is a risk factor for cataract development. Our results emphasize a previously underestimated potential long-term risk of treatment with ICS and underline the importance of targeting ICS treatment, and not least dosing, to improve the risk-benefit ratio of maintenance treatment in both asthma and COPD.

目的:全身和吸入皮质类固醇都可能增加慢性阻塞性肺病(COPD)和哮喘患者患白内障的风险。我们的目的是评估哮喘和COPD患者白内障和皮质类固醇暴露之间的关联程度。方法:根据系统评价和荟萃分析指南的首选报告项目进行系统文献综述和荟萃分析。从每篇文章中提取比值比估计值。根据研究设计,将随机效应模型应用于单独的荟萃分析中的估计池。采用荟萃回归法评估皮质类固醇暴露与白内障发生风险之间的剂量-反应关系。结果:共有19项研究符合纳入本综述的标准,其中12项研究提供了汇总分析的效果估计。除一项外,所有纳入的观察性研究都报告了哮喘和/或COPD患者队列中皮质类固醇的使用与白内障发展之间的显著关联。汇总分析显示,暴露于皮质类固醇的哮喘和COPD患者患白内障的风险平均增加了一倍。研究表明,每天高剂量吸入皮质类固醇(ICS) ≥ 1000 μg与患白内障的显著风险相关,从而易患后续白内障手术,尽管一项研究表明,全身皮质类固醇比ICS更能增加白内障风险。结论:哮喘和COPD患者的ICS治疗是白内障发生的危险因素。我们的研究结果强调了先前低估的ICS治疗的潜在长期风险,并强调了靶向ICS治疗的重要性,尤其是给药,以提高哮喘和COPD维持治疗的风险效益比。
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引用次数: 0
Optical Coherence Tomography Angiography for Evaluation of Conjunctival Vessels in Dry Eyes. 光学相干断层扫描血管造影术用于评估干眼结膜血管。
IF 1.9 4区 医学 Q2 Medicine Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.1155/2023/1609332
TongFeng Cui, HongYan Sun, ZiZhong Hu, YaBo Shi, Jiang Zhu, ManMan Jin, Bing Qin

Objective: This study aimed to evaluate conjunctival vessels in patients with dry eye disease (DED) using optical coherence tomography angiography (OCTA).

Methods: This was a cross-sectional, observational clinical study. Twenty-three eyes of 18 patients with DED and 28 eyes of 23 healthy controls were included for examination in this study. The evaluation included the application of an Ocular Surface Disease Index Questionnaire, Schirmer Basic Secretion Test, and anterior OCTA targeting the temporal conjunctiva. AngioTool software was used to quantify the total vessel length and vessel density in the 3 × 3 mm temporal region of interest.

Results: Blood vessel density measurements were compared across the OCTA systems. The total vessel length within the conjunctiva of the DED group (4799.34 ± 834.36) exceeded that of the control eye (3864.89 ± 1455.70) group (P < 0.05). However, the difference in vessel density between the two groups was not statistically significant.

Conclusion: Measurement and analysis of conjunctival blood vessels using OCTA exhibited robust repeatability. In dry eyes, the total number of conjunctival blood vessels increased in accordance with disease severity. Hypoxia of conjunctival tissue may be an important cause of dry eye disease.

目的:本研究旨在利用光学相干断层扫描血管造影术(OCTA)评估干眼病(DED)患者的结膜血管。方法:这是一项横断面观察性临床研究。本研究包括18名DED患者的23只眼睛和23名健康对照的28只眼睛进行检查。评估包括应用眼表疾病指数问卷、Schirmer基础分泌物测试和针对颞结膜的前OCTA。AngioTool软件用于量化3 × 3. mm感兴趣的时间区域。结果:比较了OCTA系统的血管密度测量结果。DED组结膜内的总血管长度(4799.34 ± 834.36)超过对照眼(3864.89 ± 1455.70)组(P 结论:OCTA对结膜血管的测量和分析具有较强的重复性。在干眼症中,结膜血管的总数随着疾病的严重程度而增加。结膜组织缺氧可能是干眼症的一个重要原因。
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引用次数: 0
Changes in Stress-Strain Index in School-Aged Children: A 3-Year Longitudinal Study. 学龄儿童应力应变指数的变化:一项为期3年的纵向研究。
IF 1.9 4区 医学 Q2 Medicine Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6680748
Zhengfei Yang, Bo Wu, Zhouyue Li, Mengting Yu, Jinyun Jiang, Shuyuan Chen, Shengsong Xu, Junwen Zeng, Mengyi Wang, Xiao Yang

Purpose: To determine three-year change of the corneal biomechanical parameter stress-strain index (SSI) in schoolchildren aged 7- 9 years and their correlation with refractive error and axial length (AL).

Methods: This is a prospective cohort study. Data of the AL, refractive error, and corneal biomechanical parameter SSI were collected at baseline and a 3-year follow-up for 217 schoolchildren. SSI, AL, and refractive error were measured via corneal visualization Scheimpflug technology (Corvis ST), IOLMaster biometry, and cycloplegic refraction. Three years of changes in SSI and its association with refractive error and AL were analyzed. Participants were divided into persistent nonmyopia (PNM), newly developed myopia (NDM), and persistent myopia (PM). The three-year difference in SSI among the three groups was analyzed.

Results: After three years of follow-up, the corneal biomechanical parameter SSI decreased in all participants (P < 0.01). There was a negative correlation between the change in SSI and the change in AL (r = -0.205, P=0.002) and a positive correlation between the change in refractive error (r = 0.183, P=0.007). After three years of follow-up, there was a decrease in the SSI for the NDM, PM, and PNM participants, with a median change of -0.05 for PNM and -0.13 and -0.09 for the NDM and PM, respectively. There was a significant decrease in corneal biomechanical properties for NDM patients compared with PNM patients (P < 0.01).

Conclusion: In 7- to 9-year-old schoolchildren, SSI decreased after three years of the longitudinal study, and the change in SSI was correlated with the change in AL and refractive error. There was a rapid decrease in corneal biomechanical properties among newly developed myopic patients.

目的:测定7-9岁学龄儿童角膜生物力学参数应力应变指数(SSI)的三年变化 年及其与屈光误差和轴向长度(AL)的相关性。方法:这是一项前瞻性队列研究。在基线和217名学童的3年随访中收集AL、屈光不正和角膜生物力学参数SSI的数据。SSI、AL和屈光不正通过角膜可视化Scheimpflug技术(Corvis ST)、IOLMaster生物测量和睫状肌麻痹屈光度进行测量。分析了三年来SSI的变化及其与屈光不正和AL的关系。参与者被分为持续性非近视(PNM)、新发近视(NDM)和持续性近视(PM)。分析三组SSI的三年差异。结果:随访3年后,所有受试者角膜生物力学参数SSI均下降(P<0.01),SSI的变化与AL的变化呈负相关(r = -0.205,P=0.002)与折射误差的变化之间的正相关性(r = 0.183,P=0.007)。经过三年的随访,NDM、PM和PNM参与者的SSI有所下降,PNM的中位数变化分别为-0.05和-0.13和-0.09。与PNM患者相比,NDM患者的角膜生物力学特性显著降低(P<0.01)。结论:在7-9岁的学童中,经过三年的纵向研究,SSI降低,SSI的变化与AL和屈光不正的变化相关。在新发展的近视患者中,角膜生物力学特性迅速下降。
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引用次数: 0
Diagnostic Accuracy of Corneal and Epithelial Thickness Map Parameters to Detect Keratoconus and Suspect Keratoconus. 角膜和上皮厚度图参数检测角膜和疑似角膜的诊断准确性。
IF 1.9 4区 医学 Q2 Medicine Pub Date : 2023-10-06 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6677932
Abdelrahman Salman, Cosimo Mazzotta, Obeda Kailani, Marwan Ghabra, Rana Omran, Ashraf Armia Balamoun, Taym Darwish, Rafea Shaaban, Hala Alhaji

Aim: To establish the diagnostic accuracy of corneal and epithelial thickness measurements obtained by spectral-domain optical coherence tomography (SD-OCT) in detecting keratoconus (KC) and suspect keratoconus (SKC).

Methods: This retrospective study reviewed the data of 144 eyes separated into three groups by the Sirius automated corneal classification software: normal (N) (n = 65), SKC (n = 43), and KC (n = 36). Corneal thickness (CT) and epithelial thickness (ET) in the central (0-2 mm) and paracentral (2-5 mm) zones were obtained with the Cirrus high-definition OCT. Areas under the curve (AUC) of receiver operator characteristic (ROC) curves were compared across groups to estimate their discrimination capacity.

Results: ROC curve analysis revealed excellent predictive ability for ET variables: minimum (Min) ET (0_2), minimum-maximum (Min-Max) ET (0_2), superonasal-inferotemporal (SN-IT) ET (2_5), Min-Max ET (2_5), and Min ET (2_5) to detect keratoconus (AUC > 0.9, all). Min-Max CT (0_2) was the only CT parameter with excellent ability to discriminate between KC and N eyes (AUC = 0.94; cutoff = ≤-32 μm). However, both ET and CT variables were not strong enough (AUC < 0.8, all) to differentiate between SKC and N eyes, with the highest diagnostic power for Min-Max ET (2_5) (AUC = 0.71; cutoff = ≤-9 μm) and central corneal thickness (CCT) (AUC = 0.76; cutoff = ≤533 μm).

Conclusion: These results demonstrate that OCT-derived CT and ET are able to differentiate between KC and N eyes, with a high level of certainty. However, Min-Max ET (2_5) was the parameter with the highest ability to detect suspect keratoconus.

目的:建立光谱域光学相干断层扫描(SD-OCT)角膜和上皮厚度测量对圆锥角膜(KC)和可疑圆锥角膜(SKC)的诊断准确性 = 65),SKC(n = 43)和KC(n = 36)。角膜厚度(CT)和中央上皮厚度(ET)(0-2 mm)和中央旁(2-5 mm)区域。将受试者-操作者特征(ROC)曲线的曲线下面积(AUC)在各组之间进行比较,以估计其辨别能力。结果:ROC曲线分析显示,ET变量具有良好的预测能力:最小(Min)ET(0_2)、最小-最大(Min-Max > 0.9)。最小最大CT(0_2)是唯一一个具有良好区分KC和N眼能力的CT参数(AUC = 0.94;切断 = ≤-32 μm)。然而,ET和CT变量都不够强(AUC μm)和中央角膜厚度(CCT)(AUC) = 0.76;切断 = ≤533 μm)。结论:这些结果表明OCT衍生的CT和ET能够以高水平的确定性区分KC和N眼。然而,最小-最大ET(2_5)是检测可疑圆锥角膜能力最高的参数。
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引用次数: 0
Etiological Factors and Visual Outcomes of Dense Vitreous Hemorrhage in Patients Aged 80 years and above over the Past Decade in a Tertiary General Hospital. 80岁患者致密性玻璃体出血的病因因素和视觉结果 在过去的十年里,在一家三级综合医院工作了几年及以上。
IF 1.9 4区 医学 Q2 Medicine Pub Date : 2023-09-28 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8851207
Yuhua Ding, Bangtao Yao, Hui Ye, Fei Wang

This study aimed to investigate the main etiological factors and visual outcomes in patients with dense vitreous hemorrhage (DVH) aged ≥80 years. We retrospectively included patients with DVH aged ≥80 years who were admitted to our ophthalmology department between January 1, 2010, and December 31, 2019. All patients underwent pars plana vitrectomy (PPV). Data regarding demographic characteristics; preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ophthalmic B-scan ultrasonography findings; intraoperative conditions; and postoperative complications were collected and analyzed. A total of 44 patients (44 eyes) were enrolled, with a median age of 82 years; among them, 25 patients (56.82%) were men. The median preoperative BCVA was 2.3 (1.1-3.0). The main etiological factors included retinal vein occlusion (RVO) (20 eyes, 45.45%), polypoidal choroidal vasculopathy (PCV) (15 eyes, 34.09%), proliferative diabetic retinopathy (PDR) (7 eyes, 15.90%), retinal arterial macroaneurysm (RAM) (1 eye, 2.27%), and posterior vitreous detachment (PVD) (1 eye, 2.27%). The median final BCVA was 1.92 (0.5-2.6). There was a significant postoperative improvement in the BCVA; moreover, branch RVO (BRVO) had a better postoperative visual prognosis than central RVO (CRVO), PCV, and PDR (P < 0.05). The final postoperative BCVA was significantly better when the initial BCVA was above hand motion (HM) than when it was HM or lower (P < 0.05). Our findings indicate that RVO, PCV, and PDR were the main causes of DVH. Microinvasive PPV is a safe and effective method that can clarify diagnosis and improve BCVA. Patients with BRVO and preoperative BCVA > HM may have a relatively good visual prognosis. For patients aged ≥80 years who have an appropriate general condition, PPV can be timely performed to treat DVH.

本研究旨在探讨年龄≥80岁的致密性玻璃体出血(DVH)患者的主要病因和视觉结果 年。我们回顾性纳入了年龄≥80岁的DVH患者 在2010年1月1日至2019年12月31日期间入住我们眼科的年。所有患者均接受了平坦部玻璃体切除术(PPV)。关于人口特征的数据;术前和术后最佳矫正视力(BCVA)、眼压(IOP)和眼科B超检查结果;术中条件;收集并分析术后并发症。共有44名患者(44眼)入选,中位年龄为82岁 年;其中男性25例(56.82%)。术前BCVA中位数为2.3(1.1-3.0)。主要病因包括视网膜静脉阻塞(RVO)(20眼,45.45%)、息肉状脉络膜血管病(PCV)(15眼,34.09%)、增殖性糖尿病视网膜病变(PDR)(7眼,15.90%)、视网膜动脉大动脉瘤(RAM)(1眼,2.27%),和后玻璃体脱离(PVD)(1眼,2.27%)。中位最终BCVA为1.92(0.5-2.6)。术后BCVA有显著改善;此外,分支RVO(BRVO)的术后视觉预后优于中心RVO(CRVO)、PCV和PDR(P P  HM可能具有相对良好的视觉预后。对于年龄≥80岁的患者 年,有适当的一般情况,可以及时进行PPV治疗DVH。
{"title":"Etiological Factors and Visual Outcomes of Dense Vitreous Hemorrhage in Patients Aged 80 years and above over the Past Decade in a Tertiary General Hospital.","authors":"Yuhua Ding,&nbsp;Bangtao Yao,&nbsp;Hui Ye,&nbsp;Fei Wang","doi":"10.1155/2023/8851207","DOIUrl":"10.1155/2023/8851207","url":null,"abstract":"<p><p>This study aimed to investigate the main etiological factors and visual outcomes in patients with dense vitreous hemorrhage (DVH) aged ≥80 years. We retrospectively included patients with DVH aged ≥80 years who were admitted to our ophthalmology department between January 1, 2010, and December 31, 2019. All patients underwent pars plana vitrectomy (PPV). Data regarding demographic characteristics; preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ophthalmic B-scan ultrasonography findings; intraoperative conditions; and postoperative complications were collected and analyzed. A total of 44 patients (44 eyes) were enrolled, with a median age of 82 years; among them, 25 patients (56.82%) were men. The median preoperative BCVA was 2.3 (1.1-3.0). The main etiological factors included retinal vein occlusion (RVO) (20 eyes, 45.45%), polypoidal choroidal vasculopathy (PCV) (15 eyes, 34.09%), proliferative diabetic retinopathy (PDR) (7 eyes, 15.90%), retinal arterial macroaneurysm (RAM) (1 eye, 2.27%), and posterior vitreous detachment (PVD) (1 eye, 2.27%). The median final BCVA was 1.92 (0.5-2.6). There was a significant postoperative improvement in the BCVA; moreover, branch RVO (BRVO) had a better postoperative visual prognosis than central RVO (CRVO), PCV, and PDR (<i>P</i> < 0.05). The final postoperative BCVA was significantly better when the initial BCVA was above hand motion (HM) than when it was HM or lower (<i>P</i> < 0.05). Our findings indicate that RVO, PCV, and PDR were the main causes of DVH. Microinvasive PPV is a safe and effective method that can clarify diagnosis and improve BCVA. Patients with BRVO and preoperative BCVA > HM may have a relatively good visual prognosis. For patients aged ≥80 years who have an appropriate general condition, PPV can be timely performed to treat DVH.</p>","PeriodicalId":16674,"journal":{"name":"Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Quality of Life of Seniors with Eye Diseases during COVID-19 COVID-19期间老年人眼病患者的生活质量
4区 医学 Q2 Medicine Pub Date : 2023-09-26 DOI: 10.1155/2023/9987483
Brian Edward Yu, Shehzad Ali, Hyunsoo Jang, Samantha So, Michael Huang, Cindy Hutnik, Monali Malvankar-Mehta
Purpose. To assess health-related quality of life (HRQoL), vision-related quality of life (VRQoL), depression and anxiety symptoms, and social support and community integration of seniors with eye diseases and to identify important predictor variables of the outcomes. Methods. A cross-sectional survey was performed in seniors with eye diseases (n = 90). Demographic characteristics and questionnaire scores were summarized. Linear regression analysis with backward stepwise selection was used to predict the value of the outcomes of eye disease. Results. Preference-based HRQoL of the study patients with eye diseases during the pandemic was likely good with a mean utility value of 0.88. VRQoL and sleep quality appeared to be good as well. Depression and anxiety symptoms appeared to be low, while community integration and social support were moderate. Furthermore, the presence of retinal disease, number of nonocular comorbidities, and education appeared to have significant negative effects on social support and community integration. The presence of retinal disease and the number of nonocular comorbidities both appeared to negatively impact VRQoL. The use of a mobility aid appeared to negatively affect depressive symptoms and sleep quality. Conclusions. Overall quality of life and wellness among seniors with eye diseases appeared to be good during the COVID-19 pandemic. However, the presence of retinal disease and the number of nonocular comorbidities both appeared to negatively impact VRQoL and social support and community integration. Education appeared to impact social support and community integration negatively. The use of a mobility aid appeared to negatively affect depressive symptoms and sleep quality.
目的。评估老年人眼病患者的健康相关生活质量(HRQoL)、视力相关生活质量(VRQoL)、抑郁和焦虑症状、社会支持和社区融入,并确定结果的重要预测变量。方法。对老年眼病患者进行横断面调查(n = 90)。总结人口学特征和问卷得分。采用线性回归分析和后向逐步选择预测眼病转归值。结果。在大流行期间,研究中眼病患者基于偏好的HRQoL可能较好,平均效用值为0.88。VRQoL和睡眠质量似乎也很好。抑郁和焦虑症状似乎较低,而社区融入和社会支持程度中等。此外,视网膜疾病的存在、非眼合并症的数量和教育程度似乎对社会支持和社区融入有显著的负面影响。视网膜疾病的存在和非眼部合并症的数量似乎都对VRQoL产生负面影响。使用助行器似乎会对抑郁症状和睡眠质量产生负面影响。结论。在COVID-19大流行期间,患有眼病的老年人的整体生活质量和健康状况似乎很好。然而,视网膜疾病的存在和非眼合并症的数量似乎都对VRQoL、社会支持和社区融入产生负面影响。教育似乎对社会支持和社区融合产生消极影响。使用助行器似乎会对抑郁症状和睡眠质量产生负面影响。
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引用次数: 0
Rehabilitation Methods for Patients with Geographic Atrophy due to Age-Related Macular Degeneration and Effects of Rehabilitation on Quality of Life. 老年性黄斑变性导致的地理萎缩患者的康复方法以及康复对生活质量的影响。
IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2023-07-08 eCollection Date: 2023-01-01 DOI: 10.1155/2023/3389750
Damla Erginturk Acar, Figen Batioglu, Aysun Idil, Esra Sahli, Dincer Goksuluk

Purpose: The purpose of the study is to evaluate the low vision rehabilitation methods and to investigate the effect of visual rehabilitation on quality of life in patients with low vision due to geographic atrophy from age-related macular degeneration (ARMD).

Methods: The better-seeing eye of 78 patients with geographic atrophy due to ARMD were included in the study. Sociodemographic characteristics, ophthalmological examination findings, and preferred low vision aids for near and distant were recorded. Fifty-seven patients who preferred to use a low vision aid device in daily life were considered as a rehabilitation group, whereas 21 patients who did not use any device were considered as a control group. The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was applied to all patients at the initial examination and at least 6 months after the initial examination.

Results: In the rehabilitation group, statistically significant increases were found in the overall composite score, and general vision, near and distance activities, social functioning, mental health, role difficulties, and dependency subscale scores of the NEI-VFQ-25 quality of life scale after low vision rehabilitation (p=0.009 for general vision, p < 0.001; for others). In the control group, there was no statistically significant change in any of the subscale scores or the overall score of the scale (p > 0.05). All patients (n = 78) were recommended to use at least one low vision aid for near vision. Hyperocular glasses were recommended for 77 patients (98.72%), magnifiers for 15 patients (19.23%), electro-optical devices for 2 patients (2.56%), and telemicroscope for one patient (1.28%). Furthermore, 17 patients (21.8%) were prescribed more than one low vision aids. However, for distance vision, only 29 patients (37.18%) received a recommendation for a low vision aid.

Conclusions: Low vision patients with ARMD-related geographic atrophy should meet with low vision aids as soon as possible and should be included in low vision rehabilitation programs.

目的:本研究旨在评估低视力康复方法,并探讨视觉康复对年龄相关性黄斑变性(ARMD)地理萎缩低视力患者生活质量的影响:方法:研究纳入了78名因年龄相关性黄斑变性(ARMD)导致的地理萎缩患者的较好视力眼。研究记录了患者的社会人口学特征、眼科检查结果以及首选的近距离和远距离低视力助视器。其中 57 名患者选择在日常生活中使用低视力助视器,被视为康复组;21 名患者不使用任何助视器,被视为对照组。所有患者在初次检查时和初次检查后至少 6 个月都接受了美国国家眼科研究所的视觉功能问卷调查(NEI-VFQ-25):结果:康复组患者在接受低视力康复治疗后,生活质量量表(NEI-VFQ-25)中的总体综合得分、一般视力、近距离和远距离活动、社会功能、心理健康、角色困难和依赖性分量表得分均有显著提高(一般视力方面,P=0.009;其他方面,P<0.001)。在对照组中,任何分量表得分或量表总分均无统计学意义上的显著变化(P > 0.05)。所有患者(78 人)都被建议使用至少一种低视力辅助近视眼镜。其中,77 名患者(98.72%)被建议佩戴远视镜,15 名患者(19.23%)被建议佩戴放大镜,2 名患者(2.56%)被建议佩戴电子光学设备,1 名患者(1.28%)被建议佩戴远视镜。此外,有 17 名病人(21.8%)獲處方多於一種低視能輔助儀器。然而,在远视方面,只有 29 名患者(37.18%)获得了低视力助视器的建议:结论:患有 ARMD 相关性地理萎缩的低视力患者应尽快配戴低视力助视器,并将其纳入低视力康复计划。
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引用次数: 0
A Novel Role for Corneal Pachymetry in Planning Cataract Surgery by Determining Changes in Spherical Equivalent Resulting from a Previous LASIK Treatment. 角膜厚度测定法在规划白内障手术中的新作用,它能确定先前 LASIK 治疗导致的球面等值变化。
IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2023-05-31 eCollection Date: 2023-01-01 DOI: 10.1155/2023/2261831
Arthur Hammer, Tjebo F C Heeren, Romesh Angunawela, John Marshall, Kamran Saha

Objectives: To provide a metric to differentiate between hyperopic and myopic ablation of a prior LASIK treatment based on the corneal pachymetry profile after laser vision correction (LVC).

Methods: Pachymetry data were retrospectively recovered from patients who had previous LASIK for refractive purposes between 2019 and 2020. Patients with any corneal disorder were excluded. Ablation spherical equivalent was predicted from the central to semiperipheral corneal thickness (CPT) ratio, both values were provided by using the Pentacam user interface software (UI), and values were computed from extracted raw pachymetry data.

Results: Data of 157 eyes of 81 patients were collected, of which data were analysed for 73 eyes of 73 patients to avoid concurrence of measurements in both eyes per subject (42% female; mean age 40.9; SD 12.8). The CPT ratio cutoff for distinction between myopic and hyperopic LASIK was 0.86 for Pentacam UI data. Sensitivity and specificity were 0.7 and 0.95, respectively. Accuracy increased with computation of the CPT ratio based on extracted raw data with sensitivity and specificity of 0.87 and 0.99, respectively. There was a marked linear correlation between the CPT ratio and the ablation spherical equivalent (R2 = 0.93).

Conclusions: CPT ratio cutoffs can correctly classify if a cornea previously had a hyperopic versus myopic LASIK surgery and estimate the ablation spherical equivalent of such treatment. This could prove useful for increased accuracy of intraocular lens (IOL) calculations for patients with no historical data of their prior LVC surgery at the time of cataract surgery planning.

目的根据激光视力矫正(LVC)后的角膜厚度曲线,提供一种区分先前 LASIK 治疗的远视和近视消融的指标:方法:从2019年至2020年期间曾因屈光目的接受过LASIK治疗的患者中回顾性地恢复了角膜厚度数据。排除了患有任何角膜疾病的患者。根据中央与半周角膜厚度(CPT)比值预测消融球面等值,这两个值均由 Pentacam 用户界面软件(UI)提供,并根据提取的原始测径数据计算值:收集了 81 名患者 157 只眼睛的数据,其中 73 名患者的 73 只眼睛的数据进行了分析,以避免每名受试者(42% 为女性;平均年龄 40.9 岁;标准差 12.8)的双眼测量数据相同。对于 Pentacam UI 数据,区分近视和远视 LASIK 的 CPT 比值临界值为 0.86。灵敏度和特异度分别为 0.7 和 0.95。根据提取的原始数据计算 CPT 比值后,准确度有所提高,灵敏度和特异度分别为 0.87 和 0.99。CPT 比值与消融球面等值之间存在明显的线性相关(R2 = 0.93):结论:CPT 比值临界值能正确区分角膜是否曾接受过远视或近视 LASIK 手术,并估算出此类治疗的消融球面等值。结论:CPT 比值临界值能正确区分角膜是否曾接受过远视或近视 LASIK 手术,并估算出此类治疗的消融球面等值,这对于在白内障手术规划时没有 LVC 手术历史数据的患者来说,有助于提高眼内晶状体(IOL)计算的准确性。
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引用次数: 0
Effects of Cycloplegic Agents on Ocular Parameters in Children with Myopia and Hyperopia. 环形角膜塑形剂对近视和远视儿童眼部参数的影响。
IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2023-05-11 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9003942
Guangzhi Qu, Bingfeng Wang, Saisai Ding, Xiaocui Liu, Lei Gao, Xuli Wang

Background: To study the effect of cycloplegia on ocular parameters in children with myopia and hyperopia.

Methods: Forty-two myopia and forty-four hyperopia eyes in children between 5 and 10 years of age were included. Measurements were taken before and after cycloplegia using 1% atropine sulfate ointment. The ocular parameters included central corneal thickness (CCT), corneal curvature (CC), anterior chamber depth (ACD), pupil diameter (PD), axial length (AL), and central retinal thickness (CRT).

Results: There was no significant difference in CCT, CC, and CRT between the two groups without cycloplegia, but the ACD of the myopia (3.64 ± 0.28 mm) group was significantly higher than that of hyperopia (3.40 ± 0.24 mm; t = -4.522; P < 0.0001). The average PD of the myopia (4.85 ± 0.87 mm) group was significantly smaller than that of the hyperopia group (5.47 ± 1.15 mm; t = 2.903; P < 0.0046). The average AL of myopia (24.25 ± 0.77 mm) was significantly higher than that of hyperopia (21.73 ± 1.24 mm; t = 12.084; P < 0.0001). However, it was found that the average PD of myopia (7.68 ± 0.51 mm) was significantly larger than that of hyperopia (7.41 ± 0.57 mm; t = 2.364; P=0.0202) under cycloplegia. As for the changes in refractive factors before and after cycloplegia, deepened ACD and enlarged PD were noted in both the groups after cycloplegia.

Conclusions: Cycloplegia not only affects ACD and PD but also leads to the reversal of PD differences between the two groups. Cycloplegia effects enabled us to study changes in all known ocular parameters in a short period.

背景: 目的研究环形角膜塑形术对近视和远视儿童眼部参数的影响:方法:纳入 42 名 5 至 10 岁儿童的近视眼和 44 名远视眼。在使用 1%硫酸阿托品软膏进行环形角膜屈光手术前后进行测量。眼部参数包括角膜中央厚度(CCT)、角膜曲率(CC)、前房深度(ACD)、瞳孔直径(PD)、轴长(AL)和视网膜中央厚度(CRT):两组患者的 CCT、CC 和 CRT 在无环麻痹的情况下无明显差异,但近视组的 ACD(3.64 ± 0.28 mm)明显高于远视组(3.40 ± 0.24 mm; t = -4.522; P < 0.0001)。近视组的平均 PD(4.85 ± 0.87 mm)明显小于远视组(5.47 ± 1.15 mm;t = 2.903;P < 0.0046)。近视组的平均 AL 值(24.25 ± 0.77 mm)明显高于远视组(21.73 ± 1.24 mm;t = 12.084;P < 0.0001)。然而,在环形角膜塑形镜下,近视的平均屈光度(7.68 ± 0.51 mm)明显大于远视(7.41 ± 0.57 mm;t = 2.364;P=0.0202)。至于环形角膜塑形术前后屈光因素的变化,两组患者在接受环形角膜塑形术后ACD加深,PD增大:结论:角膜塑形镜不仅会影响 ACD 和 PD,还会导致两组之间 PD 差异的逆转。角膜塑形镜的作用使我们能够在短时间内研究所有已知眼部参数的变化。
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引用次数: 0
Comparative analysis of the impact of selected anesthesia methods on the cognitive function of patients undergoing ophthalmic surgery 不同麻醉方式对眼科手术患者认知功能影响的比较分析
4区 医学 Q2 Medicine Pub Date : 2023-04-25 DOI: 10.31288/oftalmolzh202322125
Олена Алексєєва, Г. С. Дорофєєва, В. П. Алексєєв, І. А. Драпак
Background: Anesthesiologists should not only save patient’s life as a process, but also enable the patient to recover his/her social life after surgery, given increased longevity, high social activity throughout life, and increased use of technical equipment in everyday life. Purpose: To assess central nervous system (CNS) changes in patients undergoing penetrating keratoplasty in order to optimize the choice of anesthesia technique, while taking into account the impact of general anesthesia on postoperative cognitive functions. Material and Methods: We employed neuropsychological tests such as Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Luria’s test to examine the cognitive function of patients before surgery and 6 hours, 24 hours, 7 days and 21 days after surgery. Results: On the basis of comparative analysis of the impact of selected anesthesia methods on cognitive function of patients undergoing surgery (penetrating keratoplasty), we concluded that a combination of regional anesthesia (pterygopalatine fossa blockade), dexmedetomidine infusion (0.3 µg/kg) and general analgesia (maintenance in an oxygen/sevoflurane mixture) with exclusion of Sibazon 0.5% had the shortest and the least profound impact on the cognitive function. Conclusion: On the basis of comparative analysis of the impact of selected anesthesia methods on cognitive function of patients undergoing penetrating keratoplasty, we concluded that a combination of regional anesthesia (pterygopalatine fossa blockade), dexmedetomidine infusion (0.3 µg/kg) and general analgesia (maintenance in an oxygen/sevoflurane mixture) with removal of Sibazon 0.5% from premedication and presence of a reduced amount of fentanyl used during anesthesia had the shortest (with a mean duration of a day) and the least profound impact on cognitive state in patients undergoing ophthalmic surgery.
背景:麻醉师不仅要将患者的生命作为一个过程来挽救,而且要使患者在术后恢复他/她的社交生活,因为患者寿命延长,一生中社交活动频繁,日常生活中技术设备的使用增加。目的:评估穿透性角膜移植术患者中枢神经系统(CNS)的变化,以优化麻醉技术的选择,同时考虑全身麻醉对术后认知功能的影响。材料与方法:采用简易精神状态检查(MMSE)、额叶评估测试(FAB)、Luria试验等神经心理测试,分别于术前、术后6小时、24小时、7天、21天检测患者的认知功能。结果:在比较分析不同麻醉方式对穿透性角膜移植术患者认知功能影响的基础上,我们得出区域麻醉(翼状腭窝阻滞)、右美托咪定输注(0.3µg/kg)和全身镇痛(维持在氧/七氟醚混合物中)联合排除0.5%西巴松对认知功能的影响最短,影响最不深远。结论:在比较分析不同麻醉方式对穿透性角膜移植术患者认知功能影响的基础上,我们得出区域麻醉(翼腭窝阻滞)、右美托咪定输注(0.3µg/kg)和全身镇痛(维持在氧/七氟醚混合物中),在用药前去除0.5%的西巴松,麻醉期间减少芬太尼的用量,对接受眼科手术的患者的认知状态的影响最短(平均持续时间为一天),影响最小。
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引用次数: 0
期刊
Journal of Ophthalmology
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