Journal of Ophthalmology最新文献

Introduction: We aimed to investigate the incidence and prognosis of retinal injury in patients with lens dislocation caused by blunt eye trauma. Methods: We retrospectively analyzed 53 patients who underwent lensectomy and vitrectomy for contusive lens dislocation and had no preoperative retinal injuries. Patients were categorized according to the presence of retinal injury discovered intraoperatively. The clinical features of 53 eyes were assessed during a 3-month postoperative follow-up. Results: Retinal injuries were observed intraoperatively in 28 patients (52.8%), predominantly in peripheral regions, with a single retinal tear being the most common type. Total lens dislocation was more frequent than subluxation in the group with retinal injuries. The intraocular pressure (IOP) at the 3-month follow-up was significantly lower than the initial IOP in both groups, with no significant differences between them. The corrected distance visual acuity (CDVA) significantly improved in both groups without significant differences. Conclusion: Half of the patients without preoperative retinal injuries were found to have injuries during surgery. Total lens dislocation carried a greater risk of retinal injuries than subluxation. The improvement in CDVA after prompt retinal injury treatment did not significantly differ from that in patients without retinal injury, highlighting the importance of prompt intervention.

Purpose: To find whether the CHA₂DS₂-VASc score, a system for stratifying stroke risk among patients with atrial fibrillation, correlates with visual acuity prognosis following retinal vein occlusion (RVO). Participants and Methods: This retrospective study included 83 eyes of 83 patients with a diagnosis of branch or central RVO between June 2017 and August 2022 with at least 12 months of follow-up in Assuta Ashdod Medical Center, Ashdod, Israel. The patients were divided into three groups, with CHA₂DS₂-VASc scores of 0-2 (N = 31), 3-5 (N = 45), or 6-9 (N = 7). The change in best-corrected visual acuity (BCVA) between the groups was examined about 1 year after the presentation of RVO. Results: The patient mean age was 67.9 ± 13.8 years; 38.6% were women. The mean visual acuity was 0.83 ± 0.67 LogMAR units at the first admission and 0.78 ± 0.80 LogMAR units at the last visit. Patients with a CHA₂DS₂-VASc score from 6 to 9 had a significantly poorer BCVA prognosis at 1-year (+0.60 ± 0.94 [-0.27, 1.47] LogMAR units) compared to groups with a CHA₂DS₂-VASc score from 3 to 5 (-0.01 ± 0.65 [-0.20, 0.19] LogMAR units) and a CHA₂DS₂-VASc score from 0 to 2 (-0.12 ± 0.59 [-0.33, 0.10] LogMAR units) (p = 0.038). Conclusions: Following RVO, patients with a CHA₂DS₂-VASc score of 6 or higher had a worse prognosis in their visual acuity than patients with a lower score.

Background: To determine if cross-linking (CXL) treatment modifies any pre-existing association between corneal optical density (COD) and age in keratoconus free of corneal scarring. Methods: COD was monitored in two groups (i) before and after standard CXL treatment for keratoconus (de-epithelization with a crescent blade, n = 69 eyes) and (ii) age/gender-matched cases without any signs of keratoconus (n = 24 eyes). Seven different markers of COD were quantified using a 0-100 grey scale, supplied with Pentacam™ software. Results: Mean age (±sd, range) in Group I (19 females and 50 males) was 24.2 years (±7.2, 11-44) and in Group II (9 females and 15 males), it was 24.7 years (±7.6, 17-45). COD over the apex and along the depth of the cornea (y, arbitrary scale units) was associated with age (x, in years) in Group I at preop (y = 0.08x + 13.12, r _s  = 0.350 and p=0.003), at 12 months postop (y = 0.08x + 15.15, r _s  = 0.295 and p=0.014) and in Group II, at the start (y = 0.16x + 11.28, r _s  = 0.474 and p=0.019) and 12 months later (y = 0.24x + 8.63, r _s  = 0.600 and p=0.002). The change in COD following CXL was significantly associated with the preop value. Conclusion: CXL initially breaks down the pre-existing relationship between COD and age. This is re-established by 12 months postop. The CXL induced change in COD depends on the preop value but not on the patient's age.

Purpose: To compare the standard outcomes between the PanOptix and Symfony multifocal intraocular lenses (MIOLs) in Chinese patients. Methods: This prospective observational cohort study enrolled patients with cataracts between April 2021 and December 2021 at Xiamen Eye Center Affiliated to Xiamen University. The patients were grouped in the PanOptix (TIOL group) and Symfony (EDF group) according to the IOLs implanted. Uncorrected distant, corrected distance, binocular uncorrected intermediate, and near visual acuity (UNVA), distance-corrected intermediate and near VA (DCNVA) , defocus curve, spectacle independence, contrast sensitivity (CS), and visual disturbances were evaluated after 3 months. Results: Forty patients (80 eyes) were enrolled in the study (20/group). Three months after the operation, UNVA (0.13 ± 0.16) and DCNVA (0.08 ± 0.08) were better in the TIOL group than in the EDF group (0.22 ± 0.08 and 0.22 ± 0.08, respectively, p=0.003 and p < 0.001, respectively). The TIOL group achieved a better-than-0.15-logMAR VA from +0.5 D to -2.5 D (40 cm). VAs of the TIOL group from -1 D (100 cm) to -4 D (25 cm) were better than in the EDF group (p < 0.05). There were no significant differences in the intermediate and far vision outcomes (p > 0.05). Total near-vision spectacle independence was higher in the TIOL group (80%) than in the EDF group (50%) (p=0.039). Conclusion: Compared with EDF, TIOL leads to better near-vision outcomes without significant differences for intermediate and distant vision outcomes. Trial Registration: ClinicalTrials.gov identifier: ChiCTR2100044558.

Purpose: To study the safety and effectiveness of subthreshold micropulse (SML) 577 nm laser therapy with an individual power titration in treating patients with chronic central serous chorioretinopathy (CSC).

Methods: The study was a prospective, single-centre observation of 30 patients (30 eyes) with chronic CSC. All patients with chronic CSC were treated with a 577 nm micropulse laser. Individual power parameters for each patient were titrated in a micropulse mode. The primary outcome measure was best-corrected visual acuity (BCVA) at 6-month follow-up. The secondary outcome measures were as follows: central retinal thickness (CRT) and maximum subretinal fluid height (SRFH) according to optical coherence tomography, number of laser sessions, and treatment safety at 6-month follow-up.

Results: Before treatment, the mean BCVA was 0.35 ± 0.16, the mean CRT was 285 ± 76 µm, and the mean SRFH was 311 ± 85 µm. Six months after 577 nm SML therapy, there was a statistically significant increase in the mean BCVA with the maximum correction to 0.45 ± 0.15 (p = 0.001). The mean CRT and SRFH decreased significantly to 236 ± 45 μm (p = 0.003) and 45 ± 25 μm (p = 0.001), respectively. At the end of the follow-up, complete resorption of the subretinal fluid was noted in 50% (15 eyes), and in 43% (13 eyes), a decrease in the SRFH was observed. During the entire observation period, 25 patients underwent 1 session of 577 nm SML therapy, 2 patients underwent 2 sessions, and 3 patients underwent the intervention three times.

Conclusion: SML 577 nm therapy with individual selection of laser power in a micropulse mode is a safe and effective method of treating patients with chronic CSC. Further studies are needed to test the long-term safety and efficacy of 577 nm SML therapy with individual power settings in chronic CSC.

Purpose: We evaluated the optic disc microvasculature in healthy subjects and patients with optic nerve head drusen (ONHD), active papilledema, and acute nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCTA).

Methods: This prospective, comparative case series included sixteen eyes with ONHD, thirty-one eyes with active papilledema, sixteen eyes with acute NAION, and thirty-two healthy eyes. The Optovue AngioVue OCT and OCTA Imaging System recorded peripapillary retinal nerve fiber layer (RNFL) thickness and vessel density maps from the radial peripapillary capillary (RPC) slab.

Results: Average RNFL thicknesses were greater in eyes with ONHD, papilledema, and NAION compared to control eyes (all Ps < 0.001), but this parameter did not differ among patient groups. The mean peripapillary vessel density did not differ between the ONHD and control groups (P=1.000), nor between the NAION and papilledema groups (P=0.216). However, this value in the ONHD and control groups was significantly higher than in the NAION and papilledema groups (all Ps < 0.05).

Conclusion: RPC density is influenced during the progression of conditions such as ONHD, papilledema, and NAION. Although a decrease in vessel density values has been observed in cases of true disc edema, further research is necessary to assess the potential of OCTA in differentiating between true and pseudo-optic disc edema.

Purpose: To compare biometric and optical coherence tomography parameters as well as refractive status in preterm children aged 4-8 years with or without retinopathy of prematurity (ROP), and evaluate their correlations with age and gender-matched full-term children.

Methods: Retrospective comparative cohort study of four groups of children. Children with a history of preterm birth, including ROP who received intravitreal bevacizumab (IVB) treatment, children with a history of ROP that regressed without treatment and those with no history of ROP were compared to age and gender-matched full-term children as a control group. Best corrected visual acuity (BCVA), spherical equivalent of refraction (SE), macular and choroidal thickness, as well as biometric parameters was measured.

Results: A total of 120 eyes of 120 children (30 children in each group) were included. There was no significant difference in BCVA, SE, and subjective cylinder between groups (p=0.05, p=0.3, p=0.6, respectively). Axial length was significantly shorter, and the cornea was steeper in both ROP groups than in other groups (p=0.001, p < 0.001, respectively). The central macular thickness was significantly thicker in the treated, regressed ROP and preterm groups than in full-term children (p < 0.001). The gestational age was negatively correlated with macular thickness in both treated and regressed ROP groups (r = -0.517; p=0.003, r = - 0.490; p=0.006, respectively).

Conclusions: Children with a history of ROP had a shorter axial length, steeper cornea, and thicker macula that correlated with lower gestational age.

Pseudoxanthoma elasticum (PXE) is a rare metabolic disease with autosomal recessive inheritance. The manifestation in PXE is represented by retinal complications, pseudoxanthomas of the skin folding areas, and arterial calcification. The retinal complications are caused by the calcification of Bruch's membrane beneath retinal pigment epithelial cells (RPE) that can lead to retinal macular degeneration. The exact mechanism for the retinal pathophysiology is not known, and patients have variable symptoms and findings. Two induced pluripotent stem cell (hiPSC) lines from a patient carrying the common homozygous mutation c.3421C > T, p.Arg1141X in the ATP-binding cassette transporter gene (ABCC6; OMIM264800) were established and fully characterized. Then, RPE cells were differentiated, and molecular and functional characterization was conducted as a comparison to healthy controls. Data demonstrated that PXE-specific high-quality hiPSC lines can be established from a skin biopsy regardless of the skin-related disease phenotype and disease-specific RPE differentiation is feasible. The molecular and functional assessment of the PXE-specific RPE indicated increased pigmentation and reduced epithelial barrier functions as well as phagocytosis activity as compared to healthy controls. Although preliminary data, this indicates possible RPE-dependent factors that might explain the individual vulnerability of the retinas for macular degeneration in PXE. Future validation of the novel findings with additional PXE patients will be important.

Objective: This study aimed to investigate the risk factors associated with central serous chorioretinopathy (CSC) and analyze the relationship between vascular endothelial growth factor (VEGF), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and CSC.

Methods: A total of 109 patients diagnosed with CSC (CSC group) at our ophthalmology clinic from February 2017 to February 2021 were included, with 103 volunteers from our hospital's health examination center serving as the control group. Additionally, the new multimodal imaging classification of 109 CSC patients was further divided into simple CSC (57 cases) and complex CSC (52 cases). Demographic data, underlying diseases, medical history, and medication history were collected. Levels of VEGF, hs-CRP, and ESR were measured, and multifactorial logistic regression analysis was performed to identify factors influencing CSC. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic value of VEGF, hs-CRP, and ESR in CSC.

Results: The CSC group showed a higher proportion of males, smoking history, alcohol consumption, comorbid obstructive sleep apnea, hypothyroidism, renal disease, Helicobacter pylori infection, steroid use, and shift work compared to the control group (P < 0.05). VEGF, hs-CRP, and ESR levels were significantly higher in the CSC group than in the control group (P < 0.05). The levels of VEGF, hs-CRP, and ESR in the complex CSC group were higher than those in the simple CSC group (P < 0.05). Male gender, shift work, Helicobacter pylori infection, hypothyroidism, elevated VEGF, hs-CRP, and ESR were identified as risk factors for CSC (P < 0.05). The combined diagnostic value of VEGF, hs-CRP, and ESR (area under the ROC curve: 0.886) was higher than that of individual markers (0.722, 0.728, and 0.703, respectively) (P < 0.05).

Conclusion: Male gender, shift work, Helicobacter pylori infection, hypothyroidism, and elevated levels of VEGF, hs-CRP, and ESR are risk factors for CSC. The combined use of VEGF, hs-CRP, and ESR demonstrates higher diagnostic efficiency in identifying CSC.