Journal of Ophthalmology最新文献

Background: The myopia rate has increased rapidly worldwide, yet evidence regarding the association between dietary factors and myopia remains limited. This study assessed the association between dietary patterns and myopia among children and adolescents.

Methods: This study used the Child and Adolescent Research of Eye data between August and October 2022. Myopia was defined based on uncorrected visual acuity and noncycloplegic refraction. Dietary assessment was parent-reported via a food frequency questionnaire (FFQ). Principal component analysis was used to extract dietary patterns. Binary logistic regression was used to evaluate the association between dietary patterns and myopia.

Results: A total of 24,797 participants were included in the analysis. Controlling for confounders, the highest adherence to nuts-tubers vegetables pattern (characterized by high intake of nuts, tubers vegetables, legumes, whole grains, and aquatic products) was associated with a decreased risk of myopia compared with the lowest adherence (odds ratio [OR] = 0.933, 95% confidence interval [CI]: 0.872 to 0.999, p = 0.046). Conversely, the highest adherence to snacks pattern (characterized by high intake of fried and barbecued, fast foods and savoury snacks, sugar-sweetened beverages, desserts, and processed meats) was associated with an increased risk of myopia (OR = 1.083, 95% CI: 1.012 to 1.158, p = 0.021).

Conclusions: These findings indicate a link between dietary patterns and myopia in children and adolescents. Dietary modification could be a potential public health measure for the primary prevention of childhood myopia.

Purpose: The rapid spread of unreliable misinformation on vision-threatening diseases can significantly affect the eye health behaviors and outcomes of the patients consuming short-form social media content. This study evaluates short-form videos pertaining to vision-threatening diseases to quantify video quality, content, and popularity.

Methods: This cross-sectional study analyzed short-form videos on cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration from TikTok, Instagram Reels, and YouTube Shorts. A hashtag search identified the first fifty videos on each disease from each social media platform. Two reviewers evaluated them, resolving discrepancies with a third. Outcome measures included number of views, likes, comments, uploader source, content type, modified DISCERN score (0-5 scale), and global quality scale (GQS) score (1-5 scale). Engagement outcomes were summarized descriptively using medians and interquartile ranges, while reliability and quality outcomes were analyzed using one-way ANOVA with Tukey post hoc comparisons.

Results: TikTok videos demonstrated higher median engagement (views, likes, and comments) compared to Instagram Reels and YouTube Shorts. Videos on cataracts had higher engagement statistics compared to the other vision-threatening diseases across all platforms. Physicians were the most common video source (45%). The most common content categories were treatments/management (36%) and general symptoms (22%). YouTube Shorts had a significantly greater average DISCERN (2.93 ± 0.70) and GQS score (3.85 ± 1.26) than Instagram Reels and TikTok (p < 0.001). Videos from patients had the lowest mean DISCERN and GQS scores.

Conclusions: TikTok had the greatest median engagement levels, while YouTube Shorts had the greatest mean quality and reliability. Videos from patients and philanthropists had lower quality scores, while healthcare professionals and organizations had the highest. Future efforts should understand the patients' perspectives, address misinformation, and improve quality across all social media platforms.

Purpose: To evaluate transscleral prolene mesh in aphakic patients lacking capsular support by comparing this technique with the Yamane technique.

Methods: A comparative, prospective, randomized study was conducted on 40 eyes of 40 patients who were aphakic without capsular support. Aphakia is either posttraumatic or after complicated cataract surgery with partial or total loss of capsular support. Patients were randomly assigned to one of two groups based on the surgical intervention they received: Group A (Yamane technique) and Group B (transscleral prolene mesh technique). All patients were followed up for 3 months after surgery. Postoperative visual acuity, refraction, IOL centration, and complications were documented during the follow-up period.

Results: Patients in both groups were comparable for both ages, 55.78 (± 8.63) for Group A and 59.10 (± 9.95) for Group B, and gender. In Group A, 50% were males and 50% were females. In Group B, 60% were males and 40% were females. After excluding complicated cases, both groups were compared for preoperative and postoperative results (UCVA, BCVA, IOP, refractive errors, and IOL tilt). The two groups had no statistically significant differences (p value ≥ 0.05). Moreover, refractive errors (sphere and cylinder) showed a strong negative correlation to IOL tilt of more than 5° for both groups. Seven patients out of twenty were complicated in Group A. Three patients had IOL tilt > 5°, 2 had IOL decentration > 0.2 mm, and two had pseudophakic reverse pupillary block. Four patients out of twenty had complications in Group B. Two patients had IOL tilt > 5°, and the rest had IOL decentration > 0.2 mm.

Conclusion: The prolene mesh technique showed a considerable improvement in visual outcome compared to the Yamane technique and may even offer a safer option with fewer predictable complications. Trial Registration: ClinicalTrials.gov idendifier: NCT06363448.

Objectives: To investigate ocular parameters associated with axial length (AL) growth in children wearing orthokeratology lens during 2 years of follow-up.

Methods: This is a retrospective study. Medical records of 46 patients who underwent orthokeratology treatment for 2 years were reviewed. Baseline variables included age at initiation of orthokeratology wear, spherical equivalent (SE), central corneal thickness (CCT), and the flat and steep keratometry of corneal principal meridians. The changes in anterior chamber depth (ACD) and crystalline lens thickness (CLT) were also analyzed. The contributions of all variables to the AL elongation were assessed using univariate and multivariate regression analyses.

Result: CLT and AL significantly increased after 2 years of orthokeratology wear compared with baseline (both p < 0.01), whereas ACD did not significantly change compared with baseline (p = 0.301). Univariate analyses showed that a reduced rate of AL elongation was found in children who were older age (p = 0.02), had greater SE (p = 0.026), thicker CCT at baseline (p = 0.027), and more increase in CLT (p = 0.019) in 2 years. Furthermore, greater SE at baseline and more increase in CLT were associated with less elongation of AL during 2 years of follow-up in multivariable analyses (p = 0.044 and 0.034).

Conclusion: CLT was significantly increased in the first year and keep stable in the second year in children with orthokeratology wearing. Greater baseline SE and more increase in CLT were associated with less elongation in AL during orthokeratology wear.

Purpose: To reveal the significance of oxidative stress-related genes in the pathogenesis of thyroid eye disease (TED) and Graves' disease (GD) using a bioinformatics approach.

Methods: Utilizing datasets from the GEO database, we used the "limma" package to detect differentially expressed genes (DEGs). Oxidative stress-related DEGs related to TED and GD were identified through cross-referencing with the GeneCards database. We used a variety of methods, such as enrichment analyses, LASSO, RF techniques, PPI network analysis, and the CIBERSORT algorithm.

Results: We identified 22 oxidative stress-related DEGs related to TED and GD, primarily involved in miRNA transcription and regulation. Hub genes (DUSP1, EGR1, FOS, and JUNB) were linked to immune cells and were identified as potential diagnostic biomarkers. The developed nomogram model exhibited satisfactory calibration.

Conclusion: This computational study sheds light on the molecular pathways underlying TED and GD, proposing candidate biomarkers and therapeutic targets. However, these findings are preliminary and require further experimental validation (e.g., qPCR, western blot, and IHC) in patient tissues before their clinical utility can be assessed.

Background/aims: The aim of this study was to demonstrate a possible correlation between qualitative preoperative OCT morphological changes in epiretinal membrane (ERM) and best corrected visual acuity (BCVA).

Methods: A total of 201 patient eyes with idiopathic symptomatic ERM and cataracts were included in the retrospective study. Phacovitrectomy was performed between 2015 and 2019.

Results: ERM was classified into five OCT morphotypes. The first three corresponded to the ERM classification according to Govetto et al., Stages 1-3 without a tractional component, while the last two each had a tractional component in the sense of a lamellar macular hole and vitreomacular traction. A significant difference in preoperative BCVA was observed between all OCT morphotypes (p < 0.01). For OCT morphotypes without a tractional component, a negative correlation (p < 0.05) was observed between postoperative BCVA and lesions of the outer foveal layers (damaged retinal pigment epithelium, disrupted ellipsoid zone, and external limiting membrane). Nonedematous lesions of the inner foveal layers (detachment of the outer nuclear layer, depth of retinal layer distortion, breakage and distortion of retinal nerve fiber layers, and ERM separation) showed no correlation with either preoperative or postoperative BCVA in all OCT morphotypes (p > 0.05). Likewise, edematous changes in the inner foveal layers played no role in pre- and postoperative visual acuity prognosis (p > 0.05).

Conclusion: Preoperative OCT morphological changes in the inner foveal layers have no significance in postoperative visual acuity prognosis in ERM, in contrast to lesions of the outer central retinal layers.

Purpose: The conversion rate of ocular myasthenia gravis (OMG) to generalized myasthenia gravis (GMG) lacks definitive predictors.

Methods: This retrospective cohort study analyzed data collected at Siriraj Hospital between January 2007 and December 2019 to identify factors influencing OMG generalization and the time to conversion. The records of 200 OMG patients were reviewed and both acetylcholine receptor antibody (AChR Ab)-positive and AChR Ab-negative patients were included.

Results: Seventy-eight (39%) developed GMG, with a median conversion time of 16 months (IQR 7.88, 33.75) and a 2-year conversion rate of 25.5%. AChR Ab positivity (adjusted HR 2.88, 95% CI 1.79-4.63), thymic abnormalities (adjusted HR 2.30, 95% CI 1.41-3.74), smoking (adjusted HR 1.78, 95% CI (1.04, 3.03), and pyridostigmine dosages > 180 mg/day (adjusted HR 2.33, 95% CI 1.41-3.87) were significantly associated with shorter conversion time.

Conclusion: Thymic abnormalities and positive AChR Ab warrant routine assessment in all OMG patients. Smoking cessation is crucial, as it may impact conversion risk and time. Unlike previous findings suggesting a protective role of pyridostigmine, our data indicate a strong association between high-dose pyridostigmine and conversion to GMG, likely reflecting underlying disease severity. This underscores the need for individualized risk assessment in OMG management.

Objective: This study evaluated the effects of intravitreal injection of antivascular endothelial growth factor (VEGF) treatment on visual acuity and macular edema severity in patients with comorbid hypertension and diabetes macular edema in China.

Method: A longitudinal observational study, involving a total of 89 cases with macular edema who received anti-VEGF injection treatment, compared the changes in visual acuity and macular edema severity among four groups of patients at three different time points. Additionally, through regression analysis, it explored the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) in patients with hypertension and diabetes after receiving different numbers of anti-VEGF treatments, as well as the relationship between the number of injections and visual improvement and edema reduction.

Results: Significant improvements in BCVA and CMT were observed following anti-VEGF treatment, most notably after the first injection. The group without comorbidities demonstrated the greatest improvements, with BCVA improving from 0.20 to 0.40 logMAR and CMT decreasing from approximately 600 μm to 200 μm. In contrast, patients with hypertension and/or diabetes exhibited attenuated therapeutic responses. Multifactorial regression analysis confirmed that the presence of hypertension and/or diabetes served as an independent negative predictor for both BCVA improvement (β = 0.12, p = 0.002) and CMT reduction (β = -149.8, p < 0.001). Furthermore, poorer control of blood pressure and blood glucose levels was associated with diminished anatomical improvement.

Conclusion: In summary, patients with both hypertension and diabetes face greater challenges in terms of their overall health condition, the rate of vision decline, and the improvement of macular edema. It is recommended to initiate treatment for patients with comorbidities earlier, increase the number of injections, and combine other therapies to enhance the treatment effect.

Trial registration: Taizhou Municipal Hospital: LWYJ2025268.

Purpose: To compare the corneal spherical component (SC), regular astigmatism (RA), irregular astigmatism (IA, including asymmetry and irregularity), and visual quality 6 years after small incision lenticule extraction (SMILE) and laser subepithelial keratomileusis (LASEK) for mild-to-moderate myopia.

Methods: This retrospective, comparative study comprised the SMILE group (35 eyes) and LASEK group (36 eyes). Visual acuity, corneal topography utilizing swept-source anterior segment OCT, and wavefront aberrations were recorded preoperatively and 6 years postoperatively. Fourier analysis of keratometric-derived parameters of the anterior, posterior, and total cornea at 6 mm zone was evaluated.

Results: Six years postoperatively, the safety and efficacy indices were comparable between both groups. Fourier analysis revealed significant changes in SC decrease and asymmetry increase of the anterior and total cornea (p < 0.001), with LASEK exhibiting a more pronounced flattening effect of the anterior cornea (p = 0.001). Interestingly, RA of the anterior and total cornea decreased significantly after LASEK (p = 0.016,  0.002, respectively). Further linear correlation analysis showed that changes in SC (Δ SC) of anterior cornea and total cornea were correlated with the preoperative spherical power, mean refractive spherical equivalent (MRSE), lenticule thickness/ablation depth, ΔK1, and ΔK2 (all |r| > 0.85, p < 0.001). Compared with LASEK, SMILE induced less horizontal coma at 6 years postoperatively (p = 0.008).

Conclusions: Both SMILE and LASEK are safe and effective procedures for correction of mild-to-moderate myopia. LASEK demonstrates an advantage in flattening the anterior cornea and reducing regular astigmatism, while SMILE exhibits superior performance in inducing less horizontal coma Trial Registration: ClinicalTrials.gov identifier: NCT06673992.

Purpose: Several studies have suggested that blue-light filtering (BLF) can enhance the perception of brightness. Evidence for this effect, however, in pseudophakic patients, particularly using natural images, is lacking. The present study tested whether a common BLF spectral profile, often used in intraocular lens (IOL) designs, would influence brightness perception of natural images in pseudophakic individuals.

Methods: Forty pseudophakic participants (M = 71.15 ± 2.27 years) with 20/40 or better best-corrected visual acuity implanted with clear IOL implants completed a brightness matching task. Participants viewed a series of natural images through both a clear extraocular filter and a BLF test lens. The test lens was designed to approximate a typical BLF IOL transmission profile. Filter conditions were counterbalanced and randomized. Participants adjusted a short-wave deficient comparison field until the natural scene and the comparison fields were perceived as equally bright. Matched luminance values (log relative energy, LRE) were recorded across six trials per image. Images were achromatic or short-, mid-, and long-wave dominant.

Results: Averaged across all images, the clear lens ( $\overline{X}$  = 2.74 ± 0.14) resulted in significantly lower (t _[78] = -2.529, p = 0.007) LRE values compared to the BLF test lens ( $\overline{X}$  = 2.82 ± 0.15) indicating a modest (∼17%) increase in perceived brightness with the BLF lens. This effect was observed for four of five natural images tested and was not dependent on image contrast or chromatic content.

Conclusions: The BLF produced a significant and consistent increase in perceived brightness in pseudophakic adults. These findings provide direct psychophysical evidence that clinically relevant BLF profiles can influence brightness under natural viewing conditions. Information of this type is necessary for the evaluation of BLF IOL designs and their effects on functional visual experiences following cataract surgery.