Journal of Ophthalmology最新文献

Purpose: In clinical practice, some eyes preoperatively diagnosed with "idiopathic epiretinal membranes (iERM)" will be amended to "secondary epiretinal membranes (sERM)" once peripheral retinal hole is detected. This study utilized optical coherence tomography (OCT) images to compare the characteristics between the iERM and sERM due to peripheral retinal hole (PRH). Methods: In this retrospective, cross-sectional study, 635 eyes that had undergone pars plana vitrectomy with membrane peeling were enrolled. A total of 115 eyes (18.1%) detected with peripheral retinal holes were allocated to the sERM-PRH group while the other 520 eyes were to the iERM group. The demographic data and OCT characteristics were compared between the two groups. Besides, all the eyes were evaluated by a double-grading scheme: severity grading of ERM progression into four stages plus anatomical classification into three kinds of part-thickness macular holes associated with ERMs. Results: No significant difference was found in age, gender, symptom duration, axial length, or best-corrected visual acuity between the two groups. There was also no difference concerning the features based on OCT, ranging from central macular thickness, the ratios of the photoreceptor inner/outer segment junction line defect, intraretinal fluid, cotton ball sign, to epiretinal proliferation. However, the native difference in parafoveal thickness between the temporal and nasal quadrants was observed in the iERM group, yet disappeared in the sERM-PRH group. Moreover, eyes between the two groups were distributionally similar in both grading scales. Conclusion: Our results demonstrated that even OCT images could hardly provide effective clues for early differentiating sERM from iERM, which highlighted the necessity of a thorough pre- and intro-operative fundus examination of the peripheral retina for clinicians.

Objective: A bibliometric analysis was performed in the domain of ranibizumab and age-related macular degeneration (AMD) to delineate current trends in international research dynamics and to provide a visual representation of research hotspots and challenges associated with ophthalmic drugs over the past 15 years. This study also evaluates the sustainability of ranibizumab therapy through reduced injection burden, cost-effectiveness compared to alternative treatments, and long-term outcomes that minimize healthcare resource utilization. Method: In this cross-sectional study, bibliometrics analyzed data retrieved and extracted from the Web of Science Core Collection (WOSCC) database to analyze the evolution and thematic trends in the delivery of studies from January 1, 2008, to September 2, 2023, for ranibizumab and AMD studies. A total of 2691 articles on the field were assessed for specific characteristics such as the year of publication, journal, author, institution, country/region, citation, and keywords. Co-authorship analysis, co-occurrence analysis, co-citation analysis, and network visualization were constructed using VOSviewer. Some important subtopics identified by bibliometric characterization were further discussed and reviewed. Results: From 2008 to 2023, the cumulative number of articles published globally increased from 1 to 2,691, with the highest number of articles published in 2020 (255 papers). RETINA THE JOURNAL OF RETINAL AND VITREOUS DISEASES published the most manuscripts (285 papers) and was cited (6496 citations), followed by OPHTHALMOLOGY (193 papers) and GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY (163 papers). OPHTHALMOLOGY was the most cited (20,865 citations), with the United States (786 papers, 38,014 citations), Univ Sydney (98 papers, 5245 citations), and Kim, Jong Woo (56 papers, 550 citations) being the most productive and influential institutions, countries, and authors, respectively. Five clusters were formed by summarizing the top 100 keywords, which marked the emerging frontier of ranibizumab and AMD-related research. Further discussion of the five clusters of research is to assist the researcher in determining the scope of the research topic and planning the direction of the research. Conclusion: Over the past two decades, there has been a notable increase in the number of publications and citations pertaining to ranibizumab and AMD across various countries, institutions, and authors. This study elucidates current trends, global collaboration patterns, foundational knowledge, research hotspots, and developmental trajectories within the realm of ranibizumab-related AMD research. Key advancements in AMD treatment with ranibizumab over the last 15 years have centered on less frequent injection schedules, extended drug efficacy, and enhanced safety profiles.

Diabetes mellitus is a known risk factor for corneal epithelial defects (CEDs) after pars plana vitrectomy (PPV), but it is unclear if diabetes severity or specific diabetic risk factors are associated with an increased risk of CED. The purpose of this retrospective cohort study was to identify factors associated with CED and healing time in association with diabetes severity in diabetic patients following PPV. The electronic health record database at University of Florida in Gainesville was queried to identify patients who underwent PPV for retinal detachment (RD) between April 2016 and April 2022. Patient charts were reviewed for clinical data including type of diabetes (if present), diabetes duration and severity, and associated diabetic comorbidities. The main outcome measures included presence of a CED within one month postoperatively, treatment of CED if present, and CED healing time. A total of 637 patients were analyzed, with a total of 243 eyes (26.5%) that belonged to diabetic patients. The diabetic patients were further separated into a proliferative diabetic retinopathy (PDR) group and a nonproliferative diabetic retinopathy (NPDR) group. Diabetes was associated with the development of an initial CED (p=0.040), consistent with existing literature. There was not a significant difference in CED risk when comparing NPDR and PDR patients, although PDR patients tended to have more severe long-term outcomes with persistent corneal epithelial defects (PCEDs). This suggests that PDR patients may still require closer monitoring and earlier intervention for postoperative CED following PPV, as compared to the NPDR patient population.

Background: To elucidate the epidemiologic and clinical characteristics of pediatric traumatic canalicular lacerations treated at a tertiary hospital and analyze the prognostic factors of influencing functional outcomes. Methods: This retrospective review included all pediatric patients who sustained a primary canalicular laceration at Hebei Eye Hospital between January 1, 2013, and December 31, 2022. Data on patient demographics, mode of injury, and surgical outcomes were collected through detailed chart review. The prognostic factors of affecting functional outcomes were assessed using Fisher's exact test for categorical variables. Results: The study included 89 pediatric patients (66 males and 23 females) with a mean age of 7.26 years. There were 65 patients with lower canalicular lacerations, 19 patients with upper lacerations, and 5 patients with concurrent lacerations. Right eye damage was observed in 51 patients and 38 with damage to the left eye. The most common cause of injury was scratches caused by sharp objects (52.8%), followed by electric bicycle accidents (18.0%), falls (18.0%), and dog bites (7.9%). Statistically significant prognostic factors for functional outcomes included the location of the laceration (p=0.009), mode of injury (p=0.045), and the time interval from injury to surgical repair (p=0.032). Conclusions: In this study, key prognostic factors for pediatric canalicular lacerations included laceration location, injury mechanism, and delay in surgical repair. Variables such as age, gender, affected side, stent type, and removal timing did not significantly impact outcomes. Increasing hazard awareness of the caregiver, enhancing public education, and implementing preventive measures to reduce injury incidence are crucial for prevention.

Purpose: To compare the parameters of the optic nerve head (ONH) and inner retinal layer thickness between children and adults with microdisks (MDs) and normal-sized disks (NSDs) using optical coherence tomography (OCT). Methods: A case-control study that included 172 eyes. Four groups of patients were created and matched according to gender and disk size: 41 children with MD (disk size between 1.42 and 1.60 mm²), 41 adults with MD, 45 children with NSD (disk size between 1.80 and 2.30 mm²), and 45 adults with NSD. All subjects were imaged with spectral domain OCT. Neuroretinal rim (NRR) area, cup-disk ratio (CDR), cup volume, peripapillary retinal nerve fiber layer (pRNFL) thickness, and macular ganglion cell-inner plexiform layer (mGCIPL) thickness were obtained. Results: There was a statistical difference in the NRR area (p < 0.001), average CDR (p < 0.001), cup volume (p < 0.001), and average pRNFL thickness (p < 0.001) between children and adults with NSD. However, comparing children and adults with MD, the only differences found were the NRR area and nasal pRNFL thickness (p = 0.009 and 0.010, respectively). Conclusions: In conclusion, the ONH parameters and pRNFL thickness are different in children and adults with NSD. On the contrary, MD belonging to children and adults did not have significant differences in ONH parameters and inner retinal layer thickness. According to these findings, the evaluation of a glaucomatous lesion in MD should rely on the ONH parameters and an increase in the cup volume must raise the suspicion of glaucomatous damage, because the physiological enlargement of the cup with age in a MD with age is not to be expected.

Background: Currently available binocular indirect ophthalmoscopes (BIOs) are large and expensive. We sought to create a compact, low-cost 3D-printed BIO. Methods: The BIO was made with off-the-shelf electronics and optical components, computer-aided design (CAD), and a consumer-grade 3D printer. Ocular light safety was tested with a spectrometer. Results: The component cost of the 3D-printed BIO was $182.26. The wireless, spectacle-style BIO weighed 120 g and was more compact than commercially available BIO's, with the advantage of a battery incorporated into the frame. The BIO met the International Organization for Standardization's standards for indirect ophthalmoscopes, as well as the American National Standards Institute's Group 1 light hazard protection standards for ophthalmic instruments. Conclusions: It is possible to produce a high-quality, low-cost BIO using CAD and 3D printing. Such a BIO may be useful in both resource-rich and resource-limited settings.

Many interventions aiming to improve medication adherence in primary open-angle glaucoma (POAG) have yielded equivocal findings. This equivocacy has been attributed to several factors, including limited incorporation of health behavior theory and patient preference into intervention design. In this study, we performed a literature review of interventions aiming to improve medication adherence in POAG to develop a taxonomy of behavior change techniques (BCTs). Eligible studies measured medication adherence using electronic monitors for a minimum of 3 months. For each study, we evaluated the effectiveness of the BCTs, their basis in health behavior theory, and their usefulness in day-to-day management of POAG by surveying a sample of patients and providers. Twelve studies were included. BCTs included knowledge shaping (education), prompts (reminders), behavioral rehearsal (eye drop instillation training), and pharmacological support (combination monotherapy vs. polytherapy). Knowledge shaping, prompts, health coaching, and motivational interviewing led to an improvement in medication adherence and were perceived as being most useful in day-to-day management of POAG. Taxonomies of BCTs can help researchers to improve the design and effectiveness of interventions for improving medication adherence in POAG.

Diabetic retinopathy (DR) is a common complication of diabetes and the main cause of vision loss in the middle-aged and elderly people. miRNAs play vital roles in the development of DR. This study aimed to explore the effects of miR-16-5p on high glucose (HG)-stimulated human retinal microvascular endothelial cells (HRECs) by modulating vascular endothelial growth factor A (VEGFA) and transforming growth factor beta receptor 1 (TGFBR1). HRECs were treated with 5 mM, 10 mM, 20 mM, and 30 mM of HG to induce the DR cell model. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of miR-16-5p and mRNAs of VEGFA and TGFBR1. Western blot was used to examine VEGFA and TGFBR1 protein levels. The 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide assay was conducted to test cell proliferation. Flow cytometry with Annexin V-FITC/PI double staining was carried out to assess cell apoptosis ratio. Dual-luciferase assay was used to identify the target relationship between miR-16-5p and VEGFA and TGFBR1. Results found that the expression of miR-16-5p in HG-treated HRECs was reduced, and VEGFA and TGFBR1 expressions were upregulated. Knockdown of miR-16-5p increased VEGFA and TGFBR1 mRNA and protein levels, promoted cell proliferation, and inhibited apoptosis in HG-treated HRECs. VEGFA and TGFBR1 inhibition reversed the effect of knocking down miR-16-5p on HRECs. Dual-luciferase reporter assay revealed that VEGFA and TGFBR1 were the target of miR-16-5p. Overall, knockdown of miR-16-5p enhances proliferation and inhibits apoptosis of HRECs by upregulating VEGFA and TGFBR1 expression.

Purpose: To evaluate a modified minimally invasive technique for trans-scleral repositioning of dislocated Akreos Adapt intraocular lenses (IOLs) without scleral flaps. Methods: This retrospective case series included 17 eyes with subluxated or dislocated IOLs that underwent repositioning using a suture-in-needle, closed-loop technique. The procedure involved passing an 8-0 polypropylene suture through the IOL's four fenestrated haptics using a bent 30-gauge needle. The exterior suture knot was buried into the sclera without creating scleral flaps or dissecting the conjunctiva. Data on pre- and postoperative intraocular pressure, best-corrected visual acuity, IOL position, corneal endothelial cell counts, and intra-/postoperative complications were collected and analyzed. The follow-up period lasted at least 6 months. Results: All 17 cases demonstrated stable and well-centered IOLs with improved visual acuity. No significant complications, including IOL tilt, decentration, vitreous hemorrhage, hypotony, iris capture, or suture erosion, were observed during the follow-up. Conclusion: The suture-in-needle, closed-loop technique for trans-scleral refixation of dislocated Akreos Adapt IOLs is minimally invasive, achieves excellent anatomical and functional outcomes, and reduces the risk of complications.

Purpose: To evaluate the role of adjuvant mitomycin-C (MMC) use in cases of recurrent rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR) managed by relaxing retinotomy and retinectomy (RR). Methods: A retrospective analysis of consecutive patients undergoing vitreoretinal surgery with RR for RD and PVR was conducted. Patients were divided into two groups: those receiving 20 μg/0.1 mL MMC via the MMC sandwich method (Group 1) and those who did not (Group 2).Demographics, surgical characteristics, visual outcomes, and complications that may related to MMC were analysed. Results: A total of 28 patients (14 eyes per group) were included in the study. Differences in baseline variables between groups were not significant (p > 0.05). The mean follow-up was 15.2 ± 12.2 months. In Group 1, mean preoperative best-corrected visual acuity (BCVA) improved from 2.72 ± 0.70 logMAR to 1.59 ± 0.61 logMAR postoperatively (p=0.001). In Group 2, mean preoperative BCVA increased from 2.06 ± 0.80 logMAR to 1.77 ± 0.94 logMAR (p=0.261). Re-surgery rates were significantly lower in Group 1 (21.4%) than in Group 2 (92.8%, p=0.001). Final retinal attachment was achieved in 100% of eyes in both groups. Postoperative mean intraocular pressure (IOP) was 16.29 ± 4.46 mmHg in Group 1 and 13.92 ± 1.44 mmHg in Group 2 (p=0.081). No MMC-related toxicity was observed clinically. Conclusions: MMC, applied via the sandwich technique, appears safe and is associated with high anatomical and functional success rates while reducing re-operations.