Oman Journal of Ophthalmology最新文献

Context: Ensuring functional corneal endothelium is imperative for achieving optimal surgical outcomes following successful vitreoretinal surgery. Despite the critical role of the corneal endothelium in postoperative recovery, limited research has addressed endothelial cell damage specifically attributed to vitreoretinal procedures. This knowledge gap necessitates further investigations to better understand the potential loss of corneal endothelial cells (CECs) associated with vitreoretinal surgery.

Aims: To evaluate the effect of vitreoretinal surgery on CECs by using different endotamponading agents.

Settings and design: Prospective, nonrandomized, comparative, and observational study.

Subjects and methods: Patients (n = 32) were divided into three groups: C3F8 gas (Group A), silicone oil (Group B), and Ringer Lactate (Group C). Corneal endothelial parameters including, the corneal endothelial cell density (ECD), average cell area (AVG), coefficient of variation (CV), central corneal thickness (CCT), and percentage of hexagonal cells (HEX) were assessed preoperatively, at 1 month, and 3 month postsurgery.

Statistical analysis used: SPSS software version 16.0, Kolmogorov-Smirnov, Wilcoxon, and Chi-square tests were used. Statistical significance was set at P < 0.05.

Results: Significant differences in the changes in ECD and CCT were observed between the groups (P > 0.05). However, AVG, CV and HEX were not significantly different between the groups. No significant differences in the changes in endothelial cell parameters were noted between phakic and pseudophakic eyes.

Conclusions: CEC damage following vitrectomy with different endotamponades is a crucial consideration in vitreoretinal surgery. Vitreoretinal surgeons must carefully weigh the benefits and risks associated with different tamponade agents to safeguard corneal health in vitreoretinal surgeries.

Central serous chorioretinopathy (CSCR) occurs due to hyper-permeable choroidal capillaries, which, along with retinal pigment epithelium (RPE) dysfunction, causes a serous neurosensory retinal detachment. Circumscribed choroidal hemangiomas are also characterized by serous neurosensory detachment of the macula and cause degenerative changes to the RPE, rarely mimicking CSCR. Here, we present a case of CSCR in a middle-aged patient mimicking as a choroidal mass lesion who presented as a solitary choroidal elevation with subretinal fluid and posterior choroidal loculation of fluid and showed complete resolution of fluid after fundus fluorescence angiography-guided focal laser.

Purpose: This study aims to explore the effect of Ginkgo biloba extracts (GbE) on the prevention of posterior capsule opacification (PCO).

Study design: This study was a double-blinded, placebo-controlled, single-center randomized clinical trial.

Methods: Patients with senile cataracts randomly received GbE supplement capsules at a dose of 200 mg (n = 74) or an identical placebo (n = 70) daily for 6 months after cataract surgery. Patients' follow-ups were scheduled for up to 3 years after cataract surgery. PCO formation (Pearl/Fibrotic) was graded using slit-lamp examinations. The necessity of a Neodymium-doped yttrium aluminum garnet (Nd: YAG) laser capsulotomy was evaluated by patients' complaints of reduced visual acuity imputable to PCO.

Results: A total of 144 patients with a mean age of 64.92 ± 7.77 years were studied. The mean Log MAR visual acuity in the placebo group started to decrease at 12 months (P = 0.003) and remained significantly lower than the GbE group throughout 36 months (P = 0.005). At 1-year postsurgery, a significant difference between the two groups of GbE and Placebo was observed regarding pearl PCO score, but obvious fibrotic PCO score differences occurred 3 years after surgery. The Nd: YAG capsulotomy was performed in six eyes (6.1%) for the GbE group and 18 eyes (20.4%) for the placebo group (P = 0.004) 3 years after the cataract surgery.

Conclusion: Six months of supplementation with GbE was well tolerated and may provide some marginal prevention in the PCO formation. Besides the effect of the GbE in the inhibition of PCO, we also observed a noticeable reduction in the need for Nd: YAG laser capsulotomy.

Background: The study aimed to report the outcomes of patients treated with cenegermin 0.002% for neurotrophic keratopathy (NK) following penetrating keratoplasty (PK).

Materials and methods: This retrospective case series included patients evaluated at a tertiary care hospital who completed an 8-week course of cenegermin for NK within 12 months following PK. The primary outcome measure was NK stage, while secondary outcomes included complete epithelial healing, epithelial defect size, and best-corrected visual acuity (BCVA) at baseline and four time points during and following treatment. We also evaluated disease progression.

Results: Fourteen eyes of 14 patients were included and demonstrated significant improvement in NK stage at 4 weeks (1.1 ± 0.7; P = 0.006) and 8 weeks after treatment initiation (0.9 ± 0.7; P = 0.002) and 1 month (0.6 ± 0.5; P < 0.001) and 6 months after treatment completion (0.8 ± 0.9; P = 0.002) compared to baseline (1.6 ± 0.5). Complete epithelial healing was noted 1 month (42.9%; P = 0.016) and 6 months after treatment completion (38.5%; P = 0.016). Epithelial defect size improved to <5 mm² at all points (P < 0.05) during and after treatment compared to baseline (37.24 mm²). Improvement in BCVA was not significant at any time point. Two (14.3%) patients experienced disease progression up to 6 months of follow-up.

Conclusions: Following an 8-week course of cenegermin, patients with a history of PK demonstrated improvement in NK stage, epithelial healing, and reduced epithelial defect size lasting 6 months after treatment completion. Patients with prior PK and NK may be considered candidates for cenegermin treatment.

The relationships between visual acuity, contrast sensitivity, stereo acuity, and cognition varied, implying that domain-specific cognitive loss patterns exist. This review aims to learn how visual aids help patients with visual impairment and cognitive decline. The electronic searches had no language restrictions or research design filters. However, from 2016 forward, searches were restricted, and the electronic databases were last examined in 2022. There were 537 papers discovered in PubMed and 18,000 articles found in Google Scholar, of which ten articles fit the criteria. Patients who participated in the trials had an average age of 81-82 years. Patients with self-reported vision difficulties had a higher incidence of dementia. The majority were female populations. Auditory and visual loss was detected in 5.5% of dementia cases versus 4.9% of nondementia subjects. Early-stage cognitive impairment raises the chance of dementia later in the disease. Along with motor dysfunction, impairments in visual memory, verbal fluency, and executive functions, as well as increased depressive symptoms, predicted worse Parkinsonian disability, highlighting the critical role of nonmotor factors such as cognitive and visual dysfunction, as well as depression, in disability, even in the early stages of Parkinsonian disability.

Background: Determination of the normal range of corneal epithelial thickness (CET) profiles in different populations is important. Accordingly, the present study aimed to investigate the CET in normal eyes in Guilan province of Iran.

Materials and methods: In this cross-sectional study, a total of 169 patients (18-60 years old) who were referred to the ophthalmology clinics in Rasht for corneal refractive surgery were included. They underwent a complete ophthalmological examination, including visual acuity, intraocular pressure examination, and fundoscopy examination with a 90 D lens. Spectral-domain optical coherence tomography was used to examine CET; corneal epithelial mapping was done with Optovue I scan 500s.

Results: The mean CET at 5-6 mm and 2-5 mm zones was 52.88 ± 2.8 and 53.24 ± 2.9, in the 2 mm of the center was 53.67 ± 3.24, in the superior and inferior 5-6 mm zone was 50.8 ± 3.18 and 54.38 ± 3.53, and in superior and inferior 2-5 mm zone was 52.14 ± 2.98 and 54.41 ± 3.60, respectively; there was a significant difference between 5-6 and 2-5 mm of the superior zone. The supratemporal region had the thinnest epithelium, and the inferior region had the thickest. The central CET was statistically different between males and females, and the relationship between paracentral and peripheral thickness (2-5 and 5-6 mm) with age, especially in ages 33-46 and 47-60, was stronger.

Conclusion: The values of the CET map, defined in the present study, in a sample of Guilan population with normal eyes, can be further used as a reference (normal) range for this population.

The aim is to report corneal melting following intrastromal injection of antivascular endothelial growth factor (anti-VEGF), bevacizumab, for pre-existing corneal neovascularization. A 68-year-old male with a history of failed bilateral penetrating keratoplasties due to scarring from childhood measles and trachoma underwent right eye superficial keratectomy, intrastromal bevacizumab, and amniotic membrane transplant to control the neovascularization in an overseas center. A week later developed corneal melting. In conclusion, anti-VEGF can be used in controlling corneal neovascularization, albeit, is associated with risks such as delayed epithelial healing and corneal melting, particularly in those with limbal stem cell deficiency.