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Phospholipid Nanoemulsion-Based Ocular Lubricant for the Treatment of Dry Eye Subtypes: A Multicenter and Prospective Study. 用于治疗干眼症亚型的磷脂纳米乳液眼部润滑剂:一项多中心前瞻性研究。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-11-01 DOI: 10.1007/s40123-024-01058-y
Maria Cristina Nishiwaki-Dantas, Denise de Freitas, Denise Fornazari, Myrna Serapião Dos Santos, Tais Hitomi Wakamatsu, Caroline Nascimento Barquilha, Marília Trindade Ferrer, Helga Caputo Nunes Holzhausen, Monica Alves

Introduction: Dry eye disease (DED) is a multifactorial condition of the ocular surface (OS) characterized by loss of tear film homeostasis, ocular discomfort, and vision disturbances. Most available ocular lubricants target the aqueous deficiency of the tear, restoring only this layer, leaving the tear lipid stratum deficient, as occurs in most patients with evaporative DED. An innovative propylene glycol-hydroxypropyl guar enriched with a phospholipid nanoemulsion (PG-HPG-PH-N) is indicated to restore deficiencies in both the lipid and aqueous layers of the tear film, and its composition was designed to increase lubricant retention on the OS. The purpose of this study was to evaluate, through the Ocular Surface Disease Index (OSDI) and clinical assessment, the treatment of patients who had DED due to aqueous deficiency arising from mixed or evaporative DED subtypes with a PG-HPG-PH-N ocular lubricant at a reduced frequency of twice a day, in a prospective, multicenter, and single-arm study.

Methods: Patients were screened from days - 7 to 0, and from day 1 (baseline and first day of treatment) to day 28 of treatment with this lubricant. After visit 1 (screening visit, days - 7 to 0), designed as pre-treatment OS assessment, patients returned to their research center on days 14 and 28 of treatment for a complete assessment, including anamnesis, the OSDI, corrected visual acuity, tear breakup time (TFBUT), OS staining evaluation, tolerability index, and environmental exposure questionnaire.

Results: Seventy patients were enrolled in this study (60 women, 10 men), with a mean age of 45 (range 27-64) years. TFBUT results showed an improvement in tear film stability as vital dyes sodium fluorescein and lysamine green showed a decrease in corneal staining after 14 and 28 days of treatment. No significant adverse events were reported, demonstrating the good tolerability of the lubricant.

Conclusions: The PG-HPG-PH-N nanoemulsion can be considered to be a safe and effective ocular lubricant for treating DED due to aqueous deficiency, both mixed and evaporative subtypes.

Trial registration: Brazilian National Research Ethics Commission (ReBEC registration number 16055).

简介:干眼症(DED)是眼表(OS)的一种多因素疾病,其特点是泪膜失去平衡、眼部不适和视力障碍。现有的眼部润滑剂大多针对泪液中的水份不足,只能恢复泪液层,而泪液脂质层则缺乏,大多数蒸发性干眼症患者都会出现这种情况。一种富含磷脂纳米乳液的创新型丙二醇-羟丙基瓜尔胶(PG-HPG-PH-N)适用于恢复泪膜脂质层和水层的不足,其成分设计旨在增加操作系统上的润滑剂保持力。本研究的目的是通过眼表疾病指数(OSDI)和临床评估,评估在一项前瞻性、多中心、单臂研究中,PG-HPG-PH-N 眼部润滑剂对因混合型或蒸发型 DED 亚型引起的水液缺乏而导致的 DED 患者的治疗效果,治疗频率减少为每天两次:从第 7 天到第 0 天,以及使用该润滑剂治疗的第 1 天(基线和治疗的第一天)到第 28 天,对患者进行筛查。第1次检查(筛选检查,第7天至第0天)被设计为治疗前操作系统评估,之后,患者在治疗第14天和第28天返回研究中心进行全面评估,包括病史、OSDI、矫正视力、泪液破裂时间(TFBUT)、操作系统染色评估、耐受性指数和环境暴露问卷:本研究共招募了 70 名患者(60 名女性,10 名男性),平均年龄为 45 岁(27-64 岁不等)。TFBUT 的结果显示,治疗 14 天和 28 天后,重要染料荧光素钠和赖胺绿的角膜染色减少,泪膜稳定性得到改善。没有出现明显的不良反应,这表明润滑剂具有良好的耐受性:PG-HPG-PH-N纳米乳液可被视为一种安全有效的眼部润滑剂,可用于治疗混合型和蒸发型亚型水缺乏导致的DED:试验注册:巴西国家研究伦理委员会(ReBEC注册号16055)。
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引用次数: 0
The Macular Choroidal Thickness in Danish Children with Myopia After Two-Year Low-Dose Atropine and One-Year Wash-Out: A Placebo-Controlled, Randomized Clinical Trial. 丹麦儿童近视患者在服用两年低剂量阿托品和停药一年后的黄斑脉络膜厚度:安慰剂对照随机临床试验。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI: 10.1007/s40123-024-01051-5
Niklas C Hansen, Anders Hvid-Hansen, Toke Bek, Flemming Møller, Nina Jacobsen, Line Kessel

Introduction: Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6-12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial.

Methods: Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups (< 24 mm, 24-25 mm, or > 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect.

Results: Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P < 0.01) at baseline. There was no statistically significant change in any ChT sector after 3 years in the placebo group. Sub-foveal and nasal ChT in the 0.1% loading dose and 0.01% group were not significantly different from placebo after 2-year treatment. In the placebo group, a 1-mm increase in AL was significantly associated with a 47-µm thinner nasal ChT after 3 years (95% confidence interval (CI): - 55; - 38, adj-P < 0.001). A 10-µm thicker nasal choroid at baseline was associated with 0.13 mm (95% CI: 0.009; 0.017, adj-P < 0.001) less 3-year axial elongation.

Conclusions: The ChT in Danish children with myopia remained stable over the 3-year follow-up. A thinner choroid at myopia onset might predispose to increased axial elongation. Treatment with 0.01% atropine did not change the ChT. We speculate that low-dose atropine does not primarily reduce myopia progression via a choroidal mechanism.

Trial registration: ClinicalTrials.gov identifier, NCT03911271.

简介在一项由研究者发起的安慰剂对照双盲随机临床试验中,我们的目的是研究6-12岁丹麦近视儿童在接受2年低剂量阿托品治疗和1年停药期间黄斑脉络膜厚度(ChT)的变化:97名参与者随机接受了为期2年的0.01%治疗、为期6个月的0.1%负荷剂量治疗和为期18个月的0.01%治疗或安慰剂治疗,然后接受为期1年的停药治疗。主要结果是眼底和内外上、鼻、下和颞区的 ChT。次要结果是轴长(AL)。结果在基线、6、12、24 和 36 个月时进行测量。采用单因素方差分析检测 AL 分层组(25 mm)之间的基线 ChT 差异。为了确定ChT的纵向变化及其对AL的影响,将所有眼球纳入线性混合模型,并将单眼嵌套在研究ID中作为随机效应:结果:眼睛越长,所有脉络膜区的 ChT 都明显变薄(adj-P 结论:丹麦白内障患儿的 ChT 在所有脉络膜区都明显变薄(adj-P):丹麦近视儿童的脉络膜厚度在三年的随访中保持稳定。近视发生时脉络膜较薄可能会导致轴伸长增加。使用 0.01% 阿托品治疗并未改变 ChT。我们推测,低剂量阿托品主要不是通过脉络膜机制来减少近视的发展:试验注册:ClinicalTrials.gov 标识符,NCT03911271。
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引用次数: 0
Postoperative Pain Comparison Between Alcohol-Assisted and Transepithelial Photorefractive Keratectomy Using Nepafenac Treatment: A Novel Study. 使用奈帕芬胺治疗酒精辅助和经皮层光屈光性角膜切除术的术后疼痛比较:一项新颖的研究。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1007/s40123-024-01040-8
Nir Gomel, Nadav Shemesh, Nir Sorkin, Nadav Levinger, Shmuel Levinger, Ami Hirsch, Asaf Achiron, Eliya Levinger

Introduction: The study aimed to compare postoperative pain between alcohol-assisted and transepithelial photorefractive keratectomy in patients who received the novel analgesic preoperative nepafenac treatment 2 days preoperatively and 3 days postoperatively. Pain, stinging, tearing, light sensitivity, and stress levels were evaluated.

Methods: The study included a retrospective analysis of 55 patients divided into two groups: bilateral alcohol-assisted photorefractive keratectomy (aa-PRK) and transepithelial photorefractive keratectomy (transepithelial-PRK). Nepafenac was administered for pain control for all patients, with patients receiving four drops for 2 days before the surgery and 3 days postoperatively per clinical instructions. Patients completed questionnaires on the day of the surgery and for the first 5 days postoperatively. Statistical analysis was performed using XLSTAT (version 2023.1.2). t-Test was used to analyze and compare pain and symptom levels and Fisher's exact test for categorical data. p-Values less than 0.05 were considered statistically significant.

Results: The study examined 55 patients (49% female) with a mean age of 25.11 ± 6.81 years who had undergone bilateral surface refractive surgery to correct myopic errors. The mean baseline standard error (SE) was -3.16 ± 2.20 D. Among these patients, 27 patients underwent aa-PRK and 28 patients underwent transepithelial-PRK. Higher levels of pain were significant in the aa-PRK group (p = 0.003). However, there was no significant difference between the groups in the average levels of stinging, tearing, or light sensation. Additionally, stress levels decreased over time in both groups, with levels becoming almost equal after 5 days, and there was no significant difference in the average stress levels between the two groups.

Conclusions: The study found that patients who underwent the transepithelial-PRK procedure had significantly lower pain levels compared with those who underwent aa-PRK after being treated with nepafenac per protocol. However, there was no significant difference between the two groups in terms of stinging, tearing, light sensation, and stress levels.

简介该研究旨在比较酒精辅助和经皮层光性屈光性角膜切除术的术后疼痛情况,术前 2 天和术后 3 天,患者均接受了新型镇痛药奈帕芬酸的术前治疗。对疼痛、刺痛、流泪、光敏感和应激水平进行了评估:该研究对 55 例患者进行了回顾性分析,分为两组:双侧酒精辅助光屈光性角膜切除术(aa-PRK)和经皮层光屈光性角膜切除术(transsepithelial-PRK)。所有患者均使用奈帕芬胺(Nepafenac)控制疼痛,根据临床说明,患者在手术前 2 天和术后 3 天分别滴用 4 滴。患者在手术当天和术后前 5 天填写了调查问卷。使用 XLSTAT(版本 2023.1.2)进行统计分析。t 检验用于分析和比较疼痛和症状水平,费雪精确检验用于分析和比较分类数据:研究共调查了55名接受过双侧表面屈光手术矫正近视的患者(49%为女性),平均年龄为(25.11 ± 6.81)岁。在这些患者中,27 名患者接受了 aa-PRK 手术,28 名患者接受了经上皮-PRK 手术。aa-PRK 组患者的疼痛程度明显更高(p = 0.003)。不过,两组患者在刺痛、撕裂或轻微感觉的平均水平上没有明显差异。此外,随着时间的推移,两组患者的应激水平都有所下降,5 天后两组患者的应激水平基本持平,两组患者的平均应激水平没有明显差异:研究发现,与接受 aa-PRK 手术的患者相比,接受经上皮-PRK 手术的患者在按方案接受奈帕芬酸治疗后,疼痛程度明显降低。不过,两组患者在刺痛、撕裂、光感和压力水平方面没有明显差异。
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引用次数: 0
Parents' or Guardians' Knowledge, Attitudes and Practices in the Prevention and Management of Childhood Myopia. 家长或监护人在预防和管理儿童近视方面的知识、态度和做法。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-14 DOI: 10.1007/s40123-024-01045-3
Yifeng Qian, Peirong Lu

Introduction: The aim of this study was to assess the knowledge, attitude, and practices (KAP) of parents or guardians regarding the prevention and management of childhood myopia.

Methods: This cross-sectional study was conducted at the Department of Ophthalmology in the First Affiliated Hospital of Soochow University (Suzhou, China) between August 2023 and November 2023. Parents or guardians who willingly volunteered to take part in the study were surveyed using a self-designed questionnaire.

Results: A total of 571 participants returned valid questionnaires, among whom 288 respondents (50.44%) fell within the 31- to 40-year age group and 474 respondents (83.01%) were identified as myopic. The mean KAP scores for the knowledge, attitude and practices dimensions were 23.34 ± 3.05 (possible range: 0-26), 46.47 ± 4.02 (possible range: 12-60), and 40.52 ± 7.07 (possible range: 11-54), respectively. Structural equation modeling analysis indicated that education had a direct effect on knowledge (estimate = 0.41, P = 0.038), while knowledge directly influenced both attitude (estimate = 0.40, P < 0.001) and practices (estimate = 0.36, P < 0.001). Also, attitude was found to have a direct impact on practices (estimate = 0.45, P < 0.001).

Conclusions: Parents or guardians had adequate knowledge, a positive attitude, and proactive practices towards the prevention and management of childhood myopia, which might be affected by their educational level. This comprehensive understanding of parental perspectives highlights the potential for targeted interventions in clinical settings to further enhance pediatric eye care.

导言本研究旨在评估家长或监护人对预防和管理儿童近视的知识、态度和实践(KAP):这项横断面研究于 2023 年 8 月至 2023 年 11 月在苏州大学附属第一医院眼科进行。采用自行设计的问卷对自愿参与研究的家长或监护人进行了调查:共有 571 名参与者交回了有效问卷,其中 288 名受访者(50.44%)属于 31-40 岁年龄段,474 名受访者(83.01%)被确认为近视。知识、态度和实践三个维度的 KAP 平均得分分别为 23.34 ± 3.05(可能范围:0-26)、46.47 ± 4.02(可能范围:12-60)和 40.52 ± 7.07(可能范围:11-54)。结构方程模型分析表明,教育对知识有直接影响(估计值 = 0.41,P = 0.038),而知识直接影响态度(估计值 = 0.40,P 结论):家长或监护人对儿童近视的预防和管理有足够的知识、积极的态度和主动的做法,这可能会受到其教育水平的影响。对家长视角的全面了解凸显了在临床环境中采取有针对性干预措施的潜力,从而进一步加强儿童眼科护理。
{"title":"Parents' or Guardians' Knowledge, Attitudes and Practices in the Prevention and Management of Childhood Myopia.","authors":"Yifeng Qian, Peirong Lu","doi":"10.1007/s40123-024-01045-3","DOIUrl":"10.1007/s40123-024-01045-3","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the knowledge, attitude, and practices (KAP) of parents or guardians regarding the prevention and management of childhood myopia.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at the Department of Ophthalmology in the First Affiliated Hospital of Soochow University (Suzhou, China) between August 2023 and November 2023. Parents or guardians who willingly volunteered to take part in the study were surveyed using a self-designed questionnaire.</p><p><strong>Results: </strong>A total of 571 participants returned valid questionnaires, among whom 288 respondents (50.44%) fell within the 31- to 40-year age group and 474 respondents (83.01%) were identified as myopic. The mean KAP scores for the knowledge, attitude and practices dimensions were 23.34 ± 3.05 (possible range: 0-26), 46.47 ± 4.02 (possible range: 12-60), and 40.52 ± 7.07 (possible range: 11-54), respectively. Structural equation modeling analysis indicated that education had a direct effect on knowledge (estimate = 0.41, P = 0.038), while knowledge directly influenced both attitude (estimate = 0.40, P < 0.001) and practices (estimate = 0.36, P < 0.001). Also, attitude was found to have a direct impact on practices (estimate = 0.45, P < 0.001).</p><p><strong>Conclusions: </strong>Parents or guardians had adequate knowledge, a positive attitude, and proactive practices towards the prevention and management of childhood myopia, which might be affected by their educational level. This comprehensive understanding of parental perspectives highlights the potential for targeted interventions in clinical settings to further enhance pediatric eye care.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3095-3109"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Letter to the Editor Regarding "Efficacy of Multifocal Soft Contact Lenses in Reducing Myopia Progression Among Taiwanese Schoolchildren: A Randomized Paired-Eye Clinical Trial". 致编辑的信,内容涉及 "多焦点软性隐形眼镜在降低台湾学童近视度数加深方面的功效:随机配对眼临床试验 "的来信。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-21 DOI: 10.1007/s40123-024-01048-0
Andrew D Pucker, Stephanie Martich
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引用次数: 0
An Emerging Multi-mechanism and Multi-modal Approach in Interventional Glaucoma Therapy.
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-11-30 DOI: 10.1007/s40123-024-01073-z
J Morgan Micheletti, Mitchell Shultz, Inder Paul Singh, Thomas W Samuelson

The glaucoma treatment paradigm is in evolution. The topical medications-first approach is limited by significant barriers such as high rates of nonadherence and side effects including ocular surface disease. The era of interventional glaucoma has seen the development of selective laser trabeculoplasty (SLT), procedural pharmaceuticals, and minimally invasive glaucoma surgeries (MIGS). New and emerging data support the use of these interventional treatment modalities early in the course of glaucoma rather than reserving them for advanced or treatment-recalcitrant cases. The various treatments available represent multiple mechanisms (e.g., trabecular outflow, uveoscleral outflow, aqueous suppression) and modalities (medications, laser, incisional surgery) by which intraocular pressure (IOP) is reduced. Many patients require more than one treatment to achieve adequate IOP reduction and glaucoma control. Comprehensive IOP control-reduction of both mean IOP and IOP fluctuation-can best be achieved by targeting multiple mechanisms of IOP reduction and taking advantage of the attributes of multiple treatment modalities.

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引用次数: 0
Molecular Changes in Aqueous Humor Associated with Inflammation Following Cataract Surgery in Patients with Fuchs' Endothelial Corneal Dystrophy. 福氏内皮性角膜营养不良症患者白内障手术后与炎症相关的水液分子变化
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-11-24 DOI: 10.1007/s40123-024-01072-0
Lizaveta Chychko, Hyeck-Soo Son, Maximilian Friedrich, Ramin Khoramnia, Gerd U Auffarth, Victor A Augustin

Introduction: To evaluate the anterior chamber (AC) inflammation in the early postoperative period after cataract surgery and before Descemet membrane endothelial keratoplasty (DMEK) by quantifying oxidative stress and inflammatory mediators in aqueous humor of patients with Fuchs' endothelial corneal dystrophy (FECD).

Methods: In this prospective single-center study, 15 patients with FECD underwent cataract surgery and DMEK in a two-stage procedure. Aqueous humor was collected from the AC at the beginning of cataract surgery and 3 months later at the beginning of DMEK. In the control group, which consisted of 15 age-matched phakic patients without FECD, aqueous humor was only collected at the beginning of cataract surgery. Mediators of postoperative inflammation including TNF-α, VEGF, IL-2, IL-1 β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, GM-CSF, IFN-γ, CXCL5/ENA-78, FGF-basic, G-CSF, IL-1-α, IL-1-ra, IL-17, CCL2/MCP-1, CCL3/MIP-1a, CCL4/MIP-1b, TPO, TGF-β-1, TGF-β-2, and TGF-β-3 concentrations were measured using a Multiplex-Array-System.

Results: The concentration of TNF-α (p = 0.021), IL-6 (p = 0.005), IL-8 (p = 0.001), CXCL5/ENA78 (p = 0.002), CCL2/MCP-1 (p = 0.001) and CCL4/MIP-1b (p = 0.037) were significantly higher 3 months after cataract surgery at the beginning of DMEK compared to control group at beginning of cataract surgery. The levels of IL-2, IL-5, IL-8, IL-10, and IL-1-α were significantly higher in phakic eyes in the control group (p < 0.05) before cataract surgery.

Conclusions: The present study indicates significantly increased proinflammatory cytokines 3 months after cataract surgery in eyes with FECD. Our findings suggest postoperative inflammation in the AC up to 3 months after cataract surgery. Therefore, it may be reasonable to combine cataract surgery with DMEK in cataract patients with FECD.

引言目的:通过量化福氏内皮角膜营养不良症(FECD)患者房水中的氧化应激和炎症介质,评估白内障手术后早期和戴斯麦膜内皮角膜移植术(DMEK)前的前房炎症情况:在这项前瞻性单中心研究中,15 名 FECD 患者分两步接受了白内障手术和 DMEK。在白内障手术开始时和 3 个月后 DMEK 手术开始时,分别从白内障房水中收集房水。对照组由 15 名年龄匹配、无 FECD 的晶状体患者组成,仅在白内障手术开始时收集房水。术后炎症介质包括 TNF-α、VEGF、IL-2、IL-1 β、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12、GM-CSF、IFN-γ、CXCL5/ENA-78、FGF-basic、G-CSF、使用多重阵列系统检测了 IL-1-α、IL-1-ra、IL-17、CCL2/MCP-1、CCL3/MIP-1a、CCL4/MIP-1b、TPO、TGF-β-1、TGF-β-2 和 TGF-β-3 的浓度。结果显示与白内障手术开始时的对照组相比,白内障手术开始 3 个月后 DMEK 组的 TNF-α (p = 0.021)、IL-6 (p = 0.005)、IL-8 (p = 0.001)、CXCL5/ENA78 (p = 0.002)、CCL2/MCP-1 (p = 0.001) 和 CCL4/MIP-1b (p = 0.037) 的浓度明显升高。在对照组中,IL-2、IL-5、IL-8、IL-10 和 IL-1-α 的水平在包膜眼中明显升高(p 结论:IL-2、IL-5、IL-8、IL-10 和 IL-1-α 的水平在包膜眼中明显升高:本研究表明,白内障手术后 3 个月,FECD 患眼的促炎细胞因子水平明显升高。我们的研究结果表明,在白内障手术后的 3 个月内,白内障角膜中都存在术后炎症。因此,对患有 FECD 的白内障患者来说,将白内障手术与 DMEK 结合使用可能是合理的。
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引用次数: 0
Risk Factors and Characteristics Associated with Visual Impairment and Eye Diseases in Moyamoya Disease: Insights from a National Database. 与莫亚莫亚氏病视力损伤和眼部疾病相关的风险因素和特征:来自全国数据库的启示
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-11-23 DOI: 10.1007/s40123-024-01052-4
Youyi Song, Xin Yang, Hongzhu Yang, Hongyun Mei, Xuedan Lu, Hao Xie, Qinfeng Yang, Wenbin Duan

Introduction: This study aims to investigate the incidence and risk factors of visual impairment and eye diseases in patients with moyamoya disease (MMD), a rare cerebrovascular disorder. Understanding these associations is crucial for improving patient management and outcomes.

Methods: This study utilized International Classification of Diseases (ICD) codes from both the 9th edition (ICD-9-CM) and 10th edition (ICD-10-CM) to define diagnoses, complications, and procedures within the National Inpatient Sample (NIS) Database. Data elements were extracted from discharge summaries. Statistical analysis was performed using IBM SPSS Statistics software version 25. Chi-square tests were employed for univariate analysis to assess the relationships between visual impairment, eye diseases, and MMD. Subsequently, multivariate logistic regression was utilized to calculate odds ratios (OR) and their corresponding 95% confidence intervals (CI) over a 10-year period to further investigate these relationships.

Results: The incidence of visual impairment and eye diseases in MMD was 3.7%. Visual impairment and eye diseases in MMD were associated with Asian or Pacific Islander race (OR = 1.538, 95% CI 1.058-2.237), self-pay insurance (OR = 1.796, 95% CI 1.503-3.061), and hospitalization in the Midwest or North Central region (OR = 1.466, 95% CI 1.035-2.076). Visual impairment and eye diseases in moyamoya disease were associated with ischemic stroke (OR = 2.001, 95% CI 1.564-2.560), hypertension (OR = 1.508, 95% CI 1.089-2.088), headache (OR = 2.834, 95% CI 1.968-4.081), migraine (OR = 2.156, 95% CI 1.544-3.011), memory loss (OR = 3.866, 95% CI 1.493-10.012), and dizziness (OR = 1.322, 95% CI 0.549-3.182).

Conclusions: Our analysis of a large, population-based sample in the US reveals a notable association between MMD and the presence of visual impairment and eye diseases.

简介本研究旨在调查一种罕见的脑血管疾病--莫亚莫亚氏病(moyamoya disease,MMD)患者视力损伤和眼部疾病的发病率和风险因素。了解这些关联对于改善患者管理和治疗效果至关重要:本研究利用《国际疾病分类》(ICD)第 9 版(ICD-9-CM)和第 10 版(ICD-10-CM)的代码来定义全国住院病人抽样数据库(NIS)中的诊断、并发症和手术。数据元素从出院摘要中提取。统计分析使用 IBM SPSS 统计软件第 25 版进行。单变量分析采用了卡方检验,以评估视力损伤、眼部疾病和多发性硬化症之间的关系。随后,利用多变量逻辑回归计算出 10 年间的几率比(OR)及其相应的 95% 置信区间(CI),以进一步研究这些关系:结果:麻风病患者视力损伤和眼部疾病的发病率为 3.7%。MMD患者的视力损伤和眼部疾病与亚洲或太平洋岛民种族(OR = 1.538,95% CI 1.058-2.237)、自费保险(OR = 1.796,95% CI 1.503-3.061)以及在中西部或中北部地区住院(OR = 1.466,95% CI 1.035-2.076)有关。moyamoya 病的视力损害和眼部疾病与缺血性中风(OR = 2.001,95% CI 1.564-2.560)、高血压(OR = 1.508,95% CI 1.089-2.088)、头痛(OR = 2.834,95% CI 1.968-4.081)、偏头痛(OR = 2.156,95% CI 1.544-3.011)、记忆力减退(OR = 3.866,95% CI 1.493-10.012)和头晕(OR = 1.322,95% CI 0.549-3.182):我们对美国大量人口样本进行的分析表明,多发性硬化症与视力障碍和眼部疾病之间存在显著关联。
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引用次数: 0
Mobile Apps and Visual Function Assessment: A Comprehensive Review of the Latest Advancements. 移动应用程序和视觉功能评估:全面回顾最新进展。
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1007/s40123-024-01071-1
Caius Goh, Marilyn Puah, Zhi Hong Toh, Joewee Boon, Debbie Boey, Ryan Tay, Ashita A Sule, Renee Liu, Xing-Er Ong, Aditya Kalra, Satvik Gupta, Andres Rousselot, William Rojas-Carabali, Bryan Ang, Rupesh Agrawal

Introduction: With technological advancements and the growing prevalence of smartphones, ophthalmology has opportunely harnessed medical technology for visual function assessment as a home monitoring tool for patients. Ophthalmology applications that offer these have likewise become more readily available in recent years, which may be used for early detection and monitoring of eye conditions. To date, no review has been done to evaluate and compare the utility of these apps. This review provides an updated overview of visual functions assessment using mobile applications available on the Apple App and Google Play Stores, enabling eye care professionals to make informed selections of their use in ophthalmology.

Methods: We reviewed 160 visual function applications available on Apple iTunes and the Google Play Stores. The parameters surveyed included types of visual function tests, the involvement of healthcare professionals in their development, cost, and download count.

Results: Visual tests, including visual acuity and color vision tests, were most common among apps surveyed, and they were comparable to traditional clinical methods. Certain applications were more widely used, some of which have had studies conducted to assess the reliability of test results. Limitations of these apps include the absence of healthcare professionals' involvement in their development, the lack of approval by regulatory authorities and minimal cloud-based features to communicate results to healthcare professionals.

Conclusions: The prevalence and easy access of visual function testing applications present opportunities to enhance teleophthalmology through early detection and monitoring of eye conditions. Future development to enhance the quality of the apps should involve regulatory bodies and medical professionals, followed up by research using larger samples with longer follow-up studies to review the reliability and validity of ophthalmology applications. This would potentially enable these applications to be incorporated into the comprehensive assessment and follow-up care of patients' eye health.

导言:随着技术的进步和智能手机的日益普及,眼科已适时地利用医疗技术进行视觉功能评估,作为患者的家庭监测工具。近年来,提供这些功能的眼科应用程序也越来越容易获得,可用于早期检测和监测眼部状况。迄今为止,还没有人对这些应用程序的实用性进行过评估和比较。本综述对苹果应用商店和谷歌应用商店中的移动应用程序进行视觉功能评估的最新情况进行了概述,使眼科专业人员能够对这些应用程序在眼科中的应用做出明智的选择:我们审查了苹果 iTunes 和 Google Play 商店中的 160 款视觉功能应用程序。调查的参数包括视功能测试的类型、医护人员参与开发的情况、成本和下载次数:结果:在接受调查的应用程序中,视力测试(包括视力敏锐度和色觉测试)最为常见,它们与传统的临床方法不相上下。某些应用程序的使用范围更广,其中一些还进行了研究,以评估测试结果的可靠性。这些应用程序的局限性包括:没有医护人员参与开发、没有获得监管机构的批准以及向医护人员传达结果的云端功能极少:视觉功能测试应用程序的普及和易于获取为通过早期检测和监测眼部状况来加强远程眼科提供了机会。今后,监管机构和医疗专业人员应参与到提高应用程序质量的开发工作中来,并利用更大的样本和更长时间的跟踪研究来审查眼科应用程序的可靠性和有效性。这将有可能使这些应用程序被纳入病人眼部健康的综合评估和后续护理中。
{"title":"Mobile Apps and Visual Function Assessment: A Comprehensive Review of the Latest Advancements.","authors":"Caius Goh, Marilyn Puah, Zhi Hong Toh, Joewee Boon, Debbie Boey, Ryan Tay, Ashita A Sule, Renee Liu, Xing-Er Ong, Aditya Kalra, Satvik Gupta, Andres Rousselot, William Rojas-Carabali, Bryan Ang, Rupesh Agrawal","doi":"10.1007/s40123-024-01071-1","DOIUrl":"https://doi.org/10.1007/s40123-024-01071-1","url":null,"abstract":"<p><strong>Introduction: </strong>With technological advancements and the growing prevalence of smartphones, ophthalmology has opportunely harnessed medical technology for visual function assessment as a home monitoring tool for patients. Ophthalmology applications that offer these have likewise become more readily available in recent years, which may be used for early detection and monitoring of eye conditions. To date, no review has been done to evaluate and compare the utility of these apps. This review provides an updated overview of visual functions assessment using mobile applications available on the Apple App and Google Play Stores, enabling eye care professionals to make informed selections of their use in ophthalmology.</p><p><strong>Methods: </strong>We reviewed 160 visual function applications available on Apple iTunes and the Google Play Stores. The parameters surveyed included types of visual function tests, the involvement of healthcare professionals in their development, cost, and download count.</p><p><strong>Results: </strong>Visual tests, including visual acuity and color vision tests, were most common among apps surveyed, and they were comparable to traditional clinical methods. Certain applications were more widely used, some of which have had studies conducted to assess the reliability of test results. Limitations of these apps include the absence of healthcare professionals' involvement in their development, the lack of approval by regulatory authorities and minimal cloud-based features to communicate results to healthcare professionals.</p><p><strong>Conclusions: </strong>The prevalence and easy access of visual function testing applications present opportunities to enhance teleophthalmology through early detection and monitoring of eye conditions. Future development to enhance the quality of the apps should involve regulatory bodies and medical professionals, followed up by research using larger samples with longer follow-up studies to review the reliability and validity of ophthalmology applications. This would potentially enable these applications to be incorporated into the comprehensive assessment and follow-up care of patients' eye health.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ablation Depth-Dependent Survival Analysis of Phototherapeutic Keratectomy for Recurrent Corneal Erosion Syndrome. 复发性角膜腐蚀综合征光疗性角膜切除术的消融深度生存分析
IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1007/s40123-024-01070-2
Kunal A Gadhvi, Georgios Vakros, Alfredo Borgia, Kirithika Muthusamy, Laura de Benito-Llopis, Alexander C Day, Daniel M Gore

Introduction: Phototherapeutic keratectomy (PTK) is a treatment for recurrent corneal erosion syndrome (RCES). The aim of this study was to investigate whether deeper ablations yielded greater success rates.

Methods: Retrospective case notes review with prospective patient-reported outcome measures for all patients who had undergone PTK for RCES at a single tertiary referral unit. Patients received treatment with the Schwind Amaris® 750 s excimer laser. The primary outcome measure was recurrence-free survival of patients with ablation depth ≥ 15 µm compared to < 15 µm.

Results: Seventy eyes of 63 patients were included for analysis, of whom 39 (56%) had preceding trauma and 20 (29%) had epithelial basement membrane dystrophy (EBMD), with the remaining 11 (15%) of unknown aetiology. Twenty eyes (29%) received an ablation ≥ 15 µm (mean ablation depth 16.85 ± 3.4 µm) and 50 (71%) received < 15 µm (mean ablation depth 9.26 ± 1.5 µm). Overall, 65 eyes (93%) reported a subjective improvement in symptoms, with 46 (66%) remaining completely symptom free at the last follow-up [mean follow-up 24 (range, 9-48) months]. Eighty-five per cent of eyes in the ≥ 15 µm group remained symptom free compared to 58% of those with < 15 µm (p = 0.036).

Conclusion: PTK is an effective treatment for RCES, with deeper ablations yielding longer symptom-free survival.

介绍:光治疗性角膜切除术(PTK)是治疗复发性角膜侵蚀综合征(RCES)的一种方法。本研究旨在探讨更深层的消融是否能获得更高的成功率:方法:在一家三级转诊机构对所有接受过PTK治疗RCES的患者进行回顾性病例记录和前瞻性患者报告结果测量。患者接受的是 Schwind Amaris® 750 s 准分子激光治疗。主要结果是消融深度≥15 µm的患者的无复发生存率与结果的比较:对 63 名患者的 70 只眼睛进行了分析,其中 39 只(56%)曾有外伤,20 只(29%)患有上皮基底膜营养不良症(EBMD),其余 11 只(15%)病因不明。20只眼睛(29%)的消融深度≥15 µm(平均消融深度为16.85 ± 3.4 µm),50只眼睛(71%)的消融深度≥15 µm:PTK是治疗RCES的有效方法,消融深度越深,无症状生存期越长。
{"title":"Ablation Depth-Dependent Survival Analysis of Phototherapeutic Keratectomy for Recurrent Corneal Erosion Syndrome.","authors":"Kunal A Gadhvi, Georgios Vakros, Alfredo Borgia, Kirithika Muthusamy, Laura de Benito-Llopis, Alexander C Day, Daniel M Gore","doi":"10.1007/s40123-024-01070-2","DOIUrl":"https://doi.org/10.1007/s40123-024-01070-2","url":null,"abstract":"<p><strong>Introduction: </strong>Phototherapeutic keratectomy (PTK) is a treatment for recurrent corneal erosion syndrome (RCES). The aim of this study was to investigate whether deeper ablations yielded greater success rates.</p><p><strong>Methods: </strong>Retrospective case notes review with prospective patient-reported outcome measures for all patients who had undergone PTK for RCES at a single tertiary referral unit. Patients received treatment with the Schwind Amaris<sup>®</sup> 750 s excimer laser. The primary outcome measure was recurrence-free survival of patients with ablation depth ≥ 15 µm compared to < 15 µm.</p><p><strong>Results: </strong>Seventy eyes of 63 patients were included for analysis, of whom 39 (56%) had preceding trauma and 20 (29%) had epithelial basement membrane dystrophy (EBMD), with the remaining 11 (15%) of unknown aetiology. Twenty eyes (29%) received an ablation ≥ 15 µm (mean ablation depth 16.85 ± 3.4 µm) and 50 (71%) received < 15 µm (mean ablation depth 9.26 ± 1.5 µm). Overall, 65 eyes (93%) reported a subjective improvement in symptoms, with 46 (66%) remaining completely symptom free at the last follow-up [mean follow-up 24 (range, 9-48) months]. Eighty-five per cent of eyes in the ≥ 15 µm group remained symptom free compared to 58% of those with < 15 µm (p = 0.036).</p><p><strong>Conclusion: </strong>PTK is an effective treatment for RCES, with deeper ablations yielding longer symptom-free survival.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Ophthalmology and Therapy
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