Pub Date : 2024-03-27eCollection Date: 2024-01-01DOI: 10.1177/25158414241232285
Dalia Abdulhussein, Lee Jones, Sri Harsha Dintakurti, Mariya Moosajee
Background: Charles Bonnet syndrome (CBS) is characterized by visual hallucinations occurring in people with visual impairment. CBS can negatively impact psychological well-being, and the COVID-19 pandemic period was associated with an exacerbation of symptoms.
Objectives: To compare clinical practice patterns and reporting of CBS at a tertiary eye care center between an interval prior to the COVID-19 pandemic and an interval during the pandemic.
Design: Retrospective chart review.
Methods: A search of electronic medical records for all suspected CBS cases was conducted between 1 March 2019 and 29 February 2020 (prior pandemic interval) and between 1 September 2020 and 29 August 2021 (peri-pandemic interval). Data retrieved from records included patient demographics, visual acuity at the time of CBS onset, type of hallucinations, reporting healthcare professional, management strategies and patient-reported impact of hallucinations.
Results: In total, 223 appointments referred to CBS in 156 patients at the prior interval, while 239 appointments referred to CBS in 155 patients at the peri-pandemic interval, representing 0.07% and 0.09% of all hospital attendance, respectively. Clinical subspecialty where CBS was most commonly reported was medical retina, and a greater proportion of patients at both time intervals were female. Types of hallucinations, management strategies and patient-reported impact were seldom reported, although documentation improved at the latter interval.
Conclusion: Practice patterns and patient characteristics were similar between the two intervals; however, subtle differences suggest a growing awareness of CBS. Targeted interventions in high-burden clinical subspecialties may encourage reporting and improve documentation of CBS.
背景:查尔斯-波奈综合征(CBS)的特征是视力受损者出现视幻觉。CBS 可对心理健康产生负面影响,COVID-19 大流行期间症状加剧:目的:比较一家三级眼科医疗中心在 COVID-19 大流行前和大流行期间的临床实践模式和 CBS 报告情况:设计:回顾性病历审查:方法:对2019年3月1日至2020年2月29日(大流行前)和2020年9月1日至2021年8月29日(大流行期间)期间所有疑似CBS病例的电子病历进行检索。从记录中检索到的数据包括患者人口统计学特征、CBS发病时的视力、幻觉类型、报告的医护人员、管理策略以及患者报告的幻觉影响:在之前的间歇期,共有156名患者的223次就诊涉及CBS,而在围大流行期间,共有155名患者的239次就诊涉及CBS,分别占所有就诊人数的0.07%和0.09%。最常报告 CBS 的临床亚专科是内科视网膜,两个时间段中女性患者的比例都较高。幻觉的类型、处理策略和患者报告的影响很少被报告,尽管在后一个时间段记录的情况有所改善:结论:两个时间段的实践模式和患者特征相似;但细微的差异表明,人们对 CBS 的认识在不断提高。在高负担临床亚专科采取有针对性的干预措施可鼓励报告并改善 CBS 的记录。
{"title":"Practice patterns in reporting and documentation of Charles Bonnet syndrome: a retrospective review following COVID-19.","authors":"Dalia Abdulhussein, Lee Jones, Sri Harsha Dintakurti, Mariya Moosajee","doi":"10.1177/25158414241232285","DOIUrl":"10.1177/25158414241232285","url":null,"abstract":"<p><strong>Background: </strong>Charles Bonnet syndrome (CBS) is characterized by visual hallucinations occurring in people with visual impairment. CBS can negatively impact psychological well-being, and the COVID-19 pandemic period was associated with an exacerbation of symptoms.</p><p><strong>Objectives: </strong>To compare clinical practice patterns and reporting of CBS at a tertiary eye care center between an interval prior to the COVID-19 pandemic and an interval during the pandemic.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>A search of electronic medical records for all suspected CBS cases was conducted between 1 March 2019 and 29 February 2020 (prior pandemic interval) and between 1 September 2020 and 29 August 2021 (peri-pandemic interval). Data retrieved from records included patient demographics, visual acuity at the time of CBS onset, type of hallucinations, reporting healthcare professional, management strategies and patient-reported impact of hallucinations.</p><p><strong>Results: </strong>In total, 223 appointments referred to CBS in 156 patients at the prior interval, while 239 appointments referred to CBS in 155 patients at the peri-pandemic interval, representing 0.07% and 0.09% of all hospital attendance, respectively. Clinical subspecialty where CBS was most commonly reported was medical retina, and a greater proportion of patients at both time intervals were female. Types of hallucinations, management strategies and patient-reported impact were seldom reported, although documentation improved at the latter interval.</p><p><strong>Conclusion: </strong>Practice patterns and patient characteristics were similar between the two intervals; however, subtle differences suggest a growing awareness of CBS. Targeted interventions in high-burden clinical subspecialties may encourage reporting and improve documentation of CBS.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241232285"},"PeriodicalIF":2.5,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-25eCollection Date: 2024-01-01DOI: 10.1177/25158414241237713
Panos S Gartaganis, Panagiota D Natsi, Sotirios P Gartaganis, Petros G Koutsoukos, Horst Helbig
We report an unusual, rare case of opacification of the hydrophilic acrylic intraocular lens (IOL) 23 years after the initial surgery with significant visual deterioration. Opacification of the hydrophilic acrylic IOL was primarily due to the formation of folds on the surface of the lens material, and less so due to calcium phosphate deposits. Calcification opacification can be attributed to recent events, as evidenced by deposits of dicalcium phosphate dihydrate (CaHPO42H2O) and octacalcium phosphate (Ca8H2(PO4)65H2O), both of which are transient calcium phosphate phases, converting hydrolytically to the thermodynamically most stable hydroxyapatite (Ca10(PO4)6(OH)2). To our knowledge, this case of hydrophilic acrylic IOL opacification is the only one that has been described so late, 23 years after cataract surgery.
{"title":"A unique late-onset intraocular lens opacification 23 years after implantation: a clinical and laboratory case report.","authors":"Panos S Gartaganis, Panagiota D Natsi, Sotirios P Gartaganis, Petros G Koutsoukos, Horst Helbig","doi":"10.1177/25158414241237713","DOIUrl":"10.1177/25158414241237713","url":null,"abstract":"<p><p>We report an unusual, rare case of opacification of the hydrophilic acrylic intraocular lens (IOL) 23 years after the initial surgery with significant visual deterioration. Opacification of the hydrophilic acrylic IOL was primarily due to the formation of folds on the surface of the lens material, and less so due to calcium phosphate deposits. Calcification opacification can be attributed to recent events, as evidenced by deposits of dicalcium phosphate dihydrate (CaHPO<sub>4</sub>2H<sub>2</sub>O) and octacalcium phosphate (Ca<sub>8</sub>H<sub>2</sub>(PO<sub>4</sub>)<sub>6</sub>5H<sub>2</sub>O), both of which are transient calcium phosphate phases, converting hydrolytically to the thermodynamically most stable hydroxyapatite (Ca<sub>10</sub>(PO<sub>4</sub>)<sub>6</sub>(OH)<sub>2</sub>). To our knowledge, this case of hydrophilic acrylic IOL opacification is the only one that has been described so late, 23 years after cataract surgery.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241237713"},"PeriodicalIF":2.5,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today's era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.
{"title":"Pediatric corneal transplantation: techniques, challenges, and outcomes.","authors":"Bharat Gurnani, Kirandeep Kaur, Sameer Chaudhary, Ruminder Preet Kaur, Swatishree Nayak, Deepak Mishra, Harinikrishna Balakrishnan, Rohit Om Parkash, Arvind Kumar Morya, Amit Porwal","doi":"10.1177/25158414241237906","DOIUrl":"10.1177/25158414241237906","url":null,"abstract":"<p><p>Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today's era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241237906"},"PeriodicalIF":2.5,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20eCollection Date: 2024-01-01DOI: 10.1177/25158414241232258
Sana Niazi, Zisis Gatzioufas, Farideh Doroodgar, Oliver Findl, Alireza Baradaran-Rafii, Jacob Liechty, Majid Moshirfar
Background: New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural history of the disease over the last few decades. Features of artificial intelligence in different machine such as anterior segment optical coherence tomography, and femtosecond laser technique have improved safety, precision, effectiveness, and predictability of treatment modalities of keratoconus (from contact lenses to keratoplasty techniques). These options ingrained in artificial intelligence are already underway and allow ophthalmologist to approach disease in the most non-invasive way.
Objectives: This study comprehensively describes all of the treatment modalities of keratoconus considering machine learning strategies.
Design: A multidimensional comprehensive systematic narrative review.
Data sources and methods: A comprehensive search was done in the five main electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane), without language and time or type of study restrictions. Afterward, eligible articles were selected by screening the titles and abstracts based on main mesh keywords. For potentially eligible articles, the full text was also reviewed.
Results: Artificial intelligence demonstrates promise in keratoconus diagnosis and clinical management, spanning early detection (especially in subclinical cases), preoperative screening, postoperative ectasia prediction after keratorefractive surgery, and guiding surgical decisions. The majority of studies employed a solitary machine learning algorithm, whereas minor studies assessed multiple algorithms that evaluated the association of various keratoconus staging and management strategies. Last but not least, AI has proven effective in guiding the implantation of intracorneal ring segments in keratoconus corneas and predicting surgical outcomes.
Conclusion: The efficient and widespread clinical translation of machine learning models in keratoconus management is a crucial goal of potential future approaches to better visual performance in keratoconus patients.
Trial registration: The article has been registered through PROSPERO, an international database of prospectively registered systematic reviews, with the ID: CRD42022319338.
背景:人工智能的新发展,尤其是在角膜病的早期检测和管理方面取得的可喜成果,在过去几十年中已有利地改变了角膜病的自然病史。人工智能在不同机器(如前节光学相干断层扫描和飞秒激光技术)中的应用提高了角膜病治疗方法(从隐形眼镜到角膜成形技术)的安全性、精确性、有效性和可预测性。这些植入人工智能的方案已经开始实施,眼科医生可以用最无创的方式治疗疾病:本研究全面描述了考虑机器学习策略的所有角膜病治疗方法:设计:多维度综合系统性综述:在五大电子数据库(PubMed、Scopus、Web of Science、Embase 和 Cochrane)中进行了全面检索,无语言、时间或研究类型限制。然后,根据主要网状关键词筛选标题和摘要,选出符合条件的文章。对于可能符合条件的文章,还对全文进行了审查:人工智能在角膜病诊断和临床管理方面大有可为,包括早期检测(尤其是亚临床病例)、术前筛查、角膜屈光手术后异位预测以及指导手术决策。大多数研究采用了一种单独的机器学习算法,而少数研究则评估了多种算法,这些算法评估了各种角膜病分期和管理策略之间的关联。最后但并非最不重要的一点是,人工智能在指导角膜内环节段植入角膜和预测手术结果方面被证明是有效的:机器学习模型在角膜病管理中的高效和广泛的临床应用,是未来改善角膜病患者视觉表现的潜在方法的重要目标:该文章已在PROSPERO(前瞻性注册系统综述的国际数据库)注册,ID为CRD42022319338。
{"title":"Keratoconus: exploring fundamentals and future perspectives - a comprehensive systematic review.","authors":"Sana Niazi, Zisis Gatzioufas, Farideh Doroodgar, Oliver Findl, Alireza Baradaran-Rafii, Jacob Liechty, Majid Moshirfar","doi":"10.1177/25158414241232258","DOIUrl":"10.1177/25158414241232258","url":null,"abstract":"<p><strong>Background: </strong>New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural history of the disease over the last few decades. Features of artificial intelligence in different machine such as anterior segment optical coherence tomography, and femtosecond laser technique have improved safety, precision, effectiveness, and predictability of treatment modalities of keratoconus (from contact lenses to keratoplasty techniques). These options ingrained in artificial intelligence are already underway and allow ophthalmologist to approach disease in the most non-invasive way.</p><p><strong>Objectives: </strong>This study comprehensively describes all of the treatment modalities of keratoconus considering machine learning strategies.</p><p><strong>Design: </strong>A multidimensional comprehensive systematic narrative review.</p><p><strong>Data sources and methods: </strong>A comprehensive search was done in the five main electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane), without language and time or type of study restrictions. Afterward, eligible articles were selected by screening the titles and abstracts based on main mesh keywords. For potentially eligible articles, the full text was also reviewed.</p><p><strong>Results: </strong>Artificial intelligence demonstrates promise in keratoconus diagnosis and clinical management, spanning early detection (especially in subclinical cases), preoperative screening, postoperative ectasia prediction after keratorefractive surgery, and guiding surgical decisions. The majority of studies employed a solitary machine learning algorithm, whereas minor studies assessed multiple algorithms that evaluated the association of various keratoconus staging and management strategies. Last but not least, AI has proven effective in guiding the implantation of intracorneal ring segments in keratoconus corneas and predicting surgical outcomes.</p><p><strong>Conclusion: </strong>The efficient and widespread clinical translation of machine learning models in keratoconus management is a crucial goal of potential future approaches to better visual performance in keratoconus patients.</p><p><strong>Trial registration: </strong>The article has been registered through PROSPERO, an international database of prospectively registered systematic reviews, with the ID: CRD42022319338.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241232258"},"PeriodicalIF":2.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24eCollection Date: 2024-01-01DOI: 10.1177/25158414241232261
Panagiotis Stavrakas, Foteini Tsapardoni, Efthymios Karmiris, Ioannis Iatropoulos, Konstantinos Kounas, Spyridon Lygeros, Vassilios Kozobolis, Demetrios G Vavvas
X-linked retinoschisis (XLRS) is an inherited retinal degeneration affecting males, characterized by splitting of the retinal layers. We herein present the outcomes of surgical treatment in a case of XLRS complicated by rhegmatogenous retinal detachment (RRD). A 22-year-old male presented to the emergency department due to decreased visual acuity and visual field defect in his left eye Oculus Sinister (OS) of 1 week duration. The patient reported an early onset retinal degeneration and decreased visual acuity in both eyes since childhood in his past ocular history. Upon presentation, best corrected visual acuity (BCVA) was 6/30 on the right eye Oculus Dexter (OD) and 6/120 OS. Fundus examination revealed areas of peripheral retinal schisis, and the characteristic spoke wheel pattern on the macula of both eyes. In OS, a temporal RRD involving the macula was identified. The patient underwent surgical treatment with pars plana vitrectomy with internal limiting membrane (ILM) peeling, endolaser, and silicone oil (SO) tamponade. BCVA in OS improved to 6/60 and schistic cavities resolution was observed in the immediate postoperative period. The patient's BCVA further improved to 6/19 at 1 month, as foveal anatomy showed relative improvement. However, there was a rapid reappearance of schisis spaces in the macular area at this point, which was also followed by progressive deterioration of foveal schisis by 3 months post-operatively. The resorption and recurrence of lamellar macular schisis changes after ILM peel and presence of SO, highlights that although XLRS findings can temporarily improve upon surgical intervention, the pathogenetic mechanisms contributing to disease phenotype remain to be elucidated.
{"title":"Early recurrence of macular schisis in X-linked retinoschisis treated with vitrectomy for rhegmatogenous retinal detachment under silicone oil: case report and brief literature review.","authors":"Panagiotis Stavrakas, Foteini Tsapardoni, Efthymios Karmiris, Ioannis Iatropoulos, Konstantinos Kounas, Spyridon Lygeros, Vassilios Kozobolis, Demetrios G Vavvas","doi":"10.1177/25158414241232261","DOIUrl":"https://doi.org/10.1177/25158414241232261","url":null,"abstract":"<p><p>X-linked retinoschisis (XLRS) is an inherited retinal degeneration affecting males, characterized by splitting of the retinal layers. We herein present the outcomes of surgical treatment in a case of XLRS complicated by rhegmatogenous retinal detachment (RRD). A 22-year-old male presented to the emergency department due to decreased visual acuity and visual field defect in his left eye Oculus Sinister (OS) of 1 week duration. The patient reported an early onset retinal degeneration and decreased visual acuity in both eyes since childhood in his past ocular history. Upon presentation, best corrected visual acuity (BCVA) was 6/30 on the right eye Oculus Dexter (OD) and 6/120 OS. Fundus examination revealed areas of peripheral retinal schisis, and the characteristic spoke wheel pattern on the macula of both eyes. In OS, a temporal RRD involving the macula was identified. The patient underwent surgical treatment with pars plana vitrectomy with internal limiting membrane (ILM) peeling, endolaser, and silicone oil (SO) tamponade. BCVA in OS improved to 6/60 and schistic cavities resolution was observed in the immediate postoperative period. The patient's BCVA further improved to 6/19 at 1 month, as foveal anatomy showed relative improvement. However, there was a rapid reappearance of schisis spaces in the macular area at this point, which was also followed by progressive deterioration of foveal schisis by 3 months post-operatively. The resorption and recurrence of lamellar macular schisis changes after ILM peel and presence of SO, highlights that although XLRS findings can temporarily improve upon surgical intervention, the pathogenetic mechanisms contributing to disease phenotype remain to be elucidated.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241232261"},"PeriodicalIF":2.5,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The current data on various aspects of Brown syndrome are limited and sporadic. This review provides a coherent and comprehensive review of basic features, etiology, classification, differential diagnosis, and different management strategies of patients with Brown syndrome. In this topical review, PubMed, Scopus, and Google Scholar search engines were searched for papers, published between 1950 and January 2023 based on the keywords of this article. The related articles were collected, summarized, categorized, assessed, concluded, and presented. Brown syndrome is identified by restricted passive and active elevation of the eye in adduction. The condition is divided into congenital and acquired causes. The clinical features result from a restricted motion of the superior oblique tendon sheath through the trochlea while trying to look up in adduction. The newest explanation of the underlying pathophysiology has been explained as the presence of a fibrotic strand in the superior oblique muscle tendon with variable insertion sites which creates various elevation deficits seen in Brown syndrome. The most common clinical features include the presence of an abnormal head posture, V-pattern strabismus, and hypotropia in the primary position. Management of Brown syndrome includes watchful observation, surgical, and non-surgical procedures. Some cases might resolve spontaneously without any intervention; however, some acquired cases might require systemic and/or intra-trochlear steroid administration to treat the underlying causes. Surgical procedures such as superior oblique tenectomy and using a silicon tendon expander are indicated in the presence of hypotropia and significant abnormal head posture in the primary position.
{"title":"Brown syndrome: a literature review.","authors":"Masoud Khorrami-Nejad, Elham Azizi, Farah Fareed Tarik, Mohamad Reza Akbari","doi":"10.1177/25158414231222118","DOIUrl":"https://doi.org/10.1177/25158414231222118","url":null,"abstract":"<p><p>The current data on various aspects of Brown syndrome are limited and sporadic. This review provides a coherent and comprehensive review of basic features, etiology, classification, differential diagnosis, and different management strategies of patients with Brown syndrome. In this topical review, PubMed, Scopus, and Google Scholar search engines were searched for papers, published between 1950 and January 2023 based on the keywords of this article. The related articles were collected, summarized, categorized, assessed, concluded, and presented. Brown syndrome is identified by restricted passive and active elevation of the eye in adduction. The condition is divided into congenital and acquired causes. The clinical features result from a restricted motion of the superior oblique tendon sheath through the trochlea while trying to look up in adduction. The newest explanation of the underlying pathophysiology has been explained as the presence of a fibrotic strand in the superior oblique muscle tendon with variable insertion sites which creates various elevation deficits seen in Brown syndrome. The most common clinical features include the presence of an abnormal head posture, V-pattern strabismus, and hypotropia in the primary position. Management of Brown syndrome includes watchful observation, surgical, and non-surgical procedures. Some cases might resolve spontaneously without any intervention; however, some acquired cases might require systemic and/or intra-trochlear steroid administration to treat the underlying causes. Surgical procedures such as superior oblique tenectomy and using a silicon tendon expander are indicated in the presence of hypotropia and significant abnormal head posture in the primary position.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414231222118"},"PeriodicalIF":2.5,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10893837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-01-01DOI: 10.1177/25158414241228671
Altamash Shahriyar Ghazanfar, Aly Hamza Khowaja, Haroon Tayyab
Background: Triamcinolone acetonide is a synthetic corticosteroid with multiple ocular uses. Like other corticosteroids, it too is associated with ocular side effects such as increased intraocular pressure (IOP), glaucoma and cataracts. Suprachoroidal administration of triamcinolone is hoped to reduce the ocular side effects of the drug, especially rises in IOP. Our systematic review and meta-analysis aims to study this phenomenon.
Objectives: The purpose of this study was to evaluate the effect of suprachoroidal triamcinolone injections on IOP.
Design: Systematic review and meta-analysis.
Methods: We utilized the Medline, Scopus and Cochrane databases for this review. Studies published till June 2023, which fulfilled the eligibility criteria, were included. Studies in the English language with adult participants who were administered suprachoroidal triamcinolone without any concurrent intervention were included, whereas studies that did not report the mean and standard deviation for IOP were excluded. The outcome of interest was IOP at 1, 3 and 6 months post-suprachoroidal triamcinolone injection. IOP values from included studies were extracted onto Review Manager version 5.4 for analysis.
Results: Our search yielded 104 results, from which 22 papers were shortlisted for full-text screening. Finally, 12 studies were included in the analysis. Our analysis suggests a statistically significant increase in IOP in the first month after suprachoroidal triamcinolone injection but no significant differences at 3 and 6 months post-injection as compared to baseline.
Conclusion: Elevated IOP at 1 month post-injection must be considered when using suprachoroidal triamcinolone and adequate safety measures must be taken. However, the absence of a significant rise at 3 and 6 months post-injection indicates that this modality is safer than other existing drug delivery methods.
Trial registration: Registered with the Research Registry with the unique identifying number 'reviewregistry1656.' https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/648eefe65b6523002995eb21/.
{"title":"Effect of suprachoroidal triamcinolone on intraocular pressure: a systematic review and meta-analysis.","authors":"Altamash Shahriyar Ghazanfar, Aly Hamza Khowaja, Haroon Tayyab","doi":"10.1177/25158414241228671","DOIUrl":"10.1177/25158414241228671","url":null,"abstract":"<p><strong>Background: </strong>Triamcinolone acetonide is a synthetic corticosteroid with multiple ocular uses. Like other corticosteroids, it too is associated with ocular side effects such as increased intraocular pressure (IOP), glaucoma and cataracts. Suprachoroidal administration of triamcinolone is hoped to reduce the ocular side effects of the drug, especially rises in IOP. Our systematic review and meta-analysis aims to study this phenomenon.</p><p><strong>Objectives: </strong>The purpose of this study was to evaluate the effect of suprachoroidal triamcinolone injections on IOP.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We utilized the Medline, Scopus and Cochrane databases for this review. Studies published till June 2023, which fulfilled the eligibility criteria, were included. Studies in the English language with adult participants who were administered suprachoroidal triamcinolone without any concurrent intervention were included, whereas studies that did not report the mean and standard deviation for IOP were excluded. The outcome of interest was IOP at 1, 3 and 6 months post-suprachoroidal triamcinolone injection. IOP values from included studies were extracted onto Review Manager version 5.4 for analysis.</p><p><strong>Results: </strong>Our search yielded 104 results, from which 22 papers were shortlisted for full-text screening. Finally, 12 studies were included in the analysis. Our analysis suggests a statistically significant increase in IOP in the first month after suprachoroidal triamcinolone injection but no significant differences at 3 and 6 months post-injection as compared to baseline.</p><p><strong>Conclusion: </strong>Elevated IOP at 1 month post-injection must be considered when using suprachoroidal triamcinolone and adequate safety measures must be taken. However, the absence of a significant rise at 3 and 6 months post-injection indicates that this modality is safer than other existing drug delivery methods.</p><p><strong>Trial registration: </strong>Registered with the Research Registry with the unique identifying number 'reviewregistry1656.' https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/648eefe65b6523002995eb21/.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"16 ","pages":"25158414241228671"},"PeriodicalIF":2.5,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10845981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-14eCollection Date: 2023-01-01DOI: 10.1177/25158414231204111
Christopher Way, Andrew J Swampillai, Kin Sheng Lim, Mayank A Nanavaty
Despite the refinement of modern cataract surgery, postoperative inflammation still constitutes a substantial amount of visual morbidity worldwide. A surrogate for intraocular inflammation and blood-aqueous barrier breakdown can be objectively quantified by Laser flare photometry (LFP). This review outlines the utility of LFP in assessing the assessment of post-cataract surgery inflammation. It highlights the impact of preoperative pathological states such as uveitis and diabetes, intraoperative techniques, including efficient phacoemulsification and direct comparisons between postoperative anti-inflammatory regimes. There is a large interobserver variation in the subjective flare measurement after cataract surgery and the continued use of LFP amongst other objective, noninvasive measurements of intraocular inflammation, particularly in the further development of cataract surgery, is recommended.
{"title":"Factors influencing aqueous flare after cataract surgery and its evaluation with laser flare photometry.","authors":"Christopher Way, Andrew J Swampillai, Kin Sheng Lim, Mayank A Nanavaty","doi":"10.1177/25158414231204111","DOIUrl":"https://doi.org/10.1177/25158414231204111","url":null,"abstract":"<p><p>Despite the refinement of modern cataract surgery, postoperative inflammation still constitutes a substantial amount of visual morbidity worldwide. A surrogate for intraocular inflammation and blood-aqueous barrier breakdown can be objectively quantified by Laser flare photometry (LFP). This review outlines the utility of LFP in assessing the assessment of post-cataract surgery inflammation. It highlights the impact of preoperative pathological states such as uveitis and diabetes, intraoperative techniques, including efficient phacoemulsification and direct comparisons between postoperative anti-inflammatory regimes. There is a large interobserver variation in the subjective flare measurement after cataract surgery and the continued use of LFP amongst other objective, noninvasive measurements of intraocular inflammation, particularly in the further development of cataract surgery, is recommended.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"15 ","pages":"25158414231204111"},"PeriodicalIF":2.5,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30eCollection Date: 2023-01-01DOI: 10.1177/25158414231208284
Emmanuel Kwasi Abu, Carl Halladay Abraham, Albert Kofi Dadzie, Enyam Amewuho Morny, Michael Ntodie, Stephen Ocansey, Samuel Abokyi, Andrew Owusu-Ansah, Naa Adjeley Addo, Michael Williams, Asantewaa Aboagye-McCarthy, Godfred Sakyi-Badu, Paa Kwesi Fynn Hope, Peter Osei-Wusu Adueming
Background: Glaucoma is an optic neuropathy which causes irreversible vision loss. Standard perimetry, which is essential for glaucoma diagnosis, can only detect glaucomatous visual filed loss when considerable structural damage has occurred. Contrast sensitivity is one of the visual function tests that is reduced in eyes with glaucoma. It is known to be affected in pre-perimetric stages of glaucoma.
Objective: The objective of this study was to investigate the discriminating ability of central contrast sensitivity perimetry in eyes with and without glaucoma.
Design: The study employed a cross-sectional study design.
Methods: The study participants were made of two groups; eyes diagnosed with glaucoma by an ophthalmologist based on visual field test and optical coherence tomography (OCT) and age- and sex-matched controls who were declared free from glaucoma. Static contrast sensitivity (CS) was measured in the central 10° of visual field using a custom psychophysical test.
Results: There were 45 eyes with glaucoma and 45 age- and sex-matched controls in this study. The static CS in the glaucoma group was significantly reduced in 9 out of the 13 tested locations in the central 10° of the visual field. The mean static CS at 5°, 10°, superior hemifield and inferior hemifield were all significantly reduced in the glaucoma patients compared to the controls.
Conclusion: Static CS measurement is a sensitive approach that can be utilized to aid in the detection of glaucoma. The use of static CS can be adopted in the development of a cost-effective yet sensitive screening tool for the detection of glaucoma.
{"title":"Central contrast sensitivity perimetry discriminates between glaucomatous and non-glaucomatous eyes.","authors":"Emmanuel Kwasi Abu, Carl Halladay Abraham, Albert Kofi Dadzie, Enyam Amewuho Morny, Michael Ntodie, Stephen Ocansey, Samuel Abokyi, Andrew Owusu-Ansah, Naa Adjeley Addo, Michael Williams, Asantewaa Aboagye-McCarthy, Godfred Sakyi-Badu, Paa Kwesi Fynn Hope, Peter Osei-Wusu Adueming","doi":"10.1177/25158414231208284","DOIUrl":"https://doi.org/10.1177/25158414231208284","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is an optic neuropathy which causes irreversible vision loss. Standard perimetry, which is essential for glaucoma diagnosis, can only detect glaucomatous visual filed loss when considerable structural damage has occurred. Contrast sensitivity is one of the visual function tests that is reduced in eyes with glaucoma. It is known to be affected in pre-perimetric stages of glaucoma.</p><p><strong>Objective: </strong>The objective of this study was to investigate the discriminating ability of central contrast sensitivity perimetry in eyes with and without glaucoma.</p><p><strong>Design: </strong>The study employed a cross-sectional study design.</p><p><strong>Methods: </strong>The study participants were made of two groups; eyes diagnosed with glaucoma by an ophthalmologist based on visual field test and optical coherence tomography (OCT) and age- and sex-matched controls who were declared free from glaucoma. Static contrast sensitivity (CS) was measured in the central 10° of visual field using a custom psychophysical test.</p><p><strong>Results: </strong>There were 45 eyes with glaucoma and 45 age- and sex-matched controls in this study. The static CS in the glaucoma group was significantly reduced in 9 out of the 13 tested locations in the central 10° of the visual field. The mean static CS at 5°, 10°, superior hemifield and inferior hemifield were all significantly reduced in the glaucoma patients compared to the controls.</p><p><strong>Conclusion: </strong>Static CS measurement is a sensitive approach that can be utilized to aid in the detection of glaucoma. The use of static CS can be adopted in the development of a cost-effective yet sensitive screening tool for the detection of glaucoma.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"15 ","pages":"25158414231208284"},"PeriodicalIF":2.5,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30eCollection Date: 2023-01-01DOI: 10.1177/25158414231208279
Zeynep İpekli, Seren Pehlivanoğlu, Özgür Artunay
Background: In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases.
Objectives: To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy.
Design: Retrospective study.
Methods: The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length.
Results: PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different (p = 0.04, p < 0.001, and p = 0.02, respectively). There was a significant difference in visual acuity before and after surgery in the group that was successful with a single surgery (Friedman χ2 = 40.051, p < 0.001). There was no significant difference between the two groups in terms of intraocular pressure (p > 0.05), and glaucoma was not observed in the postoperative period.
Conclusion: Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR.
背景:在患有孔源性视网膜脱离的年轻人中,在合适的情况下,气动视网膜固定术是一种成本效益高、微创高效的方法。目的:评价气动视网膜固定术在年轻成人孔源性视网膜脱离(RRD)治疗中的作用,以及可能影响气动视网膜修复成功的因素。设计:回顾性研究。方法:该研究包括67名年龄在21岁至40岁之间的患者的67只眼睛,这些患者在2015年1月至2021年6月期间接受了气动视网膜固定术(PR)治疗原发性RRD。我们回顾性分析了可能影响PR成功的预后因素,如术前年龄、最佳矫正视力、撕裂部位、晶状体状况和轴长。结果:61.2%的患者PR成功,38.8%的患者需要二次手术。在单次手术组(第1组)和需要二次手术的组(第2组)之间,撕裂位置、轴向长度和使用的气体体积在统计学上有差异(p = 0.04,p p = 分别为0.02)。在单次手术成功的组中,手术前后的视力有显著差异(Friedmanχ2 = 40.051,p p > 0.05),术后未观察到青光眼。结论:由于它是一种微创且成本效益高的方法,可以提供快速的视觉康复,因此可以作为适合PR的年轻人的一线治疗。
{"title":"Efficacy of pneumatic retinopexy in young adults with rhegmatogenous retinal detachment.","authors":"Zeynep İpekli, Seren Pehlivanoğlu, Özgür Artunay","doi":"10.1177/25158414231208279","DOIUrl":"https://doi.org/10.1177/25158414231208279","url":null,"abstract":"<p><strong>Background: </strong>In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases.</p><p><strong>Objectives: </strong>To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length.</p><p><strong>Results: </strong>PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different (<i>p</i> = 0.04, <i>p</i> < 0.001, and <i>p</i> = 0.02, respectively). There was a significant difference in visual acuity before and after surgery in the group that was successful with a single surgery (Friedman χ<sup>2</sup> = 40.051, <i>p</i> < 0.001). There was no significant difference between the two groups in terms of intraocular pressure (<i>p</i> > 0.05), and glaucoma was not observed in the postoperative period.</p><p><strong>Conclusion: </strong>Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"15 ","pages":"25158414231208279"},"PeriodicalIF":2.5,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}