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Changes in ocular pulse amplitude and posterior ocular structure parameters in type 1 diabetic children without diabetic retinopathy. 无糖尿病视网膜病变的1型糖尿病儿童眼脉冲振幅和眼后结构参数的变化。
IF 2.5 Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221101710
Abdulvahit Asik, Semih Bolu, Ilke Direkci, Emre Aydemir, Gozde Aksoy Aydemir

Background: It is important to determine changes in posterior ocular structures in the early period before retinopathy develops in pediatric patients with type 1 diabetes mellitus (DM).

Objective: To evaluate inner plexiform layer (IPL), ganglion cell layer (GCL), and retinal nerve fiber layer (RNFL) thicknesses, as well as the relationship between choroidal thickness (CT) and ocular pulse amplitude (OPA) in type 1 diabetic children without diabetic retinopathy (DR).

Design: A prospective observational study.

Methods: Group 1 (n = 44) consisted of pediatric patients with type 1 DM without DR, and Group 2 (n = 65) of pediatric control subjects. Both intraocular pressure (IOP) and OPA were measured using a dynamic contour tonometer. CT, IPL, GCL, and RNFL were all measured using spectral domain optical coherence tomography (OCT).

Results: The mean IOP and OPA values were 16.67 ± 2.34 and 1.85 ± 0.34, respectively, in group 1, and 15.14 ± 2.17 and 1.65 ± 0.25 in Group 2 (p = 0.001 for both). The mean subfoveal CT value was 294.30 ± 67.61 μm in group 1 and 394.42 ± 69.65 μm in Group 2 (p < 0.001). The mean GCL and RNFL values were 1.09 ± 0.11 and 96.46 ± 11.69, respectively, in group 1, and 1.14 ± 0.09 and 101.73 ± 9.33 in Group 2 (p = 0.005 and p = 0.008, respectively).

Conclusions: IOP and OPA values were higher, and CT, GCL, and RNFL values were lower in children with type 1 DM during the early stages than in the healthy control group. These findings suggest that CT may be a marker of retinal involvement in children with type 1 DM without DR.

背景:在1型糖尿病(DM)患儿视网膜病变发生前早期确定后眼结构的变化是很重要的。目的:探讨无糖尿病视网膜病变(DR)的1型糖尿病患儿视网膜内丛状层(IPL)、神经节细胞层(GCL)、视网膜神经纤维层(RNFL)厚度及脉络膜厚度(CT)与眼脉冲幅值(OPA)的关系。设计:前瞻性观察性研究。方法:第一组(n = 44)为无DR的1型糖尿病患儿,第二组(n = 65)为儿童对照。眼压(IOP)和眼压(OPA)均采用动态轮廓眼压计测量。CT、IPL、GCL和RNFL均采用光谱域光学相干断层扫描(OCT)测量。结果:组1平均IOP为16.67±2.34,OPA为1.85±0.34;组2平均IOP为15.14±2.17,OPA为1.65±0.25 (p = 0.001)。1组和2组的平均CT值分别为294.30±67.61 μm和394.42±69.65 μm (p值分别为0.005和0.008)。结论:1型糖尿病患儿早期IOP、OPA值高于健康对照组,CT、GCL、RNFL值低于健康对照组。这些发现提示CT可能是无DR的1型糖尿病儿童视网膜受累的标志。
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引用次数: 1
Is there any connection between choroidal thickness and obesity? 脉络膜厚度和肥胖之间有联系吗?
IF 2.5 Pub Date : 2022-06-30 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221100649
Farshad Askarizadeh, Mohsen Heirani, Masoud Khorrami-Nejad, Foroozan Narooie-Noori, Mehdi Khabazkhoob, Alireza Ostadrahimi

Obesity is a health-threatening and epidemic medical condition that can affect individuals of different ages and is potentially associated with an increased risk of systemic and ocular disorders. Despite the well-documented adverse effects of obesity on different parts of the body vasculature, less published data are available concerning obesity-related consequences on the ocular vasculature. As the human choroid is a highly vascularized tissue, its morphology and function might be altered in obese individuals. The micro-structural changes within the choroid could also trigger development of subsequent functional abnormalities of the eye. Previous population-based studies have asserted an association between obesity and choroidal thickness; however, they reported conflicting patterns of association between obesity and changes in choroidal thickness. Therefore, to enhance our understanding of the changes in choroidal morphology secondary to obesity, we reviewed studies describing the micro-structural consequences of obesity on the choroidal thickness profile and its underlying physiological and anatomical basis. This review includes all original publications related to the association between choroidal thickness and obesity published until mid-2021 that were indexed in PubMed, Google Scholar, ScienceDirect, or Scopus.

肥胖是一种威胁健康的流行病,可影响不同年龄的个体,并可能与系统性和眼部疾病的风险增加有关。尽管肥胖对身体不同部位血管系统的不良影响有充分的文献记载,但关于肥胖对眼部血管系统的相关影响,发表的数据较少。由于人类脉络膜是一种高度血管化的组织,其形态和功能可能在肥胖个体中发生改变。脉络膜内的微观结构变化也可能引发后续眼睛功能异常的发展。先前基于人群的研究已经断言肥胖与脉络膜厚度之间存在关联;然而,他们报告了肥胖和脉络膜厚度变化之间相互矛盾的联系模式。因此,为了加深我们对肥胖引起的脉络膜形态变化的理解,我们回顾了肥胖对脉络膜厚度分布的微观结构影响及其潜在的生理和解剖学基础的研究。本综述包括在PubMed、Google Scholar、ScienceDirect或Scopus中检索到的2021年年中之前发表的所有与脉络膜厚度与肥胖之间关系相关的原始出版物。
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引用次数: 2
Down syndrome: a review of ocular manifestations. 唐氏综合征:眼部表现综述。
IF 2.5 Pub Date : 2022-06-30 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221101718
Abid Haseeb, Elisah Huynh, Reem H ElSheikh, Ahmed S ElHawary, Christina Scelfo, Danielle M Ledoux, Daniel E Maidana, Abdelrahman M Elhusseiny

Down syndrome is the most common genetically mediated intellectual disability. Although many physiologic and pathologic features of Down syndrome are discussed at length in the literature, the ocular manifestations of Down syndrome have seldom been discussed in a comprehensive fashion. Given that Down syndrome has ocular manifestations from the front to the back of the eye, it is important for physicians to become familiar with these manifestations, especially given the prevalence of Down syndrome. This review aims to discuss the varied ophthalmologic manifestations of Down syndrome - including strabismus, amblyopia, nystagmus, accommodation deficits, nasolacrimal duct obstruction, keratoconus, optic nerve pathology, neoplastic disease, and retinal pathology - to facilitate better care and visual outcomes in this important patient population.

唐氏综合症是最常见的遗传介导的智力残疾。虽然文献中对唐氏综合症的许多生理和病理特征进行了详细的讨论,但唐氏综合症的眼部表现却很少得到全面的讨论。鉴于唐氏综合症的眼部表现从眼前到眼后,医生熟悉这些表现是很重要的,特别是考虑到唐氏综合症的患病率。本文旨在讨论唐氏综合征的各种眼科表现,包括斜视、弱视、眼球震颤、调节缺陷、鼻泪管阻塞、圆锥角膜、视神经病理、肿瘤疾病和视网膜病理,以促进对这一重要患者群体的更好的护理和视力预后。
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引用次数: 9
Three-dimensional printing in ophthalmology and eye care: current applications and future developments. 眼科和眼部护理中的三维打印:当前应用和未来发展。
IF 2.3 Q2 OPHTHALMOLOGY Pub Date : 2022-06-27 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221106682
Yazan Fakhoury, Abdallah Ellabban, Usama Attia, Ahmed Sallam, Samer Elsherbiny

Three-dimensional (3D) printing uses a process of adding material in a layer-by-layer fashion to form the end product. This technology is advancing rapidly and is being increasingly utilized in the medical field as it becomes more accessible and cost-effective. It has an increasingly important role in ophthalmology and eyecare as its current and potential applications are extensive and slowly evolving. Three-dimensional printing represents an important method of manufacturing customized products such as orbital implants, ocular prostheses, ophthalmic models, surgical instruments, spectacles and other gadgets. Surgical planning, simulation, training and teaching have all benefitted from this technology. Advances in bioprinting seem to be the future direction of 3D printing with possibilities of printing out viable ocular tissues such as corneas and retinas in the future. It is expected that more ophthalmologists and other clinicians will use this technology in the near future.

三维(3D)打印采用逐层添加材料的方式形成最终产品。这项技术发展迅速,在医疗领域的应用也越来越广泛,因为它越来越容易获得,成本效益也越来越高。它在眼科和眼保健领域的作用日益重要,因为其当前和潜在的应用领域非常广泛,而且在不断发展。三维打印是制造眼眶植入物、眼科假体、眼科模型、手术器械、眼镜和其他小工具等定制产品的重要方法。手术规划、模拟、培训和教学都受益于这项技术。生物打印技术的进步似乎是 3D 打印技术的未来发展方向,未来有可能打印出角膜和视网膜等可存活的眼部组织。预计在不久的将来,会有更多的眼科医生和其他临床医生使用这项技术。
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引用次数: 0
Macular microcirculation changes after macula-off rhegmatogenous retinal detachment repair with silicone oil tamponade evaluated by OCT-A: preliminary results. OCT-A评价硅油填塞修复黄斑脱落孔源性视网膜脱离后黄斑微循环变化的初步结果。
IF 2.5 Pub Date : 2022-06-18 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221105222
Evita Evangelia Christou, Panagiotis Stavrakas, Ilias Georgalas, Georgios Batsos, Eleni Christodoulou, Maria Stefaniotou

Background: Rhegmatogenous retinal detachment (RRD) with macular involvement is a sight-threatening condition. Silicone oil (SO) is efficacious for retinal tamponade, especially in complex cases. Whether macular detachment per se or the potential tamponading agent may affect macular microcirculation after RRD repair is a matter of research.

Objectives: To investigate macular microcirculation changes using optical coherence tomography angiography (OCT-A) after pars plana vitrectomy (PPV) with intravitreal SO for RRD repair in the early posttreatment period.

Design: Prospective comparative cross-sectional study.

Data sources and methods: Fourteen eyes of 14 patients were included in the study. All eyes underwent a single successful PPV with SO tamponade for macula-off RRD. OCT-A was performed to analyze macular microcirculation and visual outcomes at 1 month postoperatively. The fellow unaffected eye was used as control.

Results: Vessel density (VD) in the superficial capillary plexus (SCP) was significantly lower at each macular region (fovea, parafovea, and perifovea) of SO-treated eyes compared with the fellow eyes (all p = 0.001). Similarly, perfusion density (PD) in the SCP was significantly lower at each macular region than the fellow eyes (all p = 0.001). There was enlargement of foveal avascular zone (FAZ) area and decrease of circularity at RRD eyes compared with the fellow ones (all p = 0.001). Postoperative logMAR visual acuity (VA) was significantly lower in treated eyes than fellow eyes and correlated inversely with foveal, parafoveal, and perifoveal VD and PD SCP (all p < 0.001). Postoperative VA had no correlation with FAZ parameters.

Conclusion: Enlargement of FAZ SCP and decrease in VD and PD SCP during the short-term follow-up were possibly attributable to ischemic changes in the macular area after RRD repair with SO tamponade. In this preliminary study, the flow density in macular capillary plexus may represent an indicator of visual outcomes.

背景:孔源性视网膜脱离(RRD)伴黄斑受累是一种视力威胁疾病。硅油(SO)是有效的视网膜填塞,特别是在复杂的情况下。黄斑脱离本身或潜在的填塞剂是否会影响RRD修复后的黄斑微循环是一个研究问题。目的:应用光学相干断层扫描血管造影(OCT-A)研究玻璃体部分切除术(PPV)玻璃体内SO治疗RRD术后早期黄斑微循环的变化。设计:前瞻性比较横断面研究。资料来源和方法:纳入14例患者的14只眼。所有的眼睛都接受了单次成功的PPV和SO填塞治疗黄斑脱落的RRD。术后1个月行OCT-A分析黄斑微循环及视力情况。另一只未受影响的眼睛作为对照。结果:so治疗组黄斑各区域(中央窝、副中央窝、周围中央窝)浅毛细血管丛血管密度(VD)明显低于对照组(p = 0.001)。同样,SCP的灌注密度(PD)在每个黄斑区域显著低于其他眼睛(均p = 0.001)。RRD组眼中央凹无血管区(FAZ)面积增大,圆度减小(p = 0.001)。术后治疗眼的logMAR视力(VA)明显低于正常眼,且与中央凹、中央凹旁和中央凹周围VD和PD SCP呈负相关(均p)。结论:短期随访期间FAZ SCP增大,VD和PD SCP降低可能与SO填塞修复RRD后黄斑区缺血性改变有关。在本初步研究中,黄斑毛细血管丛的血流密度可以作为视觉结果的一个指标。
{"title":"Macular microcirculation changes after macula-off rhegmatogenous retinal detachment repair with silicone oil tamponade evaluated by OCT-A: preliminary results.","authors":"Evita Evangelia Christou,&nbsp;Panagiotis Stavrakas,&nbsp;Ilias Georgalas,&nbsp;Georgios Batsos,&nbsp;Eleni Christodoulou,&nbsp;Maria Stefaniotou","doi":"10.1177/25158414221105222","DOIUrl":"https://doi.org/10.1177/25158414221105222","url":null,"abstract":"<p><strong>Background: </strong>Rhegmatogenous retinal detachment (RRD) with macular involvement is a sight-threatening condition. Silicone oil (SO) is efficacious for retinal tamponade, especially in complex cases. Whether macular detachment per se or the potential tamponading agent may affect macular microcirculation after RRD repair is a matter of research.</p><p><strong>Objectives: </strong>To investigate macular microcirculation changes using optical coherence tomography angiography (OCT-A) after pars plana vitrectomy (PPV) with intravitreal SO for RRD repair in the early posttreatment period.</p><p><strong>Design: </strong>Prospective comparative cross-sectional study.</p><p><strong>Data sources and methods: </strong>Fourteen eyes of 14 patients were included in the study. All eyes underwent a single successful PPV with SO tamponade for macula-off RRD. OCT-A was performed to analyze macular microcirculation and visual outcomes at 1 month postoperatively. The fellow unaffected eye was used as control.</p><p><strong>Results: </strong>Vessel density (VD) in the superficial capillary plexus (SCP) was significantly lower at each macular region (fovea, parafovea, and perifovea) of SO-treated eyes compared with the fellow eyes (all <i>p</i> = 0.001). Similarly, perfusion density (PD) in the SCP was significantly lower at each macular region than the fellow eyes (all <i>p</i> = 0.001). There was enlargement of foveal avascular zone (FAZ) area and decrease of circularity at RRD eyes compared with the fellow ones (all <i>p</i> = 0.001). Postoperative logMAR visual acuity (VA) was significantly lower in treated eyes than fellow eyes and correlated inversely with foveal, parafoveal, and perifoveal VD and PD SCP (all <i>p</i> < 0.001). Postoperative VA had no correlation with FAZ parameters.</p><p><strong>Conclusion: </strong>Enlargement of FAZ SCP and decrease in VD and PD SCP during the short-term follow-up were possibly attributable to ischemic changes in the macular area after RRD repair with SO tamponade. In this preliminary study, the flow density in macular capillary plexus may represent an indicator of visual outcomes.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/22/10.1177_25158414221105222.PMC9208039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40224947","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}
引用次数: 1
Early vitrectomy in eyes with non-diabetic vitreous hemorrhage. 非糖尿病性玻璃体出血的早期玻璃体切除术
IF 2.3 Q2 OPHTHALMOLOGY Pub Date : 2022-04-29 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221090099
Edward Foo, Piergiacomo Grassi, Kurt Spiteri-Cornish

Background: Optimal management of non-diabetic vitreous hemorrhage (NDVH) is controversial, and reliability of B-scan ultrasonography in detecting retinal tears (RTs) has been reported to be highly variable by previous literature.

Objectives: To report outcomes of conservative versus surgical management of NDVH and reliability of B-scan ultrasonography in detecting RTs and rhegmatogenous retinal detachment (RRD).

Design: Retrospective observational single-center cohort study.

Methods: Ninety-six consecutive NDVH from 96 eyes (96 patients) with minimum follow-up duration of 12 months were included.

Results: Seventy-two eyes (75%) underwent early pars plana vitrectomy (PPV), 19 (20%) were managed conservatively and 5 (5%) underwent late PPV. Initial mean best corrected visual acuities (BCVAs) were 1.95 ± 1.19, 1.19 ± 1.38, and 1.14 ± 1.04 logMAR respectively, the difference was statistically significant (p = 0.039). Mean final BCVAs were 0.92 ± 1.19, 0.59 ± 0.87, and 1.25 ± 1.89 logMAR, respectively, the difference was not significant (p = 0.447). When comparing initial and final BCVAs, the difference was significant only in the early PPV group (p = 0.00001) and was not significant in the conservative group (p = 0.066) and in the late PPV group (p = 0.46). Complications included RRD (n = 2) and re-bleed in vitrectomized cavity (n = 1) in the early surgical group, need for additional laser or cryoretinopexy to RTs (n = 2), retinal detachment (n = 1), neovascular glaucoma (n = 1), persistent vitreous hemorrhage (n = 2) in the conservative group. B-scan ultrasound showed preoperative 11.53% sensitivity and a 60.0% positive predictive value for diagnosing retinal tears (RTs) in NDVH.

Conclusion: The benefit of early PPV in NDVH seems to outweigh the risks of surgery, especially in the context of low sensitivity of B-scan in identifying RTs, and significant improvement in final BCVA following surgery may occur. NDVH should be promptly referred to vitreoretinal services, as surgery may be a safer and more advisable option.

背景:非糖尿病性玻璃体出血(NDVH)的最佳治疗方法存在争议,先前的文献报道b超检查视网膜撕裂(RTs)的可靠性存在很大差异。目的:报告NDVH的保守治疗与手术治疗的结果,以及b超检查RTs和孔源性视网膜脱离(RRD)的可靠性。设计:回顾性观察性单中心队列研究。方法:96只眼(96例)连续96例NDVH,最短随访时间为12个月。结果:早期行玻璃体切除72眼(75%),保守治疗19眼(20%),晚期行玻璃体切除5眼(5%)。初始平均最佳矫正视力(BCVAs)分别为1.95±1.19、1.19±1.38、1.14±1.04 logMAR,差异有统计学意义(p = 0.039)。平均最终BCVAs分别为0.92±1.19、0.59±0.87和1.25±1.89 logMAR,差异无统计学意义(p = 0.447)。当比较初始和最终BCVAs时,只有早期PPV组差异有统计学意义(p = 0.00001),保守组(p = 0.066)和晚期PPV组(p = 0.46)差异无统计学意义。早期手术组出现RRD (n = 2)和玻璃体切除腔内再出血(n = 1),保守组需行激光或冷冻视网膜固定术(n = 2),视网膜脱离(n = 1),新生血管性青光眼(n = 1),持续玻璃体出血(n = 2)。术前b超诊断NDVH视网膜撕裂(RTs)的敏感性为11.53%,阳性预测值为60.0%。结论:NDVH早期PPV的益处似乎大于手术的风险,特别是在b扫描识别RTs的敏感性较低的情况下,手术后最终BCVA可能会有显著改善。NDVH应立即转介到玻璃体视网膜服务,因为手术可能是一个更安全和更明智的选择。
{"title":"Early vitrectomy in eyes with non-diabetic vitreous hemorrhage.","authors":"Edward Foo, Piergiacomo Grassi, Kurt Spiteri-Cornish","doi":"10.1177/25158414221090099","DOIUrl":"10.1177/25158414221090099","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of non-diabetic vitreous hemorrhage (NDVH) is controversial, and reliability of B-scan ultrasonography in detecting retinal tears (RTs) has been reported to be highly variable by previous literature.</p><p><strong>Objectives: </strong>To report outcomes of conservative versus surgical management of NDVH and reliability of B-scan ultrasonography in detecting RTs and rhegmatogenous retinal detachment (RRD).</p><p><strong>Design: </strong>Retrospective observational single-center cohort study.</p><p><strong>Methods: </strong>Ninety-six consecutive NDVH from 96 eyes (96 patients) with minimum follow-up duration of 12 months were included.</p><p><strong>Results: </strong>Seventy-two eyes (75%) underwent early pars plana vitrectomy (PPV), 19 (20%) were managed conservatively and 5 (5%) underwent late PPV. Initial mean best corrected visual acuities (BCVAs) were 1.95 ± 1.19, 1.19 ± 1.38, and 1.14 ± 1.04 logMAR respectively, the difference was statistically significant (<i>p</i> = 0.039). Mean final BCVAs were 0.92 ± 1.19, 0.59 ± 0.87, and 1.25 ± 1.89 logMAR, respectively, the difference was not significant (<i>p</i> = 0.447). When comparing initial and final BCVAs, the difference was significant only in the early PPV group (<i>p</i> = 0.00001) and was not significant in the conservative group (<i>p</i> = 0.066) and in the late PPV group (<i>p</i> = 0.46). Complications included RRD (<i>n</i> = 2) and re-bleed in vitrectomized cavity (<i>n</i> = 1) in the early surgical group, need for additional laser or cryoretinopexy to RTs (<i>n</i> = 2), retinal detachment (<i>n</i> = 1), neovascular glaucoma (<i>n</i> = 1), persistent vitreous hemorrhage (<i>n</i> = 2) in the conservative group. B-scan ultrasound showed preoperative 11.53% sensitivity and a 60.0% positive predictive value for diagnosing retinal tears (RTs) in NDVH.</p><p><strong>Conclusion: </strong>The benefit of early PPV in NDVH seems to outweigh the risks of surgery, especially in the context of low sensitivity of B-scan in identifying RTs, and significant improvement in final BCVA following surgery may occur. NDVH should be promptly referred to vitreoretinal services, as surgery may be a safer and more advisable option.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47580118","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}
引用次数: 0
Early intraocular pressure changes following different keratoplasty techniques and association with cornea parameters and anterior chamber depth. 不同角膜移植技术后早期眼压变化与角膜参数和前房深度的关系。
IF 2.5 Pub Date : 2022-03-19 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221083359
Gulsah Gumus, Cigdem Altan, Yusuf Yildirim, Nilay Kandemir Beşek, Selim Genç, Ahmet Kirgiz, Gonul Karatas Durusoy, Alper Ağca

Background: Corneal transplantation surgery is associated with an increased risk of intraocular pressure (IOP) elevation. Increased IOP may cause irreversible vision loss and graft failure.Purpose: We aimed to evaluate early IOP changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD), and IOP changes.

Methods: We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and Descemet membrane endothelial keratoplasty (DMEK) in this observational study. ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL.

Results: In total, 22 patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and postoperatively hour 6, and between the IOP preoperatively and postoperatively hour 24 was statistically significant in the three types of surgery (p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (p = 0.021). There was no correlation between ACD, CT, K values, and IOP in any group.

Conclusion: IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

背景:角膜移植手术与眼压升高的风险增加有关。IOP升高可能导致不可逆的视力丧失和移植物衰竭。目的:我们旨在评估不同角膜移植技术后早期IOP的变化,并探讨角膜厚度(CT)、角膜测量值、前房深度(ACD)与IOP变化之间的关系。方法:在这项观察性研究中,我们纳入了接受穿透性角膜移植术(PK)、深前板层角膜移植术(DALK)和Descemet膜内皮角膜移植术(DMEK)的患者。术后24小时、第1周和第1个月分别进行ACD、CT和角膜测量。使用Tono-Pen XL在术后6小时和24小时、第1周和第1个月重复IOP测量。结果:共22例患者行PK, 12例患者行DALK, 19例患者行DMEK。三种手术方式的IOP术前与术后6小时、术后24小时比较,差异均有统计学意义(p p = 0.023)。对比三种手术方式的IOP, PK组术后第1周IOP明显高于DALK、DMEK组(p = 0.021)。各组ACD、CT、K值与IOP无相关性。结论:所有类型角膜移植术后1小时内IOP均有升高,但术后早期PK高IOP的风险较长。术后第1周应更仔细地随访PK患者,以检查IOP是否升高。
{"title":"Early intraocular pressure changes following different keratoplasty techniques and association with cornea parameters and anterior chamber depth.","authors":"Gulsah Gumus,&nbsp;Cigdem Altan,&nbsp;Yusuf Yildirim,&nbsp;Nilay Kandemir Beşek,&nbsp;Selim Genç,&nbsp;Ahmet Kirgiz,&nbsp;Gonul Karatas Durusoy,&nbsp;Alper Ağca","doi":"10.1177/25158414221083359","DOIUrl":"https://doi.org/10.1177/25158414221083359","url":null,"abstract":"<p><strong>Background: </strong>Corneal transplantation surgery is associated with an increased risk of intraocular pressure (IOP) elevation. Increased IOP may cause irreversible vision loss and graft failure.Purpose: We aimed to evaluate early IOP changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD), and IOP changes.</p><p><strong>Methods: </strong>We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and Descemet membrane endothelial keratoplasty (DMEK) in this observational study. ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL.</p><p><strong>Results: </strong>In total, 22 patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and postoperatively hour 6, and between the IOP preoperatively and postoperatively hour 24 was statistically significant in the three types of surgery (<i>p</i> < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (<i>p</i> = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (<i>p</i> = 0.021). There was no correlation between ACD, CT, K values, and IOP in any group.</p><p><strong>Conclusion: </strong>IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/79/10.1177_25158414221083359.PMC8935592.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40317835","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}
引用次数: 0
Change in contrast sensitivity and OCT parameters in idiopathic intracranial hypertension. 特发性颅内高压对比敏感度及OCT参数的变化。
IF 2.5 Pub Date : 2022-03-19 eCollection Date: 2022-01-01 DOI: 10.1177/25158414221083358
Obaidur Rehman, Parul Ichhpujani, Ekta Singla, Reetika Negi, Suresh Kumar

Background: Deterioration in peripheral contrast sensitivity (CS) can be an indicator to detect progressive deterioration of visual function in patients with idiopathic intracranial hypertension (IIH).

Objectives: The aim of this study was to evaluate the changes in central and peripheral CS and optical coherence tomography (OCT) parameters and in patients with IIH.

Design and methods: In this pilot observational study, data of 20 eyes of 10 'treatment-naïve' IIH patients were analyzed. Detailed ocular examination was performed including CS assessment using both Pelli-Robson (PR) test and Spaeth-Richman Contrast Sensitivity Test (SPARCS) along with the OCT for macular and optic nerve head (ONH) parameters. A comparative analysis was done for CS and OCT parameters from baseline to a follow-up visit > 12 months (range: 18-24 months).

Results: The study population had a female preponderance (80%, n = 8), and mean age at diagnosis was 31.9 ± 10.3 years. Mean follow-up period was 21.2 months (range: 15-24 months). At presentation, 6/6 visual acuity was noted in 75% eyes (n = 15) while all eyes had 6/6 vision at the last follow-up. Average PR score increased from 1.96 ± 0.36 to 2.30 at the last visit (Wilcoxon test: V = 0.0, p ⩽ 0.001) while average SPARCS score (total) increased from 71.85 ± 9.10 to 77.55 ± 6.20 (Paired t-test: t = -2.3, p = 0.035). Change in SPARCS score was significant in average total score (p = 0.035), and quadrant-wise score in superonasal (p = 0.014), inferonasal (p = 0.001), and inferotemporal (p = 0.021) quadrants. Same trend in SPARCS scores was observed when eyes with and without recurrence were analyzed. Statistically significant difference in retinal nerve fiber layer (RNFL) thickness (p = 0.007) and macular thickness (MT) in nasal quadrant (p = 0.006) was seen between the eyes with recurrence and without recurrence.

Conclusion: Peripheral CS showed significant difference in all eyes over time. It showed significant change in eyes with recurrence, even in the presence of intact visual acuity and preserved central CS. Changes in RNFL thickness and nasal MT could differentiate eyes which developed recurrence from normal eyes.

背景:外周对比敏感度(CS)的下降可以作为检测特发性颅内高压(IIH)患者视觉功能进行性恶化的指标。目的:本研究的目的是评估IIH患者中央和外周CS和光学相干断层扫描(OCT)参数的变化。设计与方法:在本初步观察研究中,对10例“treatment-naïve”IIH患者20只眼的数据进行分析。进行详细的眼部检查,包括使用Pelli-Robson (PR)试验和spaath - richman对比敏感度试验(SPARCS)以及黄斑和视神经头(ONH)参数的OCT进行CS评估。比较分析CS和OCT参数从基线到随访> 12个月(范围:18-24个月)。结果:研究人群中女性占多数(80%,n = 8),平均诊断年龄为31.9±10.3岁。平均随访21.2个月(15 ~ 24个月)。入院时,75%的眼睛(n = 15)的视力为6/6,而最后一次随访时所有眼睛的视力均为6/6。平均PR评分从1.96±0.36上升至2.30 (Wilcoxon检验:V = 0.0, p < 0.001),平均SPARCS评分(总)从71.85±9.10上升至77.55±6.20(配对t检验:t = -2.3, p = 0.035)。SPARCS评分的平均总分变化显著(p = 0.035),鼻上(p = 0.014)、鼻间(p = 0.001)和颞下(p = 0.021)象限的象限评分变化显著。在分析有无复发的眼睛时,观察到SPARCS评分的相同趋势。复发眼与未复发眼的视网膜神经纤维层(RNFL)厚度(p = 0.007)和鼻象限黄斑厚度(MT) (p = 0.006)差异有统计学意义。结论:随着时间的推移,各眼周围CS均有显著差异。在复发的眼睛中,即使在视力完好和中央CS保存完好的情况下,它也显示出显著的变化。RNFL厚度和鼻MT的变化可以区分复发眼与正常眼。
{"title":"Change in contrast sensitivity and OCT parameters in idiopathic intracranial hypertension.","authors":"Obaidur Rehman,&nbsp;Parul Ichhpujani,&nbsp;Ekta Singla,&nbsp;Reetika Negi,&nbsp;Suresh Kumar","doi":"10.1177/25158414221083358","DOIUrl":"https://doi.org/10.1177/25158414221083358","url":null,"abstract":"<p><strong>Background: </strong>Deterioration in peripheral contrast sensitivity (CS) can be an indicator to detect progressive deterioration of visual function in patients with idiopathic intracranial hypertension (IIH).</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the changes in central and peripheral CS and optical coherence tomography (OCT) parameters and in patients with IIH.</p><p><strong>Design and methods: </strong>In this pilot observational study, data of 20 eyes of 10 'treatment-naïve' IIH patients were analyzed. Detailed ocular examination was performed including CS assessment using both Pelli-Robson (PR) test and Spaeth-Richman Contrast Sensitivity Test (SPARCS) along with the OCT for macular and optic nerve head (ONH) parameters. A comparative analysis was done for CS and OCT parameters from baseline to a follow-up visit > 12 months (range: 18-24 months).</p><p><strong>Results: </strong>The study population had a female preponderance (80%, <i>n</i> = 8), and mean age at diagnosis was 31.9 ± 10.3 years. Mean follow-up period was 21.2 months (range: 15-24 months). At presentation, 6/6 visual acuity was noted in 75% eyes (<i>n</i> = 15) while all eyes had 6/6 vision at the last follow-up. Average PR score increased from 1.96 ± 0.36 to 2.30 at the last visit (Wilcoxon test: <i>V</i> = 0.0, <i>p</i> ⩽ 0.001) while average SPARCS score (total) increased from 71.85 ± 9.10 to 77.55 ± 6.20 (Paired <i>t</i>-test: <i>t</i> = -2.3, <i>p</i> = 0.035). Change in SPARCS score was significant in average total score (<i>p</i> = 0.035), and quadrant-wise score in superonasal (<i>p</i> = 0.014), inferonasal (<i>p</i> = 0.001), and inferotemporal (<i>p</i> = 0.021) quadrants. Same trend in SPARCS scores was observed when eyes with and without recurrence were analyzed. Statistically significant difference in retinal nerve fiber layer (RNFL) thickness (<i>p</i> = 0.007) and macular thickness (MT) in nasal quadrant (<i>p</i> = 0.006) was seen between the eyes with recurrence and without recurrence.</p><p><strong>Conclusion: </strong>Peripheral CS showed significant difference in all eyes over time. It showed significant change in eyes with recurrence, even in the presence of intact visual acuity and preserved central CS. Changes in RNFL thickness and nasal MT could differentiate eyes which developed recurrence from normal eyes.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/52/10.1177_25158414221083358.PMC8935411.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40317837","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}
引用次数: 2
Quantitative assessment of retinal fluid in neovascular age-related macular degeneration under anti-VEGF therapy 抗vegf治疗下新生血管性年龄相关性黄斑变性视网膜液的定量评估
IF 2.5 Pub Date : 2022-03-01 DOI: 10.1177/25158414221083363
G. Reiter, U. Schmidt-Erfurth
The retinal world has been revolutionized by optical coherence tomography (OCT) and anti-vascular endothelial growth factor (VEGF) therapy. The numbers of intravitreal injections are on a constant rise and management in neovascular age-related macular degeneration (nAMD) is mainly driven by the qualitative assessment of macular fluid as detected on OCT scans. The presence of macular fluid, particularly subretinal fluid (SRF) and intraretinal fluid (IRF), has been used to trigger re-treatments in clinical trials and the real world. However, large discrepancies can be found between the evaluations of different readers or experts and especially small amounts of macular fluid might be missed during this process. Pixel-wise detection of macular fluid uses an entire OCT volume to calculate exact volumes of retinal fluid. While manual annotations of such pixel-wise fluid detection are unfeasible in a clinical setting, artificial intelligence (AI) is able to overcome this hurdle by providing real-time results of macular fluid in different retinal compartments. Quantitative fluid assessments have been used for various post hoc analyses of randomized controlled trials, providing novel insights into anti-VEGF treatment regimens. Nonetheless, the application of AI-algorithms in a prospective patient care setting is still limited. In this review, we discuss the use of quantitative fluid assessment in nAMD during anti-VEGF therapy and provide an outlook to novel forms of patient care with the support of AI quantifications.
光学相干断层扫描(OCT)和抗血管内皮生长因子(VEGF)治疗已经彻底改变了视网膜世界。玻璃体内注射的数量在不断增加,新血管性年龄相关性黄斑变性(nAMD)的治疗主要是由OCT扫描检测到的黄斑液的定性评估驱动的。黄斑液的存在,特别是视网膜下液(SRF)和视网膜内液(IRF),已被用于触发临床试验和现实世界中的再治疗。然而,不同的读者或专家的评价之间可能存在很大的差异,特别是在这个过程中可能会遗漏少量的黄斑液。逐像素检测黄斑液使用整个OCT体积来计算视网膜液的精确体积。虽然这种逐像素液体检测的手动注释在临床环境中是不可行的,但人工智能(AI)能够通过提供不同视网膜隔室中黄斑液体的实时结果来克服这一障碍。定量体液评估已用于随机对照试验的各种事后分析,为抗vegf治疗方案提供了新的见解。尽管如此,人工智能算法在未来患者护理环境中的应用仍然有限。在这篇综述中,我们讨论了在抗vegf治疗期间定量液体评估在nAMD中的应用,并展望了人工智能定量支持下的新型患者护理形式。
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引用次数: 4
Clinical profile and retinal nerve fibre layer thickness of optic disc oedema patients at a tertiary care institute in North India. 印度北部三级保健机构视盘水肿患者的临床概况和视网膜神经纤维层厚度。
IF 2.5 Pub Date : 2022-02-14 eCollection Date: 2022-01-01 DOI: 10.1177/25158414211072634
Gitanjli Sood, Ramanuj Samanta, Devesh Kumawat, Ajai Agrawal, Anupam Singh

Background: Optic disc oedema (ODE) is an important manifestation in various ocular as well as systemic disorders. Measurement of retinal nerve fibre layer (RNFL) thickness in ODE patients may help in monitoring the progress of the disease and treatment response.

Objective: To assess the clinical characteristics, aetiology and retinal nerve fibre layer (RNFL) imaging features of optic disc oedema (ODE) patients.

Design: A retrospective observational study.

Methods: This hospital-based study included performed for patients presenting with unilateral or bilateral ODE at the ophthalmology outpatient department of a tertiary institute between January 2019 and December 2019. Clinical features of all ODE patients were noted. RNFL thickness was measured by spectral-domain optical coherence tomography (Cirrus 500, Carl Zeiss Meditec, Dublin, CA, USA).

Results: Sixty-four patients with ODE were seen with female preponderance (56.2%). The mean age of presentation was 36.8 ± 13.8 years. Bilateral ODE was seen in 57.8% patients. The most common cause of bilateral ODE was idiopathic intracranial hypertension (IIH) and vascular papillopathy. Retinal vein occlusion (RVO)-associated ODE was the most common unilateral presentation. Presenting visual acuity was best with IIH and worst with anterior ischaemic optic neuropathy (AION). The mean duration of symptoms was maximum with intracranial space-occupying lesion associated papilloedema and minimum with AION. The mean RNFL thickness was highest in uveitis-associated ODE, followed by compressive ON, and IIH. A positive correlation was noted between clinical ODE severity and RNFL thickness. All aetiological categories (except uveitic and compressive) had maximum RNFL thickening in the inferior quadrant and minimum in the temporal quadrant.

Conclusion: The current study provides a clinical profile and RNFL measurements of ODE patients at this locality. The clinical severity of ODE correlated positively with RNFL thickness and most of the categories of ODE followed the normative pattern of RNFL thickness (inferior > superior > nasal > temporal) despite thickening.

背景:视盘水肿(ODE)是各种眼部及全身疾病的重要表现。测量ODE患者的视网膜神经纤维层(RNFL)厚度可能有助于监测疾病进展和治疗反应。目的:探讨视盘水肿(ODE)患者的临床特点、病因及视网膜神经纤维层(RNFL)影像学特征。设计:回顾性观察性研究。方法:这项以医院为基础的研究纳入了2019年1月至2019年12月在某大专院校眼科门诊就诊的单侧或双侧ODE患者。记录所有ODE患者的临床特征。采用光谱域光学相干断层扫描(Cirrus 500, Carl Zeiss Meditec, Dublin, CA, USA)测量RNFL厚度。结果:64例ODE患者中,女性居多(56.2%)。平均发病年龄36.8±13.8岁。57.8%的患者出现双侧ODE。双侧ODE最常见的原因是特发性颅内高压(IIH)和血管乳头病。视网膜静脉阻塞(RVO)相关的ODE是最常见的单侧表现。IIH患者表现视力最佳,前缺血性视神经病变(AION)最差。症状的平均持续时间在颅内占位性病变相关的乳头状水肿中最长,在AION中最短。uvetis相关性ODE的RNFL平均厚度最高,其次是压缩性ON和IIH。临床ODE严重程度与RNFL厚度呈正相关。所有病因分类(除了葡萄膜和压缩)下象限RNFL增厚最大,颞象限最小。结论:目前的研究提供了该地区ODE患者的临床概况和RNFL测量。ODE的临床严重程度与RNFL厚度呈正相关,尽管增厚,但大多数ODE的RNFL厚度均符合标准模式(下>上>鼻>颞)。
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引用次数: 1
期刊
Therapeutic Advances in Ophthalmology
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