Pub Date : 2022-08-02DOI: 10.9734/or/2022/v17i230251
M. Nivetha
Background and Objectives: Uveitis is a potentially sight-threatening disease affecting people from all over the world. It attributes to 5-20% of legal blindness in developed countries and 25% of blindness in the developing world. Uveitis includes a varied group of intraocular inflammatory conditions that may occur at any age but affect mostly working-age people. The average annual incidence of uveitis has been reported as approximately 14- 17/1,00,000. Aim is to study the clinical and etiological pattern of anterior uveitis. Objectives are to evaluate the clinical pattern of anterior uveitis, to study the etiological pattern of anterior uveitis, to identify the complications of anterior uveitis, to assess the treatment outcome. Methods: A prospective clinical study was done in the Department of Ophthalmology, Rourkela, Odisha during September 2019 - March 2021 (18 months)between the age group of 20-80 years. Each patient was called for follow up on 1st day, 2nd day, 1 week, 3 weeks, 6 weeks from the day of presentation The complications like posterior synechiae, complicated cataract, raised IOP, macular edema were noted and the response to treatment was recorded and evaluated in each patient. Results and conclusion: Despite all efforts to identify the cause, the most common cause of anterior uveitis remained idiopathic (48.6% ) followed by immune related cause (20.3%). Visual acuity was 6/12 or worse in majority of the patients at presentation and following medical line of treatment most patients regained visual acuity of 6/9 or better after 6 weeks, which was statistically significant (p<0.0001).
{"title":"Study of Clinical and Etiological Pattern of Anterior Uveitis in Western Odisha","authors":"M. Nivetha","doi":"10.9734/or/2022/v17i230251","DOIUrl":"https://doi.org/10.9734/or/2022/v17i230251","url":null,"abstract":"Background and Objectives: Uveitis is a potentially sight-threatening disease affecting people from all over the world. It attributes to 5-20% of legal blindness in developed countries and 25% of blindness in the developing world. Uveitis includes a varied group of intraocular inflammatory conditions that may occur at any age but affect mostly working-age people. The average annual incidence of uveitis has been reported as approximately 14- 17/1,00,000. Aim is to study the clinical and etiological pattern of anterior uveitis. Objectives are to evaluate the clinical pattern of anterior uveitis, to study the etiological pattern of anterior uveitis, to identify the complications of anterior uveitis, to assess the treatment outcome. Methods: A prospective clinical study was done in the Department of Ophthalmology, Rourkela, Odisha during September 2019 - March 2021 (18 months)between the age group of 20-80 years. Each patient was called for follow up on 1st day, 2nd day, 1 week, 3 weeks, 6 weeks from the day of presentation The complications like posterior synechiae, complicated cataract, raised IOP, macular edema were noted and the response to treatment was recorded and evaluated in each patient. Results and conclusion: Despite all efforts to identify the cause, the most common cause of anterior uveitis remained idiopathic (48.6% ) followed by immune related cause (20.3%). Visual acuity was 6/12 or worse in majority of the patients at presentation and following medical line of treatment most patients regained visual acuity of 6/9 or better after 6 weeks, which was statistically significant (p<0.0001).","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130178451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-29DOI: 10.9734/or/2022/v17i130249
Girish A. Gadre, Prashant Bulchandani
Aim: Retrospective study of 74 eyes with open globe injuries requiring V-R Intervention & its correlation with ocular trauma score. Results: Commonest cause of injury: Hammer-chisel/stone in 32.43% (24) & Thorn/wooden stick 27% (20). Average age-30.5yrs. Average interval between trauma & intervention was -10.04days (4hrs – 52days). Discussion: Delay of presentation to ophthalmologist has lot of significance,high incidence of endophthalmitis & retinal detachment compared to other studies. Surgical outcome shows lower incidence of NO Light Perception & Significant reduction in number of cases with 20/200. 60% of our cases had traumatic cataract, visual acuity may be underestimated in traumatic cataract. Faulty Projection of rays probably would be better criteria than RAPD. Extension of wound beyond pars plana, and aniridia (6.7%) are important risk factor. Conclusion: Modification of raw points is recommended in OTS criteria in Indian scenario.
{"title":"Analysis of 74 Open Globe Injuries Requiring Vitreo-Retinal Intervention and Its Correlation with Ocular Trauma Score","authors":"Girish A. Gadre, Prashant Bulchandani","doi":"10.9734/or/2022/v17i130249","DOIUrl":"https://doi.org/10.9734/or/2022/v17i130249","url":null,"abstract":"Aim: Retrospective study of 74 eyes with open globe injuries requiring V-R Intervention & its correlation with ocular trauma score. \u0000Results: Commonest cause of injury: Hammer-chisel/stone in 32.43% (24) & Thorn/wooden stick 27% (20). Average age-30.5yrs. Average interval between trauma & intervention was -10.04days (4hrs – 52days). \u0000Discussion: Delay of presentation to ophthalmologist has lot of significance,high incidence of endophthalmitis & retinal detachment compared to other studies. Surgical outcome shows lower incidence of NO Light Perception & Significant reduction in number of cases with </=HM. Patients had better prognosis & visual outcome, higher incidence of 1/200- 20/50; 35.14% cases with >20/200. 60% of our cases had traumatic cataract, visual acuity may be underestimated in traumatic cataract. Faulty Projection of rays probably would be better criteria than RAPD. Extension of wound beyond pars plana, and aniridia (6.7%) are important risk factor. \u0000Conclusion: Modification of raw points is recommended in OTS criteria in Indian scenario.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133229916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A rare case of symptomatic Rathke cleft cyst resulting in severe visual compromise in a young 45 yr/f who presented with gradual progressive painless diminution of vision in both eyes. Patient noticed diminution of vision in the Left eye an year ago and later on in the Right eye for which she consulted ophthalmologists. She was diagnosed as optic neuritis and underwent treatment for the same, but vision didn’t improve. At presentation,vision in Both eyes was same, counting fingers at 2 meters. Pupillary reactions were normal, however there was bilateral disc pallor and rest fundus was normal. On systemic evaluation patient gave history of irregular menstrual periods since 3-4 months. on further investigation her S. Prolactin levels were markedly raised(59.99ng/ml). Radiology showed well defined hyperintense suprasellar lesion. Patient was operated for right frontotemporal craniotomy with decompression of RCCs by a neurosurgeon. 2 months post surgery visual acuity in RE 4/60 and LE is counting finger close to face.
{"title":"Rare Case of Misdiagnosed Rathke Pouch Cleft Leading to Severe Visual Loss","authors":"Pradeep Tekade, Prashant Bulchandani, Nikhilesh Wairagade","doi":"10.9734/or/2022/v17i130248","DOIUrl":"https://doi.org/10.9734/or/2022/v17i130248","url":null,"abstract":"A rare case of symptomatic Rathke cleft cyst resulting in severe visual compromise in a young 45 yr/f who presented with gradual progressive painless diminution of vision in both eyes. Patient noticed diminution of vision in the Left eye an year ago and later on in the Right eye for which she consulted ophthalmologists. She was diagnosed as optic neuritis and underwent treatment for the same, but vision didn’t improve. At presentation,vision in Both eyes was same, counting fingers at 2 meters. Pupillary reactions were normal, however there was bilateral disc pallor and rest fundus was normal. On systemic evaluation patient gave history of irregular menstrual periods since 3-4 months. on further investigation her S. Prolactin levels were markedly raised(59.99ng/ml). Radiology showed well defined hyperintense suprasellar lesion. Patient was operated for right frontotemporal craniotomy with decompression of RCCs by a neurosurgeon. 2 months post surgery visual acuity in RE 4/60 and LE is counting finger close to face.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129629752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-22DOI: 10.9734/or/2022/v17i130247
Aikaterini E. Mouzaka, Themistoklis K. Gialelis, Haris Sideroudi, K. Tsakiris, Vassilios P. Kozobolis
Aims: The aim of this study is to compare corneal parameters in: central corneal thickness (CCT), thinnest corneal thickness (TCT), mean radius of curvature (Rm) and anterior chamber depth (ACD) obtained from Pentacam Schiempflug and OCT Tomography imaging which are checked preoperatively and six months postoperatively after LASIK surgery. Methodology: Our sample consisted of 40 eyes. Changes in corneal dimensions were monitored before and after LASIK surgery using scheimpflug tomography (Pentacam HR) and optical coherence tomography (OCT). The parameters measured were CCT, TCT, Rm and the ACD. The results between the two techniques were compared with the Bland-Altman method. Results: During the analysis of the results, a statistically significant difference was observed between the two techniques in terms of the preoperative CCT as well as the TCT both preoperatively and postoperatively. Scheimpflug tomography gives higher values of the CCT than OCT, up to thickness 530nm, while above this it seems that OCT overestimates the thickness of the cornea. Scheimpflug tomography at the TCT seems to give higher values than OCT tomography, up to thickness 520 nm, while above that it seems that OCT tomography overestimates TCT. We have similar results postoperatively for TCT. The two techniques agree on the ACD and the Rm rating. Conclusion: How converging or different the two imaging devices are because it is important for both clinical practice and research may be a point of reference for starting a new research.
{"title":"Use of Scheimpflug Tomography and OCT Tomography to Examine Corneal Dimensional and Anterior Chamber Depth before and after LASIK Surgery","authors":"Aikaterini E. Mouzaka, Themistoklis K. Gialelis, Haris Sideroudi, K. Tsakiris, Vassilios P. Kozobolis","doi":"10.9734/or/2022/v17i130247","DOIUrl":"https://doi.org/10.9734/or/2022/v17i130247","url":null,"abstract":"Aims: The aim of this study is to compare corneal parameters in: central corneal thickness (CCT), thinnest corneal thickness (TCT), mean radius of curvature (Rm) and anterior chamber depth (ACD) obtained from Pentacam Schiempflug and OCT Tomography imaging which are checked preoperatively and six months postoperatively after LASIK surgery. \u0000Methodology: Our sample consisted of 40 eyes. Changes in corneal dimensions were monitored before and after LASIK surgery using scheimpflug tomography (Pentacam HR) and optical coherence tomography (OCT). The parameters measured were CCT, TCT, Rm and the ACD. The results between the two techniques were compared with the Bland-Altman method. \u0000Results: During the analysis of the results, a statistically significant difference was observed between the two techniques in terms of the preoperative CCT as well as the TCT both preoperatively and postoperatively. \u0000Scheimpflug tomography gives higher values of the CCT than OCT, up to thickness 530nm, while above this it seems that OCT overestimates the thickness of the cornea. Scheimpflug tomography at the TCT seems to give higher values than OCT tomography, up to thickness 520 nm, while above that it seems that OCT tomography overestimates TCT. We have similar results postoperatively for TCT. \u0000The two techniques agree on the ACD and the Rm rating. \u0000Conclusion: How converging or different the two imaging devices are because it is important for both clinical practice and research may be a point of reference for starting a new research.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114483573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case of Ischemic Central retinal vein occlusion (CRVO) caused by hypertension secondary to renal failure in IgA nephropathy. A 17 year old male came with chief complaints of sudden painless diminution of vision in RE since 15 days. On examination the Right eye showed multiple superficial retinal haemorrhages in all 4 quadrents with dilated veins and cystoid macular edema suggestive of CRVO and Left eye showed superficial flame shaped haemorrhage suggestive of grade 3 hypertensive changes.
{"title":"Central Retinal Vein Occlusion as a Presenting Feature Caused by Hypertensive Crisis Secondary to IgA Nephropathy in a Previously Undiagnosed Young Patient","authors":"Pradeep Tekade, Prashant Bulchandani, Nikhilesh Wairagade","doi":"10.9734/or/2022/v17i130246","DOIUrl":"https://doi.org/10.9734/or/2022/v17i130246","url":null,"abstract":"We present a case of Ischemic Central retinal vein occlusion (CRVO) caused by hypertension secondary to renal failure in IgA nephropathy. A 17 year old male came with chief complaints of sudden painless diminution of vision in RE since 15 days. On examination the Right eye showed multiple superficial retinal haemorrhages in all 4 quadrents with dilated veins and cystoid macular edema suggestive of CRVO and Left eye showed superficial flame shaped haemorrhage suggestive of grade 3 hypertensive changes.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130322735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-19DOI: 10.9734/or/2022/v17i130245
Najat Belkheir, Adam Albarghathi, Ghait Alsdae, Faraj Alshwin, G. Duweb
Vitiligo is a pigmentary disorder of the skin and mucous membranes with worldwide incidence of 0.5-2%. The aim of this cross sectional study was to assess the ocular involvement in vitiligo patients. Two hundred patients clinically diagnosed vitiligo attending vitiligo clinic, dermatology department, Jomhorya hospital, Benghazi-Libya over a period of 6 months enrolled in this cross-sectional study. All patients were exposed to detailed disease history and thorough dermatological examination. Out of the total cases, 100 patients had a standard Ophthalmologic examination in cooperation with an ophthalmologist in Benghazi eye hospital. Results of our study showed a slightly higher prevalence of vitiligo in females (male: female ratio 1:2.8). The mean age of onset for males was 22.4 years and for females 24.8 years and 58.5% of patients develop vitiligo below 20 years of age. Generalized vitiligo was the commonest clinical type of vitiligo (57.5%). The relationship between the duration of the disease and its type was statistically significant (P<0.05), there was also a significant relationship between the type of vitiligo and its severity (P< 0.01). Sixteen patients (8%) had segmental vitiligo and the face was the common site involved. The lower limbs were the most commonly affected sites of the body (57%). Ocular changes were seen in 40% of patients and specific ocular abnormalities like uveitis, iritis, and iris and retinal pigmentary abnormalities are present in 15% of patients, nonspecific ocular abnormalities were present in 33% of patients. There was no statistically significant correlation between specific ocular abnormalities, severity and duration of vitiligo.
{"title":"Evaluation of Ocular Findings in Vitiligo","authors":"Najat Belkheir, Adam Albarghathi, Ghait Alsdae, Faraj Alshwin, G. Duweb","doi":"10.9734/or/2022/v17i130245","DOIUrl":"https://doi.org/10.9734/or/2022/v17i130245","url":null,"abstract":"Vitiligo is a pigmentary disorder of the skin and mucous membranes with worldwide incidence of 0.5-2%. The aim of this cross sectional study was to assess the ocular involvement in vitiligo patients. Two hundred patients clinically diagnosed vitiligo attending vitiligo clinic, dermatology department, Jomhorya hospital, Benghazi-Libya over a period of 6 months enrolled in this cross-sectional study. All patients were exposed to detailed disease history and thorough dermatological examination. Out of the total cases, 100 patients had a standard Ophthalmologic examination in cooperation with an ophthalmologist in Benghazi eye hospital. Results of our study showed a slightly higher prevalence of vitiligo in females (male: female ratio 1:2.8). The mean age of onset for males was 22.4 years and for females 24.8 years and 58.5% of patients develop vitiligo below 20 years of age. Generalized vitiligo was the commonest clinical type of vitiligo (57.5%). The relationship between the duration of the disease and its type was statistically significant (P<0.05), there was also a significant relationship between the type of vitiligo and its severity (P< 0.01). Sixteen patients (8%) had segmental vitiligo and the face was the common site involved. The lower limbs were the most commonly affected sites of the body (57%). Ocular changes were seen in 40% of patients and specific ocular abnormalities like uveitis, iritis, and iris and retinal pigmentary abnormalities are present in 15% of patients, nonspecific ocular abnormalities were present in 33% of patients. There was no statistically significant correlation between specific ocular abnormalities, severity and duration of vitiligo.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"213 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133709620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-16DOI: 10.9734/or/2022/v16i430244
Jui-Teng Lin
Purpose: To derive and provide, for the first time, comprehensive analytic formulas for scleral softening volume efficacy (SVE) for accommodative gain (AG) via the increased space between ciliary body and lens (SCL) and mobility of the posterior vitreous zonules (PVZ). Study Design: To increase the AG of presbyopic eye by a new procedure, laser scleral softening (LSS). Place and Duration of Study: New Taipei City, Taiwan, between June 2022 and July 2022. Methodology: The SVE is calculated based on the time and spatial integral of the scleral temperature profiles, T(z,t), solutions of a heat diffusion equation. Analytic formulas for SVE is derived based on the covered area given by a triangle area. The SVE of a 3-D model is governed by the "volume" covered by the laser beam, or its spot size area, the effective penetration depth (z"), which is an increasing function of laser dose, but a decreasing function of the absorption coefficient (A), due to the Beer's law of laser intensity, I(z)=I0exp(-Az). The efficacy depth-range (dZ) and time-ranges (dT) are defined for efficient softening with T(z,t)>T*, where T* is the scleral softening threshold temperature. Results: The accommodative gain is proportional to the 3-D SVE given by: SEV(3D) = SEV(1D) x laser beam spot (2-D area) x total number of spots (N) acting on the sclera, which is proportional to the efficacy ranges dZ and dT, in which dZ is an increasing of laser irradiation time, whereas dT is a decreasing function of depth. Softening of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of SVE and the PVZ and SCL changes require measured data. Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. The SVE is proportional to the efficacy depth-range (dZ) and time-range (dT), in which dZ is an increasing of laser irradiation time and dT is a decreasing function of depth. The AG is proportional to the SVE(in 3-D).
{"title":"Accommodative Gain in Presbyopic Eye Using a New Procedure of Laser Scleral Softening (LSS): Part-II. Formulas for Volume Efficacy","authors":"Jui-Teng Lin","doi":"10.9734/or/2022/v16i430244","DOIUrl":"https://doi.org/10.9734/or/2022/v16i430244","url":null,"abstract":"Purpose: To derive and provide, for the first time, comprehensive analytic formulas for scleral softening volume efficacy (SVE) for accommodative gain (AG) via the increased space between ciliary body and lens (SCL) and mobility of the posterior vitreous zonules (PVZ). \u0000Study Design: To increase the AG of presbyopic eye by a new procedure, laser scleral softening (LSS). \u0000Place and Duration of Study: New Taipei City, Taiwan, between June 2022 and July 2022. \u0000Methodology: The SVE is calculated based on the time and spatial integral of the scleral temperature profiles, T(z,t), solutions of a heat diffusion equation. Analytic formulas for SVE is derived based on the covered area given by a triangle area. The SVE of a 3-D model is governed by the \"volume\" covered by the laser beam, or its spot size area, the effective penetration depth (z\"), which is an increasing function of laser dose, but a decreasing function of the absorption coefficient (A), due to the Beer's law of laser intensity, I(z)=I0exp(-Az). The efficacy depth-range (dZ) and time-ranges (dT) are defined for efficient softening with T(z,t)>T*, where T* is the scleral softening threshold temperature. \u0000Results: The accommodative gain is proportional to the 3-D SVE given by: SEV(3D) = SEV(1D) x laser beam spot (2-D area) x total number of spots (N) acting on the sclera, which is proportional to the efficacy ranges dZ and dT, in which dZ is an increasing of laser irradiation time, whereas dT is a decreasing function of depth. Softening of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of SVE and the PVZ and SCL changes require measured data. \u0000Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. The SVE is proportional to the efficacy depth-range (dZ) and time-range (dT), in which dZ is an increasing of laser irradiation time and dT is a decreasing function of depth. The AG is proportional to the SVE(in 3-D).","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130735667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-16DOI: 10.9734/or/2022/v16i430243
Jui-Teng Lin
Purpose: To derive and provide analytic formulas and proposed protocol for accommodative gain of presbyopia eyes via laser scleral softening, which causes increased space between ciliary body and lens (SCL) and mobility of the posterior vitreal zonules (PVZ). Study Design: To increase the accommodation of presbyopia by laser scleral heating/softening. Place and Duration of Study: New Taipei City, Taiwan, between April 2022 and June 2022. Purpose: To analyze the safety and efficacy of presbyopia treatment via scleral softening. Methodology: The scleral softening efficacy is calculated based on the rate equation of scleral tissue with a rate coefficient given by an Arrhenius formula, Temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including tissue damage depth, temperature penetration depth and conversion depth, governed by tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law. Results: Given the the temperature spatial and temporal profiles, scleral softening efficacy can be calculated. Scleral surface damage can be prevented by cooling window. The suggested protocol for scleral softening treatments include: a diode laser at about 1.45 to 1.5 µm or about 1.86 to1.9 µm, or about 2.0 to 2.15 µm, wavelength (with absorption coefficient about 20 to 100 cm-1); laser power about 0.2 to 0.8 W per spot, having a total of 4 to 16 spots; and irradiation time of 100 to 600 ms. Results of corneal thermal shrinkage are demonstrated by the topography changes of pig eyes, in which the scleral softening does not affect the corneal shapes. The accommodative gain is proportional to the softening efficacy (Seff) of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of Seff and the PVZ and SCL changes require measured data. Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. By choosing the laser treated areas, a dual function treatment using scleral softening for presbyopia, and cornea stromal shrinkage for hyperopia is proposed and demonstrated by topography of pig eyes.
目的:推导并提供激光巩膜软化治疗老花眼的解析公式和建议方案，该方法可导致睫状体与晶状体之间的间距增加和玻璃体后带(PVZ)的移动。研究设计:通过激光巩膜加热/软化来增加对老花眼的调节。学习地点及时间:台湾新北市，2022年4月至2022年6月。目的:分析巩膜软化术治疗老花眼的安全性和有效性。方法:根据巩膜组织的速率方程，用Arrhenius公式给出速率系数，计算巩膜软化效果，用带体积热源的热扩散方程的数值解给出温度时空分布。根据比尔定律，引入各种有效深度，包括组织损伤深度、温度穿透深度和转化深度，这些有效深度由组织吸收系数、光强和剂量(或照射时间)以及相关阈值决定，以取代传统的穿透深度。结果:在给定温度时空分布的情况下，可以计算出巩膜软化效果。冷却窗可防止巩膜表面损伤。巩膜软化治疗的建议方案包括:波长约1.45至1.5µm或约1.86至1.9µm或约2.0至2.15µm的二极管激光器(吸收系数约20至100 cm-1);激光功率约为0.2 ~ 0.8 W /个光斑，共有4 ~ 16个光斑;辐照时间为100 ~ 600ms。猪眼的地形变化证实了角膜热收缩的结果，其中巩膜软化不影响角膜形状。热激光照射后，调节增益与巩膜组织的软化效率(Seff)成正比，导致PVZ迁移率和SCL增加。但是，Seff与PVZ和SCL变化的实际关系需要实测数据。结论:巩膜软化治疗老花眼的安全性和有效性取决于激光参数(强度、剂量、光斑大小、波长)和有效深度。通过对激光治疗区域的选择，提出了采用巩膜软化治疗老花眼和角膜间质收缩治疗远视的双重功能治疗方法，并通过猪眼的地形图进行了验证。
{"title":"Efficacy Theory and Proposed Protocol for Presbyopia Correction using Scleral Softening by Non-invasive Infrared Diode Lasers","authors":"Jui-Teng Lin","doi":"10.9734/or/2022/v16i430243","DOIUrl":"https://doi.org/10.9734/or/2022/v16i430243","url":null,"abstract":"Purpose: To derive and provide analytic formulas and proposed protocol for accommodative gain of presbyopia eyes via laser scleral softening, which causes increased space between ciliary body and lens (SCL) and mobility of the posterior vitreal zonules (PVZ). \u0000Study Design: To increase the accommodation of presbyopia by laser scleral heating/softening. \u0000Place and Duration of Study: New Taipei City, Taiwan, between April 2022 and June 2022. \u0000Purpose: To analyze the safety and efficacy of presbyopia treatment via scleral softening. \u0000Methodology: The scleral softening efficacy is calculated based on the rate equation of scleral tissue with a rate coefficient given by an Arrhenius formula, Temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including tissue damage depth, temperature penetration depth and conversion depth, governed by tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law. \u0000Results: Given the the temperature spatial and temporal profiles, scleral softening efficacy can be calculated. Scleral surface damage can be prevented by cooling window. The suggested protocol for scleral softening treatments include: a diode laser at about 1.45 to 1.5 µm or about 1.86 to1.9 µm, or about 2.0 to 2.15 µm, wavelength (with absorption coefficient about 20 to 100 cm-1); laser power about 0.2 to 0.8 W per spot, having a total of 4 to 16 spots; and irradiation time of 100 to 600 ms. Results of corneal thermal shrinkage are demonstrated by the topography changes of pig eyes, in which the scleral softening does not affect the corneal shapes. The accommodative gain is proportional to the softening efficacy (Seff) of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of Seff and the PVZ and SCL changes require measured data. \u0000Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. By choosing the laser treated areas, a dual function treatment using scleral softening for presbyopia, and cornea stromal shrinkage for hyperopia is proposed and demonstrated by topography of pig eyes.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128189229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-13DOI: 10.9734/or/2022/v16i430242
Priyanka Patel, Prabha Sonwani, Suchita Singh
Primary open-angle glaucoma (POAG), also known as chronic simple glaucoma, is usually an inherited disease. Inheritance is considered multifunctional and polygenic. Glaucoma is the second leading cause of irreversible blindness worldwide, of which POAG is the most common. First-degree relatives of POAG patients are at increased risk. A reasonable risk for siblings is four and twice the risk of the normal population for the offspring, although the number of surveys varies. This case series of eight family members with POAG illustrates the stealth nature of POAG and the devastating vision loss it can cause as it progresses; emphasizing regular and comprehensive eye examinations during its early stage.
{"title":"Familial Primary Open Angle Glaucoma","authors":"Priyanka Patel, Prabha Sonwani, Suchita Singh","doi":"10.9734/or/2022/v16i430242","DOIUrl":"https://doi.org/10.9734/or/2022/v16i430242","url":null,"abstract":"Primary open-angle glaucoma (POAG), also known as chronic simple glaucoma, is usually an inherited disease. Inheritance is considered multifunctional and polygenic. Glaucoma is the second leading cause of irreversible blindness worldwide, of which POAG is the most common. First-degree relatives of POAG patients are at increased risk. A reasonable risk for siblings is four and twice the risk of the normal population for the offspring, although the number of surveys varies. This case series of eight family members with POAG illustrates the stealth nature of POAG and the devastating vision loss it can cause as it progresses; emphasizing regular and comprehensive eye examinations during its early stage.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124743046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-05DOI: 10.9734/or/2022/v16i430240
Johan A. Hutauruk, T. Gondhowiardjo, .. Suhardjo, M. B. Sasongko
Aims: In this study, we aimed to investigate the intercorrelations between tear film break up time, measured non-invasively using non-invasive keratographic break-up time (NIKBUT), higher order aberrations (HOA) and quality of vision (QoV) in pseudophakic patients. Study Design: Cross-sectional. Methods: Thirty-five pseudophakic aged patients aged 50 years or older, and 35 control phakic patients aged 17 to 23 years with corrected visual acuity of 20/20 were included in this study. All subjects underwent similar examination including QoV questionnaire, aberrometry to measure HOA, and NIKBUT. HOA was measured with the OPD-Scan/ ARK 10000 corneal analyzer (Nidek CO. Ltd), expressed as Root Mean Square (RMS) HOA and NIKBUT was assessed using non-invasive TF-Scan module Keratograph 5M (K5M), equipped with modified tear film scanning function (Oculus, Wetzlar, Germany). Statistical analysis was performed to find the correlation between NIKBUT, HOA and QoV. Results: Patients in the pseudophakic group were significantly older (median age 66 vs. 20 years; P<0.01), had shorter NIKBUT (10.5 vs. 17.2; P<0.01), lower QoV score (1.63 vs. 0.68; P=0.04), and higher RMS HOA (0.5 vs. 0.26; P<0.01) compared to control group. NIKBUT was inversely correlated with RMS HOA (r = -0.19; p = 0.03) and RMS HOA was significantly correlated with QoV, even after adjustment for age and gender (r = -0.21; P0.04). NIKBUT <9.93s was correlated with lower QoV. The area under the curve was 0.81 (95% CI = 0.67 – 0.95, p = 0.012), and had 100% sensitivity and 61% specificity. Conclusion: Shorter NIKBUT was correlated with greater HOA and greater HOA was correlated with lower QoV. NIKBUT value of shorter than 9.93s could potentially predict pseudophakic patients who will likely experience visual symptoms leading to decreased QoV; thus, the use of artificial tears might be beneficial.
目的:在本研究中，我们旨在探讨泪膜破裂时间(使用无创角膜成像破裂时间(NIKBUT)无创测量)、高阶像差(HOA)和视力质量(QoV)之间的相互关系。研究设计:横断面。方法:选取年龄在50岁及以上的35例老年假性晶状体患者和35例年龄在17 ~ 23岁，矫正视力为20/20的对照晶状体患者。所有受试者均进行了类似的检查，包括QoV问卷、像差法测量HOA和NIKBUT。HOA使用OPD-Scan/ ARK 10000角膜分析仪(Nidek CO. Ltd)测量，表示为均方根HOA (RMS)， NIKBUT使用无创TF-Scan模块Keratograph 5M (K5M)评估，配备改进的泪膜扫描功能(Oculus, Wetzlar，德国)。执行统计分析发现NIKBUT之间的相关性,阿花和QoV。结果:假性晶状体组患者明显老年化(中位年龄66岁vs. 20岁;P<0.01)， NIKBUT较短(10.5 vs. 17.2;P < 0.01),降低QoV得分(1.63和0.68;P=0.04)，较高的RMS HOA (0.5 vs. 0.26;P<0.01)。NIKBUT与RMS HOA呈负相关(r = -0.19;p = 0.03)和RMS与QoV肥厚性骨关节病变与肺部转移显著相关,即使调整年龄和性别(r = -0.21;P0.04)。NIKBUT <9.93s与较低的QoV相关。曲线下面积为0.81 (95% CI = 0.67 ~ 0.95, p = 0.012)，敏感性为100%，特异性为61%。结论:NIKBUT越短，HOA越大，QoV越低。NIKBUT值小于9.93s可以潜在地预测可能出现视觉症状导致QoV下降的假性失视患者;因此，使用人工泪液可能是有益的。
{"title":"Correlations between Quality of Vision, Higher Order Aberrations and Non-Invasive Keratographic Tear Film Break-Up Time in Pseudophakic Eyes after Uncomplicated Phacoemulsification","authors":"Johan A. Hutauruk, T. Gondhowiardjo, .. Suhardjo, M. B. Sasongko","doi":"10.9734/or/2022/v16i430240","DOIUrl":"https://doi.org/10.9734/or/2022/v16i430240","url":null,"abstract":"Aims: In this study, we aimed to investigate the intercorrelations between tear film break up time, measured non-invasively using non-invasive keratographic break-up time (NIKBUT), higher order aberrations (HOA) and quality of vision (QoV) in pseudophakic patients. \u0000Study Design: Cross-sectional. \u0000Methods: Thirty-five pseudophakic aged patients aged 50 years or older, and 35 control phakic patients aged 17 to 23 years with corrected visual acuity of 20/20 were included in this study. All subjects underwent similar examination including QoV questionnaire, aberrometry to measure HOA, and NIKBUT. HOA was measured with the OPD-Scan/ ARK 10000 corneal analyzer (Nidek CO. Ltd), expressed as Root Mean Square (RMS) HOA and NIKBUT was assessed using non-invasive TF-Scan module Keratograph 5M (K5M), equipped with modified tear film scanning function (Oculus, Wetzlar, Germany). Statistical analysis was performed to find the correlation between NIKBUT, HOA and QoV. \u0000Results: Patients in the pseudophakic group were significantly older (median age 66 vs. 20 years; P<0.01), had shorter NIKBUT (10.5 vs. 17.2; P<0.01), lower QoV score (1.63 vs. 0.68; P=0.04), and higher RMS HOA (0.5 vs. 0.26; P<0.01) compared to control group. NIKBUT was inversely correlated with RMS HOA (r = -0.19; p = 0.03) and RMS HOA was significantly correlated with QoV, even after adjustment for age and gender (r = -0.21; P0.04). NIKBUT <9.93s was correlated with lower QoV. The area under the curve was 0.81 (95% CI = 0.67 – 0.95, p = 0.012), and had 100% sensitivity and 61% specificity. \u0000Conclusion: Shorter NIKBUT was correlated with greater HOA and greater HOA was correlated with lower QoV. NIKBUT value of shorter than 9.93s could potentially predict pseudophakic patients who will likely experience visual symptoms leading to decreased QoV; thus, the use of artificial tears might be beneficial.","PeriodicalId":287685,"journal":{"name":"Ophthalmology Research: An International Journal","volume":"368 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133635140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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