Pub Date : 2021-07-29DOI: 10.35119/ASJOO.V18I1.918
Miao Yunn Lim, K. Ong
Purpose: For over 10 years, there have been zero cases of postoperative endophthalmitis (POE) after cataract surgery at Chatswood Private Hospital (CPH), Sydney, Australia. Study design: We conducted a retrospective audit study to evaluate the reasons for this, as well as the different preferences for route of antibiotic prophylaxis used. Methods: Deidentified data on cataract surgery cases for 2010–2020 were extracted and analyzed descriptively. Results: A total of 28,937 cataract surgery cases were performed at CPH from 2010-2020, for which no cases of POE were identified. The intracameral route for antibiotic prophylaxis was more commonly used compared to subconjunctival or both. Conclusion: Administration of prophylactic antibiotics, regardless of the route of administration, is beneficial and equally effective in preventing POE. Having operating theatres dedicated to ophthalmology helps maintain high standards of sterility of instrumentation and operating environments.
{"title":"Is zero incidence of postoperative endophthalmitis after cataract surgery achievable","authors":"Miao Yunn Lim, K. Ong","doi":"10.35119/ASJOO.V18I1.918","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.918","url":null,"abstract":"Purpose: For over 10 years, there have been zero cases of postoperative endophthalmitis (POE) after cataract surgery at Chatswood Private Hospital (CPH), Sydney, Australia. \u0000Study design: We conducted a retrospective audit study to evaluate the reasons for this, as well as the different preferences for route of antibiotic prophylaxis used. \u0000Methods: Deidentified data on cataract surgery cases for 2010–2020 were extracted and analyzed descriptively. \u0000Results: A total of 28,937 cataract surgery cases were performed at CPH from 2010-2020, for which no cases of POE were identified. The intracameral route for antibiotic prophylaxis was more commonly used compared to subconjunctival or both. \u0000Conclusion: Administration of prophylactic antibiotics, regardless of the route of administration, is beneficial and equally effective in preventing POE. Having operating theatres dedicated to ophthalmology helps maintain high standards of sterility of instrumentation and operating environments.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42322282","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.967
K. Ong
{"title":"Is indiscriminate use of intracameral prophylactic antibiotics in cataract surgery appropriate","authors":"K. Ong","doi":"10.35119/ASJOO.V18I1.967","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.967","url":null,"abstract":"","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43145326","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.922
Rachel Xuan, Elizabeth L S Wong, K. Ong
Background: There has been an increase in the use of routine intracameral antibiotics for endophthalmitis prophylaxis in cataract surgery. However, this can be associated with serious adverse events. Previously, subconjunctival antibiotics were the preferred route but there is minimal literature directly comparing the two. Hence, the safest and most efficacious route of prophylactic antibiotic administration remains controversial. Purpose: To evaluate the efficacy and safety of subconjunctival with intracameral antibiotics for postoperative endophthalmitis (POE) prophylaxis in patients undergoing uncomplicated cataract surgery. Methods: A literature review was conducted in Cochrane and PubMed for studies that compared the efficacy of prophylactic subconjunctival and intracameral antibiotics for post-cataract endophthalmitis. Searches were not limited to English or study design. Results: Three observational studies showed that subconjunctival and intracameral antibiotics both reduced POE rates. Intracameral antibiotics demonstrated a high efficacy (OR = 0.25, 95% CI 0.13-0.46, p < 0.0001) but was also associated with increased potential complications. All studies were conducted in a sequential nature during which cataract surgery techniques and instrumentation have improved in recent years. Conclusion: In institutions with a high incidence of endophthalmitis, routine intracameral antibiotic use would be more appropriate. However, in facilities with lower rates of POE, the subconjunctival route of delivery can be an alternative due to its better safety profile.
背景:在白内障手术中，常规眼内抗生素用于预防眼内炎的使用有所增加。然而，这可能与严重的不良事件有关。以前，结膜下抗生素是首选的途径，但很少有文献直接比较两者。因此，最安全和最有效的预防性抗生素使用途径仍然存在争议。目的:评价结膜下联合膜内抗生素预防无并发症白内障术后眼内炎(POE)的疗效和安全性。方法:在Cochrane和PubMed上进行文献综述，比较预防性结膜下抗生素和巩膜内抗生素治疗白内障后眼内炎的疗效。搜索并不局限于英语或研究设计。结果:三项观察性研究表明，结膜下和眼内抗生素均可降低POE发生率。肠道内抗生素显示出高效率(OR = 0.25, 95% CI 0.13-0.46, p < 0.0001)，但也与潜在并发症的增加有关。所有的研究都是连续进行的，在此期间，白内障手术技术和仪器近年来得到了改进。结论:在眼内炎高发的机构，常规眼内抗生素应用更为合适。然而，在POE率较低的设施中，由于其更好的安全性，结膜下输送路径可以是一种替代方案。
{"title":"Subconjunctival antibiotics: an alternative to intracameral antibiotics for endophthalmitis prophylaxis in cataract surgery","authors":"Rachel Xuan, Elizabeth L S Wong, K. Ong","doi":"10.35119/ASJOO.V18I1.922","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.922","url":null,"abstract":"Background: There has been an increase in the use of routine intracameral antibiotics for endophthalmitis prophylaxis in cataract surgery. However, this can be associated with serious adverse events. Previously, subconjunctival antibiotics were the preferred route but there is minimal literature directly comparing the two. Hence, the safest and most efficacious route of prophylactic antibiotic administration remains controversial. \u0000Purpose: To evaluate the efficacy and safety of subconjunctival with intracameral antibiotics for postoperative endophthalmitis (POE) prophylaxis in patients undergoing uncomplicated cataract surgery. \u0000Methods: A literature review was conducted in Cochrane and PubMed for studies that compared the efficacy of prophylactic subconjunctival and intracameral antibiotics for post-cataract endophthalmitis. Searches were not limited to English or study design. \u0000Results: Three observational studies showed that subconjunctival and intracameral antibiotics both reduced POE rates. Intracameral antibiotics demonstrated a high efficacy (OR = 0.25, 95% CI 0.13-0.46, p < 0.0001) but was also associated with increased potential complications. All studies were conducted in a sequential nature during which cataract surgery techniques and instrumentation have improved in recent years. \u0000Conclusion: In institutions with a high incidence of endophthalmitis, routine intracameral antibiotic use would be more appropriate. However, in facilities with lower rates of POE, the subconjunctival route of delivery can be an alternative due to its better safety profile.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"40-53"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43846796","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.808
S. Kamath, D. Shenoy, P. Raj, Norman Mendonca
We report a rare case of idiopathic intracranial hypertension following oral minocycline therapy for the treatment of acne. A 29-year-old, non-obese female, with a history of minocycline use for 1 month for treatment of acne presented with headache and transient blurred vision for 3 weeks. She was found to have bilateral disc edema with normal visual acuity and color vision. Magnetic resonance imaging of the brain was normal with partially empty sella features and enlarged tortuous optic nerve in both eyes. Cerebrospinal fluid opening pressure was high. Ultrasound B-scan was done to serially monitor the optic nerve sheath diameter. She improved significantly after stopping the minocycline and following intracranial pressure lowering measures. Idiosyncratic reaction of intracranial hypertension with minocycline can be symptomatic as early as 1 week. Consultants should be aware of this as early consult with ophthalmologists/neurologists can prevent visual loss. A simple ultrasound B-scan can prove to be a vital non-invasive tool in monitoring these patients.
{"title":"Ultrasound monitoring for minocyclineinduced idiopathic intracranial hypertension","authors":"S. Kamath, D. Shenoy, P. Raj, Norman Mendonca","doi":"10.35119/ASJOO.V18I1.808","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.808","url":null,"abstract":"We report a rare case of idiopathic intracranial hypertension following oral minocycline therapy for the treatment of acne. A 29-year-old, non-obese female, with a history of minocycline use for 1 month for treatment of acne presented with headache and transient blurred vision for 3 weeks. She was found to have bilateral disc edema with normal visual acuity and color vision. Magnetic resonance imaging of the brain was normal with partially empty sella features and enlarged tortuous optic nerve in both eyes. Cerebrospinal fluid opening pressure was high. Ultrasound B-scan was done to serially monitor the optic nerve sheath diameter. She improved significantly after stopping the minocycline and following intracranial pressure lowering measures. Idiosyncratic reaction of intracranial hypertension with minocycline can be symptomatic as early as 1 week. Consultants should be aware of this as early consult with ophthalmologists/neurologists can prevent visual loss. A simple ultrasound B-scan can prove to be a vital non-invasive tool in monitoring these patients.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43337620","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.787
B. Yu, B. Helal, Monali S. Malvankar-Mehta
Purpose: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been declared as a pandemic by the World Health Organization (WHO). The purpose of the study was to summarize the current recommendations and practice guidelines to be implemented in ophthalmology due to COVID-19. Study design: A systematic review of literature. Methods: A systematic literature search was performed using MEDLINE, EMBASE, CINAHL, Clinical Trials.gov, and ProQuest Dissertations and Theses until May 25, 2020. All conferences held through Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, and Canadian Society of Ophthalmology were also searched until May 25, 2020. Eligible articles were identified by reviewing the retrieved results. Results: In total, 57 records were retrieved from multiple databases and 0 records were identified through grey literature search. Ten articles were included for analysis. Rigorous hand hygiene, proper screening, and proper use of protective personal equipment by both staff and patients were strongly advised. Careful triage of patients upon arrival to facilities based on screening was advised along with deferral of any non-urgent appointments and implementing measures to limit exposure in waiting rooms. Routine disinfection of equipment, use of shields or barriers on slit lamps, and limiting the use of instruments and tests were strongly recommended and advised. Conclusions: The implementation of guidelines should be in place for ophthalmologic staff, facilities, and visitors to help minimize the spread of COVID-19 and promote a safer environment in ophthalmology.
{"title":"Changes in practice guidelines and regulations in ophthalmology due to COVID-19","authors":"B. Yu, B. Helal, Monali S. Malvankar-Mehta","doi":"10.35119/ASJOO.V18I1.787","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.787","url":null,"abstract":"Purpose: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been declared as a pandemic by the World Health Organization (WHO). The purpose of the study was to summarize the current recommendations and practice guidelines to be implemented in ophthalmology due to COVID-19. \u0000Study design: A systematic review of literature. \u0000Methods: A systematic literature search was performed using MEDLINE, EMBASE, CINAHL, Clinical Trials.gov, and ProQuest Dissertations and Theses until May 25, 2020. All conferences held through Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, and Canadian Society of Ophthalmology were also searched until May 25, 2020. Eligible articles were identified by reviewing the retrieved results. \u0000Results: In total, 57 records were retrieved from multiple databases and 0 records were identified through grey literature search. Ten articles were included for analysis. Rigorous hand hygiene, proper screening, and proper use of protective personal equipment by both staff and patients were strongly advised. Careful triage of patients upon arrival to facilities based on screening was advised along with deferral of any non-urgent appointments and implementing measures to limit exposure in waiting rooms. Routine disinfection of equipment, use of shields or barriers on slit lamps, and limiting the use of instruments and tests were strongly recommended and advised. \u0000Conclusions: The implementation of guidelines should be in place for ophthalmologic staff, facilities, and visitors to help minimize the spread of COVID-19 and promote a safer environment in ophthalmology.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"54-74"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44613260","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.941
Qingyun Wen, Rachel Xuan, K. Ong
Purpose: This review aimed to investigate the global incidence of postoperative endophthalmitis (POE) after cataract surgery over the last three decades, with a particular focus on the use of prophylactic intracameral antibiotics. Study design: Literature review. Methods: A literature search was performed in PubMed and Scopus. Data was collected from included studies and analyzed in IBM SPSS v27. Results: A total of 63 studies from 20 regions were included. The use of prophylactic intracameral antibiotics significantly reduced POE incidence. The baseline POE incidence in studies that involved intracameral prophylaxis tended to be high. A downward linear trend in POE incidence was observed in studies that did not involve intracameral antibiotic prophylaxis. Interestingly, a study in Japan reported the use of intracameral antibiotic prophylaxis in only 10.4% of cataract surgeries with an overall POE incidence of 0.025%, which is comparable to countries that use intracameral prophylaxis routinely. Within studies from Australia, China, Europe, India, Singapore and United States, Australia had the highest POE incidence with and without intracameral prophylaxis, while China had the lowest POE incidences. Conclusion: Intracameral antibiotics are an effective prophylaxis against POE. However, the incidence of POE is decreasing worldwide even without intracameral prophylaxis. The benefits of intracameral antibiotics should be weighed against its risks prior to its implementation as routine prophylaxis protocol for cataract surgery.
{"title":"Incidence of post-cataract surgery endophthalmitis: a chronological review and intercontinental comparison","authors":"Qingyun Wen, Rachel Xuan, K. Ong","doi":"10.35119/ASJOO.V18I1.941","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.941","url":null,"abstract":"Purpose: This review aimed to investigate the global incidence of postoperative endophthalmitis (POE) after cataract surgery over the last three decades, with a particular focus on the use of prophylactic intracameral antibiotics. \u0000Study design: Literature review. \u0000Methods: A literature search was performed in PubMed and Scopus. Data was collected from included studies and analyzed in IBM SPSS v27. \u0000Results: A total of 63 studies from 20 regions were included. The use of prophylactic intracameral antibiotics significantly reduced POE incidence. The baseline POE incidence in studies that involved intracameral prophylaxis tended to be high. A downward linear trend in POE incidence was observed in studies that did not involve intracameral antibiotic prophylaxis. Interestingly, a study in Japan reported the use of intracameral antibiotic prophylaxis in only 10.4% of cataract surgeries with an overall POE incidence of 0.025%, which is comparable to countries that use intracameral prophylaxis routinely. Within studies from Australia, China, Europe, India, Singapore and United States, Australia had the highest POE incidence with and without intracameral prophylaxis, while China had the lowest POE incidences. \u0000Conclusion: Intracameral antibiotics are an effective prophylaxis against POE. However, the incidence of POE is decreasing worldwide even without intracameral prophylaxis. The benefits of intracameral antibiotics should be weighed against its risks prior to its implementation as routine prophylaxis protocol for cataract surgery.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"19-39"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48265259","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.819
H. Ng, P. Yu, Dao-Yi Yu, W. Morgan
XEN gel stent implantation (XEN) surgery is becoming more popular due to its safety profile and efficacy, with conjunctival lymphatics thought to be critical in maintaining bleb drainage. We are reporting the case of a 75-year-old man with right eye pseudoexfoliative glaucoma who had two previous episodes of failed XEN surgery despite given needling and antimetabolite. He had a repeat XEN surgery in our center and his intraocular pressure was under control at the time of writing without any topical glaucoma medication, needling, nor antimetabolite. On examination, there was presence of prominent, dilated, and irregular lymphatic vessel originating from the distal end of the bleb. Anterior segment optical coherence tomography identified the lymphatic vessel located in the superficial Tenon’s layer, which is most likely an initial lymphatic but larger in diameter. This dilated lymphatic vessel may be an important factor for his currently successful filtration surgery.
{"title":"Prominent lymphatic vessel in a functioning bleb after repeat XEN gel stent implantation surgery in pseudoexfoliative glaucoma: a case report","authors":"H. Ng, P. Yu, Dao-Yi Yu, W. Morgan","doi":"10.35119/ASJOO.V18I1.819","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.819","url":null,"abstract":"XEN gel stent implantation (XEN) surgery is becoming more popular due to its safety profile and efficacy, with conjunctival lymphatics thought to be critical in maintaining bleb drainage. We are reporting the case of a 75-year-old man with right eye pseudoexfoliative glaucoma who had two previous episodes of failed XEN surgery despite given needling and antimetabolite. He had a repeat XEN surgery in our center and his intraocular pressure was under control at the time of writing without any topical glaucoma medication, needling, nor antimetabolite. On examination, there was presence of prominent, dilated, and irregular lymphatic vessel originating from the distal end of the bleb. Anterior segment optical coherence tomography identified the lymphatic vessel located in the superficial Tenon’s layer, which is most likely an initial lymphatic but larger in diameter. This dilated lymphatic vessel may be an important factor for his currently successful filtration surgery.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"92-97"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44694494","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 : 2021-07-29DOI: 10.35119/ASJOO.V18I1.593
S. S. Sau, A. Santiago, M. Peralta, Jimmy Jarvis Gene C. Lo, Aliana Jimenez Vera Cruz
Purpose: To determine the efficacy of various concentrations of atropine eyedrops on retarding myopia progression and axial elongation in Asian children. Study design: Meta-analysis. Methods: Randomized clinical trials and prospective interventional non-randomized studies which enrolled children aged 4 to 14 years old who received atropine treatment for myopia were included in the study. The Cochrane Collaboration 6 aspects of bias was used to assess the risk of bias for all included studies. Outcome measures were myopia progression and axial elongation. Meta-analysis was conducted using the random-effects model. Results: Eight randomized clinical trials and two prospective interventional non-randomized studies which included a total of 1,229 Asian children were included in the analysis. The pooled mean difference between control and atropine for myopia progression was 0.77 diopters (D) per year [CI 0.64, 0.89]. Subgroup analysis by concentration showed a decreasing trend with decreasing concentration. The pooled mean difference of myopia progression for 1%, 0.5%, 0.25%, and 0.1–0.125% atropine was 0.97 D/year [CI 0.72, 1.21], 0.88 D/year [CI 0.74, 1.02], 0.79 D/year [CI 0.37, 1.21], and 0.80 D/year [CI 0.62, 0.97], respectively; whereas that for 0.01% atropine was 0.46 D/year [CI -0.02, 0.94] indicating that this intervention may or may not be favorable for slowing myopia progression. The pooled mean difference between control and atropine for axial elongation was -0.22 mm [CI -0.29, -0.14] favoring atropine. Subgroup analysis by concentration also showed decreasing trend with decreasing concentration. The pooled mean difference of axial elongation for 1%, 0.5%, 0.1%, 0.05%, and 0.025% atropine was -0.44 mm [CI -0.57, -0.32], -0.19 mm [CI -0.35, -0.04], -0.10 mm [CI -0.17, -0.03], -0.21 mm [CI -0.28, -0.14], and -0.12 mm [CI -0.16, -0.08], respectively; whereas that for 0.01% atropine was -0.01 mm [CI -0.09, 0.06] indicating that this intervention may or may not be favorable in reducing axial elongation. Conclusion: This meta-analysis shows that the effects of atropine for both myopia progression and axial elongation are dose-dependent for the concentration 0.025% to 1%. Results for 0.01% atropine are still equivocal.
目的:探讨不同浓度阿托品滴眼液延缓亚洲儿童近视进展和眼轴伸长的疗效。研究设计:荟萃分析。方法:纳入4 ~ 14岁接受阿托品治疗近视儿童的随机临床试验和前瞻性干预性非随机研究。Cochrane Collaboration 6 aspects of bias用于评估所有纳入研究的偏倚风险。结果测量近视进展和轴向伸长。采用随机效应模型进行meta分析。结果:8项随机临床试验和2项前瞻性干预性非随机研究纳入分析，共纳入1229名亚洲儿童。对照组和阿托品组近视进展的总平均差异为每年0.77屈光度(D) [CI 0.64, 0.89]。浓度亚组分析显示随浓度降低呈下降趋势。1%、0.5%、0.25%和0.1-0.125%阿托品组近视进展的综合平均差值分别为0.97 D/年[CI 0.72, 1.21]、0.88 D/年[CI 0.74, 1.02]、0.79 D/年[CI 0.37, 1.21]和0.80 D/年[CI 0.62, 0.97];而0.01%的阿托品为0.46 D/年[CI -0.02, 0.94]，表明该干预可能有利于也可能不利于减缓近视进展。对照和阿托品轴向伸长率的汇总平均差异为-0.22 mm [CI -0.29， -0.14]，有利于阿托品。浓度亚组分析也随浓度的降低呈下降趋势。1%、0.5%、0.1%、0.05%和0.025%阿托品的轴向伸长率平均差值分别为-0.44 mm [CI -0.57， -0.32]、-0.19 mm [CI -0.35， -0.04]、-0.10 mm [CI -0.17， -0.03]、-0.21 mm [CI -0.28， -0.14]和-0.12 mm [CI -0.16， -0.08];而0.01%的阿托品则为-0.01 mm [CI -0.09, 0.06]，表明这种干预可能有利于也可能不利于降低轴向伸长。结论:本荟萃分析显示，阿托品对近视进展和轴向伸长的影响在0.025% ~ 1%浓度范围内呈剂量依赖性。0.01%阿托品的结果仍然模棱两可。
{"title":"Efficacy of atropine eyedrops in reducing myopia progression and axial elongation in myopic children: a meta-analysis","authors":"S. S. Sau, A. Santiago, M. Peralta, Jimmy Jarvis Gene C. Lo, Aliana Jimenez Vera Cruz","doi":"10.35119/ASJOO.V18I1.593","DOIUrl":"https://doi.org/10.35119/ASJOO.V18I1.593","url":null,"abstract":"Purpose: To determine the efficacy of various concentrations of atropine eyedrops on retarding myopia progression and axial elongation in Asian children. \u0000Study design: Meta-analysis. \u0000Methods: Randomized clinical trials and prospective interventional non-randomized studies which enrolled children aged 4 to 14 years old who received atropine treatment for myopia were included in the study. The Cochrane Collaboration 6 aspects of bias was used to assess the risk of bias for all included studies. Outcome measures were myopia progression and axial elongation. Meta-analysis was conducted using the random-effects model. \u0000Results: Eight randomized clinical trials and two prospective interventional non-randomized studies which included a total of 1,229 Asian children were included in the analysis. The pooled mean difference between control and atropine for myopia progression was 0.77 diopters (D) per year [CI 0.64, 0.89]. Subgroup analysis by concentration showed a decreasing trend with decreasing concentration. The pooled mean difference of myopia progression for 1%, 0.5%, 0.25%, and 0.1–0.125% atropine was 0.97 D/year [CI 0.72, 1.21], 0.88 D/year [CI 0.74, 1.02], 0.79 D/year [CI 0.37, 1.21], and 0.80 D/year [CI 0.62, 0.97], respectively; whereas that for 0.01% atropine was 0.46 D/year [CI -0.02, 0.94] indicating that this intervention may or may not be favorable for slowing myopia progression. The pooled mean difference between control and atropine for axial elongation was -0.22 mm [CI -0.29, -0.14] favoring atropine. Subgroup analysis by concentration also showed decreasing trend with decreasing concentration. The pooled mean difference of axial elongation for 1%, 0.5%, 0.1%, 0.05%, and 0.025% atropine was -0.44 mm [CI -0.57, -0.32], -0.19 mm [CI -0.35, -0.04], -0.10 mm [CI -0.17, -0.03], -0.21 mm [CI -0.28, -0.14], and -0.12 mm [CI -0.16, -0.08], respectively; whereas that for 0.01% atropine was -0.01 mm [CI -0.09, 0.06] indicating that this intervention may or may not be favorable in reducing axial elongation. \u0000Conclusion: This meta-analysis shows that the effects of atropine for both myopia progression and axial elongation are dose-dependent for the concentration 0.025% to 1%. Results for 0.01% atropine are still equivocal.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":"75-91"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45541551","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}
{"title":"Asia-Pacific Glaucoma Congress 2021 Abstract Book","authors":"Silvia Sanchez Di Martino","doi":"10.35119/ASJOO.V0I0.946","DOIUrl":"https://doi.org/10.35119/ASJOO.V0I0.946","url":null,"abstract":"","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41494880","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 : 2021-04-19DOI: 10.35119/ASJOO.V17I4.935
K. Ong
{"title":"Human research ethics in biomedical journals","authors":"K. Ong","doi":"10.35119/ASJOO.V17I4.935","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I4.935","url":null,"abstract":"","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"340-342"},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41670811","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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