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The asymptomatic ocular surface reservoir of coronavirus disease-19 in infants and retinopathy of prematurity screening during the pandemic. 冠状病毒19型婴儿无症状眼表病毒库及大流行期间早产儿视网膜病变筛查
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-11 eCollection Date: 2023-07-01 DOI: 10.4103/tjo.TJO-D-23-00052
Bilge Batu Oto, Yeşim Tok, Oğuzhan Kılıçarslan, Ahmet Mert Kuşkucu, Hüseyin Yetik

Purpose: This study aimed to evaluate the incidence of conjunctival and pharyngeal swab sample positivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic preterm and term infants. We aimed to detect asymptomatic carrier potential in infants.

Materials and methods: Patients screened for retinopathy of prematurity (ROP) at our clinic between January and June 2021 were recruited for this study. For all study cases, the previous history of possible exposure or contact with SARS-CoV-2, previous history of coronavirus disease-19 (COVID-19), or contact with any COVID-19 case was excluded. None of the patients showed signs of COVID-19 during sample collection. Pharyngeal and conjunctival swab samples were collected before the ophthalmic examination. Nucleic acid isolation from the samples was performed using an automated system. The presence of SARS-CoV-2 RNA in the samples was screened using a real-time polymerase chain reaction kit, and the positive samples were re-evaluated for the variant virus.

Results: Among the 127 patients with a median age of 40 weeks (range: 34-86) of postmenstrual age, positivity for SARS-CoV-2 RNA in the pharyngeal and conjunctival samples was 5/127 (3.93%) and 3/127 (2.36%), respectively. Isolated conjunctival positivity was not observed in any of the patients, and all three patients were positive for both conjunctiva and pharynx.

Conclusion: Asymptomatic infants may be a reservoir for SARS-CoV-2, and conjunctival infection in infants may be a source of virus transmission. Since ROP screening cannot be postponed during the pandemic, caution should be exercised to prevent the spread of the disease.

目的:评价无症状早产儿和足月儿结膜和咽拭子样本中SARS-CoV-2阳性的发生率。我们的目的是在婴儿中发现潜在的无症状携带者。材料和方法:招募2021年1月至6月期间在我们诊所筛查早产儿视网膜病变(ROP)的患者参加本研究。对于所有研究病例,排除了可能暴露或接触过SARS-CoV-2的病史、冠状病毒病-19 (COVID-19)的病史或与任何COVID-19病例的接触。在采集样本期间,没有患者显示出COVID-19的迹象。在眼科检查前采集咽拭子和结膜拭子样本。使用自动化系统对样品进行核酸分离。使用实时聚合酶链反应试剂盒筛选样品中SARS-CoV-2 RNA的存在,并对阳性样品进行变异病毒重新评估。结果:127例经后年龄中位数为40周(34 ~ 86周)的患者中,咽部和结膜标本中SARS-CoV-2 RNA阳性分别为5/127(3.93%)和3/127(2.36%)。所有患者均未见孤立结膜阳性,所有患者结膜和咽部均呈阳性。结论:无症状婴儿可能是SARS-CoV-2的储存库,婴儿结膜感染可能是病毒传播源。由于在大流行期间不能推迟ROP筛查,因此应谨慎行事,以防止疾病传播。
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引用次数: 0
ADAMTS18-related anterior segment dysgenesis mistaken as Axenfeld-Rieger syndrome. 与 ADAMTS18 相关的前节发育不良被误认为是 Axenfeld-Rieger 综合征。
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-09 eCollection Date: 2023-10-01 DOI: 10.4103/tjo.TJO-D-23-00034
Arif O Khan

Axenfeld-Rieger spectrum is a range of anterior segment dysgenesis (ASD) phenotypes often related to heterozygous pathogenic variants in the ocular transcription factor genes FOXC1 or PITX2. Microcornea with myopic chorioretinal atrophy, a less common ASD, is distinct, recognizable, and secondary to biallelic pathogenic variants in the metalloproteinase gene ADAMTS18. This report describes the case of a boy with ADAMTS18-related ASD that was mistaken for Axenfeld-Rieger syndrome and highlights distinguishing features.

Axenfeld-Rieger 光谱是一系列前节发育不良(ASD)表型,通常与眼部转录因子基因 FOXC1 或 PITX2 的杂合致病变体有关。小角膜伴近视脉络膜视网膜萎缩是一种较少见的 ASD,它与金属蛋白酶基因 ADAMTS18 的双倍致病变体不同,具有可识别性和继发性。本病例被误诊为阿森费尔德-里格综合征(Axenfeld-Rieger Syndrome)。
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引用次数: 0
Decreased levels of interleukin-6 level in tears and clinical changes in subjects with moderate-to-severe infection corneal ulcers treated with platelet-rich fibrin lysate eye drops. 富含血小板的纤维蛋白溶解物滴眼液治疗中度至重度感染性角膜溃疡患者泪液中白细胞介素-6水平降低及临床变化
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-04 eCollection Date: 2023-07-01 DOI: 10.4103/tjo.TJO-D-23-00023
Jehan Fauzi Rakhmandani, Indra Tri Mahayana, Felicia Widyaputri, Reny Setyowati, Agus Supartoto, Yohanes Widodo Wirohadidjojo, Suhardjo Pawiroranu

Purpose: To assess the change of interleukin-6 (IL-6) levels in tears and ocular clinical parameters in corneal ulcer patients with moderate-to-severe infection after adjunctive therapy with platelet-rich fibrin (PRF) lysate-eyedrops compared with autologous serum eyedrops.

Materials and methods: This study was a randomized double-blind controlled trial, which compared two groups of patients at Dr. Sardjito Hospital, Yogyakarta. A total of 42 patients (42 eyes) were divided into the control group (21 patients) and the intervention group (21 patients). All patients received antibacterial/antifungal therapy based on the etiology, and an adjunctive eyedrop therapy: autologous serum eyedrops for the control group and PRF lysate eyedrops for the intervention group. The IL-6 levels and clinical changes in patients, such as the area of corneal defects, pericorneal injection, and the level of blepharospasm were measured at the baseline, day 6, and day 13 after starting the treatment.

Results: Compared to baseline, the mean IL-6 level in day 13 decreased by 426.6 ± 665.4 pg/ml (P = 0.005) and 1283.7 ± 1569.1 pg/ml (P = 0.079) in the intervention and control groups, respectively. However, the difference between the two groups was not statistically significant (P = 0.164). In term of corneal defect area, there was a significant decrease at day 6 and day 13 in both groups but there was no statistically significant difference between the two groups in all time points. Similarly, the proportion of blepharospasm and pericorneal injection severity appeared to improve especially on day 13 in both groups but were not statistically different between the two.

Conclusion: There was a statistically significant decrease in IL-6 levels in the tears in patient using PRF lysate, but there was no significant difference when compared to those using autologous serum. The difference in defect area, degree of blepharospasm, and pericorneal injection was not statistically significant between the two treatment options.

目的:比较富含血小板纤维蛋白(PRF)溶出液滴眼液和自体血清滴眼液辅助治疗中重度感染的角膜溃疡患者后泪液中白细胞介素-6(IL-6)水平和眼部临床参数的变化。材料和方法:这项研究是一项随机双盲对照试验,比较了日惹Sardjito医生医院的两组患者。将42例患者(42眼)分为对照组(21例)和干预组(21名)。所有患者均根据病因接受抗菌/抗真菌治疗,并接受辅助滴眼液治疗:对照组为自体血清滴眼液,干预组为PRF裂解物滴眼液。在开始治疗后的基线、第6天和第13天测量患者的IL-6水平和临床变化,如角膜缺损面积、角膜周注射和眼睑痉挛水平。结果:与基线相比,干预组和对照组第13天的平均IL-6水平分别下降了426.6±665.4 pg/ml(P=0.005)和1283.7±1569.1 pg/ml(P=0.079)。然而,两组之间的差异没有统计学意义(P=0.164)。就角膜缺损面积而言,两组在第6天和第13天都有显著减少,但在所有时间点上,两组间没有统计学意义的差异。同样,两组的眼睑痉挛比例和角膜周注射严重程度似乎都有所改善,尤其是在第13天,但两组之间没有统计学差异。结论:使用PRF裂解物的患者泪液中IL-6水平在统计学上显著降低,但与使用自体血清的患者相比没有显著差异。两种治疗方案在缺损面积、眼睑痉挛程度和角膜周注射方面的差异无统计学意义。
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引用次数: 0
Accuracy of the postnatal growth and retinopathy of prematurity screening criteria in predicting prethreshold retinopathy of prematurity in the tertiary hospital, Bangkok, Thailand. 泰国曼谷三级医院产后生长和早产儿视网膜病变筛查标准在预测阈值前早产儿视网膜病变方面的准确性。
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-04 eCollection Date: 2023-10-01 DOI: 10.4103/tjo.TJO-D-23-00027
Chavisa Bunyavee, Kornwipa Hemarat

Purpose: The postnatal growth and retinopathy of prematurity (G-ROP), retinopathy of prematurity (ROP) predictive model, was developed in North America with high sensitivity and fewer infants examined. This study aimed to validate this model in Thai infants by assessing sensitivity and comparing it to the current American Academy of Ophthalmology (AAO) screening guideline.

Materials and methods: The records of infants screened for ROP were retrospectively reviewed from 2015 to 2020. G-ROP model was applied to calculate sensitivity for prethreshold type 1 and 2 ROP and the reduction of the number of infants examined.

Results: Of 129 infants screened, there were 102 infants who met G-ROP criteria. The mean gestational age at birth was 29.7 ± 2.7 weeks. The mean birth weight was 1177.8 ± 401.3 g. Both G-ROP and AAO detected prethreshold type 1 ROP in 24 of 24 infants (sensitivity, 100%; 95% confidence interval [CI], 85.8%-100%). Furthermore, they detected all four infants prethreshold type 2 ROP with 100% of sensitivity (95% CI, 39.8-100.0). The reduction in infants receiving examinations using G-ROP was 20.9%.

Conclusions: G-ROP model provided high sensitivity and lessen unnecessary examinations for ROP screening in Thai infants.

目的:早产儿视网膜病变(ROP)预测模型 "产后生长和早产儿视网膜病变(G-ROP)"是在北美开发的,该模型灵敏度高,受检婴儿较少。本研究旨在通过评估该模型的灵敏度并将其与现行的美国眼科学会(AAO)筛查指南进行比较,从而在泰国婴儿中验证该模型:对 2015 年至 2020 年期间接受 ROP 筛查的婴儿记录进行了回顾性审查。应用G-ROP模型计算阈值前1型和2型ROP的灵敏度以及受检婴儿数量的减少:在接受筛查的 129 名婴儿中,有 102 名婴儿符合 G-ROP 标准。婴儿出生时的平均胎龄为 29.7 ± 2.7 周。G-ROP 和 AAO 均能检测出 24 个婴儿中的 24 个婴儿患有阈值前 1 型 ROP(灵敏度为 100%;95% 置信区间 [CI],85.8%-100%)。此外,它们还检测出了所有 4 名婴儿的阈值前 2 型 ROP,灵敏度均为 100%(95% 置信区间 [CI],39.8-100.0)。使用 G-ROP 进行检查的婴儿减少了 20.9%:结论:G-ROP 模型灵敏度高,减少了泰国婴儿接受 ROP 筛查的不必要检查。
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引用次数: 0
Advantages of femtosecond laser in various corneal transplantation procedures: A narrative literature review. 飞秒激光在各种角膜移植手术中的优势:叙述性文献综述
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-04 eCollection Date: 2023-07-01 DOI: 10.4103/tjo.TJO-D-23-00067
Sang Beom Han

The ability of the femtosecond laser (FSL) to create tissue incisions at desired depth and location with minimal collateral damage to surrounding tissue may offer potential advantages for corneal transplantation surgery. FSL may enable the precise and accurate preparation of both donor and recipient tissue, which can potentially result in enhanced wound integrity, facilitation of wound healing, and improved visual outcomes. Many studies have suggested that FSL may be a viable option in various corneal transplantation procedures, such as, penetrating keratoplasty, anterior lamellar keratoplasty, endothelial keratoplasty, and novel techniques, including Bowman layer transplantation and stromal lenticule addition keratoplasty. In this review, the author presents a brief overview on the application of FSL in various corneal transplantation procedures and discusses the results of studies regarding the safety and efficacy of FSL-assisted corneal transplantation procedures.

飞秒激光(FSL)在对周围组织的附带损伤最小的情况下在所需深度和位置产生组织切口的能力可能为角膜移植手术提供潜在的优势。FSL可以精确准确地制备供体和受体组织,这可能会增强伤口完整性,促进伤口愈合,并改善视觉效果。许多研究表明,FSL可能是各种角膜移植程序的可行选择,如穿透性角膜移植、前板层角膜移植、内皮性角膜移植和新技术,包括鲍曼层移植和基质小颗粒附加角膜移植。在这篇综述中,作者简要概述了FSL在各种角膜移植程序中的应用,并讨论了FSL辅助角膜移植程序的安全性和有效性的研究结果。
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引用次数: 0
Femtosecond laser-assisted posterior capsulotomy for the treatment of capsular block syndrome. 飞秒激光辅助后囊切开术治疗囊阻滞综合征
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-03 eCollection Date: 2023-07-01 DOI: 10.4103/tjo.TJO-D-23-00042
Xian Hui Lim, Moushmi Patil, Jodhbir S Mehta

We present a novel use of femtosecond laser to treat capsular block syndrome (CBS) in a patient with dense opaque capsular block, who presented 16 years postcataract surgery. The extensive posterior capsular distension and densely opaque, milky fluid trapped behind the intraocular lens (IOL) prevented the use of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser posterior capsulotomy as primary treatment. Intra-operative optical coherence tomography enabled visualization of the posterior capsule and iris hooks were used to increase the pupillary diameter to enable femtosecond laser-assisted posterior capsulotomy to be performed in a minimally invasive technique. CBS was relieved successfully and Nd: YAG laser performed subsequently to remove residual posterior capsule opacification safely and with good visual outcomes. This method avoids risks associated with posterior vitrectomies and compromised IOL stability from inadvertent capsular bag damage, and adds to the expanding uses of femtosecond laser technology.

我们提出了一种新的飞秒激光用于治疗一名患有致密不透明囊块的患者的囊块综合征(CBS),该患者在白内障手术后16年。广泛的后囊膜扩张和眼内透镜(IOL)后面的致密不透明乳白色液体阻止了使用掺钕钇铝石榴石(Nd:YAG)激光后囊膜切开术作为主要治疗方法。术中光学相干断层扫描使后囊膜可视化,虹膜钩用于增加瞳孔直径,从而使飞秒激光辅助的后囊膜切开术能够以微创技术进行。成功缓解了CBS,随后进行Nd:YAG激光治疗,安全地去除了残留的后囊膜混浊,并取得了良好的视觉效果。这种方法避免了与后玻璃体切除术相关的风险,也避免了因囊袋意外损伤而损害IOL稳定性,并增加了飞秒激光技术的广泛应用。
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引用次数: 0
Dr. Google will see you now: But will he make you sick? 谷歌医生现在会给你看病:但他会让你生病吗?
IF 1 Q4 OPHTHALMOLOGY Pub Date : 2023-08-03 eCollection Date: 2024-07-01 DOI: 10.4103/tjo.TJO-D-23-00047
Ivan Goldberg

Advances in technology have empowered patients to seek health information and to self-diagnose online. They do so, increasingly. Instead of shying away from patients' online-gained health information, clinicians can use it to fuel discussion, answer their questions, and, thereby, reinforce the all-important doctor-patient therapeutic alliance. Through patient-centered communication, clinicians can increase patient trust and generate better health outcomes.

技术的进步赋予了患者在网上寻求健康信息和自我诊断的能力。他们越来越多地这样做。临床医生不应该回避患者在网上获取的健康信息,而是可以利用这些信息来促进讨论,回答他们的问题,从而加强至关重要的医患治疗联盟。通过以患者为中心的沟通,临床医生可以提高患者的信任度,取得更好的医疗效果。
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引用次数: 0
Big data to guide glaucoma treatment. 大数据指导青光眼治疗。
IF 1 Q4 OPHTHALMOLOGY Pub Date : 2023-07-28 eCollection Date: 2024-07-01 DOI: 10.4103/tjo.TJO-D-23-00068
Jo-Hsuan Wu, Shan Lin, Sasan Moghimi

Ophthalmology has been at the forefront of the medical application of big data. Often harnessed with a machine learning approach, big data has demonstrated potential to transform ophthalmic care, as evidenced by prior success on clinical tasks such as the screening of ophthalmic diseases and lesions via retinal images. With the recent establishment of various large ophthalmic datasets, there has been greater interest in determining whether the benefits of big data may extend to the downstream process of ophthalmic disease management. An area of substantial investigation has been the use of big data to help guide or streamline management of glaucoma, which remains a leading cause of irreversible blindness worldwide. In this review, we summarize relevant studies utilizing big data and discuss the application of the findings in the risk assessment and treatment of glaucoma.

眼科一直处于大数据医疗应用的前沿。大数据通常采用机器学习方法,在临床任务(如通过视网膜图像筛查眼科疾病和病变)中取得的成功证明了大数据具有改变眼科护理的潜力。最近,随着各种大型眼科数据集的建立,人们对确定大数据的优势是否可以扩展到眼科疾病管理的下游流程产生了更大的兴趣。利用大数据帮助指导或简化青光眼的管理是一项重要的研究领域,青光眼仍然是导致全球不可逆失明的主要原因。在这篇综述中,我们总结了利用大数据进行的相关研究,并讨论了研究结果在青光眼风险评估和治疗中的应用。
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引用次数: 0
Genetics of the anterior segment dysgenesis. 前节发育不良的遗传学。
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-07-18 eCollection Date: 2023-10-01 DOI: 10.4103/tjo.TJO-D-23-00062
Diego I Paredes, Jenina E Capasso, Celeste S Wyman, Alex V Levin

The anterior segment dysgeneses are a broad group of heterogeneous disorders characterized by developmental abnormalities of the anterior segment of the eye, including primary congenital aphakia, Peters sequence, aniridia, and Axenfeld-Rieger spectrum. These conditions can have overlapping phenotypes and both genotypic and phenotypic heterogeneity. This article provides a strategy for both phenotyping and then genotyping using a targeted stepwise approach.

前节发育异常是一大类以眼球前节发育异常为特征的异质性疾病,包括原发性先天性无晶体眼、彼得斯序列、无晶体眼和阿森费尔德-里格谱系。这些病症可能有重叠的表型以及基因型和表型异质性。本文提供了一种先进行表型分析,然后采用有针对性的逐步方法进行基因分型的策略。
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引用次数: 0
Clinical features of macular telangiectasia type 2 and comparison of staging system in Taiwanese patients. 台湾地区2型黄斑毛细血管扩张症的临床特征及分期系统比较
IF 1.1 Q4 OPHTHALMOLOGY Pub Date : 2023-06-16 eCollection Date: 2023-07-01 DOI: 10.4103/tjo.TJO-D-22-00154
Yan-Yu Chen, Yi-Ling Chen, Jian-Sheng Wu, San-Ni Chen

Purpose: The purpose of this study is to report the clinical characteristics of macular telangiectasia type 2 (MacTel 2) in Taiwan.

Materials and methods: Retrospective analysis of patients diagnosed with MacTel 2 over a 7-year period in Changhua Christian Hospital. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA) images were reviewed. Differences in BCVA and central macular thickness (CMT) were compared between the initial/baseline and final visits. The staging was performed according to the Gass and Blodi classification and OCTA.

Results: There were 38 eyes in 19 patients were collected (Male: Female = 5:14). The mean age at diagnosis was 65.90 ± 8.26 years and the follow-up duration was 39.26 ± 28.31 months. All patients had both eyes affected, and eight of the 19 patients had a history of diabetes mellitus (DM). The mean initial logarithm of the minimum angle of resolution (logMAR) BCVA was 0.40 ± 0.31 and the mean final logMAR BCVA was 0.61 ± 0.53. Difference of BCVA equal or more than two lines between both eyes was noted in 63.1% (12 of 19) of patients at the initial visit and in 78.9% (15 of 19) of patients at the final follow-up. The mean CMT was 224.42 ± 38.50 μm at baseline and 222.05 ± 40.27 μm at the final visit. OCT illustrated macular hole in three eyes of three patients. At the final follow-up, retinal-choroidal anastomosis was noted in 17 eyes. Subretinal neovascularization (SRNV) was not present in any eye.

Conclusion: Bilateral involvement, asymmetrical BCVA in both eyes, low incidence of SRNV, and high prevalence of DM were characteristics of patients of MacTel 2 in Taiwan.

目的:报告台湾地区2型黄斑毛细血管扩张症(MacTel2)的临床特点。材料和方法:回顾性分析彰化基督教医院7年来诊断为MacTel 2的患者。对最佳矫正视力(BCVA)、眼底摄影、荧光素血管造影、光学相干断层扫描(OCT)和OCT血管造影(OCTA)图像进行了回顾。比较初次/基线访视和最终访视之间BCVA和中央黄斑厚度(CMT)的差异。根据Gass和Blodi分类以及OCTA进行分期。结果:19例患者共38眼(男:女=5:14)。诊断时的平均年龄为65.90±8.26岁,随访时间为39.26±28.31个月。所有患者的双眼都受到影响,19名患者中有8名有糖尿病(DM)病史。最小分辨角(logMAR)BCVA的平均初始对数为0.40±0.31,平均最终logMAR BCVA为0.61±0.53。63.1%(12/19)的患者在初次就诊时和78.9%(15/19)的病人在最终随访时发现双眼BCVA差异等于或大于两条线。基线时的平均CMT为224.42±38.50μm,最后一次就诊时为222.05±40.27μm。OCT显示三名患者的三只眼睛出现黄斑裂孔。在最后的随访中,17只眼睛的视网膜-脉络膜吻合。视网膜下新生血管(SRNV)在任何一只眼睛中都不存在。结论:台湾MacTel 2患者双侧受累、双眼BCVA不对称、SRNV发病率低、DM患病率高是其特征。
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引用次数: 0
期刊
Taiwan Journal of Ophthalmology
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