Clinical and Experimental Ophthalmology最新文献

Background: To compare pain perception, pupil behaviours, and cytokine levels during first-eye and second-eye femtosecond laser-assisted cataract surgery (FLACS) and determine which is better regarding a short or long interval for bilateral FLACS.

Methods: Notably, 96 eyes of 48 patients with bilateral cataracts underwent the first surgeries in the left or right eye, according to a random sequence. They were further randomised into 2- and 6-week subgroups based on surgery intervals. Pupil size was measured from captured images, and pain perception was assessed using a visual analog scale (VAS). Aqueous humour prostaglandin E2 (PGE2), monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, and IL-8 levels were also quantitatively analysed. All patients were followed for 1 week to evaluate changes in endothelial cell density (ECD), central corneal thickness (CCT), and macular central subfield thickness (CST).

Results: Ocular pain was significantly higher in patients who underwent second-eye FLACS. First tear break-up time was negatively correlated with VAS score. MCP-1 levels were significantly higher in patients who underwent second-eye FLACS, and VAS scores were positively correlated with MCP-1 levels across all patients. There were no differences between sequential FLACS in miosis, PGE2, IL-6, IL-8 levels and changes in postoperative ECD, CCT, and CST. Patients who underwent second-eye FLACS after 6 weeks showed more CCT, CST, and MCP-1 changes than baseline.

Conclusion: Second-eye FLACS causes more pain and upregulated MCP-1. There was no difference between sequential FLACS in PGE2 levels, miosis, and postoperative inflammation. Furthermore, first-eye FLACS triggered a sympathetic irritation, particularly after a 6-week interval.

Background: To establish a novel vault prediction formula after implantable collamer lens (ICL) implantation that considers both anterior and posterior chamber characteristics with multi-modal parameters.

Methods: A total of 103 and 65 eyes were included in the development and validation groups, respectively. Exploratory factor analysis was performed using data from optical coherence tomography and ultrasound biomicroscopy in the development group to synthesise summative factors with different clinical significance. Dominant original metrics with heavy loadings on significant factors (absolute value of the loading coefficient >0.5) were screened for multivariate linear regression models using a stepwise method. The newly derived formula was evaluated and compared to the NK and KS formulas in the validation group.

Results: Six factors (anterior chamber angle, horizontal width, lens, iris, iridociliary complex and ciliary body) were generated after dimension reduction via factor analysis. Factors 2 (horizontal width), 3 (lens), and 5 (iridociliary complex) had a significant influence on the vault. When dominant metrics on these factors were screened for further model building, ICL size, anterior chamber width, crystalline lens rise, iris curvature, and iris-ciliary process distance were retained in the final formula, with an adjusted R² of 0.698, a median absolute error of 81.97 mm, and a root-mean-square error of 103.35 mm.

Conclusions: Multiple intraocular components, including the lens, iris, and ciliary body, play important roles in vault determination. The new formula exhibits good accuracy for vault predictions and ICL size recommendations.

Background: To investigate the prevalence and correction of anisometropia among primary school children in northwestern China.

Methods: A cross-sectional school-based study was conducted in Shaanxi Province. Visual acuity (VA) and autorefraction without cycloplegia were assessed in all participants, and some received axial length (AL) measurements. Anisometropia was categorised based on spherical equivalent (SE), cylindrical (CYL), and AL. The prevalence of anisometropia and refractive correction across different ages and sexes, and correlations between ocular parameters, were analysed.

Results: The study included 29 153 children aged 6-12 (mean age 9.52 ± 1.73 years) for VA and autorefraction measurements, and 1176 children for AL measurements. The prevalence of myopia (SE ≤ -0.50 D), hyperopia (SE ≥ +0.50 D), and anisometropia (interocular SE difference ≥1.00 D) was 65.26%, 15.09%, and 16.50%, respectively. Anisometropia severity, based on SE (χ² = 443.758, p < 0.001), CYL (χ² = 41.669, p < 0.001), and AL (χ² = 95.505, p < 0.001), increased with age, with no significant differences between sexes. Interocular SE difference correlated with interocular spherical power (r = 0.806, p < 0.001), CYL (r = 0.21, p < 0.001), and AL (r = 0.365, p < 0.001). Additionally, interocular CYL difference was positively correlated with interocular AL difference (r = 0.16, p < 0.001). Despite the high prevalence of anisometropia, less than 30% of affected children received refractive correction.

Conclusions: Anisometropia of SE, CYL, and AL increased progressively with age. Despite the elevated prevalence of anisometropia, the utilisation of refractive correction remained strikingly low.

Background: Accurate prognostic factors for primary ocular adnexal lymphoma (POAL) are scarce. Survival models and prognostic factors derived without considering competing risk factors suffer from major statistical errors. This study aimed to accurately assess prognostic factors in POAL patients using competing risk models, and compare this to the traditional COX proportional hazards model.

Methods: This retrospective study utilised data from the Surveillance, Epidemiology, and End Results (SEER) program 2010-2015 and included patients with B-cell POAL. The cumulative incidence function and Gray's test for cause-specific survival were calculated as univariate analysis. The competing risk models were a Fine-Gray subdistribution hazard model and a cause-specific model, and a traditional COX model was employed as a multivariate analysis.

Results: This study enrolled 846 eligible patients with POAL: 60 patients (7.09%) died from POAL and 123 patients (14.54%) died from other causes. Multivariate competing risk models indicated that age, laterality, histology subtype, the 7th edition of American Joint Committee on Cancer stage T, and radiotherapy were independent predictors for cause-specific survival of patients with POAL. There was high consistency between the two competing risk models. The COX model made several misestimations on the statistical significance and hazard ratios of prognostic factors.

Conclusions: This study established competing risk models as a method to assess POAL prognostic factors, which was more accurate than traditional methods that do not consider competing risk elements.

Background: Nocturnal hypoxia is common, under-diagnosed and is found in the same demographic at risk of age-related macular degeneration (AMD). The objective of this study was to determine any association between nocturnal hypoxia and AMD, its severity, and the high-risk sub-phenotype of reticular pseudodrusen (RPD).

Methods: This cross-sectional study included participants aged ≥50 years with AMD, or normal controls, exclusive of those on treatment for obstructive sleep apnoea. All participants had at home, overnight (up to 3 nights) pulse oximetry recordings and multimodal imaging to classify AMD. Classification of Obstructive Sleep Apnea (OSA) was determined based on oxygen desaturation index [ODI] with mild having values of 5-15 and moderate-to-severe >15.

Results: A total of 225 participants were included with 76% having AMD, of which 42% had coexistent RPD. Of the AMD participants, 53% had early/intermediate AMD, 30% had geographic atrophy (GA) and 17% had neovascular AMD (nAMD). Overall, mild or moderate-to-severe OSAwas not associated with an increased odds of having AMD nor AMD with RPD (p ≥ 0.180). However, moderate-to-severe OSA was associated with increased odds of having nAMD (odds ratio = 6.35; 95% confidence interval = 1.18 to 34.28; p = 0.032), but not early/intermediate AMD or GA, compared to controls (p ≥ 0.130). Mild OSA was not associated with differences in odds of having AMD of any severity (p ≥ 0.277).

Conclusions: There was an association between nocturnal hypoxia as measured by the ODI and nAMD. Hence, nocturnal hypoxia may be an under-appreciated important modifiable risk factor for nAMD.