Lingyi Zhao, Bo Zhang, Jingjing Wang, Jinliuxing Yang, Linlin Du, Tianxiao Wang, Xun Xu, Xiangui He, Jun Chen
Aim: To evaluate the short-term effects of different sunlight exposure on fundus blood flow perfusion (BFP) after near work.
Methods: In this parallel randomised controlled trial, 81 students aged 7-15 with spherical equivalent refraction between -2.00 and +3.00 diopters were randomly assigned to either a low-illuminance (4k lux) group (N=40) or high-illuminance (10k lux) (N=41). Following 1 hour indoor reading, participants had sunlight exposure matching their group's intensity for 15 minutes. BFPs in the superficial retina, deep retina and choroid were measured at four time points: pre-reading, post-reading, 5th-minute and 15th-minute sunlight exposure.
Results: Within the initial 5 minutes of sunlight exposure, the 10k lux group showed a tendency for decreased BFP, particularly in the choroid (superficial retina: -0.2, 95% CI -0.9 to 0.5; deep retina: -0.1, 95% CI -0.6 to 0.4; choroid: -0.4, 95% CI -0.8 to 0.0), while the 4k lux group exhibited an increase (superficial retina: 0.7, 95% CI 0.1 to 1.3; deep retina: 0.3, 95% CI -0.2 to 0.8; choroid: 0.1, 95% CI -0.2 to 0.5). From 5 to 15 minutes, BFP decreased in both groups. At the 5th-minute mark, the 10k lux group exhibited a greater decrease in choroid (10k -0.4 vs 4k 0.1, p=0.051). No significant difference was observed after 15 minutes of exposure.
Conclusion: Higher illuminance sunlight exposure can restore fundus BFP more rapidly than lower; however, duration remains pivotal. To prevent myopia, continuous sunlight exposure for over 15 minutes is recommended to aid in reinstating the fundus BFP increased by near work.
Trial registration number: NCT05594732.
目的:评估不同日光照射对近距离工作后眼底血流灌注(BFP)的短期影响:在这项平行随机对照试验中,81 名球面等效屈光度在 -2.00 和 +3.00 屈光度之间的 7-15 岁学生被随机分配到低照度(4k 勒克斯)组(40 人)或高照度(10k 勒克斯)组(41 人)。在室内阅读 1 小时后,参与者接受 15 分钟与本组照度相匹配的阳光照射。在阅读前、阅读后、日光照射第 5 分钟和第 15 分钟这四个时间点测量了浅层视网膜、深层视网膜和脉络膜的 BFP:结果:在阳光照射的最初 5 分钟内,10k 勒克斯组的 BFP 呈下降趋势,尤其是脉络膜(浅层视网膜:-0.2,95% CI -0.9 至 0.5;深层视网膜:-0.1,95% CI -0.6 至 0.4;脉络膜:-0.4,95% CI -0.8 至 0.0),而 4k 勒克斯组则显示出增加(视网膜浅层:0.7,95% CI 0.1 至 1.3;视网膜深层:0.3,95% CI -0.2 至 0.8;脉络膜:0.1,95% CI -0.2 至 0.5)。从 5 分钟到 15 分钟,两组的 BFP 都有所下降。在第 5 分钟时,10k 勒克斯组的脉络膜下降幅度更大(10k -0.4 vs 4k 0.1,p=0.051)。照射 15 分钟后未观察到明显差异:结论:较高照度的日光照射比较低照度的日光照射能更快地恢复眼底BFP,但持续时间仍然至关重要。结论:较高照度的日光照射能比较低照度的日光照射更快地恢复眼底BFP,但日光照射时间的长短仍然至关重要。为预防近视,建议连续照射日光15分钟以上,以帮助恢复因近距离工作而增加的眼底BFP:NCT05594732.
{"title":"Short-term effects of sunlight exposure on fundus blood flow perfusion in children: a randomised controlled trial.","authors":"Lingyi Zhao, Bo Zhang, Jingjing Wang, Jinliuxing Yang, Linlin Du, Tianxiao Wang, Xun Xu, Xiangui He, Jun Chen","doi":"10.1136/bjo-2024-325715","DOIUrl":"10.1136/bjo-2024-325715","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the short-term effects of different sunlight exposure on fundus blood flow perfusion (BFP) after near work.</p><p><strong>Methods: </strong>In this parallel randomised controlled trial, 81 students aged 7-15 with spherical equivalent refraction between -2.00 and +3.00 diopters were randomly assigned to either a low-illuminance (4k lux) group (N=40) or high-illuminance (10k lux) (N=41). Following 1 hour indoor reading, participants had sunlight exposure matching their group's intensity for 15 minutes. BFPs in the superficial retina, deep retina and choroid were measured at four time points: pre-reading, post-reading, 5th-minute and 15th-minute sunlight exposure.</p><p><strong>Results: </strong>Within the initial 5 minutes of sunlight exposure, the 10k lux group showed a tendency for decreased BFP, particularly in the choroid (superficial retina: -0.2, 95% CI -0.9 to 0.5; deep retina: -0.1, 95% CI -0.6 to 0.4; choroid: -0.4, 95% CI -0.8 to 0.0), while the 4k lux group exhibited an increase (superficial retina: 0.7, 95% CI 0.1 to 1.3; deep retina: 0.3, 95% CI -0.2 to 0.8; choroid: 0.1, 95% CI -0.2 to 0.5). From 5 to 15 minutes, BFP decreased in both groups. At the 5th-minute mark, the 10k lux group exhibited a greater decrease in choroid (10k -0.4 vs 4k 0.1, p=0.051). No significant difference was observed after 15 minutes of exposure.</p><p><strong>Conclusion: </strong>Higher illuminance sunlight exposure can restore fundus BFP more rapidly than lower; however, duration remains pivotal. To prevent myopia, continuous sunlight exposure for over 15 minutes is recommended to aid in reinstating the fundus BFP increased by near work.</p><p><strong>Trial registration number: </strong>NCT05594732.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"139-145"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Namrata Sharma, Renu Venugopal, Ritu Nagpal, Priyadarshini K, Kamna Verma, Kaushal K Verma, N R Biswas, Thirumurthy Velpandian, Seema Sen, S N Dwivedi, Radhika Tandon, Jeewan S Titiyal, Rasik Vajpayee
Purpose: To evaluate the role of topical cyclosporine A 1% (CsA) as an adjuvant therapy in patients with acute Stevens-Johnson syndrome (SJS).
Methods: This is a randomised controlled trial in which 44 patients (88 eyes) with acute SJS, presenting within 3 months from the onset of the disease, were enrolled and randomised. Group A (n=44 eyes) patients received treatment with topical CsA 1% along with standard therapy consisting of topical corticosteroids, antibiotics and lubricants. Group B (n=44 eyes) patients received topical saline drops in combination with standard therapy. Various ocular surface parameters were assessed at baseline and the 6-month follow-up.
Results: The mean age of patients (years) was 23.9±15.1 in the CsA group and 26.0±18.7 in the control group (p=0.6840). The mean time from disease onset to presentation (days) was 17.0±14.0 and 12.9±11.3 in CsA and control groups, respectively (p=0.1568). At presentation, the mean grades of severity scores of various parameters were comparable. At 6 months, both groups showed a significant improvement in the mean severity grades of conjunctival hyperaemia (A, p=0.001; B, p=0.0001), mucocutaneous junction involvement (A, p=0.001; B, p=0.0001) and meibomian gland involvement (A, p=0.0471; B, p=0.006). Compared with baseline, the grades of corneal keratinisation (baseline, 0.48±0.7; 6 months, 1.02±0.8; p=0.0015) and neovascularisation (baseline, 1.07±1.2; 6 months, 1.57±1.0; p=0.0412) worsened after 6 months of CsA therapy. Intergroup comparison of grades of various parameters however did not reveal any significant difference at 6 months.
Conclusions: Adjuvant treatment with topical CsA is not superior to standard therapy, in cases of acute SJS.
{"title":"Evaluation of adjuvant role of topical cyclosporine 1% in acute Stevens-Johnson syndrome: a randomised control trial.","authors":"Namrata Sharma, Renu Venugopal, Ritu Nagpal, Priyadarshini K, Kamna Verma, Kaushal K Verma, N R Biswas, Thirumurthy Velpandian, Seema Sen, S N Dwivedi, Radhika Tandon, Jeewan S Titiyal, Rasik Vajpayee","doi":"10.1136/bjo-2023-324901","DOIUrl":"10.1136/bjo-2023-324901","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the role of topical cyclosporine A 1% (CsA) as an adjuvant therapy in patients with acute Stevens-Johnson syndrome (SJS).</p><p><strong>Methods: </strong>This is a randomised controlled trial in which 44 patients (88 eyes) with acute SJS, presenting within 3 months from the onset of the disease, were enrolled and randomised. Group A (n=44 eyes) patients received treatment with topical CsA 1% along with standard therapy consisting of topical corticosteroids, antibiotics and lubricants. Group B (n=44 eyes) patients received topical saline drops in combination with standard therapy. Various ocular surface parameters were assessed at baseline and the 6-month follow-up.</p><p><strong>Results: </strong>The mean age of patients (years) was 23.9±15.1 in the CsA group and 26.0±18.7 in the control group (p=0.6840). The mean time from disease onset to presentation (days) was 17.0±14.0 and 12.9±11.3 in CsA and control groups, respectively (p=0.1568). At presentation, the mean grades of severity scores of various parameters were comparable. At 6 months, both groups showed a significant improvement in the mean severity grades of conjunctival hyperaemia (A, p=0.001; B, p=0.0001), mucocutaneous junction involvement (A, p=0.001; B, p=0.0001) and meibomian gland involvement (A, p=0.0471; B, p=0.006). Compared with baseline, the grades of corneal keratinisation (baseline, 0.48±0.7; 6 months, 1.02±0.8; p=0.0015) and neovascularisation (baseline, 1.07±1.2; 6 months, 1.57±1.0; p=0.0412) worsened after 6 months of CsA therapy. Intergroup comparison of grades of various parameters however did not reveal any significant difference at 6 months.</p><p><strong>Conclusions: </strong>Adjuvant treatment with topical CsA is not superior to standard therapy, in cases of acute SJS.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"10-14"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The purpose is to investigate the association between handgrip strength (HGS) and the risk of future diabetic complications in multicountry cohorts.
Methods: The association between HGS and diabetic complications was evaluated using cox models among 84 453 patients with pre-diabetes and diabetes from the UK Biobank with a 12-year follow-up. The association between HGS and longitudinal microcirculatory damage rates was assessed among 819 patients with diabetes from the Guangzhou Diabetic Eye Study (GDES) with a 3-year follow-up. Participants were divided into three age groups (<56, 56-65 and ≥65 years), and each group was further subdivided into three HGS tertiles.
Results: A 5 kg reduction in HGS was associated with increased risk for all-cause mortality (women, HR=1.10, 95% CI: 1.05 to 1.14; p<0.001; men, HR=1.13, 95% CI: 1.11 to 1.15; p<0.001). Women and men in the lowest HGS group exhibited 1.6-times and 1.3-1.5-times higher risk of myocardial infarction and stroke compared with the highest HGS group. In men, there was a higher risk of developing end-stage renal disease (HR=1.83, 95% CI: 1.30 to 2.57; p=0.001), while this was not observed in women. Both sexes in the lowest HGS group had a 1.3-times higher risk of diabetic retinopathy compared with the highest HGS group. In the GDES group, individuals with the lowest HGS showed accelerated microcirculatory damage in retina (all p<0.05).
Conclusions: Reduced HGS is significantly associated with a higher risk of diabetic complications and accelerated microvascular damage. HGS could serve as a practical indicator of vascular health in patients with pre-diabetes and diabetes.
{"title":"Handgrip strength and risks of diabetic vascular complications: Evidence from Guangzhou Diabetic Eye Study and UK cohorts.","authors":"Pingting Zhong, Shaopeng Yang, Riqian Liu, Ziyu Zhu, Yongjie Zhang, Weijing Cheng, Wei Wang","doi":"10.1136/bjo-2023-324893","DOIUrl":"10.1136/bjo-2023-324893","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to investigate the association between handgrip strength (HGS) and the risk of future diabetic complications in multicountry cohorts.</p><p><strong>Methods: </strong>The association between HGS and diabetic complications was evaluated using cox models among 84 453 patients with pre-diabetes and diabetes from the UK Biobank with a 12-year follow-up. The association between HGS and longitudinal microcirculatory damage rates was assessed among 819 patients with diabetes from the Guangzhou Diabetic Eye Study (GDES) with a 3-year follow-up. Participants were divided into three age groups (<56, 56-65 and ≥65 years), and each group was further subdivided into three HGS tertiles.</p><p><strong>Results: </strong>A 5 kg reduction in HGS was associated with increased risk for all-cause mortality (women, HR=1.10, 95% CI: 1.05 to 1.14; p<0.001; men, HR=1.13, 95% CI: 1.11 to 1.15; p<0.001). Women and men in the lowest HGS group exhibited 1.6-times and 1.3-1.5-times higher risk of myocardial infarction and stroke compared with the highest HGS group. In men, there was a higher risk of developing end-stage renal disease (HR=1.83, 95% CI: 1.30 to 2.57; p=0.001), while this was not observed in women. Both sexes in the lowest HGS group had a 1.3-times higher risk of diabetic retinopathy compared with the highest HGS group. In the GDES group, individuals with the lowest HGS showed accelerated microcirculatory damage in retina (all p<0.05).</p><p><strong>Conclusions: </strong>Reduced HGS is significantly associated with a higher risk of diabetic complications and accelerated microvascular damage. HGS could serve as a practical indicator of vascular health in patients with pre-diabetes and diabetes.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"157-164"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aurora Pecaku, Isabela Martins Melo, Reut Shor, Carolina L M Francisconi, Samara Barbara Marafon, Varun Chaudhary, Roxane Jo Hillier, Rajeev H Muni
Aim: To assess the primary reattachment rate (PARR) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) meeting the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomised Trial (PIVOT) criteria with a single break in detached retina.
Methods: A post hoc analysis of two clinical trials. To be included, patients with primary RRD had to meet PIVOT criteria but could have only one break in the detached retina. Patients with additional pathology in the attached retina were included in a secondary analysis. The primary outcome was PARR following PnR versus PPV at 1-year postoperatively.
Results: 162 patients were included. 53% (86/162) underwent PnR and 47% (76/162) had a PPV. 99% (85/86) and 86.8% (66/76) completed the 1-year follow-up visits in the PnR and PPV groups, respectively. PARR was 88.2% (75/85) in the PnR group and 90.9% (60/66) in the PPV group (p=0.6) with a mean postoperative logMAR best-corrected visual acuity of 0.19±0.25 versus 0.34±0.37 (Snellen 20/30 vs 20/44) (p=0.01) each in the PnR and PPV groups, respectively.In an additional analysis of patients who were also allowed to have any pathology in the attached retina, the PARR was 85% (91/107) and 91.6% (66/72) in the PnR and PPV groups, respectively (p=0.18).
Conclusions: PnR and PPV provide similar long-term PARR in a substantial proportion of patients meeting PIVOT criteria with only a single break in the detached retina. Therefore, in patients meeting these specific criteria, PnR is an appropriate first-line therapy as it offers superior functional outcomes without compromising PARR.
{"title":"Reattachment rate with pneumatic retinopexy versus pars plana vitrectomy for single break rhegmatogenous retinal detachment.","authors":"Aurora Pecaku, Isabela Martins Melo, Reut Shor, Carolina L M Francisconi, Samara Barbara Marafon, Varun Chaudhary, Roxane Jo Hillier, Rajeev H Muni","doi":"10.1136/bjo-2023-324005","DOIUrl":"10.1136/bjo-2023-324005","url":null,"abstract":"<p><strong>Aim: </strong>To assess the primary reattachment rate (PARR) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) meeting the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomised Trial (PIVOT) criteria with a single break in detached retina.</p><p><strong>Methods: </strong>A post hoc analysis of two clinical trials. To be included, patients with primary RRD had to meet PIVOT criteria but could have only one break in the detached retina. Patients with additional pathology in the attached retina were included in a secondary analysis. The primary outcome was PARR following PnR versus PPV at 1-year postoperatively.</p><p><strong>Results: </strong>162 patients were included. 53% (86/162) underwent PnR and 47% (76/162) had a PPV. 99% (85/86) and 86.8% (66/76) completed the 1-year follow-up visits in the PnR and PPV groups, respectively. PARR was 88.2% (75/85) in the PnR group and 90.9% (60/66) in the PPV group (p=0.6) with a mean postoperative logMAR best-corrected visual acuity of 0.19±0.25 versus 0.34±0.37 (Snellen 20/30 vs 20/44) (p=0.01) each in the PnR and PPV groups, respectively.In an additional analysis of patients who were also allowed to have any pathology in the attached retina, the PARR was 85% (91/107) and 91.6% (66/72) in the PnR and PPV groups, respectively (p=0.18).</p><p><strong>Conclusions: </strong>PnR and PPV provide similar long-term PARR in a substantial proportion of patients meeting PIVOT criteria with only a single break in the detached retina. Therefore, in patients meeting these specific criteria, PnR is an appropriate first-line therapy as it offers superior functional outcomes without compromising PARR.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"113-118"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shravya Choudhary Balla, Mohammed Hasnat Ali, Mudit Tyagi, Soumyava Basu
Background: Tuberculosis (TB)-immunoreactivity, measured in vivo (tuberculin skin test (TST)) or in vitro (interferon gamma release assay (IGRA)), can be found in latent, active or even following clearance of TB infection. In this case-control study, we compared the systemic and ocular outcomes between patients with or without TB-immunoreactivity, who received immunomodulatory therapy (IMT) for non-infectious uveitis.
Methods: We retrospectively reviewed charts of patients with (cases) or without (controls) TB-immunoreactivity (TST±IGRA), who received conventional IMT for ≥6 months, for the treatment of non-infectious uveitis. Patients who received prior or concomitant anti-TB therapy were excluded. Systemic and ocular outcomes were compared between both groups.
Results: 36 cases and 70 controls (gender-matched and age-matched) were included. New-onset pulmonary or extrapulmonary TB developed in one case and none of the controls. Based on this outcome, the absolute risk increase for systemic TB reactivation was noted to be 0.028 (95% CI 0.005 to 0.051) and the number needed to harm was 36. The incidence of persistent or recurrent (worsening ≥2 grades) intraocular inflammation during IMT was comparable between both groups (cases 18/36, controls 35/70, p=1.0). A change in anatomical site of presentation at recurrence was not seen in any case, but in six controls (p=0.15). No new focal chorio-retinal lesions were noted in either group.
Conclusions: Conventional IMT has a very low risk of systemic TB reactivation, and no additional detrimental effect on ocular outcomes, in TB-immunoreactive patients with non-infectious uveitis.
{"title":"Systemic and ocular outcomes in TB-immunoreactive patients receiving immunomodulatory therapy for non-infectious uveitis: a case-control study.","authors":"Shravya Choudhary Balla, Mohammed Hasnat Ali, Mudit Tyagi, Soumyava Basu","doi":"10.1136/bjo-2024-325625","DOIUrl":"10.1136/bjo-2024-325625","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB)-immunoreactivity, measured in vivo (tuberculin skin test (TST)) or in vitro (interferon gamma release assay (IGRA)), can be found in latent, active or even following clearance of TB infection. In this case-control study, we compared the systemic and ocular outcomes between patients with or without TB-immunoreactivity, who received immunomodulatory therapy (IMT) for non-infectious uveitis.</p><p><strong>Methods: </strong>We retrospectively reviewed charts of patients with (cases) or without (controls) TB-immunoreactivity (TST±IGRA), who received conventional IMT for ≥6 months, for the treatment of non-infectious uveitis. Patients who received prior or concomitant anti-TB therapy were excluded. Systemic and ocular outcomes were compared between both groups.</p><p><strong>Results: </strong>36 cases and 70 controls (gender-matched and age-matched) were included. New-onset pulmonary or extrapulmonary TB developed in one case and none of the controls. Based on this outcome, the absolute risk increase for systemic TB reactivation was noted to be 0.028 (95% CI 0.005 to 0.051) and the number needed to harm was 36. The incidence of persistent or recurrent (worsening ≥2 grades) intraocular inflammation during IMT was comparable between both groups (cases 18/36, controls 35/70, p=1.0). A change in anatomical site of presentation at recurrence was not seen in any case, but in six controls (p=0.15). No new focal chorio-retinal lesions were noted in either group.</p><p><strong>Conclusions: </strong>Conventional IMT has a very low risk of systemic TB reactivation, and no additional detrimental effect on ocular outcomes, in TB-immunoreactive patients with non-infectious uveitis.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"41-44"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nervine El Meshad, Haidy Soliman, Samantha Hunt, Saj Amarakoon, Ahmad Ahmad, Rebecca Ford, Richard Harrad, Vivi Choleva
Background: Corrective squint surgery has a significant psychological impact, affecting both the quality of life and mental health of patients. This study highlights the quantitative and subjective assessment of both the psychological and functional outcomes of squint surgery in adults having horizontal strabismus with no preoperative diplopia using a Quality-Of-Life Adult Strabismus 20 (QOL AS-20) questionnaire.
Method: The study is a retrospective cohort study on patients with uncomplicated, horizontal squint; with no vertical deviation and was conducted as part of a departmental clinical audit. It also aimed to challenge local clinical commissioning group (CCG) funding restrictions for what they regarded as a 'cosmetic procedure'. The QOL AS-20 questionnaires were completed before and 3 months after surgery and were analysed using the paired Wilcoxon signed rank t-test which showed significant improvement. A Freedom of Information Act request sought information on strabismus surgery funding restrictions from all CCGs to explore variations in perceptions throughout England.
Results: 28 patients were included in the study. The overall success of squint surgery was 67.5%. The median QOL AS-20 questionnaire overall score increased from 28.125 to 88.75 (p value<0.00001), functional subscale from 46.25 to 87.5 (p value<0.00001) and psychological subscale from 15 to 90 (p value<0.00001).
Conclusion: Squint surgery in non-diplopic adults with horizontal squint surgery should be regarded as restorative of normal anatomy from a pathological state rather than a cosmetic procedure.Restrictions to accessing this surgery may increase, especially during post-COVID-19. This patient-focused service evaluation demonstrates the substantial psychosocial benefits of such surgery, as evidenced through quality-of-life assessments.
{"title":"Psychological and functional outcomes of horizontal squint surgery in adults with no preoperative diplopia using Quality-of-Life AS-20 questionnaire.","authors":"Nervine El Meshad, Haidy Soliman, Samantha Hunt, Saj Amarakoon, Ahmad Ahmad, Rebecca Ford, Richard Harrad, Vivi Choleva","doi":"10.1136/bjo-2023-324719","DOIUrl":"10.1136/bjo-2023-324719","url":null,"abstract":"<p><strong>Background: </strong>Corrective squint surgery has a significant psychological impact, affecting both the quality of life and mental health of patients. This study highlights the quantitative and subjective assessment of both the psychological and functional outcomes of squint surgery in adults having horizontal strabismus with no preoperative diplopia using a Quality-Of-Life Adult Strabismus 20 (QOL AS-20) questionnaire.</p><p><strong>Method: </strong>The study is a retrospective cohort study on patients with uncomplicated, horizontal squint; with no vertical deviation and was conducted as part of a departmental clinical audit. It also aimed to challenge local clinical commissioning group (CCG) funding restrictions for what they regarded as a 'cosmetic procedure'. The QOL AS-20 questionnaires were completed before and 3 months after surgery and were analysed using the paired Wilcoxon signed rank t-test which showed significant improvement. A Freedom of Information Act request sought information on strabismus surgery funding restrictions from all CCGs to explore variations in perceptions throughout England.</p><p><strong>Results: </strong>28 patients were included in the study. The overall success of squint surgery was 67.5%. The median QOL AS-20 questionnaire overall score increased from 28.125 to 88.75 (p value<0.00001), functional subscale from 46.25 to 87.5 (p value<0.00001) and psychological subscale from 15 to 90 (p value<0.00001).</p><p><strong>Conclusion: </strong>Squint surgery in non-diplopic adults with horizontal squint surgery should be regarded as restorative of normal anatomy from a pathological state rather than a cosmetic procedure.Restrictions to accessing this surgery may increase, especially during post-COVID-19. This patient-focused service evaluation demonstrates the substantial psychosocial benefits of such surgery, as evidenced through quality-of-life assessments.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"152-156"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clara Bertret, Juliette Knoeri, Loic Leveziel, Tristan Bourcier, Françoise Brignole-Baudouin, Lilia Merabet, Nacim Bouheraoua, Vincent Michel Borderie
Aims: To report an epidemiological update of bacterial keratitis (BK) in a tertiary ophthalmology centre over 20 months compared with a previous study on the same timeframe from 1998 to 1999.
Methods: 354 patients with BK documented by microbiological corneal scraping or resolutive under antibiotics treatment from January 2020 to September 2021 were analysed retrospectively.
Results: One or several risk factors were found in 95.2% of patients: contact lens wear (45.2%), ocular surface disease (25.0%), systemic disease (21.8%), ocular trauma (11.9%) and ocular surgery (8.8%). The positivity rate of corneal scrapings was 82.5%, with 18.2% polybacterial. One hundred seventy-five (59.9%) bacteria were Gram-negative, and 117 (40.1%) were Gram-positive. The most common bacteria were Pseudomonas aeruginosa (32.5%), Moraxella spp (18.1%) and Staphylococcus aureus (8.2%). Final visual acuity (logarithm of the minimum angle of resolution) was associated with age (r=+0.48; p=0.0001), infiltrate size (r=+0.32; p<0.0001), ocular surface disease (r=+0.13; p=0.03), ocular trauma (r=-0.14; p=0.02) and contact lens wear (r=-0.26; p<0.0001). Gram-negative bacteria were responsible for deeper (r=+0.18; p=0.004) and more extensive infiltrates (r=+0.18; p=0.004) in younger patients (r=-0.19; p=0.003). Compared with the previous period, the positivity rate of corneal scrapings and the proportion of Gram-negative bacteria, especially Moraxella spp, increased. All P. aeruginosa and Moraxella spp were sensitive to quinolones, and all S. aureus were sensitive to both quinolones and methicillin.
Conclusion: Contact lens wear remained the leading risk factor. The bacteria distribution was reversed, with a predominance of Gram-negative bacteria and increased Moraxella spp.
{"title":"Predisposing factors, clinical and microbiological insights of bacterial keratitis: analysis of 354 cases from a leading French academic centre.","authors":"Clara Bertret, Juliette Knoeri, Loic Leveziel, Tristan Bourcier, Françoise Brignole-Baudouin, Lilia Merabet, Nacim Bouheraoua, Vincent Michel Borderie","doi":"10.1136/bjo-2024-325261","DOIUrl":"10.1136/bjo-2024-325261","url":null,"abstract":"<p><strong>Aims: </strong>To report an epidemiological update of bacterial keratitis (BK) in a tertiary ophthalmology centre over 20 months compared with a previous study on the same timeframe from 1998 to 1999.</p><p><strong>Methods: </strong>354 patients with BK documented by microbiological corneal scraping or resolutive under antibiotics treatment from January 2020 to September 2021 were analysed retrospectively.</p><p><strong>Results: </strong>One or several risk factors were found in 95.2% of patients: contact lens wear (45.2%), ocular surface disease (25.0%), systemic disease (21.8%), ocular trauma (11.9%) and ocular surgery (8.8%). The positivity rate of corneal scrapings was 82.5%, with 18.2% polybacterial. One hundred seventy-five (59.9%) bacteria were Gram-negative, and 117 (40.1%) were Gram-positive. The most common bacteria were <i>Pseudomonas aeruginosa</i> (32.5%), <i>Moraxella</i> spp (18.1%) and <i>Staphylococcus aureus</i> (8.2%). Final visual acuity (logarithm of the minimum angle of resolution) was associated with age (r=+0.48; p=0.0001), infiltrate size (r=+0.32; p<0.0001), ocular surface disease (r=+0.13; p=0.03), ocular trauma (r=-0.14; p=0.02) and contact lens wear (r=-0.26; p<0.0001). Gram-negative bacteria were responsible for deeper (r=+0.18; p=0.004) and more extensive infiltrates (r=+0.18; p=0.004) in younger patients (r=-0.19; p=0.003). Compared with the previous period, the positivity rate of corneal scrapings and the proportion of Gram-negative bacteria, especially <i>Moraxella</i> spp, increased. All <i>P. aeruginosa</i> and <i>Moraxella</i> spp were sensitive to quinolones, and all <i>S. aureus</i> were sensitive to both quinolones and methicillin.</p><p><strong>Conclusion: </strong>Contact lens wear remained the leading risk factor. The bacteria distribution was reversed, with a predominance of Gram-negative bacteria and increased <i>Moraxella</i> spp.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"15-20"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Markus Ritter, Allan Hummer, Maximilian Pawloff, Anna A Ledolter, David Linhardt, Michael Woletz, Gabor Gyoergy Deak, Stefan Sacu, Robin Ristl, Dariga Ramazanova, Graham E Holder, Christian Windischberger, Ursula Margarethe Schmidt-Erfurth
Background/aims: To determine the suitability of functional MRI (fMRI) as an objective measure of macular function following therapeutic intervention; conventional psychophysical measures rely heavily on patient compliance.
Methods: Twenty patients with neovascular age-related macular degeneration (nAMD) were studied with high-resolution fMRI, visual acuity, reading accuracy and speed, contrast sensitivity (CS) and microperimetry (MP) before and after 3 monthly intravitreal injections of ranibizumab. Population-receptive field retinotopic maps calculated from fMRI data were compared with psychophysical measures and optical coherence tomography.
Results: Best-corrected visual acuity (BCVA) responders (≥5 letters) showed an increase of 29.5% in activated brain area, while non-responders showed a decrease of 0.8%. Radial histograms over eccentricity allowed quantification of the absolute number of significant voxels and thus differences before and after treatment. Responders showed increases in foveal (α<0.5°) activation, while non-responders did not. Absence of intraretinal fluid and preservation of outer retinal layers was associated with higher numbers of active V1 voxels and better BCVA. Higher voxel numbers were associated with improved reading performance and, less marked, with BCVA, CS and MP.
Conclusion: The data show that retinotopic mapping using fMRI can successfully be applied objectively to evaluate the therapeutic response in nAMD patients treated with anti-vascular endothelial growth factor therapy. This demonstrates the ability of retinotopic mapping to provide an objective assessment of functional recovery at a cortical level; the technique can therefore be applied, in other degenerative macular diseases, to the assessment of potential therapeutic interventions such as gene therapy or cell replacement therapy.
{"title":"Retinotopic cortical mapping in objective functional monitoring of macular therapy.","authors":"Markus Ritter, Allan Hummer, Maximilian Pawloff, Anna A Ledolter, David Linhardt, Michael Woletz, Gabor Gyoergy Deak, Stefan Sacu, Robin Ristl, Dariga Ramazanova, Graham E Holder, Christian Windischberger, Ursula Margarethe Schmidt-Erfurth","doi":"10.1136/bjo-2021-320723","DOIUrl":"10.1136/bjo-2021-320723","url":null,"abstract":"<p><strong>Background/aims: </strong>To determine the suitability of functional MRI (fMRI) as an objective measure of macular function following therapeutic intervention; conventional psychophysical measures rely heavily on patient compliance.</p><p><strong>Methods: </strong>Twenty patients with neovascular age-related macular degeneration (nAMD) were studied with high-resolution fMRI, visual acuity, reading accuracy and speed, contrast sensitivity (CS) and microperimetry (MP) before and after 3 monthly intravitreal injections of ranibizumab. Population-receptive field retinotopic maps calculated from fMRI data were compared with psychophysical measures and optical coherence tomography.</p><p><strong>Results: </strong>Best-corrected visual acuity (BCVA) responders (≥5 letters) showed an increase of 29.5% in activated brain area, while non-responders showed a decrease of 0.8%. Radial histograms over eccentricity allowed quantification of the absolute number of significant voxels and thus differences before and after treatment. Responders showed increases in foveal (α<0.5°) activation, while non-responders did not. Absence of intraretinal fluid and preservation of outer retinal layers was associated with higher numbers of active V1 voxels and better BCVA. Higher voxel numbers were associated with improved reading performance and, less marked, with BCVA, CS and MP.</p><p><strong>Conclusion: </strong>The data show that retinotopic mapping using fMRI can successfully be applied objectively to evaluate the therapeutic response in nAMD patients treated with anti-vascular endothelial growth factor therapy. This demonstrates the ability of retinotopic mapping to provide an objective assessment of functional recovery at a cortical level; the technique can therefore be applied, in other degenerative macular diseases, to the assessment of potential therapeutic interventions such as gene therapy or cell replacement therapy.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"98-106"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takashi Nishida, Sasan Moghimi, Gopikasree Gunasegaran, Evan Walker, Jo-Hsuan Wu, Kamran Rahmatnejad, Linda M Zangwill, Sally L Baxter, Robert N Weinreb
Background/aims: To investigate the association between use of metformin and circumpapillary retinal nerve fibre layer (cpRNFL) thickness, as well as whole image capillary density (wiCD), in patients with glaucoma.
Methods: This cross-sectional study included patients with glaucoma suspect or primary open-angle glaucoma (POAG) underwent optical coherence tomography angiography imaging. Use and duration of antidiabetic medications were assessed at the time of imaging. Multivariable linear mixed-effect modelling was used to estimate the effect of diabetes medication on wiCD and cpRNFL while controlling for covariates including age, race, body mass index, diagnosis, 24-2 visual field mean deviation, and intraocular pressure, average signal strength index as well as any variables that showed a p <0.1 in the univariable analysis.
Results: A total of 577 eyes (330 POAG and 247 glaucoma suspect) of 346 patients were included. Sixty-five patients (23%) had diabetes, of whom 55 (78.5%) used metformin, and 17 (26.2%) used insulin. After adjusting for covariates, the association between metformin use and wiCD (1.56 (95% CI 0.40 to 2.71); p=0.008), duration of metformin use and wiCD (0.12 (95% CI 0.02 to 0.22) per 1 year longer; p=0.037), and metformin use and cpRNFL thickness (5.17 (95% CI 1.24 to 9.10) µm; p=0.010) had statistically significant associations in each model.
Conclusions: Metformin use was associated with higher wiCD and thicker cpRNFL. These findings indicate a potential association, underscoring the need for longitudinal studies to determine if metformin plays a role in the retinal conditions of patients with glaucoma.
{"title":"Association between metformin use with circumpapillary retinal nerve fibre layer thickness and capillary vessel density in glaucoma.","authors":"Takashi Nishida, Sasan Moghimi, Gopikasree Gunasegaran, Evan Walker, Jo-Hsuan Wu, Kamran Rahmatnejad, Linda M Zangwill, Sally L Baxter, Robert N Weinreb","doi":"10.1136/bjo-2023-325035","DOIUrl":"10.1136/bjo-2023-325035","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate the association between use of metformin and circumpapillary retinal nerve fibre layer (cpRNFL) thickness, as well as whole image capillary density (wiCD), in patients with glaucoma.</p><p><strong>Methods: </strong>This cross-sectional study included patients with glaucoma suspect or primary open-angle glaucoma (POAG) underwent optical coherence tomography angiography imaging. Use and duration of antidiabetic medications were assessed at the time of imaging. Multivariable linear mixed-effect modelling was used to estimate the effect of diabetes medication on wiCD and cpRNFL while controlling for covariates including age, race, body mass index, diagnosis, 24-2 visual field mean deviation, and intraocular pressure, average signal strength index as well as any variables that showed a p <0.1 in the univariable analysis.</p><p><strong>Results: </strong>A total of 577 eyes (330 POAG and 247 glaucoma suspect) of 346 patients were included. Sixty-five patients (23%) had diabetes, of whom 55 (78.5%) used metformin, and 17 (26.2%) used insulin. After adjusting for covariates, the association between metformin use and wiCD (1.56 (95% CI 0.40 to 2.71); p=0.008), duration of metformin use and wiCD (0.12 (95% CI 0.02 to 0.22) per 1 year longer; p=0.037), and metformin use and cpRNFL thickness (5.17 (95% CI 1.24 to 9.10) µm; p=0.010) had statistically significant associations in each model.</p><p><strong>Conclusions: </strong>Metformin use was associated with higher wiCD and thicker cpRNFL. These findings indicate a potential association, underscoring the need for longitudinal studies to determine if metformin plays a role in the retinal conditions of patients with glaucoma.</p><p><strong>Trial registration number: </strong>NCT00221897.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"45-51"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean-Baptiste Ducloyer, Yannick Eude, Christelle Volteau, Olivier Lebreton, Alexandre Bonissent, Paul Fossum, Ramin Tadayoni, Catherine P Creuzot-Garcher, Yannick Le Mer, Julien Perol, June Fortin, Alexandra Jobert, Fanny Billaud, Catherine Ivan, Alexandra Poinas, Michel Weber
Background: After idiopathic epiretinal membrane (iERM) removal, it is unclear whether the internal limiting membrane (ILM) should be removed. The objective was to assess if active ILM peeling after iERM removal could induce microscotomas.
Methods: The PEELING study is a national randomised clinical trial. When no spontaneous ILM peeling occurred, patients were randomised either to the ILM peeling or no ILM peeling group. Groups were compared at the month 1 (M1), M6 and M12 visits in terms of microperimetry, best-corrected visual acuity (BCVA) and optical coherence tomography findings. The primary outcome was the difference in microscotoma number between baseline and M6.
Results: 213 patients were included, 101 experienced spontaneous ILM peeling and 100 were randomised to the ILM peeling (n=51) or no ILM peeling group (n=49). The difference in microscotoma number between both groups was significant at M1 (3.9 more microscotomas in ILM peeling group, (0.8;7.0) p=0.0155) but not at M6 (2.1 more microscotomas in ILM peeling group (-0.5;4.7) p=0.1155). Only in the no ILM peeling group, the number of microscotomas significantly decreased and the mean retinal sensitivity significantly improved. The ERM recurred in nine patients in the no ILM peeling group (19.6%) versus zero in the ILM peeling group (p=0.0008): two of them underwent revision surgery. There was no difference in mean BCVA and microperimetry between patients experiencing or not a recurrence at M12.
Conclusion: Spontaneous ILM peeling is very common. Active ILM peeling prevents anatomical ERM recurrence but may induce retinal impairments and delay visual recovery.
{"title":"Pros and cons of internal limiting membrane peeling during epiretinal membrane surgery: a randomised clinical trial with microperimetry (PEELING).","authors":"Jean-Baptiste Ducloyer, Yannick Eude, Christelle Volteau, Olivier Lebreton, Alexandre Bonissent, Paul Fossum, Ramin Tadayoni, Catherine P Creuzot-Garcher, Yannick Le Mer, Julien Perol, June Fortin, Alexandra Jobert, Fanny Billaud, Catherine Ivan, Alexandra Poinas, Michel Weber","doi":"10.1136/bjo-2023-324990","DOIUrl":"10.1136/bjo-2023-324990","url":null,"abstract":"<p><strong>Background: </strong>After idiopathic epiretinal membrane (iERM) removal, it is unclear whether the internal limiting membrane (ILM) should be removed. The objective was to assess if active ILM peeling after iERM removal could induce microscotomas.</p><p><strong>Methods: </strong>The PEELING study is a national randomised clinical trial. When no spontaneous ILM peeling occurred, patients were randomised either to the ILM peeling or no ILM peeling group. Groups were compared at the month 1 (M1), M6 and M12 visits in terms of microperimetry, best-corrected visual acuity (BCVA) and optical coherence tomography findings. The primary outcome was the difference in microscotoma number between baseline and M6.</p><p><strong>Results: </strong>213 patients were included, 101 experienced spontaneous ILM peeling and 100 were randomised to the ILM peeling (n=51) or no ILM peeling group (n=49). The difference in microscotoma number between both groups was significant at M1 (3.9 more microscotomas in ILM peeling group, (0.8;7.0) p=0.0155) but not at M6 (2.1 more microscotomas in ILM peeling group (-0.5;4.7) p=0.1155). Only in the no ILM peeling group, the number of microscotomas significantly decreased and the mean retinal sensitivity significantly improved. The ERM recurred in nine patients in the no ILM peeling group (19.6%) versus zero in the ILM peeling group (p=0.0008): two of them underwent revision surgery. There was no difference in mean BCVA and microperimetry between patients experiencing or not a recurrence at M12.</p><p><strong>Conclusion: </strong>Spontaneous ILM peeling is very common. Active ILM peeling prevents anatomical ERM recurrence but may induce retinal impairments and delay visual recovery.</p><p><strong>Trial registration: </strong>NCT02146144.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"119-125"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}