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Improvement of stereopsis following strabismus surgery in adults: a retrospective analysis. 成人斜视手术后立体视功能的改善:回顾性分析。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-31 DOI: 10.1016/j.jcjo.2024.12.007
Oded Rock, Tiran Golani, Sari David, Mor Vered, Rasha Mosleh, Sharon Armarnik, Tamara Wygnanski-Jaffe

Objective: Adults who undergo strabismus surgery, in addition to cosmesis, could benefit from improved stereopsis. This improvement is associated with the performance of motor skill tasks in young adults; they reduce the risk of tripping or falling during everyday locomotion and improve reading efficiency. This study aimed to assess stereopsis level after strabismus surgery in adults who underwent strabismus surgery for any reason.

Methods: Retrospective observational study of adult patients who underwent strabismus surgery at our institution between 2010 and 2022.

Results: One hundred and thirty-two patients were included. Postoperatively, 48% had a stereo acuity better than 100 seconds of arc, and only 21.5% had no stereopsis. The most significant factor influencing improved stereopsis after surgery was the angle of strabismus postoperatively (p = 0.018). There was a statistically significant correlation between fusion at a distance and the stereo acuity (p = 0.0337). There was no statistically significant correlation between the stereo acuity level and the strabismus angle of deviation, the strabismus direction (vertical, horizontal, or combined), or the type (esotropia or exotropia) before or after the surgery. Although not statistically significant (p = 0.6579), the underlying cause categories were correlated with the stereo level. Patients with neurological causes demonstrated higher levels of stereopsis, followed by TED, whereas patients with childhood strabismus have the lowest probability of regaining stereopsis after surgery.

Conclusions: Although long-standing strabismus reduces the potential for binocularity, surgery may be beneficial and improve stereopsis regardless of the cause of strabismus.

目的:成人斜视手术,除了美容,可以受益于立体视觉的改善。这种改善与年轻人运动技能任务的表现有关;它们减少了在日常运动中绊倒或跌倒的风险,提高了阅读效率。本研究旨在评估因任何原因接受斜视手术的成人斜视手术后的立体视水平。方法:对2010年至2022年在我院接受斜视手术的成人患者进行回顾性观察研究。结果:纳入132例患者。术后,48%的人立体视力优于100秒弧度,只有21.5%的人没有立体视觉。影响术后立体视觉改善的最显著因素是术后斜视角度(p = 0.018)。远处融合与立体视敏度有统计学意义(p = 0.0337)。手术前后立体视敏度水平与斜视偏斜角、斜视方向(垂直、水平或联合)、斜视类型(内斜视或外斜视)均无统计学意义。虽然没有统计学意义(p = 0.6579),但潜在原因类别与立体立体水平相关。神经系统疾病患者的立体视觉水平较高,其次是TED,而儿童斜视患者在手术后恢复立体视觉的可能性最低。结论:尽管长期斜视降低了双眼视的可能性,但手术可能是有益的,可以改善立体视,而不考虑斜视的原因。
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引用次数: 0
Pterygium-like conjunctival nevus: a clinicopathological study.
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-30 DOI: 10.1016/j.jcjo.2025.01.009
Satoru Kase, Kiriko Hirooka, Emi Takakuwa, Susumu Ishida
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引用次数: 0
A case of VEXAS syndrome with therapy refractive macular involvement. 屈光性黄斑受累治疗的VEXAS综合征1例。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-15 DOI: 10.1016/j.jcjo.2025.01.002
Raphael Lechtenboehmer, Matthias M Mauschitz, Frank G Holz, Robert P Finger, Maximilian W M Wintergerst
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引用次数: 0
"Blindness" is not a contraindication for voretigene neparvovec-rzyl treatment: a review of 9 cases. “失明”不是voretigene neparvovec-rzyl治疗的禁忌症——对9例病例的回顾。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-15 DOI: 10.1016/j.jcjo.2024.12.013
Deepika C Parameswarappa, Kirk A J Stephenson, Mark Seamone, Cynthia X Qian, Rajeev H Muni, Peter J Kertes, Ajoy Vincent, Elise Héon

Objective: Biallelic RPE65 pathogenic variants may cause Leber congenital amaurosis (LCA). Voretigene neparvovec-rzyl (VN, Luxturna) is the only approved subretinal gene therapy that demonstrated benefit and safety. The eligibility criteria are vague and variable between centres. This is the first comprehensive outcome report of RPE65-LCA patients with World Health Organization blindness criteria vision treated with VN.

Design: Multicentre retrospective case series.

Participants: Patients meeting the treatment criteria for VN who had best-corrected visual acuity (BCVA) <20/400 or visual field (VF)III4e isopter <10°.

Methods: Patients were followed for a mean of 11.1 ± 4.7 months. Age, sex, BCVA, central retinal thickness (CRT), retinal atrophy, VF, full-field stimulus testing (FST), and subjective impressions were assessed.

Results: Nine patients met the inclusion criteria (mean: BCVA 1.89 LogMAR, range: 1.4 - 2.7 LogMAR, mean age: 28.7-years-old, range: 17-59 years). Though VF area did not improve, FST improved in patients with better baseline FST (-8.83 dB vs -0.56 dB; p = 0.010), and better VFV4e (7245 vs 341o2; p < 0.001) and III4e (596.1 vs 24.8o2; p = 0.011) area. VA improved in younger (20 vs 32 years; p = 0.011) patients with thinner CRT1mm (155 vs 193 µm; p = 0.038). VFV4e loss occurred in older (38 vs 19 years; p = 0.001) patients with worse baseline V4e area (1728 vs 8159o2; p < 0.001). Subjective improvement in dim light navigation skills occurred in younger patients (20.3 vs 45.3 years; p < 0.001).

Conclusions: Blindness is not a contraindication to VN treatment for RPE65-LCA. Superior results correlated with greater baseline FST but not with CRT1mm, provided that measurable outer retinal structures persist.

目的:探讨双等位基因RPE65致病性变异可能导致Leber先天性黑朦(LCA)。Voretigene neparvovec-rzyl (VN, Luxturna)是唯一被批准的视网膜下基因疗法,显示出益处和安全性。各中心的资格标准含糊不清,各不相同。这是世界卫生组织失明标准视力的RPE65-LCA患者用VN治疗的第一份综合结果报告。设计:多中心回顾性病例系列。研究对象:符合VN治疗标准且具有最佳矫正视力(BCVA)的患者。方法:患者平均随访11.1±4.7个月。评估年龄、性别、BCVA、中央视网膜厚度(CRT)、视网膜萎缩、VF、全视野刺激试验(FST)和主观印象。结果:9例患者符合纳入标准(平均:BCVA 1.89 LogMAR,范围:1.4 ~ 2.7 LogMAR,平均年龄:28.7岁,范围:17 ~ 59岁)。虽然VF面积没有改善,但基线FST较好的患者FST得到改善(-8.83 dB vs -0.56 dB;p = 0.010),和更好的VF-V4e (7245 vs 341o2;p < 0.001)和ii4e (596.1 vs 24.80 o2; = 0.011页)。年轻患者的VA有所改善(20岁vs 32岁;p = 0.011),CRT1mm较薄的患者(155 vs 193µm; = 0.038页)。VF-V4e损失发生在老年人(38岁vs 19岁;p = 0.001)基线V4e面积较差的患者(1728 vs 8159o2;P < 0.001)。较年轻的患者在昏暗灯光下导航技能上出现主观改善(20.3 vs 45.3;P < 0.001)。结论:失明不是RPE65-LCA VN治疗的禁忌症。优越的结果与更大的基线FST相关,但与CRT1mm无关,前提是可测量的视网膜外结构持续存在。
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引用次数: 0
A national benchmarking survey for quality improvement and safety in ophthalmology. 眼科质量改进与安全的国家基准调查。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1016/j.jcjo.2024.11.013
Michael T Kryshtalskyj, Jeremy Rau, Emi Sanders, Helen Chung, Andrew C Crichton, Chryssa McAlister, Alex M Ragan
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引用次数: 0
Twenty four-hour intraocular pressure fluctuation in treated glaucoma patients: a pilot study. 青光眼治疗患者24小时眼压波动:一项初步研究
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1016/j.jcjo.2024.11.010
Sunil Ruparelia, Rodolfo Bonatti, Jeremy A Murphy, Marcelo T Nicolela, Brennan D Eadie, Balwantray C Chauhan, Oksana M Dyachok, Lesya M Shuba

Objective: To conduct a pilot study to evaluate and compare the 24-hour habitual intraocular pressure (IOP) and ocular perfusion pressure (OPP) fluctuation in glaucoma patients treated with medical therapy, selective laser trabeculoplasty (SLT) or trabeculectomy.

Design: Pilot study.

Participants: Criteria for inclusion were patients aged 18 years or older with well-controlled IOP with either maximum tolerated medical therapy, previous SLT, or previous trabeculectomy.

Methods: Recruited patients were admitted to the sleep lab for 24-hour serial habitual IOP and blood pressure measurements. IOP and OPP fluctuation among the 3 treatment groups were compared.

Results: Thirty three (33) eyes from 33 patients were recruited in this study, including 11 patients in the medical therapy group, 11 patients in the SLT group, and 11 patients in the trabeculectomy group. The medical therapy group was found to have significantly higher 24-hour IOP fluctuation (8.3 ± 1.6 mmHg) than the SLT (3.5 ± 1.9 mmHg) and trabeculectomy (4.3 ± 1.3 mmHg) groups (P < 0.001). Mean 24-hour OPP fluctuation was also significantly higher in the medical therapy group (18.5 ± 4.0 mmHg) than the SLT (11.9 ± 7.3 mmHg) and trabeculectomy (14.1 ± 3.9 mmHg) groups (P < 0.05). No difference in IOP or OPP fluctuation was found between SLT and trabeculectomy groups (P > 0.05).

Conclusions: Both SLT and trabeculectomy may be more effective in reducing 24-hour IOP and OPP fluctuation than medical therapy alone. IOP and OPP fluctuation was comparable between SLT and trabeculectomy cohorts. Future studies are warranted to investigate this further.

目的:对内科治疗、选择性激光小梁成形术(SLT)和小梁切除术后青光眼患者24小时习惯性眼压(IOP)和眼灌注压(OPP)波动进行初步评价和比较。设计:初步研究。参与者:纳入标准为18岁或以上的IOP控制良好的患者,接受最大耐受性药物治疗,既往SLT或既往小梁切除术。方法:招募的患者被送入睡眠实验室进行24小时连续的习惯性IOP和血压测量。比较3个治疗组眼压和眼压波动情况。结果:本研究共招募33例患者33只眼,其中药物治疗组11例,SLT组11例,小梁切除术组11例。药物治疗组24小时IOP波动(8.3±1.6 mmHg)明显高于SLT组(3.5±1.9 mmHg)和小梁切除术组(4.3±1.3 mmHg) (P < 0.001)。药物治疗组平均24小时OPP波动(18.5±4.0 mmHg)明显高于SLT组(11.9±7.3 mmHg)和小梁切除术组(14.1±3.9 mmHg) (P < 0.05)。SLT组和小梁切除术组IOP和OPP波动无差异(P < 0.05)。结论:SLT联合小梁切除术在降低24小时IOP和OPP波动方面可能比单纯药物治疗更有效。眼内压和眼内压波动在SLT组和小梁切除术组之间具有可比性。未来的研究有必要进一步调查这一点。
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引用次数: 0
Dual-organism fungal keratitis in a novel keratoprosthesis device. 新型角膜假体装置中的双生物真菌性角膜炎。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1016/j.jcjo.2024.11.014
Mobin Abdi, Erica Darian-Smith, Gilad Litvin, David S Rootman, Clara C Chan
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引用次数: 0
Bilateral corneal perforation secondary to immunotherapy for metastatic melanoma. 转移性黑色素瘤免疫治疗继发双侧角膜穿孔1例。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1016/j.jcjo.2024.11.011
Prem A H Nichani, Alonso Gutierrez Guerinoni, David S Rootman, Clara C Chan
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引用次数: 0
Subsequent intraocular lens surgery in eyes with combined versus sequential phacovitrectomy. 联合晶状体切除术与序贯晶状体切除术在眼内的后续人工晶状体手术。
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1016/j.jcjo.2024.11.012
Fatma F Shakarchi, Ahmed F Shakarchi, Mohamed K Soliman, Abdallah A Ellabban, Ahmed B Sallam

Objective: To determine the risk factors for subsequent intraocular lens (IOL) surgery among eyes undergoing either combined or sequential phacovitrectomy.

Design: Retrospective cohort study.

Participants: Adult patients undergoing phacoemulsification at 8 United Kingdom National Health Service clinical centers between July 2003 and March 2015. Patients undergoing surgery for a dropped nucleus fragment, glaucoma, or iris problems were excluded.

Methods: The eyes were categorized into 3 groups: with previous vitrectomy, undergoing combined phacovitrectomy, and with both previous vitrectomy and current combined phacovitrectomy. These groups were compared based on preoperative ocular and systemic factors, intraoperative findings, and the subsequent need for a second IOL surgery. The Poisson model was used to calculate adjusted relative risks (aRR).

Results: 5,215 eyes were included: 2,124 with previous vitrectomy, 2,512 with combined phacovitrectomy, and 579 eyes with previous vitrectomy and currently combined phacovitrectomy. The risk of subsequent IOL surgery was 0.6% (reference group) in eyes with previous vitrectomy, 1.6% (aRR 2.6, CI: 1.4-5.1) in eyes with current combined phacovitrectomy, and 3.3% (aRR 3.8, CI: 1.7-8.3) in eyes with previous plus current combined phacovitrectomy. Other significant risk factors were age (aRR 0.98/year), pseudoexfoliation (aRR 6.76, CI: 2-28), zonular dialysis (aRR 10.6, CI: 4.8-24), scleral buckle in the current surgery (aRR 8.05, CI: 4-14), and the use of silicone oil (aRR 3.6, CI: 1.6-8.4) compared to no tamponade.

Conclusions: Combined phacovitrectomy was associated with a higher risk of IOL complications than sequential surgery. This information is useful for planning surgery in patients requiring both cataract and retinal surgeries.

目的:探讨联合或序贯晶状体切除术后人工晶状体手术的危险因素。设计:回顾性队列研究。参与者:2003年7月至2015年3月期间在8个英国国家卫生服务临床中心接受超声乳化术的成年患者。因核碎片脱落、青光眼或虹膜问题而接受手术的患者被排除在外。方法:将既往玻璃体手术组、联合玻璃体手术组、既往玻璃体手术组和目前联合玻璃体手术组分为3组。根据术前眼部和全身因素、术中发现以及随后进行第二次人工晶状体手术的需要对这两组进行比较。采用泊松模型计算调整后相对危险度(aRR)。结果:纳入5215只眼:既往玻璃体切除术2124只眼,联合玻璃体切除术2512只眼,既往玻璃体切除术和目前联合玻璃体切除术579只眼。既往玻璃体切除术的眼术后IOL手术风险为0.6%(参照组),目前联合玻璃体切除术的眼术后IOL手术风险为1.6% (aRR 2.6, CI: 1.4-5.1),既往加目前联合玻璃体切除术的眼术后IOL手术风险为3.3% (aRR 3.8, CI: 1.7-8.3)。其他重要的危险因素是年龄(aRR 0.98/年)、假脱落(aRR 6.76, CI: 2-28)、区域透析(aRR 10.6, CI: 4.8-24)、当前手术中的巩膜扣(aRR 8.05, CI: 4-14)和使用硅油(aRR 3.6, CI: 1.6-8.4)与无填塞相比。结论:与序贯手术相比,晶状体-玻璃体联合手术发生人工晶状体并发症的风险更高。这一信息对需要白内障和视网膜手术的患者的手术计划是有用的。
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引用次数: 0
Uveal metastasis: clinical characteristics, treatment, and prognostic factors in a cohort of 161 patients in China. 葡萄膜转移:中国161例患者的临床特征、治疗和预后因素
IF 3.3 4区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-01-13 DOI: 10.1016/j.jcjo.2024.12.002
Haowen Li, Jingting Luo, Zhaoxun Feng, David Maberley, Yang Li, Wenbin Wei, Yueming Liu

Objective: To investigate the clinical and prognostic features of uveal metastasis in a Chinese population and compare these features across different primary cancers.

Design: Retrospective cross-sectional study.

Participants: 161 patients with uveal metastasis at Beijing Tongren Hospital.

Methods: Clinical characteristics of the primary tumour and uveal metastasis, treatments and outcomes were reviewed. Tumor regression was assessed using B-scan ultrasonography to measure changes in tumor height.

Results: Among 161 patients, 185 eyes had uveal metastasis. Lung cancer was the most common primary tumour (49.4%), followed by breast cancer (22.4%), kidney cancer (4.3%). Uveal metastasis was the initial cancer manifestation in 39 patients (24.2%). Unilateral involvement was predominant (86.3%), with the choroid being the most common site (91%). Compared with lung cancer and other cancers, breast carcinoma patients developed uveal metastasis at a younger age (p < 0.001), had a longer interval to uveal metastasis diagnosis (0.67, 4.19, and 6.27 years, p < 0.0001), were prone to be bilateral (11.1%, 9.1%, and 27.8%; p < 0.05) and exhibited lower tumour height (4.47 ± 2.49 mm and 4.88 ± 3.01 mm, 3.09 ± 2.46 mm; p < 0.01). Local treatments (133 eyes) included plaque radiotherapy (PRT, brachytherapy), transpupillary thermotherapy (TTT), anti-VEGF and enucleation. The tumour regression correlated with increased tumor height (r = 0.5699; p < 0.05) in eyes treated with PRT (n = 15). Despite effective local tumour control, the 1-year, 3-year, and 5-year survival rates were 72.61%, 31.82%, and 19.84%, respectively (n = 103). Among the 54 deceased patients, 27 (50%) died within one year following the diagnosis of uveal metastasis. The mean survival was 18.84 months. Extraocular metastasis correlated with shorter survival (p < 0.05).

Conclusion: This study provides a comprehensive analysis of uveal metastasis in Chinese patients, highlighting the distinct characteristics from various primaries. Although survival rates remain uncertain, local therapies were effective at achieving ocular tumor control, which aligns with the expectations for patients battling metastatic cancers.

目的:探讨中国人群葡萄膜转移的临床和预后特征,并比较不同原发肿瘤的临床和预后特征。设计:回顾性横断面研究。研究对象:北京同仁医院葡萄膜转移患者161例。方法:回顾原发性肿瘤及葡萄膜转移的临床特点、治疗方法及预后。采用b超测量肿瘤高度变化来评估肿瘤消退。结果:161例患者中有185眼发生葡萄膜转移。肺癌是最常见的原发肿瘤(49.4%),其次是乳腺癌(22.4%)和肾癌(4.3%)。39例(24.2%)患者以葡萄膜转移为首发表现。单侧受累为主(86.3%),脉络膜是最常见的部位(91%)。与肺癌和其他癌症相比,乳腺癌患者出现葡萄膜转移的年龄较早(p < 0.001),确诊葡萄膜转移的时间间隔较长(0.67、4.19和6.27年,p < 0.0001),易为双侧(11.1%、9.1%和27.8%);P < 0.05),肿瘤高度分别为4.47±2.49 mm、4.88±3.01 mm、3.09±2.46 mm;P < 0.01)。局部治疗133只眼包括斑块放疗(PRT,近距离放疗)、上突热疗(TTT)、抗vegf和去核。肿瘤回归与肿瘤高度增加相关(r = 0.5699;p < 0.05) (n = 15)。尽管局部肿瘤得到有效控制,但1年、3年和5年生存率分别为72.61%、31.82%和19.84% (n = 103)。在54例死亡患者中,27例(50%)在诊断葡萄膜转移后一年内死亡。平均生存期为18.84个月。眼外转移与生存期缩短相关(p < 0.05)。结论:本研究对中国患者葡萄膜转移进行了全面分析,突出了不同原发灶的不同特点。尽管生存率仍不确定,但局部治疗在实现眼部肿瘤控制方面是有效的,这与与转移性癌症作斗争的患者的期望一致。
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Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
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