Hasil untuk "Ophthalmology"

Tatiane Vacaro Campos, Ricardo Ferreira Bento, Jeanne Oticica et al.

Ning-Yu Wang, Zi-Yu Zhu, Zi-Yun Jiao et al.

Autism spectrum disorder (ASD) represents a neurodevelopmental disorder that has been the focus of numerous studies on the central nervous system (CNS). The embryological origin of the brain and retina is shared, with the axons of retinal ganglion cells (RGC) developing into the optic nerves that enter the brain through the dorsal lateral geniculate nucleus (LGN) of the thalamus, LGN, and other visual cortices. Given the evidence that individuals with ASD exhibit impairments in the visual mechanisms, including deficits in emotional face recognition, and difficulty in maintaining gaze control as well as eye contact, some studies have documented retinal alterations in individuals with ASD. These have been identified through ophthalmic assessments, including optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and electroretinography (ERG). With the improvements in ASD animal models, it is possible to obtain a better understanding of vision dysfunction in ASD by analyzing the molecular mechanisms of retinal function and structure abnormalities. This review aims to provide a summary of the recent research on ocular alterations in ASD patients and animal models, intending to contribute to further investigation of the eye-brain connection and communication.

Meryem Feyza Cicek, Turker Oba, Abdullah Ağın et al.

Daniel Wang, BA, Bonnie Sklar, MD, James Tian, MD et al.

Objective: We developed a novel slit-lamp photography (SLP) generative adversarial network (GAN) model using limited data to supplement and improve the performance of an artificial intelligence (AI)–based microbial keratitis (MK) screening model. Design: Cross-sectional study. Subjects: Slit-lamp photographs of 67 healthy and 36 MK eyes were prospectively and retrospectively collected at a tertiary care ophthalmology clinic at a large academic institution. Methods: We trained the GAN model StyleGAN2-ADA on healthy and MK SLPs to generate synthetic images. To assess synthetic image quality, we performed a visual Turing test. Three cornea fellows tested their ability to identify 20 images each of (1) real healthy, (2) real diseased, (3) synthetic healthy, and (4) synthetic diseased. We also used Kernel Inception Distance (KID) to quantitatively measure realism and variation of synthetic images. Using the same dataset used to train the GAN model, we trained 2 DenseNet121 AI models to grade SLP images as healthy or MK with (1) only real images and (2) real supplemented with GAN-generated images. Main Outcome Measures: Classification performance of MK screening models trained with only real images compared to a model trained with both limited real and supplemented synthetic GAN images. Results: For the visual Turing test, the fellows on average rated synthetic images as good quality (83.3% ± 12.0% of images), and synthetic and real images were found to depict pertinent anatomy and pathology for accurate classification (96.3% ± 2.19% of images). These experts could distinguish between real and synthetic images (accuracy: 92.5% ± 9.01%). Analysis of KID score for synthetic images indicated realism and variation. The MK screening model trained on both limited real and supplemented synthetic data (area under the receiver–operator characteristic curve: 0.93, bootstrapping 95% CI: 0.77–1.0) outperformed the model trained with only real data (area under the receiver–operator characteristic curve: 0.76, 95% CI: 0.50–1.0), with an improvement of 0.17 (95% CI: 0–0.4; 2-tailed t test P = 0.076). Conclusions: Artificial intelligence–based MK classification may be improved by supplementation of limited real training data with synthetic data generated by GANs. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Kai-Yang Chen, Hoi-Chun Chan, Chi-Ming Chan

Abstract Background Retinal vein occlusion (RVO) is a significant retinal vascular disorder that has been hypothesized to increase the risk of cerebrovascular accidents (CVA). Given the shared vascular pathology between the retina and cerebral circulation, understanding the association between RVO and stroke incidence is critical for early intervention and risk management. This systematic review and meta-analysis aim to evaluate the risk of CVA, including ischemic and hemorrhagic subtypes, in patients with RVO. Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (CRD42024557820). A systematic search of PubMed, Cochrane Library, Scopus, Web of Science, and Embase was conducted from inception to February 2025. Studies assessing the incidence of CVA post-RVO in adult patients (≥ 18 years) were included. Two independent reviewers performed study selection, data extraction, and quality assessment using the Cochrane Risk of Bias tool for Non-Randomized studies (ROBINS-I) was used for observational cohort studies. Meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) software version 3.7, applying a fixed-effects model for low heterogeneity. Subgroup and sensitivity analyses were performed based on RVO type (BRVO vs. CRVO) and stroke subtype (ischemic vs. hemorrhagic CVA). Publication bias was evaluated using Egger’s test and funnel plots. Results A total of 14 studies (n = 97,812 patients) were included. The pooled event rate for CVA post-RVO was 37.5% (95% CI: 37.3%–37.8%), with no significant heterogeneity (I2 = 0%, p = 0.97). Subgroup analysis showed that both ischemic CVA (37.8%; 95% CI: 37.3%–38.3%) and hemorrhagic CVA (32.7%; 95% CI: 32.3%–33.1%) occurred at similar rates across branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). The mortality rate post-CVA in RVO patients was 69.0% (95% CI: 68.4%–69.5%), highlighting the severity of stroke outcomes in this population. The incidence of ischemic cardiovascular events, including myocardial infarction, was 15.7% (95% CI: 15.4%–16.0%), reinforcing the need for cardiovascular monitoring in RVO patients. The incidence of deep vein thrombosis (DVT) was relatively low (0.05%) but still warrants clinical attention in high-risk populations. Publication bias was minimal, as confirmed by Egger’s test (p > 0.24) and funnel plot symmetry. Sensitivity analyses confirmed the robustness of the pooled estimates. Conclusion This meta-analysis provides strong evidence linking RVO to an increased risk of CVA and mortality. Given the high incidence of stroke (37.5%) and mortality post-CVA (69%), early cardiovascular risk assessment and intervention are crucial. Patients with RVO should undergo comprehensive vascular risk evaluation, including blood pressure control, lipid regulation, and anticoagulation therapy when indicated. The findings support a multidisciplinary approach involving ophthalmologists, neurologists, and cardiologists for proactive stroke prevention strategies in RVO patients. Future research should explore genetic predispositions, inflammatory markers, and AI-based predictive models to improve early risk stratification and intervention.

Zhenyu Ji, Ting Su, Lu Li et al.

Purpose. To explore short-term changes in corneal astigmatism after combined silicone oil removal and cataract (SORC) surgery. Methods. We enrolled 89 patients (43 men and 46 women). Zeiss IOLMaster was used to measure corneal astigmatism status and axial length on the day before and after the SORC surgery. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were recorded. The results were compared to the outcomes at 3 days, 1 week, and 1 month postoperatively. Results. Compared to baseline, K1 decreased significantly at 3 days postoperatively (P=0.016), 1 week (P=0.009), and 1 month (P=0.035), while K2 increased significantly at 3 days postoperatively (P = 0.002), 1 week (P < 0.001), and 1 month (P = 0.001), as well as corneal astigmatism (all P < 0.001). Compared to that at the baseline, BCVA significantly improved at 3 days, 1 week, and 1 month postoperatively (all P<0.001). Meanwhile, IOP decreased significantly at 3 days postoperatively (P<0.001), 1 week (P=0.005), and 1 month (P=0.007). Similarly, axial length decreased at all follow-up time points (all P<0.001). Conclusion. Corneal astigmatism increased in the short term after the SORC operation but gradually decreased at 1 month postoperatively. BCVA improved steadily, and SORC was widely used in the clinic.

Fan Tan, Xubo Yang, Yuchen Fan et al.

Backgrounds. The treatment for amblyopia can have a substantial impact on quality of life. Conventional treatments for amblyopia have some limitations, then we try to explore a new and effective method to treat amblyopia. This study aimed to determine the potential effect of short-term plastic visual perceptual training based on VR and AR platforms in amblyopic patients. Methods. All observers were blinded to patient groupings. A total of 145 amblyopic children were randomly assigned into 2 groups: VR group (71 patients) and AR group (74 patients). In the VR group, each subject underwent a 20-min short-term plastic visual perceptual training based on a VR platform, and in the AR group, based on an AR platform. The best-corrected visual acuity (BCVA), fine stereopsis, and contrast sensitivity function (CSF) were measured before and after training. Results. The BCVA (P < 0.001) and fine stereopsis (P < 0.05) were improved significantly both in VR and AR group after training. Moreover, in the AR group, the CSF showed the value of all spatial frequencies had a statistically significant improvement after training (P < 0.05), while in the VR group, only the value of spatial frequency 12 improved significantly (P = 0.008). Conclusions. This study showed that the short-term plastic visual perceptual training based on VR and AR technology can improve BCVA, fine stereopsis and CSF of refractive amblyopia. It was suggested that the visual perceptual training based on the VR and AR platforms may be potentially applied in treatment for amblyopia and provided a high-immersing alternative.

Chia Wei Hsu, Subahari Raviskanthan, Peter W. Mortensen et al.

Purpose: The purpose of this case report was to detail a unique patient with proven systemic cobaltism from metal-on-metal prosthetic hip articulation who then presented with clinical and radiographic signs of increased intracranial pressure. Observations: A 59-year-old man with a past medical history of degenerative joint disease of the hip that status post total hip arthroplasty with cobalt-chromium implant presented with clinical and radiographic signs of increased intracranial hypertension. He underwent a revision arthroplasty with local debridement and removal of the cobalt-chromium implant and his serum cobalt level was elevated at 0.9 microg/L (normal range 0.1–0.4microg/L). One year after removal of the implant, the patient was asymptomatic and stable on acetazolamide. Conclusions: To our knowledge, this is the first such report in the English literature to associate increased intracranial hypertension with systemic cobaltism, and publication of this case report would make clinicians aware of the potential neurologic and neuro-ophthalmic presentation of metal-on-metal orthopedic prosthetics.

Po-Hsiang Kao, Lan-Hsin Chuang, Chi-Chun Lai et al.

Abstract The aim of the study is to determine the effects of monocular 0.125% atropine daily treatment on the longer axial length (AL) eyes in children with pediatric anisometropia. This was a retrospective cohort study. The charts of children with anisometropia (aged 6–15 years) who had a > 0.2-mm difference in AL between the two eyes were reviewed. Children who received monocular treatment of 0.125% atropine in the eye with longer AL were included for final analysis. The main outcome measure was the difference in AL between the two eyes after treatment. Regression analysis was used to model the changes in AL according to the time of treatment in both eyes. Finally, forty eyes in 20 patients (mean age 10.2 years) were included in the analyses. During the treatment period, AL was controlled in the treated eyes (p = 0.389) but elongated significantly in the untreated eyes (p < 0.001). The difference in AL between the treated and untreated eyes decreased from 0.57 to 0.22 mm (p < 0.001) after the 1-year treatment period. In the regression model, the best fit for the relationship between changes in AL and time during the treatment period in the treated eyes was the quadratic regression model with a concave function. In conclusion, these data suggest that 0.125% atropine daily is an effective treatment to reduce the interocular difference of AL in eyes with axial anisometropia. This pilot study provides useful information for future prospective and larger studies of atropine for the treatment of pediatric axial anisometropia.

Ana Maria Cunha, Marta Silva, Ana Catarina Pedrosa et al.

Purpose. To describe a positive clinical response of a patient with submacular Nocardia abscess due to a rapid and efficient treatment. Case report. We describe a case of a 50-year-old man with a painless visual decline of the left eye. Four years later, he had been diagnosed with systemic nocardiosis. Examination of the left eye revealed a submacular white mass with fluffy borders and another smaller white lesion, with well-defined borders, in the inferior temporal vascular arch. A systemic antibiotic treatment with SMX-TMP and intravenous imipenem and a single intravitreal injection of bevacizumab was performed. Conclusion. Prompt diagnosis and treatment ensured an expeditious resolution of the abscess and significant improvement of visual acuity. The diagnostic approach of a high index of suspicion coupled with directed treatment is required when dealing with subretinal inflammatory lesions.

Megha Gopalakrishna, Srinivasan Kavitha

Rho-kinase (ROCK) inhibitor is the newer drug available for glaucoma in the Indian market. It seems to target the actual area of disease pathology which has not been the case with the available medications. With the ever-evolving potential of these drugs in various diseases in ophthalmology, it would be wise to know about them. This review article aims to provide information regarding the role of ROCK and its inhibitors in glaucoma, corneal diseases, and retinal pathologies. A thorough search of several databases was conducted with ROCK inhibitors being one of the main keywords.

De Bernardo M, Zeppa L, Zeppa L et al.

Maddalena De Bernardo,1 Lucio Zeppa,2 Lucia Zeppa,2 Palmiro Cornetta,3 Livio Vitiello,1 Nicola Rosa1 1Department of Medicine, Surgery and Dentistry, &ldquo;Scuola Medica Salernitana&rdquo;, University of Salerno, Baronissi, Salerno, Italy; 2San Giuseppe Moscati Hospital, Avellino, Italy; 3Presidio Ospedaliero &ldquo;Maria SS Addolorata&rdquo;, ASL Salerno, Eboli, Salerno, ItalyCorrespondence: Maddalena De BernardoDepartment of Medicine, Surgery and Dentistry, &ldquo;Scuola Medica Salernitana&rdquo;, University of Salerno, Via Allende, Baronissi, Salerno 84081, ItalyTel/Fax +39 89 672407Email mdebernardo@unisa.itPurpose: To evaluate the gender-related differences in demographic and ocular biometric trends in a defined population presenting for consultation within the Italian public health system and to collect data of several ocular parameters at different stages of life, highlighting the differences between females and males.Patients and Methods: In this retrospective study, keratometry, corneal astigmatism, and axial eye length of 729 patients (729 eyes; mean age: 58&plusmn; 21 years; range: 18&ndash; 96 years) were evaluated using partial coherence interferometry. Statistical evaluation was performed utilizing a paired t-test and R2 analysis.Results: In females (396 eyes of 396 patients), mean keratometry ranged between 40.59&ndash; 47.78 D (44.27&plusmn; 1.36 D), corneal astigmatism ranged between 0&ndash; 3.82 D (1.13&plusmn; 0.74 D), and axial length ranged between 20.5&ndash; 31.32 mm (24.07&plusmn; 1.74 mm). In males (333 eyes of 333 patients), mean keratometry ranged between 38.5&ndash; 46.95 D (43.54&plusmn; 1.35 D; p&lt; 0.001), corneal astigmatism ranged between 0.1&ndash; 3.97 D (1.15&plusmn; 0.79; p=0.75), and axial length ranged between 20.41&ndash; 31.21 mm (24.57&plusmn; 1.78 mm; p&lt; 0.001). Both genders presented a shorter axial length in advanced age. Elderly males presented a higher percentage of against-the-rule astigmatism.Conclusion: Females may have steeper corneas and shorter eyes. A trend toward axial length reduction with age was observed in both genders. This finding is probably due to the difference in growth between generations, as the new ones have an higher size than the old ones.Keywords: axial eye length, corneal power, gender, mean keratometry, partial coherence interferometry

Shreyansh Doshi, Megha Gulati, Avinash Pathengay et al.

Srikanth Ramasubramanian, Parthopratim Dutta Majumder

Chin P. Siuw, Suresh Vasudevan, Mushawiathi Mustapha

Objective: Intraocular pressure (IOP) is essential in maintaining normal function of the eye. High IOP is associated with glaucoma. Many physiological factors, including age and hormones, can cause variation in IOP. This study was designed to investigate IOP changes in postmenopausal women and the associated factors, which included sex hormones and body mass index (BMI). Methods: This was a cross-sectional study. Ninety-eight women were recruited: 49 premenopausal women and 49 postmenopausal women. IOPs between the two groups were compared. The influence of estradiol, progesterone, testosterone, and BMI on IOP was analyzed by a multivariate method. P<0.05 was considered significant. Results: The age of the premenopausal group was 47.14±3.93 years and that of the postmenopausal group was 52.10±3.04 years. The other factors in both groups, which included BMI, blood pressure, and central cornea thickness, were not significantly different. The mean IOP in the postmenopausal group was significantly higher than the mean IOP in the premenopausal group (15.26±2.96 mm Hg vs. 14.07±2.65 mm Hg, P=0.04). BMI had a weak positive correlation with IOP in premenopausal women (r=0.31, P=0.03). Estradiol was less likely to influence IOP changes in the postmenopausal group as compared with the premenopausal group (B=−0.021, P=0.002). IOP was not significantly related to progesterone and testosterone levels. Conclusion: Menopausal status has a significant effect on IOP, with a significant increase in IOP seen in postmenopausal women as shown by our study. Estradiol was shown to be a protective factor in reducing IOP among postmenopausal women. Through understanding of the influence of postmenopausal status and sex hormones on IOP, glaucoma management may be improved and the target group for disease screening may be more specific.

Asahi MG, Chon AT, Gallemore E et al.

Masumi G Asahi,1 Andrew T Chon,1 Esmeralda Gallemore,1 Ron P Gallemore1,2 1Clinical Research Department, Retina Macula Institute, Torrance, CA, USA; 2Jules Stein Eye Institute, University of California, Los Angeles, CA, USA Purpose: To determine whether combination photodynamic therapy (PDT) and antivascular endothelial growth factor (VEGF) therapy is effective in the management of chronic central serous chorioretinopathy (CSC) recalcitrant to conventional therapy. Methods: This was a retrospective analysis of eight patients with chronic CSC unresponsive to topical nonsteroidal anti-inflammatory drugs, focal photocoagulation, anti-VEGF alone, or PDT alone. All patients were evaluated with a full ophthalmic examination, spectral-domain optical coherence tomography (OCT), fluorescein angiography (FA), and most with indocyanine green angiography (ICGA) followed by treatment with half-fluence PDT and intravitreal anti-VEGF injection (seven bevacizumab, one aflibercept). Patients were seen in follow-up 1 month after treatment. Results: All eight patients achieved complete resolution in subretinal fluid following combination treatment. Average duration of CSC prior to initiation of combination therapy was 7.5&nbsp;months. Mean central macular thickness on OCT decreased significantly from 401.2&plusmn;52.7 &micro;m to 297.9&plusmn;18.2 &micro;m (p=0.0010) by 4 months after treatment (1.63&plusmn;1.18&nbsp;months). Seven of eight patients were followed up for an average of 13&nbsp;months with no recurrence during that time. One case recurred at 8 months and was treated with repeat combination at that time. Frank choroidal neovascularization (CNV) was not identified in these cases on FA or ICGA studies. Eight of eight patients showed significant improvement in vision from a logMAR of 0.1125&plusmn;0.099 to 0.0125&plusmn;0.064 (p=0.019). Conclusion: Combination PDT and anti-VEGF is effective for chronic CSC which has failed conventional therapy. Associated CNV and/or inflammation may be reasons for greater success in patients treated with combination therapy. Keywords: anti-VEGF, chronic central serous chorioretinopathy, combination, photodynamic therapy, recalcitrant

S. Wray

Nina Ni, Marc A. Goldberg, Ralph C. Eagle et al.

Purpose. To present the clinical and histopathologic correlation of two cases of epithelial downgrowth (EDG) after prior intraocular surgery. Methods. Observational case reports. Results. We present two cases of EDG occurring after intraocular surgery. In both cases, after two anterior chamber injections of 5-fluorouracil (5FU), the area of EDG initially regressed. In Case 1, a limited area of EDG eventually recurred, and penetrating keratoplasty with cryotherapy was curative. In Case 2, subsequent corneal edema required Descemet-stripping automated endothelial keratoplasty, and the patient remained clinically free of EDG without further treatment. Conclusion. Intracameral 5FU may have a role in the treatment of EDG after intraocular surgery, though its precise utilization and impact remain to be defined.

T. Suie

B. Rosner