Hasil untuk "Ophthalmology"

Cong Chen, Wen-Jing Zhang, Qin Ding et al.

Abstract Objective To evaluate the real-world clinical effectiveness and safety of the 0.18 mg fluocinolone acetonide intravitreal implant (FAi) in Chinese patients with macular edema (ME) secondary to non-infectious uveitis (NIU). Methods This single-center, retrospective case series included patients diagnosed with NIU-associated ME who received an intravitreal 0.18 mg FAi injection between January and September, 2024 and completed at least 12 months of follow-up. Primary outcome measures were changes in best-corrected visual acuity (BCVA, converted to logMAR), intraocular pressure (IOP), central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) from baseline to 1, 3, 6, and 12 months post-treatment, analyzed using a linear mixed model. Inflammatory recurrence and treatment-related adverse events were also documented. Results A total of 39 patients (50 eyes) were included, with a mean age of 54.6 ± 14.8 years. The mean baseline BCVA was 0.65 ± 0.33 logMAR, and the mean CMT was 333.4 ± 108.6 μm. BCVA demonstrated significant improvement at all postoperative time points compared to baseline (all P< 0.001), reaching 0.48 ± 0.31 logMAR at 12 months. CMT showed a significant and sustained reduction postoperatively (all P< 0.001), decreasing to 239.7 ± 54.4 μm at 12 months. SFCT also decreased significantly from baseline (all P< 0.001). Postoperative IOP was significantly higher than baseline (P= 0.008, P= 0.001, P< 0.001, P< 0.001). Postoperative IOP elevation was observed in 18 eyes (36%). Management strategies included topical anti-glaucoma medication in 12 eyes and laser therapy in 3 eyes (1 selective laser trabeculoplasty and 2 diode laser cyclophotocoagulation). Notably, 3 eyes (6%) required trabeculectomy due to uncontrolled IOP. The inflammation recurrence rate during the 12-month follow-up was 14% (7/50 eyes). Implant migration into the anterior chamber occurred in one eye. No other serious ocular complications or systemic adverse events were observed. Conclusion In this real-world study, the 0.18 mg FAi effectively improved visual acuity, reduced ME, and attenuated choroidal thickening in Chinese patients with NIU-associated ME over 12 months. The primary risk was manageable IOP elevation, resulting in an overall favorable safety profile. The 0.18 mg FAi represents an effective long-term treatment option for this patient population.

Mahendra Singh, Veenu Maan, Pradeep Agarwal et al.

Purpose: This cross-sectional study aimed to estimate the prevalence and distribution of color vision deficiency (CVD) among school children aged 6–16 in the Moradabad district of Uttar Pradesh, India. Methods: Between November 1, 2022, and March 31, 2023, a multidisciplinary team conducted school-based eye screening camps, screening 1329 students from four schools. The screening included visual acuity measurement, refraction, ocular alignment evaluation, and Ishihara’s plate test for CVD. Results: Ocular examinations conducted on 1329 students from four schools unveiled a range of ocular conditions. These included bilateral moderate ptosis in 0.1%, nystagmus in 0.1%, hypermetropia in 0.6%, myopia in 7.0%, astigmatism in 2.8%, and pseudophakic in 0.1% of students. The study identified CVD in 2.4% of participants (2.8% of males and 2.2% of females). Further breakdown revealed a 2.4% prevalence on the right and 1.5% on the left, with red and green color vision deficiencies observed. Notably, primary education, middle education, and secondary education levels showed CVD prevalence of 0.4%, 0.97%, and 0.97%, respectively. Conclusion: The study contributes valuable insights into ocular morbidities, emphasizing the prevalence of CVD among school children in the Moradabad district. The findings underscore the need for tailored interventions, early screening, and awareness campaigns to address the specific needs of affected children in diverse geographical and educational settings.

Yanhua Pang, Zhi Tan, Xinxin Chen et al.

ObjectiveOptic chiasma compression and associated visual impairment induced by a non-functioning pituitary adenoma (NFPA) is commonly assessed by the optic disk and retina but is inadequate to understand the entire visual pathway impairment. We aim to evaluate the use of optical coherence tomography (OCT) coupled with diffusion tensor imaging (DTI) for the preoperative evaluation of visual pathway impairment.MethodsFifty-three patients with NFPA (categorized into mild and heavy compression subgroups) were subjected to OCT to calculate the thickness of the circumpapillary retinal nerve fiber layer (CP-RNFL), macular ganglion cell complex (GCC), macular ganglion cell layer (GCL), and macular inner plexus layer (IPL), as well as to DTI to calculate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values.ResultsCompared to mild compression, heavy compression caused decreased FA value, increased ADC value of several segments of the visual pathway, thin temporal CP-RNFL, and quadrant macular GCC, IPL, and GCL. Average CP-RNFL thickness, inferior-macular inner-ring IPL and GCC thicknesses, inferior CP-RNFL thickness, and superior CP-RNFL thickness were the best indicators of the impairment of the optic nerve, optic chiasma, optic tract, and optic radiation, respectively.ConclusionDTI and OCT parameters can effectively evaluate visual pathway impairment and are beneficial for the objective preoperative evaluation of visual pathway impairment in patients with NFPA.

Fuxiao Luan, Rui Liu, Jing Li et al.

This study retrospectively analyzes the immune and inflammatory indices of patients with lacrimal-gland benign lymphoepithelial lesion (LGBLEL) in order to screen out reference indices with higher diagnostic efficacy. The medical histories of patients whose diagnoses of LGBLEL and primary lacrimal prolapse were confirmed by pathology between August 2010 and August 2019 were collected. In the LGBLEL group, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, rheumatoid factor (RF), and immunoglobulins G, G1, G2, and G4 (IgG, IgG1, IgG2, IgG4) were higher (<i>p</i> < 0.05) and the expression level of C3 was lower (<i>p</i> < 0.05) compared to the lacrimal-gland prolapse group. Multivariate logistic regression analysis showed that IgG4, IgG, and C3 were independent risk factors for predicting LGBLEL occurrence (<i>p</i> < 0.05). The area under the receiver operating characteristic (ROC) curve of the prediction model (IgG4+IgG+C3) was 0.926, which was significantly better than that of any single factor. Therefore, serum levels of IgG4, IgG, and C3 were independent risk factors for predicting the occurrence of LGBLEL, and the combined diagnostic efficacy of IgG4+IgG+C3 was the highest.

Yi Zhou, Cong Fan, Xiao-Bo Xia et al.

Linyu Ni, Wei-kuan Lin, Amy Kasputis et al.

In our previous studies, we demonstrated the ability of an interstitial all-optical needle photoacoustic (PA) sensing probe and PA spectral analysis (PASA) to assess the aggressiveness of prostate cancer. In this clinical translation investigation, we integrated the optical components of the needle PA sensing probe into a 18G steel needle. The translational needle PA sensing probe was evaluated using intact human prostates in a simulated ultrasound-guided transperineal prostate biopsy. PA signals were acquired at 1220 nm, 1370 nm, 800 nm and 266 nm at each interstitial measurement location and quantified by PASA within the frequency range of 8–28 MHz. The measurement locations were stained for establishing spatial correlations between the quantitative measurements and the histological diagnosing. Most of the quantitative PA assessments reveal statistically significant differences between the benign and cancerous regions. Multivariate analysis combining the PASA quantifications shows an accuracy close to 90% in differentiating the benign and cancerous regions in the prostates.

Feng Xie, Michael Wu, Jenny Chan et al.

Introduction Glaucoma is a progressive, chronic condition that can have a significant impact on a patient’s health-related quality of life (HRQoL). Validated, disease-specific HRQoL tools such as the Health Utility for Glaucoma (HUG-5) tool and the Glaucoma Quality of Life Questionnaire (GlauQoL-17) can be used to monitor a patient’s quality of life. However, the utility of these tools in outpatient clinic practice is not well established. The primary objective of this study is to characterise the feasibility of administering periodic HRQoL questionnaires in glaucoma using a semi-automated workflow.Methods and analysis This study will be a single-centre, unblinded, randomised, parallel-group study with an exploratory data analysis framework. We aim to determine the feasibility of administering the HUG-5 in an outpatient clinic using a semi-automated workflow and determine patient engagement through email and telephone contact methods. We will also be investigating the association of the HUG-5 and GlauQoL-17 with patient visual field testing and visual acuity. Mean differences between groups will be tested with analysis of variance to determine if the frequency of calls affects burden, satisfaction and perceived value of information.Ethics and dissemination This study has been approved by the Hamilton Integrated Research Ethics board (ID: 13046) and will be conducted within Canadian Tri-Council Statement policy. Personal information of the study’s participants will be anonymised with identification codes and data will be kept on an encrypted server. Results of this study will be disseminated through peer-reviewed journals, conferences and internal meetings.

Iván Hernández López, Taimi Cárdenas Díaz

RESUMEN El presente trabajo aborda el uso de la inteligencia artificial en la cirugía de catarata y la incursión de Cuba en este campo. La inteligencia artificial tiene como objetivo dotar a un agente con la capacidad de tomar decisiones correctas. Dentro de los campos de la inteligencia artificial se encuentra el aprendizaje de máquinas cuyo propósito es entrenar a las computadoras para aprender de un conjunto de datos las decisiones que han de tomar, dada una situación específica. Uno de los métodos más utilizados para el entrenamiento y el aprendizaje de máquinas es el desarrollo de redes neuronales artificiales. Desde un enfoque social, se explica cómo la influencia sobre el resultado visual que puede lograrse con esta tecnología repercute en el individuo y la sociedad, y se resaltan las ventajas y las desventajas de su utilización.

Domagoj Ivastinovic, Anton Haas, Martin Weger et al.

An amendment to this paper has been published and can be accessed via the original article.

N. V. Maychuk, I. A. Mushkova, M. R. Obraztsova

Relevance. Corneal refractive surgery is a modern, dynamically developing segment of ophthalmology that provides highly predictable, safe and stable refractive results in patients with a wide range of ametropias. Corneal refractive surgery, usually is chosen by patients who lead an active lifestyle and need rapid medical and social rehabilitation, people with high requirements for the quality of life and showing increased expectations for the result of correction. Perhaps this is due to the fact that, according to a survey at the exit of the Department of refractive laser Surgery of the S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, conducted after consulting a surgeon with a description of the course of the operation and the postoperative course, about 1 % of patients refuse surgery, fearing painful sensations in the postoperative period, and 23.4 % of the expected postoperative discomfort causes strong concerns.Purpose. To study the clinical efficacy and safety of Broxinac (0.09 % bromfenac solution) in the early postoperative period of corneal refractive surgery.Materials and methods. The study included 168 patients (168 eyes) with moderate and high myopia after PRK (24 eyes), FemtoLASIK (78 eyes) and ReLEx SMILE (66 eyes), divided into equal subgroups: in the main group, Broxinac was instilled once 30 minutes after the operation, and in the control group — placebo. In the PRK subgroup of the main group, daily instillations of Broxinac were continued until complete reepithelization. The severity of the indicators “eye pain”, “photophobia”, “lacrimation”, “foreign body sensation” was evaluated on a five-point scale, the state of the corneal epithelium when stained with fluorescein, and overall satisfaction with the operation.Results and discussion. It is established that the analgesic effect occurred on average after 4.4 ± 0.6 minutes. Broxinac had a rapid, pronounced analgesic effect in patients in the early postoperative period after keratorefractive surgery, without slowing of corneal reepithelization, and can be recommended for use in clinical practice for analgesia and relief of aseptic inflammatory reaction in the early postoperative period after FemtoLASIK and PRK. The ReLEx SMILE does not require pain relief.Conclusion. Analgesia of the early postoperative period increases patient satisfaction with the result of the operation, popularizes it and helps to attract patients who previously refused surgical correction of ametropia due to fear of painful sensations.

C. J. Herrnreiter, X. Li, M. E. Luck et al.

Abstract Gut barrier dysfunction is often implicated in pathology following alcohol intoxication and burn injury. MicroRNAs (miRNAs) are negative regulators of gene expression that play a central role in gut homeostasis, although their role after alcohol and burn injury is poorly understood. We performed an integrated analysis of miRNA and RNA sequencing data to identify a network of interactions within small intestinal epithelial cells (IECs) which could promote gut barrier disruption. Mice were gavaged with ~ 2.9 g/kg ethanol and four hours later given a ~ 12.5% TBSA full thickness scald injury. One day later, IECs were harvested and total RNA extracted for RNA-seq and miRNA-seq. RNA sequencing showed 712 differentially expressed genes (DEGs) (padj < 0.05) in IECs following alcohol and burn injury. Furthermore, miRNA sequencing revealed 17 differentially expressed miRNAs (DEMs) (padj < 0.1). Utilizing the miRNet, miRDB and TargetScan databases, we identified both validated and predicted miRNA gene targets. Integration of small RNA sequencing data with mRNA sequencing results identified correlated changes in miRNA and target expression. Upregulated miRNAs were associated with decreased proliferation (miR-98-3p and miR-381-3p) and cellular adhesion (miR-29a-3p, miR-429-3p and miR3535), while downregulated miRNAs were connected to upregulation of apoptosis (Let-7d-5p and miR-130b-5p) and metabolism (miR-674-3p and miR-185-5p). Overall, these findings suggest that alcohol and burn injury significantly alters the mRNA and miRNA expression profile of IECs and reveals numerous miRNA–mRNA interactions that regulate critical pathways for gut barrier function after alcohol and burn injury.

Manish Nagpal, Rakesh Juneja, Sham Talati

Proliferative vitreoretinopathy (PVR) is the leading cause of failed rhegmatogenous retinal detachment (RRD) surgery. Based upon the presence of clinical features and due to associated underlying risk factors, it is classified into various grades based upon its severity and extent of involvement. Despite excellent skills, flawless techniques, and high-end technology applied in the management of RRD, PVR still occurs in 5–10% of cases. Due to the advancements in wide angle viewing systems, advance vitrectomy machines and fluidics, early identification, use of long-term heavy silicon oil tamponades, high-speed cutters, small-gauge vitrectomies, use of perfluorocarbon liquid (PFCL), and small-gauge forceps and scissors, the success rate in the management of PVR has increased leading to improved anatomical outcomes. However, functional outcomes do not correlate well with improved anatomical outcomes. Various complications occur after RRD repair that are responsible for re-retinal detachment and recurrence of PVR. This article highlights causes, risk factors, classification, grading, diagnosis, and approach to management of PVR and post-PVR surgery complications.

Srinivasan Sanjay, Arushi Garg, Naren Shetty et al.

Ahmed S Abdel-Wanes, Abelrahman G Salman, Azza M.A Said et al.

Aim To determine the risk factors responsible for opaque bubble layer (OBL) formation in femtosecond-laser-assisted in situ keratomileusis (FSL-LASIK). Patients and methods A retrospective, comparative study was carried out from January 2015 to January 2017 in El-Watany Eye Hospital. Two hundred eyes who were eligible for FSL-laser-assisted in situ keratomileusis (FSL was done using FS200, wavelight, Germany SR/1025-1-380) were classified into two groups. Group I: the study group with OBL formation during surgery (100 eye) and group (II): the control group without OBL formation during surgery (100 eye). Preoperative best-corrected visual acuity, spherical equivalent, and dilated fundus examination were done and corneal tomography including keratometric readings: flat keratometric readings (K1), steep keratometric readings (K2), and central corneal thickness (CCT) measurements. Programmed flap parameters were collected. Statistical analysis Statistical analysis was done using IBM SPSS, version 24. Results Among the studied 101 patients, OBL occurs bilaterally in 58 eyes among 29 patients and OBL occurs unilaterally among 42 patients. There was a statistically significant difference between OBL and non-OBL regarding preoperative steep keratometry (K2) (P<0.01) and CCT (P=0.03), where the corneal pachymetry was more than 545 µm in 57 (57%) eyes of OBL group versus 42 (42.0%) eyes in non-OBL eyes. There was no statistically significant difference between both groups regarding canal length offset (P=0.123), corneal flap thickness (P=0.489), corneal flap diameter (P=0.064), and flap hinge angle (P=0.074). Conclusion Increased corneal thickness, corneal canal length offset, and steep keratometry were significant risk factors of OBL formation. Regarding regression analysis, CCT and corneal astigmatism were statistically significant independent predictors of OBL formation.

Li Chen, Yong Tao, Jing Feng et al.

Pericytes are a population of cells that participate in normal vessel architecture and regulate permeability. Apelin, as the endogenous ligand of G protein-coupled receptor APJ, participates in a number of physiological and pathological processes. To date, the effect of apelin on pericyte is not clear. Our study aimed to investigate the potential protection mechanisms of apelin, with regard to primary rat retinal pericytes under hypoxia. Immunofluorescence staining revealed that pericytes colocalized with APJ in the fibrovascular membranes dissected from proliferative diabetic retinopathy patients. In the in vitro studies, we first demonstrated that the expression of apelin/APJ was upregulated in pericytes under hypoxia, and apelin increased pericytes proliferation and migration. Moreover, knockdown of apelin in pericyte was achieved via lentivirus-mediated RNA interference. After the inhibition of apelin, pericytes proliferation was inhibited significantly in hypoxia culture condition. Furthermore, exogenous recombinant apelin effectively prevented hypoxia-induced apoptosis through downregulating active-caspase 3 expression and increasing the ratio of B cell lymphoma-2 (Bcl-2)/Bcl-2 associated X protein (Bax) in pericytes. These results suggest that apelin suppressed hypoxia-induced pericytes injury, which indicated that apelin could be a potential therapeutic target for retinal angiogenic diseases.

Pooja Jain, J L Goyal, Subhadra Jalali et al.

C.S. Sandhya, D. Murali Krishna, G. Vijay Bhaskar

We report of the rare occurrence of pigment dispersion syndrome (PDS) with posterior subcapsular cataract in both eyes in a young male patient. The patient presented with complaints of progressive decrease in vision of one year duration. The patient also had high myopia with mild iridodonesis, phacodonesis and anterior insertion of zonules. Classical signs of PDS like Krukenberg's spindle on the posterior corneal surface were evident on slit lamp examination; transillumination defects in the iris could not be elicited by retroillumination as the iris was heavily pigmented. Gonioscopy revealed heavy and uniform pigmentation of trabecular meshwork. Evidence of a characteristic iris configuration on optical coherence tomography (OCT), namely, posterior bowing of iris in the mid periphery suggested the diagnosis of PDS. This case highlights the importance of OCT in identifying the iris configuration characteristically seen in PDS even in the absence of transillumination defects in the iris and reiterates the need to look for subtle signs like phacodonesis which are important when surgical intervention is planned.

D. Gaasterland, J. Pederson, Helen M. MacLeilan

P. Custer, R. Kennedy, J. Woog et al.

E. Bradley, Emily W. Gower, D. Bradley et al.