International Journal of Ophthalmology & Visual Science最新文献

{"title":"Prevalence of Amblyogenic Risk Factors in Congenital Nasolacrimal Duct Obstruction in a Developing Country","authors":"U. Raina, Shruti Bhattacharya, S. Gupta, Varun Saini, Banu Pavitra, Kumar Ravinesh, R. Cruz","doi":"10.11648/J.IJOVS.20210603.15","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210603.15","url":null,"abstract":"PURPOSE: Conventionally, congenital nasolacrimal duct obstruction (NLDO) has been treated as an entity with no bearing on development of visual acuity and routine refraction is not done considering the volume of patients in a in a developing Asian country like India. This research was designed to study the prevalence of amblyogenic refractive error in patients with congenital NLDO, as compared to an age-matched control group, in a developing country. METHODS: In this study, 89 patients with congenital NLDO and 78 patients as age matched controls, less than 4 years of age were included at a tertiary care centre in India. All underwent a complete ocular examination and risk factors for amblyogenic refractive error were noted based on the AAPOS guidelines. RESULTS: There was no gender predisposition and no significant difference between the two groups in terms of mode of delivery, orthoptic check-up, keratometry, axial length, fundus or anterior segment examination. Amblyogenic refractive error, as defined by the AAPOS guidelines, was found in 18 (20.5%) patients in the case group compared to 3 (3.8%) in the control group, and this was as follows: astigmatism in 10, anisometropia in 5, hyperopia in 3 subjects, and myopia in 1. These risk factors were not greater in children with unilateral NLDO compared to bilateral NLDO, but both were greater than their control group. There was also no significant difference found between the two groups in terms of distribution of anisometropia. CONCLUSIONS: The prevalence of amblyogenic refractive error in congenital NLDO was significantly higher than in the control group. Hence, a thorough evaluation is warranted in cases of congenital NLDO for early detection amblyogenic refractive error.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84868221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macular Hole Following Retained Subfoveal PFCL","authors":"Navneet S. Mehrotra, G. Mohan, M. Nagpal, S. Talati, Ak Sharma","doi":"10.11648/J.IJOVS.20210603.14","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210603.14","url":null,"abstract":"Introduction: Perfluorocarbon liquids (PFCLs) were first developed in 1970s as possible substitutes to erythrocytes because of their capacity to dissolve relatively large amounts of oxygen. Based on their properties, PFCL are widely used in complex retinal detachments, but they can cause complications in cases of subretinal retention. Migration of peripherally located subretinal PFCL towards the fovea is well established, but spontaneous resolution of sub-foveal PFCL without surgical evacuation or displacement has rarely been described. Case report: We report a case of a 48 year old male on whom a vitrectomy was performed for a retinal detachment with scleral tear following trauma. PFCL was used for ten days as a temporary intraocular tamponade for retinal flattening. A second vitrectomy was done to replace the PFCL with silicone oil, following which retained sub-foveal PFCL was noted. Result: Fourteen months later, a macular hole developed and PFCL disappeared. Slight superior displacement of the macular area was observed due to contraction of fibrous proliferation superiorly. There was no decrease in visual acuity. Patient was advised to undergo silicon oil removal. CONCLUSION: In the future, improved understanding of the mechanisms of spontaneous resolution may enable the development of non-surgical methods to displace sub-foveal PFCL.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86243871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Burden and Quality of Life of Patients with Neovascular Age-Related Macular Degeneration (nAMD) and Their Caregivers—A Review","authors":"R. Biswas, R. Roy, Nitin Maksane, Maulik Bhavsar, Ajitabha Sanyal","doi":"10.11648/J.IJOVS.20210603.13","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210603.13","url":null,"abstract":"The growing incidence of neovascular age-related macular degeneration (nAMD) in India and its debilitating consequences, such as physical, psychological, and emotional stress, are a cause of significant concern. Failing eyesight due to nAMD hinders the ability of patients to perform daily tasks, leading to dependency on others – often resulting in anxiety and depression. Although treatment options such as anti-vascular endothelial growth factors (anti-VEGFs) are readily available, long-term treatment compliance is often compromised. Thus, it is important for health care providers to be aware of the burden associated with nAMD for both patients and caregivers. India, with its large urban and rural population base, faces varied challenges in health care accessibility and affordability. Further, there is a paucity of India-specific studies to ascertain patient and caregiver burden related to nAMD. A deeper understanding of disease awareness and treatment expectations from an Indian perspective may further help clinicians to provide optimum management to patients. The current review provides insights into the quality of life (QoL) and treatment-related burden for patients with nAMD and their caregivers. Further, it emphasizes the need of PAN-India studies to ascertain the patient and caregiver burden related to nAMD, which may assist in devising treatment algorithms and pricing policies suited to the Indian population and enable patients to receive quality eye care.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78763656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal Audit as a Quality Assurance Tool to Ensure Staff and Patient Safety During COVID-19 Pandemic","authors":"S. Dubey, Shalinder Sabherwal, J. Farooqui, P. Garg, U. Mathur, Ashutosh Kumar Singh","doi":"10.11648/J.IJOVS.20210603.12","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210603.12","url":null,"abstract":"We present the process of development and implementation of an internal audit for prevention of spread of COVID-19 at a tertiary eye hospital, which can be used for further improvement of the system and be utilized by similar organizations to enhance patient and staff safety and quality of service. It is a Single center prospective audit. Based on the guidelines put forth by various international (Centers for Disease Control and Prevention, World Health Organization) and Indian (Ministry of Health and Family Welfare, All India Ophthalmological Society) authorities, preventive protocols were formulated. To ensure compliance of these protocols, audit sheets in the form of checklists and questionnaires were prepared. Facility and process audits were undertaken for registration, outpatient department and pre-surgical counseling. Pilot audits were carried out to develop more detailed audits, and implemented for one week. There was 100% compliance from the staff in personal protective equipment usage and hand hygiene. However, 21 incidents of physical distancing not being maintained by them were noted. Though there was 100% compliance in use of facemask by the staff and patients, 34.5% of patients were noticed wearing the mask improperly. It was also noted that, at the entry, thermal screening was not performed at 6/53 (11.3%) observations with no thermal screener at 3/23 instances. This study describes the process of formulating and conducting audits as a monitoring and evaluation tool, which is most relevant in ongoing COVID-19 pandemic to ensure safety of patients and health care workers.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89439182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case History of Internal Ophthalmomyiasis, a Rare and Devastating Disease","authors":"S. Noman, Murtuza Nuruddin","doi":"10.11648/J.IJOVS.20210603.11","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210603.11","url":null,"abstract":"To report a rare case of unilateral internal ophthalmomyiasis with complete visual loss. Method: An otherwise healthy 12 years old boy presented with redness and painful rapid loss of vision in his right eye for the past 12 days. There was no history of associated trauma. On examination, there was no perception of light in his right eye and normal vision in left eye. There was severe anterior and posterior segment inflammation which prevented the view of fundus. B-scan of the right eye showed diffuse choroidal and optic nerve thickening. Routine blood count and X-ray chest did not reveal any significant findings. In the midst of uncertainity regarding diagnosis and to relieve the patient from severe pain, enucleation of right eye was performed and histopathological examination of the specimen was done to confirm the diagnosis. Result: Histopathology report showed gross irregular inflammatory thickening of the choroid with severe granulomatous inflammation. There was an infective agent in the choroid having an outer cuticle and an irregular hyaline branching innner tube. These features were suggestive of ophthalmomyiasis of the choroid. Conclusion: Although rare, ophthalmomyiasis should be considered in the differential diagnosis of panuveitis. Early recognition of this condition, when tumour and other conditions are suspected, would avoid invasive surgical procedures, such as enucleation.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79762194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Bilateral Peripheral Ulcerative Keratitis","authors":"Belghmaidi Sarah, Darfaoui Zineb, Hajji Ibtissam, Moutaouakil Abdeljalil","doi":"10.11648/J.IJOVS.20210602.23","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210602.23","url":null,"abstract":"Peripheral ulcerative keratitis (PUK) is an aggressive, potentially sight-threatening cause for peripheral corneal thinning. It may precede the diagnosis of the systemic condition and therefore these cases require urgent investigation. A 43-year-old woman presented with bilateral tearing and ocular pain persisting for 7 months. Visual acuity was 6/6 in both eyes. On biomicroscopic examination, presence of crescent shaped corneal ulcer with perilesional haziness. A tear film study demonstrated decreased Schirmer test results (5mm in both eyes) and tear film break-up time (5 sec in both eyes). The interrogation and the patient revealed he had recurrent skin lesions in both legs with chronic itching, and recurrent oral and genital ulcers healing spontaneously. The diagnosis of Behcet disease was proposed. Pathergy test was negative, HLA B51 was positif. Systemic therapy was started with colchicine at a dose of 2mg/day. Eye drops and systemic prednisolone at 1mg/kg/day was continued with progressive decrease. The follow up at 3 months and 6 months showed no signs of recurrence of ulceration in both eyes. Corneal manifestation has rarely been reported in Behcet’s disease. Combined intraocular anterior and posterior segment inflammation are most common features of ocular Behcet disease. Collaborative management of ophthalmic patients having systemic illness along with internists improves overall outcomes and prevents morbidity in such patients.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74434580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shorten Myopic Axial Length with Repeated Low-lever Laser Light Therapy","authors":"Z. Lei, Qiu Kaikai, W. Bruce","doi":"10.11648/J.IJOVS.20210602.22","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210602.22","url":null,"abstract":"Purpose: This study was to confirm that repeated low-lever laser light therapy (LLLT) could control myopic axial length (AL) elongation. Methods: Twenty myopia, 5 to 13 years old, were included in this study. All subjects kept daily repeated therapy with LLLT for mean 3 months; According to the baseline AL (> 24.40 mm or not), and ages (> 10 years old or not), we built two age groups and two AL groups. The AL between baseline and follow-up as well as different groups were all tested by SPSS 26.0, respectively. Results: 85% and 75% of AL were shortened for the right and left compared with those of baseline, respectively. The follow-up right and left AL were both significantly shortened (P=.002, P=.003, respectively) from baseline mean right AL 24.52 ± 1.01 mm, left AL 24.51 ± 0.96 mm, to 24.41 ± 0.98 mm (-0.11 mm right AL shortened amount) and 24.42 ± 0.93 (-0.09 mm left AL shortened amount), respectively. Long baseline AL group was significantly (P=.02, P=.03) shortened more AL than those of small baseline AL group for both right and left AL (-0.17 mm versus -0.05 mm, P <.001, respectively). From age group aspect, although it was also significant difference changed (shortened) for right AL (P=.008), but not for left AL (P=.051). Conclusions: LLLT could control myopia axial length progression.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88544163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India","authors":"D. Arora, Anuj Sharma, R. Raman, Ankit Parasher, Chinky Sharma, D. Sharma, Bhawna Tiwari, Himanshu Arora, Abhishek Kumar, K. Gupta, Niyaaz Ahmad, S. Nautiyal, S. Verma, Deepak Anthwal, D. Sharma","doi":"10.11648/J.IJOVS.20210602.21","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210602.21","url":null,"abstract":"Aim: To study presentation of ocular cysticercosis and to evaluate its demographic data, diagnosis, treatment and outcome in hill population of Northern India. Materials and methods: This is a retrospective study carried out in Dehradun, Uttarakhand in a tertiary eye care hospital over 4 years from 2016-2020. The study involved 38 patients who presented with unilateral eye disease and were diagnosed to have ocular or adenexal cysticercosis. We analysed retrospectively their geographical data, clinical presentation, serology, imaging, response to treatment and clinical outcome. Results: Age of patients ranged from 16-54 years. Male to female ratio was 1:3.75. Total no. of eyes affected were 38. All were unilateral presentation. 30 eyes (78.94%) presented with extraocular cysticercosis and 8 eyes (21.05%) with intraocular cysticercosis. 27 of the patients (71.05%) were from lower socioeconomic status with poor hygiene and sanitation conditions. 32 (89.21%) patients gave history of association with non-vegetarian diet. Extraocular cysticercosis group had restriction of ocular motility as most prevalent presentation seen in 16 eyes (53.33%) and proptosis as the most prevalent sign seen in 17 eyes (56.66%). Cyst prevalence was most frequently detected in superior rectus muscle seen in 14 eyes (53.84%). Intraocular cysticercosis group had blurring of vision as the most prevalent presenting symptom in 8 eyes (100.0%). Panuveitis in 6 eyes (75%) and presence of subretinal cyst in 4 eyes (50%) was the most prevalent sign seen in intraocular cysticercosis group. Enzyme linked immunosorbent assay test confirmed serology in 35 cases (92.10%). The USG B-scan detected presence of scolex in 36 eyes (94.73%). Magnetic resonance imaging (MRI) confirmed deep seated extraocular cysticercosis lesions and neurocysticercosis (NCC) undetected by computerized tomography (CT). CT was diagnostic for NCC in 5 cases (13.15%). Oral Albendazole and prednisolone were successful in management of extraocular cysticercosis. Intraocular cysticercosis was treated well with pars plana vitrectomy surgery with good visual recovery. Conclusion: Extraocular cysticercosis was more prevalent than intraocular cysticercosis. Early diagnosis and treatment made a difference in final outcome of the two groups. Imaging studies of orbital B-scan ultrasonography (USG B scan), CT and MRI with immune serological test of enzyme linked immunosorbet assay (ELISA) and Western blot for anticysticercus antibodies helped in confirming the diagnosis. Extraocular cysticercosis can be managed well medically with good clinical outcome. Intraocular cysticercosisis is best treated surgically. Safer and modern vitreoretinal surgical techniques promise good surgical outcome and visual recovery. Timely intervention and frequent postoperative follow up would help in keeping a watch on development of complications and maintenance of good vision.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89462774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Avoid Giant Retinal Tear Slippage: New Surgical Approach","authors":"M. Zidi","doi":"10.11648/J.IJOVS.20210602.20","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210602.20","url":null,"abstract":"Introduction: The retinal detachment (RD) by giant tear is a rare but serious clinical form. Apart from its therapeutic difficulty, during the fluid-air exchange, it poses a problem of retinal slippage which may be responsible for therapeutic failure or at best for retinal folds with serious anatomical and functional consequences. The purpose of this study is to shed light on the keys to the success of this technique. Material and methods: Retrospective study over 5 years from January 2014-December 2019 concerning 56 cases of retinal detachment by giant tear. All the patients were operated on by vitrectomy and laser endophotocoagulation of the tear edge and on 360°. The technique involved a first transient exchange of PFCL-air followed by a second exchange of silicone-air or gas-air depending on the case. Results: Intraoperatively, no cases of slipping, even in the cases of gas tamponade, have been observed. A primary retinal re-application of the RD was noticed in 87.5% of cases. The rate of retinal detachment recurrence was 12.5% (all had an advanced vitreoretinal proliferation). After recurrence surgery, the final reapplication rate was 100%. Conclusion: Mastering the PFCL-Air exchange during vitrectomy retinal detachments by giant tearing according to the technique described helps to prevent the slippage of the retina. The gas tamponade can be an alternative to silicone tamponade in some cases of giant tears selected with lower horns above the 4 – 8 meridians.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86463598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic Neuropathy and Scleritis as the Presenting Feature of Lepra Reaction","authors":"Nishikant Borse, V. Borse, T. Borse, Shiamak Cooper","doi":"10.11648/J.IJOVS.20210602.18","DOIUrl":"https://doi.org/10.11648/J.IJOVS.20210602.18","url":null,"abstract":"A major problem in the management of leprosy patients is the occurrence of \"reactions\". These reactions are the consequences of the dynamic nature of the immune response to Mycobacterium leprae (M. leprae) that may occur before, during, or following the completion of multi-drug therapy (MDT). They can be of two types- Type 1 lepra reaction and Type 2 lepra reaction also known as Erythema Nodosum Leprosum (ENL). We report an unusual case of a 35 year old male patient who initially presented with complaints of a central scotoma. He neither had visible skin lesion suggestive of leprosy nor a history of either completion or concurrent anti leprosy drug treatment. He was diagnosed to be a case of anterior ischemic optic neuropathy for which he was treated with intravenous injections of methylprednisolone to which he significantly responded. Two months later, he complained of diminution of vision, redness and pain in the left eye which was diagnosed as scleritis. He was managed with topical prednisolone acetate eye drops. Within a week, the patient developed skin lesions over the cheekbones, ear lobules and the back of his hands. He was referred to a rheumatologist and a dermatologist for the same. The dermatologist suspected the lesions to be a manifestation of a Lepra Reaction. The presence of lepra bacilli was confirmed after taking a biopsy from the raised lesions and he turned out to be a case of undiagnosed lepromatous leprosy. He was subsequently treated with anti-leprosy drugs according to the WHO-MDT-MB along with a cover of steroids. After three months of initiation of this treatment, his ocular and dermatological lesions completely resolved. This is a unique case in which anterior ischemic optic neuropathy and scleritis preceded the symptom of leprosy, manifested as skin lesions.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74362503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}