{"title":"Effect of Smoking on Corneal Endothelium","authors":"Moaiad Abdullateef Almasoudy, Wisam Hado, Khaldoon Khalil Nile, Moaiad Abdul, Lateef Almasoudy","doi":"10.36351/pjo.v40i3.1827","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1827","url":null,"abstract":"Purpose: To determine if smoking has an effect on corneal endothelium.\u0000Study Design: Descriptive observational.\u0000Place and Duration of Study: Lamar eye center in Kerbala city in Iraq during December, 2023 and January, 2024.\u0000Methods: A total of 108 eyes were selected, 54 eyes of smokers and 54 eyes of non-smokers. The smokers included in this study had history of smoking for more than twenty years and they smoke more than 40 cigarettes per day. All the participants were male. Specular microscopy was used to determine four corneal parameters; cell density, hexagonality, coefficient of variation and central corneal thickness.\u0000Results: Patients age ranged from 50 to 60 years. Central Corneal Thickness was 515.29±40.62 and 522.37±36.68in smokers and non-smokers respectively with p= 0.32. Coefficient of variation and, Cell Densityand Hexagonal shape parameters were also not statistically different between the two groups (p> 0.05).\u0000Conclusion: Smoking does not have a statistically significant effect on the corneal endothelium in terms of cell density, hexagonality, coefficient of variation, and central corneal thickness. However, more studies are needed to provide further evidence.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"29 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702819","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":"Diagnostic System Based on Deep Learning to Detect Diabetic Retinopathy","authors":"Devendra Singh, Dinesh C. Dobhal, Janmejay Pant","doi":"10.36351/pjo.v40i3.1771","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1771","url":null,"abstract":"Purpose: To develop a machine learning based diabetic retinopathy screening system to help ophthalmologists for initial level screening.\u0000Study Design: Diagnostic accuracy study.\u0000Place and Duration of Study: Haldwani in a private hospital from January, 2023 to June, 2023.\u0000Methods: A total of 229 fundus images (people suffering from diabetic retinopathy)were used which had micro aneurysms, soft exudates, hard exudates and hemorrhages. We classified these images and pre-processed them by scaling, orienting, and color adjustments. With the help of various pre-processing techniques, we decreased the size of our dataset so that it can be handled efficiently by our model with optimal resources.Visual Geometry Group (VGG) is a type of pre-trained deep convolutional neural network (CNN). The term “deep” refers to the number of layers; the VGG-16 uses 16 and VGG-19 uses 19 convolutional layers respectively. The model was tested on fresh retinal dataset.\u0000Results: Our research has demonstrated promising results, achieving a high accuracy rate of 90% on a human dataset by utilizing VGG16 for feature extraction and a Logistic Regression classifier for classification.\u0000Conclusion: Ophthalmologists can utilize this machine learning based screening system for diabetic retinopathy screening.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"49 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689819","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":"Bilateral Glaucoma in An Infant with Phacomatosis Pigmentovascularis and Sturge-Weber Syndrome: A Rare Case Report","authors":"D. E. Yulia, D. Soeharto","doi":"10.36351/pjo.v40i3.1733","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1733","url":null,"abstract":"Prevalence of concurrent PhakomatosisPigmentovascularis (PPV)and Sturge-Weber syndrome (SWS)is unknown due to its rarity and sporadic occurrence. In this case report, we present a rare case of bilateral glaucoma in an infant with PPV and SWS. Athree-month old male infant presented with hazy cornea and visible black spots in the upper sclera and presented with intraocular pressure (IOP) of 40 and 52 mmHg in the left and right eye, respectively. Trabeculectomy-Trabeculotomy for both eyes was done which initially decreased IOP. However, high IOP recurred, and the patient was treated with topical medication.At one year follow-up, the patient had normal IOP and was responsive to light and object. Our case is a rare presentation of concurrent SWS, PPV, and bilateral glaucoma. The potential systemic comorbidities of this condition highlights that it is imperative that these patients are diagnosed early, treated promptly, and are monitored periodically.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"42 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690242","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":"Effect of Ramadan Fasting on Biometric Readings of Eye","authors":"Amna Anam, Hafiza Sadia Imtiaz, Irfan Qayyum Malik, Zeeshan Hameed","doi":"10.36351/pjo.v40i3.1508","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1508","url":null,"abstract":"Purpose: To determine change in biometric values of eye after fasting and to elucidate whether this change is significant enough to delay the refractive and cataract surgeries during fasting.\u0000Study Design: Cross sectional observational.\u0000Place and Duration of Study: Eye department, DHQ-UTH, Gujranwala, from April 2021 to May 2021.\u0000Methods: Thirty subjects of either gender between 20-40 years of age who participated in both phases were enrolled in this study. Phase 1 was conducted one week before Ramadan and 2nd phase in the last week of Ramadan. After routine ophthalmic examination, keratometric(K) values were obtained with Auto Ref-Keratometer (Canon), while Axial length (AL), Anterior chamber depth (ACD), andIntraocular lens power (IOLp)were obtained from Master-Vu A-scan (Sonomed, Model # MV4500). Data was analyzed using SPSS version 25.\u0000Results: Out of 30 participants, 66.6% were female and 33.3%were male with mean age of 29.8 years. Mean K1 increased to 43.03 D during fasting from non-fasting reading of 42.24 D, while Mean K2 increased to 43.87 D during fasting from non-fasting reading of 43.28 Dwith significantp-value (<0.05). Mean ACD was 3.15mm in non-fasting that also increased to 3.21D in fasting state. Mean AL in non-fasting state was 23.41mm that remains the same in fasting state as well. Mean IOLp in non-fasting state was 21.18D that reduced to 20.42D in fasting state with significant p-value.\u0000Conclusion: Fastingincreased thekeratometry andACD values with no effect on AL but that reduced overall intraocular lens power.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"48 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689698","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}
Omnia M. Sherif, Mohammed A. Radwan, S. A. Al-Khaldi
{"title":"Effect of Occlusion Therapy on the Deviation Angle in Patients with Partially Accommodative Esotropia and Amblyopia","authors":"Omnia M. Sherif, Mohammed A. Radwan, S. A. Al-Khaldi","doi":"10.36351/pjo.v40i3.1822","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1822","url":null,"abstract":"Purpose: To assess the impact of occlusion therapy on the deviation angle in patients with partially accommodative esotropia (ET) and amblyopia.\u0000Study Design: Retrospective chart review.\u0000Place and Duration of Study: The medical records of patients attending the pediatric ophthalmology clinic at Elite Hospital, Riyadh, Saudi Arabia between June, 2014 and September, 2021 were reviewed.\u0000Methods: We retrospectively analyzed the pre- and post-therapy, angle of deviation of 63 children with partially accommodative ET who underwent occlusion therapy for amblyopia.\u0000Results: The mean angle of deviation before and one month after using the full cycloplegic prescription glasses was 31.74 PD (range,12–85 PD) and 16.5 PD(6–45 PD), respectively. After occlusion therapy (6–18 months), the mean angle of deviation decreased to 10.03 PD (0–45 PD). Thirteen patients (20.63%) underwent surgery after completion of occlusion therapy, which was significantly less than the number of patients that would have been scheduled for surgery before proper occlusion therapy (n = 41, 65.07%).\u0000Conclusion: Amblyopia therapy should be completed before surgical intervention in patients with hypermetropia, partially accommodative ET, and amblyopia. There was a significant reduction in ET angle following occlusion therapy. Furthermore, it decreased the number of patients requiring surgery and the angle to be corrected.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708976","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}
Wimbo Sasono, I. Nyoman, Ananta Karisma, Susy Fatmariyanti, D. Legowo, Hari Basuki Notobroto
{"title":"Comparison of TGF-β and Type 1 Collagen Expression between Platelet Rich Fibrin Membrane and Conjunctival Autograft Treatment after Conjunctival Excision (An Experimental Animal Model Study)","authors":"Wimbo Sasono, I. Nyoman, Ananta Karisma, Susy Fatmariyanti, D. Legowo, Hari Basuki Notobroto","doi":"10.36351/pjo.v40i3.1791","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1791","url":null,"abstract":"Purpose: To compare TGF- β and type 1 collagen expression between Platelet rich fibrin (PRF) membrane and conjunctival autograft treatment after conjunctival excision.\u0000Study Design: Experimental animal study.\u0000Place and Duration of study: Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia from October 24, 2022 to November, 19, 2022\u0000Methods: Twenty New Zealand white rabbits were randomly assigned to either the PRF group or the conjunctival autograft group. A 5x5 mm excision was made in the temporal quadrant of the right eye of each rabbit. In the first group, the conjunctival defect was closed using a PRF membrane, while in the second group, closure was done with a conjunctival autograft from the superior quadrant of the same eye. After 14 days, all rabbits were terminated and enucleated. An immunohistochemical study of conjunctival tissue was conducted to assess TGF-β and type 1 collagen expression, and results were statistically analyzed.\u0000Results: An independent T-Test revealed that PRF membrane group exhibited higher TGF-β expression compared to the conjunctival autograft group (p = 0.000), with a mean TGF-β expression of 9.02 in the PRF membrane group and 5.76 in the conjunctival autograft group. Conversely, type 1 collagen expression was found to be higher in the conjunctival autograft group compared to the PRF membrane group (p = 0.032), with a mean type 1 collagen expression of 9.22 in the conjunctival autograft group and 6.92 in the PRF membrane group.\u0000Conclusion: TGF-β expression was higher in the PRF group and type 1 collagen expression was higher in the conjunctival autograft group.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"71 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708950","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":"Causes of Visual Impairment in a Sample of Adult Iraqi Patients","authors":"Z. Al-Khafaji, Mohammed Suhail Najam Al Salam","doi":"10.36351/pjo.v40i3.1799","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1799","url":null,"abstract":"Purpose: To identify causes of visual impairment in adult patients seeking treatment at teaching hospital in Iraq.\u0000Study Design: Descriptive observational.\u0000Place and Duration of Study: Ibn Al-Haytham Teaching Eye Hospital (IAHTEH) in Baghdad, Iraq during the year 2023.\u0000Methods: This study comprised of 125,804 adults. All the participants had comprehensive history and ocular examination. Mild, moderate and sever visual impairment were defined as from 6/9 to 6/18, 6/24 to 6/36 and 6/60 or below respectively.\u0000Results: Among 125,804 patients, the breakdown of conditions was as follows: 60,650 (48%) had cataracts, 37,741 (30%) had refractive errors, 12,071 (10%) had diabetic retinopathy, 8,328 (7%) had glaucoma, and 7,014 (5%) had experienced trauma. Most patients (54%) had severe visual impairment, followed by moderate (29%) and mild (17%) impairment. The majority of cases (45%) were in individuals aged 60 years and older, with 26% in the 40-59 years age group and 29% in the 20-39 years age group. Diabetic retinopathy was most common in the 40-59 years age group, while glaucoma and cataracts were predominantly in those aged 60 and above. Refractive errors and trauma were mainly found in the 20-39 years age group. Females accounted for 63% of patients with reduced vision, whereas males predominated among trauma cases, with 29% of trauma cases involving blunt trauma.\u0000Conclusion: Cataract is the most prevalent condition in older patients. Younger adults frequently experience refractive errors and trauma. Females are more likely to have reduced vision, whereas males are more prone to trauma-related vision issues.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"45 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715229","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}
Muthanna Basheer Yasir, Ali Nema Abushnein, Wissam Yosif
{"title":"Referral Patterns to an Ophthalmic Outpatient Clinic in a Tertiary Eye Care Center in Iraq","authors":"Muthanna Basheer Yasir, Ali Nema Abushnein, Wissam Yosif","doi":"10.36351/pjo.v40i3.1742","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1742","url":null,"abstract":"Purpose: We aim to conduct a comprehensive review of outpatients at a tertiary ophthalmology clinic to evaluate various aspects including the spectrum of eye disorders, referral patterns, reasons for referral, and patient self-assessment, with a particular focus on self-referrals.\u0000Study Design: A cross-sectional study.\u0000Place and Duration of Study: Ibn Al-Haitham Teaching Eye Hospital from April to May, 2023.\u0000Methods: Referral letters were grouped into the primary health center (PHC), secondary hospital, internal referral and private clinic. Referral letter quality was assessed based on clinical information and particular request.\u0000Results: A total of 1367 individuals aged 40.8 ± 22.17 years were eligible for study. There were 19.2% referrals form PHC, 18.4% from secondary hospitals, 10.7% from private clinics, 3.3% were internal referrals, 37.2% were self-referred and 11.3% had medical or surgical follow-up. Blurred vision was the predominant complaint of 677 (51.6%) patients. Out of 659 referral letters, 25% scored two essential information items, 5.2% scored three, and only 0.8% scored four items. The majority (97.2%) of letters provided specific requests. Among all, 26.3% of PHC, 38.2% of hospitals, 34.9% of private clinics, 21.7% self-referred and 51.1% of internally referred patients considered their situations difficult.\u0000Conclusion: Majority of cases seen in ophthalmology tertiary centers consist of common conditions that could be effectively managed by PHCs and general hospitals. Improved referral standards for specialized medical institutions may reduce tertiary hospital over population.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"20 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710181","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}
Nazia Qidwai, Shabih Zehra, Maria Hameed, Tauseef Mehmood, Wejai Kumar
{"title":"Measurement of Orbital Dimensions and Its Gender Related Differences in Various Ages of Pakistani Children","authors":"Nazia Qidwai, Shabih Zehra, Maria Hameed, Tauseef Mehmood, Wejai Kumar","doi":"10.36351/pjo.v40i3.1777","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1777","url":null,"abstract":"Purpose: To measure the orbital dimensions and their gender related differences at various ages in Pakistani children from birth to 12 years of age.\u0000Study Design: Cross sectional observational.\u0000Place and Duration of Study: Tibri Medical College and Hospital Karachi and National Institute of Child Health, Karachi from June 2022 to February 2023.\u0000Methods: Patients who underwent CT Scan head for any reason but with normal orbits were included in the study. The vertical and horizontal measurements were made for anterior, middle and posterior orbit in sagittal and axial views.\u0000Results: The mean age of the total sample of 176 children was 6.45±3.40 years. The mean horizontal dimension of the anterior side of the orbit was 28.31 mm for children aged 1-3 years, 30.63 mm for those aged 4-6 years, 32.22 mm for ages 6-9 years, and 32.93 mm for ages 10-12 years. These differences were statistically significant (p<0.05). A significant difference was observed in the mean vertical dimension for the middle and posterior sides across different age groups. There were significant differences in the vertical and horizontal dimensions of the anterior and middle sides of the orbits for children aged 1-3 years (p<0.05). However, for children aged 4-6 years, there were no significant differences between genders in any measured dimension (horizontal, vertical, or depth) (p>0.05).\u0000Conclusion: There is a phase of rapid growth from birth to 3 years of age, after which the orbit continues to grow slowly. Gender-related differences were more pronounced during this phase.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"69 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711106","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}
Ali Abbas Hassan Fazaa, Mudhher Ghani Abdulla, Saad H. Salman
{"title":"Effect of Retinectomy with Pars Plana Vitrectomy in Proliferative Vitreoretinopathy: Surgical Success and Recurrence Rate (A Comparative Study)","authors":"Ali Abbas Hassan Fazaa, Mudhher Ghani Abdulla, Saad H. Salman","doi":"10.36351/pjo.v40i3.1821","DOIUrl":"https://doi.org/10.36351/pjo.v40i3.1821","url":null,"abstract":"Purpose: To assess anatomical and functional success of pars plana vitrectomy with retinectomy in cases of proliferative vitreoretinopathy (PVR grade C).\u0000Study Design: Retrospective chart review.\u0000Place and Duration of Study: AL-Ferdous Private Eye Hospital, Baghdad, from July, 2019- June, 2023.\u0000Methods: Thirty eyes of thirty patients with PVR grade C were included in the study. One group (n=15) underwent pars plana vitrectomy (PPV) without retinectomy, while the other group (n=15) underwent PPV with retinectomy. Complications, anatomic success, and visual acuity were documented and evaluated. The relationship between retinectomy duration and postoperative visual acuity was examined using a chi-square test, with a p-value less than 0.05 considered statistically significant.\u0000Results: Mean age of the patients was 46.13±13.95 years. Retinectomy group had 8 (53.3%) males and 7 (46.7%) females. The other group had 10 (66.7%) males and 5 (33.33%) females. In group 1 there were 5 phakic and 10 pseudophakic eyes while in group 2, there were 4 phakic and11 pseudophakic eyes. Postoperative complete retinal re-attachment was achieved in 100% eyes in retinectomy group. After six months, the first group had 5 eyes (33.3%) with improved visual acuity, stable visual acuity in 7 eyes (46.6%) and worsening of vision in 3 eyes (20%). For the second group, 8 eyes (53.3%) showed improvement, stability in 4 eyes (26.7%), and worsening vision in 3 eyes (20%) with p-value > 0.05.\u0000Conclusion: Retinectomy is beneficial in treating severe PVR and improves, ultimate retinal reattachment rate.","PeriodicalId":169886,"journal":{"name":"Pakistan Journal of Ophthalmology","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712744","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}