Ophthalmic Research最新文献

{"title":"Ophthalmology Operation Note Encoding with Open-Source Machine Learning and Natural Language Processing.","authors":"Yong Min Lee, Stephen Bacchi, Carmelo Macri, Yiran Tan, Robert Casson, Weng Onn Chan","doi":"10.1159/000530954","DOIUrl":"10.1159/000530954","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate assignment of procedural codes has important medico-legal, academic, and economic purposes for healthcare providers. Procedural coding requires accurate documentation and exhaustive manual labour to interpret complex operation notes. Ophthalmology operation notes are highly specialised making the process time-consuming and challenging to implement. This study aimed to develop natural language processing (NLP) models trained by medical professionals to assign procedural codes based on the surgical report. The automation and accuracy of these models can reduce burden on healthcare providers and generate reimbursements that reflect the operation performed.</p><p><strong>Methods: </strong>A retrospective analysis of ophthalmological operation notes from two metropolitan hospitals over a 12-month period was conducted. Procedural codes according to the Medicare Benefits Schedule (MBS) were applied. XGBoost, decision tree, Bidirectional Encoder Representations from Transformers (BERT) and logistic regression models were developed for classification experiments. Experiments involved both multi-label and binary classification, and the best performing model was used on the holdout test dataset.</p><p><strong>Results: </strong>There were 1,000 operation notes included in the study. Following manual review, the five most common procedures were cataract surgery (374 cases), vitrectomy (298 cases), laser therapy (149 cases), trabeculectomy (56 cases), and intravitreal injections (49 cases). Across the entire dataset, current coding was correct in 53.9% of cases. The BERT model had the highest classification accuracy (88.0%) in the multi-label classification on these five procedures. The total reimbursement achieved by the machine learning algorithm was $184,689.45 ($923.45 per case) compared with the gold standard of $214,527.50 ($1,072.64 per case).</p><p><strong>Conclusion: </strong>Our study demonstrates accurate classification of ophthalmic operation notes into MBS coding categories with NLP technology. Combining human and machine-led approaches involves using NLP to screen operation notes to code procedures, with human review for further scrutiny. This technology can allow the assignment of correct MBS codes with greater accuracy. Further research and application in this area can facilitate accurate logging of unit activity, leading to reimbursements for healthcare providers. Increased accuracy of procedural coding can play an important role in training and education, study of disease epidemiology and improve research ways to optimise patient outcomes.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10104688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Elevated Intraocular Pressure on Retinal Ganglion Cell Density and Expression and Interaction of Retinal Aquaporin 9 and Monocarboxylate Transporters.","authors":"Yusuke Murai, Sotaro Mori, Mina Okuda, Sentaro Kusuhara, Takuji Kurimoto, Makoto Nakamura","doi":"10.1159/000533497","DOIUrl":"10.1159/000533497","url":null,"abstract":"<p><strong>Introduction: </strong>Astrocyte-to-neuron lactate shuttle (ANLS) plays an important role in the energy metabolism of neurons, including retinal ganglion cells (RGCs). Aquaporin 9 (AQP9), which is an aquaglyceroporin that can transport lactate, may be involved in ANLS together with monocarboxylate transporters (MCTs) to maintain RGC function and survival. This study aimed to investigate the impact of elevated intraocular pressure (IOP) on AQP9-MCT interaction and RGC survival.</p><p><strong>Methods: </strong>IOP was elevated in Aqp9 knock-out (KO) mice and wild-type (WT) littermates by anterior chamber microbead injection. RGC density was measured by TUBB3 immunostaining on retinal flat mounts. Immunolabeling, immunoblot, and immunoprecipitation were conducted to identify and quantitate expressions of AQP9, MCT1, MCT2, and MCT4 in whole retinas and ganglion cell layer (GCL).</p><p><strong>Results: </strong>Aqp9 KO and WT mice had similar RGC density at baseline. Microbead injection increased cumulative IOP by approximately 32% up to 4 weeks, resulting in RGC density loss of 42% and 34% in WT and Aqp9 KO mice, respectively, with no statistical difference. In the retina of WT mice, elevated IOP decreased the amount of AQP9, MCT1, and MCT2 protein and changed the AQP9 immunoreactivity and reduced MCT1 and MCT2 immunoreactivities in GCL. Meanwhile, it decreased MCT1 and increased MCT2 that interact with AQP9, without affecting MCT4 expression. Aqp9 gene deletion increased baseline MCT2 expression in the GCL and counteracted IOP elevation regarding MCT1 and MCT2 expressions.</p><p><strong>Conclusion: </strong>The compensatory upregulation of MCT1 and MCT2 with Aqp9 gene deletion and ocular hypertension may reflect the need to maintain lactate transport in the retina for RGC survival.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Atropine 0.01% Eye Drops on the Difference in Refraction and Axial Length between Right and Left Eyes.","authors":"Xintong Liang, Shifei Wei, Shi-Ming Li, Wenzai An, Jialing Du, Yunyun Sun, Jiahe Gan, Weiling Bai, Zhining Cai, Qianqian Song, Lei Yin, Ningli Wang","doi":"10.1159/000528878","DOIUrl":"10.1159/000528878","url":null,"abstract":"<p><strong>Introduction: </strong>This study sought to determine whether the application of 0.01% atropine eye drops could impact the disparity in refraction and axial length (AL) between the right and left eyes in Chinese children.</p><p><strong>Methods: </strong>The study was designed as a double-blind, placebo-controlled randomized trial. A total of 220 children aged 6-12 years were recruited from the Beijing Tongren Hospital in Beijing, China. Participants were randomized in a 1:1 ratio and were prescribed 0.01% atropine or placebo eye drops to be administered once a night to both eyes for the duration of 1 year. The cycloplegic refraction and AL were recorded including baseline, 6 months, and again at the 12 months.</p><p><strong>Results: </strong>After 1-year follow-up period, 76 (69%) and 83 (75%) subjects of the initial 220 participants were identified as the 0.01% atropine and placebo groups, respectively. The inter-ocular difference in spherical equivalent refraction (SER) and AL demonstrated stable values in the 0.01% atropine treatment group (SER: p = 0.590; AL: p = 0.322) analyzed after 1 year, but found a significant increase (SER: p &lt; 0.001; AL: p = 0.001) in the placebo group. Furthermore, over 1 year, eyes with greater myopia in the atropine group exhibited slower myopia progression (0.45 ± 0.44 D) than the lesser myopic eye (0.56 ± 0.44 D) (p = 0.003).</p><p><strong>Conclusion: </strong>This study demonstrated that 0.01% atropine could maintain the inter-ocular SER and AL difference. And 0.01% atropine appeared to be more effective in delaying the progression of myopia in eyes with more myopia than in the less myopic eyes.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10481505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Optic Nerve Head Microcirculation Using Optical Coherence Tomography Angiography and the Upstream Macrocirculation Using Color Doppler Imaging in Low-Tension and High-Tension Glaucoma Patients.","authors":"Wenbo Hou, Jun Feng, Jie Chen, Xin Li, Guiping Yang, Xuguang Sun","doi":"10.1159/000528521","DOIUrl":"10.1159/000528521","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to analyze the optic nerve head (ONH) microcirculation using optical coherence tomography angiography (OCT-A) and the upstream macrocirculation using color Doppler imaging (CDI) in low-tension and high-tension glaucoma (LTG and HTG, respectively).</p><p><strong>Methods: </strong>This cross-sectional study included 67 eyes of 67 HTG patients, 55 eyes of 55 LTG patients, and 42 eyes of 42 healthy controls. We recorded the complete ophthalmological examination, visual fields, retinal nerve fiber layer (RNFL) thickness, ONH vessel density (VD) measured using OCT-A, peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) measured using CDI. SPSS software was used for data analysis. Data are presented as mean ± standard deviation or median (interquartile range) and compared using t test or Mann-Whitney U test, as appropriate. Pearson χ2 test or Fisher's exact test was used for comparisons, as appropriate. Pearson correlation analysis was used to evaluate the correlations between variables. p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The ONH VD and RNFL thickness were considerably lower in glaucomatous eyes than in healthy eyes (both p < 0.001). Compared with the HTG group, the LTG group had lower VD in the peripapillary region (p = 0.027). Compared with the healthy group, the HTG group had lower PSV (p = 0.029 and = 0.023, respectively), lower EDV (p = 0.023 and <0.001, respectively), and higher RI (p = 0.019 and = 0.006, respectively) of the internal carotid artery (ICA) and central retinal artery (CRA). The LTG group had lower PSV (p = 0.015 and <0.001, respectively) and EDV (p = 0.047 and = 0.001, respectively) of the ophthalmic artery (OA) and CRA. The LTG group had lower PSV of CRA than the HTG group (p = 0.034). In glaucomatous eyes, peripapillary VD had a significant association with the mean defect (p < 0.001) and RNFL thickness (p < 0.001), but not with the other CDI indices (all p > 0.05).</p><p><strong>Conclusion: </strong>The ONH microcirculation and upstream macrocirculation of the large arteries exhibited differences in the blood flow characteristics between the LTG and HTG groups. These differences may improve our understanding of glaucoma. There was no correlation between the characteristics of the ONH microcirculation and the upstream macrocirculation of large vessels in the LTG and HTG groups.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodel Imaging Evidence of Traction Component in Lamellar Macular Hole with Epiretinal Proliferation.","authors":"Yu-Ting Su, Chung-May Yang, Tso-Ting Lai","doi":"10.1159/000530529","DOIUrl":"10.1159/000530529","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the association of epiretinal traction in idiopathic lamellar macular hole (LMH) with or without lamellar hole-associated epiretinal proliferation (LHEP).</p><p><strong>Methods: </strong>A retrospective consecutive case series included 108 eyes diagnosed with LMH in a single tertiary referral center. Epiretinal traction was determined by the presence of epiretinal membrane (ERM), attached posterior hyaloid, or vascular traction with multimodal imaging studies and intraoperative findings in those received surgical interventions.</p><p><strong>Results: </strong>The 53 LMHs with LHEP had similar age, refraction, initial, and final visual acuity to the 55 LMHs without LHEP. Both groups exhibited high incidences of vascular traction (with and without LHEP: 92% and 84%, p = 0.36, respectively) and ERM and/or attached posterior hyaloid (both 100%, p = 1.00). The vision improved 10.5 and 14 ETDRS letters (p = 0.60) in the 30 eyes with and 19 eyes without LHEP that underwent vitrectomy. Vascular tractions released postoperatively in 88% and 100% of LMHs with and without LHEP, respectively (p = 0.27). The LMH, ERM foveoschisis, and mixed subtypes exhibited epiretinal traction in 100% of cases in all subtypes (p = 1.00).</p><p><strong>Conclusion: </strong>Our findings indicated that epiretinal traction, evaluated by multimodal imaging, is the norm rather than the exception in LMHs showing LHEP. The presence of tractional forces should be taken into consideration when treatment was planned in LMHs.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors of Repositioning Surgery to Correct Misalignment of Toric Intraocular Lenses after Cataract Surgery: A Single-Center Retrospective Observational Study.","authors":"Honglei Li, Jiajun Sun, Huiran Bai, Lin Leng, Yunhai Dai, Xiaoming Wu","doi":"10.1159/000527408","DOIUrl":"10.1159/000527408","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to analyze the incidence and outcomes of repositioning surgery to correct misalignment of several toric intraocular lenses (IOLs) after cataract surgery.</p><p><strong>Methods: </strong>In this retrospective study, patients who underwent repositioning surgery to correct misalignment of toric IOLs following cataract surgery between January 2019 and December 2021 were enrolled. The medical data on patients' age, gender, preoperative axial length, corneal astigmatism, the axis of astigmatism, IOL models, IOL axis, uncorrected distance visual acuity, residual refraction, and postoperative outcomes were analyzed.</p><p><strong>Results: </strong>Among the 1,135 eyes implanted with toric IOLs at Qingdao Eye Hospital, 23 (2.026%, 23/1,135) underwent repositioning surgery. Univariate analysis revealed that the incidence of repositioning surgery was significantly lower with AcrySof (0.636%, 5/786) than with ZEISS (2.959%, 5/169) and TECNIS (7.222%, 13/180) IOL platforms; the incidence of repositioning surgery with monofocal toric IOLs (1.169%, 11/941) was significantly lower than multifocal toric IOLs (6.186%, 12/194) (p < 0.001); additionally, a significant difference in age was also observed (p = 0.002). Multivariate logistic regression analysis showed that the IOL platform (p = 0.004) and younger age (p = 0.006) were independent risk factors for repositioning surgery.</p><p><strong>Conclusion: </strong>The incidence of repositioning surgery of toric IOLs after cataract surgery was 2.026%. It was linked to the IOL platform, multifocal toric IOLs, and younger age.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Transcription Factor 7-Like 2 C/T Polymorphism and Diabetic Retinopathy Risk: A Meta-Analysis.","authors":"Yong Zhang, Gui-Ping Pan, Jun-Wei Cai, Yu-Ming Niu, Long-Chuan Xie","doi":"10.1159/000525803","DOIUrl":"10.1159/000525803","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested a close association between transcription factor 7-like 2 (TCF7L2) polymorphisms and diabetic retinopathy (DR) susceptibility. However, the published results were inconsistent. This meta-analysis was conducted to review and examine the relationship between TCF7L2 rs7903146 C/T polymorphism and DR risk.</p><p><strong>Materials and methods: </strong>Online databases were searched, and the related studies were identified in this meta-analysis. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to examine the statistical power. Moreover, heterogeneity test, sensitivity accumulative analysis, and publication bias were conducted to measure the statistical effect.</p><p><strong>Result: </strong>6 studies involving 12,982 subjects were included in this meta-analysis to assess the association between rs7903146 C/T polymorphism and DR susceptibility. The synthetic results indicated that the mutation of rs7903146 C/T polymorphism maybe accompanied with an increased risk for DR (T vs. C: OR = 1.26, 95% CI = 1.00-1.60, p = 0.05, I2 = 83.5%; TT vs. CC: OR = 1.79, 95% CI = 1.12-2.86, p = 0.02, I2 = 80.2%; TT vs. CC + CT: OR = 1.62, 95% CI = 1.38-1.92, p < 0.01, I2 = 32.3%). Moreover, the subgroup analysis also demonstrated an increasing risk for DR with T mutations in Caucasian descendants.</p><p><strong>Conclusion: </strong>The current evidences of meta-analysis suggested that the TCF7L2 rs7903146 C/T polymorphism might play an important role in DR susceptibility.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40577269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of Visual Impairment among Children with Special Needs in Rural China.","authors":"Jiali Wu, Jieqiong Chen, Ruyi Zhao, Lan Zeng, Tong Li, Wenqiu Wang, Huixun Jia, Fenghua Wang, Hong Zhu, Wei Tan, Xiaodong Sun","doi":"10.1159/000526494","DOIUrl":"10.1159/000526494","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have reported a high prevalence of visual defects in children with special needs. However, routine ocular examinations for these children in rural areas of China are lacking. This study aimed to evaluate the status of visual impairment (VI) in children at special education schools in rural China.</p><p><strong>Methods: </strong>A total of 316 students from two special schools in Zunyi city, Guizhou province, were enrolled. Full ophthalmic examinations were performed, and gene-sequencing services were offered to potential patients.</p><p><strong>Results: </strong>The mean age of the 316 participants was 12.27 ± 3.49 years and 75 showed abnormal ophthalmic manifestations on slit-lamp examination. Visual acuity (VA) was assessed in 232 eyes, and the mean VA (logarithm of the minimum angle of resolution, logMAR) was 0.27 ± 0.34. Whole-exome sequencing identified 19 mutations in these children, which might explain their visual complaints. Children with Down syndrome had a significantly higher prevalence of ocular disorders than those without.</p><p><strong>Conclusion: </strong>VI is common among children at special education schools in rural areas; however, routine screening and effective interventions have not been consistently implemented. Efforts should be made to address this issue in these already disadvantaged children.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effect in the Retina and Choroid after 650 nm Low-Level Red Light Therapy in Children.","authors":"Weiming Yang, Feng Lin, Meiyan Li, Ruoyan Wei, Jiaqi Zhou, Xingtao Zhou","doi":"10.1159/000527787","DOIUrl":"10.1159/000527787","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to investigate the changes in the retina and choroid of children after 650 nm low-level red light therapy (LLRLT).</p><p><strong>Methods: </strong>In this prospective study, 25 subjects in the Shanghai Eye and ENT Hospital of Fudan University were included from August 2021 to September 2021. One eye was randomly selected to receive LLRLT for 3 min. Swept-source optical coherence tomography (OCT) and OCT angiography were used to measure retinal fovea perfusion density (RFPD), retinal fovea thickness (RFT), choroidal fovea blood flow (CFBF), and choroidal fovea thickness (CFT) before LLRLT, 5 min and 1 h after LLRLT. Baseline characteristics between LLRLT and non-LLRLT eyes were compared. Changes in the retinal and choroidal parameters were analyzed by ANCOVA models. SAS software was used for data analysis. The difference was considered statistically significant if p < 0.05.</p><p><strong>Results: </strong>There was no difference in baseline characteristics between LLRLT eyes and non-LLRLT eyes. The RFPD in LLRLT eyes significantly increased 5 min after LLRLT, and the increment was 1.70 ± 0.83% (p = 0.0389). The RFPD significantly decreased from 5 min to 1 h after LLRLT with a mean of -2.62 ± 0.86% decrement (p = 0.0031). The RFPD levels returned to baseline at 1 h after LLRLT (p = 0.8646). However, compared with insignificant RFPD changes in non-LLRLT eyes, there was no significant difference in RFPD changes at any sampling point. No significant changes in RFT, CFBF, and CFT were found in LLRLT eyes at each sampling point.</p><p><strong>Conclusion: </strong>Although 3 min of LLRLT has no effect on the choroid, it may cause a short-term transient increase in RFPD. It will provide theoretical support for the role of LLRLT in myopia control.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40658910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusional Vergence Dysfunctions in Acute Acquired Concomitant Esotropia of Adulthood with Myopia.","authors":"Shiqiang Zhao, Jie Hao, Jiawen Liu, Kai Cao, Jing Fu","doi":"10.1159/000527884","DOIUrl":"10.1159/000527884","url":null,"abstract":"<p><strong>Introduction: </strong>Acute acquired concomitant esotropia (AACE) has been increasing dramatically in myopia. The aim of this study was to clarify whether fusional vergence dysfunctions exist in AACE with myopia and to explore the relationship between fusional vergence and myopia in AACE.</p><p><strong>Methods: </strong>This is a prospective clinical study. Adult AACE patients as well as controls (aged ≥18 years) both with myopia were prospectively recruited from October 2016 to August 2021. Refractive error and fusional divergence and convergence amplitude at distance were measured, as determined with a comprehensive refractor. The main outcome measures were the real value of the fusional divergence amplitude (calculated by subtracting the break point value from the angle of deviation) and the real value of the fusional convergence amplitude (calculated by subtracting the angle of deviation from the break point value). Two-sided p value of less than 0.05 was considered to indicate statistical significance.</p><p><strong>Results: </strong>Fusional vergence consisting of fusional divergence and fusional convergence in patients with AACE of adulthood was different from the controls (p < 0.001), with fusional convergence decreased and fusional divergence increased. In the linear regression analysis, spherical equivalents were significantly negatively correlated with fusional convergence (right eyes, p < 0.001; left eyes, p < 0.001) in patients with AACE of adulthood but not in controls. There was a significant difference in fusional convergence amplitude among different degrees of spherical equivalents (p < 0.001).</p><p><strong>Conclusions: </strong>Fusional vergence dysfunction exists in AACE of adulthood, which may be attributed to self-adaptation based on concomitant esotropia to maintain fusion in AACE. Fusional convergence was associated with degrees of myopia, implying the adaption would be weakened as the degree of myopia becomes serious.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}