Osman Ahmet Polat, Hidayet Şener, Zekeriya Çetinkaya, Hatice Arda
{"title":"Evaluation of Agreement Between Sweep Visual Evoked Potential Testing and Subjective Visual Acuity.","authors":"Osman Ahmet Polat, Hidayet Şener, Zekeriya Çetinkaya, Hatice Arda","doi":"10.4274/tjo.galenos.2023.37622","DOIUrl":"10.4274/tjo.galenos.2023.37622","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to evaluate the agreement of visual acuity (VA) obtained with the sweep visual evoked potential (sVEP) method with the VA obtained with the Snellen chart. The secondary objective was to examine the effect of age and gender on agreement.</p><p><strong>Materials and methods: </strong>Best corrected VAs of subjects were recorded with the Snellen chart, and sVEP testing was performed according to the recommendations of the International Society for Clinical Electrophysiology of Vision (ISCEV). Snellen VAs and sVEP measurements were analyzed using logMAR conversion for statistical analysis. Agreement was evaluated with Bland-Altman analysis.</p><p><strong>Results: </strong>The study included 49 subjects with a mean age of 53.5±17.3 years (range: 19-75 years) and mean Snellen VA of 0.31±0.32 logMAR (range: 1.3-0.0 logMAR). In the Bland-Altman analysis, the mean differences between the VA and sVEP measurements (VA-sVEP) were significantly different and outside the limits of agreement (p=0.035). A significant proportional bias (p=0.0007) was found in the regression analysis performed between VA-sVEP and the mean VA. According to the Bland-Altman analysis of sex subgroups, there was a significant difference between VA and sVEP measurements in female subjects (p=0.006). The difference between VA and sVEP measurement increased significantly with older age (R<sup>2</sup>: 0.306, p<0.001, β: 0.05 [0.03, 0.08]).</p><p><strong>Conclusion: </strong>In conclusion, sVEP measurements and VAs did not show statistical agreement. Cranial anatomy and endocrine differences of the subjects may affect their sVEP measurements. The difference between the methods varies according to VA level. Directly using sVEP results instead of VA would not be appropriate.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 5","pages":"289-293"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/14/TJO-53-289.PMC10599336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xavier Garrell-Salat, Claudia Garcia-Arumi, Yann Bertolani, Sandra Banderas García, Paul Buck, Jose Garcia-Arumi
{"title":"Tractional Retinal Detachment Related to Hemoglobin C Trait Retinopathy: A Case Report.","authors":"Xavier Garrell-Salat, Claudia Garcia-Arumi, Yann Bertolani, Sandra Banderas García, Paul Buck, Jose Garcia-Arumi","doi":"10.4274/tjo.galenos.2023.48672","DOIUrl":"10.4274/tjo.galenos.2023.48672","url":null,"abstract":"<p><p>Hemoglobin C (HbC) disease is an uncommon disease that is generally considered benign, causing only occasionally painless hematuria, osteomyelitis, and dental abnormalities. Ocular manifestations have rarely been described in these patients. Here we report a novel ophthalmological manifestation of the disease. A 20-year-old woman presented with progressive visual loss in her right eye due to tractional retinal detachment. The left eye was apparently normal, but wide-field fluorescence angiography showed mild peripheral ischemia with multiple vascular abnormalities. Vitrectomy was performed and the systemic workup revealed the presence of hemoglobinopathy C in heterozygous form. HbC disease can be sight-threating due to retinal proliferation, similar to sickle cell retinopathy. Patients affected with this disease should undergo regular surveillance. Ultra-wide angiography is a helpful examination to detect peripheral ischemia in the earlier stages.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 5","pages":"318-321"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/94/TJO-53-318.PMC10599338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Series of Cat-Scratch Disease with Ocular Manifestations: Clinical Findings and Treatment Approach.","authors":"Atakan Acar, Pınar Çakar Özdal, Berna Başarır, Kübra Özdemir Yalçınsoy, Çiğdem Altan, Özlem Budakoğlu","doi":"10.4274/tjo.galenos.2022.44692","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2022.44692","url":null,"abstract":"<p><strong>Objectives: </strong>To present the clinical and demographic characteristics, imaging findings, diagnosis and treatment approach in cases of cat scratch disease (CSD) with ocular involvement.</p><p><strong>Materials and methods: </strong>The records of 19 patients followed-up and treated between 2010 and 2020, including detailed ophthalmological examinations, imaging findings, and treatment approach, were evaluated retrospectively.</p><p><strong>Results: </strong>Twenty-three eyes of 19 patients, 7 female (37%) and 12 male (63%), were included in the study. The mean age was 34.1±13.3 (range: 11-56) years, and the mean follow-up duration was 12.6±18.0 (range: 1-81) months. Unilateral involvement was observed in 15 cases (79%). Cat contact was reported in 14 cases (74%). In 6 cases (32%), flu-like symptoms were present before the ocular complaints. The mean visual acuity (VA) at presentation was 0.42±0.36 (range: 0.001-1.0). Anterior uveitis was observed in 3 eyes (13%). Posterior segment findings included neuroretinitis in 14 (61%), superficial retinal infiltrate(s) in 8 (35%), papillitis in 3 (13%), branch retinal artery occlusion in 2 (8%), and cilioretinal artery occlusion in 1 (4%) of the eyes. All cases were positive for <i>Bartonella henselae</i> immunglobulin (Ig)M and/or IgG. Systemic antibiotic therapy was administered to all patients. Intravenous pulse or oral corticosteroids were given, especially in cases with optic disc involvement. The mean final VA was 0.80±0.25 (range: 0.01-1.0).</p><p><strong>Conclusion: </strong>CSD may present with different ocular involvement patterns. Apart from the classical neuroretinitis and macular star appearance, patients may present with isolated optic disc edema, branch retinal artery occlusion, and retinal infiltrations. In such patients, cat contact history and <i>Bartonella</i> serology should be evaluated to differentiate CSD.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"226-233"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/3a/TJO-53-226.PMC10442748.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derya Şimşek, Isabella Wagner, Christian Draper, Tülay Şimşek, Syril Dorairaj
{"title":"Cyclodialysis Cleft and Hypotony Following Combined Phacoemulsification and Excisional Goniotomy with the Kahook Dual Blade.","authors":"Derya Şimşek, Isabella Wagner, Christian Draper, Tülay Şimşek, Syril Dorairaj","doi":"10.4274/tjo.galenos.2023.60963","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2023.60963","url":null,"abstract":"<p><p>A 69-year-old woman with bilateral primary open-angle glaucoma who underwent cataract extraction with intraocular lens implantation and excisional goniotomy with the Kahook Dual Blade (KDB; New World Medical, Rancho Cucamonga, CA, USA) in both eyes one year prior was referred for evaluation of significant visual acuity loss and pain in the left eye. On initial examination, intraocular pressure in the left eye was 3 mmHg and slit lamp examination revealed normal anterior chamber depth. Gonioscopy revealed a cyclodialysis cleft that was confirmed by anterior segment optical coherence tomography. Prominent chorioretinal folds suggestive of long-standing hypotony maculopathy were observed during fundoscopic examination. The cyclodialysis cleft, thought to be created inadvertently during the KDB goniotomy, resolved after three sessions of argon laser photocoagulation and the patient's symptoms and visual acuity partially improved.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"257-260"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/77/TJO-53-257.PMC10442746.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zohreh Abedifar, Fatemeh Fallah, Fahimeh Asadiamoli, Ben Bourrie, Farahnoosh Doustdar
{"title":"<i>Chlamydia trachomatis</i> Serovar Distribution in Patients with Follicular Conjunctivitis in Iran.","authors":"Zohreh Abedifar, Fatemeh Fallah, Fahimeh Asadiamoli, Ben Bourrie, Farahnoosh Doustdar","doi":"10.4274/tjo.galenos.2022.12080","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2022.12080","url":null,"abstract":"<p><strong>Objectives: </strong><i>Chlamydia trachomatis</i> infects the urogenital tract and eyes. Anatomical tropism is correlated with serovars which are characterized according to the variation in the major outer membrane proteins encoded by the <i>ompA</i> gene. The aim of the present study was to determine the distribution of <i>C. trachomatis</i> serovars among patients with follicular conjunctivitis in Iran.</p><p><strong>Materials and methods: </strong>A total of 68 conjunctival specimens from symptomatic adults were studied for the presence of <i>C. trachomatis</i> using polymerase chain reaction (PCR) analysis. Serovars were determined by Omp1 PCR-RFLP analysis.</p><p><strong>Results: </strong><i>C. trachomatis</i> was detected in 38 (55.9%) of patients with follicular conjunctivitis, with higher <i>C. trachomatis</i> prevalence in the younger age groups. Twenty-six (38.2%) of these patients had a history of urinary tract infection. Four distinct serovars were identified in the conjunctiva samples using molecular genotyping. The most prevalent was serovar E, followed by G, I, and F.</p><p><strong>Conclusion: </strong>Our serovar distribution indicated that chlamydial follicular conjunctivitis usually has a genital source. Genital serovars may cause eye diseases, especially in sexually active adults. On the other hand, conjunctivitis might be the only sign of sexually transmitted infection. Therefore, genotyping <i>C. trachomatis</i> in ocular and genital specimens could be beneficial for acquiring more detailed epidemiological information about the etiology of the disease and monitoring treatment success.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"218-221"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/a3/TJO-53-218.PMC10442745.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aydogdy Serdarov, Banu Bozkurt, Yalçın Karaküçük, Süleyman Okudan
{"title":"Clinical Performance and Patient Satisfaction of Hybrid Contact Lenses in Patients with Keratoconus.","authors":"Aydogdy Serdarov, Banu Bozkurt, Yalçın Karaküçük, Süleyman Okudan","doi":"10.4274/tjo.galenos.2022.43077","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2022.43077","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the fitting process, clinical performance, and patient satisfaction of hybrid contact lenses (HCL) in patients with keratoconus (KC).</p><p><strong>Materials and methods: </strong>Sixty-eight KC patients (35 female, 33 male) who were prescribed HCL were included in the study. Corneal topographic parameters, best corrected visual acuity (BCVA) with eyeglasses, the number of HCL trials, prescribed HCL base curve (BC), and visual acuity with HCL were recorded from hospital records. A contact lens satisfaction survey was sent to the patients via email or WhatsApp and the data was statistically analyzed using IBM SPSS Statistics version 22.0.</p><p><strong>Results: </strong>The study included 110 eyes of 68 patients with a mean age of 27.34±8 years (range: 12-48 years). According to the Amsler-Krumeich classification, 35.5% of the eyes were stage 1, 50.9% were stage 2, and 13.5% were stage 3 or 4. Mean K1, K2, and Kmean values were 7.14±0.50 mm (range 5.72-8.30 mm), 6.63±0.49 mm (range 5.07-7.84 mm), and 6.89±0.48 mm (range 5.39-8.06 mm), respectively. The average number of lens trials was 1.59±0.82 (range 1-4). The mean BC of the prescribed HCL was 6.84±0.50 mm (range 5.60-8.00 mm). BCVA with glasses was 0.36±0.2 (range 0.05-0.8), and 0.80±0.14 (range 0.3-1.0) with HCL (p<0.0001). The overall survey score was 3.54 out of 5, the overall satisfaction score was 3.27, the average vision satisfaction score was 3.62, the average satisfaction score for lens insertion and removal was 3.01, and the average satisfaction score for lens comfort was 2.97.</p><p><strong>Conclusion: </strong>Prescribed HCL BC is usually close to the topographic K<sub>mean</sub> value and in most of the patients, fitting was successful with the first or second CL trial. The overall satisfaction score was moderate to good and the disadvantages were low comfort compared to soft CL, difficulty with insertion and removal, short lens life, and high cost.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"206-212"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/ed/TJO-53-206.PMC10442754.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Diagnostic Value of Ultrasound Biomicroscopy in Anterior Segment Diseases.","authors":"Özlem Biçer, Melek Banu Hoşal","doi":"10.4274/tjo.galenos.2022.58201","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2022.58201","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to analyze the use of ultrasound biomicroscopy (UBM) in the diagnosis and follow-up anterior segment diseases.</p><p><strong>Materials and methods: </strong>The records of patients who presented to our clinic for UBM between January 1, 2004, and December 31, 2018 were reviewed retrospectively. Demographic characteristics, indications for UBM imaging and findings of the patients were recorded. Also, the change in clinical indications over the years were analyzed.</p><p><strong>Results: </strong>The study included 1.256 eyes of 917 patients, of whom 723 (57.6%) were female and 533 (42.4%) were male. The mean age was 48.7±14.8 years (range: 12-85 years). Indications for UBM imaging were to evaluate glaucoma pathogenesis and surgical outcomes (n=764, 60.8%), iris and ciliary body masses (n=263, 20.9%), congenital anomalies of the crystalline lens and complications of cataract surgery (n=86, 6.8%), the etiology of hypotony (n=57, 4.5%), corneal diseases (n=46, 3.7%), anterior segment findings after trauma (n=22, 1.8%), conjunctival pathologies (n=11, 0.9%), and scleral pathologies (n=7, 0.6%). In patients with glaucoma, the most common reason for requesting UBM according to years was to investigate the plateau iris configuration.</p><p><strong>Conclusion: </strong>UBM is an important imaging method used in the determination of the pathophysiology of anterior segment diseases, clinical evaluation, planning of surgical treatment and analyzing the outcomes.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"213-217"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/37/TJO-53-213.PMC10442747.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral Multiple Evanescent White Dot Syndrome-Like Reaction Following the CyberKnife Stereotactic Radiotherapy for Choroidal Malignant Melanoma.","authors":"Seher Köksaldı, Murat Tunc, Ali Osman Saatci","doi":"10.4274/tjo.galenos.2023.93507","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2023.93507","url":null,"abstract":"<p><p>A 58-year-old otherwise healthy man received a diagnosis of choroidal malignant melanoma (CMM) in June 2021 and underwent a single session of (21 Gy) CyberKnife stereotactic radiotherapy (SRT). Eleven months later, we noticed 3+ anterior chamber cells with occasional vitreous cells in the left eye. Though the tumor looked regressed, there were mild optic disc leakage, early hypofluorescent and late hyperfluorescent punctate lesions scattered 360 degrees, and late staining of the mass on fluorescein angiogram. The findings were compatible with a unilateral multiple evanescent white dot syndrome (MEWDS)-like reaction that was most likely related to CyberKnife SRT-induced tumor necrosis, and a dexamethasone implant was administered intravitreally into the left eye together with topical steroids. A second intravitreal injection of dexamethasone was given three months later due to remittance of the angiographic features. As there are only a few reports on CyberKnife SRT for the treatment of CMM, we wanted to share our interesting observation of a post-treatment MEWDS-like reaction likely related to tumor necrosis syndrome with the ophthalmic community.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"261-265"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/ea/TJO-53-261.PMC10442750.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strabismus in Retinopathy of Prematurity: Risk Factors and the Effect of Macular Ectopia.","authors":"Selin Şahin Karamert, Hatice Tuba Atalay, Şengül Özdek","doi":"10.4274/tjo.galenos.2023.48310","DOIUrl":"https://doi.org/10.4274/tjo.galenos.2023.48310","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine factors associated with strabismus in patients with retinopathy of prematurity (ROP) and the relationship between strabismus and macular ectopia.</p><p><strong>Materials and methods: </strong>Patients with ROP were divided into three groups: Group 1, patients with spontaneous regression (n=45); Group 2, patients who received laser treatment (n=70); and Group 3, patients who underwent surgical treatment (n=91). Rates of anisometropia, amblyopia, nystagmus, macular ectopia, and retinal pathologies were evaluated and their impacts on strabismus development were determined. Disc-to-fovea distance (DFD) was measured from color fundus photographs and the correlation of macular ectopia with severity of strabismus was evaluated.</p><p><strong>Results: </strong>A total of 206 patients were included. Rates of anisometropia, amblyopia, nystagmus, macular ectopia, retinal pathologies causing vision loss, and strabismus were higher in Group 3 (p=0.0001) and correlated with higher stages of ROP (p=0.0001). Macular ectopia (p=0.005), retinal pathologies (p=0.005), and amblyopia (p=0.012) had the strongest impact on strabismus development in ROP patients. DFD and strabismus severity were not significantly correlated (p=0.364). Mean visual acuity (VA) was significantly higher in orthophoric patients compared to those with esotropia and exotropia (p=0.027). Esotropic patients had lower VA compared to patients with exotropia, but this finding was not statistically significant (p=0.729).</p><p><strong>Conclusion: </strong>Presence of macular ectopia, retinal pathologies, and amblyopia were the most strongly correlated risk factors for strabismus development in ROP patients. DFD was not associated with severity of strabismus. Exotropia was mostly related to higher DFD and a possible relationship between esotropia and lower VA was observed.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":"53 4","pages":"241-246"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/43/TJO-53-241.PMC10442749.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}