Medical Hypothesis, Discovery, and Innovation in Ophthalmology最新文献

{"title":"Artificial intelligence in ophthalmology: opportunities, challenges, and ethical considerations.","authors":"Kimia Kazemzadeh","doi":"10.51329/mehdiophthal1517","DOIUrl":"10.51329/mehdiophthal1517","url":null,"abstract":"<p><strong>Background: </strong>By leveraging the imaging-rich nature of ophthalmology and optometry, artificial intelligence (AI) is rapidly transforming the vision sciences and addressing the global burden of ocular diseases. The ability of AI to analyze complex imaging and clinical data allows unprecedented improvements in diagnosis, management, and patient outcomes. In this narrative review, we explore the current and emerging opportunities of utilizing AI in the vision sciences, critically examine the associated challenges, and discuss the ethical implications of integrating AI into clinical practice.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE and Google Scholar for English-language articles published from January 1, 2005, to March 31, 2025. Studies on AI applications in ophthalmology and optometry, focusing on diagnostic performance, clinical integration, and ethical considerations, were included, irrespective of study design (clinical trials, observational studies, validation studies, systematic reviews, and meta-analyses). Articles not related to the use of AI in vision care were excluded.</p><p><strong>Results: </strong>AI has achieved high diagnostic accuracy across different ocular domains. In terms of the cornea and anterior segment, AI models have detected keratoconus with sensitivity and accuracy exceeding 98% and 99.6%, respectively, including in subclinical cases, by analyzing Scheimpflug tomography and corneal biomechanics. For cataract surgery, machine learning-based intraocular lens power calculation formulas, such as the Kane and ZEISS AI formulas, reduce refractive errors, achieving mean absolute errors below 0.30 diopters and performing particularly well in highly myopic eyes. AI-based retinal screening systems, such as the EyeArt and IDx-DR, can autonomously detect diabetic retinopathy with sensitivities above 95%, while deep learning models can predict age-related macular degeneration progression with an area under the receiver operating characteristic curve exceeding 0.90. In glaucoma detection, fundus and optical coherence tomography-based AI models have reached pooled sensitivity and specificity exceeding 90%, although performance varies with disease stage and population diversity. AI has also advanced strabismus detection, amblyopia risk prediction, and myopia progression forecasting by using facial analysis and biometric data. Currently, key challenges in implementing AI in ophthalmology include dataset bias, limited external validation, regulatory hurdles, and ethical issues, such as transparency and equitable access.</p><p><strong>Conclusions: </strong>AI is rapidly transforming vision sciences by improving diagnostic accuracy, streamlining clinical workflow, and broadening access to quality eye care, particularly in underserved regions. Its integration into ophthalmology and optometry thus holds significant promise for enhancing patient outcomes and optimizing healthcare delivery. However, to harnes","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"255-272"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200325","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":"Stapler for corneal transplantation: a hypothesis.","authors":"Arturo Ramirez-Miranda, Alberto Haber-Olguin, Juan A Moya-Villamar, Lucero Pedro-Aguilar, Guillermo Raul Vera-Duarte, Gustavo Ortiz-Morales, Alejandro Navas, Denise Loya-Garcia, Enrique O Graue-Hernandez","doi":"10.51329/mehdiophthal1515","DOIUrl":"10.51329/mehdiophthal1515","url":null,"abstract":"<p><strong>Background: </strong>Corneal transplantation requires exquisite microsurgical precision, particularly during the suturing of donor and recipient tissues. In corneal transplantation procedures such as penetrating keratoplasty, the donor cornea is traditionally secured using ultrafine 10-0 nylon sutures, meticulously placed under an operating microscope to achieve precise tension and promote optimal wound healing. Although this technique remains the reference standard, it is inherently time-intensive and requires advanced microsurgical expertise. To enhance surgical efficiency and maintain clinical outcomes, recent innovations have proposed the use of a modified stapling device equipped with ultrafine nylon staples as an alternative to conventional suturing. Although experimental stapling systems have been engineered to facilitate graft fixation, widespread clinical adoption or regulatory approval has not yet been achieved, largely because of unresolved concerns regarding precision, stability, and long-term safety.</p><p><strong>Hypothesis: </strong>To address these challenges, we propose an adaptation of the skin stapler mechanism, employing nylon-based staples specifically engineered for corneal application. This study hypothesizes that the development of a specialized corneal stapler as a viable, time-efficient alternative to manual suturing in keratoplasty is feasible, contingent upon addressing critical challenges. These include replicating the biomechanical finesse and tension control of sutures, ensuring the biocompatibility of staple materials with ocular tissues, and minimizing the risk of postoperative complications such as astigmatism, wound dehiscence, and infection. The specialized corneal stapler utilizing ultrafine, biocompatible nylon staples can replicate the precision, tension control, and wound stability achieved by traditional 10-0 nylon suturing in penetrating keratoplasty, while significantly reducing operative time and technical demands. Rigorous preclinical testing and clinical validation are essential to evaluate whether stapling technology can match or exceed the standards established by traditional suturing techniques in corneal transplantation.</p><p><strong>Conclusions: </strong>The conceptual model for a specialized corneal stapler presents a promising alternative to traditional suturing techniques. However, substantial technological innovation is necessary to meet the intricate anatomical and surgical requirements of the cornea. Further research, including iterative prototyping and preclinical validation, is essential before clinical applications can be realized. Moreover, further research and clinical validation are necessary to determine whether staplers can safely and effectively replace traditional sutures during corneal transplantation.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200330","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":"COVID-19 pandemic and ophthalmology: insights from the IVORC Academic Foundation.","authors":"Fatemeh Heidary, Reza Gharebaghi","doi":"10.51329/mehdiophthal1516","DOIUrl":"10.51329/mehdiophthal1516","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The coronavirus disease 2019 (COVID-19) pandemic posed unprecedented challenges for the global academic community. The International Virtual Ophthalmic Research Center (IVORC) Academic Foundation, which is committed to advancing vision science through international collaboration, research, and education, played a pivotal role in addressing these disruptions. Central to its mission are 2 affiliated journals in ophthalmology and optometry that serve as key platforms for innovative research on ocular disease management. In response to the pandemic, the IVORC implemented a series of strategic initiatives to support the vision science community, while ensuring research continuity and safety. This report reviews COVID-19-related publications in these journals and highlights the key actions of the IVORC in strengthening preparedness for future global health crises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We reviewed COVID-19-related articles published in IVORC-affiliated journals from the onset of the pandemic through February 2025. Key findings were analyzed, focusing on the reported ocular manifestations of COVID-19 and potential ophthalmic complications associated with COVID-19 vaccination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;To sustain academic engagement and research productivity, the IVORC expanded its virtual meetings, webinars, and digital outreach initiatives, with a strong emphasis on academic writing and publication ethics. The foundation actively promoted COVID-19-related ophthalmic research, published a clinical guideline, reported ocular manifestations of the disease, encouraged the adoption of teleophthalmology, and strengthened collaborations with regional and national societies. Between early 2020 and February 2025, IVORC-affiliated journals published 19 COVID-19-related articles from researchers across 10 countries, primarily in North America, Asia, and the Middle East. These comprised 6 original articles, 5 reviews, 2 case reports, 2 editorials, 2 short communications, and 2 letters, most of which appeared in &lt;i&gt;Medical hypothesis, discovery & innovation in ophthalmology&lt;/i&gt;. Among the early contributions was a widely cited guideline for ophthalmic practice, published within months of the onset of the pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The proactive response of the IVORC to the COVID-19 crisis highlights the essential role of academic leadership in maintaining research continuity and scholarly communication during global health emergencies. The diverse and internationally authored IVORC publications reflect a commitment to innovation, collaboration, and the inclusion of perspectives from underrepresented regions. This experience reinforces the importance of prioritizing original research over publication volume-particularly clinical guidelines and studies detailing disease manifestations. Fast-track publication models must maintain rigorous editorial standards to ensure that scientific contributions rema","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200326","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":"Dynamic changes in tear film parameters after upper eyelid blepharoplasty measured with anterior segment optical coherence tomography.","authors":"Salma Tamer, Ahmed Mohamed Kamal Elshafei, Raafat Mohyeldeen Abdelrahman Abdallah, Ismail Omar, Amr Ahmed Mohamed Abdelrahman","doi":"10.51329/mehdiophthal1512","DOIUrl":"10.51329/mehdiophthal1512","url":null,"abstract":"<p><strong>Background: </strong>Upper eyelid blepharoplasty, a corrective procedure for dermatochalasis, may transiently affect eyelid function and tear film stability. This study assessed the effect of upper eyelid blepharoplasty, subjectively through questionnaires, and objectively through tear film stability and production.</p><p><strong>Methods: </strong>This non-randomized, prospective, interventional study consecutively recruited the right eyes of patients with dermatochalasis who underwent bilateral upper eyelid blepharoplasty at a tertiary center. Preoperative assessments included a standardized ophthalmic examination, ocular surface disease index (OSDI) questionnaire, Schirmer's test I, tear break-up time (TBUT) test, and anterior segment optical coherence tomography (AS-OCT) to measure tear meniscus height (TMH) and tear meniscus area (TMA). Postoperative evaluations were conducted at 1, 3, and 6 months. At the final follow-up, scar quality and patient satisfaction were assessed using the Patient and Observer Scar Assessment Scale.</p><p><strong>Results: </strong>Fifty eyes of 50 patients with a mean (standard deviation) age of 47.1 (1.6) years were included. Statistically significant postoperative changes were observed in the OSDI score, Schirmer's test value, TBUT, and TMH at the 6-month follow-up (all P < 0.001). These parameters initially worsened at 1 month and then improved significantly at 3 and 6 months, returning to or surpassing baseline levels. TMA showed a transient postoperative decline, with full recovery at 6 months. Exceptionally strong positive correlations were found between TMH or TMA and TBUT or the Schirmer's test value at most follow-up visits (all <i>P</i> > 0.05). Patient satisfaction was high, with 95% reporting satisfaction with cosmetic outcomes, and no cases of visible or hypertrophic scarring were observed at final follow-up.</p><p><strong>Conclusions: </strong>We observed significant yet transient changes in tear film parameters and subjective assessments following upper eyelid blepharoplasty. A strong correlation was observed between AS-OCT measurements and parameters of tear film stability and production. High patient satisfaction and favorable cosmetic outcomes, with no visible scarring, further support the safety and tolerability of this procedure. Further studies with larger cohorts, longer follow-up periods, and comparative designs are warranted to validate these findings and further explore the long-term effects on ocular surface health and patient-reported outcomes.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"213-222"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200327","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":"Finite element analysis of asymmetrical retinal hemorrhages in shaken baby syndrome.","authors":"Elliot H Choi, Jose A Colmenarez, John D Hong, Kourosh Shahraki, Linxia Gu, Donny W Suh","doi":"10.51329/mehdiophthal1514","DOIUrl":"10.51329/mehdiophthal1514","url":null,"abstract":"<p><strong>Background: </strong>Despite the common association between bilateral retinal hemorrhage and shaken baby syndrome (SBS), unilateral retinal hemorrhage does not necessarily exclude this diagnosis. This study used computational simulations to elucidate the biomechanical phenomena within the eye under asymmetrical shaking forces.</p><p><strong>Methods: </strong>Finite element analysis (FEA) incorporating the vitreous, vitreoretinal interface, retinal layers, and retinal vessels was performed under asymmetrical shaking conditions. To assess the stress-strain response at the preretinal, intraretinal, and subretinal locations, we divided the retinal mesh into three equally spaced layers with an element height of 0.083 mm. The remaining space within the retina was filled with the vitreous humor and attached to it via the main retinal vessels extracted from a standard fundus image. The resulting changes in shear stress and intraocular pressure (IOP) were quantified.</p><p><strong>Results: </strong>The FEA model demonstrated that increasing the rotational radius from 10 cm to 14 cm or 17 cm led to a significant increase in shear stress and IOP across the vitreoretinal interface and within the retinal layers. Specifically, shear stress in the preretinal layer increased by 70.2% (8.0 kPa vs. 4.7 kPa), in the intraretinal layer by 20.0% (5.4 kPa vs. 4.5 kPa), and in the subretinal layer by 6.1% (3.5 kPa vs. 3.3 kPa). Simultaneously, IOP in the central region increased by 157.5% (39.4 mmHg vs. 15.3 mmHg) and in the posterior region by 162.3% (41.7 mmHg vs. 15.9 mmHg) when the rotational radius was increased to 17 cm from 10 cm. Increasing the rotational radius to 17 cm led to more pronounced changes in peak IOPs, with the central region showing a change of 39.4 mmHg and the posterior region a change of 41.7 mmHg. These results indicate a direct correlation between the rotational radius and the magnitude of IOP changes in the vitreous.</p><p><strong>Conclusions: </strong>These findings highlight the critical impact of rotational radius on the biomechanical forces exerted within the eye during asymmetrical shaking events, leading to variations in shear stress and IOP that could contribute to unilateral retinal hemorrhage in SBS. These insights reveal the complexity of diagnosing SBS and emphasize the need for careful consideration of the biomechanical evidence in patients presenting with asymmetrical or unilateral retinal hemorrhage.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200328","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":"Intracorneal ring segment implantation for eyes with keratoconus and corneas thinner than 400 microns.","authors":"Hazem Mohamed Abdelhameed, Ahmed S Abo Obaia, Akram Fekry Elgazzar, Ramy Saleh Abd Ellatief Amer, Haitham Beshr Soliman, Riad Elzaher Hassan Ahmed, Shaimaa M Mostafa","doi":"10.51329/mehdiophthal1513","DOIUrl":"10.51329/mehdiophthal1513","url":null,"abstract":"<p><strong>Background: </strong>Intracorneal ring segment (ICRS) implantation is a promising and effective treatment option for keratoconus. However, a corneal thickness of less than 400 microns presents a unique challenge. This study assessed the clinical course and visual outcomes in patients with Amsler-Krumeich stage 2 or greater keratoconus and clear corneas, with a minimal corneal stromal thickness of 350 microns but less than 400 microns in the proposed implantation area, up to 6 months after ICRS implantation.</p><p><strong>Methods: </strong>This non-randomized, prospective, interventional case series was conducted at a single tertiary center, consecutively recruiting patients with keratoconus scheduled for ICRS implantation who fulfilled the eligibility criteria. Detailed ophthalmological assessments were performed at baseline and 6 months postoperatively, including measurements of uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), and manifest refraction with documentation of the spherical component of the refractive error (in diopters [D]), cylindrical component of refractive error (in diopter cylinder [DC]), and axis of astigmatism (in degrees). Corneal topographic and pachymetric evaluations were performed using Pentacam HR, including keratometry (K) values in D (flat K or K1, steep K or K2, and mean K or Km), corneal astigmatism in DC, central corneal thickness (CCT), and corneal asphericity coefficient (Q value).</p><p><strong>Results: </strong>We included nine eyes of nine patients with keratoconus and a mean (standard deviation) age of 33.2 (8.2) years (range: 25-44 years). Five patients were women (56%), and four were men (44%). All eyes experienced a statistically significant improvement in the mean visual and refractive outcomes at the 6-month postoperative visit, including UCDVA, BCDVA, sphere, and cylinder (all <i>P</i> < 0.05). Similarly, we recorded a statistically significant improvement in the mean corneal tomographic and topographic data, including the K1, K2, Km, CCT, and Q values (all <i>P</i> < 0.05). No serious complications occurred for up to 6 months of follow-up. Only one patient complained of night glare, which was successfully treated with pilocarpine 1% eyedrops for 3 months.</p><p><strong>Conclusions: </strong>ICRS implantation may offer a safe and effective option for selected patients with keratoconus and corneal thickness less than 400 microns, as evidenced by short-term improvements in visual, refractive, topographic, and tomographic parameters. No vision-threatening complications occurred. However, given the case-series study design, limited sample size, and short follow-up period, these findings should be interpreted with caution. Further controlled trials are required to validate these preliminary results.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"14 1","pages":"223-230"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200329","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":"Vascular supply of the eye: clinical anatomy.","authors":"Omer Karti, Isil Saatci, Ali Osman Saatci","doi":"10.51329/mehdiophthal1509","DOIUrl":"10.51329/mehdiophthal1509","url":null,"abstract":"<p><strong>Background: </strong>Eye function is vitally dependent on an adequate blood supply, primarily provided by the ophthalmic artery, an internal carotid artery branch. This review provides an overview of the vascular supply of the eye.</p><p><strong>Methods: </strong>A targeted search of PubMed / MEDLINE was performed using the terms \"central retinal vein,\" \"central retinal artery,\" \"internal carotid artery,\" \"ophthalmic artery,\" \"ophthalmic vein,\" \"posterior ciliary arteries,\" \"retinal capillaries,\" \"vascular supply of the eye,\" \"ocular vascular supply,\" \"external carotid artery,\" and \"vortex vein\". Studies published between 1960 and 2024 were reviewed. Relevant references cited in these publications were also analyzed.</p><p><strong>Results: </strong>Overall, 62 publications were reviewed. The ophthalmic artery branches into several arteries-the central retinal artery supplies the retina, whereas the posterior ciliary arteries supply the posterior choroid and optic nerve. The anterior ciliary arteries mainly supply the conjunctiva, sclera, ciliary body, and iris. Extraocular muscles receive their primary blood supply from the muscular branches of the ophthalmic artery, lacrimal artery, and infraorbital artery. The lacrimal gland is perfused by the lacrimal artery. The eyelids receive blood from both the internal and external carotid arteries. The superficial vascular network of the medial eyelid skin is established primarily through anastomoses between the branches of the internal carotid artery. The superficial vascular network of the lateral upper and lower eyelids is primarily derived from branches emanating from the superficial temporal artery (a branch of the external carotid artery) and the lacrimal artery. Venous drainage follows a complex pathway, beginning with the central retinal vein and the vortex veins, then draining into the ophthalmic veins, and finally into the internal jugular vein.</p><p><strong>Conclusions: </strong>The eye features a complex arterial supply and venous drainage that can vary greatly among individuals. This complex vascular system is critical for the oxygenation and nutrition of ocular tissues and the maintenance of ocular health. The arterial and venous circulation coordinate to support different regions of the eye, including the retina, choroid, and optic nerve. Understanding this intricate vascular network is essential for the diagnosis and treatment of various ocular pathologies. Abnormalities in these pathways can cause substantial problems, including vision loss.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"13 4","pages":"176-189"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597953","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 review on retinopathy of prematurity.","authors":"Pegah Rashidian, Shaghayegh Karami, Seyyed Amirhossein Salehi","doi":"10.51329/mehdiophthal1511","DOIUrl":"10.51329/mehdiophthal1511","url":null,"abstract":"<p><strong>Background: </strong>Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. It predominantly affects preterm infants with very low birth weights or extreme prematurity. Aberrant retinal vascular development, driven by hyperoxia and hypoxia-induced neovascularization, is central to ROP pathogenesis. This review explores the relationship between maternal health and ROP, evaluates current prevention strategies, assesses innovations in diagnostic and screening technologies, reviews contemporary treatments, and identifies future research directions.</p><p><strong>Methods: </strong>A literature review was conducted in the PubMed / MEDLINE, Scopus, Web of Science, and Google Scholar databases using related keywords, i.e., \"retinopathy of prematurity,\" \"retinal development,\" \"pathophysiology,\" \"vascular growth,\" \"complications,\" \"visual outcomes,\" \"maternal health factors,\" \"obstetrics,\" \"preeclampsia,\" \"risk factors,\" \"preterm birth,\" \"corticosteroids,\" \"oxygen management,\" \"treatment strategies,\" \"laser therapy,\" \"anti-VEGF agents,\" \"surgical approaches\", and \"artificial intelligence (AI)\" and targeting English studies published in the last 20 years. Additionally, the references from the selected articles were manually reviewed. Clinical trials, meta-analyses, systematic reviews, case-control studies, case series, narrative reviews, pilot studies, and relevant animal studies were included.</p><p><strong>Results: </strong>Maternal factors, such as diabetes, smoking, and preeclampsia, along with neonatal factors, such as low gestational age and extreme prematurity, are critical contributors to ROP. Key preventative strategies to reduce the risk of ROP and improve neonatal outcomes include: 1. prenatal care involves screening and managing maternal conditions, providing maternal education, and administering antenatal corticosteroids. 2. Neonatal care encompasses nutritional support, supplementation with essential fatty acids, and regulated oxygen administration. By focusing on these strategies, we can enhance the health of newborns at risk for ROP. Advances in screening, including artificial intelligence (AI)-assisted diagnostics and advanced imaging, are improving early detection. Treatment modalities such as laser photocoagulation, cryotherapy, and anti-vascular endothelial growth factor therapies have shown promise but pose challenges, including recurrence risk and systemic side effects.</p><p><strong>Conclusions: </strong>ROP continues to pose a major threat to the vision of preterm infants, particularly in regions with limited healthcare resources. Addressing ROP requires multidisciplinary team approaches that integrate obstetric and neonatal care. Preventative strategies, including prenatal care optimization, oxygen management, and nutritional support, are essential. Future efforts should focus on integrating emerging technologies and recent findings to ensure global relevance and currency.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"13 4","pages":"201-212"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597922","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":"Topical tacrolimus versus dexamethasone in managing shield ulcer of vernal keratoconjunctivitis.","authors":"Nima Rastegar Rad, Nazanin Rastgarrad","doi":"10.51329/mehdiophthal1507","DOIUrl":"10.51329/mehdiophthal1507","url":null,"abstract":"<p><strong>Background: </strong>Vernal keratoconjunctivitis (VKC) is a bilateral, chronic, allergic inflammation of the ocular surface with debilitating ocular signs and symptoms. We compared the efficacies and safeties of 1% tacrolimus eye drops and 1% dexamethasone eye drops in managing unilateral shield ulcers and corneal epitheliopathy secondary to VKC.</p><p><strong>Methods: </strong>We recruited patients with unilateral shield ulcer and corneal epitheliopathy secondary to VKC in a tertiary referral center in southeast Iran during a 12-month period. All eligible patients underwent a detailed eye examination. Participants were randomly assigned to receive either topical tacrolimus 1% or dexamethasone 1% twice daily. We recorded the best-corrected distance visual acuity (BCDVA) in decimal notation, area of the shield ulcer in square millimeters, presence or absence of re-epithelialization, and clinical symptoms of watering, mucus discharge, photophobia, burning, redness, and itching, along with any potential complications at five follow-up visits during a period of four months.</p><p><strong>Results: </strong>Thirty patients (30 eyes) were allocated to each treatment group. The groups had comparable mean ages and sex distributions (both <i>P</i> > 0.05). Both groups experienced a decreasing trend in frequencies of all symptoms, and at most follow-up visits, ocular symptoms were less frequent in the tacrolimus group than in the dexamethasone group, reaching statistically significant differences at some time points (all P < 0.05). No re-epithelialization was detected in either group at the second week post-treatment. However, an increasing trend was observed thereafter in both groups, with significantly more re-epithelialization in tacrolimus-treated eyes at the second and third months post-treatment (<i>P</i> < 0.05). Re-epithelialization remained significantly more frequent in tacrolimus-treated eyes one month after cessation of treatment (<i>P</i> < 0.05). The mean BCDVA was significantly better in tacrolimus-treated eyes than in the dexamethasone group at all follow-up visits (all <i>P</i> < 0.01). The mean shield ulcer size tended to decrease in both groups, with lesser numerical values in tacrolimus-treated eyes at the one-, two-, three-, and four-month follow-up visits. The difference reached statistical significance at the last two follow-up visits (both <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Topical tacrolimus is superior to topical dexamethasone with regard to symptoms, visual acuity, shield ulcer size, and corneal epitheliopathy associated with VKC. This suggests that tacrolimus could be administered as monotherapy for managing this debilitating ocular inflammatory condition. Further studies are required to determine the long-term safety and efficacy of this promising treatment modality.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"13 4","pages":"160-168"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597950","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":"Visio-spatial intelligence skills in non-athletes versus amateur boxers.","authors":"S'bongile Mahlangu, Musa Lewis Mathunjwa, Gerrit Jan Breukelman, Lourens Millard","doi":"10.51329/mehdiophthal1508","DOIUrl":"10.51329/mehdiophthal1508","url":null,"abstract":"<p><strong>Background: </strong>Visio-spatial intelligence (VSI) skills, including abilities such as spatial awareness, visual processing, and motor coordination, are crucial for athletic performance, particularly in combat sports such as boxing. Amateur boxers require efficient visio-spatial skills (VSS) to quickly process visual information, track opponents' movements, and execute precise techniques. However, the extent to which amateur boxing experience enhances VSS remains unclear. This study compared the VSI skills of amateur boxers to those of non-athletes.</p><p><strong>Methods: </strong>This cross-sectional, observational study recruited amateur boxers and non-athletes in the King Cetshwayo District, KwaZulu-Natal, Republic of South Africa. Participants, aged 18 to 27 years, underwent a detailed optometric screening and VSS tests, including accommodation facility, saccadic eye movements, speed of recognition, hand-eye coordination, peripheral awareness, and visual memory.</p><p><strong>Results: </strong>The study included 90 participants, consisting of 45 amateur boxers (28 [62%] men aged 18 to 25 years and 17 [38%] women aged 18 to 27 years) and 45 non-athletes (29 [64%] men aged 18 to 26 years and 16 [36%] women aged 18 to 27 years). The mean (standard deviation) age of the boxers was 20.7 (2.2) years, whereas the mean age of the non-athletes was 21.9 (2.4) years (<i>P</i> < 0.05). Amateur boxers were superior in VSS, with marked advantages in accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness, and hand-eye coordination (all <i>P</i> < 0.001). However, no significant difference was found in visual memory (<i>P</i> > 0.05). The greatest difference was observed in speed of recognition (88% higher in boxers), and the least difference was observed in visual memory (4% higher in boxers).</p><p><strong>Conclusions: </strong>VSS differ between amateur boxers and non-athletes, indicating the importance of these skills for athletic performance. These findings emphasize the potential advantages of boxing training in enhancing VSS, which could impact athletic training and performance-enhancement strategies. This underscores the value of integrating visio-spatial training into athletic programs. The observed superiority of boxers in specific VSS areas has broad implications for theories of sports vision, the selection of appropriate tests, and the development of sport-specific VSS testing protocols. Further longitudinal studies with larger sample sizes are required to verify these findings and assess changes in these skills over time.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"13 4","pages":"169-175"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597958","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}