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

{"title":"COVID-19 and children's eyes.","authors":"Nima Rastegar Rad","doi":"10.51329/mehdiophthal1488","DOIUrl":"https://doi.org/10.51329/mehdiophthal1488","url":null,"abstract":"","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 4","pages":"213-216"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868149","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":"Safety and efficacy of implantable phakic contact lens versus implantable collamer lens in myopia correction.","authors":"Ibrahim Amer, Hossameldin A Ziada, Akram Fekry Elgazzar, Walid Shaban Abdella, Ahmed Abdelaleem Abdelgbar, Islam Goda, Ramy Saleh Amer, Hamdy Osman Abdel-Rahman Osman, Sanaa Ahmed Mohamed, Mona N Mansour, Mohamed Alsadawy Hassan, Abdel Ghany Ali El Gabbar, Mohamed Atito Hamed","doi":"10.51329/mehdiophthal1482","DOIUrl":"https://doi.org/10.51329/mehdiophthal1482","url":null,"abstract":"<p><strong>Background: </strong>Phakic intraocular lenses (pIOLs) have proven to be excellent substitutes for excimer laser keratorefractive surgery in certain situations. We aimed to assess the efficacy and safety of two pIOLs, the implantable collamer lens (ICL V4c) versus the implantable phakic contact lens (IPCL V2), for myopic correction.</p><p><strong>Methods: </strong>In this prospective randomized clinical trial, we allocated eligible eyes with myopia > - 6 diopters into IPCL or ICL implantation groups, each including 100 eyes of 100 individuals. Preoperative and postoperative assessments at 3, 6, and 12 months included measurements of the spherical equivalent (SE), uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), maximum keratometry (K1), minimum keratometry (K2), mean keratometry (Kmean), anterior chamber depth (ACD), anterior chamber angle (ACA), and endothelial cell density (ECD).</p><p><strong>Results: </strong>The groups had comparable demographic characteristics and baseline visual and anatomical values (all <i>P</i> > 0.05). The UCDVA, BCDVA, and SE of the two groups were comparable at baseline and at all postoperative follow-up examinations (all <i>P</i> > 0.05). Both groups experienced significant improvements in UCDVA, BCDVA, and SE at three months postoperatively (all <i>P</i> = 0.001), and measurements remained stable for up to 12 months. Keratometry readings were comparable between the groups over the follow-up period and remained unchanged at all visits (all <i>P</i> > 0.05). The ACA in the ICL group was significantly decreased at three months postoperatively (<i>P</i> = 0.001) and then widened significantly at 6 and 12 months (both <i>P</i> = 0.001). In the IPCL group, the postoperative ACA was significantly decreased at three months (<i>P</i> = 0.001) and was comparable to that in the ICL group (<i>P</i> > 0.01). However, at the 6- and 12-month postoperative visits, the ACA was significantly narrower in the IPCL group than in the ICL group (both <i>P</i> = 0.001). The ACD in both groups was decreased at three months postoperatively (both <i>P</i> = 0.001) and remained stable until the end of the study. The ECD remained comparable between the groups at all postoperative visits (all <i>P</i> > 0.05). We did not observe a significant ECD reduction in either group at any postoperative follow-up visit (all <i>P</i> > 0.05). We encountered no serious complications in either group.</p><p><strong>Conclusions: </strong>ICL and IPCL had comparable safety and efficacy outcomes in terms of anterior chamber morphometrics, visual and refractive results, and corneal parameters. Further multicenter randomized clinical trials with longer follow-up periods, larger sample sizes, and measurement of additional anterior chamber and corneal morphometrics, vault, and other vision parameters are needed to verify these findings.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 4","pages":"160-167"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866720","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":"Pseudovitelliform maculopathy associated with hereditary hemochromatosis.","authors":"Ante Vukojevic, Marija Vukojevic, Tomislav Jukic, Igor Petricek, Kresimir Mandic, Nenad Vukojevic","doi":"10.51329/mehdiophthal1487","DOIUrl":"https://doi.org/10.51329/mehdiophthal1487","url":null,"abstract":"<p><strong>Background: </strong>Hereditary hemochromatosis (HH) is an inherited autosomal recessive iron metabolism disorder resulting from a C282Y mutation in the <i>HFE</i> gene. Mutations in the <i>HFE</i> gene may result in iron accumulation and oxidative stress in the retina, resulting in macular degeneration. This article describes two patients with HH who were treated with erythrocytapheresis or phlebotomy, with no exposure to deferoxamine or any other chelation therapy, and who developed visual symptoms.</p><p><strong>Case presentation: </strong>Both patients had known diagnoses of HH. Because of visual symptoms, they were referred to the ophthalmology clinic and underwent a retinal exam, multimodal imaging, and electrodiagnostic studies, which revealed structural and functional degeneration of the central macula. Fundus photography, fluorescein angiography, and fundus autofluorescence revealed changes at the level of the retinal pigment epithelium (RPE) in the central macula. In addition, optical coherence tomography revealed subfoveal accumulation of hyperreflective material at and below the RPE. Multifocal electroretinography confirmed a decreased cone response, whereas the full-field electroretinogram was unremarkable. Genetic testing ruled out Best's vitelliform macular dystrophy and the other known hereditary macular dystrophies. The patients had known diagnoses of HH, homozygous C282Y mutations in the <i>HFE</i> gene, and no comorbidities; thus, we presumed that HH led to the observed morphological and functional disorders of the RPE, which in turn caused structural macular changes in both patients.</p><p><strong>Conclusions: </strong>Considering the macular findings and the nature of the patients' primary illness, we believe that the accumulation of iron and photoreceptor metabolic products caused dysfunction in the RPE, which led to morphological and functional changes in the macula. Because the patients were not treated using chelating agents, we attribute the macular changes solely to iron accumulation and oxidative stress caused by the pathophysiological processes of HH. Further studies are needed to identify the plausible molecular or cellular insults underlying pseudovitelliform macular degeneration in patients with HH.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 4","pages":"203-212"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866087","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":"Non-penetrating deep sclerectomy versus combined trabeculotomy-trabeculectomy in primary congenital glaucoma.","authors":"Ibrahim Hassan Elabd, Ahmed A Elsayed, Akram Fekry Elgazzar, Ezzeldin Ramadan Ezzeldin, Mohamed Hassanein, Haitham Beshr Soliman, Ashraf Mohammed GadElkareem, Basheer Eltantawy, Mohamed Yahia Omran, Mohamed Gaber Okasha, Hatem Mahmoud, Ahmed Mohammed Madinah Alkady, Mahmoud H Abd Rbu, Hanan Saied Hegazy, Mona N Mansour, Ehab Tharwat","doi":"10.51329/mehdiophthal1483","DOIUrl":"https://doi.org/10.51329/mehdiophthal1483","url":null,"abstract":"<p><strong>Background: </strong>The primary mode of therapy in children with primary congenital glaucoma (PCG) and mild or no corneal edema is goniotomy, which has a high success rate. However, in developing countries, the diagnosis of PCG is usually delayed, and corneal cloudiness interferes with goniotomy. Therefore, trabeculotomy may be the best choice in such eyes. We compared the short-term efficacy and safety of primary combined trabeculotomy-trabeculectomy (primary CTT) with that of non-penetrating deep sclerectomy (NPDS) in managing PCG.</p><p><strong>Methods: </strong>This prospective, randomized, comparative study included patients with PCG referred to Al-Azhar University Hospitals within a 1-year period. Eyes were randomly allocated to one of two groups: eyes in <i>NPDS group</i> underwent NPDS, and those in <i>primary CTT</i> <i>group</i> underwent primary CTT. Baseline and frequent postoperative assessments of intraocular pressure (IOP), cup-to-disc ratio (C/D ratio), corneal diameter, and axial length were performed for up to 6 months. The success rates were recorded in both groups.</p><p><strong>Results: </strong>Forty eyes of 26 patients were included, with 20 eyes allocated to each group. The mean (standard deviation) age of all patients was 12.9 (9.5) months, with comparable ages and sex ratios between groups (both <i>P</i> > 0.05). Both groups demonstrated a significant reduction in IOP and C/D ratio at each postoperative visit compared to the baseline visit (all <i>P</i> < 0.001), with no significant difference detected between the groups (all <i>P</i> > 0.05), except for a significantly lower IOP in NPDS group at 1 month (<i>P</i> < 0.05). The corneal diameter and axial length were comparable between groups at baseline and remained unchanged at all postoperative visits (all <i>P</i> > 0.05). The groups had comparable success rates (<i>P</i> > 0.05). No serious complications were detected.</p><p><strong>Conclusions: </strong>CTT and NPDS both yielded reasonable IOP control and reversal of cupping in eyes with PCG. We observed equal effectiveness of the surgical procedures without major safety concerns. Further large-scale clinical trials with longer follow-up periods are needed to verify our preliminary findings.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 4","pages":"168-176"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874856","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":"Optical coherence tomography in multiple sclerosis.","authors":"Amin Najafi, Negin Ashoori, Katayoon Hosseini, Vahid Abbasi","doi":"10.51329/mehdiophthal1485","DOIUrl":"https://doi.org/10.51329/mehdiophthal1485","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic neurodegenerative disease that damages myelinated fibers within the central nervous system. Data obtained using optical coherence tomography (OCT) have recently been identified as a potential biomarker for this disease. We aimed to measure circumpapillary retinal nerve fiber layer thickness (cpRNFLT) using OCT and to compare the results in healthy participants with those of individuals having clinically definitive MS with and without a history of optic neuritis.</p><p><strong>Methods: </strong>This cross-sectional study recruited patients with clinically confirmed MS, with and without optic neuritis, and healthy individuals as a control group. We documented demographic characteristics, duration of MS, and time elapsed since the episode of optic neuritis. All participants underwent a thorough ocular examination and measurement of total, superior, and inferior cpRNFLT using swept-source OCT.</p><p><strong>Results: </strong>In participants with MS, women outnumbered men in the subsets with (90%) and without (64%) optic neuritis. The control group comprised approximately similar numbers of men and women. There was a statistically significant difference in total, superior, and inferior cpRNFLT between study groups (all <i>P</i> < 0.001). Pairwise comparisons revealed significantly thinner total, superior, and inferior cpRNFLTs in patients having MS with and without (all <i>P</i> < 0.001) optic neuritis when compared with the controls. We found significantly higher total, superior, and inferior cpRNFLTs in women than in men (all <i>P </i>< 0.05). However, we found no significant correlation between total, superior, or inferior cpRNFLT and patient age, duration of MS, or time elapsed since the optic neuritis episode (all <i>P</i> > 0.05), except for a significant moderate inverse correlation between patient age and total cpRNFLT (r = - 0.41; <i>P </i>< 0.05), indicating a loss of total cpRNFLT with age.</p><p><strong>Conclusions: </strong>Patients with clinically confirmed MS, with or without optic neuritis, had a significantly decreased cpRNFLT compared to that of healthy individuals. There was a significant inverse correlation between age and total cpRNFLT and a difference in cpRNFLT between the sexes, indicating that age and sex may influence the measurement of cpRNFLT using OCT in patients with MS. As a screening tool, OCT should be used along with other existing diagnostic modalities for patients with definite or suspected MS. Further longitudinal studies including various classifications of MS with or without isolated episodes of optic neuritis, along with diagnostic accuracy studies, could provide more robust conclusions on the suitability of OCT as a biomarker of MS.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 4","pages":"187-193"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869784","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":"Frequency and visual outcomes of herpes simplex keratitis in a Kuwaiti tertiary referral center.","authors":"Nancy M Lotfy, Nora Aldhefeery, Mariam N Alenezi, Yousuf Alherz, Yousef Taleb Ali","doi":"10.51329/mehdiophthal1475","DOIUrl":"10.51329/mehdiophthal1475","url":null,"abstract":"<p><strong>Background: </strong>Herpes simplex virus (HSV), a cause of many ocular pathologies, may affect the corneal epithelium, stroma, or endothelium, with the epithelium as the most frequently affected location. We aimed to determine the frequency and visual outcomes of HSV keratitis over a 1-year period at Farwaniya Hospital, Kuwait.</p><p><strong>Methods: </strong>This prospective observational case series included patients diagnosed with HSV keratitis who presented to the outpatient or eye casualty department between September 2022 and September 2023. Full history, demographic profile, detailed ocular and slit-lamp examinations, and visual acuity assessments were recorded prior to and after treatment. Baseline corneal sensation was assessed in the four corneal quadrants using the cotton wisp test.</p><p><strong>Results: </strong>Of the 227 patients who presented with infectious keratitis, 72 (31.7%) were diagnosed with HSV keratitis. The mean (SD) age was 45.86 (16.06) years, and 48 (66.7%) patients were male. The subtypes of HSV keratitis were endotheliitis in 27 (37.5%) patients, dendritic ulcer in 22 (30.6%), stromal keratitis with ulceration in 9 (12.5%) and without ulceration in 8 (11.1%), and geographic ulcer in 6 (8.3%). The mean baseline best-corrected distance visual acuity (BCDVA) differed significantly between the HSV keratitis subtypes (<i>P </i>< 0.001). Most patients (n = 70, 97.2%) had unilateral eye involvement, were treated within 1 - 2 weeks, and demonstrated improved BCDVA. Despite the improvement in BCDVA in all HSV keratitis subtypes, a significant difference in the median BCDVA remained after treatment (<i>P</i> < 0.001). Pairwise comparisons revealed a significantly better BCDVA after treatment in eyes with dendritic epithelial ulcers than in eyes with HSV stromal keratitis with ulceration (<i>P</i> = 0.003) or geographic epithelial ulcers (<i>P</i> = 0.005). After treatment, corneal haze and neovascularization were detected in 54 (75.0%) and 24 (33.3%) patients, respectively.</p><p><strong>Conclusions: </strong>We detected a substantial frequency of HSV keratitis in one of the governorates of Kuwait, with endotheliitis as the most common manifestation. Timely standard treatment interventions based on valid guidelines resulted in BCDVA improvement in all subtypes of HSV keratitis in our series, indicating the importance of early treatment. However, the BCDVA in eyes with dendritic epithelial ulcers remained substantially better than that in eyes with geographic epithelial ulcers or HSV stromal keratitis with ulceration, signifying the effect of the initial HSV keratitis subtype on visual outcomes. To our knowledge, this is the first study to highlight the frequency of HSV keratitis in a Kuwaiti hospital, and larger-scale research in this region is needed to further understand and manage the condition.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 2","pages":"98-105"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736306","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":"Intraocular lens power calculation formulas: a scientometric analysis.","authors":"Taher Alshammari, Alaa Tarazi, Tasneem Aloqaili, Mohammed Aloqaily, Saif Aldeen AlRyalat","doi":"10.51329/mehdiophthal1477","DOIUrl":"10.51329/mehdiophthal1477","url":null,"abstract":"<p><strong>Background: </strong>The most accurate method of intraocular lens (IOL) power calculation in cataract surgery has not been determined, and further studies are needed to reach a consensus. The aim of this study was to assess publications related to IOL power calculation formulas, mapping their yearly trends, most productive authors, top publishing countries and institutions, and areas of specialization for IOL power formulas.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis of research articles published on the topic of IOL power calculation formulas. Using PubMed, we employed appropriate search terms and filtered the results for the period of January 1, 1946, to June 28, 2023. Data were analyzed using CiteSpace, VOSviewer, and Microsoft Excel programs. The visual representations of the collected data through the use of figures was provided to demonstrate the aspects of IOL power calculation research.</p><p><strong>Results: </strong>We retrieved 5475 documents in the initial search. Analysis of these documents revealed an increase in the number of publications, from one publication in 1946 to 201 publications in 2023. The top three countries contributing to these publications were the United States, China, and Japan, collectively accounting for over 27% of the total articles. However, the two institutions with the highest contributions were located in the United Kingdom and Hungary, neither of which was among the top 10 countries in overall contributions. Overall 15 326 authors contributed to publications pertaining to IOL power calculation formulas. Among these authors, the most prolific contributors included Achim Langenbucher from Saarland University (Germany), Giacomo Savini from G.B. Bietti Foundation I.R.C.C.S. (Italy), and Kenneth J Hoffer from the University of California (United States). Saarland University emerged as the most productive institution, contributing equally to two distinct departments: the Dr. Rolf M. Schwiete Center for Limbal Stem Cell Research and Congenital Aniridia, as well as the Department of Experimental Ophthalmology. The School of Physical Science at the Open University in the United Kingdom engaged in partnership with various institutions including Eye & Laser Clinic Castrop Rauxel in Germany and Johannes Kepler University Linz in Austria. Among the top 10 keywords found in the publications were \"cataract\", \"cataract surgery\", and \"intraocular lens\".</p><p><strong>Conclusions: </strong>This study represents the first scientometric analysis of publications related to IOL power calculation formulas. The study offers valuable insights into the geographic distribution, contributing authors, and emphasis of research on the IOL power calculation formulas. Further cooperation is essential to pinpoint the most suitable formula and to address gaps in our current understanding.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 3","pages":"115-126"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111703","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":"Symptomatic dry eye disease among university students.","authors":"Khalid M Al-Zubi, Waqar A Al-Kubaisy, Yazan E Al-Azzeh, Batool K Batayneh, Hazim A Alqaraleh, Lo'ay A Abid, Ghazi O Al-Jadid Al-Majali, Noor T Alhajaj","doi":"10.51329/mehdiophthal1472","DOIUrl":"10.51329/mehdiophthal1472","url":null,"abstract":"<p><strong>Background: </strong>Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu'tah University.</p><p><strong>Methods: </strong>In this cross-sectional study conducted at Mu'tah University, Mu'tah, Jordan, from January to April 2022, 489 students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, 106 participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT).</p><p><strong>Results: </strong>Approximately 74.6% of the students self-reported experiencing DED symptoms, and 72.6% had an OSDI score > 12, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores ( < 10 mm) in 26.4% (n = 28) and 25.5% (n = 27) of the right and left eyes, respectively. We observed low TBUT scores ( < 5 s) in 19.8% (n = 21) and 18.9% (n = 20) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores (<i>P</i> = 0.003 for both right and left eyes), TBUT (<i>P</i> < 0.001 for both right and left eyes), and OSDI score (<i>P</i> < 0.001 for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + 0.30; <i>P</i> = 0.002) and left (r = + 0.34; <i>P</i> < 0.001) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - 0.24; <i>P</i> = 0.013) and left (r = - 0.23; <i>P</i> = 0.019) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - 0.25; <i>P</i> = 0.011) but not of the right eye (r = - 0.17; <i>P</i> = 0.077).</p><p><strong>Conclusions: </strong>The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide higher diagnostic yield for DED. Further studies are required to confirm this hypothesis.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 2","pages":"70-77"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736311","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":"Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study.","authors":"Mohammed Iqbal, Abdallah Hammour, Ahmed Elsayed, Ahmed Gad","doi":"10.51329/mehdiophthal1473","DOIUrl":"10.51329/mehdiophthal1473","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus (KCN) is an ectatic disorder of the cornea characterized by stromal weakness and apical protrusion of the cornea, and is associated with a gradual and painless reduction in visual acuity. KCN in pediatric patients has certain important characteristics, such as a progressive and aggressive nature. We aimed to analyze the visual, refractive, and topographic outcomes of implanting a single 210° arc-length Keraring segment according to a novel, objective, Q value-based nomogram (Q-N) for the treatment of pediatric versus adult KCN.</p><p><strong>Methods: </strong>This prospective, multicenter, non-randomized, open-label trial included 47 eyes of 47 patients who were allocated to one of two groups. The <i>adult group</i> included 33 eyes of patients ≥ 18 years of age, whereas the <i>pediatric group</i> included 14 eyes of patients aged 14 - 17 years. All patients underwent femtosecond laser-assisted implantation of a single 210° arc-length Keraring segment according to the Q-N and were followed up for 6 months. All eyes underwent visual acuity measurement, cycloplegic refraction, and corneal topography at baseline and 6 months after surgery.</p><p><strong>Results: </strong>The study groups were comparable in terms of sex proportions and KCN grades (both <i>P</i> > 0.05). The adult group exhibited significant postoperative improvements in mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), and Kmax (all <i>P</i> < 0.001) with a mean change of -0.56 logarithm of the minimal angle of resolution (logMAR), - 0.40 logMAR, 3.07 diopters (D), 0.70 D, 3.42 D, and - 5.26 D, respectively. The pediatric group exhibited significant postoperative improvements in mean UDVA, CDVA, sphere, SE, and Kmax (all <i>P</i> < 0.05) with a mean change of - 0.62 logMAR, - 0.34 logMAR, 3.18 D, 3.67 D, and - 5.37 D, respectively. There were no significant differences between the groups in terms of the mean change in visual, refractive, and topographic variables (all <i>P</i> > 0.05). No postoperative complications were observed in either group.</p><p><strong>Conclusions: </strong>Use of the objective Q-N was efficient in the treatment of pediatric KCN, with postoperative improvements in the mean visual, refractive, and topographic parameters, comparable to outcomes in adult keratoconus. Q-N achieved good corneal remodeling with subsequent improvements in visual, refractive, and topographic outcomes in both adult and pediatric patients with keratoconus. To verify our preliminary findings, we recommend further multicenter randomized clinical trials using the Q-N nomogram in a larger sample of pediatric patients with KCN as an adjunct treatment before or after CXL.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 2","pages":"78-89"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736310","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":"Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function.","authors":"Styliani Totou, Efthymios Karmiris, Menelaos Kanakis, Panos Gartaganis, Petros Petrou, Christos Kalogeropoulos, Vassilios Kozobolis, Panagiotis Stavrakas","doi":"10.51329/mehdiophthal1478","DOIUrl":"10.51329/mehdiophthal1478","url":null,"abstract":"<p><strong>Background: </strong>Exposure to high-altitude conditions during flight or similar activities affects many aspects of visual function, which is critical not only for flight safety but for any altitude-related activity. We aimed to summarize the available literature pertaining to ocular changes during flight or equivalent short-term high-altitude exposure (e.g., hypobaric chamber, effortless ascent lasting ≤ 24 h) and to highlight future research priorities.</p><p><strong>Methods: </strong>Using the PubMed/MEDLINE and Web of Science/ISI Web of Knowledge databases with structured search syntax, we conducted a systematic review of the literature spanning a 40-year period (January 1, 1983, to October 10, 2023). Articles pertaining to ocular changes during flight or flight-equivalent exposure to altitude were retrieved. The reference lists of retrieved studies were also searched, and citations of these references were included in the results.</p><p><strong>Results: </strong>Of 875 relevant PubMed and ISI publications, 122 qualified for inclusion and 20 more were retrieved from the reference lists of initially selected records, for a total of 142 articles. Reported anterior segment changes included deterioration in tear film stability and increased dry eye incidence, increased corneal thickness, discomfort and bubble formation in contact lens users, refraction changes in individuals with prior refractive surgery, decreased intraocular pressure, and alterations in pupillary reaction, contrast sensitivity, and visual fields. Photoreceptor-visual pathway changes included alterations in both photoreceptors and neuro-transduction, as evidenced in dark adaptation, macular recovery time, reduction in visual field sensitivity, and optic neuritis (likely an element of decompression sickness). Retinochoroidal changes included increases in retinal vessel caliber, retinal blood flow, and choroidal thickness; central serous chorioretinopathy; and retinal vascular events (non-arteritic ischemic optic neuropathy, high-altitude retinopathy, and retinal vein occlusion).</p><p><strong>Conclusions: </strong>The effect of short-term high-altitude exposure on the eye is, in itself, a difficult area to study. Although serious impairment of visual acuity appears to be rare, ocular changes, including tear film stability, contact lens wear, central corneal thickness, intraocular pressure, contrast sensitivity, stability of refractive surgeries, retinal vessels, visual fields, and macula recovery time, should be considered in civilian aviators. Our report provides guidance to climbers and lowlanders traveling to altitude if they have pre-existing ocular conditions or if they experience visual symptoms while at altitude. However, key outcomes have been contradictory and comprehensive studies are scarce, especially those pertaining to the choroid and retina. Such studies could not only deepen our understanding of high-altitude ocular pathophysiology, but could also off","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"12 3","pages":"127-141"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111693","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}