Eye Laterality Research Articles

Analysis of risk factors associated with secondary open-angle glaucoma in Posner-Schlossman syndrome: A retrospective case-control study.

Posner-Schlossman syndrome (PSS) is a relatively rare cause of chronic secondary open-angle glaucoma (OAG), but the exact cause is unknown. This study aimed to determine potential risk factors for OAG secondary to PSS and to provide a basis for early intervention in the development of PSS. This was a retrospective case-control study. Nine cases diagnosed with PSS and seven cases diagnosed with OAG secondary to PSS were selected and their aqueous humor assays at the first occurrence of PSS were collected. Clinical characteristics including age, sex, disease duration, eye laterality, baseline visual acuity, maximum IOP, corneal endothelial cell density, visual field, retinal nerve fiber layer thickness, cup-to-disk ratio, keratic precipitates, anterior chamber inflammation, and aqueous humor cytokine assay results were compared between the two groups. The cytomegalovirus (CMV) positivity was 55.60% in patients with PSS and 100% in patients with OAG secondary to PSS. Corneal endothelial cell density was lower in patients with CMV-positive PSS (p = 0.0116). Concentrations of basic fibroblast growth factor (bFGF), interleukin (IL)-6, and vascular cell adhesion molecule (VCAM) in patients with PSS and IL-8, IL-6, and VCAM in patients with OAG secondary to PSS were higher than standard reference values; and IL-8 concentration was significantly higher in patients with OAG secondary to PSS (p = 0.0229). There were significant positive correlations between IL-8 and IL-6, IL-6 and VCAM (p = 0.0304, p = 0.0172) and a significant negative correlation between bFGF and vascular endothelial growth factor (VEGF) (p = 0.0497). Simultaneous increase of IL-8 and IL-6 concentration levels could be used as a cytokine indicator to predict secondary OAG in patients with PSS (p = 0.0095). Simultaneous increase of IL-8 and IL-6 concentrations may be an important cause of accelerated secondary OAG in patients with PSS, with IL-8 playing a more critical role. IL-8 and IL-6 may be more reliable cytokine markers for predicting secondary OAG in PSS, However, the high possibility of secondary OAG in patients with CMV-positive PSS should not be ignored. Regulation of IL-8 and IL-6 levels may be a new strategy of preventing OAG secondary to PSS.

Comparison of anterior corneal aberrations measured by Scheimpflug and Placido Disc System for myopes

BackgroundTo ascertain the agreement of corneal aberrations obtained from the Pentacam and the KR-1W in myopic populations and to investigate the influence of the level of myopia as well as the laterality on the agreement.MethodsIn this observational study, a rotating Scheimpflug camera (Pentacam AXL) and a Hartmann-Shack wavefront analyzer with Placido-disc topographer (KR-1W) were used to measure the aberrations of myopes in the anterior corneal surface by one experienced operator. All examinations were computed across a 6 mm diameter. Six subgroups were generated according to the degree of myopia (mild, moderate, and severe myopia) and the laterality of eyes (right and left eyes).ResultsThe study included 245 eyes of 170 participants. For certain anterior corneal aberrations, statistically significant differences existed between the Pentacam and the KR-1W (all P < .05). The values of Zernike (Z)(2,0), Z(2,2), Z(3,1), and Z(4,0) varied in all levels of myopia regardless of the laterality, with the values of the Pentacam constantly larger than the KR-1W in the measurement of Z(2,0), Z(2,2), and Z(4,0). For 2nd to 6th aberrations, both instruments correlated poorly to moderately. The width of limits of agreement between the two instruments was clinically too wide (> 0.1 μm) for aberrations closely correlated with visual quality, including Z(3, ± 3), Z(3, ± 1), and Z(4,0), and almost all aberrations, indicating poor agreement.ConclusionsIn clinical practice, the Pentacam based on Scheimpflug technology and the KR-1W based on Placido Disc System are not interchangeable in measuring anterior corneal aberration for myopes regardless of myopia degree and the laterality, suggesting that a consistent instrument should be selected for surgical design as well as follow-up.

The impact of surgeon's experience and sex on the incidence of cystoid macular edema after uneventful cataract surgery.

To assess the rate of pseudophakic cystoid macular edema (pCME) in uneventful cataract surgery in surgeons in training vs experienced surgeons and to analyze the rate of pCME according to surgeon's sex. Medical reports post phacoemulsification between 2010 and 2018 at the Department of Ophthalmology, Medical University of Graz, Austria, were reviewed for pCME. A running lifetime number of preceding cataract surgeries was used to express hands-on experience. A cut-off number of 300 surgeries was defined to distinguish between surgeons in training and experienced surgeons. Outcome parameters were incidence of pCME, patient's sex and age, laterality of eye, coexistence of pseudoexfoliation syndrome (PEX), duration of surgery and surgeon's sex. 25.422 surgeries on 18.266 patients were included. The majority was performed by experienced surgeons (23.139, 91.0%) vs 2.283 (9.0%) by surgeons in training (25 surgeons, 9 (36%) female and 16 (64%) male). pCME occurred in 32 eyes (1.4%) following surgery by surgeons in training and in 152 eyes (0.7%) following surgery by experienced surgeons. Chance for pCME was 1.57 higher in training surgeries (95% CI 1.03-2.41, p = 0.034) and longer duration (OR = 1.04; 95% CI 1.02-1.07, p = 0.001). After excluding the first 100 surgeries for every surgeon in training similar results were observed. No difference in risk for pCME was found between female and male surgeons in both groups (training and experienced surgeons). In conclusion, the rate for pCME after uneventful cataract surgery is significantly higher for surgeons in training but steadily decreasing and associated to surgical time. No difference in the risk for pCME was found between female and male surgeons.

Positive Welfare Indicators in Dairy Animals

Nowadays, there is growing interest in positive animal welfare not only from the view of scientists but also from that of society. The consumer demands more sustainable livestock production, and animal welfare is an essential part of sustainability, so there is interest in incorporating positive welfare indicators into welfare assessment schemes and legislation. The aim of this review is to cite all the positive welfare indicators that have been proposed for dairy animals in theory or practice. In total, twenty-four indicators were retrieved. The most promising are exploration, access to pasture, comfort and resting, feeding, and behavioral synchronicity. Qualitative behavioral assessment (QBA), social affiliative behaviors, play, maternal care, ear postures, vocalizations, visible eye white, nasal temperature, anticipation, cognitive bias, laterality, and oxytocin have been also studied in dairy ruminants. QBA is the indicator that is most often used for the on-farm welfare assessment. Among all dairy animals, studies have been performed mostly on cattle, followed by sheep and goats, and finally buffaloes. The research on camel welfare is limited. Therefore, there is a need for further research and official assessment protocols for buffaloes and especially camels.

Clinical manifestations of 1 015 cases of herpes simplex virus keratitis

Objective: To explore the demographic distribution, clinical signs, and clinical types of herpes simplex virus keratitis (HSK). Methods: Retrospective case series. The data of 1 015 cases of HSK (1 054 eyes) diagnosed in Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University from January 2010 to June 2019 were collected. The patients included 613 males and 402 females, and the age was 47.43±16.79 years. Information of the patients such as age, sex, the season of onset, eye laterality, and clinical signs was assessed. Slit-lamp microscopy and corneal fluorescein staining were used to locate the anatomical position of lesions. HSK was classified into epithelial type, neurotrophic type, stromal type, endothelial type, and mixed type. The distribution data was compared by the Chi-square test or Fisher's exact test. Results: There were 41 children (≤14 years old; 4.04%), 338 youth (15-44 years old; 33.30%), 374 middle-aged (45-59 years old; 36.85%), and 262 elderly (≥60 years old; 25.81%) patients. The type was epithelial in 246 cases (24.24%), neurotrophic in 27 cases (2.66%), stromal in 372 cases (36.65%), endothelial in 274 cases (26.99%), and mixed in 96 cases (9.46%). There was statistically significant difference in clinical typing among the different age groups (χ2=30.197, P=0.003). Epithelial HSK was found in 141 males (57.32%) and 105 females (42.68%), neurotrophic HSK in 16 males (59.26%) and 11 females (40.74%), stromal HSK in 226 males (60.75%) and 146 females (39.25%), endothelial HSK in 171 males (62.41%) and 103 females (37.59%), and mixed HSK in 59 males (61.46%) and 37 females (38.54%). There was no statistically significant difference in clinical classification of keratitis between genders (χ2=1.519, P=0.823). Among the cases of mixed type, there were 21 cases of epithelial-stromal type (21.88%), 30 cases of epithelial-endothelial type (31.25%), 37 cases of stromal-endothelial type (38.54%), 1 case of epithelial-neurotrophic type (1.04%), and 7 cases of neurotrophic-stromal type (7.29%). Conclusions: HSK occurs mainly in middle-aged and young adults, but rarely in children. The proportion of males is higher than that of females. The proportion of stromal HSK is highest, and 9.46% of patients present mixed HSK.

Outcomes of ab-interno irrigating goniectomy with trabectome in primary and secondary glaucoma from a single center in India.

This study was done to report intermediate-term outcomes of irrigating goniectomy with trabectome (trabectome) surgery among different types of glaucoma eyes from a single center in India using a cross-sectional, longitudinal, observational study design. Fifty-three patients (58 eyes) with glaucoma who underwent irrigating goniectomy with trabectome between January 2019 and February 2020 were included. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications (AGMs), prior glaucoma surgeries, visual acuity, and intraocular pressure (IOP) on medical treatment. Post-operative data included IOP changes during the follow-up till 1-year, number of AGMs, any complications, or additional surgical intervention required. Success was defined as IOP ≤ 21 mmHg and ≥ 20% reduction of IOP from pre-operative IOP with no additional glaucoma surgery. The cohort included 58 eyes (male 53.4% and female 46.6%) ranging from 0.6 to 81 years of age. The average baseline IOP was 23.4 ± 10.2 mmHg and reduced significantly with surgery to 14.1 ± 5.3 mmHg at 1-year follow-up. The AGMs reduced from 2.4 ± 1.4 pre-surgery to 1.6 ± 1.4 at 1-year follow-up. Four eyes required additional glaucoma surgeries for IOP control. The success rate of trabectome with phacoemulsification (88%) was discernibly higher than with trabectome alone (67%). Intra-operatively, significant blood reflux was noticed in 27 eyes, of which only one required tamponading with a viscoelastic agent. This study concludes that irrigating goniectomy with trabectome has good efficacy and safety in both pediatric and adult cases of glaucoma in terms of IOP control, reduction in AGMs, and low incidence of complications in the Indian population.

Automatic interpretation and clinical evaluation for fundus fluorescein angiography images of diabetic retinopathy patients by deep learning

Background/aimsFundus fluorescein angiography (FFA) is an important technique to evaluate diabetic retinopathy (DR) and other retinal diseases. The interpretation of FFA images is complex and time-consuming, and the ability of...

Validation of metabolomic and lipidomic analyses of human tears using ultra-high-performance liquid chromatography tandem mass spectrometry

To facilitate application in ophthalmological and systemic diseases, there is a need to standardize preanalytical and analytical steps for metabo-lipidomics in human tears. We assessed different methods for each step of the workflow, from sampling to omics profiles acquisition, to provide the largest metabo-lipidomic coverage with the most robust analytical criteria in human tears. We compared reproducibility according to different extraction methods, two sampling techniques, three volumes (2 μL, 5 μL, 10 μL) and eye laterality using ultra-high-performance liquid chromatography coupled with tandem high-resolution mass spectrometry for metabolomic and lipidomic application. The effect of age on the tear metabo-lipidome was also investigated in healthy subjects. The extraction method using methanol/water provided the best results for Schirmer strip metabolomics, while Folch extraction was superior for lipidomics, whatever the sampling method used. When comparing both sampling methods, microcapillary glass tube was superior to Schirmer strip for metabolomics but comparable for lipidomics. The 5 μL volume provided a satisfying metabo-lipidomic coverage. There was no significant difference in tear metabo-lipidome between both eyes in healthy subjects. While most metabolites and lipids where not influenced by age, the phenylalanine-tyrosine-tryptophan pathway, aminoacyl t-RNA biosynthesis, and alanine-aspartate-glutamate metabolism were the 3 principal pathways associated with the 15 most variable metabolites according to age. The current findings will contribute to improve metabo-lipidomic workflow in human tears for the identification of new biomarkers. Preanalytical and analytical standardization is mandatory in order to perform better between-study comparisons and increase the chances of transferring laboratory findings into clinical practice.

Comparison of tolerance to decentration and tilt in the early postoperative period between the continuous range and bifocal intraocular lens implantation in myopic eyes

Objective: To compare decentration and tilt tolerances between continuous range intraocular lens (IOL) and bifocal IOL in myopia during the early stages post intraocular implantation. Method: A retrospective cohort study was conducted using follow-up data of 145 patients (145 eyes) who underwent phacoemulsification combined with IOL implantation in the Eye & ENT Hospital of Fudan University from January 2018 to December 2020. According to whether the axial length was less than 24.5 mm, patients were divided into non-myopic and myopic groups. According to IOL type, patients were divided into extend depth of focus (EDOF) ZXR00 IOL group (myopic 38 eyes, non-myopic 41 eyes) and bifocal ZMB00 IOL group (myopic 23 eyes, non-myopic 43 eyes). The distance and near visual acuity (log of the minimum angle of resolution visual acuity), IOL tilt and decentration, intraocular high-order aberration (HOA), coma, trefoil, spherical aberrations, modulation transfer function (MTF), as well as VF-14 index and the incidence of dysphotopsia were compared between the 2 groups at 3 months after surgery. Statistics were performed using Student's t-test, χ2 test, Pearson correlation analysis and multiple linear regression analysis. Results: In either the myopic or non-myopic group, no significant differences were found in age, gender, eye laterality, axial length and IOL degree between eyes with the two different types of IOLs (all P>0.05). At 3 months after surgery, there was no significant difference in uncorrected and best-corrected distance visual acuity between the ZXR00 IOL group and the ZXR00 IOL group, while uncorrected near visual acuity was better in the ZMB00 IOL group than the ZXR00 IOL group (t=10.41, P<0.01). The total postoperative IOL decentration in the ZXR00 IOL group and ZMB00 IOL group in myopic eyes were (0.32±0.17) and (0.38±0.16) mm, respectively, which were greater than those in non-myopic eyes [(0.22±0.12), (0.28±0.12) mm; t=3.16, 2.57; both P<0.05]. However, there were no significant differences in IOL tilt between myopic and non-myopic eyes in the 2 groups (both P>0.05). There were no significant differences in postoperative IOL tilt and decentration between the 2 groups regardless of myopia or non-myopia (all P>0.05). In myopic eyes, HOA, coma aberration and spherical aberration in the ZXR00 IOL group were significantly lower than those in the ZMB00 IOL group, while the total ocular MTF (38.15±10.12) was significantly higher than that in the ZMB00 IOL group (30.46±10.53) (all P<0.05). Pearson correlation analysis and multiple linear regression analysis showed a positive correlation between postoperative HOA and both IOL tilt and decentration in the ZMB00 IOL group (r=0.627, 0.726; β=0.446, 0.587; all P<0.01). However, no such relationship was found in the ZXR00 IOL group (all P>0.05). In myopic eyes, when the IOL tilt aberration and decentration were greater than the median, the HOAs in the ZXR00 IOL group [(0.33±0.14), (0.27±0.11) μm] were lower than those in the ZMB00 IOL group [(0.88±0.56), (0.96±0.45) μm], while the total ocular MTF (42.87±10.97, 40.22±9.30) were higher than those in the ZMB00 IOL group (25.02±8.99, 29.87±10.19) (all P<0.05). In myopic eyes, the proportion of patients with visual interference symptoms in the ZXR00 IOL group [42.11% (16/38)] was significantly lower than that in the ZMB00 IOL group [78.26%(18/23), χ²=7.59, P<0.05]. Conclusion: During the early stages after IOL implantation in myopic eyes, EDOF IOL is more tolerant to decentration and tilt than bifocal IOL.

Ocular Injuries From Drive-by Paintball Shootings

To characterize ocular injuries from drive-by paintball shootings with a focus on the severity of injuries sustained, clinical management, and visual outcomes. Retrospective, interventional case series. Setting: University practice and emergency department. Patients evaluated by the ophthalmology service for paintball injuries. Age, sex, eye laterality, mechanism of injury, initial best-corrected visual acuity (BCVA), and initial diagnosis. Clinical intervention(s), BCVA at last follow-up visit, and severity of injuries with a focus on ruptured globes. Twenty patients suffered unilateral ocular injuries from drive-by paintball shootings between January 2020 and December 2021. The median follow-up interval was 7.1 weeks (range: 3 days to 11.4 months). The average patient age at presentation was 36.6 years (range: 13-64 years). Fourteen patients (70%) had an initial BCVA of counting fingers or worse. Six patients (30%) suffered a ruptured globe injury requiring surgical repair, of whom 3 (15%) underwent subsequent evisceration. Twelve patients (60%) suffered ocular injuries requiring surgical intervention. Fifteen ocular surgeries were performed on 9 patients (45%) at our institution with 3 patients referred to outside providers for definitive surgical management due to insurance. BCVA at last follow-up visit was no light perception in 5 patients. The severity of injury after paintball-induced ocular trauma is higher in this case series than what has previously been reported in the literature. Paintball guns can cause devastating ocular injury when used as an assault weapon, and their use in unregulated settings bears further scrutiny.

The Changes in Visual Acuity Values of Japanese School Children during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic may result in a greater decrease in visual acuity (VA) among Japanese children. Our study aimed to examine Japanese children’s VA during the pandemic. VA data were collected using standard eye tests during school health check-ups conducted in 2019 and 2020 on 5893 children, in seven public elementary schools and four public junior high schools in Tokyo, Saitama, Kanagawa, and Shizuoka. VA changes were statistically analyzed. The relationship between the survey year and poor VA yielded a significant regression coefficient for the surveyed years in elementary and junior high school students. The 2019 VA value and VA change from 2019 to 2020 demonstrated a significant regression coefficient in elementary school students with VAs of “B (0.7–0.9)” and “C (0.3–0.6)”, and junior high school students with VAs of “B”, “C”, and “D (<0.3)”. An analysis of the relationship between the survey year and eye laterality of VA yielded a significant regression coefficient in the surveyed years for elementary (OR, 1.516; 95% CI, 1.265–1.818) and junior high school students (OR, 1.423; 95% CI, 1.136–1.782). Lifestyle changes during the COVID-19 pandemic might have affected VA and eye laterality in Japanese children.

Effect of eye laterality on correction of myopic astigmatism with small incision lenticule extraction (SMILE) using vector analysis.

To compare the vector analysis, visual, and refractive outcomes after myopic astigmatic correction using SMILE between the right and left eyes. This is a retrospective study including 41 right and 40 left eyes that underwent SMILE for correction of myopic astigmatism greater than 0.75 diopters (D) with a follow-up of at least 3months. Vector analysis for astigmatic correction was done. Visual and refractive parameters were compared between both groups by measuring mean postoperative logMAR uncorrected distance visual acuity, mean postoperative spherical equivalent (SE), cylinder, and refractive predictability in terms of SE and cylindrical correction. Efficacy and safety of SMILE were also determined. No significant difference was found between vector outcomes except for angle of error (AE). The right eye group yielded a negative mean AE (- 2.71 ± 5.35), while the left eye group yielded a positive mean AE (0.23 ± 9.60). Correction index, magnitude of error and refractive predictability of cylindrical correction showed undercorrection of astigmatism in both groups. The right eye group showed lower predictability for higher cylindrical correction. Visual outcomes were similar for both eyes. Rotational errors account for vectorial outcome differences between right and left eyes. Despite achieving good visual and refractive outcomes with low cylinder correction, the tendency to undercorrect between eyes due to this error may be more evident when treating higher amounts of astigmatism. More careful preoperative control for cyclotorsion is warranted for right eyes compared to left eyes.

Comparison of Intraocular Pressure between Air Puff Tonometer and Goldmann Applanation Tonometer at a Tertiary Eye Care Centre

Purpose: The purpose of this study was to evaluate the role of air puff (AP) tonometer by comparing the measurements of intraocular pressure (IOP) made using this device with those made using a Goldmann applanation tonometer (GAT) at Chittagong Eye Infirmary and Training Complex. Method: An observational and comparative study was carried out at Chittagong Eye Infirmary and Training Complex from January 2016 to January 2017. Two techniques for IOP measurements using the standard GAT and the non-contact tonometer (NCT) were compared. A total of 400 eyes from 200 patients were included in the study. Results: The mean IOP as measured by GAT in the right eye was 14.50±5.59mmHg and in the left eye was 14.87±7.03mmHg while that as measured by NCT in the right eye was 15.97±6.12mmHg and in the left eye was 15.94±6.98mmHg. The mean difference between the two methods of measurement in the right eye was 1.47±0.53mmHg and the left eye was 1.07±0.05mmHg. The readings obtained by NCT were higher than those obtained by GAT. There was no statistically significant difference found in IOP measurements between GAT and NCT according to patient’s age, gender or laterality of eyes. Conclusion: There was a significant difference in the measurement of IOP between GAT and NCT. Goldmann applanation tonometry remains the most suitable and reliable method for measuring IOP.

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

Purpose: To evaluate common indications and anatomical outcomes of PPV for posterior segment ocular diseases in patients presenting at private retina clinic in Lahore Study design: Cross sectional survey Methods and materials: Over the period of three years, from 1st April 2017 to 3oth April 2020, all patients fulfilling inclusion criterion, were included in study after approval from hospital ethical committee. After taking history and detailed ocular examination, diagnosis was confirmed by B scan or OCT, Hepatitis B &amp; C screening done. The patient age, gender, laterality of eye, lens status, macular status, type of retinal pathology, type of anesthesia, procedure done and type of vitreous tamponade if used were noted. All procedures were performed by a single surgical team and patients were followed for six months for anatomical success or any complication. Data was analyzed by SPSS 25. Results: Out of 266 total patients, 168 (63.2%) were males and 98 (36.8%) were females. Right eye was involved in 125 (47%) and left in 141 (53%). Age range was from 2 years to 83years, mean age for males was 47.30, for females 48.07 years, median age was 50 years, mean age for GA was 30.62 years and 51.71 for LA patients. The highest incidences of posterior segment ocular problems were observed in patients with age range 51 to 60 years. The commonest indication for posterior segment surgery were RRD seen in 107 (40.23%), ROSO in 51 (19.17%) and vitreous hemorrhage 33 (12.41%). Endophthalmitis was indication in 20 (7.52%), dropped nucleus in 11 (4.13%), Macular hole in 7 (2.63%) and ERM in 3 (1.13%). Asteroid hyalosis, intraocular IOFB and diagnostic vitrectomy were least common indication, each seen in 1 (0.5%) patient. Silicon oil was most commonly used Endo tamponade used in 138 (51.88%) patients. All patients were followed for 6 months with vision and retinal status. All patients who underwent pars plana vitrectomy surgery were stable with anatomical success rate till 6 months postoperatively except 10 (3.76%) who required re do operation for retinal detachment or some other complications. Conclusion: Current practice in ophthalmology shows increased frequencies of internal approach (PPV) for vitreoretinal diseases rather external approach (SB). Silicon oil was most common internal tamponade used. Diabetic retinopathy was important cause of vitreous hemorrhage and TRD. Patients should be educated regarding regular fundoscopy and good systemic control of diabetes. Higher incidence of retinal detachment among all age groups needs awareness and education about its warning ocular symptoms. Key words: PPV (Pars plana vitrectomy), RRD (Rhegmatogenous retinal detachment), SB (Scleral buckling), TRD (Tractional retinal detachment), ROSO (removal of silicon oil), GA (general anesthesia), LA (local anesthesia)

Distribution of phthisis bulbi and status of fellow eyes at a tertiary eye-care centre in Nigeria: a ten-year review.

Phthisis bulbi is an irreversible cause of visual loss with insufficient evidence about its aetiology and status of patients' fellow eyes. To identify the distribution of patients with phthisis bulbi and determine the status of their fellow eyes at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. We analysed data retrospectively retrieved from medical records of patients diagnosed with phthisis bulbi at initial clinic visit from January 2008 to December 2017. Information abstracted included biodata, laterality of phthisical eye, duration and aetiology of phthisis bulbi, visual acuity, and morbidities present in fellow eyes. Seventy-nine patients presented with unilateral phthisis bulbi. The mean age was 51±21.2 years and forty (50.6%) were males. The commonest aetiologies of phthisis bulbi were trauma 37 (46.8%), infection 17 (21.5%) and uveitis/inflammation 11 (13.9%). Seventy (88.6%) patients had morbidities in their fellow eye such as glaucoma 26 (32.9%), refractive errors 23 (29.1%) and cataract 22 (27.9%). Forty (50.6%) patients were either visually impaired or blind in their fellow eye (p=0.001). The commonest cause of phthisis bulbi was trauma. Approximately nine out of ten patients had ocular morbidities in their fellow eye. A thorough follow-up of patients with phthisis bulbi is recommended.

Development and validation of deep learning algorithms for automated eye laterality detection with anterior segment photography

This paper aimed to develop and validate a deep learning (DL) model for automated detection of the laterality of the eye on anterior segment photographs. Anterior segment photographs for training a DL model were collected with the Scheimpflug anterior segment analyzer. We applied transfer learning and fine-tuning of pre-trained deep convolutional neural networks (InceptionV3, VGG16, MobileNetV2) to develop DL models for determining the eye laterality. Testing datasets, from Scheimpflug and slit-lamp digital camera photography, were employed to test the DL model, and the results were compared with a classification performed by human experts. The performance of the DL model was evaluated by accuracy, sensitivity, specificity, operating characteristic curves, and corresponding area under the curve values. A total of 14,468 photographs were collected for the development of DL models. After training for 100 epochs, the DL models of the InceptionV3 mode achieved the area under the receiver operating characteristic curve of 0.998 (with 95% CI 0.924–0.958) for detecting eye laterality. In the external testing dataset (76 primary gaze photographs taken by a digital camera), the DL model achieves an accuracy of 96.1% (95% CI 91.7%–100%), which is better than an accuracy of 72.3% (95% CI 62.2%–82.4%), 82.8% (95% CI 78.7%–86.9%) and 86.8% (95% CI 82.5%–91.1%) achieved by human graders. Our study demonstrated that this high-performing DL model can be used for automated labeling for the laterality of eyes. Our DL model is useful for managing a large volume of the anterior segment images with a slit-lamp camera in the clinical setting.

Quickert procedure for involutional lower eyelid entropion: a multi-centre study

Background: Involutional entropion is the inward turning of the eyelid margin and commonly happens in the inferior eyelids in elderly people. The prevalence is as high as 2.1% in people ≥ 60 years old and more common in women than men. This condition may cause ocular surface irritation and discomfort secondary to contact between cilia and the ocular surface. Several etiological factors are suspected to be important causes of involutional entropion. One of them was horizontal eyelid laxity. Quickert Procedure is one of the surgical interventions recommended to correct involutional lower eyelid entropion in the elderly Asian population with 0% of recurrent entropion in a recent study by Miyamoto et al.Methods: This is a descriptive retrospective study of 16 involutional lower eyelid entropion patients (18 eyelids) that needed surgical correction.  About ten males and six females were undergone Quickert procedure to correct the involutional entropion. Patients were assessed postoperatively for 24 months to evaluate the recurrence entropion, cosmetic, and functional improvement. Data were analyzed by SPSS version 20 for Windows.Results: This study included 16 patients, with mean age was 69.8 years old which range from 62-85 years old. They consisted of 9 (56.0%) patients were male, and the rest was female (44.0%). Eleven (61.0%) patients were with left eye laterality, and 10 (63.0%) patients found without anticoagulant consumption. All patients (100.0%) had positive snapback test and achieved &gt;6 mm in distraction test. After surgical intervention, no patients (0.0%) were found to experience recurrence of involutional entropion nor ocular discomfort due to prior surgery.Conclusion: A detailed assessment of the etiology, accurate preoperative evaluation, and precision in addressing patients underlying eyelid anatomic abnormalities are needed in the selection of appropriate surgical procedures to correct entropion.

Normative data for optical coherence tomography in children: a systematic review.

The purpose of this study is to systematically review the reported data of normal optical coherence tomography (OCT) results in the paediatric population. A systematic literature search was performed using the PubMed, Embase, and Web of Science databases, using the keywords "optical coherence tomography"; "normative data" or "healthy eyes"; "children" or "paediatric population". Studies with at least 50 participants were included, irrespective of the OCT equipment employed. We excluded the OCT angiography studies or the studies investigating the choroidal thickness. Seventy-four studies were included in the final analysis and information on study design, number of participants, demographic characteristics, type of OCT equipment, OCT parameters and results was collected. Due to the high variability of OCT instruments and parameters used, a meta-analysis was not feasible. We report the normative values for the peripapillary retinal nerve fibre layer thickness and the macular retinal thickness for each ETDRS quadrant, as provided by the studies included in the present analysis. We also report the influence of ethnicity, age, gender, eye laterality, ISNT rule, spherical equivalent, and axial length on OCT results.

SELF-DESIGNATION OF THE TREATED EYE BEFORE INTRAVITREAL INJECTIONS: Prevalence and Predictors of Incorrect Calling.

To identify risk factors for incorrect self-identification of the treatment eye before intravitreal injections. This prospective study included consecutive patients who were asked to designate the eye for which the intravitreal injection was intended and were subsequently divided into two groups according to whether or not they identified the correct eye. Overall, 349 eyes (n = 349) were included, and 8.6% (n = 30) designated the incorrect eye or did not know which eye was intended for treatment. Incorrect designation was associated with diabetic macular edema (odds ratio [OR] = 0.33 [0.15-0.75]), first injection in the intended eye or ≥1 year since previous injection (OR = 0.34 [0.14-0.87]), Arabic native tongue (OR = 0.48 [0.22-1.01]), previous injection to the fellow eye (OR = 0.26 [0.10-0.64]), and concurrent treatment of both eyes (OR = 0.35 [0.16-0.74]). Multivariate analysis showed the first injection or ≥1 year since last injection in the treatment eye (R2 = 2.24%, P = 0.004, OR = 0.20 [0.07-0.57]) and previous injection in the fellow eye (R2 = 6.55%, P < 0.001, OR = 0.20 [0.07-0.52]) as significant independent predictors of incorrect identification. Several factors are associated with a greater probability for incorrect patient's self-identification of the eye laterality intended for intravitreal injections. These findings may help identify patients with a higher risk of such potential errors.

The Correlation Between Eye Laterality and Hand Laterality In Unilateral Acquired Anophthalmia Due To Ocular Trauma

The Correlation Between Eye Laterality and Hand Laterality In Unilateral Acquired Anophthalmia Due To Ocular Trauma