Improvement In Visual Function Research Articles

Anatomical and morphological results of modified femtolaser refractive autokeratoplasty in patients with keratoconus

Aim to evaluate the anatomical and morphological outcomes of modified femtolaser refractive autokeratoplasty in patients with stage II keratoconus.
 Material and methods. The study included 24 patients diagnosed with stage II keratoconus according to the Amsler Krumeich classification. All patients underwent femtolaser refractive autokeratoplasty (FRAK) according to a modified technique.
 Results. All operated patients noted an improvement in visual functions on the first day after surgery. The obtained images of optical coherence tomography showed a more uniform posterior profile in the central zone of the cornea, the absence of "folding" of the posterior surface. A characteristic feature of the postoperative period was the change in the depth of the anterior chamber its pronounced decrease was noted with a tendency to a systematic increase. In 2 months after the removal of suture fixation, the depth of the anterior chamber remained stable throughout the follow-up period. The data of confocal microscopy of the central zone of the cornea after 12 months demonstrated the absence of additional (specific) morphological changes in the cornea. The characteristic morphological changes for keratoconus remained the same as before the FRAK.

Autologous Iris transplant as plug for macular hole retinal detachment in highly myopic eyes.

To describe the anatomic and visual outcomes of eyes undergoing autologous iris transplantation for macular hole retinal detachment. Seven consecutive patients with macular hole retinal detachment were enrolled in a single-arm prospective study. All patients underwent pars plana vitrectomy with autologous iris transplantation placed in the subretinal space as a plug to close the macular hole; in one case, a posterior retinal break was also closed with the same technique. Seven patients (2 males and 5 females) with a mean age of 69.14 ± 7.79 years (range 58-80 years) were followed up for a period of six months. The best-corrected visual acuity improved from 2.44 ± 0.48 logMAR (20/2000) preoperatively to 1.90 ± 0.26 logMAR (20/800) 6 months after surgery. Optical coherence tomography analysis showed retinal adhesion around the iris plug, and the retina remained dry in the follow-up period. In this series of macular hole retinal detachments, autologous iris transplantation placed as a plug over the retinal pigment epithelium facing the macular hole opening or directly over the bare sclera achieved anatomical success with improvement in visual function.

Training with optic flow stimuli promotes recovery in cortical blindness.

Cortical blindness is a form of severe vision loss that is caused by damage to the primary visual cortex (V1) or its afferents. This condition has devastating effects on quality of life and independence. While there are few treatments currently available, accumulating evidence shows that certain visual functions can be restored with appropriate perceptual training: Stimulus sensitivity can be increased within portions of the blind visual field. However, this increased sensitivity often remains highly specific to the trained stimulus, limiting the overall improvement in visual function. Recent advances in the field of perceptual learning show that such specificity can be overcome with training paradigms that leverage the properties of higher-level visual cortical structures, which have greater capacity to generalize across stimulus positions and features. This targeting can be accomplished by using more complex training stimuli that elicit robust responses in these visual structures. We trained cortically blind subjects with a complex optic flow motion stimulus that was presented in a location of their blind field. Participants were instructed to train with the stimulus at home for approximately 30 minutes per day. Once performance plateaued, the stimulus was moved deeper into the blind field. A battery of pre- and post-training measures, with careful eye tracking, was performed to quantify the improvements. We show that 1) optic flow motion discrimination can be relearned in cortically blind fields; 2) training with an optic flow stimulus can lead to improvements that transfer to different tasks and untrained locations; and 3) such training leads to a significant expansion of the visual field. The observed expansion of the visual field was present even when eye movements were carefully controlled. Finally, we show that regular training is critical for improved visual function, as sporadic training reduced the benefits of training, even when the total numbers of training sessions were equated. These findings are consistent with the hypothesis that complex training stimuli can improve outcomes in cortical blindness, provided that patients adhere to a regular training regimen. Nevertheless, such interventions remain limited in their ability to restore functional vision.

Эффективность использования «Цитофлавина» в реабилитации пациентов после эндовитреальной хирургии регматогенной отслойки сетчатки

Purpose. Improving functional efficiency of endovitreal surgery in patients with rhegmatogenous retinal detachment (RRD), based on inclusion of Cytoflavin in system of their postoperative rehabilitation. Material and methods. The object of study included 68 patients with RRD aged 37 to 65 years. Patients underwent 25G vitrectomy with laser coagulation of rupture zones and silicone oil tamponade in the vitreal cavity. Silicone oil was removed from the vitreal cavity 3 months after operation. Patients were divided into 2 groups: the main group – 34 people who received Cytoflavin against the background of standard therapy, and the control group – 34 people with postoperative treatment with only standard therapy. The dynamics of functional effectiveness of treatment was analyzed according to data of best corrected visual acuity (BCVA) and macular photosensitivity. Laser Doppler flowmetry (LDF) was used (microcirculation index was recorded). Morphological signs of macular ischemia were recorded by optical coherence tomography angiography (OCTA). Results. In patients of the main group, who received Cytoflavin along with standard therapy, a higher level of recovery functions of macular retina was observed compared to the control group. An increase in functional activity of the macular zone correlated with postoperative dynamics of restoration of retinal thickness in the central zone. Analysis of data of LDF and OCTA showed that improvement in visual functions in patients treated with Cytoflavin is directly related to restoration of chorioretinal blood flow. Conclusion. The use of Cytoflavin in patients of the main group after endovitreal surgery for RRD led to increase in BCVA by an average of 2.6 times and macular photosensitivity of 2 times. Improving visual functions at prescribing Cytoflavin to patients is due to its positive effect on indexes of chorioretinal microcirculation and density of the macular capillary plexuses. Keywords: rhegmatogenous retinal detachment, chorioretinal blood flow, laser Doppler flowmetry, optical coherence tomography angiography, Cytoflavin.

Анализ результатов хирургического лечения макулярных разрывов с применением PRP-терапии

Actuality. Macular hole is a severe pathology of the central zone of the retina with irreversible loss of photoreceptors. There is no conservative treatment for macular hole, only surgery treatment is effective. Vitrectomy is performed followed by endotamponade of the vitreal cavity with a gas-air mixture. Methods of surgical treatment differ in the way of adaptation of the edges of the macular hole. Purpose. Analysis of the results of treatment of macular holes using PRP technology. Material and methods. We observed 10 patients diagnosed with macular hole who underwent microinvasive 25G closed posterior vitrectomy, membranopiling, macularorhexis, tamponade of macular hole with plateletrich plasma, pneumoretinopexy. At admission, the maximum corrected visual acuity ranged from 0.01 to 0.1 in 40 % of patients, 0.2–0.5 in 60 % of patients. Of the 10 cases of macular holes observed: 3 lamellar holes, 2 holes of small diameter (up to 250 microns), 5 large holes (400 microns – 1000 microns). Results. After surgery with the use of PRP therapy, improvement in visual functions was observed in 7 cases, the maximum corrected visual acuity remained unchanged in 2 cases, in 1 case visual impairment was observed due to the development of a postoperative complication in the form of hemophthalmus, which was stopped with enzyme preparations. In all cases, after the operation, the anatomical integrity of the retina was restored, which was assessed by OCT through 1 month after the intervention. Conclusion. Thus, against the background of this therapy, there is an effective closure of the macular hole, a rapid restoration of the integrity of the retinal profile, visual functions, which indicates the effectiveness of the use of PRP in the practice of a vitreoretinal surgeon. Keywords: macular hole, PRP, hemophthalmus, vitrectomy.

Микроимпульсное лазерное лечение при осложнениях ретинальной артериальной макроаневризмы

Purpose. To evaluate the effectiveness of combined laser treatment of retinal arterial macroaneurysm (RAM). Material and methods. 9 patients (9 eyes) aged 61 to 85 years old with a diagnosis of RAM and macular edema (ME) were examined. All patients underwent combined laser treatment, including threshold laser coagulation perifocal the RAM zone and subthreshold micropulse laser (SML) in the areas of edema. Angio-OCT was perfomed a month later and, if residual edema was detected, SML was repeated without additional threshold laser coagulation. Results. The best corrected visual acuity increased by 47 % (0.55 ± 0.252), the NE thickness in the RAM zone decreased by 24 % (316 ± 46.4µm), MO – by 21% (276.3 ± 10.9µm) one month after laser treatment. Conclusion. The proposed combined method of RAM laser treatment allows not only to reduce the transudative activity of RAM, but also to stimulate the resorption of ME, which leads to an improvement in visual functions and stabilization of the retinal state. Keywords: retinal arterial macroaneurysm, laser coagulation, SML.

Topographic Outcomes in Keratoconus Surgery: Epi-on versus Epi-off Iontophoresis Corneal Collagen Cross-Linking.

Background: Corneal collagen cross-linking (CXL) has become the gold standard for mild and moderate stages to stop the progression of keratoconus. We analyzed some corneal topography indices to compare iontophoresis epi-on and iontophoresis epi-off techniques throughout a two-year follow-up. Methods: A total of 64 eyes of 49 patients who underwent CXL were recruited. In 30 eyes the epi-off technique was performed, whereas the remaining 34 eyes were treated with the epi-on technique. All patients underwent a complete ophthalmologic examination that included CDVA, central and thinnest corneal thickness, Schirmer test I, TBUT test, and the Ocular Surface Disease Index. Results: In both groups, a significant improvement in visual function was recorded. No statistically significant differences between Kmax, Mean K, Flat K, Steep K values were found. Statistically significant differences (p < 0.05) between the epi-on and epi-off groups’ pachymetry before and after 24 months follow-up as well as between the epi-on and epi-off groups’ topographically thinnest point in the immediate post-surgery and 24 months after surgery were recorded. Conclusion: Our study highlighted that both techniques are valid in mid-term corneal stabilization. The advantage of the new iontophoresis epi-off cross-linking technique could be found in a faster imbibing time of the cornea, therefore reducing surgical times, with a lower risk of complications.

Age- and sex-related variations of individual retinal layer thickness in the foveal center of healthy eyes

Alterations of the visual function during life are associated with changes in the morphological parameters of the outer retinal layers of the fovea. We evaluated age- and sex-related variations of the mean thicknesses of the different retinal layers at the central foveola which provides the maximal visual acuity. The vertical expansions of the following structures were measured on spectral-domain optical coherence tomographic images of 2944 healthy eyes of 1990 subjects with ages between 5 and 85 years: the total thickness of the retinal tissue, the thickness of the retinal pigment epithelium, the lengths of photoreceptors (receptor segments), photoreceptor outer segments (POS), and photoreceptor inner segments (PIS), and the thicknesses of the ellipsoid zone (EZ), myoid zone (MZ), external limiting membrane, outer nuclear layer, Henle fiber layer, and the horizontal layer of the Müller cell cone. We found diverse morphologies of the central photoreceptor layer with different thicknesses of the EZ and interdigitation zone lines. The mean total thickness of the retinal tissue at the central foveola showed three periods: it increased between 5 and about 41 years of age, displayed a plateau until about 52 years, and decreased continuously thereafter. Photoreceptors, POS, and PIS displayed their maximal mean lengths between 5 and about 36 years of age; the lengths decreased continuously between 36 and 85 years of age. Whereas the mean thickness of the EZ did not alter across the life span, the mean thickness of MZ displayed three periods: it increased between 5 and about 21 years of age, showed a plateau until about 36 years, and decreased considerably thereafter. Sex differences were observed for five parameters in eyes of subjects aging between 55 and 85 years. We suggest that the MZ thickness reflects the level of the metabolic activity of photoreceptors. The increase in the MZ thickness, likely reflecting increasing metabolic activity of photoreceptors, might contribute to the improvement of visual function in young subjects. The decrease of the MZ thickness in the fovea of elderly might reflect a decrease of the metabolic activity perhaps resulting from mitochondrial dysfunction which is known to occur in photoreceptors of aged eyes.

Optical Evaluation of Intracorneal Ring Segment Surgery in Keratoconus.

PurposeThe purpose of this study was to assess the impact of different intracorneal ring segments (ICRS) combinations on corneal morphology and visual performance on patients with keratoconus.MethodsA total of 124 eyes from 96 patients who underwent ICRS surgery were analyzed and classified into 7 groups based on ICRS disposition and the diameter of the surgical zone (5- and 6-mm). Pre- and postoperative complete ophthalmological examinations were conducted. Corneal geometry, volume, and symmetry were studied. Zernike polynomials were used to build a virtual ray-tracing model to evaluate optical aberrations and the Visual Strehl (VS).ResultsICRS induced significant flattening across the cornea, being more pronounced on the anterior (+0.38 mm, P < 0.001) than on the posterior (+0.15 mm, P < 0.001) corneal radius. Asphericity experienced a larger change for a 6-mm surgical zone diameter (from −1.23 ± 1.1 to −1.86 ± 1.2, P < 0.001) than for a 5-mm zone (from −1.99 ± 1.1 to −2.10 ± 1.5, P = 0.536). Mean astigmatism was reduced by 2.05 D (P < 0.001). Combination four was the most effective in reducing astigmatism. Coma decreased by 30% on average and combination one produced an average reduction by 51% (P < 0.05). Patients experienced significant improvement in visual performance, best corrected visual acuity increased from 0.57 ± 0.21 to 0.69 ± 0.21 and VS changed from 0.049 ± 0.02 to 0.065 ± 0.041.ConclusionsICRS combinations implanted within 5 mm diameter zone are more effective in flattening the cornea, whereas those implanted on 6 mm diameter are as effective in reducing astigmatism and are a good choice if the asymmetry and the intended flattening are smaller. Combinations with asymmetrical implants are the best option to regularize corneal surface.Translational RelevanceThis study uses methods and metrics of optical research applied to daily clinical practice.

A METHOD FOR MORPHOMETRIC ASSESSMENT OF PATHOLOGICAL CONDITIONS OF THE RETINA AND CHOROID BASED ON SCANS OF OPTICAL COHERENCE TOMOGRAPHY OF THE EYE

Optical coherence tomography (OCT) is a modern non-contact method of diagnostic examination which makes it possible to visualize a section of the retina as close as possible to its post-mortem histological section, and enables to distinguish individual layers of the human retina in a cross-section. The software pre-installed in such devices contains many different tools, but this is still not enough for a faster, more complete and accurate analysis of the obtained scans in order to make the correct diagnosis and choose the best treatment. There are more and more new and improved technologies for image processing in the world, which sets new tasks to develop additional software that can complement and expand the functionality of diagnostic equipment. This paper proposes a method of morphometric assessment of pathological conditions of the retina and chorioidea based on optical coherence tomography scans. This method is based on the algorithm for automated segmentation of the borders of the macular macular zone pathological focus, the algorithm for calculation of the area and volume of the pathological focus which together with other algorithms for analysis of the morphometric parameters of the human eye can be used for differential diagnostics of the pathological changes in the macular zone, for more precise diagnosis of the age-related macular degeneration (AMD) stage to prescribe a certain type and volume of treatment for stabilization and improvement of the central pontine visual functions.

Importance of Early Detection of Acute Angle Closure Glaucoma: A Case Report

Background: Acute Angle Closure Glaucoma is an ocular emergency that caused by a rapid increase in intraocular pressure due to outflow obstruction of aqueous humor. This condition can result visual losses that is irreversible so that early detection with the right diagnosis by general practitioner or ophthalmologist is vital to minimize the risk of permanent damage. We report the case of a patient who gained significant improvement after glaucoma surgery immediately after diagnosed with acute angle closure glaucoma in the ER. Case Presentation; A 53-year old female was presented with a chief complaint of throbbing pain and redness on both eyes (left eye (LE) at first, followed by right eye (RE)) for 3 days. She also had blurred vision, headache, and was unable to sleep due to the pain. Her presenting visual acuity (VA) was 20/80 in the RE and hand movements in the LE, with measured intraocular pressure (IOP) was 65 mmHg in the RE and 63 mmHg in the LE. After diagnosed with acute angle closure glaucoma and senile nuclear cataract on both eyes, a series of peripheral iridotomy laser followed with trabeculectomy was performed. Four weeks after the surgery, her VA is improved to 6/6 with corrected refraction and IOP is successfully lowered to 10mmHg on both eyes. Slit-lamp examination also showed an improvement of anterior chamber depth now that it is deep. Conclusion: Although degeneration of optic nerve due to glaucoma is deemed irreversible, our patient showed a significant improvement in visual function following surgery. Early detection and early intervention with surgery might play an important role in acute closure angle glaucoma to prevent further optic nerves damage and deterioration of visual function.

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length\u2009\u2265\u200930\xa0mm

To compare the efficacy of internal limiting membrane (ILM) flap covering to that of ILM flap insertion for the treatment of macular hole retinal detachment (MHRD) in highly myopic eyes with axial length (AL) ≥ 30 mm. We retrospectively analysed the medical records of 48 MHRD patients with high myopia (AL ≥ 30 mm). According to different surgical methods, the patients were divided into a covering group (23 eyes) and an insertion group (25 eyes). The rate of retinal reattachment and MH closure were compared between the two groups, and the related factors affecting the initial anatomical results were analysed. After primary vitrectomy and single silicone oil removal, there were 18 eyes (78.3%) in the covering group, and 20 eyes (80.0%) in the insertion group had retinal reattachment (P = 1.000). Moreover, 16 eyes (69.6%) in the covering group and 17 eyes (68.0%) in the insertion group had their MHs sealed (P = 0.907). The best-corrected visual acuity (BCVA) at 12 months and the improvement in BCVA postoperatively in the two groups were not statistically significant (P = 0.543, 0.955). Logistic regression analysis showed that elongated AL (OR = 1.844, 95% CI 1.037–3.280, P = 0.037) and higher choroidal atrophy (OR = 2.986, 95% CI 1.011–8.821, P = 0.048) were risk factors affecting initial anatomical success. For extremely high-myopia MHRD with AL ≥ 30 mm, ILM flap covering and insertion can both effectively seal the MH and promote retinal reattachment, but the visual function improvement may still be limited. The longer the AL and the higher the choroidal atrophy, the greater is the risk of initial anatomical failure.

The Effect of Ophthalmic Surgery for Graves' Orbitopathy on Quality of Life: A Systematic Review and Meta-Analysis.

Background: Graves' orbitopathy (GO) has a profound negative impact on quality of life. Surgery is undertaken to preserve vision, correct diplopia, and improve aesthetics. We sought to quantify the effect of different surgical approaches on quality of life. Methods: Electronic databases Ovid-MEDLINE and EMBASE were used from inception until March 22, 2021, to identify studies assessing quality of life pre- and postsurgical intervention for GO. Two reviewers independently extracted data and performed quality assessments. Random-effects and Bayesian models for meta-analyses were utilized. Results: Ten articles comprising 632 patients with a mean age of 48.4 years (range 16-85 years) were included. All used the Graves' Ophthalmopathy Quality of Life (GO-QOL) questionnaire. For GO-QOL appearance, the pooled standardized mean improvement for patients after surgery was +0.72 (95% confidence interval [CI 0.50-0.94]), I2 = 69% [CI 52-80%]. For GO-QOL visual functioning, the pooled standardized mean difference (SMD) for patients after surgery was +0.41 [CI 0.25-0.58], I2 = 60% [CI 36-74%]. For visual appearance, orbital decompression yielded the greatest improvement (SMD +0.84 [CI 0.54-1.13]) followed by eyelid surgery (SMD +0.38 [CI 0.05-0.70]), while strabismus correction had no significant effect (SMD +0.94 [CI -0.10 to 1.99]). Conversely strabismus correction was associated with the greatest improvement (SMD +1.25 [CI 0.29-2.21]) in visual functioning, outperforming orbital decompression (SMD +0.29 [CI 0.15-0.43]) and eyelid surgery (SMD +0.12 [CI -0.18 to 0.41]). A mean improvement in GO-QOL of greater than 10 points after orbital decompression surgery was achieved in 12/14 (86%) patient groups for appearance and 5/14 (36%) patient groups for visual functioning. A mean improvement of greater than 6 points was achieved in 5 of 6 (83%) patient groups for strabismus surgery for both appearance and visual functioning. A mean improvement of greater than 6 points after eyelid surgery was achieved in 2/3 (67%) patient groups and 0/3 patient groups for visual appearance and functioning, respectively. Conclusion: Ophthalmic surgery results in substantial improvements in quality of life in patients with GO, with greater perceived effects on appearance than visual function. Orbital decompression has particular impact on visual appearance; strabismus surgery may benefit both visual appearance and function equally, whereas eyelid surgery benefits appearance alone.

Роль довголанцюгових поліненасичених жирних кислот у харчуванні немовлят

Довголанцюгові поліненасичені жирні кислоти (ДЛПНЖК) є основними функціональними жирами материнського молока. Переважаючими та функціонально найважливішими ДЛПНЖК є арахідонова (АК) і докозогексаєнова кислота (ДГК). Крім імітації складу грудного молока, існують ще дві важливі причини, щоб додавати ДЛПНЖК у молочні суміші для немовлят. По-перше, немовлята не можуть синтезувати достатню кількість ДЛПНЖК, щоб компенсувати відсутність цих речовин у продуктах харчування. По-друге, тканина мозку, сітківка очей та імунна система потребують великої кількості ДЛПНЖК як будівельного матеріалу та функціональних складових, щоб підтримати інтенсивний ріст і розвиток у ранньому дитинстві. Цей період є критичним для формування та розвитку цих органів, тому оптимальне постачання субстратів є необхідним для їх оптимального функціонування. Ці ідеї в поєднанні з результатами понад 20 рандомізованих контрольованих клінічних випробувань і численних інших досліджень, що доводять позитивний вплив харчових ДЛПНЖК на здоров’я й розвиток немовлят, свідчать про необхідність збагачення продуктів дитячого харчування ДГК і АК. Найбільш вивченими позитивними ефектами такого збагачення є поліпшення зорової функції і когнітивного розвитку дітей раннього віку. Нові дані пов’язують підвищене споживання ДЛПНЖК із корисним впливом на імунні функції і серцево-судинну систему малюків.

To determine functional visual improvement after cataract surgery in eyes with age related macular degeneration

To determine whether patients with Age related macular degeneration (ARMD) benefit from cataract surgery in terms of best corrected visual acuity (BCVA) and to assess impact of surgery on progression of ARMD.: A prospective study was carried out of patients with and without ARMD undergoing cataract surgery at our department. Patients were divided into two groups- Group A (cases) with ARMD and Group B (controls) without ARMD and other retinal pathology. BCVA of cases was recorded on day 1, day 14, 1 month and 1/month and compared to that of controls.: BCVA significantly improved but markedly less than that experienced by control eyes. No increased incidence in progression to wet form of ARMD. Cataract surgery is safe in ARMD patients with no evidence of increased complications or rates of disease advancement.

Mesenchymal stem cell secretome protects against oxidative stress-induced ocular blast visual pathologies

Visual deficits are a common concern among subjects with head trauma. Stem cell therapies have gained recent attention in treating visual deficits following head trauma. Previously, we have shown that adipose-derived stem cell (ASC) concentrated conditioned medium (ASC-CCM), when delivered via an intravitreal route, yielded a significant improvement in vision accompanied by a decrease in retinal neuroinflammation in a focal cranial blast model that indirectly injures the retina. The purpose of the current study is to extend our previous studies to a direct ocular blast injury model to further establish the preclinical efficacy of ASC-CCM. Adult C57BL/6J mice were subjected to repetitive ocular blast injury (rOBI) of 25 psi to the left eye, followed by intravitreal delivery of ASC-CCM (∼200 ng protein/2 μl) or saline within 2–3 h. Visual function and histological changes were measured 4 weeks after injury and treatment. In vitro, Müller cells were used to evaluate the antioxidant effect of ASC-CCM. Visual acuity, contrast sensitivity, and b-wave amplitudes in rOBI mice receiving saline were significantly decreased compared with age-matched sham blast mice. Immunohistological analyses demonstrated a significant increase in glial fibrillary acidic protein (a retinal injury marker) in Müller cell processes, DNA/RNA damage, and nitrotyrosine (indicative of oxidative stress) in the retina, while qPCR analysis revealed a >2-fold increase in pro-inflammatory cytokines (TNF-α, ICAM1, and Ccl2) in the retina, as well as markers for microglia/macrophage activation (IL-1β and CD86). Remarkably, rOBI mice that received ASC-CCM demonstrated a significant improvement in visual function compared to saline-treated rOBI mice, with visual acuity, contrast sensitivity, and b-wave amplitudes that were not different from those in sham mice. This improvement in visual function also was associated with a significant reduction in retinal GFAP, neuroinflammation markers, and oxidative stress compared to saline-treated rOBI mice. In vitro, Müller cells exposed to oxidative stress via increasing doses of hydrogen peroxide demonstrated decreased viability, increased GFAP mRNA expression, and reduced activity for the antioxidant catalase. On the other hand, oxidatively stressed Müller cells pre-incubated with ASC-CCM showed normalized GFAP, viability, and catalase activity. In conclusion, our study demonstrates that a single intravitreal injection of ASC-CCM in the rOBI can significantly rescue retinal injury and provide significant restoration of visual function. Our in vitro studies suggest that the antioxidant catalase may play a major role in the protective effects of ASC-CCM, uncovering yet another aspect of the multifaceted benefits of ASC secretome therapies in neurotrauma.

Human Stem Cell Transplantation for Retinal Degenerative Diseases: Where Are We Now?

Background and Objectives: Irreversible visual impairment is mainly caused by retinal degenerative diseases such as age-related macular degeneration and retinitis pigmentosa. Stem cell research has experienced rapid progress in recent years, and researchers and clinical ophthalmologists are trying to implement this promising technology to treat retinal degeneration. The objective of this systematic review is to analyze currently available data from clinical trials applying stem cells to treat human retinal diseases. Materials and Methods: We performed a systematic literature search in PubMed to identify articles related with stem cell therapies to retinal diseases published prior to September 2021. Furthermore, a systematic search in ClinicalTrials (NIH U.S. National Library of Medicine) was performed to identify clinical trials using stem cells to treat retinal diseases. A descriptive analysis of status, conditions, phases, interventions, and outcomes is presented here. Conclusions: To date, no available therapy based on stem cell transplantation is approved for use with patients. However, numerous clinical trials are currently finishing their initial phases and, in general, the outcomes related to implantation techniques and their long-term safety seem promising. In the next few years, we expect to see quantifiable results pertaining to visual function improvement.

Effectiveness of refractive error correction for people with oculocutaneous albinism in South Indian population

Introduction: Albinism comes from ‘albus’, the Latin word meaning white, and refers to a group of hereditary disorders wherein the biosynthesis of the pigment melanin is absent or reduced. Oculocutaneous albinism (OCA) is a heterogeneous and autosomal recessive disorder that involves a lack of pigment in the skin, hair, and eyes, and is associated with ocular and visual defects such as photophobia, strabismus, nystagmus and low vision. Materials and Methods: This was a cross sectional descriptive community based study conducted at a tertiary care medical college hospital. The Department of Ophthalmology enrolled 39 subjects satisfying the inclusion criteria. The diagnostic criteria for OCA patients included in the study, were those having ocular features of iris transillumination and retinal hypopigmentation in addition to depigmentation of the skin, hair and nails. Results: 39 patients with OCA were included, mean age 20 years. The largest proportion of participants (40%) included those between 16 and 25yrs. Using World Health Organization classification based on best corrected distance visual acuity, 8%, 70%, 15% and 7% of 78 eyes had normal vision, moderate VI, severe VI and blindness respectively. Conclusion: There is high prevalence of refractive, non-refractive and mixed ophthalmic disorders among albinos. There was significant improvement in visual acuity and function following optical correction and alignment in people with albinism, despite overall subnormal acuity. Refractive correction should be encouraged for people with albinism.

Results of radiation therapy for optic nerve sheath meningioma

To assess the neuro-ophthalmic symptomatology of ONSM and how it changes in response to radiotherapy. In the period from 2004 to 2018, 112 patients with ONSM aged 17 to 76 years underwent stereotactic radiotherapy. In 91 patients, visual functions varied from light perception to 1.0; in 21 patients the affected eye was blind. The prospective follow-up of 103 patients lasted 6 months to 10 years (mean follow-up duration was 57 months). Studied patients underwent either conventional fractionated radiotherapy with Novalis (n=88) or hypofractionation radiotherapy with CyberKnife (n=24). According to ophthalmological examination, in 60.5% of cases an improvement of visual functions was observed, 39.5% of patients had visual functions remain stable at the initial level. No vision impairment during irradiation was detected. Vision deterioration in the long-term follow-up was observed in 2 patients: extended tumor growth in one case and radio-induced retinopathy in the other. The study showed that this method of treatment for ONSM is effective and safe, allowing preservation of visual functions and in some cases - its improvement, while tumor growth remains under control.

The effect of cross-linking procedure on corneal wavefront aberrations in patients with keratoconus

Background/Aim. Corneal cross-linking (CXL) treatment shows the best results in stabilizing the cornea and stopping the progress of the ectatic process. The aim of the study was to assess the impact of CXL on the keratoconus regarding higher-order aberrations (HOAs) and potential improvement of visual function. Methods. In 19 patients, a standard epithelium-off CXL was performed with an energy density of three mW/cm2 for half an hour. The cornea was examined by Pentacam topography before CXL and one and six months after CXL. Best-corrected visual acuity (BCVA), topographic data, and aberrations were collected. Results. A significant reduction in vertical coma was observed from preoperative -1.03 ? 1.89 to -0.74 ? 1.73 (p = 0.004) six months after CXL, and in spherical aberration from preoperative -0.22 ? 1.05 to -0.08 ? 1.13 (p = 0.002) six months after CXL. Root mean square (RMS) HOAs six months after CXL also significantly reduced from 2.31 ? 1.82 to 2.26 ? 1.84 six months after CXL (p = 0.001). BCVA improved from preoperative 0.43 ? 0.15 to 0.71 ? 0.19 six months after surgery (p &lt; 0.001). Conclusion. CXL is a very potent treatment method for keratoconus, which significantly reduces certain corneal wavefront aberrations, especially vertical coma, spherical aberration, and RMS, and leads to a significant improvement in visual acuity.