Non-myopic Patients Research Articles

Glutathione and a Pool of Metabolites Partly Related to Oxidative Stress Are Associated with Low and High Myopia in an Altered Bioenergetic Environment.

Oxidative stress forms part of the molecular basis contributing to the development and manifestation of myopia, a refractive error with associated pathology that is increasingly prevalent worldwide and that subsequently leads to an upsurge in degenerative visual impairment due to conditions that are especially associated with high myopia. The purpose of our study was to examine the interrelation of potential oxidative-stress-related metabolites found in the aqueous humor of high-myopic, low-myopic, and non-myopic patients within a clinical study. We conducted a cross-sectional study, selecting two sets of patients undergoing cataract surgery. The first set, which was used to analyze metabolites through an NMR assay, comprised 116 patients. A total of 59 metabolites were assigned and quantified. The PLS-DA score plot clearly showed a separation with minimal overlap between the HM and control samples. The PLS-DA model allowed us to determine 31 major metabolite differences in the aqueous humor of the study groups. Complementary statistical analysis of the data allowed us to determine six metabolites that presented significant differences among the experimental groups (p < 005). A significant number of these metabolites were discovered to have a direct or indirect connection to oxidative stress linked with conditions of myopic eyes. Notably, we identified metabolites associated with bioenergetic pathways and metabolites that have undergone methylation, along with choline and its derivatives. The second set consisted of 73 patients who underwent a glutathione assay. Here, we showed significant variations in both reduced and oxidized glutathione in aqueous humor among all patient groups (p < 0.01) for the first time. Axial length, refractive status, and complete ophthalmologic examination were also recorded, and interrelations among metabolic and clinical parameters were evaluated.

Vitrectomy results for rhegmatogenous retinal detachment with concomitant macular hole in non-myopic patients.

To report on results of PPV with ILM peeling in patients with RRD and concomitant, non-causal MH and to assess for preoperative associated conditions related to this type of RRD. Patients undergoing surgical repair for RRD between 2014 and 2021 were reviewed, and subjects with concomitant, non-causal, MH were identified. A minimum follow-up of 6 months was required. We studied post-operative macular status. Over 532 eyes operated, 11 had a concurrent non-causal MH. Macula-off RRD was present in 100% of these patients.10 eyes, operated with gas tamponade were included in postoperative analysis. Preoperative PVR B or superior was recorded in 86 eyes (16.6%) of the entire cohort and in 6 eyes (54.54 %) with RRD and concomitant MH (p=0.00001). Severe hypotony with choroidal detachment was present in 15 eyes (2.81%) of the entire cohort and in 3 eyes (27.27%) with RRD and concomitant MH (p=<0.00001). RRD with concomitant MH is an infrequent association. Retinal reattachment and anatomical hole closure can be achieved in most of cases but despite this fact, functional recovery is usually not good. Preoperative PVR is a more frequent finding in this group of patients, as well as severe hypotony with choroidal detachment.

Characterizing astigmatism in the United States.

To study astigmatism and astigmatism rule by (1) determining changes in prevalence in the United States between 1971 to 1975 and 1999 to 2008 and (2) identifying associations with demographic factors. National survey. Retrospective cross-sectional study. Participants of the 1971 to 1975 and 1999 to 2008 National Health and Nutrition Examination Survey (NHANES) aged 20 to 74 years representing the U.S population were included. The 1971 to 1975 NHANES measured astigmatism in participants using an algorithm based on presenting visual acuity, lensometry, and objective refraction. Similar methods were implemented using the 1999 to 2008 NHANES data for comparison. Prevalence of clinically significant astigmatism (≥1.0 diopters [D]) was identified, and logistic regression models were used to assess demographic associations with rule of astigmatism. A total of 3371 and 13 10 participants were included from the 1970s and 2000s NHANES. Main outcomes were prevalence estimates of astigmatism and odds ratios estimating associations with demographic characteristics. There was an increase in astigmatism from the 1970s to 2000s (14% [95% CI: 13.2-14.5] vs 24% [22.8-24.6], which was more pronounced in men (12% [10.8-12.7] vs 23% [21.9-24.2]) than in women (16% [14.9-16.8] vs 24% [23.0-25.7]). In adjusted analysis of the 2000s cohort, myopic patients had 8.34 (CI: 7.30-9.54) times greater odds of astigmatism than nonmyopic patients. In the 2000s, there was increased odds of against-the-rule (ATR) astigmatism in men (odds ratio [OR], 1.4; 95% CI: 1.1-1.8) compared with women, in nonmyopic patients (OR, 2.3; 95% CI: 1.7-3.1) compared with myopic patients, and in patients aged 60 to 74 years (OR, 3.7; 95% CI: 2.7-5.1) compared with those aged 20 to 39 years. There is greater prevalence of astigmatism and ATR astigmatism in 1999 to 2008 compared with 30 years before in the U.S. Factors associated with ATR astigmatism were being male, White, and nonmyopic.

ANALYSIS OF AQUEOUS HUMOR PROTEINS IN MYOPIC PATIENTS

Introduction: myopia is the most common eye disease in the world in with substantial social, educational and economic impact. Some studies have shown changes in aqueous humour proteins in myopic patients. To estimate total Aim: protein concentration, types of proteins in aqueous humour and the correlation with myopic patients. This is a Material and Methods: Prospective study conducted on 36 eyes of 36 patients attending Department of Ophthalmology, TRIHMS, Naharlagun, who were undergoing cataract operation. Group A served as a control group with 22 eyes of non myopic patients. Group B consisted of 14 eyes of 14 myopic patients having axial length more than 26mm.Aqueous humour collected from both the groups during cataract surgery was sent for Sodium dodecylsulfate polyacrylamide gel electrophoresis ( SDS-PAGE). Signicant diffe Result: rence in relative bands width (%) in the gel patterns in myopic and non myopic patient was seen.Myopic patients had higher magnitude of protein expressions /bands in molecular weights being 55kDa (Transthyretin), 69kDa ( Albumin) and 110kDa ( Vitamin-D binding protein) than non-myopic patients. In non myopic patients ,70-90 kDa (Heat shock Protein) were very highly expressed than myopic patients. Aqueous humour proteins were Conclusions: estimated to be different between myopic and non myopic patients signicantly. These proteins can be candidates for broadening of our existing knowledge of the pathophysiological characteristics of myopia. They may help in early diagnosis and monitoring of the myopic patients can be done. They may also help in deeper understanding of mechanism which cause axial elongation in myopia.

Cost-Effectiveness of Limited Vitrectomy for Vision-Degrading Myodesopsia

Patients afflicted with clinically significant vitreous floaters suffer from vision-degrading myodesopsia, characterized by impairment in contrast sensitivity function (CSF) and decreased quality of life. This study determined the cost-effectiveness of limited vitrectomy for this condition. Retrospective, interventional case series and third-party insurer cost-utility analysis. Sixty-seven patients suffering from unilateral vitreous floaters (20 non-myopic patients with posterior vitreous detachment [PVD]; 17 myopic patients [>-2 diopters] without PVD; 30 myopic patients with PVD) completed the National Eye Institute Visual Function Questionnaire (VFQ-39) and were tested with best-corrected visual acuity (BCVA) and CSF measurements before and after limited vitrectomy. A reference case cost-utility analysis was performed. The mean VFQ-39 increased 19% (P < 0.00001) after surgery, with general vision improving 27% for the entire group and 37% for non-myopic PVD (P < 0.00001 for each). VFQ-39 correlations with time tradeoff utilities indicated a 14.4% improvement in quality of life. Mean BCVA improved 13.5% postoperatively (P < 0.00001) and CSF improved 53% (P < 0.00001). The incremental patient value gain conferred by limited vitrectomy was 2.38 quality-adjusted life-years (QALYs), and the average cost-utility ratio in 2018U.S. real dollars was $1,574/QALY. Limited vitrectomy for vision-degrading myodesopsia is clinically effective, in that it improves BCVA, CSF, and patient well-being. It is also highly cost-effective ($1,574/QALY), with an average cost-utility ratio vs. no therapy that is superior to cataract surgery ($2,262/QALY), amblyopia therapy ($2,710/QALY), and retinal detachment repair ($45,304/QALY). Myopic patients without PVD had the lowest cost-utility ratio of all ($1,338/QALY).

Intereye comparison of ocular factors in normal tension glaucoma with asymmetric visual field loss in Korean population.

PurposeTo identify ocular parameters corresponding to asymmetric visual field (VF) loss in normal tension glaucoma (NTG) through intereye comparisons.Patients and methodsMedical records of NTG patients with asymmetric and symmetric VF losses were retrospectively reviewed. The criterion for asymmetry in VF was 6 dB difference of mean deviation. Refractive error, intraocular pressure (IOP), central corneal thickness, ovality index, and peripapillary atrophy (PPA)/disc area ratio were obtained from each patient. Intereye comparison was performed for asymmetric group, symmetric group, and myopic and nonmyopic asymmetric subgroups.ResultsWe included 155 patients; 110 patients in asymmetric group and 45 patients in symmetric group. In intereye comparison for total asymmetric group, refractive error (P = 0.006), initial IOP (P = 0.001), ovality index (P = 0.008), and PPA (P < 0.001) were significantly asymmetric. For myopic subgroup, refractive error (P = 0.004), ovality index (P = 0.001), and PPA (P = 0.003) were significant factors. For nonmyopic subgroup, initial IOP (P = 0.003) and PPA (P = 0.007) were significant factors. Symmetric group showed no significant difference between the eyes. Multivariate analysis demonstrated that refractive error (P = 0.002) and PPA (P = 0.028) were significant factors in myopic subgroup, and initial IOP (P = 0.022) and PPA (P = 0.002) were significant factors in nonmyopic subgroup.ConclusionsIn this intereye comparison, the more myopic eye in myopic NTG patient, and the more pressured eye in nonmyopic NTG patient demonstrated more severe VF loss. Myopic and nonmyopic patients may follow different pathophysiologic processes. Discriminative attentions should be paid to NTG patients by subtypes.

Heavy eye syndrome versus sagging eye syndrome in high myopia

Heavy eye syndrome (HES) presents with esotropia and limited abduction due to superotemporal globe shift relative to the extraocular muscles. Sagging eye syndrome (SES) was originally described in nonmyopic patients exhibiting distance esotropia and cyclovertical strabismus with limited supraduction due to lateral rectus muscle inferodisplacement caused by degeneration of the lateral rectus-superior rectus (LR-SR) band. We hypothesized that SES might also cause strabismus in high myopia. Eleven strabismic subjects with high myopia underwent ophthalmological examination and orbital magnetic resonance imaging (MRI) to assess quantitative orbital anatomy. Of 11 subjects, 5 had HES; 6, SES. Mean axial length in subjects with HES was 32± 5 mm; in subjects with SES, 32 ± 6 mm. Average distance esotropia in subjects with HES was 61(Δ) ± 39(Δ); hypotropia was 26(Δ) ± 21(Δ). Average distance esotropia in subjects with SES was 23(Δ) ± 57(Δ); hypertropia was 2(Δ) ± 2(Δ). All 5 subjects with HES had superotemporal globe prolapse; the LR-SR band was thinned in 6 orbits and ruptured in 2. The mean angle between the lateral rectus and superior rectus muscles in HES was 121° ± 7°. In SES the LR-SR band was thinned in 7 orbits and ruptured in 5, with superotemporal soft tissue prolapse. The mean angle between the lateral rectus and superior rectus muscles was 104° ± 11°, significantly less than in HES (P < 0.001). SES occurs in highly myopic patients who also exhibit less relative globe dislocation than in HES. Unlike HES, SES exhibits superotemporal soft tissue prolapse that may limit superotemporal globe shift. The distinction is important because surgery for HES uniquely requires creation of a surgical connection between the superior rectus and lateral rectus muscles, whereas SES may be treated with conventional surgery. SES can cause strabismus in high axial myopia. Orbital MRI is useful in differentiating SES from HES.

Evaluation of the orientation of the steepest meridian of regular astigmatism among highly myopic Egyptian patients seeking non-ablative surgical correction of the refractive error.

Introduction:LASIK surgery is currently the preferred procedure to correct low to moderate myopia. The aim of this study was to determine the orientation of the steepest meridian of regular astigmatism in order to determine the relative incidence of vertical, horizontal, and oblique regular astigmatism among highly myopic Egyptian patients seeking non-ablative surgical correction of the refractive error.Methods:One hundred and one eyes of 68 highly myopic patients who were seeking refractive surgery were included in this consecutive case series study. The refractive errors were measured using an autorefractometer and confirmed by trial. We measured the uncorrected and best corrected visual acuity in Snellen lines. Keratometry, central corneal thickness, and anterior chamber depth also were measured. The cylinder power in diopters and the axis in degrees were reported. Astigmatism was graded as with the rule (i.e., vertical meridian steeper), against the rule (i.e., horizontal meridian steeper), and oblique astigmatism. The number and the percentage of eyes with the rule, against the rule, and oblique astigmatism were calculated, and the chi-squared test was performed to analyze the data.Results:The spherical refractive error ranged from −6.5 to −24.5 diopters (−13.45 ± 4.60). The cylinder power (Cyl) ranged from −0.25 to −7.5 diopters (−2.23 ± 1.28). The uncorrected visual acuity (UCVA) in Snellen lines ranged from 0.01 – 0.1 (0.03 ± 0.02). The mean for best corrected visual acuity (BCVA) in Snellen lines was 0.40 (± 0.23). The steepest meridian was vertical (i.e., with-the-rule astigmatism) in 44 eyes (43.56%), horizontal (i.e., against-the-rule astigmatism) in 27 eyes (26.73%), and oblique (i.e., oblique astigmatism) in 30 eyes (29.70%).Conclusions:The incidence of with-the-rule astigmatism in patients with high myopia was found to be much lower than in previous studies for non-myopic patients, with a higher incidence for against-the-rule astigmatism and oblique astigmatism.

Incidence, Risk Factors, and Impact of Age on Retinal Detachment after Cataract Surgery in France: A National Population Study

To assess the incidence, risk factors, and impact of age on retinal detachment (RD) after cataract surgery. Cohort study. All patients older than 40 years of age who underwent a primary cataract surgery in France between January 2009 and December2012. A Cox proportional-hazard regression model was used to analyze risk factors of RD after cataract surgery. Risk factors of RD after cataract surgery. Over 4 years, 2680167 eyes in 1787021 patients (59.4% women; mean age, 73.9±9.5 years) underwent cataract surgery. A total of 11 424 patients experienced RD after cataract surgery, with an estimated risk of 0.99% at 4 years after surgery. The odds ratio associated with increased risk of RD was 3.87 (95% confidence interval [CI], 3.79-3.95) for cataract surgery itself. The multiadjusted hazard ratio (HR) associated with increased risk of RD was 5.22 (95% CI, 5.05-5.39) for patients 40 to 54 years of age, 3.69 (95% CI, 3.60-3.79) for those 55 to 64 years of age, and 1.98 (95% CI, 1.93-2.03) for those 65 to 74 years of age as compared with those 75 years of age or older. Retinal detachment was associated with high myopia (HR, 6.12; 95% CI, 5.84-6.41), vitrectomy for perioperative capsular rupture (HR, 4.36; 95% CI, 4.07-4.68), history of eye trauma (HR, 3.98; 95%CI, 3.69-4.30), extracapsular extraction (HR, 3.11; 95% CI, 2.94-3.30), male gender (HR, 2.39; 95% CI, 2.35-2.44), and history of diabetes (HR, 1.18; 95% CI, 1.15-1.21). In myopic patients, the multiadjusted HR associated with increased risk of RD was 25.02 (95% CI, 24.76-25.18) for patients 40 to 54 years of age, 20.37 (95% CI, 20.21-20.53) for those 55 to 64 years of age, and 17.05 (95% CI, 16.85-17.25) for those 65 to 74 years of age as compared with nonmyopic patients 75 years of age or older. We provide a hierarchy of risk factors for RD onset: high myopia, young age, capsular rupture, history of eye trauma, extracapsular extraction technique, male gender, and diabetes. Young age was an additional risk factor in myopic patients.

Comparison of localized retinal nerve fiber layer defects in highly myopic, myopic, and non-myopic patients with normal-tension glaucoma: a retrospective cross-sectional study

BackgroundThe purpose of this study was to evaluate the relationship between patterns of localized retinal nerve fiber layer (RNFL) defects and the degree of myopia in patients with normal-tension glaucoma (NTG).MethodsWe retrospectively reviewed medical records of patients with high myopia (42 eyes; spherical equivalent [SE] < −6.0 diopters [D]), low to moderate myopia (93 eyes; SE −6.0D ~ and −0.5D), and emmetropia (65 eyes; SE −0.5D ~ +0.5D), all of which were diagnosed as having NTG with localized RNFL defects. On RNFL photographs, the proximity of the RNFL defect to the center of the fovea (angle I) and the sum of the angular width of the defects (angle II) were determined. The patterns of localized RNFL defects were then compared with respect to differences in angles I and II.ResultsAngle I was significantly smaller in the high myopia group than in the low to moderate myopia group (p = 0.028) and the emmetropia group (p = 0.044), while angle II was significantly larger in the high myopia group compared with the low to moderate myopia group and the emmetropia group (p < 0.001, p = 0.007).ConclusionsAmong subjects with NTG, localized RNFL defects are wider and closer to the fovea in eyes with high myopia than those with low to moderate myopia or emmetropia.

Computer‐assisted dosage calculation for strabismus therapy in myopic patients

The published dosage recommendations for the surgical correction of horizontal strabismus in non-myopic patients show large, unexplained differences. For patients with high myopia, the situation becomes even more complex because the increase in the size of the bulb also affects the geometry of the oculomotor muscles. In this study, we wanted to investigate whether computer simulations of the oculomotor plant can be used to find accurate surgical parameters. In a retrospective study, we investigated pre- and postoperative strabismus patterns in 13 patients affected by convergent (seven patients) or divergent (six patients) strabismus and high myopia. Postoperative checks were made 1 day, 1 week, 3 months and 1-6 years after the operation. For each patient, we simulated the presurgical strabismus pattern with SEE++ (see 'Further Information' for manufacturer details), a biomechanical simulation program of the oculomotor plant. The individual results of the simulations were then compared to the measured postoperative strabismus patterns. We found a trend of under-correction in the postoperative situation, resulting in four patients having a large remaining strabismus angle of more than 5 degrees. The computer simulations were able to reproduce this under-correction, and suggested an increase in dosage. We conclude that realistic biomechanical simulations of the oculomotor plant can predict the postoperative result for myopic patients accurately. The results of the computer simulation correlate well with the postoperative outcome of the patient.

Lipid peroxidation products in human subretinal fluid

The concentrations of thiobarbituric acid reacting substances (TBARS) and proteins in the subretinal fluid (SF) of patients undergoing retinal detachment surgery have been determined. We have tried to establish the correlations between these biochemical and other clinical features of these patients: evolution time of the retinal detachment, age, degree of myopia, and macular affection. Caucasian patients, 19 men and 19 women (57.42 ±12.85 average age, interval 20–80) were randomly selected for this study. SF samples were obtained by puncture after scleral indentation. TBARS and protein concentrations were determined by the corresponding colorimetric assays. A linear correlation exists between TBARS and protein contents in these samples. No correlation could be established between evolution time of the retinal detachment and TBARS content in SF. TBARS in SF increases with increasing age in nonmyopic patients. In the samples of myopic patients the correlation was established between TBARS content and degree of myopia. The group of patients with more than 10 dioptres show a significant higher TBARS concentration in SF than any of the other groups studied. It can be concluded that lipid peroxidation products in SF originate, at least partially, from rod outer segments, and that lipid peroxidation is a process that might play a role in the pathogenesis of retinal detachment, specially in myopic patients.

P 393 Lipid peroxidation products in subretinal fluid of myopic and non-myopic patients with retinal detachment

P 393 Lipid peroxidation products in subretinal fluid of myopic and non-myopic patients with retinal detachment

Lipid peroxidation products in subretinal fluid of myopic and non-myopic patients with retinal detachment.

Lipid peroxidation products in subretinal fluid of myopic and non-myopic patients with retinal detachment.