Ocular Examination Research Articles

ABCA4 Deep Intronic Variants Contributed to Nearly Half of Unsolved Stargardt Cases With a Milder Phenotype.

The purpose of this study was to investigate the contribution and natural progression of ABCA4 deep intronic variants (DIVs) among a Chinese Stargardt disease (STGD) cohort. For unsolved STGD probands, DIVs in ABCA4 were detected by next-generation sequencing, and splicing effects were evaluated by in silico tools and validated through minigene experiments. Comprehensive ocular examinations, especially fundus changes, were carried out and analyzed. These and long-term follow-up data were compared with data of patients carrying biallelic coding variants of ABCA4. Seven DIVs in ABCA4 were identified in 18 of 40 (45.0%) unsolved STGD probands, involving 2 novel and 5 known variants. Four DIVs were confirmed to effect splicing through minigene assay. The c.161-395G>A was the most prevalent DIV allele (30.6%, 11/36). In the early 5-year duration, localized maculopathy was predominant, accounting for 51.9% (14/27) of fundus recordings. Expanded macular lesion within the vascular arch, with or without flecks, was observed in 75.0% (12/16) of recordings beyond the 5-year duration, whereas generalized retinal dystrophy was rarely observed. Compared with those in the non-DIV group, the patients in the DIV group manifested milder fundus change at all disease stages (P < 0.05). Follow-up visits utilizing wide-field fundus autofluorescence (FAF) further validated the slower development of lesions. Optical coherence tomography angiography (OCTA) documented a gradual reduction in perfusion in each layer's capillaries and high-reflective deposits below the sub-RPE layer. DIVs contribute to nearly half of STGD cases with missing heritability, totally occupying 7.8% of all STGD families. Based on optimized grading criteria, patients with DIV alleles manifested localized macular lesions with slow progress. The amount of residual correctly spliced mRNA might play a role, suggesting that adding or enhancing normal ABCA4 expression might be a potential approach of intervention.

A Comprehensive Review of Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome

Background: Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare autoimmune disorder, characterized by acute tubulointerstitial nephritis and uveitis. It poses diagnostic challenges due to the mostly asynchronous onset of renal and ocular manifestations, as well as the variety of differential diagnoses. This review provides an overview of the epidemiology, pathogenesis, clinical features, diagnostic criteria, and management strategies. Methods: A comprehensive review of the peer-reviewed literature, including studies and case reports, was conducted. Results: The etiology of TINU syndrome involves an autoimmune reaction to renal and ocular antigens, leading to interstitial inflammation and tubular damage in the kidneys, and anterior uveitis with acute onset of flares. Diagnostic criteria based on ocular examination, laboratory parameters, and renal biopsy emphasize the need to exclude other systemic diseases. TINU syndrome accounts for approximately 2% of all uveitis cases. Primary treatment consists of corticosteroids, while immunomodulatory therapies (methotrexate, azathioprine, mycophenolate mofetil, or biologic agents) are reserved for refractory cases. Recurrence of uveitis appears to be more common than that of nephritis. Conclusions: TINU syndrome is rare and requires clinical suspicion for accurate diagnosis. Early diagnosis and initiation of treatment are crucial for achieving favorable outcomes. Advances in the understanding of its pathogenesis and treatment have improved patient outcomes. Further research is needed to investigate the underlying triggers and mechanisms in order to develop targeted therapies.

Analysis of the effect of congenital unilateral trochlear nerve paresis on retinal vascular density: a retrospective study.

To use swept-source optical coherence tomography angiography (SS-OCTA) to investigate the alterations in retinal vascular density (VD) in patients presenting with congenital unilateral trochlear nerve palsy. The medical records of patients diagnosed with congenital unilateral trochlear nerve palsy and those of a healthy control group were reviewed retrospectively. Comprehensive ocular examinations and SS-OCTA imaging were conducted. The study population was divided into three subgroups of eyes: paretic eyes, fellow eyes, and controls. All participants underwent comprehensive ophthalmic examinations, which included assessments of ocular motility, refraction under cycloplegia, and axial length measurement. Various strabismus tests-the cover-uncover test, prism and alternate cover test, Krimsky test, and Parks-Bielschowsky test-were conducted to confirm the diagnosis and evaluate the extent of the condition. A total of 34 patients and 39 healthy controls were included. Sex and age distributions were similar between groups. Significant differences were observed in central VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) between paretic eyes, fellow eyes, and control eyes. The fellow eye exhibited lower central VD compared to the paretic and control eyes. Inverse correlations between deviation angle and VD were noted in different SCP and DCP quadrants in paretic eyes. In our study cohort, there were significant changes in retinal VD in fellow eyes of patients with trochlear nerve palsy, which we speculate may be related to compensatory head position.

Topographic factors associated with anterior chamber angle narrowing in patients with keratoconus.

To identify topographic determinants of the anterior chamber angle (ACA) in patients with keratoconus (KCN). Four hundred and ten eyes of 294 patients with KCN were recruited for this study. First, complete ocular examinations were performed for all patients, including visual acuity measurement, refraction, and slit-lamp biomicroscopy. Then, all participants underwent corneal imaging by the Oculus Pentacam HR. The mean age of the participants was 32.40±8.52y (15-60y) and 69.5% of them were male. The mean ACA was 38.47°±5.75° (range: 14.40° to 56.50°) in the whole sample, 38.24°±6.00° in males, and 38.98°±5.11° in females (P=0.447). The mean ACA was significantly different among different groups of cone morphology, as patients with nipple cones showed the lowest mean ACA. Moreover, there were statistically significant differences in the mean ACA among different groups of cone locations, with patients having central cones exhibiting the lowest mean ACA (P<0.001). Anterior and posterior Q values were significantly, directly correlated with ACA (anterior Q: r=0.122, P=0.014, posterior Q: r=0.192, P<0.001). This study provides critical insights into the risk factors for ACA narrowing in KCN patients, which is essential for planning intraocular surgeries. Patients with nipple and central cones exhibited the most significant ACA narrowing. Additionally, more negative Q-values are associated with increased ACA narrowing, highlighting the need for targeted diagnostic and therapeutic strategies.

A prospective self-controlled study on the alterations of the ocular surface and conjunctival transcriptomic profile associated with prolonged exposure to video display terminals.

To assess the impact of prolonged and intense exposure to video display terminals (VDTs) on ocular surface homeostasis. 30 subjects limited daily VDT usage to less than 3h for one week, then extended usage to more than 8h/day for the next three weeks. Ocular symptoms and signs were evaluated weekly using the Ocular Surface Disease Index (OSDI) questionnaire and clinical examinations. Eyelid margins and meibomian glands were examined, and ocular surface samples were collected for transcriptomic analysis. Average daily VDT time increased from 2.55±0.46h initially to 11.17±2.45, 11.75±2.63, and 10.89±2.41h over three weeks. The dry eye diagnosis rate rose from 6.67% to 51.67%. Total OSDI score (P=0.008), symptoms score (P=0.014), and visual function score (P=0.002) significantly increased. Mean fluorescein break-up time (FBUT) decreased from 6.46s to 3.08s. Corneal fluorescein staining (CFS) score (P<0.001) and lissamine green conjunctival staining (LCjs) score (P=0.036) worsened. Ocular redness index (RI) increased at 1 week and 3 weeks (P=0.007, P=0.001). Telangiectasia scores of both upper and lower eyelid margins increased at 3 weeks (P=0.002, P<0.001). Meibomian gland orifice blockage worsened (P=0.014, P=0.002). Transcriptomic analysis revealed dynamic alterations in ocular surface gene expression, including inflammatory and hormonal responses. MUC5AC and TFF1 genes showed negative correlations with OSDI and conjunctival staining score, respectively. Prolonged VDT exposure deteriorates ocular surface symptoms and signs, with significant inflammatory responses and hormonal activity indicating an imbalance in ocular surface homeostasis.

Photopsias are associated with greater levels of depression and anxiety

ABSTRACT Clinical relevance Vitreous floaters have been associated with depressive and anxiety symptoms. However, there is a scarcity in the literature regarding the possible impact of vitreous flashes on the psychological status of the patients. Background Photopsias and vitreous floaters frequently co-exist. Floaters have been accompanied by exacerbated levels of depression and anxiety. The aim of this study was to examine whether the presence of photopsias in patients suffering from vitreous floaters is accompanied by exacerbated levels of anxiety and depression. Methods One hundred and four patients complaining of floaters were included in the study; 51 experienced also photopsias and 53 did not. A comprehensive ocular examination, including funduscopy and optical coherence tomography scans was performed to every patient, while their clinical and demographic data were also assessed. Every participant completed the PHQ-9, the Zung SDS, and the HADS anxiety and depression questionnaires. Results The clinical and demographic data did not differ significantly between the study groups (p > 0.05).The scores of every questionnaire were significantly higher among the patients with vitreous flashes (p < 0.05 for all). After adjustment for several confounders, the values remained significantly impaired. Conclusion Photopsias negatively affect the psychological and mental well-being of the patients, by the terms of amplified levels of depression and anxiety. These findings underscore the necessity for a more holistic approach to managing patients presenting with vitreous flashes.

A patient with TPCN2-related hypopigmentation and ocular phenotype.

Pigmentation is orchestrated by hundreds of genes involved in cellular functions going from early developmental fate of pigment cells to melanin synthesis. The Two Pore Channel 2 (TPC2) a Ca2+ and Na+ channel acidifies melanosomal pH and thus inhibits pigmentation. A young patient was recently reported with generalized hypopigmentation but uneventful ocular examination, caused by the de novo heterozygous TPCN2 variant c.628C>T;p.Arg210Cys that constitutively activates TPC2. Here we report a young patient with the same de novo variant presenting with generalized hypopigmentation, and ophthalmologic features including low grade retinal hypopigmentation and foveal hypoplasia, photophobia, mild hypermetropia, and astigmatism, which are features of albinism. Skin fragility and episodes of fever with diarrhea and fatigue were also observed. This extends the phenotype of patients with TPCN2 variants, warranting further investigations in patients with alterations of this gene, and raises the question whether TPCN2 might be considered as an albinism gene.

Ocular examinations before and after total ear canal ablation and bulla osteotomy can help recognize and prevent potential vision-threatening abnormalities in cats and dogs.

To report ocular examination findings before and after total ear canal ablation and lateral bulla osteotomy (TECALBO) and ventral bulla osteotomy (VBO) in cats and dogs. At The Ohio State University and MedVet Columbus, ophthalmic examinations were performed on client-owned animals for which a TECALBO or VBO was indicated. Examination findings and postoperative complications relating to ophthalmic and/or neuro-ophthalmic diseases were recorded prior to surgery (T0) and at 1 day (T1), 2 to 3 weeks (T14), and ± 2 months (T60) postoperatively. 28 dogs and 22 cats underwent 43 TECALBO and 20 VBO surgeries (63 ears). Reasons for surgery included otitis (52.4%), polyps (30.1%), and aural masses (17.5%). Facial nerve deficits were observed preoperatively in 5.7% of surgeries and postoperatively in 47.2% at T1 and 31.3% at T14. Horner syndrome was present preoperatively in 11.3% and postoperatively in 45.3% at T1 and 37.5% at T14. Keratoconjunctivitis sicca and corneal ulcers were noted, respectively, in 5.7% and 3.8% of cases at T0 and 5.7% and 17% at T1. Facial nerve deficits and Horner syndrome remained present in 29% (5 of 17) and 36% (5 of 14) at T60. One dog with preoperative facial nerve paralysis and Horner syndrome developed a descemetocele that required a conjunctival flap at T14. Overall, 64.2% of surgeries led to ocular and/or neuro-ophthalmic changes postoperatively. Cats and dogs undergoing TECALBO and VBO procedures should have thorough ophthalmic examinations preoperatively and postoperatively, as ocular and neuro-ophthalmic abnormalities are common in these patients. Ocular examinations are important in animals undergoing aural surgeries in order to reveal ocular abnormalities that could require follow-up care or lead to vision-threatening conditions.

Management of a case of stromal herpetic keratitis

Aims/Purpose: To present a case study of stromal herpetic keratitis (SHK) and emphasize the importance of accurate differential diagnosis and appropriate therapeutic approaches in primary care settings.Methods: A detailed anamnesis and ocular examination were conducted, including fluorescein staining to identify dendritic corneal ulcers indicative of herpetic keratitis (HK). The patient was followed closely with a combination of antiviral and corticosteroid therapy.Results: A 20‐year‐old woman presented with 72 hours of left eye redness, pain, tearing, and vision loss. No traumatic history was reported, but a recent herpetic lesion on the upper lip was noted. Clinical examination revealed significant conjunctival hyperemia and a characteristic dendritic lesion on the cornea. Detailed examination with a slit lamp showed a central dendritic ulcer stained with fluorescein and peripheral infected cells stained with rose Bengal, alongside a focal stromal inflammation. These findings confirmed the diagnosis of SHK. Follow‐up revealed resolution of the stromal inflammation and closure of the dendritic epithelial defect.Conclusions: The case underscores the critical need for accurate diagnosis of HK subtypes, as SHK requires specific treatment with topical corticosteroids in addition to antiviral therapy. Clinical guidelines indicate that the benefits of corticosteroid use in SHK outweigh the risks, though close monitoring is essential to mitigate adverse effects such as increased intraocular pressure and cataract formation. This case highlights the importance of prompt specialist referral when primary care practitioners encounter complex ocular presentations, ensuring timely and appropriate management to prevent irreversible vision loss.References Guidelines for Ocular Herpes Management. SECOIR Monography: Update on Corneal Infections. Chapters 7 and 11.

Association of ABO and Rh blood groups with retinal structural indices

Purpose: To determine the association between ABO and Rh blood groups with retinal structural indices including macular thickness and peripapillary retinal nerve fiber layer thickness.Methods: This cross‐sectional study was conducted using convenience sampling in a tertiary referral eye hospital in Tehran, Iran. Study participants were referred to the hospital laboratory to test their blood group. Ocular examinations were performed including measurement of visual acuity, auto‐refraction, subjective refraction, and slit‐lamp biomicroscopes. Retinal imaging was carried out using Spectral‐domain optical coherence tomography under dilated papillary conditions.Results: According to the multiple linear regression model, the global retinal nerve fiber layer thickness [coefficient: ‐3.05 (95% confidence interval: ‐5.30 to ‐0.74); p = 0.010] and retinal nerve fiber layer thickness in the superior [coefficient: ‐4.65 (95% confidence interval: ‐8.40 to ‐0.89), p &lt; 0.001] and inferior [coefficient: ‐4.00 (95% confidence interval: ‐7.81 to ‐0.19); p = 0.040] quadrants were significantly thinner in individuals with blood type B compared to those with other ABO blood groups. The average [coefficient: 12.69 (95% confidence interval: 4.12‐21.64); p = 0.004) and central [coefficient: 16.21 (95% confidence interval: 6.44‐25.97); p = 0.001) macular thicknesses were significantly thicker in AB group compared to other blood groups. The average macular thickness was significantly thinner in Rh+ compared to the Rh‐ group [coefficient: ‐8.33 (95% confidence interval: ‐15.4 to ‐1.25); p = 0.021].Conclusions: Retinal structural indices are related to blood groups implying a genetic linkage. Clinicians should consider blood groups in the clinical evaluation of retinal structural indices to avoid misdiagnoses. It is also recommended that the optical coherence tomography devices include the blood group in their databases.

Investigation on the relationship between disc hemorrhage and primary open‐angle glaucoma using genome‐wide association study

Aims/Purpose: To investigate the genetic loci related of disc hemorrhage (DH) using genome‐wide association studies (GWAS) and the causal association between DH and primary open‐angle glaucoma (POAG) in East Asian population.Methods: The GWAS was conducted on 8,488 Koreans who underwent ocular examination and fundus photography to determine the presence of DH and POAG. After identifying significant single nucleotide polymorphisms (SNPs) associated with DH, we conducted an analysis to determine the heritability and genetic correlation for DH and POAG. The SNPs discovered in the current research were utilized as instrumental variables (IVs) for the two‐sample Mendelian randomization (MR) analysis. The POAG outcome dataset was validated using Biobank Japan data (n = 179,351), which comprise the East Asian population.Results: We found that the rs62463744 (TMEM270;ELN), rs11658281 (CCDC42) and rs77127203 (PDE10A;LINC00473) were SNPs associated with DH. The SNP heritability of DH was estimated as 6.7% with showing the absence of the genetic correlation with POAG. The MR analysis using 9 SNPs as IVs, revealed that the causal association of DH on POAG for East Asian population was not present using IVW method [odd ratio (OR) = 1.01, p = 0.69].Conclusions: The novel loci underlying DH in Korea cohort revealed SNPs in the ELN, CCDC41 and LINC00473 genes. However, the causal effects of DH on the risk of glaucoma were not found. These absence of the causal association with DH on POAG implies that the current understanding of DH is a risk factor for glaucoma, warranting further investigations.

Topographic determinants of anterior chamber angle narrowing in patients with keratoconus

Purpose: To identify topographic determinants of the anterior chamber angle in a sample of patients with keratoconus.Methods: Two hundred patients who visited a tertiary eye hospital and were diagnosed with keratoconus, were recruited for this study. First, complete ocular examinations were performed for all patients, including measurement of uncorrected distance visual acuity, objective and subjective refraction, and slit‐lamp biomicroscopy. Then, all study participants underwent corneal imaging by the Pentacam rotating Scheimpflug imaging system. The keratoconus was diagnosed based on distorted keratometric mires, scissoring of retinoscopic reflex, abnormal corneal topography (inferior‐superior asymmetry, focal or inferior steepening, or a bow‐tie pattern with skewed radial axes &gt; 21°) consistent with keratoconus as well as the presence of at least one keratoconus biomicroscopic sign.Results: The mean age of study participants was 32.40± 8.52 years (15‐60 years) and 69.5% of them were male. No statistically significant difference was found in the anterior chamber angle between males and females (p‐value = 0.447). There was a statistically significant inverse correlation between anterior chamber angle and age (r = ‐0.262, p‐value &lt; 0.001). The mean anterior chamber angle was significantly different among different groups of cone morphology; patients with nipple cone had the lowest mean anterior chamber angle (p‐value = 0.001). Moreover, there was a statistically significant difference in the mean anterior chamber angle among different groups of cone location; the lowest mean anterior chamber angle belonged to patients with central cones (p &lt; 0.001). Anterior and posterior Q‐values were significantly directly correlated with anterior chamber angle (anterior Q: r = 0.122, p‐value = 0.014, posterior Q: r = 0.192, p‐value &lt; 0.001).Conclusions: Keratoconus patients with nipple and central cones and more negative Q‐values were more prone to anterior chamber angle narrowing. It is recommended that the risk of angle closure be taken into account in this group of patients for diagnostic and treatment procedures.

Artificial intelligence virtual assistants in primary eye care practice.

To propose a novel artificial intelligence (AI)-based virtual assistant trained on tabular clinical data that can provide decision-making support in primary eye care practice and optometry education programmes. Anonymised clinical data from 1125 complete optometric examinations (2250 eyes; 63% women, 37% men) were used to train different machine learning algorithm models to predict eye examination classification (refractive, binocular vision dysfunction, ocular disorder or any combination of these three options). After modelling, adjustment, mining and preprocessing (one-hot encoding and SMOTE techniques), 75 input (preliminary data, history, oculomotor test and ocular examinations) and three output (refractive, binocular vision status and eye disease) features were defined. The data were split into training (80%) and test (20%) sets. Five machine learning algorithms were trained, and the best algorithms were subjected to fivefold cross-validation. Model performance was evaluated for accuracy, precision, sensitivity, F1 score and specificity. The random forest algorithm was the best for classifying eye examination results with a performance >95.2% (based on 35 input features from preliminary data and history), to propose a subclassification of ocular disorders with a performance >98.1% (based on 65 features from preliminary data, history and ocular examinations) and to differentiate binocular vision dysfunctions with a performance >99.7% (based on 30 features from preliminary data and oculomotor tests). These models were integrated into a responsive web application, available in three languages, allowing intuitive access to the AI models via conventional clinical terms. An AI-based virtual assistant that performed well in predicting patient classification, eye disorders or binocular vision dysfunction has been developed with potential use in primary eye care practice and education programmes.

Patient Awareness of Wet Age-Related Macular Degeneration and Need for Regular Fundal Examinations

Purpose: To evaluate degree of insight, accessibility to medical care, and availability of regular ocular screening examinations before diagnosis for Korean patients with wet age-related macular degeneration.Methods: Data were collected from 95 patients by questionnaire and analyzed at Seoul National University Boramae Medical Center.Results: Although 80.0% of the patients considered themselves old, only 2.1% thought they were susceptible to wet age-related macular degeneration. Of the overall patients, 48.4% thought their disease was serious despite treatment with intravitreal injections. A majority (71.6%) thought that medical care was easily accessible, 67.4% answered that hospitals were located close by, and 90.5% answered that it was easy to make appointments and they had time to visit the hospital. However, only 15.8% answered that they had undergone regular ocular examinations before being diagnosed with wet age-related macular degeneration.Conclusions: Although most patients believed that they had easy access to medical care, only 15.8% underwent regular ocular examinations. Therefore, regular ocular examinations, including fundal examinations, are required in national health screening programs. It is also important to raise public awareness of wet age-related macular degeneration by educating the general population.

Clinical and Imaging Characteristics of PRPH2 Retinopathies in a Longitudinal Cohort and Diagnostic Implications.

The purpose of this study was to define genotypic-phenotypic correlations related to PRPH2-associated retinopathies in an observational longitudinal cohort and to improve diagnostic accuracy. Individuals with PRPH2 variants were identified by genetic sequencing of 263 individuals (including 59 families). Ocular examinations with multimodal imaging were evaluated. Two pathogenic/likely pathogenic PRPH2 variants were identified in 22 individuals with retinopathies, low genetic susceptibility to age-related macular degeneration (AMD) and younger age of onset. The mean follow-up was 14 years. One family and 4 independent cases (n = 7) were heterozygous for the variant rs121918563 L185P (p.Leu185Pro). The individuals developed retinopathy compatible with autosomal dominant pattern dystrophy (PD), including adult-onset vitelliform macular dystrophy and butterfly macular dystrophy in their fourth to fifth decades of life, evolving to retinal pigment epithelial (RPE) irregularities and central macular atrophy 20years later. Two families and an independent case (n = 15) had the rs281865373 splice-site variant c.828+3A>T (IVS2+3A>T) presenting as retinal flecks consistent with adult-onset fundus flavimaculatus with macular dystrophy and diffuse RPE atrophy consistent with central areolar chorioretinal dystrophy (CACD) in the fifth decade of life progressing to extensive atrophy in the sixth to eighth decades. The L185P variant was associated with better visual acuity (VA) during follow-up versus c.828+3A>T variant. Some individuals were initially misdiagnosed with geographic atrophy secondary to AMD. Individuals with the L185P variant had less severe disease with clinical manifestation typical of PD and better VA. More advanced disease with CACD and worse VA were associated with the c.828+3A>T variant. Results contribute to knowledge about genotypic-phenotypic associations of PRPH2 retinopathies and inform clinical and therapeutic end points.

STABLE trial of spectacle provision and driving safety among myopic motorcycle users in Vietnam: study protocol for a stepped-wedge, cluster randomised trial

BackgroundTraffic crashes are the leading cause of death globally for people aged 5–29 years, with 90% of mortality occurring in low- and middle-income countries (LMICs). The STABLE (Slashing Two-wheeled Accidents by Leveraging Eyecare) trial was designed to determine whether providing spectacles could reduce risk among young myopic motorcycle users in Vietnam.MethodsThis investigator-masked, stepped-wedge, cluster randomised naturalistic driving trial will recruit 625 students aged 18–23 years, driving ≥ 50 km/week, with ≥ 1-year driving experience and using motorcycles as their primary means of transport, in 25 clusters of 25 students in Ho Chi Minh City, Vietnam. Motorcycles of consenting students who have failed self-testing on the WHOeyes app will be fitted with Data Acquisition Systems (DAS) with video cameras and accelerometers. Video clips (± 30 s) of events flagged by the accelerometer will be reviewed for crash and near-crash events per 1000 km driven (main outcome). Five clusters of 25 students will be randomly selected every 12 weeks to undergo ocular examination and an estimated 40% of these will have bilateral spherical equivalent < − 0.5 D, and better-eye presenting distance visual acuity < 6/12, correctable bilaterally to ≥ 6/7.5. They will be given free distance spectacles and their driving data before receiving spectacles will be analysed as the control condition and subsequent data as the intervention condition. Secondary outcomes include visual function, cost-effectiveness and self-reported crash events.DiscussionSTABLE will be the first randomised trial of vision interventions and driving safety in a LMIC.Trial registrationClinicalTrials.gov, NCT05466955. Initial registration: 20 July 2022, most recent update: 9 July 2024.

Ocular Morbidity among Orphans and Vulnerable Children Living in Shelters in Ibadan Metropolis

Background: Globally, orphans and vulnerable children (OVC) represent a significant population at risk of poor health as well as a high risk of developing ocular disorders. These ocular disorders could lead to childhood visual impairment or blindness if left undetected or untreated. This study therefore focuses on ocular morbidity among OVC living in shelter facilities to provide relevant data for planning eye care interventions. Methods: A descriptive, cross-sectional study was conducted among OVC ages 5–16 years living within shelter facilities in Ibadan, Oyo State. Sociodemographic characteristics were obtained. Ocular examinations, including visual acuity measurements, colour vision test, Hirschberg test, anterior and posterior segments assessment, and cycloplegic refraction were conducted. Descriptive and inferential analysis was done with IBM SPSS Statistics version 24. All analyses were at 5% level of statistical significance. Results: A total of 497 eligible OVC participated in the study. The mean age was 11 ± 3.4 years, and 263 (52.9%) were males. The prevalence of ocular morbidity was 18.1%. The most common types of ocular morbidity were refractive errors 47 (9.5%) and allergic conjunctivitis 18 (3.6%), with more females affected by both conditions, 28 (59%) and 11 (61%), respectively. Ocular morbidity was most common (28.3%) among the 14–16 years age group (P = 0.001). Conclusion: Refractive errors and allergic conjunctivitis, which are treatable ocular conditions, were the most common ocular morbidities among these children. Regular eye screening as well as the provision of quality and affordable eye care services is advocated for this vulnerable population of children.

Incidence of PAX6 single nucleotide polymorphisms in congenital iridofundal coloboma and other congenital ocular abnormalities: a tertiary care hospital experience from central India

Purpose of this study is to identify selected single nucleotide polymorphisms (SNP) of the PAX6 gene and to assess their correlation with congenital iridofundal colobomas and other congenital ocular anomalies.Material and methods. It was a case-control study done on 45 patients aged from 75 days to 58 years (mean age 29.36 ± 14.4 years) with irido-fundal coloboma and 45 healthy controls aged 35.23 ± 13.92 years. Ocular examination was done by using slit-lamp microscopy inspection, fundoscopy and intraocular pressure measurement. Genotyping was done by using the polymerase chain reaction — restriction fragment length polymorphism (PCR-RFLP) method.Results. Two irido — fundal coloboma patients showed CT (+/-) heterozygous genotype of rs667773 SNP and the rest were wild-type CC (-/-) homozygous genotype. All controls showed CC-/- wild-type homozygous genotype. PAX6 SNP rs3026354 showed CC (-/-) wild-type homozygous genotype condition in all patients. Neither CG (+/-) heterozygous nor homozygous GG (+/+) genotype was reported in patients and controls. SNP rs662702, genotype pattern was CC-/- wild type homozygous in all patients and controls. CC genotype frequency was 95.56 and CT genotype was 4.4% while C allele frequency was 97.78 and T allele frequency was 2.22 % in rs667773 C&gt;T SNP. rs3026354C&gt;G SNP had 100 % CC genotype and C allele frequency in both case and control populations. SNP rs 662702C&gt;T showed 100 % CC genotype and C allele frequency in the case and control respectively.Conclusion. The elevated frequency of the CC genotype with C allele was more common in irido fundal patients. Two heterozygous CT genotype of rs667773C&gt;T SNP were reported in two irido-fundal coloboma patients.

Ocular safety of 222-nm far-ultraviolet-c full-room germicidal irradiation: A 36-month clinical observation.

The ocular safety of 222-nm far-ultraviolet-C (UV-C) irradiation, widely recognized for its germicidal properties, was evaluated in a clinical setting to assess its long-term health effects on the human eye. This prospective observational study involved a 36-month follow-up of physicians working in an ophthalmic examination room equipped with 222-nm UV-C lamps. Initially, a 12-month observation showed no signs of acute or chronic ocular damage. To further substantiate these findings, the study period was extended to 36 months, during which four participants underwent regular ocular examinations, including assessments of visual acuity, refractive error, and corneal endothelial cell density. The irradiation dose was meticulously controlled to remain within the previous threshold limit of 22 mJ/cm2 over an 8-h period, as advised by the ACGIH prior to 2022. Results indicated no significant changes in these parameters, suggesting no clinically significant ocular hazards associated with prolonged exposure to 222-nm UV-C irradiation under real-world conditions. Additionally, no delayed side effects, such as pterygium, keratopathies, or cataracts, were observed. Our study supports the safe use of 222-nm UV-C for microbial disinfection in occupied environments and provides a robust foundation for updated safety guidelines.

Long-Term Evaluation of Ocular Surface and Meibomian Gland Function after Laser-Assisted in situ Keratomileusis Surgery.

Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery. But it may lead to temporary dry eye due to reversible damage to the corneal subbasal nerve plexus. However, evidence on chronic ocular surface changes are unclear. This study reports the ocular surface changes, partial blinking rates, and meibomian gland statuses in eyes that underwent LASIK for at least 48 months. Cross-sectional, matched case-control comparison study, including 48 post-LASIK patients and 48 sex-, age-, smoking-, and axial length-matched healthy controls, recruited from a community eye screening program. Outcome measures include anterior segment clinical findings, keratographic and meibographic imaging. Totally, 48 right eyes of 48 post-LASIK Chinese patients (39 females, 2 smokers) were analyzed with 48 right eyes of 48 matched healthy controls. The mean age at the time of ocular surface examination was 50 ± 11 years, and the axial length 26±1 mm. Post-LASIK eyes had a lower quality of meibum (p = 0.008) compared to healthy controls. Post-LASIK eyes were associated with a shorter Schirmer's test (p = 0.03). The ocular surface disease index (OSDI) score was higher in post-LASIK patients (p = 0.00001). Other anterior segment examination parameters, partial blinking rate, meibomian gland dropout, lipid layer thickness, noninvasive tear break-up time, and tear meniscus height were comparable between the 2 groups. Up to 75% of post-LASIK patients complained of on-going, chronic dry eye symptoms. Post-LASIK eyes were associated with a reduced aqueous tear production. Post-LASIK patients with chronic dry eye symptoms are advised to have periodic ocular surface evaluation. Treatments might be considered in patients with poor tear film stability.