Ophthalmology Hospital Research Articles

Development of machine learning-based models for vault prediction in implantable collamer lens surgery according to implant orientation.

The main objective was to develop a prediction model based on machine learning to calculate the postoperative vault as well as the ideal implantable collamer lens (ICL) size, considering for the first time the implantation orientation in a Caucasian population. Arruzafa Ophthalmological Hospital (Cordoba, Spain) and Barraquer Ophthalmology Center (Barcelona, Spain). Multicenter, randomized, retrospective study. Anterior segment biometric data from 235 eyes of patients who underwent ICL lens implantation surgery were collected using the anterior segment optical coherence tomography (AS-OCT) CASIA II, to train and validate five types of multiple regression models based on advanced machine learning techniques. To perform an external validation a dataset of 45 observations was used. The Pearson correlation coefficient between observed and predicted values was similar in the five models in the external validation, with least absolute shrinkage and selection operator (LASSO) regression being the highest (r = 0.62, p < 0.001), followed by random forest regression model (r = 0.60, p < 0.001) and backward stepwise regression (r = 0.58, ρ < 0.001). In addition, the predictions generated by the different models showed closer agreement with the actual vault compared with the Nakamura formulas. Using the new methods, about 70% of the observations had a prediction error below 150 µm. Advanced forms of regressions models based on machine learning allow satisfactory calculation of the ideal lens size, offering greater precision to surgeons customizing surgery according to implant orientation.

Effects of infliximab biosimilar on retinal microvasculature in Crohn’s disease patients evaluated by optical coherence tomography angiography

Objective To compare the retinal microcirculation in Crohn’s disease cases under infliximab (IFX) biosimilar with controls that are age- and sex-matched in terms of disease severity. Background Crohn’s disease is a relapsing, remitting condition that affects the gastrointestinal tract. One approach to management is to use biological therapy. Patients and methods This cross-sectional case-control study was carried out at the outpatient clinic of the gastroenterology and hepatology departments of the Faculty of Medicine at Menofia University and was imaged at Shebin Elkom Ophthalmology Hospital. The study included 60 participants who were divided into three groups with no ophthalmologic history or symptoms. Results Regarding slit examination findings, within group A 14 (70%) cases had eye dryness, and six (30) had allergic keratoconjunctivitis; within group B 11 (55%) cases were normal, five (25%) cases showed dryness, and three (15%) had allergic keratoconjunctivitis; and there was anterior uveitis in one (5%) patient; in group C 10 (50%) patients were normal, seven (35%) patients showed dryness, and three (15%) had allergic keratoconjunctivitis. There was a significant increase in dryness and allergic keratoconjunctivitis within group A compared with groups B and C (P=0.04). Conclusion Our study concluded that patients with moderate to severe Crohn’s disease who received IFX biosimilar had higher eye dryness, allergic keratoconjunctivitis, and longer disease duration. Therefore, the use of IFX should be limited.

Prediction of Seven Artificial Intelligence-Based Intraocular Lens Power Calculation Formulas in Medium-Long Caucasian Eyes.

Purpose: To compare the accuracy of seven artificial intelligence (AI)-based intraocular lens (IOL) power calculation formulas in medium-long Caucasian eyes regarding the root-mean-square absolute error (RMSAE), the median absolute error (MedAE) and the percentage of eyes with a prediction error (PE) within ±0.5 D. Methods: Data on Caucasian patients who underwent uneventful phacoemulsification between May 2018 and September 2023 in MW-Med Eye Center, Krakow, Poland and Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Kyiv, Ukraine were reviewed. Inclusion criteria, i.e., complete biometric and refractive data, were applied. Exclusion criteria were as follows: intraoperative or postoperative complications, previous eye surgery or corneal diseases, postoperative BCVA less than 0.8, and corneal astigmatism greater than 2.0 D. Prior to phacoemulsification, IOL power was computed using SRK/T, Holladay1, Haigis, Holladay 2, and Hoffer Q. The refraction was measured three months after cataract surgery. Post-surgery intraocular lens calculations for Hill-RBF 3.0, Kane, PEARL-DGS, Ladas Super Formula AI (LSF AI), Hoffer QST, Karmona, and Nallasamy were performed. RMSAE, MedAE, and the percentage of eyes with a PE within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 were counted. Results: Two hundred fourteen eyes with axial lengths ranging from 24.50 mm to 25.97 mm were tested. The Hill-RBF 3.0 formula yielded the lowest RMSAE (0.368), just before Pearl-DGS (0.374) and Hoffer QST (0.378). The lowest MedAE was achieved by Hill-RBF 3.0 (0.200), the second-lowest by LSF AI (0.210), and the third-lowest by Kane (0.228). The highest percentage of eyes with a PE within ±0.50 D was obtained by Hill-RBF 3.0, LSF AI, and Pearl-DGS (86.45%, 85.51%, and 85.05%, respectively). Conclusions: The Hill-RBF 3.0 formula provided highly accurate outcomes in medium-long eyes. All studied AI-based formulas yielded good results in IOL power calculation.

Myopia control in the community (optical interventions, biometry, protocol)

In many countries, &gt;50% of university students are myopic, with prevalence rising. Increasing myopia is associated with higher risks of eye disease. Myopia control is necessary because, for example, slowing myopia progression by 1D should reduce the likelihood of a patient developing myopic maculopathy by 40%. Several approaches are available that have slowed progression by ~50% in randomised control trials. In order of decreasing safety/increasing risk of complications, these are spectacle lenses that provide peripheral plus power, contrast reducing spectacle lenses, soft contact lenses providing peripheral plus power, ortho‐keratology, low dose atropine, and repeated low‐level red light therapy (RLRL). Recently, it has been argued that RLRL may not meet safety standards and this will not be considered further.With approximately half of older children/adolescents becoming eligible for myopia control, in most countries it is not feasible for all cases to be managed in hospital ophthalmology units. Increasingly, myopia control is being undertaken in community optical practices and this talk will address best practice, and advantages and disadvantages of this myopia control being undertaken in a community setting.Key considerations are whether community optical practices can provide the breadth of interventions required, and have appropriate skills and equipment. Concerning the breadth of interventions, most clinicians in community optical practices are optometrists and only in a few countries are optometrists able to prescribe therapeutic pharmacological agents. All the optical interventions listed above are potentially available to optometrists. Whether atropine is appropriate depends on the age, clinical characteristics (e.g., rate of progression, axial length, family history), and patient/carer preferences. Optometrists must follow appropriate referral guidelines and make patients aware of alternative approaches to those that they can provide.Concerning the skills required, practitioners should follow recent International Myopia Institute (IMI) guidelines, referring young children with risk factors for syndromic myopia. These require a full history and eye examination, including ophthalmoscopy. Several biometers have been developed for use in myopia control and are increasingly found in optical practices. The evolving debate on the necessity of axial length measurements and/or cycloplegic refraction in myopia control will be considered, noting the 2023 IMI myopia management algorithms.The importance of clinical presentation is emphasised. For example, a child who develops mild myopia at age 12‐14y is likely to be suitable for optical myopia control. If the optometrist has been monitoring for some years reducing hypermetropia progressing to slowly developing myopia then it is questionable whether cycloplegic refraction is required. In contrast, a 5‐7 year‐old who at the first eye examination has moderate myopia requires cycloplegic refraction to exclude pseudo‐myopia.It is concluded that as myopia control is changing from specialist to routine eye care, it must become an essential message for dissemination by all eye care practitioners. As with other commonplace ocular conditions, straightforward cases are likely to be increasingly managed in the community and more complicated cases in secondary care. The lack of state funding, cost of interventions and therefore accessibility will be considered.

METHODS OF FORMING OPEN RECREATIONAL SPACES IN CHILDREN'S HOSPITALS (A CASE STUDY OF THE KHARKIV CITY)

The article examines the features of the formation of open recreational spaces (ORS) for children's hospitals (CHs) in Kharkiv. Based on the analysis of regulatory documents, it was found that in Ukraine CHs are divided into multi-profile and single-profile, as well as specialized institutions. Multi-profile institutions provide a wide range of medical services for children with various diseases, for example, regional and city children's hospitals, while singleprofile institutions focus on the treatment of specific diseases, such as infectious or oncological. Specialized centers (rehabilitation, cardiology, etc.) are also distinguished that require special areas for rest and rehabilitation. The analysis of CHs in Kharkiv showed that most institutions have imperfectly organized territories, often unsuitable for full-fledged use. Many hospitals are parts of medical complexes or are located in dense urban development, which limits the space for ORS. The main shortcomings are insufficient landscaping, lack of necessary areas for children with various types of diseases, lack of special areas for rehabilitation and limited access for children with disabilities. Based on the analysis of the typology and needs of different hospitals, general recommendations for the Kharkov CHs were developed. For multi-profile hospitals, it is recommended to create multifunctional areas that will allow for physical rehabilitation, educational activities and relaxation, etc. (multimodal spaces, safe play, sports, recreational, etc.) For single-profile hospitals, it is worth providing highly specialized areas that will meet specific needs: sensory spaces for ophthalmology and otolaryngology hospitals, sports grounds with adaptive equipment for physiotherapy and traumatology hospitals. Thus, the article justifies the need to create ORSs in CHs that take into account the needs of different categories of patients. The proposed solutions are aimed at reducing stress, stimulating physical activity, and ensuring psychoemotional comfort, which ultimately contributes to the accelerated recovery of children and the improvement of working conditions for medical personnel.

Foundations of ophthalmology in Dutch East Indies: A look at distribution of early ophthalmology medical facilities (1900‒1942)

This research examines the development of ophthalmology as a medical specialty in the Dutch East Indies between the years 1900 and 1942. The research is focus on the establishment of ophthalmology medical facilities, consist of ophthalmology hospitals, departments of ophthalmology, and ophthalmology outpatient clinics. The methods used in this research are a literature review of archival documents and spatio-temporal analysis. The primary source of archival documents for this study are the Medical Journal for the Dutch East Indies (Geneeskundig Tijdschrift voor Nederlandsch-Indie), Communications from the Civil Medical Service (Mededeelingen van den Burgerlijk Geneeskundige Dienst), Communications from the Public Health Service (Mededeelingen van den Dienst der Volksgezondheid), and Kolonial Verslaag. A spatio-temporal analysis was conducted to look at the distribution of medical facilities over time, using a phase division into three periods: 1900‒1910, 1901‒1930, and 1931‒1942. This research indicates that the establishment of ophthalmology medical facilities was a response to the prevalence of eye health problems in the Dutch East Indies during the nineteenth century. During the period between 1900 and 1910, a notable advancement in ophthalmology occurred with the establishment od ophthalmology hospital. These facilities were predominantly concentrated in Java, particularly in cities that served as administrative centers, such as Bandung and Semarang. From 1911 to 1930, the number of medical facilities increased with the establishment of departments of ophthalmology in hospital and ophthalmology outpatient clinics. The construction of medical facilities commenced in Sumatra, particularly in Padang and Perbaoengan. In contrast, the medical facilities constructed during the period between 1931 and 1942 were exclusively outpatient clinics. The findings indicate that the early ophthalmology medical facilities were concentrated in Java and Sumatra. Additionally, this study delves into the diagnostic and therapeutic measures employed by ophthalmologists to address a spectrum of eye diseases. Based on these findings, it can be inferred that the establishment of ophthalmology medical facilities in the Dutch East Indies signified the acceptance of ophthalmology as a specialized field dedicated to advancing public health and encouraged further research into eye diseases and their treatment.

Clinical profile and etiological spectrum of patients presenting with corneal hydrops over a 12-year period.

To describe the demographics, clinical characteristics, and management of corneal hydrops in patients presenting to a multi-tier ophthalmology hospital network in India. Cross-sectional hospital-based study. Of the total of 3,140,941 new patients presenting between October 2010 and March 2022, patients with a clinical diagnosis of corneal hydrops in at least one eye were included in the study. All the data was collected using an electronic medical record system. 1291 eyes of 1110 patients were diagnosed with corneal hydrops and included in the study and 961 patients (83.69%) had a unilateral affliction. Corneal hydrops was noted to be significantly more common in males (62.43%) and adults (62.7%). The most common age group at presentation was during the second decade of life with 472 (42.52%) patients. They were more commonly from the higher socio-economic status (77.3%) and from the urban geography (44.23%). In the 1291 eyes, 567 (43.92%) eyes had a visual impairment of blindness (> 20/400-20/1200) followed by moderate visual impairment (> 20/70-20/200) in 166 (12.86%) eyes. Overall, the most common etiology was keratoconus in 1,082 (83.81%) eyes followed by primary congenital glaucoma (PCG) in 91 (7.05%) eyes. Surgical intervention to hasten the recovery of hydrops was performed in 7.82% of eyes with ectasia and as a definite management in 7.05% eyes with PCG. Visual rehabilitation was with contact lenses in 29.1% eyes and keratoplasty in 13.94% eyes. Corneal hydrops is predominantly unilateral and is more common in males. Keratoconus was the commonest etiological condition; however, the risk of hydrops was highest in keratoglobus, followed by PMD. Most affected age was the second decade of life and visual impairment was severe in majority (60%). A surgical intervention was performed in a third of the cases.

Accuracy of 7 artificial intelligence based intraocular lens power calculation formulas in extremely long Caucasian eyes: Short title: AI-based IOL calculation in extra-long eyes

To compare 7 AI-based IOL power calculation formulas in extremely long eyes DESIGN: : Retrospective accuracy and validity analysis. SETTING: Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Ukraine STUDY POPULATION: : Patients with highly myopic eyes, who underwent uneventful phacoemulsification OBSERVATION PROCEDURES: Prior to cataract surgery IOL power was calculated. The power of the implanted IOL was randomly selected from the outcomes of SRK/T, Holladay 2 or Barrett Universal II. Three months after phacoemulsification, refraction was measured. Post-surgery IOL power calculations were performed utilizing the following formulas: Hill-RBF 3.0, Kane, PEARL-DGS, Ladas Super Formula AI (LSF AI), Hoffer QST, Karmona and Zhu-Lu. root mean square absolute error (RMSAE), median absolute error (MedAE) and percentage of eyes with prediction error (PE) within ±0.50 D RESULTS: : Forty eight eyes with axial length exceeding 30.00 mm were studied. Hill-RBF 3.0 yielded the lowest RMSAE (0.788) with statistical superiority only over Karmona (0.956, p=0.021). In terms of MedAE, outcomes obtained by Hoffer QST (0.442) and Hill-RBF (0.490) were statistically significant vs LSF AI (0.800, p=0.013, p=0.008, respectively). The highest percentage of eyes with PE within ±0.50 D was achieved by Hill-RBF 3.0, Kane and Hoffer QST (54.17% each) statistically significant as follows: both Hill-RBF and Kane vs LSF AI (27.08%) and Karmona (39.58%), and Hoffer QST vs LSF AI. All tested formulas demonstrated comparable trueness, with Hill-RBF 3.0 being more accurate than Karmona (RMSAE), and LSF AI being less accurate than Hoffer QST and Hill-RBF 3.0 (MedAE).

Comparative Analysis of AI Chatbots ChatGPT, Gemini, and Copilot’s Answers to Common Cataract Questions

Purpose: To compare the readability and quality of the answers given by artificial intelligence (AI) chatbots to the twenty-five most frequent searches about cataracts on Google. Study Design: Cross sectional comparative study. Place and Duration of study: Serdivan State Hospital's Ophthalmology Department from March 2024 to April 2024. Methods: The word 'Cataract' was entered into Google Trends, and 25 trending searches made worldwide since 2004 were identified. These 25 trending searches were entered separately into AI programs. The answers were examined for quality using the Ensuring Quality Information for Patients (EQIP) test, while the readability was evaluated using the Flesch-Kincaid Reading Ease (FKRE) and Flesch-Kincaid Grade Level (FKGL). Results: The keywords searched most frequently were ‘Cataract surgery,’‘Eye cataract and 'After Cataract’. The EQIP category of all three AI chatbots was found to be 'serious quality issues.' When EQIP scores were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.007, respectively), while there was no significant difference between Gemini and Copilot (p:0.098). When FKRE values were compared, ChatGPT had a lower median value than Gemini and Copilot (p:0.001, p:0.001, respectively), with no significant difference between Gemini and Copilot (p:0.557). When FKGL values were compared, ChatGPT had a higher median value than Gemini and Copilot (p:0.003, p:0.001, respectively), with no significant difference between Gemini and Copilot(p:0.245). Conclusion: All three AI chatbots had an EQIP category of 'serious issues with quality .'The readability of all three was not at the recommended level.

Comparison between surgical outcome of bilateral recession and unilateral recession-resection in intermittent exotropia

Purpose The aim of this study was to compare the postoperative drift after bilateral lateral rectus recession (BLR) compared to unilateral lateral rectus recession combined with medial rectus resection (R&amp;R) in children with intermittent exotropia. Patients and methods This is a prospective comparative study that included 52 patients with intermittent exotropia [range=20–50 prism diopters (PD)] who were recruited from the Pediatric Ophthalmology Clinic of the Research Institute of Ophthalmology, Giza, and Beni-Suef University Hospital, Beni-Suef, Egypt between February and September 2020. The patients were randomly divided into two equal groups: BLR group and R&amp;R group, each of 26 patients. The patients were subjected to complete ophthalmic examination including best corrected visual acuity and a full cycloplegic refraction. An alternate prism cover test with accommodative target was used to measure the deviations in the nine positions of gaze, both for distance and near. The cover test was used to examine the control of exodeviation. The ocular dominance was measured by hole in card test. Accommodative convergence/accommodation ratio was measured using the gradient method. The amblyopia cases were not included in this study. According to the postoperative results after 1 year, the patients were assigned to one of the following groups: success [esophoria or esotropia≤5 PD or exophoria or exotropia≤10 PD], overcorrection (esophoria or esotropia &gt;5 PD), and undercorrection or recurrence (exophoria or exotropia &gt;10 PD). Results There was a statistically significant improvement in the angle of deviation after surgery in both groups. In the BLR group, the mean angle of deviation significantly improved from 37.5±5.34 PD preoperatively to 0.58±1.39 PD at 6 months (P&lt;0.00001) and to −2.73±5.95 PD at 12 months (P&lt;0.00001), while in the R&amp;R group, it significantly improved from 39.62±6.15 PD preoperatively to −1.38±2.06 PD at 6 months (P&lt;0.00001) and to −4.42±7.5 PD at 12 months (P&lt;0.00001). At 12 months, the surgical success rate was 92.3% in the BLR group and 84.62% in the R&amp;R group, with no statistically significant difference (P&gt;0.05). There were no serious intraoperative or postoperative complications in either group. Conclusion With long-term follow up, the BLR group appeared to have more stable results on ocular alignment compared to the R&amp;R group.

Clinico-demographic profile and visual outcomes of pseudophakic bullous keratopathy in a multi-tier eyecare network in India.

The purpose of this study is to present the clinico-demographic characteristics of pseudophakic bullous keratopathy (PBK), its visual outcomes, factors associated with the choice of treatment, and poor visual outcomes of PBK. In this hospital-based retrospective study, electronic medical records data of new patients who presented to a multi-tier ophthalmology hospital network in India (November 2010-June 2022) were extracted. Patients with at least 4 weeks of follow-up were analyzed for visual outcome data. Bivariate analysis and multivariate logistic regression were used to determine the factors associated with the treatment choice and poor visual outcomes. Of the 3,323,247 electronic records (with an average follow-up of 293 days) examined, 10,522 eyes of 10,158 patients (0.3%) had PBK. The majority were managed non-surgically (n = 7372; 70.1%), with increased odds of poor visual outcome by 3.46 times (AdjOR: 3.04-3.92, P < 0.001). Those belonging to the non-paying category had higher odds of poor visual outcome (AdjOR: 1.48, 95%CI: 1.29-1.69; P < 0.001). Surgical management improved vision by 0.72 logMAR (95%CI: 0.60-0.73; P < 0.001). A total of 41.2% (n = 113/274) of cases that underwent Descemet's membrane endothelial keratoplasty and 18.4% (n = 285/1551) of Descemet's stripping endothelial keratoplasty attained last follow-up visual acuity (LVA) of 6/18 or better. About three in every thousand patients had PBK. Surgical interventions improved visual acuity significantly. About four in ten patients who underwent DMEK attained a vision of 6/18 or better at the last follow-up visit. Markers of lower socioeconomic strata were independently associated with poor visual outcomes.

Epidemiology of Common Eye Diseases in North Kordofan, Sudan

Introduction: Eye illness epidemiology is critical because it identifies the most dangerous diseases in the community and helps decision-makers make better management decisions. This study aims to explore the epidemiology of prevalent eye diseases in north Kordofan State. Methodology: This retrospective descriptive study was conducted at El-Obeid Teaching Hospital's Ophthalmology Department, North Kordofan State, Sudan, and Dr. Khalil's Ophthalmology Center. Out of almost 50000 patient files, we selected 1000 files for this study using a random systemic selection of 1 in 50. The data collection sheet was created, and all data were collected. Results: The corneal diseases made up 19.6% of the 1000 cases in this study, followed by conjunctival 17.7%, lens 15.3%, eye surface 9.8%, uveal tract 9.1%, refractive errors 6.4%, eye lids 5.4%, orbital 5.4%, glaucoma 4.3%, retinopathy 4.6%, anterior chamber diseases 2.1%, lacrimal drainage system disorders 1.8%, and nerve palsies 0.5%. Conclusion: The western Sudan is heavily affected by eye diseases, with corneal diseases being the most common, closely followed by conjunctival diseases. This report delves into the eye disease situation in western Sudan. With absence of such literature from Sudan, the findings of this study presenting baseline of future research in this context.

Analysis of corneal remodeling post-myopic photorefractive keratectomy with the WaveLight® EX500 excimer laser

Refractive error is becoming a significant public health issue. Photorefractive Keratectomy (PRK) is a corneal surface surgical technique that removes the corneal epithelium before stromal photoablation by ultraviolet radiation from the Excimer laser. We designed a retrospective study to characterize corneal remodeling after myopic Photorefractive Keratectomy and assess the accuracy of laser-predicted ablation depth (AD). This study took place in 15–20 National Ophthalmology Hospital, Paris, France. 150 eyes with preoperative manifest spherical equivalent between − 10.00D and − 0.25D and cylinder < 3D, treated with the WaveLight® EX500 laser between 01/2019 and 01/2023, were followed for at least three months. The main outcome measurements were postoperative changes in epithelial (ET) and stromal (ST) thicknesses measured with spectral domain optical coherence tomography and mean simulated keratometry (SimK) assessed with corneal topography. The central ET significantly decreased at M1, increased over the preoperative value from M1 to M6, and stabilized after M6. The increase in central ET after M1 was associated with an increase in mean SimK (r = 0.34). The achieved AD was 7.9 ± 8.0 µm greater than the laser-predicted AD. Stromal over-ablation was significantly and independently associated with myopia > 6D preoperative mean SimK > 44D and transepithelial procedures.

Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study.

This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the Growing Up in New Zealand study cohort. A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data. Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05). Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.

The Pattern of Corneal Diseases in North Kordofan State

Background: All corneal diseases cause ocular morbidity and decrease vision, or even blindness, so early management intervention is critical. This study sought to evaluate several corneal disorders, including corneal foreign bodies, corneal tears, and ruptured globes. Methodology: This retrospective descriptive study was undertaken in El-Obeid Teaching Hospital's Ophthalmology Emergency Department in North Kordofan State, Sudan, as well as Dr. Khalil's Ophthalmology Center. This study sample, which represents the entire corneal illness, was obtained from 1000 patient files for various eye conditions. Results: This study examines 205 patients with corneal disorders to assess the prevalence of corneal diseases in North Kordofan State. The study found that the disease is more common in males, with 48 out of 78 patients (62%) being male and 38% being female. The male-to-female ratio is 1.6:1. The age group that is most affected is the group of individuals younger than 9 years, accounting for 34% of the affected population. This is followed by the age groups of 10–20 years, 21–32 years, 33–53 years, and &gt;54 years, which account for 24%, 18%, 14%, and 9%, respectively. Regarding the classification of corneal disorders, the most prevalent form is foreign body corneal disease, accounting for 38% of cases. This is followed by corneal tear (16%), corneal opacity (15%), corneal tear with iris prolapses (10%), bacterial corneal ulcer (7%), and rupture globe (6%). The incidence rates of viral corneal ulcers, chemical trauma, burn trauma, and keratoconus are 3%, 3%, 1%, and 1%, respectively. Conclusion: Eye trauma is prevalent in north Kordofan, leading to an upsurge in corneal illnesses including foreign body cornea, corneal tear, and ruptured globe.

Impact of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis in Alexandria-Egypt

BackgroundThis study aimed at measuring the effect of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis and identifying the specific risk factors to both microbial and non-microbial keratitis independently.MethodsA cross-sectional study was conducted at Alexandria Ophthalmology Hospital from May to October 2023. All contact lens wearers attending the outpatient clinic had undergone face-to-face interviews using a standardized validated questionnaire which included demographic data and contact lenses (CLs) hygiene risk factors. Participants were classified into two groups; normal group and keratitis group. Keratitis group was further subdivided into non-microbial and microbial group.ResultsThe study included 245 contact lens wearers; 149 normal cases, 50 (20.4%) contact lens-related non-microbial keratitis (CLNK) cases, and 46 (18.8%) contact lens-related microbial keratitis (CLMK) cases. Sharing contact lenses and eye trauma were significant risk factors for both CLNK (p=0.036), (p=0.001) and CLMK (p=0.003), (p=0.017). CLs wear duration for more than 12 hours was associated with an increased risk of CLNK by about 4 times (p=0.030) and overnight wear of contact lenses increased the risk of CLNK by 2.6 times (p=0.030). Showering or swimming in lenses was identified as a significant risk factor for CLMK (p=0.012), moreover washing lenses with tap water increased the risk of CLMK (p=0.030).ConclusionsPoor compliance with contact lenses hygiene rules results in a high prevalence of contact lens-related keratitis. Eye trauma and sharing contact lenses were significant hygiene risk factors for both contact lens-related non-microbial keratitis and contact lens-related microbial keratitis.

Fungal keratitis among inpatients with corneal ulcers in Thai Binh, Vietnam: A retrospective observational study

Background: Infectious keratitis can be caused by bacteria, fungi, and viruses. Fungi are a common pathogen, especially in developing countries like India, Nepal, and Bangladesh where the prevalence ranges from 20% to 60%. In Vietnam, fungal keratitis accounted for the highest number of keratitis cases in a study conducted at the central eye hospital over a 5-year period (57%). Therefore, it is necessary to collect specific background information connected to the types of fungal keratitis in corneal ulcer cases in this region. Aims and Objectives: The aim of this study was to investigate the prevalence of fungal keratitis and the epidemiological features in 216 cases of fungal keratitis out of a total of 240 cases of infectious keratitis. Materials and Methods: This retrospective study collected secondary data from medical records of 240 inpatients with infectious keratitis who were treated at the ophthalmology hospital in Thai Binh, Vietnam, from January 01st, 2021 to June 30th, 2022. Patients with a positive fungal-directed smear were analyzed in detail for the type of fungus isolated, sociodemographic data, predisposing risk factors, prior treatment modalities, and laboratory results for the distribution pattern of fungus species. Results: Among the 240 cases, 126 (52.5%) were diagnosed with fungal keratitis by direct microscopic examination. Culture results showed the highest rate of Fusarium spp. (43.3%). The age group of 41–60 years was most commonly involved (40.5%). Males were more affected by fungal keratitis than females, (53.2% compared to 46.8%), with farmers being the most common occupation correlated with fungal keratitis (55.6%). The rate of fungal keratitis patients due to agricultural injuries was the highest compared to other risks (47.6%) and most patients self-medicated before going to the hospital, with many not knowing or remembering what medications they had taken (52.4%). Conclusion: The study revealed a high rate of fungal keratitis among the total of infectious keratitis cases in Thai Binh, Vietnam. Fusarium spp. was the most commonly isolated fungi. The study also highlighted the impact of agricultural injuries on fungal keratitis, especially in regions like Thai Binh.

The carbon footprint of French hospital ophthalmology consultations.

France carbon footprint, with 604 million tons of CO2 equivalent (CO2eq) annual emissions, far exceeds the worldwide scientific specifications to not exceed 2 °C of warming in 2100. The healthcare sector is one of the biggest contributors to greenhouse gas emissions. The aim of this study is to quantify and evaluate the carbon footprint of the consultation activity of an ophthalmology department at a single institution in France. The perimeter of the investigation included consultations and excluded the surgeries and the hospitalisation. We calculated the carbon footprint of a single day of practice in our scope of investigation. We included consumption of energy, patient travel, staff travel, pharmaceutics and medical devices purchases, computer hardware, biomedical equipment/exam materials, and waste. We used the official French public database of emission factors: Base Empreinte® of the Environmental and Energy Management Agency of France. The carbon footprint of a single day of our department was estimated at 1 688.65 kgCO2eq. It represents an average of 9.28 kgCO2eq per patient. Energy consumption contributed for 114.80 kgCO2eq (6.8%), travel for 1324.76 kgCO2eq (78.4%), pharmaceutics and medical devices for 208.33 kgCO2eq (12.3%), equipment for 14.38 kgCO2eq (0.9%) and waste for 26.38 kgCO2eq (1.6%). This study highlights the importance of patient travels, and possibly pharmaceutics, in the carbon footprint of hospital ophthalmology practice in France. More studies are needed to establish it at the national or international scale, as well as more carbon footprint analyses on products, especially those of high prices, to increase the accuracy of these studies.

Correlation of posterior segment lesions with anterior segment biometric parameters and FBN1 genotype in patients with Marfan syndrome

Objective: To investigate the characteristics of posterior segment lesions in Marfan syndrome (MFS) patients and their relationship with anterior segment biometric parameters and FBN1 genotype. Methods: A cross-sectional study was conducted. A total of 121 MFS patients, 76 males and 45 females, with an average age of (11.72±11.66) years, who visited the Department of Ophthalmology, Eye & ENT Hospital of Fudan University from January 2013 to March 2023 were included. The presence of posterior scleral staphyloma was observed using B-mode ultrasound, and macular lesions were identified and classified using the atrophy-traction-neovascularization system based on ultra-widefield fundus images, color fundus images, and optical coherence tomography scans. Anterior segment biometric parameters, including axial length of the eye, average corneal curvature, corneal astigmatism, horizontal corneal diameter, anterior chamber depth, and lens thickness, were collected, and the direction and extent of lens dislocation were observed. Molecular genetic analysis of FBN1 gene mutations in patients was performed using next-generation sequencing based on a panel of ocular genetic diseases, and the impact of the genotype and anterior segment biometric parameters on the posterior segment manifestations was analyzed. Results: Sixty patients exhibited posterior segment lesions, including retinal detachment (4 cases, 3.31%), macular lesions (47 cases, 38.84%), and posterior scleral staphyloma (54 cases, 44.63%). There was statistically significant difference in axial length of the eye between patients with and without posterior scleral staphyloma [23.09 (22.24, 24.43) and 27.04 (25.44, 28.88) mm], between patients with and without macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.78) mm], and between patients with and without atrophic macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.79) mm] (all P<0.001). There was statistically significant difference in anterior chamber depth between patients with and without macular lesions [3.11 (2.75, 3.30) and 3.34 (3.09, 3.60) mm] (P<0.05). There was also statistically significant difference in corneal astigmatism between patients with and without posterior scleral staphyloma [2.15 (1.20, 2.93) and 1.40 (1.00, 2.20) diopters] (P<0.05). The location and region of the FBN1 gene mutation not only showed statistically significant difference from the positive rates of posterior scleral staphyloma and macular lesions (all P<0.05), but also influenced the occurrence of atrophic macular lesions (both P<0.05). Patients with FBN1 mutations located in the transforming growth factor β regulatory sequence had the highest proportion of posterior scleral staphyloma and macular lesions (both 10/11). Conclusions: Posterior scleral staphyloma and macular lesions have a relatively high incidence in MFS patients and tend to progress to more severe grades. The age, axial length of the eye, anterior chamber depth, corneal astigmatism, and location and region of the FBN1 gene mutation are factors affecting the posterior segment lesions in MFS patients.

Role of Optical Coherence Tomography (OCT), Fundus Photography, and Amsler Grid in Detection of Macular Disorders Associated with High Myopia

Abstract Background High myopia refers to ametropia characterized by elongation of optic axis and retinal and choroidal degeneration in the fundus, and high myopic patients present with various degrees of structural and functional retinal changes and thinning of the retinal thickness. Active screening for high myopic patients with imaging techniques by OCT, Fundus photography and amsler grid and providing patients with corresponding treatment on this basis may effectively reduce the risk of irreversible visual function damage. Objective To point to the importance of combining OCT, fundus photography with amsler grid testing in patients with high myopia. Methods This study was conducted on 40 eyes from EI-Demerdash Hospital outpatient clinic and ophthalmology department investigations unit in the period from June 2021 till May 2022; the patients were 24 females (60.0%) and 16 males (40.0%) with age ranged from 16 to 50 years. Results Our investigations gave us an idea about the macular diseases associated with high myopia and the importance of combining use of OCT, fundus imaging and amsler grid with patients with high myopia. These findings consist of chorioretinal atrophy, foveoschisis, choroidal neovascularization, dehiscence of retinal layers known as retinoschisis (foveoschisis or extre foveoschisis), macular holes (lamellar and full thickness), posterior retinal detachment. We can early detect theses changes in macula of highly myopic patients by Amsler grid testing as daily self monitoring and this can be useful in directing the patient to more sophisticated investigation tool like OCT and fundus photography and therefore give the patient the optimal chance to save the vision. Conclusion OCT combined with fundus photography and amsler grid testing are helpful tools that allow detailed evaluation of the macula in eyes with pathological myopia and easily anticipate, diagnose and follow up diseases associated with high myopia.