Ophthalmology Department Of Hospital Research Articles

Decreased macular choriocapillaris in thyroid-associated ophthalmopathy: focusing on chorioretinal folds with and without optic disc edema.

The aim of this study was to evaluate the vessel density (VD) of the macular choriocapillaris (CC) and retina in thyroid-associated ophthalmopathy (TAO) patients with chorioretinal folds (CRFs) with and without optic disc edema (ODE) and the correlations of these characteristics with visual function. This was a cross-sectional study. Twenty TAO patients with CRFs (35 eyes) and 20 normal subjects (normal group, 40 eyes) were recruited at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from March 2018 to October 2022. Then, CRF patients were divided into two groups, the ODE and non-ODE groups (NODE), based on the presence or absence of ODE. All the patients underwent optical coherence tomography angiography (OCTA) and the VD of the macular CC and retina was computed. The correlation of VD and visual function was analyzed. Compared with the normal group, the macular whole-image VD in the retinal superficial layer (SLR-mwiVD: 49.82 ± 3.38 in the normal group, 42.44 ± 5.40 in the NODE group, and 42.51 ± 5.37 in the ODE group), deep layer (DLR-mwiVD: 51.05 ± 6.23 in the normal group, 45.71 ± 6.66 in the NODE group, and 46.31 ± 5.48 in the ODE group), and CC (CC-mwiVD: 70.23 ± 2.47 in the normal group, 68.04 ± 3.73 in the NODE group, and 63.09 ± 6.51 in the ODE group) was decreased in the NODE (all p < 0.05) and ODE group (all p < 0.01). There was no difference in these parameters except CC-mwiVD between the ODE and NODE groups. The CC-mwiVD in the ODE group (63.09 ± 6.51) was significantly reduced compared with that in the NODE group (68.04 ± 3.73, p = 0.004). All these VD parameters were negatively correlated with BCVA, VF-PSD, and P100 latency and positively associated with VF-MD, P100 amplitude, and HRR scores (all p < 0.05). There was a significant decrease in the VD of the macular CC and retina of patients with CRFs with or without ODE, which was correlated with visual dysfunction. The VD of the macular CC in CRF patients with ODE was significantly reduced compared with that in the NODE group, but similar results were not observed in the retina.

Increased peripapillary capillaries in patients with acute leukemia by using optical coherence tomography angiography

PurposeTo evaluate the radial peripapillary capillary vessel density (RPC-VD) and thickness of the retinal nerve fiber layer (RNFL) in acute leukemia (AL) and the associations of these characteristics with blood laboratory parameters. METHODSA cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from February 2019 to April 2022. Sixty eyes of 30 patients diagnosed with AL and sixty eyes of 30 matched healthy controls were included. Optical coherence tomography angiography (OCTA) in the 4.5-mm Angio Disc scan mode and the Ganglion cell complex scan mode were performed for all participants. Correlation analyses were used to examine the associations of RPC-VD and RNFL with blood laboratory parameters. RESULTSPatients in the AL group had significantly increased RPC-VD in the whole-image (51.42±0.35 vs. 49.52±0.36) and peripapillary fields (53.90±0.43 vs. 51.17±0.50) compared with people in the control group (all P<0.001), while no difference was found for RPC-VD in the inside optic disk fields in the two groups. The RNFL in the AL group was significantly thicker than that in the control group (131.10±3.89 μm vs. 115.03±2.22 μm, P<0.05). Complete blood count (CBC) parameters, including red blood cells, hemoglobin and hematocrit, had a significant negative correlation with RPC-VD and RNFL (all P <0.05). CONCLUSIONAn increased RPC-VD and a thicker RNFL are evidence of fundus changes in patients with early-stage AL, and these metrics may be related to decreases in red blood cells, hemoglobin and hematocrit.

A Syringe in an Emergency Saves Time: An Audit on the Utility of Syringe Provision in Eye Emergency.

Background Patient satisfaction is the top priority of health care facilities in addition to the quality of health care delivery services. The convenience of health care receivers, be it temporal or monetary, fall in this domain. Hospitals should be equipped with dealing with all kinds of emergencies no matter how trivial or catastrophic. Aim To improve the provision of emergency care equipment (1 c.c. syringes) in the examination room of our ophthalmology department by 50% in two months' time. Materials and methods This quality improvement project (QIP) was conducted in the ophthalmology department of a teaching hospital in Khyber Pakhtunkhwa. This QIP was conducted over a period of two months in the form of three cycles. All cooperative patients with embedded and superficial corneal foreign bodies who presented to the eye emergency were included in the project. The provision of 1 c.c. syringes in the emergency eye care trolley of the eye examination roomwas ensured at all times after the first cycle survey. A record was maintained of the percentage of patients receiving syringes from the department as well as the percentage of patients purchasing them from the pharmacy. The progress was measured every 20 days, following the approval of this QI project. Results A total of 49 patients were included in this QIP. This QIP shows that the provision of syringes was improved to 92.8% and 88.2% in cycles 2 and 3from the previous statistics of 16.6% in the first cycle. Conclusions It is concluded that this QIP achieved its target. The provision of emergency equipment, such as a 1 cc syringe costing less than 1/20thof a dollar, is a simple act that saves resources and improves patient satisfaction.

How many children with large clear cornea do not have glaucoma?

A horizontal corneal diameter greater than 2 standard deviations from the mean (9.8 mm) or greater than 11 mm in term infants defines megalocornea (herein referred to as a large clear cornea). The aim of the current study was to report on the incidence and clinical characteristics of children presenting with large clear cornea that do not suffer glaucoma. A retrospective chart review of children presenting with large clear cornea to the pediatric ophthalmology unit of the ophthalmology department of Alexandria Main University Hospital in the period from March 2011 to December 2020 was conducted. A large clear cornea was defined as a horizontal white-to-white corneal diameter (as measured by calipers) greater than 12 mm. Glaucoma was diagnosed according to the childhood glaucoma research network (CGRN) criteria and the axial length was used to filter out eyes with large clear corneas due to congenital high myopia. Out of 120 eyes of 91 (58 males) children a total of 76 eyes of 67 (41 males) children were diagnosed with glaucoma and 44 eyes of 24 (17 males) children (36.7%) did not suffer glaucoma. Out of these, 30 eyes were classified as myopia and 14 eyes as congenital megalocornea. More than one third of eyes presenting with large clear corneas may not have glaucoma, and almost two thirds of these eyes (that are not suffering from glaucoma) demonstrate axial myopia.

Doubt flap technique in pterygium surgery

Background: A pterygium is a triangular fibrovascular sub-epithelial ingrowth of degenerative bulbar conjunctival tissue over the limbus onto the cornea. The mainstay of treatment is surgery with more measures to decrease the recurrence rate. Pterygium doesn’t need intervention unless there is an extension of the lesion towards the center of the cornea and it encroaches on the visual axis, or is symptomatic in terms of redness and discomfort. Objective: To present a new surgical technique for managing primary pterygium. We aim to find a more effective method than the one previously used. We wanted to demonstrate and prove that this technique has low recurrence rates. Patients and Methods: A Hospital-based interventional case series study, sampling done by simple random sampling from the outpatient departments. The study was conducted in the ophthalmology department of Erbil teaching hospital in Erbil city for eight months from August 2021-April 2022. In the current study 40 patients with pterygium were operated that they were attending the ophthalmology department in this hospital. Results: The result revealed 3 cases of recurrence of 7.5% out of 40 cases using a dual flap technique as a new approach for treating pterygium in the follow-up of 3 months, in which the mean ± SD of age was 46.3 ± 10.537 years. Twenty four cases were female, and 16 were male; all of the lesions were nasally located pterygium. In the sample we used in the study 5 patients had had pterygium excision using other techniques in the past at least once, and neither of them recurred utilizing this approach. Conclusion: The double flap is a proper alternative technique in pterygium surgery; this new procedure, dual conjunctival flap with 7.5% recurrence rates and provides safe and comparable results to current methods.

Doubt flap technique in pterygium surgery

Background: A pterygium is a triangular fibrovascular sub-epithelial ingrowth of degenerative bulbar conjunctival tissue over the limbus onto the cornea. The mainstay of treatment is surgery with more measures to decrease the recurrence rate. Pterygium doesn’t need intervention unless there is an extension of the lesion towards the center of the cornea and it encroaches on the visual axis, or is symptomatic in terms of redness and discomfort.&#x0D; Objective: To present a new surgical technique for managing primary pterygium. We aim to find a more effective method than the one previously used. We wanted to demonstrate and prove that this technique has low recurrence rates.&#x0D; Patients and Methods: A Hospital-based interventional case series study, sampling done by simple random sampling from the outpatient departments. The study was conducted in the ophthalmology department of Erbil teaching hospital in Erbil city for eight months from August 2021-April 2022. In the current study 40 patients with pterygium were operated that they were attending the ophthalmology department in this hospital.&#x0D; Results: The result revealed 3 cases of recurrence of 7.5% out of 40 cases using a dual flap technique as a new approach for treating pterygium in the follow-up of 3 months, in which the mean ± SD of age was 46.3 ± 10.537 years. Twenty four cases were female, and 16 were male; all of the lesions were nasally located pterygium. In the sample we used in the study 5 patients had had pterygium excision using other techniques in the past at least once, and neither of them recurred utilizing this approach.&#x0D; Conclusion: The double flap is a proper alternative technique in pterygium surgery; this new procedure, dual conjunctival flap with 7.5% recurrence rates and provides safe and comparable results to current methods.

Color doppler ultrasound analysis of pathological myopia induced changes in retrobulbar blood flow and its relationship with characteristic changes in myopia.

To analyze changes in retrobulbar blood flow in patients with pathological myopia using color doppler ultrasound (CDU), and to explore the relationship of these changes with the characteristic changes resulting from myopia. One hundred and twenty patients who met the selection criteria in the ophthalmology department of He Eye Specialist Hospital from May 2020 to May 2022 were included in this study. Patients with normal vision (n=40) were considered Group-A, patients with low and moderate myopia (n=40) were considered Group-B, and patients with pathological myopia (n=40) were considered Group-C. All three groups underwent ultrasonography. The peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), and resistance index (RI) of the ophthalmic artery, central retinal artery, and posterior ciliary artery were recorded and compared, and the characteristics of these parameters and myopia severity were analyzed. Pathological myopia resulted in significantly lower PSV and EDV of the ophthalmic artery, central retinal artery and posterior ciliary artery and higher RI values than patients with normal vision and low/moderate myopia (P<0.05). Pearson correlation analysis showed that retrobulbar blood flow changes were significantly correlated with age, eye axis, best corrected visual acuity, and retinal choroidal atrophy. CDU can objectively evaluate the retrobulbar blood flow changes in pathological myopia, and such blood flow changes are significantly correlated with the characteristic changes of myopia.

Long-term effects of meteorological factors and extreme weather on daily outpatient visits for conjunctivitis from 2013 to 2020: a time-series study in Urumqi, China.

Conjunctivitis is a common multifactorial inflammatory ocular surface disease characterized by symptoms such as congestion, edema, and increased secretion of conjunctival tissue, and the potential effects of meteorological factors as well as extreme meteorological factors on conjunctivitis and their lagging effects have not been fully evaluated. We obtained the electronic case information of 59,731 outpatients with conjunctivitis from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) for the period from January 1, 2013, to December 31, 2020. Meteorological data for daily mean temperature (°C), daily relative humidity (%), daily average wind speed (m/s), and atmospheric pressure (hPa) were obtained from the China Meteorological Data Sharing Service. The air pollutant data were obtained from 11 standard urban background fixed air quality monitors. A time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) were used to fit the effects of exposure to different meteorological factors and extreme weather on conjunctivitis outpatient visits. Subgroup analyses were performed on gender, age and season, and type of conjunctivitis. Univariate and multifactorial model results indicated that each 10-unit increase in mean temperature and relative humidity was associated with an increased risk of conjunctivitis outpatient visits, while each 10-unit increase in atmospheric pressure was associated with a decreased risk. The results of the extreme weather analysis suggested that extremely low levels of atmospheric pressure and relative humidity as well as extreme levels of temperature were associated with an increased risk of outpatient conjunctivitis visits, and extreme wind speeds were associated with a decreased risk. The results of the subgroup analysis suggested gender, age, and seasonal differences. We conducted the first large sample size time-series analysis in the large city furthest from the ocean in the world and confirmed for the first time that elevated mean temperature and extreme low levels of relative humidity in Urumqi were risk factors for local conjunctivitis outpatient visits, while elevated atmospheric pressure and extreme low levels of wind speed were protective factors, and there were lagged effects of temperature and atmospheric pressure. Multicenter studies with larger sample sizes are needed.

Combined trabeculotomy-trabeculectomy for glaucoma after congenital cataract surgery: long-term results

ObjectifNotre étude présente les résultats à long terme (> 5 ans) de la chirurgie du glaucome faisant suite à une chirurgie de la cataracte congénitale. NatureÉtude rétrospective. MéthodesIl s'agit d'une revue de synthèse des dossiers médicaux de tous les enfants qui ont fait l'objet, entre 2005 et 2014, d'une intervention en raison d'un glaucome après avoir subi une chirurgie de la cataracte congénitale au service d'ophtalmologie pédiatrique du département d'ophtalmologie de l'Alexandria Main University Hospital (Alexandrie, Égypte) et pour lesquels on dispose d'un suivi à 5 ans. Les données démographiques, cliniques et chirurgicales ont été tirées des dossiers médicaux. La réussite reposait sur la stabilité et/ou le rétablissement de l'excavation du nerf optique comparativement à ce qui a été observé lors de la visite initiale et, en l'absence de cette donnée, sur une pression intraoculaire (PIO) inférieure à la PIO initiale et une PIO inférieure à 16 mm Hg avec (réussite mitigée) ou sans (réussite complète) collyre antiglaucomateux. RésultatsLes dossiers médicaux de 48 enfants ont été passés en revue. On disposait des données de suivi pendant au moins 5 ans pour 32 yeux de 24 enfants, qui ont donc été inclus dans l’étude. L’âge moyen (± é.-t.) des enfants de l’étude était de 11,6 ± 11,3 mois (fourchette : 3,2–52,0 mois) lors de l'examen initial, et la durée moyenne du suivi (± é.-t.) était de 105,5 ± 31,4 mois (fourchette : 60–156 mois). Sur le total des 47 chirurgies du glaucome, une technique reposant à la fois sur une chirurgie de l'angle et une chirurgie filtrante avec antimétabolite était l'intervention le plus souvent réalisée (n = 30; 63,8 %). Les pourcentages annuels de réussite de la cinquième à la treizième année après l'intervention se chiffraient respectivement comme suit : 69,6 %; 68,8 %; 77,8 %; 50,0 %; 71,4 %; 60,0 %; 50,0 %; 83,3 % et 50,0 %. ConclusionsLa chirurgie du glaucome réalisée après une chirurgie de la cataracte congénitale demeure sûre, et son efficacité s'est maintenue pendant les 13 années suivantes.

Clinical features and factors affecting prognosis and partial deterioration of ocular papilloma: a retrospective study of 298 cases.

This study aimed to analyze the clinicopathological features of ocular papilloma, a common benign tumor, and the risk factors related to its recurrence and partial deterioration. We collected and analyzed the clinical information of 298 patients (51.68% males) with mean age of 41.54 ± 21.95years, in the ophthalmology department of the West China Hospital. Clinical and pathological factors that might be related to papilloma recurrence and partial deterioration were studied. The top three papilloma sites were bulbar conjunctiva, eyelid skin and palpebral conjunctiva. Moreover, 3.59% of lesions presented a malignant transformation, and 16.28% of patients had one or more recurrences after an average follow-up of 4.47years. The multivariate logistic regression model showed that multiple lesions were a risk factor for recurrence (p = 0.022, OR = 3.088, 95% CI: 1.180-8.079), while cryotherapy decreased the recurrence risk (p = 0.044, OR = 0.364, 95% CI: 0.136-0.972). Additionally, elderly patients and lesions on the corneal limbus or cornea had a higher risk of malignant transformation (p = 0.004 and 0.01, OR = 1.086 and 7.827, 95% CI: 1.027-1.150 and 1.629-37.596, respectively). Ocular papilloma usually occurs in middle-aged and young patients, with no significant gender differences. Older patients and lesions on the corneal limbus or cornea are risk factors for partial malignant transformation. Finally, multiple lesions were a risk factor for recurrence, and cryotherapy reduced the recurrence rate.

Association of chorioretinal thickness with chronic kidney disease

ObjectiveTo assess retinal and choroidal thickness changes in chronic kidney disease (CKD) patients using spectral domain optical coherence tomography (SD-OCT).BackgroundCKD is a devastating health trouble. The eye and the kidney share similar structural and genetic pathways, so that kidney disease and ocular disease may be closely linked. OCT is a precise, fast method for high-definition scanning of the retina and choroid.Patients and methodsA cross sectional study was conducted at Menoufia University Hospital ophthalmology department on 144 eyes of 72 CKD patients divided into 3 groups according to the stage of CKD as follows: group 1: CKD stage 1–2, with Glomerular Filtration Rate (GFR) > 60 ml/min/1.73m2 group 2: CKD stage 3, GFR 30–59 ml/min/1.73m2 and group 3: CKD stage 4–5, eGFR < 29 ml/min/1.73m2. All patients underwent full ophthalmologic examination followed by OCT assessment of retinal, retinal nerve fiber layer (RNFL) and choroidal thickness.ResultsRetinal and choroidal thickness were reduced in group 2 (CKD stage 3) and group 3 (CKD stage 4–5) compared with group 1 (CKD stage 1–2). The reduction was more severe in group 3 than group 2. RNFL thickness did not differ between groups. A thinner retina and choroid were associated with an elevated serum C-reactive protein (CRP) concentration, and greater degrees of proteinuria.ConclusionChorioretinal thinning in CKD is associated with a lower eGFR, a higher CRP, and greater proteinuria. Further studies, in a large scale of patients, are needed to detect whether these eye changes reflect the natural history of CKD.

Evaluation of Subfoveal Choroidal Thikness in Patients with Posterior Uveitis

Background: Inflammation of the retina, choroid, and nearby tissues such the vitreous, optic nerve head, and retinal arteries may all occur in posterior uveitis. Aim and objectives: This study's primary objective was to use OCT with improved depth of focus to find changes in subfoveal choroidal thickness in posterior uveitis. Subjects and methods: Thirty patients with posterior uveitis who were visiting the ophthalmology departments of Al-Azhar University Hospitals and Kobry El-Qobba Military Specialized Eye Hospital in Cairo, Egypt, were the subjects of this prospective research. The trial lasted between six and twelve months. Results: as regard the main fundus changes distribution among the studied patients; the most prevalent finding was Chorioretinitis (56.7%) while choroiditis was found in 53.3% and retinitis was found in 30.0%. Also the SFCT was significantly higher in patients than control eyes. Conclusion: An increase in SCFT may be a sign of subclinical inflammation in the retina and choroid that is occurring during the quiescent period.

Assessment of changes in optic disc parameters and peripapillary retinal nerve fiber layer thickness in myopic patients and its correlation with axial length and degree of myopia.

The present study aimed to assess the changes in optic disc and peripapillary retinal nerve fiber layer (RNFL) parameters in myopic patients and its correlation with axial length (AL) and spherical equivalent (SE) using optical coherence tomography (OCT). This was a cross-sectional study carried out from August 2019 to September 2021 in the ophthalmology department of a tertiary care hospital in eastern India. Myopic patients in the age group of 20-40 years and SE between - 0.5 to - 10 Diopters (D) were included in the study. Patients were divided into two groups on the basis of degree of myopia and AL. Appropriate statistical analysis was done at the end of the study period. The study included 307 eyes of 307 myopic patients. There were 181 females (58.96%) and 126 males (41.04%). The mean age of the patients enrolled for the study was 28.78 ± 5.76 years. Statistically significant difference (P < 0.001) was found between SE and AL in between the subgroups of A and B. With every 1 D increase in SE, the average peripapillary RNFL thickness decreased by 0.61 μ while with every 1 mm increase in AL, the average peripapillary RNFL thickness was found to reduce by 1.03 μ. Analysis of optic nerve head parameters and RNFL thickness by OCT for the diagnosis should be compared with a normative control group that has been matched for refractive error and AL instead of comparison with a normative database that has only been age matched.

Treatment of nonarteritic anterior ischemic optic neuropathy with an endothelin antagonist: ENDOTHELION (ENDOTHELin antagonist receptor in Ischemic Optic Neuropathy)—a multicentre randomised controlled trial protocol

BackgroundNonarteritic anterior ischemic optic neuropathy (NAAION) is a major cause of blindness in individuals over 50 years of age, with no available effective treatment. The oral dual endothelin receptor antagonist, bosentan, increases retinal optic nerve head blood flow in healthy humans and glaucoma patients. The objective of this trial is to assess the efficacy of bosentan administered at the acute stage in improving outcomes in NAAION patients.MethodsENDOTHELION (ENDOTHELin antagonist receptor in Ischemic Optic Neuropathy) is a phase III, interventional, prospective, multicentre, placebo-controlled randomised double-blind clinical trial. The primary outcome is change in the visual field mean deviation (MD) at 3 months (Humphrey 30-2 SITA standard programme). Secondary outcomes include MD and visual acuity changes up to 24 months, changes in peripapillary retinal nerve fibre and macular ganglion cell layer thickness in the affected eye, as measured by optical coherence tomography, rate of NAAION bilateralisation at 2 years, and quality-of-life. Patients over 50 years of age presenting with typical NAAION of recent onset (less than 21 days) are randomly assigned to either 125 mg oral bosentan or placebo, twice a day, during 8 weeks. Besides visits during the treatment phase, patients attend follow-up visits at 2, 3, 6, 12 and 24 months. The inclusion of patients began in August 2015 at five French University hospital ophthalmology departments and two specialised ophthalmology centres. It is planned to include 86 patients in this trial. To date we have included 72 patients and 49 have completed the full follow-up process.DiscussionAn endothelin receptor antagonist is a potential approach to improving the anatomical and functional prognosis of patients with NAAION. This multicentre double-blind randomised controlled trial is an opportunity to assess (1) the effect of bosentan on the structure and function of the optic nerve in NAAION, at 3 months, (2) the effect of bosentan on the bilateralisation rate at 24 months and (3) the tolerance profile of bosentan in this population.Trial registrationClinicalTrials.gov NCT02377271. Registered on March 3, 2015.

Changes to intraocular pressure and its correlation with corneal diameter in infants aged from 0 to 36 months.

ObjectiveThis study examines the distribution and development of intraocular pressure (IOP) in infants aged from 0 to 36 months and analyzes its correlation with corneal diameter.MethodsThe study used a retrospective case analysis methodology. Healthy infants treated in the ophthalmology department of Hebei Children's Hospital from December 2012 to December 2020 were included in the study. Among these infants, 385 had their IOP measured, and 432 had their corneal diameters measured. Furthermore, information such as birth history, growth and development, IOP, and corneal diameter were collected. Their IOPs were measured with an iCare portable rebound tonometer when the child was awake and calm, and the corneal diameter was measured with a Castroviejo caliper under chloral hydrate sedation. The infants were divided into five groups according to age, and SPSS statistical software was used to analyze, compare, and correlate IOP and corneal diameter variations.ResultsThe mean IOP values of 0–1 month, 1–6 months, 6–12 months, 12–24 months and 24–36 months groups were 7.42 ± 1.92, 9.10 ± 2.85, 12.00 ± 3.15, 13.72 ± 3.09, and 15.14 ± 2.67 mmHg, respectively. The differences in IOP of the 0–1 month old infants and the 1–6 months old infants with the other three groups were statistically significant; the difference in IOP between the 6–12 months group and the 24–36 months group was statistically significant. In the studied groups, the horizontal corneal diameters were 9.78 ± 0.14, 10.50 ± 0.29, 10.86 ± 0.23, 11.38 ± 0.07, and 11.72 ± 0.04 mm, respectively, and the vertical diameters of the cornea were 9.28 ± 0.26, 10.07 ± 0.18, 10.28 ± 0.14, 10.56 ± 0.24, and 10.85 ± 0.03 mm, respectively. The differences in the vertical and horizontal diameters of the cornea among the groups were statistically significant.ConclusionInfants' IOP and corneal diameter positively correlate with age, and they peak in the first 12 months.

Macular and peripapillary optical coherence tomography angiography metrics in thyroid-associated ophthalmopathy with chorioretinal folds

PurposeTo evaluate macular and radial peripapillary capillary (RPC) microvascular densities and the thickness of the retinal nerve fiber layer (RNFL) in thyroid-associated ophthalmopathy (TAO) with chorioretinal folds (CRFs) and the associations of these characteristics with visual function. MethodA cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from March 2018 to August 2021. All patients underwent ocular examination, ophthalmic function tests and optical coherence tomography angiography (OCTA). The microvascular densities in the macula and optic papilla in the TAO with CRFs or without CRFs. Correlation analyses were used to examine the association of microvascular density and visual function. ResultsTen TAO patients with CRFs (CRF group, 20 eyes) and 10 TAO patients without CRFs (NCRF group, 20 eyes) were recruited for the study. Visual function measurements, including best-corrected visual acuity (BCVA), were found to be worse in the CRF group (all p < 0.05). The macular whole-image vessel density in the superficial layer (SLR-mwiVD) was significantly decreased in the CRF group (p < 0.05). The RPC whole-image vessel density (RPC-wiVD) was significantly decreased in the CRF group (p < 0.05), particularly in the temporal subfields. The P100 amplitude of visual evoked potentials (VEPs) was positively associated with SLR-mwiVD and RPC-wiVD. The thickness of RNFL in the CRF group was obviously thicker than that in the NCRF group (p < 0.05). ConclusionsOur study showed decreased microvascular density of the macula and RPC and thicker RNFL in TAO patients with CRFs. CRFs with decreased microvascular density should be regard as an indicator of visually threatening conditions.

Occurrence of cystoid macular edema after uneventful phacoemulsification in diabetic patients without retinopathy: A hospital-based comparative study

This study aims to determine the incidence of CME after uneventful phacoemulsification in diabetic patients without any signs of retinopathy and nondiabetic patients in early post-operative periods. The present study was a prospective, comparative, hospital-based study conducted from December 2019 to December 2020 in the Ophthalmology department of a tertiary care referral hospital in Eastern India. All patients aged between 50 to 80 years of either sex with cataract grade nuclear sclerosis II–III with or without cortical cataract and early posterior subcapsular cataract undergoing uncomplicated phacoemulsification surgery by a single surgeon were included in the study. The patients were divided into 2 groups. Group 1 consisted of Type 2 diabetes mellitus patients with cataracts with no retinopathy changes on funduscopy and group 2 included healthy non-diabetic patients with cataracts. Comprehensive baseline evaluation including central retinal thickness (CRT) measurement using optical coherence tomography was done in all cases. Best corrected visual acuity (BCVA) and CRT were assessed 1 week and 6 weeks following surgery. Seventy-four patients were included in the study. Both the groups consisted of 37 cases each. The mean age in group 1 and group 2 was 62.24 ± 6.36 and 63.30 ± 6.39 years respectively. One patient in each group developed clinical CME in the postoperative period. The incidence of CME in our study was 2.7%. Improvement in BCVA was comparable in both groups and statistically insignificant. An increase in CRT was found to be statistically significant (P= 0.047) in group 1 at the 6th week follow-up. Visual outcomes in diabetic patients without retinopathy are similar to normal patients following uncomplicated phacoemulsification surgery.

Comparisons of visual outcomes between bilateral implantation and mix-and-match implantation of three types intraocular lenses.

To compare binocular static visual acuity (SVA), stereopsis, contrast sensitivity (CS) and dynamic visual acuity (DVA) of 5 combinations of bifocal intraocular lenses (IOLs), trifocal IOLs and extended-depth-of-focus (EDOF) IOLs in age-related cataract patients. Two hundred and ninety-two eyes of 146 patients who underwent cataract surgery in the ophthalmology department of the First Affiliated Hospital of Chongqing Medical University were involved. Subgroups included group MM (33patients, bilaterally bifocal IOL, ZMB00), group TT (31patients, bilaterally trifocal IOL, AT LISA tri839MP), group XX (34patients, bilaterally EDOF IOL, ZXR00), group MX (25patients, bifocal IOL, ZMB00 + EDOF IOL, ZXR00) and group TX (23patients, trifocal IOL, AT LISA tri839MP + EDOF IOL, ZXR00). The uncorrected SVAs (UDVA, UIVA and UNVA), uncorrected DVAs (UDDVA, UIDVA and UNDVA), near and distance stereopsis, and CS were assessed 3months postoperatively. Subgroups of TT, XX, MX and TX showed better UIVA than MM (bP = 0.039, 0.021, 0.035 and 0.037, respectively). MX showed better UNVA than MM and TX (bP = 0.031 and 0.013, respectively). MX group had the optimal outcomes of both near and distance stereopsis. In the UDDVA, XX group and MX group showed better outcomes than TX group at 24 fps (frames per second) (bP = 0.019 and 0.023, respectively). XX group and MX group showed optimal outcomes at all speeds of UIDVA (P = 0.001, 0.005, 0.003 and 0.005, respectively). As the speed increased, the XX group and the MX group showed better UNDVA than the MM group and the TT group (P = 0.019, 0.002 and 0.003, respectively). Mix-and-match implantation of bifocal IOLs and EDOF IOLs provides excellent and stable binocular visual outcomes including SVA, stereopsis and DVA in distant and near distances.

Children with strabismus and amblyopia presented abnormal spontaneous brain activities measured through fractional amplitude of low-frequency fluctuation (fALFF).

PurposeBased on fMRI technology, we explored whether children with strabismus and amblyopia (SA) showed significant change in fractional amplitude of low-frequency fluctuation (fALFF) values in specific brain regions compared with healthy controls and whether this change could point to the clinical manifestations and pathogenesis of children with strabismus to a certain extent.MethodsWe enrolled 23 children with SA and the same number matched healthy controls in the ophthalmology department of the First Affiliated Hospital of Nanchang University, and the whole brain was scanned by rs-fMRI. The fALFF value of each brain area was derived to examine whether there is a statistical difference between the two groups. Meanwhile, the ROC curve was made in a view to evaluate whether this difference proves useful as a diagnostic index. Finally, we analyzed whether changes in the fALFF value of some specific brain regions are related to clinical manifestations.ResultsCompared with HCs, children with SA presented decreased fALFF values in the left temporal pole: the superior temporal gyrus, right middle temporal gyrus, right superior frontal gyrus, and right supplementary motor area. Meanwhile, they also showed higher fALFF values in specific brain areas, which included the left precentral gyrus, left inferior parietal, and left precuneus.ConclusionChildren with SA showed abnormal fALFF values in different brain regions. Most of these regions were allocated to the visual formation pathway, the eye movement-related pathway, or other visual-related pathways, suggesting the pathological mechanism of the patient.

Clinical Observation and Genotype-Phenotype Analysis of ABCA4- Related Hereditary Retinal Degeneration before Gene Therapy.

Hereditary retinal degeneration (HRD) is an irreversible eye disease that results in blindness in severe cases. It is most commonly caused by variants in the ABCA4 gene. HRD presents a high degree of clinical and genetic heterogeneity. We determined genotypic and phenotypic correlations, in the natural course of clinical observation, of unrelated progenitors of HRD associated with ABCA4. To analyze the relationship between the phenotypes and genotypes of ABCA4 variants. A retrospective clinical study of five cases from the ophthalmology department of the People's Hospital of Wuhan University from January 2019 to October 2020 was conducted. We tested for ABCA4 variants in the probands. We performed eye tests, including the best-corrected visual acuity, super-wide fundus photography and spontaneous fluorescence photography, optical coherence tomography, and electrophysiological examination. Disease-causing variants were identified in the ABCA4 genes of all patients. Among these, seven ABCA4 variants were novel. All patients were sporadic cases; only one patient had parents who were relatives, and the other four patients were offspring of unrelated parents. Two patients presented with Stargardt disease, mainly with macular lesions, two presented with retinitis pigmentosa (cone-rod type), and one presented with cone dystrophy. The visual acuity and visual field of the five patients showed varying degrees of deterioration and impairment. The same ABCA4 mutation can lead to different clinical phenotypes, and there is variation in the degree of damage to vision, visual field, and electrophysiology among different clinical phenotypes. Clinicians must differentiate between and diagnose pathologies resulting from this mutation.