Improvement In Visual Acuity Research Articles

Initial experiences of switching to faricimab for neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in an Asian population.

To describe the early experiences of patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) whose treatment was switched to faricimab from other anti-vascular endothelial growth factor (VEGF) agents. This is a prospective cohort of eyes with nAMD and PCV that were previously treated with anti-VEGF agents other than faricimab. We evaluated visual acuity (VA), central subfield thickness (CST), macular volume (MV), pigment epithelial detachment (PED) height, and choroidal thickness (CT) after one administration of faricimab. Where present, fluid was further evaluated according to intraretinal fluid (IRF), subretinal fluid (SRF), or within PED. Seventy-one eyes from 71 patients were included (45.07% PCV and 54.93% typical nAMD). The mean [standard deviation (± SD)] VA, CST, and MV improved from 0.50 logMAR (± 0.27 logMAR) to 0.46 logMAR (± 0.27 logMAR) (p = 0.20), 383.35 µm (± 111.24 µm) to 322.46 µm (± 103.89 µm (p < 0.01), and 9.40 mm3 (± 1.52 mm3) to 8.75 mm3 (± 1.17 mm3) (p < 0.01) from switch to post switch visit, respectively. The CT reduced from 167 µm (± 151 µm) to 149 µm (± 113 µm) (p < 0.01). There was also a significant reduction in the maximum PED height between visits [302.66 µm (± 217.97 µm)] and the post switch visit [236.66 µm (± 189.05 µm); p < 0.01]. This difference was greater in PEDs that were predominantly serous in nature. In the eyes with typical nAMD (n = 39), improvements were significant for CST, MV, CT, and PED. In the eyes with PCV (n = 32), only reductions in CT were statistically significant, while VA, CST, MV, and PED only showed numerically smaller improvements. One patient developed mild vitritis without vasculitis, which resolved with topical steroids with no sequelae. In our case series of Asian nAMD patients, switching to faricimab was associated with a stable VA and meaningful anatomical improvements, particularly with typical nAMD subtypes.

Renal impairment may indicate postoperative low vision in young patients with proliferative diabetic retinopathy undergoing vitrectomy.

To innovatively evaluate the impact of renal impairment in young work age patients with proliferative diabetic retinopathy (PDR) on their visuality after vitrectomy. To find out whether it is possible to better predict the improvement of visual acuity after vitrectomy in working-age people without adding additional preoperative testing. In view of the fact that diabetic retinopathy and diabetic nephropathy are common diabetic complications of microvascular damage, it is considered whether preoperative renal function can be used as this evaluation index. This paper studies the design under this theme. This retrospective study included 306 patients (306 eyes) diagnosed with PDR and undergoing vitrectomy in our hospital from January 2016 to June 2023. Relevant baseline data were collected, including age, history of kidney disease and clinical laboratory test results. According to the International Standard Logarithmic Visual Acuity Checklist, the best corrected visual acuity was tested on the first day of admission and one month after surgery, and the difference between the two was subtracted. A difference >0 was defined as "vision improved". Patients were classified as vision-improved group (n=245) and non-improved group (n=61). The differences in baseline serum urea nitrogen, creatinine, uric acid, Cystatin C, estimated glomerular filtration rate (eGFR) and urine protein distribution between the two groups were statistically analyzed, binary regression analysis was performed for meaningful parameters, and random forest model ranked the characteristics in importance. 1.A higher level of serum cystatin C [1.02(0.80,1.48) mg/L vs 0.86(0.67,1.12) mg/L, P<0.001] and a lower eGFR [82.3(50.33, 115.11) ml/(min/1.73m²) vs 107.69(73.9, 126.01) ml/(min/1.73m²), P=0.002] appeared in the non-(vision-)improved group compared with the vision-improved group. 2. The occurrence of preoperation proteinuria history of nephropathy take a larger proportion in non-improved group. 3. Univariate regression analysis showed history of nephrology (OR=1.887, P=0.028), preoperative serum urea nitrogen (OR=0.939, P=0.043), cystatin C (Cys-C) concentration (OR=0.75, P=0.024), eGFR (OR=1.011, P=0.003) and proteinuria (OR=3.128, P<0.001) were influencing factors to postoperative visual acuity loss in young working age PDR patients. Excluding other confounding factors, preoperative proteinuria is an independent risk factor for postoperative vision improvement in working-age PDR populations (OR=2.722, P=0.009). 4. The accuracy of the prediction random forst model is 0.81. The model appears to be superior in terms of positive prediction. In young work aged PDR patients undergoing vitrectomy, preoperative urine protein can be an independent indicator of postoperative visual loss. Aggressive correction of kidney injury before surgery may help improve postoperative vision in patients with PDR.

The impact of additional visual tasks in physical exercise on balance ability among 9-10-year-old children: the mediating effect of visual acuity.

This study aimed to explore the effects of additional visual tasks in physical exercise on the vision and balance ability of children, and to verify whether children's vision mediated the influence of physical exercise on their balance ability. The study randomly selected 86 students aged 9-10 years old from a school in Suzhou city, dividing them into an experimental group (n = 43) and a control group (n = 43). The experimental group participated in physical exercise with additional visual tasks, while the control group engaged in routine physical exercise. The experiment lasted for 16 weeks, with kinetic visual acuity (KVA), uncorrected distance visual acuity (UDVA), static balance, and dynamic balance measured before and after the experiment. The results showed that after the experiment, the experimental group had significantly improved kinetic visual acuity (KVA), uncorrected distance visual acuity (UDVA), static balance, and dynamic balance. In contrast, the control group had significantly decreased kinetic visual acuity, no significant improvement in uncorrected distance visual acuity, and no significant difference in dynamic balance and static balance. In the experimental group, there was a moderate positive correlation between kinetic visual acuity and uncorrected distance visual acuity, and a moderate positive correlation between uncorrected distance visual acuity and both static and dynamic balance. The study also found that uncorrected distance visual acuity partially mediated the effect of additional visual tasks during physical exercise on static and dynamic balance among children. In conclusion, adding visual tasks to physical exercise had a positive effect on improving children's vision and balance ability. Kinetic visual acuity and uncorrected distance visual acuity were positively correlated, and uncorrected distance visual acuity was positively correlated with both static and dynamic balance. Uncorrected distance visual acuity partially mediated the effect of physical exercise on children's balance ability.

Childhood amblyopia: A systematic review of recent management options.

This study reviews the current information on treatment of childhood amblyopia, with the goal of improving visual functions. The authors searched various online databases including PubMed, Web of Science, ProQuest, Scopus, Google Scholar, Ebsco, and Medline. The articles, published between 2002 and 2023, included in this study were used to assess the different modalities for the management of different types of childhood amblyopia. The final systematic review included 41 studies from different countries, covering 4060 children with a mean age 6.8 ± 124 years. The findings showed that childhood amblyopia commonly treated through a systemic approach, i.e., starting with treatment of refractive errors with given optical adaptation time, followed by visually stimulating amblyopic eye by covering the dominant eye with patching, Atropine or Bangerter filters. Refractive adaptation period of 18-22 weeks has proven to show a significant improvement in visual acuity. It has been confirmed that 2 h patching is effective for the first time treated amblyopes, and if there is no improvement, increase the period to 6 h daily. Novel methods that improve binocular function such as dichoptic, perceptual training, video gaming, and drugs that facilitate visual neuroplasticity, are useful in the treatment of amblyopia that is not responsive to conventional therapy. The study concludes that significant evidence show that childhood amblyopia is treated through a systemic approach. Starting from correcting refractive errors with a period of optical adaptation, followed by patching therapy and atropine penalization. New methods that improve the binocular functions and medications that facilitate visual neuroplasticity have found to be useful in the treatment of amblyopia that is not responsive to conventional treatment.

A Comparative Study of Visual Outcome and IOP Changes in Postoperative PCO Cases Among Diabetics and Non Diabetics Following Nd: YAG Laser Capsulotomy

Background: Posterior capsular opacification is the most common long term complication of modern IOL surgery.ND: YAGlaserre mains the corner stone of its treatment. In this study, an attempt is made to study the visualoutcome and change in the intraocular pressure following Nd: YAG laser capsulotomy and compare the resultsbetween diabetic patients and non-diabetic patients.Method: This was a prospective study of 100 patients (50 diabetics and 50 nondiabetics), conducted in KhajaBanda Nawaz Teaching and General Hospital, Kalaburgai. All patients in the age group 45-75 years, attendingthe regular OPD who presented with visually significant posterior capsular opacification and were treated withNd:YAG laser capsulotomy. Patients were included in the study taking into consideration inclusion and exclusioncriterias. Patients were followed up on first day, first week and the four weeks and the improvement in the BCVAand the changein IOP (Intra Ocular pressure) were recorded.Results: All the patients treated for PCO with Nd:YAG laser capsulotomy showed an improvement in visualacuity. The visual outcome at four weeks (41%had &gt; 6/12) was found to be better than that at first week (34 % hadthe same) and first day (16% had the same). The final visualoutcome at 4 weeks was found to be better in nondiabetics(52% had&gt;6/12) compared to diabetics (30% had&gt;6/12). All the patients showed an increase in IOP atthe first day and first week of follow up and return to near normal of baseline values at four weeks of follow up,the pattern of change in IOP being similar in both the study groups.Conclusion: Nd:YAG laser capsule to May effectively improves the visualacuity inpatients with visually significantPCO. The comparatively poor outcome in the diabetic group can be attributed to the associated retinopathychanges. Nd:YAGl aser capsulotomy is associated with a transient rise in the intraocular pressure in all patientswhich can very rarely remain persistently high.

The Effects of Cataract Surgery on Children's Vision: A Systematic Review.

Five-fifths of all incidents of blindness in Saudi Arabia may be attributed to cataracts. Cataracts are the second major cause of blindness, responsible for 35.5% of cases. Therefore, the purpose of the research was to measure the visual acuity improvement after cataract surgery in children. This systematic review followed PRISMA guidelines for reporting systematic reviews. All procedures followed the recommendations of the Cochrane handbook. Studies of varying study designs, both published and unpublished, are included. Retrospective studies with outcomes of pediatric cataract surgery were identified from various databases. After an initial screening, 108 out of 167 items were deemed unsuitable for publication. There were 59 full-text papers assessed for inclusion, and only seven matched the criteria. All the articles included were of a very high standard. Both the duration of therapy and the target population varied widely between the studies. The results indicated that the majority of childhood cataracts are hereditary. Primary posterior capsulectomy and anterior vitrectomy combined with cataract extraction and intra-ocular lens implantation is the treatment of choice for pediatric cataracts. It is recommended that surgery be performed in a properly equipped facility staffed by trained, cooperative personnel and that different procedures be used to enhance post-operative follow-up.

Encircling continuous suture technique for the management of extensive traumatic cyclodialysis: A case report.

To report a surgical technique of cyclopexy, wherein two laps of encircling continuous sutures are placed around the limbus to treat refractory extensive cyclodialysis. Color fundus photography, swept-source optical coherence tomography (OCT) for the anterior segment, and spectral-domain OCT for the macula. Previous attempts, including indirect cyclopexy and direct external cyclopexy with gas injection, failed to successfully resolve the severe cyclodialysis and associated hypotonic maculopathy. In the third surgery, two laps of encircling continuous sutures were placed around the limbus at the distances of 2-3 mm and 3-4 mm, along with phacoemulsification, intraocular lens implantation, and capsular tension ring placement. Following the surgery, hypotony and hypotonic maculopathy were effectively resolved, resulting in a significant improvement in visual acuity, that has been maintained over a year. The described surgical technique of encircling continuous sutures may be a viable option for the treatment of severe cyclodialysis.

Using adaptive optics to optimize the spherical aberration of eyes implanted with EDOF and enhanced monofocal intraocular lenses.

To assess the effect of change in ocular spherical aberration (SA) with adaptive optics on visual acuity (VA) at different defocus after implantation of extended depth-of-focus (EDOF) and enhanced monofocal intraocular lenses (IOLs). Narayana Nethralaya Eye Hospital, Bangalore, India. Prospective, longitudinal, observational. 80 eyes (40 patients) that had cataract surgery were included in the study. 40 eyes were implanted with Eyhance EDOF IOLs and the remaining with Vivity EDOF IOLs. Baseline ocular aberrations were measured with a visual adaptive optics aberrometer, then the optimal SA was determined by increasing it in steps of -0.01 μm up to -0.1 μm until the maximum improvement in near distance VA was observed for a given eye. Then the defocus curve for each eye was measured after modifying the ocular SA by magnitude equal to optimal SA. Most of the eyes accepted a negative induced SA of -0.05 μm (Eyhance group: 67.6%; Vivity group, 45.2%). In the Eyhance group (dominant eyes), VA improved at -2 diopters (D) ( P < .02) only and degraded at 0 D, +0.5 D, and +1 D defocus ( P < .05). In the Vivity group, the VA remained unchanged at all defocus ( P > .05). In the Eyhance group (nondominant eyes), VA improved at -3.5 D defocus only and degraded at +1.5 D and +2 D defocus ( P < .05). In the Vivity group, VA improved at -2.5 D defocus ( P < .05) only. A negative induced SA of -0.05 μm in implanted eyes was optimal for a slight improvement in distance-corrected near and intermediate VA without any significant decrease in baseline distance-corrected VA.

Insights into Visual Outcomes and Determinants in Pituitary Adenoma Surgery: A 5-Year Retrospective Cohort Study.

To investigate the long-term visual outcome and their determinants after an operation in Thai pituitary adenoma (PA). A retrospective cohort study was conducted on PA patients who underwent surgery at Rajavithi Hospital. Baseline characteristics and visual parameters, including visual acuity (VA) and visual field (VF), were analyzed in relation to the visual prognosis outcome. The outcome was defined as VA improvement at 1-year postoperatively. Visual parameters were measured at each follow-up visit and compared. Factors for improved visual prognosis were evaluated using logistic regression analysis. A total cohort of 87 patients (64.37% female), 62.07% showed improvement in visual outcome. Most improvement occurred immediately after surgery, evident at the 1-month visit. The mean follow-up time was 47.45 months (±28.49 SD), mean difference in VA improvement at 1-year was -0.56 logMAR (95% CI -0.73, -0.47). In multivariable logistic regression model, prolonged onset duration was associated with a reduced odds of improved visual outcome, with an odds ratio (OR) of 0.946 (95% CI 0.899-0.996, p = 0.034). Baseline characteristics, tumor volume, Hardy and Knops classification, and surgical approaches were not identified as significant predictors. Both TSS and transcranial approaches are effective for pituitary adenoma. A prompt operation is recommended for patients with prolonged onset duration, with thorough discussion on poor postoperative visual outcomes.

Long-Term Outcomes of Phacoemulsification Surgeries at ECWA Eye Hospital: A Prospective Clinical Cohort Study.

Phacoemulsification has proven to be a breakthrough technique in cataract surgery. Its popularity has grown dramatically as procedures and equipment have advanced, improving both safety and efficiency. This study presents long-term outcomes from phacoemulsification surgeries performed at the Evangelical Church Winning All (ECWA) Eye Hospital, a tertiary eye care center. This prospective clinical cohort study followed standard practices for operations performed under local anesthesia. Ophthalmologists evaluated long-term outcomes and predictors of improved visual acuity after phacoemulsification cataract surgery. The visual recovery of the patients over time was evaluated, and the factors that influence the gains in vision were identified. A total of 177 patients were subjected to treatment at our facilities during the study period. There were 116 male and 61 female patients, which resulted to a male-to-female ratio of 1 : 0.53. The average age of the patients was 59.18 years with a standard deviation of 11.38 years. Of the 259 eyes treated, 249 eyes (96.1%) achieved a high success rate with visual acuity of 6/6 - 6/18. Ten (10) eyes (3.9%) had moderate acuity between <6/18 and 6/60. Follow-up examinations over five years after phacoemulsification showed poor vision outcomes among old patients. The primary factor that affected improvement in visual acuity among patients was amblyopia, present in 30% of cases. Posterior capsular opacification and macular edema collectively accounted for 20% of poor vision cases, while optic atrophy, glaucoma, and retinal hemorrhage each represented approximately 10% of poor vision cases. The phacoemulsification approach demonstrated a highly effective restoration of vision for the vast majority, while long-term data analysis indicated the potential for age-related variability in postoperative visual gains.

A case of syphilitic chorioretinitis masquerading as acute posterior multifocal placoid pigment epitheliopathy

Ocular involvement can be the first and only manifestation of syphilis, and it may mimic any sign of posterior segment involvement. We report a 22-year-old man with syphilitic multifocal chorioretinitis who had clinical and imaging findings with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) features in both eyes without any systemic and neurological symptoms. Systemic antibiotic and corticosteroid treatment led to regression in multifocal chorioretinitis lesions and improvement in visual acuity. Syphilis may present as APMPPE. Syphilis tests should be kept in mind and carefully evaluated in the differential diagnosis of patients presenting with intraocular inflammation of unknown origin.

Transscleral fixation of intraocular lens in the treatment of lens subluxation in children

This study evaluated the effectiveness and safety of IOL implantation with transscleral fixation using the knotless Z-suture technique in pediatric patients with congenital lens subluxation. The study included 24 children (36 eyes) with grade III congenital subluxation of the lens who underwent phacoaspiration of the subluxated lens with IOL implantation with transscleral fixation using the knotless Z-suture performed in the Kazakh Research Institute of Eye Diseases in Almaty in the period from 2017 to 2021. The average observation period was 31.7±11.3 months (2.0 to 4.5 years). The stability of the IOL position, the state of the intrascleral sutures, visual acuity after surgery, the presence and severity of complications in the long-term period were evaluated. All patients (100%) had a significant improvement in visual acuity after surgery. No intraoperative complications were registered in any of the cases. Postoperative complications were noted in 8.3% of cases (n=3). The final functional outcome of surgical treatment depended on the presence of concomitant pathology, the main cause of low vision was the development of refractive amblyopia due to refractive errors. The presented technique of transscleral fixation of IOL has proven to be reliable, which is especially important for pediatric patients considering their high physical activity and expected lifespan.

Multifocal intraocular lens implantation in children with unilateral congenital cataracts.

To evaluate the vision recovery, reconstruction of binocular visual function, and influencing factors after multifocal intraocular lens implantation in children with unilateral congenital cataracts. University hospital. Prospective clinical study. In the prospective clinical study, 55 children aged 3 to 14 with unilateral congenital cataracts received multifocal intraocular lenses (TECNIS ZMB00) posterior optic capture from 2019 to 2022. Corrected distance visual acuity (CDVA; 5 m), distance-corrected intermediate visual acuity (DCIVA; 66 cm), distance-corrected near visual acuity (DCNVA; 33 cm), stereoscopic vision, visual quality (objective scatter index [OSI] and modulation transfer function [MTF]), axial length (AL), keratometry (K), and contrast sensitivity (CS), as well as postoperative occlusion compliance were evaluated before and after surgery. At the final follow-up, 90.91% (50/55) patients showed significant improvement in visual acuity (VA) after surgery. CDVA, DCIVA and DCNVA were 0.23 ± 0.17, 0.39 ± 0.15, and 0.44 ± 0.15 logMAR, respectively. 69.09% (38/55) patients achieved good VA (better than 0.3 logMAR).52.76% (25/48) patients had a positive Titmus test. OSI and MTF were 1.24 ± 0.91 and 42.45 ± 12.30, respectively. 73.68% (28/38) of the patients (better than 0.3 logMAR) underwent strict occlusion therapy. Postoperative VA is correlated with preoperative CDVA ( r = -0.829, P < .001), corneal astigmatism ( r = 0.384, P = .036), △AL (difference between the cataract eyes and contralateral eyes, r = -0.490, P = .006), and occlusion compliance ( r = -0.806, P < .001). Multifocal intraocular lens implantation could obtain relatively satisfactory VA (CDVA, DCIVA and DCNVA) and the binocular visual function of children with unilateral congenital cataracts. Postoperative VA is related to preoperative VA, corneal astigmatism, △AL, and occlusion compliance.

Rituximab in the Treatment of Non-Infectious Uveitis: A Review.

Non-infectious uveitis (NIU) is an immune-mediated disorder manifesting as ocular pain, redness, floaters, and photophobia, and is a leading cause of preventable blindness. Managing NIU presents considerable challenges due to the condition's resistance to high-dose corticosteroids and various immunotherapies. This review assesses the efficacy and safety of rituximab (RTX) in the treatment of NIU, based on individual case reports and small-scale studies. A cohort of 78 patients (20 males, 58 females), with a mean onset age of 32.3 years (range 8-72), was analyzed. Juvenile idiopathic arthritis (JIA) was the most frequently associated comorbidity, affecting 28 patients, while anterior uveitis was the predominant subtype, observed in 26 of 47 cases. Prior to RTX therapy, patients had been treated with an average of 1.7 conventional immunosuppressive agents (range 0-5) and 1.1 biologics (range 0-4). RTX was introduced following the failure of high-dose corticosteroids, immunosuppressive drugs, and biologics to control the uveitis. The median time from diagnosis to RTX initiation was 7.7 years (range 0.25-21). Post-RTX, 44.2% of patients experienced improvement in visual acuity, 79.5% achieved resolution of ocular inflammation, and 8.9% showed partial improvement. Additionally, 81.1% were able to reduce their corticosteroid dosage. Overall, 88.6% (69 out of 78) demonstrated a positive response to RTX treatment. These findings indicate that RTX may serve as an effective therapeutic option for NIU unresponsive to steroids and multiple immunotherapies. It may also warrant consideration as a potential first-line treatment in certain cases.

Influence of preoperative dilation time on the effect of cataract ultrasonography combined with goniostomy in patients with primary closed angle glaucoma and its clinical significance.

To evaluate the impact of preoperative pupil dilation time on the outcomes of cataract ultrasonoemulsification combined with goniostomy in patients with primary angle-closure glaucoma (PACG). A retrospective analysis was conducted on 106 PACG patients who underwent cataract ultrasonoemulsification with goniostomy. Patients were divided into two groups based on pupil dilation times: group A (dilation time between 20 to 30 minutes) and group B (dilation time between 30 minutes to 1 hour). Pre- and postoperative intraocular pressure (IOP), visual acuity, pupil diameter, anterior chamber depth (ACD), and lens thickness (LT) were measured. Surgical time and cumulative dissipated energy (CDE) were also analyzed. Multivariate analysis was performed to identify independent risk factors for postoperative complications. Both groups showed significant postoperative improvement in visual acuity (P < 0.05). Group B exhibited significantly lower postoperative IOP than group A (P < 0.05). There were significant increases in ACD and pupil diameter and a decrease in LT post-dilation in both groups (all P < 0.05). Group B showed a deeper ACD, thinner LT, and larger pupil diameter compared to group A (all P < 0.05). While CDE was similar between groups, operation duration was longer in group A (P < 0.05). Disease course > 5.5 years, preoperative IOP > 25.14 mmHg, pupil diameter before dilation < 4.895 mm, ACD before dilation < 2.105 mm, and dilation time ≤ 30 minutes were independent risk factors for postoperative complications. Preoperative pupil dilation time > 30 minutes leads to better surgical outcome. Several preoperative factors, including dilation time ≤ 30 minutes, are independent risk factors for postoperative complications.

Effect of Low Vision Devices on Visual Acuity and Visual Function of Students of Schools for the Blind in Southeast Nigeria

Aim: To determine the effect of low vision aids (LVA) on the visual acuity and visual function of students of schools for the blind in South East Nigeria. Settings and design: This was a cross-sectional, interventional study conducted in three schools for the blind in Southeast, Nigeria. Methods: All students who consented and met the eligibility criteria from these schools were enlisted for the study. Each participant underwent visual acuity assessment and a thorough eye examination, which included tests involving low vision aids. Participants who had improvement in their vision were provided with low vision aids and reassessed four months later. In addition, changes in functional vision were assessed using the LV Prasad Functional Vision Questionnaire. Results: Ninety-two students made up of 52 (57.0%) men and 40 (43.0%) women were examined. The mean age was 18.4 ± 6.4 years. Eighty-eight (95.7%) students had visual acuity &lt;3/60 in the better eye before refraction. Eleven (12%) students had improvement in visual acuity to ≥6/60 in the better eye with refraction. Thirteen (14.1%) students had improvement by at least one grade of the WHO visual acuity categories with the use of low vision aids and 10 (76.9%) of these were able to read N10 or better. The improvement in functional vision was statistically significant (P &lt; 0.001). Conclusion: Low Vision Aids are important in the rehabilitation of students with residual vision.

Short-term Visual Outcome Following Anterior Chamber Intraocular Lens Implantation—The Experience of a Rural Teaching Hospital

Purpose: To report the indications, frequency and short-term visual outcome of anterior chamber intraocular lens implantation (ACIOL) in a rural tertiary hospital; as well as to describe the reasons for poor visual outcome following ACIOL implantation. Methods: This was a retrospective descriptive study of all patients aged at least 18 years who underwent cataract extraction and implantation of ACIOL between January 2004 and May 2023. Information retrieved from the case records included preoperative visual acuity, indication for ACIOL implantation, first-day postoperative visual acuity, and 6 weeks postoperative visual acuity. Results: A total of 133 eyes of 126 patients were reviewed in this study. The mean age was 60.9 years, with a male-to-female ratio of 1.7:1. The most common indication for ACIOL use was a posterior capsular rent (70.7%). The first-day postoperative visual acuity was 6/18 or better in 7 (5.3%) patients, and by the sixth postoperative week, this proportion had increased to 28.6% (38 patients). The most common complication on the first day post-op was striate keratopathy (72.9%), while the most common at 6 weeks was pseudophakic bullous keratopathy (21.1%). Conclusion: Although complications were noted with the use of ACIOLs, improvement in visual acuity was observed at 6 weeks. ACIOLs may still be relevant in settings where automated vitrectomy equipment is not readily available, but the availability of expertize is required for its implantation and the complication profile of ACIOLs must always be taken into consideration.

Diffuse Unilateral Subacute Neuroretinitis: A Case Report Documenting Transretinal Migration of Nematodes

Abstract Purpose: To report two cases of diffuse unilateral subacute neuroretinitis (DUSN) from northern Iran and to present the sequential imaging. Methods: Two patients with large subretinal nematodes were evaluated and managed in our clinic. Serial fundus photography and optical coherence tomography (OCT) imaging were used to document the course of the disease. Laser photocoagulation was administered to manage the patients. Results: The migration of the nematodes from subinternal limiting membrane space to subretinal space was documented in one case, coinciding with the onset of inflammatory and destructive processes. Both patients were successfully managed using laser photocoagulation alone. Follow-up examinations revealed partial recovery of the outer retinal layers and improvement in visual acuity. Nevertheless, some persistent atrophy in the retinal nerve fiber layer and ellipsoid layer was noted in the final examination. Conclusions: We presented two cases of DUSN from northern Iran, with OCT documentation of transretinal migration in one case. Photocoagulation laser alone is an effective treatment modality in the early stage. The suboptimal final visual acuity appears to be linked to both inner and outer retinal layers’ damage.

Ayurvedic management of Dome-shaped maculopathy: A case report

Dome-Shaped Maculopathy (DSM) is a rare condition characterized by the anterior convex elevation of the macula toward the vitreous cavity. Due to a lack of available data about DSM, the exact cause is not known. In Ayurveda, analysis of DSM can be done on the basis of the predominance of aggravated Dosha (~regulatory functional factors of the body) and their specific Gunas (~properties). This condition can be taken as a result of the vitiation of all three Doshas with the dominancy of Vata. Timira (~one of the diseases causing visual disturbance) is one of the Drishtigata roga (~ eyesight disorders). A 31-year-old female presented to the Shalakya tantra outpatient department with blurred vision in her left eye and headache that had persisted for four years. On the basis of the optical coherence tomography, she was diagnosed with DSM along with subretinal fluid. Ama pachana (~enhancing digestion), Vatanulomana (~pacification of obstructed Vata), Tridosha shamaka (~reducing alleviated regulating functional factors), Rasayana (~rejuvenation therapy), and Shothahara chikitsa (~anti-inflammatory) were adopted in the management that was focused in reducing the subretinal fluid and preventing further complications such as retinal detachment. In this case, subretinal fluid was decreased after Virechana karma, but the level of subretinal fluid was noticed again after Tarpana. The visual acuity was improved from 6/24 to 6/12 in the left eye and was maintained after one month of follow-up and the complaint of headache was also resolved. The patient in this case was nonmyopic with dome-shaped macula and subretinal fluid and with Ayurvedic intervention; the subretinal fluid was lessened, resulting in an improvement in visual acuity.

Correlation between improvement of visual acuity and degree of decompression of the optic canal in patients with parasellar meningioma: a single centre retrospective analysis

Correlation between improvement of visual acuity and degree of decompression of the optic canal in patients with parasellar meningioma: a single centre retrospective analysis