Visual Function Scores Research Articles

Early intervention of extracorporeal shockwave therapy sustained positive long-term effect on rotator cuff healing: A randomized controlled trial with 3-year follow-up

BackgroundThe long-term effects of extracorporeal shockwave therapy (ESWT) on rotator cuff repair are unknown. ObjectivesTo investigate the functional outcomes and structural changes of ESWT at 3-year follow-up after rotator cuff repair. MethodsA randomized clinical trial was conducted, including patients who underwent rotator cuff repair. The patients were assigned to two groups based on whether they underwent radial ESWT 3 months postoperatively. The ESWT Group received 5 weeks of rehabilitation and ESWT weekly, whereas the CONTROL Group received only rehabilitation. Visual analog scale (VAS) pain score and functional scores were analyzed at 3 months (baseline), 6 months, and 3 years follow-up. In addition, MRI and ultrasonography were used to assess tendon maturation, integrity, tendon quality, acromiohumeral distance (AHD), and muscle fatty infiltration. ResultsFinally, 32 participants completed all the assessments. At the final follow-up, 2 patients in the ESWT Group (16.5 %) versus one patient in the CONTROL Group (6.25 %) had rotator cuff failure (P = 0.176). The ESWT treatment showed similar clinical outcomes in VAS-pain score, functional scores, tendon quality, AHD, and muscle fatty infiltration versus the CONTROL Group (Ps > 0.05). MRI analysis indicated improved tendon healing after ESWT treatment at both 6-month (P = 0.036) and 3-year follow-up (P = 0.028). ConclusionEarly intervention with radial ESWT sustained long-term effects on the healing of the repaired rotator cuff and similar functional outcomes at long-term follow-up compared with standard rehabilitation.

Change in Visual Acuity of Patients With Fuchs Endothelial Corneal Dystrophy Over 1 Year.

To determine whether the clinical and paraclinical course of Fuchs endothelial corneal dystrophy (FECD) over 1 year is related to the extent of triplet repetition in the transcription factor 4 (TCF4) gene. A prospective study with a 1-year follow-up was conducted. A total of 104 patients (160 eyes) with FECD and an equivalent number of age- and sex-matched control subjects without FECD were included. At inclusion, the corneas were graded using the modified Krachmer grade (KG) and patients were genotyped for the number of trinucleotide repeats (TNRs) in the TCF4 gene by the short tandem repeat assay. Visual acuity, Scheimpflug tomographic features, and the Visual Function and Corneal Health Status using a visual disability instrument were measured on 2 visits at 1-year intervals. KGs ranged from 1 to 6, and 46% of eyes had grades 1 to 4. 71% of the patients harbored TNR expansion (>40) versus 13% in control subjects ( P < 0.001). Severity at inclusion was higher in the presence of TNR expansion when considering eyes independently (mean grade ±SD, 4.08 ± 1.42) without TNR expansion and 4.66 ± 1.27 with TNR expansion ( P = 0.024). In 1 year, the ETDRS score significantly decreased by -2.97 (95% confidence interval -4.69 to -1.26, P = 0.001) and the ETDRS score with glare by -4.25 (95% confidence interval -6.22 to -2.27, P < 10 -5 ). There was no relationship between the rate of decline and TNR expansion or KG. Central corneal thickness and Visual Function and Corneal Health Status scores did not significantly vary. It is possible to measure a subtle progression of FECD over a period as short as 1 year. We did not find a relationship between the presence of TNR expansion and the speed of deterioration over 1 year. This work should facilitate the design of future clinical trials on FECD.

A multifactorial screening model based on the Graves ophthalmopathy quality of life scores in dysthyroid optic neuropathy.

To validate the Graves ophthalmopathy quality of life (GO-QOL) questionnaire in screening DON and to construct an effective model. A total of 194 GO patients were recruited and divided into DON and non-DON (mild and moderate-to-severe) groups. Eye examinations were performed, and quality of life was assessed by the GO-QOL questionnaire. The random forest, decision tree model, receiver operator characteristic (ROC) curve, accuracy and Brier score were determined by R software. In GO-QOL, age, best corrected visual acuity (BCVA), exophthalmos, CAS, severity, and Gorman score were found to be factors related to visual function scores. On the appearance scale, gender, duration of GO, BCVA, exophthalmos, CAS and severity of GO were relevant. Both the visual function scores and appearance scores were significantly lower in DON groups than in non-DON groups (33.18 ± 24.54 versus 81.26 ± 17.39, 60.08 ± 24.82 versus 76.14 ± 27.56). The sensitivity, specificity, and AUC of the visual function scores were 91.1%, 81.7% and 0.939, respectively Visual function scores were used to construct a decision tree model. The sensitivity, specificity, and AUC of the model were 92.9%, 88.0% and 0.941, respectively, with an accuracy of 89.7% and a Brier score of 0.024. Visual function scores were qualified as a screening method for DON, with a cutoff point of 58. A multifactorial screening model based on visual function scores was constructed.

Study on correlation between perioperative cognitive function and nutritional status in elderly patients with gastric cancer

Objective: To investigate the cognitive function and nutritional status of elderly patients with gastric cancer during perioperative period, and to analyze their correlation. Methods: Aged patients undergoing gastric cancer surgery in The Affiliated Cancer Hospital of Shandong First Medical University from March to October 2021 were selected as the subjects of this study. The monitoring data of cognitive function and nutritional status were retrospectively analyzed from 1 to 3 days before surgery, 1 and 3 days after surgery, 7 days after surgery (before discharge) and 30 days after surgery to analyze the correlation between cognitive function and nutritional status in elderly patients with gastric cancer. Results: the incidence of mild cognitive impairment in elderly patients with gastric cancer was 52.43 %, the visual space of the two groups' (mild cognitive impairment) ability of execution, name, attention, language, abstract thinking, delayed memory and cognitive function scores were lower than 1 set of directional force (cognitive function in normal group), statistically significant difference (P < 0.05). The nutritional status of elderly patients with gastric cancer was lower than that of healthy elderly group at the same period (P < 0.05). The scores of visual spatial executive function, name, attention, delayed memory, orientation and total score of cognitive function in elderly gastric cancer patients were positively correlated with nutritional status (P < 0.05). Conclusions: The cognitive function and nutritional status of elderly patients with gastric cancer are both in a low state during treatment and a higher level of cognitive function can help patients maintain a more correct nutritional cognition, and the nutritional status of patients will be relatively better. There is a positive correlation between cognitive function and nutritional status in elderly patients with gastric cancer, which should be paid attention to in the treatment.

Influence of continuous 4C nursing on quality of life and self-care ability of patients with diabetes retinopathy: An observational study.

This study aims to investigate the impact of continuous 4C nursing on patients with diabetes retinopathy (DR) and its influence on self-care ability. A total of 100 DR patients admitted to our hospital from October 2020 to October 2022 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group received routine care, while the observation group received continuous 4C care. The nursing effects of both groups were compared. After nursing, the observation group showed a lower self-rating anxiety scale score and a higher self-care ability scale score compared to the control group (P < .05). The SQQL-VI scores for all social activities were also higher in the observation group (P < .05). Additionally, the observation group had lower levels of fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin than the control group (P < .05). Moreover, the observation group had higher visual acuity and lower intraocular pressure than the control group (P < .05). The visual impairment rate was lower and the overall compliance rate was higher in the observation group compared to the control group (P < .05). After nursing, both groups showed improvements in symptoms, visual function, physical function, psychological and social activity scores, visual acuity, and patient satisfaction scores. The observation group showed greater improvements compared to the control group (P < .05). The application of continuous 4C nursing in DR patients has shown positive effects, including improved patient compliance and satisfaction, enhanced patient quality of life and visual acuity. These findings suggest that continuous 4C nursing should be widely promoted and applied in clinical practice.

Correlation between Postoperative Visual Acuity and Patient-Related Outcomes in Senile Cataract

Aims: This study assessed visual function (VF) and quality of life (QOL) post cataract surgery and their relationship with post-operative presenting visual acuity (PVA) in patients operated for senile cataract in two hospitals in Jos, North-central Nigeria.&#x0D; Study Design: A retrospective, hospital-based, cross-sectional survey.&#x0D; Place and duration of study: The study took place in the Eye units of the Bingham University Teaching Hospital and the Faith Alive Foundation Hospital both in Jos, North-Central Nigeria between June and August 2021.&#x0D; Methodology: Patients aged 40 years and above, operated on for senile cataract within 18 months before the onset of the study were included. Sociodemographic data and surgical history were obtained from patients and their surgical records. Visual acuity at presentation was assessed at six weeks or more postoperative period with available correction using Snellen’s acuity and converted to the LogMAR scale. A trained research assistant administered the VF-14 item and QOL-12 item questionnaires and responses were scored using Fletcher’s guidelines. Data was analyzed with STATA version 16.0 using the geometric mean, range, percentages, and Spearman’s rank test.&#x0D; Results: Eighty-seven (69.6%) participants aged 40-104 years, mean of 67.2 ± 12.0 years with a male-to-female ratio of 1.1:1 were enrolled. Their mean PVA was 0.6LogMAR (6/24) which improved to 0.3LogMAR (6/12). The mean total VF and QOL were 87.1% and 97.5% respectively. Depth perception (99.6%), visual perception, and peripheral vision (94.2% each) scored the highest in the VF subscales. Mental well-being (97.9%) scored the highest in the QOL subscale, followed by social interaction (97.3%). There was a negative correlation between PVA and mean total VF (rs = -0.4, P&lt;0.0001) and QOL (rs = -0.3, P = 0.011).&#x0D; Conclusion: In this study population, VF and QOL scores improved with increasing PVA.

Assessment of quality of life of patients which visual impairment and a diagnosis of cataract

: Cataract is the leading cause of blindness, reducing economic productivity further leading to reduced quality of life (QOL). Various studies done around the globe have demonstrated that cataract and its diagnosis have been associated with poor quality of life and increased mortality. A thorough literature search showed limited study to assess the quality of life in patients with cataract in India. Hence, we designed this study to assess the quality of life of patients which visual impairment and a diagnosis of cataract.This cross-sectional study was conducted in patients diagnosed with cataract with visual impairment visiting the tertiary care center. The study was approved by the Institutional Ethics Committee and patients were recruited after they gave written informed consent. The participants were divided into two groups, Group 1 consisted of male patient whereas Group 2 consisted of female patients. The participant was assessed for visual functioning (VF) and Quality of Life.: The results of our study have demonstrated that out of total 84 participants recruited in the study, majority of them were female (n=50) and both groups were comparable at the time of presentation. All patients had a significant visual impairment at the time of presentation with 22 male participants and 33 female participants had grade III or more visual impairment. All patients had compromised quality of life as evident by the responses obtained from the participants on the visual functional score and quality of life scores. There was also a statistically (p&amp;#60;0.05) higher number of female participants as compared to male participants who had quite a lot of problems of noticing of objects off to side, had to make adjustment to darkness after being in bright light, problem in locating things when it was surrounded by lot of other things.All patients had compromised quality of life as evident by the responses obtained from the participants on the visual functional score and quality of life scores. Though participants in both groups with grade III onwards had higher visual functional scores and quality of life scores.

근원적 인지 메커니즘을 통한 난독증 탐구

Objectives The purpose of this paper is to identify dyslexia among various types of learning disabilities, explain its manifestation mechanism, and demonstrate it clinically.&#x0D; Methods This paper shows that through the fundamental cognitive mechanism, not only can the characteristics of dyslexia be understood in the most fundamental, essential, and holistic way, but also a better understanding of how dyslexia is fundamentally manifested. For clinical proof, non-verbal intelligence test (K-CTONI-2), Korean version of Children's Visual Perception Development Test (K-DTVP-3), the Korean Reading Test (KOLRA), and speech hearing test were administered to 7 elementary school students who continued to experience difficulties despite receiving reading education.&#x0D; Results Dyslexia begins with an excessively imbalanced structure of the brain's large visual and small auditory cognitive spaces. Due to the imbalance between the two cognitive spaces, visual acuity and visual memory appear strong, while auditory acuity and auditory memory appear weak, resulting in auditory internal attention deficit, which is the most important cognitive condition for language development. Auditory internal attention deficit in turn interferes with auditory information processing, resulting in serious difficulties in written language development and various symptoms observed in dyslexic children. The test results showed a low auditory function score compared to a high visual function score.&#x0D; Conclusions Dyslexia occurs due to functional defects in hierarchical cognitive processes such as auditory sensation, memory, and thought processing caused by an imbalance between the brain's small auditory cognitive space and large visual cognitive space. This paper presents directions for effective dyslexia treatment based on research results.&#x0D;

Comparison of Changes in Quality of Life Based on Changes in Disease Severity in Graves Ophthalmopathy Patients Following Intraorbital Triamcinolone Acetonide Injection

Abstract&#x0D; Introduction &amp; Objectives : Graves ophthalmopathy (GO) is associated with visual impairment and appearance changes, affecting the quality of life. Intraorbital injection of triamcinolone acetonide (TCA) in GO resulted in clinical improvement, but its effect on the quality of life is unknown. The objective of this study was to compare the changes in quality of life after intraorbital injection of TCA between different groups based on changes in disease severity.&#x0D; Methods : Intraorbital injection of TCA was performed on 30 subjects with GO. Disease severity was assessed according to the European Group of Graves Ophthalmopathy (EUGOGO) criteria. Quality of life was measured using the Indonesian version of Graves Ophthalmopathy Quality of Life (GO-QOL) questionnaire. Changes in disease severity and GO-QOL scores were recorded before intraorbital injection of TCA and 1 month after. Subjects were divided into groups based on changes in disease severity: decreased, remained constant, and increased. Changes in quality of life between the groups were compared statistically.&#x0D; Results : Changes in GO-QOL appearance scores in patients with decreased disease severity were significantly higher (p= 0.016) than those in patients whose disease severity remained constant. Changes in GO-QOL visual function scores in patients with decreased disease severity were higher but not statistically significant (p&gt; 0.05) compared to those in patients whose disease severity remained constant.&#x0D; Conclusion : Changes in the appearance aspect of quality of life after intraorbital injection of TCA in patients with decreased disease severity are better than that in patients whose disease severity remained constant, whereas changes in the visual function aspect are not significantly different.

The MOG antibody non-P42 epitope is predictive of a relapsing course in MOG antibody-associated disease

BackgroundMyelin oligodendrocyte glycoprotein (MOG) IgG seropositivity is a prerequisite for MOG antibody-associated disease (MOGAD) diagnosis. While a significant proportion of patients experience a relapsing disease, there is currently no biomarker...

Transcutaneous electrical acupoint stimulation for rehabilitation after total knee arthroplasty: a systematic review and meta-analysis.

Rehabilitation after total knee arthroplasty (TKA) has become an indispensable part of the treatment strategy for degenerative joint disease. Despite some current research demonstrating efficacy of transcutaneous electrical acupoint stimulation (TEAS) for post-TKA rehabilitation, the evidence is not conclusive. To systematically assess the evidence supporting TEAS for rehabilitation after TKA. A literature search of the PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang, and Chinese Scientific Journal Data databases for relevant studies published up to October 16, 2023, was performed. Main indicators included visual analog scale (VAS) and functional scores; secondary indicators included range of motion (ROM), interleukin-6 (IL-6) and C-reactive protein (CRP) levels, and analgesia-related adverse events. Risk of bias was evaluated using the Cochrane Tool, and meta-analysis was performed using Review Manager version 5.4. Twenty RCTs with 1295 participants were included. TEAS improved several outcomes compared to control groups. The TEAS group had significantly greater pain reduction at postoperative 6 h, 12 h, 24 h, 48 h, 72 h, 7 days, and 14 days. Moreover, TEAS significantly improved the Hospital for Special Surgery Knee Score, Knee Society Score, and ROM. Patients who underwent TEAS exhibited a lower incidence of analgesia-related adverse events and lower IL-6 and CRP levels. Available evidence indicates that the application of TEAS in patients undergoing TKA is related to postoperative pain alleviation, functional improvement, and fewer adverse events associated with analgesia.

Immune-related visual dysfunction in thyroid eye disease: a combined orbital and brain neuroimaging study.

To investigate the pathological interplay between immunity and the visual processing system (VPS) in thyroid eye disease (TED). A total of 24 active patients (AP), 26 inactive patients (IP) of TED, and 27 healthy controls (HCs) were enrolled. Orbital magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI) were conducted for each participant. Multiple MRI parameters of the intraorbital optic nerve (ON) were assessed. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were calculated. Correlation analyses were carried out on the above parameters and clinical characteristics. Visual functioning scores differentiated between the AP and IP groups. The ON subarachnoid space and ON sheath diameter were significantly higher in AP than in IP. Six vision-related brain regions were identified in TED patients compared with HCs, including right calcarine (CAL.R), right cuneus (CUN.R), left postcentral gyrus (PoCG.L), right middle temporal gyrus (MTG.R), left superior frontal gyrus (SFG.L), and left caudate (CAU.L). The brain activity of MTG.R, SFG.L, and CAU.L differentiated between the AP and IP groups. The correlation analysis revealed a close association among the vision-related brain regions, MRI parameters of ON, and clinical characteristics in AP and IP, respectively. Combined orbital and brain neuroimaging revealed abnormalities of the VPS in TED, which had a close correlation with immune statuses. Vision-related brain regions in TED might be possibly altered by peripheral immunity via a direct or indirect approach. The discovery of this study explained the disparity of visual dysfunction in TED patients with different immune statuses. With the uncovered neuroimaging markers, early detection and intervention of visual dysfunction could be achieved and potentially benefit TED patients. • Patients with different immune statuses of thyroid eye disease varied in the presentation of visual dysfunction. • The combined orbital and brain neuroimaging study identified six altered vision-related brain regions, which had a significant correlation with the MRI parameters of the intraorbital optic nerve and immunological characteristics. • Peripheral immunity might possibly give rise to alterations in the central nervous system part of the visual processing system via a direct or indirect approach.

Impact of primary glaucoma on health-related quality of life in China: the handan eye study

BackgroundWe assessed health-related quality of life (HRQOL) and its determinants among rural glaucoma participants compared to age-matched normal controls in the population-based Handan Eye Study (HES), in rural Yongnian County, northern China.MethodsWe enrolled 99 adults with glaucoma (mean age 63.0 ± 11.0 years), including primary open-angle glaucoma (POAG, n = 67) and primary angle-closure glaucoma (PACG, n = 32) and 102 controls (mean age 58.5 ± 5.3 years) with normal visual acuity and visual field and no history of glaucoma. Results of ophthalmic examinations and socioeconomic data were recorded. HRQOL was measured using the EQ-5D (converted to utility valves, UVs), and visual function (VF) and vision-related quality of life (VRQOL) were evaluated using the visual function-quality of life (VF-QOL) instrument.Primary and secondary outcome measuresEQ-5D and VF-QOL scores.ResultsThe mean UVs, VF, and VRQOL scores for glaucoma cases were 0.98 ± 0.04, 87.9 ± 15.2, and 95.5 ± 12.8, respectively, significantly worse than VF (94.4 ± 4.4) and VRQOL (100.0 ± 0.0) among controls, even after adjusting for age, gender, educational level, and family income (P = 0.015, P = 0.033). UVs were significantly lower among glaucoma participants with impaired VRQOL (55.4 ± 11.5) compared to those with normal VRQOL scores (99.1 ± 2.8) (UVs: 0.92 ± 0.08 vs. 0.99 ± 0.03, P = 0.036), also after adjustment for age and family income (P = 0.006). Participants with PACG had significantly lower VF and VRQOL scores compared to POAG (77.8 ± 21.4 vs. 92.9 ± 6.8, P < 0.001; 89.0 ± 18.1 vs. 98.7 ± 7.5, P < 0.001).ConclusionParticipants with glaucoma have worse visual function and related quality of life compared to age-matched normal population controls. Participants with PACG have lower VF and VRQOL compared to those with POAG. UVs can be used for cost-effectiveness research and to support public health strategies for glaucoma in rural China.

Clinical feature and disease outcome in patients with myelin oligodendrocyte glycoprotein antibody-associated disorder: a Chinese study

BackgroundTo identify factors associated with relapse risk and disability in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD).MethodBetween 2016 and 2021, 186 patients with MOGAD were included in the study. Factors associated...

Visual findings in children exposed to Zika in utero in Nicaragua.

Knowledge regarding the frequency of ocular abnormalities and abnormal visual function in children exposed to Zika virus (ZIKV) in utero but born without congenital Zika syndrome (CZS) is limited. We hypothesized that children exposed to ZIKV in utero born without CZS may have visual impairments in early childhood. We performed ophthalmic examination between 16 and 21 months of age and neurodevelopment assessment at 24 months of age with the Mullen Scales of Early Learning test (MSEL) on children enrolled in a cohort born to women pregnant during and shortly after the ZIKV epidemic in Nicaragua (2016-2017). ZIKV exposure status was defined based on maternal and infant serological testing. Visual impairment was defined as abnormal if the child had an abnormal ophthalmic exam and/or low visual reception score in the MSEL assessment. Of 124 children included in the analysis, 24 (19.4%) were classified as ZIKV-exposed and 100 (80.6%) unexposed according to maternal or cord blood serology. Ophthalmic examination showed that visual acuity did not differ significantly between groups, thus, 17.4% of ZIKV-exposed and 5.2% of unexposed had abnormal visual function (p = 0.07) and 12.5% of the ZIKV-exposed and 2% of the unexposed had abnormal contrast testing (p = 0.05). Low MSEL visual reception score was 3.2-fold higher in ZIKV-exposed than unexposed children, but not statistically significant (OR 3.2, CI: 0.8-14.0; p = 0.10). Visual impairment (a composite measure of visual function or low MESL visual reception score) was present in more ZIKV-exposed than in unexposed children (OR 3.7, CI: 1.2, 11.0; p = 0.02). However, the limited sample size warrants future investigations to fully assess the impact of in utero ZIKV exposure on ocular structures and visual function in early childhood, even in apparently healthy children.

Abstract #1407112: Assessment of the Thyroid Eye Disease Specific Graves’ Ophthalmopathy Quality of Life Questionnaire in Non-Inflammatory or Inactive Thyroid Eye Disease Patients

Patients (pts) with inactive/non-inflammatory thyroid eye disease (TED) previously reported similar negative quality of life as those with active/inflammatory TED, using TED-specific Graves’ ophthalmopathy quality of life (GO-QOL) scores. Mean visual function and appearance scores of 58.6 and 62.3, respectively, indicated significant disease impact. Here we examined specific areas of quality of life affected by non-inflammatory TED. An online survey of pts with inactive TED, as assessed by pt healthcare provider, was conducted in January 2020. Questions from the GO-QOL evaluated TED impact on specific activities (reading, watching TV, hobby or pastime, driving, walking outdoors, moving around the house, and bicycling), appearance and social interactions on a 3-point scale: seriously or very much/a little/not at all limited, or not applicable. Caregiver assistance was also evaluated. 100 pts (47, 47% female) with inactive TED were identified (mean age 45.2 ± 7.6 yrs). Outside of individual symptoms, 28 (28%) reported that severe impact on quality of life was the major negative feature of TED. On specific GO-QOL items, watching TV and reading were the activities most affected, with 86 (86%) and 85 (85%) pts reporting some limitation, respectively, and 32 (32%) and 28 (28%) reporting serious limitation. 70 (70%) pts reported some difficulty driving, 59 (59%) reported some limitation walking outdoors, and 57 (57%) reported limitation with hobbies or pastimes. 58 (58%) reported hindrance to something they wanted to do in the past week. 77 (77%) pts felt like their appearance had changed because of TED with 11 (11%) reporting that their appearance had changed very much. 71 (71%) reported a negative influence on self-confidence with 25 (25%) reporting serious impact. 72 (72%) reported appearing less often in photos than before TED. 32 (32%) reported receiving caregiver (primarily partners) help for daily activities and 41% (13/32) of caregivers were extremely involved in communication with the pt’s healthcare provider. Among the tasks most necessitating aid from a caregiver, 69% (22/32) received help grocery shopping and cooking, 56% (18/32) received help with transportation, and 44% (14/32) received help with household tasks and general healthcare. This analysis indicates pts with inactive/non-inflammatory TED continue to feel the negative quality of life impact of TED after the acute/inflammatory presentation fades with many suffering from limitations of daily living activities. Pts also report that TED continues to affect their appearance and how they interact with people, with almost a third relying on caregiver help.

Postoperative residual vertical deviation affects quality of life in Asian patients with thyroid-associated ophthalmopathy (Graves ophthalmopathy).

To evaluate the treatment effect of strabismus surgery for Graves ophthalmopathy in an ethnic Chinese population. A prospective clinical study. Thirty-one patients with Graves ophthalmopathy who had undergone strabismus surgery at National Taiwan University Hospital between 2012 and 2013 were consecutively recruited. The subjective outcome was evaluated using the Graves' Ophthalmopathy Quality-of-Life (GO-QoL) questionnaire, and the ocular deviation was measured preoperatively and postoperatively by use of a prism cover test. The GO-QoL scores for visual functioning and appearance improved significantly after surgery (preoperative scores 32.6 ± 19.9 and 43.8 ± 26.4, postoperative scores 55.2 ± 24.4 and 54.1 ± 27.6, respectively; P < .05). Motor success was achieved in 61.3% of the patients, and their postoperative visual scores were higher (61.5 ± 22.5) than the scores of those who experienced motor failure (45.3 ± 26.8, P = .048). The postoperative visual function scores showed a negative correlation with the residual vertical deviation (R2 = 0.546, P = .040). A higher increase in GO-QoL visual scores and a lower residual vertical deviation in downgaze were achieved among patients without previous decompression surgery. Our surgical methods resulted in a motor success rate of 76.5% for the correction of vertical deviation. GO-QoL scores and ocular deviation improved significantly after strabismus surgery. Precise correction of vertical deviation was of greater importance than horizontal deviation for visual function scores. Our surgical methods were effective for the correction of vertical deviation in Graves ophthalmopathy.

Quality of life and tomography indices in patients with keratoconus

Keratoconus is a corneal ectasia that leads to thinning and steepening of the corneal surface. We aimed to assess the relationship between quality of life and corneal tomography indices, irrespective of visual acuity. This was a cross-sectional study using a translated and validated Keratoconus Outcomes Research Questionnaire (KORQ) in Arabic language. We screened patients with keratoconus using the Belin/Ambrósio D-Index. We included the best-seeing eye in each patient with keratoconus, with a best corrected visual acuity better than 0.5. We collected variables including KORQ scores, flattest meridian keratometry, steepest meridian keratometry, mean keratometry front, maximum simulated keratometry, astigmatism front, Q value front, and thickness at the thinnest location. We performed linear regression analysis to identify predictors of the visual function score and symptom score. Sixty-nine patients were included in this study, 43 (62.3%) male and 26 (37.7%) female patients, with a mean age 34.0 ± 11.50 years. The only predictor for visual function score was sex (β = 11.64, 95% confidence interval: 3.50-19.78). None of the topographic indices were related to quality of life. In this study, quality of life in patients with keratoconus was not related to specific tomography indices and might be related to visual acuity itself.

Clinical outcomes and prognostic factors in patients with optic neuritis related to NMOSD and MOGAD in distinct ethnic groups from Latin America.

Optic neuritis (ON) can be an initial manifestation of neuromyelitis optica spectrum disorder (NMOSD) associated with aquaporin 4-antibody (AQP4-Ab) or myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease (MOGAD). Additionally, both diseases may have overlapping paraclinical and radiological features. These diseases may have different outcomes and prognoses. We aimed to compare clinical outcomes and prognostic features of patients with NMOSD and MOGAD presenting ON as first attack, from different ethnic groups in Latin America. We conducted a retrospective observational multicenter study in patients from Argentina (n=61), Chile (n=18), Ecuador (n=27), Brazil (n=30), Venezuela (n=10) and Mexico (n=49) with MOGAD or NMOSD related ON. Predictors of disability outcomes at last follow-up, namely visual disability (Visual Functional System Score ≥4), motor disability (permanent inability to walk further than 100m unaided) and wheelchair dependence based on EDSS score were evaluated. After a mean disease duration of 42.7 (±40.2) months in NMOSD and 19.7 (±23.6) in MOGAD, 55% and 22% (p>0.001) experienced permanent severe visual disability (visual acuity from 20/100 to 20/200), 22% and 6% (p=0.01) permanent motor disability and 11% and 0% (p=0.04) had become wheelchair dependent, respectively. Older age at disease onset was a predictor of severe visual disability (OR=1,03 CI95%1.01-1.05, p=0.03); older age at disease onset (OR=1,04 CI95%1.01-1.07, p=0.01), higher number of relapses (OR=1,32 CI95%1.02-1.71, p=0.03) and rituximab treatment (OR=0,36 CI95%0.14-0.90, p=0.02) were predictors of permanent motor disability, whereas ON associated with myelitis at disease onset was a predictor of wheelchair dependency (OR=4,16, CI95%1.23-14.08, p=0,02) in NMOSD patients. No differences were found when evaluating distinct ethnic groups (Mixed vs. Caucasian vs. Afro-descendant) CONCLUSIONS: NMOSD was associated with poorer clinical outcomes than MOGAD. Ethnicity was not associated with prognostic factors. Distinct predictors of permanent visual and motor disability and wheelchair dependency in NMOSD patients were found.

Pneumatic Retinopexy Versus Pars Plana Vitrectomy for the Management of Retinal Detachment: A Systematic Review and Meta-Analysis.

Pneumatic retinopexy (PnR) was proposed as an alternative to pars plana vitrectomy (PPV) in certain circumstances. PnR is an outpatient procedure and more cost-effective. However, its benefits should be judged alongside its success rate and adverse events. Herein, we compare the efficacy and safety of PnR and PPV for rhegmatogenous retinal detachment (RRD) repair. We searched the PubMed, Scopus, EMBASE, Web of Science, Cochrane, and Google Scholar databases. Observational and interventional studies comparing the efficacy and safety of PnR and PPV were included. The outcomes were the success rate of the treatment, improvement in visual acuity, and adverse event rates. Subgroup analysis was performed based on the lens and macula status. Eleven articles were eligible to enter our study; these consisted of 11,346 patients with a mean age of 74.1. PnR was superior to PPV in terms of retinal displacement, photoreceptor integrity, visual function, and vertical metamorphopsia scores. In the meta-analysis, PPV showed higher a reattachment rate than PnR (OR = 3.39, 95% CI 2.25-5.11). Subgroup analysis showed that the advantage of PPV over PnR was more pronounced in studies with fewer phakic eyes, more macula-on patients, and in cases with primary PnR failure. While PnR patients had better pre-op (SMD = - 0.58, 95% CI = - 1.16 to 0.00) and post-op (SMD = - 0.45, 95% CI = - 0.60 to - 0.30) LogMAR, the improvement in visual acuity after surgery was higher in PPV patients (SMD = 0.49, 95% CI = - 0.15 to 1.13). The success rate of PnR was higher in studies published after 2015 compared to previous studies (82% vs. 59%). Cataract formation and surgery were significantly higher in the PPV arm, while the occurrence of new retinal tears was more frequent in the PnR group. PnR can be used as the primary procedure for RRD repair in selected cases. However, we propose some modifications to the PIVOT criteria, e.g., the exclusion of cases presenting with several risk factors of poor outcomes.