Worse Eye Research Articles

Strabismus, stereoacuity, accommodation and convergence in young adults born premature and screened for retinopathy of prematurity.

The aim of the study was to evaluate strabismus, stereoacuity, accommodation and convergence in prematurely born young adults; screened for retinopathy of prematurity in the neonatal period and compare with term-born individuals of the same age. The study participants included 59 prematurely born individuals with a birthweight of ≤1,500 grams and 44 term-born controls, all born during 1988-1990 in Stockholm County, Sweden. Ocular alignment was assessed with a cover test, stereoacuity with the TNO stereo test and the amplitude of accommodation and the near point of convergence with the Royal Air Force Rule. Seven of 59 (12%) preterms had manifest strabismus, 4/59 (7%) had esotropia and 3/59 (5%) exotropia. One of 44 (2%) controls had esotropia; no other controls had manifest strabismus. Stereoacuity was within normal limits in 38/59 (64%) preterms and 43/44 (98%) controls, p < 0.01; the difference remained after excluding those with strabismus. A neurological complication at 2.5 years of age was the strongest risk factor for subnormal stereoacuity within the preterm group after excluding those with strabismus. The mean amplitude of accommodation was poorer in the preterms than the controls in better (p < 0.05) and worse eyes (p < 0.05). The preterms were more likely to have an amplitude of accommodation below the minimum, according to Hofstetter's equation. There were no differences between the groups regarding the near point of convergence. Prematurely born young adults had a higher prevalence of strabismus, reduced stereoacuity and worse amplitude of accommodation than term-born controls.

Refractive Errors among Urban Poor Population in Shah Alam, Selangor:

International Association of Prevention Blindness (IAPB) reported 1.1 billion people worldwide live with vision loss. Ninety percent of vision loss is treatable or preventable. Management and Science University (MSU) prevention of blindness project (POB) is an outreach community project providing eye care accessibility to underserved communities. This paper aimed to report the prevalence of refractive errors among the urban poor population in Shah Alam, Selangor, Malaysia. A total of 433 participants were involved in a cross-sectional study. Spherical equivalent (SE) of 0.50 D in the worse eye is considered refractive errors, which SE of &gt;-0.50 D is myopia, and SE of &gt;050 D as hyperopia. Low myopia was defined as SE less than -3.00 D; moderate myopia is defined as SE between -3.00 to -5.99 D, and high myopia is defined as SE -6.00 D and above. Astigmatism is considered as cylindrical refraction greater than 0.50D in either eye. Anisometropia is defined as differences SE of 1D of equal with or greater between two eyes Myopia in one eye and hyperopia in the fellow eye SE difference than 0.50D is considered antimetropia. Presbyopia is defined as near vision worse than N6 at 40cm when best-corrected distance visual acuity was better than 6/12. Out of 433 participants were recruited, 242 (55.68%) were male, and 191 (44.32%) were female and a mean age of 55.97(SD = 10.55). For types of refractive errors, 28.41% participants were presbyopia, 28.18% were myopia, 14.78% were hyperopia, 24.94% were emmetropia, 3.70% were antimetropia, and 54.04% were astigmatism. Most of the reported myopia cases have low myopia (79.51%), followed by moderate myopia (13.12%) and high myopia (7.38%). Approximately 75.06% of the population studied were affected by refractive errors and significantly associated with age. This study suggests a need for interventions to allevaiate refractive errors in urban poor areas and other communities affected by providing access and affordable eye care services.

Teprotumumab for chronic thyroid eye disease

ABSTRACT Purpose To describe the treatment of nine patients with chronic, low clinical activity score thyroid eye disease with teprotumumab. Methods A retrospective series of patients with chronic thyroid eye disease (TED) and low clinical activity score (CAS) treated with teprotumumab infusion therapy. Inclusion criteria: adults over 18 years of age with TED for greater than 9 months and CAS of 1 or less. All patients included in the analyses completed a full series of eight infusions. Primary outcome measures included proptosis and eyelid retraction in both eyes. Secondary outcomes included CAS, reported adverse effects, and surgery post-treatment. Results Nine patients met all inclusion criteria, seven females and two males with mean age of 50.2 years and TED diagnosis of 6.25 years. Three patients had a baseline CAS of 1 and 6 had a CAS of 0. Mean proptosis reduction in the worse eye was 4.0 ± 2.4 mm immediately post-treatment (p = .02). Five out of nine patients had extended follow-up (average 16.8 ± 5.1 weeks) with mean proptosis reduction of 4.2 ± 2.8 mm at last follow-up (p = .03). Mean reduction in eyelid retraction in the worse eye was 0.3 ± 1.6 mm post-treatment (p = .58) and 0.5 ± 0.9 mm at last follow-up (p = .30). Three patients reported infusion-related myalgias, two hair thinning, one exacerbated chronic tinnitus, and one hyperglycemia. Conclusions We report clinically and statistically significant proptosis reduction in nine patients with chronic, low CAS TED treated with teprotumumab. Teprotumumab may be an effective treatment option for these patients.

1032-P: Prevalence of Diabetic Retinopathy in Youth-Onset Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Study

Most prevalence estimates for diabetic retinopathy (DR) in youth are from limited data in selected populations and may not represent true prevalence. The SEARCH for Diabetes in Youth study included a longitudinal cohort of youth-onset T1D and T2D (2001-2020). Using retinal photos (left and right eyes) obtained on cohort participants (n=2519 T1D and n=447 T2D at first follow-up and n=1014 T1D and n=239 T2D at second follow-up), we characterized the prevalence of mild, moderate and proliferative DR (worst eye). Overall prevalence was standardized to the sex and race/ethnicity distribution of registered cases (n=7,277). At first retinal photo [mean (std) disease duration of 7.7(2.0) years for T1D and 7.5(2.1) years for T2D], the prevalence of DR (all grades) for T1D was 21.3/100 cases (95% CI: 19.5, 23.1) and for T2D it was 31.3/100 cases (95% CI: 26.8, 35.9). By the second photo [mean (std) of 12.5 (2.2) years post dx for T1D and 12.4 (2.1) years for T2D] the prevalence was 52.0/100 cases (95% CI: 48.6, 55.3) for T1D and 55.7/100 cases (95% CI: 48.7, 62.7) for T2D (Table). Compared to other groups, a higher proportion of non-Hispanic Black participants had evidence of DR, all grades combined (p<0.05 for both T1D and T2D). Proliferative DR was uncommon. Research to identify modifiable risk factors, early in disease course, as well as socioeconomic determinants, may offer opportunity to reduce risk.View largeDownload slideView largeDownload slide DisclosureE. T. Jensen: None. B. E. Klein: None. S. Meuer: None. E. J. Mayer-davis: None. J. Rigdon: None. K. Rezaei: None. E. A. Lundeen: None. D. Dabelea: None. S. Saydah: None. L. M. Dolan: None. R. Dagostino: Consultant; Self; AstraZeneca, Biogen, Daiichi Sankyo. A. K. Mottl: Advisory Panel; Self; Bayer U. S.

Socioeconomic mechanisms of myopia boom in China: a nationwide cross-sectional study

ObjectivesTo assess the association between socioeconomic development and the myopia boom in China.DesignNationwide cross-sectional study.SettingWe used data from the China Family Panel Study (CFPS 2010), and the Chinese National Survey...

Refractive errors and visual impairment among children and adolescents in southernmost China

BackgroundRefractive errors and visual impairment in southernmost China have not been reported previously. We aim to investigate and determine the age-specific prevalence of myopia, hyperopia, astigmatism, and visual impairment based on a large population cross-sectional study in Hainan area of southernmost tropical province in China.MethodsA population-based sample of 31,524 children aged 6–15 years from Hainan was assessed. Non-cycloplegic autorefraction and visual acuity (VA) analyses were performed on all participants and a subgroup of participants undergoing cycloplegia.ResultsOf all participants, 23.0% presented uncorrected VA (UCVA) was worse than 20/40 in worse eye, 6.0% presented mild presenting visual acuity impairment (PVAI), 7.0% presented moderate PVAI, 0.2% presented severe PVAI in the better eye, and 46.9% presented abnormal UCVA [worse than 20/25 (≥ 6, < 8 years old) and worse than 20/20 (≥ 8 years and older)] at least in one eye. The overall prevalence of myopia [spherical equivalent (SE) ≤ − 0.50 D] and high myopia (SE ≤ − 6.00 D) were 46.0%, 1.0% respectively. Hyperopia [SE ≥ + 1.00 D (≥ 7 years old) and SE ≥ + 2.00 D (≥ 6, < 7 years old)] and significant hyperopia (SE ≥ + 3.00 D) were 4.2 and 0.6%, respectively. Astigmatism [cylinder ≥ 1.00 D (≥ 7 years old) and ≥ 1.75 D (≥ 6, < 7 years old)] was found in 31.9%.ConclusionsMyopia was the most common refractive error in southernmost province in China (Hainan). Its prevalence increased with age, while hyperopia prevalence showed a decreasing trend. However, myopia, especially high myopia prevalence was much lower than in other urban regions across China.

Relationship between corneal exam findings, best-corrected visual acuity (BCVA), and ocular symptoms in patients with relapsed or refractory multiple myeloma (RRMM) receiving belantamab mafodotin (belamaf).

8033 Background: Belantamab mafodotin (GSK2857916; belamaf; BLENREP) is a B-cell maturation antigen (BCMA)-targeting antibody–drug conjugate approved in the US and EU as a monotherapy for the treatment of adult patients with RRMM. Ocular events (OEs) during the pivotal DREAMM-2 trial (NCT03525678) included corneal exam findings (punctate keratopathy and microcyst-like epithelial changes), BCVA changes, and ocular symptoms. Dose reductions or delays based on corneal exam findings and BCVA were used to manage OEs. Here we performed a post hoc investigation of relationships between corneal exam findings, BCVA changes, and patient-reported ocular symptoms to explore if BCVA changes and symptoms could guide dosing, rather than corneal exams. Methods: Eye evaluations (including a corneal exam and BCVA assessment of Snellen visual acuity) were performed on all patients receiving single-agent belamaf (2.5 mg/kg) by ophthalmologists at baseline and prior to each belamaf dose. Changes in the corneal epithelium (Ker) and BCVA were both assessed as per protocol-defined criteria and assessment of grade (Gr) was based on the worse eye. BCVA grading was relative to baseline. Patient-reported ocular symptoms were reported as per the Common Terminology Criteria for Adverse Events. Results: In 12.5% of eye evaluations Gr 3–4 Ker was associated with minimal or no (Gr ≤1) BCVA changes. When patient-reported ocular symptoms were also considered, only 7.5% of evaluations found Gr 3–4 Ker with Gr ≤1 BCVA changes or ocular symptoms. Mild or no (Gr ≤2) Ker was associated with Gr ≤1 BCVA changes in 59.5% of evaluations, or in 38.8% of evaluations with no ocular symptoms reported. Overall, Gr 3–4 Ker were found in 24.9% of evaluations; by contrast, patients had Gr 2–4 BCVA changes or ocular symptoms in 53.7% of evaluations. Association of corneal epithelium changes (Ker) with BCVA changes and ocular symptoms. Conclusions: These findings highlight that BCVA changes and ocular symptoms should be further investigated to determine if they can be used as alternatives (eg, frequency of eye examinations based on symptoms) for the management of belamaf dosing to potentially reduce the burden on patients and healthcare professionals. Clinical trial information: NCT03525678. [Table: see text]

Comparison of Topical Instillation From Single-dose and Multidose Eye Drop Containers in Glaucoma: A Multicenter Randomized Cross-sectional Trial.

We compared the quality of instillation of topical treatments from single-dose (SGD) or multidose (MTD) containers in glaucoma patients and showed neither a significant difference between the type of container nor a significant relationship to upper limb mobility. To describe and compare the quality of instillation of topical treatments with SGD or MTD containers in glaucoma patients. To assess factors likely to influence instillation, particularly the upper limb mobility. This multicenter, cross-sectional study included open-angle glaucoma patients with the same self-instilled treatment over at least 3 months. Patients were asked to successively self-administer a drop of artificial tears from SGD and MTD containers in front of an observer. The order of instillation (eye and container) was randomized. Correct instillation was defined as the administration of 1 drop in the lower fornix, without any contact between the tip of the device and the ocular surface. The Quick Disabilities of the Arm, Shoulder, and Hand self-questionnaire assessed upper limb mobility. A total of 239 eyes from 173 patients were included. For the worst eye group 33% of patients performed correct instillation with MTD versus 32% using SGD (P=1). In the best eye group, 31.7% patients performed a correct instillation with MTD administration versus 27.5% with SGD (P=0.327). Multivariate analysis showed a significant association between an inadequate SGD instillation, old age (P=0.021), the severity of the visual field deficits (P=0.035), and a low quality of life score (P=0.028). No association existed between the Quick Disabilities of the Arm, Shoulder, and Hand score and the quality of instillation. These results suggest that the handling of single-use containers should be practiced by patients and evaluated by physicians, especially for the elderly population and those with advanced glaucoma. No difference in instillation quality was found between SGD and MTD.

Impact of low luminance conditions on quality of life for the visually impaired: development of the Low Luminance Questionnaire Japanese version.

This study aimed to develop a Japanese version of the Low Luminance Questionnaire (LLQ-J) and to evaluate its reliability and validity. Cross-sectional study. LLQ-J was developed by standardized methods. A total of 101 patients comprising 55 with age-related macular degeneration, 25 with glaucoma, 15 with regressed proliferative diabetic retinopathy, and 6 with retinitis pigmentosa were included in this study. The patients completed the LLQ-J and Japanese version of the visual function Questionnaire-25 (VFQ-25). Using the LLQ-J data, floor and ceiling effects were computed. To examine internal consistency, some patients completed the LLQ-J a second time 2-4weeks later and the data were analyzed for Cronbach's alpha and intra-class correlation coefficients (ICCs). Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured, and low-luminance deficit (LLD) was calculated. Criterion validity was also tested. No ceiling or floor effects were present in the LLQ-J data. Cronbach's alfa was 0.88, and ICCs were higher than 0.70 for all subscales. Moderate to high correlation was observed between LLQ-J and VFQ-25 (p < 0.01), confirming concurrent validity. "General dim lighting" and "Peripheral vision" were significantly associated with LLVA in the better eye (p < 0.05). "Mobility", "General dim lighting" and "Peripheral vision" were significantly associated with LLD (p < 0.05). "Emotional distress" was significantly associated with BCVA in the worse eye (p < 0.05). No subscales were associated with BCVA of the better eye. The LLQ-J is a valid and reliable questionnaire for assessing QOL under low luminance conditions.

Visual outcomes in children with syndromic craniosynostosis: a review of 165 cases.

To determine visual outcomes and prevalence of amblyogenic risk factors in children with Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes. We conducted a single-centre, retrospective chart review of patients assessed at our unit between October 2000 and May 2017. Our outcome measures were as follows: ageat first and last examination, refraction, horizontal ocular alignment, alphabet pattern deviations, anterior segment appearance, fundus examination findings, visual evoked potentials (VEPs) and genetics. The study's primary endpoint was the proportion of children achieving best-corrected visual acuity (BCVA) ≥ 6/12 in the better eye at final visit, as per UK driving standards. 165 patients were included in this study. Breakdown of diagnoses was as follows: Crouzon (n = 60), Apert (n = 57), Pfeiffer (n = 14) and Saethre-Chotzen (n = 34). 98 patients were male. Of 133 patients with full BCVA data available, 76.7% achieved BCVA ≥ 6/12 in the better eye. Of 122 patients, anisometropia >1.00 dioptre sphere (DS) affected 18.9% and astigmatism ≥1.00DS in at least one eye affected 67.2%. Of 246 eyes, 48.4% had oblique astigmatism. Of 165 patients, 60 had exotropia and 12 had esotropia. 48 of 99 patients demonstrated 'V' pattern. On multivariable logistic regression, nystagmus (p = 0.009) and ON involvement (p = 0.001) were associated with decreased vision in the worse eye. Normal VEPs were associated with better BCVA (p = 0.036). There was a high prevalence of amblyogenic factors, however, the majority achieved BCVA ≥ 6/12 in their better eye. Optic neuropathy and nystagmus had the most significant impact on vision. VEPs can help the in overall assessment of visual function.

Visual field-based grading of disease severity in newly diagnosed primary open angle glaucoma patients presenting to a tertiary eye care centre in India.

To evaluate the severity of primary open angle glaucoma (POAG) at presentation using visual field analysis and its relationship to demographic and ocular factors in patients presenting to a tertiary eye care centre. Cross-sectional study. Newly diagnosed POAG patients were classified as early, moderate, or severe stage in the worse eye based on the Humphrey visual field testing using Hodapp-Parrish-Andersons criteria. The groups were compared for differences in demographics and ocular characteristics. Statistical analysis was done using STATA 14.1 (Texas, USA). The average age of 71 eligible patients was 60.04 ± 9.53 years, and the cohort had 29.5% females. Among the subjects, 19 (26.7%) had early, 24 (33.3%) had moderate and 28 (38.89%) had severe POAG at presentation. There was no statistically significant difference among different stages of glaucoma with respect to age and sex groups. No statistical association was found with education, occupation status, presenting complaints, family history of glaucoma, or systemic diseases between the different stages of severity. 5.6% with severe disease presented with a relative afferent pupillary defect (RAPD). The mean intraocular pressure (IOP) in the severe stage was 22.54 ± 5.27 mmHg, which was not statistically higher than the other groups (P = 0.726). Newly diagnosed POAG patients predominantly present at moderate or severe stage of disease, reflecting either the asymptomatic nature of the disease or a lack of access to vision care services. Existing screening programmes need to be improved, with special attention to women and individuals less than 50 years of age.

Self-help group for addressing depression and anxiety in the visually impaired. A Pilot Study

Background: This work describes a vision rehabilitation approach integrated with a self-help group, for psychological support of visually impaired people. The effectiveness and benefits of attending self- help group was analyzed in accordance to anxiety, depression symptoms and visual functions. Methods: The study, an observational perspective non randomized, was done on 31 visually impaired subjects, 16 females and 15 males, with a mean age of 63.7. Visual acuity, reading speed, anxiety and depression levels were valued before and after self-help group. Results: After the attending period of self-help group, a decrease to 0.74 LogMAR (± 0.3) and 1.08 LogMAR (± 0.3) for the best corrected visual acuity was registered for the best and the worst eye respectively (p>0.05). There were significant improvements in anxiety (p<0.01) and depression levels (p<0.01). The average reading rate increased to 61.7 (± 24.4) wpm (p<0.01), representing 23% improvement. We found that anxiety was significantly determinant on the reading speed (p=0.02). Conclusion: The results of this preliminary study suggest that this innovative approach can enhance visual functions with an effect on self-efficacy, it can offer support to the patients to cope with the onset of depression and anxiety and it can be a tool to promote psychological and social welfare.

Binocular Visual Field and Vision-Related Quality of Life in Patients With Hemianopia.

Hemianopias can have a severe impact on functional ability and quality of life (QoL). Binocular visual field (VF) analysis is clinically more relevant to visual function than monocular VF. The aim is to analyze the binocular VF of patients with hemianopias and its association with the monocular VF and to assess the QoL of these patients through questionnaires specifically related to vision compared with healthy controls. The case-control study included patients with hemianopias and controls. Sex, age, general history, etiology, location of the lesion, and time since the lesion appeared were recorded. Monocular VF and Esterman binocular VF were performed. VF defect, mean defect (MD), and Esterman scores were recorded. Visual Activities Questionnaire (VAQ-33) and Visual Function Questionnaire (VFQ-25) questionnaires were administered. Twenty patients with hemianopia and 22 healthy controls were included. The Esterman score in homonymous hemianopia patients (n = 17) correlated with best eye MD (r = -0.62, P = 0.01), worst eye MD (r = -0.70, P = 0.002), and average MD (r = -0.68, P = 0.003). Compared with healthy control subjects, patients with homonymous hemianopia had significantly lower VFQ-25 score and in 10/12 subscales (all P < 0.001). VAQ-33 scores revealed lower overall and subscales scores with the exception of light/dark adaptation (P = 0.08). Correlations were found between monocular and binocular VF scores and general vision (r = -0.55), peripheral vision (on both questionnaires, r-range -0.75 to 0.47), VFQ-25 and VAQ-33 overall scores (r = -0.59, -0.49 and 0.50), and glare disability (r = 0.53 and 0.67). Hemianopic VF defects involve a major alteration in the patients' vision-related QoL.

Association Between the Asymmetric Dimethylarginine Levels and Glaucoma Severity: A Cross-Sectional Analysis of the LIGHT Study.

PurposeAsymmetric dimethylarginine (ADMA), a potent endogenous inhibitor of nitric oxide synthase, may be involved in the pathophysiology of glaucoma by dysfunctioning nitric oxide and oxidative stress. The purpose of this study was to determine whether the serum ADMA level is associated with the severity of glaucoma.MethodsOne hundred twenty-five patients with glaucoma (mean age 69.4 years) were analyzed in this cross-sectional study. The severity of glaucoma was determined by the visual field mean deviation in the worse eye; severe, a mean deviation ≤ −12 dB; and mild, a mean deviation > −12 dB. The serum ADMA levels were classified into three groups according to tertiles; low (T1), intermediate (T2), and high group (T3).ResultsThe mean serum ADMA levels in the severe glaucoma group was significantly higher than that in the mild glaucoma group (0.41 vs. 0.39 µmol/L; P = 0.031). A significantly higher prevalence of patients with severe glaucoma was found in the T3 group than that in the T1 group (T1, 44.7% and T3, 68.2%; P = 0.018). In the multivariable logistic regression analysis adjusted for the potential confounders, e.g., age, sex, obesity, smoking, hypertension, diabetes, and renal function, the odds ratio for severe glaucoma in the T3 group was significantly higher than that in the T1 group (odds ratio 3.02; 95% confidence interval 1.04 to 8.79; P = 0.043).ConclusionsA significant association between higher serum ADMA levels and severe glaucoma was found, and this association remained significant after adjusting for the potential confounders.

The agreement between the Irvine 4 diopter prism test and assessment of ocular fixation in microtropia with identity

ABSTRACT Microtropia describes a primary ocular deviation of less than 10 prism diopters associated with harmonious anomalous retinal correspondence and reduced stereopsis. It is routinely accepted that children with microtropia are less likely to achieve equal vision following occlusion therapy than those with bifoveal fixation. The most commonly used methods of diagnosing a microtropia are the 4 diopter prism test (4∆PT) and assessment of ocular fixation. This study examines the agreement between the two tests. One hundred and twelve typically developing children without a manifest strabismus who were able to undertake a linear visual acuity test and had two or more lines of anisoacuity following refractive adaption to their full cycloplegic correction underwent assessment of the 4∆PT and ocular fixation along with their routine orthoptic examination. One hundred and twelve children (46 boys and 66 girls) attending the Orthoptic department who fitted the above criteria were included in the analysis. The mean age at examination was 6 years. 80.3% had anisometropia of at least 1.25 diopters. The 4∆PT indicated a microtropia in 74 cases, whereas assessment of fixation indicated a microtropia in 68 cases. In 88 cases (78.6%), the results of the two tests agreed. Analysis found only moderate agreement between the two tests (k = 0.540 (CI 0.379–0.700)). Logistic regression analysis comparing those children where the two tests agreed with those where they disagreed found no difference in the level of anisoacuity (p = 0.7823), degree of anisometropia (p = 0.9385), the vision in the worst eye (p = 0.5260), the refractive error in the “worst” eye (p = 0.865), or the age at the time of testing (p = 0.4485) between the two groups. When assessing for a microtropia, it was found that not all children who elicit a central suppression response on the 4∆PT are found to be fixing eccentrically and vice versa. This could potentially have implications for the treatment of their amblyopia. It is important not to rely on just one test at one time to make the diagnosis of microtropia. Rather, if one or other test indicates a microtropia the first time they are attempted, this should be reassessed regularly as treatment progresses and certainly before treatment is stopped and suboptimal visual acuity is accepted.

The effects of amblyopia on children’s reading performance after patching treatment

The purpose of this study was to evaluate the effects of amblyopia on children's reading performance after the successful patching treatment with 20/20 visual acuity (VA) in the treated eye. The treated amblyopes group included 10 children with strabismic amblyopia diagnosed on the first visit presenting VA equal or better than 0.0 logMAR (20/20 Snellen) in the better vision eye and VA worse than 0.2 logMAR (20/32 Snellen) in the worse eye that underwent patching treatment of amblyopia reaching a final VA equal to 0.0 logMAR in the treated eye. The control group comprised 10 children matched by age, gender and school-grade with no visual disorders. Reading performance was evaluated according to reading acuity (RA), critical print size (CPS), reading speed (RS) at 0.7 logMAR, and maximum reading speed (MRS) using the MNREAD chart. Binocular reading performance was compared between groups and no statistically significant differences were found on RA, CPS, RS, or MRS (p > 0.05). When analyzing monocular reading performances of treated amblyopes, a worse RA (p = 0.04) and CPS (p = 0.04) were observed on the previously amblyopic eye when compared to the fellow eye. When comparing the fellow eye from treated amblyopes and a randomly selected eye from controls, no statistically significant differences on RA, CPS, RS, or MRS were found (p > 0.05). The results suggest that even patients who reached 20/20 VA in the treated eye after patching treatment for amblyopia may present persistent impaired reading performance. These findings reinforce the importance of reading performance testing as a tool when evaluating the visual function development in amblyopic patients.

Outcome of Off-Label AREDS 2 Supplementation for the Treatment of Macular Degeneration in Non-Proliferative Idiopathic Type 2 Macular Telangiectasia.

PurposeTo evaluate if off-label Age-Related Eye Disease Study 2 (AREDS2) supplementation prevents visual and anatomical deterioration in non-proliferative Idiopathic Macular Telangiectasia Type 2 (IMT2).Patients and MethodsThis is a single-center retrospective, comparative study of 82 IMT2 eyes treated with AREDS2 from January 1st, 2013 to January 1st, 2018. The study analysis consisted of a non-comparative arm, which included all AREDS2 eyes, and a comparative arm (27 AREDS2 and 42 untreated eyes) that only included eyes with complete follow-up data. Eyes were evaluated at baseline, 12 and 24 months. Better/worse eye sub-analysis was performed in the comparative study arm. Primary outcomes were best corrected visual acuity (BCVA) and optical coherence tomography (OCT) anatomical characteristics including largest cavitation diameter, central macular thickness (CMT), and length of ellipsoid zone (EZ) loss at 24 months.ResultsIn the non-comparative arm, AREDS2 eyes showed stable BCVA (0.28 ± 0.18 logMAR at baseline vs 0.26 ± 0.19 logMAR at 24 months; p = 0.35) and OCT anatomical features after 24 months of supplementation. In the comparative arm, BCVA mean difference was greater for untreated eyes at 24 months (−0.09 ± 0.15 vs 0.03 ± 0.11 logMAR; p = <0.001). AREDS2 eyes had decreased cavitary diameter and EZ loss compared to untreated eyes at the study endpoint (p = 0.01 and p = 0.02, respectively). CMT remained stable for both cohorts throughout the study. For better/worse eye analysis, untreated eyes had worse BCVA at 24 months in both better and worse eyes (both p = 0.01). For anatomical outcomes, increases in both EZ loss (p = 0.04) and cavitary diameter (p = 0.001) among untreated eyes were only significant for eyes with worse baseline BCVA.ConclusionOur results suggest that off-label AREDS2 supplementation in non-proliferative IMT2 may prevent anatomical and visual deterioration in a subset of eyes.

LIMPACT DES THERAPIES TRADITIONNELLES SUR LA PRISE EN CHARGE DES MALADES MENTAUX

In spite of the development of the psychiatry in Morocco, the traditional therapy is another current phenomenon always using to treat mental disorder. The surnatural was dominating in the representation of the mental disorder, and it as well at the level of its origin as of its treatment.The objective of this work is to describe the cultural perception of the first psychiatric symptoms by the families of the mental sick, to determine the first approach of care.It is about a descriptive forward-looking study using a heteroquestionnary including a sample of 184 families of hospitalized or consultant patient to the Ar-razipsychiatric hospital in Sale (Morocco) over a period of three months of the current year.We counted 184 families who have a member consulted or hospitalized at the Arrazi hospital. 38% represent mother of patient. All the socioeconomic and educational levels were represented. Almost all the diseases were founded with a big ascendancy of the psychotic disorders. The appeal to Fkihs in front of first symptoms was almost important the conversifs disorders and anxious seem to be the preference illness of this kind of practice but you should not forget that the psychoses also represent a not insignificant rate with 66%. The cultural interpretations of the mental illness are represented by the charm in 35 % of the cases, the Toukal (deliberate poisoning) in 29% and the ownership by devils in 21 %. The bad eye is reported in 20%. More than 63% of families turned to the traditional therapy in front of the first psychiatric symptoms, while only 36 % returned the patients at a general doctor or a psychiatrist. 62 % of families continue to turn to the traditional therapies in spite of the psychiatric follow-up, in this case they tend to stop the medical treatment in 30 % of the cases. There is a significant link between the first orientation and the interpretation of the disease. Traditherapeutes was more requested at the patients of whom families think that their disease is of surnatural origin (p = 0,001). The appeal to the traditional therapy and the residence in rural areas and not schooling are also strongly correlated. (P = 0,011 and p = 0,001). The Moroccan psychiatry was able to realize a lot of progress during the last two decades, in spite of the insufficiency of the human resources and the infrastructures. Additional efforts are necessary, especially with the high request of care, for it all the community should participate in the promotion of the mental health to reduce the stigmatization of this discipline and offer a better management of patients. The family is at the heart of the care of the mental disorders. Simple interventions with family can largely improve the quality of life of the sick person and that of the whole family.

Living with satisfactory vision and no comorbidity 28 years after bilateral retinoblastoma: a case report and mini literature review

Background: Retinoblastoma is the most common primary intraocular malignancy in children, although it is a rare neural retinal tumor. Improving the quality of life is the next goal after the primary medical goal of life preservation. The genotype-phenotype correlation may vary with the progression of retinoblastoma. Expressivity is determined by different RB1 gene mutations among individuals. Herein, we share our experience on the evaluation of the long-term progression of retinoblastoma, its treatment consequences, its impact on the quality of life, and how the underlying genotypes are related to the phenotypes. We provide a review of the relevant literature and present a case of a sporadic heritable bilateral retinoblastoma.&#x0D; Case Presentation: We report the outcomes of a 28-year follow-up of a female diagnosed with an infantile disease. The patient’s best eye, according to the tumor classification and genetic results, was treated conservatively whereas the worst eye was enucleated. On re-examinations, she had complications of the treatment she received. Therefore, another intervention was administered for several years. The patient’s pathogenic variant and RB1 gene mutational inactivation were predispositions to the recurrence of the tumor and non-ocular primary malignancy. Nevertheless, the disease had no progression. The patient is stable despite her type of retinoblastoma, which is the sporadic heritable bilateral form.&#x0D; Conclusions: Each phenotype of bilateral retinoblastoma varies in progression. The nature of the genetic mutation may determine its expressivity. It is of great significance to individualize every decision. In each case, the sequelae of the disease and treatment-induced complications may have an impact on the quality of the patient’s life.

Impact of incident age-related macular degeneration and associated vision loss on vision-related quality of life

BackgroundWe examined the associations between the 6-year incidence of age-related macular degeneration (AMD) and vision-related quality of life (VRQoL), and the contribution of presenting visual acuity (VA), in an Asian...