AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbi...AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbil,Iraq.The target population consisted of high school students selected through a multi-stage cluster sampling method.Comprehensive visual examinations were performed for all students,including measurement of uncorrected and corrected visual acuity,objective and subjective refraction,and distance and near cover tests.NPC was evaluated using a single 6/12 visual target mounted on a centrally positioned Gulden fixation stick.Ocular symptoms were investigated through interviews.RESULTS:Of the 996 selected students,921 participated in the study.Of them,543(58.96%)were female,and their ages ranged from 13 to 22y.The prevalence of tropia was 3.58%[95%confidence interval(CI):2.38%-4.78%],observed in 3.44%of males and 3.68%of females.Exotropia(1.95%,95%CI:1.06%-2.85%)was more common than esotropia(1.52%,95%CI:0.73%-2.31%).The 15.42%(95%CI:13.09%-17.75%)of students had phoria.Exophoria(13.79%,95%CI:11.56%-16.02%)was significantly more prevalent than esophoria(1.63%,95%CI:0.81%-2.45%).The prevalence of NPC abnormality in the total study population was 24.97%(95%CI:22.18%-27.77%).It was 26.72%(95%CI:22.26%-31.18%)in males and 23.76%(95%CI:20.18%-27.34%)in females(P=0.307).The most common symptom in phoria was headache(86.62%,95%CI:81.02%-92.22%),followed by tired or sore eyes(61.97%,95%CI:53.99%-69.96%).The most common symptoms in tropia were blurry vision(93.94%,95%CI:79.77%-99.26%)and difficulty concentrating(87.88%,95%CI:76.74%-99.01%).CONCLUSION:Among Erbil’s high school students,the prevalence of strabismus,particularly the exodeviation type,is relatively high,and a significant percentage of students have NPC abnormalities.Addressing and correcting these binocular vision problems,due to their associated visual symptoms,can lead to an improvement in students’quality of life and academic performance.展开更多
AIM:To evaluate the efficacy of the total computer vision syndrome questionnaire(CVS-Q)score as a predictive tool for identifying individuals with symptomatic binocular vision anomalies and refractive errors.METHODS:A...AIM:To evaluate the efficacy of the total computer vision syndrome questionnaire(CVS-Q)score as a predictive tool for identifying individuals with symptomatic binocular vision anomalies and refractive errors.METHODS:A total of 141 healthy computer users underwent comprehensive clinical visual function assessments,including evaluations of refractive errors,accommodation(amplitude of accommodation,positive relative accommodation,negative relative accommodation,accommodative accuracy,and accommodative facility),and vergence(phoria,positive and negative fusional vergence,near point of convergence,and vergence facility).Total CVS-Q scores were recorded to explore potential associations between symptom scores and the aforementioned clinical visual function parameters.RESULTS:The cohort included 54 males(38.3%)with a mean age of 23.9±0.58y and 87 age-matched females(61.7%)with a mean age of 23.9±0.53y.The multiple regression model was statistically significant[R²=0.60,F=13.28,degrees of freedom(DF=17122,P<0.001].This indicates that 60%of the variance in total CVS-Q scores(reflecting reported symptoms)could be explained by four clinical measurements:amplitude of accommodation,positive relative accommodation,exophoria at distance and near,and positive fusional vergence at near.CONCLUSION:The total CVS-Q score is a valid and reliable tool for predicting the presence of various nonstrabismic binocular vision anomalies and refractive errors in symptomatic computer users.展开更多
AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy s...AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.展开更多
Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially me...Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.展开更多
AIM:To measure the contrast sensitivity(CS)using computer-based Chart2020 software pre-and post-white light exposure with and without blue-blocking lenses(BBLs).METHODS:The study included participants aged 18 to 25y(n...AIM:To measure the contrast sensitivity(CS)using computer-based Chart2020 software pre-and post-white light exposure with and without blue-blocking lenses(BBLs).METHODS:The study included participants aged 18 to 25y(n=30 eyes),where baseline CS was measured before the experiment.Following this,the participants were exposed to two white light-emitting diodes(LEDs;450 lx each),placed at a 45-degree angle from the participant’s eye and 80 cm from the light source.All participants were randomly divided into three groups(BBL1-Placebo lens,BBL2-Crizal Prevencia,BBL3-Duravision)by sequential randomisation,which was double-blinded.Post-light exposure,the CS was measured monocularly with a calibrated computer-based CS Chart-2020 software at different log units.RESULTS:CS measured using Chart-2020 software at 0.8,1.5,6,12,and 18 cpd pre-and post-white LED exposure with and without BBLs showed a significant difference(P<0.05)in contrast threshold and log contrast at 6 cpd and 18 cpd(P<0.05)and showed no significant differences in 0.8,1.5,12 cpd(P>0.05).CONCLUSION:This study shows that exposure to white LEDs can diminish CS,while BBLs may ameliorate these negative effects.展开更多
AIM:To evaluate the effects of polarized and nonpolarized sunglasses on visual functions,including distance and near visual acuity,phoria,stereopsis and contrast sensitivity across five spatial frequencies(1.5,3,6,12,...AIM:To evaluate the effects of polarized and nonpolarized sunglasses on visual functions,including distance and near visual acuity,phoria,stereopsis and contrast sensitivity across five spatial frequencies(1.5,3,6,12,18 cycles/degree).METHODS:A before-after study was conducted on 45 emmetropic students from Shahid Beheshti University of Medical Sciences.Visual acuity,contrast sensitivity,stereopsis and phoria were measured under three conditions:without sunglasses,with non-polarized sunglasses and with polarized sunglasses.Tests were conducted under controlled glare conditions to simulate outdoor environments.RESULTS:A total of 45 participants were evaluated,comprising 17 males(37.8%)and 28 females(62.2%).The mean age was 21.67±2.31y(range 18-27y).The mean of distance and near visual acuity in all three conditions were equal to 0.00 logMAR.Contrast sensitivity generally decreased slightly with the use of non-polarized sunglasses compared to the no-sunglasses condition.The mean stereopsis with polarized sunglasses was 101.33±56.139 arc sec,which was worse than the no-sunglasses condition(94.33±46.632 arc sec)and better than the non-polarized sunglasses condition(105.67±58.965 arc sec),although these changes were not significant.In the phoria parameter,distance phoria appeared more affected than near phoria.CONCLUSION:Polarized and non-polarized sunglasses do not significantly affect visual acuity,stereopsis,or phoria under controlled glare conditions.Slight changes in contrast sensitivity are noted,but they are not statistically significant.展开更多
AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observationa...AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observational study,144 digital screen users were assessed for dry eye disease(DED)using subjective and objective measures.The Ocular Surface Disease Index(OSDI)Questionnaire evaluated symptoms,followed by clinical assessments,including slit lamp biomicroscopy,tear breakup time(TBUT),Oxford Scheme grading,and Schirmer I test.DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs(OSDI,Schirmer I test,or ocular staining).The prevalence of DED was calculated based on the proportion of patients meeting these criteria.RESULTS:Of the 144 participants(mean age:34.6±15.2y),78(54.2%)were female.The use of digital screens varied between 2-8h(mean duration:4.1±2.7h)per day.The mean OSDI score,TBUT score,and the Schirmer I scores were 22.7±10.5(max-min:24.4-20.9),6.8±4.2s(max-min:7.5-6.1),and 12.3±4.6 mm(max-min:13.1-11.5)respectively with 95%confidence interval(β=1.96),and a two-tailed statistical significance level of 5%(α=0.05).With increased screen use,TBUT shortened and OSDI scores increased significantly(P<0.01),though Schirmer I scores were unaffected(P>0.05).The prevalence of DED ranged from 6.3%to 22.9%in those using screens for more than 2h,with an overall prevalence of 67.4%among digital screen users.CONCLUSION:There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.展开更多
Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes ...Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.展开更多
AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to pred...AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to predict the severity of diabetic retinopathy(DR)in the United States population.METHODS:The observational study enlisted patients diagnosed with DR from the National Health and Nutrition Examination Survey(NHANES)database,spanning the period from 2005 to 2008.The severity of DR was defined according to Early Treatment for Diabetic Retinopathy Study(ETDRs).The effect of NLR,PLR,SII,and RDW on proliferative diabetic retinopathy(PDR)were explored using multivariable logistic regression analysis model.Subgroup analysis and restricted cubic splines(RCS)were conducted to assess the robustness of the correlations across subgroups and to explore nonlinear relationships between four indices and PDR.The receiver operating characteristic(ROC)analysis was employed for the purpose of assessing and evaluating the predictive efficacy of NLR,PLR,SII,and RDW in determining the severity of DR.RESULTS:After adjusting for other confounders(age,gender,race,body mass index,diabetes duration,and HbA1c)in multivariable analysis,a unit increase of PLR×0.1,SII×0.01,and RDW would raise the risk for PDR by 15.6%,22.2%,and 33%,respectively.Particularly,there was a 2.208-fold greater risk of PDR in individuals with an elevated NLR(OR=2.208,95%CI,1.348-3.617,P<0.001).RCS analyses showed positive relationships of four indices and PDR after segmented regression based on their own turning points.The results of ROC analysis revealed that PLR+RDW[area under the curve(AUC)=0.772,95%CI:0.669-0.874]had the best predictive value for PDR,compared with NLR+PLR+SII(AUC=0.697,95%CI:0.570-0.825)or RDW alone(AUC=0.736,95%CI:0.646-0.826).CONCLUSION:The combination of RDW and NLR demonstrates a promising ability to predict the severity of DR across the United States population,and it could be promisingly used in clinics for monitoring the progress of DR.展开更多
AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students usin...AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.展开更多
AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive ...AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.展开更多
BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to ...BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.展开更多
AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A system...AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.展开更多
BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact ...BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary appro...BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.展开更多
AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this r...AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this randomized double-blind clinical trial study,48(24 cases)and 38 eyes(19 cases)underwent myopic astigmatism and hyperopic astigmatism LASIK.One eye of each individual was randomly assigned to AO centration and the fellow eye underwent the PC-centered method.The clinical outcomes including uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),safety and efficacy indexes,subjective spherical equivalent(SE)and corneal high-order aberrations(HOAs)were measured at baseline and 6mo postoperatively.RESULTS:In the myopic group,the mean preoperative SE and astigmatism were-4.12±0.87(-2.88 to-6.00)diopter(D)and-0.88±0.79(0 to-2.75)D,respectively.In the hyperopic group,the mean preoperative SE and astigmatism were 0.93±0.59(-0.25 to 2.25)D and-0.73±1.00(0 to-4.25)D,respectively.At 6mo postoperatively,the safety and efficacy indexes were similar for centration in myopic and hyperopic LASIK groups.In the myopic group,significant changes were found in horizontal trefoil(P=0.041)and oblique trefoil(P=0.031)in favor of AO centration treatment.CONCLUSION:Femtosecond-LASIK is a safe and efficacious procedure for treatment of myopic and hyperopic astigmatism.AO-centered and PC-centered approaches provide similar visual and refractive outcomes.Myopic astigmatism LASIK with AO centration leads to slightly better corneal aberration outcomes.展开更多
BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve p...BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve patient survival,adjuvant chemotherapy is commonly administered based on established postoperative guidelines.Despite advancements in chemotherapy delivery,the overall response rate remains below 50%,primarily due to the lack of targeted therapies tailored to specific patient populations.AIM To explore sensitive biomarkers to assess the efficacy of postoperative adjuvant chemotherapy in appropriate patient subgroups.METHODS This study retrospectively analyzed 1628 patients who underwent radical gastrectomy for GC at our hospital in 2017 and 2018,with a subsequent five-year follow-up.Patients were divided based on whether they received postoperative adjuvant chemotherapy.The study aimed to determine optimal cutoff values for various biomarkersneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,CA724,and CA242-using receiver operating characteristic(ROC)curves.Based on the optimal ROC cut-off,a novel combined metric,NLR-CEA,was developed to assess the efficacy of adjuvant chemotherapy following GC surgery.RESULTS Cox subgroup analysis demonstrated that postoperative adjuvant chemotherapy significantly improved overall survival in the NLR-CEA_Low group with a rate of 0.41(0.26-0.63).In the NLR-CEA_Middle group,the protective effect was observed at 0.69(0.54-0.87),while in the NLR-CEA_High group,it was 0.73(0.53-0.99).Notably,a 32%difference in the efficacy of chemotherapy was observed between the NLR-CEA_Low and NLR-CEA_High groups.CONCLUSION NLR-CEA is an effective biomarker for evaluating the efficacy of postoperative adjuvant chemotherapy in GC.Patients with NLR-CEA_Low exhibit significantly better responses to chemotherapy compared to those with NLRCEA_High.展开更多
The effect of iron concentration on the microstructural and structural properties of ZnO for electrolysis and photodetector applications was investigated.The thin layers of un-doped and doped ZnO with different percen...The effect of iron concentration on the microstructural and structural properties of ZnO for electrolysis and photodetector applications was investigated.The thin layers of un-doped and doped ZnO with different percentages of Fe(2,4,and 6 wt.%)were deposited by spin-coating on glass substrates.Sample characterization was done by X-ray diffraction(XRD),atomic force microscopy(AFM),scanning electron microscopy(SEM),energy-dispersive X-ray spectroscopy(EDS),UV−Vis absorption spectra and X-ray photoelectron spectroscopy(XPS).Structural measurements by XRD showed that all the layers were composed of polycrystallines with a hexagonal Wurtzite structure.Two new peaks were also discovered after the doping process belonging to the Fe_(2)O_(4)(400)and(440)crystal phase.Morphological analysis showed that the surface roughness values of ZnO layers ranged between 8 and 45 nm.XPS studies confirmed the presence of Fe in 3+states in ZnO layers.An average transmittance of 90%was measured by UV−Vis in the wavelength range of 200−900 nm.The values of the energy gap(Eg)decreased with an increase in the concentration of Fe.AFM topography results confirmed that ZnO-based thin layers had a relatively uniform surface.The efficiency of these samples has been confirmed for their use in many electrical applications,including photodetectors and electrolysis of contaminated solutions.展开更多
BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches....BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.展开更多
文摘AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbil,Iraq.The target population consisted of high school students selected through a multi-stage cluster sampling method.Comprehensive visual examinations were performed for all students,including measurement of uncorrected and corrected visual acuity,objective and subjective refraction,and distance and near cover tests.NPC was evaluated using a single 6/12 visual target mounted on a centrally positioned Gulden fixation stick.Ocular symptoms were investigated through interviews.RESULTS:Of the 996 selected students,921 participated in the study.Of them,543(58.96%)were female,and their ages ranged from 13 to 22y.The prevalence of tropia was 3.58%[95%confidence interval(CI):2.38%-4.78%],observed in 3.44%of males and 3.68%of females.Exotropia(1.95%,95%CI:1.06%-2.85%)was more common than esotropia(1.52%,95%CI:0.73%-2.31%).The 15.42%(95%CI:13.09%-17.75%)of students had phoria.Exophoria(13.79%,95%CI:11.56%-16.02%)was significantly more prevalent than esophoria(1.63%,95%CI:0.81%-2.45%).The prevalence of NPC abnormality in the total study population was 24.97%(95%CI:22.18%-27.77%).It was 26.72%(95%CI:22.26%-31.18%)in males and 23.76%(95%CI:20.18%-27.34%)in females(P=0.307).The most common symptom in phoria was headache(86.62%,95%CI:81.02%-92.22%),followed by tired or sore eyes(61.97%,95%CI:53.99%-69.96%).The most common symptoms in tropia were blurry vision(93.94%,95%CI:79.77%-99.26%)and difficulty concentrating(87.88%,95%CI:76.74%-99.01%).CONCLUSION:Among Erbil’s high school students,the prevalence of strabismus,particularly the exodeviation type,is relatively high,and a significant percentage of students have NPC abnormalities.Addressing and correcting these binocular vision problems,due to their associated visual symptoms,can lead to an improvement in students’quality of life and academic performance.
基金Supported by Ongoing Research Funding Program(ORFFT-2025-054-1),King Saud University,Riyadh,Saudi Arabia.
文摘AIM:To evaluate the efficacy of the total computer vision syndrome questionnaire(CVS-Q)score as a predictive tool for identifying individuals with symptomatic binocular vision anomalies and refractive errors.METHODS:A total of 141 healthy computer users underwent comprehensive clinical visual function assessments,including evaluations of refractive errors,accommodation(amplitude of accommodation,positive relative accommodation,negative relative accommodation,accommodative accuracy,and accommodative facility),and vergence(phoria,positive and negative fusional vergence,near point of convergence,and vergence facility).Total CVS-Q scores were recorded to explore potential associations between symptom scores and the aforementioned clinical visual function parameters.RESULTS:The cohort included 54 males(38.3%)with a mean age of 23.9±0.58y and 87 age-matched females(61.7%)with a mean age of 23.9±0.53y.The multiple regression model was statistically significant[R²=0.60,F=13.28,degrees of freedom(DF=17122,P<0.001].This indicates that 60%of the variance in total CVS-Q scores(reflecting reported symptoms)could be explained by four clinical measurements:amplitude of accommodation,positive relative accommodation,exophoria at distance and near,and positive fusional vergence at near.CONCLUSION:The total CVS-Q score is a valid and reliable tool for predicting the presence of various nonstrabismic binocular vision anomalies and refractive errors in symptomatic computer users.
基金Supported by Mashhad University of Medical Sciences.
文摘AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.
文摘Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.
文摘AIM:To measure the contrast sensitivity(CS)using computer-based Chart2020 software pre-and post-white light exposure with and without blue-blocking lenses(BBLs).METHODS:The study included participants aged 18 to 25y(n=30 eyes),where baseline CS was measured before the experiment.Following this,the participants were exposed to two white light-emitting diodes(LEDs;450 lx each),placed at a 45-degree angle from the participant’s eye and 80 cm from the light source.All participants were randomly divided into three groups(BBL1-Placebo lens,BBL2-Crizal Prevencia,BBL3-Duravision)by sequential randomisation,which was double-blinded.Post-light exposure,the CS was measured monocularly with a calibrated computer-based CS Chart-2020 software at different log units.RESULTS:CS measured using Chart-2020 software at 0.8,1.5,6,12,and 18 cpd pre-and post-white LED exposure with and without BBLs showed a significant difference(P<0.05)in contrast threshold and log contrast at 6 cpd and 18 cpd(P<0.05)and showed no significant differences in 0.8,1.5,12 cpd(P>0.05).CONCLUSION:This study shows that exposure to white LEDs can diminish CS,while BBLs may ameliorate these negative effects.
文摘AIM:To evaluate the effects of polarized and nonpolarized sunglasses on visual functions,including distance and near visual acuity,phoria,stereopsis and contrast sensitivity across five spatial frequencies(1.5,3,6,12,18 cycles/degree).METHODS:A before-after study was conducted on 45 emmetropic students from Shahid Beheshti University of Medical Sciences.Visual acuity,contrast sensitivity,stereopsis and phoria were measured under three conditions:without sunglasses,with non-polarized sunglasses and with polarized sunglasses.Tests were conducted under controlled glare conditions to simulate outdoor environments.RESULTS:A total of 45 participants were evaluated,comprising 17 males(37.8%)and 28 females(62.2%).The mean age was 21.67±2.31y(range 18-27y).The mean of distance and near visual acuity in all three conditions were equal to 0.00 logMAR.Contrast sensitivity generally decreased slightly with the use of non-polarized sunglasses compared to the no-sunglasses condition.The mean stereopsis with polarized sunglasses was 101.33±56.139 arc sec,which was worse than the no-sunglasses condition(94.33±46.632 arc sec)and better than the non-polarized sunglasses condition(105.67±58.965 arc sec),although these changes were not significant.In the phoria parameter,distance phoria appeared more affected than near phoria.CONCLUSION:Polarized and non-polarized sunglasses do not significantly affect visual acuity,stereopsis,or phoria under controlled glare conditions.Slight changes in contrast sensitivity are noted,but they are not statistically significant.
文摘AIM:To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years.METHODS:In a cross-sectional,observational study,144 digital screen users were assessed for dry eye disease(DED)using subjective and objective measures.The Ocular Surface Disease Index(OSDI)Questionnaire evaluated symptoms,followed by clinical assessments,including slit lamp biomicroscopy,tear breakup time(TBUT),Oxford Scheme grading,and Schirmer I test.DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs(OSDI,Schirmer I test,or ocular staining).The prevalence of DED was calculated based on the proportion of patients meeting these criteria.RESULTS:Of the 144 participants(mean age:34.6±15.2y),78(54.2%)were female.The use of digital screens varied between 2-8h(mean duration:4.1±2.7h)per day.The mean OSDI score,TBUT score,and the Schirmer I scores were 22.7±10.5(max-min:24.4-20.9),6.8±4.2s(max-min:7.5-6.1),and 12.3±4.6 mm(max-min:13.1-11.5)respectively with 95%confidence interval(β=1.96),and a two-tailed statistical significance level of 5%(α=0.05).With increased screen use,TBUT shortened and OSDI scores increased significantly(P<0.01),though Schirmer I scores were unaffected(P>0.05).The prevalence of DED ranged from 6.3%to 22.9%in those using screens for more than 2h,with an overall prevalence of 67.4%among digital screen users.CONCLUSION:There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.
基金Supported by Noor Ophthalmology Research Center.
文摘Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.
基金Supported by Tianjin Natural Science Foundation(No.23JCZXJC00140).
文摘AIM:To assess and compare the utility of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic inflammation index(SII),and red blood cell distribution width(RDW)as potential biomarkers to predict the severity of diabetic retinopathy(DR)in the United States population.METHODS:The observational study enlisted patients diagnosed with DR from the National Health and Nutrition Examination Survey(NHANES)database,spanning the period from 2005 to 2008.The severity of DR was defined according to Early Treatment for Diabetic Retinopathy Study(ETDRs).The effect of NLR,PLR,SII,and RDW on proliferative diabetic retinopathy(PDR)were explored using multivariable logistic regression analysis model.Subgroup analysis and restricted cubic splines(RCS)were conducted to assess the robustness of the correlations across subgroups and to explore nonlinear relationships between four indices and PDR.The receiver operating characteristic(ROC)analysis was employed for the purpose of assessing and evaluating the predictive efficacy of NLR,PLR,SII,and RDW in determining the severity of DR.RESULTS:After adjusting for other confounders(age,gender,race,body mass index,diabetes duration,and HbA1c)in multivariable analysis,a unit increase of PLR×0.1,SII×0.01,and RDW would raise the risk for PDR by 15.6%,22.2%,and 33%,respectively.Particularly,there was a 2.208-fold greater risk of PDR in individuals with an elevated NLR(OR=2.208,95%CI,1.348-3.617,P<0.001).RCS analyses showed positive relationships of four indices and PDR after segmented regression based on their own turning points.The results of ROC analysis revealed that PLR+RDW[area under the curve(AUC)=0.772,95%CI:0.669-0.874]had the best predictive value for PDR,compared with NLR+PLR+SII(AUC=0.697,95%CI:0.570-0.825)or RDW alone(AUC=0.736,95%CI:0.646-0.826).CONCLUSION:The combination of RDW and NLR demonstrates a promising ability to predict the severity of DR across the United States population,and it could be promisingly used in clinics for monitoring the progress of DR.
文摘AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.
文摘AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.
文摘BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.
基金Supported by Sichuan Province Science and Technology Plan(No.2023YFS0506)Medical Research Project of Jinniu District,Chengdu,Sichuan Province(No.JNKY2024-94)Xinglin Scholar Program at Chengdu University of Traditional Chinese Medicine(No.ZYTS2023028).
文摘AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.
文摘BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
文摘BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.
基金Supported by Noor Ophthalmology Research Center.
文摘AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this randomized double-blind clinical trial study,48(24 cases)and 38 eyes(19 cases)underwent myopic astigmatism and hyperopic astigmatism LASIK.One eye of each individual was randomly assigned to AO centration and the fellow eye underwent the PC-centered method.The clinical outcomes including uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),safety and efficacy indexes,subjective spherical equivalent(SE)and corneal high-order aberrations(HOAs)were measured at baseline and 6mo postoperatively.RESULTS:In the myopic group,the mean preoperative SE and astigmatism were-4.12±0.87(-2.88 to-6.00)diopter(D)and-0.88±0.79(0 to-2.75)D,respectively.In the hyperopic group,the mean preoperative SE and astigmatism were 0.93±0.59(-0.25 to 2.25)D and-0.73±1.00(0 to-4.25)D,respectively.At 6mo postoperatively,the safety and efficacy indexes were similar for centration in myopic and hyperopic LASIK groups.In the myopic group,significant changes were found in horizontal trefoil(P=0.041)and oblique trefoil(P=0.031)in favor of AO centration treatment.CONCLUSION:Femtosecond-LASIK is a safe and efficacious procedure for treatment of myopic and hyperopic astigmatism.AO-centered and PC-centered approaches provide similar visual and refractive outcomes.Myopic astigmatism LASIK with AO centration leads to slightly better corneal aberration outcomes.
文摘BACKGROUND Gastric cancer(GC)is an aggressive malignancy of the gastrointestinal tract characterized by high recurrence rates following radical gastrectomy.To enhance treatment efficacy,reduce recurrence,and improve patient survival,adjuvant chemotherapy is commonly administered based on established postoperative guidelines.Despite advancements in chemotherapy delivery,the overall response rate remains below 50%,primarily due to the lack of targeted therapies tailored to specific patient populations.AIM To explore sensitive biomarkers to assess the efficacy of postoperative adjuvant chemotherapy in appropriate patient subgroups.METHODS This study retrospectively analyzed 1628 patients who underwent radical gastrectomy for GC at our hospital in 2017 and 2018,with a subsequent five-year follow-up.Patients were divided based on whether they received postoperative adjuvant chemotherapy.The study aimed to determine optimal cutoff values for various biomarkersneutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,CA724,and CA242-using receiver operating characteristic(ROC)curves.Based on the optimal ROC cut-off,a novel combined metric,NLR-CEA,was developed to assess the efficacy of adjuvant chemotherapy following GC surgery.RESULTS Cox subgroup analysis demonstrated that postoperative adjuvant chemotherapy significantly improved overall survival in the NLR-CEA_Low group with a rate of 0.41(0.26-0.63).In the NLR-CEA_Middle group,the protective effect was observed at 0.69(0.54-0.87),while in the NLR-CEA_High group,it was 0.73(0.53-0.99).Notably,a 32%difference in the efficacy of chemotherapy was observed between the NLR-CEA_Low and NLR-CEA_High groups.CONCLUSION NLR-CEA is an effective biomarker for evaluating the efficacy of postoperative adjuvant chemotherapy in GC.Patients with NLR-CEA_Low exhibit significantly better responses to chemotherapy compared to those with NLRCEA_High.
基金the support received from the Researchers Supporting Project(No.RSP2024R404),King Saud University,Riyadh,Saudi Arabia。
文摘The effect of iron concentration on the microstructural and structural properties of ZnO for electrolysis and photodetector applications was investigated.The thin layers of un-doped and doped ZnO with different percentages of Fe(2,4,and 6 wt.%)were deposited by spin-coating on glass substrates.Sample characterization was done by X-ray diffraction(XRD),atomic force microscopy(AFM),scanning electron microscopy(SEM),energy-dispersive X-ray spectroscopy(EDS),UV−Vis absorption spectra and X-ray photoelectron spectroscopy(XPS).Structural measurements by XRD showed that all the layers were composed of polycrystallines with a hexagonal Wurtzite structure.Two new peaks were also discovered after the doping process belonging to the Fe_(2)O_(4)(400)and(440)crystal phase.Morphological analysis showed that the surface roughness values of ZnO layers ranged between 8 and 45 nm.XPS studies confirmed the presence of Fe in 3+states in ZnO layers.An average transmittance of 90%was measured by UV−Vis in the wavelength range of 200−900 nm.The values of the energy gap(Eg)decreased with an increase in the concentration of Fe.AFM topography results confirmed that ZnO-based thin layers had a relatively uniform surface.The efficiency of these samples has been confirmed for their use in many electrical applications,including photodetectors and electrolysis of contaminated solutions.
文摘BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.
