Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE...Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.展开更多
This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP se...This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP second-generation probes(Eye OP1). After treatment, the mean intraocular pressure(IOP) significantly decreased from 26.8±7.2 to 18.8±6.1 mm Hg at day 1 and to 14.7±3.4 mm Hg at month 6(all P<0.001). Mean laser flare-cell photometry value steeply increased after surgery from 12.1±7.5 to 64.1±53.9 ph/ms(P=0.001) at day 1, and then progressively decreased to respectively 60.6±49.7 at day 7, 43.5±38.5 at day 14 and 28.2±18.3 at month 1(all P<0.05), returning at levels similar to baseline ones at month 3 and month 6(respectively 16.7±6.2 and 12.8±10.2, both P>0.05). A significant negative correlation was found between postoperative increase of aqueous flare values and anterior chamber depth(R=-0.568, P=0.014). This timeframe may be considered reasonable for repeating UCP treatment, when required.展开更多
AIM： To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions （A.sBD） in a non-presbyopic population of video display unit （VDU） users with flat-panel displays. METHODS： ...AIM： To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions （A.sBD） in a non-presbyopic population of video display unit （VDU） users with flat-panel displays. METHODS： One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertical deviation, strabismus and eye diseases. Finally, the remaining participants underwent an exhaustive assessment of their accommodative and binocular vision status. RESULTS： Eighty-nine VDU users （46 females and 43 males） were included in this study. They used flat-panel displays for an average of 5±1.9h a day. Twenty subjects presented A.sBD （22.5%）. Convergence excess was the most frequent non-strabismic binocular dysfunction （9 subjects）, followed by fusional vergence dysfunction （3 subjects） and convergence insufficiency （2 subjects）. Within the accommodative dysfunctions, accommodative excess was the most common （4 subjects）, followed by accommodative insufficiency （2 subjects）. Moderate to severe eye symptoms were found in 13 subjects with ANSBD. CONCLUSION： Significant eye symptoms in VDU users with accommodative and/or non-strabismic binocular dysfunctions often occur and should not be underestimated; therefore, an appropriate evaluation of accommodative and binocular vision status is more important for this population,展开更多
AIM:To evaluate choroidal thickness,medium choroidal vessel thickness(MCVT)and large choroidal vessel thickness(LCVT)in normal children and adult subjects.METHODS:Manual measurements of subfoveal choroidal thickness(S...AIM:To evaluate choroidal thickness,medium choroidal vessel thickness(MCVT)and large choroidal vessel thickness(LCVT)in normal children and adult subjects.METHODS:Manual measurements of subfoveal choroidal thickness(SFCT),MCVT and LCVT at subfoveal and 750μm nasal and temporal to fovea locations were completed on enhanced-depth imaging optical coherence tomography(EDI-OCT)scans of normal children and adult subjects.RESULTS:Fifty adult and fifty-seven child subjects were included in the study(including 80 adult and 103 child eyes).Mean(±SD)SFCT of adult and children eyes in the study was 309.3±95.7μm and 279.3±50.4μm respectively.SFCT and subfoveal MCVT in adult eyes were significantly more than children(P=0.01 and P≤0.0001 respectively).CONCLUSION:There is choroidal thickening with associated thickening of medium choroidal vessels in adults,suggesting that there is alteration in choroidal vasculature with ageing.展开更多
Glaucoma,a progressive age-related optic neuropathy characterized by the death of retinal ganglion cells,is the most common neurodegenerative cause of irreversible blindness worldwide.The therapeutic management of gla...Glaucoma,a progressive age-related optic neuropathy characterized by the death of retinal ganglion cells,is the most common neurodegenerative cause of irreversible blindness worldwide.The therapeutic management of glaucoma,which is limited to lowering intraocular pressure,is still a challenge since visual loss progresses in a significant percentage of treated patients.Restricted dietary regimens have received considerable attention as adjuvant strategy for attenuating or delaying the progression of neurodegenerative diseases.Here we discuss the literature exploring the effects of modified eating patterns on retinal aging and resistance to stressor stimuli.展开更多
Dopamine and its receptors have been widely studied in the neurological conditions and in the retina. In this study, we evaluated the possible role of dopamine in rhegmatogenous retinal detachment(RRD) by comparing th...Dopamine and its receptors have been widely studied in the neurological conditions and in the retina. In this study, we evaluated the possible role of dopamine in rhegmatogenous retinal detachment(RRD) by comparing the amount of 3,4-dihydroxyphenylacetic acid(DOPAC), a surrogate index of retinal dopamin levels, in the vitreous sample of patients affected by RRD with those affected by macular pucker and vitre ous hemorrhage. Our results showed that significantly higher levels of DOPAC were found in the vitreou sample of patients affected by RRD compared with those affected by vitreous hemorrhage and macula pucker(P = 0.002). Specifically, no trace of the substance was found in vitreous hemorrhage and macula pucker samples. A slightly significant positive correlation was found among DOPAC and post-operativ best corrected visual acuity(r = 0.470, P = 0.049). No correlation was found between DOPAC and the day elapsed between diagnosis and surgery(P = 0.317). For the first time our findings suggest that DOPAC i released in RRD, but not in other retinal diseases such as vitreous hemorrhage and macular pucker. More over, we showed a correlation between visual acuity outcome and the amount of DOPAC in the vitreous This might have a potential, although still unknown, implication in the pathogenesis of the disease and/o in the associated photoreceptors loss. This study was approved by the Ethics Committee of Rome Tor Ver gata University Hospital(R.S.92.10) on September 24, 2010.展开更多
Glaucoma, the leading cause of visual impairment and irreversible blindness worldwide, is a multifactorial, progressive optic neuropathy characterized by loss of retinal ganglion cells, alterations of the optic nerve ...Glaucoma, the leading cause of visual impairment and irreversible blindness worldwide, is a multifactorial, progressive optic neuropathy characterized by loss of retinal ganglion cells, alterations of the optic nerve head, and specific visual field defects. Clinical evidence shows that intraocular pressure is the major risk factor of the treatable disease. However, in some patients, glaucoma develops and continues to progress despite normal intraocular pressure values, suggesting that other risk factors are involved in the disease. Consequently, neuroprotective treatments, focused on preventing retinal ganglion cells death by acting on different therapeutic strategies but not focused on intraocular pressure reduction, has therefore become of great interest. In this contest, coenzyme Q10, showing evidence in slowing or reversing pathological changes typical of the disease, has been proposed as a potential neuroprotective agent in glaucoma. In this review, we describe the possible mechanisms of action of coenzyme Q10 and the recent evidence in literature regarding the neuroprotective activity of the molecule.展开更多
Background: A decrease in trabecular cell number has been reported in treated glaucoma patients. The mechanisms of this cell loss are poorly understood. This study evaluates the effect of benzalkonium-preserved (BAC+)...Background: A decrease in trabecular cell number has been reported in treated glaucoma patients. The mechanisms of this cell loss are poorly understood. This study evaluates the effect of benzalkonium-preserved (BAC+) or preservative-free (BAC-) antiglaucoma medications on expression of apoptotic markers expression by cultured human trabecular cells to see whether apoptosis may be one mechanism by which trabecular cells.展开更多
AIM:To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy(NAION)present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.ME...AIM:To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy(NAION)present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.METHODS:This was a retrospective chart review.All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed.Patients were included if they had documented disc edema and follow up of at least 3 mo.Patients with progressive NAION were identified if they worsened in 2 out of 3 parameters:visual acuity≥3 Snellen lines;Color vision≥4 Ishihara plates;the visual field defect involved a new quadrant.The clinical characteristics,time from symptom onset to presentation,systemic risk factors and visual outcome were compared to patients with stable NAION.RESULTS:Totally 122 NAION cases met the inclusion criteria.Mean age was 58.1 y(range 22-74),70%were men.Twenty cases(16.4%)had progressive NAION.Patients with progressive NAION did not differ from stable NAION in their demographics,systemic risk factors or in their initial visual deficit.At last follow up,median visual acuity was 1.0 log MAR(IQR 0.64-1.55)in patients with progressive NAION,vs 0.18(IQR 0.1-0.63)in stable NAION(P<0.001).Median color vision testing was 0 plates correct(IQR 0-2.5%)vs 92%plates correct(IQR 50%-100%)in the stable NAION group(P<0.001).Patients with progressive NAION differed in the time from symptom onset to presentation(median 2 d vs 5 d,P=0.011).CONCLUSION:We find no identifiable risk factors associated with progressive NAION.Progressors arrive earlier for ophthalmological evaluation.展开更多
Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement o...Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.展开更多
Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater sol...Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry</span></span><sup><span style="font-family:Verdana;">?</span></sup><span style="font-family:""><span style="font-family:Verdana;"> test initially positive, ocular surface disease index (OSDI) score ≥ 12 and <33, tear film breakup time (TBUT) ≤ 10 seconds, Shirmer I test result ≤ 10 mm/5 minutes, corneal staining ≥ 1. Additionally, all the patients selected corresponded to a dry eye type 2 - 3 severity degree - mild and moderate - Dry Eye Workshop Study (DEWS) classification. The InflammaDry test is used to measure levels of MMP9 at the beginning and the end of the study. All patients were treated exclusively with isotonic seawater solution 5 times a day for 3 weeks. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p < 0.001). </span><b><span style="font-family:Verdana;">Conclusions</span></b><span style="font-family:Verdana;">: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.展开更多
Dear Editor,We write to describe two cases of corneal ectasia occurred after photorefractive keratectomy.Due to the wide diffusion of refractive surgery,many ophthalmologists attempted to identify the risk factors and...Dear Editor,We write to describe two cases of corneal ectasia occurred after photorefractive keratectomy.Due to the wide diffusion of refractive surgery,many ophthalmologists attempted to identify the risk factors and prevention methods to avoid such severe complication of this technique.展开更多
AIM：To determine the outcome of non-investigational treatment with intravitreal bevacizumab（IVB） in neovascular age-related macular degeneration（AMD）patients.· METHODS：Retrospective chart review of 81 eyes ...AIM：To determine the outcome of non-investigational treatment with intravitreal bevacizumab（IVB） in neovascular age-related macular degeneration（AMD）patients.· METHODS：Retrospective chart review of 81 eyes with neovascular AMD followed-up for at least 12 mo and received 3-monthly loading IVB injections.Re-treat was based upon the individual clinician＇s judgment.Bestcorrected visual acuity（BCVA） and optical coherence tomography measurements of central foveal thickness outcomes were evaluated at 12,24 mo.· RESULTS：Eighty-one eyes（of 75 patients） completed12 mo of follow-up and 44 eyes（of 41 patients） completed24 mo of follow-up.The mean baseline logMAR BCVA significantly improved from 0.94±0.69 to 0.85±0.68 at12mo（P〈0.001） and from 0.91±0.65 to 0.85±0.60（P=0.004）at 24 mo.The proportion of eyes that lost 〈15 logMAR letters at 12 mo was 90.1%and at 24 mo was 81.8%.IVB was effective in improving visual acuity in both treatment naive and previous photodynamic therapy（PDT）-treated subgroups.Treatment naive patients required significantly fewer injections than patients with prior PDT.Multiple regression analysis identified that poorer baseline visual acuity was associated with greater improvement in visual acuity（P=0.015）.· CONCLUSION：Fewer injections in clinical practice may result in suboptimal visual outcomes compared with clinical trials of IVB in neovascular AMD patients.Poor baseline visual acuity and prior PDT treatment may also improve vision after IVB.The safety and durability of effect was maintained at 24 mo.展开更多
AIM:To review the management of cataract in children in a tertiary hospital in a developing country,and to highlight the challenges therein.· METHODS:The hospital records of children aged 15 years or less that ha...AIM:To review the management of cataract in children in a tertiary hospital in a developing country,and to highlight the challenges therein.· METHODS:The hospital records of children aged 15 years or less that had cataract surgery at University of Nigeria Teaching Hospital,Enugu from 2005 to 2008 were reviewed retrospectively.Information was obtained on bio-data,pre-and post-operative visual acuity(VA),biometry,and type of surgery,use of intraocular lens(IOL) and presence of co-morbidity.SPSS was used for data entry and analysis.· RESULTS:The hospital records of 21 children(26 eyes) were analyzed.There were 12 males(57.1%) and 9 females(42.9%).Pre-operative VA could not be assessed in 11 eyes(42.3%),14 eyes(53.9%) had VA <3/60 and one eye(3.8%) had VA 6/60.Biometry was done in only 5 eyes(19.2%).All eyes had standard extracapsular cataract extraction without primary posterior capsulectomy;12 eyes(46.2%) had posterior chamber intraocular lens(PC-IOL) implant while 13 eyes(50.0%) had no IOL.After 12 weeks of follow up,vision assessment was available in only 15 eyes.With best correction,VA of 6/18 or better was achieved in only 5 eyes(33.3%).· CONCLUSION:Inadequate facilities and inadequate follow up after surgery are some of the challenges in managing paediatric cataract in the developing countries.If these challenges are not addressed,cataract will remain a major cause of childhood blindness and low vision in Africa for many years.There should be collaboration between Paediatric Ophthalmology Centres in industrialized and developing countries to enhance skill transfer.Governmental and International Non-governmental Organizations can go a long way to facilitate this exchange.展开更多
AIMTo report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age...AIMTo report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age related macular degeneration (AMD).展开更多
Dear Editor,In the past, enucleation has been considered the only available option and the standard of care for the management of malignant intraocular tumors. Thanks to the advances in the field of radiotherapy, new ...Dear Editor,In the past, enucleation has been considered the only available option and the standard of care for the management of malignant intraocular tumors. Thanks to the advances in the field of radiotherapy, new therapeutic approaches have been developed in the last decades, such as plaque brachytherapy and proton beam therapy(PBT)^([1]).展开更多
We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly d...We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly during HIV infection. Its frequency increases with the decrease in CD4 T lymphocytes and the passage to the AIDS stage. Its pathophysiology in this context is complex and multifactorial. Hemorrhagic complications usually appear for platelets less than 50,000/mm3 and this risk is greater at a rate of less than 20,000/mm3. Retinal hemorrhages may go unnoticed, only macular localization results in clinical expression. OCT is of paramount importance in accurate topographic diagnosis of macular hemorrhages by locating their seats which can be pre, intra or under retinal. Management requires the balance of infectious and hematologic factors. Ophthalmic surgical treatments should be considered in a second step.展开更多
Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola...Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.展开更多
Introduction: Refractive disturbances have been observed during hyperglycemia. However, there remains controversy as to the types of disturbances that it induces. Objective: To determine the types of refractive distur...Introduction: Refractive disturbances have been observed during hyperglycemia. However, there remains controversy as to the types of disturbances that it induces. Objective: To determine the types of refractive disturbances observed during hyperglycemia in humans. Population and Methods: This was an observational and cross-sectional study with an analytical purpose conducted from July to November 2021. Emmetropia, hypermetropia, and myopia as well as blood glucose levels were compared between day 0 (D0) and day 30 (D30) after initiation of hypoglycemic therapy in 222 people (444 eyes) with recently discovered hyperglycemia (Chi-2;p Results: At D0, the mean of blood glucose was 18.1 mmol/L ± 8.2 vs 6.9 mmol/L ± 3.0 at D30 (p = 0.001). At day 0, 80% (n = 355) of eyes were hypermetropic compared to 73.9% (n = 328) at D30 (p = 0.02). At D0, 14.2% of eyes (n = 63) were myopic compared to 11.3% (n = 50) at D30 (p = 0.02). Refraction improved from 0.75 to 1.5D for 34.5% (n = 18) of hypermetropic eyes and 10.2% (n = 2) of myopic eyes. Conclusion: Our results show that hypermetropia is the most common ametropia during hyperglycemia. Moreover, these data suggest that the normalization of blood glucose improves refraction.展开更多
文摘Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.
文摘This is a prospective interventional clinical study evaluating intraocular inflammation developed after Ultrasound Cyclo Plasty(UCP) for the treatment of glaucoma. Eighteen eyes of 18 patients were treated with UCP second-generation probes(Eye OP1). After treatment, the mean intraocular pressure(IOP) significantly decreased from 26.8±7.2 to 18.8±6.1 mm Hg at day 1 and to 14.7±3.4 mm Hg at month 6(all P<0.001). Mean laser flare-cell photometry value steeply increased after surgery from 12.1±7.5 to 64.1±53.9 ph/ms(P=0.001) at day 1, and then progressively decreased to respectively 60.6±49.7 at day 7, 43.5±38.5 at day 14 and 28.2±18.3 at month 1(all P<0.05), returning at levels similar to baseline ones at month 3 and month 6(respectively 16.7±6.2 and 12.8±10.2, both P>0.05). A significant negative correlation was found between postoperative increase of aqueous flare values and anterior chamber depth(R=-0.568, P=0.014). This timeframe may be considered reasonable for repeating UCP treatment, when required.
文摘AIM： To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions （A.sBD） in a non-presbyopic population of video display unit （VDU） users with flat-panel displays. METHODS： One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertical deviation, strabismus and eye diseases. Finally, the remaining participants underwent an exhaustive assessment of their accommodative and binocular vision status. RESULTS： Eighty-nine VDU users （46 females and 43 males） were included in this study. They used flat-panel displays for an average of 5±1.9h a day. Twenty subjects presented A.sBD （22.5%）. Convergence excess was the most frequent non-strabismic binocular dysfunction （9 subjects）, followed by fusional vergence dysfunction （3 subjects） and convergence insufficiency （2 subjects）. Within the accommodative dysfunctions, accommodative excess was the most common （4 subjects）, followed by accommodative insufficiency （2 subjects）. Moderate to severe eye symptoms were found in 13 subjects with ANSBD. CONCLUSION： Significant eye symptoms in VDU users with accommodative and/or non-strabismic binocular dysfunctions often occur and should not be underestimated; therefore, an appropriate evaluation of accommodative and binocular vision status is more important for this population,
文摘AIM:To evaluate choroidal thickness,medium choroidal vessel thickness(MCVT)and large choroidal vessel thickness(LCVT)in normal children and adult subjects.METHODS:Manual measurements of subfoveal choroidal thickness(SFCT),MCVT and LCVT at subfoveal and 750μm nasal and temporal to fovea locations were completed on enhanced-depth imaging optical coherence tomography(EDI-OCT)scans of normal children and adult subjects.RESULTS:Fifty adult and fifty-seven child subjects were included in the study(including 80 adult and 103 child eyes).Mean(±SD)SFCT of adult and children eyes in the study was 309.3±95.7μm and 279.3±50.4μm respectively.SFCT and subfoveal MCVT in adult eyes were significantly more than children(P=0.01 and P≤0.0001 respectively).CONCLUSION:There is choroidal thickening with associated thickening of medium choroidal vessels in adults,suggesting that there is alteration in choroidal vasculature with ageing.
文摘Glaucoma,a progressive age-related optic neuropathy characterized by the death of retinal ganglion cells,is the most common neurodegenerative cause of irreversible blindness worldwide.The therapeutic management of glaucoma,which is limited to lowering intraocular pressure,is still a challenge since visual loss progresses in a significant percentage of treated patients.Restricted dietary regimens have received considerable attention as adjuvant strategy for attenuating or delaying the progression of neurodegenerative diseases.Here we discuss the literature exploring the effects of modified eating patterns on retinal aging and resistance to stressor stimuli.
文摘Dopamine and its receptors have been widely studied in the neurological conditions and in the retina. In this study, we evaluated the possible role of dopamine in rhegmatogenous retinal detachment(RRD) by comparing the amount of 3,4-dihydroxyphenylacetic acid(DOPAC), a surrogate index of retinal dopamin levels, in the vitreous sample of patients affected by RRD with those affected by macular pucker and vitre ous hemorrhage. Our results showed that significantly higher levels of DOPAC were found in the vitreou sample of patients affected by RRD compared with those affected by vitreous hemorrhage and macula pucker(P = 0.002). Specifically, no trace of the substance was found in vitreous hemorrhage and macula pucker samples. A slightly significant positive correlation was found among DOPAC and post-operativ best corrected visual acuity(r = 0.470, P = 0.049). No correlation was found between DOPAC and the day elapsed between diagnosis and surgery(P = 0.317). For the first time our findings suggest that DOPAC i released in RRD, but not in other retinal diseases such as vitreous hemorrhage and macular pucker. More over, we showed a correlation between visual acuity outcome and the amount of DOPAC in the vitreous This might have a potential, although still unknown, implication in the pathogenesis of the disease and/o in the associated photoreceptors loss. This study was approved by the Ethics Committee of Rome Tor Ver gata University Hospital(R.S.92.10) on September 24, 2010.
文摘Glaucoma, the leading cause of visual impairment and irreversible blindness worldwide, is a multifactorial, progressive optic neuropathy characterized by loss of retinal ganglion cells, alterations of the optic nerve head, and specific visual field defects. Clinical evidence shows that intraocular pressure is the major risk factor of the treatable disease. However, in some patients, glaucoma develops and continues to progress despite normal intraocular pressure values, suggesting that other risk factors are involved in the disease. Consequently, neuroprotective treatments, focused on preventing retinal ganglion cells death by acting on different therapeutic strategies but not focused on intraocular pressure reduction, has therefore become of great interest. In this contest, coenzyme Q10, showing evidence in slowing or reversing pathological changes typical of the disease, has been proposed as a potential neuroprotective agent in glaucoma. In this review, we describe the possible mechanisms of action of coenzyme Q10 and the recent evidence in literature regarding the neuroprotective activity of the molecule.
文摘Background: A decrease in trabecular cell number has been reported in treated glaucoma patients. The mechanisms of this cell loss are poorly understood. This study evaluates the effect of benzalkonium-preserved (BAC+) or preservative-free (BAC-) antiglaucoma medications on expression of apoptotic markers expression by cultured human trabecular cells to see whether apoptosis may be one mechanism by which trabecular cells.
文摘AIM:To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy(NAION)present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.METHODS:This was a retrospective chart review.All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed.Patients were included if they had documented disc edema and follow up of at least 3 mo.Patients with progressive NAION were identified if they worsened in 2 out of 3 parameters:visual acuity≥3 Snellen lines;Color vision≥4 Ishihara plates;the visual field defect involved a new quadrant.The clinical characteristics,time from symptom onset to presentation,systemic risk factors and visual outcome were compared to patients with stable NAION.RESULTS:Totally 122 NAION cases met the inclusion criteria.Mean age was 58.1 y(range 22-74),70%were men.Twenty cases(16.4%)had progressive NAION.Patients with progressive NAION did not differ from stable NAION in their demographics,systemic risk factors or in their initial visual deficit.At last follow up,median visual acuity was 1.0 log MAR(IQR 0.64-1.55)in patients with progressive NAION,vs 0.18(IQR 0.1-0.63)in stable NAION(P<0.001).Median color vision testing was 0 plates correct(IQR 0-2.5%)vs 92%plates correct(IQR 50%-100%)in the stable NAION group(P<0.001).Patients with progressive NAION differed in the time from symptom onset to presentation(median 2 d vs 5 d,P=0.011).CONCLUSION:We find no identifiable risk factors associated with progressive NAION.Progressors arrive earlier for ophthalmological evaluation.
文摘Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.
文摘Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry</span></span><sup><span style="font-family:Verdana;">?</span></sup><span style="font-family:""><span style="font-family:Verdana;"> test initially positive, ocular surface disease index (OSDI) score ≥ 12 and <33, tear film breakup time (TBUT) ≤ 10 seconds, Shirmer I test result ≤ 10 mm/5 minutes, corneal staining ≥ 1. Additionally, all the patients selected corresponded to a dry eye type 2 - 3 severity degree - mild and moderate - Dry Eye Workshop Study (DEWS) classification. The InflammaDry test is used to measure levels of MMP9 at the beginning and the end of the study. All patients were treated exclusively with isotonic seawater solution 5 times a day for 3 weeks. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p < 0.001). </span><b><span style="font-family:Verdana;">Conclusions</span></b><span style="font-family:Verdana;">: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.
文摘Dear Editor,We write to describe two cases of corneal ectasia occurred after photorefractive keratectomy.Due to the wide diffusion of refractive surgery,many ophthalmologists attempted to identify the risk factors and prevention methods to avoid such severe complication of this technique.
文摘AIM：To determine the outcome of non-investigational treatment with intravitreal bevacizumab（IVB） in neovascular age-related macular degeneration（AMD）patients.· METHODS：Retrospective chart review of 81 eyes with neovascular AMD followed-up for at least 12 mo and received 3-monthly loading IVB injections.Re-treat was based upon the individual clinician＇s judgment.Bestcorrected visual acuity（BCVA） and optical coherence tomography measurements of central foveal thickness outcomes were evaluated at 12,24 mo.· RESULTS：Eighty-one eyes（of 75 patients） completed12 mo of follow-up and 44 eyes（of 41 patients） completed24 mo of follow-up.The mean baseline logMAR BCVA significantly improved from 0.94±0.69 to 0.85±0.68 at12mo（P〈0.001） and from 0.91±0.65 to 0.85±0.60（P=0.004）at 24 mo.The proportion of eyes that lost 〈15 logMAR letters at 12 mo was 90.1%and at 24 mo was 81.8%.IVB was effective in improving visual acuity in both treatment naive and previous photodynamic therapy（PDT）-treated subgroups.Treatment naive patients required significantly fewer injections than patients with prior PDT.Multiple regression analysis identified that poorer baseline visual acuity was associated with greater improvement in visual acuity（P=0.015）.· CONCLUSION：Fewer injections in clinical practice may result in suboptimal visual outcomes compared with clinical trials of IVB in neovascular AMD patients.Poor baseline visual acuity and prior PDT treatment may also improve vision after IVB.The safety and durability of effect was maintained at 24 mo.
文摘AIM:To review the management of cataract in children in a tertiary hospital in a developing country,and to highlight the challenges therein.· METHODS:The hospital records of children aged 15 years or less that had cataract surgery at University of Nigeria Teaching Hospital,Enugu from 2005 to 2008 were reviewed retrospectively.Information was obtained on bio-data,pre-and post-operative visual acuity(VA),biometry,and type of surgery,use of intraocular lens(IOL) and presence of co-morbidity.SPSS was used for data entry and analysis.· RESULTS:The hospital records of 21 children(26 eyes) were analyzed.There were 12 males(57.1%) and 9 females(42.9%).Pre-operative VA could not be assessed in 11 eyes(42.3%),14 eyes(53.9%) had VA <3/60 and one eye(3.8%) had VA 6/60.Biometry was done in only 5 eyes(19.2%).All eyes had standard extracapsular cataract extraction without primary posterior capsulectomy;12 eyes(46.2%) had posterior chamber intraocular lens(PC-IOL) implant while 13 eyes(50.0%) had no IOL.After 12 weeks of follow up,vision assessment was available in only 15 eyes.With best correction,VA of 6/18 or better was achieved in only 5 eyes(33.3%).· CONCLUSION:Inadequate facilities and inadequate follow up after surgery are some of the challenges in managing paediatric cataract in the developing countries.If these challenges are not addressed,cataract will remain a major cause of childhood blindness and low vision in Africa for many years.There should be collaboration between Paediatric Ophthalmology Centres in industrialized and developing countries to enhance skill transfer.Governmental and International Non-governmental Organizations can go a long way to facilitate this exchange.
文摘AIMTo report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age related macular degeneration (AMD).
文摘Dear Editor,In the past, enucleation has been considered the only available option and the standard of care for the management of malignant intraocular tumors. Thanks to the advances in the field of radiotherapy, new therapeutic approaches have been developed in the last decades, such as plaque brachytherapy and proton beam therapy(PBT)^([1]).
文摘We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly during HIV infection. Its frequency increases with the decrease in CD4 T lymphocytes and the passage to the AIDS stage. Its pathophysiology in this context is complex and multifactorial. Hemorrhagic complications usually appear for platelets less than 50,000/mm3 and this risk is greater at a rate of less than 20,000/mm3. Retinal hemorrhages may go unnoticed, only macular localization results in clinical expression. OCT is of paramount importance in accurate topographic diagnosis of macular hemorrhages by locating their seats which can be pre, intra or under retinal. Management requires the balance of infectious and hematologic factors. Ophthalmic surgical treatments should be considered in a second step.
文摘Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.
文摘Introduction: Refractive disturbances have been observed during hyperglycemia. However, there remains controversy as to the types of disturbances that it induces. Objective: To determine the types of refractive disturbances observed during hyperglycemia in humans. Population and Methods: This was an observational and cross-sectional study with an analytical purpose conducted from July to November 2021. Emmetropia, hypermetropia, and myopia as well as blood glucose levels were compared between day 0 (D0) and day 30 (D30) after initiation of hypoglycemic therapy in 222 people (444 eyes) with recently discovered hyperglycemia (Chi-2;p Results: At D0, the mean of blood glucose was 18.1 mmol/L ± 8.2 vs 6.9 mmol/L ± 3.0 at D30 (p = 0.001). At day 0, 80% (n = 355) of eyes were hypermetropic compared to 73.9% (n = 328) at D30 (p = 0.02). At D0, 14.2% of eyes (n = 63) were myopic compared to 11.3% (n = 50) at D30 (p = 0.02). Refraction improved from 0.75 to 1.5D for 34.5% (n = 18) of hypermetropic eyes and 10.2% (n = 2) of myopic eyes. Conclusion: Our results show that hypermetropia is the most common ametropia during hyperglycemia. Moreover, these data suggest that the normalization of blood glucose improves refraction.
