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The Ocular Surface Jul 2023Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality,...
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO) and soil pollution (from chromium), but not from air pollution from CO or PM. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
Topics: Humans; Air Pollution; Particulate Matter; Dry Eye Syndromes; Conjunctiva; Life Style
PubMed: 37062427
DOI: 10.1016/j.jtos.2023.04.007 -
Indian Journal of Ophthalmology May 2021The incidence of leishmaniasis is reported to be up to 1 million per year. To date, there has been no comprehensive review describing the diversity of clinical... (Review)
Review
The incidence of leishmaniasis is reported to be up to 1 million per year. To date, there has been no comprehensive review describing the diversity of clinical presentations of ocular leishmaniasis (OL) and its treatment. This systematic review aims to address this knowledge gap and provide a summary of the clinical presentation, natural course, and treatment options for OL. Our study identified a total of 57 published articles as describing cases of OL involving: adnexa (n = 26), orbit (n = 1), retina (n = 7), uvea (n = 18) and cornea (n = 6). Though well described and easily treated, palpebral leishmaniasis is often misdiagnosed and may lead to chronic issues if untreated. The retinal manifestations of Leishmaniasis consist of self-resolving hemorrhages secondary to thrombocytopenia. Two main uveitis etiologies have been identified: uveitis in the context of active Leishmanial infection (associated with immunosuppression) and uveitis occurring as an immune reconstitution syndrome. Corneal involvement in most geographic areas generally follows an aggressive course, most often ending in corneal perforation if left untreated. In the Americas, a chronic indolent interstitial keratitis may also occur. Topical steroids are of little use in keratitis (systemic antileishmanials being the cornerstone of treatment). However, these are essential in cases of uveitis, with or without concomitant systemic antileishmanial therapy. In conclusion, though ocular involvement in Leishmaniasis is rare, severe sight-threatening consequences follow if left untreated. Early diagnosis, enthusiastic follow-up and aggressive treatment are essential for good outcomes.
Topics: Cornea; Corneal Perforation; Humans; Keratitis; Leishmaniasis; Uveitis
PubMed: 33913831
DOI: 10.4103/ijo.IJO_2232_20 -
Nutrients Dec 2022The retinal vessel caliber (RVC) is an important biomarker of cardiovascular diseases, which can be semi-automatically measured by fundus photography. This review... (Meta-Analysis)
Meta-Analysis Review
The retinal vessel caliber (RVC) is an important biomarker of cardiovascular diseases, which can be semi-automatically measured by fundus photography. This review investigated the associations between the RVCs and the life styles of early life, such as physical activity (PA), sedentary behavior (SB), dietary and sleep, by summarizing the findings from studies on children and adolescents. Two databases (Medline and Embase) were searched from their inception to 30 June 2022. The selected studies were literatures on observational designs, fundus photographs, retinal vessels and lifestyles of children or adolescents. Correlation coefficients of unhealthy life styles and RVCs were transformed to Fisher's z-scores, and the random-effects model was applied to pool data. A total of 18 observational studies were selected; the lifestyles accessed include 9 studies for PA and SB, 8 studies for dietary and 1 study for sleep. The meta-analysis on the correlation coefficients of regression models found the high level of SB (qualified by screen time, ST) was associated the narrower central retinal arteriolar equivalent (CRAE) among children (r = -0.043, 95% confidence intervals [CI] -0.078 to -0.009). By comparing the first and fourth quartiles of PA, the meta-analysis showed that more indoor PA was associated with smaller venular calibers and more outdoor PA was associated with wider CRAE (r = 0.88, 95%CI -3.33 to 0). Unhealthy lifestyles might be harmful on the retinal microcirculation among children and adolescents but their health effect seems not to be as significant as those in adults.
Topics: Adult; Humans; Child; Adolescent; Retinal Vessels; Arterioles; Retina; Microcirculation; Life Style
PubMed: 36615807
DOI: 10.3390/nu15010150 -
International Journal of Pediatric... Nov 2017Tympanic membrane cholesteatoma (TMC) is a rare anomaly found in pediatric patients with no significant otologic history. Its pathogenesis appears distinct from... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Tympanic membrane cholesteatoma (TMC) is a rare anomaly found in pediatric patients with no significant otologic history. Its pathogenesis appears distinct from congenital mesotympanic cholesteatoma. This systematic review and meta-analysis evaluates the management of TMC.
METHODS
Two authors independently conducted a systematic review using the PubMed-NCBI, Cochrane Library, and Web of Science databases. Studies describing cases of pediatric TMC were included. Patients with history of chronic otitis, otorrhea, trauma, or otologic surgery were excluded.
RESULTS
Seventeen articles were included for a total of 45 patients. Mean age was 35.9 months with 56% female. Patients aged ≥36 months had significantly larger cholesteatomas than younger patients (4.2 vs 1.9 mm, p = 0.004). Nine patients (20%) had middle ear extension but none had middle ear or ossicular disease. CT scans influenced management in 1 of 26 patients. All patients were managed surgically by transcanal approach (93%) or retroauricular approach (7%). Surgery involved enucleation without TM perforation (80%) or complete excision with TM grafting (20%). In 23 patients, the fibrous TM remained intact, and there were no recurrences in this group at a mean follow-up of 11 months. Overall, there was 1 recurrence (2%), eventually requiring reoperation. No patients experienced persistent tympanic membrane perforation, chronic otitis, or hearing loss.
CONCLUSION
TMC occurs in pediatric patients without an otologic history. Associated middle ear involvement has not been reported. CT scanning may not be necessary for work up and management of this disorder. A transcanal approach with enucleation is often sufficient treatment. Risk of recurrence appears lower than with congenital mesotympanic cholesteatoma.
Topics: Adolescent; Child; Child, Preschool; Cholesteatoma, Middle Ear; Ear, Middle; Female; Hearing Loss; Humans; Male; Otologic Surgical Procedures; Recurrence; Tympanic Membrane; Tympanic Membrane Perforation
PubMed: 29106870
DOI: 10.1016/j.ijporl.2017.08.027 -
Journal of Glaucoma May 2016Numerous studies have detected choroidal thickness abnormalities and changes in open-angle glaucoma (OAG), as measured by enhanced depth imaging optical coherence... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Numerous studies have detected choroidal thickness abnormalities and changes in open-angle glaucoma (OAG), as measured by enhanced depth imaging optical coherence tomography technologies, but the results have not always been consistent. Therefore, a meta-analysis and systematic review was performed to evaluate the choroidal thickness in OAG.
MATERIALS AND METHODS
A comprehensive literature search was performed on Medline, Embase, ISI Web of Science, Cochrane Central Register of Controlled Trials, Google Scholar, and Chinese databases including Wangfang and CNKI (China National Knowledge Infrastructure). Eligible articles were identified by reviewing the retrieved results. For continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence interval (CI). Statistical analysis was performed using STATA 12.0 software.
RESULTS
Twenty-two case-control or cross-sectional studies were included in the present meta-analysis. The results of our study showed that there was no significant difference in subfoveal choroidal thickness between patients with OAG and controls (WMD=-7.94; 95% CI, -26.01 to 10.13; P=0.389). Similar findings were obtained for the average peripapillary choroidal thickness (WMD=-14.24; 95% CI, -30.20 to 1.73; P=0.08).
CONCLUSIONS
Our meta-analysis found no significant difference in the choroidal thickness both under the fovea and around the optic nerve head between OAG patients and controls. On the basis of the anatomic features of blood supply in optic nerve head, it is plausible that the choroidal thickness is not an appropriate parameter to evaluate the damage of OAG, and choroidal thinning may not be an important component of glaucomatous optic neuropathy.
Topics: Case-Control Studies; Choroid; Cross-Sectional Studies; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Optic Disk; Organ Size; Tomography, Optical Coherence
PubMed: 25943737
DOI: 10.1097/IJG.0000000000000275 -
International Ophthalmology Oct 2018To perform a systematic review of the literature examining about the pachychoroid diseases spectrum. (Review)
Review
PURPOSE
To perform a systematic review of the literature examining about the pachychoroid diseases spectrum.
METHODS
A systematic literature search was performed using the Medline database. A total of four studies directly relevant to our search are reviewed here.
RESULTS
A structurally and functionally intact choroid tissue is vitally important for the retina function. While central retinal artery is responsible to supply the 2/3, internal part of the retina, choroidal vein network is responsible for the remaining 1/3 external part. Abnormal choroidal blood flow leads to photoreceptor dysfunction and photoreceptor death in the retina. The methods used in the visualization of the choroid are ICG angiography (indocyanine green angiography), OCT (optic coherence tomography) devices which are often used nowadays, and its advanced version, OCT angiography. Pachychoroid diseases are a spectrum of 4 different disease groups. These groups are essentially the stages of the disease itself, as the increased severity in the previous group leads the patient to the next group of disease.
CONCLUSION
The spectrum comprises the following 4 disease groups: Pachychoroid Pigment Epitheliopathy, Central Serous Chorioretinopathy, Pachychoroid Neovasculopathy, Polipoidal Choroidal Vasculopathy. Common Characteristics: Increased choroidal thickening, pathologically dilated veins in the Haller's layer (pachy-veins), thinning in Sattler's and choriocapilleris layers.
Topics: Choroid; Choroid Diseases; Fluorescein Angiography; Fundus Oculi; Humans; Tomography, Optical Coherence; Visual Acuity
PubMed: 28766279
DOI: 10.1007/s10792-017-0666-4 -
Facial Plastic Surgery : FPS Aug 2010The eyelids and eyebrows provide communicative, emotional, and protective functions through a complex interplay of muscles, tendons, and other local soft tissues. A... (Review)
Review
The eyelids and eyebrows provide communicative, emotional, and protective functions through a complex interplay of muscles, tendons, and other local soft tissues. A surgical intervention involving these regions are renowned for their deceptive simplicity and notable complications. With these challenges in mind, this article provides the reader with a detailed and systematic review of the eyelid and brow anatomy.
Topics: Blepharoplasty; Eyebrows; Eyelids; Face; Forehead; Humans; Orbit; Plastic Surgery Procedures
PubMed: 20524165
DOI: 10.1055/s-0030-1254327 -
Acta Ophthalmologica Sep 2021To conduct a systematic review and meta-analysis on the levels of oxidative stress markers and antioxidants in keratoconus compared to healthy subject. (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis on the levels of oxidative stress markers and antioxidants in keratoconus compared to healthy subject.
METHOD
The PubMed, Cochrane Library, Embase, Science Direct and Google Scholar databases were searched on 1st June 2020 for studies reporting oxidative and antioxidative stress markers in keratoconus and healthy controls. Main meta-analysis was stratified by type of biomarkers, type of samples (tears, cornea, aqueous humour and blood) and type of corneal samples (stromal cells, epithelium and endothelium).
RESULTS
We included 36 articles, for a total of 1328 keratoconus patients and 1208 healthy controls. There is an overall increase in oxidative stress markers in keratoconus compared with healthy controls (standard mean deviation (SMD) = 0.94, 95% confidence interval (95% CI) 0.55-1.33), with a significant increase in reactive oxygen and nitrogen species (1.09, 0.41-1.78) and malondialdehyde (1.78, 0.83-2.73). There is an overall decrease in antioxidants in keratoconus compared with healthy controls (-0.63, -0.89 to -0.36), with a significant decrease in total antioxidant capacity/status (-1.65, -2.88 to -0.43), aldehyde/NADPH dehydrogenase (-0.77, -1.38 to -0.17), lactoferrin/transferrin/albumin (-1.92, -2.96 to -0.89) and selenium/zinc (-1.42, -2.23 to -0.61). Oxidative stress markers were higher in tears and in cornea of keratoconus than in aqueous humour, and antioxidants were decreased in tears, aqueous humour and blood without difference between sample type. Oxidative stress markers increased in stromal cells and antioxidants decreased in endothelium.
CONCLUSION
Oxidative stress markers and antioxidants were dysregulated in keratoconus, involving an imbalance of redox homeostasis in tears, cornea, aqueous humour and blood.
Topics: Antioxidants; Aqueous Humor; Biomarkers; Cornea; Humans; Keratoconus; Oxidative Stress; Tears
PubMed: 33354927
DOI: 10.1111/aos.14714 -
BMJ Open Ophthalmology Nov 2023To explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy... (Meta-Analysis)
Meta-Analysis
PURPOSE
To explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy (DON).
METHODS
Studies in the literature that focused on OCT, OCTA and DON were retrieved by searching PubMed, EMBASE, Cochrane databases and Clinical Trial before 20 June 2023. The methodological quality was assessed using the Newcastle-Ottawa scale. The quantitative calculation was performed using Review Manager V.5.3.
RESULTS
Twelve studies met the eligibility criteria and were included. DON group presented lower macular ganglion cell complex in the overall, superior and inferior hemifields compared with the non-DON group. Furthermore, the ganglion cell layer and inner plexiform layer in DON group was thinner in contrast to the non-DON group. The optic nerve head vessel density was lower in the DON group than that in the non-DON group. A reduction of radial peripapillary capillary vessel density could be seen in the DON group than the non-DON group in overall, inside disc, peripapillary, superior-hemifield, temporal and nasal. Besides, the macular superficial retinal capillary layer of non-DON and DON is lower than the healthy control group.
CONCLUSIONS
This study supported the potential value of OCT and OCTA metrics as novel biomarkers of DON. Ophthalmologists should comprehensively consider the retinal structure and microvasculature in dealing with DON.
ETHICS AND DISSEMINATION
This systematic review included data from published literature and was exempt from ethics approval. Results would be disseminated through peer-reviewed publication and presented at academic conferences engaging clinicians.
PROSPERO REGISTRATION NUMBER
CRD42023414907.
Topics: Humans; Tomography, Optical Coherence; Optic Disk; Angiography; Retinal Ganglion Cells; Optic Nerve Diseases
PubMed: 37996119
DOI: 10.1136/bmjophth-2023-001379 -
Journal of Plastic, Reconstructive &... Dec 2023The process of carving an auricular framework is technically challenging and unique to the patient. As such, there is a need for a robust and reliable training model for... (Review)
Review
INTRODUCTION
The process of carving an auricular framework is technically challenging and unique to the patient. As such, there is a need for a robust and reliable training model for practicing and planning ear reconstruction. The aim of this study is to assess the best models and methods available to practice the carving of an auricular framework.
METHODS
A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines using MEDLINE, Embase, and Cochrane databases. Terms such as "ear", "reconstruction" and "teaching" were searched.
RESULTS
A total of 354 articles were identified, and 13 studies met the inclusion criteria. Vegetables, animal tissue, synthetic materials, as well as more advanced methods such as 3D-printed moulds, were analysed. The similarity of these materials to human costal cartilage was investigated to determine the best or most suitable ones for the purpose. The methods used in the studies were also analysed. Due to heterogeneity of the studies, it was not possible to conduct a quantitative analysis.
CONCLUSION
This review identifies that for the junior surgeons at the skill acquisition phase of their training in auricular framework carving repetition using firstly a cheap synthetic material would be most useful, followed by animal cartilage or 3D printing using silicone. These materials bear the most resemblance to human costal cartilage, and by repeating the carvings, proficiency will improve. Those surgeons with an established ear reconstruction practise, wishing to undertake immediate pre-operatively simulation could benefit from cross-sectional imaging and 3D printing of a patient's non-affected ear to ensure a good match.
Topics: Animals; Humans; Ear, External; Plastic Surgery Procedures; Costal Cartilage; Cartilage; Printing, Three-Dimensional
PubMed: 37826969
DOI: 10.1016/j.bjps.2023.09.044