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Arquivos Brasileiros de Oftalmologia 2024We aimed to study reported cases of nasopharyngeal carcinoma presenting with ophthalmic manifestations with and without a prior diagnosis of nasopharyngeal carcinoma.
PURPOSE
We aimed to study reported cases of nasopharyngeal carcinoma presenting with ophthalmic manifestations with and without a prior diagnosis of nasopharyngeal carcinoma.
METHODS
We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted using the MEDLINE database in PubMed and Google Scholar. We included patients with a previous diagnosis of nasopharyngeal carcinoma in Group I and those without a prior diagnosis of nasopharyngeal carcinoma in Group II. Data included demographics, clinical presentation, history of nasopharyngeal carcinoma, treatment, histopathological description, World Health Organization classification, and outcome.
RESULTS
Fifty-eight patients (26 in Group I and 32 in Group II) were included. The male-to-female ratio was 3:1. The mean age of the patients (53.3 ± 11.7 years and 54.8 ± 16.2 years, respectively) and gender did not differ significantly between the two groups. The most common ocular presentations were diplopia and proptosis in the first group (each in 34.6%), whereas visual disturbance was most common in the second group (46.9%). Treatment options and World Health Organization grading were comparable. The outcome in 38 patients (after a comparable follow-up period) was significantly better in group II (p=0.003). There was no statistically significant difference in the outcome of 23 patients in correlation with World Health Organization grades II versus III irrespective of group (p=0.094).
CONCLUSIONS
The demographics of patients with nasopharyngeal carcinoma presenting with ophthalmic manifestations were similar between the two study groups, with a wide age range and male predominance. Patients presenting initially to ophthalmologists with no history of nasopharyngeal carcinoma have a more favorable outcome. World Health Organization grading may have less value as a prognostic indicator.
Topics: Humans; Databases, Factual; Exophthalmos; Eye; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Eye Diseases
PubMed: 38451680
DOI: 10.5935/0004-2749.2022-0241 -
BMC Ophthalmology Mar 2024Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU).
METHODS
We searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias.
RESULTS
The findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71).
CONCLUSION
This study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.
Topics: Humans; Polyethylene; Eye Diseases; Eye; Intensive Care Units; Ophthalmic Solutions
PubMed: 38448859
DOI: 10.1186/s12886-024-03360-6 -
Cureus Jan 2024Gestational diabetes mellitus (GDM) is one of the most common endocrine disorders to occur during pregnancy due to the increase in circulating human placental lactogen... (Review)
Review
Gestational diabetes mellitus (GDM) is one of the most common endocrine disorders to occur during pregnancy due to the increase in circulating human placental lactogen (hPL) and possible beta-cell sensitivity. While GDM can be managed either with diet and exercise or pharmacological interventions, it is associated with significant maternal and neonatal complications. Maternal complications include short- and long-term conditions such as pre-eclampsia, preterm birth, arrest of labor, future development of type 2 diabetes mellitus (T2DM), and cardiovascular disorders. Neonates can develop hypoglycemia and hypocalcemia and have a large gestational age (LGA). New research has also highlighted another possible long-term complication for both mothers and offspring, which is the development of cancer. Cancer has various types of progression, but most cause systemic symptoms leading to a reduced quality of life. Cancer can be terminal and can affect the majority of the population; thus, significant effort is being employed to try and reduce its occurrence. This systematic review was conducted with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, ScienceDirect, and ProQuest databases. Initially, 136,019 publications were identified. Through the screening process, a total of 27 publications were finalized within the scope of this paper. Most studies observing maternal cancer with a history of GDM found that there was an association between the increased risk of cancer and GDM. Specifically, these studies identified the association of GDM with breast, ovarian, cervical, and uterine cancer, as well as other non-reproductive organs such as the thyroid and pancreas. Cancer development in the offspring also presented an association with mothers who developed GDM. The most prevalent cancer evaluated was leukemia, and it was specifically associated with a maternal history of GDM. With the consistent rise in the incidence of cancer, any attempts to reduce its development are imperative to assess. While GDM is essentially a temporary condition that resolves following pregnancy in most patients, the possibility of contributing to future conditions years after its occurrence creates a sense of urgency and necessity to reduce the incidence of GDM. Researchers should be able to identify other unknown biomarkers that contribute to the development of cancer in mothers who experienced GDM as well as their infants.
PubMed: 38435884
DOI: 10.7759/cureus.53328 -
Journal of Translational Medicine Mar 2024Retinal degenerative disorders (RDDs) cause vision loss by damaging retinal neurons and photoreceptors, affecting individuals of all ages. Cell-based therapy has emerged... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Retinal degenerative disorders (RDDs) cause vision loss by damaging retinal neurons and photoreceptors, affecting individuals of all ages. Cell-based therapy has emerged as an effective approach for the treatment of RDDs with promising results. This meta-analysis aims to comprehensively evaluate the efficacy of cell therapy in treating age-related macular degeneration (AMD), retinitis pigmentosa (RP), and Stargardt macular degeneration (SMD) as the most prevalent RDDs.
METHODS
PubMed, Scopus, Web of Science, and Embase were searched using keywords related to various retinal diseases and cell therapy treatments until November 25th, 2023. The studies' quality was evaluated using the Joanna Briggs Institute's (JBI) checklist for quasi-experimental studies. Visual acuity measured as LogMAR score was used as our main outcome. A three-level random-effect meta-analysis was used to explore the visual acuity in patients who received cell-based therapy. Heterogeneity among the included studies was evaluated using subgroup and sensitivity analyses. Moreover, meta-regression for the type of cells, year of publication, and mean age of participants were performed.
RESULTS
Overall, 8345 studies were retrieved by the search, and 39 met the eligibility criteria, out of which 18 studies with a total of 224 eyes were included in the meta-analysis. There were 12 studies conducted on AMD, 7 on SMD, and 2 on RP. Cell therapy for AMD showed significant improvement in LogMAR (p < 0.05). Also, cell therapy decreased the LogMAR score in SMD and RP (p < 0.01 and p < 0.0001, respectively). Across all conditions, no substantial publication bias was detected (p < 0.05).
CONCLUSION
The findings of the study highlight that the application of cell therapy can enhance the visual acuity in AMD, SMD, and RP.
Topics: Humans; Retina; Macular Degeneration; Visual Acuity; Cell- and Tissue-Based Therapy
PubMed: 38431596
DOI: 10.1186/s12967-024-05016-x -
Journal of Neurology May 2024Stroke is a leading cause of morbidity and mortality. Retinal imaging allows non-invasive assessment of the microvasculature. Consequently, retinal imaging is a... (Review)
Review
BACKGROUND
Stroke is a leading cause of morbidity and mortality. Retinal imaging allows non-invasive assessment of the microvasculature. Consequently, retinal imaging is a technology which is garnering increasing attention as a means of assessing cardiovascular health and stroke risk.
METHODS
A biomedical literature search was performed to identify prospective studies that assess the role of retinal imaging derived biomarkers as indicators of stroke risk.
RESULTS
Twenty-four studies were included in this systematic review. The available evidence suggests that wider retinal venules, lower fractal dimension, increased arteriolar tortuosity, presence of retinopathy, and presence of retinal emboli are associated with increased likelihood of stroke. There is weaker evidence to suggest that narrower arterioles and the presence of individual retinopathy traits such as microaneurysms and arteriovenous nicking indicate increased stroke risk. Our review identified three models utilizing artificial intelligence algorithms for the analysis of retinal images to predict stroke. Two of these focused on fundus photographs, whilst one also utilized optical coherence tomography (OCT) technology images. The constructed models performed similarly to conventional risk scores but did not significantly exceed their performance. Only two studies identified in this review used OCT imaging, despite the higher dimensionality of this data.
CONCLUSION
Whilst there is strong evidence that retinal imaging features can be used to indicate stroke risk, there is currently no predictive model which significantly outperforms conventional risk scores. To develop clinically useful tools, future research should focus on utilization of deep learning algorithms, validation in external cohorts, and analysis of OCT images.
Topics: Humans; Stroke; Tomography, Optical Coherence; Retinal Diseases; Retinal Vessels; Risk Assessment; Retina
PubMed: 38430271
DOI: 10.1007/s00415-023-12171-6 -
Frontiers in Pediatrics 2024Prolonged mechanical ventilation, commonly used to assist preterm newborns, increases the risk of developing bronchopulmonary dysplasia (BPD). In recent decades, studies... (Review)
Review
INTRODUCTION
Prolonged mechanical ventilation, commonly used to assist preterm newborns, increases the risk of developing bronchopulmonary dysplasia (BPD). In recent decades, studies have demonstrated that systemic corticosteroids play a significant role in the prevention and management of BPD. In this systematic review of randomized controlled trials (RCTs), we evaluated the association between the administration of systemic corticosteroids in preterm infants and its long-term outcomes, such as neurodevelopment, growth, extubation rate, and related adverse effects.
METHODS
We conducted an electronic search in Medline, Scopus, and PubMed using the following terms: "premature infants" and "corticosteroids." We considered all RCTs published up to June 2023 as eligible. We included all studies involving preterm newborns treated with systemic corticosteroids and excluded studies on inhaled corticosteroids.
RESULTS
A total of 39 RCTs were evaluated. The influence of steroids administered systemically during the neonatal period on long-term neurological outcomes remains unknown, with no influence observed for long-term growth. The postnatal administration of systemic corticosteroids has been found to reduce the timing of extubation and improve respiratory outcomes. Dexamethasone appears to be more effective than hydrocortisone, despite causing a higher rate of systemic hypertension and hyperglycemia. However, in the majority of RCTs analyzed, there were no differences in the adverse effects related to postnatal corticosteroid administration.
CONCLUSION
Dexamethasone administered during the neonatal period appears to be more effective than hydrocortisone in terms of respiratory outcomes; however, caution should be taken when administering dexamethasone. Data derived from current evidence, including meta-analyses, are inconclusive on the long-term effects of the administration of systemic steroids in preterm infants or the possibility of neurodevelopmental consequences.
PubMed: 38419972
DOI: 10.3389/fped.2024.1344337 -
Translational Vision Science &... Feb 2024Retinal images contain rich biomarker information for neurodegenerative disease. Recently, deep learning models have been used for automated neurodegenerative disease...
PURPOSE
Retinal images contain rich biomarker information for neurodegenerative disease. Recently, deep learning models have been used for automated neurodegenerative disease diagnosis and risk prediction using retinal images with good results.
METHODS
In this review, we systematically report studies with datasets of retinal images from patients with neurodegenerative diseases, including Alzheimer's disease, Huntington's disease, Parkinson's disease, amyotrophic lateral sclerosis, and others. We also review and characterize the models in the current literature which have been used for classification, regression, or segmentation problems using retinal images in patients with neurodegenerative diseases.
RESULTS
Our review found several existing datasets and models with various imaging modalities primarily in patients with Alzheimer's disease, with most datasets on the order of tens to a few hundred images. We found limited data available for the other neurodegenerative diseases. Although cross-sectional imaging data for Alzheimer's disease is becoming more abundant, datasets with longitudinal imaging of any disease are lacking.
CONCLUSIONS
The use of bilateral and multimodal imaging together with metadata seems to improve model performance, thus multimodal bilateral image datasets with patient metadata are needed. We identified several deep learning tools that have been useful in this context including feature extraction algorithms specifically for retinal images, retinal image preprocessing techniques, transfer learning, feature fusion, and attention mapping. Importantly, we also consider the limitations common to these models in real-world clinical applications.
TRANSLATIONAL RELEVANCE
This systematic review evaluates the deep learning models and retinal features relevant in the evaluation of retinal images of patients with neurodegenerative disease.
Topics: Humans; Algorithms; Alzheimer Disease; Deep Learning; Machine Learning; Neurodegenerative Diseases; Datasets as Topic; Retina
PubMed: 38381447
DOI: 10.1167/tvst.13.2.16 -
BMC Ophthalmology Feb 2024Studies on the factors affecting vault after posterior chamber phakic Implantable Collamer Lens (ICL) have been carried out, but most of them are single-centered and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Studies on the factors affecting vault after posterior chamber phakic Implantable Collamer Lens (ICL) have been carried out, but most of them are single-centered and subjective selections of parameters. The present study aimed to systematically analyze the factors for vault.
METHODS
A systematic review of case series, case-control, and cohort studies derived from the articles published in PubMed, the Cochrane Library, Embase, Web of Science, CNKI, CBM, Wanfang and VIP, as well as ClinicalTrials, which were conducted to search for studies on factors of vault using four core terms: phakic intraocular lenses, vault, risk factor and observational study, from January 01, 1997, to February 20, 2023. The included studies were meta-analyzed quantitatively and described qualitatively. Subsequently, meta-regression and subgroup analysis were used.
RESULTS
We identified 13 studies (1,607 subjects), and 14 factors were considered. Meta-analysis showed that anterior chamber depth (ACD), horizontal corneal white-to-white (hWTW), ICL-size, and age are dual effects of the abnormal vaults; anterior chamber volume (ACV) and lens thickness (LT) are a one-way effect; while axial length (AL), ICL- spherical equivalent (ICL-SE) and Km are insignificant. In addition, descriptive analysis of anterior chamber angle (ACA), horizontal sulcus to sulcus (hSTS), ciliary processes height (T value), crystalline lens rise (CLR), and gender showed that all factors except gender tend to have significant effects on vault. Sensitivity analysis showed stable combined results. Country and design respectively affect the heterogeneity in ACD and ICL-size at low vault, while design affects the heterogeneity in ACD at high vault. No publication bias exists.
CONCLUSIONS
Vault after ICL is related to multiple factors, especially anterior segmental biologic parameters, and they are weighted differently. We hope to provide a reference for the selection and adjustment of ICL.
Topics: Humans; Phakic Intraocular Lenses; Myopia; Lens Implantation, Intraocular; Refraction, Ocular; Lens, Crystalline; Retrospective Studies; Observational Studies as Topic
PubMed: 38360631
DOI: 10.1186/s12886-024-03325-9 -
BMC Ophthalmology Feb 2024Africa is one of the continents with a substantial burden of glaucoma, where it is approximately twice as common as it is worldwide. If left untreated, glaucoma can...
BACKGROUND
Africa is one of the continents with a substantial burden of glaucoma, where it is approximately twice as common as it is worldwide. If left untreated, glaucoma can cause blindness and permanent vision loss if it is not addressed promptly. Good knowledge is essential for preventing glaucoma's irreversible blindness and ocular damage. However, no systematic review has been done to report the pooled percentage of adults in Africa who have good knowledge about glaucoma. This study aimed to estimate the level of knowledge about glaucoma in Africa and its determinants.
METHODS
The study followed the PRISMA guidelines for systematic review. Seven electronic databases which include PubMed/MEDLINE, Web of Science, PROQUEST (PQDT), CINAHL (EBSCO), Google Scholar, African Journal Online, and WHO HINARI databases were searched from January 1, 2013, to July 31, 2023for studies conducted with a focus on the knowledge about glaucoma among adults in Africa. The quality of the final articles was assessed using the Joanna Briggs Institute quality assessment tool for cross-sectional studies.
RESULTS
In the present systematic review, 2781 articles were initially identified and evaluated. Of these, eight studies that met the inclusion criteria were included in the final analysis. In this review, the proportion of knowledge about glaucoma among adults in Africa was low. Educational status, family history of glaucoma, occupation, being a male, and having a history of eye examination were the main determinants of good knowledge about glaucoma among adults in Africa.
CONCLUSION
The systematic review found that only a few had good knowledge about glaucoma. Education campaigns and eye exam promotions are recommended to enhance awareness.
TRAIL REGISTRATION
This systematic review was registered on 30/07/2023 with PROSPERO ID: CRD42023430723.
Topics: Adult; Male; Humans; Cross-Sectional Studies; Glaucoma; Africa; Eye; Blindness
PubMed: 38355482
DOI: 10.1186/s12886-024-03333-9 -
International Ophthalmology Feb 2024The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were... (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched.
METHODS
Standardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was - 1.19 (95% CI - 1.71, - 0.68).
RESULTS
The SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was - 0.01 (95% CI - 0.48, 0.47).
CONCLUSION
This meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.
Topics: Humans; Child; Intraocular Pressure; Myopia; Sclera; Tonometry, Ocular
PubMed: 38319543
DOI: 10.1007/s10792-024-02929-w