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Ceska a Slovenska Oftalmologie :... 2024The authors present a case of a thirty-eight-year-old patient with Alport syndrome. The patient had several ocular symptoms of the disease and has been treated for...
The authors present a case of a thirty-eight-year-old patient with Alport syndrome. The patient had several ocular symptoms of the disease and has been treated for systemic problems in connection with Alport syndrome since he was fifteen years old. At that age the patient also underwent a kidney transplant in order to deal with renal insufficiency. To date, he still uses immunosuppressants and antihypertensives. Furthermore, the patient suffers from perceptive deafness. The patient visited our clinic in 2021 with a request to solve his high refractive error, in which the diopters were so high that it was not possible to place them in spectacles. The patient's best corrected visual acuity was 0.6 with -8.0sph/-4.0cyl/ax15 in the right eye and 0.7partim with -8.0sph/-4.0cyl/ax155 in the left eye. The autorefractometer values were -6.25sph/-6.75cyl/ax17 in the right eye and -6.75sph/-6.5cyl/ax155 in the left eye. During the eye examination we found a number of ocular manifestations that are typical of Alport syndrome. On the cornea there were opacities as a residue of corneal erosions, and at one of the following check-ups we also found a newly developed corneal erosion. Subsequently, we found an anterior lenticonus and incipient cataract. Upon performing OCT, a typical temporal macular atrophy was evident. Fundus examination in artificial mydriasis showed just a minimal manifestation of fleck retinopathy. Due to the clinical manifestation we decided to perform cataract surgery and implant a monofocal toric intraocular lens in both eyes. There were no complications during the operations, however the surgeon registered a non-standard structure of the lens capsule. The capsule was more fragile, and performing capsulorhexis was much more complicated. A week after the surgery, higher cylinder diopters were still present. A decrease of the higher diopters was noticeable one month after surgery. The time interval between the first operation and the second operation was one month. The patient was highly satisfied with result, and uncorrected visual acuity improved by over four lines. After surgery the patient needed low diopters for near as well as far distance. In the case of this patient, the ocular manifestations were detected and treated in adulthood. Nevertheless, early detection of ocular symptoms of Alport syndrome in young patients before renal failure could lead to timely start of the treatment and delay a possible renal transplant. In case of any suspicion of Alport syndrome it is advised to send the patient to a pediatrician, and at an older age to an internal medicine specialist, for further examination.
Topics: Humans; Nephritis, Hereditary; Male; Adult; Refractive Surgical Procedures; Visual Acuity
PubMed: 38925900
DOI: 10.31348/2024/28 -
Ceska a Slovenska Oftalmologie :... 2024The aim of this study was to evaluate the outcomes of Ozurdex® (DEX) implant in patients with diabetic macular edema (DME) in real-world clinical practice, and to...
OBJECTIVE
The aim of this study was to evaluate the outcomes of Ozurdex® (DEX) implant in patients with diabetic macular edema (DME) in real-world clinical practice, and to determine the correlation between known OCT biomarkers and the effect of treatment.
MATERIAL AND METHODS
This retrospective study included 42 eyes of 33 patients (16 women, 17 men) treated with DEX at the Department of Ophthalmology, Faculty of Medicine and Dentistry of Palacký University and University Hospital Olomouc for DME indication between 2020 and 2023. Follow-up examinations were conducted at 1, 3, and 6 months after the first DEX application. The main assessed parameters were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), OCT biomarkers. The results were subsequently statistically evaluated.
RESULTS
At the first follow-up after DEX application, there was an average decrease in CRT of 186 ±146µm and a gain of 3 ±7 letters. Positive morphological and functional responses were observed in 39 eyes (92.9%) and 23 eyes (54.8%) respectively. The disorganization of retinal inner layers (DRIL) biomarker was initially present in 41 eyes (97.6%), with reduction or disappearance observed in 13 eyes (31%) post-application. Eyes with ellipsoid zone disruption (EZ disruption) had an average initial BCVA of 49.6 letters, compared to 57.8 letters in the group without this biomarker. The mean gain in BCVA was +8.7 letters in treatment-naive eyes and +2.1 letters in previously treated eyes. Chronic DME was less frequent in treatment-naive (n = 1, 14.3%) compared to previously treated eyes (n = 28, 84.8%). All these results were statistically significant (p < 0.05). An increase in IOP post-DEX application occurred in 9 patients (21.4%).
CONCLUSION
Our results confirm DEX as a safe and effective treatment option for DME. Treatment-naive patients achieved better functional outcomes. We confirmed ellipsoid zone disruption (EZ disruption) as a negative biomarker. Additionally, we demonstrated the capacity of DEX to reduce disorganization of the retinal inner layers (DRIL).
Topics: Humans; Macular Edema; Male; Female; Diabetic Retinopathy; Dexamethasone; Retrospective Studies; Middle Aged; Aged; Intravitreal Injections; Drug Implants; Visual Acuity; Glucocorticoids; Tomography, Optical Coherence
PubMed: 38925895
DOI: 10.31348/2024/29 -
Ceska a Slovenska Oftalmologie :... 2024To compare functional and anatomical outcomes between the inverted flap technique and conventional removal of the internal limiting membrane (ILM) in the surgical...
AIM
To compare functional and anatomical outcomes between the inverted flap technique and conventional removal of the internal limiting membrane (ILM) in the surgical management of idiopathic macular hole (IMH).
MATERIAL AND METHODS
We retrospectively evaluated the anatomical and functional results in 67 eyes of 65 patients operated on for IMH. The patients were operated on either using the conventional ILM peeling technique (first group) or with the inverted ILM flap technique (second group). 43 eyes of 41 patients were included in the first group, 24 eyes of 24 patients in the second group. We indicated for surgery only patients with IMH stage 2-4 according to the Gasse classification. Best corrected visual acuity (VA) was always determined before and two months after surgery. Furthermore, a comparison of both techniques was made according to the average letter gain after surgery, and the effect of surgery was evaluated using OCT with regard to whether IMH closure succeeded. For both techniques, 25G PPV with SF6 tamponade was performed.
RESULTS
Hole closure took place in 41 eyes with conventional ILM removal. In one eye, the hole did not close even after reoperation with the same technique. Median ETDRS letter gain was 7.0. VA remained the same in 2 eyes (4.7%), worsened in 7 cases (16.2%), and improved in all other cases (79.0%). In 16 eyes (37.2%), VA improved by 2 or more lines of ETDRS charts. Using the inverted flap technique, the hole was closed in all 24 monitored eyes. Median ETDRS letter gain was 9.5. VA remained the same in 2 eyes (8.3%), worsened in 2 cases (8.3%), and improved in all other cases (83.3%). In 12 eyes (50.0%), VA improved by 2 or more lines of ETDRS charts. There were no serious complications intraoperatively or postoperatively.
CONCLUSION
Our study demonstrated the safety and efficacy of both methods. Although the results were not statistically significant, the inverted flap technique recorded a greater ETDRS letter gain (9.5 vs. 7.0) and proportion of closed holes (100% vs. 95.3%) compared to the conventional ILM peeling technique in our set of eyes.
Topics: Humans; Surgical Flaps; Retrospective Studies; Retinal Perforations; Visual Acuity; Vitrectomy; Female; Male; Middle Aged; Aged
PubMed: 38925893
DOI: 10.31348/2024/31 -
JMIR MHealth and UHealth Jun 2024Early detection of cognitive impairment or dementia is essential to reduce the incidence of severe neurodegenerative diseases. However, currently available diagnostic...
BACKGROUND
Early detection of cognitive impairment or dementia is essential to reduce the incidence of severe neurodegenerative diseases. However, currently available diagnostic tools for detecting mild cognitive impairment (MCI) or dementia are time-consuming, expensive, or not widely accessible. Hence, exploring more effective methods to assist clinicians in detecting MCI is necessary.
OBJECTIVE
In this study, we aimed to explore the feasibility and efficiency of assessing MCI through movement kinetics under tablet-based "drawing and dragging" tasks.
METHODS
We iteratively designed "drawing and dragging" tasks by conducting symposiums, programming, and interviews with stakeholders (neurologists, nurses, engineers, patients with MCI, healthy older adults, and caregivers). Subsequently, stroke patterns and movement kinetics were evaluated in healthy control and MCI groups by comparing 5 categories of features related to hand motor function (ie, time, stroke, frequency, score, and sequence). Finally, user experience with the overall cognitive screening system was investigated using structured questionnaires and unstructured interviews, and their suggestions were recorded.
RESULTS
The "drawing and dragging" tasks can detect MCI effectively, with an average accuracy of 85% (SD 2%). Using statistical comparison of movement kinetics, we discovered that the time- and score-based features are the most effective among all the features. Specifically, compared with the healthy control group, the MCI group showed a significant increase in the time they took for the hand to switch from one stroke to the next, with longer drawing times, slow dragging, and lower scores. In addition, patients with MCI had poorer decision-making strategies and visual perception of drawing sequence features, as evidenced by adding auxiliary information and losing more local details in the drawing. Feedback from user experience indicates that our system is user-friendly and facilitates screening for deficits in self-perception.
CONCLUSIONS
The tablet-based MCI detection system quantitatively assesses hand motor function in older adults and further elucidates the cognitive and behavioral decline phenomenon in patients with MCI. This innovative approach serves to identify and measure digital biomarkers associated with MCI or Alzheimer dementia, enabling the monitoring of changes in patients' executive function and visual perceptual abilities as the disease advances.
Topics: Humans; Cognitive Dysfunction; Male; Female; Aged; Middle Aged; Neuropsychological Tests; Hand; Aged, 80 and over; Surveys and Questionnaires; Qualitative Research
PubMed: 38924786
DOI: 10.2196/48777 -
Translational Vision Science &... Jun 2024Individualized ocular refraction customization (IORC) lenses can be individually adjusted depending on the initial relative peripheral refraction to determine the myopic... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Individualized ocular refraction customization (IORC) lenses can be individually adjusted depending on the initial relative peripheral refraction to determine the myopic defocus (MD). We aimed to compare visual performance of children wearing IORC lenses with different amounts of MD to determine whether higher MD resulted in greater visual compromise.
METHODS
This study included 184 myopic children aged eight to 12 years, and 172 completed the trial. The participants were randomly assigned to wear IORC lenses with low (IORC-L, 2.50 D), medium (IORC-M, 3.50 D), or high (IORC-H, 4.50 D) MD or single-vision spectacle lenses (SVL). Distance and near best-corrected visual acuity (BCVA), contrast sensitivity function (CSF) and questionnaires were evaluated at baseline and after six and 12 months.
RESULTS
CSF over all frequencies and distance and near BCVA were not affected by lens design (all P > 0.05). The SVL group outperformed the three IORC lens groups in terms of ghosting images at baseline, and IORC-H and IORC-M groups outperformed IORC-L group (all P < 0.001); however, no differences were observed at the six- or 12-month visit. There were no significant differences among the four groups for any other subjective variables at any of the follow-up visits regarding vision clarity, vision stability, eyestrain, dizziness, headache, or overall vision satisfaction (all P > 0.05).
CONCLUSIONS
The IORC lenses with an actual MD of 4.50 D provided acceptable objective and subjective visual performance and were well tolerated by children.
TRANSLATIONAL RELEVANCE
IORC lenses with an actual MD of 4.50 D provided acceptable visual performance.
Topics: Humans; Child; Myopia; Eyeglasses; Female; Male; Visual Acuity; Refraction, Ocular; Contrast Sensitivity; China; Surveys and Questionnaires; East Asian People
PubMed: 38922628
DOI: 10.1167/tvst.13.6.21 -
Biomimetics (Basel, Switzerland) Jun 2024This paper describes a novel bionic eye binocular vision system designed to mimic the natural movements of the human eye. The system provides a broader field of view and...
This paper describes a novel bionic eye binocular vision system designed to mimic the natural movements of the human eye. The system provides a broader field of view and enhances visual perception in complex environments. Compared with similar bionic binocular cameras, the JEWXON BC200 bionic binocular camera developed in this study is more miniature. It consumes only 2.8 W of power, which makes it ideal for mobile robots. Combining axis and camera rotation enables more seamless panoramic image synthesis and is therefore suitable for self-rotating bionic binocular cameras. In addition, combined with the YOLO-V8 model, the camera can accurately recognize objects such as clocks and keyboards. This research provides new ideas for the development of robotic vision systems.
PubMed: 38921251
DOI: 10.3390/biomimetics9060371 -
Biomimetics (Basel, Switzerland) May 2024Mycelium-based composites (MBCs) are biomaterials with scientifically proven potential to improve sustainability in construction. Although mycelium-based products are...
Mycelium-based composites (MBCs) are biomaterials with scientifically proven potential to improve sustainability in construction. Although mycelium-based products are not entirely new, their use in engineering presents challenges due to the inherent properties of this fungal material. This study investigated professional architects' and interior designers' perceptions of MBCs, focusing on familiarity, aesthetic appeal, and willingness to use. The first phase of the survey explored respondents' views on material-related ecological design principles. In the second phase, respondents evaluated ten small architectural objects crafted from MBCs, focusing on form, detail, and visual appeal. The last phase of the survey measured their interest in using mycelium in their design work. The results revealed that MBCs were relatively unknown among the surveyed professionals; only every second respondent knew this material. Despite this, 90% found MBCs visually appealing after seeing the examples. Interestingly, the natural, unprocessed appearance of the material was assessed as less aesthetically pleasing, with thermal treatment improving its perceived value. Architects were more receptive to using MBCs in their professional projects for customers than for personal use. This observation points to a 'double standard': professional architects are more open to using MBCs in projects not intended for their own use.
PubMed: 38921213
DOI: 10.3390/biomimetics9060333 -
Behavioral Sciences (Basel, Switzerland) May 2024The aim of this study was to investigate the impact of extended bridge expertise on rapid perceptual processing and brain functional plasticity in early adulthood,...
The aim of this study was to investigate the impact of extended bridge expertise on rapid perceptual processing and brain functional plasticity in early adulthood, utilizing functional magnetic resonance imaging (fMRI). In this investigation, we compared 6 high-level college bridge players with 25 college students lacking bridge experience, assessing their intelligence and working memory. Additionally, we scrutinized behavioral performance and whole-brain activation patterns during an image perceptual judgment task. Findings indicated significant group and interaction effects at the behavioral level. Bridge players exhibited prolonged reaction times and enhanced accuracy on card tasks. At the neural level, the activation level of bridge players in the occipital lobe exceeded that of ordinary college students, with more pronounced group effects in the motor area and inferior parietal lobule during card tasks. This implies that bridge expertise in early adulthood induces functional plasticity changes in regions associated with visual processing and automated mathematical computation.
PubMed: 38920802
DOI: 10.3390/bs14060469 -
BMC Ophthalmology Jun 2024To evaluate the optical performance and safety of a new multifocal lens with a novel optical design featuring two additional foci (or intensifiers) in patients with... (Observational Study)
Observational Study
BACKGROUND
To evaluate the optical performance and safety of a new multifocal lens with a novel optical design featuring two additional foci (or intensifiers) in patients with cataract and presbyopia.
METHODS
In this single-center, non-randomized prospective observational study, 31 patients underwent implantation of the new multifocal IOL between March 2020 and November 2021 at a tertiary clinical center in Buenos Aires and Ramos Mejia, Argentina. Postoperative examinations with emphasis on uncorrected and corrected visual acuity at distance and near and at two different intermediate distances (80 cm and 60 cm) were performed during the 3 postoperative months.
RESULTS
Of the 31 patients who underwent implantation of the new IOL, 30 underwent bilateral surgery (61 eyes in total). At 3 months, all 61 eyes had an uncorrected distance visual acuity (UCDVA) of at least 0.15 logMAR; 57 eyes (93%) had an uncorrected distance visual acuity (UCDVA) of 0.1 logMAR and 27 eyes (44%) had an UCDVA of 0.0 logMAR. At 80 cm, 60 eyes (98%) had an uncorrected intermediate visual acuity (UCIVA) of at least 0.1 log MAR and 48 eyes (79%) had an UCIVA of 0.0 logMAR.
CONCLUSION
The new multifocal IOL with a novel optical concept (5 foci) showed a wide range of visual acuity especially at intermediate and near distances in patients undergoing cataract surgery. Uncorrected visual acuity was excellent at all tested distances, monocularly and binocularly, spectacle independence and patient satisfaction were high.
Topics: Humans; Visual Acuity; Prospective Studies; Female; Male; Aged; Multifocal Intraocular Lenses; Middle Aged; Prosthesis Design; Presbyopia; Refraction, Ocular; Lens Implantation, Intraocular; Pseudophakia; Phacoemulsification; Cataract; Lenses, Intraocular; Aged, 80 and over; Follow-Up Studies
PubMed: 38918765
DOI: 10.1186/s12886-024-03521-7 -
BMC Ophthalmology Jun 2024The success of the strabismus surgery can hinge on several factors. One of these factors is refractive condition like hyperopia or myopia. Our study seeks to evaluate...
BACKGROUND
The success of the strabismus surgery can hinge on several factors. One of these factors is refractive condition like hyperopia or myopia. Our study seeks to evaluate the surgical outcomes in patients with esotropia and myopia.
METHODS
This case-control study encompassed all surgical cases of esotropia at Torfe and Negah Hospital between 2016 and 2021, which satisfied our specified inclusion criteria. The initial variables from electronic medical records were collected, including demographic, clinical, and surgery-related factors. At the final follow-up appointment, the level of eye deviation, both at distance and near, was recorded. We considered the operation a "success" for patients with a post-surgery distance eye deviation of 10(Pd) or less. Patients with greater deviation were classified as surgery failure. Statistical analyses were executed using SPSS software (version 16.0), and a P-value less than 0.05 was considered significant.
RESULTS
Of the 194 patients evaluated, 112 were incorporated into the study. Surgical failure was observed in 14.29% of myopic patients, 29.79% of hyperopic patients, and 31.82% of emmetropic patients. The myopia group displayed a 0.19 odd ratio for surgical failure compared to the combined hyperopia and emmetropia groups, not statistically significant (OR: 0.19, CI 95%: 0.03-1.02). Additionally, patients diagnosed with Lateral Rectus Under-action were found to be 6.85 times more likely to experience surgery failure(OR: 6.85, CI 95%: 1.52-30.94). An elevated risk of surgical failure was also identified in patients who underwent Inferior Oblique Weakening procedure, indicated by a 3.77-fold increase in the odds ratio for failure(OR: 3.77, CI 95%: 1.08-13.17).
CONCLUSION
In our study, despite numerical disparities, there was no statistical difference among the success rates of all esotropia patients with different refractive errors. The patients with LRUA or IOOA showed lower success rates. Myopic patients had higher post-op overcorrection with lower reoperation rates compared to hyperopic or emmetropic patients.
Topics: Humans; Esotropia; Male; Female; Ophthalmologic Surgical Procedures; Case-Control Studies; Oculomotor Muscles; Child; Visual Acuity; Child, Preschool; Vision, Binocular; Retrospective Studies; Adult; Refraction, Ocular; Myopia; Adolescent; Hyperopia; Treatment Outcome; Middle Aged; Young Adult; Follow-Up Studies
PubMed: 38918731
DOI: 10.1186/s12886-024-03531-5