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Frontiers in Medicine 2024To evaluate adult-onset neuronal intranuclear inclusion disease (NIID)-related retinopathy with guanine-guanine-cytosine repeat expansions in .
PURPOSE
To evaluate adult-onset neuronal intranuclear inclusion disease (NIID)-related retinopathy with guanine-guanine-cytosine repeat expansions in .
MATERIALS AND METHODS
Neuro-ophthalmic evaluations, including best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure (IOP), ultrasound biomicroscopy, pupillometry, fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), Humphrey visual field, full-field electroretinography (ERG), and multifocal ERG (mf-ERG) were performed in patients with gene-proven NIID.
RESULTS
Nine patients (18 eyes) were evaluated, with a median age of 62 years (55-68) and only one man was included in our study. Six patients presented with decreased visual acuity or night blindness, whereas the other three were asymptomatic. The visual acuity was measured from 20/200 to 20/20. Miosis was present in eight patients, four of whom had ciliary process hypertrophy and pronation, and three of whom had shallow anterior chambers. Fundus photography, FAF, and OCT showed consistent structural abnormalities mainly started from peripapillary areas and localized in the outer layer of photoreceptors and inner ganglion cell layer. ERG and mf-ERG also revealed retinal dysfunction in the corresponding regions.
CONCLUSION
Patients with NIID showed both structural and functional retinopathies which were unique and different from common cone-rod dystrophy or retinitis pigmentosa. Patients with miosis may have a potential risk of an angle-closure glaucoma attack. Neuro-ophthalmic evaluations is essential for evaluating patients with NIID, even without visual symptom.
PubMed: 38288273
DOI: 10.3389/fmed.2024.1188193 -
Case Reports in Ophthalmology 2024Pseudophakic pupillary block angle-closure glaucoma is an uncommon complication following uneventful cataract surgery with posterior chamber intraocular lens (IOL)...
INTRODUCTION
Pseudophakic pupillary block angle-closure glaucoma is an uncommon complication following uneventful cataract surgery with posterior chamber intraocular lens (IOL) implantation. Interestingly, capsular block syndrome (CBS) has been reported as another plausible cause of pseudophakic pupillary block angle-closure glaucoma, especially in the early postoperative period. Unlike early postoperative CBS, late postoperative CBS is not associated with a shallow anterior chamber, myopic shift, or elevated intraocular pressure. We report a case of late postoperative CBS presenting with an acute-onset pupillary block angle-closure attack occurring 13 years after uneventful cataract surgery with posterior chamber IOL implantation, which has not been reported in the literature.
CASE PRESENTATION
An 87-year-old male diagnosed with pseudoexfoliation syndrome developed pseudophakic pupillary block following uneventful cataract surgery with posterior chamber IOL implantation. Late-onset CBS has been identified as the underlying cause of the pupillary block. The combination of zonular laxity observed in pseudoexfoliation syndrome and the presence of a Soemmering ring are potential predisposing factors for this condition. After performing laser peripheral iridotomy (LPI) followed by Nd: YAG capsulotomy, the pupillary block was resolved and vision was improved.
CONCLUSION
CBS should be considered as a potential cause of pseudophakic pupillary block, even in the late postoperative period. The management of late-onset CBS accompanied by pupillary block angle-closure glaucoma typically includes LPI to eliminate the pupillary block, followed by Nd: YAG capsulotomy.
PubMed: 38288026
DOI: 10.1159/000536118 -
Frontiers in Bioscience (Landmark... Jan 2024Although the current role of cytokines and neuroinflammation in glaucoma remains obscure, it represents an expanding field in research. The purpose of this study was to...
BACKGROUND
Although the current role of cytokines and neuroinflammation in glaucoma remains obscure, it represents an expanding field in research. The purpose of this study was to analyze cytokines in the aqueous humor (AH) of glaucoma patients and in retinas from an glaucoma animal model, to aid in determining the role of neuroinflammation in glaucoma.
METHODS
AH samples were collected from 20 patients during cataract surgeries (controls: n = 10, age = 70.3 ± 9.742; glaucoma: n = 10, age: 66.5 ± 8.073) in Shanghai East Hospital, an affiliate of Tongji University, between September 2018 and March 2019 and analyzed in duplicate by Luminex cytokine polystyrene color bead-based multiplex assay. Retinas from female Sprague-Dawley rats (n = 6) were harvested and cultured with or without 60 mmHg of hydrostatic pressure for 24 hours. Retinal ganglion cells (RGCs) were quantified using Brn3a staining. Cytokines in the retina and culture medium were analyzed by rat cytokine array (Abcam).
RESULTS
At baseline, patients with primary angle closure glaucoma (PACG) have significantly lower levels of IL-6 and IP-10 and a higher level of PDGF-BB in their AH, compared to the controls. Postoperatively, patients with PACG have significantly higher levels of IL-1ra, IL-13, and MIP-1α and a lower level of IL-6. Elevated hydrostatic pressure led to significant RGC loss in the retina, , as well as the upregulation of ciliary neurotrophic factor (CNTF), IL-6, IL-10, IL-4, and TIMP-1 alongside the downregulation of PDGF-AA, MMP-8, TNF-α, and IFN-γ. Furthermore, eight cytokines were detected as being downregulated in the culture medium, including PDGF-AA, MMP-8, and IL-4.
CONCLUSIONS
Proinflammatory cytokines showed changes in both AH and . Further studies are needed on the role of these cytokines and their corresponding signaling pathways in both neurodegeneration and glaucoma.
Topics: Humans; Female; Rats; Animals; Middle Aged; Aged; Aged, 80 and over; Interleukin-6; Aqueous Humor; Neuroinflammatory Diseases; Interleukin-4; Matrix Metalloproteinase 8; Glaucoma, Open-Angle; Rats, Sprague-Dawley; China; Glaucoma; Cytokines; Models, Animal; Retina
PubMed: 38287812
DOI: 10.31083/j.fbl2901029 -
Asia-Pacific Journal of Ophthalmology... 2024
Topics: Humans; Glaucoma, Angle-Closure; Cataract; Cataract Extraction; Intraocular Pressure; Phacoemulsification
PubMed: 38278701
DOI: 10.1016/j.apjo.2024.100034 -
Journal of Clinical Medicine Jan 2024This study aimed to evaluate the effect of cataract extraction on intraocular pressure at 6, 12, and 24 months and their difference compared to the baseline in diverse... (Review)
Review
BACKGROUND AND OBJECTIVES
This study aimed to evaluate the effect of cataract extraction on intraocular pressure at 6, 12, and 24 months and their difference compared to the baseline in diverse glaucoma subtypes.
MATERIALS AND METHODS
We carried out research in the MEDLINE, Cochrane Library and EMBASE databases, as of April 2022 for relevant papers, filtered according to established inclusion and exclusion criteria. The meta-analysis evaluated the Mean Reduction and relative Standard Error in these subpopulations at predetermined times. A total of 41 groups (2302 eyes) were included in the systematic review. Due to the significant heterogeneity, they were analysed through a Random Effects Model.
RESULTS
We obtained these differences from baseline: (1) Open Angle Glaucoma at 6, 12 and 24 months, respectively: -2.44 mmHg, -2.71 mmHg and -3.13 mmHg; (2) Angle Closure Glaucoma at 6, 12 and 24 months, respectively: -6.81 mmHg, -7.03 mmHg and -6.52 mmHg; (3) Pseudoexfoliation Glaucoma at 12 months: -5.30 mmHg; (4) Ocular Hypertension at 24 months: -2.27 mmHg.
CONCLUSIONS
Despite a certain variability, the reduction in ocular pressure was statistically significant at 6, 12 and 24 months in both Open Angle Glaucoma and Angle Closure Glaucoma, the latter being superior. Data for Pseudoexfoliation Glaucoma and for Ocular Hypertension are available, respectively, only at 12 months and at 24 months, both being significant.
PubMed: 38256642
DOI: 10.3390/jcm13020508 -
Journal of Ophthalmology 2024To compare corneal higher-order aberrations (HOAs), refractive error, and ocular biological parameters before and after phacoemulsification combined with...
Changes in Corneal Higher-Order Aberrations and Ocular Biometric Measurements after Phacoemulsification Combined with Goniosynechialysis in Primary Angle Closure/Glaucoma Patients.
PURPOSE
To compare corneal higher-order aberrations (HOAs), refractive error, and ocular biological parameters before and after phacoemulsification combined with goniosynechialysis (Phaco-GSL) in primary angle closure/glaucoma (PAC/PACG) patients with different axial lengths (ALs).
METHODS
In this prospective study, cataract patients diagnosed with PAC/PACG were categorized into two groups based on their ALs: the short AL group (AL ≤ 22.5 mm) and the normal AL group (22.5 < AL ≤ 24.5 mm). The pre- and postsurgery measurements of intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were conducted at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Additionally, the assessments included corneal HOAs, the number of antiglaucoma medications, visual field parameters, manifest refraction, and other ocular biological parameters before surgery and at the final follow-up.
RESULTS
Prior to surgery, the two groups exhibited no significant differences, except for AL, curvature value, and (4, 0) of the posterior corneal surface (all < 0.01). Following surgery, BCVA improved, and IOP decreased significantly in both groups ( < 0.01). Both anterior and total corneal HOAs, along with (3, -3), increased in the two groups (all < 0.05), with the normal AL group exhibiting a significantly greater increase in total cornea (3, -3) than the short AL group (=0.047). The normal AL group also exhibited a slight tendency towards hyperopia ( < 0.01). Significant changes were observed in the visual field index and mean deviation in both groups ( < 0.05).
CONCLUSIONS
Phaco-GSL resulted in an increased corneal HOAs, particularly trefoil, with variations based on the patient's AL. Patients with normal ALs tended to shift towards hyperopia after surgery.
PubMed: 38250183
DOI: 10.1155/2024/5833543 -
Ophthalmic Research 2024This study investigated the clinical characteristics of and risk factors for microcystic macular edema (MME) in patients with chronic primary angle-closure glaucoma... (Observational Study)
Observational Study
INTRODUCTION
This study investigated the clinical characteristics of and risk factors for microcystic macular edema (MME) in patients with chronic primary angle-closure glaucoma (CPACG) and primary open-angle glaucoma (POAG).
METHODS
This retrospective observational study included 1,588 eyes from 926 glaucoma inpatients and analyzed the patients' basic demographic information, visual field parameters, macular scans, and peripapillary retinal nerve fiber layer thickness.
RESULTS
Our findings were that the incidence rate of MME was 3.97% (34/857) in CPACG and 5.88% (43/731) in POAG. MME was predominantly diagnosed at an advanced stage in CPACG (almost 100%) compared to POAG (93.02%). MME was most frequently involved in the inferior (83.12%) quadrant of the peri-macular region in both CPACG and POAG. Risk factors for MME occurrence in CPACG and POAG included lower visual field mean deviation (OR = 1.14, 95%: CI 1.05-1.24, p = 0.003; OR = 1.14, 95% CI: 1.06-1.21, p < 0.001) and younger age (OR = 0.92, 95% CI: 0.88-0.96, p < 0.001; OR = 0.96, 95% CI: 0.93-0.99, p = 0.003), while female sex (OR = 0.30, 95% CI: 0.11-0.84, p = 0.022) reduced the MME occurrence in POAG.
CONCLUSION
MME could develop in both CPACG and POAG patients, occurring earlier in POAG. The inferior peri-macular region is commonly affected. Younger age and poorer visual field are risk factors for MME in glaucoma patients.
Topics: Humans; Glaucoma, Angle-Closure; Male; Female; Retrospective Studies; Glaucoma, Open-Angle; Middle Aged; Visual Fields; Aged; Macular Edema; Tomography, Optical Coherence; Intraocular Pressure; Risk Factors; Chronic Disease; Retinal Ganglion Cells; Incidence; Nerve Fibers
PubMed: 38246159
DOI: 10.1159/000535900 -
The British Journal of Ophthalmology Jan 2024To develop an artificial intelligence (AI) algorithm that diagnoses cataracts/corneal diseases from multiple conditions using smartphone images.
AIM
To develop an artificial intelligence (AI) algorithm that diagnoses cataracts/corneal diseases from multiple conditions using smartphone images.
METHODS
This study included 6442 images that were captured using a slit-lamp microscope (6106 images) and smartphone (336 images). An AI algorithm was developed based on slit-lamp images to differentiate 36 major diseases (cataracts and corneal diseases) into 9 categories. To validate the AI model, smartphone images were used for the testing dataset. We evaluated AI performance that included sensitivity, specificity and receiver operating characteristic (ROC) curve for the diagnosis and triage of the diseases.
RESULTS
The AI algorithm achieved an area under the ROC curve of 0.998 (95% CI, 0.992 to 0.999) for normal eyes, 0.986 (95% CI, 0.978 to 0.997) for infectious keratitis, 0.960 (95% CI, 0.925 to 0.994) for immunological keratitis, 0.987 (95% CI, 0.978 to 0.996) for cornea scars, 0.997 (95% CI, 0.992 to 1.000) for ocular surface tumours, 0.993 (95% CI, 0.984 to 1.000) for corneal deposits, 1.000 (95% CI, 1.000 to 1.000) for acute angle-closure glaucoma, 0.992 (95% CI, 0.985 to 0.999) for cataracts and 0.993 (95% CI, 0.985 to 1.000) for bullous keratopathy. The triage of referral suggestion using the smartphone images exhibited high performance, in which the sensitivity and specificity were 1.00 (95% CI, 0.478 to 1.00) and 1.00 (95% CI, 0.976 to 1.000) for 'urgent', 0.867 (95% CI, 0.683 to 0.962) and 1.00 (95% CI, 0.971 to 1.000) for 'semi-urgent', 0.853 (95% CI, 0.689 to 0.950) and 0.983 (95% CI, 0.942 to 0.998) for 'routine' and 1.00 (95% CI, 0.958 to 1.00) and 0.896 (95% CI, 0.797 to 0.957) for 'observation', respectively.
CONCLUSIONS
The AI system achieved promising performance in the diagnosis of cataracts and corneal diseases.
PubMed: 38242700
DOI: 10.1136/bjo-2023-324488 -
International Journal of Ophthalmology 2024To compare the three-dimensional choroidal vascularity index (CVI) and choroidal thickness between fellow eyes of acute primary angle-closure (F-APAC) and chronic...
Three-dimensional choroidal vascularity index and choroidal thickness in fellow eyes of acute and chronic primary angle-closure using swept-source optical coherence tomography.
AIM
To compare the three-dimensional choroidal vascularity index (CVI) and choroidal thickness between fellow eyes of acute primary angle-closure (F-APAC) and chronic primary angle-closure glaucoma (F-CPACG) and the eyes of normal controls.
METHODS
This study included 37 patients with unilateral APAC, 37 with asymmetric CPACG without prior treatment, and 36 healthy participants. Using swept-source optical coherence tomography (SS-OCT), the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally. Pearson's correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.
RESULTS
The mean subfoveal CVIs were 0.35±0.10, 0.33±0.09, and 0.29±0.04, and the mean subfoveal choroidal thickness were 315.62±52.92, 306.22±59.29, and 262.69±45.55 µm in the F-APAC, F-CPACG, and normal groups, respectively. All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes (<0.05), while there were no significant differences between the F-APAC and F-CPACG eyes. In the peripapillary region, the mean overall CVIs were 0.21±0.08, 0.20±0.08, and 0.19±0.05, and the mean overall choroidal thickness were 180.45±54.18, 174.82±50.67, and 176.18±37.94 µm in the F-APAC, F-CPACG, and normal groups, respectively. There were no significant differences between any of the two groups in all peripapillary sectors. Younger age, shorter axial length, and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness (<0.05).
CONCLUSION
The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls. Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG. A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.
PubMed: 38239961
DOI: 10.18240/ijo.2024.01.06