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Scientific Reports Jun 2024The Persian Eye Cohort Study, a population-based cross-sectional study from 2015 to 2020, examined refractive error prevalence among 48,618 Iranian adults aged 31 to 70....
The Persian Eye Cohort Study, a population-based cross-sectional study from 2015 to 2020, examined refractive error prevalence among 48,618 Iranian adults aged 31 to 70. The study encompassed six centers in Iran, employing random cluster sampling for demographic, medical, and socioeconomic data collection through interviews. Ophthalmic exams included visual acuity, automated and manual objective refraction, subjective refraction, slit lamp, and fundus examinations. Using the spherical equivalent definition, the sample population was categorized into groups. Results indicated a mean age of 49.52 ± 9.31 and a mean refractive error of 0.26 diopters (D) ± 1.6 SD (95% CI - 0.27 to -0.24), ranging from -26.1 to + 18.5 SD. Prevalence of myopia (< -0.5D) and hyperopia (> + 0.5D) was 22.6% (95% CI 22.2-23%) and 12.5% (95% CI 12.1-12.8%), respectively. Regarding different age groups, the prevalence of hyperopia and astigmatism exhibited a steady and significant rise with increasing age (p-value < 0.001 for both). The prevalence of Myopia, however, showed a distinctive pattern, initially increasing in adults under 45, declining in those aged 55-64, and rising again among individuals aged 60 and older. Female gender, older age, urban residency, higher education, higher income, and Fars ethnicity were significantly related to a higher prevalence of myopia (p-value < 0.001 for all). Female gender (p-value < 0.001), aging (p-value < 0.001), urban residency (p-value = 0.029), and lower-income (p-value = 0.005) were significantly related to higher prevalence of hyperopia. Astigmatism (> 1D) was prevalent in 25.5% of participants (95% CI 25.1-25.9%) and correlated with male gender, aging, urban residency, illiteracy, and higher income (p-value < 0.001, < 0.001, < 0.001, < 0.001, 0.014, respectively). The study's comparison with regional and international surveys highlighted the increase in myopia among those over 65 due to higher nuclear cataract rates in older adults. Myopia positively related to education, income, and urban residency, while hyperopia did not exhibit such associations.
Topics: Humans; Iran; Middle Aged; Male; Female; Adult; Prevalence; Aged; Refractive Errors; Cross-Sectional Studies; Cohort Studies; Myopia; Hyperopia
PubMed: 38914645
DOI: 10.1038/s41598-024-65328-2 -
International Ophthalmology Jun 2024To evaluate the effect of pregnancy on the anterior chamber, corneal parameter, and intraocular pressure measurements; and compare the results between trimesters,...
PURPOSE
To evaluate the effect of pregnancy on the anterior chamber, corneal parameter, and intraocular pressure measurements; and compare the results between trimesters, postpartum and non-pregnant healthy age-matched women.
METHODS
This prospective study included 41 pregnant women and 53 non-pregnant women. Four measurements were taken from the pregnant women, in each trimester and postpartum third month, and once from the control group. Of the individuals included in the study, anterior chamber depth (ACD), anterior chamber volume (ACV), K1 (flat keratometry), K2 (steep keratometry), Kmean (mean value of K1 and K2), anterior chamber angle (ACA), central corneal thickness (CCT), thinnest corneal thickness (TCT), astigmatism value (AST), corneal volume (CV), biometry, axial length (AL), spherical equivalent (SFEQ), intraocular lens power (ILP), VA (visual acuity) datas were recorded.
RESULTS
We observed a statistically significant decrease in K2, CCT, ACD, AL and CV in the postpartum period (p = 0.025, p < 0.001, p = 0.029, p = 0.005, p = 0.004 respectively) and a statistically significant increase in ACV, CCT, and TCT as the gestational week progressed in the pregnant group (p = 0.007, p < 0.001, p = 0.025, respectively). A statistically significant decrease in IOP towards to the third trimester, and an increase in the postpartum period was observed (p < 0.001). We did not observe statistically significant changes in K1, Kmean, AST, ACA, VA, ILP, and SFEQ values.
CONCLUSION
It is important to investigate the physiological changes that may occur during pregnancy, distinguish them from pathological changes, and avoid unnecessary treatment. We consider that it's also important to guide the timing of anterior segment surgeries such as cataract and refractive surgery and to prescribe glasses/contact lenses.
Topics: Humans; Female; Prospective Studies; Pregnancy; Adult; Postpartum Period; Pregnancy Trimesters; Intraocular Pressure; Anterior Eye Segment; Young Adult; Visual Acuity; Biometry; Cornea; Anterior Chamber
PubMed: 38913127
DOI: 10.1007/s10792-024-03173-y -
International Ophthalmology Jun 2024The purpose of this study was to investigate the visual and refractive outcomes in patients with pseudoexfoliation (PXF) undergoing routine cataract surgery and to...
BACKGROUND
The purpose of this study was to investigate the visual and refractive outcomes in patients with pseudoexfoliation (PXF) undergoing routine cataract surgery and to compare the accuracy of intraocular lens (IOL) power calculation formulae.
METHODS
Retrospective case-series study from Shamir medical center, a public hospital, Israel. Medical records of patients who underwent routine cataract surgery between January 2019 and August 2021 were investigated. Postoperative visual acuity and manifest refraction were examined. The error in predicted refraction and IOL power calculation accuracy within a range of ± 0.50 to ± 1.00 diopters were compared between different IOL calculating formulae.
RESULTS
151 eyes of 151 patients ages 73.9 ± 7.1 years were included in this study- 58 eyes in the PXF group and 93 eyes in the control group. The mean absolute error (MAE) for the BUII formula was 0.63D ± 0.87 for the PXF group and 0.36D ± 0.48 for the control group (p < 0.05). The MAE for the Hill-RBF 3.0 formula was 0.61D ± 0.84 for the PXF group and 0.42D ± 0.55 for the control group (p = 0.05). There were significant differences in MAE and MedAE between PXF group and control group measures (p < 0.05). In the PXF group there were no significant differences between the different formulae.
CONCLUSIONS
There were significant differences in accuracy of IOL power calculations in all formulae between PXF group and control group measures. PXF patients show hyperopic shift from predicted refraction. Barret universal II formula had the highest proportion of eyes with absolute error in prediction below or equal to 0.50 D in both PXF and control groups.
Topics: Humans; Exfoliation Syndrome; Retrospective Studies; Aged; Female; Male; Visual Acuity; Refraction, Ocular; Lenses, Intraocular; Biometry; Aged, 80 and over; Optics and Photonics; Reproducibility of Results
PubMed: 38913082
DOI: 10.1007/s10792-024-03195-6 -
Translational Vision Science &... Jun 2024To assess the impact of ocular confounding factors on aqueous humor (AH) proteomic and metabolomic analyses for retinal disease characterization.
PURPOSE
To assess the impact of ocular confounding factors on aqueous humor (AH) proteomic and metabolomic analyses for retinal disease characterization.
METHODS
This study recruited 138 subjects (eyes): 102 with neovascular age-related macular degeneration (nAMD), 18 with diabetic macular edema (DME), and 18 with cataract (control group). AH samples underwent analysis using Olink Target 96 proteomics and Metabolon's metabolomics platform Data analysis included correlation, differential abundance, and gene-set analysis.
RESULTS
In total, 756 proteins and 408 metabolites were quantified in AH. Total AH protein concentration was notably higher in nAMD (3.2-fold) and DME (4.1-fold) compared to controls. Pseudophakic eyes showed higher total AH protein concentrations than phakic eyes (e.g., 1.6-fold in nAMD) and a specific protein signature indicative of matrix remodeling. Unexpectedly, pupil-dilating drugs containing phenylephrine/tropicamide increased several AH proteins, notably interleukin-6 (5.4-fold in nAMD). Correcting for these factors revealed functionally relevant protein correlation clusters and disease-relevant, differentially abundant proteins across the groups. Metabolomics analysis, for which the relevance of confounder adjustment was less apparent, suggested insufficiently controlled diabetes and chronic hyperglycemia in the DME group.
CONCLUSIONS
AH protein concentration, pseudophakia, and pupil dilation with phenylephrine/tropicamide are important confounding factors for AH protein analyses. When these factors are considered, AH analyses can more clearly reveal disease-relevant factors.
TRANSLATIONAL RELEVANCE
Considering AH protein concentration, lens status, and phenylephrine/tropicamide administration as confounders is crucial for accurate interpretation of AH protein data.
Topics: Humans; Aqueous Humor; Female; Proteomics; Male; Aged; Metabolomics; Eye Proteins; Middle Aged; Cataract; Diabetic Retinopathy; Macular Edema; Wet Macular Degeneration; Aged, 80 and over
PubMed: 38913008
DOI: 10.1167/tvst.13.6.17 -
Folia Histochemica Et Cytobiologica Jun 2024Diabetic cataract (DC) is a common ocular complication of diabetes. Mitofusin 2 (MFN2), a mitochondrial fusion protein, is involved in the pathogenesis of cataract and...
INTRODUCTION
Diabetic cataract (DC) is a common ocular complication of diabetes. Mitofusin 2 (MFN2), a mitochondrial fusion protein, is involved in the pathogenesis of cataract and diabetic complications. However, its role and molecular mechanisms in DC remain unclear.
MATERIALS AND METHODS
DC models in rats were induced by intraperitoneal injection of streptozocin (STZ) for 12 weeks. We measured the body weight of rats, blood glucose concentrations, sorbitol dehydrogenase (SDH) activity and advanced glycation end products (AGE) content in the lenses of rats. MFN2 mRNA and protein expression levels in the lenses were detected by RT-qPCR and western blot assays. In vitro, human lens epithelial (HLE) B3 cells were treated for 48 h with 25 mM glucose (high glucose, HG) to induce cell damage. To determine the role of MFN2 in HG-induced cell damage, HLE-B3 cells were transfected with lentivirus loaded with MFN2 overexpression plasmid or short hairpin RNA (shRNA) to overexpress or knock down MFN2 expression, followed by HG exposure. Cell viability was assessed by CCK-8 assay. Flow cytometry was used to detect cell apoptosis and reactive oxygen species (ROS) level. JC-1 staining showed the changes in mitochondrial membrane potential (Δψm). The mediators related to apoptosis, mitochondrial damage, and autophagy were determined.
RESULTS
STZ-administrated rats showed reduced body weight, increased blood glucose levels, elevated SDH activity and AGE content, suggesting successful establishment of the DC rat model. Interestingly, MFN2 expression was significantly downregulated in DC rat lens and HG-induced HLE-B3 cells. Further analysis showed that under HG conditions, MFN2 overexpression enhanced cell viability and inhibited apoptosis accompanied by decreased Bax, cleaved caspase-9 and increased Bcl-2 expression in HLE-B3 cells. MFN2 overexpression also suppressed the mitochondrial damage elicited by HG as manifested by reduced ROS production, recovered Δψm and increased mitochondrial cytochrome c (Cyto c) level. Moreover, MFN2 overexpression increased LC3BⅡ/LC3BⅠ ratio and Beclin-1 expression, but decreased p62 level, and blocked the phosphorylation of mTOR in HG-treated HLE-B3 cells. In contrast, MFN2 silencing exerted opposite effects.
CONCLUSIONS
Our findings indicate that MFN2 expression may be essential for preventing lens epithelial cell apoptosis during development of diabetic cataract.
PubMed: 38912568
DOI: 10.5603/fhc.98875 -
Journal of Surgical Case Reports Jun 2024Wound burping is a technique used to treat intraocular pressure spikes in the immediate postoperative period after cataract surgery. A 55-year-old man with no history of...
Wound burping is a technique used to treat intraocular pressure spikes in the immediate postoperative period after cataract surgery. A 55-year-old man with no history of glaucoma presented with painless blurring of vision in his left eye following cataract surgery 20 days earlier. Ophthalmic examination disclosed elevated intraocular pressure, mild conjunctival hyperemia, corneal microcystic epithelial edema, and mild anterior chamber reaction. In an attempt to lower the intraocular pressure quickly, the corneal wound was 'burped' at the slitlamp. Upon burping the wound, a large epithelial bulla formed instantly in the cornea. The patient's blinking caused the corneal epithelial bulla to burst and collapse. Examination the next day disclosed the detached epithelium had sloughed off completely. The epithelial defect healed gradually over 10 days. Wound burping to release aqueous humor after the corneal epithelium has healed over the surgical incision can result in corneal epithelial detachment and should be avoided.
PubMed: 38912434
DOI: 10.1093/jscr/rjae244 -
Clinical Case Reports Jul 2024If an intraocular lens (IOL) is incorrectly labeled, problems can arise for surgeons and patients. Precise biometry is important to accurately determine the IOL power...
KEY CLINICAL MESSAGE
If an intraocular lens (IOL) is incorrectly labeled, problems can arise for surgeons and patients. Precise biometry is important to accurately determine the IOL power and prevent the implantation of the wrong IOL. Labeling and verifying IOLs with accuracy is crucial to ensuring the best possible results of cataract surgery.
ABSTRACT
Mislabeling of IOLs can cause unpredictable problems for surgeons. However, we can prevent incorrect IOLs by using precise biometry to determine accurate IOL power and safely implant the correct IOL. A 50-year-old female with no medical or ocular history came to our clinic complaining of decreased vision in both eyes that had been ongoing for several months. After being diagnosed with cataracts, primary angle closure suspect, and high hyperopia, the patient underwent phacoemulsification surgery. A posterior chamber IOL was implanted, and visco-goniosynechialysis was performed. During follow-up appointments, it was discovered that the patient had an uncorrected visual acuity of 20/50 in her right eye, which was corrected to 20/20 with a + 7.00 D lens. Upon further evaluation, it was determined that the source of the error was due to a manufacturing mislabeling of the IOL power. The patient then underwent successful IOL exchange surgery, and her best-corrected visual acuity became 20/20 with no significant refraction. This case highlights an uncommon source of refractive surprise after phacoemulsification surgery, successfully managed with IOL exchange surgery using the same IOL power from a different brand.
PubMed: 38911921
DOI: 10.1002/ccr3.9104 -
Cureus May 2024Corneal calcification typically progresses slowly but can occasionally advance rapidly. This report details severe stromal calcification following repeat Descemet's...
Corneal calcification typically progresses slowly but can occasionally advance rapidly. This report details severe stromal calcification following repeat Descemet's stripping automated endothelial keratoplasty (DSAEK) in a 75-year-old patient with diabetes, hypertension, and prior ocular surgeries, including cataract surgery, intraocular lens extraction with suturing, and trabeculectomy. Persistent epithelial defects after the surgery led to rapid central stromal calcification within four weeks, significantly reducing visual acuity. Management included switching from betamethasone sodium phosphate to fluorometholone, facilitating complete epithelial recovery within two months. However, persistent stromal opacity necessitated a subsequent penetrating keratoplasty. Infrared absorption spectrophotometry identified calcium phosphate as the primary component of the calcification. This case highlights the importance of vigilant monitoring and proactive management of epithelial defects to prevent rapid calcification following endothelial keratoplasty.
PubMed: 38910785
DOI: 10.7759/cureus.60956 -
Cureus May 2024Minimally invasive glaucoma surgery (MIGS) is a cutting-edge approach to treating glaucoma that provides a range of techniques and technology to reduce intraocular...
Minimally invasive glaucoma surgery (MIGS) is a cutting-edge approach to treating glaucoma that provides a range of techniques and technology to reduce intraocular pressure (IOP). An 80-year-old man with visually significant cataracts and primary open-angle glaucoma (POAG) underwent combined cataract surgery and TrabEx+ (MicroSurgical Technology, Washington, United States) in his left eye, a unique type of MIGS, as we described in this study. Over the one-year follow-up, this patient showed improved visual function with well-controlled IOP without anti-glaucoma medications.
PubMed: 38910641
DOI: 10.7759/cureus.60905 -
Archivos de La Sociedad Espanola de... Jun 2024A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe,...
INTRODUCTION
A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU.
METHODS
We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain.
RESULTS
93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p .025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (-28.3%, p 0.03).
DISCUSSION
Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture.
CONCLUSION
Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate.
PubMed: 38909893
DOI: 10.1016/j.oftale.2024.06.009