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Indian Journal of Ophthalmology Jul 2024To report the preliminary experience and initial clinical results following SMILE for the treatment of mixed astigmatism.
PURPOSE
To report the preliminary experience and initial clinical results following SMILE for the treatment of mixed astigmatism.
METHODS
Thirteen eyes of nine patients with a mean age of 27 ± 4.36 years were included in the series. In 8/13 eyes, myopic SMILE license and in 4/13 eyes, hyperopic SMILE license (available as part of an open/research software) was used for the treatment. The mean follow-up was 9.5 ± 8.7 (0.5-24) months, and the median follow-up was 6 months.
SETTING
Nethradhama Superspeciality Eye Hospital, Bangalore, India.
DESIGN
Exploratory study.
RESULTS
The mean preoperative sphere, cylinder, and spherical equivalent (SE) were 1.44 ± 1.63, -2.70 ± 2.30, and -0.24 ± 1.14 D, which changed to -0.03 ± 0.30, -0.28 ± 0.48, and -0.18 ± 0.49 D, respectively, 6 months postoperatively. Furthermore, 85% (11/13) eyes were within ± 0.50 D, 92% (12/13) eyes were within ± 1.00 D, while all eyes were within ± 1.50 D of SE correction. All eyes were within ± 1.00 D of cylinder correction. In addition, 92% (12/13) eyes had UDVA better than 20/32, with 54% (7/13) eyes having UDVA 20/20 or better. Safety and efficacy indices were 1.08 and 0.92, respectively. No eyes lost more than 1 line of CDVA. The mean corneal higher order aberrations (HOA) increased from 0.111 ± 0.048 to 0.209 ± 0.056 (P < 0.001). The mean objective scatter index (OSI) did not show a significant change (pre = 0.71 ± 0.69, 6 months = 0.89 ± 0.20; P = 0.35).
CONCLUSION
Early experience showed that SMILE was feasible for the management of eyes with mixed astigmatism, without any intraoperative complications, unique to the procedure.
Topics: Humans; Astigmatism; Male; Adult; Female; Visual Acuity; Feasibility Studies; Refraction, Ocular; Corneal Surgery, Laser; Follow-Up Studies; Young Adult; Corneal Topography; Corneal Stroma; Software; Lasers, Excimer; Treatment Outcome; Retrospective Studies; Myopia; Microsurgery
PubMed: 38905464
DOI: 10.4103/IJO.IJO_1273_23 -
Indian Journal of Ophthalmology Jul 2024The anterior segment in individuals with high myopia has different features compared to those without myopia. IOLMaster 700 and Oculus Pentacam AXL are two accurate...
PURPOSE
The anterior segment in individuals with high myopia has different features compared to those without myopia. IOLMaster 700 and Oculus Pentacam AXL are two accurate optical biometers. Both devices measure the cornea differently and thus yield different results when measuring intraocular lens (IOL) power. The purpose of this study is to assess the agreement of the IOL power calculation between IOLMaster 700 and Oculus Pentacam AXL in patients with high myopia.
METHODS
A prospective, analytical cross-sectional study was conducted to assess the agreement between the IOL power calculation with IOLMaster 700 and Oculus Pentacam AXL. In this study, 44 eyes were examined using Oculus Pentacam AXL and IOLMaster 700, and IOL power was calculated using the Barret Universal II formula and the AMO Sensar AR40E. The Bland-Altman plot was used to evaluate the agreement between the two devices.
RESULTS
Based on the IOLMaster 700 examination, 44 eyes with high myopia had axial lengths ranging from 26.05 to 34.02 mm. The mean IOL power was 8.26 ± 4.755 and 8.58 ± 4.776 based on IOLMaster 700 and Oculus Pentacam AXL, respectively. The Bland-Altman plot revealed good agreement between the two devices, with a mean difference of -0.3182 in the IOL power calculation and a 95% LoA of 0.88099-0.24462 with a 95% confidence interval.
CONCLUSION
Both devices showed good agreement in the IOL power calculation in patients with high myopia.
Topics: Humans; Prospective Studies; Male; Cross-Sectional Studies; Female; Lenses, Intraocular; Biometry; Refraction, Ocular; Adult; Middle Aged; Reproducibility of Results; Optics and Photonics; Myopia; Axial Length, Eye; Myopia, Degenerative
PubMed: 38905462
DOI: 10.4103/IJO.IJO_1350_23 -
Indian Journal of Ophthalmology Jul 2024The medical condition referred to as "central retinal artery occlusion" (CRAO) was first documented by Albrecht von Graefe in 1859. Subsequently, CRAO has consistently... (Review)
Review
The medical condition referred to as "central retinal artery occlusion" (CRAO) was first documented by Albrecht von Graefe in 1859. Subsequently, CRAO has consistently been identified as a serious medical condition that leads to substantial visual impairment. Furthermore, it is correlated with vascular complications that have the potential to affect crucial organs such as the brain and heart. A considerable amount of research has been extensively published on the various aspects of this topic, which is marked by notable debates and misconceptions, especially regarding its management and outcomes. The primary aim of this review article is to analyze the latest developments in the understanding of CRAO, which includes its causes, techniques for retinal imaging, systemic evaluation, and therapeutic strategies, such as vitrectomy. This review article offers readers a comprehensive learning experience to gain knowledge on the fundamental principles and recent advancements in CRAO.
Topics: Humans; Retinal Artery Occlusion; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity; Fundus Oculi; Vitrectomy; Risk Factors
PubMed: 38905460
DOI: 10.4103/IJO.IJO_2826_23 -
Indian Journal of Ophthalmology Jul 2024
Topics: Humans; Tomography, Optical Coherence; Macular Degeneration; Fluorescein Angiography; Fundus Oculi; Macula Lutea; Male; Visual Acuity; Diagnosis, Differential; Female
PubMed: 38905458
DOI: 10.4103/IJO.IJO_3168_23 -
Indian Journal of Ophthalmology Jul 2024
Topics: Humans; Phakic Intraocular Lenses; Refraction, Ocular; Lens Implantation, Intraocular; Lens, Crystalline; Myopia; Biometry
PubMed: 38905456
DOI: 10.4103/IJO.IJO_1402_24 -
International Ophthalmology Jun 2024This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults.
METHODS
A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
RESULTS
Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
CONCLUSIONS
OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
Topics: Humans; Orthokeratologic Procedures; Myopia; Refraction, Ocular; Visual Acuity; Axial Length, Eye; Contact Lenses; Child; Risk Assessment
PubMed: 38904856
DOI: 10.1007/s10792-024-03175-w -
Investigative Ophthalmology & Visual... Jun 2024Interphotoreceptor retinoid-binding protein's (IRBP) role in eye growth and its involvement in cell homeostasis remain poorly understood. One hypothesis proposes early...
PURPOSE
Interphotoreceptor retinoid-binding protein's (IRBP) role in eye growth and its involvement in cell homeostasis remain poorly understood. One hypothesis proposes early conditional deletion of the IRBP gene could lead to a myopic response with retinal degeneration, whereas late conditional deletion (after eye size is determined) could cause retinal degeneration without myopia. Here, we sought to understand if prior myopia was required for subsequent retinal degeneration in the absence of IRBP. This study investigates if any cell type or developmental stage is more important in myopia or retinal degeneration.
METHODS
IBRPfl/fl mice were bred with 5 Cre-driver lines: HRGP-Cre, Chx10-Cre, Rho-iCre75, HRGP-Cre Rho-iCre75, and Rx-Cre. Mice were analyzed for IRBP gene expression through digital droplet PCR (ddPCR). Young adult (P30) mice were tested for retinal degeneration and morphology using spectral-domain optical coherence tomography (SD-OCT) and hematoxylin and eosin (H&E) staining. Function was analyzed using electroretinograms (ERGs). Eye sizes and axial lengths were compared through external eye measurements and whole eye biometry.
RESULTS
Across all outcome measures, when bred to IRBPfl/fl, HRGP-Cre and Chx10-Cre lines showed no differences from IRBPfl/fl alone. With the Rho-iCre75 line, small but significant reductions were seen in retinal thickness with SD-OCT imaging and postmortem H&E staining without increased axial length. Both the HRGP-Cre+Rho-iCre75 and the Rx-Cre lines showed significant decreases in retinal thickness and outer nuclear layer cell counts. Using external eye measurements and SD-OCT imaging, both lines showed an increase in eye size. Finally, function in both lines was roughly halved across scotopic, photopic, and flicker ERGs.
CONCLUSIONS
Our studies support hypotheses that for both eye size determination and retinal homeostasis, there are two critical timing windows when IRBP must be expressed in rods or cones to prevent myopia (P7-P12) and degeneration (P21 and later). The rod-specific IRBP knockout (Rho-iCre75) showed significant retinal functional losses without myopia, indicating that the two phenotypes are independent. IRBP is needed for early development of photoreceptors and eye size, whereas Rho-iCre75 IRBPfl/fl knockout results in retinal degeneration without myopia.
Topics: Animals; Mice; Retinal Degeneration; Eye Proteins; Tomography, Optical Coherence; Mice, Knockout; Retinol-Binding Proteins; Electroretinography; Disease Models, Animal; Myopia; Mice, Inbred C57BL; Retina
PubMed: 38904640
DOI: 10.1167/iovs.65.6.32 -
Investigative Ophthalmology & Visual... Jun 2024Recent studies have shown that the retinal pigment epithelium (RPE) relies on fatty acid oxidation (FAO) for energy, however, its role in overall retinal health is...
PURPOSE
Recent studies have shown that the retinal pigment epithelium (RPE) relies on fatty acid oxidation (FAO) for energy, however, its role in overall retinal health is unknown. The only FAO disorder that presents with chorioretinopathy is long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD). Studying the molecular mechanisms can lead to new treatments for patients and elucidate the role of FAO in the RPE. This paper characterizes the chorioretinopathy progression in a recently reported LCHADD mouse model.
METHODS
Visual assessments, such as optokinetic tracking and fundus imaging, were performed in wildtype (WT) and LCHADD mice at 3, 6, 10, and 12 months of age. Retinal morphology was analyzed in 12-month retinal cross-sections using hematoxylin and eosin (H&E), RPE65, CD68, and TUNEL staining, whereas RPE structure was assessed using transmission electron microscopy (TEM). Acylcarnitine profiles were measured in isolated RPE/sclera samples to determine if FAO was blocked. Bulk RNA-sequencing of 12 month old male WT mice and LCHADD RPE/sclera samples assessed gene expression changes.
RESULTS
LCHADD RPE/sclera samples had a 5- to 7-fold increase in long-chain hydroxyacylcarnitines compared to WT, suggesting an impaired LCHAD step in long-chain FAO. LCHADD mice have progressively decreased visual performance and increased RPE degeneration starting at 6 months. LCHADD RPE have an altered structure and a two-fold increase in macrophages in the subretinal space. Finally, LCHADD RPE/sclera have differentially expressed genes compared to WT, including downregulation of genes important for RPE function and angiogenesis.
CONCLUSIONS
Overall, this LCHADD mouse model recapitulates early-stage chorioretinopathy seen in patients with LCHADD and is a useful model for studying LCHADD chorioretinopathy.
Topics: Animals; Disease Models, Animal; Mice; Retinal Pigment Epithelium; Mice, Inbred C57BL; Long-Chain-3-Hydroxyacyl-CoA Dehydrogenase; Choroid Diseases; Male; Retinal Diseases; Microscopy, Electron, Transmission
PubMed: 38904639
DOI: 10.1167/iovs.65.6.33 -
Translational Vision Science &... Jun 2024This study enhances Meibomian gland (MG) infrared image analysis in dry eye (DE) research through artificial intelligence (AI). It is comprised of two main stages:...
PURPOSE
This study enhances Meibomian gland (MG) infrared image analysis in dry eye (DE) research through artificial intelligence (AI). It is comprised of two main stages: automated eyelid detection and tarsal plate segmentation to standardize meibography image analysis. The goal is to address limitations of existing assessment methods, bridge the curated and real-world dataset gap, and standardize MG image analysis.
METHODS
The approach involves a two-stage process: automated eyelid detection and tarsal plate segmentation. In the first stage, an AI model trained on curated data identifies relevant eyelid areas in non-curated datasets. The second stage refines the eyelid area in meibography images, enabling precise comparisons between normal and DE subjects. This approach also includes specular reflection removal and tarsal plate mask refinement.
RESULTS
The methodology achieved a promising instance-wise accuracy of 80.8% for distinguishing meibography images from 399 DE and 235 non-DE subjects. By integrating diverse datasets and refining the area of interest, this approach enhances meibography feature extraction accuracy. Dimension reduction through Uniform Manifold Approximation and Projection (UMAP) allows feature visualization, revealing distinct clusters for DE and non-DE phenotypes.
CONCLUSIONS
The AI-driven methodology presented here quantifies and classifies meibography image features and standardizes the analysis process. By bootstrapping the model from curated datasets, this methodology addresses real-world dataset challenges to enhance the accuracy of meibography image feature extraction.
TRANSLATIONAL RELEVANCE
The study presents a standardized method for meibography image analysis. This method could serve as a valuable tool in facilitating more targeted investigations into MG characteristics.
Topics: Humans; Artificial Intelligence; Dry Eye Syndromes; Meibomian Glands; Female; Male; Middle Aged; Image Processing, Computer-Assisted; Adult; Diagnostic Techniques, Ophthalmological; Aged; Infrared Rays
PubMed: 38904611
DOI: 10.1167/tvst.13.6.16 -
The Tokai Journal of Experimental and... Jul 2024Two methods are available for intraocular lens (IOL) insertion when the lens capsule is unavailable, including suture and sutureless fixations in which the IOL haptics... (Comparative Study)
Comparative Study
OBJECTIVE
Two methods are available for intraocular lens (IOL) insertion when the lens capsule is unavailable, including suture and sutureless fixations in which the IOL haptics are fixed in the sclera. The IOL position and refractive error after both procedures were compared.
METHODS
Data were retrospectively extracted from patients who underwent IOL insertion at our institution by suture or sutureless fixation (suture fixation: 12 eyes and sutureless fixation: 15 eyes). The postoperative IOL tilt angle and decentration distance were automatically calculated. The difference between the postoperative refractive error and the preoperative expected refractive value was determined and statistically investigated.
RESULTS
IOL position, tilt, and decentration were not significantly different between the two groups, but the refractive difference was significantly lower in the sutureless fixation group ( = 0.035). No significant correlation was found between IOL position and refractive difference.
CONCLUSIONS
Short-term results reveal that both the suture and sutureless fixation groups performed well, with no significant deviation in IOL tilt and decentration compared to previous reports. However, suture fixation was significantly more prone to refractive differences than sutureless fixation.
Topics: Humans; Lens Implantation, Intraocular; Retrospective Studies; Sclera; Male; Female; Suture Techniques; Aged; Sutureless Surgical Procedures; Lenses, Intraocular; Middle Aged; Refractive Errors; Aged, 80 and over; Sutures
PubMed: 38904241
DOI: No ID Found