The latest medical research on Ophthalmology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about ophthalmology gathered by our medical AI research bot.

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Double-session micropulse transscleral laser (CYCLO G6) for the treatment of glaucoma.

Lasers in Medical Science

This study aims to evaluate the effectiveness and safety of double-session micropulse transscleral (MP3) laser for the treatment of glaucoma. This ...

Correction to: Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial.

Lasers in Medical Science

After publication of this paper, the authors determined that the name of the author Tamer Mohamed Shosha was incorrectly spelled. The correct prese...

A Missense Mutation in OPA1 Causes Dominant Optic Atrophy in a Chinese Family.

J Ophthalmol

To investigate the genetic causes and clinical characteristics of dominant optic atrophy (DOA) in a Chinese family.

A 5-generation pedigree of 35 family members including 12 individuals affected with DOA was recruited from Shenzhen Eye Hospital, China. Four affected family members and one unaffected family member were selected for whole exome sequencing. Sanger sequencing was used to confirm and screen the identified mutation in 18 members of the family. The disease-causing mutation was identified by bioinformatics analysis and confirmed by segregation analysis. The clinical characteristics of the family members were analyzed.

A heterozygous missense mutation (c.1313A>G, p.D438G) in optic atrophy 1 (OPA1) was identified in 10 individuals affected with DOA in this family. None of the unaffected family members had the mutation. Patients in this family had vision loss since they were children or adolescence. The visual acuity decreased progressively to hand movement, except for one patient (IV-12) who had relatively good vision of 20/30 and 20/28. The fundus typically manifested as optic disc pallor. The visual fields, optical coherence tomography, and visual evoked potential suggested variable degree of abnormality in patients. Patients who had a history of cigarette smoking and alcohol drinking had more severe clinical manifestations.

Our results suggest that the p.D438G mutation in OPA1 causes optic atrophy in this family. The patients who carried the mutation demonstrated heterogeneous clinical manifestations in this family. This is the first report on the c.1313A>G (p.D438G) mutation of OPA1 in a Chinese family affected with DOA.

Screening for Stereopsis of Children Using an Autostereoscopic Smartphone.

J Ophthalmol

The advantage of using an autostereoscopic smartphone is that it can achieve 3D effects without the need for glasses. The purpose of this study was to evaluate whether this technology could be utilized to detect stereoacuity.

An autostereoscopic smartphone was used to imitate Lang stereotest I & II, Pass Test 3, Dinosaur Stereoacuity Test, and the Random Dot Stereo Acuity Test to screen the stereopsis of children from 3-6 years old.

No significant difference was found between each pair of groups (autostereoscopic smartphone vs. Lang stereotest I, Lang stereotest II, Pass Test 3, Dinosaur Stereoacuity Test, and Random Dot Stereo Acuity Test, respectively; Wilcoxon signed-rank test, P value all >0.05). All of the weighted kappa were higher than 0.84. Therefore, all of the comparisons between measurements showed a high level of agreement.

The autostereoscopic smartphone is an effective tool when used for the screening of deficiency in stereopsis.

Association between Metformin and a Lower Risk of Age-Related Macular Degeneration in Patients with Type 2 Diabetes.

J Ophthalmol

This population-based, retrospective cohort study was to investigate whether metformin is associated with a lower risk of subsequent age-related macular degeneration (AMD) in patients with type 2 diabetes.

Using the Taiwan National Health Insurance Research Database from 2001 to 2013, 68205 subjects with type 2 diabetes were enrolled in the study cohort. Among them, 45524 were metformin users and 22681 were nonusers. The metformin and nonmetformin groups were followed until the end of 2013. Cox regression analyses were used to estimate hazard ratios (HRs) for AMD development associated with metformin use. Confounders included for adjustment were age, sex, and comorbidities (hypertension, hyperlipidemia, coronary artery disease, obesity, diabetic retinopathy, chronic kidney disease, and insulin treatment). Furthermore, propensity score (PS) matching method was used to choose the matched sample, and PS-adjusted Cox regression was performed. Finally, how HRs changed according to metformin treatment duration and dose was also evaluated in the metformin group.

After adjusting for confounders, the metformin group had a significantly lower risk of AMD (adjusted HR = 0.54; 95% confidence interval [CI], 0.50-0.58). In the PS-matched sample, the significance remained (adjusted HR = 0.57; 95% CI, 0.52-0.63). In the metformin group, the adjusted HRs for the second (1.5-4 years) and third (≥4 years) tertiles of metformin treatment duration were 0.52 and 0.14, respectively, compared with the first tertile (<1.5 years). We also found significant trends of lower HRs (all p-value for trend <0.05) with increasing total and average doses.

Among patients with type 2 diabetes, those who use metformin are at a significantly lower risk of developing AMD relative to individuals who do not use metformin. Also, the trend of a significantly lower AMD risk was found with a higher dose of metformin.

An Alternative Psychophysical Diagnostic Indicator of the Aging Eye.

J Ophthalmol

Impaired adaptation to changes in lighting levels as well as mesopic visual function is a common complaint in those over the age of 65. The use of photostress is a well-established method to test the adaption rate and the response of the visual cycle. In this study, we test visual function recovery to mesopic luminance stimuli following a long duration photostress in young and elderly subjects. If successful in strongly differentiating aging macular function, these methods may also be useful in the study of pathologies such as age-related macular degeneration.

A group of 12 older normal subjects (mean age 75.1 ± 4.79) and a control group of 5 younger normal subjects (mean age 26.2 ± 4.19) were subjected to macular photostress using the OraLux photostress system. The OraLux system provides a diffuse light source bleaching 84% of cone photopigment while maintaining an exposure safety factor of 200 times less than the maximum safe exposure. After each photostressing session, macular recovery was tracked using a foveal, variable contrast, flickering stimulus of mean luminance in the high mesopic range. Recovery was tracked for 300 seconds. The endpoint was time to recovery to each individual's baseline sensitivity as determined by two static sensitivity trials prior to photostress.

Proportional hazards analysis of recovery time yielded a statistically significant difference between the older group and the young group (HR = 0.181; p=0.0289). The estimated hazard ratio of 0.181 indicates that older subjects return to baseline at less than one-fifth the rate of younger subjects. The hazards ratio remained statistically significant after adjusting for visual acuity (HR = 0.093; p=0.0424).

Photostress recovery of flicker sensitivity under mesopic conditions is a strong differentiator of aging macular function. This agrees with subject-reported complaints in reduced luminance conditions after exposure to bright lights such as night driving. The qualitative similarity between the aging retina and changes in early AMD suggests that flicker recovery following photostress may be useful as a surrogate endpoint in AMD clinical trials.

Comparison of Corneal Parameters of Children with Diabetes Mellitus and Healthy Children.

J Ophthalmol

To compare differences in central corneal thickness (CCT), corneal curvature, and other corneal measurements of children with diabetes mellitus (DM) and healthy children, and to investigate related factors.

This was a case-control study. From January to February 2018, 50 children with diabetes mellitus were selected as a case group, and 46 healthy children and adolescents without diabetes mellitus were selected as a control group. Corneal topography and CCT were analyzed using a corneal topography measuring apparatus and biometrics (IOL Master). In the diabetic group, we analyzed whether age, course of disease, sex, glycosylated hemoglobin, triglyceride level, total cholesterol, body mass index (BMI), parental BMI, birth history, feeding history, pregnancy, or puerperal history were related to corneal morphology.

There was a significant difference in CCT between groups, but no significant differences were found in corneal diameter, corneal curvature R1 or R2, or corneal topography. Central corneal thickness was not correlated with other clinical factors in the diabetes group.

Early screening and close follow-up of keratopathy in children with diabetes are imperative.

Descemet Membrane Endothelial Keratoplasty for Corneal Decompensation Secondary to Phakic Intraocular Lenses.

J Ophthalmol

To describe the surgical technique and clinical outcomes of bilensectomy (pIOL explant and phacoemulsification), followed by DMEK performed for bullous keratopathy secondary to pIOL.

Seven eyes of seven patients, who developed corneal decompensation after pIOL implantation, underwent bilensectomy followed by DMEK in a two-step procedure. Main outcome measures included uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, endothelial cell density (ECD) at 1, 3, 6, and 12 months, and intraoperative and postoperative complications.

DMEK was performed at a mean time of 9.83 ± 8.23 months after bilensectomy. BCVA (log MAR) improved in all eyes, increasing from 1.11 ± 0.78 preoperatively to 0.54 ± 0.21, 0.28 ± 0.23, 0.21 ± 0.21, and 0.17 ± 0.17 at 1, 3, 6, and 12 months after DMEK. One year after surgery, mean spherical equivalent and cylinder were -0.70 ± 0.92 D and -1.50 ± 0.54 D, respectively. ECD decreased by 62 ± 4%, 69 ± 4%, 74 ± 4%, and 77 ± 3% at 1, 3, 6, and 12 months after DMEK. There was one case of primary graft failure and no other postoperative complications.

The two-step technique bilensectomy followed by DMEK is a feasible technique for the management of bullous keratopathy secondary to pIOL, providing a fast visual recovery with good visual and refractive results.

Unilateral Levator Aponeurosis Excision for Marcus Gunn Syndrome and Risk Factors of Residual Jaw Winking.

J Ophthalmol

To investigate the association of ptosis, levator, and jaw winking in Marcus Gunn jaw-winking synkinesis (MGJWS), and the risk factor of preservation and outcomes of the unilateral levator excision and frontalis suspension.

Clinical features of MGJWS case series from 2011 to 2018 were retrospectively reviewed. Association between jaw winking and ptosis/levator function was statistically analyzed. The patients underwent unilateral levator excision and frontalis suspension using silicone rod or autogenous fascia lata. Clinical outcomes were evaluated in operated patients and the independent risk factors of residual jaw winking were investigated after a long follow-up.

There were 42 MGJWS patients in 2011 to 2018, accounting for 2.87% of all congenital blepharoptosis. 80% of mild jaw winking was accompanied with mild ptosis and fair levator function, and moderate-to-severe jaw winking was often accompanied with moderate-to-severe ptosis and poor levator function (P < 0.05). Ptosis showed a strong association with excursion of jaw winking (R = 0.785, P < 0.01). Jaw winking was resolved in all 34 operated patients with good correction of ptosis. Severity of jaw winking is an independent risk factor for the residual synkinesis after surgery. Severe preoperative jaw winking had an 18.05 times increased risk of postoperative residual synkinesis compared with moderate jaw winking (P < 0.05).

In MGJWS eyelid excursion of jaw winking has a direct correlation with ptosis and dysfunction of levator muscle. Unilateral levator aponeurosis excision and frontalis suspension is an efficient approach for MGJWS. Severe jaw winking is a risk factor of residual eyelid synkinesis after surgery.

Xeroderma Pigmentosum: Ocular Findings in an Isolated Brazilian Group with an Identified Genetic Cluster.

J Ophthalmol

Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder characterized by increased susceptibility to UV radiation- (UVR-) induced skin pigmentation, skin cancers, ocular surface disease, and, in some patients, sunburn and neurological degeneration. Eight different genes are affected, and the prevalence of the disease differs across the world. The present study describes the main ophthalmologic features and symptoms in patients with XP in this case series.

Patients were examined consecutively at the University Hospital of the Federal University of Goias between January 2016 and June 2018. All patients underwent ophthalmologic examination and were asked about their ophthalmological history and the presence of ocular symptoms.

Twenty-one patients with genetic confirmation were evaluated. The genetic variants XPV and XPC were detected in the patients. The most prevalent findings include eyelid changes, observed in 80.9% of the patients, and ocular surface changes as punctate keratopathy, occurring in 16 patients (76.2%), corneal neovascularization, and corneal opacities. Six patients (28.5%) presented corneoconjunctival tumor. More than half of patients had previous history of treatment of ocular neoplasia. Ocular burning was the most reported symptom.

The ocular characteristics identified in this study corroborate the existing literature, mainly related to the surface. Concerning the XP variant and the gravity of ocular signs, XPC has earlier and more severe symptoms than XPV. Due to their relative rarity, publications of XP cases are important to understand the possible damages caused by the disease in the eyes and surrounding area.

Application of 14-MHz Ultrasonography with Tissue Harmonic Imaging to Determine Posterior Capsule Integrity in Traumatic Cataract.

J Ophthalmol

To report the application of 14-MHz ultrasonography with tissue harmonic imaging (14 MHz + THI) to determine the integrity of the posterior capsule (PC) in traumatic cataract (TC).

Patients with TC who were scheduled to undergo cataract extraction and whose PC could not be observed by slit lamp examination were included in the study. The status of the PC was determined by 14 MHz + THI before cataract extraction and confirmed during surgery. The results regarding PC integrity obtained from 14 MHz + THI and intraoperative direct observation were compared.

The study enrolled 52 eyes of 52 patients (49 men and 3 women), with a mean age of 42.15 years ± 11.23 (SD). The nature of the trauma was blunt (3 eyes) or sharp (49 eyes). The 14 MHz + THI method showed 21 PCs to be intact and 31 to have ruptured before cataract surgery. During surgery, 23 PCs were observed to be intact, while 29 PCs were ruptured. 27 PCs were ruptured and 19 were intact, as determined by the two methods. The 14 MHz + THI observations were consistent with the intraoperative observations of the PC (kappa = 0.764), with no significant difference between the two methods (P=0.687). The sensitivity, specificity, and accuracy of 14 MHz + THI for observation of the PC were 93.10%, 82.60%, and 88.46%, respectively.

The 14 MHz + THI method can accurately reveal the integrity of the PC in TC. It has important clinical value in the selection of cataract surgery methods and the prediction of complications during TC surgery.

Update on Myopia Risk Factors and Microenvironmental Changes.

J Ophthalmol

The focus of this update is to emphasize the recent advances in the pathogenesis and various molecular key approaches associated with myopia in ord...