The optimal surgery to repair rhegmatogenous retinal detachment (RRD) is unknown. The purpose of this trial was to compare outcomes of pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) ...for the management of primary RRD.
Prospective, randomized controlled trial.
Patients with RRD demonstrating a single retinal break or a group of breaks in detached retina within 1 clock hour above the 8- and 4-o'clock meridians, with any number, location and size of retinal breaks or lattice degeneration in attached retina.
Patients were randomized to undergo either PnR or PPV. Macula-on and macula-off patients were assigned to intervention group by stratified randomization and were treated within 24 and 72 hours, respectively.
The primary outcome was 1-year Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA). Important secondary outcomes were subjective visual function (25-item National Eye Institute Visual Function Questionnaire), metamorphopsia score (M-CHARTS), and primary anatomic success.
One hundred seventy-six patients were recruited between August 2012 and May 2016. ETDRS VA after PnR exceeded that after PPV by 4.9 letters at 12 months (79.9±10.4 letters vs. 75.0±15.2 letters; P = 0.024). Mean ETDRS VA also was superior for the PnR group compared with the PPV group at 3 months (78.4±12.3 letters vs. 68.5±17.8 letters) and 6 months (79.2±11.1 letters vs. 68.6±17.2 letters). Composite 25-item National Eye Institute Visual Function Questionnaire scores were superior for PnR at 3 and 6 months. Vertical metamorphopsia scores were superior for the PnR group compared with the PPV group at 12 months (0.14±0.29 vs. 0.28±0.42; P = 0.026). Primary anatomic success at 12 months was achieved by 80.8% of patients undergoing PnR versus 93.2% undergoing PPV (P = 0.045), with 98.7% and 98.6%, respectively, achieving secondary anatomic success. Sixty-five percent of phakic patients in the PPV arm underwent cataract surgery in the study eye before 12 months versus 16% in the PnR group (P < 0.001).
Pneumatic retinopexy should be considered the first line treatment for RRD in patients fulfilling Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) recruitment criteria. Pneumatic retinopexy offers superior VA, less vertical metamorphopsia, and reduced morbidity when compared with PPV.
IntroductionThere is a notable under-representation of women in leadership positions in ophthalmology despite the increasing number of women as ophthalmologists. Gender inequality in editorial boards ...of ophthalmology journals has not been investigated on a global scale. This study will aim to evaluate the representation of women as editorial board members in ophthalmology journals across different regions, journal subspecialties and impact factors.Methods and analysisThis will be a cross-sectional study describing the gender composition of editorial boards in ophthalmology journals globally. Ulrich’s Periodicals Directory and SCImago Journal & Country Rank will be used to comprehensively identify journals indexed with the keyword, ‘ophthalmology’. All journals with active websites and lists of editorial boards will be included. Journals will be categorised according to the World Bank’s 2021 classification of countries by income and region, and classified into ophthalmology subspecialties based on publication scope. Impact factors will be obtained from Journal Citation Reports. The gender and academic degrees of each editorial board member will be determined based on journal profiles, institutional websites or name query feature on an online interface. The research impact of each editorial board member will be ascertained from the author records on Web of Science. The gender proportion will be presented for all journals combined, and then for journals grouped by regions, subspecialties and impact factors. Editorial board member characteristics including academic degrees and research productivity measures will be compared between men and women. These comparisons will be made using the χ2 test for categorical variables and the independent samples t-test for continuous variables.Ethics and disseminationThis study did not require research ethics approval given the use of publicly available data and lack of human subjects. The results will be presented at scientific meetings and published in peer-reviewed journals.
ObjectivesThe objective of this analysis is to present a current view of the field of ophthalmology and vision research and artificial intelligence (AI) from topical and geographical perspectives. ...This will clarify the direction of the field in the future and aid clinicians in adapting to new technological developments.MethodsA comprehensive search of four different databases was conducted. Statistical and bibliometric analysis were done to characterise the literature. Softwares used included the R Studio bibliometrix package, and VOSviewer.ResultsA total of 3939 articles were included in the final bibliometric analysis. Diabetic retinopathy (391, 6% of the top 100 keywords) was the most frequently occurring indexed keyword by a large margin. The highest impact literature was produced by the least populated countries and in those countries who collaborate internationally. This was confirmed via a hypothesis test where no correlation was found between gross number of published articles and average number of citations (p value=0.866, r=0.038), while graphing ratio of international collaboration against average citations produced a positive correlation (r=0.283). Majority of publications were found to be concentrated in journals specialising in vision and computer science, with this category of journals having the highest number of publications per journal (18.00 publications/journal), though they represented a small proportion of the total journals (<1%).ConclusionThis study provides a unique characterisation of the literature at the intersection of AI and ophthalmology and presents correlations between article impact and geography, in addition to summarising popular research topics.
To assess the safety and efficacy of short-term DensironXTRA tamponade for repair of complicated rhegmatogenous retinal detachments (RRD). This is a retrospective consecutive case series of patients ...undergoing pars plana vitrectomy (PPV) with intravitreal DensironXTRA and a comparator group with gas (sulfur hexafluoride (SF
) or perfluoropropane (C
F
)) tamponades by a single surgeon between January 2017 and November 2020 at a tertiary care centre. A total of 121 eyes with DensironXTRA and 81 comparator eyes with a gas tamponade were included. The DensironXTRA group had a significantly higher number of cases with inferior breaks (82% vs. 48%; p < 0.0001) and a history of previous PPV for RRD (64% vs. 12%; p < 0.0001). DensironXTRA was removed after a median period of 70 (IQR: 48.5-105.5) days. There was similar anatomical success in both the comparator gas tamponade and DensironXTRA groups (98.8% vs. 97.5%, p = 0.6506). Although both groups experienced a significant improvement in visual acuity, this change was significantly higher in the comparator gas tamponade group versus DensironXTRA group (p = 0.0017). There was no significant change in IOP in the DensironXTRA group (mean difference - 0.7; 95% CI - 1.753 to 0.331, p = 0.1785). The rates of complications were low and not significantly different between the two groups. There was no evidence for central macular thinning with DensironXTRA compared to the contralateral eye without RRD as well as with DensironXTRA in situ versus after its removal. DensironXTRA is a promising short-term tamponade agent with good anatomical and functional outcomes and low rates of complications for the repair of complicated RRDs.
Hyperpalatable foods are highly pleasurable and possess a heightened capacity to stimulate eating. Adolescents appear especially vulnerable to hyperpalatable foods. These foods are typically high in ...sugar, fat, or both, but the specific elements that underlie their increased consumption are still not clearly understood. Combinations of high fat and high sugar may particularly intensify overeating. Animal models allow investigation of the consumption of these foods separately from many of the environmental and psychological influences that impact eating in humans. The current study compared intakes of sucrose, fat, and a sucrose-fat combination when offered to male and female rats intermittently (2 h, three times per week for five weeks) during the vulnerable period of adolescence. Consumption of these foods, and of freely available normally nutritive lab chow was measured. Animals given the sucrose-fat food consumed significantly more than all other groups and were the only group to show significant increases in consumption during the first week. Moreover, the sucrose-fat group consumed significantly less chow than any other group. In comparison with previous reports in adult rats, adolescent rats appeared to heighten consumption of the sucrose-fat food more markedly and to show less pronounced sex differences. These data highlight the unique vulnerability and increased biological susceptibility of adolescent rats to sweet-fat food rewards and demonstrate the need to similarly investigate the preference for and the consumption of different hyperpalatable foods in human adolescents.
Background
Canada’s fee-for-service physician reimbursement system, where a set rate is provided for each service, suggests that a physician sex pay gap should not exist. However, recent evidence has ...questioned this presumption.
Objectives
To characterize trends in demographics and billing, overall and by sex, for dermatologists compared to other medical and surgical specialty groups in Ontario, Canada.
Methods
Using population-based data, analysis of physician billing and clinical activity from Ontario, Canada, over 27 years (1992-2018) was performed. Multilevel regression models were used to examine unadjusted and adjusted differences in payments between females and males over time, while controlling for age, distinct patients seen, patient visits, and full-time equivalent.
Results
A total of 22 389 physicians were included in the analyses, including 381 dermatologists. The proportion of female dermatologists increased from 32% in 1992 to 46% in 2018. Dermatologists’ median Ontario Health Insurance Plan (OHIP) payments were $415 340 (IQR: 285 630-566 580) in 1992 compared to $296 750 (IQR: 164 480-493 180) in 2018. Male dermatologists’ OHIP payments were 20% more than their female counterparts across the entire study period. After adjusting for practice volumes, there was no significant pay gap amongst female and male dermatologists (P = .42); however, the sex pay gap remained significant for the other specialty groups (P < .001). From 1992 to 2018, dermatologists on average saw 19% fewer distinct patients per year and 15% fewer visits per patient.
Conclusions
The overall sex pay gap within medical dermatology can be attributed to differences in practice patterns, whereas the sex pay gap remained significant in the other specialty groups.
ObjectiveThis study aimed to examine the publication patterns and present a current view of the field of uveitis using a bibliometric analysis.DesignBibliometric analysis.Methods and analysisA ...comprehensive search of three databases including MEDLINE, EMBASE and Cochrane was conducted from 1 January 2000 to 31 December 2022. Search results from all three databases were subjected to analysis by Bibliometrix, an R programme that analyses large literature dataset with statistical and mathematical models. Visualisation of collaboration networks and relevance between countries was presented with VOSviewer.ResultsA total of 26 296 articles were included in the analysis. The field of uveitis has undergone a significant exponential growth since 2000, with an average growth rate of 4.14%. The most substantial annual growth was between the years 2021 and 2022 (36%). According to the corresponding author’s countries, the three most productive countries were Turkey (3288, 12.6%), the USA (3136, 12%) and Japan (1981, 7.6%). The USA (243, 31.4%), England (117, 15%) and Germany (62, 8%) are the top three countries that contributed to clinical trials. The average international collaboration of all countries was 2.5%.ConclusionsUveitis literature has undergone significant growth in the past two decades. The demographic factors of publishing countries lead to their various productivity and types of these uveitis studies, which is closely associated with the countries’ scientific research resources and patient populations.
ObjectiveIn this study, we investigated the demographic trends of patients undergoing ophthalmic surgeries based on geographic region, priority level, and sex.Methods and analysisThis ...population-based retrospective cohort study used the Ontario Health Wait Times Information System (WTIS) database from 2010 to 2021. The WTIS contains non-emergent surgical case volume and wait time data for 14 different regions, three priority levels (high, medium and low) and six ophthalmic subspecialty procedures.ResultsOver the study period, on average 83 783 women and 65 555 men underwent ophthalmic surgery annually in Ontario. Overall, women waited an aggregate mean of 4.9 days longer than men to undergo surgery, and this disparity persisted across all geographic and priority stratifications. The average age at the time of surgery has been increasing slowly at a rate of 0.02 years/year (95% CI 0.00 to 0.05), with women being 0.6 years older than men overall.ConclusionThese findings indicate that women have consistently longer wait times than men. The results of this study may be a sign of systemic sex-based differences that could be affecting women who need to be further explored for health equity.
IntroductionThe aim of this study is to provide an insight into the literature at the intersection of artificial intelligence and ophthalmology.Methods and analysisThe project will be performed in ...four key stages: formulation of search terms, literature collection, literature screening and literature analysis. A comprehensive search of databases including Scopus, Web of Science, Dimensions and Cochrane will be conducted. The Distiller SR software will be used for manual screening all relevant articles. The selected articles will be analysed via R Bibliometrix, a program for mathematical analysis of large sets of literature, and VOSviewer, which creates visual representations of connections between articles.Ethics and disseminationThis study did not require research ethics approval given the use of publicly available data and lack of human subjects. The results will be presented at scientific meetings and published in peer-reviewed journals.
Women have historically been under-represented in the editorial boards of ophthalmology journals despite the increasing proportion of women in ophthalmology over the past decades.1 Previous studies ...have only characterised representation of women as editors for select journals based mainly in North America.2 3 The purpose of this cross-sectional study was to evaluate the representation of women in editorial boards of ophthalmology journals globally and across various ophthalmology subspecialty journals. This study also compared the demographic characteristics and research productivity between men and women in the editorial board.
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