Glaucoma is a heterogeneous group of chronic neurodegenerative disorders characterized by a relatively selective, progressive damage to the retinal ganglion cells (RGCs) and their axons, which leads ...to axon loss and visual field alterations. To date, many studies have shown the role of various elements, mainly metals, in maintaining the balance of prooxidative and antioxidative processes, regulation of fluid and ion flow through cell membranes of the ocular tissues. Based on the earlier and current research results, their relationship with the development and progression of glaucoma seems obvious and is increasingly appreciated. In this review, we aimed to summarize the current evidence on the role of trace elements in the pathogenesis and prevention of glaucomatous diseases. Special attention is also paid to the genetic background associated with glaucoma-related abnormalities of physiological processes that regulate or involve the ions of elements considered as trace elements necessary for the functioning of the cells.
This study aims to investigate the prevalence of visual impairments, such as myopia, hyperopia, and astigmatism, among school-age children (7-9 years) in Lubelskie Voivodeship (Republic of Poland) ...and apply artificial intelligence (AI) in the detection of severe ocular diseases. A total of 1049 participants (1.7% of the total child population in the region) were examined through a combination of standardized visual acuity tests, autorefraction, and assessment of fundus images by a convolutional neural network (CNN) model. The results from this artificial intelligence (AI) model were juxtaposed with assessments conducted by two experienced ophthalmologists to gauge the model's accuracy. The results demonstrated myopia, hyperopia, and astigmatism prevalences of 3.7%, 16.9%, and 7.8%, respectively, with myopia showing a significant age-related increase and hyperopia decreasing with age. The AI model performance was evaluated using the Dice coefficient, reaching 93.3%, indicating that the CNN model was highly accurate. The study underscores the utility of AI in the early detection and diagnosis of severe ocular diseases, providing a foundation for future research to improve paediatric ophthalmic screening and treatment outcomes.
Though several procedures of IOL implantation have been described (sutured scleral fixation, intra-scleral fixation, angle-supported anterior chamber, and anterior chamber or retropupillary iris-claw ...IOLs), there are no randomized trials which are comparing different techniques. Hence, the surgical treatment of aphakia still remains controversial and challenging. The purpose of this study was to compare the long-term efficacy and the rate of complications of anterior versus posterior Iris-claw intraocular lenses (IOL) implantation to correct for the treatment of aphakia without sufficient capsule support.
Consecutive eyes having secondary implantation of aphakic iris-fixated IOLs with a follow-up of at least 5 years were considered. Mean correct distance visual acuity (CDVA) changes, percentage of eyes with CDVA improvement, mean corneal endothelial cell density (CECD) loss and the rate of other complications were used for statistical analysis. The study evaluated a total of 180 eyes (Group A: 87 anterior chamber iris-claw fixation, Group B: 93 retropupillary iris-claw implantation) of 180 consecutive different patients, with aphakia of various reasons. CDVA improved significantly in both groups after surgery (P<0.001, ANOVA), and was remarkably higher than baseline in both groups from first week and during the entire follow-up (P<0.001, Tukey's Honest Significant Difference). There was no statistically significant difference in CDVA between the two groups during each follow-up visits (P = NS, unpaired t-test) and in the CDVA improvement percentage between the two groups (P = 0.882, Chi-square test). No significant changes in CECD were noted after surgery in both groups (ANOVA Group A: P = 0.067, Group B: P = 0.330P). No intra-operative complications occurred in both groups. There was no statistically significant difference in the rate of complications between the two groups (P = NS, Chi-square test), except for pigment precipitates which were higher in Group A (P<0.05, Chi-square test).
Five-year follow-up shows that secondary implantation of aphakic IOLs is effective and safe for the correction treatment of aphakia in eyes without capsule support.
Purpose
To analyse the postoperative foveal avascular zone (FAZ) area, superficial vessel density (SVD) and deep vessel density (DVD) and their correlation with functional (best‐corrected visual ...acuity, BCVA) and anatomical outcomes (foveal macular thickness, FMT) after surgery for rhegmatogenous retinal detachment (RRD) repair.
Method
Patients with RRD eyes, successfully treated with a single pars plana vitrectomy (PPV) with gas tamponade and a minimum 12 months follow‐up, were re‐examined. Foveal avascular zone (FAZ) area, SVD, DVD and FMT were evaluated by using optical coherence tomography angiography (OCTA) and compared to fellow eye.
Results
Fifty‐six patients with macula‐on and 37 with macula‐off RRD were included in the study. In both groups, no difference in FMT and FAZ area was found compared to fellow eyes. In macula‐on RRD eyes, a lower parafoveal DVD (p = 0.001) was detected; FAZ area was related to FMT (p = 0.025), and the postoperative BCVA was correlated with parafoveal DVD (p = 0.010) and FAZ area (p = 0.003). In macula‐off RRD eyes, lower parafoveal SDV (p = 0.012), and foveal and parafoveal DVD (p = 0.012 and p < 0.001, respectively) were observed. BCVA was related to FAZ area (p = 0.012), foveal SVD (p = 0.005) and parafoveal DVD (p = 0.010).
Conclusion
Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower vessel density in the superficial and deep retinal plexus compared to fellow healthy eyes; BCVA was related to FAZ area and vessel density.
The aim of the study is to evaluate the progression of visual field (VF) defects over 16 years of observation and to assess abnormalities in vessels and retinal nerve fibre layer (RNFL) thickness in ...patients with optic disc drusen (ODD). Both static automated perimetry (SAP) and semi-automated kinetic perimetry (SKP) were performed in 16 eyes of 8 patients (mean age 54 years) with ODD among 26 eyes of 13 patients examined 16 years before. The area of I2e, I4e, III4e, and V4e isopters was measured in deg2. The MD and PSD parameters were estimated using SAP. Optical coherence tomography angiography (OCT-A) was additionally performed in 16 ODD eyes and 16 eyes of 8 healthy subjects to estimate the RNFL thickness and vessel density of the optic nerve disc and the macula. The differences in all isopter areas of SKP and SAP parameters after 16 years were not significant. The analysis of OCT-A showed a significant reduction of the vessel density and RNFL of the peripapillary area in each segment in patients with ODD, compared with the control group. The highest reduction of RNFL was observed in the superior segment of the optic disc area (92.56μm vs 126.63μm) also the macular thickness was decreased in ODD patients, compared with the control group. In the macula, there was a significant vascular defect in the whole superficial layer and in the parafoveal deep layer. A strong significant correlation of the parafoveal deep plexus with MD and PSD parameters was detected. In conclusion, VF loss due to ODD after 16 years of the follow-up was not significant both in SKP and SAP. ODD caused a reduced vessel density and RNFL, as well as macular thickness in OCT-A. SAP parameters were influenced by parafoveal deep plexus.
This article aims to provide a comprehensive review of the biochemical changes observed in the anterior chamber of the eye in diabetic patients. The increased levels of inflammatory markers, ...alterations in antioxidant defense mechanisms, and elevated levels of advanced glycation end products (AGEs) in the aqueous humor (AH) are explored. Additionally, the impact of these biochemical changes on diabetic retinopathy progression, increased intraocular pressure, and cataract formation is discussed. Furthermore, the diagnostic and therapeutic implications of these findings are presented. This study explores potential biomarkers for detecting diabetic eye disease at an early stage and monitoring its progression. An investigation of the targeting of inflammatory and angiogenic pathways as a potential treatment approach and the role of antioxidant agents in managing these biochemical changes is performed.
•A systemic inflammatory response frequently coexists with status epilepticus, and therefore should be assessed routinely.•The assessment of SIRS among SE patients, may contribute to more effective ...planning of treatment and outcome prediction.•There is a link between the presence of SIRS and resistance to SE treatment.
This study was aimed at identifying patients with systemic inflammatory response syndrome (SIRS) and determining whether the presence of SIRS on admission was associated with drug resistance and poor outcome in status epilepticus (SE) patients.
We conducted a prospective review of patients consecutively admitted to two territory centers over a 7-year period. SIRS was considered present if the necessary criteria persisted for 12h. Other potential outcome predictors in a cohort of patients with SE were also collected. The primary outcome was defined as mortality during 30 days of observation, and the secondary outcome was defined as refractory SE. Logistic regression was used to determine independent predictors.
Of 127 subjects, 85 patients met the inclusion criteria. In the entire population, 43% developed SIRS at SE onset and, among them, 16% had SIRS attributed to SE alone. Subjects with refractory SE accounted for 39%, and the mortality rate for the entire population was 35%. SIRS was independently associated with drug resistance (OR 3.93, 95% CI: 1.57–9.9) and death (OR 6.76, 95% CI: 1.33–34.32).
We observed that approximately half of the patients with SE developed SIRS, and that SIRS is the independent risk factor for drug resistance and death. We also observed that SIRS was a secondary event for SE itself.
Technological advancement has brought commendable changes in medicine, advancing diagnosis, treatment, and interventions. Telemedicine has been adopted by various subspecialties including ...ophthalmology. Over the years, teleophthalmology has been implemented in various countries, and continuous progress is being made in this area. In underserved populations, due to socioeconomic factors, there is little or no access to healthcare facilities, and people are at higher risk of eye diseases and vision impairment. Transportation is the major hurdle for these people in obtaining access to eye care in the main hospitals. There is a dire need for accessible eye care for such populations, and teleophthalmology is the ray of hope for providing eye care facilities to underserved people. Numerous studies have reported the advantages of teleophthalmology for rural populations such as being cost-effective, timesaving, reliable, efficient, and satisfactory for patients. Although it is being practiced in urban populations, for rural populations, its benefits amplify. However, there are certain obstacles as well, such as the cost of equipment, lack of steady electricity and internet supply in rural areas, and the attitude of people in certain regions toward acceptance of teleophthalmology. In this review, we have discussed in detail eye health in rural populations, teleophthalmology, and its effectiveness in rural populations of different countries.
The study aimed to analyze the changes within the bioelectrical activity of the cervical spine and masticatory muscles during the change of visual stimulus-open and closed eyes test. After applying ...the inclusion criteria, 50 subjects were included in the study, with visual impairment ranging from -0.5 to -5.75 Diopters. Four muscle pairs were analyzed: the anterior part of the temporalis muscle (TA), the superficial part of the masseter muscle (MM), the anterior belly of the digastric muscle (DA), and the middle part of the sternocleidomastoid muscle (SCM) belly during rest, teeth clenching, teeth clenching on dental cotton rollers, and active mouth opening. Statistical analysis showed a significant decrease in the bioelectrical activity during teeth clenching of all analyzed muscles during the closed eyes test. Significant decreases of electromyographic values were also observed during resting activity within TA muscles, during teeth clenching with dental cotton rollers within SCM and DA muscles, and during active mouth opening within the right masseter. Changing the visual stimulus from open eyes to closed eyes in people with myopia affects the bioelectrical activity of the masticatory and cervical spine muscles.
•Residual attention network (RAN) - is network architecture, which employs convolutional layers, integrates a diverse attention mechanism within its deep structure.•Our study shows that RAN is a ...suitable tool for distinguishing between optic disc drusen and normal optic discs on the basis of OCT-A B-scans of the optic nerve head.•Deep learning in ocular imaging may be used as a possible solution to screen, diagnose and monitor major eye diseases for patients in primary care and community settings, including ODD.
In this study the authors propose a new solution for distinguish healthy cases and those with optic disc drusen (ODD) utilizing Residual Attention Network (RAN). This network architecture, which employs convolutional layers, integrates a diverse attention mechanism within its deep structure. In this study, an unique approach is adopted, involving the iterative division and subsequent recombination of a single image B-scan obtained using OCT-A. Overall, 116 images of ODD obtained using optical coherence tomography - angiography (OCT-A) have been analysed and compared to images of healthy optic discs. A sequence of trials was conducted, considering the random partitioning of data into training, validation, and test elements, with proportions of 60 %, 20 %, and 20 %, respectively. The minimum accuracy exceeded 86 %, while the maximum values were higher than 98 %. The accuracy for analyzing healthy cases and ones with ODD has gained very satisfactory results. Our study shows that RAN is a suitable tool for distinguishing between optic disc drusen and normal optic discs on the basis of OCT-A B-scans of the optic nerve head. Deep learning may be used as a possible solution to screen for patients with ODD.
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