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Purpose: The objective of this study was to evaluate the clinical efficacy of a 4D digital strabismus and amblyopia visual function correction system (4D-DSAAVFCS) in combination with conventional modalities compared with conventional modalities alone in children with anisometropic amblyopia. Methods: This nonrandomized controlled study collected data on best-corrected visual acuity (BCVA), simultaneous vision, fusion vision, near stereoscopic vision, the amplitude of P100 wave (graphic evoked visual potentials), and the latency of P100 wave from both eyes at the beginning of the treatment and one year later. The Mann‒Whitney U test was used to compare BCVA contrasts in different subgroups, and the independent samples t test was used to compare the amplitude and latency of P100 wave contrasts in different subgroups. The basic cure rate, simultaneous vision recovery rate, fusion vision recovery rate, and near stereoscopic vision recovery rate contrasts in different subgroups were compared via the chi-square test. Results: This study included 393 children (217 boys and 176 girls) aged 3 to 12 years with anisometropic amblyopia who were treated at the Aier Eye Hospital of Wuhan University from January 2020 to December 2022. The children were divided into two groups, the 4D group (263 cases) and the traditional group (130 cases), on the basis of the treatment modality. The children in the traditional group received treatment through the conventional method of occlusion and regular training. Meanwhile, the children in the 4D group received treatment through the traditional method and the 4D-DSAAVFCS. The 4D group was divided into two age groups: 3 ~ 6 years (161 cases) and 6 ~ 12 years (102 cases). The basic cure rate of the 4D group was significantly better than that of the traditional group (χ2 = 4.318, P < 0.05). There were no statistically significant differences in the BCVA, the latency of P100 wave, or the amplitude of P100 wave between the 4D group and the traditional group before treatment (U=-0.117, t=-0.05, all P > 0.05). After one year of treatment, a statistically significant difference was observed between the 4D group and the conventional group in terms of BCVA, the latency of P100 wave, and the amplitude of P100 wave (U=-1.243, t=-0.853, t=-1.546, all P < 0.05). These results suggest that the therapeutic effect was greater in the 4D group than in the conventional group. The recovery rates of simultaneous vision, convergent fusion, divergent fusion, and near stereoscopic vision were significantly greater in the 4D group than in the conventional group (χ2 = 4.344, 4.726, 5.123, and 2.036, respectively; all P < 0.05). Additionally, the basic cure rate of children aged 3 ~ 6 years in the 4D group was significantly greater than that of children aged 6 ~ 12 years (χ2 = 2.365, P < 0.05). In this study, BCVA was significantly lower in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (U = -1.267, P < 0.05). Similarly, the amplitude of P100 wave was also significantly greater in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (t = -1877, P < 0.05). The latency of P100 wave was lower in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (t=-0.998, P < 0.05). Additionally, the recovery rate of near stereoscopic vision was significantly greater in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (χ2 = 4.534, P < 0.05). Conclusion: The combination of the traditional method with the 4D-DSAAVFCS was more effective than the traditional method alone in treating amblyopic children. This approach was particularly helpful in improving the visual acuity of the children and restoring their optic nerve conduction function, simultaneous vision, fusion vision, and near stereoscopic vision. The combination of the traditional method and the 4D-DSAAVFCS is more effective for younger children. [ABSTRACT FROM AUTHOR]

Background: Bandage contact lenses are important aids for aftercare following ocular surgery and for a wide variety of ocular surface conditions. However, bandage contact lenses also bear the risk of fostering microbial infections of the cornea. We herein report the safety profile of bandage contact lenses from a comprehensive review of medical records in a tertiary care eye hospital in Germany. Methods: We identified 638 consecutive patients who had been prescribed at least one bandage lens during the past 10 years. For these, we performed a computerized search for the following adverse events: (1) endophthalmitis, (2) emergency keratoplasty and (3) vision loss of at least 2 lines according to the Early Treatment Diabetic Retinopathy Study (ETDRS). We manually assessed the relatedness of each event to the bandage lens. Events later than 100 days following the bandage lens prescription were not considered to be related to bandage contact lenses. Results: We observed 267 adverse events, with 120 occurring within 100 days after bandage lens prescription. This left a total of 18 endophthalmitis events, 21 penetrating keratoplasties and 81 eyes with vision loss of at least 2 ETDRS lines (for individual review of relatedness). Only two episodes of endophthalmitis could be linked to bandage lens wear. All other adverse events were due to causative conditions that had already been present prior to bandage contact lens insertion. Conclusions: Severe adverse events after bandage contact lens wear are not uncommon because lenses are used in patients suffering from preexisting ocular conditions. However, severe adverse events were almost never caused by the bandage contact lenses directly in our hands. We therefore conclude that bandage contact lenses are safe given proper ophthalmological supervision. [ABSTRACT FROM AUTHOR]

Backgroud: The aim of this study was to investigate the associations between fluctuation in blood pressure (BP), ocular perfusion pressure (OPP) and visual field (VF) progression in normal-tension glaucoma (NTG). Methods: This prospective, longitudinal study included 44 patients with NTG. Only newly diagnosed NTG patients who had not been treated with a glaucoma medication were included. Patients were examined every year for 7 years. Intraocular pressure (IOP), heart rate (HR), systolic BP (SBP), diastolic BP (DBP), ocular perfusion pressure (OPP), and diastolic ocular perfusion pressure (DOPP) were measured at the same time. Ophthalmic examinations, including perimetry, were performed also. Initial VF were compared with follow-up data after 7 years. Results: After 7 years of follow-up, 9 of the 44 patients showed VF progression. The standard deviation (SD) of SBP and OPP were significantly associated with VF progression (P = 0.007, < 0.001, respectively). Multiple regression analysis showed that VF progression was significantly associated with SD of OPP (odds ratio, OR = 2.012, 95% CI = 1.016–3.985; P = 0.045). Conclusions: Fluctuation in OPP was associated with VF progression in patients with NTG. [ABSTRACT FROM AUTHOR]

Background: Few ocular trauma studies have addressed mortality outcomes. We sought to determine characteristics of mortality-related ocular trauma admissions and compared them with non-fatal injuries. Methods: A retrospective study was conducted using de-identified data of patients admitted with major trauma from the National Trauma Data Bank (2008–2014). Patients with ocular injury were identified using ICD- 9CM codes. Demographics, intention and mechanism, types of ocular and head injuries, and injury severity were documented. Mortality was determined using post-admission disposition. Statistical analysis using student t-test, chi-square, and odds ratios (OR) calculations were performed with STATA-17 software. Significance was set at P < 0.05. Results: Of 316,485 patients admitted with ocular trauma, 12,233 (3.86%) were mortality related. Expired patients were older than survivors: mean (SD) of 50.1(25.5) vs. 41.5(22.8) years. White (OR = 1.32; P < 0.001), ≥ 65years old (OR = 2.25; P < 0.001), and male (OR = 1.05; P = 0.029) patients were most likely to expire than their counterparts. Common mechanisms of injury in survivors were falls (25.3%), motor vehicle traffic-occupant, MVTO (21.8%) and struck by/against (18.1%) and for fatal injuries, falls (29.7%), MVTO (21.9%) and firearms (11.5%). Traumatic brain injury (TBI) was documented in 88.2% of mortality-related admissions. Very severe injury severity scores (ISS > 24) (OR = 19.19; P < 0.001) and severe Glasgow Coma Score (GCS < 8) (OR = 19.22; P < 0.001) were most associated with mortality than survival. Firearms were most associated with very severe ISS (OR = 3.73; P < 0.001), severe GCS (OR = 4.68; P < 0.001) and mortality (OR = 5.21; P < 0.001) than other mechanisms. Patients with cut/pierce injuries had the greatest odds of survival (OR = 13.48; P < 0.001). Optic nerve/visual pathways injuries (3.1%) had the highest association with very severe ISS (OR = 2.51; P < 0.001), severe GCS (OR = 3.64; P < 0.001) and mortality (OR = 2.58; P < 0.001) than other ocular injuries. Black patients with very severe ISS (OR = 32.14; P < 0.001) and severe GCS (OR = 31.89; P < 0.001) were more likely to expire than other race/ethnicities with similar injury severity. Conclusions: Mortality-related admissions were older, male, and mostly of White race than ocular trauma admissions of survivors. Firearms were the deadliest mechanism. TBI was commonly associated and patients with optic nerve/pathway injuries, very severe ISS and severe GCS had higher mortality rates. Characteristics and demographic variations identified in this study may be useful in developing focused measures aimed at preventing trauma-related deaths. [ABSTRACT FROM AUTHOR]

Background: This study aimed at comparing drivers' and non-drivers' results in the Adult Developmental Eye Movement with Distractors test (ADEMd) and the Useful Field of View test (UFOV). Methods: One hundred and twenty Spaniards (mean age 50.90 ± 17.32 years) without eye disease voluntarily participated in this cross-sectional descriptive study. Participants in a single experimental session completed a questionnaire on sociodemographic, health, eyesight, and driving information. They also performed the ADEMd and UFOV tests randomly following standardized protocols. The ADEMd is a visual-verbal test that measures saccadic efficiency and visual attention. Brown-Forsythe (B–F) tests with Games-Howell post-hoc adjustments were conducted to assess differences between groups. Groups were formed according to sex, age (young adults, adults, and older adults), and driver/non-driver for further analysis. Additionally, associations between dependent variables were assessed through Spearman's correlations. Results: Drivers obtained significantly better results in the ADEMd compared with non-drivers. Non-significant differences between drivers and non-drivers were encountered in the UFOV. Additionally, significant differences were observed between sexes and age groups. It is worth highlighting that non-driver's age significantly correlated with worse ADEMd performance (rho =.637 to.716). This correlation was non-significant in drivers. Similarly, reading hours significantly correlated with better ADEMd performance in non-drivers (rho = −.291 to −.363), but not in drivers. The only significant correlations between ADEMd and UFOV tests were found in drivers (rho =.307 to.410). Conclusion: Considering all the discussed results, it could be hypothesized that the driving task promotes abilities, such as oculomotor and cognitive function, which are relevant for the performance in the ADEMd. However, this hypothesis is based on correlational outcomes and further studies should causally assess this possible relation. [ABSTRACT FROM AUTHOR]

Background: Readmissions and in-hospital mortality among patients with severe vision impairment or blindness (SVI/B) has not been fully studied. We investigated hospital outcomes for adults with SVI/B in the United States. Methods: Using the Nationwide Readmission Database year 2017, we analyzed primary outcomes for thirty-day readmission rates for patients with and without SVI/B. Secondary outcomes were in-hospital mortality rates for readmitted patients, in-hospital mortality rates for index patients, the five most common principal diagnoses for readmission, and resource utilization. Results: 34,558 patients had an index admission for SVI/B vs. 24,600,000 who did not. Patients with SVI/B had a 13.3% [4,383] readmission rate within 30 days compared to 8.4% [2,033,329] without SVI/B. Compared to readmitted patients without SVI/B patients, those with SVI/B were older (mean [SD] age: 64.4 [SD ± 19] vs. 61.4 [SD ± 20] years) and had more comorbidities (Charlson comorbidity score ≥ 3: 79.2% [ 3,471] vs. 60.9% [1,238,299]). The mortality rate among patients readmitted with SVI/B was 5.38% [236] vs. 4.02% [81,740] for patients without SVI/B, p-value = 0.016. Top reasons for readmissions among patients with SVI/B included sepsis 12% [526], heart failure 10.5% [460)], acute renal failure 4.4% [193], complications due to type II diabetes mellitus 4.1% [178], and pneumonia 2.7% [118]. The mean length of stay for readmitted patients with SVI/B was 6.3 days (confidence interval [CI]: 6.0-6.7 days), vs. 5.6 days for patients without SVI/B (CI: 5.5–5.8 days), p-value < 0.01. The mean hospital charges for readmitted patients with SVI/B was $57,202 (CI: $53,712–$61,292) vs. $51,582 (CI: $49,966–$53,198), p-value < 0.01. Conclusion: Patients with SVI/B had higher readmission rates and greater mortality on readmissions than those without SVI/B. Interventional studies for optimal discharge strategies are critically needed to improve clinical and resource utilization outcomes in patients with SVI/B. [ABSTRACT FROM AUTHOR]

Background: To explore the efficacy and safety of laser peripheral iridoplasty (LPIp) with different energy levels and locations in the treatment of primary angle closure disease (PACD) assessed by swept-source anterior segment optical coherence tomography (AS-OCT). Methods: We enrolled patients with PACD following best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber gonioscopy, ultrasound biomicroscopy(UBM), optic disc OCT, and visual field examinations. After Pentacam and AS-OCT measurements, the patients were randomly divided into four treatment groups for LPIp with two different energy levels (high vs. low energy) and two locations (far from the periphery vs. near the periphery) and combined with laser peripheral iridotomy. BCVA, IOP, pupil diameter, central anterior chamber depth, anterior chamber volume, anterior opening distance (AOD)500, AOD750, trabecular iris angle (TIA)500, and TIA750 in four quadrants before and after laser treatment were compared. Results: We followed up 32 patients (64 eyes; average age, 61.80 ± 9.79 years; 8 patients/16 eyes per group) for up to 2 years. The IOP of all enrolled patients was decreased after surgery compared to that before (t = 3.297, P = 0.002), the volume of the anterior chamber was increased (t=-2.047, P = 0.047), and AOD500, AOD750, TIA500, and TIA750 were increased (all P < 0.05). Within-group comparisons showed that BCVA in the low-energy/far-periphery group was improved after surgery (P < 0.05). After surgery, the IOP was decreased in the two high-energy groups, whereas the volume of the anterior chamber, AOD500, AOD750, TIA500, and TIA750 were increased in all groups (all P < 0.05). However, when comparing every two groups, the high-energy/far-periphery group showed a stronger effect on pupil dilation than the low-energy/near-periphery group (P = 0.045). The anterior chamber volume in the high-energy/near-periphery group was larger than that in the high-energy/far-periphery group (P = 0.038). The change in TIA500 was for 6 points smaller in the low-energy/near-periphery group than in the low-energy/far-periphery group (P = 0.038). Other parameters showed no significant group differences. Conclusion: LPIp combined with iridotomy can effectively reduce IOP, increase anterior chamber volume, increase chamber angle opening distance, and widen the trabecular iris angle. Intraoperatively, high-energy laser spots positioned one spot diameter from the scleral spur can obtain the best effect and safety. Swept-source AS-OCT can safely and effectively quantify the anterior chamber angle. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of myopia and hyperopia and their associated demographic and ocular factors in people 60 years of age and above. Methods: The sampling was performed using a multi-stage stratified random cluster sampling method. The complete demographic and case history information were collected through an interview. Then, all participants underwent optometric examinations including measurement of uncorrected and best-corrected visual acuity, objective, and subjective refraction. Myopia and hyperopia were defined as a spherical equivalent (SE) refraction worse than -0.50 diopters (D) and + 0.50 D, respectively. Results: Three thousand three hundred ten of 3791 invitees participated, and the data of 3263 individuals were analyzed for this report. The mean age of participants was 68.25 ± 6.53 (60 to 97) years, and 1895 (58.1%) of them were female (number of male/female participants = 1368/1895). The prevalence of myopia and hyperopia was 31.65% (95% CI: 29.68 -33.61) and 45.36% (95% CI: 43.36 -47.37), respectively. The prevalence of severe myopia and hyperopia was 1.14% (95% CI: 0.73 -1.55) and 2.27% (95% CI: 1.57 -2.97), respectively. Based on the results of multiple logistic regression, the prevalence of myopia had a statistically significant direct relationship with age (OR: 1.04; p < 0.001), history of glaucoma surgery (OR:2.75; p < 0.001), pseudophakia (OR: 2.27; p < 0.001), axial length (OR:3.05; p < 0.001), and mean keratometry (OR:1.61; p < 0.001). The education level was significantly inversely related to the myopia prevalence. Moreover, a history of glaucoma surgery (OR:0.44; p < 0.001), pseudophakia (OR = 0.15; p < 0.001), axial length (OR:35; p < 0.001) and mean keratometry (OR:0.62; p < 0.001) were significantly inversely related to the prevalence of hyperopia. 19% and 40.02% of myopic and hyperopic patients had complete visual acuity after correction of refractive error, respectively. Conclusion: The prevalence of refractive errors was high in the Iranian elderly population. A large percentage of the elderly still did not have complete visual acuity after the correction of refractive errors indicating the necessity for attention to other ocular diseases in this age group. The history of cataract and glaucoma surgery could be associated with a myopic shift of refractive error. [ABSTRACT FROM AUTHOR]

Background: The main way to prevent blindness from Glaucoma is by early detection and diagnosis; and to do so the awareness must be raised among people where Glaucoma is defined as an acquired chronic optic neuropathy characterized by optic disk cupping and visual field loss. Lack of knowledge about this disease is one of the most important reasons that made it develop to advanced stages. Based on that, we conducted scientific research to assess peoples' awareness and knowledge about Glaucoma. After reviewing the literature, it was found that this study is the first in Syria. Methods: We conducted a cross-sectional study in May 2022. The study included participants, who are above 20 years old, from visitors of Al-Mouwasat University Hospital in Damascus, Syria. During one week, Data was gathered according to the questionnaire, which was presented through face-to-face interviews with participants. We have allocated one point (1) to each question. Three levels of knowledge were adopted, namely; weak level from (0) to (3), average level from (4) to (7) and good level from (8) to (11). Associations between participants' demographic and other details were tested using Chi-square test and other tests, and a p-value of < 0.05 was considered significant. Results: A total of 500 participants were interviewed. For awareness of Glaucoma, 33.6% of the participants (n = 168) had heard of Glaucoma, and 66.4% hadn't (n = 332). Mean test results for the knowledge of Glaucoma was 1.62 out of 11, and only 8% of participants (n = 40) had a good knowledge of Glaucoma. Education Level, governorate, and department of hospital that the patient came for significantly affected the knowledge of Glaucoma. Moreover, hospital, Ophthalmologists' Clinics, and health staff (M = 5.45) were the better Resource for information than family, relatives, and friends (M = 3.16). Finally, social media and the Internet group had the lowest mean test results (M = 1.23). These test results were significant, with a p-value < 0.001. Conclusion: The percentage of knowledge and awareness was significantly low. Organized community awareness methods must disseminate more ability to increase the general public's understanding to avoid injury and late diagnosis of Glaucoma. [ABSTRACT FROM AUTHOR]

Background: An increasing prevalence of mental disorders (MDs) has been reported among children and adolescents. However, only few studies have conducted ocular examinations, including those on refractive status, in these groups of patients. Thus, the purpose of this study was to evaluate the refractive status and ocular findings in children and adolescents with MDs compared with matched controls with similar socioeconomic backgrounds. Methods: A total of 178 participants with MDs and 200 controls were recruited between April 2021 and May 2022. All the children and adolescents underwent cycloplegic or noncycloplegic autorefraction and retinoscopy, slit-lamp biomicroscopy, and dilated fundus examinations. Ocular alignment was assessed using Hirschberg, Krimsky, or prism cover tests. The prevalence of refractive errors and ocular findings was the main outcome. Results: Twenty-seven percent of patients with MDs and 8% of controls had ocular findings, the most common of which were conjunctivitis, keratitis, and trichiasis. For refractive status, 70% (124/178) of patients with MDs had myopia ≤-1.00 DS, and 2% (4/178) had hyperopia ≥+2.00 DS. In the control group, 70% (140/200) of patients had myopia ≤-1.00 DS, and 1% (2/200) had hyperopia ≥+2.00 DS. No differences were observed between the MD and control groups. However, the patients in the MD group (14.25±2.69 years) were significantly more susceptible to strabismus (P<0.05) and amblyopia (P<0.01) than those in the control group (13.65±3.04 years). There was a substantial difference between the two groups in the time spent on screen-based devices (P<0.001). Furthermore, mental retardation (OR=3.286, P<0.01), emotional disorders (OR=2.003, P<0.01), and adjustment disorders (OR=2.629, P<0.01) were associated with an increased risk of amblyopia. Depression (OR =1.362, P<0.01) and emotional disorders (OR=2.205, P<0.01) were associated with a higher prevalence of strabismus. Conclusion: Ophthalmological examinations should be performed in children and adolescents with MDs because MDs are associated with a high prevalence of refractive errors and ocular diseases. Detection and intervention of ocular and refractive findings in children and adolescents with MDs are necessary and effective in alleviating the economic burden in healthcare and improving individuals' quality of life [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was evaluate the effect of governmental support in the form of Health Transformation Plan (HTP) on increasing the cataract surgical rate.Methods: The number of cataract surgeries was collected from Iranian cataract surgery clinics during 2019. HTP was implemented in 2014. Forty-seven major and forty-five minor surgery centers were selected from all provinces. In each center, sampling was done from 2012, 2013, 2015, and 2016.Results: On average, 6202 and 7134 cataract surgery rate were performed before and after HTP, respectively. The cataract surgical rate rose by 15.03% after the HTP. After HTP, the proportion of cataract surgery increased by 21.32% in governmental centers and decreased by 17.56%, 24.45%, and 14.89% in private, insurance, and charity centers, respectively. The cataract surgical rate was 4093 and 6026 in the first economic quartile (the poorest), 3669 and 4595 in the second quartile, 5884 and 5928 in the third quartile, and 8427 and 9681 in the fourth quartile (the richest) before and after HTP, respectively. The highest growth in the cataract surgical rate was seen in the first quartile (47.24%) followed by the second (25.26%), fourth (14.88%), and third quartiles (0.74%).Conclusion: The Health Transformation Plan has been successful in increasing the cataract surgical rate in the low-income group and identifying differences in the services as well as the economic groups within the population. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of ocular trauma in Iranian children aged 6-12 years.Methods: This population-based cross-sectional study, comprised the first phase of the Shahroud Schoolchildren Eye Cohort Study on primary school children using cluster sampling in urban areas and census in rural areas. The students underwent the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic, cycloplegic, and subjective refraction. The history of trauma, hospitalization, and surgery due to trauma was collected from parents using a questionnaire.Results: The data of the trauma history was recorded for 5267 out of 5620 students. The mean age of the students was 9.7 ± 1.7 years (range: 6-12 years), 53.7% of them were boys, and 79.3% were from urban areas. A positive history of ocular trauma was found in 285 participants, and the lifetime prevalence of ocular injury (95% CI) was 5.2% (4.6-5.9). Blunt trauma was the most common ocular injury with a prevalence of 66.2%. There was a significant positive assocation between ocular trauma and living in rural areas (OR: 1.49, p: 0.012), older age (OR: 1.17, p < 0.001), and male sex (OR: 1.62, p: 0.002). Furthermore, 9.3% and 4.7% of the traumas required hospitalization and surgical intervention, respectively.Conclusion: This study found a marked prevalence of ocular trauma compared to previous studies. Male sex, older age, and living in rural areas were associated with ocular trauma, which could be due to differences in lifestyle preference, outdoor exposure, and dangerous situations. Educational programs and safety instructions should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the status of astigmatism in preschool children in Wuxi City, and explore the risk factors related to astigmatism. The risk factors related to astigmatism development as predictors can help us identify preschool children who need vision screening at an early stage to ensure good visual quality.Methods: The cross-sectional study was conducted in 10 kindergartens randomly selected in five districts of Wuxi City in November 2018. All preschool children were measured by objective refractometry under non-cycloplegic refraction. The basic information of preschool children was collected. The relevant factors of astigmatism in the questionnaire were completed by parents. Spss 26. 0 software was used for univariate and multivariate correlation analysis.Results: A total of 889 preschool children participated in the study, 864 were finally included in the study. The prevalence of astigmatism was 36.0%. The risk of astigmatism in premature children was higher than that in non-premature children (adjusted odds ratio = 1.841). The prevalence of astigmatism with parents' astigmatism history was higher, compared with preschool children without parents' astigmatism history (adjusted odds ratio = 2.037). When maternal age at childbirth was older (≥ 35 years old), the risk of astigmatism increased in preschool children (adjusted odds ratio = 2.181). Compared with bottle feeding, the risk of astigmatism for mixed feeding and breastfeeding reduced in preschool children. Compared with preschool children exposed to electronic screen for less than 2 h every day, preschool children exposed to electronic screen for more than 2 h had an increased risk of astigmatism (P = 0.004).Conclusion: The prevalence of astigmatism among preschool children in Wuxi City was high. Some risk factors such as premature birth, parents' astigmatism history, maternal age at childbirth, feeding pattern, and electronic screen exposure time were closely related to the occurrence of astigmatism among preschool children. For preschool children with significant risk factors, their eyesight should be checked regularly to ensure their visual quality. [ABSTRACT FROM AUTHOR]

Background: Based on endophthalmitis vitrectomy study, intravitreal injection of antibiotics is preferred for initial management of cases of acute post cataract surgery endophthalmitis (APCE) with presenting vision of hand motions (HM). This study aimed to compare outcomes of early and complete vitrectomy (VIT) and vitreous tap and antibiotic injection (T&I) in cases of APCE presented with vision of HM.Methods: In this prospective study, cases of APCE with vision of HM between 2018 and 2020 were enrolled. According to the time of presentation, the patients were arranged into two groups (VIT vs. T&I). Demographic data, elapsed time to developing endophthalmitis, past medical history, microbiology results, complications, and final visual acuity were recorded and analyzed.Results: Seventy-six eyes of 76 patients were enrolled. Fifty-three eyes underwent T&I and twenty-three were arranged into the VIT group. Past medical history of 34.2% of patients was significant for diabetes mellitus. There was a statistically significant lower logMAR in VIT group compared to T&I group (diff = 0.14, 95% CI: 0.04 to 0.24, P-value = 0.007). The comparison of the diabetic and non-diabetic patients in both groups showed that the visual outcome was better in non-diabetic cases compared to the diabetic subjects. There was no statistically significant difference between the diabetic and non-diabetic groups regarding the superiority of procedure.Conclusion: Based on our results, we could recommend that it's maybe better to do early and complete vitrectomy as the initial management of APCE with the vision of HM. Past medical history of diabetes mellitus is not a determining factor for choosing initial management between vitrectomy and antibiotic injection. [ABSTRACT FROM AUTHOR]

Background: To determine the 12-year incidence of and trends in rhegmatogenous retinal detachment (RRD) requiring surgery in Korea.Methods: This was a nationwide, population-based, retrospective study. We identified 53,179 patients with incident RRD requiring surgery using the Korean National Health Claims Database from 2004 to 2015. We estimated the crude incidence rates and age- and sex-standardized incidence rates per 100,000 person-years in each year during the study period. A joinpoint regression analysis was performed to determine the trend.Results: The average annual incidence rate was 9.78 (95% CI: 9.70-9.86). Male patients showed an incidence rate (10.68 [95% CI: 10.57-10.80]) 1.20 times that of female patients (8.87 [95% CI: 8.76-8.98]). The incidence showed a bimodal distribution; the highest peak was in the 60-64 year age group (23.77 [95% CI: 23.18-24.35]) and the second peak was in the 20-24 year age group (7.68 [95% CI: 7.41-7.95]). An increasing trend of RRD incidence was observed in the total population throughout the study period using joinpoint analysis (annual percentage change [APC], 2.05; 95% CI: 0.7-3.4). The increasing trend was more prominent among individuals aged under 50 years (APC, 3.44; 95% CI: 2.3-4.6), while among those aged 50 years or above, the increasing incidence was observed only in male patients.Conclusions: In Korea, the incidence of RRD has increased recently. People in the < 50 year age group accounted for the major part of this significant increase, which is related to the increasing incidence of myopia in the young generation in Asia. [ABSTRACT FROM AUTHOR]

Background: Existing evidence suggests that visual field defect in eyes with glaucoma significantly varies between individuals. The following study compared the central visual field defects with the peripheral visual field defects in patients with suspect glaucoma and primary open-angle glaucoma (POAG) and investigated whether using the central visual field test alone could result in loss of clinically valuable information.Methods: In this prospective observational study, 167 eyes from 89 patients with suspect glaucoma or POAG were first examined with static automated perimetry (SAP), followed by a peripheral visual field test on Octopus 900 perimeter (Haag-Streit, Koeniz, Switzerland). The peripheral visual field test was performed by "Auto Kinetic Perimetry" program, in which Goldmann III4e stimuli randomly moved along 16 vectors at a constant angular velocity of 5 deg/s.Results: Glaucomatous peripheral visual field defects were seen in 18% of the eyes with a normal central visual field. In addition, 86% of glaucoma patients with moderate-to-severe central visual field defects had corresponding peripheral visual field defects in the form of localized or diffuse depression of the isopters. Furthermore, a moderate correlation was found between the central and peripheral visual fields. The median test duration was 71 s for the peripheral test and 803 s for the central test (p < 0.001).Conclusions: Our study demonstrated the diversity of glaucomatous visual field defects, as well as the possibility of losing the clinically valuable information due to focusing on the central visual field test alone. The peripheral kinetic perimetry is clinically feasible to complement the central static perimetry for a comprehensive assessment of visual function in glaucoma patients. [ABSTRACT FROM AUTHOR]

Backgrounds: Myopia has become a global public health problem. Children with early onset of myopia are at particular risk of complications associated with myopia. Younger children and children with greater initial myopic refractive errors are at a greater risk of myopia progression. Therefore, it is essential to identify subjects at high risk of developing myopia to facilitate myopia prevention in the early stage, especially during the preschool period. The purpose of this study was to determine whether premyopia and myopia in preschool children can be predicted by easily obtainable parameters.Methods: Data was collected in a population-based cohort. Comprehensive examinations included height, weight, refraction, axial length (AL), and corneal radius of curvature (CR), with a follow-up of 2 years. Parental myopia history was obtained from a questionnaire. Myopia was defined as spherical equivalent (SE) ≤ - 0.50 D. Premyopia was defined as - 0.50 D < SE ≤ + 0.75 D. Multivariate linear regression models were fitted to determine the associations between these parameters at baseline and future SE. To predict premyopia and myopia, Cox proportional hazard regression analysis coupled with a nomogram was used.Results: A total of 830 children (433 boys and 397 girls) were included (40.83 ± 3.43 months old at baseline). A significantly negative relationship was observed in the multivariate analysis between baseline AL, AL/CR, two myopic parents, and the future SE after adjusting for age and gender (coefficient = - 0.291, coefficient = - 5.791, coefficient = - 0.273, respectively, both p <  0.001). Higher baseline AL, AL/CR (hazard ratio (HR) = 4.916, HR = 2.979, respectively, comparing the top quartile with the bottom quartile, both p <  0.001) and two myopic parents (HR = 1.756, compared to no myopic parents, p = 0.001) were associated with a higher risk of future onset of premyopia. From the nomogram, AL/CR was found to have the most enormous effect on survival. Different baseline AL and AL/CR values (both Log Rank p <  0.001) had different survival curves.Conclusions: AL and AL/CR could be used as obtainable indicators for identifying subjects at high risk of developing premyopia and myopia in young preschool children. [ABSTRACT FROM AUTHOR]

Background: This report describes the design and methodology of the "Eyes of Africa: The Genetics of Blindness," a collaborative study funded through the Human Heredity and Health in Africa (H3Africa) program of the National Institute of Health.Methods: This is a case control study that is collecting a large well phenotyped data set among glaucoma patients and controls for a genome wide association study. (GWAS). Multiplex families segregating Mendelian forms of early-onset glaucoma will also be collected for exome sequencing.Discussion: A total of 4500 cases/controls have been recruited into the study at the end of the 3rd funded year of the study. All these participants have been appropriately phenotyped and blood samples have been received from these participants. Recent GWAS of POAG in African individuals demonstrated genome-wide significant association with the APBB2 locus which is an association that is unique to individuals of African ancestry. This study will add to the existing knowledge and understanding of POAG in the African population. [ABSTRACT FROM AUTHOR]

Background: Eye injury is a serious worldwide public health problem that may cause blindness. In children, blindness has functional impact and psychosocial implications. As indicated in many worldwide studies, identification of risk factors associated with the socio-cultural context may prevent eye injuries. The objetive of the study is to describe the sociodemographic and epidemiological characteristics of pediatric eye injury and its effects on ocular structures in a public hospital from Colombia.Method: A retrospective cross-sectional study was carried out between January 1, 2015, and December 31, 2017, in a tertiary public hospital of a medium-sized city located in the Northeast of Colombia. Children under 15 years old with trauma to the eyeball or its adnexa were included. The Birmingham Eye Trauma Terminology System (BETTS) was used. Eye burns and Ocular adnexa were also included.Results: 61 cases of eye injuries were recorded, 67.21% (41 cases) of which were males. 57.37% (35 cases) corresponded to closed-globe injuries both contusion and lamellar laceration. Visual acuity fluctuated between 20/20 and 20/40. 14.75% (9 cases) were open-globe injuries while 50% (4 cases) were penetrating trauma. 27.86% of the injuries (17 cases) did not directly compromise the eyeball, 58.82% (10 of these cases) of which corresponded to eyelid wounds, and neither of those had visual acuity information.Conclusion: The study showed that the majority of eye injuries in children under 15 years old, from a public hospital in the Northeast of Colombia, are closed globe, caused by blows, and occur in males. [ABSTRACT FROM AUTHOR]

Background: Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls.Methods: A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant.Results: Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively].Conclusions: The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications. [ABSTRACT FROM AUTHOR]

Background: To compare plasma fatty acids (FAs) between participants with primary open-angle glaucoma (POAG) and participants without neuropathy in an elderly population and to investigate specific FAs pattern in POAG.Methods: We conducted a population-based study in participants older than 75 years. Participants underwent a comprehensive eye examination with optic nerve photographs, visual field test and optic nerve OCT with RNFL thickness measurement. Glaucomatous status was defined according to the International Society for Epidemiologic and Geographical Ophthalmology classification. Lipids were extracted from plasma and FAs methylesters prepared and analyzed by gas chromatography-mass spectrometry.Results: Among the 1153 participants of the Montrachet study 810 were retained for analysis and 68 had POAG. The mean age was 82.11 ± 3.67. In multivariable analysis FAs levels were not different between POAG participants and controls (P = 0.078). A FAs pattern characterized by high negative weight of gamma-linoleic acid, eicosapentaenoic acid polyunsaturated FAs (PUFAs), Cis-7 hexadecenoic acid monounsaturated FAs (MUFAs) and high positive weight of eicosadienoic acid, docosatetraenoic acid, docosapentaenoic n-6, alpha linoleic acid PUFAs, eicosenoic acid MUFAs, margaric acid and behenic acid saturated FAs was positively associated with POAG. After adjustment for major confounders, individuals in the upper tertile of FAs pattern scores compared with those in the lower tertile were more likely to present POAG (OR = 3.09 [95% CI 1.29-7.40] P = 0.013).Conclusions: We found no significant difference regarding isolated plasma FAs between participants with POAG and participants without neuropathy in elderly but specific FAs pattern might be associated with POAG. [ABSTRACT FROM AUTHOR]

Background: To assess the associations of axial length with age-related cataract within a span of 10 years in an Asian population in southern Taiwan.Methods: A retrospective cohort study examined 960 adults who underwent cataract surgery at the Kaohsiung Chang Gung Memorial Hospital in year 2008 and year 2018. Axial length was assessed with the ultrasound biometry and/or the Zeiss IOLMaster. Eyes with prior blunt eye trauma or had underwent vitrectomy operations were excluded. The significance of the changes in axial length between the two cohorts was determined after performing age-matched analyses. Due to utilization of ultrasound biometry and/or Zeiss IOLMaster, axial length corrections with our mean difference in measurement results, which were similar to previous studies on comparison between the two measurement tools, were carried out.Results: Axial length showed an age-related elongation in 10-year cross-sectional data, from a mean of 23.65 ± 1.80 mm in year 2008 to a mean of 24.30 ± 1.90 in year 2018 (p = 0.003). Patients with high myopia (axial length > 26 mm) increased significantly over the 10-year period from 8.1 to 16 % (p < 0.001). A birth cohort effect on axial length was evident as the axial lengths of year 2008 cohort were shorter than the 2018 cohort when they were in the same operation age group. In particular, persons born after the 1960s demonstrated a predominant increase in axial length in both cohorts.Conclusions: Our study confirms a trend in increase of axial myopia, especially high myopias, over the 10-year period. A novel finding of this study was discovering a birth cohort effect on axial length, especially in persons born after the 1960s in southern Taiwan. [ABSTRACT FROM AUTHOR]

Background: The prevalence of age-related macular degeneration (AMD) varies from 6.8 to 18.3% for all forms of AMD and from 0.6 to 2.6% for late AMD according to race, suggesting the existence of genetic differences among races. The purpose of this study was to determine the genetic causes of differences in the prevalence of AMD among individuals of different races.Methods: We collected 138 AMD-associated single nucleotide polymorphisms (SNPs) from a genome-wide association studies catalog. Their population-level allele frequencies were derived based on the 1000 Genomes Project and Korean Reference Genome Database. We used Fisher's exact tests to assess whether the effect allele at a given SNP was significantly enriched or depleted in the database.Results: European, American, and South Asian populations showed similar heatmap patterns, whereas East Asian, and Korean populations had distinct patterns. Korean populations exhibited patterns that were different from those of the other groups; rs5754227 (SYN3), rs1626340 (TGFBR1/COL15A1), rs3750846(ARMS2/HTRA1), and rs9564692 (B3GALTL) were enriched, whereas rs2230199 (C3) and rs73036519 (EXOC3L2/MARK4) were depleted in Koreans; these SNPs are associated with late AMD. The genetic risk score calculated from allele frequencies was not less in East Asians than in Europeans.Conclusion: The prevalence of AMD is lower in Asians than in Europeans. However, our study showed that genetic risk scores in East Asians were similar to those in Europeans, which may explain why the global projected number of people with AMD by 2040 is in largest for East Asians, including Koreans. [ABSTRACT FROM AUTHOR]

Background: Early detection of glaucoma is paramount to maintain patients' eyesight, however glaucomatous vision loss tends to begin in the periphery with up to 50% of patients unaware they are affected. Because glaucomatous vision loss is permanent, screening appears attractive, but currently is not cost-effective. Therefore we aim to investigate the utility of genetic pre-screening for glaucoma in a population-based setting, called EyeLife.Methods: EyeLife adopts a double blind prospective design with contrasting groups. Selected participants (n = 1600) from the Lifelines cohort are 55 years of age or older, and of either the highest or lowest 20% of the genetic risk distribution for glaucoma. We obtained a highly curated list of genetic variants from the literature to obtain each participants' genetic risk for glaucoma. Participants will undergo comprehensive ophthalmic screening. The primary outcome is the relative risk of glaucoma given a high genetic risk compared to a low genetic risk.Discussion: If genetic pre-screening is successful, it will increase the yield of a glaucoma screening program by focusing on high-risk individuals. This, in turn, may improve long-term visual health of middle-aged and elderly people.Trial Registration: Ethics approval was obtained on January 31, 2019, and the study was retrospectively registered with the Netherlands Trial Register ( NL8718 ) on the 17th of June, 2020. [ABSTRACT FROM AUTHOR]

Background: Vision loss is a major public health concern that significantly affects developing countries, including South Africa. Although existing literature have reported on the prevalence, causes, and impact of vision loss on the quality of life of affected individuals (children and adults) in parts of South Africa, there is no evidence of the prevalence and associated factors of vision loss in the general population. Hence, this study aimed to determine the prevalence of vision loss and its associated factors in South Africa using a population-based survey.Methods: Secondary analyses were conducted using data from the South African National Health and Nutrition Examination Survey (SANHANES-1), a population-based national health survey conducted from 2011 to 2012. Vision loss was defined as presenting visual acuity (PVA) worse than Snellen 6/12 in the better eye. Visual acuity was assessed by clinicians and participants' subjective response to vision-related questions. Univariate and multiple logistic regression models were used to examine the association of the independent variables with vision loss.Results: The analytic sample comprised 4346 individuals with a mean age of 39.1 years. Female sex accounted for 55.6% of the participants. The prevalence of vision loss among participants was 9.2% (95% CI: 7.7-10.9). Older age (45-54 years, OR = 2.99, p < 0.001; 55-64 years, OR = 5.78, p < 0.001 and ≥ 65 years, OR = 5.12, p < 0.001), female sex (OR = 1.50, p = 0.016), and previous diabetes diagnosis (OR = 2.28, p = 0.001) were significantly associated with increased odds of vision loss. Further, secondary school education (OR = 0.71, p = 0.031), white ethnicity (OR = 0.11, p = 0.007), residing in Mpumalanga province (OR = 0.12, p < 0.001) and having never had an eye examination (OR = 0.56, p = 0.003) were significantly associated with reduced odds of vision loss.Conclusion: Almost one in ten participants had vision loss. Adopting strategies targeted at reducing barriers to the utilization of eye care services will promote early detection and management of blinding conditions, and thereby, decrease the burden of vision loss in South Africa. [ABSTRACT FROM AUTHOR]

Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients' life was evaluated by questionnaires survey.Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.Results: Twenty-one Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was - 0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ±0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ±1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.Conclusions: Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate. [ABSTRACT FROM AUTHOR]

Background: The polymorphisms rs6885224 and rs634990 have been reported to be associated with high myopia in many populations. As there is still no report on whether these two SNPs are associated with myopia in the Tujia and Miao minority areas of China, we conducted a replication study to evaluate the association of single-nucleotide polymorphisms in the regions 5p15.2 and 15q14 with high myopia in Tujia and Miao Chinese populations.Methods: We performed a comprehensive meta-analysis of 5831 cases and 7055 controls to assess whether rs6885224 in the 5p15.2 region and rs634990 in the 15q14 region are associated with high myopia. Our replication study enrolled 804 individuals. Genomic DNA was extracted from venous leukocytes, and these two SNPs were genotyped by Sanger sequencing. Allele and genotype frequencies were analysed using χ2 tests, and ORs and 95% CIs were calculated.Results: According to the results of the meta-analysis, rs6885224 in the CTNND2 gene showed no association with myopia [p = 0.222, OR = 1.154, 95% CI (0.917-1.452)]. Conversely, rs634990 in the 15q14 region did exhibit a significant correlation with myopia [p = 7.270 × 10- 7, OR = 0.817, 95% CI (0.754-0.885)]. In our replication study, no association with high myopia in the Tujia and Miao populations was found for rs634990 or rs6885224. The following were obtained by allele frequency analysis: rs6885224, p = 0.175, OR = 0.845, and 95% CI = 0.662-1.078; rs634990, p = 0.087, OR = 0.84, and the 95% CI = 0.687-1.026. Genotype frequency analysis yielded p = 0.376 for rs6885224 and p = 0.243 for rs634990.Conclusions: Our meta-analysis results show that rs634990 was significantly associated with myopia but that rs6885224 was not. Nevertheless, in our replication study, these two SNPs showed no association with myopia in the Tujia and Miao Chinese populations. This is the first report involving Tujia and Miao ethnic groups from Enshi minority areas. However, the sample size needs to be expanded and more stringent inclusion and exclusion criteria need to be formulated to verify the findings. [ABSTRACT FROM AUTHOR]

Background: Limited data is available on retinal vessel morphology in the north China. The study aimed to evaluate the prevalence of retinal vascular abnormalities (RVAs) and investigate their associations with the self-reported diagnosis of cardiovascular and cerebrovascsular diseases (CCVds) in a rural adult population of northeast China.Methods: A population-based, cross-sectional study was conducted, using the cluster random sampling method. One eye of each participant was photographed with a non-mydriatic fundus camera. RVAs including focal and general arteriolar narrowing (FAN and GAN), arteriovenous nicking (AVN), arteriolar sheathing (AS), and retinopathy were evaluated. Data on self-reported diagnosis of cardiovascular and cerebrovascular diseases and status of smoking and alcohol drinking were obtained from questionnaires.Results: Among the 6267 participants with an age ≥ 50 years, photographs were obtained of 99.2%, with quality sufficient to perform retinal evaluations in 82.5%. The prevalence of FAN, AVN, AS, retinopathy and GAN were 9.1, 8.9, 5.0, 6.6 and 6.2%, respectively. All the retinal lesions were associated with hypertension (all P < 0.01). After adjusting for age, gender, and left/right eyes, hypertension, hyperlipidaemia, diabetes mellitus, habits of past or current smoking and alcohol consumption, AVN was strongly associated with the self-reported diagnosis histories of coronary heart diseases(CHD) (OR, 1.44; 95% CI, 1.09, 1.89) and retinopathy was significantly associated with a self-reported diagnosis of stroke (OR, 2.05; 95% CI, 1.18, 3.57).Conclusions: The overall prevalence of retinal microvascular abnormalities in this population was relatively higher than that reported in other regions of the world. Retinopathy is associated with the self-reported diagnosis of stroke while AVN was associated with the self-reported diagnosis of CHD, but the remaining retinal lesions were not consistently associated with CCVds. Thus, an examination of retinal microvascular characteristics may offer clues to CCVds and could be a potentially novel biomarkers for CCVds risk. [ABSTRACT FROM AUTHOR]

Background: Knowing the pattern and presentation of the diseases is critical for management strategies. To inform eye-care policy we quantified the pattern of vitreo-retinal (VR) diseases presenting at the national referral hospital in Bhutan.Methods: We reviewed all new patients over three years from the retinal clinic of the Jigme Dorji Wangchuck National Referral Hospital. Demographic data, presenting complaints and duration, treatment history, associated systemic diseases, diagnostic procedures performed, and final diagnoses were quantified. Comparisons of the expected and observed frequency of gender used Chi-squared tests. We applied a sampling with replacement based bootstrap analysis (10,000 cycles) to estimate the population means and the standard errors of the means and standard error of the 10th, 25th, 50th, 75th and 90th percentiles of the ages of the males and females within 20-year cohorts. We then applied t-tests employing the estimated means and standard errors. The 2913 subjects insured that the bootstrap estimates were statistically conservative.Results: The 2913 new cases were aged 47.2 ± 21.8 years. 1544 (53.0%) were males. Housewives (953, 32.7%) and farmers (648, 22.2%) were the commonest occupations. Poor vision (41.9%), screening for diabetic and hypertensive retinopathy (13.1%), referral (9.7%), sudden vision loss (9.3%), and trauma (8.0%) were the commonest presenting symptoms. Coexistent diabetes and hypertension were the most common associated systemic diseases. Haematological tests (blood sugar, HbA1c and lipid profile, 31.8%), OCT (27.4%), refraction (9.9%), B-scan (8.7%), fundus photography (8.0%) were the most commonly performed diagnostic tests. Hypertensive retinopathy (18.9%) was the commonest VR disease, followed by refractive errors referred for retinal evaluation (16.7%), diabetic retinopathy with macular oedema (15.8%), and AMD (11.0%). Retinal detachment was more prevalent in females (83 vs. 41, p = 0.007). Rare vision-threatening diseases like seasonal hyper-acute pan-uveitis also presented.Conclusions: The developing VR service in Bhutan is challenged by the spectrum of diseases, limited human resources (e.g. one retinal surgeon during the study), and accessibility to tertiary eye-care services, all amidst difficult terrain. Sustained effort and robust coordination among the eye-care professionals, government and non-governmental organisations are critical for optimising VR services, especially as rates of diseases such as diabetes and hypertension grow. [ABSTRACT FROM AUTHOR]

Background: Dry Eye Disease (DED) is a multifactorial disease of the interpalpebral ocular surface and tear film that leads to discomfort, fatigue and disturbance in vision. DED affects patients' quality of life and leads eventually to decrease of productivity. Moreover, it has a considerable socioeconomic burden. It is a growing underdiagnosed health issue and the possible associated risk factors are very common and keep growing worldwide.Purpose: To assess the prevalence of DED and potential associated risk factors in the Northern West Bank of Palestine.Methods: A cross sectional study was conducted in 16 selected towns in Northern West Bank governorates during December 2016 to September 2017. An interviewer-assisted Ocular Surface Disease Index (OSDI) questionnaire was used to study DED symptoms in the study population. Further evaluation of clinical signs of DED was performed using the following objective tests: tear film break-up time (TBUT), fluorescein corneal staining (FL/S) and Schirmer test. Subjects with an OSDI score of 13 or above were considered symptomatic of DED, and DED was defined if an OSDI score ≥ 13 is accompanied by at least one of the following signs in the worse eye: TBUT ≤10 s, Schirmer score ≤ 5 mm and fluorescein corneal staining ≥ grade 1.Results: Seven hundred sixty-nine subjects were recruited from the general non-clinical population in the West Bank. The mean age of participants was 43.61 ± 18.57 years ranging from 18 to 90 years. Females constitute 52.7% of the study population. Based on the diagnostic criteria, the prevalence of DED was 64% (95% confidence interval 60.6-67.3). DED was significantly associated with female gender p = (0.001) and older age p = (0.001).Conclusion: The prevalence of DED is high in the study population. Older age and female gender were associated risk factors with the development of DED. [ABSTRACT FROM AUTHOR]

Introduction: Globally, eye diseases are considered as one of the major contributors of nonfatal disabling conditions. In Bangladesh, 1.5% of adults are blind and 21.6% have low vision. Therefore, this paper aimed to identify the community-based prevalence and associated risk factors of eye diseases among slum dwellers of Dhaka city.Methods: The study was carried out in two phases. In the first phase, a survey was conducted using multistage cluster sampling among 1320 households of three purposively selected slums in Dhaka city. From each household, one family member (≥ 18 years old) was randomly interviewed by trained data collectors using a structured questionnaire. After that, each of the participants was requested to take part in the second phase of the study. Following the request, 432 participants out of 1320 participants came into the tertiary care hospitals where they were clinically assessed by ophthalmologist for presence of eye diseases. A number of descriptive and inferential statistics were performed using Stata 13.Result: The majority of total 432 study participants were female (68.6%), married (82.6%) and Muslim (98.8%). Among them almost all (92.8%) were clinically diagnosed with eye disease. The most prevalent eye diseases were refractive error (63.2%), conjunctivitis (17.1%), visual impairment (16.4%) and cataract (7.2%). Refractive error was found significantly associated with older age, female gender and income generating work. Cataract was found negatively associated with the level of education, however, opposite relationship was found between cataract and visual impairment.Conclusion: Our study provides epidemiologic data on the prevalence of eye diseases among adult population in low-income urban community of Dhaka city. The high prevalence of refractive error, allergic conjunctivitis, visual impairment, and cataract among this group of people suggests the importance of increasing access to eye care services. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the prevalence of refractive error (RE) in older adults in China, and most have focused on East China. Our study determined the prevalence and risk factors of RE in Han and Yi adults aged 40-80 years in rural and urban areas in Yunnan Province, Southwest China.Methods: Our cross-sectional study is part of the China National Health Survey (CNHS). The age-adjusted prevalence rates of RE in Han and Yi adults aged 40-80 years in Yunnan were compared. We used a multivariate logistic regression model to identify risk factors for myopia and hyperopia.Results: Among 1626 participants, the age-adjusted prevalence rates of myopia, hyperopia, high myopia and astigmatism were 26.35% (95%CI 24.01-28.70%), 19.89% (95%CI 18.16-21.61%), 2.64% (95%CI 1.75-3.53%), and 56.82% (95%CI 54.31-59.34%). Compared to the Yi population, the Han population had higher prevalence of myopia (31.50% vs 16.80%, p < 0.0001), high myopia (3.34% vs 1.31%, p = 0.049) and astigmatism (60.07% vs 50.67%, p = 0.026) but lower prevalence of hyperopia (16.58% vs 27.37%, p < 0.0001). In the multivariate logistic regression, individuals aged 45-49 (p < 0.001), 50-54 (p < 0.001), 55-59 (p = 0.014), and 60-64 years (p = 0.005) had a lower myopia risk than those aged 40-44 years, and individuals aged 50-54 (p = 0.002), 55-59, 60-64 and 65 years and older (all p < 0.001) had a higher hyperopia risk than those aged 40-44 years. Myopia was also associated with height (p = 0.035), time spent in rural areas (p = 0.014), undergraduate/graduate education level (p = 0.001, compared with primary school or lower education level) and diabetes (p = 0.008). The Yi population had a higher risk of hyperopia than the Han population (p = 0.025). Moreover, hyperopia was related to time spent in rural areas (p < 0.001) and pterygium (p = 0.019).Conclusions: Our study investigated the overall prevalence of RE in older adults in rural and urban areas of Southwest China. Compared to the Yi population, the Han population had a higher prevalence of myopia, high myopia and astigmatism but a lower risk of hyperopia. The prevalence of myopia in the Han population in underdeveloped Southwest China was similar to that of residents in East China or of Chinese Singaporeans under urban or rural settings. [ABSTRACT FROM AUTHOR]

Purpose: To assess the incidence of acute-onset endophthalmitis after separate bilateral cataract surgeries less than 5 days apart (SBCS5).Methods: The medical records of all patients who underwent SBCS5 at a single medical center between October 10, 2012 and July 31, 2017 were retrospectively reviewed.Results: The medical records for treatment of 5374 eyes of 2687 patients were examined. The mean interval between the first and second surgeries was 3 days. No case of bilateral simultaneous endophthalmitis was observed. Unilateral endophthalmitis developed in five eyes of five patients. Thus, the incidence of endophthalmitis after SBCS5 was 0.093%. All cases of endophthalmitis occurred in the first operated eye. SBCS5 was 15% less expensive than unilateral cataract surgery.Conclusion: The incidence of endophthalmitis after SBCS5 was acceptably low with topical but not intracamaral antibiotic prophylaxis. SBCS5 was also less expensive than unilateral cataract surgery. [ABSTRACT FROM AUTHOR]

Background: To study basal epithelial cell (BEC), sub-basal nerve plexus (SBN) and Langerhans cell (LC) density in patients with type 2 diabetes mellitus (T2DM) with corneal punctate epitheliopathy (CPE) and to assess their association with time to healing of CPE.Methods: Retrospective study of in vivo confocal microscopy (IVCM) in 160 eyes from 160 patients with T2DM diagnosed with CPE due to a single cause. Key exclusion criteria included multiple-causes for CPE or treatment with autologous serum. A total of 149 eyes from 149 gender- age- and aetiolgy-matched patients with CPE without T2DM comprised the control group. Electronic records were reviewed for demographic features, history of T2DM and aetiology of CPE. Density of BEC, SBN and LC were compared between the two groups.Results: The healing time in days for CPE with different aetiologies in the T2DM and control groups were as follows: dry eye (21.56 ± 2.41; 7.00 ± 2.19; P = 0.001); meibomian gland dysfunction (26.42 ± 6.04; 9.21 ± 2.55; P = 0.001); cataract extraction (38.00 ± 19.62; 25.83 ± 11.49; P = 0.043); drug induced (53.19 ± 18.83; 41.86 ± 23.87; P = 0.018) and exposure (38.25 ± 14.13; 29.00 ± 13.67; P = 0.026). LC density was 38.70 ± 9.65 cells/mm2 in the T2DM group comparedwith 25.53 ± 3.54 cells/mm2 in the controls (P = 0.001). SBN density was 11.76 ± 1.69 mm/mm2 in the T2DM group compared with 20.92 ± 1.43 mm/mm2 in the controls (P = 0.001). BEC density in the T2DM group was 4982 ± 1178 cells/mm2 compared with 5739 ± 394 cells/mm2 in the control group (P = 0.018). Age and duration of T2DM had no relationship with healing time (multiple linear regression, P = 0.618; P = 0.787). The density of LC in the T2DM group showed a negative correlation with SBN density (r = 0.350; R2 = 0.1225; P = 0.034). The density of SBN in the T2DM group showed a positive correlation with BEC density (r = 0.427; R2 = 0.1823; P = 0.008). The density of BEC in the T2DM group showed a negative correlation with healing time (r = 0.931; R2 = 0.8668; P = 0.001).Conclusions: Utilising IVCM, we have demonstrated increased LC and decreased SBN in patients with T2DM and CPE. Both may be related to lower BEC density and nuclei enhanced reflection. Furthermore, decreased BEC density may lead to delay in cornea epithelium healing in the T2DM group comparedwith controls. An immune-mediated response may play a role in delayed wound closure in patients with T2DM. [ABSTRACT FROM AUTHOR]

Background: To evaluate wide-field laser ophthalmoscopy (Optomap 200Tx) for screening retinal lesions before myopic refractive surgery.Methods: Seventy-eight eyes of 78 consecutive refractive surgery candidates were included in this study. All subjects underwent Optomap 200Tx, mydriatic slit-lamp lens examination and the Goldmann three-mirror contact lens examination, which was considered as the reference method for determining retinal lesions.Results: Forty of 78 eyes had retinal lesions (51.28%) and three eyes had retinal breaks (3.85%), which were diagnosed by the Goldmann three-mirror contact lens examination. Compared to the Goldmann three-mirror contact lens examination, the detection rate with the Optomap 200Tx was 91.73%% for retinal lesions, while the detection rate of mydriatic slit-lamp lens exams was 81.20%. There were no statistically significant differences among the three methods used for the diagnoses of myopic conus, tessellation and retinal breaks(all p > 0.05). For peripheral retinal lesions, the detection rate of the Optomap 200Tx examinations were similar to the Goldmann three-mirror contact lens exams (all p > 0.05), but were higher than the results of slit-lamp lens examinations (all p < 0.05). Regarding the vitreoretinal adhesions, the Goldmann three-mirror contact lens examinations had higher detection rates than did the Optomap 200Tx examinations (p = 0.031).Conclusions: The Optomap 200Tx examinations is a convenient and feasible method to determine fundus pathological changes in myopic patients, especially for patients who can not endure pupil dilation. In order to avoid misdiagnosis of peripheral retinal lesions, Goldmann three-mirror contact lens examination is needed. [ABSTRACT FROM AUTHOR]

Background: In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby.Methods: Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests.Results: Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS.Conclusions: The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Background: Limited data exist collating most of the associated factors for strabismus in one analysis. The aim of this study was to assess the prevalence of strabismus and to analyse associated factors in former preterm and full-term infants.Methods: In this cross-sectional study, 239 former preterm infants with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants with GA ≥ 37 weeks underwent detailed ophthalmologic examination in the age of 4-10 years and perinatal data assessment for risk factor analysis. Ophthalmologic examinations included cover testing, best corrected visual acuity, cycloplegic objective refraction, slit lamp as well as fundus examinations. For association analysis with strabismus, the following data was collected and included in multivariable analysis: sex, age at examination, anisometropia, myopic and hyperopic refractive error (≥ 3 dioptres), astigmatism, birth weight percentile, gestational age, retinopathy of prematurity occurrence, maternal age at childbirth, mother smoking, breastfeeding < 3 months, artificial ventilation, intraventricular bleeding, and other perinatal adverse events.Results: Overall, 4/264 (2%) full-term infants, 15/125 (12%) preterm-infants with GA 29-32 weeks without ROP, 13/59 (22%) preterm infants with GA ≤ 28 weeks without ROP and 14/55 (26%) with GA ≤ 32 weeks with retinopathy of prematurity were affected by strabismus. In the multivariable regression model strabismus was associated with GA (OR = 0.84 per week; p = 0.001), hyperopic refractive error (OR = 4.22; p = 0.002) and astigmatism (OR = 1.68; p = 0.02).Conclusion: This investigation highlights that low gestational age and refraction of the eye are independent risk factors for strabismus, while the other factors show less independent influence. [ABSTRACT FROM AUTHOR]

Background: To determine the prevalence and associated factors for myopia and high myopia among older population in a rural community in Eastern China.Methods: A community-based, cross-sectional survey was conducted in the Weitang town located in Suzhou, an urban metropolis in East China. A total of 5613 Chinese residents aged 60 years and older were invited to complete a questionnaire and participated in a detailed eye examination,including measurements of visual acuity and refractive error using autorefraction and subjective refraction. Myopia and high myopia was defined as SE < -0.5 diopters (D) and < -5.0 D, respectively.Results: Among the 5613 participating individuals, 4795 (85.4%) complete refraction data of phakic right eye was included for analysis. The age-adjusted prevalence was 21.1% (95% confidence interval [CI], 19.9-22.2) for myopia and 2.5% (95% CI, 2.1-2.9) for high myopia. The prevalence of myopia tended to increase significantly with age(p < 0.001),and women had a higher rate of myopia than men (p < 0.001). According to multivariate logistic regression analysis, adults who were older (odds ration[OR]:1.05; 95% CI:1.04-1.07), spent more time for sleeping at night (OR:1.12;95% CI: 1.06-1.18),or had cataract (OR:1.60;95% CI:1.36-1.88) and family history of myopia (OR:1.47;95% CI:1.23-1.77), are more susceptible to myopia (p < 0.001). People who had older age, family history, cataract and specially longer night-time sleep duration, would have a higher risk of myopia.Conclusion: Myopia and high myopia among rural old adult population in Eastern China presents common. The current literature unanticipated suggests that there was a positive significant association between prevalence of myopia and night-time sleep duration among adult. Our data provide some evidence of this relationship and highlight the need for larger studies to further investigate this relationship longitudinally and explore mechanism therein. [ABSTRACT FROM AUTHOR]

Background: Matrix metalloproteinases (MMPs) polymorphisms have been implicated in the pathogenesis of glaucoma risk. However, the results were controversial. We performed a meta-analysis to evaluate the precise associations between MMPs polymorphisms and glaucoma risk.Methods: Related studies were reviewed by searching electronic databases within four databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the association between the most common polymorphisms of MMPs and glaucoma risk. Heterogeneity, publication bias and sensitivity analysis were conducted to guarantee the statistical power.Results: Overall, 11 selected articles involving 2,388 cases and 2,319 controls were included in this meta-analysis. Significant associations were only found between MMP-9 rs17576 G > A polymorphism (GA vs. GG: OR = 0.80, 95%CI = 0.67-0.97, P = 0.02, I2 = 0%), MMP-9 rs3918249 C > T polymorphism (TT vs. CC + CT: OR = 0.71, 95%CI = 0.51-0.98, P = 0.04, I2 = 0%) and glaucoma risk in the general population. Subgroup analysis also suggested that MMP-9 rs17576 G > A was related to glaucoma in the Caucasian population (GA vs. GG: OR = 0.67, 95%CI = 0.45-1.00, P = 0.05; GA + AA vs. GG: OR = 0.66, 95%CI = 0.45-0.97, P = 0.03, I2 = 0%).Conclusions: Our meta-analysis demonstrates that MMP-9 rs17576 G > A polymorphism might be a protective factor against the development of glaucoma in Caucasian population. [ABSTRACT FROM AUTHOR]

Background: To determine the influences of myopia and optic disc size on ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) thickness profiles obtained by spectral domain optical coherence tomography (OCT).Methods: One hundred and sixty-eight eyes of 168 young myopic subjects were recruited and assigned to one of three groups according to their spherical equivalent (SE) values and optic disc area. All underwent Cirrus HD-OCT imaging. The influences of myopia and optic disc size on the GCIPL and RNFL thickness profiles were evaluated by multiple comparisons and linear regression analysis. Three-dimensional surface plots of GCIPL and RNFL thickness corresponding to different combinations of myopia and optic disc size were constructed.Results: Each of the quadrant RNFL thicknesses and their overall average were significantly thinner in high myopia compared to low myopia, except for the temporal quadrant (all Ps ≤0.003). The average and all-sectors GCIPL were significantly thinner in high myopia than in moderate- and/or low-myopia (all Ps ≤0.002). The average OCT RNFL thickness was correlated significantly with SE (0.81 μm/diopter, P < 0.001), axial length (-1.44 μm/mm, P < 0.001), and optic disc area (5.35 μm/mm2, P < 0.001) by linear regression analysis. As for the OCT GCIPL parameters, average GCIPL thickness showed a significant correlation with SE (0.84 μm/diopter, P < 0.001) and axial length (-1.65 μm/mm, P < 0.001). There was no significant correlation of average GCIPL thickness with optic disc area. Three-dimensional curves showed that larger optic discs were associated with increased average RNFL thickness and that more-myopic eyes were associated with decreased average GCIPL and RNFL thickness.Conclusion: Myopia can significantly affect GCIPL and RNFL thickness profiles, and optic disc size has a significant influence on RNFL thickness. The current OCT maps employed in the evaluation of glaucoma should be analyzed in consideration of refractive status and optic disc size. [ABSTRACT FROM AUTHOR]

Background: To evaluate the clinical outcomes after the implantation of a new trifocal diffractive intraocular lens (IOL) combined with Enhanced depth of focus (EDOF) technology. Methods: The study enrolled 80 eyes of 40 patients who underwent cataract surgery with bilateral implantation of a diffractive trifocal IOL (Reviol Tri-ED) designed with a combination of enhanced depth of focus. Mean age was 52. 09 ± 11.32 years (range from 45 to 70 years). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA), corrected near visual acuity (CNVA), keratometry (K), and manifest refraction spherical equivalent (MRSE) were evaluated pre- and postoperatively. The contrast sensitivity, defocus curves, and a questionnaire evaluating individual satisfaction were also estimated. Results: There was a significant improvement in UDVA, CDVA, UNVA, CNVA, CIVA postoperatively. The defocus curve confirmed good visual acuity also in the intermediate distance. The postoperative MRSE was ranged from -0. 75 to 0.75 diopters. Contrast sensitivity also significantly improved postoperatively. The patient satisfaction was high. Conclusion: The new trifocal EDOF IOL provides visual improvement for far, intermediate, and near distances with a high level of visual quality and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: To identify success predictors and to study the role of the fellow untreated eye as a co-variable for adjustment of intraocular pressure (IOP) outcomes following selective laser trabeculoplasty (SLT) in early open-angle glaucoma (OAG) patients. Methods: A case series was carried out. Patients with uncontrolled early OAG or ocular hypertension (inadequate IOP control requiring additional treatment) underwent SLT (one single laser session) performed by the same surgeon in a standardized fashion. The same preoperative medical regimen was maintained during follow-up for all patients. Post-treatment assessments were scheduled at week 1 and months 1, 2, and 3. In order to account for possible influence of IOP fluctuation on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed adjusting for IOP changes (between visits variation) of the untreated fellow eye (adjusted analysis). Pre and post-laser IOP values were compared using paired t-test. Factors associated with the magnitude of IOP reduction were investigated using multiple regression analysis. Results: A total of 45 eyes of 45 patients were enrolled. Mean IOP was reduced from 20.8 ± 5.1 to 14.9 ± 2. 9 mmHg at month 3 (p < 0.001). Adjusted success rate (defined as IOP reduction = 20%) was 64% and mean percentage of IOP reduction was 23.1 ± 14.3% at last follow-up visit. Considering unadjusted post-laser IOP values, it was found a 20% greater absolute IOP reduction (median [interquartile range] 6 mmHg [4-7] vs 5 mmHg [3-7]; p = 0.04), with a success rate of 76%. Although baseline IOP was significantly associated with both adjusted and unadjusted post-laser IOP reduction, a stronger association was found when unadjusted IOP values were considered (p < 0.001 and R² = 0.35; p < 0.001 and R² = 0.67, respectively). Age, mean deviation (MD) index, central corneal thickness and type of glaucoma were not significant predictors (p = 0.150). Conclusions: In this group of patients with early OAG or ocular hypertension, our short-term results confirmed SLT as a safe and effective alternative for IOP reduction. Although better outcomes were found in eyes with higher preoperative IOP, this effect was mitigated when results were adjusted to the fellow untreated eye (to the influence of between visits-IOP fluctuations). [ABSTRACT FROM AUTHOR]

Background: Myopia has become a significant global public health concern, and is highly prevalent worldwide especially in Asian countries. It is associated with genetic factors as well as socioeconomic status; however, the underlying cause for school myopia has not been established. This study evaluates the impact of living environment on school myopia in Chinese school-aged children.Methods: A large cross-sectional sample of area- and ethnicity-matched school children; a total of 43, 771 children from 12 cities participated in this study. The presence of myopia was self-reported and potential risk factors were determined by questionnaires.Results: The self-reported prevalence of myopia in Chinese children was 31.8 % (n = 13, 928). In multiple logistic regression analysis, higer risk of myopia among school-aged children was significantly positively associated with both parental myopia (OR = 3.57; 95 % CI: 3.26-3.90), living in 1-3 floor (OR = 1.28; 95 % CI: 2.57-3.15), 4-6 floor (OR = 1.84; 95 % CI: 1.73-1.95) and 7 floor or more (OR = 2.02; 95 % CI: 1.88-2.16). Particularly, housing type was independently associated with myopia after stratified by parental myopia. An increasing prevalence of myopia was found with increasing floor of housing type in each outdoor time group.Conclusions: Housing type was independently associated with myopia, after stratified by parental myopia. Flat room, lower living floor and more outdoor time may be protective factors for myopia among school-aged children in mainland China. [ABSTRACT FROM AUTHOR]

Background: To evaluate the short-term reproducibility of diurnal intraocular pressure (IOP) and ocular perfusion pressure (OPP) measurements in normal volunteers, untreated normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG) patients.Methods: Fifty-four healthy volunteers (control group), 67 NTG patients and 54 POAG patients were recruited. The IOPs of both eyes were measured with a Goldmann applanation tonometer at 3-h intervals over 2 consecutive days. Blood pressure (BP) measurements were collected at the same times. The mean IOP/OPP, peak IOP/OPP, trough IOP/OPP and IOP/OPP fluctuations on each day were also calculated. The intraclass correlation coefficients (ICCs) were used to evaluate the reproducibilities.Results: In the control group, the ICCs of mean IOP, peak IOP, trough IOP and IOP fluctuation were 0.921, 0.889, 0.888, and 0.661, respectively, and the ICCs of the mean OPP, peak OPP, trough OPP and OPP fluctuations were 0.962, 0.918, 0.953, and 0.680, respectively. In the NTG group, the ICCs of the mean IOP, peak IOP, trough IOP and IOP fluctuation were 0.862, 0.741, 0.798, and 0.290, respectively, and the ICCs of the mean OPP, peak OPP, trough OPP and OPP fluctuations were 0.947, 0.828, 0.927, and -0.008, respectively. In the POAG group, the ICCs of the mean IOP, peak IOP, trough IOP and IOP fluctuation were 0.857, 0.666, 0.808, and 0.546, respectively, and the ICCs of the mean OPP, peak OPP, trough OPP and OPP fluctuation were 0.934, 0.842, 0.910, and 0.093, respectively.Conclusion: The IOP measurements within a single day were not highly reproducible in the short-term. The normal volunteers exhibited better IOP and OPP reproducibilities than the glaucoma patients. The IOP and OPP fluctuations could not be accurately evaluated based on the IOP or OPP measurements within a single day. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency and vitamin D receptor gene polymorphisms are known to be significantly associated with high myopia. Whether this genetic variant may impact primary open-angle glaucoma is largely unknown. This study investigated whether vitamin D receptor gene polymorphisms are altered in primary open-angle glaucoma subjects carrying the risk allele, and whether vitamin D deficiency is an important factor in the development of glaucoma. Methods: Seventy-three POAG patients and 71 age-matched controls from the Han population were enrolled. Serum levels of 1a, 25-Dihydroxyvitamin D3 were measured by enzyme-linked immunoabsorbent assay. Vitamin D receptor polymorphisms (Cdx-2, Fok I, Bsm I and Taq I) were analyzed using real-time polymerase-chain reaction high resolution melting analysis. Results: Serum levels of 1a, 25-Dihydroxyvitamin in primary open-angle glaucoma patients were lower than in age-matched controls. Statistical analysis revealed a significant difference in the allelic frequencies of the BsmI and TaqI genotypes between primary open-angle glaucoma patients and age-matched controls, while other polymorphisms did not show any significant differences. Conclusions: Vitamin D deficiency and the presence of the BsmI 'B' allele and the TaqI 't' allele are relevant risk factors in the development of glaucoma. Trial Registration: Clinical Trials.gov: NCT02539745 . The study was registered retrospectively on August 3rd, 2015. The first participant was enrolled on July 4th, 2013. [ABSTRACT FROM AUTHOR]

Background: Commonly used vision-targeted health-related quality of life questionnaires almost exclusively focus items on vision under daytime conditions. Older adults even when in good eye health frequently report experiencing vision problems at night and under low environmental light levels, and psychophysical studies also document these visibility problems. Here we compare the progression of self-reported low luminance visibility problems and self-reported visibility problems under daytime conditions in older adults. Methods: Trained interviewers administered two questionnaires to older adults in normal eye health: the National Eye Institute Visual Function Questionnaire - 25 (NEI VFQ-25) where items are almost entirely focused on difficulties in daytime activities, and the Low Luminance Questionnaire (LLQ) where items are focused on difficulties seeing at night and under low luminance conditions. The following visual functions were also measured: visual acuity, low luminance visual acuity, low luminance deficit, contrast sensitivity, light sensitivity in the macula, and rod-mediated dark adaptation. The protocol was repeated 3 years later. Results: Scores on the NEI VFQ-25 composite and its subscales were unchanged between baseline and 3-year follow-up, whereas scores on the LLQ composite and 5 of 6 subscales significantly decreased (corresponding to less functionality) at the 3-year follow-up. Participants were more likely to display a ≥ 5 point decrease on the LLQ composite than on the NEI VFQ-25 over 3 years. Visual functional tests were largely unrelated to changes in NEI VFQ-25 and LLQ scores from baseline to follow-up. Conclusions: Older adults' vision-targeted quality of life as measured by questionnaire is more likely to exhibit a practically significant decrease over 3 years using a questionnaire that focused on low luminance activities (LLQ) than one focused on daytime activities (NEI VFQ-25). That the results of visual functional testing did not correspond to older adults' decline in self-reported problems in low luminance activities emphasizes the importance of questionnaires in understanding visual difficulties from the patients' own perspective. [ABSTRACT FROM AUTHOR]

Background: The glaucoma-specific blindness prevalence in Nigeria (0.7 %, 95 % CI 0.6-0.9 %) among those aged ≥40 years is one of the highest ever reported. This study determined the risk factors for open-angle glaucoma (OAG) in adults examined in the Nigeria National Blindness and Visual Impairment Survey.Methods: A nationally representative sample of 13,591 people aged ≥40 years in 305 clusters in Nigeria were examined (response rate 90.4 %) between January 2005 to June 2007. Everyone had logMAR visual acuity measurement, Frequency Doubling Technology (FDT) visual field testing, autorefraction, A-scan biometry and optic disc assessment. Full ocular examination (n = 6397), included Goldmann applanation tonometry. Values for defining glaucoma using International Society of Geographical and Epidemiological Ophthalmology criteria were derived from the study population. Disc images were graded by Moorfields Eye Hospital Reading Centre. Socio-demographic factors (age, gender, ethnicity, literacy and place of residence), ocular parameters (intraocular pressure [IOP], axial length and mean ocular perfusion pressure [MOPP]) and systemic parameters (blood pressure, blood glucose and body mass index [BMI]) were assessed for association with OAG.Results: Thirteen thousand eighty-one (96 %) of 13,591 participants had vertical cup:disc ratio measured in at least one eye. 682 eyes of 462 participants were classified as OAG, with 12,738 controls. In univariate analyses the following were associated with OAG: increasing age, male gender, Igbo and Yoruba ethnic groups, illiteracy, longer axial length, higher IOP, lower MOPP, greater severity of hypertension and low BMI (underweight). In multivariate analysis, increasing age (odds ratio [OR] 1.04, 95 % CI 1.03-1.05), higher IOP (OR 1.22, 95 % CI 1.18-1.25) and Igbo ethnicity (OR 1.73, 95 % CI 1.18-2.56) were independent risk factors for OAG.Conclusion: Case detection strategies for OAG should be improved for those aged ≥40 years and for ethnic groups most at risk as a public health intervention. [ABSTRACT FROM AUTHOR]

Background: Although the association between metabolic syndrome and intraocular pressure is well known, the relationship between the intraocular pressure and different combination of the components of metabolic syndrome has not been actively researched yet. The study aimed to investigate the relationship between the intraocular pressure and metabolic syndrome components with their different combinations.Methods: Thirty-one thousand two hundred seventy one healthy people aged 19-79 who attended a community hospital for a health check-up between January 2011 and December 2013 were enrolled in the study. Subjects with a history of intraocular disease, at least in one eye and those receiving medical treatment for glaucoma were excluded. Metabolic syndrome was diagnosed following the criteria defined in Circulation 2009.Results: Subjects with combination of three metabolic syndrome components of triglycerides, abdominal obesity, and fasting glucose had the highest intraocular pressure. And subjects with the combination of four components of blood pressure, high-density lipoproteins, triglycerides, fasting glucose had a significantly higher intraocular pressure than ones with the combination of all five metabolic syndrome components.Conclusions: The difference in the risk of high intraocular pressure according to the different combination of the metabolic syndrome components could be confirmed. If additional follow-up studies are conducted, the findings can be used as an indicator for predicting intraocular pressure increases in patients with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background: Excessive weight is a well-known risk factor for microvascular diseases. Changes in thickness in a vascular tissue, such as the choroid, can be useful to evaluate the effect of obesity on the microvascular system. The aim of this study was to evaluate the choroidal thickness (CT) changes in obese women, using optical coherence tomography (OCT).Methods: The prospective clinical study included examination of the right eyes of 72 patients. The right eyes of 68 patients were examined and served as the controls. A complete ophthalmological examination and OCT imaging were performed for each group studied. The CT in each eye was measured using OCT.Results: The obese group consisted of 72 female patients with a mean age of 37.27 ± 1.18 years. The control group included 68 female subjects with a mean age of 37.85 ± 7.98 years (p > 0.05). There was no statistical significant difference for the foveal retinal thickness measurements between the two groups (p > 0.5). Our study revealed significant choroidal tissue thickening subfoveally and at areas 500 μm temporal, 500 μm nasal, and 1500 μm nasal to the fovea in the obese group (all p < 0.05). There was a positive correlation between body mass index (BMI) and CT changes.Conclusions: CT may increase in obese women and a positive correlation was found between BMI and CT. The trial protocol was approved by the Local Ethical Committee of the Kırıkkale University, date of registration: April 27, 2015 (registration number: 10/11). [ABSTRACT FROM AUTHOR]

Background: Vascular insufficiency has been reported to be a cause of normal tension glaucoma (NTG). The aim of this study was to compare ocular perfusion pressure (OPP) and ophthalmic artery flow (OAF) between patients with NTG and those without glaucoma.Methods: We considered one eye each from 31 NTG and 15 non-glaucoma control patients. Blood pressure and intraocular pressure (IOP) were measured in the sitting position, for calculation of OPP. Humphrey visual field (HVF) assessment was then carried out on NTG patients. All patients then underwent Transcranial Doppler ultrasound measurements of OAF parameters, including mean flow velocity (MFV), end diastolic velocity (EDV), peak systolic velocity (PSV) and resistive index (RI). We looked at differences in OPP and OAF parameters between the two groups, and their correlations in NTG patients. T-tests, χ (2), ANOVA and Pearson Correlation tests were performed, with p < 0.05 considered statistically significant.Results: There were no statistically significant differences in OPP between the NTG and control groups (60.5+/-8.7 mmHg and 62.9+/-10.2 mmHg respectively, p = 0.393), and also no statistically significant differences in MFV, EDV, PSV and RI (all p > 0.05). In the NTG group, there were positive correlations between OPP and both MFV (r = 0.416, p = 0.020) and EDV (r = 0.369, p = 0.041). There were no statistically significant correlations between HVF mean deviation and OPP or OAF parameters (all p > 0.05).Conclusion: There is no difference in OPP and OAF parameters between patients with NTG and non-glaucoma controls, suggesting that vascular insufficiency or dysregulation by themselves may not account for the pathogenesis of NTG. [ABSTRACT FROM AUTHOR]