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14 pages, 1770 KiB

Open AccessArticle

Anterior Scleral Thickness and Other Dimensions in Nanophthalmos by Swept-Source Optical Coherence Tomography: A Comparative Study

by José Ignacio Fernández-Vigo, Olivia Rodríguez-Quet, Elena Montolío-Marzo, Bárbara Burgos-Blasco, Bachar Kudsieh, Julio González-Martin-Moro and Julián García-Feijóo

J. Clin. Med. 2023, 12(17), 5564; https://doi.org/10.3390/jcm12175564 - 26 Aug 2023

Cited by 3 | Viewed by 1418

Abstract

Purpose: The purpose of this study is to assess the ocular dimensions of the anterior and posterior segment, including the anterior scleral thickness (AST) in nanophthalmos compared to control eyes. Methods: A cross-sectional comparative study was carried out in two groups: 46 eyes [...] Read more.

Purpose: The purpose of this study is to assess the ocular dimensions of the anterior and posterior segment, including the anterior scleral thickness (AST) in nanophthalmos compared to control eyes. Methods: A cross-sectional comparative study was carried out in two groups: 46 eyes of 28 patients with nanophthalmos, defined as axial length (AXL) < 20.5 mm, and 60 eyes of 30 controls paired by age and sex. The AST and ocular wall thickness (OWT) were measured by optical coherence tomography in the temporal and nasal quadrants at 1, 2, and 3 mm from the scleral spur. Also, the anterior chamber depth (ACD), white-to-white (WTW), lens thickness (LT), subfoveal choroidal thickness (SFCT), and retinal thickness (RT) were evaluated. Results: The mean AXL was 19.3 ± 1.5 mm in the nanophthalmos group and 23.9 ± 1.1 mm in the control group (p < 0.001). The OWT was thicker in all measurement points in nanophthalmos (p < 0.001). There were no differences in the AST measurements between groups, except for the AST1 and the AST3 in the nasal quadrant. ACD was shallower and LT was thicker in nanophthalmos, with WTW being larger in controls (p < 0.001). SFCT and RT were thicker in nanophthalmos compared to healthy individuals (p < 0.001). Conclusions: Significant anatomical differences are found in nanophthalmic eyes. They present a shallower ACD; thicker LT, OWT, choroid, and retina; and smaller WTW diameter—although no relevant differences in the AST were observed. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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12 pages, 677 KiB

Open AccessArticle

The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study

by Eric W. Lai, Ying-Hsuan Tai, Hsiang-Ling Wu, Ying-Xiu Dai, Tzeng-Ji Chen, Yih-Giun Cherng and Shih-Chung Lai

J. Clin. Med. 2023, 12(9), 3203; https://doi.org/10.3390/jcm12093203 - 29 Apr 2023

Cited by 1 | Viewed by 1770

Abstract

Autoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Health [...] Read more.

Autoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Health Insurance research database to compare the incidences of DED and corneal surface damage between subjects with and without ATD. Multivariable Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the ophthalmological outcomes. A total of 50,251 matched pairs with 748,961 person-years of follow-up were included for analysis. The incidence of DED was 16.37 and 8.36 per 1000 person-years in the ATD and non-ATD groups, respectively. ATDs were significantly associated with increased DED (aHR: 1.81, 95% CI: 1.73–1.89, p < 0.0001). This association was generally consistent across the subgroups of age, sex, different comorbidity levels, and use of systemic corticosteroids or not. Furthermore, patients with ATD had a higher risk of corneal surface damage compared with non-ATD subjects (aHR: 1.31, 95% CI: 1.19–1.44, p < 0.0001), including recurrent corneal erosions (aHR: 2.00, 95% CI: 1.66–2.41, p < 0.0001) and corneal scars (aHR: 1.26, 95% CI: 1.01–1.59, p = 0.0432). Other independent factors for corneal surface damage were age, sex, diabetes mellitus, Charlson Comorbidity Index scores, and use of systemic corticosteroids. Our results suggested that ATDs were associated with higher risks of DED and corneal surface damage. Considering the high prevalence of ATD, prophylactic and therapeutic strategies should be further developed to prevent irreversible vision loss in this susceptible population. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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10 pages, 30039 KiB

Open AccessArticle

The Impact of Color Vision Deficiency on the Capability of Ophthalmologists to Diagnose Benign and Malignant Choroidal Tumors

by Mutasem Elfalah, Saif Aldeen AlRyalat, Nakhleh E. Abu-Yaghi, Mona Mohammad, Ibrahim AlNawiaseh, Deema Rayyan, Moath Albliwi, Mohammad Elfalah, Fawaz AlSarairah and Yacoub A. Yousef

J. Clin. Med. 2023, 12(7), 2744; https://doi.org/10.3390/jcm12072744 - 6 Apr 2023

Cited by 3 | Viewed by 2354

Abstract

Background: Color vision deficiency (CVD) is an under-reported problem among medical personnel, and its impact is still not well characterized. We aim to assess the impact of CVD among ophthalmologists on the accuracy of diagnosing different benign and malignant choroidal lesions. Methods: This [...] Read more.

Background: Color vision deficiency (CVD) is an under-reported problem among medical personnel, and its impact is still not well characterized. We aim to assess the impact of CVD among ophthalmologists on the accuracy of diagnosing different benign and malignant choroidal lesions. Methods: This is a cross-sectional study conducted on ophthalmologists. We used a web-based survey to collect responses through professional ophthalmology society social media. The survey included a set of five images for normal fundus, choroidal nevus, circumscribed choroidal hemangioma, choroidal metastasis, and choroidal melanoma, wherein each image simulated the three main types of CVD: protanopia, deuteranopia, and tritanopia, in addition to a non-simulated image. Results: Forty-one participants were included, with a mean age of 40 (±9.2) years. They were 28 (68%) men and 13 (32%) women. Participants showed significantly low accuracy for definite diagnosis for circumscribed choroidal hemangioma, nevus, melanoma, and metastasis when the images simulated protanopia and deuteranopia, but not tritanopia. Nevertheless, participants maintained the capability to recognize the nature of the lesions for both simulated and non-simulated images if they were benign or malignant, thereby ensuring immediate referral for specialized care. The exception was with simulated choroidal nevi images, wherein participants incorrectly assigned simulated protanopia and deuteranopia nevi images to malignant lesions. Conclusion: Protanopia and deuteranopia affected the accuracy of diagnosing several choroidal lesions; however, ophthalmologists with those two simulated CVDs were still able to discriminate between benign and malignant tumors. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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10 pages, 982 KiB

Open AccessArticle

Adherence to Annual Fundus Exams among Chinese Population with Diagnosed Diabetes

by Yifan Zhou, Xiaowen Li, Qinglei Sun, Jin Wei, Haiyun Liu, Keyan Wang and Jianfeng Luo

J. Clin. Med. 2022, 11(22), 6859; https://doi.org/10.3390/jcm11226859 - 21 Nov 2022

Cited by 2 | Viewed by 1776

Abstract

Adherence to annual fundus examinations in the Chinese population with diabetes and its correlates have not been investigated. The present study obtained data for the first nationally representative survey in China, China Health and Retirement Longitudinal Survey (CHARLS), which collected a wide range [...] Read more.

Adherence to annual fundus examinations in the Chinese population with diabetes and its correlates have not been investigated. The present study obtained data for the first nationally representative survey in China, China Health and Retirement Longitudinal Survey (CHARLS), which collected a wide range of data every 2 years, including demographic, socioeconomic, medical and lifestyle-related information. The adherence rates to annual fundus exams across four waves (2011–2018) were assessed. Univariate and multivariable logistic regressions were used to determine factors associated with adherence. The adherence rates to annual fundus examinations of ou study population were 23.6% in 2011, 15.3% in 2013, 17.5% in 2015 and 21.5% in 2018, respectively. Consistent results over four waves showed that non-adherent patients had a relatively lower educational level, insufficient diabetes medication use, fewer non-medication treatments and irregular physical examination compared to those who were adherent to the annual fundus exam (all p values < 0.05). These variables were further identified as factors associated with adherence according to univariate and multivariate logistic regression analyses (all p values < 0.05). The present study provides explicit evidence that the adherence rate to annual fundus examinations among Chinese population with diabetes is worryingly low. Insufficient educational attainment, especially specific diabetes education, has a negative impact on patients’ adherence to clinical guideline for eye health. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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8 pages, 1061 KiB

Open AccessArticle

Prevention of Surgery-Induced Dry Eye by Diquafosol Eyedrops after Femtosecond Laser-Assisted Cataract Surgery

by Kenichiro Yamazaki, Junko Yoneyama, Ryuta Kimoto, Yuko Shibata and Tatsuya Mimura

J. Clin. Med. 2022, 11(19), 5757; https://doi.org/10.3390/jcm11195757 - 28 Sep 2022

Cited by 1 | Viewed by 2039

Abstract

Purpose: To analyze the protective effects of diquafosol eyedrops on the ocular surface following femtosecond laser-assisted cataract surgery (FLACS). Design: A prospective, randomized contralateral study. Methods: Bilateral FLACS with a trifocal IOL (PanOptix) implantation was performed in 40 eyes in 20 patients (10 [...] Read more.

Purpose: To analyze the protective effects of diquafosol eyedrops on the ocular surface following femtosecond laser-assisted cataract surgery (FLACS). Design: A prospective, randomized contralateral study. Methods: Bilateral FLACS with a trifocal IOL (PanOptix) implantation was performed in 40 eyes in 20 patients (10 males, 10 females, average age 68.8 ± 6.3 years old). Patients received 3% diquafosol eyedrops six times daily in one randomly chosen eye (diquafosol group), and physiological saline six times a day in the other eye (control group). Other medication included 1.5% levofloxacin, 0.1% dexamethasone and 0.1% diclofenac three times daily in both eyes. The pre and post-operative tear break-up time (BUT), superficial punctate keratopathy (SPK) scores and visual function were compared between both eyes, and all patients answered the dry-eye-related quality of life score (DEQS) questionnaire. Results: The BUT between groups was similar pre-operatively and on the first day post-op; however, the BUT was statistically longer in the diquafosol group compared to saline at 1 week (5.5/3.7 s) and 2 weeks (4.8/3.0 s) (p < 0.05). There was no difference in the SPK score, best corrected distance visual acuity, tear meniscus height, contrast sensitivity, DEQS and Schirmer test at all time points. Spherical aberration was statistically lower in the diquafosol group at 1 week. The protective effects of diquafosol on the BUT was more pronounced in patients with a pre-operative BUT of less than 5 s compared with those with a BUT longer than 6 s. Conclusions: Diquafosol eyedrops prevented the shortening of the BUT following FLACS, even in patients with short pre-operative BUT values. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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12 pages, 775 KiB

Open AccessArticle

Tweenager Computer Visual Syndrome Due to Tablets and Laptops during the Postlockdown COVID-19 Pandemic and the Influence on the Binocular and Accommodative System

by Concepción De-Hita-Cantalejo, José-María Sánchez-González, Carmen Silva-Viguera and María Carmen Sánchez-González

J. Clin. Med. 2022, 11(18), 5317; https://doi.org/10.3390/jcm11185317 - 9 Sep 2022

Cited by 2 | Viewed by 2048

Abstract

The aim of our study was to compare computer visual syndrome (CVS) in a tweenager student population who use tablets and laptops only to play versus CVS in tweenagers who use these digital devices at school to study, in addition to playing. The [...] Read more.

The aim of our study was to compare computer visual syndrome (CVS) in a tweenager student population who use tablets and laptops only to play versus CVS in tweenagers who use these digital devices at school to study, in addition to playing. The tests performed were a validated survey for children for the detection of CVS and accommodative and vergence tests. The CVS item questionnaire was divided into four main groups based on questions concerning the following: (I) the digital device usage time, (II) musculoskeletal and ergonomic nature, (III) visual symptoms, and (IV) ocular surface symptoms. The high-demand digital device group showed worse punctuation in all item groups. From the optometric perspective, when the subjects were classified according to the CVS, high-demand participants presented a clear tendency to exophoria with statistically significant differences in distance vision (−1.94 ± 4.48 Δ) and near vision (−5.78 ± 8.62 Δ) (p < 0.01). Our results establish a relationship between the increased use of electronic devices and computer vision syndrome in the preadolescent population. In addition, this situation is related to the presence of visual, accommodative, and binocular dysfunctions that could affect the efficiency of the visual system. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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12 pages, 3622 KiB

Open AccessArticle

Direct Estimation of Choroidal Thickness in Optical Coherence Tomography Images with Convolutional Neural Networks

by Yibiao Rong, Zehua Jiang, Weihang Wu, Qifeng Chen, Chuliang Wei, Zhun Fan and Haoyu Chen

J. Clin. Med. 2022, 11(11), 3203; https://doi.org/10.3390/jcm11113203 - 4 Jun 2022

Cited by 4 | Viewed by 2329

Abstract

Automatic and accurate estimation of choroidal thickness plays a very important role in a computer-aided system for eye diseases. One of the most common methods for automatic estimation of choroidal thickness is segmentation-based methods, in which the boundaries of the choroid are first [...] Read more.

Automatic and accurate estimation of choroidal thickness plays a very important role in a computer-aided system for eye diseases. One of the most common methods for automatic estimation of choroidal thickness is segmentation-based methods, in which the boundaries of the choroid are first detected from optical coherence tomography (OCT) images. The choroidal thickness is then computed based on the detected boundaries. A shortcoming in the segmentation-based methods is that the estimating precision greatly depends on the segmentation results. To avoid the dependence on the segmentation step, in this paper, we propose a direct method based on convolutional neural networks (CNNs) for estimating choroidal thickness without segmentation. Concretely, a B-scan image is first cropped into several patches. A trained CNN model is then used to estimate the choroidal thickness for each patch. The mean thickness of the choroid in the B-scan is obtained by taking the average of the choroidal thickness on each patch. Then, 150 OCT volumes are collected to evaluate the proposed method. The experiments show that the results obtained by the proposed method are very competitive with those obtained by segmentation-based methods, which indicates that direct estimation of choroidal thickness is very promising. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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11 pages, 643 KiB

Open AccessArticle

Risk Factor Analysis of Early-Onset Cataracts in Taiwan

by Lung-Hui Tsai, Ching-Chung Chen, Chien-Ju Lin, Sheng-Pei Lin, Ching-Ying Cheng and Hsi-Pao Hsieh

J. Clin. Med. 2022, 11(9), 2374; https://doi.org/10.3390/jcm11092374 - 23 Apr 2022

Cited by 4 | Viewed by 2386

Abstract

Purpose: According to previous studies, the prevalence rate of cataracts has increased in recent years. This study aims to investigate and analyze the risk factors of early-onset cataracts in Taiwan. Methods: A total of 71 subjects aged between 20 and 55 were diagnosed [...] Read more.

Purpose: According to previous studies, the prevalence rate of cataracts has increased in recent years. This study aims to investigate and analyze the risk factors of early-onset cataracts in Taiwan. Methods: A total of 71 subjects aged between 20 and 55 were diagnosed with cataracts in a medical center. Participants were divided into three groups: control, early-onset cataract (EOC), and combined (EOC combined with dry eye) groups. Eye examinations including autorefraction, best-corrected visual acuity (BCVA), subjective refraction, axial length, fundus, slit lamp, and reactive oxygen species (ROS, including total antioxidative capacity, TAC; C-reactive protein, CRP; and glutathione peroxidase, GPx) were performed. In addition, a questionnaire on patient information, history, habits, family history, and Depression Anxiety Stress Scales (DASS) was completed before the examination. Results: 27 non-EOC (control group), 20 EOC, and 24 combined patients participated in the study. Compared with the control group, Body Mass Index (BMI), gender, educational level, hypertension, diabetes, hyperlipidemia, chronic pain, and body-related diseases were significantly different between the three groups. Family history was also significantly different: family heart disease, hypertension, asthma, allergies, stroke, and immune system were also significantly different. In addition, subjects who took hypertensive drugs, antihistamines, and other medications were also significantly different. Statistical analysis indicated that best corrective visual acuity and the spherical equivalent were significantly different between the three groups. Similar results were found in CRP blood analysis. Discussion and Conclusion: According to the results, EOC may result from systemic diseases. The risk corresponded to an increase in ROS blood analysis. Furthermore, eye drops and medicine intake significantly influenced EOC patients. To prevent or defer early-onset cataracts, monitoring physical health, CRP, and GPx analysis may be worth considering in the future. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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9 pages, 532 KiB

Open AccessArticle

Increased Risk of Refractive Errors and Amblyopia among Children with Ptosis: A Nationwide Population-Based Study

by Ning-Yi Hsia, Li-Yen Wen, Ching-Ying Chou, Cheng-Li Lin, Lei Wan and Hui-Ju Lin

J. Clin. Med. 2022, 11(9), 2334; https://doi.org/10.3390/jcm11092334 - 22 Apr 2022

Cited by 2 | Viewed by 1953

Abstract

Background: This study aimed to investigate the risk of refractive errors (astigmatism, myopia, and hyperopia) and amblyopia in children with ptosis and association between age at diagnosis of ptosis and subsequent risks of vision problems. Methods: Retrospective claims data from the Taiwan National [...] Read more.

Background: This study aimed to investigate the risk of refractive errors (astigmatism, myopia, and hyperopia) and amblyopia in children with ptosis and association between age at diagnosis of ptosis and subsequent risks of vision problems. Methods: Retrospective claims data from the Taiwan National Health Insurance Research Database (NHIRD) were analyzed. We identified 1799 children aged 0–18 years who were newly diagnosed with ptosis between 2000 and 2012 and 7187 individuals without the disease. Both cohorts were followed up until 2013 to estimate the incidence of refractive errors and amblyopia. Results: Children with ptosis had 5.93-fold, 3.46-fold, 7.60-fold, and 13.45-fold increases in the risk of developing astigmatism, myopia, hyperopia, and amblyopia, respectively, compared with the control cohort (astigmatism: adjusted hazard ratio, aHR = 5.93, 95% confidence interval, CI = 5.16–6.82; myopia: aHR = 3.46, 95% CI = 3.13–3.83; hyperopia: aHR = 7.60, 95% CI = 5.99–9.63; amblyopia: aHR = 13.45, 95% CI = 10.60–17.05). Children diagnosed with ptosis at an age older than 3 years old had a higher risk of myopia than patients diagnosed with ptosis before age 3. There was no significant difference of the risk of astigmatism, amblyopia, and hyperopia between age groups. Conclusions: Children with ptosis may exhibit a higher risk of astigmatism, myopia, hyperopia, and amblyopia than children without ptosis. The risk of myopia is higher in children with ptosis diagnosed at >3 years than those diagnosed at ≤3 years. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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Review

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10 pages, 562 KiB

Open AccessReview

Corneal Complications after COVID-19 Vaccination: A Systemic Review

by Li-Ying Huang, Chun-Chi Chiang, You-Ling Li, Hung-Yin Lai, Yi-Ching Hsieh, Ying-Hsuen Wu and Yi-Yu Tsai

J. Clin. Med. 2022, 11(22), 6828; https://doi.org/10.3390/jcm11226828 - 18 Nov 2022

Cited by 11 | Viewed by 2442

Abstract

Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine [...] Read more.

Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27–83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1–42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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12 pages, 623 KiB

Open AccessReview

The Association between Vision Impairment and Depression: A Systematic Review of Population-Based Studies

by Gianni Virgili, Mariacristina Parravano, Davide Petri, Erica Maurutto, Francesca Menchini, Paolo Lanzetta, Monica Varano, Silvio Paolo Mariotti, Antonio Cherubini and Ersilia Lucenteforte

J. Clin. Med. 2022, 11(9), 2412; https://doi.org/10.3390/jcm11092412 - 25 Apr 2022

Cited by 20 | Viewed by 4042

Abstract

We conducted a systematic review and meta-analysis to investigate whether depression is associated with vision impairment (VI) in population-based studies in adults. MEDLINE and EMBASE were searched, from inception to June 2020. Studies were included if they provided two-by-two data for calculating the [...] Read more.

We conducted a systematic review and meta-analysis to investigate whether depression is associated with vision impairment (VI) in population-based studies in adults. MEDLINE and EMBASE were searched, from inception to June 2020. Studies were included if they provided two-by-two data for calculating the OR of association between VI and depression, or crude and/or an adjusted odds ratio (OR) with a corresponding 95% confidence interval (CI) were reported. The proportion of VI and depression was also extracted. ORs were pooled using random-effect models, proportions were pooled using random intercepts logistic regression models. Overall, 29 articles (31 studies) were included: of those, 18 studies used survey data (622,312 participants), 10 used clinical examination data (69,178 participants), and 3 used administrative databases (48,162,290 participants). The proportion of depression (95%CI) was 0.17 (0.13–0.22) overall and 0.27 (0.21–0.33) in VI subjects. The proportion of VI was 0.10 (0.07–0.16) overall and 0.20 (0.13–0.29) in depressed subjects. The association between VI and depression was direct: crude ORs were 1.89 (1.51–2.37) for survey data, 2.17 (1.76–2.67) for clinical examination data, and 3.34 (1.01–11.11) for administrative databases; adjusted ORs were 1.75 (1.34–2.30), 1.59 (1.22–1.96), and 2.47 (0.97–6.33), respectively. In conclusion, VI and depression are prevalent morbidities and should be actively sought when either is identified, especially in older adults. Full article

(This article belongs to the Special Issue Advances in Vision Disorders: Causes and Epidemiology)

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