Clinical features and treatment outcomes of intraocular lymphoma: a single-center experience in China

AIM:To investigate the clinical manifestations,diagnostic approaches,treatments,and outcomes of intraocular lymphoma.METHODS:In this retrospective study,16 patients(28 eyes)with intraocular lymphoma were recruited in the Department of Ophthalmology,Peking Union Medical College Hospital,from 2004 to 2019.All patients underwent comprehensive ophthalmic examinations.Vitreous specimens of 13 patients were sent for cytopathology examination and other adjunctive diagnostic procedures.Three patients were diagnosed with intraocular lymphoma according to analysis of the histopathological results of systemic lymphoma by one clinician.Twenty-three eyes were treated with intravitreal administration of methotrexate,4 eyes could not receive ocular treatment due to life-threatening lymphoma,and 1 eye did not require ocular treatment because the fundus lesions regressed after systematic chemotherapy.RESULTS:In 28 eyes,25 eyes were diagnosed with vitreoretinal lymphoma,and 3 eyes were diagnosed with ciliary body lymphoma,all of which were non-Hodgkin diffuse large B cell lymphomas.The final visual acuity improved in 15 eyes(54%),remained unchanged in 5 eyes(18%),and decreased in 8 eyes(29%).Anterior segment inflammation disappeared or reduced in 8 and 5 eyes,respectively;and 15 eyes had no anterior segment reaction.Twenty eyes had mild vitreous opacity,1 eye had mild vitritis,and 7 eyes had pars plana vitrectomy combinedwith silicone oil tamponade.Fundus lesions disappeared in 9 eyes and were relieved in 5 eyes;4 eyes showed no changes,and the remaining 10 eyes’fundus were normal.CONCLUSION:The clinical manifestations of intraocular lymphoma are diverse,and the misdiagnosis rate is high.Cytopathological analysis of vitreous is one of the gold standards for the diagnosis.Immunohistochemistry,gene rearrangement and flow cytometric immunophenotypic analysis can improve the diagnostic rate.Ocular chemotherapy or radiotherapy regimens may preserve visual acuity,and a multidisciplinary team can provide individualized treatment for the patients.     

Efficacy of Carbamazepine Combined with Botulinum Toxin A in the Treatment of Blepharospasm and Hemifacial Spasm

 Purpose: To observe the efficacy of the combined treatment of carbamazepine and botulinum toxin A for blepharospasm and hemifacial spasm. Methods: Fifty-eight patients with either blepharospasm or hemifacial spasm were randomly divided into treatment and control groups. In the treatment group, 30 patients were administered with local intramuscular injections of botulinum toxin A and oral carbamazepine 100 mg/time,3 times/day for 60 days. Twenty-eight subjects in the control group underwent local intramuscular injections of botulinum toxin A only. Results: After combined treatment, the complete remission rate was 90%, which was significantly higher than that of the of the control group (67.9%, P<0.05，X2=4.733). However, no statistical significance was noted regarding the duration of therapeutic effects between the treatment group (range 14~40 weeks; 19.2 weeks on average) and control group (range 12~36 weeks; 18 weeks on average). Conclusion: The combined therapy of carbamazepine and topical injections of botulinum toxin A had increased efficacy in the treatment of blepharospasm or hemifacial spasm, but had no significant effect in terms of the duration of the therapeutic effect.     

Clinical Features and Differential Diagnosis of Acute Idio-pathic Blind Spot Enlargement Syndrome

Purpose： To study the clinical manifestations and the diag- nostic and differential diagnostic characteristics of acute idio- pathic blind spot enlargement syndrome （AIBSES）. Methods： Six patients diagnosed with AIBSES underwent complete eye examinations including fundus photography, fundus fluorescein angiography（FFA）, indocyanine green an- giography （ICGA）, optical coherence tomography （OCT）, electroretinogram （ERG）, and visual field examinations. Results： All patients had enlarged blind spots of variable sizes and densities. Three eyes had mild swelling of the optic disc and one eye had peripapillary scarring that corresponded to the permanent field defect. Two patients who underwent FFA had fluorescein leakage of blood vessels around the optic disc and ICGA highlighted diffuse, small hypofluorescent spots scatter- ing throughout the posterior pole. OCT showed that the inner and outer segment （IS/OS） line were absent in five patients and the middle cone outer segment tip line was absent in the nasal macular area in one eye.     

Clinical Analysis of the Incidence and the Treatment of Pediatric Cataract Patients with Optic-nerve Maldevelopment

 Purpose: To interpret the incidence of optic-nerve maldevelopment in postoperative pediatric cataract patients, and evaluate the clinical efficacy of administration of murine nerve growth factor (mNGF) in such patients. Method: Pattern visual evoked potential (P-VEP) was used to measure the visual pathway function in 28 cases (56 eyes) with bilateral congenital cataract and 13 cases (13 eyes) with unilateral congenital cataract who underwent cataract extraction and intraocular lens implantation surgeries. The results were compared with 25 age-sex-matched healthy children (50 eyes). We administered mNGF in 13 cases (23 eyes) who had visual pathway disorder. The efficacy of mNGF injection was observed. P100 latencies, which were used as a main parameter in P-VEP measurement, were analyzed statistically. Result: When compared with normal children, the P100 latency was significantly prolonged in the congenital cataract group (P<0.05). A significant improvement was noted in the visual pathway of subjects treated with mNGF (P<0.05). Conclusion: Compared with normal children, the congenital cataract patients are more vulnerable to optic-nerve maldevelopment. Murine NGF likely plays a protective and nutritive role in the development of optic nerve in cases of optic-nerve maldevelopment followed by congenital cataract surgery.     

Effect of lens surgery on health-related quality of life in preschool children with congenital ectopia lentis

AIM: To evaluate the effect of lens surgery on health-related quality of life (HRQoL) of preschool children with congenital ectopia lentis (CEL). METHODS: A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center. Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study. All of them completed the child and proxy (parental) PedsQL™ 4.0 before and after the surgery. Their preoperative scores were compared to their postoperative ones. Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children. RESULTS: Thirty-two children with CEL successfully underwent surgery without any complications, among whom 8 had monocular surgery and 24 had binocular surgery. Preoperative and postoperative questionnaires were completed by 32 child-parent pairs. Surgical intervention could significantly improve the vision of affected children (P<0.001). The medians of physical, psychosocial and total health scores self-reported by the children were 68.75 (62.50, 81.25), 65.00 (60.00, 80.00) and 67.39 (60.87, 78.26) preoperatively and were 93.75 (87.50, 100.00), 90.00 (83.33, 96.67) and 89.13 (85.32, 95.65) postoperatively. The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children (P<0.001). All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents (P<0.001). In the physical functioning evaluation, the preoperative score reported by parents of girls was higher than parents of boys (P=0.041), and the postoperative score of girls was higher than that of boys (P=0.036). CONCLUSION: CEL is associated with significantly worse quality of life in preschool children. Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.     

Prevalence of heterophoria in a population of school children in central China:the Anyang Childhood Eye Study

AIM:To investigate the prevalence of heterophoria and the relationship between heterophoria and refractive error in a school-based study conducted in central China.METHODS:A total of 23637 th-grade children were recruited into the cross-sectional school-based Anyang Childhood Eye Study(ACES)by cluster sampling method.Heterophoria was examined using alternate cover and cover-uncover testing.The Maddox rod and prism test were conducted at 33 cm and 6 m distance fixation.Uncorrected viual acuity(UCVA)and best-corrected viual acuity(BCVA)were recorded as logarithm of the minimum angle of resolution(logM AR)with cycloplegic autorefraction by administrating of Mydrin-P and 1.0%cyclopentolate.Hyperopia was defined as the spherical equivalent(SE)refraction of+0.50 D or greater,and higher hyperopia was defined as+2.00 D or greater.Emmetropia was defined as the SE refraction in the range of-0.49 to+0.49 D,and myopia was in the SE refraction range from-0.50 D to less.RESULTS:Totally 2260 students in grade 7 were examined.Response rate among eligible children was 95.64%.Totally 486 children,22.66%of the population,were diagnosed with heterophoria in which 479 were diagnosed with exophoria at near distance,and 6 with esophoria.Totally 89(4.15%)children were diagnosed with heterophoria in which 82 had exophoria,and 7 had esophoria at far distance.Exophoria was common at near fixation(22.33%).Myopia was examined to be related to exophoria at near distance(OR 3.03,95%CI 2.33-3.95)and far distance fixation(OR 1.90,95%CI 1.09-3.32).CONCLUSION:Exophoria is a predominant heterophoria for 7 th-grade junior school in central China.Significant associations are discovered between heterophoria and refractive error.Hyperopia is associated with esophoria,and myopia is associated with exophoria.     

Surgical Treatment for the Proliferative Retinal Detachment Associated with Macular Hole in the Morning Glory Syndrome

 PURPOSE:To evaluate the efficacy of vitrectomy with peripapillary photocoagulation and silicone oil tamponade for the proliferative retinal detachment associated with macular hole in children with morning glory syndrome.   METHODS:Eight children with morning glory syndrome (mean age 8.0±2.8 years; range 5–13 years) were included; all patients had unilateral eye disease and were initially misdiagnosed as having bilateral squint or amblyopia, with best corrected visual acuity &;lt;6/60. Five patients could not cooperate with the fundus examination and one patient had lens opacities. B ultrasound confirmed that all eight patients had retinal detachment and optic disc dysplasia. All patients underwent standard 3-port pars plana vitrectomy surgery (20G for three cases and 23G for five cases). At surgery, all patients were confirmed to have morning glory syndrome, macular hole, and proliferative retinal detachment; two cases had a funnel-shaped bulge. All the retinal detachments involved the macular area, and macular hole was detected in the abnormal expansion excavation of the optic disk. The epiretinal membrane and subretinal membrane were completely removed during surgery. Combined photocoagulation in the abnormal expansion excavation of the optic disk, and silicone oil tamponade were also performed. RESULTS:All eyes achieved anatomical resolution of retinal detachment. After follow-ups ranging from eight months to four years, the visual function for all patients was improved by postoperative refractive correction associated with vision training. Best corrected visual acuity was 6/600 to 6/30 at the final follow-up, no retinal detachment recurred, and no silicone oil fluid entered the subretinal space. The silicone oil was successfully removed postoperatively after a mean of 1.5 years.   CONCLUSION:Vitrectomy with peripapillary photocoagulation and silicone oil tamponade is effective in treating the proliferative retinal detachment associated with macular hole in children with morning glory syndrome.       

Ocular disorders in children with spastic subtype of cerebral palsy

AIM: To document common ocular abnormalities in children with spastic subtype of cerebral palsy (CP) and to find out whether any correlation exists between their occurance and etiologic factors.METHODS: Totally 194 patients with the diagnosis of spastic type CP were enrolled in this retrospective study. Detailed ophthalmic examinations were performed. Demographic data and neuroradiological findings were documented. Kruskal-Wallis, Mann Whitney U, Pearson Chi-square tests and Student’s t tests were used in the statistical analysis.RESULTS: The mean age was 64.7±44.2 months on the first ophthalmic examination. Prevalences of diplegia (47.4%) and tetraplegia (36.1%) were found to be higher than the frequency of hemiplegia (16.5%) in our study population. Etiologic factor was asphyxia in 60.8% of the patients. Abnormal ocular findings were present in 78.9% of the patients. Statistically significant poor vision was detected in tetraplegia group among all the spastic ubtypes of CP (P=0.000). Anisometropia and significant refractive error were found in 14.4% and 70.1% of the patients, respectively. Thirty-six children (18.6%) had nystagmus and 107 children (55.2%) had strabismus. Lower gestational age and birth weight were statistically higher in patients with esotropia than exotropia (P=0.009 and P=0.024, respectively). Abnormal morphology of the optic disc was present in 152 eyes (39.2%). Severe periventricular leukomalacia (PVL) was found in 48 patients and statistically significant poor vision was detected in the presence of PVL (P=0.000).CONCLUSION: Spastic diplegic or tetraplegic CP patients with positive neuroradiological symptoms, younger gestational age and lower birth weight ought to have detailed ophthalmic examinations as early as possible to provide best visual rehabilitation.     

Diagnostic Value of the Post-Processing Technique of Multi-Slice Spiral CT in Orbital Cyst Diseases

Purpose:To analyze the features of CT imaging of orbital cystic disease. Methods:.A total of 30 patients were pathologically confirmed with orbital cystic disease between January 2007 and March 2012. Prior to operation, the participants underwent CT scans with image processing by maximum intensity projection (MIP) and volume rendering (VR). Preoperative CT diagnostic outcomes were compared with postoperative pathological findings. Results:.The patients presented with round,.oval and dumbbell shaped masses. Fourteen cases of dermoid cyst and 8 cases of epidermoid cyst showed heterogeneous density. Among the dermoid cyst patients, 6 cases had demixing phenomenon, 3 cases had lipid drift and 5 cases showed mild or moderate intensity enhancement in the cyst wall. No intensity enhancement was observed in the epidermoid cyst patients. Five cases had high intensity due to hemorrhage and 3 patients presented with adjacent sclerotin arc compression;.5 cases of myxoid cyst had homogenous density and no intensity enhancement was found when iohexol was injected..Three patients with atheromatous cyst had heterogeneous density,.with CT value ranging from -36Hu to 191Hu. Floss was noted centrally in 1 case and mild to moderate intensity enhancement was observed in the cyst wall with iohexol injection. Conclusion:.Multi-slice CT is useful in the diagnosis of orbital cystic disease. Multi-slice CT combined with image processing can be helpful in displaying the location and size of masses, and revealing the relationship between masses and surrounding boney tissue, providing an objective basis for surgical planning when combined with 3D-CT imaging.     

Unilateral foveomacular retinitis resembling solar retinopathy among young soldiers in Korean army and associated multimodal imaging findings

AIM: To describe the clinical features and multimodal images of unilateral foveomacular retinitis in young Korean soldiers. METHODS: Ten patients having foveomacular retinitis were included. Fluorescein angiography, fundus autofluorescence(FAF), infrared reflectance(IR), and spectral-domain optical coherence tomography(SD-OCT) were analyzed.RESULTS: All patients were young males experienced insidious visual decline without exposure to bright light. Initial and final vision ranged from hand movement to 20/20(median 20/200) and 20/2000 to 20/20(median 20/500), respectively. Vision decreased in 6 patients while improved in two. Typical macular abnormality was yellow granular spots. SD-OCT showed ellipsoid zone(EZ) or interdigitation zone(IZ) disruption of fovea. The degree of EZ/IZ damage correlated with vision. Lesions were clearly visualized through IR and matched with SD-OCT findings.CONCLUSION: This is the first case series of foveomacular retinitis diagnosed with multimodal imaging. Foveomacular retinitis should be suspected in sudden unilateral visual decline especially in young soldiers. SD-OCT is the most important diagnostic modality.     

Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions

AIM:To evaluate the diagnostic properties of wide-field fundus autofluorescence (FAF) scanning laser ophthalmoscope (SLO) imaging for differentiating choroidal pigmented lesions.METHODS:A consecutive series of 139 patients were included, 101 had established choroidal melanoma with 13 untreated lesions and 98 treated with radiotherapy. Thirty-eight had choroidal nevi. All patients underwent a full ophthalmological examination, undilated wide-field imaging, FAF and standardized US examination. FAF images and imaging characteristics from SLO were correlated with the structural findings in the two patient groups.RESULTS:Mean FAF intensity of melanomas was significantly lower than the FAF of choroidal nevi. Only 1 out of 38 included eyes with nevi touched the optic disc compared to 31 out of 101 eyes with melanomas. In 18 out of 101 melanomas subretinal fluid was seen at the pigmented lesion compared to none seen in eyes with confirmed choroidal nevi. In “green laser separation”, a trend towards more mixed FAF appearance of melanomas compared to nevi was observed. The mean maximal and minimal transverse and longitudinal diameters of melanomas were significantly higher than those of nevi.CONCLUSION:Wide-field SLO and FAF imaging may be an appropriate non-invasive diagnostic screening tool to differentiate benign from malign pigmented choroidal lesions.     

Optical and visual quality comparison of implantable collamer lens and femtosecond laser assisted laser in situ keratomileusis for high myopia correction

AIM: To explore the diagnostic performance of isolated-check visual evoked potential (icVEP) for primary open-angle glaucoma (POAG) in both highly myopic and non-highly myopic populations and compare it with those of optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) parameters. METHODS: A total of 126 participants were recruited, including 31 highly myopic participants with POAG (HM-POAG), 36 non-highly myopic participants with POAG (NHM-POAG), 25 highly myopic participants without POAG (HM) and 34 controls without high myopia (Normal). All the participants underwent a complete ophthalmic examination. The signal-to-noise ratio (SNR) was used to assess the icVEP. Both qualitative and quantitative diagnostic performances of OCT, HRT and the icVEP were analyzed and compared. RESULTS: Based on the criterion of SNR≤1, the diagnostic performance of the icVEP in highly myopic subjects [area under the receiver operating characteristic curve (AUC)=0.862] was better than that in non-highly myopic subjects (AUC=0.789), and the SNR had fairly good specificity. In distinguishing the HM-POAG and HM groups, the AUC of the SNR was not different from those of the OCT and HRT parameters (P>0.05) in either the qualitative or quantitative comparison. In the qualitative analysis, the icVEP showed good consistency with damage to the central 10° of the visual field (kappa=0.695-0.747, P<0.001). CONCLUSION: The icVEP has the potential to discriminate individuals with and without POAG, especially in populations with high myopia.     

Characteristics of retinal vein occlusion with final vision better than 78 letters after sequential therapy with ranibizumab and triamcinolone acetate

AIM: To analyze the reasons that may lead to the different vision result by combining the ranibizumab and triamcinolone acetate (TA) in sequence to treat macular edema in retinal vein occlusion (RVO). METHODS: Ranibizumab and TA were combined in sequence to treat 43 patients with macular edema secondary to RVO. Six months after the treatment, patients with central fovea thickness (CFT) less than 300 μm in optical coherence tomography (OCT) were collected into GroupsⅠand Ⅱ, based on vision acuity (VA) better than 78 letters or less than 60 letters. The age, baseline VA, duration from onset to treatment, CFT at the baseline, sub-retinal fluid (SRF), sub-foveal exudates and injection times of TA and ranibizumab were taken into comparison. RESULTS: The mean age of the subjects was 46.4y in Group Ⅰbut 57.5y in Group Ⅱ. The difference of age was significant between groups (P<0.01). The mean baseline VA was 51.4 letters in Group Ⅰand 43.9 letters in Group Ⅱ (P<0.05). The baseline CFT were 670.9 μm in Group Ⅰwith SRF in 54.3% patients and 678.1 μm in Group Ⅱ with SRF in 52.9% (P>0.05). The mean number of injections of TA was 0.9 and the mean number of injections of ranibizumab was 2.3 in Group Ⅰbut 1.7 and 2.9 respectively in Group Ⅱ. The treatment times of ranibizumab had no difference between the 2 groups (P>0.05) but the difference of TA injection times was significant, P<0.05. Subfoveal exudates at final stage happened in no subjects in Group Ⅰ but in 45.83% subjects in Group Ⅱ. CONCLUSION: This combined treatment is safer than TA injection and cheaper than ranibizumab injection alone. Younger patients and earlier treatment will help to get better vision outcome. Subfoveal exudates at the final stage have significant relationship with vision outcome. No relationship existed between the baseline CFT, SRF and the vision outcome.     

Preoperative evaluation and outcome of corneal transplantation for limbal dermoids: a ten-year follow-up study

AIM: To summarize preoperative evaluation and outcome of corneal transplantation for limbal dermoids for ten years. METHODS: Eighty-five patients diagnosed with limbal dermoids and treated with corneal transplantation were analyzed retrospectively. All patients were further divided into two groups according to absence or presence of neovascularization surrounding the dermoids in the corneal stroma. Eighty-two eyes were treated with tumor excision combined with partial lamellar sclerokeratoplasty, and the other three eyes were performed by penetrating keratoplasty. The size and location of the tumor, the associated ocular and systemic anomalies, the depth of the corneal penetration of tumor tissues, the preoperative and postoperative best-corrected visual acuity (BCVA), graft survival and cosmetic outcome, and surgical complications were recorded respectively. RESULTS: The average age at surgery was 5.3y (range, 3mo-36y). The mean size of dermoids was 6.1±1.6 mm. The 43.5% of eyes (37/85) were present with hair at the surface of the dermoid and 72.9% of dermoids were located inferotemporal of the eye. Amplyopia was present in 34.1% of patients (29/85) and 9.4% of patients (8/85) had lipodermoids. Eighteen patients suffered from Goldenhar’s syndrome with an accessory ear. The 75% of patients in group 1 had involvement of the corneal deep stroma down to Descemet’s membrane without involving it, but 71.4% of patients had Descemet’s membrane involvement in group 2. Preoperative BCVA ranged from counting fingers to 20/20. Postoperatively 81.1% had a BCVA of 20/800 or better. There was no significant difference between the post-surgical BCVA of the two groups (t=1.584, P>0.05). The grafts of 70.5% patients were present as 1+ opacity, 21.1% as 2+ opacity, 8.2% as 3+ opacity and none as 4+ opacity. Surgical complications included graft rejection, microperforation, prolonged reepithelialization, steroid glaucoma, interface neovascularization, and interface hemorrhage. CONCLUSION: The dermoids with neovascularization surrounding them in the corneal stroma invaded deeper tissues in the cornea than those with no neovascularization surrounding them in the corneal stroma. Therefore, surgeons should take care to avoid corneal perforation during the corneal transplantation operation. The majority of patients markedly improved their cosmetic appearance after surgery.     

Influence of severity and types of astigmatism on visual acuity in school-aged children in southern China

AIM: To investigate the influence of astigmatism on visual acuity in school-aged children, and to define a cutoff for clinically significant astigmatism. METHODS: This is a population-based, cross-sectional study. Among 5053 enumerated children aged 5-15y in Guangzhou, 3729 (73.8%) children aged 7-15 with successful cycloplegic auto-refraction (1% cyclopentolate) and a reliable visual acuity measurement were included. Ocular measurement included external eye, anterior segment, media and fundus and cycloplegic auto-refraction. Primary outcome measures included the relationship between severity and subtypes of astigmatism and the prevalence of visual impairment. Three criteria for visual impairment were adopted: best-corrected visual acuity (BCVA) ≤0.7, uncorrected visual acuity (UCVA) ≤0.5 or <0.7 in the right eye. RESULTS: Increases of cylinder power was significantly associated with worse visual acuity (UCVA: β=0.051, P<0.01; BCVA: β=0.025, P<0.001). A substantial increase in UCVI and BCVI was seen with astigmatism of 1.00 diopter (D) or more. Astigmatism ≥1.00 D had a greater BCVI prevalence than cylinder power less than 1.00 D (OR=4.20, 95%CI: 3.08-5.74), and this was also true for hyperopic, emmetropic and myopic refraction categories. Oblique astigmatism was associated with a higher risk of BCVI relative to with the rule astigmatism in myopic refractive category (OR=12.87, 95%CI: 2.20-75.38). CONCLUSION: Both magnitude and subtypes of astigmatism influence the prevalence of visual impairment in school children. Cylinder ≥1.00 D may be useful as a cutoff for clinically significant astigmatism.     

Effectiveness of in-office blood pressure measurement by eye care practitioners in early detection and management of hypertension

AIM: To investigate the number of hypertensive patients, the optometrist is able to identify by routinely taking blood pressure (BP) measurements for patients in “at-risk” groups, and to sample patients’ opinions regarding in-office BP measurement. Many of the optometrists in Saudi Arabia practice in optical stores. These stores are wide spread, easily accessible and seldom need appointments. The expanding role of the optometrist as a primary health care provider (PHCP) and the increasing global prevalence of hypertension, highlight the need for an integrated approach towards detecting and monitoring hypertension.METHODS:Automated BP measurements were made twice (during the same session) at five selected optometry practices using a validated BP monitor (Omron M6) to assess the number of patients with high BP (HBP) -in at-risk groups-visiting the eye clinic routinely. Prior to data collection, practitioners underwent a two-day training workshop by a cardiologist on hypertension and how to obtain accurate BP readings. A protocol for BP measurement was distributed and retained in all participating clinics. The general attitude towards cardiovascular health of 480 patients aged 37.2 (±12.4)y and their opinion towards in-office BP measurement was assessed using a self-administered questionnaire.RESULTS: A response rate of 83.6% was obtained for the survey. Ninety-three of the 443 patients (21.0%) tested for BP in this study had HBP. Of these, (62 subjects) 66.7% were unaware of their HBP status. Thirty of the 105 subjects (28.6%) who had previously been diagnosed with HBP, still had HBP at the time of this study, and only 22 (73.3%) of these patients were on medication. Also, only 25% of the diagnosed hypertensive patients owned a BP monitor.CONCLUSION: Taking BP measurements in optometry practices, we were able to identify one previously undiagnosed patient with HBP for every 8 adults tested. We also identified 30 of 105 previously diagnosed patients whose BP was poorly controlled, twenty-two of whom were on medication. The patients who participated in this study were positively disposed toward the routine measurement of BP by optometrists.     

Prognostic factors and clinical features of rhino-orbital-mucormycosis cases: an update for patient and visual survivals

AIM: To determine the frequency of patients’ vision survival and prognostic factors and evaluate clinical features in rhino-orbital mucormycosis. METHODS: Forty-three eyes of 43 patients followed up with orbital mucormycosis infections were included in the study. Demographic characteristics of the patients, symptoms at admission, ophthalmologic and non-ophthalmologic examination findings, clinical findings during follow-up, medical and surgical procedures, and complications were recorded. Patient survival was determined by assessing the incidence of mortality, and vision survival was defined as achieving a final visual acuity of at least light perception. RESULTS: Twenty-seven (62.8%) patients were male, and 16 (37.2%) were female. When the underlying disease status of the patients was examined, it was observed that all patients had an underlying disease and diabetes constituted the majority (65.2%). Periorbital swelling (69.8%) and ophthalmoplegia (53.5%) were the most common symptoms and findings at the admission of patients with mucormycosis infection. The disease resulted in death in 22 (51.2%) patients. The presence of fever and shorter duration of antifungal therapy were associated with lower patient survival. Exenteration surgery was not found to be associated with the survival of the patients. Frozen eye, loss of pupillary light reflex, and development of central retinal artery occlusion were associated with lower vision survival. CONCLUSION: This study presents one of the most extensive patient series in the literature on rhino-orbital mucormycosis. Knowing the patients’ symptoms at the time of admission and the clinical findings during the infection process will increase awareness about the disease.     

阿托品联合双焦镜控制青少年轻中度近视疗效分析

Objective To evaluate the efficacy and safety of topical atropine and bifocal lens in slowing the progression of myopia and ocular axial elongation in children with slight to moderate myopia. Methods This trial included 62 children with slight to moderate myopia. They were all being treated in the Second Hospital of the Zhengzhou of Henan. Forty-two children were treated with 1% atropine ointment once daily before sleep for 1 year, and were demanded to wear bifocal lens at the same time. The other children were assigned to control group. Baseline and last assessments of refractive errors by cycloplegic autorefiaction and of axial length were done by ultrasound biometry. Intraocular pressure and corneal curvature were also recorded. The results were compared with data of control subjects. Results The visual acuity of 38 eyes (36.84%) in the treated group cutted down, compared with 80% in the control group. After 1 year, the mean progression of myopia and of axial elongation in the control group was -1.19±1.48D and 0.70± 0.63mm respectively. In the atropine-treated eyes, the mean progression of myopia was only±0.06± 0.79D and of axial elongation was 0.09± 0.19mm. Five children were forced to stop treatment because of photophobia and anaphylactic conjunctivitis. No other major adverse effects related to the treatment were noted. Conclusions 1% Atropine ointment and bifocal lens are safe and effective treatment for retarding myopic progression in slight to moderate myopia.This treatment is well tolerated by most children.     

阿托品联合双焦镜控制青少年轻中度近视疗效分析

Objective To evaluate the efficacy and safety of topical atropine and bifocal lens in slowing the progression of myopia and ocular axial elongation in children with slight to moderate myopia. Methods This trial included 62 children with slight to moderate myopia. They were all being treated in the Second Hospital of the Zhengzhou of Henan. Forty-two children were treated with 1% atropine ointment once daily before sleep for 1 year, and were demanded to wear bifocal lens at the same time. The other children were assigned to control group. Baseline and last assessments of refractive errors by cycloplegic autorefiaction and of axial length were done by ultrasound biometry. Intraocular pressure and corneal curvature were also recorded. The results were compared with data of control subjects. Results The visual acuity of 38 eyes (36.84%) in the treated group cutted down, compared with 80% in the control group. After 1 year, the mean progression of myopia and of axial elongation in the control group was -1.19±1.48D and 0.70± 0.63mm respectively. In the atropine-treated eyes, the mean progression of myopia was only±0.06± 0.79D and of axial elongation was 0.09± 0.19mm. Five children were forced to stop treatment because of photophobia and anaphylactic conjunctivitis. No other major adverse effects related to the treatment were noted. Conclusions 1% Atropine ointment and bifocal lens are safe and effective treatment for retarding myopic progression in slight to moderate myopia.This treatment is well tolerated by most children.     

Amblyopia screening for first and second-grade children in Jordan

AIM: To share the results of a national screening program for amblyopia in school children in the north of Jordan. METHODS: This is a prospective national screening study for amblyopia. The program rolls first and second-grade children (6 to 7 years old) in the north of Jordan. The eye examination included: best-corrected visual acuity, cover-uncover test, and cycloplegic retinoscopy. Monocular visual acuity was tested using an ETDRS visual acuity chart without correction. Moreover, children were tested with full cycloplegic refraction when the test criteria were met. Unilateral amblyopia was defined as a best-corrected visual acuity difference of 2 or more lines. In comparison, bilateral amblyopia was defined as a best-corrected visual acuity of 20/40 or worse in the best eye. RESULTS: The prevalence of amblyopia for the total sample tested (n=17 203) was 2.78% (n=479). The most common cause of amblyopia was hypermetropia (64.45%), followed by previous ocular surgeries (15.1%), myopia (10.43%), strabismus (9.39%), and congenital cataract (0.63%). CONCLUSION: This is the first and only study, identi?ng modifiable risk factors in Jordanian children with amblyopia. In their first couple of years of elementary education, many Jordanian children are affected by amblyopia and pass unnoticed. A more governmental effort is needed into screening programs to improve vision in the Jordanian population.