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Patel R, Nair S, Choudhry H, Jaffry M, Dastjerdi M. Ocular manifestations of liver disease: an important diagnostic aid. Int Ophthalmol 2024; 44:177. [PMID: 38622271 PMCID: PMC11018673 DOI: 10.1007/s10792-024-03103-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE This review examined existing literature to determine various ocular manifestations of liver pathologies, with a focus on metabolic deficiencies as well as viral and immune liver conditions. METHODS Recent data were compiled from PubMed from 2000 to 2020 using keywords that were relevant to the assessed pathologies. Ocular presentations of several liver pathologies were researched and then summarized in a comprehensive form. RESULTS Several ocular manifestations of liver disease were related to vitamin A deficiency, as liver disease is associated with impaired vitamin A homeostasis. Alcoholic liver cirrhosis can result in vitamin A deficiency, presenting with Bitot spots, xerosis, and corneal necrosis. Congenital liver diseases such as mucopolysaccharidoses and peroxisomal disorders are also linked with ocular signs. Viral causes of liver disease have associations with conditions like retinal vasculitis, keratoconjunctivitis sicca, retinopathies, Mooren's ulcer, and Sjogren's syndrome. Autoimmune hepatitis has been linked to peripheral ulcerative keratitis and uveitis. CONCLUSIONS Building strong associations between ocular and liver pathology will allow for early detection of such conditions, leading to the early implementation of management strategies. While this review outlines several of the existing connections between hepatic and ophthalmic disease, further research is needed in the area in order to strengthen these associations.
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Affiliation(s)
- Riya Patel
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, USA
| | - Smriti Nair
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, USA
| | - Hassaam Choudhry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, USA.
| | - Mustafa Jaffry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, USA
| | - Mohammad Dastjerdi
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, USA
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Lin ZJ, Long JY, Li J, Wang FN, Chu W, Zhu L, Li YL, Fan LL. Case report: Whole exome sequencing identified a novel mutation (p.Y301H) of MAF in a Chinese family with congenital cataracts. Front Med (Lausanne) 2024; 11:1332992. [PMID: 38487030 PMCID: PMC10937461 DOI: 10.3389/fmed.2024.1332992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/07/2024] [Indexed: 03/17/2024] Open
Abstract
Background Congenital cataracts stand as the primary cause of childhood blindness globally, characterized by clouding of the eye's lens at birth or shortly thereafter. Previous investigations have unveiled that a variant in the V-MAF avian musculoaponeurotic-fibrosarcoma oncogene homolog (MAF) gene can result in Ayme-Gripp syndrome and solitary cataract. Notably, MAF mutations have been infrequently reported in recent years. Methods In this investigation, we recruited a Chinese family with non-syndromic cataracts. Whole exome sequencing and Sanger sequencing were applied to scrutinize the genetic anomaly within the family. Results Through whole exome sequencing and subsequent data filtration, a new mutation (NM_005360, c.901T>C/p.Y301H) in the MAF gene was detected. Sanger sequencing validated the presence of this mutation in another affected individual. The p.Y301H mutation, situated in an evolutionarily preserved locus, was not detected in our 200 local control cohorts and various public databases. Additionally, multiple bioinformatic programs predicted that the mutation was deleterious and disrupted the bindings between MAF and its targets. Conclusion Hence, we have documented a new MAF mutation within a Chinese family exhibiting isolated congenital cataracts. Our study has the potential to broaden the spectrum of MAF mutations, offering insights into the mechanisms underlying cataract formation and facilitating genetic counseling and early diagnosis for congenital cataract patients.
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Affiliation(s)
- Zhao-Jing Lin
- Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jie-Yi Long
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
| | - Juan Li
- Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, China
| | - Fang-Na Wang
- Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, China
| | - Wei Chu
- Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, China
| | - Lei Zhu
- Department of Obstetrics and Gynecology, Ordos Central Hospital, Ordos, China
| | - Ya-Li Li
- Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, China
| | - Liang-Liang Fan
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
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Hložánek M, Cilečková L, Alió JL, Autrata R, Zelenayová N, Komínek M, Cendelín J, Mahelková G. Risk of visual axis opacification in infants with and without primary IOL implantation after congenital cataract surgery performed during the first 4 months of age. Graefes Arch Clin Exp Ophthalmol 2023; 261:3643-3649. [PMID: 37329362 PMCID: PMC10667373 DOI: 10.1007/s00417-023-06143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/19/2023] Open
Abstract
PURPOSE The study evaluates the rate of postoperative formation of a pupillary membrane (PM) and posterior visual axis opacification (PVAO) in infants with and without primary IOL implantation during the first 4 months of infancy. METHODS Medical records for 144 eyes (101 infants) operated between 2005 and 2014 were evaluated. A posterior capsulectomy and anterior vitrectomy were performed. Primary IOL implantation was performed in 68 eyes, while 76 eyes were left aphakic. There were 16 bilateral cases in the pseudophakic group and 27 in the aphakic group. The follow-up period was 54.3 ± 21.05 months and 49.1 ± 18.60 months, respectively. Fisher's exact test was used for statistical analysis. The two-sample t-test with equal variance was used to compare surgery age, follow-up period and time intervals of complications. RESULTS The mean age of surgery was 2.1 ± 0.85 months in the pseudophakic and 2.2 ± 1.01 months in the aphakic group. PM was diagnosed in 40% pseudophakic and 7% aphakic eyes. A second surgery for PVAO was performed in 72% pseudophakic and 16% aphakic eyes. Both were significantly higher in the pseudophakic group. In the pseudophakic group, the number of PVAO was significantly higher in infants operated before 8 weeks of age compared to surgery age 9-16 weeks. The frequency of PM was not age-dependent. CONCLUSION Although it remains feasible to implant an IOL during the primary surgery, even in very young infants, there should always be solid arguments for this decision since it puts the child at higher risk of repeated surgeries under general anaesthesia.
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Affiliation(s)
- Martin Hložánek
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic.
| | - Lenka Cilečková
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic
| | - Jorge L Alió
- Department of Pathology and Surgery (Ophthalmology), Faculty of Medicine, University Miguel Hernandez, Avenida de la Universidad, s/n, 03202 Elche, Alicante, Spain
- Vissum Miranza Instituto Oftalmologico de Alicante, C/Cabañal, 1, 03016, Alicante, Spain
| | - Rudolf Autrata
- Department of Paediatric Ophthalmology, Faculty of Medicine, Masaryk University and University Hospital Brno, Černopolní 9, 62500, Brno, Czech Republic
| | - Nina Zelenayová
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic
| | - Martin Komínek
- Department of Paediatric Ophthalmology, Faculty of Medicine, Masaryk University and University Hospital Brno, Černopolní 9, 62500, Brno, Czech Republic
| | - Jiří Cendelín
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic
| | - Gabriela Mahelková
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 15006, Prague 5, Czech Republic
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Blanca CP, Isabel PC, Sergio IM, Candela CL, Honorio BG, Enrique EG. Straatsma Syndrome and cataract: case report and review of the literature. Rom J Ophthalmol 2023; 67:416-418. [PMID: 38239417 PMCID: PMC10793372 DOI: 10.22336/rjo.2023.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 01/22/2024] Open
Abstract
Straatsma Syndrome is known as unilateral myopia, amblyopia, and myelinated retinal nerve fibers (MRNF). The syndrome can be associated with other findings such as nystagmus, strabismus, and optic nerve hypoplasia among others. However, no cases associated with cataract have been reported. The visual prognosis depends on the myelinated retinal nerve fibers extension, the early amblyopia therapy, and the coexistence of other signs. We present the case of a 4-year-old girl with Straatsma Syndrome and cataract in the left eye. Despite the cataract surgical treatment with the refractive error correction and the amblyopia therapy, no visual improvement has been reported. Abbreviations: MRNF = Myelinated retinal nerve fibers, LE = Left eye, PD = Prism dioptres, BCVA = Best-corrected visual acuity, RE = Right eye, HM = Hand movement, CF = Counting fingers.
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Affiliation(s)
- Casado-Pelaez Blanca
- Department of Ophthalmology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pascual-Camps Isabel
- Department of Ophthalmology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Inat-Moreno Sergio
- Department of Ophthalmology, La Fe University and Polytechnic Hospital, Valencia, Spain
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Liu H, Zhang D, Hu F, Xu P, Zhang S, Wu J. Mutational spectrum in a Chinese cohort with congenital cataracts. Mol Genet Genomic Med 2023; 11:e2196. [PMID: 37337769 PMCID: PMC10496047 DOI: 10.1002/mgg3.2196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/23/2023] [Accepted: 05/04/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND To identify the mutational spectrum in a Chinese cohort with congenital cataracts. METHODS Probands (n = 164) with congenital cataracts and their affected or unaffected available family members were recruited for clinical examinations and panel-based next-generation sequencing, then classified into a cohort for further mutational analysis. RESULTS After recruitment (n = 442; 228 males and 214 females), 49.32% (218/442) of subjects received a clinical diagnosis of congenital cataracts, and 56.88% (124/218) of patients received a molecular diagnosis. Eighty-four distinct variants distributed among 43 different genes, including 42 previously reported variants and 42 novel variants, were detected, and 49 gene variants were causally associated with patient phenotypes; 27.37% of variants (23/84) were commonly detected in PAX6, GJA8 and CRYGD, and the three genes covered 33.06% of cases (41/124) with molecular diagnosis. The majority of genes were classified as genes involved in nonsyndromic congenital cataracts (19/43, 44.19%) and were responsible for 56.45% of cases (70/124). The majority of functional and nucleotide changes were missense variants (53/84, 63.10%) and substitution variants (74/84, 88.10%), respectively. Nine de novo variants were identified. CONCLUSION This study provides a reference for individualized genetic counseling and further extends the mutational spectrum of congenital cataracts.
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Affiliation(s)
- Hong‐Li Liu
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
| | - Dao‐Wei Zhang
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
| | - Fang‐Yuan Hu
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
| | - Ping Xu
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
| | - Sheng‐Hai Zhang
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
| | - Ji‐Hong Wu
- Eye Institute, Eye and ENT Hospital, College of MedicineFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationScience and Technology Commission of Shanghai MunicipalityShanghaiChina
- Key Laboratory of Myopia (Fudan University)Chinese Academy of Medical Sciences, National Health CommissionShanghaiChina
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Tibrewal S, Sharma P, Rath S, Ganesh S. Sutureless Cataract Surgery in the Pediatric Age Group: Is It Advisable? J Pediatr Ophthalmol Strabismus 2023; 60:302. [PMID: 37478194 DOI: 10.3928/01913913-20230616-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
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Menezes Filho C, Messias A, Antunes-Foschini R. Strabismus development after pediatric cataract surgery associated with age at surgery, intraocular lens implantation, and visual acuity outcome. Strabismus 2023; 31:139-144. [PMID: 37407591 DOI: 10.1080/09273972.2023.2231038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
PURPOSE Approximately half of the children operated on for cataracts develop strabismus. We determined what factors predict its development. METHODS In a retrospective, cross-sectional study, children who underwent cataract surgery before age 5 between 2010 and 2017 in a tertiary center in Brazil were identified from medical records. Subsequently, patients were invited for an ophthalmological examination to assess visual acuity, refraction, and strabismus (constant or intermittent heterotropy of any magnitude). In addition, age at surgery, cataract laterality, intraocular lens implantation, surgical complications, nystagmus, anisometropia, and elapsed time between surgery and the present examination were assessed using logistic regression. RESULTS Surgery was performed in 74 eyes of 46 patients (21 males). The median age at surgery was 6.4 (3.7-29.6) months, and the interval between surgery and this examination was 32.5 (18.0-53.0) months. Strabismus was present in 33 (72%) patients, 35% had esotropia and 33% exotropia. One patient had strabismus surgery before the examination. Age at surgery (OR 0.95; p-value .018), IOL implantation (OR 0.08; p-value .027), and current visual acuity on the worse eye (OR 1.16; p-value .036) were associated with strabismus. CONCLUSIONS Strabismus development after pediatric cataract surgery is associated with age at surgery, intraocular lens implantation, and visual-acuity outcomes of the worse eye.
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Affiliation(s)
- Celso Menezes Filho
- Ribeirão Preto Medical School, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo
| | - Andre Messias
- Ribeirão Preto Medical School, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo
| | - Rosalia Antunes-Foschini
- Ribeirão Preto Medical School, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo
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Irfani I, Wahyu T, Oktarima P, Caesarya S, Sari M, Karfiati F. Accuracy of the SRK/T Formula in Pediatric Cataract Surgery. CLINICAL OPTOMETRY 2023; 15:1-8. [PMID: 36628129 PMCID: PMC9826636 DOI: 10.2147/opto.s390994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Determining IOL power is an important step in achieving the desired postoperative refractive target, but this determination remains challenging, as currently the used formulas were developed using IOL power calculations derived from adults. PATIENTS AND METHODS This is a retrospective analytical study with the period of June 2018 to May 2019. All of the data were taken from medical records in referral tertiary eye hospital in Indonesia. All type of cataracts underwent uncomplicated surgeries and in-the-bag IOL implantation were included in this study, while aphakia, secondary IOL implantation, primary sulcus implantation, and history of ocular disorders were excluded. The data were analyzed using Wilcoxon sign-rank, paired t, and Kruskal-Wallis tests. RESULTS Sixty-seven patients (106 eyes) were found to meet the inclusion criteria, average age was 7.35 ± 4.61 years (1.00 to 17.00 years). Average targeted refraction was 1.69 ± 2.06 D (-0.38-+6.99 D), and spherical equivalent (actual postoperative refraction) was -0.90 ± 1.45 D (-4.38 to +2.75 D). There was statistically significant difference between preoperative targeted refraction and actual postoperative refraction (p < 0.001). Mean absolute prediction error (APE) in general was 1.34 ± 1.18 D, 1.22 ± 0.88 D (in short eyes), 1.52 ± 1.37 D (in moderate eyes), and 0.69 ± 0.52 D (in long eyes) (p = 0.202). Mean APE in age group <7 years old was 1.27 ± 1.18 D and ≥7 years-old was 1.42 ± 1.19 D (p = 0.429). CONCLUSION SRK/T formula is fairly accurate in calculating IOL power in pediatric cataract surgery. Mean APE in this study was within the range of accurate mean APE in pediatric patients despite differentiated axial length and age.
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Affiliation(s)
- Irawati Irfani
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Tri Wahyu
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Primawita Oktarima
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Sesy Caesarya
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Maya Sari
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Feti Karfiati
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
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Rastogi A, Singiri D, Kumar P, Thakar M, Baindur S, Bhardwaj A. Predictive Accuracy of the Hill-RBF 2.0 Formula in Pediatric Eyes: Comparison of 5 Intraocular Lens Formulas. J Pediatr Ophthalmol Strabismus 2022:1-6. [PMID: 36102265 DOI: 10.3928/01913913-20220811-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the predictive accuracy of the Hill-Radial Basis Function (Hill-RBF) 2.0 formula with the Barrett Universal II, Hoffer Q, SRK/T, and Holladay 1 formulas in pediatric eyes. METHODS In this observational study, 99 eyes of 70 children 4 to 18 years old with clinically significant congenital or developmental cataracts attending the pediatric ophthalmology clinic in Guru Nanak Eye Centre were included. Optical biometry was performed in all patients with the Lenstar LS-900 (Haag-Streit). Intraocular lens (IOL) power predicted by the Hill-RBF formula was selected. Mean absolute prediction error (MAE) at 8 weeks of follow-up was calculated for the Hill-RBF, Barrett Universal II, Hoffer Q, SRK/T, and Holladay 1 IOL power formulas. Percentages of eyes having residual refraction within ±0.50, ±0.50 to ±1.00, and greater than ±1.00 diopters (D) of target refraction were calculated. RESULTS The MAEs were 1.08 ± 1.00 D for the Hill-RBF, 1.24 ± 1.20 D for the Barrett Universal II, 1.25 ± 1.06 D for the Hoffer Q, 1.25 ± 1.10 D for the SRK/T, and 1.28 ± 1.01 D for the Holladay 1 formulas. The Hill-RBF formula had the lowest MAE, which was significantly lower than the Holladay 1 and Hoffer Q formulas. However, the difference in MAE between the Hill-RBF and the SRK/T and Barrett Universal II formulas was not statistically significant (P > .05). The Hill-RBF group had the maximum percentage of eyes with residual error within ±0.50 D of the target refraction. CONCLUSIONS The overall evidence from the studies indicates that the Hill-RBF method that uses artificial intelligence and works independent of specific anatomical features is non-inferior to the Barrett Universal II, Hoffer Q, SRK/T, and Holladay 1 formulas in pediatric eyes. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].
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Zhang Y, Zhang C, Chen S, Hu J, Shen L, Yu Y. Research Progress Concerning a Novel Intraocular Lens for the Prevention of Posterior Capsular Opacification. Pharmaceutics 2022; 14:pharmaceutics14071343. [PMID: 35890240 PMCID: PMC9318653 DOI: 10.3390/pharmaceutics14071343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/12/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Posterior capsular opacification (PCO) is the most common complication resulting from cataract surgery and limits the long-term postoperative visual outcome. Using Nd:YAG laser-assisted posterior capsulotomy for the clinical treatment of symptomatic PCO increases the risks of complications, such as glaucoma, retinal diseases, uveitis, and intraocular lens (IOL) pitting. Therefore, finding how to prevent PCO development is the subject of active investigations. As a replacement organ, the IOL is implanted into the lens capsule after cataract surgery, but it is also associated with the occurrence of PCO. Using IOL as a medium for PCO prophylaxis is a more facile and efficient method that has demonstrated various clinical application prospects. Thus, scientists have conducted a lot of research on new intraocular lens fabrication methods, such as optimizing IOL materials and design, and IOL surface modification (including plasma/ultraviolet/ozone treatment, chemical grafting, drug loading, coating modification, and layer-by-layer self-assembly methods). This paper summarizes the research progress for different types of intraocular lenses prepared by different surface modifications, including anti-biofouling IOLs, enhanced-adhesion IOLs, micro-patterned IOLs, photothermal IOLs, photodynamic IOLs, and drug-loading IOLs. These modified intraocular lenses inhibit PCO development by reducing the residual intraoperative lens epithelial cells or by regulating the cellular behavior of lens epithelial cells. In the future, more works are needed to improve the biosecurity and therapeutic efficacy of these modified IOLs.
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Affiliation(s)
- Yidong Zhang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Chengshou Zhang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Silong Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Jianghua Hu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
- Jiande Branch, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Lifang Shen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Yibo Yu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
- Correspondence:
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Kavitha V, Heralgi MM, Aafreen S. Analysis of postoperative visual and surgical outcome following surgery for absorbed cataract in pediatric age group and the intraoperative difficulties. Indian J Ophthalmol 2022; 70:788-793. [PMID: 35225515 PMCID: PMC9114569 DOI: 10.4103/ijo.ijo_1091_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To analyze the postoperative visual and surgical outcomes following surgery for pediatric-absorbed cataracts and intraoperative difficulties. METHODS This prospective longitudinal study included 43 eyes (30 children) with absorbed cataracts aged between 6 months and 18 years (either sex). All children underwent best-corrected visual acuity (BCVA), anterior and posterior segment evaluation, rubella titer estimation, intraocular lens (IOL) power calculation, superior small incision cataract surgery with or without posterior capsulotomy/anterior vitrectomy/IOL implantation under general anesthesia, visual rehabilitation, and were followed up for 1 year. RESULTS The mean age was 7.89 ± 4.84 years. Preoperative BCVA distance: 39 eyes had either perception of light (PL) or counting finger close to face (CFCF); near BCVA: all eyes had either PL or N36. Postoperative (12 months) distant BCVA: a majority of the eyes (27) had 6/60-1/60, 11 eyes had 6/18-6/36; near: N18 in 19 eyes, N6 in 7 eyes. Anterior continuous curvilinear capsulorrhexis (ACCC) was possible in eight eyes. Cortical aspiration was difficult in 16 eyes (peripheral calcified ring). A majority (32 eyes) underwent in the sulcus implantation (in-the-bag: eight eyes); two eyes: no IOL, one eye: secondary IOL. Eleven eyes had early postoperative inflammation. At 12 months, one eye underwent membranectomy for visual axis opacification and 38 eyes had well-centered IOLs. CONCLUSION Surgery in absorbed cataracts is challenging because of the anatomic disorganization of the absorbed lens. By adopting appropriate surgical methods and good visual rehabilitation, one can achieve satisfactory surgical and visual outcomes, highlighting the need for surgical intervention.
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Affiliation(s)
- V Kavitha
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
| | - Mallikarjun M Heralgi
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
| | - Saba Aafreen
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
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FYCO1 Frameshift Deletion in Wirehaired Pointing Griffon Dogs with Juvenile Cataract. Genes (Basel) 2022; 13:genes13020334. [PMID: 35205377 PMCID: PMC8871958 DOI: 10.3390/genes13020334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
Different breed-specific inherited cataracts have been described in dogs. In this study, we investigated an inbred family of Wirehaired Pointing Griffon dogs in which three offspring were affected by juvenile cataract. The pedigree suggested monogenic autosomal recessive inheritance of the trait. Whole-genome sequencing of an affected dog revealed 12 protein-changing variants that were not present in 566 control genomes, of which two were located in functional candidate genes, FYCO1 and CRYGB. Targeted genotyping of both variants in the investigated family excluded CRYGB and revealed perfect co-segregation of the FYCO1 variant with the juvenile cataract phenotype. This variant, FYCO1:c.2024delG, represents a 1 bp frameshift deletion predicted to truncate ~50% of the open reading frame p.(Ser675Thrfs*5). FYCO1 encodes the FYVE and coiled-coil domain autophagy adaptor 1, a known regulator of lens autophagy, which is required for the normal homeostasis in the eye. In humans, at least 37 pathogenic variants in FYCO1 have been shown to cause autosomal recessive cataract. Fcyo1−/− knockout mice also develop cataracts. Together with the current knowledge on FYCO1 variants and their functional impact in humans and mice, our data strongly suggest FYCO1:c.2024delG as a candidate causative variant for the observed juvenile cataract in Wirehaired Pointing Griffon dogs. To the best of our knowledge, this study represents the first report of a FYCO1-related cataract in domestic animals.
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Liu X, Sachdeva G, Ibrahim H, Charalambides M, Denniston AK. Clinical Evaluation of AI in Medicine. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Behandlung der kongenitalen und frühkindlichen Katarakt. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-021-00511-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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AYGIT ED. Kongenital katarakt vaka serisi. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.990221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Zhang JS, Wang JD, Yusufu M, Cao K, Jin SS, Xiong Y, Li J, Sun XL, Chen SY, Liu ZY, Fu J, Li L, You QS, Wan XH. The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years. BMC Ophthalmol 2021; 21:332. [PMID: 34511057 PMCID: PMC8436493 DOI: 10.1186/s12886-021-02098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years. Methods This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.
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Affiliation(s)
- Jing Shang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jin Da Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shan Shan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Ying Xiong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Jing Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Xiu Li Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shu Ying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Zhen Yu Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Li Li
- National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Qi Sheng You
- Casey Eye Institute, Oregon Health Science University, Oregon, USA
| | - Xiu Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China.
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17
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Meng X, Cao X, Jia Y, Pan J, Du Y, Li X. Sutured scleral fixation of posterior chamber intraocular lens in children under the age of 9 with congenital ectopia lentis. Ophthalmic Res 2021; 64:837-843. [PMID: 34247162 DOI: 10.1159/000516324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/28/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Xuyun Meng
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xi Cao
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yiyue Jia
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jianhui Pan
- Department of Ophthalmology, Guiping City People's Hospital, Guiping, China
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xia Li
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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18
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Tătaru CI, Tătaru CP, Costache A, Boruga O, Zemba M, Ciuluvică RC, Sima G. Congenital cataract - clinical and morphological aspects. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:105-112. [PMID: 32747900 PMCID: PMC7728133 DOI: 10.47162/rjme.61.1.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Congenital cataract is one of the main causes of blindness in newborns and children. According to the World Health Organization (WHO), there are about 14 million children suffering from congenital cataract. Our study is based on 82 children, males – 46 (56.1%) and females – 36 (43.9%), with congenital cataract operated in the same ophthalmological centre in Bucharest, Romania. Of the 82 patients, 49 (59.76%) had bilateral cataract and 33 (40.24%) unilateral cataract. Clinically, the most frequent was the total cataract, followed by lamellar, nuclear and cerulean. We employed nine surgical approaches in our patients, depending on the type of intraocular lens (IOL). Morphologically, obvious changes were rendered evident at the level of anterior and posterior capsules, as well as subcapsular.
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Affiliation(s)
- Cătălina Ioana Tătaru
- Department of Ophthalmology, Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; ,
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Jiang J, Lei S, Zhu M, Li R, Yue J, Chen J, Li Z, Gong J, Lin D, Wu X, Lin Z, Lin H. Improving the Generalizability of Infantile Cataracts Detection via Deep Learning-Based Lens Partition Strategy and Multicenter Datasets. Front Med (Lausanne) 2021; 8:664023. [PMID: 34026791 PMCID: PMC8137827 DOI: 10.3389/fmed.2021.664023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Infantile cataract is the main cause of infant blindness worldwide. Although previous studies developed artificial intelligence (AI) diagnostic systems for detecting infantile cataracts in a single center, its generalizability is not ideal because of the complicated noises and heterogeneity of multicenter slit-lamp images, which impedes the application of these AI systems in real-world clinics. In this study, we developed two lens partition strategies (LPSs) based on deep learning Faster R-CNN and Hough transform for improving the generalizability of infantile cataracts detection. A total of 1,643 multicenter slit-lamp images collected from five ophthalmic clinics were used to evaluate the performance of LPSs. The generalizability of Faster R-CNN for screening and grading was explored by sequentially adding multicenter images to the training dataset. For the normal and abnormal lenses partition, the Faster R-CNN achieved the average intersection over union of 0.9419 and 0.9107, respectively, and their average precisions are both > 95%. Compared with the Hough transform, the accuracy, specificity, and sensitivity of Faster R-CNN for opacity area grading were improved by 5.31, 8.09, and 3.29%, respectively. Similar improvements were presented on the other grading of opacity density and location. The minimal training sample size required by Faster R-CNN is determined on multicenter slit-lamp images. Furthermore, the Faster R-CNN achieved real-time lens partition with only 0.25 s for a single image, whereas the Hough transform needs 34.46 s. Finally, using Grad-Cam and t-SNE techniques, the most relevant lesion regions were highlighted in heatmaps, and the high-level features were discriminated. This study provides an effective LPS for improving the generalizability of infantile cataracts detection. This system has the potential to be applied to multicenter slit-lamp images.
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Affiliation(s)
- Jiewei Jiang
- School of Electronic Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Shutao Lei
- School of Communications and Information Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Mingmin Zhu
- School of Mathematics and Statistics, Xidian University, Xi'an, China
| | - Ruiyang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiayun Yue
- School of Electronic Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhongwen Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiamin Gong
- School of Electronic Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Jiang J, Wang L, Fu H, Long E, Sun Y, Li R, Li Z, Zhu M, Liu Z, Chen J, Lin Z, Wu X, Wang D, Liu X, Lin H. Automatic classification of heterogeneous slit-illumination images using an ensemble of cost-sensitive convolutional neural networks. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:550. [PMID: 33987248 DOI: 10.21037/atm-20-6635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Lens opacity seriously affects the visual development of infants. Slit-illumination images play an irreplaceable role in lens opacity detection; however, these images exhibited varied phenotypes with severe heterogeneity and complexity, particularly among pediatric cataracts. Therefore, it is urgently needed to explore an effective computer-aided method to automatically diagnose heterogeneous lens opacity and to provide appropriate treatment recommendations in a timely manner. Methods We integrated three different deep learning networks and a cost-sensitive method into an ensemble learning architecture, and then proposed an effective model called CCNN-Ensemble [ensemble of cost-sensitive convolutional neural networks (CNNs)] for automatic lens opacity detection. A total of 470 slit-illumination images of pediatric cataracts were used for training and comparison between the CCNN-Ensemble model and conventional methods. Finally, we used two external datasets (132 independent test images and 79 Internet-based images) to further evaluate the model's generalizability and effectiveness. Results Experimental results and comparative analyses demonstrated that the proposed method was superior to conventional approaches and provided clinically meaningful performance in terms of three grading indices of lens opacity: area (specificity and sensitivity; 92.00% and 92.31%), density (93.85% and 91.43%) and opacity location (95.25% and 89.29%). Furthermore, the comparable performance on the independent testing dataset and the internet-based images verified the effectiveness and generalizability of the model. Finally, we developed and implemented a website-based automatic diagnosis software for pediatric cataract grading diagnosis in ophthalmology clinics. Conclusions The CCNN-Ensemble method demonstrates higher specificity and sensitivity than conventional methods on multi-source datasets. This study provides a practical strategy for heterogeneous lens opacity diagnosis and has the potential to be applied to the analysis of other medical images.
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Affiliation(s)
- Jiewei Jiang
- School of Electronic Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Liming Wang
- School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Haoran Fu
- School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yibin Sun
- School of Electronic Engineering, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Ruiyang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhongwen Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingmin Zhu
- School of Mathematics and Statistics, Xidian University, Xi'an, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongni Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiyang Liu
- School of Computer Science and Technology, Xidian University, Xi'an, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Chen W, He S, Hu L, Zhu J, Xie W, Xiang D. Ultrasound biomicroscopy for the assessment of postoperative complications after congenital cataract surgery. Quant Imaging Med Surg 2021; 11:1483-1489. [PMID: 33816184 DOI: 10.21037/qims-20-185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background The aim of the present study was to investigate the role of ultrasound biomicroscopy (UBM) in the evaluation of postoperative complications in children with congenital cataracts. Methods A retrospective study was conducted between September 2012 and December 2016 at Guangzhou Women and Children's Medical Center. Red reflex test and high-resolution bag/balloon UBM were performed to evaluate postoperative congenital cataracts. The red reflex test results were recorded, and UBM imaging results were recorded and analyzed. Different postoperative complications were classified based on the UBM imaging features, and a second procedure was performed accordingly. The UBM images were compared with the images captured from the intraoperative videos. Results In total, we looked at 120 eyes in 96 patients (65 males and 31 females) in the present study. The age of the cohort was 3-76 months. A total of 51 eyes with poor red reflex were included. There were complications in 46 eyes after congenital cataract surgery, as detected by UBM, including posterior capsular opacification (n=29 eyes), pupil block (n=8 eyes), synechia (n=5 eyes), hyphema (n=1 eye), and abnormal intraocular lens (IOL) placement (n=3 eyes). UBM images showed specific features of postoperative complications. Conclusions UBM is a valuable tool for the early evaluation of postoperative complications of congenital cataracts, especially for those with media opacities or when pupil dilation is not possible.
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Affiliation(s)
- Wensi Chen
- Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Shiping He
- Department of Cataract, Aier Eye Hospital of Zhongshan Xiaolan, Zhongshan, China
| | - Lanxiang Hu
- Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jie Zhu
- Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wanhua Xie
- Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Daoman Xiang
- Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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22
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Abstract
The successful outcome of treatment for infant and childhood cataract depends on many factors. It is crucial that the treatment falls into a phase in which neither the eye nor the visual pathway and visual cortex are fully developed. This review summarizes the current state of knowledge and provides an overview of the epidemiology, causes and clinical forms, early detection and, above all, treatment options. Special attention is paid to time-critical stages of development, according to which the therapeutic concepts are based. Complications, such as amblyopia and glaucoma are discussed in detail. In addition to surgical aspects, much emphasis is placed on orthoptic-refractive aftercare, the quality and execution of which is the essential predictor of a good functional outcome.
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Affiliation(s)
- Wolf A Lagrèze
- Department of Ophthalmology, Medical Faculty, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
- School of Orthoptics, Department of Ophthalmology, University Hospital Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
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Sen P, Chandra K, Jain E, Sen A, Kumar A, Mohan A, Shah C. Audit of 1000 consecutive cases of sutureless cataract surgery in children above two years of age. Indian J Ophthalmol 2021; 68:460-465. [PMID: 32057003 PMCID: PMC7043184 DOI: 10.4103/ijo.ijo_1138_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To study the safety of sutureless cataract surgery and risk factors for wound leak of clear corneal incision in children affected with congenital or developmental cataract. Methods It is a retrospective, noncomparative interventional case study involving children in the age group of 2 to 16 years, who underwent cataract surgery with intraocular lens implantation with the minimum follow up of 1 month. Results Out of 1000 eyes studied, lens matter aspiration with intraocular lens implantation with or without primary posterior capsulorhexis and anterior vitrectomy was done in 609 and 391 eyes, respectively. Incisions of 943 eyes did not require sutures while sutures were applied for wound leak in 57 eyes on the table and in 5 eyes on postoperative day 1. Risk of wound leak for suture application was found to be greater in patients; having age less than 5 years (P < 0.0001), surgeries performed by junior surgeons (P < 0.0003), wound problems (P < 0.0001), intraocular lens (IOL) related factors (P < 0.0001), use of iris hooks (P < 0.0001), and anterior capsulorhexis extension (P < 0.0001). On the first postoperative day, anterior chamber reaction (P < 0.0001) and fibrinous membrane (P = 0.0007) were significantly more in the sutured group. Incidence of postoperative complications was 0.98 per sutured eyes (59 complications in 60 eyes). One patient developed endophthalmitis after suture removal. Conclusion Sutureless clear corneal incision in pediatric patients undergoing cataract surgery can achieve stable wound. However, after hydro closure, every wound should be checked for water tightness and the leaky wound should be sutured.
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Affiliation(s)
- Pradhnya Sen
- Children Eye Care Center, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Kriti Chandra
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Elesh Jain
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Alok Sen
- Department of Retina and Uvea, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Amit Kumar
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Amit Mohan
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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Clinical Evaluation of AI in Medicine. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_310-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Lu K, Du HT, Lian AL, Su Y, Wang F. Effect of purine-rich box1 on proliferation of fibroblasts. Int J Ophthalmol 2020; 13:1827-1832. [PMID: 33215017 DOI: 10.18240/ijo.2020.11.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/27/2020] [Indexed: 12/30/2022] Open
Abstract
Fibroblasts are pleomorphic cells that have a multi-directional effect on organ morphogenesis, tissue homeostasis, and immune response. In fibrotic diseases, fibroblasts synthesize large amounts of extracellular matrix (ECM), leading to scarring and organ failure. Purine-rich box1 (PU.1) is a specific transcription factor of hematopoietic cell and belongs to the E26 transformation specificity (ETS) family. Recently, it was found that the transcription factor PU.1 is an important regulatory factor of the profibrotic gene expression program. TGF-β had been proved to play an important role in many ocular tissue fibrosis diseases, and up-regulated the expression of PU.1 in fibroblasts producing ECM in a Smad-3 dependent manner. We explore the effect of PU.1 on fibrosis of different ocular tissues from this perspective. This article reviews the role of PU.1 and its effects on fibrosis of ocular tissue and other tissues.
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Affiliation(s)
- Ke Lu
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Hai-Tao Du
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ai-Ling Lian
- Department of Centric Operating Room, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ying Su
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Feng Wang
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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26
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Abstract
The successful outcome of treatment for infant and childhood cataract depends on many factors. It is crucial that the treatment falls into a phase in which neither the eye nor the visual pathway and visual cortex are fully developed. This review summarizes the current state of knowledge and provides an overview of the epidemiology, causes and clinical forms, early detection and, above all, treatment options. Special attention is paid to time-critical stages of development, according to which the therapeutic concepts are based. Complications, such as amblyopia and glaucoma are discussed in detail. In addition to surgical aspects, much emphasis is placed on orthoptic-refractive aftercare, the quality and execution of which is the essential predictor of a good functional outcome.
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Affiliation(s)
- Wolf A Lagrèze
- Klinik für Augenheilkunde, Medizinische Fakultät, Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland. .,Schule für Orthoptik, Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
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27
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Khamraeva LS, Narzullaeva DU, Katargina LA, Kruglovà TB. Indices of refraction in children with pseudophakia predisposed to abnormal refractive error changes after congenital cataract extraction. ACTA ACUST UNITED AC 2020. [DOI: 10.21516/2072-0076-2020-13-3-51-55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | | | - T. B. Kruglovà
- Helmholtz National Medical Research Center of Eye Diseases
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28
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Management of Aphakia with Visual Axis Opacification after Congenital Cataract Surgery Based on UBM Image Features Analysis. J Ophthalmol 2020; 2020:9489450. [PMID: 32832142 PMCID: PMC7428953 DOI: 10.1155/2020/9489450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/30/2020] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this study was to study the imaging features of ultrasound biomicroscopy (UBM) in the aphakia with visual axis opacification (VAO) after congenital cataract surgery. Methods From May 2015 to May 2018, aphakia patients with VAO who underwent congenital cataract surgery were examined by high-resolution bag/balloon UBM technique, and the results of UBM imaging were analyzed. According to UBM imaging features, different types of VAO were classified. Results A total of 38 children (55 eyes) with VAO were included. 17 patients were bilateral, and 21 patients were unilateral. Patients with VAO were classified into 3 groups according to the UBM imaging features: membranous fibrosis VOA (17 cases, 28 eyes), cortical regeneration VOA (15 cases, 20 eyes), and mixed VOA (6 cases, 7 eyes). The patients in the membranous fibrosis group underwent Nd:YAG laser posterior capsulotomy, those in the cortical regeneration group underwent anterior vitrectomy, and those in the mixed type group underwent anterior vitrectomy with RF capsulotomy tip. After surgery, VAO were removed in all patients. During the follow-up period, in the membranous fibrotic VAO group, iris adhesion and pupillary occlusion were found in 2 eyes, and anterior vitrectomy combined with separation of iris adhesion was performed. In cortical regenerative and mixed type VAO groups, anterior vitrectomy was performed without opacity in the axial region. The total recurrence rate of VAO was 3.46%. Conclusion After congenital cataract surgery, the UBM imaging features of aphakia with VAO are helpful to evaluate the condition of VAO before reoperation so as to choose the optimal surgical method to achieve better therapeutic effect.
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Kaur S, Khurana S, Ram J. Frosted lens opacities. Indian J Ophthalmol 2020; 68:1453. [PMID: 32587192 PMCID: PMC7574049 DOI: 10.4103/ijo.ijo_2264_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Savleen Kaur
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surbhi Khurana
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Chou YY, Zhang BL, Gan LY, Ma J, Zhong Y. Efficacy of intracameral preservative-free triamcinolone acetonide in pediatric cataract surgery: a meta-analysis. Graefes Arch Clin Exp Ophthalmol 2020; 258:2205-2212. [PMID: 32533281 DOI: 10.1007/s00417-020-04765-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/29/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the efficacy of intracameral preservative-free triamcinolone acetonide (TA) on reducing inflammatory reactions after pediatric cataract surgery. METHODS Researches were comprehensively searched in PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to 30 November, 2019. Data of interest were extracted and analyzed by Review Manager 5.2. The primary outcome was cell deposits. The secondary outcomes included posterior synechias, fibrinous anterior chamber reaction, visual axis obscuration, and posterior capsule opacification. The odds ratio (OR), weight mean difference (WMD), and their 95% confidence intervals (95% CI) were used to assess the strength of the association. RESULTS In total, 45 articles were obtained. Finally, 5 studies with a total of 308 eyes were enrolled in this meta-analysis. Among these, 134 eyes underwent intracameral TA treatment and 174 eyes did not. In intracameral TA treatment group, the incidence of cell deposits (OR = 0.35, 95% CI 0.16-0.76, P = 0.008), posterior synechias (OR = 0.44, 95% CI 0.23-0.86, P = 0.02), and fibrinous anterior chamber reaction (OR = 0.12, 95% CI 0.01-1.05, P = 0.05) were lower compared to those in patients without intracameral TA treatment. Meanwhile, the incidence of visual axis obscuration (OR = 0.10, 95% CI 0.01-0.85, P = 0.04) and posterior capsule opacification (OR = 0.09, 95% CI 0.02-0.55, P = 0.009) were also reduced significantly. The intraocular pressure (IOP) was evaluated at the first month postoperatively (WMD = 0.84 mmHg, 95% CI 0.14-1.53, P = 0.02), but within the normal range. There was no difference of IOP between two groups at 6 months or above after operation (P = 0.93). CONCLUSIONS The intracameral preservative-free TA in pediatric cataract surgery contributed to much less inflammatory reaction with the normal IOP range.
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Affiliation(s)
- Yu-Yu Chou
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Bi-Lei Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lin-Yang Gan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Sen P, Gupta N, Mohan A, Shah C, Sen A, Jain E. Causes of delayed presentation of pediatric cataract: A questionnaire-based prospective study at a tertiary eye care center in central rural India. Indian J Ophthalmol 2020; 68:603-607. [PMID: 32174578 PMCID: PMC7210835 DOI: 10.4103/ijo.ijo_872_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/28/2019] [Accepted: 10/22/2019] [Indexed: 11/04/2022] Open
Abstract
Purpose To find out the sociodemographic, sociocultural, and socioeconomic factors leading to delay in pediatric cataract surgery and its impact on final visual outcome. Methods A prospective interview-based analytical cohort study was conducted on 156 children aged 0-16 years with either unilateral or bilateral congenital/developmental cataracts. Caregivers were interviewed using a pretested validated questionnaire. Time intervals between recognition by a caregiver to consultation were denoted as Delay-1 and between consultations to surgical intervention as Delay-2. Spearman's rank correlation was used to determine the presence of correlation between causes of delay and visual outcome. Results The mean age of presentation was 7.78 ± 4.34 years. Mothers were the first informant of the problem (n = 110, 70.5%). Out of 156 children, only 8 (5.1%) children presented to the hospital within 1 month by caregivers and 26 (16.7%) children underwent surgery within 2 months of advice. About 22 (14.1%) children had total cumulative delay of 1-6 months, 11 (7%) had delay of 6-12 months, and 115 (73.71%) had delay of >12 months. The most common cause identified for Delay-1 was unawareness in 41 cases (26.28%), however, for Delay-2 major factor responsible was cost (n = 38, 24.35%). The median preoperative visual acuity was 1.31 logMAR and median postoperative visual acuity at 4 weeks was 0.61 logMAR. (P < 0.001) Less age at surgery, upper socioeconomic status, less time delay, and better preoperative vision were positively correlated to better visual outcomes. Conclusion Delay in presentation for childhood cataract surgery remains a significant problem in central rural India. Delay in surgery is multifactorial which includes unawareness, cost, misdiagnosis, self-treatment, distance from the hospital, lack of family support, and poor socioeconomic status.
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Affiliation(s)
- Pradhnya Sen
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of a Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Namrata Gupta
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of a Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Amit Mohan
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of a Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of a Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Alok Sen
- Vitreoretina and Uvea, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Elesh Jain
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of a Ophthalmology, Chitrakoot, Madhya Pradesh, India
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Vianna LM, Prescott CR, Ferraz LO. Trifocal toric intra-ocular lens implantation in pediatric traumatic cataract. Am J Ophthalmol Case Rep 2020; 17:100575. [PMID: 31909292 PMCID: PMC6938961 DOI: 10.1016/j.ajoc.2019.100575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose To present the case of a 6-year-old child who presented with a traumatic cataract and was treated with trifocal toric intra-ocular lens implantation. Observations The child's uncorrected distance visual acuity improved from +0.7 logMAR preoperatively to 0.00 logMAR after cataract surgery, with spectacle independence and no reported side effects Conclusions and importance In carefully selected pediatric patients with traumatic cataracts, trifocal toric intra-ocular lenses may offer some benefit over standard monofocal lenses
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Affiliation(s)
- Lucas M.M. Vianna
- State University of Rio de Janeiro, 77 Boulevard 28 de Setembro, Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto da Visão Cabo Frio, 15 Raul Veiga Street, Cabo Frio, Rio de Janeiro, Brazil
- Corresponding author. Instituto da Visão Cabo Frio, 15 Raul Veiga Street, Cabo Frio, Rio de Janeiro, Brazil.
| | | | - Lívio O. Ferraz
- State University of Rio de Janeiro, 77 Boulevard 28 de Setembro, Rio de Janeiro, Rio de Janeiro, Brazil
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Knöpfel EB, Vilches C, Camargo SMR, Errasti-Murugarren E, Stäubli A, Mayayo C, Munier FL, Miroshnikova N, Poncet N, Junza A, Bhattacharya SS, Prat E, Berry V, Berger W, Heon E, Moore AT, Yanes Ó, Nunes V, Palacín M, Verrey F, Kloeckener-Gruissem B. Dysfunctional LAT2 Amino Acid Transporter Is Associated With Cataract in Mouse and Humans. Front Physiol 2019; 10:688. [PMID: 31231240 PMCID: PMC6558864 DOI: 10.3389/fphys.2019.00688] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/16/2019] [Indexed: 11/13/2022] Open
Abstract
Cataract, the loss of ocular lens transparency, accounts for ∼50% of worldwide blindness and has been associated with water and solute transport dysfunction across lens cellular barriers. We show that neutral amino acid antiporter LAT2 (Slc7a8) and uniporter TAT1 (Slc16a10) are expressed on mouse ciliary epithelium and LAT2 also in lens epithelium. Correspondingly, deletion of LAT2 induced a dramatic decrease in lens essential amino acid levels that was modulated by TAT1 defect. Interestingly, the absence of LAT2 led to increased incidence of cataract in mice, in particular in older females, and a synergistic effect was observed with simultaneous lack of TAT1. Screening SLC7A8 in patients diagnosed with congenital or age-related cataract yielded one homozygous single nucleotide deletion segregating in a family with congenital cataract. Expressed in HeLa cells, this LAT2 mutation did not support amino acid uptake. Heterozygous LAT2 variants were also found in patients with cataract some of which showed a reduced transport function when expressed in HeLa cells. Whether heterozygous LAT2 variants may contribute to the pathology of cataract needs to be further investigated. Overall, our results suggest that defects of amino acid transporter LAT2 are implicated in cataract formation, a situation that may be aggravated by TAT1 defects.
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Affiliation(s)
- Emilia Boiadjieva Knöpfel
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss National Centre of Competence in Research Kidney.CH, University of Zurich, Zurich, Switzerland
| | - Clara Vilches
- Genes, Disease and Therapy Program, Molecular Genetics Laboratory – IDIBELL, Barcelona, Spain
- U730 and U731, Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
| | - Simone M. R. Camargo
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ekaitz Errasti-Murugarren
- U730 and U731, Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
- Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Andrina Stäubli
- Institute of Medical Molecular Genetics, University of Zurich, Zurich, Switzerland
- Department of Biology, ETH Zurich, Zurich, Switzerland
| | - Clara Mayayo
- Genes, Disease and Therapy Program, Molecular Genetics Laboratory – IDIBELL, Barcelona, Spain
- Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Francis L. Munier
- Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
| | | | - Nadège Poncet
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Alexandra Junza
- Metabolomics Platform, IISPV, Department of Electronic Engineering, Universitat Rovira i Virgili, Tarragona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Shomi S. Bhattacharya
- Andalusian Molecular Biology and Regenerative Medicine Centre – CABIMER, Seville, Spain
- UCL Institute of Ophthalmology, London, United Kingdom
| | - Esther Prat
- Genes, Disease and Therapy Program, Molecular Genetics Laboratory – IDIBELL, Barcelona, Spain
- U730 and U731, Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
- Genetics Section, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Vanita Berry
- Andalusian Molecular Biology and Regenerative Medicine Centre – CABIMER, Seville, Spain
| | - Wolfgang Berger
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Institute of Medical Molecular Genetics, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich – ZNZ, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Elise Heon
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anthony T. Moore
- Andalusian Molecular Biology and Regenerative Medicine Centre – CABIMER, Seville, Spain
- Moorfields Eye Hospital, London, United Kingdom
- Department of Ophthalmology, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Óscar Yanes
- Metabolomics Platform, IISPV, Department of Electronic Engineering, Universitat Rovira i Virgili, Tarragona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Virginia Nunes
- Genes, Disease and Therapy Program, Molecular Genetics Laboratory – IDIBELL, Barcelona, Spain
- U730 and U731, Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
- Genetics Section, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Manuel Palacín
- U730 and U731, Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
- Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Francois Verrey
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss National Centre of Competence in Research Kidney.CH, University of Zurich, Zurich, Switzerland
| | - Barbara Kloeckener-Gruissem
- Institute of Medical Molecular Genetics, University of Zurich, Zurich, Switzerland
- Department of Biology, ETH Zurich, Zurich, Switzerland
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Grama A, Blaga L, Nicolescu A, Deleanu C, Militaru M, Căinap SS, Pop I, Tita G, Sîrbe C, Fufezan O, Vințan MA, Vulturar R, Pop TL. Novel Mutation in GALT Gene in Galactosemia Patient with Group B Streptococcus Meningitis and Acute Liver Failure. ACTA ACUST UNITED AC 2019; 55:medicina55040091. [PMID: 30987402 PMCID: PMC6524007 DOI: 10.3390/medicina55040091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/14/2019] [Accepted: 04/01/2019] [Indexed: 02/05/2023]
Abstract
Classic galactosemia is an autosomal recessive disorder caused by the deficiency of the enzyme galactose-1-phosphate uridyltransferase (GALT) involved in galactose metabolism. Bacterial infections are a known cause of early morbidity and mortality in children with classic galactosemia. The most common agent is Escherichia coli, but in rare situations, other bacteria are incriminated. We report a case of a three-week-old female patient with galactosemia, who presented with Group B Streptococcus (GBS) meningitis/sepsis. She received treatment with antibiotics, supportive therapy, and erythrocyte transfusion, but after a short period of improvement, she presented acute liver failure with suspicion of an inborn error of metabolism. Rapid nuclear magnetic resonance (NMR) spectroscopy from urine showed highly elevated values of galactose and galactitol. Under intensive treatment for acute liver failure and with a lactose-free diet, her clinical features and laboratory parameters improved considerably. Genetic testing confirmed compound heterozygous status for GALT mutations: c.563 A>G [p.Q188R] and c. 910 C>T, the last mutation being a novel mutation in GALT gene. In countries without an extensive newborn screening program, a high index of suspicion is necessary for early diagnosis and treatment of galactosemia.
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Affiliation(s)
- Alina Grama
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Ligia Blaga
- Discipline of Neonatology, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Alina Nicolescu
- NMR Laboratory, "Petru Poni" Institute of Macromolecular Chemistry, Romanian Academy of Sciences, 700487 Iaşi, Romania.
- "Costin D. Neniţescu" Institute of Organic Chemistry, Romanian Academy of Sciences, 060023 Bucharest, Romania.
| | - Călin Deleanu
- NMR Laboratory, "Petru Poni" Institute of Macromolecular Chemistry, Romanian Academy of Sciences, 700487 Iaşi, Romania.
- "Costin D. Neniţescu" Institute of Organic Chemistry, Romanian Academy of Sciences, 060023 Bucharest, Romania.
| | - Mariela Militaru
- Medical Genetics, Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
- Genetic Center Cluj-Napoca, 400363 Cluj-Napoca, Romania.
| | - Simona Sorana Căinap
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Irina Pop
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Georgia Tita
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Claudia Sîrbe
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Otilia Fufezan
- Radiology Department, Children's Emergency Clinical Hospital, Cluj-Napoca, 400378, Romania.
| | - Mihaela Adela Vințan
- Pediatric Neurology Clinic, Children's Emergency Clinical Hospital, Department of Neurosciences, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
| | - Romana Vulturar
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
- Cognitive Neuroscience Laboratory, Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, 400084 Cluj-Napoca, Romania.
- Imogen Medical Institute, 400012 Cluj-Napoca, Romania.
| | - Tudor Lucian Pop
- Second Pediatric Clinic, Department of Mother and Child, University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj-Napoca, 400012 Cluj-Napoca, Romania.
- Center of Expertise for Pediatric Liver Rare Disorders, Children's Emergency Clinical Hospital, 400177 Cluj-Napoca, Romania.
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Lin H, Li R, Liu Z, Chen J, Yang Y, Chen H, Lin Z, Lai W, Long E, Wu X, Lin D, Zhu Y, Chen C, Wu D, Yu T, Cao Q, Li X, Li J, Li W, Wang J, Yang M, Hu H, Zhang L, Yu Y, Chen X, Hu J, Zhu K, Jiang S, Huang Y, Tan G, Huang J, Lin X, Zhang X, Luo L, Liu Y, Liu X, Cheng B, Zheng D, Wu M, Chen W, Liu Y. Diagnostic Efficacy and Therapeutic Decision-making Capacity of an Artificial Intelligence Platform for Childhood Cataracts in Eye Clinics: A Multicentre Randomized Controlled Trial. EClinicalMedicine 2019; 9:52-59. [PMID: 31143882 PMCID: PMC6510889 DOI: 10.1016/j.eclinm.2019.03.001] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/12/2019] [Accepted: 03/03/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND CC-Cruiser is an artificial intelligence (AI) platform developed for diagnosing childhood cataracts and providing risk stratification and treatment recommendations. The high accuracy of CC-Cruiser was previously validated using specific datasets. The objective of this study was to compare the diagnostic efficacy and treatment decision-making capacity between CC-Cruiser and ophthalmologists in real-world clinical settings. METHODS This multicentre randomized controlled trial was performed in five ophthalmic clinics in different areas across China. Pediatric patients (aged ≤ 14 years) without a definitive diagnosis of cataracts or history of previous eye surgery were randomized (1:1) to receive a diagnosis and treatment recommendation from either CC-Cruiser or senior consultants (with over 5 years of clinical experience in pediatric ophthalmology). The experts who provided a gold standard diagnosis, and the investigators who performed slit-lamp photography and data analysis were blinded to the group assignments. The primary outcome was the diagnostic performance for childhood cataracts with reference to cataract experts' standards. The secondary outcomes included the evaluation of disease severity and treatment determination, the time required for the diagnosis, and patient satisfaction, which was determined by the mean rating. This trial is registered with ClinicalTrials.gov (NCT03240848). FINDINGS Between August 9, 2017 and May 25, 2018, 350 participants (700 eyes) were randomly assigned for diagnosis by CC-Cruiser (350 eyes) or senior consultants (350 eyes). The accuracies of cataract diagnosis and treatment determination were 87.4% and 70.8%, respectively, for CC-Cruiser, which were significantly lower than 99.1% and 96.7%, respectively, for senior consultants (p < 0.001, OR = 0.06 [95% CI 0.02 to 0.19]; and p < 0.001, OR = 0.08 [95% CI 0.03 to 0.25], respectively). The mean time for receiving a diagnosis from CC-Cruiser was 2.79 min, which was significantly less than 8.53 min for senior consultants (p < 0.001, mean difference 5.74 [95% CI 5.43 to 6.05]). The patients were satisfied with the overall medical service quality provided by CC-Cruiser, typically with its time-saving feature in cataract diagnosis. INTERPRETATION CC-Cruiser exhibited less accurate performance comparing to senior consultants in diagnosing childhood cataracts and making treatment decisions. However, the medical service provided by CC-Cruiser was less time-consuming and achieved a high level of patient satisfaction. CC-Cruiser has the capacity to assist human doctors in clinical practice in its current state. FUNDING National Key R&D Program of China (2018YFC0116500) and the Key Research Plan for the National Natural Science Foundation of China in Cultivation Project (91846109).
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Affiliation(s)
- Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Ruiyang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Yahan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Weiyi Lai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Dongxuan Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Tongyong Yu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Wangting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Jinghui Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Mingmin Yang
- Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, The Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong 518040, China
| | - Huiling Hu
- Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, The Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong 518040, China
| | - Li Zhang
- Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China
| | - Yang Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Xuelan Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Jianmin Hu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Ke Zhu
- Kaifeng Eye Hospital, Kaifeng, Henan 475000, China
| | - Shuhong Jiang
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, China
| | - Yalin Huang
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Gang Tan
- The First Affiliated Hospital of the University of South China, Hengyang, Hunan 421001, China
| | - Jialing Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xiaoming Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Xinyu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Yuhua Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Xialin Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Bing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
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Hamm LM, Boluk KA, Black JM, Dai S, Thompson B. Phenomenological approach to childhood cataract treatment in New Zealand using semi-structured interviews: how might we improve provision of care. BMJ Open 2019; 9:e024869. [PMID: 30782745 PMCID: PMC6352803 DOI: 10.1136/bmjopen-2018-024869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To understand how we might improve the provision of medical care for children with cataracts. DESIGN A phenomenological design was employed. Semi-structured interviews were conducted to capture rich descriptions of the phenomena. Our goal in the interview and the analysis was to understand the sources of distress associated with treatment for cataract and deprivation amblyopia which (1) could be addressed by the medical community and (2) related to treatment adherence. SETTING Interviews were conducted by a non-clinician researcher in New Zealand (NZ) in a location chosen by informants. In NZ, the red reflex screening test is performed shortly after birth, and surgery to remove paediatric cataracts is publicly funded. PARTICIPANTS Families of children who had a history of cataract in Auckland, NZ were posted an invitation to participate. Twenty families were interviewed. RESULTS Our analysis illustrated that informants described a wide range of experiences, from declined cataract surgery to full adherence to medical advice including years of patching for more than 4 hours a day. Across these experiences, we identified three relevant themes; timing of diagnosis, communication between the parent and clinician, and parental social support networks. CONCLUSION The medical community may be better placed to support families dealing with childhood cataract by improving detection of childhood cataract, building appropriate communication pathways and promoting social support, with an emphasis on empathetic, individualised care.
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Affiliation(s)
- Lisa M Hamm
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Karla A Boluk
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Shuan Dai
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
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Jinagal J, Gupta G, Agarwal A, Aggarwal K, Akella M, Gupta V, Suri D, Gupta A, Singh S, Ram J. Safety and efficacy of dexamethasone implant along with phacoemulsification and intraocular lens implantation in children with juvenile idiopathic arthritis associated uveitis. Indian J Ophthalmol 2019; 67:69-74. [PMID: 30574896 PMCID: PMC6324120 DOI: 10.4103/ijo.ijo_713_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of intraoperative intravitreal dexamethasone implant in patients of juvenile idiopathic arthritis (JIA)-associated uveitis undergoing phacoemulsification with posterior chamber intraocular lens (PCIOL) implantation. METHODS Retrospectively, data of patients with JIA-associated uveitis undergoing phacoemulsification with PCIOL implantation with intraoperative dexamethasone implant injection were analyzed. Patients with a minimum follow-up of 6 months were included. Primary outcome measures were ocular inflammation, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and worsening of uveitis. RESULTS 8 eyes of 6 patients were included. BCVA was significantly improved at 1, 3, and 6 months postoperatively 0.20 ± 0.09, P = 0.008; 0.18 ± 0.11, P = 0.008; and 0.24 ± 0.11, P = 0.01, respectively. No statistical difference noted in mean IOP at various follow-up visits. None developed worsening of uveitis or Cystoid macular edema. CONCLUSION Intraoperative intravitreal dexamethasone implant is a safe and effective in preventing and managing the postoperative inflammation in children with JIA-associated uveitic cataract.
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Affiliation(s)
- Jitender Jinagal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Gaurav Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Aniruddha Agarwal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Kanika Aggarwal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Madhuri Akella
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Deepti Suri
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Anju Gupta
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Surjit Singh
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Mohammadpour M, Shaabani A, Sahraian A, Momenaei B, Tayebi F, Bayat R, Mirshahi R. Updates on managements of pediatric cataract. J Curr Ophthalmol 2018; 31:118-126. [PMID: 31317088 PMCID: PMC6611931 DOI: 10.1016/j.joco.2018.11.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 11/02/2018] [Accepted: 11/14/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose A comprehensive review in congenital cataract management can guide general ophthalmologists in managing such a difficult situation which remains a significant cause of preventable childhood blindness. This review will focus on surgical management, postoperative complications, and intraocular lens (IOL)-related controversies. Methods Electrical records of PubMed, Medline, Google Scholar, and Web of Science from January 1980 to August 2017 were explored using a combination of keywords: "Congenital", "Pediatric", "Childhood", "Cataract", "Lens opacity", "Management", "Surgery", "Complication", "Visual rehabilitation”, and "Lensectomy". A total number of 109 articles were selected for the review process. Results This review article suggests that lens opacity obscuring the red reflex in preverbal children and visual acuity of less than 20/40 is an absolute indication for lens aspiration. For significant lens opacity that leads to a considerable risk of amblyopia, cataract surgery is recommended at 6 weeks of age for unilateral cataract and between 6 and 8 weeks of age for bilateral cases. The recommended approach in operation is lens aspiration via vitrector and posterior capsulotomy and anterior vitrectomy in children younger than six years, and IOL implantation could be considered in patients older than one year. Most articles suggested hydrophobic foldable acrylic posterior chamber intraocular lens (PCIOL) for pediatrics because of lower postoperative inflammation. Regarding the continuous ocular growth and biometric changes in pediatric patients, under correction of IOL power based on the child's age is an acceptable approach. Considering the effects of early and late postoperative complications on the visual outcome, timely detection, and management are of a pivotal importance. In the end, the main parts of post-operation visual rehabilitation are a refractive correction, treatment of concomitant amblyopia, and bifocal correction for children in school age. Conclusions The management of congenital cataracts stands to challenge for most surgeons because of visual development and ocular growth. Children undergoing cataract surgery must be followed lifelong for proper management of early and late postoperative complications. IOL implantation for infants less than 1 year is not recommended, and IOL insertion for children older than 2 years with sufficient capsular support is advised.
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Affiliation(s)
- Mehrdad Mohammadpour
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Shaabani
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sahraian
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Momenaei
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Tayebi
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Bayat
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Majid S, Ateeq A, Bukari S, Hussain M. Outcomes of cataract surgery in Microophthalmia. Pak J Med Sci 2018; 34:1525-1528. [PMID: 30559816 PMCID: PMC6290192 DOI: 10.12669/pjms.346.14622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To find out outcomes of cataract surgery with Microophthalmia in children less than two years. Methods This cross-sectional study was conducted at Al-Ibrahim Eye Hospital, Karachi from January 2016 to August 2017. It included thirty micro ophthalmic eyes of infants with visually significant cataract of age less than two years who had cataract surgery without intraocular lens implantation. Axial length of globe was 19 mm or less in all thirty eyes of seventeen infants. in which thirteen infants had bilateral cataract and four had unilateral cataract. Result Thirty Simple Micro ophthalmic eyes from seventeen patients having visually significant congenital cataract were studied. Thirteen had bilateral cataract and four had unilateral cataract. Mean preoperative IOP was 9.0±1.2 mmHg and postoperative IOP after three months was 10.9±3.2 mmHg. Three patients had secondary capsular opacification 17.6%. Two patients had posterior synachae 11.8% after three months. Conclusion The results suggest that cataract surgery in simple microophthalmia is safe procedure. Postoperative complications in this study were within acceptable limits. Long term study with intraocular lens is required to confirm our observation.
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Affiliation(s)
- Saima Majid
- Dr. Saima Majid, FCPS. Department of Ophthalmology, Isra Postgraduate institute of Ophthalmology, Karachi, Pakistan
| | - Asim Ateeq
- Dr. Asim Ateeq, FCPS. Department of Ophthalmology, Isra Postgraduate institute of Ophthalmology, Karachi, Pakistan
| | - Sadia Bukari
- Dr. Sadia Bukhari, FCPS. Department of Ophthalmology, Isra Postgraduate institute of Ophthalmology, Karachi, Pakistan
| | - Munawar Hussain
- Dr. Munawar Hussain, M.S.Ophth. Department of Ophthalmology, Isra Postgraduate institute of Ophthalmology, Karachi, Pakistan
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Abstract
Children who are treated for congenital cataracts later exhibit impairments in configural face analysis. This has been explained in terms of a critical period for the acquisition of normal face processing. Here, we consider a more parsimonious account according to which deficits in configural analysis result from the abnormally high initial retinal acuity that children treated for cataracts experience, relative to typical newborns. According to this proposal, the initial period of low retinal acuity characteristic of normal visual development induces extended spatial processing in the cortex that is important for configural face judgments. As a computational test of this hypothesis, we examined the effects of training with high-resolution or blurred images, and staged combinations, on the receptive fields and performance of a convolutional neural network. The results show that commencing training with blurred images creates receptive fields that integrate information across larger image areas and leads to improved performance and better generalization across a range of resolutions. These findings offer an explanation for the observed face recognition impairments after late treatment of congenital blindness, suggest an adaptive function for the acuity trajectory in normal development, and provide a scheme for improving the performance of computational face recognition systems.
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Hartmann EE, Drews-Botsch C, DuBois LG, Cotsonis G, Lambert SR. Correlation of monocular grating acuity at age 12 months with recognition acuity at age 4.5 years: findings from the Infant Aphakia Treatment Study. J AAPOS 2018; 22:299-303.e2. [PMID: 30031874 PMCID: PMC7872073 DOI: 10.1016/j.jaapos.2018.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/18/2018] [Accepted: 03/24/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine whether grating acuity at age 12 months can be used to predict recognition acuity at age 4.5 years in children treated for unilateral congenital cataract enrolled in the Infant Aphakia Treatment Study (IATS). METHODS Traveling testers assessed monocular grating acuity at 12 months of age (Teller Acuity Card Test [TACT]) and recognition acuity at 4.5 years of age (Amblyopia Treatment Study Electronic Visual Acuity Testing, HOTV) in children treated for visually significant monocular cataract in the IATS. Spearman rank correlation was used to evaluate the relationship between visual acuities at the two ages in the treated eyes. RESULTS Visual acuity data at both ages were available for 109 of 114 children (96%). Grating acuity at 12 months of age and recognition acuity at 4.5 years of age were significantly correlated for the treated eyes (rspearman = 0.45; P = 0.001). At age 4.5 years, 67% of the subjects who had grating acuity at 12 months of age within the 95% predictive limits in their treated eye demonstrated recognition acuity better than 20/200. Similarly, at age 4.5 years 67% of the subjects who had grating acuity at age 12 months below the 95% predictive limits in their treated eye demonstrated recognition acuity of 20/200 or worse. CONCLUSIONS A single grating acuity assessment at age 12 months predicts recognition acuity in a child treated for unilateral congenital cataract in only two-thirds of cases. Clinicians should consider other factors, such as patching compliance and age at surgery, when using an early grating acuity assessment to modify treatment.
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Affiliation(s)
- E Eugenie Hartmann
- Department of Vision Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Carolyn Drews-Botsch
- Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lindreth G DuBois
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, Georgia
| | - George Cotsonis
- Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Scott R Lambert
- Department of Ophthalmology, Stanford University, Stanford, California
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Jiang J, Liu X, Liu L, Wang S, Long E, Yang H, Yuan F, Yu D, Zhang K, Wang L, Liu Z, Wang D, Xi C, Lin Z, Wu X, Cui J, Zhu M, Lin H. Predicting the progression of ophthalmic disease based on slit-lamp images using a deep temporal sequence network. PLoS One 2018; 13:e0201142. [PMID: 30063738 PMCID: PMC6067742 DOI: 10.1371/journal.pone.0201142] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/12/2018] [Indexed: 11/21/2022] Open
Abstract
Ocular images play an essential role in ophthalmology. Current research mainly focuses on computer-aided diagnosis using slit-lamp images, however few studies have been done to predict the progression of ophthalmic disease. Therefore exploring an effective approach of prediction can help to plan treatment strategies and to provide early warning for the patients. In this study, we present an end-to-end temporal sequence network (TempSeq-Net) to automatically predict the progression of ophthalmic disease, which includes employing convolutional neural network (CNN) to extract high-level features from consecutive slit-lamp images and applying long short term memory (LSTM) method to mine the temporal relationship of features. First, we comprehensively compare six potential combinations of CNNs and LSTM (or recurrent neural network) in terms of effectiveness and efficiency, to obtain the optimal TempSeq-Net model. Second, we analyze the impacts of sequence lengths on model's performance which help to evaluate their stability and validity and to determine the appropriate range of sequence lengths. The quantitative results demonstrated that our proposed model offers exceptional performance with mean accuracy (92.22), sensitivity (88.55), specificity (94.31) and AUC (97.18). Moreover, the model achieves real-time prediction with only 27.6ms for single sequence, and simultaneously predicts sequence data with lengths of 3-5. Our study provides a promising strategy for the progression of ophthalmic disease, and has the potential to be applied in other medical fields.
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Affiliation(s)
- Jiewei Jiang
- School of Computer Science and Technology, Xidian University, Xi’an, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiyang Liu
- School of Computer Science and Technology, Xidian University, Xi’an, China
- School of Software, Xidian University, Xi’an, China
| | - Lin Liu
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Shuai Wang
- School of Software, Xidian University, Xi’an, China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haoqing Yang
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Fuqiang Yuan
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Deying Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Kai Zhang
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Liming Wang
- School of Computer Science and Technology, Xidian University, Xi’an, China
- School of Software, Xidian University, Xi’an, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongni Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Changzun Xi
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiangtao Cui
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Mingmin Zhu
- School of Mathematics and Statistics, Xidian University, Xi’an, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Demirkılınç Biler E, Yıldırım Ş, Üretmen Ö, Köse S. Long-term Results in Pediatric Developmental Cataract Surgery with Primary Intraocular Lens Implantation. Turk J Ophthalmol 2018; 48:1-5. [PMID: 29576890 PMCID: PMC5854852 DOI: 10.4274/tjo.80947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 06/07/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the outcomes of pediatric developmental cataract surgery with primary intraocular lens (IOL) implantation. MATERIALS AND METHODS Patients between 2 and 16 years old who underwent cataract surgery with primary IOL implantation were retrospectively evaluated. Age at time of surgery, pre- and postoperative best corrected visual acuities, postoperative ocular complications, and any accompanying ocular pathologies were obtained from the patients' charts. Mean refractive changes and degree of myopic shift were analyzed according to the age groups. Operated eyes were also compared with the fellow eyes in unilateral cases. RESULTS A total of 101 eyes of 65 patients were included. The average age at time of surgery was 76±40 months and the average follow-up period was 44±30 months. Among the 78 eyes that could be assessed for visual acuity improvement, 66 (84.6%) of them showed ≥2 lines of improvement. The difference in the mean refractive change between the 2-5 years old and 8-16 years old age groups was found to be statistically significant. However, the mean refractive change per year was not found to be significant between the same age groups. In unilateral cases, the operated eyes showed a greater myopic change than the fellow eyes, with no statistically significant difference. The most common postoperative complication was visual axis opacity. CONCLUSION Good visual outcomes can be achieved following pediatric cataract surgery with primary IOL implantation. Optic axis opacities were the most common postoperative complications. Overall, refractive changes following surgery are inevitable, and more prominent in younger age groups.
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Affiliation(s)
| | - Şeyda Yıldırım
- Adıyaman University Research and Training Hospital, Department of Ophthalmology, Adıyaman, Turkey
| | - Önder Üretmen
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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Šimunović M, Paradžik M, Škrabić R, Unić I, Bućan K, Škrabić V. Cataract as Early Ocular Complication in Children and Adolescents with Type 1 Diabetes Mellitus. Int J Endocrinol 2018; 2018:6763586. [PMID: 29755521 PMCID: PMC5883981 DOI: 10.1155/2018/6763586] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/28/2018] [Indexed: 12/19/2022] Open
Abstract
Cataract is a rare manifestation of ocular complication at an early phase of T1DM in the pediatric population. The pathophysiological mechanism of early diabetic cataract has not been fully understood; however, there are many theories about the possible etiology including osmotic damage, polyol pathway, and oxidative stress. The prevalence of early diabetic cataract in the population varies between 0.7 and 3.4% of children and adolescents with T1DM. The occurrence of diabetic cataract in most pediatric patients is the first sign of T1DM or occurs within 6 months of diagnosis of T1DM. Today, there are many experimental therapies for the treatment of diabetic cataract, but cataract surgery continues to be a gold standard in the treatment of diabetic cataract. Since the cataract is the leading cause of visual impairment in patients with T1DM, diabetic cataract requires an initial screening as well as continuous surveillance as a measure of prevention and this should be included in the guidelines of pediatric diabetes societies.
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Affiliation(s)
- Marko Šimunović
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Martina Paradžik
- Department of Ophthalmology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Roko Škrabić
- School of Medicine, University of Split, Šoltanska 2, Split, Croatia
| | - Ivana Unić
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Kajo Bućan
- Department of Ophthalmology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
| | - Veselin Škrabić
- Department of Pediatrics, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
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Lin HT, Long EP, Chen JJ, Liu ZZ, Lin ZL, Cao QZ, Zhang XY, Wu XH, Wang QW, Lin DR, Li XY, Liu JC, Luo LX, Qu B, Chen WR, Liu YZ. Timing and approaches in congenital cataract surgery: a four-year, two-layer randomized controlled trial. Int J Ophthalmol 2017; 10:1835-1843. [PMID: 29259901 DOI: 10.18240/ijo.2017.12.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/16/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches. METHODS In this prospective, randomized controlled trial, we recruited congenital cataract patients aged 3mo or younger before cataract surgery. Sixty-one eligible patients were randomly assigned to two groups according to surgical timing: a 3-month-old group and a 6-month-old group. Each eye underwent one of three randomly assigned surgical procedures, as follows: surgery A, lens aspiration (I/A); surgery B, lens aspiration with posterior continuous curvilinear capsulorhexis (I/A+PCCC); and surgery C, lens aspiration with posterior continuous curvilinear capsulorhexis and anterior vitrectomy (I/A+PCCC+A-Vit). The long-term best-corrected visual acuity (BCVA) and the incidence of complications in the different groups were compared and analyzed. RESULTS A total of 57 participants (114 eyes) with a mean follow-up period of 48.7mo were included in the final analysis. The overall logMAR BCVA in the 6-month-old group was better than that in the 3-month-old group (0.81±0.28 vs 0.96±0.30; P=0.02). The overall logMAR BCVA scores in the surgery B group were lower than the scores in the A and C groups (A: 0.80±0.29, B: 1.02±0.28, and C: 0.84±0.28; P=0.007). A multivariate linear regression revealed no significant relationships between the incidence of complications and long-term BCVA. CONCLUSION It might be safer and more beneficial for bilateral total congenital cataract patients to undergo surgery at 6mo of age than 3mo. Moreover, with rigorous follow-up and timely intervention, the postoperative complications in these patients are treatable and do not compromise visual outcomes.
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Affiliation(s)
- Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Er-Ping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing-Jing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhen-Zhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhuo-Ling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qian-Zhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xia-Yin Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Hang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qi-Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Duo-Ru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jin-Chao Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Li-Xia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Bo Qu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Wei-Rong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yi-Zhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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Decreased incidence of glaucoma in children with asthma using inhaled corticosteroid: a cohort study. Oncotarget 2017; 8:105463-105471. [PMID: 29285264 PMCID: PMC5739651 DOI: 10.18632/oncotarget.22252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022] Open
Abstract
Among the anti-inflammatory medications used for treating asthma, corticosteroids are the most effective. The effects of orally administered corticosteroids on intraocular pressure and lens opacity have been well defined, but the influence of inhaled corticosteroids (ICS) on children has yet to be clearly explained. Therefore, we used a nationwide cohort database to investigate glaucoma in childhood asthma patients using ICS. We analyzed a dataset of 1,000,000 randomly sampled individuals from Taiwan's 2000 National Health Insurance Research Database. The study cohort included 5,380 patients who were first diagnosed with asthma (ICD9: 493.X) diagnosis when they were six years old or younger. All subjects were followed through December 2011. We applied Cox's proportional hazard model to determine whether ICS use has a correlation with glaucoma. Of the 5,380 patients enrolled in this study, we identified 1,232 patients who had used ICS and 4,148 patients who had no history of ICS administration throughout the follow-up period. The prevalence of glaucoma was significantly lower in patients using ICS, with a 0.52-fold decreased risk of developing glaucoma in comparison to the control group [adjusted hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.28∼0.96]. Among the evaluated comorbidities, cataract was positively associated with glaucoma in asthma children (adjusted HR 8.22; 95% CI = 2.59∼26.12). This study provides not only the first but also strong evidence that the glaucoma incidence in the ICS group is lower than that in the non-ICS group in children with asthma. Further consultation with an ophthalmologist regarding the high-risk group of asthma children with cataracts is necessary.
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Construction and implications of structural equation modeling network for pediatric cataract: a data mining research of rare diseases. BMC Ophthalmol 2017; 17:74. [PMID: 28526015 PMCID: PMC5438536 DOI: 10.1186/s12886-017-0468-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of rare diseases are complex diseases caused by a combination of multiple morbigenous factors. However, uncovering the complex etiology and pathogenesis of rare diseases is difficult due to limited clinical resources and conventional statistical methods. This study aims to investigate the interrelationship and the effectiveness of potential factors of pediatric cataract, for the exploration of data mining strategy in the scenarios of rare diseases. METHODS We established a pilot rare disease specialized care center to systematically record all information and the entire treatment process of pediatric cataract patients. These clinical records contain the medical history, multiple structural indices, and comprehensive functional metrics. A two-layer structural equation model network was applied, and eight potential factors were filtered and included in the final modeling. RESULTS Four risk factors (area, density, location, and abnormal pregnancy experience) and four beneficial factors (axis length, uncorrected visual acuity, intraocular pressure, and age at diagnosis) were identified. Quantifiable results suggested that abnormal pregnancy history may be the principle risk factor among medical history for pediatric cataracts. Moreover, axis length, density, uncorrected visual acuity and age at diagnosis served as the dominant factors and should be emphasized in regular clinical practice. CONCLUSIONS This study proposes a generalized evidence-based pattern for rare and complex disease data mining, provides new insights and clinical implications on pediatric cataract, and promotes rare-disease research and prevention to benefit patients.
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Boswell BA, Korol A, West-Mays JA, Musil LS. Dual function of TGFβ in lens epithelial cell fate: implications for secondary cataract. Mol Biol Cell 2017; 28:907-921. [PMID: 28209733 PMCID: PMC5385940 DOI: 10.1091/mbc.e16-12-0865] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 12/29/2022] Open
Abstract
The most common vision-disrupting complication of cataract surgery is posterior capsule opacification (PCO; secondary cataract). PCO is caused by residual lens cells undergoing one of two very different cell fates: either transdifferentiating into myofibroblasts or maturing into lens fiber cells. Although TGFβ has been strongly implicated in lens cell fibrosis, the factors responsible for the latter process have not been identified. We show here for the first time that TGFβ can induce purified primary lens epithelial cells within the same culture to undergo differentiation into either lens fiber cells or myofibroblasts. Marker analysis confirmed that the two cell phenotypes were mutually exclusive. Blocking the p38 kinase pathway, either with direct inhibitors of the p38 MAP kinase or a small-molecule therapeutic that also inhibits the activation of p38, prevented TGFβ from inducing epithelial-myofibroblast transition and cell migration but did not prevent fiber cell differentiation. Rapamycin had the converse effect, linking MTOR signaling to induction of fiber cell differentiation by TGFβ. In addition to providing novel potential therapeutic strategies for PCO, our findings extend the so-called TGFβ paradox, in which TGFβ can induce two disparate cell fates, to a new epithelial disease state.
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Affiliation(s)
- Bruce A Boswell
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, OR 97239
| | - Anna Korol
- Department of Pathology and Molecular Medicine, McMaster University Health Science Centre, Hamilton, ON L8N 3Z5, Canada
| | - Judith A West-Mays
- Department of Pathology and Molecular Medicine, McMaster University Health Science Centre, Hamilton, ON L8N 3Z5, Canada
| | - Linda S Musil
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, OR 97239
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49
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Liu X, Jiang J, Zhang K, Long E, Cui J, Zhu M, An Y, Zhang J, Liu Z, Lin Z, Li X, Chen J, Cao Q, Li J, Wu X, Wang D, Lin H. Localization and diagnosis framework for pediatric cataracts based on slit-lamp images using deep features of a convolutional neural network. PLoS One 2017; 12:e0168606. [PMID: 28306716 PMCID: PMC5356999 DOI: 10.1371/journal.pone.0168606] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/11/2016] [Indexed: 12/12/2022] Open
Abstract
Slit-lamp images play an essential role for diagnosis of pediatric cataracts. We present a computer vision-based framework for the automatic localization and diagnosis of slit-lamp images by identifying the lens region of interest (ROI) and employing a deep learning convolutional neural network (CNN). First, three grading degrees for slit-lamp images are proposed in conjunction with three leading ophthalmologists. The lens ROI is located in an automated manner in the original image using two successive applications of Candy detection and the Hough transform, which are cropped, resized to a fixed size and used to form pediatric cataract datasets. These datasets are fed into the CNN to extract high-level features and implement automatic classification and grading. To demonstrate the performance and effectiveness of the deep features extracted in the CNN, we investigate the features combined with support vector machine (SVM) and softmax classifier and compare these with the traditional representative methods. The qualitative and quantitative experimental results demonstrate that our proposed method offers exceptional mean accuracy, sensitivity and specificity: classification (97.07%, 97.28%, and 96.83%) and a three-degree grading area (89.02%, 86.63%, and 90.75%), density (92.68%, 91.05%, and 93.94%) and location (89.28%, 82.70%, and 93.08%). Finally, we developed and deployed a potential automatic diagnostic software for ophthalmologists and patients in clinical applications to implement the validated model.
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Affiliation(s)
- Xiyang Liu
- School of Computer Science and Technology, Xidian University, Xi’an, China
- School of Software, Xidian University, Xi’an, China
| | - Jiewei Jiang
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Kai Zhang
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiangtao Cui
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Mingmin Zhu
- School of Mathematics and Statistics, Xidian University, Xi’an, China
| | - Yingying An
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Jia Zhang
- School of Computer Science and Technology, Xidian University, Xi’an, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongni Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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50
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Zhao YE, Gong XH, Zhu XN, Li HM, Tu MJ, Coursey TG, Pflugfelder SC, Gu F, Chen D. Long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses in children: An ultrasound biomicroscopy study. PLoS One 2017; 12:e0172979. [PMID: 28301497 PMCID: PMC5354427 DOI: 10.1371/journal.pone.0172979] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/12/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses (IOLs) in children after pediatric cataract surgery. Methods IOL was implanted in the ciliary sulcus in 21 eyes of 14 children, and in the capsular bag in 19 eyes of 12 children for the treatment of pediatric cataract in an institutional setting. Ultrasound biomicroscopy (UBM) was performed. Main outcome measures included IOL decentration, IOL tilt, anterior chamber depth (ACD), angle-opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and incidence of postoperative complications. Results The mean follow-up period was 6.81 ± 1.82 years. Comparing to the capsular bag fixation group, the ciliary sulcus fixation group had higher vertical IOL decentration, horizontal IOL tilt, and vertical IOL tilt (p = 0.02, 0.01,0.01, respectively), higher incidence of iris-IOL contact and peripheral anterior synechia (p = 0.001, 0.03, respectively), smaller ACD, AOD500, and TIA (p = 0.02, 0.03, 0.04, respectively), higher mean IOP (17.10 ±6.06 mmHg vs.14.15± 4.74 mmHg, p = 0.01), and higher incidence of secondary glaucoma (28.57% vs. 10.53%, p = 0.007).There was no significant difference between the two groups with regard to the BCVA, refractive errors, incidence of myopic shift, nystagmus, strabismus, and visual axis opacity. Conclusions Ciliary sulcus fixation of IOLs in pediatric eyes may increase IOL malposition and crowding of the anterior segment, and may associate with a higher risk of secondary glaucoma compared to capsular bag fixation of IOLs.
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Affiliation(s)
- Yun-e Zhao
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xian-hui Gong
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue-ning Zhu
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - He-ming Li
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meng-jun Tu
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Terry G. Coursey
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Stephen C. Pflugfelder
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Feng Gu
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail: (DC); (FG)
| | - Ding Chen
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail: (DC); (FG)
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