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Bisen AC, Srivastava S, Mishra A, Sanap SN, Biswas A, Choudhury AD, Dubey A, Gupta NM, Yadav KS, Mugale MN, Bhatta RS. Pharmaceutical Emulsions: A Viable Approach for Ocular Drug Delivery. J Ocul Pharmacol Ther 2024; 40:261-280. [PMID: 38654153 DOI: 10.1089/jop.2023.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Amol Chhatrapati Bisen
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Saurabh Srivastava
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
| | - Anjali Mishra
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
| | - Sachin Nashik Sanap
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Arpon Biswas
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
| | | | - Ayush Dubey
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
| | - Neeraj Mohan Gupta
- Department of Chemistry, Government P. G. College, Guna, Madhya Pradesh, India
| | - Karan Singh Yadav
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
- Division of Toxicology and Experimental Medicine; CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Madhav Nilakanth Mugale
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
- Division of Toxicology and Experimental Medicine; CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Rabi Sankar Bhatta
- Pharmaceutics and Pharmacokinetics Division, Lucknow, Uttar Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
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Kodali S, He CH, Patel S, Tao A, Szlechter M, Parsikia A, Mbekeani JN. Characteristics of ocular injuries associated with mortality in patients admitted with major trauma. BMC Ophthalmol 2024; 24:125. [PMID: 38504178 PMCID: PMC10949718 DOI: 10.1186/s12886-024-03392-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: 10/25/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Few ocular trauma studies have addressed mortality outcomes. We sought to determine characteristics of mortality-related ocular trauma admissions and compared them with non-fatal injuries. METHODS A retrospective study was conducted using de-identified data of patients admitted with major trauma from the National Trauma Data Bank (2008-2014). Patients with ocular injury were identified using ICD- 9CM codes. Demographics, intention and mechanism, types of ocular and head injuries, and injury severity were documented. Mortality was determined using post-admission disposition. Statistical analysis using student t-test, chi-square, and odds ratios (OR) calculations were performed with STATA-17 software. Significance was set at P < 0.05. RESULTS Of 316,485 patients admitted with ocular trauma, 12,233 (3.86%) were mortality related. Expired patients were older than survivors: mean (SD) of 50.1(25.5) vs. 41.5(22.8) years. White (OR = 1.32; P < 0.001), ≥ 65years old (OR = 2.25; P < 0.001), and male (OR = 1.05; P = 0.029) patients were most likely to expire than their counterparts. Common mechanisms of injury in survivors were falls (25.3%), motor vehicle traffic-occupant, MVTO (21.8%) and struck by/against (18.1%) and for fatal injuries, falls (29.7%), MVTO (21.9%) and firearms (11.5%). Traumatic brain injury (TBI) was documented in 88.2% of mortality-related admissions. Very severe injury severity scores (ISS > 24) (OR = 19.19; P < 0.001) and severe Glasgow Coma Score (GCS < 8) (OR = 19.22; P < 0.001) were most associated with mortality than survival. Firearms were most associated with very severe ISS (OR = 3.73; P < 0.001), severe GCS (OR = 4.68; P < 0.001) and mortality (OR = 5.21; P < 0.001) than other mechanisms. Patients with cut/pierce injuries had the greatest odds of survival (OR = 13.48; P < 0.001). Optic nerve/visual pathways injuries (3.1%) had the highest association with very severe ISS (OR = 2.51; P < 0.001), severe GCS (OR = 3.64; P < 0.001) and mortality (OR = 2.58; P < 0.001) than other ocular injuries. Black patients with very severe ISS (OR = 32.14; P < 0.001) and severe GCS (OR = 31.89; P < 0.001) were more likely to expire than other race/ethnicities with similar injury severity. CONCLUSIONS Mortality-related admissions were older, male, and mostly of White race than ocular trauma admissions of survivors. Firearms were the deadliest mechanism. TBI was commonly associated and patients with optic nerve/pathway injuries, very severe ISS and severe GCS had higher mortality rates. Characteristics and demographic variations identified in this study may be useful in developing focused measures aimed at preventing trauma-related deaths.
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Affiliation(s)
- Sruthi Kodali
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Catherine H He
- Department of Ophthalmology & Visual Sciences, Yale School of Medicine, New Haven, Conn, USA
| | - Sheel Patel
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Alice Tao
- Department of Ophthalmology, Jamaica Hospital Medical Center, New York Medical College, Queens, NY, USA
| | - Moshe Szlechter
- Department of Surgery (Ophthalmology), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY, USA
| | - Afshin Parsikia
- Department of Research Services, University of Pennsylvania, Philadelphia, PA, USA
| | - Joyce N Mbekeani
- Department of Surgery (Ophthalmology), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA.
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY, USA.
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Seery CW, Choudhry HS, Dastjerdi MH. Zone 1 trauma: wound dehiscence compared to primary trauma. Int Ophthalmol 2024; 44:74. [PMID: 38349413 DOI: 10.1007/s10792-024-02923-2] [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: 01/24/2023] [Accepted: 12/17/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE The study aims to assess if Zone 1 globe injuries hold a favorable prognosis for all situations, including wound dehiscence, or just primary traumatic injuries. METHODS Retrospective cross-sectional chart review of patients who underwent open globe repair from 1/1/2019 to 12/1/2020 at an urban hospital setting was evaluated for final visual outcomes, associated ocular pathology, long-term complications, and need for further surgeries. RESULTS Fifty-eight eyes were identified-38 primary trauma and 20 dehisced wounds (11 penetrating keratoplasties, five clear corneal incisions, one laceration, one extracapsular cataract extraction, one radial keratotomy, and one tectonic graft). Dehisced wounds had more posterior segment pathology vs primary trauma, i.e., hemorrhagic choroidal, vitreous hemorrhage, retinal detachment, choroidal effusion (all 20% vs 2.63%, 5.26%, 5.26%, and 0%, respectively), vitreous prolapse (20% vs 2.63%), and uveal prolapse (80% vs 36.84%). Dehisced wounds had more traumatic aphakia (40% vs 0%) and dislocated lenses (15% vs 0%). Primary trauma was more likely to have traumatic cataracts (55.26% vs 10%) or no lens changes (44.74% vs 25%). About 10% dehisced wounds required enucleation (0% primary trauma). Cataract/secondary intraocular lens surgery was performed in 34% of the primary traumas (10% in dehisced wounds). Primary traumas achieved 20/40 vision or better in 44.74% (10% dehisced wounds). About 7.89% of patients with wound dehiscence ended with no light perception (none in primary trauma). CONCLUSION Zone 1 open globe injuries due to wound dehiscence may exhibit worse prognosis compared to primary trauma open globe injury. More important than the zone of injury may be the source.
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Affiliation(s)
- Christopher W Seery
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
- Bascom Palmer Eye Institute at the University of Miami, Miami, US
| | - Hassaam S Choudhry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
| | - Mohammad H Dastjerdi
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA.
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Chen Q, Liang L, Shi Y, Lu F. Epidemiological and clinical characteristics of open globe injuries in Southwest China. Front Med (Lausanne) 2024; 11:1303683. [PMID: 38384411 PMCID: PMC10879276 DOI: 10.3389/fmed.2024.1303683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Background Open globe injuries (OGIs) are one of the leading causes of monocular vision loss, and the clinical characteristics of OGIs are region specific. The features and patterns of OGIs in Southwest China are poorly known and not well studied. Our study aimed to review the epidemiological and clinical characteristics of patients hospitalized for OGIs in Southwest China. Methods A retrospective study of OGI patients admitted to the West China Hospital from January 1st, 2015, to December 31st, 2019, was performed. Demographic characteristics and injury details were recorded. The Birmingham Eye Trauma Terminology system and the ocular trauma score (OTS) were used. Results A total of 3,014 patients were included. The male-to-female ratio was 5.2:1, and the mean age was 35.6 ± 19.1 years. 15.2% of patients were from the ethnic groups. The highest-risk occupation was the farmer (30.3%), followed by the worker (28.5%). OGIs occurred more frequently in people with middle (37.0%) and primary school (33.1%) education levels. Types of injuries included 46.8% penetration, 21.2% rupture, 2.9% perforation, and 29.1% intraocular foreign body (IOFB). The injuries types differed between age and occupation groups (p < 0.001). IOFBs had a higher risk of causing endophthalmitis, retinal detachment, and traumatic cataracts (p < 0.001). The most common injuries resulted from sharp objects (72.7%). The causes of the injuries were significantly associated with age, ethnicity, and occupation (p < 0.001). Explosion injuries and attacks by animals were more common among people of Tibetan and Yi ethnicities. Blunt trauma, vehicle crashes, falls and age older than 60 years were risk factors for a lack of light perception and lower OTS scores prognosis. Conclusion OGIs in Southwest China mainly affected working-aged males, especially workers or farmers. Severe vision loss and IOFBs are more common findings. OGIs in older patients and ethnic minorities requires additional attention.
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Affiliation(s)
| | | | | | - Fang Lu
- The Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Sharifi M, Sedaghat M, Vaseie M. Ocular injuries sustained at home in five metropolitan cities: a review of 5008 cases. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2024; 12:194-202. [PMID: 38601050 PMCID: PMC11002462 DOI: 10.51329/mehdiophthal1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/20/2024] [Indexed: 04/12/2024]
Abstract
Background In Iran, ocular injuries sustained at home are a growing public health issue, and few studies have explored their prevalence and the frequencies of different causes of these injuries. We investigated the features of ocular injuries at home among children and adolescents (aged < 18 years), adults (18 - 64 years), and the elderly ( ≥ 65 years) in five metropolitan cities. Methods In this cross-sectional study, we recruited individuals with ocular injuries sustained at home who presented to 12 public/teaching hospitals in five metropolitan cities during a 5-month period. Using clinical records within the emergency department archives, we collected the following data: age, sex, frequency of injuries requiring hospital admission or surgical intervention, and causes of eye injuries, documented as 1) cleaning products, 2) chemical products, 3) kitchen items, 4) cooking activities, 5) toys, 6) falls from height, 7) sports equipment, 8) penetrating or cutting, 9) abrasions, 10) foreign bodies, and 11) direct blows by other individuals. Results Of 5008 participants from the five cities, 74% (n = 3711) were male and 26% (n = 1297) were female. The most frequent causes of injury among children and adolescents, adults, and the elderly were toys, kitchen items, and cooking activities, respectively. In children and adolescents, injuries were caused by kitchen items, toys, foreign bodies, and direct blows by other individuals more frequently than in adults or the elderly, and by cleaning products and abrasions more frequently than in the elderly (all P < 0.05). In adults, injuries were caused by cleaning products, cooking activities, falls from height, sports equipment, penetrating or cutting, and abrasions more frequently than in children and adolescents or the elderly (all P < 0.05), and by kitchen items, toys, and blows by other individuals more frequently than in the elderly (all P < 0.05). In the elderly, injuries were caused by chemical products more frequently than in children and adolescents or adults, and by cooking activities, falls from height, and sports equipment more frequently than in children and adolescents (all P < 0.05). In adults, the frequency of ocular injuries was significantly higher in Tehran and lower in Mashhad when comparing each with that of the other four cities (all P < 0.05). We found a significantly higher frequency of ocular injuries by cleaning and chemical products in Tehran, by toys in Shiraz, by falls from height in Isfahan, and by direct blows by other individuals in Ahvaz when comparing each to that of the other four cities (all P < 0.05). Regarding the prevalence of severe ocular injuries among the children/adolescent and adult age groups, conditions were relatively better in Shiraz and relatively unfavorable in Mashhad. Conclusions Ocular trauma was more common in male individuals and the younger age groups. Approximately half of the causes were kitchen items, toys, and foreign bodies, which are avoidable by enhancing public eye health awareness. The prevalence of severe ocular injuries in individuals aged < 18 years was high, highlighting the necessity of nationwide preventive strategies for pediatric ocular injuries.
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Affiliation(s)
- Meisam Sharifi
- Emergency Medicine Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sedaghat
- Emergency Medicine Department, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Mohammad Vaseie
- Emergency Medicine Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Meng X, Wang Q, Chen S, Zhang S, Yu J, Li H, Chen X, Wang Z, Yu W, Zheng Z, Zhou H, Luo J, Wang Z, Chen H, Wu N, Hu D, Chen S, Wei Y, Cui H, Song H, Chen H, Wang Y, Zhong J, Chen Z, Zhang H, Yang T, Li M, Liu Y, Dong X, Du M, Wang X, Yao X, Lin H, Li MJ, Yan H. An interpretable model predicts visual outcomes of no light perception eyes after open globe injury. Br J Ophthalmol 2024; 108:285-293. [PMID: 36596662 DOI: 10.1136/bjo-2022-322753] [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: 10/16/2022] [Accepted: 12/17/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The visual outcome of open globe injury (OGI)-no light perception (NLP) eyes is unpredictable traditionally. This study aimed to develop a model to predict the visual outcomes of vitrectomy surgery in OGI-NLP eyes using a machine learning algorithm and to provide an interpretable system for the prediction results. METHODS Clinical data of 459 OGI-NLP eyes were retrospectively collected from 19 medical centres across China to establish a training data set for developing a model, called 'VisionGo', which can predict the visual outcome of the patients involved and compare with the Ocular Trauma Score (OTS). Another 72 cases were retrospectively collected and used for human-machine comparison, and an additional 27 cases were prospectively collected for real-world validation of the model. The SHapley Additive exPlanations method was applied to analyse feature contribution to the model. An online platform was built for real-world application. RESULTS The area under the receiver operating characteristic curve (AUC) of VisionGo was 0.75 and 0.90 in previtrectomy and intravitrectomy application scenarios, which was much higher than the OTS (AUC=0.49). VisionGo showed better performance than ophthalmologists in both previtrectomy and intravitrectomy application scenarios (AUC=0.73 vs 0.57 and 0.87 vs 0.64). In real-world validation, VisionGo achieved an AUC of 0.60 and 0.91 in previtrectomy and intravitrectomy application scenarios. Feature contribution analysis indicated that wound length-related indicators, vitreous status and retina-related indicators contributed highly to visual outcomes. CONCLUSIONS VisionGo has achieved an accurate and reliable prediction in visual outcome after vitrectomy for OGI-NLP eyes.
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Affiliation(s)
- Xiangda Meng
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qihua Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Ophthalmology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Song Chen
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shijie Zhang
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Jinguo Yu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haibo Li
- Department of Ocular Trauma, Xiamen University Xiamen Eye Center, Xiamen, Fujian, China
| | - Xinkang Chen
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhaoyang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wenzhen Yu
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heding Zhou
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, Zhejiang, China
| | - Jing Luo
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhiliang Wang
- Department of Ophthalmology, Fudan University Huashan Hospital, Shanghai, China
| | - Haoyu Chen
- Department of Ocular Trauma, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Nan Wu
- Department of Ophthalmology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dan Hu
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Suihua Chen
- Department of Ophthalmology, General Hospital of Eastern Theater Command, Nanjing, Jiangsu, China
| | - Yong Wei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haibin Cui
- Department of Ocular Trauma, Heilongjiang Province Ophthalmology Hospital, Harbin, Heilongjiang, China
| | - Huping Song
- Department of Ophthalmology, Xi'an People's Hospital (Xi'an No.4 Hospital), Xi'an, Shaanxi, China
| | - Huijin Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yun Wang
- Department of Ophthalmology, Xining First People's Hospital, Xining, Qinghai, China
| | - Jie Zhong
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Zhen Chen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tiantian Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengxuan Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xue Dong
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Mei Du
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Xiaohong Wang
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Xuyang Yao
- Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Mulin Jun Li
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Department of Bioinformatics, The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
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Choudhry HS, Zhu A, Shaikh S, Zaki H, Masket S, Law SK. Epidemiology of Consumer-Product-Related Ocular Injuries in the Geriatric Population in the United States. Ophthalmol Ther 2024; 13:367-384. [PMID: 37995015 PMCID: PMC10776527 DOI: 10.1007/s40123-023-00852-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The purpose of this study was to assess trends in consumer-product-related geriatric ocular injuries using National Electronic Injury Surveillance System (NEISS) data. Understanding the specific consumer products and settings coded in the NEISS dictionary that contribute to geriatric (≥ 65 years) ocular injuries, along with changing patterns during events like the COVID-19 pandemic, provides crucial insights for tailoring therapy and preventative strategies. This ultimately may reduce the burden of eye injuries on both older adults and healthcare systems. METHODS This was a retrospective population-based cohort study. The NEISS database was used to study eye injuries in geriatric adults from 2010 to 2021. Patients were categorized by age groups (65-74, 75-84, 85-94, ≥ 95 years), and data on demographics, injury types, product categories, and COVID-19 impact were collected. Pearson's chi-squared test (with p < 0.001 taken to indicate significance) was used to assess differences in expected ratios between age groups. RESULTS A total of 168,685 eye injury cases in adults aged 65 years and older were analyzed. Household items, tools, and gardening products accounted for over 75% of injuries. Most injuries occurred at home (65.3%). Contusions/abrasions (40.3%) and a foreign body (19.3%) were common diagnoses. Females had more household-item-related injuries, while males had more foreign body injuries. Regarding therapeutic disposition, 93.7% of all injuries were treated/examined and released, which showed a decreasing trend as age increased, while hospital admission/transfer rates increased with age. Compared to before COVID-19, the percentage of injuries during COVID-19 due to tools decreased (from 22.5% to 18.3%), while injuries due to gardening/lawn/landscaping/patio products increased (from 13.8% to 15.3%). CONCLUSIONS Our study characterizes geriatric ocular injuries and COVID-19 impact, highlighting common products and locations. Different age groups showed different injury patterns. Understanding these trends can aid injury prevention strategies for consumers and healthcare providers. Demographics and injury frequencies differed based on age and sex. Future research should further explore post-COVID-19 trends.
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Affiliation(s)
- Hassaam S Choudhry
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - Aretha Zhu
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | - Sadiq Shaikh
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | - Haider Zaki
- Medical Science Building, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | | | - Simon K Law
- UCLA Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA, 90095, USA
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8
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Tan SI, Hoskin AK, Khatri A, Dave VP, Bhalerao S, Romero J, Agrawal R. Prognostic factors of open-globe injuries: A review. Indian J Ophthalmol 2023; 71:3587-3594. [PMID: 37991288 PMCID: PMC10788744 DOI: 10.4103/ijo.ijo_1496_23] [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: 06/07/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023] Open
Abstract
Open-globe injuries (OGI) can lead to significant visual impairment. The Ocular Trauma Score (OTS) is the most widely recognized tool for predicting visual outcomes. This review aimed to identify prognostic factors and assess the effectiveness of the OTS in predicting visual outcomes. Twenty-one articles published on PubMed and Google Scholar were analyzed. Initial visual acuity and the zone of injury were found to be the most significant prognostic factors for OGI. Other significant prognostic factors include retinal detachment/involvement, relative afferent pupillary defect, vitreous hemorrhage, vitreous prolapse, type of injury, hyphema, lens involvement, and duration from incidence of OGI to vitrectomy. Of the 21 studies evaluated, 11 investigated the effectiveness of OTS. Four studies concluded that OTS was effective overall, while six studies suggested that it was only useful in certain OGI categories. Thus, there is a need for further research to develop an optimized ocular trauma prognosticating system.
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Affiliation(s)
- Sze Ing Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Annette K Hoskin
- Save Sight Institute, The University of Sydney, Australia
- Lions Eye Institute, The University of Western Australia, Australia
| | - Anadi Khatri
- Department of Ophthalmology, Birat Aankha Aspatal, Biratnagar, Nepal
- Department of Opthalmology, Byers Eye Institute at Stanford, Stanford University, Palo Alto, USA
| | - Vivek P Dave
- Department of Ocular Immunology, Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sushank Bhalerao
- Shantilal Shanghvi Cornea Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Jose Romero
- Department of Ocular Trauma, Unidad Nacional de Oftalmologia de Guatemala, Guatemala, USA
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Singapore Eye Research Institute, Singapore
- Duke‐NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Ashenef B, Diress M, Yeshaw Y, Dagnew B, Gela YY, Akalu Y, Abdurahman A, Abebaw K. Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia. Clin Ophthalmol 2023; 17:3149-3161. [PMID: 37881781 PMCID: PMC10597370 DOI: 10.2147/opth.s408171] [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: 03/08/2023] [Accepted: 08/04/2023] [Indexed: 10/27/2023] Open
Abstract
Background Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021. Methods An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment. Results The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment. Conclusion Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.
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Affiliation(s)
- Baye Ashenef
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Abdulhenan Abdurahman
- Department of Human Physiology, School of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Kassa Abebaw
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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10
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Li C, Fu Y, Liu S, Yu H, Yang X, Zhang M, Liu L. The global incidence and disability of eye injury: an analysis from the Global Burden of Disease Study 2019. EClinicalMedicine 2023; 62:102134. [PMID: 37599904 PMCID: PMC10432781 DOI: 10.1016/j.eclinm.2023.102134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Background The aim of the present study was to estimate the incidence, years lived with disability (YLDs), and cause of eye injury at global, regional, and national levels by age and sex based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods This is a retrospective demographic analysis based on aggregated data. GBD 2019 included the burden of eye injury worldwide and its temporal and spatial characteristics in the past three decades. The Bayesian meta-regression tool and DisMod-MR 2.1 were used to analyse the estimates based on a linear regression mode of the age-standardised rates (ASR). Average annual percent change (AAPC) was calculated to represent the temporal trends of the ASR. Findings Globally, there were 59,933.29 thousand (95% uncertainty interval [UI]: 45,772.34-77,084.03) incident cases and 438.4 thousand (95% UI: 132.44-898.38) YLDs of eye injury in 2019. Both the ASR of incidence and YLDs decreased from 1990 to 2019, with AAPC -0.46 (95% confidence interval [CI]: -0.52 to -0.39) and -0.45 (95% CI: -0.52 to -0.39), respectively. Males had higher rates of incidence and YLDs in all age groups. Young and middle-aged adults had higher disease burdens. Regionally, Australasia had the highest ASR of YLDs to be 9.51 (95% UI: 3.00-19.58) per 100,000. Nationally, New Zealand had the highest burden of eye injury to be 11.33 (95% UI: 3.57-23.10) per 100,000. Foreign bodies, exposure to mechanical forces, and falls were the main causes of global eye injury burden in 2019, and there was an increased worldwide burden due to road injuries and executions and police conflict compared with 1990. Interpretation Our findings suggest that the incidence and burden of eye injury have decreased over the last 30 years, while the absolute number of eye injuries has substantially increased, representing a major public health concern. Males and young adults were affected to a greater degree than females and elder individuals. More attention should be paid to road injuries and executions and police conflict in order to prevent eye injury. Funding Guangdong Provincial People's Hospital (GDPH) Supporting Fund for Talent Program (KY0120220263).
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Affiliation(s)
- Cong Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
- School of Medicine South China University of Technology, Guangzhou, Guangdong, 510006, China
| | - Yongyan Fu
- Department of Ophthalmology, The People's Hospital of Liaoning Province, 33 Wenyi Road, Shenhe District, Shenyang, 110016, China
| | - Shunming Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, Guangdong, 510080, China
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Macular Disease Research Laboratory, Department of Ophthalmology, Sichuan University, West China Hospital, Chengdu, Sichuan, 610041, China
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
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11
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Arora A, Priyadarshini SR, Das S, Mohanty A, Shanbhag SS, Sahu SK. Carbide Gun-Related Ocular Injuries: A Case Series. Cornea 2023; 42:726-730. [PMID: 35867658 DOI: 10.1097/ico.0000000000003095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to report a case series of sight-threatening ocular injuries caused by calcium carbide guns used as fire crackers. METHODS Medical records of 15 eyes of 14 patients with ocular injuries caused while using carbide guns, visiting the Institute, from January 2021 to January 2022, were retrospectively reviewed. The collected data included patients' demography (age, sex), presenting ophthalmic features, management, and outcome. Grade I and II ocular injuries were managed medically. All grade III-V injuries were managed using Amniotic Membrane Transplantation. RESULTS All patients were male. The mean age of the patients was 23.57 ± 11.76 years. According to the Dua classification, 5 eyes (33.3%) had Grade I-II ocular surface burns, 3 eyes (20%) had grade III burns, and 7 eyes (46.6%) had grade IV-VI burns. Presenting visual acuity ranged between hand movements to 20/50, and in 6 eyes (40%), the visual acuity was ≤20/200. Five eyes were managed medically alone, and 10 (66.6%) eyes needed surgical intervention (Amniotic Membrane Transplantation). After a mean follow-up of 14.23 ± 11.92 weeks, complete epithelization was seen in 10 eyes (66.6%). Partial limbal stem cell deficiency and its sequelae such as conjunctivalization of the cornea were noted in 7 eyes (46.6%). CONCLUSIONS Calcium carbide-related ocular injuries can result in corneal blindness secondary to limbal stem cell deficiency in young individuals. Loss of vision in this age group can lead to loss of economic productivity and cosmetic disfigurement. More advocacy efforts are thus needed to prevent these injuries.
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Affiliation(s)
- Anchal Arora
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Smruti Rekha Priyadarshini
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Sujata Das
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Amrita Mohanty
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Swapna S Shanbhag
- Cornea and Anterior Segment Services, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad.Funded by the Hyderabad Eye Research Foundation
| | - Srikant Kumar Sahu
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
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12
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Pham AT, Whitescarver TD, Beatson B, Purt B, Yonekawa Y, Shah AS, Colyer MH, Woreta FA, Justin GA. Ophthalmic trauma: the top 100 cited articles in Ophthalmology journals. Eye (Lond) 2022; 36:2328-2333. [PMID: 34975150 PMCID: PMC9674607 DOI: 10.1038/s41433-021-01871-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/26/2021] [Accepted: 11/19/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To analyze the top 100 cited papers on ophthalmic trauma. METHODS A literature search of Ophthalmology journals within the ISI Web of Science database for the most cited papers related to ophthalmic trauma. RESULTS The most cited articles were published between 1943 and 2013, the greatest number being published in 2000. Ophthalmology (45), Archives of Ophthalmology (17), and the American Journal of Ophthalmology (15) published most of the articles. The institutions with the highest number of publications were Wilmer Eye Institute (10) and Massachusetts Eye and Ear Infirmary (7). Sixty-seven percent of the articles originated from the USA. The most common type of trauma studied was non-open-globe injuries and the most frequent topic studied were pathological conditions secondary to trauma (34), particularly endophthalmitis (8), and optic neuropathy (6). Articles presenting a standardized classification system for eye injury received the highest average of citations per publication. Types of research most frequently cited were observational clinical studies (62) and epidemiological studies (30); the least frequent were clinical trials (2). CONCLUSION This bibliographic study provides a historical perspective of the literature and identifies trends within the most highly influential papers on ophthalmic trauma. Many of these articles emerged within the past three decades and came from Ophthalmology journals that remain high impact to this day. Clinical trials have been difficult to conduct and are lacking, reflecting a critical need in ophthalmic trauma research, as most of our understanding of ophthalmic trauma comes from observational and epidemiological studies.
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Affiliation(s)
- Alex T Pham
- Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA.
| | - Todd D Whitescarver
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
| | - Bradley Beatson
- Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Boonkit Purt
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Yoshihiro Yonekawa
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Ankoor S Shah
- Departments of Ophthalmology, Boston Children's Hospital, Massachusetts Eye & Ear and Harvard Medical School, 300 Longwood Ave, Fegan 4, Boston, MA, 02115, USA
| | - Marcus H Colyer
- Department of Ophthalmology, Madigan Army Medical Center, Tacoma, WA, 98431, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Fasika A Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
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13
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Stürmer J. [Ophthalmologic Emergencies in the General Practice]. PRAXIS 2022; 111:687-698. [PMID: 36102023 DOI: 10.1024/1661-8157/a003900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Ophthalmologic Emergencies in the General Practice Abstract. Even though ophthalmological care is now very well developed even in rural areas, many patients with an eye problem still consult their family doctor or general internist as a first step. The general internist must then decide on an ad-hoc basis if that he or she can manage the problem with a simple treatment available to him or her (tear substitutes, topical antibiotics or a combination of steroids and antibiotics) or if a referral to the nearest ophthalmologist is necessary.
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Affiliation(s)
- Jörg Stürmer
- Augenklinik, Kantonsspital Winterthur, Winterthur, Schweiz
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14
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Abousy M, Schilling A, Qiu M, Justin GA, Rajaii F, Li X, Woreta FA. Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis. Clin Ophthalmol 2022; 16:1365-1373. [PMID: 35529954 PMCID: PMC9075008 DOI: 10.2147/opth.s359384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. Methods We analyzed Accreditation Council for Graduate Medical Education (ACGME) case log data and de-identified case logs from US ophthalmology residency programs for residents graduating in 2018. Current Procedural Terminology (CPT) codes documented as “Globe Trauma” and trauma-related “Oculoplastic and Orbit” codes including lid lacerations and lateral canthotomies were analyzed. Results 38 residency programs provided case logs (response rate: 32.2%). Residents performed an average of 7.24±4.37 open globe repairs, 8.66±6.94 lid laceration repairs, 0.49±1.4 orbital fracture repairs, 1.22±1.81 lateral canthotomies, and 0.28±0.69 anterior chamber washouts as primary surgeon. On average, the most logged “Globe Trauma” procedure was open globe repair as primary surgeon. The more common trauma-related “Oculoplastic and Orbit” procedure was lid laceration repair as primary surgeon. 42.8% of residents did not log any lateral canthotomy procedures. Medium programs performed significantly more canthotomies than large programs (F(2166) = 6.35, p = 0.002), and large programs performed significantly more orbital fracture repairs than small and medium programs (F(2166) = 4.45, p = 0.013). Conclusion Significant variation in globe trauma volume exists across programs. ACGME guidelines require a minimum of four globe trauma procedures for graduation, but procedures like anterior chamber paracentesis count towards this requirement. Open globe repairs, simple lid lacerations, and lateral canthotomies are basic skills every graduating resident should be competent in. Updating ACGME case log requirements for ophthalmic trauma and increasing opportunities for wet lab simulations may assist in ensuring graduating ophthalmology residents’ competency in performing these procedures.
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Affiliation(s)
- Mya Abousy
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andy Schilling
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary Qiu
- Department of Ophthalmology, University of Chicago Medicine, Chicago, IL, USA
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Fatemeh Rajaii
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ximin Li
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Correspondence: Fasika A Woreta, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA, Email
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15
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Jac-Okereke CC, Jac-Okereke CA, Ezegwui IR, Umeh RE. Current pattern of ocular trauma as seen in tertiary institutions in south-eastern Nigeria. BMC Ophthalmol 2021; 21:420. [PMID: 34865621 PMCID: PMC8645126 DOI: 10.1186/s12886-021-02162-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background Ocular trauma is a leading cause of monocular blindness worldwide and in developing countries, are not only more common but also more severe. Industrialization and urbanization may alter or modify prevalent aetiological factors and the presentation of ocular trauma. Objective To determine the current pattern of eye injuries in Teaching Hospitals in Enugu State. Methods This prospective cross-sectional descriptive study was carried out at the eye clinics and emergency units of two tertiary institutions in Enugu, Nigeria. Consecutive ocular trauma patients were enrolled over a 5-month period. On presentation, they underwent ocular examination including visual acuity (which was categorized according to the WHO classification of visual impairment and blindness}, anterior and posterior segment examinations. Injuries were grouped using the Birmingham Eye Trauma Terminology system. Results Within the study period, 2545 new patients presented to the hospitals where the study was conducted. A total of 89 patients presented with ocular trauma, giving an incidence of 3.5%. The male to female ratio was 1.3:1 and patients aged 10 to 19 years formed the majority (24%). Domestic accidents (22%) were the most common cause of ocular injuries while blunt objects (57%) were the most common agents. Closed globe injuries constituted 76% of all injuries. Forty-three per cent of patients presented within 24 h of injury. Conclusion Ocular trauma is still prevalent in South-eastern Nigeria and there has indeed been a change in the pattern as well as the incidence. Assault and road traffic accidents have emerged as important causes of eye injuries. In addition, there has been an improvement in the health-seeking behaviour of people living in Enugu and this may reflect positively on the uptake of recommended preventive strategies.
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Affiliation(s)
| | | | | | - Rich Enujioke Umeh
- University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria
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16
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Khatatbeh AE, Othman E, Alalawneh AM, Khraisat HA, Alawneh S, Ahmed M, Abbas K. Changes of Patterns and Outcomes of Ocular and Facial Trauma Among Children in Jordan. Cureus 2021; 13:e16833. [PMID: 34513423 PMCID: PMC8409692 DOI: 10.7759/cureus.16833] [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] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The eye is the second most common organ affected by trauma after hands and feet. Eye trauma is a common cause of visual morbidity and may result in irreversible visual impairment and blindness. Ocular and facial trauma contribute to significant proportions of visual deficits among young children. This study aimed to explore the changes in trend including the pattern and outcomes of ocular and facial trauma among children between the last twenty years. Methodology A retrospective study was conducted between January 2020 and April 2021. The medical records of the patients who attended the Royal Medical Services (RMS) military hospital between January 1999 and December 2019 suffering from eye trauma which required hospitalization were enrolled in the study and reviewed regarding age, gender, mechanism of trauma, the severity of the trauma, eye structures involved, and visual outcome. The patients were divided into three groups based on the time of trauma: Group A for injuries in the period (January 1, 1999 to December 31, 2005), Group B for the period (January 1, 2006 to December 31, 2012), and Group C for the period (January 1, 2013 to December 31, 2019). The collected data was analyzed and compared to explore whether there is any change in the pattern and visual morbidity of eye injuries over time. The most frequent finding of eye injury was corneal wound in Groups A and B patients, while in Group C the most common ocular injury was ecchymosis or sub-conjunctival hemorrhage. Results Three-thousand one-hundred and thirty only patients (3130 eyes) aged between 2 and 14 years (mean 7.11 ± 3.13) were included in the study. The male to female ratio was 2:1. 1864 patients (56.6%) were at five years of age or younger. The most common place of injury in the three groups was on the street. This ratio decreased from 64.0% in Group A to 48.8% in Group C. Stone was the commonest etiology of injury in Group A (38.0%) while wood and fall were the commonest in Group B (28.5%) and Group C (37.1%) respectively. Open globe injuries constituted 67.0% of patients in Group A, 64.7% of patients in Group B, and 51.2% of patients in Group C. Normal or mild visual impairment was noted in patients of Group C (43.9%) as compared to the patients in Groups A (7.5%) and B (8.3%) at presentation. The final vision of normal or mild visual impairment was reported in 37.1%, 38.5%, and 77.5% of patients in Groups A, B, and C respectively. Conclusion The current study is a retrospective analysis of twenty years in Jordan and has comprehensively explored the trends and patient outcomes with respect to ocular and facial trauma among children. We revealed that over time, such injuries became less frequent and less serious than before with better patient outcomes. Furthermore, higher rates of closed globe injuries were reported in recent years. There was a dramatic increase in the rate of indoor injuries compared with outdoor ones which were mostly caused by falls with better initial and final visual outcomes. These injuries are preventable with the implementation of adequate safety measures which would significantly reduce the burden of visual impairment and cosmetic disfigurement among youngsters.
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Affiliation(s)
| | - Enas Othman
- Dentistry, King Hussein Medical Center, Amman, JOR
| | - Ali M Alalawneh
- Medicine, Queen Rania Al Abdullah Hospital for Children, Amman, JOR
| | - Hiba A Khraisat
- Ophthalmology, Queen Rania Al Abdullah Hospital for Children, Amman, JOR
| | - Samer Alawneh
- Ophthalmology, King Hussein Medical Center, Amman, JOR
| | - Moiz Ahmed
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.,Medicine and Surgery, Sindh Medical College, Karachi, PAK
| | - Kiran Abbas
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
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17
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Bober NK, Kumaran N, Williamson TH. Outcomes Following Pars Plana Vitrectomy for Severe Ocular Trauma. J Ophthalmic Vis Res 2021; 16:408-414. [PMID: 34394870 PMCID: PMC8358761 DOI: 10.18502/jovr.v16i3.9449] [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: 05/05/2020] [Accepted: 03/29/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate outcomes and presenting characteristics for subjects undergoing pars plana vitrectomy for ocular trauma. Methods Retrospective study of 113 patients who underwent pars plana vitrectomy for severe ocular trauma at [name deleted to maintain the integrity of the review process] between 1999 and 2018. Data were collected on age, gender, initial and final visual acuity (LogMAR), mode of injury, type of injury, number of surgeries performed, follow-up duration, type of tamponade, presence of phthisis, and retinal detachment. The Birmingham Eye Trauma Terminology System (BETTS) was employed. Results We identified assault and contusion injuries to be the most common mode and type of ocular injury in our cohort. Furthermore, through follow-up we noted a varied number of operations required by patients presenting with ocular trauma and a statistically significant improvement in visual acuity from 1.73 ( ± 0.86) LogMAR to 1.17 ( ± 1.03; p < 0.01) LogMAR. A statistically significant difference in final visual acuity was also noted between BETTS classified type of injury groups (p < 0.01). Notably, only 7.3% and 8.2% of patients developed phthisis or a persisting retinal detachment, respectively, during follow-up. Conclusion Our study demonstrates that ocular trauma requiring pars plana vitrectomy can require a varied number of operations with a guarded visual prognosis. However, a small percentage will proceed to develop phthisis following intervention.
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Affiliation(s)
- Natalia K Bober
- St Thomas' Hospital, London, UK.,King's College Medical School, London, UK
| | | | - Tom H Williamson
- St Thomas' Hospital, London, UK.,King's College Medical School, London, UK
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18
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Bhatt V, Bhatt D, Barot R, Sheth J. Ultrasound Biomicroscopy for Zonular Evaluation in Eyes with Ocular Trauma. Clin Ophthalmol 2021; 15:3285-3291. [PMID: 34393478 PMCID: PMC8357616 DOI: 10.2147/opth.s323349] [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: 06/10/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the role of ultrasound biomicroscopy (UBM) in detecting zonular abnormalities in eyes with ocular trauma. Patients and Methods Prospective study of 143 eyes of 143 patients with ocular trauma and having opaque media was evaluated using a UBM. The presence or absence of zonular damage (zonular tears and/or zonular stretching) was examined and the clock-hour involvement was noted. Results One-hundred and one eyes had blunt trauma (70.63%; group 1), while 42 eyes had penetrating trauma (29.37%; group 2) The mean age of the patient population was 48.01±17.93 years with a male:female ratio of 2.11:1. Group 1 had significantly greater visual acuity than group 2 (p = 0.03). Zonular damage was present in 79 (55.2%) eyes, including zonular tears (48 eyes; 33.6%) and zonular stretching (31 eyes; 21.7%). Zonular damage was seen significantly more in eyes with blunt trauma (64.28%) as compared to penetrating trauma (25.74%) (p = 0.015). On quantitative analysis, zonular damage between 3 and 6 clock hours was most frequent, both in eyes having zonular tears (70.83%) and zonular stretching (96.77%). Additionally, 3–6 clock hours of zonular stretching was seen significantly more in blunt trauma as compared to penetrating trauma (p = 0.015). Conclusion UBM is an effective imaging modality to diagnose zonular abnormalities in patients with ocular trauma having opaque media. The ability to detect the presence of zonular weakness and their quantification by performing a UBM is critical to formulate the optimal surgical approach and avoid any untoward surgical complications.
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Affiliation(s)
- Vaidehi Bhatt
- Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Memorial Hospital, Thane, Maharashtra, India
| | - Deepak Bhatt
- Department of Imaging, UBM Institute, Mumbai, Maharashtra, India
| | - Rakesh Barot
- Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Memorial Hospital, Thane, Maharashtra, India
| | - Jay Sheth
- Department of Vitreoretinal, Surya Eye Institute and Research Center, Mumbai, Maharashtra, India
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Ayalon A, Fanadka F, Levov D, Saabni R, Moisseiev E. Detection of Intraorbital Foreign Bodies Using Magnetic Resonance Imaging and Computed Tomography. Curr Eye Res 2021; 46:1917-1922. [PMID: 34325598 DOI: 10.1080/02713683.2021.1945108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE We analyze the detectability of intraorbital foreign bodies (OrbFBs) of various types and sizes using computed tomography (CT) and magnetic resonance imaging using a three-Tesla machine (MRI 3 T). METHODS An ex vivo model of sheep eyes with preserved extraocular muscles and orbital fat tissue placed in the orbital cavity of the human skull was created for this study. Foreign bodies made of four different materials - plastic, bottle glass, stone and wood - each in three different sizes (large, intermediate and small) were inserted into the soft tissue of the orbit in the extraocular space. Each orbit was scanned by CT and MRI. Images were analyzed by a senior radiologist and underwent masked review by three oculoplastic surgeons. RESULTS Analysis of MRI and CT scans identified distinguishing characteristics for each of the four materials. This information was further integrated into a clinical algorithm. CT allowed easier identification of most of the embedded materials compared to MRI. Smaller OrbFB size was associated with lower detectability. Review of CT yielded 94.4% agreement between oculoplastic specialists in detecting OrbFbs using CT scans and allowed detection of most OrbFBs. In contrast, the overall agreement with MRI was lower: 66.7% with T1 MPRAGE, 50% with T1TSE, 88.9% with T2 TSE and 72.2% with T2 TSE FS. Plastic was the most difficult material to detect in all size categories. CONCLUSIONS CT offers a clear advantage over MRI for detecting and localizing nonmetallic OrbFBs of all sizes, except for plastic. Plastic OrbFBs can be detected with CT depending on size but are more visible in MRI scans.
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Affiliation(s)
- Anfisa Ayalon
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Feda Fanadka
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dimitry Levov
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ramei Saabni
- Department of Animal Health and Epidemiology, Veterinary Service and Animal Health, Rishon Le-Zion, Israel
| | - Elad Moisseiev
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Kedwany SM, Saleh MGA, Tohamy D, Mostafa MM. Outcome of Pediatric Traumatic Cataract in Upper Egypt: A Tertiary Center Study. Clin Ophthalmol 2021; 15:1583-1589. [PMID: 33888974 PMCID: PMC8057834 DOI: 10.2147/opth.s282080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To demonstrate the demographic features, causative agents, and outcome of pediatric traumatic cataract surgery in eyes without posterior segment involvement at Assiut University Hospital, Upper Egypt. Patients and Methods This is a retrospective study on children (aged <18 years old) who underwent traumatic cataract surgery from January to June 2019. Children with posterior segment injury and those who did not complete 6 months of postoperative follow-up were excluded. The demographic features, mechanism and time of eye injury, clinical features, surgical approach, and outcome were recorded and analyzed. Results The study included 34 eyes of 34 children, 23 (68%) of them were boys. The mean age at the time of cataract surgery was 10±3.97 years. Twenty-one eyes sustained open globe injury (62%) with the most common cause of trauma was wooden sticks, while 13 eyes had closed globe injury (38%) with the most common cause of injury was thrown stones. The time interval between eye injury and cataract surgery ranged from 1 day to 9 years with a median of 2.05 months. Posterior chamber intraocular lenses were implanted in all eyes; in 33 eyes, the posterior chamber intraocular lenses were implanted primarily at the time of cataract extraction. Corrected distance visual acuity significantly improved from 2.63±0.66 LogMAR preoperatively, to 0.41±0.38 LogMAR postoperatively (p < 0.001). Conclusion Pediatric traumatic cataract is commonly present in primary school age especially after open globe injury. Primary prevention through health awareness should target this age population. Useful vision can be regained with timely proper surgical intervention and posterior chamber intraocular lens implantation. Clinicaltrials.gov Id NCT04630509.
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Affiliation(s)
- Salma M Kedwany
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed G A Saleh
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dalia Tohamy
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Magdi M Mostafa
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
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21
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Naguib S, Bernardo-Colón A, Cencer C, Gandra N, Rex TS. Galantamine protects against synaptic, axonal, and vision deficits in experimental neurotrauma. Neurobiol Dis 2020; 134:104695. [PMID: 31778813 PMCID: PMC7769189 DOI: 10.1016/j.nbd.2019.104695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/22/2019] [Accepted: 11/24/2019] [Indexed: 01/03/2023] Open
Abstract
Our goal was to investigate the neuroprotective effects of galantamine in a mouse model of blast-induced indirect traumatic optic neuropathy (bITON). Galantamine is an FDA-approved acetylcholinesterase inhibitor used to treat mild-moderate Alzheimer's disease. We exposed one eye of an anesthetized mouse to repeat bursts of over-pressurized air to induce traumatic optic neuropathy. Mice were given regular or galantamine-containing water (120 mg/L) ad libitum, beginning immediately after blast and continuing for one month. Electroretinograms and visual evoked potentials were performed just prior to endpoint collection. Histological and biochemical assessments were performed to assess activation of sterile inflammation, axon degeneration, and synaptic changes. Galantamine treatment mitigated visual function deficits induced by our bITON model via preservation of the b-wave of the electroretinogram and the N1 of the visual evoked potential. We also observed a reduction in axon degeneration in the optic nerve as well as decreased rod bipolar cell dendritic retraction. Galantamine also showed anti-inflammatory and antioxidant effects. Galantamine may be a promising treatment for blast-induced indirect traumatic optic neuropathy as well as other optic neuropathies.
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Affiliation(s)
- Sarah Naguib
- Department of Ophthalmology and Visual Sciences, 11435 MRB IV, 2213 Garland Ave, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
| | - Alexandra Bernardo-Colón
- Vanderbilt Eye Institute, 2311 Pierce Ave, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Caroline Cencer
- Department of Ophthalmology and Visual Sciences, 11435 MRB IV, 2213 Garland Ave, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
| | - Neha Gandra
- Department of Ophthalmology and Visual Sciences, 11435 MRB IV, 2213 Garland Ave, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
| | - Tonia S Rex
- Department of Ophthalmology and Visual Sciences, 11435 MRB IV, 2213 Garland Ave, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Vanderbilt Eye Institute, 2311 Pierce Ave, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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22
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Le-Bel G, Guérin LP, Carrier P, Mouriaux F, Germain L, Guérin SL, Bazin R. Grafting of an autologous tissue-engineered human corneal epithelium to a patient with limbal stem cell deficiency (LSCD). Am J Ophthalmol Case Rep 2019; 15:100532. [PMID: 31440691 PMCID: PMC6699139 DOI: 10.1016/j.ajoc.2019.100532] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose In this study, we evaluated the feasibility of recovering the corneal surface integrity in a patient suffering from unilateral LSCD through the transplantation of cultured autologous corneal epithelial cells. Methods Human corneal epithelial cells (HCECs) were isolated from a limbal biopsy of the contralateral eye of a patient with unilateral LSCD and cultured in monolayer in the presence of an irradiated human fibroblasts feeder layer (iHFL). To produce a cultured autologous corneal epithelium (CACE), HCECs were seeded on a fibrin substrate and maintained in culture until confluence. The in vitro obtained CACE was then used to treat the affected eye of the patient. Two years later, a successful penetrating keratoplasty was performed. Results Efficient restoration of the corneal epithelium was achieved following transplantation of CACE indicating probable re-colonization of the cornea by stem cells. Corneal transparency was restored after removing the scarred stroma by performing a penetrating keratoplasty. Conclusion CACE produced in vitro was shown to restore a normal corneal surface capable of sustaining a viable and clear penetrating keratoplasty and reestablished a near normal vision in a unilateral LSCD patient.
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Affiliation(s)
- Gaëtan Le-Bel
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada.,Département de Chirurgie, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Louis-Philippe Guérin
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Patrick Carrier
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département de Chirurgie, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Frédéric Mouriaux
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada.,CNRS, UMR 6301 ISTCT, CERVOxy, GIP CYCERON, F-14074, Caen, France.,CHU de Rennes, Service d'Ophtalmologie, F-35033, Cedex 9, France
| | - Lucie Germain
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada.,Département de Chirurgie, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Sylvain L Guérin
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Richard Bazin
- CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.,Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.,Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada
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23
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Court JH, Lu LM, Wang N, McGhee CNJ. Visual and ocular morbidity in severe open-globe injuries presenting to a regional eye centre in New Zealand. Clin Exp Ophthalmol 2018; 47:469-477. [PMID: 30414237 DOI: 10.1111/ceo.13439] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/02/2018] [Accepted: 11/03/2018] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Open-globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society. BACKGROUND To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand. DESIGN Retrospective study. PARTICIPANTS A total of 385 eyes of 381 patients over a 10-year period. METHODS Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes. MAIN OUTCOME MEASURES Complications of injury, visual acuity at 3 months and final follow-up, and final status of the eye. RESULTS The estimated annual incidence of OGI was 2.8 per 100 000. Working-age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over-represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001). CONCLUSIONS AND RELEVANCE The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at-risk groups to target with education and prevention strategies.
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Affiliation(s)
- Jennifer H Court
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Lucy M Lu
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Nancy Wang
- Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
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Abstract
Woundhealing disorders characterized by impaired or delayed re-epithelialization are a serious medical problem that is painful and difficult to treat. Gelsolin (GSN), a known actin modulator, supports epithelial cell regeneration and apoptosis. The aim of this study was to estimate the potential of recombinant gelsolin (rhu-pGSN) for ocular surface regeneration to establish a novel therapy for delayed or complicated wound healing. We analyzed the influence of gelsolin on cell proliferation and wound healing in vitro, in vivo/ex vivo and by gene knockdown. Gelsolin is expressed in all tested tissues of the ocular system as shown by molecular analysis. The concentration of GSN is significantly increased in tear fluid samples of patients with dry eye disease. rhu-pGSN induces cell proliferation and faster wound healing in vitro as well as in vivo/ex vivo. TGF-β dependent transcription of SMA is significantly decreased after GSN gene knockdown. Gelsolin is an inherent protein of the ocular system and is secreted into the tear fluid. Our results show a positive effect on corneal cell proliferation and wound healing. Furthermore, GSN regulates the synthesis of SMA in myofibroblasts, which establishes GSN as a key protein of TGF-β dependent cell differentiation.
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25
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Wang W, Zhou Y, Zeng J, Shi M, Chen B. Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China. Acta Ophthalmol 2017; 95:e503-e510. [PMID: 28371405 DOI: 10.1111/aos.13438] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 02/13/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China. METHODS A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system. RESULTS Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p < 0.001). In patients under 18 years, the most frequently occurring injury was open globe (84.5%, n = 349) with corneal penetration (59.3%, n = 245). Overall, an operation was performed in 1865 (92.8%) cases, and 144 cases (7.2%) were treated conservatively with medication. The average OTS score was 47.1 ± 19.5. The visual prognosis was closely correlated with the initial VA (r = 0.570, p = 0.000) and the OTS score (r = 0.603, p = 0.000). CONCLUSION This study describes the epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China. Notably, a high rate of firework-related ocular trauma occurred during the months adjacent to the Chinese New Year festival. Specific injury prevention strategies, such as the use of protective eyewear, need to target the workplace to reduce the incidence and severity of ocular trauma.
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Affiliation(s)
- Wanpeng Wang
- Department of Ophthalmology; The Second Xiangya Hospital of Central South University; Changsha Hunan, China
| | - Yalan Zhou
- Department of Ophthalmology; The Second Xiangya Hospital of Central South University; Changsha Hunan, China
| | - Jun Zeng
- Department of Ophthalmology; The Second Xiangya Hospital of Central South University; Changsha Hunan, China
| | - Meng Shi
- Department of Ophthalmology; The Second Xiangya Hospital of Central South University; Changsha Hunan, China
| | - Baihua Chen
- Department of Ophthalmology; The Second Xiangya Hospital of Central South University; Changsha Hunan, China
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26
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Abu EK, Boadi-Kusi SB, Opuni PQ, Kyei S, Owusu-Ansah A, Darko-Takyi C. Ocular Health and Safety Assessment among Mechanics of the Cape Coast Metropolis, Ghana. J Ophthalmic Vis Res 2016; 11:78-83. [PMID: 27195090 PMCID: PMC4860992 DOI: 10.4103/2008-322x.158890] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To conduct an ocular health and safety assessment among mechanics in the Cape Coast Metropolis, Ghana. Methods: This descriptive cross sectional study included 500 mechanics using multistage sampling. All participants filled a structured questionnaire on demographic data, occupational history and ocular health history. Study participants underwent determination of visual acuity (VA) using LogMAR chart, external eye examination with a handheld slit lamp biomicroscope, dilated fundus examination, applanation tonometry and refraction. Results: Out of 500 mechanics, 433 were examined (response rate, 87%) comprised of 408 (94.2%) male and 25 (5.8%) female subjects. The prevalence of visual impairment (i.e. presenting VA < 6/18) among the respondents was 2.1%. Eye injuries were reported in 171 (39.5%) mechanics probably due to the large number of workers, 314 (72.5%), who did not use eye protective devices. Mechanics in the auto welding category were at the highest risk of sustaining an eye injury (odds ratio [OR], 13.4; P < 0.001). Anterior segment ocular disorders were mostly pterygia while posterior segment eye disorders included glaucoma suspects and retinochoroidal lesions. The development of pterygia was associated with the number of years a mechanic stayed on the job. Eye care seeking behavior among the participants was poor. Conclusion: Eye injuries were prevalent among the mechanics as the use of eye protection was low. Eye safety should be made an integral part of the public health agenda in the Cape Coast Metropolis.
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Affiliation(s)
- Emmanuel Kwasi Abu
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Bert Boadi-Kusi
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Ghana; Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Prince Quarcoo Opuni
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Kyei
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Andrew Owusu-Ansah
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Charles Darko-Takyi
- Department of Optometry, School of Physical Sciences, University of Cape Coast, Cape Coast, Ghana; Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
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