Open Journal of Ophthalmology

Journal Information
ISSN / EISSN : 21657408 / 21657416
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 257
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SHERPA/ROMEO
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Shoshi Flaka, Hoxha-Shoshi Mire, Shoshi Fitore, Shoshi Fjolla, Shoshi Avdyl
Open Journal of Ophthalmology, Volume 10, pp 33-43; doi:10.4236/ojoph.2020.101005

Abstract:
Introduction: Myopia is the refractive anomaly of the eye in which the conjugate focus of the retina is at some finite point in front of the eye, when the eye is not accommodating. Myopia is else known as short-sightedness and is considered as one of the most frequent causes of reduced vision especially in adolescents. Adolescence is one of the life periods when most cases are diagnosed with myopia. Purpose: The aim of this study was to identify myopia in pre-school and school children (3 - 9 years old in Prishtina), to determine the prevalence of myopia among other refractive anomalies in cases included in the study; compare the prevalence of myopia in this population in Prishtina to other countries in the world; determine the effect of hereditary and socio-economic factors on the prevalence of myopia; and determine the degrees of myopia in our cases included in our study. Materials and Methods: This was a cross-sectional study involving 1027 pre-school children and pupils from 4 schools in Prishtina, aged 3 - 9 years old, who were screened for refractive anomalies, with a special focus on the incidence of myopia in this age group. The data were collected by screening children in the institutions of pre-school and primary school education, including 2 primary schools and two kindergarten during a two-year period 2010-2012 in Prishtina. Results: On the screening of pre-school and school children for refractive anomalies, were included 1027 subjects of ages 3 - 9 years old. Of the 1027 children screened 536 (52.2%) were male and 491 (47.8%) were female. Statistically, the prevalence of refractive anomalies in the total population studied is significant based on the resulting value (P < 0.0001). In general, the prevalence of refractive anomalies in this study results in 164/103 with an interval of 141/103 in 186/103 for 95% CI. Based on the age, out of 168 patients identified with refractive anomalies, the prevalence of refractive anomalies was 9.9% in the patients of age 3 and 21.4% on the patients of age 7. The prevalence of myopia as a specific refractive anomaly was present in 33 cases 3.4%. Other patients were diagnosed with hypermetropia 37 cases (3.8%) and with astigmatism 44 cases (4.5%). Out of 33 cases with myopia, 20 cases or 60% were diagnosed with a slight degree myopia (myopia of first degree or -1.0 to -3.0 DS). 13 cases were diagnosed with intermediate degree myopia (-3 to -6 DS). There were no cases with severe myopia identified in this study. Conclusions: The Prishtina study is a report of prevalence of myopia among pre-school and school-age children in the municipality. The study reveals that refractive error and myopia were significantly common finding among the study group, and the prevalence was found to be even higher in children within the school age-group. The number of newly diagnosed myopia was significant, suggesting the need for a robust school eye health programme, regular assessment of school children for...
Wei Zhao, Tao Wang, Jiezheng Yang, Shiyi Yin, Ting Wang, Lei Zhong, Lili Chen, Shiqi Ling
Open Journal of Ophthalmology, Volume 10, pp 142-153; doi:10.4236/ojoph.2020.102016

Abstract:
Purpose: Increased conjunctival arteries and lymphangions accelerate the cellular immune response in recurrent pterygium, however, which plays a more important role warrants further investigation. The aim of the study is to compare the roles of lymphatic and blood vessels in pterygium recurrence. Methods: Histological sections from 48 excised recurrent pterygia (including 14 Grade 1, 20 Grade 2, and 14 Grade 3 tissues) were examined. Histological sections from seven nasal epibulbar conjunctival segments served as normal controls. Blood and lymphatic vessels were evaluated and compared according to blood microvessel density (BMD), blood vascular area (BVA), lymphatic microvessel density (LMD), and lymph-vascular area (LVA). Furthermore, the following relationships were analyzed: LMD and pterygium recurrence time (RT), LVA and RT, BMD and RT, BVA and RT. Results: Compared to LVA, LMD, BVA, and BVD values in normal control tissues, these values were markedly enhanced in recurrent pterygia tissues. The LMD/BMD and LVA/BVA ratios were significant increased in Grade 2 and 3 recurrent pterygia, suggesting that development of conjunctival lymphangions was not proportional to blood vessel growth. LMD, LVA and BVA were significantly correlated with RT for all grades of pterygia, while BMD was the only factor correlated with RT in Grade 1 pterygia. Moreover, no significant correlation was found between BMD and RT in Grade 2 and 3 pterygia. Conclusion: Compared to blood vessels, lymphangions might have a greater impact on pterygium recurrence.
Kingsley Ekemiri, Ngozika Esther Ezinne, Cilena Ramdhani, Daniel Chinonyerem Achugwo, Chioma Chinyere Ekemiri
Open Journal of Ophthalmology, Volume 10, pp 174-179; doi:10.4236/ojoph.2020.102019

Abstract:
Background: Juvenile Rheumatoid Arthritis (JRA) is an inflammatory disease that affects the joints of children and is associated with ocular complications, like uveitis and cataract. Patients with such complications can benefit from a low vision assessment to improve their functionality and their quality of life. In this case study, the importance of early detection and management of ocular complications of JRA, as well as visual rehabilitation through a low vision assessment, are highlighted and discussed. Case Presentation: A 12-year-old female of East Indian descent presented to the Low Vision Center of the University of the West Indies Optometry Eye Unit, bilaterally aphakic (absence of crystalline lens) as a result of complications she developed secondary to a systemic condition diagnosed as JRA. She presented with a distance visual acuity of 2.30 logMAR in the RE, and 1.64 logMAR in the LE, at near she was able to read 8.0 M and 3.2 M at a distance of 8 cm for RE & LE respectively. She has a history of ocular disorder secondary to JRA such as cataract, uveitis, upon low vision assessment a new spectacle prescription and an illuminated stand magnifier of 8D was issued, the patient was satisfied with the outcome of the treatment, management and low vision device issued. Conclusion: At the end of the low vision assessment, the patient was extremely satisfied and looked forward to the prospect of returning to school. Although JRA can have severe ocular complications, with the correct management, a patient’s quality of life can be dramatically improved thus stressing the importance of these types of visual assessments.
Prudence Ada Assoumou, Tatiana Mba Aki, Olele Oussavou, Emmanuel Mve Mengome
Open Journal of Ophthalmology, Volume 10, pp 69-76; doi:10.4236/ojoph.2020.101009

Abstract:
Introduction: Nystagmus is a static ocular disorder characterized by an oscillatory, involuntary and rhythmic movement of eyes. In Libreville, no data on the subject is available. The purpose of this study is to describe clinical characteristics of nystagmus in albinos living in Libreville. Methods: This is a descriptive, cross-sectional study including 43 albinos with oculocutaneous albinism and nystagmus during the period from February 01, 2017 to February 01, 2018. Variables studied were age, sex, visual acuity, objective refraction, characteristics of the nystagmus including morphology, direction, intensity and associated signs such as stiff neck and squint. Results: The mean age was 21.2 ± 17 years with a female-dominated ratio of 0.53. The visual acuity from afar without correction (AVLSC) was less than 3/10 in 88.4% of the cases. The most common ametropia was astigmatism in 51.2% of cases. Nystagmus was present in all albinos. The spring type was found in 69.7% of cases. The direction was horizontal in 67.4% of the cases and rotary in 32.6% of the cases. The intensity was moderate in 55.8% of cases. The blocking position was the primary near vision position in 69.7% of the cases. Nystagmus was associated with a stiff neck in 28% of the cases and strabismus in 48.8% of the cases. Conclusion: The albinos nystagmus living in Libreville is of the spring type, horizontal direction, of moderate intensity and calmed in the primary position in near vision.
Shoshi Flaka, Hoxha-Shoshi Mire, Shoshi Fitore, Shoshi Fjolla, Shoshi Avdyl, Flaka Shoshi, Mire Hoxha-Shoshi, Fitore Shoshi, Fjolla Shoshi, Avdyl Shoshi
Open Journal of Ophthalmology, Volume 10, pp 1-9; doi:10.4236/ojoph.2020.101001

Abstract:
Lipodermoids are abnormal epibulbar growths of the adipose tissue. A conjunctival lesion, the lipodermoid (dermolipoma) is usually located near the temporal fornix and is composed of adipose tissue and dense connective tissue. The overlying conjunctival epithelium is normal, and hair follicles are absent. Lipodermoids may be extensive, sometimes involving orbital tissue, lacrimal gland, and extraocular muscle. Surgical treatment is only indicated when the existing lipodermoid disturbs the patient either functionally or aesthetically. Purpose The main purpose of this study is to present our experience on the surgical treatment of lipodermoids in those cases when lipodermoids cause functional and aesthetic problem to the patient. Materials and Methods In our study we have included two cases of male gender, one with bilateral lipodermoid (in both eyes) while the other with a mono lateral lipodermoid (only in one eye). The treatment was surgical, where we carefully removed the lipodermoid lesion inside palpebral fissures, to fully preserve the bulbar conjunctiva and Tenon’s membrane during the removal of the conjunctival lipodermoid.Surgery was performed under local anesthesia (lidocaine 2% and adrenaline). The surgical area was set ready by using betadine 5%. Results In both cases there were neither intra-operative nor extra-operative complications and the results were positive.Also the functional and aesthetic problems were corrected. There was no recurrence encountered.Conclusions In conclusion, based on the results of this study, in the rare cases of lipodermoids where surgical treatment is necessary, it is very important to perform a careful surgical intervention, in order to prevent any intra-operative injuries of the lacrimal gland and the lateral and superior rectus muscles. In general the surgical treatment is a successful method on treating lipodermoids, in cases when they concern the patient both functionally and aesthetically.
Zhaoxia Kuang, Yong Yao, Ye Yuan, Yueting Ma, Guanglin Chen, Yingying Su, Xingkai Zhang, Vishal Jhanji, Dennis Lam, Kuang Zhaoxia, et al.
Open Journal of Ophthalmology, Volume 10, pp 21-27; doi:10.4236/ojoph.2020.101003

Abstract:
Background: Dry eye syndrome, which affects 10% to 20% of adults, is a disorder of the tear film and is associated with symptoms of ocular discomfort. Smart Plug is a mechanical treatment in which the tear drainage system is blocked in order to aid in the preservation of natural tears on the ocular surface. Purpose: To evaluate the long-term clinical efficacy of Smart Plug in the treatment of aqueous tear deficiency dry eye. Patients and Methods: Retrospective study. Three hundred and two patients with aqueous tear deficiency dry eye were enrolled and all the patients accepted the punctual plug of Smart plug from Jan. 2011 to Jan. 2016. The clinical symptoms, Schirmer’s I test, Fluorescein staining (FL), tear break up time (TBUT), and complications were observed and analyzed. Results: Three hundred and two patients (604 eyes) were treated with Smart Plug (22 cases accepted upper and lower punctual plug, 280 cases only lower punctual plug). There were 109 males (36.1%) and 193 females (63.9%) with a mean age of 44.54 years old (Range from 25 to 83 years). Ten cases required the upper Smart Plug after lower punctual plug insertion because of no significantly improved symptoms. Smart plug was removed in 3 patients (1%) due to tearing. Six patients had mild postoperative tearing and no special treatment was required. Lacrimal canaliculitis occurred postoperatively in 8 cases (2.6%) (6 lower and 2 upper), and the affected plug was removed and treated with topical antibiotic eye drops. The BUT, SIT and FL scores of all patients were significantly improved from (2.11 ± 1.01, 4.20 ± 1.07, 6.06 ± 1.97) to (4.34 ± 1.22, 9.01 ± 1.56, 2.33 ± 1.28) respectively after at least 36 months of follow-up (All P P < 0.05). Conclusion: During a mean follow-up of 4.3 years, Smart plug is an effective method for the treatment of aqueous tear deficiency dry eye in spite of its postoperative complications such as canaliculitis and tearing.
Nina Staneva Stoyanova, Marieta Konareva-Kostianeva, Vesela Mitkova-Hristova
Open Journal of Ophthalmology, Volume 10, pp 164-173; doi:10.4236/ojoph.2020.102018

Abstract:
Objective: To compare the values of exophthalmos measured by computed tomography (CT) and Hertel exophthalmometry (HE) in patients with thyroid-associated ophthalmopathy (TAO). Material and Methods: One hundred and seventy eyes were examined in 85 patients with TAO. Each patient underwent a complete ophthalmic examination, Hertel exophthalmometry, and CT of the orbits through a 16-slice CT scanner (Bright Speed, General Electric), measuring the extraocular muscles, the total muscle thickness sum (MTS), and proptosis. The patients were divided into two groups-with activity and without TAO activity, the activity being assessed by means of the Clinical Activity Score (CAS) and the severity-according to the EUGOGO classification. Results: TAO activity was detected in 45 patients (90 eyes, 53%) with MTS of 23.54 ± 5.73 mm, IOP of 19.78 ± 4.49 mm Hg, Hertel exophthalmos of 23.08 ± 4.19 mm and measured by CT-23.32 ± 4.33 mm. Forty patients (80 eyes, 47%) were without TAO activity, with MTS of 19.28 ± 4.03, IOP of 16.6 ± 4.51 mm Hg, Hertel exophthalmos of 20.03 ± 3.84 mm and measured by CT-19.84 ± 4.47 mm. A correlation was detected between exophthalmos and: MTS, IOP, the activity and severity of TАО. High congruence was established between the two methods of measuring exophthalmos-CT and HE (Pearson correlation, r = 0.690, p = 0.000). Conclusion: Our results showed a high degree of consistency between Hertel exophthalmometry and multidetector CT for the evaluation of exophthalmos in patients with TAO. Exophthalmos is an important clinical feature and its measurement and monitoring over time assess the clinical course and outcome of treatment.
Diaz-Llopis Manuel, Pinazo-Duran Maria Dolores, Diaz-Guiñon Loreto, Rahhal-Ortuño Miriam, Gallego-Pinazo Roberto, Dolz-Marco Rosa, Diaz-Guiñon Teresa, Diaz Maria, Romero Francisco Javier
Open Journal of Ophthalmology, Volume 10, pp 221-229; doi:10.4236/ojoph.2020.103023

Abstract:
Purpose: Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). Methods: A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry? test initially positive, ocular surface disease index (OSDI) score ≥ 12 and Results: The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p Conclusions: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.
Carlos E. Rivera, Erika Cantor, Andres Castillo, Alexander Martinez, Lyle Newball, Juan C. Rueda, Alejandro Valencia, Sandra Belalcazar, Tulio Cabal, Oscar Albis-Donado, et al.
Open Journal of Ophthalmology, Volume 10, pp 99-114; doi:10.4236/ojoph.2020.102012

Abstract:
Objective: To establish the prevalence and risk factors of Primary Open Angle Glaucoma (POAG) among patients with Systemic Hypertension (SH) and Diabetes Mellitus (DM) in six cities of Colombia. Methods: A cross-sectional study among hypertensive and diabetic patients was conducted in Colombia. This study included 2067 subjects older than 50 years of age diagnosed with SH and/or DM. Participants underwent a complete ophthalmic examination including intraocular pressure (IOP) measurement by Goldmann tonometry and blood pressure measurement. The glaucoma diagnosis was confirmed by structural and functional evidence. Interviews and standardized questionnaires were used to evaluate participants’ lifestyle and other health conditions. Results: Among participants with DM/SH, 142 cases of POAG were confirmed for a prevalence of 5.6% [95% CI: 4.6 - 6.6], while 9.1% were glaucoma suspects [95% CI: 7.8% - 10.4%]. The majority of confirmed cases (77.5%) were undiagnosed. The prevalence of POAG was significantly higher with male gender, greater age, and diastolic blood pressure > 90 mmHg as risk factors. Conclusion: We found a high prevalence of POAG in patients with adequate SH and DM care in a novel Latino population. We also found great unawareness of the disease in this population. Our results have potentially enormous public health implications for Colombia and other Latino populations.
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