Open Journal of Ophthalmology
ISSN / EISSN : 21657408 / 21657416
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 251
Latest articles in this journal
Open Journal of Ophthalmology, Volume 10, pp 77-88; doi:10.4236/ojoph.2020.101010
Purpose: Growth factors (GFs) and neurotrophins can decelerate retinal degeneration. This study aimed to investigate the safety, efficacy and durability of subtenon injections of autologous platelet-rich plasma (aPRP) which is a rich source of GFs in retinitis pigmentosa (RP) patients. Methods: 154 eyes of 77 RP patients with various degrees of narrowed visual field were investigated in this study. Each patient received three injections with 4-week intervals and followed for at least 12 months. The examinations and the tests were obtained before the injection, 1 month after the third injection and every 3 months during the study. The primary aim was to evaluate the effects of aPRP on visual acuity (VA) and visual functions, the second aim was to estimate the duration of the therapy effect and the need for additional aPRP injection. Results: Median age of the 77 RP patients was 35.2 ± 13.9 years. All of the eyes received 3 monthly bilateral subtenon aPRP injections. Of these patients 26 received an additional one, 12 received additional two and 1 patient received additional 3 injections with 3-month interval. There were no significant ocular or systemic side effects. The mean baseline VA was 0.22 ± 0.18 Snellen lines. It improved to 0.31 ± 0.19 following three aPRP injections, which was statistically significant. At the end of the study period, the mean VA was 0.27 ± 0.22 Snellen lines. Conclusion: The subtenon injection of aPRP might be an effective therapy and might have a positive influence in the preservation of visual functions and visual acuity of RP patients.
Open Journal of Ophthalmology, Volume 10, pp 89-98; doi:10.4236/ojoph.2020.101011
Background: The iStent inject is a Micro-Invasive Glaucoma Surgical (MIGS) device that has shown to reduce IOP and to be safe for glaucoma patients with fewer complications than regular surgery. Objective: To investigate, up to 15 - 20 months, the efficacy and safety of implantation of two second-generation trabecular microbypass stents in patients with or without prior glaucoma surgery. Methods: Fifty-seven eyes were implanted with the iStent inject. The population was comprised of eyes with primary open-angle glaucoma (n = 51), pseudoexfoliation glaucoma (n = 5) and ocular hypertension (n = 1). Major outcome parameters included IOP, medication needs and corrected distance visual acuity (CDVA). Follow-up time points were one day, 2 - 4 months, 9 - 14 months and 15 - 20 months. Results: The main reason to perform MIGS was IOP reduction in 68.4%, reduced number of medications due to drug intolerance in 24.6% and reduced medication due to compliance issues in 7.0% of the eyes. IOP decreased by 22.47%, from 19.40 ± 3.83 mmHg preoperatively (preop) to 15.04 ± 1.67 mmHg at 15-20 months postoperatively. IOP reduction was achieved at all follow-up time points (p < 0.001). A decrease in the number of medications was achieved in 32.1% of the patients after 15 - 20 months. Conclusions: Insertion of the iStent inject in patients with or without prior glaucoma surgery shows effective and sustained improvements in IOP with no safety concerns.
Open Journal of Ophthalmology, Volume 10, pp 59-68; doi:10.4236/ojoph.2020.101008
Purpose: To investigate macular morphology by spectral domain optical coherence tomography (SDOCT) in children with history of the retinopathy of prematurity (ROP). Materials and methods: In this cross-sectional study we included 35 eyes of 18 patients, aged 4 to 8 years, with history of ROP. Twenty-one eyes had received treatment for type 1 pre-threshold ROP. The others showed spontaneous regression of the disease. A 7 × 7-mm retinal area was sampled using a 3-dimensional scanning protocol with high-resolution spectral domain optical coherence tomography (SOCT Copernicus REVO). The central foveal thickness, mean macular thickness, macular volume and foveal depression were measured. The macular anatomy and the foveal contour were examined. Results: The mean birth weight was 1338.29 ± 324.05 grams. Mean gestational age at birth was 29.37 ± 2.07 weeks. Twenty-one eyes were treated with laser or cryotherapy. All of them showed regression of the disease. The mean best corrected visual acuity was 20/28. The average central foveal thickness was 262.26 ± 37.39, with 68.57% of preterm > 240 μm and 22.86% > 220 μm. In all eyes, the foveal contour is abnormal. A foveal depression was absent in 25 eyes (71%). Conclusion: In the majority of children with a history of ROP, we found changes in macular morphology, including retention of inner retinal layers and absent foveal depression. In our study foveal hypoplasia was associated with good functional outcome.
Open Journal of Ophthalmology, Volume 10, pp 69-76; doi:10.4236/ojoph.2020.101009
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.
Open Journal of Ophthalmology, Volume 10, pp 55-58; doi:10.4236/ojoph.2020.101007
Purpose: The aim of our study was to assess the variations in fusion and stereopsis before and after refractive surgery. Methods: We conducted a retrospective study. 140 patients (78 M, 62 F) were selected, aged 20 - 59 years (mean age 36 ± 10 DS). All patients received a comprehensive ophtalmological and orthoptic examination. Surgery was performed using a MEL-80 excimer laser (Carl Zeiss Meditec, Jena, Germany). Results: Fusional convergence amplitudes after refractive eye surgery range from at near 18 - 20 PD in 42 (30%) patients; 25 - 30 PD in 56 (40%) patients; 35 - 40 PD in 42 (30%) patients, at far 20 - 25 PD in 84 (60%) patients; 30 - 40 PD in 56 (40%) patients, fusional divergence at near after refractive eye surgery range from at near 6 - 8 PD in 108 (75.7%) patients; 10 - 12 PD in 52 (37.1%), at far 6 - 8 PD in 126 (90%) patients; 10 - 12 PD in 14 (10%) patients. None of the patients developed any ocular deviations. NCP, on average, decreases from 9.4 ± 1.5 cm to 9.1 ± 0.9 cm after. None of these patients with a normal NCP before surgery developed an abnormal NCP after refractive surgery. Eighteen patients (12.8%) had a stereopsis higher than 60 s of arch before surgical intervention. Of these, in 2 cases (2.8%) stereopsis increased from 200 to 40 s of arch after surgery. In the rest of patients stereopsis remained unchanged. Conclusion: The increase in fusion at near appears to be considerably interesting, whereas there is no worsening of stereopsis. A careful pre-surgery orthoptic evaluation is extremely revelant for a safe refractive surgery, this reducing the risk of complications associated with fusion and stereopsis.
Open Journal of Ophthalmology, Volume 10, pp 44-54; doi:10.4236/ojoph.2020.101006
Background: Diabetic retinopathy (DR) is a common complication of diabetes mellitus and a major cause of vision loss in the working age population. Its pathogenesis is poorly understood but may involve low grade chronic inflammation and angiogenesis. The aim of this study was to evaluate the relationship between serum levels of one inflammatory (IL-6) and angiogenic cytokine (VEGF-A) with the presence and severity of DR in type 2 diabetic mellitus patients. Methods: From January to June 2019, we conducted a cross-sectional analytical study on 84 patients out of which 31 developed DR and 53 did not. All patients underwent complete ophthalmological examination and laboratory analysis for IL-6 and VEGF-A with ELISA Technique. We studied the relation of IL-6 and VEGF-A with the presence and severity of DR, HBA1c, the duration of diabetes. Results: The group with DR had statistically significant higher levels of VEGF-A compared to the control group (390.5 pg/ml vs. 173.1 pg/ml; p = 0.007). There was no significant difference in IL-6 levels between both groups (42.8 pg/ml vs. 31.7 pg/ml; p = 0.10). Equally there was no association between these 2 cytokines and macular oedema or with the severity of DR. The level of IL-6 was associated to the balance of diabetes (p = 0.006) although VEGF-A was not (p = 0.15). Moreover, Il-6 (p = 0.31) and VEGF-A (p = 0.24) were not linked to the duration of diabetes. Conclusion: Serum concentrations of VEGF-A have an effect on the development of DR. They correlate with the presence of the disease but IL-6 does not. However, IL-6 was associated to the balance of diabetes. These 2 biomarkers may play a role in the pathophysiology of diabetes and the diabetic retinopathy. Findings on Il-6 and VEGF-A may therefore contribute to the development of the diagnosis tools and caretaking of diabetes and diabetic retinopathy.
Open Journal of Ophthalmology, Volume 10, pp 33-43; doi:10.4236/ojoph.2020.101005
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...
Open Journal of Ophthalmology, Volume 10, pp 1-9; doi:10.4236/ojoph.2020.101001
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.
Open Journal of Ophthalmology, Volume 10, pp 28-32; doi:10.4236/ojoph.2020.101004
Background: Postoperative Endophthalmitis is a rare complication after intraocular surgeries. However, it remains one of the most devastating complications following cataract surgery because of its poor prognosis. We describe the effects of antibiotic prophylaxis on the incidence of postoperative endophthalmitis after cataract surgery, particularly phacoemulsification. Aim of the work: To identify risk factors of acute endophthalmitis and describe the effects of antibiotic prophylaxis on the incidence of postoperative endophthalmitis after phacoemulsification surgery. Methods: A prospective randomized cataract surgery study recruited 300 patients; 150 patients who received just intracameral vigamox at the end of surgery without topical antibiotics before surgery and 150 patients who received both intracameral vigamoxas well as topical perioperative vigamox which either just half an hour before surgery or three days preceding surgery. We took a conjunctival swab before and after vigamox administration in order to detect the type of conjunctival flora in the Libyan population as well as the effect of the vigamox on the conjunctival flora by using Phoenix-BD machine. In total we collected 166 specimens (83 patients). Results: In all groups no acute post-operative endophthalmitis was reported. Conclusions: The study was based on intracameral Moxifloxacin at the end of surgery with and without topical antibiotics drops administration. The incidence of postcataract endophthalmitis was not reported in our study after using intracameral antibiotics, as it seems to be effective in preventing endophthalmitis after cataract surgery.
Open Journal of Ophthalmology, Volume 10, pp 21-27; doi:10.4236/ojoph.2020.101003
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.