เผยแพร่ผลงานวิจัยของจักษุแพทย์ไทย ในจดหมายข่าว Academy Express

Updated 2022-09-28 21:36:00


เผยแพร่ผลงานวิจัยของจักษุแพทย์ไทย

ในจดหมายข่าว Academy Express


Academy Express เป็นจดหมายข่าว อิเล็กทรอนิกส์ ที่จัดทำโดย American Academy of Ophthalmology ส่งทาง email ทุกสัปดาห์ ถึงสมาชิกของ 19 องค์กร วิชาชีพทางจักษุวิทยาใน Asia Pacific region รวมทั้ง RCOPT ราชวิทยาลัยฯเชิญชวนสมาชิกจักษุแพทย์ ติดตาม ผลงานวิจัยของจักษุแพทย์ไทย ในคอลัมน์ ASIA PACIFIC JOURNAL STUDIES ในจดหมายข่าวดังกล่าว

 

ท่านสมาชิกจักษุแพทย์ที่มีผลงานวิจัยใหม่ในวารสารวิชาการทางจักษุวิทยาที่เป็น indexed journal ส่งผลงานเพื่อเผยแพร่ใน Academy Express ฉบับต่อไปได้ที่ yyosanan@gmail.com หรือ admin@rcopt.org

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 24 Sep 2022

 

Bevacizumab can be given as injections or eyedrops for posterior blepharitis

 

In a prospective open-label study, the efficacy and safety of bevacizumab eye drops and intra-meibomian gland (MG) injections of bevacizumab were compared in 30 patients with meibomian gland dysfunction-associated posterior blepharitis. The primary outcomes were improvements in telangiectasia grade and lid margin neovascularized area (LMNA) measurements from baseline. At 3 months, no significant differences in telangiectasia grade and LMNA measurements were noted between the treatment groups, but only the injection group showed significant improvements in both telangiectasia grade and LMNA. Significant improvements in corneal staining, meiboscores, and fluorescein break-up time were also seen in patients given injections compared with patients given eye drops. No serious adverse events were observed.

Frontiers in Medicine (Lausanne), June 2022

https://pubmed.ncbi.nlm.nih.gov/35711967/

 


Academy Express Asia Pacific Edition ฉบับวันที่ 17 Sep 2022

 

Antigen immunotherapy is not generally effective against Pythium keratitis

 

Pythium insidiosum keratitis is a sight-threatening eye disease with no effective treatment. While Pythium insidiosum antigen immunotherapy (PIAI) has been reported to have an acceptable safety profile, its efficacy is questionable. Records from 10 patients with Pythium keratitis were reviewed; each patient received 3 doses of PIAI, injected subcutaneously at 2- week intervals. None of the patients had a favorable response to PIAI. Therapeutic penetrating keratoplasty (TPK) and scleral graft were undertaken in 6 and 3 eyes, respectively, and enucleation was done in one eye on the first visit. A second TPK was undertaken in the 3 eyes with scleral graft. In the end, 7 eyes were eviscerated or enucleated and only 3 eye globes were saved. The study concluded that PIAI was not effective in treating Pythium keratitis; radical surgery, including therapeutic keratoplasty, scleral graft, evisceration, and enucleation, is still the preferred treatment.

The American Journal of Tropical Medicine and Hygiene, July 2022

https://pubmed.ncbi.nlm.nih.gov/35895358/

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 10 Sep 2022

 

Ketoconazole treatment reduces the severity of central serous chorioretinopathy

 

A retrospective study evaluated the effects of ketoconazole, a first-line cortisol inhibitor for the treatment of central serous chorioretinopathy (CSCR), on the resolution of subretinal fluid (SRF) in 41 patients with CSCR. All patients were ketoconazole-naïve and were split into control and treatment groups; those in the treatment group were administered oral ketoconazole 400 or 600 mg daily for 3-6 weeks. A survival analysis was performed to determine the time interval from presentation to clinical resolution of SRF. Fewer patients in the treatment group needed rescue therapy at 12 weeks than patients in the control group (23.8% vs 50.0%, respectively), and significant increases in CSCR resolution were seen with ketoconazole. Prolonged CSCR durations were more likely to be noted in older patients with thick choroids in fellow eyes.

Clinical Ophthalmology, June 2022

https://pubmed.ncbi.nlm.nih.gov/35711967/

 


Academy Express Asia Pacific Edition ฉบับวันที่ 3 Sep 2022

 

In healthy eyes, vertical strabismus can be assessed with digital photography tests

 

Investigators used digital photography to determine the mean difference of vertical corneal light reflex (VCLR) among healthy eyes. One hundred fifty-five participants first received complete eye examinations and then 2 digital photographs were taken, with the flash on, while participants fixated their eyes on near and distant targets. The Photo-Hirschberg test was then used to analyze the 280 qualified images collected. The mean horizontal corneal diameter was 11.5 mm for the near photographs and 11.4 mm for the distance photographs. Regarding the correlation analysis, at 1- and 6-m fixation the percentages of participants within an acceptable range of vertical fusion were 95% and 100%, respectively. The normal range of the VCLR ratio noted in this study suggests that the Photo-Hirschberg test could be used when screening for vertical strabismus cases. International Ophthalmology, online ahead of print

https://pubmed.ncbi.nlm.nih.gov/35796908/

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 27 Aug 2022

 

The Cogan lid twitch test is reliable in detecting ocular myasthenia gravis

 

This observational study evaluated interobserver and intra-observer reliability of 3 eyelid tests-lid fatigability test (LFT), Cogan lid twitch (CLT), and forced eyelids closure test (FECT)-in 35 patients with ptosis associated with various conditions, including ocular myasthenia gravis. Video clips of all tests were recorded using a smartphone and then distributed to 3 neuro-ophthalmologists and 3 general ophthalmologists trained to evaluate the tests. Results showed moderate-to- substantial interobserver and intra-observer reliability for CLT among the neuro- ophthalmologists, but results were more varied among the general ophthalmologists. The FECT and LFT tests had lower interobserver and intra-observer reliability in both groups. The authors conclude that CLT is the most reliable test, but all tests should be interpreted with caution by general ophthalmologists. Journal of Neuro- Ophthalmology, June 2022

https://pubmed.ncbi.nlm.nih.gov/34860746/

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 20 Aug 2022

 

Relative afferent pupillary defect grading can help to evaluate visual field parameters

 

This prospective, cross-sectional study looked at the correlations between relative afferent pupillary defect (RAPD) magnitude and visual field parameters in 52 patients with unilateral or asymmetrical bilateral optic neuropathy or retinopathy. The RAPD clinical plus scale was divided into the following grades: 1+, initial weak constriction; 2+, initial stall then dilatation; 3+, immediate dilatation; and grade 4+, fixed amaurotic pupil. Each increase in RAPD clinical plus grade was correlated with a 5-db mean deviation increase. There was also a strong correlation between RAPD neutral density filter grades and visual field index differences. The RAPD clinical grading system is a low-cost approach that could potentially have wider availability than more sophisticated and costly central visual field evaluation methods.

PLoS ONE, May 2022

https://pubmed.ncbi.nlm.nih.gov/35617321

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 13 Aug 2022

 

Reversed-contrast eye charts lead to better visual acuity in patients with glaucoma

 

A cross-sectional study compared near visual acuity (VA) in 177 glaucomatous eyes (177 patients) with use of a standard VA chart (black text on white background) vs a reversed-contrast chart (white text on black background). Near VA was measured with a device with an antiglare screen at a 40-cm distance from both charts. A significantly better average near VA was noted with the reversed-contrast chart than with the standard chart; more prominent differences were seen in patients with advanced glaucoma. Sixty-two percent of patients preferred the reversed-contrast version of the chart. Therefore, reversed-contrast materials may improve reading performance in patients with glaucoma.

Clinical & Experimental Optometry, May 2022

https://pubmed.ncbi.nlm.nih.gov/35605620/

 

 


Academy Express Asia Pacific Edition ฉบับวันที่ 6 Aug 2022

 

Three common biometric devices show agreement in measuring total corneal power

 

A prospective observational study in 34 patients with keratoconus and 100 healthy volunteers evaluated agreement of total corneal power (TCP) measurements and other biometric parameters with swept- source anterior segment optical coherence tomography (CASIA 2), Scheimpflug tomography (Pentacam AXL), and swept-source optical biometery (IOL Master 700). The reproducibility and repeatability of TCP were high for both the keratoconus and health groups for all 3 devices, with intraclass coefficients ranging from 0.995 to 0.998. Agreement between the devices also was high. It is important to note, however, that these devices cannot be used interchangeably.

PLoS ONE, May 2022

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9129016/

 

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 30 Jul 2022

 

 

Routine lab testing before elective cataract surgeries is not always necessary

 

Investigators conducted a prospective review to determine the incidence of abnormal preoperative laboratory test results in 401 healthy individuals scheduled for elective cataract surgeries and whether these tests have any benefits. Rates of postponement or cancellation of surgeries also were evaluated. Overall, 8.2% of the individuals needed additional management, and 2.2% had surgeries postponed or canceled. While results from electrocardiograms (EKGs), chest x-rays, and anti-HIV tests were valuable, a complete blood count test was not as beneficial as a preoperative laboratory investigation. Patients aged 260 years were at the greatest risk of having positive EKG results that led to cancellation or postponement of surgery.

Clinical Ophthalmology, May 2022

https://pubmed.ncbi.nlm.nih.gov/35642180/

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 23 Jul 2022

 

 

Platelet-rich plasma eyedrops have potential in treating dry eye disease

 

Investigators conducted both a comparative study of epitheliotrophic factor concentrations in autologous serum (AS) vs those in platelet-rich plasma (PRP) and a prospective randomized control trial of AS and PRP eyedrop efficacy in treating dry eye disease (DED). Ten patients with DED (20 eyes) were included in both studies. In general, concentrations of epidermal growth factor, fibronectin, platelet-derived growth factor-AB, and transforming growth factor- B1 were higher in PRP than in AS. After 1 month of use, significant improvements in both Ocular Surface Disease Index (OSDI) and modified dry eye questionnaire scores were seen with PRP eyedrops, but AS eyedrop usage only led to significant improvements in OSDI scores.

Scientific Reports, May 2022

https://pubmed.ncbi.nlm.nih.gov/35618742/

 


Academy Express Asia Pacific Edition ฉบับวันที่ 16 Jul 2022

 

Just over half of patients with MGD regularly maintain lid hygiene

 

A cross-sectional study evaluated the level and predictor of compliance with lid hygiene in 77 patients with symptomatic meibomian gland dysfunction (MGD) via a validated 7- item questionnaire. All patients were instructed to perform lid hygiene twice daily, and after 8 weeks they were asked to complete the questionnaire. Good compliance with lid hygiene (high or medium adherence) was reported by 55% of patients. Higher scores of meibomian gland expressibility and moderate-to-severe ocular surface staining were significantly associated with compliance, while a lack of time was the most notable reason for noncompliance. Appropriate patient education and optimization methods of lid hygiene may promote patient compliance. Clinical Ophthalmology, April 2022

https://pubmed.ncbi.nlm.nih.gov/35469287/

 

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 9 Jul 2022

 

Trabeculotomy and CTT maintain lower IOP in primary congenital glaucoma

 

A retrospective study examined the long-term success of surgery in 55 patients (81 eyes) with primary congenital glaucoma (PCG) who underwent one of the following procedures: trabeculotomy, trabeculectomy, goniotomy, combined trabeculotrabeculectomy (CTT), or diode

transscleral cyclophotocoagulation (TSCPC). Surgical success was defined as an IOP between 5 and 21 mm Hg with or without antiglaucoma medications. Success rates for all procedures combined were 68.8% at 1 year, 63.8% at 3 years, and 53.7% at 5 years. The highest cumulative success rates at 1 year were for trabeculotomy (80.1%) and CTT (79.4%). TSCPC had the lowest success rate (26.7%). The high success rates for trabeculotomy and CTT were maintained over 3 and 5 years. Journal of Glaucoma, April 2022

https://pubmed.ncbi.nlm.nih.gov/35353783/

 

 

Academy Express Asia Pacific Edition ฉบับวันที่ 2 Jul 2022

 

A machine learning model can accurately grade CMVR in HIV-positive patients

 

To assess the diagnostic accuracy of machine learning technology for cytomegalovirus retinitis (CMVR) screening in patients with human immunodeficiency virus (HIV) infection, investigators generated a screening protocol for CMVR by fundus photography. One hundred sixty-five eyes of 90 HIV-positive patients were first evaluated for CMVR with binocular indirect ophthalmoscopy. A single central field of the fundus image was recorded from each eye and all images were then interpreted by both a machine learning model and a third- year ophthalmology resident. Sensitivity and specificity for the machine learning model in detecting and grading CMVR were 69% and 100%, respectively, similar to the sensitivity and specificity of the ophthalmology resident grading (68% and 98%, respectively). Therefore, machine learning technology is a useful tool for ophthalmologists in potentially preventing blindness from CMVR.

Retina, April 2022

https://pubmed.ncbi.nlm.nih.gov/35436264/