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

Academy Express Asia Pacific Edition ฉบับวันที่ 25 Jun 2022

Optic neuritis caused by MOG antibody may be associated with COVID-19 infection

In this case study, a 35-year-old Thai woman presented with reported acute blurred vision in her left eye with pain on eye movement for 6 days; she also had had a dry cough for 1 week before the onset of visual loss. Visual acuity was 20/32 in the right eye. She also had bilateral disc swelling which was more prominent in the left eye. Imaging showed a swollen optic nerve sheath complex in both eyes. She subsequently tested positive for COVID-19 infection and had a positive serology test for serum anti-myelin oligodendrocyte glycoprotein (MOG) antibody; therefore, she was diagnosed with COVID-19-associated MOG antibody optic neuritis. This case, along with several others reported in the literature, suggests that there may be an association between COVID-19 infection and MOG antibody-associated disease; however, larger case-controlled studies are required to confirm these findings.

American Journal of Ophthalmology Case Reports, June 2022

https://pubmed.ncbi.nlm.nih.gov/35313470/

Academy Express Asia Pacific Edition ฉบับวันที่ 18 Jun 2022

Inaccurate PIC diagnoses have been seen with anterior segment OCT imaging

A cross-sectional study evaluated the diagnostic performance of manual grading of anterior segment OCT (AS-OCT) in the detection of plateau iris configuration (PIC) based on the presence of standardized ultrasound biomicroscopy (UBM) criteria. One hundred seventy-nine eyes were analyzed, and 47.5% were diagnosed as having PIC. Interobserver agreement rates of primary angle closure by the 3 graders, based on AS-OCT images, were between 0.68 and 0.70. The accuracy of the manual graders in detecting PIC from AS-OCT images ranged from 51.2% to 65.0%. Given these data, AS-OCT imaging does not appear to be a good substitute for UBM in PIC detection and is not recommended for use in patients with primary angle closure.

BMJ Open Ophthalmology, March 2022

https://pubmed.ncbi.nlm.nih.gov/35402728/

Academy Express Asia Pacific Edition ฉบับวันที่ 11 Jun 2022

Lasers and Orbscan create different parameter measurements for the Implantable Collamer Lens

Horizontal corneal white-to-white (WTW) and anterior chamber depth (ACD) measured by Orbscan are the parameters commonly used for calculating size of the Implantable Collamer Lens (ICL), a phakic IOL. However, Orbscan is not always available in every refractive surgery center, and it has also been withdrawn from distribution. This retrospective review of 83 eyes with ICL implantation (42 patients) compared WTW and ACD measured from machines incorporated with WaveLight femtosecond and excimer laser systems with those measured with Orbscan. The measurements taken with the two laser systems were in good agreement with the Orbscan measurements; however, there was a statistically significant difference in the proportion of eyes with unacceptable postoperative vaults between the laser systems data set and the Orbscan data set (14.5% vs 6.0%, respectively). Therefore, the Orbscan and laser system WTW and ACD measurements may not be interchangeable when selecting ICL size.

BMJ Open Ophthalmology, March 2022

https://pubmed.ncbi.nlm.nih.gov/35372697/

Academy Express Asia Pacific Edition ฉบับวันที่ 4 Jun 2022

The ANTERION optical biometer has performance comparable to that of GALILEI G6

In a prospective study conducted at a tertiary eye center, investigators compared the performance of a new swept-source OCT optical biometer, ANTERION, in ocular biometrics and IOL calculations vs the reference standard of the dual Scheimpflug analyzer GALILEI G6 in 96 eyes with cataracts. Eyes were scanned with both devices in a random fashion, and parameters were analyzed in terms of mean difference and intraclass correlation coefficients. There were significant differences in all parameters between the devices, with the exception of anterior chamber depth, but excellent agreement. The mean difference in axial length between ANTERION and GALILEI G6 was 0.03 mm. Calculated IOL power revealed that 94% were within 1 D; the prediction error was 0.03 D. While ANTERION and GALILEI G6 calculate IOL and perform other biometric tasks equally well, it is important to note that the devices cannot be used interchangeably.

Scientific Reports, March 2022

https://pubmed.ncbi.nlm.nih.gov/35246594/

Academy Express Asia Pacific Edition ฉบับวันที่ 28 May 2022

Levator resection shows efficacy in severe ptosis with poor levator function

In a retrospective interventional study, data from 38 ptotic eyelids in 31 patients with severe simple congenital ptosis and levator function of 34 mm who had undergone maximal levator resection beyond Whitnall ligament were reviewed to evaluate the functional and cosmetic outcomes of surgery as well as the factors that influenced surgical success. Successful surgical outcomes, defined as "at least good functional and cosmetic outcomes," were achieved in 84% of patients at 12 months after surgery. The only factor that significantly influenced the surgical success rate was the length of the resected levator muscle; the mean lengths in the successful and unsuccessful groups were 18.15 mm and 14.29 mm, respectively. Therefore, this surgical approach is highly effective in patients with severe simple congenital ptosis and poor levator function.

Clinical Ophthalmology, February 2022

https://pubmed.ncbi.nlm.nih.gov/35210749/

Academy Express Asia Pacific Edition ฉบับวันที่ 21 May 2022

Pediatric pleomorphic liposarcoma is rare and may be treatment refractory.

Thai investigators report a case of a primary orbital pleomorphic liposarcoma in an 11-year-old boy with an enlarging, painless lower right eyelid mass that was discovered 4 months prior to the clinician visit. Imaging revealed a large, well- circumscribed lobulated mass, and a biopsy revealed a pleomorphic spindle cell neoplasm consistent with pleomorphic liposarcoma presentation. There was no evidence of distant metastasis. The patient underwent 4 chemotherapy cycles, but at the 12-week follow-up visit the mass was found to have grown larger. A total orbital exenteration was then performed, and at 6 months after surgery there were no signs of liposarcoma recurrence.

American Journal of Ophthalmology Case Reports, March 2022

https://pubmed.ncbi.nlm.nih.gov/35146183/

Academy Express Asia Pacific Edition ฉบับวันที่ 14 May 2022

Anatomic and visual improvements in PCV are seen with aflibercept injections

Investigators conducted a multicenter prospective study to determine the timing of complete polypoidal regression on indocyanine green angiography (ICGA) after aflibercept injections for polypoidal choroidal vasculopathy (PCV) in 40 eyes. Eligible eyes received fixed-dose aflibercept injections monthly for 3 months, then every 8 weeks for 1 year (or monthly if fluid persisted on OCT). Two retina specialists reviewed post- treatment ICGAs and categorized them as complete regression (complete disappearance of polypoidal lesions), partial regression (reduced in size or number), or no regression. At 2 months after aflibercept injections were given, complete polypoidal regression was seen in 11 of the 40 eyes (27.5%); median duration of time from baseline to achieve complete regression was 3 months. Eyes that had achieved complete polypoidal regression also had significantly better visual acuity (median letter gain) than those who had not. These findings support the consideration of aflibercept for PCV.

Ophthalmology Retina, January 2022

https://pubmed.ncbi.nlm.nih.gov/33781929/

Academy Express Asia Pacific Edition ฉบับวันที่ 7 May 2022

Combination of acyclovir and ganciclovir shows efficacy in EBV- associated uveitis

A retrospective cohort study was conducted in 22 patients with Epstein-Barr virus (EBV)-associated uveitis to determine the characteristics of the disease as well as treatment outcomes. The primary assessment was treatment success, defined by clinical improvement and absence of viral DNA confirmed by polymerase chain reaction (PCR). Sixty-seven percent of patients had human immunodeficiency virus infection; cytomegalovirus (38%) was the most common co-infecting pathogen. Seventy-three percent of patients had undetectable EBV infection in the intraocular fluid after treatment; the most widely used treatment regimen was a combination of systemic acyclovir and intravitreal ganciclovir injection (58% of patients). Journal of Clinical Virology, January 2022

https://pubmed.ncbi.nlm.nih.gov/35007895/

Academy Express Asia Pacific Edition ฉบับวันที่ 30 Apr 2022

Improvements in visual outcomes are seen with vitrectomy plus ILM peeling

A Thai retrospective cohort study evaluated the visual outcomes and macular anatomic structures seen with spectral-domain OCT (SD-OCT) in 14 patients with epiretinal membrane foveoschisis who underwent 23G vitrectomy and internal limiting membrane (ILM) peeling. The main outcomes were best-corrected visual acuity (BCVA) and anatomic appearance on SD-OCT assessed during preoperative evaluations and postoperative follow-ups at 1, 3, 6, and 12 months. Significant improvements in BCVA were observed at the 3-, 6-, and 12-month postoperative visits. At month 12, there were vision improvements of 23 lines in 57% of patients and vision improvements of 1 or 2 lines in 14% of patients. Nearly all patients achieved anatomical foveal restoration; only one had persistent intraretinal schisis at 12 months. No significant visual impairments were observed.

BMC Ophthalmology, December 2021

https://pubmed.ncbi.nlm.nih.gov/34911498/

Academy Express Asia Pacific Edition ฉบับวันที่ 23 Apr 2022

Dry eye symptoms worsened during the COVID-19 lockdown period in Thailand

Investigators assessed the impact of COVID-19 lockdown measures on dry eye symptoms through a community-based, cross-sectional study conducted during the first wave of the COVID-19 outbreak in Thailand (June and July 2020). An online survey was distributed via social media with questions about demographics, dry eye symptoms (scores ranging from 0 = always having symptoms to 4 = no symptoms), and the use of visual display terminals (VDTs). Of the 535 respondents, 37% reported being diagnosed with dry eye disease (DED). During the COVID-19 lockdown period, the overall mean dry eye symptom scores significantly decreased, from 81.6 to 79.8, while the mean daily VDT usage increased from 10.55 to 13.08 hours. Female gender (odds ratio [OR] 1.86) and increased VDT usage during the lockdown (OR 5.68) were independently associated with worsening dry eye symptoms.

Scientific Reports, December 2021

https://pubmed.ncbi.nlm.nih.gov/34952901

Academy Express Asia Pacific Edition ฉบับวันที่ 16 Apr 2022

Vitreous syphilis antibody tests can help confirm syphilitic uveitis

A prospective case-control study was carried out to determine the sensitivity and specificity of syphilis antibody tests in vitreous samples. Enzyme immunoassay (EIA) had the greatest sensitivity in detecting vitreous syphilitic antibody (90.9%), followed by rapid plasma regain (80.0%) and fluorescent treponemal antibody-absorption (FTA-ABS) (78.9%), The EIA and FTA-ABS tests had the highest specificity as well, detecting 100% of the syphilis antibody. The results show that vitreous syphilis antibody tests have potential as supplementary methods of confirming syphilitic uveitis.

Eye (London), January 2022

https://pubmed.ncbi.nlm.nih.gov/35034091/

Academy Express Asia Pacific Edition ฉบับวันที่ 9 Apr 2022

The Krimsky test provides an accurate measurement of angle of deviation in strabismus

Investigators in Thailand compared the Photo-Hirschberg and Krimsky tests' measurements of angle of deviation with the measurement from an alternate prism cover test (APCT) in 33 patients with horizontal strabismus. The angle of deviation measured with the APCT was used as the baseline comparator. For the Photo- Hirschberg test, patients were photographed and the images analyzed with computer software, and then the corneal light reflex displacement was converted into prism diopter. Twenty-eight patients were also given the Krimsky test. The Krimsky test was found to be more reliable than the Photo-Hirschberg test for measuring angle of deviation.

PLOS One, December 2021

https://pubmed.ncbi.nlm.nih.gov/34851974/

Academy Express Asia Pacific Edition ฉบับวันที่ 2 Apr 2022

A deep learning algorithm may have future use in diabetic retinopathy screening

In this study, validation of the clinical performance of an automated diabetic retinopathy (DR) screening model was conducted, in preparation for future real-life application. The model analyzed 2533 Nidek camera fundus images and 1989 Eidon camera images of DR cases. In the training phase, the Nidek-trained model achieved a sensitivity of 93% and a specificity of 91%, whereas the Eidon-trained model achieved an 88% sensitivity and an 85% specificity. During the clinical verification phase, the sensitivity and specificity for the Eidon model were similar to that seen in the first phase, but the sensitivity of the Nidek model declined from the first phase to 82%. Therefore, the images from the Eidon camera yielded a more desirable performance from the deep learning algorithm model in differentiating referable DR than did the images from the Nidek camera. This algorithm is a potential alternative for standard DR screening tools in real-world clinical care settings.

Translational Vision Science & Technology, November 2021

https://pubmed.ncbi.nlm.nih.gov/34767624/