เผยแพร่ผลงานวิจัยของจักษุแพทย์ไทย ในจดหมายข่าว Academy Express
Updated 2022-09-28 21:36:00
เผยแพร่ผลงานวิจัยของจักษุแพทย์ไทย
ในจดหมายข่าว Academy Express
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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/