Can Google Help Your Nearsightedness? A Google Trend Analysis of Public Interest in Myopic Progression

Sugi Panneerselvam, Nina Diklich, Jonathan Tijerina, Michelle M Falcone, Kara M Cavuoto Department of Ophthalmology, Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Kara M Cavuoto, Department of Ophthalmology, Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA, Tel +1-305-326-6324, Fax +1-305-547-3675, Email [email protected]: To explore public interest in myopia progression and management and to correlate these trends to available treatments.Methods: Keywords were chosen for interest in myopia overall and those signifying interest in myopia treatments. Treatment options were separated into four main categories: atropine, glasses, contact lenses, and orthokeratology. Search terms were queried across ten years of Google Trends data and the relative search volume was analyzed to quantify the change in search volume over time.Results: A positive linear trend over time was present for all myopia interest keywords except “nearsighted” (p = 0.074) and “near work myopia” (p = 0.086). Interest in the four myopia treatment categories included in this study also displayed a significant positive trend over time. There is also a statistically significant positive correlation between all four treatment options and four of the seven categories of population interest, “myopia control”, “myopia”, “myopia progression”, and “screen time myopia”.Conclusion: This study demonstrates the utility of GT to correlate public interest in myopia treatments over time. All treatment terms had statistically significant linear search volume growth over a ten-year period. The positive correlation between interest in myopia as a health problem and available treatments supports existing evidence that GT can track rising public health concerns and corresponding treatment-seeking behaviors.Keywords: myopia, Google Trends, nearsighted, orthokeratology, atropin

Alterations to Melanocortinergic, GABAergic and Cannabinoid Neurotransmission Associated with Olanzapine-Induced Weight Gain

Background/Aim: Second generation antipsychotics (SGAs) are used to treat schizophrenia but can cause serious metabolic side-effects, such as obesity and diabetes. This study examined the effects of low to high doses of olanzapine on appetite/ metabolic regulatory signals in the hypothalamus and brainstem to elucidate the mechanisms underlying olanzapineinduced obesity. Methodology/Results: Levels of pro-opiomelanocortin (POMC), neuropeptide Y (NPY) and glutamic acid decarboxylase (GAD65, enzyme for GABA synthesis) mRNA expression, and cannabinoid CB1 receptor (CB1R) binding density (using [ 3 H]SR-141716A) were examined in the arcuate nucleus (Arc) and dorsal vagal complex (DVC) of female Sprague Dawley rats following 0.25, 0.5, 1.0 or 2.0 mg/kg olanzapine or vehicle (36/day, 14-days). Consistent with its weight gain liability, olanzapine significantly decreased anorexigenic POMC and increased orexigenic NPY mRNA expression in a dose-sensitive manner in the Arc. GAD65 mRNA expression increased and CB1R binding density decreased in the Arc and DVC. Alterations to neurotransmission signals in the brain significantly correlated with body weight and adiposity. The minimum dosage threshold required to induce weight gain in the rat was 0.5 mg/kg olanzapine. Conclusions: Olanzapine-induced weight gain is associated with reduced appetite-inhibiting POMC and increased NPY. This study also supports a role for the CB1R and GABA in the mechanisms underlying weight gain side-effects, possibly b

Effect of clinical parameters on the ocular surface microbiome in children and adults

Kara M Cavuoto,1,* Roberto Mendez,2,* Darlene Miller,1 Anat Galor,1,3 Santanu Banerjee2 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, 2Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, 3Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA *These authors contributed equally to this work Purpose: To perform a pilot study to characterize the effect of clinical parameters on the ocular surface microbiome (OSM) in children and adults using 16s ribosomal RNA sequencing.Methods: Prospective, cross-sectional study using 16s sequencing to evaluate the OSM. Comparisons were made in bacterial composition by 1) age, 2) gender, 3) sampling location of the ocular and periocular surfaces, and 4) topical drop use. 16s sequencing was performed using Illumina MiSeq 250 and analyzed using Qiime.Results: Thirty patients (15 children [mean 3.7 years], 15 adults [mean 60.4 years]) were sampled. Both principal coordinate analysis and unifrac distance analysis showed significant differences in the composition between the pediatric and adult OSMs (both p=0.001). The eyelid margin microbiota did not show any distinct clustering compared to conjunctiva within the pediatric samples but tended to show a distinction between anatomic sites in adult samples. No differences in OSM were noted by topical drop use.Conclusion: 16s sequencing is a useful tool in evaluating the OSM in patients of all ages, showing a distinct difference between pediatric and adult microbiomes. Keywords: ocular microbiome, conjunctival microbiome, eyelid margin microbiome, skin microbiome, 16s rRNA, paucibacterial, Qiim

The quest for effective pain control during suture adjustment after strabismus surgery: a study evaluating supplementation of 2% lidocaine with 0.4% ropivacaine

Howard D Palte, Kara M Cavuoto, Lalitha Sundararaman, Steven Gayer, Joyce Schiffman, Hilda CapoBascom Palmer Eye Institute, Miami, FL, USAPurpose: To determine whether the addition of 0.4% ropivacaine to the standard 2% lidocaine peribulbar anesthetic block improves pain scores during suture adjustment in patients undergoing strabismus surgery with adjustable sutures.Methods: Prospective, double-blind study of 30 adult patients aged 21–84 years scheduled for elective strabismus surgery with adjustable sutures. Patients were divided into two groups of 15 patients each based on the local anesthetic. Group A received 2% lidocaine and Group B received 2% lidocaine/0.4% ropivacaine. Pain was assessed using the visual analog scale (VAS) preoperatively and at 2, 4, and 6 hours postoperatively. The Lancaster red-green test was used to measure ocular motility at the same time points.Results: The pain scores in the two groups were low and similar at all measurement intervals. The VAS for Group A versus Group B at 2 hours (1.7 versus 2.4, P=0.5) and 4 hours (3.5 versus 3.7, P=0.8) showed no benefit from the addition of ropivacaine. At 6 hours, the VAS (3.7 versus 2.7) was not statistically significant, but the 95% confidence interval indicated that ropivacaine may provide some benefit. A repeated measures ANOVA did not find a statistically significant difference in VAS scores over time (P=0.9). In addition, the duration of akinesia was comparable in both groups (P=0.7).Conclusion: We conclude that the 50:50 mixture of 2% lidocaine with 0.4% ropivacaine as compared to 2% lidocaine in peribulbar anesthetic blocks in adjustable-suture strabismus surgery does not produce significant improvements in pain control during the postoperative and adjustment phases. In addition, ropivacaine did not impair return of full ocular motility at 6 hours, which is advantageous in adjustable-suture strabismus surgery.Keywords: adjustable-suture strabismus surgery, postoperative ocular motility, local anesthetic block, postoperative pai

Prevalence of refractive errors in children with retinoblastoma

Victor M Villegas,1,2 Shuo-Chieh Wu,1 Timothy G Murray,2 Kara M Cavuoto,1 Hilda Capo,1 Craig A McKeown1 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, FL, USA; 2Miami Ocular Oncology and Retina, Miami, FL, USA Purpose: The main purpose of this study was to investigate refractive errors in children with unilateral and bilateral retinoblastoma (RB).Methods: An institutional review board–approved consecutive retrospective cohort study was undertaken. Subjects underwent examination under general anesthesia as part of their RB follow-up, which included evaluation by a single pediatric ophthalmologist. Cycloplegic retinoscopy was performed and keratometry data assessed with a handheld Retinomax K Plus 3 keratorefractometer (Righton Ophthalmic Instruments).Results: The study included 61 eyes of 37 subjects, with 18 (49%) males and 19 females. Seventeen eyes (28%) had hyperopia with spherical equivalent ≥3 D. Refractive astigmatism ≥1.5 D was present in 32% of all eyes. Nine (38%) subjects had anisometropia ≥2 D. Fifteen (63%) subjects had anisometropia ≥1 D.Conclusion: This study reports the high proportion of amblyogenic refractive risk factors in children with RB, both in RB-affected eyes and contralateral normal eyes. Keywords: retinoblastoma, hyperopia, myopia, astigmatism, amblyopia, anisometropia &nbsp