Results of the Pinhole Test Correlate with Hybrid Contact Lens Visual Acuity in Patients with Visual Impairment due to Corneal Diseases

Peer reviewe

Advancements in Postoperative Care after Cataract Surgery

Non peer reviewe

Multifocal intraocular lenses and retinal diseases

Purpose Multifocal intraocular lenses (MIOLs) are often discouraged in patients with or at risk of retinal disorders (including diabetic retinopathy, age-related macular degeneration, and epiretinal membranes), as MIOLs are believed to reduce contrast sensitivity (CS). Concerns with MIOLs have also been raised in individuals with visual field defects, fixation instability or eccentric preferred retinal locations. The aim of this study is to review the influence of MIOL on quality of vision in patients with retinal diseases. Methods We reviewed the PubMed and Web of Science databases to identify relevant studies using the following keywords: multifocal intraocular lens, cataract surgery, cataract extraction, lens exchange, diabetic retinopathy, age-related macular degeneration, and contrast sensitivity. Results Studies evaluating CS in MIOLs present conflicting results: MIOLs either did not influence CS or resulted in worse performance under low-illuminance conditions and higher spatial frequencies when compared to monofocal IOLs. Nevertheless, MIOLs preserved CS levels within the age-matched normal range. Two studies reported that patients with concurrent retinal diseases receiving a MIOL, both unilaterally and bilaterally, reported a significant improvement in visual-related outcomes. Individuals with a monofocal IOL in one eye and a MIOL in the fellow eye reported greater subjective satisfaction with the MIOL. Conclusion We were unable to find evidence suggesting that patients with retinal diseases should be advised against MIOLs. Nevertheless, more research is needed to address the aforementioned concerns and to optimize the use of MIOLs in eyes with retinal disease.Peer reviewe

Should Multifocal Intraocular Lenses Become a Standard in Phacoemulsification Cataract Surgery?

Cataracts impair daily activities such as reading, outdoor sports, and driving, which may not match best-corrected visual acuity at optimal room light conditions, but can be just as important to patients [...

Imaging Modalities Employed in Diabetic Retinopathy Screening: A Review and Meta-Analysis

Introduction: Urbanization has caused dramatic changes in lifestyle, and these rapid transitions have led to an increased risk of noncommunicable diseases, such as type 2 diabetes. In terms of cost-effectiveness, screening for diabetic retinopathy is a critical aspect in diabetes management. The aim of this study was to review the imaging modalities employed for retinal examination in diabetic retinopathy screening. Methods: The PubMed and Web of Science databases were the main sources used to investigate the medical literature. An extensive search was performed to identify relevant articles concerning “imaging”, “diabetic retinopathy” and “screening” up to 1 June 2021. Imaging techniques were divided into the following: (i) mydriatic fundus photography, (ii) non-mydriatic fundus photography, (iii) smartphone-based imaging, and (iv) ultrawide-field imaging. A meta-analysis was performed to analyze the performance and technical failure rate of each method. Results: The technical failure rates for mydriatic and non-mydriatic digital fundus photography, smartphone-based and ultrawide-field imaging were 3.4% (95% CI: 2.3–4.6%), 12.1% (95% CI: 5.4–18.7%), 5.3% (95% CI: 1.5–9.0%) and 2.2% (95% CI: 0.3–4.0%), respectively. The rate was significantly different between all analyzed techniques (p < 0.001), and the overall failure rate was 6.6% (4.9–8.3%; I2 = 97.2%). The publication bias factor for smartphone-based imaging was significantly higher than for mydriatic digital fundus photography and non-mydriatic digital fundus photography (b = −8.61, b = −2.59 and b = −7.03, respectively; p < 0.001). Ultrawide-field imaging studies were excluded from the final sensitivity/specificity analysis, as the total number of patients included was too small. Conclusions: Regardless of the type of the device used, retinal photographs should be taken on eyes with dilated pupils, unless contraindicated, as this setting decreases the rate of ungradable images. Smartphone-based and ultrawide-field imaging may become potential alternative methods for optimized DR screening; however, there is not yet enough evidence for these techniques to displace mydriatic fundus photography

Methodological challenges with randomized clinical trials for multifocal intraocular lenses

Non peer reviewe

Imaging Modalities Employed in Diabetic Retinopathy Screening: A Review and Meta-Analysis

Introduction: Urbanization has caused dramatic changes in lifestyle, and these rapid transitions have led to an increased risk of noncommunicable diseases, such as type 2 diabetes. In terms of cost-effectiveness, screening for diabetic retinopathy is a critical aspect in diabetes management. The aim of this study was to review the imaging modalities employed for retinal examination in diabetic retinopathy screening. Methods: The PubMed and Web of Science databases were the main sources used to investigate the medical literature. An extensive search was performed to identify relevant articles concerning “imaging”, “diabetic retinopathy” and “screening” up to 1 June 2021. Imaging techniques were divided into the following: (i) mydriatic fundus photography, (ii) non-mydriatic fundus photography, (iii) smartphone-based imaging, and (iv) ultrawide-field imaging. A meta-analysis was performed to analyze the performance and technical failure rate of each method. Results: The technical failure rates for mydriatic and non-mydriatic digital fundus photography, smartphone-based and ultrawide-field imaging were 3.4% (95% CI: 2.3–4.6%), 12.1% (95% CI: 5.4–18.7%), 5.3% (95% CI: 1.5–9.0%) and 2.2% (95% CI: 0.3–4.0%), respectively. The rate was significantly different between all analyzed techniques (p < 0.001), and the overall failure rate was 6.6% (4.9–8.3%; I2 = 97.2%). The publication bias factor for smartphone-based imaging was significantly higher than for mydriatic digital fundus photography and non-mydriatic digital fundus photography (b = −8.61, b = −2.59 and b = −7.03, respectively; p < 0.001). Ultrawide-field imaging studies were excluded from the final sensitivity/specificity analysis, as the total number of patients included was too small. Conclusions: Regardless of the type of the device used, retinal photographs should be taken on eyes with dilated pupils, unless contraindicated, as this setting decreases the rate of ungradable images. Smartphone-based and ultrawide-field imaging may become potential alternative methods for optimized DR screening; however, there is not yet enough evidence for these techniques to displace mydriatic fundus photography

The prevalence of astigmatism and spectacle wear in Polish schoolchildren

Introduction: Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood to prevent visual impairment. The aim of this study was to evaluate the prevalence of astigmatism and spectacle wear among Polish schoolchildren. Methods: A cross-sectional study was carried out in children aged 6 to 14 years old from 50 schools in Poland. The presence of astigmatism was assessed by non-cycloplegic autorefraction, and defined as a cylinder equal to or greater than 0.75 D. Children were classified as living in urban or rural areas according to the school location. Spectacle wear was defined as having spectacles at school. Results: The study included 1041 children and 52.3% were girls (n = 544). The mean age was 8.62 ± 2.04 years. The prevalence of astigmatism was 7.3% (95% confidence interval [CI]: 5.8–9.1%). Only 21.7% of children with astigmatism wore spectacles at school. Astigmatism was diagnosed in 8.2% of boys (95% CI: 6.0–11.0%) and 6.4% of girls (95% CI: 4.5–8.8%; p = .13); cylindrical anisometropia was present in 19/76 (25.0%) of children with astigmatism (95% CI: 15.8%–36.3%). Against-the-rule astigmatism was the most common; it was observed in 48.7% of children with astigmatism, followed by with-the-rule astigmatism (44.7%) and oblique astigmatism (6.6%). The prevalence of astigmatism was not linearly correlated with age (r = 0.24; p = .53). Gender, age, and place of living were not significantly associated with the presence of astigmatism. Conclusions: This study reports a low prevalence of astigmatism in Polish school children. However, the majority of children with astigmatism were uncorrected. Further, longitudinal studies are warranted.info:eu-repo/semantics/publishedVersio

Bevacizumab in diabetic macular edema. A retrospective analysis of the efficacy of treatment in a group of 100 patients

INTRODUCTION. The aim of the study was to retrospectively evaluate the efficacy of intravitreal injections of bevacizumab in a large group of diabetic macular edema (DME) patients. MATERIA LS AND METHODS. One hundred patients (125 eyes) suffering from diabetes type 1 or 2 and DME were treated with two or three monthly 1.25-mg intravitreal injections of bevacizumab. RESULTS . The mean (SD) best correct visual acuity (BCVA) before treatment was 63.8 (± 26.2) letters. At months 1, 2, and 3 the mean change (SE) in BCVA from baseline was +4.4 (± 0.49), +4.9 (0.38), and +3.1 (± 0.39) letters, respectively. The mean macular retinal thickness dropped from 457 (± 183) microns to 308 (± 122) microns after three months. The improvement of retinal morphology in optical coherence tomography was evident: a decrease in the number of intraretinal cysts and a generalised shrinkage of retinal macular edema. There were no serious adverse effects of the treatment. CONCLUSION. The majority of patients with DME showed an improvement in visual acuity, particularly after the first injection of bevacizumab. Bevacizumab therapy is an interesting alternative to DME treatment

Zastosowanie bewacizumabu w leczeniu cukrzycowego obrzęku plamki

Cukrzycowy obrzęk plamki (DME) może wystąpić w dowolnym momencie przebiegu retinopatii cukrzycowej i stanowi wiodącą przyczynę pogorszenia widzenia w populacji osób chorych na cukrzycę. U większości pacjentów, którzy długo chorują na cukrzycę, w pewnym momencie rozwinie się retinopatia cukrzycowa z DME. Cukrzycowy obrzęk plamki to nagromadzenie płynu w warstwie splotowatej zewnętrznej oraz jądrzastej wewnętrznej siatkówki na skutek uszkodzenia bariery krew&#8211;siatkówka. Prowadzi to do destrukcji tych warstw, zaburzeń nerwowo-siatkówkowych i w efekcie do pogorszenia widzenia. W ostatnich latach zmienia się podejście do leczenia DME. Miejsce konwencjonalnej laseroterapii zastępuje terapia lekami podawanymi doszklistkowo. Wyniki wielu badań dowodzą wyższości leków anty-VEGF w porównaniu z laseroterapią, a dobre rezultaty są zauważone również w leczeniem skojarzonym. W materiale zebranym w Klinice Okulistyki Gdańskiego Uniwersytetu Medycznego stwierdza się zmniejszenie obrzęku plamki oraz poprawę ostrości widzenia u pacjentów leczonych bewacizumabem (3 iniekcje doszklistkowe). Forum Medycyny Rodzinnej 2011, tom 5, nr 4, 317&#8211;32