Ophthalmologic Repercussions of Orbital Fractures

Orbital fractures refer to all continuity solutions involving the wall of the orbit. They are responsible for serious complications, particularly ophthalmological. Objective: To identify the epidemiological, anatomical and clinical aspects as well as the possible ocular complications of orbital fractures in the Gbêkê region. Methods: Prospective study from July 1, 2020, to October 31, 2020, i.e., a duration of 4 months. It took place in the ophthalmology department of the University Hospital of Bouaké. Patients with orbital fractures with ocular repercussions received during the study period were included. Results: Out of 27 cases of orbital floor fracture received, 20 had ocular complications, i.e., a prevalence of 74.07%. The average age was 32 years with extremes of 18 and 48 years. The male gender predominated with 80%, i.e. a sex ratio of 4. Subconjunctival hemorrhage was the most frequent reason for consultation (70%). The etiology was dominated by road traffic accidents (85%). The average consultation time was 24 hours. 80% of the patients had a distance visual acuity (DVA) between 3/10 and 10/10.) Diplopia was observed in 60% of patients. Blow out fracture (70%) was the most prominent orbital lesion. At the paraclinical level, 80% of the patients had performed a CT scan of the orbit. Evisceration was the predominant ophthalmologic surgical management (4 patients). At the bone level, reconstruction of the orbital floor with a polydioxanone plate (PDS) was performed in 50% of patients. Conclusion: The risk of ocular injury in orbital fractures is frequent because of the close relationship between the orbit and the eyeball.

Determinants of the Ophthalmological Follow-Up of Sickle Cell Patients at the National Center of Research and Care for Sickle Cell Patients in Lome-Togo

Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .

Effect of Optimization of Hemodialysis on Ophthalmological Variables in Patients with End Stage Renal Disease

Background: Conventional hemodialysis (HD) used in treating end stage renal disease (ESRD) can result in multiorgan insult including the eye-owing to the resultant reperfusion after the ischemic event. Optimization of HD can be done using a process called remote ischemia which includes applying cycles of brief, nonlethal ischemia followed by reperfusion to one limb. This method sends signal to the end organs to prepare themselves for the upcoming ischemia thus preventing their injury. Aim: To evaluate the effect of remote ischemia preconditioning in HD on ophthalmological variables. Patients and Methods: A pre-post interventional analytical study conducted on patients receiving hemodialysis. Remote ischemia preconditioning was done before each HD session incorporating 3 cycles of alternating ischemia and reperfusion (5 minutes each) performed in the upper limb using sphygmomanometer cuff. Ophthalmic examination was done at baseline and 3 months after HD optimization. Assessment was done half to one hour pre- and post-session for visual acuity, corneal, conjunctival deposits, tear break up time (TBUT), anterior chamber depth and central macular thickness. Results: The study included 50 eyes of 25 patients with almost equal gender distribution and mean age of 37.52 ± 9.824 years. They were maintained on hemodialysis for median 10 years (range 3-25 years). The commonest cause of ESRD was hypertension. The studied ocular parameters showed insignificant change after pre-conditioned HD except for TBUT that was statistically longer (p = 0.018). Conclusion: Optimization of hemodialysis using remote ischemia does not seem to have significant ocular effect apart from prolonged TBUT. .

Prevalence and characteristics of ophthalmological extra-intestinal manifestations in Chinese patients with inflammatory bowel disease

AIM：To investigate the prevalence of ophthalmological extra-intestinal manifestations（O-EIMs） in Chinese patients with inflammatory bowel disease（IBD） and to identify risk factors for the development of O-EIMs.METHODS：The study population consisted of Chinese patients with a definite diagnosis of Crohn＇s disease（CD） or ulcerative colitis（UC） in a large teaching hospital between January 1995 and December 2014.Demographic and clinical characteristics of patients were extracted retrospectively.RESULTS： In this twenty-year cohort,645 IBD patients（517 with UC,128 with CD） were registered.Among them122（18.9%） exhibited at least one EIM.Of 13 patients（2.0%） developed O-EIMs,7 of CD（5.5%） and 6 of UC（1.2%）.Clinical ophthalmological manifestations included redness（76.9%）,burning（61.5%）,pain（38.5%）,itching（15.4%） of eyes and vision change（7.7%）.O-EIMs included episcleritis（7）,uveitis（5） and dry eye（1）.OEIMs were more prevalent in female（odds ratio for male0.61,95% confidence interval 0.52-0.73,P 〈0.0001）,and patients who had IBD diagnosis at young age（odds ratio for patients aged 〉30 years 0.76,95% confidence interval0.65-0.88,P 〈0.0001）.CONCLUSION： The frequency of O-EIMs in Chinese patients with IBD is lower than the rates reported in the studies of European and American countries.Episcleritisand uveitis are the most common O-EIMs.O-EIMs are more frequent in patients with CD and more prevalent in female and patients who have IBD diagnosis at young age.

Photo News from 2019 International Ophthalmological Forum Hosted by AACO

2019 International Ophthalmological Forum(IOF 2019)was successfully held in Shenzhen,China during May 24-26,2019.The forum was hosted by Afro-Asian Council of Ophthalmology(AACO),Guang Dong Medical Association(GDMA)and co-hosted by Zhongshan Ophthalmic Center(ZOC),Sun Yat-sen University and Shenzhen Eye Hospital(SZEH),China.Top scientists,relevant experts and scholars.

Photo News from 2019 International Ophthalmological Forum Hosted by AACO

2019 International Ophthalmological Forum(IOF 2019)was successfully held in Shenzhen,China during May 24-26,2019.The forum was hosted by Afro-Asian Council of Ophthalmology(AACO),Guang Dong Medical Association(GDMA)and co-hosted by Zhongshan Ophthalmic Center(ZOC),Sun Yat-sen University and Shenzhen Eye Hospital(SZEH),China.Top scientists.

Photo News from WOC 2018 World Forum of Ophthalmological Journal Editors

Chairs, World Forum of Ophthalmological Journal Editors:Prof. Neil Bressler (middle), Prof. Richard Parrish II (right)and Prof. Jose Carlos Pastor (left)Prof. Neil Bressler (Editor-in-Chief of JAMA Ophthalmology)gave a lecture at the World Forum of Ophthalmological Journal

Epidemiological, Clinical and Therapeutic Profiles of Ophthalmological Complications of Rhino-Sinusitis in a Tertiary Facility in Black Africa

Introduction: Rhinosinusitis is one of the most common ENT diseases. Its main complications are of three types: cranial, endo-cranial and ophthalmological. The aim of this study was to contribute to the study of ophthalmological complications of rhino-sinusitis in our context. Material and Methods: This was a prospective study, of descriptive type, of six (6) months (July-December 2017), concerning the patients received and treated for ophthalmological complications of rhino-sinusitis at the National IgnaceDeen Hospital. Results: During our study period, we collected 32 ophthalmological complications of rhinosinusitis, i.e. 65.31% of cases. The average age of our patients was 34.25 ± 15.15 years with extremes of 8 and 76 years and a sex ratio of 0.45. A history of rhinitis and/or rhino-sinusitis was reported in all our patients. Housewives were the most affected socio-professional group, accounting for 34.37% of cases. The average consultation time was 20 ± 52 days. Tearing, palpebral oedema and purulent rhinorrhea were present in all our patients. Preseptal cellulitis and abscess were the most common complications, accounting for 56.25% and 28.12% of cases respectively. The treatment was medical-surgical. Drainage of a subperiosteal abscess of the ethmoid involved 53.12% of cases. Surgical treatment of the maxillary sinus and/or ethmoid by endoscopy was sometimes associated. The evolution was favourable in all cases. Conclusion: Ophthalmological complications of rhino-sinusitis are still frequent in our developing countries. Their management must be multidisciplinary.

Ophthalmological instruments of Al-Halabi fill in a gap in the biomedical engineering history

Al-Halabi is an intriguing ophthalmologist who invented numerous surgicalinstruments for treating various eye diseases. The illustrations of such instrumentsin his invaluable book “Kitab Al-Kafi fi Al-Kuhl” reflect his willingness toteach. Moreover, he included in his book a magnificent illustration of theanatomical structure of the eye. The book reflects Al-Halabi’s medical practice andteaching and shows several advanced medical techniques and tools. Hisinvaluable comments reflect his deep experimental observations in the field ofophthalmology. The current article provides proof that Al-Halabi is one of ourearly biomedical engineers from more than 800 years ago. Al-Halabi represents aring in the chain of biomedical engineering history. His surgical instrumentsrepresent the biomechanics field. Al-Halabi should be acknowledged among thebiomedical engineering students for his various contributions in the field ofsurgical instruments.

World Integrated Medicine Master TANG You-zhi——Doctor of Ophthalmological Surgery for Chairman Mao

INTRODUCTION OF TANG YOUZHI TANG You-zhi, alias Kunwu, born in July 1926 in Hangzhou, Zhejiang province, is an Ophthalmological scientist on Chinese medicine.From 1942 to1947, he learned from Lu Nanshan, a famous doctor of Traditional Chinese Medicine Ophthalmology in Shanghai.After returning to Hangzhou, he opened up the TANG Kunwu Eye Clinic.In 1952, the Ministry of Health enrolled students to train Chinese medicine researchers.

Importance of the stem cell microenvironment for ophthalmological cell-based therapy

Cell therapy is a promising treatment for diseases that are caused by cell degeneration or death. The cells for clinical transplantation are usually obtained by culturing healthy allogeneic or exogenous tissue invitro. However, for diseases of the eye, obtaining the adequate number of cells for clinical transplantation is difficult due to the small size of tissue donors and the frequent needs of long-term amplification of cells in vitro, which results in low cell viability after transplantation. In addition, the transplanted cells often develop fibrosis or degrade and have very low survival. Embryonic stem cells(ESCs) and induced pluripotent stem cells(i PS) are also promising candidates for cell therapy. Unfortunately, the differentiation of ESCs can bring immune rejection, tumorigenicity and undesired differentiated cells, limiting its clinical application. Although i PS cells can avoid the risk of immune rejection caused by ES cell differentiation post-transplantation, the low conversion rate, the risk of tumor formation and the potentially unpredictable biological changes that could occur through genetic manipulation hinder its clinical application. Thus, the desired clinical effect of cell therapy is impaired by these factors. Recent research findings recognize that the reason for low survival of the implanted cells not only depends on the seeded cells, but also on the cell microenvironment, which determines the cell survival, proliferation and even reverse differentiation. When used for cell therapy, the transplanted cells need a specific three-dimensional structure to anchor and specific extra cellular matrix components in addition to relevant cytokine signaling to transfer the required information to support their growth. These structures present in the matrix in which the stem cells reside are known as the stem cell microenvironment. The microenvironment interaction with the stem cells provides the necessary homeostasis for cell maintenance and growth. A large number of studies suggest that to explore how to reconstruct the stem cell microenvironment and strengthen its combination with the transplanted cells are key steps to successful cell therapy. In this review, we will describe the interactions of the stem cell microenvironment with the stem cells, discuss the importance of the stem cell microenvironment for cell-based therapy in ocular diseases, and introduce the progress of stem cell-basedtherapy for ocular diseases.

Application of traditional indexes and adverse events in the ophthalmologic perioperative medical quality evaluation during 2010-2012

AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital. METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection, drug adverse events, and equipment related adverse events. RESULTS: There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and 2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were 96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72% and 90.17%, respectively ( P <0.05); the diagnostic accordance rates before and after operation were 99.86%, 99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and 76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospital during 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case (0.07%), 2 cases (0.12%), and 4 cases (0.21%), respectively; the medical device adverse events for each year were 3 cases (0.20%), 5 cases (0.30%), and 6 cases (0.31%), respectively. Noticeably, only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34% (5/1483), 0.48% (8/1662) and 0.52% (10/1931), respectively. Though incidence was rising during the three years, no statistical significance was observed (P>0.05). It is the same case with drugs and medical devices adverse events (P>0.05). CONCLUSION: Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures.

Photo News from 2019 International Ophthalmological Forum Hosted by AACO

2019 International Ophthalmological Forum (IOF 2019) was successfully held in Shenzhen, China during May 24-26, 2019. The forum was hosted by Afro-Asian Council of Ophthalmology (AACO), Guang Dong Medical Association (GDMA) and co-hosted by Zhongshan Ophthalmic Center (ZOC), Sun Yat-sen University and Shenzhen Eye Hospital (SZEH), China.

Ophthalmologic manifestations of celiac disease

Celiac disease is an autoimmune disorder that affects the small intestine of genetically predisposed individuals.Ophthalmic manifestations are within the extra-intestinal manifestations,and can be divided into those of autoimmune disorders or those due to absorptive disabilities.This article reviewed the ophthalmologic manifestation of celiac disease.Ophthalmic symptoms are rare,but should be investigated in patients with celiac disease and taken into consideration as the first systemic manifestation.

Research trends of worldwide ophthalmologic randomized controlled trials in the 21st century:A bibliometric study

Background:Randomized controlled trials(RCTs)are often considered the gold standard and the cornerstone for clinical practice.However,bibliometric studies on worldwide RCTs of ophthalmology published in the 21st century have not been reported in detail yet.This study aims to perform a bibliometric study and visualization analysis of worldwide ophthalmologic RCTs in the 21st century.Methods:Global ophthalmologic RCTs from 2000 to 2022 were searched in the Web of Science Core Collection.The number of publications,country/region,institution,author,journal,and research hotspots of RCTs were analyzed using HistCite,VOSviewer,CiteSpace,and Excel software.Results:2366 institutions and 90 journals from 83 countries/regions participated in the publication of 1769 global ophthalmologic RCTs,with the United States leading in the number of volumes and research field,and the Moorfields Eye Hospital contributing to the most publications.Ophthalmology received the greatest number of publications and co-citations.Jeffrey S.Heier owned the most publications and Jost B.Jonas owned the most cocitations.The knowledge foundations of global ophthalmologic RCTs were mainly retinopathy,glaucoma,dry eye disease(DED),and cataracts,and anti-vascular endothelial growth factor(VEGF)therapy(ranibizumab),topical ocular hypotensive medication,laser trabeculoplasty.Anti-VEGF therapy for age-related macular degeneration(AMD),DME(diabetic macular edema),and DED,the use of new diagnostic tools,and myopia were the hottest research highlights.Anti-VEGF therapy,prompt laser,triamcinolone,and verteporfin photodynamic therapy for AMD,DME,and CNV(choroidal neovascularization),DED,myopia,and open-angle glaucoma were the research hotspots with the longest duration.The future research hotspots might be DED and the prevention and control of myopia.Conclusions:Overall,the number of global ophthalmologic RCTs in the 21st century was keeping growing,there was an imbalance between the regions and institutions,and more efforts are required to raise the quantity,quality,and global impact of high-quality clinical evidence in developing countries/regions.