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

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.

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.

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.

Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Improving the training abilities of ophthalmic educators: the Ophthalmology Foundation’s initiatives

Our goal as medical educators is for our students to learn what they need to know and competently perform ophthalmic procedures.In addition,the students need to have good communication skills and behave professionally and ethically(1,2).Most medical educators are not taught how to teach but rather learn by role-modeling their mentors.This can be good or bad depending on the mentor!In addition,the amount of knowledge and numbers of surgical procedures is ever increasing and yet,in most countries,the amount of time to train and become competent is not changing.Thus,our goal of creating competent ophthalmologists is ever more challenging.

Guidelines on clinical research evaluation of artificial intelligence in ophthalmology(2023)

With the upsurge of artificial intelligence(AI)technology in the medical field,its application in ophthalmology has become a cutting-edge research field.Notably,machine learning techniques have shown remarkable achievements in diagnosing,intervening,and predicting ophthalmic diseases.To meet the requirements of clinical research and fit the actual progress of clinical diagnosis and treatment of ophthalmic AI,the Ophthalmic Imaging and Intelligent Medicine Branch and the Intelligent Medicine Committee of Chinese Medicine Education Association organized experts to integrate recent evaluation reports of clinical AI research at home and abroad and formed a guideline on clinical research evaluation of AI in ophthalmology after several rounds of discussion and modification.The main content includes the background and method of developing this guideline,an introduction to international guidelines on the clinical research evaluation of AI,and the evaluation methods of clinical ophthalmic AI models.This guideline introduces general evaluation methods of clinical ophthalmic AI research,evaluation methods of clinical ophthalmic AI models,and commonly-used indices and formulae for clinical ophthalmic AI model evaluation in detail,and amply elaborates the evaluation methods of clinical ophthalmic AI trials.This guideline aims to provide guidance and norms for clinical researchers of ophthalmic AI,promote the development of regularization and standardization,and further improve the overall level of clinical ophthalmic AI research evaluations.

Flipped classroom approach to global outreach:cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.