Perceptual learning with hand – eye coordination as an effective tool for managing amblyopia: A prospective study

Purpose: Amblyopia is a serious condition resulting in monocular impairment of vision. Although traditional treatment improves vision, we attempted to explore the results of perceptual learning in this study. Methods: This prospective cohort study included all patients with amblyopia who were subjected to perceptual learning. The presenting data on vision, stereopsis and contrast sensitivity were documented in a pretested online format, and the pre? and post?treatment information was compared using descriptive, cross?tabulation and comparative methods on SPSS 2.2. The mean values were obtained, and P < 0.05 was considered statistically significant. Results: The cohort consisted of 47 patients (23 females and 24 males) with a mean age of 14.11 ± 7.13 years. A statistically significant improvement was detected in visual acuity after the perceptual learning session, and the median follow?up period was 17 days. Also, significant improvements were observed in stereopsis but not in the visual outcomes among the age groups. Conclusion: Perceptual learning with hand–eye coordination is an effective method for managing amblyopia. This approach can improve vision in all age groups. However, visual improvement is significantly influenced by ocular alignment.

Effect of intravitreal injection of Ranibizumab on macular edema in retinal vein occlusion and the analysis of visual acuity recovery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the effect of intravitreal injection of ranibizumab in the treatment of retinal vein occlusion macular edema(RVO-ME), and to apply Logistic regression analysis to screen the factors that affect the vision recovery of patients. <p>METHODS: A total of 106 patients(106 eyes)with retinal vein occlusion and macular edema who were treated in the ophthalmology clinic of our hospital from January 2018 to June 2019 were selected for the study. The clinical data of the patients were retrospectively analyzed and all were given 0.05mL ranibizumab. The monoclonal antibody was injected into the vitreous cavity of the affected eye, and the patients were followed up to observe the treatment effect. The patients were divided into good group and poor group according to the degree of vision recovery after 3mo of treatment, and the two-class Logistic regression analysis was used to screen the factors that affect the vision recovery of patients.<p>RESULTS: The Logarithm of the minimum angle of resolution(LogMAR)of the affected eye at 1d, 1wk, 1, and 3mo after treatment was significantly lower than before treatment, and the macular foveal retinal thickness(CRT)was significantly lower than before treatment. The difference was statistically significant(all P<0.05), and there was no significant difference in the average intraocular pressure of the affected eye before and after treatment(P>0.05). During and after the treatment, the patient did not develop complications such as endophthalmitis, increased intraocular pressure, lens opacity, and retinal detachment. Logistic regression analysis showed that there was no capillary perfusion in the foveal area of the macula and the center of the macula before treatment. Incomplete outer membrane and incomplete inner plexiform layer structure in the concave area are risk factors that affect the efficacy of ranibizumab injection. <p>CONCLUSION: Intravitreal injection of ranibizumab in the treatment of retinal vein occlusion combined with macular edema is effective and safe in the short term. It can effectively reduce macular edema of the affected eye, improve vision, and normal intraocular pressure after treatment, and it is easy to operate and effective. It has the advantages of repeating, little damage to tissues, no obvious adverse reactions, less pain for patients, economical and practical. In addition, the lack of capillary perfusion in the foveal area of the macula before treatment, the incomplete outer membrane of the foveal area, and the incomplete structure of the inner plexiform layer are risk factors that affect the efficacy of ranibizumab in the treatment of retinal vein occlusion and macular edema.

Análisis de costos en la cirugía de catarata por facoemulsificación bilateral simultánea versus facoemulsificación bilateral secuencial / Cost analysis of simultaneous bilateral phacoemulsification cataract surgery versus sequential bilateral phacoemulsification

RESUMEN Objetivo: Evaluar el costo en la cirugía de catarata por facoemulsificación bilateral simultánea vs. facoemulsificación bilateral secuencial, con implante de lente intraocular. Métodos: Se realizó un estudio analítico de evaluación económica en 762 pacientes mayores de 50 años, intervenidos de catarata con la cirugía de facoemulsificación bilateral simultánea (grupo I), y 762 pacientes operados de catarata con la cirugía de facoemulsificación bilateral secuencial (grupo II), en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, del año 2014 al 2019. Se evaluaron los costos en recursos humanos, materiales e indirectos, así como los costos totales de ambos grupos después de la intervención quirúrgica, partiendo de la demostración científica de que ambos procedimientos son igualmente eficaces. Resultados: Predominó la edad de 61 a 80 años y el sexo femenino (75 por ciento) en ambos grupos. Los costos unitarios relacionados con los recursos humanos disminuyeron en 1,69 pesos para el grupo I, mientras que los costos totales y unitarios en relación con los recursos materiales fueron similares en ambos grupos. Los costos unitarios indirectos disminuyeron en 3,63 pesos en el grupo I. Finalmente, el costo unitario total para el grupo de cirugía bilateral simultánea resultó 6,19 pesos menor que el de cirugía bilateral secuencial. Conclusiones: La cirugía de catarata por facoemulsificación bilateral simultánea tiene menores costos que la facoemulsificación bilateral secuencial(AU)

ABSTRACT Objective: Evaluate the cost of simultaneous bilateral phacoemulsification cataract surgery vs. sequential bilateral phacoemulsification with intraocular lens implantation. Methods: An analytic economic evaluation was conducted of 762 patients aged over 50 years undergoing simultaneous bilateral phacoemulsification cataract surgery and 762 patients undergoing sequential bilateral phacoemulsification cataract surgery at Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period 2014-2019. Evaluation was performed of costs incurred on human resources and materials, indirect costs, and total costs for the two groups after surgery, starting from the scientific certainty that both procedures are equally effective. Results: The 61-80 years age group and female sex (75 percent) prevailed in both groups. Human resources unit costs decreased 1.69 CUP in group I, whereas material resources total and unit costs were similar in both groups. Indirect unit costs decreased 3.63 CUP in group I. Total unit cost was 6.19 CUP lower in the simultaneous bilateral surgery group than in the sequential bilateral surgery group. Conclusions: Simultaneous bilateral phacoemulsification cataract surgery is more cost-effective than sequential bilateral phacoemulsification(AU)

Effects of different phases IOL implantation on the postoperative visual recovery and complications in patients with traumatic cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the visual recovery and complications in patients with traumatic cataract treated by intraocular lens Ⅰ phase implantation and Ⅱ phase implantation.?METHODS: Totally 86 patients with traumatic cataract (86 eyes) treated in our hospital from January 2014 to December 2016 were enrolled in the retrospective study, and they were divided into the control group ( treated by intraocular lens Ⅰ phase implantation, 46 eyes) and the observation group ( treated by intraocular lens Ⅱ phase implantation, 40 eyes). The general situation of surgery, the visual recovery at 6mo after operation and the incidence rate of complications in two groups were observed.?RESULTS: There were no significant differences in surgical time, intraoperative blood loss and hospitalization time between the two groups (P>0. 05). There was no significant difference in the excellent and good rate of visual acuity between the two groups before operation between the twogroups (P>0. 05). At 6mo after operation, the excellent and good rates of visual acuity in two groups obviously increased ( P<0. 05 ), while there was no significant difference in the excellent and good rates of visual acuity at 6mo after operation between the two groups ( P > 0. 05 ). There was no significant difference between the two groups in the incidence rates of posterior capsule rupture and vitreous body prolapse (P>0. 05). The incidence rates of corneal edema, iridocyclitis and posterior capsular opacification in the observation group after operation were significantly lower than those in control group (P<0. 05).?CONCLUSION:The effects of IOLⅠphase implantation and Ⅱ phase implantation are similar in patients with traumatic cataract, in terms of the general situation and improvement of visual recovery. However, the incidence of complications after Ⅱ phase implantation is relatively lower.

Clinical Analysis of Factors Affecting Successful Occlusion Treatment and Visual Recovery Time in Amblyopia

PURPOSE: To evaluate the factors affecting successful occlusion treatment and visual recovery time in patients with amblyopia when best corrected visual acuity (BCVA) improved up to 1.0 after occlusion. METHODS: Forty-eight patients aged 2 to 13 years old with amblyopia due to refractive errors or strabismus were selected. The duration of treatment needed to achieve a BCVA of 1.0 was compared according to the cause of amblyopia (anisometropia, strabismus, combined), initial BCVA of the amblyopic eye, and the age at treatment, as well as other factors. RESULTS: The mean age of amblyopic treatment was 5.4 years old and the mean duration of treatment was 22.9 months. The duration of treatment was longer in children whose initial BCVA was lower than 0.2, those with spherical equivalent of the amblyopic eye higher than +3.0D and those older than 6 years old. However, there were no significant differences according to the cause of amblyopia. CONCLUSIONS: The duration of treatment needed to achieve a BCVA of 1.0 was prolonged when the initial BCVA in the amblyopic eye was lower than 0.2, the age at treatment was more than 6 years old, or the spherical equivalent of the amblyopic eye was higher than +3.0D at treatment. These factors can be used to predict the duration of occlusion treatment.

Factores predictivos para resultados funcionales en la cirugía del agujero macular idiopático / Predictive factors for attaining functional results in the idiopathic macular hole surgery

Introducción: el agujero macular idiopático (AMI) es una maculopatía frecuente, caracterizada por una dehiscencia de retina en la zona foveal. Actualmente, aparecen discrepancias morfofuncionales tras su cirugía y el periodo de recuperación visual varía y puede ser largo. Por tal motivo, toma valor la consideración de factores predictivos para la recuperación visual posquirúrgica del agujero macular idiopático. Objetivo: esta revisión de la literatura pretende mostrar los factores predictivos relacionados con los resultados funcionales de la cirugía del AMI. Métodos se realizó una búsqueda en diferentes publicaciones y textos básicos de la especialidad. Resultados: se encontró que las investigaciones recogen dentro de los factores de buen pronóstico para la recuperación funcional: estadío 2 del agujero macular, menor tiempo de evolución, diámetro superior menor de 400 µm, factor forma del agujero macular > 0,9, índice del agujero macular < 0,5, tipo de cierre en U y recuperación de la línea límite de los segmentos externos de los conos en la fóvea, entre otros. Conclusiones: en esta revisión se exponen con claridad los factores relacionados con la recuperación funcional tras la cirugía del agujero macular idiopático, cuya consideración constante proporcionará a los oftalmólogos las herramientas para brindar una atención médica de excelencia y, por consiguiente, una elevación de la calidad de vida de los pacientes con esta enfermedad

Introduction: idiopathic macular hole is a common maculopathy characterized by retinal deshicence in the foveal area. There occur at present some morphofunctional discrepancies after surgery and the visual recovery period could be long. For these reasons, it is important to consider predictive factors for the postsurgical visual recovery of the idiopathic macular hole. Objective: this literature review was aimed at showing the predictive factors related to the functional results of the idiopathic macular hole surgery, for which a search into different publications and basic textbooks of the specialty was made. Methods: search into different publications and basic textbooks of the specialty. Results: the research works collected some factors of good prognosis for functional recovery such as: staging II of the macular hole, less time of evolution, upper diameter lower than 400 Ám, macular hole form over 0.9, macular hole index lower than 0.5, U-type closure and recovery of the limit line of the external segments of cones in the fovea, among other factors. Conclusions: this review clearly presents the factors related to functional recovery after idiopathic macular hole surgery; the permanent consideration of these factors will provide the ophthalmologists with the necessary tools to render optimal medical care, and consequently, a rise of the life of quality in those patients suffering Keywords: idiopathic macular hole, predictive factors, functional visual recovery from this disease

Clinical Characteristics of Optic Neuritis in Koreans Greater than 50 Years of Age

PURPOSE: To report clinical characteristics of optic neuritis (ON) in Koreans >50 years of age. METHODS: A retrospective chart review was performed on patients with ON between January 2000 and December 2009. We obtained the best-corrected visual acuity (BCVA), Goldmann perimetry, relative afferent pupillary defect (RAPD), and color function tests as well as brain magnetic resonance imaging (MRI) findings in patients who were in the acute stage of the disorder. RESULTS: Nine eyes in eight patients were included. The mean age of patients at presentation was 60.5 years (range, 53 to 71 years). Six patients were female, and two were male. There was one patient with bilateral ON. The mean BCVA at presentation was 20 / 400 (no light perception-20 / 70). Eight eyes (89%) complained of pain with eye movement. Six eyes (66%) had disc edema. Central scotoma was the most common field defect. All eyes had color abnormalities. Five eyes in four patients showed abnormalities of the involved optic nerves on MRI. The patients were followed for a mean of 11.3 months (range, 2 to 34 months). All of the patients recovered to a BCVA of 20 / 40 or better within 2 months. On the last follow-up, the mean BCVA was 20 / 20 (20 / 40 to 20 / 16). Four eyes showed remnant central scotoma. One eye had remnant RAPD, and two eyes had mild color abnormalities. CONCLUSIONS: Although ON is uncommon in elderly patients, it can develop in patients >50 years of age, and clinical features of optic neuritis in elderly patients are similar to those of younger patients.

Clinical Manifestations of Optic Neuritis

Optic neuritis is an acute inflammatory disease of the optic nerve. Visual loss in optic neuritis is typically sudden and accompanied visual field defects. We attempted to characterize the clinical manifestations of optic neuritis based on visual acuity and visual field changes. Eighteen patients were included in this study who completed at least 3 month follow-up. we observed these patients with no medication in ten, with oral prednisolone in seven and with intravenous methylprednisolone in one. Statistically significant visual recovery occurred at first and second month and twenty eyes of 27 eyes (74%) had improved o.5 or more. Most common type of visual field defect was central scotoma (74%) and 85% of eyes who showed abnormal visual fields at first visit recovered normal visual field during follow-up period.

Clinical Results of Silicone Foldable IOL Implanted Through Small Incision

Small incision cataract surgery has many advantages such as less induced corneal astigmatism, fast visual recovery, and fast rehabilitation. We had implatned the newly developed Staar AA-4203 foldable silicone IOL in the ag of 100 cataractous eye and followed for at least 3 months (3-0 months, mean 6 months). Silicone IOLs were implanted using a specific injector through 4mm scleral pocket incision after continuous circular capsulorhexis and bimanual phacoemulsification. The lenses were centered well in 99% of eyes. Tear of anterior capsule occurred in one eye (1%), and tear of both anterior and posterior cassule occurred in another one eye (1%) during IOL implatation. The IOL was displaced into the vitreous in the latter eye, which was reoperated. The preoperative and postoperative cornedal astigmatism at 1 day, 1 month, 2 month and 3 month was -O.14 +/- 0.83 D of with the rule astigmatism (WTR), -0.55 +/- 1.06 D of WTR, -0.28 +/- 0.91 D of WTR, -0.07 +/- 0.81 D of WTR, and O.01 +/- 0.84 D of against the rule astigmatism respectively. Uncorrected VA of 1.0 was 35% at postoperative 1 day, 52% at 1 month, 48% at 2 month. Corrected VA of 1.0 was 65% at postoperative 1 day, 87% at 1 month, 88% at 2 month. Inflammatory reaction in the anterior chamber and vitreous had subsided within one or two months without any complications in 99% of eyes. Fibrinous membrane on the suface of IOL occurred in 2 eyes (2%), one of which caused grave sequelae. The results, although it showed early postoperative results, reflected that the above silicone foldable IOL fitted to the small incision cataract surgery guaranteed us the safety and fast visual recovery.