Cyclophotocoagulation versus Ahmed Glaucoma Implant in Neovascular Glaucoma with Poor Vision at Presentation.

Purpose: To evaluate the outcomes of surgical intervention in eyes with neovascular glaucoma (NVG) and poor vision, comparing the Ahmed glaucoma implant with cyclophotocoagulation (CPC). Patients and Methods: This study is a double-armed cohort retrospective review of medical records of patients with NVG who had a visual acuity of 20/200 or less and underwent one of the two procedures as a primary intervention: Ahmed glaucoma valve (AGV) or cyclophotocoagulation (CPC). The study was conducted at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, from January 2014 to June 2019, with a total study period of 1 year. The main outcome measures included the surgical success rate, changes in intraocular pressure (IOP), the number of antiglaucoma medications, corrected distance visual acuity, and the reoperation rate for glaucoma. Results: The preoperative IOP was 40.4 ± 10.6 mmHg (Median 40) in the CPC group and 39.4 ± 10.2 mmHg (Median 40) in the AGV group (P = 0.6). At 1 year, the IOP ranged from 12.5 to 28 mmHg (Median 18) in the CPC group and 14 to 21.5 mmHg (Median 17) in the AGV group (P = 0.016). Survival analysis showed a 51% success rate in the CPC group and an 89% success rate at 1 year in the AGV group (p>0.0001). Conclusion: CPC and AGV procedures yielded good outcomes with similar IOP levels 12 months after the surgery. However, AGV demonstrated a higher overall success rate and a lower medication requirement than CPC.

Corrigendum: Altered composition of the oral microbiota in depression among cigarette smokers: A pilot study.

[This corrects the article DOI: 10.3389/fpsyt.2022.902433.].

Risk factors, complications, and outcomes of phacoemulsification cataract surgery complicated by retained lens fragments in Asian eyes: A 10-year retrospective study.

PURPOSE: To study the risk factors, visual outcomes, and sequelae of phacoemulsification surgery complicated by retained lens fragments (RLFs). METHODS: This single-center case-control study enrolled consecutive eyes complicated by RLF and compared them to age- and gender-matched uneventful cataract surgery cases at a tertiary care teaching hospital. Biometric, intraoperative, and postoperative data were collected. The primary outcome measures were risk factors, visual outcomes, and rate of postoperative complications. RESULTS: The study and control groups included 282 and 289 eyes, respectively. The estimated incidence of RLF was 1.47% during the study. We found a statistically higher risk of RLF among diabetics (P < 0.001), those with a history of intravitreal injections (P = 0.001), eyes with dense nuclear sclerosis, anterior capsular cataract (P < 0.001), and posterior polar cataract (P = 0.01). There was a statistically higher risk of RLF in eyes with a higher mean preoperative visual acuity (logarithm of the minimum angle of resolution) (P < 0.001) and in cases performed by trainees (P < 0.001). Most eyes in the RLF group (n = 207, 73.4%) retained their preoperative vision or experienced a one-line improvement in visual acuity and 14 eyes (5.3%) experienced more than one-line improvement in vision. CONCLUSION: Although RLFs are rare, they can affect the quality of postoperative vision and outcomes of complicated phacoemulsification surgery.

Altered Composition of the Oral Microbiota in Depression Among Cigarette Smokers: A Pilot Study.

Alterations in the oral microbiota composition may influence mental health. However, linkages between compositional changes in the oral microbiota and their role in mental health among cigarette smokers remain largely unknown. In this study, we used shotgun metagenomics data for the oral microbiome of 105 participants. The data showed Bacteroidota, Fusobacteriota, Firmicutes, Proteobacteria, and Actinobacteria to be the most abundant phyla; Streptococcus, Haemophilus D, and Veillonella are the most abundant genera. Then, we clustered our subjects into avoidance and activation groups based on the behavioral activation for depression scale (BADS). Interestingly, the avoidance group exhibited a higher oral microbiome richness and diversity (alpha diversity). Differential abundance testing between BADS avoidance and activation groups showed the phyla Bacteroidota (effect size 0.5047, q = 0.0037), Campylobacterota (effect size 0.4012, q = 0.0276), Firmicutes A (effect size 0.3646, q = 0.0128), Firmicutes I (effect size 0.3581, q = 0.0268), and Fusobacteriota (effect size 0.6055, q = 0.0018) to be significantly increased in the avoidance group, but Verrucomicrobiota (effect size-0.6544, q = 0.0401), was found to be significantly decreased in the avoidance risk group. Network analysis of the 50 genera displaying the highest variation between both groups identified Campylobacter B, Centipeda, and Veillonella as hub nodes in the avoidance group. In contrast, Haemophilus and Streptococcus were identified as hub nodes in the activation group. Next, we investigated functional profiles of the oral microbiota based on BADS avoidance and activation groups and found Lysine degradations pathway was significantly enriched between both groups (ANCOM-BC, q = 0.0692). Altogether, we provide evidence for the presence of depression-related changes in the oral microbiota of smokers and possible functional contribution. The identified differences provide new information to enrich our understanding of oral microbiota-brain axis interplay and their potential impact on mental health.

Insights on hydrogen spillover on carbonaceous supports.

Hydrogen spillover is important in solid-phase catalytic hydrogenation reactions, as well as in hydrogen storage and scavenging. The present study explores the nature of this phenomenon by examining the effects of hydrogen pressure and addition of carbonaceous additives, such as carbon nanotubes (CNT) and C60 fullerene, on hydrogenation reaction kinetics and its products distribution. For these purposes, a solid-phase hydrogenation reaction was studied, where 1,4-bis-(phenyl-ethynyl)benzene (PEB) was used as a hydrogen acceptor. To the best of our knowledge, this is the first study in which both the reaction kinetics and products distribution of the solid-phase organic hydrogen acceptor were analyzed. A demonstration of hydrogen spillover phenomenon was provided on the basis of the combined interpretation of kinetics and hydrogenated organic products distribution, under different reaction conditions. The results were explained in terms of hydrogen active species availability, distribution and relative migration distance of these species through the carbonaceous media. The insights into the hydrogen spillover chemistry obtained in this research allow for a better understanding of this phenomenon and its implementation in the future hydrogen storage and transportation, and hydrogen-generating devices, including safety aspects of all these applications.

Physician Satisfaction With Virtual Ophthalmology Clinics During the COVID-19 Pandemic: A Tertiary Eye Care Center Experience.

Background In this study, we aimed to assess ophthalmologists' experience with teleophthalmology during the coronavirus disease 2019 (COVID-19) pandemic in the central region of Saudi Arabia. In addition, we evaluated their satisfaction level and explored their satisfaction determinants. Methodology We conducted an online survey for ophthalmologists who participated in the virtual ophthalmology clinic during COVID-19 between November 2020 and September 2021. The survey was used to evaluate ophthalmologists' experience with teleophthalmology during the pandemic. Ophthalmologists were asked to measure their satisfaction with equipment and technical issues, communication, and clinical assessment, and to provide an overall program evaluation. Data were analyzed via frequency measures (e.g., numbers, percentages, mean, and standard deviation). Results Out of the 113 ophthalmologists who were invited to participate in our study, 71 completed the survey. In total, 23 (32.4%) participants were general ophthalmologists, 15 (21.1%) were subspecialists in the cornea, 16 (22.5%) were subspecialists in glaucoma, one (1.4%) was a subspecialist in neuro-ophthalmology, seven (9.9%) were subspecialists in pediatric ophthalmology, eight (11.3%) were subspecialists in the retina, and one (1.4%) participant was a subspecialist in oculoplastic. Overall, 56.3% of the respondents were satisfied with teleophthalmology. Ophthalmologists who subspecialized in the retina demonstrated higher levels of satisfaction than other subspecialties. The most common challenge reported by ophthalmologists in the virtual consultation was the lack of adequate equipment to evaluate the patients (53.5%), followed by technical issues (43.7%) and the patients' lack of experience in using virtual consultation services (38%). Overall satisfaction score was the highest among ophthalmologists who reported providing at least five video consultations before the survey. Conclusions The findings from our study suggest that the subspeciality of ophthalmologists and the number of video consultations conducted by ophthalmologists are important determinants in their level of satisfaction with teleophthalmology. The majority of the respondents were satisfied with the virtual clinic during the COVID-19 pandemic. The current pandemic could pave the way for the future use of telemedicine in ophthalmology if virtual eye examinations become standardized.

Intermediate Outcomes of Deep Sclerectomy in Juvenile Glaucoma.

PRCIS: In this retrospective study of patients with predominantly severe juvenile open-angle glaucoma, deep sclerectomy (DS) achieved a success rate [defined as intraocular pressure (IOP) between 5 to 18 mm Hg] of 72% at 3 years. PURPOSE: The purpose of this study was to evaluate the safety and efficacy of DS in patients with juvenile open-angle glaucoma (JOAG). METHODS: A retrospective chart review of all JOAG patients that underwent DS with mitomycin C at a tertiary care eye center during the period from May 2014 to May 2019. RESULTS: A total of 50 eyes in 37 patients were included. The mean age at the time of surgery was 27.1±11.3 years and the majority of patients (86%) had a cup-disc ratio of 0.8 to 0.9. The mean duration of follow-up was 26.1±13.4 months (range 12 to 54 mo). Mean IOP was reduced from 26.1±13.4 mm Hg at baseline to 15.2±6.4 mm Hg at the last follow-up visit (P<0.01). Moreover, the mean number of glaucoma medications decreased from 3.8±0.5 at baseline to 0.8±1.2 at the last follow-up visit (P<0.01). The cumulative probabilities of overall success (defined as IOP between 5 and 18 mm Hg) at 12, 24, and 36 months were 94%, 85%, and 72%, respectively. Hypotony occurred in 4 eyes (8%), and in one of these patients, the final visual acuity was >2 lines worse compared with presentation. No other vision-threatening complications were encountered. CONCLUSION: DS in JOAG was safe and successfully controlled IOP in most patients for 3 years.

Axial Length Changes Following Surgical Intervention in Children With Primary Congenital Glaucoma.

Background: Primary congenital glaucoma (PCG) is a challenging condition to diagnose, treat and effectively monitor. Serial assessment of intraocular pressure (IOP), optic disc cupping, refraction, and axial length (AxL) after surgery are useful to assess disease control. This study aimed to evaluate AxL changes in relation to IOP changes following glaucoma surgery in children with PCG. Methods: We retrospectively studied AxL changes in children with PCG undergoing surgery. Eyes of children aged ≤ 4 years that did not have prior ocular surgery and that underwent at least one glaucoma surgery during the course of follow-up between June 2014 and July 2018, were included. The effect of change in IOP on change in AxL was estimated using linear mixed effects models. Results: A total of 105 eyes (of 72 children) with PCG underwent glaucoma surgery representing 26.4% (105/397) eyes. The mean ± SD age of children at baseline was 3.53 ± 4.04 months. At baseline, the mean IOP and AxL were 26.63 ± 9.57 mmHg and 21.67 ± 1.82 mm, respectively. During the course of follow-up post-surgery, the IOP decreased by a mean of 7.25 ± 12.08 mmHg while the AxL increased by a mean of 0.70 ± 1.40 mm. A multivariable mixed effects linear regression revealed that change in AxL was significantly associated with change in IOP (p=0.030) and time since first surgery (p<0.001). A substantial reduction in IOP (≥35 mmHg) was needed at 3 months post-surgery, for AxL to regress. Conclusion: In children with PCG who undergo glaucoma surgery, change in IOP significantly influences change in AxL. For AxL to regress, a substantial reduction in IOP is needed post-surgery.

The Effect of Tube Ligature on the Safety and Efficacy of Ahmed Glaucoma Valve Surgery.

PRECIS: In this matched case-control study, ligature of the Ahmed glaucoma valve (AGV) was associated with a reduction in the rate of postoperative complications without affecting the surgical success rate or the visual outcome following the procedure. PURPOSE: The purpose of this study was to compare the safety and efficacy of AGV surgery with and without tube ligation. MATERIALS AND METHODS: This was a retrospective, matched case-control study. A review was performed of patients who underwent AGV surgery with tube ligation between June 2015 and December 2017 (ligated AGV group). Cases were matched with controls who underwent AGV surgery without tube ligation (nonligated AGV group). Data were compared on postoperative intraocular pressure (IOP), the number of glaucoma medications, surgical success rates, complications, and vision. RESULTS: There were 49 eyes in the ligated AGV group, and 98 eyes in the nonligated AGV group. Baseline characteristics were similar between groups except for the number of glaucoma medications (3.72±0.55 in the ligated AGV group vs. 3.92±0.92 in the nonligated AGV group; P<0.01). At 18 months, IOP was 16.7±6.3 mm Hg in the ligated AGV group and 17.3±8.0 mm Hg in the nonligated AGV group (P=0.76). In addition, the mean number of glaucoma medications was 2.38±1.10 in the ligated AGV group and 1.68±1.51 in the nonligated AGV group (P=0.56). The overall success rate at 12 months was similar between groups (P=0.84). The overall rate of complications was statistically lower in the ligated AGV group (28.6%) compared with the nonligated AGV group (73.5%) (P<0.01). The mean change in logarithm of the minimum angle of resolution acuity was similar between groups (P=0.50). CONCLUSION: Tube ligation in AGV surgery may be an effective measure that reduces the rate of postoperative complications without affecting the success rate or visual outcomes of the surgery.

ExPress mini shunt device with trabeculectomy surgery in patients with uncontrolled glaucoma of Middle Eastern descent.

PURPOSE: The aim of this study is to assess the efficacy and safety of ExPress mini shunt in glaucoma patients of Middle Eastern descent. METHODS: This is a prospective cohort study. Uncontrolled glaucoma patients were subjected to ExPress mini-shunt implant. Pre- and post-operative glaucoma clinical indices were measured and compared. Both intra- and postoperative complications and surgical success rates were assessed. In addition to comparing a group of combined ExPress mini-shunt implant with cataract surgery versus ExPress mini-shunt implant alone. RESULTS: A total of 35 eyes of 31 patients were involved. The most common type of glaucoma was primary open-angle glaucoma in 13 eyes (37.1%). Fourteen eyes (40.0%) were combined ExPress device with cataract surgery. The mean intraocular pressure (IOP) (±standard deviation) at the last visit dropped from 24.6 mmHg (±8.3) to 13.9 mmHg (±4.5). There was a significant reduction in the number of postoperative glaucoma medications from 3.0 ± 0.5 to 1.3 (±0.7). In cases combined with cataract extraction, the patients required fewer anti-glaucoma medications. Complete success was achieved in 22 eyes (63%) and qualified success was achieved in 9 eyes (26%), whereas 4 eyes (11%) were considered a failure. The two most common complications encountered were hypotony (28.6%) and hyphema (11.4%). CONCLUSION: Among the studied population of patients, ExPress offers IOP reduction that is comparable to reported rates following standard trabeculectomy. Postoperative hyphema was encountered at a slightly higher rate.

The integration of transabdominal ultrasound simulators into an ultrasound curriculum.

INTRODUCTION: Simulation is increasingly used throughout medicine. Within ultrasound, simulators are more established for learning transvaginal and interventional procedures. The use of modern high-fidelity transabdominal simulators is increasing, particularly in centres with large trainee numbers. There is no current literature on the value of these simulators in gaining competence in abdominal ultrasound. The aim was to investigate the impact of a new ultrasound curriculum, incorporating transabdominal simulators into the first year of training in a UK radiology academy. METHODS: The simulator group included 13 trainees. The preceding cohort of 15 trainees was the control group. After 10 months, a clinical assessment was performed to assess whether the new curriculum resulted in improved ultrasound skills. Questionnaires were designed to explore the acceptability of simulation training and whether it had any impact on confidence levels. RESULTS: Trainees who had received simulator-enriched training scored higher in an objective clinical ultrasound assessment, which was statistically significant (p = 0.0463). End confidence scores for obtaining diagnostic images and demonstrating pathology were also higher in the simulation group. All trainees stated that transabdominal simulator training was useful in early training. CONCLUSIONS: This initial study shows that embedded into a curriculum, transabdominal ultrasound simulators are an acceptable training method that can result in improved ultrasound skills and higher confidence levels. Using simulators early in training could allow trainees to master the basics, improve their confidence, enabling them to get more educational value from clinical ultrasound experience while reducing the impact of training on service provision.

Anatomic variations of the paranasal sinuses in the general pediatric population.

BACKGROUND: The prevalence of sinuses' anatomic variations in the healthy pediatric population has not been studied. The study describes the prevalence of known anatomic variations with regard to gender and age in this population. METHODS: A single academic institute observational cohort study. A total of 200 head CT scans were reviewed, subdivided into five equal age subgroups (0-4.99; 5-7.99; 8-10.99; 11-13.99; 14-17 years), with an equal male to female ratio. Different subgroups were randomly assigned to two senior residents (100 CTs each). A senior rhinologist and radiologist were randomly selected to review 100 CTs each. Consensus was reached after a joint review. Each CT was evaluated for the presence of sinuses and the following variations: deviated septum, frontoethmoidal, infraorbital, posterior-ethmoid cells (Kuhn, Haller, and Onodi cells, respectively) and concha bullosa. Definitions were made according to the European Position on Rhinosinusitis 2012. RESULTS: Gender did not affect sinus development or anatomical variations. The frontal and sphenoid sinuses were significantly less developed in the 0-4.99 years group. The point prevalence of concha bullosa and deviated septum significantly increased with age. The point prevalence of Haller cells demonstrated borderline significance among age groups, with children 0-4.99 demonstrating the lowest point prevalence. A significant association was found between the existence of Haller cells to Kuhn and Onodi cells. CONCLUSIONS: Anatomical variations should be expected in the pediatric population. Familiarity with their point prevalence and associations may assist pediatric endoscopic sinus surgery planning.

Incidence, Risk Factors and Surgical Outcomes of Cataract among Patients with Uveitis in a University Referral Hospital in Riyadh, Saudi Arabia.

Purpose: To investigate incidence, risk factors, and surgical outcomes of cataract among uveitis patients. Methods: Retrospective review of 1000 patients (1582 eyes). Results: At initial presentation, cataract was diagnosed in 290 (18.3%) eyes and was most common in eyes with anterior uveitis. Fuchs' uveitis, herpetic uveitis, and presumed tuberculous uveitis were leading clinical entities associated with cataract at presentation. During follow-up, cataract developed in additional 200 (12.6%) eyes and was most common in eyes with anterior uveitis. Significant risk factors at presentation included age >18 years, female gender, presence of keratic precipitates, hypopyon, and posterior synechiae. Among the 490 eyes with cataract, 204 underwent cataract extraction during follow-up period. Best corrected vision of ≥20/40 was achieved in 122 (60.1%) eyes. Conclusions: Incidence of cataract differed depending on anatomic and etiologic diagnoses of uveitis. There is a significant association between severity of inflammation at presentation and development of cataract.

The Role of Diet in Glaucoma: A Review of the Current Evidence.

Intraocular pressure (IOP) reduction by medications, laser, or surgery remains the mainstay of treatment in glaucoma. However, the role of complementary and alternative medicine (CAM) in glaucoma has received great interest from both patients and ophthalmologists. Previous evidence suggests that diet, a major domain of CAM, can influence an individual's IOP level. Furthermore, certain dietary components have been linked to the incidence and progression of glaucoma. In this review, we aim to provide a summary of the current evidence regarding the role of obesity, certain dietary components, and dietary supplements in glaucoma.

A Review of Passive RFID Tag Antenna-Based Sensors and Systems for Structural Health Monitoring Applications.

In recent few years, the antenna and sensor communities have witnessed a considerable integration of radio frequency identification (RFID) tag antennas and sensors because of the impetus provided by internet of things (IoT) and cyber-physical systems (CPS). Such types of sensor can find potential applications in structural health monitoring (SHM) because of their passive, wireless, simple, compact size, and multimodal nature, particular in large scale infrastructures during their lifecycle. The big data from these ubiquitous sensors are expected to generate a big impact for intelligent monitoring. A remarkable number of scientific papers demonstrate the possibility that objects can be remotely tracked and intelligently monitored for their physical/chemical/mechanical properties and environment conditions. Most of the work focuses on antenna design, and significant information has been generated to demonstrate feasibilities. Further information is needed to gain deep understanding of the passive RFID antenna sensor systems in order to make them reliable and practical. Nevertheless, this information is scattered over much literature. This paper is to comprehensively summarize and clearly highlight the challenges and state-of-the-art methods of passive RFID antenna sensors and systems in terms of sensing and communication from system point of view. Future trends are also discussed. The future research and development in UK are suggested as well.

Results of conservative treatment of volar plate sprains of the proximal interphalangeal joint with and without avulsion fracture.

The prognosis of isolated volar plate sprains of the proximal interphalangeal (PIP) joint is related to the extension deficit. Some consider an associated avulsion fracture as a sign of severity. The goal of this study was to find out whether the outcomes of conservative treatment in PIP volar plate injury was impacted by the presence of an avulsion fracture. Our series included 75 patients, 27 years old on average, of which 58 were men. All sprains were stable. The X-rays were normal in 52 cases (group 1); an avulsion fracture was found in 23 cases (group 2). The patients were treated by buddy taping during the day and a straight finger splint at night for 3 weeks. At the last follow-up, no significant difference was found between the two groups regarding pain, extension/flexion range of motion or edema. The results of this study show that the prognosis of conservative treatment of PIP volar plate injuries does not depend on the presence of an avulsion fracture.

Unsuspected serious abdominal trauma after falls among community-dwelling older adults.

BACKGROUND: In elderly community-dwelling patients who experience ground-level falls, fractures or brain injury are the major concern. Serious abdominal injury is seldom contemplated. AIM: Identify all such patients presenting after a simple fall and admitted with serious blunt abdominal trauma to a single academic medical centre. DESIGN: Retrospective chart analysis. METHOD: All patients with both diagnoses aged 65 years or more admitted over 1 year to the department of medicine, geriatrics, surgery or urology were identified. RESULTS: Out of 546 patients screened, three cases of ground-level falls leading to splenic rupture, isolated gallbladder rupture with gallstone ileus and perinephric hematoma were found (0.55%) and are reported. CONCLUSIONS: Falls in elderly patients are exceedingly common mandating recognition of even rare complications. Physicians should be more aware of the possibility of occult and serious consequences of blunt abdominal trauma after falls among older adults, albeit rare.