Phacoemulsification versus Laser Peripheral Iridotomy for Treating Primary Angle Closure Glaucoma: A Systematic Review and Meta-Analysis.

Background: Primary Angle Closure Glaucoma (PACG), is caused by narrowing the iridocorneal angle and increases the risk of blockage in the trabecular meshwork. Phacoemulsification and laser peripheral iridotomy (LPI) effectively control IOP elevation and widen the angle. This systematic review and meta-analysis compared Phacoemulsification and LPI Effectiveness for PACG. Methods: We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared Phacoemulsification and LPI for individuals with PACG. We sought to evaluate the following outcomes: mean IOP, number of glaucoma medications, visual acuity (VA), visual field (VF) progression, peripheral anterior synechiae (PAS), Shaffer gonioscopy grading, central corneal thickness (CCT), central endothelial cell density (CECD), and poor response to surgery. The standardized mean difference (SMD) was used to represent continuous outcomes, while the risk ratio (RR) was used to represent dichotomous outcomes. Results: 5 RCTs that enrolled 917 participants were deemed eligible. The phacoemulsification group showed statistically significance lower mean CCT and CECD and lower risk of poor response to surgery compared to LPI (SMD = -1.10; 95% -1.50, -0.70; P<0.001, SMD -366.12; 95% -652.59, -79.65; P=0.01, and RR 0.35; 95% 0.23, 0.54; P<0.001 respectively). There were no significant improvement in IOP and number of medications between both groups (SMD = -0.74; 95% CI = -2.26, 0.78; P=0.34, and SMD -17.58; 95% CI = -50.28, 15.12; P=0.29 respectively). Finally, there were also no significant differences in VA, VF progression, PAS, and mean Shaffer gonioscopy grading between both groups. Conclusion: Phacoemulsification showed statistically significant lower mean corneal thickness, central endothelial cell density, and lower risk of poor response to surgery compared to LPI. However, there were no significant differences in mean IOP, number of medications, VA, VF progression, PAS, and mean Shaffer gonioscopy grading between Phacoemulsification and LPI.

Ophthalmic Manifestations of Arterial Tortuosity Syndrome: Case Series of Patient and Carriers.

PURPOSE: The aim of this study was to report the detailed ophthalmic findings in a young patient with genetically confirmed arterial tortuosity syndrome (ATS) and the findings in 8 family members who were carriers. METHODS: Nine members of the same Saudi family were assessed at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, for ATS-related ocular changes after homozygosity for the pathogenic variant of SLC2A10 gene was confirmed in 1 member. All family members underwent complete ophthalmic examination, genetic testing, and corneal tomography at presentation and at 6-month follow-up. RESULTS: All ophthalmic features were manifested in our patient with ATS including schisis-like splitting of the stromal layer with greater peripheral thinning, pannus, deep posterior stromal opacities, myopia, high astigmatism, and keratoglobus. The ocular phenotype was also expressed in some carriers ranging from mild myopia to the full spectrum of corneal abnormalities associated with ATS. CONCLUSIONS: Our study provided further insights into the phenotype in both patients with ATS and carriers. Annual ophthalmic examination is warranted in both types of patients and must undergo from early life onward to detect progressive ectasia which may necessitate corneal crosslinking.

High-milking sheep have a lower ovulation rate and tend to yield fewer embryos in response to superovulation and intrauterine artificial insemination.

Antagonistic relationship between milk yield and reproduction is reported in several livestock species. This study aimed to investigate whether genetic merit for milk production in dairy sheep affects responses to superovulation, embryo yield and quality. A total of 21 cross-bred Sarda x Lacaune ewes homogeneous for age, parity and stage of lactation were included. The ewes were stratified as high-producing or low-producing based on their genetic merit for milk production estimated by a pentatrait repeatability animal model. Oestrus was synchronized using an intravaginal progesterone pessary inserted on Day 0 and removed on Day 14. Superovulatory treatment consisted of 350 I.U. of porcine FSH administered in eight decreasing intramuscular doses every 12 hr with a total dose of 10 ml of solution starting 12 days after insertion of sponges. Laparoscopic artificial insemination (AI) was performed 48 hr after pessary removal. Surgical embryo recovery was performed at Day 8 after pessary removal. Correlation between breeding value for milk production and the number of corpora lutea (CL) was significantly different from zero (-0.49). High-producing ewes had a lower number of CL than low-producing counterparts (7.6 ± 2.50 vs 12.1 ± 5.16 respectively; p < .02). Furthermore, there was a tendency for high-producing ewes to yield fewer embryos than low-producing females (5.3 ± 3.46 vs 9.18 ± 5.11; p = .09). No differences were observed between ewes in both genetic groups with regard to the number of embryos of grades 1, 2 and 3. To our knowledge, this is the first report highlighting an antagonism between genetic merit for milk production and the ability to produce embryos in sheep. These results deserve to be considered in sheep breeding programmes.

Non-genetic sources of variation of milk production and reproduction and interactions between both classes of traits in Sicilo-Sarde dairy sheep.

This work aimed to study the sources of variation in productive and reproductive traits of the dairy Sicilo-Sarde ewes and to further investigate the interaction between both classes of traits. After edits, a database containing 5935 lactation records collected during 6 successive years in eight dairy flocks in the North of Tunisia was used. Total milked milk (TMM) in the milking-only period was retained as productive trait. The interval from the start of the mating period to the subsequent lambing (IML) and the lambing status (LS) were designed as reproductive traits. Sicilo-Sarde ewes had an average TMM of 60.93 l (±44.12) during 132.8 days (±46.6) after a suckling period of 100.4 days (±24.9). Average IML was 165.7 days. In a first step, the major factors influencing milk production and reproductive traits were determined. The significant sources of variation identified for TMM were: flock, month of lambing, year of lambing, parity, suckling length, litter size and milking-only length. Flock×month of the start of the mating period, parity, year of mating and litter size were identified as significant factors of variation for IML, while flock×month of the start of the mating period, parity and year of mating were identified as significant sources of variation for LS. In a second step, variance components were estimated using a three traits threshold mixed model, which combined LS as categorical trait and TMM and IML as continuous traits. Repeatability estimates were 0.21 (±0.03) for TMM, 0.09 (±0.02) for IML, and 0.10 (±0.05) for LS. Moreover, TMM and IML were found to be favorably associated for the flock× year of lambing effect (-0.45±0.18) but unfavorably associated for the animal effect (0.20±0.09).

Seasonality of oestrus, ovulation and ovulation rate of Sicilo-Sarde sheep.

This study aimed to investigate monthly changes in oestrus and ovulatory activity of Sicilo-Sarde sheep. Experimental animals comprised 25 adult and 10 maiden ewes at the start of the experiment. For 12 consecutive months (September-August), the females were exposed to natural photoperiod and permanently kept in presence of seven aproned rams. Oestrus was checked daily and ovarian activity was monitored by monthly endoscopies during the last week of each month. Ovulation rate for a particular month was assessed as the sum of corpora lutea or corpora albicans present on both ovaries at the time of endoscopy. Proportions of ewes observed in oestrus at least once a month were lowest in March (24.3%) and highest in June and October (100%). They tended (p < 0.06) to be different according to age, dropping during summer from a common value of 100% in June to 85.7% and 90% in July and then to 57.1% and 70% in August for, respectively, the Adults and Maiden females. Overall, the experimental period, 92.5% and 83.8% of Adult and Maiden ewes ovulated at least once per month (p < 0.01) respectively. Least proportions ovulating, attained 60% and 30% in April for, respectively, Adult and Maiden ewes before peaking up at 100% again in May (p < 0.05). Mean (±SD) ovulation rate of Sicilo-Sarde sheep is 1.40 ± 0.503. Adult females had a higher (p < 0.001) ovulation rate than Maiden sheep with respective average values of 1.51 ± 0.516 and 1.16 ± 0.373. It varied little between months and decreased in Adults from a maximum value of 1.95 in October to a minimum value of 1.16 in April. It is concluded that benchmarking seasonal variations of reproductive activity in Sicilo-Sarde breed would be valuable in designing improved management calendars for this breed.