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1.
Cureus ; 16(6): e61826, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38975538

RESUMO

Artificial intelligence (AI) has emerged as a transformative force in healthcare, particularly in the field of ophthalmology. This comprehensive review examines the current applications of AI in ophthalmology, highlighting its significant contributions to diagnostic accuracy, treatment efficacy, and patient care. AI technologies, such as deep learning algorithms, have demonstrated exceptional performance in the early detection and diagnosis of various eye conditions, including diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucoma. Additionally, AI has enhanced the analysis of ophthalmic imaging techniques like optical coherence tomography (OCT) and fundus photography, facilitating more precise disease monitoring and management. The review also explores AI's role in surgical assistance, predictive analytics, and personalized treatment plans, showcasing its potential to revolutionize clinical practice and improve patient outcomes. Despite these advancements, challenges such as data privacy, regulatory hurdles, and ethical considerations remain. The review underscores the need for continued research and collaboration among clinicians, researchers, technology developers, and policymakers to address these challenges and fully harness the potential of AI in improving eye health worldwide. By integrating AI with teleophthalmology and developing AI-driven wearable devices, the future of ophthalmic care promises enhanced accessibility, efficiency, and efficacy, ultimately reducing the global burden of visual impairment and blindness.

2.
Cureus ; 16(5): e60487, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38883086

RESUMO

A relatively rare neurocutaneous condition known as linear nevus sebaceous syndrome (LNSS) is marked by a variety of symptoms as well as the unusual characteristics of developing mosaic RASopathies of phacomatoses. Mental retardation, seizures, and midline facial linear nevus sebaceous were the usual diagnostic triad. A hallmark of LNSS is the papillomatous growth of the epidermis, also known as nevus sebaceous. In this case report, we presented a case of a 13-year-old male with LNSS with a vascular conjunctival lesion and a coloboma of the optic disc.

3.
Cureus ; 16(4): e58235, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38745815

RESUMO

Polydactyly-myopia syndrome is a rare genetic condition characterized by the co-occurrence of polydactyly and myopia. Herein, we present the case of a 28-year-old Muslim male, born of consanguineous parents, who presented with complaints of diminished vision since childhood. Ophthalmologic examination revealed severe myopia with characteristic fundus changes indicative of high myopia. Additionally, the patient exhibited polydactyly in all limbs, with a positive family history of both polydactyly and myopia. This case underscores the importance of recognizing and managing rare syndromes to provide appropriate genetic counseling and clinical care. Further research is warranted to elucidate the underlying genetic mechanisms and optimize therapeutic strategies for polydactyly-myopia syndrome. Awareness of this syndrome among healthcare providers is essential to facilitate early diagnosis and intervention for affected individuals and their families.

4.
Cureus ; 16(4): e58718, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38779265

RESUMO

This review provides a comparative analysis of visual outcomes and complications associated with three prominent refractive surgical techniques: intraocular collamer lens (ICL) implantation, small-incision lenticule extraction (SMILE), and laser-assisted in situ keratomileusis (LASIK). Refractive surgeries aim to correct myopia, hyperopia, and astigmatism, offering patients an alternative to corrective lenses. The review highlights the importance of comparing these procedures to guide clinical decision-making effectively. Each technique is described, emphasizing its unique advantages and considerations. While LASIK remains widely favored for its rapid visual recovery and high patient satisfaction, ICL is suitable for patients with higher refractive errors or corneal irregularities. Although relatively newer, SMILE shows promise with potential benefits such as corneal biomechanical stability and a reduced risk of dry eye syndrome. However, each procedure carries its distinct complications, reinforcing the need for personalized patient care and informed decision-making. Understanding these techniques' relative efficacy and safety profiles is essential for optimizing outcomes and enhancing patient satisfaction. Continued advancements in technology and surgical techniques promise further improvements in refractive surgery outcomes, underscoring the importance of ongoing research and innovation.

5.
Cureus ; 16(4): e58867, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38800227

RESUMO

Vogt-Koyanagi-Harada (VKH) disease is an idiopathic immune-related sickness that affects multiple systems and melanocytes in organs such as the uvea, ear, and meninges. The primary cause of activity is cellular immunological responses. Vogt-Koyanagi disease is identified primarily by skin abnormalities and anterior uveitis. Harada's illness is distinguished by neurological symptoms and exudative retinal detachments, which are associated with the HLA-DR4 and HLA-DRw53 genes. Pigmented races, such as Hispanics and Native Americans, are more likely to have VKH disease. Clinical features are blurred vision, floaters, alopecia, vitiligo, diffuse choroidal inflammation with disc edema, and exudative retinal detachment. Differential diagnoses include posterior scleritis, uveal effusion syndrome, central serous chorioretinopathy, and sympathetic ophthalmitis. The investigations used are optical coherence tomography (OCT), fundus fluorescein angiography (FA), and B-scan ultrasonography (USG). Treatment is done by using systemic steroids, cycloplegics, and immunosuppressants.

6.
Cureus ; 16(4): e58884, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38800342

RESUMO

One of the most dangerous parasite infections, cysticercosis, is found practically everywhere in the world. Cysticercus cellulosae is the larval stage of the swine tapeworm Taenia solium, which causes cysticercosis. Orbital or ocular cysticercosis (OOC) is an avoidable cause of blindness. There are two types of ocular cysticercosis: intraocular (in the anterior chamber, subretinal space, or vitreous) and extraocular (in the orbital tissues or subconjunctival space). Here, we report a rare case of extraocular muscle cysticercosis that presented as a solitary, well-defined lobulated mass near the medial canthus in the right eye and was well managed medically with antihelminthic drugs and corticosteroid therapy. The key to diagnosing myocysticercosis is orbital imaging. Although brain and ocular involvement in cysticercosis is common, extraocular muscle cysticercosis is extremely uncommon and mainly affects young people and children. Orbital pseudotumor, idiopathic myositis, and hydatid cysts are a few differential diagnoses for ocular cysticercosis. It is critical to recognize and treat such illnesses as early as feasible to avoid serious consequences. Public health measures are essential to eradicate this disease in the area.

7.
Cureus ; 16(3): e56674, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38646317

RESUMO

Diabetic retinopathy, nephropathy, and neuropathy are significant microvascular complications of diabetes mellitus, contributing to substantial morbidity and mortality worldwide. This comprehensive review examines the clinical relationship between these complications, focusing on shared pathophysiological mechanisms, bidirectional relationships, and implications for patient management. The review highlights the importance of understanding the interconnected nature of diabetic complications and adopting a holistic approach to diabetes care. Insights gleaned from this review underscore the necessity for early detection, timely intervention, and integrated care models involving collaboration among healthcare professionals. Furthermore, the review emphasizes the need for continued research to elucidate underlying mechanisms, identify novel therapeutic targets, and assess the efficacy of integrated care strategies in improving patient outcomes. By fostering interdisciplinary collaboration and knowledge exchange, future research endeavors hold the potential to advance our understanding and management of diabetic complications, ultimately enhancing patient care and quality of life.

8.
Cureus ; 16(3): e56796, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38654796

RESUMO

This comprehensive review examines the efficacy, safety, and implications of intravitreal OZURDEX and intravitreal bevacizumab in treating diabetic macular edema (DME). DME is a common complication of diabetes mellitus and a leading cause of vision loss. OZURDEX, through sustained release of dexamethasone, targets inflammation and vascular permeability, while bevacizumab inhibits vascular endothelial growth factor (VEGF), reducing angiogenesis. However, differences in safety profiles exist, with OZURDEX associated with an increased risk of intraocular pressure elevation and cataract formation and bevacizumab potentially carrying systemic risks. The choice between these treatments should be individualized, considering patient preferences, ocular and systemic comorbidities, and cost-effectiveness. Collaboration among healthcare providers is essential for the comprehensive management of DME. Future research should focus on long-term comparative studies, predictors of treatment response, and exploration of novel therapeutic targets to optimize treatment outcomes for patients with DME.

9.
Cureus ; 16(3): e56450, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38638778

RESUMO

Pseudoexfoliation syndrome (PEX) presents a significant clinical challenge due to its diverse ocular manifestations, including glaucoma and zonular weakness of the lens, which can lead to irreversible visual impairment if left untreated. We report a case of a 78-year-old male presenting with bilateral visual impairment persisting for four years, with a more pronounced decline in the right eye over the past six months. Examination revealed aphakia with pseudoexfoliative material in the right eye, a cataract with pseudoexfoliative material in the left eye, and a notable intraocular pressure (IOP) discrepancy. Surgical intervention was required for both eyes, with cataract extraction and IOP-lowering procedures performed to preserve vision and prevent further deterioration. This case underscores the importance of timely recognition and comprehensive management of PEX-related ocular complications to optimize visual outcomes and quality of life for affected individuals. Close collaboration between ophthalmologists and other healthcare professionals is essential to address the multifaceted nature of PEX and tailoring treatment strategies to individual patient needs. Further research is needed to elucidate the underlying pathophysiology of PEX and refine therapeutic approaches to mitigate its detrimental effects on vision.

10.
Cureus ; 16(3): e55842, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38590483

RESUMO

This case report presents the clinical course of a 53-year-old male farmer with nephrotic syndrome, specifically focal segmental glomerulosclerosis, who developed a fulminant eye infection. While receiving maintenance hemodialysis and immunosuppressive therapy, the patient presented with sudden onset redness, discharge, and decreased vision in his right eye. Initial management with topical antibiotics and steroids failed to halt the progression of the infection, leading to corneal perforation and iris prolapse within a few days. Despite the discontinuation of immunosuppressive medications and initiation of broad-spectrum antimicrobial therapy, the patient's compromised renal function and anaemia precluded surgical intervention. This case underscores the challenges in managing severe ocular infections in immunocompromised patients. It highlights the importance of early recognition, aggressive antimicrobial therapy, and close ophthalmologic monitoring in preventing sight-threatening complications. Despite intensive management, the prognosis for visual recovery in such cases may be poor, emphasizing the need for preventive strategies and careful surveillance in high-risk patient populations.

11.
Cureus ; 16(3): e56958, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38665717

RESUMO

Corneal endothelial dysfunction poses significant challenges in ophthalmology, leading to corneal edema and vision loss. Traditional treatments, including corneal transplantation, are limited by donor scarcity and potential complications. Nanoparticle-mediated cell delivery emerges as a promising approach for corneal endothelial regeneration, offering targeted and minimally invasive solutions. This comprehensive review provides insights into the role of nanoparticles in enhancing cell survival, integration, and therapeutic efficacy. We discuss the current understanding of corneal endothelial dysfunction, emphasizing the importance of regeneration. Furthermore, we explore the potential implications of nanoparticle-mediated approaches in clinical practice, highlighting opportunities for personalized treatment strategies. Future directions are also discussed, including optimization of nanoparticle design and exploration of combination therapies. Overall, this review elucidates the promising advancements in nanoparticle-mediated cell delivery for corneal endothelial regeneration and underscores the importance of continued research efforts in this evolving field.

12.
Cureus ; 16(3): e57234, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38686253

RESUMO

Background Diabetes has become an epidemic, significantly impacting ocular health as one of its end-organ responses. Among the various ocular complications, alterations in corneal morphology stand out. Central corneal thickness (CCT) and endothelial cell function are vital parameters in assessing intraocular pressure, conducting pre-refractive surgery evaluations, and maintaining corneal transparency. Understanding these changes in diabetic individuals compared to non-diabetics is crucial for managing ocular health in this population. Aim and objective This study evaluates and compares CCT and endothelial cell changes between diabetic individuals and age-matched non-diabetics. By analyzing these parameters, the study seeks to provide insights into the impact of diabetes on corneal morphology and its implications for ocular health. Methods The study recruited 124 patients from the Ophthalmology Outpatient Department (OPD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi. A cross-sectional research design was employed to collect data over six months. Patients were carefully selected, and informed consent was obtained from all participants. CCT and endothelial cell parameters were assessed using specular microscopy, a non-invasive imaging technique. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) for inferential statistics, such as t-tests and ANOVA, and comparing parameters between diabetic and non-diabetic groups. Findings were interpreted based on both statistical significance and clinical relevance. Results In diabetic patients, the mean CCT was 547.91 µm, while it was 523.62 µm in non-diabetic individuals. The T statistic for this variable was 5.14, indicating a 17 significant difference between the two groups. Similarly, significant differences were found between diabetics and non-diabetics for endothelial cell density, coefficient of variation, and hexagonality, as evidenced by their respective T statistics of 7.46, 5.17, and 4.91. Endothelial cell density averaged 2375 cells/mm2 in diabetics and 2666.95 cells/mm2 in non-diabetics. Additionally, the coefficient of variation was higher among people with diabetes (40.87%) compared to non-diabetics (35.09%). Hexagonality, a measure of endothelial cell shape, was lower in diabetic corneas (40.48%) than in non-diabetic corneas (46.46%). Conclusion The study observed significant differences in corneal morphology, including central thickness and endothelial cell changes, between diabetic and non-diabetic individuals. These findings underscore the impact of diabetes on ocular health and emphasize the importance of monitoring corneal parameters in diabetic patients. Understanding these changes can aid in better management and treatment strategies for ocular complications associated with diabetes.

13.
Cureus ; 16(2): e54273, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38496130

RESUMO

This review comprehensively explores pan-retinal photocoagulation (PRP) as a pivotal intervention in visually rehabilitating individuals afflicted with proliferative diabetic retinopathy (PDR). The review begins by elucidating the significance of PDR within the spectrum of diabetic retinopathy (DR), emphasizing the progressive nature of the disease and the consequential impact on visual health. A detailed analysis of PRP follows, encompassing its definition, purpose, and historical development, shedding light on the procedural intricacies and mechanisms of action. The postoperative care and follow-up section underscores the necessity of vigilant monitoring for complications, visual recovery, and the importance of regular ophthalmic check-ups. The subsequent discussion delves into patient education and counseling, stressing the need to manage expectations, encourage lifestyle modifications, and highlight the significance of follow-up appointments. The review concludes with insights into future directions, including advancements in laser technology and emerging therapies, offering a glimpse into the evolving landscape of DR management. By addressing ongoing challenges and embracing innovative approaches, this review provides a comprehensive guide for clinicians, researchers, and healthcare practitioners who visually rehabilitate individuals struggling with PDR.

14.
Cureus ; 16(2): e54752, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38523956

RESUMO

Diabetic macular edema (DME) poses a significant threat to the vision and quality of life of individuals with diabetes. This comprehensive review explores recent advancements in DME management, focusing on integrating automated quantification techniques and anti-vascular endothelial growth factor (anti-VEGF) interventions. The review begins with an overview of DME, emphasizing its prevalence, impact on diabetic patients, and current challenges in management. It then delves into the potential of automated quantification, leveraging machine learning and artificial intelligence to improve early detection and monitoring. Concurrently, the role of anti-VEGF therapies in addressing the underlying vascular abnormalities in DME is scrutinized. The review synthesizes vital findings, highlighting the implications for the future of DME management. Promising outcomes from recent clinical trials and case studies are discussed, providing insights into the evolving landscape of personalized medicine approaches. The conclusion underscores the transformative potential of these innovations, calling for continued research, collaboration, and integration of these advancements into clinical practice. This review aims to serve as a roadmap for researchers, clinicians, and industry stakeholders, fostering a collective effort to enhance the precision and efficacy of DME management.

15.
Cureus ; 16(2): e54064, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38481887

RESUMO

This case report emphasizes the varied clinical features of Laurence-Moon-Bardet-Biedl syndrome (LMBBS) in a 10-year-old girl, presenting a rare combination of atypical retinitis punctata albescens, polydactyly, central obesity, and non-alcoholic fatty liver disease (NAFLD). Despite extensive management efforts, the patient's visual impairment remained unchanged, highlighting the challenging and progressive nature of LMBBS, particularly its ocular manifestations. Genetic counseling played a crucial role, stressing the significance of early genetic analysis in consanguineous marriages for anomaly detection and informed family planning. This case enhances our comprehension of LMBBS and emphasizes the necessity for ongoing research and multidisciplinary care to tackle its complexities.

19.
Cureus ; 15(5): e39047, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37378243

RESUMO

Strabismus is a disorder in which the eyes are incorrectly lined up with each other. Either eye is always or infrequently looking inward (esotropia) or outward (exotropia). A 19-year-old male patient came to the Ophthalmology Outpatient Department (OPD) with complaints of outward deviation of the left eye for five years. It was associated with a diminution of vision in the left eye for three years. The patient reported a history of a road traffic accident (RTA) five years ago before the development of deviation of the left eye. On examination, the Hirschberg test showed a corneal light reflex falling beyond the limbus. After obtaining due consent for anesthesia risk and medicine fitness, the patient underwent squint correction surgery (medial rectus resection) and was started on oral and topical antibiotics with a 15-day follow-up period. Postoperative orthophoria was achieved.

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