The Analgesic Effect of a Transdermal Lappaconitine Patch Combined With Ibuprofen Suspension for Children After Adenoidectomy and Tonsillectomy: A Randomized Clinical Trial.

PURPOSE: To study the analgesic effects and side effects of a transdermal lappaconitine (TLA) patch, ibuprofen suspension (IS), and TLA combined with IS (TLACIS) after adenoidectomy and tonsillectomy. DESIGN: Prospective, randomized clinical trial. METHODS: The patients were randomized into three groups defined by different analgesic drug regimens: the TLA group, the IS group, and the TLACIS group. Pain scores at 2, 12, and 24 hours after surgery and adverse-event reports within the first postoperative week were collected. RESULTS: Ultimately, this study included 102 cases in the TLA group, 101 cases in the IS group, and 101 cases in the TLACIS group. At 2 hours after surgery, the pain scores of the TLA and the TLACIS groups were both significantly lower than that of the IS group (all P < .05). At 12 and 24 hours after surgery, the pain score of the TLACIS group was significantly lower than those of the TLA and IS groups (all P < .05); furthermore, the pain score of the IS group was significantly lower than that of the TLA group (P < .05). Within 1 week after the operation, there was no significant difference in the incidence of adverse events. CONCLUSIONS: The addition of a TLA patch can speed the onset of analgesia. In terms of analgesic effects, IS alone is more advantageous than TLA alone, while the combination of TLA and IS has the best analgesic effect. No significant differences were found in the incidence of adverse events among the three regimens.

Comparison of three VST orthokeratology lenses in axial length growth and average corneal reshaping in myopia children: A retrospective self-controlled study.

Purpose: To determine the differences in myopia control efficiency and corneal reshaping between three different brands of orthokeratology (OK) lenses (Lucid, Euclid, and Alpha). Method: We retrospectively reviewed subjects who started simultaneously using different brands of OK lenses. For each participant, every 6 months in the 19 months of following, the changes in axial length (AL), horizontal and vertical maximum distances of the treatment zone (HMDTZ and VMDTZ), width of the high convex zone (WHCZ), distance of decentration, and horizontal and vertical components of the decentration vector were measured. The average values of the above data, the average value of the decentration vector (ADV), and the average value of decentration calculated algebraically (ADA) were calculated. Results: All the three pairs (Lucid (n = 46) vs. Euclid (n = 46): groups Lucid-versus-Euclid-Lucid (LE-L) and LE-E), Lucid (n = 50) vs. Alpha (n = 50): groups LA-L and LA-A), and Euclid (n = 17) vs. Alpha (n = 17): groups EA-E and EA-A) showed good comparability. Regarding the change in AL during 19 months, none of the pairs showed significant differences (LE-L:0.27 ± 0.24 mm, LE-E:0.31 ± 0.24 mm (p = 0.68); LA-L:0.36 ± 0.26 mm, LA-A:0.36 ± 0.27 mm (p = 0.85); EA-E:0.34 ± 0.27 mm, EA-A:0.41 ± 0.28 mm (p = 0.63)). Regarding treatment zone, Lucid showed the largest HMDTZ and VMDTZ (both p < 0.05). Regarding the WHCZ, none of the pairs showed significant differences. For the ADV and ADA, Lucid had more ADV and ADA than Euclid (ADV: LE-L:0.73 ± 0.44 mm, LE-E:0.55 ± 0.45 mm, p < 0.05; ADA: LE-L:0.80 ± 0.41 mm, LE-E:0.63 ± 0.44 mm, p < 0.05), and the remaining pairs showed no significant difference. For the overall cohort with 113 eyes, the change in AL was weakly correlated with both ADV and ADA (both p < 0.05). Regarding the ADV/ADA, all pairs showed no significant differences, indicating equal lens position stability. Conclusion: After OK, there were no significant differences between the different pairs of the three brands in AL growth, WHCZ, or lens position stability, although Lucid had a larger treatment zone than Euclid and Alpha, and Lucid had more decentration than Euclid. A larger lens decentration were weakly related to less AL growth.

Axial length shortening after orthokeratology and its relationship with myopic control.

PURPOSE: To determine the pattern of axial variation in subjects with initial shortened axial length during the entire period of orthokeratology and to discuss the possibility of shortened AL after one month of orthokeratology becoming a predictor of myopia control. METHOD: This study retrospectively included 106 children with myopia aged 8 to 14 wearing OK lenses. Fifty-four eyes with shortened axial length (AL) at the first-month visit were enrolled in the axial length shortening (ALS) group, and fifty-two eyes without shortened AL were enrolled in the no axial length shortening (NALS) group. Axial length and refractive error at baseline and within the entire period of orthokeratology (20 months), including fitting, washout period and re-wear, were measured. Eighty-five children who started wearing single vision spectacle were also included as a control group. RESULTS: In the ALS group, AL became longer after shortening and slowly exceeded baseline; afterward, AL experienced a rebound during the washout period and shortened again if OK lenses were re-worn. After washout period, significant difference in AL (ALS:0.28 ± 0.19 mm, NALS: 0.52 ± 0.17 mm) and spherical equivalent (ALS:-0.43 ± 0.44D, NALS:-0.91 ± 0.40D) between the two groups were found(P<0.05). The changes in AL and SE were both significantly correlated with the changes in AL at the first-month visit (P<0.05). CONCLUSION: After AL is shortened in the initial stage of orthokeratology, it will experience a rapid rebound during the washout period, and the shortening can reappear when re-wearing OK lenses. Hence, the evaluation of orthokeratology will be more objective and accurate after the wash-out period. In addition, the existence and degree of axial shortening can be used as a predictor of long-term myopia development.

Bacterial Culture of Tear Duct Infections Secondary to Congenital Nasolacrimal Duct Obstructions.

Purpose: To investigate the microbial profile of congenital nasolacrimal duct obstruction (CNLDO) in Chinese children. Methods: We retrospectively reviewed the medical records of 330 consecutive children (330 eyes) who were diagnosed with tear duct infections secondary to CNLDO and were admitted to the Children's Hospital of Fudan University from January 2013 to January 2020. Bacterial cultures were grown from tear duct samples of each patient. Samples from conjunctival secretions were cultivated on blood or chocolate agar. Clinically significant bacterial growth was reported. Results: Of the 330 eyes considered, 62.7% (207/330) were associated with positive bacterial cultures. A total of 223 isolates were detected from 207 culture-positive eyes. Among the 223 isolates, 52.0% (116/223) were Gram-positive bacteria and 47.1% (105/223) were Gram-negative bacteria. The most prevalent Gram-positive bacteria were Streptococcus viridans (67 isolates, 30%), followed by Staphylococcus aureus (36 isolates, 16.1%) and Streptococcus pneumoniae (5 isolates, 2.2%). The most prevalent Gram-negative bacteria were Neisseria (nonpathogenic) (25 isolates, 11.2%), followed by Escherichia coli (16 isolates, 7.2%) and Haemophilus influenzae (16 eyes, 7.2%). Antibiotic susceptibility test results suggested that both Gram-positive and Gram-negative bacteria were highly sensitive to most of the tested antibiotics. Conclusions: S. viridans and S. aureus are the most prevalent bacteria in tear duct infections secondary to CNLDO. Broad-spectrum antibacterial eye drops are suggested as empirical antibiotic treatments.

A2AR Antagonists Upregulate Expression of GS and GLAST in Rat Hypoxia Model.

BACKGROUND: The aim of this study was to research the effects of glutamine synthetase (GS) and glutamate aspartate transporter (GLAST) in rat Müller cells and the effects of an adenosine A2AR antagonist (SCH 442416) on GS and GLAST in hypoxia both in vivo and in vitro. METHODS: This study used RT-PCR and Western blotting to quantify the expressions of GS and GLAST under different hypoxic conditions as well as the expressions of GS and GLAST at different drug concentrations. A cell viability assay was used to assess drug toxicity. RESULTS: mRNA and protein expression of GS and GLAST in hypoxia Group 24 h was significantly increased. mRNA and protein expressions of GS and GLAST both increased in Group 1 µM SCH 442416 compared with other groups. One micromolar SCH 442416 could upregulate GS and GLAST's activity in hypoxia both in vivo and in vitro. CONCLUSIONS: Hypoxia activates GS and GLAST in rat retinal Müller cells in a short time in vitro. (2) A2AR antagonists upregulate the activity of GS and GLAST in hypoxia both in vivo and in vitro.

Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy.

PURPOSE: To study the characteristics of choroid thickness (CT) of the optic disc and macula in children with type 1 diabetes mellitus (T1DM) without visual impairment and diabetic retinopathy (DR) and analyse associated factors. METHODS: A square area of 6 × 6 mm around the centre of the optic disc and macula was scanned. The indices analysed mainly included CT at the macular centre (1 mm), and temporal, superior, nasal or inferior aspect of the inner ring (1-3 mm) and outer ring of (3-6 mm) optic disc and macula. Independent risk factors were analysed using multifactor linear regression. RESULTS: A total of 44 children with T1DM and 48 healthy subjects were enrolled. The diabetic group showed significant increase in the inferior inner ring of parapapillary CT (100.99 ± 30.42 µm versus 89.41 ± 34.00 µm, p = 0.04) and nasal outer ring of parapapillary CT (157.02 ± 47.35 µm versus 131.15 ± 35.17 µm, p = 0.01) as compared to those values in the healthy controls. Spherical equivalent refraction and family history of hypertension are independent factors of both peripappillary choroid thickness (PPCT) and macular choroid thickness (PMCT). Spherical equivalent refraction (p = 0.01) and serum cholesterol (p = 0.03) were independent factors of the inferior inner ring of parapapillary CT, whereas family history of hypertension was an independent factor of the nasal outer ring of parapapillary CT (p = 0.001). CONCLUSION: In children with diabetes without DR or visual impairment, the CT increase in nasal outer ring of parapapillary (PPNO) and the inferior inner ring of parapapillary (PPII) may be the characteristic pre-DR alteration at the early stage of DM. For children with higher serum cholesterol and family history of hypertension, the change of the nasal outer ring of parapapillary CT and the inferior inner ring of parapapillary CT may be more advanced.

Influence of Overnight Orthokeratology Lens Treatment Zone Decentration on Myopia Progression.

PURPOSE: To investigate the effect of OK lens treatment zone decentration on myopia control. METHODS: We retrospectively selected 30 OK lens wearers who met the following conditions in our hospital from more than 1300 cases: wearing lens in both eyes and only one eye was off-center while the other one was centric for more than 12 months. During the period of follow-up, the UCVA of each eye was better than 0.1 of logMAR and there were no obvious tropia, Kappa angle, and complications such as glare and diplopia. RESULT: Among 30 cases, 15 are males and 15 are females, with an average age of 9.3 ± 1.51Y. There were no significant differences in equivalent spherical lens, astigmatism, e value, flat K, steep K, astigmatism, lens diameter, and toric between the two groups (p > 0.05). The average distance of decentration was 0.73 ± 0.25 mm. Axis growth per year in was 0.20 ± 0.24 mm the OK-lens-decentered group and 0.29 ± 0.20 mm in the OK-lens-centric group, which shows significant difference between them (p < 0.05). According to the direction of decentration, 30 decentered eyes were divided into temporal group (20 eyes) and other direction group (10 eyes). The efficiency of myopia control (the growth of AL per year in OK-lens-decentered eye/the growth of AL per year in the contralateral OK-lens-centric eye) was 0.69 ± 0.50 in the temporal decentration group and 0.75 ± 0.52 in the other direction group, showing no significant difference between them (p > 0.05). There was no significant correlation between the efficiency of myopia control and the degree of decentration among temporal decentration group (p > 0.05). CONCLUSION: This self-control study without much interference factors shows that the decentration of OK lens can delay the development of myopia more effectively than being centric when uncorrected visual acuity was acceptable without obvious corneal complications, glare, or ghosting.

Comparison of Corneal Parameters of Children with Diabetes Mellitus and Healthy Children.

PURPOSE: To compare differences in central corneal thickness (CCT), corneal curvature, and other corneal measurements of children with diabetes mellitus (DM) and healthy children, and to investigate related factors. METHODS: This was a case-control study. From January to February 2018, 50 children with diabetes mellitus were selected as a case group, and 46 healthy children and adolescents without diabetes mellitus were selected as a control group. Corneal topography and CCT were analyzed using a corneal topography measuring apparatus and biometrics (IOL Master). In the diabetic group, we analyzed whether age, course of disease, sex, glycosylated hemoglobin, triglyceride level, total cholesterol, body mass index (BMI), parental BMI, birth history, feeding history, pregnancy, or puerperal history were related to corneal morphology. RESULTS: There was a significant difference in CCT between groups, but no significant differences were found in corneal diameter, corneal curvature R1 or R2, or corneal topography. Central corneal thickness was not correlated with other clinical factors in the diabetes group. CONCLUSION: Early screening and close follow-up of keratopathy in children with diabetes are imperative.

Dry Eye Disease Is More Prevalent in Children with Diabetes than in Those without Diabetes.

Purpose: To compare the prevalence of dry eye disease between children with and without diabetes, and analyze the factors associated with dry eye disease in children with diabetes.Materials and methods: 38 children with diabetes were selected as cases, and 40 children without diabetes constituted the control group. The prevalence of dry eye disease in both groups was statistically analyzed. Related factors of dry eye disease were analyzed in children with diabetes.Results: The prevalence of dry eye disease in the case group was significantly higher than that in the control group (P < .01), with the attributable proportion among the exposed (0.827) and the population attributable fraction (0.700). Univariate analysis showed that the diabetes duration, best-corrected visual acuity, corneal sensation, and levels of glycosylated hemoglobin were associated with dry eye disease in children with diabetes. Logistic regression analysis revealed that only diabetes duration and corneal sensation were independent factors associated with dry eye disease. The diabetes duration was significantly higher and the level of corneal sensation was significantly lower in subjects with dry eye disease than in those without dry eye disease.Conclusions: Early screening and close follow-up of dry eye disease in children with diabetes should be strictly implemented, especially in children with a long duration of diabetes and those with peripheral neuropathy.

Retinal Microvascular Abnormalities in Children with Type 1 Diabetes Mellitus Without Visual Impairment or Diabetic Retinopathy.

Purpose: To study the characteristics and associated factors of retinal microvascular abnormalities in children with type 1 diabetes mellitus (T1DM) without visual impairment and diabetic retinopathy (DR). Methods: Case-control hospital-based study including children with or without DM. Optical coherence tomography angiography (OCTA; CIRRUS HD-OCT model 5000) was used to scan 6 × 6 mm square area of posterior retina and optic disc. The indexes analyzed mainly included vascular length density (VD), perfusion density (PD), and foveal avascular zone area, perimeter, and morphology. Independent risk factors were analyzed by multifactor linear regression. Results: A total of 47 children with T1DM and 44 healthy subjects were enrolled. Statistical analysis showed that VD within 1 to 3 mm (inner ring) of the macula in the case group was smaller than that in the control group (18.561 ± 1.151/mm: 19.161 ± 0.464/mm; P< 0.001), and mother's excessive weight gain during pregnancy was an independent factor (P = 0.004); VD within 3 to 6 mm (outer ring) of the macula in the case group was smaller than that in the control group (19.044 ± 0.847/mm; 19.404 ± 0.496/mm, P = 0.029), while serum creatinine level was revealed to be an independent factor (P = 0.009); PD within 3 to 6 mm of the macula in the case group was higher than that in the control group (0.456 ± 0.015: 0.442 ± 0.030) (P = 0.003), with no independent factor observed in regression analysis. Conclusion: Retinal microvasculopathy had already occurred in the parafoveal area of diabetic children without visual impairment and DR; early screening and close follow-up were recommended for children with high-risk factors.