Journal of Ophthalmology and Research is an open access, peer-reviewed, bimonthly online journal encourage researchers to publish their new findings or ideas in an open access flatform. Journal focusing on “Eye-to-Eye” roundtable discussions on current topics, diagnosis and therapy in Ophthalmology, new diagnostic and surgical techniques, instrument and therapy updates, results of clinical trials and research findings.
Pregnancy as a Retinal Stress Test: The Retina as a Window into Mothers Vascular and Immune Health
Pregnancy represents a unique physiologic state characterized by dynamic vascular, immune, and hematologic adaptations that support maternal and fetal health. While these changes are often well tolerated, they may also unmask or exacerbate underlying systemic disease, contributing to maternal morbidity during pregnancy and the postpartum period. The retina, as a highly vascular and metabolically active tissue, offers a rare, noninvasive window into these systemic processes in vivo. This editorial perspective frames pregnancy as a physiologic “stress test,” highlighting how retinal findings can reflect broader maternal vascular, immune, and thrombotic dysfunction. Visual symptoms and retinal changes may serve as early indicators of hypertensive disorders of pregnancy, immune-mediated disease, and postpartum hypercoagulability. Despite this, ophthalmic manifestations are frequently underrecognized or attributed to benign physiologic changes, leading to missed opportunities for early diagnosis and intervention. By integrating ophthalmologic evaluation into maternal care, clinicians may improve risk stratification and facilitate earlier identification of high-risk conditions. This perspective underscores the importance of interdisciplinary collaboration and proposes a clinical framework in which retinal findings are recognized as meaningful markers of systemic disease rather than isolated ocular phenomena. Future research is needed to further define the prognostic value of retinal changes and to establish evidencebased guidelines for incorporating ophthalmology into maternal health care
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Postoperative Ocular Outcomes Associated with Intraoperative Hypotension: A Global Matched Cohort Study
Purpose: To explore the possible ocular complications of intraoperative hypotension (IOH) using data from the TriNetX research platform, which provides de-identified patient records from numerous healthcare organizations worldwide. Methods: Patients with and without IOH were identified on the TriNetX research platform using ICD-10 codes. The dataset initially included 144,130 patients with IOH and 4,912,179 patients without IOH. Propensity score matching based on sex, race, and relevant ICD-10 diagnoses (diseases of the circulatory, nervous, and respiratory systems, as well as endocrine, nutritional, and metabolic diseases) was used to create balanced groups of 139,967 patients with and without IOH. The outcomes that were evaluated included ischemic optic neuropathy, optic atrophy, retinal ischemia, retinal artery occlusion, and retinal vein occlusion after having a procedure that included the use of anesthesia. Risk ratios were calculated following propensity score matching. Results: The risk of ischemic optic neuropathy was 0.01% in patients without IOH and 0.04% in those with IOH (RR: 2.94, 95% CI: 1.70, 5.10, p <0.0001). Optic atrophy also showed a significant association, with risks of 0.04% in patients without IOH and 0.06% in those with IOH (RR: 1.55, 95% CI: 1.11, 2.16, p=0.01). The risk of retinal artery occlusion was 0.02% for patients without IOH compared to 0.05% for those with IOH (RR: 2.60, 95% CI: 1.67, 4.05, p<0.001). Retinal ischemia was not shown to have a significant association (RR: 1.25, 95% CI: 0.59, 2.67, p=0.56), as well as retinal vein occlusion (RR: 1.41, 95% CI: 0.82, 2.44, p=0.21). Conclusions: Patients who experience IOH have a significantly greater risk for ocular complications, supporting the need for close intraoperative monitoring and post-operative ophthalmic follow-up.
Study on Causes of Noncompliance to Anti-glaucoma Medication in Glaucoma Patients
Purpose: To have an in-depth understanding regarding the compliance of patients, their knowledge and attitude towards AGM (Anti-Glaucoma Medication) and also to explore various factors affecting AGM compliance in glaucoma patients attending a medical college attached hospital in Hyderabad, Telangana. Materials and Methods: We have done a cross-sectional study in ophthalmology outpatient department of two teaching hospitals in South India. Data collection was done with the help of a modified questionnaire previously published in studies. A total of 27 questions were included in the questionnaire. The data was collected. MS-Excel was used for coding. It was then analyzed using SPSS software (version 20, IBM USA). Results: A total of 229 patients were recruited in the study. Of them 56.3% were males and 43.7% were females. The mean age of patients in our study group was 55.03 years. In our study there was no correlation between age, gender and expenditure on AGM and compliance. 170 (74.2%) patients did not miss their AGM dosage in a month. The most common reason for missing their AGM was forgetfulness and the next common reason was ‘medication got over’. We found an association between patients using AGM for longer duration and better compliance (p value=0.026), but there was no correlation between age, gender and expenditure on AGM and compliance. Conclusion: Our study was done on patients who have come to the OPD for follow up, their compliance would be better than the patients who do not come for followup examinations. Hence community-based studies need to be conducted to know more regarding the reasons for lack of compliance. Also, ophthalmologists need to pay attention to the issue of non-compliance toward AGM among glaucoma patients attending the hospitals. A support system to remind patients about glaucoma medications is required to improve compliance.
Ophthalmic Outcomes Across CKD Stages in Systemic Lupus Erythematosus
Purpose: Systemic lupus erythematosus (SLE) carries renal and ocular morbidity. Chronic kidney disease (CKD) may worsen inflammatory and microvascular injury. This study evaluated whether CKD stage is associated with increased ophthalmic complications in SLE. Methods: Adults with SLE in the TriNetX Research Network were stratified by CKD stage (1-5 and ESRD) and propensity-score matched 1:1 to SLE patients without CKD on age, sex, race, hypertension, diabetes mellitus, and other baseline variables. Patients with pre-existing ophthalmic diagnoses were excluded. Incident episcleritis, scleritis, cataract, hypertensive retinopathy, low vision, and blindness were assessed using risk ratios (RR) with 95% confidence intervals. Direct measures of lupus disease activity were not available in the database. Results: Matched cohorts ranged from 5,500 to 28,000 patients. Inflammatory complications were elevated in early CKD: episcleritis (RR 1.54-1.94, stages 1-3) and scleritis (RR 1.43-2.08, stages 1-4). Cataract risk was increased across stages, highest in stage 1 (RR 1.75) and modestly elevated thereafter (RR 1.11-1.29). Hypertensive retinopathy demonstrated a clear severity gradient, rising from stage 1 (RR 1.56) to ESRD (RR 2.73). Vision-threatening outcomes also increased with CKD severity, with blindness peaking in ESRD (RR 2.28) and low vision elevated across all stages (RR 1.22-1.56). Conclusions: Advancing CKD severity in SLE is associated with progressively higher inflammatory, vascular, and vision-threatening ophthalmic complications. These findings support CKD-stage-guided ophthalmic surveillance to reduce preventable vision loss.
Systemic Lupus Erythematosus (SLE) Pericarditis as a Predictor of Ophthalmic Inflammation
Purpose: To assess the probability that pericarditis in patients with systemic lupus erythematosus (SLE) is associated with ophthalmic inflammation using data from the TriNetX Global Research Network. Methods: Patients with SLE with and without pericarditis were identified in the TriNetX database, using ICD-10 codes. Propensity score matching delineated two cohorts based on age, sex, race, hydroxychloroquine prescription and already existing disorders. Outcomes evaluated included the development of anterior uveitis, posterior uveitis, panuveitis, retinal vasculitis, episcleritis, scleritis, keratitis, and optic neuritis. Cerebrovascular disease risk, and mortality were collected over a 10- year period. Statistical analysis included Kaplan-Meier graphs as well as risk rates, used to compare the likelihood of getting a cerebrovascular disease. Results: Four out of the eight inflammatory diseases being assessed in SLE pericarditis patients demonstrated significantly increased risks. The relative risk of posterior uveitis was 1.803 compared with matched SLE controls without pericarditis (95% CI: 1.154–2.815, p < .01). Retinal vasculitis risk was approximately doubled (RR = 2.002, 95% CI: 1.171–3.423, p < .01). Patients with SLE pericarditis had a 1.609-fold increased risk of episcleritis (95% CI: 1.100–2.350, p < .05) and a 1.742-fold increased risk of scleritis (95% CI: 1.213–2.502, p < .01). Mortality did not differ significantly between groups. Conclusions: The presence of pericarditis and SLE has an association to long-term risk of posterior uveitis, retinal vasculitis, episcleritis, and scleritis. These findings emphasize the need for early detection using ophthalmologic screening for patients diagnosed with pericarditis.
Recent Advances in the Diagnosis and Management of Ptosis: A Systematic Review of Surgical and Non-surgical Interventions
Ptosis, the abnormal drooping of the upper eyelid, is a condition with both functional and cosmetic consequences that can significantly impair vision and quality of life. Recent years have witnessed notable advances in its diagnosis and treatment, reflecting a shift toward more personalized, less invasive, and technologically driven approaches. This systematic review synthesizes the latest developments in ptosis management from 2018 to 2025, including surgical refinements, nonsurgical pharmacologic therapies, device-based aids, and artificial intelligenceassisted diagnostic tools. Traditional surgical techniques such as levator resection, frontalis sling, and Müller’s muscle-conjunctival resection continue to demonstrate high efficacy, with evolving modifications improving complication profiles and recovery times. Non-surgical interventions, particularly the use of oxymetazoline 0.1%, offer effective eyelid elevation in patients with mild-to-moderate acquired ptosis, providing a valuable alternative for non-surgical candidates. Innovations in diagnostics, including AI-powered image analysis, smartphone-based assessment tools, and biomechanical eyelid modeling, are enhancing early detection, surgical planning, and postoperative monitoring. Additionally, experimental approaches involving smart biomaterials, such as magneto-responsive implants and genetic profiling, are emerging with promising applications in neurogenic and congenital ptosis. Despite these advancements, gaps remain in standardizing outcome measures and validating newer technologies in large, diverse patient populations. The field is clearly moving toward an integrated, precision medicine model, where treatment decisions are guided by both anatomical and technological insights. Continued interdisciplinary research will be essential to translate these innovations into scalable clinical practice and optimize outcomes for individuals affected by ptosis
An Analysis of Publication Rates, Trends, and Characteristics of Retinal Detachment Trials on ClinicalTrials.gov
Background: Retinal detachment (RD) is a sight-threatening condition that requires timely intervention to prevent irreversible vision loss. Despite advances in surgical and pharmacologic management, the landscape of RD registered clinical trials (RCT) remains under-characterized in the literature. This study aimed to describe the characteristics, publication trends, and potential gaps in RD trials registered on ClinicalTrials.gov. Methods: A comprehensive search of ClinicalTrials.gov was conducted on January 1, 2025, using keywords related to RD. Two authors independently verified study eligibility, with discrepancies resolved by a third reviewer. Data were extracted on study type, phase, sponsorship, location, population, principal investigator characteristics, and completion status. Trials completed before January 1, 2022, were analyzed for publication status and outcomes using PubMed and Google Scholar. Statistical significance was defined as p < 0.05. Results: A total of 405 RD-focused CTs were identified. Over the past two decades, RD trials increased significantly, although at a slower rate than all RCTs. RD trials were predominantly interventional (74.1%) and non-industry sponsored (85.2%). The most common study types were drug-based (44.0%) and procedural interventions (33.7%). Majority of trials were conducted internationally (p=0.0371) and focused on adults (p=0.0008). Male principal investigators led 72.6% of trials, and MD-only investigators accounted for the majority (61.2%). Among the 202 completed studies, 64.3% (p<0.003) were published, with positive outcomes significantly more likely to be reported than negative ones (84.6% vs. 15.4%, p < 0.0001). Conclusion: This study provides a comprehensive overview of RD clinical research. It illustrates the expanding global effort into this field. Less than two-thirds of the completed trials were published, with positive outcome studies significantly more represented in the published literature.
Acknowledgement to Authors, Reviewers and Editors of Journal of Ophthalmology and Research in 2025
Abstract not available in the source database.
Copyright (c) 2025 Journal of Ophthalmology and Research
Study on Ocular Surface Changes in Patients with Unilateral Pterygium Compared to their Normal Eye
Background: The purpose of our study was to estimate the variations between TBUT (Tear film breakup time) Schirmers test (ST)value and MGD(Meibomian gland dysfunction) between a normal eye and an eye with pterygium. Methods: 50 patients with unilateral pterygium were enrolled in our study. TBUT, ST measurements, MGD and conjunctival congestion were evaluated. The results were compared between eyes with pterygium (Cases)and normal eyes of the same patient (controls). Pterygium was graded based on the length of limbal invasion into 3 grades. We have also evaluated the relationship between grades of pterygium and TBUT and Schirmer I test . Results: The mean TBUT in cases(eyes with pterygium) was 5.16±1.89 seconds and the mean TBUT in controls(eyes without pterygium) was 7.00±1.47 seconds . The mean wetting length of Schirmer’s strip was 10.96±3.51mm in cases and 13.90±4.5 mm in controls. Schirmer’s test was statistically significant between the eyes with pterygium and eyes without pterygium with P < 0.0001. In patients with pterygium 36% had MGD (Meibomian gland dysfunction) of varying severity whereas 26.5% of eyes without pterygium had MGD. There was no association of MGD between eyes with pterygium and the eyes without pterygium. Conclusion: Our study has shown that TBUT and Schirmers test values have an association with pterygium.
Pseudexfoliation: Therapeutical Treatment in Ocular Hypertension Related to Pseudoexfoliation Syndrome
Glaucoma is a disease characterized by progressive damage to the optic nerve, with or without elevated intraocular pressure; and is one of the leading causes of irreversible blindness worldwide. Pseudoexfoliation has been identified as the leading cause of secondary open-angle glaucoma. It is a disease that affects over 60-70 million people. The pathophysiology of pseudoexfoliation is characterized by the deposition in the eye tissues of a fibrillar material. Intraocular deposits are found in the trabecular meshwork, cornea, lens, and iris, leading to significant ocular and visual morbidity. The prevalence of the disease varies by geographic location and ethnicity, and a number of environmental, demographic, genetic, and molecular factors have been identified as potential causes. Despite the high morbidity, there is still no definitive cure for pseudoexfoliation. Treatments are aimed at managing elevated intraocular pressure, including local, systemic, or surgical therapy.
Eyelid Reconstruction Following Mohs Micrographic Surgery: Outcomes, Comparison of Techniques and Complications, an Asian Perspective
Purpose: To evaluate the surgical outcomes, complications, and recurrence rates in patients undergoing eyelid reconstruction following Mohs micrographic surgery. Methods: This single-institution retrospective study included 25 patients who underwent eyelid reconstruction after Mohs surgery between January 1, 2014, and December 31, 2022. Data on demographics, lesion characteristics, surgical techniques, and outcomes were analysed. Results: The mean patient age was 67.2 years (range: 49–89); 72% were male and 28% were female. Majority were Chinese (68%) and the rest comprised other races (32%). Lesion sizes were classified as small (<20 mm, 36%), medium (20–30 mm, 40%), or large (>30 mm, 24%). The majority (88%) were basal cell carcinomas, with the lower eyelid most commonly affected (96%), particularly the medial canthus (50%). Reconstruction was successful in all 25 cases, with no evidence of tumour recurrence over a median follow-up period of 36 months. Reconstruction techniques included full-thickness skin grafts (upper inner arm: 64%; upper eyelid: 12%), upper eyelid tarsoconjunctival grafts with lower eyelid myocutaneous flaps (16%), the modified Hughes procedure (4%), and direct closure (4%). Complications requiring repeat surgical intervention occurred in 3 (12%) of cases, while minor complications managed conservatively occurred in 2 (8%). Post-operative issues included lagophthalmos (4%), medial ectropion (8%), and graft dehiscence (8%). Conclusion: Eyelid reconstruction post-Mohs surgery can be successfully performed through various techniques tailored to defect size, location, and lamella involvement. Asian eyelids with prominent medial epicanthal folds, may benefit from full-thickness skin grafts. Close coordination with the Mohs surgeon and timely defect closure are essential to optimizing results.
Refractive Status of diabetic patients at Bangladesh Medical University (BMU)
Background: In Bangladesh, where diabetes affects millions of adults, understanding the refractive status of diabetic patients is vital for improving eye care and preventing avoidable vision loss. Aim: To assess the refractive status of diabetic patients by identifying the prevalence and types of refractive errors and evaluating their association with blood glucose levels. Additionally, it seeks to determine the impact of diabetes on visual acuity and the effectiveness of refractive correction. Methods: This cross-sectional study at BMU's Ophthalmology Department assessed refractive status in 200 adult diabetic patients (simple random sampling). Diabetic status was biochemically confirmed. Refractive errors were measured via objective and subjective techniques, followed by bestcorrected visual acuity. Diabetic control was recorded. Data was analyzed using SPSS 26, employing descriptive statistics, correlation, and linear regression. Results: Among the 200 diabetic patients studied, 53.5% were male and 46.5% female. The most frequent visual complaint, 58.5%, was blurred vision for both near and distance. Notably, 62% of participants exhibited poor glycemic control. Simple myopia was the predominant refractive error in both right 41.5% and left 42.5% eyes, followed by hyperopia 37.5% and 36.5%. A strong positive correlation was found between myopia and nuclear sclerosis r=0.73, with regression analysis indicating that 52% of nuclear sclerosis variability was explained by myopia. Significantly, 14.5% of right eyes and 13.0% of left eyes showed no visual improvement after refractive correction, suggesting co-existing diabetic ocular pathology. Conclusion: The findings of this study will help to identify high burden refractive errors in diabetic patients. Simple myopia and hypermetropia are utmost common and related with diabetic and lens changes. Numerous patients had compacted their visual acuity despite improvement, signifying basic diabetic eye complications. These findings highlight the necessity for regular refractive assessments as portion of diabetic eye care to allow early detection and recover visual outcomes in this helpless group.
Corneal Hysteresis as a Biomarker for Screening and Diagnosis of Normal Tension Glaucoma
Background: NTG stands as a subtype of glaucoma, which results in optic nerve damage with visual field loss when IOP remains within the normal range. The traditional IOP measurement technique causes NTG diagnosis to be delayed. Glaucoma risk assessment and progression evaluation now rely on corneal hysteresis as a measurement for understanding corneal biomechanics. Objective: The study aims to explore corneal hysteresis as a diagnostic tool in NTG diagnosis at the same time examining its relationship to RNFL measures. Methodology: This analytical cross-sectional research involved 100 participants, including 50 patients who had received an NTG diagnosis and 50 healthy subjects matched for age and gender. A complete eye examination, including a procedure for IOP measurement by Goldmann applanation tonometry and CH evaluation through Ocular Response Analyzer (ORA) testing and assessment of central corneal thickness (CCT) with pachymetry and RNFL thickness assessment with optical coherence tomography (OCT), was performed on 100 participants. SPSS conducted the statistical evaluation utilizing p<0.05 as the significance threshold. Result: NTG patient CH levels averaged 9.2 ± 0.6 mmHg, which showed a significant difference compared to control values at 9.5 ± 0.8 mmHg (p=0.036). The average RNFL thickness was considerably thinner in NTG eyes (77.3 ± 8.6 μm) than in control eyes (96.8 ± 7.2 μm) based on statistical assessment (p=0.001). Reduction of CCT measured at 512.9 ± 23.7 μm occurred in subjects with NTG and produced statistically significant results when compared with controls (521.6 ± 19.8 μm, p=0.049). Research results identified a statistically significant relationship between decreased CH and RNFL thinning in patients suffering from NTG (Pearson correlation, p = 0.002), indicating optic nerve structure damage based on reduced CH levels. Conclusion: The clinical value of corneal hysteresis emerges from its ability to predict progression of retinal nerve fiber layer thickness deterioration in NTG patients as the study shows lower corneal hysteresis in NTG patients is associated with increased retinal nerve fiber layer thinning, making it a possible additional tool for screening NTG patients and to support risk assessment through non-invasive testing
Inflammatory Mediators in the Pathophysiology of Diabetic Retinopathy (INSPIRE): Study Design and Baseline Characteristics
Purpose: To evaluate inflammatory intraocular and systemic cytokines associated with diabetic retinopathy (DR) and diabetic macular edema (DME). Methods: The INflammatory MediatorS in the PathophysIology of Diabetic REtinopathy (INSPIRE) study is a prospective, placebo-controlled, interventional study that enrolled 328 eyes of 164 adult patients with type II diabetes. 118 (236 eyes) diabetic patients with moderate nonproliferative diabetic retinopathy (NPDR) were randomized to either topical ketorolac 0.45% (Acuvail®) or placebo (Refresh Optive ®, preservative free) in double-masked fashion. A cohort of 23 (46 eyes) patients with diabetes but no retinopathy (No DR) and 23 patients with proliferative diabetic retinopathy (PDR) were also enrolled. All patients underwent complete ophthalmic examination including bilateral aqueous biopsies to test for 24 inflammatory cytokines and 5 classes of prostaglandins. A group of 107 patients without diabetes who were undergoing elective vitrectomy for non-inflammatory conditions had blood and aqueous fluid collected at the time for surgery for cross-comparison analysis. Results: There was similar age and sex distribution across cohorts. The study population was predominantly white. Longer duration of diabetes was observed in the NPDR and PDR groups. The ocular characteristics of all patients were similar for visual acuity, IOP, lens status and median central subfield thickness. Discussion: The INSPIRE study may provide greater understanding of the role of inflammation in DR and allow for the discovery of novel biomarkers and therapeutic targets that can better predict risk of vision loss and prevent progression of DR and DME.
Prevalence of Neovascular Glaucoma in Retinal Diseases in a Tertiary eye care Centre of Bangladesh.
Background: Neovascular glaucoma (NVG) is a severe sight-threatening condition resulting from retinal ischemia, leading to neovascularization in the anterior segment of the eye. The burden of retinal diseases is particularly significant in low- and middle-income countries including Bangladesh due to limited access to early screening. Aim: To determine the prevalence of neovascular glaucoma in retinal diseases and assess its associated sociodemographic factors, visual status, and management practices among patients in a tertiary eye care center in Bangladesh. Result: Among 38 respondents with retinal diseases, the prevalence of NVG was 97.4%, primarily linked to diabetic retinopathy 57.9% and central retinal vein occlusion 26.3%. Respondents had a mean age ± SD is 53.32 ± 9.433 years, with nearly equal gender distribution. Visual complaints were dominated by blurred vision, redness, and pain 71.1%. Comorbidities included diabetes 47.5% and hypertension 42.4%. Anterior segment findings highlighted iris neovascularization 78.9%, while posterior findings included hemorrhages 34.2% and macular edema 10.5%. Gonioscopy findings showed open angles in 63.2% and neovascularization in 28.9%. The most frequent intraocular pressure (IOP) reading status for the right eye was 35 mm of Hg, observed in 10.5% of cases, while the left eye had the highest frequency at 20 mm of Hg, occurring in 13.2% of cases. The post-surgical management of IOP in the cohort. A significant proportion, 34.2%, underwent post-surgical IOP monitoring, while 65.8% did not. Similarly, only 15.8% of patients received medications for IOP management post-surgery, indicating that the majority, 84.2%, did not require such intervention. Methods: This cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from October 2022 to November 2024. Patients aged ≥18 years with retinal diseases were included, while those with unrelated glaucoma or incomplete data were excluded. Data were collected using a pre-tested questionnaire and detailed ophthalmological evaluations, including gonioscopy and visual acuity assessments. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 26.0. Findings were presented by frequency and percent table. Conclusion: Neovascular glaucoma is highly prevalent among patients with retinal diseases, particularly those with diabetic retinopathy and retinal vein occlusion in Bangladesh. Early detection and comprehensive management are crucial to mitigating its impact and preventing blindness in resource-limited settings.
Comparison between Boys and Girls of Refractive Status in Some Selected Secondary Schools in Dhaka City
Background: Refractive errors are a major cause of visual impairment, affecting 12.8 million children globally, particularly in low-resource settings. Gender differences in refractive errors remain underexplored in Bangladesh, where 40% of school-aged children reportedly face undetected vision problems. Aim: The aim of this study was to assess and compare the refractive status among boys and girls in selected secondary schools in Dhaka City to identify gender-based differences and associated factors. Methodology: This analytical cross-sectional study was conducted from July 20204 to December 2024 in three secondary schools in Dhaka: Zinzira PM Pilot School and College, Aymona Khatun High School, and Shahjahanpur High School. A total of 175 students, aged 13–18 years, were selected using purposive sampling. Data was collected through pre-tested semi-structured questionnaires and comprehensive eye examinations, including visual acuity and refraction tests, conducted by trained health professionals. The association between gender and refractive status was analyzed using chi-square tests, with significance set at p<0.05. Ethical approval and informed consent were obtained prior to the study. Result: Most respondents 62.3% were aged 16–18 years, with a mean age of 16.51±1.45 years; 54.3% were boys. Hyperopia was the most prevalent refractive error 54.9%, followed by myopia 40.8%, with significant associations observed between myopia (p-value 0.041), eye strain (p-value 0.015), and gender, where girls were more affected. The χ² test revealed significant bilateral refractive symmetry for OD_sph (p-value 0.038, right; p-value 0.042, left) and OD_Cyl (p-value 0.025, right; p-value 0.031, left), highlighting the need for targeted interventions to address uncorrected refractive issues. Conclusion: Significant gender differences were observed in refractive status, with girls experiencing more myopia and eye strain. Early detection and gender-specific interventions are essential to address refractive errors and improve eye health among secondary school students in Dhaka.
Macular Thickness Variation after Conventional and Short-Pulse Laser Treatment in Diabetic Patient by Optical Coherence Tomography
Background: Diabetic retinopathy is a leading cause of blindness, and this study evaluates the comparative impact of conventional and short pulse laser photocoagulation on macular thickness in PDR patients to optimize treatment outcomes. Aim: The aim of this study was to evaluate changes in macular thickness in patients with PDR treated with conventional single-spot laser photocoagulation versus short pulse laser photocoagulation, using Optical Coherence Tomography (OCT) measurements at baseline, 1 week, and 4 weeks post-treatment. Methodology: This prospective longitudinal study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2023-June 2024, total 22 PDR patients was selected by using consecutive sampling (11 eyes per group). Group I underwent single-spot laser photocoagulation in one session, and Group II received short pulse laser photocoagulation in two sessions. Inclusion criteria included PDR without macular edema (central thickness <300 \u00b5m) and diabetes mellitus, while exclusion criteria ruled out significant ocular comorbidities. Macular thickness was assessed using OCT before treatment and at 1- and 4-weeks post-treatment. All procedures were standardized, performed by a single surgeon, and data were analyzed with Statistical Package for the Social Sciences (SPSS) version 26. Result: The results showed significant increases in macular thickness in both groups, with the conventional laser group demonstrating a rise from 234.45 ± 44.91 μm pre-laser to 431.45 ± 104.12 μm at 4 weeks, and the short pulse laser group increasing from 241 ± 39.68 μm to 317.82 ± 94.82 μm. Statistically significant changes were observed at both 1-week and 4-week time points in both groups p=0.001. The study also highlighted differences in laser parameters, with the short pulse laser group using higher power, shorter pulse duration, and more spots compared to the conventional laser group. Both treatments demonstrated effectiveness in altering macular structure, with short pulse laser showing greater precision and efficiency. Conclusion: Both conventional and short pulse laser photocoagulation significantly increased macular thickness, with the short pulse laser showing greater efficacy. These results suggest that short pulse laser may offer a more efficient treatment for PDR.
Visual Assessment of the Rickshaw Pullers in Dhaka City
Background: Rickshaw pullers in Dhaka City work long hours in harsh conditions, affecting their eyesight and overall health, which may impair job performance and quality of life. Aim: The study aimed to assess the present visual status of the rickshaw pullers in Dhaka city which assists the eye specialist and policy makers to take necessary steps to overcome the visual impairment of the rickshaw pullers. Result: Among 219 rickshaw pullers, 38.8% were aged 31-40 years, 89.5% lacked formal education, and 95.4% had over five years of experience. While 74.9% could read without difficulty, 21.5% struggled with the standard eye chart, and only 6.4% were diagnosed with eye problems. Most, 51% had good vision, though 7% reported poor vision. Diabetes and hypertension affected 3.2% each, while 64.4% worked over 9 hours daily. Significant associations were found between age and refractive status (p=0.011) and workload and income (p=0.006). Methods: This cross-sectional study, conducted over three months (August to October 2024) among 219 rickshaw pullers in Dhaka City, selected via purposive sampling. Male rickshaw pullers aged 18 years or above with at least one year of experience were included, while those with severe visual impairments or disabilities were excluded. Data were collected using a pre-tested structured questionnaire and visual assessments with a Snellen chart, Ishihara plates, and reading tests. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 26, employing descriptive and inferential methods, with significance set at p<0.05. Ethical approval was obtained, and participants provided informed consent, ensuring confidentiality and data integrity. Conclusion: The study reveals significant visual health issues among rickshaw pullers in Dhaka City, highlighting the need for eye care interventions and regular screenings to improve their vision and quality of life, ensuring better occupational performance and well-being.
Copyright (c) 2024 Journal of Ophthalmology and Research
Preserflo™-Baerveldt Hybrid Implant: A Novel Approach for Glaucoma Drainage Surgery
Purpose: To investigate the efficacy and safety of a new technique connecting a Baerveldt glaucoma implant to a PreserfloTM micro-shunt. Design: Retrospective non-comparative consecutive case series. Methods: A retrospective consecutive case series analysing data collected from Electronic Patient Records at St Thomas’ Hospital. All procedures were performed by a single surgeon (KSL) between November 2021 and February 2023. The following data were collected: demographic variables, IOP, number of glaucoma medications, complications and glaucoma subtype. Results: Ten eyes underwent connection of the Baerveldt glaucoma plate to a Preserflo™ implant either as a primary combined procedure or as a secondary staged procedure. The mean age of our patients was 68.4 ± 10.9. The mean preoperative IOP was 25.6 ± 7.5 mmHg. The mean number of topical glaucoma medication preoperatively was 3.4 ± 0.7 with 4 patients also being on acetazolamide. All complications resolved without sequalae. One patient needed injection of viscoelastic at the slit lamp. At 6 months, the mean IOP was 11.7 ± 3.7 mmHg with a mean number of topical glaucoma medication of 0.7 ± 1.2, with 70% being off glaucoma medication. At 1 year, the mean IOP at 1 year was 11.7 ± 4.2 mmHg with a mean number of topical glaucoma medication of 1.1 ± 1.2, with 44% being on no glaucoma medications. Conclusions: This novel technique is a safe and effective way to use as a primary combined procedure in high-risk eyes where Preserflo™ is likely to fail. It can also be used as a secondary procedure to salvage a failed PreserfloTM.
Semi- Automating Laser Vision Correction
The purpose of this study is to show a semi-automated laser vision correction (LVC) with the transepithelial photorefractive keratectomy (TransPRK) surgery technique. Since more surgical steps have been automated over the years, we have standardized the TransPRK technique. We have been using it since 2010. This paper aims to illustrate the processes that are readily applicable to automation. To meet the patient's expectations and ensure that the patient has uncorrected visual acuity at least equal to the preoperative corrected vision with glasses, patient selection is crucial in refractive surgical procedures. One major benefit of automating the surgery is that it can be performed in an analogous way by each surgeon or laser correction centre, so once the standard and results are good, these can be performed by different surgeons.
Visual Outcome after Systemic Steroid Therapy in Traumatic Optic Neuropathy
Background: Traumatic optic neuropathy (TON) is an acute injury of the optic nerve due to trauma. It is an ocular emergency that demanding early treatment. Systemic steroids and surgical decompression are the recommended treatment. Objective: To assess the visual outcomes after systemic steroid therapy among patients with TON. Methods: This prospective observational study was conducted at Department of Neuro-ophthalmology, National Institute of Ophthalmology and Hospital (NIO&H), Dhaka, Bangladesh, from December 2019 to February 2022, on 48 eyes of 48 patients with TON. Patients were selected on selection criteria; they underwent detail ocular examination as well as relevant investigations. Methylprednisolone 1 gram was given intravenously for 5 days followed by oral prednisolone tablet 1 mg/kg body weight daily in tapering dose for 2 weeks. They were followed up on 1 week, 1 month and 3 months after starting treatment. Best corrected visual acuity (BCVA) in log MAR unit, color vision by Ishihara pseudoisochromatic chart and relative afferent pupillary defect (RAPD) grades were assessed in each follow up. Morphology of the disc was assessed prior to starting treatment and at final follow up. Results: The mean(±SD) base-line BCVA was 0.99±0.22 Log MAR unit, it was 0.89±0.30, 0.69±0.37 and 0.39±0.37 after 1 week, 1 month and 3 months respectively. The mean base-line value of color vision was 1.48±2.27, it was 8.98±3.65, 18.15±7.00 and 23.02±8.66 after 1 week, 1 month and 3 months respectively. We found a significant improvement in RAPD grading at final follow up (p <0.001). Pallor of the disc was found among 20 patients at final follow-up (<0.001). Conclusion: Visual status of patients with traumatic optic neuropathy improves by systemic steroid therapy. It is evident by significant improvement of visual acuity, color vision and RAPD grading.
Surgical Approach of Basal Cell Carcinoma on the Lower Eyelid: A Case Report
Basal cell carcinoma (BCC) is a common malignant tumor, originating from the basal cell layer of the epidermis. One of the known risk factors of BCC is intense exposure to ultraviolet radiation. The most common location is in the head and neck area, including the eyelids. More than 50% of BCCs of the eyelid initially occur on the lower lid. The gold standard of diagnosis of BCC is histopathology. Surgical excision using Mohs surgery is the first line of treatment for periocular BCC. Careful consideration should be made on reconstructing the eyelid after successful mass removal. Early diagnosis and treatment lead to a better functional and aesthetic outcome after surgery.
Glaucoma Screened at the Ophthalmology Clinic of PZaGa Hospital Androva Mahajanga, Madagascar.
Introduction: Glaucoma is an anterior optic neuropathy, usually bilateral but often asymmetric characterised by the association of pathological excavation of the optic disc, visual field alteration, an open or closed iridocorneal angle and often ocular hypertony. Materials and Methods: This was a prospective, cross-sectional, descriptive study over a period of 8 months from October 2017 to May 2018 carried out in the Ophthalmology Clinic of university hospital Professeur ZAFISAONA Gabriel Mahajanga. The purposes of this study were to determine the prevalence, identify the risk factors and describe the epidemio-clinical aspects of glaucoma. Results: Among the 3660 patients examined during the study period, 31 cases of glaucoma were diagnosed, representing a frequency of 0.84%. Male predominance was observed with a sex ratio of 2.10. The mean age was 65.07 +/- 0.12 years. Among the general risk factors for glaucoma recorded, hypertension ranked first with 38.70% of cases, followed by diabetes with 12.90% of cases. Local risk factors were previous eye surgery (10.82%), followed by eye trauma (6.45%). The visual field was agonic in 24.19% of cases and seven cases of total blindness were found (11.66%). Conclusion: Glaucoma was discovered late. All patients with a family history of glaucoma and aged 40 or over should be screened systematically during ophthalmological consultations.
Orbital Pseudotumor Masquerading as Orbital Cellulitis
A 55-year-old albanian male was referred to the Ophtalmology Department in Mother Theresa University Hospital Tirana, with blurried vision, painful proptosis, limitied eye movements diplopia and chemosis of the right eye for three days. Two years ago he was diagnosed with orbital cellulitis. Over the next 72 hours, he did not clinically improve as it was expected. a diffuse infiltrative mass of orbital muscles and fat on the right eye with exophtalmy of this side that suggested for infiltrative tumor. Based on the results of radiology, it was required biopsy. Histopathology revealed the presence of lymphocites, plasma cells, myofibrolastic cells and collagen, with diagnose of inflammatory chronic moderated lesion. Given the negative workup, the presentation was determined to be consistent with idiopathic orbital inflammation via a diagnosis of exclusion. Therefore, the patient was treated with intravenous steroids that produced pronounced improvement within 24 hours. The patient was discharged in improved condition with a prednisone taper and ophtalomoly follow-up. Orbital pseudotumor if often misdiagnosed as orbital cellulitis, because of the similar presentation. It is important to consider differential diagnose when the initial diagnose and treatment does not progress as we expect.
Association of C-reactive Protein with Diabetic Retinopathy in Young People with Type-I Diabetes Mellitus
Background: Diabetic retinopathy (DR) is a chronic, progressive sight threatening disease of the retinal microvasculature and is a significant complication of diabetes mellitus (DM). Type l diabetes mellitus (T1DM) is one of the most common metabolic conditions in childhood and adolescence. C-reactive protein (CRP) plays a major role in the human innate immune response and serves as a stable plasma biomarker indicating the presence of low-grade systemic inflammation. Objective: This study aimed to assess the association of C-reactive protein (CRP) with diabetic retinopathy in young people with T1DM. Methods: A total of 60 T1DM patients were included; of them 30 T1DM patients with retinopathy (cases- Group I) and 30 patients of T1DM without retinopathy (controls- Group II), aged between 10 to 24 years. Complete clinical evaluation including history, physical examination, relevant ocular examinations like visual acuity test, slit lamp examination, fundus examination both direct and indirect ophthalmoscopy and color fundus photography were done accordingly. Serum high sensitivity CRP (hs-CRP) level was measured following standard procedure. Results: It was observed that, mean hs-CRP was significantly increased in retinopathy group compare to without retinopathy group (5.08±1.29 mg/L versus 3.43±0.69 mg/L, p<0.001). Mean hs-CRP level had significant difference among National Screening Committee (NSC) grading of retinopathy (p<0.001). Mean hs-CRP level was gradually increased with NSC grades. An age-adjusted and sex-adjusted model revealed that patients with highest hs-CRP (>4 mg/L) were 13.1 times more likely to have DR. Serum hs-CRP had a significant strong positive correlation with HbA1c in Group I (r=+.831, p<0.001) and Group II (r=.666, p<0.001). Patients with retinopathy group had significantly higher duration of DM and HbA1c compare to without retinopathy group (p<0.05), but this relation was lost in multivariate logistic regression model. Conclusion: C-reactive protein (CRP) is strongly associated with diabetic retinopathy. Serum CRP also significantly related to different grades of retinopathy.
Rejection of corneal transplant after administration of SARS-CoV-2 messenger RNA vaccine
Purpose: This study reports the frequency of corneal allograft rejection following vaccination with a messenger RNA (mRNA) vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and describes the rate of rejection. Methods: This retrospective and observational study included 64 patients who underwent keratoplasty, and the rates of rejection corrected for the observation period were analyzed. Results: Nine cases of rejection were observed following mRNA vaccination, with an observational period of 804 days, while the no-vaccination control group had two cases of rejection during an observational period of 923 days. The overall rate ratio of rejection related to vaccination, compared to that in the control group, was 5.74. Notably, the second vaccination correlated with the most prominent rate ratio 27. Conclusion: Corneal transplant rejection is suspected to be associated with SARS-CoV-2 mRNA vaccination. Rejection, believed to be induced by vaccination, is primarily observed in the early stages of the vaccination process.