bluuebunny/crossref_metadata_2025 huggingface dataset:
DYSLIPIDEMIA CHANGES EXERCISE ENERGY EXPENDITURE IN MICE TRANSGENIC FOR HUMAN APOCIII
Authors: Rodrigues Teixeira Junior Nilton , Rodrigues Jimenes Diogo , Schultz Cristiany , Augusto Berti Jairo
Published: May 2023

Hypertriglyceridemia is a predisposing factor for several metabolic diseases in the worldtoday. Their cause is multifactorial, several factors are directly linked to the modification ofplasma lipid metabolism, among them are genetics and exercise. The genic overexpression ofapoCIII makes the animal hypertriglyceridemic and high levels of blood cholesterol, enablingfurther studies to be done on its metabolic profile. This study investigates how apoCIIIoverexpression and exercise modify the metabolism of genetically modified mice, especiallytheir energy expenditure. We used 15-month-old male C57Bl/6 mice, subdivided into 4groups: 2 NTG groups (non-transgenic mice that were submitted to training and theircontrols) and 2 CIII groups (transgenic Mice with basal triglyceridemia above 300mg/dL thatwere submitted to training and their controls). The exercised groups underwent for 8 weeks amoderate intensity training for 40 minutes 3 times a week. All animals were submitted to astress test to evaluate performance and energy expenditure. The trained animals had higherenergy expenditure during all stages of the test (p<0.01) and the area under curve of the EEshowed that the trained animals had higher caloric consumption (p<0.001), while the animalCIII sed had a much higher energy expenditure than its control NTG sed (p<0.001). Weconclude that dyslipidemia makes the CIII animal less fit for exercise, and trained animalshave lower energy expenditure independent of dyslipidemia and produced more work.
AGE AND OBESITY INTERFERES IN MUSCLE HYPERTROPHY IN RATS UNDERGOING HIIT TRAINING
Authors: Rodrigues Jimenes Diogo , Cândido Fernanda , Rodrigues Teixeira Júnior Nilton , Rinaldi Wilson , Patrícia Barbosa Carmem
Published: May 2023

Sarcopenic obesity is a condition characterized by the simultaneous presence of obesity andsarcopenia, which is the loss of muscle mass and function. Is a growing concern, especiallyamong the elderly population, and it is important to address both obesity and sarcopeniathrough lifestyle modifications, such as exercise and proper nutrition, to improve overallhealth and quality of life. Our study aimed to evaluate the effect of HIIT training on themuscle fiber area of the EDL muscle in obese rats of different ages. For that, Wistar rats, 7and 12 months old, submitted or not to a HFD diet were subjected to HIIT training, 3 times aweek, on alternate days, for 8 consecutive weeks. After the euthanasia EDL muscles wascollected and processed histologically. Our data showed that HIIT training was able topromote muscle hypertrophy even with consumption of this diet, indicating that practicingthis exercise can stimulate protein synthesis even under conditions of obesity.
INVESTIGATING WRITING CHALLENGES ENCOUNTERED BY SAUDI EFL LEARNERS
Authors: Khasawneh Mohmmad
Published: May 2023

This study aimed at investigating the types of writing tasks produced by Saudi EFL learners. It also aimed at exploring the writing challenges encountered by those students. The sample of this study consists of (261) students enrolled in ENG (011). The students were randomly chosen from three different colleges: college of business, college of medicine, and college of engineering. The researcher used a questionnaire with (13) items asking about the challenges faced by the students during writing tasks. The results of this study revealed that the most frequently writing tasks produced by the students were essays for exams, synthesis, and reflection papers. The results also revealed that ‘organizing paragraphs’, ‘using proper connections and transitions’, and ‘inability to keep writing flow’ were the most frequent challenges of writing tasks reported by the students. The present study provided some recommendations and pedagogical implications for policymakers and curriculum designers to take action in an attempt to avoid or lessen these challenges.
ESTRESSE E BURNOUT NA PROFISSÃO DOCENTE
Authors: Yaegashi João Gabriel , Otero Cleber Sanfelici , Yaegashi Solange Franci Raimundo , Oliveira Marta Regina Furlan de
Published: May 2023

O estado de saúde é um aspecto fundamental para a qualidade de vida do professor, sendo uma condição necessária para que ele possa executar, com êxito, o seu trabalho. Todavia, o contexto escolar pode ser considerado múltiplo, complexo, dinâmico e interativo. Para lidar com esse contexto multifacetado, o professor, elemento crucial no processo educativo, precisa se adaptar às demandas provenientes desse ambiente de trabalho. Nesse sentido, por meio de uma revisão de literatura, tem-se como objetivo investigar quais são os principais fatores psicossociais, estruturais e relacionais na profissão docente que podem desencadear o estresse e o burnout em professores que atuam na Educação Infantil, bem como discutir a responsabilidade civil dos empregadores/instituições de ensino nos casos de burnout. Os resultados revelam que a carga de trabalho, as relações interpessoais e as condições do ambiente escolar constituem os agentes que mais desencadeiam estresse e burnout nos professores. Conclui-se que ações de prevenção e suporte social são necessárias para garantir a qualidade de vida dos docentes.
ARES DE PROGRESSO E CONSERVADORISMO
Authors: De  Almeida Orlando Evelyn , Ferreira de Mello Nicoli , De Lemos Neli
Published: May 2023

As aparentes ambiguidades existentes entre os ares de progresso e as várias faces do conservadorismo no Brasil são elementos que marcaram a História. Com isso, objetivamos discutir essas aparentes ambiguidades considerando os modos como foram representadas questões relacionadas às mulheres na Revista Manchete (1973). Para isso, utilizamos como metodologia a análise do discurso, tendo a revista como fonte histórica. A partir de estudos que englobam a História Cultural, História da Educação e História das Mulheres, concluímos que um projeto político, pedagógico, cultural e social esteve atrelado à produção e veiculação dessas representações por meio das revistas.
VIOLÊNCIA NO ENSINO SUPERIOR
Authors: Ribas Haira Lima , Silva Cleonice Aparecida Raphael da , Marchesoni Laís Bastos
Published: May 2023

O presente artigo de revisão bibliográfica, tem como objetivo compreender as manifestações de violência no ensino superior, tendo como base teórica a Teoria Crítica da Sociedade, especialmente os estudos de Theodor W. Adorno. Foi realizada uma busca de artigos e pesquisas sobre a temática na base de dados da SciELO, na plataforma google acadêmico e no Catálogo de Teses e Dissertações da CAPES, em oito de abril de 2022 e para a sistematização dos dados foi utilizada a análise de conteúdo proposta por Adorno (2008). Como resultado, foram encontrados quatro artigos e uma dissertação que coadunam com a proposta da presente revisão, pois retratam as formas de violência que se manifestam no ensino superior, como  o trote, o bullying e o preconceito, sendo estes últimos modos mais regredidos para a expressão da agressividade psíquica, o que evidencia que a verticalização da educação não garante o desenvolvimento global e que a universidade revela uma estrutura social que tem como base a dominação.
AUTORREALIZAÇÃO E SAÚDE MENTAL
Authors: Vieira Leite Eduardo , Silva da Fonseca Laerte , De Souza Medrado Jackelyne , Souza de Carvalho Gabriele
Published: May 2023

O objetivo deste artigo é investigar o amadurecimento dos mecanismos atencionais, por meio das tarefas trigonométricas, visando a autorrealização e preservando a saúde mental. A metodologia empregada foi a pesquisa teórica e documental para estabelecer uma matriz de referência aplicando-a em tarefas relativas às noções das relações trigonométricas no triângulo retângulo, de um livro aprovado no PNLD (2018). O artigo está estruturado em três etapas: levantamento bibliográfico, cuja intenção é criar a fundamentação sobre a autorrealização, saúde mental e mecanismos atencionais; elaboração da matriz de referência; aplicação da matriz nas tarefas do referido assunto. Ao final da pesquisa, após realização da matriz referencial e análise do livro constatou-se que uma quantidade considerável das tarefas analisadas dificulta o amadurecimento e a focalização da atenção do aluno mais do que contribuem para seu engajamento. Isso implica em consequências negativas para a saúde mental positiva, distanciando esses alunos do seu processo de autorrealização.
VIOLÊNCIA ESCOLAR SOB A PERSPECTIVA DE PROFESSORES DA REDE BÁSICA DE ENSINO DO BRASIL
Authors: Santos Nicoli Brandão dos , Silva Andressa Stephanie Fernandes , Teixeira Renata Plaza , Diniz Michael Macedo , Ribeiro Victor Barbosa
Published: May 2023

A escola é um ambiente de pluralidade de ideias e situações de conflitos. Neste estudo, objetivou-se avaliar os quadros de violência escolar sofrida por professores. Para tanto, um questionário online foi aplicado em professores da rede básica de ensino avaliando questões socioeconômicas e violência escolar. Muitos professores relataram já terem sofrido algum tipo de violência, predominantemente a agressão verbal. Outros tipos também foram identificados: agressão física, ameaças, dano ao patrimônio, assédio sexual e racismo. Observou-se que professores das redes municipal e estadual estão mais expostos, mulheres e os que atuam no Centro-Oeste. Conclui-se que são muitos professores sujeitos à violência em seu ambiente de trabalho. Adicionalmente, o fato de termos encontrado um maior percentual dessa violência nas redes municipal e estadual indica um possível baixo investimento, por parte dos governos estaduais e municipais, na qualidade do trabalho docente e no controle de indicadores que podem estar ligados a essa violência.
Insights into dung beetle (Coleoptera: Scarabaeidae: Scarabaeinae) distribution along an elevational gradient in a tepui table-top mountain in the Brazilian Amazon
Authors: Salomão Renato Portela , Kohlmann Bert , Mendes Célio Vandré Raia , Vaz-de-Mello Fernando , Lira André Felipe Araujo
Published: May 2023

Elevational gradients are excellent models to understand species distribution across sites with marked shifts in environmental conditions. In northern South America, tepuis are table-top mountains with elevations above 1000 m and high biodiversity and endemism levels. In this study, we assessed the effect of elevation on dung beetle (Coleoptera: Scarabaeidae: Scarabaeinae) assemblage structure (species richness, abundance, and biomass) in Tepequém, a tepui located in northern Brazil. Dung beetles were sampled with pitfall traps within seven elevational bands from 250 to 850 m. A total of 83 individuals from 14 species were collected, Oxysternon festivum (Linnaeus, 1758) and an unidentified Onthophagus species being the most abundant. Elevation did not affect beetle species richness and biomass. However, species composition from 750 to 850 m differed statistically from that recorded at lower elevations. Our results suggest that beetle assemblages possess a bimodal distribution along an altitudinal gradient on the Tepequém. The contrasting vegetation structure of tepuis between highlands (shrubland savannah vegetation) and lowlands (tropical rainforest) explains the different composition of the assemblages. This study should be considered as a starting point in improving our understanding of the dung beetle diversity of tepuis, which present a unique singular relationship between elevation and species diversity.
Spi-C and PU.1 Counterregulate Rag1 and Igκ Transcription to Effect Vκ-Jκ Recombination in Small Pre-B Cells
Authors: Xu Li S , Zhu Jiayu T , Raczkowski Hannah L , Batista Carolina R , DeKoter Rodney P
Published: May 2023

B cell development requires the ordered rearrangement of Ig genes encoding H and L chain proteins that assemble into BCRs or Abs capable of recognizing specific Ags. Igκ rearrangement is promoted by chromatin accessibility and by relative abundance of RAG1/2 proteins. Expression of the E26 transformation-specific transcription factor Spi-C is activated in response to dsDNA double-stranded breaks in small pre-B cells to negatively regulate pre-BCR signaling and Igκ rearrangement. However, it is not clear if Spi-C regulates Igκ rearrangement through transcription or by controlling RAG expression. In this study, we investigated the mechanism of Spi-C negative regulation of Igκ L chain rearrangement. Using an inducible expression system in a pre-B cell line, we found that Spi-C negatively regulated Igκ rearrangement, Igκ transcript levels, and Rag1 transcript levels. We found that Igκ and Rag1 transcript levels were increased in small pre-B cells from Spic−/− mice. In contrast, Igκ and Rag1 transcript levels were activated by PU.1 and were decreased in small pre-B cells from PU.1-deficient mice. Using chromatin immunoprecipitation analysis, we identified an interaction site for PU.1 and Spi-C located in the Rag1 promoter region. These results suggest that Spi-C and PU.1 counterregulate Igκ transcription and Rag1 transcription to effect Igκ recombination in small pre-B cells.
Comparison of novel clinic-based approach (amblyopia school) Vs. home-based occlusion for amblyopia therapy – A retrospective study
Authors: Bhattacharya Subhajit , Subhedar Ketaki , Bhadauria Madhu , Shukla Ranjana , Manaktala Ruchita , Kumar Abhinav , Wilson Ayush
Published: May 2023

Purpose:

To compare visual outcomes of standard occlusion therapy at home versus clinic in amblyopic children.

Methods:

A retrospective study of case records of children aged <15 years with diagnosis of strabismic or anisometropic amblyopia or both was conducted at a tertiary eye hospital located in rural North India between Jan 2017–Jan 2020. Those with at least 1 follow-up visit were included. Children with ocular co-morbidities were excluded. Treatment in clinic by admission or at home was based on the parents’ discretion. Children in clinic group underwent part time occlusion & near work exercises for minimum 1 month, in classroom format which we called amblyopia school. Those in home group underwent part time occlusion as per PEDIG recommendations. Primary outcome measure was improvement in number of Snellen’s lines at the end of 1 month & at final follow-up.

Results:

We included 219 children with mean age of 8.8±3.23 years, out of which clinic group had 122 (56%) children. At one-month, visual improvement in clinic group (2.1±1.1 lines) was significantly greater than home group (mean=1.1±0.8 lines) (P < 0.001). Both groups continued to improve vision on follow-up, however the vision in the clinic group (2.9±1.2 lines improvement at mean follow-up of 4.1±1.6 months), continued to be better than home group (2.3±1.1 lines improvement at mean follow-up 5.1±0.9 months) (P = 0.05).

Conclusion:

Clinic based amblyopia therapy in the form of an amblyopia school can help expedite visual rehabilitation. Thus, it may be a better option for rural settings where patients in general tend to be poorly compliant.
Sub-Bowman keratomileusis versus femtosecond laser in situ keratomileusis on the long-term visual recovery: A comparative study
Authors: Feng Yi , He Rui , Qu Min , Ma Qiuxia , Tian Huiqin
Published: May 2023

Purpose:

To explore the long-term visual quality of the same subjects after sub-Bowman keratomileusis (SBK) or femtosecond laser in situ keratomileusis (FS-LASIK).

Methods:

This prospective study included patients screened for corneal refractive surgery at the Refractive Surgery Center of our Hospital between November 2017 and March 2018. One eye underwent SBK, while the other eye underwent FS-LASIK. Total higher-order aberrations, coma aberrations, and clover aberrations were evaluated before and at 1 month and 3 years after the procedure. The visual satisfaction of both eyes was investigated, respectively. The participants completed a surgical satisfaction questionnaire.

Results:

Thirty-three patients were included. There were no significant differences in total higher-order aberrations, coma aberrations, and clover aberrations between the two procedures before and 1 month and 3 years after surgery (all P > 0.05), except for the total coma aberrations in FS-LASIK were significantly higher compared with the SBK group at 1 month after surgery [0.51 (0.18, 0.93) vs. 0.77 (0.40, 1.22), P = 0.019]. The surgical satisfaction questionnaire scores of the SBK group and the FS-LASIK group were 9.8 ± 0.8 and 9.8 ± 0.8, respectively, at 1 month, and 9.7 ± 0.9 and 9.7 ± 1.0, respectively, at 3 years (all P > 0.05).

Conclusion:

There were no differences in corneal aberrations and satisfaction between SBK and FS-LASIK procedures at 1 month and 3 years.
Need of optical aids for schools for blind students in Pune and Nasik districts and compliance of their use
Authors: Chavan Amruta , Gogate Parikshit , Wagh Shailesh , Telap Sharad , Phadke Supriya , Chandore Sonali , Avhad Komal , Gogate Siddharth , Naidu Purshottam
Published: May 2023

Purpose:

To assess the need for spectacles and low-vision aids (LVA) in students attending schools for the blind and study their compliance with use.

Methods:

Comprehensive ocular evaluation was performed using a hand-held slit lamp and ophthalmoscope. Vision acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart for distance, as well as for near. Spectacles and LVAs were dispensed after refraction and LVA trial. Follow-up was performed to assess the vision using the LV Prasad Functional Vision Questionnaire (LVP-FVQ) along with compliance with use after 6 months.

Results:

Of the 456 students examined from six schools, 188 (41.2%) were female; 147 (32.2%) were <10 years of age. In all, 362 (79.4%) were blind since birth. The students dispensed only LVAs were 25 (5.5%), only spectacles were 55 (12.1%), and both spectacle and LVAs were 10 (2.2%). The vision improved using LVAs in 26 (5.7%) and using spectacles in 64 (9.6%). There was a significant improvement in LVP-FVQ scores (P < 0.001). Also, 68/90 students were available for follow-up, of whom 43 (63.2%) were compliant to use. Causes of not wearing spectacles or LVA in 25 were left somewhere or lost 13 (52%), broken 3 (12%), uncomfortable to use 6 (24%), not interested to use 2 (8%), and got operated 1 (4%).

Conclusion:

Although the dispensing of LVA and spectacles improved the visual acuity and vision function of 90/456 (19.7%) students, nearly a third were not using them after 6 months. Efforts need to be taken to improve the compliance of use.
Post-vitrectomy secondary macular holes: Risk factors, clinical features, and multivariate analysis of outcome predictors
Authors: Jain Mukesh , Narayanan Raja , Gopal Lingam , Padhi Tapas R , Behera Umesh C , Panda Krushna G , Tabasum Runa , Banjare Nadeem K
Published: May 2023

Purpose:

We report clinical characteristics, risk factors, treatment outcomes, and prognostic predictors of post-vitrectomy secondary macular holes (MHs).

Methods:

This was a retrospective observational case series from November 2014 to December 2020. Eyes that developed secondary MH, two weeks and beyond after primary vitrectomy for non-MH indications, were enrolled. Pre- and intraoperative records were screened to exclude pre-existence of MH. Eyes with multiple vitreoretinal surgeries prior to MH detection and tractional myopic maculopathy were excluded.

Results:

A total of 29 eyes of 29 patients with a mean age of 52 years developed secondary MH post-vitrectomy. The most common indications for primary vitrectomy were rhegmatogenous retinal detachment (RRD, 48.2%) and tractional retinal detachment (TRD, 24.1%). Time to MH detection after primary vitrectomy was 91.5 ± 117.6 days. The mean minimum hole diameter was 530 ± 298 microns. Epi-retinal membrane and cystoid degeneration was noted in 6 (20.7%) and 12 (41.3%) eyes, respectively (p = 0.088). The mean time from MH detection to MH repair was 34 ± 42 days. The surgical intervention included internal limiting membrane peeling with tamponade in 25 eyes. Overall, 80% showed anatomic hole closure, 90.9% versus 57.1% in the RRD and TRD (p = 0.092), respectively. The mean best-corrected visual acuity (BCVA) at the final visit was 0.71 logarithm of the minimum angle of resolution. Thirteen eyes (52%) had a BCVA of 20/100 or better. Minimal hole diameter (p = 0.029) only predicted final visual acuity. The interval between MH diagnosis and repair did not affect hole closure significantly (p = 0.064).

Conclusion:

Secondary MH post-vitrectomy closed successfully with limited visual improvement and trails behind idiopathic MH.
Relatively anterior lens position in primary angle-closure glaucoma eyes with long axial length
Authors: Chen Jiawei , Zhang Yan , Huang Yuqiang , Ng Tsz Kin , Huang Chukai
Published: May 2023

Purpose:

To evaluate the refractive status and ocular biometric parameters in primary angle-closure glaucoma (PACG) eyes with different axial lengths (ALs).

Methods:

In total, 742 Chinese PACG subjects with complete ophthalmic examinations were enrolled. The refractive status was categorized as myopia (spherical equivalent [SE] ≤−0.5 D), emmetropia (−0.5 D < SE < +0.5 D), and hyperopia (SE ≥+0.5 D), whereas the AL was divided into short (AL <22.5 mm), regular (22.5 ≤ AL <23.5 mm), and long (AL ≥23.5 mm). The refractive status and ocular biometric parameters were compared among different AL groups.

Results:

The mean AL of the PACG eyes was 22.53 ± 0.84 mm (range: 19.68–25.57 mm). The refractive status was significantly different among different AL groups (P < 0.001). Also, 92.6% of hyperopic PACG eyes showed AL <23.5 mm, and 19.0% of myopic PACG eyes showed AL ≥23.5 mm. The SE showed significant differences among different AL groups only in the hyperopic subjects (P = 0.012). The AL was significantly longer in myopic eyes (P < 0.001). The PACG eyes with longer AL exhibited lower keratometry, longer central anterior chamber depth and corneal diameter, and lens position and relative lens position closer to the anterior (P < 0.001).

Conclusion:

Axial hyperopia was common in PACG eyes, and axial myopia was not uncommon. Relatively anterior lens position could explain the occurrence of PACG in the eyes with long AL.
Clinical and surgical outcomes of glaucoma drainage device tube in ciliary sulcus versus anterior chamber in North Indian glaucoma patients
Authors: Jha Ujjwal P , Kumar Suresh , Jindal Varsha , Gupta Gayana , Ichhpujani Parul
Published: May 2023

Purpose:

To evaluate the outcome of glaucoma drainage device (GDD) insertion of tube through ciliary sulcus (CS) versus anterior chamber (AC) placement in the North Indian population

Methods:

This retrospective comparative case series included 43 patients in CS group and 24 in AC group, who underwent GDD implantation, from March 2014 to February 2020. The main outcome measures were intraocular pressure (IOP), number of anti-glaucoma medications, best corrected visual acuity (BCVA), and complications.

Results:

Sixty-seven eyes of 66 patients were included in study with mean follow-up of 25.04 months (range, 12–69 months) in the CS group and 17.4 months (range, 13–28 months) in the AC group. Preoperatively the two groups were similar except for postpenetrating keratoplasty glaucoma (PPKG) and pseudophakic patients, which were higher in the CS group (P < 0.05). Both groups showed statistically insignificant difference in postoperative IOP and BCVA at last follow-up (P = 0.173, P = 0.495, respectively). Postoperative complications were similar, except for corneal decompensation which was significantly higher in the AC group (P = 0.042).

Conclusion:

Our findings suggest that there was no statistically significant difference in mean IOP between the CS and AC groups at the last follow-up. CS placement of tube of GDD appears to be effective and safe technique. However, CS placement of tube resulted in lesser corneal decompensation and thus should be preferred in pseudophakic/aphakic patients, especially PPKG.
Assessment of intraocular pressure measurement between Goldman applanation tonometer, rebound tonometer, non-contact tonometer, and its correlation with central corneal thickness
Authors: Porwal Amit C , Shrishrimal Meghna , Punamia Ravin P , Mathew Bennet Chacko
Published: May 2023

Purpose:

To compare readings of intraocular pressure (IOP) taken with the Goldmann applanation tonometer (GAT), the non-contact tonometer (NCT), and the rebound tonometer (RBT), and to compare their correlation with central corneal thickness (CCT).

Methods:

This was a prospective, cross-sectional, observational study to which patients above 18 years of age were enrolled. A total of 400 eyes of 200 non-glaucomatous patients underwent IOP recordings using the GAT, NCT, and RBT, and CCT was also noted. Informed consent of the patients was taken. The IOP readings taken via the three methods were compared and correlated with CCT. Paired t test was used to compare the two devices. Simple and multivariate linear regression analyses were used to study the relationship between factors. A P value less than 0.05 was considered significant. Correlation was determined using the Pearson correlation coefficient, and a Bland–Altman graph was plotted.

Results:

Mean IOP measured by the NCT was 15.65 ± 2.80 mmHg, by the RBT was 14.23 ± 3.05 mmHg, and by the GAT was 14.69 ± 2.97 mmHg. The mean CCT was 510.61 ± 33.83 microns. The difference between mean IOP recorded by the NCT and that by the RBT was 1.41 ± 2.39 mmHg, between the NCT and GAT was 0.95 ± 2.03 mmHg, and between the GAT and RBT was 0.45 ± 2.22 mmHg. The difference between the IOP values was statistically significant (P < 0.005). All tonometers showed a statistically significant correlation with CCT, but it was observed that the NCT had a stronger correlation (0.4037).

Conclusion:

The IOP readings taken by all the three methods were comparable; however, RBT values were closer to GAT values. CCT did influence the IOP values, and this should be kept in mind while evaluating.
Real-world outcomes and complications of different surgical approaches for significant submacular haemorrhages
Authors: Boral Subhendu Kumar , Agarwal Deepak , Das Arnab , Chakraborty Debdulal , Mandal Santanu
Published: May 2023

Purpose:

To evaluate the outcomes and complications after different surgical management of cases with significant sumacular hemorrhage (SMH) of size more than 4 disc diameter (DD).

Methods:

It was a retrospective interventional study. All consecutive 103 cases of significant SMHs were treated by vitrectomy and divided into three groups. In Group A (<4 weeks, confined to the macula or extending inferiorly, n = 62), vitrectomy, subretinal cocktail of tissue plasminogen activator (tPA), antivascular endothelial growth factor, and air with SF6 gas; in Group B (4–8 weeks, extending beyond macula, n = 31), subretinal tPA followed by SMH drainage either by retinotomy (Group B-1, n = 17) or by temporal 180-degree retinectomy (Group B-2, n = 14) with silicone oil (SO) tamponade; and in Group C (>8 weeks, extending beyond macula, n = 10), SMH removal with autologous retinal pigment epithelium (RPE)-Choroid patch graft transplantations with SO tamponade were performed. Parameters evaluated were best corrected visual acuity (BCVA), Optos, optical computerized tomography, and ultrasonography as required.

Results:

Significant visual improvement was seen from mean preoperative to mean postoperative BCVA in Group A (P < 0.001), Group B (P < 0.001), and Group C (P < 0.001). Postoperative complications were recurrent SMH (4.84% vs 12.90% vs 10%), vitreous hemorrhage (6.45%, GroupA), hyphema (4.84% vs 12.90% vs 10%), hypotony (nil vs 3.23% vs 20%), macular hole formation (6.45%, Group A), epiretinal membrane (16.13%, Group B), and retinal detachment (3.23%, Group A and 10%, Group C).

Conclusion:

Surgical approaches for significant submacular hemorrhage are visually awarding, though certain specific complications may arise.
Visual outcome in pediatric uveitis: A retrospective data review in 277 children
Authors: Sivakoti Prasanna , Swaminathan Meenakshi , Magesan Kowsigan , Pyare Richa , George Amala E , Ganesh Sudha K , Biswas Jyotirmay , Dutta Majumder Parthopratim
Published: May 2023

Purpose:

This study aimed to describe visual outcomes in cases of pediatric uveitis in an Indian population and to analyze various factors affecting these outcomes.

Methods:

Single-center, retrospective chart review of 277 cases of uveitis in patients under the age of 18 years. Variables assessed included age and sex distribution, anatomical location of uveitis, systemic associations, complications, and various treatment strategies used, including long-term immunomodulation and surgical management of complications if required. The main outcome was the final visual acuity.

Results:

At the final visit, 51.5% of the eyes showed improvement in the final visual acuity, while vision remained stable in 28.7% and 19.7% of the eyes showed worsening of vision at the final follow-up. A total of 19.4% of patients were blind in at least one eye at the final visit, and 16 patients (5.77%) remained bilaterally blind at the final follow-up. The presence of cataract (p = 0), posterior uveitis (p = 0.005), and retinal detachment (p = 0.014) were the most significant risk factors for predicting worse visual outcomes. More than half (65.7%) of patients reported a complication at some point in their follow-up, and the most common complication was cataract. In total, 50.9% of patients required long-term immunomodulatory therapy.

Conclusion:

Pediatric uveitis remains a challenging condition to treat and follow-up, and the visual outcome remains guarded for most patients.
Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes
Authors: Parekh Dhruval , Asokan Rashima , Purkait Sutapa , Iqbal Asif
Published: May 2023

Purpose:

To compare the visual performance of two simultaneous-vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes.

Methods:

A double-masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High- and low-contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens.

Results:

High-contrast distance visual acuity showed a significant difference between CMF (0.00 [−0.10–0.04]) and PureVision2 modified monovision (PVMMV; −0.10 [−0.14–0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; −0.10 [−0.20–0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low-contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50–85]; P = 0.007, CMMV: 70 [70–100]; P = 0.006) and with CMF (50 [40–70]; P = 0.005) when compared to spectacles (50 [30–70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40–0.50]; P = 0.001, CMF: 0.40 [0.40–0.46]; P = 0.007) compared with spectacles (0.40 [0.30–0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033).

Conclusion:

Modified monovision provided superior high-contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low-contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.
Endogenous fungal endophthalmitis following COVID-19 infection with microbiological and molecular biological correlation – A report of two cases
Authors: Mohan Sashwanthi , Kandle Kaustubh , Ganesan Suganeswari , Prakash V Jaya , Mistry Suraj , Anand AR , Biswas Jyotirmay
Published: May 2023

This case report describes three eyes of two patients, who were diagnosed to have endogenous fungal endophthalmitis post coronavirus disease 2019 (COVID-19) infection. Both patients underwent vitrectomy with intravitreal anti-fungal injection. Intra-ocular samples confirmed the fungal etiology by conventional microbiological investigations and polymerase chain reaction in both cases. The patients were treated with multiple intravitreal and oral anti-fungal agents; however, vision could not be salvaged.
The 20/20/20 rule: Practicing pattern and associations with asthenopic symptoms
Authors: Datta Sourav , Sehgal Shivalika , Bhattacharya Bidisha , Satgunam Prem Nandhini
Published: May 2023

Purpose:

The present work style and lifestyle have increased the digital device use. Therefore, an increase in digital eyestrain is to be expected. We undertook a survey during coronavirus disease 2019 (COVID-19) pandemic to investigate the practice of 20/20/20 rule and its association with digital device use and asthenopic symptoms. While this rule is commonly advised, little is known about its validity.

Methods:

An online survey form was disseminated through social media and emails. The questions for eye-related symptoms were similar to the convergence insufficiency symptom survey (CISS). Participants with age ≥5 years were included, with parents completing the survey for children (≤16 years).

Results:

A total of 432 participants (mean ± standard deviation [SD]: 26.06 ± 13.92 years) were enrolled, of which 125 responses were for children. The 20/20/20 rule was practiced only by 34% of the participants either regularly (n = 38) or occasionally (n = 109). Those who had complaints of burning sensation and headache tended to practice this rule. Among adult participants, more females (47%) practiced this rule when compared to males (23%). Also, adult females significantly (P = 0.04) had more symptoms score when compared to males. In children, no such gender difference was found.

Conclusion:

Only one-third of participants practice the 20/20/20 rule at least occasionally. More number of adult females being symptomatic and practicing in greater number could be due to higher prevalence of dry eye condition in females. While the symptom of burning sensation could be related to dry eye, that of headache could be related to refractive error or binocular vision dysfunctions.
COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis
Authors: Sanjay Srinivasan , Kawali Ankush , Mahendradas Padmamalini
Published: May 2023

A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.
A retrospective study to assess visual field improvement following augmented trabeculectomy
Authors: Fang Clarissa E H , Hakim Mohamad T , Siddiqui Muhammad M , Armstrong Deborah , Shankar Vikas
Published: May 2023

Purpose:

To explore the visual field (VF) changes two years following augmented trabeculectomy.

Methods:

A retrospective study of patients who underwent augmented trabeculectomy surgery with mitomycin C by a single surgeon at East Lancashire Teaching Hospitals NHS Trust over 3 years. Patients with a minimum of two years postoperative follow-up were included. Baseline characteristics, intraocular pressure (IOP), VF, number of glaucoma medications, and complications were recorded.

Results:

In total, 206 eyes were included, 97 (47%) patients were female, and the mean age was 73.8 ± 10.3 (range 43 to 93) years. One hundred thirty-one (63.6%) eyes were pseudophakic before trabeculectomy. The patients were divided into three outcome groups according to VF outcome. Seventy-seven (37.4%) patients had stable VF, 35 (17.0%) patients showed VF improvement, and 94 (45.6%) had VF deterioration. The overall mean preoperative IOP was 22.7 ± 8.0 mmHg and postoperative IOP 10.4 ± 4.2 mmHg, with a reduction of 50.2% (P < 0.001). In total, 84.5% of postoperative patients did not require glaucoma medications. A higher number of patients with postoperative IOP ≥15 mmHg had deteriorating VF (P < 0.001). Based on preoperative MD distribution, VF improvement or stability was more achievable with patients with a preoperative VF defect up to −12 dB (n = 41, 59.4%) and in those with greater than −24 dB (n = 25, 64.1%).

Conclusion:

Trabeculectomy continues to be an effective means of lowering IOP in patients with uncontrolled glaucoma and is important in stabilizing or improving visual fields. We recommend early trabeculectomy to prevent further VF deterioration. This may help in maintaining VF for driving status and, thus, quality of life.
Rectus muscle pseudo-adherence syndrome
Authors: Pujari Amar , Virani Baiju , Chauhan Nidhi , Mahalingam Karthikeyan , Thangavel Rajeswari , Saxena Rohit
Published: May 2023

Purpose:

To describe a clinical entity called “rectus muscle pseudo-adherence syndrome” following buckling surgery.

Methods:

A retrospective data review was undertaken to analyze the clinical profile of strabismus patients who had developed it following buckling surgery. Between 2017 and 2021, a total of 14 patients were identified. The demography, surgical details, and intraoperative challenges were reviewed.

Results:

The average age of the 14 patients was 21.71 ± 5.23 years. The mean pre-op deviation was 42.35 ± 14.35 prism diopters (PD) of exotropia, and the mean post-op deviation was 8.25 ± 4.88 PD of residual exotropia at 26.16 ± 19.53 months follow-up. Intraoperatively, in the absence of a buckle, the thinned-out rectus adhered to the underlying sclera with much denser adhesions along its margins. When there was a buckle, the rectus muscle adhered to the outer surface of the buckle again, but less densely, with marginal union into the surrounding tenons. In both scenarios, due to the absence of protective muscle coverings, the rectus muscles were naturally adsorbed onto the immediately available surface in the presence of active healing by the tenons.

Conclusion:

While correcting ocular deviations following buckling surgery, a false sense of an absent, slipped, or thinned-out rectus muscle is very much possible. This is due to active healing of the muscle with the surrounding sclera or the buckle in a single layer of tenons. This is the rectus muscle pseudo-adherence syndrome, where the culprit is the healing process and not the muscle.
Smartphone for retinal imaging – Case series in resource-limited rural settings
Authors: Vishwanath  , Swamy Deepak T , Gaddi Daneshwari S
Published: May 2023

Purpose:

There is a clinical need for a cost-effective, reliable, easy-to-use, and portable retinal photography. The use of smartphone fundus photography for documentation of retinal changes in resource-limited settings, where retinal imaging was not previously possible, is studied here. The introduction of smartphone-based retinal imaging has resulted in the increase in available technologies for fundus photography. On account of the cost, fundus cameras are not readily available in ophthalmic practice in developing countries. Because smartphones are readily available, easy to use, and also portable, they present a low-cost alternative method in resource-limited settings. The aim is to explore the use of smartphones (iphones) for retinal imaging in resource-limited settings.

Methods:

A smartphone (iphone) was used to acquire retinal images with the use of +20 D lens in patients with dilated pupils by activating the video mode of the camera.

Results:

Clear retinal images were obtained in different clinical conditions in adults and children, including branch retinal vein occlusion with fibro-vascular proliferation, choroidal neo-vascular membranes, presumed ocular toxoplasmosis, diabetic retinopathy, retinoblastoma, ocular albinism, and hypertensive retinopathy.

Conclusion:

New inexpensive, portable, easy-to-operate cameras have revolutionized retinal imaging and screening programs and play an innovative role in research, education, and information sharing.
Clinical study of profile of retinal detachment in vasculitis and its management at tertiary eye care hospital
Authors: Nagaraj Kalpana B , Hiremath Chandrashekarayya H , Tumbadi Kavitha L , Pankaja PS , Shilpa YD , Hemalatha BC
Published: May 2023

Purpose:

The aim of the study was to understand the clinical profile and anatomical and visual outcome in Tractional/Combined (Tractional + Rhegmatogenous) Retinal Detachment due to vasculitis after surgical intervention.

Methods:

It was an interventional retrospective study of all cases who underwent surgery for RD with vasculitis at a single tertiary eye care center for over a period of 6 years. Patients with retinal detachment due to vasculitis were included in the study. All patients underwent the following surgical procedures: 240 belt buckle with three-port pars plana vitrectomy with membrane dissection and peeling with fluid gas exchange/with endolaser with silicon oil/C3 F8 gas injection.

Results:

In our study, 83.33% had preoperative vision of less than 6/60, whereas postoperatively 66.66% had vision of less than 6/60. Postoperatively 33.33% patients had vision better than 6/36. Of the six eyes operated for vasculitis with RD, retina was attached in five eyes following surgery. One patient had recurrent retinal detachment due to extensive proliferative vitreoretinopathy changes, and he was advised re-procedure but was lost for follow-up. The anatomical success was 83.33% on the first surgery.

Conclusion:

The overall anatomic success rate of retina reattachment surgery in vasculitis patient was good, and the visual outcome following the surgery can improve in majority of the cases. Hence, timely intervention is advocated.
Augmented loop myopexy with concurrent intraocular lens implantation for myopic strabismus fixus
Authors: Shetty Shashikant B , Aguiar Marushka , Vijayalakshmi P , Pradhan Priyarthi
Published: May 2023

Purpose:

To evaluate safety profile and surgical outcomes of loop myopexy with concurrent intra-ocular lens implantation in cases of myopic strabismus fixus (MSF).

Methods:

A retrospective chart review of patients who underwent loop myopexy with concurrent small incision cataract surgery with intra-ocular lens implantation between January 2017 and July 2021 for MSF at a tertiary eye care centre was undertaken. A minimum of 6 months of follow-up after surgery was required for inclusion. The main outcome measures were improvement in alignment postoperatively, improvement in extra-ocular motility postoperatively, intraoperative and postoperative complications and post-operative visual acuity.

Results:

12 eyes of 7 patients (male (6): female (1)) underwent modified loop myopexy at a mean age of 46.86 years (range 32-65 years). 5 patients underwent bilateral loop myopexy with intra-ocular lens implantation whereas 2 patients underwent unilateral loop with intra-ocular lens implantation. All eyes underwent additional medial rectus (MR) recession with lateral rectus (LR) plication. At the last follow-up, mean esotropia improved to 16 prism dioptres (PD) (Range: 10-20 PD) from 80 PD (Range:60-90PD), P = 0.016; and success (deviation ≤20PD) was achieved in 73% (95% CI 48 to 89%). Mean hypotropia at presentation was 10 PD (range 6-14 PD), which improved to 0 PD (range 0-9 PD), P = 0.063. Mean BCVA improved from 1.08 LogMar to 0.3 LogMar units.

Conclusion:

Loop myopexy combined with intra-ocular lens implantation is a safe and effective procedure in the management of patients who have Myopic Strabismus Fixus with visually significant cataract and improves both visual acuity and ocular alignment significantly.
Single-bolus dexmedetomidine in prevention of emergence delirium in pediatric ophthalmic surgeries: A randomized controlled trial
Authors: Raman Sonali , Viswanathan Jagadeesh , Surya Janani , Raman Rajiv
Published: May 2023

Purpose:

Emergency delirium (ED), a common postoperative neurologic complication, causes behavioral disturbances leading to self-traumas and also has long-term adverse effects in children. Our aim was to investigate the efficacy of a single-bolus dose of dexmedetomidine in reducing the incidence of ED. Additionally, pain relief, number of patients who needed rescue analgesia, hemodynamic parameters, and adverse events were assessed.

Methods:

One hundred and one patients were randomly allocated into two groups: 50 patients received 15 mL of dexmedetomidine 0.4 μg/kg (group D) and 51 patients received volume-matched normal saline (group C). Hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were monitored regularly throughout the procedure. ED was assessed with Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and pain was measured using the modified Objective Pain Score (MOPS).

Results:

The incidences of ED and pain were higher in group C than group D (P < 0.0001 and P < 0.0001, respectively). Group D showed significant decrease in MOPS and PAEDS values at 5, 10, 15, and 20 min (P < 0.05), HR at 5 min (P < 0.0243), and SBP at 15 min (P < 0.0127). There was no significant difference in DBP between the two groups at any time point. The mean blood pressure (MBP) at 10 min was significantly less in group D than group C (P < 0.001).

Conclusion:

Dexmedetomidine 0.4 μg/kg as a single bolus over 10 min immediately after intubation is effective for the prevention of ED and significantly reduces the need of rescue analgesia without compromising the hemodynamic parameters in children undergoing ophthalmic surgery.