bluuebunny/crossref_metadata_2025 huggingface dataset:
Cluster headache associated with oculomotor nerve palsy
Authors: Alrawashdeh Hamzeh Mohammad , Jaber Bahaa Al-Din Mustafa , Alharazneh Abdelrahman , Al-Habahbeh Omar
Published: May 2024

Cluster headaches are a series of short, excruciating, and unilateral pain that happens for a short period at a time over days, weeks, or months and may awake people from sleep. It is situated behind, in, or around one eye only with possible radiation to the forehead at the same side. Cluster headache is characterized by many ocular features. However, extraocular muscle involvement is unusual in this type of headache. We present a case of chronic cluster headache associated with diplopia due to oculomotor nerve palsy in a 24-year-old man, which responded successfully to oral steroid. This presentation is rare. Therefore, ophthalmologists and neurologists should consider it in their list of a differential diagnosis. A short course of oral prednisolone has a role in the management of patients in such cases.
Acute postoperative infectious endophthalmitis caused by Gram-negative organisms
Authors: Al-Abri Mohamed , Al-Hinai Ahmed , Al-Abri Abdulrahman , Lobo Rashmi Mercy
Published: May 2024

Endophthalmitis is a rare but potentially sight-threatening ophthalmic condition characterized by marked inflammation of intraocular tissues and fluids. Bacteria is the most common cause of postoperative acute infectious endophthalmitis of which Gram-positive (GP) bacteria is the predominant isolate which constituted 47% of all positive vitreous cultures in endophthalmitis vitrectomy study. On the other hand, Gram-negative bacteria constituted 11.5% with poor visual outcomes compared to GP cases due to the fulminant and destructive nature of such pathogens despite prompt and appropriate treatment initiation. In this report, we would like to share the three cases of acute postoperative infectious endophthalmitis caused by Gram-negative organisms and highlight the challenges that might be faced when dealing with such presentations.
Knowledge, attitudes, and practices toward research among Oman medical specialty board residents
Authors: Abri Hajar Al , Atiq Elham , Alrawahi Abdul Hakeem
Published: May 2024

OBJECTIVES:

The Accreditation Council for Graduate Medical Education has mandated residency programs to teach the basic principles of research in residency programs. This study aimed to assess the research knowledge, attitude, and practice among the Oman Medical Specialty Board (OMSB) residents. Secondarily, it aimed to asses associations between different factors and research-related knowledge, attitude, and practice.

MATERIALS AND METHODS:

This cross-sectional study was conducted among all residents who were involved in OMSB various training programs in the academic year 2018/2019. A validated self-administered questionnaire was used. Hard copies of the questionnaire were delivered to residents in addition to the online forms. Data were entered using EpiData entry software and analyzed using SPSS version 24.

RESULTS:

A total of 256 residents participated in the study with a response rate of 46.5%. Around 55% of included residents have poor knowledge level, and 44% have moderate knowledge level. The study showed that the majority (93%) of the residents have positive research attitude. However, the practice domain showed that only 27.8% of residents have published articles as first or coauthor. Lack of time was reported as a major hindrance in nearly two-thirds of the residents. Lack of training (56%), lack of research-focused curriculum (47%), and lack of effective supervision (46%) were among major reported obstacles beside others.

CONCLUSIONS:

This study showed that OMSB residents have inadequate knowledge and lagging research practices, but a positive attitude toward research. This emphasizes the need for research-focused curricula and further training. In addition, applying new regulations, including mandatory manuscript submission, may improve the practice status.
A rare presentation of bilateral ophthalmic relapse of pediatric chronic myeloid leukemia: Multimodal imaging and treatment
Authors: Garg Gaurav , Patidar Narendra , Dubey Satyendra
Published: May 2024

Chronic myeloid leukemia (CML) rarely presents under 15 years of age, and its incidence is as low as 2% of all leukemia. Ophthalmic manifestations often present either initially with the diagnosis or as a sign of relapse after remission. The recommended treatment is systemic chemotherapy, intrathecal chemotherapy, ocular irradiation, and/or intravitreal methotrexate. Herein, we report a 13-year-old child with a history of CML and central nervous system relapse under remission currently. He presented to us with bilateral ophthalmic relapse. He was treated with ocular irradiation and intrathecal chemotherapy. On follow-up, the ophthalmic infiltration showed resolution, which was also seen on multimodal imaging.
Correlation of retinal nerve fiber layer thickness with perimetric staging in primary open-angle glaucoma – A cross-sectional study
Authors: Bhat K. Subrahmanya , Reddy M. Vaishnavi , Pai Vijay
Published: May 2024

BACKGROUND:

Glaucoma is a progressive optic neuropathy, characterized by structural optic nerve damage with corresponding field defects. Primary open-angle glaucoma (POAG) is the most common. Although perimetry is the gold standard, retinal nerve fiber layer (RNFL) thickness by spectral-domain optical coherence tomography (SD-OCT) has proved reliable in the detection of pre-perimetric glaucoma. There is preferential involvement of various sectors of the peripapillary RNFL in the different stages of POAG.

PURPOSE:

The purpose of this study is to assess RNFL thickness and determine preferential involvement of different sectors of peripapillary RNFL in the various stages of POAG using SD-OCT.

MATERIALS AND METHODS:

Forty-nine patients with POAG underwent complete ophthalmic examination including visual field testing and RNFL thickness measurement. Perimetric findings were used to categorize them into mild, moderate, and severe stages of glaucoma. The RNFL thickness values were analyzed and compared with perimetric results.

RESULTS:

The average RNFL loss in mild, moderate, and severe POAG was 25.44%, 29.67%, and 44.15%, respectively. A statistically significant correlation (P < 0.05) between RNFL loss and severity of glaucoma was found in all except the superior and temporal sectors. A statistically significant (P < 0.05) negative correlation was noted between visual field index and RNFL loss in all sectors except the nasal-superior in moderate POAG and all sectors in severe POAG. Mean deviation and RNFL loss showed a significant positive correlation in temporal-inferior (TI) sector in mild POAG and all sectors in the severe group.

CONCLUSION:

RNFL thickness decreases with increase in glaucoma severity and is a reliable parameter to differentiate mild from severe POAG. The TI followed by nasal-inferior RNFL sector is the most sensitive to glaucomatous damage in all three stages.
Pattern of astigmatism using partial coherence interferometry in patients of different age groups undergoing cataract surgery
Authors: Vats Sumedha , Kumari Lalitha , Goenka Ranjit , Agrawal Mohini , Mishra Sanjay
Published: May 2024

BACKGROUND:

Astigmatism is a refractive error that accounts for 70% of refractive errors in the elderly population. It is important to be aware of the distribution, extent, and type of astigmatism in patients undergoing cataract surgery to guide in reducing postoperative spectacle dependency.

AIM:

To study the demography, amount, and pattern of astigmatism using partial coherence interferometry in patients of different age groups undergoing cataract surgery.

MATERIALS AND METHODS:

A cross-sectional observational study. Keratometry and demography data were collected for patients planned for cataract surgery at a tertiary care center between January 2018 and December 2019. It was done with noncontact partial coherence interferometry in patients above 50 years undergoing cataract surgery.

RESULTS:

Out of 385 patients, 216 (56%) were males and 169 (44%) were females. Astigmatism was more common in males than females (P= 0.00). Against-the-rule (ATR) astigmatism was found in 262 cases (68%), while with-the-rule (WTR) astigmatism was seen in 87 cases (23%). ATR was more common than WTR (P= 0.00). The number of patients with ATR seems to be increased with aging eyes and was more common between 61 and 70 years of age group (P= 0.00). The total amount of astigmatism increased with increasing age (P= 0.00029) which was found to be significant. Frthermore, there was a gradual change of WTR to ATR astigmatism with aging eyes.

CONCLUSION:

Two hundred and sixty-two cases (68%) had ATR astigmatism mainly seen in the age group of 61–70 years. Majority had astigmatism up to 1.0 D that can be easily managed by simple cost-effective keratorefractive procedures like on-axis incision, opposite clear corneal incision, and limbal relaxing incisions.
Ocular findings in children with acute leukemia at a tertiary care center in South America
Authors: Benvenuto Franco , Sgroi Mariana , Guillen Soledad S , Ancona David , Fandiño Adriana
Published: May 2024

PURPOSE:

The purpose of this study was to evaluate ophthalmological findings in patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) in a Latin American population.

MATERIALS AND METHODS:

This was a single-center, retrospective study. The observational analysis was conducted in AML and ALL patients seen as a routine examination at the department of ophthalmology of tertiary care center in Argentina between March 1, 2017, and February 28, 2018.

RESULTS:

Overall, 137 patients with acute leukemia were included. The mean age was 7.9 ± 5.2 years (0–18), and 55% were male (n = 75) and 45% female (n = 45). At least one-fifth (n = 31) of the patients presented some type of ocular manifestation (23%). The most frequently observed manifestation was retinal hemorrhages (n = 14), followed by papilledema (n = 9) and ocular surface involvement (n = 5). The eye involvement was more frequently identified in the AML group (24%), compared to the ALL group (22%), especially papilledema with central nervous system compromise ALL (5%) and AML (11%), P < 0.01. The presence of hemorrhages was similar in both groups. In patients with retinal hemorrhage (n = 14), the mean hematological findings were hemoglobin 7.4 ± 0.4 g/dL (6.5–8.0), erythrocytes 2.5M ± 0.3/mm3 (confidence interval [CI], 2.0–3.1), and platelets 76,000 ± 32,000/mm3 (CI, 8000–384,000). Patients without retinal findings (n = 123), the mean hematological findings were hemoglobin 9.1 ± 0.6 g/dL (8.0–10.2), erythrocytes 3.2M ± 0.6/mm3 (CI, 2.5–3.5), and platelets 92,000 ± 44,000/mm3 (CI, 42.000–390.000). Multivariable analysis found that hemoglobin levels were the most reliable predictive factor for retinal findings. It was observed that the risk diminishes in patients with levels higher than 8.5 g/dL, and that it increased in patients with levels ranging between 6.5 and 7.5 g/dL at least twice (P < 0.01).

CONCLUSIONS:

Our results show that ocular involvement occurs in a high percentage of patients with leukemia with a clear clinical, humoral, and sometimes prognostic correlation, suggesting routine ophthalmologic evaluation in these patients.
Optic neuritis secondary to the Pfizer-BioNTech-162b2 COVID-19 vaccine managed with plasmapheresis
Authors: Shah Paras P. , Gelnick Samuel , Zhu Daniel , Wong Amanda , Verma Rashmi
Published: May 2024

The COVID-19 pandemic has had a significant public health impact globally, with inoculation now paramount in limiting the spread of the disease. Although the safety and efficacy profiles of COVID-19 vaccines are well documented, it is upon the medical community to be aware of adverse effects to appropriately advise and treat patients. We report the case of a 39-year-old female who was hospitalized with optic neuritis (ON) 1 week after her second dose of the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine. The patient did not have any significant medical history, including personal or familial history of multiple sclerosis or any other demyelinating disease, other than prior COVID-19 infection. She had since made a full recovery and tested negative at the time of hospitalization for ON. Over the course of her admission, the patient’s visual acuity (VA) deteriorated from 20/400 to no light perception. After methylprednisolone was ineffective, she was started on plasmapheresis (PLEX) therapy which resulted in mild improvement of VA. To our knowledge and after a thorough PubMed literature search, this is the first reported case of isolated ON associated with COVID-19 vaccination.
Optical coherence tomography predictors of the outcomes of occlusion therapy in anisometropic amblyopia
Authors: Palani Subashree , Baskaran Antony Arokiadass , Rinita Deborah
Published: May 2024

AIM:

(1) To compare optical coherence tomography (OCT) parameters between amblyopic eyes and fellow eyes in patients presenting with anisometropic amblyopia. (2) To find OCT factors predicting the outcomes of occlusion therapy.

MATERIALS AND METHODS:

This prospective study was conducted in a tertiary eye care center for a period of 20 months. Fifty-four children diagnosed with anisometropic amblyopic were included in the study. After complete ophthalmic and OCT examination, patients were advised to undergo occlusion therapy with large spectacle patch. Patients were reviewed after 6 months to record improvement in visual acuity and analyze their OCT parameters. Statistical tests used were paired “t” test and independent “t” test.

RESULTS:

The mean age of 54 study patients was 9.24 ± 2.82 years. For comparison of OCT parameters, they were classified as myopic (22 patients), hypermetropic (24 patients), and astigmatic (8 patients) groups. In the anisomyopic amblyopia group, the mean inner macular thickness was significantly increased in fellow eyes (304.09 ± 11.06 μm) compared to amblyopic eyes (297.59 ± 14.16 μm). In the anisohyperopic amblyopia group, the outer macular thickness significantly increased in amblyopic eyes (286.43 ± 18.63 μm) when compared to fellow eyes (272.62 ± 14.90 μm). In the follow-up visit, 28 patients showed improvement and 6 patients did not show improvement in final best-corrected visual acuity, and the OCT parameters in amblyopic eyes of these two groups did not differ significantly.

CONCLUSION:

Abnormal experience in early life does not affect the maturation process of retinal layers as evident by OCT parameters, and these parameters cannot predict the outcomes of occlusion therapy.
Can trainees perform Ahmed glaucoma valve surgery as effectively as attendings?
Authors: Ustaoglu Melih , Huynh Hugh , Esin Sharmenie , Shukla Aakriti Garg , Razeghinejad Reza
Published: May 2024

OBJECTIVE:

To compare the surgical outcomes and early postoperative complications of Ahmed glaucoma valve (AGV) implantation performed by residents with those performed by attending physicians.

METHODS:

This is a retrospective, case–control study. Data were gathered from chart reviews of consecutive cases of AGV model FP7 implantation between January 2014 and July 2017. Postoperative 1-year results of patients who had at least 3 months follow-up were evaluated.

RESULTS:

One hundred and forty-four eyes of 144 patients were included in this study: 72 patients in the resident group, and 72 age- and sex-matched patients in the attending group. Hyphema and shallow anterior chamber were significantly more common in the resident group vs. attending group (25% vs. 2.8% and 19.4% vs. 7.0%; P = 0.001 and P = 0.04, respectively). Neovascular glaucoma (NVG) was more common in resident vs. attending group (30.6% vs. 1.4%; P < 0.001). No significant difference in mean intraocular pressure (IOP) was found at any postoperative follow-up visits between the surgery groups (P > 0.05, for all). The number of postoperative visits within 3 months was similar between the groups (P = 0.84).

CONCLUSION:

Resident-performed AGV surgery lowered IOP, similar to attending-performed surgery. More frequent complications were observed in the resident group, which might be due to the predominance of NVG in this group.
Cladosporium spp. endogenous endophthalmitis simulating the classic “headlight-in-the-fog” appearance of active toxoplasmosis
Authors: Hamid Abbas Abd , Lay Suan Amelia Lim , Hashim Hanizasurana , Kamarudin Zabri , Muhammed Julieana
Published: May 2024

Endogenous fungal endophthalmitis caused by an unusual fungus poses both diagnostic and therapeutic challenges. We report a case of endogenous endophthalmitis caused by a rare mold, namely Cladosporium spp., which presented with a foveal abscess. A 52-year-old male patient who was diagnosed with rectal carcinoma presented with pain, redness, and a loss of vision in the right eye. He had been experiencing the symptoms for 1 week. The patient had undergone gastrointestinal surgery 2 weeks before experiencing the eye complaint. His best-corrected visual acuity was hand movements. Fundus examination revealed a foveal abscess of around a half-disc diameter in size that simulated retinochoroiditis with vitritis. Optical coherence tomography of the macula revealed a hyperreflective lesion in the fovea, which breached the full thickness of the fovea and extended into the preretinal space. Ocular toxoplasmosis was considered. On that basis, oral trimethoprim/sulfamethoxazole was given for 1 week, although the patient's condition worsened. A vitreous tap and an intravitreal combination of vancomycin, ceftazidime, and amphotericin B were administered twice but did not improve the patient's condition. Pars plana vitrectomy was performed and the vitreous biopsy results revealed the presence of Cladosporium spp. Intravitreal voriconazole was given three times and the foveal abscess resolved into a scar. Endophthalmitis caused by Cladosporium spp. is uncommon and published case reports are extremely limited. The present case may provide insight into the variable presentation of fungal endophthalmitis and, therefore, assist with the early diagnosis and appropriate management of the condition.
Diagnostic accuracy of indigenously developed computer-based binocular vision assessment
Authors: Kumar P. Praveen , Shajahan T. , Hussaindeen Jameel Rizwana
Published: May 2024

CONTEXT:

The increased prevalence of nonstrabismic binocular vision anomalies (NSBVA) has given rise to the need for cost-effective screening and diagnostic tools.

AIMS:

The aim of the study is to assess the efficacy of an indigenously developed computer-based binocular vision assessment software (Train Your Eyes®) in screening NSBVA.

SUBJECTS AND METHODS:

Subjects who visited the binocular vision clinic of a tertiary eye care center with asthenopic symptoms between January 2019 and January 2020 were included in the study. Patients with other ocular comorbidities and stereopsis poorer than 500 arc seconds were excluded. All subjects underwent a comprehensive eye examination followed by binocular vision assessment using both the manual and computer-based methods.

STATISTICAL ANALYSIS USED:

Receiver operating characteristic (ROC) curves were utilized to choose the cut-off points that maximize the sensitivity and specificity.

RESULTS:

The mean (standard deviation) age of 88 subjects was 22 (4.5) years with 34 males. Based on the conventional manual assessment, 71 (81%) were diagnosed to have NSBVA and 17 (19%) had normal binocular vision. Based on the ROC analysis, the following cut-off points are proposed: 14 prism diopter (PD) for near positive fusional vergence amplitudes, 4.5 PD for near negative fusional vergence amplitudes, 4.5 cycles per minute (cpm) for binocular accommodative facility, and 3.5 cpm for monocular accommodative facility. All the binocular vision parameters demonstrated statistical significance in the ROC analysis (P < 0.05).

CONCLUSIONS:

The software-based screening tool was found to be highly sensitive in identifying NSBVA and thus could be used as a potential screening tool in the clinic and community.
Extent of glaucomatous damage on the first presentation
Authors: Bhedasgaonkar Sayali , Nadkarni Snehal U.
Published: May 2024

AIM:

The aim is to determine the magnitude of glaucomatous damage in the asymptomatic subjects identified with primary glaucoma for the first time and thus to evaluate the significance and efficacy of screening measures for glaucoma.

MATERIALS AND METHODS:

An observational retrospective cohort study of 100 asymptomatic patients of age more than 40 years, diagnosed with and under treatment for primary glaucoma was performed. Patients were categorized into having early, moderate, and severe glaucoma, according to standard automated perimetry (SAP) mean deviation (MD) in the worse eye (<−6, −6 to −12 and >−12 dB, respectively). Risk factors were correlated with the severity of glaucoma at presentation and statistically analyzed.

RESULTS:

About 32%, 33%, and 35% of patients were found to have early, moderate, and severe stages of glaucoma with average MD of −3.51 ±1.53, −8.65 ±1.64, −17.15 ± 5.13 on SAP, respectively. The association of risk factors such as age (P = 0.006) and glaucoma awareness (P = 0.044) with the severity of glaucoma was statistically significant. There was no direct statistical correlation found between gender, history of diabetes mellitus, family history of glaucoma, intraocular pressure, central corneal thickness, the angle width, and the severity of glaucoma in our study.

CONCLUSION:

Majority of cases with primary glaucoma show no symptoms until advanced irreversible stages. Early screening and proper treatment are the only ways to halt its progression. In spite of available facilities, 68% of patients in our study were found to have moderate-to-severe stages of glaucoma. This indicates that our screening measures should reach the masses at the primary level, with a focus on awareness programs.
Transcaruncular medial orbitotomy: A globe sparing intervention in management of COVID associated mucormycosis [CAM]
Authors: Katti Venkatram , Ramamurthy Lakshmi B. , Seetalakshmi DK , Prakash Anoosha
Published: May 2024

AIMS:

To describe a novel method of transcaruncular medial orbitotomy, local debridement and amphotericin B irrigation into orbit for COVID-19-associated rhino-orbital mucormycosis. Also to evaluate its its outcome in controlling the disease, increasing the survival rate and as a globe-sparing intervention in them.

METHODOLOGY:

A total of ten COVID-19-associated mucormycosis patients with clinical and radiological evidence of orbital involvement with necrotic tissue localized in medial orbit were considered for our study. A transcaruncular modified medial orbitotomy with medial and inferomedial orbit debridement was done along with placement of scalp vein catheter by a single surgeon. Postoperatively 3.5 mg/ml liposomal amphotericin B irrigation through the catheter was done for 5 sittings. Correction of underlying systemic conditions and intravenous antifungals were given. Clinical response to the procedure was noted on postoperative week 1, week 4, and 3rd month (week 12).

RESULTS:

The mean age group was noted to be 49.9 years with a male: female ratio of 2.3:1. All patients were diabetics with 5 being newly detected diabetes after COVID infection. All the ten patients showed significant clinical improvement at the first follow-up (week 1). Five patients at 1st month showed clinical and radiological improvement, while one patient had worsening of orbital disease for which exenteration was done. Three patients succumbed to the disease due to altered cardiopulmonary status and 1 patient was lost to follow-up. All 6 survived patients were stable till the last follow-up. Hence, mortality rate accounted to 30% and globe survival of 40% in the current study.

CONCLUSION:

Transcaruncular approach to orbit for adequate debridement combined with amphotericin irrigation is a novel technique that can be considered for compartmental involvement of orbit in mucormycosis. Debridement removes the necrotic tissue, while local amphotericin irrigation directly reaches the target tissues that effectively halts the disease progression and hence can be considered an effective globe-sparing intervention without affecting the disease outcome.
Case report: Mirror-image hypermetropic anisometropia in nontwin brothers
Authors: Farvardin Hajar , Shamsi Anis , Farvardin Majid
Published: May 2024

Mirror-image is a term to describe a physical characteristic of some identical twins that appear asymmetrically on opposite sides as if they are looking in a mirror. Mirror-image anisometropia in monozygotic twins was previously reported in the ophthalmic literature. In this article, we describe a case of mirror-image hypermetropic anisometropia in siblings aged 8 and 5 years old. Nontwin brothers, 8 and 5 years old, with mirror-image hypermetropic anisometropia, were referred to the pediatric ophthalmology clinic. Corrected distant visual acuity was 20/20 (ocula dextra [OD]), 20/60 (ocula sinistra [OS]) in the older brother, and 20/50 (OD), 20/20 (OS) in the younger brother. Cycloplegic refraction was + 3.5 − 1.25 × 180 (OD), +7.75 − 1.5 × 30 (OS), and + 7.0 − 0.75 × 20 (OD), +2.0 − 1.0 × 170 (OS) in the older and younger brother, respectively. The axial length difference between the two eyes was 1.47 mm in the older and 2.01 mm in the younger brother. Hypermetropic anisometropia that may lead to anisometropic amblyopia may happen in nontwin brothers. This emphasizes the importance of complete ophthalmologic examination in the siblings of all patients with anisometropia.
Visual outcomes and factors predictive of visual loss in Behcet's disease in Sultan Qaboos University Hospital, Oman
Authors: Al Kharousi Nadiya , Khalfan Alnaabi Khalfan Salim , Almahrouqi Omar , Mal Washoo
Published: May 2024

PURPOSE:

This study aimed to evaluate the visual outcomes and associated factors in Omani patients with Behcet's disease (BD).

METHODOLOGY:

This is a descriptive retrospective analytical cohort study. All Omani patients of age 5–65 years with a confirmed clinical diagnosis of BD having ocular manifestation who attended the Rheumatology and Ophthalmology clinics at Sultan Qaboos University Hospital, Oman from January 2018 to October 2020. The demographic data, clinical findings, systemic, and ocular examination of all the recruited patients were retrieved from the electronic patient record.

RESULTS:

The study included 31 male and 16 female participants. The median age is 29.7 ± 10.6 years. Most patients with ocular manifestations presented in the third decade of their life (21–30 years' age). The most common ocular manifestations in our study were uveitis (91.5%) followed by vitritis (40.4%), and retinal vasculitis (36.2%). The most common ocular complications in order of frequency were cataract (27.7%), posterior synechiae (23.4%), and cystoid macular edema (21.2%). In this study, 22.7% of the patients with BD-related ocular manifestations reported severe visual loss. In addition, when adding the patients with severe visual loss secondary to complications such as secondary glaucoma and optic nerve atrophy, the severe visual loss cumulatively reported being 50% for both groups.

CONCLUSION:

The clinical characteristics of ocular manifestations in BD in Oman are similar to data from studies that have been conducted in other countries. However, our study found that the severity of ocular manifestations was more dominant among females. This study finding can be helpful for clinicians to predict ocular manifestations of BD to plan a timely follow-up and subsequently prevent further severe complications or visual loss.
Impact of COVID-19-related lockdown on retinal disorders treated with intravitreal injections
Authors: Brar Manpreet , Grewal Satinder Pal Singh , Grewal Dilraj S , Sharma Mansi , Dogra Mangat Ram
Published: May 2024

PURPOSE:

To study functional changes in vision and morphological changes on optical coherence tomography (OCT) scans in patients where intravitreal therapy (IVT) with injections has been delayed due to COVID-19 pandemic lockdown.

METHODS:

Retrospective cross-sectional study included 77 eyes with the diagnosis of exudative age-related macular degeneration (eAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO), regularly receiving IVT with anti-vascular endothelial growth factor (Anti-VEGF) injections or dexamethasone implant and were not able to receive the injections as intended due to lockdown. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and qualitative morphological features on OCT were analyzed pre- and post-therapy break off.

RESULTS:

The mean duration of IVT break-off was 57 days. Mean BCVA logarithm of minimum angle of resolution (logMAR) worsened from 0.33 (20/42) to 0.35 (40/44) (P = 0.02) and mean CFT increased from 297.90 μm to 402.16 μm (P < 0.01), from pretherapy break-off to return visit. Worsening of the visual acuity was seen across all the three disease cohorts, significantly more in the eyes with eAMD.

CONCLUSION:

Marginal decline in the visual acuity and worsening of the OCT features were observed as a result of delay in the IVT injections of DME, eAMD and RVO patients.
A comparative clinical study of postoperative care by teleophthalmology and in-person consultation at hospital outpatient department after an uncomplicated cataract surgery
Authors: Dole Kuldeep , Pakhale Sneha , Gandhi Anuprita , Deshpande Madan , Deshpande Rahul , Kulkarni Sucheta
Published: May 2024

BACKGROUND:

Teleophthalmology provides an opportunity to conduct consultations in far-flung and remote areas that have no access to specialized eye care. However, there is a paucity of studies to assess the effect of missing in-person follow-up on initial postoperative visits. The study thus aims to compare postoperative satisfaction and uncorrected distance visual activity after an uneventful phacoemulsification cataract surgery in patients with teleconsultation approach to those with hospital visit.

MATERIALS AND METHODS:

The prospective observation study (n = 240) was conducted in patients who underwent surgery for cataract. Pre- and post-operative data were collected and divided into two groups based on the type of postoperative follow-up. All patients were scheduled for ophthalmic reviews in the hospital on day 1, day 7, and day 30–40 (hospital visit group) or through teleconsultation on days 1 and 7 followed by a hospital visit on days 30–40 (teleconsultation group). Outcomes evaluated in both groups were complications, patient satisfaction, and uncorrected distance visual acuity.

RESULTS:

Most patients in both groups were in the age group of 51–70 years. Overall satisfaction was comparable in teleconsultation and hospital visit groups (3.74 ± 0.23 vs. 3.72 ± 0.27; P = 0.22). The majority of patients had visual acuity 6/18-6/6 on postoperative day 1, day 7, and day 30–40 in both groups. Lid edema, pain, redness, watering, and congestion complications were more in the hospital visit group on postoperative day 1.

CONCLUSION:

The study concludes that patients with no preexisting ocular and systemic comorbidity undergoing an uneventful phacoemulsification cataract surgery teleconsultation approach can be used for follow-up without any impact on the postoperative visual outcome and patient satisfaction, thereby increasing the efficiency and productivity of health-care system.
Granulomatous lesion in the caruncle: Primary syphilitic lesion in a HIV male patient
Authors: Boned Fustel Paula , Ruiz Uriel Rodrigo Butron , Sarrió Mercedes Hurtado
Published: May 2024

Syphilis ocular manifestations can occur at any stage of the disease and involve almost any ocular structure. In this case report, we present a very rare conjunctival affectation that was the primary syphilitic lesion in a HIV-positive male patient. The diagnosis was supported by the serologic test, the dark-field microscopy of the lesion, and the exceptional treatment response.
Preeruptive intracoronal resorption
Authors: Clark Kendra , Tahmasbi Mehrnaz , Augsburger Robert A. , Jalali Poorya
Published: May 2024

Introduction:

Preeruptive intracoronal resorption (PEIR) is described as the cavitation of intracoronal dentin just below the dentinoenamel junction in the coronal portion of an unerupted tooth. The aim of this study was to analyze cone-beam computed tomography (CBCT) scans of teeth affected by PEIR and report the radiographic findings.

Materials and Methods:

In this retrospective study, a total of 26 CBCT scans including 33 PEIR-affected teeth were evaluated. The following data were documented: age, sex, affected tooth, presence and location of enamel/cementum disruption, lesion extension, radiographic distance of lesion to the pulp, pericoronal radiolucency, and periapical radiolucency.

Results:

Third molars were the primary teeth affected (88%). A radiographic disruption of the external surface of the tooth was noted in all cases. Disruption of the enamel only was observed in 29 cases, followed by disruption of enamel and cementum in two cases, and disruption of the cementum only in two cases. Twenty-one cases (64%) showed lesions extending to or above the cementoenamel junction (CEJ), and 12 cases (36%) displayed lesions extending below the CEJ. In 21 cases, the lesion progressed close to the root canal system, leaving <1 mm of dentin. However, due to the limitations of CBCT imaging, resorptive pulpal exposure could not be accurately determined. One case exhibited a pericoronal radiolucency, whereas none of the 33 cases displayed signs of a periapical radiolucency.

Conclusion:

These data suggest that PEIR is a form of external resorption. CBCT is a viable tool for the identification of cases with PEIR, and for determining the extent of the resorptive defect.
Preoperative nonsteroidal anti-inflammatory drugs on the success of inferior alveolar nerve block in irreversible pulpitis
Authors: Gupta Alpa , Aneja Kritika , Wadhwa Jitesh , Aggarwal Vivek , Sidhu Sejal , Mehta Namrata
Published: May 2024

Introduction:

The inflammatory conditions of pulp often lead to pain which is managed by adequate anesthesia. Achieving optimum anesthethic effect in such conditions is difficult; therefore, various supplemental techniques have been used to enhance the effect. Premedication is one such technique vastly studied. This study aimed to critically analyze the systematic reviews, including their respective meta-analyses, to summarize the data regarding the role of nonsteroidal anti-inflammatory drugs (NSAIDs) on the success of inferior alveolar nerve block (IANB) in patients with irreversible pulpitis.

Materials and Methods:

The protocol was formulated using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, and the formulated PICO question was “Is there any effect of oral premedication with NSAIDs on the anesthetic success of IANB in irreversible pulpitis?” The reviews were analyzed using a measurement tool to assess systematic reviews (AMSTAR).

Results:

Twelve reviews were selected, out of which three were finally included for detailed analysis and their AMSTAR scores were 'high.' Individual meta-analyses results pointed toward the anesthetic success of IANB with NSAIDs as oral premedication.

Conclusion:

The current overview justifies the use of NSAIDs by highlighting the supporting and conflicting data of each systematic review.
Assessment of quality of life among dental practitioners using magnification devices during nonsurgical root canal treatment in the Kingdom of Saudi Arabia
Authors: Boreak Nezar Mohammed , Shabi Afnan Yahya , Alshawkani Hamed Ahmed Ali , Ageeli Walaa Aqeel , Madhhali Zainab Mousa , Al Juman Abdulrahman Saeed , Shibli Ahmed Ali , Najmi Hussain Hassan
Published: May 2024

Introduction:

This study was conducted to assess the effect of magnification devices (MDs) during nonsurgical root canal treatment (RCT) on quality of life

(

QOL) among dental professionals of the Kingdom of Saudi Arabia. The dental practitioners performing endodontic treatment were evaluated for ergonomic, postural, psychological, and financial issues associated with and without the use of MDs.

Materials and Methodology:

A total of 1650 dental professionals (general dentists and endodontists) were recruited from public and private sectors of Saudi Arabia from October 2021 to December 2021. The World Health Organization's QOL assessment questionnaire (WHOQOL-BREF) was administered to conduct the study. The questionnaire addressed four domains of QOL which included physical, psychological, procedural, and financial. Statistical analysis was done by SPSS software® version 23.0. Descriptive analysis, ANOVA test, and unpaired t-test were used.

Results:

All dental professionals completed the survey. 41.5% reported the use of MDs out of which dental loupe was most commonly used. Work-related musculoskeletal disorders were the most frequent physical difficulty which was faced by 61.5% of dental practitioners while performing RCT. 80% of DPs revealed that MDs improve manual abilities while performing RCT. MDs also relieved psychological, physical, and postural stress by 49.2%, 64.6%, and 63%, respectively. Further 72% of the dental professionals reported improved quality of work after the usage of MD.

Conclusion:

MDs are commonly used by dental professionals during RCT in Saudi Arabia. It is believed that its use can lead to a better ergonomic, postural, and psychological state of these dental professionals.
Endodontic management of unusual extraoral cutaneous sinus tract
Authors: Alshammari Mohammad A. , Alzoubi Fahad M.
Published: May 2024

Chronically, draining cutaneous sinus tracts are a common manifestation of pulpal necrosis with periapical pathosis that requires endodontic treatment to heal. However, it is frequently misdiagnosed with cutaneous lesions and incorrectly treated. A clinical case of an 8-year-old girl presented with an extraoral cutaneous sinus tract of the right submandibular region after long-term pus drainage was misdiagnosed by her dermatologist. The odontogenic origin of the sinus tract was made by tracing an unusual pathway of the sinus tract utilizing cone-beam computed tomography. The clinical and radiographic examination revealed a necrotic pulp, with chronic periapical abscess and cutaneous drainage of the immature mandibular right first molar. Endodontic therapy and mineral trioxide aggregate apexification were performed. The cutaneous sinus tract showed signs of healing after 1 month from treatment initiation and complete radiographic healing was noted after 18th month recall. Cutaneous extraoral sinus tracts of endodontic origin can be easily misdiagnosed and mistreated. Utilizing cone-beam computed tomography to trace the sinus tract revealed an unusual pathway confirming the odontogenic origin of the sinus tract. Correct treatment resulted in regaining the patient her self-confidence, saving the tooth, and healing of the facial sinus tract.
Assessment of adult oral health literacy among patients visiting Government dental college, Shimla, Himachal Pradesh
Authors: Gurung Deepak , Bhardwaj Vinay Kumar , Fotedar Shailee , Thakur Arun Singh
Published: May 2024

Background:

The major role of oral health literacy (OHL) lies in the utilization of health services as low literacy leads to reduced participation and engagement in preventive health programs.

Aim:

This study aimed to assess the adult OHL among patients visiting the Tertiary care institute in north India.

Materials and Methods:

The source of data for this descriptive qualitative study was patient visiting the outpatient department. Data collection procedure included information obtained from the subject recorded on a structured pro forma using OHL-Adults Questionnaire. Mann–Whitney U test, Kruskal–Wallis test with post hoc Bonferroni test, and Spearman's rho correlation were applied. Multiple logistic regressions were used and the dependent variable (OHL) was regressed for predicted independent variables. Parameter estimate of inadequate and marginal OHL for various predictor variables was regressed considering the adequate OHL as standard reference.

Results:

The inadequate literacy score was statistically significant for age, educational qualification, and number of times of visit to dentist in lifetime in the final regression model. The marginal score was significant for age, educational qualification, and frequency of visit to dentist in the final regression model.

Conclusion:

Total dental visit in lifetime is an important indicator for better OHL in this study. Orientation of oral health promotion programs requires due importance for both the marginal and inadequate OHL.
An overview of leprosy with its oral manifestations
Authors: Singh Manisha , Sawhney Hemant , Mishra Richa , Kumar Jayant
Published: May 2024

Background:

Leprosy is caused byMycobacterium lepraewhich most commonly affects the skin and peripheral nerves. The other sites of leprosy include the liver, kidneys, eyes, oral mucosa, lymph nodes, bones and joints, and gonads. The oral involvement in leprosy includes the tongue, lips, hard palate, buccal mucosa, uvula, faucial pillars, and involvement of gums.

Aim:

The aim of this comprehensive review is to create the awareness among dental professionals about the classification, pathogenesis, clinical features, diagnosis and management, reactions of leprosy, and oral aspects of leprosy. The awareness among dental professionals will help in the early detection and treatment of leprosy patients.

Methods:

The comprehensive data were obtained based on the electronic data search about the classification, pathogenesis, clinical features, and oral aspects of leprosy on Google Scholar and PubMed.

Results:

A total of 14 articles were selected for the purpose of classification, pathogenesis, clinical features, and oral aspects of leprosy.

Conclusion:

The oral examination of these patients will be helpful in the early diagnosis and treatment of leprosy patients.
A comprehensive look at magnetic resonance imaging
Authors: Subharina Mahapatra , Manjula Hebbale , Amit Mhapuskar , Simran Singh
Published: May 2024

Introduction:

High-resolution pictures of soft tissue may be obtained using magnetic resonance imaging (MRI). Sophisticated chemical and physical data may be gathered using this spectroscopic approach, which depends on the magnetic resonance principle as its base.

Aim:

The purpose of this article was to provide a short overview of MRI, different contrast agents in MRI, its use in oral medicine, its contraindications, and the most recent MRI discoveries and artifacts related to MRI.

Methods:

An online search was conducted using databases such as PubMed, Embase, Web of Science, Scopus, and Google Scholar to locate articles that dealt with MRI, oral medicine, recent advancements, dental applications, and contrast agents. The search was limited to studies that were published before March 2022.

Results:

A total of 31 articles were included and analyzed for this review.

Conclusion:

MRI is more sensitive than other imaging modalities in the diagnosis of soft tissue in the head-and-neck area; the use of three-dimensional imaging will expand further advancements in this imaging modality.
Aromatherapy for the prevention of postoperative nausea and vomiting: A systematic review and meta-analysis
Authors: Wang Jian-Ying , Huang Hsueh-Yang , Chu Wan-O , Peng Tzu-Rong , Lee Ming-Chia , Chen Shih-Ming , Lee Jen-Ai
Published: May 2024

ABSTRACT

Objectives:

Postoperative nausea and vomiting (PONV) are common complications following surgical procedures. While drug-based treatments are standard, there is increasing interest in nonpharmacological alternatives, such as aromatherapy, due to potential benefits and minimal side effects. This study aimed to assess the effectiveness of aromatherapy in preventing PONV.

Materials and Methods:

A comprehensive systematic review and meta-analysis were conducted using PubMed, Cochrane Library, EMBASE, and CINAHL databases for studies published up to May 2023. The included studies were randomized controlled trials (RCTs) and nonrandomized studies of interventions that examined the impact of aromatherapy on PONV. The risk of bias was assessed, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was employed to evaluate the certainty of the evidence.

Results:

Eleven studies were selected for review, with eight RCTs included in the meta-analysis. Aromatherapy effectively reduced postoperative nausea severity (standardized mean difference [SMD]: −0.93, 95% confidence interval [CI]: −1.64 to −0.22; P = 0.010), but the reduction in vomiting episodes was not statistically significant (SMD: −0.81, 95% CI: −1.98-0.37; P = 0.180). Subgroup analysis indicated that ginger essence, lavender, and peppermint oils were particularly effective in managing postoperative nausea. However, due to significant statistical heterogeneity and potential biases in the studies, the results should be interpreted with caution. The certainty of the evidence, as evaluated by the GRADE approach, was low.

Conclusion:

Preliminary evidence supports the potential benefit of aromatherapy in reducing the severity of postoperative nausea. However, given the low certainty of current evidence, more rigorous and standardized research is needed. The safety, affordability, and potential benefits to patient comfort make aromatherapy a promising area for further research in postoperative care.
Adipose-derived stem cells and antibiotics: A novel synergistic approach for treating implant-related osteomyelitis
Authors: Yeh Kuang-Ting , Wu Wen-Tien , Wang Chen-Chie , Lee Ru-Ping
Published: May 2024

ABSTRACT

Implant-related osteomyelitis poses a significant challenge in orthopedic practice, particularly due to the increasing prevalence of antibiotic-resistant infections and biofilm-associated complications. This article focused on exploring the potential of combination therapy with adipose-derived stem cells (ADSCs) and antibiotics to overcome these challenges, thereby enhancing treatment efficacy. A systematic synthesis of the results of recent in vivo studies, predominantly those using rat models, was performed. Studies that evaluated the effectiveness of ADSCs combined with antibiotics against common pathogens in implant-related osteomyelitis, particularly Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis, were selected. A significant reduction in symptoms such as swelling, abscess formation, and bacterial burden in the ADSCs + antibiotic-treated group was observed in all studies. In addition, microcomputed tomography revealed reduced osteolysis, indicating enhanced bone preservation. Furthermore, histological examination revealed improved tissue structure and altered immune response, signifying the dual role of ADSCs in enhancing antibiotic action and modulating the immune system. This review highlights the promising role of the concurrent use of ADSCs and antibiotics in the treatment of implant-related osteomyelitis. This novel therapeutic strategy has the potential to revolutionize the management of complex orthopedic infections, especially those resistant to conventional treatments. However, further research is required to translate the results of animal studies into clinical applications and to develop optimized treatment protocols for human use.