bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the WINROP screening algorithm among preterm infants in East Malaysia
Authors: Kadir Nurhayati Abdul , Ahmad Syed Shoeb , Ghani Shuaibah Abdul , Bastion Mae-Lyn Catherine 
Published: January 2021

Objective: To prospectively validate the WINROP (Weight, Insulin-like growth factor 1, Neonatal, Retinopathy of Prematurity) screening algorithm (www.winrop.com) based on longitudinal measurements of neonatal body weights in predicting the development of severe retinopathy of prematurity (ROP) among preterm infants admitted to the neonatal intensive care unit of a tertiary care center in East Malaysia.
Methods: All premature infants of less than 32 weeks gestational age (GA) were included in this cohort. Their body weight was measured weekly from birth to 36 weeks postmenstrual age and entered into the computer-based surveillance system: WINROP. Infants were then classified by the system into high- or low-risk alarm group. The retinopathy findings were recorded according to Early Treatment for ROP criteria. However, the screening and management of infants were done according to the recommendations of the Continuous Practice Guidelines, Ministry of Health, Malaysia. The team members involved in screening and those recording the findings were kept blinded from each other.
Results: A total of 151 infants with median GA at birth of 30 weeks (interquartile range [IQR] Å} 2.1) and mean birth weight of 1,264 g (standard deviation Å} 271) were analyzed. High-risk alarm was signaled in 85 (56.3%) infants and 9 (6.6%) infants developed type 1 ROP. One infant in the low-risk alarm group developed type 1 ROP requiring laser retinal photocoagulation. The median time lag from the high-risk alarm signal to the development of type 1 ROP was 10.4 (IQR Å} 8.4) weeks.
Conclusion: In this cohort, the WINROP algorithm had a sensitivity of 90%, with negative predictive value of 98.5% (95% confidence interval) for detecting infants with type 1 ROP and was able to predict infants with ROP earlier than their due screening date. This study shows that a modified version of the WINROP algorithm aimed at specific populations may improve the outcome of this technique.
Comparative study of ocular manifestations of HIV infection at a tertiary care hospital in Maharashtra, India
Authors: Ambekar Sanjeevani , Badale Dhiraj , Kadam Dileep , Salvi Sonali 
Published: January 2021

Purpose: We conducted the study to observe the change in infection patterns with the introduction of highly active antiretroviral therapy (HAART) and correlation of CD4 count with various ocular manifestations of acquired immune deficiency syndrome (AIDS).
Design: This was a prospective observational cohort study.
Methods: The study was conducted at a tertiary care teaching institute with established antiretroviral therapy (ART) centre. A total of 240 eyes of 120 ART-naive patients were enrolled. Ocular manifestations of these patients were observed and followed up for six months for any change with HAART.
Results: Out of 240 eyes, 24 showed ocular involvement (10%), of which human immunodeficiency virus (HIV) microangiopathy and molluscum contagiosum were most common. Out of the four cases of HIV microangiopathy, two cases demonstrated complete resolution after six months of ART. Only one of three cases of cytomegalovirus (CMV) retinitis showed healing after six months of ART.
Conclusions: Vision-threatening CMV retinitis and herpes zoster ophthalmicus can improve if specific treatment is initiated promptly. There is direct correlation between CD4 count, ocular manifestation, and prognosis of the patients; 33.33% of patients showed improvement in ophthalmic manifestations after HAART during a follow-up period of 6 months.
Eyelash in lacrimal punctum: demonstrating a negative pressure in the lacrimal sac
Authors: Verma Anil Kumar , Dogra Avantika , Tuli Rajeev 
Published: January 2021

Eyelashes are normally arranged in two or three rows on the upper and lower eyelids. They are more numerous on the upper eyelid, with approximately 150 eyelashes being present on the upper and 75 on the lower eyelid. Eyelashes, like body hair, are shed regularly every 100 to 150 days. Usually, the shed eyelashes do not cause any symptoms.
However, the cilia may sometimes get misplaced and end up in the lacrimal puncta, meibomian gland orifice, subconjunctival space, and corneal stroma. An eyelash that gets misplaced into the punctum has the potential to cause additional problems. Once the eyelash enters the punctum, the barbs on the hair prevent it from being expelled.
Dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction: a pilot trial to assess impact on coexisting sinus symptoms
Authors: Mehta Ankur , Yi Wan , Ananda Arjuna , Ghabriel Raf 
Published: January 2021

Purpose: To report on coexistent sinus symptoms in a population of patients who underwent endonasal dacryocystorhinostomy (DCR) surgery for nasolacrimal duct obstruction (NLDO) in a pilot study designed to test and refine methods and to estimate patient sample size for a larger multicentre randomised trial.
Methods: Ninety-four consecutive patients with NLDO who underwent endonasal DCR by three surgeons in both public and private practice over a two-year period were included in this study. Questionnaires were given preceding DCR surgery and at 10 weeks post-surgery. Sinus symptoms including sinusitis, nasal congestion, hyposmia, nasal discharge, and facial pressure were assessed in the questionnaire. All subjects underwent primary endonasal DCR and all patients underwent the same post-operative regimen.
Results: Questionnaire responses revealed that 48/94 (51%) patients had one or more sinus symptoms prior to DCR surgery. Ten-week post-DCR follow-up questionnaires were obtained from 77/94 (82%) patients. About 20/31 (65%) patients with one or more sinus symptoms prior to DCR surgery reported resolution of coexisting sinus symptoms by 10 weeks post-DCR surgery.
Conclusion: The data from this pilot study suggest that approximately half of patients attending for NLDO have coexisting sinus symptoms. There was some loss to follow-up. This pilot study highlighted the need for a validated patient questionnaire, longer length of follow-up, control groups for surgical intervention, and use of perioperative medications. Any clinical trial designed to assess the impact of endonasal surgery on sinus symptoms would need to enrol several hundred patients in order to reach a statistically valid conclusion.
Fuchs endothelial corneal dystrophy and small eyes
Authors: Lim Nicole Shao-Yuen , Males John 
Published: January 2021

Aim: To determine whether there is an association between Fuchs endothelial corneal dystrophy (FECD) and shorter axial length (AL), shallower anterior chamber depth (ACD) and higher spherical equivalent (SE). In addition, to evaluate whether there is a correlation between AL and severity of corneal decompensation in FECD, using corneal thickness as a proxy.
Design: Retrospective cohort study.
Methods: This was a single-centre study conducted in a cornea clinic in Sydney, Australia. Detailed clinical measurements of 91 eyes of 50 FECD patients were compared with 110 eyes of 55 controls. Main outcome measures included AL, ACD and SE. Other outcome measures included central corneal thickness, visual acuity, intraocular pressure and keratometry.
Results: Mean AL of FECD patients was 23.6 mm (standard deviation [SD] ±0.9 mm), compared with 24.7 mm (SD ±1.8 mm) for controls (1.1 mm difference [95% confidence interval [CI] 0.5-1.6], p < 0.001, independent sample t-test); corresponding means for ACD were 3.0 and 3.3 mm (0.32 mm difference [95%CI 0.2-0.5], p < 0.001, independent t-test). Eleven out of the 22 FECD patients with available refraction data had hypermetropic refraction compared with 16 out of 36 controls (p = 0.68, chi-squared test). The mean SE of FECD patients (+0.10D) was higher than controls (−1.33D) (1.4D difference [0.1-2.8], p = 0.04, independent t-test). No statistically significant correlation was found between AL and corneal thickness (p = 0.28, linear regression).
Conclusion: In this retrospective cohort study, a strong association was established between FECD and small eyes, with shorter AL and shallower ACD, compared with controls. These results have important implications for surgical planning, as shorter AL and ACD in FECD patients likely contribute to their high risk of corneal decompensation following cataract surgery.
SITA standard testing with Humphrey visual field analyzer versus full threshold testing with frequency doubling perimetry: a comparison of patient preference and perception
Authors: Kadavath Meethal Najiya Sundus , Lokapavani Velumuri , Asokan Rashima , Vijaya Lingam , George Ronnie Jacob 
Published: January 2021

Purpose: To compare patient preference for Swedish Interactive Threshold Algorithm (SITA) standard 24-2 protocol in Humphrey visual field analyzer (HVF) and full threshold N-30 protocol in frequency doubling perimetry (FDP) by primarily evaluating their perception about the test procedure and test targets along with surveying the factors that influence the patient concentration during perimetry and elements that determine the level of perimetry task difficulty.
Methods: This study enrolled a subset of subjects from the Chennai Glaucoma Study. Each subject underwent a comprehensive ophthalmic examination after which they were randomly allocated to perform HVF and FDP with a 30-minute interval between the two procedures. SITA standard 24-2 protocol in HVF and full threshold N-30 protocol in FDP were used. This was followed by the administration of a questionnaire that mainly assessed the components such as (a) the patient preference for test procedure and test targets, (b) the factors influencing the patient concentration during perimetry performance, and (c) the impression about the level of perimetry task difficulty. The patient responses from the survey for each of the subcategories were obtained and analyzed using Chi-square test.
Results: A total of 42 subjects with a mean age of 59.7 (SD 9.7) years were included, among which 18 (42.86%) were male and 24 (57.14%) were female. Thirty-two (76.19%) subjects felt both FDP and HVF were easy to perform, eight subjects (19.05%) felt that both perimetry techniques were difficult to perform, and two subjects (4.76%) found FDP procedure was easier than HVF, whereas the distribution was not statistically significant (Chi-square, p = 0.7). Pressing the button as a response to peripheral stimulus perception and inability to maintain steady central fixation for prolonged duration were the most commonly reported factors that influenced the level of difficulty of the perimetry tasks. A dark room ambience set for performing HVF was preferred by 32 (76.20%) subjects.
Conclusion: There was no significant difference in the patient preference for test procedure and peripheral test targets. A black central fixation as in FDP and dark room ambience set for HVF were preferred.
Macular buckle with Morin–Devin T implant for pathological myopia with macular hole
Authors: Anand Abhishek , Agarwal Lalit , Agrawal Nisha , Anand Atul Kumar 
Published: January 2021

Introduction: Pathological myopia is commonly associated with myopic traction maculopathy, which includes foveoschisis, foveal retinal detachment, macular hole (MH) and/or macular detachment (MD). Macular buckling is a rarely practiced extraocular surgical modality these days. The purpose of this study was to investigate the efficacy of primary buckling with Morin–Devin T implant for MD with MH and posterior staphyloma.
Case description: A 52-year-old female presented with light perception vision in her right eye with posterior staphyloma, localized neurosensory detachment, and MH. She underwent primary macular buckling with Morin–Devin T implant. During the immediate postoperative day the wedge indentation was found misaligned to the fovea. A revision surgery was done after 2 weeks for repositioning of the macular wedge. Spectral domain optical coherence tomography confirmed indentation at the MH with resolution of subretinal fluid and hole closure. Her BCVA was 2/60 at 3 months postoperative and it remained the same even at 6 months of follow-up.
Conclusions: Primary macular buckling can be an effective procedure in eyes with MH with detachment and posterior staphyloma with or without associated foveoschisis. Morin–Devin T implant placement is a relatively simple procedure with short surgical time and excellent outcome.
Intercellular adhesive molecule-1 (ICAM-1) in proliferative diabetic retinopathy
Authors: Victor Andi A. , Gondhowiardjo Tjahjono D. , Dharma Rahayuningsih , Jusman Sri W. A. , Yandri Vivi R. , Yuneta Ressa , Yuriza Rizky E. P. 
Published: January 2021

Purpose: To determine the level of intercellular adhesion molecule-1 (ICAM-1) in vitreous fluid of patients with proliferative diabetic retinopathy (PDR) and its affecting factors including HbA1c level, duration of diabetes mellitus (DM) and insulin usage.
Methods: A cross-sectional study was conducted in Cipto Mangunkusumo National General Central Hospital, Jakarta, Indonesia from June 2015 to August 2016. Thirty-three consecutive vitreous samples harvested from PDR patients underwent vitrectomy. The level of vitreous ICAM-1 was determined by enzyme-linked immunosorbent assay.
Results: Based on the glycemic status, vitreous ICAM-1 level in the uncontrolled glycemic group (21.61 ng/ml) was lower than controlled glycemic group (24.20 ng/ml). Patients with DM for more than 10 years had higher level of vitreous ICAM-1 (26.30 ng/ml). Vitreous ICAM-1 level in DM patients with insulin was higher than those without insulin (27.07 ng/ml vs. 24.17 ng/ml). There was no statistically significant difference between vitreous ICAM-1 levels among all groups (p > 0.05).
Conclusion: The concentration of vitreous ICAM-1 may not be influenced by glucose control and conventional insulin therapy.
Ocular surface squamous neoplasia: a case series
Authors: Yaghoobi Gholamhossein , Hosseini Rad Abbas , Heydari Saeed Reza , Nikandish Malihe 
Published: January 2021

Purpose: This study was conducted to show diverse clinical presentation of ocular surface squamous neoplasia with a rare presentation of caruncle squamous cell carcinoma (SCC).
Methods: All cases that had suspicious ocular lesion were included in the treatment study. A detailed history including demographic data was obtained. Clinical features regarding the type of lesion, location, and the involvement of cornea were evaluated. For all patients, excisional biopsy following “Shield’s no-touch technique” with 3 to 4 mm margins of uninvolved tissue and cryotherapy at excisional margins was done. All specimens were sent for a histopathological evaluation. Topical chemotherapy (mitomycin C, 0.02%) was used as an adjunctive therapy following surgical excision for large and diffuse ocular surface tumors. All patients were subjected to long-term regular follow-ups.
Results: Twenty-six patients (18 men and 8 women) with a mean age of 54.2 years were enrolled in this study. The results showed that the most common localization was bulbar conjunctiva (92%). Nodular lesions (46.5%) and SCC (57.5%) were the most common clinical and histopathological features, respectively. We observed one rare case of primary SCC of the left caruncle in a 68-year-old man who had an asymptomatic medial canthal mass. Recurrence was found in two patients with SCC, one of them having an orbital extension.
Conclusion: The early suspicion of ocular surface neoplasia will be accomplished with a simple excision in most cases, leading to a favorable outcome except in severe progressive cases.
Pterygium excision with suture-less and glue-free conjunctival autograft
Authors: Wali Fariha S. , Jawed Muhammad , Talpur Rafeen , Shaikh Naeemullah , Shujaat Shehnilla , Talpur Khalid I. 
Published: January 2021

Introduction: Pterygium excision is a commonly encountered surgery with different methods being used. These procedures range from simple excision to use of grafts. Limbal conjunctival autograft is currently the most popular surgical procedure. The most common method of autograft fixation is suturing. But it has its own drawbacks like increased operating time, post-operative discomfort, inflammation, buttonholes, necrosis, giant papillary conjunctivitis, scarring, and granuloma formation. Glue is widely used due to many advantages like easy fixation of the graft, shorter operation time, and reduction in complications and post-operative discomfort but at the same time has some disadvantages also like high cost, the risk of transmission of infectionsand inactivation by iodine preparations.
Purpose: In the following study, we describe a simple method of accomplishing conjunctival autograft adherence during pterygium surgery avoiding possible complications associated with the use of fibrin glue or sutures.
Design: Prospective study.
Method: We used conjunctival autograft, which was not sutured or glued to the scleral bed. The fibrin formed from the oozing blood was used to get the graft adhesion to the scleral bed. This study was approved by institutional review board, and written consent form was taken from each participant.
Results: The suture-less and glue-free conjunctival autograft was found to have excellent results in terms of surgical outcome as well as post-operative recovery. In addition, risk of side effects related to sutures and glue was eliminated.
Conclusion: Suture-less and glue-free conjunctival autograft is a new, easy, and cheaper technique for the management of pterygium.
Letter to our readers
Authors: Ong Keith 
Published: January 2021

Dear Readers,
We would like to announce that Asian Journal of Ophthalmology (Asian JO) is now a fully online, open-access journal, without the registration requirements for readers. Although Asian JO is not listed on MEDLINE’S PubMed yet, it is indexed in Scopus and Google Scholar. Articles can be found either through those services or through our extensive archive.
Asian JO was the official journal of the Southeast Asian Glaucoma Interest Group (SEAGIG). It was initially published in 1998 and, at that time, was one of the few journals in Asia for authors to publish in. Asian JO is now an international journal serving authors and readers around the world with a publishing team in three continents.
The first publisher of Asian JO was Scientific Communications, based in Hong Kong, which later relocated to New Zealand. When the publisher retired, it became inactive. Fortunately, Professor Paul Chew along with his team at National University of Singapore managed to keep it afloat until Kugler Publications of the Netherlands became its official publisher. Paul asked me to join him in the role as Chief Editor as he needed to devote more time to develop his inventions, which include the micropulse transcleral laser therapy for glaucoma and the Paul Glaucoma Implant shunt. I was introduced to Asian JO when I asked Paul for advice on which journal to publish an article on the Ong Eye Speculum for glaucoma surgery.
Asian JO promotes the publication of novel ideas and surgical techniques. Brief reports and case reports can convey clinical gems that will improve the management of ophthalmology patients. Some journals reject papers describing innovative ideas because they may not conform to the standard research presentation format, but we believe this is a crucial part of the process of scientific discovery.
We have also re-established our role as the official journal of Asia-Pacific Glaucoma Society. For this reason, the next issue of Asian JO will be dedicated to abstracts for the Asia-Pacific Glaucoma Congress (APGC), to be held in Kuala Lumpur on August 14-16, 2020. Hence, Kugler Publications and Asian JO will be present at this conference, and we hope to meet readers and authors to discuss how we can improve the journal.
With kind regards,Dr. Keith OngChief Editor
Bilateral orbital metastasis as an initial presentation of hepatocellular carcinoma
Authors: Myint Kay Thi , Thant Ko Ko , Thazin Moe 
Published: January 2021

Purpose: To describe a case of biopsy-confirmed bilateral orbital metastasis of previously undiagnosed hepatocellular carcinoma, presenting with bilateral proptosis.
Case description: A 57-year-old man presented with painless bilateral proptosis over 2 months. At presentation, the best-corrected visual acuity was 20/60 in the right eye and 20/20 in the left eye. Ocular examination revealed bilateral asymmetrical non-axial proptosis with Hertel exophthalmometer reading of 24 mm in the right eye and 22 mm in the left eye. There was mild inferior displacement in both eyes. Apart from mild exposure keratopathy in the right eye, both anterior and posterior segment examinations were not remarkable. Orbital computerized tomography (CT) scan showed soft tissue masses in the superotemporal quadrants of both orbits associated with lytic bone lesions. An orbital biopsy confirmed that it was metastatic hepatocellular carcinoma (HCC). Ultrasound abdomen revealed multifocal HCC with underlying cirrhosis. We planned for further investigations such as hepatitis serology, alfa-fetoprotein, and CT abdomen, but he refused to proceed with investigations and treatment.
Conclusion: Orbital metastasis, more so as a bilateral involvement, is a rare phenomenon. It may present as an initial manifestation of undiagnosed systemic cancer. Orbital metastasis should be considered when diagnosing patients with bilateral proptosis, and orbital biopsy is crucial for histopathological diagnosis.
Results of early versus standard silicone stent removal following external dacryocystorhinostomy under local anesthesia
Authors: Limbu Ben , Sim Benjamin , Shrestha Mohan K. , Tabin Geoffrey , Saiju Rohit 
Published: January 2021

Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature.
Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up.
Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively.
Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.