bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of choroidal structure and vascularity indices with image binarization of swept source optical coherence tomography images
Authors: Rishi Pukhraj , Akhtar Zeeshan , Agrawal Rupesh , Agrawal Ashutosh , Rishi Ekta 
Published: May 2024

PURPOSE:
To evaluate choroidal vascularity index (CVI) among normal subjects using image binarization of swept source optical coherence tomography (SS-OCT).

MATERIALS AND METHODS:
Four hundred and sixty eyes of 230 normal participants were included. Total circumscribed choroidal area, luminal area, stromal area (SA), and CVI were derived from SS-OCT scans using open-source software (ImageJ) with the modified Niblack method. Both CVI and subfoveal choroidal thickness (SFCT) were correlated with age, refractive error, intraocular pressure, and mean ocular perfusion pressure (MOPP) using mixed linear model analysis. Pearson's correlation coefficient was used to determine the relationship between age and each dependent factor. Analyses were performed using the SPSS software version 20.0 (IBM Corp., Armonk USA) and statistical significance was tested at 5%.

RESULTS:
The mean age was 42.1 (±17.6) years. Mean SFCT was 307 ± 79 μm. Mean CVI was 66.80 (±3.8)%. There was statistically significant positive correlation between CVI and increasing age (r = 0.259, P < 0.0001) and statistically significant negative correlation between SFCT and age (r = −0.361, P < 0.0001). There was positive linear correlation between refractive error and CVI (r = 0.220, P < 0.0001) and negative correlation between SFCT and refractive error. There was no significant effect of MOPP on both CVI (P = 0.07) and SFCT (P = 0.7).

CONCLUSION:
CVI and SFCT are significantly correlated with age and refractive error in normal Indian eyes.
Characterization of red eye cases presented to the eye emergency clinic at a tertiary care hospital during COVID-19 Pandemic
Authors: Al Tamimi Haidar Faisal , Allawi Mohammed Nadhem , Hanumantharayappa Kishore 
Published: May 2024

BACKGROUND:
The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018.

MATERIALS AND METHODS:
This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem.

RESULTS:
Out of 7895 eye patients attended eye A and E clinic during March–July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis.

CONCLUSION:
There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals.
Incidence, risk factors, progression, and involution in retinopathy of prematurity at a tertiary care center in South India
Authors: Deb Debolina , Annamalai Radha , Muthukumar Muthayya 
Published: May 2024

BACKGROUND:
Retinopathy of prematurity (ROP) is a vasculoproliferative disorder of immature retina, seen in preterm babies. Multiple risk factors attribute to this condition. Our aim was to correlate the role of any early neonatal surgeries with low gestational age (GA) and birth weight (BW) on preterm babies as a risk factor on the progression of ROP.

METHODS:
A prospective, cohort study conducted in a hospital in South India over 3 years, including 600 babies with GA <35 weeks and BW <2500 g. Babies were divided into Group A (ROP) and Group B (no ROP). Group A included A1 (severe ROP) and A2 (nonsevere ROP) based on early treatment of ROP classification. We compared various risk factors of ROP, specifically the association of any early neonatal surgery undergone by these babies, on progression of ROP. The Chi-square test, unpaired t-test, and one-way analysis of variance tests were used for the comparisons and considered statistically significant if P < 0.05.

RESULTS:
28.7% babies developed ROP, with 37.6% requiring treatment (Aggressive ROP in 2.1% of babies). Low GA and BW, longer duration on ventilator, respiratory distress syndrome, apnea of prematurity, Patent Ductus Arteriosus, sepsis, anemia, thrombocytopenia, history of blood transfusion, and history of early neonatal surgery under GA were associated with babies with ROP (P < 0.005), strongly with severe ROP. The most common surgeries undergone by the babies developing ROP were inguinal herniotomy under general anesthesia.

CONCLUSION:
The study predicts preterm babies undergoing early surgical interventions are at risk of progressing to severe ROP, hence warranting frequent follow-ups.
Clinical association and visual morbidity in uveitis with systemic diseases: An analysis from a tertiary ophthalmic center
Authors: Annamalai Radha , Mahesh Abhinav , Biswas Jyotirmay 
Published: May 2024

AIM:
The aim of this study was to identify the incidence, etiology, most common presentations, complications, and the causes of visual loss in posterior uveitis (PU).

MATERIALS AND METHODS:
A retrospective study was conducted on a cohort of 125 patients with PU with a minimum follow-up of 6 months. Ocular evaluation consisted of slit-lamp examination, indirect ophthalmoscopy, tonometry, and refraction. Ancillary ophthalmic investigations such as fundus fluorescein angiography, optical coherence tomography, and B-scan ultrasonography were done. Laboratory tests were performed on blood on all patients and in aqueous humor samples obtained by anterior chamber paracentesis in cases of diagnostic dilemmas. All the data were analyzed using SPSS program.

RESULTS:
PU occurred in 61%. Infections were noted in 34% and autoimmune diseases in 27%. The most frequent presentation was choroiditis. The most common etiologies were tubercular uveitis in 50%, Toxoplasma retinochoroiditis in 23%, and autoimmune category of serpiginous choroiditis in 56% of patients. Complications occurred in 27% and were most commonly cystoid macular edema and macular scarring. Polymerase chain reaction (PCR), nested PCR, and real-time PCR on ocular fluids were required for diagnosis in 30%. A combination of laboratory investigations on blood and aqueous humor samples were confirmation in 88%.

CONCLUSION:
PU and its sequelae are known to be sight threatening and are associated with systemic diseases. They have diverse etiologies and presentations. Identification of etiology is important as management is diametrically opposite in infections and autoimmune diseases.
Is there a relationship between keratoconus and ocular Demodex mites?
Authors: Kurtul Bengi Ece , Kaya Ozlem Makbule , Kakac Ahmet , Cetinkaya Yasemin Fatma 
Published: May 2024

BACKGROUND:
The background of this study was to evaluate the relationship between keratoconus (KC) occurrence and ocular Demodex infestation together with the effects of Demodex on the ocular surface.

METHODS:
Thirty-eight eyes of 20 KC patients (KC group) and 40 eyes of 20 age- and sex-matched healthy subjects (control group) were included in this cross-sectional study. Demodex species (folliculorum/brevis), clinical symptoms such as eye rubbing, Ocular Surface Disease Index (OSDI), corneal topography findings, tear break-up time (TBUT), and Schirmer test scores were evaluated. KC eyes were also divided into two subgroups according to KC severity and presence of Demodex. Demodex was detected using conventional light microscopy.

RESULTS:
The mean age was 25.90 ± 7.01 years in the KC group, and 26.52 ± 8.94 years in the control group (P = 0.731). While unexpectedly no Demodex were detected in the control group, Demodex were detected in the KC group, including 8 eyes (21.1%) with Demodex folliculorum, and 10 eyes with D. folliculorum + Demodex brevis (26.3%) (P < 0.001). As the KC severity worsened, the percentage of eyes with Demodex mites increased (43.8% in the mild/moderate subgroup and 66.7% in the severe subgroup, P < 0.001). The number of rubbing eyes and OSDI scores were significantly higher, and TBUT levels were significantly lower in the KC Demodex + and Demodex − subgroups than the control group (P < 0.001 for all), but there is no significant difference between the KC Demodex + and Demodex − subgroups regarding ocular surface parameters (P = 1.0).

CONCLUSIONS:
Although the number of patients is relatively small and there is no follow-up data after Demodex treatment, KC and ocular Demodex infestation seem to be associated. Demodex-related inflammation and associated eye rubbing may contribute to KC progression.
Refractive outcomes following yttrium aluminum garnet laser (532 nm green laser) in severe retinopathy of prematurity
Authors: Jossy Ajax , Kasturi Nirupama , Madhukar Swapnil Parchand , Babu K Ramesh , Elias Salin 
Published: May 2024

PURPOSE:
To assess the refractive outcomes in eyes with severe Retinopathy of prematurity (ROP) after treatment with the frequency-doubled neodymium-doped yttrium aluminum garnet (Nd-YAG) laser 532 nm (green laser) at 1–2 years of age and compare with eyes that underwent spontaneous regression of ROP and to identify the risk factors associated with the refractive outcomes in laser-treated eyes with severe ROP.

METHODOLOGY:
Infants who underwent laser treatment with green laser were enrolled in Group 1 and those who had spontaneous regression of ROP were enrolled in Group 2. All these children underwent a visual assessment, refraction using 1% cyclopentolate eye drops and indirect ophthalmoscopy at 1–2 years of age. Data regarding the gestational age, sex, birth weight, inborn (born in our institution) or outborn (born outside and referred to us), stage and zone of ROP and laser spots given were obtained from the treatment records. Data were analyzed using SSPS 19.0 software for Windows (SSPS Inc., Chicago, Illinois, USA).

RESULTS:
A total of 102 infants were enrolled, 51 in each group. Visual acuity ranged from 0.25–1 cycles per cm in both groups. Spherical equivalent (SE) ranged from − 8.25 D to + 5.50 D in Group 1 and −1.00D to +4.00D in Group 2. Group 1 had an incidence of 23.5% Myopia and 33.4% Astigmatism which was significantly more than Group 2. The linear regression model predicted a decrease in the SE by 0.658D if the number of laser spots increased by 1000 (P < 0.001). No other risk factors (gestational age/birth weight) were found to have a significant association with refractive errors in the lasered ROP group.

CONCLUSIONS:
Eyes with laser-treated severe ROP are frequently associated with myopia and astigmatism when compared to spontaneously regressed ROP. The number of laser spots delivered has a direct association with the amount of refractive error.
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.
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.
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.