bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)
Authors: Azubuike Samuel Onyinyechukwu 
Published: June 2024

ABSTRACT
The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.
A Comparison of the Mydriatic Efficacy of Tropicamide and Phenylephrine Eye Drops Administered as a Vaporized Spray in One Eye and Conventional Drop Instillation in the Other Eye in an Indian Pediatric Cohort
Authors: Vinay P. G. , Bhat Sunayana , Mathews Meera Mary 
Published: June 2024

Purpose:
To determine by serial measurements and compare the pupillary mydriasis effect of tropicamide and phenylephrine drops administered as a vaporized spray over closed lids in one eye and through conventional instillation of eye drops in the other eye in a pediatric cohort.

Methods:
This prospective study was conducted on healthy children aged 6–15 years. After visual assessment, investigator 1 examined the child for initial pupillary size. Investigator 2 instilled the drops in one eye and applied the spray to the other eye randomly, and the response of the child was noted using the Wong-Baker pain rating scale. The eyes receiving the spray and the eyes receiving drop instillation were considered as Groups 1 and 2, respectively. Subsequently, serial pupillary measurements were carried out every 10 min for up to 40 min by investigator 1. The patient compliance for the two methods of drug instillation was also compared.

Results:
The study comprised 80 eyes. At 40 min, both the groups showed no statistical difference in the mydriasis effect, with Group 1 showing 7.23 mm mydriasis and Group 2 showing 7.58 mm (P = 0.058). The analysis of the pain rating scale showed better compliance with the spray method of drug instillation, which was statistically significant (P = 0.044).

Conclusions:
Our study shows that spray application is a less invasive method for pupillary dilatation, which has better compliance and provides equally good dilatation as conventional methods. This study proves the efficacy of spray application in an Indian pediatric cohort.
Delayed-Onset Endophthalmitis after Intravitreal Aflibercept Injection
Authors: Akbarzadeh Ali , Rahimi Masoud , Zand Amin , Falavarjani Khalil Ghasemi 
Published: June 2024

Purpose:
To describe delayed-onset infectious endophthalmitis 4 months after intravitreal aflibercept injection.

Methods:
An 80-year-old female was referred with signs and symptoms of clinical endophthalmitis 4 months after intravitreal injection of aflibercept for choroidal neovascularization. Noninfectious causes of panuveitis were excluded and she was diagnosed with delayed-onset postinjection infectious endophthalmitis. Vitreous and aqueous specimens were prepared and antibiotics (vancomycin and ceftazidime) were injected intravitreally.

Results:
Vitreous culture was positive for Staphylococcus epidermidis. During the 1st month after the antibiotic injections, symptoms and signs of the patient improved and became stable during the 6-month follow-ups.

Conclusions:
Delayed-onset infectious endophthalmitis can be presented following intravitreal injections. Late presentation of uveitis in postinjected eyes needs complete investigations to rule out infectious endophthalmitis as an ophthalmic emergency.
Clinical Course and Optical Coherence Tomography of Ocular Angiostrongyliasis: A Case Report
Authors: Luangsawang Kanin , Wongsantimeth Veeraphatra , Treeyawedkul Sirinan 
Published: June 2024

Purpose:To report the clinical course and optical coherence tomography (OCT) findings of ocular angiostrongyliasis.Methods:A 36-year-old female with a history of ingesting regular raw freshwater shrimp and other raw food presented with acute unilateral painless visual loss in the right eye. Her right eye’s best-corrected visual acuity (BCVA) was 1 ft of the count finger. Fundus examination showed vitritis, generalized retinal pigment epithelial alteration, and a moving roundworm in the vitreous at the 6 o’clock position. Macular OCT of her right eye showed thinning of the retina, loss of the external limiting membrane and ellipsoid zone, subretinal hyper-reflective material clumping, and hyper-reflective foci at the superficial choroidal layer.Results:The patient was administered oral and topical prednisolone. The roundworm, identified asAngiostrongyluscantonensis, was wholly extracted from the vitreous using a 23G sclerotomy port and pars plana vitrectomy. The final BCVA was 1 ft of the count finger.Conclusion:This case report describes an infrequent presentation and illustrates the clinical course and OCT findings of ocular angiostrongyliasis.
Quantitative Analysis of Inner, Middle, and Outer Retinal Thickness by Optical Coherence Tomography in Children and Adolescents
Authors: Ghassemi Fariba , Salari Farhad , Hatami Vahid , Bazvand Fatemeh , Shamouli Hadi , Mohebbi Masoumeh , Sabour Siamak 
Published: June 2024

Purpose:
To describe the variance of inner, middle, and outer retinal layer thicknesses (IRT, MRT, and ORT) at the macular area in children and adolescents with normal eyes in different age groups.

Methods:
This cross-sectional study enrolled subjects aged 5–18 years with normal eyes. The macula was scanned by optical coherence tomography (6 mm × 6 mm AngioScan-Optovue). Four age groups were defined (≤7, 7–10, 11–14, and ≥14 years). The influences of age and gender were analyzed.

Results:
One hundred and thirty-nine eyes of 69 subjects with a mean age of 10.92 ± 3.51 years were registered. The mean whole macular thickness (MT) was 297.32 ± 11.05 in males and 303.197 ± 13.32 in females (P = 0.01, t-test). The MT in each aging group was 301.47 ± 2.5, 295.53 ± 1.71, 300.81 ± 2.12, and 298.6 ± 1.87, subsequently (P = 0.17, analysis of variance test). Significant differences were found between the sexes at the perifoveal area and mainly in IRT. No correlation between eyes was noted. We observed that the RT fluctuates during growth and that gender has some influence on the evolution of RT. IRT and MRT changed reciprocally in all macular areas, whereas ORT expanded in all age groups of children and adolescents.

Conclusions:
No subsegmental retinal thickness difference between eyes was observed in pediatric groups in this study, while gender had some influence on perifoveal IRT. Despite the fact that this study is not a longitudinal study, we can get some insight into the developmental changes in retinal thickness and its clinical applications in children and adolescents.
Dynamic Electrooculography Findings for Medial Rectus Myofascial Release in Esodeviation
Authors: Mohamadi Alireza , Vasaghi-Gharamaleki Behnoosh , Mirzajani Ali , Jafarzadehpur Ebrahim 
Published: June 2024

Purpose:
To determine which mechanisms are operative in releasing the extraocular myofascial tissue in response to extraocular myofascial release (EOMR) and to evaluate the effect of EOMR on saccadic velocity and esodeviation angle in patients with convergence spasm.

Methods:
Fourteen patients with convergence spasm aged 20–35 participated in this research. The treatment included touching the medial rectus and its interrelated fascial tissue with the index finger pulp from over the eyelid for at least 300 s and applying very gentle and uniform pressure. We evaluated the saccadic velocity obtained from dynamic electrooculography (EOG) and the angle of deviation. The findings of dynamic EOG were used as a reliable quantitative method to assess eye movement function.

Results:
The amount of esodeviation decreased significantly at both far 2.39Δ, 95% confidence interval (CI) (1.27–3.52) (P = 0.002) and near 5.57Δ, 95% CI (4.67–6.47) (P = 0.001) after two sessions of EOMR in a week. There was no significant difference in saccadic velocities before and after treatment.

Conclusion:
In the short term, the EOMR only affects the static condition of the eye. Therefore, a significant improvement could be seen in the deviometric findings. However, the dynamic properties of the extraocular muscles did not improve and probably needed a more extended treatment period for acting the long-term mechanisms.
Posterior Microphthalmos Pigmentary Retinopathy Syndrome with Angle-Closure Glaucoma
Authors: Sassi Hela , Ammar Khaled , Ouederni Meriem , Cheour Monia 
Published: June 2024

Purpose:To describe a particular form of posterior microphthalmos pigmentary retinopathy syndrome (PMPRS) with an atypical clinical presentation of pigment retinal dystrophy and an association to an inconstant complication which is angle-closure glaucoma (ACG).Methods:A 40-year-old male patient with ACG on maximal topical treatment was referred to our department for uncontrolled intraocular pressure. Best-corrected visual acuity was 2/10 in the right eye and light perception in the left eye. Intraocular pressure was 36 mmHg bilaterally. He had 360° peripheral anterior synechiae on gonioscopy. Fundus examination revealed total cupping with pale retinal lesions in both eyes and a few pigment deposits in the midperiphery of the right eye. Multimodal imaging was done.Results:Fundus autofluorescence revealed patchy areas of hypoautofluorescence. Optical coherence tomography (OCT) showed bilateral foveoschisis and macular folds. Anterior segment OCT showed a circumferential iridocorneal angle closure. Axial length measured with ultrasound biomicroscopy was 18.4 mm in the right eye and 18.1 in the left eye. Electroretinogram revealed attenuated scotopic responses. The patient was diagnosed with nanophthalmos–retinitis pigmentosa (RP)–foveoschisis syndrome complicated with ACG. A combined surgery with phacoemulsification - anterior vitrectomy - intraocular lens implantation and trabeculectomy was performed in both eyes with a satisfactory outcome.Conclusions:In its typical forms, PMPR syndrome is an association of nanophthalmos - RP - foveoschisis and optic nerve head (ONH) drusen. Incomplete phenotypes may lack ONH drusen or foveoschisis. Patients with PMPRS have to be screened for iridocorneal angle synechia and ACG.
Management of Malignant Glaucoma
Authors: Sadeghi Reza , Momeni Ali , Fakhraie Ghasem , Eslami Yadollah , Zarei Reza , Vahedian Zakieh , Safizadeh Mona , Tabatabaei Seyed Mehdi 
Published: June 2024

Purpose:To compare the outcomes of various invasive and noninvasive approaches to the treatment of malignant glaucoma.Methods:Glaucoma-related keywords were looked up in PubMed and Google Scholar, and related articles up to 2022 were used to put together this review article.Results:Numerous surgical methods and techniques have been introduced in the past few years. This review outlined current knowledge regarding the nonsurgical and surgical management of malignant glaucoma. In this regard, we first briefly outlined the clinical presentation, pathophysiology, and diagnosis of this disorder. Then, the current evidence on the management of malignant glaucoma was reviewed. Finally, we discuss the need for treatment of the other eye and the factors that might affect the outcome of surgical intervention.Conclusions:Fluid misdirection syndrome, or malignant glaucoma, is a severe disorder that can occur spontaneously due to surgical intervention. The pathophysiology of malignant glaucoma is complicated, and numerous theories exist about the underlying mechanisms that may contribute to the disease. Malignant glaucoma can be treated conservatively using medications, laser therapy, or surgery. Laser treatments and medical treatments have been adequate for the treatment of glaucoma, but the effects have generally been short-lived, and surgical treatment has proved to be the most effective. There have been a variety of surgical methods and techniques introduced. Still, none have been studied in a large proportion of patients as a control case to compare effectiveness, outcomes, and recurrence. Pars plana vitrectomy with irido-zonulo-capsulectomy still seems to have the best results.
Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method
Authors: Moghisseh Bardia , Modir Hesameddin , Moshiri Esmail , Motaghinia Zahra , Bozorgmanesh Mohammadreza 
Published: June 2024

Purpose:
To compare dexmedetomidine, ketamine, and etomidate in the induction of sedation and hemodynamic changes in patients undergoing cataract surgery by phacoemulsification method.

Methods:
This was a double-blind clinical trial study carried out on 128 patients. Using the block randomization method, the patients were divided into four equal groups (dexmedetomidine, ketamine, etomidate, and control). Mean arterial pressure, heart rate, and arterial oxygen saturation, Ramsay Sedation Score were recorded every 5 min intraoperatively, in recovery, and 1, 2, 4, and 6 h postoperatively. Moreover, the Aldrete score was measured in recovery time for discharge from the recovery room.

Results:
The mean age of participants was found to be 63.16 ± 6.07 years, and there was no statistically significant difference between the groups in terms of age, sex, and body mass index, SpO2, and heart rate (P > 0.05). From 15 min after the start of surgery to 6 h postoperatively, the mean arterial pressure in the dexmedetomidine group was significantly lower than that in the other three groups, including ketamine, etomidate, and control (P < 0.05). The mean sedation score (Ramsay) during recovery and 1 h postoperatively was higher in the dexmedetomidine group compared with that in the control group, whereas the recovery time in the dexmedetomidine group was higher than that in the other groups (P < 0.001). In addition, the amount of propofol consumption in the two groups of dexmedetomidine and ketamine was significantly less than that in the etomidate and control groups (P < 0.001).

Conclusions:
According to the results, dexmedetomidine caused better hemodynamic changes with more reduction in blood pressure and heart rate, and patients in the dexmedetomidine group did not require any specific medical treatment. Moreover, higher patient satisfaction and longer recovery duration were observed in the dexmedetomidine group than in the other study groups. As such, it is suggested that dexmedetomidine be used as an adjuvant in cataract surgery for more sedation, analgesia, and optimal intraoperative conditions.
Corneal Biomechanical Changes after Corneal Cross-Linking in Patients with Keratoconus
Authors: Hamid Adel , Jahadi-Hosseini Hamidreza , Khalili Mohammad Reza , Jahanbani-Ardakani Hamidreza 
Published: June 2024

Purpose:
To evaluate the changes in biomechanical properties of the cornea using the Corvis ST device after the treatment of keratoconus patients with ultraviolet-A/riboflavin corneal cross-linking (CXL).

Methods:
Thirty-seven eyes from 37 consecutive patients with progressive keratoconus were included in this prospective observational case series. Corneal biomechanical parameters including the length of the applanated cornea (L1 and L2), corneal movement velocity during applanation (V1 and V2) at the moment of the first and second applanation, deformation amplitude (DA), distance between bending points of the cornea points of the cornea (PD), and concave radius of curvature (R) at the point of the highest concavity were recorded using the Corvis ST at baseline, 3 months, and 1 year after CXL.

Results:
The mean age of the patients was 23.27 years (range, 19–31 years). Among CorVis ST corneal biomechanical parameters, L1, DA, PD, and R at the point of the highest concavity did not change significantly. The length of the applanated cornea at the moment of second applanation (L2) showed a significant change 3 months after CXL, but no significant difference was found between the 3-month and 1-year values of this parameter. Corneal movement velocity during applanation (V1 and V2) did not change 3 months after doing CXL, but the changes in these parameters were significant 1 year after CXL.

Conclusions:
Although the CorVis ST device may detect changes in some biomechanical properties of cornea after the treatment of keratoconus patients with CXL, many parameters remain unchanged, and this device cannot readily be used to find the effects of CXL.
Comparison of Visual Field Measurements in Glaucomatous Eyes using Oculus and Metrovision Perimeters
Authors: Daneshvar Ramin , Ehsaei Asieh , Moghadas Sharif Nasrin , Pato Zahra 
Published: June 2024

Purpose:
To investigate the agreement between the Oculus and Metrovision perimeters in the visual field evaluation of glaucoma patients.

Methods:
In this cross-sectional study, 41 consecutive glaucoma patients were enrolled. After detailed clinical examinations, visual field testing was performed for all patients using the Oculus and Metrovision perimeters. The interval time between the two visual field examinations was 30 min.

Results:
A total of 22 participants were male (53.7%) and the mean ± standard deviation (SD) age was 58.6 ± 9.1 years. The absolute average of the mean deviation (MD) in the oculus perimeter (8.24 ± 4.92 dB) was higher compared to the Metrovision perimeter (4.02 ± 4.62; P < 0.001). This difference was also evident in the Bland–Altman graph. The loss variance (pattern SD) values of Oculus perimeter (28.58 ± 16.40) and Metrovision perimeter (28.10 ± 28.45) were not significantly different; although based on the Bland–Altman plots in the lower MDs, the agreement is better and the data dispersion is lower, and in the higher MDs, the agreement is lower. The parameters of four visual field quadrants were also compared and showed poor correlations (P < 0.001).

Conclusion:
The Oculus and Metrovision perimeter devices have good agreement in lower MDs; however, they cannot be used interchangeably.
Efficacy and Safety of Iris-Claw Intraocular Lens in Pediatric Ectopia Lentis: A Literature Review
Authors: Yulia Dian Estu , Soeharto Diajeng Ayesha 
Published: June 2024

Purpose:To review current evidence regarding the use of iris-claw intraocular lens (IOL) in terms of its efficacy and safety in the population of pediatric ectopia lentis.Methods:A comprehensive literature search of six electronic databases (PubMed-NCBI, Medline-OVID, Embase, Cochrane, Scopus, and Wiley) and secondary search through reference lists was conducted using keywords selected a priori. All primary studies on the use of iris-claw in pediatric ectopia lentis that evaluated visual acuity (VA), complications, and endothelial cell density (ECD) were included and critically appraised using the Newcastle–Ottawa Scale.Results:Ten studies were eligible for inclusion with an overall sample size of 168 eyes of children with ectopia lentis, and the majority of studies evaluated anterior iris-claw IOL. All studies reported improvement in postoperative VA. The most commonly reported complication across studies was IOL decentration. All studies reported decreasing ECD, and this was observed in both anterior and retropupillary iris-claw IOL.Conclusion:Current evidence shows that iris-claw IOL is effective in terms of improving VA in pediatric ectopia lentis. Due to the lack of long-term evidence of its safety in children, one must remain cautious regarding potential endothelial cell loss. Further high-quality, interventional, long-term studies are needed.
The Effect of Post-Coronavirus Disease 2019 Infection on the Retinal Microvasculature
Authors: El-Haddad Nermien Salah El-Dien Mohammed , Abd El-Wahed Elham , Abd El-Wahab Adel , Shalaby Sawssan , Farag Mona Mohammad Aly , Mohammed Nesma Sied , Shawky Shrief 
Published: June 2024

Purpose:
To evaluate the short-term microvasculature changes of the macula and optic disc following coronavirus disease 2019 (COVID-19).

Methods:
This study included 150 eyes (50 eyes of healthy controls and 100 eyes of patients) during the 1st month following COVID-19 recovery, as evidenced by two negative polymerase chain reactions. A complete ophthalmic examination and optical coherence tomography angiography were performed to detect the deep and superficial macular vessel density (VD). In addition, the VD of the optic disc was evaluated.

Results:
Deep VD (DVD) showed a statistically significant decrease in post-COVID-19 patients, particularly those with severe COVID-19. This reduction occurred in the whole image, parafoveal, and perifoveal VD (P = 0.002, P = 0.002, and P < 0.001, respectively). Concerning the superficial VD (SVD), only the superior hemisphere of the whole image density was statistically significantly reduced (P = 0.037). There was no statistically significant difference in foveal VD (both deep and superficial vessel) among the study groups (P = 0.148 and P = 0.322, respectively). Regarding the foveal avascular zone (FAZ), there was no statistically significant among groups (P = 0.548). Regarding the optic disc, the whole image VD and redial peripapillary capillary VD demonstrated a highly significant decrease, particularly in cases of severe COVID-19. Conversely, inside disc VD showed a nonsignificant change among the study groups.

Conclusions:
According to the findings of the current study, retinal microvasculature was affected in the 1st month following recovery from COVID-19. DVD was significantly reduced more than SVD. In addition, peripapillary VD decreased, whereas the FAZ was unaffected.