Rationale and protocol paper for the Asia Pacific Network for inherited eye diseases.

PURPOSE: There are major gaps in our knowledge of hereditary ocular conditions in the Asia-Pacific population, which comprises approximately 60% of the world's population. Therefore, a concerted regional effort is urgently needed to close this critical knowledge gap and apply precision medicine technology to improve the quality of lives of these patients in the Asia-Pacific region. DESIGN: Multi-national, multi-center collaborative network. METHODS: The Research Standing Committee of the Asia-Pacific Academy of Ophthalmology and the Asia-Pacific Society of Eye Genetics fostered this research collaboration, which brings together renowned institutions and experts for inherited eye diseases in the Asia-Pacific region. The immediate priority of the network will be inherited retinal diseases (IRDs), where there is a lack of detailed characterization of these conditions and in the number of established registries. RESULTS: The network comprises 55 members from 35 centers, spanning 12 countries and regions, including Australia, China, India, Indonesia, Japan, South Korea, Malaysia, Nepal, Philippines, Singapore, Taiwan, and Thailand. The steering committee comprises ophthalmologists with experience in consortia for eye diseases in the Asia-Pacific region, leading ophthalmologists and vision scientists in the field of IRDs internationally, and ophthalmic geneticists. CONCLUSIONS: The Asia Pacific Inherited Eye Disease (APIED) network aims to (1) improve genotyping capabilities and expertise to increase early and accurate genetic diagnosis of IRDs, (2) harmonise deep phenotyping practices and utilization of ontological terms, and (3) establish high-quality, multi-user, federated disease registries that will facilitate patient care, genetic counseling, and research of IRDs regionally and internationally.

Patients' perception of personal protective equipment during the SARS-Cov-2 pandemic.

BACKGROUND: Since the outbreak of the coronavirus (SARS-Cov-2), wearing personal protective equipment (PPE) has become necessary. Patients' ability to recognize staff is disrupted impacting on the relationship between healthcare worker and patient. OBJECTIVE: Assess the patients' perspective of healthcare workers wearing PPE and its effect on communication. METHODS: Admitted Orthopaedic patients during the first wave of SARS-Cov-2 were surveyed about the experience with staff wearing PPE. In response to feedback, individual badges with large pictures and names were introduced to wear over PPE. Patient views and response to the badges was collected from surveying admitted patients. RESULTS: Patients encountered staff wearing face masks and felt this was appropriate in the context of the pandemic. 44% responded that they would prefer staff wearing badges with names, roles and pictures more visible. Following the introduction of badges, patients were better able to recognize staff roles and remember names. Hospital staff felt this was a positive change to help improve rapport while wearing PPE. CONCLUSION: Wearing PPE affects patients' ability to recognize individuals in a fast-paced environment such as an acute hospital. Introducing badges was an intervention based on patient feedback and an important adaptation to sustained PPE use to improve the patient's experience.

Bilateral Choroidal Osteoma in a Teenage Girl With Chronic Posterior Scleritis.

A 14-year-old girl with bilateral chronic posterior scleritis was referred to us for poor control of ocular inflammation. There was an incidental finding of choroidal osteoma bilaterally whereby the choroidal mass in her right eye demonstrated a significant tumor growth in a short duration of two months. The right eye choroidal tumor was orangy in color with a well-defined margin, two-disc diameter in size, and located at the macula encroaching the fovea. Multimodal imaging assessments, including serial color fundus photo, enhanced depth imaging optical coherence tomography (EDI-OCT), and B scan ultrasonography monitoring, confirmed a continuous rapid growth of choroidal osteoma with episodes of scleritis flare-ups. Furthermore, intolerance toward second-line immunosuppressants and loss of follow-ups during the coronavirus disease 2019 (COVID-19) pandemic lockdown led to frequent relapses of her posterior scleritis. Therefore, a new treatment plan was designed, and close monitoring of choroidal osteoma growth and control of posterior scleritis were initiated. Subsequently, bilateral posterior scleritis remained quiescent, and her vision remained stable with stagnant growth of choroidal osteoma.

An Unusual Cytomegalovirus Ocular Manifestation in a Non-HIV Patient.

A 60-year-old Aboriginal man with underlying severe exfoliative dermatitis, treated with oral azathioprine and oral prednisolone, presented with left painful red eye for ten days. On initial presentation, left eye vision was poor at hand motion. There was corneal endotheliitis over the left eye with severe anterior chamber inflammation obscuring the fundus view. B-scan ultrasonography showed evidence of vitritis with a flat retina. An urgent aqueous tap for viral polymerase chain reaction (PCR) yielded positive cytomegalovirus (CMV) DNA results. As CMV infection commonly affects immunosuppressed individuals, his systemic immunosuppressants were withheld temporarily. He was successfully treated with combination intravenous ganciclovir, intravitreal ganciclovir 2mg/0.1ml, and topical ganciclovir 2%. His vision improved significantly from hand motion to 20/40. There was no reactivation of CMV infection post-treatment.

Association between tooth loss and hypertension: A cross-sectional study.

CONTEXT: Cardiovascular diseases (CVD) are one of the leading causes of premature deaths among noncommunicable disease. Hypertension increases the risk of cardiovascular events. In addition to well-known risk factors for hypertension like obesity, lack of physical activity, studies have shown independent association between tooth loss and increased blood pressure and stroke. However, the relevant literature is not conclusive. AIMS: Aim of our study was to investigate the association between tooth loss and increased blood pressure among adult patients. METHODS AND MATERIAL: A cross-sectional study among 270 adults aged 20-59 years was conducted. The dependent variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). The main exploratory variable was the number of self-reported natural teeth for each dental arch. They were recorded as 10 or more natural teeth, less than 10 natural teeth, and no natural teeth. Data were analyzed using descriptive statistics, independent t-test, ANOVA, and multiple linear regression analysis. RESULTS: Mean SBP was 125.3 mmHg and DBP was 78.9 mmHg. Moreover, 29.3% of participants had hypertension, 8.9% were edentulous, 22.8% had lost more than 10 teeth, and 68.3% had lost less than 10 teeth. Increased SBP was seen with increased tooth loss among participants. After adjusting for all covariates, no significant association between tooth loss and SBP and DBP was seen. CONCLUSIONS: The mean SBP was higher among the participants who were edentulous than partially edentulous. However, there was no significant association between tooth loss and SBP and DBP after adjusting for confounding factors.