Low-level red-light therapy for myopia control in children: A systematic review and meta-analysis

Abstract Introduction Low-Level Red-Light (LLRL) Therapy is a safe and natural way to promote healing and reduce inflammation in the body. When it comes to treating myopia in children, LLRL therapy is recent, and its efficacy and safety still are not clear. Methods A systematic review and meta-analysis of the literature for LLRL was conducted in accordance with the PRISMA guidelines on November 5, 2022. Databases, including PUBMED, Cochrane Library, Web of Science, and Embase were queried. A meta-analysis of random effects was conducted. Inclusion criteria included Randomized Controlled Trials (RCTs) or observational studies where LLRL therapy was used in children (3‒15 years old) with myopia. Exclusion criteria were studies with other ocular abnormalities. Efficacy was evaluated through the mean change in Axial Length (AL) and cycloplegic Spherical Equivalent Error (SER), while safety was evaluated by monitoring adverse effects. Results A total of 5 final studies were included (4 RCTs, and 1 observational), in which 685 total patients were analyzed. The mean age was 9.7 ± 0.66 years, with 48,2% female patients. The number of eyes in the LRLL arm is 714 and, in the control, arm is 656. LLRL showed better results in SER and AL mean change (OR = 0.58; 95% CI 0.33 to 0.83; p < 0.00001, and MD -0.33; 95% CI -0.52 to -0.13; p = 0.001, respectively), in comparison to the control group. There was no significant difference in adverse effects between groups (MD = 5.76; 95% CI 0.66 to 50.14; p = 0.11). Conclusion LLRL therapy is a non-invasive, effective, and safe short-term treatment option; however, long-term evaluation, particularly in comparison to other therapies, requires additional investigation.

Advances in ophthalmic preparation: the role of drug nanocrystals and lipid-based nanosystems.

Nanocrystals and lipid-based nanosystems have the potential to play a crucial role in a significant shift in the treatment of ophthalmic diseases. These drug delivery systems allow overcoming the barriers imposed by anatomy and physiology of the organ of vision. This review aims to present new perspectives for these innovative preparations, emphasising the applications of the nanocrystal and lipid-based nanosystem while outlining their advantages and the drawbacks. The in vivo performance of the lipid-based nanosystems was highlighted. Lipid-based nanosystems and nanocrystals showed a prolonged effect, improved ocular bioavailability, upper therapeutic efficacy, higher permeation, prolonged residence time, and sustained drug release, compared to the current applications. Well-established and innovative developments updates of these systems are highlighted herein.

An evaluation of estimation methods for determining addition in presbyopes.

PURPOSE: The optical correction of presbyopia must be handled individually. Our aim was to compare the methods used in addition to the refractive near vision, with the final addition used in presbyopic patients. METHODS: Eighty healthy subjects with a mean age of 49.7 years (range 40 to 60 years) were studied. Tentative near additions were determined using four different techniques: one-half amplitude accommodation with minus lenses (AAL); one-third accommodative demand with positive lens (ADL); balanced range of accommodation with minus and positive lenses (BRA) and crossed cylinder test with initial myopisation (CCT). The power of the addition was then refined to arrive at the final addition. RESULTS: The mean tentative near additions were lower than the final addition for ADL and BRA addition methods. The mean differences between tentative and final additions were low for all the tests examined (less than 0.25 D). The intervals between the 95% limits of agreement differed substantially and were always higher than ±0.50 D. CONCLUSION: All the methods used displayed similar behavior and provided a tentative addition close to the final addition. The coefficient of agreements (COA) detected suggests that every tentative addition should be adjusted according to the particular needs of the patient.

An evaluation of estimation methods for determining addition in presbyopes / Avaliação de diferentes métodos para determinar adição em présbitas

PURPOSE: The optical correction of presbyopia must be handled individually. Our aim was to compare the methods used in addition to the refractive near vision, with the final addition used in presbyopic patients. METHODS: Eighty healthy subjects with a mean age of 49.7 years (range 40 to 60 years) were studied. Tentative near additions were determined using four different techniques: one-half amplitude accommodation with minus lenses (AAL); one-third accommodative demand with positive lens (ADL); balanced range of accommodation with minus and positive lenses (BRA) and crossed cylinder test with initial myopisation (CCT). The power of the addition was then refined to arrive at the final addition. RESULTS: The mean tentative near additions were lower than the final addition for ADL and BRA addition methods. The mean differences between tentative and final additions were low for all the tests examined (less than 0.25 D). The intervals between the 95% limits of agreement differed substantially and were always higher than ±0.50 D. CONCLUSION: All the methods used displayed similar behavior and provided a tentative addition close to the final addition. The coefficient of agreements (COA) detected suggests that every tentative addition should be adjusted according to the particular needs of the patient.

OBJETIVO: A correção óptica da presbiopia deve ser manejada individualmente. Nosso intuito é de comparar os métodos usados para calcular a adição na elaboração do grau para perto em pacientes présbitas. MÉTODOS: Oitenta pacientes com média de idade de 49,7 anos (intervalo de 40 a 60 anos) foram estudados. Adições provisórias foram determinadas usando quatro diferentes técnicas: metade da amplitude de acomodação com lentes negativas (AAL); um terço da demanda acomodativa com lentes positivas (ADL); média aritmética da acomodação usando lentes positivas e negativas (BRA); teste com o cilindro cruzado com miopização (CCT). O grau final foi refinado até chegar a graduação final da adição. RESULTADOS: A média das adições nos testes foram menores que as adições finais nos métodos ADL e BRA. As diferenças médias entre os testes e o grau final foram baixas em todos os métodos (menores que +0,25 D). Os intervalos entre os 95% dos limites da concordância diferenciaram substancialmente e foram todos maiores que ±0.50 D. CONCLUSÃO: Todos os métodos usados demonstraram comportamentos similares e forneceram resultados bem próximos da adição final. O coeficiente de concordância (COA) detectado, sugere que todos os métodos utilizados devem ser ajustados de acordo com as necessidades do paciente.

New concepts in accommodation and presbyopia / Novos conceitos em acomodação e presbiopia

The authors conducted a review of classical and conflicting theories of accommodation and presbyopia. They make a critical comparison with the findings of magnetic resonance imaging (MRI) that have been developed in recent decades. Based on these studies, formulates a new approach on the subject, shifting the focus of the discussion of the lens to the posterior pole of the eye.

Os autores revisaram as teorias clássicas e conflitantes sobre acomodação e presbiopia. E as compararam criticamente com os achados de imagem por ressonância magnética (MRI) que têm se desenvolvido nas últimas décadas. Baseado nestes estudos, formulam uma nova abordagem sobre o tema, mudando o foco da discussão do cristalino para o polo posterior do olho.

Estudo da acuidade visual de escolares da rede estadual e da rede particular de ensino do município de Barueri - SP, 1991 / A study of visual acuity in school children belonging to government and private schools in the county of Barueri, Greater São Paulo, Brazil, 1991

Discute as açöes da Saúde Ocular em escolares na rede de ensino, além de fazer análise minuciosa das diferenças existentes entre as duas redes de ensino e as diferentes idades estudadas

Rabdomiossarcoma ocular: estudo clínico de 12 casos / Ocular rabdomiossarcoma: clinical study of 12 cases

Foram avaliados 12 pacientes com rabdomiossarcoma ocular em relaç*o aos seguintes dados: sexo, idade, raça, tempo de história, localizaçäo do tumor, exame ocular e estudo anatomopatológico. Os resultados mostraram-se concordantes com a literatura. 8 casos tiveram um seguimento adequado tendo sido analisados em relaçäo ao tratamento, evoluçäo e complicaçöes. Os 2 pacientes que foram a óbito tinham sido submetidos a radioterapia isoladamente. A paciente que recebeu radioterapia e quimioterapia associada a exenteraçäo respondeu bem à terapêutica e pode ser considerada curada. Os demais pacientes foram tratados com quimioterapia e radioterapia, näo tendo apresentado recorrências até o momento, sendo que os autores concluem ser este o melhor esquema terapêutico

Retinoblastoma: estudo clínico e anátomo-patológico de 90 casos / Retinoblastoma: clinical and anatomo-pathological study of 90 cases

Foram estudados 90 casos de retinoblastoma internados na enfermaria da Clínica Oftalmológica da Faculdade de Medicina da USP. Foram analisados dados de prevalência em relaçäo a sexo, idade, olho acometido, história familiar, raça, sinais e sintomas referidos, achados oculares e ssitêmicos, estudo anátomo-patológico, evoluçäo clínica e tratamento. Os autores observaram que o diagnóstico em nosso meio é feito tardiamente que ocorre uma alta taxa de abandono ao tratamento pelos pacientes estudados

Análise clínica retrospectiva do desvio vertical dissociado / A retrospective clinical analysis of dissociated vertical deviation

Estudaram-se 38 pacientes com desvio vertical dissociado. Cada paciente foi estudado segundo os seguintes itens: incidência; distribuiçäo por sexo; antecedentes familiares de distúrbios de motilidade extrínseca; associaçäo com outras doenças oculares ou sistêmicas; idade de aparecimente do estrabismo; tipo de estrabismo; época do diagnóstico do desvio; padräo de fixaçäo; condiçöes sensoriais; variaçäo alfabética; nistagmo. Os resultados säo apresentados e discutidos; a importância do diagnóstico do desvio vertical dissociado é ressaltada

Paralisia traumática dos nervos troclear direito e oculomotor esquerdo / Traumatic paralysis of the right trochlear and left oculomotor nerves

O caso de um paciente com paralisia traumática dos nervos troclear direito e oculomotor esquerdo é apresentado. O quadro clínico descrito inclui exotropia com paralisia da aduçäo do olho esquerdo, além da exiclotorçäo do olho direito e posiçäo de cabeça compensatória. Säo feitas consideraçöes sobre a possível localizaçäo da lesäo ao nível do tronco cerebral e a possibilidade do comprometimento do fascículo longitudinal medial