Assessment of corneal endothelial cell parameters using specular microscopy in previously infected SARS-CoV-2 patients.

PURPOSE: To examine the long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the corneal endothelium. METHODS: This was a comparative, cross-sectional study that included subjects who had recovered from SARS-CoV-2 infection for at least 6 months (group 1) and a group of age- and sex-matched controls with no prior symptomatology or documentation of SARS-CoV-2 infection (group 2). After full ophthalmological evaluation, specular microscopy was used to examine the endothelial cell parameters, including endothelial cell density, coefficient of variation, hexagonality, average area, and central corneal thickness. RESULTS: Sixty-four and 53 right eyes were included in groups 1 and 2, respectively. No statistically significant differences were detected in any of the examined specular parameters between the two groups. CONCLUSION: SARS-CoV-2 infection may have no delayed sequel on the corneal endothelium. Future prospective studies with repeated examinations in the same subjects would be useful.

Screening of Primary School Children for Amblyopia and Amblyogenic Factors in Central Cairo, Egypt.

OBJECTIVE: To measure the prevalence of amblyopia and amblyogenic factors among primary school children and to evaluate distance visual acuity (VA) as a screening test to detect amblyopia and define its cutoff value. SUBJECTS AND METHODS: A cross-sectional study was conducted on primary school children in two schools in Central Cairo. Children underwent assessment of visual acuity using Landolt broken ring. Comprehensive ophthalmologic examination was performed for amblyopia suspects at the Ophthalmology Department of Ain Shams University Hospitals, including reassessment of best-corrected visual acuity (BCVA) using the same chart. RESULTS: A total of 352 children were examined. Reduced screening VA (amblyopia suspect) was detected in 47 subjects (13.35%) proved amblyopia after comprehensive examination was 1.98% (7 cases). Refractive errors (REs) were present in all suspected and proved amblyopia cases (100%) but was only present in 11.6% of nonamblyopic students (P < 0.05). The prevalence of hyperopia in the whole sample was 3.6%, and was 27.6% in subjects with RE. Thirty percent of hyperopic eyes were amblyopic. The prevalence of myopia was 9.3% of the whole sample and 70% of students with RE. Only 9% of myopic eyes were amblyopic. Mild to moderate amblyopia (VA better than 0.2log MAR) was 42.9%, while severe amblyopia represented 57.1%. CONCLUSION: This study emphasizes the importance of school-based eye care system targeting the detection of amblyopia by application of a fast screening distance VA test with a cutoff value of high sensitivity at log MAR 0.539 (Snellen's VA equivalent 6/18).

Visual-Evoked-Response-Supported Outcome of Intravitreal Erythropoietin in Management of Indirect Traumatic Optic Neuropathy.

PURPOSE: Investigating the efficacy of intravitreal injection of erythropoietin (EPO) in managing indirect traumatic optic neuropathy (ITON) of different durations. METHODS: A case series that included two groups of ITON patients: recent ITON group (<3 months trauma duration; 7 eyes) and old duration ITON group (3-36 months; 7 eyes). Diagnostic computerized tomography (CT) and baseline flash visual evoked response (VER) were performed at the presentation time. At the initial visit and each follow-up, all patients had undergone assessment of best-corrected visual acuity (BCVA), pupil reaction, and anterior and posterior segments. VER was repeated 1 and 3 months after injection. All patients received an intravitreal injection of 2000 IU EPO in 0.2 ml of commercially available sterile EPREX 4000 solution, Jansen Cilag, Zug, Switzerland. Five patients had received a second injection 3 months later. RESULTS: Significant improvement was found in BCVA, VER amplitude, and latency (P < 0.0001, 0.0154, and 0.0291, respectively). Initial values of BCVA, VER amplitude, and latency correlated significantly to the final values. Differences between recent and old trauma groups were insignificant in the three parameters. In patients who received second injection, further clinical but statistically insignificant improvement was noted in BCVA in 60% of patients, VER amplitude in 50% of patients, and in VER latency in 100% of patients. No complications were recorded. CONCLUSION: Intravitreal injection of EPO may be effective and safe in treatment of recent and old indirect traumatic optic neuropathy.

Ocular aberrations in amblyopic children.

PURPOSE: To study the pattern of ocular aberrations in amblyopic children, and evaluate a possible relation to etiology and treatment outcomes of amblyopia. METHODS: The WaveScan Wavefront System (AMO, Santa Ana, CA, USA) aberrometer was used to assess 75 eyes (60 children) after instillation of 1% cyclopentolate eyedrops. There were 29 males and 31 females with a mean age of 9.23 ± 2.55 years (range, 5-14 years). The study sample was subdivided into four groups; 16 emmetropic non-amblyopic eyes (control group); 24 pre-treatment newly diagnosed amblyopic eyes; 16 eyes of treated amblyopes and; 19 eyes with refractory amblyopia. RESULTS: Amblyopes had statistically significant greater root mean square (RMS) values for whole eye aberrations, 2nd order aberrations, defocus ([Formula: see text]) and astigmatism ([Formula: see text]) compared to emmetropes (P < 0.0001). The refractory amblyopic group showed statistically significant differences in whole eye RMS, 2nd order- aberrations, defocus ([Formula: see text]) and astigmatism ([Formula: see text]) when compared to treated amblyopic groups (P < 0.0001). Apart from a statistically significant difference in 5th order RMS of pre-treated amblyopes versus the control group, no other significant differences were found in higher order aberrations (HOAs: coma, spherical, higher-order astigmatism, trefoil, or 3rd, 4th, 5th or 6th order terms) between emmetropes and any of the amblyopic groups. CONCLUSION: Lower order aberrations remain the major factor that affect retinal image quality and hence amblyopia development especially in ametropic eyes. This can be corrected optically. Studying HOA profile in amblyopic eyes failed to explain why refractory amblyopia does not respond to orthoptic treatments. This outcome indicates that theories of central problems in image processing and binocular interaction are likely the main cause of refractory amblyopia.