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2.
Int Ophthalmol ; 44(1): 315, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38967725

RESUMO

Acute acquired comitant esotropia (AACE) is mainly characterized by sudden onset, accompanied by diplopia, without extraocular muscles paralysis or ocular motility disorders. In recent years, the incidence of AACE has been increasing, researchers have found that this phenomenon may be related to the widespread use of electronic devices and the increase in the number of people working from home during the COVID-19 pandemic. However, its neural mechanisms have not been fully elucidated. This article primarily reviews the latest developments in the diagnosis and treatment of AACE from the perspectives of etiology and treatment methods, aiming to provide direction for future in-depth exploration of the pathogenesis and treatment approaches of this disease.


Assuntos
COVID-19 , Esotropia , Humanos , Esotropia/diagnóstico , Esotropia/terapia , Esotropia/fisiopatologia , Esotropia/etiologia , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , Doença Aguda , Músculos Oculomotores/fisiopatologia , SARS-CoV-2
5.
Int Ophthalmol ; 44(1): 325, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38985362

RESUMO

PURPOSE: To evaluate the histopathologic findings of Levator palpebralis superioris (LPS) muscle biopsy after LPS resection for treatment of congenital ptosis and its possible relation with surgical outcomes.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: [Seyed Mohsen] Last name [Rafizadeh]. Author 6 Given name: [Seyed Ali] Last name [Sonbolestan].Also, kindly confirm the details in the metadata are correct.The author names and the sequence are correct. METHODS: Congenital ptosis patients were enrolled in this retrospective study. All of them underwent full ophthalmologic examination included of Margin-reflex distance 1 (MRD-1) and LPS function measurement preoperatively. The patients were followed for 3 months for the postoperative period and after that the measurements were repeated. Histologic parameters including percentages of fat, striated and smooth muscle, and fibrous tissue. The histopathologic findings and their possible correlation with the measurements are analyzed. RESULTS: Sixty-seven patients with unilateral congenital ptosis were enrolled. 45 patients (67.2%) were males. The mean age of patients was 16.10 ± 11.18 years. The patients' MRD-1 was improved significantly from 0.82 ± 1.26 mm to 3.85 ± 1.25 mm after LPS resection (P = 0.000). The success rate was 80.3%. There were no correlations between MRD change and histopathologic tissue percentages but significant correlation was found between success of surgery and fibrous tissue percentage of resected sample (P = 0.033). CONCLUSIONS: The histopathology of the LPS may be useful in prediction of surgical outcome after LPS resection in congenital ptosis patients. The percentage of fibrous tissue play an important role.


Assuntos
Blefaroplastia , Blefaroptose , Músculos Oculomotores , Humanos , Blefaroptose/cirurgia , Blefaroptose/congênito , Blefaroptose/diagnóstico , Masculino , Músculos Oculomotores/cirurgia , Músculos Oculomotores/patologia , Feminino , Estudos Retrospectivos , Criança , Adolescente , Blefaroplastia/métodos , Pré-Escolar , Adulto , Adulto Jovem , Pálpebras/cirurgia , Pálpebras/patologia , Biópsia , Seguimentos , Resultado do Tratamento
6.
Front Endocrinol (Lausanne) ; 15: 1387217, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38868741

RESUMO

Background: The current clinical practice lacks sufficient objective indicators for evaluating thyroid-associated ophthalmopathy (TAO). This study aims to quantitatively assess TAO by evaluating levator palpebrae superioris (LPS) using Dixon-T2WI. Methods: The retrospective study included 231 eyes (119 patients) in the TAO group and 78 eyes (39 volunteers) in the normal group. Dixon-T2WI provided data on maximum thickness of LPS (LPS_T) and signal intensity ratio (LPS_SIR) between the muscle and ipsilateral brain white matter. TAO diagnosis and assessment of its activity and severity were quantitatively determined using LPS_T and LPS_SIR. Results: In the TAO group, LPS_T and LPS_SIR were higher than those in the normal group (p < 2.2e-16). The upper lid retraction (ULR) ≥ 2 mm group exhibited higher LPS_T and LPS_SIR compared to the ULR < 2 mm and normal groups. Optimal diagnostic performance was achieved with an AUC of 0.91 for LPS_T (cutoff: 1.505 mm) and 0.81 for LPS_SIR (cutoff: 1.170). LPS_T (p = 2.8e-07) and LPS_SIR (p = 3.9e-12) in the active phase were higher than in the inactive phase. LPS_T and LPS_SIR showed differences among the mild, moderate-to-severe, and sight-threatening groups (p < 0.05). ROC showed an AUC of 0.70 for LPS_T (cutoff: 2.095 mm) in judging the active phase, and 0.78 for LPS_SIR (cutoff: 1.129). For judging the moderate-to-severe and above, AUC was 0.76 for LPS_T (cutoff: 2.095 mm) and 0.78 for LPS_SIR (cutoff: 1.197). Conclusion: The maximum thickness and SIR of LPS provide imaging indicators for assisting in the diagnosis and quantitative evaluation of TAO.


Assuntos
Oftalmopatia de Graves , Imageamento por Ressonância Magnética , Músculos Oculomotores , Humanos , Oftalmopatia de Graves/diagnóstico , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Músculos Oculomotores/patologia , Músculos Oculomotores/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Idoso , Pálpebras/patologia , Estudos de Casos e Controles
7.
BMC Ophthalmol ; 24(1): 271, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918731

RESUMO

BACKGROUND: The success of the strabismus surgery can hinge on several factors. One of these factors is refractive condition like hyperopia or myopia. Our study seeks to evaluate the surgical outcomes in patients with esotropia and myopia. METHODS: This case-control study encompassed all surgical cases of esotropia at Torfe and Negah Hospital between 2016 and 2021, which satisfied our specified inclusion criteria. The initial variables from electronic medical records were collected, including demographic, clinical, and surgery-related factors. At the final follow-up appointment, the level of eye deviation, both at distance and near, was recorded. We considered the operation a "success" for patients with a post-surgery distance eye deviation of 10(Pd) or less. Patients with greater deviation were classified as surgery failure. Statistical analyses were executed using SPSS software (version 16.0), and a P-value less than 0.05 was considered significant. RESULTS: Of the 194 patients evaluated, 112 were incorporated into the study. Surgical failure was observed in 14.29% of myopic patients, 29.79% of hyperopic patients, and 31.82% of emmetropic patients. The myopia group displayed a 0.19 odd ratio for surgical failure compared to the combined hyperopia and emmetropia groups, not statistically significant (OR: 0.19, CI 95%: 0.03-1.02). Additionally, patients diagnosed with Lateral Rectus Under-action were found to be 6.85 times more likely to experience surgery failure(OR: 6.85, CI 95%: 1.52-30.94). An elevated risk of surgical failure was also identified in patients who underwent Inferior Oblique Weakening procedure, indicated by a 3.77-fold increase in the odds ratio for failure(OR: 3.77, CI 95%: 1.08-13.17). CONCLUSION: In our study, despite numerical disparities, there was no statistical difference among the success rates of all esotropia patients with different refractive errors. The patients with LRUA or IOOA showed lower success rates. Myopic patients had higher post-op overcorrection with lower reoperation rates compared to hyperopic or emmetropic patients.


Assuntos
Esotropia , Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Visão Binocular , Acuidade Visual , Humanos , Esotropia/cirurgia , Esotropia/fisiopatologia , Masculino , Feminino , Procedimentos Cirúrgicos Oftalmológicos/métodos , Estudos de Casos e Controles , Músculos Oculomotores/cirurgia , Músculos Oculomotores/fisiopatologia , Criança , Acuidade Visual/fisiologia , Pré-Escolar , Visão Binocular/fisiologia , Estudos Retrospectivos , Adulto , Refração Ocular/fisiologia , Miopia/cirurgia , Miopia/fisiopatologia , Miopia/complicações , Adolescente , Hiperopia/cirurgia , Hiperopia/fisiopatologia , Hiperopia/complicações , Resultado do Tratamento , Pessoa de Meia-Idade , Adulto Jovem , Seguimentos
8.
Turk J Ophthalmol ; 54(3): 133-139, 2024 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-38836622

RESUMO

Objectives: To examine changes in tear oxidative stress levels and tear film functions in patients with blepharoptosis and dermatochalasis following conjunctiva-Müller muscle resection (CMMR) and blepharoplasty surgeries. Materials and Methods: This prospective study included 32 healthy controls and 62 patients with blepharoptosis or dermatochalasis. CMMR surgery was performed in 20 eyes and upper blepharoplasty was performed in 42 eyes. Tear oxidative stress markers (8-hydroxy-2'-deoxyguanosine [8-OHdG] and 4-hydroxy-2-nonenal [4-HNE]) were quantified by enzyme-linked immunosorbent assay and tear film functions were evaluated preoperatively and at 1 and 6 months postoperatively. The same assessments were performed in the control group at the same time points. Results: Preoperative tear 8-OHdG and 4-HNE levels were lower in healthy controls (52.8±13.5 ng/mL and 27.8±6.4 ng/mL, respectively) compared to patients with dermatochalasis (86.1±37.2 ng/mL and 29.8±11.1 ng/mL, respectively) and blepharoptosis (90.4±39.3 ng/mL and 43.1±4.2 ng/mL, respectively) (p<0.001). 8-OHdG levels were increased at 1 month after CMMR, while both markers were decreased 1 month postoperatively in the blepharoplasty group (p=0.034). Schirmer 1 and OSDI scores did not change throughout the visits in both patient groups, but a temporary decrease in tear break-up time (TBUT) was observed after CMMR (p=0.017). Conclusion: Dermatochalasis and blepharoptosis were associated with higher tear oxidative stress levels. CMMR surgery caused a temporary decrease in TBUT scores and an increase in oxidative stress in the first postoperative month.


Assuntos
8-Hidroxi-2'-Desoxiguanosina , Blefaroplastia , Blefaroptose , Túnica Conjuntiva , Músculos Oculomotores , Estresse Oxidativo , Lágrimas , Humanos , Estresse Oxidativo/fisiologia , Blefaroptose/cirurgia , Blefaroptose/metabolismo , Feminino , Masculino , Estudos Prospectivos , Lágrimas/metabolismo , Blefaroplastia/métodos , Pessoa de Meia-Idade , Túnica Conjuntiva/metabolismo , Túnica Conjuntiva/cirurgia , Músculos Oculomotores/cirurgia , Músculos Oculomotores/metabolismo , 8-Hidroxi-2'-Desoxiguanosina/metabolismo , Adulto , Biomarcadores/metabolismo , Ensaio de Imunoadsorção Enzimática , Idoso , Aldeídos/metabolismo
9.
PLoS Genet ; 20(6): e1010935, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38875306

RESUMO

Gene regulatory networks that act upstream of skeletal muscle fate determinants are distinct in different anatomical locations. Despite recent efforts, a clear understanding of the cascade of events underlying the emergence and maintenance of the stem cell pool in specific muscle groups remains unresolved and debated. Here, we invalidated Pitx2 with multiple Cre-driver mice prenatally, postnatally, and during lineage progression. We showed that this gene becomes progressively dispensable for specification and maintenance of the muscle stem (MuSC) cell pool in extraocular muscles (EOMs) despite being, together with Myf5, a major upstream regulator during early development. Moreover, constitutive inactivation of Pax7 postnatally led to a greater loss of MuSCs in the EOMs compared to the limb. Thus, we propose a relay between Pitx2, Myf5 and Pax7 for EOM stem cell maintenance. We demonstrate also that MuSCs in the EOMs adopt a quiescent state earlier that those in limb muscles and do not spontaneously proliferate in the adult, yet EOMs have a significantly higher content of Pax7+ MuSCs per area pre- and post-natally. Finally, while limb MuSCs proliferate in the mdx mouse model for Duchenne muscular dystrophy, significantly less MuSCs were present in the EOMs of the mdx mouse model compared to controls, and they were not proliferative. Overall, our study provides a comprehensive in vivo characterisation of MuSC heterogeneity along the body axis and brings further insights into the unusual sparing of EOMs during muscular dystrophy.


Assuntos
Proteína Homeobox PITX2 , Proteínas de Homeodomínio , Fator Regulador Miogênico 5 , Músculos Oculomotores , Fator de Transcrição PAX7 , Fatores de Transcrição , Animais , Humanos , Camundongos , Diferenciação Celular/genética , Linhagem da Célula/genética , Proliferação de Células/genética , Regulação da Expressão Gênica no Desenvolvimento , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Camundongos Endogâmicos mdx , Desenvolvimento Muscular/genética , Músculo Esquelético/metabolismo , Músculo Esquelético/crescimento & desenvolvimento , Distrofia Muscular de Duchenne/genética , Distrofia Muscular de Duchenne/metabolismo , Distrofia Muscular de Duchenne/patologia , Fator Regulador Miogênico 5/genética , Fator Regulador Miogênico 5/metabolismo , Músculos Oculomotores/metabolismo , Fator de Transcrição PAX7/metabolismo , Fator de Transcrição PAX7/genética , Células-Tronco/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo
10.
Sci Rep ; 14(1): 14300, 2024 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-38906967

RESUMO

We aim to explore the alterations of objective ocular torsion after unilateral lateral rectus recession-medial rectus resection (R&R) for intermittent exotropia (IXT). Seventy-two IXT patients undergoing R&R between March and June 2023 were enrolled. Ophthalmological examinations were performed before surgery and at 1 week and 1 month after surgery, mainly including prism and alternate cover test and optical coherence tomography. The mean disc-foveal angle of eyes showing intorsion significantly increased from - 1.5 ± 0.9° preoperatively to 2.0 ± 2.0° at 1 week (P = 0.0227) and 2.2 ± 1.6° at 1 month postoperatively (P = 0.0054). The mean disc-foveal angle of eyes exhibiting extorsion significantly reduced from 12.8 ± 1.9° preoperatively to 9.8 ± 3.1° at 1 week (P < 0.0001) and 9.7 ± 2.7° at 1 month postoperatively (P < 0.0001). The improvement of ocular extorsion at postoperative 1 month was more pronounced in patients with extorsion in operative eye compared to those with extorsion in inoperative eye (P = 0.0101). The improvement of ocular torsion was observed following R&R for IXT, with a greater effect noted in cases where the surgery was performed on the eye exhibiting extorsion.


Assuntos
Exotropia , Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Humanos , Exotropia/cirurgia , Masculino , Feminino , Músculos Oculomotores/cirurgia , Criança , Procedimentos Cirúrgicos Oftalmológicos/métodos , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Pré-Escolar , Adolescente , Tomografia de Coerência Óptica , Adulto , Anormalidade Torcional/cirurgia , Anormalidade Torcional/etiologia , Adulto Jovem , Resultado do Tratamento
11.
J Binocul Vis Ocul Motil ; 74(2): 41-47, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38884629

RESUMO

PURPOSE: Our study aims to investigate the effect of decreasing distance from the patient to the fixation target on the measurement of strabismus with a known distance-near disparity. METHODS: Strabismus measurements were taken by one pediatric ophthalmologist at our standard distance of 18 feet and compared to those taken at 16, 14, 12, and 10 feet from the fixation target. A clinically meaningful difference was defined as >2.5 prism diopters (PD), since a difference of that magnitude may alter surgical planning. RESULTS: Thirty-nine subjects, including 22 exotropes and 17 esotropes, were included in this study. Mean prism diopter difference (PDD) in the exotrope group at lengths of 16, 14, 12, and 10 feet compared to 18 feet were 1.3 (SD 1.9, range 0-6), 1.3 (SD 2.2, range 0-8), 1.7 (SD 3.2, range 0-14), and 2.8 (SD 4.4, range 0-14), respectively. Among esotropes, the mean PDD at the same distances were 1.1 (SD 1.9, range 0-7), 2.1 (SD 2.6, range 0-7), 3.9 (SD 4.9, range 0-19), and 4.3 (SD 5.1, range 0-19). The percentages of exotropes with a PDD of >2.5 at 16, 14, 12, and 10 feet compared to 18 feet were 13.6% (n = 3), 13.6% (n = 3), 18.2% (n = 4), and 27.3% (n = 6), respectively. In the esotrope group, 11.8% (n = 2), 35.3% (n = 6), 47.1% (n = 8), and 47.1% (n = 8) had a PDD of >2.5 at the same distances, respectively. CONCLUSION: This pilot study is the first to investigate the change in measured angle of strabismus at various non-mirrored distances from the patient to the fixation target. Our methodology defines a framework that could be used in a higher-powered study to further our understanding of the effect of room length on strabismus evaluation.


Assuntos
Estrabismo , Humanos , Projetos Piloto , Criança , Feminino , Masculino , Pré-Escolar , Adolescente , Estrabismo/diagnóstico , Estrabismo/fisiopatologia , Exotropia/diagnóstico , Exotropia/fisiopatologia , Visão Binocular/fisiologia , Esotropia/diagnóstico , Esotropia/fisiopatologia , Adulto , Músculos Oculomotores/fisiopatologia , Adulto Jovem , Técnicas de Diagnóstico Oftalmológico
12.
J Binocul Vis Ocul Motil ; 74(2): 84-90, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38924773

RESUMO

PURPOSE: To analyze characteristics and trends of strabismus surgeries in an Israeli hospital over 2 decades. METHODS: A descriptive, retrospective study including all strabismus surgeries (666) performed during 2000-2019 at an Israeli tertiary hospital. Electronic medical records (EMRs) were directly retrieved to produce an anonymized database. RESULTS: No trends were evident for age, sex, or ethnicity (p = .294, 0.914 and p = .167, respectively). The mean number of horizontal muscles remained stable, while an increase was noted in the mean number of muscles operated on to repair vertical strabismus (p < .0001). Among acquired cases, a 2.67-fold increase was noted in the proportion of spontaneous strabismus and a decrease of traumatic causes to a third (p < .001). An increase was noted in the proportion of exotropia among horizontal strabismus corrections (p = .022), and esotropia correction techniques distribution changed (p = .004). Reoperations comprised a third of all cases during both decades (p = .198). Reoperations were more prevalent among younger and Jewish patients (p < .001 and p = .024, respectively). Techniques to correct esotropia and exotropia differed significantly between primary surgeries and reoperations (p < .00001 each). CONCLUSIONS: The complexity of surgical techniques increased over time. Ethnic minorities were less prone to reoperations.


Assuntos
Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Estrabismo , Centros de Atenção Terciária , Humanos , Centros de Atenção Terciária/estatística & dados numéricos , Centros de Atenção Terciária/tendências , Masculino , Estudos Retrospectivos , Feminino , Estrabismo/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/tendências , Procedimentos Cirúrgicos Oftalmológicos/estatística & dados numéricos , Criança , Adulto , Adolescente , Pessoa de Meia-Idade , Pré-Escolar , Israel/epidemiologia , Reoperação/estatística & dados numéricos , Reoperação/tendências , Adulto Jovem , Idoso , Lactente , Idoso de 80 Anos ou mais
13.
BMC Ophthalmol ; 24(1): 249, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867149

RESUMO

BACKGROUND: To evaluate the clinical findings of patients with SOP who underwent surgery. METHODS: This historical cohort study was performed on 1057 SOP patients managed with surgery in Farabi Hospital, Iran, from 2011 to 2022. RESULTS: There were 990 (93.7%) patients with unilateral SOP with the mean age of 21.8 ± 14.8 years. Of these, 715 patients (72.2%) were diagnosed with congenital SOP, and 275 patients (27.8%) had acquired SOP (P < 0.001). In contrast, 67 (6.3%) patients were diagnosed with bilateral SOP, with the mean age of 19.4 ± 15.6 years. Among these, 18 cases exhibited the masked type. The mean angle of vertical deviation in primary position at far in unilateral and bilateral cases was 15.6 ± 8.3 and 13.3 ± 9.1 △, respectively (P < 0.001). In unilateral cases, abnormal head posture (AHP) was detected in 847 (85.5%) patients and 12 (1.2%) had paradoxical AHP. Amblyopia was found in 89 (9.9%) unilateral and 7 (10.3%) bilateral cases. Solitary inferior oblique myectomy, was the most common surgery in both unilateral (n = 756, 77.1%) and bilateral (n = 35, 52.2%) patients. The second surgery was performed for 84 (8.6%) unilateral and 33 (49.3%) bilateral cases (P < 0.001). The prevalence of amblyopia and the mean angle of horizontal deviation were significantly higher in patients who needed more than one surgery (all P < 0.05). CONCLUSION: Congenital SOP was more than twice as frequent as acquired SOP and about 90% of unilateral and 50% of bilateral cases were managed with one surgery. Amblyopia and significant horizontal deviation were the most important factors for reoperation. TRIAL REGISTRATION: The Institutional Review Board approval was obtained from the Tehran University of Medical Sciences (IR.TUMS.FNM.REC.1400.012) and this study adhered to the tenets of the Declaration of Helsinki and HIPAA.


Assuntos
Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Músculos Oculomotores/cirurgia , Músculos Oculomotores/fisiopatologia , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Criança , Procedimentos Cirúrgicos Oftalmológicos/métodos , Pré-Escolar , Doenças do Nervo Troclear/cirurgia , Doenças do Nervo Troclear/fisiopatologia , Doenças do Nervo Troclear/congênito , Irã (Geográfico)/epidemiologia , Idoso , Estrabismo/cirurgia , Estrabismo/fisiopatologia , Visão Binocular/fisiologia , Resultado do Tratamento , Lactente
14.
BMC Ophthalmol ; 24(1): 242, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38853240

RESUMO

BACKGROUND: Learning to perform strabismus surgery is an essential aspect of ophthalmologists' surgical training. Automated classification strategy for surgical steps can improve the effectiveness of training curricula and the efficient evaluation of residents' performance. To this end, we aimed to develop and validate a deep learning (DL) model for automated detecting strabismus surgery steps in the videos. METHODS: In this study, we gathered 479 strabismus surgery videos from Shanghai Children's Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, spanning July 2017 to October 2021. The videos were manually cut into 3345 clips of the eight strabismus surgical steps based on the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR: strabismus). The videos dataset was randomly split by eye-level into a training (60%), validation (20%) and testing dataset (20%). We evaluated two hybrid DL algorithms: a Recurrent Neural Network (RNN) based and a Transformer-based model. The evaluation metrics included: accuracy, area under the receiver operating characteristic curve, precision, recall and F1-score. RESULTS: DL models identified the steps in video clips of strabismus surgery achieved macro-average AUC of 1.00 (95% CI 1.00-1.00) with Transformer-based model and 0.98 (95% CI 0.97-1.00) with RNN-based model, respectively. The Transformer-based model yielded a higher accuracy compared with RNN-based models (0.96 vs. 0.83, p < 0.001). In detecting different steps of strabismus surgery, the predictive ability of the Transformer-based model was better than that of the RNN. Precision ranged between 0.90 and 1 for the Transformer-based model and 0.75 to 0.94 for the RNN-based model. The f1-score ranged between 0.93 and 1 for the Transformer-based model and 0.78 to 0.92 for the RNN-based model. CONCLUSION: The DL models can automate identify video steps of strabismus surgery with high accuracy and Transformer-based algorithms show excellent performance when modeling spatiotemporal features of video frames.


Assuntos
Aprendizado Profundo , Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Estrabismo , Gravação em Vídeo , Humanos , Estrabismo/cirurgia , Músculos Oculomotores/cirurgia , Oftalmologia/educação , Curva ROC , Competência Clínica , Redes Neurais de Computação , Algoritmos , Internato e Residência , Educação de Pós-Graduação em Medicina/métodos
15.
Niger Postgrad Med J ; 31(2): 147-155, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38826018

RESUMO

BACKGROUND: The thickness of extraocular muscles (EOMs) is important in the management of several conditions associated with EOM enlargement. This study determined the normative values of EOM diameters in adult patients seen at a teaching hospital in Nigeria. MATERIALS AND METHODS: The study measured the thickness of the EOMs and the interzygomatic line (IZL) on brain images of 300 patients with non-orbital conditions (150 computed tomography [CT] and 150 magnetic resonance imaging [MRI]) archived in the radiological database of Delta State University Hospital, Nigeria, after ethical clearance. The Statistical Package for the Social Sciences (version 23) was used to obtain descriptive statistics and further compare the variables based on gender, age groups and laterality. The association between parameters was tested using Pearson's correlation test. A probability value of <5% was considered significant. RESULTS: The thickest muscles were the medial rectus (0.42 ± 0.08 cm) and superior muscle group (0.42 ± 0.33 cm) on CT and the inferior rectus (0.40 ± 0.08 cm) on MRI. The diameters were symmetrical with sexual dimorphism in the superior muscle group on CT, medial and lateral recti on MRI and sum of all EOMs on both imaging groups (P < 0.05). The superior muscle group and the sum of all EOMs showed significant age group variations and a positive correlation with age. We noted a positive correlation between each EOM diameter and the sum of all EOMs besides the IZL (P < 0.05). CONCLUSION: This study offers normative data regarding EOMs that radiologists and ophthalmologists can use to diagnose disease conditions that cause EOM enlargement and further assess their response to treatment.


Assuntos
Imageamento por Ressonância Magnética , Músculos Oculomotores , Tomografia Computadorizada por Raios X , Humanos , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/anatomia & histologia , Masculino , Feminino , Adulto , Nigéria , Estudos Retrospectivos , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Idoso , Valores de Referência , Adulto Jovem , Adolescente
16.
Eur Thyroid J ; 13(4)2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38847819

RESUMO

Purpose: This study aims to report correlations between thyroid-stimulating immunoglobulin (TSI) and both clinical and radiological parameters in recent-onset symptomatic thyroid eye disease (TED) patients. Methods: A prospective cohort study of TED patients managed at the Chinese University of Hong Kong from January 2014 to May 2022. Serum TSI levels were determined with the functional assay. Outcomes included the Clinical Activity Score (CAS), marginal reflex distance1 (MRD1), extraocular muscle motility restriction (EOMy), exophthalmos, and diplopia. The radiological assessment included cross-sectional areas and signal of extraocular muscles on STIR-sequence MRI. Results: A total of 255 (197 female) treatment-naive patients, with an average onset age of 50 ± 14 years (mean ± s.d.), were included. Elevated pre-treatment TSI level was observed in 223 (88%) patients. There was a weak positive correlation between TSI and CAS (r = 0.28, P = 0.000031), MRD1 (r = 0.17, P = 0.0080), and the size of the levator palpebrae superioris/superior rectus complex (r = 0.25, P = 0.018). No significant correlation existed between TSI and STIR signals. The AUC and optimal cut-off value for clinical active TED were 0.67 (95% CI: 0.60-0.75) and 284% (specificity: 50%, sensitivity: 85%). In total, 64 patients received intravenous methylprednisolone (IVMP) during the study interval, and they had a higher baseline TSI level than those who did not have IVMP (P = 0.000044). Serial post-IVMP TSI among the 62 patients showed a significant reduction compared to the baseline level (P < 0.001). Both the baseline and post-IVMP TSI levels, and percentages of TSI changes were comparable between patients who responded and did not respond to the first course of IVMP. Conclusion: TSI can be a serum biomarker for the diagnosis, prognosis, and treatment response of TED. Further validation should be warranted.


Assuntos
Oftalmopatia de Graves , Imunoglobulinas Estimuladoras da Glândula Tireoide , Humanos , Feminino , Masculino , Oftalmopatia de Graves/sangue , Oftalmopatia de Graves/epidemiologia , Oftalmopatia de Graves/tratamento farmacológico , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto , Imunoglobulinas Estimuladoras da Glândula Tireoide/sangue , Idoso , Músculos Oculomotores/diagnóstico por imagem , Hong Kong/epidemiologia , Imageamento por Ressonância Magnética , Diplopia/epidemiologia , Exoftalmia/epidemiologia , Exoftalmia/sangue
17.
Int Ophthalmol ; 44(1): 278, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918293

RESUMO

PURPOSE: Strabismus reoperation in Graves' ophthalmopathy (GO) is complicated and challenging. The purpose of this study was to evaluate the various surgical strategies of strabismus reoperation and their outcomes in patients with GO. METHODS: A retrospective study was conducted on strabismus reoperations performed at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China from 2008 to 2018. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, various surgical procedures performed and surgical outcomes. Surgical methods included rectus recession for newly developed strabismus, rectus resection for undercorrection and anterior advancement of a previously recessed rectus for overcorrection. Surgical success was defined as an absence of diplopia, a horizontal deviation of ≤ 10 prism diopters (PD) and a vertical deviation of ≤ 5 PD at distance in primary and reading positions. RESULTS: Of the 153 GO patients receiving strabismus surgery, 27 cases (20 males, 7 females) underwent reoperation for strabismus, with a reoperation rate of 17.6%. Success rates of reoperation in patients with a previous undercorrection and overcorrection were 45% and 71.4%, respectively. Success rates of rectus recession, rectus resection and anterior advancement were 47.1%, 66.7% and 50%, respectively. Two patients underwent the third surgery. The overall success rate was 51.9%. CONCLUSIONS: Rectus recession is an effective method for GO patients with newly-developed strabismus. Rectus resection may benefit some patients with undercorrection who underwent a maximal degree of rectus recession. Anterior advancement of a previously recessed rectus is effective for cases with overcorrection.


Assuntos
Oftalmopatia de Graves , Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Reoperação , Estrabismo , Humanos , Oftalmopatia de Graves/cirurgia , Oftalmopatia de Graves/complicações , Oftalmopatia de Graves/diagnóstico , Masculino , Estrabismo/cirurgia , Estrabismo/etiologia , Estrabismo/fisiopatologia , Feminino , Estudos Retrospectivos , Reoperação/estatística & dados numéricos , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Pessoa de Meia-Idade , Adulto , Movimentos Oculares/fisiologia , Visão Binocular/fisiologia , Idoso , Seguimentos , Resultado do Tratamento , Acuidade Visual , Adulto Jovem
18.
Int Ophthalmol ; 44(1): 213, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38700596

RESUMO

PURPOSE: This study aimed to explore the diagnostic value of whole-orbit-based multiparametric assessment on Dixon MRI for the evaluation of the thyroid eye disease (TED) activity. METHODS: The retrospective study enrolled patients diagnosed as TED and obtained their axial and coronal Dixon MRI scans. Multiparameters were assessed, including water fraction (WF), fat fraction (FF) of extraocular muscles (EOMs), orbital fat (OF), and lacrimal gland (LG). The thickness of OF and herniation of LG were also measured. Univariable and multivariable logistic regression was applied to construct prediction models based on single or multiple structures. Receiver operating characteristic (ROC) curve analysis was also implemented. RESULTS: Univariable logistic analysis revealed significant differences in water fraction (WF) of the superior rectus (P = 0.018), fat fraction (FF) of the medial rectus (P = 0.029), WF of OF (P = 0.004), and herniation of LG (P = 0.012) between the active and inactive TED phases. Multivariable logistic analysis and corresponding receiver operating characteristic curve (ROC) analysis of each structure attained the area under the curve (AUC) values of 0.774, 0.771, and 0.729 for EOMs, OF, and LG, respectively, while the combination of the four imaging parameters generated a final AUC of 0.909. CONCLUSIONS: Dixon MRI may be used for fine multiparametric assessment of multiple orbital structures. The whole-orbit-based model improves the diagnostic performance of TED activity evaluation.


Assuntos
Oftalmopatia de Graves , Músculos Oculomotores , Órbita , Curva ROC , Humanos , Masculino , Feminino , Oftalmopatia de Graves/diagnóstico , Oftalmopatia de Graves/diagnóstico por imagem , Estudos Retrospectivos , Pessoa de Meia-Idade , Órbita/diagnóstico por imagem , Órbita/patologia , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Adulto , Idoso , Imageamento por Ressonância Magnética Multiparamétrica/métodos , Imageamento por Ressonância Magnética/métodos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/patologia
19.
Strabismus ; 32(2): 91-101, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38773721

RESUMO

Purpose: To assess long-term visual and neurodevelopmental outcomes in children with congenital Zika syndrome (CZS) after strabismus surgery. Methods: A consecutive sample of five children with CZS who underwent strabismus surgery was enrolled. All children underwent a standardized pre- and postoperative protocol including binocular best-corrected visual acuity (BCVA) using the Teller Acuity Cards II (TAC II), ocular alignment, functional vision using the functional vision developmental milestones test (FVDMT), and neurodevelopmental milestone evaluation using the Bayley Scales of Infant Development-Third Edition (BSID-III). Scores of the FVDMT outcomes considering the child's developmental age based on the BSID-III score were compared with scores from postoperative assessment. Results: Five children with CZS (3 girls, 2 boys) were enrolled with a mean age at baseline (preoperative) of 35.0 ± 0.7 months (range, 34-36 months) and at final assessment of 64.4 ± 0.5 months (range, 64-65 months). Preoperative BCVA was 1.2 ± 0.5 logMAR and at final assessment 0.7 ± 0.1 logMAR. Successful strabismus surgery outcome was maintained in 4/5 (80.0%) of children at final assessment. The children's BSID-III scores showed significant neurodevelopment delay at the initial assessment (corresponding developmental mean age was 4.7 months) and at their final assessment (corresponding developmental mean age was 5.1 months). There was improvement or stability in 34/46 items evaluated in the FVDMT (73.9%) when comparing baseline with 2-year follow-up. Conclusions: Strabismus surgery resulted in long-term ocular alignment in the majority of children with CZS. All the children showed improvement or stability in more than 70.0% of the functional vision items assessed. Visual and neurodevelopmental dysfunction may be related to complex condition and associated disorders seen in CZS including ocular, neurological, and skeletal abnormalities.


Assuntos
Procedimentos Cirúrgicos Oftalmológicos , Estrabismo , Acuidade Visual , Infecção por Zika virus , Humanos , Feminino , Masculino , Estrabismo/cirurgia , Estrabismo/fisiopatologia , Pré-Escolar , Infecção por Zika virus/complicações , Acuidade Visual/fisiologia , Seguimentos , Músculos Oculomotores/cirurgia , Músculos Oculomotores/fisiopatologia , Visão Binocular/fisiologia , Transtornos do Neurodesenvolvimento/etiologia , Fatores de Tempo , Resultado do Tratamento
20.
J Binocul Vis Ocul Motil ; 74(2): 75-77, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38805021

RESUMO

This study is a qualitative analysis of the consent process for strabismus surgery, using recordings of physicians doing a mock consent for bilateral medial rectus recession. There is considerable variation in the risks of surgery and odds of complications that are cited by pediatric ophthalmologists during the consent process. We propose a reference table with complication rates for use during the consent process.


Assuntos
Consentimento Livre e Esclarecido , Músculos Oculomotores , Procedimentos Cirúrgicos Oftalmológicos , Estrabismo , Humanos , Estrabismo/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Músculos Oculomotores/cirurgia , Complicações Pós-Operatórias , Criança
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