Wednesday, March 26, 2014

WHICH IS BETTER, LRI OR TORIC IOL?

This study published in Asia-Pacific Journal of Ophthalmology concludes:

Both toric IOLs and arcuate corneal incisions reduce moderate to high preexisting corneal astigmatism during cataract surgery; however, toric IOL implantation was more effective and predictable.


Wednesday, March 12, 2014

SLEEPING POSITION AND GLAUCOMA

This interesting report on a Korean study in the American Journal of Ophthalmology reports that sleeping on one side may worsen glaucoma on that side.   Some quotes:

People with worsening glaucoma on just one side were also more likely to sleep with the affected eye facing downward. The researchers say that position raises the eye's internal pressure and probably hastens deterioration of the eye.

Certainly, if one has severe damage in one eye it would seem to make sense to attempt to...sleep on the side with less eye damage - or on your back. But Schultz warns that sleeping on your back may not be the answer for people who are predisposed to sleep apnea, which is another risk factor for worsening glaucoma.

SOURCE: bit.ly/1gBVUWu American Journal of Opthalmology, online December 15, 2013.

VITAMIN D AND MYOPIA

This interesting study in Investigative Ophthalmology and Visual Science assessed the relationship between vitamin D and refractive error in Korean adolescents. 

The myopia group had a significant positive relationship between refractive error and serum vitamin D concentration, whereas the non-myopia group did not have any significant relationship.  In multiple linear regression analyses, refractive error was significantly associated with low serum vitamin D concentration after adjustment for area of residence, parental income, total energy intake, dietary Ca intake, milk consumption and smoking experience. The prevalence of high myopia was significantly associated with the lowest concentration of serum vitamin D after adjustment for the confounding factors. Smoking experience showed inverse associations with both refractive error and the prevalence of high myopia.  Conclusions: Low serum vitamin D concentration was associated with myopia prevalence in Korean adolescents. This relationship was particularly notable in adolescents with high myopia.

TOPICAL GLUCOSE AND VISUAL RECOVERY IN GLAUCOMA PATIENTS

Interesting study in ophthalmology concludes:

Topical glucose temporarily improves psychophysical visual parameters in some individuals with primary open angle glaucoma, suggesting that neuronal energy substrate delivery to the vitreous reservoir may recover function of "sick" retinal neurons.

CHALAZION AND VITAMIN A DEFICIENCY

This from the American Journal of Ophthalmology:

The average Vitamin A level in young children with multiple chalazia was low.  CONCLUSIONS: Low serum Vitamin A is associated with chalazion in young children in southwest China, especially young children. 

MEIBOMIAN GLAND DYSFUNCTION, DRY EYE, AND AZITHROMYCIN

Findings published online first in JAMA Ophthalmology. 

Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease, which affects tens of millions of Americans. However, there is no FDA–approved treatment for MGD. Researchers from the Schepens Eye Research Institute/Massachusetts Eye and Ear and Harvard Medical School have just identified a potential therapy. "We discovered that azithromycin, an antibiotic, can directly stimulate the function of human meibomian gland epithelial cells," said First Author Yang Liu, M.D., a postdoctoral fellow at Schepens Eye Research Institute and Harvard Medical School. Their finding is outlined in a Research Letter that was published Online First in JAMA Ophthalmology. This finding is very clinically significant, because topical azithromycin is the most commonly prescribed MGD treatment in the USA, but its use is 'off–label,' which means the drug's efficacy has not yet been evaluated and approved by the Food and Drug Administration for patients with MGD. This antibiotic has been presumed to be effective because of its anti–inflammatory and anti–bacterial actions, which may suppress the MGD–associated conjunctival inflammation (i.e. posterior blepharitis) and growth of lid bacteria.
This study investigates the use of aspirin and macular degeneration risk:

The pooled effects from current literatures suggest that aspirin use is not associated with macular degeneration, but it increased the risk of the neovascular (the wet form) macular degeneration.

CONTACT LENS PROBLEMS AND AGE

This study in Optom Visual Science looks at the relationship between corneal infectious and inflammatory events in contact lens wearers and age:

PURPOSE:

Previous studies have reported that the risk of corneal infections and inflammations with soft contact lens wear is highest in late adolescence and early adulthood. This study assesses the associations between patient age and other factors that may contribute to these events in younger patients. 

RESULTS:

Wearers aged 18-21 years reported more recent nights with less than 6 hours of sleep, more colds/flu, and higher stress levels. Wearers 18-21 and those 22-25 years were more likely to wear contact lenses when showering and also reported more frequent naps with soft contact lenses. They reported sleeping in their contacts after alcohol use, when traveling, and when away from home. Lower rates of regular hand washing before lens application was also associated with these groups. In addition, the relationship between reactive replacement and recommended replacement was dependent on age.

CONCLUSIONS:

Patient age influences lens wearing behaviors, environmental exposures, and other determinants of health that may contribute to increased corneal infectious and inflammation events in younger wearers. 

Tuesday, March 11, 2014

COMPUTER VS. HARD COPY READING AND BLINK RATE

According to this study:

When compared with an equivalent hard copy control condition, blink rates were not reduced during computer operation. It is proposed that the previously observed differences in blink rate are more likely to be produced by changes in cognitive demand rather than the method of presentation. However, a higher percentage of incomplete blinks was noted during computer operation, which may have been associated with visual fatigue.

Monday, March 10, 2014

DOXYCYCLINE FOR USE IN DIABETIC RETINOPATHY

According to this study in JAMA Ophthalmology:

To our knowledge, this is the first observation suggesting a link between a low-dose oral anti-inflammatory agent and subclinical improvement in inner retinal function. Oral doxycycline may be a promising therapeutic strategy targeting the inflammatory component of diabetic retinopathy. Furthermore, study results suggest that frequency doubling perimetry, which primarily measures inner retinal function, is responsive to intervention and may be a useful clinical trial end point for proof-of-concept studies in patients with diabetic retinopathy

GLAUCOMA AND SLEEP APNEA

This paper concludes:

Several lines of evidence suggest an association between (normal-tension) glaucoma and sleep apnoea syndrome (SAS). It is hypothesised that the glaucomatous damage may result from impaired perfusion of the optic nerve head secondary to repetitive prolonged apnoeas. Therefore, screening for SAS in suspectible glaucoma patients is recommended.

Tuesday, March 04, 2014

BODY MASS INDEX (BMI) AND AGE-RELATED CATARACT

According to this study:

The overall findings suggest that elevated BMI may increase the risk of ARC, especially posterior subcapsular cataracts. Further trials are needed to investigate the effect of weight reduction in obese populations on the risk of ARC.