Annals of Eye Science

Background: Previous studies that assessed the association of sensorineural hearing loss (SNHL) and pseudoexfoliation syndrome (PEX) produced contradictory results. We conducted a meta-analysis to further evaluate this relationship. Methods: Eligible studies that evaluated the association between SNHL and PEX were identified. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated employing random-effects models. Subgroup analysis and meta-regression were performed to assess heterogeneity by several covariates. Publication bias was tested by Begg’s funnel plot and Egger’s regression test. Results: A total of 14 eligible studies, involving 1,142 PEX patients and 9,914 controls, were included in this meta-analysis. Overall analysis showed that patients with PEX, when compared with the control group, experienced a significantly increased risk for hearing loss [OR: 3.74 (95% CI: 2.56 to 5.47); P<0.001]. Substantial heterogeneity was observed. Subgroup analysis revealed a decrease in this heterogeneity in age- and sex-matched studies and in studies that used the same definition of hearing loss. Meta-regression analysis showed that definition of hearing loss contributed to substantial heterogeneity (P=0.044). No evidence of publication bias was observed. Discussion: We found that PEX is associated with an increased risk of SNHL. The effect of PEX on the prevalence of hearing loss indicates that PEX is clearly a systemic disease with potential otological complications.

Wenbin Huang

Jifa Kuang

Feilan Chen

Yu Fu

Association of sensorineural hearing loss and pseudoexfoliation syndrome: a meta-analysis

感音神经性听力损失与假性剥脱综合征的关联：一项荟萃分析

Background: To investigate the outcome of cataract surgery in patients with legal blindness defined as best-corrected visual acuity (BCVA) of 20/1,000 or lower and to determine factors influencing the visual outcome in these patients.

Jang-Hun Lee

Sang Beom Han

Evaluation of visual outcome after cataract surgery in patients with legal blindness

法定盲患者白内障术后视力结果评估

Gurinder Singh

Editorial: cataract surgery in the legally blind

社论：法定失明者的白内障手术

Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.

Ye Dai

Xiaoting Ruan

Wei Wang

Xiaoyun Chen

Guangming Jin

Lanhua Wang

Xiaoxun Gu

Bo Qu

Jianping Liu

Xuhua Tan

Enen Zhang

Jun Fu

Lixia Luo

Zhenzhen Liu

Yizhi Liu

Changes in corneal curvature and aberrations after cataract surgery

白内障手术后角膜曲率和像差的改变

Patty P. A. Dhooge

B. Jeroen Klevering

Charles Bonnet syndrome: a condition of the visually impaired

查尔斯·邦纳综合征：视觉障碍者的一种病症

Background and Objective: Advances in teleophthalmology and artificial intelligence (AI) for diabetic retinal screening is of growing public health interest. Currently, only 30–40% of patients with diabetes adhere to recommended diabetes screening guidelines. To enhance early detection and reduce vision threatening complications, there has been a growing number of teleophthalmology programs and novel AI algorithms with the aim to improve eye care access. The purpose of this review is to assess current literature on teleophthalmology and AI for use in diabetic retinopathy (DR) screening, and to discuss advances and barriers to these innovative technologies. Methods: Literature review involving teleophthalmology and AI for DR screening, with focus on the past decade. Key Content and Findings: Teleophthalmology has demonstrated the ability to increase DR screening rates, enable earlier eye care access, and reduce healthcare costs. Novel AI-based DR screening programs appear accurate and effective, but detection of other ocular pathologies is still under development and not yet approved in the United States. Logistical, technological, financial, and legal barriers limit widespread adoption and long-term sustainability of teleophthalmology programs. Conclusions: The use of teleophthalmology and AI algorithms expands eye care access and helps prevent vision loss from DR and potentially other sight threatening conditions. Transparency in the process utilized for arriving at a particular diagnosis or decision to refer, often referred to as the "black box", remains a multifaceted issue within the field of telemedicine for developing trust and improving patient-centered outcomes.

Tanvi Chokshi

Maria Jessica Cruz

Jonathon Ross

Glenn Yiu

Advances in teleophthalmology and artificial intelligence for diabetic retinopathy screening: a narrative review

远程眼科与糖尿病视网膜病变筛查中的人工智能进展：一项叙述性综述

: Ocular cicatricial pemphigoid (OCP) is a subcategory of mucous membrane pemphigoid (MMP) where the conjunctiva is the main site of inflammation. It is a chronic and autoimmune disease characterized by acute and chronic conjunctivitis that can progress to severe conjunctival cicatrization, corneal opacification, ocular surface keratinization, and eyelid abnormalities. OCP can lead to structural damage that can result in visual impairment, visual loss, and blindness, and can have a significant impact in a patient's quality of life. Patients may manifest with varying symptoms, degrees of severity and may have different rates of progression. Early diagnosis and appropriate systemic immunosuppression are of utmost importance for prompt and adequate disease control. Various systemic immunomodulatory therapies (IMTs), including anti-metabolites, alkylating, and biologic agents have been utilized to achieve inflammation control and remission. Careful monitoring of disease progression is important to assess response and to modify and escalate therapy if needed. Treatment to alleviate symptoms of dry eye disease and address trichiasis and other eyelid abnormalities is recommended as well. A multidisciplinary approach to optimize clinical care is recommended in the management of patients with OCP. This review will address the immunopathogenesis, clinical features, keys to diagnosis and staging of patients with OCP. It will highlight the current immunomodulators utilized for disease management and proposed stepladder strategies. This review will discuss the updated roles of combination therapy, novel use of biologics as well as the recent use of adrenocorticotropic hormone (ACTH) analog in severe recalcitrant cases.

Claudia Castiblanco

Ocular cicatricial pemphigoid: diagnosis and systemic management

眼瘢痕性类天疱疮：诊断与系统管理

Background: The incidence of syphilis has been increasing in the United States over the last two decades, with a more recent increase among women. Ocular syphilis is an uncommon but important complication of syphilis, most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration. Untreated ocular syphilis may lead to permanent vision loss, underscoring the importance of appropriate evaluation and treatment of ocular syphilis. Case Description: In a retrospective, non-contiguous case series, we highlight four patients diagnosed and treated with ocular syphilis at a single institution. Four presentations of ocular syphilis are illustrated: anterior and intermediate uveitis, optic neuritis, posterior uveitis, and panuveitis. All patients initially presented with a decreased visual acuity (VA). One patient had a previous diagnosis of human immunodeficiency virus (HIV). Three patients were treated with intravenous (IV) penicillin and one patient with IV ceftriaxone. All had a return to their baseline VA after their course of treatment. Conclusions: Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations. All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing. Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection. Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.

Madeline Beckman

Lana M. Rifkin

Ocular syphilis: a case series of four patients and a review of the literature

眼梅毒：四例患者病例系列及文献综述

Abstract: Sickle cell disease (SCD) is a widespread hemoglobinopathy that results in significant patient morbidity and mortality. Vascular occlusion can cause acute pain, acute chest syndrome, and avascular necrosis, while hemolysis and endothelial disruption can cause ischemic stroke, leg ulcers, pulmonary hypertension, and priapism. All ocular and orbital structures can be affected by SCD ischemic events, including orbital bone infarction, ischemic optic neuropathy, retinal artery occlusion, hyphema, secondary glaucoma, sickle cell maculopathy, and sickle cell retinopathy. Proliferative sickle cell retinopathy (PSR) is the most common cause of vision loss. Untreated PSR can lead to macular ischemia, vitreous hemorrhage, and tractional retinal detachment. Ophthalmic screening exams and multimodal imaging can lead to earlier detection of sickle cell retinopathy and improved patient outcomes. SCD patients undergoing vitreoretinal surgery may require coordination of care with hematologists to avoid ischemic complications. While hydroxyurea was the only United States Food and Drug Administration approved treatment for several decades, patients with SCD now have several more treatment options. Despite the United States screening all infants for SCD, there can be delays in diagnosis and treatment. This review article aims to provide an overview of sickle disease for the ophthalmologist, and to discuss emerging treatment options and current management of SCD ocular complications.

Oladipupo O. Anibire

Daniel A. Brill

Basil K. Williams Jr

Sickle cell retinopathy and systemic disease

镰状细胞视网膜病变与全身性疾病

Background and Objective: Social media (SoMe) has emerged as a tool in health professions education (HPE), particularly amidst the challenges posed by the coronavirus disease 2019 (COVID-19) pandemic. Despite the academia's initial skepticism SoMe has been gaining traction in supporting learning communities, and offering opportunities for innovation in HPE. Our study aims to explore the integration of SoMe in HPE. Four key components were outlined as necessary for a successful integration, and include designing learning experiences, defining educator roles, selecting appropriate platforms, and establishing educational objectives. Methods: This article stemmed from the online Teaching Skills Series module on SoMe in education from the Ophthalmology Foundation, and drew upon evidence supporting learning theories relevant to SoMe integration and models of education. Additionally, we conducted a literature review considering English-language articles on the application of SoMe in ophthalmology from PubMed over the past decade. Key Content and Findings: Early adopters of SoMe platforms in HPE have leveraged these tools to enhance learning experiences through interaction, dialogue, content sharing, and active learning strategies. By integrating SoMe into educational programs, both online and in-person, educators can overcome time and geographical constraints, fostering more diverse and inclusive learning communities. Careful consideration is, however, necessary to address potential limitations within HPE. Conclusions: This article lays groundwork for expanding SoMe integration in HPE design, emphasizing the supportive scaffold of various learning theories, and the need of furthering robust research on examining its advantages over traditional educational formats. Our literature review underscores an ongoing multifaceted, random application of SoMe platforms in ophthalmology education. We advocate for an effective incorporation of SoMe in HPE education, with the need to comply with good educational practice.

Helena Prior Filipe

Mila Kostic

Mildred Lopez

Karl Golnik

Making the case for the evolving role of social media in health professions education and a literature review on the application of some in ophthalmology

为健康专业教育中社交媒体不断演变的作用提供依据及眼科学中某些应用的文献综述

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