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JOURNAL REVIEW
Year : 2018  |  Volume : 56  |  Issue : 4  |  Page : 278-280

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1 Department of Paediatric Ophthalmology and Glaucoma, M. N. Eye Hospital, Chennai, Tamil Nadu, India
2 Swamy Eye Clinic, M. N. Eye Hospital, Chennai, Tamil Nadu, India

Date of Web Publication19-Feb-2019

Correspondence Address:
Dr. Shruti Nishanth
M. N. Eye Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_102_18

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How to cite this article:
Nishanth S, Ariga M. Journal scan. TNOA J Ophthalmic Sci Res 2018;56:278-80

How to cite this URL:
Nishanth S, Ariga M. Journal scan. TNOA J Ophthalmic Sci Res [serial online] 2018 [cited 2019 Mar 24];56:278-80. Available from: http://www.tnoajosr.com/text.asp?2018/56/4/278/252484




  A Mobile Phone Informational Reminder to Improve Eye Care Adherence among Diabetic Patients in Rural China: A randomized Controlled Trial Top


Chen T, Zhu W, Tang B, Jin L, Fu H, Chen Y, et al. A mobile phone informational reminder to improve eye care adherence among diabetic patients in rural China: A randomized controlled trial. Am J Ophthalmol 2018;194:54-62.

Aim: The aim is to determine whether short message service (SMS) reminders improve adherence to scheduled ocular examinations among patients with diabetes in rural China. Methodology: A total of 233 diabetic patients owning a mobile phone, attending eye clinics in rural China, were selected for the study. They were randomized into two groups: intervention group – 119 patients (receiving reminder SMS at 1 week and 3 days before their scheduled appointments with additional information regarding the nature of the disease and importance of regular eye examination) and control group – 114 patients (receiving only oral reminders of their next appointment from hospital staff at initial visit, not receiving a reminder SMS). The total cost for this was about US $5.38/patient. Results: Attendance was higher in the intervention group (42.9%) compared to the control group (14%). Diabetic retinopathy knowledge score and patient satisfaction score between baseline and endline were significantly higher in the intervention group.

Take-home message

SMS reminders can serve as a cost-effective approach in improving compliance to follow-up, which can ensure timely intervention for the patient to prevent sight-threatening complications. It can be made useful in other scenarios to improve attendance rates following cataract surgery or for glaucoma patients.


  Spectral-Domain Optical Coherence Tomography: Helping the Clinician Diagnose Glaucoma – A Report by the American Academy of Ophthalmology Top


Chen TC, Hoguet A, Junk AK, Nouri-Mahdavi K, Radhakrishnan S, Takusagawa HL, et al. Spectral-domain OCT: Helping the clinician diagnose glaucoma: A report by the American Academy of Ophthalmology. Ophthalmology 2018;125:1817-27.

Purpose: The purpose is to evaluate the current published literature on the ability of spectral domain optical coherence tomography (SD-OCT) to help the clinician diagnose glaucoma. Introduction: OCT is a noninvasive method to image the ocular structures. OCT images are based on the varying reflectivity of different ocular structures to light. SD-OCT has a high resolution and faster acquisition speeds compared to the earlier time-domain OCT machines. Methodology: A peer-reviewed literature search was conducted and 74 articles were assessed and their results were compiled. Results: The most commonly studied glaucoma OCT parameters were the retinal nerve fiber layer (RNFL) thickness parameter, followed by macular parameters and then optic nerve parameters. The most commonly studied SD-OCT machine was the Cirrus, followed by the RTVue, the Spectralis, and the 3-dimensional OCT. Despite different software protocols, all SD-OCT instruments are able to detect the same typical pattern of glaucomatous RNFL loss that affects primarily the inferior, inferior temporal, superior, and superior temporal regions of the optic nerve. Across many SD-OCT instruments, macular imaging also can detect a preferential inferior, inferior temporal, and superior temporal thinning in patients with glaucoma compared with controls. Best disc parameters for detecting glaucomatous nerve damage are global rim area, inferior rim area, and vertical cup-to-disc ratio. Studies suggest that newer reference-plane-independent optic nerve parameters (Bruch's membrane opening-minimum rim width) may have the same or better detection capability when compared with older reference-plane-dependent disc parameters.

Take-home message

Structural glaucomatous damage can be detected by SD-OCT. The optic nerve, RNFL, and macular parameters can help the clinician distinguish the anatomic changes that are associated with patients with glaucoma when compared with normal subjects.


  Randomized, Controlled, Phase 2 Trial of Povidone-Iodine/dexamethasone Ophthalmic Suspension for Treatment of Adenoviral Conjunctivitis Top


Pepose JS, Ahuja A, Liu W, Narvekar A, Haque R. Randomized, controlled, phase 2 trial of povidone-iodine/dexamethasone ophthalmic suspension for treatment of adenoviral conjunctivitis. Am J Ophthalmol 2018. pii: S0002-9394(18) 30536-1.

Aim: The aim is to evaluate the efficacy/safety of an ophthalmic suspension of povidone-iodine (PVP-I) 0.6% and dexamethasone 0.1% in patients with acute adenoviral conjunctivitis. Design: The study was a multicentric, randomized, vehicle-controlled, double-masked trial which was in its Phase 2 trial phase and conducted in India. Methods: Adults with a positive Rapid Pathogen Screening Adeno Detector Plus test were randomized 1:1:1 to PVP-I 0.6% plus dexamethasone 0.1%, PVP-I 0.6% alone, or placebo. One drop of study medication was applied to each eye QID for 5 days. The first dose was administered in the office on day 1 (visit 1), with office visits for efficacy and safety evaluations on day 3 (visit 2), day 6 (visit 3), and day 12 (visit 4), with a 1-day window allowed. Efficacy measures included clinical resolution and adenoviral eradication. Endpoints: Composite endpoint of clinical resolution: (1) absence of watery conjunctival discharge and bulbar conjunctival redne ss and adenoviral eradication (negative cell culture immunofluorescence assay [CC-human infectious Cryptosporidium]) in the study eye; (2) the individual measurement of clinical resolution or adenoviral eradication; (3) expanded clinical cure (both watery conjunctival discharge and bulbar conjunctival redness scores of 0 or 1); and (4) global clinical score (sum of bulbar conjunctival redness and watery conjunctival discharge scores, total score: 0–6) Results: Overall, 144 patients were included in the efficacy analysis. PVP-I plus dexamethasone was given to 48 patients.PVP-I was given to 50 participants. Placebo was given to 46 subjects. The proportion of patients with clinical resolution at the day 6 visit was higher with PVP-I plus dexamethasone (31.3%) than with placebo (10.9%) and PVP-I alone (18.0%). The proportion with adenoviral eradication (primary study eye) was higher with PVP-I plus dexamethasone than with placebo at the day 3. Discontinuation owing to adverse events occurred in 37 patients.

Take-home message

PVP-I plus dexamethasone appeared safe and well tolerated and significantly improved clinical resolution and adenoviral eradication in patients with acute adenoviral conjunctivitis.


  Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia Top


Fricke TR, Tahhan N, Resnikoff S, Papas E, Burnett A, Ho SM, et al. Global prevalence of presbyopia and vision impairment from uncorrected presbyopia: Systematic review, meta-analysis, and modelling. Ophthalmology 2018;125:1492-9.

Introduction: Presbyopia was estimated to affect more than 1 billion people globally in 2005, with more than half unable to access the necessary refractive correction to overcome the associated vision impairment (VI). The global presbyopia prevalence estimates involved extensive extrapolation and a high degree of uncertainty. Data for presbyopia correction rates similarly were limited and correction estimates similarly uncertain. In addition to the paucity of evidence, the authors noted a need to increase consistency in presbyopia prevalence study methodology to enable comparability. Need for this Study: This study needs to understand presbyopic epidemiologic factors and correction coverage which is critical to overcoming the burden of VI from uncorrected presbyopia. Presbyopia prevalence and spectacle correction coverage were estimated by systematic review and meta-analysis of epidemiologic evidence, then modeled to expand to the country, region, and global estimate. Methods: Systematic reviews of presbyopia prevalence and spectacle correction coverage were done. Prevalence data for presbyopia were gathered from 0 to 90 years or older and information was gathered from previous studies and the results compiled into a single study to gain more statistical power within the World Health Organization global burden of disease regions. A model based on amplitude of accommodation adjusted for myopia rates to match the regionally meta-analyzed presbyopia prevalence was developed. The models were used to estimate presbyopia prevalence and spectacle correction coverage in each age group in urban and rural areas of every country in the world and combined with population data to estimate the number of people with near visual impairment. Results: There was an estimated 1.8 billion people (prevalence: 25%; 95% confidence interval [CI]) globally with presbyopia in 2015, 826 million (95% CI) of whom had near VI because they had no, or inadequate, vision correction. Global unmet need for presbyopia correction in 2015 is estimated to be 45% (95% CI). People with presbyopia are more likely to have adequate optical correction if they live in an urban area of a more developed country with higher health expenditure and lower inequality.

Take-home message

There is a significant burden of visual impairment from uncorrected presbyopia, with the greatest burden in rural areas of low-resource countries.


  Four-Year Follow-Up of the Changes in Anterior Segment After Phakic Collamer Lens Implantation Top


Lu Y, Yang N, Li X, Kong J. Four-year follow-up of the changes in anterior segment after phakic Collamer lens implantation. Am J Ophthalmol 2017;178:140-9.

Purpose: The purpose is to assess the changes and relationship in central vaulting, flare intensity, and crystalline lens thickness during a follow-up period of 4 years after implantable Collamer lens (ICL) implantation in eyes with high myopia. Design: This is a retrospective observational study. Methods: Ninety-eight eyes of 50 patients were followed up with routine measurements of (1) central vaulting, (2) crystalline lens thickness, (3) endothelial cell density, and (4) aqueous flare postoperatively. Data were analyzed by repeated-measures analysis of variance. The relationship between the annual change in crystal lens thickness after surgery and age was evaluated by Pearson correlation coefficient and linear regression. Results: There was a continuous reduction in central vaulting and endothelial cell density as well as an increase in crystalline lens thickness in ICL eyes from 1 month onward to 5 years postoperatively (P < 0.001). Aqueous flare intensity increased significantly after surgery and returned to normal 1 year later.Conclusions: The changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the 1st year after ICL implantation, tending to be relatively stable afterward.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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