Web Query Behaviour Concerning HEV (Blue) Light in Ophthalmology

Background: High-energy visible (HEV) possesses high-frequency in the violet-blue band of the visible light spectrum. Blue light has relevance to ophthalmology via photochemically-induced retinal injury. Objectives: To explore the spatial-temporal mapping of online search behavior concerning HEV light. Materials and Methods: We retrieved raw data of web search volume, via Microsoft Google Trends, using five search topics; "Biological effects of HEV light", "Vision impairment", "Macular degeneration", "Retinal tear", and "Retinal detachment", for the period 2004-2020. Results: Web users, mainly from Far-East Asia and Australasia, were most interested in seeking online information concerning "Macular degeneration" and "Vision impairment" search topics, moderately interested in "Biological effects of HEV light" and "Retinal detachment", and least interested in "Retinal tear". Internet users from the Middle East and Arab world contributed minimally to the holistic map. Web queries increased at both chronological ends, 2004-2006 and 2018-2020; however, these trends were respondent to specific search topics. For instance, the search volume for the "Biological effects of HEV light" increased significantly in 2018-2020. Predictive modeling was most accurate for "Biological effects of HEV light". The strongest correlation was for "Vision impairment" versus "Macular degeneration". ANOVA, linear modeling, and machine learning unanimously agreed on predictors' significant effect (search topics and time) on the web search volume. Conclusion: Web queries' mapping provided indirect evidence on the causality between HEV light and retinal damage. Future research mandates rigor observational and experimental studies.

YAG-laser retinotomy in the complex treatment of horseshoe tear and rhegmatogenous retinal detachment

Horseshoe-shaped retinal tear leads to rhegmatogenous retinal detachment (RRD) in 61-83% of cases. Vitreoretinal traсtion is the main factor in the development of horseshoe tears and RRD. In this aspect, YAG-laser retinotomy is promising, which makes it possible to eliminate the traction component by excision area of the horseshoe tear with vitreoretinal adhesion (VRA). Purpose. To analyze the results of YAG-laser retinotomy in the treatment of patients with complicated horseshoe tears and rhegmatogenous retinal detachment. Material and methods. The study included 97 patients (100 eyes). Of these, 54 patients (57 eyes) with complicated horseshoe retinal tears and 43 patients (43 eyes) with local RRD. Patients with complicated horseshoe tears underwent YAG-laser retinotomy at the base of the horseshoe tear. Patients with local RRD underwent a combined laser-surgical technology, which included YAG-laser retinotomy of the horseshoe tear area with vitreoretinal adhesion, pneumatic retinopexy and barrier laser photocoagulation. Results. In the group of patients with complicated horseshoe tears, complete retinal attachment was achieved in 15 eyes (58%), partial retinal attachment - in 7 eyes (27%). In the group of patients with local RRD complete retinal attachment was achieved in 40 patients (93%). There was a stable anatomical result and no changes in functional parameters. Conclusion. YAG-laser retinotomy eliminates vitreoretinal traction in the area of horseshoe tear and prevents the development of rhegmatogenous retinal detachment. Application of YAG-laser retinotomy as the first step of a microinvasive combined laser-surgical technology for the treatment of RRD makes it possible to obtain a high anatomical result, reduce the risk of retinal redetachment, and also preserve the initially high visual functions of patients.

Vitreous hemorrhage of unknown origin in adult non-diabetic non-traumatic eyes: a retrospective analysis and the lessons we learn from it

Objective: To analyse the causes of vitreous hemorrhage (VH) of unknown origin in non-diabetic nontraumatic eyes and evaluate the results regarding the underlying cause and time of surgery. Methods and Analysis: Retrospective analysis of 125 eyes with a dense VH of unknown origin, who underwent vitrectomy at a varied time point. Preoperative and postoperative data were compared between the groups with the three major causes of VH as well as between the eyes with an early (≤5 days after presentation) and a late (>5 days after presentation) vitrectomy. Results: Most common causes of VH were retinal vessel occlusion (RVO; 39/125; 31.1%), retinal tears (36/125; 28.8%) and submacular hemorrhage (34/125; 27.2%). Postoperative visual acuity improved significantly in all eyes (2.14 vs. 1.04 logMAR, p<0.01) with better outcome in eyes with retinal tears. Early vitrectomy group had better functional outcome regardless of underlying cause (p=0.02). Final visual outcome correlated significantly with the underlying cause of VH (p<.001) and time to treatment in the retinal tear group (p<.001). Conclusion: We encourage performing early minimal invasive vitreoretinal surgery in cases of non-diabetic, non-traumatic VH. More than three of four of the cases are caused by retinal tear/retinal detachment, submacular hemorrhage and RVO. Early surgical treatment had better functional outcome on the longer run.

Rhegmatogenous retinal detachment with giant retinal tear in a child with Marfan’s syndrome: a rare ocular emergency

A 7-year-old boy with Marfanoid habitus presented with sudden and painless decrease in the vision of the right eye. Ocular examination revealed rhegmatogenous retinal detachment with 360° giant retinal tear in the right eye and small peripheral retinal breaks with lattice degeneration in the left eye. The patient underwent a 23-gauge pars plana vitrectomy with scleral buckling in the right eye and laser around the breaks in the left eye. At 1-week follow-up visit, the child presented with similar complaints in the left eye as were seen in the right eye. This was later managed effectively with 23-gauge pars plana vitrectomy only. So, with our case report, we would like to highlight the need for aggressive screening in children who are diagnosed with Marfan’s syndrome and the need for prophylactic treatment in the unaffected eye.