To determine functional visual improvement after cataract surgery in eyes with age related macular degeneration

To determine whether patients with Age related macular degeneration (ARMD) benefit from cataract surgery in terms of best corrected visual acuity (BCVA) and to assess impact of surgery on progression of ARMD.: A prospective study was carried out of patients with and without ARMD undergoing cataract surgery at our department. Patients were divided into two groups- Group A (cases) with ARMD and Group B (controls) without ARMD and other retinal pathology. BCVA of cases was recorded on day 1, day 14, 1 month and 1/month and compared to that of controls.: BCVA significantly improved but markedly less than that experienced by control eyes. No increased incidence in progression to wet form of ARMD. Cataract surgery is safe in ARMD patients with no evidence of increased complications or rates of disease advancement.

Ancient Stone Inscription Image Denoising and Inpainting Methods Based on Deep Neural Networks

Chinese ancient stone inscriptions contain Chinese traditional calligraphy culture and art information. However, due to the long history of the ancient stone inscriptions, natural erosion, and poor early protection measures, there are a lot of noise in the existing ancient stone inscriptions, which has adverse effects on reading these stone inscriptions and their aesthetic appreciation. At present, digital technologies have played important roles in the protection of cultural relics. For ancient stone inscriptions, we should obtain more perfect digital results without multiple types of noise, while there are few deep learning methods designed for processing stone inscription images. Therefore, we propose a basic framework for image denoising and inpainting of stone inscriptions based on deep learning methods. Firstly, we collect as many images of stone inscriptions as possible and preprocess these images to establish an inscriptions image dataset for image denoising and inpainting. In addition, an improved GAN with a denoiser is used for generating more virtual stone inscription images to expand the dataset. On the basis of these collected and generated images, we designed a stone inscription image denoising model based on multiscale feature fusion and introduced Charbonnier loss function to improve this image denoising model. To further improve the denoising results, an image inpainting model with the coherent semantic attention mechanism is introduced to recover some effective information removed by the former denoising model as much as possible. The experimental results show that our image denoising model achieves better results on PSNR, SSIM, and CEI. The final results have obvious visual improvement compared with the original stone inscription images.

Efficacy of Intra-Arterial Thrombolysis for Acute Central Retinal Artery Occlusion: A Meta-Analysis

<b><i>Introduction:</i></b> The best management strategy still remains strong controversy for acute nonarteritic central retinal artery occlusion (CRAO). We thus performed a meta-analysis to determine the efficacy of intra-arterial thrombolysis (IAT) for visual improvement according to different times from symptom onset. <b><i>Methods:</i></b> We searched EMBASE, PubMed, and Web of Science for relevant studies assessing efficiency of IAT in patients with CRAO compared with standard therapy. Fixed-effects and random-effects models were performed. <b><i>Results:</i></b> Five eligible studies including 459 patients with acute CRAO were pooled in the meta-analysis. In all, 219 (47.7%) received IAT, and the mean time from symptom onset to IAT was 13 h. The pooled analysis demonstrates odds ratio (OR) for the procedure of IAT and any visual improvement to be 1.520 (95% confidence intervals [CIs] 1.258–1.837; <i>p</i> &#x3c; 0.001). Subgroup analyses further indicated that the CRAO patients who received IAT achieved any visual improvement more easily within 6 h from symptom onset (OR = 1.703, 95% CI 1.219–2.381; <i>p</i> = 0.002), but not those beyond 6 h (OR = 1.260, 95% CI 0.973–1.632; <i>p</i> = 0.080). <b><i>Conclusion:</i></b> Our meta-analysis of available published data supports IAT to be an alternative treatment option for CRAO patients within 6 h from symptom onset.

EFFECT OF PART-TIME PATCHING THERAPY ON VISUAL OUTCOME IN PATIENTS WITH ANISOMETROPIC AMBLYOPIA VISITING AFIO RAWALPINDI

Objective: To determine the effect of amblyopia patching therapy on visual outcome in young and adults at 6th and 12th week. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi, Pakistan, from Sep 2018 to Jan 2020. Methodology: Out of 110, follow up was successfully completed by 91 eyes. Subjects were divided into young and adult based on age. Age ranging from 5-12 years included in the young group and adult group included those ranging from 13-20 years. Anisometropic amblyopia was considered. Amblyopia due to any other disease were excluded. Subjects were advised patching therapy daily for 4 hours in the affected eye. Follow up was 3 weekly for 12 weeks and the effect of patching therapy was assessed by visual improvement. Statistical analysis was done with SPSS version 21. Result: Out of 91 eyes with amblyopia, 51 (56.6%) were included in the young group while 40 (43.4%) were included in the adult group. In the young group, visual improvement was seen in 40 (78.4%) while in the adult group 24 (60%) showed improvement in vision. Mean visual improvement in young was 1.66 ± 1.099 while 1.03 ± 0.944 in the adult group. Maximum visual improvement in both groups was seen till the 6th week of patching. Conclusion: Patching therapy is effective even at later ages too. However, continuing patching for more than 6 weeks doesn’t show much improvement in vision.

Streptococcus infantarius Endophthalmitis after XEN Gel Stent Implantation

Purpose: To report a case of Streptococcus infantarius endophthalmitis related to the use of a XEN® Gel Stent.Case summary: A 75-year-old male was referred to our practice with a diagnosis of endophthalmitis 55 days after XEN® Gel Stent implantation. He had primary open-angle glaucoma. Visual acuity was 20/50. Slit-lamp examination revealed conjunctival injection and anterior chamber inflammation with hypopyon. Fundus examination showed inflammatory cells with exudative materials in the vitreous. The aqueous sampling for culture of causative micro-organisms was followed by removal of the XEN® Gel Stent, along with anterior chamber irrigation and intracameral and intravitreal injection of antibiotics. Streptococcus infantarius was isolated after 5 days. Vitrectomy, anterior chamber lavage, and intravitreal injection of antibiotics were additionally performed to control the intraocular inflammation. Sixteen days after vitrectomy, the intraocular inflammation disappeared. The choroidal detachment was resolved 34 days after vitrectomy. Visual improvement was limited to 20/100 at 6 months.Conclusions: XEN® Gel Stent-related bacterial endophthalmitis was successfully treated by implant removal, vitrectomy, and proper intraocular antibiotic treatment.

Optic nerve injury in preoperative imaging is associated with visual improvement outcome in endoscopic optic nerve decompression

Summary Objective To evaluate potential clinical parameters having an impact on visual outcome after endoscopic optic nerve decompression in acute optic neuropathy patients. Methods A retrospective chart review of patients with acute optic neuropathy, who underwent endoscopic optic nerve decompression between June 2001 and November 2018 at an academic center was performed. Patients were divided into groups according to visual improvement after surgical treatment (yes/no). Following clinical parameters were compared between groups: perioperative steroid use, evidence of optic nerve affection in preoperative neuroimaging, additional optic nerve sheath incision, surgery delay and preoperative C-reactive protein (CRP) levels. Further subgroups analyses were conducted based on etiology (trauma/tumor). Results Among 32 included cases, 16 patients (50%) reported visual improvement after endoscopic optic nerve decompression. There was no significant difference in visual improvement between etiology subgroups (trauma: n = 9/20 (45%) vs. tumor: n = 7/12 (58.3%), p = 0.465). Tumor subgroup patients with visual improvement had a significantly higher prevalence of optic nerve affection in preoperative neuroimaging than those without visual improvement (p = 0.018, φ = 0.683). Perioperative steroid administration was negatively associated with visual outcome (p = 0.034, φ = 0.375). Nerve sheath incision, surgery delay and preoperative CRP levels did not have a significant impact on visual outcome (p > 0.05). Conclusion Radiological findings can help as an indicator for surgical treatment since an affected optic nerve in preoperative neuroimaging resulted in better visual outcome after surgery. The use of steroids should be considered more carefully since it did not show any beneficial effect.

Visual Acuity Approach to a Patient with a Rose-K Contact Lens - A Case Report

Objective- Providing a healthy satisfactory visual acuity approach to a patient of Keratoconus fitted with a Rose-K contact lens. Introduction- Rose K lens is an effective option for visual improvement in irregular cornea such as Keratoconus. Contact lenses are the mainstay therapy for Keratoconus and are the treatment modality of choice in 90% of patients due to corneal surface irregularity. Case History- A 32-year-old female patient visited at Ahooja Eye & Dental Institute, Gurugram, with the chief complaint of diminished vision in her left eye for the last one month. The patient did not complain about diminished vision in the right eye. Earlier, the patient had diagnosed with the case of Keratoconus somewhere else and suggested to be continued with the glasses. The patient had a history of spectacles in the last 7 years and using the current prescription for the last 4 months. Visual acuity for distance & near, with glass and the current prescription was recorded. Conclusion- In our case, after all the presented findings and trial, one pair of Rose K2 lenses of varying total diameter and optic zone diameter was ordered. The patient was asked to visit for lens collection and follow up after 6 months. Lastly, it is advised that all Rose k practitioners keep at least two to three trial lenses, assess the fit in each fit, and choose lenses based on corneal topography. Key words: Rose K Contact Lenses, Keratoconus, Visual Acuity, Topography.