Open Access Case study

Axenfeld-Rieger Syndrome: Case Report

Amanda Dinalli Francisco, Thiago Sande Miguel, Ana Luiza Mansur Souto, Daniel Almeida da Costa, Maurício Bastos Pereira

Ophthalmology Research: An International Journal, Page 8-12
DOI: 10.9734/or/2022/v16i230229

Aims:To describe a Axenfeld-Rieger Syndrome.

Presentation of Case: MCL, 7 years old, female, brown, was taken to the ophthalmology outpatient clinic of the Hospital Universitário Antônio Pedro, Brazil by her parents, complaining of low visual acuity and malformation of the pupil perceived since birth.

Discussion: Axenfeld-Rieger Syndrome is a rare and hereditary disease. Clinically, Axenfeld's anomaly is characterized by the presence of posterior embryotoxon, and there may be adherence of iridian tissue in its periphery. In addition to Rieger's anomaly, posterior embryotoxon is added to iris hypoplasia and iris thickness defects, uveal ectropion and pupillary alterations, such as corectopia. Rieger's syndrome is associated with extraocular changes, of which hypodontia, myicrodontia, maxillary hypoplasia, telecanthus, hypertelorism and hypospadias stand out.

Conclusions: Therefore, the importance of early diagnosis, follow-up and adequate treatment becomes evident in order to preserve the visual function of patients and thus avoid an unfavorable evolution.

Open Access Case study

Congenital Ocular Melanocytosis: Case Report

Thiago Sande Miguel, Fernanda Bekman Diniz Mitleg Rocha, Tais Cristina Rossett, Felipe Bekman Diniz Mitleg Rocha, Eduardo de França Damasceno, Daniel Almeida da Costa

Ophthalmology Research: An International Journal, Page 22-25
DOI: 10.9734/or/2022/v16i230231

Aims: To describe Congenital Ocular Melanocytosis.

Presentation of Case: LPC, 7 years old, male, brown, with no previous comorbidities, was taken to the ophthalmology outpatient clinic of the Hospital Universitário Antônio Pedro, Brazil by parents who alleged the presence of bluish-looking lesions in the sclera of the child's right eye since birth.

Discussion: Congenital Ocular Melanocytosis is a rare pathology characterized by an increase in the number, size and pigmentation of melanocytes. Its pathophysiological picture is unknown, but it is believed to be due to an alteration in the migration of melanocytes from the neural crest to the epidermis during the embryonic process. This condition can be complicated by glaucoma and uveal melanoma. Gonioscopy is essential in these cases to assess whether there is pigmentation of the trabeculae, so that the propaedeutics of investigation of glaucoma becomes essential in these patients, since 10% of cases can complicate this condition.

Conclusions: Congenital Ocular Melanocytosis early in life and the importance of monitoring these patients should be emphasized. Comprehensive tests are important for early detection and treatment, in order to improve the prognosis and avoid more severe consequences than what can happen from melanocytosis.

Open Access Original Research Article

Prevalence and Predictors of Anxiety and Depression among Glaucoma Patients in a Tertiary Health Institution in South-South Nigeria

Nnenne N. Ani, Godswill Inye Nathaniel

Ophthalmology Research: An International Journal, Page 13-21
DOI: 10.9734/or/2022/v16i230230

Aim: To determine the prevalence and factors associated with Anxiety and Depression among `glaucoma patients.

Study Design: It was a hospital-based cross-sectional study.

Place and Duration of Study: This study was carried out at the Department of Ophthalmology, University of Port Harcourt Teaching Hospital Port Harcourt, Nigeria. From February to June 2016.

Patients and Methods: Glaucoma patients aged 18 years or older with no history of coexisting ocular pathology or chronic systemic illness were included in the study. Hospital Anxiety and Depression Scale (HADS) questionnaires were administered. Ocular examinations done included visual acuity, applanation tonometry, and ophthalmoscopy. Perimetry was done using a standard achromatic perimetry with a fast threshold central 30-2 strategy. Data obtained from the subjects were analysed using SPSS (Version 20), and p value set at < 0.05.

Results: There were 141 males (47%) and 158 females (53%) giving a male: female ratio 1:1.12. The age range was 20-86 years with mean age of 53.61± 14.23 years. The prevalence of Anxiety and Depression were 37.5% and 34.1% respectively, while 53 subjects (17.7%) had both anxiety and depression. The mean scores of anxiety and depression among the study subjects were 6.49±3.851 (CI 6.05-6.93) and 5.78±3.832 (95% CI 5.35-6.21) respectively. Family history (O.R=1.893;P-value=0.019), previous membership of a Glaucoma Society(O.R=2.633;P-value=0.007), and BCVA in the better eye(O.R=0.235;P-value=0.001), were significant predictors of anxiety while age(O.R=0.774;P-value=0.029), educational status (O.R=0.139;P-value=0.001), and BCVA in the better eye (O.R=4.865;P-value=0.001) were significant predictive factors for depression after adjustment for cofounding factors.

Conclusion: There is high prevalence of Anxiety and Depression among this cohort of glaucoma patients. Combined management of glaucoma patients with Neuropsychiatrists will promote a holistic management with early detection of mental health challenges.

Open Access Original Research Article

The Effect of Monochromatic Aberrations of the Cornea on Contrast Sensitivity under Photopic and Mesopic Conditions

E. Pateras, K. Ladopoulos, P. Drakopoulos

Ophthalmology Research: An International Journal, Page 26-35
DOI: 10.9734/or/2022/v16i230233

Purpose: Vision is one of the most important senses. The first stage of vision is the creation of the observed object’s image on the retina. The quality of the retinal image is affected by several factors, such as   diffraction, sampling on the retina, chromatic aberration, scattering and higher order aberrations. The measurement of the quality is achieved both with subjective (visual acuity, contrast sensitivity) and objective methods (PSF, MTF, Strehl ratio, RMS). The purpose of this project is the measurement of higher order aberrations of the anterior corneal surface (with a Placido corneal topographer) and of the contrast sensitivity (with a Pelli Robson optotype). Then, we will try to find if there is a correlation between them.

Methods and Materials: 20 persons participated in this survey, divided in two groups of 10 persons each. The first group (group 1) included subjects up to 39 years old and the second group (group 2) from 40 years and up. The participants didn’t have any pathological problems, except lower order refractive errors. Both eyes of each individual were included in the procedure. First, the higher order aberrations of the anterior corneal surface were measured, with the implementation of a Placido corneal topographer. This was followed by a measurement of the contrast sensitivity. The whole procedure took place under two lighting conditions, both photopic and mesopic. The examination presentation of the higher order aberrations is performed with the use of Zernike polynomials.

Results: The results of the measuring procedure showed that for the first group, under photopic conditions (luminance 32.70 cd/m2) the mean value (± standard deviation) for the higher order aberrations RMS and decimal logarithm contrast sensitivity was 0.073 ± 0.018μm and 1.54 ± 0,16 (contrast 2.88 ± 1.24%) respectively. For the second group the corresponding values were 0.080 ± 0.036μm and 1.59 ± 0.16 (contrast 2.57 ± 1.24%). Accordingly, under mesopic conditions (luminance 1.14 cd/m2) the values for the first group were 0.252 ± 0.064 μm and 1.27 ± 0.15 (contrast 5.37 ± 2.06%), while for the second were 0.253 ± 0.069μm and 1.32 ± 0.12 (contrast 4.79 ± 1.35%). Spherical aberration and coma (horizontal and vertical) were also measured for both groups under photopic and mesopic conditions. The results showed that for the first group, under photopic conditions, RMS for coma and spherical aberration is 0.033 ± 0.014 μm and 0.022 ± 0.011 μm respectively, while for the second group 0.041 ± 0.027 μm and 0.024 ± 0.008 μm. Under mesopic conditions, the relevant results are 0.139 ± 0.065 μm and 0.124 ± 0.035μm for the first group and 0.149 ± 0.066 μm and 0.107 ± 0.038 μm for the second group.

Finally, we should mention here that the equivalent defocus error corresponding to the higher order aberration RMS was estimated. The results for all the participants (without age separation), are 0.23 ± 0.09D (photopic conditions) and 0.28 ± 0.07D (mesopic conditions).

Conclusions: From the statistical analysis of the results we conclude that there exists a symmetry between left and right eyes regarding higher order aberrations. Furthermore, it seems that age is not a significant factor for differences on the magnitude of higher order aberrations both under photopic and mesopic conditions as well. Similar conclusions are also reached for the contrast sensitivity measurements. In addition, we have observed that a correlation exists between the higher order aberrations of the anterior corneal surface and the contrast sensitivity, for both photopic and mesopic conditions. Correlation also exists between coma and contrast only under photopic conditions. But there is no significant correlation between spherical aberration and contrast. The age difference of these two groups has not an effect on the results. Finally, the equivalent defocus is too small, both for photopic and mesopic conditions and between each   other, in order to be clinically significant.

Open Access Review Article

A Study of Corneal Thickness in Type 2 Diabetes Mellitus with and without Diabetic Retinopathy

Rashmi Ramani, Shashank Banait

Ophthalmology Research: An International Journal, Page 1-7
DOI: 10.9734/or/2022/v16i230228

Background: It is essential to assess the corneal thickness in diabetes patient.

Introduction: diabetes mellitus is a major cause of blindness throughout the worldDiabetic retinopathy is the most importance given on day to day basics studies especially for ophthalmologist studied indicators in eye. However, functional oddities have been recognised in cornea too like changes in central corneal thickness.

Objectives: 1. To estimate the central corneal thickness (CCT) of type 2 diabetes mellitus patients without diabetic retinopathy age/sex matched normal people. 2. To measure central corneal thickness (CCT) of type 2 diabetes mellitus patient with diabetic retinopathy with age/ sex matched normal person.

Methods: This is a hospital based case control study.

Expected Results: The central corneal thickness is more in type 2 diabetes patients than non-diabetic individual.