Day 1 :
Keynote Forum
Jiping Cai
Nanjing Medical University, China
Keynote: Traumatic chiasmal syndrome following traumatic brain injury
Time : 11:15 - 11:45
Biography:
Jiping Cai has more than 25 years working experience in ophthalmology. His clinical and research interests are vitreo-retinal diseases such as retinal detachment, diabetic retinopathy, retinal vascular diseases orbital diseases such as thyroid-associated orbitopathy and orbital tumor.
Abstract:
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perceptions are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity has a variable presentation, and was not necessarily related to the severity of the craniocerebral trauma.
Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.
- Ophthalmology | Ocular Oncology | Pediatric Ophthalmology | Neuro-Ophthalmology | Diabetic Retinopathy | Strabismus
Location: Vancouver, Canada
Session Introduction
Puneet Sharma
Ophthalmologists, India
Title: Effect of ND: YAG laser posterior capsulotomy on intraocular pressure, refraction, anterior chamber depth, and macular thickness
Biography:
Puneet Sharma is an ophthalmologist currently working in India. He has an impressive track record, having published numerous research papers and displaying a keen interest in various fields, including Retina and Retinal Detachment, Cornea Disorders and Treatments, Dry Eye & Low Vision, and Ophthalmology Surgery.
Abstract:
Purpose: To see the effect of Nd: YAG laser capsulotomy on intraocular pressure (IOP), refraction, best-corrected visual acuity (BCVA), anterior chamber depth (ACD), and macular thickness.
Methodology: The authors conducted a prospective, descriptive study on pseudophakic eyes with posterior capsule opacification who underwent Nd: YAG laser capsulotomy. BCVA, IOP, spherical equivalent (SE), macular thickness and ACD were noted preoperatively at 1 hr postoperatively and at 1-month follow-up. Patients were divided into two groups based on energy used (Group I ≤50 mJ, Group II >50 mJ). None of the patients received prophylactic anti-glaucoma medications either before or after the procedure.
Results: There were 96 eyes of 83 patients. Mean total energy levels were 26.64±12.92 mJ in Group I and 81.96±32.10 mJ in Group II. BCVA at 1 hr and 1 month postoperatively improved significantly in both the groups compared to preoperative BCVA (P<0.001). There was no significant change in SE compared to preoperative values in both the groups. The ACD continued to increase significantly in both the groups at both 1 hr and 1-month follow-up. In Group I, IOP increased at 1 hr postoperatively (P=0.023) and declined to preoperative levels at 1 month. In Group II, IOP increased at 1 hr postoperatively (P<0.001) and did not return to preoperative levels at 1-month follow-up (P=0.003). Likewise, macular thickness increased at 1 hr in both groups (P<0.001). In Group I, macular thickness decreased significantly to preoperative level at 1 month whereas in Group II, it remained significantly high at 1-month follow-up (P=0.006). There was no case with serious rise in IOP or cystoid macular edema.
Conclusions: Statistically significant increment in IOP and macular thickness occurs after Nd: YAG laser capsulotomy which however may not necessitate the use of any medications.
Lin Chen
Hospital of Chongqing Medical University, China
Title: The incidence and risk factors for dry eye after pediatric strabismus surgery
Biography:
Lin Chen, a pioneering ophthalmologist, has played a pivotal role in revolutionizing eye care at the esteemed Hospital of Chongqing Medical University in China. Dr. Chen's dedication to improving vision and treating ocular ailments has earned her widespread recognition.
Abstract:
Aim: To investigate the incidence and risk factors for dry eye after pediatric strabismus surgery.
Methods: Children aged 5 to 12 who underwent strabismus surgery were included in this single-center, prospective, cohort study. The ocular surface assessments were conducted 1 day before and 1 week, 4 weeks and 8 weeks after surgery. The main outcome measures are the incidence of dry eye after strabismus surgery and associated risk factors.
Results: A total of 84 eyes (48 children) that underwent strabismus surgery were included in the study. The mean age at surgery was 7.21 years. The incidence of dry eye was 47.62% at 1 week, 10.71% at 4 weeks, 0% at 8 weeks after surgery. The preoperative tear breakup time (BUT) were lower in the dry eye group than that in the non-dry eye group (P<=0.01). The univariate analysis showed that preoperative BUT was significantly associated with the incidence of dry eye after pediatric strabismus surgery (odds ratio [OR]: 0.647, confidence interval [IC]: 0.503~0.833, P<=0.01).
Conclusions: Dry eye commonly occurs after pediatric strabismus surgery. Tear film instability is more common than deficient aqueous tear production in patients with dry eye after surgery. Children with a low preoperative BUT are more likely to develop dry eye after strabismus surgery.
Sangkyung Choi
VHS Medical Center, South Korea
Title: Analysis of refractive changes after cataract surgery according to the haptic shape of intraocular lenses
Biography:
Sangkyung Choi is an ophthalmologist based in Seoul, South Korea. After graduating from Seoul National University, she finished her ophthalmology training at Korean Veterans Hospital. Dr. Choi was a research fellow at Wilmer Eye Institute in the Ocular Microbiology department. She also completed her clinical and research fellowship at Seoul National University Hospital, studying artificial cornea. She performs various surgeries including cataract operations, glaucoma surgeries, keratoplasty as well as refractive surgeries. She has performed over 35,000 ocular surgeries over the course of her career. She spends the remaining time on research and teaching.
Abstract:
Purpose: To analyze and compare refractive error changes according to different haptic intraocular lenses, after cataract surgery.
Methods: We retrospectively reviewed the medical records of 508 eyes of 254 subjects who underwent cataract surgeries in both eyes, with one eye using the MBI® SAL302AC(C loop haptic IOL), and the other using the Zeiss® CT ASPHINA509M (plate haptic IOL). By using Barrett Universal II formula, prediction errors were calculated at 1 week, 2 weeks, 1 month, 2 months and 6 months after the surgery.
Results: In the C loop group, prediction error was -0.26 ± 0.42 D at postoperative 1 week, -0.17 ± 0.45 D at postoperative 2 weeks. Hyperopic shift which reduced myopia progressed until postoperative 2 weeks (p<0.001), and then there was no significant shift after postoperative 2 weeks. In the plate group, prediction error was -0.37 ± 0.45 D at postoperative 1 week, -0.25 ± 0.44 D at postoperative 2 weeks, -0.11 ± 0.44 D at postoperative 1 month, -0.04 ± 0.44 D at postoperative 2 months. Hyperopic shift progressed at postoperative 2 weeks (p<0.001), 1 month (p<0.001), 2 months (p=0.02), and then there was no significant shift after postoperative 2 months. There were no significant differences between the two groups in the mean and median absolute error at postoperative 2 months.
|
MBI®SAL302AC |
Zeiss®CT Asphina509M |
|
|
|
|
|
|
Overall Diameter |
13.0 mm |
11.0 mm |
|
Optic diameter |
6.0 mm |
6.0 mm |
|
Haptic design |
C loop |
Plate |
|
Haptic angle |
0 degree |
0 degree |
|
Material |
hydrophobic Acrylic |
hydrophilic acrylic(25%) with hydrophobic surface |
|
Optic type |
Biconvex, Aspheric |
Aspheric |
Table: Refractive error with Barrett Universal II formula
Conclusions: In both the C loop and plate groups, refraction was myopic at postoperative 1 week, and then the C loop group progressed hyperopic shift until postoperative 2 weeks, and the plate group progressed hyperopic shift until postoperative 2 months. At postoperative 2 months, prediction error of the plate group shows more hyperopic tendency than the C loop group, but there was no significant difference between the two groups in accuracy based on the absolute.
- Ophthalmic Genetics and Gene Therapy | Optical Imaging and Sensing | Optical Technologies and Laser Science in Ophthalmology | Ophthalmology Surgery
Location: Vancouver, Canada
Session Introduction
Idiberto Jose Zotarelli-Filho
Ophthalmology and Eye Plastic, Brazil
Title: Cellular therapy for intravitreal use in ischemic retinopathy and macular degeneration: A systematic review
Biography:
Idiberto José Zotarelli Filho worked at Clinical Unioftal, Brazil, specializing in a wide range of ophthalmic and aesthetic services, offering routine examinations, diagnosis, and treatment of various eye diseases, as well as conducting eye surgeries, eye plastics procedures, and providing advanced aesthetic treatments.
Abstract:
Introduction: In the scenario of eye diseases, diabetic retinopathy and retinal vein occlusion are the two most common ischemic retinopathies in the world. Ischemia is caused by retinal vascular diseases due to decreased blood perfusion and the appearance of areas of retinal non- perfusion. Also, age-related macular degeneration (AMD) is the most common cause of irreversible vision loss in people over 65 years of age in industrialized countries. By 2020 around 200 million people will be affected by AMD worldwide.
Objective: The present systematic review study aimed to highlight the main clinical findings of the treatment of ischemic retinopathy and age-related macular degeneration through cell therapy with bone marrow stem cells.
Methods: The rules of the Systematic Review-PRISMA Platform were followed. The search was carried out from March 2022 to June 2022 in Scopus, PubMed, Science Direct, Scielo and Google Scholar databases. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument.
Results and Conclusions: It was found 235 articles involving retinitis pigmentosa, macular degeneration, and bone marrow stem cell therapy. A total of 51 were fully evaluated and 28 studies were included and developed in a systematic review in the results field. The symmetrical Funnel Plot does not suggest a risk of bias between the small sample size studies. It was concluded that intravitreal injection of bone marrow-derived stem cells in a patient with retinal vascular occlusion sequelae demonstrated that the procedure is feasible and safe to be performed in humans as there were no signs of infection, inflammation or development of intraocular tumor formation. Also, neurotrophic effects correlate with vasculature preservation, suggesting that bone marrow-derived stem cells can be used in the treatment of diseases such as retinal degenerations and vasculopathy that currently lack effective treatment. The authors concluded that stem cells can protect retinal cells from degeneration and also suggested that they were able to replace some types of lost retinal neurons.
Mostafa Bondok
University of British Columbia, Canada
Title: Addressing unmatched ophthalmology applicants in canadian residency programs: Exploring viable solutions
Biography:
Mostafa Bondok has a background in Medical Education, Health Equity, Accessibility Technology, and Methodological studies. He is a medical student at the University of British Columbia.
Abstract:
Statement of the Problem: Applicants to ophthalmology have experienced disproportionately higher rates of going unmatched during the CaRMS process compared to other specialties. Our research aims to examine this phenomenon by identifying trends and comparing match data to other specialties.
Methodology & Theoretical Orientation: Using a retrospective, cross-sectional design, Qualitative trends in CaRMS outcomes of ophthalmology applicants were compared to other specialties from 2013-2022.
Findings: Data was obtained from 608 ophthalmology, 5,153 surgery, and 3,092 top five (most competitive) specialty first choice applicants from 2013-2022. Ophthalmology applicants were more likely to go unmatched (18.9% [120/608]) than applicants to the top five (11.9% [371/3,092]) and surgical (13.5% [702/5,153]) specialties (p<0.001) and were twice as likely to rank no alternate disciplines (31.8%; p<0.001) over the study period. In the first iteration, when alternate disciplines were ranked, match rate to alternate disciplines was highest for ophthalmology applicants (0.41; p<0.001). The majority (57.8%) of unmatched ophthalmology applicants do not participate in the second iteration.
Statement of the Problem: Applicants to ophthalmology have experienced disproportionately higher rates of going unmatched during the CaRMS process compared to other specialties. Our research aims to examine this phenomenon by identifying trends and comparing match data to other specialties.
Methodology & Theoretical Orientation: Using a retrospective, cross-sectional design, Qualitative trends in CaRMS outcomes of ophthalmology applicants were compared to other specialties from 2013-2022.
Findings: Data was obtained from 608 ophthalmology, 5,153 surgery, and 3,092 top five (most competitive) specialty first choice applicants from 2013-2022. Ophthalmology applicants were more likely to go unmatched (18.9% [120/608]) than applicants to the top five (11.9% [371/3,092]) and surgical (13.5% [702/5,153]) specialties (p<0.001) and were twice as likely to rank no alternate disciplines (31.8%; p<0.001) over the study period. In the first iteration, when alternate disciplines were ranked, match rate to alternate disciplines was highest for ophthalmology applicants (0.41; p<0.001). The majority (57.8%) of unmatched ophthalmology applicants do not participate in the second iteration.
Asaad A Ghanem
Mansoura University, Egypt
Title: Correlation between corneal elevation topography and perimetric changes in patients with primary open angle glaucoma
Biography:
Asaad A Ghanem has completed his MD at the age of 35 years from Mansoura University, Egypt. He is the head of Glaucoma department of Mansoura University, Egypt. He has over 70 publications that have been cited over 453 times, and his publication h-index is 14. He has been serving as an editorial board member of several reputed journals.
Abstract:
Aim: The aim of this study is to assess Scheimpflug topographic elevation maps in patients with POAG and correlate the results with their perimetric changes.
Methods: This was an analytical observational cross-sectional study. The study included 130 eyes of 70 subjects which were divided into 78 eyes of 44 patients diagnosed with POAG and 52 eyes of 26 control subjects. Measurement of IOP, visual field examination in patients with POAG using Humphrey Field Analyzer (2003 Carl Zeiss Meditec), Germany were done. Subjects were scanned using TMS-5 topographer (Topographic Modeling System, version 5. Tomey Corp. Nagoya, Japan) to measure central corneal thickness, mean anterior keratometry, maximum anterior and posterior topographic elevation maps in the central 3, 5, and 7 mm.
Results: 78 patients with POAG classified according to visual field deterioration using Hodapp-Anderson-Parrish grading scale into mild glaucoma 33 eyes, moderate glaucoma 19 eyes, severe glaucoma 26 eyes and 52 eyes control were included in the study. The mean age of the patients with POAG was 57.82 ± 7.78 years; 22 eyes (50%) were male and 22 eyes (50%) were female. The average age of control subjects was 56.62 ± 8.48 years; 12 eyes (46.2%) were male and 14 eyes (53.8%) were female, average CCT was 530.3 ± 23.58 µm, average mean anterior keratometry (MAK) was 42.97 ± 1.42 D, average maximum anterior elevation (MAE) in 3,5 and 7mm zone was 5.31 ± 2.28, 12.10 ± 6.94 and 44.04 ± 21.99 µm respectively and average maximum posterior elevation (MPE) in 3,5 and 7mm zone was 8.46 ± 2.10, 19.90 ± 9.39 and 62.72 ± 28.82 µm respectively in patients with POAG, whereas average CCT was 543.0 ± 31.02µm, average MAK was 43.11 ± 1.73 D, average MAE in 3,5 and 7mm zone was 4.52 ± 1.97, 5.90 ± 2.71 and 27.19 ± 8.55 µm respectively.
Conclusion: Evaluation of corneal elevation topography by scheimpflug imaging showed forward shifting of the anterior and posterior corneal surfaces in POAG.
Marrie A.
Cairo University, Egypt
Title: The safety and efficacy of black tea extract in the treatment of acute bacterial conjunctivitis: A rabbit model
Biography:
Marrie A is an assistant professor in Cairo University, Egypt specialized in cornea and refractive.
Abstract:
Purpose: To determine the safety and efficacy of black tea extract in the treatment of bacterial conjunctivitis in a rabbit model and compare it with that of gatifloxacin drops.
Methods: Black tea extract was tested in vitro on bacterial cultures of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Forty-two rabbit eyes were cultured with either MRSA (n.21) or P. aeruginosa (n.21) and further divided into a control group (n.5), a tea group (n.8) treated with black tea extract and a gatifloxacin group (n.8) treated with 0.3% gatifloxacin eye drops. Conjunctival swabs were collected on the third and fifth days.
Results: The tea extract successfully inhibited the growth of both organisms at a concentration of 400 mg/mL. Rabbits in the treatment groups showed a reduction in the clinical index on day 2 (P, 0.01), unlike the control group (P.0.1), for both organisms. Resolution of conjunctivitis was achieved on days 4 and 5 in the tea and gatifloxacin groups, respectively. On days 3 and 5, while the control group still showed considerable bacterial growth, the tea and gatifloxacin groups showed its inhibition.
Conclusion: Tea extract has antimicrobial effects similar to those of gatifloxacin in a rabbit model of conjunctivitis.
Key Words: Tea extract, Conjunctivitis, MRSA, Pseudomonas aeruginosa