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A comparative study to evaluate the effect of various postoperative treatment protocols on dry eye and patient satisfaction after phacoemulsification

Indian J Ophthalmol. 2023 Apr;71(4):1638-1642. doi: 10.4103/IJO.IJO_2775_22.

ABSTRACT

PURPOSE: Foreign body sensation and irritation are common after cataract surgery, as is the exacerbation of dry eye disease if present. This study compared postoperative dry eye treatments and patient satisfaction.

METHODS: Age-related cataract patients undergoing phacoemulsification were recruited and were divided randomly into 4 postoperative treatment groups: Group A: Antibiotic + Steroids; Group B: Antibiotic + Steroids + Mydriatic; Group C: Antibiotic + Steroids + Mydriatic + Non-steroidal Ant-inflammatory drugs (NSAIDs); Group D: Antibiotic + Steroids + Mydriatic + NSAID + Tear substitute. Patients were assessed at 1, 3, and 5 weeks post-operatively for uncorrected distance and near vision, best corrected visual acuity (BCVA) for distance and near, Schirmer’s-1 test, and Tear Film Break-Up Time test. At each visit, patients were assessed for dry eye-related subjective parameters using Ocular Surface Disease Index questionnaire.

RESULTS: Study participants numbered 163. (87 male and 76 female patients). No statistically significant difference was present in visual acuity for near and distance. The mean values of Schirmer’s test and TFBUT were better in group D patients at each postoperative visit, with significant differences noted in comparison with other groups. The patient response to pain and dry eye symptoms was superior in groups C and D, with group D producing the best results. Compared to group A, patients in groups C and D were more satisfied with their vision and surgery.

CONCLUSION: The addition of tear substitutes to steroids and NSAIDs has been associated with decreased dry eye-related symptoms and a better subjective feeling of vision, although no significant difference was noted in vision measured objectively.

PMID:37026315 | DOI:10.4103/IJO.IJO_2775_22

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Efficacy and safety of topical 2% rebamipide ophthalmic suspension in dry eye disease at tertiary care centre

Indian J Ophthalmol. 2023 Apr;71(4):1598-1602. doi: 10.4103/IJO.IJO_2586_22.

ABSTRACT

PURPOSE: To evaluate the effect and side effects of topical 2% rebamipide ophthalmic suspension in dry eye disease.

METHOD: This prospective randomized case control study included total 80 patients (40 cases and 40 controls) of dry eye. Symptoms were graded according to OSDI scoring system and specific tests for dry eye included Tear film breakup time (TBUT), Schirmer’s test, Fluorescein corneal staining (FCS), Rose Bengal staining) were performed. Case group received 2% rebamipide ophthalmic suspension four times daily and control group given carboxymethylcellulose 0.5% four times daily. The follow ups had done at two, six and twelve weeks.

RESULTS: The maximum numbers of patients were between 45-60 years. Patient with mild moderate and severe OSDI Score shows marked improvement. Mild TBUT score showed improvement but statistically not significant (P value-0.34). In moderate and severe TBUT Score statistically significant improvement (P value- 0.0001, 0.0001). In all grade FCS shows statistically significant improvement with p value-0.0001, 0.0001, and 0.028 respectively. Schirmer’s test score in all cases had shown improvement but statistically not significant and P value were 0.09, 0.07, and 0.07 respectively. In mild, moderate and severe Rose Bengal staining statistically significant improvement (P value -0.027, 0.0001, and 0.04) .The only side effect was dysgeusia (10% patients).

CONCLUSION: Rebamipide 2% ophthalmic suspension showed significant improvement in symptoms and signs of dry eye. It able to modify epithelial cell function, improve tear stability, and suppress inflammation suggests that it may be a first drug of choice for severe dry eye disease.

PMID:37026308 | DOI:10.4103/IJO.IJO_2586_22

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Study of dry eye syndrome: Focus on causative factors, treatment modalities, quality of life, and preservatives used in eye drops

Indian J Ophthalmol. 2023 Apr;71(4):1587-1592. doi: 10.4103/IJO.IJO_3359_22.

ABSTRACT

PURPOSE: Dry eye syndrome (DES) is a global issue occurring due to tear deficiency or excessive tear evaporation. It is associated with a variety of symptoms causing ocular discomfort. The purpose of the study was to evaluate causative factors, treatment modalities, quality of life, and preservatives used in eye drops.

METHODS: This prospective, follow-up study was conducted in the ophthalmology outpatient department of a tertiary care teaching hospital. Patients older than 18 years of age of either sex diagnosed with DES and willing to give written informed consent were included. The patients were subjected to the Ocular surface disease index Questionnaire (OSDI Questionnaire) twice; at the time of the first visit and at 15 days follow-up.

RESULTS: A male preponderance was observed with a 1.86:1 male-to-female ratio. The mean age of the study population was 29.15 ± 10.07 years. The most common presenting complaints were symptoms related to dryness of the eyes followed by refractive error. Exposure to TV/computer screen for more than 6 hours is the most common causative factor. There was a statistically significant improvement in overall quality of life (QoL) in patients of DES on treatment. However, no significant difference was seen in the improvement of quality of life in comparison with different preservatives used in prescribed eye drops for the treatment of DES.

CONCLUSION: DES can adversely affect the quality of life of patients. Prompt treatment of this condition can significantly improve the patient’s QoL. Physicians should be encouraged to perform quality of life evaluations for patients with DES to guide them in treatment with more individual-specific treatment options.

PMID:37026306 | DOI:10.4103/IJO.IJO_3359_22

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Tear film microbiome in Sjogren’s and non-Sjogren’s aqueous deficiency dry eye

Indian J Ophthalmol. 2023 Apr;71(4):1566-1573. doi: 10.4103/IJO.IJO_2821_22.

ABSTRACT

PURPOSE: To understand the bacterial microbiome changes associated with Sjogren’s syndrome (SS) and non-Sjogren’s syndrome (NSS) aqueous-deficient dry eyes compared to healthy eyes.

METHODS: Bacterial microbiome was generated from the deoxyribonucleic acid of tear film samples in healthy (n = 33), SS (n = 17), and NSS (n = 28) individuals. Sequencing of the V3-V4 region of the 16S rRNA gene was performed on the Illumina HiSeq2500 platform. Quantitative Insights Into Microbial Ecology (QIIME) pipeline was used to assign taxa to sequences. Statistical analysis was performed in R to assess the alpha diversity and beta diversity indices. Significant changes between the healthy, SS, and NSS cohorts were depicted by principal coordinate analysis (PCoA), differential abundance, and network analysis.

RESULTS: Tear microbiome was generated in healthy, SS, and NSS samples. Phyla Actinobacteria, Firmicutes, and Bacteroidetes showed significant changes in SS and NSS compared to healthy. Genera Lactobacillus and Bacillus were predominantly present in all samples. PCoA and heat map analysis showed distinct clusters for SS and NSS from the healthy cohort. Genera Prevotella, Coriobacteriaceae UCG-003, Enterococcus, Streptomyces, Rhodobacter, Ezakiella, and Microbacterium significantly increased in abundance in SS and NSS compared to a healthy cohort. Bacteria-bacteria interaction in SS, NSS, and healthy cohorts was predicted by CoNet network analysis. This analysis predicted a major hub of interaction for the pro-inflammatory bacterium Prevotella in the SS and NSS cohorts.

CONCLUSION: The results of the study indicate significant changes in the phyla and genera in SS and NSS compared to healthy. Both discriminative analysis and network analysis indicated a possible association of predominant pro-inflammatory bacteria with SS and NSS.

PMID:37026303 | DOI:10.4103/IJO.IJO_2821_22

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Evaluation of post-operative dry eye in upper and lower eyelid reconstruction: A cross-sectional study

Indian J Ophthalmol. 2023 Apr;71(4):1561-1565. doi: 10.4103/IJO.IJO_2829_22.

ABSTRACT

PURPOSE: In cases of eyelid malignancies requiring full thickness excisional biopsy followed by reconstruction of the created defect, the Meibomian glands are lost. Post-operative varying degrees of dry eye disease (DED) are expected in such patients. The aim was to evaluate the objective and subjective statuses of DED in cases of full thickness eyelid reconstruction following excisional biopsy because of malignancies. Methods: This was a cross-sectional pilot study. Objective and subjective dry eye parameters are assessed in cases of full thickness eyelid reconstruction following excisional biopsy because of malignancies in 37 eyes at 6 months post-operative follow-up. Analysis of variance and Chi square test were used for statistical analysis.

RESULTS: When compared with fellow eye, all the parameters were found to be statistically significant (P < 0.0). Subjective assessment of dry eye by ocular surface disease index (OSDI) scoring did not corroborate with the objective data (p 0.00). Lower eyelid reconstruction showed a minimum number of dry eye cases (P > 0.05).

CONCLUSION: Prevalence of post-operative dry eye is more with increasing percentage of full thickness upper eyelid reconstruction. Disparity was found between objective and subjective parameters of dry eye in patients requiring varying percentages of upper eyelid reconstruction because of malignancies.

PMID:37026302 | DOI:10.4103/IJO.IJO_2829_22

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Dry eye parameters measured with an ocular surface analyzer in eyes after vitrectomy for vitreomacular interface disorders

Indian J Ophthalmol. 2023 Apr;71(4):1551-1555. doi: 10.4103/IJO.IJO_3029_22.

ABSTRACT

PURPOSE: Dry eye disease (DED) might be caused by multiple ocular surgical interventions. The aim of the study was to estimate the extent of DED in patients undergoing core vitrectomy for vitreoretinal interface disorders.

METHODS: In this prospective observational study, we included patients with 12 months of follow-up after vitrectomy. The following data were collected as controls: age, sex, best-corrected visual acuity before and after surgery, and phakic status. In OSA (ocular surface analysis), the following parameters were evaluated: NIBUT (non-invasive tear break-up time), sltDear (thickness of the lipid layer), Meibomian gland (MGD) loss, and the height of tear meniscus. Shapiro-Wilk test, Wilcoxon rank-sum test, and Mann-Whitney U tests were used for statistical analysis.

RESULTS: We evaluated 48 eyes of 24 patients (10 men, 14 women; 64.63 ± 14.10 years) 1 year after vitrectomy. From the analyzed ocular surface parameters, NIBUT was significantly lower in operated versus non-operated eyes (P = 0.048). The higher the level of difference in MGD loss between both eyes, the higher the level of difference in NIBUT between both eyes (rs = 0.47, P = 0.032).

CONCLUSION: NIBUT levels were still decreased 12 months after vitrectomy. Patients with more pronounced MGD loss or decreased NIBUT levels in the fellow eye were more likely to experience such disorders. The tear meniscus height was lower in patients undergoing surgery for retinal detachment than in those with vitreoretinal disorders. This might allow the suggestion to include artificial tears in pre- and post-operative care in vitrectomized eyes.

PMID:37026300 | DOI:10.4103/IJO.IJO_3029_22

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Evaluation of the ocular surface in asymptomatic glaucoma patients on topical medications and following trabeculectomy – A cross-sectional study

Indian J Ophthalmol. 2023 Apr;71(4):1521-1525. doi: 10.4103/IJO.IJO_2812_22.

ABSTRACT

PURPOSE: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti-glaucoma medication use and compare it with the age-matched normal population.

METHODS: Objective clinical evaluation was done by tear film break-up time (TBUT) and Schirmer’s test (ST) in the three groups-trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ≧10), chronic anti-glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded.

RESULTS: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty-six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034).

CONCLUSION: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.

PMID:37026294 | DOI:10.4103/IJO.IJO_2812_22

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Lid wiper epitheliopathy in symptomatic and asymptomatic dry eye subjects

Indian J Ophthalmol. 2023 Apr;71(4):1499-1502. doi: 10.4103/IJO.IJO_2709_22.

ABSTRACT

PURPOSE: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects.

METHODS: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi-square test was used for statistical analysis.

RESULTS: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2).

CONCLUSION: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.

PMID:37026290 | DOI:10.4103/IJO.IJO_2709_22

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Dietary behavior of video game players and esports players in Germany: a cross-sectional study

J Health Popul Nutr. 2023 Apr 6;42(1):29. doi: 10.1186/s41043-023-00373-7.

ABSTRACT

BACKGROUND: Video gaming and competitive gaming (esports) are gaining more and more recognition in society as well as in research. Increasingly, health-related topics are the focus of research on video game and esports players. Although video gaming is often associated with energy drinks and fast food, no studies have yet examined the players’ dietary behavior. Therefore, the aim of this cross-sectional study is to investigate the dietary behavior and additional health-related data of video game players and esports players in Germany.

METHODS: Between July and October 2020, 817 participants (87.1% male; 24.2 ± 6.9 years), divided into video game players and esports players, were surveyed via an online questionnaire about their dietary, health, and gaming behaviors. Descriptive statistics were performed on all questions. To investigate statistically significant differences between video game players and esports players, the Mann-Whitney-U-Test and Kruskall-Wallis-Test were used. Partial Spearman correlations were used to examine possible associations between dietary behavior, health status, well-being, and video game playing time.

RESULTS: Water was the primary source of fluid intake for the players (10.9 ± 7.0 l/week). The average weekly consumption of energy drinks was 0.4 ± 0.9 L. Energy drinks (rho = 0.14; p < 0.01) as well as soft drinks (rho = 0.14; p < 0.01) are positively correlated with the video game playing time. Participants ate 7.5 ± 10.4 servings of fast food per month, which has a positive association with video game playing time (rho = 0.13; p < 0.01). In contrast, vegetables (1.7 ± 1.6 servings/day) and fruits (0.9 ± 1.0 servings/day) are eaten almost daily.

CONCLUSION: In this survey, the dietary behavior of video game players and esports players is similar to that of the German general population. Nevertheless, there is a need for improvement. Especially energy drinks, which are already documented to have adverse health effects, should be limited. In addition, the consumption of fast food and meat should also be reduced, and healthier foods such as fruits and vegetables should be increased instead. Early education and support regarding the associated risks with unhealthy foods is important within the target group.

PMID:37024994 | DOI:10.1186/s41043-023-00373-7

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Identification of cell barcodes from long-read single-cell RNA-seq with BLAZE

Genome Biol. 2023 Apr 6;24(1):66. doi: 10.1186/s13059-023-02907-y.

ABSTRACT

Long-read single-cell RNA sequencing (scRNA-seq) enables the quantification of RNA isoforms in individual cells. However, long-read scRNA-seq using the Oxford Nanopore platform has largely relied upon matched short-read data to identify cell barcodes. We introduce BLAZE, which accurately and efficiently identifies 10x cell barcodes using only nanopore long-read scRNA-seq data. BLAZE outperforms the existing tools and provides an accurate representation of the cells present in long-read scRNA-seq when compared to matched short reads. BLAZE simplifies long-read scRNA-seq while improving the results, is compatible with downstream tools accepting a cell barcode file, and is available at https://github.com/shimlab/BLAZE .

PMID:37024980 | DOI:10.1186/s13059-023-02907-y