Vitamin D Supplementation and the Incidence of Cataract Surgery in Older Australian Adults

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Vitamin D Supplementation and the Incidence of Cataract Surgery in Older Australian Adults

Created
Tags CGMHOPH
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

中文摘要

這份研究的目的是評估維生素D補充劑是否可以減少老年澳大利亞人的白內障手術發生率。研究是D-Health Trial的附屬研究，D-Health Trial是一項從2014年至2020年在澳大利亞進行的隨機、雙盲、安慰劑對照試驗，探討每月口服維生素D的療效。研究對象需排除高血鈣、高副甲狀腺素血症、腎結石、軟骨餘骨症或肺結節病等情況，以及每天攝取超過500 IU維生素D的人。總共隨機分配了21,315人，但有1,390人未達到此分析的資格標準，因此最終分析對象為19,925人。經過追蹤5年半，結果顯示每月口服60,000 IU維生素D3對白內障手術發生率沒有顯著影響，且與年齡、性別、身體質量指數、預測的血清25(OH)D濃度或環境紫外線輻射無關。本研究的發現意味著在維生素缺乏屬低盛行率的澳大利亞老年人群中，定期口服維生素D補充劑對減少白內障手術發生率沒有幫助。

English Abstract

The study aimed to investigate the potential role of vitamin D supplementation in reducing the incidence of cataract surgery in older Australian adults. The study was an ancillary analysis of the D-Health Trial, a randomized, double-masked, placebo-controlled trial of monthly vitamin D conducted from 2014 to 2020 within the Australian general population. A total of 19,925 participants were included, and the effect of vitamin D supplementation on the incidence of cataract surgery was assessed through linkage to universal health insurance records and hospital data. The results showed no evidence that monthly supplementation with 60,000 IU of vitamin D3 for up to 5 years reduced the incidence of cataract surgery. This finding was consistent across prespecified subgroup analyses, including people predicted to have low vitamin D status at baseline. The study suggests that the associations detected in observational studies may not be causal, and further research is needed to investigate the potential link between vitamin D and cataract.

Which Dry Eye? The Case for Precise Diagnostic Terminology in Ophthalmology

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Which Dry Eye? The Case for Precise Diagnostic Terminology in Ophthalmology

Created
Tags CGMHOPH Cornea
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 239-241, Copyright © 2022

英文摘要

This editorial discusses the importance of precise diagnostic terminology in ophthalmology, using dry eye disease as an example. The term “dry eye” may lead people to misunderstand the condition as a lack of tears, but in fact, it is a multifactorial disease of the ocular surface involving tear film imbalance, inflammation, and neurosensory abnormalities. This ambiguous terminology can lead to misdiagnosis and mistreatment. The article suggests re-examining these terms and increasing their specificity to more accurately reflect individual ocular surface disease phenotypes. Also, careful attention should be paid to the words used to describe the course of the disease. Precise terminology helps to reconsider the underlying causes of a patient’s condition and to proceed with treatment in a more rational manner.

中文摘要

本篇探討了眼科中精確診斷術語的重要性，以乾眼症為例。乾眼症這一術語可能讓人誤解為眼睛缺乏淚液，但實際上，乾眼症是一種多因素導致的眼表疾病，包括淚膜失衡、炎症、神經感覺異常等。這種模糊的術語可能導致誤診和誤治。文章建議重新審視這些術語，提高特異性，以便更準確地反映個體眼表疾病的表型。同時，還需要注意描述疾病過程的用詞。精確的術語有助於重新考慮患者的病因，從而更合理地進行治療。

Effectiveness of Microinvasive Glaucoma Surgery in the United States

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Effectiveness of Microinvasive Glaucoma Surgery in the United States

Created
Tags CGMHOPH Glaucoma
Journal Ophthalmology
Status 已上網
校稿者 黃奕修 醫師

Intelligent Research in Sight Registry Analysis 2013e2019 Shuang-An Yang, MD, MPH,1,2 Elizabeth C. Ciociola, BA,3 William Mitchell, MBBS, MPH,2 Nathan Hall, MSc,4 Alice C. Lorch, MD, MPH,4 Joan W. Miller, MD,4 David S. Friedman, MD, PhD,4 Michael V. Boland, MD, PhD,4 Tobias

Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 242-255, Copyright © 2022 American Academy of Ophthalmology

英文摘要

Summary: This study aimed to evaluate the effectiveness of micro-invasive glaucoma surgery (MIGS) with and without concurrent phacoemulsification. In current United States clinical practice, MIGS has substantially lower reoperation rates when performed with phacoemulsification, particularly for endoscopic cyclophotocoagulation (ECP) and goniotomy or canaloplasty. However, the efficacy of these procedures has not been fully demonstrated, as most published studies to date are retrospective series without control groups. Furthermore, little is known about patient factors predicting positive outcomes after MIGS procedures. The results showed that ECP (94%) and goniotomy or canaloplasty (76%) were more likely to be performed with phacoemulsification than ab interno Xen implantation (29%). Lower reoperation rates were observed in patients undergoing MIGS with concurrent phacoemulsification. However, nearly one-quarter of patients undergoing standalone ab interno Xen implantation and goniotomy or canaloplasty required reoperation within two years. Future studies are needed to determine the role of MIGS in different types of glaucoma.

中文摘要

摘要：本研究評估了微創性青光眼手術（MIGS）與是否合併晶状体超声乳化术（phacoemulsification）的有效性。在美國目前的臨床實踐中，與phacoemulsification一起進行的MIGS具有顯著較低的二次手術率，尤其對於內窺鏡下睫狀體光凝固術（ECP）和切口房角手術或管成形術。然而，迄今為止發表的大多數研究都是沒有對照組的回顧性系列，因此尚未充分證明其效能。此外，對於MIGS手術後預測良好結果的患者因素知之甚少。結果顯示，ECP（94%）和切口房角手術或管道成形術（76%）比內窺鏡下Xen凝膠支架植入術（29%）更可能與phacoemulsification一起進行。在MIGS與phacoemulsification聯合進行的患者中，觀察到較低的二次手術率。然而，單獨進行內窺鏡下Xen植入術和切口房角手術或管道成形術的近四分之一患者在兩年內需要再次手術。未來有必要進行更多研究來確定MIGS在不同類型的青光眼中的作用。

Ocular Adverse Events after Coronavirus Disease 2019 mRNA Vaccination

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Ocular Adverse Events after Coronavirus Disease 2019 mRNA Vaccination

Created
Tags CGMHOPH Neuro, Retina, Uveitis
Journal Ophthalmology
Status 已上網
校稿者 黃奕修 醫師

Yohei Hashimoto MD, PhD, Hayato Yamana MD, PhD, Masao Iwagami MD, PhD, Sachiko Ono MPH, PhD, Yoshinori Takeuchi DVM, PhD, Nobuaki Michihata MD, PhD, Kohei Uemura PhD, Hideo Yasunaga MD, PhD, Makoto Aihara MD, PhD 及 Toshikatsu Kaburaki MD, PhD
Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 256-264, Copyright © 2022 American Academy of Ophthalmology

英文摘要

This study aimed to investigate the risk of ocular adverse events following COVID-19 mRNA vaccine administration. Researchers employed two study designs: matched cohort and self-controlled case series (SCCS) studies. Individuals who received the COVID-19 vaccine (BNT162b2) from February 2021 to September 2021 were included. The study analyzed individuals who developed ocular adverse events. The findings revealed no significant increase in the risk of uveitis, scleritis, retinal vein occlusion (RVO), or optic neuritis after vaccination.

However, there were some limitations, such as the inability to obtain detailed information about the eyes and potential unmeasured confounders in the matched cohort study. Despite these limitations, this research provides important insights into the association between COVID-19 vaccines and ocular adverse events.

中文摘要

本研究旨在調查2019冠狀病毒病(COVID-19) mRNA疫苗接種後眼科不良反應的風險。研究人員使用了兩種研究設計：配對隊列Matched cohort研究和自控病例序列self-controlled case series研究。從2021年2月至2021年9月接種COVID-19疫苗(BNT162b2)的個體被納入研究。研究人員分析了發生眼科不良反應的個體。研究發現疫苗接種後，葡萄膜炎、鞏膜炎、視網膜靜脈阻塞(RVO)和視神經炎的風險並無顯著增加。

然而，研究存在一些限制，如無法獲得眼睛的詳細信息，配對隊列研究中可能存在未測量的混淆因素等。儘管如此，這項研究為了解COVID-19疫苗與眼科不良事件之間的關聯提供了重要信息。

Benign Lobular Inner Nuclear Layer Proliferations of the Retina Associated with Congenital Hypertrophy of the Retinal Pigment Epithelium

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Benign Lobular Inner Nuclear Layer Proliferations of the Retina Associated with Congenital Hypertrophy of the Retinal Pigment Epithelium

Created
Tags CGMHOPH Neuro Retina
Journal Ophthalmology
Status 已上網
校稿者 黃奕修 醫師

Christian J. Sanfilippo MD, Michael Javaheri MD, Sheryl Handler MD, Jesse L. Berry MD, David Cobrinik MD, PhD, Matthew A. Deardorff MD, PhD, Miao Sun PhD, Ryan J. Schmidt MD, PhD, Andrew J. Barkmeier MD 及 Aaron Nagiel MD, PhD
Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 265-273, Copyright © 2022 American Academy of Ophthalmology

英文摘要

This case series describes four patients with novel benign intraretinal tumors of the inner nuclear layer (INL), which have not been previously reported. These patients underwent ophthalmic examinations, fundus photography, fluorescein angiography, OCT, OCT angiography, and whole exome sequencing. Two of the patients also had separate CHRPE lesions. The authors propose the term “benign lobular inner nuclear layer proliferation” for these lesions. The tumors were discovered incidentally in children or young adults and appeared as smooth, white-opaque masses on examination. OCT revealed homogeneous, hyperreflective lesions within the INL. No significant changes were observed during follow-up, suggesting a benign nature. The study also reports a possible predisposition to the development of both INL tumors and CHRPE lesions in some patients. Further research is needed to better understand the features, natural history, and potential associations of these novel tumors.

中文摘要

本病例系列描述了四名患有新型良性視網膜內核層（INL）腫瘤的患者，這些腫瘤以前從未被報導過。這些患者接受了眼科檢查、眼底攝影、螢光素眼底血管造影、OCT、OCT血管造影和全外顯子定序。結論: 我們描述了一種新型良性INL腫瘤，其中兩名患者與單獨的CHRPE病變相關。我們提出“良性分葉狀內核層增生”這個術語來描述這些病變。此類視網膜腫瘤源於神經感覺視網膜的固有細胞類型，罕見且與預後和全身關聯有不同的意義。

在本病例系列中，我們報告了4名患有良性視網膜內腫瘤的患者的臨床和影像學表現。其中兩名患者還表現出與CHRPE病變相關的特徵。OCT血管造影顯示病變為無血管，並且隨訪兩年內未觀察到病變變化。綜合以上資訊，我們認為這是一種未曾描述過的視網膜腫瘤類型。然而，進一步的研究和更多患者的數據仍然有助於進一步了解這些病變的特徵、自然史和潛在關聯。

在這個病例系列中，所有患者均為兒童或年輕人，腫瘤在眼底檢查中意外發現。較大的病變呈光滑的白色不透明質地，由多個小叶連接成弧形。如果這些單獨的病變是獨立形成的，那麼這可能意味著這些患者容易形成這些病變。這可能表明存在一種潛在的疾病，使患者容易患上兩種不同類型的後段病變。

在已知的視網膜內腫瘤中，良性分葉狀內核層增生具有特殊性，因為它們完全位於INL內。此外，其他已知視網膜內腫瘤的OCT特徵也已經描述得很詳細。在這些病例中，我們報告了從未在人類中描述過的具有此類細胞類型的腫瘤。

值得注意的是，病例2的患者有顱縫早閉導致斜頭症的病史，並在6個月大時接受手術治療。然而，根據目前的研究和數據，尚無法確定這些腫瘤是否與特定的基因變異或全身疾病有關。在隨後的研究中，需要更多的患者數據來確定這些腫瘤的特徵、自然史以及潛在的全身關聯。

總之，本病例系列報告了4名患有視網膜內核層良性腫瘤的患者，這些腫瘤與以前描述的腫瘤類型有所不同。雖然目前的研究和患者數據有限，但這些發現為未來進一步研究和了解這種新型視網膜腫瘤提供了基礎。

An Eye-Trackinge Based Dichoptic Home Treatment for Amblyopia

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An Eye-Trackinge Based Dichoptic Home Treatment for Amblyopia

Created
Tags CGMHOPH Neuro,pediatric
Journal Ophthalmology
Status 已上網
校稿者 黃奕修 醫師

Tamara Wygnanski-Jaffe MD, Burton J. Kushner MD, Avital Moshkovitz PhD, Michael Belkin MD 及 Oren Yehezkel PhD
Ophthalmology, 2023-03-01, 卷 130, 期 3, 頁面 274-285, Copyright © 2022 American Academy of Ophthalmology

英文摘要

This study compared the efficacy of a novel binocular eye-tracking-based home treatment with traditional patching treatment in improving visual acuity in children with amblyopia. A total of 103 children aged 4 to 9 years with anisometropic, small-angle strabismic, or mixed amblyopia participated in the trial. The results demonstrated that the novel binocular treatment and conventional patching treatment had similar effects on visual acuity improvement after 16 weeks. Additionally, significant improvements in stereopsis and binocular visual acuity were observed in the binocular treatment group, despite a treatment duration twice as short as that of the patching group. No potential risks, such as diplopia, eye strain, and seizures, were observed in the binocular treatment group.

中文摘要

本研究比較了一種新型的雙目眼動追踪為基礎的家庭治療與傳統貼片治療在改善弱視兒童視力方面的成效。103名4至9歲患有不等視性、小角度斜視或混合性弱視的兒童參加了試驗。研究結果顯示，新型雙目治療與傳統貼片治療在16周後的視力改善方面具有相似的效果。此外，雙目治療組在立體視和雙眼視力方面也顯著改善，儘管治療時間是貼片組的兩倍短。雙目治療組未出現譬如雙視、眼部疲勞和癲癇發作等潛在風險。