Background: The background of this study was to evaluate the relationship between hyperemia, vascularization index (VI), and recurrence characteristics in recurrent pterygium using objective digital image analysis and to assess the reproducibility of the proposed imaging methodology. Methods: A prospective cross-sectional study was conducted in 25 patients with recurrent pterygium. Standardized anterior segment photographs were obtained and analyzed using Fiji (ImageJ). Hyperemia, VI, and morphometric parameters, including relative area (AR%), were quantified using image-processing algorithms. Associations between imaging parameters and recurrence characteristics were evaluated using linear regression models. Interobserver reproducibility was assessed using Cohen’s kappa coefficient. Results: Twenty-five eyes from 25 patients were included (8 men and 17 women; mean age, 60.9 ± 6.6 years). Most recurrences occurred within 1–3 years after surgery (mean, 2.28 ± 1.06 years). Median hyperemia grade was 2 (range, 1–3). Mean VI was 42.7% ±19.7%, and mean AR% was 14.2% ±10.9%. No significant associations were found between VI, hyperemia, AR%, age, sex, and time to recurrence (all P > 0.05). Interobserver agreement was good for hyperemia assessment (κ =0.78) and very good for VI measurements (κ = 0.84). Conclusions: Digital image analysis is a reproducible and objective tool for quantifying hyperemia and vascularization in recurrent pterygium, supporting standardized clinical assessment.
Purpose: To determine the prevalence of visual impairment (VI) and blindness in a tertiary eye care cohort, and to identify associated risk factors using World Health Organization (WHO) criteria applied to the better-seeing eye (BSE). Subjects and Methods: Retrospectively reviewed 17,537 myopic subjects aged 10–35 years from India. All patients underwent standardized examinations, including refraction, best-corrected visual acuity, and fundus assessment. Isomyopia, anisomyopia, and high anisomyopia were defined by interocular spherical equivalent differences. Retinal changes were graded by META-pathologic myopia criteria. The VI and blindness were classified per WHO definitions applied to the BSE. Multivariable logistic regression identified independent risk factors for VI. Results: Of 17,537 participants, 79.4% had isomyopia, 16.7% had anisomyopia, and 3.9% had high-anisomyopia. The BSE-defined VI was observed in 0.6% overall (isomyopia: 0.3%; anisomyopia: 1.5%; and high anisomyopia: 2.8%). One participant met WHO criteria for blindness. In multivariable analysis, very high myopia was the strongest predictor of VI (adjusted odds ratio [aOR]: 31.8; 95% confidence interval: 3.50–289.4; P = 0.002), followed by pathological myopia (aOR: 7.9; P < 0.001). After adjustment, anisomyopia and high anisomyopia were associated with lower odds of BSE-defined VI (aOR: 0.21 and 0.02; both P < 0.001), a finding likely attributable to preservation of vision in the fellow eye rather than a true protective biological effect. Conclusion: In this hospital-based cohort, WHO-defined VI was uncommon overall but increased with greater interocular asymmetry, while blindness was rare and limited to high anisomyopia. Very high myopia and pathologic retinal changes were the strongest predictors of VI, highlighting the need for early detection, axial-length monitoring, and targeted retinal surveillance in high-anisomyopia patients.
Context: Visual disorders in adolescents are an important public health issue, particularly in vulnerable populations such as riparian communities, where access to ophthalmologic care is limited. Aims: The aims of this study were to describe the prevalence of ocular disorders among adolescents evaluated in the Looking to the Future Project (Projeto Enxergando o Futuro), identify predictors of refractive errors, assess the influence of age and sex, and estimate effective refractive error coverage (eREC). Settings and Design: This was a cross-sectional study conducted in a riparian population, analyzing a subset of students enrolled in the project. Subjects and Methods: A total of 228 adolescents aged 11–18 years were evaluated. Variables included visual complaints, use of corrective lenses, ocular motility, eyelid and conjunctival findings, Ishihara color vision testing, cycloplegic refraction, biomicroscopy, and retinography. The mean spherical equivalent was calculated. Statistical Analysis Used: Descriptive statistics were expressed as absolute and relative frequencies. Predictors of refractive errors were analyzed using univariate and multivariate logistic regression models. Model performance was assessed using receiver operating characteristic (ROC) curves. eREC was calculated. Results: Among the evaluated students (52.6% – male), blurred vision was the most frequent complaint (34.2%). The prevalence of myopia was 10.1%, hyperopia 8.3%, and astigmatism 2.2%, totaling 21.1% ametropia. Amblyopia was identified in 4.4% of participants. Altered extraocular motility was observed in 4.8%, color vision deficiency in 2.2%, and retinographic abnormalities in 2.2%. Myopia progression was estimated at −0.181 D/year. Age, blurred vision, tearing, and prior use of glasses were independent predictors of refractive errors, mainly driven by myopia. For hyperopia, tearing was the only independent predictor. ROC curve areas ranged from 0.77 to 0.81. Global eREC was 17.65%. Conclusions: There was a high prevalence of ametropia among riparian adolescents, with evidence of progressive myopia. The low eREC highlights gaps between diagnosis and correction, supporting the need for strengthened public health strategies, including age-stratified screening and periodic follow-up.
Background: Ethambutol is a first-line antituberculosis agent widely associated with ocular toxicity, particularly optic neuropathy. However, its potential effects on corneal histology and anterior segment structures remain poorly understood. Objective: This study aimed to evaluate histopathological changes in the cornea following high-dose ethambutol administration in a mouse model. Methods: This experimental laboratory study involved 10 healthy adult BALB/c mice randomly divided into control and treatment groups. The treatment group received oral ethambutol at a dose of 25 mg/kg body weight daily for 28 days, whereas the control group received distilled water under identical conditions. After euthanasia, ocular tissues were harvested and processed for histological examination using hematoxylin and eosin staining. Corneal layers, including the epithelium, stroma, Descemet’s membrane, and endothelium, were evaluated microscopically for structural alterations. Results: Histological analysis demonstrated notable corneal alterations in the ethambutol-treated group compared with controls. The observed changes included epithelial thinning, stromal edema, inflammatory cell infiltration, irregularity of Bowman’s layer, and endothelial cell pleomorphism with reduced cellular density. Mean corneal thickness was lower in teh treatment group (160.27 µm) than in the control group (166.61 µm); however, the difference was not statistically significant (P = 0.079). These findings suggest possible dose-related anterior segment toxicity associated with systemic ethambutol exposure. Conclusion: High-dose ethambutol administration may induce histopathological changes in the cornea, suggesting potential anterior segment toxicity. Further studies are required to determine the clinical relevance and reversibility of these findings in humans.
Background: Transphotorefractive keratectomy (tPRK) is an evolving surface ablation technique for the correction of myopia that avoids flap-related complications while aiming to provide excellent refractive outcomes. However, evidence regarding its impact on optical quality and aberrometric parameters remains limited. Aims and Objectives: To evaluate the safety, efficacy, predictability, and optical quality of one-step transphotorefractive keratectomy using an aberration-free treatment profile through clinical and aberrometric assessment. Materials and Methods: This retrospective analytical study included patients aged 21–50 years with myopia, with or without astigmatism, and a preoperative spherical equivalent between 0 and −9.50 diopters who underwent one-step tPRK using the SCHWIND Amaris 1050RS excimer laser. Clinical data were collected preoperatively and at postoperative days 1, 7, 30, and 90. Outcomes were assessed according to safety, efficacy, predictability, and optical quality using visual acuity, refraction, corneal thickness, Sirius corneal aberrometry, and Peramis ocular aberrometry. Results: Sixty-one eyes from 47 patients were included. Mean patient age was 34 years, and the median preoperative spherical equivalent was −4.5 D, improving to −0.25 D at 30 days and remaining stable at 90 days (P < 0.001). The predictability index was 96.1%, and the safety index was 1.52, with no eye losing more than two lines of corrected distance visual acuity. Total corneal root mean square (RMS) decreased from 1.27 to 0.99 µm (P = 0.007). Ocular RMS decreased by approximately 80% (7.35 to 1.30 µm), while the Strehl ratio improved from 0.02 to 0.17, representing an 85% increase in optical quality. Conclusion: One-step tPRK demonstrated excellent safety, efficacy, and refractive predictability, while significantly improving optical quality. Despite an increase in higher-order aberrations, the reduction in total RMS and improvement in Strehl ratio indicate enhanced retinal image quality and support the effectiveness of the aberration-free treatment profile.
