搜索结果：Transactions of the Ophthalmological Society of Australia

This year we celebrate the publication of the 50th volume of Clinical and Experimental Ophthalmology (CEO), the official journal of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). The roots of the journal lie in the Transactions of the Ophthalmological Society of Australia, which was published annually from 1939 to 1971 to record the proceedings from the annual meeting of the Ophthalmological Society of Australia. With the formation of the Australian College of Ophthalmologists in 1969, a standardised training programme was developed for Australian ophthalmologists. It was then decided that the annual meeting proceedings would be suspended, and a full journal would be launched to stimulate reporting of clinical and academic activities, and to support clinical education. Thus, in 1973, the first of three annual issues of the Australian Journal of Ophthalmology (AJO) was published. Today, with an estimated 30 000 or more academic journals currently in existence, the launch of another would hardly raise eyebrows. However, 50 years ago the founding members felt obliged to apologise for adding to the number of scientific publications: ‘While the proliferation of another medical journal is regretted, it is a necessary part of fulfilling some of the objectives of the College’.1 Each of the five decades since the launch has seen change and transformation as the journal has kept abreast with developments in academic publishing. Since the launch of what was to become CEO in 1973, there have been nine Editors-in-Chief, each of whom shaped the journal with their own vision and strategy. The 1980s was a period of early growth. In 1982, external reviewers were utilised for the first time, as the Editor-in-Chief recognised that the Editorial Board would struggle to provide expert opinions on the diverse yet increasingly specialised topics. In 1985, the AJO merged with the Transactions of the Ophthalmological Society of New Zealand to form the Australian and New Zealand Journal of Ophthalmology (ANZJO). This cemented the ties between the ophthalmic communities of both countries and was the precursor to the merging of the Australian and New Zealand ophthalmic societies a decade later. During the 1990s, the Editor-in-Chief discussed the merits of the emerging ISI ‘citation index’2 and worked to entice Australasian authors to publish their best research in ANZJO. In 1999 the journal expanded to six annual issues, and was also launched online on the World Wide Web, enabling readers from all over the world to access articles. The 2000s were a time of globalisation as the journal evolved from a regionally focussed publication into a highly respected international journal. In 2000, the journal name was changed to Clinical and Experimental Ophthalmology to appeal to a larger and more international authorship and readership, and 6 years later the annual volume was expanded to the current nine issues. In 2009, the first Special Issue was published, featuring a selection of invited review papers on the theme of imaging in ophthalmology. During the 2010s, CEO became the first ophthalmology journal to launch an iPad app, and evolved into a top tier journal. After a decade of dedicated focus by the Editors-in-Chief on improving the quality of the published articles, the Journal Impact Factor (JIF) increased such that by 2019, CEO was ranked 11th in the field of ophthalmology in the world and the journal became one of the highest JIF-ranked medical journals in Australasia. In the past 2 years, CEO has become the first quartile-1 ophthalmology journal to appoint a woman Editor-in-Chief, and women's representation on the Editorial Board has increased to 50%. The first CEO Social Media Editor has recently been appointed, and the subsequent launch on Twitter has resulted in CEO papers achieving record Altmetric scores. Of course the ultimate success of a journal can be measured by the impact of the published papers on fellow researchers, practice or policy. Citations are considered the key indicator of impact, so as we celebrate the 50th anniversary of CEO, it seems timely to reflect on the articles that have generated the most citations over the years. Looking at the impactful articles from the last 50 years, seven papers stand out, having attracted more than 200 cites since publication. The oldest of these was published in 1998; a clinical science study presenting an 18-month follow-up of exudative age-related macular degeneration (AMD) and intravitreal triamcinolone.3 The remaining six were all published in the current millennium. Two more clinical science papers feature in this list; one 2003 paper from the Blue Mountains Eye Study reporting on the prevalence and associations of dry eye syndrome in an older population,4 and another paper from 2001 looking at the safety and efficacy of intravitreal triamcinolone for cystoid macular oedema in uveitis.5 This latter paper is the second highest cited CEO article of the past 50 years, and has received 290 citations to date. The popularity and impact of review papers is evident, along with their ability to quickly accrue citations; four of the seven most cited papers are review articles, with three of them published in the last decade. A 2012 article focused on the epidemiology and pathophysiology of central serous chorioretinopathy,6 while a 2000 review that described the early pathology of retinal neurodegeneration in diabetes7 is the third highest cited CEO article on the list, with 282 citations to date. The remaining two papers were commissioned for editions of the journal Special Issues; the first Special Issue was published in 2009, and one has been published almost every year since. The 2012 Special Issue was based around the theme of glaucoma, and the highest cited paper from that issue aimed to define the clinical and experimental concepts of glaucoma.8 The most cited article published in 50 years of CEO is also the most recently published of all the top-cited 50 articles; a review of the global prevalence, major risk factors, screening practices and public health challenges of diabetic retinopathy9 was commissioned for the 2016 Special Issue on diabetic eye disease, and this has attracted 359 citations at the time of this article going to press. Every Editor-in-Chief knows how difficult it can be to predict which articles will have the most impact, particularly as it can take a number of years for an article to reach its peak annual citation frequency. Thus, it is interesting to look at the most cited of the recently published papers to find any clues as to new hot topics. Examining papers published during the last 2 years there are five research paper themes which are accruing good numbers of citations. Papers in the areas of glaucoma,10, 11 AMD,12, 13 cataract14, 15 and refractive surgery16 are already generating significant attention. Topical papers on COVID-1917-19 and climate change20 are also having impact, reflecting two of the most important issues facing society at this time. Examining the articles that are impacting on fellow researchers can highlight topical themes in the short term, and can measure research influence in the longer term. However, no study of the most impactful ophthalmic research published in Australasia would be complete without travelling back 80 years to Norman Gregg's seminal article, ‘Congenital cataract following German measles in the mother’,21 published in 1941 in Transactions of the Ophthalmological Society of Australia. Gregg noticed a relationship between congenital cataracts in babies born to mothers who reported rubella infection while pregnant. Despite a degree of scepticism from some peers, Gregg's theory became universally accepted, and ultimately altered the study of birth defects as researchers expanded the potential causes to include viruses. At the time of this article going to press, Gregg's paper has been cited 1289 times. As we celebrate 50 years of the RANZCO journal, we thank past and present Editors-in-Chief, Editorial Board members, authors and reviewers for their support and contributions over the years. Clinical and Experimental Ophthalmology is now accessed by more than 7000 institutions globally, with more than 350 000 article downloads each year. We continue to embrace developments in academic publishing, and look forward to another 50 years of publishing impactful articles. Victoria Cartwright is the Managing Editor for Clinical and Experimental Ophthalmology.

BACKGROUND: Keratoconus is an ectatic (weakening) disease of the cornea, which is the clear surface at the front of the eye. Approximately 10% to 15% of patients diagnosed with keratoconus require corneal transplantation. This may be full-thickness (penetrating) or partial-thickness (lamellar). OBJECTIVES: To compare visual outcomes after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty for keratoconus, and to compare additional outcomes relating to factors which may contribute to poor visual outcomes (e.g. astigmatism, graft rejection and failure). SEARCH METHODS: We searched a number of electronic databases including CENTRAL, PubMed and EMBASE without using any date or language restrictions. We last searched the electronic databases on 31 October 2013. We also handsearched the proceedings of several international ophthalmic conferences. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing the outcomes of DALK and penetrating keratoplasty in the treatment of keratoconus. DATA COLLECTION AND ANALYSIS: Two authors assessed trial quality and extracted data independently. For dichotomous data (graft failure, rejection, achievement of functional vision) results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). For continuous data (postoperative best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), keratometric astigmatism and spherical equivalent) results were expressed as mean differences (MDs) and 95% CIs. MAIN RESULTS: We identified two completed studies, with a total of 111 participants (n = 30 and n = 81), both conducted in Iran, that met our inclusion criteria. Participants had moderate to severe keratoconus pre-operatively and were randomly allocated to receive either DALK or penetrating keratoplasty. Only one eye of each participant was treated as part of the trials. The smaller study had 12 month follow-up data for all participants. For the larger study, four DALK surgeries had to be abandoned due to technical failure and visual and refractive outcomes were not measured in these participants. Follow-up length for the remaining 77 participants ranged from 6.8 to 36.4 months, with all 77 followed for at least three months post-suture removal. Details of the randomisation procedure were unavailable for the smaller study and so sensitivity analyses were conducted to determine if the results from this study had affected the overall results of the review.Neither of the included studies reported a difference between groups on any of the measures of post-graft visual achievement, keratometric astigmatism or spherical equivalent. A single case of graft failure in a penetrating keratoplasty was reported. No postoperative graft failures were reported in the DALK group of either study.Instances of graft rejection were reported in both groups, in both studies. The majority of these cases were successfully treated with steroids. The data, which related to all cases in each study - given that the four cases that did not go ahead as planned had already technically failed without presence of rejection - showed that rejection was less likely to occur in DALK (odds ratio (OR): 0.33, 95% confidence interval (CI) 0.14 to 0.81, GRADE rating: moderate).Results of the sensitivity analysis indicated that inclusion of the Razmju 2011 study did not bias the results with regards to rejection episodes. While sensitivity analysis showed altered results with regards to failure rates, the data available from the Javadi 2010 study alone had a very wide 95% CI, suggesting an imprecise estimate. Therefore, even after removal of the Razmju 2011 data, it is still difficult to draw conclusions regarding superiority of one technique over another with regards to graft failure.DALK was unable to be completed as planned in four cases and in a further three cases, complications during dissection required further intervention. Other adverse events, of varying severity, were reported in both intervention groups with similar frequency. For both types of surgery, these included postoperative astigmatism, steroid induced ocular hypertension and persistent epithelial defects. In recipients of DALK, one participant had interface neovascularisation (a proliferation of blood vessels where the host and donor cornea come together) and one had wrinkling of Descemet's membrane, the basement membrane separating the corneal stroma from the corneal endothelium. In the penetrating keratoplasty groups, one participant required graft resuturing and one had an atonic pupil, a condition in which the pupil dilates and is non-reactive.Overall, the quality of the evidence was rated as very low to moderate, with methodological limitations, incomplete data analysis and imprecision of findings, as well as high risk of bias in several areas for both studies. AUTHORS' CONCLUSIONS: We found no evidence to support a difference in outcomes with regards to BCVA at three months post-graft or at any of the other time points analysed (GRADE rating: very low). We also found no evidence of a difference in outcomes with regards to graft survival, final UCVA or keratometric outcomes. We found some evidence that rejection is more likely to occur following penetrating keratoplasty than DALK (GRADE rating: moderate). The small number of studies included in the review and methodological issues relating to the two, mean that the overall quality of the evidence in this review is low. There is currently insufficient evidence to determine which technique may offer better overall outcomes - final visual acuity and time to attain this, keratometric stabilisation, risk of rejection or failure, or both, and risk of other adverse events - for patients with keratoconus. Large randomised trials comparing the outcomes of penetrating keratoplasty and DALK in the treatment of keratoconus are needed.

Seasonal cyclicity is a ubiquitous feature of acute infectious diseases [1] and may be a ubiquitous feature of human infectious diseases in general, as illustrated in Tables 1–4. Each acute infectious disease has its own seasonal window of occurrence, which, importantly, may vary among geographic locations and differ from other diseases within the same location. Here we explore the concept of an epidemic calendar, which is the idea that seasonality is a unifying feature of epidemic-prone diseases and, in the absence of control measures, the local calendar can be marked by epidemics (Fig 1). A well-known example of a calendar marked by epidemics is that of the Northern Hemisphere, where influenza outbreaks occur each winter [2, 3] (hence the colloquial reference to winter as "the flu season"). In contrast, chickenpox outbreaks peak each spring [4, 5], and polio transmission historically occurred each summer [6]. Seasonal variation in infectious disease transmission plays an important role in determining when epidemics happen; however, it is not the sole determinant. For instance, some infectious diseases with known seasonal transmission, such as pertussis and measles, can display multi-annual outbreaks, meaning their epidemics occur in multi-year intervals, such as every two or four years, rather than annually. This is because the timing of these epidemics is determined by a combination of (i) seasonal transmission and (ii) different processes shaping the number of susceptible individuals in the population, a sufficient number of which is a prerequisite for an outbreak. Within the fields of infectious disease ecology and epidemic modeling, seasonal variation in transmission is known as seasonal forcing [78]. Over the past century, attention has been paid to detailing the cyclicity and mechanisms of seasonal forcing for a few diseases of public interest, such as measles, influenza, and cholera (e.g., see contemporary work by [3, 79, 80]). Despite these notable examples, disease seasonality has yet to be systemically and/or rigorously characterized for the majority of infections. Here, I aim to motivate future studies of disease seasonality by drawing attention to the importance of seasonality in public health, medicine, and biology. I will explore documented seasonal cycles in human infections, including notifiable and neglected tropical diseases. I also aim to present a holistic view of hypothesized drivers of seasonality for each disease, with the caveat that, for the majority of infections, the current state of the science is insufficient to draw conclusions about seasonal timing, seasonal magnitude, and geographic variation in incidence. Although published data regarding disease seasonality are limited for individual diseases, collectively the body of work on disease seasonality is vast and reveals that infections—which may differ enormously in their pathology and/or ecology—coalesce via underlying seasonal drivers.

OCCUPATIONAL APPLICATIONS Ophthalmologists and other eye-care physicians frequently use clinical examination equipment that restricts access to patients and requires the adoption of sustained, non-neutral working postures of the neck and shoulders. The use of ergonomic principles in the design of examination equipment could help reduce these physical demands, which may be partly responsible for the high prevalence of neck and shoulder pain among ophthalmologists. This study compared the effects of a set of this alternative “ergonomic” equipment to a set of conventional equipment on measures of neck and shoulder muscle activity and upper arm posture during simulations of common clinical ophthalmologic tasks. Results suggested that some aspects of the alternative equipment may help reduce exposures to sustained, non-neutral working postures of the neck and shoulder among ophthalmologists. Ophthalmologists and other eye-care physicians may consider implementing similar alternative equipment interventions into their practices.TECHNICAL ABSTRACT Background: Ophthalmologists report a high prevalence of work-related musculoskeletal symptoms, particularly of the neck and shoulders. Improving the design of equipment used in the clinical environment may reduce exposures to physical risk factors (e.g., sustained muscular exertions and non-neutral postures) associated with neck and shoulder pain among ophthalmologists. Purpose: This study compares estimates of neck and shoulder muscle activity and upper arm posture during use of conventional and alternative examination equipment common in clinical ophthalmologic practice. Methods: Fifteen ophthalmologists performed one mock clinical examination using conventional equipment and one mock clinical examination using alternative equipment with the potential to reduce exposure to sustained muscular exertions and non-neutral upper arm postures. The alternative equipment included a slit lamp biomicroscope with inclined viewing oculars, adjustable elbow supports, and a wider tabletop with more room for supporting the arms in comparison to the conventional slit lamp biomicroscope. A wireless binocular indirect ophthalmoscope was also evaluated that had a more even weight distribution than the conventional design. Measurements of upper trapezius and anterior deltoid muscle activity, upper arm posture, and perceived usability were used to compare the conventional and alternative equipment. Results: In comparison to the conventional slit lamp biomicroscope, the alternative slit lamp biomicroscope led to (i) 12% to 13% reductions in upper trapezius muscle activity levels, (ii) a 9% reduction in left anterior deltoid muscle activity levels, and (iii) a 15% reduction in the percentage of work time spent with the left upper arm elevated in positions greater than 60º. In addition, participants rated the comfort and adjustability of both the alternative slit lamp biomicroscope and binocular indirect ophthalmoscope more favorably than the conventional equipment. Conclusions: The results suggest that the alternative slit lamp biomicroscope may help to reduce overall muscular demands and non-neutral postures of the neck and shoulder region among ophthalmologists.

BACKGROUND: The Aboriginal health workforce provide responsive, culturally safe health care. We aimed to co-design a culturally safe course with and for the Aboriginal health workforce. We describe the factors which led to the successful co-design, delivery, and evaluation of the "Managing hepatitis B" course for the Aboriginal health workforce. METHODS: A Participatory Action Research approach was used, involving ongoing consultation to iteratively co-design and then develop course content, materials, and evaluation tools. An Aboriginal and Torres Strait Islander research and teaching team received education in chronic hepatitis B and teaching methodologies. Pilot courses were held, in remote communities of the Northern Territory, using two-way learning and teach-back methods to further develop the course and assess acceptability and learnings. Data collection involved focus group discussions, in-class observations, reflective analysis, and use of co-designed and assessed evaluation tools. RESULTS: Twenty-six participants attended the pilot courses. Aboriginal and Torres Strait Islander facilitators delivered a high proportion of the course. Evaluations demonstrated high course acceptability, cultural safety, and learnings. Key elements contributing to success and acceptability were acknowledging, respecting, and integrating cultural differences into education, delivering messaging and key concepts through an Aboriginal and Torres Strait Islander lens, using culturally appropriate approaches to learning including storytelling and visual teaching methodologies. Evaluation of culturally safe frameworks and findings from the co-design process led to the creation of a conceptual framework, underpinned by meeting people's basic needs, and offering a safe and comfortable environment to enable productive learning with attention to the following: sustenance, financial security, cultural obligations, and gender and kinship relationships. CONCLUSIONS: Co-designed education for the Aboriginal health workforce must embed principles of cultural safety and meaningful community consultation to enable an increase in knowledge and empowerment. The findings of this research can be used to guide the design of future health education for First Nations health professionals and to other non-dominant cultures. The course model has been successfully transferred to other health issues in the Northern Territory.

Abstract Arthropods are the cause of considerable human morbidity. In spite of numerous text books and reviews published on arthropods of medical importance, this is the first paper in the world to present a comprehensive review of specimens sent to a medical entomology laboratory over an extended period. The Department of Medical Entomology at Westmead Hospital is the New South Wales reference laboratory for arthropods of medical importance. In the years 1988–2017, there were 5655 samples submitted for identification. Some 25 orders, 188 families and 177 different genera were recorded, with 170 unique species. The most common specimens included the Australian paralysis tick Ixodes holocyclus (708 specimens submitted), the bird mite Ornithonyssus bursa (506), bed bugs Cimex spp. (149), moth flies Clogmia spp. (135), head lice Pediculus capitis (105), pubic lice Pthirus pubis (91) and scabies Sarcoptes scabiei (57). In 1211 samples submitted, there was no evidence for any life stages of arthropods. For these common samples, data analysed included yearly and seasonal trends, female vs. male patient submissions and the age classes of the patients. Some species such as I. holocyclus , O. bursa , Cimex spp., Clogmia spp. and P. capitis demonstrated strong seasonal trends. In the case of the female vs. male patients, there were significant differences in submissions with O. bursa , P. capitis , P. pubis and with the samples containing no arthropod evidence. Of these, only with P. pubis did more males submit than females. Younger ages classes (<10 years) were more associated with I. holocyclus and P. capitis , older patients >70 years) with scabies, mature females (50–69 years) with samples containing no evidence of arthropods and middle‐aged adults (40–69) with the remainder of the common samples. Key diagnostic features are included for some of the more challenging arthropod species to distinguish and as well as case studies provided of situations involving unique or unusual infestations. The data provides useful information on the risks that arthropods of medical importance pose to the community and will refine educational programs.

IMPORTANCE: Australia is the only developed country to still have pockets of endemic trachoma. The research provides up-to-date, population-based prevalence data of later complications of trachoma amongst a national sample of Indigenous adults. BACKGROUND: To report the prevalence of trachomatous trichiasis (TT) in Indigenous Australians aged 40 years and older. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 1738 (41% male) Indigenous Australians aged 40 years or older, living amongst 30 randomly selected Australian sites, stratified by remoteness. METHODS: Anterior segment examination was performed and trachoma grading for the presence of TT and corneal opacification (CO) was conducted using the WHO (WHO) simplified grading system. MAIN OUTCOME MEASURES: Prevalence of TT. RESULTS: A total of three (0.17%) participants had TT, and there were no confirmed cases of trachomatous CO in the NEHS. All three participants with TT were female and aged 40 years or older. Although they had likely spent their childhoods in more remote areas, two of the three confirmed cases resided in an urban and outer regional area at the time of their examinations. CONCLUSIONS AND RELEVANCE: Our data are in line with ongoing national trachoma surveillance reports that suggest the prevalence of late sequences of trachoma appear to be decreasing in Australia.

The annexation of Austria by Nazi Germany from 1938 to 1945, or "Anschluss", was the darkest chapter in the country's history. The contributions presented in this paper demonstrate that we still feel the aftermath of this horrible period. It was horrible not only because Austria was a victim of Nazi terror, but, moreover, was a perpetrator of it. While invading Austria, poorly prepared German troops were surprised to be received with cheering crowds, much less the overcrowded Heldenplatz during Hitler's speech to the Austrian population on 15 March 1938. Everything was well prepared for the arrival of the German occupiers: already the years before, subsidiaries of the NSDAP were active in Austria, and there were suddenly hundreds of thousands of swastikas and flags available and an extreme and sophisticated system of denunciation. Many Austrians, including doctors, achieved leading positions during the Nazi period. Doctors represented the highest proportion of Austrian academics who were members of the NSDAP (though it is worth noting that many of their Jewish colleagues had already been expelled from the country), and they were heavily implicated in committing ethical misconduct, in particular in the execution of the "euthanasia" T4-programme, where handicapped children and adults were killed. After World War II, many tainted physicians and university professors were reinstated in their former positions and had the opportunity of a post-war career. This was the main reason for the general backlog in research and development in Austria in comparison with most countries of the Western world.

PURPOSE: Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All humans have physiologic tremors that are of low amplitude and not discernible to the naked eye; they do not adversely affect the majority of the population's daily functioning. However, during microsurgery, such tremors can be problematic. In this review, we focus on the impact of physiological tremors on ophthalmic microsurgery and offer a comparative discussion on the impact of such tremors on other surgical specialties. METHODS: A single investigator used the MEDLINE database (via PubMed) to search for and identify articles for inclusion in this systematic review. Ten key factors were identified as potentially having an impact on tremor amplitude: beta-blockers, muscle fatigue, robotic systems, handheld tools/micromanipulators, armrests/wrist supports, caffeine, diet, sleep deprivation, consuming alcohol, and workouts (exercise). These key terms were then searched using the advanced Boolean search tool and operators (i.e., AND, OR) available on PubMed: (*keyword*) AND (surgeon tremor OR microsurgery tremor OR hand steadiness OR simulator score). RESULTS: Ten studies attempted to quantify the baseline severity of operator physiologic tremor. Approximately 89% of studies accessing the impact of tremors on performance in regards to surgical metrics reported an improvement in performance compared to 57% of studies concluding that tremor elimination was of benefit when considering procedural outcomes. CONCLUSIONS: Robotic technology, new instruments, exoskeletons, technique modifications, and lifestyle factors have all demonstrated the potential to assist in overcoming tremors in ophthalmology.

Abstract Pluripotent stem cells (PSCs) hold great potential for novel therapeutic approaches to regenerate or replace functionally impaired tissues. Since the introduction of the induced pluripotent stem cell technology in 2006, the number of scientific publications on this topic has constantly been increasing. However, so far no therapy based on PSCs has found its way into routine clinical use. In this study, we examined research trends related to clinical trials involving PSCs based on data obtained from ClinicalTrials.gov, the ICTRP database from the World Health Organization, as well as from a search of all individual databases that are included in the ICTRP using a multistep search algorithm. Following a stringent inclusion/exclusion procedure 131 studies remained that could be classified as clinical trials involving PSCs. The magnitude of these studies (77.1%) was observational, which implies that no cells were transplanted into patients, and only a minority of studies (22.9%) were of an interventional study type. The number of clinical trials involving induced pluripotent stem cells (iPSCs, 74.8%) was substantially higher than the one involving embryonic stem cells (ESCs, 25.2%). However, the picture changes completely when focusing on interventional studies, where in the majority (73.3%) of cases ESCs were used. Interestingly, also the study duration was significantly shorter for interventional versus observational trials ( p = 0.002). When focusing on the geographical study regions, it became obvious that the greatest part of all observational trials was performed in the USA (41.6%) and in France (16.8%), while the magnitude of interventional studies was performed in Asian countries (China 36.7%, Japan 13.3%, South Korea 10.0%) and in the field of ophthalmology. In summary, these results indicate that only a limited number of trials were focusing on the actual transplantation of PSCs into patients in a rather narrow field of diagnoses. The future will tell us, if the iPSC technology will ultimately overcome the current challenges and will finally make its way into routine clinical use.

Sero-survey of rubella IgM antibodies was carried out among children aged 0-10 years in Jos, Nigeria. Blood samples were collected from the subjects and sera extracted. Of the 93(100%) assayed for the rubella IgM antibody, 42(45.2%) were seropositive for rubella IgM antibody while 51(54.8%) were seronegative. A breakdown of the seropositive subjects reveals that 14(15.1%) of the infected children were males while 28(30.1%) were females. Those subjects within the age groups of 1-2, 3-4 and 5-6 years had the highest prevalence of 8(8.6%) followed by those within the age groups of 7-8, 9-10 years with 7(7.5%). Blood transfusion as a risk factor did not show any significant influence on the status of the subjects. The demographic data of the mothers of the subjects were also linked with the seropositivity of the children.

BACKGROUND: AI-powered image generation technology holds the potential to reshape medical practice, yet it remains an unfamiliar technology for both medical researchers and clinicians alike. Given the adoption of this technology relies on clinician understanding and acceptance, we sought to demystify its use in ophthalmology. To this end, we present a literature review on image generation technology in ophthalmology, examining both its theoretical applications and future role in clinical practice. METHODS: First, we consider the key model designs used for image synthesis, including generative adversarial networks, autoencoders, and diffusion models. We then perform a survey of the literature for image generation technology in ophthalmology prior to September 2024, presenting both the type of model used and its clinical application. Finally, we discuss the limitations of this technology, the risks of its misuse and the future directions of research in this field. RESULTS: Applications of this technology include improving AI diagnostic models, inter-modality image transformation, more accurate treatment and disease prognostication, image denoising, and individualised education. Key barriers to its adoption include bias in generative models, risks to patient data security, computational and logistical barriers to development, challenges with model explainability, inconsistent use of validation metrics between studies and misuse of synthetic images. Looking forward, researchers are placing a further emphasis on clinically grounded metrics, the development of image generation foundation models and the implementation of methods to ensure data provenance. CONCLUSION: Compared to other medical applications of AI, image generation is still in its infancy. Yet, it holds the potential to revolutionise ophthalmology across research, education and clinical practice. This review aims to guide ophthalmic researchers wanting to leverage this technology, while also providing an insight for clinicians on how it may change ophthalmic practice in the future.

BACKGROUND: Local tolerance of topical glaucoma treatment is important to achieve a good compliance. The aim of this study was to evaluate the consequences of local anti-glaucoma drug side effects on the vision-related quality of life (QoL). METHODS: A mail survey was sent to 20,000 homes of a panel representative of the French population asking whether one member of the family was suffering from ocular hypertension (OHT) or glaucoma. (POAG) A computer-assisted telephone interviewing system was used to confirm self-reported glaucoma, to describe the disease and its treatment, and medical item consumption. Vision-related QoL was assessed with the NEI-VFQ-25 (National Eye Institute Visual - Function Questionnaire) and local tolerance with the COMTOL (Comparison of Ophthalmic Medications for TOLerability). RESULTS: 13,352 homes (66.7%) answered the mail. 581 people declared they were suffering from glaucoma or OHT. Prevalence was 1.8%, increasing with age. 204 patients were selected at random Their NEI-VFQ-25 global score showed an overall good QoL. Two domain scores showed some deterioration: general health and driving. 62.4% of the patients cited at least one local side effect. 25.4% had burning, 20.8% blurred vision and 20.2% tearing. Poor vision related QoL was associated with the presence of local side effects leading to poor perceived treatment satisfaction. Dissatisfied patients visited their ophthalmologist more frequently. CONCLUSION: Based on a representative French sample, poor vision related QoL was associated with topical drug side effects that also impact patient satisfaction and compliance. Longitudinal data collection should be performed to confirm our findings.

An analysis was conducted of the major findings of a long term follow up study of 3076 subjects who were exposed to viral infections in utero and who at the time of analysis were up to 40 years of age. Mortality and morbidity were compared with those in a control population matched for sex and date and area of birth. An excess of cancers (16 cases against seven) appeared to be clustered among those exposed to herpes viruses (varicella or cytomegalovirus). There was evidence of an increased risk of diabetes among those exposed to mumps during the first trimester (four cases among 128 subjects against none in 148 controls). The most surprising finding was a decrease of diseases of the skin and subcutaneous tissue and of the nervous system among subjects exposed to antenatal varicella zoster infection. The mechanism for the association may include production of fetal anti-idiotype antibodies in response to transplacentally acquired maternal autoantibodies.

An epidemiological and genetical study of osteogenesis imperfecta (OI) in Victoria, Australia confirmed that there are at least four distinct syndromes at present called OI. The largest group of patients showed autosomal dominant inheritance of osteoporosis leading to fractures and distinctly blue sclerae. A large proportion of adults had presenile deafness or a family history of presenile conductive hearing loss. A second group, who comprised the majority of newborns with neonatal fractures, all died before or soon after birth. These had characteristic broad, crumpled femora and beaded ribs in skeletal x-rays. Autosomal recessive inheritance was likely for some, if not all, of these cases. A third group, two thirds of whom had fractures at birth, showed severe progressive deformity of limbs and spine. The density of scleral blueness appeared less than that seen in the first group of patients and approximated that seen in normal children and adults. Moreover, the blueness appeared to decrease with age. All patients in this group were sporadic cases. The mode of inheritance was not resolved by the study, but it is likely that the group is heterogeneous with both dominant and recessive genotypes responsible for the syndrome. The fourth group of patients showed dominant inheritance of osteoporosis leading to fractures, with variable deformity of long bones, but normal sclerae.

Microneedles is the technique of drug delivery enhancement, which was primarily designed for facilitating percutaneous drug delivery. Started from the development of simple solid microneedles, providing microporation of stratum corneum and therefore enhancement of topical drug delivery, for two decades the technique has progressed in various modifications such as hollow, coated, dissolving and hydrogel forming microneedles. In their turn, the modifications have resulted in new mechanisms of drug delivery enhancement and followed by the expansion of applicability range in terms of targeted tissues and organs. Thus, in addition to percutaneous drug delivery, microneedles have been considered as an efficient technique facilitating ocular, oral mucosal, gastrointestinal, ungual and vaginal drug administration. It is anticipated that the technique of microneedle-assisted drug delivery will soon become relevant for majority of organs and tissues.

Infection by bacteria, viruses, and parasites may lead to fetal death, organ injury, or limited sequelae depending on the pathogen. Here, we consider the role of infection during pregnancy in fetal development including placental development and function, which can lead to fetal growth restriction. The classical group of teratogenic pathogens is referred to as 'TORCH' (Toxoplasma gondii, others like Treponema pallidum, rubella virus, cytomegalovirus, and herpes simplex virus) but should include a much broader group of pathogens including Parvovirus B19, Varicella zoster virus, and Plasmodium falciparum to name a few. In this review, we describe the influence of different infections in utero on fetal development and the short- and long-term outcomes for the neonate. In some cases, the mechanisms used by these pathogens to disrupt fetal development are well known. Bacterial infection of the developing fetal lungs and brain begins with an inflammatory cascade resulting in cytokine injury and oxidative stress. For some pathogens like P. falciparum, the mechanisms involve oxidative stress and apoptosis to disrupt placental and fetal growth. An in utero infection may also affect the long-term health of the infant; in many cases, a viral infection in utero increases the risk of developing type 1 diabetes in childhood. Understanding the varied mechanisms employed by these pathogens may enable therapies to attenuate changes in fetal development, decrease preterm birth, and improve survival.