Purpose: To survey recently graduated European ophthalmologists concerning cataract surgery (CS) training opportunities. Setting: Countries affiliated to the European Board of Ophthalmology (EBO). Design: Cross-sectional study of anonymous survey results. Methods: A 23-question online survey was emailed to candidates who sat the EBO Diploma Examination as residents between 2018 and 2022. Results: 821 ophthalmologists from 30 countries completed the survey. The mean residency duration was 4.73 (SD 0.9) years. The mean reported number of entire CS procedures performed was 80.7 (SD 100.6) at the end of residency, but more than 25% of respondents (n = 210) had received no live CS training during their residency. The self-confidence (scale, 1 to 10) to perform a simple case or challenging case, manage posterior capsular rupture, and realize a corneal stitch were rated 4.1, 3.2, 4.2, 2.4, respectively. We observed extensive variation in clinical exposure to CS and self-reported confidence to perform CS between European trainees. Females reported a mean of 18% fewer entire procedures than their male colleagues and were also less confident in their surgical skills (P < .05). Trainees in residency programs longer than 5 years performed fewer procedures and were less confident than trainees in residences of shorter duration (P < .001). The importance of fellowships to complete surgical education was rated 7.7 out of 10. Conclusions: CS training across European countries lacks harmony. Female ophthalmology trainees continue, as in other specialties, to experience apparent gender bias. European level recommendations seem necessary to raise and harmonize competency-based CS training programs and promote post-residency fellowship training programs.
21 November 2019 in Graefe's Archive for Clinical and Experimental Ophthalmology
The purpose of this study was to determine the value of duplex and color Doppler sonography in the detection of ocular involvement in Behçet's disease. Duplex and color Doppler sonography was done in 21 patients with Behçet's disease and ocular involvement and in 22 patients with Behçet's disease but without ocular involvement. Twenty health volunteers also were examined as a control group. Flow velocities in the central retinal artery, posterior ciliary arteries, and ophthalmic artery were measured in the patients with Behçet's disease. In patients with Behçet's disease and ocular involvement, peak systolic velocities in the central retinal, posterior ciliary, and ophthalmic arteries were 7.3 +/- 2.3, 12.8 +/- 3.1, and 35.8 +/- 7.2 cm/sec, respectively. In patients with Behçet's disease but without ocular involvement, these values were 10.0 +/- 1.9, 17.3 +/- 3.4, and 33.5 +/- 4.0 cm/sec, respectively. In control subjects, the respective calculated values were 12.3 +/- 1.0, 16.5 +/- 1.6, and 35.8 +/- 4.4 cm/sec. For the central retinal and posterior ciliary arteries, peak systolic and diastolic velocities were significantly lower in patients with Behçet's disease and ocular involvement than in control subjects and patients with Behçet's disease but without ocular involvement (p < .001). Peak systolic and diastolic velocities in the central retinal artery were significantly lower in patients with Behçet's disease but without ocular involvement than in the control group (p < .001); however, no difference was observed for the posterior ciliary artery. Flow velocities in the ophthalmic artery were not significantly different among groups. These findings suggest that duplex and color Doppler sonography may be helpful in the diagnosis of ocular involvement in patients with Behçet's disease.
1 September 2019 in Journal of Neuro-Ophthalmology
Background: Although alterations in the peripapillary retinal nerve fiber layer (RNFL) in patients with idiopathic intracranial hypertension (IIH) have been characterized using optical coherence tomography (OCT), there are little data regarding the peripapillary vasculature in this patient population. Our aim was to evaluate findings of OCT angiography (OCT-A) in the peripapillary region in addition to the RNFL measurements on OCT in patients with IIH. Methods: Thirty-eight eyes of 19 patients with IIH and 42 eyes of 21 healthy controls were enrolled in our study. Papilledema was graded according to the Frisen scale. Peripapillary RNFL and vessel density were evaluated with OCT and OCT-A, respectively. Results: RNFL thickness was found to be increased with OCT, but this was statistically significant only in the inferior location in IIH patients when compared with the control group. There was a significant decrease in mean peripapillary vessel density measured with OCT-A in IIH patients with papilledema when compared with the control group (P < 0.05). Conclusions: In patients with IIH, there was a decrease in peripapillary vessel density measured by OCT-A, and this decrease may be a consequence of the swelling of axons in the peripapillary retina due to papilledema. However, autoregulatory vascular mechanisms may also play a role in decreased peripapillary vessel density.