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Bajaj G, Singh V, Sagar P, Gupta R, Singhal NK. Phosphoenolpyruvate carboxykinase-1 targeted siRNA promotes wound healing in type 2 diabetic mice by restoring glucose homeostasis. Int J Biol Macromol 2024; 270:132504. [PMID: 38772464 DOI: 10.1016/j.ijbiomac.2024.132504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
It is well-accepted that the liver plays a vital role in the metabolism of glucose and its homeostasis. Dysregulated hepatic glucose production and utilization, leads to type 2 diabetes (T2DM). In the current study, RNA sequencing and qRT-PCR analysis of nanoformulation-treated T2DM mice (TGthr group) revealed beneficial crosstalk of PCK-1 silencing with other pathways involved in T2DM. The comparison of precise genetic expression profiles of the different experimental groups showed significantly improved hepatic glucose, fatty acid metabolism and several other T2DM-associated crucial markers after the nanoformulation treatment. As a result of these improvements, we observed a significant acceleration in wound healing and improved insulin signaling in vascular endothelial cells in the TGthr group as compared to the T2DM group. Enhanced phosphorylation of PI3K/Akt pathway proteins in the TGthr group resulted in increased angiogenesis as observed by the increased expression of endothelial cell markers (CD31, CD34) thereby improving endothelial dysfunctions in the TGthr group. Additionally, therapeutic nanoformulation has been observed to improve the inflammatory cytokine profile in the TGthr group. Overall, our results demonstrated that the synthesized therapeutic nanoformulation referred to as GPR8:PCK-1siRNA holds the potential in ameliorating hyperglycemia-associated complications such as delayed wound healing in diabetes.
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Affiliation(s)
- Geetika Bajaj
- National Agri-Food Biotechnology Institute (NABI), Sector-81, S.A.S Nagar, Mohali 140306, Punjab, India; Department of Biotechnology, Panjab University, Sector 25, Chandigarh 160014, India
| | - Vishal Singh
- National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur 342005, India
| | - Poonam Sagar
- National Agri-Food Biotechnology Institute (NABI), Sector-81, S.A.S Nagar, Mohali 140306, Punjab, India
| | - Ritika Gupta
- National Agri-Food Biotechnology Institute (NABI), Sector-81, S.A.S Nagar, Mohali 140306, Punjab, India
| | - Nitin Kumar Singhal
- National Agri-Food Biotechnology Institute (NABI), Sector-81, S.A.S Nagar, Mohali 140306, Punjab, India.
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Pfeil JM, Barth T, Lagrèze WA, Lorenz B, Hufendiek K, Liegl R, Breuss H, Bemme S, Aisenbrey S, Glitz B, Süsskind D, Gabel-Pfisterer A, Skevas C, Krohne TU, Kakkassery V, Bründer MC, Engelmann K, Guthoff R, Walter P, Choritz L, Stahl A. Treated Cases of Retinopathy of Prematurity in Germany: 10-Year Data from the Retina.net Retinopathy of Prematurity Registry. Ophthalmol Retina 2024; 8:579-589. [PMID: 38104929 DOI: 10.1016/j.oret.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/14/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To analyze changes in demographic parameters and retreatment patterns over a 10-year period in a clinical routine setting of infants with retinopathy of prematurity (ROP) requiring treatment documented in the German Retina.net ROP registry. DESIGN Multicenter, noninterventional, observational registry study recruiting patients treated for ROP. SUBJECTS A total of 692 eyes of 353 infants treated for ROP were documented in the Retina.net ROP registry over a 10-year period between 2011 and 2020. These cases cover about 15% of all infants treated for ROP in Germany. METHODS The Retina.net ROP registry was established in 2012 to jointly collect information on infants treated for ROP. The database collects information on demographic parameters (gestational age [GA], birth weight, neonatal comorbidities) as well as treatment parameters (type of treatment, weight and age at treatment, and stage of ROP). A total of 19 centers contributed to the analysis. This is the 10-year analysis of data from 2011 to 2020, in which we focus on changes over time regarding the respective parameters. MAIN OUTCOME MEASURES Changes over time in demographic parameters and treatment patterns for ROP in Germany. RESULTS The overall incidence of treatment requiring ROP was 3.5% of all infants screened for ROP at participating centers. Gestational age, weight at birth, and weight at treatment remained stable over the 10-year period, whereas postmenstrual and postnatal age at treatment increased moderately but statistically significantly over the years. The most prevalent ROP severity stage at treatment was stage 3+ in zone II (76.6% of all treated eyes). Treatment patterns changed considerably from predominantly laser treatments in 2011 (75% of all treated eyes) to predominantly ranibizumab treatments in 2020 (60.9% of all treated eyes). The overall retreatment rate was 15.6%. Retreatment rates differed between initial treatment modalities (14.1% after laser coagulation, 12% after bevacizumab and 24.5% after ranibizumab). Treatment-associated systemic or ophthalmic complications were rare. CONCLUSIONS This data analysis represents one of the largest documented cohorts of infants treated for ROP. The data on demographic parameters and treatment patterns provide useful information for further improvement of ROP management. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Johanna M Pfeil
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Teresa Barth
- Department of Ophthalmology, University of Regensburg, Regensburg, Germany
| | - Wolf A Lagrèze
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig University Giessen, Giessen, Germany
| | | | - Raffael Liegl
- Department of Ophthalmology, University Medicine Bonn, Bonn, Germany
| | - Helge Breuss
- Department of Ophthalmology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Sebastian Bemme
- Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany
| | - Sabine Aisenbrey
- Department of Ophthalmology, Vivantes Klinikum Neukoelln, Berlin, Germany
| | - Barbara Glitz
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Daniela Süsskind
- University Eye Hospital, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | | | - Christos Skevas
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim U Krohne
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Vinodh Kakkassery
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | | | - Katrin Engelmann
- Department of Ophthalmology, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Rainer Guthoff
- Department of Ophthalmology, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - Peter Walter
- Department of Ophthalmology, University Hospital RWTH Aachen, Germany
| | - Lars Choritz
- Department of Ophthalmology, Otto von Guericke University, Magdeburg, Germany
| | - Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany.
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Raimondi R, Falfeli T, Bogdanova-Bennet A, Varma D, Habib M, Kotagiri A, Steel DH, Grinton M. Outcomes of Treatment-Resistant Neovascular Age-Related Macular Degeneration Switched from Aflibercept to Faricimab. Ophthalmol Retina 2024; 8:537-544. [PMID: 38040055 DOI: 10.1016/j.oret.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE Although previous studies have demonstrated the efficacy of faricimab in treatment-naive patients with neovascular age-related macular degeneration (nAMD), its outcomes in patients switched from aflibercept are less understood. This study aimed to assess clinical anatomical and functional outcomes of switching to faricimab in patients undergoing aflibercept intravitreal injections (IVIs) for nAMD with suboptimal response. DESIGN Retrospective case series. SUBJECTS Patients with nAMD at a single tertiary care center who were switched from aflibercept to faricimab due to persistent suboptimal response. METHODS Patients had received a minimum of 6 consecutive IVIs of aflibercept and showed persistent presence of intraretinal (IRF) or subretinal fluid (SRF) on OCT despite receiving aflibercept at 4 or 6-weekly intervals at the time of the switch. Patients receiving 4-weekly aflibercept were switched with either 2 or 3 loading doses of 4-weekly faricimab injections. Regression models were used to identify predictors of clinical outcomes. MAIN OUTCOME MEASURES Visual acuity, central macular thickness (CMT), and OCT parameters were assessed preswitch and postswitch. RESULTS Eighty-one eyes of 68 patients were included. The mean age was 79.1 years (standard deviation: 8.9), and females constituted 53% of cases. A statistically significant reduction in CMT was observed postswitch (P < 0.0001). The proportion of cases with IRF (P = 0.0219) and SRF (P < 0.000) decreased significantly. Overall clinical improvement on OCT was noted in 80% of patients. No significant improvement in ETDRS vision was observed. There was no evidence that switching regimen (2 vs. 3 loading doses) had an independent effect on clinical outcomes. CONCLUSION Among patients with treatment-resistant nAMD, switching from aflibercept to faricimab may serve as a safe and effective option. Significant anatomical improvements were observed, with a trend toward visual stability. The loading regimen with 2 faricimab injections appeared to be sufficient for nonnaive patients. However, a longer follow-up and larger studies are warranted to confirm these findings. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Raffaele Raimondi
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom.
| | - Tina Falfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada; The Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anna Bogdanova-Bennet
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
| | - Deepali Varma
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
| | - Maged Habib
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom; Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ajay Kotagiri
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
| | - David H Steel
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom; Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael Grinton
- Sunderland Eye Infirmary, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
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Park ASY, Wong GHT, Tan KWS, Cheung BWS, Oremus M, Cheong AMY, Thompson B. Efficacy of perceptual learning in low vision: A systematic review and meta-analysis. Optom Vis Sci 2024; 101:305-320. [PMID: 38990233 DOI: 10.1097/opx.0000000000002157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Visual perceptual learning (PL) shows promise for enhancing visual functions in individuals with visual impairment. OBJECTIVE This systematic review aimed to evaluate the effectiveness of PL in improving visual function. STUDY ELIGIBILITY Eligible studies were those examining the efficacy of PL in individuals with low vision. STUDY APPRAISAL AND SYNTHESIS METHODS The review protocol was registered with the international Prospective Register of Systematic Reviews (ID CRD42022327545) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Screened studies were synthesized using random-effects meta-analysis and narrative synthesis following Synthesis Without Meta-analysis guidelines. The quality of the evidence was assessed using the Cochrane risk-of-bias tool and the JBI Critical Appraisal Tool for Quasi-Experimental studies. RESULTS Fifty studies were included, covering various visual impairments and employing different PL interventions. Most studies had low risk of bias. Meta-analysis showed significant improvement in visual search for individuals with cortical blindness (Hedges' g = 0.71; 95% confidence interval, 0.48 to 0.93; p=0.002); all other analyses did not show significant improvements-reading in central vision loss and cortical blindness, and visual field in peripheral vision loss and cortical blindness. However, the narrative synthesis provided evidence showing effectiveness, particularly in individuals with central vision loss and cortical blindness, demonstrating positive effects on reading, contrast sensitivity, visual field, and motion perception. LIMITATIONS Variations in study design, PL protocols, outcome measures, and measurement methods introduced heterogeneity, limiting the analysis. CONCLUSIONS The efficacy of PL in vision rehabilitation remains uncertain. Although meta-analysis results were mostly inconclusive, the narrative synthesis indicated improved visual functions following PL, consistent with individual study findings. IMPLICATIONS OF KEY FINDINGS Future research should optimize intervention parameters, explore long-term effects, and assess generalizability across diverse populations and visual impairment etiologies. Larger randomized controlled trials using standardized outcome measures are needed to advance the field.
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Affiliation(s)
| | - Ginny H T Wong
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Ken W S Tan
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Blossom W S Cheung
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Liu Y, Lawler T, Liu Z, Thuruthumaly C, Vajaranant T, Wallace R, Tinker L, Nalbandyan M, Mares J. Low Macular Pigment Optical Density Is Associated with Manifest Primary Open-Angle Glaucoma in Older Women. Curr Dev Nutr 2024; 8:103789. [PMID: 38974349 PMCID: PMC11225677 DOI: 10.1016/j.cdnut.2024.103789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 07/09/2024] Open
Abstract
Background Lower density of carotenoids lutein and zeaxanthin (L/Z) in the macula (i.e., macular pigment) has been linked to greater risk for age-related eye disease. Objectives We evaluated whether macular pigment optical density (MPOD) was associated with manifest primary open-angle glaucoma (POAG) among older women in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2). Methods MPOD was measured with customized heterochromatic flicker photometry in women who attended CAREDS2 (2016-2019) and CAREDS1 (2001-2004) study visits. Manifest POAG at CAREDS2 was assessed using visual fields, disc photos, optical coherence tomography, and medical records. Age-adjusted linear and logistic regression models were used to investigate the cross-sectional association between POAG and MPOD at CAREDS2, and MPOD measured 15 years earlier at CAREDS1. Results Among 426 CAREDS2 participants (mean age: 80 y; range: 69-98 y), 26 eyes with manifest POAG from 26 participants were identified. Glaucomatous eyes had 25% lower MPOD compared to nonglaucomatous eyes [mean (SE): 0.40 (0.05) compared with 0.53 (0.01)] optical density units (ODU), respectively (P = 0.01). Compared with MPOD quartile 1, odds for POAG were lower for women in quartiles 2-4 (P-trend = 0.01). After excluding eyes with age-related macular degeneration, associations were similar but not statistically significant (P-trend = 0.16). Results were similar for MPOD measured at CAREDS1. Conclusions Our results add to growing evidence that low MPOD may be a novel glaucoma risk factor and support further studies to assess the utility of dietary interventions for glaucoma prevention.
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Affiliation(s)
- Yao Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Thomas Lawler
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Thasarat Vajaranant
- Department of Ophthalmology and Visual Sciences, University of Illinois-Chicago, Chicago, IL, United States
| | - Robert Wallace
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States
| | - Lesley Tinker
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Marine Nalbandyan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Julie Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, United States
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Schlunck G, Maier P, Maier B, Maier W, Strempel S, Reinhard T, Heinzelmann S. Next-Generation Sequencing of the Human Aqueous Humour Microbiome. Int J Mol Sci 2024; 25:6128. [PMID: 38892316 PMCID: PMC11173048 DOI: 10.3390/ijms25116128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/27/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
The microbiome of the ocular surface has been characterised, but only limited information is available on a possible silent intraocular microbial colonisation in normal eyes. Therefore, we performed next-generation sequencing (NGS) of 16S rDNA genes in the aqueous humour. The aqueous humour was sampled from three patients during cataract surgery. Air swabs, conjunctival swabs from patients as well as from healthy donors served as controls. Following DNA extraction, the V3 and V4 hypervariable regions of the 16S rDNA gene were amplified and sequenced followed by denoising. The resulting Amplicon Sequence Variants were matched to a subset of the Ribosomal Database Project 16S database. The deduced bacterial community was then statistically analysed. The DNA content in all samples was low (0-1.49 ng/µL) but sufficient for analysis. The main phyla in the samples were Acinetobacteria (48%), Proteobacteria (26%), Firmicutes (14%), Acidobacteria (8%), and Bacteroidetes (2%). Patients' conjunctival control samples and anterior chamber fluid showed similar patterns of bacterial species containing many waterborne species. Non-disinfected samples showed a different bacterial spectrum than the air swab samples. The data confirm the existence of an ocular surface microbiome. Meanwhile, a distinct intraocular microbiome was not discernible from the background, suggesting the absence of an intraocular microbiome in normal eyes.
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Affiliation(s)
- Günther Schlunck
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79110 Freiburg im Breisgau, Germany; (G.S.); (P.M.); (T.R.)
| | - Philip Maier
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79110 Freiburg im Breisgau, Germany; (G.S.); (P.M.); (T.R.)
| | - Barbara Maier
- Institute for Infection Prevention and Control, Faculty of Medicine, University of Freiburg, 79110 Freiburg im Breisgau, Germany;
| | - Wolfgang Maier
- Bioinformatics Group, Department of Computer Science, University of Freiburg, Georges-Köhler-Allee 106, 79110 Freiburg im Breisgau, Germany;
| | | | - Thomas Reinhard
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79110 Freiburg im Breisgau, Germany; (G.S.); (P.M.); (T.R.)
| | - Sonja Heinzelmann
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79110 Freiburg im Breisgau, Germany; (G.S.); (P.M.); (T.R.)
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Grassi MO, Viggiano P, Borrelli E, Boscia G, Molfetta T, Malerba MG, D'Addario M, Giancipoli E, Alessio G, Boscia F. Comparative Study on Anti-VEGF in Wet Age-Related Macular Degeneration in the Setting Based on Lean Methodology from the Bari Intravitreal Injection Registry (BIVIR). Ophthalmol Ther 2024; 13:1619-1634. [PMID: 38619788 PMCID: PMC11109068 DOI: 10.1007/s40123-024-00927-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Optimizing treatment protocols for wet age-related macular degeneration (wAMD) is an ongoing challenge, as it involves a delicate balance between achieving therapeutic efficacy and minimizing invasive procedures' frequency. This study aimed to apply the Lean methodology and evaluate the effectiveness of this new setting on intravitreal therapy for wAMD, employing different anti-vascular endothelial growth factors (VEGF) drugs (bevacizumab, brolucizumab, aflibercept, ranibizumab), drawing data from the Bari Intravitreal Injections Registry (BIVIR). METHODS This was a retrospective, monocentric, nonrandomized, comparative study. Lean methodology was employed to design the new setting and the BIVIR collected information from electronic medical records. Clinical data of four groups, stratified based on the first-line anti-VEGF agents used, were compared. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) changes were compared between the four groups at 3 and 12 months. RESULTS Out of 4990 eyes and 41,323 intravitreal injections (IVs) recorded in BIVIR, 1421 eyes of 1182 patients were included. The mean number of IVs in first year was 6.1 ± 2.5, with no significant differences among the four subgroups. The mean change in BCVA was + 6.2 letters [95% confidence interval (CI) 5.6-6.8] after two IVs, and + 5.9 (95% CI 5.1-6.8) letters after three IVs; at three months, brolucizumab was associated with a greater mean increase in BCVA than bevacizumab (p = 0.050); aflibercept (p = 0.044) and ranibizumab p = 0.047). At the 1-year follow-up, the mean change was + 6.3 letters (95% CI 5.4-7.2), brolucizumab and ranibizumab were associated with a superior improvement in BCVA compared to aflibercept (p = 0.033). Regarding the CRT, a significant reduction was observed in the subgroup treated with brolucizumab at the 3-month follow-up, compared to bevacizumab (p = 0.003), aflibercept (p = 0.015), and ranibizumab (p < 0.001); Aflibercept exhibited a superior effect than ranibizumab (p = 0.001). At 1-year follow-up, aflibercept resulted in a more significant reduction of macular thickness compared to ranibizumab (p = 0.016) while no significant differences were observed among the other drugs. CONCLUSIONS Our practical experience showed the effectiveness of the new setting in the treatment of wAMD. This comparative study at 1 year suggested a predominant brolucizumab efficacy on functional outcomes. In addition, brolucizumab and aflibercept appeared to have similar efficacy in fluid control.
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Affiliation(s)
- Maria Oliva Grassi
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy.
| | - Pasquale Viggiano
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
| | - Enrico Borrelli
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Boscia
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
| | - Teresa Molfetta
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
| | | | - Maria D'Addario
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
| | - Ermete Giancipoli
- UOC Oftalmologia, Dipartimento di Scienze Mediche e Chirurgiche, University of Foggia, Foggia, Italy
| | - Giovanni Alessio
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
| | - Francesco Boscia
- DIBRAIN Department, University of Bari, Piazza Giulio Cesare, 11, Bari, Italy
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208
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Terheyden JH, Ost RAD, Behning C, Mekschrat L, Bildik G, Wintergerst MWM, Holz FG, Finger RP. Evaluation of the test-retest and inter-mode comparability of the Impact of Vision Impairment questionnaire in people with chronic eye diseases. Graefes Arch Clin Exp Ophthalmol 2024; 262:1933-1943. [PMID: 38180569 PMCID: PMC11106107 DOI: 10.1007/s00417-023-06334-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/03/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE The main objective of this study is to assess the test-retest and inter-administration mode reliability of the Impact of Vision Impairment profile (IVI), a common patient-reported outcome measure (PROM) for people with chronic eye diseases. METHODS The IVI was administered to adult patients with stable, chronic eye diseases two to four times per participant (average intervals between administrations 12 to 20 days; maximum two phone interviews, paper administration, electronic administration) by two trained interviewers. Rasch models were fit to the data. Intra-class correlation coefficients (ICCs), mean differences and Cronbach's alpha between test-retest administrations (two phone interviews) and inter-mode comparisons were calculated. RESULTS Two hundred-sixteen patients (mean age 67 ± 12 years, 40% male) were included in the study. The IVI met all psychometric requirements of the Rasch model, and the division into the domains of functional items (IVI_F) and emotional items (IVI_E) corresponded to the German validation study. ICCs (all for IVI_F and IVI_E, respectively) for the retest administrations were 0.938 and 0.912, and 0.853 and 0.893 for inter-mode comparisons phone/paper, 0.939 and 0.930 for phone/electronic, and 0.937 and 0.920 for paper/electronic (all p < 0.01). Mean differences (all for IVI_F and IVI_E, respectively) for the retest administrations were 2.8% and 0.7% and ranged from 2.0% to 6.2% and from 0.4 % to 4.9% between administration modes. Cronbach's alpha ranged from 0.886 to 0.944 for retest and inter-mode comparisons. CONCLUSION Due to the high test-retest reliability and the almost equally high comparability of different modes of administration of the IVI, the study endorses its use as a robust PROM to capture vision-related quality of life. Our results further support the use of the IVI as an endpoint in clinical trials and may simplify implementing it in both clinical trials or real-world evidence generation by offering multiple administration modes with high reliability.
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Affiliation(s)
- Jan Henrik Terheyden
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.
| | - Reglind A D Ost
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Charlotte Behning
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Liza Mekschrat
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Gamze Bildik
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | | | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
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Bovone C, De Rosa L, Pellegrini M, Ruzza A, Ferrari S, Camposampiero D, Ponzin D, Zauli G, Yu AC, Busin M. Deep Anterior Lamellar Keratoplasty Using Dehydrated versus Standard Organ Culture-Stored Donor Corneas: Prospective Randomized Trial. Ophthalmology 2024; 131:674-681. [PMID: 38160881 DOI: 10.1016/j.ophtha.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To compare the outcomes of deep anterior lamellar keratoplasty (DALK) using dehydrated versus standard organ culture-stored donor corneas for eyes with keratoconus. DESIGN Prospective, randomized, single-center trial conducted in Italy. PARTICIPANTS Adult patients (age ≥ 18 years) with keratoconus scheduled for elective DALK. METHODS Patients undergoing successful type 1 bubble pneumatic dissection using a standard DALK technique were randomized during surgery to receive either dehydrated (n = 30) or standard organ culture-stored (n = 30) donor corneas. MAIN OUTCOME MEASURES The primary study outcome was best spectacle-corrected visual acuity (BSCVA) 12 months after surgery. Secondary outcomes were refractive astigmatism (RA), endothelial cell density (ECD), and complication rates. RESULTS Postoperative BSCVA did not significantly differ between groups at both time points: mean difference at 6 months was 0.030 logarithm of the minimum angle of resolution (logMAR; 95% confidence interval [CI], -0.53 to 0.10 logMAR; P = 0.471) and at 12 months was -0.013 logMAR (95% CI, -0.10 to 0.08 logMAR; P = 0.764). No significant differences between groups were observed in terms of postoperative RA and ECD at all time points. In the first 3 days after DALK, an epithelial defect was present in 10 patients (33%) in the organ culture cornea group and in 29 patients (97%) in the dehydrated cornea group. Complete re-epithelialization was achieved by day 7 in all patients (100%) in both groups. CONCLUSIONS The study provides evidence that the use of dehydrated corneas is noninferior to the use of standard organ culture donor corneas for DALK. Corneal tissue dehydration represents a viable solution that can allow long-term cornea preservation and avoid wastage of unused corneas. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Cristina Bovone
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Luigi De Rosa
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Marco Pellegrini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | | | | | | | - Diego Ponzin
- Fondazione Banca degli Occhi del Veneto, Venice, Italy
| | - Giorgio Zauli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Angeli Christy Yu
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Massimo Busin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy.
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Javed A, Qadir MO, Lee S, Mitra A, Tyagi A, Sharma A, Lett K, Ch'ng S. Rethinking the urgency priority system in round hole detachments, which should be done first? Macula on or macula off. Eye (Lond) 2024; 38:1407-1408. [PMID: 38279039 PMCID: PMC11126689 DOI: 10.1038/s41433-024-02930-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024] Open
Affiliation(s)
- A Javed
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK.
| | - M O Qadir
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Lee
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Mitra
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Tyagi
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Sharma
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - K Lett
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Ch'ng
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
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211
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Bhargava M, Bhambhani V, Sen A, Johri A. Corneal foreign body post laser in-situ keratomileusis: Diagnosis, management, outcome and review of literature. Am J Ophthalmol Case Rep 2024; 34:102038. [PMID: 38532848 PMCID: PMC10963190 DOI: 10.1016/j.ajoc.2024.102038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/17/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose To report a case of metallic corneal foreign-body (CFB) penetrating the Laser in situ keratomileusis (LASIK) flap and its successful outcome. To highlight usefulness of Anterior Segment Optical Coherence Tomography (ASOCT) in diagnosis and management of post-LASIK CFB. To enumerate other similar cases published in literature. Method A 30-year-old male presented to the emergency department of a tertiary eye care centre with a metallic CFB. He had undergone uneventful LASIK elsewhere 4-years back. He was unaware of any trauma. CFB removal was attempted elsewhere but abandoned as CFB appeared deeply embedded. ASOCT showed CFB had penetrated LASIK flap and lodged into midstroma, 207 μm deep. CFB was successfully removed in operation theatre along with the application of cyanoacrylate glue and bandage contact lens. A review of literature for CFB in post-LASIK patients was done through PubMed search. Result Postoperative course was uncomplicated and there was a follow up period of 4 months. Vision improved to unaided 20/20 and N/6 from preoperative 20/60 and N/10. Review of literature of 24 patients showed Post-LASIK FB was more common in males (79%). None of the patients except for one had protective eye-wear. Metallic FB was most common followed by organic FB. Flap complications were present in seven patients. Diffuse lamellar keratitis (DLK) and epithelial ingrowth were the most common post-FB removal complications occurring in six (25%) and four (16.6%) patients respectively. Conclusion Post-LASIK patients with CFB need to be inspected for flap related complications. CFB can be successfully removed, although DLK, epithelial ingrowth, microbial keratitis, astigmatism, can occur post-CFB removal. ASOCT can delineate CFB and flap related details and thus is an additional useful imaging tool in such scenarios.
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Affiliation(s)
- Mona Bhargava
- Department of Cornea, Aditya Birla Sankara Nethralaya, 147/1 E M Bypass Road, Kolkata, 700099, India
| | - Varsha Bhambhani
- Department of Cornea, Aditya Birla Sankara Nethralaya, 147/1 E M Bypass Road, Kolkata, 700099, India
| | - Ahana Sen
- Aditya Birla Sankara Nethralaya, 147/1 E M Bypass Road, Kolkata, 700099, India
| | - Aditi Johri
- Department of Cornea, Aditya Birla Sankara Nethralaya, 147/1 E M Bypass Road, Kolkata, 700099, India
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212
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Brotherton C, Megaw R. Molecular Mechanisms Governing Sight Loss in Inherited Cone Disorders. Genes (Basel) 2024; 15:727. [PMID: 38927662 PMCID: PMC11202562 DOI: 10.3390/genes15060727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Inherited cone disorders (ICDs) are a heterogeneous sub-group of inherited retinal disorders (IRDs), the leading cause of sight loss in children and working-age adults. ICDs result from the dysfunction of the cone photoreceptors in the macula and manifest as the loss of colour vision and reduced visual acuity. Currently, 37 genes are associated with varying forms of ICD; however, almost half of all patients receive no molecular diagnosis. This review will discuss the known ICD genes, their molecular function, and the diseases they cause, with a focus on the most common forms of ICDs, including achromatopsia, progressive cone dystrophies (CODs), and cone-rod dystrophies (CORDs). It will discuss the gene-specific therapies that have emerged in recent years in order to treat patients with some of the more common ICDs.
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Affiliation(s)
- Chloe Brotherton
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road, Edinburgh EH4 2XU1, UK;
| | - Roly Megaw
- Princess Alexandra Eye Pavilion, NHS Lothian, Chalmers St., Edinburgh EH3 9HA, UK
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213
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Galvez-Olortegui J, Bouchikh-El Jarroudi R, Silva-Ocas I, Palacios-Herrera H, Cubillas-Martin M, Zavaleta-Mercado M, Burgueño-Montañes C, Galvez-Olortegui T. Systematic review of clinical practice guidelines for the diagnosis and management of retinal vein occlusion. Eye (Lond) 2024; 38:1722-1733. [PMID: 38467863 PMCID: PMC11156943 DOI: 10.1038/s41433-024-03008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/08/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND/OBJECTIVES To assess the methodological quality of Clinical Practice Guidelines (CPG) for the diagnosis and management of Retinal Vein Occlusion (RVO). METHODS A systematic review of CPGs for the diagnosis and management of RVO was carried out with a search in databases, metasearch engines, CPG development institutions, ophthalmology associations and CPG repositories until April 2022. Search update was performed on April 2023, with no new record available. Five CPGs published in the last 10 years in English/Spanish were selected, and 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment of each CPG by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications were performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out. RESULTS The lowest score (mean 18.8%) was for domain 5 'applicability', and the highest score (mean 62%) was for domain 4 'clarity of presentation'. The 2019 American guideline (PPP) presented the best score (40.4%) in domain 3 'rigour of development'. When evaluating the overall quality of the CPGs analysed, all CPGs could be recommended with modifications. In the meta-synthesis, anti-VEGF therapy is the first-choice therapy for macular oedema associated with RVO, but there is no clear recommendation about the type of anti-VEGF therapy to choose. Recommendations for diagnosis and follow-up are similar among the CPGs appraised. CONCLUSION Most CPGs for the diagnosis and management of RVO have a low methodological quality assessed according to the AGREE-II. PPP has the higher score in the domain 'rigour of development'. Among the CPGs appraised, there is no clear recommendation on the type of anti-VEGF therapy to choose.
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Affiliation(s)
- Jose Galvez-Olortegui
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru.
- Service of Ophthalmology, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Universidad Nacional de Tumbes, Tumbes, Peru.
| | - Rachid Bouchikh-El Jarroudi
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Service of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department of Surgery, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Isabel Silva-Ocas
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Centro de Excelencia en Glaucoma, Clinica GO-Vision, Lima, Peru
| | - Hector Palacios-Herrera
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Servicio de Retina y Vitreo, EP Oftalmólogos asociados, Lima, Peru
| | | | - Miguel Zavaleta-Mercado
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Instituto de Investigaciones Oftalmológicas y Ciencias Visuales Avanzadas Zavaleta Mercado (Innovaz), Oruro, Bolivia
| | - Carmen Burgueño-Montañes
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Service of Ophthalmology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Tomas Galvez-Olortegui
- Evidence Based Ophthalmology Unit (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
- Centro de Excelencia en Glaucoma, Clinica GO-Vision, Lima, Peru
- Department of Ophthalmology, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
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214
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Mishra P, Kanaujia V, Kesarwani D, Sharma K, Nanda J, Mishra P. Visual Outcomes in Malignant Hypertensive Retinopathy Cases: A Clinical and Spectral Domain Optical Coherence Tomography Study. Cureus 2024; 16:e62945. [PMID: 39050341 PMCID: PMC11265969 DOI: 10.7759/cureus.62945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2024] [Indexed: 07/27/2024] Open
Abstract
Objective The objective is to correlate visual outcomes in malignant hypertensive retinopathy with changes in systemic causative factors and spectral domain optical coherence tomography (SD OCT) morphologic parameters. Materials and methods This is a prospective observational study including patients presenting within two weeks of acute rise of systolic blood pressure (SBP) ≥ 180 mm Hg or diastolic blood pressure (DBP) ≥ 120 mm Hg and with posterior segment involvement in both eyes. Baseline SBP, DBP, mean arterial pressure (MAP), best corrected visual acuity (BCVA), and SD OCT parameters such as central macular thickness (CMT), subfoveal choroidal thickness (SCT), and sub-retinal fluid (SRF) height were measured at presentation and followed monthly up to three months. These variables at baseline and three months were compared and correlated. Results Thirty-three patients (66 eyes) having malignant hypertension were included in the study. Diverse clinical presentations noted among patients were optic disc edema, hard exudates in the macula, peripapillary splinter hemorrhage, cotton wool spots, Elschnig spots, exudative retinal detachment, optic neuropathy, and severe exudative retinopathy. SD OCT shows hyperreflective dots and intraretinal fluid with or without SRF. At three months, the mean SBP, DBP, MAP, CMT, SRF, and SCT all decreased significantly from baseline (p<0.001). Changes in SBP, DBP, MAP, and SCT correlated significantly with changes in BCVA (p<0.001). Conclusion In malignant hypertensive retinopathy, macular edema with SRF is the major cause of mild-to-moderate decrease BCVA at presentation, but macular ischemia, exudative RD, and optic neuropathy can cause a significant decrease in vision. A decrease in SBP, DBP, MAP, and SCT correlate significantly with visual outcomes.
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Affiliation(s)
- Priyadarshini Mishra
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Vikas Kanaujia
- Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
| | | | - Kumudini Sharma
- Ophthalmology, Hind Institute of Medical Sciences, Lucknow, IND
| | - Jayadev Nanda
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Prabhaker Mishra
- Biostatistics & Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND
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Zhu P, Yuan G, Wan L, Chen S, Zhu W, Jiang H, Liu X, Zhang J. LONG-TERM OUTCOME OF TRANSSCLERAL FOUR-POINT FIXATION OF AKREOS INTRAOCULAR LENS WITH CLOSED CONTINUOUS-LOOP SUTURE. Retina 2024; 44:1015-1020. [PMID: 38295391 DOI: 10.1097/iae.0000000000004058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE To report the long-term clinical outcomes of transscleral four-point fixation of Akreos intraocular lens using a closed continuous-loop suture technique. METHODS This was a retrospective, multicenter, interventional case series. Primary outcome measures were best-corrected visual acuity, intraocular pressure, corneal endothelial cell density, and complications with a minimum of 1-year follow-up. RESULTS One hundred and ninety-two eyes of 177 patients from two surgical hospital sites were identified. The mean best-corrected visual acuity improved from 0.88 ± 0.74 logarithm of the minimum angle of resolution (Snellen 20/152) preoperatively to 0.42 ± 0.52 logarithm of the minimum angle of resolution (Snellen 20/53) postoperatively ( P < 0.001). The mean preoperative intraocular pressure was 17.51 ± 8.67 mmHg, and the mean postoperative intraocular pressure at final follow-up was 15.08 ± 4.18 mmHg ( P = 0.001). The mean corneal endothelial cell density significantly reduced from 2,259 ± 729 cells/mm 2 to 2077 ± 659 cells/mm 2 , representing a cell loss of 5.73% ( P < 0.001). The intraocular lens was fixed well during follow-up. There were no intraoperative complications noted. Postoperative complications included transient ocular hypertension in 15 eyes (7.81%), hypotony in two eyes (1.04%), retinal detachment in one eye (0.52%), and macular edema in one eye (0.52%). CONCLUSION The transscleral four-point fixation Akreos intraocular lens using the closed continuous-loop suture technique was effective and safe with satisfactory visual acuity with a minimum of 1-year follow-up.
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Affiliation(s)
- Pingfan Zhu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Gongqiang Yuan
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Lei Wan
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China
| | - Shijiu Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Wenting Zhu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Han Jiang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Xiaoyan Liu
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
| | - Jingjing Zhang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China; and
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Chen Y, Fang Y, Zhao J, He W, Ma B, Zhu X. Influence of Lens Thickness on Accuracy of Kane, Hill-RBF 3.0, Barrett Universal II, Emmetropia Verifying Optical, and Pearl-DGS Formulas in Eyes with Nonhigh Myopia and High Myopia. Curr Eye Res 2024; 49:605-614. [PMID: 38363071 DOI: 10.1080/02713683.2024.2316717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To investigate the influence of lens thickness (LT) on accuracy of Kane, Hill-RBF 3.0 Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO), and Pearl-DGS formulas in eyes with different axial lengths (AL). METHODS The prospective cohort study was conducted at Eye and ENT Hospital of Fudan University. Patients who had uneventful cataract surgery between March 2021 and July 2023 were recruited. Manifest refraction was conducted two-month post-surgery. Eyes were divided into 4 groups based on AL: short (<22mm), medium (22-24.5 mm), medium long (24.5-26mm) and very long (≥26mm). In each AL group, eyes were then divided into 3 subgroups based on the LT measured with IOLmaster700: thin (<4.5 mm), medium (4.5-5.0 mm), and thick (≥ 5 mm). The influence of LT on accuracy of Kane, Hill-RBF 3.0, BUII, EVO, and Pearl-DGS formulas were investigated in each AL group. RESULTS A total of 327 eyes from 327 patients were analyzed, with 64, 102, 73 and 88 eyes in each AL group, respectively. In eyes with AL < 24.5 mm, myopic PE was significantly associated with greater LT using all the 5 formulas (all p < 0.05). Backward stepwise multivariate regression analyses revealed that LT was an important influencing factor for PE in all 5 formulas, particularly in eyes with AL <24.5 mm. In eyes with AL <24.5 mm and LT > 5.0 mm, PE of all 5 formulas calculated with the optional parameter LT were more myopic than those calculated without LT. CONCLUSIONS Thicker LT was associated with more myopic PE among eyes with AL <24.5 mm when using all 5 formulas. Further optimization of current formulas is necessary, especially for eyes with short AL and thick LT.
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Affiliation(s)
- Yuxi Chen
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Bo Ma
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi Province, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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217
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Grasso PA, Gurioli M, Boccardo L. Effects of brightness variations on a smartphone-based version of Radner reading charts. Eye (Lond) 2024; 38:1556-1561. [PMID: 38321175 PMCID: PMC11126558 DOI: 10.1038/s41433-024-02950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the equivalence of smartphone-based measurements of near visual acuity under different screen brightness conditions with a standard near visual acuity test. METHODS On a sample of 85 participants, we have evaluated near visual acuity with a smartphone-based version of the Radner reading chart at three distinct screen brightness levels. Results have been compared with those obtained with classical Radner paper charts. RESULTS We have found that, when a sufficient screen brightness is employed, the smartphone-based version of the Radner reading chart produces results that are in line with the paper Radner charts while low brightness levels lead to a significant underestimation of reading acuities. This result was consistent across different refractive conditions. CONCLUSIONS In conclusion, we have shown that handheld devices, such as smartphones, can be potentially exploited for remote measurements of near visual acuity provided a correct control of brightness screen is employed.
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Affiliation(s)
- Paolo A Grasso
- Department of Physics and Astronomy, University of Florence, Florence, Italy.
| | - Massimo Gurioli
- Department of Physics and Astronomy, University of Florence, Florence, Italy
| | - Laura Boccardo
- Department of Physics and Astronomy, University of Florence, Florence, Italy
- Institute for Research and Studies in Optics and Optometry, Vinci (FI), Italy
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Sonnenfeld ML, Pappadis MR, Reistetter TA, Raji MA, Ottenbacher K, Al Snih S. Vision Impairment and Frailty Among Mexican American Older Adults: A Longitudinal Study. J Appl Gerontol 2024; 43:755-764. [PMID: 38412864 PMCID: PMC11052670 DOI: 10.1177/07334648241231374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
We examined the relationship between vision impairment (VI) and new-onset frailty among non-frail Mexican American older adults (≥70 years) at baseline and determined the differential impact of VI on each frailty criteria. Data were from an 18-year prospective cohort from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998/1999, N = 1072 to 2016, N = 175). Frailty was defined as ≥3 criteria: unintentional weight loss of >10 pounds, weakness, exhaustion, low physical activity, and slowness. VI was defined as difficulty in recognizing a friend at arm's length's away, across the room, or across the street. We found that participants with VI (near or distant) and distant VI had greater odds of frailty (near or distant VI, OR = 1.89, 95% CI = 1.30-2.73 and distant VI, OR = 1.95, 95% CI = 1.34-2.86, respectively) after controlling for covariates over time. Early screening (optimal management) of VI may prevent or delay onset of frailty among older Mexican Americans.
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Affiliation(s)
- Mandi L Sonnenfeld
- Michael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety (IQuEST), Houston, TX, USA
| | - Monique R Pappadis
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Timothy A Reistetter
- Department of Occupational Therapy, School of Health Professions, UT Health San Antonio, San Antonio, TX, USA
| | - Mukaila A Raji
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kenneth Ottenbacher
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
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Wu G, Hu Y, Zhu Q, Liang A, Du Z, Zheng C, Liang Y, Zheng Y, Hu Y, Kong L, Liang Y, Amadou MLDJ, Fang Y, Liu Y, Feng S, Yuan L, Cao D, Lin J, Yu H. Development and validation of a simple and practical model for early detection of diabetic macular edema in patients with type 2 diabetes mellitus using easily accessible systemic variables. J Transl Med 2024; 22:523. [PMID: 38822359 PMCID: PMC11140894 DOI: 10.1186/s12967-024-05328-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/20/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE Diabetic macular edema (DME) is the leading cause of visual impairment in patients with diabetes mellitus (DM). The goal of early detection has not yet achieved due to a lack of fast and convenient methods. Therefore, we aim to develop and validate a prediction model to identify DME in patients with type 2 diabetes mellitus (T2DM) using easily accessible systemic variables, which can be applied to an ophthalmologist-independent scenario. METHODS In this four-center, observational study, a total of 1994 T2DM patients who underwent routine diabetic retinopathy screening were enrolled, and their information on ophthalmic and systemic conditions was collected. Forward stepwise multivariable logistic regression was performed to identify risk factors of DME. Machine learning and MLR (multivariable logistic regression) were both used to establish prediction models. The prediction models were trained with 1300 patients and prospectively validated with 104 patients from Guangdong Provincial People's Hospital (GDPH). A total of 175 patients from Zhujiang Hospital (ZJH), 115 patients from the First Affiliated Hospital of Kunming Medical University (FAHKMU), and 100 patients from People's Hospital of JiangMen (PHJM) were used as external validation sets. Area under the receiver operating characteristic curve (AUC), accuracy (ACC), sensitivity, and specificity were used to evaluate the performance in DME prediction. RESULTS The risk of DME was significantly associated with duration of DM, diastolic blood pressure, hematocrit, glycosylated hemoglobin, and urine albumin-to-creatinine ratio stage. The MLR model using these five risk factors was selected as the final prediction model due to its better performance than the machine learning models using all variables. The AUC, ACC, sensitivity, and specificity were 0.80, 0.69, 0.80, and 0.67 in the internal validation, and 0.82, 0.54, 1.00, and 0.48 in prospective validation, respectively. In external validation, the AUC, ACC, sensitivity and specificity were 0.84, 0.68, 0.90 and 0.60 in ZJH, 0.89, 0.77, 1.00 and 0.72 in FAHKMU, and 0.80, 0.67, 0.75, and 0.65 in PHJM, respectively. CONCLUSION The MLR model is a simple, rapid, and reliable tool for early detection of DME in individuals with T2DM without the needs of specialized ophthalmologic examinations.
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Affiliation(s)
- Guanrong Wu
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Qibo Zhu
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Anyi Liang
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Zijing Du
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Chunwen Zheng
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Yanhua Liang
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
- Department of Ophthalmology, The People's Hospital of JiangMen, Jiangmen, China
| | - Yuxiang Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yunyan Hu
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Lingcong Kong
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Yingying Liang
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Maman Lawali Dan Jouma Amadou
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Yuejuan Liu
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China
| | - Songfu Feng
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Ling Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dan Cao
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China.
| | - Jinxin Lin
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Eye Institute, Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China.
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Putera I, Ten Berge JCEM, Thiadens AAHJ, Dik WA, Agrawal R, van Hagen PM, La Distia Nora R, Rombach SM. Clinical Features and Predictors of Treatment Outcome in Patients with Ocular Tuberculosis from the Netherlands and Indonesia: The OculaR TB in Low versus High Endemic Countries (ORTEC) Study. Ocul Immunol Inflamm 2024:1-12. [PMID: 38820475 DOI: 10.1080/09273948.2024.2359614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE To describe and compare clinical features, treatment approaches, and treatment outcomes of ocular tuberculosis (OTB) patients in the Netherlands, a low tuberculosis (TB)-endemic country, and Indonesia, a high TB-endemic country. We also aimed to identify predictors of treatment outcomes. METHODS A medical chart review of 339 OTB patients (n = 93 from the Netherlands and n = 246 from Indonesia) was performed. The primary outcome was response to treatment, whether with or without anti-tubercular treatment, after six months of treatment initiation (good versus poor responders). RESULTS Indonesian OTB patients displayed a higher prevalence of chest radiograph findings indicative of TB infection (p < 0.001) and concurrent active systemic TB (p = 0.011). Indonesian cohort exhibited a more acute and severe disease profile, including uveitis duration ≤ 3 months (p < 0.001), blindness (p < 0.001), anterior chamber (AC) cells ≥ 2+ (p < 0.001), and posterior synechiae (p < 0.001). Overall proportions of good responders to treatment were 67.6% in the Netherlands and 71.5% in Indonesia. Presence of AC cell ≥ 2+ (adjusted odds ratio (aOR): 2.12, 95% CI: 1.09-4.14), choroidal lesions other than serpiginous-like choroiditis (SLC) or tuberculoma (aOR: 4.47, 95% CI: 1.18-16.90), and retinal vasculitis (aOR: 2.32, 95% CI: 1.10-4.90) at baseline were predictors for poor response to treatment. CONCLUSIONS Despite a more severe initial clinical presentation in the Indonesian cohort, the overall treatment outcomes of OTB was comparable in both cohorts. Three baseline clinical features were identified as predictors of treatment outcomes.
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Affiliation(s)
- Ikhwanuliman Putera
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Alberta A H J Thiadens
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Willem A Dik
- Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Duke NUS Medical School, Singapore, Singapore
- Ocular Infections and Antimicrobial Group, Singapore Eye Research Institute, Singapore, Singapore
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - P Martin van Hagen
- Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rina La Distia Nora
- Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Saskia M Rombach
- Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Gibelalde A, Pinar-Sueiro S, Ibarrondo O, Ruiz Miguel M, Martínez Soroa I, Mendicute J. Characteristics of pseudophakic retinal detachment and risk factors of recurrence. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00092-6. [PMID: 38823449 DOI: 10.1016/j.oftale.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND The present study was designed to gain knowledge about the prognostic factors and evolution of pseudophakic retinal detachment (PRD) and to analyse the main characteristics of PRD, such as the mean time to retinal detachment following cataract surgery, as well as the clinical factors associated with the risk of recurrence and worse anatomical and functional outcomes. METHODS This was a retrospective monocentric study of 330 patients with PRD who underwent surgery between 2012 and 2020. All patients were pseudophakic and were referred for retinal detachment surgery at Donostia University Hospital (Terciary Hospital, Spain). RESULTS The mean age of the patients at the time of phacoemulsification was 63.06 ± 10.8 years, and 49.09% of them had moderate myopia [axial length (AL) (23.5-26.5 mm)]. In our series, macular detachment was evident in 69.09% (n = 228) of the patients. The mean time that elapsed between phacoemulsification and PRD surgery was 4.04 ± 4.17 years, which was reduced by half in the event of surgical complications (2.24 ± 2.65). The rate of PRD was 28.79%. The anatomical results in terms of retinal reapplication were better with the combination of vitrectomy and scleral buckling (83.1% vs. 70.5%) (p = 0,127) compared with vitrectomy. The variables associated with a higher risk of recurrence were male sex (hazard ratio (HR) = 1.75), macular detachment (HR = 2.00) and the presence of proliferative vitreoretinopathy (PVR) (HR = 3.21). CONCLUSIONS PRD usually occurs within 4 years of phacoemulsification, although it may occur significantly earlier in the event of surgical complications. Macular involvement, PVR, and male sex are all associated with a higher risk of PRD recurrence.
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Affiliation(s)
- A Gibelalde
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain.
| | - S Pinar-Sueiro
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - O Ibarrondo
- Unidad de Investigación AP-OSI, Alto Deba Integrated Health Care Organization, Arrasate-Mondragón, Mondragon, Spain
| | - M Ruiz Miguel
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - I Martínez Soroa
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - J Mendicute
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
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Machalińska A, Kuligowska A, Ziontkowska-Wrzałek A, Stroynowska B, Pius-Sadowska E, Safranow K, Machaliński J, Mozolewska-Piotrowska K, Machaliński B. The Severity of Diabetic Retinopathy Corresponds with Corneal Nerve Alterations and Ocular Discomfort of the Patient. Int J Mol Sci 2024; 25:6072. [PMID: 38892258 PMCID: PMC11173272 DOI: 10.3390/ijms25116072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Diabetic retinopathy (DR) remains the leading cause of blindness in the working-age population. Its progression causes gradual damage to corneal nerves, resulting in decreased corneal sensitivity (CS) and disruption of anterior-eye-surface homeostasis, which is clinically manifested by increased ocular discomfort and dry eye disease (DED). This study included 52 DR patients and 52 sex- and age-matched controls. Ocular Surface Disease Index (OSDI) survey, tear film-related parameters, CS, and in vivo corneal confocal microscopy (IVCM) of the subbasal plexus were performed. Furthermore, all patients underwent tear sampling for neurotrophin and cytokine analysis. OSDI scores were greater in DR patients than in controls (p = 0.00020). No differences in the Schirmer test score, noninvasive tear film-break-up time (NIBUT), tear meniscus or interferometry values, bulbar redness, severity of blepharitis or meibomian gland loss were found. In the DR group, both the CS (p < 0.001), and the scotopic pupil diameter (p = 0.00008) decreased. IVCM revealed reduced corneal nerve parameters in DR patients. The stage of DR was positively correlated with the OSDI (Rs = +0.51, 95% CI: + 0.35-+0.64, p < 0.001) and negatively correlated with IVCM corneal nerve parameters and scotopic pupillometry (Rs = -0.26, 95% CI: -0.44--0.06, p = 0.0097). We found negative correlations between the OSDI and IVCM corneal innervation parameters. The DR group showed lower tear film-brain-derived neurotrophic factor (BDNF) levels (p = 0.0001) and no differences in nerve growth factor (NGF)-β, neurotrophin (NT)-4, vascular endothelial growth factor (VEGF), interleukin (IL)-1β, IL-4, IL-5, IL-6, or IL-12 concentrations. Tumor necrosis factor (TNF)-α, IL-2, IL-8, IL-10, granulocyte macrophage colony-stimulating factor (GM-CSF), and interferon (IFN)-γ levels were decreased among patients with DR. Corneal innervation defects have a direct impact on patients' subjective feelings. The evolution of DR appears to be associated with corneal nerve alterations, emphasizing the importance of IVCM.
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Affiliation(s)
- Anna Machalińska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Agnieszka Kuligowska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Alicja Ziontkowska-Wrzałek
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Beata Stroynowska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Ewa Pius-Sadowska
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (E.P.-S.); (B.M.)
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Jan Machaliński
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Katarzyna Mozolewska-Piotrowska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.K.); (A.Z.-W.); (B.S.); (J.M.); (K.M.-P.)
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (E.P.-S.); (B.M.)
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Goh KL, Abbott CJ, Campbell TG, Cohn AC, Ong DN, Wickremasinghe SS, Hodgson LAB, Guymer RH, Wu Z. Clinical performance of predicting late age-related macular degeneration development using multimodal imaging. Clin Exp Ophthalmol 2024. [PMID: 38812454 DOI: 10.1111/ceo.14405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/17/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND To examine whether the clinical performance of predicting late age-related macular degeneration (AMD) development is improved through using multimodal imaging (MMI) compared to using colour fundus photography (CFP) alone, and how this compares with a basic prediction model using well-established AMD risk factors. METHODS Individuals with AMD in this study underwent MMI, including optical coherence tomography (OCT), fundus autofluorescence, near-infrared reflectance and CFP at baseline, and then at 6-monthly intervals for 3-years to determine MMI-defined late AMD development. Four retinal specialists independently assessed the likelihood that each eye at baseline would progress to MMI-defined late AMD over 3-years with CFP, and then with MMI. Predictive performance with CFP and MMI were compared to each other, and to a basic prediction model using age, presence of pigmentary abnormalities, and OCT-based drusen volume. RESULTS The predictive performance of the clinicians using CFP [AUC = 0.75; 95% confidence interval (CI) = 0.68-0.82] improved when using MMI (AUC = 0.79; 95% CI = 0.72-0.85; p = 0.034). However, a basic prediction model outperformed clinicians using either CFP or MMI (AUC = 0.85; 95% CI = 0.78-91; p ≤ 0.002). CONCLUSIONS Clinical performance for predicting late AMD development was improved by using MMI compared to CFP. However, a basic prediction model using well-established AMD risk factors outperformed retinal specialists, suggesting that such a model could further improve personalised counselling and monitoring of individuals with the early stages of AMD in clinical practice.
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Affiliation(s)
- Kai Lyn Goh
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Carla J Abbott
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Thomas G Campbell
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Amy C Cohn
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Dai Ni Ong
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Sanjeewa S Wickremasinghe
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Lauren A B Hodgson
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Zhichao Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
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Brissette A, Cole B, Hall B. Visual Function After Implantation of Trifocal and Trifocal Toric Intraocular Lenses Using Intraoperative Aberrometry. Clin Ophthalmol 2024; 18:1547-1554. [PMID: 38832075 PMCID: PMC11146617 DOI: 10.2147/opth.s450979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To evaluate patient outcomes and visual function following trifocal and trifocal toric intraocular lens (IOL) implantation using intraoperative aberrometry at a single site in the US. Methods This prospective, single arm study included 21 subjects that completed 3 month follow-up. Inclusion criteria were visually significant cataract and potential post-operative visual acuity of 20/25 or better. Endpoints included postoperative prediction error, refractive outcomes, uncorrected visual acuities at distance (UDVA), intermediate (UIVA), and near (UNVA), contrast sensitivity, and subject responses on the modified Visual Function Quality of Life Questionnaire (VF-14 QOL). Results Binocular UDVA, UIVA, and UNVA were 20/25 or better in 100% (21/21), 100% (21/21), 90% (19/21) of subjects. The absolute prediction error was 0.50 D or less in 79% (33/42) of eyes, and 81% (34/42) and 86% (36/42) of eyes achieved ≤0.5 D of residual astigmatism and manifest refraction spherical equivalent, respectively. On the modified VF-14 QOL, driving at night, reading small print, and reading a newspaper or book were the tasks that had the lowest percentages of subjects reporting no difficulty or a little difficulty. Conclusion Implantation with trifocal and trifocal toric IOLs using intraoperative aberrometry can provide high refractive precision, leading to excellent visual performance and low visual task difficulty at all ranges (distance, intermediate, and near).
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Affiliation(s)
- Ashley Brissette
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Brigette Cole
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
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Arrigo A, Aragona E, Allamprese M, Battaglia Parodi M. Ophthalmologists' awareness of geographic atrophy: An Italian survey including 365 participants. Eur J Ophthalmol 2024:11206721241258428. [PMID: 38809658 DOI: 10.1177/11206721241258428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE Geographic atrophy (GA) is a severe complication of age-related macular degeneration (AMD) and leads to irreversible visual decline. To date, no effective treatment is available for GA patients. However, a number of new therapies have recently been approved and several others are in the pipeline. This rapid evolution of prospects for GA patients requires constant updating of ophthalmologists' understanding of GA and its management so as to provide the appropriate treatment. For this reason, Società Italiana di Scienze Oftalmologiche (S.I.S.O.) has designed a specific survey to gauge the position of Italian ophthalmologists in this regard. METHODS The three hundred and sixty-five Italian ophthalmologists who agreed to take part received a seventeen-part questionnaire guaranteeing privacy and anonymity. The survey was compiled through an online portal and the results were sent directly to S.I.S.O. ETS. Two graders analyzed the data and recorded the results. RESULTS The results showed a high level of self-assessed awareness and understanding of GA, as well as considerable willingness to further improve knowledge of the disease. Most of the participants claimed to have effective rules of conduct in place for managing GA patients, including prompt response, involving a high prevalence of nutraceutical prescriptions and lifestyle recommendations. CONCLUSIONS This survey provided an overview of how GA patients are managed in Italy. The Italian ophthalmology community appears to be ready to adopt the upcoming treatments for GA.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | | | - Maurizio Battaglia Parodi
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
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Perone JM, Goetz C, Zevering Y, Derumigny A. Principal Component Analysis of a Real-World Cohort of Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty Cases: Demonstration of a Powerful Data-Mining Technique for Identifying Areas of Research. Cornea 2024:00003226-990000000-00569. [PMID: 38830189 DOI: 10.1097/ico.0000000000003584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Principal component analysis (PCA) is a descriptive exploratory statistical technique that is widely used in complex fields for data mining. However, it is rarely used in ophthalmology. We explored its research potential with a large series of eyes that underwent 3 keratoplasty techniques: Descemet membrane endothelial keratoplasty (DMEK), conventional Descemet stripping automated endothelial keratoplasty (ConDSAEK), or ultrathin-DSAEK (UT-DSAEK). METHODS All consecutive DMEK/DSAEK cases conducted in 2016 to 2022 that had ≥24 months of follow-up were included. ConDSAEK and UT-DSAEK were defined as preoperative central graft thickness ≥130 and <130 μm, respectively. Seventy-six patient, disease, surgical practice, and temporal outcome variables were subjected to PCA, including preoperative anterior keratometry, the use of sulfur hexafluoride gas (SF6) versus air for primary tamponade, and postoperative best corrected visual acuity and endothelial cell density. Associations of interest that were revealed by PCA were assessed with the Welch t test or Pearson test. RESULTS A total of 331 eyes were treated with DMEK (n = 165), ConDSAEK (n = 95), or UT-DSAEK (n = 71). PCA showed that ConDSAEK and UT-DSAEK clustered closely, including regarding postoperative best corrected visual acuity, and were clearly distinct from DMEK. PCA and follow-up univariate analyses suggested that in DMEK, 1) flatter preoperative anterior keratometry (average, K1, and K2) associated with more rebubbling (P = 0.004-0.089) and graft detachment (P = 0.007-0.022); 2) graft marking did not affect postoperative ECD; and 3) lower postoperative endothelial cell density associated with SF6 use (all P > 0.001) and longer surgery (P = 0.005-0.091). All associations are currently under additional investigation in our hospital. CONCLUSIONS PCA is a powerful technique that can rapidly reveal clinically relevant associations in complex ophthalmological datasets.
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Affiliation(s)
- Jean-Marc Perone
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, Mercy Hospital, Metz, France
| | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Mercy Hospital, Metz, France; and
| | - Yinka Zevering
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Mercy Hospital, Metz, France; and
| | - Alexis Derumigny
- Department of Applied Mathematics, Delft University of Technology, Delft, the Netherlands
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Muma S, Naidoo KS, Hansraj R. Situation analysis on the integration of refractive error services provided by optometrists into the national health services in Kenya. BMC Public Health 2024; 24:1442. [PMID: 38811959 PMCID: PMC11138047 DOI: 10.1186/s12889-024-18960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/27/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Even though the burden of uncorrected refractive error could potentially be addressed through innovative and cost-effective approaches, integration of the services into the National Health Services (NHS) is desirable. However, minimal information exists on the current situation warranting the need for evidence about the integration of refractive error service provided by optometrists into the national health services in Kenya. METHODS A situation analysis of the Kenyan refractive error services provided by optometrists within the NHS was undertaken based on access to service delivery, service coverage, and human resource. A strengths, weaknesses, opportunities, and threats analysis was undertaken based on the existent evidence to identify the core factors that could potentially facilitate or hinder the integration of refractive error services provided by optometrists within the National Health Services. The proportion of optometrists to be integrated in the NHS was estimated based on the minimum ratios recommended by the World Health Organization. RESULTS A section of tertiary and secondary healthcare facilities in Kenya have specific services to address refractive errors within the NHS with most facilities lacking such services. Treatment of refractive error occurs at the level of eye care general services. There are 11,547 health facilities offering primary care services in Kenya. However, none of them offers refractive error services and only a section of facilities offering county health referral services provides eye care services which is limited to refraction without provision of spectacles. The existing workforce comprises of ophthalmologists, optometrists and ophthalmic clinical officers, together with nurses and other general paramedical assistants. Optometrists, ophthalmologists and ophthalmic clinical officers are allowed to undertake refraction. However, optometrists majorly practices in the private sector. Centralization of eye care services in urban areas, weak referral systems, and a shortage in the workforce per population was observed. CONCLUSIONS The Kenyan NHS should advocate for primary care and reorient the current hospital-based delivery approach for refractive error services. This is attributed to the fact that provision of refractive error services at primary care remains effective and efficient and could translate to early detection of other ocular conditions. The existing human resources in the eye health ecosystem in Kenya should maximize their efforts towards addressing uncorrected refractive error and optometrists should be integrated into the NHS.
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Affiliation(s)
- Shadrack Muma
- College of Health Sciences, Department of Optometry, University of KwaZulu-Natal, Durban, South Africa.
- , PO Box 811, Kisumu, Kenya.
| | - Kovin Shunmugam Naidoo
- College of Health Sciences, Department of Optometry, University of KwaZulu-Natal, Durban, South Africa
- ONESIGHT EssilorLuxottica Foundation, Paris, France
| | - Rekha Hansraj
- College of Health Sciences, Department of Optometry, University of KwaZulu-Natal, Durban, South Africa
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Umaefulam V, Safi S, Lingham G, Gordon I, Mueller A, Krishnam NS, Alves Carneiro VL, Yu M, Evans JR, Keel S. Approaches for delivery of refractive and optical care services in community and primary care settings. Cochrane Database Syst Rev 2024; 5:CD016043. [PMID: 38808577 PMCID: PMC11134311 DOI: 10.1002/14651858.cd016043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Uncorrected refractive error is a leading cause of vision impairment which, in most cases, can be managed with the appropriate spectacle correction. In 2021, the World Health Assembly endorsed a global target of a 40-percentage-point increase in effective coverage of refractive error by 2030. To achieve this global target, equitable access to refractive and optical services within community and primary care settings needs to be strengthened. This review will inform the development of technical guidance to support improvements in the testing and correction of refractive error among World Health Organization (WHO) member states. OBJECTIVES To determine the range of approaches for delivery of refractive and optical care services in community and primary care settings, and the methods employed for their evaluation. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and Global Health databases, grey literature, and annual reports and websites of relevant organizations involved in eye-care delivery from January 2002 to November 2022 to identify approaches for refractive and optical service delivery. SELECTION CRITERIA We included observational and interventional studies, reviews, and reports from relevant organizations related to delivering refractive services and optical services for preschool and school-aged children and adults in community and primary care settings published between January 2002 and November 2022. We searched for studies and reports published within the last 20 years because vision impairment due to uncorrected refractive error has only recently become a public health and eye health priority, therefore we did not expect to find much relevant literature until after 2002. DATA COLLECTION AND ANALYSIS Two review authors screened titles, abstracts and full texts, and extracted data. We resolved any discrepancies through discussion. We synthesized data, and presented results as tables, figures, and case studies. This project was led by the World Health Organization (WHO) Vision and Eye Care Programme. MAIN RESULTS We identified 175 studies from searches of databases and grey literature, 146 records from company reports, and 81 records from website searches of relevant organizations that matched our inclusion criteria. Delivery approaches for refractive and optical services in community care included school-based, pharmacy, and outreach models, whereas primary care approaches comprised vision centre, health centre, and a combination of vision or health centre and door-to-door delivery. In community care, school-based and outreach approaches were predominant, while in primary care, a vision-centre approach was mainly used. In the WHO African region, the school-based and outreach approaches were mainly reported while, in the Americas, the outreach approach was mostly used. Very few approaches for service delivery were reported in the WHO Eastern Mediterranean region. Prominent gaps exist in the evaluation of the approaches, and few studies attempted to evaluate the approaches for delivery of refractive and optical care services. AUTHORS' CONCLUSIONS We comprehensively describe a range of approaches for delivery of refractive and optical services in community and primary care. Further evaluation of their effectiveness will better inform the application of these service-delivery approaches. The study outcomes will help guide WHO member states in strengthening refractive and optical services at community and primary care levels. FUNDING This scoping review was supported by the Vision and Eye care Programme, World Health Organization and ATscale Global Partnership. REGISTRATION The protocol of this scoping review was published in the Open Source Framework.
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Affiliation(s)
- Valerie Umaefulam
- Vision and Eye Care Programme, World Health Organization, Geneva, Switzerland
| | - Sare Safi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gareth Lingham
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Iris Gordon
- International Centre for Eye Health (ICEH), London School of Hygiene & Tropical Medicine, London, UK
| | - Andreas Mueller
- Noncommunicable Diseases, World Health Organization, Melbourne, Australia
| | | | - Vera L Alves Carneiro
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Mitasha Yu
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Jennifer R Evans
- International Centre for Eye Health (ICEH), London School of Hygiene & Tropical Medicine, London, UK
| | - Stuart Keel
- Vision and Eye Care Programme, World Health Organization, Geneva, Switzerland
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D’Esposito F, Gagliano C, Bloom PA, Cordeiro MF, Avitabile A, Gagliano G, Costagliola C, Avitabile T, Musa M, Zeppieri M. Epigenetics in Glaucoma. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:905. [PMID: 38929522 PMCID: PMC11205742 DOI: 10.3390/medicina60060905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Primary open angle glaucoma (POAG) is defined as a "genetically complex trait", where modifying factors act on a genetic predisposing background. For the majority of glaucomatous conditions, DNA variants are not sufficient to explain pathogenesis. Some genes are clearly underlying the more "Mendelian" forms, while a growing number of related polymorphisms in other genes have been identified in recent years. Environmental, dietary, or biological factors are known to influence the development of the condition, but interactions between these factors and the genetic background are poorly understood. Several studies conducted in recent years have led to evidence that epigenetics, that is, changes in the pattern of gene expression without any changes in the DNA sequence, appear to be the missing link. Different epigenetic mechanisms have been proven to lead to glaucomatous changes in the eye, principally DNA methylation, post-translational histone modification, and RNA-associated gene regulation by non-coding RNAs. The aim of this work is to define the principal epigenetic actors in glaucoma pathogenesis. The identification of such mechanisms could potentially lead to new perspectives on therapeutic strategies.
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Affiliation(s)
- Fabiana D’Esposito
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK; (F.D.)
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
- Eye Clinic, Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Philip Anthony Bloom
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK; (F.D.)
- Western Eye Hospital, Imperial College Healthcare NHS Trust, London NW1 5QH, UK
| | - Maria Francesca Cordeiro
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
- Western Eye Hospital, Imperial College Healthcare NHS Trust, London NW1 5QH, UK
| | - Alessandro Avitabile
- Eye Clinic, Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Giuseppe Gagliano
- Eye Clinic, Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Ciro Costagliola
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Teresio Avitabile
- Eye Clinic, Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Zhang Y, Liu B, Yang M, Li S, Qu Y, Ma Y, Ye L, Mei J. 16S rRNA sequencing in chronic dacryocystitis. Clin Exp Optom 2024:1-10. [PMID: 38811366 DOI: 10.1080/08164622.2024.2358246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/28/2024] [Indexed: 05/31/2024] Open
Abstract
CLINICAL RELEVANCE The pathogenesis of chronic dacryocystitis (CDC) is associated with a variety of bacteria. Investigating microflora has the potential to provide a theoretical basis for preventing and treating CDC. BACKGROUND 16S rRNA sequencing is a sequence-based bacterial analysis. The application of 16S rRNA sequencing in CDC is rarely reported. METHODS A case-control study of infected and healthy eyes diagnosed as CDC patients was conducted. Seventy-eight patients were divided into A (conjunctival sac secretions from healthy eyes), B (conjunctival sac secretions from affected eyes), and C (lacrimal sac secretions from affected eyes) groups. The flora of samples was analysed with 16S rRNA sequencing, and the data was analysed using QIIME, R, LefSE and other software. The potential functions were analysed by PICRUSt. RESULTS A total of 1440 operational taxonomic units (OTUs) were obtained, 139 specific to group A, 220 specific to group B, and 239 specific to group C. There was no significant difference in α index between the three groups. The beta diversity and grouping analysis data indicated that the three groups of flora were similar in species richness and diversity, but there were some differences in composition. In group A, the abundance of Pseudomonadaceae, Chlorobacteria, Moraceae, Staphylococcaceae, Bacillariophyceae, Immunobacterium spp. and Bacillus spp. was higher; in group B, the abundance of Burkholderiaceae, Sphingomonas, Rhizobia, Stalked Bacteria, Sphingomonadaceae, Enterobacteriaceae, Shortwaveomonas spp. was higher; in group C, the abundance of Streptococcus digestiveis, Propionibacterium, Enterobacteriaceae, Anaerobacteriaceae, Propionibacteriaceae, Bacillus spp. Neisseria spp. and Shortactomonas spp. was higher. Six pathways were identified to assess the potential microbial functions. CONCLUSION Alterations in the microbiota of the conjunctiva and lacrimal sac are associated with the pathogenesis of CDC, which may provide certain guidance for antibiotic treatment of CDC.
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Affiliation(s)
- Yongxin Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Beian Liu
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Meina Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Shixu Li
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Yunhao Qu
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Yingge Ma
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Lin Ye
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jun Mei
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Patel SV, Hodge DO, Baratz KH. Corneal Backscatter, Pachymetric Indices, and Ectasia Indices for the Assessment of Fuchs Endothelial Corneal Dystrophy. Cornea 2024:00003226-990000000-00568. [PMID: 38830190 DOI: 10.1097/ico.0000000000003577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/15/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE To determine whether corneal backscatter, pachymetric indices, and ectasia indices derived from Scheimpflug tomography can identify Fuchs endothelial corneal dystrophy (FECD) corneas with abnormal tomography, the relationships between these parameters and tomographic edema in FECD, and if these parameters help predict improvement in central corneal thickness (CCT) after Descemet membrane endothelial keratoplasty (DMEK). METHODS Tomography maps of 132 eyes of 80 subjects with FECD were analyzed to determine how backscatter, pachymetric, and ectasia parameters compared with the instrument's normative database and if any predicted tomographic edema. Tomography maps from a separate group undergoing DMEK were split into derivation (48 eyes of 39 subjects) and validation (45 eyes of 41 subjects) subgroups to derive a predictive model of improvement in CCT after DMEK. Backscatter, pachymetric, and ectasia parameters were incorporated to determine if the model could be enhanced. RESULTS Among all ectasia, pachymetric, and backscatter parameters, at best only 65% of FECD corneas with definite tomographic edema could be identified based on the instrument's normative database. Among all parameters individually, the highest sensitivity for detecting tomographic edema was 77%. Anterior and mid-corneal backscatter featured in a model predicting improvement in CCT after DMEK with high performance in derivation (R2 = 0.79; 95% confidence interval, 0.65-0.87) and validation (R2 = 0.72; 95% confidence interval, 0.52-0.83) subgroups. CONCLUSIONS The Scheimpflug camera software program could not reliably detect abnormal tomography in FECD from corneal backscatter, pachymetric indices, or ectasia indices. Corneal backscatter contributes to, but does not enhance, a predictive model of improvement in CCT after DMEK.
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Affiliation(s)
- Sanjay V Patel
- Department of Ophthalmology, Mayo Clinic, Rochester, MN; and
| | - David O Hodge
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
| | - Keith H Baratz
- Department of Ophthalmology, Mayo Clinic, Rochester, MN; and
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Quah NQX, Javed KMAA, Arbi L, Hanumunthadu D. Real-World Outcomes of Faricimab Treatment for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema. Clin Ophthalmol 2024; 18:1479-1490. [PMID: 38827773 PMCID: PMC11141735 DOI: 10.2147/opth.s463624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/09/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose The purpose of this study was to assess preliminary real-world outcomes in neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) treated with intravitreal faricimab. Patients and Methods This was a retrospective, observational consecutive-case real-world study of patients with nAMD or DME initiated on intravitreal faricimab between November 2022 and April 2023. Treatment-naïve patients and patients previously treated with alternate anti-vascular endothelial growth factor (anti-VEGF) agents were initiated on an intended treatment plan of four monthly faricimab injections as a loading regime. Efficacy was assessed across four treatment groups. Primary outcomes assessed for both cohorts were changes in best corrected visual acuity (BCVA) and central subfield thickness (CST) on optical coherence tomography (OCT). Secondary outcomes were alterations in OCT-defined structural features. Results From 127 patients, 146 eyes received at least one dose of faricimab. Mean BCVA, measured in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, from baseline to fifth visit increased from: 59.0±12.8 to 62.2±14.3 in treatment-naïve nAMD; 61.1±17.6 to 63.5±14.8 in previously-treated nAMD; 61.1±13.0 to 72.8±11.5 in treatment-naïve DME; and 60.8±14.6 to 63.3±15.6 in previously-treated DME. Mean CST reduced in all four treatment groups between initiation to final loading dose, from: 442.8±172.0µm to 305.2±117.0µm (p<0.0001) in treatment-naïve nAMD; 355.2±115.1µm to 297.9±92.54µm (p<0.0001) in previously-treated nAMD; 465.8±109.1µm to 343.1±100.3µm (p<0.0001) in treatment-naïve DME; and 492.5±133.1µm to 388.5±131.4µm (p<0.0001) in previously-treated DME. Conclusion Real-world outcomes showed some improvement in BCVA and CST for nAMD and DME following faricimab administration, including in patients previously treated with other anti-VEGF agents. Further work involving larger cohorts over longer periods is required to determine whether improvement is maintained, and if intervals can be extended to match those observed in clinical trials.
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Affiliation(s)
- Nicole Q X Quah
- Department of Ophthalmology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | | | - Lamees Arbi
- Department of Ophthalmology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Daren Hanumunthadu
- Department of Ophthalmology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
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Suanno G, Genna VG, Maurizi E, Dieh AA, Griffith M, Ferrari G. Cell therapy in the cornea: The emerging role of microenvironment. Prog Retin Eye Res 2024; 102:101275. [PMID: 38797320 DOI: 10.1016/j.preteyeres.2024.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
The cornea is an ideal testing field for cell therapies. Its highly ordered structure, where specific cell populations are sequestered in different layers, together with its accessibility, has allowed the development of the first stem cell-based therapy approved by the European Medicine Agency. Today, different techniques have been proposed for autologous and allogeneic limbal and non-limbal cell transplantation. Cell replacement has also been attempted in cases of endothelial cell decompensation as it occurs in Fuchs dystrophy: injection of cultivated allogeneic endothelial cells is now in advanced phases of clinical development. Recently, stromal substitutes have been developed with excellent integration capability and transparency. Finally, cell-derived products, such as exosomes obtained from different sources, have been investigated for the treatment of severe corneal diseases with encouraging results. Optimization of the success rate of cell therapies obviously requires high-quality cultured cells/products, but the role of the surrounding microenvironment is equally important to allow engraftment of transplanted cells, to preserve their functions and, ultimately, lead to restoration of tissue integrity and transparency of the cornea.
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Affiliation(s)
- Giuseppe Suanno
- Vita-Salute San Raffaele University, Milan, Italy; Eye Repair Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Eleonora Maurizi
- Centre for Regenerative Medicine ''S. Ferrari'', University of Modena and Reggio Emilia, Modena, Italy
| | - Anas Abu Dieh
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
| | - May Griffith
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.
| | - Giulio Ferrari
- Vita-Salute San Raffaele University, Milan, Italy; Eye Repair Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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235
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Patel D, Abdi S, Carmichael J, Balaskas K, Blandford A. What are the experiences of teleophthalmology in optometric referral pathways? A qualitative interview study with patients and clinicians. BMJ Open 2024; 14:e078161. [PMID: 38803257 PMCID: PMC11129051 DOI: 10.1136/bmjopen-2023-078161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/17/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Implementing teleophthalmology into the optometric referral pathway may ease the current pressures on hospital eye services caused by over-referrals from some optometrists. This study aimed to understand the practical implications of implementing teleophthalmology by analysing lived experiences and perceptions of teleophthalmology in the optometric referral pathway for suspected retinal conditions. DESIGN Qualitative in-depth interview study SETTING: Fourteen primary care optometry practices and four secondary care hospital eye services from four NHS Foundation Trusts across the UK. PARTICIPANTS We interviewed 41 participants: patients (17), optometrists (18), and ophthalmologists (6) who were involved in the HERMES study. Through thematic analysis, we collated and present their experiences of implementing teleophthalmology. RESULTS All participants interviewed were positive towards teleophthalmology as it could enable efficiencies in the referral pathway and improve feedback and communication between patients and healthcare professionals. Concerns included setup costs for optometrists and anxieties from patients about not seeing an ophthalmologist face to face. However, reducing unnecessary visits and increasing the availability of resources and capacity were seen as significant benefits. CONCLUSIONS Overall, we report positive experiences of implementing teleophthalmology into the optometric referral pathway for suspected retinal conditions. Successful implementation will require appropriate investment to set up and integrate new technology and remunerate services, and continued evaluation to ensure timely feedback to patients and between healthcare professionals is received. TRIAL REGISTRATION NUMBER ISRCTN18106677.
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Affiliation(s)
- Dilisha Patel
- UCL Interaction Centre, University College London, London, UK
| | - Sarah Abdi
- UCL Interaction Centre, University College London, London, UK
| | - Josie Carmichael
- UCL Interaction Centre, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Ann Blandford
- UCL Interaction Centre, University College London, London, UK
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Arnould L, Balsat E, Hashimoto Y, White A, Kong G, Dunn H, Fan L, Gabrielle PH, Bron AM, Creuzot-Garcher CP, Lawlor M. Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry. Br J Ophthalmol 2024:bjo-2023-325077. [PMID: 38789132 DOI: 10.1136/bjo-2023-325077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE To evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up. METHODS A retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications. Qualified success (QS) was defined similarly, allowing the use of IOP-lowering medications. RESULTS The Xen 45 gel stent implant was implanted in 646 eyes of 515 patients. Preoperative IOP was 21.4±7.6 (mean±SD) mm Hg on 2.7±1.3 IOP-lowering medication and mean deviation was -10.2±8.4 dB. After 24-month follow-up, IOP was 16.8±7.3 mm Hg (mean reduction of 21.7%) on 1.2±1.4 IOP-lowering medications. CS and QS rates at 24 months were 26% and 48%, respectively. CS and QS were higher in the Xen stand-alone group (33% and 52%, respectively) than in the Xen+cataract group (16% and 42%, respectively). Bleb needling was performed in 28.4% of cases, and 18% underwent a secondary procedure. CONCLUSIONS The Xen 45 gel stent implant offers acceptable long-term efficacy for the treatment of open-angle glaucoma. However, there is a significant rate of reoperation and needling, and outcomes are less effective if combined with cataract surgery.
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Affiliation(s)
- Louis Arnould
- Ophthalmology, Centre Hospitalier Universitaire de Dijon, Dijon, France
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), (EA 7460), Dijon, France
| | - Elise Balsat
- Ophthalmology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Yohei Hashimoto
- Ophthalmology, Save Sight Institute, Sydney, New South Wales, Australia
| | - Andrew White
- Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - George Kong
- Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
| | - Hamish Dunn
- Ophthalmology, Save Sight Institute, Sydney, New South Wales, Australia
| | - Leo Fan
- Ophthalmology, Save Sight Institute, Sydney, New South Wales, Australia
| | - Pierre-Henry Gabrielle
- Ophthalmology, Centre Hospitalier Universitaire de Dijon, Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, INRA Centre de Dijon, Dijon, France
| | - Alain M Bron
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, INRA Centre de Dijon, Dijon, France
- Ophthalmology, University Hospital, Dijon, France
| | - Catherine P Creuzot-Garcher
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, INRA Centre de Dijon, Dijon, France
- Ophthalmology, University Hospital, Dijon, France
| | - Mitchell Lawlor
- Ophthalmology, Save Sight Institute, Sydney, New South Wales, Australia
- Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia
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237
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Rinaldi L, Rigo S, Pani M, Bisoglio A, Khalaf K, Minonzio M, Shiffer D, Romeo MA, Verzeletti P, Ciccarelli M, Bordoni MG, Stranges S, Riboli E, Furlan R, Barbic F. Long-COVID autonomic syndrome in working age and work ability impairment. Sci Rep 2024; 14:11835. [PMID: 38782998 PMCID: PMC11116376 DOI: 10.1038/s41598-024-61455-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Long-COVID19 has been recently associated with long-sick leave and unemployment. The autonomic nervous system functioning may be also affected by SARS-CoV-2, leading to a chronic autonomic syndrome. This latter remains widely unrecognized in clinical practice. In the present study, we assessed the occurrence of Long-COVID19 Autonomic Syndrome in a group of active workers as well as the relationships between their autonomic dysfunction and work ability. This prospective observational study was conducted during the 2nd wave of the pandemic in Italy. Forty-five patients (53.6 ± 8.4 years; 32 M) hospitalized for COVID19, were consecutively enrolled at the time of their hospital discharge (T0) and followed-up for 6 months. Autonomic symptoms and work ability were assessed by COMPASS31 and Work Ability Index questionnaires at T0, one (T1), three and six (T6) months after hospital discharge and compared to those retrospectively collected for a period preceding SARS-CoV-2 infection. Clinical examination and standing test were also performed at T1 and T6. One in three working-age people developed a new autonomic syndrome that was still evident 6 months after the acute infection resolution. This was associated with a significant reduction in the work ability. Recognition of Long-COVID19 Autonomic Syndrome may promote early intervention to facilitate return to work and prevent unemployment.
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Affiliation(s)
- Luca Rinaldi
- Occupational Medicine, IRCCS Salvatore Maugeri, University of Pavia, Pavia, Italy
| | - Stefano Rigo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Margherita Pani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Andrea Bisoglio
- Department of Neurosurgery, University Vita e Salute S. Raffaele, Milan, Italy
| | - Kareem Khalaf
- Department of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Maura Minonzio
- IRCCS Humanitas Research Hospital, Internal Medicine, 20089, Rozzano, Italy
| | - Dana Shiffer
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Internal Medicine, 20089, Rozzano, Italy
| | - Maria Angela Romeo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Michele Ciccarelli
- IRCCS Humanitas Research Hospital, Internal Medicine, 20089, Rozzano, Italy
| | | | - Saverio Stranges
- Departments of Epidemiology and Biostatistics, Family Medicine and Medicine, Western University, London, ON, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elio Riboli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- School of Public Health, Imperial College London, London, UK
| | - Raffaello Furlan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Internal Medicine, 20089, Rozzano, Italy
| | - Franca Barbic
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
- IRCCS Humanitas Research Hospital, Internal Medicine, 20089, Rozzano, Italy.
- Departments of Epidemiology and Biostatistics, Family Medicine and Medicine, Western University, London, ON, Canada.
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238
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Sakanishi Y, Usui-Ouchi A, Morita S, Sakuma T, Ebihara N. Relationship between Image Quality and Reproducibility of Surgical Images in 3D Digital Surgery. J Clin Med 2024; 13:3051. [PMID: 38892762 PMCID: PMC11172911 DOI: 10.3390/jcm13113051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/14/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: Ophthalmic three-dimensional (3D) digital surgery can reproduce high-definition surgical images; however, 3D digital surgery is limited by recording capacities. We examined the relationship between the minimum image quality required to reproduce surgical images and recording capacity. Methods: Patients who underwent simultaneous vitrectomy and cataract surgery by the same surgeon using a 3D digital surgery system at Juntendo University Urayasu Hospital between February and October 2021 were evaluated. Various quality (Q) and frame rate (FR) settings were used for each case. Four vitreous surgeons evaluated the reproducibility of recorded images of macular manipulation for epiretinal membrane (ERM) and macular hole (MH) cases and those of peripheral retinal manipulation for rhegmatogenous retinal detachment (RRD) cases. The video bitrate and minimum settings required to reproduce surgical images and factors affecting surgical image reproducibility were examined. Results: A total of 129 eyes of 129 patients were observed. The minimum image quality required to reproduce surgical images was 11.67 Mbps. The Q and FR for periretinal processing and Q for macular manipulation affected surgical image reproducibility (p = 0.025, p = 0.019, and p = 0.07, respectively). The minimum recording settings required to obtain highly reproducible images were Q = 3 and FR = 40. The total file size for vitrectomy video recordings with these settings was as compact as 3.17 GB for 28 min. Conclusions: During 3D digital surgery, highly reproducible surgical images can be obtained with a small storage capacity using settings of at least Q = 3 and FR = 40.
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Affiliation(s)
- Yoshihito Sakanishi
- Juntendo University Urayasu Hospital, Tomioka 2-1-1, Urayasu 279-0021, Chiba, Japan; (A.U.-O.); (S.M.); (T.S.); (N.E.)
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239
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Di Girolamo N. Biologicals and Biomaterials for Corneal Regeneration and Vision Restoration in Limbal Stem Cell Deficiency. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2401763. [PMID: 38777343 DOI: 10.1002/adma.202401763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/15/2024] [Indexed: 05/25/2024]
Abstract
The mammalian cornea is decorated with stem cells bestowed with the life-long task of renewing the epithelium, provided they remain healthy, functional, and in sufficient numbers. If not, a debilitating disease known as limbal stem cell deficiency (LSCD) can develop causing blindness. Decades after the first stem cell (SC) therapy is devised to treat this condition, patients continue to suffer unacceptable failures. During this time, improvements to therapeutics have included identifying better markers to isolate robust SC populations and nurturing them on crudely modified biological or biomaterial scaffolds including human amniotic membrane, fibrin, and contact lenses, prior to their delivery. Researchers are now gathering information about the biomolecular and biomechanical properties of the corneal SC niche to decipher what biological and/or synthetic materials can be incorporated into these carriers. Advances in biomedical engineering including electrospinning and 3D bioprinting with surface functionalization and micropatterning, and self-assembly models, have generated a wealth of biocompatible, biodegradable, integrating scaffolds to choose from, some of which are being tested for their SC delivery capacity in the hope of improving clinical outcomes for patients with LSCD.
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Affiliation(s)
- Nick Di Girolamo
- Mechanisms of Disease and Translational Research, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
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240
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Madsen MBM, Ivarsen A, Hjortdal J. Visual function after ultrathin Descemet's stripping automated endothelial keratoplasty or Descemet's membrane endothelial keratoplasty combined with cataract surgery: a randomised controlled clinical trial. Br J Ophthalmol 2024; 108:654-661. [PMID: 37290822 DOI: 10.1136/bjo-2023-323304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
AIMS To compare best-corrected visual acuity (BCVA), contrast sensitivity and endothelial cell density (ECD) after ultrathin Descemet's stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet's membrane endothelial keratoplasty (DMEK). METHODS A randomised, single-blinded, single-centre design was used. 72 patients with Fuchs' endothelial dystrophy and cataract were randomised to UT-DSAEK or DMEK combined with phacoemulsification and lens implantation. 27 patients with cataract were included in a control group and treated with phacoemulsification and lens implantation. The primary outcome was BCVA at 12 months. RESULTS Compared with UT-DSAEK, DMEK resulted in better BCVA with mean differences of 6.1 early treatment diabetic retinopathy study (ETDRS) (p=0.001) after 3 months, 7.4 ETDRS (p<0.001) after 6 months and 5.7 ETDRS (p<0.001) after 12 months. The control group obtained significantly better BCVA with a mean difference of 5.2 ETDRS (p<0.001) compared with DMEK 12 months postoperatively. Compared with UT-DSAEK, contrast sensitivity was significantly better 3 months after DMEK with a mean difference of 0.10 LogCS (p=0.03). However, our study found no effect after 12 months (p=0.08). ECD was significantly lower after UT-DSAEK compared with DMEK with mean differences of 332 cells/mm2 (p<0.01) after 3 months, 296 cells/mm2 (p<0.01) after 6 months and 227 cells/mm2 (p=0.03) after 12 months. CONCLUSIONS Compared with UT-DSAEK, DMEK resulted in better BCVA 3, 6 and 12 months postoperatively. Twelve months postoperatively, DMEK had a higher ECD than UT-DSAEK; however, no difference in contrast sensitivity was found. TRIAL REGISTRATION NUMBER NCT04417959.
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Affiliation(s)
| | - Anders Ivarsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus N, Denmark
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus N, Denmark
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241
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Kong CF, Go C, Goolam S, Yeung S. Diagnostic utility of in vivo confocal microscopy in Acanthamoeba keratitis following corneal crosslinking. BMJ Case Rep 2024; 17:e257279. [PMID: 38772872 DOI: 10.1136/bcr-2023-257279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024] Open
Abstract
Acanthamoeba keratitis (AK) is a rare but potentially sight-threatening complication of corneal collagen crosslinking (CXL) for keratoconus. In this report, we describe an early adolescent male who underwent routine CXL for progressive keratoconus in his left eye. Preprocedural left visual acuity (VA) was 6/9. At day 5 postprocedure, multifocal corneal infiltrates were identified. Corneal scrape, bandage contact lens cultures and herpetic and Acanthamoeba PCR were negative. In vivo, confocal microscopy (IVCM) identified Acanthamoeba cysts within the corneal stroma. Intensive amoebicidal therapy was initiated, but recovery was complicated by significant inflammation, resulting in widespread aggressive corneal vascularisation necessitating topical steroids and steroid-sparing agents. At 10 months, his left VA was 6/24. This report emphasises the importance of maintaining a high index of suspicion for AK in cases of post-CXL microbial keratitis and highlights the diagnostic value of IVCM, particularly in culture-negative and PCR-negative cases.
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Affiliation(s)
- Cheng Fei Kong
- The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia
- Westmead Hospital, Westmead, New South Wales, Australia
| | - Christopher Go
- The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia
- Westmead Hospital, Westmead, New South Wales, Australia
| | - Saadiah Goolam
- The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia
- Westmead Hospital, Westmead, New South Wales, Australia
| | - Season Yeung
- Westmead Hospital, Westmead, New South Wales, Australia
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242
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Bressler I, Aviv R, Margalit D, Rom Y, Ianchulev T, Dvey-Aharon Z. Autonomous screening for laser photocoagulation in fundus images using deep learning. Br J Ophthalmol 2024; 108:742-746. [PMID: 37217293 PMCID: PMC11137462 DOI: 10.1136/bjo-2023-323376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/15/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Diabetic retinopathy (DR) is a leading cause of blindness in adults worldwide. Artificial intelligence (AI) with autonomous deep learning algorithms has been increasingly used in retinal image analysis, particularly for the screening of referrable DR. An established treatment for proliferative DR is panretinal or focal laser photocoagulation. Training autonomous models to discern laser patterns can be important in disease management and follow-up. METHODS A deep learning model was trained for laser treatment detection using the EyePACs dataset. Data was randomly assigned, by participant, into development (n=18 945) and validation (n=2105) sets. Analysis was conducted at the single image, eye, and patient levels. The model was then used to filter input for three independent AI models for retinal indications; changes in model efficacy were measured using area under the receiver operating characteristic curve (AUC) and mean absolute error (MAE). RESULTS On the task of laser photocoagulation detection: AUCs of 0.981, 0.95, and 0.979 were achieved at the patient, image, and eye levels, respectively. When analysing independent models, efficacy was shown to improve across the board after filtering. Diabetic macular oedema detection on images with artefacts was AUC 0.932 vs AUC 0.955 on those without. Participant sex detection on images with artefacts was AUC 0.872 vs AUC 0.922 on those without. Participant age detection on images with artefacts was MAE 5.33 vs MAE 3.81 on those without. CONCLUSION The proposed model for laser treatment detection achieved high performance on all analysis metrics and has been demonstrated to positively affect the efficacy of different AI models, suggesting that laser detection can generally improve AI-powered applications for fundus images.
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Affiliation(s)
| | | | | | - Yovel Rom
- AEYE Health, New York, New York, USA
| | - Tsontcho Ianchulev
- AEYE Health, New York, New York, USA
- Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
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243
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Zhang C, Cheng S, Chen H, Yang J, Chen Y. New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study. Front Immunol 2024; 15:1404785. [PMID: 38835770 PMCID: PMC11148381 DOI: 10.3389/fimmu.2024.1404785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/07/2024] [Indexed: 06/06/2024] Open
Abstract
Purpose To investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection. Methods A cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection. Results 31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p<0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively). Conclusion Mild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.
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Affiliation(s)
- Chenxi Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shiyu Cheng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huan Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Khanam T, Parekh M. Importance of gauging wet lab training outcome to increase safety and enhance the uptake of DMEK surgery. Eye (Lond) 2024:10.1038/s41433-024-03144-8. [PMID: 38769468 DOI: 10.1038/s41433-024-03144-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024] Open
Affiliation(s)
- Tina Khanam
- Moorfields Eye Hospital NHS Foundation trust, London, UK.
- Spire St. Anthony's, London, UK.
- Centre For Sight, London, UK.
- My-iClinic, London, UK.
- The Royal College of Ophthalmologists, London, UK.
| | - Mohit Parekh
- Institute of Ophthalmology, University College London, London, UK
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245
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Olteanu G, Ciucă-Pană MA, Busnatu ȘS, Lupuliasa D, Neacșu SM, Mititelu M, Musuc AM, Ioniță-Mîndrican CB, Boroghină SC. Unraveling the Microbiome-Human Body Axis: A Comprehensive Examination of Therapeutic Strategies, Interactions and Implications. Int J Mol Sci 2024; 25:5561. [PMID: 38791599 PMCID: PMC11122276 DOI: 10.3390/ijms25105561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
This review scrutinizes the intricate interplay between the microbiome and the human body, exploring its multifaceted dimensions and far-reaching implications. The human microbiome, comprising diverse microbial communities inhabiting various anatomical niches, is increasingly recognized as a critical determinant of human health and disease. Through an extensive examination of current research, this review elucidates the dynamic interactions between the microbiome and host physiology across multiple organ systems. Key topics include the establishment and maintenance of microbiota diversity, the influence of host factors on microbial composition, and the bidirectional communication pathways between microbiota and host cells. Furthermore, we delve into the functional implications of microbiome dysbiosis in disease states, emphasizing its role in shaping immune responses, metabolic processes, and neurological functions. Additionally, this review discusses emerging therapeutic strategies aimed at modulating the microbiome to restore host-microbe homeostasis and promote health. Microbiota fecal transplantation represents a groundbreaking therapeutic approach in the management of dysbiosis-related diseases, offering a promising avenue for restoring microbial balance within the gut ecosystem. This innovative therapy involves the transfer of fecal microbiota from a healthy donor to an individual suffering from dysbiosis, aiming to replenish beneficial microbial populations and mitigate pathological imbalances. By synthesizing findings from diverse fields, this review offers valuable insights into the complex relationship between the microbiome and the human body, highlighting avenues for future research and clinical interventions.
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Affiliation(s)
- Gabriel Olteanu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania;
| | - Maria-Alexandra Ciucă-Pană
- Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bagdasar-Arseni Emergency Hospital, 050474 Bucharest, Romania;
| | - Ștefan Sebastian Busnatu
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Dumitru Lupuliasa
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania; (D.L.); (S.M.N.)
| | - Sorinel Marius Neacșu
- Department of Pharmaceutical Technology and Bio-Pharmacy, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania; (D.L.); (S.M.N.)
| | - Magdalena Mititelu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania;
| | - Adina Magdalena Musuc
- Institute of Physical Chemistry—Ilie Murgulescu, Romanian Academy, 060021 Bucharest, Romania
| | - Corina-Bianca Ioniță-Mîndrican
- Department of Toxicology, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Steluța Constanța Boroghină
- Department of Complementary Sciences, History of Medicine and Medical Culture, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
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Balparda K, García-Onrubia L, Valentín-Bravo FJ, Escobar-Giraldo M, Caro Magdaleno M, Acera Osa A, Merayo-Lloves J, Galarreta DJ. Rasch validation of the Keratoconus End-Points Assessment Questionnaire in a Spanish population with keratoconus. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00089-6. [PMID: 38768852 DOI: 10.1016/j.oftale.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/21/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To carry out a methodologically complete validation of the Spanish version of the Keratoconus End-Points Assessment Questionnaire (KEPAQ) in a Spanish population with keratoconus. METHODS Analytical, prospective study, including patients with keratoconus without previous surgical history, in which a measurement of quality of life was performed using the KEPAQ questionnaire, a complete exploration of the anterior pole and a corneal elevation topography with the Galilei G6 topographer. The evaluation of the psychometric characteristics of the scale in the studied population was carried out using Rasch modeling. RESULTS A total of 140 patients with keratoconus were included, with a median age of 26.0 years, the majority (57.6%) being men. For the KEPAQ-E subscale, the median score was 69.3, with a reliability of 0.85 and an eigenvalue of the first contrast of 2.34. For the KEPAQ-F, the median score was 56.4, with a reliability of 0.88 and an eigenvalue of 2.00. All infit and outfit parameters were within normal limits for both subscales. A significant evaluation was found between the evaluations of both subscales (rho = 0.696; p < 0.001). The evaluations of the subscales and various clinical and tomographic characteristics showed a significant classification between them (p value between 0.048 y 0.001). CONCLUSION The KEPAQ is a psychometrically robust and valid scale to evaluate quality of life in the Spanish population with keratoconus. This questionnaire can be easily used for both clinical and research aims.
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Affiliation(s)
- K Balparda
- Práctica Privada, Medellín, Colombia; The affiliation of K. Balparda, L. García-Onrubia, and F.J. Valentín-Bravo at the time of this article was the Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
| | - L García-Onrubia
- Fundación Jiménez Díaz, Madrid, Spain; The affiliation of K. Balparda, L. García-Onrubia, and F.J. Valentín-Bravo at the time of this article was the Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - F J Valentín-Bravo
- Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain; The affiliation of K. Balparda, L. García-Onrubia, and F.J. Valentín-Bravo at the time of this article was the Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Escobar-Giraldo
- Departamento de Oftalmología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - M Caro Magdaleno
- Hospital Universitario Virgen Macarena, Sevilla, Spain; Red de Enfermedades Inflamatorias REI-RICORS RD21/0002/0011, Instituto de Salud Carlos III, Madrid, Spain
| | - A Acera Osa
- Red de Enfermedades Inflamatorias REI-RICORS RD21/0002/0011, Instituto de Salud Carlos III, Madrid, Spain; Grupo de Oftalmobiología Experimental (GOBE), Universidad del País Vasco, Leioa, Vizcaya, Spain; Ikerbasque, Fundación Vasca para la Ciencia, Bilbao, Vizcaya, Spain
| | - J Merayo-Lloves
- Red de Enfermedades Inflamatorias REI-RICORS RD21/0002/0011, Instituto de Salud Carlos III, Madrid, Spain; Instituto Fernández Vega, Oviedo, Asturias, Spain
| | - D J Galarreta
- Red de Enfermedades Inflamatorias REI-RICORS RD21/0002/0011, Instituto de Salud Carlos III, Madrid, Spain; Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Nijm L, Matossian C, Rhee MK, Stephens JD, Rosselson ME, Majmudar PA, Gollamudi SR, Patel RH, Bauskar A, Montieth A, Vantipalli S, Gibson A, Metzinger JL, Goldstein MH, Gurses Ozden R. Early Real-World Patient and Staff Experience with an Intracanalicular Dexamethasone Insert. Clin Ophthalmol 2024; 18:1391-1401. [PMID: 38784434 PMCID: PMC11114144 DOI: 10.2147/opth.s448973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose To evaluate both the early experience of real-world patients treated with dexamethasone ophthalmic insert (0.4 mg; DEXTENZA®), hereafter referred to as DEX, after cataract surgery as well as staff/practice integration of DEX relative to eyedrops. Patients and Methods This was a cross-sectional survey study of 23 cataract practices in the United States. Respondents were patients and practice staff who had experience with DEX following cataract surgery. Both patients and practice staff completed an online survey. Descriptive statistics summarized the survey responses to portray the experience of the respondents. Results Surveys were completed by 62 patients and 19 practice staff. Almost all patients (93%) were satisfied or extremely satisfied with DEX. Patients highly preferred DEX (93%) to topical steroid drops (7%) based on past experiences with topical steroid drops. Most practice staff (95%) were satisfied or highly satisfied with DEX, reporting a 45% reduction in time spent educating patients on postoperative drop use and a 46% decrease in time spent addressing calls from pharmacies regarding postoperative medications. Conclusion Incorporating the DEX insert into clinical practice in cataract surgery practices can improve patient adherence, while potentially providing significant savings to practices in terms of time spent educating patients and responding to patient and pharmacy call-backs.
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Affiliation(s)
- Lisa Nijm
- Warrenville EyeCare and LASIK, Warrenville, IL, USA
- University of Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | | | | | | | | | | | | | - Ravi H Patel
- Eye Associates of Central Texas, Round Rock, TX, USA
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248
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Wu XY, Fang HH, Xu YW, Zhang YL, Zhang SC, Yang WH. Bibliometric analysis of hotspots and trends of global myopia research. Int J Ophthalmol 2024; 17:940-950. [PMID: 38766336 PMCID: PMC11074204 DOI: 10.18240/ijo.2024.05.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/14/2023] [Indexed: 05/22/2024] Open
Abstract
AIM To gain insights into the global research hotspots and trends of myopia. METHODS Articles were downloaded from January 1, 2013 to December 31, 2022 from the Science Core Database website and were mainly statistically analyzed by bibliometrics software. RESULTS A total of 444 institutions in 87 countries published 4124 articles. Between 2013 and 2022, China had the highest number of publications (n=1865) and the highest H-index (61). Sun Yat-sen University had the highest number of publications (n=229) and the highest H-index (33). Ophthalmology is the main category in related journals. Citations from 2020 to 2022 highlight keywords of options and reference, child health (pediatrics), myopic traction mechanism, public health, and machine learning, which represent research frontiers. CONCLUSION Myopia has become a hot research field. China and Chinese institutions have the strongest academic influence in the field from 2013 to 2022. The main driver of myopic research is still medical or ophthalmologists. This study highlights the importance of public health in addressing the global rise in myopia, especially its impact on children's health. At present, a unified theoretical system is still needed. Accurate surgical and therapeutic solutions must be proposed for people with different characteristics to manage and intervene refractive errors. In addition, the benefits of artificial intelligence (AI) models are also reflected in disease monitoring and prediction.
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Affiliation(s)
- Xing-Yang Wu
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Hui-Hui Fang
- School of Future Technology, South China University of Technology, Guangzhou 510641, Guangdong Province, China
| | - Yan-Wu Xu
- School of Future Technology, South China University of Technology, Guangzhou 510641, Guangdong Province, China
| | - Yan-Ling Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Shao-Chong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Wei-Hua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, Guangdong Province, China
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249
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Knecht KT, Chiriac G, Guan HD. The potential impact of a vegetarian diet on glaucoma. Surv Ophthalmol 2024:S0039-6257(24)00048-1. [PMID: 38768761 DOI: 10.1016/j.survophthal.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.
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Affiliation(s)
- Kathryn T Knecht
- Loma Linda University School of Pharmacy, Loma Linda, California, USA
| | - Gabriela Chiriac
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Howard D Guan
- Loma Linda University Eye Institute, Loma Linda, California, USA.
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250
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Vineyard K, Ong J, Soares B, Osteicoechea D, Kadipasaoglu CM, Waisberg E, Tavakkoli A, Vizzeri G, Lee AG. Refractive shifts in astronauts during spaceflight: mechanisms, countermeasures, and future directions for in-flight measurements. Eye (Lond) 2024:10.1038/s41433-024-03124-y. [PMID: 38760461 DOI: 10.1038/s41433-024-03124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/11/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Affiliation(s)
- Kelsey Vineyard
- Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Benjamin Soares
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | | | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Gianmarco Vizzeri
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
| | - Andrew G Lee
- Texas A&M School of Medicine, Bryan, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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