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Sampige R, Ong J, Waisberg E, Zaman N, Sarker P, Tavakkoli A, Lee AG. XR-SANS: a multi-modal framework for analyzing visual changes with extended reality (XR) in Spaceflight Associated Neuro-Ocular Syndrome (SANS). Eye (Lond) 2024; 38:2680-2685. [PMID: 38802484 PMCID: PMC11427693 DOI: 10.1038/s41433-024-03147-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Ritu Sampige
- School of Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA.
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, MA, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
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Waisberg E, Ong J, Lee AG. Google search spike of "My Eyes Hurt" in United States after solar eclipse: an analysis and future prevention. Eye (Lond) 2024; 38:2677-2679. [PMID: 38773259 PMCID: PMC11427567 DOI: 10.1038/s41433-024-03145-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 05/23/2024] Open
Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Daich Varela M, Sanders Villa A, Pontikos N, Crossland MD, Michaelides M. Digital health and wearable devices for retinal disease monitoring. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06634-3. [PMID: 39297890 DOI: 10.1007/s00417-024-06634-3] [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: 05/28/2024] [Revised: 07/30/2024] [Accepted: 08/29/2024] [Indexed: 09/21/2024] Open
Abstract
Digital health is wielding a growing influence across all areas of healthcare, encompassing various facets such as telemedicine, artificial intelligence (AI), and electronic healthcare records. In Ophthalmology, digital health innovations can be broadly divided into four categories: (i) self-monitoring home devices and apps, (ii) virtual and augmented reality visual aids, (iii) AI software, and (iv) wearables. Wearable devices can work in the background, collecting large amounts of objective data while we do our day-to-day activities, which may be ecologically more valid and meaningful to patients than that acquired in traditional hospital settings. They can be a watch, wristband, piece of clothing, glasses, cane, smartphone in our pocket, earphones, or any other device with a sensor that we carry with us. Focusing on retinal diseases, a key challenge in developing novel therapeutics has been to prove a meaningful benefit in patients' lives and the creation of objective patient-centred endpoints in clinical trials. In this review, we will discuss wearable devices collecting different aspects of visual behaviour, visual field, central vision, and functional vision, as well as their potential implementation as outcome measures in research/clinical trial settings. The healthcare landscape is facing a paradigm shift. Clinicians have a key role of collaborating with the development and fine-tuning of digital health innovations, as well as identifying opportunities where they can be leveraged to enhance our understanding of retinal diseases and improve patient outcomes.
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Affiliation(s)
- Malena Daich Varela
- Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Alejandro Sanders Villa
- Facultad de Enfermería y Obstetricia, Universidad Nacional Autónoma de México, Mexico City, México
- Primero Salud, Mexico City, México
| | - Nikolas Pontikos
- Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Michael D Crossland
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Michel Michaelides
- Moorfields Eye Hospital, London, UK.
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK.
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4
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Suh A, Ditelberg S, Szeto JJ, Kumar D, Ong J, Robert Gibson C, Mader TH, Waisberg E, Lee AG. Safety protocols, precautions, and countermeasures aboard the International Space Station (ISS) to prevent ocular injury. Surv Ophthalmol 2024:S0039-6257(24)00097-3. [PMID: 39236988 DOI: 10.1016/j.survophthal.2024.08.005] [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: 04/22/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/07/2024]
Abstract
The International Space Station (ISS) is a $100 billion epicenter of human activity in the vacuum of space, displaying mankind's collective endeavor to explore the cosmic frontier. Even within the marvels of technological sophistication aboard the ISS, the human eye remains a highly vulnerable structure. In the absence of multiple layers of protection and risk assessments, crewmembers would face a substantial increase in vulnerability to ocular injury. Aside from stringent preflight screening criteria for astronauts, the ISS is equipped with ophthalmic medications, environmental control and life support systems (e.g., humidity regulation, carbon dioxide removal, pressurized device regulators), and radiation protection to reduce ocular injury. Moreover, additional countermeasures are currently being developed to mitigate the effects of spaceflight-associated neuro-ocular syndrome (SANS) and lunar dust toxicity for the Artemis Program missions. The success of future endeavors hinges not only on continued technological innovation, but also respecting the intricate interplay between human physiology and the extraterrestrial environments. Establishing habitations on the Moon and Mars, as well as NASA's Gateway Program (humanity's first space station around the Moon), will introduce a new set of challenges, underscoring the necessity for continuous insights into ocular health in space. We discuss the safety protocols, precautions, and countermeasures implemented on the ISS to prevent ocular injury - an aspect often overshadowed by the grandeur of space exploration.
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Affiliation(s)
- Alex Suh
- Tulane University School of Medicine, New Orleans, Louisiana, United States.
| | - Sarah Ditelberg
- Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States
| | - Jonathan J Szeto
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Divy Kumar
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, United States
| | - C Robert Gibson
- KBR, NASA Johnson Space Center, Houston, Texas, United States
| | - Thomas H Mader
- NASA Ophthalmology Consultant, Moab, Utah, United States
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, Texas, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, United States; University of Texas MD Anderson Cancer Center, Houston, Texas, United States; Texas A&M College of Medicine, Texas, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
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5
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Waisberg E, Ong J, Paladugu P, Kamran SA, Zaman N, Tavakkoli A, Lee AG. Radiation-induced ophthalmic risks of long duration spaceflight: Current investigations and interventions. Eur J Ophthalmol 2024; 34:1337-1345. [PMID: 38151034 DOI: 10.1177/11206721231221584] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
PURPOSE As the average duration of space missions increases, astronauts will experience longer periods of exposure to risks of long duration space flight including microgravity and radiation. The risks from long-term exposure to space radiation remains ill-defined. We review the current literature on the possible and known risks of radiation on the eye (including radiation retinopathy) after long duration spaceflight. METHODS A PubMed and Google Scholar search of the English language ophthalmic literature was performed from inception to July 11, 2022. The following search terms were utilized independently or in conjunction to build this manuscript: "Radiation Retinopathy", "Spaceflight", "Space Radiation", "Spaceflight Associated Neuro-Ocular Syndrome", "Microgravity", "Hypercapnia", "Radiation Shield", "Cataract", and "SANS". A concise and selective approach of references was conducted in including relevant original studies and reviews. RESULTS A total of 65 papers were reviewed and 47 papers were included in our review. CONCLUSION We discuss the potential and developing countermeasures to mitigate these radiation risks in preparation for future space exploration. Given the complex nature of space radiation, no single approach will fully reduce the risks of developing radiation maculopathy in long-duration spaceflight. Understanding and appropriately overcoming the risks of space radiation is key to becoming a multi-planetary species.
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Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Joshua Ong
- Department of Ophthalmology, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, USA
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Texas A&M College of Medicine, Bryant, Texas, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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6
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Waisberg E, Ong J, Masalkhi M, Lee AG. Near infrared/ red light therapy a potential countermeasure for mitochondrial dysfunction in spaceflight associated neuro-ocular syndrome (SANS). Eye (Lond) 2024; 38:2499-2501. [PMID: 38702514 PMCID: PMC11385221 DOI: 10.1038/s41433-024-03091-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/06/2024] Open
Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | | | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Houston, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Orione M, Rubegni G, Tartaro R, Alberghina A, Fallico M, Orione C, Russo A, Tosi GM, Avitabile T. Utilization of apple vision pro in ophthalmic surgery: A pilot study. Eur J Ophthalmol 2024:11206721241273574. [PMID: 39140319 DOI: 10.1177/11206721241273574] [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: 08/15/2024]
Abstract
PURPOSE This paper explores the application of Apple Vision Pro in ophthalmic surgery, assessing its potential benefits in providing real-time imaging overlay, surgical guidance, and collaborative opportunities. MATERIALS AND METHOD The device was worn by 10 ophthalmic surgeons during eyelid malposition surgery. All surgeons performed the entire surgery while wearing the visor. At the end of procedure, all operators had to rate Apple Vision Pro visor according to 10 specific item and system usability scale (SUS) questionnaire. RESULTS The surgeons used the Apple Vision Pro during the entire procedure, and the results were positive, with high ratings for practicality, freedom of movement, integration into workflow, and learning. All surgeons rated the Apple Vision Pro above 85/100 in the SUS. CONCLUSION The incorporation of Apple Vision Pro in oculoplastic surgery offers several advantages, including improved visualization, enhanced precision, and streamlined communication among surgical teams. According to our preliminary results Apple Vision Pro could represents a valuable tool in ophthalmic surgery, with implications for enhancing surgical techniques and advancing XR research in the surgical field.
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Affiliation(s)
- M Orione
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - G Rubegni
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - R Tartaro
- Ophthalmology Unit, Ospedale Santo Spirito, Casale Monferrato, Italy
| | - A Alberghina
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - M Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - C Orione
- Ophthalmology Unit, Ospedale Santo Spirito, Casale Monferrato, Italy
| | - A Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - G M Tosi
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - T Avitabile
- Department of Ophthalmology, University of Catania, Catania, Italy
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Kamran SA, Hossain KF, Ong J, Waisberg E, Zaman N, Baker SA, Lee AG, Tavakkoli A. FA4SANS-GAN: A Novel Machine Learning Generative Adversarial Network to Further Understand Ophthalmic Changes in Spaceflight Associated Neuro-Ocular Syndrome (SANS). OPHTHALMOLOGY SCIENCE 2024; 4:100493. [PMID: 38682031 PMCID: PMC11046204 DOI: 10.1016/j.xops.2024.100493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/11/2024] [Accepted: 02/05/2024] [Indexed: 05/01/2024]
Abstract
Purpose To provide an automated system for synthesizing fluorescein angiography (FA) images from color fundus photographs for averting risks associated with fluorescein dye and extend its future application to spaceflight associated neuro-ocular syndrome (SANS) detection in spaceflight where resources are limited. Design Development and validation of a novel conditional generative adversarial network (GAN) trained on limited amount of FA and color fundus images with diabetic retinopathy and control cases. Participants Color fundus and FA paired images for unique patients were collected from a publicly available study. Methods FA4SANS-GAN was trained to generate FA images from color fundus photographs using 2 multiscale generators coupled with 2 patch-GAN discriminators. Eight hundred fifty color fundus and FA images were utilized for training by augmenting images from 17 unique patients. The model was evaluated on 56 fluorescein images collected from 14 unique patients. In addition, it was compared with 3 other GAN architectures trained on the same data set. Furthermore, we test the robustness of the models against acquisition noise and retaining structural information when introduced to artificially created biological markers. Main Outcome Measures For GAN synthesis, metric Fréchet Inception Distance (FID) and Kernel Inception Distance (KID). Also, two 1-sided tests (TOST) based on Welch's t test for measuring statistical significance. Results On test FA images, mean FID for FA4SANS-GAN was 39.8 (standard deviation, 9.9), which is better than GANgio model's mean of 43.2 (standard deviation, 13.7), Pix2PixHD's mean of 57.3 (standard deviation, 11.5) and Pix2Pix's mean of 67.5 (standard deviation, 11.7). Similarly for KID, FA4SANS-GAN achieved mean of 0.00278 (standard deviation, 0.00167) which is better than other 3 model's mean KID of 0.00303 (standard deviation, 0.00216), 0.00609 (standard deviation, 0.00238), 0.00784 (standard deviation, 0.00218). For TOST measurement, FA4SANS-GAN was proven to be statistically significant versus GANgio (P = 0.006); versus Pix2PixHD (P < 0.00001); and versus Pix2Pix (P < 0.00001). Conclusions Our study has shown FA4SANS-GAN to be statistically significant for 2 GAN synthesis metrics. Moreover, it is robust against acquisition noise, and can retain clear biological markers compared with the other 3 GAN architectures. This deployment of this model can be crucial in the International Space Station for detecting SANS. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada
| | - Khondker Fariha Hossain
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan
| | - Ethan Waisberg
- Department of Ophthalmology, University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada
| | - Salah A. Baker
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
| | - Andrew G. Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, Texas
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas
- Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Ophthalmology, Texas A&M College of Medicine, Texas
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada
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Waisberg E, Ong J, Masalkhi M, Mao XW, Beheshti A, Lee AG. Mitochondrial dysfunction in Spaceflight Associated Neuro-Ocular Syndrome (SANS): a molecular hypothesis in pathogenesis. Eye (Lond) 2024; 38:1409-1411. [PMID: 38326485 PMCID: PMC11126720 DOI: 10.1038/s41433-024-02951-3] [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: 01/12/2024] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Mouayad Masalkhi
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Xiao W Mao
- Division of Biomedical Engineering Sciences, Department of Basic Sciences, Loma Linda University Health, Loma Linda, CA, USA
| | - Afshin Beheshti
- Blue Marble Space Institute of Science, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Texas, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Ong J, Carrabba NV, Waisberg E, Zaman N, Memon H, Panzo N, Lee VA, Sarker P, Vogt AZ, Laylani N, Tavakkoli A, Lee AG. Dynamic Visual Acuity, Vestibulo-Ocular Reflex, and Visual Field in National Football League (NFL) Officiating: Physiology and Visualization Engineering for 3D Virtual On-Field Training. Vision (Basel) 2024; 8:35. [PMID: 38804356 PMCID: PMC11130928 DOI: 10.3390/vision8020035] [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: 03/28/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA
| | | | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge CB2 1TN, UK
- Moorfields Eye Hospital, NHS Foundation Trust, London EC1V 2PD, UK
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Hamza Memon
- Texas A&M School of Medicine, Bryan, TX 77807, USA
| | | | - Virginia A Lee
- Department of Biology, University of Virginia, Charlottesville, VA 22903, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Ashtyn Z Vogt
- Dean McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA
| | - Noor Laylani
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Andrew G Lee
- Texas A&M School of Medicine, Bryan, TX 77807, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX 77555, USA
- University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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Ong J, Waisberg E, Masalkhi M, Suh A, Kamran SA, Paladugu P, Sarker P, Zaman N, Tavakkoli A, Lee AG. "Spaceflight-to-Eye Clinic": Terrestrial advances in ophthalmic healthcare delivery from space-based innovations. LIFE SCIENCES IN SPACE RESEARCH 2024; 41:100-109. [PMID: 38670636 DOI: 10.1016/j.lssr.2024.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 04/28/2024]
Abstract
The phrase "Bench-to-Bedside" is a well-known phrase in medicine, highlighting scientific discoveries that directly translate to impacting patient care. Key examples of translational research include identification of key molecular targets in diseases and development of diagnostic laboratory tests for earlier disease detection. Bridging these scientific advances to the bedside/clinic has played a meaningful impact in numerous patient lives. The spaceflight environment poses a unique opportunity to also make this impact; the nature of harsh extraterrestrial conditions and medically austere and remote environments push for cutting-edge technology innovation. Many of these novel technologies built for the spaceflight environment also have numerous benefits for human health on Earth. In this manuscript, we focus on "Spaceflight-to-Eye Clinic" and discuss technologies built for the spaceflight environment that eventually helped to optimize ophthalmic health on Earth (e.g., LADAR for satellite docking now utilized in eye-tracking technology for LASIK). We also discuss current technology research for spaceflight associated neuro-ocular syndrome (SANS) that may also be applied to terrestrial ophthalmic health. Ultimately, various advances made to enable to the future of space exploration have also advanced the ophthalmic health of individuals on Earth.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States.
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Alex Suh
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States; Texas A&M College of Medicine, TX, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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12
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Waisberg E, Ong J, Zaman N, Kamran SA, Sarker P, Tavakkoli A, Lee AG. Head-mounted display cataract surgery: a new frontier with eye tracking and foveated rendering technology. Eye (Lond) 2024; 38:1022-1023. [PMID: 37857719 DOI: 10.1038/s41433-023-02794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA.
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA.
- Department of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA.
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA.
- University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Texas A&M College of Medicine, Bryan, TX, USA.
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
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13
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Kamran SA, Hossain KF, Ong J, Zaman N, Waisberg E, Paladugu P, Lee AG, Tavakkoli A. SANS-CNN: An automated machine learning technique for spaceflight associated neuro-ocular syndrome with astronaut imaging data. NPJ Microgravity 2024; 10:40. [PMID: 38548790 PMCID: PMC10978911 DOI: 10.1038/s41526-024-00364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/12/2024] [Indexed: 04/01/2024] Open
Abstract
Spaceflight associated neuro-ocular syndrome (SANS) is one of the largest physiologic barriers to spaceflight and requires evaluation and mitigation for future planetary missions. As the spaceflight environment is a clinically limited environment, the purpose of this research is to provide automated, early detection and prognosis of SANS with a machine learning model trained and validated on astronaut SANS optical coherence tomography (OCT) images. In this study, we present a lightweight convolutional neural network (CNN) incorporating an EfficientNet encoder for detecting SANS from OCT images titled "SANS-CNN." We used 6303 OCT B-scan images for training/validation (80%/20% split) and 945 for testing with a combination of terrestrial images and astronaut SANS images for both testing and validation. SANS-CNN was validated with SANS images labeled by NASA to evaluate accuracy, specificity, and sensitivity. To evaluate real-world outcomes, two state-of-the-art pre-trained architectures were also employed on this dataset. We use GRAD-CAM to visualize activation maps of intermediate layers to test the interpretability of SANS-CNN's prediction. SANS-CNN achieved 84.2% accuracy on the test set with an 85.6% specificity, 82.8% sensitivity, and 84.1% F1-score. Moreover, SANS-CNN outperforms two other state-of-the-art pre-trained architectures, ResNet50-v2 and MobileNet-v2, in accuracy by 21.4% and 13.1%, respectively. We also apply two class-activation map techniques to visualize critical SANS features perceived by the model. SANS-CNN represents a CNN model trained and validated with real astronaut OCT images, enabling fast and efficient prediction of SANS-like conditions for spaceflight missions beyond Earth's orbit in which clinical and computational resources are extremely limited.
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Affiliation(s)
- Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, US
| | - Khondker Fariha Hossain
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, US
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, US
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, US
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, US
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, US
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, US
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, US
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, US
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, US
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, US
- University of Texas MD Anderson Cancer Center, Houston, TX, US
- Texas A&M College of Medicine, Bryan, TX, US
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, US
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, US.
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14
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Waisberg E, Ong J, Masalkhi M, Zaman N, Sarker P, Lee AG, Tavakkoli A. Apple Vision Pro and why extended reality will revolutionize the future of medicine. Ir J Med Sci 2024; 193:531-532. [PMID: 37365445 DOI: 10.1007/s11845-023-03437-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
Apple unveiled its highly anticipated mixed-reality headset, called the Apple Vision Pro on June 5, 2023. The primary user interface relies on eye tracking, hand, gestures, cameras, and sensors, eliminating the need for physical controllers such as keyboards or touch screens. The refined capabilities of this technology can be utilized for diverse purposes, including but not limited to medical and surgical education, and remote medical consultations. All things considered, virtual reality is a highly promising area for the future of medicine, from improving medical education and vision screening to physical and psychological rehabilitation. We look forward to further innovations in this exciting area for years to come.
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Affiliation(s)
- Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
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15
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Waisberg E, Ong J, Masalkhi M, Zaman N, Sarker P, Lee AG, Tavakkoli A. The future of ophthalmology and vision science with the Apple Vision Pro. Eye (Lond) 2024; 38:242-243. [PMID: 37542175 PMCID: PMC10810972 DOI: 10.1038/s41433-023-02688-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Affiliation(s)
- Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin, Ireland.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmologys, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
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16
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Zaman N, Ong J, Waisberg E, Masalkhi M, Lee AG, Tavakkoli A, Zuckerbrod S. Advanced Visualization Engineering for Vision Disorders: A Clinically Focused Guide to Current Technology and Future Applications. Ann Biomed Eng 2024; 52:178-207. [PMID: 37861913 DOI: 10.1007/s10439-023-03379-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Head-mounted visualization technology, often in the form of virtual, augmented, and mixed reality (VAMR), has revolutionized how visual disorders may be approached clinically. In this manuscript, we review the available literature on VAMR for visual disorders and provide a clinically oriented guide to how VAMR technology has been deployed for visual impairments. The chief areas of clinical investigation with VAMR are divided include (1) vision assessment, (2) vision simulation, and (3) vision rehabilitation. We discuss in-depth the current literature of these areas in VAMR and upcoming/future applications to combat the detrimental impact of visual impairment worldwide.
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Affiliation(s)
- Nasif Zaman
- Human-Machine Perception Laboratory, University of Nevada, Reno, NV, USA
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, University of Nevada, Reno, NV, USA
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17
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Masalkhi M, Waisberg E, Ong J, Zaman N, Sarker P, Lee AG, Tavakkoli A. Apple Vision Pro for Ophthalmology and Medicine. Ann Biomed Eng 2023; 51:2643-2646. [PMID: 37332003 DOI: 10.1007/s10439-023-03283-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
The emergence of new technologies continues to break barriers and transform the way we perceive and interact with the world. In this scientific article, we explore the potential impact of the new Apple XR headset on revolutionizing accessibility for individuals with visual deficits. With its rumored exceptional 4-K displays per eye and 5000 nits of brightness, this headset has the potential to enhance the visual experience and provide a new level of accessibility for users with visual impairments. We delve into the technical specifications, discuss the implications for accessibility, and envision how this groundbreaking technology could open up new possibilities for individuals with visual deficits.
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Affiliation(s)
- Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- Houston Methodist Hospital, The Houston Methodist Research Institute, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
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18
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Waisberg E, Ong J, Masalkhi M, Zaman N, Kamran SA, Sarker P, Lee AG, Tavakkoli A. Text-to-image artificial intelligence to aid clinicians in perceiving unique neuro-ophthalmic visual phenomena. Ir J Med Sci 2023; 192:3139-3142. [PMID: 36787030 DOI: 10.1007/s11845-023-03315-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023]
Affiliation(s)
- Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
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19
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Waisberg E, Ong J, Zaman N, Kamran SA, Tavakkoli A, Lee AG. The impact of COVID-19 on managing ophthalmic diseases: an international, descriptive study. Ir J Med Sci 2023; 192:3101-3103. [PMID: 36773204 PMCID: PMC9918813 DOI: 10.1007/s11845-023-03306-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Anecdotally, the COVID-19 pandemic has resulted in more severe cases of eye disease, decreased medication compliance/availability, and decreased treatment volume due to the lockdown. AIMS We aim to quantify and bring together a variety of international perspectives from ophthalmologists of different subspecialties to characterize the global impact of COVID-19 on managing various ophthalmic disease. METHODS An online survey of 10 questions was conducted among ophthalmologists using a specialized survey program. RESULTS Fifty-two ophthalmologists were successfully contacted. Survey respondents include ophthalmologists from USA, Canada, Korea, Mexico, and New Zealand. Based on the results of our survey, 1 year after the pandemic, ophthalmic disease severity has worsened as well as a decrease in examination and medication compliance. CONCLUSIONS Ophthalmologists across the world have reported a general increase in disease severity and decrease in medication and examination compliance 1 year after the beginning of COVID-19.
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Affiliation(s)
- Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, USA
| | - Andrew G Lee
- 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
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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20
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Waisberg E, Ong J, Masalkhi M, Zaman N, Kamran SA, Sarker P, Tavakkoli A, Lee AG. The Case for Expanding Visual Assessments During Spaceflight. Prehosp Disaster Med 2023; 38:518-521. [PMID: 37365808 PMCID: PMC10445111 DOI: 10.1017/s1049023x23005964] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023]
Abstract
Spaceflight associated neuro-ocular syndrome (SANS) is one of the potential barriers to human long-duration spaceflight (LDSF), including a manned mission to Mars. While a large barrier, the pathophysiology of SANS is not well understood, and functional and structural findings from SANS continue to be further characterized. Currently on the International Space Station (ISS), scheduled visual assessments are static visual acuity, Amsler grid, and a self-reported survey. Additional visual assessments may help the understanding of this neuro-ophthalmic phenomenon, as well as the effects of spaceflight of overall ocular health. In this paper, a case is made for expanding scheduled visual assessments to include dynamic visual, contrast sensitivity (CS), visual field testing, and virtual reality-based metamorphopsia assessment during spaceflight. These further assessments may play a key role in helping to determine the structural and functional changes associated with SANS, which are crucial to maintain astronaut vision during LDSF, as well as for developing countermeasures. Finally, a brief discussion is provided about current challenges to expanding visual testing during spaceflight and potential solutions to these barriers, specifically head-mounted visual assessment technology.
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Affiliation(s)
- Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MichiganUSA
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NevadaUSA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NevadaUSA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NevadaUSA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NevadaUSA
| | - Andrew G. Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TexasUSA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TexasUSA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TexasUSA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New YorkUSA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TexasUSA
- University of Texas MD Anderson Cancer Center, Houston, TexasUSA
- Texas A&M College of Medicine, TexasUSA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IowaUSA
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21
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Ong J, Waisberg E, Masalkhi M, Kamran SA, Lowry K, Sarker P, Zaman N, Paladugu P, Tavakkoli A, Lee AG. Artificial Intelligence Frameworks to Detect and Investigate the Pathophysiology of Spaceflight Associated Neuro-Ocular Syndrome (SANS). Brain Sci 2023; 13:1148. [PMID: 37626504 PMCID: PMC10452366 DOI: 10.3390/brainsci13081148] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
Spaceflight associated neuro-ocular syndrome (SANS) is a unique phenomenon that has been observed in astronauts who have undergone long-duration spaceflight (LDSF). The syndrome is characterized by distinct imaging and clinical findings including optic disc edema, hyperopic refractive shift, posterior globe flattening, and choroidal folds. SANS serves a large barrier to planetary spaceflight such as a mission to Mars and has been noted by the National Aeronautics and Space Administration (NASA) as a high risk based on its likelihood to occur and its severity to human health and mission performance. While it is a large barrier to future spaceflight, the underlying etiology of SANS is not well understood. Current ophthalmic imaging onboard the International Space Station (ISS) has provided further insights into SANS. However, the spaceflight environment presents with unique challenges and limitations to further understand this microgravity-induced phenomenon. The advent of artificial intelligence (AI) has revolutionized the field of imaging in ophthalmology, particularly in detection and monitoring. In this manuscript, we describe the current hypothesized pathophysiology of SANS and the medical diagnostic limitations during spaceflight to further understand its pathogenesis. We then introduce and describe various AI frameworks that can be applied to ophthalmic imaging onboard the ISS to further understand SANS including supervised/unsupervised learning, generative adversarial networks, and transfer learning. We conclude by describing current research in this area to further understand SANS with the goal of enabling deeper insights into SANS and safer spaceflight for future missions.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA
| | | | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89512, USA
| | | | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89512, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89512, USA
| | - Phani Paladugu
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89512, USA
| | - Andrew G. Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX 77555, USA
- University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Texas A&M College of Medicine, Bryan, TX 77030, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA 50010, USA
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