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Goodman D, Zhu AY. Utility of artificial intelligence in the diagnosis and management of keratoconus: a systematic review. FRONTIERS IN OPHTHALMOLOGY 2024; 4:1380701. [PMID: 38984114 PMCID: PMC11182163 DOI: 10.3389/fopht.2024.1380701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/23/2024] [Indexed: 07/11/2024]
Abstract
Introduction The application of artificial intelligence (AI) systems in ophthalmology is rapidly expanding. Early detection and management of keratoconus is important for preventing disease progression and the need for corneal transplant. We review studies regarding the utility of AI in the diagnosis and management of keratoconus and other corneal ectasias. Methods We conducted a systematic search for relevant original, English-language research studies in the PubMed, Web of Science, Embase, and Cochrane databases from inception to October 31, 2023, using a combination of the following keywords: artificial intelligence, deep learning, machine learning, keratoconus, and corneal ectasia. Case reports, literature reviews, conference proceedings, and editorials were excluded. We extracted the following data from each eligible study: type of AI, input used for training, output, ground truth or reference, dataset size, availability of algorithm/model, availability of dataset, and major study findings. Results Ninety-three original research studies were included in this review, with the date of publication ranging from 1994 to 2023. The majority of studies were regarding the use of AI in detecting keratoconus or subclinical keratoconus (n=61). Among studies regarding keratoconus diagnosis, the most common inputs were corneal topography, Scheimpflug-based corneal tomography, and anterior segment-optical coherence tomography. This review also summarized 16 original research studies regarding AI-based assessment of severity and clinical features, 7 studies regarding the prediction of disease progression, and 6 studies regarding the characterization of treatment response. There were only three studies regarding the use of AI in identifying susceptibility genes involved in the etiology and pathogenesis of keratoconus. Discussion Algorithms trained on Scheimpflug-based tomography seem promising tools for the early diagnosis of keratoconus that can be particularly applied in low-resource communities. Future studies could investigate the application of AI models trained on multimodal patient information for staging keratoconus severity and tracking disease progression.
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Grant A, Roy-Gagnon MH, Bastasic J, Talekar A, Miller G, Li G, Freeman EE. Exploring ethnic and racial differences in intraocular pressure and glaucoma: The Canadian Longitudinal Study on aging. Heliyon 2024; 10:e28611. [PMID: 38586381 PMCID: PMC10998131 DOI: 10.1016/j.heliyon.2024.e28611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To determine whether self-reported race/ethnicity is associated with intraocular pressure (IOP) and glaucoma and to explore whether any associations are due to social, behavioral, genetic, or health differences. Design Cross-sectional analysis of population-based data. Methods We used the Canadian Longitudinal Study on Aging Comprehensive Cohort, which consists of 30,097 adults aged 45-85 years. Race/ethnicity was self-reported. Corneal-compensated intraocular pressure (IOP) was measured in mmHg using the Reichert Ocular Response Analyzer. Participants were asked to report if they have ever had a diagnosis of glaucoma and whether they used eye care in the past year. A glaucoma polygenic risk score (PRS) was calculated. Logistic and linear regression models were used. Results Black individuals had higher mean IOP levels (beta coefficient (β) = 1.46; 95% confidence interval [CI], 0.62, 2.30) while Chinese, Japanese and Korean (β = -1.00; 95% CI, -1.63, -0.38) and Southeast Asian and Filipino individuals (β = -1.56; 95% CI, -2.68, -0.43) had lower mean IOP levels as compared to White individuals after adjustment for sociodemographic, behavioral, genetic, and health-related variables. Black people were more likely to report glaucoma as compared to White people after adjustment (odds ratio [OR] = 2.43; 95% CI, 1.27, 4.64). Conclusion Racial and ethnic differences in IOP and glaucoma were identified. Adjusting for sociodemographic, behavioral, genetic, and health-related variables did not fully explain these differences. Longitudinal research is needed to further explore the reasons for these differences and to understand their relevance to disease pathogenesis and progression.
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Affiliation(s)
- Alyssa Grant
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Joseph Bastasic
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Akshay Talekar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Garfield Miller
- Ottawa Eye Institute, The Ottawa Hospital, Ottawa, Canada
- Department of Ophthalmology, University of Ottawa, Ottawa, Canada
| | - Gisele Li
- Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Ellen E. Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Canada
- Bruyère Research Institute, Ottawa, Canada
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KhalafAllah MT, Zangwill LM, Proudfoot J, Walker E, Girkin CA, Fazio MA, Weinreb RN, Bowd C, Moghimi S, De Moraes CG, Liebmann JM, Racette L. Racial Differences in Diagnostic Accuracy of Retinal Nerve Fiber Layer Thickness in Primary Open-Angle Glaucoma. Am J Ophthalmol 2024; 259:7-14. [PMID: 38708401 PMCID: PMC11068369 DOI: 10.1016/j.ajo.2023.10.012] [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: 05/07/2024]
Abstract
Purpose To evaluate the diagnostic accuracy of retinal nerve fiber layer thickness (RNFLT) by spectral-domain optical coherence tomography (OCT) in primary open-angle glaucoma (POAG) in eyes of African (AD) and European descent (ED). Design Comparative diagnostic accuracy analysis by race. Participants 379 healthy eyes (125 AD and 254 ED) and 442 glaucomatous eyes (226 AD and 216 ED) from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Methods Spectralis (Heidelberg Engineering GmbH) and Cirrus (Carl Zeiss Meditec) OCT scans were taken within one year from each other. Main Outcome Measures Diagnostic accuracy of RNFLT measurements. Results Diagnostic accuracy for Spectralis-RNFLT was significantly lower in eyes of AD compared to those of ED (area under the receiver operating curve [AUROC]: 0.85 and 0.91, respectively, P=0.04). Results for Cirrus-RNFLT were similar but did not reach statistical significance (AUROC: 0.86 and 0.90 in AD and ED, respectively, P =0.33). Adjustments for age, central corneal thickness, axial length, disc area, visual field mean deviation, and intraocular pressure yielded similar results. Conclusions OCT-RNFLT has lower diagnostic accuracy in eyes of AD compared to those of ED. This finding was generally robust across two OCT instruments and remained after adjustment for many potential confounders. Further studies are needed to explore the potential sources of this difference.
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Affiliation(s)
- Mahmoud T. KhalafAllah
- Vision Science Graduate Program, The University of Alabama at Birmingham, Birmingham, USA
- Department of Ophthalmology, Menoufia University, Shebin Elkom, Egypt
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - James Proudfoot
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - Evan Walker
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - Christopher A. Girkin
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, USA
| | - Massimo A. Fazio
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, USA
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - Christopher Bowd
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, USA
| | - C. Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, NY, USA
| | - Jeffrey M. Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, NY, USA
| | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, USA
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Trollip L, Alberto K, Makgotloe A. Optic Nerve Sheath Diameter: A Cross-Sectional Study of Ultrasonographic Measurement in Healthy Black South African Adults. Life (Basel) 2023; 13:1979. [PMID: 37895361 PMCID: PMC10608246 DOI: 10.3390/life13101979] [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: 06/12/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Ultrasonographic optic nerve sheath diameter (ONSD) measurement is an accurate, portable, and non-invasive method of detecting raised intracranial pressure that can also reflect dynamic, real-time changes in intracranial pressure fluctuations. Various studies have shown the mean range of ONSD to vary greatly across different population groups. This study aimed to determine the mean ONSD in healthy Black South African adults. In this cross-sectional study, healthy black South African adult participants underwent optic nerve sheath ultrasound of the right eye, with the diameter being measured at 3 mm behind the retina in two different planes. The average of the two measurements was used to find the mean optic nerve sheath diameter. This measurement was compared to that found in a Canadian adult population, and the effect of age, gender, and co-morbidities on ONSD was assessed. A total of 99 participants were included in this study, of which 39 were male and 60 were female. The mean ONSD was found to be 5.1 mm (SD ± 0.33). This value was significantly higher than the mean ONSD observed in the Canadian population (p < 0.001). There was no significant difference found between the mean ONSD in males and females (p = 0.652), and both age and presence of co-morbidities were not found to significantly correlate with ONSD. (p = 0.693 and p = 0.974, respectively).
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Affiliation(s)
- Lindy Trollip
- Department of Ophthalmology, University of Witwatersrand, Johannesburg 2193, South Africa; (K.A.); (A.M.)
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Li J, Li C, Huang Y, Guan P, Huang D, Yu H, Yang X, Liu L. Mendelian randomization analyses in ocular disease: a powerful approach to causal inference with human genetic data. J Transl Med 2022; 20:621. [PMID: 36572895 PMCID: PMC9793675 DOI: 10.1186/s12967-022-03822-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/11/2022] [Indexed: 12/27/2022] Open
Abstract
Ophthalmic epidemiology is concerned with the prevalence, distribution and other factors relating to human eye disease. While observational studies cannot avoid confounding factors from interventions, human eye composition and structure are unique, thus, eye disease pathogenesis, which greatly impairs quality of life and visual health, remains to be fully explored. Notwithstanding, inheritance has had a vital role in ophthalmic disease. Mendelian randomization (MR) is an emerging method that uses genetic variations as instrumental variables (IVs) to avoid confounders and reverse causality issues; it reveals causal relationships between exposure and a range of eyes disorders. Thus far, many MR studies have identified potentially causal associations between lifestyles or biological exposures and eye diseases, thus providing opportunities for further mechanistic research, and interventional development. However, MR results/data must be interpreted based on comprehensive evidence, whereas MR applications in ophthalmic epidemiology have some limitations worth exploring. Here, we review key principles, assumptions and MR methods, summarise contemporary evidence from MR studies on eye disease and provide new ideas uncovering aetiology in ophthalmology.
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Affiliation(s)
- Jiaxin Li
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Cong Li
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Yu Huang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China ,grid.413405.70000 0004 1808 0686Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Peng Guan
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Desheng Huang
- grid.412449.e0000 0000 9678 1884Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, Liaoning China
| | - Honghua Yu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Xiaohong Yang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Lei Liu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
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McClain IJ, Rooney DM, Tabin GC. Intraocular pressure screening during high-volume cataract surgery outreach in Ethiopia. BMC Ophthalmol 2022; 22:397. [PMID: 36199054 PMCID: PMC9533624 DOI: 10.1186/s12886-022-02618-1] [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: 03/23/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Glaucoma is the leading cause of irreversible blindness worldwide and is often undetected in resource-limited settings. Early screening and treatment of elevated intraocular pressure (IOP) reduces both the development and progression of visual field defects. IOP screening in developing countries is limited by access to ophthalmic equipment, trained ophthalmic staff, and follow up. High-volume cataract surgery outreaches in resource-limited countries provide ample opportunity for glaucoma screening, intervention and follow up. Methods This prospective cross-sectional study took place during a cataract outreach campaign sponsored by the Himalayan Cataract Project (HCP) in partnership with Felege Hiwot Hospital in Bahir Dar, Ethiopia, during April 5th – April 10th 2021. IOP was measured on the surgical eye of patients before undergoing small incision cataract surgery (SICS) using rebound tonometry with an iCare tonometer model IC100. Results Intraocular pressure (IOP) was measured in 604 eyes of 595 patients who received SICS. Mean IOP was 12.1 mmHg (SD = 5.0 mmHg). A total of 29 patients had an IOP greater than 21 mmHg representing 4.8% of total IOP measurements. A total of 17 patients received oral acetazolamide prior to surgery to acutely lower IOP. Six of these patients had their surgery delayed due to elevated IOP and 9 patients received excisional goniotomy at the time of SICS. A temporal approach during SCIS was taken for all patients with elevated IOP to allow for possible trabeculectomy at a future date. Discussion IOP screening during high-volume cataract outreach campaigns can be performed safely, accurately and on a large scale with minimal resources and supplemental training. Pre-operative IOP measurement can improve surgical care at the time of cataract surgery as well as help establish long-term follow up for patients with glaucoma.
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Affiliation(s)
- Ian J McClain
- Larner College of Medicine, University of Vermont, 46 Colchester Avenue, Burlington, Vermont, 05401, USA. .,Himalayan Cataract Project, Waterbury, VT, USA.
| | - David M Rooney
- Himalayan Cataract Project, Waterbury, VT, USA.,Department of Ophthalmology, Stanford University, Palo Alto, California, USA
| | - Geoffrey C Tabin
- Himalayan Cataract Project, Waterbury, VT, USA.,Department of Ophthalmology, Stanford University, Palo Alto, California, USA
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7
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Hoffmann EM, Aghayeva F, Wagner FM, Fiess A, Nagler M, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Pfeiffer N, Schuster AK. Intraocular Pressure and Its Relation to Ocular Geometry: Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2022; 63:40. [PMID: 35089330 PMCID: PMC8802016 DOI: 10.1167/iovs.63.1.40] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to investigate the association between intraocular pressure (IOP) and ocular geometry. Methods The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Study participants underwent a comprehensive ophthalmologic examination including noncontact tonometry, objective refraction, optical biometry, and Scheimpflug imaging of the anterior segment at the first 5-year follow-up examination (in 2012–2017). Multivariable linear regression analysis was carried out to determine associations of IOP and geometric parameter of the human phakic eye, namely central corneal thickness (CCT), corneal curvature, anterior chamber depth (ACD), lens thickness, and axial length. In addition, the relationship of IOP and the anterior chamber angle (ACA) width was analyzed. Results There were 6640 participants with phakia (age 57.3 ± 10.2 years, 49.1% women) that were included in this cross-sectional analysis. Mean IOP was 14.8 ± 2.9 mm Hg in the right eyes and 14.9 ± 2.9 mm Hg in the left eyes. IOP increased with higher CCT, greater posterior segment length, higher age (all P < 0.001), thicker lens (P = 0.003), and female sex (P = 0.05), whereas the ACD was not associated with higher IOP. The IOP increased with a narrower ACA in univariable analysis (P < 0.001), but not in adjusted analysis in subjects with an open angle. Conclusions IOP values are related to ocular geometry, as shown in this population-based study on Caucasian subjects. Thus, knowledge of the architecture of the eye is an important factor when measuring IOP. Longitudinal evaluation will analyze whether some of these parameters are also risk factors for the development of glaucoma.
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Affiliation(s)
- Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Fidan Aghayeva
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix M Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Achim Fiess
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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8
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Kelekele JTK, Kayembe DL, Mwanza JC. Profile of central corneal thickness and corneal endothelial cell morpho-density of in healthy Congolese eyes. BMC Ophthalmol 2021; 21:185. [PMID: 33888064 PMCID: PMC8063471 DOI: 10.1186/s12886-021-01947-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the pachymetric and corneal endothelial cell morphometric features and their relationship to ocular and systemic factors in healthy Congolese subjects. Methods Non-contact specular microscopy was used in 278 healthy eyes (278 subjects) to measure central corneal thickness (CCT), corneal endothelial cell density (CECD) along with cell size, coefficient of variation (CV) in cell size, and hexagonality (HEX). The lower and upper reference limits and average values for each parameter were determined. Correlation and association of average values with anthropo-demographic and clinical variables were assessed. Results The mean age was 38.9 ± 17.2 years (10.9–80.7 years). Average values were 504.2 ± 30.7 μm (CCT), 2907.1 ± 290.9 cells/mm2 (CECD), 348.5 ± 38.4 μm2 (cell size), 32.9 ± 3.6% (CV), and 51.8 ± 7.2% (HEX). CCT was 504.9 ± 33.6 μm in men and 503.6 ± 28.3 μm in women (p = .73); values for CECD were 2917.1 ± 253.5 cells/mm2 and 2899.2 ± 317.8 cells/mm2 (p = 0.61), respectively. Lower and upper reference limits were 449.6 μm and 566.0 μm for CCT, and 2165.3 cells/mm2 and 3414.4 cells/mm2 for CECD, respectively. CCT correlated with body mass index (BMI), (r = − 0.12, P = 0.04). CECD decreased with age (r = − 0.49, P < 0.001), BMI (r = − 0.20, P = 0.001), intraocular pressure (r = − 0.13, P = 0.029) and ocular perfusion pressure (r = − 0.28, P = 0.028). CECD decayed by 8.3 cells/mm2 or 0.30% per year of age and CCT decreased by 0.72 μm per kg/m2. Conclusions Mean central cornea was thinner, CECD higher, and references limits lower than reported in other African populations. The CCT and CECD normative values reported herein will be useful for both clinical and research purposes in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01947-x.
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Affiliation(s)
| | - David L Kayembe
- Department of Ophthalmology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Claude Mwanza
- Department of Ophthalmology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo.,Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Ma D, Wei S, Sun Y, Li SM, An WZ, Hu JP, Cao K, Yang XH, Lin CX, Guo JY, Li H, Fu J, Wang N. Distribution of IOP and its relationship with refractive error and other factors: the Anyang University Students Eye Study. Int J Ophthalmol 2021; 14:554-559. [PMID: 33875947 DOI: 10.18240/ijo.2021.04.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/29/2020] [Indexed: 02/02/2023] Open
Abstract
AIM To investigate the distribution of intraocular pressure (IOP) and its relationship with refractive error and other factors in university students from Anyang, China. METHODS A university-based study was conducted. Subjects were invited to complete ophthalmic examinations, including visual acuity, noncontact tonometry (NCT), cycloplegic autorefraction, and ocular biometry. Univariable and multivariable analyses were used to evaluate the associations between IOP and other factors. Only data from right eyes were used in analysis. RESULTS A total of 7720 subjects aged 16 to 26 years old were included, and 2834 (36.4%) of the participants were male. The mean IOP of the right eye for all subjects was 15.52±3.20 mm Hg (95%CI: 15.45, 15.59). Using multivariate linear regression analysis, IOP was found to correlate significantly with younger age (P<0.001; standardized regression coefficient β, -0.061; regression coefficient β, -0.139; 95%CI: -0.18, -0.09), higher myopic refractive error (P=0.044; standardized β, -0.060; regression coefficient β, -0.770; 95%CI: -0.15, -0.002), higher central corneal thickness (P<0.001; standardized β, 0.450; regression coefficient β, 0.044; 95%CI: 0.04, 0.05), and shorter axial length (AL; P<0.001; standardized β, -0.061; regression coefficient β, -0.163; 95%CI: -0.25, -0.07). CONCLUSION This study described the normal distribution of IOP. In Chinese university students aged 16-26y, higher IOP is associated with younger age, higher myopic refractive error, higher thickness of the central cornea, and shorter AL.
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Affiliation(s)
- Dandan Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Shifei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Wen-Zai An
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Jian-Ping Hu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Xiao-Hui Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Cai-Xia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Ji-Yuan Guo
- Anyang Eye Hospital, Anyang 455000, Henan Province, China
| | - He Li
- Anyang Eye Hospital, Anyang 455000, Henan Province, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
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Li Z, Li S, Liu R, Scheetz J, Xiao O, Zhang J, Wang D, Guo X, Jong M, Sankaridurg P, He M. Distribution of intraocular pressure and related risk factors in a highly myopic Chinese population: an observational, cross-sectional study. Clin Exp Optom 2021; 104:767-772. [PMID: 33689617 DOI: 10.1080/08164622.2021.1878817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Clinical relevance: Those with high myopia are more likely to have glaucoma compared to those without myopia and intraocular pressure was a key factor for developing glaucoma. Thus, investigating the distribution of intraocular pressure and associated factors among those with high myopia is of high importance.Background: The aim of this work is to investigate the distribution of intraocular pressure and the correlated risk factors in a highly myopic Chinese population.Methods: A total of 884 Chinese participants with bilateral high myopia (≤ -6.00 D spherical power) were included from the Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort Study. All participants underwent a comprehensive ocular examination, including ocular biometry, cycloplegic refractometry, and intraocular pressure measurement with Goldmann applanation tonometry. Information on smoking and drinking status was also collected.Results: The mean spherical equivalence of left eyes was -10.02 ± 3.58 D with a mean axial length of 27.48 ± 1.55 mm. The overall mean intraocular pressure was 15.1 ± 2.4 mmHg (95% confidence interval, 15.0 to 15.3 mmHg). The intraocular pressure in the -6.00D to -7.99D spherical equivalence group, -8.00D to -9.99D spherical equivalence group, and ≤ -10.00 D group were 15.3 ± 2.4 mmHg, 15.1 ± 2.5 mmHg, and 15.0 ± 2.4 mmHg, respectively (p = 0.979). In multiple regression models, intraocular pressure in high myopes was not associated with spherical equivalence (p = 0.354) or axial length (p = 0.601), but significantly higher in those who were younger (non-standardised beta, -0.018; p = 0.007), smoked tobacco (non-standardised beta, 1.085; p = 0.001) and had greater central corneal thickness (non-standardised beta, 0.021; p < 0.001).Conclusion: Intraocular pressure was 15.1 ± 2.4 mmHg among subjects with a mean age of 22.8 years in this highly myopia Chinese population. These findings suggested that highly myopic Chinese persons of a younger age and greater central corneal thickness were more likely to have higher intraocular pressure.
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Affiliation(s)
- Zhixi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Shuhua Li
- Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, China
| | - Ran Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.,New England College of Optometry, Boston, USA
| | - Jane Scheetz
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Ou Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Decai Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.,Wilmer Eye Institute, Johns Hopkins University, Baltimore, USA
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia
| | | | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Gab-Alla AA. Reference Values of the Central Corneal Thickness with Different Refractive Errors for the Adult Egyptian Population. Clin Ophthalmol 2020; 14:3465-3474. [PMID: 33122882 PMCID: PMC7588499 DOI: 10.2147/opth.s277137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/24/2020] [Indexed: 11/05/2022] Open
Abstract
AIM To generate reference values of the central corneal thickness (CCT) with different refractive errors for the adult eastern Egyptian population. SUBJECTS AND METHODS This study was a retrospective, observational, and cross-sectional study. It included 1166 eyes (1166 subjects) scheduled for LASIK, who came to private refractive eye centre, Ismailia, Egypt. The study period was from January 2018 to January 2020. The subjects were divided into a broad range of myopia with spherical equivalent (SE) ≤-0.5D and hyperopia (SE) ≥+0.5D. Then, the myopic eyes divided into low (SE>-3.0D), moderate (SE-3.0D to >-6.0D), and high (SE≤-6.0D). Similarly, the hyperopic eyes were divided into low (SE<+3.0D) and moderate (SE+3.0D to <+6.0D) and high ≥+6.0D. The refractive error was measured by an auto-refractometer, and CCT was measured using ultrasonic pachymetry. RESULTS The data of 556 myopic eyes in 556 subjects (31.1% males and 68.9% females) and 610 hyperopic subjects (34.4% males and 65.6% females) were included in this study. The mean±SD of CCT for the total myopic subjects was 532.8±32.6μm, range (470 to 627μm). The mean±SD of SE was -4.06±2.50D, range (-0.50 to -14.00D). The mean±SD of CCT for the total hyperopic subjects was 530.8±37.2μm, range (471 to 616μm). The mean±SD of SE was +3.57±1.98D, range (+0.50 to +8.50D). About 16.2% of the myopic eyes and 12.7% of the hyperopic eyes have CCT less than 500μm. CONCLUSION The mean of the central corneal thickness of the eastern Egyptian population was 532.8μm for myopic and 530.8μm for hyperopic subjects, respectively. The myopic and hyperopic subjects show a reduction in CCT with age. Females have a thinner cornea than males, 16.2% of the myopic eyes and 12.7% of the hyperopic eyes have CCT less than 500μm.
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Affiliation(s)
- Amr A Gab-Alla
- Suez Canal University, Faculty of Medicine, Ophthalmology Department, Ismailia, Egypt,Correspondence: Amr A Gab-Alla Suez Canal University, Faculty of Medicine, Ophthalmology Department, Ring Road, Ismailia, EgyptTel +201222836261 Email
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Abstract
SIGNIFICANCE Icare HOME rebound tonometry is increasingly adopted into clinical practice for IOP phasing of glaucoma patients and suspects. Because of measurement differences with applanation tonometry and diurnal fluctuations, interpretation of the IOP measured with Icare HOME phasing can be challenging. PURPOSE The purpose of this study was to use a large patient cohort to develop a practical, analytical tool for interpreting Icare HOME measurements with respect to applanation pressure. METHODS IOP measurements using the Icare HOME and an applanation tonometer were taken prospectively in 498 consecutive patients. Bland-Altman, frequency distribution, and linear regression analysis were applied to determine measurement differences. A novel criterion, Threshold Icare HOME IOP, was developed to assist identification of elevation above target applanation pressure, considering the expected diurnal variation and measurement variability. RESULTS Icare HOME tended to underestimate applanation tonometry (mean bias, -1.7 mmHg; 95% limits of agreement, -7.0 to +3.6). Overall, differences were within ±3 mmHg in 71.5% and ±5 mmHg in 92% of patients. Based on the novel criterion developed, Icare HOME measurements that exceed target applanation pressure by 6 mmHg or greater are generally outside the 95% limit of expected observations. CONCLUSIONS The Threshold Icare HOME IOP is a novel and practical criterion that can assist clinicians in their interpretation of Icare HOME phasing measurements with respect to target applanation pressures. Elevation above the expected thresholds may prompt closer monitoring or even modifications to glaucoma management.
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Bagus T, Alberto K, Muteba M, Makgotloe A. Analysis of corneal biometry in a black South African population. AFRICAN VISION AND EYE HEALTH 2019. [DOI: 10.4102/aveh.v78i1.495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Muhsen S, Alkhalaileh F, Hamdan M, AlRyalat SA. Central corneal thickness in a Jordanian population and its association with different types of Glaucoma: cross-sectional study. BMC Ophthalmol 2018; 18:279. [PMID: 30373555 PMCID: PMC6206916 DOI: 10.1186/s12886-018-0944-6] [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: 10/25/2017] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Central corneal thickness (CCT) has long been implicated to affect glaucoma predisposition. Several reports have identified that thinner CCT is a risk factor for open-angle glaucoma, and that CCT can be very variable between different ethnic groups. In this study, we aim to identify the relation between CCT and different glaucoma parameters in different types of glaucoma in an Arabian ethnicity. METHODS We classified our participants into four main groups: primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), pseudoexfoliative glaucoma (PXFG), and a control group. We obtained demographics, intraocular pressure (IOP), cup to disc ratio (CDR), visual field mean deviation (MD) and pattern standard deviation (PSD), CCT, and retinal nerve fiber layer (RNFL) thickness for each participant. RESULTS We included A total of 119 eyes with glaucoma, including POAG (54 eyes), PXFG (31 eyes) and PACG (34 eyes), we also included 57 control eyes. We found that PACG eyes have the thinnest CCT. Mean measurements of CCT for our groups were: 538.31 μm (SD = 36.30) in eyes with POAG, 544.45 μm (SD = 28.57) in eyes with PXFG, 506.91 μm (SD = 34.55) in eyes with PACG and 549.63 μm (SD = 42.9) in the control group. We found that CCT is significantly correlated with CDR (p = 0.012, r = - 0.231), MD (p < 0.001, r = 0.327),and RNFL thickness (p = .007, r = .283). CONCLUSION In Arabian ethnicity, PACG patients have the thinnest CCT compared to other types of glaucoma, namely POAG and PXFG. We demonstrated that glaucomatous eyes with thinner corneas will probably have more advanced glaucomatous optic neuropathy. Our results emphasize the importance of taking ethnicity into account upon glaucoma management.
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Affiliation(s)
- Sana' Muhsen
- Ophthalmology, Glaucoma and Anterior Segment Surgeon, University of Jordan Hospital, The University of Jordan, Amman, Jordan
| | | | - Mohammad Hamdan
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Saif Aldeen AlRyalat
- Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan.
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