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Muhsin ZJ, Qahwaji R, AlShawabkeh M, AlRyalat SA, Al Bdour M, Al-Taee M. Smart decision support system for keratoconus severity staging using corneal curvature and thinnest pachymetry indices. EYE AND VISION (LONDON, ENGLAND) 2024; 11:28. [PMID: 38978067 PMCID: PMC11229244 DOI: 10.1186/s40662-024-00394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/17/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND This study proposes a decision support system created in collaboration with machine learning experts and ophthalmologists for detecting keratoconus (KC) severity. The system employs an ensemble machine model and minimal corneal measurements. METHODS A clinical dataset is initially obtained from Pentacam corneal tomography imaging devices, which undergoes pre-processing and addresses imbalanced sampling through the application of an oversampling technique for minority classes. Subsequently, a combination of statistical methods, visual analysis, and expert input is employed to identify Pentacam indices most correlated with severity class labels. These selected features are then utilized to develop and validate three distinct machine learning models. The model exhibiting the most effective classification performance is integrated into a real-world web-based application and deployed on a web application server. This deployment facilitates evaluation of the proposed system, incorporating new data and considering relevant human factors related to the user experience. RESULTS The performance of the developed system is experimentally evaluated, and the results revealed an overall accuracy of 98.62%, precision of 98.70%, recall of 98.62%, F1-score of 98.66%, and F2-score of 98.64%. The application's deployment also demonstrated precise and smooth end-to-end functionality. CONCLUSION The developed decision support system establishes a robust basis for subsequent assessment by ophthalmologists before potential deployment as a screening tool for keratoconus severity detection in a clinical setting.
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Affiliation(s)
- Zahra J Muhsin
- Department of Computer Science, University of Bradford, Bradford, BD7 1DP, UK.
| | - Rami Qahwaji
- Department of Computer Science, University of Bradford, Bradford, BD7 1DP, UK
| | | | | | - Muawyah Al Bdour
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Majid Al-Taee
- Department of Computer Science, University of Bradford, Bradford, BD7 1DP, UK
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Al Bdour M, Abu-Ameerh M, Gharaibeh A, AlQudah R, Hubaishy L, AlAdwan M, AlRyalat SA. Intrastromal corneal ring segments for keratoconus patients: up to 12 years follow up. Int Ophthalmol 2024; 44:50. [PMID: 38336951 DOI: 10.1007/s10792-024-02912-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 12/24/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Intrastromal corneal ring segment (ICRS) implantation is a surgical technique developed with the purpose of avoiding the progression of corneal protrusion and is considered a viable option for managing patients with keratoconus as it stabilizes or improves vision thus delaying or excluding the need of more advanced surgical intervention such as penetrating keratoplasty. However, long term follow up is still limited to determine its actual success in achieving this goal. The current project aims to provide an extended follow up reporting a mean followup of around 5 years, extending up to 12.5 years. METHODS We recruited patients who performed their ICRS between 2008 and 2013. We contacted patients for a follow up exam with a possible corneal tomography. For each patient, we obtained baseline pre operative data and latest follow up data which included visual acuity, subjective refraction, clinical slit-lamp exam, and corneal tomography. We compared the change in best corrected visual acuity and maximum keratometry readings from clinical visits before ring implantation to the latest follow up. RESULTS A total of 68 eyes for 53 patients were included. The mean duration of follow up was 53.87 (± 38.8) months, with a maximum duration of 153 months. We found a significant improvement in corrected and uncorrected visual acuity, keratometries and refraction during the follow up period. On correlation analysis, strong negative significant correlation was found between duration since surgery and change in uncorrected visual acuity (p = 0.03, ρ = 0.338) and mean keratometry values (p = 0.033, ρ = 0.296). At the latest follow up for majority of patients with more than 100 weeks of follow up (12 eyes), uncorrected visual acuity were equal to or worse than baseline. CONCLUSION This study represents the largest follow up for ICRS implanted in keratoconus patients. Improvement of visual acuity following ICRS implantation can be expected in the first few years, after which, a decline occurring thereafter.
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Affiliation(s)
- Muawyah Al Bdour
- Department of Ophthalmology, The University of Jordan, Amman, 11942, Jordan
| | | | - Almutez Gharaibeh
- Department of Ophthalmology, The University of Jordan, Amman, 11942, Jordan
| | - Ruba AlQudah
- Department of Ophthalmology, The University of Jordan, Amman, 11942, Jordan.
| | - Lana Hubaishy
- Department of Ophthalmology, The University of Jordan, Amman, 11942, Jordan
| | - Mai AlAdwan
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
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Bruschi G, Ghiglioni DG, Cozzi L, Osnaghi S, Viola F, Marchisio P. Vernal Keratoconjunctivitis: A Systematic Review. Clin Rev Allergy Immunol 2023; 65:277-329. [PMID: 37658939 PMCID: PMC10567967 DOI: 10.1007/s12016-023-08970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/05/2023]
Abstract
Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, and pain due to corneal involvement of shield ulcers. Vernal keratoconjunctivitis is categorized within ocular diseases. The diagnosis is clinical, as no sure biomarkers pathognomonic of the disease have yet been identified. The VKC therapy relies on different types of drugs, from antihistamines and topical steroids to cyclosporine or tacrolimus eye drops. In extremely rare cases, there is also the need for surgical treatment for the debridement of ulcers, as well as for advanced glaucoma and cataracts, caused by excessive prolonged use of steroid eye drops. We performed a systematic review of the literature, according to PRISMA guideline recommendations. We searched the PubMed database from January 2016 to June 2023. Search terms were Vernal, Vernal keratoconjunctivitis, and VKC. We initially identified 211 articles. After the screening process, 168 studies were eligible according to our criteria and were included in the review. In this study, we performed a systematic literature review to provide a comprehensive overview of currently available diagnostic methods, management of VKC, and its treatments.
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Affiliation(s)
| | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy.
| | - Laura Cozzi
- Università degli Studi di Milano, Milan, Italy
| | - Silvia Osnaghi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
| | - Francesco Viola
- Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
| | - Paola Marchisio
- Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via della Commenda 9, 20122, Milan, Italy
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Artesani MC, Esposito M, Valentini D, Villani A, Fiocchi AG, Buzzonetti L. Vernal keratoconjunctivitis in Down syndrome: a case report. BMC Ophthalmol 2023; 23:106. [PMID: 36932345 PMCID: PMC10021954 DOI: 10.1186/s12886-023-02855-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Down syndrome (DS) or Trisomy 21 is the most common chromosomal disease and is characterized by possible heart defects, cognitive impairment and visual disorders. CASE PRESENTATION We describe for the first time a 17-year-old Caucasian girl suffering from Down syndrome associated with vernal keratoconjunctivitis (VKC), a rare disorder of the anterior segment of the eye, characterized by intense photophobia, redness, watering eyes and itching due to an inflammatory-allergic reaction of the cornea and conjunctiva. On slit-lamp examination, the girl showed conjunctival hyperemia, papillary hypertrophy, giant papillae and corneal leukoma in right eye as a result of a previous corneal ulcer. A successful topical immunosuppressant therapy with cyclosporin 1% was started. CONCLUSION So far, to our knowledge, this is the first description of VKC in a patient with DS. Finding an inflammatory-allergic disease such as VKC in DS is unusual but it must be taken into account because keratoconus, one of the most frequent eye pathologies in DS, can be secondary to an unrecognized VKC.
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Affiliation(s)
- Maria Cristina Artesani
- Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4 00165, Rome, Italy.
| | | | - Diletta Valentini
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Luca Buzzonetti
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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AlRyalat SA, Aburumman R, Taweel L, Al-Rawi H, Dababseh S, Al Bdour M. The impact of having a relative in a need for cornea: the Knowledge, Attitude, and Willingness for Corneal Donation (KAWCD) questionnaire. Cell Tissue Bank 2022; 23:899-908. [PMID: 35476259 DOI: 10.1007/s10561-022-10005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/31/2022] [Indexed: 11/02/2022]
Abstract
Despite the advancement in the field of corneal transplantation, corneal donation is still the only source for cornea. In our study, we aimed to find predictors for a person's willingness toward cornea donation, and the impact of having a relative in a need for cornea transplantation on the willingness to donate cornea. The study included two cohorts to be compared, first degree relatives of patients waiting for corneal transplantation, and general ophthalmology patients who do not have relatives waiting for corneal donation. We designed questionnaire on Knowledge, Attitude, and Willingness for Cornea Donation (KAWCD), a tool specifically designed to measure the knowledge about corneal donation, and the attitude towards it. A total of 269 participants were included in this study, with a mean age of 49.59 (± 17.24) years. We included 182 (67.7%) participants who did not have a relative with or in need for corneal transplantation, and 87 (32.3%) participants who are first degree relatives to patients on the waiting list for corneal transplantation. Upon assessing factors predicting willingness for corneal donation, we found that attitude (p < 0.001; OR 1.126 (95% CI 1.08 to 1.17)) and age (p = 0.022; OR 0.973 (95% CI 0.95 to 0.99)) are the only predictors for willingness to donate. We found that the willingness to donate cornea is related to the attitude, rather than the knowledge about corneal donation. We believe awareness campaigns should focus on encouragement to donate corneas, rather than providing information about it.
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Affiliation(s)
| | - Razan Aburumman
- School of Medicine, The University of Jordan, Amman, 11910, Jordan.
| | - Luma Taweel
- School of Medicine, The University of Jordan, Amman, 11910, Jordan
| | - Hadeel Al-Rawi
- School of Medicine, The University of Jordan, Amman, 11910, Jordan
| | - Sohayla Dababseh
- School of Medicine, The University of Jordan, Amman, 11910, Jordan
| | - Muawyah Al Bdour
- Department of Ophthalmology, The University of Jordan, Amman, Jordan
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