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Dihan Q, Chauhan MZ, Eleiwa TK, Hassan AK, Sallam AB, Khouri AS, Chang TC, Elhusseiny AM. Using Large Language Models to Generate Educational Materials on Childhood Glaucoma. Am J Ophthalmol 2024:S0002-9394(24)00144-2. [PMID: 38614196 DOI: 10.1016/j.ajo.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE To evaluate the quality, readability, and accuracy of large language model (LLM) generated patient education materials (PEMs) on childhood glaucoma, and their ability to improve existing online information's readability. DESIGN Cross-sectional comparative study. METHODS We evaluated responses of ChatGPT-3.5, ChatGPT-4, and Bard to three separate prompts requesting they write PEMs on "childhood glaucoma." Prompt A required PEMs be "easily understandable by the average American." Prompt B required PEMs be written "at a 6th-grade level using Simple Measure of Gobbledygook (SMOG) readability formula." We then compared responses' quality (DISCERN questionnaire, Patient Education Materials Assessment Tool (PEMAT)), readability (SMOG, Flesch-Kincaid Grading Level (FKGL)), and accuracy (Likert Misinformation scale). To assess the improvement of readability for existing online information, Prompt C requested LLM rewrite 20 resources from a Google search of keyword "childhood glaucoma" to the American Medical Association-recommended "6th-grade level." Rewrites were compared on key metrics such as readability, complex words (≥3 syllables), and sentence count. RESULTS All 3 LLM generated PEMs that were of high quality, understandability, and accuracy (DISCERN≥4, ≥70% PEMAT understandability, Misinformation score=1). Prompt B responses were more readable than Prompt A responses for all 3 LLM (p≤0.001). ChatGPT-4 generated the most readable PEMs compared to ChatGPT-3.5 and Bard (p≤0.001). Although Prompt C responses showed consistent reduction of mean SMOG and FKGL scores, only ChatGPT-4 achieved the specified 6th-grade reading level (4.8 ± 0.8 and 3.7 ± 1.9, respectively). CONCLUSION LLMs can serve as strong supplementary tools in generating high quality, accurate, and novel PEMs, and improving the readability of existing PEMs on childhood glaucoma.
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Affiliation(s)
- Qais Dihan
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Muhammad Z Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Taher K Eleiwa
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Amr K Hassan
- Department of Ophthalmology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Albert S Khouri
- Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Ta C Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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Chauhan MZ, Eleiwa TK, Abdelnaem S, Kwok A, Hunter DG, Phillips PH, Sallam AB, Elhusseiny AM. Risk of abducens nerve palsy following COVID-19 vaccination. J AAPOS 2024; 28:103867. [PMID: 38458601 DOI: 10.1016/j.jaapos.2024.103867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 03/10/2024]
Abstract
PURPOSE To investigate the prevalence and risk of new-onset abducens nerve palsy and acute-onset diplopia following mRNA COVID-19 vaccination. METHODS In this retrospective, population-based study, patient data from the COVID-19 Research Network of TriNetX was searched via the TriNetX Analytics platform for patients who received specific vaccinations based on Common Procedural Technology codes. We recorded instances of newly diagnosed abducens nerve palsy and diplopia within 21 days following each vaccination event. RESULTS Of the 3,545,224 patients (mean age at vaccination, 46.2 ± 21.3 years) who received the mRNA COVID-19 vaccine, 12 (<0.0001%) patients had a new diagnosis of abducens nerve palsy and 453 (0.013%) had acute-onset diplopia within 21 days of first dose of COVID-19 vaccination. After propensity score matching, the relative risk for new abducens nerve palsy diagnosis after the first dose of COVID-19 vaccination was not significantly different from that after influenza (RR, 0.77), Tdap (RR, 1.0), or the second dose of the COVID-19 vaccinations (RR, 1.00). Furthermore, there was a lower risk of abducens nerve palsy diagnosis after the first dose of the COVID-19 vaccination compared with the risk after COVID-19 infection (RR, 0.15). CONCLUSIONS The risk of a new abducens nerve palsy diagnosis following the first dose of the COVID-19 vaccine is lower than the risk associated with COVID-19 infection itself. There is no evidence to suggest a causal relationship between COVID-19 vaccination and the development of abducens nerve palsy.
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Affiliation(s)
- Muhammad Z Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Taher K Eleiwa
- Department of Ophthalmology, Benha University, Benha, Egypt
| | - Salah Abdelnaem
- Department of Immunology, University of Arkansas for Medical Sciences, Little Rock
| | - Alexander Kwok
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - David G Hunter
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts
| | - Paul H Phillips
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock; Department of Ophthalmology, Ain Shams University, Cairo, Egypt
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock; Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts.
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Hassan AK, Eleiwa TK, Hassan MA, Sallam AB, Ali HT, Abdelnaem S, Gise R, Phillips PH, Elhusseiny AM. Quality, Reliability, and Readability of Online Information on Idiopathic Intracranial Hypertension. J Neuroophthalmol 2024:00041327-990000000-00597. [PMID: 38527126 DOI: 10.1097/wno.0000000000002130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND To evaluate the quality & reliability, technical quality, and readability of patient-targeted online information on idiopathic intracranial hypertension. METHODS In this cross-sectional study, we searched Google and Bing search engines for the terms "idiopathic intracranial hypertension" and "pseudotumor cerebri." We evaluated the first 50 search outcomes for each search term. Peer-reviewed articles, targeted advertisements, book chapters, videos, personal blogs, websites intended for healthcare professionals, and non-English websites were excluded. Websites were classified as institutional or private. Two independent reviewers assessed each website for 1) quality and reliability using DISCERN, Health on the Net Code of Conduct (HONcode), and JAMA criteria and 2) technical quality based on 11 criteria. Readability was evaluated using 6 measures (Flesch-Kincaid Reading Ease score and grade level, Gunning Fog, Simple Measure of Gobbledygook (Smog) index, Coleman-Liau index, and automated readability index). RESULTS Sixty-three websites (37 institutional) were included. The mean scores for the DISCERN, HONcode, and JAMA criteria were 3.6 ± 1 (1-4.8; 1: worse, 5: best), 10.3 ± 2.8 (2-16; 0: worse, 16: best), and 2 ± 1.3 (0-4; 0: worse, 4: best), respectively. The mean technical quality score was 0.8 ± 0.1 (0.5-1). The mean Flesch-Kincaid grade level score was 8.9 ± 1.8 (3.3-13.3). For Flesch-Kincaid grade level, 47 (74.6%) websites scored a grade level of 10 or less. For Gunning Fog Score, 35 websites (55.6%) scored from 7.3 to 10.8. For the Smog Index, 46 (73%) websites scored 5.7-8. The mean Coleman Liau Index was 16 ± 2.1 (9.6-22.2). For the automated readability index, 30 (50.7%) websites scored less than the eighth grade. No statistically significant difference was present between institutional and private websites except for JAMA, which scored higher in private websites (2.4 vs 1.7, P = 0.03). CONCLUSIONS Our findings suggest that online information on idiopathic intracranial hypertension/pseudotumor cerebri for patients generally demonstrates moderate to good quality and reliability. Although most websites maintain credible technical quality, the readability exceeds recommended levels for the average American reader. This may impede understanding, emphasizing the need for future improvements.
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Affiliation(s)
- Amr K Hassan
- Department of Ophthalmology (AKH, HTA), Faculty of Medicine, South Valley University, Qena, Egypt; Department of Ophthalmology (TKE), Benha Faculty of Medicine, Benha University, Benha, Egypt; Department of Ophthalmology (MAH, SA), Al Mabaret Al Ma'adi Hospital, Cairo, Egypt; Department of Ophthalmology (ABS, PHP, AME), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Ophthalmology (RG, AME), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Eleiwa TK, Elhusseiny AM. Re: Kianian et al.: Enhancing the assessment of large language models in medical information generation (Ophthalmol Retina. 2024;8:195-201). Ophthalmol Retina 2024:S2468-6530(24)00010-1. [PMID: 38363243 DOI: 10.1016/j.oret.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Taher K Eleiwa
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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Eleiwa TK, Youssef GH, Elsaadani IA, Abdelrahman SN, Khater AA. Debulking corneal biopsy with tectonic amniotic membrane transplantation in refractory clinically presumed fungal keratitis. Sci Rep 2024; 14:521. [PMID: 38177182 PMCID: PMC10767135 DOI: 10.1038/s41598-023-50987-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024] Open
Abstract
The treatment of fungal keratitis (FK) is challenging due to the subacute indolent course, and initial misdiagnosis. In this retrospective case series, we highlight both the diagnostic and therapeutic roles of corneal biopsy together with amniotic membrane transplantation (AMT) in patients with refractory clinically presumed FK. Debulking biopsy and tectonic AMT were performed during the initial presentation. Biopsy specimens were sent for KOH smears and cultures. After KOH smears confirmed the presence of fungal elements, topical voriconazole 1% was prescribed for the first 72 h then tailored according to the clinical response and the culture results. The outcome measures were complete resolution of infection and restoration of corneal integrity. Cases associated with culture proven bacterial keratitis were excluded. Twelve cases were included in the study. KOH smears confirmed the presence of fungal growth in all specimens. Cultures grew Aspergillus in 6/12 cases, sensitive to voriconazole (5/6) and amphotericin (3/6); Fusarium (4/12), sensitive to both voriconazole and amphotericin; and no growth in 2/12 cases. Amphotericin 0.15% eye drops were added to the 7 cases with proven sensitivity and to the remaining 2 culture negative cases. Gradual resolution of infection was seen in all cases after 35.6 ± 7.8 days. In FK, a debulking biopsy simultaneously with AMT help decrease the microbial load, suppress the inflammatory process, support the corneal integrity, confirm the presence of fungal pathogen.
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Affiliation(s)
- Taher K Eleiwa
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University Hospitals, Benha University, Al-Sahaa Street, Diverted From Farid Nada St., Benha, 13511, Egypt.
| | - Gehad H Youssef
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University Hospitals, Benha University, Al-Sahaa Street, Diverted From Farid Nada St., Benha, 13511, Egypt
| | - Ibrahim Abdelkhalik Elsaadani
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University Hospitals, Benha University, Al-Sahaa Street, Diverted From Farid Nada St., Benha, 13511, Egypt
| | - Samar N Abdelrahman
- Department of Clinical Pathology, Benha University Hospitals, Benha University, Benha, Egypt
| | - Ahmed A Khater
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University Hospitals, Benha University, Al-Sahaa Street, Diverted From Farid Nada St., Benha, 13511, Egypt
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Elhusseiny AM, Hassan AK, Hassan MA, Eleiwa TK, Ali HT, Abdelnaem S, Chauhan MZ, Shaikh O, Khouri AS, Sallam AB. Quality, Reliability, Technical Quality, and Readability of Google Online Information on Childhood Glaucoma. J Pediatr Ophthalmol Strabismus 2023:1-6. [PMID: 38112390 DOI: 10.3928/01913913-20231114-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE To evaluate the quality, reliability, technical quality, and readability of online information related to childhood glaucoma. METHODS In this cross-sectional study, no human subjects were studied. Analysis was done for online websites on childhood glaucoma. The terms "childhood glaucoma," "pediatric glaucoma," "congenital glaucoma," "buphthalmos," and "big eyes" were entered into the Google search engine and the first 100 search results were assessed for quality, reliability, technical quality, and readability. Peer-reviewed articles, patient forum posts, dictionary definitions, and websites that appeared as targeted ads, were not in English, or were not focused on humans were excluded. Each website was evaluated for (1) quality and reliability using the DISCERN, HONcode, and JAMA criteria; (2) technical quality assessing 11 technical aspects; and (3) readability using six separate criteria (Flesch-Kincaid Reading Ease Score and Grade Level, Gunning Fog Index score, the Simple Measure of Gobbledygook Index, Coleman-Liau Index, and Automated Readability Index). RESULTS The median scores for the DISCERN, HONcode, and JAMA criteria were 2.6 (range = 1 to 4.75; 1 = worst, 5 = best), 10 (range = 0 to 16; 0 = worst, 16 = best), and 2 (range = 0 to 4; 0 = worst, 4 = best), respectively. The median technical quality score was 0.7. Readability was poor among most websites, with a median Flesch-Kincaid grade Grade Level Score of 9.3. The median Gunning Fog Index score was 9.8. There was a statistically significantly higher JAMA score and Gunning Fog Index score among the private websites compared to the institutional websites. However, institutional websites had higher technical quality. CONCLUSIONS Online information on childhood glaucoma had poor to moderate quality and reliability. The technical quality is good; however, most websites' readability was above the recommended 5th to 6th grade reading level. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XXX-XXX.].
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Kuziez L, Eleiwa TK, Chauhan MZ, Sallam AB, Elhusseiny AM, Saeed HN. Corneal Adverse Events Associated with SARS-CoV-2/COVID-19 Vaccination: A Systematic Review. Vaccines (Basel) 2023; 11:vaccines11010166. [PMID: 36680010 PMCID: PMC9860789 DOI: 10.3390/vaccines11010166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Vaccines against coronavirus disease 2019 (COVID-19) have played an important global role in reducing morbidity and mortality from COVID-19 infection. While the benefits of vaccination greatly outweigh the risks, adverse events do occur. Non-ocular adverse effects of the vaccines have been well-documented, but descriptions of ophthalmic effects remain limited. This systematic review aims to provide an overview of reported cases of corneal adverse events after receiving vaccination against COVID-19 and to compile existing clinical data to bring attention to these phenomena. Our review discusses corneal graft rejection, including proposed mechanisms, herpetic keratitis, and other reported corneal complications. Ophthalmologists and primary care physicians should be aware of such possible associations.
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Affiliation(s)
- Lana Kuziez
- Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Taher K. Eleiwa
- Department of Ophthalmology, Benha University, Benha 13518, Egypt
| | - Muhammad Z. Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Ahmed B. Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Correspondence: (A.M.E.); (H.N.S.)
| | - Hajirah N. Saeed
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL 60661, USA
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60611, USA
- Correspondence: (A.M.E.); (H.N.S.)
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Tavakkoli F, Eleiwa TK, Elhusseiny AM, Damala M, Rai AK, Cheraqpour K, Ansari MH, Doroudian M, H Keshel S, Soleimani M, Djalilian AR, Sangwan VS, Singh V. Corneal stem cells niche and homeostasis impacts in regenerative medicine; concise review. Eur J Ophthalmol 2023:11206721221150065. [PMID: 36604831 DOI: 10.1177/11206721221150065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The limbal stem cells niche (LSCN) is an optimal microenvironment that provides the limbal epithelial stem cells (LESCs) and strictly regulates their proliferation and differentiation. Disturbing the LSCN homeostasis can lead to limbal stem cell dysfunction (LSCD) and subsequent ocular surface aberrations, such as corneal stromal inflammation, persistent epithelial defects, corneal neovascularisation, lymphangiogenesis, corneal opacification, and conjunctivalization. As ocular surface disorders are considered the second main cause of blindness, it becomes crucial to explore different therapeutic strategies for restoring the functions of the LSCN. A major limitation of corneal transplantation is the current shortage of donor tissue to meet the requirements worldwide. In this context, it becomes mandatory to find an alternative regenerative medicine, such as using cultured limbal epithelial/stromal stem cells, inducing the production of corneal like cells by using other sources of stem cells, and using tissue engineering methods aiming to produce the three-dimensional (3D) printed cornea. Limbal epithelial stem cells have been considered the magic potion for eye treatment. Epithelial and stromal stem cells in the limbal niche hold the responsibility of replenishing the corneal epithelium. These stem cells are being used for transplantation to maintain corneal epithelial integrity and ultimately sustain optimal vision. In this review, we summarised the characteristics of the LSCN and their current and future roles in restoring corneal homeostasis in eyes with LSCD.
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Affiliation(s)
- Fatemeh Tavakkoli
- Department of Community Health, College of Health Technology, Cihan University, Erbil, Iraq.,SSR Stem Cell Biology Laboratory, Brien Holden Eye Research Centre, Centre for Ocular Regeneration, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, Hyderabad, India.,Centre for Genetic Disorders, Banaras Hindu University, Varanasi, India
| | - Taher K Eleiwa
- Department of Ophthalmology, Benha University, Benha, Egypt
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mukesh Damala
- SSR Stem Cell Biology Laboratory, Brien Holden Eye Research Centre, Centre for Ocular Regeneration, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, Hyderabad, India.,School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Amit K Rai
- Centre for Genetic Disorders, Banaras Hindu University, Varanasi, India
| | - Kasra Cheraqpour
- Translational Eye Research Center, Farabi Eye Hospital, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad H Ansari
- Ophthalmic Research Center, Department of Ophthalmology, Labbafinejad Medical Center, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Doroudian
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, 145440Kharazmi University, Tehran, Iran
| | - Saeed H Keshel
- Department of Tissue Engineering and Applied Cell Sciences, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Department of Ophthalmology, 159636Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Ali R Djalilian
- Department of Ophthalmology, 159636Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Vivek Singh
- SSR Stem Cell Biology Laboratory, Brien Holden Eye Research Centre, Centre for Ocular Regeneration, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, Hyderabad, India
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Eleiwa TK, Elsaadani IA, Elhusseiny AM. Association of trachoma with vision-related quality of life in children. Ocul Surf 2023; 27:89-91. [PMID: 36379422 DOI: 10.1016/j.jtos.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/22/2022] [Accepted: 11/05/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Taher K Eleiwa
- Department of Ophthalmology, Benha University Hospitals, Benha University, Benha, Egypt
| | - Ibrahim A Elsaadani
- Department of Ophthalmology, Benha University Hospitals, Benha University, Benha, Egypt
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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Hassanpour K, H. ElSheikh R, Arabi A, R. Frank C, M. Elhusseiny A, K. Eleiwa T, Arami S, R. Djalilian A, Kheirkhah A. Peripheral Ulcerative Keratitis: A Review. J Ophthalmic Vis Res 2022; 17:252-275. [PMID: 35765625 PMCID: PMC9185208 DOI: 10.18502/jovr.v17i2.10797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/10/2022] [Indexed: 11/24/2022] Open
Abstract
Peripheral ulcerative keratitis (PUK) is a rare but serious ocular condition that is an important clinical entity due to its ophthalmological and systemic implications. It is characterized by progressive peripheral corneal stromal thinning with an associated epithelial defect and can be associated with an underlying local or systemic pro-inflammatory condition, or present in an idiopathic form (Mooren ulcer). Associated conditions include autoimmune diseases, systemic and ocular infections, dermatologic diseases, and ocular surgery. Cell-mediated and autoantibody- mediated immune responses have been implicated in the pathogenesis of PUK, destroying peripheral corneal tissue via matrix metalloproteinases. Clinically, patients with PUK present with painful vision loss, a peripheral corneal ulcer, and often adjacent scleritis, episcleritis, iritis, or conjunctivitis. Diagnostic evaluation should be focused on identifying the underlying etiology and ruling out conditions that may mimic PUK, including marginal keratitis and Terrien marginal degeneration. Treatment should be focused on reducing local disease burden with topical lubrication, while simultaneously addressing the underlying cause with antimicrobials or anti-inflammatory when appropriate. Existing and emerging biologic immunomodulatory therapies have proven useful in PUK due to autoimmune conditions. Surgical treatment is generally reserved for cases of severe thinning or corneal perforation.
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Affiliation(s)
- Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reem H. ElSheikh
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amir Arabi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Charles R. Frank
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Abdelrahman M. Elhusseiny
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Taher K. Eleiwa
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Shiva Arami
- Department of Medicine, Division of Rheumatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Ali R. Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ahmad Kheirkhah
- Department of Ophthalmology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
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Elhusseiny AM, Soleimani M, Eleiwa TK, ElSheikh RH, Frank CR, Naderan M, Yazdanpanah G, Rosenblatt MI, Djalilian AR. OUP accepted manuscript. Stem Cells Transl Med 2022; 11:259-268. [PMID: 35303110 PMCID: PMC8968724 DOI: 10.1093/stcltm/szab028] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
The corneal epithelium serves to protect the underlying cornea from the external environment and is essential for corneal transparency and optimal visual function. Regeneration of this epithelium is dependent on a population of stem cells residing in the basal layer of the limbus, the junction between the cornea and the sclera. The limbus provides the limbal epithelial stem cells (LESCs) with an optimal microenvironment, the limbal niche, which strictly regulates their proliferation and differentiation. Disturbances to the LESCs and/or their niche can lead to the pathologic condition known as limbal stem cell deficiency (LSCD) whereby the corneal epithelium is not generated effectively. This has deleterious effects on the corneal and visual function, due to impaired healing and secondary corneal opacification. In this concise review, we summarize the characteristics of LESCs and their niche, and present the current and future perspectives in the management of LSCD with an emphasis on restoring the function of the limbal niche.
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Affiliation(s)
- Abdelrahman M Elhusseiny
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mohammad Soleimani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Taher K Eleiwa
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Reem H ElSheikh
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Charles R Frank
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Morteza Naderan
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Yazdanpanah
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Corresponding author: Ali R. Djalilian, Cornea Service, Stem Cell Therapy and Corneal Tissue Engineering Laboratory, Illinois Eye and Ear Infirmary, 1855 W. Taylor Street, M/C 648, Chicago, IL 60612, USA.
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12
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Eleiwa TK, Elhusseiny AM, ElSheikh RH, Ali SF. An Update on Pediatric Corneal Imaging Techniques. Int Ophthalmol Clin 2022; 62:59-71. [PMID: 34965226 DOI: 10.1097/iio.0000000000000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Abstract
Purpose: To describe a case of juvenile idiopathic arthritis (JIA)-associated anterior uveitis after receiving the Sinopharm COVID-19 vaccine.Methods: A retrospective case report.Result: An 18-year-old girl, with a history of antinuclear antibody positive oligoarticular JIA, presented with bilateral anterior uveitis 5 days after the second dose of the Sinopharm COVID-19 vaccine. Ocular examination revealed anterior uveitis with reduced visual acuity in both eyes. Anterior segment optical coherence tomography showed hyperreflective dots in the anterior chamber (AC) and fine endothelial granularities representing the circulating cells in the AC. Uveitis in both eyes resolved gradually after topical steroid treatment without recurrence.Conclusion: This report demonstrates a potential causal association of COVID-19 vaccine with anterior uveitis.
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Affiliation(s)
- Reem H ElSheikh
- Department of Ophthalmology, Cairo University Hospitals, Cairo, Egypt
| | - Abid Haseeb
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Taher K Eleiwa
- Department of Ophthalmology, Benha University, Benha, Egypt
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA.,Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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14
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Elhusseiny AM, Eleiwa TK, Yacoub MS, George J, ElSheikh RH, Haseeb A, Kwan J, Elsaadani IA, Abo Shanab SM, Solyman O, Saeed HN. Relationship between screen time and dry eye symptoms in pediatric population during the COVID-19 pandemic. Ocul Surf 2021; 22:117-119. [PMID: 34363976 DOI: 10.1016/j.jtos.2021.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Abdelrahman M Elhusseiny
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Taher K Eleiwa
- Department of Ophthalmology, Benha University Hospitals, Benha University, Benha, Egypt
| | - Magdi S Yacoub
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
| | - Joseph George
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Reem H ElSheikh
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
| | - Abid Haseeb
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - James Kwan
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Ibrahim A Elsaadani
- Department of Ophthalmology, Benha University Hospitals, Benha University, Benha, Egypt
| | - Sheren M Abo Shanab
- Department of Ophthalmology, Research Institute of Ophthalmology, Cairo University, Cairo, Egypt
| | - Omar Solyman
- Department of Ophthalmology, Research Institute of Ophthalmology, Cairo University, Cairo, Egypt
| | - Hajirah N Saeed
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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15
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Sayed AM, Shousha MA, Baharul Islam MD, Eleiwa TK, Kashem R, Abdel-Mottaleb M, Ozcan E, Tolba M, Cook JC, Parrish RK. Mobility improvement of patients with peripheral visual field losses using novel see-through digital spectacles. PLoS One 2020; 15:e0240509. [PMID: 33052969 PMCID: PMC7556490 DOI: 10.1371/journal.pone.0240509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate see-through Augmented Reality Digital spectacles (AR DSpecs) for improving the mobility of patients with peripheral visual field (VF) losses when tested on a walking track. DESIGN Prospective Case Series. PARTICIPANTS 21 patients with peripheral VF defects in both eyes, with the physical ability to walk without assistance. METHODS We developed the AR DSpecs as a wearable VF aid with an augmented reality platform. Image remapping algorithms produced personalized visual augmentation in real time based on the measured binocular VF with the AR DSpecs calibration mode. We tested the device on a walking track to determine if patients could more accurately identify peripheral objects. MAIN OUTCOME MEASURES We analyzed walking track scores (number of recognized/avoided objects) and eye tracking data (six gaze parameters) to measure changes in the kinematic and eye scanning behaviors while walking, and assessed a possible placebo effect by deactivating the AR DSpecs remapping algorithms in random trials. RESULTS Performance, judged by the object detection scores, improved with the AR DSpecs (P<0.001, Wilcoxon rank sum test) with an average improvement rate of 18.81%. Two gaze parameters improved with the activated algorithm (P<0.01, paired t-test), indicating a more directed gaze on the central path with less eye scanning. Determination of the binocular integrated VF with the DSpecs correlated with the integrated standard automated perimetry (R = 0.86, P<0.001), mean sensitivity difference 0.8 ± 2.25 dB (Bland-Altman). CONCLUSIONS AR DSpecs may improve walking maneuverability of patients with peripheral VF defects by enhancing detection of objects in a testing environment.
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Affiliation(s)
- Ahmed M. Sayed
- Biomedical Engineering Department, Helwan University, Helwan, Egypt
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
- Electrical Engineering and Computer Science, MSOE University, Milwaukee, WI, United States of America
- * E-mail: (MAS); (AS)
| | - Mohamed Abou Shousha
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
- Department of Electrical and Computer Engineering, University of Miami, Miami, FL, United States of America
- Biomedical Engineering Department, University of Miami, Miami, FL, United States of America
- * E-mail: (MAS); (AS)
| | - MD Baharul Islam
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
- Department of Computer Science, American University of Malta, BML, Malta
| | - Taher K. Eleiwa
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
- Faculty of Medicine, Department of Ophthalmology, Benha University, Benha, Egypt
| | - Rashed Kashem
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | - Mostafa Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, FL, United States of America
| | - Eyup Ozcan
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
- Net Eye Medical Center, Gaziantep, Turkey
| | - Mohamed Tolba
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | - Jane C. Cook
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | - Richard K. Parrish
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
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16
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Eleiwa TK, Elsawy A, Syed ZA, Roongpoovapatr V, Sayed AM, Yoo SH, Abou Shousha M. In-vivo Three-dimensional Characteristics of Bowman's Layer and Endothelium/Descemet's Complex Using Corneal Microlayer Tomography in Healthy Subjects. Curr Eye Res 2020; 45:659-667. [PMID: 32064952 DOI: 10.1080/02713683.2019.1691238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To characterize the three-dimensional (3D) thickness profile and age-related changes of Bowman's layer (BL), and endothelium/Descemet's membrane (En/DM) complex among healthy individuals using Corneal Microlayer Tomography (CML-T), and to describe its repeatability and accuracy.Methods: Sixty-six eyes of 41 healthy volunteers; 27 eyes (< 40 years old), and 39 eyes (>40 years old) were imaged using HD-OCT. Automatic and manual segmentation of the corneal layers was performed, and 3D thickness maps were generated, using custom-built CML-T software. A regional analysis of mean thickness parameters between the 2 age groups was performed. A regression analysis was used to assess the correlation between age, and thickness maps. Intraclass Correlation Coefficients (ICC), Coefficients of Variation (COV), and Bland-Altman plots were used to assess the reliability of the repeated measurements in 198 locations.Results: CML-T successfully mapped the BL and En/DM in all included eyes. Thickness maps showed a significant increase in corneal thickness (CT), BL thickness (BMT), and En/DM complex thickness (DMT) toward the periphery with a mean difference 28 µm (p < .001), 1.1 µm (p < .001), and 1.4 µm (p < .001), respectively. There was a strong correlation between age and central DMT (r = 0.61; p < .001), while there was no correlation between age and both CT, and BMT. ICC values ranged from 0.9 (BMT) to 0.997 (DMT), and from 0.808 (BMT) to 0.979 (CT) for intraoperator repeatability of manual measurements, and the accuracy of auto matic measurements, respectively. COV values were lower than 7.5% in all cases.Conclusion: CML-T is a novel tool that can generate 3D-thickness maps of both BL and En/DM. CT, BMT, and DMT increase toward the periphery in healthy corneas. DMT increases with aging, while BMT does not. We also report excellent repeatability, accuracy and good agreement between automatic and manual measurements.
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Affiliation(s)
- Taher K Eleiwa
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Amr Elsawy
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Electrical and Computer Engineering, University of Miami, Miami, FL, USA
| | - Zeba A Syed
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Ahmed M Sayed
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Biomedical Engineering Department, Helwan University, Helwan, Egypt
| | - Sonia H Yoo
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mohamed Abou Shousha
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Electrical and Computer Engineering, University of Miami, Miami, FL, USA.,Biomedical Engineering, University of Miami, Miami, FL, USA
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Eleiwa TK, Cook JC, Elsawy AS, Roongpoovapatr V, Volante V, Yoo S, Abou Shousha M. Diagnostic Performance of Three-Dimensional Endothelium/Descemet Membrane Complex Thickness Maps in Active Corneal Graft Rejection. Am J Ophthalmol 2020; 210:48-58. [PMID: 31678558 DOI: 10.1016/j.ajo.2019.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the performance of 3-dimensional (3D) endothelium/Descemet membrane complex thickness (En/DMT) maps vs total corneal thickness (TCT) maps in the diagnosis of active corneal graft rejection. DESIGN Cross-sectional study. METHODS Eighty-one eyes (32 clear grafts and 17 with active rejection, along with 32 age-matched control eyes) were imaged using high-definition optical coherence tomography (HD-OCT), and a custom-built segmentation algorithm was used to generate 3D color-coded maps of TCT and En/DMT of the central 6-mm cornea. Regional En/DMT and TCT were analyzed and compared between the studied groups. Receiver operating characteristic curves were used to determine the accuracy of En/DMT and TCT maps in differentiating between studied groups. Main outcome measures were regional En/DMT and TCT. RESULTS Both regional TCT and En/DMT were significantly greater in actively rejecting grafts compared to both healthy corneas and clear grafts (P < .001). Using 3D thickness maps, central, paracentral, and peripheral En/DMT achieved 100% sensitivity and 100% specificity in diagnosing actively rejecting grafts (optimal cut-off value [OCV] of 19 μm, 24 μm, and 26 μm, respectively), vs only 82% sensitivity and 96% specificity for central TCT, OCV of 587 μm. Moreover, central, paracentral, and peripheral En/DMT correlated significantly with graft rejection severity (r = 0.972, r = 0.729, and r = 0.823, respectively; P < .001). CONCLUSION 3D En/DMT maps can diagnose active corneal graft rejection with excellent accuracy, sensitivity, and specificity. Future longitudinal studies are required to evaluate the predictive and prognostic role of 3D En/DMT maps in corneal graft rejection.
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18
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Sayed AM, Kashem R, Abdel-Mottaleb M, Roongpoovapatr V, Eleiwa TK, Abdel-Mottaleb M, Parrish RK, Abou Shousha M. Toward Improving the Mobility of Patients with Peripheral Visual Field Defects with Novel Digital Spectacles. Am J Ophthalmol 2020; 210:136-145. [PMID: 31606442 DOI: 10.1016/j.ajo.2019.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the efficacy of novel Digital spectacles (DSpecs) to improve mobility of patients with peripheral visual field (VF) loss. DESIGN Prospective case series. METHODS Binocular VF defects were quantified with the DSpecs testing strategy. An algorithm was implemented that generated personalized visual augmentation profiles based on the measured VF. These profiles were achieved by relocating and resizing video signals to fit within the remaining VF in real time. Twenty patients with known binocular VF defects were tested using static test images, followed by dynamic walking simulations to determine if they could identify objects and avoid obstacles in an environment mimicking a real-life situation. The effect of the DSpecs were assessed for visual/hand coordination with object-grasping tests. Patients performed these tests with and without the DSpecs correction profile. RESULTS The diagnostic binocular VF testing with the DSpecs was comparable to the integrated monocular standard automated perimetry based on point-by-point assessment with a mismatch error of 7.0%. Eighteen of 20 patients (90%) could identify peripheral objects in test images with the DSpecs that they could not previously. Visual/hand coordination was successful for 17 patients (85%) from the first trial. The object-grasping performance improved to 100% by the third trial. Patient performance, judged by finding and identifying objects in the periphery in a simulated walking environment, was significantly better with the DSpecs (P = 0.02, Wilcoxon rank sum test). CONCLUSIONS DSpecs may improve mobility by facilitating the ability of patients to better identify moving peripheral hazardous objects.
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Affiliation(s)
- Ahmed M Sayed
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, Helwan University, Helwan, Egypt
| | - Rashed Kashem
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Mostafa Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | | | - Taher K Eleiwa
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Ophthalmology, Faculty of Medicine, Benha University, Egypt
| | - Mohamed Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Richard K Parrish
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Mohamed Abou Shousha
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, University of Miami, Miami, Florida, USA.
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