1
|
Ayaki M, Hanyuda A, Negishi K. Presbyopia Progression From the Age of 40 to 79 Years in Glaucoma Patients Treated With Prostaglandin F Receptor Agonists. Transl Vis Sci Technol 2025; 14:25. [PMID: 40423614 PMCID: PMC12124147 DOI: 10.1167/tvst.14.5.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Accepted: 03/29/2025] [Indexed: 05/28/2025] Open
Abstract
Purpose The aim of this study was to compare the near add power of glaucoma patients and controls between the ages of 40 and 79 years. Methods This was a cross-sectional study of 2724 bilateral phakic participants aged between 40 and 79 years, which included 1615 controls and 1109 patients with primary open-angle glaucoma who were using prostaglandin F (FP) receptor agonists. Participants were classified into eight age groups: 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, and 75-79 years of age. We compared the near add power and other ocular parameters between glaucoma patients and controls by age group. Results There was a significant difference between glaucoma patients and controls and in spherical equivalent, intraocular pressure, cup/disc ratio, ganglion cell complex thickness, peripapillary retinal nerve fiber layer thickness, and use of dry eye eyedrops across all or many of the age groups studied. The near add power of glaucoma patients was comparable to controls of the immediately older age group until 65-69 years, indicating that the advancement of near add power of glaucoma patients was approximately five years earlier than in controls until that age range. Conclusions There was an earlier progression of presbyopia determined by near add power in glaucoma patients treated with FP receptor agonists compared with controls. Translational Relevance Between ages 40 and 79 years, glaucoma patients treated with prostaglandin F receptor agonists had higher near add power than controls. This knowledge could contribute to informing better management of glaucoma patients with presbyopia.
Collapse
Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
2
|
Shijo T, Yagi-Yaguchi Y, Ibrahim O, Kasamatsu H, Mori-Ogiwara Y, Tomida D, Noma H, Murat D, Yamaguchi T. Intracellular dark endothelial spots: A new imaging biomarker for the development of bullous keratopathy after cataract surgery. Graefes Arch Clin Exp Ophthalmol 2025:10.1007/s00417-025-06846-1. [PMID: 40299060 DOI: 10.1007/s00417-025-06846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Revised: 04/03/2025] [Accepted: 04/22/2025] [Indexed: 04/30/2025] Open
Abstract
PURPOSE Intracellular dark endothelial spots (IDES) on specular microscopy indicate corneal endothelial stress, and can be an imaging biomarker for subsequent endothelial cell density (ECD) loss after endothelial keratoplasty. This study evaluated the risk factors for the development of bullous keratopathy (BK) by comparing low ECD patients with or without IDES before cataract surgery. METHODS This retrospective study included 106 consecutive patients who underwent cataract surgery with a preoperative ECD of less than 1000 cells/mm2. The patients were divided into 2 groups according to presence of IDES. The medical charts were retrospectively reviewed for preoperative central corneal thickness (CCT), ECD, anterior chamber depth (ACD), presence of IDES, presence of guttae, grade of nuclear sclerosis, intraoperative posterior capsule rupture (PCR) and development of BK after cataract surgery. The clinical factors were compared in patients with or without IDES and the risk factors for BK after cataract surgery were evaluated. RESULTS The mean preoperative ECD was 687 ± 124 cells/mm2. IDES were observed in 41 eyes (38.7%). IDES were significantly more common in eyes with shallow ACD than in those with deep ACD (P = 0.033). Twenty-two eyes (20.8%) developed BK after cataract surgery. IDES were significantly associated with the development of BK (31.7%) compared to those without BK (13.9%, P = 0.03). CCT, nuclear sclerosis, PCR, and IDES were identified as significant risk factors for postoperative BK (P < 0.0083). CONCLUSION IDES can be used as a new imaging biomarker that suggests a potential risk for development of BK in patients with shallow anterior chamber who are to undergo cataract surgery.
Collapse
Affiliation(s)
- Taiyo Shijo
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Yukari Yagi-Yaguchi
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Osama Ibrahim
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Hirotsugu Kasamatsu
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Yurina Mori-Ogiwara
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Daisuke Tomida
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Dogru Murat
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan
| | - Takefumi Yamaguchi
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5 - 11 - 13, Sugano, Ichikawa, Chiba, 272 - 8513, Japan.
| |
Collapse
|
3
|
Gallo Afflitto G, Aiello F, Surico PL, Malek DA, Mori T, Swaminathan SS, Maurino V, Nucci C. Cataract and Risk of Fracture: A Systematic Review, Meta-Analysis, and Bayesian Network Meta-Analysis. Ophthalmology 2025:S0161-6420(25)00130-7. [PMID: 39978438 DOI: 10.1016/j.ophtha.2025.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 02/10/2025] [Accepted: 02/12/2025] [Indexed: 02/22/2025] Open
Abstract
TOPIC To evaluate the odds ratio (OR) and hazard ratio (HR) of bone fracture in phakic subjects with cataract compared with phakic subjects without cataract and pseudophakic individuals. CLINICAL RELEVANCE Despite the growing recognition of the link between cataract and fracture, the available evidence remains inconclusive. METHODS The results of this meta-analysis were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered on the International Prospective Register of Systematic Reviews (ID: CRD42024587477). Four electronic databases were searched from their inception to May 2024: PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two reviewers performed title and abstract screening, full-text assessment, and study quality appraisal. Frequentist inference meta-analysis and Bayesian network meta-analyses (NMAs) were conducted to assess the OR and HR of fracture among the 3 groups of interest. RESULTS Sixteen articles met the predefined inclusion and exclusion criteria, with the 11 included in the quantitative synthesis encompassing a population of 4 713 458 subjects and reporting on 284 811 fractures. The certainty of evidence was rated from low to moderate. Compared with subjects without cataract, the OR and the HR for fractures in the cataract group were 1.44 (95% confidence interval [CI]: 0.75-2.75; P > 0.05) and 1.51 (95% CI: 1.14-2.01; P = 0.0152), respectively. Bayesian NMAs indicated that subjects with cataracts have an increased OR and HR of fractures compared with both phakic subjects without cataracts (OR: 3.0 [95% credible interval (CrI): 2.8-3.3]; HR 1.1 [95% CrI: 1.09-1.12]) and pseudophakic individuals (OR: 1.7 [95% CrI: 1.6-1.8]; HR: 1.28 [95% CrI: 1.24-1.31]). Pseudophakic individuals exhibit a 27% reduction in fracture risk compared with phakic individuals with cataracts, with 1 less fracture event for every 8 pseudophakic subjects. CONCLUSION Low-certainty evidence suggests a higher fracture risk in individuals with cataract compared with those without. Moderate-certainty evidence indicates that pseudophakic individuals have the lowest fracture risk compared with phakic patients with or without cataract. Further research should explore the causal link between cataract and fracture risk and evaluate the impact of cataract surgery on fracture prevention. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Gabriele Gallo Afflitto
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy; Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Pier Luigi Surico
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Davina A Malek
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Tommaso Mori
- Moores Cancer Center, University of California San Diego, La Jolla, California; Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Swarup S Swaminathan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
4
|
Ayaki M, Hanyuda A, Negishi K. Presbyopia and associated factors specific to age groups. Clin Exp Optom 2025:1-6. [PMID: 39938940 DOI: 10.1080/08164622.2025.2461737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 01/08/2025] [Accepted: 01/28/2025] [Indexed: 02/14/2025] Open
Abstract
CLINICAL RELEVANCE Presbyopia rapidly progresses between 40 and 55 years of age and the amplitude of accommodation is lost around 55 years of age; however, the factors associated with presbyopia by age group in relation to ocular surface and retinal thickness have not been determined. BACKGROUND Age and other factors are associated with presbyopia, however, factors specific to age groups have not been described. METHODS Near add power was compared among 3000 healthy individuals grouped by age; 40s (aged 40-49 years), 50s (aged 50-59 years), and 60s (aged 60-69 years). Regression analysis and comparison of odds ratios for risk factors of presbyopia determined by near add power were conducted. RESULTS The mean near add power was 1.21 ± 0.66 D in 40s, 2.16 ± 0.59 D in 50s, and 2.72 ± 0.44 D in 60s. Regression analysis of near add power and ocular parameters indicated age, astigmatic errors, intra-ocular pressure, mean deviation, thickness of ganglion cell complex (GCC) and peripapillary retinal nerve fibre layer (RNFL) were associated with near add power in 40s, whilst age, tear break-up time, and peripapillary RNFL were associated with near add power in 60s. Comparison of odds ratios for risk factors for reaching mean near add power in each age group revealed that age, astigmatic errors, mean deviation (40s only), and GCC and RNFL thickness were significant in 40s and 50s, whilst tear break-up time and RNFL thickness were significant in 60s. CONCLUSIONS Age and numerous other factors were significantly associated with near add power in 40s and 50s, while fewer factors were significant in 60s, suggesting age-specific management for presbyopia may be recommended.
Collapse
Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Lutsenko N, Isakova O, Rudycheva O, Kyrylova T. Preoperative OCT lens evaluation in posterior subcapsular cataract - prevention of complications from phacoemulsification. Graefes Arch Clin Exp Ophthalmol 2025; 263:443-450. [PMID: 39243286 DOI: 10.1007/s00417-024-06632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/09/2024] Open
Abstract
PURPOSE To assess the possibility of anterior segment optical coherence tomography (AS-OCT)-based preoperative evaluation of the lens in order to prevent and predict intraoperative complications of posterior subcapsular cataract (PSC) surgery. METHODS This prospective study included 512 eyes diagnosed with PSC. AS-OCT was performed using Line, Cross Line and 3D Cornea scans to visualize the posterior capsule. The posterior capsule and opacities in the subcortical and cortical lens, their relationship and the state of the retrolenticular space were assessed. The study sample was divided into three groups while taking into account the revealed morphological changes in the lens. Groups 1, 2, and 3 comprised 312, 185 and 15 eyes, respectively, with each group characterized by a specific type (1, 2 or 3) of morphological AS-OCT changes in the PSC. Surgery consisted of ultrasound phacoemulsification with intraocular lens implantation. Well-known measures related to cataract surgery stages were performed, if required, to preserve the integrity of the posterior capsule, while taking into account the type of PSC changes. We preoperatively determined the eyes at risk for intraoperative posterior capsular rupture (PCR) and detection of posterior capsular plaque (PCP), and compared this data with the postoperative data on the state of the posterior capsule. RESULTS The PSC cases with an expected rate of intraoperative complications of 0 to 10% were classified as those with a low risk, whereas the rest, with a high risk of complications. Only eyes with type 2 or type 3 PSC changes were expected to have a high risk of intraoperative PCP, and only eyes with type 3 PSC changes, a high risk of PCR. In groups 1, 2 and 3, the rates of intraoperative PCP were 0%, 100% and 46.7%, respectively, and the rates of intraoperative PCR, 0%, 0% and 53.3%, respectively. There was a significant positive correlation between preoperative OCT-based morphology of the lens and intraoperative complications (r = 0.88, p ≤0.001). Sensitivity and specificity for the method of AS-OCT-based evaluation of risks of intraoperative complications in PSC surgery were 98.8% and 96.5%, respectively. CONCLUSION AS-OCT allows evaluating preoperatively posterior lens opacification morphology and posterior capsular changes, determining the risks of complications, and performing surgical planning for PSC. KEY MESSAGES What is Known? Complications (posterior capsule (PC) rupture with or without vitreous loss and residual PC plaque) are common in, and affect the expected outcome of, posterior subcapsular cataract (PSC) surgery. What is new? PC plaque is most likely in eyes with preoperative type 2 changes in the PSC, whereas eyes with preoperative type 3 changes are likely to show PC rupture or residual PC plaque. AS-OCT enables an experienced surgeon to predict the risks of intraoperative complications in, and perform surgical planning for, PSC surgery.
Collapse
Affiliation(s)
- Nina Lutsenko
- Zaporizhzhia Medical Academy of Postgraduate Education, Zaporizhzhia, Ukraine.
- Eye Microsurgery Department, Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine.
- Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine.
| | - Oxana Isakova
- Zaporizhzhia Medical Academy of Postgraduate Education, Zaporizhzhia, Ukraine
- Eye Microsurgery Department, Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine
- Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
| | - Olga Rudycheva
- Zaporizhzhia Medical Academy of Postgraduate Education, Zaporizhzhia, Ukraine
- Eye Microsurgery Department, Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine
- Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
| | - Tetyana Kyrylova
- Zaporizhzhia Medical Academy of Postgraduate Education, Zaporizhzhia, Ukraine
- Eye Microsurgery Department, Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine
- Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
| |
Collapse
|
6
|
Alipour F, Abdi P, Asadigandomani H, Rezakhani M, Moosaie F, Jafari F, Yaseri M, Motamed-Gorji N, Khalili F, Tavakoli R, Tahkor A, Mohseni M, Salimpour S, Aref SMJM, Mirzaei M, Soleimani M, Shahraki K, Alizade Y, Shoja MR, Khataminia GR, Behrouz MJ, Hashemi H. Prevalence of cataracts in Iran based on the Persian eye cohort study. Sci Rep 2024; 14:31812. [PMID: 39738422 PMCID: PMC11685764 DOI: 10.1038/s41598-024-83080-5] [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: 09/10/2024] [Accepted: 12/11/2024] [Indexed: 01/02/2025] Open
Abstract
The PERSIAN eye cohort study is a population-based study that evaluates the overall prevalence of cataracts and their subtypes (nuclear sclerosis, cortical, and PSC) in Iran. In this study, from January 2015 to September 2021, 16,016 participants over 35 years of age from four provinces who were selected by random cluster sampling were examined. Demographic information, education, socioeconomic status, and place of residence were collected through interviews. The cataract status of the study participants was examined by two experienced ophthalmologists using slit lamp photography. The average age of the study participants was 49.52 ± 9.31 and 8891 (55.5%) were female. The overall prevalence of each type of cataract, nuclear sclerosis, cortical, and PSC was 18.90%, 12.65%, 9.20%, and 3.08%, respectively. The results indicated that the prevalence of any type of cataract (adjusted OR = 0.85, 95% CI: 0.78-0.92, p < 0.001) and NS cataract (adjusted OR = 0.80, 95% CI: 0.73-0.88, p < 0.001) is lower in women. The risk of developing cataracts increased exponentially with aging. The prevalence of any type of cataract and cortical subtype was higher in rural than urban populations. Also, the risk of developing cataracts decreased with an increase in education level and socioeconomic status and some Iranian races such as Arabs, Azari, and Guilak were also at a higher risk of cataracts. The results of this study indicate the importance of a comprehensive regard of cataract as one of the causes of avoidable blindness in Iran due to its higher prevalence than the global average.
Collapse
Affiliation(s)
- Fateme Alipour
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Parisa Abdi
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran.
| | - Hassan Asadigandomani
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Mehran Rezakhani
- Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moosaie
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fateme Jafari
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Khalili
- Liver and Gastrointestinal Diseases Research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Tavakoli
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Masoome Mohseni
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Guilan, Iran
| | - Samira Salimpour
- Geriatric Ophthalmology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mohammad Mirzaei
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Kourosh Shahraki
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Yousef Alizade
- Department of Ophthalmology, Amiralmomenin Hospital, Gillan University of Medical Sciences, Rasht, Iran
| | - Mohammad Reza Shoja
- Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mahmoud Jabbarvand Behrouz
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | | |
Collapse
|
7
|
Hashemi H, Pakzad R, Aghamirsalim M, Hashemi A, Khabazkhoob M. Decomposition of Economic Inequality in Age-Related Macular Degeneration by Using Oaxaca-Blinder Decomposition: Tehran Geriatric Eye Study. Ophthalmic Epidemiol 2024:1-9. [PMID: 39531588 DOI: 10.1080/09286586.2024.2415047] [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: 06/27/2024] [Revised: 09/15/2024] [Accepted: 10/05/2024] [Indexed: 11/16/2024]
Abstract
PURPOSE To investigate economic inequality in age-related macular degeneration (AMD) and decompose it into its determinants using Oaxaca-Blinder decomposition (OBD). METHODS The Tehran Geriatric Eye Study was a cross-sectional study conducted on individuals aged 60 years and older, utilizing stratified random cluster sampling. Each participant received a comprehensive optometric, and slit-lamp examination. Diagnosis and classification of AMD were conducted utilizing fundus camera images. RESULTS The data of the 3268 participants were analyzed. According to OBD, a significant difference was found in AMD between the rich and poor groups (8.36%) disfavoring the poor (p < 0.001). The explained and unexplained portions comprised 93.37% and 6.63% of the difference (p < 0.001 and p = 0.405, respectively). Among study variables, age (coefficient = 4.70; p < 0.001), economic status (coefficient = 3.58; p = 0.004), and myopia (coefficient = 0.73; p = 0.001) were significant determinants of inequality in the explained portion. CONCLUSION A significant disparity in the prevalence of AMD was observed between individuals of different socioeconomic statuses, primarily attributed to the explained factors. Factors such as age, economic status, and myopia were found to have the most substantial impact in exacerbating the inequality that disadvantaged the poor group (contributing percentages: 52.17%, 39.73%, and 8.10%, respectively). The findings of this research can be valuable for health policymakers in prioritizing and addressing the determinants of inequality within the population.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohamadreza Aghamirsalim
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Hanyuda A, Kubota M, Kubota S, Masui S, Yuki K, Ayaki M, Negishi K. Establishing the cutoff value of near visual acuity for assessment of early presbyopia. Jpn J Ophthalmol 2024; 68:709-716. [PMID: 39215880 PMCID: PMC11607044 DOI: 10.1007/s10384-024-01114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE There is limited evidence to evaluate the numerical cutoff point for detecting early presbyopia. Thus, we aimed to establish a clinically relevant optimal cutoff value of near visual acuity for detecting early presbyopia. STUDY DESIGN Prospective diagnostic accuracy study. METHODS We included consecutive individuals aged ≥ 20 years with a binocular-corrected distance visual acuity of ≥ 20/25 who did not undergo ophthalmic surgery between December 17, 2020 and December 19, 2021, at two healthcare facilities in Japan. Binocular distance-corrected near visual acuity at 40 cm, accommodative amplitude, awareness of presbyopia, and Near Activity Visual Questionnaire scores were examined. The optimal cutoff values of distance-corrected near visual acuity for diagnosing early presbyopia were evaluated using receiver operating characteristic plots. RESULTS Among 115 participants, 74 (64.3%) had presbyopia. The proportion of participants with no difficulty performing near-vision tasks decreased markedly when near visual acuity decreased to 20/20 (> 0.00 logMAR). A cutoff value of 0.00 logMAR for distance-corrected near visual acuity was optimal, showing high sensitivity of 56.76% and specificity of 92.68%, as opposed to the commonly used cutoff value of 0.40 logMAR (20/50; sensitivity, 9.46% and specificity, 100%) for diagnosing early presbyopia. CONCLUSION Near visual acuity of 0.00 logMAR (20/20) could be the optimal cutoff value for diagnosing early presbyopia.
Collapse
Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Miyuki Kubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa, Japan
- Graduate School of Median and Governance, Keio University, Kanagawa, Japan
| | - Shunsuke Kubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa, Japan
- Graduate School of Median and Governance, Keio University, Kanagawa, Japan
- Hazawa-Kubota Eye Clinic, Kanagawa, Japan
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| |
Collapse
|
9
|
Duong NM, Nguyen Vu NQ, Le HT. Diagnostic Assessment of Nuclear Cataracts Using a Smartphone-Attachable Slit-Lamp Device: A Cross-Sectional Study in Vietnam. Cureus 2024; 16:e73783. [PMID: 39691138 PMCID: PMC11650093 DOI: 10.7759/cureus.73783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2024] [Indexed: 12/19/2024] Open
Abstract
Purpose The purpose of this study was to compare the accuracy and agreement in nuclear cataract opacity classification between the Smart Eye Camera (SEC) device, and the slit-lamp. Methods A cross-sectional study was conducted with a convenient sampling of 221 eyes from 139 patients with phakic eyes, visiting IVISION Eye Center, Ho Chi Minh City, Vietnam, from November 1, 2023, to April 30, 2024. Two grading systems, Lucio-Buratto (Buratto) and World Health Organization (WHO), were used to compare the effectiveness of the two devices, with statistical analysis using Spearman's correlation coefficient and Cohen's kappa to evaluate the agreement level. Results Results showed no significant difference in Buratto and WHO grading between the two devices (p > 0.05), indicating consistency between the two measurement methods. Spearman's correlation coefficient demonstrated a strong correlation between the results from both devices, with r = 0.797 for Buratto and r = 0.579 for WHO (p < 0.001). The reliability was confirmed by high weighted-kappa values (k = 0.774 for Buratto and k = 0.539 for WHO). Conclusion The SEC's comparable effectiveness to the slit-lamp supports its potential utility in blindness-prevention screening efforts.
Collapse
Affiliation(s)
- Nguyet M Duong
- Pediatrics Department, Ho Chi Minh City Eye Hospital, Ho Chi Minh City, VNM
- Ophthalmology Department, IVISION Eye Center, Ho Chi Minh City, VNM
| | - Nhu Q Nguyen Vu
- Optometry Department, IVISION Eye Center, Ho Chi Minh City, VNM
| | - Hai T Le
- Optometry Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VNM
| |
Collapse
|
10
|
Pongsachareonnont PF, Sakthong P, Chaikitmongkol V, Tsutsumi WD, Bhoomibunchoo C, Hurst CP, Teerawattananon Y, Kulvichit K. Health Utility Values Among Patients With Diabetic Retinopathy, Wet Age-Related Macular Degeneration, and Cataract in Thailand: A Multicenter Survey Using Time Trade-Off, EQ-5D-5L, and Health Utility Index 3. Value Health Reg Issues 2024; 44:101030. [PMID: 39089062 DOI: 10.1016/j.vhri.2024.101030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/24/2024] [Accepted: 06/20/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES This study aimed to establish normative health utility data in Thai patients with diabetic retinopathy, wet age-related macular degeneration, and cataract; evaluate the sensitivity of different utility instruments to visual impairment; explore the relationship among these health utility values with the vision-specific quality of life (QoL); and assess the association of baseline characteristics and visual acuity level with health utility values and vision-specific QoL. METHODS This multicenter cross-sectional survey included 309 patients from tertiary eye centers. We used health utility instruments (time trade-off [TTO], EuroQol five-dimension [EQ-5D-5L], and Health Utility Index 3 [HUI3]) and vision-specific QoL instrument (National Eye Institute Visual Function Questionnaire) for face-to-face interviews. Demographic data and Early Treatment Diabetic Retinopathy Study visual acuity were recorded during the participants ophthalmic visits. Univariable and multivariable mixed-effect models were used to evaluate factors associated with the utility scores. Health utility scores among each type of eye disease were compared. RESULTS The overall mean utility values from the TTO, EQ-5D-5L, and HUI3 were 0.84 ± 0.25, 0.70 ± 0.19, and 0.68 ± 0.26, respectively. The health utility scores obtained from TTO and HUI3 showed a significant response to severe visual impairment or worse. Health utility scores from HUI3 (r = 0.54; P < .01) and EQ-5D-5L (r = 0.43; P < .01) displayed a moderate correlation with the National Eye Institute Visual Function Questionnaire score. There were no significant differences in health utility value among the 3 diseases upon adjusting for the visual acuity level and demographics. CONCLUSIONS Visual acuity level has a greater impact on a patient's QoL than the type of eye disease. HUI3 and EQ-5D-5L and TTO are suitable for measuring health utility in leading causes of blindness.
Collapse
Affiliation(s)
- Pear Ferreira Pongsachareonnont
- Department of Ophthalmology, Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Department of Ophthalmology, Queen's University and Kingston Health Sciences Centre, Kingston, Canada.
| | - Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Voraporn Chaikitmongkol
- Department of Ophthalmology, Retina Division, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Chavakij Bhoomibunchoo
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Cameron P Hurst
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Bangkok, Thailand and Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Kittisak Kulvichit
- Department of Ophthalmology, Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
| |
Collapse
|
11
|
Lin YF, Xie JX, Chen XL. Changes in PEDF, MMP-2, and TGF-β2 levels in the aqueous humor of cataract patients and their correlation with disease severity. Clinics (Sao Paulo) 2024; 79:100402. [PMID: 39413500 PMCID: PMC11530841 DOI: 10.1016/j.clinsp.2024.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/13/2024] [Accepted: 05/22/2024] [Indexed: 10/18/2024] Open
Abstract
OBJECTIVE To explore the changes of Pigment Epithelium-Derived Factor (PEDF), Matrix Metalloproteinase-2 (MMP-2), and Transforming Growth Factor-β2 (TGF-β2) levels in the aqueous humor of cataract patients and their correlation with disease severity. METHODS 93 cataract patients and 56 healthy subjects were study objects. PEDF, MMP-2, and TGF-β2 levels of aqueous humor were compared, and the correlation between each index and Lens Opacity Classification System (LOCS) III classification was analyzed. ROC curve was used to analyze the evaluation value of the combined detection of each index on cataract development, and logistic regression to analyze the influence of the changes of each index on cataract development. RESULTS PEDF levels were lower and MMP-2 and TGF-β2 levels were higher in the aqueous humor of cataract patients than in healthy subjects. PEDF levels in the aqueous humor were negatively correlated with LOCS III classification, while MMP-2 and TGF-β2 levels were positively correlated with LOCS III classification. The AUC value of combined detection was higher than that of PEDF, MMP-2, and TGF-β2 in the aqueous humor alone. MMP-2 ≥ 15.13 pg/mL, TGF-β2 ≥ 385.91 pg/mL and PEDF < 198.85 ng/mL were risk factors for cataract development. CONCLUSION The changes in PEDF, MMP-2, and TGF-β2 levels in the aqueous humor of cataract patients are related to LOCS III classification. The combined detection is valuable in evaluating cataract development.
Collapse
Affiliation(s)
- Yong Feng Lin
- Department of Ophthalmology, Longyan People's Hospital, Longyan City, Fujian Province, China.
| | - Jin Xia Xie
- Department of Ophthalmology, Longyan People's Hospital, Longyan City, Fujian Province, China
| | - Xiao Luan Chen
- Department of General Surgery, Longyan Hospital of Traditional Chinese Medicine affiliated to Xiamen University, Longyan City, Fujian Province, China
| |
Collapse
|
12
|
Philibert A, Tousignant B, Fillion M, Da Silva J, Mergler D. Characterizing visual field loss from past mercury exposure in an Indigenous riverine community (Grassy Narrows First Nation, Canada): a cluster-based approach. Environ Health 2024; 23:81. [PMID: 39375679 PMCID: PMC11457346 DOI: 10.1186/s12940-024-01119-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 09/23/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND Between 1962 and 1975, a chlor-alkali plant in Canada discharged approximately 9 metric tons of mercury (Hg) into the Wabigoon River. Over the following decades, biomarkers of Hg exposure of persons from Grassy Narrows First Nation (Asubpeeschoseewagong Anishinabek), located downriver from the discharge, reflected Hg concentrations in fish. Hg exposure is known to target the calcarine fissure, resulting in visual field (VF) loss. Most studies and clinical reports focus solely on peripheral VF loss; little is known about the impact of Hg on the central and paracentral portions. The present study sought to characterize the patterns of VF loss with respect to past and current Hg. METHODS A 28-year hair-Hg (HHg) database, created from a 1970-97 government biomonitoring program, served to select study participants with ≥ 4 year-based HHg measurements (n = 81). Blood-Hg was assessed for current exposure. Light sensitivity thresholds across the VF were analyzed monocularly, using a Humphrey Field Analyzer (HFA). Following post-hoc exclusions, based on HFA interpretation indices, 65 participants were retained. Both eyes were combined for analyses (n = 130 eyes). Unsupervised hierarchical clustering of HFA plot data was used to identify patterns of VF loss. A series of mixed effects models (MEM) were performed to test the associations for current Hg exposure with respect to HFA interpretation indices and clusters, as well as for longitudinal past Hg exposure. RESULTS The clustering approach decomposed the light sensitivity deficits into 5 concentric clusters, with greatest loss in the peripheral clusters. No relation was observed between any of the cluster scores and current blood-Hg. VF deficits increased with past Hg exposure. Longitudinal MEM showed that HHg was significantly (p < 0.05) associated with all peripheral, paracentral, and central cluster scores, as well as with HFA interpretation indices. CONCLUSIONS Past Hg exposure in Grassy Narrows First Nation was associated with present day VF loss. The cluster-based location-specific approach identified patterns of VF loss associated with long-term Hg exposure, in both the peripheral and the central areas. The functional implications of this type of visual loss should be investigated.
Collapse
Affiliation(s)
- Aline Philibert
- Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (CINBIOSE), CP 8888, Université du Québec À Montréal, Succ. Centreville, Montréal, Québec, H3C 3P8, Canada
| | - Benoit Tousignant
- School of Optometry, Université de Montréal, 3744 Jean-Brillant, Montréal, Québec, H3T 1P1, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
| | - Myriam Fillion
- Département Science et Technologie, Université TÉLUQ, 5800 Saint-Denis St, Montréal, Québec, H2S 3L4, Canada
| | - Judy Da Silva
- Grassy Narrows First Nation, General Delivery, Grassy Narrows, Ontario, P0X 1B0, Canada
| | - Donna Mergler
- Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (CINBIOSE), CP 8888, Université du Québec À Montréal, Succ. Centreville, Montréal, Québec, H3C 3P8, Canada.
| |
Collapse
|
13
|
Hashemi A, Nabovati P, Hashemi H, Khabazkhoob M. Prevalence and Associated Factors of Pseudoexfoliation Syndrome in an Iranian Elderly Population: The Tehran Geriatric Eye Study. Ophthalmic Epidemiol 2024; 31:430-438. [PMID: 38095577 DOI: 10.1080/09286586.2023.2291787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 08/18/2023] [Accepted: 11/27/2023] [Indexed: 09/08/2024]
Abstract
PURPOSE To investigate the prevalence and associated factors of pseudoexfoliation syndrome (PEX) in an Iranian elderly population. METHODS This study, a population-based cross-sectional study conducted on individuals ≥60 years in Tehran, the capital of Iran in 2019 using a multi-stage stratified random cluster sampling. All study participants underwent complete ocular examination (including measurement of uncorrected and best-corrected visual acuity, refraction, slit-lamp biomicroscopy). The PEX was diagnosed based on the presence of white fluffy dandruff-like pseudoexfoliative material on the pupillary margin, on the anterior lens capsule, and/or the trabecular meshwork. RESULTS Of the 3791 invitees, 3310 participated in the TGES (response rate: 87.3%). After applying exclusion criteria, the data of 3274 individuals were analyzed for this report. The overall prevalence of PEX was 3.63% (95% CI:2.67-4.58) in this study. 81.1% of PEX cases were bilateral. The prevalence of PEX increased significantly with advancing age in a linear trend from 2.38% (95%: 1.27-3.48) in the age group 60-64 years to 6.48% (95%: 2.02-10.95) in the age group ≥80 years (OR = 1.05, p = 0.008). According to the multiple logistic regression model, advancing age (OR: 1.06, p = 0.002) and the presence of cataract (OR: 5.02, p < 0.001) were significantly associated with increased odds of PEX. CONCLUSION The results showed a lower prevalence of PEX in the Iranian elderly compared to previous studies on the elderly population. Advancing age and cataracts were the only associated factors of PEX in the present study.
Collapse
Affiliation(s)
- Alireza Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
A S, Raviraj K, M K, G P. Importance of Grading Cataracts in Predicting Recovery Time and Final Visual Outcomes After Cataract Surgery. Cureus 2024; 16:e69309. [PMID: 39398717 PMCID: PMC11470987 DOI: 10.7759/cureus.69309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2024] [Indexed: 10/15/2024] Open
Abstract
INTRODUCTION Cataracts have been considered as one of the major causes for reducing the vision-related quality of life and increasing the risk of comorbidities and mortality among the general population. AIM This study aimed to assess the importance of grading cataracts in predicting recovery time and final visual outcomes after cataract surgery. METHOD A retrospective consecutive case review of elective cataract surgeries performed in a tertiary care hospital during a three-year period from 2019 to 2021 was studied. The postoperative visual status was correlated with grading. RESULTS The reports of this study implicate the fact that 16.4% of the patients had grade 1 anterior segment cataracts. Visual acuity of perfect vision (6/6P) was obtained in 24% of patients, and 41.2% of patients had grade 1 anterior segment cataract surgery on day 1 (p<0.005). Perfect vision at 6/6 visual acuity was obtained in 24% of patients, and 27.5% of patients had grade 2 anterior segment cataract surgery in week 1 (p<0.05). CONCLUSION The study shows that patients with grade 1 anterior segment cataract surgery had a better visual recovery time and visual outcome. The grading system of cataracts has further shown improvement in the vision care of the patients, along with showing reliability and monitoring of cataract formation.
Collapse
Affiliation(s)
- Sangeetha A
- Physiology, Mahatma Gandhi Medical College & Research Institute, Puducherry, IND
| | - K Raviraj
- Anatomy, Chettinad Hospital & Research Institute, Chennai, IND
| | - Kumaresan M
- Anatomy, Mahatma Gandhi Medical College & Research Institute, Puducherry, IND
| | - Priyanka G
- Physiology, Sree Balaji Medical College & Hospital, Chennai, IND
| |
Collapse
|
15
|
Soleimani M, Cheraqpour K, Salari F, Fadakar K, Habeel S, Baharnoori SM, Banz S, Tabatabaei SA, Woreta FA, Djalilian AR. All about traumatic cataracts: narrative review. J Cataract Refract Surg 2024; 50:760-766. [PMID: 38350230 PMCID: PMC11196203 DOI: 10.1097/j.jcrs.0000000000001424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024]
Abstract
Ocular trauma is an important cause of monocular blindness worldwide. Injury to the lens after blunt or penetrating trauma is common and can result in vision impairment. Selecting the most appropriate therapeutic approaches depends on factors such as patients' age, mechanism of trauma, and underlying clinical conditions. Early management, especially within childhood, is essential because of the difficulties involved in examination; anatomical variations; as well as accompanying intraocular inflammation, amblyopia, or vitreoretinal adhesions. The objective of this study was to provide a comprehensive review of the epidemiology and clinical management of traumatic cataract, highlighting the significance of accurate diagnosis and selection of the optimal therapeutic approach.
Collapse
Affiliation(s)
- Mohammad Soleimani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Fadakar
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samer Habeel
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Mahbod Baharnoori
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Soraya Banz
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- University of Edinburgh, UK
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fasika A. Woreta
- Wilmer Eye Institute, Johns Hopkins Medical Institute, Baltimore, MD, USA
| | - Ali R. Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|
16
|
Mai EL, Chen BH, Su TY. Innovative utilization of ultra-wide field fundus images and deep learning algorithms for screening high-risk posterior polar cataract. J Cataract Refract Surg 2024; 50:618-623. [PMID: 38350234 PMCID: PMC11146186 DOI: 10.1097/j.jcrs.0000000000001419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE To test a cataract shadow projection theory and validate it by developing a deep learning algorithm that enables automatic and stable posterior polar cataract (PPC) screening using fundus images. SETTING Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan. DESIGN Retrospective chart review. METHODS A deep learning algorithm to automatically detect PPC was developed based on the cataract shadow projection theory. Retrospective data (n = 546) with ultra-wide field fundus images were collected, and various model architectures and fields of view were tested for optimization. RESULTS The final model achieved 80% overall accuracy, with 88.2% sensitivity and 93.4% specificity in PPC screening on a clinical validation dataset (n = 103). CONCLUSIONS This study established a significant relationship between PPC and the projected shadow, which may help surgeons to identify potential PPC risks preoperatively and reduce the incidence of posterior capsular rupture during cataract surgery.
Collapse
Affiliation(s)
- Elsa L.C. Mai
- From the Department of Electric Engineering, Yuan-Ze University, Taoyuan City, Taiwan (Mai, Chen, Su); Department of Ophthalmology, Far Eastern Memorial Hospital, Taiwan (Mai); Yuanpei University of Medical Technology, Hsinchu, Taiwan (Mai)
| | - Bing-Hong Chen
- From the Department of Electric Engineering, Yuan-Ze University, Taoyuan City, Taiwan (Mai, Chen, Su); Department of Ophthalmology, Far Eastern Memorial Hospital, Taiwan (Mai); Yuanpei University of Medical Technology, Hsinchu, Taiwan (Mai)
| | - Tai-Yuan Su
- From the Department of Electric Engineering, Yuan-Ze University, Taoyuan City, Taiwan (Mai, Chen, Su); Department of Ophthalmology, Far Eastern Memorial Hospital, Taiwan (Mai); Yuanpei University of Medical Technology, Hsinchu, Taiwan (Mai)
| |
Collapse
|
17
|
Ortiz-Morales G, Ramos-Davila EM, Elizondo-Fernández B, Arreola-Martinez J, Garcia JN, Valdez-Garcia JE. LASIK is associated with early cataract surgery in healthy patients. Int Ophthalmol 2024; 44:125. [PMID: 38431898 DOI: 10.1007/s10792-024-03060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To evaluate the association between LASIK and early cataract phacoemulsification surgery (PE). METHODS A matched case-control study was conducted. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity (CDVA), axial length, and cataract grade. RESULTS A total of 213 patients were included. 85 patients were classified as post-LASIK group and 128 as controls. The mean age at the time of LASIK was 42.32 ± 9.24 years. The mean CDVA before PE was 0.29 ± 0.19 Log MAR in post-LASIK group and 0.34 ± 0.22 Log MAR in controls (p = 0.07). The mean axial length was 23.99 ± 1.78 mm in post-LASIK group and 23.62 ± 0.98 mm in controls (p = 0.085). The mean nuclear cataract grading was 1.36 in post-LASIK group and 1.47 in controls (p = 0.34). The mean age at the time of PE was 60.18 ± 7.46 years in post-LASIK group and 67.35 ± 9.28 in controls (p < 0.0005). The difference between the mean age of LASIK and the mean age of PE was 17.85 ± 5.72 years. There was a positive association between the post-LASIK group and the age of PE ≤ 55 years (OR: 4.917, 95% CI: 2.21-10.90, p < 0.001). CONCLUSION LASIK may be associated with early PE. Patients with LASIK had a 7-year earlier PE compared to a matched control group.
Collapse
Affiliation(s)
| | | | | | | | - Jose Nava Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
| | - Jorge E Valdez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
- School of Medicine and Health Sciences, Av. Ignacio Morones Prieto 3000. Colonia Los Doctores, 64710, Monterrey, Nuevo León, Mexico.
| |
Collapse
|
18
|
Ripa M, Ricci F, Rizzo S. Pain experience in patients undergoing topical anesthesia alone versus topical plus intracameral anesthesia during cataract surgery. Eur J Ophthalmol 2024; 34:425-431. [PMID: 37498980 DOI: 10.1177/11206721231187424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE To evaluate and compare the pain experience and discomfort during cataract surgery and over the 24 hours after surgery in patients undergoing either topical anesthesia alone or topical anesthesia plus intracameral anesthesia, provided by using a standard topical anesthesia regimen and a 0.2-mL dose of Mydrane®. METHODS Prospective study involving 100 patients who underwent cataract surgery receiving either topical anesthesia alone (group 1, n = 50) or topical anesthesia plus intracameral anesthesia (group 2, n = 50) between January 2021 and March 2022. The pain experienced by patients during and after surgery was assessed using a pain scale and a questionnaire. One hour after surgery, patients were asked to rate the intensity of discomfort they experienced throughout the procedure by pointing to a 0-100 Visual Analogue Scale (VAS). RESULTS According to VAS measurements, patients who underwent surgery under topical anesthesia reported more significant pain than those who underwent surgery under topical anesthesia plus intracameral anesthesia during and over the 24 hours after surgery. (p = 0.02 and p = 0.01, respectively). Patients undergoing topical anesthesia had 2.34-fold greater odds of having pain during surgery [95% Confidence Interval (CI): 1.58-5.25, p = 0.03]. CONCLUSIONS Topical anesthesia plus intracameral anesthesia lower intraoperative and postoperative pain levels, improving patient cooperation and representing a useful analgesic delivery method in cataract surgery.
Collapse
Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Ophthalmology Department, Catholic University "Sacro Cuore", Rome, Italy
| | - Francesco Ricci
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Ophthalmology Department, Catholic University "Sacro Cuore", Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Ophthalmology Department, Catholic University "Sacro Cuore", Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| |
Collapse
|
19
|
Obana A, Ote K, Gohto Y, Yamada H, Hashimoto F, Okazaki S, Asaoka R. Deep learning-based correction of cataract-induced influence on macular pigment optical density measurement by autofluorescence spectroscopy. PLoS One 2024; 19:e0298132. [PMID: 38349916 PMCID: PMC10863874 DOI: 10.1371/journal.pone.0298132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE Measurements of macular pigment optical density (MPOD) using the autofluorescence spectroscopy yield underestimations of actual values in eyes with cataracts. Previously, we proposed a correction method for this error using deep learning (DL); however, the correction performance was validated through internal cross-validation. This cross-sectional study aimed to validate this approach using an external validation dataset. METHODS MPODs at 0.25°, 0.5°, 1°, and 2° eccentricities and macular pigment optical volume (MPOV) within 9° eccentricity were measured using SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany) in 197 (training dataset inherited from our previous study) and 157 eyes (validating dataset) before and after cataract surgery. A DL model was trained to predict the corrected value from the pre-operative value using the training dataset, and we measured the discrepancy between the corrected value and the actual postoperative value. Subsequently, the prediction performance was validated using a validation dataset. RESULTS Using the validation dataset, the mean absolute values of errors for MPOD and MPOV corrected using DL ranged from 8.2 to 12.4%, which were lower than values with no correction (P < 0.001, linear mixed model with Tukey's test). The error depended on the autofluorescence image quality used to calculate MPOD. The mean errors in high and moderate quality images ranged from 6.0 to 11.4%, which were lower than those of poor quality images. CONCLUSION The usefulness of the DL correction method was validated. Deep learning reduced the error for a relatively good autofluorescence image quality. Poor-quality images were not corrected.
Collapse
Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
- Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kibo Ote
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Hidenao Yamada
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Fumio Hashimoto
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Shigetoshi Okazaki
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| |
Collapse
|
20
|
Almaliotis D, Almpanidou S, Chatzimbalis T, Nikolaidou A, Talimtzi P, Karampatakis V. Correlation between color vision, visual acuity, contrast sensitivity and photostress recovery in the visually impaired: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:742-747. [PMID: 38333302 PMCID: PMC10849460 DOI: 10.1097/ms9.0000000000001522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/09/2023] [Indexed: 02/10/2024] Open
Abstract
Background To investigate the correlation of colour vision, visual acuity, contrast sensitivity, and photostress recovery time test scores in visually impaired patients. Materials and methods A total of 133 subjects were enroled and 133 eyes were examined. The pathological group consisted of 76 (57.1%) males with an average age of 68.0 (SD=13.2) and 57 (42.9%) females, with an average age of 68.1 (SD=15.2), Mann-Whitney U test was used to evaluate the differences in K-colour tests, HRR, visual acuity, Contrast Sensitivity test and photostress recovery time test between two different groups of severity. Results Correlations were found among colour vision tests, visual acuity, contrast sensitivity, and photostress recovery time scores in eyes with age-related macular degeneration, with diabetic retinopathy, with optic nerve diseases, and various other retinal diseases (P<0.05). In patients with moderate-visual impairments. Conclusions The colour vision test scores correlate with the scores of visual acuity, contrast sensitivity, and photostess recovery time test. It may be a useful clinical surrogate for functional vision.
Collapse
Affiliation(s)
- Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
21
|
Shimizu E, Tanji M, Nakayama S, Ishikawa T, Agata N, Yokoiwa R, Nishimura H, Khemlani RJ, Sato S, Hanyuda A, Sato Y. AI-based diagnosis of nuclear cataract from slit-lamp videos. Sci Rep 2023; 13:22046. [PMID: 38086904 PMCID: PMC10716159 DOI: 10.1038/s41598-023-49563-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/09/2023] [Indexed: 12/18/2023] Open
Abstract
In ophthalmology, the availability of many fundus photographs and optical coherence tomography images has spurred consideration of using artificial intelligence (AI) for diagnosing retinal and optic nerve disorders. However, AI application for diagnosing anterior segment eye conditions remains unfeasible due to limited standardized images and analysis models. We addressed this limitation by augmenting the quantity of standardized optical images using a video-recordable slit-lamp device. We then investigated whether our proposed machine learning (ML) AI algorithm could accurately diagnose cataracts from videos recorded with this device. We collected 206,574 cataract frames from 1812 cataract eye videos. Ophthalmologists graded the nuclear cataracts (NUCs) using the cataract grading scale of the World Health Organization. These gradings were used to train and validate an ML algorithm. A validation dataset was used to compare the NUC diagnosis and grading of AI and ophthalmologists. The results of individual cataract gradings were: NUC 0: area under the curve (AUC) = 0.967; NUC 1: AUC = 0.928; NUC 2: AUC = 0.923; and NUC 3: AUC = 0.949. Our ML-based cataract diagnostic model achieved performance comparable to a conventional device, presenting a promising and accurate auto diagnostic AI tool.
Collapse
Affiliation(s)
- Eisuke Shimizu
- OUI Inc., Tokyo, Japan.
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
- Yokohama Keiai Eye Clinic, Yokohama, Japan.
| | - Makoto Tanji
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Shintato Nakayama
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Toshiki Ishikawa
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Hiroki Nishimura
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Yokohama Keiai Eye Clinic, Yokohama, Japan
| | | | - Shinri Sato
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Yokohama Keiai Eye Clinic, Yokohama, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| |
Collapse
|
22
|
Vought R, Vought V, Shah M, Szirth B, Bhagat N. EyeArt artificial intelligence analysis of diabetic retinopathy in retinal screening events. Int Ophthalmol 2023; 43:4851-4859. [PMID: 37847478 DOI: 10.1007/s10792-023-02887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Early detection and treatment of diabetic retinopathy (DR) are critical for decreasing the risk of vision loss and preventing blindness. Community vision screenings may play an important role, especially in communities at higher risk for diabetes. To address the need for increased DR detection and referrals, we evaluated the use of artificial intelligence (AI) for screening DR. METHODS Patient images of 124 eyes were obtained using a 45° Canon Non-Mydriatic CR-2 Plus AF retinal camera in the Department of Endocrinology Clinic (Newark, NJ) and in a community screening event (Newark, NJ). Images were initially classified by an onsite grader and uploaded for analysis by EyeArt, a cloud-based AI software developed by Eyenuk (California, USA). The images were also graded by an off-site retina specialist. Using Fleiss kappa analysis, a correlation was investigated between the three grading systems, the AI, onsite grader, and a US board-certified retina specialist, for a diagnosis of DR and referral pattern. RESULTS The EyeArt results, onsite grader, and the retina specialist had a 79% overall agreement on the diagnosis of DR: 86 eyes with full agreement, 37 eyes with agreement between two graders, 1 eye with full disagreement. The kappa value for concordance on a diagnosis was 0.69 (95% CI 0.61-0.77), indicating substantial agreement. Referral patterns by EyeArt, the onsite grader, and the ophthalmologist had an 85% overall agreement: 96 eyes with full agreement, 28 eyes with disagreement. The kappa value for concordance on "whether to refer" was 0.70 (95% CI 0.60-0.80), indicating substantial agreement. Using the board-certified retina specialist as the gold standard, EyeArt had an 81% accuracy (101/124 eyes) for diagnosis and 83% accuracy (103/124 eyes) in referrals. For referrals, the sensitivity of EyeArt was 74%, specificity was 87%, positive predictive value was 72%, and negative predictive value was 88%. CONCLUSIONS This retrospective cross-sectional analysis offers insights into use of AI in diabetic screenings and the significant role it will play in automated detection of DR. The EyeArt readings were beneficial with some limitations in a community screening environment. These limitations included a decreased accuracy in the presence of cataracts and the functional cost of EyeArt uploads in a community setting.
Collapse
Affiliation(s)
- Rita Vought
- The Institute of Ophthalmology and Visual Science (IOVS), Rutgers-New Jersey Medical School (Rutgers NJMS), 90 Bergen St., Suite 6100, Newark, NJ, 07103, USA
| | - Victoria Vought
- The Institute of Ophthalmology and Visual Science (IOVS), Rutgers-New Jersey Medical School (Rutgers NJMS), 90 Bergen St., Suite 6100, Newark, NJ, 07103, USA
| | - Megh Shah
- The Institute of Ophthalmology and Visual Science (IOVS), Rutgers-New Jersey Medical School (Rutgers NJMS), 90 Bergen St., Suite 6100, Newark, NJ, 07103, USA
| | - Bernard Szirth
- The Institute of Ophthalmology and Visual Science (IOVS), Rutgers-New Jersey Medical School (Rutgers NJMS), 90 Bergen St., Suite 6100, Newark, NJ, 07103, USA
| | - Neelakshi Bhagat
- The Institute of Ophthalmology and Visual Science (IOVS), Rutgers-New Jersey Medical School (Rutgers NJMS), 90 Bergen St., Suite 6100, Newark, NJ, 07103, USA.
| |
Collapse
|
23
|
Kinoshita K, Kodera S, Hatsusaka N, Egawa R, Takizawa H, Kubo E, Sasaki H, Hirata A. Association of nuclear cataract prevalence with UV radiation and heat load in lens of older people -five city study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:123832-123842. [PMID: 37991619 DOI: 10.1007/s11356-023-31079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Epidemiological studies have reported that the frequency of nuclear cataracts (NUCs) is high among the elderly and in tropical countries. Ultraviolet (UV) irradiation and lens temperature are considered as key physical contributors, although their precise quantification is difficult. The aim of this study is to investigate the association of NUC prevalence with UV irradiation and heat load. First, we assessed the lens temperature using thermodynamic modeling considering the thermophysiological response. We then conducted a multivariate linear regression analysis for the epidemiological analysis of NUC prevalence across five cities. A strong correlation was observed between NUC prevalence and the combined effects of UV irradiation and cumulative equivalent minutes at 43 °C (CEM43°C) derived from the computed lens temperature (adjusted R2 = 0.933, p < 0.0001). Heat load significantly contributed to the prevalence at 52%, surpassing the contributions of UV irradiation (31%) and the decline in DNA repair capacity in the lens (17%). These results suggested that both UV radiation and heat load are associated with NUC, with heat load contributing more. Our findings provided important implications for future interventions, particularly in the context of global warming.
Collapse
Affiliation(s)
- Kotaro Kinoshita
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan
| | - Sachiko Kodera
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Japan
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Ryusuke Egawa
- School of Engineering, Tokyo Denki University, Tokyo, Japan
| | | | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan.
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Japan.
| |
Collapse
|
24
|
Ramezani A, Sabbaghi H, Katibeh M, Ahmadieh H, Kheiri B, Yaseri M, Moradian S, Alizadeh Y, Soltani Moghadam R, Medghalchi A, Etemad K, Behboudi H. Prevalence of cataract and its contributing factors in Iranian elderly population: the Gilan eye study. Int Ophthalmol 2023; 43:4503-4514. [PMID: 37584824 DOI: 10.1007/s10792-023-02851-7] [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: 03/02/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran. METHODS This population-based cross-sectional study was performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement. RESULTS Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16; P < 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63; P < 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001). CONCLUSION Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight.
Collapse
Affiliation(s)
- Amirreza Ramezani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Velenjak Street, Tehran, 198353-5511, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Katibeh
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Moradian
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Alizadeh
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Reza Soltani Moghadam
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Abdolreza Medghalchi
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Behboudi
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran.
| |
Collapse
|
25
|
Brézin AP, Monnet D, Lignereux F, Rozot P, Jilet L, Abdoul H. Impact of a handpiece with a built-in fluidics pressure sensor on phacoemulsification: a multicentre prospective comparative study. BMJ Open Ophthalmol 2023; 8:e001431. [PMID: 37973548 PMCID: PMC10661016 DOI: 10.1136/bmjophth-2023-001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE We assessed whether the immediate pressure adjustments provided by a phacoemulsification handpiece with a built-in pressure sensor (Active Sentry, AS) could decrease the amount of energy delivered in the eye during cataract surgery. METHODS AND ANALYSIS The Study of Active Sentry in Cataract Surgery was a multicentre prospective clinical trial. The Centurion system (Alcon Labs) was used and we compared phacoemulsifications performed with the AS handpiece with procedures using a sensor placed in the phacoemulsifier (non-AS). The primary outcome measure was the cumulative dissipated energy (CDE) used during the procedures. The secondary outcome measures were the total, longitudinal and torsional ultrasound (US) times, the duration of the surgery and the amount of fluid used during the surgeries. RESULTS The study analysed 1432 (800 AS and 632 non-AS) procedures. The mean patient age was 72.4±10.0 years. The median CDE was respectively 6.3 (IQR 3.5-9.9) and 6.7 (IQR 4.5-11.5) with and without AS (p=0.0001). The median US time was, respectively, 48.0 s (IQR 34.0-68.0) and 55.0 s (IQR 38.0-80.0) with and without AS (p<0.0001). Torsional and longitudinal US times were reduced with AS. The median duration of the procedure was, respectively, 9.0 min (IQR 7.0-12.0) and 10.0 min (IQR 7.0-13.0) (p=0.0002) with and without AS. The median balanced salt solution volume used was 52.0 cm3 (IQR 41.0-72.0) and 57.0 cm3 (IQR 42.0-81.0) with and without AS (p=0.0018). CONCLUSION The phacoemulsifications performed with a pressure sensor built in the handpiece delivered less energy in the eye and were shorter. TRIAL REGISTRATION NUMBER NCT04732351.
Collapse
Affiliation(s)
- Antoine P Brézin
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | - Dominique Monnet
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | | | | | - Lea Jilet
- Université Paris Cité, URC Paris Centre, Paris, France
| | - Hendy Abdoul
- Université Paris Cité, URC Paris Centre, Paris, France
| |
Collapse
|
26
|
Li X, Qu Y, Yang Q, Li R, Diao Y, Wang J, Wu L, Zhang C, Cui S, Qin L, Zhuo D, Wang H, Wang L, Huang Y. Cellular Localization of FOXO3 Determines Its Role in Cataractogenesis. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:1845-1862. [PMID: 37517685 DOI: 10.1016/j.ajpath.2023.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023]
Abstract
The transcription factor forkhead box protein (FOX)-O3 is a core regulator of cellular homeostasis, stress response, and longevity. The cellular localization of FOXO3 is closely related to its function. Herein, the role of FOXO3 in cataract formation was explored. FOXO3 showed nuclear translocation in lens epithelial cells (LECs) arranged in a single layer on lens capsule tissues from both human cataract and N-methyl-N-nitrosourea (MNU)-induced rat cataract, also in MNU-injured human (H)-LEC lines. FOXO3 knockdown inhibited the MNU-induced increase in expression of genes related to cell cycle arrest (GADD45A and CCNG2) and apoptosis (BAK and TP53). H2 is highly effective in reducing oxidative impairments in nuclear DNA and mitochondria. When H2 was applied to MNU-injured HLECs, FOXO3 underwent cleavage by MAPK1 and translocated into mitochondria, thereby increasing the transcription of oxidative phosphorylation-related genes (MTCO1, MTCO2, MTND1, and MTND6) in HLECs. Furthermore, H2 mediated the translocation of FOXO3 from the nucleus to the mitochondria within the LECs of cataract capsule tissues of rats exposed to MNU. This intervention ameliorated MNU-induced cataracts in the rat model. In conclusion, there was a correlation between the localization of FOXO3 and its function in cataract formation. It was also determined that H2 protects HLECs from injury by leading FOXO3 mitochondrial translocation via MAPK1 activation. Mitochondrial FOXO3 can increase mtDNA transcription and stabilize mitochondrial function in HLECs.
Collapse
Affiliation(s)
- Xiaoqi Li
- Medical School of Chinese PLA, Beijing, China; State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Yingxin Qu
- Department of Ophthalmology, Chinese Aerospace 731 Hospital, Beijing, China
| | - Qinghua Yang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Runpu Li
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yumei Diao
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Junyi Wang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lingling Wu
- State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Chuyue Zhang
- State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Shaoyuan Cui
- State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Limin Qin
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Deyi Zhuo
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Huiyi Wang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Liqiang Wang
- State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China; Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Yifei Huang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
27
|
Pur DR, Lin T, Iordanous Y, Bursztyn LLCD. Patient perspective on the participation of ophthalmology residents in their cataract surgery. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:443-448. [PMID: 35623411 DOI: 10.1016/j.jcjo.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the proportion of patients consenting to resident participation in cataract surgery and to identify factors predictive of consent. DESIGN Prospective cross-sectional study. PARTICIPANTS The 330 consecutive patients referred for cataract evaluation from February-April 2021 to 3 surgeons at a tertiary care referral centre in London, Ontario. METHODS Using a standardized disclosure script, individuals were asked about resident participation in their cataract surgery. A phone survey and medical record review were conducted to obtain clinical and demographic information. Predictors of consent were assessed using logistic regression modelling. RESULTS Responses were received from 279 individuals (85% response rate), with a mean age of 71.7 ± 8.6 years, and 113 were female. The consent rate was 71%. Prior negative experience with any medical trainee was an independent predictor for refusing resident participation (odds ratio [OR] = 3.10; 95% CI, 1.32-7.28; p = 0.009). Nonconsenters also had more prior negative experiences with other physicians (35% vs 23%; p = 0.031) and knew someone who had had a problem after eye surgery (36% vs 22%; p = 0.016). Individuals with an occupation involving apprenticeship (OR = 2.87; 95% CI, 1.08-7.67; p = 0.035) and those with a preoperative acuity of 20/200 or worse (OR = 2.78; 95% CI, 1.03-7.14; p = 0.043) were more likely to consent. CONCLUSIONS Patients should be explicitly asked about resident involvement. Negative experiences can make individuals reluctant to have learners involved in their future care. Patient education describing the apprenticeship model in medicine may increase consent.
Collapse
Affiliation(s)
- Daiana R Pur
- Schulich School of Medicine and Dentistry, Western University, London, Ont..
| | - Tony Lin
- Department of Ophthalmology, Western University, London, Ont
| | | | | |
Collapse
|
28
|
Alipour F, Hashemi H, Lashay A, Jafari F, Motamed-Gorji N, Jabbarvand Behrouz M, Mirzaei M, Alizade Y, Soleymani MR, Shoja MR, Shahraki K, Khataminia GR, Poustchi H, Malekzadeh R. PERSIAN Eye Cohort Study (PECS): Design, Methodology. ARCHIVES OF IRANIAN MEDICINE 2023; 26:459-469. [PMID: 38301109 PMCID: PMC10685732 DOI: 10.34172/aim.2023.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/03/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND To report the study protocol, methodology and latest enrollment data of a large epidemiological multi-central eye cohort named PERSIAN Eye Cohort Study (PECS), originating from the ongoing PERSIAN Cohort Study, to investigate the distribution of ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature. METHODS A central committee designed the study and equipped six chosen centers (Khameneh, Some'e Sara, Hoveizeh, Yazd, Rafsanjan and Zahedan). A focal point in each center conducted the study under close supervision of the central committee. RESULTS This ongoing study was launched in 2014. Out of 65,580 eligible participants of the PERSIAN Cohort, 48,618 individuals aged 35-70 have been enrolled in the PECS (response rate: 74.13%) until June 2021. Slit lamp and fundus photography were performed for 28,702 (59.03%) and 27,437 (56.43%) individuals, respectively. CONCLUSION This large epidemiological multi-central eye cohort can improve our epidemiological knowledge of the prevalent ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature. This will be very useful for future planned nationwide and global interventions.
Collapse
Affiliation(s)
- Fateme Alipour
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Lashay
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jafari
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Jabbarvand Behrouz
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mirzaei
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Alizade
- Amiralmomenin hospital, Department of ophthalmology, Gillan University of Medical Sciences, Rasht, Iran
| | | | - Mohammad Reza Shoja
- Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kourosh Shahraki
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Hossein Poustchi
- Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29
|
Ghanbarnia MJ, Hosseini SR, Ghasemi M, Roustaei GA, Mekaniki E, Ghadimi R, Bijani A, Rasoulinejad SA. Association of age-related eye diseases with cognitive frailty in older adults: a population-based study. Aging Clin Exp Res 2023:10.1007/s40520-023-02458-z. [PMID: 37269465 DOI: 10.1007/s40520-023-02458-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Age-related eye diseases and cognitive frailty (CF) are both important predictors of adverse health outcomes in older adults, however, little is known about their association. AIMS To demonstrate the association between age-related eye diseases and cognitive frailty in a population of Iranian older adults. METHODS In this cross-sectional, population-based study, we included 1136 individuals (female n = 514) aged 60 years and older (mean 68.8 ± 6.7 years) who participated in the second cycle of the Amirkola Health and Aging Project (AHAP) between 2016 and 2017. Cognitive function and frailty were evaluated based on Mini-Mental State Examination (MMSE) and the FRAIL scale respectively. Cognitive frailty was defined as coexistence of cognitive impairment (CI) and physical frailty (PF), excluding confirmed cases of dementia such as Alzheimer's disease. Cataract, diabetic retinopathy (DR), age-related macular degeneration (AMD), elevated intraocular pressure (IOP ≥ 21 mmHg) and glaucoma suspects (vertical cup to disc ratio (VCDR) ≥ 0.6) were diagnosed based on standardized grading protocols. Associations between eye diseases and cognitive frailty were evaluated through binary logistic regression analysis. RESULTS Overall, CI, PF and CF were observed in 257 (22.6%), 319 (28.1%) and 114 (10.0%) participants respectively. After adjusting for confounders and ophthalmic conditions, individuals with cataract were more likely to have CF (OR 1.66; p-value 0.043), while DR, AMD, elevated IOP and glaucoma suspects (OR 1.32, 1.62, 1.42, 1.36, respectively) were not significantly associated with CF. Furthermore, cataract was significantly associated with CI (OR 1.50; p-value 0.022), but not with frailty (OR 1.18; p-value 0.313). CONCLUSION Older adults with cataract were more likely to have cognitive frailty and cognitive impairment. This association demonstrates the implications of age-related eye diseases beyond ophthalmology and substantiates the need for further research involving cognitive frailty in the context of eye diseases and visual impairment.
Collapse
Affiliation(s)
- Mohammad Javad Ghanbarnia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehrnoosh Ghasemi
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Gholam Abbas Roustaei
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ebrahim Mekaniki
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Ahmad Rasoulinejad
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
| |
Collapse
|
30
|
Boix-Lemonche G, Nagymihaly RM, Lumi X, Petrovski G. The human lens is capable of trilineage differentiation towards osteo-, chondro-, and adipogenesis-a model for studying cataract pathogenesis. Front Bioeng Biotechnol 2023; 11:1164795. [PMID: 37324433 PMCID: PMC10264667 DOI: 10.3389/fbioe.2023.1164795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
The potential for trilineage differentiation of cells in tissues represents a model for studying disease pathogenesis and regeneration pathways. Human lens trilineage differentiation has not yet been demonstrated, and so has calcification and osteogenic differentiation of human lens epithelial cells in the whole human lens. Such changes can pose a risk for complications during cataract surgery. Human lens capsules (n = 9) from cataract patients undergoing uneventful surgery were trilineage-differentiated toward osteogenesis, chondrogenesis, and adipogenesis. Furthermore, whole human healthy lenses (n = 3) collected from cadaveric eyes were differentiated into bone and characterized by immunohistochemistry. The cells in the human lens capsules were capable of undergoing trilineage differentiation, while the whole human healthy lenses could undergo osteogenesis differentiation, expressing osteocalcin, collagen I, and pigment epithelium-derived factor. We, hereby, show an ex vivo model for cataract formation through different stages of opacification, as well as provide in vivo evidence from patients undergoing calcified lens extraction with bone-like consistency.
Collapse
Affiliation(s)
- Gerard Boix-Lemonche
- Department of Ophthalmology, Center for Eye Research and Innovative Diagnostics, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Xhevat Lumi
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Goran Petrovski
- Department of Ophthalmology, Center for Eye Research and Innovative Diagnostics, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, Split, Croatia
| |
Collapse
|
31
|
Tanaya T, Swain TA, Clark ME, Swanner JC, Lolley VR, Callahan MA, McGwin G, Owsley C. Comparing Rod-Mediated Dark Adaptation in Older Adults before and after Cataract Surgery. Curr Eye Res 2023; 48:512-517. [PMID: 36662498 PMCID: PMC10407937 DOI: 10.1080/02713683.2023.2171438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE Studies on age-related macular degeneration often use rod-mediated dark adaptation (RMDA) to evaluate macular functional health, studying eyes with cataract and pseudophakic eyes within the same sample. We examine a poorly understood issue-whether rod intercept time (RIT), a measure of RMDA, changes after cataract surgery and intraocular lens (IOL) insertion as compared to RIT before cataract surgery. Cataract may serve as a filter reducing photo-bleach magnitude prior to surgery, biasing RMDA interpretation. METHODS A pre-/post-cataract surgery design was used. Persons with nuclear sclerotic and/or cortical cataract per the electronic health record were enrolled. Prior to cataract surgery, visual acuity, RMDA, and the LOCS III classification documenting cataract presence/severity were measured. Thirty days after surgery (mean), visual acuity and RMDA were repeated, followed by fundus photos to document macular health. RESULTS Twenty-four participants (mean age 72.7 years, standard deviation 5.6) enrolled. All eyes had nuclear sclerotic and nuclear color cataract; 68% had cortical cataract. All IOLs were monofocal with 21 having blue blocking characteristics and 3 had clear IOLs. Most eyes had higher RIT post-surgery (15.6 min, SD 6.7) as compared to pre-surgery (13.7 min, SD 6.4), p = 0.0006, meaning that RMDA was slower post-surgery. Eyes with moderate cataract (<4 on any LOCS III grade) had RIT that increased on average by 0.7 min; those with more advanced cataract (≥4) had RIT that increased by 3.1 min (p = 0.0116). Results were unchanged when clear IOLs were removed from analysis. CONCLUSION RMDA was significantly slower (RIT was greater) following cataract surgery, with the greatest impact on RIT in older eyes after surgery for more advanced cataract. These findings suggest that persons with more advanced cataract may bias results when evaluating RMDA using RIT.
Collapse
Affiliation(s)
- Tarushi Tanaya
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas A. Swain
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham AL, USA
| | - Mark E. Clark
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jason C. Swanner
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia R. Lolley
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael A. Callahan
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gerald McGwin
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham AL, USA
| | - Cynthia Owsley
- Department of Ophthalmology & Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
32
|
Tousignant B, Chatillon A, Philibert A, Da Silva J, Fillion M, Mergler D. Visual Characteristics of Adults with Long-Standing History of Dietary Exposure to Mercury in Grassy Narrows First Nation, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4827. [PMID: 36981736 PMCID: PMC10049103 DOI: 10.3390/ijerph20064827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Since the 1960s, Grassy Narrows First Nation (Ontario, Canada) has been exposed to methyl mercury (Hg) through fish consumption, resulting from industrial pollution of their territorial waters. This cross-sectional study describes the visual characteristics of adults with documented Hg exposure between 1970 and 1997. Oculo-visual examinations of 80 community members included visual acuity, automated visual fields, optical coherence tomography [OCT], color vision and contrast sensitivity. Median age was 57 years (IQR 51-63) and 55% of participants were women. Median visual acuity was 0.1 logMAR (Snellen 6/6.4; IQR 0-0.2). A total of 26% of participants presented a Visual Field Index inferior to 62%, and qualitative losses assessment showed concentric constriction (18%), end-stage concentric loss (18%), and complex defects (24%). On OCT, retinal nerve fiber layer scans showed 74% of participants within normal/green range. For color testing with the Hardy, Rand, and Rittler test, 40% presented at least one type of color defect, and with the Lanthony D-15 test, median color confusion index was 1.59 (IQR 1.33-1.96). Contrast sensitivity showed moderate loss for 83% of participants. These findings demonstrate important loss of visual field, color vision, and contrast sensitivity in older adults in a context of long-term exposure to Hg in Grassy Narrows First Nation.
Collapse
Affiliation(s)
- Benoit Tousignant
- School of Optometry, Université de Montréal, 3744 Jean-Brillant, Montreal, QC H3T 1P1, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, 7101 Avenue du Parc, Montreal, QC H3N 1X9, Canada
| | - Annie Chatillon
- School of Optometry, Université de Montréal, 3744 Jean-Brillant, Montreal, QC H3T 1P1, Canada
| | - Aline Philibert
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
| | - Judy Da Silva
- Grassy Narrows First Nation, General Delivery, Grassy Narrows, ON P0X 1B0, Canada
| | - Myriam Fillion
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
- Département Science et Technologie, Université TÉLUQ, 5800, Rue Saint-Denis, Bureau 1105, Montréal, QC H2S 3L5, Canada
| | - Donna Mergler
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et L’environnement (Cinbiose), Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC H3C 3P8, Canada
| |
Collapse
|
33
|
McCormick I, Kim MJ, Hydara A, Olaniyan SI, Jobe M, Badjie O, Sanyang NMB, Jarju G, Njai M, Sankareh A, Bastawrous A, Allen L, Mactaggart I, Burton MJ, Ramke J. Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys. BMJ Open 2023; 13:e069325. [PMID: 36882236 PMCID: PMC10008479 DOI: 10.1136/bmjopen-2022-069325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE Monitoring health outcomes disaggregated by socioeconomic position (SEP) is crucial to ensure no one is left behind in efforts to achieve universal health coverage. In eye health planning, rapid population surveys are most commonly implemented; these need an SEP measure that is feasible to collect within the constraints of a streamlined examination protocol. We aimed to assess whether each of four SEP measures identified inequality-an underserved group or socioeconomic gradient-in key eye health outcomes. DESIGN Population-based cross-sectional survey. PARTICIPANTS A subset of 4020 adults 50 years and older from a nationally representative sample of 9188 adults aged 35 years and older in The Gambia. OUTCOME MEASURES Blindness (presenting visual acuity (PVA) <3/60), any vision impairment (VI) (PVA <6/12), cataract surgical coverage (CSC) and effective cataract surgical coverage (eCSC) at two operable cataract thresholds (<6/12 and <6/60) analysed by one objective asset-based measure (EquityTool) and three subjective measures of relative SEP (a self-reported economic ladder question and self-reported household food adequacy and income sufficiency). RESULTS Subjective household food adequacy and income sufficiency demonstrated a socioeconomic gradient (queuing pattern) in point estimates of any VI and CSC and eCSC at both operable cataract thresholds. Any VI, CSC <6/60 and eCSC <6/60 were worse among people who reported inadequate household food compared with those with just adequate food. Any VI and CSC <6/60 were worse among people who reported not enough household income compared with those with just enough income. Neither the subjective economic ladder question nor the objective asset-wealth measure demonstrated any socioeconomic gradient or pattern of inequality in any of the eye health outcomes. CONCLUSION We recommend pilot-testing self-reported food adequacy and income sufficiency as SEP variables in vision and eye health surveys in other locations, including assessing the acceptability, reliability and repeatability of each question.
Collapse
Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Min J Kim
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia
| | | | - Modou Jobe
- MRC Unit The Gambia at LSHTM, Banjul, Gambia
| | - Omar Badjie
- Directorate of Health Promotion and Education, Ministry of Health, Kotu, Gambia
| | | | - Gibril Jarju
- Directorate of Planning and Information, Ministry of Health, Kotu, Gambia
| | - Modou Njai
- Directorate of Health Promotion and Education, Ministry of Health, Kotu, Gambia
| | - Alhagie Sankareh
- Regional Directorate of Health Services, West Coast Health Region, Ministry of Health, Kanifing, Gambia
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Luke Allen
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
34
|
Hashemi H, Bouyeh A, Khabazkhoob M. Association between Refractive Errors and Ocular Biometry in an Elderly Population. Optom Vis Sci 2023; 100:74-81. [PMID: 36705717 DOI: 10.1097/opx.0000000000001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE The anterior chamber depth in hyperopic eyes is significantly deeper than that in myopic eyes, and this finding is independent of the axial length. PURPOSE This study aimed to determine the relationship between and refractive errors and ocular biometric components in a geriatric population 60 years and older. METHODS The present population-based cross-sectional study was performed using a multistage random cluster sampling method in Tehran, Iran. After selecting the samples, visual acuity measurement, autorefraction, subjective refraction, and slit-lamp examination were performed for all participants. Ocular biometric indices were measured with Pentacam AXL (Oculus, Wetzlar, Germany). RESULTS The correlation coefficients of spherical equivalent with axial length, corneal radius of curvature, axial length/corneal radius of curvature ratio, and anterior chamber depth were -0.40, 0.14, -0.63, and -0.18, respectively, after controlling the effects of age, sex, and nuclear cataract. The axial length (24.84 vs. 21.21 mm), the anterior chamber depth (2.74 vs. 2.34 mm), the ratio of the axial length to the corneal radius of curvature (3.35 vs. 2.71), and the anterior chamber volume (138.59 and 105.54 mm 3 ) were the highest and lowest in myopic and hyperopic individuals, respectively (all P < .001). In the first model, axial length and nuclear cataract were significantly inversely related to the spherical equivalent. However, corneal radius of curvature, anterior chamber depth, central corneal thickness, and corneal diameter had a significant direct relationship with the spherical equivalent. In the second model, the axial length/corneal radius of curvature ratio and cataract showed an inverse relationship with the spherical equivalent, whereas anterior chamber depth and corneal diameter had a direct relationship with the spherical equivalent. CONCLUSIONS Among the biometric components, the axial length/corneal radius of curvature ratio has the strongest relationship with refractive errors. The anterior chamber depth is lower in myopes compared with hyperopes after controlling the effect of axial length.
Collapse
Affiliation(s)
| | - Aria Bouyeh
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
35
|
Ripa M, Sherif A. Cataract surgery training: Report of a trainee's experience. Oman J Ophthalmol 2023; 16:59-63. [PMID: 37007242 PMCID: PMC10062068 DOI: 10.4103/ojo.ojo_128_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/09/2022] [Accepted: 12/02/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND To report a trainee's experience gained in the cataract extraction training program after the COVID-19 pandemic. METHODS An ophthalmologist was trained in phacoemulsification and intraocular lens (IOL) implantation in the ETAPE foundation, Eye Center, Cairo for a period of 4 weeks by three expert cataract surgeons. The training was tailored to the previous trainee's experience according to his residency logbook and supervised by one expert cataract surgeon. The training included didactic lectures, clinical observations, and hands-on practical experience. In addition, the trainee was provided with a logbook to record details of patients operated on and procedures observed. RESULTS The trainee performed 58 phacoemulsification surgery with IOL implantation and two extracapsular cataract extraction over the 4 weeks. Seven patients underwent intraoperative complications. Surgical time (ST) improved from 48.77 ± 9.65 min in the 1stweek to 19.34 ± 1.31 min during the last week of training (P = 0.046). Poisson regression showed that patients affected by less severe cataracts were more likely to exhibit a lower incidence of complications than patients affected by more severe cataracts. In addition, patients operated on during the 1stweek were more likely to show a higher incidence of complications than those operated on during the last week. CONCLUSIONS The 4-week surgical training effectively improved surgical confidence and micro incisional skills according to ST reduction and complication rate occurrence. Ophthalmologists benefit from enhancing their cataract skills in a short time following a well-structured cataract extraction course. This could undoubtedly lead to improved surgical outcomes for patients undergoing cataract extraction.
Collapse
|
36
|
Zhang X, Xiao Z, Li X, Wu X, Sun H, Yuan J, Higashita R, Liu J. Mixed pyramid attention network for nuclear cataract classification based on anterior segment OCT images. Health Inf Sci Syst 2022; 10:3. [PMID: 35401971 PMCID: PMC8956780 DOI: 10.1007/s13755-022-00170-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022] Open
Abstract
Nuclear cataract (NC) is a leading ocular disease globally for blindness and vision impairment. NC patients can improve their vision through cataract surgery or slow the opacity development with early intervention. Anterior segment optical coherence tomography (AS-OCT) image is an emerging ophthalmic image type, which can clearly observe the whole lens structure. Recently, clinicians have been increasingly studying the correlation between NC severity levels and clinical features from the nucleus region on AS-OCT images, and the results suggested the correlation is strong. However, automatic NC classification research based on AS-OCT images has rarely been studied. This paper presents a novel mixed pyramid attention network (MPANet) to classify NC severity levels on AS-OCT images automatically. In the MPANet, we design a novel mixed pyramid attention (MPA) block, which first applies the group convolution method to enhance the feature representation difference of feature maps and then construct a mixed pyramid pooling structure to extract local-global feature representations and different feature representation types simultaneously. We conduct extensive experiments on a clinical AS-OCT image dataset and a public OCT dataset to evaluate the effectiveness of our method. The results demonstrate that our method achieves competitive classification performance through comparisons to state-of-the-art methods and previous works. Moreover, this paper also uses the class activation mapping (CAM) technique to improve our method's interpretability of classification results.
Collapse
Affiliation(s)
- Xiaoqing Zhang
- Research Institute of Trustworthy Autonomous Systems, Southern University of Science and Technology, Shenzhen, 518055 China
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Zunjie Xiao
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Xiaoling Li
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325035 China
| | - Xiao Wu
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Hanxi Sun
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, 510060 China
| | - Risa Higashita
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
- Present Address: Tomey Corporation, Nagoya, Japan
| | - Jiang Liu
- Research Institute of Trustworthy Autonomous Systems, Southern University of Science and Technology, Shenzhen, 518055 China
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055 China
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325035 China
- Guangdong Provincial Key Laboratory of Brain-inspired Intelligent Computation, Southern University of Science and Technology, Shenzhen, 518055 China
| |
Collapse
|
37
|
Melese EK, Shibeshi MA, Sherief ST. Prevalence of Pseudoexfoliation Among Adults and Its Related Ophthalmic Variables in Southern Ethiopia: A Cross-Sectional Study. Clin Ophthalmol 2022; 16:3951-3958. [PMID: 36471727 PMCID: PMC9719280 DOI: 10.2147/opth.s391290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 09/01/2023] Open
Abstract
PURPOSE A community-based study was conducted to determine the prevalence and sociodemographic factors of pseudoexfoliation syndrome among adults in Southern Ethiopia. PATIENTS AND METHODS A community-based cross-sectional study was conducted among subjects aged 40 years or older. Subjects underwent standardized examination, including portable slit-lamp biomicroscopy before and after pupillary dilatation, and intraocular pressure measurement using Tono-Pen. Pseudoexfoliation was diagnosed on slit-lamp examination by the presence of white dandruff-like material on the pupillary margin and/or on the anterior lens capsule of one or both eyes. RESULTS Among 760 participants, the prevalence of pseudoexfoliation was 12.0% (95% confidence interval: 9.7-14.3%). The mean age of pseudoexfoliation cases was 63.9 years (SD 9.96, age range 40-90 years). The prevalence increased with increasing age, with 26.9% of those 60 or older affected. Slightly higher proportion of males (12.4%) were found to have pseudoexfoliation in either of the eyes than females (11.6%) which was not statistically significant (p = 0.738). Mean IOP in subjects with pseudoexfoliation was found to be 20.65 ± 5.15 mmHg, while it was 15.0 ± 2.3 mmHg for those without pseudoexfoliation. The difference between the two populations was found to be statistically significant (P < 0.05). CONCLUSION The prevalence of pseudoexfoliation in eyes of people in Southern Ethiopia appears greater than that reported in other places of Africa and Asia. Pseudoexfoliation occurs at a relatively younger age in our population. Increasing age is associated with the presence of pseudoexfoliation, and pseudoexfoliation in turn is associated with higher intraocular pressure.
Collapse
Affiliation(s)
- Ephrem Kibru Melese
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Menen Ayalew Shibeshi
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sadik Taju Sherief
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
38
|
Hatsusaka N, Tanimura N, Yamazaki M, Mita N, Ukai Y, Seki Y, Miyashita H, Mito T, Kubo E, Sasaki H. Vision With Retrodots and Factors for Declining Visual Function. Invest Ophthalmol Vis Sci 2022; 63:17. [DOI: 10.1167/iovs.63.12.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
- Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | | | - Mai Yamazaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Norihiro Mita
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yuki Ukai
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yusuke Seki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Hisanori Miyashita
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Tsuyoshi Mito
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, Japan
- Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| |
Collapse
|
39
|
Rose A, Rae WI, Sweetlove MA, Ngetu L, Benadjaoud MA, Marais W. Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation. SA J Radiol 2022; 26:2495. [PMID: 36262829 PMCID: PMC9575381 DOI: 10.4102/sajr.v26i1.2495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Occupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes. OBJECTIVES This study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors. METHOD A cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3. RESULTS The study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance. CONCLUSION The findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting. CONTRIBUTION The research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.
Collapse
Affiliation(s)
- André Rose
- Center for Health Systems Research and Development, Faculty of Humanities, University of the Free State, Bloemfontein, South Africa
| | - William I.D. Rae
- Prince of Wales Hospital, Faculty of Medical Imaging, University of Sydney, Sydney, Australia
| | - Margaret A. Sweetlove
- Department of Medical Physics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Lumko Ngetu
- Department of Ophthalmology, Faculty of Health, University of the Free State, Bloemfontein, South Africa
| | - Mohamed A. Benadjaoud
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France,Department of Radiobiology and Regenerative Medicine (SERAMED), Fontenay-aux-Roses, France
| | - Wayne Marais
- Department of Ophthalmology, Faculty of Health, University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
40
|
Heroor A, Vaidee V. Intracameral bleeding during femtolaser assisted cataract surgery: A case report. Am J Ophthalmol Case Rep 2022; 27:101655. [PMID: 35856007 PMCID: PMC9287357 DOI: 10.1016/j.ajoc.2022.101655] [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: 05/03/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose To report a case of anterior chamber bleeding that was noted post completion of laser during femtosecond laser assisted cataract surgery (FLACS). Observations A 54 yr old woman with no ocular and systemic morbidity underwent Right Eye FLACS.Vacum loss was noted due to patient's eye movements. Suction and Docking was achieved at the 2nd attempt, following which laser treatment was uneventful. An intracameral bleed was noted superiorly extending towards center of the anterior chamber. Cataract surgery with IOL implantation was uneventful. Post-operative course was uneventful. Conclusions and importance This is the first report in literature of intracameral bleeding during FLACS. It is essential to proceed with caution in patients with repeated vacuum loss due to a higher risk of developing intraocular bleeds.
Collapse
|
41
|
Hashemi H, Asharlous A, Yekta A, Aghamirsalim M, Nabovati P, Sadoughi MM, Khabazkhoob M. Astigmatism profile in the elderly population: Tehran Geriatric Eye Study. Jpn J Ophthalmol 2022; 66:461-473. [PMID: 35947225 DOI: 10.1007/s10384-022-00936-x] [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: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the prevalence of astigmatism and its associated factors and examine astigmatism symmetry patterns in an elderly population. STUDY DESIGN Population based cross-sectional study. METHODS The present population-based cross-sectional study was conducted on an elderly population above 60 years of age in Tehran, Iran in 2019. The sampling was done using the stratified multistage random cluster sampling method. All study participants underwent a complete optometric examination and slit-lamp biomicroscopy. RESULTS The prevalence of astigmatism higher than -0.50, -1.00, and -2.00 D was 83% (95% CI: 81 -84), 52 % (95% CI: 50 -54), and 19% (95% CI: 17-20), respectively. These prevalence was 79%(95% CI: 77-81), 46(95% CI: 44-49) and 14(95% CI: 13-16) in subjects without a history of ocular surgery, respectively. Based on cylinder power worse than -1.00 D, 10% (95% CI: 9-12), 20% (95% CI: 18-22), and 21% (95% CI:19-23) of study participants had with the rule, against the rule, and oblique astigmatism, respectively. According to the results of the multiple regression model, male gender, older age, low education level, pure posterior subcapsular cataract, pseudophakia, and myopia were independent factors associated with astigmatism. The prevalence of anisorule astigmatism was 57 % (95% CI: 56-59), the most common anisorule astigmatism was against the rule-oblique type with a prevalence of 36% (95% CI: 34-38). CONCLUSION The prevalence of astigmatism was high in the elderly population of Tehran. More than half of the participants in this study had anisorule astigmatism, and against the rule-oblique combination was more prevalent than other types. A posterior subcapsular cataract, a history of cataract surgery, and myopia were the associated factors of astigmatism in this study.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Sadoughi
- Department of Ophthalmology, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
42
|
Hu EH, Buie T, Jensen RJ, Wu D, Pamnani RD. Comparative Study of Safety Outcomes Following Nucleus Disassembly with and without the miLOOP Lens Fragmentation Device During Cataract Surgery. Clin Ophthalmol 2022; 16:2391-2401. [PMID: 35942081 PMCID: PMC9356701 DOI: 10.2147/opth.s370290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the effect of a microinterventional lens prefragmentation wire loop device (miLOOP®; Carl Zeiss Meditec AG, Oberkochen, Germany), on adverse events (AEs), cumulative dispersed energy (CDE), and vision outcomes when used before phacoemulsification of high-grade mature cataracts. Setting Three ambulatory surgical centers in the Peoria, IL region. Design Retrospective comparative consecutive case series; single-surgeon. Methods Patient outcomes were compared before and after introduction of miLOOP-assisted lens fragmentation prior to phacoemulsification during cataract surgeries performed 2016‒2020. The primary outcome was intraoperative AE rate/type. Secondary outcomes included ultrasound cumulative dispersed energy (CDE) administered during phacoemulsification, postoperative AEs, and best-corrected visual acuity (BCVA). Results Data from 765 subjects (mean age 72.9 years; 1025 eyes) comprised 524 conventional lens disassembly (Control) eyes and 501 Device eyes. One hundred percent of the cataracts in both groups were advanced WHO Grade 3+ nuclei. Significantly fewer intraoperative AEs occurred in the Device group versus Controls (2.2% and 6.3% of eyes, respectively; p=0.0011). Postoperative AE rates were comparable between groups (Controls=2.9%, Device=3.5%). Mean CDE from ultrasound was significantly reduced by 21% when the microfilament loop device was used for nuclear disassembly (9.6±5.2 CDE units) versus Controls (11.6±6.4 CDE units; p<0.0001). Median postoperative BCVA was 20/25 Snellen (0.091 logMAR) in both groups. More than 70% of both Control and Device eyes had postoperative BCVA better than 20/30 Snellen. Conclusion Microinterventional lens fragmentation was associated with lower ultrasound energy use and improved intraoperative safety than traditional unassisted surgery of advanced high-grade cataracts, while maintaining similarly acceptable postoperative complication rates and BCVA functional outcomes.
Collapse
Affiliation(s)
| | | | | | - David Wu
- University of Illinois at Chicago, Chicago, IL, USA
| | | |
Collapse
|
43
|
Ahmad MSZ, Ahmed M, Khedr M, Borgia A, Madden A, Ranganath LR, Kaye S. Association of alkaptonuria and low dose nitisinone therapy with cataract formation in a large cohort of patients. JIMD Rep 2022; 63:351-360. [PMID: 35822094 PMCID: PMC9259401 DOI: 10.1002/jmd2.12288] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/23/2022] Open
Abstract
Homogentisic acid (HGA) lowering, disease modifying off-label nitisinone therapy has been used in the United Kingdom National Alkaptonuria Centre (NAC) since 2012. This study evaluated the serendipitous observation of cataract in a large cohort of patients with the very rare disease alkaptonuria (AKU), over a 5-year period. Patients with AKU who attended the NAC since 2012. Standard physical examination and ocular assessment, including photographs of the crystalline lens were taken before commencement of nitisinone 2 mg daily and annually over 5 years. Photographs were randomised and graded by two independent observers using the WHO cataract classification. AKU patients who did not receive nitisinone were included as a control group. HGA was measured on acidified 24 h urine (u-HGA24) and HGA and tyrosine in fasting acidified serum samples (sHGA, sTYR) at each visit. Patients without suitable lens images were excluded. Cataract (mean grade 1) was noted at baseline in 47 out of 62 (76%) with a mean (SD) age of 44 (14) years. In nitisinone-treated patients, there were significant increases in the mean grade of nuclear (0.18, p < 0.01) and cortical (0.38, p < 0.01) lens opacities over the mean duration of 4.93 years of the study. Worsening of the nuclear cataract and cortical lens opacities by at least 1 grade was noted in 14 out of 46 (30%) and 11 out of 46 (24%) patients, respectively. There is an increased prevalence and progression of cataract in AKU and a possible association of nitisinone with cataract progression.
Collapse
Affiliation(s)
| | - Mahmoud Ahmed
- Department of OphthalmologyRoyal Liverpool University HospitalLiverpoolUK
| | - Milad Khedr
- Clinical Biochemistry and Metabolic MedicineRoyal Liverpool University HospitalLiverpoolUK
| | - Alfredo Borgia
- Department of OphthalmologyRoyal Liverpool University HospitalLiverpoolUK
| | - Andrea Madden
- Department of OphthalmologyRoyal Liverpool University HospitalLiverpoolUK
| | | | - Stephen Kaye
- Department of OphthalmologyRoyal Liverpool University HospitalLiverpoolUK
| |
Collapse
|
44
|
Heng JS, Arevalo JF, Handa JT. Visual acuity after cataract surgery in Macular Telangiectasia Type 2 Stage 3 to 5. Int J Retina Vitreous 2022; 8:38. [PMID: 35690847 PMCID: PMC9188048 DOI: 10.1186/s40942-022-00386-0] [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: 02/12/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate visual acuity after cataract surgery in eyes with Macular Telangiectasia (MacTel) Type 2. METHODS Single-center retrospective cohort study of patients with MacTel Type 2 who underwent cataract surgery and were managed at the same institution. Patients underwent pre-operative assessment by a retinal specialist with examination and optical coherence tomography (OCT) at the same institution. The main outcome measure was the post-operative change in best corrected visual acuity (BCVA). Secondary study outcomes were achieving post-operative BCVA better than Snellen acuity of 20/40 and time to BCVA loss by two lines or more (10 or more ETDRS letters). RESULTS A total of 20 eyes (11 patients) underwent cataract surgery and were followed for a median of 25.5 months (IQR 17.5-44.2 months). The median post-operative BCVA improvement was 10.5 letters (IQR 3.50-20.25). Nuclear sclerosis severity [β = 8.99 (95% CI 3.35, 14.6), p = 0.00177] was associated with post-operative change in BCVA and central foveal ellipsoid zone (EZ) breaks [OR 1.33 × 10-9 (95% CI 5.12 × 10-10-3.43 × 10-9), p < 0.001] on OCT was inversely correlated with post-operative BCVA > 20/40 using a multivariate generalized linear model. Central foveal EZ breaks [HR 1.77 × 109 (95% CI 3.86 × 108, 8.11 × 109), p < 0.001] and MacTel Type 2 disease stage [HR 2.83, (95% CI 1.12, 7.12), p = 0.027] were independently associated with shorter time to vision loss of two lines or more in a multivariate Cox regression model. CONCLUSIONS Visual acuity significant improved after cataract surgery in eyes with MacTel Type 2 regardless of disease severity. The presence of central foveal EZ breaks may predict poorer post-operative visual acuity and subsequent vision loss from disease progression.
Collapse
Affiliation(s)
- Jacob S Heng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, USA.,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, USA.,Wilmer Eye Institute, The Johns Hopkins Hospital, 400 N. Broadway, Smith 3015, Baltimore, USA
| | - J Fernando Arevalo
- Wilmer Eye Institute, The Johns Hopkins Hospital, 400 N. Broadway, Smith 3015, Baltimore, USA
| | - James T Handa
- Wilmer Eye Institute, The Johns Hopkins Hospital, 400 N. Broadway, Smith 3015, Baltimore, USA.
| |
Collapse
|
45
|
Tegegn MT, Assaye AK, Belete GT, Munaw MB. Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study. J Int Med Res 2022; 50:3000605221104761. [PMID: 35698450 PMCID: PMC9201317 DOI: 10.1177/03000605221104761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/16/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia. METHODS We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract. RESULTS A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1-32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5-38.4), rural residence (AOR = 1.7; 95% CI: 1.02-2.7), unmarried status (AOR = 1.9; 95% CI: 1.2-3.2), illiteracy (AOR = 2.9; 95% CI: 1.4-6.1), unemployed status (AOR = 1.7; 95% CI: 1.1-2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04-2.4) were significantly associated with visually significant cataract. CONCLUSION In this study, visually significant cataract was found to be high, which requires immediate public health intervention.
Collapse
Affiliation(s)
- Melkamu Temeselew Tegegn
- Department of Optometry, School of Medicine,
College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
| | - Aragaw Kegne Assaye
- Department of Optometry, School of Medicine,
College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
| | - Gizachew Tilahun Belete
- Department of Optometry, School of Medicine,
College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
| | - Minychil Bantihun Munaw
- Department of Optometry, School of Medicine,
College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
| |
Collapse
|
46
|
Zhang XQ, Hu Y, Xiao ZJ, Fang JS, Higashita R, Liu J. Machine Learning for Cataract Classification/Grading on Ophthalmic Imaging Modalities: A Survey. MACHINE INTELLIGENCE RESEARCH 2022; 19:184-208. [DOI: 10.1007/s11633-022-1329-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 01/04/2025]
Abstract
AbstractCataracts are the leading cause of visual impairment and blindness globally. Over the years, researchers have achieved significant progress in developing state-of-the-art machine learning techniques for automatic cataract classification and grading, aiming to prevent cataracts early and improve clinicians’ diagnosis efficiency. This survey provides a comprehensive survey of recent advances in machine learning techniques for cataract classification/grading based on ophthalmic images. We summarize existing literature from two research directions: conventional machine learning methods and deep learning methods. This survey also provides insights into existing works of both merits and limitations. In addition, we discuss several challenges of automatic cataract classification/grading based on machine learning techniques and present possible solutions to these challenges for future research.
Collapse
|
47
|
Attention to region: Region-based integration-and-recalibration networks for nuclear cataract classification using AS-OCT images. Med Image Anal 2022; 80:102499. [DOI: 10.1016/j.media.2022.102499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/31/2022] [Accepted: 05/24/2022] [Indexed: 01/16/2023]
|
48
|
Feng L, Zhao F, Ke X, Zhao J, Shi M. Correlation Between Degree of Lens Opacity and the Phacoemulsification Energy Parameters Using Different Imaging Methods in Age-Related Cataract. Transl Vis Sci Technol 2022; 11:24. [PMID: 35315873 PMCID: PMC8944395 DOI: 10.1167/tvst.11.3.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose To compare the correlation between degree of lens opacity and the phacoemulsification energy parameter in patients with age-related cataract as determined by slit lamp, 25-MHz ultrasound biomicroscopy (UBM), and Scheimpflug imaging (Pentacam) and to evaluate the application of these three methods to measuring lens opacification. Methods This observational study was conducted in 319 patients (381 eyes) with different types of age-related cataract. The average age of patients was 67.3 ± 11.4 years. The degree of lens opacity acquired by slit lamp, 25-MHz UBM, and Pentacam was determined by the Lens Opacity Classification System III (LOCSIII), pixel units calculated by ImageJ, and lens density, respectively. We primarily analyzed and compared the correlation between lens opacity and the cumulative dissipated energy (CDE) values of phacoemulsification. Results Cortical, nuclear, and posterior subcapsular (PSC) cataracts were evaluated as follows: LOCSIII grades 3.31 ± 1.42, 3.29 ± 1.49, and 0.91 ± 0.83; pixel units 120.91 ± 22.8, 93.2 ± 15.9, and 99.7 ± 13.0; and lens density 51.8 ± 31.2, 21.2 ± 6.10, and 53.3 ± 35.3, respectively. The CDE values were 12.1 ± 12.4, 13.5 ± 9.11, and 3.93 ± 1.96. In cortical cataract, there was a linear correlation among LOCSIII, pixel units, and CDE value (r = 0.560, r = 0.832, and r = 0.582, respectively; both P < 0.05), but lens density had no correlation with other parameters. In nuclear cataract, there was a linear correlation among LOCSIII, lens density, and CDE value (r = 0.747, r = 0.865, and r = 0.906, respectively; both P < 0.05), but pixel units had no correlation with other parameters. In PSC, only pixel units and LOCSIII showed a correlation. Conclusions The various imaging methods offered different advantages in terms of determining lens opacity, a feature related to types of age-related cataracts. Choosing the most suitable imaging method to evaluate lens opacification based on the type of age-related cataract is important for accurately predicting the phacoemulsification parameters for cataract surgery. Translational Relevance Determining the appropriate phacoemulsification strategy depends on quantitative analysis of the degree of lens opacity to reduce intraoperative and postoperative complications and to obtain the optimal postoperative visual outcome.
Collapse
Affiliation(s)
- Li Feng
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, The Key Laboratory of Lens Research, Liaoning Province, Shenyang, China
| | - Fangkun Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, The Key Laboratory of Lens Research, Liaoning Province, Shenyang, China
| | - Xin Ke
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, The Key Laboratory of Lens Research, Liaoning Province, Shenyang, China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, The Key Laboratory of Lens Research, Liaoning Province, Shenyang, China
| | - Mingyu Shi
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, The Key Laboratory of Lens Research, Liaoning Province, Shenyang, China
| |
Collapse
|
49
|
The Impact of Cataract Surgery on Contrast Visual Acuity and Retinal Sensitivity in Patients with Retinitis Pigmentosa. J Ophthalmol 2021; 2021:2281834. [PMID: 34820138 PMCID: PMC8608543 DOI: 10.1155/2021/2281834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To determine the effects of cataract surgery on contrast visual acuity and retinal sensitivity in patients with retinitis pigmentosa. Methods Retinal sensitivity and contrast visual acuity were determined by microperimetry (MAIA) and contrast sensitivity acuity tester (CAT-CP), respectively, before and after cataract surgery. The significance of the correlations between visual acuity, retinal sensitivity, contrast visual acuity, improvements after surgery, and macular structure before and after cataract surgery was determined. Results Retinal sensitivity and contrast visual acuity were significantly improved after cataract surgery. The correlations among postoperative visual acuity, postoperative retinal sensitivities, and preoperative ellipsoid zone length were significant. The postoperative retinal sensitivity of the central 10° and the ellipsoid zone length was particularly significantly correlated. Preoperative contrast visual acuity and the amount of improvement and preoperative retinal sensitivity and the amount of improvement were significantly negatively correlated. The contrast visual acuity under both the 100% and 10% photopic and mesopic conditions improved significantly after cataract surgery. Conclusions Cataract surgery in retinitis pigmentosa patients with preserved ellipsoid zones significantly improved retinal sensitivity and contrast visual acuity. Cataract surgery can be expected to improve retinal sensitivity and contrast visual acuity under various conditions, even if preoperative visual parameters are low, as long as the ellipsoid zone is preserved.
Collapse
|
50
|
Askarian B, Ho P, Chong JW. Detecting Cataract Using Smartphones. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2021; 9:3800110. [PMID: 34786216 PMCID: PMC8580365 DOI: 10.1109/jtehm.2021.3074597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/27/2021] [Accepted: 03/15/2021] [Indexed: 12/04/2022]
Abstract
Objective: Cataract, which is the clouding of the crystalline lens, is the most prevalent eye disease accounting for 51% of all eye diseases in the U.S. Cataract is a progressive disease, and its early detection is critical for preventing blindness. In this paper, an efficient approach to identify cataract disease by adopting luminance features using a smartphone is proposed. Methods: Initially, eye images captured by a smartphone were cropped to extract the lens, and the images were preprocessed to remove irrelevant background and noise by utilizing median filter and watershed transformation. Then, a novel luminance transformation from pixel brightness algorithm was introduced to extract lens image features. The luminance and texture features of different types of cataract disease images could be obtained accurately in this stage. Finally, by adopting support vector machines (SVM) as the classification method, cataract eyes were identified. Results: From all the images that we fed into our system, our method could diagnose diseased eyes with 96.6% accuracy, 93.4% specificity, and 93.75% sensitivity. Conclusion: The proposed method provides an affordable, rapid, easy-to-use, and versatile method for detecting cataracts by using smartphones without the use of bulky and expensive imaging devices. This methodcan be used for bedside telemedicine applications or in remote areas that have medical shortages. Previous smartphone-based cataract detection methods include texture feature analysis with 95 % accuracy, Gray Level Co-occurrence Matrix (GLCM) method with 89% accuracy, red reflex measurement method, and RGB color feature extraction method using cascade classifier with 90% accuracy. The accuracy of cataract detection in these studies is subject to changes in smartphone models and/or environmental conditions. However, our novel luminance-based method copes with different smartphone camera sensors and chroma variations, while operating independently from sensors’ color characteristics and changes in distances and camera angle. Clinical and Translational Impact—This study is an early/pre-clinical research proposing a novel luminance-based method of detecting cataract using smartphones for remote/at-home monitoring and telemedicine application.
Collapse
Affiliation(s)
- Behnam Askarian
- Department of Electrical and Computer EngineeringTexas Tech University Lubbock TX 79409 USA
| | - Peter Ho
- Lubbock Eye Clinic Lubbock TX 79410 USA
| | - Jo Woon Chong
- Department of Electrical and Computer EngineeringTexas Tech University Lubbock TX 79409 USA
| |
Collapse
|