AJO International最新文献

{"title":"Validation of the ocular trauma score and identification of additional prognostic factors in open-globe injuries","authors":"Jacob A. Mascaro ,&nbsp;Hongyi Ren ,&nbsp;Sergei V. Dmitruk ,&nbsp;Andrew D. Fernandez ,&nbsp;Harrison L. Ngo ,&nbsp;Yasaman Ataei ,&nbsp;John Le ,&nbsp;Surbhi Bansal","doi":"10.1016/j.ajoint.2024.100041","DOIUrl":"https://doi.org/10.1016/j.ajoint.2024.100041","url":null,"abstract":"<div><h3>Objective</h3><p>This study's aim was to validate the Ocular Trauma Score (OTS) for open globe injuries and to identify additional pre-operative factors that may affect the final visual acuity outcomes of patients with open globe injuries.</p></div><div><h3>Design</h3><p>This was a retrospective cross-sectional study done via chart review.</p></div><div><h3>Methods</h3><p>This was a single center study of patients who presented to VCU Medical Center from 2013 to 2020. A total of 140 patients with open globe injuries were included in the study. OTS was calculated for each patient based on the initial study by Kuhn et al. OTS predicted visual acuities were compared with the actual final visual acuities using Mann Whitney U test. The distribution of visual acuities in each OTS category was also compared with the original study by Kuhn et al. using Chi square analysis. The effects of lens involvement, presence of an intraocular foreign body, zone of injury, and time of surgery on the final visual acuity outcomes were also analyzed using Mann Whitney U test. The main outcome measure was the final visual acuity in Snellen and LogMAR equivalents.</p></div><div><h3>Results</h3><p>LP/HM was the most common presenting visual acuity category (59%) and OTS 1 was the most common OTS (45%). OTS reliably predicted final visual acuity in most cases, except for OTS 1 and 4, where there were significant differences between our study and the Kuhn et al. study. Of the four pre-operative factors analyzed, lens status and foreign body had significant effects on final visual acuity outcomes – injuries with an atraumatic lens or without an IOFB had better final VAs than predicted by OTS. Zone of injury and time of surgery had no significant effects.</p></div><div><h3>Conclusion</h3><p>Our study finds that OTS is overall a reliable predictor of final visual acuity and further validates it as a tool for open globe injury prognostication. However, our investigation showed that certain factors were not adequately accounted for by OTS, demonstrating the importance of considering other pre-operative factors when using OTS.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000418/pdfft?md5=6e5aa169d839503d20b463201ad0679d&pid=1-s2.0-S2950253524000418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Gabapentinoids in pain resolution after Photorefractive Keratectomy: A Systematic Review and Meta-Analysis","authors":"Obaid Ur Rehman ,&nbsp;Eeman Ahmad ,&nbsp;Shahzaib Ahmed ,&nbsp;Umar Akram ,&nbsp;Eeshal Fatima ,&nbsp;Aymen Shafqat ,&nbsp;Zain Ali Nadeem ,&nbsp;Abdullah Ahmed ,&nbsp;Imtanan Fazal ,&nbsp;Abdulqadir J Nashwan","doi":"10.1016/j.ajoint.2024.100039","DOIUrl":"10.1016/j.ajoint.2024.100039","url":null,"abstract":"<div><h3>Introduction</h3><p>Photorefractive Keratectomy (PRK) is a procedure used for the correction of refractive errors. It is specifically preferred in cases of reduced corneal thickness or anterior basement membrane dystrophy. Despite being a viable treatment option, post-operative pain is one of the main concerns of PRK. Studies have shown that gabapentin and pregabalin reduce pain as compared to placebo after PRK. Therefore, we aim to conduct a meta-analysis that studies the efficacy of gabapentinoids after PRK.</p></div><div><h3>Methods</h3><p>A comprehensive search was done using PubMed/MEDLINE, Scopus, and the Cochrane Library from inception till March 2024 for published randomized controlled trials (RCTs) that included 18 years or older patients of PRK who used gabapentinoids (Pregabalin, Gabapentin) for pain resolution. RevMan (version 5.3) was used to calculate Mean differences (MD) with their 95 % confidence intervals (CI).</p></div><div><h3>Results</h3><p>A total of 3 RCTs were included after a comprehensive screening. The studies included 312 participants. The mean age of the participants in the intervention group was 27.3 years. Gabapentinoid therapy was associated with no significant improvement in pain reduction on operation day post-PRK (MD = -0.64; 95 % CI, -1.63 to 0.35; p-value = 0.20) or after 24 h of operation (MD = -0.45; 95 % CI, -2.01 to 1.11; p-value = 0.57). No significant benefit in terms of total rescue analgesia use post-PRK was observed (MD = -0.69; 95 % CI, -2.88 to 1.51; p-value = 0.5). However, a statistically significant benefit was observed two days after PRK (MD = -0.66 (95 % CI, -1.27 to -0.05; p-value = 0.03).</p></div><div><h3>Conclusion</h3><p>Gabapentinoids do not show significant efficacy in pain resolution post-PRK as compared to the placebo.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295025352400039X/pdfft?md5=9bbdfd1ad97cad791761a02d2e416e11&pid=1-s2.0-S295025352400039X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer orbital metastases: Clinical, histopathological features and disease related survival in a retrospective case series","authors":"Sofia Peschiaroli ,&nbsp;Fabrizio Piccinni ,&nbsp;Giovanni Cuffaro ,&nbsp;Monica Maria Pagliara ,&nbsp;Maria Grazia Sammarco ,&nbsp;Antonio Mulè ,&nbsp;Angela Santoro ,&nbsp;Mariachiara Savino ,&nbsp;Federico Giannuzzi ,&nbsp;Tommaso Tartaglione ,&nbsp;Gustavo Savino","doi":"10.1016/j.ajoint.2024.100040","DOIUrl":"10.1016/j.ajoint.2024.100040","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the clinical, radiological and histopathological features, and long-term follow-up of patients with orbital metastases originating from a primary breast carcinoma. Main outcomes were: demographic characteristics of the population, clinical ophthalmological presentation, histological features, orbital metastasis latency, disease related survival, mortality rate.</p></div><div><h3>Design</h3><p>A retrospective observational case-series.</p></div><div><h3>Methods</h3><p>The medical records of 10 female patients affected by orbital metastases originating from a primary breast carcinoma referring at our tertiary referral center from 01/2016 to 12/2023, were reviewed.</p></div><div><h3>Results</h3><p>The median age was 63 (71.50 - 57.25) years (time of orbital biopsy). The prevalent histotype of orbital metastases of breast cancer was lobular 9.00 (90 %). The median orbital metastasis latency time in months was 9 months (IQR: 11 - 5) (in one case the orbital metastases were the first manifestation of an unknown primary tumor). The median Disease Related Survival (DRS) during the observation period was 17.50 months and the 24 months survival rate 57.14 %. The overall Mortality Rate in our population was 60 %.</p></div><div><h3>Conclusions</h3><p>The most frequent histotype of breast cancer orbital metastasis is the lobular one. The primary tumor precedes the onset of orbital metastasis in the majority of cases and tends to present with the classic symptoms of a mass occupying and infiltrating space. Orbital metastases are a sign that the disease is at an advanced stage, the mortality rate is high and DRS low.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000406/pdfft?md5=708f717b6412a510ebd174d9031fd904&pid=1-s2.0-S2950253524000406-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features and associations of optic neuritis in the Middle East: A cross-sectional study","authors":"Ayah Hajjar ,&nbsp;Anu Jacob ,&nbsp;Scott Smith ,&nbsp;Luai Eldweik","doi":"10.1016/j.ajoint.2024.100038","DOIUrl":"10.1016/j.ajoint.2024.100038","url":null,"abstract":"<div><h3>Background</h3><p>Differences exist in the clinical profile of optic neuritis (ON) among various populations. The present study outlines the features of optic neuritis and its associations in Middle Eastern population.</p></div><div><h3>Methods</h3><p>In a single tertiary care neuro-ophthalmology clinic, we reviewed charts between 2016 and 2021, to identify patients with optic neuritis. Patients with at least one single episode of ON, and a follow up for at least 6 months were only included. Patients from countries outside the Middle East were not eligible. We performed a sub-analysis using data from the clinic, laboratory, and radiological findings to classify patients with optic neuritis into 4 groups: idiopathic ON, multiple sclerosis associated optic neuritis (MS-ON), neuromyelitis optica spectrum disorder associated optic neuritis (NMOSD-ON), and myelin oligodendrocyte glycoprotein associated disease optic neuritis (MOGAD-ON).</p></div><div><h3>Results</h3><p>77 patients met the criteria for inclusion in the study. Approximately, two thirds of the patients (64%, 95% CI [0.52–0.74]) had MS-ON, 17 patients had idiopathic ON (22.6%, 95% CI [0.13–0.33]), 6 patients were diagnosed with NMOSD-ON (8%, 95% CI [0.02–0.16]), and 4 patients had MOG-ON (5.3%, 95% CI [0.01–0.13]). More than half of patients with idiopathic ON were found to have clinically isolated syndrome (CIS) and thus to be at high risk of developing MS. Among all patients enrolled in the study, the mean age was 29.8 ± 9.53 years. Patients with MS-ON and MOG-ON were relatively younger compared to patients from other groups (<em>P</em> = 0.0005). There was a female preponderance among all groups except MOG-ON, where 80% were males (<em>P</em> = 0.11). The pre- and post-treatment logMAR visual acuity (VA) tended to be worse in NMOSD-ON than other categories (<em>P</em> = 0.062). Optic disc swelling was more common among patients with MOGAD-ON, and least common in patients with NMOSD (100% vs 0%, <em>P</em> = 0.001). 5 patients presented with simultaneous bilateral involvement, and all but one had NMOSD-ON. 29% of patients had recurrence during the time of the study with significant difference in prevalence across groups. There was no difference in the involvement of the chiasm, or the retro-chiasmal pathways across groups.</p></div><div><h3>Conclusions</h3><p>Our study demonstrates that multiple sclerosis (MS) is the predominant CNS demyelinating disease associated with optic neuritis (ON) in the Middle Eastern population, mirroring trends observed in Western populations. The clinical and radiological features of each subtype showed no significant divergence compared to findings from studies conducted in other regions globally. These insights contribute to a deeper understanding of ON's clinical spectrum and aid in refining diagnostic and management strategies in the Middle Eastern population.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000388/pdfft?md5=666d6d5ec2ff123419d5341626d71eaa&pid=1-s2.0-S2950253524000388-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of facedown and non-facedown positions after vitrectomy with fovea-sparing internal limiting membrane peeling and air tamponade for treating myopic foveoschisis with foveal detachment: A prospective, randomized interventional study","authors":"Ke Zhu ,&nbsp;Boya Lei ,&nbsp;Fang Song ,&nbsp;Rui Jiang ,&nbsp;Qing Chang ,&nbsp;Gezhi Xu","doi":"10.1016/j.ajoint.2024.100036","DOIUrl":"10.1016/j.ajoint.2024.100036","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the anatomical and visual outcomes after vitrectomy with facedown (FD) or non-FD positions for treating myopic foveoschisis (MF) with foveal detachment.</p></div><div><h3>Design</h3><p>Prospective, randomized interventional study.</p></div><div><h3>Methods</h3><p>55 eyes with MF and foveal detachment that underwent vitrectomy with fovea-sparing internal limiting membrane (ILM) peeling and air tamponade were randomized to either the postoperative FD (26 eyes) or non-FD (29 eyes) positions. Best-corrected visual acuity (BCVA) and optical coherence tomography were assessed at baseline, 2 weeks, 3 months, and 6 months after vitrectomy with fovea-sparing ILM peeling and air tamponade with the FD or non-FD positions. Logistic and linear regression analyses were performed to study correlations between clinical factors and foveoschisis resolution and postoperative BCVA.</p></div><div><h3>Results</h3><p>All patients completed ≥6 months of follow-up. MF and foveal detachment were completely resolved in 22 eyes (92 %) in the FD group and 22 eyes (76 %) in the non-FD group (<em>P</em> = 0.160). Macular hole-associated retinal detachment occurred in one eye in the FD (4 %) and non-FD (3 %) groups. The postoperative best-corrected visual acuity (BCVA) at 6 months did not differ significantly between the two groups (<em>P</em> = 0.495). The BCVA improved by ≥0.3 logMAR in 14 eyes (58 %) in the FD group versus 17 eyes (59 %) in the non-FD group (<em>P</em> = 0.983). Central foveal thickness (CFT) and height of foveal detachment were significantly associated with foveoschisis resolution (<em>P</em> = 0.045 and 0.039, respectively). Better preoperative BCVA and foveoschisis resolution were significantly associated with better postoperative BCVA (<em>P</em> = 0.031 and 0.003, respectively).</p></div><div><h3>Conclusions</h3><p>The non-FD position appeared to be as effective as the FD position after vitrectomy with fovea-sparing ILM peeling and air tamponade for treating MF with foveal detachment.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000364/pdfft?md5=4287fdd4dd68809ab1887f43c8b1a98d&pid=1-s2.0-S2950253524000364-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the impact of tadalafil on progression of age-related macular degeneration: a health insurance claims database analysis","authors":"Tracy Z. Lang ,&nbsp;John R. O'Fee ,&nbsp;Khristina I. Lung ,&nbsp;David S. Boyer ,&nbsp;Andrew A. Moshfeghi ,&nbsp;Brian C. Toy","doi":"10.1016/j.ajoint.2024.100037","DOIUrl":"10.1016/j.ajoint.2024.100037","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the effect of tadalafil use on progression of early/intermediate to advanced exudative or non-exudative age-related macular degeneration (AMD) in a real-world population.</p></div><div><h3>Design</h3><p>Retrospective cohort study utilizing Optum's de-identified Clinformatics® Data Mart Database (CDM).</p></div><div><h3>Methods</h3><p>Patients were included from January 2015 to December 2020 aged 55 and older with an index International Classification of Diseases, Tenth Revision (ICD-10) diagnosis of early or intermediate AMD who had a 2-year period of continuous enrollment prior to the index diagnosis date (lookback period), 5 years of continuous follow-up, and who did not meet any exclusion criteria (claims for a phosphodiesterase-5 (PDE-5) inhibitor other than tadalafil during the study, diagnosis of advanced non-exudative or exudative AMD, or claims for exudative AMD treatment during the lookback period). Treated patients with claims for tadalafil during the study period were matched 1:1 to untreated controls by age, sex, race, and smoking status. We assessed the effect of any tadalafil use, high (≥2700 mg) cumulative dose tadalafil vs. matched untreated controls, high (&gt;2700 mg) vs. low (≤2700 mg) cumulative dose tadalafil, and the 2-year cumulative dose of tadalafil (per 100 mg) as a continuous variable on incidence of progression to exudative or advanced non-exudative AMD during the 2-year follow-up.</p></div><div><h3>Results</h3><p>There was no significant difference in odds of progression to exudative AMD or advanced non-exudative AMD in the control vs treated groups (OR = 0.802, 95% CI (0.558–1.152), <em>p</em> = 0.233; OR = 1.326, 95% CI (0.757–2.323), <em>p</em> = 0.323). High (≥2700 mg) cumulative dose tadalafil was not associated with a significant difference in odds of progression to exudative AMD or advanced non-exudative AMD when compared to the matched controls (OR = 0.455, 95% CI (0.202–1.025), <em>p</em> = 0.057; OR = 1.000, 95% CI (0.318–3.142), <em>p</em> = 1.000). There was no significant difference in odds of progression to exudative AMD or advanced non-exudative AMD in the high (&gt;2700 mg) vs. low (≤2700 mg) cumulative dose tadalafil (OR = 0.590, 95% CI (0.296–1.177), <em>p</em> = 0.134; OR = 1.039, 95% CI (0.440–2.460), <em>p</em> = 0.931). Lastly, there was no significant difference in odds of progression to exudative AMD or advanced non-exudative AMD when assessing the 2-year cumulative tadalafil dose (per 100 mg) as a continuous variable (OR = 1.000, 95% CI (1.000–1.000), <em>p</em> = 0.305; OR = 1.000, 95% CI (1.000–1.000), <em>p</em> = 0.878).</p></div><div><h3>Conclusion</h3><p>In a retrospective cohort study of a large nationwide health insurance claims database, tadalafil use was not associated with progression of AMD.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000376/pdfft?md5=7877785fb274c73ead16d562c34f658d&pid=1-s2.0-S2950253524000376-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing contact lenses uptake among school-going children and teenagers with myopia attending selected eye clinics in Kenya","authors":"Gellause Kololi ,&nbsp;Emmanuel E. Okenwa-Vincent ,&nbsp;Tecla Jerotich Sum","doi":"10.1016/j.ajoint.2024.100033","DOIUrl":"https://doi.org/10.1016/j.ajoint.2024.100033","url":null,"abstract":"<div><h3>Objective</h3><p>Contact lens (CL) use for myopia correction among children and teenagers has become a focal point of global interest. Yet, spectacles remain dominant for vision correction in this age group. This study investigated the factors affecting CL uptake among myopic school-going children and teenagers attending Kenyan eye clinics.</p></div><div><h3>Study Design</h3><p>Cross-sectional study.</p></div><div><h3>Methods</h3><p>A survey conducted across 13 Kenyan eye clinics, involving myopic participants aged 8–19 years. Data collection employed a mixed-method using validated semi-structured questionnaires that also included a 3-level Likert scale to elicit responses regarding factors that influenced the uptake of CLs. Analysis techniques included descriptive statistics, chi-square, and Cramer's V.</p></div><div><h3>Results</h3><p>85 participants, with a mean age of 13.4 ± 2.1 years, who were more of females (54.1%) were included in the study. While CL uptake was low (17.6%), spectacles remained the preferred myopia correction method among the participants. Factors favoring CL preference were appropriate visual clarity with CL (59%), enhanced self-esteem and social acceptance (64%). Major barriers to CL uptake were fear of eye injuries (60%), limited CL knowledge (55%), and fewer CL professionals (48%). Eye care professionals were the primary CL information source. A weak association was observed between spectacles’ perceived bulkiness and CL uptake (Cramer's V: 0.223, <em>p</em> = 0.121). However, vision clarity (Cramer's V: 0.387, <em>p</em> = 0.002) and social acceptance (Cramer's V: 0.351, <em>p</em> = 0.005) showed stronger associations with CL uptake in children and teenagers in the study.</p></div><div><h3>Conclusion</h3><p>While information gaps and limited professional availability hinder CL uptake among Kenyan students, benefits like better vision clarity and improved social acceptance promote their use. Efforts to address information gaps and highlight CL advantages are recommended to foster broader acceptance.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000339/pdfft?md5=a485312fac2d4d16412c0fd9f0af98c8&pid=1-s2.0-S2950253524000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glaucoma is associated with poorer self-rated vision, vision concerns and health: Results from 59,168 questionnaire responses","authors":"Jens Rovelt ,&nbsp;Josefine Freiberg ,&nbsp;Marcel Reimann ,&nbsp;Marianne Benn ,&nbsp;Christian Torp-Pedersen ,&nbsp;Miriam Kolko ,&nbsp;FOREVER consortium","doi":"10.1016/j.ajoint.2024.100035","DOIUrl":"https://doi.org/10.1016/j.ajoint.2024.100035","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to examine self-rated vision, vision concerns, and general health in individuals with and without glaucoma. Such assessments offer a broad view of a person's overall well-being and potential health issues and provide valuable insights into the characteristics of glaucoma patients.</p></div><div><h3>Design</h3><p>Cross-sectional.</p></div><div><h3>Methods</h3><p>We used questionnaire responses from Project FOREVER (Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability) to evaluate self-rated vision and general health on a scale ranging from 1 (excellent), 2 (good), 3 (reasonable), 4 (poor) to 5 (very bad). Additionally, the vision concerns were rated on a scale from 1 (never), 2 (rarely), 3 (once in a while), 4 (often) to 5 (always). A glaucoma diagnosis was self-reported and obtained from the questionnaire. To investigate the strength and direction of associations, we used binomial logistic regression models including self-assessment, age, and sex as confounding variables and glaucoma status as the dependent variable.</p></div><div><h3>Results</h3><p>This study analyzed questionnaire data from 59,168 participants, with an average age of 55.2 years (SD 15.0), and 62.0 % being women. Of these, 900 individuals (1.5 %) reported having a glaucoma diagnosis. Individuals having glaucoma reported poorer self-ratings in vision, vision concerns and general health. Specifically, the odds ratios for the poorest ratings were 2.46 for self-rated vision (95 % CI 1.70–3.55, <em>p</em> &lt; 0.001), 8.04 for self-rated vision concerns (95 % CI 5.44–11.90, <em>p</em> &lt; 0.001) and 1.86 for self-rated health (95 % CI 1.16–2.98, <em>p</em> = 0.010).</p></div><div><h3>Conclusion</h3><p>Glaucoma status is associated with poorer self-assessments of vision, vision concerns, and health. This suggests that individuals with glaucoma experience more vision and health challenges than people without the disease and the three assessments can be used as tools to characterize glaucoma patients in risk profiling efforts.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000352/pdfft?md5=263099f4f6713fc39a3e7e148b78eab4&pid=1-s2.0-S2950253524000352-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study evaluating the usability of MonŒil, a ChatGPT-based education tool in ophthalmology","authors":"Claudio XOMPERO,&nbsp;Walid BENETTAYEB,&nbsp;Eric H. SOUIED,&nbsp;Carl-Joe MEHANNA","doi":"10.1016/j.ajoint.2024.100032","DOIUrl":"https://doi.org/10.1016/j.ajoint.2024.100032","url":null,"abstract":"<div><h3>Importance</h3><p>There is an increasing use of artificial intelligence (AI) in ophthalmology to respond to the needs of patients to access reliable, easy-to-understand medical information.</p></div><div><h3>Objective</h3><p>To assess patient satisfaction with the usability of MonŒil, an AI-based platform designed for patient education in ophthalmology.</p></div><div><h3>Design</h3><p>This was a pilot cross-sectional study of the usability of MonŒil by patients followed for advanced age-related macular degeneration (AMD). MonŒil is based on ChatGPT-4 technology with specific ophthalmology-focused customizations and accessibility enhancements, and is freely available at <em>monoeil.help</em>. Patients were given 20 min of unsupervised interaction with no prior training or guidance, after which their feedback was collected.</p></div><div><h3>Setting</h3><p>The study was performed in the ophthalmology department at the Creteil University Hospital.</p></div><div><h3>Participants</h3><p>Participants included 54 patients diagnosed with advanced AMD defined presenting for follow-up. Patients had to be older than 50 years of age, capable of giving informed consent, and able to understand and interact with MonŒil. Exclusion criteria were severe visual and cognitive impairment that prevented interaction with MonŒil.</p></div><div><h3>Main Outcome(s) and Measure(s)</h3><p>The primary outcome was the usability of MonŒil as measured by the System Usability Scale (SUS) questionnaire.</p></div><div><h3>Results</h3><p>Of the 54 participants, 34 were female (62.96 %). The mean age of the cohort was 77.76±8.14 years (range 58 to 97 years). The mean SUS score was 90.23±12.04 with a median of 92.50 (range 42.50 to 100.00), indicating excellent usability. There was a positive relationship between visual acuity and SUS score (regression coefficient 0.30 (95 % CI 0.08 to 0.51), r2=0.19, <em>p</em> = 0.0077).</p></div><div><h3>Conclusions and Relevance</h3><p>MonŒil demonstrated excellent usability and satisfaction in a sample population of elderly patients with advanced AMD. These results suggest that AI-based tools like MonŒil can enhance patient education with minimal oversight in a complex field like ophthalmology, supporting its use as an adjunct to the physician-patient discussion. Further studies may be necessary to establish the applicability of MonŒil to a broader user base, and to assess its usefulness and clinical impact on patient outcomes such as patient knowledge and vision-related quality of life.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100032"},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000327/pdfft?md5=0d565968f77c687abb04b1d701e28a80&pid=1-s2.0-S2950253524000327-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital radiotherapy with combined intravenous methylprednisolone and mycophenolate mofetil in moderate-to-severe thyroid eye disease","authors":"Kenneth Ka Hei Lai ,&nbsp;Ryan Hong Yu Fong ,&nbsp;Fatema Mohamed Ali Abdulla Aljufairi ,&nbsp;Jake Uy Sebastian ,&nbsp;Karen Kar Wun Chan ,&nbsp;Joyce Ka Yee Chin ,&nbsp;Kenneth Chun Wai Wong ,&nbsp;Hanson Yiu Man Wong ,&nbsp;George Pak Man Cheng ,&nbsp;Wilson Wai Kuen Yip ,&nbsp;Alvin Lerrmann Young ,&nbsp;Clement Chee Yung Tham ,&nbsp;Chi Pui Pang ,&nbsp;Kelvin Kam Lung Chong","doi":"10.1016/j.ajoint.2024.100031","DOIUrl":"10.1016/j.ajoint.2024.100031","url":null,"abstract":"<div><h3>Purpose</h3><p>To report the clinical outcomes of orbital radiotherapy (ORT) with combined intravenous methylprednisolone (IVMP) and mycophenolate mofetil (MMF) in thyroid eye disease (TED) patients with restrictive myopathy.</p></div><div><h3>Design</h3><p>Prospective comparative case series of patients managed at The Chinese University of Hong Kong from 2015 to 2021.</p></div><div><h3>Methods</h3><p>The primary outcome was the change in Gorman diplopia score at 52 weeks. Secondary outcomes were the changes in extraocular muscle motility (EOMy), area of extraocular muscle (EOM) on MRI, exophthalmos, and marginal reflex distance (MRD) 1 and MRD2 at 52 weeks.</p></div><div><h3>Results</h3><p>A total of 40 (29 females) TED patients, medium age 56 years, were treated with the double regimen: combined IVMP and MMF (17) or triple regimen: IVMP, MMF, and ORT (23). The triple group has a higher age (<em>P</em> = 0.028). Sex, smoking history, thyroid, and pre-treatment orbital status were comparable between the 2 groups. EOMy improved more after the triple regimen(<em>P</em> = 0.026). Nine patients from the triple group showed a significant reduction in the size of the inferior rectus (both eyes: <em>P</em> &lt; 0.05), while five from the double group showed no significant reduction of any EOM on MRI. The improvement of CAS, diplopia score, exophthalmos, MRD1, and MRD2 were similar. No patient reported any severe or organ-threatening side effects from IVMP, MMF, or ORT requiring discontinuation of treatment.</p></div><div><h3>Conclusion</h3><p>The triple regimen demonstrates better structural and functional outcomes in TED-related restrictive myopathy. Future randomized clinical trials are warranted to clarify the adjuvant role of ORT in this specific indication of TED management.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 2","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000315/pdfft?md5=c1725650fbe4fac92929d9eb84629858&pid=1-s2.0-S2950253524000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141038127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}