AJO International最新文献

{"title":"Factors affecting quality of life in patients with neovascular age-related macular degeneration","authors":"Benjamin Sommer Thinggaard ,&nbsp;Yousif Subhi ,&nbsp;Fadumo Abdullah Ismail ,&nbsp;Maria Pedersen ,&nbsp;Lars Morsø ,&nbsp;Jakob Grauslund ,&nbsp;Lonny Stokholm","doi":"10.1016/j.ajoint.2024.100066","DOIUrl":"10.1016/j.ajoint.2024.100066","url":null,"abstract":"<div><h3>Purpose</h3><p>This study examines how factors such as age, sex, best corrected visual acuity (BCVA), driving ability, and perceived treatment effectiveness influence quality of life (QoL) among patients with neovascular age-related macular degeneration (nAMD) in treatment with anti-vascular endothelial growth factor (VEGF) injections. Such information might be invaluable for healthcare providers, enabling them to understand who benefits from treatment.</p></div><div><h3>Design</h3><p>Survey-based cross-sectional study</p></div><div><h3>Methods</h3><p>We used questionnaire responses from patients receiving intravitreal anti-VEGF injections for nAMD to evaluate self-reported QoL, measured by the Macular Degeneration Quality of Life questionnaire. Background questions in the survey gathered patient information, while BCVA was obtained from medical records. The associations between self-rated QoL and various factors were analyzed using binomial logistic regression and linear regression. We calculated crude odds ratio (OR) and β-coefficient as well as OR and β-coefficient adjusted for sex, age, and BCVA.</p></div><div><h3>Results</h3><p>This study included 348 individuals, median age 79.2 years (IQR 75.0–84.0), with 58.3 % women. In the adjusted logistic model, factors associated with a QoL above average were male sex (OR 1.65, 95 % CI 1.04, 2.63), BCVA above 0.5 Snellen in best seeing eye (OR 11.16, 95 % CI 4.24, 29.35), preserved driving ability (OR 3.35, 95 % CI 1.80, 6.26), and perceiving treatment effectiveness (OR 2.15, 95 % CI 1.07, 4.34). The adjusted linear regression revealed the same associations, yet the positive relationship between QoL and biological sex was significant in the crude model but not in the adjusted model (β: 0.30, 95 % CI -0.04, 0.64).</p></div><div><h3>Conclusion</h3><p>Good visual acuity and driving ability strongly correlate with high QoL in patients with nAMD. Perceptions of the effectiveness of anti-VEGF treatment double the likelihood of high QoL, highlighting the need for further investigation into its potential clinical implications.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000662/pdfft?md5=56384a5249e24af4818a8efb5b27b373&pid=1-s2.0-S2950253524000662-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142099698","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":"Testing the power of Google DeepMind: Gemini versus ChatGPT 4 facing a European ophthalmology examination","authors":"Matteo Mario Carlà ,&nbsp;Federico Giannuzzi ,&nbsp;Francesco Boselli ,&nbsp;Stanislao Rizzo","doi":"10.1016/j.ajoint.2024.100063","DOIUrl":"10.1016/j.ajoint.2024.100063","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to compare the performances of Google Gemini and ChatGPT-4, facing a triple simulation of the European Board of Ophthalmologists (EBO) multiple choices exam.</p></div><div><h3>Design</h3><p>Observational study.</p></div><div><h3>Methods</h3><p>The EBO multiple choice examination consists of 52 questions followed by 5 statements each, for a total of 260 answers. Statements may be answered with “True”, “False” or “Don't Know”: a correct answer is awarded 1 point; an incorrect is penalized 0.5 points; “don't know” scores 0 points. At least 60 % correct answers are needed to pass the exam. After explaining the rules to the chatbots, he entire question with the 5 statements was input. The rate of correct answers and the final score were collected. The exam simulation was repeated 3 times with randomly generated questions.</p></div><div><h3>Results</h3><p>Google Gemini and ChatGPT-4 succeed in EBO exam simulations in all 3 cases, with an average 85.3 ± 3.1 % and 83.3 ± 2.4 % of correct answers. Gemini had a lower error rate compared to ChatGPT (6.7 ± 1.5 % vs. 13.0 ± 2.6 %, <em>p</em> = 0.03), but answered “Don't know” more frequently (8.0 ± 2.7 % vs. 3.7 ± 1.5 %, <em>p</em> = 0.05). Both chatbots scored at least 70 % of correct answers in each exam subspecialty across the 3 simulations. Converting the percentages into points, Gemini scored 213.5 ± 9.3 points on average, compared to 199.8 ± 7.1 points for ChatGPT (<em>p</em> = 0.21).</p></div><div><h3>Conclusions</h3><p>Google Gemini and ChatGPT-4 can both succeed in a complex ophthalmology examination on widespread topics, with higher accuracy compared to their former versions, highlighting their evolving importance in educational and informative setting.</p></div><div><h3>Precis</h3><p>Google Gemini and ChatGPT-4 were both able to succeed in 3 consecutive exam simulations of the European Board of Ophthalmologists with an average of 85 % and 83 % correct answers, respectively. Google Gemini showed significantly less errors when compared to ChatGPT.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000637/pdfft?md5=4e9c209c1a98a7ea76ea9d21c9040f92&pid=1-s2.0-S2950253524000637-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021410","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":"Surgical outcomes in patients with congenital superior oblique palsy: A comparison between clinical and radiological diagnosis","authors":"Maryam Saatchi ,&nbsp;Shervin Sharif Kashani ,&nbsp;Anita Ebrahimpour ,&nbsp;Motahereh Sadegi ,&nbsp;Mohammadreza Akbari ,&nbsp;Arash Mirmohammadsadegi ,&nbsp;Babak Masoomian ,&nbsp;Masoud Aghsaei Fard","doi":"10.1016/j.ajoint.2024.100064","DOIUrl":"10.1016/j.ajoint.2024.100064","url":null,"abstract":"<div><h3>Purpose</h3><p>The diagnosis of superior oblique (SO) palsy can be achieved by examining the radiological and clinical characteristics. Despite their usefulness, the radiological and clinical methods are not always aligned to each other. The objective of this research is to analyze the surgical results of eyes with SO palsy, based on whether the diagnosis was made radiologically or clinically.</p></div><div><h3>Design</h3><p>A prospective study, conducted at a single tertiary hospital.</p></div><div><h3>Methods</h3><p>Following the diagnosis of SO palsy, either through clinical assessment or radiological imaging, the patients were categorized into three distinct groups according to their clinical measurements and MRI findings. Group 1 exhibited consistent clinical measurements and MRI findings indicating SO palsy, whereas Group 2 displayed clinical measurements without MRI confirmation. In contrast, Group 3 presented inconclusive measurements, but MRI scans revealed signs of atrophy. Patients underwent inferior oblique (IO) myectomy with and without contralateral inferior rectus recession and ocular deviation before and after myectomy were collected.</p></div><div><h3>Results</h3><p>The study included 49 patients with congenital unilateral SO palsy (average age: 30 years). Out of 35 patients who tested positive across all three stages of the test, 15 did not show notable muscle atrophy in their MRI findings. In contrast, among those who displayed muscle atrophy in their MRI scans, 58.8 % had positive outcomes in all steps of the three-step assessment. Group 1 and 3 displayed a reduced muscle volume measuring 110.988 ± 42.49 mm³ and 91.5 ± 56.8 mm³, respectively, on the affected side. Group 2 showcased a muscle volume of 184.1 ± 44.64 mm³ on the affected side. In all three groups with SO palsy eyes who underwent IO myectomy, there was a reduction in hypertropia in the primary position, with no statistically significant differences observed among the groups (<em>P</em> = 0.1). All five patients with SO palsy who underwent IO myectomy with contralateral inferior rectus recession were classified in group 3, and they exhibited a significant reduction in hypertropia postoperatively.</p></div><div><h3>Conclusion</h3><p>Comparable results can be attained through IO surgery in patients with SO palsy, regardless of whether they are diagnosed through clinical or radiological means.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000649/pdfft?md5=53b4f95acf1644183b1141899f563648&pid=1-s2.0-S2950253524000649-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001902","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":"Artificial intelligence, adversarial attacks, and ocular warfare","authors":"Michael Balas ,&nbsp;David T Wong ,&nbsp;Steve A Arshinoff","doi":"10.1016/j.ajoint.2024.100062","DOIUrl":"10.1016/j.ajoint.2024.100062","url":null,"abstract":"<div><h3>Purpose</h3><p>We explore the potential misuse of artificial intelligence (AI), specifically large language models (LLMs), in generating harmful content related to ocular warfare. By examining the vulnerabilities of AI systems to adversarial attacks, we aim to highlight the urgent need for robust safety measures, enforceable regulation, and proactive ethics.</p></div><div><h3>Design</h3><p>A viewpoint paper discussing the ethical challenges posed by AI, using ophthalmology as a case study. It examines the susceptibility of AI systems to adversarial attacks and the potential for their misuse in creating harmful content.</p></div><div><h3>Methods</h3><p>The study involved crafting adversarial prompts to test the safeguards of a well-known LLM, OpenAI's ChatGPT-4.0. The focus was on evaluating the model's responses to hypothetical scenarios aimed at causing ocular damage through biological, chemical, and physical means.</p></div><div><h3>Results</h3><p>The AI provided detailed responses on using Onchocerca volvulus for mass infection, methanol for optic nerve damage, mustard gas for severe eye injuries, and high-powered lasers for inducing blindness. Despite significant safeguards, the study revealed that with enough effort, it was possible to bypass these constraints and obtain harmful information, underscoring the vulnerabilities in AI systems.</p></div><div><h3>Conclusion</h3><p>AI holds the potential for both positive transformative change and malevolent exploitation. The susceptibility of LLMs to adversarial attacks and the possibility of purposefully trained unethical AI systems present significant risks. This paper calls for improved robustness of AI systems, global legal and ethical frameworks, and proactive measures to ensure AI technologies benefit humanity and do not pose threats.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000625/pdfft?md5=8082ec440eda4dbceca3671b311f30c2&pid=1-s2.0-S2950253524000625-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963620","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":"Clinical and genetic spectrum of coloboma: A proposal for a comprehensive approach to pediatric patients","authors":"D Ferri-Rufete ,&nbsp;L Baleta-Riera ,&nbsp;D Casas-Alba ,&nbsp;S Balsells ,&nbsp;A Llorca-Cardeñosa ,&nbsp;M Barraso ,&nbsp;J Català ,&nbsp;E Casas ,&nbsp;J Díaz ,&nbsp;C Fresno ,&nbsp;F Palau ,&nbsp;AF Martínez-Monseny","doi":"10.1016/j.ajoint.2024.100061","DOIUrl":"10.1016/j.ajoint.2024.100061","url":null,"abstract":"<div><h3>Purpose</h3><p>to analyze pediatric coloboma cases to (1) identify ophthalmological and systemic associations, (2) establish the variables with the highest probability of reaching a genetic diagnosis and worse visual prognosis and (3) propose a clinical and genetical assessment protocol.</p></div><div><h3>Design and methods</h3><p>Descriptive, retrospective and single-center study. Patients under 18 years of age diagnosed with iris, chorio-retinal and/or optic disc coloboma under follow-up by a reference Pediatric Ophthalmology Unit have been selected from January 2012 to December 2022. A comprehensive data collection and analysis was performed to evaluate phenotype, molecular and prognosis correlations.</p></div><div><h3>Results</h3><p>A total of 214 patients with a mean age of 11.3 years (6.8 SD) were included (57% female). Among them, 50.9% presented with bilateral coloboma and 66.8% with other ophthalmological alterations (28.5% with microphthalmia). Systemic involvement was observed in 28%, being neurological dysfunction (24.8%) and craniofacial dysmorphic features (18.2%) the most frequent. Molecular diagnosis was reached in 19.2% and clinical exome sequencing had the highest diagnostic yield (22.2%). Bilaterality, macula involvement, short stature and neurological, craniofacial dysmorphic, cardiovascular, and renal anomalies were associated with reaching a genetic diagnosis (<em>p</em> &lt; 0.05). Patients with craniofacial dysmorphic features, hearing, neurologic, cardiac abnormalities or short stature had a worse visual prognosis according with a multivariate model (<em>p</em> &lt; 0.05). A diagnosis and follow-up protocol was developed.</p></div><div><h3>Conclusion</h3><p>It is imperative to ascertain diagnostic and prognostic indicators in individuals with coloboma to facilitate genetic counseling, mitigate potential complications, and enhance the overall well-being of patients and their families</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000613/pdfft?md5=a8bfb347da05cba263f8a8d73930004b&pid=1-s2.0-S2950253524000613-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949811","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":"Accessibility of United States ophthalmology hospital webpages to people with visual disabilities","authors":"Mostafa Bondok ,&nbsp;Mohamed S. Bondok ,&nbsp;Rishika Selvakumar ,&nbsp;Christian El-Hadad ,&nbsp;Edsel Ing","doi":"10.1016/j.ajoint.2024.100059","DOIUrl":"10.1016/j.ajoint.2024.100059","url":null,"abstract":"<div><h3>Purpose</h3><p>Enhancing the accessibility of ophthalmology webpages can help individuals with vision access needs obtain essential appointment information, educational resources, and available ophthalmic services. This study evaluated the accessibility of these webpages for patients with visual impairment and color vision deficiencies.</p></div><div><h3>Design</h3><p>Retrospective cross-sectional study.</p></div><div><h3>Methods</h3><p>In February 2024, the Web Content Accessibility Guidelines 2.0 (WCAG 2.0) were used to assess the accessibility of the web homepages of the top-ranked ophthalmology institutes in the United States using three evaluation tools: AChecker, ARC Toolkit, and WAVE. The webpages of the 38 top-ranked hospitals for ophthalmology in the 2023 US News &amp; World Report were evaluated.</p></div><div><h3>Results</h3><p>All assessed ophthalmology hospital and institute webpages had accessibility issues. The issues identified by each tool significantly impeded webpage navigation, with the mean number of issues as follows: AChecker (13.08, SD = 14.51), ARC Toolkit (16.21, SD = 17.68), and WAVE (6.47, SD = 7.14). The mean number of color contrast issues per website was 10.18 (SD = 15.84), present in 87 % (33/38) of the websites assessed. Most issues made information and interface components difficult to perceive (297/497, 59.76 %), and websites difficult to navigate or operate (145/497, 29.18 %). Common issues affecting people who are blind or have low vision and rely on screen readers included the absence of alternative text for images, hyperlinks without destination information, and missing instructions for user data input (e.g., search bars).</p></div><div><h3>Conclusions</h3><p>Ophthalmology webpages should be revised to comply with WCAG guidelines to improve accessibility for people with vision access needs. Addressing these issues can reduce information inequities for patients with visual disabilities and enhance their understanding of clinical processes, treatment, care plans, and available services such as transportation and online support groups.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100059"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000595/pdfft?md5=7da28d0993cdb0d13e732591815415e5&pid=1-s2.0-S2950253524000595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839326","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":"State of the art, advantages and drawbacks of XEN 63 gel stent in glaucoma surgery","authors":"Matteo Mario Carlà ,&nbsp;Gloria Gambini ,&nbsp;Alfonso Savastano ,&nbsp;Federico Giannuzzi ,&nbsp;Francesco Boselli ,&nbsp;Stanislao Rizzo","doi":"10.1016/j.ajoint.2024.100058","DOIUrl":"10.1016/j.ajoint.2024.100058","url":null,"abstract":"<div><h3>Purpose</h3><p>The XEN gel stent (Allergan) is a minimally-invasive, subconjunctival bleb-forming device designed for glaucoma surgery. Originally available in three sizes (45, 63 and 140 μm), it consists of a flexible, permanent collagen implant that is positioned ab-interno.</p></div><div><h3>Design</h3><p>Narrative review.</p></div><div><h3>Methods</h3><p>A search was conducted in the Cochrane Central, PubMed/Medline, Google Scholar, Web of Science, and ClinicalTrials.gov databases for studies related to the XEN 63 model up to May 2024.</p></div><div><h3>Results</h3><p>Initial studies with the previous version of the XEN 63 device indicated a significant reduction in intraocular pressure (IOP), although the failure rate was over 30 % due to the absence of intraoperative mitomycin C. The complete success rate—defined as final IOP ≤18 mmHg with at least a 20 % reduction from baseline—was approximately 25 %. Subsequent reports following the introduction of the revised XEN 63 stent model demonstrated IOP reductions of 40–45 % from baseline. This newer model also significantly reduced the need for postoperative topical medications. After 12–18 months of follow-up, the complete success rates reported were around 60 %, and the final IOP values were lower than those observed with the XEN 45 stent in comparative studies. The most common postoperative complication is hypotony, which varies from 18 to 66 %. While usually subclinical and treatable with medical intervention, 3–5 % of cases lead to complications such as choroidal detachment or anterior chamber shallowing. Other infrequent adverse events include anterior chamber hemorrhage and hyphema. The rates of needing subsequent needling procedures are similar to those observed with the XEN 45 stent, ranging from 10 to 35 %.</p></div><div><h3>Conclusion</h3><p>The XEN 63 stent has shown promising results and greater efficacy in lowering IOP compared to the XEN 45 stent. Further research is essential to determine its long-term efficacy and confirm the rate of postoperative complications.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100058"},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000583/pdfft?md5=49eb2c8b8d86733c938445c0afa52b5f&pid=1-s2.0-S2950253524000583-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853832","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":"Gender analysis of ophthalmology fellowship program directors and trainees","authors":"Kelly N. Miller ,&nbsp;Mojisola A. Lawson ,&nbsp;Nikisha Q. Richards","doi":"10.1016/j.ajoint.2024.100057","DOIUrl":"10.1016/j.ajoint.2024.100057","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the gender ratios of ophthalmology fellows and fellowship program directors.</p></div><div><h3>Design</h3><p>Quantitative cross-sectional study.</p></div><div><h3>Methods</h3><p>Programs were identified using the Association of University Professors of Ophthalmology (AUPO) and the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) websites. Programs were contacted via email survey to determine the gender of the current fellow(s) and fellowship program director in the academic year 2022–2023. Fisher's Exact Test* was undertaken to establish statistical significance (<em>p</em> &lt; 0.05) between female program director percentages across fellowship subspecialties.</p></div><div><h3>Results</h3><p>220 out of 287 programs were analyzed: pediatrics (9.1 %), neuroophthalmology (9.5 %), cornea (13.2 %), oculoplastics (16.8 %), uveitis (4.1 %), glaucoma (18.6 %), surgical retina (24.1 %), medical retina (2.3 %), and oncology/pathology (2.3 %). Women fellow-dominated subspecialties (&gt;50 %) included pediatric ophthalmology (69.4 %), neuro-ophthalmology (65.6 %), oculoplastics (61.4 %), and cornea (58.8 %). Uveitis (45.4 %), glaucoma (44.6 %), and surgical retina (32.8 %) were considered women fellow minority subspecialties (&lt; 50 %). Medical retina and oncology/pathology had equal representation of fellows (50 %). Women fellowship directors remain in the minority (&lt; 50 %) across six of the nine fellowships examined; neuro-ophthalmology, oculoplastics, cornea, glaucoma, surgical retina, and oncology/pathology. The women fellow-dominated subspecialties had higher rates of women fellowship program directors (40.2 %) versus women fellow minority subspecialties (28.1 %) (<em>p</em> = 0.0811*).</p></div><div><h3>Conclusion</h3><p>There is a lack of women representation throughout the ophthalmology fellowship program leadership. Subspecialties with predominant women program directors have higher women fellow representation. Future investigations will focus on fellowship applicants and the influence the gender of the program director may have on selection criteria for various subspecialty training.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000571/pdfft?md5=78a303710ef771662ccff3a9556dabf1&pid=1-s2.0-S2950253524000571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712207","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":"Heavy silicone oil tamponade in retinal detachment surgery: A systematic review and single-arm meta-analysis on Densiron 68 and Oxane HD","authors":"Matteo Mario Carlà ,&nbsp;Carlos Mateo ,&nbsp;Federico Giannuzzi ,&nbsp;Francesco Boselli ,&nbsp;Stanislao Rizzo","doi":"10.1016/j.ajoint.2024.100055","DOIUrl":"10.1016/j.ajoint.2024.100055","url":null,"abstract":"<div><h3>Purpose</h3><p>Heavy silicone oils (HSOs) have been introduced in rhegmatogenous retinal detachment (RRD) surgery to support inferior/posterior breaks and proliferative vitreoretinopathy (PVR). This meta-analysis assessed the results and adverse effects of two widespread HSOs in RRD surgery.</p></div><div><h3>Design</h3><p>Systematic review and meta-analysis.</p></div><div><h3>Methods</h3><p>The study was conducted in accordance with PRISMA guidelines and registered on PROSPERO. We retrieved randomized controlled trials, prospective, retrospective and cross-sectional studies discussing the treatment of RRD with HSO injection (Densiron 68 or Oxane HD), published from 2000 to nowadays, conducting a computer-based search of the following databases: PubMed/Medline, Embase, Cochrane, Google Scholar and Web of Science. This meta-analysis focused on primary success rates, visual acuity (VA) improvement and postoperative complications.</p></div><div><h3>Results</h3><p>A total of 16 retrospective/prospective cohort studies on 723 eyes (506 with Densiron 68 and 217 with Oxane HD tamponade), divided into 345 primary and 378 recurrent RRDs were included. Following GRADE scale, 11 studies had a “moderate” and 5 a “low” evidence level. Mean duration of HSO tamponade ranged from 7.2 weeks to 15.3 months, but generally lasting 3–6 months. Pooled primary success rate was 79% (95%CI: 72 to 86%), being 85% (95%CI: 78 to 91%) in Oxane studies and 76% (95%CI: 66 to 87%) in Densiron studies. After HSO removal, recurrences of RRD were 6–50%, highest in studies with greater baseline recurrent RRD. Pooled VA improvement was 0.47 LogMAR (95%CI: 0.29 to 0.65). Studies with Oxane showed average VA improvement of 0.31 LogMAR (95%CI: -0.18 to 0.80), while VA improvement was 0.47 LogMAR (95%CI: 0.33 to 0.75) in Densiron studies. Differently from Oxane studies, all the 9 studies in the Densiron 68 subgroup reported final mean VA improvement. Even if affected by great heterogeneity, the major adverse effects were anterior chamber inflammation (pooled average 20%, 95%CI: 13 to 26%), HSO emulsification (pooled average 16%, 95%CI: 10 to 21%) and IOP elevation (pooled average 22%, 95%CI: 16 to 27%).</p></div><div><h3>Conclusion</h3><p>HSO offers good anatomical outcomes in complex RRD cases, while visual outcomes, although improving, are significantly hampered by poor baseline condition. Inflammation, emulsification and raise of IOP are well-known postoperative adverse effects.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100055"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950253524000558/pdfft?md5=8173af6d0a370036620803b73662b44e&pid=1-s2.0-S2950253524000558-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700354","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":"Advanced diagnostic approaches for SHAPU: Metagenomic sequencing and interleukin analysis","authors":"Ranju Kharel Sitaula ,&nbsp;Rajeev Shrestha ,&nbsp;Pratap Karki ,&nbsp;Haramaya Gurung ,&nbsp;Anadi Khatri KC ,&nbsp;Nishan Katuwal ,&nbsp;Navin Adhikari ,&nbsp;Rajendra Bhatta ,&nbsp;Eliya Shrestha ,&nbsp;Indraman Maharjan ,&nbsp;Pursottam Joshi ,&nbsp;Biraj Man Karmacharya ,&nbsp;Angira Shrestha ,&nbsp;Ananda K Sharma ,&nbsp;Sagun Narayan Joshi ,&nbsp;Madan Prasad Upadhaya","doi":"10.1016/j.ajoint.2024.100056","DOIUrl":"10.1016/j.ajoint.2024.100056","url":null,"abstract":"<div><h3>Purpose</h3><p>Seasonal Hyperacute Panuveitis (SHAPU) is an ocular emergency where the genesis between infective and immunological is under investigation. This is the first report in the literature that attempts to explore the unidentified cause using next-generation metagenomic sequencing and immunomarker analysis.</p></div><div><h3>Design</h3><p>Cross-sectional quantitative study.</p></div><div><h3>Methods</h3><p>In this study, vitreous samples were collected from the SHAPU cases during the outbreak of 2019/2020. The vitreous samples of 10 random cases got selected for metagenomic next-generation sequencing. And 5 vitreous samples ran for immune analysis of levels of interleukin (IL) 6 and 10 using the ELISA technique. The ocular samples were extracted and sequenced on Illumina iSeq100 and analyzed through CZ ID platform. The true hits, for the suspected causative organisms were confirmed using qPCR through designed primers specific for that particular organism.</p></div><div><h3>Results</h3><p>A total of 30 eyes of 30 patients were included. Upon sequencing the DNA libraries, hits were observed for Streptococcus pneumoniae in 2/10 cases, confirmed by qPCR. IL-6 level was increased in 5/5 cases with IL-6/IL-10 greater than 1.</p></div><div><h3>Conclusion</h3><p>We report the presence of S. pneumoniae for the first time using a metagenomics analysis and increased IL-6 to IL-10 ratio via immune-analysis, indicating that SHAPU could have both infective and immunological facets on its causation.</p></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 3","pages":"Article 100056"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295025352400056X/pdfft?md5=f28712d9614b71c191f8a3591b4e603f&pid=1-s2.0-S295025352400056X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706196","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}