Clinical and Experimental Optometry最新文献

{"title":"Evaluating referrals of flashing lights and floaters coming into secondary care from primary care.","authors":"Shahzaib Rehan, Roger McPherson","doi":"10.1080/08164622.2024.2319759","DOIUrl":"10.1080/08164622.2024.2319759","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Optometrists should look to take every opportunity to expand their knowledge, understanding and skills pertaining to vitreoretinal conditions.</p><p><strong>Background: </strong>Despite the existence of acute eye care schemes and the up-skilling of optometrists, many units are still noticing large numbers of poor-quality referrals with high false positive rates. The authors pondered whether these schemes are effective.</p><p><strong>Methods: </strong>At two different time points, a prospective analysis of patients took place, of all the flashing lights and floaters referrals coming into secondary care at the Royal Glamorgan Hospital, Wales, UK. The following data was captured: the exact source of the primary care referral, the diagnosis being queried, the secondary care diagnoses made and the secondary care management decisions. The accuracy of retinal break and Shafer's sign detection were also directly compared between primary care and secondary care using Cohen's Kappa Coefficient.</p><p><strong>Results: </strong>For the 2018 period, <i>n</i> = 51 patients were included. For the 2022-23 period <i>n</i> = 100 patients were included. The majority of referrals during both periods were from optometrists (>80%) via the WECS pathway. The most common diagnoses being queried were retinal breaks (~50%), followed by retinal detachments (~20%). Interestingly up to 20% of patients seen in secondary care were diagnosed as normal examinations and ~ 20%. Over 1/3 of patients were discharged after their first visit to the EEC. Statistically significant differences were found between the accuracy of retinal tear and Shafer's identification between the primary and secondary care settings.</p><p><strong>Conclusion: </strong>A high number of false positive referrals are coming into secondary care from the WECS pathway and clear training and education needs have been identified.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"33-39"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological and pathological changes to the eye and vision during and after pregnancy.","authors":"Bao N Nguyen, Alexis Ceecee Britten-Jones, Bang V Bui, Lorraine E Walker, Peta Titter","doi":"10.1080/08164622.2024.2410031","DOIUrl":"10.1080/08164622.2024.2410031","url":null,"abstract":"<p><p>Pregnancy introduces a multitude of changes in the body, including hormonal fluctuations and metabolic changes, which can lead to atypical ocular signs and symptoms. Ocular manifestations range from fluctuations in vision, to microstructural changes in the retina and choroid, to dry eye disease. This narrative review highlights the range of pregnancy-related effects on the eye and vision that are likely to present in the context of routine eyecare. Specifically, physiological ocular changes and pathological ocular changes that manifest for the first time, or are exacerbated, in uncomplicated pregnancy are discussed. The literature has evolved from simply noting differences in the eye between pregnant and non-pregnant groups, to refining knowledge of the proposed underlying pathophysiology with the advent of newer technologies in eyecare. A particular focus of this review is navigating when pregnancy changes in the eye occur or peak during the gestational period, and whether the changes are short-lived or might extend past pregnancy. While many pregnancy-associated changes are temporary and resolve post-partum, it is also recognised that some changes persist after pregnancy, with a notable absence of literature on ocular changes with loss or termination of pregnancy. Currently or previously pregnant women (or those planning to become pregnant), and other health professionals, should be educated about the importance of seeking eyecare before, during and after pregnancy.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"5-13"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raman spectroscopy to investigate early biochemical alterations in human tears caused by contact lenses.","authors":"Riccardo Rolandi, Alessandro Duse, Silvia Tavazzi, Rita Grandori, Fabio Pezzoli, Erika Ponzini","doi":"10.1080/08164622.2024.2419981","DOIUrl":"10.1080/08164622.2024.2419981","url":null,"abstract":"<p><strong>Clinical relevance: </strong>The interaction between contact lenses and tear film plays a critical role in lens biocompatibility and can influence discomfort during wear. Early detection of biochemical changes is important for improving ocular surface health, preventing complications, and developing advanced lens materials to enhance long-term comfort.</p><p><strong>Background: </strong>The pursuit of biocompatible lens materials requires a thorough understanding of their interaction with tear environment. The aim of this study is to evaluate different approaches to investigate early alterations in tear biomolecular profiles induced by lens wear.</p><p><strong>Methods: </strong>Two participants wore different CLs and underwent ocular analysis before CL insertion (T0), after 2-hour wear (T2), and two hours after removing the CL (T4), evaluating non-invasive tear break-up time (NIBUT), tear meniscus height (TMH), and osmolarity. Forty CLs were used. At the same time points, tears were collected and analysed by Raman spectroscopy.</p><p><strong>Results: </strong>Tear film stability, as measured by NIBUT, decreased post-lens wear (T0 <i>vs</i> T2, <i>p</i> = 0.034 and 0.025 for S1 and S2, respectively) but showed recovery within 2 hours (T0 <i>vs</i> T4, <i>p</i> > 0.05 for both S1 and S2), while TMH and osmolarity remained unchanged (T0 <i>vs</i> T2 <i>vs</i> T4, <i>p</i> > 0.05 for both S1 and S2). Raman spectroscopy highlighted notable changes in the biomolecular profile of tears after lens wear, particularly in the 2700-3200 cm^-1 spectral window related to C-H stretching, which is sensitive to CH, CH₂ and CH₃ groups, their functional chemistry group, and the surrounding microenvironment.</p><p><strong>Conclusions: </strong>Contact lens wear induces subtle biochemical, subclinical alterations in tears that can be detected early by Raman spectroscopy. The method is promising for analysing the subject-specific responses to lenses, also with possible individual variability in the timing of these changes. In addition, this approach can provide insights for designing biocompatible materials and for the early detection of subclinical biomarkers.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"14-20"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of fungal keratitis caused by <i>Tintelnotia destructans</i>.","authors":"Isabel Romero-Barranca, Manuel Caro-Magdaleno, Beatriz Mataix-Albert, José López-Barba, Jaime Cordero-Ramos, Enrique Rodríguez-de-la-Rúa","doi":"10.1080/08164622.2024.2319762","DOIUrl":"10.1080/08164622.2024.2319762","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"94-96"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top ten golden rules for carving out a successful career in academic research.","authors":"Nathan Efron","doi":"10.1080/08164622.2024.2410881","DOIUrl":"10.1080/08164622.2024.2410881","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal vessel diameters in intermediate age-related macular degeneration using <i>en face</i> optical coherence tomography.","authors":"Lisa Nivison-Smith, Alvia Faiza, Tithi Roy, Matt Trinh","doi":"10.1080/08164622.2024.2311703","DOIUrl":"10.1080/08164622.2024.2311703","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Clinical assessment of age-related macular degeneration (AMD) relies on biomarkers that do not necessarily reflect the contributions of vascular dysfunction. Validation of clinically accessible methods of measuring retinal vascular integrity could provide a more holistic understanding of AMD-related changes to facilitate appropriate care.</p><p><strong>Background: </strong>There is conflicting evidence if retinal vessel calibre is significantly altered in the early stages of AMD. This study examined the outer and inner diameters of first order retinal vessels in intermediate AMD eyes using en face optical coherence tomography (OCT).</p><p><strong>Methods: </strong>Retinal en face (6 × 6 mm) OCT images were examined in a single eye of participants with intermediate AMD (<i>n</i> = 46) versus normal macula (<i>n</i> = 43) for arterioles (all identifiable) and venules (40/46 and 39/43 identifiable). All participants were aged ≥50 years without diabetes mellitus, hypertension, or other systemic vascular disease.</p><p><strong>Results: </strong>Intra- and inter-grader agreement was good-to-excellent for all en face OCT measurements of arteriole and venule diameters (intraclass correlation coefficient = 0.87 to 0.99). Arteriolar outer diameters (82.3 ± 19.8 µm vs 73.8 ± 16.1 µm; <i>p</i> < 0.05) and inner diameters (35.1 ± 8.4 µm vs 31.5 ± 8.1 µm; <i>p</i> < 0.05) were significantly greater in AMD eyes compared to normal eyes. Venular inner diameter was significantly greater (43.1 ± 9.5 µm vs 39.2 ± 10.1 µm; <i>p</i> < 0.05), but outer diameter remained unchanged (<i>p</i> = 0.17) in AMD eyes compared to normal eyes.</p><p><strong>Conclusion: </strong>Arteriolar dilation and altered venular inner diameter were observed in intermediate AMD eyes. These results support further investigation of vascular contributions to AMD in the early stages of disease, possibly using the en face OCT imaging modality.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"27-32"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Ease of adaptation' predicts preferred spectacle prescriptions better than visual acuity: a retrospective analysis.","authors":"Amy R Hughes, Mark Bullimore, David Elliott","doi":"10.1080/08164622.2024.2304060","DOIUrl":"10.1080/08164622.2024.2304060","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Factors predicting patient acceptance of a new spectacle prescription need to be determined to make optimal prescribing decisions.</p><p><strong>Background: </strong>Clinicians usually prescribe for best visual acuity. However, for some patients, a partial change is prescribed to ease adaptation, despite providing suboptimal visual acuity. This study seeks to develop an understanding of which factors predict patient preference between spectacle prescriptions by using a retrospective analysis to compare ease of adaptation, subjective quality of distance vision and optimal distance visual acuity.</p><p><strong>Methods: </strong>A retrospective analysis utilised a 196-patient data set in which participants wore two prescriptions, one based on the subjective refraction of an optometrist modified by judgement and one on autorefractor results modified for ease of adaptation by an algorithm. Spectacles were worn for 3 weeks each, and participants responded to questions about which prescription they preferred and their quality of distance vision and ease of adaptation (on a 0-10 scale) with each prescription. A logistic regression analysed which variables predicted whether participants responded yes or no to the question 'If you had purchased these spectacles for $100 (US$200 adjusted to 2023 value), would you be happy with them?'</p><p><strong>Results: </strong>There was a significant difference between the preferred and non-preferred prescriptions for the subjective quality of distance vision rating (medians 9 vs. 8; Z = -7.80, <i>p</i> < 0.0001) and ease of adaptation rating (medians 8 vs. 5; Z = -8.32, <i>p</i> < 0.0001) but the distance binocular visual acuity was not significantly different (both means = -0.09 logMAR; Z = -0.60, <i>p</i> = 0.55). Of all participants, 94% preferred the prescription deemed easier to adapt to but only 59% preferred the prescription with better subjective quality of distance vision and best visual acuity.</p><p><strong>Conclusion: </strong>Distance visual acuity was not found to be a useful predictor of participant preference to a new prescription and is likely over-relied upon in practice. The results support the adjustment of the subjective prescription where appropriate to aid patient adaptation and comfort.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"79-86"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talking technology: exploring chatbots as a tool for cataract patient education.","authors":"I Brahim Edhem Yılmaz, Levent Doğan","doi":"10.1080/08164622.2023.2298812","DOIUrl":"10.1080/08164622.2023.2298812","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Worldwide, millions suffer from cataracts, which impair vision and quality of life. Cataract education improves outcomes, satisfaction, and treatment adherence. Lack of health literacy, language and cultural barriers, personal preferences, and limited resources may all impede effective communication.</p><p><strong>Background: </strong>AI can improve patient education by providing personalised, interactive, and accessible information tailored to patient understanding, interest, and motivation. AI chatbots can have human-like conversations and give advice on numerous topics.</p><p><strong>Methods: </strong>This study investigated the efficacy of chatbots in cataract patient education relative to traditional resources like the AAO website, focusing on information accuracy,understandability, actionability, and readability. A descriptive comparative design was used to analyse quantitative data from frequently asked questions about cataracts answered by ChatGPT, Bard, Bing AI, and the AAO website. SOLO taxonomy, PEMAT, and the Flesch-Kincaid ease score were used to collect and analyse the data.</p><p><strong>Results: </strong>Chatbots scored higher than AAO website on cataract-related questions in terms of accuracy (mean SOLO score ChatGPT: 3.1 ± 0.31, Bard: 2.9 ± 0.72, Bing AI: 2.65 ± 0.49, AAO website: 2.4 ± 0.6, (<i>p</i> < 0.001)). For understandability (mean PEMAT-U score AAO website: 0,89 ± 0,04, ChatGPT 0,84 ± 0,02, Bard: 0,84 ± 0,02, Bing AI: 0,81 ± 0,02, (<i>p</i> < 0.001)), and actionability (mean PEMAT-A score ChatGPT: 0.86 ± 0.03, Bard: 0.85 ± 0.06, Bing AI: 0.81 ± 0.05, AAO website: 0.81 ± 0.06, (<i>p</i> < 0.001)) AAO website scored better than chatbots. Flesch-Kincaid readability ease analysis showed that Bard (55,5 ± 8,48) had the highest mean score, followed by AAO website (51,96 ± 12,46), Bing AI (41,77 ± 9,53), and ChatGPT (34,38 ± 9,75, (<i>p</i> < 0.001)).</p><p><strong>Conclusion: </strong>Chatbots have the potential to provide more detailed and accurate data than the AAO website. On the other hand, the AAO website has the advantage of providing information that is more understandable and practical. When patient preferences are not taken into account, generalised or biased information can decrease reliability.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"56-64"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraocular pressure fluctuations assessment in professional wind instrument players.","authors":"Veronica Noya-Padin, Hugo Pena-Verdeal, Noelia Nores-Palmas, Maria J Giraldez, Eva Yebra-Pimentel","doi":"10.1080/08164622.2024.2301983","DOIUrl":"10.1080/08164622.2024.2301983","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Due to the long-time that wind musicians spend playing their instruments, it is important to investigate if intraocular pressure could be affected by this activity.</p><p><strong>Background: </strong>To assess the intraocular pressure fluctuations and fluctuations affecting factors in professional wind musicians while playing different tones.</p><p><strong>Methods: </strong>Thirty professional wind musicians (23.0 ± 3.20 years) were recruited from the Professional Music College of A Coruña. A questionnaire about environmental/demographic factors was given to participants. Intraocular pressure was measured four times by ICare IC100 tonometer: before, during low and high-pitched tones, and immediately after stopping playing the wind instrument.</p><p><strong>Results: </strong>Pairwise comparison revealed statistical differences between measurement points (Sidak, all <i>p</i> ≤ 0.019), except between before playing and while playing low-pitched tones (Sidak, <i>p</i> = 1.000). Intraocular pressure increases during high pitch playing and decreases after stopping playing. No significant differences in intraocular pressure fluctuation were reported between physically active (>2 days/week) and non-physically active participants (Unpaired t-test, <i>p</i> = 0.680). All intraocular pressure values were positively correlated (Pearson's correlation, all <i>r</i> ≥ 0.505, <i>p</i> ≤ 0.004). Intraocular pressure fluctuations were negatively correlated with musical playing years (Pearson's correlation, <i>r</i> = - 0.396, <i>p</i> = 0.030). There were no significant correlations among intraocular pressure fluctuation and gender, age, weight, height, or daily time playing (Pearson's correlation, all <i>p</i> ≥ 0.058).</p><p><strong>Conclusion: </strong>Professional wind musicians suffer intraocular pressure peaks while playing high-pitched tones; therefore, ocular fundus evaluation and visual campimetry should be performed as routine tests in the visual exam of this population.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"21-26"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exemplifying practice-based research: the influence of age on myopia progression.","authors":"David Berkow, Mark Dunne, Nicola S Logan, Stephen J Anderson","doi":"10.1080/08164622.2024.2309219","DOIUrl":"10.1080/08164622.2024.2309219","url":null,"abstract":"<p><strong>Clinical relevance: </strong>The electronic storage of patient records and modern-day search engines present private practitioners with a unique opportunity to extract valuable data for investigative research purposes. However, practitioners seldom harness this resource and consequently a vast repository of clinical data remains largely unexplored.</p><p><strong>Background: </strong>This study, based on real-world data from an optometric practice, stands as an example of how clinicians can actively contribute to research. In doing so it underscores the role played by age in determining the rate of natural myopia progression.</p><p><strong>Methods: </strong>A retrospective data analysis of the refractive status, age and optical correction type of participants, was conducted over six years. Forty-four participants were recruited (25 contact lens and 19 spectacle wearers), with a presenting age varying from 5 to 20 years (median, 11 years). Non-cycloplegic, monocular foveal refractions were completed using a ShinNippon open-field autorefractor, corroborated with subjective refraction. The mean spherical equivalent refractive error was calculated for the participants' initial visit (baseline measure) and for a six-year follow-up visit (progression measure), with myopia progression defined as the difference between these measures. Statistical analyses were computed using Decision Tree Analysis, with a significance level set at 95%.</p><p><strong>Results: </strong>The participant age at first visit exerted a significant influence on natural myopia progression over the assessment period (F 1,42 = 17.11, <i>p</i> < 0.001). Individuals aged ≤ 10 years had approximately twice the myopic progression (mean, -2.27 D) of those aged > 10 years (mean, -1.13 D). Neither degree of myopia at the initial visit nor optical correction type had a significant effect on progression (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Utilizing the advantage of small real-world data samples, the benefit of research by private practitioners was demonstrated, providing evidence that the age at which a child first presents for an eye examination is highly influential in determining their rate of myopia progression.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"87-91"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}