Clinical and Experimental Optometry最新文献

{"title":"Patient evaluated economic impact of keratoconus in New Zealand.","authors":"Lize Angelo, Akilesh Gokul, Isaac Samuels, Charles Nj McGhee, Mohammed Ziaei","doi":"10.1080/08164622.2024.2410026","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410026","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Few studies have investigated the economic burden of keratoconus to patients and society including a patient's lifetime expenditure. Analysing disease cost is important in advocating funding and planning for appropriate management and treatment.</p><p><strong>Background: </strong>Keratoconus can be an expensive disease, including costs associated with visual rehabilitation and surgery. This study aimed to assess direct and indirect expenditures incurred by keratoconus subjects, to estimate the lifetime per capita cost and the total costs of keratoconus per year in Auckland, New Zealand.</p><p><strong>Methods: </strong>A cross-sectional study where participants with keratoconus were recruited from public and private clinics to complete an anonymous questionnaire. A keratoconus health expenditure questionnaire was used to assess direct and indirect expenditures for participants. Estimated lifetime per capita costs and total direct and indirect costs associated with keratoconus were calculated.</p><p><strong>Results: </strong>Responses from 110 participants were recorded. Most participants (55.5%) were between the ages of 21 and 30, 59.1% were male, and Pacific People were over-represented (14.5%) compared to the national population. The prevalence of visual rehabilitation was low with 74.5% of participants never wearing contact lenses and 32.7% of subjects wearing spectacles purchased over 24 months prior. Few participants (26.5%) had subsidised care, including private health insurance with optical cover or the contact lens subsidy. Total direct and indirect costs are estimated to be NZD 30.9 million per year with an estimated lifetime per capita out-of-pocket cost of NZD 79,254.</p><p><strong>Conclusion: </strong>Subjects with keratoconus experience significant direct and indirect costs with limited subsidisation from the government and private health insurance. The significant out-of-pocket costs required for managing keratoconus are likely a significant barrier to accessing appropriate visual rehabilitation in New Zealand.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459429","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":"Advancing optometry education through global frameworks and international collaborations.","authors":"Khyber Alam, Jingyi Chen, May Ho, Yazan Gammoh, Lisa Jansen, Neilsen DeSouza, Amy Lim, Garry Fitzpatrick, Jessica Neuville","doi":"10.1080/08164622.2024.2412254","DOIUrl":"https://doi.org/10.1080/08164622.2024.2412254","url":null,"abstract":"<p><p>Global curriculum initiatives aim to enhance the education of optometrists across the world. This is done by establishing competencies and frameworks necessary for consistency in education and training. Through collaboration and knowledge exchange between educators and institutions, future optometrists can be equipped with the latest evidence-based knowledge and skills to deliver quality eye care, regardless of geographical location. This paper explores the concept of a global curriculum by investigating the global similarities and differences in definitions of optometry, regulation of the profession, assessment of competency, accreditation standards for education providers, curriculum frameworks, and scope of practice. Despite the challenges of advancing optometric education, there appear to be many opportunities to explore collaboration on an international scale. Three case studies are presented which demonstrate international collaborations among education providers to train local optometrists. Future technological advancements and the use of artificial intelligence may assist the development and delivery of a global curriculum.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388514","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":"Ten tips for writing a brilliant PhD thesis - and enjoying the process.","authors":"Nathan Efron","doi":"10.1080/08164622.2024.2413706","DOIUrl":"https://doi.org/10.1080/08164622.2024.2413706","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388520","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":"Radial polarisation patterns identify macular damage: a machine learning approach.","authors":"Gary P Misson, Stephen J Anderson, Mark C M Dunne","doi":"10.1080/08164622.2024.2410890","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410890","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Identifying polarisation-modulated patterns may be an effective method for both detecting and monitoring macular damage.</p><p><strong>Background: </strong>The aim of this work is to determine the effectiveness of polarisation-modulated patterns in identifying macular damage and foveolar involvement using a methodology that involved feature selection, Naïve Bayes supervised machine learning, cross validation, and use of an interpretable nomogram.</p><p><strong>Methods: </strong>A cross-sectional study involving 520 eyes was undertaken, encompassing both normal and abnormal cases, including those with age-related macular disease, diabetic retinopathy or epiretinal membrane. Macular damage and foveolar integrity were assessed using optical coherence tomography. Various polarisation-modulated geometrical and optotype patterns were employed, along with traditional methods for visual function measurement, to complete perceptual detection and identification measures. Other variables assessed included age, sex, eye (right, left) and ocular media (normal, pseudophakic, cataract). Redundant variables were removed using a Fast Correlation-Based Filter. The area under the receiver operating characteristic curve and Matthews correlation coefficient were calculated, following 5-fold stratified cross validation, for Naïve Bayes models describing the relationship between the selected predictors of macular damage and foveolar involvement.</p><p><strong>Results: </strong>Only radially structured polarisation-modulated patterns and age emerged as predictors of macular damage and foveolar involvement. All other variables, including traditional logMAR measures of visual acuity, were identified as redundant. Naïve Bayes, utilising the Fast Correlation-Based Filter selected features, provided a good prediction for macular damage and foveolar involvement, with an area under the receiver operating curve exceeding 0.7. Additionally, Matthews correlation coefficient showed a medium size effect for both conditions.</p><p><strong>Conclusions: </strong>Radially structured polarisation-modulated geometric patterns outperform polarisation-modulated optotypes and standard logMAR acuity measures in predicting macular damage, regardless of foveolar involvement.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388518","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":"Comparative analysis of central versus peripheral visual field test grids in the diagnosis of glaucoma.","authors":"Christian Kirou, Ali Khazandi, Jose J Estevez","doi":"10.1080/08164622.2024.2410034","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410034","url":null,"abstract":"<p><p>Accumulating evidence has recognised central visual field defects (CVFDs) as a common feature of glaucoma. Current glaucoma screening guidelines include peripherally biased perimetry (24-2 protocols), but test grids exist to test the integrity of the central visual field (10-2 protocols). However, the added benefit of incorporating central visual field assessments alongside peripheral-biased testing grids remains unclear. This scoping review aimed to compare the diagnostic accuracy of central versus peripheral visual field tests. A systematic search of six databases yielded relevant studies among glaucoma subjects. These studies were synthesised narratively, focusing on diagnostic performance indicators such as the area under the curve, sensitivity, specificity, diagnostic agreement, and structure-function concordance. Of the 1875 studies screened, 16 were included in the review. The comparative analyses demonstrated a similar diagnostic performance when comparing the ability of the 24-2 and 10-2 test grids to detect glaucoma or CVFDs. When utilising the mean deviation, the 24-2 area under the curve ranged between 0.81-0.87 and 0.74-0.84 for the 10-2, whilst the area under the curve of the pattern standard deviation was 0.95 and 0.82, respectively. The pattern standard deviation showed sensitivities reaching 0.75 for the 24-2 and 0.60 for the 10-2, with specificities as high as 0.95 for both test grids. Across all disease stages, CVFDs detected on the 24-2 demonstrated up to 88% agreement with functional damage detected on the 10-2. The agreement between structure-function damage was greatest when combining test grids with optical coherence tomography (88.7%). This review indicates that the 24-2 and 10-2 testing protocols offer comparable diagnostic performance for glaucoma, including detecting CVFDs. While targeted macula screening could provide additional diagnostic value in certain contexts, the evidence remains inconclusive. Further longitudinal studies, incorporating optical coherence tomography, are necessary to confirm these findings and consider the routine inclusion of CVFD screening in clinical practice.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388515","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":"Five-year changes in retinal nerve fibre layer thickness in the adult population: a population-based cohort study.","authors":"Hassan Hashemi, Mehdi Khabazkhoob, Samira Heydarian, Mohammad Hassan Emamian, Akbar Fotouhi","doi":"10.1080/08164622.2024.2410879","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410879","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Distinguishing between the pathological thinning of the retinal nerve fibre layer (RNFL) and age-related reduction requires a comprehensive understanding of the longitudinal changes in RNFL thickness within a healthy population.</p><p><strong>Background: </strong>To determine five-year changes in RNFL thickness and associated factors in people aged 45-69 years.</p><p><strong>Methods: </strong>This report pertains to the second and third phases of the Shahroud Eye Cohort Study. Participants were recruited by a multi-stage cluster sampling in Shahroud, Iran. Data on demographic details, visual acuity, non-cycloplegic refraction, and slit-lamp biomicroscopy were collected. High-definition optical coherence tomography was employed for retinal imaging.</p><p><strong>Results: </strong>A total of 1,524 eyes from 908 participants were examined. The average RNFL thickness was 92.2 ± 8.5 (95% CI: 91.6 to 92.8) and 93.1 ± 8.7 μm (95% CI: 92.5 to 93.7) in the first and second phases with a five-year mean change of 0.95 ± 4.15 μm (95% CI: 0.70 to 1.20). The RNFL thickness mean changes in the superior, inferior, nasal, and temporal quadrants were 2.51 ± 7.86 (95% CI: 2.01 to 3.02), 2.93 ± 7.39 (95% CI: 2.56 to 3.29), -0.53 ± 6.15 (95% CI: -0.84 to -0.21), and -1.01 ± 4.67 μm (95% CI: -1.27 to -0.75), respectively. The five-year changes in average RNFL thickness were inversely correlated with axial length (β = -0.69, <i>p</i> < 0.001), mean keratometry (β = -0.37, <i>p</i> = 0.017), and baseline RNFL thickness (β = -0.617, <i>p</i> < 0.001). In hyperopic individuals, the increase in average RNFL thickness (β = 0.65, <i>p</i> = 0.012) was significantly greater than in those with emmetropia. Macular volume (β = 1.65, <i>p</i> < 0.001) showed a direct association with five-year changes in average RNFL thickness.</p><p><strong>Conclusion: </strong>Over 5 years, RNFL thickness changes were clinically insignificant in the normal population. The mean RNFL thickness seems to remain stable unless there is ocular disease. However, increased axial length and steeper keratometric readings were linked to RNFL thinning. Those with thicker RNFL measurements were at higher risk of thinning over time.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388516","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":"Refractive errors, amblyopia risk factors and vision screening in children aged 7-10 years in Aotearoa New Zealand.","authors":"Rebecca W Findlay, Lucy K Goodman, Nicola S Anstice, Carol Chelimo, Cameron C Grant, Joanna M Black","doi":"10.1080/08164622.2024.2410036","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410036","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Vision screening is important for detecting undiagnosed vision conditions that are common in school-aged children. However, current vision screening protocols are poor at detecting vision conditions that are most common in the Aotearoa New Zealand paediatric population.</p><p><strong>Background: </strong>Uncorrected refractive error and amblyopia are the most common causes of visual impairment in children. The most appropriate vision screening method depends on the refractive error profile of the population. This study aimed to: estimate the prevalence of refractive errors and amblyopia risk factors among children living in Aotearoa New Zealand; describe previous participation in preschool vision screening and determine the diagnostic accuracy of potential screening methods.</p><p><strong>Methods: </strong>Children aged 7-10 years received comprehensive eye examinations, including cycloplegic refraction, in their school. Eye examination results were assessed for refractive error and amblyopia risk factors. The sensitivity and specificity of individual vision tests for detecting any vision conditions was calculated to assess the most effective tests for vision screening.</p><p><strong>Results: </strong>Eye examinations were completed for 237 children and cycloplegic refraction data was available for 220 of these children. Significant refractive error (need for glasses) was detected in 23.6% of children (7.7% myopia, 7.7% hyperopia, 15.0% astigmatism). Amblyopia risk factors were detected in 9.1% of children. Preschool vision screening had been completed by 78.5% of children. Distance visual acuity screening alone had a sensitivity of 39% for detecting vision conditions, with addition of the Spot Vision Screener improving sensitivity to 65%.</p><p><strong>Conclusion: </strong>Astigmatism is the most frequent refractive error among children aged 7-10 years living in Aotearoa New Zealand. Distance visual acuity screening alone is ineffective in detecting refractive error in children in Aotearoa New Zealand. Further research investigating refractive errors across the paediatric population in Aotearoa New Zealand is required to determine the optimal timing and appropriate protocols for school-aged vision screening.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388519","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":"Effectiveness of surgical approach in the management of non-traumatic corneal perforations.","authors":"Onur Furundaoturan, Melis Palamar, Sait Egrilmez, Ayse Yagci, Ozlem Barut Selver","doi":"10.1080/08164622.2024.2411415","DOIUrl":"https://doi.org/10.1080/08164622.2024.2411415","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Non-traumatic aetiologies are one of the leading causes of corneal perforations. The management of corneal perforation is quite challenging and complex for anterior segment surgeons. The appropriate surgical approach for each case is usually determined on the basis of a combination of many different parameters.</p><p><strong>Background: </strong>The study aimed to evaluate surgical approach options and outcomes in the treatment of non-traumatic corneal perforations.</p><p><strong>Methods: </strong>Patient data who underwent surgery for non-traumatic corneal perforation between 2016 and 2023 were retrospectively evaluated. Medical records were assessed in terms of age, gender, perforation aetiology, the first and last examination notes, surgical approach, follow-up time, and additional surgeries and outcomes according to anatomical, therapeutic and functional success. Anterior segment photographs were investigated for thorough explanation of the examinations.</p><p><strong>Results: </strong>Forty-five eyes of 45 patients were included (mean age 61.2 ± 22.4 (90-2), female/male ratio 20/25). Surgical approaches applied according to the size and location of the perforation site included fibrin glue application (6), amniotic membrane transplantation (AMT) (9), corneal patch graft application(15), and tectonic keratoplasty (15). The ratio of inflammatory and infectious causes as the two main indications was 29/16. Globe integrity was ensured with the first surgery in 27 eyes. However, 17 eyes required secondary surgical attempts due to failure of the first approach and 1 eye underwent evisceration. AMT was the least successful method among other methods in anatomical, therapeutic, and functional assessment.</p><p><strong>Conclusion: </strong>There are various surgical approaches for repairing non-traumatic corneal perforations, each with its own advantages and disadvantages. These include high tissue resistance, the ability to remove necrotic tissue, ease of access, and anti-inflammatory activity. It is possible to successfully repair corneal perforations with single and combined methods, considering the above-mentioned features, especially depending on the size and location of the defect. While AMT is a viable and time-saving choice - especially in the lack of donor tissues - further interventions are necessary in most circumstances.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380128","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":"Retinopathy of prematurity screening: can the examination time be reduced?","authors":"Sabit Kimyon, Alper Mete, Sevim Ayça Seyyar","doi":"10.1080/08164622.2024.2410025","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410025","url":null,"abstract":"<p><strong>Clinical relevance: </strong>Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. Screening examinations that maintain accuracy, while improving the experience for families, could increase adherence to follow-up and decrease workload.</p><p><strong>Background: </strong>Traditional ROP screening examinations are known to be uncomfortable for babies and stressful for parents. A new strategy is proposed and tested for the accuracy of the outcome and the time taken.</p><p><strong>Methods: </strong>In this new screening strategy, the examiner performs a complete retinal examination on the first visit. If the area and stage of the nasal and temporal retinal regions are similar or the stage of the temporal half is worse, only the posterior pole and temporal half of the retina are evaluated at subsequent visits. A retrospective patient file review was conducted to compare the new proposal with accepted methods. ROP examination time was compared prospectively.</p><p><strong>Results: </strong>The data of 57 consecutive patients treated for ROP were evaluated. The ROP zone was the same in the nasal and temporal retina in all eyes at the first and last visit before treatment. Only two eyes had worse ROP stage in the nasal half at presentation but both halves developed the same degree of stage during follow-up. None of the treatment decisions were based only on the nasal region of the retina. Examination time was evaluated in 40 eyes of 20 infants. The average total time required for an examination with the accepted method was 241.3 ± 112.5 seconds. However, with the proposed strategy, the examination time was significantly reduced to 172.3 ± 69.2 seconds (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This screening strategy shortens examination time, which may help reduce pain and related adverse events.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342729","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":"Post traumatic focal globe rupture.","authors":"Arnav Panigrahi, Nawazish Shaikh","doi":"10.1080/08164622.2024.2410032","DOIUrl":"https://doi.org/10.1080/08164622.2024.2410032","url":null,"abstract":"","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342727","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}