Clinical ophthalmology (Auckland, N.Z.)最新文献

{"title":"Relationships of the Duration from Onset and Macular Morphology with Metamorphopsia After Surgery for Macula-Off Rhegmatogenous Retinal Detachment.","authors":"Tadanobu Sato, Tadamichi Akagi, Daigo Kobayashi, Akiko Anraku, Yohei Nozaki, Takumi Ando, Hiromitsu Yoshida, Hiroko Terashima, Hiruma Hasebe, Takeo Fukuchi","doi":"10.2147/OPTH.S512396","DOIUrl":"10.2147/OPTH.S512396","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationships among postoperative metamorphopsia and postoperative macular morphological changes and the duration from the onset of visual field disturbance to surgery (DVD) in patients who underwent surgery for macula-off rhegmatogenous retinal detachment (RRD).</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 33 eyes of 33 patients who underwent pars plana vitrectomy (PPV) for macula-off RRD with known onset of symptoms of visual field disturbance at Niigata University Medical and Dental Hospital or Saiseikai Niigata Hospital and were followed up for at least 6 months postoperatively. Optical coherence tomography images of the macula obtained at 6 months postoperatively and DVD were analyzed, and the associations of the DVD with vertical metamorphopsia (vM) and horizontal metamorphopsia (hM) at 6 months postoperatively were evaluated using M-CHARTS.</p><p><strong>Results: </strong>vM was significantly correlated with the DVD and ellipsoid zone (EZ) disruption (<i>P</i> = 0.004 and <i>P</i> = 0.008, respectively), while hM was significantly correlated only with the DVD (<i>P</i> = 0.018). vM was significantly smaller in eyes with a DVD ≤ 7 days (0.34 ± 0.35)) than in eyes with a DVD ≥ 8 days (0.69 ± 0.32) (<i>P</i> = 0.005). In the multivariate analyses, postoperative vM was significantly associated with EZ disruption and the DVD (≤ 7 or ≥ 8 days) (<i>P</i> = 0.012 and <i>P</i> = 0.014, respectively).</p><p><strong>Conclusion: </strong>Metamorphopsia after PPV for macula off RRD was associated with the DVD and EZ disruption.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1119-1128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782289","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":"CompaRative Safety Analysis of Innovator and BioSimilar Ranibizumab in Chorioretinal Vascular Diseases - The CRsIBS Study.","authors":"Debdulal Chakraborty, Tushar Kanti Sinha, Sourav Sinha, Rupak Kanti Biswas, Aniruddha Maiti, Subhendu Boral, Arnab Das, Soumava Mandal, Ranabir Bhattacharya, Shouvick Dan, Dinesh Rungta","doi":"10.2147/OPTH.S515479","DOIUrl":"10.2147/OPTH.S515479","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the safety profiles of biosimilar ranibizumab (Razumab™) and innovator ranibizumab (Accentrix™) in the management of chorioretinal vascular diseases across a large, diverse patient cohort in a multicenter retrospective study.</p><p><strong>Methods: </strong>This multicenter, retrospective study analyzed data from 39,226 eyes treated with either biosimilar or innovator ranibizumab across 21 centers in India between January 2016 and March 2024. Eligible patients received intravitreal injections for conditions including age-related macular degeneration (AMD), diabetic macular edema (DME), retinal vein occlusion (RVO), and myopic choroidal neovascularization (CNVM). Patients were followed for a minimum of three months, with adverse events documented during follow-up visits. Safety outcomes were assessed based on ocular and systemic adverse events, with statistical analyses comparing frequencies between groups using chi-square and t-tests.</p><p><strong>Results: </strong>A total of 46,520 injections were administered in the innovator group (20,283 eyes; mean 2.29±1.53 injections per eye) and 45,310 injections in the biosimilar group (18,943 eyes; mean 2.39±1.61 injections per eye). Both groups showed comparable safety profiles. Ocular adverse events were mostly mild, with similar rates of transient blurring, subconjunctival hemorrhage, and ocular pain. Serious ocular events, including endophthalmitis, were rare (2 cases in each group). Systemic adverse events, such as myocardial infarction and cerebrovascular accidents, were also rare, with no statistically significant differences between groups. A higher incidence of anterior chamber inflammation was noted in the biosimilar group (p=0.005), while headache was significantly more common in this group (p=0.0002).</p><p><strong>Conclusion: </strong>This large-scale real-world study demonstrates that biosimilar ranibizumab offers a comparable safety profile to innovator ranibizumab in the management of chorioretinal vascular diseases. The affordability of biosimilar ranibizumab enhances its potential as a cost-effective alternative, particularly in resource-limited settings, without compromising safety.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1093-1102"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765843","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 Self-Test Refraction, Autorefraction, and Subjective Refraction.","authors":"Abraão Ferreira de Sousa Neto Kós, Bernardo Kaplan Moscovici, Cesar Vilar, Mario Augusto Pereira Dias Chaves, Maíra Gomes Barbosa Da Silva, Maurício Agne Neuwald, André Lins De Medeiros, Jonathan Clive Lake, Antonio Francisco Pimenta Motta, Patrick Frensel de Moraes Tzelikis, Pedro Carlos Carricondo, Larissa Gouvea, Walton Nosé, Wilson Takashi Hida","doi":"10.2147/OPTH.S510850","DOIUrl":"10.2147/OPTH.S510850","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the performance of a self-refraction device (EyeQue Vision Check 2, EyeQue, USA) with autorefraction (OPD-Scan III, NIDEK) and subjective cycloplegic refraction in measuring refractive errors.</p><p><strong>Methods: </strong>This descriptive study included 80 eyes from 40 patients. Measurements were obtained using the portable EyeQue device, OPD-Scan III, and subjective cycloplegic refraction performed by an experienced examiner. Spherical equivalent (SE), cylindrical power, and axis values were analyzed using power vector decomposition (M, J0, J45) to improve accuracy in comparing methods. The main outcome was the agreement between self-refraction, autorefraction, and subjective refraction.</p><p><strong>Results: </strong>The EyeQue device showed lower variability and greater homogeneity in spherical measurements but exhibited lower precision for cylindrical power and axis than subjective refraction. Power vector analysis revealed that EyeQue overestimated spherical equivalent (M) and produced higher J0 values, suggesting a tendency to alter cylindrical correction. Although comparable to OPD-Scan in spherical refraction, EyeQue demonstrated inconsistencies in astigmatism correction, particularly in J45 components.</p><p><strong>Conclusion: </strong>The EyeQue device is a promising tool for large-scale screenings due to its affordability and portability. However, its limitations in astigmatism and axis measurements indicate that subjective refraction should complement rather than replace it. Therefore, further refinement and validation in diverse populations are recommended.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1085-1092"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765844","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":"Fear of Cataract Surgery and Vision Loss: The Effects of Health Literacy and Patient Comprehension at an Academic Hospital-Based Eye Clinic.","authors":"Samantha Hu, Stephanie Wey, Rainier Arthur Yano, Lisa Diane Kelly","doi":"10.2147/OPTH.S490630","DOIUrl":"10.2147/OPTH.S490630","url":null,"abstract":"<p><strong>Purpose: </strong>This qualitative study assessed the relationship between health literacy and perceptions surrounding fear of cataract surgery and fear of vision loss in patients presenting to a Midwestern, urban, safety-net hospital-based clinic setting.</p><p><strong>Patients and methods: </strong>Forty-two patients were recruited from the Hoxworth Eye Clinic at the University of Cincinnati Medical Center. The inclusion criteria were as follows: established patient at the clinic, age 50 or older, diagnosis of cataract by ICD-10 and/or physical exam, and no history of prior cataract surgery. Each patient completed a survey of demographic information and questions targeting their understanding and attitudes surrounding cataract pathology and treatment, and the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF), a validated 7-item word recognition test assessing patient health literacy. Two-tailed t-tests assuming equal variances and chi-squared tests conducted in Excel were used in statistical analyses.</p><p><strong>Results: </strong>In our cohort (n = 42), there was no association between score on the REALM-SF and fear of cataract surgery (p = 0.87), but there was a significant association between fear of cataract surgery and belief that cataract surgery would improve vision (p = 0.03). Conversely, there was no significant association between fear of vision loss and belief that cataract surgery would improve vision (p = 0.92). The factors underlying these findings may be further clarified when attitudes surrounding cataract surgery and vision are categorized based upon best corrected visual acuity (BCVA). Patients with BCVA worse than 20/40 in only one eye fear cataract surgery more than patients with BCVA more than 20/40.</p><p><strong>Conclusion: </strong>In our patient population, neither health literacy nor understanding of cataract pathology was associated with fear of cataract surgery. However, given patients who feared cataract surgery were less likely to believe cataract surgery would improve vision, clarifying goals of surgery and addressing patient fears should be prioritized. Interestingly, this may be more important at earlier stages of non-visually significant cataracts for patients with good vision.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1103-1110"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774883","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":"Varenicline Solution Nasal Spray for the Treatment of Dry Eye Disease in Sjogren's Disease: A Pilot Study.","authors":"Angela S Gupta, Taylor J Linaburg, Emma Iacobucci, Patrick A Augello, Vivian L Qin, Gui-Shuang Ying, Vatinee Y Bunya, Mina Massaro","doi":"10.2147/OPTH.S512364","DOIUrl":"10.2147/OPTH.S512364","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the efficacy of varenicline solution nasal spray (VNS) in treating dry eye disease (DED) associated with moderate to severe Sjogren's disease and analyzed tear film cytokine levels of patients with DED and Sjogren's disease before and after VNS use.</p><p><strong>Methods: </strong>This was a pilot study involving a single-center, single-arm investigator-initiated trial. Patients with moderate to severe Sjogren's disease were given VNS 0.03 mg twice daily for 28 days. Patients were assessed on day 0 before VNS use, day 14 and day 28. Clinical exam findings, symptomatology as measured by the eye dryness score, and tear cytokines were assessed at baseline and day 28.</p><p><strong>Results: </strong>Thirty-nine subjects were included. Between day 0 and day 28, there was a statistically significant improvement in the eye dryness score (p = 0.01), corneal staining (p < 0.001), and conjunctival staining (p = 0.04). There was a statistically significant increase in tear secretion by unanesthetized Schirmer's in subjects with a baseline Schirmer's ≤5 mm (n = 35 eyes, p = 0.02) and a non-statistically significant increase in tear secretion in subjects with a baseline Schirmer's of 6-10 mm (n = 16 eyes, p = 0.79). There was a statistically significant decrease in tear film cytokine concentration of IFNγ (p = 0.0003), IL-12p70 (p < 0.0001), IL-17a (p = 0.004), IL-1β (p = 0.007), IL-2 (p < 0.0001), IL-4 (p = 0.01), and TNF-α (p = 0.02), and no significant change in IL-6 (p = 0.56) and IL-10 (p = 0.18).</p><p><strong>Conclusion: </strong>Our findings add to existing evidence that VNS improves subjective dry eye symptoms, corneal and conjunctival staining, and tear secretion in a subset of tear-deficient patients, while providing new evidence that VNS reduces concentration of pro-inflammatory cytokines in the tear film.</p><p><strong>Clinical trial registration number: </strong>NCT05700422.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1073-1084"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756477","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":"Dynamic Muscle Stimulation of the Periorbital Area for Improvement of Blinking in Dry Eye Patients.","authors":"James G Chelnis, Alexandra Chelnis","doi":"10.2147/OPTH.S513989","DOIUrl":"10.2147/OPTH.S513989","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether Dynamic Muscle Stimulation technology (DMSt) in the peri-orbital area improves blinking quality in subjects with lower lid laxity and dry eye disease (DED) due to Meibomian Gland Dysfunction (MGD).</p><p><strong>Patients and methods: </strong>Eligible subjects had lower lid laxity and DED due to MGD. Treatment consisted of DMSt administered 4 times at 1-week intervals. Outcome measures were tested before each treatment and at the follow-up (FU) 4 weeks after the final treatment. The main hypothesis was a decrease in the proportion of subjects with lower lid laxity, defined as abnormal lower lid distraction test (LLDT) or abnormal snap-back test (SBT). Outcomes related to DED comprised the modified meibomian gland score (mMGS), tear breakup time (TBUT), and symptoms of DED (OSDI). Other outcomes included the Margin to Reflex Distance 1 and 2 (MRD1 and MRD2), estimation of blink rate, blink quality, and eyelid appearance.</p><p><strong>Results: </strong>30 subjects completed FU. LLDT decreased from 11.1 (SD 2.2) mm to 5.3 (SD 1.3) mm (P<0.0001). The proportion of subjects with normal LLDT and SBT increased from 3% to 80% and from 30% to 93%, respectively (p<0.0001). Lower lid laxity decreased from 100% at BL to 23% at FU (p<0.0001). MRD2 gradually decreased from 5.5 (SD 0.9) mm at BL to 5.0 (SD 0.4) mm at FU (P<0.001). TBUT, mMGS, and OSDI changed by +286%, -78%, and -53%, respectively (P<0.0001). The proportion of subjects with normal eyelid appearance, blink quality, blink rate and eyelid closure increased from 0 to 63% (p<0.0001), 0 to 73% (p<0.0001), 36% to 93% (p<0.0001) and 73% to 100% (p<0.01), respectively. No adverse events occurred.</p><p><strong>Conclusion: </strong>In DED patients, DMSt in the peri-orbital area decreases lower lid laxity and improves blinking quality. These, in turn, may be useful for managing signs and symptoms of DED due to MGD.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1057-1071"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756473","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":"Optimal Timing for Intraocular Pressure Measurement Following Femtosecond Laser-Assisted Cataract Surgery: A Systematic Review and Meta-Analysis.","authors":"William J Herspiegel, Brian E Yu, Monali S Malvankar-Mehta, Cindy M L Hutnik","doi":"10.2147/OPTH.S509212","DOIUrl":"10.2147/OPTH.S509212","url":null,"abstract":"<p><strong>Purpose: </strong>Femtosecond laser-assisted cataract surgery (FLACS) has increasingly been adopted worldwide. Lagging behind is evidence-based consensus regarding optimal timing for intraocular pressure (IOP) measurement following FLACS. The purpose of this study was to determine if enough evidence currently exists to guide best practice.</p><p><strong>Methods: </strong>A comprehensive literature search was performed on MEDLINE and EMBASE until February 6th, 2023. Articles reporting IOP measurements following uncomplicated FLACS were screened. For change in IOP at various post-operative timepoints, standardized mean difference (SMD) was calculated as the mean difference in IOP from baseline. Risk of Bias Assessment was conducted following data extraction.</p><p><strong>Results: </strong>The meta-analysis incorporated six randomized clinical studies involving a total of 1356 eyes from 1032 participants. Post-operative day one was the only timepoint with a non-significant increase in IOP (SMD = -0.08 [95% CI: -0.41 to +0.24]) compared to the 7-days, 30-days, 60 to 90-days, and 180-days follow-up periods. All studies except one utilized an ophthalmic viscosurgical device (OVD) in their procedure; this was the only publication that reported a decrease in IOP from baseline within the 1-day follow-up period.</p><p><strong>Conclusion: </strong>The results suggest that the optimal time to measure IOP is within the first 24 hours after FLACS. However, these findings are limited by a small study sample. Future prospective clinical trials may be beneficial to determine if specific timepoints within the first 24 hours exist to optimize outcomes and patient reported experiences.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1045-1055"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756475","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":"Intravitreal Bevacizumab Alone Vs Combined With Topical Timolol-Dorzolamide or Dorzolamide for Diabetic Macular Edema: A Systematic Review and Meta-Analysis.","authors":"Rahaf A Hubayni, Jumanah Qedair, Ziad M Bukhari, Ali S Alsudais, Orjwan Salah Badghaish, Razan Osama Bawazir, Abdullah S AlQahtani, Hashem Almarzouki","doi":"10.2147/OPTH.S509136","DOIUrl":"10.2147/OPTH.S509136","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic macular edema (DME) is a major cause of vision loss in diabetes. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of intravitreal bevacizumab (IVB) combined with topical timolol-dorzolamide versus dorzolamide alone in DME patients.</p><p><strong>Patients and methods: </strong>A literature search was conducted across multiple databases until March 2024. Randomized controlled trials (RCTs) comparing IVB (1.25 mg, monthly) with topical dorzolamide-timolol (twice daily) or dorzolamide alone (twice daily) were included. Primary outcomes assessed were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at various intervals.</p><p><strong>Results: </strong>Four RCTs involving 98 patients (150 eyes) were analyzed, with a mean age of 57.9 years and a female predominance (55.1%). The subgroup meta-analysis indicated a weighted mean difference (WMD) in BCVA of -0.125 [95% CI: -0.21 to -0.041]. The IVB+D group showed no significant difference in WMD compared to the IVB and IVB+TD groups. IOP measurements revealed a WMD of -1.244 mmHg [95% CI: -2.548 mmHg to 0.06 mmHg], with a significant increase in the IVB group compared to the IVB+D and IVB+TD groups. CMT analysis showed a WMD of -78.875 μm [95% CI: -118.606 μm to -39.145 μm], with no significant differences among groups.</p><p><strong>Conclusion: </strong>Concurrent IVB with topical timolol-dorzolamide or dorzolamide alone demonstrated similar efficacy in improving BCVA and CMT in DME patients. However, the IVB+TD combination resulted in a more significant reduction in IOP compared to IVB alone.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1007-1019"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733718","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":"Detection Rate of Diabetic Retinopathy Before and After Implementation of Autonomous AI-based Fundus Photograph Analysis in a Resource-Limited Area in Belize.","authors":"Houri Esmaeilkhanian, Karen G Gutierrez, David Myung, Ann Caroline Fisher","doi":"10.2147/OPTH.S490473","DOIUrl":"10.2147/OPTH.S490473","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the use of an autonomous artificial intelligence (AI)-based device to screen for diabetic retinopathy (DR) and to evaluate the frequency of diabetes mellitus (DM) and DR in an under-resourced population served by the Stanford Belize Vision Clinic (SBVC).</p><p><strong>Patients and methods: </strong>The records of all patients from 2017 to 2024 were collected and analyzed, dividing the study into two time periods: Pre-AI (before June 2022, prior to the implementation of the LumineticsCore^® device at SBVC) and Post-AI (from June 2022 to the present) and subdivided into post-COVID19 and pre-COVID19 periods. Patients were categorized based on self-reported past medical history (PMH) as DM positive (diagnosed DM) and DM negative (no PMH of DM). AI camera outcomes included: negative for more than mild DR (MTMDR), positive for MTMDR, and insufficient exam quality.</p><p><strong>Results: </strong>A total of 1897 patients with a mean age of 47.6 years were included. The gradability of encounters by the AI device was 89.1%. The frequency of DR detection increased significantly in the Post-AI period (55/639) compared to the Pre-AI period (38/1258), including during the COVID-19 pandemic. The mean age of DR diagnosis was significantly lower in the Post-AI period (44.1 years) compared to Pre-AI period (60.7 years) among DM negative patients. There was a significant association between having DR and hypertension. Additionally, the detection rate of DM increased in the Post-AI period compared to Pre-AI period.</p><p><strong>Conclusion: </strong>Autonomous AI-based screening significantly improves the detection of patients with DR in areas with limited healthcare resources by reducing dependence on on-field ophthalmologists. This innovative approach can be seamlessly integrated into primary care settings, with technicians capturing images quickly and efficiently within just a few minutes. This study demonstrates the effectiveness of autonomous AI in identifying patients with both DR and DM, as well as associated high-burden diseases such as hypertension, across various age ranges.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"993-1006"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722721","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":"Microbial Keratitis Before, During and After the COVID-19 Pandemic, and the Role of Contact Lens Wear and Hand Hygiene.","authors":"Anna C Randag, Liesbeth Wellens, Nelly Kazemian, Barbara Schimmer, Jeroen van Rooij","doi":"10.2147/OPTH.S512671","DOIUrl":"10.2147/OPTH.S512671","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, there was a significant decline in the number of patients with both non-urgent and urgent ophthalmologic conditions presenting to emergency departments, leading to concerns about the whereabouts of patients in need of care. We hypothesized that there was an actual decrease in microbial keratitis (MK) cases, due to reduced contact lens (CL) wear and improved hand hygiene, including alcohol-based hand disinfection. Besides, we questioned if non-pharmaceutical interventions would have a sustained effect after the COVID-19 pandemic.</p><p><strong>Methods: </strong>Retrospectively, characteristics of patients presenting with MK at a large ophthalmic tertiary referral center were compared during 9 March-15 June of 2018 and 2019 (\"pre-COVID\"), 2020 (\"COVID\") and 2022 and 2023 (\"post-COVID\"). In an online cross-sectional survey among CL wearers, CL wear and hand hygiene habits were compared for the recall months February and April 2020.</p><p><strong>Results: </strong>Three hundred and one MK patients were included: 79 in 2018, 69 in 2019, 41 in 2020, 60 in 2022 and 52 in 2023. Presentation delay was ≥4 days in 38% during COVID, compared to 54% pre-COVID (p = 0.106). The proportion of CL related MK did not differ (p = 0.704). Fewer patients were admitted than pre-COVID (p = 0.026), without a difference in admission indications (p = 0.322). <i>Pseudomonas aeruginosa</i> and <i>Staphylococcus aureus</i> cases were not observed during COVID. Post-COVID, MK by <i>Pseudomonas aeruginosa</i> occurred more often than pre-COVID (p < 0.001). In the online survey with 791 respondents, hand washing before CL insertion and removal and hand disinfection were reported more often in April 2020 than February 2020 (respectively, p = 0.001, p < 0.001 and p < 0.001).</p><p><strong>Conclusion: </strong>We found no evidence of MK patients facing barriers to accessing hospital care during the COVID-19 pandemic, as presentation delays were not longer and cases not more severe. Our data suggest that a decreased MK incidence may be due to improved hand hygiene practices, including alcohol-based hand disinfection.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1033-1043"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712507","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}