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

{"title":"Ease of Use and Acceptability of an at-Home Vision Screening Kit in a Primarily Non-English Speaking, Underserved Population.","authors":"Timothy Do, Michael Nguyen, Kara Her, Bryan Kuo, Kevin Leung Chau, Madeleine Lu, Michele C Lim","doi":"10.2147/OPTH.S504861","DOIUrl":"10.2147/OPTH.S504861","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to investigate the ease of use, acceptability, and accuracy of a simple at-home vision screening kit in a non-English speaking socially disadvantaged population.</p><p><strong>Design: </strong>This is a single site, prospective, cross-sectional study.</p><p><strong>Methods: </strong>Patients at a clinic that provided free medical care to an urban, predominantly Asian, underserved population were invited to participate in this study. We designed a program for at-home vision assessment, which consisted of a simple at-home vision kit (Rosenbaum near card, Amsler grid) and instructions for use given in verbal and written form in the patient's own language. Testing was performed in each eye during an in-person visit. Patients were then asked to test at-home and were later contacted by telephone to record the results. A survey questionnaire assessing the ease of use and acceptability of the vision kit was then administered.</p><p><strong>Results: </strong>One hundred and one of 141 patients completed the study. Of those patients, 60.4% were female, 79.2% were Asian, 95% were born outside of the United States, 81.2% did not speak English as their primary language, 47.5% were not enrolled in health insurance, and 67.3% expressed difficulty in accessing eye care. The results of our survey (n = 101) demonstrated that 90% would continue utilizing the vision screening kit, 91.1% would recommend the vision screening kit to others, and 82.2% rated the vision screening kit as extremely easy to use. The Spearman's rank correlation coefficient for the in-person VA logMAR scores and at-home VA logMAR scores was calculated to be <i>ρ =</i> 0.862, <i>p < 0.0001</i> in the right eye and <i>ρ</i> = 0.834, <i>p < 0.0001</i> in left eye.</p><p><strong>Conclusion: </strong>Our tailored protocol and design of a simple at-home vision screening kit was widely accepted and easy to use by an underserved population in which English was not the primary spoken language. The kit demonstrated excellent correlation between in-person and at-home VA results.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"1021-1032"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712505","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":"Incidence and Factors Related to Double Anterior Chamber Complications After Deep Anterior Lamellar Keratoplasty.","authors":"Jane Huang, Kohei Asano, Eiichi Uchio","doi":"10.2147/OPTH.S508993","DOIUrl":"10.2147/OPTH.S508993","url":null,"abstract":"<p><strong>Background: </strong>Deep anterior lamellar keratoplasty (DALK) has safety advantages over penetrating keratoplasty. However, one of the serious complications of DALK is Descemet membrane (DM) detachment, which can lead to double anterior chamber (DAC) and visual impairment. This study examines the incidence and factors related to the complication of DAC after DALK, including preexisting conditions such as atopic dermatitis (AD).</p><p><strong>Methods: </strong>This is a retrospective evaluation of all patients who underwent DALK from January 2019 to April 2024 in the Department of Ophthalmology, Fukuoka University Hospital. Cases with DAC postoperatively were analyzed statistically. A total of 85 eyes in 73 patients were included. We excluded eyes with preexisting corneal perforations that required grafts that were less than 6mm in diameter. A binomial logistic predictive model was used to determine factors associated with postoperative DAC. Collated variables were age, AD, preexisting corneal diseases, donor button size, intraoperative DM perforation, and cornea supply source.</p><p><strong>Results: </strong>Among 85 eyes that underwent DALK, 12 eyes (14.1%) developed postoperative DAC. Binomial regression analysis revealed preexisting corneal diseases (p=0.031) including preoperative DM perforation, infectious keratitis, keratoconus, corneal dystrophy, and corneal scar, intra-operative DM perforation (p=0.049), and AD (p=0.031) to be significant factors associated with DAC. This binomial regression model had 83.3% sensitivity and 78.0% specificity.</p><p><strong>Conclusion: </strong>AD and preexisting corneal diseases were significant factors in DAC after DALK, and DALK during active infection predisposes to DAC, while intraoperative perforation was also significantly associated. Our study suggests that these factors could be of importance in considering the mechanism of pathogenesis of DM and DAC.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"985-991"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701502","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":"Evaluation of the Retinal Nerve Fiber Layer and Ganglion Cell Layer After Laser-Assisted in situ Keratomileusis, Femtosecond-Laser in-situ Keratomileusis, and Small Incision Lenticule Extraction Using Optical Coherence Tomography.","authors":"Yasmine Maher Shaaban, Tamer Abdel Fattah Badran","doi":"10.2147/OPTH.S509766","DOIUrl":"10.2147/OPTH.S509766","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of applied suction using microkeratome Laser-assisted in situ keratomileusis. (LASIK), femtosecond-laser in-situ keratomileusis (Fs-LASIK), and Small Incision Lenticule Extraction (Fe-SMILE) on the thickness of the Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Layer (GCL).</p><p><strong>Patients and methods: </strong>This study included 72 eyes divided into three groups, each with 24 eyes. Each group underwent one of three different procedures. Preoperatively, at one day, one week, and three months postoperatively, Spectral Domain Optical Coherence Tomography (SD-OCT) was used to evaluate the thickness of RNFL and GCL.</p><p><strong>Results: </strong>Preoperatively and at one day, one week, and three months postoperatively, the mean values for RNFL thickness in the LASIK group were 93.2 ± 3.2, 105.9 ± 3.8, 106.2 ± 3.3, and 93.3 ± 3.6 μm, respectively; for the Fs-LASIK group, they were 95.9 ± 3.1, 100.2 ± 3.3, 100.5 ± 3.3, and 96.1 ± 3.1 μm, respectively; and for the Fe-SMILE group, they were 95.6 ± 1.9, 99.8 ± 1.7, 100.2 ± 1.8, and 95.8 ± 1.9 μm, respectively. The mean values for GCL thickness in the LASIK group were 73.9 ± 4.7, 90.2 ± 2.8, 90.8 ± 2.2, and 74.8 ± 4.5 μm, respectively; for the Fs-LASIK group, they were 77.8 ± 4.2, 80.2 ± 3.7, 80.3 ± 3.7, and 77.8 ± 3.5 μm, respectively; and for the Fe-SMILE group, they were 77.0 ± 3.7, 79.8 ± 3.6, 80 ± 3.7, and 77.1 ± 3.6 μm, respectively.</p><p><strong>Conclusion: </strong>All three procedures resulted in a transient increase in RNFL and GCL thicknesses. This increase was rapid, limited, transient, and reversible. It peaked for a week and returned to baseline by the end of this three-month study. At day one and day seven post-operatively, the Lasik group exhibited statistically significantly higher values than the Fs-Lasik and Fe-Smile groups.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"973-984"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694716","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 the Aireen System with Telemedicine Evaluation by an Ophthalmologist - A Real-World Study.","authors":"Martin Šín, Renata Ženíšková, Martin Slíva, Kamila Dvořák, Jozefína Vaľková, Jan Bayer, Barbora Karasová, Jan Tesař, Dana Fillová, Martin Prázný","doi":"10.2147/OPTH.S511233","DOIUrl":"10.2147/OPTH.S511233","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare general ophthalmologists, retina specialists, and Aireen AI screening system with the clinical reference standard of a three-member high-level expert committee for diabetic retinopathy (DR) in the evaluation of fundus images for DR.</p><p><strong>Patients and methods: </strong>The study was designed as a diagnostic, multicenter, cross-sectional, non-randomized diagnostic study. The cohort included in the clinical investigation consisted of 1274 patients with diabetes mellitus (DM) type I or II. Each patient underwent one-field fundus photography using a non-mydriatic camera to assess findings of DR. One hundred and nineteen subjects (9.3%) were excluded from the clinical investigation based on Aireen system assessment. In the clinical investigation, all images were assessed at three independent levels of evaluation: 1) general ophthalmologists (GO) - without subspecialty training in the retina; 2) retina specialists (RS); and 3) system Aireen. In cases where there may be disagreements amongst groups, the image is referred for assessment by the Diabetic Retinopathy Board (DRB).</p><p><strong>Results: </strong>The overall prevalence of any DR was 31.9% (368 cases out of 1154 DM), according to the DRB. Overall concordance between AI system Aireen and GO and RS assessments in the detection of DR from fundus photography occurred in 734 cases (63.6%). The number of disagreements between Aireen system, GO and RS evaluation occurred in 420 (36.4%) cases. Sensitivity for GO was 87.0% (95% CI: 83.6; 90.4), for RS was 82.9% (95% CI: 79.1; 86.7), and for AI system Aireen was 92.1% (95% CI: 89.3; 94.9). Specificity was 76.5% (95% CI: 73.5; 79.5), 81.2% (95% CI: 78.5; 83.9), and 90.7% (95% CI: 88.7; 92.7) for GO, RS and AI system Aireen, respectively.</p><p><strong>Conclusion: </strong>This real-world study illustrates the potential use of AI system Aireen in screening for DR. It exhibits higher sensitivity and specificity compared to telemedicine evaluation of one field fundus image.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"957-964"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694435","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":"Development and Evaluation of a Deep Learning Algorithm to Differentiate Between Membranes Attached to the Optic Disc on Ultrasonography.","authors":"Vaidehi D Bhatt, Nikhil Shah, Deepak C Bhatt, Supriya Dabir, Jay Sheth, Tos T J M Berendschot, Roel J Erckens, Carroll A B Webers","doi":"10.2147/OPTH.S501316","DOIUrl":"10.2147/OPTH.S501316","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to create and test a deep learning algorithm that could identify and distinguish between membranes attached to optic disc [OD; retinal detachment (RD)/posterior vitreous detachment (PVD)] based on ocular ultrasonography (USG).</p><p><strong>Patients and methods: </strong>We obtained a database of B-scan ultrasonography from a high-volume imaging center. A transformer-based Vision Transformer (ViT) model was employed, pre-trained on ImageNet21K, to classify ultrasound B-scan images into healthy, RD, and PVD. Images were pre-processed using Hugging Face's AutoImage Processor for standardization. Labels were mapped to numerical values, and the dataset was split into training and validation (505 samples), and testing (212 samples) subsets to evaluate model performance. Alternate methods, such as ensemble strategies and object detection pipelines, were explored but showed limited improvement in classification accuracy.</p><p><strong>Results: </strong>The AI model demonstrated high classification performance, achieving an accuracy of 98.21% for PVD, 97.22% for RD, and 95.83% for normal cases. Sensitivity was 98.21% for PVD, 96.55% for RD, and 92.86% for normal cases, while specificity reached 95.16%, 100%, and 95.42%, respectively. Despite the overall strong performance, some misclassification occurred, with seven instances of RD being incorrectly labeled as PVD.</p><p><strong>Conclusion: </strong>We developed a transformer-based deep learning algorithm for ocular ultrasonography that accurately identifies membranes attached to the optic disc, distinguishing between RD (97.22% accuracy) and PVD (98.21% accuracy). Despite seven misclassifications, our model demonstrates robust performance and enhances diagnostic efficiency in high-volume imaging settings, thereby facilitating timely referrals and ultimately improving patient outcomes in urgent care scenarios. Overall, this promising innovation shows potential for clinical adoption.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"939-947"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694712","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":"The Visual Outcomes After Pars Plana Vitrectomy for Dropped Lens Fragments in the National Eye Hospital of Vietnam.","authors":"Nguyen Kien Trung, Nguyen Le Trung","doi":"10.2147/OPTH.S505893","DOIUrl":"10.2147/OPTH.S505893","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of visual acuity results and analysis of influencing factors after vitrectomy surgery to treat complications of nuclear fragment fall at the Vietnam National Eye Hospital.</p><p><strong>Patients and methods: </strong>A cross-sectional study description of 35 patients (35 eyes) at Vietnam National Eye Hospital assessment of Visual acuity pre and post-pars plana vitrectomy, and some related factors.</p><p><strong>Results: </strong>Patients had low visual acuity (VA) upon admission, with 82.9% (29/35 eyes) ranging from CF 1m to LP (+). At 3 months, VA mainly improved to levels 3 and 4, with only 3/35 eyes achieving better than 20/40. The primary factors influencing visual outcomes were anterior segment lesions, timely detection, and treatment to enhance postoperative vision.</p><p><strong>Conclusion: </strong>After PPV, most patients showed some improvement, though changes in VA varied among individuals. Key factors affecting visual outcomes included anterior segment lesions, highlighting the importance of timely detection and treatment to improve postoperative vision.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"965-971"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694728","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":"Virtual Reality Visual Field Testing in Glaucoma: Benefits and Drawbacks.","authors":"Adrian T Babel, Mohamed M Soumakieh, Allison Y Chen, Caroline Wong, Douglas R da Costa, David R P Almeida","doi":"10.2147/OPTH.S511803","DOIUrl":"10.2147/OPTH.S511803","url":null,"abstract":"<p><strong>Importance: </strong>Virtual reality-assisted visual field testing (VRVFT) is a novel modality for evaluating glaucoma progression, offering potential advantages over standard automated perimetry (SAP). To date, no narrative literature review has comprehensively discussed the benefits and drawbacks of VRVFT for glaucoma patients.</p><p><strong>Observations: </strong>A narrative literature review was conducted using PubMed and MEDLINE via EBSCOhost, covering articles published from 2014 to October 2023. The search terms used were \"virtual reality visual field\" AND \"glaucoma\". Filters applied included \"Free full text\", \"Full text\", and \"Peer Reviewed.\" Inclusion criteria encompassed studies evaluating VRVFT in relation to glaucoma. Exclusion criteria included duplicates, meta-analyses, literature not discussing glaucoma or VRVFT, and other literature reviews. Sixteen studies met the inclusion criteria, comprising various study designs. VRVFT showed comparable reliability and efficacy to SAP in detecting glaucomatous visual field defects. Benefits of VRVFT included improved accessibility, patient comfort, and resource optimization. Drawbacks included technical limitations such as restricted luminance range, lack of sophisticated eye-tracking in some devices, and implementation challenges like patient technology familiarity and access to equipment.</p><p><strong>Conclusion: </strong>VRVFT presents several benefits, making it a promising alternative or complement to conventional glaucomatous visual field testing in outpatient clinics and remote settings. Addressing technical limitations and standardizing protocols are essential for broader clinical adoption.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"933-937"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694730","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":"Outcomes in Recurrent Rhegmatogenous Retinal Detachment Repair: Does Scleral Buckling at Primary or Secondary Surgery Impact Results?","authors":"Mélanie Hébert, Jérôme Garneau, Sihame Doukkali, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani","doi":"10.2147/OPTH.S507985","DOIUrl":"10.2147/OPTH.S507985","url":null,"abstract":"<p><strong>Background/objectives: </strong>To analyze outcomes in recurrent rhegmatogenous retinal detachment (re-RRD) repair using pars plana vitrectomy (PPV) combined with scleral buckle (SB) at the first or second surgery.</p><p><strong>Subjects/methods: </strong>Patients with primary uncomplicated RRD at initial presentation who were operated for re-RRD between 2014 and 2018 were included in this retrospective cohort study (n = 127). Patients were compared based on first and second surgery sequence: PPV then PPVSB (PPV-PPVSB: n = 51, 40%), or PPVSB then PPV (PPVSB-PPV: n = 76, 60%). Anatomical and functional outcomes were evaluated with second surgery success (2SS) defined as absence of reoperation after the second surgery and final pinhole visual acuity (PHVA) in logarithm of the minimum angle of resolution (logMAR), respectively.</p><p><strong>Results: </strong>Mean age at initial presentation was 65.7 years. There were 78 (61%) men and 56 (44%) pseudophakic patients. Median [Q1, Q3] baseline PHVA in logMAR was 0.70 [0.18, 2.30]. SB at first or second surgery did not significantly alter 2SS (PPV-PPVSB: 38, 75% vs PPVSB-PPV: 57, 75%; p = 1.00) or silicone oil use at second surgery (PPV-PPVSB: 18, 35% vs PPVSB-PPV: 36, 47%; p = 0.40). At final follow-up, PHVA did not significantly differ by sequence (p = 0.16).</p><p><strong>Conclusion: </strong>In re-RRD repair, SB at first or second surgery did not alter 2SS and final PHVA.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"949-956"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Ophthalmic Steroids in the Management of Polypoidal Choroidal Vasculopathy: A Systematic Review.","authors":"Gitalisa Andayani Adriono, Ichsan Fauzi Triyoga, Marcello Mikhael Kadharusman, Andi Arus Victor, Ari Djatikusumo, Anggun Rama Yudantha, Mario Marbungaran Hutapea","doi":"10.2147/OPTH.S517296","DOIUrl":"10.2147/OPTH.S517296","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to clarify the role of ophthalmic steroids in polypoidal choroidal vasculopathy (PCV) treatment.</p><p><strong>Methods: </strong>A systematic literature search was performed using Scopus, PubMed, MEDLINE, Cochrane, ProQuest, and manual searches. The primary outcome was changes in best-corrected visual acuity. The secondary outcomes were anatomical changes and incidence of adverse events.</p><p><strong>Results: </strong>Of the 100 articles identified, 9 studies were included: six treatment-naive studies, two anti-VEGF resistant studies, and one involving hemorrhagic retinal detachment. Triamcinolone acetonide was administered in seven studies, and dexamethasone in two. Altogether, 194 eyes received ophthalmic steroids in the form of intravitreal solution and slow-released implant. Overall, eight out of nine studies revealed visual acuity improvement from baseline to final follow-up, although only two studies reported significant results (0.33 ± 0.29 logMAR and 0.66 ± 0.28 logMAR) to final follow-up (0.16 ± 0.27 logMAR and 0.36 ± 0.31 logMAR). Adverse events were documented in six studies, with cataracts (6/96) and ocular hypertension (10/96) being the most common. Polyp regression and pigment epithelial detachment rates demonstrated a decline ranging from 50% to 100%. The maximum reduction observed in the central foveal thickness and central retinal thickness was -131.4 μm and -261.7 μm, respectively.</p><p><strong>Conclusion: </strong>Ophthalmic steroids may serve as an effective adjunctive treatment for PCV patients, irrespective of anti-VEGF resistance or hemorrhagic involvement, and may be considered as a potential monotherapy in resource-limited settings, with minimal side effects.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"915-931"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665749","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":"Statistical Evaluation of Smartphone-Based Automated Grading System for Ocular Redness Associated with Dry Eye Disease and Implications for Clinical Trials.","authors":"John D Rodriguez, Adam Hamm, Ethan Bensinger, Samanatha J Kerti, Paul J Gomes, George W Ousler Iii, Palak Gupta, Carlos Gustavo De Moraes, Mark B Abelson","doi":"10.2147/OPTH.S506519","DOIUrl":"10.2147/OPTH.S506519","url":null,"abstract":"<p><strong>Purpose: </strong>This study introduces a fully automated approach using deep learning-based segmentation to select the conjunctiva as the region of interest (ROI) for large-scale, multi-site clinical trials. By integrating a precise, objective grading system, we aim to minimize inter- and intra-grader variability due to perceptual biases. We evaluate the impact of adding a \"horizontality\" parameter to the grading system and assess this method's potential to enhance grading precision, reduce sample size, and improve clinical trial efficiency.</p><p><strong>Methods: </strong>We analyzed 29,640 images from 450 subjects in a multi-visit, multi-site clinical trial to assess the performance of an automated grading model compared to expert graders. Images were graded on a 0-4 scale, in 0.5 increments. The model utilizes the DeepLabV3 architecture for image segmentation, extracting two key features-horizontality and redness. The algorithm then uses these features to predict eye redness, validated by comparison with expert grader scores.</p><p><strong>Results: </strong>The bivariate model using both redness and horizontality performed best, with a Mean Absolute Error (MAE) of 0.450 points (SD=0.334) on the redness scale relative to expert scores. Expert graded scores were within one unit of the mean grade in over 85% cases, ensuring consistency and optimal training set for the predictive model. Models incorporating both features outperformed those using only redness, reducing MAE by 5-6%. The optimal generalized model improved predictive accuracy with horizontality such that 93.0% of images were predicted with an absolute error less than one unit difference in grading.</p><p><strong>Conclusion: </strong>This study demonstrates that fully automating image analysis allows thousands of images to be graded efficiently. The addition of the horizontality parameter enhances model performance, reduces error, and supports its relevance to specific Dry Eye manifestations. This automated method provides a continuous scale and greater sensitivity to treatment effects than standard clinical scales.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"907-914"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652555","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}