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18%±12.2% (P=0.63) in controls. Significant correlations between change in IOP and change in ONH VD (correlation coefficient [r]=-0.42, P=0.04), and between change in IOP and change in RPC VD (r=-0.48, P=0.02) were observed in the cases, whereas none were observed in the controls. When multiple testing was considered, no significant changes in flow area and VD were observed in cases and controls.

The reduction of IOP by a PGA in treatment-naive eyes was significantly correlated to the increase in ONH VD and RPC VD. This may indicate a mechanism by which IOP reduction modulates the risk of glaucoma progression by improving ocular microperfusion.

The reduction of IOP by a PGA in treatment-naive eyes was significantly correlated to the increase in ONH VD and RPC VD. This may indicate a mechanism by which IOP reduction modulates the risk of glaucoma progression by improving ocular microperfusion.

There are no standardized process quality indicators (QIs) in glaucoma care. Although they can be inferred from guidelines and trials, they should be designed and standardized to allow better assessment of the quality of care.

QIs are crucial for assessing the performance of any health care system. To allow efficiency, effectiveness, and patient-centeredness, there is a need for prompt acquisition of up-to-date information. Among the available QIs, process indicators have the highest sensitivity to frequent changes and could better reflect the implementation outcomes of novel ideas and technology. This study aimed to map the available information regarding process QIs in glaucoma care, identify the current development stage of these indicators, and systematically synthesize them.

We performed a scoping review of 4 electronic bibliographic databases for studies reporting on process QIs in glaucoma. We retrieved 7502 references and created a domain list reflecting the core idea underlying each indicator.

We summarized information from 18 documents and listed 20 domains. The most mentioned domains were follow-up, optic nerve head assessment, visual field test, and intraocular pressure. Indicators regarding the quality of life assessment, patient assistance, or presence of written protocols were less frequently mentioned.

There are notable variations among process QIs in glaucoma and significant heterogeneity in their descriptions in published studies. Although novel indicators can be inferred from guidelines and trials, they should be designed and standardized for better assessment of performance in health systems to improve their quality.

There are notable variations among process QIs in glaucoma and significant heterogeneity in their descriptions in published studies. Although novel indicators can be inferred from guidelines and trials, they should be designed and standardized for better assessment of performance in health systems to improve their quality.

To assess the full thickness macular hole (FTMH) size using the choroidal hypertransmission signal on spectral domain optical coherence tomography (SD-OCT), and to compare this method to the standard aperture measurement of the minimum aperture size at the level of the neurosensory retina.

Cross-sectional study of retrospective data.

Eyes with FTMH imaged on SD-OCT were included. Two independent masked graders used the device's built-in caliper tool to measure the FTMH minimum aperture size at the level of the neurosensory retina, and the size of the corresponding hypertransmission signal below the level of the retinal pigment epithelium (RPE)/ Bruch's membrane complex. find more To assess the reproducibility of the hypertransmission measurement in tilted scans, two measurements were obtained and compared; the first was traced parallel to the RPE (parallel-hypertransmission), and the second was horizontal to the image frame (horizontal-hypertransmission), both using Image J software.

A total of 31 eyes were enrolled. The mean FTMH minimum aperture size was smaller compared to both the choroidal parallel-hypertransmission and horizontal-hypertransmission measurements (mean ± SD 335.7 ± 139.5 μm, 376.7 ± 150.6 μm, 375.1 ± 150.0 μm, respectively. P<0.001 for both comparisons).

The proposed hypertransmission measurement is a feasible and reproducible alternative to assess FTMH size and could provide the basis for an automated FTMH measurement on cross-sectional SD-OCT scans, as presented in this study, or on the SD-OCT volumetric dataset by using an en face projection.

The proposed hypertransmission measurement is a feasible and reproducible alternative to assess FTMH size and could provide the basis for an automated FTMH measurement on cross-sectional SD-OCT scans, as presented in this study, or on the SD-OCT volumetric dataset by using an en face projection.

To evaluate the outcomes and safety of retropupillary iris-claw intraocular lens (RICI) implantation and associated pars plana vitrectomy (PPV).

Multicenter, national audit of 325 eyes (325 patients). Demographics, surgical details, and complications are described. Visual acuity (VA), intraocular pressure (IOP) and central retinal thickness assessed by OCT were collected at 1, 3, 6 and 12 months after surgery. Kaplan-Meier curves were created to assess the cumulative probability of postoperative VA and IOP levels, macular edema (ME) development and corneal decompensation.

The cumulative probability of final VA ≤0.3 logMAR (≥20/40 Snellen) was 75.6% at 12-months follow-up. The probability of IOP >21, ≥25 and ≥30 mmHg was 48.1%, 33.1% and 19.0%, and the probability of IOP-lowering drops was 50.9% at 12 months. Glaucoma surgery was required in 4.3% of the eyes (14/325). link2 The cumulative probability of ME was 20.5% at 12-months and was greater in complicated cataract surgery than in IOL-luxation eyes (26% vs 16.7%, p=0.04). Corneal transplantation was required in 2.8% of the eyes (9/325).

This study on 325 eyes with aphakia or IOL dislocation managed with the RICI technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counselling and preoperative discussions.

This study on 325 eyes with aphakia or IOL dislocation managed with the RICI technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counselling and preoperative discussions.

To evaluate the association between female reproductive factors and the incidence of exudative age-related macular degeneration (AMD).

A total of 1,297,388 postmenopausal women over 50 years of age who participated in both national health screening and cancer screening in 2009 were identified using the Korea National Health Insurance System database. Data on female reproductive factors were collected using a self-administered questionnaire. Patients were followed up until 2018, and the incident cases of exudative AMD were identified. The hazard ratios and 95% confidence intervals for exudative AMD were estimated using the multivariable-adjusted Cox proportional hazard model.

During a mean follow-up of 7.27 years, 4,086 patients were newly diagnosed with exudative AMD. The hazard ratio (95% confidence intervals) for exudative AMD was 1.14 (1.01-1.31) for a reproductive period ≥ 40 years compared to a reproductive period < 30 years, and 1.72 (1.48-2.00) for patients with ≥ 5 years of hormone replacement therapy (HRT), and 1.29 (1.09-1.52) for those with 2-5 years of HRT compared to those who never underwent HRT.

Female reproductive factors were associated with the risk of exudative AMD. Greater lifetime exposure to endogenous and exogenous estrogen was associated with a higher incidence of exudative AMD.

Female reproductive factors were associated with the risk of exudative AMD. Greater lifetime exposure to endogenous and exogenous estrogen was associated with a higher incidence of exudative AMD.

To present a surgical technique that allows rescue (repositioning) of a dislocated Akreos AO model intraocular lens (IOL) using scleral sutures.

The surgical technique is described with supplemental video.

The technique was used in 4 eyes of 3 patients with 2-18 months of followup information. The IOL was well positioned and the visual acuity (as limited by other disease) was good, without adverse events.

Scleral suture techniques for repositioning of the Akreos AO IOL offers a suitable alternative to IOL exchange.

Scleral suture techniques for repositioning of the Akreos AO IOL offers a suitable alternative to IOL exchange.

Prehospital procedures (PHP) by emergency medical services (EMS) are performed regularly in penetrating trauma patients despite previous studies demonstrating no benefit. We sought to examine the influence of PHPs on outcomes in penetrating trauma patients in urban locations where transport to trauma center is not prolonged. We hypothesized that patients without PHPs would have better outcomes than those undergoing PHP.

This was an Eastern Association for the Surgery of Trauma-sponsored, multicenter, prospective, observational trial of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. The impact of PHPs and transport mechanism on in-hospital mortality were examined.

Of 2,284 patients included, 1,386 (60.7%) underwent PHP. The patients were primarily Black (n = 1,527, 66.9%) males (n = 1,986, 87.5%) injured by gunshot wound (n = 1,510, 66.0%) with 34.1% (n = 726) having New Injury Severity Score of ≥16. A total of 1,427 patients (62.5rban settings, even when performed during transport. Therefore, PHP should be forgone in lieu of immediate transport to improve patient outcomes.

Prognostic, level III.

Prognostic, level III.

Atopic dermatitis (AD) is complex with unmet needs and management challenges in clinical practice. link3 Little is known about patient satisfaction among adults with AD.

The aim of the study was to determine patterns and predictors of patient satisfaction among adults with AD.

Data were analyzed from the 2000-2015 Medical Expenditure Panel Survey. Patient satisfaction was assessed by the Consumer Assessment of Healthcare Providers and Systems survey.

Atopic dermatitis (linear regression; adjusted β [95% confidence interval 95% CI] = -0.75 [-1.25 to -0.25]) was associated with lower patient satisfaction compared with no AD. Adults with 1 or more office-based visits had increased odds of high satisfaction (>75th percentile; logistic regression; adjusted odds ratio [95% CI] = 1.81 [1.30-2.52]). Adults who saw an outpatient dermatologist or allergist had lower satisfaction (adjusted β [95% CI] = -0.65 [-1.27 to -0.03]). Patient satisfaction among adults with AD was associated with older age (adjusted β [95% CI] = 40-59 years, 1.85 [0.90-2.80]; ≥60 years, 6.13 [5.18-7.09]) and inversely associated with lower income (-1.82 [-2.68 to -0.96]) or middle income (-0.85 [-1.59 to -0.12]), race/ethnicity (Hispanic, -1.40 [-2.42 to -0.38]; other/multiracial, -2.34 [-3.53 to -1.15]), public (-4.50 [-6.43 to -2.58]) or no insurance (-4.53 [-6.47 to -2.59]), and multimorbidity (-0.48 [-0.61 to -0.35]).

Adults with AD in the United States had decreased patient satisfaction, particularly those with lower income, fewer outpatient visits, and multimorbidity. There are substantial unmet needs in patient satisfaction for AD.

Adults with AD in the United States had decreased patient satisfaction, particularly those with lower income, fewer outpatient visits, and multimorbidity. There are substantial unmet needs in patient satisfaction for AD.