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7 points higher) than those without VI (
< 0.05). Those with cataract reported the highest daily activities and visual symptoms difficulty (7.6 points and 2.2 points higher, respectively,
< 0.05). Greater severity of VI was associated with increased self-reported difficulty for both factors, and for all causes of VI.
We present a psychometrically validated visual questionnaire particularly suited to older adults in residential homes. We show a significant association between cause/severity of VI and difficulty with daily activities and visual symptoms after adjusting for sociodemographic and medical factors.
Understanding the impact of vision loss on visual functions in the elderly will help in planning and resource allocation for developing early intervention programs for the elderly.
Understanding the impact of vision loss on visual functions in the elderly will help in planning and resource allocation for developing early intervention programs for the elderly.
The Caregiver's Congenital Glaucoma QoL (CarCGQoL) questionnaire was proposed as a measure of QoL of caregivers with children with primary congenital glaucoma (PCG). Support for its psychometric properties among other diagnostic groups is required for scores to be interpreted in the same manner across groups. Therefore we investigated the measurement properties and cross-diagnostic validity of the CarCGQoL questionnaire among caregivers of children with congenital cataract, retinopathy of prematurity (ROP), and blinding corneal disorders.
Eight hundred ninety-one caregivers (mean age, 28.3 years; 76% mothers) of children with congenital cataract (n = 407), ROP (n = 272), and blinding corneal disorders (n = 212) completed the CarCGQoL questionnaire. Rasch analysis was used to investigate the psychometric properties. Unidimensionality (by principal components analysis of residuals, PCA) was examined for each group and for pooled sample. Differential item functioning (DIF) was investigated to explore whetherIF must be taken into account.
When evaluating the impact of interventions on the caregiver's QoL using the CarCGQoL questionnaire in a pooled sample of pediatric ocular conditions, cross-diagnostic DIF must be taken into account.
Variation in retinal thickness with eye size complicates efforts to estimate retinal ganglion cell number from optical coherence tomography (OCT) measures. We examined the relationship among axial length, the thickness and volume of the ganglion cell layer (GCL), and the size of the optic chiasm.
We used OCT to measure GCL thickness over 50 degrees of the horizontal meridian in 50 healthy participants with a wide range of axial lengths. Using a model eye informed by individual biometry, we converted GCL thickness to tissue volume per square degree. We also measured the volume of the optic chiasm for 40 participants using magnetic resonance imaging (MRI).
There is a positive relationship between GCL tissue volume and axial length. Given prior psychophysical results, we conclude that increased axial length is associated with increased retinal ganglion cell size, decreased cell packing, or both. We characterize how retinal ganglion cell tissue varies systematically in volume and spatial distribution as a function of axial length. This model allows us to remove the effect of axial length from individual difference measures of GCL volume. We find that variation in this adjusted GCL volume correlates well with the size of the optic chiasm.
Our results provide the volume of ganglion cell tissue in the retina, adjusted for the presumed effects of axial length upon ganglion cell size and/or packing. The resulting volume measure accounts for individual differences in the size of the optic chiasm, supporting its use to characterize the post-retinal visual pathway.
Variations in ametropia can confound clinical measures of retinal features. We present a framework within which the thickness and volume of retinal structures can be measured and corrected for the effects of axial length.
Variations in ametropia can confound clinical measures of retinal features. We present a framework within which the thickness and volume of retinal structures can be measured and corrected for the effects of axial length.
Diabetics are more prone to suffer from dry eye (DE). The ages of diabetes are decreasing, so ocular surface status in younger generations is worthy of attention. We used tandem mass tag (TMT)-labeled proteomics and weighted correlation network analysis (WGCNA) to identify differentially expressed proteins in the tear proteome of adults and children with diabetic DE.
Study subjects were divided into six groups of 10, including three groups each for adults and children. The adult groups included diabetics with DE (A), diabetics without DE (B), and normal controls (C); the corresponding groups of children were identified as (D), (E), and (F). DE tests were performed on all subjects. We extracted total proteins and labeled them with TMTs for analysis. WGCNA was used to recognize hub genes.
Tear film function was poorer in patients with diabetic DE. In adults, 1922 proteins were identified, and WGCNA analysis revealed three hub genes related to diabetic DE. For children, 2709 proteins were identified, and WGCNA analysis identified one hub gene related to diabetic DE. Kyoto Encyclopedia of Genes and Genomes analysis found similarities among metabolic pathways involved in differential expression of proteins in adult and child tear samples.
The pathogenesis of diabetic DE was highly similar in adults and children. The differentially expressed tear proteins in type 2 diabetes of adults and children was associated with inflammation, immune factors, and lipid metabolism.
Our findings found high similarities in the pathogenesis of diabetic DE in adults and children.
Our findings found high similarities in the pathogenesis of diabetic DE in adults and children.
The purpose of this study was to evaluate experimentally the efficacy of femtosecond laser (FL)-assisted capsulotomy using an eye model with different degrees of zonular dehiscence (ZD).
An eye model with ZD was created by removing the total iris and including the planned range of the ZD in porcine and human cadaver eyes. PKM2 inhibitor cell line FL-assisted capsulotomies (laser group) and manual capsulotomies (manual group) were created for the eye model with 0, 45, 135, 180, and 270degrees of ZD. The continuity, mean diameter, ellipticity, and decentration of the capsulotomy were evaluated using the captured images. The same evaluation of FL-assisted capsulotomies was done for five human cadaver eyes with 180degrees of ZD.
In the laser group, no differences were seen in the mean diameter, ellipticity, and decentration, although the manual group resulted in significantly larger, ovalized, and decentered capsulotomies with different degrees of ZD (
< 0.001,
<0.001, and
=0.0317, respectively). Continuous capsulotomies or capsulotomies with microadhesions were obtained up to 180degrees of ZD, and incomplete treatment areas were seen in eyes with 270degrees of ZD. Capsulotomy of the human cadaver eyes with 180degrees of ZD showed similar results to those of porcine eyes.
In this experimental study, FL-assisted capsulotomy showed favorable results in eyes with between 0 and 180degrees of ZD compared to conventional manual capsulotomy.
Our experimental model can simulate the capsulotomy in cases with ZD, the results are useful when determining the indication for FL-assisted capsulotomies.
Our experimental model can simulate the capsulotomy in cases with ZD, the results are useful when determining the indication for FL-assisted capsulotomies.
Topical carbonic anhydrase inhibitors (CAIs) can influence retinal fluid distribution, but their role in treating central serous chorioretinopathy (CSCR) has not been studied. We examined the efficacy of a topical CAI (dorzolamide) in treating chronic CSCR.
Prospective, nonrandomized, controlled intervention study of patients with chronic CSCR of at least 3 months duration. Observed controls (
= 15) were recruited consecutively from 2016 to 2017; treated cases (
= 18) were recruited from 2018 to 2019. Controls were observed without active intervention, whereas treated cases were treated with topical dorzolamide for 3 months. The study end points were change in central macular thickness (CMT), change in best corrected visual acuity (BCVA), and proportion of eyes achieving complete resolution of subretinal fluid (SRF). All end points were at 3 months.
Treated patients who received topical CAI had greater reduction in CMT (-145.6 µm, 95% confidence interval [CI] -170.5 to -120.7) compared to observed controls (-45.1 µm, 95% CI -65.3 to -25.1) at the main study end point of 3 months (
= 0.015). A higher proportion of treated patients achieved complete resolution of SRF compared to observed controls (77.8% vs. 40.0%,
= 0.04) at 3 months. However, change in BCVA at 3 months was similar in both groups (
= 0.12).
Topical CAI resulted in more rapid reduction of CMT compared to observation. These results, if confirmed in other studies, suggest topical CAI may be a viable treatment option for patients with chronic CSCR.
Topical CAI is used to treat a number of retinal disorders, and may be a novel treatment option for chronic CSCR.
Topical CAI is used to treat a number of retinal disorders, and may be a novel treatment option for chronic CSCR.
To generate the first open dataset of retinal parafoveal optical coherence tomography angiography (OCTA) images with associated ground truth manual segmentations, and to establish a standard for OCTA image segmentation by surveying a broad range of state-of-the-art vessel enhancement and binarization procedures.
Handcrafted filters and neural network architectures were used to perform vessel enhancement. Thresholding methods and machine learning approaches were applied to obtain the final binarization. Evaluation was performed by using pixelwise metrics and newly proposed topological metrics. Finally, we compare the error in the computation of clinically relevant vascular network metrics (e.g., foveal avascular zone area and vessel density) across segmentation methods.
Our results show that, for the set of images considered, deep learning architectures (U-Net and CS-Net) achieve the best performance (Dice = 0.89). For applications where manually segmented data are not available to retrain these approaches, our findings suggest that optimally oriented flux (OOF) is the best handcrafted filter (Dice = 0.86). Moreover, our results show up to 25% differences in vessel density accuracy depending on the segmentation method used.
In this study, we derive and validate the first open dataset of retinal parafoveal OCTA images with associated ground truth manual segmentations. Our findings should be taken into account when comparing the results of clinical studies and performing meta-analyses. Finally, we release our data and source code to support standardization efforts in OCTA image segmentation.
This work establishes a standard for OCTA retinal image segmentation and introduces the importance of evaluating segmentation performance in terms of clinically relevant metrics.
This work establishes a standard for OCTA retinal image segmentation and introduces the importance of evaluating segmentation performance in terms of clinically relevant metrics.
