AJO International最新文献

{"title":"Structural and functional clinician-reported outcomes show strong correlations with patient-reported outcomes in Retinitis Pigmentosa","authors":"Sofia Teixeira ,&nbsp;Maria Franca ,&nbsp;Nuno Gouveia ,&nbsp;Bruno Teixeira ,&nbsp;Rufino Silva ,&nbsp;Joaquim Murta ,&nbsp;João Pedro Marques","doi":"10.1016/j.ajoint.2025.100105","DOIUrl":"10.1016/j.ajoint.2025.100105","url":null,"abstract":"<div><h3>Purpose</h3><div>Retinitis Pigmentosa (RP) is the most common inherited retinal disease (IRD). The Michigan Retinal Degeneration Questionnaire (MRDQ) is a validated patient-reported outcome (PRO) measure designed to assess visual function in IRDs. This study aims to explore the association between functional and structural clinician-reported outcomes (CROs) and PROs in RP.</div></div><div><h3>Design</h3><div>Cross-sectional study</div></div><div><h3>Methods</h3><div>Study conducted at a Portuguese IRD referral center, including genetically confirmed RP patients from the IRD-PT registry (retina.com.pt). Collected clinical data encompassed demographics, genetic results, best-corrected visual acuity (BCVA), mean deviation (MD) and foveal sensitivity (FS) from automated static perimetry, ultra-widefield fundus autofluorescence (UW-FAF) patterns, and ellipsoid zone area measurements from spectral-domain optical coherence tomography (SD-OCT). Participants completed the Portuguese version of the MRDQ.</div></div><div><h3>Results</h3><div>The study included 72 RP patients (50% female, mean age 46.96±17.24 years) with disease-causing variants across twelve different genes. Median BCVA of the better-seeing eye was 71.50 (61.00, 80.00) ETDRS letters. A significant negative correlation (p&lt;0.001) was found between BCVA and all MRDQ domains. MD and FS also correlated negatively (p&lt;0.002) with several MRDQ domains. In structural measures, ellipsoid zone (EZ) area showed significant negative correlations with all MRDQ parameters (p&lt;0.05) except scotopic function and photosensitivity. UW-FAF patterns showed a significant association with scotopic (p=0.02) and mesopic peripheral functions (p=0.01).</div></div><div><h3>Conclusion</h3><div>This study reveals a strong correlation between PRO measures and both functional and structural CROs in RP. The MRDQ is a valuable tool for understanding self-perceived visual function in RP and should be used in therapeutic trials and personalized low vision rehabilitation.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420538","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":"Chat GPT 4o vs residents: French language evaluation in ophthalmology","authors":"Leah Attal ,&nbsp;Elad Shvartz ,&nbsp;Nakhoul Nakhoul ,&nbsp;Daniel Bahir","doi":"10.1016/j.ajoint.2025.100104","DOIUrl":"10.1016/j.ajoint.2025.100104","url":null,"abstract":"<div><h3>Purpose</h3><div>Chatbots capable of answering multiple-choice questions (MCQs) at a level comparable to residents could serve as affordable, 24/7 available educational tools with comprehensive explanations. Their non-judgmental nature could enable residents to freely ask questions without hesitation. Therefore, this study's aim is to evaluate ChatGPT 4o's accuracy to MCQs from the national ophthalmology residency examination in French language, compared to residents and other leading AI chatbots</div></div><div><h3>Methods</h3><div>A set of 600 questions from the national ophthalmology examination was translated into French and submitted to ChatGPT 4o, ChatGPT 4, and Gemini Advanced. The generated responses were compared to official correction grids to evaluate their accuracy. Additionally, variations over time, specialties, and accuracy with both text-based and image-based questions were analysed and compared to residents’ results.</div></div><div><h3>Results</h3><div>ChatGPT 4o achieved an accuracy rate of 67.5 %, outperforming the accuracy of ChatGPT 4 and Gemini Advanced. However, Gemini Advanced exhibited greater sensitivity to the ethical considerations involved in medical advice generation. ChatGPT 4o demonstrated consistent accuracy over time, with particular strength in the fundamentals of ophthalmology, ocular pathologies, and refractive surgery. Its performance in image processing was significantly improved compared to other chatbots, though still inferior to text-based processing.</div></div><div><h3>Conclusion</h3><div>ChatGPT 4o demonstrates sufficient accuracy to pass the ophthalmology national examination, though its performance falls short compared to that of residents. These findings suggest that the use of ChatGPT 4o as an educational tool in ophthalmology residency is promising, even in a non-English language. However, further improvements are needed to enhance its performances.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143291832","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":"Impact of a novel limbal-rigid contact lens on potential cost savings in Stevens-Johnson syndrome patients from postmarket surveillance","authors":"Kenichi Kimura ,&nbsp;Mayumi Ueta ,&nbsp;Hideki Fukuoka ,&nbsp;Koji Kitazawa ,&nbsp;Tsutomu Inatomi ,&nbsp;Shigeru Kinoshita ,&nbsp;Ryoichi Shiota ,&nbsp;Naoki Yamauchi ,&nbsp;Jiro Miyazaki ,&nbsp;Satomi Sakabayashi ,&nbsp;Satoshi Teramukai ,&nbsp;Kojiro Imai ,&nbsp;Kenji Konomi ,&nbsp;Yuichi Uchino ,&nbsp;Yoko Ogawa ,&nbsp;Takefumi Yamaguchi ,&nbsp;Jun Shimazaki ,&nbsp;Yoshiyuki Satake ,&nbsp;Chie Sotozono","doi":"10.1016/j.ajoint.2025.100101","DOIUrl":"10.1016/j.ajoint.2025.100101","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the safety, efficacy, and potential-cost-savings of a newly-developed limbal-rigid contact lens (CL) via postmarket surveillance (PMS).</div></div><div><h3>Design</h3><div>Postmarket prospective observational use-results surveillance with cost-savings analysis.</div></div><div><h3>Methods</h3><div>We examined 80 eyes of 68 Stevens-Johnson syndrome (SJS) cases using the newly-developed Suncon Kyoto-CS limbal-rigid CL (Sun Contact Lens). CL-wear-associated best-corrected visual acuity (BCVA), objective signs (i.e., bulbar-conjunctival hyperemia, upper-eyelid conjunctival scarring, eye discharge, keratoconjunctival epithelial defect, corneal opacification, and corneal neovascularization), and subjective symptoms (i.e., dryness and eye pain) at baseline and at 6-months of CL use were measured and compared, with adverse events noted. Potential cost savings from improvements in CL-wear-related BCVA were estimated based on the potential for improvements in each patient's visual-impairment-grade under the Japanese Pharmaceuticals and Medical Devices Agency (PMDA) disability pension plan. Main outcome measures were potential cost savings via use of the CL. Secondary outcome measures were CL safety and efficacy via PMS.</div></div><div><h3>Results</h3><div>At 6-months of CL use, the median BCVA in the CL-fitted eyes improved from 1.30 to 0.70 logMAR compared to that of spectacle correction at baseline (<em>P</em> &lt; 0.001), and improvement of bulbar-conjunctival hyperemia, dryness, and eye pain was observed (<em>P</em> &lt; 0.001, <em>P</em> &lt; 0.001, and <em>P</em> &lt; 0.001, respectively). No serious adverse events occurred. Potential-cost-savings analysis showed visual-impairment-grade improvement in 18 (28.6 %) of 63 patients. Considering the financial amount of the PMDA disability pension, estimated total potential cost savings was &gt;6.9-million U.S. dollars.</div></div><div><h3>Conclusion</h3><div>The newly-developed limbal-rigid CL was found safe and effective for treating SJS-associated ocular sequelae, and potentially reduces disability-pension costs.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427657","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":"Computational analysis of reproducibility and image quality of 2011 and 2017 models of Heidelberg Spectralis SD-OCT machines","authors":"Kyoung A Viola Lee ,&nbsp;Corey Tesdahl ,&nbsp;Keith Zimmerman ,&nbsp;Kimberly Jun ,&nbsp;Sabrina Khalil ,&nbsp;Alexander Shahin ,&nbsp;Abdullah Abou-Samra ,&nbsp;Ramesh Ayyala ,&nbsp;Radouil Tzekov","doi":"10.1016/j.ajoint.2025.100099","DOIUrl":"10.1016/j.ajoint.2025.100099","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluate the integrity, reproducibility, and image quality of total retinal thickness (TRT) measurements between two generations of Spectralis Spectral Domain Optical Coherence Tomography (SD-OCT) instruments (Old OCT: 2011, New OCT: 2017).</div></div><div><h3>Design</h3><div>Prospective cohort study evaluating TRT measurements across two visits.</div></div><div><h3>Subjects and participants</h3><div>Fourteen healthy individuals (28 eyes, age range: 22-54 years) underwent TRT measurements using both Old and New OCT models, with each eye receiving three consecutive scans per visit.</div></div><div><h3>Methods and testing</h3><div>TRT measurements were performed using the Posterior Pole Algorithm (PPA) and Early Treatment Diabetic Retinopathy Study (ETDRS) grid protocols. Reproducibility was evaluated using Average Pairwise Pearson Correlation (APPC), while image quality was measured by Signal-to-Noise Ratio (SNR) and Contrast-to-Noise Ratio (CNR). Agreement between the devices was analyzed through Bland-Altman plots, and spatial variability was visualized using heatmaps. The dimensionality reduction techniques Principal Component Analysis (PCA) and Multidimensional Scaling (MDS) were employed to explore data patterns.</div></div><div><h3>Main outcome measures</h3><div>Reproducibility of TRT measurements, image quality, and the degree of agreement between the two OCT models.</div></div><div><h3>Results</h3><div>Both the Old and New OCT models demonstrated high reproducibility (APPC: 0.995-0.998). While there was not a statistically significance difference in reproducibility between the OCT models, image quality analysis revealed superior SNR and CNR values for the New OCT in the left eye only, with significant improvements noted (CNR: p = 0.0040 at Visit 2; SNR: p = 0.0383 at Visit 1). Bland-Altman analysis confirmed strong agreement, with minimal mean differences and narrower limits of agreement for the New OCT. Heatmap analysis indicated greater inter-patient variability in the nasal retinal regions, while intra-patient variability was consistently low (&lt;1%) across both devices. PCA and MDS plots affirmed the reproducibility of measurements.</div></div><div><h3>Conclusions</h3><div>Both SD-OCT models provide reliable and consistent TRT measurements, with the New OCT offering marginally enhanced image quality. However, the reproducibility of the New OCT does not significantly outperform the Old OCT, supporting the use of both devices for accurate TRT assessment in clinical settings. Further studies may be required to evaluate these findings in pathological conditions.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171592","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":"Adjuntive nicergoline therapy for severe persistent corneal epithelial defects.","authors":"Valeria Oliva-Biénzobas ,&nbsp;Enrique O. Graue-Hernandez ,&nbsp;Guillermo Raul Vera-Duarte ,&nbsp;Jesus Cabral-Macías ,&nbsp;Juan Serna-Ojeda ,&nbsp;Victor Boullosa ,&nbsp;Arturo Ramirez-Miranda ,&nbsp;Vishal Jhanji ,&nbsp;Victor L. Perez ,&nbsp;Alejandro Navas","doi":"10.1016/j.ajoint.2025.100103","DOIUrl":"10.1016/j.ajoint.2025.100103","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to determine the effect of nicergoline in patients with persistent corneal epithelial defects.</div></div><div><h3>Methods</h3><div>This is a prospective, non-comparative interventional study. The study included ten eyes of 9 patients with persistent corneal epithelial defects unresponsive to conventional therapy. Patients were treated with 10 mg nicergoline orally twice daily for at least two weeks. Slit-lamp examination, photography, corneal fluorescein dye testing, and best-corrected visual acuity were performed before and after treatment.</div></div><div><h3>Results</h3><div>Two male and seven female patients with persistent corneal epithelial defects unresponsive to conventional therapy treated with oral nicergoline were included. The average age was 60.9 years (51–76 years). The most frequent diagnoses associated with persistent corneal defects were neurotrophic (3 patients) and exposure ulcer (2 patients). In eight eyes (72.7 %), epithelial defects entirely healed between 10 and 28 days of treatment with nicergoline (mean resolution time 17 days). Epithelial defects persisted in 2 eyes (27.3 %).</div></div><div><h3>Conclusion</h3><div>Nicergoline represents a potential therapeutic option in patients with abnormal corneal healing responses. Further studies and clinical trials must be conducted to prove safety and efficacy as a treatment for persistent corneal epithelium defects in humans.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171591","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":"Psychological empowerment after presbyopia correction: A narrative from Zanzibari women and men","authors":"Christine Graham ,&nbsp;Omar Juma Othman ,&nbsp;Adam Ali ,&nbsp;Eden Mashayo ,&nbsp;Ronnie Graham ,&nbsp;Fatma Omar ,&nbsp;Ving Fai Chan","doi":"10.1016/j.ajoint.2025.100098","DOIUrl":"10.1016/j.ajoint.2025.100098","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the empowerment experiences of Zanzibari craftswomen (<em>n</em> = 19) who received presbyopia correction, as well as perspectives from their husbands (<em>n</em> = 5) and male community leaders (<em>n</em> = 4).</div></div><div><h3>Design</h3><div>Qualitative phenomenological approach</div></div><div><h3>Methods</h3><div>Nineteen craftswomen who received presbyopia correction, five of their husbands and four community leaders were participated in the interviews. Craftswomen participants represented various crafts and locations across Zanzibar (Unguja <em>n</em> = 10, Pemba <em>n</em> = 9), with interviews conducted in Swahili. Data collection involved semi-structured interviews, and analysis employed both inductive and deductive thematic techniques.</div></div><div><h3>Results</h3><div>Craftswomen reported that wearing spectacles enhanced their ability to work, increased productivity, and improved confidence and independence. Psychological empowerment (PE) was evident in their decision-making and autonomy, as well as their capacity to support their families financially. Men observed the positive effects of spectacles on the women's self-reliance and community contributions. Participants noted that community attitudes toward wearing glasses were generally supportive, although some stigma persisted.</div></div><div><h3>Conclusion</h3><div>Presbyopia correction through spectacles facilitated significant PE among Zanzibari women, enhancing their independence, confidence, and productivity. A supportive community environment further bolstered empowerment, underscoring the importance of accessible eye care in improving quality of life and well-being.</div></div><div><h3>Precis</h3><div>We explored the empowerment experiences of 19 Zanzibari craftswomen following presbyopia correction, incorporating perspectives from their husbands and community leaders. Using a qualitative phenomenological approach, semi-structured interviews revealed enhanced productivity, independence, confidence, and psychological empowerment among the women. Male participants observed increased self-reliance and community contributions. While community attitudes were supportive, some stigma persisted. This highlights the transformative impact of accessible eye care on women's quality of life and underscore its broader societal benefits.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104498","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":"Natural history of non-neovascular pigment epithelial detachments (PEDs): Comparison between serous and drusenoid PEDs","authors":"Mathilde M. Goudot ,&nbsp;Eric H. Souied ,&nbsp;Donato Colantuono ,&nbsp;Camille Jung ,&nbsp;Carl-Joe Mehanna ,&nbsp;Benjamin Memmi ,&nbsp;Giuseppe Querques ,&nbsp;Salomon-Yves Cohen ,&nbsp;Alexandra Miere","doi":"10.1016/j.ajoint.2025.100100","DOIUrl":"10.1016/j.ajoint.2025.100100","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the long-term natural history of non-neovascular pigment epithelial detachments (nnPEDs), by comparing the multimodal imaging features of either serous or drusenoid PEDs (SPED and DPED) in patients with age-related macular degeneration.</div></div><div><h3>Methods</h3><div>Eyes with nnPEDs &gt; 700 μm in width and a height &gt; 150 μm on spectral domain optical coherence tomography (SD-OCT), with at least 12 months follow-up, were included. SPED and DPED were distinguished. SD-OCT qualitative and quantitative variables were compared at baseline, at the time of maximal PED height, and at the final visit.</div></div><div><h3>Results</h3><div>Forty-seven eyes of 31 patients were followed for 69 ± 35 months (mean age 68 ± 7.2 years): 27 eyes in the DPED group and 20 eyes in the SPED group. SPEDs were significantly higher and wider than DPEDs at the maximal PED height visit (<em>p</em> = 0.007 and <em>p</em> = 0.023, respectively). More apertures (<em>p</em> = 0.007), i.e., sharply demarcated discontinuities of the PED, and lateral subretinal fluid (<em>p</em> = 0.008) were observed in SPEDs. There was no significant difference between the two groups in the qualitative analysis or in the evolution over time. Ten eyes (50 %) with SPEDs and 11 eyes (41 %) with DPEDs (<em>p</em> = 0.46) progressed toward geographic atrophy, and 4 eyes (20 %) with SPEDs and 3 eyes (11 %) with DPEDs (<em>p</em> = 0.68) progressed toward fibrosis.</div></div><div><h3>Conclusion</h3><div>This analysis of large nnPEDs revealed that large PEDs pose a high risk of complications regardless of their nature.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171590","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":"Time spent on eye disease screening, optical care, and care navigation within a federally qualified health center","authors":"Madeline K. Weber ,&nbsp;Maria A. Woodward ,&nbsp;Ming-Chen Lu ,&nbsp;Leslie M. Niziol ,&nbsp;Jade Livingston ,&nbsp;Mildred Silva Zuccaro ,&nbsp;Suzanne Winter ,&nbsp;Rithambara Ramachandran ,&nbsp;Leroy Johnson ,&nbsp;Amanda K. Bicket ,&nbsp;Angela R. Elam ,&nbsp;Paula Anne Newman-Casey","doi":"10.1016/j.ajoint.2024.100097","DOIUrl":"10.1016/j.ajoint.2024.100097","url":null,"abstract":"<div><h3>Purpose</h3><div>To quantify time spent on eye disease screening, optical care, and care navigation tasks during the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program at a federally qualified health center (FQHC) in Michigan, with the goal of anticipating workforce needs to inform the scalability of similar programs in low-resource settings.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Ophthalmic technicians recorded time spent with MI-SIGHT participants on eye disease screening tasks and optical care over 22 days from October 1 to October 31, 2023, and care navigation tasks over 22 days from December 4, 2023, to February 2, 2024. Eye disease screening tasks included a health history, measuring visual acuity, contrast sensitivity, intraocular pressure, pachymetry, taking external and fundus photos and macular and retinal nerve fiber layer optical coherence tomography images. Optical care tasks included refraction, ordering glasses, coordinating glasses pickups, dispensing and fitting glasses, and handling returns. Care navigation tasks included scheduling follow-up appointments, assisting with insurance, and providing medical interpretation and education. Minutes spent on tasks were summarized with descriptive statistics (mean, standard deviation, median, minimum, and maximum). Full-time equivalent (FTE) was calculated as the percentage of full-time hours over 22 days.</div></div><div><h3>Results</h3><div>154 participants receiving care through the MI-SIGHT program were included. Technicians spent 21.4 % of an FTE on eye disease screening, 23.6 % on optical care, and 12.1 % on care navigation, with remaining FTE spent on other tasks including outreach, study coordination and research (42.9 %).</div></div><div><h3>Conclusions</h3><div>Integrating optical care and care navigation services within a free eye disease screening program is time-intensive but can help deliver comprehensive, accessible eye care to low-income populations. The MI-SIGHT program offers a model for expanding eye care services in FQHCs and improving vision outcomes for medically underserved communities. This study provides insights into personnel needs to guide the scaling of similar programs in low-resource settings.</div></div><div><h3>Precis</h3><div>The Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program offers a novel approach to eye care by providing free eye disease screenings, optical services, and care navigation at a federally qualified health center to improve vision outcomes and eye health in underserved communities. This time study provides workforce estimates to guide the scaling of similar comprehensive eye care programs in low-resource settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104308","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":"Geographical disparities in the prevalence of diabetic retinopathy in two contiguous states of South India","authors":"Siddharth Narendran ,&nbsp;Meenakshi Ambati ,&nbsp;Pricilla J ,&nbsp;Sujay Jaju ,&nbsp;Rekha Sreedhar ,&nbsp;Anju Jose ,&nbsp;Joseph Magagnoli ,&nbsp;Jaishree Pandian ,&nbsp;Karthik Srinivasan ,&nbsp;Rodney J Morris ,&nbsp;Kim Ramasamy ,&nbsp;Narendran Venkatapathy","doi":"10.1016/j.ajoint.2024.100096","DOIUrl":"10.1016/j.ajoint.2024.100096","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to examine geographic disparities in the prevalence of Diabetic Retinopathy (DR) and Vision-Threatening Diabetic Retinopathy (VTDR) between two neighboring South Indian states—Tamil Nadu (TN) and Kerala (KL).</div></div><div><h3>Design</h3><div>A retrospective cross-sectional analysis was conducted, utilizing medical records from five major tertiary hospitals focusing on Type II Diabetes Mellitus (DM) patients aged over 40, from January 2016 to January 2018.</div></div><div><h3>Methods</h3><div>Data from 213,440 patients with Type II DM were analyzed, including variables such as age, sex, duration of diabetes, and distance traveled to healthcare facilities. Propensity score matching (PSM) was employed to adjust for demographic, clinical, and spatial differences. Falsification tests was performed using Age-Related Macular Degeneration (ARMD) and Macular Hole (MH) as control outcomes.</div></div><div><h3>Results</h3><div>The prevalence of DR and VTDR was 21.22 % and 10.87 % in the KL cohort, compared to 8.47 % and 3.26 % in the TN cohort, respectively. Adjusted logistic regression, incorporating demographic, clinical, and spatial factors, showed that the KL cohort had an odds ratio of 1.912 (95 % CI: 1.810–2.020) for DR and 2.073 (95 % CI: 1.922–2.236) for VTDR. After PSM for both individual and spatial factors, the odds ratios for the KL cohort were 1.845 (95 % CI: 1.724–1.977) for DR and 1.917 (95 % CI: 1.746–2.105) for VTDR.</div></div><div><h3>Conclusion</h3><div>This study identifies regional disparities in DR and VTDR between TN and KL. These findings suggest the need for further research and targeted interventions to better understand and address the factors contributing to these disparities.</div></div><div><h3>Precis</h3><div>This study investigates the significant geographical disparities in the prevalence of Diabetic Retinopathy (DR) between Tamil Nadu and Kerala, two neighboring South Indian states with similar healthcare infrastructures. Analyzing over 200,000 patient records using robust statistical methods, including propensity score matching, the study reveals stark regional differences in DR prevalence. These findings emphasize the need for tailored public health interventions and further research into genetic, socioeconomic, and environmental determinants of diabetic eye diseases.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104309","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":"Clinical and management factors linked to good visual outcomes in Acanthamoeba keratitis: A Systematic review and meta-analysis","authors":"Germán Mejía-Salgado ,&nbsp;Juan Daniel Ribero ,&nbsp;Joaquín Alonso Pérez-Vivas ,&nbsp;Emmanuel Vazquez ,&nbsp;Ana María Amaya-Sánchez ,&nbsp;Alejandro Tello ,&nbsp;Virgilio Galvis","doi":"10.1016/j.ajoint.2024.100095","DOIUrl":"10.1016/j.ajoint.2024.100095","url":null,"abstract":"<div><h3>Purpose</h3><div>Summarize clinical characteristics and management-related factors associated with good visual outcomes in <em>Acanthamoeba</em> keratitis (AK), aiming to evaluate their collective impact on a global scale.</div></div><div><h3>Design</h3><div>Systematic review and metanalysis.</div></div><div><h3>Methods</h3><div>The study was registered with PROSPERO (CRD42024538378). Searches were conducted in PubMed, Embase, Virtual Health Library, and MedXRiv on January 13, 2024. Primary studies involving at least 10 eyes diagnosed with AK were included. The risk of bias was assessed using validated tools depending on the study design. Data extraction focused on demographics, clinical features, diagnostic methods, and treatment outcomes. Narrative synthesis, proportion meta-analysis, I² heterogeneity assessment, and Mann-Whitney U test were performed.</div></div><div><h3>Results</h3><div>Eighty-one studies involving 3,854 individuals (4,033 eyes) were analyzed. Patients who achieved good visual outcomes (final Corrected Distance Visual Acuity [CDVA] of 20/25 or better) were younger (mean age 27.7 vs. 35.8 years, <em>p</em>=0.031). Significant predictors of good visual outcomes included radial keratoneuritis (OR=3.44, 95 % CI: 1.57–7.52) and corneal epitheliopathy alone (OR=2.22, 95 % CI: 1.27–3.89) at presentation. Conversely, the presence of a ring-shaped stromal infiltrate at presentation (OR=0.21, 95 % CI: 0.07–0.58) and the use of corticosteroids before diagnosis (OR=0.18, 95 % CI: 0.09–0.68) were associated with a lower likelihood of achieving good visual outcomes. Post-diagnosis corticosteroid use did not significantly affect outcomes.</div></div><div><h3>Conclusion</h3><div>Early-stage AK signs, indicated by corneal epitheliopathy and radial keratoneuritis without a ring-shaped stromal infiltrate, are associated with good visual outcomes. Corticosteroid use before diagnosis is detrimental, but post-diagnosis use does not significantly impact outcomes. Younger patients generally have a better prognosis.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171585","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}