AJO International最新文献

{"title":"Intravitreal dexamethasone implant concomitant to cataract surgery in retinitis pigmentosa: potential retinal preservation effect","authors":"Maria Cristina Savastano ,&nbsp;Claudia Fossataro ,&nbsp;Federico Giannuzzi ,&nbsp;Benedetto Falsini ,&nbsp;Giorgio Placidi ,&nbsp;Valentina Cestrone ,&nbsp;Elena D'Agostino ,&nbsp;Ludovica Paris ,&nbsp;Debora Napoli ,&nbsp;Clara Rizzo ,&nbsp;Enrica Strettoi ,&nbsp;Stanislao Rizzo","doi":"10.1016/j.ajoint.2024.100085","DOIUrl":"10.1016/j.ajoint.2024.100085","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the potential maintenance of the ellipsoid zone (EZ) by optical coherence tomography (OCT) of retinitis pigmentosa (RP) patients, treated with intravitreal dexamethasone implant at the same time of cataract surgery.</div></div><div><h3>Design</h3><div>In this retrospective cohort study, sixty-two eyes of patients with RP and cataract were enrolled and sorted in two groups.</div></div><div><h3>Methods</h3><div>The first group (“Ozucat\" group) included 26 eyes of patients who underwent cataract surgery combined to dexamethasone intravitreal implant (Ozurdex, DEX implant). The second (“cataract alone” group) included 38 eyes who underwent only cataract surgery.</div></div><div><h3>Main Outcomes Measure</h3><div>We evaluated best corrected visual acuity (BCVA) in ETDRS letters and EZ length with retinal structural assessment (OCT).</div></div><div><h3>Results</h3><div>In the Ozucat group, the increase in EZ length from baseline was statistically significant both at 6-months (p&lt;0.0001) and 12-months (p&lt;0.0001) compared to “cataract alone” group. However, no statistical difference in BCVA was highlighted between the two groups.</div></div><div><h3>Conclusion</h3><div>Our study showed that eyes with typical RP, presenting cataract and concomitant signs of retinal inflammation, treated by combined cataract surgery and intravitreal dexamethasone implant, exhibited a maintenance of the EZ integrity, suggesting a potential retinal preservation effect of steroids.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744003","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":"FaceFinder: A machine learning tool for identification of facial images from heterogenous datasets","authors":"George R. Nahass ,&nbsp;Jeffrey C. Peterson ,&nbsp;Kevin Heinze ,&nbsp;Akriti Choudhary ,&nbsp;Nikhila Khandwala ,&nbsp;Chad A. Purnell ,&nbsp;Pete Setabutr ,&nbsp;Ann Q. Tran","doi":"10.1016/j.ajoint.2024.100083","DOIUrl":"10.1016/j.ajoint.2024.100083","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop an algorithm to automate the organization of large photo databases using the Haar cascade algorithm for face and eye detection and machine learning tools in Python.</div></div><div><h3>Design</h3><div>Retrospective study for the purposes of clinical tool development.</div></div><div><h3>Methods</h3><div>We developed an algorithm, termed FaceFinder, to identify front facing images in a large dataset of facial, orthodontal and miscellaneous images. FaceFinder works by detecting the presence of faces and at least two eyes using the Haar cascade. Execution time was recorded using different-sized datasets. A total of 895 images were analyzed by FaceFinder using various thresholds for face and eye detection. Precision, recall, specificity, accuracy, and F1 score were computed by comparison to ground truth labels of the images as determined by a human grader.</div></div><div><h3>Results</h3><div>Using medium thresholds for face and eye detection, FaceFinder reached recall, accuracy, and F1 score of 89.3%, 91.6%, and 92.9%, respectively with an execution time per image was 0.91 s. Using the highest threshold for face and eye detection, FaceFinder achieved precision and specificity values of 98.3% and 99.2% respectively.</div></div><div><h3>Conclusions</h3><div>FaceFinder is capable of sorting through a heterogenous dataset of photos of patients with craniofacial disease and identifying high-quality front-facing facial images. This capability allows for automated sorting of large databases that can facilitate and expedite data preparation for further downstream analyses involving artificial intelligence and facial landmarking.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663814","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":"Gender based differences in electronic medical record utilization in an academic ophthalmology practice","authors":"Madeline Ngo ,&nbsp;Whitney Stuard Sambhariya ,&nbsp;Madeline Myers ,&nbsp;Jennifer Cao ,&nbsp;Shivani Kamat ,&nbsp;Melanie Truong-Le","doi":"10.1016/j.ajoint.2024.100082","DOIUrl":"10.1016/j.ajoint.2024.100082","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate gender differences in EMR interaction among female and male ophthalmologists at a large tertiary academic center.</div></div><div><h3>Design</h3><div>Retrospective, cross sectional analysis</div></div><div><h3>Methods</h3><div>Data from Electronic Medical Record (EMR) system log files and health system administrative data from May 2022 to May 2023 were collected at an academic center. Primary outcomes were differences in time spent interacting with the EMR and In-basket message load between male and female ophthalmologists. Statistical analysis was adjusted for each physicians’ patient panel size, patient panel gender breakdown, and number of appointments.</div></div><div><h3>Results</h3><div>There were 30 ophthalmologists, 8 (27%) of whom were female. There was a significantly shorter mean length of employment for female ophthalmologists (5.62 ± 8.24 vs 15.26 ± 13.34 years, <em>p</em> = 0.028). In the 12-month analysis period, there was no significant difference in the total number of patients seen between female and male ophthalmologists. However, female ophthalmologists spent 69.6% more total time in the EMR system (409vs 241 h/MD, <em>p</em> &lt; 0.001). Female ophthalmologists spent 118% more time on task oriented in-basket sections such as patient notification, staff messages, and results (18 vs 8 h/ MD, <em>p</em> &lt; 0.001). Female ophthalmologists also received more in-basket messages, with a notable 750% higher volume of patient notification messages (187 vs 22, <em>p</em> &lt; 0.001) while male ophthalmologists received more Care Everywhere functionality notifications (14 vs 3, <em>p</em> &lt; 0.001) and hospital messages (477 vs 233, <em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>In our cohort, male ophthalmologists’ mean duration of employment was nearly 3 times longer than female ophthalmologists. Despite comparable patient panels and appointment completion rates, female ophthalmologists spent significantly more time in the EMR system and received significantly more in-basketand task directed messages. These findings underscore the need for further studies addressing gender disparities and promoting gender equity in ophthalmology practice settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700061","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":"Evolving practice patterns of young retinal specialists: A five-year comparison of treatment and surgical preferences","authors":"Vincent Huang ,&nbsp;Brian L VanderBeek ,&nbsp;Sidney A Schechet ,&nbsp;Hemang K Pandya ,&nbsp;Mitul C Mehta ,&nbsp;Jonathan C Tsui","doi":"10.1016/j.ajoint.2024.100081","DOIUrl":"10.1016/j.ajoint.2024.100081","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe trends in demographics and practice patterns of young retina specialists over a five-year follow-up period.</div></div><div><h3>Design</h3><div>A cross-sectional study of young retinal specialists conducted through an online social media platform to evaluate practice patterns for common conditions.</div></div><div><h3>Methods</h3><div>An anonymous survey was performed among U.S.-based young retinal specialists from a variety of practice environments in early stages of practice between August and September 2022. Results were compared to survey results from 2017.</div></div><div><h3>Results</h3><div>In 2022, the survey population included 358 members with 101 respondents compared to 44 respondents in 2017. Most respondents preferred bevacizumab as first-line treatment for foveal-involving diabetic macular edema (DME) (60%), vein occlusions (54%), and macular degeneration (56%). Aflibercept was more popular as first-line for DME patients with poor vision (51%) compared to those with good vision (18%). For proliferative diabetic retinopathy (PDR) without macular edema, respondents prefer panretinal photocoagulation alone (43%) or in combination with anti-VEGF (48%) over anti-VEGF alone (10%). Respondents repaired rhegmatogenous retinal detachments using combined vitrectomy-buckle (20%), primary scleral buckle (10%), and pneumatic retinopexy (PR) (10%). The percentage of respondents who have used PR at least once increased significantly from 2017 to 2022. From 2017 to 2022, more respondents use masks (29.5% to 82.8%) and post-injection antibiotics (2.3% to 16.0%) when performing injections while a smaller minority use topical gel anesthesia (34.1% to 15.5%).</div></div><div><h3>Conclusions</h3><div>Survey results suggest more providers are more likely to observe good visual acuity in diabetic edema and use laser alone in PDR without edema. In addition, longitudinal trends show increased use of PR, masks and post-injection antibiotics, and decreased use of topical gel anesthesia.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663813","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":"Candida parapsilosis keratitis: A case series","authors":"Liam D. Price ,&nbsp;Daniel Sibley,&nbsp;Scott Hau,&nbsp;Kirithika Muthusamy","doi":"10.1016/j.ajoint.2024.100080","DOIUrl":"10.1016/j.ajoint.2024.100080","url":null,"abstract":"<div><h3>Purpose</h3><div>to describe the diagnosis and management of <em>Candida parapsilosis</em> keratitis</div></div><div><h3>Design</h3><div>a retrospective, observational case series.</div></div><div><h3>Methods</h3><div>this study was carried out in a single-centre tertiary referral eye hospital and includes 20 eyes of 19 patients. Electronic case notes and in vivo confocal microscopy (IVCM) records were searched for the keyword ‘<em>parapsilosis’</em>, with inclusion if there was keratitis with either a corresponding positive polymerase chain reaction (PCR) or microbial culture result for <em>Candida parapsilosis</em>. Individual case notes were reviewed to obtain information regarding diagnosis, treatment, and final visual outcomes. Cases were excluded if a patient was lost to follow-up before the end of antifungal treatment.</div></div><div><h3>Results</h3><div>the risk factors for <em>C. parapsilosis</em> keratitis were: ocular surface disease, concurrent topical steroid use, previous corneal surgery and long-term contact lens wear. The mean presenting corrected distance visual acuity (CDVA) was LogMAR 1.49 (range 0.2 – 2.3), with a final CDVA of LogMAR 1.11 (-0.2 – 2.3). Where used, microbiological culture was positive in 19 out of 20 cases, PCR in 6 out of 11 cases, and IVCM in 8 out of 13 cases. Two-thirds of cases were managed with either topical voriconazole or amphotericin B, with four cases surgically managed by therapeutic keratoplasty and two cases requiring evisceration.</div></div><div><h3>Conclusions</h3><div>Patients presenting with microbial keratitis with risk factors for <em>C. parapsilosis</em> keratitis should be managed with a high degree of clinical suspicion. Post-infection visual outcomes are poor but reflect pre-existing ocular comorbidities. Delays in diagnosis can be reduced by through the use of ICVM and PCR.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663893","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":"Is Automated Machine Learning useful for ocular toxoplasmosis identification and classification of the inflammatory activity?","authors":"Carlos Cifuentes-González ,&nbsp;William Rojas-Carabali ,&nbsp;Germán Mejía-Salgado ,&nbsp;Gabriela Flórez-Esparza ,&nbsp;Laura Gutiérrez-Sinisterra ,&nbsp;Oscar J. Perdomo ,&nbsp;Jorge Enrique Gómez-Marín ,&nbsp;Rupesh Agrawal ,&nbsp;Alejandra de-la-Torre","doi":"10.1016/j.ajoint.2024.100079","DOIUrl":"10.1016/j.ajoint.2024.100079","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the performance of Automated Machine Learning (AutoML) models in diagnosing ocular toxoplasmosis (OT) and classifying its inflammatory activity from fundus photographs.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Fundus photographs from OT patients in two Colombian referral centers and an open-source OT database were classified into active OT, inactive OT, and no OT. Image quality assessment excluded images with artifacts but included blurry images due to vitritis. Photos were uploaded to Amazon Web Services S3 and Google Cloud Bucket. Two models were developed on each platform: a binary model (active/inactive OT vs. no OT) and a multiclass model (active OT, inactive OT, and no OT). Datasets were split into 70% for training, 20% for testing, and 10% for validation. Sensitivity, specificity, precision, accuracy, F1-score, the area under the precision-recall curve (AUPRC), and Cohen's Kappa were calculated for each platform and model. An external validation using an open-source image bank was performed.</div></div><div><h3>Results</h3><div>The binary model on AWS showed a sensitivity of 0.97, specificity of 0.98, and AUPRC of 1.00, while the Google Cloud binary model had a sensitivity of 0.82, specificity of 0.91, and AUPRC of 0.91. The multiclass model on AWS achieved an F1 score of 0.88, with Cohen's Kappa of 0.81, while the Google Cloud model reached an F1 score of 0.88, with Cohen's Kappa of 0.82. External validation for Google Cloud achieved an accuracy of 87.5% and 80.3% in the binary and multiclass models, respectively.</div></div><div><h3>Conclusions</h3><div>AutoML is a powerful tool for diagnosing OT and classifying inflammatory activity, potentially guiding diagnosis and treatment decisions.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663864","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":"Primary care telehealth visits are associated with earlier eye care in diabetic patients with high socioeconomic vulnerability","authors":"Peter J. Weng ,&nbsp;Jamie J. Karl ,&nbsp;Hemal Patel ,&nbsp;Ariana Allen ,&nbsp;Jullia Rosdahl ,&nbsp;Stefanie Schuman","doi":"10.1016/j.ajoint.2024.100077","DOIUrl":"10.1016/j.ajoint.2024.100077","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify factors associated with an ophthalmology visit in patients with Type 2 Diabetes Mellitus (T2DM), particularly among patients with high socioeconomic vulnerability (SeV).</div></div><div><h3>Design</h3><div>Comparative utilization analysis.</div></div><div><h3>Methods</h3><div>A retrospective review of the Duke Epic Database was performed on outpatient visits with a T2DM diagnosis between January 1, 2019 and January 1, 2024. Patients were included if they were over the age of 18 and had a subsequent outpatient visit 1 year after their first documented visit. Age, race, sex, hemoglobin a1c values, zip codes of residence and outpatient primary care clinic, and usage of primary care telehealth visits and nutrition services were also collected. SeV scores were calculated from the Social Vulnerability Index, established by the CDC. Logistic regression models were used to calculate odds ratios for health care services on the first ophthalmology visit and diabetic retinopathy diagnoses at first visit.</div></div><div><h3>Results</h3><div>Of the 42,151 patients with T2DM, 12,491 (29.6 %) visited an ophthalmology clinic. 35.6 % (3,677/10,338) of the lowest SeV quartile (least vulnerable) and 26.3 % (2,821/10,716) of the highest SeV quartile (most vulnerable) visited an ophthalmology clinic. In both SeV quartiles, primary care telehealth visits and nutrition services were associated with an increased odds of ophthalmology visit (<em>p</em> &lt; 0.001). Odds of proliferative diabetic retinopathy (PDR) at first ophthalmology visit were 75 % higher in the highest SeV quartile compared to the lowest SeV quartile (95 % CI: 1.29–2.38, <em>p</em> &lt; 0.001). When SeV quartiles were evaluated separately, telehealth was associated with significantly reduced odds of PDR at initial ophthalmology visit in only the highest SeV quartile (<em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>We found that primary care telehealth visits are associated with both an increased odds of visiting an ophthalmology clinic and a reduced odds of PDR at this first visit in patients who reside in areas with the highest levels of socioeconomic vulnerability. Additional studies on telehealth services, especially in patients with high SeV, are warranted and could help to improve understanding of the role of technology in screening for diabetic retinopathy.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571350","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":"Mycophenolate mofetil for the treatment of cicatrizing conjunctivitis secondary to ocular pemphigoid","authors":"Krista Thompson ,&nbsp;Blessing Johnny ,&nbsp;Ebuka Eziama ,&nbsp;Arturo R. Dominguez ,&nbsp;Jennifer H. Cao","doi":"10.1016/j.ajoint.2024.100078","DOIUrl":"10.1016/j.ajoint.2024.100078","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the use of mycophenolate mofetil (MMF) in a large cohort of patients undergoing treatment for ocular mucous membrane pemphigoid (ocMMP).</div></div><div><h3>Design</h3><div>This was a retrospective consecutive observational chart review of patients with cicatrizing conjunctivitis associated with pemphigoid (ocMMP) at the University of Texas Southwestern Medical Center in Dallas, TX from 2016 to 2023 who underwent treatment with MMF.</div></div><div><h3>Methods</h3><div>Data collection included patient demographics, medical and ocular history, clinical findings, slit lamp photographs, biopsy results, additional testing, disease stage, time on MMF, patient response to treatment, and side effects of treatment. The data was analyzed with logistic regression using IBM SPSS (version 29). The dependent variable was remission status.</div></div><div><h3>Results</h3><div>A total of 52 patients with cicatrizing conjunctivitis associated with pemphigoid were treated with MMF, of which 37 (71.2 %) patients had biopsy proven disease. Of the cohort, 29 (55.8 %) patients were female and 23 (44.2 %) patients were male. The mean age at initiation of MMF therapy was 65.1 years (range 35–93). The best degree of response achieved by each patient in our cohort was as follows: no response (4, 7.7 %), partial response (28, 53.8 %), clinical remission with steroids (4, 7.7 %), steroid-free remission (14, 26.9 %), and durable drug-free remission (2, 3.8 %). The mean time of treatment with MMF was 35.5 months (range 2–118), with a mean follow up time of 42.7 months (range 3–123). The mean time to clinical remission was 6.7 months (range 1–18), while the mean time to steroid-free remission was 7.2 months (range 2–18). Of the entire cohort, 16 (30.8 %) patients reported side effects. The most common side effect was nausea (7 patients). There was one adverse event (anemia, 1, 1.9 %). Overall, 30 (57.7 %) patients discontinued MMF, most commonly due to side effects (11 patients) or inadequate disease control (11 patients).</div></div><div><h3>Conclusion</h3><div>Mycophenolate mofetil (MMF) can be beneficial in ocMMP as a steroid-sparing alternative. Although effective, side effects and discontinuation of treatment were common.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586320","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":"Corneal and conjunctival abnormalities in a cohort of survivors from the Western African Ebola virus disease outbreak","authors":"Tolulope Fashina ,&nbsp;Nam V. Nguyen ,&nbsp;Ye Huang ,&nbsp;Casey Randleman ,&nbsp;Caleb D. Hartley ,&nbsp;John G. Mattia ,&nbsp;Matthew J. Vandy ,&nbsp;Lloyd C. Harrison-Williams ,&nbsp;Jalikatu Mustapha ,&nbsp;Jean-Claude Mwanza ,&nbsp;Brent R. Hayek ,&nbsp;Ian Crozier ,&nbsp;Jessica G. Shantha ,&nbsp;Steven Yeh","doi":"10.1016/j.ajoint.2024.100075","DOIUrl":"10.1016/j.ajoint.2024.100075","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize corneal and conjunctival abnormalities (CCAs) and their impact on visual acuity in a cohort of survivors from the Western African Ebola virus disease (EVD) outbreak.</div></div><div><h3>Design</h3><div>A post hoc analysis of 121 patients, who had previously undergone screening for the Ebola Virus Persistence in Ocular Tissues and Fluids study, was performed.</div></div><div><h3>Methods</h3><div>Patients underwent a comprehensive ophthalmic exam at the Lowell and Ruth Gess Eye Hospital in Freetown, Sierra Leone. Demographic (including age, sex, and the number of days spent in the Ebola treatment unit and examination (such as visual acuity, and ocular complications) data were collected and used for the analysis. Visual acuity was either uncorrected or corrected with spectacles. Descriptive and inferential statistical analyses were performed, and a p-value &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 242 eyes (121 patients) were included in this study. The mean age was 31.5 ± 16.1 years, and 70 % were female. Of 242 eyes, 28 (11.5 %) eyes of 15 patients (12.4 %) presented with at least one or more corneal or conjunctival abnormalities. Within eyes that demonstrated CCAs, the findings included dry eye (28.6 % of eyes), band keratopathy (25 % of eyes), and corneal scar (21.4 % of eyes). Corneal edema was found in 14.3 % of eyes, while pterygium and epithelial bullae were each found in 7.1 % of affected eyes. Patients without CCAs had better visual acuity compared to patients with CCAs although the difference was not statistically significant (0.82 ± 1.17 vs 1.01 ± 1.29, p = 0.4). A subset of patients with CCAs also reported ocular symptoms including eye pain, light sensitivity, excessive tearing, and blurry vision.</div></div><div><h3>Conclusion</h3><div>In this post hoc analysis, we observed CCAs in 12 % of EVD survivors. These findings highlight the potential for corneal and conjunctival sequelae during EVD survivorship and the need for ongoing ophthalmic care for this vulnerable population.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535503","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 Iridex MP3 and P3 probes on long-term intraocular pressure control after MicroPulse Transscleral-Cyclophotocoagulation","authors":"Baltaj Sandhur ,&nbsp;Charles Zhang ,&nbsp;Yousef Yousef ,&nbsp;Sinan Ersan ,&nbsp;Andrew Schwartz ,&nbsp;Dmitriy Belous ,&nbsp;Mohit Jethi ,&nbsp;Sandra F Sieminski","doi":"10.1016/j.ajoint.2024.100076","DOIUrl":"10.1016/j.ajoint.2024.100076","url":null,"abstract":"<div><h3>Purpose</h3><div>Micropulse transscleral cyclophotocoagulation (MP-TSCPC) is a glaucoma procedure that delivers energy to the ciliary body with minimal collateral-damage. We aim to assess the long-term effectiveness of MP-TSCPC using the original MP3 and revised P3 probe.</div></div><div><h3>Methods and design</h3><div>Baseline Retrospective cohort study was performed to obtain baseline characteristics, intraocular pressure (IOP), number of IOP-lowering medications, and best-corrected visual acuity (BCVA) were obtained from pre- and post-operative visits of patients treated with MP-TSCPC. Failure was defined as IOP&gt;21 mmHg, reduced IOP&lt;20% below baseline, or IOP&lt;5 mmHg on 2 consecutive follow-up visits after post-operative month 1, reoperation for glaucoma, or loss of vision to no light perception.</div></div><div><h3>Results</h3><div>A total of 113 eyes were enrolled, 44 using the MP3 probe and 69 with the revised P3 probe. Survival analysis found a 75% failure rate in patients treated with the revised P3 probe by the final visit with a mean time to failure (MTTF) of 4.8 ± 0.7 months which was higher than the original probe at 66% failure rate with a MTTF of 6.1 ± 1.1 months (<em>p</em> = 0.04). All causes of failure were due to high IOP and 67% required repeat treatment with MP-TSCPC or incisional surgery. Prior to censure of data from failure, both probes had significant reduction in IOP compared to pre-operative IOP at all time points. No significant changes in BCVA were found. Both groups were associated with low rates of complications.</div></div><div><h3>Conclusion</h3><div>Both probes had a very low rate of visually significant complications when performed in a standardized method in accordance with surgical procedure and power settings recommended by Iridex; however, were associated with a high rate of single procedure failure due to uncontrolled IOP over the long term. The revised P3 probe was associated with a higher rate of failure. Patients experienced a reduction in IOP; however, a large proportion required additional treatment compared to the original MP3 probe.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"1 4","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535504","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}