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Ocular surface heat flux density as a biomarker related to diabetic retinopathy (pilot study) 作为糖尿病视网膜病变相关生物标志物的眼表面热通量密度(试点研究)
Pub Date : 2024-03-26 DOI: 10.1016/j.aopr.2024.03.004
Lukyan Anatychuk, Roman Kobylianskyi, Oleg Zadorozhnyy, Taras Kustryn, Illia Nasinnyk, Andrii Korol, Nataliya Pasyechnikova
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引用次数: 0
Integration of smartphone technology and artificial intelligence for advanced ophthalmic care: A systematic review 将智能手机技术与人工智能整合用于高级眼科护理:系统回顾
Pub Date : 2024-03-25 DOI: 10.1016/j.aopr.2024.03.003
Kai Jin , Yingyu Li , Hongkang Wu , Yih Chung Tham , Victor Koh , Yitian Zhao , Ryo Kawasaki , Andrzej Grzybowski , Juan Ye

Background

The convergence of smartphone technology and artificial intelligence (AI) has revolutionized the landscape of ophthalmic care, offering unprecedented opportunities for diagnosis, monitoring, and management of ocular conditions. Nevertheless, there is a lack of systematic studies on discussing the integration of smartphone and AI in this field.

Main text

This review includes 52 studies, and explores the integration of smartphones and AI in ophthalmology, delineating its collective impact on screening methodologies, disease detection, telemedicine initiatives, and patient management. The collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases, glaucoma, cataract, visual impairment in children and ocular surface diseases. Moreover, the utilization of smartphone-based imaging modalities, coupled with AI algorithms, is able to provide timely, efficient and cost-effective screening for ocular pathologies. This modality can also facilitate patient self-monitoring, remote patient monitoring and enhancing accessibility to eye care services, particularly in underserved regions. Challenges involving data privacy, algorithm validation, regulatory frameworks and issues of trust are still need to be addressed. Furthermore, evaluation on real-world implementation is imperative as well, and real-world prospective studies are currently lacking.

Conclusions

Smartphone ocular imaging merged with AI enables earlier, precise diagnoses, personalized treatments, and enhanced service accessibility in eye care. Collaboration is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations, promising a potential revolution in care access and global eye health equity.

背景智能手机技术与人工智能(AI)的融合彻底改变了眼科医疗的面貌,为眼科疾病的诊断、监测和管理提供了前所未有的机遇。正文 本综述包括 52 项研究,探讨了智能手机和人工智能在眼科领域的融合,描述了其对筛查方法、疾病检测、远程医疗计划和患者管理的共同影响。汇总研究结果表明,基于智能手机的人工智能筛查在各种眼科疾病(包括主要视网膜疾病、青光眼、白内障、儿童视力障碍和眼表疾病)的筛查中表现出色。此外,基于智能手机的成像模式与人工智能算法相结合,能够提供及时、高效和具有成本效益的眼部病变筛查。这种模式还能促进患者自我监测、远程患者监测,并提高眼科护理服务的可及性,尤其是在服务不足的地区。涉及数据隐私、算法验证、监管框架和信任问题的挑战仍有待解决。此外,对真实世界的实施情况进行评估也势在必行,而目前还缺乏真实世界的前瞻性研究。结论智能手机眼部成像与人工智能相结合,可实现更早的精确诊断、个性化治疗,并提高眼科护理服务的可及性。要想在负责任地利用这些创新技术的同时应对伦理和数据安全方面的挑战,合作是至关重要的。
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引用次数: 0
Application of sentiment and word frequency analysis of physician review sites to evaluate refractive surgery care 应用医生评论网站的情感和词频分析评估屈光手术护理
Pub Date : 2024-03-07 DOI: 10.1016/j.aopr.2024.03.002
Victoria Vought , Rita Vought , Andrew S. Lee , Irene Zhou , Mansi Garneni , Steven A. Greenstein

Background

Online physician reviews increase transparency in health care, helping patients make informed decisions about their provider. Language processing techniques can quantify this data and allow providers to better understand patients' experiences, perspectives, and priorities. The objective of this study was to assess patient satisfaction and understand the aspects of care that are valued by patients seeking refractive care using sentiment and word frequency analysis.

Methods

Written reviews and Star ratings for members of the Refractive Surgery Alliance Society practicing in the United States were collected from Healthgrades, a popular physician rating website. Surgeons with at least one written review were included in the study. Reviews were scored from -1 (most negative) to +1 (most positive) using Valence Aware Dictionary sEntiment Reasoner (VADER). Reviews were stratified by demographic characteristics, namely gender, region, and years in practice. Word frequency analysis was applied to find the most common words and phrases.

Results

A total of 254 specialists and 3104 reviews were analyzed, with an average of 4.4/5 stars and mean 48 ratings each. Most physicians had positive reviews (96%, average VADER ​= ​0.69). Younger physicians (<20 years since residency) had significantly higher Stars rating than senior peers (>20 years) (P ​< ​0.001). A similar trend was observed in VADER score (0.71 vs 0.69), although not statistically significant (P ​= ​0.06). No statistical differences were observed between Stars rating and VADER score by gender (P ​= ​0.66, P ​= ​0.83) or by geographical region (P ​= ​0.74, P ​= ​0.07). "Staff" (n ​= ​1269), "professional" (n ​= ​631), "office" (n ​= ​523), "questions" (n ​= ​424), and "friendly" (n ​= ​386) were frequently used in reviews, along with phrases such as "the staff" (n ​= ​273) and "my questions" (n ​= ​174). "Surgery" (n ​= ​719), "staff" (n ​= ​576), "procedure" (n ​= ​251), "experience" (n ​= ​243), and "professional" (n ​= ​240) were the most common words in positive reviews, while "surgery" (n ​= ​147), "office" (n ​= ​86), "staff" (n ​= ​54), "time" (n ​= ​47), and "insurance" (n ​= ​28) were the most commonly used in negative reviews.

Conclusions

Both the average Stars and VADER sentiment score suggest a high satisfaction among refractive patients. Word frequency analysis revealed that patients value non-clinical aspects of care, including interactions with staff, insurance coverage, and wait-times, suggesting that improving non-clinical factors could enhance patient satisfaction with refractive surgery.

背景在线医生评论提高了医疗保健的透明度,有助于患者对其医疗服务提供者做出明智的决定。语言处理技术可以量化这些数据,让医疗服务提供者更好地了解患者的经历、观点和优先事项。本研究的目的是通过情感和词频分析来评估患者的满意度,并了解寻求屈光治疗的患者所重视的医疗服务方面。至少有一篇书面评论的外科医生被纳入研究范围。评论采用 Valence Aware Dictionary sEntiment Reasoner (VADER) 从-1(最负面)到+1(最正面)进行评分。根据性别、地区和从业年限等人口统计学特征对评论进行了分层。结果共分析了 254 位专家和 3104 条评论,平均 4.4/5 星级,平均 48 条评论。大多数医生都有好评(96%,平均 VADER = 0.69)。年轻医生(实习期满 20 年)的 Stars 评分明显高于资深医生(20 年)(P <0.001)。VADER 评分也有类似趋势(0.71 vs 0.69),但无统计学意义(P = 0.06)。按性别(P = 0.66,P = 0.83)或地理区域(P = 0.74,P = 0.07)划分,"星星 "评分和 VADER 分数之间没有统计学差异。评论中经常使用 "工作人员"(n = 1269)、"专业"(n = 631)、"办公室"(n = 523)、"问题"(n = 424)和 "友好"(n = 386),以及 "工作人员"(n = 273)和 "我的问题"(n = 174)等短语。"手术"(n = 719)、"工作人员"(n = 576)、"程序"(n = 251)、"经验"(n = 243)和 "专业"(n = 240)是正面评论中最常用的词语,而 "手术"(n = 147)、"办公室"(n = 86)、"工作人员"(n = 54)、"时间"(n = 47)和 "保险"(n = 28)则是负面评论中最常用的词语。结论 平均星级和 VADER 情感评分都表明屈光患者的满意度很高。词频分析表明,患者重视护理的非临床方面,包括与工作人员的互动、保险范围和等待时间,这表明改善非临床因素可以提高患者对屈光手术的满意度。
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引用次数: 0
Health-related quality of life measurements in children and adolescents with refractive errors: A scoping review 屈光不正儿童和青少年的健康相关生活质量测量:范围审查
Pub Date : 2024-03-07 DOI: 10.1016/j.aopr.2024.03.001
Wei Wu , Lisha Yi , Kai Zhang , Zipei Chen , Caiping Shi , Chen Chen , Yilu Cai , Lidan Hu , Xiangjun Chen

Background

Refractive errors, particularly myopia, are the leading visual disorders worldwide, significantly affecting the quality of life (QOL) even after correction. This scoping review focuses on health-related quality of life (HRQOL) measurements for children and adolescents with refractive errors.

Main text

We explored generic and disease-specific HRQOL tools, examining their content, psychometric properties, and the impact of various interventions on QOL. Two English databases—PubMed, Embase, and one Chinese database, CNKI, were searched for relevant studies published from January 2001 to October 2023. Inclusion criteria encompassed studies using standardized instruments to assess the QOL of children aged 0–18 with refractive errors. The review compares prevalent HRQOL measurements, analyzes children's refractive error assessments, and discusses intervention effects on patient QOL.

Conclusions

The study underlines the necessity of developing disease-specific QOL instruments for very young children and serves as a practical guide for researchers in this field. The findings advocate for a targeted approach in HRQOL assessment among the pediatric population, identifying critical gaps in current methodologies.

背景屈光不正,尤其是近视,是全球主要的视觉疾病,即使在矫正后也会严重影响生活质量(QOL)。正文我们探讨了通用的和特定疾病的 HRQOL 工具,研究了它们的内容、心理测量学特性以及各种干预措施对 QOL 的影响。我们在两个英文数据库--PubMed 和 Embase,以及一个中文数据库--CNKI 中检索了 2001 年 1 月至 2023 年 10 月间发表的相关研究。纳入标准包括使用标准化工具评估 0-18 岁屈光不正儿童 QOL 的研究。该综述比较了普遍的 HRQOL 测量方法,分析了儿童屈光不正评估结果,并讨论了对患者 QOL 的干预效果。结论该研究强调了为年幼儿童开发特定疾病 QOL 工具的必要性,并为该领域的研究人员提供了实用指南。研究结果提倡在儿科人群中采用有针对性的方法进行 HRQOL 评估,并指出了当前方法中存在的关键差距。
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引用次数: 0
Personalized treatment concepts in extraocular cancer 眼外癌的个性化治疗理念
Pub Date : 2024-03-01 DOI: 10.1016/j.aopr.2024.02.003
Sitong Ju , Alexander C. Rokohl , Yongwei Guo , Ke Yao , Wanlin Fan , Ludwig M. Heindl

Background

The periocular skin is neoplasms-prone to various benign and malignant. Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas. In recent decades, immunotherapy has significantly advanced oncology, allowing the autoimmune system to target and destroy malignant cells. Skin malignancies, especially periocular tumors, are particularly sensitive to immunotherapy. This technique has dramatically impacted the successful treatment of challenging tumors.

Main text

Extraocular cancers, including eyelid (basal cell carcinoma, squamous cell carcinoma, melanoma, merkel cell carcinoma), conjunctival tumors (conjunctival melanoma, ocular surface squamous neoplasia) and other rare tumors, are unique and challenging clinical situations. Several genetic alterations associated with the pathogenesis of these diseases have been identified, and molecular mechanism are essential for the development of the immunotherapy agents, such as Hedgehog pathway inhibitors (vismodegib and sonidegib) for basal cell carcinoma, BRAF/MEK inhibitors (vemurafenib, dabrafenib, and encorafenib) for melanoma, and immune checkpoint inhibitors (Avelumab, pembrolizumab) for Merkel cell carcinoma.

Conclusions

The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures. Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type, tumor molecular profile, expected response rate, and candidacy for systemic treatment.

背景眼周皮肤容易发生各种良性和恶性肿瘤。与其他皮肤区域的恶性肿瘤相比,眼周恶性肿瘤更具侵袭性,治愈和修复也更具挑战性。近几十年来,免疫疗法大大推动了肿瘤学的发展,使自身免疫系统能够靶向摧毁恶性细胞。皮肤恶性肿瘤,尤其是眼周肿瘤,对免疫疗法尤为敏感。正文眼外肿瘤,包括眼睑肿瘤(基底细胞癌、鳞状细胞癌、黑色素瘤、梅克尔细胞癌)、结膜肿瘤(结膜黑色素瘤、眼表鳞状细胞瘤)和其他罕见肿瘤,都是独特而具有挑战性的临床病例。目前已发现与这些疾病的发病机制相关的几种基因改变,而分子机制对于免疫疗法药物的开发至关重要,如治疗基底细胞癌的刺猬通路抑制剂(vismodegib 和 sonidegib)、治疗黑色素瘤的 BRAF/MEK 抑制剂(vemurafenib、dabrafenib 和 encorafenib)以及治疗梅克尔细胞癌的免疫检查点抑制剂(Avelumab 和 pembrolizumab)。结论眼周皮肤癌的最佳治疗方法取决于肿瘤的类型和大小,以及是否累及眼眶和附件结构。应根据肿瘤类型、肿瘤分子特征、预期反应率以及是否适合全身治疗等因素,考虑使用化疗靶向疗法和免疫检查点抑制剂进行辅助治疗和新辅助治疗。
{"title":"Personalized treatment concepts in extraocular cancer","authors":"Sitong Ju ,&nbsp;Alexander C. Rokohl ,&nbsp;Yongwei Guo ,&nbsp;Ke Yao ,&nbsp;Wanlin Fan ,&nbsp;Ludwig M. Heindl","doi":"10.1016/j.aopr.2024.02.003","DOIUrl":"10.1016/j.aopr.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><p>The periocular skin is neoplasms-prone to various benign and malignant. Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas. In recent decades, immunotherapy has significantly advanced oncology, allowing the autoimmune system to target and destroy malignant cells. Skin malignancies, especially periocular tumors, are particularly sensitive to immunotherapy. This technique has dramatically impacted the successful treatment of challenging tumors.</p></div><div><h3>Main text</h3><p>Extraocular cancers, including eyelid (basal cell carcinoma, squamous cell carcinoma, melanoma, merkel cell carcinoma), conjunctival tumors (conjunctival melanoma, ocular surface squamous neoplasia) and other rare tumors, are unique and challenging clinical situations. Several genetic alterations associated with the pathogenesis of these diseases have been identified, and molecular mechanism are essential for the development of the immunotherapy agents, such as Hedgehog pathway inhibitors (vismodegib and sonidegib) for basal cell carcinoma, BRAF/MEK inhibitors (vemurafenib, dabrafenib, and encorafenib) for melanoma, and immune checkpoint inhibitors (Avelumab, pembrolizumab) for Merkel cell carcinoma.</p></div><div><h3>Conclusions</h3><p>The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures. Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type, tumor molecular profile, expected response rate, and candidacy for systemic treatment.</p></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"4 2","pages":"Pages 69-77"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667376224000118/pdfft?md5=edb4a670137034508a3c47340bef9273&pid=1-s2.0-S2667376224000118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140082944","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}
引用次数: 0
Regenerative treatment of ophthalmic diseases with stem cells: Principles, progress, and challenges 利用干细胞再生治疗眼科疾病:原理、进展与挑战
Pub Date : 2024-02-28 DOI: 10.1016/j.aopr.2024.02.001
Yifei Niu , Junfeng Ji , Ke Yao , Qiuli Fu

Background

Degenerate eye disorders, such as glaucoma, cataracts and age-related macular degeneration (AMD), are prevalent causes of blindness and visual impairment worldwide. Other eye disorders, including limbal stem cell deficiency (LSCD), dry eye diseases (DED), and retinitis pigmentosa (RP), result in symptoms such as ocular discomfort and impaired visual function, significantly impacting quality of life. Traditional therapies are limited, primarily focus on delaying disease progression, while emerging stem cell therapy directly targets ocular tissues, aiming to restore ocular function by reconstructing ocular tissue.

Main text

The utilization of stem cells for the treatment of diverse degenerative ocular diseases is becoming increasingly significant, owing to the regenerative and malleable properties of stem cells and their functional cells. Currently, stem cell therapy for ophthalmopathy involves various cell types, such as embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), mesenchymal stem cells (MSCs), and retinal progenitor cells (RPCs). In the current article, we will review the current progress regarding the utilization of stem cells for the regeneration of ocular tissue covering key eye tissues from the cornea to the retina. These therapies aim to address the loss of functional cells, restore damaged ocular tissue and or in a paracrine-mediated manner. We also provide an overview of the ocular disorders that stem cell therapy is targeting, as well as the difficulties and opportunities in this field.

Conclusions

Stem cells can not only promote tissue regeneration but also release exosomes to mitigate inflammation and provide neuroprotection, making stem cell therapy emerge as a promising approach for treating a wide range of eye disorders through multiple mechanisms.

背景青光眼、白内障和老年性黄斑变性(AMD)等退行性眼病是全球失明和视力受损的主要原因。其他眼部疾病,包括角膜缘干细胞缺乏症(LSCD)、干眼病(DED)和视网膜色素变性(RP),会导致眼部不适和视觉功能受损等症状,严重影响生活质量。正文由于干细胞及其功能细胞具有再生性和可塑性,利用干细胞治疗各种退行性眼病正变得越来越重要。目前,干细胞治疗眼病涉及多种细胞类型,如胚胎干细胞(ESCs)、诱导多能干细胞(iPSCs)、间充质干细胞(MSCs)和视网膜祖细胞(RPCs)。在本文中,我们将回顾目前利用干细胞再生眼组织的进展,包括从角膜到视网膜的关键眼组织。这些疗法旨在解决功能细胞丧失的问题,恢复受损的眼组织,或以旁分泌介导的方式进行。我们还概述了干细胞疗法针对的眼部疾病,以及该领域的困难和机遇。结论干细胞不仅能促进组织再生,还能释放外泌体减轻炎症和提供神经保护,使干细胞疗法成为通过多种机制治疗各种眼部疾病的有前途的方法。
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引用次数: 0
The use of lens anterior capsule disc for corneal endothelium protection during femtosecond laser-assisted cataract surgery in eyes with low endothelial cell density 在飞秒激光辅助白内障手术中使用晶状体前囊盘保护低内皮细胞密度眼的角膜内皮
Pub Date : 2024-02-28 DOI: 10.1016/j.aopr.2024.02.002
Nina Asrini Noor, Johan Hutauruk, Tjahjono D. Gondhowiardjo
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引用次数: 0
Efficacy of 3% diquafosol combined with azelastine hydrochloride in allergic conjunctivitis patients with dry eye 3% 地卡夫索联合盐酸阿司匹林对过敏性结膜炎干眼症患者的疗效
Pub Date : 2024-02-10 DOI: 10.1016/j.aopr.2024.01.006
Lin Lin , Yirui Zhu , Kelan Yuan, Yujie Mou, Hanhe Zhao, Yayin Wu, Xiuming Jin
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引用次数: 0
Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition 评估与功能性上眼睑位置不正有关的未识别的视力缺陷
Pub Date : 2024-02-01 DOI: 10.1016/j.aopr.2024.01.007
Linyan Wang , Davin C. Ashraf , Michael Deiner , Oluwatobi O. Idowu , Seanna R. Grob , Bryan J. Winn , M Reza Vagefi , Robert C. Kersten

Objective

To investigate whether functional upper eyelid malposition is associated with unrecognized deficits in automated perimetry among glaucoma patients by examining patients undergoing eyelid surgery who had not been identified as requiring eyelid taping during glaucoma field testing.

Methods

In this retrospective pre-post study, an automated database search followed by manual chart review was used to identify eligible patients from January 2012 to March 2020. Included patients had reliable visual field testing within two years before and after functional upper blepharoplasty or ptosis repair and no comorbid ocular diagnoses. As part of routine practice, glaucoma visual field technicians taped patients with pupil-obstructing eyelid malposition; taped examinations were excluded from analysis. Clinical and demographic characteristics, mean deviation, and pattern standard deviation were evaluated within a two year period before and after eyelid surgery.

Results

The final analysis included 60 eyes of 38 patients. Change in visual field parameters after eyelid surgery did not reach statistical significance in crude or adjusted analyses. Among patients with ptosis, the margin reflex distance-1 was not associated with change in mean deviation after surgery (Pearson R2 ​= ​0.0061; P ​= ​0.700). Five of 17 eyes excluded from analysis due to unreliable pre-operative visual fields demonstrated substantial improvement after surgery.

Conclusions

Functional upper eyelid malposition does not appear to cause spurious visual field abnormalities among glaucoma patients with reliable visual fields who were determined not to require eyelid taping at the time of their visual fields. Unreliable visual fields could be a sign of eyelid interference in this population.

目的通过对接受眼睑手术但在青光眼视野测试中未被确认为需要眼睑粘贴的患者进行检查,研究功能性上眼睑位置不正是否与青光眼患者未被发现的自动周边测量缺陷有关。方法在这项事后回顾性研究中,通过自动数据库搜索和人工病历审查来确定 2012 年 1 月至 2020 年 3 月期间符合条件的患者。所纳入的患者在功能性上睑成形术或上睑下垂修复术前后两年内均接受过可靠的视野测试,且无合并眼部诊断。作为常规做法的一部分,青光眼视野技术人员会对瞳孔阻塞性眼睑错位患者进行录音;录音检查不纳入分析。对眼睑手术前后两年内的临床和人口统计学特征、平均偏差和模式标准偏差进行了评估。在粗略分析和调整分析中,双眼皮手术后视野参数的变化均未达到统计学意义。在上睑下垂患者中,边缘反射距离-1与术后平均偏差的变化无关(Pearson R2 = 0.0061;P = 0.700)。在因术前视野不可靠而被排除在分析之外的 17 只眼睛中,有 5 只在术后得到了实质性的改善。结论在视野可靠且在视野检查时被确定不需要眼睑粘贴的青光眼患者中,功能性上眼睑位置不正似乎不会导致假性视野异常。不可靠的视野可能是眼睑干扰这一人群的信号。
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引用次数: 0
Efficacy of 3% diquafosol combined with azelastine hydrochloride in allergic conjunctivitis patients with dry eye 3% 地卡夫索联合盐酸阿司匹林对过敏性结膜炎干眼症患者的疗效
Pub Date : 2024-02-01 DOI: 10.1016/j.aopr.2024.01.006
Lin Lin, Yirui Zhu, Kelan Yuan, Yujie Mou, Hanhe Zhao, Yaying Wu, Xiuming Jin
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引用次数: 0
期刊
Advances in ophthalmology practice and research
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