bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the challenges in implementation of the royal college of ophthalmologists (RCOphth) 2020 guidelines on hydroxychloroquine retinopathy screening at Rochdale eye unit, United Kingdom
Authors: Noor Maha , Khan Rehna , Kafle Suresh 
Published: December 2022

AbstractPurpose: The Royal College of Ophthalmologists (RCOphth) updated their hydroxychloroquine (HCQ) retinopathy screening guidelines in 2020. The aim of our study was to analyse the implementation of these guidelines at Rochdale Eye Unit, UK, along with identification of any challenges/areas for development.Methods: A retrospective study of patients visiting the hydroxychloroquine screening clinic at Rochdale Eye Unit between 1st January – 1st of March 2022 was performed. Utilizing the 2020 RCOphth guidelines as a “gold standard” screening clinic checklist, data were collected determining if patients fulfilled screening criteria, if the department's data collection proforma identified patients with risk factors for developing retinopathy, the investigations undertaken, documentation and communication of the diagnosis, and selection of an appropriate outcome.Results: 54 patients were identified, 14 males and 40 females, 100% of whom were on HCQ therapy. 37% did not meet the screening criteria. A paper proforma comprising of drug, dose, duration, renal disease, tamoxifen use, and macular co‐morbidity was completed for 100% of patients, however, did not include patient's ethnicity, weight (cumulative dose calculation), or last renal function. 51 patients (94%) had SD‐OCT and FAF as first line investigation. 10 patients (19%) also had Visual Field‐10‐2. Currently, there is no standardized process for interpretation of investigations and documentation of findings. Although, 100% of diagnoses were communicated to the GP, there no was evidence of written information about HCQ retinopathy or results of investigations being sent to patients at present. 19 patients (35%) had the incorrect outcome selected, including re‐invitation for annual monitoring despite treatment cessation or prior to >5 years of HCQ treatment.Conclusions: To address the encountered challenges, we recommend review of all bookings unfulfilling screening criteria, devising a more comprehensive proforma (including ethnicity, weight, last renal function) and a six‐point clinician's checklist comprising of proforma review, investigation interpretation/documentation aid, prompt for communicating with patient/referrer, considering driving eligibility, and guidance for selecting appropriate outcome.
Adaptive chin rest device for optimizing visual field testing
Authors: Dogahe Sepideh Jamali , Wentworth Adam , Sadeghmousavi Mostafa , Khanna Sunil , Khanna Cheryl 
Published: December 2022

AbstractPurpose: Evaluation of an adjustable chin rest apparatus for visual field machine.Methods: The HFA 60‐4 visual field test was performed in the primary position and then repeated in the optimum head turn angle using an adjustable chin rest to maximize a visual field for each subject. The optimum head turn angle was calculated using a 3D face model. A 3D model of the face of the subjects was reconstructed using a single facial photo and a Convolutional Neural Networks (CNN), which is a deep learning algorithm. The angles between visual axis and all points around it on the face surface were calculated and the points on the 3D face model with the angle less than 60 degrees was used to predict the optimal head turn angle. A chin rest apparatus for a visual field system was made by 3D printing. The chin rest apparatus includes a moveable chin rest insert coupled to the base and configured to be adjusted to one of a plurality of head turn angles.Results: Three eyes from three healthy subjects (2 female and 1 male) with the mean age of 27.33, CI: 7.37 were enrolled. The visual field defects cause by the facial contour of the subject was decreased by turning the subject's head relative to a vertical axis away from (nasally) the eye being tested using a visual field system with the adaptive chin rest. The mean threshold of the visual field tests of all eyes in the primary angle and optimized angle was 1496, CI: 380.22 and 1567.67, CI: 295.37 respectively. Mean of the degree of head turn to maximize the visual field for all individuals was 6.67 degrees, CI: 2.88.Conclusions: The described adaptive chin rest can be used to position a subject's head at an optimal head turn angle that minimizes the visual field defects caused by the facial contours and maximizes the measured visual field of the subject. This technology can be used in far peripheral visual field tests for early detection of glaucoma as well as accurate follow up of disease progression.
The association between ocular biometric components and corneal aberrations in elderly
Authors: Yekta Abbas Ali , Hashemi Hasan , Khabazkhoob Mehdi , Mesbahi Shima , Moghaddam Hadi Ostadi , Shandiz Javad Heravian , Yekta Yeganeh , Khorasani Abbas Azimi , Ehsaei Asieh 
Published: December 2022

AbstractPurpose: To determine the association between ocular biometric components and corneal aberrations in individuals aged 60 years and older.Methods: In a cross‐sectional study, multi‐stage cluster sampling was performed in Tehran, the capital of Iran. After selecting the samples, all study participants underwent ophthalmic examinations including visual acuity, refraction, anterior and posterior segment examination using slit‐lamp biomicroscopy as well as corneal imaging by Pentacam AXL. The corneal aberrations were measured for a sub‐sample.Results: This report analysed 644 eyes of 415 individuals after applying the inclusion and exclusion criteria. Of these, 236 (56.9%) were females. The mean age of participants was 66.36 ± 4.70 years (range: 60–79 years). According to the generalized estimation equation (GEE), the root mean square (RMS) of higher‐order aberrations (HOA) was related to age (β = 0.081, p = 0.002), crystalline lens thickness (β = 0.08, p < 0.001), and corneal diameter (β = −0.04, p = 0.014). The RMS of total Coma aberration was directly related to the intraocular ocular pressure (β = 0.001, p = 0.044), female sex (β = 0.02, p = 0.05), and crystalline lens thickness (β = 0.06, p < 0.001). There was a direct relationship between the RMS of third‐ and fourth‐order HOAs and crystalline lens thickness (p < 0.001). Spherical aberration was directly related to the male sex (β = −0.02, p = 0.004), axial length (β = 0.05, p < 0.001), central corneal thickness (β = 0.001, p = 0.025), and inversely related to anterior chamber depth (β = −0.07, p = 0.031) and crystalline lens thickness (β = −0.25, p < 0.001).Conclusions: The results of this study showed that ocular biometric components are related to corneal aberrations in the elderly. It is necessary to pay attention to this finding in the clinical affairs of the elderly.
Geographic atrophy in AMD ‐ prognostic factors based on long‐term follow‐up
Authors: Cedro Luca , Hoffmann Laura , Katja Hatz 
Published: December 2022

AbstractPurpose: So far, the natural course of geographic atrophy (GA) progression in age‐related macular degeneration (AMD) has primarily been investigated by colour fundus photography (CF) and fundus autofluorescence (FAF) imaging. The aim of this long‐term retrospective, observational clinical study was to show the enlargement rate (ER) of GA, defined as complete retinal pigment epithelium and outer retinal atrophy (cRORA) and to find predictors of progression.Methods: All patients available in the database of Vista Augenklinik Binningen, Switzerland, with follow‐up of at least 24 months and existing GA in at least one eye, regardless of neovascular AMD (nAMD) being present initially or in the course of disease, were included. SD‐OCT and FAF evaluations were performed according to a standardized protocol. The cRORA area ER (mm2/year), the cRORA square root area ER (mm/yr), the FAF GA area and the condition of the outer retina (inner−/outer segment (IS/OS) and external limiting membrane (ELM) disruption scores) were determined.Results: 204 eyes of 129 patients (64% females) were included. Mean follow‐up time was 4.2 ± 2.2 (range 2–10) years. 109 of 204 (53.4%) eyes were classified as wet AMD (neovascular aspect being present initially or in the course of disease), 95 of 204 (46.6%) eyes were classified as exclusively dry AMD. The primary lesion was unifocal in 146 (72%) eyes and multifocal in 58 (28%) eyes. A strong correlation was observed between the area of cRORA (SD‐OCT) and the FAF GA area (r = 0.924; p < 0.001). Mean ER was 1.44 ± 1.2 mm2/year and mean square root ER 0.29 ± 0.19 mm/year. There was no significant difference in mean ER between eyes without (dry AMD) and with intravitreal anti‐VEGF injections (nAMD) (0.30 ± 0.19 mm/year vs. 0.28 ± 0.20 mm/year; p = 0.466). Eyes with a multifocal atrophy pattern at baseline (n = 58) had a significantly higher mean ER compared to eyes with a unifocal pattern (0.34 ± 0.19 mm/year vs. 0.27 ± 1.19 mm/year; p = 0.008). There were moderate significant correlations between ELM and IS/OS disruption scores and visual acuity at baseline, 5 and 7 years (all r values ca. −0.5; p < 0.001).Conclusions: SD‐OCT evaluated cRORA area might serve as a GA parameter comparable to traditional FAF measurement. The dispersion pattern might be a predictor of ER, whereas anti‐VEGF treatment seems not to be associated with ER.
Analysis of progression rate of idiopathic macular hole and optimal cut‐off for baseline minimum linear diameter and base diameter
Authors: Kim Joo Young , Kim Raeyoung , Kim Mirinae , Park Young Gun , Park Young‐Hoon 
Published: December 2022

AbstractPurpose: To determine the cut‐off points of minimum linear diameter (MLD) and base diameter (BD) at which the progression rate of idiopathic macular hole (MH) decreases before vitrectomy.Methods: This retrospective study compared optical coherence tomography (OCT) taken at baseline and on operation day for patients with stage 2, 3, and 4 idiopathic MH to determine the changes in MLD, BD, height, and MH index. The idiopathic MH progression rate was calculated by dividing each difference in OCT parameters by the time interval.Results: A total of 244 eyes of 235 patients were included. The average age of the patients was 64.12 ± 7.69 (40–85) years. The average time interval from baseline to operation was 36.65 ± 25.20 (7–197) days. Unclosed MHs were found in 14 eyes (5.7%). The progression rate obtained through simple linear regression decreased as the baseline MLD and BD increased (p = 0.044 and p = 0.002, respectively). The optimal cut‐off points obtained through piecewise regression were 295.0 μm for MLD and 414.0 μm for BD.Conclusions: In idiopathic MH with MLD < 295.0 μm or BD < 414.0 μm, the progression rates of MLD and BD were significantly faster. It would ultimately be beneficial for visual prognosis to perform vitrectomy without delay in patients with idiopathic MH with an MLD < 295.0 μm or BD < 414.0 μm.
Efficacy and safety of preoperative intravitreal dexamethasone implants for cataract surgery in patients with uveitis with persistent inflammation
Authors: Hong Seo‐Yeon , Kim Raeyoung 
Published: December 2022

AbstractPurpose: This study aimed to evaluate the efficacy and safety of intravitreal dexamethasone implants for cataract surgery in patients with uveitis with frequent recurrence according to injection timing.Methods: We retrospectively reviewed medical records of patients with non‐infectious uveitis who underwent cataract surgery in Seoul St. Mary's hospital. Patients received intravitreal dexamethasone implant injections into the eyes within 3 months prior to cataract surgery. Patients were divided into two groups: patients administered intravitreal dexamethasone implant injections within 1 month (group 1) or between 1 to 3 months (group 2) prior to cataract surgery. Recurrence of uveitis, postoperative visual outcomes, and safety were reviewed. The time gap between the first uveitis recurrence and cataract surgery, anterior chamber/vitreous cell, best corrected visual acuity(BCVA), and intraocular pressure(IOP) were measured. Patients were followed up for at least 6 months after cataract surgery.Results: In total, 70 eyes of 70 patients were included in the analysis (group 1: 40, group 2: 30). Mean age was 46.60 ± 16.93 and 50.73 ± 13.42 years, respectively(p > 0.05). Groups 1 and 2 included 20(50%) and 10(33.3%) patients with uveitis‐related systemic diseases, respectively (p > 0.05). BCVA was significantly improved at postoperative day 1, week 1, and months 1 and 6 in both groups (all p < 0.05). No significant between‐group differences in BCVA were observed at any time point (p > 0.05). The recurrence of uveitis after cataract surgery was significantly earlier in group 2 than in group 1 (p = 0.04). The occurrence of cystoid macular edema was significantly lower in Group 1 (p = 0.03) Survival analysis of uveitis recurrence did not reveal a significant difference (p > 0.05).Conclusions: Intraoperative intravitreal dexamethasone implant within 3 months before cataract surgery may be considered a safe and effective option for patients with uveitis with poorly controlled inflammation.
Inner retinal layers' thickness changes in relation to age in healthy eyes
Authors: Remis‐Gonzalez Melisa , Moreira‐Estebaranz Carolina , Puell María , Cedrun‐Sanchez Juan 
Published: December 2022

AbstractPurpose: Characterizing the structural change of the macula produced by aging in healthy eyes is essential to discriminate physiological alterations typical of aging from other pathological signs. In this study, macular thicknesses measured by spectral‐domain optical coherence tomography (SD‐OCT) were characterized in young, middle‐aged, and older subjects without ocular pathology.Methods: The study design was observational cross‐sectional and was conducted in 154 eyes of 154 healthy participants between 20 and 80 years (mean 44 ± 18 years of age) divided into three age groups: young (20–39), middle‐aged (40–59) and older (60–80). Macular thicknesses were measured through SD‐OCT using the grid employed of the Early Treatment Diagnostic Retinopathy Study (ETDRS). We analysed five sub‐fields: the central fovea and the four regions (temporal, nasal, superior, inferior) of the parafoveal ring. Mean macular thicknesses were recorded for each of the three retinal segmentations: the inner retinal layer (IRL), the outer retinal layer (ORL) and the total retinal layer. Comparisons of macular thicknesses across age groups were performed.Results: Mean total and ORL thicknesses were not significantly different in the central subfield and each region of the parafoveal ring of the ETDRS grid (temporal, nasal, nasal, inferior and overall) for the three age groups. However, age had a significant effect on IRL thickness in each region of the parafoveal ring. In the superior, nasal and inferior regions, mean IRL thicknesses decreased significantly in the older age group compared to the other age groups (all p < 0.0001). In the temporal region, mean IRL thickness decreased with age and was significantly different for each of the three age groups (p < 0.0001).Conclusions: Age did not significantly influence total and ORL thicknesses in the macula. However, the macular thickness of the IRL decreased in subjects older than 60 years of age.
Combining retinal neuronal and microvascular measurements improves discriminative power for multiple sclerosis patients without previous optic neuritis
Authors: Chua Jacqueline , Bostan Mihai , Sim Yin Ci , Bujor Inna , Schmetterer Leopold , Popa‐Cherecheanu Alina 
Published: December 2022

AbstractPurpose: Quantitative thinning of optic nerves and changes in retinal microvasculature have been detected in multiple sclerosis patients without optic neuritis (MSNON). However, data on how both retinal neuronal and microvascular parameters jointly influence the diagnostic performance is lacking. To investigate the diagnostic performance of neuronal and microvascular changes to detect the presence of MSNON from normal controls.Methods: This is a cross‐sectional study of 51 MS participants (n = 76 eyes) and 71 age‐ and sex‐matched healthy controls (n = 117 eyes). Retinal macular ganglion cell complex (GCC) and retinal nerve fibre layer (RNFL) thicknesses and capillary densities from the superficial (SCP) and deep capillary plexuses (DCP) were obtained from the optical coherence tomography (Cirrus AngioPlex model HD‐OCT 5000). We also compensated RNFL thickness for ocular anatomical factors. Thickness and vascular measurements and their corresponding areas under the receiver operating characteristic curves (AUCs) were compared between groups.Results: All retinal structural and vascular parameters were significantly altered in MS (p ≤ 0.012). The best neuronal parameter for detecting MS was compensated RNFL from the optic nerve head region (AUC = 0.85), followed by GCC from the macular region (AUC = 0.79) while the best microvasculature parameter was the SCP (AUC = 0.66). Combining retinal neuronal and microvascular parameters improved its diagnostic performance for MS detection (AUC = 0.90; P < 0.001). The joint model including both neuronal and microvasculature significantly improved the discrimination between MS and normal compared with each parameter separately (p = 0.027).Conclusions: Combining retinal neuronal and microvasculature parameters improved the discrimination of MSNON. Further studies may be warranted to evaluate the clinical utility of retinal parameters in risk prediction for disease progression.
Ocular hypo pressure treatment in rats with chronic glaucoma: Refractive, functional and structural neuroretinal study
Authors: Campo Lorena Arias , Rufas Ines Munuera , Perié Manuel Subías , Altabás María José Vicente , Tello Alvaro , Castro‐Roger Luisa , Mallen Victor , Palomar Elisa Viladés , Ciordia Beatriz Cordón , Pablo Luis , Rodrigo Maria Jesus 
Published: December 2022

AbstractPurpose: To evaluate the effect of ocular hypo‐pressure treatment on refraction and neuroretina of rat eyes with chronic glaucoma by sex over 24 weeks, as compared to glaucomatous rats non‐treated and healthy controls.Methods: One hundred and fifty five Long‐Evans rat's eyes were analysed retrospectively. 25 glaucomatous (G) rat's eyes, 60 glaucomatous eyes treated with a hipo pressure formulation of Brimonidine ‐ LAPONITE® (G‐B) and 70 healthy (H) eyes. Intraocular pressure (IOP) was measured with rebound tonometer, retinal ganglion cells (RGC) functionality with electroretinography (ERG), and diopter power (D) and neuroretinal estructure with peripapilary retinal nerve fibre layer (pRNFL) and ganglion cell layer (GCL) protocols using non‐invasive technology of optic coherence tomography, over 6 months.Results: G‐B cohort presented lower IOP values during weeks 1, 4 and 8 (p < 0.001) compared to G cohort no treated, and even to H eyes during first week (10.36 ± 1.21 vs. 13.37 ± 2.58 mmHg; p < 0.001). All cohorts both sexes experienced a trend to emmetropia throughout the follow‐up, especially throughout the first 8 weeks of the study and in males (p < 0.033). G cohort showed the lowest diopter value (1.06 ± 3.94 D; p < 0.035), G‐B cohort showed the biggest value and no differences in refraction compared to H eyes (3.67 ± 0.00 vs 3.61 ± 1.90 D; p > 0.203) in week 24. pRNFL thickness differences were mainly found on the inferior sectors. G‐B cohort showed bigger thickness in pRNFL (p = 0.034) and GCL (p = 0.038) compared to G cohort at week 24. G‐B cohort registered higher ERG signal compared to G cohort (41.20 ± 8.75 vs. 18.68 ± 24.77 μV; p = 0.012) and even H eyes (41.2 ± 8.75 vs. 26.00 ± 22.50 μV; p = 0.001) at week 24.Conclusions: Ocular hypo pressure treatment slowed the trend of diopter power and neurorretinal thickness loss, and preserved better functionality of RGC compared to glaucomatous eyes non‐treated.
Evaluation of generated synthetic OCT images in deep‐learning models for glaucoma detection
Authors: Wong Damon , Jith Ashish , Chong Rachel , Crowston Jonathan , Chua Jacqueline , Bujor Inna , Hussain Rahat , Vithana Eranga , Girard Michael , Ting Daniel , Ching‐Yu Cheng , Aung Tin , Popa‐Cherecheanu Alina , Schmetterer Leopold 
Published: December 2022

AbstractPurpose: To evaluate the use of synthetically generated OCT images for the development of deep‐learning models in glaucoma detection.Methods: Progressively Grown Generative Adversarial Network (PGGAN) models for glaucoma and healthy eyes were developed with data from 862 Asian glaucoma eyes and 990 Asian normal eyes to generate synthetic circumpapillary OCT images. Glaucoma detection deep‐learning models were trained using 1200, 10 000, 60 000 or 200 000 of the generated images, equally split between glaucoma and normal. Detection performance was evaluated on real images from an Asian dataset of 140 eyes from 112 subjects and a Caucasian dataset of 300 eyes from 160 subjects, with half of each being glaucoma. Results were compared with a glaucoma detection model trained with real images from 600 glaucoma and 600 healthy eyes, and with global retinal nerve fibre layer (RNFL) measurements using Area Under the Curve (AUC) analysis.Results: Glaucoma detection performance improved with increasing synthetic dataset size, from an AUC of 0.945 [95% CI: 0.917–0.974] and 0.856 [95% CI: 0.819–0.889] on the Asian and Caucasian test data respectively when 1200 synthetic images were used, to AUCs of 0.969 [95% CI: 0.949–0.987] and 0.897 [95% CI: 0.867–0.927] when 200 000 synthetic images were used. The model trained on 200 000 synthetic images was significantly better (p < 0.05) than the model trained on real images on the Caucasian test data (0.838 [95% CI: 0.800–0.874]) but not on the Asian test data (0.962 [95% CI: 0.939–0.985]). Both detection models showed significantly better AUCs than that of global RNFL for both Asian (0.920 [95% CI: 0.884–0.957]) and Caucasian (0.833 [95% CI: 0.793–0.869]) test datasets.Conclusions: Synthetically circumpapillary OCT images used to train deep‐learning glaucoma detection models showed similar performance to a model trained with real data, and could potentially be used to facilitate sharing of imaging data while addressing privacy considerations.