bluuebunny/crossref_metadata_2025_split huggingface dataset:
Has the use of optical coherence tomography in community optometrists’ referrals improved diagnostic accuracy for glaucoma?
Authors: Yang Yingjia , Thornton Richard , Lockwood Alastair , Kirwan James 
Published: January 2022

AbstractPurposeIn recent years, community optometry practices have begun to use optical coherence tomography (OCT) as part of glaucoma assessment, the result of which is increasingly cited as a reason for referral into hospital glaucoma clinics. We aim to assess whether the addition of OCT scanning has improved diagnostic accuracy of glaucoma referrals from community optometry practices.MethodsA prospective observational study was conducted, which includes all glaucoma referrals from community optometrists to the Portsmouth Glaucoma Referral Refinement (GRR) scheme from July 2019 until February 2020. Patient demographics, tests performed, reasons for referral, and the final diagnosis from glaucoma clinic were collated. A positive diagnosis includes open angle glaucoma, ocular hypertension, glaucoma suspect and narrow angle glaucoma.ResultsA total of 248 eligible referrals were analysed. Overall, the positive predictive rate was 20% (n = 50), which is similar to previous audits of glaucoma referrals in Portsmouth (1). 25 subjects had an OCT scan as part of their referral, and the OCT given as a reason for referral in 24 of these cases. 25% (n = 6) resulted in a positive diagnosis; however, all these patients had at least 2 other abnormal tests at initial assessment (from IOP, disc appearance, and visual field testing) which were also reasons for referral, suggesting they would have been referred regardless of the OCT. In six cases, the only reason for referral was OCT findings, none resulted in a positive diagnosis after clinic review. The highest PPV (75%, n = 6) was achieved when all three of IOP, disc, and visual field were given as reasons for referral.ConclusionsThe use of OCT in glaucoma assessment at community optometry practices is still not very widespread. This early evidence suggests OCT performed by community optometrists does not improve diagnostic accuracy of referrals into hospital eye services.Reference1. Lockwood, A., Kirwan, J. and Ashleigh, Z., 2010. Optometrists referrals for glaucoma assessment: a prospective survey of clinical data and outcomes. Eye, 24(9), pp. 1515–1519.
Evaluation of OCT parameters in the patients with pseudo exfoliation and normal IOP: an OCT angiography study
Authors: Halkiadakis Ioannis , Tzimis Vasillis , Vernikou Anna , Kollia Elpida , Markopoulos Ioannis , Tzakos Michalis 
Published: January 2022

AbstractPurposeTo compare peripapillary retinal nerve fiber layer thickness (RNFL), ganglion cell complex (GCC) optic nerve head vessel density (VD) results measured using optical coherence tomography angiography (OCTA) in the patients with pseudoexfoliative syndrome (PEXS) with aged‐matched healthy individuals.MethodsThe RNFL, GCC and papillary VD of 40 eyes of patients with PEXS and 40 eyes of aged‐matched normal controls were examined using OCTA (AngioVue™). Patients with increased IOP and or signs of glaucoma were excluded from the study. The VD was measured with a 4.5 × 4.5 mm papillary scan. VD was calculated by an automated density measuring tool in the AngioVue™ software.ResultsMean age of PEXS patients was 76.5 ± 6.6 and of healthy controls was 72.4 ± 9.2 (p = 0.18). There were no significant differences in RNFL and VD values of all regions in eyes compared to control eyes (p < 0.05 for all comparisons).ConclusionsThere is no difference in RNFL and peripapillary VD between healthy eyes and PEXS eyes with normal IOP.
Surgical management of ophthalmic abnormalities in Peters plus syndrome: case report
Authors: Monia Cheour , Fehmy Nafaa , Meriem Ouederni , Maamouri Rym , Hela Sassi , Chelly Zied 
Published: January 2022

AbstractPurposeTo report a case of a patient with Peters plus syndrome (PPS) who underwent combined synechiolysis, penetrating keratoplasty, and trabeculectomy.MethodsA four‐year‐old female with bilateral central opacified cornea was referred to our department for corneal transplantation. Slit‐lamp examination demonstrated horizontal nystagmus, bilateral central corneal opacity and iridocorneal adhesion without lenticular involvement, which is characteristic of type I Peters anomaly. Intraocular pressure was 22 mmHg in the right eye and 26 mmHg in the left eye. Posterior segment ultrasonography showed no vitreous or retinal abnormalities. General and systemic examination revealed short stature and developmental delay without any other abnormality. The diagnosis of PPS was clinically made. The patient underwent combined synechiolysis, penetrating keratoplasty, and trabeculectomy of her left eye that was more affected.ResultsSix months postoperatively, corneal graft was clear with normal depth anterior chamber and normal intraocular pressure. For the right eye, the patient was put on antiglaucomatous eye drops while waiting for corneal transplantationConclusionsGlaucoma was proven to be a significant risk factor for graft failure and rejection after penetrating keratoplasty for Peters anomaly(1). In this case, combined surgeries were performed to allow better visual outcome and intraocular pressure control.Bibliography1. Dolezal KA, Besirli CG, Mian SI, Sugar A, Moroi SE, Bohnsack BL. Glaucoma and Cornea Surgery Outcomes in Peters Anomaly. Am J Ophthalmol 2019;208: 367–375.
Oxygenation in glaucoma patients: Influence of age and oxidative stress
Authors: Türksever Cengiz , Todorova Margarita G. 
Published: January 2022

AbstractPurposeTo evaluate retinal oxygenation in glaucoma patients and to compare it with that of healthy controls.MethodsRetinal vessel oxygen saturation was measured in 46 eyes of 34 Caucasian individuals with primary open angle glaucoma (POAG) and in 21 eyes of 17 age‐matched controls using the oximetry tool of Retinal Vessel Analyser (RVA: IMEDOS Systems UG, Jena, Germany). The mean oxygen saturation of the major arterioles (A‐SO2) and venules (V‐SO2), as well as the corresponding arterio‐venular difference (A‐V SO2), were calculated. Glaucomatous damage was assessed by Optical Coherence Tomography (Carl Zeiss Meditec, Dublin, CA, USA) and static automated perimetry (Octopus, program G2/ standard strategy: Haag‐Streit International, Köniz, Switzerland). In addition, we calculated the mean retinal oxygen extraction (O2‐E) per micron of nerve fibre layer thickness, O2‐E [µm/%] by dividing the mean retinal nerve fibre layer (RNFL) thickness with the mean A‐V SO2.ResultsIn glaucoma patients, A‐SO2 and V‐SO2 values were significantly increased and their difference decreased, when compared to controls (p < 0.017; linear mixed‐effects model). Whereas V‐SO2 and A‐V SO2 were not influenced by age, the A‐SO2 was severely reduced and the O2‐E significantly increased in elderly glaucoma patients, than in younger glaucoma patients (p = 0.003, correspondingly p = 0.004). Also, higher O2‐E in glaucoma patients correlated negatively with the neuroretinal rim area (p < 0.019), and positively with the mean defect of the visual field (p = 0.012)ConclusionsThe presented structure‐metabolic approach supposes that ganglion cells axons in glaucomatous eyes are influenced by aging and are probaly more exposed to oxidative stress, which seems to contribute to progression of glaucomatous damage.
Neuroimaging in normal tension glaucoma: to scan or not to scan?
Authors: Szymanska Maja , Capellan Pamela , Yap Timothy , Cordeiro Maria F. 
Published: January 2022

AbstractPurposeTo determine the frequency, yield and possible cost implications of brain imaging in patients with normal tension glaucoma (NTG).MethodsRetrospective case series of patients from a single centre in West London who underwent brain imaging as part of diagnostic workup for NTG between January 2018 and May 2021. The main outcome measures included the frequency of requests, and diagnostic yield for relevant and incidental findings. Secondarily, we examined the prevalence of NTG risk factors and whether they were documented in patient notes.ResultsNotes from 496 patients with NTG were analysed. Among them, 47 (9%) had an imaging scan requested by their ophthalmologist. Only 1 patient (2%) was found to have an intracranial lesion compressing the optic chiasm. Other incidental findings included 1 meningioma (2%), 1 pituitary cyst (2%), and 12 patients showing small vessel disease (26%). The number needed to test for one positive finding was 50 (assuming no tumours were missed). The estimated cost of the scans requested was £64 719. However, the costs of treating a brain tumour can range from £13 200 to £180 000 annually, depending on the grade1. Based on these findings and the literature review, we propose a new guideline based to help clinicians in the evaluation of NTG patients to improve diagnostic yield.ConclusionsIntracranial compressive lesions are an important differential diagnosis to NTG. However, a more judicious approach to the use of neuroimaging is required.Bibliography1. Macmillan Cancer Support. Routes from Diagnosis: The most detailed map of cancer survivorship yet (2014), Pg 46 available at: https://www. macmillan.org.uk/_images/Routesfromdiagnosisreport_tcm9‐265651.pdf.
Automatic segmentation of the waist of the nerve fiber layer at the ONH with AI
Authors: Kisonaite Konstancija , Raeme Faisal , Yu Zhaohua , Sandberg Melin Camilla , Brusini Irene , Bendazzoli Simone , Wang Chunliang , Söderberg Per 
Published: January 2022

AbstractPurposeTo evaluate a machine learning AI‐tool for automatic segmentation of the waist of the nerve fiber layer at the optic nerve head (ONH).MethodsOCT‐volumes of the ONH were captured from eyes with early to manifest glaucoma (OCT‐2000) and eyes without glaucoma (OCT‐Triton). The angularly resolved segmentation consisted of first detecting the inner limit of the retina in the OCT volume with AI‐model I. Subsequently, the OCT volume was resampled into 500 radial images distributed at equidistant angles in the frontal plane. In each radial image, the Optic nerve head Pigment epithelium Central Limit (OPCL) was identified manually with a specially developed tool and automatically with AI‐model II. Model II was trained for OPCL location on a training set of radial images. Ground truth was provided as manual annotations. Finally, the Pigment‐epithelium‐Inner‐limit of the retina‐Minimal Distance (PIMD) was estimated at each angle as the shortest distance between OPCL and the closest point on the inner limit of the retina. PIMD estimated both automatically and based on manual annotation of OPCL were compared in a test data set. All radial images in the test data set were manually annotated by three different annotators.ResultsFor both groups of eyes examined, the automatic and manual estimates of the angular distribution of PIMD overlapped. The eyes without glaucoma expressed the expected peak thickness of the waist of the nerve fiber layer inferiorly and superiorly, while the glaucomatous eyes lost most of this angular dependence. A 95% confidence interval for the mean difference of automatically estimated PIMD between eyes without glaucoma and glaucomatous eyes was 220 ± 85 μm. An analysis of interobserver variability in PIMD‐estimates demonstrated minor differences.ConclusionsAI‐based estimation of the waist of the nerve fiber layer at the ONH angularly resolved is reliable and precise enough to detect a difference between early to manifest glaucoma and non‐glaucoma.
Impact of the COVID‐19 pandemic on the glaucoma surgical waiting list
Authors: Cardeñosa Nuria Cuenca , Blazquez Javier Guzman , Martinez Teresa Perez , Fernandez Gonzalez Maria Carmen , Ortega Campos Maria Pilar , Martin Carmen Pizzamiglio , de Paz Sergio Perez , Reina Alfonso Rubio , Diaz Oier Perez 
Published: January 2022

AbstractPurposeThe purpose is to study the impact caused by the pandemic situation (COVID‐19) on the waiting time for glaucoma surgery and to study the differences between the severity of glaucoma according to the affectation of the visual field in patients included in this surgical waiting list.MethodsFor this, a retrospective random sampling analytical study has been carried out. The cases are the patients included in the glaucoma surgical waiting list of the Toledo Hospital Complex in the pandemic period, from January 2020 to May 2021; and controls are the patients included from July 2018 to December 2019. A total of 99 patients have been recruited. The variables that have been calculated are: the surgical waiting time, the severity of the glaucoma based on the affectation of the visual field through the Modified glaucoma Staging System, age, gender, type of glaucoma, affected eye, need for reoperation and the number of active ingredients needed pre‐ and post‐surgery.The hypothesis contrast test used for ordinal qualitative variables was the Mann‐Whitney Test, for continuous quantitative variables the Student's t Test for independent data, and the Chi2 Test for dichotomous qualitative variables.ResultsAs a result, there are statistically significant differences (p = 0.045) in the degree of severity of glaucoma measured with the Modified glaucoma Staging System, glaucoma being less severe in the group affected by the pandemic. Significant differences have also been found in age, the 2020–2021 group being younger (72.33 ± 10.8 years versus 67.64 ± 11.26 years). There are no statistically significant differences about the need of post‐surgery needling (19.2% in 2018–2019 group versus 17% in 2020–2021 group (p = 0.776)). There are no statistically significant differences in the waiting time for gluacoma surgery between the two groups (68 ± 40.4 days in 2018–2019 versus 78.47 ± 74.35 days in 2020–2021 (p = 0.380).ConclusionsThe impact of the COVID‐19 pandemic seems to have caused that younger patients and patients with less visual field involvement undergo earlier surgery, but it is possible that the onset of progression and the difficulty in check‐ups have led to the need for surgery. On the other hand, it has been possible to maintain the waiting time for surgery similar to the period without a pandemic.
Delayed follow‐up of glaucoma patients due to COVID‐19 pandemic – impact on disease progression
Authors: Szymanska Maja , Normando Eduardo , Cordeiro Maria F. 
Published: January 2022

AbstractPurposeTo determine the impact of delayed follow‐up on the disease course in patients with glaucoma.MethodsA retrospective case series of 224 glaucoma patients. Data analysis from the hospital electronic medical record was performed on patients attending the glaucoma clinic between April and May 2021 at Charing Cross Hospital, London, United Kingdom, after easing of the national lockdown due to COVID‐19 pandemic. The main outcome measures included increased intraocular pressure (IOP), worsening of visual field (VF) defect, thinning of retinal nerve fibre layer (RNFL) and the posterior pole using spectral domain Optical Coherence Tomography (OCT).ResultsNotes from 224 patients were analysed. Among them, 24 patients were identified to develop a progression of glaucoma. Majority of patients (10, 42%) had open angle glaucoma, 6 (25%) had normal tension glaucoma, 5 (21%) were glaucoma suspects, 2 (8%) had narrow angle glaucoma and 1 (4%) had angle closure glaucoma. The mean IOP (±SD) pre‐lockdown was 15.4 ± 3.8 mmHg and post‐lockdown was 16.7 ± 5.4 mmHg (p < 0.05). The average RNFL thickness pre‐lockdown was 79.7 ± 15.7 µm and post‐lockdown was 78.8 ± 15.6 µm (p > 0.05). Of the 24 patients who developed progression, 16 had an increase in IOP (mean ∆ IOP was 3.8 ± 1.8 mmHg; p < 0.05), 19 patients had a clinically significant RNFL thinning (mean ∆ was 3.3 ± 1.4 µm; p < 0.05) and 9 patients had worsening of VF. The average timing between pre‐ and post‐lockdown visit was 15.1 months (SD ± 7.6).ConclusionsThese results confirm that a proportion of patients developed glaucoma progression during the COVID Lockdown which could be attributed to delayed follow‐up. Further analyses of these data will be needed to confirm how the results of this study could help to guide future decisions making and guidance on prioritising and managing glaucoma patients if disruption to standard of care occurs.
Glaucoma rose plots: redesigning circumpapillary progression analysis
Authors: Yap Timothy , Davis Benjamin Michael , Bloom Philip , Cordeiro M. Francesca , Normando Eduardo 
Published: January 2022

AbstractPurposeTo evaluate glaucoma rose plot analysis (RPA), a novel display of circumpapillary optical coherence tomography (OCT) progression data.MethodsA novel RPA protocol was developed to automatically analyse and display progression analysis of circumpapillary retinal nerve fibre layer (cRNFL) OCT data. A clustering technique was employed to allow circumferential statistical determination of progressing regions of varying widths, without the use of predefined sectors. Results were presented in the form of an angular histogram for each eye. RPA was evaluated using data from primary open‐angle glaucoma (POAG) or POAG suspect eyes and compared to a gold‐standard determined by three clinicians’ assessment of OCT series and linear regression plots. Each eye was graded as ‘progressing’ or ‘stable/unaffected’. Rose plots were assessed using objective and subjective methods to confirm their relevance and practical application. Objectively, the area of red rose petals was compared. Subjectively, rose plots were assessed by three masked assessors as suspicious of progression or not.ResultsA total of 743 scans making up registered series from 98 eyes were analysed. The mean ± SD number of visits was 8.5 ± 3.8 μm in the progressing eyes, and 7.1 ± 2.8 μm in the stable or unaffected eyes (p = 0.06). Rose plots were able to distinguish progressing eyes from stable or unaffected eyes with area under receiver‐operating characteristic curve (AUROC) of 0.968 (95% CI: 0.92–1.00) compared to 0.706 (95% CI: 0.585–0.826) using global cRNFL thickness. Furthermore, agreement on progression status between clinician graders using RPA was greater than when assessing OCT scans and linear regression plots (Fleiss’ kappa = 0.86, 95% CI: 0.81–0.91 compared with 0.66, 95% CI: 0.54–0.77).ConclusionsGlaucoma RPA is a representative and intuitive progression analysis tool that can improve the reproducibility of clinical decision making. As RPA is a statistical (deterministic) technique not dependent on deep learning, this should facilitate rapid clinical translation.
A comparative study of difluprednate 0.05% nanoemulsion vs prednisolone acetate 1% + phenylephrine 0.12% suspension on postoperative inflammation treatment following cataract surgery
Authors: Valvecchia Gerardo , Kaufer Robert , Ferroni Carlos , Zaldívar Roger , Masseroni Manuela , Idiart Cecilia , Ferroni Valeria , Marino Flavia , Nuñez Myriam , del Papa Melina Sol , Passerini María Silvia 
Published: January 2022

AbstractPurposeTo investigate if Difluprednate 0.05% nanoemulsion (DIFL) administered once a day (BID) is non‐inferior than Prednisolone acetate 1% + Phenylephrine hydrochloride 0.12% (P+P) administered four times a day (QID), on post‐operative inflammation treatment following cataract surgery.MethodsA multicentric, randomized, double‐masked, parallel‐group, non‐inferiority study was performed in 259 patients who underwent phacoemulsification. Primary endpoint was corneal thickness. Non‐inferior anti‐inflammatory efficacy was considered if the difference in corneal thickness between baseline and Day 4 did not differ beyond 17 µm between treatments. Secondary endpoints were cell & flare, best‐corrected visual acuity (BCVA), endothelial cell count, OCT‐central macular thickness, and intraocular pressure (IOP). All outcomes were evaluated at baseline, day 1, 4, and 28 after surgery.Results225 patients finished the study. The difference in corneal thickness at baseline and Day 4 did not differ beyond 17 µm between treatments (IC95% −2.78 µm – 14.84 µm), with no statistically significant differences between treatments (p = 0.523). There were no statistically significant differences between groups in flare & cells at all study times (p > 0.05). No statistically significant differences were reported between treatments in BCVA (p = 0.455), although BCVA logMAR improved in DIFL group at Day 1 (from 0.198 to 0.177), while P+P group did not improve (from 0.219 to 0.234). No statistically significant differences were reported in endothelial cell count (p = 0.811), OCT‐central macular thickness (p = 0.869), and in intraocular pressure outcome (p = 0.316). At Day 28, four patients reported elevated IOP (>21 mmHg), three of which belonged to P+P.ConclusionsDifluprednate 0.05% ophthalmic nanoemulsion administered BID is at least as effective as Prednisolone acetate 1% + Phenylephrine 0.12% suspension administered QID on anti‐inflammatory treatment following cataract surgery.
Accommodative and convergence anomalies in patients with opioid use disorder
Authors: Yekta Abbas Ali , Khabazkhoob Mehdi , Ghobadi Mohaddeseh , Hashemi Hassan , Ali Talaee , Fathi Hamidreza , Yekta Yegane , Nabovati Payam , Ostadimoghaddam Hadi , Shandiz Javad Heravian 
Published: January 2022

AbstractPurposeTo determine the prevalence of accommodative and convergence anomalies and their related factors in a population of young adults with opioid use disorder (OUD).MethodsThis cross‐sectional study was conducted using a convenience sampling method. The study sample included male young adults with OUD who referred to a specialized drug‐dependence rehabilitation center in Mashhad, Iran. The diagnosis of OUD was made by a psychologist based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) criteria. All patients underwent complete optometric examinations.ResultsEighty male young adults with OUD were included in this study. The mean age of participants was 30.5 ± 3.9 years (age range = 19 to 35 years). The prevalence of accommodative and convergence disorders was 33.75% (95% CI: 23.55–45.19) and 25.00 (95% CI: 15.99–35.94), respectively. Accommodative insufficiency (22.5%, 95% CI: 13.91‐ 33.21) had a higher prevalence than accommodative excess (3.75%, 95% CI: 0.78–10.57) and accommodative infacility (7.50%, 95% CI: 2.80–15.61). Convergence insufficiency (18.75%, 95% CI: 10.89–29.03) had a higher prevalence compared to convergence excess (3.75%, 95% URL: https://mc.manuscriptcentral.com/ceoptom Email: TCEO-peerreview@journals.tandf.co.uk Clinical and Experimental Optometry For Review CI: 0.78–10.57) and basic exophoria (2.50%, 95% CI: 0.30–8.74). According to the multiple logistic regression, a significant inverse relationship was observed between pupil size with accommodative insufficiency (OR = 0.45), accommodative infacility (OR = 0.67), and convergence insufficiency (OR = 0.55).ConclusionsThe results of the present study showed a higher prevalence of accommodative and convergence disorders in OUD patients compared to the prevalence reported in previous studies conducted on the normal populations with a similar age range.