Hasil untuk "Ophthalmology"

C. Frey

Jing Cong, Xueqi Lin, Jiayue Yuan et al.

Abstract Introduction This work aims to compare the 12-month changes in refractive outcomes, safety, efficacy, predictability, corneal biomechanics, and corneal topography between keratorefractive lenticule extraction (KLEx) and KLEx combined with prophylactic corneal collagen cross-linking (KLEx Xtra). Methods A prospective, randomized, controlled trial was conducted with 80 eyes in each group. The primary endpoint was the manifest refraction spherical equivalent (MRSE) at 12 months postoperatively in both groups. Secondary endpoints included visual outcomes, corneal biomechanical parameters, and topographic changes. The study has been registered at ClinicalTrials.gov (No. NCT06992011). Results At the 12-month follow-up, a small statistically significant difference in MRSE was observed between the two groups (KLEx Xtra: − 0.02 ± 0.38 D and − 0.17 ± 0.35 D, p = 0.047). Both groups demonstrated comparable and favorable safety and efficacy indices at 12 months. While corneal haze occurred universally early after the CXL procedure, it persisted in a subset of eyes for up to 6 months. At 12 months postoperatively, both KLEx and KLEx Xtra groups showed significant changes in corneal biomechanical parameters. The KLEx Xtra group exhibited enhanced biomechanical strength, with a significant improvement in parameters such as first applanation velocity (A1 V), Corvis biomechanical index (CBI), stiffness parameter at applanation 1 (SP-A1), and stress–strain index (SSI), compared to the KLEx group at 12 months postoperatively (p < 0.05). There were no significant differences between the two groups in corneal topographic parameters up to 6 months postoperatively, but at 12 months, the KLEx group showed significantly higher steep K value of anterior corneal surface (K2 F) compared to the KLEx Xtra group. Conclusions KLEx Xtra demonstrates superior refractive accuracy with a reduced risk of myopic regression within 12 months of follow-up while also enhancing corneal biomechanical strength, making it a viable alternative for people with high myopia. Trial Registration The study has been registered at Clinicaltrials.gov, NCT06992011 (retrospectively registered at May 7, 2025).

K. Jirsova, G. Jones

Alaleh Azhir, Shawn N. Murphy, Hossein Estiri

Machine learning in medicine is typically optimized for population averages. This frequency weighted training privileges common presentations and marginalizes rare yet clinically critical cases, a bias we call the average patient fallacy. In mixture models, gradients from rare cases are suppressed by prevalence, creating a direct conflict with precision medicine. Clinical vignettes in oncology, cardiology, and ophthalmology show how this yields missed rare responders, delayed recognition of atypical emergencies, and underperformance on vision-threatening variants. We propose operational fixes: Rare Case Performance Gap, Rare Case Calibration Error, a prevalence utility definition of rarity, and clinically weighted objectives that surface ethical priorities. Weight selection should follow structured deliberation. AI in medicine must detect exceptional cases because of their significance.

Ines Frajtag, Marko Švaco, Filip Šuligoj

The use of robotics, computer vision, and their applications is becoming increasingly widespread in various fields, including medicine. Many face detection algorithms have found applications in neurosurgery, ophthalmology, and plastic surgery. A common challenge in using these algorithms is variable lighting conditions and the flexibility of detection positions to identify and precisely localize patients. The proposed experiment tests the MediaPipe algorithm for detecting facial landmarks in a controlled setting, using a robotic arm that automatically adjusts positions while the surgical light and the phantom remain in a fixed position. The results of this study demonstrate that the improved accuracy of facial landmark detection under surgical lighting significantly enhances the detection performance at larger yaw and pitch angles. The increase in standard deviation/dispersion occurs due to imprecise detection of selected facial landmarks. This analysis allows for a discussion on the potential integration of the MediaPipe algorithm into medical procedures.

Thomas Saigre, Vincent Chabannes, Christophe Prud'Homme et al.

We present a comprehensive computational model to simulate the coupled dynamics of aqueous humor flow and heat transfer in the human eye. To manage the complexity of the model, we make significant efforts in meshing and efficient solution of the discrete problem using high-performance resources. The model accurately describes the dynamics of the aqueous humor in the anterior and posterior chambers and accounts for convective effects due to temperature variations. Results for fluid velocity, pressure, and temperature distribution are in good agreement with existing numerical results in the literature. Furthermore, the effects of postural changes and wall shear stress behavior are analyzed, providing new insights into the mechanical forces acting on ocular tissues. Overall, the present contribution provides a detailed three-dimensional simulation that enhances the understanding of ocular physiology and may contribute to further progress in clinical research and treatment optimization in ophthalmology.

Rui-Hua Jing, Deng-Ke Zhou, Zhuo-Yan Yang et al.

AIM: To use two-sample Mendelian randomization (MR) method to study uveitis causal association with wet age-related macular degeneration (wAMD) risk from the genetic level. METHODS: Two-sample MR analysis was used to assess the causal role of uveitis on wAMD risk, using the 8 genetic variants associated strongly with uveitis as instrumental variables. Besides, eight MR methods [inverse variance weighted (IVW), weighted median, MR-Egger regression, weighted mode, simple mode, robust adjusted profile score (RAPS), contamination inverse-variance weighted method, and debiased inverse-variance weighted method] were used to get the whole causal estimate for multiple instrumental single nucleotide polymorphism (SNPs). The MR analysis was based on Europeans. RESULTS: Uveitis was related to a higher risk of wAMD [odds ratio (OR): 1.08, 95% confidence interval (CI) 1.03–1.12; P=1.03×10-3] with the IVW method. No heterogeneity and directional pleiotropy were detected. On the contrary, no significant results were detected in reverse MR analysis. CONCLUSION: Uveitis is related to an increased risk of wAMD. Due to the high blindness rate of wAMD, understanding and controlling the risk factors of AMD is of great significance for reducing its incidence and early diagnosis and treatment.

Giovanna Villar dos Santos, Nelson Chama Capelanes, Bernardo Kaplan Moscovici et al.

RESUMO Objetivo: Delinear o perfil oftalmológico de pacientes de um ambulatório oftalmológico, a fim de conhecer as demandas locais, bem como, as necessidades de investimento em saúde ocular mais específicas. Métodos: Estudo de caráter transversal, observacional e retrospectivo, que realizou o levantamento de 1.942 prontuários nos anos de 2022 e 2023 e analisou, por meio do teste do qui-quadrado, teste Shapiro-Wilks (N≥100) e comparação entre os dados pela análise de variância, os seguintes pontos: diagnóstico oftalmológicos, média, sexo, presença de doenças crônicas e seguimento. Resultados: A média etária no geral foi de 49,6 ± 21,3 anos, com prevalência do sexo feminino em 2022 (56,2%), 2023 (61,3%) e no geral (59,4%). Houve maior prevalência da resposta "não" para a presença de doenças crônicas nos anos de 2022 (53,9%), 2023 (53,8%) e no geral (53,8%), além de maior prevalência no seguimento ambulatorial para todas as análises; todavia, a resposta "sim" para doenças crônicas esteve relacionada a maiores taxas de seguimento cirúrgico, encaminhamentos e retornos. As patologias prévias mais prevalentes encontradas foram hipertensão arterial sistêmica, diabetes mellitus e hipotireoidismo, dentre os diagnósticos incidentes no serviço, erros refracionais (52,7%), catarata (22,4%), glaucoma (8%) e degeneração macular (5,6%). Conclusão: Os achados deste estudo confirmam as demandas esperadas para um serviço ambulatorial e espera, com seus resultados, contribuir com a estatística nacional e a gestão dos recursos do hospital local.

Matthew Lynch, Sophie Manoy, Peter D. Sly et al.

Summary: Background: Ataxia-telangiectasia (A-T) is a rare multisystem disease characterised by neurodegenerative cerebellar ataxia, lung disease, immune deficiency, high cancer risk, and mitochondrial dysfunction. A-T cells demonstrate defective endoplasmic reticulum-mitochondrial connectivity disrupting calcium homoeostasis and mitochondrial fusion, which are corrected in vitro by the triheptanoin metabolite, heptanoate. Methods: We performed a Phase 2a/b trial of triheptanoin with a three-arm placebo-controlled dose-escalation design. Doses escalated at 2-month intervals for 12 months in the sequence 0%, 10%, 20%, 35% of calculated caloric intake. The primary outcome was cell death in respiratory epithelial cells. Key secondary outcomes included scales for assessment and rating of ataxia (SARA), international cooperative ataxia rating scale (ICARS), speech and swallowing function, and novel biomarker discovery. Findings: 31 participants with A-T were enrolled aged from 4 to 37 years (median 16-years). For the maximum dose vs. placebo or no dose, significant improvements was observed for the primary outcome percent nasal cell death (mean difference (MD) = −9.7%, 95% confidence interval (CI) −16.0, 4.6). The SARA subscale kinetic function improved (MD = −5.8, 95% CI −10.4, −1.2), as did ICARS subscales gait (MD = −0.5, 95% CI −0.9, −0.1) and fine motor disturbance (MD = −2.7, 95% CI −4.3, −1.1). Speech intelligibility (MD = −12.8, 95% CI −21.2, −4.3) and swallowing safety (−0.9, 95% CI −1.6, −0.3) improved. Adverse events including abdominal pain, nausea, vomiting, and diarrhoea, requiring dose capping at 20%, were observed in 12 (38%) participants. Interpretation: Improvements in mitochondrial function in A-T cells in vivo in patients occurred after triheptanoin. The biomarkers neurofilament light chain and interferon signature stimulated gene scores may allow for monitoring of disease progression and treatment response. Funding: Funded by Medical Researcher Futures Fund Australia (GA89314), The University of Queensland, Wesley Research Institute, and BrAshA-T.

Soham Chakraborty, Ayush Roy, Payel Pramanik et al.

Deep learning and computer vision methods are nowadays predominantly used in the field of ophthalmology. In this paper, we present an attention-aided DenseNet-121 for classifying normal and glaucomatous eyes from fundus images. It involves the convolutional block attention module to highlight relevant spatial and channel features extracted by DenseNet-121. The channel recalibration module further enriches the features by utilizing edge information along with the statistical features of the spatial dimension. For the experiments, two standard datasets, namely RIM-ONE and ACRIMA, have been used. Our method has shown superior results than state-of-the-art models. An ablation study has also been conducted to show the effectiveness of each of the components. The code of the proposed work is available at: https://github.com/Soham2004GitHub/DADGC.

Yu-Hsi Chen

Automated data labeling techniques are crucial for accelerating the development of deep learning models, particularly in complex medical imaging applications. However, ensuring accuracy and efficiency remains challenging. This paper presents iterative refinement strategies for automated data labeling in facial landmark diagnosis to enhance accuracy and efficiency for deep learning models in medical applications, including dermatology, plastic surgery, and ophthalmology. Leveraging feedback mechanisms and advanced algorithms, our approach iteratively refines initial labels, reducing reliance on manual intervention while improving label quality. Through empirical evaluation and case studies, we demonstrate the effectiveness of our proposed strategies in deep learning tasks across medical imaging domains. Our results highlight the importance of iterative refinement in automated data labeling to enhance the capabilities of deep learning systems in medical imaging applications.

Yining Jiao, Amy Oldenburg, Yinghan Xu et al.

Optical coherence tomography (OCT) is a popular modality in ophthalmology and is also used intravascularly. Our interest in this work is OCT in the context of airway abnormalities in infants and children where the high resolution of OCT and the fact that it is radiation-free is important. The goal of airway OCT is to provide accurate estimates of airway geometry (in 2D and 3D) to assess airway abnormalities such as subglottic stenosis. We propose $\texttt{NeuralOCT}$, a learning-based approach to process airway OCT images. Specifically, $\texttt{NeuralOCT}$ extracts 3D geometries from OCT scans by robustly bridging two steps: point cloud extraction via 2D segmentation and 3D reconstruction from point clouds via neural fields. Our experiments show that $\texttt{NeuralOCT}$ produces accurate and robust 3D airway reconstructions with an average A-line error smaller than 70 micrometer. Our code will cbe available on GitHub.

Ni Made Ayu Surasmiati, Ariesanti Tri Handayani, I Wayan Eka Sutyawan

Background The prevalence of refractive errors is reported to be higher in children born preterm. Factors such as gestational age, birth weight, and retinopathy of prematurity status, have a significant impact on the refractive development in preterm infants. Prematurity and low birth weight affect the development of organ systems in infants, including the eyes. In addition to immature retinas, other eye conditions, such as refractive status, are also observed. This study aimed to determine the risk factors of refractive status, specifically refractive errors (spherical equivalent, astigmatism, and anisometropia) in premature infants at a tertiary hospital in Bali. Methods A cross-sectional study was conducted involving 53 premature infants. This study collected samples from January to August 2023 at the Neonatal Intensive Care Unit of Prof. dr. IGNG Ngoerah General Hospital. Data regarding gender, gestational age, birth weight, retinal condition, spherical equivalent, and refractive disorders were collected. The relationship between risk factors and spherical equivalent, astigmatism, and anisometropia were analyzed using multiple regression analysis with statistical significance set at p<0.05. Results Hypermetropia is the most common finding in premature infants, followed by myopia and astigmatism. The prevalence of myopia (9.4%) and astigmatism (5.7%) is also more common among newborns of gestational age ≤30 weeks (p=0.024). Chronological age was significantly associated with spherical equivalent (β=0.424; p=0.019). Conclusion In premature infants, chronological age was the risk factor of spherical equivalent. Other risk factors were not associated with the prevalence of refractive errors among premature infants.

Suparmi Suparmi, Harka Prasetya, Harka Prasetya et al.

IntroductionNight blindness is the first sign of vitamin A deficiency (VAD), which can lead to blindness if left untreated. University students may be at risk of VAD-related night blindness due to unhealthy eating attitudes and inadequate vitamin A intake. This study aimed to determine the relationship between knowledge and attitudes toward vitamin A consumption affecting night blindness in university students.MethodsThis cross-sectional study involved 409 third-year university students of Universitas Islam Sultan Agung, Semarang, Indonesia. Participants completed questionnaires about socio-demographics, their knowledge of vitamin A, and attitudes toward vitamin A consumption. Night blindness symptoms among university students were assessed using the Low Luminance Questionnaire (LLQ), followed by a bivariate analysis of the Chi-Square test. Multivariate binary logistic regressions were used to determine whether the independent variables were associated with night blindness. A p-value less than 0.05 indicated significance.ResultsThe prevalence of high-symptom night blindness was higher among males (26.4%) than females (5.7%). Out of 409 university students, 48 from the non-medicine cluster of the study program had a night blindness symptom. The prevalence was lower in students who studied in the medicine cluster program. The level of knowledge on vitamin A had a significant relationship with symptoms of night blindness [prevalence ratio (PR) = 2.239 (95% CI = 1.110–4.516)]. The attitudes toward vitamin A consumption were significantly associated with night blindness (PR = 2.560, 95% CI = 1.215–5.392).DiscussionThe results of this study show that the risk of night blindness in university students can be prevented by increasing their knowledge and attitudes toward consuming vitamin A-rich food. The university can provide health promotion and vitamin A supplementation to avoid night blindness among academia.

Luis Filipe Nakayama, João Matos, Justin Quion et al.

Over the past two decades, exponential growth in data availability, computational power, and newly available modeling techniques has led to an expansion in interest, investment, and research in Artificial Intelligence (AI) applications. Ophthalmology is one of many fields that seek to benefit from AI given the advent of telemedicine screening programs and the use of ancillary imaging. However, before AI can be widely deployed, further work must be done to avoid the pitfalls within the AI lifecycle. This review article breaks down the AI lifecycle into seven steps: data collection; defining the model task; data pre-processing and labeling; model development; model evaluation and validation; deployment; and finally, post-deployment evaluation, monitoring, and system recalibration and delves into the risks for harm at each step and strategies for mitigating them.

Fan-Sheng Kong, Fan-Sheng Kong, Zijing Lu et al.

BackgroundPolycystic ovary syndrome (PCOS) is a complex, multifactor disorder in women of reproductive age worldwide. Although RNA editing may contribute to a variety of diseases, its role in PCOS remains unclear.MethodsA discovery RNA-Seq dataset was obtained from the NCBI Gene Expression Omnibus database of granulosa cells from women with PCOS and women without PCOS (controls). A validation RNA-Seq dataset downloaded from the European Nucleotide Archive Databank was used to validate differential editing. Transcriptome-wide investigation was conducted to analyze adenosine-to-inosine (A-to-I) RNA editing in PCOS and control samples.ResultsA total of 17,395 high-confidence A-to-I RNA editing sites were identified in 3,644 genes in all GC samples. As for differential RNA editing, there were 545 differential RNA editing (DRE) sites in 259 genes with Nucleoporin 43 (NUP43), Retinoblastoma Binding Protein 4 (RBBP4), and leckstrin homology-like domain family A member 1 (PHLDA) showing the most significant three 3′-untranslated region (3′UTR) editing. Furthermore, we identified 20 DRE sites that demonstrated a significant correlation between editing levels and gene expression levels. Notably, MIR193b-365a Host Gene (MIR193BHG) and Hook Microtubule Tethering Protein 3 (HOOK3) exhibited significant differential expression between PCOS and controls. Functional enrichment analysis showed that these 259 differentially edited genes were mainly related to apoptosis and necroptosis pathways. RNA binding protein (RBP) analysis revealed that RNA Binding Motif Protein 45 (RBM45) was predicted as the most frequent RBP binding with RNA editing sites. Additionally, we observed a correlation between editing levels of differential editing sites and the expression level of the RNA editing enzyme Adenosine Deaminase RNA Specific B1 (ADARB1). Moreover, the existence of 55 common differentially edited genes and nine differential editing sites were confirmed in the validation dataset.ConclusionOur current study highlighted the potential role of RNA editing in the pathophysiology of PCOS as an epigenetic process. These findings could provide valuable insights into the development of more targeted and effective treatment options for PCOS.

Xiaohong Chen, Yanjian Chen, Xingchui Lin et al.

Objective: To investigate the feasibility and effectiveness of hydrogen in the treatment of retinitis pigmentosa (RP) patients through the drinking of hydrogen-rich water (HRW). Methods: RP patients clinically diagnosed in our hospital were selected and given HRW for drinking at 400–500 ml twice a day for four consecutive weeks. Changes in best corrected visual acuity (BCVA), intraocular pressure, the retinal thickness, and choroidal thickness, as well as the amplitude and peak time of visual electrophysiological examinations before and after HRW drinking were observed. Data were statistically analyzed. Results: In total, 24 eyes of 13 patients with RP (3 males and 10 females aged–27-65 years old, were enrolled in the study. The BCVA after HRW drinking was 0.34 ± 0.25, which was statistically improved compared with that before (P < 0.05). There were no significant differences in intraocular pressure, retinal lhickness, or choroidal thickness before and after HRW drinking (all P > 0.05). The amplitudes of the b-wave in Dark-adaptation 0.01 response, a and b waves in Dark-adaptation 3.0 response, the Dark-adaptation Ops total wave, a and b waves in Light-adaptation 3.0 response, and the Light-adaptation Flicker response of electroretinogram (ERG) were significantly higher than those before HRW drinking (all P < 0.05). The corresponding peak times iwere mproved to some extent compared to those before HRW consumption (all P < 0.05). Six patients with RP (11 eyes) had a BCVAm ore than 20/200. The amplitude and peak time of the P100 -ave from the 1°p attern visual evoked potentials (PVEP) were not significantly different from those before HRW drinking (P > 0.05), while the data from the 15′ PVEP were statistically different (P < 0.05). Seven patients with RP (13 eyes) had a BCVA less than. 20/200 No significant differences were found in the amplitude and peak time of the P2 wave from the 1.0 Hz flash visual evoked potentials (FVEP) and the amplitude from the 12 Hz FVEP compared with those before HRW drinking (all P > 0.05). Conclusion: Short-term HRW drinking slightly improved visual function in patients with primary RP, whereas no significant improvement was found in the thickness of the retina and choroid.

Aaron Y. Lee, J. Campbell, T. Hwang et al.

of image-based data needs to be accurate and reliable, this is difficult to accomplish in settings that use multiple proprietary devices data storage digital image Imaging

T. Wong, F. Bandello

Ophthalmology departments in academic medical centers (AMCs) have a triple mission of clinical care, teaching, and research. The coronavirus 2019 (COVID-19) pandemic has had a major impact on how the AMCs operate. In addition to ophthalmologists and other subspecialists being called to the front lines (e.g., to cover general wards), COVID-19 has required strategic and operational changes in each of the AMCs’ triple missions. Herein, we outline common practices and possible long-term impacts.

Engin Akyol, Ahmed M. Hagag, S. Sivaprasad et al.