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Frontiers in Medicine 2024To determine the agreement between intraocular pressure (IOP) measurements using conventional Goldmann applanation tonometry (GAT) and SUOER SW-500 Rebound Tonometer.
INTRODUCTION
To determine the agreement between intraocular pressure (IOP) measurements using conventional Goldmann applanation tonometry (GAT) and SUOER SW-500 Rebound Tonometer.
METHODS
This was a retrospective observational study where 205 eyes of 106 glaucoma patients had their IOPs measured by 2 fellowship trained ophthalmologists. Data were analyzed using the Bland-Altman method of differences. Correlation was measured using the Pearson coefficient.
RESULTS
Most of our patients were Chinese (88.7%) and female (51.9%). The average age was 66.9 years. The range of IOPs as measured by GAT was 2 to 58 mm Hg. Using the Bland-Altman method to compare GAT and SUOER SW-500 Rebound Tonometer. The tonometer overestimated the IOP by 0.5 mm Hg in the right eye and underestimated it by 0.1 mm Hg in the left eye. Overall, the tonometer overestimated the IOP by 0.2 mmHg. The Tonometer IOP correlated well with GAT, with a Pearson coefficient of correlation() of 0.89 ( < 0.001) for the right eye and 0.86 ( < 0.001) for the left eye, respectively. In patients with GAT IOP ≥ 21 mm Hg ( = 25), the Tonometer underestimated the IOP by 2.96 mm Hg.
DISCUSSION
The IOP measurements from the SUOER SW-500 Rebound Tonometer correlates well with the conventional GAT in measuring the IOP within normal ranges of IOP. SUOER SW-500 Rebound Tonometer may be of use, especially if the risk of transmission of infection is high considering that the probes are disposable. It is easy to use and its small size and portability makes it useful in situations where the patient is unable to be examined at the slit lamp.
PubMed: 38938385
DOI: 10.3389/fmed.2024.1269332 -
Microorganisms Jun 2024Ophthalmologists' diagnostic and treatment competence in Acanthamoeba keratitis varies widely. This investigator-initiated, retrospective, single-center chart review...
Ophthalmologists' diagnostic and treatment competence in Acanthamoeba keratitis varies widely. This investigator-initiated, retrospective, single-center chart review examined the electronic patient files regarding PCR-positive Acanthamoeba keratitis. We included corneal and contact lens assessments. We further reviewed the patient's medical history, corneal scraping results regarding viral or fungal co-infections, and the duration from symptom onset to final diagnosis. We identified 59 eyes of 52 patients from February 2010 to February 2023, with 31 of 52 (59.6%) being female patients. The median (IQR, range) patient age was 33 (25.3 to 45.5 [13 to 90]) years, and the mean (SD, range) time to diagnosis after symptom onset was 18 (10.5 to 35 [3 to 70]) days. Overall, 7 of 52 (7.7%) patients displayed a bilateral Acanthamoeba infection, and 48 (92.3%) used contact lenses at symptom onset. Regarding other microbiological co-infections, we found virologic PCR testing in 45 of 52 (86.5%) patients, with 3 (6.7%) positive corneal scrapings. Fungal cultures were performed in 49 of 52 (94.2%) patients, with 5 (10.2%) positive corneal scrapings. The medical treatment success rate was 45/46 (97.8%). This study raises awareness of patient education in contact lens handling and screens for further microbial co-infections in suspected Acanthamoeba cases.
PubMed: 38930596
DOI: 10.3390/microorganisms12061214 -
Journal of Clinical Medicine Jun 2024Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD...
Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD affects diagnostic accuracy and distinguish between malignant choroidal melanoma and benign choroidal nevus among ophthalmologists. In this cross-sectional study, we engaged ophthalmologists through a web-based survey distributed via the professional ophthalmology society's social media channels. The survey encompassed a series of three fundus images representing normal fundus, choroidal nevus, and choroidal melanoma. Each image underwent simulation for the three primary types of CVD-protanopia, deuteranopia, and tritanopia-alongside a non-simulated version. The study included 41 participants, averaging 40 years of age (±9.2), comprising 28 (68%) men and 13 (32%) women. Significantly lower rates of identifying orange pigments were observed in simulated protanopia images compared to non-simulated ones ( = 0.038). In simulated deutranopia images, the recognition of melanotic lesions was notably reduced compared to non-simulated images ( = 0.048). No such limitation was observed for tritanopia. However, participants retained their ability to identify subretinal fluid and estimate tumor thickness in simulated and non-simulated images. Concerning simulated images of choroidal nevi, participants misdiagnosed nevi as choroidal melanoma in 37% of cases in simulated protanopia nevi images and 41% in simulated deutranopia nevi images. This resulted in unnecessary referrals of benign lesions as malignant, emphasizing the potential for mistaken diagnoses. Nevertheless, almost all simulated images of malignant melanoma were correctly referred for specialized oncological treatment. The simulated CVD conditions of protanopia and deuteranopia affected the accuracy of identifying the melanotic nature of the choroidal tumor and the presence of orange pigments. This limitation led to challenges in correctly diagnosing choroidal melanoma and choroidal nevus, resulting in extra referrals for nevus cases. However, participants were safe and could still determine the possible risk of eyes with choroidal melanoma, so most referred melanoma cases to specialized oncologists as needed.
PubMed: 38930154
DOI: 10.3390/jcm13123626 -
Medicina (Kaunas, Lithuania) May 2024We present a case of bilateral endogenous endophthalmitis with an extremely rare etiology of . A 42-year-old asplenic patient with bilateral deterioration of visual...
We present a case of bilateral endogenous endophthalmitis with an extremely rare etiology of . A 42-year-old asplenic patient with bilateral deterioration of visual acuity presented to the Emergency Department. The sudden deterioration of visual acuity, which prompted the patient to visit the ophthalmologist, was the first sign of the onset of sepsis. The physicians' attention, in addition to poor visual acuity and intense inflammation on ophthalmologic examination, was drawn to the reported flu-like symptoms. They were accompanied by high C-reactive protein results and abnormalities in echocardiography. A blood culture isolated the bacterium Immunocompromised patients are particularly susceptible to infection. Endophthalmitis of this etiology has a very aggressive course, both ophthalmic and systemic. Therefore, quick diagnosis and initiation of adequate therapy are crucial.
Topics: Humans; Endophthalmitis; Capnocytophaga; Adult; Sepsis; Gram-Negative Bacterial Infections; Male; Anti-Bacterial Agents
PubMed: 38929513
DOI: 10.3390/medicina60060896 -
Children (Basel, Switzerland) Jun 2024Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the...
BACKGROUND
Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the effectiveness of electronic artificial intelligence (AI) large language models (LLMs), such as ChatGPT-4, BingAI, and Gemini in responding to patient inquiries about retinopathy of prematurity (ROP).
METHODS
The answers of LLMs for fifty real-life patient inquiries were assessed using a 5-point Likert scale by three ophthalmologists. The models' responses were also evaluated for reliability with the DISCERN instrument and the EQIP framework, and for readability using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Coleman-Liau Index.
RESULTS
ChatGPT-4 outperformed BingAI and Gemini, scoring the highest with 5 points in 90% (45 out of 50) and achieving ratings of "agreed" or "strongly agreed" in 98% (49 out of 50) of responses. It led in accuracy and reliability with DISCERN and EQIP scores of 63 and 72.2, respectively. BingAI followed with scores of 53 and 61.1, while Gemini was noted for the best readability (FRE score of 39.1) but lower reliability scores. Statistically significant performance differences were observed particularly in the screening, diagnosis, and treatment categories.
CONCLUSION
ChatGPT-4 excelled in providing detailed and reliable responses to ROP-related queries, although its texts were more complex. All models delivered generally accurate information as per DISCERN and EQIP assessments.
PubMed: 38929329
DOI: 10.3390/children11060750 -
Biology Jun 2024Eales' Disease is an idiopathic peripheral retinal vasculopathy first described by British ophthalmologist Henry Eales in 1880. Most prevalent in healthy young males,... (Review)
Review
Eales' Disease is an idiopathic peripheral retinal vasculopathy first described by British ophthalmologist Henry Eales in 1880. Most prevalent in healthy young males, Eales' Disease often presents with symptoms of sudden blurry or decreased vision and floaters. Although no clear, standardized stage of the disease exists, it progresses through three overlapping phases-peripheral periphlebitis, ischemic capillary ischemia, and retinal neovascularization. The etiology of Eales' Disease is unknown and appears to be multifactorial, but post-TB hypersensitivity to tuberculoprotein and DNA is the most potential cause in the etiology of Eales' Disease. With a thorough examination of the clinical presentation and diagnosis of Eales' Disease-incorporating the latest clinical findings related to the condition-the investigation for Eales' Disease extends to explore recent potential connections with other ocular conditions or possible cofactors, such as glaucoma, uncontrolled diabetes, drug abuse, or inherited medical conditions. Moreover, focusing on critical insights into the treatment of Eales' Disease across its various stages of progression, the overarching goal of the paper is to refine and suggest possible future diagnostic and therapeutic strategies. Widening our understanding of pathophysiology and utilizing various treatment options for individual patients holds immense potential for advancing ocular medicine and optimizing patient care for people with this disease with unknown pathophysiology.
PubMed: 38927340
DOI: 10.3390/biology13060460 -
Translational Vision Science &... Jun 2024This study investigated the distribution of fundus tessellation density (FTD) in a Chinese pediatric population and its potential in reflecting early myopic maculopathy...
PURPOSE
This study investigated the distribution of fundus tessellation density (FTD) in a Chinese pediatric population and its potential in reflecting early myopic maculopathy (tessellated fundus).
METHODS
Participants were enrolled from kindergartens, primary schools, and middle schools, with cluster sampling in Shanghai, China. A series of ophthalmic examinations was conducted. Based on fundus photograph, FTD was quantitatively assessed using an artificial intelligence algorithm, and tessellated fundus was diagnosed by well-trained ophthalmologists.
RESULTS
A total of 14,234 participants aged four to 18 years were included, with 7421 boys (52.1%). Tessellated fundus was observed in 2200 (15.5%) participants. The median of FTD was 0.86% (range 0.0-42.1%). FTD increased with age and axial length. In the logistics regression, larger FTD was independently associated with tessellated fundus (P < 0.001). The area under curves of receiver operating characteristic curve for categorizing tessellated fundus using FTD was 0.774, and the cutoff point of FTD was 2.22%.
CONCLUSIONS
The density of fundus tessellation was consistent with the severity of myopia. FTD could help diagnose the early stage of myopic maculopathy, tessellated fundus, providing a new pattern for myopia screening and detection of early myopic fundus changes.
TRANSLATIONAL RELEVANCE
Quantification of fundus tessellation with artificial intelligence could help detect early myopic maculopathy.
Topics: Humans; Male; Adolescent; Child; Female; Fundus Oculi; Child, Preschool; China; ROC Curve; Myopia, Degenerative; Macular Degeneration; Artificial Intelligence; Photography
PubMed: 38922627
DOI: 10.1167/tvst.13.6.22 -
International Ophthalmology Jun 2024To provide a comprehensive microbiological profile of bacterial dacryocystitis in South Australia. By identifying the specific microorganism and antibiotic...
PURPOSE
To provide a comprehensive microbiological profile of bacterial dacryocystitis in South Australia. By identifying the specific microorganism and antibiotic susceptibility, this study intends to aid ophthalmologists in choosing appropriate empirical antibiotic therapies and development of evidence-based clinical guidelines.
METHOD
A retrospective study was conducted at the Royal Adelaide Hospital (RAH) over five years (2018-2023) of patients with acute dacryocystitis. The study included 43 patients, and data encompassed demographic information, clinical presentation, microbiological analysis, management, and outcomes. Patients with chronic dacryocystitis were excluded.
RESULTS
Among the 43 patients included in the study (female 28 (65%), mean age: 64 years old), the most common clinical features were pain (74%) and swelling (70%). Organisms were identified in 49% of patients, with the predominant bacteria being Staphylococcus aureus (42%), Streptococcus species (19%), and Escherichia coli (8%). Aggregatibacter species (8%), Morganella morganii (4%), Enterobacter cloaceae (4%), Hafnia alvei (4%), mixed anaerobes (4%), E coliforms (4%) and Pseudomonas aeruginosa (4%) were also identified. The most frequently prescribed empirical antibiotics were amoxicillin-clavulanic acid (50%), flucloxacillin (33%) and cefalexin (18%).
CONCLUSION
The microbiological trends of acute dacryocystitis have largely remained consistent, with a predominance of Gram positive organisms. This is the most recent profile analysis of acute dacryocystitis in South Australia and will help form evidence-based clinical guidelines.
Topics: Humans; Female; Middle Aged; Dacryocystitis; Male; Eye Infections, Bacterial; Retrospective Studies; South Australia; Acute Disease; Anti-Bacterial Agents; Aged; Tertiary Care Centers; Adult; Bacteria; Microbial Sensitivity Tests; Aged, 80 and over
PubMed: 38922457
DOI: 10.1007/s10792-024-03236-0 -
Frontiers in Neurology 2024In central retinal artery occlusion (CRAO) or retinal stroke, which is usually a vision-threatening condition, timely diagnosis is imperative to improve the chances of...
In central retinal artery occlusion (CRAO) or retinal stroke, which is usually a vision-threatening condition, timely diagnosis is imperative to improve the chances of retinal preservation and to establish adequate secondary prevention measures. Even though retinal strokes have been traditionally assigned to the field of ophthalmology, while considering reperfusion therapy as the only way to avoid permanent vision loss, we suggest prompt evaluation of CRAO causes (primarily related to cardiovascular risk factors) performed by a well-organized interdisciplinary team (ophthalmologist and neurologist) in a neurovascular center with stroke expertise. Therefore, the most suitable adjunct method for rapidly diagnosing non-arteritic CRAO could be target transorbital ultrasound, performed by an experienced neurologist/neurosonologist in the stroke unit. Consequently, after an ophthalmological assessment, a final decision on thrombolytic therapy could be made. We accept that further research is obviously needed to determine whether transorbital ultrasound could replace ophthalmological investigation in the case of a suspected acute retinal stroke. We assert that retinal stroke requires interdisciplinary treatment in cooperation with neurologists and ophthalmologists, with an additive value for each to achieve the best results for the patient.
PubMed: 38915799
DOI: 10.3389/fneur.2024.1397751 -
Scientific Reports Jun 2024Identification of an early biomarker and effective testing device to differentiate dry eye disease secondary to autoimmune disease (Sjögren's syndrome dry eye disease)...
Identification of an early biomarker and effective testing device to differentiate dry eye disease secondary to autoimmune disease (Sjögren's syndrome dry eye disease) from non-Sjögren's dry eye disease are prerequisites for appropriate treatment. We aimed to demonstrate the capacity of a new photo-detection device to evaluate tear lactoferrin levels as a tool for differentiating systemic conditions associated with dry eye disease. Patients with non-Sjögren's and Sjögren's syndrome dry eye disease (n = 54 and n = 52, respectively) and controls (n = 11) were enrolled. All participants completed the Ocular Surface Disease Index questionnaire. Tear collection was performed with Schirmer test, and tear break-up time was examined using a slit lamp. Tear lactoferrin was evaluated using our newly developed photo-detection device. The average lactoferrin concentration was significantly lower in samples from patients with non-Sjögren's dry eye disease (0.337 ± 0.227 mg/mL, n = 54) and Sjögren's syndrome dry eye disease (0.087 ± 0.010 mg/mL, n = 52) than in control samples (1.272 ± 0.54 mg/mL, n = 11) (p < 0.0001). Further, lactoferrin levels were lower in patients with Sjögren's syndrome dry eye disease than in those with non-Sjögren's dry eye disease (p < 0.001). Our cost-effective, antibody-free, highly sensitive photo-detection device for evaluating tear lactoferrin levels can assist ophthalmologists in differentiating different types of dry eye diseases.
Topics: Lactoferrin; Humans; Tears; Sjogren's Syndrome; Female; Middle Aged; Dry Eye Syndromes; Male; Adult; Biomarkers; Diagnosis, Differential; Aged; Fluorescence
PubMed: 38914667
DOI: 10.1038/s41598-024-65487-2