Agreement Between Swept-source Optical Coherence Tomography and Rotating Scheimpflug Camera in Measurement of Corneal Parameters in Normal and Keratoconic Eyes

Purpose: This study aimed to assess the agreement between topographic indices of healthy subjects and keratoconus (KCN) patients using a swept-source optical coherence tomography (SS-OCT CASIA2) versus a Scheimpflug camera (Pentacam). Methods: 40 eyes of 23 patients with KCN and 40 eyes of 20 healthy subjects were included and evaluated with the CASIA2, followed by the Pentacam. Two consecutive modalities were obtained for one eye of each patient. Corneal parameters, including anterior keratometry at steep (Ks) and flat meridians (Kf), anterior astigmatism, anterior and posterior corneal elevation values, thinnest corneal thickness, and apex corneal thickness, were evaluated. Results: CASIA2 and Pentacam showed perfect agreement (95% limits of agreement (LoA): -0.22 to 0.68, 95% LoA: -1.5 to 1.44 D) and good correlation (Intraclass correlation (ICC):0.986, ICC:0.987; to 0.68, 95% LoA: -1.5 to 1.44 D) and good correlation (Intraclass correlation (ICC):0.986, ICC:0.987; P <0.01) for anterior (Ks) in normal and ectatic corneas, respectively. The cylinder amount had moderate agreement and correlation (95% LoA: -0.55 to 0.47D, ICC: 0.797, P <0.01) in normal, and moderate to strong agreement and correlation (95% LoA: -1.57 to 0.87D, ICC=0.911, P <0.01) in Keratoconic eyes. There was a fair agreement for anterior and posterior corneal elevation values in normal subjects (95% LoA: -3.09 to 4.59, 95% LoA: -6.91 to 7.31D). The thinnest corneal thickness amount had an excellent agreement in normal and KCN patients (ICC: 0.983, 0.953; respectively). Conclusions: Although the devices had different mean indices values, they had a good agreement based on the Bland–Altman plots. Since Pentacam is accepted as the standard tool for diagnosing ectatic cornea, pentacam CASIA2 is also helpful for early diagnosis of KCN

Comparison of CSV-1000 and Metrovision contrast sensitivity tests in normal eyes

Background: Measuring contrast sensitivity (CS) allows a better understanding of the visual performance of the human eye. This study aimed to examine the correlation and agreement between the results of two sinewave grating-based CS measurement methods, Metrovision and CSV-1000, in normal eyes. Methods: This cross-sectional, comparative study was performed between December 2018 and April 2019, at an optometry clinic. Subjects underwent comprehensive ocular examinations, which included pupil reflexes, subjective refraction, external eye examinations, smooth pursuit eye movement assessment, the cover–uncover test, and detailed slit-lamp examination of the anterior and posterior segments. Metrovision and CSV-1000 were employed to assess CS under photopic conditions. The correlation and agreement of the results of the two tests were evaluated. Results: CS was measured for 104 normal eyes for 3, 6, 12, and 18 cycles per degree (cpd) spatial frequencies (participants’ mean age ± standard deviation: 37.3 ± 26.4 years). The CSV-1000 measurements were significantly higher for the 3 and 6 cpd spatial frequencies (both P = 0.01); however, at higher spatial frequencies, CS scores were similar. The highest and lowest differences between the two tests were recorded for the 3 cpd spatial frequency and 18 cpd spatial frequency, respectively. Except for the 3 cpd spatial frequency, in both eyes, the findings correlated significantly between the CSV-1000 and Metrovision (P < 0.05). The narrowest and widest limits of agreement between the two tests were found for the 12 and 3 cpd spatial frequencies, respectively. Conclusions: The CSV-1000 method estimated CS higher than the Metrovision method, mostly at lower spatial frequencies. Furthermore, the agreement between the two methods was greater at higher spatial frequencies than at lower frequencies. This should be kept in mind when using the two methods interchangeably in visual screening

Impact of vision therapy on eye-hand coordination skills in students with visual impairment

Purpose: To evaluate the enhancing effects of vision therapy on eye–hand coordination skills in students with visual impairments. Methods: Thirty-five visually impaired patients who underwent vision therapy comprised the treatment group, and 35 patients with impaired vision who received no treatment comprised the control group. Full ophthalmic examinations were performed, including biomicroscopy, retinoscopy, and assessments of subjective refraction and visual acuity. Eye–hand coordination was evaluated using the Frostig test. Vision therapy in the treatment group was performed using the Bernell–Marsden ball, perceptual-motor pen, random blink test, and random shape assessment. Results: Data were analyzed for the 35 visually impaired patients and 35 control participants. The mean age was 11.51 ± 3.5 and 11.09 ± 3.1 years in the treatment and control groups, respectively. Female participants comprised 80% of the treatment group and 57% of the control group. Before treatment, the mean scores on the Frostig test were 22.74 ± 4.32 and 21.60 ± 4.10 in the treatment and control groups, respectively, and after treatment, the mean Frostig test scores were 24.69 ± 3.99 and 21.89 ± 3.92, respectively. Statistically significant intergroup differences were found in eye–hand coordination (P < 0.05). No significant intergroup differences were noted in the distance and near visual acuity values. Conclusion: The results demonstrated that vision therapy could significantly improve eye–hand coordination, but no enhancement was found in near or distance visual acuity

Comparison of Keratoconus Cone Location of Different Topo/tomographical Parameters

Purpose: To compare the corneal cone location on different maps and instruments, and their agreements, with elevation maps.Methods: In 90 left eyes with bilateral keratoconus, the apex of cone location was determined based on the maximum simulated keratometry (Kmax) location on the anterior sagittal curvature map by Pentacam HR, the maximum curvature on the mean curvature map by ATLAS 9000, most elevated point of the island of positive elevation relative to the best fit sphere on the front and back corneal elevation maps by Pentacam HR, and thinnest point on the thickness map by Pentacam HR and Orbscan, and the thinnest points on pachymetry and epithelial thickness maps by RTVue OCT.Results: There was a significant difference among the location on different maps along the x- and y-axes (p < .001). The lowest agreement with the cone apex on both front and back elevation maps was for the anterior sagittal curvature map and the highest agreement for the Pentacam thickness map. The majority of keratoconus cone apexes were displaced in the inferotemporal direction on the different maps except for the epithelial thickness maps.Conclusions: Despite the variability between different devices and methods; the thickness map on the Pentacam HR showed the highest correlation with the front and back elevation maps, while the RTVue epithelial thickness map showed the poorest correlation. Based on this study, epithelial thickness maps and anterior curvature maps should be utilized with caution to determine the location of the cone

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Safiri S, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY &amp; HEPATOLOGY. 2019;4(12):913-933.Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd