Aplicațiile inteligenței artificiale în oftalmologie

Department of Ophtalmology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi,Romania, Gheorghe Asachi” Technical University of Iasi, Faculty of Chemical Engineering and Environmental Protection 11 “Cristofor- Simionescu”, Department of Chemical EngineeringRezumat. Instrumentele inteligenței artificiale și, îndeosebi, rețelele neuronale artificiale, sunt tot mai des implicate în diagnosticul și managementul personalizat al bolilor oftalmologice. Imaginile OCT sunt utilizate pentru diagnosticul precoce, monitorizarea și managementul bolilor retinei, cum ar fi edem macular diabetic (EMD) și degenerescență maculară legată de vârstă (DMLV). Citirea automată a OCT a avut rezultate promițătoare în EMD și în identificarea formelor exudative ale DMLV. Cea mai frecventă utilizare a rețelelor neuronale în oftalmologie a fost în stabilirea precoce a diagnosticului de glaucom, atunci când sunt dubii de diagnostic. Rețelele neuronale au avut un rol important în stabilirea necesităţii iniţierii terapiei precoce antiglaucomatoase pentru a preveni progresia bolii. Numeroase studii din literatura de specialitate demonstrează folosirea cu succes a acestor instrumente ale inteligenței artificiale în oftalmologie, pe direcții cum ar fi: evaluarea câmpului vizual, a nervului optic, a stratului fibrelor nervoase retiniene, oferind astfel o mai bună precizie în identificarea progresiei în glaucom şi a modificărilor retiniene în diabet. În oftalmologie, Inteligenta artificiala are potențialul de a crește accesul pacientului la screening / diagnostic clinic și la scăderea costurilor enorme solicitate de asistența medicală, mai ales atunci când riscul apariției bolii este ridicat sau comunitățile se confruntă cu resurse financiare reduse. Reţelele neuronale artificiale sunt utile în stabilirea diagnosticului diferitelor boli, însă informaţiile obţinute au rolul de a ajuta decizia finală care va fi luată de clinician, dar nu va înlocui rolul acestuia.Artificial intelligence tools, and especially artificial neural networks, are increasingly involved in the diagnosis and personalized management of ophthalmic diseases. OCT images are used for early diagnosis, monitoring and management of retinal diseases such as diabetic macular edema (EMD) and age-related macular degeneration (DMLV). Automatic reading of OCT has had promising results in EMD and in identifying exudative forms of DMLV. The most common use of neural networks in ophthalmology has been in early diagnosis of glaucoma, when there is doubt about the diagnosis. Neural networks have played an important role in determining the need for early antiglaucoma therapy to prevent disease progression. Numerous studies in the literature demonstrate the successful use of these tools of artificial intelligence in ophthalmology, in directions such as: assessment of visual field, optic nerve, retinal nerve fiber layer, thus providing better accuracy in identifying progression in glaucoma. and retinal changes in diabetes. Conclusions. In ophthalmology, Artificial Intelligence has the potential to increase patient access to screening / clinical diagnosis and to reduce the enormous costs required by healthcare, especially when the risk of disease is high or communities face limited financial resources. Artificial neural networks are useful in diagnosing various diseases, but the information obtained is intended to help the final decision that will be made by the clinician, but will not replace his role

Difficulties in Performing Daily Activities in Patients with Dry Eye before and after Treatment

Dry eye disease (DED) represents an important public health problem causing visual discomfort which affects the quality of life. This paper investigates the current comprehension of DED on life quality and vision. Methods: This research consists of a cross-sectional study of 121 patients, with a mean age of 70 ± 9 years, diagnosed with DED. All patients were treated in the University Clinic for Ophthalmology in “St. Spiridon” Emergency Hospital, Iasi. For all patients, we evaluated visual acuity on the Snellen chart, tear breakup time (TBUT), Schirmer I test scores, and contrast sensitivity. For this study, we used the Visual Functioning Questionnaire—25 (VFQ-25) version 2000, modified and adapted for this research (19 items). Results: Prior to treatment, patients had very high difficulty reading a text in a newspaper or on TV, reading prices on products in shops, or recognizing people they already met. Performing manual work or favorite activities was also very difficult. Post-treatment visual challenges improved in the majority of cases, regardless of the treatment method used. Conclusions: We found that symptomatic dry eye disease was associated with reduced ability in performing several important vision-related daily tasks and has a significant impact on life quality and visual performance

Classification Algorithms Used in Predicting Glaucoma Progression

In this paper, various machine learning algorithms were used in order to predict the evolution of open-angle glaucoma (POAG). The datasets were built containing clinical observations and objective measurements made at the Countess of Chester Hospital in the UK and at the “St. Spiridon” Hospital of Iași, Romania. Using these datasets, different classification problems were proposed. The evaluation of glaucoma progression was conducted based on parameters such as VFI (Visual field index), MD (Mean Deviation), PSD (Pattern standard deviation), and RNFL (Retinal Nerve Fiber Layer). As classification tools, the following algorithms were used: Multilayer Perceptron, Random Forest, Random Tree, C4.5, k-Nearest Neighbors, Support Vector Machine, and Non-Nested Generalized Exemplars. The best results, with an accuracy of over 90%, were obtained with Multilayer Perceptron and Random Forest algorithms. The NNGE algorithm also proved very useful in creating a hierarchy of the input values according to their influence (weight) on the considered outputs. On the other hand, the decision tree algorithms gave us insight into the logic used in their classification, which is of practical importance in obtaining additional information regarding the rationale behind a certain rule or decision

Computer Vision Syndrome: An Ophthalmic Pathology of the Modern Era

Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence

Mitochondria-Targeted Curcumin: A Potent Antibacterial Agent against Methicillin-Resistant <i>Staphylococcus aureus</i> with a Possible Intracellular ROS Accumulation as the Mechanism of Action

Mitocurcumin (a triphenylphosphonium curcumin derivative) was previously reported as a selective antitumoral compound on different cellular lines, as well as a potent bactericidal candidate. In this study, the same compound showed strong antimicrobial efficacy against different strains of methicillin-resistant Staphylococcus aureus (MRSA). The minimum inhibitory concentration was identical for all tested strains (four strains of MRSA and one strain of methicillin-sensitive Staphylococcus aureus), suggesting a new mechanism of action compared with usual antibacterial agents. All tested strains showed a significant sensitivity in the low micromolar range for the curcumin-triphenylphosphonium derivative. This susceptibility was modulated by the menadione/glutathione addition (the addition of glutathione resulted in a significant increase in minimal inhibitory concentration from 1.95 to 3.9 uM, whereas adding menadione resulted in a decrease of 0.49 uM). The fluorescence microscopy showed a better intrabacterial accumulation for the new curcumin-triphenylphosphonium derivative compared with simple curcumin. The MitoTracker staining showed an accumulation of reactive oxygen species (ROS) for a S. pombe superoxide dismutase deleted model. All results suggest a new mechanism of action which is not influenced by the acquired resistance of MRSA. The most plausible mechanism is reactive oxygen species (ROS) overproduction after a massive intracellular accumulation of the curcumin-triphenylphosphonium derivative

Clinical Study on the Ocular Manifestations in Patients with Obstructive Sleep Apnea Syndrome—Preliminary Results

Obstructive sleep apnea syndrome is a multisystemic disorder associated with a series of side effects. Obstructive sleep apnea syndrome (OSAS) includes hypoxemia and is correlated with an increased incidence for various neuronal conditions, including glaucoma, strokes, reduced mental ability, depressive disorders, peripheral neuropathy, and non-arteritic ischemic optic neuropathy. This study&rsquo;s aims are the evaluation of the degree of ocular surface damage in obstructive sleep apnea patients (in the absence of the continuous positive airway pressure treatment) and the structural changes in the optic nerve, and to establish correlation between the degree of damage to the ocular surface (eye dryness by Schirmer test) and corneal biomechanics by ocular response analyzer. The subjects included in the study will be grouped as follows: a group of patients with glaucoma and obstructive sleep apnea syndrome that will be compared to patients with glaucoma only as well as identifying the evolution of structural changes in patients with glaucoma and sleep apnea syndrome. A prospective study included 65 eyes from 65 subjects diagnosed with obstructive sleep apnea (45 eyes of 45 subjects with glaucoma and OSAS as well as 20 subjects, 20 eyes with dry-eye syndrome and OSAS) who did not follow the continuous positive airway pressure treatment. The control group consisted of 45 subjects (45 eyes) with (mild or moderate) primary open-angle treated glaucoma without obstructive sleep apnea. All patients had ophthalmologic evaluations according to a standardized protocol. Moreover, respiratory functional parameters (apnea&ndash;hypopnea index&mdash;AHI) and the body mass index were recorded. Within the studied group, patients with mild or moderate primary open-angle glaucoma, with moderate or severe dry-eye syndrome, patients with floppy-eyelid syndrome, with optical non-arteritis ischemic neuropathy, and a patient with retinal central vein occlusion were identified. The increased rate of the apnea syndrome during sleep produces a severe disorder of the ocular surface and a retinal neuro-degenerative disorder. The eyes of patients with sleep apnea syndrome (SAS) and glaucoma have lower mean intraocular pressure than eyes with glaucoma without SAS. However, the mean C/D ratio in eyes with glaucoma correlates with the severity of SAS. There is a positive correlation between the severity of the apnea and the ocular disorder&rsquo;s degree similar to the studies in the literature review. The joint cooperation between the sleep specialists and ophthalmologists can lead to the improvement of the vascular and ocular status for the obstructive sleep apnea patients