Primary Phacoemulsification and Intraocular Lens Implantation for Acute Primary Angle-Closure

Background: To investigate the effect of primary phacoemulsification on intraocular pressure (IOP) in patients with acute primary angle-closure (PAC) and coexisting cataract. Methodology: Sixteen eyes of 14 patients with acute PAC received phacoemulsification and intraocular lens implantation as initial management for medically uncontrolled IOP in a retrospective chart review. The effects on IOP, vision, anterior chamber depth (ACD), and number of antiglaucoma medications were evaluated. Principal Findings: The postoperative IOP was reduced in 16 eyes (100%). The mean 6 standard deviation preoperative IOP was 48.81616.83 mm Hg, which decreased postoperatively to 16.46610.67 mm Hg at 1 day, 9.4363.03 mm Hg at 1 week

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

A Glaucoma Detection System Based on Generative Adversarial Network and Incremental Learning

Among various eye diseases, glaucoma is one of the leading causes of blindness. Glaucoma is also one of the most common eye diseases in Taiwan. Glaucoma screenings can use optical coherence tomography (OCT) to locate areas in which the retinal nerve fiber layer is thinning. However, because OCT equipment is costly, only large hospitals with well-equipped facilities will have OCT, and regular eye clinics cannot afford such expensive equipment. This has caused many glaucoma patients to worsen because they cannot get an early diagnosis in regular eye clinics in time. This paper proposes a method of using a generative adversarial network (GAN) to generate corresponding OCT images from fundus images to assist family doctors in judging whether further examination is needed based on the generated OCT images to achieve early detection and treatment of glaucoma. In addition, in order to improve the classification accuracy of the system deployed in different hospitals or clinics, this paper also proposes to use the incremental training method to fine-tune the model. The model can be quickly applied by adding a small number of images from a specific clinic or hospital. Experimental results show that the cosine similarity between the generated OCT image and the real OCT image is 97.8%. Combined with the proposed transfer learning method, the classification accuracy of the classification model reaches 83.17%. As well as the use of the incremental method, the accuracy of identifying glaucoma is approximately 78.94%, which is 8.77% higher than the 70.17% accuracy of the initial model. Experimental results show the effectiveness and feasibility of our proposed method

Retinal Vessel Density in Optical Coherence Tomography Angiography in Optic Atrophy after Nonarteritic Anterior Ischemic Optic Neuropathy

Aims. To compare optical coherence tomography angiography (OCT-A) retinal vasculature measurements between normal and optic atrophy after nonarteritic anterior ischemic optic neuropathy (NAION) subjects. Design. This prospective observational study was conducted between July 2015 and August 2016 at the ophthalmology outpatient department of a referral center in Taiwan. Peripapillary (4.5 × 4.5 mm) and parafoveal (6 × 6 mm) OCT-A scans were acquired. Measurements of the peripapillary region were obtained in two areas: (1) circumpapillary vessel density (cpVD) and (2) whole enface image vessel density (wiVD). Results. 13 participants with optic atrophy after NAION had lower peripapillary vessel density than the 18 age-matched participants in the healthy control (HC) group (p<0.001 for both cpVD and wiVD). However, the parafoveal vessel density was not significantly different between the two groups (p=0.49). The areas under the receiver operating characteristic curve for the HC and NAION eyes were 0.992 for cpVD and 0.970 for wiVD. cpVD and wiVD were significantly correlated with the average retinal nerve fiber layer thickness (p<0.001 for both). Conclusion. Peripapillary retinal perfusion is significantly decreased in optic atrophy after NAION. OCT-A may aid in the understanding of structure-function-perfusion relationships in NAION

A Glaucoma Detection System Based on Generative Adversarial Network and Incremental Learning

Among various eye diseases, glaucoma is one of the leading causes of blindness. Glaucoma is also one of the most common eye diseases in Taiwan. Glaucoma screenings can use optical coherence tomography (OCT) to locate areas in which the retinal nerve fiber layer is thinning. However, because OCT equipment is costly, only large hospitals with well-equipped facilities will have OCT, and regular eye clinics cannot afford such expensive equipment. This has caused many glaucoma patients to worsen because they cannot get an early diagnosis in regular eye clinics in time. This paper proposes a method of using a generative adversarial network (GAN) to generate corresponding OCT images from fundus images to assist family doctors in judging whether further examination is needed based on the generated OCT images to achieve early detection and treatment of glaucoma. In addition, in order to improve the classification accuracy of the system deployed in different hospitals or clinics, this paper also proposes to use the incremental training method to fine-tune the model. The model can be quickly applied by adding a small number of images from a specific clinic or hospital. Experimental results show that the cosine similarity between the generated OCT image and the real OCT image is 97.8%. Combined with the proposed transfer learning method, the classification accuracy of the classification model reaches 83.17%. As well as the use of the incremental method, the accuracy of identifying glaucoma is approximately 78.94%, which is 8.77% higher than the 70.17% accuracy of the initial model. Experimental results show the effectiveness and feasibility of our proposed method

Intraocular pressure changes after phacoemulsification+intraocular lens implantation.

<p>Intraocular pressure changes after phacoemulsification+intraocular lens implantation.</p

Comparison of patients' pre- and post-operative characteristics.

<p>Comparison of patients' pre- and post-operative characteristics.</p

Application and Validation of LUXIE: A Newly Developed Virtual Reality Perimetry Software

Purpose: To report the application of LUXIE and validate its reliability by comparing the test results with those of Humphrey Field Analyzer 3 (HFA3). Methods: In this pilot study, we prospectively recruited participants who had received HFA3 SITA standard 30-2 perimetry and tested them with LUXIE on the same day. LUXIE is a software designed for visual field testing cooperating with HTC Vive Pro Eye, a head-mounted virtual reality device with an eye-tracking system. The test stimuli were synchronized with eye movements captured by the eye-tracking system to eliminate fixation loss. The global, hemifields, quadrants, glaucoma hemifield test (GHT) sectors, and point-by-point retinal sensitivities were compared between LUXIE and HFA3. All participants were asked to fill out a post-test user survey. Results: Thirty-eight participants with 65 eyes were enrolled. LUXIE demonstrated good correlations with HFA3 in global (r = 0.81), superior hemifield (r = 0.77), superonasal, superotemporal, and inferonasal quadrants (r = 0.80, 0.78, 0.80). The user survey showed that participants were more satisfied with LUXIE in operating difficulty, comfortability, time perception, concentration, and overall satisfaction. Conclusions: LUXIE demonstrated good correlations with HFA3. Fixation loss could be eliminated in LUXIE with the eye-tracking system. The application of virtual reality devices such as the HTC Vive Pro Eye makes telemedicine and even home-based self-screening visual field tests possible. Key Messages: 1. Virtual reality perimetry is a developing technology that has the potential in telemedicine, and home self-screening visual field tests. 2. LUXIE demonstrated good correlations with Humphrey Field Analyzer 3 in visual field retinal sensitivities