NOVEL METHODS OF MERIDIONAL AND CIRCUMFERENTIAL ANTERIOR CHAMBER ANGLE IMAGING

Ph.DDOCTOR OF PHILOSOPH

Translational Medicine in the Era of Social Media: A Survey of Scientific and Clinical Communities

Background: The integration of new scientific discoveries into clinical practice costs considerable time and resources. With the increased use of social media for scientific communication, new opportunities arise to "bridge the gap" in translational medicine. The present study aimed to investigate how medical professionals access scientific information and understand their view on the role of social media in translational medicine. Methods: A questionnaire regarding (i) the use of social media for scientific updates, (ii) the opportunities and challenges of social media for translational medicine, (iii) social media function Chatbot, and (iv) participant demographics was developed. The survey link was posted online from February, 2018, until April, 2018. Results: A total of 555 professionals responded to the survey. Respondents identified themselves predominantly as researcher/scientists (27%) or medical/biomedical students (15%). The majority of participants was employed at a university or research institute (59%), and most practiced either in Europe (48%) or in Asia (37%). Seventy-eight percent of respondents reported receiving most of scientific news and updates via non-social media options, such as journal websites and newspapers. Fifty-one percent of respondents believed that social media could contribute to closing the gap between scientific discovery and translation to medical application. The most crucial opportunity created by social media was found to be "connecting the right scientist to the right clinician." Participants rated "the translation of scientific finding to clinical practice is too fast before the safety is properly demonstrated" as the most crucial challenge. Half of the respondents were aware of their institutions policy on the professional use of social media. Only 2% of respondents had previously used Chatbot. Conclusions: Overall, medical professionals were positive about the idea that social media could contribute to the progress of translational medicine. However, it is clear that they are still being cautious about using social media for professional purposes. To fully harness the potential of social media on translational medicine, the medical community needs to be provided with educational programs, guidelines, and support infrastructure within social media.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Comorbidities in children hospitalized with severe acute malnutrition

Background: As per the National Family Health Survey-4 data, 7.9% of under-five children in the state of Tamil Nadu are severely wasted. The outcome of hospitalized severe acute malnutrition (SAM) children is dependent on the comorbidities present. Objective: The objective of this study is to describe the comorbid conditions in SAM children hospitalized in a tertiary care center. Methodology: This study was a hospital-based descriptive study, conducted from July 2015 to June 2016. A total number of 200 children, who were admitted with SAM as per the World Health Organization criteria, were included in the study. Systemic illness, anemia, vitamin deficiencies, sepsis, retroviral infection, tuberculosis, pneumonia, acute gastroenteritis, urinary tract infection (UTI), measles, skin infections, and worm infestations were the comorbidities considered. Results: Among 200 hospitalized SAM children, the median (interquartile) age was 15 (11–21.75) months; there were 93 (46.5%) boys. Acute gastroenteritis (57.5%) was the most common comorbidity, followed by pneumonia (44.5%), anemia (27%), systemic illness (17%), worm infestation (13.5%), UTI (13.5%), sepsis (13%), skin infection (8%), measles (6%), vitamin deficiency (4%), retroviral infections (3.5%), and tuberculosis (1%). The case fatality rate was 10.5%. Conclusion: Prompt identification of comorbidities is crucial in hospitalized SAM children, which will pave way for their treatment, resulting in better outcomes

Anterior Chamber Angle Assessment System

In this paper, we propose an automatic anterior chamber angle assessment system for Anterior Segment Optical Coherence Tomography (AS-OCT). In our system, the automatic segmentation method is used to segment the clinical structures, which are then used to recover standard clinical ACA measurements. Our measurements can not only support clinical assessments, but also be utilized as features for detecting anterior angle closure in automatic glaucoma diagnosis

Multidisciplinary Ophthalmic Imaging Automated Analysis of Angle Closure From Anterior Chamber Angle Images

PURPOSE. To evaluate a novel software capable of automatically grading angle closure on EyeCam angle images in comparison with manual grading of images, with gonioscopy as the reference standard. METHODS. In this hospital-based, prospective study, subjects underwent gonioscopy by a single observer, and EyeCam imaging by a different operator. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. An eye was classified as having angle closure if there were two or more quadrants of closure. Automated grading of the angle images was performed using customized software. Agreement between the methods was ascertained by j statistic and comparison of area under receiver operating characteristic curves (AUC). RESULTS. One hundred forty subjects (140 eyes) were included, most of whom were Chinese (102/140, 72.9%) and women (72/140, 51.5%). Angle closure was detected in 61 eyes (43.6%) with gonioscopy in comparison with 59 eyes (42.1%, P ¼ 0.73) using manual grading, and 67 eyes (47.9%, P ¼ 0. CONCLUSIONS. Customized software for automated grading of EyeCam angle images was found to have good agreement with gonioscopy. Human observation of the EyeCam images may still be needed to avoid gross misclassification, especially in eyes with extensive angle closure

Evaluation of Choroidal Thickness, Intraocular Pressure, and Serum Osmolality After the Water Drinking Test in Eyes With Primary Angle Closure

PURPOSE. We evaluated changes in choroidal thickness (ChT), IOP, ocular biometry, and serum osmolality after the water drinking test (WDT) in subjects with previous acute primary angle closure (APAC) and primary angle closure glaucoma (PACG). METHODS. We evaluated 38 subjects, including 21 with APAC and 17 with PACG. Each subject underwent IOP measurement, A-scan biometry, spectral domain-optical coherence tomography (SDOCT), anterior segment-optical coherence tomography (ASOCT), and osmolality measurements at baseline, 30, and 60 minutes after consuming at least 10 mL/kg of water. The ChT at the macula was measured from SDOCT images using the 7-line scan protocol. The fellow-eyes of APAC (FE-APAC) were compared to eyes with PACG. RESULTS. The mean age 6 SD of the study subjects was 62.8 6 8.6 years and 21 (55.3%) were females. At baseline, serum osmolality was significantly lower (P < 0.001) in the FE-APAC group, whereas ChT was similar in both groups (P ¼ 0.56). At 30 minutes after WDT, both groups demonstrated a significant increase in IOP (FE-APAC, 3.0 [95% confidence interval {CI}, 1.52, 4.48] mm Hg; PACG, 5.06 [95% CI, 3.68, CONCLUSIONS. The increase in IOP after WDT was higher in PACG eyes compared to FE-APAC; however, the latter had lower serum osmolality at baseline. Change in mean ChT following WDT was associated with a lower baseline serum osmolality

Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma.

OBJECTIVES: Vitamin D is involved in visual health and function. Our objective was to determine whether age-related vitamin D insufficiency was associated with the presence and the severity of primary open angle glaucoma (POAG) in a case-control study of older adults. STUDY DESIGN: Case-control study. MAIN OUTCOME MEASURES: One hundred fifty cases diagnosed with moderate-to-severe POAG (mean, 75.1±8.5 years; 42.0% female) and 164 healthy controls (mean, 73.0±7.9 years; 59.8% female) were included. POAG diagnosis was based on classical diagnostic criteria of optic nerve cupping and/or RNFL thinning, measured with optical coherence tomography. Severe POAG was defined as Humphrey visual field mean deviation (MD) worse than -12dB. Vitamin D insufficiency was defined as serum 25OHD≤75nmol/L. Age, gender, mean arterial pressure, vitamin D supplementation, visual acuity, and intraocular pressure were used as potential confounders. RESULTS: POAG cases had lower mean serum 25OHD concentration than controls (42.9±25.7nmol/L versus 49.4±29.5nmol/L, P=0.039) and a greater prevalence of vitamin D insufficiency (90.7% versus 82.3%, P=0.032). Increased mean serum 25OHD concentrations were associated with lower POAG frequency, even after adjustment for potential confounders (OR=0.89 per 10nmol/L of 25OHD, P=0.045). Similarly, vitamin D insufficiency was associated with POAG (OR=2.09, P=0.034). Among POAG cases, no 25OHD difference was observed between moderate and severe POAG cases (respectively, 39.2±23.3nmol/L versus 45.1±26.7nmol/L, P=0.188); and no between-group difference regarding the prevalence of vitamin D insufficiency (88.9% versus 94.0%, P=0.313). CONCLUSIONS: Decreased serum 25OHD concentration was associated with POAG. There was no 25OHD difference between moderate and severe POAG

Determinants of lamina cribrosa depth in healthy Asian eyes: the Singapore Epidemiology Eye Study

Aim To investigate the determinants of lamina cribrosa depth (LCD) in healthy eyes of Chinese and Indian Singaporean adults. Methods The optic nerve head (ONH) of the right eye of 1396 subjects (628 Chinese and 768 Indian subjects) was imaged with optical coherence tomography (OCT, Spectralis, Heidelberg, Germany). LCD was defined as the distance from the Bruch’s membrane opening (LCD-BMO) or the peripapillary sclera (LCD-PPS) reference plane to the laminar surface. A linear regression model was used to evaluate the relationship between the LCD and its determinants. Results Both LCDs were significantly different between the two races (LCD-BMO: 421.95 (95% CI 365.32 to 491.79) µm in Chinese vs 430.39 (367.46–509.81) µm in Indians, p=0.021; and LCD-PPS: 353.34 (300.98–421.45) µm in Chinese vs 376.76 (313.39–459.78) µm in Indians, p<0.001). In the multivariable regression analysis, the LCD-PPS of the whole cohort was independently associated with females (β=−31.93, p<0.001), Indians subjects (β=21.39, p=0.004) (Chinese as the reference), axial length (Axl) (β=−6.68, p=0.032), retinal nerve fibre layer thickness (RNFL) (β=0.71, p=0.019), choroidal thickness (ChT) (β=0.41, p<0.001), vertical cup disc ratio (VCDR) (β=24.42, p<0.001) and disc size (β=−60.75, p=0.001). For every 1 year older in age, the LCD-PPS was deeper on average by 1.95 µm in Chinese subjects (p=0.01) but there was no association in Indians subjects (p=0.851). Conclusions The LCD was influenced by age, gender, race, Axl, RNFL, ChT, VCDR and disc size. This normative LCD database may facilitate a more accurate assessment of ONH cupping using OCT in Asian populations