Anterior Chamber Angle Evaluation Using Gonioscopy: Consistency and Agreement between Optometrists and Ophthalmologists

SIGNIFICANCE In our intermediate-tier glaucoma care clinic, we demonstrate fair to moderate agreement in gonioscopy examination between optometrists and ophthalmologists, but excellent agreement when considering open versus closed angles. We highlight the need for increased consistency in the evaluation and recording of angle status using gonioscopy. PURPOSE The consistency of gonioscopy results obtained by different clinicians is not known but is important in moving toward practice modalities such as telemedicine and collaborative care clinics. The purpose of this study was to evaluate the description and concordance of gonioscopy results among different practitioners. METHODS The medical records of 101 patients seen within a collaborative care glaucoma clinic who had undergone gonioscopic assessment by two clinicians (one optometrist and either one general ophthalmologist [n = 50] or one glaucoma specialist [n = 51]) were reviewed. The gonioscopy records were evaluated for their descriptions of deepest structure seen, trabecular pigmentation, iris configuration, and other features. These were compared between clinicians (optometrist vs. ophthalmologist) and against the final diagnosis. RESULTS Overall, 51.9 and 59.8% of angles were graded identically in terms of deepest visible structure when comparing between optometrist versus general ophthalmologist and optometrist versus glaucoma specialist, respectively. The concordance increased when considering ±1 of the grade (67.4 and 78.5%, respectively), and agreement with the final diagnosis was high (>90%). Variations in angle grading other than naming structures were observed (2.0, 30, and 3.9% for optometrist, general ophthalmologist, and glaucoma specialist, respectively). Most of the time, trabecular pigmentation or iris configuration was not described. CONCLUSIONS Fair to moderate concordance in gonioscopy was achieved between optometrists and ophthalmologists in a collaborative care clinic in which there is consistent feedback and clinical review. To move toward unified medical records and a telemedicine model, improved consistency of record keeping and angle description is required

Efficient Looping Units for FPGAs

∗ Special thanks to Grigoris Dimitroulakos for presenting this paper at the ISVLSI 2010 venu

Implementation of Wireless Communications Systems on FPGA-Based Platforms

Wireless communications are a very popular application domain. The efficient implementation of their components (access points and mobile terminals/network interface cards) in terms of hardware cost and design time is of great importance. This paper describes the design and implementation of the HIPERLAN/2 WLAN system on a platform including general purpose microprocessors and FPGAs. Detailed implementation results (performance, code size, and FPGA resources utilization) are presented. The main goal of the design case presented is to provide insight into the design aspects of a complex system based on FPGAs. The results prove that an implementation based on microprocessors and FPGAs is adequate for the access point part of the system where the expected volumes are rather small. At the same time, such an implementation serves as a prototyping of an integrated implementation (System-on-Chip), which is necessary for the mobile terminals of a HIPERLAN/2 system. Finally, firmware upgrades were developed allowing the implementation of an outdoor wireless communication system on the same platform