Journal articles on the topic 'Photography and blindness'
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Baker, George. "Sharing Seeing." October 174 (December 2020): 163–75. http://dx.doi.org/10.1162/octo_a_00412.
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In 2007, artist Sharon Lockhart made a large-scale photograph of two young girls reading braille, based on a specific photograph by August Sander from the 1930s made in an institute for blind children. Turning to the widespread iconography of blindness in the history of photography, this essay considers the importance of such images for a larger theory of photographic spectatorship. Lockhart's image of blind children relates to Sander's photograph, but does not duplicate it in all respects; her alteration of the historical image opens onto the larger non-coincidence of vision that photographic seeing instantiates. Ultimately, Lockhart's relational practice of photography-connecting each photograph she makes to prior images, while never fully duplicating or replicating them-provides a model for understanding the relational dynamics of photographic spectatorship. The essay also discusses Paul Strand, Roland Barthes's Camera Lucida, Kaja Silverman's World Spectators, “straight photography,” and Michael Fried.
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Dokumaci, Arseli. "Vision Portraits." Film Quarterly 76, no. 2 (2022): 48–54. http://dx.doi.org/10.1525/fq.2022.76.2.48.
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In his most recent documentary feature Vision Portraits, award-winning filmmaker Rodney Evans follows the stories of four artists – choreographer and dancer Kayla Hamilton, writer Ryan Knighton, photographer John Dugdale and Evans the filmmaker – who are either born sighted (or, like Hamilton, partially sighted) as they negotiate their way out of sightedness into blindness. This article analyzes how Vision Portraits depicts becoming blind as a “rite of passage”, that is, a process in which the wisdom, expertise and embodied knowledge of blind people initiate the newcomers into blindness, guiding them in the process, and showing how blindness, contrary to societal assumptions, can in fact be a bliss, and how arts (including visual arts such as photography and filmmaking) can be practiced regardless of the “absence” of sight or how much there is left of it.
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Fomenko, Andrey N. "Beyond the Threshold of the Visible: The Photographic Objects of Alexander Ugay." Vestnik of Saint Petersburg University. Arts 11, no. 2 (2021): 263–87. http://dx.doi.org/10.21638/spbu15.2021.206.
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One of the features of photography is the fact that the process of formation of the image is invisible — in contrast to painting. It is as if photography, which makes the world more visible, evades visual control. The transition to digital techniques partly reduces this “dark side” of photography, but it also allows us to make better sense of analogous photography and reflect on its dual nature. Alexander Ugay, a contemporary artist from Kazakhstan, who in his practice shifts from photography as an image to photography as an object, substance and process, is an example of such a reflection; the thematization of the nature of the medium is combined in his practice with the theme of memory and oblivion. In his Objects of Memory (2013), he photographed the back of pictures from several archives of the Stalinist camps — the procedure that emphasizes the material and ephemeral character of the prints. The iconic aspect is almost entirely excluded from Time Capsule (2011 — present time) that reveals the self-destructive nature of the act of taking picture. The series of “obscuratons” (2017–2018) — complex pinhole cameras with a lot of holes — is a preliminary result of this reflection of photographic dialectics of the visible and the invisible. Every obscuraton functions alternately as a devise for creating an image (equivalent to human vision) and as an object integrated in some environment side by side with the other things. The polemics with an idea of total visual control can be read here; the machines of vision prove to be machines of blindness. The general impression is that the sole purpose of the emphasis on physical and chemical processes, the use of the particular iconographic resources and references to historical realities have a single goal in Ugay’s projects: the dissolution of meanings and disintegration of forms.
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McCulloch, Douglas. "Shot in the Dark: Blindness and the Zero Point of Photography." Afterimage 39, no. 6 (May 1, 2012): 7–10. http://dx.doi.org/10.1525/aft.2012.39.6.7.
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Howie, Elizabeth. "Contesting plant-blindness with photography: Michael “Nick” Nichols’s portrait of a giant sequoia." photographies 14, no. 3 (September 2, 2021): 521–35. http://dx.doi.org/10.1080/17540763.2021.1960411.
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Nouzeilles, Gabriela. "Theaters of Pain: Violence and Photography." PMLA/Publications of the Modern Language Association of America 131, no. 3 (May 2016): 711–21. http://dx.doi.org/10.1632/pmla.2016.131.3.711.
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The Photograph is violent.—Roland Barthes, Camera LucidaWho are you, who will look at these photographs, and by what right, and what will you do about it?—James Agee, Let Us Now Praise Famous MenIn His Entry for Eye in Le Dictionnaire Critique (1929-30), Georges Bataille Refers to the Human Compulsion to Look as a response to a “blind thirst for blood,” triggered by the spectacle of extreme violence, including torture. But why, Bataille wonders, would someone's “absurd eyes be attracted, like a cloud of flies, to something so repugnant?” (19). He attributes to the human eye the cannibalistic disposition that comes from our “inexplicable acuity of horrors” and from the disturbing fascination that the eye itself exerts over our sensibility. The extreme seductiveness of the eye, Bataille hints, is probably “at the very edge of horror” (17). He connects the unstable edge that separates such contradictory responses with the idea of the eye as a critical tool, in which “critical” refers to the act of discerning and the act of cutting—as shown in the infamous opening of Tuis Buñuel and Salvador Dalí's film Un chien andalou (“An Andalusian Dog” [1929]), when the eye of a young woman is sliced open by a razor in front of the camera. This violence against embodied (and sexualized) vision points not only to the notion of the eye as a misleading mimetic apparatus but also to the image of the eye as a hole or gap. The split eye is resignified as ocular replication, which, unexpectedly, triggers the proliferation of images and the loss of sight that come from seeing too much. Indeed, the swarm of eyes that populates Bataille's visual imagery grimly alludes to the compulsion to watch violent acts to the point of blindness.
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Gajiwala, Uday R., Swapnil Pachchigar, Dhaval Patel, Ishwar Mistry, Yash Oza, Dhaval Kundaria, and Shamanna B R. "Non-mydriatic fundus photography as an alternative to indirect ophthalmoscopy for screening of diabetic retinopathy in community settings: a comparative pilot study in rural and tribal India." BMJ Open 12, no. 4 (April 2022): e058485. http://dx.doi.org/10.1136/bmjopen-2021-058485.
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ObjectivesThe impending and increasing prevalence of diabetic retinopathy (DR) in India has necessitated a need for affordable and valid community outreach screening programme for DR, especially in rural and far to reach indigenous local communities. The present study is a pilot study aimed to compare non-mydriatic fundus photography with indirect ophthalmoscopy for its utilisation as a feasible and logistically convenient screening modality for DR in an older age, rural, tribal population in Western India.Design and settingThis community-based, cross-sectional, prospective population study was a part of a module using Rapid Assessment of Avoidable Blindness and DR methodology in 8340 sampled participants with ≥50 years age. In this study, the diabetics identified were screened for DR using two methods: non-mydriatic fundus photography on the field by trained professionals, that were then graded by a retina specialist at the base hospital and indirect ophthalmoscopy by expert ophthalmologists in the field with masking of each other’s findings for its utility and comparison.ResultsThe prevalence of DR, sight threatening DR and maculopathy using indirect ophthalmoscopy was found to be 12.1%, 2.1% and 6.6%, respectively. A fair agreement (κ=0.48 for DR and 0.59 for maculopathy) was observed between both the detection methods. The sensitivity and specificity of fundus photographic evaluation compared with indirect ophthalmoscopy were found to be 54.8% and 92.1% (for DR), 60.7% and 90.8% (for any DR) and 84.2% and 94.8% (for only maculopathy), respectively.ConclusionNon-mydriatic fundus photography has the potential to identify DR (any retinopathy or maculopathy) in community settings in Indian population. Its utility as an affordable and logistically convenient cum practical modality is demonstrable. The sensitivity of this screening modality can be further increased by investing in better resolution cameras, capturing quality images and training and validation of imagers.Trial registration numberCTRI/2020/01/023025; Clinical Trial Registry, India (CTRI).
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O’Brien, Kieran S., Raghunandan Byanju, Ram Prasad Kandel, Bimal Poudyal, Mariya Gautam, John A. Gonzales, Travis C. Porco, et al. "Village-Integrated Eye Worker trial (VIEW): rationale and design of a cluster-randomised trial to prevent corneal ulcers in resource-limited settings." BMJ Open 8, no. 8 (August 2018): e021556. http://dx.doi.org/10.1136/bmjopen-2018-021556.
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IntroductionCorneal opacity is a leading cause of blindness worldwide. In resource-limited settings, untreated traumatic corneal abrasions may result in infection and ultimately, opacity. Although antimicrobial treatment of corneal ulcers may successfully cure infections, the scarring that accompanies the resolution of infection can still result in visual impairment. Prevention may be the optimal approach for reducing corneal blindness. Studies have employed community health workers to provide prompt administration of antimicrobials after corneal abrasions to prevent infections, but these studies were not designed to determine the effectiveness of such a programme.Methods and analysisThe Village-Integrated Eye Worker trial (VIEW) is a cluster-randomised trial designed to assess the effectiveness of a community health worker intervention to prevent corneal ulcers. Twenty-four Village Development Committees (VDCs) in Nepal were randomised to receive a corneal ulcer prevention programme or to no intervention. Female Community Health Volunteers (FCHVs) in intervention VDCs are trained to diagnose corneal abrasions, provide antimicrobials and to refer participants when needed. An annual census is conducted over 3 years in all study VDCs to assess the incidence of corneal ulceration via corneal photography (primary outcome). Masked outcome assessors grade corneal photographs to determine the presence or absence of incident corneal opacities. The primary analysis is negative binomial regression to compare the incidence of corneal ulceration by study arm.Ethics and disseminationThe University of California San Francisco Committee on Human Research, Nepal Netra Jyoti Sangh and the Nepal Health Research Council have given ethical approval for the trial. The results of this trial will be presented at local and international meetings and submitted to peer-reviewed journals for publication.Trial registration numberNCT01969786; Pre-results.
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Kim, Hyeong-Min, Kwangsic Joo, Jinu Han, and Se-Joon Woo. "Clinical and Genetic Characteristics of Korean Congenital Stationary Night Blindness Patients." Genes 12, no. 6 (May 21, 2021): 789. http://dx.doi.org/10.3390/genes12060789.
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In this study, we investigated the clinical and genetic characteristics of 19 Korean patients with congenital stationary night blindness (CSNB) at two tertiary hospitals. Clinical evaluations, including fundus photography, spectral-domain optical coherence tomography, and electroretinography, were performed. Genetic analyses were conducted using targeted panel sequencing or whole exome sequencing. The median age was 5 (3–21) years at the initial examination, 2 (1–8) years at symptom onset, and 11 (5–28) years during the final visit. Genetic mutations were identified as CNGB1 and GNAT1 for the Riggs type (n = 2), TRPM1 and NYX for the complete type (n = 3), and CACNA1F (n = 14) for the incomplete type. Ten novel variants were identified, and best-corrected visual acuity (BCVA) and spherical equivalents (SE) were related to each type of CSNB. The Riggs and TRPM1 complete types presented mild myopia and good BCVA without strabismus and nystagmus, whereas the NYX complete and incomplete types showed mixed SE and poor BCVA with strabismus and nystagmus. This is the first case series of Korean patients with CSNB, and further studies with a larger number of subjects should be conducted to correlate the clinical and genetic aspects of CSNB.
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Pieczynski, Janusz, and Andrzej Grzybowski. "Review of Diabetic Retinopathy Screening Methods and Programmes Adopted in Different Parts of the World." European Ophthalmic Review 09, no. 01 (2015): 49. http://dx.doi.org/10.17925/eor.2015.09.01.49.
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Introduction:One of most common diabetic complications is diabetic retinopathy (DR). Sight-threatening DR can be avoided when diagnosed early and treated in a timely fashion. The aim of this study is to review current worldwide DR screening programmes and studies.Methods:A PubMed platform search was performed to find clinical trials or studies of current DR screening methods.Results:Direct and indirect ophthalmoscopy is still used, but digital photography of the retina seems to be the most efficient, objective and cost-effective.Conclusions:DR screening programmes are developed all over the world. They help to detect early sight-threatening DR, treat it in a timely fashion and in this fashion help to avoid expensive, advanced treatment or even prevent to develop blindness among working age people.
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Gupta, Sanjeev K., Anshuman Sharma, Sanjay Agarwal, Sanjay Gupta, and Shalini Sarouthia. "The prevalence of retinopathy in diabetes mellitus and associated risk factors: a community-based cross sectional study in peri urban area." International Journal Of Community Medicine And Public Health 5, no. 6 (May 22, 2018): 2226. http://dx.doi.org/10.18203/2394-6040.ijcmph20181991.
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Background: Visual impairment i.e. diabetic retinopathy is the one of most common manifestation of diabetes mellitus. Globally it is becoming an increasing public health problem especially in the developing countries because of increase in number of diabetic patients.Methods: A cross sectional study was conducted in the vicinity of Urban Heath and Training Centre (UHTC), Peoples University, Bhopal over a period of 6 months through screening in camps held, which included a total of 840 participants (aged ≥25 years) by following simple random procedure and in those who had newly diagnosed or long standing diabetes were referred to ophthalmologist for further evaluation. Retinopathy was determined by ophthalmoscopy and fundus photography. Anthropometric measurements (BMI), glycosylated haemoglobin were also evaluated among the confirmed diabetic patients in the study.Results: An increased prevalence of diabetes (5.95%) and retinopathy (28%) (95% CI 11.2-32.0) was found. In all age groups prevalence of bilateral blindness, bilateral low vision, unilateral blindness and unilateral low vision were respectively 2%, 28%, 0%, 70%. Independent risk indicators for the occurrence of diabetes such as age, BMI, HbA1c, were found significant for the occurrence of retinopathy in the study population.Conclusions: Visual impairment due to diabetic retinopathy remains an important public health problem in people with diabetes so timely interventions are required to resolve this major issue.
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Supanji, Supanji, Ayudha Bahana Ilham Perdamaian, Dinda Ajeng Anindita, Tri Wahyu Widayanti, Firman Setya Wardhana, Muhammad Bayu Sasongko, Mohammad Eko Prayogo, Angela Nurini Agni, and Chio Oka. "rs3753394 Complement Factor H (CFH) Gene Polymorphism in Patients with Age-Related Macular Degeneration (AMD) in Indonesian Population." BIO Web of Conferences 41 (2021): 06001. http://dx.doi.org/10.1051/bioconf/20214106001.
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Neovascular Age-related Macular Degeneration (nAMD) is one of the major factors for blindness and impaired visual acuity in elderly people. The aim of this study was CFH gene screening in Age-Related Macular Degeneration patients in Indonesia. This study was performed in 106 AMD patients and 104 controls for genomic markers in the Complement Factor H (CFH). The diagnosis of AMD was carried out by retinal specialists based on color fundus photography and optical coherence tomography. Informed consent was given to patients then proceed to blood sampling and recording of body parameters (BMI, smoking, other systemic diseases). CFH polymorphisms were then analyzed by PCR-restriction fragment length polymorphism (PCR-RFLP). There was no association between genetics polymorphism with nAMD. From the research can be inferred that association between genetics polymorphism with nAMD was insignificant.
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Latif, Jahanzaib, Shanshan Tu, Chuangbai Xiao, Sadaqat Ur Rehman, Mazhar Sadiq, and Muhammad Farhan. "Digital Forensics Use Case for Glaucoma Detection Using Transfer Learning Based on Deep Convolutional Neural Networks." Security and Communication Networks 2021 (November 29, 2021): 1–13. http://dx.doi.org/10.1155/2021/4494447.
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In parallel with the development of various emerging fields such as computer vision and related technologies, e.g., iris identification and glaucoma detection, criminals are developing their methods. It is the foremost reason for the blindness of human beings that affects the eye’s optic nerve. Fundus photography is carried out to examine this eye disease. Medical experts evaluate fundus photographs, which is a time-consuming visual inspection. Most current systems for automated glaucoma detection in fundus images rely on segmentation-based features nuanced by the underlying segmentation methods. Convolutional neural networks (CNNs) are powerful tools for solving image classification tasks, as they can learn highly discriminative features from raw pixel intensities. However, their applicability to medical image analysis is limited by the nonavailability of large sets of annotated data required for training. In this work, we aim to accelerate this process using a computer-aided diagnosis of this severe disease with the help of transfer learning based on deep convolutional neural networks. We have suggested the Inception V-3 approach for image classification based on convolution neural networks. Our developed model has the potential to address this CNN model’s problem of classification accuracy, and with imaging data, our proposed method outperforms recent state-of-the-art approaches. The case study for digital forensics is an essential component of emerging technologies, and hence glaucoma detection plays a vital role in it.
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Venkatesan, Varshini, Haripriya K., Mounika M., and Angelin Gladston. "Multistage Transfer Learning for Stage Detection of Diabetic Retinopathy." International Journal of Ambient Computing and Intelligence 13, no. 1 (January 1, 2022): 1–24. http://dx.doi.org/10.4018/ijaci.304725.
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Diabetic retinopathy is one of the most threatening complications of diabetes that leads to permanent blindness if left untreated. Severity of the diabetic retinopathy disease is based on presence of microaneurysms, exudates, neovascularisation and haemorrhages. Convolutional neural networks have been successfully applied in many adjacent subjects, and for diagnosis of diabetic retinopathy itself. In this paper, an automatic deep-learning-based method for stage detection of diabetic retinopathy by single photography of the human fundus is proposed. Additionally, the multistage approach to transfer learning, which makes use of similar datasets with different labelling, is experimented. The proposed architecture gives high accuracy in classification through spatial analysis. Amongst other supervised algorithms involved, proposed solution is to find a better and optimized way to classifying the fundus image with little pre-processing techniques. The proposed architecture deployed with dropout layer techniques yields 78 percent accuracy.
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Tomić, Martina, Dario Rahelić, Tamara Poljičanin, Romano Vrabec, and Petar Raštegorac. "Telemedicine for Diabetic Retinopathy Screening in Croatia." Collegium antropologicum 44, no. 3 (2020): 175–79. http://dx.doi.org/10.5671/ca.44.3.11.
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Diabetic retinopathy (DR) is the leading cause of preventable blindness in working-age adults associated with devastating personal and socioeconomic consequences. The increasing use of anti-vascular endothelial growth factor (anti-VEGF) agents over the past decade and telemedicine implementation in systematic DR screening resulted in a decliningtrend of new blindness due to diabetes in several countries. Telemedicine is the remote delivery of healthcare services over the telecommunications infrastructure. It allows healthcare providers to evaluate, diagnose, and treat patients without the need for an in-person visit. Teleophthalmology is a telemedicine branch, mostly focused on diabetic retinopathy and retinopathy of prematurity. Screening for DR in Croatia is commonly performed annually, only by ophthalmologists using dilated slit-lamp biomicroscopic fundus examination. Due to the insufficient number of ophthalmologists and the lack of a formal call system, many diabetic patients do not perform annual screening. In an ideal DR screening model in Croatia, each diabetes center in university or general hospitals throughout Croatia (17 centers) would have one small digital fundus camera and an educated nurse who would perform dilated fundus photography. Electronic images from diabetes centers would be transferred for remote grading to the same hospitals’ ophthalmology departments or a central grading center for DR screening in Croatia. Grading for DR would be performed by an ophthalmologist, medical retina specialist. Patients would be annually invited by mail from the National Diabetes Registry to come to the nearest diabetes center for a fundus photographing and DR screening. Each patient with a positive result would be promptly referred to the medical retina specialist at the closest ophthalmology department for further examination and treatment.
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Rodriguez-Acuña, Rafael, Eduardo Mayoral, Manuel Aguilar-Diosdado, Reyes Rave, Beatriz Oyarzabal, Carmen Lama, Ana Carriazo, and Maria Asuncion Martinez-Brocca. "Andalusian program for early detection of diabetic retinopathy: implementation and 15-year follow-up of a population-based screening program in Andalusia, Southern Spain." BMJ Open Diabetes Research & Care 8, no. 1 (October 2020): e001622. http://dx.doi.org/10.1136/bmjdrc-2020-001622.
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IntroductionDiabetic retinopathy (DR) is a preventable cause of vision loss and blindness worldwide. We aim at analyzing the impact of a population-based screening program of DR using retinal photography with remote reading in terms of population coverage, diagnosis of asymptomatic DR and impact on visual disability, in the region of Andalusia, Spain, in the period 2005–2019.Research design and methodsDescriptive study. Sociodemographic and clinical features included in the Andalusian program for early detection of diabetic retinopathy (APDR) were analyzed. Population coverage, annual incidence of DR, and DR severity gradation were analyzed. Estimated data on prevalence and incidence of legal blindness due to DR were included.Results407 762 patients with at least one successful DR examination during the study period were included. Most of the performed retinographies (784 584, 84.3%) were ‘non-pathological.’ Asymptomatic DR was detected in 52 748 (5.9%) retinographies, most of them (94.2%) being classified as ‘mild to moderate non-proliferative DR.’ DR was detected in 44 815 patients, while sight-threatening DR (STDR) in 6256 patients; cumulative incidence of DR was 11.0% and STDR was 1.5%, as DR and STDR was detected in 44 815 and 6256 patients, respectively. Annual incidence risk per patient recruitment year progressively decreased from 22.0% by January 2005 to 3.2% by June 2019.ConclusionsImplementation of a long-term population-based screening program for early detection of DR is technically feasible and clinically viable. Thus, after 15 years of existence, the program has enabled the screening of the vast majority of the target population allowing the optimization of healthcare resources and the identification of asymptomatic DR.
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Patil, Prerana, and Niharika Krishna Shetty. "Comparison between Retinal Ophthalmoscopy Vs Fundus Photography with ETDRS Field for Clinical Screening of Diabetic Retinopahty." Journal of Evolution of Medical and Dental Sciences 11, no. 1 (January 28, 2022): 141–46. http://dx.doi.org/10.14260/jemds/2022/27.
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BACKGROUND Screening of Diabetic retinopathy is essential for detection of diabetic retinopathy and its management. Diabetic retinopathy is a common and preventable cause of blindness in adults. Laser pan-retinal photocoagulation has been proven to have established efficacy in treating diabetic visual loss. Since India has a wide geographical area and there is a lack of trained ophthalmologists in peripheral India, there is an immense need for telemedicine in diabetic retinopathy screening. This study was done to evaluate the comparability of non-stereoscopic fundus photography with conventional fundoscopy for detection of diabetic maculopathy. METHODS All patients with diabetic retinopathy and mixed retinopathy presenting to Ophthalmology OPD at Sri Siddhartha Medical College between June 2020 and June 2021, were included in the study. The patients were evaluated for visual acuity on Snellen Visual Acuity Chart, Anterior Segment evaluation on a slit-lamp examination. Fundus was evaluated with 90 Diopter Volk lens with Slit Lamp biomicroscopy, Direct Ophthalmoscopy with Welch Allyn ophthalmoscope with medium size aperture, and the peripheral fundus was seen by an Indirect Ophthalmoscope with 20 Diopter lens Volk lens. ETDRS 7 Field Picture on Carl Zeiss Meditec AG VISUCAM SN model AA107 was taken. The observations were subjected to the statistical analysis of Cohen’s Kappa and the percentile description. RESULTS The commonest retinopathy was moderate non-proliferative diabetic retinopathy (NPDR), seen in 41.667 %. The commonest maculopathy found was the absence of maculopathy seen in 78.3 % of cases. There was perfect agreement (Kappa k-1.00) in the evaluation of background retinopathy on Conventional Fundoscopy and Fundus imaging, P-value < 0.001. There was moderate agreement (Kappa k-0.5) in the evaluation of maculopathy on Conventional Fundoscopy and Fundus imaging, Pvalue < 0.001, only for CSME and No maculopathy. However diffuse macular oedema and Ischemic Maculopathy were missed on Fundus Photography. CONCLUSIONS Non-Stereoscopic Fundus Photography is a good telemedicine tool for diabetic retinopathy screening, but there is under-diagnosis of it, though it can detect diabetic maculopathy. As a diagnosis”Absence of maculopathy” is inconclusive until and unless screened by Conventional Ophthalmoscopy. KEY WORDS Diabetic Retinopathy, Maculopathy, Clinically Significant Macular Oedema, NonStereoscopic Fundus Imaging, Ophthalmoscopy.
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Mao, Yumei, Yanling Long, Bo Liu, Qingling Cao, Yijian Li, Sha Li, Gang Wang, Xiaohong Meng, and Shiying Li. "Ocular Characteristics of Patients with Leber Congenital Amaurosis 6 Caused by Pathogenic RPGRIP1 Gene Variation in a Chinese Cohort." Journal of Ophthalmology 2021 (November 9, 2021): 1–8. http://dx.doi.org/10.1155/2021/9966427.
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Purpose. To delineate the clinical and genetic characteristics of Chinese patients with RPGRIP1-associated Leber congenital amaurosis 6 (LCA6). Methods. After screening 352 unrelated families with clinically diagnosed RP, five LCA6 patients with RPGRIP1 variations from unrelated Chinese families were identified. Full ophthalmology examinations, including decimal best-corrected visual acuity (BCVA), fundus photography, fundus autofluorescence imaging, spectral-domain optical coherence tomography (SD-OCT), full-field electroretinography (ffERG), multifocal electroretinography (mfERG), perimetry, and flash visual evoked potential (FVEP), were performed. Target next-generation sequencing (NGS) and Sanger sequencing were performed for the five patients to identify and to validate candidate disease-causing variants. Results. Five patients were molecularly diagnosed as the LCA6 associated with RPGRIP1 variation, with typical clinical characteristics including congenital night blindness, nystagmus, and visual defect, at an early age. Interestingly, LCA6 exhibited extensive clinical heterogeneity and the changes in the morphology and function were not completely consistent in the five LCA6 patients. Case 1 showed extensive inferior-nasal retinal atrophy with a corresponding area of hypofluorescence in fundus autofluorescence, and the fundus photograph was nearly normal in cases 2 and 3. The ERG results displayed a moderately reduced rod-system response in cases 1 and 2 and a significant reduced rod-system response in case 3. Both case 4 and case 5 showed mottled pigmentation in fundi and an unrecordable rod and cone-system response in ERG. Moreover, we identified eight compound variants and one homozygous variant in the five patients with RPGRIP1. Conclusions. This is the largest report focused on the clinical electrophysiological features of patients with associated LCA6 caused by the variation in the RPGRIP1 gene in the Chinese population with an enriched phenotypic and genotypic background of LCA6 to improve future gene therapies.
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Hirsch, Linda, Christina Schneegass, Robin Welsch, and Andreas Butz. "To See or Not to See." Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies 5, no. 1 (March 19, 2021): 1–25. http://dx.doi.org/10.1145/3448123.
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People visit public places with different intentions and motivations. While some explore it carefully, others may just want to pass or are otherwise engaged. We investigate how to exploit the inattentional blindness (IB) of indirect users in the design of public interfaces to apply to such diverse needs. Beginning with a structured literature study in the ACM Digital Library on IB, we analyzed 135 publications to derive design strategies that benefit from IB or avoid IB. Using these findings, we selected three existing interfaces for information presentation on a large public square and created two additional interfaces ourselves. We then compared users' perceptions through a self-reported photography study (N = 40). Participants followed one of four scripted profiles to imitate different user intentions, two for direct and two for indirect users. We hypothesized that direct users would recognize the interfaces, while indirect users would experience IB and ignore them. Our results show that direct users reported up to 68% of our interfaces, whereas indirect users noticed only 16%. Thus, IB can be exploited to hide interfaces from indirect users while keeping them noticeable to direct users.
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Bhawarkar, Yash, Kaustubh Bhure, Vinayak Chaudhary, and Bhavana Alte. "Diabetic Retinopathy Detection From Fundus Images Using Multi-Tasking Model With EfficientNet B5." ITM Web of Conferences 44 (2022): 03027. http://dx.doi.org/10.1051/itmconf/20224403027.
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Diabetic Retinopathy (DR) is a common eye disease that affects over 3 million people annually. People with diabetes are more prone to suffer from Diabetic Retinopathy. This condition can cause blurring of vision and blindness. Early detection and treatment are the most effective ways to manage Diabetic Retinopathy. Due to the huge number of diabetic patients and the need for more accurate and automatic diagnosis, the development of deep neural networks has been acknowledged. One of the issues with deep learning classification tasks, particularly in the medical field, is a lack of labelled training data. Transfer learning enables the deep learning model to be trained with a minimal Training Dataset. In Deep convolutional networks, transfer learning can be utilized to solve the problem of insufficient training data. Previous studies on deep neural networks have been promising. Through a color fundus photography study, we have developed a model to identify the different stages of Diabetic Retinopathy using Deep learning. Our proposed model has achieved 87% of accuracy with the help of EfficientNet model. The main aim of this work is to develop a robust system for detecting DR automatically.
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Jivraj, Imran, Chris J. Rudnisky, Emmanuel Tambe, Graham Tipple, and Matthew T. S. Tennant. "Identification of Ocular and Auditory Manifestations of Congenital Rubella Syndrome in Mbingo." International Journal of Telemedicine and Applications 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/981312.
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Purpose. Congenital rubella syndrome (CRS) is a global cause of preventable hearing impairment, blindness, and intellectual impairment. The present study sought to identify ocular and auditory manifestations of CRS in school-aged children in Mbingo, Cameroon.Design. Cross sectional study.Subjects. Students at two schools, one for children with hearing impairment, were screened for cataract, congenital glaucoma, and pigmentary retinopathy.Methods. Students underwent seven-field digital fundus photography through a dilated pupil using a Topcon NW200 nonmydriatic camera. Images were assessed by retina specialists in Canada via teleophthalmology. Clinical evidence was integrated to form case definitions for CRS based on Center for Disease Control and Prevention guidelines. Serological evidence of rubella infection was obtained using standardized IgG antibody titers.Main Outcome Measure. Number of probable and suspicious cases of CRS.Results. Between September 2009 and May 2010, 320 students participated. There were 28 (10.2%) probable cases, 104 (37.8%) suspects, and 143 (52.0%) unaffected. Rubella IgG serology was positive in 79 (48.7%) of children with hearing impairment and 11 (7.4%) of children with normal hearing.Conclusions. The present study identified 28 probable cases of CRS. Furthermore, 92.6% of students with normal hearing did not possess rubella IgG antibodies making future cases of CRS likely without intervention.
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Edwards, Liz, and Serena Pollastri. "Biodiversity Logbooks: Design for noticing nature at a hyperlocal scale." Artifact 9, no. 1 (December 1, 2022): 24.1–24.21. http://dx.doi.org/10.1386/art_00024_1.
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This article considers the pedagogical importance of noticing nature at the hyperlocal scale, and the role that design can play in nurturing and supporting these processes. Biodiversity Logbooks are a set of educational resources that promote direct engagement with everyday environments through a variety of creative methods, including cyanotype photography, physical computing, collaborative mapping and journaling. These tools are intended to be used in combination to develop skills of noticing plants in their habitats and understanding how different environments support different life forms. This article argues that while complex environmental phenomena are often addressed at the global scale (with local impacts presented as scalable outcomes), focusing on small, often overlooked details can have beneficial pedagogical outcomes. These consist of increased attentiveness and care for the needs of other species, better retention of knowledge generated through embodied experience and stronger connection with place. In the article, the impacts of the project as described by the teachers who participated in the experience are discussed in connection to broader epistemological issues. These include plant blindness as a widespread phenomenon in urban populations, and the importance of observing messy entanglements and non-scalable dynamics when building knowledge about the environment.
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Niu, Chenchen, Thazah P. Prakash, Aneeza Kim, John L. Quach, Laryssa A. Huryn, Yuechen Yang, Edith Lopez, et al. "Antisense oligonucleotides targeting mutant Ataxin-7 restore visual function in a mouse model of spinocerebellar ataxia type 7." Science Translational Medicine 10, no. 465 (October 31, 2018): eaap8677. http://dx.doi.org/10.1126/scitranslmed.aap8677.
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Spinocerebellar ataxia type 7 (SCA7) is an autosomal dominant neurodegenerative disorder characterized by cerebellar and retinal degeneration, and is caused by a CAG-polyglutamine repeat expansion in the ATAXIN-7 gene. Patients with SCA7 develop progressive cone-rod dystrophy, typically resulting in blindness. Antisense oligonucleotides (ASOs) are single-stranded chemically modified nucleic acids designed to mediate the destruction, prevent the translation, or modify the processing of targeted RNAs. Here, we evaluated ASOs as treatments for SCA7 retinal degeneration in representative mouse models of the disease after injection into the vitreous humor of the eye. Using Ataxin-7 aggregation, visual function, retinal histopathology, gene expression, and epigenetic dysregulation as outcome measures, we found that ASO-mediated Ataxin-7 knockdown yielded improvements in treated SCA7 mice. In SCA7 mice with retinal disease, intravitreal injection of Ataxin-7 ASOs also improved visual function despite initiating treatment after symptom onset. Using color fundus photography and autofluorescence imaging, we also determined the nature of retinal degeneration in human SCA7 patients. We observed variable disease severity and cataloged rapidly progressive retinal degeneration. Given the accessibility of neural retina, availability of objective, quantitative readouts for monitoring therapeutic response, and the rapid disease progression in SCA7, ASOs targeting ATAXIN-7 might represent a viable treatment for SCA7 retinal degeneration.
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Lee, Chia-Cheng, Shi-Chue Hsing, Yu-Ting Lin, Chin Lin, Jiann-Torng Chen, Yi-Hao Chen, and Wen-Hui Fang. "The Importance of Close Follow-Up in Patients with Early-Grade Diabetic Retinopathy: A Taiwan Population-Based Study Grading via Deep Learning Model." International Journal of Environmental Research and Public Health 18, no. 18 (September 16, 2021): 9768. http://dx.doi.org/10.3390/ijerph18189768.
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(1) Background: Diabetic retinopathy (DR) can cause blindness. Current guidelines on diabetic eye care recommend more frequent eye examinations for more severe DR to prevent deterioration. However, close follow-up and early intervention at earlier stages are important for the prevention of disease progression of other diabetes mellitus (DM) complications. The study was designed to investigate the association between different stages of DR in type 2 DM patients and the progression of DR; (2) Methods: A total of 2623 type 2 DM patients were included in this study. In these patients, a total of 14,409 fundus color photographs was obtained. The primary outcome was the progression of DR; (3) Results: The progression of DR was highly associated with the initial grade of DR (p < 0.001). Severe nonproliferative diabetic retinopathy (NPDR) was the most likely to progress to proliferative diabetic retinopathy (PDR), followed by moderate NPDR, mild NPDR, and no retinopathy. However, progression to the next stage of DR showed a different trend. We used no retinopathy as a reference. Mild NPDR showed the highest risk for progression to the next stage [hazard ratio (HR): 2.00 (95% conference interval (CI): 1.72–2.32)] relative to higher initial grades [HR (moderate NPDR): 1.82 (95% CI: 1.58–2.09) and HR (severe NPDR): 0.87 (95% CI: 0.69–1.09)]. The same trend was observed in the multivariate analysis, in which mild NPDR presented the highest risk for progression to the next stage (adjusted HR (mild NPDR): 1.95 (95% CI: 1.68–2.27), adjusted HR (moderate NPDR): 1.73 (95% CI: 1.50–1.99), and adjusted HR (severe NPDR): 0.82 (95% CI: 0.65–1.03)); (4) Conclusions: Type 2 diabetic patients with earlier-grade DR appeared to exhibit more rapid development to the next grade in our study. As these findings show, more frequent fundus color photography follow-up in earlier-grade DR patients is important to slow DR progression and awaken self-perception.
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Ahi, Berat, Volkan Atasoy, and Sibel Balci. "AN ANALYSIS OF PLANT BLINDNESS IN TURKISH TEXTBOOKS USED AT THE BASIC EDUCATION LEVEL." Journal of Baltic Science Education 17, no. 2 (April 25, 2018): 277–87. http://dx.doi.org/10.33225/jbse/18.17.277.
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The importance of plants is not as clearly understood as that of animals. This lack of attention is called “plant blindness” and is considered one of the most important problems in biology education. Textbooks do not put much emphasis on plants and, therefore, they may contribute to plant blindness. In this research, ten textbooks used for teaching at the basic education level in Turkey were analyzed for plant blindness using the document analysis method. The words and photographs associated with plants and animals were analyzed. The data analysis did not find any evidence that could lead to a conclusion of plant blindness based on the text and photos of these textbooks. However, if the number of plant and animal species covered is increased, and more words and photos are used to introduce these species, children will become more familiar with plants and animals. Besides textbooks, other educational tools can be analyzed in terms of plant blindness to expand on the related literature. Keywords: plant blindness, photograph in textbook, document analysis, written text.
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Feng, Liwen, Kailai Nie, Qing Huang, and Wei Fan. "Complement factor H deficiency combined with smoking promotes retinal degeneration in a novel mouse model." Experimental Biology and Medicine 247, no. 2 (November 13, 2021): 77–86. http://dx.doi.org/10.1177/15353702211052245.
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Age-related macular degeneration is the leading cause of blindness in the elderly. The Y402H polymorphism in complement factor H promotes disease-like pathogenesis, and a Cfh+/− murine model can replicate this phenotype, but only after two years. We reasoned that by combining CFH deficiency with cigarette smoke exposure, we might be able to accelerate disease progression to facilitate preclinical research in this disease. Wild-type and Cfh+/− mice were exposed to nose-only cigarette smoke for three months. Retinal tissue morphology and visual function were evaluated by optical coherence tomography, fundus photography and autofluorescence, and electroretinogram. Retinal pigment epithelial cell phenotype and ultrastructure were evaluated by immunofluorescence staining and transmission electron microscopy. Cfh+/− smoking mice showed a dome-like protruding lesion at the ellipsoid zone (drusen-like deposition), many retinal hyper-autofluorescence spots, and a marked decrease in A- and B-wave amplitudes. Compared with non-smoking mice, wild-type and Cfh+/− smoking mice showed sub-retinal pigment epithelium complement protein 3 deposition, activation of microglia, metabolic waste accumulation, and impairment of tight junctions. Microglia cells migrated into the photoreceptor outer segment layer in Cfh+/− smoking mice showed increased activation. Our results suggest that exposing Cfh+/− mice to smoking leads to earlier onset of age-related macular degeneration than in other animal models, which may facilitate preclinical research into the pathophysiology and treatment of this disease.
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Khan, Taskeen, Melanie Y. Bertram, Ruxana Jina, Bob Mash, Naomi Levitt, and Karen Hofman. "Preventing diabetes blindness: Cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa." Diabetes Research and Clinical Practice 101, no. 2 (August 2013): 170–76. http://dx.doi.org/10.1016/j.diabres.2013.05.006.
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Yusuf, Ahmed Mohamud, Rebecca Claire Lusobya, John Mukisa, Charles Batte, Damalie Nakanjako, and Otiti Juliet-Sengeri. "Validity of smartphone-based retinal photography (PEEK-retina) compared to the standard ophthalmic fundus camera in diagnosing diabetic retinopathy in Uganda: A cross-sectional study." PLOS ONE 17, no. 9 (September 6, 2022): e0273633. http://dx.doi.org/10.1371/journal.pone.0273633.
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Introduction Diabetic retinopathy (DR) is one of the major complications of diabetes mellitus and is a significant cause of blindness worldwide. In Uganda, the prevalence of diabetes is approximately 2.7% of the urban population and 1% in rural areas. Many diabetics cannot access an eye exam due to the lack of less costly and user-friendly equipment that primary eye workers can use. Smartphone-based fundus photography allows for a cheap and mobile fundus examination. The study aimed to determine the sensitivity and specificity of the Portable Eye Examination Kit (PEEK) retina compared to a standard ophthalmic fundus camera (Zeiss Visucam 200) for the diagnosis of DR. Methods From January-March 2020, 286 people with diabetes (type 1 & 2) patients were seen at Kiruddu National referral hospital diabetes clinic. All participants had funduscopy with PEEK retina and the standard ophthalmic fundus camera following ophthalmic examination and pupillary dilation. The PEEK retina’s sensitivity, specificity and reliability were determined using an ophthalmic fundus camera as the gold standard. Results The participants’ mean age was 51 with a standard deviation of ±11years, 213 (74.5%) were females, and the majority (93.4%) had Type 2 diabetes. The overall Sensitivity of PEEK retina for DR was 84% (95% CI 70.9–83.5), while the specificity was 79.9% (95% CI 76–83.5) with a positive predictive value (PPV) of 30.9% (95% CI 23.2–39.4) and a negative predictive value (NPV) of 97.9% (95% CI 95.9–99.1). Conclusions PEEK retina has high sensitivity and specificity, making it suitable for screening and diagnostic purposes. Therefore, we recommend the integration of the PEEK retina in the screening and diagnosis of DR in resource-limited settings.
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Cioana, Milena, Jiawen Deng, Ajantha Nadarajah, Maggie Hou, Yuan Qiu, Sondra Song Jie Chen, Angelica Rivas, et al. "ODP185 Diabetic Retinopathy Prevalence in Pediatric Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A308. http://dx.doi.org/10.1210/jendso/bvac150.637.
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Abstract Type 2 diabetes mellitus (T2DM) is on the rise in children and adolescents. Diabetic retinopathy (DR) is a leading cause of blindness in adult patients with diabetes. However, the exact prevalence of DR and its determinants in pediatric patients with T2DM are unknown. Understanding the burden of DR in pediatric T2DM can help inform screening and management clinical practice guidelines. This systematic review and meta-analysis aimed to determine the prevalence and determinants of DR in pediatric T2DM. The main outcome was the pooled prevalence of DR in pediatric T2DM. Other important outcomes included the assessment of the impact of diabetes duration, method of retinopathy diagnosis, sex, race, and obesity on prevalence. We searched MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and the grey literature from inception until April 4, 2021 for relevant data. No language restrictions were applied, and searches were limited to human studies. Two reviewers independently screened for studies of T2DM patients diagnosed <21 years of age with observational study design and ≥10 participants. Risk of bias evaluation was performed and level of evidence analysis was conducted using the Oxford Centre for Evidence-Based Medicine criteria. A random-effects meta-analysis was used to pool the results. Out of 1849 screened studies, 24 studies met the inclusion criteria. The overall prevalence of DR in pediatric T2DM was 6.58% (95%CI 3.46-10.46, I 2 =96%,n=9026). Most cases were classified as minimal or mild non-proliferative DR. Six cases were sight-threatening. Prevalence was higher in studies using fundoscopy than fundus photography to evaluate DR (0.47% [95%CI 0. 00-3.30, I 2 =0%,n=135] vs. 18.20% [95%CI 7.92-31.28, I 2 =89%,n=718]), suggesting that fundus photography was more sensitive in detecting DR than fundoscopy. The risk of DR rose progressively post-diagnosis; while1.25% (95%CI 0. 00-4. 01, I 2 =13%,n=213) of patients had DR <3 years post T2DM diagnosis, this figure rose to33. 03% (95%CI 25.79-40.66, I 2 =0%,n=162) >5 years after diagnosis. Obesity and sex did not impact DR prevalence. White/Middle Eastern patients had a DR prevalence of 7.43% (95%CI 0. 00-31.37; I 2 =97%,P <0. 001, n=4419),while Asians had a higher prevalence of 14.85% (95%CI 0.91-39.16; I 2 =93%,P <0. 001, n=501). In conclusion, DR is a frequent complication in children and adolescents in the early years post T2DM diagnosis. Screening for DR at diagnosis and annually thereafter using fundus photography is critical to allow early detection and management to prevent visual impairment in these patients. Presentation: No date and time listed
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Tsegaw, Asamere, Shitaye Alemu, Abere Dessie, Christopher C. Patterson, Eldryd H. O. Parry, David I. W. Phillips, and Elisabeth R. Trimble. "Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients Attending the Diabetic Clinic of the University of Gondar Hospital, Northwest Ethiopia." Journal of Ophthalmology 2021 (March 31, 2021): 1–7. http://dx.doi.org/10.1155/2021/6696548.
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Objective. To investigate the level of diabetic retinopathy in type 2 diabetes (T2DM) patients attending the University of Gondar Hospital (UGH) Diabetic Clinic, Northwest Ethiopia. Methods. An audit was carried out involving a total of 739 T2DM patients attending at the diabetic clinic of UGH. They represented approximately 90% and 50% of all T2DM patients under regular review at the urban and rural diabetic clinics of UGH, respectively. All were supervised by the same clinical team for a long period. Eye examinations were performed for visual acuity, cataract, and retinal changes (retinal photography and slit-lamp biomicroscopy). Body mass index (BMI) and HbA1c levels were measured. The presence or absence of hypertension was recorded. Results. Men constituted 41.5% of the group, the mean age at diagnosis of T2DM was 50.4 years, and 50.2% were hypertensive. The BMI was 25.0 ± 4.1 kg/m2, and HbA1c was 7.75 ± 1.63% (61.2 ± 17.8 mmol/mol) (mean ± SD, for BMI and HbA1c)). Severe visual impairment/blindness was reported in 10.6%, 15.2% had cataract, 16.0% had retinopathy, and 11.1% had maculopathy. The prevalence of retinopathy increased with time from diagnosis of T2DM (chi-square for trend, p < 0.001 ) and with increasing HbA1c level (chi-square for trend, p = 0.03 ). Conclusion. These results compare well with the most recent results in well-equipped, wealthier regions of the world and show the importance of stable healthcare infrastructure for chronic-disease management.
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Hao, Zhaohu, Rong Xu, Xiao Huang, Xinjun Ren, Huanming Li, and Hailin Shao. "Application and observation of artificial intelligence in clinical practice of fundus screening for diabetic retinopathy with non-mydriatic fundus photography: a retrospective observational study of T2DM patients in Tianjin, China." Therapeutic Advances in Chronic Disease 13 (January 2022): 204062232210973. http://dx.doi.org/10.1177/20406223221097335.
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Objective: To observe the consistency of a preliminary report of artificial intelligence (AI) in the clinical practice of fundus screening for diabetic retinopathy (DR) using non-mydriatic fundus photography. Methods: Patients who underwent DR screening in the Metabolic Disease Management Center (MMC) of our hospital were selected as research participants. The degree of coincidence of the AI preliminary report and the ophthalmic diagnosis was compared and analyzed, and the kappa value was calculated. Fundus fluorescein angiography (FFA) was performed in patients referred to the out-of-hospital ophthalmology department, and the consistency between fluorescein angiography and AI diagnosis was evaluated. Results: In total, 6146 patients (12,263 eyes) completed the non-mydriasis fundus examination. The positive DR screening rate was 24.3%. When considering moderate nonproliferative retinopathy as the cut-off point, the kappa coefficient was 0.75 ( p < 0.001), the sensitivity was 0.973, and the precision was 0.642, which was shown in the precision–recall curve. Fifty-nine patients referred to receive FFA were compared with non-mydriatic AI diagnoses. The kappa coefficient was 0.53, and the coincidence rate was 66.9%. Conclusion: Non-mydriasis fundus examination combined with AI has a medium-high consistency with ophthalmologists in DR diagnosis, conducive to early DR screening. Combining diagnosis and treatment modes with the Internet can promote the development of telemedicine, alleviate the shortage of ophthalmology resources, and promote the process of blindness prevention and treatment projects.
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Sharada M, S. Kalpana, Sweekruthi G K, and Anuradha A. "Association between diabetic retinopathy and diabetic nephropathy: A clinical study." Indian Journal of Clinical and Experimental Ophthalmology 8, no. 1 (March 15, 2022): 137–41. http://dx.doi.org/10.18231/j.ijceo.2022.025.
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Diabetes mellitus is a leading cause of blindness worldwide. The disease affects the generalized micro and macro vasculature of various structures. Retina, kidney and peripheral nerves are the major sites of micro vasculature involvement. Our study aims to find the correlation between diabetic retinopathy (DR) and diabetic nephropathy. This non-randomized, prospective study was conducted at a tertiary care hospital in South India between November 2014 and May 2016. Study included 100 patients with diabetic nephropathy referred for fundoscopy from the nephrourology department, excluding those with hazy media enough to interfere with a detailed fundus examination and management. All subjects underwent complete ocular examination and systemic evaluation after obtaining informed consent. Visual acuity, fundoscopy by direct and indirect ophthalmoscope, fundus photography and optical coherence tomography were done as and when required. Blood investigations like fasting blood sugar, post prandial blood sugar, glycosylated haemoglobin, haemoglobin levels, serum creatinine and blood urea nitrogen, lipid profile, urine routine and 24-Hour urine albumin were recorded. DR was classified according to ETDRS classification and different grades were compared with grades of nephropathy and association was analysed statistically.: There was significant association between fundal changes and albumin excretion in urine. Among subjects with massive albuminuria, 64.7% of them had proliferative DR (PDR). Among subjects with moderate albuminuria, majority had Moderate NPDR and subjects with microalbuminuria majority had normal fundus. There was a positive correlation between DR and total cholesterol. The severity of DR correlates with severity of diabetic nephropathy.
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Chen, Ying-Jen, Jiann-Torng Chen, Ming-Cheng Tai, Chang-Min Liang, Yuan-Yuei Chen, and Wei-Liang Chen. "Serum Iron and Risk of Diabetic Retinopathy." Nutrients 12, no. 8 (July 31, 2020): 2297. http://dx.doi.org/10.3390/nu12082297.
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Background: Diabetic retinopathy (DR) is indicated as a major cause of blindness in the world. Emerging evidence supports the interaction of iron metabolism with diabetes. However, little research is available concerning the relationship between iron metabolism and DR. The intent of this paper is to describe the correlation between serum iron and the occurrence of DR. Methods: A total of 5321 participants who underwent related examinations as part of the National Health and Nutrition Examination Survey (2005–2008) were included. DR was defined by the criteria of the Early Treatment for Diabetic Retinopathy Study based on nonmydriatic fundus photography. The cutoff point of serum iron for DR was explored by the receiver operating characteristics curve. The relationship of serum iron with the occurrence of DR was explored by multivariate logistic regression models. Results: Participants with DR had significantly lower serum iron than the control group. Serum iron was negatively correlated with the occurrence of DR after the adjustment of pertinent variables (an odds ratio (OR) of 0.995 (95% CI: 0.992–0.999)). After dividing serum iron into quartiles, the third quartile was associated with DR with an OR of 0.601 (95% CI: 0.418–0.863). Furthermore, the cutoff point of serum iron had an inverse relationship for the occurrence of DR with an OR of 0.766 (95% CI: 0.597–0.984). Conclusion: Serum iron has an inverse association with the occurrence of DR in diabetic adults. The assessment of serum iron levels might be a part of follow-up visits with diabetic patients.
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You, Hyelin, and David Sierpina. "A Novel Pathogenic Variant in the RDH5 Gene in a Patient with Fundus Albipunctatus and Severe Macular Atrophy." Case Reports in Genetics 2022 (April 6, 2022): 1–7. http://dx.doi.org/10.1155/2022/1183772.
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Purpose. To report a novel 11-cis retinol dehydrogenase gene (RDH5) variant discovered in a 57-year-old male with fundus albipunctatus (FA) complicated by severe macular atrophy. Methods. The patient was evaluated with a complete ophthalmic examination, optical coherence tomography (OCT), color fundus photography, green wavelength fundus autofluorescence, visual field testing, full-field ERG (ffERG), and multifocal ERG (mfERG). Genetic analysis investigating gene variants involved in inherited retinal disorders was performed. Results. The patient presented with a rapid decline in visual acuity and a history of poor night vision. On fundoscopy, he exhibited a phenotype characteristic of FA accompanied by severe macular atrophy bilaterally. Heterozygous variants in the RDH5 gene were identified, including a novel missense variant, c.814_815del (p.Leu272Aspfs ∗ 63), and a known pathogenic nonsense variant, c.160C > T (p.Arg54 ∗ ). Fundus autofluorescence demonstrated bull’s eye maculopathy and hyperautofluorescent perifoveal rings bilaterally. OCT showed foveal atrophy of the outer retina and scattered hyper-reflective lesions in the peripheral macula. The ffERG results showed a severely diminished scotopic and photopic response. The mfERG results demonstrated minimal response in the central macula. Conclusions. Fundus albipunctatus is a rare, congenital form of stationary night blindness caused almost exclusively by the RDH5 gene. This patient’s clinical presentation, diagnostic studies, and genetic testing confirmed the diagnosis of FA. Additionally, he exhibited severe macular atrophy, not typically found in FA. Two RDH5 gene variants were identified, one of which is the novel variant, c.814_815del (p.Leu272Aspfs ∗ 63). We suggest that this RDH5 genotype may be associated with a more progressive phenotype of FA contributing to macular atrophy.
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Sethi, Muhammad Junaid, Umer Khan, Natasha Junaid, Nazli Gul, Ishan Ullah, and Muhammad Israr. "The Genetics and Clinical Presentation of Retinitis Pigmentosa A Tertiary Care Hospital Study." Pakistan Journal of Medical and Health Sciences 16, no. 11 (November 30, 2022): 799–801. http://dx.doi.org/10.53350/pjmhs20221611799.
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Objective: This study aims to analyze the retinitis pigmentosa patients' Clinical Presentation and inheritance patterns. Research conducted at the tertiary care hospital Material and methods: this tertiary care hospital study was carried out at a level I trauma center between 05 January 2018 to 05 January 2021. fifty-six patients and members of their families underwent an ophthalmic evaluation to help identify those with the condition and define its phenotype. The family tree was traced. Several relatives also had optical gheremco tomography and fundus photography. Results: at Presentation, 52 eyes (47%) were judged to be legally blind, whereas 38 (32%) had some degree of visual impairment. The visual field was narrowed in 22 instances ( 40%) due to the brightness of the interaction. In terms of inheritance patterns, we discovered that three cases were autosomal dominant (4%), 39 cases were autosomal recessive (70%), and three cases were x-linked (6%). Of the total cases, 11 (20%) were isolated incidents. There were 48 patients with a conventional retinitis pigmentosa image (86%) and eight patients with an unusual RP picture (12%), including three instances of pericentric RP (5%), 3 cases of Usher's disease (4%) and 1 case of retinitis punctata albescence (2%) bardet-biedl were identified in a single patient. Conclusions: Retinitis Pigmentosa Patients Have A Very Significant Risk Of Becoming Blind. Autosomal Recessive sporadically follows the Most Prevalent Pattern Of Inheritance. Early Detection Of Retinitis Pigmentosa Is Important In Preventing Blindness From The Disease, As Is Encouraging Patients To Forego Marriages To First Cousins. Keywords: Genetics and Clinical, Presentation, Retinitis Pigmentosa, kpc
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Asia, Al-Omaisi, Cheng-Zhang Zhu, Sara A. Althubiti, Dalal Al-Alimi, Ya-Long Xiao, Ping-Bo Ouyang, and Mohammed A. A. Al-Qaness. "Detection of Diabetic Retinopathy in Retinal Fundus Images Using CNN Classification Models." Electronics 11, no. 17 (August 31, 2022): 2740. http://dx.doi.org/10.3390/electronics11172740.
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Diabetes is a widespread disease in the world and can lead to diabetic retinopathy, macular edema, and other obvious microvascular complications in the retina of the human eye. This study attempts to detect diabetic retinopathy (DR), which has been the main reason behind the blindness of people in the last decade. Timely or early treatment is necessary to prevent some DR complications and control blood glucose. DR is very difficult to detect in time-consuming manual diagnosis because of its diversity and complexity. This work utilizes a deep learning application, a convolutional neural network (CNN), in fundus photography to distinguish the stages of DR. The images dataset in this study is obtained from Xiangya No. 2 Hospital Ophthalmology (XHO), Changsha, China, which is very large, little and the labels are unbalanced. Thus, this study first solves the problem of the existing dataset by proposing a method that uses preprocessing, regularization, and augmentation steps to increase and prepare the image dataset of XHO for training and improve performance. Then, it takes the advantages of the power of CNN with different residual neural network (ResNet) structures, namely, ResNet-101, ResNet-50, and VggNet-16, to detect DR on XHO datasets. ResNet-101 achieved the maximum level of accuracy, 0.9888, with a training loss of 0.3499 and a testing loss of 0.9882. ResNet-101 is then assessed on 1787 photos from the HRF, STARE, DIARETDB0, and XHO databases, achieving an average accuracy of 0.97, which is greater than prior efforts. Results prove that the CNN model (ResNet-101) has better accuracy than ResNet-50 and VggNet-16 in DR image classification.
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Voigt, Margarete, Sebastian Schmidt, Thomas Lehmann, Benjamin Köhler, Christof Kloos, Ulrich Voigt, Daniel Meller, Gunter Wolf, Ulrich Müller, and Nicolle Müller. "Prevalence and Progression Rate of Diabetic Retinopathy in Type 2 Diabetes Patients in Correlation with the Duration of Diabetes." Experimental and Clinical Endocrinology & Diabetes 126, no. 09 (November 28, 2017): 570–76. http://dx.doi.org/10.1055/s-0043-120570.
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Abstract Aims We examined prevalence and progression of retinopathy in dependence on diabetes duration in order to estimate the probability of progression. Patients/Methods In a retrospective cohort-analysis from an academic outpatient department of endocrinology and metabolic diseases we analyzed 17461 consultations of 4513 patients with DM2 from 1987 to 2014. 50.3% of the patients (n=2272) had at least one documented result of funduscopy. Results 25.8% of the patients had retinopathy (20.2% non-proliferative, 4.7% proliferative, 0.7% were not classified, 0.1% blindness). The prevalence of retinopathy in dependence on diabetes duration was 1.1% at diagnosis, 6.6% after 0<5 years, 12% after 5<10 years, 24% after 10<15 years, 39.9% after 15<20 years, 52.7% after 20<25 years, 58.7% after 25<30 years and 63% after ≥30 years. In a subset of 586 (25.7%) patients with retinal photography of 3 consecutive years 7.0% showed deterioration after one and 12.2% after two years; 2.6% improved after one and 2.8% after two years. 201 (34.3%) of this group had<10 years diabetes and lower deterioration (4.5% worsened after one and 9.5% after two years). Their retinopathy mainly transformed from no retinopathy to non-proliferative. Four patients (2.0%) developed proliferative retinopathy. Conclusions/Interpretations Within the first 10 years of diabetes duration, the prevalence of retinopathy is low and the progression infrequent. Most patients have a non-proliferative form which can be reversible and rarely requires interventions. Patients with DM2 without retinopathy and good glycaemic control do not run into additional risk from expanding funduscopy intervals to biennial.
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Chandrasekaran, Subhashini, William Kass, Loka Thangamathesvaran, Nicole Mendez, Peter Khouri, Bernard C. Szirth, and Albert S. Khouri. "Tele-glaucoma versus clinical evaluation: The New Jersey Health Foundation Prospective Clinical Study." Journal of Telemedicine and Telecare 26, no. 9 (May 28, 2019): 536–44. http://dx.doi.org/10.1177/1357633x19845273.
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Introduction Glaucoma, the second most common cause of blindness, is normally detected in clinic. With technological improvements, tele-glaucoma exams can identify these changes off-site. The quality of tele-glaucoma exams needs to be compared with that of traditional exams. This study’s purpose was to validate the tele-glaucoma programme, which allows a physician comprehensive access to patients’ data, by comparing results to clinical examinations. Methods A prospective study of 107 subjects evaluated in clinic and then tele-glaucoma stations, which consisted of non-mydriatic fundus photography, puff-tonometry, auto-refraction and Optical Coherence Tomography (OCT). The OCT captured central corneal thickness, angle anatomy, cup-to-disc ratio (CDR), retinal nerve fibre layer distribution and posterior-pole ganglion cell complex data. Results Intraocular pressure (IOP) comparisons between clinical and tele-glaucoma exams had strong positive Pearson correlation coefficients (0.8248 OD, 0.8672 OS). Strong positive correlations were seen for CDR (0.7835 OD, 0.8082 OS) as well as diagnosis (glaucoma, no glaucoma or glaucoma suspect). A moderate positive correlation was seen for return to clinic time (RTC). Tele-glaucoma had an average lower RTC (2.7 vs 3.9 months). Tele-glaucoma was more likely to elicit a non-glaucomatous diagnosis not found in clinic vs a diagnosis found only in clinic (18% vs 5% of subjects). Discussion Tele-glaucoma allows for detecting glaucoma remotely. These advancements alleviate patient difficulties with obtaining adequate glaucoma screenings and helps ophthalmologists triage patients with more severe pathology. Our study indicates that our tele-glaucoma protocol is comparable to a clinical exam in its ability to detect glaucoma. Further studies will be needed for off-site testing and transferring data separately for analysis.
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Silim, Anhar Hafiz, Raja Norliza Raja Omar, Othmaliza Othman, Rona Asnida Nasaruddin, and Norshamsiah Md Din. "Retinal nerve fibre layer thickness measured by spectral domain optical coherence tomography amongst early primary open-angle glaucoma patients at Hospital Melaka." Malaysian Journal of Ophthalmology 2, no. 3 (September 24, 2020): 203–18. http://dx.doi.org/10.35119/myjo.v2i3.73.
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Introduction: Glaucoma is second only to cataract as a cause of blindness worldwide and Asians account for almost half the cases. Retinal nerve fibre layer (RNFL) assessment is an important objective method for diagnosis and monitoring of glaucoma as it develops earlier than the development of visual field defects.
Purpose: To estimate the proportion of primary open-angle glaucoma (POAG) patients with normal RNFL thickness (RNFLT) amongst early POAG patients who were under follow-up at the Ophthalmology Department, Hospital Melaka (Melaka, Malaysia).
Study design: Observational cross-sectional study.
Materials and methods: Consecutive sampling of 64 POAG patients who were diagnosed as early POAG as defined by the Glaucoma Staging System 2 (GSS 2) into stage 1 and 2 on Octopus visual field test were recruited in this study. Data collected included demographic data, refraction, slit-lamp examination, intraocular pressure (IOP), gonioscopy, peripapillary retinal nerve fibre layer thickness (RNFLT) measured by spectral-domain optical coherence tomography (SD-OCT), and fundus photography.
Results: Among 64 eyes, 57.8% were found to have normal and 42.2% to have abnormal RNFLT classification. There was no difference in terms of age, gender or ethnicity between those with normal and abnormal RNFLT. Mean IOP at presentation, mean duration of POAG, and mean spherical dioptres were compared between the two groups. Only mean spherical dioptres showed a significant difference between the two groups, p < 0.001. An increase of spherical dioptres also had a moderate positive correlation with RNFLT in most optic disc quadrants except the nasal, temporal, superonasal, and inferonasal quadrants.
Conclusion: OCT cannot be used as a diagnostic tool alone, especially in early glaucoma, as it showed a normal RNFLT in almost half the patients. RNFLT in early POAG had significant correlation with spherical dioptres in most quadrants.
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Manivannan, Sowmiya Saras, Radha Annamalai, and Muthayya Muthukumar. "Profile of Clinical Features and Visual Loss in Diabetic Retinopathy Associated with Anaemia in Patients of Chennai City, India." Journal of Evolution of Medical and Dental Sciences 10, no. 45 (December 28, 2021): 3884–88. http://dx.doi.org/10.14260/jemds/2021/785.
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BACKGROUND Diabetic retinopathy is one of the commonest causes of preventable blindness. Anaemia develops earlier in diabetes patients and can hasten the development and progression of both microvascular and macrovascular complications of diabetes mellitus. The objective of the study was to identify and estimate the prevalence of anaemia in patients with diabetic retinopathy and its correlation with the progression of retinopathy, development of complications and the prognosis of vision. METHODS This was a retrospective study on 250 patients conducted over a period of 3 years. Comprehensive physical examination, ophthalmic evaluation using slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography, ancillary fundus fluorescein angiography and optical coherence tomography (OCT) were performed. Blood investigations consisted of fasting blood sugar, glycosylated HbA1C, lipid profile and haemoglobin levels were estimated. RESULTS The prevalence of anaemia in patients with DM was 69 %. The prevalence of anaemia was higher in women and the age group most commonly affected was 45 to 55 years. Diabetic retinopathy was more common in men, but the severity of retinopathy was more in women. A significant association was seen between the duration of diabetes (longer than 5 years), the severity of anaemia, control of hypertension and hyperlipidaemia. The type of retinopathy most commonly associated with anaemia was moderate non-proliferative diabetic retinopathy with clinically significant macular oedema. Visual loss occurred in 16 patients. CONCLUSIONS Identification and treatment of anaemia can prevent the progression of retinopathy. Our study suggests that the evaluation and treatment of anaemia should be a part of initial and follow-up visits in all diabetic patients with ophthalmic features as there is a definite association between visual loss and anaemia in diabetes mellitus. KEY WORDS Anaemia, Diabetic Retinopathy, Maculopathy, Macular Oedema, Haemoglobin
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Athikarisamy, Sam Ebenezer, Geoffrey Christopher Lam, Stuart Ross, Shripada Cuddapah Rao, Debbie Chiffings, Karen Simmer, Max K. Bulsara, and Sanjay Patole. "Comparison of wide field imaging by nurses with indirect ophthalmoscopy by ophthalmologists for retinopathy of prematurity: a diagnostic accuracy study." BMJ Open 10, no. 8 (August 2020): e036483. http://dx.doi.org/10.1136/bmjopen-2019-036483.
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ObjectivesRetinopathy of prematurity (ROP) is a vasoproliferative disease of the preterm retina with the potential to cause irreversible blindness. Timely screening and treatment of ROP are critical. Neonatal nurses trained in wide field digital retinal photography (WFDRP) for screening may provide a safe and effective strategy to reduce the burden of ophthalmologists in performing binocular indirect ophthalmoscopy (BIO). The objective of the study was to determine the diagnostic accuracy of WFDRP in the diagnosis of referral warranting ROP (RWROP).DesignProspective diagnostic accuracy study.SettingA tertiary neonatal intensive care unit in Perth, Western Australia.ParticipantsPreterm infants who fulfilled the Australian ROP screening criteria (gestational age (GA) <31 weeks, birth weight (BW) <1250 g).InterventionSets of 5–6 images per eye (index test) were obtained within 24–48 hours prior to or after the BIO (reference standard), and uploaded onto a secured server. A wide field digital camera (RetCam, Natus, Pleasanton, California, USA) was used for imaging. A paediatric ophthalmologist performed the BIO. The ophthalmologists performing BIO versus reporting the images were masked to each other’s findings.Primary outcomeThe area under the receiver operating characteristic (ROC) curve was used as a measure of accuracy of WFDRP to diagnose RWROP.ResultsA total of 85 infants (mean BW; 973.43 g, mean GA; 29 weeks) underwent a median of two sessions of WFDRP. There were 188 episodes of screening with an average of five images per eye. WFDRP identified RWROP in 7.4% (14/188 sessions) of examinations. In one infant, BIO showed bilateral plus disease and WFDRP did not pick up the plus disease. WFDRP image interpretation had a sensitivity of 80%, specificity of 94.5% for the detection of RWROP. The ‘area under the ROC curve’ was 88% when adjusted for covariates.ConclusionsWFDRP by neonatal nurses was feasible and effective for diagnosing RWROP in our set up.Trial registration numberACTRN12616001386426.
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Appukumran, Rohan, Kripanidhi Shyamsundar, Mohini Agrawal, Rolli Khurana, Anju Pannu, and Praveen Kumar. "Eight years’ experience in mobile teleophthalmology for diabetic retinopathy screening." Medical hypothesis discovery and innovation in ophthalmology 11, no. 4 (February 3, 2023): 162–70. http://dx.doi.org/10.51329/mehdiophthal1460.
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Background: Screening for diabetic retinopathy in the community without compromising the routine workof ophthalmologists at hospitals is the essence of teleophthalmology. This study was aimed at investigating theefficacy of teleophthalmology practice for screening diabetic retinopathy from 2012 to 2020. It was also aimed at comparing the 2-year prevalence of camps organized by a district hospital in South India, as well as the footfall, reporting, follow-up, patient response, and diagnostic efficacy at these camps.
Methods: All patients with diabetes and unexplained vision deterioration attending the mobile camp unitsunderwent non-dilated fundus photography. Patients underwent teleconsultation with the ophthalmologist atthe district hospital, and those requiring intervention were called to the district hospital. Trends were studiedfor the number of patients reporting to the hospital. Patient satisfaction was recorded based on a questionnaire.
Results: A total of 682 camps were held over 8 years, and 30 230 patients were examined. Teleconsultationwas done for 12 157 (40.21%) patients. Patients requiring further investigations, intervention for diabeticretinopathy, or further management of other ocular pathologies were urgently referred to the district hospital(n= 3293 [10.89%] of 30 230 examined patients). The severity and presence of clinically significant macularedema increased significantly with an increased duration of diabetes mellitus (P < 0.001). The percentage ofteleconsultations showed an increasing trend over the years (P = 0.001). Similarly, considering trends of patientsreporting to the hospital, the attrition rate decreased over the years (P < 0.05). A total of 10 974 of 12 157(90.27%) patients who underwent teleophthalmic consultation were satisfied with the service.
Conclusions: Teleconsultations over the years showed an increasing trend, and the attrition rate decreased overthe years. Teleophthalmology is achieving success in providing high-quality service, easy access to care, and inincreasing patient satisfaction. Future studies on the role of teleophthalmology for other leading preventablecauses of blindness seem possible and necessary.
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Kim, Kwang Baek, and Doo Heon Song. "Intelligent Automatic Extraction of Canine Cataract Object with Dynamic Controlled Fuzzy C-Means based Quantization." International Journal of Electrical and Computer Engineering (IJECE) 8, no. 2 (April 1, 2018): 666. http://dx.doi.org/10.11591/ijece.v8i2.pp666-672.
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Canine cataract is developed with aging and can cause the blindness or surgical treatment if not treated timely. Since the pet owner do not have professional knowledge nor professional equipment, there is a growing need of providing pre-diagnosis software that can extract cataract-suspicious regions from simple photographs taken by cellular phones for the sake of preventive public health. In this paper, we propose a software that is highly successful for that purpose. The proposed software uses dynamic control of FCM clusters in quantification and trapezoid membership function in fuzzy stretching in order to enhance the intensity contrast from such rough photograph input. Through experiment, the proposed system demonstrates sufficiently enough accuracy in extraction (successful in 42 out of 45 cases) with better quality comparing with previous attempt.
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Davies, Temre N., and Donald D. Hoffman. "Attention to Faces: A Change-Blindness Study." Perception 31, no. 9 (September 2002): 1123–46. http://dx.doi.org/10.1068/p3391.
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What strategies does human vision use to attend to faces and their features? How are such strategies altered by 2-D inversion or photographic negation? We report two experiments in which these questions were studied with the flicker task of the change-blindness literature. In experiment 1 we studied detection of configural changes to the eyes or mouth, and found that upright faces receive more efficient attention than inverted faces, and that faces shown with normal contrast receive more efficient attention than faces shown in photographic negative. Moreover, eyes receive greater attention than the mouth. In experiment 2 we studied detection of local changes to the eyes or mouth, and found the same results. It is well known that inversion and negation impair the perception and recognition of faces. The experiments presented here extend previous findings by showing that inversion and negation also impair attention to faces.
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Chatziralli, Irini, and Anat Loewenstein. "Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature." Pharmaceutics 13, no. 8 (July 26, 2021): 1137. http://dx.doi.org/10.3390/pharmaceutics13081137.
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Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. The purpose of this review is to gather the existing literature regarding the use of the approved anti-vascular endothelial growth (anti-VEGF) agents in the treatment of DR. Methods: A comprehensive literature review in PubMed engine search was performed for articles written in English language up to 1 July 2021, using the keywords “diabetic retinopathy”, “ranibizumab”, “aflibercept”, and “anti-VEGF”. Emphasis was given on pivotal trials and recent robust studies. Results: Intravitreal anti-VEGF agents have been found to significantly improve visual acuity and reduce retinal thickness in patients with diabetic macular edema (DME) in a long-term follow-up ranging from 1 to 5 years and are considered the standard-of-care in such patients. Regarding DR, intravitreal anti-VEGF agents provided ≥2-step improvement in DR severity on color fundus photography in about 30–35% of patients with NPDR at baseline, in the majority of clinical trials originally designed to evaluate the efficacy of intravitreal anti-VEGF agents in patients with DME. Protocol S and CLARITY study have firstly reported that intravitreal anti-VEGF agents are non-inferior to panretinal photocoagulation (PRP) in patients with proliferative DR (PDR). However, the use of new imaging modalities, such as optical coherence tomography-angiography and wide-field fluorescein angiography, reveals conflicting results about the impact of anti-VEGF agents on the regression of retinal non-perfusion in patients with DR. Furthermore, one should consider the high “loss to follow-up” rate and its devastating consequences especially in patients with PDR, when deciding to treat the latter with intravitreal anti-VEGF agents alone compared to PRP. In patients with PDR, combination of treatment of intravitreal anti-VEGF agents and PRP has been also supported. Moreover, in the specific case of vitreous hemorrhage or tractional retinal detachment as complications of PDR, intravitreal anti-VEGF agents have been found to be beneficial as an adjunct to pars plana vitrectomy (PPV), most commonly given 3–7 days before PPV, offering reduction in the recurrence of vitreous hemorrhage. Conclusions: There is no general consensus regarding the use of intravitreal anti-VEGF agents in patients with DR. Although anti-VEGF agents are the gold standard in the treatment of DME and seem to improve DR severity, challenges in their use exist and should be taken into account in the decision of treatment, based on an individualized approach.
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Bacellar-Galdino, Marianna, Fabiano Montiani-Ferreira, Andre Tavares Somma, Ricardo Guilherme D'Otaviano de Castro Vilani, and Ivan Roque de Barros Filho. "Ophthalmic findings in sheep treated with closantel in Curitiba, Brazil." May-2020 13, no. 5 (2020): 860–64. http://dx.doi.org/10.14202/vetworld.2020.860-864.
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Background and Aim: Closantel is a widely used anti-parasitic drug that is known to cause ophthalmic problems that lead to blindness. The aim of this study was to investigate the possible electroretinographic changes in sheep that received closantel. Materials and Methods: Twenty-four 30-day-old Suffolk sheep were split into control group (12 animals) and closantel group (12 animals). The latter group received 15 mg/kg of closantel subcutaneously immediately after the first electroretinography (ERG). The ISCEV protocol was used to perform the ERGs pre-dose (0), 7, and 30 days after treatment. Statistical analyses to compare ERG responses using t-test and analysis of variance were performed (p<0.05). Three months later, the animals were euthanized and the eyes and a part of optic nerve were collected for histopathology. Photography of the retina and optic nerve was taken, and measures of the retinal layers were made and analyzed by paired t-test. Results: Closantel group showed a significant increase of the mean scotopic a-wave amplitude from 0 to 7 days after closantel administration, using a stimulus of 10,000 mcd.s/m2 and a decrease of the mean scotopic and photopic a-wave amplitude (from 7 to 30 days) using the same flash intensity, as well as a decrease in mean photopic b-wave amplitude (from 7 to 30 days) within the group. Control group showed a significant increase of the mean scotopic b-wave implicit time from pre to 30 days after treatment and an increase of the mean scotopic a-wave implicit time from pre to 7 days after treatment, with the stimulus of 10,000 mcd.s/m2. This group also showed a decrease in mean photopic b-wave implicit time (from pre to 30 days after treatment), using a stimulus of 10,000 mcd.s/m2 and a decrease in mean photopic a-wave implicit time from pre to 30 days after treatment, using a stimulus of 3000 mcd.s/m2. The no difference was found in images neither in the measurements of the retina layers. Conclusion: As observed by ERG responses and the histopathology, a dose of 15 mg/kg of closantel does not significantly affect retinal and optic nerve structures in sheep but the electroretinographic results, however, showed alterations on the phototransduction.
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Scanlon, P. H. "Article Commentary: The English national screening programme for sight-threatening diabetic retinopathy." Journal of Medical Screening 15, no. 1 (March 2008): 1–4. http://dx.doi.org/10.1258/jms.2008.008015.
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Objectives The main objective of the national screening programme is to reduce the risk of sight loss among people with diabetes due to diabetic retinopathy (DR). Methods Offering two-field mydriatic digital photographic screening to all people with diabetes in England over the age of 12 years. Stage of development The programme is in its infancy, receiving the first year's annual reports from approximately 96 screening programmes, each of which have developed to offer screening to a minimum number of 12,000 people with diabetes, which would cover a population of 350,000 people with 3.4% diabetes prevalence. The national programme has commenced the External quality assurance (QA) programme in order to achieve and sustain the highest possible standards. Potential benefits England has a population of two million people with diabetes over the age of 12 and it is believed that there is a prevalence of blindness of 4200 and an annual incidence of blindness of 1280 people with diabetes. This programme has the potential to reduce the prevalence of blindness in England from 4200 people to 1000 people and a conservative estimate of reducing the annual incidence of DR blindness by one-third would save 427 people per annum from blindness. These figures are based on the UK certification of blindness but if World Health Organization (WHO) definitions are used the prevalence, incidence and potential reductions in blindness are much greater.
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Lorenz, Birgit, Joana Tavares, L. Ingeborgh van den Born, João P. Marques, and Hendrik P. N. Scholl. "Current Management of Inherited Retinal Degeneration Patients in Europe: Results of a Multinational Survey by the European Vision Institute Clinical Research Network." Ophthalmic Research 64, no. 4 (2021): 622–38. http://dx.doi.org/10.1159/000514540.
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<b><i>Purpose:</i></b> An increasing number of gene therapies are developed for Inherited Retinal Degenerations (IRD). To date, 1 treatment has been approved for clinical use (FDA USA 2017, EMA Europe 2018, MoHAP UAE 2019, SFDA Saudi Arabia 2019, Swiss Medic Switzerland 2020, TGA Australia 2020, and BFR Brazil 2020). While such therapies do not provide complete cure, they may halt degeneration or partially restore function. Identification of well-characterized patients is an emerging need. We conducted the first multinational survey to understand the management of IRDs in Europe. <b><i>Methods:</i></b> An electronic survey questionnaire containing 112 questions was developed and sent to the 101 EVICR.net clinical centers (14 European countries and Israel). <b><i>Results:</i></b> The overall response rate was 49%. Only 14% of responding centers do not see IRD patients; 52% that manage IRD patients follow <i>≥</i>200 patients, 16% > 1,000. Databases exist in 86% of the centers; of these, 75% are local files, 28% local Web-based database, and 19% national Web-based. IRD patients are referred to EVICR.net centers mainly by general ophthalmologists, patient self-referrals, and medical retina specialists. Most IRD patients are first seen in adulthood. Most prominent signs and symptoms depend on the age of onset, for example, nystagmus in infancy, or night blindness, and reduced visual acuity at older age. The time from inquiring for first appointment and clinical diagnosis varies among countries: in 29% of centers, the mean time is <4 weeks, although can be up to 35 months in others. The time to genetic diagnosis is ≥4 weeks, the maximum 10 years, likely depending on access to genetic testing, and the improvement of the tests available. Comprehensive eye examination always includes autofluorescence imaging and perimetry (86% static, 76% kinetic, and 21% microperimetry), and frequently optical coherence tomography (OCT) (95%), electroretinography (93%), and fundus photography (93%). Identified genotypes were reported in 40–80% patients by 69% of centers, and in 80–100% by 5%. Genetic testing is provided by public health insurance in 77% of centers, private health insurance in 38%, center budget in 13%, research funds in 18%; and 15% of centers do not have access to genetic testing. <b><i>Conclusion:</i></b> At the start of this era of ocular gene therapy for IRD patients, this first international survey on management of IRDs in Europe highlights significant heterogeneity between centers and across countries and provides important baseline data for researchers, clinicians, pharmaceutical companies, and investors.
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Neha, Nargis, Channabasappa Seema, Balakrishna Nischala, and Niharika Singri. "A study to correlate the central corneal thickness to the severity of diabetic retinopathy and HbA1c levels in type 2 diabetes mellitus." International Journal of Clinical and Experimental Ophthalmology 5, no. 2 (December 14, 2021): 029–38. http://dx.doi.org/10.29328/journal.ijceo.1001041.
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Background: Diabetic retinopathy (DR) is one of the most common causes of preventable blindness. Patients with Diabetes Mellitus (DM) develop not only DR but also corneal endothelial damage leading to anatomical and physiological changes in cornea. Central corneal thickness (CCT) is a key parameter of refractive surgery and Intraocular pressure (IOP) estimation. The role of CCT and higher glycemic index in DR needs to be researched upon. Objectives: To identify the corneal endothelial morphology in patients with type 2 DM, to measure the Central Corneal thickness (CCT) in patients with type 2 Diabetes Mellitus, to assess the relationship of CCT with HbA1C levels in the study group and to correlate the CCT with the severity of Diabetic retinopathy in the study group. Methods: A cross-sectional observational study was conducted between January 2018 and June 2019 in Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The study included 100 subjects with type 2 DM for 5 years or more. Patients with comorbidities that may affect the severity of DR or alter CCT and other corneal endothelial parameters such as glaucoma, previous ocular surgery or trauma, corneal degenerations and dystrophies, chronic kidney disease and Hypertension were excluded. DR was assessed by dilated fundoscopy, fundus photography and optical coherence imaging of the macula and graded as per the Early Treatment of Diabetic Retinopathy Study (ETDRS) classification. CCT and other corneal endothelial parameters were measured through specular microscopy. Relevant blood investigations including blood sugar levels were done for all patients. Statistical analysis: Relationship between CCT and grades of DR and HbA1c levels were established using the Chi-Square test. The level of significance was set at p < 0.05. Results: The mean CCT in patients with no diabetic retinopathy, very mild and mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe and very severe NPDR and PDR was 526.62 ± 8.084 μm, 542.07 ± 8.713 μm, 562.16 ± 8.255 μm, 582.79 ± 7.368 μm and 610.43 ± 18.256 μm respectively. Analysis of the relationship between CCT and severity of DR showed a statistically significant positive correlation between the two parameters (Pearson r = 0.933, P=0.001). Beyond this, a correlation was found between all the corneal endothelial parameters and severity of DR. Multivariate analysis showed that advanced DR was positively correlated with CV (r = 0.917) and CCT (r = 0.933); while it was negatively correlated with ECD (r = -0.872) and Hex (r = -0.811). A statistically significant correlation was also found between CCT and HbA1c. Also increasing age, duration of DM and higher glycemic index were positively correlated with severity of DR. Conclusion: This study, by demonstrating a strong correlation between the central corneal thickness to the severity of DR and HbA1c levels emphasizes the importance of evaluation of corneal endothelial morphology in the early screening and diagnosis of microvascular complications of DM.
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Ren, Yan-xin, Jing-xue Ma, Feng Zhao, Jian-bin An, Yu-xin Geng, and Li-ya Liu. "Effects of Curcumin on Epidermal Growth Factor in Proliferative Vitreoretinopathy." Cellular Physiology and Biochemistry 47, no. 5 (2018): 2136–46. http://dx.doi.org/10.1159/000491525.
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Background/Aims: Proliferative vitreoretinopathy (PVR) is a common refractory eye disease that causes blindness and occurs after retinal detachment or retinal reattachment. Epidermal growth factor (EGF) has been shown to play an important role in the migration and proliferation of retinal pigment epithelium (RPE) cells, which promote PVR. Curcumin inhibits RPE cell proliferation, but it is not known whether it participates in the formation of PVR. Curcumin regulates the biological functions of EGF, which plays important roles in the development of PVR. This study aimed to evaluate the effect of curcumin on the regulation of EGF in PVR. Methods: Rabbit RPE cells were cultured, and EGF expression was detected by immunocytochemistry. MTT assay was conducted to determine cell proliferation induced by different concentrations of EGF. Immunocytochemical staining was used to detect EGF expression after treatment with curcumin at varying concentrations. Real-time PCR (RT-PCR) and western blot analysis were used to detect the concentrations of EGF mRNA and protein after treatment with curcumin. After RPE cells and curcumin were injected into experimental rabbit eyes, the cornea, aqueous humor, lens, and vitreous opacity were observed and recorded simultaneously by indirect ophthalmoscopy, fundus color photography, and B-ultrasonography. The vitreous body was extracted, and the EGF content in the vitreous humor was measured by enzyme-linked immunosorbent assay (ELISA). Results: At each time point (24, 48, and 72 h), cell proliferation gradually increased with increasing EGF concentrations (0, 3, 6, and 9 ng/mL) in a dose-dependent manner. Cell proliferation between EGF concentrations of 9 and 12 ng/mL were no different, which suggested that 9 ng/mL EGF was the best concentration to use to stimulate RPE cell proliferation in vitro. Under all EGF concentrations (0, 3, 6, 9, and 12 ng/mL), RPE cell proliferation increased with time (from 24 to 72 h), suggesting a time–effect relationship. Curcumin downregulated EGF expression in RPE cells, which also indicated time–effect and dose–effect relationships. The best curcumin concentration for the inhibition of EGF expression was 15 µg/mL. RT-PCR and western blot analyses indicated that the EGF mRNA and expression of the protein in RPE cells treated with curcumin significantly decreased with time. Ocular examinations revealed that the vitreous opacity was lower and the proliferative membrane was thinner in the curcumin group compared with the control group. The PVR grade and the incidence of retinal detachment were significantly lower in the experimental group than in the control group. ELISA results showed that the EGF content in vitreous humor was higher in the control group than in the curcumin group. The curcumin and control groups were significantly different at each time point. Conclusion: Curcumin inhibited RPE cell proliferation by downregulating EGF and thus effectively inhibited the initiation and development of PVR.