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Youssif AA, Onyekaba NA, Naithani R, Abdelazeem K, Fathalla AM, Abdel-Rhaman MS, Jammal AA, Medeiros FA. Social history and glaucoma progression: the effect of body mass index, tobacco and alcohol consumption on the rates of structural change in patients with glaucoma. Br J Ophthalmol 2024:bjo-2023-323186. [PMID: 38621956 DOI: 10.1136/bjo-2023-323186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND/AIMS Although obesity, tobacco and alcohol consumption were linked to the progression of numerous chronic diseases, an association of these social history aspects with glaucoma progression is not yet determined. This study aims to investigate the effect of body mass index (BMI) and history of tobacco and alcohol use on the rates of retinal nerve fibre layer (RNFL) change over time in glaucoma patients. METHODS 2839 eyes of 1584 patients with glaucoma from the Duke Ophthalmic Registry were included. Patients had at least two spectral-domain optical coherency tomography (SD-OCT) tests over a minimum 6-month follow-up. Self-reported history of alcohol and tobacco consumption was extracted from electronic health records and mean BMI was calculated. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on RNFL change over time. RESULTS Mean follow-up time was 4.7±2.1 years, with 5.1±2.2 SD-OCT tests per eye. 43% and 54% of eyes had tobacco or alcohol consumption history, respectively, and 34% were classified as obese. Higher BMI had a protective effect on glaucoma progression (0.014 µm/year slower per each 1 kg/m2 higher; p=0.011). Tobacco and alcohol consumption were not significantly associated with RNFL change rates (p=0.473 and p=0.471, respectively). Underweight subjects presented significantly faster rates of structural loss (-0.768 µm/year; p=0.002) compared with normal weight. CONCLUSIONS In a large clinical population with glaucoma, habits of tobacco and alcohol consumption showed no significant effect on the rates of RNFL change. Higher BMI was significantly associated with slower rates of RNFL loss.
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Affiliation(s)
- Asmaa A Youssif
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | | | - Rizul Naithani
- Duke Eye Center, Duke University, Durham, North Carolina, USA
| | | | - Ahmed M Fathalla
- Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | | | - Alessandro A Jammal
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA
| | - Felipe A Medeiros
- Duke Eye Center, Duke University, Durham, North Carolina, USA
- Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA
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Mostafa MM, Abdelmotaal H, Abdelazeem K, Goda I, Abdel-Radi M. Q-value customized versus wavefront-optimized ablation in femtosecond laser-assisted LASIK for myopia and myopic astigmatism: a prospective contralateral comparative study. Eye Vis (Lond) 2022; 9:43. [PMID: 36320050 PMCID: PMC9628024 DOI: 10.1186/s40662-022-00312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
Background Corneal refractive surgery for myopia results in an oblate shift with increased postoperative aberrations inversely affecting the quality of vision. Aspheric ablation profiles have been introduced to minimize such a problem. The aim of this study was to compare changes in corneal asphericity, central and mid-peripheral pachymetry between the Q-value customized and the wavefront-optimized (WFO) ablation profiles.
Methods A prospective, comparative non-randomized fellow eye study was conducted. Eighty eyes of 40 eligible patients underwent femtosecond laser-assisted laser in situ keratomileusis for myopia and myopic astigmatism. In each patient, the more myopic eye was included in the custom-Q ablation experimental group and the other less myopic eye was included in the WFO control group. For the custom-Q group, the target asphericity was set to the preoperative Q-value. Corneal asphericity, central and mid-peripheral pachymetric changes and the root mean square of corneal higher-order aberrations (RMSh) were assessed 6 months following surgery. Visual and refractive outcomes were also evaluated in both platforms 6 months postoperatively. Results The mean preoperative refractive spherical equivalent was significantly more myopic in the custom-Q group than in the WFO group (P = 0.001). The mean Q-value changed from − 0.2 ± 0.1 to 0.6 ± 0.7 and from − 0.2 ± 0.1 to 0.4 ± 0.5 in the custom-Q and WFO groups, respectively. The oblate shift in corneal asphericity was not significantly different between both treatment groups (P = 0.094). The mean ablation depth at the pupillary center was significantly greater in the custom-Q group (P = 0.011), while there was no significant difference at the mid-peripheral pachymetry (P = 0.256). The RMSh significantly increased in both treatment profiles (P < 0.001) with no significant difference between the two groups (P = 0.06). The uncorrected distance visual acuity (UDVA) and the manifest refraction spherical equivalents (MRSE) significantly improved in both treatment groups (P < 0.001). Conclusions The custom-Q treatment profile with target asphericity set at the preoperative Q-value achieved comparable outcomes vs. the WFO profile in terms of postoperative corneal asphericity and mid-peripheral pachymetry despite the greater amount of ablation, the smaller optical zone, and the resulting increase in postoperative corneal flattening in the custom-Q group. Trial registration (Clinicaltrials.gov): NCT04738903, 4 February 2021- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04738903
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Affiliation(s)
- Magdi Mohammad Mostafa
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Hazem Abdelmotaal
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Islam Goda
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Mahmoud Abdel-Radi
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt.
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Abdelazeem K, Abdelmoneim H, Nouby G, Abdelmoneim M, Fathalla A. Risk factors for ectasia after laser in situ keratomileusis in an Egyptian population sample. Delta J Ophthalmol 2022. [DOI: 10.4103/djo.djo_70_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Fathalla A, Said M, Wasfi E, Abdelazeem K, Soliman K, Masood I. Primary trabeculectomy with mitomycin C in the treatment of medically uncontrolled inflammatory glaucoma and primary open-angle glaucoma: a comparative study. Delta J Ophthalmol 2022. [DOI: 10.4103/djo.djo_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Abdelazeem K, Al-Hussaini AK, El-Sebaity DM, Kedwany SM. Epidemiology, Etiologies, and Complications of Playtime Open Globe Injuries in Children. J Pediatr Ophthalmol Strabismus 2021; 58:385-389. [PMID: 34851791 DOI: 10.3928/01913913-20210426-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the epidemiology, etiologies, and complications of playtime open globe injuries in children at the Assiut University Hospital, Egypt. METHODS This prospective cross-sectional study enrolled children with open globe injury who were admitted to Assiut University Hospital during a 6-month period (January to July 2016). All causes of trauma that occurred during playtime (at home, outside home, at the club, or at school) were recorded and analyzed. RESULTS Eighty-one children (age = 18 years and younger; mean ± standard deviation age = 8.35 ± 4.84 years) were admitted with open globe injury, and 32 of them (39.51%) sustained ocular trauma during playtime. The majority of children were boys (n = 23, 71.88%). The causes of trauma during playtime were: playing with sharp objects (n = 11; 34.38%), playing with a wooden stick (n = 7; 21.88%), falling on the ground (n = 5; 15.63%), trauma by a stone (n = 2; 6.25%), trauma during running (n = 1; 3.13%), playing with a plastic toy (n = 1; 3.13%), and unknown causes (n = 5; 15.63%). The sites of globe perforation were corneal (n = 23; 71.88%), corneoscleral (n = 8; 25%), and scleral (n = 1; 3.13%). CONCLUSIONS Playtime trauma that causes open globe injury and visual disability is avoidable and constituted approximately half of the open globe injuries in this study population. Corneal involvement occurred in almost all open globe injuries. Parental supervision for children during playtime is crucial to injury prevention. Children should avoid playing with sharp, dangerous objects and desist from playing or running on unsafe ground. [J Pediatr Ophthalmol Strabismus. 2021;58(6):385-389.].
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Tohamy D, Sharaf M, Abdelazeem K, Saleh MGA, Rateb MF, Soliman W, Kedwany SM, Omar Abdelmalek M, Medhat MA, Tohamy AM, Mahmoud H. Ocular Manifestations of Post-Acute COVID-19 Syndrome, Upper Egypt Early Report. J Multidiscip Healthc 2021; 14:1935-1944. [PMID: 34326644 PMCID: PMC8315779 DOI: 10.2147/jmdh.s323582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/08/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the ocular manifestations of post-acute COVID-19 syndrome. Methods A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done. Results Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006). Conclusion Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.
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Affiliation(s)
- Dalia Tohamy
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | - Mohamed Sharaf
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | | | | | | | - Wael Soliman
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | | | | | - Mohammed A Medhat
- Tropical Medicine and Gastroenterology Department, Assiut University, Assiut, Egypt
| | - Amal M Tohamy
- Neuology Department, Assiut University, Assiut, Egypt
| | - Hany Mahmoud
- Ophthalmology Department, Sohag University, Sohag, Egypt
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Abdelmotaal H, Abdou AA, Omar AF, El-Sebaity DM, Abdelazeem K. Pix2pix Conditional Generative Adversarial Networks for Scheimpflug Camera Color-Coded Corneal Tomography Image Generation. Transl Vis Sci Technol 2021; 10:21. [PMID: 34132759 PMCID: PMC8242686 DOI: 10.1167/tvst.10.7.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose To assess the ability of pix2pix conditional generative adversarial network (pix2pix cGAN) to create plausible synthesized Scheimpflug camera color-coded corneal tomography images based upon a modest-sized original dataset to be used for image augmentation during training a deep convolutional neural network (DCNN) for classification of keratoconus and normal corneal images. Methods Original images of 1778 eyes of 923 nonconsecutive patients with or without keratoconus were retrospectively analyzed. Images were labeled and preprocessed for use in training the proposed pix2pix cGAN. The best quality synthesized images were selected based on the Fréchet inception distance score, and their quality was studied by calculating the mean square error, structural similarity index, and the peak signal-to-noise ratio. We used original, traditionally augmented original and synthesized images to train a DCNN for image classification and compared classification performance metrics. Results The pix2pix cGAN synthesized images showed plausible subjectively and objectively assessed quality. Training the DCNN with a combination of real and synthesized images allowed better classification performance compared with training using original images only or with traditional augmentation. Conclusions Using the pix2pix cGAN to synthesize corneal tomography images can overcome issues related to small datasets and class imbalance when training computer-aided diagnostic models. Translational Relevance Pix2pix cGAN can provide an unlimited supply of plausible synthetic Scheimpflug camera color-coded corneal tomography images at levels useful for experimental and clinical applications.
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Affiliation(s)
- Hazem Abdelmotaal
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed A Abdou
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed F Omar
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Khaled Abdelazeem
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Abdelmotaal H, Abdel‐Radi M, Rateb MF, Eldaly ZH, Abdelazeem K. Comparison of the phaco chop and drill-and-crack techniques for phacoemulsification of hard cataracts: A fellow eye study. Acta Ophthalmol 2021; 99:e378-e386. [PMID: 32914563 DOI: 10.1111/aos.14582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/06/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To quantify the intraoperative parameters and postoperative outcomes after using the phaco chop technique in one eye and drill-and-crack technique in the other eye in patients with bilateral dense brunescent cataract. METHODS The Lens Opacities Classification System III grading system was used to select 132 eyes of 66 patients with bilateral nuclear opalescence (NO) grade NO4 or grade NO5. One eye in each patient with bilateral dense brunescent cataract was subjected to phacoemulsification using the phaco chop technique, while the other eye was subjected to phacoemulsification with the drill-and-crack technique for nucleus disassembly. The intraoperative parameters were quantified. Surgical outcome was assessed preoperatively and 1 day, 4 weeks and 12 weeks postoperatively, and the outcomes of the two techniques were compared. RESULTS There was no significant difference between the techniques in operative parameters [cumulative dissipated energy (p = 0.74), surgical time (p = 0.68) or surgical difficulty during nucleus disassembly (p = 0.80)]. There was no significant difference in the postoperative change in central corneal thickness between the techniques at day 1, 4 weeks and 12 weeks or in corneal endothelial cell density loss at 4 and 12 weeks (p > 0.05). There was no significant difference between the techniques in the mean corrected distance visual acuity (logarithm of the minimum angle resolution) at 4 weeks postoperatively (p = 0.25). CONCLUSION The phaco chop and drill-and-crack techniques are equally effective for disassembly of hard NO4 and NO5 cataracts.
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Affiliation(s)
- Hazem Abdelmotaal
- Department of Ophthalmology Faculty of medicine Assiut University Assiut Egypt
| | - Mahmoud Abdel‐Radi
- Department of Ophthalmology Faculty of medicine Assiut University Assiut Egypt
| | - Mahmoud F. Rateb
- Department of Ophthalmology Faculty of medicine Assiut University Assiut Egypt
| | - Zeiad H. Eldaly
- Department of Ophthalmology Faculty of medicine Assiut University Assiut Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology Faculty of medicine Assiut University Assiut Egypt
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Hetta HF, Mohamed AAA, Zahran AM, A Mahran S, MY Sayed M, GA Saleh M, Abdelazeem K, Batiha GES, Al-Rejaie S, Waheed Y, Muhammad K, M Hassanien M. Possible Role of Regulatory B Cells in Different Behçet's Disease Phenotypes and Therapies: First Report from Egypt. J Inflamm Res 2021; 14:737-744. [PMID: 33727848 PMCID: PMC7955029 DOI: 10.2147/jir.s279912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/28/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIM The data about the role of regulatory B cells (Breg) in Behcet Disease (BD) are scarce. We aimed to evaluate the frequency of total B lymphocytes and Breg cells in different BD phenotypes and therapies attempting to unravel their function. METHODS This cross-sectional study included 35 BD patients and 39 healthy controls (HCs). The demographic data of the study subjects were collected including age and gender. Current medications including disease-modifying anti-rheumatic drugs (DMARDs) were recorded. All patients underwent testing for baseline laboratory investigations including full blood count, liver and kidney function tests, erythrocyte sedimentation rate (ESR) by Westergren blot and C-reactive protein (CRP). Measurement of the total B lymphocytes and their subtypes B regulatory lymphocytes by flow cytometric assay. Assessment of BD activity was done using the revised Behçet's Disease Current Activity Form (BDCAF) 2006 and Behçet's Syndrome Activity Score (BSAS) 1111111111. All participants were assessed for the presence of erectile dysfunction using the International Index of Erectile Function (IIEF-5 score), and for depression using the Beck Depression Inventory. RESULTS A dramatic drop in the number of B cells, total and regulatory, was observed in the patients compared to the HCs. Regulatory cells (Bregs) tend to be upregulated with genital ulcers or vascular disease. Bregs but not B lymphocytes were associated with BSAS and ESR. Neither the total B lymphocytes nor the Bregs correlated with CRP or the sexual function or depression scores. Of all the used medications, low-dose aspirin was seen with markedly high Bregs proportions. CONCLUSION This study supports the role of B cells in BD pathogenesis and strongly suggests a possible role for Bregs in the resolution of different BD manifestations.
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Affiliation(s)
- Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Correspondence: Helal F Hetta Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt Email
| | - Alaa A A Mohamed
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Asmaa M Zahran
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Safaa A Mahran
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Marwa MY Sayed
- Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed GA Saleh
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicines, Damanhour University, Damanhur, 22511, Egypt
| | - Salim Al-Rejaie
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, 44000, Pakistan
| | - Khalid Muhammad
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, 15551, United Arab Emirates
| | - Manal M Hassanien
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
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Abdelmotaal H, Mostafa MM, Mostafa ANR, Mohamed AA, Abdelazeem K. Classification of Color-Coded Scheimpflug Camera Corneal Tomography Images Using Deep Learning. Transl Vis Sci Technol 2020; 9:30. [PMID: 33384884 PMCID: PMC7757611 DOI: 10.1167/tvst.9.13.30] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose To assess the use of deep learning for high-performance image classification of color-coded corneal maps obtained using a Scheimpflug camera. Methods We used a domain-specific convolutional neural network (CNN) to implement deep learning. CNN performance was assessed using standard metrics and detailed error analyses, including network activation maps. Results The CNN classified four map-selectable display images with average accuracies of 0.983 and 0.958 for the training and test sets, respectively. Network activation maps revealed that the model was heavily influenced by clinically relevant spatial regions. Conclusions Deep learning using color-coded Scheimpflug images achieved high diagnostic performance with regard to discriminating keratoconus, subclinical keratoconus, and normal corneal images at levels that may be useful in clinical practice when screening refractive surgery candidates. Translational Relevance Deep learning can assist human graders in keratoconus detection in Scheimpflug camera color-coded corneal tomography maps.
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Affiliation(s)
- Hazem Abdelmotaal
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Magdi M Mostafa
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ali N R Mostafa
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdelsalam A Mohamed
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Soliman W, Nassr MA, Abdelazeem K, Al-Hussaini AK. Appearance of herpes simplex keratitis on anterior segment optical coherence tomography. Int Ophthalmol 2019; 39:2923-2928. [PMID: 31309437 DOI: 10.1007/s10792-019-01142-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/06/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE To describe the anterior segment AS-OCT findings of herpetic simplex keratitis. METHODS Forty-two eyes of 42 patients with proven herpetic keratitis of varying severity were included in this prospective, observational, non-comparative case series study. All subjects underwent ophthalmologic examination and AS-OCT imaging. RESULTS Twenty-five of the 42 eyes (59.5%) had sub-epithelial infiltrates. In 11 of these cases, the overlying epithelium appeared intact, but in 14 cases, hydropic changes, heaping, and defects were observed. Seventeen eyes (40.5%) showed stromal involvement: six cases with scar at presentation and one case associated with uveitis. Stromal infiltrates were also seen, in ten cases, as a diffuse or local lentiform or spindle-shaped hyper-reflective area in the stroma. CONCLUSION Herpetic keratouveitis has characteristic features on AS-OCT images. This study demonstrates that herpetic keratitis also has characteristic AS-OCT features, including sub-epithelial infiltration and specific stromal hyper-reflective patterns. These features are not unique to herpetic keratitis, but AS-OCT imaging may provide useful supplementary information for diagnosing and monitoring herpetic keratitis.
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Affiliation(s)
- Wael Soliman
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed A Nassr
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.,North West Anglia NHS Foundation Trust, Peterborough, UK
| | - Khaled Abdelazeem
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt. .,Department of Ophthalmology, Assiut University Hospitals, Assiut, 71515, Egypt.
| | - Ashraf K Al-Hussaini
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Soliman W, Mohamed TA, Abdelazeem K, Sharaf M. Trans-scleral posterior capsulorhexis in combined lens extraction and silicone oil removal. Eur J Ophthalmol 2019; 30:224-228. [PMID: 30871372 DOI: 10.1177/1120672119836002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM The aim of this study was to study the safety and efficacy of posterior capsulorhexis in vitrectomized eyes undergoing combined phacoemulsification or irrigation/aspiration and silicone oil removal. METHODS This prospective non-randomized interventional study involved 115 silicone-filled eyes of 115 previously vitrectomized patients. All patients underwent combined phacoemulsification or underwent irrigation/aspiration and silicone oil removal, followed by foldable intraocular lens implantation combined with primary posterior trans-scleral capsulorhexis. A 23-gauge trans-scleral vitrectomy probe was used to form the posterior capsulorhexis (vitrectorhexis). Patients were followed for 6 months. RESULTS Intraocular lenses maintained good centration in the capsular bag during and after trans-scleral posterior capsulorhexis. No complications were observed in the postoperative period regarding lens centration or size of the posterior capsulorhexis. No included eyes needed YAG laser posterior capsulotomy and no recurrent retinal detachment was reported during follow-up. CONCLUSION Performing primary trans-scleral capsulorhexis in patients undergoing combined phacoemulsification, or irrigation/aspiration and silicone oil removal, enabled achievement of an early postoperative clear visual axis and prevented the onset of dense postoperative posterior capsular opacification in previously silicone-filled eyes. This technique is reproducible and may facilitate additional intra-operative procedures and uncomplicated postoperative follow-up of retinal detachment patients without requiring YAG laser capsulotomy.
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Affiliation(s)
- Wael Soliman
- Ophthalmology Department, Assiut University Hospital, Assiut, Egypt
| | - Tarek A Mohamed
- Ophthalmology Department, Assiut University Hospital, Assiut, Egypt
| | | | - Mohamed Sharaf
- Ophthalmology Department, Assiut University Hospital, Assiut, Egypt
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Abdelazeem K, Ismail M, Elsedfy H, Aly M. Effect of femtosecond-assisted intrastromal implantation of MyoRing for keratoconus on corneal asphericity. Delta J Ophthalmol 2019. [DOI: 10.4103/djo.djo_57_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Soliman W, Sharaf M, Abdelazeem K, El-Gamal D, Nafady A. Ultrastructural effects of silicone oil on the clear crystalline lens of the human eye. Eur J Ophthalmol 2018; 28:566-572. [PMID: 29566539 DOI: 10.1177/1120672118757433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.
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Affiliation(s)
- Wael Soliman
- 1 Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed Sharaf
- 1 Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Khaled Abdelazeem
- 1 Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dalia El-Gamal
- 2 Department of Histology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Allam Nafady
- 3 Department of Pathology, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt.,4 Electron Microscopy Unit, Assiut University, Assiut, Egypt
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Mahfouz H, Elrazek AMAA, Abdelazeem K, Elfattah M, Foad M, Salama K, Elbanna A, Bilasy S, Fakhry M. Noninvasive prediction of HCV-4 SVR by 2D US: a randomized study using data mining algorithm. Al-Azhar Assiut Med J 2016. [DOI: 10.4103/1687-1693.180454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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