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Mesfin Y, Kong A, Backus BT, Deiner M, Ou Y, Oatts JT. Pilot study comparing a new virtual reality-based visual field test to standard perimetry in children. J AAPOS 2024:103933. [PMID: 38729256 DOI: 10.1016/j.jaapos.2024.103933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/07/2024] [Accepted: 02/11/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE To assess the feasibility and performance of Vivid Vision Perimetry (VVP), a new virtual reality (VR)-based visual field platform. METHODS Children 7-18 years of age with visual acuity of 20/80 or better undergoing Humphrey visual field (HVF) testing were recruited to perform VVP, a VR-based test that uses suprathreshold stimuli to test 54 field locations and calculates a fraction seen score. Pearson correlation coefficients were calculated to evaluate correlation between HVF mean sensitivity and VVP mean fraction seen scores. Participants were surveyed regarding their experience. RESULTS A total of 37 eyes of 23 participants (average age, 12.9 ± 3.1 years; 48% female) were included. All participants successfully completed VVP testing. Diagnoses included glaucoma (12), glaucoma suspect (7), steroid-induced ocular hypertension (3), and craniopharyngioma (1). Sixteen participants had prior HVF experience, and none had prior VVP experience, although 7 had previously used VR. Of the 23 HVF tests performed, 9 (39%) were unreliable due to fixation losses, false positives, or false negatives. Similarly, 35% of VVP tests were unreliable (as defined by accuracy of blind spot detection). Excluding unreliable HVF tests, the correlation between HVF average mean sensitivity and VVP mean fraction seen score was 0.48 (P = 0.02; 95% CI, 0.09-0.74). When asked about preference for the VVP or HVF examination, all participants favored the VVP, and 70% were "very satisfied" with VVP. CONCLUSIONS In our cohort of 23 pediatric subjects, VVP proved to be a clinically feasible VR-based visual field testing, which was uniformly preferred over HVF.
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Affiliation(s)
- Yeabsira Mesfin
- Department of Ophthalmology, UCSF School of Medicine, San Francisco, California
| | - Alan Kong
- Department of Ophthalmology, UCSF School of Medicine, San Francisco, California
| | | | - Michael Deiner
- Department of Ophthalmology, UCSF School of Medicine, San Francisco, California
| | - Yvonne Ou
- Department of Ophthalmology, UCSF School of Medicine, San Francisco, California
| | - Julius T Oatts
- Department of Ophthalmology, UCSF School of Medicine, San Francisco, California.
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2
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Wang L, Ashraf DC, Deiner M, Idowu OO, Grob SR, Winn BJ, Vagefi MR, Kersten RC. Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition. Adv Ophthalmol Pract Res 2024; 4:39-44. [PMID: 38406664 PMCID: PMC10891280 DOI: 10.1016/j.aopr.2024.01.007] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
Objective To investigate whether functional upper eyelid malposition is associated with unrecognized deficits in automated perimetry among glaucoma patients by examining patients undergoing eyelid surgery who had not been identified as requiring eyelid taping during glaucoma field testing. Methods In this retrospective pre-post study, an automated database search followed by manual chart review was used to identify eligible patients from January 2012 to March 2020. Included patients had reliable visual field testing within two years before and after functional upper blepharoplasty or ptosis repair and no comorbid ocular diagnoses. As part of routine practice, glaucoma visual field technicians taped patients with pupil-obstructing eyelid malposition; taped examinations were excluded from analysis. Clinical and demographic characteristics, mean deviation, and pattern standard deviation were evaluated within a two year period before and after eyelid surgery. Results The final analysis included 60 eyes of 38 patients. Change in visual field parameters after eyelid surgery did not reach statistical significance in crude or adjusted analyses. Among patients with ptosis, the margin reflex distance-1 was not associated with change in mean deviation after surgery (Pearson R2 = 0.0061; P = 0.700). Five of 17 eyes excluded from analysis due to unreliable pre-operative visual fields demonstrated substantial improvement after surgery. Conclusions Functional upper eyelid malposition does not appear to cause spurious visual field abnormalities among glaucoma patients with reliable visual fields who were determined not to require eyelid taping at the time of their visual fields. Unreliable visual fields could be a sign of eyelid interference in this population.
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Affiliation(s)
- Linyan Wang
- Department of Ophthalmology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Davin C. Ashraf
- Department of Ophthalmology, University of California, San Francisco, USA
- Department of Ophthalmology, Oregon Health and Science University, Portland, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Oluwatobi O. Idowu
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Seanna R. Grob
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Bryan J. Winn
- Department of Ophthalmology, University of California, San Francisco, USA
| | - M Reza Vagefi
- Department of Ophthalmology, University of California, San Francisco, USA
- Department of Ophthalmology, Tufts Medical Center, Boston, USA
| | - Robert C. Kersten
- Department of Ophthalmology, University of California, San Francisco, USA
- Department of Ophthalmology, Tufts Medical Center, Salt Lake City, USA
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3
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Chang CC, Saifee M, Ton L, Ashraf D, Winn BJ, Kersten R, Vagefi MR, Deiner M, Grob SR. Eye Trauma in Mixed Martial Arts and Boxing. Ophthalmic Plast Reconstr Surg 2024; 40:75-87. [PMID: 37656909 PMCID: PMC10926996 DOI: 10.1097/iop.0000000000002510] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE To evaluate and compare eye and face trauma in mixed martial arts (MMA) and boxing. DESIGN Retrospective cohort study. METHODS Data from boxing and MMA competitions were extracted from the Nevada Athletic Commission (NAC) between 2000 and 2020. Details of competitions, contestants, outcomes, and injuries were extracted. RESULTS In total 1539 boxing injuries (from 4313 contests) and 1442 MMA injuries (from 2704 contests) were identified. Boxing had higher eye injury rates compared to MMA ( p < 0.0001), with an odds ratio of 1.268 (95% CI, 1.114-1.444). Eye trauma represented 47.63% of boxing injuries and 25.59% of MMA injuries, with periocular lacerations being the most common eye injury in both. Orbital fractures represented 17.62% of eye injuries in MMA and 3.14% in boxing contests. However, 2%-3% were retinal in both sports, and 3.27% were glaucomatous in boxing. MMA contestants had an odds ratio of 1.823 (95% CI, 1.408-2.359) for requiring physician evaluation following an eye injury compared with boxing. MMA contestants also had a higher rate of face ( p < 0.0001) and body ( p < 0.0001) injuries. For both sports, an increased number of rounds and being the losing fighter were associated with increased odds of eye and face injury. CONCLUSION Although boxing has a higher rate of eye injuries, MMA eye injuries are more likely to require physician evaluation. MMA contestants also have a higher rate of orbital fractures and face and body trauma. A detailed postfight examination and long-term follow-up of ocular injury in combat sports will be vital in proposing reforms to prevent eye trauma.
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Affiliation(s)
- Chih-Chiun Chang
- University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Murtaza Saifee
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Lauren Ton
- University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Davin Ashraf
- Orbit and Oculofacial Plastic Surgery, Department of Ophthalmology, Oregon Health & Sciences University, Portland, Oregon, U.S.A
| | - Bryan J Winn
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
- Orbit and Oculofacial Plastic Surgery, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A
| | - Robert Kersten
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
- Orbit and Oculofacial Plastic Surgery, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A
| | - M Reza Vagefi
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
- Orbit and Oculofacial Plastic Surgery, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
- F.I. Proctor Foundation, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Seanna R Grob
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
- Orbit and Oculofacial Plastic Surgery, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A
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4
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Prajna NV, Prajna L, Teja V, Gunasekaran R, Chen C, Ruder K, Zhong L, Yu D, Liu D, Abraham T, Ao W, Deiner M, Hinterwirth A, Seitzman G, Doan T, Lietman T. Apollo Rising: Acute Conjunctivitis Outbreak in India, 2022. Cornea Open 2023; 2:e0009. [PMID: 37719281 PMCID: PMC10501505 DOI: 10.1097/coa.0000000000000009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Purpose To identify pathogens associated with the 2022 conjunctivitis outbreak in Tamil Nadu, India. Methods This prospective study was conducted in November of 2022. Patients with presumed acute infectious conjunctivitis presenting to the Aravind Eye Clinic in Madurai, India were eligible. Anterior nares and conjunctival samples from participants were obtained and processed for metagenomic RNA deep sequencing (RNA-seq). Results Samples from 29 patients were sequenced. A pathogen was identified in 28/29 (97%) patients. Coxsackievirus A24v, a highly infectious RNA virus, was the predominant pathogen and detected in 23/29 patients. Human adenovirus D (HAdV-D), a DNA virus commonly associated with conjunctivitis outbreaks, was detected in the remaining patients (5/29). Hemorrhagic conjunctiva was documented in both HAdV-D and coxsackievirus A24v affected patients but was not the predominant clinical presentation. Phylogenetic analysis of coxsackievirus A24v revealed a recent divergence from the 2015 outbreak. Conclusions Coxsackievirus A24v and HAdV-D were co-circulating during the 2022 conjunctivitis outbreak in Tamil Nadu, India. Clinical findings were similar between patients with HAD-V and coxsackievirus A24v associated conjunctivitis. As high-throughput technologies become more readily accessible and cost-effective, unbiased pathogen surveillance may prove useful for outbreak surveillance and control.
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Affiliation(s)
| | | | | | | | - Cindi Chen
- Francis I. Proctor Foundation, San Francisco, United States
| | - Kevin Ruder
- Francis I. Proctor Foundation, San Francisco, United States
| | - Lina Zhong
- Francis I. Proctor Foundation, San Francisco, United States
| | - Danny Yu
- Francis I. Proctor Foundation, San Francisco, United States
| | - David Liu
- Francis I. Proctor Foundation, San Francisco, United States
| | - Thomas Abraham
- Francis I. Proctor Foundation, San Francisco, United States
| | - Wendy Ao
- Francis I. Proctor Foundation, San Francisco, United States
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, San Francisco, United States
| | | | - Gerami Seitzman
- Francis I. Proctor Foundation, San Francisco, United States
- Department of Ophthalmology, University of California, San Francisco, San Francisco, United States
| | - Thuy Doan
- Francis I. Proctor Foundation, San Francisco, United States
- Department of Ophthalmology, University of California, San Francisco, San Francisco, United States
| | - Thomas Lietman
- Francis I. Proctor Foundation, San Francisco, United States
- Department of Ophthalmology, University of California, San Francisco, San Francisco, United States
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Lalitha P, Prajna NV, Gunasekaran R, Teja GV, Sharma SS, Hinterwirth A, Ruder K, Zhong L, Chen C, Deiner M, Huang C, Pinsky BA, Lietman TM, Doan T, Seitzman GD. Deep sequencing analysis of clinical samples from patients with acute infectious conjunctivitis during the COVID-19 delta surge in Madurai, India. J Clin Virol 2022; 157:105318. [PMID: 36242841 PMCID: PMC9534536 DOI: 10.1016/j.jcv.2022.105318] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Received: 08/12/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Seasonal outbreaks of infectious conjunctivitis remain a public health issue. Determination of outbreak etiologies in the context of a worldwide pandemic may provide useful information to guide public health strategies. The aim of this study was to identify pathogens associated with outpatient infectious conjunctivitis during the COVID-19 Delta surge. METHODS This prospective study was conducted from April 2021 to September 2021. All outpatients presenting to the Aravind Eye Center (Madurai, India) with signs and symptoms consistent with acute infectious conjunctivitis were eligible. Three swabs were obtained from each participant: one from each conjunctiva and one from the anterior nares. Samples were processed for metagenomic RNA deep sequencing (RNA-seq). RESULTS Samples from 106 study participants were sequenced. The most common presenting symptoms were tearing (86%) and itching (71%). Preauricular lymphadenopathy was present in 38% of participants. 20% of participants had close contacts with similar symptoms. Systemic symptoms such as coughing, runny nose, vomiting or diarrhea were uncommonly reported. 60% of all participants used some medicated eye drops upon enrollment. 75% of study participants demonstrated infection with human adenovirus D (HAdV-D). 11% of conjunctivitis was associated with SARS-CoV-2. 15% had no definitive pathogen detected. 8% of all participants had codetection of more than one pathogen on RNA-seq. CONCLUSIONS During the COVID-19 Delta surge in India, HAdV-D was the most common pathogen associated with infectious conjunctivitis. SARS-CoV-2 was the second most common associated pathogen. Seasonal surveillance may be necessary for the determination of emerging and reemerging pathogens responsible for infectious conjunctivitis.
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Affiliation(s)
| | | | | | | | | | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States
| | - Kevin Ruder
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, CA, United States
| | - ChunHong Huang
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States,Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Thomas M. Lietman
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States,Department of Ophthalmology, University of California, San Francisco, CA, United States
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States,Department of Ophthalmology, University of California, San Francisco, CA, United States,Corresponding author
| | - Gerami D. Seitzman
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States,Department of Ophthalmology, University of California, San Francisco, CA, United States
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6
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Prajna NV, Lalitha P, Teja GV, Gunasekaran R, Sharma SS, Hinterwirth A, Ruder K, Zhong L, Chen C, Deiner M, Huang C, Pinsky BA, Lietman TM, Seitzman GD, Doan T. Outpatient human coronavirus associated conjunctivitis in India. J Clin Virol 2022; 157:105300. [PMID: 36209621 PMCID: PMC9512524 DOI: 10.1016/j.jcv.2022.105300] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 08/12/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Viral conjunctivitis (pink eye) can be highly contagious and is of public health importance. There remains significant debate whether SARS-CoV-2 can present as a primary conjunctivitis. The aim of this study was to identify pathogens associated with outpatient infectious conjunctivitis during the COVID-19 Delta surge. METHODS This prospective study was conducted in the spring and summer months of 2021. 106 patients with acute conjunctivitis who presented to the Aravind Eye Center in Madurai, India were included. One anterior nasal swab and one conjunctival swab of each eye were obtained for each enrolled patient. Samples were subsequently processed for unbiased metagenomic RNA deep sequencing (RNA-seq). Outcomes included clinical findings and codetection of other pathogens with SARS-CoV-2 in patients with conjunctivitis. RESULTS Among the 13 patients identified with human coronavirus RNA fragments in their swabs, 6 patients had SARS-CoV-2 infection, 5 patients had coinfections of SARS-CoV-2 and human adenovirus (HAdV), 1 patient had a coinfection with human coronavirus OC43 and HAdV, and 1 patient had a coinfection of Vittaforma corneae and SARS-CoV-2. 30% had bilateral disease and symptoms on presentation. Petechial hemorrhage was noted in 33% of patients with SARS-CoV-2 infection. No patients with SARS-CoV-2 or SARS-CoV-2 and HAdV infections had subepithelial infiltrates on presentation. All patients denied systemic symptoms. CONCLUSIONS Among the patients presented with conjunctivitis associated with human coronavirus infection, over 50% of the patients had co-infections with other circulating pathogens, suggesting the public-health importance of broad pathogen testing and surveillance in the outpatient conjunctivitis population.
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Affiliation(s)
| | | | | | | | | | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America
| | - Kevin Ruder
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, CA, United States of America
| | - ChunHong Huang
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States of America,Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Thomas M. Lietman
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America,Department of Ophthalmology, University of California, San Francisco, CA, United States of America
| | - Gerami D. Seitzman
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America,Department of Ophthalmology, University of California, San Francisco, CA, United States of America
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, United States of America,Department of Ophthalmology, University of California, San Francisco, CA, United States of America,Corresponding author at: 490 Illinois Street, Floor 2, San Francisco, CA, 94158 United States of America
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7
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Greenfield JA, Deiner M, Nguyen A, Wollstein G, Damato B, Backus BT, Wu M, Schuman JS, Ou Y. Virtual Reality Oculokinetic Perimetry Test Reproducibility and Relationship to Conventional Perimetry and OCT. Ophthalmology Science 2022; 2:100105. [PMID: 36276927 PMCID: PMC9562375 DOI: 10.1016/j.xops.2021.100105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/27/2022]
Abstract
Purpose Vivid Vision Perimetry (VVP; Vivid Vision, Inc) is a novel method for performing in-office and home-based visual field assessment using a virtual reality platform and oculokinetic perimetry. Here we examine the reproducibility of VVP Swift and compare results with conventional standard automated perimetry (SAP) and spectral-domain (SD) OCT. Design Cross-sectional study. Participants Fourteen eyes of 7 patients with open-angle glaucoma (OAG) (average age, 64.6 years; 29% women) and 10 eyes of 5 patients with suspected glaucoma (average age, 61.8 years; 40% women) were enrolled. Methods Patients with OAG and suspected glaucoma were enrolled prospectively and underwent 2 VVP Swift examinations. Results were compared with 1 conventional SAP examination (Humphrey Visual Field [HVF]; Zeiss) and 1 SD OCT examination. Main Outcome Measures Mean sensitivity (in decibels) obtained for each eye in 2 VVP Swift test sessions and a conventional SAP examination, thickness of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) for the SD OCT examination, and mean test durations of the VVP Swift and SAP examinations. Results The mean test duration of VVP Swift in both eyes (8.5 minutes) was significantly shorter (P < 0.001) than SAP (12.2 minutes). The average absolute difference of the mean sensitivity between the 2 VVP Swift sessions was found to be 0.73 dB (95% confidence interval [CI], 0.40–1.06). A statistically significant association was found between average mean sensitivity measurements from the VVP and mean deviation (MD) measurements obtained by the HVF with a Pearson correlation coefficient of 0.86 (95% CI, 0.70–0.94; P < 0.001). Mean visual sensitivity measurements from the VVP Swift test were significantly associated with average RNFL thickness (r = 0.66; P = 0.014) and GCC thickness (r = 0.63; P = 0.02), whereas the correlation coefficients between HVF MD and RNFL and GCC were 0.86 (P < 0.001) and 0.83 (P < 0.001), respectively. Conclusions Our results demonstrated that the VVP Swift test can generate reproducible results and is comparable with conventional SAP. This suggests that the device can be used by clinicians to assess visual function in glaucoma.
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Affiliation(s)
- Jason A. Greenfield
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Michael Deiner
- Department of Ophthalmology and Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Anwell Nguyen
- Department of Ophthalmology and Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
- Department of Biomedical Engineering, NYU Tandon School of Engineering, New York, New York
- Department of Neural Science, NYU School of Arts and Sciences, New York, New York
| | - Bertil Damato
- Department of Ophthalmology and Proctor Foundation, University of California, San Francisco, San Francisco, California
- Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Mengfei Wu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
- Department of Biomedical Engineering, NYU Tandon School of Engineering, New York, New York
- Department of Neural Science, NYU School of Arts and Sciences, New York, New York
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, New York, New York
- Department of Neuroscience and Physiology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Yvonne Ou
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
- Correspondence: Yvonne Ou, MD, Department of Ophthalmology, University of California, San Francisco, 10 Koret Way, K141, San Francisco, CA 94143.
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8
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Bountogo M, Sié A, Coulibaly B, Ruder K, Chen C, Zhong L, Colby E, Lebas E, Deiner M, Hinterwirth A, Lietman TM, Seitzman GD, Doan T. Deep sequencing analysis of acute conjunctivitis in Burkina Faso, Africa. Int Health 2022; 15:101-103. [PMID: 35076074 PMCID: PMC9808514 DOI: 10.1093/inthealth/ihac001] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Seasonal and epidemic conjunctivitis (pink eye) infections are highly contagious and impose a significant economic burden worldwide. Long-term visual impairment can occur. METHODS This study used metagenomic deep sequencing to evaluate pathogens causing acute infectious conjunctivitis in Burkina Faso. RESULTS We found that pathogens causing conjunctivitis in Burkina Faso are diverse, with human adenoviruses responsible for a small fraction of the samples tested. CONCLUSIONS These results are unexpected and suggest the importance of regional surveillance.
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Affiliation(s)
- Mamadou Bountogo
- Centre de Recherche en Sante de Nouna, Rue Namory Keita, BP02, Nouna, Burkina Faso
| | - Ali Sié
- Centre de Recherche en Sante de Nouna, Rue Namory Keita, BP02, Nouna, Burkina Faso
| | - Boubacar Coulibaly
- Centre de Recherche en Sante de Nouna, Rue Namory Keita, BP02, Nouna, Burkina Faso
| | - Kevin Ruder
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Cindi Chen
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Lina Zhong
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Emily Colby
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Elodie Lebas
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA 94158, USA
| | - Armin Hinterwirth
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA
| | - Thomas M Lietman
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA,Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA 94158, USA
| | - Gerami D Seitzman
- F. I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Floor 2, San Francisco, CA 94158, USA,Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA 94158, USA
| | - Thuy Doan
- Corresponding author: Tel: 1-415-476-6939; E-mail:
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9
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Fathy C, Cehelyk E, Israilevich R, Deiner M, Venkateswaran N, Kim T. When ophthalmology goes virtual amid a pandemic: content analysis of the 2020 #ASCRSVirtualMeeting. J Cataract Refract Surg 2021; 47:563-569. [PMID: 33149042 DOI: 10.1097/j.jcrs.0000000000000463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/05/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the use and impact of the social media platform Twitter during the 2020 ASCRS Virtual Meeting. SETTING Social media platform Twitter.com. DESIGN Retrospective review. METHODS Retrospective analysis of Twitter use during the ASCRS Virtual Meeting in May 2020. All tweets and associated metadata pertaining to the conference were compiled starting from when the virtual meeting was announced (April 8, 2020) to 2 weeks postconference (May 31, 2020). Two coders independently coded all tweets and excluded tweets if they were irrelevant or no longer available. RESULTS A total of 501 tweets were reviewed, of which 48.5% of tweets came from private accounts, 23.1% from academic institutions, 14.4% from ASCRS accounts, 12.4% from industry, and 1.6% from professional organizations; 146 tweets (29.1%) were shared before, 303 tweets (60.5%) during, and 52 tweets (10.4%) after the conference. A total of 315 tweets (62.9%) promoted conference events, 137 tweets (27.3%)) were about research studies, 136 tweets (27.1%) were social posts, 115 tweets (23.0%) were from industry sponsors, 22 tweets (4.4%) were self-promotion, and 5 tweets (1.0%5) were not categorized. Twitter impressions on the ASCRS account increased by 79% in 2020 compared with the 2019 annual meeting. CONCLUSIONS To the author's knowledge, this is the first study to describe how Twitter users engaged with a virtual ophthalmology meeting through social media during the coronavirus pandemic. Findings from this study offer insight into how the ophthalmology community can use social media during conferences and highlight opportunities for networking through social media for both virtual and in-person conferences in the future.
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Affiliation(s)
- Cherie Fathy
- From the Wills Eye Hospital, Philadelphia, Pennsylvania (Fathy); Sidney Kimmel Medical College, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania (Cehelyk, Israilevich); University of San Francisco, Department of Ophthalmology, San Francisco, California (Deiner); Duke University Eye Center, Durham, North Carolina (Venkateswaran, Kim)
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10
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Godwin W, Prada JM, Emerson P, Hooper PJ, Bakhtiari A, Deiner M, Porco TC, Mahmud H, Landskroner E, Hollingsworth TD, Medley GF, Pinsent A, Bailey R, Lietman TM, Oldenburg CE. Trachoma Prevalence After Discontinuation of Mass Azithromycin Distribution. J Infect Dis 2021; 221:S519-S524. [PMID: 32052842 PMCID: PMC7289551 DOI: 10.1093/infdis/jiz691] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Indexed: 12/03/2022] Open
Abstract
Background As the World Health Organization seeks to eliminate trachoma by 2020, countries are beginning to control the transmission of trachomatous inflammation–follicular (TF) and discontinue mass drug administration (MDA) with oral azithromycin. We evaluated the effect of MDA discontinuation on TF1–9 prevalence at the district level. Methods We extracted from the available data districts with an impact survey at the end of their program cycle that initiated discontinuation of MDA (TF1–9 prevalence <5%), followed by a surveillance survey conducted to determine whether TF1–9 prevalence remained below the 5% threshold, warranting discontinuation of MDA. Two independent analyses were performed, 1 regression based and 1 simulation based, that assessed the change in TF1–9 from the impact survey to the surveillance survey. Results Of the 220 districts included, TF1–9 prevalence increased to >5% from impact to surveillance survey in 9% of districts. Regression analysis indicated that impact survey TF1–9 prevalence was a significant predictor of surveillance survey TF1–9 prevalence. The proportion of simulations with >5% TF1–9 prevalence in the surveillance survey was 2%, assuming the survey was conducted 4 years after MDA. Conclusion An increase in TF1–9 prevalence may represent disease resurgence but could also be due to measurement error. Improved diagnostic tests are crucial to elimination of TF1–9 as a public health problem.
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Affiliation(s)
- William Godwin
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - Joaquin M Prada
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Paul Emerson
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - P J Hooper
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - Michael Deiner
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Travis C Porco
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Hamidah Mahmud
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - Emma Landskroner
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amy Pinsent
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin Bailey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas M Lietman
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Catherine E Oldenburg
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
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11
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Nattagh K, Zhou H, Rinella N, Zhang Q, Dai Y, Foote KG, Keiner C, Deiner M, Duncan JL, Porco TC, Wang RK, Schwartz DM. OCT Angiography to Predict Geographic Atrophy Progression using Choriocapillaris Flow Void as a Biomarker. Transl Vis Sci Technol 2020; 9:6. [PMID: 32832213 PMCID: PMC7414606 DOI: 10.1167/tvst.9.7.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 02/10/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose To investigate the relationship between choriocapillaris (CC) flow void (FV) percentage and geographic atrophy (GA) growth rate, and study how variations in FV percentage surrounding GA predict regional GA growth. Methods This prospective, longitudinal study enrolled subjects with GA secondary to nonexudative age-related macular degeneration. Optical coherence tomography angiography imaged the CC and FV percentage was evaluated using a validated algorithm. GA growth rate was measured as the difference in the square root of GA area divided by the months between baseline and follow-up imaging. Results Twelve eyes from 7 subjects with a mean age of 80 ± 5 years (range 74-86) were studied once at baseline and 7 to 16 months later. GA expansion rate was positively correlated with increased CC FV percentage (Spearman rank correlation coefficient r = 0.69 [P = 0.038] and 0.76 [P = 0.013]) within the 6 x 6 mm scanned macular region and the 2° margin surrounding each GA lesion, respectively. Regions with CC FV at baseline located within 480 µm from the GA margin showed 33% greater chance of becoming atrophic compared with regions within 480 µm from the GA margin that did not show CC FV at baseline. Conclusions GA expansion rate and CC FV density throughout the macular region and surrounding the GA margin were significantly correlated. The regional magnitude of FV immediately surrounding GA was associated with GA growth into that region. Translational Relevance CC FV analysis may facilitate prediction of GA growth over time for patients with advanced nonneovascular age-related macular degeneration.
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Affiliation(s)
- Khashayar Nattagh
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Nicholas Rinella
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Yining Dai
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Katharina G. Foote
- Department of Ophthalmology, University of California, San Francisco, CA, USA
- School of Optometry and Vision Science Graduate Group, University of California- Berkeley, Berkeley, CA, USA
| | - Cathrine Keiner
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Jacque L. Duncan
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Travis C. Porco
- Department of Ophthalmology, University of California, San Francisco, CA, USA
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Daniel M. Schwartz
- Department of Ophthalmology, University of California, San Francisco, CA, USA
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12
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Godwin W, Prada JM, Emerson P, Hooper PJ, Bakhtiari A, Deiner M, Porco TC, Mahmud H, Landskroner E, Hollingsworth TD, Medley GF, Pinsent A, Bailey R, Lietman TM, Oldenburg CE. Erratum to: Trachoma Prevalence After Discontinuation of Mass Azithromycin Distribution. J Infect Dis 2020; 221:2086. [PMID: 32215646 PMCID: PMC7289543 DOI: 10.1093/infdis/jiaa082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- William Godwin
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - Joaquin M Prada
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Paul Emerson
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - P J Hooper
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, USA
| | - Michael Deiner
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Travis C Porco
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Hamidah Mahmud
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - Emma Landskroner
- Francis I Proctor Foundation, University of California, San Francisco, California, USA
| | - T Deirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amy Pinsent
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin Bailey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas M Lietman
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Catherine E Oldenburg
- Francis I Proctor Foundation, University of California, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
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13
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Lietman TM, Pinsent A, Liu F, Deiner M, Hollingsworth TD, Porco TC. Models of Trachoma Transmission and Their Policy Implications: From Control to Elimination. Clin Infect Dis 2019; 66:S275-S280. [PMID: 29860288 PMCID: PMC5982784 DOI: 10.1093/cid/ciy004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 11/24/2022] Open
Abstract
Despite great progress in eliminating trachoma from the majority of worldwide districts, trachoma control seems to have stalled in some endemic districts. Can mathematical models help suggest the way forward? We review specific achievements of models in trachoma control in the past. Models showed that, even with incomplete coverage, mass drug administration could eliminate disease through a spillover effect, somewhat analogous to how incomplete vaccine campaigns can eliminate disease through herd protection. Models also suggest that elimination can always be achieved if enough people are treated often enough with an effective enough drug. Other models supported the idea that targeting ages at highest risk or continued improvements in hygiene and sanitation can contribute meaningfully to trachoma control. Models of intensive targeting of a core group may point the way to final eradication even in areas with substantial transmission and within-community heterogeneity.
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Affiliation(s)
- Thomas M Lietman
- Francis I. Proctor Foundation, San Francisco.,Department of Ophthalmology, San Francisco.,Department of Epidemiology and Biostatistics, San Francisco.,Global Health Sciences, University of California, San Francisco
| | - Amy Pinsent
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | | | - Michael Deiner
- Francis I. Proctor Foundation, San Francisco.,Department of Ophthalmology, San Francisco
| | - T Deirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, United Kingdom
| | - Travis C Porco
- Francis I. Proctor Foundation, San Francisco.,Department of Ophthalmology, San Francisco.,Department of Epidemiology and Biostatistics, San Francisco
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14
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Qin J, Rinella N, Zhang Q, Zhou H, Wong J, Deiner M, Roorda A, Porco TC, Wang RK, Schwartz DM, Duncan JL. OCT Angiography and Cone Photoreceptor Imaging in Geographic Atrophy. Invest Ophthalmol Vis Sci 2019; 59:5985-5992. [PMID: 30572343 PMCID: PMC6306079 DOI: 10.1167/iovs.18-25032] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose To compare cone spacing and choriocapillaris (CC) perfusion adjacent to geographic atrophy (GA) in patients with age-related macular degeneration (AMD) and age-similar normal eyes. Methods Subjects were imaged using adaptive optics scanning laser ophthalmoscopy (AOSLO), fundus autofluorescence (FAF), and swept-source optical coherence tomography angiography. The GA border was identified using FAF images; CC flow void was analyzed in 1° regions extending from the GA border. A grader masked to CC perfusion selected regions of interest (ROIs) with unambiguous cone mosaics in AOSLO images. At each ROI, cone spacing and CC flow void were converted to Z-scores (standard deviations from the mean of 12 normal eyes aged 50 to 81 years for cone spacing, and 60 normal eyes age 51 to 88 years for CC flow void). Results Excluding regions of GA and drusen, CC flow void in eight eyes of six patients with AMD was significantly greater than in four age-similar normal eyes (exact permutation test, P = 0.024). CC flow void was negatively correlated with distance from the GA margin (r = -0.35; 95% confidence interval [CI], -0.53 to -0.12). Increased cone spacing was significantly correlated with CC flow void (r = 0.33; 95% CI, 0.12 to 0.59). Cone spacing was increased in 39% of ROIs, while CC flow void was increased in 96% of ROIs. Conclusions In eyes with GA due to AMD, CC hypoperfusion was significantly correlated with, and more extensive than, cone photoreceptor loss. The results suggest that reduced CC perfusion contributes to the development of GA.
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Affiliation(s)
- Jia Qin
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Nicholas Rinella
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, Washington, United States
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, Washington, United States
| | - Jessica Wong
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Austin Roorda
- School of Optometry and Vision Science Graduate Group, University of California, Berkeley, California, United States
| | - Travis C Porco
- Department of Ophthalmology, University of California, San Francisco, California, United States.,Francis I. Proctor Foundation, University of California, San Francisco, California, United States
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, United States
| | - Daniel M Schwartz
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Jacque L Duncan
- Department of Ophthalmology, University of California, San Francisco, California, United States
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15
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Afshar AR, Deiner M, Allen G, Damato BE. The Patient's Experience of Ocular Melanoma in the US: A Survey of the Ocular Melanoma Foundation. Ocul Oncol Pathol 2018; 4:280-290. [PMID: 30320098 DOI: 10.1159/000485189] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/08/2017] [Indexed: 12/20/2022] Open
Abstract
Background Ocular melanomas threaten patients with early death, visual handicap, and loss of the eye. The aims of this study were to identify aspects of care that patients with ocular melanoma considered most important and to determine whether patients felt their needs had been adequately addressed. Methods A cross-sectional study including US ocular melanoma patients and their caregivers. An online survey of US ocular melanoma patients was designed and conducted by the Ocular Melanoma Foundation. Results The cohort included 180 patients with uveal melanoma and 4 with conjunctival melanoma. Median follow-up was 3 years. A third of patients reported that their uveal melanoma had initially been diagnosed as a nevus. Most uveal melanomas were treated with brachytherapy. Almost 50% of patients had no genetic tumor analysis. Screening methods reported most commonly were computed tomography and liver function tests. Metastatic disease developed in 11% of patients. Few patients (13.3%) reported an offer of psychological support. Most dissatisfaction was with lack of advice on financial aspects of care and lack of psychological counseling, with women tending to express more dissatisfaction with care. Many patients complained about the way ophthalmologists delivered bad news to them. Conclusions This patients' perspective highlights directions for research, education, and other measures to improve the care of patients with ocular melanoma in the US and elsewhere.
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Affiliation(s)
- Armin R Afshar
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Grant Allen
- Ocular Melanoma Foundation, Washington, DC, USA
| | - Bertil E Damato
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.,Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA
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16
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Pinsent A, Liu F, Deiner M, Emerson P, Bhaktiari A, Porco TC, Lietman T, Gambhir M. Probabilistic forecasts of trachoma transmission at the district level: A statistical model comparison. Epidemics 2017; 18:48-55. [PMID: 28279456 PMCID: PMC5340843 DOI: 10.1016/j.epidem.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 01/20/2017] [Accepted: 01/31/2017] [Indexed: 11/09/2022] Open
Abstract
The World Health Organization and its partners are aiming to eliminate trachoma as a public health problem by 2020. In this study, we compare forecasts of TF prevalence in 2011 for 7 different statistical and mechanistic models across 9 de-identified trachoma endemic districts, representing 4 unique trachoma endemic countries. We forecast TF prevalence between 1-6 years ahead in time and compare the 7 different models to the observed 2011 data using a log-likelihood score. An SIS model, including a district-specific random effect for the district-specific transmission coefficient, had the highest log-likelihood score across all 9 districts and was therefore the best performing model. While overall the deterministic transmission model was the least well performing model, although it did comparably well to the other models for 8 of 9 districts. We perform a statistically rigorous comparison of the forecasting ability of a range of mathematical and statistical models across multiple endemic districts between 1 and 6 years ahead of the last collected TF prevalence data point in 2011, assessing results against surveillance data. This study is a step towards making statements about likelihood and time to elimination with regard to the WHO GET2020 goals.
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Affiliation(s)
- Amy Pinsent
- Department of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
| | - Fengchen Liu
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
| | - Michael Deiner
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA; Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Paul Emerson
- International Trachoma Initiative, Atlanta, GA, USA; School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Travis C Porco
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA; Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Thomas Lietman
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA; Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Manoj Gambhir
- Department of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
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17
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Enanoria WTA, Worden L, Liu F, Gao D, Ackley S, Scott J, Deiner M, Mwebaze E, Ip W, Lietman TM, Porco TC. Evaluating Subcriticality during the Ebola Epidemic in West Africa. PLoS One 2015; 10:e0140651. [PMID: 26484544 PMCID: PMC4618845 DOI: 10.1371/journal.pone.0140651] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 09/29/2015] [Indexed: 11/23/2022] Open
Abstract
The 2014–2015 Ebola outbreak is the largest and most widespread to date. In order to estimate ongoing transmission in the affected countries, we estimated the weekly average number of secondary cases caused by one individual infected with Ebola throughout the infectious period for each affected West African country using a stochastic hidden Markov model fitted to case data from the World Health Organization. If the average number of infections caused by one Ebola infection is less than 1.0, the epidemic is subcritical and cannot sustain itself. The epidemics in Liberia and Sierra Leone have approached subcriticality at some point during the epidemic; the epidemic in Guinea is ongoing with no evidence that it is subcritical. Response efforts to control the epidemic should continue in order to eliminate Ebola cases in West Africa.
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Affiliation(s)
- Wayne T. A. Enanoria
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Lee Worden
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Fengchen Liu
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Daozhou Gao
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Sarah Ackley
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - James Scott
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
- Mathematics and Statistics, Colby College, Waterville, Maine, United States of America
| | - Michael Deiner
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | | | - Wui Ip
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Thomas M. Lietman
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Travis C. Porco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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18
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Prasad BP, Bhatta RC, Chaudhary J, Sharma S, Mishra S, Cuddapah PA, Stoller NE, Yu SN, Rahman SA, Deiner M, Keenan JD, Gaynor BD. Agreement between novice and experienced trachoma graders improves after a single day of didactic training. Br J Ophthalmol 2015; 100:762-5. [PMID: 26405104 DOI: 10.1136/bjophthalmol-2015-307224] [Citation(s) in RCA: 2] [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] [Received: 06/03/2015] [Accepted: 09/07/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Prevalence estimates and treatment decisions for trachoma are based entirely on ocular clinical examination. The aim of the current study is to demonstrate that ophthalmic assistants can be trained and certified to provide trachoma grading within a single day. METHODS Conjunctival photographs from an area with endemic trachoma were randomised into two sets of 60 cases. Photographs were graded for trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI) by three experienced graders. Inter-rater reliability of eight ophthalmic assistants and three experienced graders were compared before and after training. RESULTS The mean κ agreement between the ophthalmic assistants and the consensus grades of the experienced graders for TF was 0.38 (95% CI 0.18 to 0.58) before training, and increased to 0.60 (95% CI 0.42 to 0.78) after training (p=0.07). The mean κ agreement for TI was 0.16 (95% CI 0.02 to 0.30) before training, and increased to 0.39 (95% CI 0.20 to 0.58) after training (p=0.02). CONCLUSION A single day of training improves agreement between prospective and experienced trachoma graders, and provides the basis for certification of workers who are able to accurately grade trachoma and generate reliable prevalence estimates.
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Affiliation(s)
| | | | | | - Shekhar Sharma
- National Trachoma Program, Nepal Netra Jyoti Sangh, Tripureswor, Kathmandu, Nepal
| | - Sailesh Mishra
- National Trachoma Program, Nepal Netra Jyoti Sangh, Tripureswor, Kathmandu, Nepal
| | - Puja A Cuddapah
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Nicole E Stoller
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Sun N Yu
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Salman A Rahman
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Jeremy D Keenan
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Bruce D Gaynor
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
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19
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Abstract
The recent increase in measles cases in California may raise questions regarding the continuing success of measles control. To determine whether the dynamics of measles is qualitatively different in comparison to previous years, we assess whether the 2014-2015 measles outbreak associated with an Anaheim theme park is consistent with subcriticality by calculating maximum-likelihood estimates for the effective reproduction numbe given this year’s outbreak, using the Galton-Watson branching process model. We find that the dynamics after the initial transmission event are consistent with prior transmission, but does not exclude the possibilty that the effective reproduction number has increased.
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Affiliation(s)
- Seth Blumberg
- St. Mary's Medical Center, San Francisco, California, USA; FI Proctor Foundation, UCSF, San Francisco, California, USA; Fogarty International Center, NIH, Bethesda, Maryland, USA
| | - Lee Worden
- FI Proctor Foundation, UCSF, San Francisco, California, USA
| | - Wayne Enanoria
- FI Proctor Foundation, UCSF, San Francisco, California, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, California, USA
| | - Sarah Ackley
- FI Proctor Foundation, UCSF, San Francisco, California, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, California, USA
| | | | - Fengchen Liu
- FI Proctor Foundation, UCSF, San Francisco, California, USA
| | - Daozhou Gao
- FI Proctor Foundation, UCSF, San Francisco, California, USA
| | - Thomas Lietman
- FI Proctor Foundation, UCSF, San Francisco, California, USA; Department of Ophthalmology, UCSF, San Francisco, California, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, California, USA
| | - Travis Porco
- FI Proctor Foundation, UCSF, San Francisco, California, USA; Department of Ophthalmology, UCSF, San Francisco, California, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, California, USA
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20
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Abstract
The eye is a highly specialized structure that gathers and converts light information into neuronal signals. These signals are relayed along axons of retinal ganglion cells (RGCs) to visual centers in the brain for processing. In this review, we discuss the pathfinding tasks RGC axons face during development and the molecular mechanisms known to be involved. The data at hand support the presence of multiple axon guidance mechanisms concentrically organized around the optic nerve head, each of which appears to involve both growth-promoting and growth-inhibitory guidance molecules. Together, these strategies ensure proper optic nerve formation and establish the anatomical pathway for faithful transmission of information between the retina and the brain.
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Affiliation(s)
- S F Oster
- Department of Ophthalmology, Program in Neuroscience, University of California San Francisco, K107, Beckman Vision Sciences Bldg, 10 Kirkham St, San Francisco, CA 94143, USA
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21
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Abstract
Agrin is thought to be the nerve-derived factor that initiates acetylcholine receptor (AChR) clustering at the developing neuromuscularjunction. We have investigated the signaling pathway in mouse C2 myotubes and report that agrin induces a rapid but transient tyrosine phosphorylation of the AChR beta subunit. As the beta-subunit tyrosine phosphorylation occurs before the formation of AChR clusters, it may serve as a precursor step in the clustering mechanism. Consistent with this, we observed that tyrosine phosphorylation of the beta subunit correlated precisely with the presence or absence of clustering under several experimental conditions. Moreover, two tyrosine kinase inhibitors, herbimycin and staurosporine, that blocked beta-subunit phosphorylation also blocked agrin-induced clustering. Surprisingly, the inhibitors also dispersed preformed AChR clusters, suggesting that the tyrosine phosphorylation of other proteins may be required for the maintenance of receptor clusters. These findings indicate that in mammalian muscle, agrin-induced AChR clustering occurs through a mechanism that requires tyrosine phosphorylation and may involve tyrosine phosphorylation of the AChR itself.
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Affiliation(s)
- M Ferns
- Department of Physiology, University of California at San Francisco, 94143-0444, USA
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22
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Abstract
Cilia with a distal membrane expansion enclosing a coiled end of the axoneme (paddle cilia or discocilia) have been commonly reported in marine invertebrates. We recently showed that paddle cilia in molluscan veligers are artifacts of non-physiological conditions. Here we investigated the possible mechanisms of formation of paddle cilia under hypotonic conditions; particularly, whether a helical conformational change of doublet microtubules induced by Ca or proton flux is responsible. Typical paddle cilia are induced by hypotonic Ca-free solutions at normal or low pH, showing that axonemal coiling does not require Ca influx or proton efflux. In addition, Triton-demembranated straight axonemes do not coil in high Ca solutions. Most decisively, complete removal of paddle ciliary membranes with detergents, but not mere permeabilization, causes immediate uncoiling and straightening of the axonemes to approximately their original length before hypotonic treatment. These findings and other data show that axonemal coiling in paddles is due to membrane tensile stress acting on an elastic axoneme. Light and electron microscopy of paddles show that axonemes coil uniformly toward the direction of the effective stroke (doublets nos 5–6), even when beating is inhibited by sodium azide or glutaraldehyde before hypotonic treatment. This indicates that axonemes possess an intrinsic asymmetry of stiffness within the beat plane, independent of active microtubule sliding. Paddle cilia thus reveal important mechanical properties of ciliary axonemes and membranes that should be useful for understanding ciliary function.
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Affiliation(s)
- M Deiner
- Boston University Marine Program, Marine Biological Laboratory, Woods Hole, MA 02543
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23
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