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Mouridsen Korsgaard posted an update 6 days, 8 hours ago
Intervention, policy needs, and prevention are discussed.
To determine the tipping point at which peripapillary vessel density (pVD), measured using optical coherence tomography angiography (OCT-A), is associated with detectable visual field (VF) loss in cases of open-angle glaucoma (OAG).
Peripapillary retinal nerve fibre layer (pRNFL) thickness and pVD were measured using OCT and OCT-A in 166 healthy participants, those with suspected glaucoma and patients with early-stage OAG. All participants were Koreans. A broken-stick model was used to determine the tipping points below which pRNFL thickness (pRNFLT) or pVD reduction was associated with significant VF loss. The slopes were computed above and below the tipping points for the relationship between pVD, pRNFLT and VF sensitivity (VFS).
Tipping points were detected for pRNFLT globally and in the inferior and superior quadrants, at which there were significant differences between the slopes above and below the tipping points. CORT125134 ic50 The slopes above the tipping points were approximately zero. However, no tipping point was found for pVD in the global area or regional sectors.
The relationship between pVD and VFS does not show a tipping point. This suggests that the correlation between pVD-VFS may be linear and stronger than that of pRNFLT-VFS, even at the early stage of glaucoma.
The relationship between pVD and VFS does not show a tipping point. This suggests that the correlation between pVD-VFS may be linear and stronger than that of pRNFLT-VFS, even at the early stage of glaucoma.
To describe some novel vitreoretinal microstructural findings in patients with mild familial exudative vitreoretinopathy (FEVR) on ultra-wide-field scanning laser ophthalmoscopy (UWF-SLO) and UWF optical coherence tomography (UWF-OCT) and to evaluate their clinical significance.
A total of 32 patients and 32 healthy controls were studied. An additional independent 40 FEVR patients, 44 patients with non-FEVR retinopathies and 40 healthy controls participated in a diagnostic test to validate the abilities of novel findings in FEVR screening.
A novel anatomic change, named Temporal Mid-Peripheral Vitreoretinal Interface Abnormality (TEMPVIA), was found on UWF-SLO in 88.3% of FEVR patients and in none of the healthy controls. The clinical significance of TEMPVIA was further validated by a diagnostic test in new independent cases, with satisfying sensitivity (91.5%) and specificity (98.8%) and Youden Index 0.90. In addition to foveal hypoplasia, some previously unrecognised, novel clinical changes in FEVR, for instance, retinoschisis, focal retinal thickening, sudden thinning of the retina and retinal ridge, were identified using UWF-OCT.
The results of this study have led to an update of the clinical spectrum of FEVR and have improved our understanding of its pathogenesis. TEMPVIA is therefore suggested to be a useful biomarker in the screening strategy for mild FEVR.
The results of this study have led to an update of the clinical spectrum of FEVR and have improved our understanding of its pathogenesis. TEMPVIA is therefore suggested to be a useful biomarker in the screening strategy for mild FEVR.
To propose and validate a new pterygium grading system based on slit-lamp evaluation.
This prospective cross-sectional study included 217 patients with pterygium. All patients underwent slit-lamp examination, and slit-lamp photographs were independently graded by two graders twice. A total of eight parameters were evaluated and all parameters were assigned with a score of 1-4 (normal-severe). Intra-rater and inter-rater reliability as determined by weighted Cohen’s kappa analysis.
A total of 868 independent assessment, based on 217 slit-lamp images, were performed by two graders. For conjunctival assessment, the intra-rater reliability was excellent for body thickness (κ=0.81-0.89) and size at limbus (κ=0.87-0.92), substantial-to-excellent for body vascularity (κ=0.72-0.86), and moderate-to-excellent for body length (κ=0.57-0.81), whereas the inter-rater reliability was excellent for size at limbus (κ=0.86), substantial for body thickness (κ=0.72-0.73) and body vascularity (κ=0.66-0.75), and moderate for body length (κ=0.54-0.57). For corneal assessment, the intra-rater reliability was excellent for all four parameters (κ=0.84-0.90) whereas the inter-rater reliability was excellent for head length (κ=0.86-0.87), substantial-to-excellent for head vascularity (κ=0.78-0.82), substantial for Stocker’s line (κ=0.79-0.80) and head thickness (κ=0.67-0.69). The grading system was named SLIT2, which included
tocker’s line,
ize at limbus,
ength of head/body,
njection/vascularity of body/head, and
hickness of body/head.
The proposed SLIT2 grading system, consisting of eight components, may serve as a reliable tool to standardise the reporting of pterygium severity and disease recurrence for clinical and research applications.
The proposed SLIT2 grading system, consisting of eight components, may serve as a reliable tool to standardise the reporting of pterygium severity and disease recurrence for clinical and research applications.
The purpose of this study was to estimate the total healthcare cost associated with diabetic retinopathy (DR) in the population aged 18years and older in Hungary, and its projection for the year 2045.
A cost model was developed based on the standardised rapid assessment of avoidable blindness with the diabetic retinopathy module (RAAB+DRM) methodology and recently reported prevalent-based cost of illness model. Projection for 2045 was made based on the estimation for increasing diabetes mellitus (DM) prevalence of the International Diabetes Federation. Costs were analysed from the perspective of the healthcare system and the patients. Our DR cost model was constructed according to the Scottish DR grading scale and based on the DR severity stadium.
The total DR-associated healthcare cost was US$145.8 million in 2016 and will increase to US$169.0 million by 2045. The two major cost drivers were intravitreal antivascular endothelial growth factor injections and vitrectomies in this study (US$126.4 million in 2016 and US$146.