Optic nerve head vessel density in different stages of pseudoexfoliation disease

2020 ◽  
pp. bjophthalmol-2020-317605
Author(s):  
Mona Safizadeh ◽  
Amirreza Shaabani ◽  
Alireza Kamalipour ◽  
Masoud Aghsaei Fard ◽  
Kaileen Yeh ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Capillary Density ◽  
Cross Sectional Study ◽  
Vascular Density ◽  
Cross Sectional ◽  
Sectoral Differences ◽  
Fellow Eyes

PurposeTo evaluate the superficial vascular density of the optic nerve head in different stages of pseudoexfoliation disease using optical coherence tomography angiography (OCTA).MethodsIn this cross-sectional study, 57 normal eyes, 41 eyes with pseudoexfoliation syndrome (PXS), 82 eyes with pseudoexfoliation glaucoma (PXG) and 27 non-glaucomatous fellow eyes of PXG (NL-PXG) that had OCTA were included. Circumpapillary RNFL (cpRNFL) thickness and circumpapillary capillary density (cpCD) were compared among the groups after adjusting for confounders using linear-mixed model.ResultsPXG eyes had thinner global RNFL and lower cpCD (74.2±14.3 µm and 36.7±10.0%) than control (103.3±8.6 µm and 52.5±2.3%), PXS (96.8±8.8 µm and 51.5±2.3%), and NL-PXG eyes (96.3±11.1 µm and 50.1±3.9%) (p<0.001). After adjustment for age, gender and signal strength index, global cpRNFL thickness was comparable among control, PXS and NL-PXG. NL-PXG had the lowest cpCD (p=0.045) and sectoral cpCD compared to PXS and control eyes. Although cpCD was comparable between control and PXS (p=0.425) eyes, sectoral differences (p=0.009 and 0.004, for inferonasal and temporal-inferior cpCD, respectively) were detectable between the two groups. AUROC for differentiating NL-PXG eyes from normal were better for cpCD (0.78) compared to cpRNLF (0.69).ConclusionsOCTA can detect reduced capillary density before significant changes in cpRNFL in fellow eyes of PXG patients. This can enable earlier detection of glaucomatous loss in pseudoexfoliation disease and enhance management of the disease.

scholarly journals Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Blood Perfusion ◽  
Cross Sectional Study ◽  
Vascular Density ◽  
Optical Coherence ◽  
Cross Sectional

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

Clinical relevance of protruded retinal layers in minimum rim width measurement of the optic nerve head

2018 ◽  
Vol 103 (10) ◽  
pp. 1401-1405
Author(s):  
Lucas A Torres ◽  
Faisal Jarrar ◽  
Glen P Sharpe ◽  
Donna M Hutchison ◽  
Eduardo Ferracioli-Oda ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Diagnostic Accuracy ◽  
Optic Nerve Head ◽  
Cross Sectional Study ◽  
Retinal Nerve Fibre Layer ◽  
Mean Deviation ◽  
Cross Sectional ◽  
Retinal Layers ◽  
Rnfl Thickness ◽  
Oct Imaging

Background/aimsOptical coherence tomography (OCT) imaging of the optic nerve head minimum rim width (MRW) has recently been shown to sometimes contain components besides extended retinal nerve fibre layer (RNFL). This study was conducted to determine whether excluding these components, termed protruded retinal layers (PRLs), from MRW increases diagnostic accuracy for detecting glaucoma.MethodsIn this cross-sectional study, we included 123 patients with glaucoma and 123 normal age-similar controls with OCT imaging of the optic nerve head (24 radial scans) and RNFL (circle scan). When present, PRLs were manually segmented, and adjusted MRW measurements were computed. We compared diagnostic accuracy of adjusted versus unadjusted MRW measurement. We also determined whether adjusted MRW correlates better with RNFL thickness compared with unadjusted MRW.ResultsThe median (IQR) visual field mean deviation of patients and controls was −4.4 (−10.3 to −2.1) dB and 0.0 (−0.6 to 0.8) dB, respectively. In the 5904 individual B-scans, PRLs were identified less frequently in patients (448, 7.6%) compared with controls (728, 12.3%; p<0.01) and were present most frequently in the temporal sector of both groups. Areas under the receiver operating characteristic curves and sensitivity values at 95% specificity indicated that PRL adjustment did not improve diagnostic accuracy of MRW, globally or temporally. Furthermore, adjusting MRW for PRL did not improve its correlation with RNFL thickness in either group.ConclusionWhile layers besides the RNFL are sometimes included in OCT measurements of MRW, subtracting these layers does not impact clinical utility.

scholarly journals The association of socio-demographic and environmental factors on childhood diarrhea in Cambodia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 303
Author(s):  
Vong Pisey ◽  
Pannee Banchonhattakit
Keyword(s):  
Maternal Age ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Childhood Diarrhea ◽  
Public Health Concern ◽  
Cross Sectional ◽  
One Year

Background: Diarrhea is still the leading cause of childhood death worldwide, as well as a major cause for concern in developing countries. This study was conducted to investigate the factors related to childhood diarrhea in Cambodia. Methods: A cross-sectional study of the secondary data from the Cambodia Demographic and Health Survey 2014 was conducted using the combination of household data and children’s data. A generalized linear mixed model was used to analyze the determinant factors of childhood diarrhea. Results: The surveys included 2,828 children, aged 12 to 35 months. The prevalence of diarrhea in the last 2 weeks was 16.44% (95% CI: 14.72%-18.31%). Factors with statistically significant associations with childhood diarrhea in Cambodia were: maternal  unemployment, compared with being in employment (AOR = 1.43; 95% CI: 1.14-1.78); the child being male (AOR = 1.25; 95%CI: 1.02-1.53); the presence of unimproved toilet facilities (AOR = 1.17; 95%CI: 1.05-1.31) compared with improved toilet facilities; and unhygienic disposal of children’s stools (AOR = 1.32; 95%CI: 1.06-1.64) compared with hygienic disposal of children’s stools when controlling for other covariates. Both maternal age (one year older; AOR = 0.85; 95%CI: 0.78– 0.93) and child age (one month older; AOR = 0.86; 95%CI: 0.78-0.94) had significant negative associations with the occurrence of childhood diarrhea. Conclusion: Childhood diarrhea remains a public health concern in Cambodia. The probability of diarrhea occurring is shown to be increased by maternal unemployment, the sex of the child being male, lack of provision of improved toilet facilities, and the unhygienic disposal of children’s stools; whereas increasing maternal age and child’s age were associated with a reduced chance of diarrhea occurring. On the basis of these results, we recommend provision of programs focusing on reducing diarrhea through the construction of improved toilet facilities and the promotion of behavior to improve hygiene, specifically targeting younger mothers.

scholarly journals Bruch’s membrane opening enlargement and its implication on the myopic optic nerve head

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mi Sun Sung ◽  
Min Young Heo ◽  
Hwan Heo ◽  
Sang Woo Park
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Lamina Cribrosa ◽  
Cross Sectional Study ◽  
Multivariate Regression Model ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Cross Sectional ◽  
Bruch’S Membrane Opening ◽  
Parapapillary Atrophy

AbstractWe examined the association between Bruch’s membrane opening (BMO) area and various ocular parameters and investigated the implication of BMO enlargement on the myopic optic nerve head. One hundred eighty-five myopic eyes were included in this cross-sectional study. Among the included eyes, 53 having axial lengths between 26 and 27 mm were further analyzed to investigate the association between BMO area and various ocular parameters. BMO area, BMO-minimum rim width (BMO-MRW), peripapillary choroidal thickness (pCT), width of β-parapapillary atrophy with and without Bruch’s membrane (PPA+BM and PPA−BM), and presence of lamina cribrosa (LC) defect were evaluated. We found that BMO area tended to increase with increasing axial length, but varied among the highly myopic eyes even though they had similar degrees of myopia. In the subgroup analysis of eyes with axial lengths between 26 and 27 mm, BMO area was highly variable and it significantly correlated with PPA−BM width and temporal-inferior, nasal-inferior, and nasal BMO-MRW and pCT. LC defects were more common in myopic eyes with enlarged BMO. A multivariate regression model revealed that higher intraocular pressure, enlarged BMO, and thinner BMO-MRW were associated with LC defects in highly myopic eyes. These findings should be considered when evaluating myopic eyes.

scholarly journals The association of socio-demographic and environmental factors on childhood diarrhea in Cambodia

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 303
Author(s):  
Vong Pisey ◽  
Pannee Banchonhattakit ◽  
Wongsa Laohasiriwong
Keyword(s):  
Maternal Age ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Childhood Diarrhea ◽  
Public Health Concern ◽  
Cross Sectional ◽  
One Year

Background:Diarrhea is still the leading cause of childhood death worldwide, as well as a major cause for concern in developing countries. This study was conducted to investigate the factors related to childhood diarrhea in Cambodia. Methods:A cross-sectional study of the secondary data from the Cambodia Demographic and Health Survey 2014 was conducted using the combined dataset of household data and children’s data. A generalized linear mixed model was used to analyze the determinant factors of childhood diarrhea. Results:The surveys included 2,828 children, aged 12 to 35 months. The prevalence of diarrhea in the last 2 weeks was 16.44% (95% CI: 14.72%-18.31%). Factors with statistically significant associations with childhood diarrhea in Cambodia were: maternal unemployment, compared with being in employment (AOR = 1.43; 95% CI: 1.14-1.78); the child being male (AOR = 1.25; 95%CI: 1.02-1.53); the presence of unimproved toilet facilities (AOR = 1.17; 95%CI: 1.05-1.31) compared with improved toilet facilities; and unhygienic disposal of children’s stools (AOR = 1.32; 95%CI: 1.06-1.64) compared with hygienic disposal of children’s stools when controlling for other covariates. Both maternal age (one year older; AOR = 0.85; 95%CI: 0.78– 0.93) and child age (one month older; AOR = 0.86; 95%CI: 0.78-0.94) had significant negative associations with the occurrence of childhood diarrhea. Conclusion:Childhood diarrhea remains a public health concern in Cambodia. The probability of diarrhea occurring is shown to be increased by maternal unemployment, the sex of the child being male, lack of provision of improved toilet facilities, and the unhygienic disposal of children’s stools; whereas increasing maternal age and child’s age were associated with a reduced chance of diarrhea occurring. On the basis of these results, we recommend provision of programs focusing on reducing diarrhea through the construction of improved toilet facilities and the promotion of behavior to improve hygiene, specifically targeting younger mothers.

scholarly journals Linking Differences in Eating Behavior with Appetitive Hormones in Women

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 594-594
Author(s):  
Debra Kirsty Tacad ◽  
Christine Bowlus ◽  
Leslie Woodhouse ◽  
Sridevi Krishnan ◽  
Nancy Keim
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Bimodal Distribution ◽  
Cross Sectional Study ◽  
Blood Collection ◽  
Response Curves ◽  
Chi Square ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Time To Peak

Abstract Objectives Examine and compare the hormones related to satiety in women identified as 1) restrained + disinhibited eaters, 2) restrained, non-disinhibited eaters, or 3) unrestrained, non-disinhibited eaters. We hypothesized restrained eaters with disinhibition would have a different pattern of appetitive hormones involved in food intake regulation. Methods 178 women from a cross-sectional study completed the three factor eating questionnaire (TFEQ), and were classified as restrained + disinhibited eaters (RD, n = 38), restrained, non-disinhibited eaters (R, n = 52), or unrestrained, non-disinhibited eaters (LL, n = 88). Women fasted for 12 h prior to baseline blood collection, and postprandial blood was collected after a meal challenge at 30 min, 3 h, and 6 h. Data were evaluated for outliers and missingness, and transformed and imputed using multivariate normal imputation. Differences in glucose, insulin and ghrelin were analyzed using a linear mixed model comparing groups. Time to peak and nadir for glucose, insulin and ghrelin were calculated from response curves. Chi square tests of proportions were used to determine whether the distribution of participants in the three groups were different in their times to peak and nadir. Results There were no significant differences between groups in ghrelin or insulin concentrations over time. However, overall glucose levels in RD were significantly lower than R and LL groups (P = 0.05 and P = 0.03, respectively). Chi-squared tests indicated that a greater proportion of women in the RD group reached peak glucose at 3 h, compared to women in R and LL with peak glucose occurring at 30 min (P = 0.04). Glucose nadir displayed a bimodal distribution in R, with more women at baseline and 3 h compared to RD and LL (P = 0.05). Ghrelin nadir was reached at 3 h for more participants in RD and LL, but occurred later at 6 h in more participants in R (P = 0.04). Conclusions Dietary restraint and disinhibition are associated with circulating glucose and ghrelin concentrations; however, prospective research is needed to determine if there is a causal relationship. Funding Sources USDA CRIS 2032-51530-022, 2032-51530-025, and 2032-51530-026-00-D, and a grant from Arla Foods Inc.

scholarly journals Optic Nerve Sonography in the Diagnostic Evaluation of Pseudopapilledema and Raised Intracranial Pressure: A Cross-Sectional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Masoud Mehrpour ◽  
Fatemeh Oliaee Torshizi ◽  
Shooka Esmaeeli ◽  
Salameh Taghipour ◽  
Sahar Abdollahi
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Head ◽  
Cross Sectional Study ◽  
Optic Disk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nerve Sheath ◽  
Nerve Sonography ◽  
Optic Nerve Sonography

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination.Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes.Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100% for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90% for the right eye and 87% for the left eye.Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage.

scholarly journals Corneal Segmentation Analysis Increases Glaucoma Diagnostic Ability of Optic Nerve Head Examination, Heidelberg Retina Tomograph’s Moorfield’s Regression Analysis, and Glaucoma Probability Score

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
F. Saenz-Frances ◽  
L. Jañez ◽  
C. Berrozpe-Villabona ◽  
L. Borrego-Sanz ◽  
L. Morales-Fernández ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Open Angle Glaucoma ◽  
Characteristic Curve ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Receiver Operator Characteristic Curve ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Segmentation Analysis

Purpose. To study whether a corneal thickness segmentation model, consisting in a central circular zone of 1 mm radius centered at the corneal apex (zone I) and five concentric rings of 1 mm width (moving outwards: zones II to VI), could boost the diagnostic accuracy of Heidelberg Retina Tomograph’s (HRT’s) MRA and GPS.Material and Methods. Cross-sectional study. 121 healthy volunteers and 125 patients with primary open-angle glaucoma. Six binary multivariate logistic regression models were constructed (MOD-A1, MOD-A2, MOD-B1, MOD-B2, MOD-C1, and MOD-C2). The dependent variable was the presence of glaucoma. In MOD-A1, the predictor was the result (presence of glaucoma) of the analysis of the stereophotography of the optic nerve head (ONH). In MOD-B1 and MOD-C1, the predictor was the result of the MRA and GPS, respectively. In MOD-B2 and MOD-C2, the predictors were the same along with corneal variables: central, overall, and zones I to VI thicknesses. This scheme was reproduced for model MOD-A2 (stereophotography along with corneal variables). Models were compared using the area under the receiver operator characteristic curve (AUC).Results. MOD-A1-AUC: 0.771; MOD-A2-AUC: 0.88; MOD-B1-AUC: 0.736; MOD-B2-AUC: 0.845; MOD-C1-AUC: 0.712; MOD-C2-AUC: 0.838.Conclusion. Corneal thickness variables enhance ONH assessment and HRT’s MRA and GPS diagnostic capacity.

Association Between Glycaemic Control and the Intake of Thiazide Diuretics, Beta Blockers and Levothyroxine in People Without Diabetes

2019 ◽  
Author(s):  
Johannes Roth ◽  
Nicole Müller ◽  
Nadine Kuniss ◽  
Gunter Wolf ◽  
Ulrich Alfons Müller
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Beta Blockers ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Drug Intake ◽  
Oral Glucose ◽  
Minor Importance ◽  
Cross Sectional ◽  
Additional Information

Abstract Objective The pharmacological additional information for many medications includes warnings stating that the blood sugar control may be worsened by the intake of certain drugs. However a quantification of the effects is missing. This may result in confusion for patients as well as for their physicians. The aim of this study was to assess a potential association between medication (beta blockers, thiazides, levothyroxine) and HbA1c in people without diabetes. Methods In this cross-sectional study we analysed data from 2 921 people (7 699 visits) without diabetes (age 46.6 y; 69.1% women; BMI 27.6±6.4 kg/m²; HbA1c 5.2%) who had at least one HbA1c determination and a complete documentation of their drug intake. An oral glucose tolerance test was not performed. The participants were divided in 8 groups (no regular drug intake, levothyroxine alone, beta blockers alone, thiazides alone, combination 2 of 3, combination of all 3). Patients with known distorting influences of the HbA1c were excluded. Results People with no regular drug intake had an HbA1c of 5.4% [35.8 mmol/mol]. The HbA1c of the group that took all 3 drugs in combination was 5.6% [38.2 mmol/mol]. A multiple linear mixed model showed an increase in HbA1c for thiazides (β=0.0558, p=0.025) and a decrease for combination of levothyroxine and thiazide (β=−0.0765, p=0.010). Conclusion Thiazides and the combination of levothyroxine and thiazides were associated with slight changes in HbA1c. In this study there was no association between the intake of beta blockers and HbA1c. At least for people without diabetes these effects seem to be of minor importance.

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