Ideal Illumination for Smartphone-based Trabeculectomy Bleb Photography

Purpose: Ophthalmology has seen numerous novel uses for smartphones over the years including fundus photography, telemedicine, and operative videography. However, anterior segment photography for assessing and documenting trabeculectomy bleb morphology using a smartphone has not been explored in detail. With the current study, we aim to characterize ideal illumination for the anterior segment smartphone photography in trabeculectomy patients. Methods: Thirty status post-trabeculectomy patients were enrolled in this study. Native camera application and FiLMiC pro camera application were used on iPhone X to compare bleb images using yellow and white pen-torches as illumination source. Measured bleb area was compared using ImageJ software from the two apps in different illumination settings by charting boxplots and using one-way ANOVA test using R software to establish consistency. Bland-Altman interoperability for repeatability of blebarea measurements was analyzed by plotting Bland-Altman plots. Signal-to-noise ratio was calculated using ImageJ for native camera images using slit-lamp camera images as reference. Subjective rating of these images was then performed by two experienced ophthalmologists and kappa coefficient was calculated for inter-operator repeatability. Statistical analysis was performed. Results: The measured bleb area from images taken from both apps showed no significant difference, thereby establishing consistency, and Bland-Altman analysis indicated good repeatability and reproducibility. It was noted that SNR was lower for images shot in close illumination as compared to the ones shot in intermediate and distant illumination. Cohen’s kappa coefficient was 0.7 for images with distant illumination using white light and 0.65 for images clicked with illumination at an intermediate distance using yellow light, suggesting substantial agreement between the observers. Conclusion: Smartphone photography is a reliable tool for morphological assessment trabeculectomy blebs. Optimal illumination helps achieve results free from digital noise and better delineation of specific morphological features. Intermediate illumination and distant illumination provides much better results in terms of high SNR while avoiding overexposure and clipping of highlight information in the images.

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Choroidal vascularity index in thyroid-associated ophthalmopathy: a cross-sectional study

Eye and Vision ◽

10.1186/s40662-021-00242-6 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Pasquale Loiudice ◽

Marco Pellegrini ◽

Michele Marinò ◽

Barbara Mazzi ◽

Ilaria Ionni ◽

...

Keyword(s):

Cross Sectional Study ◽

Activity Score ◽

Enhanced Depth Imaging ◽

Clinical Activity ◽

Healthy Controls ◽

Cross Sectional ◽

Clinical Activity Score ◽

Significant Difference ◽

Thyroid Associated Ophthalmopathy ◽

Imagej Software

Abstract Background Hemodynamic changes have been observed in patients with Graves’ disease. The aim of our study was to evaluate choroidal vascular change using the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO). Methods In this cross-sectional observational study, 40 patients affected by TAO were recruited. Forty healthy individuals, matched for age and sex, served as controls. Foveal enhanced-depth imaging optical coherence tomography scans were obtained from all participants. Images were binarized using the ImageJ software and luminal area (LA) and total choroidal area (TCA) were measured. CVI was calculated as the proportion of LA to TCA. The relation between CVI or subfoveal choroidal thickness (SFCT) and clinical activity score, exophthalmometric value, diplopia status, gender, and age was evaluated. Results CVI was significantly higher in patients with TAO (P = 0.004). No significant difference was observed in SFCT (P = 0.200) and TCA (P = 0.153) comparing TAO patients and healthy controls. LA was significantly higher in TAO group (P = 0.045). On multiple regression analysis, CVI was associated with TCA (P = 0.043). No association was found between SFCT or CVI and TCA, clinical activity score, exophthalmometric value, Inami value, diplopia status, gender or age (P > 0.05). Conclusions This is the first study that has demonstrated an increase in CVI in eyes with TAO compared with healthy controls and has assessed its association with clinical features.

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Assessing Stability of Crutch Users by Non-Contact Methods

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063001 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3001

Author(s):

Achilles Vairis ◽

Suzana Brown ◽

Maurice Bess ◽

Kyu Hyun Bae ◽

Jonathan Boyack

Keyword(s):

Signal To Noise Ratio ◽

Time Derivative ◽

Assistive Devices ◽

Signal To Noise ◽

Physically Disabled ◽

Significant Difference ◽

Novice Users ◽

Noise Ratio ◽

Physically Disabled People

Enhancing gait stability in people who use crutches is paramount for their health. With the significant difference in gait compared to users who do not require an assistive device, the use of standard gait analysis tools to measure movement for temporary crush users and physically disabled people proves to be more challenging. In this paper, a novel approach based on video analysis is proposed as non-contact low-cost solution to the more expensive alternative with the data collected from processed videos, two values are calculated: the Signal to Noise Ratio (SNR) of acceleration, and the Signal to Noise Ratio of the jerk (time derivative of acceleration), to assess the user’s stability while they walk with crutches. The adopted methodology has been tested on a total of 10 participants. Five are temporary users of assistive devices with one being a long-term user and the other four novice users, and five are disabled participants who use those assistive devices permanently. Preliminary results show differences between novice users, long-term users, and physically disabled users. The approach is promising and could improve the assessment of crutch user stability, allowing for the correction of gait for individuals while using an inexpensive non-contact setup and preventing unnecessary falls.

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Subtle changes of the crystalline lens after cycloplegia: a retrospective study

BMC Ophthalmology ◽

10.1186/s12886-021-01884-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cheng Dai ◽

Meng Liu ◽

Xiaodong Lv ◽

Binzhong Li

Keyword(s):

Retrospective Study ◽

Children And Adolescents ◽

Population Change ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Crystalline Lens ◽

Equivalent Diameter ◽

Crystalline Morphology ◽

Significant Difference ◽

Before And After

Abstract Background The purpose of this study was to evaluate the shape of the crystalline lens in terms of biometry and diopters before and after cycloplegia using the CASIA2 swept-source (SS) optical coherence tomography (OCT) system on the anterior segment. Methods This was a retrospective study. Children and adolescents (26 males and 29 females, aged 4–21 years) with simple ametropia were selected for optometry and CASIA2 imaging at 2 separate visits before and after cycloplegia. Diopter values were derived from the spherical power (S) obtained by optometry. Biometric parameters of the crystalline lens, including the anterior chamber depth (ACD), anterior and posterior curvature of the lens (ACL and PCL), lens thickness (LTH), lens decentration (LD), lens tilt (LT), and equivalent diameter of the lens (LED), were measured by the CASIA2 system. The differences in these parameters after compared with before cycloplegia were determined, and their relationships were analyzed. Results Fifty-five participants (106 eyes) were initially enrolled. There was a significant difference (P < 0.05) in the S (t=-7.026, P < 0.001), ACD (t=-8.796, P < 0.001), ACL (t=-13.263, P < 0.001) and LTH (t = 7.363, P < 0.001) after compared with before cycloplegia. The change in the PCL (t = 1.557, P = 0.122), LD (t = 0.876, P = 0.383), LT (t = 0.440, P = 0.661) and LED (t=-0.351, P = 0.726) was not statistically significant (P > 0.05). There was a significant (P < 0.05) correlation of the change in the S with that in the ACL (r = 0.466, P < 0.001), LTH (r=-0.592, P < 0.001), and LED (r = 0.223, P = 0.021) but not the PCL (r = 0.19, P = 0.051), LD (r=-0.048, P = 0.0628) or LT (r=-0.022, P = 0.822). Furthermore, the change in the ACD was closely related to the change in crystalline morphology. However, in children and adolescents, we found that the change in crystalline morphology was unrelated to age. Conclusions Changes in lens morphology after compared with before cycloplegia are mainly related to the ACL and LTH, but there is no difference in the PCL, LD, LT, or LED. In the adolescent population, change in the S is related to change in the ACL, LED and LTH. However, age is unrelated to the shape and tendency of the crystalline lens. Further research is required to determine whether the same conclusion applies to different age groups and different refractive states (myopia, hyperopia, emmetropia) .

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A novel approach to radiographic detection of bucco-palatal/lingual dilacerations: A preliminary study with ImageJ

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/09544119211030717 ◽

2021 ◽

pp. 095441192110307

Author(s):

Samed Satir ◽

Muhammed Hilmi Buyukcavus ◽

Kaan Orhan

Keyword(s):

Longitudinal Axis ◽

Control Group ◽

Single Root ◽

Novel Approach ◽

Significant Difference ◽

Spectrum Feature ◽

Group 2 ◽

Imagej Software ◽

And Control ◽

Control Group Group

The purpose of our study is to determine whether bucco-palatal/lingual (BPL) root dilacerations (RD), especially in single root teeth, can be determined using the ImageJ program through only one periapical radiography. Extracted teeth without any RD ( n = 8) were determined as the control group (Group 1) and with RD in apical 1/3 part at least 20° with the longitudinal axis in the BPL direction ( n = 8) as the study group (Group 2). With the help of a simple holder system prepared, digital periapical radiographs of all teeth were taken in an anteroposterior position. Histogram analysis of all periapical radiographs was performed using the spectrum feature of ImageJ software. It was aimed to make a dilaceration analysis by comparing the groups using mean, standard deviation, minimum, maximum, and bin width values. As a result of the Mann-Whitney U test, all mean and maximum values showed a statistically significant difference between the study and control groups ( p < 0.05). This pilot study revealed that the ImageJ software can be used to diagnose BPL dilaceration in the apical 1/3 part of the root. It is important for dentists and patients that it can contribute to limiting the radiation dose to which patients will be exposed.

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Minimizing table time in patients with claustrophobia using focused ferumoxytol-enhanced MR angiography (f-FEMRA): a feasibility study

British Journal of Radiology ◽

10.1259/bjr.20210430 ◽

2021 ◽

Vol 94 (1125) ◽

pp. 20210430

Author(s):

Puja Shahrouki ◽

Kim-Lien Nguyen ◽

John M. Moriarty ◽

Adam N. Plotnik ◽

Takegawa Yoshida ◽

...

Keyword(s):

Image Quality ◽

Mr Angiography ◽

Signal To Noise Ratio ◽

Diagnostic Image Quality ◽

Diagnostic Confidence ◽

Motion Artefact ◽

Scan Time ◽

Wilcoxon Rank Sum Test ◽

Significant Difference ◽

Noise Ratio

Objectives: To assess the feasibility of a rapid, focused ferumoxytol-enhanced MR angiography (f-FEMRA) protocol in patients with claustrophobia. Methods: In this retrospective study, 13 patients with claustrophobia expressed reluctance to undergo conventional MR angiography, but agreed to a trial of up to 10 min in the scanner bore and underwent f-FEMRA. Thirteen matched control patients who underwent gadolinium-enhanced MR angiography (GEMRA) were identified for comparison of diagnostic image quality. For f-FEMRA, the time from localizer image acquisition to completion of the angiographic acquisition was measured. Two radiologists independently scored images on both f-FEMRA and GEMRA for arterial and venous image quality, motion artefact and diagnostic confidence using a 5-point scale, five being best. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aorta and IVC were measured. The Wilcoxon rank-sum test, one-way ANOVA with Tukey correction and two-tailed t tests were utilized for statistical analyses. Results: All scans were diagnostic and assessed with high confidence (scores ≥ 4). Average scan time for f-FEMRA was 6.27 min (range 3.56 to 10.12 min), with no significant difference between f-FEMRA and GEMRA in diagnostic confidence (4.86 ± 0.24 vs 4.69 ± 0.25, p = 0.13), arterial image quality (4.62 ± 0.57 vs 4.65 ± 0.49, p = 0.78) and motion artefact score (4.58 ± 0.49 vs 4.58 ± 0.28, p > 0.99). f-FEMRA scored significantly better for venous image quality than GEMRA (4.62 ± 0.42 vs 4.19 ± 0.56, p = 0.04). CNR in the IVC was significantly higher for steady-state f-FEMRA than GEMRA regardless of the enhancement phase (p < 0.05). Conclusions: Comprehensive vascular MR imaging of the thorax, abdomen and pelvis can be completed in as little as 5 min within the magnet bore using f-FEMRA, facilitating acceptance by patients with claustrophobia and streamlining workflow. Advances in knowledge: A focused approach to vascular imaging with ferumoxytol can be performed in patients with claustrophobia, limiting time in the magnet bore to 10 min or less, while acquiring fully diagnostic images of the thorax, abdomen and pelvis.

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A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽

10.1093/qjmed/hcab109.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Basma Helal Mohamed ◽

Othman Ali Othman Ziko ◽

Hisham M Khairy Abd El Dayem ◽

Nancy Ezzelregal Khamis Ahmed

Keyword(s):

Corneal Thickness ◽

Anterior Segment ◽

P Value ◽

Eye Drops ◽

Subconjunctival Injection ◽

Fibrovascular Tissue ◽

Significant Difference ◽

Group 2 ◽

Group 1 ◽

Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

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Gender similarity in low agreement between written and video ISAAC asthma questionnaires

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2006.547 ◽

2016 ◽

Vol 65 (4) ◽

Author(s):

M. Gharagozlou ◽

S. Khalili ◽

M. Hallajmofrad ◽

R. Mohammadzadeh ◽

G. Mousavi ◽

...

Keyword(s):

Secondary Schools ◽

School Children ◽

Childhood Asthma ◽

Central Area ◽

Kappa Coefficient ◽

Asthma Prevalence ◽

International Studies ◽

Asthma Symptoms ◽

Significant Difference ◽

Gender Similarity

Background and Aim. The prevalence of childhood asthma varies among different nations and appears to have increased in recent years. It has been difficult to determine this prevalence precisely and compare the communities due to the lack of a standardized method. The International Studies of Asthma and Allergies in Childhood (ISAAC) has developed a written and video questionnaire to measure asthma prevalence and overcome these difficulties. This study was carried out to determine the prevalence of childhood asthma in Kashan, the central area of Iran, and to assess the agreement between the ISAAC written and video questionnaires and its gender relationship. Methods. Between December 2002 and June 2003, 2533 school children, aged 13-14 years, in Kashan secondary schools completed sequentially the ISAAC written and video questionnaires. The agreement between responses to the two questionnaires for reported “ever wheeze”, “exercise wheeze”, “night wheeze” and “night cough” was determined, using kappa coefficient and concordance. Results. The prevalence of asthma symptoms were significantly lower in the responses to the video questionnaire compared with the written questionnaire. Kappa coefficient showed only poor to fair agreement (κ = 0.13- 0.24) between video and written questionnaires, although the concordance between them always exceeded 60%. Conclusions. This study showed that reported asthma symptoms based on video questionnaires were significantly lower than the written questionnaire, and that there is low agreement between the two questionnaires which requires further investigation to explain the findings. In addition, this investigation revealed no significant difference between the genders for this low agreement.

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Detection of Hydroxychloroquine Retinal Toxicity by Automated Perimetry in 60 Rheumatoid Arthritis Patients with Normal Fundoscopic Findings

Global Journal of Health Science ◽

10.5539/gjhs.v8n3p59 ◽

2015 ◽

Vol 8 (3) ◽

pp. 59 ◽

Cited By ~ 2

Author(s):

Qader Motarjemizadeh ◽

Naser Samadi Aidenloo ◽

Mohammad Abbaszadeh

Keyword(s):

Rheumatoid Arthritis ◽

Early Detection ◽

Anterior Segment ◽

Field Testing ◽

Retinal Toxicity ◽

Screening Tests ◽

Automated Perimetry ◽

Cross Sectional ◽

Dry Eyes ◽

Significant Difference

<p>Hydroxychloroquine (HCQ) is an antimalarial drug used extensively in treatment of autoimmune diseases such as rheumatoid arthritis. Retinal toxicity is the most important side effects of this drug. Even after the drug is discontinued, retinal degeneration from HCQ can continue to progress. Consequently, multiple ophthalmic screening tests have been developed to detect early retinopathy. The aim of the current study was to evaluate the value of central 2-10 perimetry method in early detection of retinal toxicity. This prospective cross-sectional investigation was carried out on 60 rheumatoid arthritis patients, who had been receiving HCQ for at least 6 months and still were on their medication (HCQ intake) at the time of enrollment. An ophthalmologist examined participants using direct and indirect ophthalmoscopy. Visual field testing with automated perimetry technique (central 2-10 perimetry with red target) was performed on all included subjects twice in 6 months interval: The first one at the time of enrollment and the second one 6 months later. Males and females did not show any significant difference in terms of age, duration of therapy, daily and cumulative HCQ dose, anterior or posterior segment abnormalities, hypertension, body mass index, and best corrected visual acuity. Anterior segment was abnormal in 9 individuals including 3 subjects with macular pigmentary changes, 4 individuals with cataract and 2 cases with dry eyes. Moreover, 12 subjects had retinal pigmented epithelium (RPE) in their posterior segments. After 6 months, depressive changes appeared in 12 subjects. Additionally, HCQ therapy worsened significantly the perimetric results of 5 (55.6%) patients with abnormal anterior segment. A same trend was observed in perimetric results of 6 (50.0%) subjects with abnormal posterior segments (P=0.009). The daily dose of HCQ (P=0.035) as well as the cumulative dose of hydroxychloroquine (P=0.021) displayed statistically significant associations with perimetric results. Central 2-10 perimetry is a useful method for early detection of HCQ retinal toxicity, but more comprehensive studies, with larger sample size, longer-term follow-up and more precise techniques are mandatory to confirm HCQ retinal toxicity.</p>

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Bracket base remnants after orthodontic debonding

The Angle Orthodontist ◽

10.2319/121112-930.1 ◽

2013 ◽

Vol 83 (5) ◽

pp. 885-891 ◽

Cited By ~ 7

Author(s):

Matteo Zanarini ◽

Antonio Gracco ◽

Monica Lattuca ◽

Silvia Marchionni ◽

Maria Rosaria Gatto ◽

...

Keyword(s):

Energy Dispersive ◽

Scanning Electron Micrographs ◽

X Ray ◽

Significant Difference ◽

Group A ◽

Fixed Appliances ◽

Group B ◽

Imagej Software ◽

Bracket Base ◽

Scanning Electron

ABSTRACT Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding. Materials and Methods: Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed; the brackets presenting some remnants on the base (n = 818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n = 100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data. Results: Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P < .0001 and P = .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%); group B, bases showing sizable enamel fragments (7%); group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P < .323 and P = .0001, respectively). Conclusion: The objective of an atraumatic debonding is not achieved yet; in some cases the damage could be clinically relevant.

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Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

10.21203/rs.3.rs-1245764/v1 ◽

2022 ◽

Author(s):

Mahmoud Ekram ◽

Ahmed Mohamed Kamal Elshafei ◽

Asmaa Anwar Mohamed ◽

Mohamed Farouk Sayed Othman Abdelkader

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Contact Lens ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Case Series ◽

Care Group ◽

Case Series Study ◽

Significant Difference ◽

The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

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