The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Abstract Background: To observe the retinal lesions in HIV/AIDS patients and to evaluate the consistency of non-mydriatic ultra-wide-field (UWF) retinal imaging and mydriatic slit lamp biomicroscope with Superfield lens. Methods: 193 eyes of 98 consecutive HIV/AIDS patients were enrolled. The retinal lesions in each patients were observed through UWF fundus imaging and slit lamp biomicroscopic with Superfield lens whose consistency was analyzed. Results: 100 eyes (51.8%） had fundus lesions, 20 eyes (20%) presented posterior microvascular retinopathy (MVR), 19 eyes (19%) presented peripheral MVR, 15 eyes (15%) presented early stage cytomegalovirus retinitis (CMVR), 6 eyes showed initial stage CMVR, and 51 eyes showed other changes (papilledema, etc.). The consistency of two methods was moderate in detecting the isolated peripheral lesions (Kappa = 0.445) or HIV-related MVR (Kappa = 0.513), and high in inspecting the posterior/posterior involved lesions (Kappa = 0.831) or CMVR (Kappa = 1.0). The detection rate of UWF retinal imaging and slit lamp biomicroscopic were 15.5%（30/193）and 17.6%（34/193）(P=0.557＞0.05) for HIV-related MVR, 7.8% (15/193) (P=1.000＞0.05) for CMVR, 37.3% (72/193) and 33.7% (65/193) (P=0.118＞0.05) for posterior/posterior involved lesions, 8.8% (17/193) and 17.6% (34/193) (P=0.001＜0.05) for isolated peripheral lesions , respectively. Conclusions: The HIV-related MVR can be posterior or peripheral. Various fundus changes appear in HIV/AIDS patients, not only MVR or CMVR. The non-mydriatic UWF fundus imaging system and mydriatic slit lamp biomicroscope exhibited good consistency and nondiscriminatory detection rate for CMVR, HIV-related MVR and posterior lesions, but not for isolated peripheral lesions.

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Neonatal eye screening for 203 healthy term newborns using a wide-field digital retinal imaging system

10.21203/rs.2.16561/v1 ◽

2019 ◽

Author(s):

Kenneth Teow Kheng Leong ◽

Siti Nur Amira Abu Kassim ◽

Jasvinjeet Kaur Sidhu ◽

Zayani Zohari ◽

Thivakar Sivalingam ◽

...

Keyword(s):

Imaging System ◽

Retinal Imaging ◽

Common Finding ◽

Wide Field ◽

Retinal Haemorrhage ◽

Cross Sectional ◽

Ocular Abnormalities ◽

Eye Screening ◽

Term Newborns ◽

Retinal Haemorrhages

Abstract Purpose This study aimed to determine the proportion and types of ocular abnormalities detected in healthy term newborns and also the risk factors associated with retinal haemorrhages. Method This cross-sectional study comprised of 203 participants, all healthy term newborn infants in the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a six months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared with similar studies previously published in the literature. Results Total ocular abnormalities were detected in 34% infants. The most common finding was retinal haemorrhage in 29.6% infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly four times higher risk of newborns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1 minute increment in the duration of 2nd stage of labour. Newborns delivered via SVD with episiotomy had 2.5 higher odds of developing retinal haemorrhage in newborns compared to SVD without episiotomy. Conclusion Universal eye screening for all newborns using a wide-field digital imaging system is possible, safe and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage. Although most resolve spontaneously, a longitudinal study is needed to study the long term effect of retinal haemorrhages in these infants.

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Neonatal eye screening for 203 healthy term new-borns using a wide-field digital retinal imaging system

BMC Ophthalmology ◽

10.1186/s12886-021-01882-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kenneth Teow Kheng Leong ◽

Siti Nur Amira Abu Kassim ◽

Jasvinjeet Kaur Sidhu ◽

Zayani Zohari ◽

Thivakar Sivalingam ◽

...

Keyword(s):

Imaging System ◽

Retinal Imaging ◽

Common Finding ◽

Wide Field ◽

Retinal Haemorrhage ◽

Cross Sectional ◽

Ocular Abnormalities ◽

New Born ◽

Eye Screening ◽

Eye Examination

Abstract Background The current practice for new-born eye examination by an Ophthalmologist in Malaysian hospitals is limited to only preterm new-borns, syndromic or ill infants. Healthy term new-borns are usually discharged without a thorough eye examination. This study is aimed at determining the proportion and types of ocular abnormalities detected in purportedly healthy term new-borns. Method This cross-sectional study is comprised of 203 participants, all purportedly healthy term new-born infants from the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a 6 months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared and correlated with similar studies published in the literature previously. Results Total ocular abnormalities were detected in 34% of the infants. The most common finding was retinal haemorrhage in 29.6% of the infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of new-borns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1-min increment in the duration of 2nd stage of labour. Conclusion Universal eye screening for all new-borns using a wide-field digital imaging system is realistically possible, safe, and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage.

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Wide-field Imaging of Retinal Diseases

US Ophthalmic Review ◽

10.17925/usor.2015.08.02.125 ◽

2015 ◽

Vol 08 (02) ◽

pp. 125 ◽

Cited By ~ 1

Author(s):

Esther Lee Kim ◽

Andrew A Moshfeghi ◽

◽

Keyword(s):

Retinal Imaging ◽

Vascular Diseases ◽

Posterior Uveitis ◽

Fundus Photography ◽

Wide Field ◽

Advantages And Disadvantages ◽

Fundus Imaging ◽

Multiple Imaging ◽

Field Imaging ◽

Wide Field Imaging

Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications.

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Design and Simulation of an Ultra-Wide Field Optical Coherence Tomography Retinal Imaging System

Photonics ◽

10.3390/photonics8110476 ◽

2021 ◽

Vol 8 (11) ◽

pp. 476

Author(s):

Shanshan Liang ◽

Xinyu Li ◽

Jiajing Kang ◽

Mingming Wan ◽

Jiahui Wang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Imaging System ◽

Optical Design ◽

Retinal Imaging ◽

Wide Field ◽

Optical Coherence ◽

Tomography System ◽

Imaging Simulation ◽

Unique Approach ◽

Working Distance

Peripheral retinal imaging is a unique approach for assessing and monitoring ocular diseases. In this paper, we proposed a design for an optical coherence tomography system to accomplish ultrawide field (>120°) retinal imaging without montages. Scanning of the sample arm was achieved via two ellipsoidal mirrors. The optical design software Zemax and an eye model were used to estimate the inherent aberrations in the system and the optical performance of retinal imaging. Simulation results of the aberrations in the designed system indicated that the designed system can achieve an unprecedented imaging field of view (FOV) while maintaining acceptable resolution without sacrificing the working distance. This work suggests that ultrawide field optical coherence tomography retinal imaging is achievable, which is highly important for the diagnosis and treatment of ocular—especially peripheral—retinopathy.

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Association Between Types of Posterior Staphyloma and Refractive Error After Cataract Surgery for High Myopia

Frontiers in Neurology ◽

10.3389/fneur.2021.736404 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jing Wu ◽

Ruochen Wang ◽

Can Liu ◽

Yu Zhou ◽

Ziyuan Jiang ◽

...

Keyword(s):

Cataract Surgery ◽

Refractive Error ◽

High Myopia ◽

Imaging System ◽

Linear Regression Analysis ◽

Wide Field ◽

Multivariate Linear Regression Analysis ◽

Posterior Staphyloma ◽

Fundus Imaging ◽

Corrected Distance Visual Acuity

Purpose: To investigate the association between different types of posterior staphyloma (PS) and refractive error (RE) after cataract surgery in patients with high myopia.Methods: This retrospective study included 113 eyes of 113 highly myopic patients with PS. PS was detected using a wide-field fundus imaging system. PS was classified into wide macular, narrow macular, and other types. RE equaled the actual spherical equivalent (SE) minus the targeted SE values 3 months after cataract surgery.Results: The rates of wide macular, narrow macular, and other types of PS were 46.02, 39.82, and 14.16%, respectively. There were no significant differences in best corrected distance visual acuity (BCDVA) or SE among the three classifications of PS before cataract surgery (P > 0.05). However, postoperative BCDVA and SE were significantly different among the three types of PS patients (P < 0.05). The average RE values were 0.98 ± 1.00 D, 0.19 ± 0.87 D, 0.13 ± 0.59 D, respectively; the statistical differences of RE were <0.01, <0.01, and 0.81 (wide macular vs. narrow macular, wide macular vs. other types, narrow macular vs. other types), respectively. Multivariate linear regression analysis revealed that higher hyperopia RE after surgery was associated with wide macular staphyloma (P < 0.001), more myopic SE (P = 0.003), and increased BCDVA (P = 0.002) before surgery.Conclusions: Wide macular PS may be associated with more hyperopic RE; it may serve as a critical biomarker of hyperopic RE after cataract surgery in highly myopic patients.

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Developing and establishing an advanced nursing practice for HIV abd AIDS patients.

Pflege ◽

10.1024/1012-5302.15.6.293 ◽

2002 ◽

Vol 15 (6) ◽

pp. 293-299 ◽

Cited By ~ 2

Author(s):

Rebecca Spirig ◽

Dunja Nicca ◽

V. Werder ◽

J. Voggensperger ◽

Miriam Unger ◽

...

Keyword(s):

Nursing Practice ◽

Aids Patients ◽

Advanced Nursing Practice ◽

Hiv Aids

Die Entwicklung und Etablierung einer erweiterten und vertieften Pflegepraxis («Advanced Nursing Practice») ist ein wichtiger Schritt in Richtung einer zukunftsorientierten Pflege. An der HIV-Sprechstunde der Medizinischen Universitätspoliklinik des Kantonsspitals Basel, wo akut- und chronischkranke PatientInnen mit HIV/Aids medizinisch und pflegerisch behandelt werden, wurde deshalb ein Aktionsforschungsprojekt in Gang gesetzt mit dem Ziel, PatientInnen kompetentere Dienstleistungen anzubieten. Partizipative Aktionsforschung ist ein Prozess, mit dem gleichzeitig Wissen über ein System generiert und dieses System verändert wird. Im Mittelpunkt des Prozesses steht die kontinuierliche Analyse, Verbesserung und Evaluation der Pflege zugunsten von Patienten und Angehörigen. Eine erweiterte und vertiefte HIV/Aids-Pflegepraxis erfordert solides Grundlagenwissen über die Krankheit und über die aktuelle Behandlung. Patientenpräferenzen, Caring, Erfahrungswissen und Evidenz sind wesentliche konzeptuelle Grundpfeiler. Neben der Aneignung von neuen Kenntnissen spezialisierten sich die Pflegenden in einem von ihnen gewählten Gebiet der HIV/Aids-Pflege, z.B. im Umgang mit Medikamenten und der Bedeutung der Therapietreue, Gesundheitsförderung und Prävention oder im Umgang mit Symptomen, um Beratungen und Schulungen für PatientInnen und Angehörige anzubieten. Mit einer erweiterten und vertieften Pflegepraxis werden Pflegende befähigt, den sich abzeichnenden Veränderungen im Gesundheitswesen zukünftig proaktiv begegnen zu können.

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