المؤلفون: Dayakar Yadalla, Emily M. Schehlein, Rengaraj Venkatesh, Joshua D. Stein, Joshua R. Ehrlich, David W. Hutton

المصدر: Ophthalmology Retina. 5:1107-1114

مصطلحات موضوعية: 0303 health sciences, Pediatrics, medicine.medical_specialty, Refractive error, genetic structures, Referral, medicine.diagnostic_test, business.industry, Eye disease, Visual impairment, Fundus photography, Glaucoma, Diabetic retinopathy, medicine.disease, eye diseases, Posterior segment of eyeball, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, Medicine, medicine.symptom, business, 030304 developmental biology

الوصف: Purpose Rural screening camps in India historically have focused on detection of cataract and uncorrected refractive error. This study aimed to increase detection, referral, and follow-up for posterior segment diseases (PSDs) in rural eye camps using a novel technology-driven eye camp model. Design A clustered nonrandomized trial in the catchment area of Aravind Eye Care System (AECS) Pondicherry, to compare 2 eye camp models: the traditional AECS eye camp model and the novel, technology-driven, eye camp model. Participants Patients 40 to 75 years of age who attended free camps conducted by AECS Pondicherry. Those with corneal pathologic features were excluded because this precluded an adequate view of the posterior segment to screen for PSD. Methods The clinical protocols in the 2 arms were standardized and the same study team was used in both study arms. The unit of allocation to the 2 study arms was at the level of the eye camp, rather than the level of the individual study participant. Main Outcome Measures The primary study outcome was detection of suspected PSD (glaucoma, diabetic retinopathy, age-related macular degeneration, other PSDs). Secondary outcomes included: (1) the proportion of referred participants who underwent an examination at the base hospital and (2) the proportion with confirmed PSD on examination at the base hospital. Results The study included 11 traditional and 18 novel eye camps with a total of 3048 participants (50% in each study arm). The mean age of all participants was 58.4 ± 9.1 years and 1434 participants (47%) were men. The proportion receiving a referral for PSD was significantly greater in the novel (8.3%) compared with the traditional (3.6%) eye camp (P Conclusions In a resource-constrained setting, use of digital fundus photography in novel eye camps resulted in increased detection of and referral for PSD. Further research is needed to determine whether this intervention is cost effective and may contribute to prevention of avoidable blindness and visual impairment in South India. Further research also is needed to improve follow-up of patients referred from camps for suspicion of PSD.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::1751f9750e6723b1f3eb308ae2b0521aTest
https://doi.org/10.1016/j.oret.2021.01.005Test

المؤلفون: Sabyasachi Sengupta, Rengaraj Venkatesh, Mohideen Abdul Kader, Pradeep Y. Ramulu, Elizabeth C. Ciociola, Janey L. Wiggs, Sharmila Rajendrababu, Srinivasan Kavitha, Ganesh Raman, Nazlee Zebardast

المصدر: American Journal of Ophthalmology. 230:188-199

مصطلحات موضوعية: Proband, 0303 health sciences, medicine.medical_specialty, Biometry, business.industry, Siblings, Concordance, Gonioscopy, Heritability, Logistic regression, Tonometry, Ocular, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, Residual correlation, Humans, Closure (psychology), Sibling, Glaucoma, Angle-Closure, business, 030304 developmental biology, Cohort study

الوصف: To estimate the heritability of ocular biometric and anterior chamber morphologic parameters and to determine predictors of angle closure concordance in South Indian probands with angle closure and their siblings DESIGN: Prospective observational cohort study METHODS: Subjects received a standardized ophthalmic examination, A-scan ultrasonography, pachymetry, and anterior segment optical coherence tomography (ASOCT) imaging. Heritability was calculated using residual correlation coefficients adjusted for age, sex, and home setting. Concordant sibling pairs were defined as both proband and sibling with angle closure. Predictors of angle closure concordance among siblings were calculated using multivariable logistic regression models.A total of 345 sibling pairs participated. All anterior chamber parameters were highly heritable (P.001 for all). Similarly, all iris parameters, axial length, lens thickness (LT), central corneal thickness, anterior lens curvature, lens vault (LV), spherical equivalent, and intraocular pressure were moderately to highly heritable (P.004 for all). LV and LT were more heritable among concordant siblings (P.05 for both). In contrast, ASOCT angle parameters had statistically insignificant heritability estimates. In multivariable analyses, siblings older than their probands were more likely to be concordant for angle closure (OR 1.05, 95% CI 1.01, 1.09; P = .02) and siblings with deeper anterior chamber depths (ACDs) compared to their proband were less likely to be concordant for angle closure (OR 0.74, 95% CI 0.64, 0.86; P.001).Iris, anterior chamber, and lens parameters may be heritable whereas angle parameters were not. LT and LV may play important roles in the pathogenesis of angle closure. Siblings who are older or have a shallower ACD may need more careful disease monitoring.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::86b51d9b81d04b14481cb30886d8d018Test
https://doi.org/10.1016/j.ajo.2021.04.038Test

المؤلفون: Sanil Joseph, Rengaraj Venkatesh, Alan L. Robin, Sankalp S. Sharma, David C. Musch, Brenda W. Gillespie, Maria A. Woodward, Nakul S. Shekhawat, Leslie M. Niziol

المصدر: Ophthalmology. 128:1060-1069

مصطلحات موضوعية: 0303 health sciences, medicine.medical_specialty, Pediatrics, genetic structures, medicine.diagnostic_test, Referral, business.industry, fungi, Fundus photography, Diabetic retinopathy, Odds ratio, medicine.disease, eye diseases, Confidence interval, Posterior segment of eyeball, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, Epidemiology, 030221 ophthalmology & optometry, medicine, Cluster randomised controlled trial, business, 030304 developmental biology

الوصف: Purpose To assess whether routine fundus photography (RFP) to screen for posterior segment disease at community eye clinics (vision centers [VCs]) in India increases referral to centralized ophthalmolic care. Design Stepped-wedge, cluster-randomized trial. Participants Patients aged 40 to 75 years and those aged 20 to 40 years with a known history of hypertension or diabetes mellitus presenting to 4 technician-run VCs associated with the Aravind Eye Care System in India. Methods VCs (clusters) were randomized to standard care or RFP across five 2-week study periods (steps). Patients in each cluster received standard care initially. At the start of each subsequent step, a randomly chosen cluster crossed over to providing RFP to eligible patients. All clusters took part in RFP during the last step. Standard care involved technician eye exams, optional fundus photography, and teleconsultation with an ophthalmologist. RFP involved eye exams, dilation and 40-degree fundus photography, and teleconsultation with an ophthalmologist. Main Outcome Measures Standard care and RFP clusters were compared by the proportion of patients referred for in-person evaluation by an ophthalmologist because of fundus photography findings and urgency of referral (urgently in ≤ 2 weeks vs. nonurgently in > 2 weeks). Generalized linear mixed models adjusting for cluster and step were used to estimate the odds of referral due to fundus photography findings compared with standard care. Results A total of 1447 patients were enrolled across the VCs, including 737 in the standard care group and 710 in the RFP group. Compared with standard care, the RFP group had a higher proportion of referrals due to fundus photography findings (11.3% vs. 4.4%), nonurgent referrals due to fundus photography (9.3% vs. 3.3%), and urgent referrals due to fundus photography (1.8% vs. 1.1%). The RFP intervention was associated with a 2-fold increased odds of being referred because of photography findings compared with standard care (odds ratio, 2.07; 95% confidence interval, 0.98–4.40; P = 0.058). Conclusions Adding RFP to community eye clinics was associated with an increased odds of referral compared with standard care. This increase in referral was mostly due to nonurgent posterior segment disease.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::cfc42b4ef174409e59339a8ce5a7cea5Test
https://doi.org/10.1016/j.ophtha.2020.11.025Test

المؤلفون: Sumathy Sundar, Satish Kumar Muddana, Rengaraj Venkatesh, Olivia Hess

المصدر: Journal of Cataract and Refractive Surgery. 47:471-475

مصطلحات موضوعية: medicine.medical_treatment, India, Anxiety, behavioral disciplines and activities, Cataract, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Phacoemulsification, business.industry, Perioperative, Middle Aged, Cataract surgery, humanities, Sensory Systems, Ophthalmology, Blood pressure, Anesthesia, 030221 ophthalmology & optometry, Surgery, medicine.symptom, business, Music, 030217 neurology & neurosurgery, Period (music)

الوصف: Purpose To determine whether preoperative and perioperative music exposure reduced patient self-rated anxiety and physiologic indicators of stress during first-time phacoemulsification cataract surgery in the high-volume setting. Setting Aravind Eye Care System, Pondicherry, India. Design Prospective single-masked randomized controlled trial. Methods Patients were provided music before and during first-time phacoemulsification in 1 group and patients underwent surgery without music in another group. Measurements of blood pressure (BP), heart rate, respiration rate, and a Likert scale anxiety rating were collected at preoperative, perioperative, and postoperative timepoints. Results One hundred sixty-five patients (aged 53-65 years) were provided music using a portable MP3 player before and during first-time phacoemulsification, and 165 patients underwent surgery without music. Systolic and diastolic BPs were statistically significantly lower in the music intervention group at the postoperative timepoint, with similar physiologic measures between groups during the perioperative timepoints. In the preoperative period, before music exposure, 62 patients (38%) in the music group reported being very or extremely anxious. After 10 minutes of music exposure, only 7 patients (4%) reported this anxiety level. In the perioperative period, 80 patients (48%) in the intervention group reported feeling not at all or a little anxious, compared with 50 patients (30%) of the control group. In the postoperative period, 139 (84%) music group patients felt not at all or a little anxious postoperatively compared with 92 patients (56%) in the control group. Conclusions Marked reductions in self-reported anxiety preoperatively, intraoperatively, and postoperatively when exposed to music and a statistically significant decrease in postoperative BP showed that music can be an inexpensive and effective solution to improve the patient experience of cataract surgery in the high-volume setting.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::598f9ce7f2ce39719b394aca7f45415aTest
https://doi.org/10.1097/j.jcrs.0000000000000485Test

المؤلفون: Annamalai Odayappan, Fredrick Moutappa, Rajesh Vedachalam, Rengaraj Venkatesh, Pankaja Dhoble, Shivananda Narayana, Veena Kannusamy, Priya Sivakumar

المصدر: Eye (Lond)

مصطلحات موضوعية: medicine.medical_specialty, genetic structures, media_common.quotation_subject, Vision Disorders, MEDLINE, India, Vision, Low, Article, 03 medical and health sciences, 0302 clinical medicine, Denial, Severe visual impairment, Perception, Humans, Medicine, In patient, media_common, business.industry, Perspective (graphical), Low vision, Ophthalmology, Eyeglasses, Family medicine, 030221 ophthalmology & optometry, business, Psychosocial, Retinitis Pigmentosa, 030217 neurology & neurosurgery

الوصف: AIM: To understand the barriers in utilisation of low vision assistive products (LVAPs) from the perspective of patients with low vision. METHODS: Patients referred to low vision clinic in a tertiary eye care hospital in India who were prescribed LVAPs but were un-willing to accept the products were interviewed using questionnaires. Data pertaining to the age, diagnosis, gender, occupation, preferred LVAPs, patient’s perception of vision loss and the primary reason for non-acceptance of LVAPs were analysed. RESULTS: A total of 235 among the 413 patients who noticed improvement in visual performance with LVAPs were unwilling to utilise these products. The questionnaire revealed that 53% of the patients who felt they were not candidates for LVAPs were experiencing severe visual impairment (p 60 years (25%; p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::18f99b567949b4ab609f48a3bd65efb8Test
https://doi.org/10.1038/s41433-019-0545-5Test

المؤلفون: Colin E. Willoughby, Srinivasan Kavitha, Bryan M. Williams, Rengaraj Venkatesh, Gabriela Czanner, David S. Friedman, Silvester Czanner, Venkatesh Krishna Adithya

المصدر: Journal of Imaging
Volume 7
Issue 6
Journal of Imaging, Vol 7, Iss 92, p 92 (2021)

مصطلحات موضوعية: Computer science, diagnosis, Computer applications to medicine. Medical informatics, R858-859.7, Article, 030218 nuclear medicine & medical imaging, Convolution, 03 medical and health sciences, 0302 clinical medicine, Photography, Medical imaging, Redundancy (engineering), medicine, Radiology, Nuclear Medicine and imaging, Segmentation, generative model, Electrical and Electronic Engineering, TR1-1050, Block (data storage), business.industry, Pattern recognition, QA75.5-76.95, Computer Graphics and Computer-Aided Design, Generative model, medicine.anatomical_structure, glaucoma, machine learning, classification, Electronic computers. Computer science, 030221 ophthalmology & optometry, Benchmark (computing), Computer Vision and Pattern Recognition, Artificial intelligence, business, Optic disc

الوصف: Current research in automated disease detection focuses on making algorithms “slimmer” reducing the need for large training datasets and accelerating recalibration for new data while achieving high accuracy. The development of slimmer models has become a hot research topic in medical imaging. In this work, we develop a two-phase model for glaucoma detection, identifying and exploiting a redundancy in fundus image data relating particularly to the geometry. We propose a novel algorithm for the cup and disc segmentation “EffUnet” with an efficient convolution block and combine this with an extended spatial generative approach for geometry modelling and classification, termed “SpaGen” We demonstrate the high accuracy achievable by EffUnet in detecting the optic disc and cup boundaries and show how our algorithm can be quickly trained with new data by recalibrating the EffUnet layer only. Our resulting glaucoma detection algorithm, “EffUnet-SpaGen”, is optimized to significantly reduce the computational burden while at the same time surpassing the current state-of-art in glaucoma detection algorithms with AUROC 0.997 and 0.969 in the benchmark online datasets ORIGA and DRISHTI, respectively. Our algorithm also allows deformed areas of the optic rim to be displayed and investigated, providing explainability, which is crucial to successful adoption and implementation in clinical settings.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5460679921794759aa489d24ea3c9385Test

المؤلفون: Alan L. Robin, Bonnielin K. Swenor, Pradeep Y. Ramulu, Wesam Shamseldin Shalaby, Annamalai Odayappan, Aakriti Garg Shukla, Kavitha Srinivasan, Rengaraj Venkatesh

المصدر: American Journal of Ophthalmology

مصطلحات موضوعية: medicine.medical_specialty, Visual acuity, genetic structures, Cross-sectional study, Population, Visual impairment, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, Risk factor, Prospective cohort study, education, Low vision, 030304 developmental biology, 0303 health sciences, education.field_of_study, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Comorbidity, Coronavirus, Ophthalmology, 030221 ophthalmology & optometry, Secondary Outcome Measure, Physical therapy, Visual disability, medicine.symptom, business

الوصف: PURPOSE: TO assess perceptions and implications of COVID-19 infection across the spectrum of individuals with visually impairment (VI) and those with normal sight. DESIGN: Prospective cross-sectional comparative study. METHODS: Setting: institutional. PATIENTS: 232 patients and their caregivers. Four groups were created based on better eye characteristics: blind (best-corrected distance visual acuity [BCDVA]

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2b8041ad094458dd51cfa3a310a496e6Test
http://europepmc.org/articles/PMC7997933Test

المؤلفون: S Usha Tejaswini, Swati Upadhyaya, Priya Sivakumar, Rengaraj Venkatesh

المصدر: Indian Journal of Ophthalmology
Indian Journal of Ophthalmology, Vol 68, Iss 8, Pp 1683-1685 (2020)

مصطلحات موضوعية: medicine.medical_specialty, genetic structures, medicine.medical_treatment, Radius–Maumenee syndrome, Glaucoma, Case Reports, Episcleral veins, nonpenetrating deep sclerectomy, 03 medical and health sciences, 0302 clinical medicine, lcsh:Ophthalmology, Refractory, medicine, Trabeculectomy, Surgical treatment, Carbon dioxide laser-assisted sclerectomy surgery, business.industry, idiopathic elevated episcleral venous pressure, sclera patch grafting, medicine.disease, Diagnosis of exclusion, eye diseases, Surgery, Ophthalmology, Episcleral venous pressure, lcsh:RE1-994, 030221 ophthalmology & optometry, Etiology, business, 030217 neurology & neurosurgery

الوصف: We report a rare case of dilated episcleral veins with unilateral secondary open-angle glaucoma. Our case highlights the possible differentials to be considered and the systematic investigations to be done while ruling out the etiologies. Radius–Maumenee syndrome is a diagnosis of exclusion. Raised IOP can remain refractory to the medical therapy and conventional trabeculectomy carries higher risk of complications. Here, we discuss the choice of surgical treatment and its implications on management of this secondary open-angle glaucoma.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5aa2ff2a7acc03364418cb89386d1497Test
http://europepmc.org/articles/PMC7640848Test

المؤلفون: Aravind Haripriya, Kalpana Narendran, Alan L. Robin, Shivkumar Chandrashekharan, Madhu Shekhar, Pradeep Y. Ramulu, Rengaraj Venkatesh, Rengappa Ramakrishnan, Ravilla D. Ravindran

المصدر: Ophthalmology. 126:362-371

مصطلحات موضوعية: 0303 health sciences, Intraocular pressure, medicine.medical_specialty, Visual acuity, Intraoperative Complication, genetic structures, business.industry, medicine.medical_treatment, Pseudoexfoliation, Postoperative complication, Intraocular lens, Phacoemulsification, Cataract surgery, eye diseases, Surgery, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, sense organs, medicine.symptom, business, 030304 developmental biology

الوصف: Purpose To compare intraoperative complication rates, 1-year visual outcomes, and postoperative complication rates over the first postoperative year in eyes with and without pseudoexfoliation undergoing cataract surgery. Design Prospective, comparative, interventional study. Participants Nine hundred thirty eyes with cataract and uncomplicated pseudoexfoliation (without phacodonesis, clinically shallow anterior chambers, or pupil size Methods All eyes underwent phacoemulsification with IOL implantation and were followed up at 1 day, 1 month, 3 months, and 1 year after surgery. Main Outcome Measures Association of pseudoexfoliation status with intraoperative complication rates, 1-year best-corrected visual acuity, and any other complications. Results Mean ages were 63.0±6.9 years and 57.9±7.3 years in the pseudoexfoliation and control groups, respectively (P Conclusions Pseudoexfoliation eyes without shallow anterior chamber, small pupils, or apparent zonulopathy may represent eyes with lower risks of complications. Despite smaller pupils and denser cataracts, pseudoexfoliation eyes without clinically apparent preoperative zonulopathy were not at a higher risk of intraoperative or postoperative complications or worse visual outcomes after cataract surgery.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::dacd95a273f3493b3a38d27d953e3008Test
https://doi.org/10.1016/j.ophtha.2018.10.027Test

المؤلفون: Manavi D Sindal, Rengaraj Venkatesh, Sabyasachi Sengupta, Utsab Pan, Prabu Baskaran

المصدر: Ophthalmology Retina. 3:146-153

مصطلحات موضوعية: 0303 health sciences, medicine.medical_specialty, Validation study, genetic structures, medicine.diagnostic_test, Cross-sectional study, business.industry, Physical examination, Diabetic retinopathy, Fundus (eye), medicine.disease, eye diseases, Confidence interval, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, Diabetes mellitus, 030221 ophthalmology & optometry, medicine, Retinal imaging, business, 030304 developmental biology

الوصف: Purpose To determine the sensitivity and specificity of a smartphone-based fundus camera, the Remidio Fundus on Phone (FOP; Remidio Innovative Solutions Pvt. Ltd., Bengaluru, India) in detecting diabetic retinopathy (DR) compared with a conventional tabletop fundus camera and clinical examination. Design Cross-sectional, single-site, instrument validation study. Participants Consecutive patients with diabetes who had no DR (n = 55 eyes), mild to moderate nonproliferative diabetic retinopathy (NPDR; n = 70 eyes), severe NPDR (n = 46 eyes), proliferative diabetic retinopathy (PDR; n = 62 eyes), and diabetic macular edema (DME; n = 44 eyes). Methods All participants underwent a dilated examination to determine the grade of DR. Then all participants had mydriatic 45° fundus photographs obtained from three fields of view with the Remidio FOP and a Topcon tabletop fundus camera (Topcon Medical Systems, Inc., Oakland, NJ). Two masked retina specialists graded images for DR and DME, using National Health Service guidelines as well as for image quality using predefined criteria. Main Outcome Measure Sensitivity and specificity of the Remidio FOP for the detection of any DR compared to clinical examination. Results One hundred thirty-five subjects (233 eyes) were recruited for the study. Compared with the reference clinical examination, using images from the Remidio FOP, graders 1 and 2 reported a sensitivity of 93.1% (95% confidence interval [CI] = 88.3–96.4) and 94.3% (95% CI = 89.7–97.2) and a specificity of 89.1% (95% CI = 68.2–92.2) and 94.5% (95% CI = 84.9–98.9), respectively, in identifying any DR (κ = 0.55; 95% CI = 0.50–0.57). With images from the Topcon camera, graders reported similar sensitivities and specificities with marginally better agreement (κ = 0.68; 95% CI = 0.67–0.73). The sensitivity of detecting DR gradually increased from R1 to R3 disease using both cameras. Both graders classified significantly fewer images as “ungradable” (2.6%–4.3% for Topcon vs. 1.7%–2.1% for Remidio FOP) and more images as excellent from the Remidio FOP (59%–74%) than the Topcon device (52%–61%). Conclusions The Remidio FOP device was found to have high sensitivity and specificity for the detection of any grade of DR with good agreement between graders. The rate of ungradable images was acceptably low and image quality was marginally better with the Remidio FOP.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::37d7aa1e72c942c570bcc6e026916f0eTest
https://doi.org/10.1016/j.oret.2018.09.016Test