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1.
D S W Ting M L Tay-Kearney I Constable J Vignarajan Y Kanagasingam 《Eye (London, England)》2013,27(7):848-853
Background
To evaluate the optimal compression level of retinal color digital video recordings, a novel video-based imaging technology, in screening for diabetic retinopathy (DR).Design
Evaluation of a diagnostic technique.Methods
A total of 36 retinal videos, captured using EyeScan (Ophthalmic Imaging System), were compressed from original uncompressed file size of 1 GB (gigabyte) to four different compression levels—100 MB (megabyte) (Group 1); 30 MB (Group 2); 20 MB (Group 3); and 5 MB (Group 4). The videos were subsequently interpreted by an ophthalmologist and a resident using the International Clinical Diabetic Retinopathy Severity Scales.Main outcome measures
The sensitivity, specificity and κ coefficient for DR grading detected by were calculated for each compression level (Groups 1–4), with reference to the original uncompressed retinal videos.Results
Groups 1, 2, and 3 graded by both readers had sensitivity and specificity >90% in detecting DR, whereas for group 4, the sensitivity and specificity were 70.6% and 94.7% for ophthalmologist and 80.0% and 72.2% medical officer, respectively. The κ correlation in detecting DR for groups 1, 2, and 3 were >0.95, whereas for Group 4, the κ was 0.76 and 0.66 for ophthalmologist and medical officer, respectively.Conclusion
Retinal video recording is a novel and effective DR screening technique with high sensitivity, specificity and κ correlation. With its compressibility, this is a potential effective technique that can be widely implemented in a routine, mobile, and tele-ophthalmology setting for DR screening services. 相似文献2.
Purpose
To identify the major causes of severe childhood visual impairment and blindness among students attending schools for the blind in a coastal district of Andhra Pradesh (AP) in South India.Methods
Children ≤16 years of age attending six schools for the blind in the study area were interviewed and examined in the year 2009, and causes were classified according to the World Health Organization Program for Prevention of Blindness (WHO/PBL) childhood blindness proforma. A total of 113 children underwent a detailed eye examination by an experienced ophthalmologist.Results
The major causes of blindness were congenital eye anomalies in 46 children (41.4; 95% confidence interval (CI): 32.3–50.6), followed by retinal disorders in 21 children (18.9% 95% CI: 11.6–26.2), cataract in 9 children (9.7% 95% CI: 2.9–12.9), and corneal conditions (scar and Staphyloma) in 8 children (7.1% 95% CI: 2.4–11.8). More than half the children (56.6%) were blind due to conditions that could have been treated or prevented.Discussion
Congenital anomalies were found to be the most common cause of blindness. The majority of the cases were due to avoidable causes of blindness. Therefore, robust screening measures may help reduce the burden of visual impairment in children. 相似文献3.
M Waisbourd B Lee M H Ali L Lu P Martinez B Faria A Williams M R Moster L J Katz G L Spaeth 《Eye (London, England)》2015,29(10):1321-1328
Purpose
To determine the sensitivity and specificity of various methods of detecting a relative afferent pupillary defect (RAPD) in patients with glaucoma-related diagnoses.Patients and methods
Patients underwent RAPD evaluation using the swinging flashlight method (SFM), the magnifier-assisted SFM, and pupillography using the Konan RAPDx. Main outcome measures were sensitivity and specificity of three methods of RAPD evaluation in detecting visual field mean deviation (MD), cup to disc ratio (CDR), disc damage likelihood scale (DDLS), and retinal nerve fiber layer (RNFL) asymmetry.Results
Eighty-one consecutive patients from the Wills Eye Hospital glaucoma service were enrolled, 60 with glaucoma and 21 with ocular hypertension or glaucoma suspect. Thirty-one percent of subjects had MD asymmetry>5 dB, 19.7% had CDR asymmetry≥0.20, 26.7% had DDLS asymmetry≥2, and 38.2% had RNFL asymmetry>10 microns. Sensitivity values for pupillography were 93.3% (95% CI, 68.1–99.8) for detecting MD asymmetry, 80.0% (95% CI, 51.9–95.7) for CDR asymmetry, 100.0% (95% CI, 73.5–100.0) for DDLS asymmetry, and 69.2% (95% CI, 38.6–90.9) for RNFL asymmetry. Specificity values were 41.2% (95% CI, 24.7–59.3) for detecting MD asymmetry, 32.8% (95% CI, 21.3–46.0) for CDR asymmetry, 33.3% (95% CI, 18.0–51.8) for DDLS asymmetry, and 42.9% (95% CI, 21.8–66.0) for RNFL asymmetry. Pupillography amplitude score was correlated with MD asymmetry (r2=0.41, P<0.001) and area under the curve was 0.84.Conclusion
Automated pupillography had higher sensitivity and lower specificity in detecting MD, CDR, DDLS, and RNFL asymmetry. Within the bounds of the cohort tested, this method had limited case-finding ability. 相似文献4.
C H L Lim N A Carnt M Farook J Lam D T Tan J S Mehta F Stapleton 《Eye (London, England)》2016,30(3):447-455
Purpose:
To investigate independent risk factors for contact lens-related microbial keratitis in Singapore and estimate their impact on disease load.Methods:
Cases were contact lens wearers presenting to Singapore National Eye Centre with microbial keratitis between 2008 and 2010. Community contact lens wearers were recruited as controls. All wearers completed a previously validated questionnaire describing contact lens wear history, hygiene and compliance habits, and demographics. Risk factors significant in univariate analysis (P<0.2) were evaluated in a multivariate model.Results:
In all, 58 cases of microbial keratitis and 152 contemporaneous controls were identified. When controlling for other variables, Chinese had a 7 × lower risk compared with other races (95% CI: 2.3–21.3, P=0.001). Those aged between 25 and 44 years were at 3 × increased risk compared with younger wearers (95% CI: 1.1–9.6, P=0.04). Occasional overnight contact lens wear (less often than one night per week) was associated with a 4 × higher risk (95% CI: 1.2–15.4, P=0.03) compared with daily use. Not washing hands before handling was associated with a 13 × increased risk (95% CI: 1.9–84.8, P=0.008). Use of multipurpose solution A carried a 16 × higher risk compared with hydrogen peroxide (95% CI: 1.5–174.0, P=0.02). The combined PAR% for modifiable risk factors (occasional overnight wear, not washing of hands, and MPS A) was 82%.Conclusions:
Consistent with previous findings, independent risk factors for contact lens-related microbial keratitis include poor hand hygiene, occasional overnight wear, and type of lens care solution. Prolonged overnight or extended contact lens use was infrequent in this population. 相似文献5.
S P Hashim F A Al Mansouri M Farouk A A Al Hashemi R Singh 《Eye (London, England)》2014,28(11):1304-1309
Purpose
This study was conducted to investigate the prevalence and progression of glaucoma in patients receiving treatment for obstructive sleep apnea (OSA). We also investigated whether there is an association between severity of OSA and the incidence of glaucoma.Methods
A total of 39 patients aged >30 years who had been diagnosed with moderate and severe OSA in the sleep clinic at Hamad General Hospital were assessed for the presence of glaucoma. The severity of OSA was graded as mild, moderate, or severe based on American Association of Sleep Medicine (AASM) criteria using the apnea hypopnea index. Before enrollment, all patients underwent a complete ophthalmic examination including serial visual field tests, optical coherence tomography (OCT) with fundus photographs, and pachymetry. Enrolled patients were followed up in the ophthalmology outpatient clinic and sleep clinic for a period of 3 years.Results
Examinations found that 8 (20.5% 95% confidence interval (CI) 9.9–37%) of the 39 patients with OSA had glaucoma. Six (75% 95% CI 36–96%) of these patients had normal-tension glaucoma (NTG) and two (25% 95% CI 4.5–64.4%) patients had high-tension glaucoma. Among the 27 patients with severe OSA, 7 (25.9% 95% CI 8–34%) had glaucoma, and among 12 patients with moderate OSA, 1 (8.3% 95% CI 0.1–15%) had glaucoma. During the course of follow-up, two patients who previously did not have glaucoma were reclassified as NTG and two patients with glaucoma deteriorated. A higher prevalence of glaucoma in the severe OSA group compared with the moderate OSA group was found, albeit a statistically significant difference could not be attained (P=0.4).Conclusions
Our study showed that severe OSA is an important risk factor for developing glaucoma. Adequate treatment of OSA, along with optimal ophthalmic care, resulted in better control of glaucoma. 相似文献6.
T Succar G Zebington F Billson K Byth S Barrie P McCluskey J Grigg 《Eye (London, England)》2013,27(10):1151-1157
Aim
The Virtual Ophthalmology Clinic (VOC) is an interactive web-based teaching module, with special emphasis on history taking and clinical reasoning skills. The purpose of this study was to determine the impact of VOC on medical students'' learning.Methods
A randomised controlled trial (RCT) was conducted with medical students from the University of Sydney (n=188) who were randomly assigned into either an experimental (n=93) or a control group (n=95). A pre- and post-test and student satisfaction questionnaire were administered. Twelve months later a follow-up test was conducted to determine the long-term retention rate of graduates.Results
There was a statistically significant (P<0.001) within-subject improvement pre- to post rotation in the number of correctly answered questions for both the control and experimental groups (mean improvement for control 10%, 95% CI 1.3–2.6, and for experimental 17.5%, 95% CI 3.0–4.0). The improvement was significantly greater in the experimental group (mean difference in improvement between groups 7.5%, 95% CI 0.8–2.3, P<0.001). At 12 months follow-up testing, the experimental group scored on average 1.6 (8%) (95%CI 0.4 to 2.7, P=0.007) higher than the controls.Conclusion
On the basis of a statistically significant improvement in academic performance and highly positive student feedback, the implementation of VOC may provide a means to address challenges to ophthalmic learning outcomes in an already crowded medical curriculum. 相似文献7.
Aims
To validate a new photogrammetric technique for quantifying eye surface area and using this to quantify the degree of improvement in symmetry in patients with oral–ocular synkinesis following Botulinum toxin injection.Study design
Feasibility study and retrospective outcomes analysisMethods
Ten patients'' photographs were chosen from a photographic database. Their eye surface areas were measured independently by two raters using a graphics tablet. One rater repeated the procedure after 15 days. Bland–Altman plots were computed, ascertaining inter-rater and intra-rater variability. The eye surface areas of 19 patients were then derived from photographs taken before and after Botulinum toxin injections. Paired t-tests were used to analyse the significance of the difference in pre- and post-treatment symmetry.Results
Ninety per cent of eye surface areas derived from the two raters were within a coefficient of variation of 0.1 (95% CI: 0.05–0.15). Similarly, 90% of eye surface areas derived from one rater had a coefficient of variation of 0.08 (95% CI: 0.04–0.12). Botulinum toxin significantly reduced synkinesis resulting from lip puckering, Mona Lisa smiling and Hollywood smiling (P<0.05).Conclusions
We have proposed a clinically valid tool for quantifying the effects of Botulinum toxin treatment for oral–ocular synkinesis. We recommend this method be used to monitor the response of such patients when receiving Botulinum toxin treatment.Level of evidence
2c. 相似文献8.
H Lindekleiv M G Erke G Bertelsen T Peto K A Arntzen H Schirmer T Wilsgaard E B Mathiesen I Nj?lstad 《Eye (London, England)》2013,27(11):1281-1287
Purpose
To examine the cross-sectional relationship between drusen, late age-related macular degeneration (AMD), and cognitive function.Methods
We included 2149 stroke-free participants from the population-based Tromsø Study in Norway. Retinal photographs were graded for presence of drusen and AMD. Cognitive function was assessed using the verbal memory test (short verbal memory), digit-symbol coding test (processing speed), and the tapping test (psychomotor tempo). We assessed the relationship between drusen, late AMD, and cognitive test scores, adjusted for potential confounders.Results
Late AMD was associated with decreased performance in the verbal memory test (standardized β=−0.23, 95% confidence interval (CI): −0.51 to −0.01). Intermediate and large drusen were associated with decreased performance in the digit-symbol coding test (standardized β=−0.14 and –0.19, 95% CIs: −0.23 to −0.05 and −0.29 to −0.09, respectively). Participants with large drusen were more likely to have test scores in the lowest quartile of the digit-symbol coding test (odds ratio (OR)=1.9, 95% CI: 1.1–3.5) and the tapping test (OR=1.6, 95% CI: 1.0–2.6), but not in the verbal memory test (OR=1.0, 95% CI: 0.6–1.6).Conclusions
The findings suggest a relationship between drusen deposition and reduced cognitive function. Although the relationships between drusen, late AMD, and the cognitive test results varied in strength and significance across the types of cognitive test, and may partly have been caused by residual confounding, it is not unlikely that a genuine but weaker relationship exists between drusen deposition and cognitive decline. 相似文献9.
T D L Keenan R L Johnston P H J Donachie J M Sparrow I M Stratton P Scanlon 《Eye (London, England)》2013,27(12):1397-1404
Aims
To report estimates of the prevalence of diabetic retinopathy (DR) and maculopathy grades for a large cohort of patients managed by the UK hospital eye service (HES).Methods
Anonymised data were extracted from 30 UK NHS hospital trusts using a single ophthalmic electronic medical record (EMR) for the period from April 2000 to November 2010 to create the National Ophthalmology Database (NOD). From 2007, the EMR facilitated capture of a nationally agreed-upon standardised data set (DR Structured Assessment) relating to the presence or absence of clinical signs of DR and maculopathy. An algorithm in the software automatically calculated the Early Treatment of Diabetic Retinopathy Study grades of retinopathy and maculopathy.Results
Between 2007 and 2010, 307 538 patients had data on the NOD, with 76 127 (24.8%) patients having been recorded as having diabetes. The proportion of patients with diabetes who had a structured assessment increased from 50.7% (2007) to 86.8% (2010). In each NHS year, 12.6–20.6% of eyes with structured assessments had no DR; 59.6–67.3% had non-proliferative DR; and 18.3–20.9% had active or regressed proliferative DR. Clinically significant macular oedema was present in 15.8–18.1% of eyes, and in 8.7–10.0% of eyes, this involved the central macula.Conclusion
This study provides contemporary estimates of the prevalence of retinopathy and maculopathy grades in a large cohort of patients with diabetes managed by the UK HES. Centre-involving diabetic macular oedema, potentially amenable to anti-VEGF therapy, is present in the eyes of almost 10% of these patients. This information is useful for clinicians, health-care economists, and commissioners involved in planning and delivering diabetic eye services. 相似文献10.
Purpose
To compare the results of silicone and polypropylene Ahmed glaucoma valves (AGV) implanted during the first 10 years of life.Methods
A prospective study was performed on 50 eyes of 33 patients with paediatric glaucoma. Eyes were matched to either polypropylene or silicone AGV. In eyes with bilateral glaucoma, one eye was implanted with polypropylene and the other eye was implanted with silicone AGV.Results
Fifty eyes of 33 children were reviewed. Twenty five eyes received a polypropylene valve, and 25 eyes received a silicone valve. Eyes implanted with silicone valves achieved a significantly lower intraocular pressure (IOP) compared with the polypropylene group at 6 months, 1 year, and 2 years postoperatively. The average survival time was significantly longer (P=0.001 by the log-rank test) for the silicone group than for the polypropylene group and the cumulative probability of survival by the log-rank test at the end of the second year was 80% (SE: 8.0, 95% confidence interval (CI): 64–96%) in the silicone group and 56% (SE: 9.8, 95% CI: 40–90%) in the polypropylene group. The difference in the number of postoperative interventions and complications between both groups was statistically insignificant.Conclusion
Silicone AGVs can achieve better IOP control, and longer survival with less antiglaucoma drops compared with polypropylene valves in children younger than 10 years. 相似文献11.
Purpose
To describe and measure the discriminatory performance of three new superior–inferior asymmetry indices for detecting primary open angle glaucoma (POAG) and to compare these with the glaucoma hemifield test (GHT).Methods
In all, 412 control and 247 POAG eyes were selected from a visual field database of patients attending the Manchester Royal Eye Hospital. Age-adjusted defect asymmetries were calculated for each of the 22 vertically mirrored test point pairs used in the GHT. The three new indices, hemifield mean difference (HMD) and hemifield standard deviation (HSD) of the asymmetry values along with the number of test pairs (NP) falling outside the 85% probability limits of the control population, were calculated. ROC curves of the indices and GHT were constructed. Agreement between the indices was explored with a proportional Venn diagram and 3 × 3 contingency tables. Cases of disagreement between the indices were reviewed.Results
The area under the ROC curves were HMD=0.745 (95% confidence interval (CI) 0.705–0.786), HSD=0.864 (95% CI 0.833–0.894), NP=0.863 (95% CI 0.832–0.893) and GHT=0.792 (95% CI 0.754–0.829). The Venn diagram and contingency tables highlighted the good agreement between HSD, NP and GHT. Agreement was 78% (HSD vs GHT) and 82% (NP vs GHT) in the control sample and 70% (HSD vs GHT) and 71% (NP vs GHT) in the POAG sample. Five cases are presented where disagreement existed between the indices.Conclusions
The new HSD and NP asymmetry indices perform better than GHT in differentiating between normal and POAG eyes in this data set. GHT can fail to detect significant asymmetry, detected by HSD and NP, when an early defect crosses sector boundaries. 相似文献12.
H B Smith S B Jyothi O A R Mahroo P N Shams M Sira S Dey T Adewoyin V T F Cheung C A Jones 《Eye (London, England)》2012,26(11):1418-1423
Purpose
It is vital that surgeons undertaking oculoplastic procedures are able to show that the surgery they perform is of benefit to their patients. Not only is this fundamental to patient-centred medicine but it is also important in demonstrating cost effectiveness. There are several ways in which benefit can be measured, including clinical scales, functional ability scales, and global quality-of-life scales. The Glasgow benefit inventory (GBI) is an example of a patient-reported, questionnaire-based, post-interventional quality-of-life scale that can be used to compare a range of different treatments for a variety of conditions.Methods
A cross-sectional study was undertaken using the GBI to score patient benefit from four commonly performed oculoplastic procedures. It was completed for 66 entropion repairs, 50 ptosis repairs, 41 ectropion repairs, and 41 external dacryocystorhinostomies (DCR). The GBI generates a scale from −100 (maximal detriment) through zero (no change) to +100 (maximal benefit).Results
The total GBI scores of patients undergoing surgery for entropion, ptosis, ectropion, and external DCR were: +25.25 (95% CI 20.00–30.50, P<0.001), +24.89 (95% CI 20.04–29.73, P<0.001), +17.68 (95% CI 9.46–25.91, P<0.001), and +32.25 (95% CI 21.47–43.03, P<0.001), respectively, demonstrating a statistically significant benefit from all procedures.Conclusion
Patients derived significant quality-of-life benefits from the four most commonly performed oculoplastic procedures. 相似文献13.
Aim
To determine the validity of laser photocoagulation as a prophylactic treatment in the prevention of rhegmatogenous retinal detachment (RRD) in a group of paediatric patients presenting with chorioretinal coloboma.Methods
Observational case series of consecutive patients aged 0–15 years with chorioretinal coloboma seen in a tertiary eye hospital were reviewed. Data were analysed with SPSS version 16, a P-value of <0.05 was considered significant.Results
One hundred and ninety-eight patients (335 eyes) were identified. The prevalence of retinal detachment and ocular anomalies was 17.6 and 87.2%, respectively. Ocular anomalies included iris coloboma (71%), microcornea (45.1%), nystagmus (41.5%), strabismus (21.2%), and microphthalmos (19.1%). The prevalence of retinal detachment was 2.9% in those eyes that received prophylactic laser photocoagulation, whereas the risk of retinal detachment was 24.1% in eyes left untreated. Post-operative complications following retinal detachment surgery occurred in 86.7% eyes; the most frequent being recurrent retinal detachment (53.8%). The mean duration of follow-up was 1.59±0.21 years (0–7 years) and 0.79±0.16 years (0–8 years) in the group that had laser and in those that were treatment naive, respectively.Conclusions
Prophylactic laser treatment appears to have a protective effect for the prevention of RRD in eyes with chorioretinal coloboma. Measures towards prophylactic therapy should be instituted to reduce the risk of retinal detachment in choroid colobomatous eyes due to the problems in the management of these retinal detachments. 相似文献14.
Purpose
Anatomically, the eyes and paranasal sinuses are neighboring structures and some studies have mentioned eye disease in conjunction with chronic rhinosinusitis (CRS). However, to the best of our knowledge, no prior research has investigated the risk of developing open-angle glaucoma (OAG) among CRS patients. This study aims to provide an estimated risk of developing OAG among patients with CRS by using a population-based data set in Taiwan.Methods
This retrospective cohort study used data sourced from the ‘Longitudinal Health Insurance Database 2000''. A total of 15 642 CRS patients were included in the study cohort and 46 926 subjects were randomly extracted as a comparison cohort. A cox proportional-hazards regression analysis was performed to calculate the 5-year risk of subsequently developing OAG following a diagnosis of CRS between the study cohort and the comparison cohort.Results
The incidence rate of developing OAG over the 5-year follow-up period was 5.45 (95% CI: 4.95–5.98) per 1000 person-years for the study cohort and 2.80 (95% CI: 2.60–3.03) per 1000 person-years for the comparison cohort. After censoring the cases that died over the 5-year period and adjusting for the factors of monthly income, geographic region, hypertension, diabetes, coronary heart disease, hyperlipidemia, and hypothyroidism the hazard ratio for developing OAG over the 5-year period for subjects with CRS to subjects without CRS was 1.73 (95% CI: 1.53–1.96).Conclusion
We found that those subjects with CRS had a significantly higher risk of developing OAG over the 5-year follow-up period as compared with subjects without CRS. 相似文献15.
M Sehi N Bhardwaj Y S Chung D S Greenfield Advanced Imaging for Glaucoma Study Group 《Eye (London, England)》2012,26(12):1527-1535
Purpose
The objective of this study is to assess whether baseline optic nerve head (ONH) topography and retinal nerve fiber layer thickness (RNFLT) are predictive of glaucomatous visual-field progression in glaucoma suspect (GS) and glaucomatous eyes, and to calculate the level of risk associated with each of these parameters.Methods
Participants with ≥28 months of follow-up were recruited from the longitudinal Advanced Imaging for Glaucoma Study. All eyes underwent standard automated perimetry (SAP), confocal scanning laser ophthalmoscopy (CSLO), time-domain optical coherence tomography (TDOCT), and scanning laser polarimetry using enhanced corneal compensation (SLPECC) every 6 months. Visual-field progression was assessed using pointwise linear-regression analysis of SAP sensitivity values (progressor) and defined as significant sensitivity loss of >1 dB/year at ≥2 adjacent test locations in the same hemifield at P<0.01. Cox proportional hazard ratios (HR) were calculated to determine the predictive ability of baseline ONH and RNFL parameters for SAP progression using univariate and multivariate models.Results
Seventy-three eyes of 73 patients (43 GS and 30 glaucoma, mean age 63.2±9.5 years) were enrolled (mean follow-up 51.5±11.3 months). Four of 43 GS (9.3%) and 6 of 30 (20%) glaucomatous eyes demonstrated progression. Mean time to progression was 50.8±11.4 months. Using multivariate models, abnormal CSLO temporal-inferior Moorfields classification (HR=3.76, 95% confidence interval (CI): 1.02–6.80, P=0.04), SLPECC inferior RNFLT (per −1 μm, HR=1.38, 95% CI: 1.02–2.2, P=0.02), and TDOCT inferior RNFLT (per −1 μm, HR=1.11, 95% CI: 1.04–1.2, P=0.001) had significant HRs for SAP progression.Conclusion
Abnormal baseline ONH topography and reduced inferior RNFL are predictive of SAP progression in GS and glaucomatous eyes. 相似文献16.
Objective
To clarify the screening potential of the Amsler grid and preferential hyperacuity perimetry (PHP) in detecting or ruling out wet age-related macular degeneration (AMD).Evidence acquisition
Medline, Scopus and Web of Science (by citation of reference) were searched. Checking of reference lists of review articles and of included articles complemented electronic searches. Papers were selected, assessed, and extracted in duplicate.Evidence synthesis
Systematic review and meta-analysis. Twelve included studies enrolled 903 patients and allowed constructing 27 two-by-two tables. Twelve tables reported on the Amsler grid and its modifications, twelve tables reported on the PHP, one table assessed the MCPT and two tables assessed the M-charts. All but two studies had a case–control design. The pooled sensitivity of studies assessing the Amsler grid was 0.78 (95% confidence intervals; 0.64–0.87), and the pooled specificity was 0.97 (95% confidence intervals; 0.91–0.99). The corresponding positive and negative likelihood ratios were 23.1 (95% confidence intervals; 8.4–64.0) and 0.23 (95% confidence intervals; 0.14–0.39), respectively. The pooled sensitivity of studies assessing the PHP was 0.85 (95% confidence intervals; 0.80–0.89), and specificity was 0.87 (95% confidence intervals; 0.82–0.91). The corresponding positive and negative likelihood ratios were 6.7 (95% confidence intervals; 4.6–9.8) and 0.17 (95% confidence intervals; 0.13–0.23). No pooling was possible for MCPT and M-charts.Conclusion
Results from small preliminary studies show promising test performance characteristics both for the Amsler grid and PHP to rule out wet AMD in the screening setting. To what extent these findings can be transferred to a real clinic practice still needs to be established. 相似文献17.
Purpose
Previous epidemiologic studies that focused on the association between open-angle glaucoma (OAG) and dementia showed inconsistent results. In the present study, we explored the association between OAG and dementia in an ethnic Chinese (ie, Taiwanese) population using a population-based data set.Methods
We retrieved data on study subjects for this case-control study from the Longitudinal Health Insurance Database 2000. We identified 7770 patients who had a diagnosis of dementia as cases, and 7770 subjects matched in terms of sex and age, which were randomly extracted as controls. A conditional logistic regression conditioned on age group, sex, and index year was used to assess the association of dementia with previously diagnosed OAG among the sampled patients.Results
Of 15 540 patients, 1.70% had prior OAG, including 2.02% of the dementia group and 1.38% of the controls. After adjusting for patient socioeconomic characteristics and comorbid medical disorders, dementia patients were more likely to have had prior OAG than controls (odds ratio (OR): 1.44; 95% confidence interval (CI): 1.12–1.85; P<0.01). In addition, female dementia patients were more likely to have had prior OAG than controls (OR: 1.93; 95% CI: 1.35–2.77; P<0.001), whereas no statistical difference in prior OAG between male dementia patients and controls was found.Conclusions
Female dementia patients were associated with a higher proportion of prior OAG than were the controls. 相似文献18.
Purpose
To assess the prevalence of refractive errors, including myopia, high myopia, hyperopia, astigmatism, and anisometropia, in rural adult Koreans.Methods
We identified 2027 residents aged 40 years or older in Namil-myeon, a rural town in central South Korea. Of 1928 eligible residents, 1532 subjects (79.5%) participated. Each subject underwent screening examinations including autorefractometry, corneal curvature measurement, and best-corrected visual acuity.Results
Data from 1215 phakic right eyes were analyzed. The prevalence of myopia (spherical equivalent (SE) <−0.5 diopters (D)) was 20.5% (95% confidence interval (CI): 18.2−22.8%), of high myopia (SE <−6.0 D) was 1.0% (95% CI: 0.4−1.5%), of hyperopia (SE>+0.5 D) was 41.8% (95% CI: 38.9−44.4%), of astigmatism (cylinder <−0.5 D) was 63.7% (95% CI: 61.0−66.4%), and of anisometropia (difference in SE between eyes >1.0 D) was 13.8% (95% CI: 11.9−15.8%). Myopia prevalence decreased with age and tended to transition into hyperopia with age up to 60−69 years. In subjects older than this, the trend in SE refractive errors reversed with age. The prevalence of astigmatism and anisometropia increased consistently with age. The refractive status was not significantly different between males and females.Conclusions
The prevalence of myopia and hyperopia in rural adult Koreans was similar to that of rural Chinese. The prevalence of high myopia was lower in this Korean sample than in other East Asian populations, and astigmatism was the most frequently occurring refractive error. 相似文献19.
Purpose
To describe the visual outcomes and morbidity of newly referred uveitis patients.Methods
Retrospective cohort study of 133 newly referred uveitis patients with active uveitis who required care in a tertiary center for at least 1 year. Main outcomes were best-corrected visual acuity (BCVA) at referral and 1 year after referral, duration of visual impairment, systemic medications used, as well as all complications and surgeries during the first year of follow-up. Generalized estimating equation models was used to assess prognosticators for poor BCVA.Results
The mean age at onset of uveitis was 43 years. The proportion of patients with at least one eye with BCVA ≤0.3 decreased from 35% at referral to 26% (P=0.45) at 1-year follow-up. The mean duration of visual impairment in the first year after referral was 4 months per affected eye. At 1-year follow-up, bilateral visual impairment was observed in 4% but at least one ocular complication developed in 66% and 30% of patients required at least one intraocular surgery. Systemic immunosuppressive treatment was required in 35% of patients and the mean number of visits to ophthalmologist was 11 per year, while 8% of patients required hospital admission. Prognosticators for poor visual outcome included surgery undergone before referral (odds ratio (OR), 3; 95% CI, 1–11; P=0.047), visual impairment at referral (OR, 21; 95% CI, 8–54; P<0.001), and glaucoma before referral (OR, 7; 95% CI, 2–28; P=0.007).Conclusions
Patients with severe uveitis had a favorable BCVA 1 year after referral with only 4% of patients having bilateral visual impairment. This, in contrast to the prolonged duration of visual impairment during the first year of follow-up and the demanding care. 相似文献20.