Ophthalmic Pathology Research Articles

Tracking and diameter estimation of retinal vessels using Gaussian process and Radon transform.

Extraction of blood vessels in retinal images is an important step for computer-aided diagnosis of ophthalmic pathologies. We propose an approach for blood vessel tracking and diameter estimation. We hypothesize that the curvature and the diameter of blood vessels are Gaussian processes (GPs). Local Radon transform, which is robust against noise, is subsequently used to compute the features and train the GPs. By learning the kernelized covariance matrix from training data, vessel direction and its diameter are estimated. In order to detect bifurcations, multiple GPs are used and the difference between their corresponding predicted directions is quantified. The combination of Radon features and GP results in a good performance in the presence of noise. The proposed method successfully deals with typically difficult cases such as bifurcations and central arterial reflex, and also tracks thin vessels with high accuracy. Experiments are conducted on the publicly available DRIVE, STARE, CHASEDB1, and high-resolution fundus databases evaluating sensitivity, specificity, and Matthew's correlation coefficient (MCC). Experimental results on these datasets show that the proposed method reaches an average sensitivity of 75.67%, specificity of 97.46%, and MCC of 72.18% which is comparable to the state-of-the-art.

The first description of the complete natural history of uveal melanoma by two Scottish surgeons, Allan Burns and James Wardrop.

James Wardrop (1782-1869), a young Scottish surgeon and an early ophthalmologist in Edinburgh, is credited for describing in 1809 retinoblastoma as an entity in his treatise 'Observations on Fungus Haematodes or Soft Cancer'. His treatise also reveals that Allan Burns (1781-1813), another young Scottish surgeon and anatomist, had invited Wardrop to assist in enucleating an eye from a 41-year-old Glasgow woman who, in retrospect, had a uveal melanoma. Her eye had become blind 4months after symptoms of exudative retinal detachment had appeared, and it had become painful after a further 2-4months. The tumour eventually perforated the sclera, and she died within a year thereafter of hepatic metastases. Burns and Wardrop went on to publish detailed parallel accounts of the symptoms, signs, ophthalmic pathology and post-mortem findings regarding the primary, recurrent and metastatic tumour. Burns may have performed the post-mortem after exhuming the body, a common occurrence in early 19th Century Scotland, a thriving hub for teaching morbid anatomy to young surgeons at the time.

New Precision Metrics for Contrast Sensitivity Testing.

Visual sensitivity is comprehensively described by the contrast sensitivity function (CSF), but current routine clinical care does not include its assessment because of the time-consuming need to estimate thresholds for a large number of spatial frequencies. The quick CSF method, however, dramatically reduces testing times by using a Bayesian information maximization rule. We evaluate the test-retest variability of a tablet-based quick CSF implementation in a study with 100 subjects who repeatedly assessed their vision with and without optical correction. We first discuss two commonly used measures of repeatability, intraclass correlation and the Bland-Altman Coefficient of Repeatability, and show that they are vulnerable to artifacts. Instead, we propose to formulate precision as an information retrieval task: from all repeat test scores, can we retrieve a certain individual based on their first test score? We then use rank-based analyses such as mean average precision as a better measure to compare different test metrics, and show that the highest test-retest precision is achieved using a summary statistic, the area under the log CSF (AULCSF). This demonstrates the benefit of assessment of the whole CSF compared to sensitivity at individual spatial frequencies only. AULCSF also yields best discrimination performance (99.2%) between measurements that were taken with and without glasses, respectively, even better than CSF Acuity. The tablet-based quick CSF thus enables the rapid and reliable home monitoring of visual function, which has the potential to improve early diagnosis and treatment of ophthalmic pathologies such as diabetic retinopathy or age-related macular degeneration.

The Irrational Prescription of Medicines for Children in Ophthalmic Practice

Despite progress made in recent years, it was noted that the need for more drugs, developed and tested specifically for children. Recently, in connection with the expansion of drug market, in particular, children’s medicines to doctors and parents is a difficult choice - whether the children need to take a wide range of medicines for these diseases? At the end of the last century, the WHO concerned about this issue, then its experts concluded that two-thirds of all medicines used in children value at all useless. One of the important issues - general-purpose medicines not intended for children (off-label) and non-registered for use in the pediatric medicines (unlicensed use). The purpose of research. To study the rationality use drugs in actual pediatric ophthalmic practice. Analysis of the medical records of 456 children with these ophthalmic pathology. Assessment indicator: the number of appointments “off-label” children, polypharmacy. 456 children received the drugs, the average load on 1 patient was 5.7. 693 assigned to the drug off label that was 29.8%, almost every third. Contraindications for use in children is the lack of data on the pharmacokinetic and pharmacodynamic parameters of medicines in children. Conclusion. In clinical practice ophthalmologists prescribe too many drugs - a high degree of polypharmacy and often unnecessary medication is contraindicated in children and unproven efficacy and safety. Conclusion. In clinical practice, ophthalmic doctors prescribe too many drugs - a high degree of polypharmacy and very often unnecessary drugs contraindicated to children with unproven efficacy and safety

A decade of surgical eye removals in Ontario: a clinical-pathological study

ObjectiveTo assess patient demographics, clinical indications, and pathologic causes of surgically removed eyes over a decade in Ontario (Canada) and to identify areas of ocular disease management needing more attention. DesignRetrospective cross-sectional study. ParticipantsThe surgically removed eyes of 713 consecutive mainly adult patients from 2004 to 2013. MethodsDemographic, clinical, and pathologic data were collected on all eyes received by the University of Toronto Ophthalmic Pathology Laboratory from 2004 to 2013. ResultsOf the 713 eyes removed, enucleations accounted for 60% of cases, eviscerations for 39% of cases, and exenteration for 1% of cases. The most common clinical indications for surgical eye removal were blind painful eye (37%), neoplasm (35%), and trauma (6%). The leading pathologic causes of eye removal were neoplasm (36%), glaucoma (21%), infection or inflammation (17%), and trauma (16%). Glaucoma-related findings were the most common pathologic findings observed (38%), regardless of the primary cause. ConclusionsA blind painful eye and neoplasms were the most commonly documented indications prior to removal of the eye. Common pathologies included glaucoma, neoplasms, infection/inflammation, and trauma. However, regardless of the primary cause, glaucoma-related pathologies were the most common pathologic findings. Refractory eye disease and pain continue to be important reasons for removal of eyes among patients in Ontario. More effective and targeted management strategies are needed to reduce the need for this radical eye surgery of last resort.

Importance of investigation of fetal eyes : Supplement to fetal autopsy

The investigation of fetal eyes is asubspecialty, which is performed by only a few ophthalmic pathologists and pathologists in specialized centers. If acertain fetal syndrome is suspected, the fetal eyes should be removed and submitted for ophthalmic pathological investigation in a specialized center. This can provide additional diagnostic information allowing a final classification of asyndrome and the comprehensive genetic counselling of parents with respect to future pregnancies. This article provides an overview of the histopathological findings in fetal eyes, which are of particular relevance for the pediatric pathological autopsy. In addition, the basic points of ocular development, the preparation of fetal eyes and frequent artifacts are presented.

Retinal artery occlusion

Retinal artery occlusion leads to profound visual impairment in the affected eye. It is rarely caused by local ophthalmic pathologies. Most patients present with alarge number of cardio- and cerebrovascular risk factors. Visual loss is the leading symptom in central retinal artery occlusion (CRAO), whereas acircumscribed visual field defect is claimed in branch retinal artery occlusion (BRAO). Although many attempts have been made to improve the course of the disease, no effective therapy is available. There is some hope that intravenous fibrinolysis could influence the natural course but the therapeutic window is small (ca.4.5 h), and treatment efficacy is still not proven. It is important for ophthalmologists to guide the patients to acomprehensive and prompt neurological and cardiological diagnostic work-up.

Updates in ophthalmic pathology.

Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

Update on conjunctival pathology.

Conjunctival biopsies constitute a fairly large number of cases in a typical busy ophthalmic pathology practice. They range from a single biopsy through multiple mapping biopsies to assess the extent of a particular pathological process. Like most anatomical sites, the conjunctiva is subject to a very wide range of pathological processes. This article will cover key, commonly encountered nonneoplastic and neoplastic entities. Where relevant, sections will include recommendations on how best to submit specimens to the ophthalmic pathology laboratory and the relevance of up-to-date molecular techniques.

Histopathological spectrum of ophthalmic lesions in Chhattisgarh: study from a tertiary care centre

Background: Ophthalmic pathology is a subspecialty of cellular pathology which deals with the diagnosis and characterization of eye diseases. Ophthalmic pathologists study tissues excised by ophthalmologists through evisceration and enucleation and other small biopsies from various ophthalmic surgeries. Ophthalmic lesions include a wide spectrum of lesions ranging from benign, premalignant to malignant lesions. The diagnosis of these lesions is based on the clinical as well as histopathological features. Methods: The present study was an observational prospective study conducted on a 62 ophthalmic biopsies received in Histopathology laboratory, Department of Pathology, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur, Chhattisgarh, India, between March 2016 and October 2016. Institutional ethics committee of Pt. J.N.M. Medical College, Raipur, India has approved this study. Informed written consent was collected from the patients or their relatives. Results: Out of 62 cases of ophthalmic biopsies, 38 (61.29%) were non-neoplastic and 24 (38.71%) were neoplastic lesions. Among non-neoplastic lesions, inflammatory lesions of lacrimal sac were more common 16 (42%) followed by conjuctival lesions 10 (26.3%). Among the neoplastic lesions, retinoblastoma was the most common malignancy 11 (45.83%). Conclusions: The most common ocular malignancy was retinoblastoma; among non-neoplastic disorder, chronic dacryoadenitis followed by benign lesions of conjunctiva. Some ocular masses composed of rhino sporangium involving conjunctiva, lid or lacrimal sac.

Ophthalmic disorders as a manifestation of Parkinson's disease

Parkinson's disease is a severe neurodegenerative disease accompanied with the degeneration of dopaminergic neurons in the central and peripheral nervous system. The diagnosis of Parkinson's disease can still be made only on the stage of irreversible and nearly total degeneration of the nigrostriatum dopaminergic system and exhaustion of brain compensatory mechanisms that explains the low efficacy of therapy. Ophthalmic pathology is one of the nonmotor symptoms of Parkinson's disease. This can be explained firstly by the fact that eye is a 'peripheral part of brain' and secondly by the involvement of dopaminergic neurons (dopamine-producing cells) that are subject to the selective degeneration during Parkinson's disease in the regulation of visual function in the eye and brain. Dopaminergic neurons and dopamine receptors are present in all structures of the eye. Parkinson's disease cause abnormalities not only in the retina but in the whole optic tract and can be considered as peripheral manifestations of the disease that precede the well-known motor dysfunctions. This review describes ophthalmological symptoms of Parkinson's disease, possible pathophysiological mechanisms of their development, optical disorders in experimental models of Parkinson's disease and also the perspectives of experimental and clinical studies of visual disorders for the development of preclinical diagnosis of Parkinson's disease.

Evaluation of risk factors impact on cataract development for uranium industry workers

The abundance and rough relative risk of cataract among 544 workers at the hydrometallurgical plant of Stepnogorsk Mining and Chemical Combine, depending on the total integrated dose of external irradiation, taking into account non-radiation factors, was studied. The conducted studies showed a statistically significant high abundance of ophthalmic pathology, including cataracts among workers in the main group compared with the control group. A statistically significant trend in the increase of cataracts with an increase in the total integrated dose, smoking index of more than 20 packs/year, increase in body weight and persons suffering from hypertension. As a result of a multivariate analysis of risk factors connection to cataract, we revealed that the cumulative dose and length of exposure are the main indicators predicting the development of cataracts for uranium industry adult workers. It is known that age is a key risk factor for many diseases, including cataracts. Lens opacity is a pluricausal manifestation, which is based on the mechanism associated with the course of time.

Взаимосвязь офтальмопатологии с состоянием опорно-двигательного аппарата

Взаимосвязь офтальмопатологии с состоянием опорно-двигательного аппарата

Значение ультразвуковой допплерографии в диагностике офтальмопатологии

Значение ультразвуковой допплерографии в диагностике офтальмопатологии

Optical Measurement of Straylight in Eyes With Cataract.

To measure straylight in a cohort of patients with cataract using a novel optical instrument and to correlate optical straylight values with clinical grade of cataracts and psychophysical straylight values. Measurements were performed on 53 eyes of 44 patients with cataract admitted to the ophthalmology service of the university hospital in Murcia, Spain, and 9 young volunteers with no known ophthalmic pathology. Lens opacities were classified according to the Lens Opacities Classification System Ill (LOCS III) under slit-lamp examination. Intraocular straylight was additionally assessed psychophysically using the C-Quant straylight meter (Oculus Optikgeräte GmbH, Wetzlar, Germany). Optical measurements of the logarithm of the straylight parameter ranged from 1.01 to 2.01 (mean: 1.43 ± 0.244) in patients with cataract and 0.80 to 1.08 (mean: 0.92 ± 0.104) in healthy young volunteers. Straylight differed by a statistically significant amount among different LOCS III groups (P < .05). Moreover, the optically measured straylight parameter was positively correlated to the psychophysically estimated value (r = 0.803, P < .05). A new compact optical instrument suitable for clinical measurements of straylight in the human eye has been developed. Optically measured straylight values were highly correlated to those that were obtained psychophysically. Optical measurement of straylight can be used for the objective classification of cataract opacities based on their optical impact. [J Refract Surg. 2016;32(12):846-850.].

РАСПРЕДЕЛЕНИЕ ГЕНОТИПОВ И АЛЛЕЛЕЙ ПОЛИМОРФИЗМОВ rs759853 И rs9640883 ГЕНА AKR1B1 У БОЛЬНЫХ ДИАБЕТИЧЕСКОЙ РЕТИНОПАТИЕЙ, КАТАРАКТОЙ САХАРНЫМ ДИАБЕТОМ 2 ТИПА

Цель исследования – сравнение распределения генотипов и аллелей полиморфизмов rs759853 и rs9640883 гена AKR1B1 у больных диабетической ретинопатией (ДР), катарактой и сахарным диабетом 2 типа (СД2Т). В исследовании приняли участие 409 человек, которые были разделены на пять групп: 1-я – 98 пациентов с катарактой, которые не имели СД2Т; 2-я – 76 пациентов с катарактой и I стадией ДР (без видимых изменений на глазном дне); 3-я – 64 пациента с катарактой и непролиферативной ДР; 4-я – 64 пациента с катарактой и пролиферативной ДР; 5-я – контрольная группа – 107 пациентов без офтальмологической патологии соответствующих другим группам по возрасту и полу. Результаты работы показали, что по полиморфизму rs759853 гена AKR1B1 в группах больных было снижение частоты предкового генотипа G/G на фоне увеличения частоты гетерозиготы G/A при катаракте и при СД2Т без ретинопатии и увеличение частоты мутантной гомозиготы А/А при ДР (в 3,3–3,9 раза).В общем при ДР имело место снижение частоты предкового аллеля G и увеличение частоты мутантного аллеля А полиморфизма rs759853 гена AKR1B1. По полиморфизму rs9640883 гена AKR1B1показано существенное увеличение частоты предкового генотипа G/G у больных СД2Т (в 1,4–1,6 раза) на фоне уменьшения частоты гетерозиготы G/A (в 1,4–1,9 раза). Поскольку гомозиготный генотип А/А вообще оказывался у больных ДР, можно было обосновать предположение о проективной роли аллеля А rs9640883 в развитии ДР.

Development of ophthalmic pathology and precision medicine

As an indispensable professional, ophthalmic pathology plays an important role in the development of the ophthalmology. With the worldwide attention and promotion of precision medicine and the rapid development of modern medical testing technology, the development of pathology is facing the challenges of survival and development opportunities. We discuss the relationship between the development of pathology and the precision medicine to explain that the precise pathological diagnosis is the basis of the implementation of precision medicine. Ophthalmic pathology workers should be the first to improve the accuracy of the diagnosis of ocular diseases, in order to play a greater role in the future of precision medicine in the diagnosis of pathology. (Chin J Ophthalmol, 2016, 52: 724-727).

Chi-Chao Chan: passion is very important for the success

Chi-Chao Chan ( Figure 1 ), M.D., an American board certified ophthalmologist, is a Scientist Emerita of the National Eye Institute (NEI), National Institutes of Health (NIH), USA. She studied at Zhongshan Medical College (now Sun Yat-sen University Medical School) in China [1961–1967], went to USA in 1968. In USA, Dr. Chan received both bachelor (BA, 1972) and medical doctorate (MD, 1975) degrees from Johns Hopkins University, completed ophthalmology residency at Stanford University Medical Center in 1979, and two post-doctorial fellowships at the Wilmer Institute, Johns Hopkins (ophthalmic pathology, 1979–1982) and at the NEI, NIH (clinical immunology, 1982–1986), respectively. She got tenured and became the Chief of Immunopathology Section in the Laboratory of Immunology and the Chief of Histopathology Core at NEI/NIH; became a world expert in ophthalmic pathology and ocular immunology.

Pupillary reaction according to a balance autonomic nervous organ of vision in healthy children

PurposeFor the diagnosis and prevention of asthenopic complaints need to study pupillary reactions normal in response to light stimulus and the presentation of the object in the vicinity of somatically healthy persons without ophthalmic pathology taking into account the balance of the autonomic innervation. The aim of the work was to study the direct pupillary reaction to light stimulus.MethodsPupillografiya was performed in 78 somatically healthy individuals (156 eyes) in the age of 5–9 years. 27 people prevailed balance the sympathetic autonomic nervous system, in 34 parasympathetic, 17 persons observed eutonic. The visual acuity, refraction static on autorefractometry Humphrey, Oftalmometres on Oftalmometres Zhavalya and ultrasound biometry of eyes have been studied. Provision of accommodation (RA) have been determined by the method Dashevskiy. The balance of the autonomic nervous system has been studied with the help of cardio‐vascular index Cerdo.ResultsAll the healthy children, whose emmetropic refraction had been observed, had visual acuity for distance 1.0 ± 0.02 in the both eyes. The pupil reaction with the sympathetic innervation before the light stimulus by direct reaction was OD 63.65 ± 2.61 mm2, OS 66.92 ± 2.27 mm2. The eutonic reaction was OD 34.99 ± 1.18 mm2, OS 31.77 ± 1.42 mm2. The reaction with the parasympathetic innervation was OD 28.93 ± 0.94 mm2, OS 25.72 ± 1.08 mm2. After the presentation of the light the reaction with the prevalence of sympathetic innervation was OD 15.77 ± 1.09 mm2, OS 15.87 ± 1.30 mm2. The eutonic pupillary area was OD 10.73 ± 1.13 mm2, OS 8.74 ± 0.60 mm2, while the pupillary area with a predominance of parasympathetic innervation was OD 8.63 ± 0.74 mm2, OS 7.19 ± 0.54 mm2.ConclusionsThe connection between types of autoinnervation interrelationship must be studied for the diagnostic and intreatment of asthenopia.

Iris claw

SummaryIris claw has been proposed in the management of aphakia, as anterior chamber and scleral IOL fixation. Fixation of this PMMA lens is based on enclavation of a fold of iris tissue without sutures, centered over pupil without affecting mydriasis, iris vasculature and o fluorescein leakage) angle structuresangle structures.Surgical procedure of anterior versus posterior implantation will be detailled. Per‐ and postoperative complications will be discussed.The choice of surgical modality may be individualised for specific patients taking into consideration anatomical characteristics (anterior chamber depth, EC count), prexisting ophthalmic pathologies, and surgeon experience.isting ophthalmic pathologies.