Signs Of Eye Disease Research Articles

An efficient enhanced stacked auto encoder assisted optimized deep neural network for forecasting Dry Eye Disease

Meibomian Gland Dysfunction (MGD) and Dry Eye Disease (DED) comprise two of the most significant eye diseases, impacting millions of sufferers worldwide. Several etiological factors influence the early symptoms of DED. Early diagnosis and treatment of erectile dysfunction may significantly improve the Quality of Life (QoL) for people. The current study introduces the ESAE-ODNN, an improved stacked autoencoder-aided optimised deep neural network, as a new way to predict DED using feature selection (FS), feature extraction (FE), and classification. The approach described here is novel because it merges chaotic maps into FS, employs SLSTM-STSA for improved classification accuracy (CA), and optimizes with the adaptive quantum rotation of the Enhanced Quantum Bacterial Foraging Optimisation Algorithm (EQBFOA). The present study enhances prediction functions by extracting MGD-related features and complicated relationships from the DED dataset. To ensure essential feature identification, the ESAE minimizes irrelevant and redundant features. To predict the DED, the ESAE first applies FE and then implements an ODNN classifier. This method fine-tunes the ODNN framework to enhance the effectiveness of the classification. The proposed ESAE-ODNN classification system efficiently assists in the early diagnosis of DED. Combining advanced Deep Learning (DL) methods with optimization can help us understand MGD features better and sort the data with the best accuracy (96.34%). The experimental evaluation with relevant performance metrics indicates that the proposed method is efficient in diverse aspects: accurate identification, reduced complexity, and fine-tuned performance. The ESAE-ODNN’s robustness in handling intricate feature indications and high-dimensional data outperforms the existing state-of-the-art techniques.

Alterations in dynamic regional homogeneity within default mode network in patients with thyroid-associated ophthalmopathy.

Thyroid-associated ophthalmopathy (TAO) is a significant autoimmune eye disease known for causing exophthalmos and substantial optic nerve damage. Prior investigations have solely focused on static functional MRI (fMRI) scans of the brain in TAO patients, neglecting the assessment of temporal variations in local brain activity. This study aimed to characterize alterations in dynamic regional homogeneity (dReHo) in TAO patients and differentiate between TAO patients and healthy controls using support vector machine (SVM) classification. Thirty-two patients with TAO and 32 healthy controls underwent resting-state fMRI scans. We calculated dReHo using sliding-window methods to evaluate changes in regional brain activity and compared these findings between the two groups. Subsequently, we employed SVM, a machine learning algorithm, to investigate the potential use of dReHo maps as diagnostic markers for TAO. Compared to healthy controls, individuals with active TAO demonstrated significantly higher dReHo values in the right angular gyrus, left precuneus, right inferior parietal as well as the left superior parietal gyrus. The SVM model demonstrated an accuracy ranging from 65.62 to 68.75% in distinguishing between TAO patients and healthy controls based on dReHo variability in these identified brain regions, with an area under the curve of 0.70 to 0.76. TAO patients showed increased dReHo in default mode network-related brain regions. The accuracy of classifying TAO patients and healthy controls based on dReHo was notably high. These results offer new insights for investigating the pathogenesis and clinical diagnostic classification of individuals with TAO.

Effective Cataract Identification System using Deep Convolution Neural Network

INTRODUCTION: The paper introduces a novel approach for the early detection of cataracts using images captured using smartphones. Cataracts are a significant global eye disease that can lead to vision impairment in individuals aged 40 and above. In this article, we proposed a deep convolution neural network (CataractsNET) trained using an open dataset available in Github which includes images collected through google searches and images generated using standard augmentation mechanism.
 OBJECTIVES: The main objective of this paper is to design and implement a lightweight network model for cataract identification that outperforms other state-of-the-art network models in terms of accuracy, precision, recall, and F1 Score.
 METHODS: The proposed neural network model comprises nine layers, guaranteeing the extraction of significant details from the input images and achieving precise classification. The dataset primarily comprises cataract images sourced from a standardized dataset that is publicly available on GitHub, with 8000 training images and 1600 testing images.
 RESULTS: The proposed CataractsNET model achieved an accuracy of 96.20%, precision of 96.1%, recall of 97.6%, and F1 score of 96.1%. These results demonstrate that the proposed method outperforms other deep learning models like ResNet50 and VGG19.
 CONCLUSION: The paper concludes that identifying cataracts in the earlier stages is crucial for effective treatment and reducing the likelihood of experiencing blindness. The widespread use of smartphones makes this approach accessible to a broad audience, allowing individuals to check for cataracts and seek timely consultation with ophthalmologists for further diagnosis.

On the structure of eye diseases in children leading to blindness or low vision in various countries of the world

The review presents differences in the nosological structure of ophthalmic pathology leading to childhood blindness and low vision in different countries. Worldwide, 1.4 million children are blind, about three quarters of whom live in the poorest regions of Africa or Asia. In lowincome countries, the congenital cataract is one of the leading causes of visual impairment in children, while retinopathy of prematurity is more common in middle-income countries. Uncorrected refractive errors both in children and adults, remain a major cause of visual impairment in all countries. The development of new technologies and quality medical care impacts the structure of blindness and low vision causes, as well as their geographical specificities. The analysis showed that much effort is required from large-scale state programs of prevention, early diagnosis, treatment and rehabilitation of children with socially significant eye diseases.

Relationship of structural and functional visual biomarkers with measures of amyloid, tau, and neurodegeneration across the AD continuum

AbstractBackgroundThe eye often reflects changes seen in the brain in neurodegenerative diseases. This study sought to examine the relationship of contrast sensitivity measured using frequency doubling technology (FDT) and retinal thickness measured using optical coherence tomography (OCT) with temporal lobe neurodegeneration, cerebral tau deposition, and mean plasma ptau181 in older adults along the Alzheimer’s disease (AD) continuum.MethodParticipants included 28 individuals with subjective cognitive decline (SCD), 18 mild cognitive impairment (MCI), 4 with AD, and 30 age‐matched cognitive normal (CN) from the Indiana Memory and Aging Study at the Indiana ADRC. Participants were excluded from the study if they had significant eye disease determined to interfere with OCT, FDT, non‐AD dementia, or exclusion for MRI or PET. Mean deviation (MD) and pattern standard deviation (PSD) from FDT were used as measures of contrast sensitivity. OCT scans from each eye to measure retinal thickness in the retinal nerve fiber layer (RNFL) and macula. MRI scans were processed using Freesurfer v6 to measure medial (MTL) and lateral temporal lobe (LTL) volumes. LTL SUVR values were extracted from [18F]flortaucipir PET scans. Plasma ptau 181 was measured using a SIMOA assay. Finally, the association between contrast sensitivity, average RNFL thickness, macular volumes with temporal lobe volumes, LTL tau, and mean plasma ptau181 was assessed using a partial Pearson correlation, covaried for age, sex, and diagnosis. p<0.05 was considered significant.ResultRNFL thickness was decreased in patients with AD. Hippocampal volume correlated with RNFL thickness and macular volume in both eyes and with PSD in the left eye. The inferior temporal volume correlated with MD in both eyes, while mean plasma ptau181 with PSD in both eyes. Finally, lateral temporal lobe tau was correlated with the inner retinal layers of ganglion cell layer plus inner plexiform layer thickness.ConclusionContrast sensitivity correlates with temporal lobe volumes and mean plasma ptau181. RNFL thinning and macular volumes are associated with hippocampal atrophy, and inner retinal nuclear layers correlate with lateral temporal tau. Imaging of the eye may represent a useful biomarker to screen patients at risk for AD prior to more invasive and prolonged testing.

Перспективы применения протеомного анализа в офтальмологии

This paper reviews the perspectives of proteomic analysis of tear and aqueous humor to determine biomarkers for the differential diagnosis of eye disorders. The methodology of sample collection and the advantages and disadvantages of the available methods are discussed in detail. The results of proteomic mapping of tear and aqueous humor in dry eye disease, keratoconus, glaucoma, cataract, age-related macular degeneration, and diabetic retinopathy are described. The association between the levels of identified proteins and their role in triggering pathological processes, e.g., oxidative stress with autophagy (and, as a result, tissue dystrophy), initiation of inflammation, and impairment of metabolic processes at the molecular level with activation of pathological proteolysis (that ultimately lead to cellular and tissue changes with the development of the above-mentioned diseases) are of particular importance. This paper also emphasizes the practical relevance of using proteomics to study the pathogenesis of eye diseases, which implies determining the association between genotype and phenotype of a patient in clinical practice with further treatment personalization. Proteomics also provides an early noninvasive diagnosis of socially significant eye diseases. KEYWORDS: proteomic analysis, tear, aqueous humor, mass spectrometry, eye disorders. FOR CITATION: Krylova A.A., Zakharchuk A.V., Krivosheina O.I., Pekov S.I., Popov I.A. Perspectives of proteomic analysis in ophthalmology. Russian Journal of Clinical Ophthalmology. 2023;23(4):213–218 (in Russ.). DOI: 10.32364/2311-7729-2023-23-4-7.

Ocular Mucus Membrane Pemphigoid: A Primary Versus Secondary Entity.

The purpose of this review was to investigate the idea that inflammatory events of the conjunctiva and ocular surface may act as triggering events for the onset of ocular mucus membrane pemphigoid (oMMP). A retrospective chart review of patients with biopsy-proven oMMP and no systemic pemphigoid disease. The presence, or absence, of the following inflammatory conditions at the time of OMMP diagnosis was noted: significant eyelid disease, significant atopic eye disease, Stevens-Johnson syndrome, graft-versus-host disease, viral keratitis, sarcoidosis with ocular involvement, chemical burns, medicamentosa, Sjogren syndrome, systemic lupus erythematosus with ocular involvement, and epidemic keratoconjunctivitis. Response to immunomodulatory therapy (IMT) was also recorded. A total of 779 patient records were identified. Conjunctival biopsy was present in 724 patients, with 646 (89.2%) being positive. One hundred thirty-nine patients (21.5%) with positive biopsies had extraocular pemphigoid disease and were excluded from further analysis. Of the 507 included patients, 154 (30.4%) had at least one of the specified inflammatory conditions present at the time of OMMP diagnosis. One hundred eighteen patients (23.3%) had only 1 such condition, 35 (6.9%) had 2, and 1 patient had 3. In patients with at least one of these conditions present, response to IMT was seen in 84.9% of patients with sufficient follow-up. Our study suggests that oMMP may arise as a secondary pathology to acute inflammatory events or chronic inflammatory states of the conjunctiva and ocular surface.

Association of retinal nerve fiber layer thickness with temporal lobe atrophy

AbstractBackgroundThe retinal nerve fiber layer (RNFL) is an extension of the brain that often reflects changes seen in the brain in neurodegenerative diseases. The purpose of this study was to examine the relationship of RNFL thickness measured using optical coherence tomography (OCT) with temporal lobe neurodegeneration in older adults along the Alzheimer’s disease (AD) continuum.MethodParticipants included 26 individuals with subjective cognitive decline (SCD), 21 mild cognitive impairment (MCI/{AD}) and 28 age‐matched cognitively normal (CN) from the Indiana Memory and Aging Study at the Indiana Alzheimer’s Disease Research Center. Participants were excluded from the study if they had significant eye disease determined to interfere with OCT and other ocular measures, non‐AD dementia, or exclusion for MRI. OCT scans were acquired from each eye to measure peripapillary RNFL among other metrics. Structural MRI scans were acquired and processed using Freesurfer version 6 to measure medial and lateral temporal lobe volumes. Finally, the association between the average RNFL thickness and bilateral mean hippocampus, amygdala, and lateral temporal lobe volumes was assessed using a partial Pearson correlation, covaried for age, sex, diagnosis, and total intracranial volume (ICV). A p‐value of p<0.05 was considered significant.ResultPeripapillary RNFL thickness was generally decreased in patients with AD compared to all other groups. In addition, average RNFL thickness across the retina was significantly correlated with brain atrophy, including bilateral mean hippocampal, amygdala, and lateral temporal lobe volumes.ConclusionRNFL thinning measured using OCT is associated with regional atrophy in medial and lateral lobes. Imaging of the eye may represent a useful biomarker to screen patients at risk for AD prior to more invasive and prolonged testing.

Risk of physical injuries in children and teens with ophthalmic diagnoses in the OptumLabs Data Warehouse

To evaluate how eye diseases affect the risk of injuries (fractures, musculoskeletal, head and eye injuries) in children and teens. Claims from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, were analyzed. Eligible subjects were aged <19years at the time of their eye disease diagnosis, enrolled in the health plan between 2007 and 2018, and had >1 visit for >1 significant eye disease (strabismus, amblyopia, nystagmus, structural diseases), based on ICD9/10 codes. Controls were children in the same database who had no eye disease codes reported. Demographics and injury claims (fractures, musculoskeletal injuries, head injuries and eye injuries) were compared. The overall incidence of any subsequent physical injury (even into adulthood) was 29% in eye disease patients and 23% in controls (P<0.001). After accounting for covariates, the hazard ratio for injury with any type of eye disease was 1.14 (95% CI, 1.13-1.15), 1.17 (95% CI, 1.16-1.18), 0.97 (95% CI, 0.96-0.98), and 1.63 (95% CI, 1.60-1.66) for musculoskeletal injuries, fractures, head injuries, and eye injuries, respectively. The eye disease with the highest adjusted injury risk was nystagmus (HR=1.26; 95% CI, 1.23-1.28), followed by optic neuritis and pseudotumor cerebri (HR=1.25). The eye diseases with the lowest risk included amblyopia, esotropia, and glaucoma (HR≤1.06). There was an increased long-term risk of physical injury among children and teens with eye disease. The clinical significance of these small differences is unclear.

Prevalence of pediatric eye disease in the optumlabs data warehouse

ABSTRACT Purpose To define the prevalence of medical eye disease diagnoses among children enrolled in commercial insurance plans in the United States and to evaluate differences among groups based on the US census region, race/ethnicity, and familial net worth. Methods : Retrospective study of de-identified claims data from the OptumLab® Data Warehouse (OLDW) between 2007 and 2018. All children (<19 years) in the OLDW with coverage were studied and those with a claim for a significant eye disease (strabismus, amblyopia, nystagmus or structural eye disorders) with minimum 6-months follow-up were studied. Baseline characteristics were extracted for the calculation of eye disease prevalence, including age, sex, race/ethnicity, region of residence, and family net worth. The prevalence of each type of eye disease was calculated among all children and by baseline characteristics. Results : 10,759,066 children met the study criteria. The presence of any significant eye diagnosis was 6.7%. Disease was diagnosed more often in whites (6.9%) than blacks (5.6%) and Hispanics (5.9%). The most common eye disease diagnosed was strabismus (3.2%) followed by amblyopia (1.5%). In the North-East region, there was a 10.6% prevalence of any significant eye disease diagnosis, whereas in the Mid-West, it was 7.4% followed by the South and West (5.9% and 5.3%, respectively) (p < .001). There was an increase in eye disease diagnoses with increasing income (5.5% in<$25,000 and 9.4% in >$500,000 household net worth groups, p > .001). Conclusion : Diagnosis of significant eye diseases is relatively common in American children. The most common medical eye disease diagnosis is strabismus. Prevalence of eye disease diagnosis from claims data varies between geographical regions and different income groups. This may reflect differences in healthcare utilization rather than true disease prevalence.

Incidence of sight-threatening diabetic retinopathy in an established urban screening programme: An 11-year cohort study.

Systematic annual screening to detect sight-threatening diabetic retinopathy (STDR) is established in the United Kingdom. We designed an observational cohort study to provide up-to-date data for policy makers and clinical researchers on incidence of key screening endpoints in people with diabetes attending one screening programme running for over 30years. All people with diabetes aged ≥12years registered with general practices in the Liverpool health district were offered inclusion. Data sources comprised: primary care (demographics, systemic risk factors), Liverpool Diabetes Eye Screening Programme (retinopathy grading), Hospital Eye Services (slit lamp biomicroscopy assessment of screen positives). 133,366 screening episodes occurred in 28,384 people over 11years. Overall incidences were: screen positive 6.7% (95% CI 6.5-6.8), screen positive for retinopathy 3.1% (3.0-3.1), unassessable images 2.6% (2.5-2.7), other significant eye diseases 1.0% (1.0-1.1). 1.6% (1.6-1.7) had sight-threatening retinopathy confirmed by slit lamp biomicroscopy. The annual incidence of screen positive and screen positive for retinopathy showed consistent declines from 8.8%-10.6% and 4.4%-4.6% in 2007/09 to 4.4%-6.8% and 2.3%-2.9% in 2013/17, respectively. Rates of STDR (true positive) were consistently below 2% after 2008/09. Screen positive rates were higher in first time attenders (9.9% [9.4-10.2] vs. 6.1% [6.0-6.2]) in part due to ungradeable images (4.1% vs. 2.3%) and other eye disease (2.4% vs. 0.8%). 4.5% (3.9-5.2) of previous non-attenders had sight-threatening retinopathy. Compared with people with type 2 diabetes, those with type 1 disease demonstrated higher rates of screen positive (11.9% vs. 6.0%) and STDR (6.4% vs. 1.2%). Overall prevalence of any retinopathy was 27.2% (27.0-27.4). In an established screening programme with a stable population screen, positive rates show a consistent fall over time to a low level. Of those who are screen positive, fewer than 50% are screen positive for diabetic retinopathy. Most are due to sight threatening maculopathy. The annual incidence of STDR is under 2% suggesting future work on redefining screen positive and supporting extended intervals for people at low risk. Higher rates of screen positive and STDR are seen in first time attenders. Those who have never attended for screening should be specifically targeted.

Surgical management of the orbit in thyroid eye disease: lateral orbital decompression.

Lateral orbital wall decompression is one of many well established techniques available to surgeons in management of patients with clinically significant thyroid eye disease (TED). Several different surgical approaches have been described in the literature and are reviewed herein. Lateral orbital wall decompression remains a popular technique for surgical management of TED, with a recent American Society of Ophthalmic Plastic and Reconstructive Surgery survey showing that 22.6% of respondents preferred a single-wall procedure, with 36.8% of that subset preferring lateral wall decompression alone. Surgical techniques for lateral orbital wall decompression differ based on several steps, such as the incisional approach, whether to take an ab-interno versus ab-externo approach, and whether to remove orbital fat to achieve further decompression. In addition, technological advances have produced an array of tools available to the orbital surgeon to achieve efficient and accurate bone removal. Lateral orbital wall decompression for TED, despite being an older technique, remains a popular and well established procedure for orbital decompression. Though no randomized controlled clinical trial supports one decompression technique over another for TED, lateral orbital wall decompression offers many benefits such as its ease of access and visualization of the orbital space.

The prevalence of eye diseases in the elderly population is a global problem of modernity

The priority problem of various industrial and developing countries, which largely determine the health of the population and, above all, older age groups, is currently eye diseases. Most modern researchers consider age-related macular degeneration, glaucoma, and cataracts to be eye diseases. Socially significant eye diseases have a high prevalence and are the leading cause of blindness in various countries. Authors analyzed the prevalence of glaucoma, age-related macular degeneration, and cataracts according to domestic and foreign publications in recent years. The results of the studies considered in the scientific review indicate a continuing gain in socially significant eye diseases, the frequency of which increases with age. The high incidence of the studied pathology is observed in China, India, and Russia. The study shows socially significant eye diseases to be the most critical problem in various countries, including the Russian Federation. The relevance of this pathology will increase due to the ongoing aging of the population and an increase in their share in the demographic structure of many states. The high prevalence of age-related macular degeneration, cataracts, and glaucoma leads to an increase in the number of people on the planet with complete or partial vision loss, which significantly disrupts their social functioning and requires significant financial costs for treatment and ensuring an acceptable level and quality of life. The data presented in the review and obtained results are of practical importance for the organization of monitoring of eye diseases and the development of an appropriate state and health strategy.

Glaucoma as a socially significant eye disease among adults and children under 14

Glaucoma as a socially significant eye disease among adults and children under 14

Prevalence of Dry Eye Disease in Africa: A Systematic Review and Meta-analysis.

Dry eye disease is a significant public health problem globally. The magnitude of the dry eye disease problem in Africa is, however, unknown. This study provides important and lacking information on dry eye disease in Africa. This study aimed to estimate the prevalence of dry eye disease in Africa. A systematic online literature search was conducted for articles on dry eye disease in Africa. Meta-analysis was conducted to estimate the prevalence of dry eye disease in Africa and meta-regression to explore the association between dry eye and sex, age, study population, country of study, and type of study. The overall prevalence estimate of dry eye disease in Africa was 42.0% (95% confidence interval [CI], 30.7 to 53.8%). The prevalence rates of dry eye disease in male and female individuals were 42.1% (95% CI, 28.5 to 56.3%) and 44.4% (95% CI, 30.2 to 59.0%), respectively; in South Africa, Ghana, Nigeria, and Egypt, the rates were 54.9% (95% CI, 39.0 to 70.4%), 38.3% (95% CI,17.7 to 61.4%), 41.4% (95% CI, 20.1 to 64.5%), and 34.9% (95% CI, 13.2 to 60.6%) respectively; and in school, hospital, and population-based studies, the rates were 51.6% (95% CI, 40.6 to 62.6%), 38.7% (95% CI, 21.9 to 57.0%), and 37.4% (95% CI, 27.4 to 48.0%). respectively. The prevalence rates of dry eye disease were 36.9% (95% CI, 26.7 to 51.1%) in a "normal" population and 44.2% (95% CI, 18.0 to 67.9%) in a population with known risk conditions. There were no associations between dry eye disease prevalence and sex (P = .88), type of study (P = .42), country of study (P = .33), study population (P = .59), and the diagnostic criteria used (P = .36). There seems to be a significant dry eye disease burden in Africa. This may pose an important public health problem that requires immediate attention and action. More epidemiological studies in Africa are needed to fully understand this problem to inform policy decisions.

Understanding the Dual Dilemma of Dry Eye and Glaucoma: An International Review.

Glaucoma-related ocular surface disease (G-OSD) is a significant, yet often underdiagnosed, ocular co-morbidity affecting 40% to 59% of glaucoma patients worldwide. Although the use of topical glaucoma medications represents a proven strategy to control the untoward effects of high intraocular pressure, this treatment can profoundly disrupt the homeostasis of the tear film. The cumulative effect of medications, preservatives, and excipients alter underlying cellular structures which results in tear film abnormalities and instability of the ocular surface. Furthermore, these chronic inflammatory changes have been shown to impact efficacy of glaucoma treatment, patient compliance with therapy and overall quality of life. The pathogenesis of G-OSD is multifactorial and involves a vicious self-perpetuating cycle of inflammatory cytokines and proteins. The diagnosis of such disease is based on similar tests used in assessing traditional dry eye, taking into consideration findings specific to this patient population. The hallmark of treatment for these patients is to minimize the ocular surface inflammatory response by choosing glaucoma therapies that spare the ocular surface such as preservative free formulations and initiating dry eye treatment early in the course of care. In summary, glaucoma affects millions of patients around the world and chronic use of topical glaucoma medications may negatively impact the patient's ocular surface, symptoms, and vision. Understanding the pathogenesis of G-OSD, recognizing its risk factors and incorporating diagnostic and therapeutic strategies that restore and maintain ocular surface homeostasis will result in improved care for our patients.

Axial length variation with the use of silicone oil tamponade

Background Silicone oil (SO) tamponade is the method of choice as a long-term stable retinal tamponade. Axial length (AL) and ocular biometry are reported to change with the use of SO. However, these changes are not well studied in eyes. Objectives To measure the change in AL before SO injection, as a tamponade, and then following its removal for accurate choice of intraocular lens (IOL) power. Patients and methods This prospective case series study was conducted in the Ophthalmology Department, Menoufia University Hospital, Egypt. The study included 100 eyes of 100 patients who gave consent, with age ranging from 9 to 83 years, undergoing retinal detachment (RD) repair via three-port vasectomy with SO injection and combined SO removal with phacoemulsification after 3–6 months. Eyes with rhegmatogenous RD less than 3 months old with no other significant eye disease were included. Ophthalmic examination included best-corrected visual acuity, intraocular pressure Goldmann tonometry, and AL measurement by A-scan ultrasound and IOL Master500. Results Using IOL Master500 and A-scan, there were no significant differences between the two devices in the mean values of AL at different times of assessment (P = 0.137 and 0.075); otherwise, there was a significant higher mean values of the AL in SO-filled eyes than before operation (P 1 = 0.053 and 0.025). On the contrary, there were no significant differences in the AL either after SO removal than before operation (P 2 = 0.577 and 0.151, respectively), or after SO removal than in SO-filled eyes (P 3 = 0.167 and 0.415, respectively). Conclusion From our study, we conclude that the AL after injection of SO increased by 0.70 mm, whereas following removal of SO would increase by 0.2 mm compared with before SO injection in cases with RD status.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

Introduction.Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods.A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results.For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion.The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

Predictive value of screening tests for sight‐threatening eye disease in a UK population

AbstractBackground/AimsTo determine the performance of combinations of structural and functional screening tests in detecting sight‐threatening eye disease in a cohort of elderly subjects recruited from primary careMethods505 subjects ≥ 60 years underwent: Frequency Doubling Technology (FDT) perimetry; iVue OCT (iWellness® and peripapillary retinal nerve fibre layer (RNFL) scans); IOP with the Ocular Response Analyzer (ORA), all performed by an ophthalmic technician. The reference standard was a full ophthalmic examination by an experienced clinician who was masked to the index test results. Subjects were classified as presence or absence of sight‐threatening eye disease (clinically significant cataract, primary open angle glaucoma, intermediate or advanced AMD and significant diabetic retinopathy). Univariate and multivariate logistic regression was used to determine the association between abnormal screening test results and the presence of sight‐threatening eye disease.Results171 subjects (33.8%) had one or more sight‐threatening eye disease(s). The multivariate analysis found significant associations with any of the target conditions for visual acuity &lt; 6/12, an abnormal FDT and peripapillary RNFL thickness outside the 99% normal limit. The sensitivity of this optimised screening panel was 61.3% (95% CI 53.5‐68.7); specificity 78.8% (CI 74.0‐83.1), positive predictive value 59.5% (CI 53.7‐65.2) and an overall diagnostic accuracy of 72.9% (CI 68.8‐76.8).ConclusionA subset of screening tests may provide an accurate and efficient means of population screening for significant eye disease in the elderly. This study provides useful preliminary data to inform the development of further larger, multicentre screening studies to validate this screening panel.

Role of advanced technology in the detection of sight-threatening eye disease in a UK community setting

Background/aimsTo determine the performance of combinations of structural and functional screening tests in detecting sight-threatening eye disease in a cohort of elderly subjects recruited from primary care.Methods505 subjects aged ≥60...