Vision Center Research Articles

Investigation of Building Automation Systems in Terms of Lighting Efficiency

Considering that energy consumption is constantly increasing along with a gradual decrease in energy resource reserves, energy is the most current and pending issue in today's world. Several academic studies have been conducted on the efficient use of energy resources. For this purpose, the idea of "smart building" has been proposed to use energy more efficiently in buildings. With building automation systems, which are indispensable elements of these smart buildings, the energy consumption of buildings can be greatly reduced. In this study, the lighting efficiency of a building automation system built at a training point in the Marmara University Mehmet Genç campus, Vocational School of Technical Sciences, was examined. The Sauter Vision Center software program was used at the observation center of the system. The results were analyzed in terms of efficiency by comparing the energy values in certain time periods obtained from the program with the energy values calculated in full use. The analysis yielded a lighting efficiency value of 54%, which was found to exceed the values reported in the literature.

Unmasking colorectal cancer: A high-performance semantic network for polyp and surgical instrument segmentation

Colorectal cancer (CRC) remains a significant health concern, with colonoscopy serving as the gold standard for diagnosis. Accurately segmenting polyps from colonoscopy images is crucial for detecting polyps and preventing CRC. However, challenges such as varying polyp sizes, blurred edges, and uneven brightness hinder segmentation accuracy. Leveraging artificial intelligence (AI) and robot-assisted surgery mechanisms can aid surgeons and physicians in detecting and treating polyps. To address these challenges, we propose a Colorectal Network (CR-Net), an AI-based encoder-decoder network for precise polyp and surgical instrument segmentation. CR-Net incorporates a pre-trained Visual Geometry Group model with 16 convolution layers (VGG16), attention mechanisms, redesigned skip connections, and horizontal dense connections within a U-Net architecture. The VGG16 encoder captures robust visual features, while redesigned skip connections accommodate complex data dimensions, leading to enhanced segmentation outcomes. Horizontal dense connections transfer overlooked features from the encoder to subsequent layers, further improving segmentation accuracy. Additionally, a spatial attention block enhances spatial features and ensures compatibility during upsampling. Evaluation of datasets including the Kvasir segmentation (Kvasir-SEG) dataset, Computer Vision Center Clinic Database (CVC-ClinicDB), Kvasir-Instrument dataset, and University of Washington Sinus Surgery Live (UW-Sinus-Surgery-Live) dataset demonstrates CR-Net's superior performance, achieving Dice Similarity Coefficients of 96.21%, 96.54%, 96.32%, and 92.84%, respectively, surpassing previous methods. These results highlight CR-Net's potential in empowering healthcare professionals through advanced AI-driven engineering applications. By bridging AI techniques with engineering innovations, CR-Net represents a significant advancement in CRC diagnosis and treatment.

Diagnostic Performance of the Offline Medios Artificial Intelligence for Glaucoma Detection in a Rural Tele-Ophthalmology Setting

PurposeThis study assesses the diagnostic efficacy of offline Medios Artificial Intelligence (AI) glaucoma software in a primary eyecare setting, using non-mydriatic fundus images from Remidio's Fundus-on-Phone (FOP NM-10). AI results were compared with tele-ophthalmologists' diagnoses and with a glaucoma specialist's assessment for those participants referred to tertiary eyecare hospital. DesignProspective, cross-sectional study Participants303 participants from 6 satellite vision centers of a tertiary eye hospital MethodsAt the vision center, participants underwent comprehensive eye evaluations, including clinical history, visual acuity measurement, slit lamp examination, intraocular pressure measurement, and fundus photography using the FOP NM-10 camera. Medios AI-Glaucoma software analysed 42-degrees disc-centric fundus images, categorizing them as normal, glaucoma, or suspect. Tele-ophthalmologists who were glaucoma fellows with a minimum of 3 years of ophthalmology and 1 year of glaucoma fellowship training, masked to AI results, remotely diagnosed subjects based on the history and disc appearance. All participants labelled as disc suspects or glaucoma by AI or tele-ophthalmologists underwent further comprehensive glaucoma evaluation at the base hospital, including clinical examination, Humphrey visual field analysis (HFA), and Optical Coherence Tomography (OCT). AI and tele-ophthalmologist diagnoses were then compared with a glaucoma specialist's diagnosis. Main Outcome MeasuresSensitivity and Specificity of Medios AI ResultsOut of 303 participants, 299 with at least one eye of sufficient image quality were included in the study. The remaining 4 participants did not have sufficient image quality in both eyes. Medios AI identified 39 participants (13%) with referable glaucoma. The AI exhibited a sensitivity of 0.91 (95% CI: 0.71 - 0.99) and specificity of 0.93 (95% CI: 0.89 - 0.96) in detecting referable glaucoma (definite perimetric glaucoma) when compared to tele-ophthalmologist. The agreement between AI and the glaucoma specialist was 80.3%, surpassing the 55.3.% agreement between the tele-ophthalmologist and the glaucoma specialist amongst those participants who were referred to the base hospital. Both AI and the tele-ophthalmologist relied on fundus photos for diagnoses, while the glaucoma specialist's assessments at the base hospital were aided by additional tools such as HFA and OCT. Furthermore, AI had fewer false positive referrals (2 out of 10) compared to the tele-ophthalmologist (9 out of 10). ConclusionMedios offline AI exhibited promising sensitivity and specificity in detecting referable glaucoma from remote vision centers in southern India when compared with teleophthalmologists. It also demonstrated better agreement with glaucoma specialist’s diagnosis for referable glaucoma participants.

Drug utilization pattern of romosozumab and other osteoporosis treatments in Japan, 2019-2021.

Describe real-world treatment of osteoporosis and romosozumab treatment patterns in Japan. Data for patients initiating romosozumab or other antiosteoporotic medications between March 01, 2018, and May 31, 2022, were extracted from the Medical Data Vision (MDV) and Japan Medical Data Center (JMDC) databases. Patients were categorized into four cohorts: those who newly initiated romosozumab within the first (MDV: n = 4782; JMDC: n = 2578) or second (MDV: n = 3888; JMDC: n = 2446) year after launch and those who initiated teriparatide (TPTD; MDV: n = 14,576; JMDC: n = 8259) or non-TPTD antiosteoporotic medications within the first year of romosozumab launch (MDV: n = 352,142; JMDC: n = 185,785). Mean age, sex, baseline cardiovascular history, comorbidities, and concomitant medications were similar across cohorts. In the MDV database, fracture history was higher in the romosozumab year-1 (59.3%), year-2 (64.1%), and TPTD (65.5%) cohorts versus the non-TPTD cohort (24.4%). Similar rates were identified in the JMDC database: romosozumab year-1 (64.7%), year-2 (66.6%), TPTD (67.5%), and non-TPTD (27.8%). Vertebral fractures were most common in all cohorts. 12-month romosozumab discontinuation varied between the year-1 and year-2 cohorts in MDV (62.4% and 58.8%) and JMDC (57.1% and 52.7%), whereas mean number of injections remained consistent (MDV: 9.7 and 9.8; JMDC: 7.3 and 7.8). Romosozumab persistence was lower in year-1 versus year-2 (MDV: 37.6% and 42.9%; JMDC: 41.2% and 47.3%). Patients initiating romosozumab and TPTD had a high fracture history. Given the dual effects of promoting bone formation and suppressing resorption, improving romosozumab adherence and persistence over time may be important for antiosteoporotic therapy.

Approaches for delivery of refractive and optical care services in community and primary care settings.

Uncorrected refractive error is a leading cause of vision impairment which, in most cases, can be managed with the appropriate spectacle correction. In 2021, the World Health Assembly endorsed a global target of a 40-percentage-point increase in effective coverage of refractive error by 2030. To achieve this global target, equitable access to refractive and optical services within community and primary care settings needs to be strengthened. This review will inform the development of technical guidance to support improvements in the testing and correction of refractive error among World Health Organization (WHO) member states. To determine the range of approaches for delivery of refractive and optical care services in community and primary care settings, and the methods employed for their evaluation. We searched CENTRAL, MEDLINE, Embase and Global Health databases, grey literature, and annual reports and websites of relevant organizations involved in eye-care delivery from January 2002 to November 2022 to identify approaches for refractive and optical service delivery. We included observational and interventional studies, reviews, and reports from relevant organizations related to delivering refractive services and optical services for preschool and school-aged children and adults in community and primary care settings published between January 2002 and November 2022. We searched for studies and reports published within the last 20 years because vision impairment due to uncorrected refractive error has only recently become a public health and eye health priority, therefore we did not expect to find much relevant literature until after 2002. Two review authors screened titles, abstracts and full texts, and extracted data. We resolved any discrepancies through discussion. We synthesized data, and presented results as tables, figures, and case studies. This project was led by the World Health Organization (WHO) Vision and Eye Care Programme. We identified 175 studies from searches of databases and grey literature, 146 records from company reports, and 81 records from website searches of relevant organizations that matched our inclusion criteria. Delivery approaches for refractive and optical services in community care included school-based, pharmacy, and outreach models, whereas primary care approaches comprised vision centre, health centre, and a combination of vision or health centre and door-to-door delivery. In community care, school-based and outreach approaches were predominant, while in primary care, a vision-centre approach was mainly used. In the WHO African region, the school-based and outreach approaches were mainly reported while, in the Americas, the outreach approach was mostly used. Very few approaches for service delivery were reported in the WHO Eastern Mediterranean region. Prominent gaps exist in the evaluation of the approaches, and few studies attempted to evaluate the approaches for delivery of refractive and optical care services. We comprehensively describe a range of approaches for delivery of refractive and optical services in community and primary care. Further evaluation of their effectiveness will better inform the application of these service-delivery approaches. The study outcomes will help guide WHO member states in strengthening refractive and optical services at community and primary care levels. This scoping review was supported by the Vision and Eye care Programme, World Health Organization and ATscale Global Partnership. The protocol of this scoping review was published in the Open Source Framework.

Predictability of Existing IOL Formulas After Cataract Surgery in Patients with a Previous History of Radial Keratotomy: A Retrospective Cohort Study and Literature Review.

This study aims to evaluate the accuracy of 12 different intraocular lens (IOL) power calculation formulas for post-radial keratotomy (RK) eyes. The investigation utilizes recent advances in topography/tomography devices and artificial intelligence (AI)-based calculators, comparing the results to those reported in current literature to assess the efficacy and predictability of IOL calculations for this patient group. In this retrospective study, 37 eyes from 24 individuals with a history of RK who underwent cataract surgery at Hoopes Vision Center were analyzed. Biometry and corneal topography measurements were taken preoperatively. Subjective refraction was obtained 6 months postoperatively. Twelve different IOL power calculations were used, including the American Society of Cataract and Refractive Surgery (ASCRS) post-RK online formula, and the Barrett True K, Double K modified-Holladay 1, Haigis-L, Panacea, Camellin-Calossi, Emmetropia Verifying Optical (EVO) 2.0, Kane, and Prediction Enhanced by Artificial Intelligence and output Linearization-Debellemanière, Gatinel, and Saad (PEARL-DGS) formulas. Outcome measures included median absolute error (MedAE), mean absolute error (MAE), arithmetic mean error (AME), and percentage of eyes achieving refractive prediction errors (RPE) within ± 0.50 D, ± 0.75 D, and ± 1 D for each formula. A search of the literature was also performed by two independent reviewers based on relevant formulas. Overall, the best performing IOL power calculations were the Camellin-Calossi (MedAE = 0.515 D), the ASCRS average (MedAE = 0.535 D), and the EVO (MedAE = 0.545 D) and Kane (MedAE = 0.555 D) AI-based formulas. The EVO and Kane formulas along with the ASCRS calculation performed similarly, with 48.65% of eyes scoring within ± 0.50 D of the target range, while the Equivalent Keratometry Reading (EKR) 65 Holladay formula achieved the greatest percentage of eyes scoring within ± 0.25 D of the target range (35.14%). Additionally, the EVO 2.0 formula achieved 64.86% of eyes scoring within the ± 0.75 D RPE category, while the Kane formula achieved 75.68% of eyes scoring within the ± 1 D RPE category. There was no significant difference in MAE between the established and newer generation formulas (P > 0.05). The Panacea formula consistently underperformed when compared to the ASCRS average and other high-performing formulas (P < 0.05). This study demonstrates the potential of AI-based IOL calculation formulas, such as EVO 2.0 and Kane, for improving the accuracy of IOL power calculation in post-RK eyes undergoing cataract surgery. Established calculations, such as the ASCRS and Barrett True K formula, remain effective options, while under-utilized formulas, like the EKR65 and Camellin-Calossi formulas, show promise, emphasizing the need for further research and larger studies to validate and enhance IOL power calculation for this patient group.

A global centralized magnetic flux leakage small defect detection network

Abstract To solve the problem that magnetic-flux-leakage (MFL) small defects are difficult to accurately detect by machine learning methods, a global centralized magnetic flux leakage small defect detection network (RCFPNet) is proposed. RCFPNet consists of simulation data enhancement, improved feature extraction (backbone), an improved centralized feature pyramid (CFP) and a detection head network. The MFL defect data of various scales and shapes are simulated by ANSYS simulation software and superimposed with the actual detected MFL defects to expand the dataset. The Repvgg module is used to replace the 3*3 convolution of the backbone to improve the detection speed. An improved spatially explicit vision center scheme (EVC) and a global centralized regulation rule (GCR) for feature fusion networks are proposed for feature fusion networks. RCFPNet is based on an improvement of the YOLOv5 network. Experiments have proven that RCFPNet has improved detection speed and accuracy and has achieved good results in the detection of magnetic leakage small defects. Experiments show that when the IOU = 0.5, the accuracy rate of this algorithm is 96.1%, and the reasoning time is 8.9 ms.

Transcranial static magnetic field stimulation over hMT+ inhibits visual motion discriminability

Visuomotor performance acting on a moving target is fundamentally based on visual motion discriminability, and its neural basis is presumed to be human MT (hMT+), a motion vision center of the dorsal visual pathway. In this study, we investigated whether and how the accuracy and speed of motion discrimination are affected by applying transcranial static magnetic field stimulation (tSMS) to hMT+, which reduces cortical excitability. Sixteen participants performed a motion direction discrimination (MDD) task using a random dot kinematogram before (Pre-test) and during (During-test) application of the tSMS over left hMT+. The correct rate of the MDD task was significantly lower in the During-test compared to the Pre-test, an effect not seen with the sham condition. The inhibition effects were observed only for the right visual field corresponding to hMT+ in the stimulated hemisphere. On the other hand, no modulatory effect of tSMS was observed in the reaction time. We, therefore, demonstrated the inhibitory effect of tSMS on the left hMT+ impairs the accuracy but not the speed of motion information processing in the contralateral visual field.

Evaluation of a telemedicine-enabled universal eye health delivery model in rural southern India.

To evaluate the accuracy of tele-ophthalmic examination (TOE) for common ocular conditions in comparison with the gold-standard in-person examination (IPE) for diagnosis and treatment advice. In a prospective, diagnostic accuracy validation study, we recruited 339 consecutive new patients, aged ≥16 years, visiting a vision centre (VC) associated with Aravind Eye Hospital in south India during January and February, 2020. All participants underwent the TOE, followed by IPE on the same visit. The in-person ophthalmologist was masked to the TOE diagnosis and treatment advice. Data were analysed via the sensitivity specificity of TOE versus the gold-standard IPE. TOE achieved high sensitivity and specificity for identifying normal eyes with 87.4% and 93.5%, respectively. TOE had high sensitivity for cataracts (91.7%), infective conjunctivitis (72.2%), and moderate sensitivity for pterygium (62.5%), DR (57.1%), non-serious injury (41.7%), but low sensitivity for glaucoma (12.5%). TOE had high specificity ranging from 93.5% to 99.8% for all diagnoses. The sensitivity for treatment advice ranged from 58.1% to 77.2% and specificity from 96.9% to 100%. The TOE in VCs has acceptable accuracy to an IPE by an ophthalmologist for correctly identifying and treating major eye ailments. Through providing universal eye care to rural populations, this model may contribute to work toward achieving Universal Health Coverage, which is a linchpin of the health-related U.N. Sustainable Development Goals (SDG).

Association between APOL1 risk variants and the occurrence of sepsis in Black patients hospitalized with infections: a retrospective cohort study.

Two risk variants in the apolipoprotein L1 gene (APOL1) have been associated with increased susceptibility to sepsis in Black patients. However, it remains unclear whether APOL1 high-risk genotypes are associated with occurrence of either sepsis or sepsis-related phenotypes in patients hospitalized with infections, independent of their association with pre-existing severe renal disease. A retrospective cohort study of 2242 Black patients hospitalized with infections. We assessed whether carriage of APOL1 high-risk genotypes was associated with the risk of sepsis and sepsis-related phenotypes in patients hospitalized with infections. The primary outcome was sepsis; secondary outcomes were short-term mortality, and organ failure related to sepsis. Of 2242 Black patients hospitalized with infections, 565 developed sepsis. Patients with high-risk APOL1 genotypes had a significantly increased risk of sepsis (odds ratio [OR]=1.29 [95% CI, 1.00-1.67; p=0.047]); however, this association was not significant after adjustment for pre-existing severe renal disease (OR = 1.14 [95% CI, 0.88-1.48; p=0.33]), nor after exclusion of those patients with pre-existing severe renal disease (OR = 0.99 [95% CI, 0.70-1.39; p=0.95]). APOL1 high-risk genotypes were significantly associated with the renal dysfunction component of the Sepsis-3 criteria (OR = 1.64 [95% CI, 1.21-2.22; p=0.001]), but not with other sepsis-related organ dysfunction or short-term mortality. The association between high-risk APOL1 genotypes and sepsis-related renal dysfunction was markedly attenuated by adjusting for pre-existing severe renal disease (OR = 1.36 [95% CI, 1.00-1.86; p=0.05]) and was nullified after exclusion of patients with pre-existing severe renal disease (OR = 1.16 [95% CI, 0.74-1.81; p=0.52]). APOL1 high-risk genotypes were associated with an increased risk of sepsis; however, this increased risk was attributable predominantly to pre-existing severe renal disease. This study was supported by R01GM120523 (QF), R01HL163854 (QF), R35GM131770 (CMS), HL133786 (WQW), and Vanderbilt Faculty Research Scholar Fund (QF). The dataset(s) used for the analyses described were obtained from Vanderbilt University Medical Center's BioVU which is supported by institutional funding, the 1S10RR025141-01 instrumentation award, and by the CTSA grant UL1TR0004from NCATS/NIH. Additional funding provided by the NIH through grants P50GM115305 and U19HL065962. The authors wish to acknowledge the expert technical support of the VANTAGE and VANGARD core facilities, supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA068485) and Vanderbilt Vision Center (P30 EY08126). The funders had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Association between APOL1 risk variants and the occurrence of sepsis in Black patients hospitalized with infections: a retrospective cohort study

Background:Two risk variants in the apolipoprotein L1 gene (APOL1) have been associated with increased susceptibility to sepsis in Black patients. However, it remains unclear whether APOL1 high-risk genotypes are associated with occurrence of either sepsis or sepsis-related phenotypes in patients hospitalized with infections, independent of their association with pre-existing severe renal disease.Methods:A retrospective cohort study of 2242 Black patients hospitalized with infections. We assessed whether carriage of APOL1 high-risk genotypes was associated with the risk of sepsis and sepsis-related phenotypes in patients hospitalized with infections. The primary outcome was sepsis; secondary outcomes were short-term mortality, and organ failure related to sepsis.Results:Of 2242 Black patients hospitalized with infections, 565 developed sepsis. Patients with high-risk APOL1 genotypes had a significantly increased risk of sepsis (odds ratio [OR]=1.29 [95% CI, 1.00–1.67; p=0.047]); however, this association was not significant after adjustment for pre-existing severe renal disease (OR = 1.14 [95% CI, 0.88–1.48; p=0.33]), nor after exclusion of those patients with pre-existing severe renal disease (OR = 0.99 [95% CI, 0.70–1.39; p=0.95]). APOL1 high-risk genotypes were significantly associated with the renal dysfunction component of the Sepsis-3 criteria (OR = 1.64 [95% CI, 1.21–2.22; p=0.001]), but not with other sepsis-related organ dysfunction or short-term mortality. The association between high-risk APOL1 genotypes and sepsis-related renal dysfunction was markedly attenuated by adjusting for pre-existing severe renal disease (OR = 1.36 [95% CI, 1.00–1.86; p=0.05]) and was nullified after exclusion of patients with pre-existing severe renal disease (OR = 1.16 [95% CI, 0.74–1.81; p=0.52]).Conclusions:APOL1 high-risk genotypes were associated with an increased risk of sepsis; however, this increased risk was attributable predominantly to pre-existing severe renal disease.Funding:This study was supported by R01GM120523 (QF), R01HL163854 (QF), R35GM131770 (CMS), HL133786 (WQW), and Vanderbilt Faculty Research Scholar Fund (QF). The dataset(s) used for the analyses described were obtained from Vanderbilt University Medical Center’s BioVU which is supported by institutional funding, the 1S10RR025141-01 instrumentation award, and by the CTSA grant UL1TR0004from NCATS/NIH. Additional funding provided by the NIH through grants P50GM115305 and U19HL065962. The authors wish to acknowledge the expert technical support of the VANTAGE and VANGARD core facilities, supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA068485) and Vanderbilt Vision Center (P30 EY08126). The funders had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Short term clinical observation of keratoconus treated with stromal lenticule addition keratoplasty combined with corneal collagen cross-linking

Objective: To investigate the efficacy of Femtosecond laser-assisted stromal lenticule addition keratoplasty (SLAK) combined with corneal collagen cross-linking (CXL) in the treatment of middle and advanced Keratoconus. Methods: It was a retrospective case series study. Data of 23 cases (24 eyes) of keratoconus treated with femtosecond laser-assisted SLAK combined with CXL in Laser Vision Centre of Xi'an No.1 Hospital from September 2020 to June 2022 were collected, including 16 males and 7 females, aged (23.69±5.18) years. The thickness, diopter number and diameter of the donor corneal stromal lens were assessed. uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and diopter were recorded before and 1, 3, and 6 months after surgery. Sirius 3D fault corneal topography instrument to measure flat simulated keratometry (Kf), steep simulated keratometry (Ks) and the difference between them (ΔK), as well as central corneal thickness (CCT) and corneal high-order aberration. Results: Six months after surgery, CCT (454.83±50.01) μm were significantly higher than before (384.92±35.45) μm (P<0.05). Six months after surgery, UCVA (1.41±0.32) was significantly lower than before (1.11±0.33)(P<0.05). Six months after surgery, spherical diopter [(-15.73±7.89) D], Kf [(56.82±4.76) D] and Ks [(61.00±4.70) D] were significantly higher than before [(-12.08±5.99) D, (53.55±4.95) D, (58.65±5.10) D] (P<0.05). There was no significant difference in BCVA, column mirror degree and higher order aberrations before and 6 months after surgery(P>0.05). No corneal stromal lens folds, melting and displacement were observed in all eyes during the follow-up period, and no corneal opacity or immune rejection was observed. Conclusions: femtosecond laser-assisted SLAK combined with CXL can significantly increase the corneal thickness of keratoconus and has good effectiveness. In addition, six months of postoperative follow-up of patients showed no significant changes in BCVA and high-order aberrations in the 6 mm central diameter of the cornea, and no postoperative adverse reaction were found in all eyes, indicating that the operation has certain safety.

RDD-YOLOv5: Road Defect Detection Algorithm with Self-Attention Based on Unmanned Aerial Vehicle Inspection.

Road defect detection is a crucial aspect of road maintenance projects, but traditional manual methods are time-consuming, labor-intensive, and lack accuracy. Leveraging deep learning frameworks for object detection offers a promising solution to these challenges. However, the complexity of backgrounds, low resolution, and similarity of cracks make detecting road cracks with high accuracy challenging. To address these issues, a novel road crack detection algorithm, termed Road Defect Detection YOLOv5 (RDD-YOLOv5), was proposed. Firstly, a model was proposed to integrate the transformer structure and explicit vision center to capture the long-distance dependency and aggregate key characteristics. Additionally, the Sigmoid-weighted linear activations in YOLOv5 were replaced with the Gaussian Error Linear Units to enhance the model's nonlinear fitting capability. To evaluate the algorithm's performance, a UAV flight platform was constructed, and experimental freebies were provided to boost inspection efficiency. The experimental results demonstrate the effectiveness of RDD-YOLOv5, achieving a mean average precision of 91.48%, surpassing the original YOLOv5 by 2.5%. The proposed model proves its ability to accurately identify road cracks, even under challenging and complex traffic backgrounds. This advancement in road crack detection technology has significant implications for improving road maintenance and safety.

Impact of depression in Elderly patients with low vision

OBJECTIVE: To determine the effects of depression in the elder patients suffering from low vision and correlate depression with low vision.&#x0D; METHOD: A cross-sectional study was performed on 91 subjects who visited Low Vision Center at Mayo Hospital Lahore. All the patients were asked to fill the questionnaire. Qualitative data was analyzed through frequency and percentage. This study was conducted from September to November 2020.&#x0D; RESULTS: Forty six out of ninety one (50.5%) patients had trouble in reading regular size print. Fifty three percent were having difficulty to sign documents. Forty percent were having difficulty in recognizing faces. Sixty three (69.2%) patients had difficulty in independent travelling. Reduced vision leading to unhappy feeling sometimes was experienced by 39.6% of the participants. Out of 91, 40 patients of low vision having depression get frustrated when they could not perform certain tasks. Poor daily routine work was found in 50.5%. Patient having mild, severe and very severe glare problem were 51.7%, 24.2% and 6.6% respectively. Severe problem while watching television is found in 39.6% patients. Depressive patients having thoughts of hurting themselves were 3.3%. Thirty eight percent felt that ignorance could develop stress.&#x0D; CONCLUSION: There were high chances in low vision patients to develop depression because of visual loss, functional impairment, and difficulty in daily life activities. Visual impairment restricted a person's independence, and worsened the quality of life. If a person is counseled properly, it is beneficial in increasing the functional performance and will also help him or her to avoid developing depression.&#x0D; KEYWORDS: Low vision, Depression.

Living with an iconic aid

There are plenty of objects that are conspicuous in the way they signal to the surroundings that the user has some kind of physical impairment. Most obvious are perhaps wheelchairs, motorized wheelchairs, hearing aids and crutches. These objects can be described as aids in the sense that the purpose is either to mitigate the effects of reduced physical abilities or to compensate for the loss of a sensory faculty. The focus of this article concerns an object that both increases mobility and replaces such a faltering capacity. It might even be the most iconic of all aids: the mobility cane, also known as the white cane, long cane or white stick. Based on the work at a Swedish Low Vision and Resource Centre, this article discusses the use of the white cane among people with severe and progressive visual impairment. The fact is that this aid, which for an outsider would easily seem to be a rather natural choice, can arouse completely different feelings in somebody who has a severe visual impairment. It is a well-known circumstance amongst low visions teachers and therapists that persons with acquired or progressive sight impairment are often not quite happy about using the aid. Therefore, the aim of the article is to utilize notions of everyday experiences to gain further insights into why the white cane for many of its potential users are associated with strong feelings of both personal ambiguity and social stress. In order to highlight these emotional, and still cultural and political, tensions, the discussion is grounded in critical disability studies and informed by ableism, stigma, and passing as theoretical concepts.

Knowledge, attitude, perception and education on contact lenses for refractive errors in Kenya

Background: Globally, contact lenses are an important part of the management process for refractive errors. Contact lenses are accepted widely in developed countries, but they are currently less used in developing countries like Kenya.Aim: To assess the knowledge, attitudes and perceptions (KAP) (both pre- and post-education) to contact lens uptake specifically for correction of refractive errors by patients attending a Kenyan University Eye Clinic.Setting: Academic Vision Centre, Masinde Muliro University of Science and Technology, Kakamega, Kenya.Methods: A quasi-experimental cross-sectional study was performed by reviewing all records from February 2014 to March 2020; 360 records were purposively selected. Thereafter, a structured questionnaire with educative content on contact lenses was administered by phone and online to determine KAP. Responses were collected over a period of one month. Knowledge, attitudes and perceptions were categorised and scored, and descriptive statistics and paired t-tests were used for data analysis.Results: More women (58.3%) and mostly students (59.2%) participated, with ages from 16 to 38 years (mean age and standard deviation of 22.85 ± 4.32). Overall, there was poor knowledge of contact lenses for refractive errors (96.7%). Attitudes to contact lenses were unfavourable, both pre- and post-education (94.7% and 92.8%). Perceptions of contact lens uptake were negative pre-education (92.5%) but positive post-education (95.3%).Conclusion: Education changed perceptions of contact lens usage for refractive errors correction, but even with some focused education, negative attitudes and poor knowledge regarding contact lenses persisted in the sample. Practitioners should inform patients about contact lenses as a possibility for refractive error management, and institutions training eye care providers should consolidate their clinical teaching regarding contact lenses.Contribution: This study showed that the more people with refractive errors are knowledgeable about contact lenses, the more uptake of contact lenses will happen, optometrists and ophthalmologists should educate people more on contact lenses.

A technological approach to "Reaching the Unreached" - Leveraging teleophthalmology services in Rural Gujarat.

Early detection of sight-threatening disorders by technological applications like teleophthalmology and prompt treatment can help decrease visual impairment. This study evaluated the role of teleophthalmology in underserved rural areas along with cost-saving estimates for the end user. A prospective, observational, cross-sectional hospital-based study was conducted over 3 months. First 1000 teleconsultations were included. None of the patients denied providing informed consent. The patients were consulted at the eight vision centers and three satellite centers of the hospital in the nearby rural and tribal regions closer to their residential places. These vision and satellite centers were connected to the base hospital like a hub and spoke model with a teleophthalmology network. Cataract (n = 301, 30.1%) and refractive error (n = 290, 29%) were the most common diagnosis. 42.1% of patients were referred to base hospital for further evaluation. Thus, a total of 57.9% of patients were not required to visit the base hospital for initial consultation, saving time and money. Furthermore, 15.1% of patients were provided medical treatment at the vision center and satellite center, which helped in making teleophthalmology cost-saving for the patients. An average of Rs. 621/- were saved per patient for the community in our study. Networked teleophthalmology model can be an affordable and feasible tool for providing eye care delivery services in rural and tribal regions of Gujarat and the whole country, especially for the end user. Thus, it may be a workable model in ophthalmology practice with substantial cost saving to the community.

The effect of social determinants of health on severity of microbial keratitis presentation at a tertiary eye care hospital in Southern India.

Understanding the association between social determinants of health (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and identify risk factors associated with worse disease, such as presenting visual acuity (VA) and time to initial presentation. This was a cross-sectional study was conducted with patients presenting with MK to the cornea clinic at a tertiary care hospital in Madurai, India. Patient demographics, SDoH survey responses, geographic pollution, and clinical features at presentation were collected. Descriptive statistics, univariate analysis, multi-variable linear regression models, and Poisson regression models were utilized. There were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were female and 55% did not visit a vision center (VC) prior to presenting to the clinic. The median presenting logarithm of the minimum angle of resolution (logMAR) VA was 1.1 [Snellen 20/240, inter-quartile range (IQR) = 20/80 to 20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, for the districts from which the patients traveled was 24.3 μg/m3 (SD = 1.6). Age- and sex-adjusted linear regression and Poisson regression results showed that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer time to presentation compared to those who did (incidence rate ratio = 2.0, 95% confidence interval = 1.3-3.0, P = 0.001). Patient SDoH and environmental exposures can impact MK presentation. Understanding SDoH is important for public health and policy implications to mitigate eye health disparities in India.

Commentary: Leap forward in presbyopia management - Correcting beyond spectacles.

Commentary: Leap forward in presbyopia management - Correcting beyond spectacles.

The effect of COVID-19 on referral patterns for clinical electrophysiological testing.

To provide an overview of the effect that the COVID-19 pandemic has had on visual electrophysiology referral patterns and the subsequent effect this may have on patients. All electrodiagnostic tests performed at Kensington Vision and Research Centre, Toronto Canada, in a 3-month period prior to the COVID-19 pandemic (1 September 2019 to 30 November 2019) were compared to a 3-month period after the start of the COVID-19 pandemic (1 September 2021 to 30 November 2021). A total of 502 patients had electrodiagnostic testing carried out in the designated time periods: 292 in the time period prior to the COVID-19 pandemic and 210 patients after. There was a significant change in the reason for referral in patients pre-COVID compared to post-COVID (p = 0.004). There was a 43% reduction in referrals for drug monitoring, 25% reduction for hereditary pathology and a 27% increase in acquired pathology after the start of the COVID-19 pandemic compared to before. There was a substantial decrease in the total number of patients referred after the start of the COVID-19 pandemic compared to pre-COVID with inherited retinal pathology and drug monitoring patients being 2 populations most affected by the disruption to healthcare services.