Ophthalmology Commons^™

Enhancing Patient Understanding: The Impact Of Educational Videos On Ophthalmology Visits, Anna Zhao

Medical Student Research Symposium

A major component of effective patient-centered care is the patient’s understanding of their health condition and treatments. Increased knowledge of medical conditions can positively modify health behaviors, such as more participation in cancer screening and better adherence to medications. However, the readability of educational materials often does not match the patients’ reading abilities. Instead, educational videos, which have gained prominence with the emergence of tele-visits following COVID-19, have shown promise in being beneficial to patients with lower literacy levels. For ocular pathologies, early identification and care are key in preventing vision loss. Tele-education in ophthalmology could increase patient awareness of …

Topical Anesthetic Gel Interferes With Antibacterial Efficacy Of Povidone-Iodine Both In Vitro And In Vivo, Cecilly Kelleher Bs, Jacob Im Md, Linda Kang Bs, Aleksey Mishulin Md, Sukhvinder Singh Phd, Ashok Kumar Phd

Medical Student Research Symposium

Purpose: To evaluate the effects of viscous lidocaine gel on the antimicrobial efficacy of povidone-iodine (PI) and their order of application in both in vitro and in vivo models.

Methods: In vitro antibacterial effects were tested against Staphylococcus aureus (S. aureus) with disc diffusion methods for application of lidocaine alone, PI alone, PI before lidocaine, and lidocaine before PI. Zones of inhibition were measured after incubation at 37°C overnight. Mouse eyes were colonized with S. aureus for in vivo study to which PI and/or lidocaine were applied in various combinations. Eyes were then rinsed with saline, and …

Assessment Of The Nanodropper Eye Drop Adaptor For Glaucoma Medications, Nicholas Pryde, Parker J. Williams, Faisal Ridha Al-Timimi, John Michael Guest

Medical Student Research Symposium

Assessment of the Nanodropper Eye Drop Adaptor for Glaucoma Medications

Nicholas Pryde, BS¹; Parker J. Williams, DO ¹; John-Michael Guest, MD¹; Bret A. Hughes, MD¹; Faisal Ridha MD¹

¹Kresge Eye Institute and Wayne State University Department of Ophthalmology, Detroit, MI, USA

Purpose: To determine the dispensed volume change for seven medications with and without the Nanodropper adaptor.

Methods: Sequentially, 100 µL of each medication was dispensed by micropipette into a 1.5 mL Eppendorf tube, and mass without the tube was determined with a precision balance (Practum, Germany). The mean mass was …

Functional Attenuation Coefficient Imaging Of Rod Inner Segment: The Shape Of Things To Come, Cole Goodman

Medical Student Research Symposium

Purpose: Dysfunction of mitochondria and their linked processes within the rod cell (i.e., the rod energy-landscape) are leading hypotheses for rod atrophy in retinitis pigmentosa (RP). It remains unclear how to translate the detailed information available from isolated cell / mitochondria studies into how mitochondria are functioning and responding to treatment in vivo. Here we present a new rod energy-landscape biomarker that can help address this problem using a common clinical tool.

Methods: In mice, OCT data was converted into attenuation coefficients (AC) to map the light-scattering of mitochondria within the inner segment (IS), which fills ~75% of its volume …

Corneal Disease And Air Pollution Levels In Detroit: Preliminary Results And Future Directions​, Sachin Ketkar, Matthew Silbergleit, Vaama Patel

Medical Student Research Symposium

Purpose: To determine if Detroit zip codes with elevated air pollution levels demonstrate increased incidence of corneal disease.

Background: 82 million people in the United States live in counties with air quality concentrations above the National Ambient Air Quality Standards. Air pollution’s detrimental effects on an individual’s health has been well documented. Much of this research has focused on the pulmonary system. The eye, another mucous membrane exposed to the external environment, has been largely ignored

Methods: After an initial literature review of similar studies, 14 corneal diseases and 5 pollutants were selected to be evaluated. Kresge Eye Institute’s patient …

Professional Coaching In Residency: A Novel Approach To Decrease Resident Burnout, Matthew Silbergleit, Shibandri Das, Mark S. Juzych, Pradeepa Yoganathan

Medical Student Research Symposium

Purpose: To implement and analyze an organizational level coaching program for ophthalmology residents at the Kresge Eye Institute (KEI) as the front-line method for prevention and management of physician burnout.

Background: Burnout is a well-documented stressor in medicine and has been shown to significantly increase unprofessional conduct and medical errors. A recent, promising model to tackle burnout in the medical field is coaching. The Harvard Business Review and American Medical Association have demonstrated the positive effects of coaching on professional performance and well-being.

Methods: We plan on utilizing the Kern Method to develop a resident wellness curriculum addressing resident burnout. …

Complication Rates In Resident Cataract Surgery After Elective Operating Room Shutdown During The Covid-19 Pandemic, Michael Schneider, Christian Mehregan Md, Collin Richards, Shibandri Das Md, Xihui Lin Md

Medical Student Research Symposium

Purpose: To assess the types of cataract surgeries being performed at one large eye institute from before and after the COVID-19 induced shutdown of elective surgeries in Spring 2020.

Methods: This is a retrospective chart review study of operative reports from resident performed cataract surgeries from January 1st, 2020 through July 31st, 2020. Cataract surgeries were categorized into Pre-COVID (Jan – Mar 2020) if they occurred prior to operating room (OR) shutdown on March 18th, 2020 and Post COVID for all cases which occurred after the shutdown orders were lifted (May – July 2020). A resident survey was also used …

Post-Operative Day 1 Versus Day 0 Follow-Up For Uncomplicated Cataract Surgeries: A Comparison Of Post-Operative Outcomes And Managements, Harsh Parekh Bs, Shibandri Das Md, Vaama Patel Md, Ryan Freedman Md, Sabba Mansoor Bs, Amanda Ismail Md, Faisal Ridha Al-Timimi Md

Medical Student Research Symposium

Purpose: To compare the postoperative outcomes and management of uncomplicated cataract surgery (CEIOL) patients seen on post-operative day zero (POD 0) versus post-operative day one (POD 1).

Methods: A retrospective chart review of 533 patients who had CEIOL at the Kresge Eye Institute from December 2017 to September 2019 was performed. Visual acuity (VA) and intraocular pressure (IOP) were collected from the pre-operative visit, and the first and second post-operative day visits. In addition, changes in management were recorded from the first post-operative day visit. Patients were excluded if they had a complex cataract procedure, had combined glaucoma filtering surgery, …

Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To evaluate ophthalmology resident anxiousness and cardiovascular response by tracking resident heart rate (HR) when performing cataract surgery during their last year of residency.

Methods: A prospective analysis of 31 cataract cases, completed by three residents (two females and one male), at the Kresge Eye Institute in August and September 2020 was performed. Inclusion criteria for cases included all cataract cases performed by PGY-4 residents at the Kresge Eye Institute who downloaded the Heart Graph app supported by iOS. Residents with android mobile devices were excluded from the study. Informed consent was obtained from all residents who utilized the …

Antiviral Prophylaxis May Not Provide Benefit In Patients With Posner-Schlossman Syndrome, Patrick Lee

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Chee SP, Jap A. Cytomegalovirus anterior uveitis: outcome of treatment. Br J Ophthalmol. 2010 Dec;94(12):1648-52. https://doi.org/10.1136/bjo.2009.167767 for a patient on antiviral prophylaxis for recurrent episodes of Posner-Schlossman Syndrome.

Trends In The Sources Of Endophthalmitis At Kresge Eye Institute, Anita Vaishampayan, Kresge Eye Institute

Medical Student Research Symposium

Purpose

Endophthalmitis is a defined as a purulent inflammation of the intraocular fluids, namely the vitreous and aqueous humor. Endophthalmitis most commonly develops from infection, but can also be acquired from inflammatory and neoplastic conditions. We sought to determine these sources at our institute and to look for trends in our urban population.

Methods

A retrospective chart review of patients who attended the Kresge Eye Institute in Detroit, MI between 2003 to 2018 was performed. Patient list was identified from our EMR using the diagnoses codes related endophthalmitis. Information gathered included demographics, type of tissue/fluid cultured, the presumed source of …

Long-Term Outcomes Of Bleb Needling Following Primary Glaucoma Filtering Surgery In Primary Open Angle Glaucoma, Bryen Turco, Vaama Patel, Chaesik Kim, Justin Tannir, Lauren Keshishian, Anju Goyal, Mark Juzych, Bret Hughes, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To determine the long-term success rate of bleb needling in a predominantly African American population and to identify factors associated with success.

Methods: We conducted a retrospective, observational clinical study in patients with primary open angle glaucoma. Patients who underwent a primary trabeculectomy, with or without an express shunt placement, and then subsequently had a bleb needling procedure were selected for this study. Patients were followed every three months for a period of two years. Failure criteria included achieving an intraocular pressure (IOP) of greater than 20 mmHg or greater than 80% of the pre-needling value on …

Empiric Antibiotic Use For Infectious Conjunctivitis Provides Little Clinical Benefit, Matthew M. Rolain

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Rose PW, Harnden A, Brueggemann AB, et al. Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trial. Lancet. 2005;366(9479):37-43. doi: 10.1016/S0140-6736(05)66709-8.

Inflammation In The Pathogenesis Of Diabetic Retinopathy, Haoshen Shi

Wayne State University Dissertations

The general purpose of these studies is to investigate inflammation in diabetic retinopathy in an effort to identify key intervention points to develop as treatments. Firstly, we showed that the neuropeptide VIP displayed protective immunoregulatory effects on retinal endothelial cells cultured under high glucose conditions. This effect was carried out, in part through the VPAC2 receptor.

Next, we studied the β-adrenergic receptor agonist, Compound 49b, and its effect on the pro-resolving RvD1 pathway. Compound 49b was previously shown to suppress both inflammatory and apoptotic responses in DR. We demonstrated that Compound 49b rescued the high glucose-induced decrese in RvD1 and …

Improving Aav Transduction Efficiency In Retinal Bipolar Cells For Optogenetic Vision Restoration, Shengjie Cui

Wayne State University Dissertations

Recombinant adeno-associated virus (AAV) vectors are the most promising vehicles for therapeutic gene delivery to the retina. We are developing AAV-mediated expression of optogenetic tools in surviving inner retinal neurons as a potential strategy to restoring vision after the death of photoreceptor cells in retinal degeneration. Targeting optogeneitc tools, such as channelrhodopsin-2 (ChR2), to retinal bipolar cells (RBCs) is particularly attractive. In particular, our lab has recently developed an optimized mGluR6 promoter-based virus vector that can mainly target ChR2 to rod bipolar cells. However, AAV-mediated transduction efficiency in RBCs is relatively low. The transduction efficiency could be affected by a …

Mitochondria Mediates Caspase-Dependent And Independent Retinal Cell Death In Staphylococcus Aureus Endophthalmitis, Pawan K. Singh, Ashok Kumar

Ophthalmology Faculty Research Publications

Bacterial endophthalmitis, a vision-threatening complication of ocular surgery or trauma, is characterized by increased intraocular inflammation and retinal tissue damage. Although significant vision loss in endophthalmitis has been linked to retinal cell death, the underlying mechanisms of cell death remain elusive. In this study, using a mouse model of Staphylococcus aureus endophthalmitis and cultured human retinal Müller glia (MIO-M1 cell line), we demonstrate that S. aureus caused significant apoptotic cell death in the mouse retina and Müller glia, as evidenced by increased number of terminal dUTP nick end labeling and Annexin V and propidium iodide-positive cells. Immunohistochemistry and western blot …

Expression And Functions Of Il-24 And Socs3 In Pseudomonas Aeruginosa Keratitis In A C57bl/6 Mouse Model, Bing Xu

Wayne State University Dissertations

The aim of this study was to elucidate the expression and functions of interleukin (IL)-24 and suppressor of cytokine signaling 3 (SOCS3), and their regulatory relationship in C57BL/6 mouse corneas in response to Pseudomonas aeruginosa (PA) infection. Among IL-20R cytokines, only IL-24 was induced at both mRNA and protein levels by the infection, and this upregulation was dampened by flagellin pretreatment. Time course studies revealed that IL-24 expression was markedly elevated, followed by a subsidence and second elevation, a pattern shared with SOCS3 but not IL-1β or IL-6. Silencing of IL-24 enhanced S100A8/A9 expression, and suppressed SOCS3, IL-1β, IL-1RN, and …

Dendrimer Based Nanotherapeutics For Ocular Drug Delivery, Siva Pramodh Kambhampati

Wayne State University Dissertations

PAMAM dendrimers are a class of well-defined, hyperbranched polymeric nanocarriers that are being investigated for ocular drug and gene delivery. Their favorable properties such as small size, multivalency and water solubility can provide significant opportunities for many biologically unstable drugs and allows potentially favorable ocular biodistribution. This work exploits hydroxyl terminated dendrimers (G4-OH) as drug/gene delivery vehicles that can target retinal microglia and pigment epithelium via systemic delivery with improved efficacy at much lower concentrations without any side effects.

Two different drugs Triamcinolone acetonide (TA) and N-Acetyl Cysteine (NAC) conjugated to G4-OH dendrimers showed tailorable sustained release in physiological relevant …

Characterization Of High-Voltage-Activated Calcium Channels In Retinal Bipolar Cells, Qi Lu

Wayne State University Dissertations

Retinal bipolar cells, conveying visual information from photoreceptors to ganglion cells, segregate visual information into multiple parallel pathways through their diversified cell types and physiological properties. Voltage-gated Ca²⁺ channels could be particularly important underlying the diversified physiological properties of different BCs. In this dissertation, I investigated the high-voltage-activated (HVA) calcium current in retinal bipolar cells in mice. In the first part of my dissertation, I characterized multiple bipolar cell-expressing GFP and/or Cre transgenic mouse lines. In the second part of my dissertation, by performing whole-cell patch-clamp recordings, I examined the electrophysiological properties of HVA calcium currents among CBCs and …

Protein Tyrosine Phosphatase-1b Regulates The Tyrosine Phosphorylation Of The Adapter Grb2-Associated Binder 1 (Gab1) In The Retina, Ammaji Rajala, Ashok K. Dilly, Raju Vs Rajala

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gab1 (Grb2-associated binder 1) is a key coordinator that belongs to the insulin receptor substrate-1 like family of adaptor molecules and is tyrosine phosphorylated in response to various growth factors, cytokines, and numerous other molecules. Tyrosine phosphorylated Gab1 is able to recruit a number of signaling effectors including PI3K, SHP2 and PLC-γ. In this study, we characterized the localization and regulation of tyrosine phosphorylation of Gab1 in the retina.

Results

Our immuno localization studies suggest that Gab1 is expressed in rod photoreceptor inner segments. We found that hydrogen peroxide activates the tyrosine phosphorylation of Gab1 ex vivo and …

Substance P And The Host Immune Response, Megan Elizabeth Foldenauer

Wayne State University Dissertations

This body of work examined the mechanism by which SP regulates host immunity, specifically, its control of growth factors and TLR expression in the P. aeruginosa-infected cornea. The role of mTOR and VIP in corneal infection and inflammation also was tested.

SP has a dual role in bacterial infection, unexpectedly upregulating growth factor production. This was accompanied by macrophage-specific upregulation of pro-inflammatory cytokines, downregulation of anti-inflammatory cytokines, and upregulation of anti-apoptotic genes, as well as a decrease in arginase-producing macrophages (M2 cells), important in stromal healing in these mice. All of these lead to worsened disease, despite the stimulatory effects …

Vip And Host Immunity, Xiaoyu Jiang

Wayne State University Dissertations

The purpose of the current dissertation was to examine how VIP regulates host immunity and corneal healing, specifically, its control of growth factors and TLR expression in the P. aeruginosa infected cornea. Firstly, VIP treatment increased growth factor expression (EGF, GHF, FGF and VEGF) in infected cornea. Notably, treatment with a mixture of EGF, FGF and HGF prevented corneal perforation, reduced pro-inflammatory cytokines and bacterial plate count, while increasing anti-inflammatory cytokines and antimicrobials such as murine beta-defensin2 and 3.

We also investigated the expression of TLR-signaling pathways in P. aeruginosa infected corneas with or without VIP treatment. PCR array and …

Defensins In Ocular Immunity, Minhao Wu

Wayne State University Dissertations

Corneal infection with P. aeruginosa results in corneal perforation in susceptible

B6, but not resistant BALB/c mice. This study explored their role mBD 1-4 in corneal

infection, and their potential synergy. Immunostaining and real-time RT-PCR data

demonstrated that their expression was either constitutive (mBD1 and mBD2) or

inducible (mBD3 and mBD4) in normal BALB/c and B6 corneas, and disparately

regulated in BALB/c vs B6 corneas after infection. Knock down studies using siRNA

treatment indicated that mBD2 and mBD3, but neither mBD1 nor mBD4, is required in

ocular defense. Moreover, in vivo studies demonstrated individual and combined effects

of mBD2 and …

Effects Of Curcumin On Retinal Oxidative Stress And Inflammation In Diabetes, Renu A. Kowluru, Mamta Kanwar

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Oxidative stress and inflammation are implicated in the pathogenesis of retinopathy in diabetes. The aim of this study is to examine the effect of curcumin, a polyphenol with antioxidant and anti-inflammatory properties, on diabetes-induced oxidative stress and inflammation in the retina of rats.

Methods

A group of streptozotocin-induced diabetic rats received powdered diet supplemented with 0.05% curcumin (w/w), and another group received diet without curcumin. The diets were initiated soon after induction of diabetes, and the rats were sacrificed 6 weeks after induction of diabetes. The retina was used to quantify oxidative stress and pro-inflammatory markers.

Results

Antioxidant …