Ophthalmology Commons^™

Acute-Onset Central Serous Retinopathy After Immunization With Covid-19 Mrna Vaccine, Nicholas Fowler, Noe R. Mendez Martinez, Bernardo Velazquez Pallares, Ramiro S. Maldonado

Ophthalmology and Visual Science Faculty Publications

Purpose
We report the case of a 33-year-old male who presented with unilateral central serous retinopathy three days after the injection of a COVID-19 vaccine.

Observations
A 33-year-old healthy Hispanic male referred to the ophthalmology service due to blurry vision and metamorphopsia in the right eye without any flashes, floaters, eye redness or pain. The patient reported that 69 hours prior to presentation he received the first dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine. He denied any past ocular history or pertinent medical history. He does not take any medicines and denies stressful factors in his life. The clinical …

Development Of Parameters Towards Voice Bifurcations, Takeshi Ikuma, Andrew J. Mcwhorter, Lacey Adkins, Melda Kunduk

School of Medicine Faculty Publications

Pathological vocal folds are known to exhibit multiple oscillation patterns, depending on tissue imbalance, subglottal pressure level, and other factors. This includes mid-phonation changes due to bifurcations in the underlying voice source system. Knowledge of when changes in oscillation patterns occur is helpful in the assessments of voice disorders, and the knowledge could be transformed into useful objective measures. Mid-phonation bifurcations can occur in rapid succession; hence, a fast classification of oscillation pattern is critical to minimize the averaging of data across bifurcations. This paper proposes frequency-ratio based short-term measures, named harmonic disturbance factor (HDF) and biphonic index (BI), towards …

Elovanoids Downregulate Sars-Cov-2 Cell-Entry, Canonical Mediators And Enhance Protective Signaling In Human Alveolar Cells, Jorgelina M. Calandria, Surjyadipta Bhattacharjee, Nicholas J. Maness, Marie Audrey I. Kautzmann, Aram Asatryan, William C. Gordon, Khanh V. Do, Bokkyoo Jun, Pranab K. Mukherjee, Nicos A. Petasis, Nicolas G. Bazan

School of Medicine Faculty Publications

The pro-homeostatic lipid mediators elovanoids (ELVs) attenuate cell binding and entrance of the SARS-CoV-2 receptor-binding domain (RBD) as well as of the SARS-CoV-2 virus in human primary alveoli cells in culture. We uncovered that very-long-chain polyunsaturated fatty acid precursors (VLC-PUFA, n-3) activate ELV biosynthesis in lung cells. Both ELVs and their precursors reduce the binding to RBD. ELVs downregulate angiotensin-converting enzyme 2 (ACE2) and enhance the expression of a set of protective proteins hindering cell surface virus binding and upregulating defensive proteins against lung damage. In addition, ELVs and their precursors decreased the signal of spike (S) protein found in …

Intravitreal Gene Therapy Vs. Natural History In Patients With Leber Hereditary Optic Neuropathy Carrying The M.11778g>A Nd4 Mutation: Systematic Review And Indirect Comparison, Nancy J. Newman, Patrick Yu-Wai-Man, Valerio Carelli, Valerie Biousse, Mark Moster, Catherine Vignal-Clermont, Robert C. Sergott, Thomas Klopstock, Alfredo A. Sadun, Jean-François Girmens, Chiara La Morgia, Adam A. Debusk, Neringa Jurkute, Claudia Priglinger, Rustum Karanjia, Constant Josse, Julie Salzmann, François Montestruc, Michel Roux, Magali Taiel, José-Alain Sahel

Wills Eye Hospital Papers

Objective: This work aimed to compare the evolution of visual outcomes in Leber hereditary optic neuropathy (LHON) patients treated with intravitreal gene therapy to the spontaneous evolution in prior natural history (NH) studies.

Design: A combined analysis of two phase three randomized, double-masked, sham-controlled studies (REVERSE and RESCUE) and their joint long-term extension trial (CLIN06) evaluated the efficacy of rAAV2/2-ND4 vs. 11 pooled NH studies used as an external control.

Subjects: The LHON subjects carried the m.11778G>A ND4 mutation and were aged ≥15 years at onset of vision loss.

Methods: A total of 76 subjects received a single …

Evaluation Of Multi-Level Barriers And Facilitators In A Large Diabetic Retinopathy Screening Program In Federally Qualified Health Centers: A Qualitative Study, Ana Bastos De Carvalho, S. Lee Ware, Tamara Belcher, Franceska Mehmeti, Eric B. Higgins, Robert Sprang, Cody Williams, Jamie L. Studts, Christina R. Studts

Ophthalmology and Visual Science Faculty Publications

BACKGROUND: Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports. Previous studies of determinants of TDRS focus on patients' perspectives, with few studies targeting upstream multi-level barriers and facilitators. Addressing this gap, this qualitative study aimed to identify and evaluate multi-level perceived determinants of TDRS in Federally Qualified Health Centers (FQHCs), to inform …

A Randomized Trial To Improve Adherence To Follow-Up Eye Examinations Among People With Glaucoma, Benjamin E Leiby, Sarah E. Hegarty, Tingting Zhan, Jonathan S Myers, L Jay Katz, Julia A Haller, Michael Waisbourd, Christine Burns, Meskerem Divers, Jeanne Molineaux, Jeffrey Henderer, Charles Brodowski, Lisa A Hark

Department of Pharmacology and Experimental Therapeutics Faculty Papers

INTRODUCTION: Appointment nonadherence is common among people with glaucoma, making it difficult for eye care providers to monitor glaucoma progression. Our objective was to determine whether the use of patient navigators, in conjunction with social worker support, could increase adherence to recommended follow-up eye appointments.

METHODS: A randomized, controlled trial evaluated the effectiveness of an intervention that used patient navigators and social workers to improve patient adherence to follow-up eye care compared with usual care. Participants with glaucoma and other eye diseases (N = 344) were identified at primary care clinics in community settings through telemedicine screening of imaging and …

Retinal Ganglion Cells Underlying Visual Perception And Predation In Mice, Keith Patrick Johnson

Arts & Sciences Electronic Theses and Dissertations

The spike trains of retinal ganglion cells (RGCs) are the sole source of visual information to the brain. In mice, more than 40 RGC types send signals to more than 50 brain areas. RGCs that perform nonlinear operations to extract specific visual features (e.g., the motion of an object against a background) are called feature detectors. Those that linearly integrate local changes in light inten-sity are known as pixel encoders. Most mouse RGC types are feature detectors. In the first part of my dissertation, I discovered a pixel encoder RGC type in mice, the PixON-RGC. I revealed how the unique …

Role Of Interferon Gamma Release Assay In The Diagnosis And Management Of Mycobacterium Tuberculosis-Associated Uveitis: A Review, Samra Rahman, Muhammad Irfan, Rehman Siddiqui

Section of Pulmonary & Critical Care

Tuberculosis (TB)-associated uveitis is a common cause of infectious uveitis in the developing world. Diagnosis of TB uveitis remains a challenge. The role of interferon gamma release assays (IGRAs) is uncertain. Herein we summarise the available literature on the utility of IGRAs in the diagnosis and management of TB uveitis. We searched PubMed database from 1 August 2010 to 31 July 2020 using the following keywords alone and in combination: 'interferon-gamma release assay', 'QuantiFERON', 'T-SPOT.TB', 'TB uveitis', 'serpiginous like choroiditis', 'tuberculoma', 'TB vasculitis', 'TB panuveitis' and 'ocular tuberculosis'. Data from 58 relevant studies were collated. The review is focused on …

The Driving Simulator Visual Field In Glaucoma – A Novel Task To Test Available Field Of View, Deepta Ghate

Theses & Dissertations

Glaucoma causes peripheral vision loss and impaired driving performance. We developed a novel driving simulator visual field task (DSVF) in a panoramic driving simulator to map the available field of view under different perceptual task loads in naturalistic settings. Our hypothesis is that “available field of view” will decrease with increasing task load in both glaucoma subjects and controls. This is a cross-sectional study with 28 glaucoma subjects and 19 controls. DSVF (60̊ x 20̊ visual field at 2.5 m) was tested in a high-fidelity interactive driving simulator in 4 different scenarios: a) no distractions b) no driving condition with …

Retinal Vasculitis: A Case Study, Peter Maduka, Sarah G. Bonaffini, Naman Shah, Deepika Malik

Stratford Campus Research Day

Purpose: To describe a case of idiopathic retinal vasculitis.

Methods: Case report and literature review.

Case: A healthy 25-year-old female presented with a one-week history of a large floater in her right eye. Patient’s subjective complaint of floaters, including the scotoma on VF and the FA findings were most consistent with retinal vasculitis displaying predominant venous involvement. However, findings for acute macular neuroretinopathy and multiple evanescent white dot syndrome (MEWDS) were present as well. Autoimmune and infectious disease panels were negative. Neuro consult and brain MRI showed nonspecific, non contributory findings. Several weeks later, following Medrol dose pack, patient reported …

Terson-Like Syndrome Associated With Familial Retinal Arteriolar Tortuosity (Frat) And A Spontaneous Spinal Hemorrhage, Peter Maduka, David R. Lally

Stratford Campus Research Day

Background: Familial retinal arteriolar tortuosity (fRAT) is an autosomal dominant disorder that is characterized by tortuosity of the second and third order retinal arterioles in the macular and peripapillary areas. The genetics of fRAT are incompletely understood but have been associated with a missense mutation in the COL4A1 gene in some cases. fRAT is not typically associated with visual loss and prognosis is good. However, the tortuous arterioles can bleed, causing intraretinal, preretinal, and/or subretinal hemorrhages.

Objective: To describe a case of Terson-like syndrome associated with familial retinal arteriolar tortuosity (fRAT) in the setting of spontaneous spinal hemorrhage.

Results: A …

Sociodemographic And Economic Factors In Outcomes Of Tube Shunts For Neovascular Glaucoma, Wesam S Shalaby, Amirmohsen Arbabi, Jonathan S Myers, Marlene R Moster, Reza Razeghinejad, L Jay Katz, Aakriti G Shukla

Wills Eye Hospital Papers

Importance: Few studies have analyzed associations between sociodemographic factors and neovascular glaucoma (NVG) outcomes.

Aim and background: To determine the potential impact of sociodemographic and economic factors on the NVG tube shunt surgery outcomes.

Design: Retrospective, single-center, comparative case series.

Participants: Consecutive patients who underwent tube shunt surgery for NVG and had ≥6 months of follow-up.

Materials and methods: Regional average adjusted gross income (AGI) was determined by cross-referencing self-reported residential zip codes with average AGI per zip code supplied by the Internal Revenue Service. Two groups were created: (1) lower-income: individuals from neighborhoods with the lowest 10% of AGI …

Critique Of Experimental Procedures Targeting Retinitis Pigmentosa, Jenna Goss

Honors College

Retinitis Pigmentosa (RP) is a group of hereditary genetic disorders, all causing degradation of the retina through loss of rod photoreceptor cells, ultimately causing loss of vision and in many cases complete blindness. Despite the prevalence o fRetinitis Pigmentosa disorders, safe and effective treatment methods have not yet been approved to stop or regain vision loss in patients diagnosed with RP. However, the ophthalmic field as a whole is working on several new technologies and procedures in order to both slow loss of vision as well as potentially regain lost sight. In this thesis, I describe the genetic causes and …

3d Printed Adjustable Glasses: A New Model Of Corrective Lens Delivery For Pediatric Refractive Error In Underserved Communities, Nathan Ostlie, Mari Ogino, Donny Suh, Gabe Linke, James Hermsen

Child Health Research Institute Pediatric Research Forum

Purpose:

Uncorrected refractive error (URE) remains a major cause of preventable vision impairment in the pediatric population with large inequities in disease burden. The present study aims to elucidate the global burden of pediatric URE and explore the current lens delivery systems which address this problem. Within this framework, we introduce a new model of corrective lens delivery that may improve upon existing models.

Methods:

The present study involved an extensive literature review of epidemiological data to determine the global prevalence of URE. Prevalence data was then compared against WHO data on refractionist coverage gaps divided by region. …

Anterior Chamber Characteristics, Endothelial Parameters, And Corneal Densitometry After Descemet Stripping Automated Endothelial Keratoplasty In Patients With Fuchs Dystrophy., Remzi Karadag, Kristin Hammersmith, Parveen Nagra, Christopher J Rapuano

Wills Eye Hospital Papers

Purpose: To compare anterior segment parameters in patients with Fuchs endothelial dystrophy (FED) who underwent Descemet stripping automated endothelial keratoplasty (DSAEK) in one eye and no corneal surgery in the fellow eye.

Methods: This prospective study was conducted on 28 eyes of 14 patients with FED who underwent DSAEK in one eye at least one year prior (DSAEK group) and no corneal surgery in the fellow eye (control group). Each eye was analyzed with the anterior segment optical coherence tomography, specular microscopy, and Scheimpflug imaging systems. Data were compared between the two groups.

Results: The mean age of the patients …

The Influence Of Axial Myopia On Optic Disc Characteristics Of Glaucoma Eyes., Jasmin Rezapour, Christopher Bowd, Jade Dohleman, Akram Belghith, James A Proudfoot, Mark Christopher, Leslie Hyman, Jost B Jonas, Massimo A Fazio, Robert N Weinreb, Linda M Zangwill

Wills Eye Hospital Papers

This study characterizes differences in glaucomatous eyes with and without high axial myopia using custom automated analysis of OCT images. 452 eyes of 277 glaucoma patients were stratified into non (n = 145 eyes), mild (n = 214 eyes), and high axial myopia (axial length (AL) > 26 mm, n = 93 eyes). Optic disc ovality index, tilt and rotation angle of Bruch´s membrane opening (BMO) and peripapillary choroidal thickness (PCT) were calculated using automated and deep learning strategies. High myopic optic discs were more oval and had larger BMO tilt than mild and non-myopic discs (both p < 0.001). Mean PCT was thinnest in high myopic eyes followed by mild and non-myopic eyes (p < 0.001). BMO rotation angle, global retinal nerve fiber layer (RNFL) thickness and BMO-minimum rim width (MRW) were similar among groups. Temporal RNFL was thicker and supranasal BMO-MRW was thinner in high myopic eyes. BMO tilt and PCT showed moderate and temporal RNFL and nasal BMO-MRW showed weak but significant associations with AL in multivariable analyses (all p < 0.05). Large BMO tilt angle and thin PCT are characteristics of highly myopic discs and were not associated with severity of glaucoma. Caution should be exercised when using sectoral BMO-MRW and RNFL thickness for glaucoma management decisions in myopic eyes.

Advances In The Treatment Of Congenital Ptosis, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Ocular Surface And Fornix Reconstruction: Flaps, Grafts And Blood Supply, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

The Many Uses Of 5-Fluorouracil In Oculoplastic Surgery, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Orbital Vascular Anomalies: Classification And Treatment, Alon Kahana

Conference Presentation Abstracts

No abstract provided.