Eye Diseases Commons^™

Limitations Of Telemedicine Vs. Face-To-Face Eye Examination In A Patient With New Headaches, Joseph Hallak, Od, Danielle Kalberer, Od

Optometric Clinical Practice

Background: During the emergence and rise of COVID-19, precaution directives and limitations on in-person eye examinations re-routed a significant portion of care to telemedicine and virtual modalities. While these technologies allowed for healthcare communications that otherwise could not occur during such trying times, there are major limitations to these sanctioned applications. This report will present a seemingly benign case that could have easily been re-routed from an in-person examination to a telemedicine version due to the patient’s seemingly “routine” vision complaints.

Case Report: A 50-year-old male patient contacted the eye clinic with a complaint of a minor, new, unexplained headache …

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …

Barriers To Screening For Diabetic Retinopathy: A Scoping Review, Amy Cooper Rn, Bsn, Lajerica Bates Rn, Bsn, Julie Bridges Rn, Bsn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

More than 34 million people in the United States have diabetes. Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of vision loss. Risk factors for diabetic retinopathy include Type 1 and Type 2 Diabetes, hypertension, smoking, and being African American or Hispanic/Latino. This scoping review seeks to analyze the current research on ways to increase vision screenings, thus reducing cases of diabetic retinopathy in adults.

Methods

Between September 2020 and November 2021, a search was conducted using PubMed, EBSCOhost, Medline, and CINAHL to identify articles using keywords such as diabetic retinopathy and ophthalmology. This …

Effect Of Phacoemulsification On Intraocular Pressure In Eyes With Functioning Tube Shunts, Wesam Shamseldin Shalaby, Sonali Patel, Sophia Lam, Allen Ganjei, Aakriti Garg Shukla, Natasha Kolomeyer, Daniel Lee, L. Jay Katz, Marlene Moster, Jonathan Myers, Reza Razeghinejad

Wills Eye Hospital Papers

Purpose: To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in eyes with functioning tube shunts.

Methods: This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent phacoemulsification and had ≥24 months of follow-up. The primary end point was defined as surgical failure (IOP > 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP >18 and >15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed.

Results: Twenty-seven eyes of 27 patients with moderate or …

Local Ocular Safety Of The Subconjunctival Injection Of Cetuximab In Rabbits, Hossein Aghaei, Ahmad Kheirkhah, Ali Mohammad Alizadeh, Acieh Es'haghi, Roshanak Aliakbar-Navahi, Zahra Keikha, Samira Chaibakhsh

Faculty, Staff and Student Publications

BACKGROUND: To evaluate the safety of different doses of subconjunctival cetuximab in rabbits.

METHODS: After general anesthesia rabbits received a subconjunctival injection of 2.5 mg in 0.5 ml, 5 mg in 1 ml, and 10 mg in 2 ml of cetuximab in their right eyes (two rabbits in each group). A similar volume of normal saline solution was injected subconjunctivally in the left eyes. The histopathologic changes were evaluated after enucleation with the aid of H&E staining.

RESULTS: No significant difference were observed between the treated and control eyes in terms of conjunctival inflammation, goblet cell density, or limbal blood …

Scar Formation In The Presence Of Mitomycin C And The Anti-Fibrotic Antibody In A Rabbit Model Of Glaucoma Microsurgery: A Pilot Study, Aakriti Garg Shukla, Tatyana Milman, Jolanta Fertala, Andrzej Steplewski, Andrzej Fertala

Wills Eye Hospital Papers

Purpose: This study aimed to evaluate the utility of a rationally engineered antibody that directly blocks collagen fibrillogenesis to reduce scar tissue formation associated with subconjunctival glaucoma surgery.

Material and methods: Fourteen eyes of 7 adult rabbits underwent glaucoma filtering surgery using XEN 45 Gel Stent. The rabbits’ eyes were divided randomly into three treatment groups: (i) treated with the antibody, (ii) treated with mitomycin C, and (iii) treated with the antibody and mitomycin C. Following surgeries, the intraocular pressure and bleb appearance were evaluated in vivo. The rabbits were sacrificed 8 weeks after the surgery, and their eyes were …

The Circadian E3 Ligase Fbxl21 Regulates Myoblast Differentiation And Sarcomere Architecture Via Myoz1 Ubiquitination And Nfat Signaling, Bo Hu, Jian-Xing Ma, Adam S Duerfeldt

Faculty, Staff and Student Publications

Diabetic retinopathy and age-related macular degeneration are common retinal diseases with shared pathophysiology, including oxidative stress-induced inflammation. Cellular mechanisms responsible for converting oxidative stress into retinal damage are ill-defined but have begun to clarify. One common outcome of retinal oxidative stress is mitochondrial damage and subsequent release of mitochondrial DNA into the cytosol. This leads to activation of the cGAS-STING pathway, resulting in interferon release and disease-amplifying inflammation. This review summarizes the evolving link between aberrant cGAS-STING signaling and inflammation in common retinal diseases and provides prospective for targeting this system in diabetic retinopathy and age-related macular degeneration. Further defining …

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 …

Comparative Evaluation Of The Effect Of Calcium Silicate And Epoxy Resinbased Root Canal Sealers On Postoperative Pain In Patients With Primary Endodontic Lesion: A Randomized Clinical Study, Kaur Supreet, Karkala Venkappa Kishan, Nimisha Chinmay Shah, Ruchi Shah, Manan G Shroff, Shreya Volety

Faculty, Staff and Student Publications

INTRODUCTION: This study's objective was to assess and compare postoperative pain response between bioceramic sealer (Nishika BG) and epoxy resin based (AH Plus) in patients with primary endodontic lesion at time interval of 24 h, 48 h, and 7 days using the Visual Analog Scale (VAS).

MATERIALS AND METHODS: The study included 40 individuals with necrotic pulp and apical periodontitis. Calcium hydroxide was administered as the intracanal medication during the two-visit endodontic therapy. They were subsequently allocated randomly to either the AH Plus root canal sealer or the Nishika Canal Sealer BG, with a total of 20 participants in each …

Conjunctival And Lingual Mucosal Neuromas Without Multiple Endocrine Neoplasia Type 2b, Talia N. Shoshany, Christopher J. Rapuano, Tatyana Milman

Wills Eye Hospital Papers

Purpose: To report a patient with conjunctival and buccal neuromas and enlarged corneal nerves without Multiple Endocrine Neoplasia 2B (MEN2B).

Observations: A 28-year-old female presented with progressively enlarging bilateral limbal conjunctival growths. Slit lamp examination was notable for enlarged corneal nerves and well-circumscribed gelatinous subepithelial limbal nodules. Systemic examination revealed similar lesions on the tongue. Conjunctival biopsy demonstrated a mucosal neuroma. The patient underwent endocrine workup for MEN2B and genetic testing for the RET-proto oncogene mutations, all of which were negative.

Conclusions and Importance: The findings in our patient may be compatible with pure mucosal neuroma syndrome. The pattern of …

Defining The Role Of Ab Externo Xen Gel Stent In Glaucomatous Eyes With Prior Failed Surgical Intervention, Lillian K To, Rupak K Dhoot, Alice Z Chuang, Sam Karimaghaei, Francisco Guevara-Abadia, Ruchi D Shah, Robert M Feldman

Faculty, Staff and Student Publications

PURPOSE: To evaluate the safety and efficacy of Xen45 Gel stent (Xen; Allergan) in eyes that have failed prior surgical intervention, compared to traditional glaucoma drainage device (GDD) or continuous-wave cyclophotocoagulation (CPC). Since this population has low expected success rates with additional surgery, it is vital to compare to standard-of-care surgical options.

METHODS: Retrospective, single-center, case-control study of ab externo transconjunctival Xen shunt in eyes that have previously undergone trabeculectomy and/or GDD surgery. Postoperative data were collected for 18 months. Failure was defined as no light perception, additional glaucoma surgery required, or intraocular pressure (IOP) of < 6 mmHg after 6 weeks postoperatively.

RESULTS: Eighteen Xen eyes …

Direct Costs Of Second Aqueous Shunt Implant Versus Transscleral Cyclophotocoagulation (The Assists Trial), Jack X Ma, Alice Z Chuang, Robert M Feldman, Steve L Mansberger, Angelo P Tanna, Lauren S Blieden, Daniel Shoham, Nicholas P Bell, Ronald L Gross, Louis R Pasquale, David S Greenfield, Jeffrey M Liebmann, Robert N Weinreb

Faculty, Staff and Student Publications

PRCIS: The cost of cyclophotocoagulation is less than the cost of a second glaucoma drainage device.

PURPOSE: To compare the total direct costs of implantation of a second glaucoma drainage device (SGDD) with transscleral cyclophotocoagulation (CPC) for patients with inadequately controlled intraocular pressure (IOP) reduction, despite the presence of a preexisting glaucoma drainage device in the ASSISTS clinical trial.

METHODS: We compared the total direct cost per patient, including the initial study procedure, medications, additional procedures, and clinic visits during the study period. The relative costs for each procedure during the 90-day global period and the entire study period were …

Ectopic Lymphoid Structures In The Aged Lacrimal Glands, Jeremias G Galletti, Kaitlin K Scholand, Claudia M Trujillo-Vargas, Zhiyuan Yu, Olivier Mauduit, Vanessa Delcroix, Helen P Makarenkova, Cintia S De Paiva

Faculty, Staff and Students Publications

Aging is a complex biological process in which many organs are pathologically affected. We previously reported that aged C57BL/6J had increased lacrimal gland (LG) lymphoid infiltrates that suggest ectopic lymphoid structures. However, these ectopic lymphoid structures have not been fully investigated. Using C57BL/6J mice of different ages, we analyzed the transcriptome of aged murine LGs and characterized the B and T cell populations. Age-related changes in the LG include increased differentially expressed genes associated with B and T cell activation, germinal center formation, and infiltration by marginal zone-like B cells. We also identified an age-related increase in B1

Lacrimal Gland Epithelial Cells Shape Immune Responses Through The Modulation Of Inflammasomes And Lipid Metabolism, Vanessa Delcroix, Olivier Mauduit, Menglu Yang, Amrita Srivastava, Takeshi Umazume, Cintia S De Paiva, Valery I Shestopalov, Darlene A Dartt, Helen P Makarenkova

Faculty, Staff and Students Publications

Lacrimal gland inflammation triggers dry eye disease through impaired tear secretion by the epithelium. As aberrant inflammasome activation occurs in autoimmune disorders including Sjögren's syndrome, we analyzed the inflammasome pathway during acute and chronic inflammation and investigated its potential regulators. Bacterial infection was mimicked by the intraglandular injection of lipopolysaccharide (LPS) and nigericin, known to activate the NLRP3 inflammasome. Acute injury of the lacrimal gland was induced by interleukin (IL)-1α injection. Chronic inflammation was studied using two Sjögren's syndrome models: diseased

Vitamin C Contributes To Epigenetic Regulation Of Genes Related To Diabetic Retinopathy In Retinal Endothelial Cells, Elizabeth L. Turner, Jonathon Reynolds, Walker Kay, Marianne Becnel, Matthew Conway, Alexander Kim, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

No abstract provided.

A Multicenter Analysis Of Nucleic Acid Quantification Using Aqueous Humor Liquid Biopsy In Retinoblastoma: Implications For Clinical Testing, Deborah H Im, Sarah Pike, Mark W Reid, Chen-Ching Peng, Shreya Sirivolu, Hans E Grossniklaus, G Baker Hubbard, Alison H Skalet, Kellyn N Bellsmith, Carol L. Shields, Sara E Lally, Andrew W Stacey, Bibiana J Reiser, Aaron Nagiel, Rachana Shah, Liya Xu, Jesse L Berry

Wills Eye Hospital Papers

PURPOSE: Retinoblastoma (RB) is most often diagnosed with clinical features and not diagnosed with tumor biopsy. This study describes tumor-derived analyte concentrations from aqueous humor (AH) liquid biopsy and its use in clinical assays.

DESIGN: Case series study.

PARTICIPANTS: Sixty-two RB eyes from 55 children and 14 control eyes from 12 children from 4 medical centers.

METHODS: This study included 128 RB AH samples including: diagnostic (DX) samples, samples from eyes undergoing treatment (TX), samples after completing treatment (END), and during bevacizumab injection for radiation therapy after completing RB treatment (BEV). Fourteen-control AH were analyzed for unprocessed analytes (double-stranded DNA …

A Critical Appraisal Of The Physicochemical Properties And Biological Effects Of Artificial Tear Ingredients And Formulations, Judy Weng, Michael K. Fink, Ajay Sharma

Pharmacy Faculty Articles and Research

Dry eye disease is among the most prevalent diseases affecting the ocular surface. Artificial tears remain the cornerstone therapy for its management. There are currently a wide variety of marketed artificial tears available to choose from. These artificial tears differ significantly in their composition and formulation. This article reviews the physicochemical and biological properties of artificial tear components and how these characteristics determine their use and efficacy in the management of dry eye. Furthermore, this article also discusses the various formulations of artificial tears such as macro and nanoemulsion and the type of preservatives present in them.

A Qualitative Description Of Barriers To Visual Rehabilitation Experienced By Stroke Survivors With Visual Impairment In Alberta, Canada, Kiran Pohar Manhas, Katelyn Brehon, Jennis Jiang, Karim F. Damji, Fiona Costello

Department of Ophthalmology & Visual Sciences

Background: Post-stroke visual impairment (VI) is a common but under-recognized care challenge. Common manifestations of post-stroke VI include: diplopia, homonymous hemianopia, oscillopsia secondary to nystagmus, and visual inattention or neglect. In acute care settings, post-stroke VI recognition and treatment are often sub-optimal as emphasis is placed on survival. Stroke survivors with VI often face inconsistencies when accessing care out of hospital because variable availability and subsidization of visual rehabilitation. We sought to identify gaps in care experienced by stroke survivors with VI from stroke survivors' and care providers' perspectives.
Methods: We conducted a qualitative description study across 12 care sites …

Correction To: Stabilization Of Mcl-1 By E3 Ligase Traf4 Confers Radioresistance, Ming Li, Feng Gao, Xiaoying Li, Yu Gan, Shuangze Han, Xinfang Yu, Haidan Liu, Wei Li

Faculty, Staff and Students Publications

No abstract provided.

Comparison Between The Casia Ss-1000 And Pentacam In Measuring Corneal Curvatures And Corneal Thickness Maps, Robert M Feldman, Gene Kim, Alice Z Chuang, Atsushi Shiraishi, Keiichiro Okamoto, Makoto Tsukamoto

Faculty, Staff and Student Publications

PURPOSE: To compare the intra-device repeatability and inter-device reproducibility between two anterior segment imaging instruments, the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) and Pentacam (OCULUS, Arlington, WA) in measuring anterior segment parameters.

METHODS: Single-center, prospective clinical trial. Participants ≥20 years of age were included. One eye was randomly selected, each imaged by three CASIA SS-1000 devices and three Pentacam devices by three different examiners. Each photographer operated a pair of devices, one CASIA SS-1000 and one Pentacam. The image order for each participant was determined by a random permutation table. Three images were taken from each device. A total of …

A Low-Fat/Sucrose Diet Rich In Complex Carbohydrates Reverses High-Fat/Sucrose Diet-Induced Corneal Dysregulation, Prince K Akowuah, Carolina Lema, Rolando E Rumbaut, Alan R Burns

Faculty, Staff and Students Publications

High-fat/sucrose diet feeding in mice causes loss of corneal nerve function and impairs corneal wound healing. While changing to a diet with a low fat/sugar composition and enrichments in complex carbohydrates mitigates the reduction in nerve function, it remains to be determined if it has an effect on corneal wound healing. In this study, 6-week-old C57BL/6 male mice were fed either a normal diet or a high-fat/sucrose diet for 20 weeks. A third group (diet reversal) was placed on a high-fat/sucrose diet for 10 weeks followed by a normal diet for an additional 10 weeks. A central corneal epithelial abrasion …

A Case Of Traumatic Hyphema In A Healthy Young Male, Casey Wilson, Thelmari Raubenheimer

South Atlantic Division GME Research Day 2023

No abstract provided.

Selective Laser Trabeculoplasty In A Rural Sub-Saharan African Population, Grant Slagle, Richard Chitedze, Vincent Saka, William E. Sponsel

West Florida Division GME Research Day 2023

No abstract provided.

Diabetic Retinopathy And The Role Of Vegf, Aishwarya Gatiganti, Laura Valdez, Andrew Tsin Ph.D.

School of Medicine Publications

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. It works by disrupting the neural and vascular components in the retina and leads to loss of neural interaction/function, vascular permeability, and angiogenesis. It can be classified into two general stages: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). DR can also lead to vascular leakage and cause diabetic macular edema (DME), the most common cause of vision loss in DR (Duh, Sun et al. 2017). There are currently a wide range of therapies, but they are limited in their efficacy and side effects. None of …

Distinctions Between Choroidal Neovascularization And Age Macular Degeneration In Ocular Disease Predictions Via Multi-Size Kernels Ξcho-Weighted Median Patterns, Alex Liew, Sos Agaian, Samir Benbelkacem

Publications and Research

Age-related macular degeneration is a visual disorder caused by abnormalities in a part of the eye’s retina and is a leading source of blindness. The correct detection, precise location, classification, and diagnosis of choroidal neovascularization (CNV) may be challenging if the lesion is small or if Optical Coherence Tomography (OCT) images are degraded by projection and motion. This paper aims to develop an automated quantification and classification system for CNV in neovascular age-related macular degeneration using OCT angiography images. OCT angiography is a non-invasive imaging tool that visualizes retinal and choroidal physiological and pathological vascularization. The presented system is based …

High Energy Blue Light Induces Oxidative Stress And Retinal Cell Apoptosis, Jessica Malinsky

Capstone Showcase

Blue light (BL) is a high energy, short wavelength spanning 400 to 500 nm. Found in technological and environmental forms, BL has been shown to induce photochemical damage of the retina by reactive oxygen species (ROS) production. Excess ROS leads to oxidative stress, which disrupts retinal mitochondrial structure and function. As mitochondria amply occupy photoreceptors, they also contribute to oxidative stress due to their selectively significant absorption of BL at 400 to 500 nm. ROS generation that induces oxidative stress subsequently promotes retinal mitochondrial apoptosis. BL filtering and preventative mechanisms have been suggested to improve or repair BL-induced retinal damage, …

Examining The Effects Of Hyperglycemia On Retinal Regeneration, Emmanuella Ec Kyllians

Theses and Dissertations--Biology

Diabetes is a disease that affects how the body processes glucose, leading to a cascade of other complications, one of which is diabetic retinopathy (DR). DR is a neurovascular disease that affects the retina and research has revealed the role of retinal neurodegeneration in its development. Animal models like zebrafish have emerged as important tools for studying the molecular and cellular mechanisms underlying DR. On the other hand, retinitis pigmentosa (RP) is a degenerative disease that involves the progressive degeneration of rods and cones, and hyperglycemia has been found to impair regeneration. Therefore, this study aims to examine the effects …

Heat Shock Protein 90 (Hsp90) System In Health And Disease., Daniella Munezero

Graduate Theses, Dissertations, and Problem Reports (ETD)

Cells rely on heat shock proteins (HSP) to facilitate and regulate the folding of the substrate proteins into their native state, and degradation if misfolding cannot be prevented. HSP90, a member of the HSP family, is a potential target for treatment of cancer and neurodegenerative diseases. Unfortunately, several clinical trials for cancer treatment have been discontinued due to cell toxicity accompanying HSP90 inhibition. HSP90 has four distinct but structurally similar paralogs. HSP90 inhibitors target all the paralogs despite increasing proof of functional differences among the paralogs. Understanding the in vivo function of HSP90 and the role played by each paralog …

A Phase 3b Study For Management Of Ocular Side Effects In Patients With Epidermal Growth Factor Receptor-Amplified Glioblastoma Receiving Depatuxizumab Mafodotin, Colin J Vize, Stella K Kim, Tim Matthews, Marian Macsai, Ryan Merrell, Sigmund Hsu, Madan Gopal Kundu, Jennifer Yoon, Emma Kennedy, Madhavi Pai, Earle Bain, Andrew B Lassman, Golnaz Moazami

Faculty, Staff and Student Publications

INTRODUCTION: The Understanding New Interventions with GBM ThErapy (UNITE) study was designed to assess the effect of prophylaxis for ocular side effects (OSEs) in patients with glioblastoma receiving the antibody-drug conjugate (ADC) depatuxizumab mafodotin. UNITE (NCT03419403) was a phase 3b, open-label, randomized, exploratory study performed at 18 research sites in 5 countries.

METHODS: The study enrolled adult patients with epidermal growth factor receptor-amplified, histologically confirmed, newly diagnosed supratentorial glioblastoma or grade IV gliosarcoma, and a Karnofsky Performance Status ≥70, receiving depatuxizumab mafodotin. All patients were administered depatuxizumab mafodotin during concurrent radiotherapy and temozolomide and with adjuvant temozolomide. Ninety patients were …

Return To Sport Following Acl Reconstruction With Slope-Correcting High Tibial Osteotomy In The Elite Athlete, Walter R Lowe, Alfred Mansour, Steven Higbie, Connor Galloway, Jacquelyn Kleihege, Lane Bailey

Faculty, Staff and Student Publications

Background: Increased posterior tibial slope is a strong predictor of anterior cruciate ligament (ACL) graft re-injury. A concomitant slope-reducing high tibial osteotomy (HTO) has been suggested to decrease re-tear risk in these cases although little is known regarding outcomes following ACL reconstruction with HTO, especially in elite athletic patients.

Indications: A 19-year-old National Collegiate Athletics Association (NCAA) Division 1 running back presented with an ACL tear, lateral meniscus tear, and posterior tibial slope of 19° (case 1). A 19-year-old NCAA Division 1 soccer forward presented with an ACL graft re-tear and posterior tibial slope of 21° (case 2).

Technique: Anterior …