Eye Diseases Commons^™

Eye Care Protocol In Critically Ill Pediatric Patients On Neuromuscular Blockage, Jinnie Tkach

Dissertations

Abstract

Problem: Patients admitted to the pediatric intensive care unit (PICU) are at increased risk for the development of ocular surface disease (OSD) due to impaired ocular mechanisms while intubated, sedated, and on continuous neuromuscular blockade. The purpose of this project is to prevent OSD and vision impairments by increasing the frequency of eye care in accordance with a PICU eye care protocol.

Methods: An observational descriptive study was conducted utilizing retrospective and prospective chart review. Comparisons were drawn between the 2021 pre intervention group and the 2022 post intervention group regarding the impact of linking lubricating eye ointment orders …

Prognosticators Of Visual Acuity After Indirect Traumatic Optic Neuropathy, Alex J Wright, Joanna H Queen, Emilio P Supsupin, Alice Z Chuang, John J Chen, Rod Foroozan, Ore-Ofe O Adesina

Faculty, Staff and Student Publications

BACKGROUND: The purpose of this study is to determine whether there are radiographic and systemic clinical characteristics that can predict final visual outcomes in patients with indirect traumatic optic neuropathy (iTON).

METHODS: This study is a retrospective, multicenter case series of adult patients with iTON treated initially at large, urban, and/or academic trauma centers with follow-up at an affiliated ophthalmology clinic. In addition to detailed cranial computed tomography characteristics, demographics, systemic comorbidities, coinjuries, blood products administered, and intracranial pressure, along with other factors, were gathered. LogMAR visual acuity (VA) at the initial presentation to the hospital and up to 12 …

Charles Bonnet Syndrome: A Case Report, Christian Scouarnec, Martin M. Forsberg

Rowan-Virtua Research Day

Charles Bonnet syndrome (CBS) involves nonthreatening hallucinations in patients who have no neurological and no psychological abnormalities but with significant visual impairment secondary to ocular disease, such as macular degeneration, cataracts and diabetic retinopathy. When a patient loses vision, their visual system doesn’t process new images. Without data coming through the eyes, the brain fills the void and makes up images or recalls stored images for you to see and this is what causes the hallucinations in CBS.

Many physicians are unaware of CBS and its prevalence, and with proper detection, physicians can help treat their patients with a frequently …

Cannabinoids And Retinal Fibrotic Disorders., Lucy June Sloan

Electronic Theses and Dissertations

Retinal fibrosis is detrimental to vision. Retinal pigment epithelial (RPE) cells contribute to several retinal fibrotic diseases. Upon exposure to TGF-β, a key fibrotic cytokine, RPE cells trans-differentiate to myofibroblasts marked by the integration of α-SMA fibers into F-actin stress fibers, which confer strong contractility. Myofibroblasts produce and contract the collagen-rich fibrotic scar and disrupt retinal architecture. In this study, we investigated the in vitro effects of the putative endocannabinoid compound N-oleoyl dopamine (OLDA) on TGF-β2 induced porcine RPE cell contraction and α-SMA expression. Using an in vitro collagen matrix contraction assay, we found that OLDA inhibited TGF-β2 induced contraction …

Spectroscopic Measurements Of Meibum Compositional, Structural, And Functional Relationships To Elucidate The Role Of Meibum In Dry Eye., Anthony Chigozie Ewurum

Electronic Theses and Dissertations

The major aim of my dissertation was to investigate the etiology of dry eye disease which affects about 7 million people in the United States, causing symptoms that can lead to visual disturbance. Correlation between dry eye and an abnormal lipid layer of the tear film has been found. Tear film lipids originate mostly from the meibomian glands. Cholesteryl ester (CE) and Wax ester (WE) lipids make up most of the human meibum lipidome and the CE/WE ratio has been shown to decrease in patients with meibomian gland dysfunction. Model studies using synthetic CE and WE, although providing some insight, …

Anti-Retinal Igg Antibodies In Patients With Early And Advanced Type 2 Macular Telangiectasia, Samuel Mclenachan, Chandrakumar Balaratnasingam, Rachael C. Heath Jeffery, Shang Chih Chen, Dan Zhang, Geoffrey Chan, Rosa Dolz-Marco, Tommaso Bacci, Johnny Lo, Steven Wiffen, Lawrence A. Yannuzzi, Fred K. Chen

Research outputs 2022 to 2026

Type 2 idiopathic macular telangiectasia (MacTel-2) is a progressive adult-onset macular disease associated with bilateral perifoveal vascular changes, Muller cell degeneration and increased blood-retinal barrier permeability. The pathophysiological mechanisms of MacTel-2 remain unclear, however it was previously reported that anti-retinal antibodies in MacTel-2 patients are a significant feature of the disease. In this study, we aimed to compare the prevalence of anti-retinal antibodies in patients MacTel-2, healthy controls and patients with other retinal diseases. MacTel-2 patients diagnosed with multimodal imaging were enrolled and their disease severities were graded using spectral-domain optical coherence tomography. For comparison, patients with age-related macular degeneration …

Crispr/Cas9 Genome Editing: Future Treatment Of Duane Retraction Syndrome, Muhammad Raihan Zulfikar, Editha Renesteen, Bantari W.K. Wardhani

Pharmaceutical Sciences and Research

Duane Retraction Syndrome (DRS) is characterized by limited eye movement. One of its causes is a mutation in the CHN1, MAFB, or SALL4 gene. Nowadays, the treatment for DRS is limited to glasses, occlusion, and surgery. However, this treatment has not been able to cure the disease’s hereditary issue. Another strategy to be considered for the treatment is CRISPR/Cas9, a tool for performing gene editing with a wide range of applications, including treating genetic diseases. We made sgRNA as a first step in using CRISPR/Cas9 as a treatment for DRS in silico using the CCTop website. By computing sgRNA, conducting …

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Interpersonal Communication In Eye Care: An Analysis Of Potential Impacts On Cataract Surgery Candidates’ Expectations And Behaviors, Amy Hellem, Sara Labelle, Cynthia Matossian, Paul Karpecki

Communication Faculty Articles and Research

Purpose: To identify cataract surgery candidates’ knowledge, beliefs, desires and emotions as they relate to cataract surgery generally as well as to their behavioral intent to adhere to a doctor-recommended pre-surgical ocular surface prep routine designed to improve refractive outcomes and prevent surgical complications.

Methods: This national, noninterventional, cross-sectional, mixed methods survey included 278 US adults ages 65 and older with no history of cataract surgery in either eye.

Results: Only 20% of participants said they want to have cataract surgery, and even fewer (8%) said they wish they could have cataract surgery right away. Fear was the predominant emotion …

Single-Cell Transcriptional Profiling Of Murine Conjunctival Immune Cells Reveals Distinct Populations Expressing Homeostatic And Regulatory Genes, Jehan Alam, Ghasem Yazdanpanah, Rinki Ratnapriya, Nicholas Borcherding, Cintia S De Paiva, Dequan Li, Stephen C Pflugfelder

Faculty, Staff and Students Publications

Immune cells in the exposed conjunctiva mucosa defend against environmental and microbial stresses. Expression profiling by single-cell RNA sequencing was performed to identify conjunctival immune cell populations expressing homeostatic and regulatory genes. Fourteen distinct clusters were identified, including myeloid cells (neutrophils, monocytes, macrophages), dendritic cells (DC), and lymphoid cells (B, T, γδT, ILC2, and NK) lineages. Novel neutrophil [lipocalin (Lcn2) high and low), and MHCIIlo macrophage (MP) clusters were identified. More than half of the cells map to myeloid and dendritic cell populations with differential expression profiles that include genes with homeostatic and regulatory functions: Serpinb2 (MHCIIlo macrophage), …

Diagnosis Of Polypoidal Choroidal Vasculopathy From Fluorescein Angiography Using Deep Learning, Yu-Yeh Tsai, Wei-Yang Ling, Shih-Jen Chen, Paisan Ruamviboonsuk, Cheng-Ho King, Chia-Ling Tsai

Publications and Research

Purpose: To differentiate polypoidal choroidal vasculopathy (PCV) from choroidal neovascularization (CNV) and to determine the extent of PCV from fluorescein angiography (FA) using attention-based deep learning networks.

Methods: We build two deep learning networks for diagnosis of PCV using FA, one for detection and one for segmentation. Attention-gated convolutional neural network (AG-CNN) differentiates PCV from other types of wet age-related macular degeneration. Gradient-weighted class activation map (Grad-CAM) is generated to highlight important regions in the image for making the prediction, which offers explainability of the network. Attention-gated recurrent neural network (AG-PCVNet) for spatiotemporal prediction is applied for segmentation …

Secretogranin Iii Stringently Regulates Pathological But Not Physiological Angiogenesis In Oxygen-Induced Retinopathy, Chang Dai, Prabuddha Waduge, Liyang Ji, Chengchi Huang, Ye He, Hong Tian, Elizabeth Zuniga-Sanchez, Amit Bhatt, Iok-Hou Pang, Guanfang Su, Keith A Webster, Wei Li

Faculty, Staff and Students Publications

Conventional angiogenic factors, such as vascular endothelial growth factor (VEGF), regulate both pathological and physiological angiogenesis indiscriminately, and their inhibitors may elicit adverse side effects. Secretogranin III (Scg3) was recently reported to be a diabetes-restricted VEGF-independent angiogenic factor, but the disease selectivity of Scg3 in retinopathy of prematurity (ROP), a retinal disease in preterm infants with concurrent pathological and physiological angiogenesis, was not defined. Here, using oxygen-induced retinopathy (OIR) mice, a surrogate model of ROP, we quantified an exclusive binding of Scg3 to diseased versus healthy developing neovessels that contrasted sharply with the ubiquitous binding of VEGF. Functional immunohistochemistry visualized …

Ataxia Pancytopenia Syndrome Associated Ocular Albinism: A Clinical Vignette, Dru Curtis, Catherine Boon, Stephanie Ryan, Nausheen Khuddus

North Florida Division GME Research Day 2022

No abstract available.

Corneal Ulcer On The Verge Of Rupture: An Ocular Emergency In A Free-Standing Emergency Room, Kevin Thomas, Garrett Root

South Atlantic Division GME Research Day 2022

No abstract provided.

Effect Of Glaucoma On Melanopsin Retinal Ganglion Cells In Mice, Abigail Mcmullen

Williams Honors College, Honors Research Projects

Within the mammalian retina, there are melanopsin-containing ganglion cells. These intrinsically photoreceptive cells help control behavioral aspects of vision as well as to aid in circadian rhythms. In this project, it will be determined whether or not glaucoma has an effect on these cells, and what that effect is, from different points in the disease. Glaucoma is an eye disease that damages the retinal ganglion cells and eventually causes them to die, also it can be linked to irregular circadian rhythm. Many techniques will be used to prepare this project but computer imaging will be the primary method for determining …

Glaucoma Alters The Morphology Of Mouse Melanopsin-Containing Retinal Ganglion Cells, Kristin Keenan

Williams Honors College, Honors Research Projects

Melanopsin ganglion cells are intrinsically photosensitive ganglion cells in the mammalian retina. These cells mediate aspects of non-image forming vision to help regular circadian rhythm. Glaucoma is an eye disease involving an increase in intraocular pressure that has been linked to irregular circadian rhythm. This project will investigate the impact glaucoma has on these melanopsin ganglion cells at different pathological timepoints. This will be performed by using dissection, immunohistochemistry, and computer imaging methods to visualize, trace, and measure the cells’ morphologies in both control and glaucomatous retinas at different timepoints of disease to analyze if glaucoma has a significant effect …

A Proposed Method To Verify Physician Visual Estimation Of Intraoperative Corneal Edema From Refractive Measurement Images During Cataract Surgery, Karalee Corley

CMC Senior Theses

A patient’s resultant vision quality in a restorative Femtosecond Laser Assisted Cataract Surgery (FLACS) can be fine tuned via an intraoperative measurement of refractive power and axis of astigmatism in the aphakic state. Standard preoperative measurements often disagree with intraoperative measurements (Optiwave Refractive Analysis; Alcon, Inc.) on account of the inclusion or exclusion of posterior corneal curvature, leaving the ultimate lens selection to physician discretion. One additional suggested cause of disagreement is swelling at the corneal incision site (Corley and Carmack 2020).The following proposes a method to verify visual estimation of intraoperative corneal swelling from 2D gray-scale images collected during …

Review Of Evidence For Environmental Causes Of Uveal Coloboma, Evan B Selzer, Delphine Blain, Robert B Hufnagel, Philip J Lupo, Laura E Mitchell, Brian P Brooks

Faculty, Staff and Student Publications

Uveal coloboma is a condition defined by missing ocular tissues and is a significant cause of childhood blindness. It occurs from a failure of the optic fissure to close during embryonic development and may lead to missing parts of the iris, ciliary body, retina, choroid, and optic nerve. Because there is no treatment for coloboma, efforts have focused on prevention. While several genetic causes of coloboma have been identified, little definitive research exists regarding the environmental causes of this condition. We review the current literature on environmental factors associated with coloboma in an effort to guide future research and preventative …

Retrobulbar Hematoma In A Patient With Thyroid Eye Disease, Christina Y Weng

Faculty, Staff and Students Publications

A 37-year-old female with a history of thyroid eye disease presented after trauma to the right side of her face. Visual acuity was light perception and a relative afferent pupillary defect was detected. There was gross proptosis of the unruptured right globe with diffuse conjunctival hemorrhage. Computed tomography revealed an intraconal retrobulbar hematoma (RBH) with anterior herniation of the globe. The extraocular muscles were thickened, consistent with her thyroid eye disease, and her superior rectus was avulsed. The optic nerve was on stretch, but there was no evidence of transection. The patient ultimately underwent enucleation with the plan for an …

Oral Administration Of A Dual Eta/Etb Receptor Antagonist Promotes Neuroprotection In A Rodent Model Of Glaucoma, Bindu Kodati, Nolan R Mcgrady, Hayden B Jefferies, Dorota L Stankowska, Raghu R Krishnamoorthy

Faculty, Staff and Student Publications

PURPOSE: Glaucoma is a neurodegenerative disease associated with elevated intraocular pressure and characterized by optic nerve axonal degeneration, cupping of the optic disc, and loss of retinal ganglion cells (RGCs). The endothelin (ET) system of vasoactive peptides (ET-1, ET-2, ET-3) and their G-protein coupled receptors (ET

METHODS: Male and female Brown Norway rats were subjected to the Morrison model of ocular hypertension by injection of hypertonic saline through the episcleral veins. Following IOP elevation, macitentan (5 mg/kg body wt) was administered orally 3 days per week, and rats with IOP elevation were maintained for 4 weeks. RGC function was determined …

Initial Experiences Using Plasma Rich In Growth Factors To Treat Keratoneuralgia, Margaret Wang, Sowmya Yennam, Stephen Pflugfelder

Faculty, Staff and Students Publications

Keratoneuralgia, a clinical diagnosis of sensitized corneal pain without visible ocular surface damage, generally has minimal response to conventional therapies. Causes include refractive surgery and chronic dry eye. We evaluated the efficacy of Plasma Rich in Growth Factors (PRGF), a novel treatment prepared using a commercially available kit, in patients with keratoneuralgia. A retrospective chart review identified patients who had the clinical diagnosis of keratoneuralgia and were treated with PRGF for at least 3 months from October 2015 to April 2020 at a single academic institution. Both objective eye exam findings and concurrent treatments were obtained at baseline, 3 months, …

Sibling Concordance In Symptom Onset And Atrophy Growth Rates In Stargardt Disease Using Ultra-Widefield Fundus Autofluorescence, Rachael C. Heath Jeffery, Jennifer A. Thompson, Johnny Lo, Tina M. Lamey, Terri L. Mclaren, John N. De Roach, Dimitar N. Azamanov, Ian L. Mcallister, Ian J. Constable, Fred K. Chen

Research outputs 2022 to 2026

Purpose: To investigate concordance in symptom onset, area of dark autofluorescence (DAF), and growth rate (GR) between Stargardt disease siblings at an age-matched time point. Methods: In this retrospective longitudinal study of sibling pairs with identical biallelic ABCA4 variants, age at symptom onset, best-corrected visual acuity, atrophy area, and effective radius of DAF on ultra-widefield fundus autofluorescence were recorded. Absolute intersibling differences for both eyes were compared with absolute interocular differences using the Mann-Whitney test. Results: Overall 39 patients from 19 families were recruited. In 16 families, age-matched best-corrected visual acuity and DAF were compared between siblings. In 8 families, …

Gut Microbiota From Sjögren Syndrome Patients Causes Decreased T Regulatory Cells In The Lymphoid Organs And Desiccation-Induced Corneal Barrier Disruption In Mice, Laura Schaefer, Claudia M Trujillo-Vargas, Firas S Midani, Stephen C Pflugfelder, Robert A Britton, Cintia S De Paiva

Faculty, Staff and Students Publications

Sjögren syndrome (SS) is an autoimmune inflammatory disorder characterized by secretory dysfunction in the eye and mouth; in the eye, this results in tear film instability, reduced tear production, and corneal barrier disruption. A growing number of studies show that homeostasis of the ocular surface is impacted by the intestinal microbiome, and several 16S sequencing studies have demonstrated dysbiosis of the intestinal microbiota in SS patients. In this study, we utilized metagenomic sequencing to perform a deeper analysis of the intestinal microbiome using stools collected from sex- and age-matched healthy (n = 20), dry eye (n = 4) …

New, Potent, Small Molecule Agonists Of Tyrosine Kinase Receptors Attenuate Dry Eye Disease, Zhiyuan Yu, Shaon Joy, Tianxiong Mi, Ghasem Yazdanpanah, Kevin Burgess, Cintia S De Paiva

Faculty, Staff and Students Publications

Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin3 (NT-3) bind to tyrosine kinase (Trk) receptors, TrkA, TrkB, and TrkC, respectively. This study investigated the efficacy of novel molecule agonists of Trk receptors in an in vivo model of dry eye disease (DED). Small molecule TrkC agonist (C1) and a pan-Trk agonist (pan) were synthesized for this. C57BL/6J mice were subjected to desiccating stress (DS) and received bilateral eye drops of C1, pan, or vehicle (2x/day). Dry eye signs, inflammation and expression of corneal barrier function, and conjunctival goblet cell (GC) densities were measured as part of the DED …

Spatial Transcriptomics Of The Lacrimal Gland Features Macrophage Activity And Epithelium Metabolism As Key Alterations During Chronic Inflammation, Olivier Mauduit, Vanessa Delcroix, Takeshi Umazume, Cintia S De Paiva, Darlene A Dartt, Helen P Makarenkova

Faculty, Staff and Students Publications

The lacrimal gland (LG) is an exocrine gland that produces the watery part of the tear film that lubricates the ocular surface. Chronic inflammation, such as Sjögren’s syndrome (SS), is one of the leading causes of aqueous-deficiency dry eye (ADDE) disease worldwide. In this study we analyzed the chronic inflammation in the LGs of the NOD.B10Sn-H2b/J (NOD.H-2b) mice, a mouse model of SS, utilizing bulk RNAseq and Visium spatial gene expression. With Seurat we performed unsupervised clustering and analyzed the spatial cell distribution and gene expression changes in all cell clusters within the LG sections. Moreover, for the …

Role Of Meibum And Tear Phospholipids In The Evaporative Water Loss Associated With Dry Eye., Samiyyah M. Sledge

Electronic Theses and Dissertations

It is generally believed that the tear film lipid surface film inhibits the rate of evaporation (Revap) of the underlying tear aqueous. It is also generally believed that changes in the composition of the tear film lipid layer is responsible for an increase in Revap in patients with dry eye. Both of these ideas have never been proven. The purpose of the current studies was to test these ideas. Revap was measured in vitro gravimetrically. Lipid spreading was measured using Raman spectroscopy and microscopy. The influence of the following surface films on the Revap of the sub phase of physiologically …

Frequency Of Hepatitis B, Hepatitis C And Human Immunodeficiency Virus In Patients Undergoing Cataract Surgery, Mahfouth Abdalla Bamashmus, Ahmed Mousa Abdulrahim

Hadhramout University Journal of Natural & Applied Sciences

The aim of this study is to assess the frequency of Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency (HIV) viral infections in patients undergoing cataract surgery. This study was conducted among 1,203 patients above the age of 17 years who were scheduled for cataract surgery at Yemen Magrabi Hospital from January 1st, through December 31st, 2012. Patients had investigations for HBV, HCV and HIV and findings were analyzed. The total number of patients screened was 1,203 including 603 (51.1%) males and 600 (49.9%) females. The mean (+SD) age was 59.96 + 12.39 years. Out of the 1,203 cataract …

Super-Resolution Microscopy Reveals Photoreceptor-Specific Subciliary Location And Function Of Ciliopathy-Associated Protein Cep290, Valencia L Potter, Abigail R Moye, Michael A Robichaux, Theodore G Wensel

Faculty, Staff and Students Publications

Mutations in the cilium-associated protein CEP290 cause retinal degeneration as part of multiorgan ciliopathies or as retina-specific diseases. The precise location and the functional roles of CEP290 within cilia and, specifically, the connecting cilia (CC) of photoreceptors, remain unclear. We used super-resolution fluorescence microscopy and electron microscopy to localize CEP290 in the CC and in the primary cilia of cultured cells with subdiffraction resolution and to determine effects of CEP290 deficiency in 3 mutant models. Radially, CEP290 localizes in close proximity to the microtubule doublets in the region between the doublets and the ciliary membrane. Longitudinally, it is distributed throughout …

Klebsiella Pneumoniae Cryptogenic Liver Abscess And Endophthalmitis – A Case Report And Review Of Literature, Mihai Leonard Grecescu, Monica Grecescu, Andreea Smarandache Maria, Cristian Mihai Branescu, Anca Anghelache, Anca Silvia Dumitriu, Stana Paunica, Andreea Cristina Costea

Journal of Mind and Medical Sciences

Klebsiella pneumoniae has emerged as the predominant pathogenic agent of liver abscess in Asia, and the incidence is increasing worldwide. Hypervirulent strains are associated with septic metastatic dissemination in the eyes, lungs, and central nervous system, causing severe morbidity. We present the case of a 54year old man, with no previous comorbidities, admitted in emergency for the blind red painful eye. Further investigation documented septic endophthalmitis with transscleral extension and orbital cellulitis. Thoraco-abdominal computed tomography evidenced a hepatic abscess as the locus of the primary infection. Intravenous antibiotherapy with cefuroxime, followed by meropenem and vancomycin were efficient for managing the …

Optical Coherence Tomography Based Indices In Predicting Functional Outcome Of Macular Hole Surgery: A Retrospective Chart Review, Haroon Tayyab, Rehman Siddiqui, Sana Jahangir, Shiraz Hashmi

Section of Ophthalmology

Objectives: The objective of this study was to assess the utility of novel macular hole indices of Optical Coherence Tomography (OCT) and predicting the functional outcome of surgery.
Methods: This was a retrospective chart review of 28 eyes who underwent surgery for idiopathic Full Thickness Macular Hole (FTMH) at The Aga Khan University Hospital (AKUH), Karachi from January 2016 to March 2020. Data of preoperative OCTs were recovered from data server of OCT machine. Measurements of the pre-operative OCTs were calculated using caliper function of OCT software by two independent technicians. Parameters included Macular Hole Index (MHI), Traction Hole Index …