Optometry Commons^™

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, …

Il-17 Producing Lymphocytes Cause Dry Eye And Corneal Disease With Aging In Rxrα Mutant Mouse, Jehan Alam, Ghasem Yazdanpanah, Rinki Ratnapriya, Nicholas Borcherding, Cintia S De Paiva, Dequan Li, Rodrigo Guimaraes De Souza, Zhiyuan Yu, Stephen C Pflugfelder

Faculty, Staff and Students Publications

PURPOSE: To investigate IL-17 related mechanisms for developing dry eye disease in the Pinkie mouse strain with a loss of function RXRα mutation.

METHODS: Measures of dry eye disease were assessed in the cornea and conjunctiva. Expression profiling was performed by single-cell RNA sequencing (scRNA-seq) to compare gene expression in conjunctival immune cells. Conjunctival immune cells were immunophenotyped by flow cytometry and confocal microscopy. The activity of RXRα ligand 9-cis retinoic acid (RA) was evaluated in cultured monocytes and γδ T cells.

RESULTS: Compared to wild type (WT) C57BL/6, Pinkie has increased signs of dry eye disease, including decreased tear …

Problems In Csf And Ophthalmic Disease Research, Ryan Machiele, Benjamin Jay Frankfort, Hanspeter Esriel Killer, David Fleischman

Faculty, Staff and Students Publications

There has been significant interest and progress in the understanding of cerebrospinal fluid pressure and its relationship to glaucoma and other ophthalmic diseases. However, just as every physiologic fluid pressure fluctuates, cerebrospinal fluid pressure (CSFP) is similarly dynamic. Coupling this with the difficulty in measuring the pressure, there are many obstacles in furthering this field of study. This review highlights some of the difficulties in CSFP research, including fluid compartmentalization, estimation equations, and pressure fluctuation. Keeping these limitations in mind will hopefully improve the quality and context of this burgeoning field.

Systematic Profiling Of Dnmt3a Variants Reveals Protein Instability Mediated By The Dcaf8 E3 Ubiquitin Ligase Adaptor, Yung-Hsin Huang, Chun-Wei Chen, Venkatasubramaniam Sundaramurthy, Mikołaj Słabicki, Dapeng Hao, Caroline J Watson, Ayala Tovy, Jaime M Reyes, Olga Dakhova, Brielle R Crovetti, Christina Galonska, Minjung Lee, Lorenzo Brunetti, Yubin Zhou, Katrina Tatton-Brown, Yun Huang, Xiaodong Cheng, Alexander Meissner, Peter J M Valk, Lionel Van Maldergem, Mathijs A Sanders, Jamie R Blundell, Wei Li, Benjamin L Ebert, Margaret A Goodell

Faculty, Staff and Students Publications

Clonal hematopoiesis is a prevalent age-related condition associated with a greatly increased risk of hematologic disease; mutations in DNA methyltransferase 3A (DNMT3A) are the most common driver of this state. DNMT3A variants occur across the gene with some particularly associated with malignancy, but the functional relevance and mechanisms of pathogenesis of the majority of mutations are unknown. Here, we systematically investigated the methyltransferase activity and protein stability of 253 disease-associated DNMT3A mutations, and found that 74% were loss-of-function mutations. Half of these variants exhibited reduced protein stability and, as a class, correlated with greater clonal expansion and acute …

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) …

Selective Vulnerability Of The Intermediate Retinal Capillary Plexus Precedes Retinal Ganglion Cell Loss In Ocular Hypertension, Priyamvada M Pitale, Guofu Shen, Rohini R Sigireddi, Maria Polo-Prieto, Yong H Park, Solomon E Gibson, Peter D Westenskow, Roomasa Channa, Benjamin J Frankfort

Faculty, Staff and Students Publications

Introduction: Glaucoma, a disease of retinal ganglion cell (RGC) injury and potentially devastating vision loss, is associated with both ocular hypertension (OHT) and reduced ocular blood flow. However, the relationship between OHT and retinal capillary architecture is not well understood. In this project, we studied microvasculature damage in mice exposed to mild levels of induced OHT.

Methods: Mild OHT was induced with the microbead model for 2 weeks. At this time point, some retinas were immunostained with CD31 (endothelium), Collagen IV (basement membrane), and RBPMS (RGCs) for z-stack confocal microscopy. We processed these confocal images to distinguish the three retinal …

Selectively Targeting Disease-Restricted Secretogranin Iii To Alleviate Choroidal Neovascularization, Liyang Ji, Prabuddha Waduge, Lili Hao, Avinash Kaur, Wencui Wan, Yan Wu, Hong Tian, Jinsong Zhang, Keith A Webster, Wei Li

Faculty, Staff and Students Publications

Choroidal neovascularization (CNV), a leading cause of blindness in the elderly, is routinely treated with vascular endothelial growth factor (VEGF) inhibitors that have limited efficacy and potentially adverse side effects. An unmet clinical need is to develop novel therapies against other angiogenic factors for alternative or combination treatment to improve efficacy and safety. We recently described secretogranin III (Scg3) as a disease-selective angiogenic factor, causally linked to diabetic retinopathy and acting independently of the VEGF pathway. An important question is whether such a disease-selective Scg3 pathway contributes to other states of pathological angiogenesis beyond diabetic retinopathy. By applying a novel …

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 …

Cathepsin S Is A Novel Target For Age-Related Dry Eye, Zhiyuan Yu, Jinmiao Li, Gowthaman Govindarajan, Sarah F Hamm-Alvarez, Jehan Alam, De-Quan Li, Cintia S De Paiva

Faculty, Staff and Students Publications

Cathepsin S (CTSS) is a protease that is proinflammatory on epithelial cells. The purpose of this study was to investigate the role of CTSS in age-related dry eye disease. Ctss−/− mice [in a C57BL/6 (B6) background] of different ages were compared to B6 mice. CTSS activity in tears and lacrimal gland (LG) lysates was measured. The corneal barrier function was investigated in naïve mice or after topical administration of CTSS eye drops 5X/day for two days. Eyes were collected, and conjunctival goblet cell density was measured in PAS-stained sections. Immunoreactivity of the tight junction proteins, ZO-1 and occludin, was …

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 …

Investigation Of The Suitability Of A Commercial Radiation Sensor For Pretherapy Dosimetry Of Radioiodine Treatment Patients, Janet O'Callaghan, Dervil Cody, Jennie Cody

Articles

Radioiodine (I-131) therapy is routinely used to treat conditions of the thyroid. Dosimetry planning in advance of I-131 therapy has been shown to improve patient treatment outcomes. However, this pretherapy dosimetry step requires multiple outpatient appointments and is not feasible for patients living at greater distances. Here, the feasibility of a commercially available smartphone-operated radiation sensor (Smart Geiger Pro, Technonia) for at-home patient pretherapy dosimetry has been investigated. The influence of both treatment-specific parameters (radioisotope activity, gamma photon energy, patient size) and external factors (sensor placement and motion) on the ability of the radiation sensor to accurately quantify radiation dose …

Characterisation Of Holographic Recording In Environmentally Stable Photopolymerisable Glass, Tatsiana Mikulchyk, Pamela Stoeva, Alicja Kaworek, Mohamed Oubaha, Brian Rogers, Suzanne Martin, Dervil Cody, Izabela Naydenova

Articles

Photopolymerisable glasses are holographic recording materials which provide good recording capability, improved dimensional stability, and negligible shrinkage. Recently, a novel photopolymerisable hybrid sol-gel (PHSG) for holographic recording of volume gratings has been reported. The PHSG has significantly improved gelation time and high water resistance, both of which make it an attractive material for mass production of holographic optical elements (HOEs) with no sensitivity to ambient humidity. In order to achieve full control over the performance of the material and further improve its properties, a study of grating formation under holographic patterning is essential. This paper reports characterisation of the grating …

A Magnetic Nanoparticle-Doped Photopolymer For Holographic Recording, Muhammad Irfan, Suzanne Martin, Muhammad Ahmed Obeidi, Scott Miller, Frank Kuster, Dermot Brabazon, Izabela Naydenova

Articles

Functionalised holograms are important for applications utilising smart diffractive optical elements for light redirection, shaping and in the development of sensors/indicators. This paper reports on holographic recording in novel magnetic nanocomposites and the observed temperature change in dry layers and liquid samples exposed to alternating magnetic field (AMF). The nanocomposite consists of N-isopropylacrylamide (NIPA)-based polymer doped with magnetic nanoparticles (MNPs), and local heating is achieved through magnetic induction. Here, volume transmission holographic gratings (VTHGs) are recorded with up to 24% diffraction efficiency (DE) in the dry layers of magnetic nanocomposites. The dry layers and liquid samples are then exposed to …

Environmental Impacts Of Contact Lens Waste, Abigail Wilhelmi

Arts & Sciences Undergraduate Showcase

Contact lenses have been used for decades to correct vision, and over 150 million people use contact lenses today. The materials used to make contact lenses have evolved drastically, but ultimately resulted in a specific plastic, silicone-derived hydrogel, which provides maximal comfort and clear vision, while also maintaining the eye health of the user. Contact lenses have enhanced the lives of many people, but a topic that is often left out of contact lens discussions is that of plastic waste. Single-use plastic and increased plastic pollution have recently been areas of concern and expanded research. Contact lenses are often forgotten …

Importance Of Optometric Practices, Nikhita Jacob

Honors Projects

This research examines what effect education has on people’s decision-making. More specifically, whether better education leads to better decisions and health outcomes, and why that is important for optometry. Every decision someone makes depends on some type of information, whether it is heard, read about, watched, or experienced. The more information someone has, the more confident someone can be in the decisions they make. Access to information and to education, whether it is through school, libraries, or news channels, is not always equal. It is important that people are informed about subjects as important as their health, by those who …

Basic And Applied Studies Of Human Visual Function: Implications For Visually Demanding Occupations, Julie Lovell

Theses & Dissertations

Color vision is a complex process providing important information about objects within our environment. Color vision deficiency either congenital or acquired can impact real world performance. Current working environments either require normal color vision or utilize color as a tool to highlight critical information. The use of color in the workplace provides several advantages. Hence, color vision screening is required for entry into professions and occupational certifications. Acquired color vision deficiency may also impact job performance requiring clinical screening. The present dissertation focused on the considerations outlined by the Commission on Behavior and Social Sciences when choosing a clinical test …

Understanding Blue Light Retinal Damages And The Methods Of Prevention, Amelia Lee

Senior Honors Theses

Light emitting diode (LED) lights that comprise television screens, phone displays, laptops, and tablets have been studied by scientists in order to understand the implications of blue light radiation and the effects that it has on the human body—especially the retina of the eye. The retina is comprised of highly metabolic cells, and when those cells are placed under oxidative stress, death occurs causing ocular disease. Additionally, excess blue light exposure causes shifts in biological rhythms that govern patterns of alertness and sleep. Recently scientists began studying the methods of blue light prevention. Some studies show that blue light radiation …

Thank You Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you to all the reviewers!

Conjunctival Intraepithelial Neoplasia: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Gelatinous, vascularized lesions of the conjunctiva are a subset of ocular surface tumors that are derived from various cell types. The more worrisome origins include diagnoses of conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). Topical treatments such as mitomycin-C, 5-fluorouracil, and interferon alfa-2b are now used as single therapy or in conjunction with surgical excision.

Case Report: This case features a 78-year-old Caucasian male with CIN treated with surgical removal and topical interferon alfa-2b. In addition to discussing the details of this case, this report highlights important caveats of the treatment and management of the …

Occlusive Retinal Vasculitis Secondary To Sjogren’S Syndrome: A Case Report And Review, Lynn Finnegan Od, Danielle Kalberer Od

Optometric Clinical Practice

Background: To bring attention to the potential and serious ophthalmic sequalae of Sjogren’s syndrome, specifically occlusive retinal vasculitis.

Case: A 70-year-old male patient without previous ocular pathology presented with acute onset, bilateral, painless vision loss. Fundus evaluation revealed extensive retinal occlusive disease with bilateral disc edema, cystoid macular edema, and diffuse phlebitis. The patient was admitted, received a full systemic work-up and was carefully co-managed by ophthalmology, neurology, infectious disease, vascular surgery, dermatology, rheumatology and medicine. Evaluation supported a leading diagnosis of Sjogren’s syndrome associated vasculitis.

Conclusion: The patient underwent treatment with oral steroids and intravitreal injections of anti-vascular endothelial …

Occipital Lobe Abscess Causing Homonymous Hemianopsia After A Dental Procedure, Kristin Mcdougall Od, Julie Staats Od, Ashley Fritz Od

Optometric Clinical Practice

Background: A homonymous hemianopsia visual field defect is defined as vision loss on the same side of the vertical midline in both eyes. Although the vast majority are caused by an ischemic stroke, other neurologic etiologies must be considered and ruled out. This case highlights the importance of a rapid and thorough investigation of a patient’s symptoms using both clinical examination and imaging to reduce the risk of permanent complications and potential fatality.

Case Report: A 67-year-old Caucasian male presented to the eye clinic with sudden onset reduced peripheral vision to his right side in both eyes. Entering visual acuities …

Choroidal Melanoma: Screening For Metastasis And Frequency Of Incidental Second Primary Cancer Diagnosis., Ethan Leyda Od

Optometric Clinical Practice

Background: Choroidal melanoma is the most common primary intraocular malignancy in adults. This case report reviews clinical diagnostic features, imaging techniques, treatment, prognosis, and systemic work-up of choroidal melanomas. It also addresses choroidal melanoma metastasis and the incidental finding of second primary cancers through whole-body screening.

Case Report: A 71-year-old white male reported to the Cleveland VA Medical Center optometry retina clinic for a second opinion exam of an asymptomatic choroidal lesion in the right eye. The lesion was a 6 mm gray choroidal mass in the inferior peripheral fundus, with orange pigmentation, retinal pigmented epithelial hypertrophy along the superior …

Ocular Characteristics Of Non-Covid-19 Patients: A Retrospective Study Of Time-Sensitive Ophthalmic Care During The Pandemic, Yun-Ping Moore Od, Laura Ward Msph, Farah Gulaid Od, Susan A. Primo Od, Mph

Optometric Clinical Practice

Purpose: To analyze the cohort of clinical patients seen during the COVID-19 pandemic shutdown at Emory Eye Center in comparison with prior weeks.

Method: We conducted a retrospective chart review from three outpatient clinical sites over a period of eighteen weeks, which covered pre-COVID-19 dates as well as the dates of when our clinics were closed near the beginning of the COVID-19 pandemic. We utilized data from providers assigned to daily triage coverage for in-person exams. Primary diagnosis and visit type data were extracted to look for trends and commonalities among urgent or time-sensitive patients.

Results: For the nine weeks …

Dean's View, Timothy Wingert Od

Optometric Clinical Practice

Dean of University of the Incarnate Word-Rosenberg School of Optometry shares insight.

Perfect Storm, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

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 …

Structure And Dynamics Of Photoreceptor Sensory Cilia, Theodore G Wensel, Valencia L Potter, Abigail Moye, Zhixian Zhang, Michael A Robichaux

Faculty, Staff and Students Publications

The rod and cone photoreceptor cells of the vertebrate retina have highly specialized structures that enable them to carry out their function of light detection over a broad range of illumination intensities with optimized spatial and temporal resolution. Most prominent are their unusually large sensory cilia, consisting of outer segments packed with photosensitive disc membranes, a connecting cilium with many features reminiscent of the primary cilium transition zone, and a pair of centrioles forming a basal body which serves as the platform upon which the ciliary axoneme is assembled. These structures form a highway through which an enormous flux of …

Transitional Vocational Program For Persons With Low Vision And Other Visual Impairments, Andria Lubben, Karen Park, Susan Macdermott, Becki Cohill

Summer 2021 Virtual OTD Capstone Symposium

Background: Low Vision is a life-altering visual disability (CDC, 2015). OTs work with individuals with low vision and work in the workplace and education, however, there is no research on OTs working with individuals with low vision in work or post educational settings (Butler, 2016). Vocational and educational needs are often not being met for individuals with low vision (Barbieri et al., 2019).

Problem: OTs have a limited role in adolescent transition to the workplace and higher education in individuals with low vision and other visual impairments.

Purpose: To understand transitional programs that support vocational and educational development of individuals …

‘Missing The Target’ – A Critical Examination Of Policy Frameworks For Aboriginal And Torres Strait Islander Inclusion Into The Allied Health Professions, Andrea Simpson, Tim Pitman

Australian Indigenous HealthBulletin

Objective

This paper focuses on critically examining the inclusion of Aboriginal and Torres Strait Islander people in policy frameworks by regulatory health peak bodies against the backdrop of the Government’s response to the Closing the Gap (2020) report.

Method

Websites of ten allied health professional bodies were searched and analysed as policy as text.

Results

Of the ten professions examined, the search strategy identified 9 professions were signatories or co-signatories on Reconciliation Action Plans (RAP) and three professions made mention of Aboriginal and Torres Strait Islander equity strategies to enter the profession as part of accreditation standards.

Conclusions

Professional bodies …

Evaluation Of The Spot™ Photoscreener’S Efficacy For Detecting Amblyopia Risk Factors Compared To Optometrists’ Examinations In 305 South Dakota Children, Jeremy J. Kudrna Md, Eric Habbe Md, Andrea Bordewyk Md, Hadly Carson Eisenbeisz Ms-Iv, Ryan Scarborough Od, Terrence Spencer Md

Aesculapius Journal (Health Sciences & Medicine)

Purpose: This study sought to further validate the efficacy of the SPOT^TM photoscreener version (v) 3.0.0500 as a screening device for amblyopia risk factors (ARF).

Methods: This was a cross-sectional study from five different western South Dakota outpatient clinics. Data from 610 eyes of 305 children aged 6 months to 13.5 years collected between July 2018 to September 2018 were analyzed, using both the out-of-box referral criteria and the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria. Optometrist (eye care provider or ECP) cycloplegia practice patterns were deferred to each clinics’ specific protocols. Power vector and …