Ophthalmology Commons^™

A Hybrid Deep Learning-Based Approach For Visual Field Test Forecasting, Ashkan Abbasi, Sowjanya Gowrisankaran, Wei-Chun Lin, Xubo Song, Bhavna Josephine Antony, Gadi Wollstein, Joel Schuman, Hiroshi Ishikawa

Wills Eye Hospital Papers

OBJECTIVE: Longitudinal assessment of visual field (VF) testing is essential in glaucoma management. Conventional VF forecasting methods require numerous prior tests, while deep learning techniques have shown promising results with fewer tests. This study introduces a hybrid deep learning framework to enhance flexibility and accuracy in VF test forecasting.

DESIGN: A retrospective longitudinal study using deep learning-based VF forecasting models.

SUBJECTS AND CONTROLS: A total of 1750 subjects (healthy and glaucoma patients) with 19 437 Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal glaucoma cohorts at the University of Pittsburgh and New York University.

METHODS: Three deep …

Is There Evidence For Changes In Antibiotic Resistance Of Microorganisms Causing Postcataract Surgery Endophthalmitis: A Systematic Review, Christina J Flaxel, Justine R Smith, Nieraj Jain, Leo A Kim, Stephen Jae Kim, Maureen G Maguire, Christina Y Weng, Steven Yeh

Faculty, Staff and Students Publications

Background/aims: To review the evidence for changes in antibiotic resistance patterns before and after cataract surgery since the advent of routine use of intracameral (IC) antibiotic prophylaxis and development of newer topical fluoroquinolones pre- and postcataract surgery.

Methods: Literature searches in the National Library of Medicine PubMed database were conducted between 2019 and 2021 and updated in 2024. There were no date restrictions, and the search was limited to high-quality studies published in English. The initial combined searches yielded 583 articles, and the search update in 2024 yielded 9 articles. Of these 592 articles, 26 presented original research that met …

Structural Updates To The Implant And Refill Needle Of The Port Delivery Platform, Dante J. Pieramici, Peter A. Campochiaro, Margaret Chang, Ian Pearce, Carl D. Regillo, Shamika Gune, Nancy Holekamp, Carlos Quezada-Ruiz, Shrirang V. Ranade, Natasha Singh, Geoffrey Wise, Joshua Horvath

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to report the impact of component-level changes and manufacturing process improvements on septum durability in the ocular implant of the Port Delivery Platform (PD-P), more commonly known as the Port Delivery System with ranibizumab (PDS) with its current formulation.

METHODS: Laboratory tests were conducted to determine (1) the bond strength of the septum to the overmold, (2) the amount of force utilized for the refill needle to puncture the septum, and (3) septum durability over 50 years. To simulate multiple refill-exchanges over long-term clinical use, implants were aged at elevated temperature in saline …

Postoperative Intraocular Lens Tilt From Preoperative Full Crystalline Lens Geometry Using Machine Learning, Eduardo Martinez-Enriquez, Gonzalo Velarde-Rodríguez, Nicolás Alejandre-Alba, Derick Ansah, Sindhu Kishore, Álvaro De La Peña, Ramya Natarajan, Pravin Vaddavalli, Yue Zhao, Joseph O Okudolo, Dylan B Mcbee, Ugur Celik, Mujdat Cetin, Jen-Li Dong, Yuli Lim, Li Wang, Douglas Donald Koch, Scott Macrae, Susana Marcos

Faculty, Staff and Students Publications

In cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL), requiring precise preoperative selection of parameters to optimize postoperative visual quality. Three-dimensional customized eye models, which can be constructed using quantitative data from anterior segment optical coherence tomography, provide a robust platform for virtual surgery. These models enable simulations and predictions of the optical outcomes for specific patients and selected IOLs. A critical step in building these models is estimating the IOL's tilt and position preoperatively based on the available preoperative geometrical information (ocular parameters). In this study, we present a machine learning model that, …

Endothelial Micu1 Protects Against Vascular Inflammation And Atherosclerosis By Inhibiting Mitochondrial Calcium Uptake, Lu Sun, Ruixue Leng, Monan Liu, Meiming Su, Qingze He, Zhidan Zhang, Zhenghong Liu, Zhihua Wang, Hui Jiang, Li Wang, Shuai Guo, Yiming Xu, Yuqing Huo, Clint L Miller, Maciej Banach, Yu Huang, Paul C Evans, Jaroslav Pelisek, Giovanni G Camici, Bradford C Berk, Stefan Offermanns, Junbo Ge, Suowen Xu, Jianping Weng

Faculty, Staff and Students Publications

Mitochondrial dysfunction fuels vascular inflammation and atherosclerosis. Mitochondrial calcium uptake 1 (MICU1) maintains mitochondrial Ca2+ homeostasis. However, the role of MICU1 in vascular inflammation and atherosclerosis remains unknown. Here, we report that endothelial MICU1 prevents vascular inflammation and atherosclerosis by maintaining mitochondrial homeostasis. We observed that vascular inflammation was aggravated in endothelial cell–specific Micu1 knockout mice (Micu1ECKO) and attenuated in endothelial cell–specific Micu1 transgenic mice (Micu1ECTg). Furthermore, hypercholesterolemic Micu1ECKO mice also showed accelerated development of atherosclerosis, while Micu1ECTg mice were protected against atherosclerosis. Mechanistically, MICU1 depletion increased mitochondrial Ca2+ influx, thereby decreasing the expression …

Disease Activity Criteria Impact Dosing Interval Assignment In Neovascular Age-Related Macular Degeneration Trials, Marco A Zarbin, Christina Y Weng, Nikolas J S London, Adrian Hock Chuan Koh, Roberto Gallego-Pinazo, Varun Chaudhary, Audrey Souverain, Ivaylo Stoilov, Philippe Margaron

Faculty, Staff and Students Publications

No abstract provided.

Disease Activity Criteria Impact Dosing Interval Assignment In Neovascular Age-Related Macular Degeneration Trials, Marco A Zarbin, Christina Y Weng, Nikolas J S London, Adrian Hock Chuan Koh, Roberto Gallego-Pinazo, Varun Chaudhary, Audrey Souverain, Ivaylo Stoilov, Philippe Margaron

Faculty, Staff and Students Publications

No abstract provided.

Addressing Diabetic Retinopathy Prevalence In Low-Income Communities: Barriers To Quality Healthcare And Strategies For Equitable Treatment Access, Morkeia A. Mutchelknaus

Honors Thesis

Studies have shown a strong correlation between diabetes and individuals in low-income communities, which often lack access to equitable healthcare for a variety of reasons. This honors thesis will focus on diabetic retinopathy, its prevalence, prevention, and treatment strategies in both low- and high-income communities. A comprehensive literature review was conducted to define diabetic retinopathy, assess its prevalence, and review past and present approaches to its treatment and prevention. This paper aims to identify strategies to improve healthcare accessibility in low-income communities by analyzing current strategies in place to prevent and treat diabetic retinopathy and proposing potential solutions that will …

Real-World Impact Of Latanoprostene Bunod Ophthalmic Solution 0.024% In Glaucoma Therapy: A Narrative Review, W. Daniel Stamer, Thomas Chiu, Da-Wen Lu, Tsing Hong Wang, Prin Rojanapongpun, Ngamkae Ruangvaravate, Youn Hye Jo, Marlene R. Moster, Murray Fingeret, Nora Lee Cothran, Jessica Steen, Ian B. Gaddie, Ömür Uçakhan-Gündüz, Wesam S. Shalaby, Cindy M. L. Hutnik

Wills Eye Hospital Papers

Latanoprostene bunod ophthalmic solution (LBN) 0.024% is a topical nitric oxide (NO)-donating prostaglandin F2α (PGF2α) analog first approved in November 2017 for reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG). This narrative review describes the unique mechanism of action of LBN and summarizes available real-world data. Upon instillation, LBN is metabolized into latanoprost acid and butanediol mononitrate, which is further reduced to NO and an inactive metabolite. Latanoprost acid increases aqueous humor outflow primarily through the uveoscleral (unconventional) pathway, whereas NO increases outflow through the trabecular (conventional) pathway. Eight studies were identified: 2 …

Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read

Journal of Academic Ophthalmology

Background: Applicants to ophthalmology residency programs have increasingly expressed interest in international surgical rotations. As such, ophthalmology residency program directors (PDs) have expanded international offerings to meet this desire but the true number of residency programs with international offerings is unknown. Methods: In February 2023, the official residency websites of all 125 accredited US-based ophthalmology residency programs were analyzed for any mention of international rotations. Websites were identified using a Google™ search by entering the program name and “ophthalmology residency.” All websites were surveyed for information regarding international rotations including the presence/absence of an international rotation and any additional information …

Trends In Resident Cataract Surgery Complication Rates Under A Single Experienced Supervising Attending, Simran Ohri, Jason A. Zehden, Dipen Kumar, Roma Pegany, Zhidong Zhang, Kenneth Cohen, Alice Y. Zhang

Teaching and Learning Faculty Publications

Purpose: To evaluate resident surgical complication rates under the supervision of an experienced attending surgeon over five years.

Setting: A single academic medical center at University of North Carolina at Chapel Hill, Chapel Hill, NC.

Design: Retrospective chart review.

Methods: Retrospective review of the first 30e50 cases performed by five classes of residents supervised by a single experienced attending surgeon with over twenty years of experience as a surgical educator. Data was collected from Accreditation Council for Graduate Medical Education (ACGME) surgical logs and operative notes. Preoperative risk factors, operative technique, and intraoperative complication rates were analyzed.

Results: A total …

Early Postoperative Intraocular Pressure Profile Following Micropulse Vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study, Wesam S. Shalaby, Amirmohsen Arbabi, Jae-Chiang Wong, Aakriti G. Shukla, Reza Razeghinejad, Daniel Lee, Marlene R. Moster, Jonathan S. Myers, Natasha N. Kolomeyer

Wills Eye Hospital Papers

Aim: To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC).

Methods: Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020–2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral).

Results: Twenty-six eyes (15 CW and 11 MP) …

Retinal Hemorrhage Associated With Neonatal Idiopathic Thrombocytopenia, Samara J. Hamou, Iniya K. Adhan, Maureen E. Lloyd, Barry N. Wasserman

Wills Eye Hospital Papers

PURPOSE: To describe a premature neonate with thrombocytopenia and retinal hemorrhage.

OBSERVATION: A 33 week premature neonate with neonatal thrombocytopenia (34 × 10⁹ platelet) was found to have left eye retinal hemorrhage. Bilateral retinal exam showed a healthy optic nerve and macula. A 10–12 disc diameter large nasal subretinal hemorrhage with an intraretinal white-centered hemorrhage was found. No other retinal abnormalities were found. Resolution of the hemorrhage occurred over the next three months. By this time, thrombocytopenia resolved (final platelet count: 259 × 10⁹/L), and the patient was able to fix and follow.

CONCLUSIONS AND IMPORTANCE: Neonatal …

Dietary Effects On The Retina Of Hamsters, Nicole El-Darzi, Natalia Mast, Yong Li, Irina A. Pikuleva

Faculty Scholarship

The retina is a sensory tissue in the back of the eye, which captures visual information and relays it to the brain. The retinal pigment epithelium separates the neural retina from the choroidal (systemic) circulation and is thereby exposed to circulating lipoprotein particles. Herein, we used hamsters and conducted various retinal evaluations of animals fed either a normal diet or a Western-type diet (WTD). Prior to evaluations, hamsters were injected with indocyanine green (ICG), a fluorescent dye that binds to various proteins and lipids in the systemic circulation. The WTD increased plasma levels of total and HDL cholesterol 1.8- and …

Evolving Trends In Retinoblastoma Management: A 16-Year Clinicopathological Analysis Of Enucleated Eyes, Ari H. August, Darcy Curtis, Maya Eiger-Moscovich, Antonio Yaghy, Sara E. Lally, Jerry A. Shields, Carol L. Shields, Ralph C. Eagle, Tatyana Milman

Wills Eye Hospital Papers

PURPOSE: New treatments for advanced retinoblastoma (RB) have offered alternatives to primary enucleation. We assessed the impact of these therapies on the indications for enucleation and the histopathological findings in enucleated eyes with RB.

MATERIALS AND METHODS: Eyes of all patients who underwent enucleation for RB at a single institution between January 2005 and August 2021 were included. Data collected retrospectively included demographics, clinical and pathologic staging, pathologic findings, and management. Statistical analysis included Kendall’s τb, Pearson χ², and Cramér’s V.

RESULTS: There were 254 eyes from 252 patients with information available for review. Annual enucleations decreased between …

Targeting The Mycn-Mdm2 Pathways For Cancer Therapy: Are They Druggable?, Wei Wang, Yi Du, Sayantap Datta, Josef F Fowler, Hannah T Sang, Najah Albadari, Wei Li, Jennifer Foster, Ruiwen Zhang

Faculty, Staff and Students Publications

Targeting oncogenes and their interactive partners is an effective approach to developing novel targeted therapies for cancer and other chronic diseases. We and others have long suggested the MDM2 oncogene being an excellent target for cancer therapy, based on its p53-dependent and -independent oncogenic activities in a variety of cancers. The MYC family proteins are transcription factors that also regulate diverse biological functions. Dysregulation of MYC, such as amplification of MYCN, is associated with tumorigenesis, especially for neuroblastoma. Although the general survival rate of neuroblastoma patients has significantly improved over the past few decades, high-risk neuroblastoma still presents a …

Fluorescence Lifetime Imaging Ophthalmoscopy (Flio): A Novel Retinal Metabolic Biomarker For Multiple Sclerosis, Daniel Markowitz, Kylee Shivok, Elizabeth Affel, Ms, Jose S. Pulido, Md, Ms, Mba, Mph, Thomas P. Leist, Md, Phd, Gyorgy Hajnoczky, Md, Phd, Mahdi Alizadeh, Phd, Robert Sergott, Md

Farber Institute for Neuroscience Staff Papers and Presentations

Introduction

- Fluorescence lifetime imaging ophthalmoscopy (FLIO, Heidelberg Engineering, Figures 1 and 2), a novel in vivo retinal imaging biomarker, generates fluorescence decay lifetimes in 2 spectral channels corresponding to the following metabolic processes:

- Short Spectral Channel (SSC): 498 – 560 nm

• Corresponds to macular pigment, flavin adenine dinucleotide (FAD) and oxidative phosphorylation.

- Long Spectral Channel (LSC): 560 – 720nm

• Corresponds to predominantly lipofuscin and lysosomal function

- Based upon animal experimental models and clinical data, mitochondrial dysfunction has a role in the pathophysiology of both inflammatory and degenerative components of Multiple Sclerosis

Associations Of Long-Term Exposure To Temperature With Coronary Artery Calcification Risk Among Middle-Aged Adults: The Coronary Artery Risk Development In Young Adults (Cardia) Study, Dandan Zhao, Jie Yao, Yuanfei Li, David R Jacobs, Yinan Zheng, Chunyu Liu, Yingbin Fu, Margaret M Deangelis, Donald Lloyd-Jones, Lifang Hou, Kai Zhang

Faculty, Staff and Students Publications

BACKGROUND: The impact of ambient temperature on population health has drawn increasing attention as climate change drives more extreme temperatures globally. However, little research has investigated its connection to subclinical cardiovascular diseases. This study aims to examine the impact of long-term exposure to temperature on coronary artery calcification (CAC) among middle-aged Black and White adults in four U.S. areas with varying climate and weather conditions.

METHODS: This study compiled long-term environmental temperature data and individual coronary artery Agatston score (0 vs. >0) from the Coronary Artery Risk Development in Young Adults study. It employed logistic regression and examined the influences …

Semaglutide And Nonarteritic Anterior Ischemic Optic Neuropathy, Cindy X Cai, Michelle Hribar, Sally Baxter, Kerry Goetz, Swarup S Swaminathan, Alexis Flowers, Eric N Brown, Brian Toy, Benjamin Xu, John Chen, Aiyin Chen, Sophia Wang, Cecilia Lee, Theodore Leng, Joshua R Ehrlich, Andrew Barkmeier, Karen R Armbrust, Michael V Boland, David Dorr, Danielle Boyce, Thamir Alshammari, Joel Swerdel, Marc A Suchard, Martijn Schuemie, Fan Bu, Anthony G Sena, George Hripcsak, Akihiko Nishimura, Paul Nagy, Thomas Falconer, Scott L Duvall, Michael Matheny, Benjamin Viernes, William O'Brien, Linying Zhang, Benjamin Martin, Erik Westlund, Nestoras Mathioudakis, Ruochong Fan, Adam Wilcox, Albert Lai, Jacqueline C Stocking, Sahar Takkouche, Lok Hin Lee, Yangyiran Xie, Izabelle Humes, David B Mccoy, Mohammad Adibuzzaman, Raymond G Areaux, William Rojas-Carabali, James Brash, David A Lee, Nicole G Weiskopf, Louise Mawn, Rupesh Agrawal, Hannah Morgan-Cooper, Priya Desai, Patrick B Ryan

Faculty, Staff and Student Publications

Importance

Semaglutide, a glucagonlike peptide-1 receptor agonist (GLP-1RA), has recently been implicated in cases of nonarteritic anterior ischemic optic neuropathy (NAION), raising safety concerns in the treatment of type 2 diabetes (T2D).

Objective

To investigate the potential association between semaglutide and NAION in the Observational Health Data Sciences and Informatics (OHDSI) network.

Design, Setting, and Participants

This was a retrospective study across 14 databases (6 administrative claims and 8 electronic health records). Included were adults with T2D taking semaglutide, other GLP-1RA (dulaglutide, exenatide), or non–GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from December 1, 2017, to December 31, 2023. The incidence proportion …

Intraocular Pressure Changes Associated With Psychological Stress Or Anxiety In Both Healthy And Glaucoma-Diagnosed Patients, Triston Crook, Porter Biggs, James Fini, Zane Kingsbury

Annual Research Symposium

No abstract provided.