Ophthalmology Commons^™

Real-World Assessment (Rwa): Validity Evidence For Cataract Surgery With A Tool Your Faculty Will Actually Use, Grace L. Paley, Hui Zhao, Victoria M. Addis, Casey J. Beal, Geetha K. Davis, Gabriela M. Espinoza, Michael S. Lee, Stacy L. Pineles, Jamie B. Rosenberg, Robert T. Swan, Misha F. Syed, Evan L. Waxman, Susan M. Culican

Journal of Academic Ophthalmology

Background: We developed and implemented a real-world assessment tool (RWA) for resident surgery. It was designed to improve utility by reducing faculty and trainee cost (completion and training time, cognitive burden). RWA uses an entrustability scale where higher scores indicate a resident’s readiness for independent surgical practice. We describe a two-phase implementation of RWA and report validity evidence for cataract surgery assessment.

Methods: RWA was developed iteratively with resident and faculty input and piloted at a single residency program in phase 1. Phase 2 implemented RWA at 11 ophthalmology residency programs. The main outcome measures were 1) number …

Student Perceptions Of A Novel No-Cost Mobile Application For Ophthalmic History And Physical Examination, Soryan Kumar, Anagha Lokhande, Spandana Jarmale, Arnav Kumar, Samantha Rosenthal, Grayson W. Armstrong, Michael Migliori, Jamie Schaefer

Journal of Academic Ophthalmology

Background: Mobile applications have shown promise in enhancing medical trainee performance. In ophthalmology, a comprehensive mobile app can streamline the trainee education process by providing guidance for patient intake. Language barriers pose additional challenges impacting the quality of care for Spanish-speaking patients; literature has documented the adverse impacts of inadequate translation on quality of medical care for both trainees and patients. We aim to develop a free mobile application to guide medical trainees through the ophthalmic patient intake process and assist with Spanish-language translation.

Methods: We developed EyeCheck as a free mobile application for ophthalmology trainee education with …

Community Outreach Vision Screenings With Student-Led Eye Health Education Improves Student Eye Health Knowledge And Ophthalmic Health Disparities Awareness, Tannia M. Rodriguez, Karim Dirani, Samantha M. Arsenault, Ryan Lee Freedman, John-Michael Guest, Kathleen George, Collin Richards, Leo Hall, Mark S. Juzych, Anju Goyal

Journal of Academic Ophthalmology

BACKGROUND: The high prevalence of vision impairment and discordant lack of eye care utilization makes it essential to develop effective avenues to educate the future physician work force regarding basic eye health knowledge and ophthalmic health disparities. The public is often not aware that blinding eye diseases can begin asymptomatically. It is important for medical students to understand basic eye health knowledge, such as blinding eye diseases can begin asymptomatically. The purpose of this study was to assess the impact of an eye health knowledge 5-Point Teaching Intervention (5PTI) and structured patient intake form on student eye health knowledge and …

A 32-Year-Old Male With Corneal Hydrops, Justin Anderson, Ryan Grinnell, Kristina Domanski, Jamie Baydoun

School of Medicine Faculty Research

A 32-year-old male with a history of left eye keratoconus presented to the emergency department with left eye pain and blurry vision for two days. Out of concern for corneal hydrops, ophthalmology was consulted, and the diagnosis was confirmed. Per ophthalmology recommendations, the patient was started on hypertonic saline and prednisolone eye drops and referred to a corneal specialist.

Systemic Effects Of Anti-Vegf Intravitreal Injection In Patients With Age-Related Macular Degeneration: A Multi-Institutional Real-World Study, Tzu-Yi Lin, Yi-Ting Hsieh, Sunir J. Garg, Lee-Jen Chen, Kuan-Jen Chen, Wei-Chi Wu, Chi-Chun Lai, Yih-Shiou Hwang, Eugene Yu-Chuan Kang

Wills Eye Hospital Papers

PURPOSE: In individuals aged >50 years, age-related macular degeneration (AMD) is the leading cause of irreversible blindness. Intravitreal injections of antivascular endothelial growth factor (VEGF) agents (bevacizumab, ranibizumab, and aflibercept) show good efficacy and similar incidences of systemic adverse events (SAEs). However, comparative studies between agents are limited. Our study aimed to compare the real-world SAE risks of bevacizumab, ranibizumab, and aflibercept users.

METHODS: This retrospective cohort study identified new bevacizumab, ranibizumab, and aflibercept users in a multi-institutional database in Taiwan between 2014 and 2019. Inverse probability of treatment weights (IPTW) with propensity scores was conducted to achieve homogeneity among …

A Unilateral Myopic Shift Secondary To Sturge-Weber Syndrome Results In Refractive Amblyopia Of The Fellow Eye In A Pediatric Patient, Mckenzie Stewart, Christina Twardowski

Posters

A 4-year-old patient with unilateral glaucoma secondary to Sturge-Weber Syndrome causes a myopic shift. The fellow healthy eye maintains high hyperopia resulting in anisometropic refractive amblyopia, requiring occlusion therapy. It is well documented that a glaucomatous high IOP causes an expansion of the globe due to excessive plasticity of collagen fibers in pediatric eyes. The elongated axial length induces myopic shifts. In this patient, the myopic shift in her glaucomatous eye resulted in a unilateral high hyperopic refractive error in the fellow eye with normal ocular health. This anisometropia is enough to cause amblyopia in the hyperopic eye. In past …

Effects Of The Covid-19 Pandemic On Clinical Manifestations And Therapeutic Outcomes In Acute Endophthalmitis, Ana Maria Dascalu, Sanda Jurja, Carmen Luminita Mocanu, Cristina Alexandrescu, Daniela Stana, Madalina Totir, Ece Ergin, Corneliu Tudor, Catalin Cicerone Grigorescu, Dragos Serban, Laurentiu Simion, Dan Dumitrescu, Andrei Marin, Catalin Teodor Constantinescu, Bogdan Mihai Cristea

Journal of Mind and Medical Sciences

Endophthalmitis incidence and clinical characteristics was reported to change during Covid-19 pandemic, due to multiple influencing factors, such as prolonged lockdown periods, persistent immune suppression following Sars-Cov-2 infection, and mask wearing. We conducted a retrospective eight-year study, during January 2016 and December 2023, that aims to investigates the differences in terms of etiology, clinical characteristics and outcomes in cases with acute endophthalmitis, admitted before (2016-2019) and during Covid-19 pandemic (2020-2023). The two study subgroups were homogenous in term of age, gender distribution, associated comorbidities, and addressability. During Covid-19 pandemic there were significant delays in presentation (p=0.02), more cases of endogenous …

Ocular Myasthenia Gravis; A Case Report, Amy Garbo Maxey Od, Kristin Wilson Od

Optometric Clinical Practice

Abstract

Background: Myasthenia gravis (MG) is an autoimmune disease disorder that affects the skeletal muscles causing increased fatigability and weakness. When it affects the ocular muscles only, it is known as ocular myasthenia gravis (OMG). Patients with OMG will often have symptoms of diplopia and ptosis, which will be worse towards the end of the day. This case report will discuss the common symptoms of OMG as well as the appropriate treatment and management. It will also review the diagnostic tests used to aid in the diagnosis of OMG and discuss the prognosis of OMG. Case Report: A 67-year-old male …

Longitudinal Assessment Of Retinopathy Of Prematurity (Longrop) Study: Impacts Of Viewing Time And Ability To Compare On Detection Of Change, Tatiana R. Rosenblatt, Hashem H. Ghoraba, Marco H. Ji, Caroline R. Baumal, Audina M. Berrocal, Cagri G. Besirli, Kimberly A. Drenser, Anna L. Ells, C. Armitage Harper, G. Baker Hubbard, Eric D. Nudleman, Polly A. Quiram, Irena Tsui, Yoshihiro Yonekawa, Edward H. Wood, Jochen Kumm, Darius M. Moshfeghi

Wills Eye Hospital Papers

PURPOSE: This study compared two imaging grading techniques to assess the utility of longitudinal image-based analysis in retinopathy of prematurity (ROP) screening: (1) time-limited without image comparison (a proxy for bedside indirect ophthalmoscopy, termed sBIO) and time-unlimited with image comparison (for telemedicine grading, termed TELE) screening. We tested two hypotheses: (1) H1: TELE was superior to sBIO for the detection of change (Tempo)-same, better, or worse and (2) H2: granular data of change (e.g., at the image and feature level) is integrated by graders to achieve the Tempo assessment.

DESIGN: Prospective reliability analysis.

METHODS: Gold standard reference (GS) was a …

Umbilical Amniotic Membrane (Am-Uc) As A Skin Substitute In Periocular Reconstruction: A Case Series, Jane Spadaro, Komalpreet Tur, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Iodine Contrast Should Be Avoided In Patients With Or At Risk For Thyroid Eye Disease, Jane Spadaro, Brittany Simmons, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Anatomy Of Lower Eyelid Fat Pad Vasculature As Found In Lower Eyelid Blepharoplasties, Irene Lee, Nishita Sheth, Evan Black, Christopher Delmarkarian, Julie Woodward

Conference Presentation Abstracts

No abstract provided.

Orbital Perivascular Epithelioid Cell Neoplasm (Pecoma): A Case Report And Systematic Review, Jane Spadaro, Christopher Hysell, Robert Folberg, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Artificial Intelligence And Machine Learning In Ocular Oncology, Retinoblastoma (Armor): Experience With A Multiracial Cohort, Vijitha S. Vempuluru, Rajiv Viriyala, Virinchi Ayyagari, Komal Bakal, Patanjali Bhamidipati, Krishna Krishore Dhara, Sandor R. Ferenczy, Carol L. Shields, Swathi Kaliki

Wills Eye Hospital Papers

Background: The color variation in fundus images from differences in melanin concentrations across races can affect the accuracy of artificial intelligence and machine learning (AI/ML) models. Hence, we studied the performance of our AI model (with proven efficacy in an Asian-Indian cohort) in a multiracial cohort for detecting and classifying intraocular RB (iRB). Methods: Retrospective observational study. Results: Of 210 eyes, 153 (73%) belonged to White, 37 (18%) to African American, 9 (4%) to Asian, 6 (3%) to Hispanic races, based on the U.S. Office of Management and Budget's Statistical Policy Directive No.15 and 5 (2%) had no reported race. …

Corneal Neurotization For Neurotrophic Keratitis In Congenital Trigeminal Aplasia: A Case Series, Jane Spadaro, Nahrain Schumaier, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Nmosd Mitochondrial Fluorescence Correlates With Ganglion Cell Layer Loss Consistent With Retinal Vasculitis, Francesco Cappellani, Md, Daniel M. Markowitz, Bs, Elizabeth Affel, Ms, Jose S. Pulido, Md, Brian Fernandez, Md, Robert C. 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 mitochondrial metabolic processes
• Short Spectral Channel (SSC): 498 – 560 nm Ø Corresponds to flavin adenine dinucleotide (FAD) and oxidative phosphorylation.
• Long Spectral Channel (LSC): 560 – 720nm Ø Corresponds to predominantly lipofuscin and lysosomal function
• Based upon animal experimental models and clinical data, mitochondrial dysfunction has a role in the pathophysiology of NMOSD

Lamina Cribrosa Microstructure In Nonhuman Primates With Naturally Occurring Peripapillary Retinal Nerve Fiber Layer Thinning, Palaiologos Alexopoulos, Arthur G Fernandes, Zeinab Ghassabi, Ronald Zambrano, Anse Vellappally, Eitan Shemuelian, Tingfang Lee, Jiyuan Hu, Armando Burgos-Rodriguez, Melween I Martinez, Joel S. Schuman, Amanda D Melin, James P Higham, John Danias, Gadi Wollstein

Wills Eye Hospital Papers

PURPOSE: The lamina cribrosa (LC) is hypothesized to be the site of initial axonal damage in glaucoma with the circumpapillary retinal nerve fiber layer thickness (RNFL-T) widely used as a standard metric for quantifying the glaucomatous damage. The purpose of this study was to determine in vivo, 3-dimensional (3D) differences in the microstructure of the LC in eyes of nonhuman primates (NHPs) with naturally occurring glaucoma.

METHODS: Spectral-domain optical coherence tomography (OCT) scans (Leica, Chicago, IL, USA) of the optic nerve head were acquired from a colony of 50 adult rhesus monkeys suspected of having high prevalence of glaucoma. The …

Transorbital Alternating Current Stimulation In A Double-Masked Randomized Clinical Trial: Visual Functional Effect And Quality Of Life, Maria De Los Angeles Ramos Cadena, Ashley Sohn, Heather Livengood, Ting-Fang Lee, Batsheva Rubin, Jiyuan Hu, Bernhard A. Sabel, Rachel Matayev, Joseph Panarelli, Gadi Wollstein, Joel S. Schuman

Wills Eye Hospital Papers

PURPOSE: To determine the efficacy and safety of repetitive transorbital alternating current stimulation (rtACS) treatment by assessing vision-related quality of life and visual function outcome in subjects treated with rtACS versus sham-control.

STUDY DESIGN: Double masked, randomized, sham-controlled clinical trial (NCT03188042).

SUBJECTS: Sixteen subjects with moderate-to-advanced glaucoma (visual field [VF] mean deviation [MD] ≤-6.00 decibels) randomized into sham (9 subjects) or rtACS intervention (7 subjects) groups.

METHODS: Subjects underwent 10 rtACS sessions over 2 weeks. All subjects had comprehensive ocular examination at baseline, 1-week, and 4-weeks posttreatment.

MAIN OUTCOME MEASURES: Visual acuity (VA), contrast sensitivity (CS), VF MD, number of …

Prognostic Impact Of Notch1 Intracellular Domain, P63, And C-Myc In Lacrimal Gland Adenoid Cystic Carcinoma, Jiawei Zhao, Michelle D Williams, Mike Hernandez, Grace Kuang, Hila Goldberg, Janet Fan, Jing Ning, Renata Ferrarotto, Bita Esmaeli

Faculty, Staff and Student Publications

PURPOSE: We assessed whether NICD1 expression, c-MYC expression, and P63 expression by immunohistochemistry (IHC) correlate with prognosis and high-risk clinicopathological features in lacrimal gland adenoid cystic carcinoma (ACC).

METHODS: Records of patients with lacrimal gland ACC who underwent surgery between 1998 to 2018 were reviewed. Clinicopathologic and treatment data were collected. Tumor tissues were subjected to light microscopy and IHC.

RESULTS: Of 43 patients treated during the study period, 21 had archived tumor tissue available and were included. The median age at diagnosis was 47 years, and 13 patients (62%) were male. Thirteen patients (62%) had T2 disease, and none …

Investigation Of Change And Stability In Medical Students’ Ophthalmology Specialty Intention From Matriculation To Graduation: Gender And Racial/Ethnic Differences, Douglas Grbic

Journal of Academic Ophthalmology

Purpose

Using data from a national sample of graduating medical students, this study describes the patterns of change and stability in ophthalmology intentions relative to various other specialties and explains how those patterns vary by the intersection of gender and race/ethnicity.

Method

National survey data from MD-granting medical school graduates who matriculated between 2013-2014 and 2018-2019 and graduated by 2021-2022 were examined. The outcome consisted of four groups based on ophthalmology specialty intention at matriculation and graduation: non-ophthalmology, switched out, switched to, and reaffirmation. Percentages for “reaffirmation” and “switched to” were each compared to the median values for 13 major …