Optometry Commons^™

Editor's Note: Debbie Hettler, Od, Mph, Paul B. Freeman Od

Optometric Clinical Practice

Editor's note

Where Have All The Doctors Gone?, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

R Exams And Continuous Assessment, Eugene Hickey

Case studies: Digital Education

The traditional format of CA, the midterm test, was proving inadequate for our final year students. Waiting several weeks into semester before getting detailed feedback on their performance and the congestion of several midterm tests from different modules were having a negative impact on the learning experience. To that end a regular series of CA work was deemed preferential. It would be unfeasible to do this during class, and it is more student-friendly to let them do these in their own time. Therefore, online tests hosted on a VLE were seen as the solution. To ensure that students were working …

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 …

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 …

Characterizing The Genetic Basis For Inherited Retinal Disease: Lessons Learned From The Foundation Fighting Blindness Clinical Consortium's Gene Poll, Kari Branham, Lassana Samarakoon, Isabelle Audo, Allison R Ayala, Janet K Cheetham, Stephen P Daiger, Patty Dhooge, Jacque L Duncan, Todd A Durham, Abigail T Fahim, Rachel M Huckfeldt, Robert B Hufnagel, Susanne Kohl, Ramiro S Maldonado, Michele Melia, Michel Michaelides, Mark E Pennesi, José-Alain Sahel, Juliana M Ferraz Sallum, Mandeep S Singh, Dror Sharon, Kimberly Stepien, Kaylie Jones, Christina Y Weng

Faculty, Staff and Students Publications

PURPOSE: The Foundation Fighting Blindness (FFB) Consortium is a collaboration of 41 international clinical centers that manage patients affected with inherited retinal diseases (IRDs). The annual Consortium gene poll was initiated in 2020 to capture the genetic cause of disease in patients with IRD and associated clinical practices of Consortium sites. Data from the 2022 gene poll are reported here.

METHODS: In 2022, academic, private practice, and government ophthalmology clinics that are members of the Consortium centers were polled to identify per-case IRD genetic causality from a list of 387 syndromic and nonsyndromic IRD genes. The survey also assessed how …

Pfkfb3 Connects Glycolytic Metabolism With Endothelial Dysfunction In Human And Rodent Obesity, Robert K Batori, Zsuzsanna Bordan, Caleb A Padgett, Yuqing Huo, Feng Chen, Reem T Atawia, Rudolf Lucas, Masuko Ushio-Fukai, Tohru Fukai, Eric J Belin De Chantemele, David W Stepp, David J R Fulton

Faculty, Staff and Students Publications

Obesity and type 2 diabetes (T2D) increase cardiovascular risk, largely due to altered metabolic state. An early consequence of T2D/obesity is the loss of endothelial function and impaired nitric oxide (NO) signaling. In blood vessels, endothelial nitric oxide synthase (eNOS) synthesizes NO to maintain vessel homeostasis. The biological actions of NO are compromised by superoxide that is generated by NADPH oxidases (NOXs). Herein we investigated how altered metabolism affects superoxide/NO balance in obesity. We found that eNOS expression and NO bioavailability are significantly decreased in endothelial cells (ECs) from T2D patients and animal models of obesity. In parallel, PFKFB3, a …

Dna Methylation Profiling At Base-Pair Resolution Reveals Unique Epigenetic Features Of Early-Onset Colorectal Cancer In Underrepresented Populations, Jason Sheng Li, Karen Riggins, Li Yang, Chaorong Chen, Patricia Castro, Wedad Alfarkh, Neda Zarrin-Khameh, Michael E Scheurer, Chad J Creighton, Benjamin Musher, Wei Li, Lanlan Shen

Faculty, Staff and Students Publications

BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC) has been rising at an alarming rate in the USA, and EOCRC disproportionately affects racial/ethnic minorities. Here, we construct comprehensive profiles of EOCRC DNA methylomes at base-pair resolution for a cohort of Hispanic and African American patients.

RESULTS: We show the epigenetic landscape of these EOCRC patients differs from that of late-onset colorectal cancer patients, and methylation canyons in EOCRC tumor tissue preferentially overlapped genes in cancer-related pathways. Furthermore, we identify epigenetic alterations in metabolic genes that are specific to our racial/ethnic minority EOCRC cohort but not Caucasian patients from TCGA. Top …

Feasibility Of Ex Vivo Ligandomics, Prabuddha Waduge, Remya Ammassam Veettil, Bojun Zhang, Chengchi Huang, Hong Tian, Wei Li

Faculty, Staff and Students Publications

We developed ligandomics for the in vivo profiling of vascular ligands in mice, discovering secretogranin III (Scg3) as a novel angiogenic factor that selectively binds to retinal vessels of diabetic but not healthy mice. This discovery led to the development of anti-Scg3 therapy for ocular vasculopathies. However, in vivo ligandomics requires intracardial perfusion to remove unbound phage clones, limiting its use to vascular endothelial cells (ECs). To extend ligandomics to non-vascular cells, we investigated ex vivo ligandomics. We isolated ECs and retinal ganglion cells (RGCs) from diabetic and healthy mouse retinas by immunopanning. We quantified the binding of clonal phages …

Molecular Mechanism Of Congenital Cataract Caused By G91 Deletion In Cryβa1, Akosua Konadu Boateng

All ETDs from UAB

The Deletion of Glycine 91 is a mutational hotspot in the CRYβA1 gene (mutant named βA3ΔG91), which causes autosomal dominant congenital nuclear cataracts in several ethnically diverse populations worldwide. Previous in-vitro studies of recombinant βA3ΔG91 protein revealed that this mutation results in defective protein folding, reduced solubility, and oligomerization with other crystallins. While βA3/A1-crystallin is primarily known as a structural protein in the lens, it also plays a role in autophagy regulation in the retinal pigment epithelium (RPE) by controlling endolysosomal acidification through the V-ATPase proton pump. This study employs a novel βA3ΔG91 knock-in mouse model to investigate the pathogenic …

Prevalence Of Meibomian Gland Dysfunction In A Young Adult Population, Tyler Thomas

All ETDs from UAB

Background Meibomian gland dysfunction (MGD) varies in prevalence depending on the demographic and can significantly impact quality of life. There is a lack of research on MGD in young adult, professional student populations. Professional students often experience high levels of stress, reduced sleep, and increased electronic device use, which may elevate their risk for developing MGD. Specific Aims This cross-sectional clinical analysis has two specific aims: (1) to determine the prevalence of MGD in a young adult, professional student population, and (2) to identify potential risk factors and clinical assessments correlated with MGD. Methods A total of 147 professional students …

Accuracy And Repeatability Of Autorefraction In Young Adults: A Comparison Of Cycloplegic And Non-Cycloplegic Methods, Megan Doyle, Veronica O'Dwyer O'Dwyer, Michael Moore, Síofra Harrington

Articles

Clinical Relevance: Cycloplegic refraction remains crucial in young adults, where accommodative activity can obscure accurate refractive status. Autorefractor repeatabil­ity is essential for precise optical correction and refractive error categorisation in clinical and research settings.

Background: Cycloplegic autorefraction is recommended for individuals up to 20 years to prevent hyperopia underestimation and myopia overestimation. This study evaluated differences between non-cycloplegic and cycloplegic spherical equivalent refraction following cyclopentolate hydrochloride (cycloplegic agent) administration in young adults. This study also explored whether this difference varied by refractive status (hyperopia (≥1.00D), emmetropia ( >−0.50, < 1.00D), myopia (≤-0.50D)) or pre- instillation of proxymetacaine hydrochloride and whether cycloplegia improved autorefractor repeatability.

Methods: Participants were 182 young adults (17–30 years) (mean (standard deviation): 21.66 …

More Than Meets The Eye: A Phenomenological Study Of Self-Concept, Identity, And Meaning-Making In Adults With Acquired Vision Loss, Melinda M. Szilva

Theses and Dissertations (Comprehensive)

The qualitative research project examines the lived experience of acquired vision loss in adulthood and its impact on the way participants see themselves and the world around them, both sensorially and metaphorically. The research question, “What are the lived experiences of adults with acquired vision loss as they relate to identity and conceptions of self?” is informed by the researcher’s clinical practice as a psychotherapist in a low vision clinic. The dissertation includes a literature review focussed on the psychosocial aspects of vision loss to provide insight into the intended population and context for the study. Data for the phenomenological …

Visual Acuity, Full-Field Stimulus Thresholds, And Electroretinography For 4 Years In The Rate Of Progression Of Ush2a-Related Retinal Degeneration (Rush2a) Study, David G Birch, Peiyao Cheng, Maureen G Maguire, Jacque L Duncan, Allison R Ayala, Janet K Cheetham, Nicole R Doucet, Todd A Durham, Abigail T Fahim, Frederick L Ferris, Rachel M Huckfeldt, Michele Melia, Michel Michaelides, Mark E Pennesi, José-Alain Sahel, Katarina Stingl, Ajoy Vincent, Christina Y Weng

Faculty, Staff and Students Publications

PURPOSE: To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the

DESIGN: Prospective natural history study.

PARTICIPANTS: Participants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.

METHODS: BCVA, FST, fundus-guided microperimetry, static perimetry, and spectral domain OCT were performed annually and ERG at baseline and 4 years only. Mixed effects models were used to estimate annual rates of change with 95% confidence intervals. Associations of change from baseline to 4 years between BCVA, FST, ERG, and other metrics were assessed …

Dlk-Dependent Axonal Mitochondrial Fission Drives Degeneration After Axotomy, Jorge Gómez-Deza, Matthew Nebiyou, Mor R Alkaslasi, Francisco M Nadal-Nicolás, Preethi Somasundaram, Anastasia L Slavutsky, Wei Li, Michael E Ward, Trent A Watkins, Claire E Le Pichon

Faculty, Staff and Students Publications

Currently there are no effective treatments for an array of neurodegenerative disorders to a large part because cell-based models fail to recapitulate disease. Here we develop a reproducible human iPSC-based model where laser axotomy causes retrograde axon degeneration leading to neuronal cell death. Time-lapse confocal imaging revealed that damage triggers an apoptotic wave of mitochondrial fission proceeding from the site of injury to the soma. We demonstrate that this apoptotic wave is locally initiated in the axon by dual leucine zipper kinase (DLK). We find that mitochondrial fission and resultant cell death are entirely dependent on phosphorylation of dynamin related …

How Scientists Can Investigate Perception: Phenomenological Foundations For Qualitative Research, Kimberly Tucker

Electronic Theses and Dissertations

While medicine makes visible symptoms of disease, phenomenology provides a different tool for making illness experience visible. Phenomenology offers a tool for a new kind of description and a different kind of knowledge of disease. It holds a unique epistemic power through the descriptions it generates through the application of the transcendental phenomenological method. Husserl’s method, outlined in Ideas I, provides the steps for its implementation in clinical research. This dissertation explores the application of the transcendental phenomenological method as a foundation for research on perception, with the goal of characterizing phenomenological validity as a proper goal of medical epistemology. …

Clinical Applications Of Phenomenology: Analysis Of Lived Experience Of Eye Disease, Kimberly Tucker

Graduate Student Research Symposium

This paper presents a phenomenological study that explores the embodied experience of vision loss within the context of eye disease, while also providing a detailed discussion of the methodological approaches utilized in the research. Phenomenology is integrated to address clinical epistemic concerns, particularly the limitations of conventional vision tests in fully capturing perception and the lived experiences of vision loss. This interdisciplinary approach builds on the clinical understanding of eye disease by incorporating the broader dimensions of the lifeworld that intersect with visual impairment in degenerative eye diseases. While standard clinical approaches focus primarily on measurable aspects of visual function, …

Corneal Transplants And Their Impact, Bianca Estrada

Honors Capstones

A corneal transplant, also called keratoplasty or corneal grafting, is a type of surgery where damaged or diseased corneal tissue is replaced by a healthy donor cornea. The first successful corneal transplant was performed in 1905 by Dr. Eduard Zirm, but since then, surgical advancements have developed greatly, leading to more beneficial outcomes. Corneal blindness is a major form of reversible blindness that is manageable with healthy donor cornea transplantation. Other recipients or possible candidates for corneal transplantation include those with keratoconus, Fuchs’ dystrophy, eye infections, or eye injuries. This remarkable surgery is now one of the most common transplant …

Impact Of Proxymetacaine On The Dynamics Of Cyclopentolate In White 6- To 7-Year-Olds, Megan Doyle, Veronica O'Dwyer, Siofra Harrington

Articles

Purpose

This study compared the efficacy of cyclopentolate hydrochloride at 10-, 20- and 30-min post-instillation in White 6- to 7-year-olds, with and without prior instillation of proxymetacaine hydrochloride. The primary aim was to determine if accurate autorefraction values can be obtained sooner than the current standard of 30-min post-cycloplegia. The secondary aim was to investigate whether proxymetacaine hydrochloride enhances the efficiency of cyclopentolate.

Methods

Participants were 112 White 6- to 7-year-olds from the Child Eye Health Study. The right eye received 0.5% proxymetacaine hydrochloride and 1.0% cyclopentolate hydrochloride, and the left eye received only 1.0% cyclopentolate hydrochloride. Non-cycloplegic and cycloplegic …

Total Retinal Thickness Is An Important Factor In Evaluating Diabetic Retinal Neurodegeneration, Noor-Us-Sabah Ahmad, Kristen Staggers, Kyungmoo Lee, Nitish Mehta, Amitha Domalpally, Benjamin J Frankfort, Yao Liu, Roomasa Channa

Faculty, Staff and Students Publications

OBJECTIVE: Macular retinal nerve fibre layer (mRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) measurements are important markers of diabetic retinal neurodegeneration (DRN). In this cross-sectional study, we aimed to quantify the contribution of total retinal thickness (TRT) and other factors in the variation of mRNFL and GC-IPL thickness among participants with diabetes.

METHODS AND ANALYSIS: We used macular-centred spectral domain-optical coherence tomography scans from participants with diabetes in the UK Biobank. Two multiple linear regression models (prior to and after adjusting for TRT) were used to determine factors associated with mRNFL and GC-IPL thicknesses. A p value of less …