1,720,958 research outputs found
Comparison of smartphone ophthalmoscopy with slit-lamp biomicroscopy for grading diabetic retinopathy
No full textPurpose To assess the accuracy and reliability of smartphone ophthalmoscopy, we compared the ability of a smartphone ophthalmoscope with that of a slit-lamp biomicroscope to grade diabetic retinopathy (DR) in patients with diabetes mellitus (DM). Design Clinical-based, prospective, comparative instrument study. Methods This comparative clinical study was performed in 120 outpatients (240 eyes) with type 1 or type 2 DM. After pupil dilation, the patients underwent smartphone ophthalmoscopy with the D-Eye device, followed by dilated retinal slit-lamp examination, to grade DR according to a 5-step scale. Results Overall exact agreement between the 2 methods was observed in 204 of 240 eyes (85%) (simple κ = 0.78; CI 0.71-0.84) and agreement within 1 step was observed in 232 eyes (96.7%). Compared to biomicroscopy, the sensitivity and specificity of smartphone ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Smartphone ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in 9 eyes (3.75%) and 4 eyes (1.7%), respectively, because of cataract and/or small pupil diameter. Conclusion Smartphone ophthalmoscopy showed considerable agreement with dilated retinal biomicroscopy for the grading of DR. The portability, affordability, and connectivity of a smartphone ophthalmoscope make smartphone ophthalmoscopy a promising technique for community screening programs
Comparison of Smartphone Ophthalmoscopy with Slit-lamp Biomicroscopy for Undilated Glaucoma Screening
No full textA randomised controlled trial of ranibizumab with and without ketorolac eyedrops for exudative age-related macular degeneration
No full textAIMS:
To evaluate whether ketorolac eyedrops and ranibizumab intravitreal injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularisation (CNV).
METHODS:
This was a pilot study of eyes with new-onset CNV. A total of 56 patients were enrolled consecutively and randomised in a 1:1 ratio to receive combination treatment with intravitreal ranibizumab and topical ketorolac (group 1) or ranibizumab alone (group 2). All patients received monthly 0.5-mg ranibizumab intravitreal injections for 3 months, after which monthly injections were administered in accordance with the standard of care. Group 1 patients also self-administered one drop of ketorolac three times a day for 6 months. All patients were followed up for 6 months.
RESULTS:
At 6 months, both groups showed a significant improvement in best-corrected visual acuity (both, p<0.001). The two treatments did not show significant differences in terms of the number of ranibizumab injections required. However, the mean 6-month change in central macular thickness (CMT) in the combination group was -124 μm (-29.7%; p<0.001), while in the ranibizumab-only group, the change was -86.9 μm (-19.5%; p=0.001); thus, the combination treatment resulted in a greater reduction (p=0.003). The combination treatment had no adverse effects.
CONCLUSIONS:
This pilot study is the first to prospectively investigate the efficacy and safety of a combination of 0.45% ketorolac eyedrops three times a day and intravitreal ranibizumab injections in patients with CNV, and suggests that topical ketorolac supplements the activity of intravitreal ranibizumab in reducing CMT in CNV
Twelve-month results of treatment with intravitreal ranibizumab, intravitreal ranibizumab plus ketorolac eye drops, and intravitreal ranibizumab plus low-fluence photodynamic therapy for exudative age-related macular degeneration
No full textPurpose
To compare the effectiveness of treatment with intravitreal ranibizumab (IVR), IVR plus ketorolac eye drops, and IVR plus low-fluence photodynamic therapy (PDT) for choroidal neovascularization (CNV).
Methods
This was a multicenter, prospective, pilot study of eyes with new-onset CNV. Seventy-five eyes were enrolled consecutively and randomized to one of 3 groups at a ratio of 1:1:1. Group 1 (n = 25) received IVR; Group 2 (n = 25) received IVR along with topical ketorolac eye drops 3 times a day; while Group 3 (n = 25) received 1 session of low-fluence PDT followed by IVR. In all groups, ranibizumab 0.5 mg was injected monthly for 3 months, and then as needed in accordance with the standard of care. All patients were followed up for 12 months.
Results
At 12 months, all groups showed significant improvements in best-corrected visual acuity (BCVA; p < 0.001). Group 2 showed a greater mean 12-month BCVA improvement than both groups 1 and 3 (p = 0.049 and p = 0.039, respectively). The mean 12-month change in central macular thickness (CMT) was -131 μm (-29.4%; p < 0.001) in Group 1, -138 μm (-33.4%; p < 0.001) in Group 2, and -129 μm (-29.5%; p < 0.001) in Group 3. Group 2 showed a greater mean CMT reduction than both Groups 1 and 3 (p = 0.002 and p = 0.014, respectively), while anatomical improvements were similar between Groups 1 and 3. None of the 3 groups showed any adverse effects.
Conclusions
This is the first study to report better BCVA outcomes over a 12-month period with a combination of 0.45% ketorolac eye drops 3 times a day and IVR in patients with CNV, further indicating that topical ketorolac supplements the CMT-reducing activity of IVR in CNV. A combination therapy of PDT plus ranibizumab injections did not yield anatomical or functional improvements; however, fewer ranibizumab injections were required. Larger trials are needed to confirm the findings of this pilot study
A Novel Device to Exploit the Smartphone Camera for Fundus Photography
Get PDFPurpose. To construct an inexpensive, convenient, and portable attachment for smartphones for the acquisition of still and live retinal images. Methods. A small optical device based on the principle of direct ophthalmoscopy was designed to be magnetically attached to a smartphone. Representative images of normal and pathological fundi were taken with the device. Results. A field-of-view up to ~20° was captured at a clinical resolution for each fundus image. The cross-polarization technique adopted in the optical design dramatically diminished corneal Purkinje reflections, making it possible to screen patients even through undilated pupils. Light emission proved to be well within safety limits. Conclusions. This optical attachment is a promising, inexpensive, and valuable alternative to the direct ophthalmoscope, potentially eliminating problems of poor exam skills and inexperienced observer bias. Its portability, together with the wireless connectivity of smartphones, presents a promising platform for screening and telemedicine in nonhospital settings. Translational Relevance. Smartphones have the potential to acquire retinal imaging for a portable ophthalmoscopy
Treatment of Exudative Age-Related Macular Degeneration with Ranibizumab Combined with Ketorolac Eyedrops or Photodynamic Therapy
Get PDFPurpose: To evaluate whether ketorolac eyedrops plus intravitreal ranibizumab (IVR) or verteporfin photodynamic therapy plus IVR provides additional benefit over IVR monotherapy for treatment of choroidal neovascularization in age-related macular degeneration. Methods: This was a prospective, randomized, pilot study in 75 patients with naive choroidal neovascularization. Patients were randomized 1:1:1 into 3 groups: ranibizumab monotherapy (RM), ranibizumab plus ketorolac, or ranibizumab plus loading-phase reduced-fluence verteporfin photodynamic therapy (RV) groups. Results: At 12 months, all groups showed significant improvement in both best-corrected visual acuity and central retinal thickness. The mean best-corrected visual acuity change from baseline to 12 months was-0.14 ± 0.52 logMAR (20/73 ± 20/29),-0.25 ± 0.60 logMAR (20/46 ± 20/27), and-0.10 ± 0.30 (20/97 ± 20/40) logMAR in RM, ranibizumab plus ketorolac, and RV groups, respectively. The mean central retinal thickness change from baseline to 12 months was-125 ± 15 m,-141 ± 21 m, and-130 ± 15 m in RM, ranibizumab plus ketorolac, and RV groups, respectively. Both ranibizumab plus ketorolac and RV groups required fewer IVR treatments than RM. Conclusion: Compared with RM and ranibizumab plus verteporfin photodynamic therapy, the combination of 0.45% ketorolac eyedrops 3 times a day and ranibizumab in patients with choroidal neovascularization provided superior best-corrected visual acuity and central retinal thickness outcomes. Both combination regimens required fewer IVR injections than RM during the 12-month follow-up period
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
- …
