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Image Modeling of the Human Eye
Written by pioneers in the field, this groundbreaking resource gives you full details on state-of-the-art 2D and 3D eye imaging and modeling techniques that are paving the way to breakthrough clinical applications in eye health. It's the first book to explore in depth a new generation of computational methods that combine image processing, simulation, and statistical discrimination tools in efforts to improve early detection of cataracts, diabetic retinopathy, glaucoma, iridocyclitis, corneal haze, maculopathy, and other visual impairments and conditions. Supported by 250 illustrations, this comprehensive volume presents the essentials of the human eye, eye imaging systems, and imaging optics. You discover latest advances in computer-based detection and identification of various eye conditions, including issues involving automatic retinal image registration, computer-based optic disc localization, and contour detection using ellipse fitting and wavelet transform. The book explains various infra-red and bio-heat analysis methods, including 2D and 3D ocular surface temperature profiles produced by FEM simulation of the eye structure. This unique volume examines corneal surface temperature with contact lens wear, boundary element modeling of heat transfer in the eye, and the role of aqueous humor hydrodynamics in human eye heat transfer. Moreover, you find chapters that explore age factors, temperature measurement during silicone hydrogel lens wear, and IR imaging.
eBook
Human Eye Imaging and Modeling
Advanced image processing and mathematical modeling techniques are increasingly being used for the early diagnosis of eye diseases. This comprehensive reference details the latest advances and computer-based techniques in imaging and modeling of the human eye. Featuring contributions by well-known experts in the field, it covers imaging of fundus and infrared images, diagnosis of diabetes retinopathy and glaucoma, estimation of tear evaporation of dry eye, computer simulation of the human eye based on principles of heat transfer, various bioheat equations to predict interior temperatures based on the surface temperatures, and more.
eBook
Teaming-up nurses with ophthalmologists to expand the reach of eye care in a middle-income country: Validation of health data acquisition by nursing staff in a telemedicine strategy
Telemedicine can be used to conduct ophthalmological assessment of patients, facilitating patient access to specialist care. Since the teleophthalmology models require data collection support from other health professionals, the purpose of our study was to assess agreement between the nursing technician and the ophthalmologist in acquisition of health parameters that can be used for remote analysis as part of a telemedicine strategy. A cross-sectional study was conducted with 140 patients referred to an ophthalmological telediagnosis center by primary healthcare doctors. The health parameters evaluated were visual acuity (VA), objective ophthalmic measures acquired by autorefraction, keratometry, and intraocular pressure (IOP). Bland-Altman plots were used to analyze agreement between the nursing technician and the ophthalmologist. The Bland-Altman analysis showed a mean bias equal to zero for the VA measurements [95%-LoA: -0.25–0.25], 0.01 [95%-LoA: -0.86–0.88] for spherical equivalent (M), -0.08 [95%-LoA: -1.1–0.95] for keratometry (K) and -0.23 [95%-LoA: -4.4–4.00] for IOP. The measures had a high linear correlation (R [95%CI]: 0.87 [0.82–0.91]; 0.97 [0.96–0.98]; 0.96 [0.95–0.97] and 0.88 [0.84–0.91] respectively). The results observed demonstrate that remote ophthalmological data collection by adequately trained health professionals is viable. This confirms the utility and safety of these solutions for scenarios in which access to ophthalmologists is limited.
Journal Article
Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services in Trans Nzoia County, Kenya: study protocol for a cluster randomised controlled trial
Background
Globally, eye care provision is currently insufficient to meet the requirement for eye care services. Lack of access and awareness are key barriers to specialist services; in addition, specialist services are over-utilised by people with conditions that could be managed in the community or primary care. In combination, these lead to a large unmet need for eye health provision.
We have developed a validated smartphone-based screening algorithm (Peek Community Screening App). The application (App) is part of the Peek Community Eye Health system (Peek CEH) that enables Community Volunteers (CV) to make referral decisions about patients with eye problems. It generates referrals, automated short messages service (SMS) notifications to patients or guardians and has a program dashboard for visualising service delivery.
We hypothesise that a greater proportion of people with eye problems will be identified using the Peek CEH system and that there will be increased uptake of referrals, compared to those identified and referred using the current community screening approaches.
Study design
A single masked, cluster randomised controlled trial design will be used. The unit of randomisation will be the ‘community unit’, defined as a dispensary or health centre with its catchment population. The community units will be allocated to receive either the intervention (Peek CEH system) or the current care (periodic health centre-based outreach clinics with onward referral for further treatment). In both arms, a triage clinic will be held at the link health facility four weeks from sensitisation, where attendance will be ascertained. During triage, participants will be assessed and treated and, if necessary, referred onwards to Kitale Eye Unit.
Discussion
We aim to evaluate a M-health system (Peek CEH) geared towards reducing avoidable blindness through early identification and improved adherence to referral for those with eye problems and reducing demand at secondary care for conditions that can be managed effectively at primary care level.
Trial registration
The Pan African Clinical Trials Registry (PACTR),
201807329096632
. Registered on 8 June 2018.
Journal Article
Clinical history and management recommendations of the smooth muscle dysfunction syndrome due to ACTA2 arginine 179 alterations
Purpose
Smooth muscle dysfunction syndrome (SMDS) due to heterozygous
ACTA2
arginine 179 alterations is characterized by patent ductus arteriosus, vasculopathy (aneurysm and occlusive lesions), pulmonary arterial hypertension, and other complications in smooth muscle–dependent organs. We sought to define the clinical history of SMDS to develop recommendations for evaluation and management.
Methods
Medical records of 33 patients with SMDS (median age 12 years) were abstracted and analyzed.
Results
All patients had congenital mydriasis and related pupillary abnormalities at birth and presented in infancy with a patent ductus arteriosus or aortopulmonary window. Patients had cerebrovascular disease characterized by small vessel disease (hyperintense periventricular white matter lesions; 95%), intracranial artery stenosis (77%), ischemic strokes (27%), and seizures (18%). Twelve (36%) patients had thoracic aortic aneurysm repair or dissection at median age of 14 years and aortic disease was fully penetrant by the age of 25 years. Three (9%) patients had axillary artery aneurysms complicated by thromboembolic episodes. Nine patients died between the ages of 0.5 and 32 years due to aortic, pulmonary, or stroke complications, or unknown causes.
Conclusion
Based on these data, recommendations are provided for the surveillance and management of SMDS to help prevent early-onset life-threatening complications.
Journal Article
The prevalence of ocular involvement in patients with inflammatory bowel disease
The aim of this prospective randomized clinical study was to evaluate the prevalence of ocular involvement in patients with inflammatory bowel disease (IBD).
We prospectively evaluated 116 patients who went to the gastroenterology clinic with endoscopically proven IBD between December 2001 and February 2005. All patients were examined for evidence of ocular manifestations of IBD. Twenty patients had Crohn's disease and 96 had ulcerative colitis. The examination consisted of slit-lamp examinations, tonometry, visual acuity, and indirect ophthalmoscopy.
The mean age of the 116 patients with IBD who were enrolled was 40.6 +/- 14.4 years (range 16 to 75). Twelve of 20 patients (60%) with Crohn's disease and 22 of 96 patients (22.92%) with ulcerative colitis had ocular involvement. The most common ocular findings were conjunctivitis (8.62%) and blepharitis (6.9%) followed by uveitis (5.17%), cataract (5.17%), and episcleritis (3.45%). Extraintestinal complications were seen in 12 (35.3%) of 34 patients with ocular involvement and in 16 (19.5%) of 82 patients without ocular involvement.
Because the ocular complaints of IBD patients are often nonspecific, it may be helpful to performed eye examinations as a routine component in the follow-up of these patients. It is well-known that early diagnosis and treatment of ocular involvement may prevent serious ocular complications that could be associated with significant visual morbidity. In addition, clinicians should be aware that some ocular diseases, such as uveitis and scleritis, might precede a diagnosis of ulcerative colitis or Crohn's disease.
Journal Article
Fabry disease in children: correlation between ocular manifestations, genotype and systemic clinical severity
Background/aimsFabry disease is an X linked lysosomal disorder associated with severe multiorgan failure and premature death. This study aims to determine the prevalence of ophthalmic manifestations in children with the condition and investigate the correlation with genotype and systemic disease severity.MethodsThe records of 26 children from 18 pedigrees with Fabry disease undergoing regular ophthalmic and systemic examination were reviewed. All pedigrees underwent GLA gene sequencing to determine genotype. Correlations between ocular and systemic phenotype and genotype were investigated.ResultsCorneal verticillata occurred in 50% of the children in this study (95% CI, 29% to 79%). Children with ophthalmic manifestations were more likely to have loss-of-function GLA mutations (p=0.003). Retinal vascular tortuosity was seen in seven children (27%), all of whom had systemic symptoms suggestive of autonomic neuropathy, such as diarrhoea and syncope. These symptoms seemed less prevalent in children without retinal vascular changes, although this did not reach statistical significance (p=0.134).ConclusionOphthalmic manifestations of Fabry disease are common even in young children with loss-of-function GLA gene mutations. Although the limited sample size possibly prevented statistical significance, systemic symptoms of autonomic neuropathy often coexist with retinal vascular changes and may share the same pathogenesis.
Journal Article
Participant referral rate in the National Eye Health Survey (NEHS)
To present the rates of referral of participants in the National Eye Health Survey (NEHS) for further eye care.
A national sample of 3098 non-Indigenous Australians aged 50-98 and 1738 Indigenous Australians aged 40-92 years living in 30 randomly selected sites was recruited using a door-to-door approach. Participants completed a general questionnaire and a series of eye tests, including vision and anterior segment assessment, intra-ocular pressure measurement, visual field testing and fundus photography. A predefined protocol was used to guide the referral of participants for follow up eye care. An ophthalmologist was on-call to assist with the triaging of participants.
Of the total sample, 32.1% (994/3098) of non-Indigenous participants and 43.6% (757/1738) of Indigenous participants were referred for further eye care (p<0.001). A significant difference in referral rates for Indigenous Australians was observed between regions of differing geographic remoteness [range = 32.2% (Inner Regional)-60.4% (Very Remote), p <0.001]. After adjusting for covariates, males (OR = 1.24, 95% CI: 1.06-1.46), older age (OR = 1.02 per year, 95% CI: 1.01, 1.02) and longer time since previous eye examination (OR = 1.15 per year, 95% CI: 1.12, 1.19) were associated with higher rates of eye care referral in the non-Indigenous population. In the Indigenous population, older age (OR = 1.02 per year, 95% CI: 1.01-1.03), self-reported diabetes (OR = 1.70, 95% CI: 1.37-2.12), greater geographical remoteness (OR = 1.19, 95% CI: 1.09-1.29) and longer time since previous eye examination (OR = 1.10 per year, 95% CI: 1.07, 1.13) were associated with a higher rate of referral after multivariate adjustments. A total of 25 participants (1.4%) were referred for urgent follow-up of potentially sight threatening conditions.
Our data has identified several high risk groups that required ophthalmic referral including older Australians, non-Indigenous men, Indigenous Australians with self-reported diabetes and those residing in very remote populations who may benefit from improvements in the provision and/or uptake of eye health services. Future longitudinal research is warranted to evaluate the feasibility and efficacy of implementing a referral protocol within a population-based research setting.
Journal Article