Ultraviolet-A absorbance analysis in thin porcine corneas pre-and post-crosslinking

ABSTRACT Purpose: To determine the absorbance coefficient of the thin porcine cornea to ultraviolet-A radiation (365 nm) submitted for crosslinking. Methods: This in vitro, benchtop experiment using cadaver tissue study analyzed 12 porcine corneal lamellas, which were obtained using a microkeratome after mechanical de-epithelization and separated into three thickness groups: 180, 300, and 360 μm. The corneal thickness values were measured by anterior-segment optical coherence tomography. All lamellas had ultraviolet-A (365 nm) absorbance measured with a 96-well plate spectrophotometer using an ultraviolet transparent microplate before riboflavin instillation and preand post-crosslinking according to the Dresden protocol. Results: The ultraviolet absorbance profiles of the 180, 300, and 360 μm groups were obtained as α-coefficients of 12.85, 76.55, and 120.27, respectively. A theoretical formula was calculated though a statistical analysis that demonstrated the correlation between stromal lamellar thickness and ultraviolet absorbance. Conclusions: Corneal thickness and ultraviolet-A spectral absorbance of corneal lamellas showed linear correlation. These findings can potentially contribute to the optimization of ultraviolet-A application during crosslinking, making the treatment of corneas with thickness <400 μm safe and personalized energy delivery for each corneal thickness.

Use of artificial intelligence in ophthalmology: a narrative review

ABSTRACT BACKGROUND: Artificial intelligence (AI) deals with development of algorithms that seek to perceive one's environment and perform actions that maximize one's chance of successfully reaching one's predetermined goals. OBJECTIVE: To provide an overview of the basic principles of AI and its main studies in the fields of glaucoma, retinopathy of prematurity, age-related macular degeneration and diabetic retinopathy. From this perspective, the limitations and potential challenges that have accompanied the implementation and development of this new technology within ophthalmology are presented. DESIGN AND SETTING: Narrative review developed by a research group at the Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. METHODS: We searched the literature on the main applications of AI within ophthalmology, using the keywords "artificial intelligence", "diabetic retinopathy", "macular degeneration age-related", "glaucoma" and "retinopathy of prematurity," covering the period from January 1, 2007, to May 3, 2021. We used the MEDLINE database (via PubMed) and the LILACS database (via Virtual Health Library) to identify relevant articles. RESULTS: We retrieved 457 references, of which 47 were considered eligible for intensive review and critical analysis. CONCLUSION: Use of technology, as embodied in AI algorithms, is a way of providing an increasingly accurate service and enhancing scientific research. This forms a source of complement and innovation in relation to the daily skills of ophthalmologists. Thus, AI adds technology to human expertise.

In search of disambiguation: development of eye drop bottle sleeves to aid in identification and survey among possible users. A cross-sectional study

BACKGROUND: Considerable numbers of individuals present low vision, blindness, illiteracy and other conditions that could possibly impair their identification of medications, such as eye drops. Through helping these individuals to identify their eye drops, they can achieve greater autonomy. Misidentification can be avoided through use of multisensory sleeves that can be adapted to most eye drop bottles. Correct use of eye drops is important for preventing progression of diseases like glaucoma that could potentially lead to blindness. OBJECTIVE: To develop bottle sleeves to aid in identification of eye drops and then interview a group of possible users to evaluate the acceptance of the solution. DESIGN AND SETTING: Cross-sectional survey performed at an ophthalmological clinic in São Paulo (SP), Brazil. METHODS: We describe the development of multisensory sleeves to assist in identification of eye drops. To assess the acceptance of this solution, we interviewed 18 patients who were currently using three or more types of eye drops. RESULTS: We developed four prototypes for eye drop bottle sleeves and conducted an acceptance test on them. Most of the patients who answered the survey about the sleeves were elderly. Most (95%) reported believing that the sleeves would help reduce the risk of mixing up eye drops with other medications that also dispense drops. They also believed that these would increase their autonomy in using eye drops. CONCLUSION: The solution presented was well accepted and may help increase safety in using eye drops through preventing misidentification.

Do automotive window films affect drivers' safety by decreasing vision sensitivity? A Cross-sectional study / Películas automotivas e perda de acuidade visual? Estudo transversal

ABSTRACT Objective: To measure visual acuity in high contrast and low contrast sensitivities in different grades of visible light transmission films in three different positions (front, lateral and rear windows). Methods: Forty-four healthy volunteers between 30-75 y-o, with BCVA better than 0,5, were tested in the 5 following vehicles with different grades of visible light transmission films. Vehicle 1: 75% in the front and 70% in the lateral and rear windows; Vehicle 2: 70% in the front and lateral windows and 28% in the rear; Vehicle 3: 70% in the front, 28% in the lateral and 15% rear; Vehicle 4: 35% in all 3 windows; Vehicle 5: 50% in the front, 20% in the lateral and 15% in the rear. Descriptive statistics were used and the average of the 3 measurements of VA was considered. Wilcoxon Test was applied to compare the average visual acuity in each vehicle and position. P value<0.05 was considered statistically significant. Results: According to the Brazilian Traffic Regulations for driving in categories C/D/E, when low contrast was tested in the front window, all visible light transmissions were borderline, in the lateral window they were all outside the limit, while in the rear window for both low and high contrast, all visible light transmissions tested were outside the limit and also borderline for driving in categories A/B, with the exception of the vehicle with visible light transmission of 35%. Conclusion: Visual acuity is affected, especially in the rear window, by the use of automotive films. The study is an alert that window films is a possible cause of accidents and may contribute to the revision of traffic regulations worldwide.

RESUMO Objetivo: Medir a acuidade visual em alto e baixo contraste nas diversas graduações de transparência de filmes em três janelas de veículos: frontal, lateral e traseira. Métodos: Foram avaliados 44 voluntários saudáveis entre 30 e 75 anos, com acuidade visual melhor corrigida acima de 0,5, em cinco veículos, sendo: veículo 1, com 75% de transparência frontal e 70% na lateral e traseira; veículo 2, com 70% na frontal e na lateral e 28% na traseira; veículo 3, com 70% na frontal, 28% na lateral e 15% na traseira; veículo 4, com 35% nas três janelas; e veículo 5, com 50% na frontal, 20% na lateral e 15% na traseira. Foi realizada estatística descritiva utilizando a média de três medidas consecutivas, com teste de Wilcoxon para comparar a média de acuidade visual em cada janela, e foi considerado estatisticamente significativo quando valor de p<0,05. Resultados: Todas as transparências testadas nos vidros reduziram a acuidade visual em situação de baixo contraste para níveis limítrofes na janela frontal e níveis ilegais na lateral para conduzir veículos nas categorias C/D/E. Na janela traseira, tanto em alto quanto em baixo contraste, todas as transparências mostraram redução da acuidade visual para níveis ilegais para categorias C/D/E e limítrofes para as categorias A/B, exceto na transparência de 35%. Conclusão: A acuidade visual é reduzida pelo uso dos filmes automotivos, especialmente na janela traseira. Condutores de veículos com filmes devem ser alertados pelo risco aumentado de acidentes. Esse dado científico propõe revisões nas regulações de tráfego mundiais.

Metaboloma use in ophthalmology / Uso de metaboloma em oftalmologia: uma revisão narrativa

ABSTRACT It is part of the omic sciences to search for an understanding of how the cellular system of organisms works as well as studying their biological changes. As part of the omic sciences, we can highlight the genomics whose function is the study of genes, the transcriptomics that studies the changes in the transcripts, the proteomics responsible for understanding the changes that occur in proteins, and the metabolomics that studies all the metabolic changes that occur in a certain system when it is submitted to different types of stimuli. Metabolomics is the science that studies the endogenous and exogenous metabolites in biological systems, which aims to provide comparative quantitative or semi-quantitative information about all metabolites in the system. This review aims to describe the main applications of metabolomics science in ophthalmolog. We searched the literature on main applications of metabolomics science in ophthalmology, using the MEDLINE and LILACS databases, with the keywords "metabolomics" and "ophthalmology", from January 1, 2009, to April 5, 2021. We retrieved 216 references, of which 58 were considered eligible for intensive review and critical analysis. The study of the metabolome allows a better understanding of the metabolism of ocular tissues. The results are important to aid diagnosis and as predictors of the progression of many eye and systemic diseases.

RESUMO Faz parte das ciências ômicas buscar entender como funciona o sistema celular dos organismos e estudar suas alterações biológicas. Como parte das ciências ômicas, destacam-se a genômica, cuja função é o estudo dos genes; a transcriptômica, que estuda as mudanças nos transcritos; a proteômica, responsável por entender as mudanças que ocorrem nas proteínas, e a metabolômica, que estuda todo o metabolismo das alterações que ocorrem em um determinado sistema quando ele é submetido a diferentes tipos de estímulos. A metabolômica é a ciência que estuda os metabólitos endógenos e exógenos em sistemas biológicos, visando fornecer informações comparativas quantitativas ou semiquantitativas sobre todos os metabólitos do sistema. Esta revisão teve como objetivo descrever as principais aplicações da ciência metabolômica na oftalmologia. Trata-se de revisão narrativa desenvolvida por um grupo de pesquisa da Universidade Federal de São Paulo, em São Paulo (SP). Buscaram-se, na literatura, as principais aplicações da ciência metabolômica em oftalmologia, utilizando as bases de dados Medline® e Lilacs, com as palavras-chave "metabolomics" e "oftalmologia", de 1º de janeiro de 2009 a 5 de abril de 2021. Foram recuperadas 216 referências, das quais 58 foram consideradas elegíveis para revisão intensiva e análise crítica. O estudo do metaboloma permite um melhor entendimento do metabolismo dos tecidos oculares. Os resultados são importantes para auxiliar no diagnóstico e como preditores da progressão de muitas doenças oculares e sistêmicas.

Eye diseases during pregnancy: a study with the medical data warehouse in the eye clinic of the Ludwig-Maximilians-Universität München in Munich in Germany

ABSTRACT Objective To analyze the most common ophthalmologic disorders in pregnant women seen in a hospital in Munich in Germany using a big data analysis system, as well as to compare the results obtained with those from other epidemiological studies that used different data acquisition methods. Methods We retrospectively analyzed electronic health records of pregnant women who were seen at the ophthalmology department from 2003 to 2019 at the Ludwig-Maximilians-Universität München hospital. The main complaints that led to ophthalmic consultations during this period were evaluated, and also the variation in intraocular pressure of patients throughout gestational trimesters by analyzing data from the data warehouse system. Results A total of 27,326 electronic health records were analyzed. Of participants, 149 (0.54%) required eye care during pregnancy. Their mean intraocular pressure was 17mmHg in the first trimester, 12mmHg in the second trimester, and 14mmHg in the third trimester. The most prevalent findings were dry eye (29.3%) and conjunctivitis (16%), and ametropia (16%). The most common posterior segment problem was diabetic retinopathy (4.6%). The lower mean intraocular pressure in the second and third trimester found in our study is in accordance with other studies that used other method for data acquisition. Conclusion The most common ophthalmic conditions found in this study population were dry eye, conjunctivitis, and ametropia. The use of data warehouse proved to be useful for acquiring and analyzing data from many patients. This study results are comparable with other studies in published literature that adopted different methodology.

COVID 19 repercussions in ophthalmology: a narrative review

BACKGROUND: The new coronavirus of 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally and has repercussions within ophthalmological care. It has caused ocular manifestations in some patients, which can spread through eye secretions. OBJECTIVES: The purpose of this review was to summarize the currently available evidence on COVID-19 with regard to its implications for ophthalmology. DESIGN AND SETTING: Narrative review developed by a research group at Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil, and at Ludwig-Maximilians-Universität, Munich, Germany. METHODS: We searched the literature on the repercussions of COVID-19 within ophthalmological care, using the MEDLINE and LILACS databases, with the keywords "COVID-19", "ophthalmology" and "coronavirus", from January 1, 2020, to March 27, 2021. Clinical trials, meta-analysis, randomized controlled trials, reviews and systematic reviews were identified. RESULTS: We retrieved 884 references, of which 42 were considered eligible for intensive review and critical analysis. Most of the studies selected reported the evidence regarding COVID-19 and its implications for ophthalmology. CONCLUSIONS: Knowledge of eye symptoms and ocular transmission of the virus remains incomplete. New clinical trials with larger numbers of patients may answer these questions in the future. Moreover, positively, implementation of innovative changes in medicine such as telemedicine and artificial intelligence may assist in diagnosing eye diseases and in training and education for students.

Geração de dados sintéticos para classificação de disléxicos por meio de aprendizado de máquina / Synthetic data generation for classification of dyslexics by machine learning / Generación de datos sintéticos para clasificación de disléxicos mediante aprendizaje automático

Objetivo: Este estudo pretende aplicar a técnica de geração de dados sintéticos com auxílio de técnicas de limpeza de dados para a classificação de disléxicos e não - disléxicos. Método: Os outliers foram selecionados por especialista. Foi feito uma geração sintética de dados. para cada um de cinco algoritmos foram selecionados características com busca exaustiva. Cada algoritmo foi executado com as características selecionadas e então suas curvas de calibração foram comparadas. Resultados: A regressão logística se destacou como o melhor algoritmo, apresentando o resultado de 99% de acurácia e área sob a curva ROC de 0,999, além de ter obtido a melhor curva de calibração Conclusão: O uso da geração sintética de dados e seleção de características foram capazes de fazer todos os algoritmos avaliados obterem ótimos resultados na classificação de disléxicos e não disléxicos. A regressão logística foi selecionado como melhor algoritmo para classificação de disléxicos.

Objective: This study aims to apply the synthetic data generation technique with the aid of data cleaning techniques for the classification of dyslexics and non - dyslexics. Method: Outliers were selected by specialist. Synthetic of data Generated. For each of five algorithms, characteristics were selected with exhaustive search. Each algorithm was executed with the selected characteristics and then their calibration curves were compared. Results: Logistic regression presented the best results with 99% accuracy and area under the ROC curve of 0.999, besides obtaining the best calibration curve. Conclusion: The use of synthetic data generation and feature selection were able to make all algorithms achieve excellent results in the classification of dyslexic and non - dyslexic. Logistic regression was selected as the best algorithm for dyslexic classification.

Objetivo: Este estudio tiene como objetivo aplicar la técnica de generación de datos sintéticos con la ayuda de técnicas de limpieza de datos para la clasificación de disléxicos y no disléxicos. Método: los valores atípicos fueron seleccionados por especialistas. Se realizó una generación sintética de datos. Para cada uno de los cinco algoritmos, se seleccionaron características con búsqueda exhaustiva. Cada algoritmo se ejecutó con las características seleccionadas y luego se compararon sus curvas de calibración. Resultados: La regresión logística se destacó como el mejor algoritmo, presentando el resultado del 99% de precisión y área bajo la curva ROC de 0.999, además de obtener la mejor curva de calibración. Conclusión: El uso de la generación de datos sintéticos y la selección de Estas características lograron que todos los algoritmos evaluados obtuvieron excelentes resultados en la clasificación de disléxicos y no disléxicos. Se seleccionó la regresión logística como el mejor algoritmo para la clasificación disléxica.

Uma Experiência Estética e didática sobre ciência e tecnologia por meio da literatura / An Aesthetic and Didactic Experience on Science and Technology based on Literature

Resumo Introdução: Discutimos o Potencial Estético-Formativo da Literatura para uma Crítica Estética da tecnologia em seus diversos âmbitos entre estudante dos cursos superiores em Tecnologia em Saúde da UNIFESP. Objetivos: Verificar o potencial estético da literatura para pensar a tecnologia. Metodologia: Leitura de clássicos da literatura universal por meio da Metodologia do Laboratório de Humanidades e Tecnologia, atividade complementar oferecida aos estudantes dos cursos de tecnologia em saúde da UNIFESP. Para coleta dos dados usamos da Observação Participante e História Oral de Vida. Análise fundamentada na Fenomenologia Hermenêutica. Resultados: Com base em uma compreensão Estética da formação da Racionalidade humana, nossa atividade parece ser capaz de promover a análise crítica da tecnologia sob diversos âmbitos, tanto conceituais quanto para uma prática social e produtiva. Conclusão: Sugerimos a metodologia do LabHumTec como meio de possibilitar uma formação estética e humanística para produção e inovação tecnológica.

Abstract Introduction: This paper reflects the Aesthetic-Formative Potential of Literature, considering the various aspects of Aesthetic Criticism of technology, which were discussed among undergraduate students of Health Technology at UNIFESP. Objectives: Our aim is to analyze the aesthetic potential of literature to think about technology. Methodology: Reading and discussions based on classics from universal literature during the meetings of the Complementary Activity, named Methodology of the Humanities and Technology Laboratory, which was offered to students of Health Technology courses at UNIFESP. For data collection, we used Participant Observation and Oral History of Life methods. The analysis was based on Hermeneutic Phenomenology. Results: Based on an Aesthetic understanding of the formation of Human Rationality, our activity seems capable of promoting the critical analysis of science and technology in various areas, both conceptual and social and productive practice. Conclusion: This research suggests the LabHumTec methodology as a way to enable an aesthetic and humanistic formation for production and technological innovation.

Quando a cor ajuda / When color helps

RESUMO Objetivo: Reduzir a identificação errônea de colírios, por meio do uso de substâncias com cores diferentes. Métodos: Um grupo de 34 voluntários saudáveis foi apresentado a dois grupos de quatro colírios cada. Todos os colírios foram colocados em frascos idênticos sem rótulo. Em um grupo de quatro colírios, todos tinham conteúdos transparentes. No outro grupo, cada um dos quatro possuía uma substância de cor diferente. A cada um foi atribuído um número, e o voluntário foi solicitado a identificá-lo por meio da cor. Medimos o índice de acerto na identificação dos colírios dos dois grupos. Resultados: Os voluntários possuíam nível de formação desde Fundamental incompleto até Pós-Graduação completa, sendo 16 do sexo masculino (48%) e 18 do sexo feminino (52%), com idades variando de 21 até 87 anos. O índice de acerto no grupo de colírios coloridos foi de 88% e, no grupo de colírios transparentes, de 24%. Conclusão: O uso de colorações em colírios pode auxiliar na diferenciação entre os frascos e prevenir a identificação errônea.

ABSTRACT Objective: To reduce the inappropriate identification of eye drops, through the use of different colors. Methods: A group of 34 healthy volunteers was presented to two groups of four eye drops each. All eye drops were placed in identical, unlabelled vials. In one group, all four eye drops were transparent. In the other group, each had a different color. A number was assigned to each eye drop, and the volunteer was asked to identify it by color. We measured the correct index in the identification of the eye drops of the two groups. Results: The volunteers had a level of education from incomplete junior school to complete graduate course, with 16 males (48%) and 18 females (52%), age range of 21 to 87 years. The success rate in the group of colored eye drops was 88% and, in the group of transparent, 24%. Conclusion: The use of colorings in eye drops can help distinguishing the vials and preventing misidentification.