Clinical correlation between automated vision screening under cycloplegia and retinoscopy in young children / Correlação clínica entre triagem visual automatizada sob cicloplegia e retinoscopia em crianças pequenas

ABSTRACT Purpose: To evaluate the clinical performance of the Spot Vision Screener and establish clinical correlations between automated screening and retinoscopy following induction of cycloplegia in preverbal children. Methods: In this prospective, cross-sectional study, children aged 6-36 months were evaluated using the Spot Vision Screener. A complete ophthalmologic examination, including cycloplegic refraction assessment, was performed, followed by repeat spot vision screening and retinoscopy in all cases to establish correlations regarding hypermetropia, myopia, and astigmatism following induction of induction cycloplegia. Results: The study included 185 children. The sensitivity of the automated screener after cycloplegia was 100% (95%CI: 85.18-100%), and specificity was 87.04% (95%CI: 80.87-91.79%). Positive and negative predictive values were 52.27% (42.36-62.01%) and 100%, respectively. Compared to retinoscopy, the Spot Vision Screener overestimated spherical values by 0.62 D (95%CI: 0.56-0.69) in the right eye and by 0.60 (95%CI: 0.54-0.66) in the left eye and cylindrical values by -0.38 D in the right eye (95%CI: -0.42--0.33) and by -0.39 D in the left eye (95%CI: -0.43--0.34). For overall spherical and cylindrical values, the difference was 0.61 D (95%CI: 0.57-0.65) and -0.38 D (95%CI: -0.41--0.35) in the left and right eyes, respectively. Conclusion: A substantial correlation was found between retinoscopy and objective data captured by the device. This shows that technology can be used in conjunction, reaching a more accurate diagnosis and identifying amblyopia risk factors as early as possible. Photoscreening may make a difference at the population level for early screening and intervention.

RESUMO Objetivo: Avaliar o desempenho clínico do Spot Vision Screener e estabelecer correlações clínicas entre a triagem automatizada e a retinoscopia após indução de cicloplegia em crianças pré-verbais. Métodos: Neste estudo transversal prospectivo, crianças de 6 a 36 meses foram avaliadas usando o Spot Vision Screener. O exame oftalmológico completo, incluindo refração cicloplégica, foi então realizado, seguido de repetição da triagem automatizada e retinoscopia em todos os casos, a fim de estabelecer correlações quanto à hipermetropia, miopia e astigmatismo após a indução de cicloplegia. Resultados: O estudo incluiu 185 crianças. A sensibilidade do dispositivo de triagem automática após cicloplegia foi de 100% (IC 95%: 85,18-100%) e a especificidade foi de 87,04% (IC 95%: 80,87-91,79%). Os valores preditivos positivos e negativos foram de 52,27% (42,36 - 62,01%) e 100%, respectivamente. Em comparação com a retinoscopia, o Spot Vision Screener superestimou os valores esféricos em 0,62 D (IC 95%: 0,56 - 0,69) no olho direito e em 0,60 (IC 95%: 0,54 - 0,66) no olho esquerdo e os valores cilíndricos em -0,38 D (IC 95%: -0,42 a -0,33) no olho direito e por -0,39 D (IC 95%: -0,43 a -0,34) no olho esquerdo. A diferença para os valores esféricos e cilíndricos de forma geral foi de 0,61 D (IC 95%: 0,57 - 0,65) e -0,38 D (IC 95%: -0,41 a -0,35), respectivamente. Conclusão: Foi encontrada correlação substancial entre a retinoscopia e os dados objetivos captados pelo dispositivo. Isso mostra que a tecnologia pode ser usada em conjunto, contribuindo para um diagnóstico mais preciso e identificando os fatores de risco de ambliopia o mais precocemente possível. A técnica automatizada pode fazer a diferença em nível populacional para triagem e intervenção precoce.

Urine Specific Gravity Measurement for Fluid Balance in Neonates on Intravenous Fluids in a Neonatal Intensive Care Unit: An Open Label Randomized Controlled Trial

Background: Urine specific gravity reflects hydration status and correlates well with urine osmolality. Objective: To compare intravenous fluid therapy guided with and without inclusion of urine specific gravity to the standard parameters for maintaining postnatal weight loss within permissible limits in neonates admitted to the intensive care unit. Methods: An open-label randomized controlled trial was conducted, including neonates requiring intravenous fluids for ?72 hours, randomized into the study (urine specific gravity guided fluids) and control arms. The outcomes of the study were to determine proportion of neonates with weight loss within permissible limits, mean percentage weight loss and number of days to reach maximum weight loss. Results: 80 preterm and term neonates (40 in each arm) were enrolled. A comparable proportion of neonates had weight loss within permissible limits in study arm and in control arms [39 (97.5%) vs 36 (90%); P=0.165]. The (mean (SD) percentage weight loss was significantly less in the study arm compared to control arm [All neonates: 7.2(2.6) vs 9.3(3.5); P=0.004); preterm neonates: 7.7 (2.8) vs 11 (3.9); P=0.008)]. Preterm neonates in the study arm attained nadir weight significantly earlier than in the controls (P=0.03) and attained complete enteral feeding earlier. Urine specific gravity showed a moderate negative correlation with the percentage weight loss. Conclusion: Using urine specific gravity to regulate intravenous fluids in neonates resulted in a significant reduction in postnatal weight loss, especially in preterm neonates

Refractometry as an alternative to the biuret method for measuring total serum proteins in Podocnemis expansa (Podocnemididae) and Phrynops geoffroanus (Chelidae) / Refratometria como alternativa ao método do biureto para mensuração de proteínas séricas totais em Podocnemis expansa e Phrynops geoffroanus (Podocnemididae, Chelidae)

Total serum protein is a significant indicator of health condition in animals. The aim of this study was to analyze the precision of the portable refractometer in determining the concentration of total serum proteins in Podocnemis expansa and Phrynops geoffroanus. A total of 26 animals were used. The blood samples were collected from the supraoccipital sinus and stored in tubes without anticoagulant. Total serum protein was determined using both the biuret reaction and refractometry. The total serum protein mean concentration (g dL-1) with biuret method and refractometry for P. expansa were 3.16 and 3.2; and for P. geoffroanus were 3.56 and 2.72, respectively. These results indicate that total serum protein values can be determined with precision in P. expansa and P. geoffroanus using a portable refractometer.

A proteína sérica total é um indicador significativo do estado de saúde em animais. O objetivo desse estudo foi analisar a precisão do refratômetro portátil para determinar a concentração de proteínas séricas totais em Podocnemis expansa e Phrynops geoffroanus. Foram utilizados um total de 26 animais. As amostras de sangue foram coletadas por punção do seio supraoccipital e armazenadas em tubos sem anticoagulante. A concentração de proteína sérica total foi determinada utilizando tanto a reação de biureto como um refratômetro portátil. A média da proteína sérica total (g dL-1) pela reação de biureto e pela refratometria para P. expansa foram de 3,16 e 3,2; e para P. geoffroanus foram de 3,56 e 2,72, respectivamente. Estes resultados indicam que os valores de proteínas séricas totais podem ser determinados com precisão em P. expansa e P. geoffroanus usando o refratômetro portátil.

Investigations on the effects of mouthrinses on the colour stability and surface roughness of different dental bioceramics

PURPOSE: In this study, three bioceramic materials, [IPS Empress CAD (Ivoclar), IPS e.max CAD (Ivoclar), and Lava Ultimate CAD (3M ESPE)] were treated with three commercial mouthrinses [Listerine, Tantum Verde, and Klorhex]; and changes in colour reflectance and surface roughness values were then quantitatively assessed. MATERIALS AND METHODS: One hundred and twenty ceramic samples, with dimensions of 2 × 12 × 14 mm, were prepared and divided into nine sample groups, except three control samples. The samples were immersed in the mouthrinse solutions for 120 hrs, and changes in colour reflectance and surface roughness values were measured by UV light spectrophotometry (Vita Easyshade; VITA Zahnfabrik) and by profilometer device (MitutoyoSurftest SJ-301), respectively. The change of surface roughness was inspected by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: There was a positive correlation between the ΔE and increase in the surface roughness. Two of the ceramic materials, IPS Empress and Lava Ultimate, were affected significantly by the treatment of the mouthrinse solutions (P<.05). The most affecting solution was Tantum Verde and the most affected material was Lava Ultimate. As expected, the most resistant material to ΔE and chemical corrosion was IPS e max CAD among the materials used. CONCLUSION: This work implied that mouthrinse with lower alcohol content had less deteriorating effect on colour and on the surface morphology of the bioceramic materials.

Cálculo biométrico en pacientes operados de catarata / Biometrical calculation in patients operated for cataract

Introducción: para obtener resultados satisfactorios en el implante de lentes intraoculares, se requiere de un estudio previo a la operación de catarata y del cálculo correcto del lente. Objetivo: determinar los resultados refractivos de esta cirugía mediante el cálculo biométrico. Métodos: se realizó un estudio descriptivo y prospectivo de 149 ojos de pacientes operados de catarata, en el Centro Oftalmológico del estado venezolano de Apure, desde enero hasta abril del 2014. Resultados: predominaron el sexo femenino (61,7 %) y el grupo etario de 60-69 años (41,6 %). Los valores de la queratometría oscilaron entre las 43-44 dioptrías (67,0 %) y la longitud axial fue de 22-24 mm (70,5 %). El mayor porcentaje de los ojos operados correspondió a los corregidos con el lente intraocular implantado (79,2 %). Conclusiones: los resultados refractivos de los pacientes intervenidos quirúrgicamente demostraron la importancia del cálculo del lente intraocular previo a la extracción de catarata.

Introduction: to obtain satisfactory results in the implant of intraocular lens, a previous study to the cataract surgery and to the correct calculation of the lens is required. Objective: to determine the refractive results of this surgery by means of the biometrical calculation. Methods: a descriptive and prospective study of 149 cataract operated patients was carried out in the Ophthalmology Center in the Venezuelan state of Apure, from January to April, 2014. Results: feminine sex (61.7%) and the age group 60-69 years (41.6%) prevailed. The keratometry values fluctuated between 43-44 diopters (67.0%) and the axial longitude was of 22-24 mm (70.5%). The highest percentage in the operated eyes corresponded to those corrected with the implanted intraocular lens (79.2%). Conclusions: the refractive results of the surgically treated patients demonstrated the importance of the calculation obtained from the intraocular lens previous to the cataract extraction.

Comparison of corneal astigmatisms measured by Lenstar LS900 and auto-refractor / 天津医药

Objective To compare the differences of corneal keratometry and corneal astigmatism measured by Len?star LS900 and KR-1 auto-refractor of age-related cataract. Methods Seventy-six patients with cataract (76 eyes) were in?cluded in this study. Flat keratometry (K1), steep keratometry (K2), mean keratometry (Km) and astigmatism were measured before operation by Lenstar LS900 and KR-1 auto-refractor. The parameters of astigmatism were transformed into J0 and J45 by Fourier vector transform, and which was compared. Results Values of K1, K2, Km, J0 and J45 were (43.960±1.440) D, (44.901±1.319)D, (44.430±1.336)D, 0.043±0.402 and 0.017±0.425 measured by Lenstar LS900, respectively, and which measured by KR-1 auto-refractor were (44.007 ± 1.400)D, (44.859 ± 1.338)D, (44.433 ± 1.330)D,-0.058 ± 0.322 and 0.031 ± 0.419, respectively. There was no statistical difference between these values measured by two instruments ( P>0.05). The Bland-Altman plots showed that two devices had coincident results for corneal parameters. Conclusion Lenstar LS900 and KR-1 auto-refractor can be applied in the measurement of corneal astigmatism of age-related cataract before surgery.

Biometria no crescimento do olho alto míope na infância / Biometry in the growth of the high myopic eye in childhood

OBJETIVO: Determinar se o crescimento do globo ocular mensurado através da biometria óptica e ultrassônica em uma população pediátrica de altos míopes é significante, assim como variação significante da espessura do cristalino, profundidade da câmara anterior, curvatura corneana e achados fundoscópicos durante o acompanhamento. MÉTODOS: Uma população pediátrica (idade média: 8,7anos), 11 olhos de crianças portadoras de alta miopia (refração média inicial: -11,28D) foi submetida a avaliação seriada num período de nove meses incluindo-se biometria óptica (IOLMaster, Zeiss) e ultrassônica (Ultrascan, Alcon; técnica de contato), refratometria estática, oftalmoscopia indireta e retinografia. RESULTADOS: No período de nove meses, o crescimento do olho foi estatisticamente significante em 64% (7 olhos) e não ocorreu em 36% (3 olhos), com modificação do comprimento axial médio (pré=26,76 mm; final=26,98 mm). Neste período, o equivalente esférico refracional aumentou em 45% (5 olhos), não apresentou variação em 27% (3 olhos), com modificação da refração média (pré=-11,28 D; final=-11,69 D). Não houve variação estatisticamente significante da espessura do cristalino, profundidade da câmara anterior, curvatura corneana e do aspecto fundoscópico. CONCLUSÃO: No grupo de crianças com alta miopia acompanhadas num período de nove meses, demonstrou-se o crescimento do globo ocular com variação do comprimento axial tanto pela técnica de biometria óptica quanto ultrassônica, e com aumento da refratometria média. Outros parâmetros estudados como espessura do cristalino, profundidade da câmara anterior e curvatura da córnea não demonstraram variação no período de tempo do estudo.

PURPOSE: To determine if the growth of the axial length measured by optical and ultrasound biometry in a pediatric population of high myopes is significant, as well as significant variation of lens thickness, anterior chamber depth, corneal curvature and ophthalmoscopic findings during follow-up. METHODS: A pediatric population (mean age: 8.7 years old) of 11 high myopic eyes (mean initial refractive error: -11.28 D) was submitted to serial evaluation over a 9-months period including optical (IOLMaster, Zeiss) and ultrasound biometry (Ultrascan, Alcon, contact technique), cycloplegic refraction, indirect ophthalmoscopy and fundus photography. RESULTS: During a 9-months period, eye growth was significant in 64% (7 eyes) and did not occur in 36% (3 eyes), with change in the mean axial length (pre=26.76 mm; final=26.98 mm). During this period, refractive spherical equivalent increased in 45% (5 eyes), did not show variation in 27% (3 eyes), with a change in mean refraction (pre=-11.28 D; final=-11.69 D). There was no statistically significant variation of lens thickness, anterior chamber depth, corneal curvature and ophthalmoscopic findings. CONCLUSION: Ocular globe growth (axial length) measured by optic and ultrasound biometry was significant in the high myopic pediatric population examined. The findings suggest that axial length variation preceded variation of other structures in the sample examined. In a group of children with high myopia followed during a 9-months period, ocular growth was demonstrated with variation of axial length either with optical or ultrasound biometry techniques, and change in mean refraction. Other parameters studied as lens thickness, anterior chamber depth and corneal curvature did not demonstrate variation during the time of the study.

Consumo infantil de bebidas lácteas: sólidos solúveis totais (Brix) e pH / Child's consumption of drinks milk: total soluble solids (Brix) and pH

O objetivo deste estudo foi o de avaliar a quantidade de Sólidos Solúveis Totais (SST) e o valor do pH em bebidas lácteas (iogurtes e achocolatados), comercializadas em Teresina e consumidas por crianças. Foram avaliadas 20 bebidas lácteas por meio do experimento casualizado com 3 repetições para cada amostra. As leituras do grau Brix foram feitas por refratometria, utilizando-se o refratômetro de Abbé, e o pH foi avaliado por potenciometria. O teor médio de SST variou de 11,0 Brix a 22,0 Brix. Com relação ao pH, os valores médios mínimo e máximo para as bebidas lácteas foram 3,79 e 6,71, respectivamente. Por meio dos resultados obtidos, pôde-se concluir que a elevada concentração de SST, verificada nas bebidas lácteas, associada a um baixo pH, pode contribuir para o desenvolvimento de lesões de cárie e erosão dental, caso esses alimentos sejam consumidos, em excesso, pelas crianças.

The main objective of this study is to proceed an evaluation of the amount of total soluble solids (TSS) and the pH value in lactic drinks (yogurt and chocolate milk) commercialized in Teresina and consumed by children. Twenty lactic drinks were evaluated in this experiment with 3 repetitions of study case in each sample. The Brix degrees measurement was made by refractometry using an Abbé refractometer and the pH was evaluated using potentiometry. The medium content of TSS was in a range between 11,0 ºBrix and 22,0 ºBrix. Meanwhile the minimum maximum pH the medium values were 3,79 and 6,71. From this results what can be concluded is that a high concentration of TSS can be verified in lactic drinks, associated with a low pH may contribute to the development of cavity lesions and dental erosion in case of the excess consumption of this products by children.

Density Change of Local Anesthetics and a Mixed Solution Can Be Estimated by Refractometry / 대한마취과학회지

BACKGROUND: Baricity of the local anesthetics is a major determinant of the distribution of local anesthetics in CSF. The purpose of this study was to assess the value of refractometry in measuring the specific gravity of CSF, local anesthetics and adding solutions, and then comparing these to the density of CSF and local anesthetics. METHODS: CSF samples were obtained from 30 patients during spinal anesthesia. 0.5% hyperbaric tetracaines were diluted with CSF to create a 1:1 to 1:10 density and specific gravity measurements were made at room temperature, using a refractometer. 2% lidocaine was diluted with distilled water, normal saline, 5% and 10% dextrose water to create 2%, 1%, 0.67%, 0.5% and 0% mixtures measured respectively. RESULTS: Specific gravity of CSF was 1.0066 +/- 0.0006 and SG of 0.5% tetracaine was 1.0285 +/- 0.0028. The effect of specific gravity on the concentrations of tetracaine was determined by linear regression with r = 0.9803, y = 1.0060 + 0.0440 X x. Dilutions of 2% lidocaine with adding solutions were distilled water, y = 1.0008 + 0.0078 X x ; normal saline, y = 1.0056 + 0.0053 X x ; 5% dextrose, y = 1.0208 - 0.0022 X x ; and 10% dextrose, y = 1.0436 - 0.0135 X x. CONCLUSIONS: The relationship between concentration and specific gravity of local anesthetics is linear. We conclude that refractometry is a reliable method to predict density of local anesthetics.

Study on the refractive state of silicone oil tamponade eyes / 中华眼底病杂志

Purpose To study the refractive state of silicone oil tamponade eyes. Methods To calculate the theoretical refractive state of eyes with silicone oil based on clinical visual optics and to perform retinoscopy on 48 silicone oil filled eyes with pars plana vitrectomy (PPV) and 45 ones with PPV plus lensectomy with retinal reposition, and then study theoretical and experimental differences of diopter in silicone oil filled eyes. Results Postoperative diopter of the former increases (+6.26?1.20) D than preoperative diopter, while that of the latter is (+11.40?2.22) D. Conclusion Hyperopic changes are found in silicone oil tamponade eyes, and the experimental values are lower than the theoretical ones. This may be helpful in predicting the change of diopter of silicone oil tamponade eyes.