Clinical validation of a novel smartphone application for measuring visual acuity

Introduction: The rise of telemedicine in the wake of the COVID-19 pandemic has posed challenges for ophthalmologists and optometrists, as there are hardly any smartphone applications that meet high accuracy requirements for obtaining visual acuity (VA) in clinical use. The application vision.app is a novel smartphone app that adjusts the angular size of the optotype based on the face-device distance in real time. The high spatial resolution of modern smartphone screens facilitates measurements at a handheld distance, which makes it particularly valuable for use in pediatric populations which struggle to focus on distant stimuli. Method(s): As part of a prospective validation study, we obtained the best corrected VA (BCVA) in n = 48 eyes using vision.app. The app displayed a Landolt C optotype and used a 4 force choice procedure loosely based on FrACT (Freiburg Visual Acuity & Contrast Test). Results were compared to BCVA measurements taken using a standard ETDRS chart placed at 10 feet (3 m). To assess the similarity of measurement methods, a statistical analysis was performed based on a two-tailed, paired t test. Result(s): The t-test revealed no significant difference in measured BCVA (P = 0.415), with a mean difference between clinical and app measurements of less than one letter (0.005 logMAR). Conclusion/Relevance: Self-measured visual acuity with vision.app is accurate compared to the gold standard. This has the potential to facilitate home monitoring for adult patients;however, a separate study is warranted to validate the results for children. Copyright © 2022

COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS: We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS: Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS: AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.

Prevalence of allergic diseases among Korean adolescents during the COVID-19 pandemic: comparison with pre-COVID-19 11-year trends.

OBJECTIVE: During the coronavirus disease 2019 (COVID-19) pandemic, emergency department utilization and hospitalization rates for allergic diseases declined and the severity of allergies among admitted patients was low. This study aimed to determine the prevalence of allergic diseases among adolescents and the changes in trend during the COVID-19 pandemic compared with those during the preceding 11 years. SUBJECTS AND METHODS: We analyzed data from the nationwide web-based self-report Korea Youth Risk Behavior Survey. From 2009 to 2020, adolescents aged 13-18 years participated in the survey. The survey period was divided into pre-pandemic Periods I (2009-2011), II (2012-2014), III (2015-2017), and IV (2018-2019) and the pandemic period (Period V, 2020). The current prevalence of asthma, allergic rhinitis, atopic dermatitis, allergic morbidity (having at least one of the three conditions) and changes in the prevalence before and during the COVID-19 pandemic were analyzed. RESULTS: Data of 787,043 participants were analyzed after weighting the study population (mean age, 15.1 years; males, 52.3%). The prevalence of asthma, allergic rhinitis, atopic dermatitis, and allergic morbidity was 2.1%, 18.4%, 6.8%, and 23.6%, respectively. The prevalence of allergic morbidity increased between Periods I and IV but declined significantly from Periods IV to V. From Periods I to IV, the prevalence of asthma decreased, the prevalence of allergic rhinitis increased, and the prevalence of atopic dermatitis remained unchanged. During Period V, the prevalence of all three conditions decreased. CONCLUSIONS: It is necessary to update management measures and develop relevant policies in response to the altered prevalence of allergic diseases since the outbreak of COVID-19.

Real-Time Low-Cost Personal Monitoring for Exposure to PM2.5 among Asthmatic Children: Opportunities and Challenges

This study aims to evaluate the accuracy and effectiveness of real-time personal monitoring of exposure to PM concentrations using low-cost sensors, in comparison to conventional data collection method based on fixed stations. PM2.5 data were measured every 5 min using a low-cost sensor attached to a bag carried by 47 asthmatic children living in the Seoul Metropolitan area between November 2019 and March 2020, along with the real-time GPS location, temperature, and humidity. The mobile sensor data were then matched with station-based hourly PM2.5 data using the time and location. Despite some uncertainty and inaccuracy of the sensor data, similar temporal patterns were found between the two sources of PM2.5 data on an aggregate level. However, average PM2.5 concentrations via personal monitoring tended to be lower than those from the fixed stations, particularly when the subjects were indoors, during nighttime, and located farther from the fixed station. On an individual level, a substantial discrepancy is observed between the two PM2.5 data sources while staying indoors. This study provides guidance to policymakers and researchers on improving the feasibility of personal monitoring via low-cost mobile sensors as an alternative or supplement to the conventional station-based monitoring.

Pediatric eye in the wild blue yonder

Purpose/Relevance: This workshop will discuss the unique challenges of establishing and maintaining a practice in pediatric ophthalmology in a location far from an academic center. Emphasis will be placed on clinical situations encountered in remote locations and on some of the solutions employed by a panel of experienced clinicians. Remote approaches have become especially relevant for pediatric ophthalmologists since the onset of the COVID-19 pandemic. Target Audience: Pediatric ophthalmologists and trainees. Current Practice: Pediatric ophthalmology is a multifaceted subspecialty which frequently interfaces with other pediatric specialists typically located in an academic center. Current standard of care mandates timely and accurate diagnosis and treatment regardless of geographic location. Establishing vision screening protocols, ROP coverage, genetic counseling, and post-operative care are but a few of the challenges in non-academic practice settings. Best Practice: Pediatric ophthalmologists will benefit from discussion of approaches to medical and surgical challenges that present in remote practice locales. Many of these same problems are encountered by practitioners in urban settings, when performing mission eye care, and more recently during COVID. Expected Outcomes: At the conclusion of the workshop members of the audience can be expected to learn from the collective experience of the panelists. Many of these innovative approaches are applicable to the practice of pediatric ophthalmology in any setting, thus improving patient outcomes. Format: Didactic lecture, case presentation, and open question and answer forum. Summary: This workshop will present innovative approaches to common problems encountered by pediatric ophthalmologists. These approaches are applicable to remote locations, many urban settings, mission eye care, and patient care during the current coronavirus pandemic.

Impact of COVID-19 on mental health in eye care professionals, staff and students

Introduction: The aim of this study was to evaluate the impact of COVID-19 pandemic on mental health in eye care professionals, staff, and optometry students. Methods: A 23-question survey was sent through social media and email to ophthalmologists, optometrists, staff, and optometry students. Demographics, stress level before and during COVID-19, positive and negative factors which impact mental health and screening questions for depression and anxiety were collected. Results: A total of 2,134 individuals from 50 USA states and Canada responded to the survey, including 887 optometrists, 252 ophthalmologists, 794 optometry students, and 185 eye care staff (16 had missing job information). There were 1319 participants (61.8%) stated that COVID 19 had a negative impact on their mental health, vs 25.4% stating no impact and 12.6% stating a positive impact. Participants reported significantly higher stress during COVID-19 compared to before, 3.49 ( ± 1.12) vs 2.86 ( ± 1.02) on a scale of 1-5 (P < 0.0001). The top 3 self-reported factors that have negatively impacted mental health were: worries about family /friends being infected with COVID-19, worry about being infected with COVID-19 myself, and social isolation. The top 3 activities that helped maintain mental health were: outdoor activities, family time, and exercise. Conclusion/Relevance: Overall, 38.4% of the respondent reported symptoms of depression, anxiety, or both and 61.8% reported worsening mental health during COVID-19. Female, young people, and minority (Asians) were the risk factors for depression, anxiety, and psychological stress. This study warrants further monitoring and specific interventions for eye care practitioners during the COVID-19 pandemic to prevent mental health disorders.