Visual fields in glaucoma: Where are we now?

Visual fields are an integral part of glaucoma diagnosis and management. COVID has heightened the awareness of the potential for viral spread with the practice of visual fields modified. Mask artefacts can occur due to fogging of the inferior rim of the trail lens. Fortunately, the risk of airborne transmission when field testing is low. The 24-2c may be useful to detect early disease and the 10-2 more sensitive to detect advanced loss. The SITA faster test algorithm is able to reduce testing time thereby improving clinic efficiency, however, may show milder results for moderate or severe glaucoma. The technician has an important role of supervising the visual field performance to achieve reliable output. Home monitoring can provide earlier detection of progression and thus improve monitoring of glaucoma as well as reduce the burden of in-clinic assessments. Artificial Intelligence has been found to have high sensitivity and specificity compared to expert observers in detecting field abnormalities and progression as well as integrating structure with function. Although these advances will improve efficiency and guide accuracy, there will remain a need for clinicians to interpret the results and instigate management.

Applicability of a colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for SARS-CoV-2 detection in high exposure risk setting.

OBJECTIVES: During the third wave, the growing number of COVID-19 case clusters reported countrywide in Thailand demonstrated the rapidly evolving characteristics of SARS-CoV-2, the causative agent of the COVID-19 pandemic. The rapid spread of COVID-19 infections had been extensively reported in public areas and construction camps, as well as in congested communities with poor sanitation. High demand for SARS-CoV-2 genome testing and quick reporting by an hour for case identification and isolation characterizes the COVID-19 crisis in Thailand. This situation leads to an urgent need for alternative molecular tests which are reliable, rapid, and cost-effective. METHODS: In this study, we assessed colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP), using real-time reverse transcription-polymerase chain reaction (RT-PCR) as a reference standard, for active case finding in suspected (mostly asymptomatic) cases living in high-risk areas of Bangkok. RESULTS: The diagnostic performance of the RT-LAMP compared with real-time RT-PCR in specimens from 549 Thais were computed in a real-world field study setting. Our study demonstrated that RT-LAMP achieved robust identification of SARS-CoV-2 infection, with a diagnostic sensitivity and specificity of 91.67% and 100%, respectively. CONCLUSION: RT-LAMP is a reliable assay for SARS-CoV-2 detection and is scalable for use in the emergency response to a nationwide pandemic, despite resource limitations. The RT-LAMP real-world data derived from this field study validate its potential use in laboratory practice. RT-LAMP is a good choice as a laboratory-based SARS-CoV-2 molecular test when real-time RT-PCR is not available.

Field Evaluation of a Duplex RT-RAA Assay for Rapid Detection of SARS-CoV-2 - Hebei Province, China, January 2021.

Introduction: Recently, a local cluster epidemic has occurred in Shijiazhuang City, Hebei Province. Failure to promptly identify patients with fever in rural areas was the major reason for this epidemic. Methods: We presented the field evaluation of a new real-time reverse transcription recombinase-aided amplification (RT-RAA) kit incorporating an endogenous internal control in a single-tube format, completed at the Hebei CDC from January 17, 2021 to January 27, 2021. Results: We evaluated the diagnostic performance of RT-RAA assay using automatic extracted RNA of 808 clinical samples. Compared with reverse transcriptase real-time quantitative PCR (qRT-PCR), RT-RAA kit achieved 92.41% sensitivity, 98.78% specificity and a 96.29% coincidence rate, demonstrating an excellent agreement between the RT-RAA assay and qRT-PCR assay. Furthermore, 58 samples were extracted using a manual extraction method within 5 minutes, but only samples with high nucleic acid concentration (cycle threshold value not higher than 32) could be stably detected. Discussion: The RT-RAA is more suitable to meet the needs of rapid, sensitive, and accurate detection in community-level medical institutions.

Evaluation of a rapid antigen detection test (Panbio™ COVID-19 Ag Rapid Test Device) as a point-of-care diagnostic tool for COVID-19 in a pediatric emergency department.

We evaluated the Panbio™ COVID-19 Ag Rapid Test Device as a point-of-care diagnostic tool for COVID-19 in 357 patients at a pediatric emergency department. Thirty-four patients tested positive by reverse transcription polymerase chain reaction, of which 24 were positive by the antigen assay. The sensitivity and specificity of the assay were 70.5% and 100%, respectively.