The Chinese Version of Oxford Depression Questionnaire: A Validation Study in Patients with Mood Disorders.

Background: Emotional blunting is prevalent in patients with mood disorders and adversely affects the overall treatment outcome. The Oxford Depression Questionnaire is a validated psychometric instrument for assessing emotional blunting. We aimed to evaluate the reliability and validity of the Chinese version of the ODQ (ODQ) in Chinese patients with mood disorders. Methods: 136 mood disorders patients and 95 healthy control participants were recruited at the First Affiliated Hospital of Zhejiang University, School of Medicine. Patients were assessed using the ODQ, Beck Depression Inventory-II (BDI-II), and Montgomery-Asberg Depression Rating Scale (MADRS). Internal consistency reliability and test-retest reliability were analyzed. Confirmatory factor analysis and correlation analysis were used to evaluate construct and convergent validity. Results: A total of 136 patients with mood disorders and 95 healthy controls participated in this study. Cronbach α values were 0.928 (ODQ-20) and 0.945 (ODQ-26). Test-retest reliability coefficients were 0.798 (ODQ-20) and 0.836 (ODQ-26) (p<0.05); intraclass correlation coefficient values were 0.777 (ODQ-20) and 0.781 (ODQ-26) (p<0.01). The score of ODQ was positively correlated with BDI-II and MADRS (r=0.326~0.719, 0.235~0.537, p<0.01). The differences in the ODQ scores between the patient and control groups were statistically significant. Conclusion: The reliability, structural validity, and criterion validity of the ODQ applied to patients with mood disorders meet the psychometric requirements, and the scale can be used to assess emotional blunting in Chinese patients with mood disorders.

The Chinese Brief Cognitive Test: Normative Data Stratified by Gender, Age and Education.

The aim of this study was to develop a brief version of cognitive assessment test for evaluating the efficacy of treatments targeting cognitive impairments in Chinese schizophrenia patients, to examine its reliability, and establish normative data. Stratified according to age, gender, and educational level, healthy adult subjects were recruited from fifteen institutions in seven administrative regions of China and 723 valid samples were obtained, of which 50 were retested. Generalized Linear Models were conducted to analyze the effects of age, sex, and education. There was no significant difference between genders, while significant effects were demonstrated respectively among age and education on the normative data of C-BCT. The Cronbach α of C-BCT is 0.75, and the test-retest reliability (ICC) ranged from 0.62 to 0.76. Normative data of C-BCT were generated by gender, age and education, and the effects of these demographic factors were analyzed. It revealed good internal consistency and test-retest reliability of C-BCT.

Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography.

Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affected by subjective judgment of the clinicians. Previous studies had reported to identify the presence of PAS by measuring the changes of morphological parameters of the anterior chamber angle (ACA) under the pupillary light reflex, by anterior segment optical coherence tomography (AS-OCT). However, this method was invalid for some subjects who had low sensitiveness to light. This article describes an air-puff dynamic anterior segment optical coherence tomography (DAS-OCT) system that can evaluate the presence of PAS in a non-contact approach. The peripheral cornea is deformed by an air puff jetted from the DAS-OCT, causing a transfer of force to the ACA, just as how indentation gonioscopy works. The dynamic changes of the ACA before and after the air puff are recorded by OCT. Ten eyes of normal subjects were enrolled in this study to validate the repeatability and availability of the measurements. Then, ten samples of the ACA from five subjects with ACG were recruited and were assigned into two groups, the non PAS group (NPAS) and PAS group, according to the results of gonioscopy. The ACA structural parameters including the angle opening distance at 750 µm to the scleral spur (AOD750) and the trabecular-iris space area at 750 µm anterior to the scleral spur (TISA750) were then calculated automatically by a custom-written algorithm. The intraclass correlation coefficient (ICC) of measured parameters was all above 0.85 for normal subjects, exhibiting good repeatability. For patients, both parameters showed significant differences between the two groups after the air puff, while no differences were observed before the air puff. AOD750dif and TISA750dif between two groups showed more significant differences, indicating that they could be used as indicators to identify the presence of PAS. In conclusion, the DAS-OCT system proposed in this study is demonstrated effective to identify the presence of PAS by measuring the changes of the ACA via a noncontact approach. It shows great potential for applications in guidance for diagnosis of angle closure glaucoma.

In situ assessment of lens elasticity with noncontact optical coherence elastography.

Lens biomechanics has great potential for application in clinical diagnostics and treatment monitoring of presbyopia and cataracts. However, current approaches to lens elastography do not meet the desired safety or sensitivity for clinical application. In this regard, we propose a noncontact optical coherence elastography (OCE) method to facilitate quantitative in situ imaging of lens elasticity. Elastic waves induced by air-pulse stimulation on the limbus propagate to the lens and are then imaged using custom-built swept-source optical coherence tomography to obtain the elastic wave velocity and Young's modulus. The proposed OCE method was first validated by comparing the results of in situ and in vitro measurements of porcine lenses. The results demonstrate that the Young's modulus measured in situ was highly consistent with that measured in vitro and had an intraclass correlation coefficient of 0.988. We further investigated the elastic changes induced by cold storage and microwave heating. During 36-hour cold storage, the mean Young's modulus gradually increased (from 5.62 ± 1.24 kPa to 11.40 ± 2.68 kPa, P < 0.0001, n = 9) along with the formation of nuclear opacities. 15-second microwave heating caused a greater increase in the mean Young's modulus (from 6.86 ± 1.21 kPa to 25.96 ± 8.64 kPa, P < 0.0025, n = 6) without apparent cataract formation. Accordingly, this study reports the first air-pulse OCE measurements of in situ lenses, which quantified the loss of lens elasticity during simulated cataract development with good repeatability and sensitivity, thus enhancing the potential for adoption of lens biomechanics in the clinic.

In vivo non-contact measurement of human iris elasticity by optical coherence elastography.

Quantifying the mechanical properties of the iris can offer valuable insights into the pathophysiology of primary angle closure glaucoma. However, current techniques for iris elastography remain ex vivo with limited clinical applications. This article describes a proposition for a non-contact and non-invasive air-puff optical coherence elastography (OCE) system that can evaluate iris elasticity in vivo. Ten eyes recruited from seven subjects underwent OCE imaging acquisition under three different illumination conditions. The Young's modulus of each eye was detected and shown to be inversely proportional to the iris length, indicating a relationship between mechanical properties and morphology of the iris. With its noninvasive and high-resolution features, this air-puff system shows great potential for applications in clinical ophthalmology.

Identification of peripheral anterior synechia with anterior segment optical coherence tomography.

PURPOSE: To generate a model that evaluates the presence and extent of peripheral anterior synechia (PAS) based on anterior segment optical coherence tomography (AS-OCT). METHODS: The extent of PAS involvement in the eyes of patients with angle closure was assessed by indentation gonioscopy, and the part of non-PAS and PAS were assigned into two groups (NPAS and PAS). Anterior chamber angles were then imaged by AS-OCT with light-emitting diode (LED) irradiation directly into the pupils, leading to pupillary constriction and increasing anterior chamber angle width. Parameters including the angle opening distance at 750 µm anterior to the scleral spur (AOD750) and trabecular-iris space area at 750 µm anterior to the scleral spur (TISA750) were then obtained. The differences before and after LED irradiation of AOD750 and TISA750 were calculated and used to generate a PAS model based on binary logistic regression. Validation data were then tested. RESULTS: A total of 258 AS-OCT images in 14 eyes were assigned to the modeling data, and 120 were assigned to the validation data. There were no differences in AOD750 and TISA750 in the dark between NPAS and PAS (PAOD750 = 0.258, PTISA750 = 0.486), whereas after LED light exposure, TISA750light was larger in NPAS than in PAS (P = 0.047). The light-dark differences of both parameters showed significant differences between the two groups (PAOD750dif = 0.019, PTISA750dif < 0.001). The area under the curve of the model performance was 0.841, and the overall correct rate was 80.8% based on the validation data. CONCLUSIONS: The present study demonstrates that the AS-OCT-based PAS model could be useful in the identifying of the presence of synechial angle closure and evaluating the extent of PAS in a single eye.

Diurnal variation of corneal elasticity in healthy young human using air-puff optical coherence elastography.

Due to the disruption of intraocular pressure (IOP) and central corneal thickness (CCT), diurnal variation in normal young human corneal elasticity is not clear. Using the custom-built air-puff optical coherence elastography, one eye of 21 normal subjects is enrolled randomly to measure the central corneal elasticity, IOP, and CCT in different time points within a day. Based on the multi-level model, the corneal elastic modulus is found to have a linear positive relation with IOP (P < .01) but not CCT (P = .175) and time point (P = .174-.686). A new indicator, corneal elasticity change rate, is proposed to present the magnitude of corneal elasticity change caused by 1 mmHg IOP, which can correct the interference effect of IOP. The results show that the corneal elasticity in the normal young human does not have the characteristics of diurnal variation under IOP control. Furthermore, IOP plays an important role in the corneal elasticity, and corneal elasticity change rate can increase the comparability of results between individuals.

In vivo noninvasive measurement of spatially resolved corneal elasticity in human eyes using Lamb wave optical coherence elastography.

Current elastography techniques are limited in application to accurately assess spatially resolved corneal elasticity in vivo for human eyes. The air-puff optical coherence elastography (OCE) with an eye motion artifacts correction algorithm is developed to distinguish the in vivo cornea vibration from the eye motion and visualize the Lamb wave propagation clearly in healthy subjects. Based on the Lamb wave model, the phase velocity dispersion curve in the high-frequency is calculated to obtain spatially resolved corneal elasticity accurately with high repeatability. It is found that the corneal elasticity has regional variations and is correlated with intraocular pressure, which suggests that the method has the potential to provide noninvasive measurement of spatially resolved corneal elasticity in clinical practice.