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1.
J. optom. (Internet) ; 17(3): [100490], jul.-sept2024. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-231868

RESUMO

Purpose: To evaluate the efficacy of anti-suppression exercises in children with small-angle esotropia in achieving binocular vision. Methods: A retrospective review of patients aged 3–8 years who underwent anti-suppression exercises for either monocular or alternate suppression between January 2016 and December 2021 was conducted. Patients with esotropia less than 15 prism diopters (PD) and visual acuity ≥ 6/12 were included. Patients with previous intra-ocular surgery or less than three-month follow-up were excluded. Success was defined as the development of binocular single vision (BSV) for distance, near, or both (measured clinically with either the 4 prism base out test or Worth four dot test) and maintained at two consecutive visits. Qualified success was defined as the presence of diplopia response for both distance and near. Additionally, improvement in near stereo acuity was measured using the Stereo Fly test. Results: Eighteen patients with a mean age of 5.4 ± 1.38 years (range 3–8 years) at the time of initiation of exercises were included in the study. The male female ratio was 10:8. The mean best corrected visual acuity was 0.18 LogMAR unit(s) and the mean spherical equivalent was +3.8 ± 0.14 diopters (D). The etiology of the esotropia was fully accommodative refractive esotropia (8), microtropia (1), post–operative infantile esotropia (4), partially accommodative esotropia (1), and post-operative partially accommodative esotropia (4). Patients received either office-based, home-based, or both modes of treatment for an average duration of 4.8 months (range 3–8). After therapy, BSV was achieved for either distance or near in 66.6 % of patients (95 % CI = 40.03–93.31 %). Binocular single vision for both distance and near was seen in 50 % of children. Qualified success was observed in 38.46% of patients. Persistence of suppression was observed in one patient (5.5 %)... (AU)


Assuntos
Humanos , Criança , Supressão , Visão Binocular , Esotropia , Acuidade Visual , Terapêutica
2.
J. optom. (Internet) ; 17(3): [100506], jul.-sept2024. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-231870

RESUMO

Purpose: To investigate the visual function correlates of self-reported vision-related night driving difficulties among drivers. Methods: One hundred and seven drivers (age: 46.06 ± 8.24, visual acuity [VA] of 0.2logMAR or better) were included in the study. A standard vision and night driving questionnaire (VND-Q) was administered. VA and contrast sensitivity were measured under photopic and mesopic conditions. Mesopic VA was remeasured after introducing a peripheral glare source into the participants' field of view to enable computation of disability glare index. Regression analyses were used to assess the associations between VND-Q scores, and visual function measures. Results: The mean VND-Q score was -3.96±1.95 logit (interval scale score: 2.46±1.28). Simple linear regression models for photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index significantly predicted VND-Q score (P<0.05), with mesopic VA and disability glare index accounting for the greatest variation (21 %) in VND-Q scores followed by photopic contrast sensitivity (19 %), and mesopic contrast sensitivity (15 %). A multiple regression model to determine the association between the predictors (photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index) and VND-Q score yielded significant results, F (4, 102) = 8.58, P < 0.001, adj. R2 = 0.2224. Seeing dark-colored cars was the most challenging vision task. Conclusion: Changes in mesopic visual acuity, photopic and mesopic contrast sensitivity, as well as disability glare index are associated with and explain night driving-related visual difficulties. It is recommended to incorporate measurement of these visual functions into assessments related to driving performance.(AU)


Assuntos
Humanos , Masculino , Feminino , Condução de Veículo , Visão Noturna , Acidentes de Trânsito , Visão de Cores , Visão Mesópica , Ofuscação/efeitos adversos
3.
J. optom. (Internet) ; 17(3): [100510], jul.-sept2024. tab
Artigo em Inglês | IBECS | ID: ibc-231872

RESUMO

Purpose: To evaluate the association between visual symptoms and use of digital devices considering the presence of visual dysfunctions. Methods: An optometric examination was conducted in a clinical sample of 346 patients to diagnose any type of visual anomaly. Visual symptoms were collected using the validated SQVD questionnaire. A threshold of 6 hours per day was used to quantify the effects of digital device usage and patients were divided into two groups: under and above of 35 years old. A multivariate logistic regression was employed to investigate the association between digital device use and symptoms, with visual dysfunctions considered as a confounding variable. Crude and the adjusted odds ratio (OR) were calculated for each variable. Results: 57.02 % of the subjects reported visual symptoms, and 65.02% exhibited some form of visual dysfunction. For patients under 35 years old, an association was found between having visual symptoms and digital device use (OR = 2.10, p = 0.01). However, after adjusting for visual dysfunctions, this association disappeared (OR = 1.44, p = 0.27) and the association was instead between symptoms and refractive dysfunction (OR = 6.52, p < 0.001), accommodative (OR = 10.47, p < 0.001), binocular (OR = 6.68, p < 0.001) and accommodative plus binocular dysfunctions (OR = 46.84, p < 0.001). Among patients over 35 years old, no association was found between symptoms and the use of digital devices (OR = 1.27, p = 0.49) but there was an association between symptoms and refractive dysfunction (OR = 3.54, p = 0.001). Conclusions: Visual symptoms are not dependent on the duration of digital device use but rather on the presence of any type of visual dysfunction: refractive, accommodative and/or binocular one, which should be diagnosed.(AU)


Assuntos
Humanos , Masculino , Feminino , Visão Ocular , Testes Visuais , Campos Visuais , Pessoas com Deficiência Visual , Visão Binocular , Inquéritos e Questionários , Optometria
4.
J. optom. (Internet) ; 17(3): [100491], jul.-sept2024. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-231873

RESUMO

Background and objectives: The invention described herein is a prototype based on computer vision technology that measures depth perception and is intended for the early examination of stereopsis. Materials and methods: The prototype (software and hardware) is a depth perception measurement system that consists on: (a) a screen showing stereoscopic models with a guide point that the subject must point to; (b) a camera capturing the distance between the screen and the subject's finger; and (c) a unit for recording, processing and storing the captured measurements. For test validation, the reproducibility and reliability of the platform were calculated by comparing results with standard stereoscopic tests. A demographic study of depth perception by subgroup analysis is shown. Subjective comparison of the different tests was carried out by means of a satisfaction survey. Results: We included 94 subjects, 25 children and 69 adults, with a mean age of 34.2 ± 18.9 years; 36.2 % were men and 63.8 % were women. The DALE3D platform obtained good repeatability with an interclass correlation coefficient (ICC) between 0.94 and 0.87, and coefficient of variation (CV) between 0.1 and 0.26. Threshold determining optimal and suboptimal results was calculated for Randot and DALE3D test. Spearman's correlation coefficient, between thresholds was not statistically significant (p value > 0.05). The test was considered more visually appealing and easier to use by the participants (90 % maximum score). Conclusions: The DALE3D platform is a potentially useful tool for measuring depth perception with optimal reproducibility rates. Its innovative design makes it a more intuitive tool for children than current stereoscopic tests. Nevertheless, further studies will be needed to assess whether the depth perception measured by the DALE3D platform is a sufficiently reliable parameter to assess stereopsis.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Visão Binocular , Percepção de Profundidade , Visão Ocular , Testes Visuais
5.
J. optom. (Internet) ; 17(3): [100514], jul.-sept2024. tab
Artigo em Inglês | IBECS | ID: ibc-231876

RESUMO

Purpose: To analyze binocular vision of individuals aged 18 to 35 years diagnosed with keratoconus, utilizing spectacles and rigid gas-permeable (RGP) contact lenses. Research was led by the Universidad Autónoma de Aguascalientes, México and Fundación Universitaria del Área Andina Pereira, Colombia. Methods: A single center, prospective non-randomized, comparative, interventional, open-label study, in which the differences in binocular vision performance with both spectacles and RGP contact lenses was carried out from December 2018 to December 2019. Sampling was performed according to consecutive cases with keratoconus that met the inclusion criteria until the proposed sample size was reached. Results: Rigid gas-permeable (RGP) contact lenses notably enhanced distance and near visual acuity in keratoconus patients compared to spectacles. Visual alignment analysis shows exophoria at both distances and is slightly higher with RGP contact lenses. The difference was statistically significant (p<0.05), with 82.5 % presenting compensated phoria with spectacles and pnly 42.50% with RGP contact lenses. Stereoscopic vision improved while wearing RGP contact lenses (42.59 %), although accommodation and accommodative flexibility remained within normal ranges. Conclusions: Patients with keratoconus fitted with RGP contact lenses have improved binocular vision skills such as visual acuity, stereopsis, and accommodative flexibility. However, even when the vergence and motor system is decompensated with respect to normal ranges, the range between break and recovery points for both fusional reserves and the near point of convergence (NPC) improves with the use of RGP contact lenses, giving indications of an adaptive condition of the motor system from the medium to the long term.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Ceratocone , Óculos , Lentes de Contato , Visão Binocular , Testes Visuais , Colômbia , México , Oftalmologia , Estudos Prospectivos
6.
PeerJ Comput Sci ; 10: e2063, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983191

RESUMO

Lack of an effective early sign language learning framework for a hard-of-hearing population can have traumatic consequences, causing social isolation and unfair treatment in workplaces. Alphabet and digit detection methods have been the basic framework for early sign language learning but are restricted by performance and accuracy, making it difficult to detect signs in real life. This article proposes an improved sign language detection method for early sign language learners based on the You Only Look Once version 8.0 (YOLOv8) algorithm, referred to as the intelligent sign language detection system (iSDS), which exploits the power of deep learning to detect sign language-distinct features. The iSDS method could overcome the false positive rates and improve the accuracy as well as the speed of sign language detection. The proposed iSDS framework for early sign language learners consists of three basic steps: (i) image pixel processing to extract features that are underrepresented in the frame, (ii) inter-dependence pixel-based feature extraction using YOLOv8, (iii) web-based signer independence validation. The proposed iSDS enables faster response times and reduces misinterpretation and inference delay time. The iSDS achieved state-of-the-art performance of over 97% for precision, recall, and F1-score with the best mAP of 87%. The proposed iSDS method has several potential applications, including continuous sign language detection systems and intelligent web-based sign recognition systems.

7.
PeerJ Comput Sci ; 10: e2146, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983210

RESUMO

In recent years, the growing importance of accurate semantic segmentation in ultrasound images has led to numerous advances in deep learning-based techniques. In this article, we introduce a novel hybrid network that synergistically combines convolutional neural networks (CNN) and Vision Transformers (ViT) for ultrasound image semantic segmentation. Our primary contribution is the incorporation of multi-scale CNN in both the encoder and decoder stages, enhancing feature learning capabilities across multiple scales. Further, the bottleneck of the network leverages the ViT to capture long-range high-dimension spatial dependencies, a critical factor often overlooked in conventional CNN-based approaches. We conducted extensive experiments using a public benchmark ultrasound nerve segmentation dataset. Our proposed method was benchmarked against 17 existing baseline methods, and the results underscored its superiority, as it outperformed all competing methods including a 4.6% improvement of Dice compared against TransUNet, 13.0% improvement of Dice against Attention UNet, 10.5% improvement of precision compared against UNet. This research offers significant potential for real-world applications in medical imaging, demonstrating the power of blending CNN and ViT in a unified framework.

8.
PeerJ Comput Sci ; 10: e2110, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983218

RESUMO

Recognizing hand-object interactions presents a significant challenge in computer vision. It arises due to the varying nature of hand-object interactions. Moreover, estimating the 3D position of a hand from a single frame can be problematic, especially when the hand obstructs the view of the object from the observer's perspective. In this article, we present a novel approach to recognizing objects and facilitating virtual interactions, using a steering wheel as an illustrative example. We propose a real-time solution for identifying hand-object interactions in eXtended reality (XR) environments. Our approach relies on data captured by a single RGB camera during a manipulation scenario involving a steering wheel. Our model pipeline consists of three key components: (a) a hand landmark detector based on the MediaPipe cross-platform hand tracking solution; (b) a three-spoke steering wheel model tracker implemented using the faster region-based convolutional neural network (Faster R-CNN) architecture; and (c) a gesture recognition module designed to analyze interactions between the hand and the steering wheel. This approach not only offers a realistic experience of interacting with steering-based mechanisms but also contributes to reducing emissions in the real-world environment. Our experimental results demonstrate the natural interaction between physical objects in virtual environments, showcasing precision and stability in our system.

9.
PeerJ Comput Sci ; 10: e2114, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983224

RESUMO

Given the prevalent issues surrounding accuracy and efficiency in contemporary stereo-matching algorithms, this research introduces an innovative image segmentation-based approach. The proposed methodology integrates residual and Swim Transformer modules into the established 3D Unet framework, yielding the Res-Swim-UNet image segmentation model. The algorithm estimates the disparateness of segmented outputs by employing regression techniques, culminating in a comprehensive disparity map. Experimental findings underscore the superiority of the proposed algorithm across all evaluated metrics. Specifically, the proposed network demonstrates marked improvements, with IoU and mPA enhancements of 2.9% and 162%, respectively. Notably, the average matching error rate of the algorithm registers at 2.02%, underscoring its efficacy in achieving precise stereoscopic matching. Moreover, the model's enhanced generalization capability and robustness underscore its potential for widespread applicability.

10.
Front Surg ; 11: 1418679, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983589

RESUMO

Objective: The development of surgical microscope-associated cameras has given rise to a new operating style embodied by hybrid microsurgical and exoscopic operative systems. These platforms utilize specialized camera systems to visualize cranial neuroanatomy at various depths. Our study aims to understand how different camera settings in a novel hybrid exoscope system influence image quality in the context of neurosurgical procedures. Methods: We built an image database using captured cadaveric dissection images obtained with a prototype version of a hybrid (microsurgical/exoscopic) operative platform. We performed comprehensive 4K-resolution image capture using 76 camera settings across three magnification levels and two working distances. Computer algorithms such as structural similarity (SSIM) and mean squared error (MSE) were used to measure image distortion across different camera settings. We utilized a Laplacian filter to compute the overall sharpness of the acquired images. Additionally, a monocular depth estimation deep learning model was used to examine the image's capability to visualize the depth of deeper structures accurately. Results: A total of 1,368 high-resolution pictures were captured. The SSIM index ranged from 0.63 to 0.85. The MSE was nearly zero for all image batches. It was determined that the exoscope could accurately detect both the sharpness and depth based on the Laplacian filter and depth maps, respectively. Our findings demonstrate that users can utilize the full range of camera settings available on the exoscope, including adjustments to aperture, color saturation, contrast, sharpness, and brilliance, without introducing significant image distortions relative to the standard mode. Conclusion: The evolution of the camera incorporated into a surgical microscope enables exoscopic visualization during cranial base surgery. Our result should encourage surgeons to take full advantage of the exoscope's extensive range of camera settings to match their personal preferences or specific clinical requirements of the surgical scenario. This places the exoscope as an invaluable asset in contemporary surgical practice, merging high-definition imaging with ergonomic design and adaptable operability.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38971399

RESUMO

Birds are highly dependent on their vision for orientation and navigation. The avian eye differs from the mammalian eye as the retina is avascular, leaving the inner, highly metabolically active layers with a very long diffusion distance to the oxygen supply. During flight at high altitudes, birds face a decrease in environmental oxygen partial pressure, which leads to a decrease in arterial oxygen levels. Since oxygen perfusion to the retina is already limited in birds, we hypothesize that visual function is impaired by low oxygen availability. However, the visual performance of birds exposed to hypoxia has not been evaluated before. Here, we assess the optomotor response (OMR) in zebra finches under simulated high-altitude hypoxia (10%) and show that the OMR is largely maintained under hypoxia with only a modest reduction in OMR, demonstrating that birds can largely maintain visual function at high altitudes. The method of our study does not provide insight into the mechanisms involved, but our findings suggest that birds have evolved physiological mechanisms for retinal function at low tissue oxygen levels.

13.
Adv Sci (Weinh) ; : e2403578, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38973336

RESUMO

Addressing the critical need for swift and precise nutritional profiling in healthcare and in food industry, this study pioneers the integration of vision-language models (VLMs) with chemical analysis techniques. A cutting-edge VLM is unveiled, utilizing the expansive UMDFood-90k database, to significantly improve the speed and accuracy of nutrient estimation processes. Demonstrating a macro-AUCROC of 0.921 for lipid quantification, the model exhibits less than 10% variance compared to traditional chemical analyses for over 82% of the analyzed food items. This innovative approach not only accelerates nutritional screening by 36.9% when tested amongst students but also sets a new benchmark in the precision of nutritional data compilation. This research marks a substantial leap forward in food science, employing a blend of advanced computational models and chemical validation to offer a rapid, high-throughput solution for nutritional analysis.

15.
Cureus ; 16(7): e63851, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38974399

RESUMO

Calotropis is a small perennial plant that is native to regions with tropical climates in countries like India, where it is found throughout the country. The leaves of the Calotropis plant have been used as an offering to gods since ancient times. Accidental contact with the sap of the plant, called latex, can lead to eye injury and affect vision significantly if left untreated. However, if treated in time and appropriately, vision can be restored. A 30-year-old gentleman reported to emergency medicine with accidental contact in his right eye with Calotropis plant sap. He had complaints of blurring of vision, foreign body sensation, and intolerance to light. On ocular examination, there was conjunctival congestion with corneal edema with Descemet's membrane folds. The best-corrected visual acuity (BCVA) in the right eye was 6/18 parts not improving on the pinhole. The patient was started on systemic and topical antibiotics, topical steroids, and lubricating drops immediately. After two months of treatment, the vision improved gradually, the BCVA in the right eye was 6/6, and the patient was asymptomatic. This is a case report of an uncommon injury due to plant sap, with grave consequences if left untreated. Early intervention and prompt medical management led to recovery in a short time period.

16.
Cureus ; 16(6): e61841, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38975490

RESUMO

Ensuring access to proper eye health services is not only a fundamental human right but also crucial for preserving an individual's quality of life, preventing blindness, and promoting overall well-being. This is especially true in low-income countries like Sub-Saharan Africa (SSA) where recognizing the intricate relationship between access to healthcare and social determinants of health (SDOH ) is crucial to addressing health disparities. The goal of this study was to elucidate and highlight not only the barriers millions face in obtaining eye care but also pave the way for interventions and policies aimed at creating equitable access across diverse populations. To do this, a scoping review was conducted across the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed databases for studies meeting the search terms and inclusion criteria. The results show that intervention strategies that increase vision care must extend beyond the healthcare sector to address the multifaceted challenges. Collaborating with stakeholders involved in addressing broader livelihood issues, such as food security, education, and SDOH, becomes imperative to ensure comprehensive and sustainable improvements in vision care accessibility in SSA.

17.
Nanomicro Lett ; 16(1): 238, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38976105

RESUMO

The emergence of the Internet-of-Things is anticipated to create a vast market for what are known as smart edge devices, opening numerous opportunities across countless domains, including personalized healthcare and advanced robotics. Leveraging 3D integration, edge devices can achieve unprecedented miniaturization while simultaneously boosting processing power and minimizing energy consumption. Here, we demonstrate a back-end-of-line compatible optoelectronic synapse with a transfer learning method on health care applications, including electroencephalogram (EEG)-based seizure prediction, electromyography (EMG)-based gesture recognition, and electrocardiogram (ECG)-based arrhythmia detection. With experiments on three biomedical datasets, we observe the classification accuracy improvement for the pretrained model with 2.93% on EEG, 4.90% on ECG, and 7.92% on EMG, respectively. The optical programming property of the device enables an ultra-low power (2.8 × 10-13 J) fine-tuning process and offers solutions for patient-specific issues in edge computing scenarios. Moreover, the device exhibits impressive light-sensitive characteristics that enable a range of light-triggered synaptic functions, making it promising for neuromorphic vision application. To display the benefits of these intricate synaptic properties, a 5 × 5 optoelectronic synapse array is developed, effectively simulating human visual perception and memory functions. The proposed flexible optoelectronic synapse holds immense potential for advancing the fields of neuromorphic physiological signal processing and artificial visual systems in wearable applications.

18.
BMC Med Inform Decis Mak ; 24(1): 191, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38978027

RESUMO

BACKGROUND: Recent advances in Vision Transformer (ViT)-based deep learning have significantly improved the accuracy of lung disease prediction from chest X-ray images. However, limited research exists on comparing the effectiveness of different optimizers for lung disease prediction within ViT models. This study aims to systematically evaluate and compare the performance of various optimization methods for ViT-based models in predicting lung diseases from chest X-ray images. METHODS: This study utilized a chest X-ray image dataset comprising 19,003 images containing both normal cases and six lung diseases: COVID-19, Viral Pneumonia, Bacterial Pneumonia, Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), and Tuberculosis. Each ViT model (ViT, FastViT, and CrossViT) was individually trained with each optimization method (Adam, AdamW, NAdam, RAdam, SGDW, and Momentum) to assess their performance in lung disease prediction. RESULTS: When tested with ViT on the dataset with balanced-sample sized classes, RAdam demonstrated superior accuracy compared to other optimizers, achieving 95.87%. In the dataset with imbalanced sample size, FastViT with NAdam achieved the best performance with an accuracy of 97.63%. CONCLUSIONS: We provide comprehensive optimization strategies for developing ViT-based model architectures, which can enhance the performance of these models for lung disease prediction from chest X-ray images.


Assuntos
Aprendizado Profundo , Pneumopatias , Humanos , Pneumopatias/diagnóstico por imagem , Radiografia Torácica/métodos , Radiografia Torácica/normas , COVID-19/diagnóstico por imagem
19.
Artigo em Inglês | MEDLINE | ID: mdl-38978825

RESUMO

Background: The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as "a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire. Methods: This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart. Results: Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach's alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS. Conclusions: The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.

20.
Artigo em Inglês | MEDLINE | ID: mdl-38978826

RESUMO

Background: Vascular endothelial growth factor (VEGF) is the primary substance involved in retinal barrier breach. VEGF overexpression may cause diabetic macular edema (DME). Laser photocoagulation of the macula is the standard treatment for DME; however, recently, intravitreal anti-VEGF injections have surpassed laser treatment. Our aim was to evaluate the efficacy of intravitreal injections of aflibercept or ranibizumab for managing treatment-naive DME. Methods: This single-center, retrospective, interventional, comparative study included eyes with visual impairment due to treatment-naive DME that underwent intravitreal injection of either aflibercept 2 mg/0.05 mL or ranibizumab 0.5 mg/0.05 mL at Al-Azhar University Hospitals, Egypt between March 2023 and January 2024. Demographic data and full ophthalmological examination results at baseline and 1, 3, and 6 months post-injection were collected, including the best-corrected distance visual acuity (BCDVA) in logarithm of the minimum angle of resolution (logMAR) notation, slit-lamp biomicroscopy, dilated fundoscopy, and central subfield thickness (CST) measured using spectral-domain optical coherence tomography. Results: Overall, the 96 eyes of 96 patients with a median (interquartile range [IQR]) age of 57 (10) (range: 20-74) years and a male-to-female ratio of 1:2.7 were allocated to one of two groups with comparable age, sex, diabetes mellitus duration, and presence of other comorbidities (all P >0.05). There was no statistically significant difference in baseline diabetic retinopathy status or DME type between groups (both P >0.05). In both groups, the median (IQR) BCDVA significantly improved from 0.7 (0.8) logMAR at baseline to 0.4 (0.1) logMAR at 6 months post-injection (both P = 0.001), with no statistically significant difference between groups at all follow-up visits (all P >0.05). The median (IQR) CST significantly decreased in the aflibercept group from 347 (166) µm at baseline to 180 (233) µm at 6 months post-injection, and it decreased in the ranibizumab group from 360 (180) µm at baseline to 190 (224) µm at 6 months post-injection (both P = 0.001), with no statistically significant differences between groups at all follow-up visits (all P >0.05). No serious adverse effects were documented in either group. Conclusions: Ranibizumab and aflibercept were equally effective in achieving the desired anatomical and functional results in patients with treatment-naïve DME in short-term follow-up without significant differences in injection counts between both drugs. Larger prospective, randomized, double-blinded trials with longer follow-up periods are needed to confirm our preliminary results.

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