The advent of artificial intelligence (AI) technologies has emerged as a promising solution to enhance healthcare efficiency and improve patient outcomes. The objective of this study is to analyse ...the knowledge, attitudes, and perceptions of healthcare professionals in Pakistan about AI in healthcare. We conducted a cross-sectional study using a questionnaire distributed via Google Forms. This was distributed to healthcare professionals (e.g., doctors, nurses, medical students, and allied healthcare workers) working or studying in Pakistan. Consent was taken from all participants before initiating the questionnaire. The questions were related to participant demographics, basic understanding of AI, AI in education and practice, AI applications in healthcare systems, AI's impact on healthcare professions and the socio-ethical consequences of the use of AI. We analyzed the data using Statistical Package for Social Sciences (SPSS) statistical software, version 26.0. Overall, 616 individuals responded to the survey while n = 610 (99.0%) of respondents consented to participate. The mean age of participants was 32.2 ± 12.5 years. Most of the participants (78.7%, n = 480) had never received any formal sessions or training in AI during their studies/employment. A majority of participants, 70.3% (n = 429), believed that AI would raise more ethical challenges in healthcare. In all, 66.4% (n = 405) of participants believed that AI should be taught at the undergraduate level. The survey suggests that there is insufficient training about AI in healthcare in Pakistan despite the interest of many in this area. Future work in developing a tailored curriculum regarding AI in healthcare will help bridge the gap between the interest in use of AI and training.
Purpose To determine the incremental benefit of swept-source optical coherence tomography (SS-OCT) in identifying occult macular disease preoperatively in patients scheduled for routine cataract ...surgery. Setting Shahzad Eye Hospital, Karachi, Pakistan. Design Prospective case series. Methods Preoperative SS-OCT scans were performed in all patients scheduled to have cataract surgery between January and March 2016. Scans were subsequently reviewed for the presence of macular abnormalities. Patients with clinically detectable retinal pathologies were excluded. Results Of the 179 eligible patients, 155 were included in the study. Macular pathology was noted in 17 patients (10.9%). The most commonly identified conditions were age-related macular degeneration (n = 5), idiopathic epiretinal membrane (n = 4), and vitreomacular interface abnormalities (n = 4). Other abnormalities included cystoid macular edema (n = 2) and ellipsoid zone abnormalities (n = 2). Media opacities precluded interpretation of 9 scans (4.7%). Conclusions Swept-source OCT was an effective noninvasive modality for detecting macular structural abnormalities, especially in the presence media opacities. Optical coherence tomography imaging should be considered as an adjunct to routine dilated fundus examination for macular evaluation, particularly if premium intraocular lenses are being considered.
We report a case of a young male with symptomatic isolated venous macro-aneurysm without any associated systemic disease. Multi modal imaging was useful in making the correct diagnosis. To the best ...of our knowledge, primary isolated venous macro-aneurysm has not been reported previously.
Rhegmatogenous retinal detachment (RRD) is a common ophthalmic emergency. Population-based data on primary RRD incidence has been variable, with large differences reported. This study is the first ...large-scale prospective examination of the incidence of primary RRD in the United Kingdom.
The authors established a two-year prospective, population-based observational study recruiting all cases of primary RRD in Scotland. The annual incidence was calculated and analyzed in relation to age, sex, refractive error, and lens status. A national, population-based tool, the Scottish Index of Multiple Deprivation (SIMD), was used to examine the socioeconomic distribution of all incident cases.
A total of 1244 cases were identified during the study period from a population of 5,168,500 yielding an annual incidence of 12.05 per 100,000 population (95% confidence interval, 11.35-12.70). The age-specific incidence increased to a peak in both sexes in the 60- to 69-year age group. RRD was significantly more frequent in males than in females (14.70 vs. 8.75 per 100,000; P < 0.001). Of the cases without previous intraocular surgery, 53.2% were myopic, with a spherical equivalent refractive error > -1 D, 23.4% had undergone cataract surgery, and 10.4% had sustained traumatic injury. A strong association was found between RRD incidence and affluence, with a significant rising trend across quintiles of deprivation.
The estimated annual incidence of primary RRD in Scotland is 12.05 per 100,000. Based on this estimate, there are approximately 7300 new cases annually in the United Kingdom. RRD incidence increases with age, is more common in men and right eyes, and is strongly associated with affluence.
Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of ...our knowledge, this is the first case report of Candida sub-retinal abscess as initial presentation in an immunocompetent patient.
A 32-year old, generally fit and well, female presented to us with gradually deteriorating vision in her right eye. Visual acuity was counting fingers in the right eye and, 20/30 in the left eye. Right eye fundus examination showed a full thickness, yellowish-white foveal lesion, and significant vitreous haze. Left eye examination was normal. Upon direct questioning, the patient disclosed history of backstreet abortion 3 weeks prior to the onset of her ocular symptoms. She underwent vitreous tap and intravitreal antibiotics (amphotericin B, 5 μg/0.5 ml). Vitreous culture showed profuse growth of Candida albicans. Because her condition was progressively deteriorating, she underwent 25 g vitrectomy plus repeat intravitreal amphotericin B under general anaesthesia. Three weeks post-vitrectomy, vitreous inflammation resolved completely, and the sub-retinal abscess healed with a macular scar formation. Over a follow-up of 4 years, no recurrences were observed.
Our case highlights the importance of considering Candida albicans infection in the differential diagnosis of sub-retinal abscesses. Although immunocompromised states are traditionally identified as predisposing factors for fungal infections, fungal endogenous endophthalmitis can occur in healthy individuals as well.
To evaluate the recently described optical coherence tomography (OCT) based classification of epiretinal membrane (ERM) and its usefulness in predicting the functional outcome.
A retrospective ...observational review of OCT scans of patients with the diagnosis of idiopathic ERM was carried out from January 2016 to June 2021. All consecutive images diagnosed with any stage of idiopathic ERM and fulfilled the eligibility criteria were included in the analysis. ERM was identified on OCT scans as a thin hyperreflective layer over the inner layers of retina. OCT scans of patients with ERM who underwent vitrectomy, were independently staged as per the new classification by two independent retinal surgeons to form a consensus on stage. Best corrected visual acuity (BCVA) in logMAR scale and central subfield thickness (CST) on pre- and post-operative spectral domain OCT scans were the variables noted for all patients at the time of diagnosis and at 6 and 12mo follow up visit after undergoing intervention. Partial correlation coefficient was computed between BCVA (logMAR) and CST by ERM stage adjusting by baseline measures.
Clinical charts of 74 patients with idiopathic ERM were assessed. Clinically significant improvement in BCVA overtime was observed with significant difference in median visual acuity of patients with Stage II-IV ERM with
<0.001. The median CST of all patients with stage II-IV ERM showed similar consistent improvement with
<0.001 from baseline to 12
month. Our results showed not only gain in visual acuity but also shift from baseline to anatomical normalization of CST in stage II. We found a decrease in CST with difference of 166 µm and 151 µm in stage III and stage IV respectively. Our results remained consistent with the hypothesis of improved visual outcomes with all stages of ERM with adjusted moderate linear correlation between visual acuity and CST in stage II-IV (
>0.3).
Equally significant visual outcomes of patients with ERM staged II-IV and therefore can be counselled for improved visual acuity after surgical removal of ERM with improvement up to 5 lines on Snellen's chart from the baseline.
ObjectiveThe purpose of this paper was to conduct a systematic review of existing literature on simulation-based training of cataract surgery. Available literature was evaluated and projections on ...how current findings could be applied to cataract surgery training were summarised. The quality of included literature was also assessed.Methods and analysisThe PubMed, Embase and Cochrane Library databases were searched for articles pertaining to simulation training in cataract surgery on 18 November 2019. Selected articles were qualitatively analysed.ResultsA total of 165 articles were identified out of which 10 met inclusion criteria. Four studies reported construct validity of the EyeSi simulator. Six studies demonstrated improved surgical outcomes corresponding to training on the simulator. Quality assessment of included studies was satisfactory.ConclusionCurrent studies on simulation training in cataract surgery all point towards it being an effective training tool with low risk of study biases confounding this conclusion. As technology improves, surgical training must embrace and incorporate simulation technology in training.
The aim of this study was to assess changes in subfoveal choroidal thickness (SFCT), measured using swept-source optical coherence tomography (SS-OCT), after routine phacoemulsification cataract ...surgery.
This is a prospective, interventional, controlled study that took place at Shahzad Eye Hospital, Karachi, Pakistan, between February 2015 and January 2016.
One hundred and one patients who were undergoing routine cataract surgery were recruited. One eye per patient was included. The unoperated fellow eyes acted as controls.
Swept-source optical coherence tomography scans were performed preoperatively, 1 week postoperatively, and 1 month postoperatively. Two independent graders evaluated the scans to measure the SFCT. The SFCT was measured and recorded for OCT scans from each visit. The general linear model repeated analysis technique was used to assess data from the 3 different time intervals, and paired t tests were used to assess a statistically significant difference between mean preoperative and postoperative SFCT. Probability values of less than 0.05 were considered to be statistically significant.
The mean preoperative SFCT in the study eye was 272.9 ± 96.2; SFCT was 278.9 ± 101.4 (p = 0.051) and 281.5 ± 105.2 (p = 0.01) at week 1 and month 1, respectively. In the control eyes, the mean measurement of preoperative SFCT was 274.2 ± 98.5; measurements were 273.8 ± 100.7 (p = 0.875) and 277.9 ± 103.1 (p = 0.063) at week 1 and month 1, respectively.
There was a gradual increase in SFCT at 1 month after cataract removal in the study eyes. The effect was more pronounced in younger individuals and nondiabetic individuals.
Cette étude visait à mesurer les variations de l’épaisseur choroïdienne sous-fovéolaire (ECSF) au moyen de la tomographie par cohérence optique de source à balayage (SS-OCT, pour swept-source optical coherence tomography) à la suite d’une chirurgie de la cataracte par phacoémulsification conventionnelle.
Étude interventionnelle comparative et prospective, tenue au Shahzad Eye Hospital de Karachi, au Pakistan, entre février 2015 et janvier 2016.
Cent un patients qui devaient subir une chirurgie de la cataracte de routine ont été recrutés. On a inclus un œil par patient pour les besoins de l’étude. L’œil non opéré a servi de témoin.
On a utilisé la tomographie par cohérence optique de source à balayage (SS-OCT) pour réaliser des images avant la chirurgie de même que 1 semaine et 1 mois après l’intervention. Deux évaluateurs indépendants ont examiné les images pour mesurer l’ECSF. Cette dernière a été mesurée et enregistrée à chaque visite. On a eu recours à une technique d’analyses répétées du modèle linéaire généralisé afin de comparer les données recueillies aux 3 visites, tandis que le test t pour échantillons appariés a servi à déterminer l’existence d’une différence statistiquement significative entre l’ECSF moyenne préopératoire et postopératoire. Les valeurs de probabilité de moins de 0,05 étaient considérées statistiquement significatives.
L’ECSF préopératoire moyenne dans les yeux à l’étude était de 272,9 ± 96,2; elle se chiffrait à 278,9 ± 101,4 (p = 0,051) et à 281,5 ± 105,2 (p = 0,01) à la semaine 1 et au mois 1, respectivement. Dans les yeux témoins, l’ECSF préopératoire moyenne s’élevait à 274,2 ± 98,5; les mesures étaient de 273,8 ± 100,7 (p = 0,875) et de 277,9 ± 103,1 (p = 0,063) à la semaine 1 et au mois 1, respectivement.
On a enregistré une augmentation graduelle de l’ECSF 1 mois après la chirurgie de la cataracte dans les yeux à l’étude, effet qui était plus prononcé chez les sujets jeunes et les sujets non diabétiques.
A 25-year-old male presented with a complaint of acute visual loss in his right eye for two days. There was a history of visual loss in the left eye six months ago. Comprehensive eye examination ...showed evidence of posterior uveitis, and a placoid lesion on the right fundus. Further physical examination showed maculopapular rashes on the upper back which was highly suggestive of syphilis. Blood tests for venereal disease research laboratory (VDRL) test and fluorescent treponemal antibody absorption (FTA-ABS) test were ordered, which were both positive. Ocular syphilis should be suspected in all cases of uveitis. Early diagnosis and prompt treatment with appropriate antibiotics can prevent permanent visual loss.
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