To determine static and dynamic pupillometry characteristics before and after implantable collamer lens (ICL) (V4 and V4c) implantation.
Shanghai, China.
Prospective consecutive observational case ...series.
Patients who had either V4 or V4c ICL implantation were included in this observational study. An automatic quantitative pupillometry system (MonCv3) was used for pupillometry preoperatively and 1 week, 1 month, and 3 months after surgery. Static pupillometry measurements (pupil diameters PDs at 4 standardized illumination levels) and dynamic parameters (including initial PD, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, and velocity of dilation) were measured.
The study comprised 98 eyes (50 patients). Mesopic and low photopic PDs declined by 0.32 mm and 0.27 mm, respectively, at 3 months after ICL implantation; scotopic PD declined at 1 week and recovered to preoperative levels at 3 months; and high photopic PD remained unchanged. Regarding the pupil light reflex, contraction amplitude and velocity declined after surgery, whereas other dynamic parameters remained unchanged. The static and dynamic pupillary characteristics were similar between the V4 and V4c ICL groups.
The V4 and V4c ICLs had similar influences on iris motility. ICL implantation had a miotic effect under mesopic and low photopic illumination conditions, resulting in decreases in pupil contraction amplitude and velocity in light reflexes.
In the traditional recommendation algorithms, due to the rapid development of deep learning and Internet technology, user-item rating data is becoming increasingly sparse. The simple inner product ...interaction mode adopted by the collaborative filtering method has a cold start problem and cannot learn the complex nonlinear structural features between users and items, while the content-based algorithm encounters the difficulty of effective feature extraction. In response to this problem, a hybrid model is proposed based on deep learning and Stacking integration strategy. The traditional recommendation algorithm is first fused by using the Stacking integration strategy to make up for the shortcomings of the single recommendation algorithm to achieve better recommendation performance. The fusion-based model learns the more abstract and deeper nonlinear interaction features by deep learning technology, which makes the model performance gain further. The experiment comparison on the MovieLens-1m dataset shows that the proposed hybrid recommendation model can significantly improve the accuracy of rating prediction.
Thymic epithelial tumors (TETs) are rare mediastinal tumors whose tumorigenesis mechanism is poorly understood. Characterization of molecular alterations in TETs may contribute to a better ...understanding of tumorigenesis and prognosis. Hybrid capture‐based next‐generation sequencing was performed on tumor tissues from 47 TETs (39 thymomas and 8 thymic carcinomas) to detect mutations in 315 tumor‐associated genes. In total, 178 nonsynonymous mutations were identified, with a median of 3.79 per tumor in 47 TETs. Higher tumor mutation burden (TMB) level was more common in older TET patients, and significantly associated with the more advanced pathological type, especially in thymic carcinomas (TC) patients. The gene mutation profiles of B1‐3, A/AB, and TC patients varied greatly. In the actionable mutations analysis, we found 32 actionable mutations in 24 genes. Among them, NFKBIA and TP53 mutations was the most frequently, which were only identified in TCs. Additionally, TCGA database analysis found that the expression of NFKBIA mRNA in the TCs were significantly higher than thymomas. TET patients with high NFKBIA expression had shorter overall survival compared with patients with low/medium NFKBIA expression, thus providing insights to consider NFKBIA as a potential prognosis biomarker and therapeutic target in TETs.
Targeted next‐generation sequencing revealed different gene mutation profiles in different pathological types of thymic epithelial tumor (TET) patients. NFKBIA mutations, only identified in our study, were clustered in C‐type TET, and its expression was associated with poor prognosis, as well as TP53 mutations and TMB.
We present a new technique that allows an intraocular lens to be explanted through the small incisions used in modern cataract surgery.
The intraocular lens optic is cut into three connected pieces ...at the 1-mm-wide end with scissors. Then, with the stabilizing counterforce provided by a pair of vitreoretinal forceps through a paracentesis, the middle piece is removed first, followed by the two side pieces connected with haptics flipped over at the connected part. These two parts overlap each other when passing through the incision, eventually resulting in the explantation of the intraocular lens, as an intact piece.
We believe this method provides a simple and effective way to remove intraocular lens through very small incisions, which could also reduce complications and hasten patient's recovery.
Purpose
The aim of this study was to assess the efficacy and safety of a novel releasing-closing-tapping approach in the treatment of persistent macular holes (PMHs) after initial surgery with ...internal limiting membrane (ILM) peeling.
Methods
We retrospectively analyzed patients with PMHs after initial surgery with ILM peeling who were treated with a novel releasing-closing-tapping approach. After repeated pars plana vitrectomy (PPV), the surgeon effectively released the adhesion between the edges and retinal pigment epithelium (RPE) by gently scraping the retinal neuroepithelium. Then, the hole was converted into a transverse slit, and the edges were gently tapped flat so that they attached to the RPE, and no space was left under the edges. Finally, air tamponade was carried out. The primary outcome measures included MH closure and the change in best-corrected visual acuity (BCVA) from preoperatively to postoperatively.
Results
The study included 11 PMH patients with a mean age of 63.82 ± 3.31 years. The mean minimum linear diameter of PMHs was 666.3 ± 208.1 μm, and the mean basal diameter was 1547.2 ± 351.8 μm. MH closure was achieved in 90.9% (10/11) of eyes, with significant improvement of visual acuity from 1.19 ± 0.30 logMAR to 0.65 ± 0.29 logMAR postoperatively.
Conclusion
The releasing-closing-tapping approach with repeated PPV is a simple, effective, and safe surgical procedure for refractory PMHs after initial surgery with ILM peeling that can significantly improve the visual outcome and achieve a high surgical success rate.
The purpose of this study is to assess the accuracy of artificial intelligence (AI)-based screening for diabetic retinopathy (DR) and to explore the feasibility of applying AI-based technique to ...community hospital for DR screening.
Nonmydriatic fundus photos were taken for 889 diabetic patients who were screened in community hospital clinic. According to DR international classification standards, ophthalmologists and AI identified and classified these fundus photos. The sensitivity and specificity of AI automatic grading were evaluated according to ophthalmologists' grading.
DR was detected by ophthalmologists in 143 (16.1%) participants and by AI in 145 (16.3%) participants. Among them, there were 101 (11.4%) participants diagnosed with referable diabetic retinopathy (RDR) by ophthalmologists and 103 (11.6%) by AI. The sensitivity, specificity and area under the curve (AUC) of AI for detecting DR were 90.79% (95% CI 86.4-94.1), 98.5% (95% CI 97.8-99.0) and 0.946 (95% CI 0.935-0.956), respectively. For detecting RDR, the sensitivity, specificity and AUC of AI were 91.18% (95% CI 86.4-94.7), 98.79% (95% CI 98.1-99.3) and 0.950 (95% CI 0.939-0.960), respectively.
AI has high sensitivity and specificity in detecting DR and RDR, so it is feasible to carry out AI-based DR screening in outpatient clinic of community hospital.
Purpose:
To evaluate the vault change and anterior segment movement induced by mydriasis in moderate-to-high myopic eyes with implantable collamer lenses (ICL).
Setting:
Shanghai, China
Design:
A ...prospective consecutive observational study.
Methods:
A total of 45 eyes of 24 patients with ICL V4 implantation and 128 eyes of 65 patients with ICL V4c implantation were included and analyzed. Anterior chamber depth, posterior corneal endothelium-to-ICL distance, and vault before and after mydriasis were measured by Pentacam (Oculus, Wetzlar, Germany) at 1, 3, and 6 months after surgery.
Results:
Significant vault increases and anterior chamber depth increases induced by mydriasis were noted in both ICL V4 and V4c groups at 1, 3, and 6 months postoperatively. The corneal endothelium-ICL distance increased significantly in eyes with implanted ICL V4c after mydriasis at 3 and 6 months. Moreover, mydriasis-induced vault increases were greater in the ICL V4 group than in the ICL V4c group at 3 and 6 months. In eyes with implanted ICL V4c, mydriasis-induced vault increases were significantly greater at 1 month than at 3 and 6 months.
Conclusion:
Mydriasis results in a general vault increase in eyes with implanted ICLs. The adjustment of the pressure equilibrium via the central hole of the ICL V4c has an important role in vault change. The mydriasis-induced vault increases tend toward stability after 3 months postoperatively. Mydriasis is relatively safe in eyes with ICL implantation.
Purpose:
To investigate the influence of refractive error on pupil diameters in highly myopic eyes with implantable collamer lenses.
Setting:
Shanghai, China.
Design:
A prospective consecutive ...observational study.
Methods:
Sixty-six eyes of 66 patients that underwent ICL V4c implantation were included. Pupil diameters before and 1 week, 1 month, and 3 months after surgery were measured using an automatic pupillometry system (MonCv3; Metrovision, Pérenchies, France) under four standardized illumination conditions: 0, 1, 10, and 100 cd/m2. The correlations between changes in pupil diameter and spherical equivalent values and patient age were investigated.
Results:
Based on preoperative spherical equivalent values, included eyes were divided into a high-myopia group (–6.3 to −9.9 D (diopters)) and a super-high-myopia group (–10 to −20 D). Pupil sizes remained unchanged after surgery in the high-myopia group and decreased at 1 and 10 cd/m2 in the super-high-myopia group. A between-group comparison showed that pupils were significantly smaller in the super-high-myopia group 1 week postoperatively under all illumination conditions and remained smaller at 1 month and 3 months under 1 and 10 cd/m2 lighting conditions. Preoperative spherical equivalent values were significantly correlated with the percent decrease in pupil diameter 1 week postoperatively under 0, 1, and 10 cd/m2 illumination conditions; the greater the degree of myopia, the greater the reduction in pupil diameter.
Conclusion:
Preoperative refractive error significantly affects pupil diameter in highly myopic eyes after implantable collamer lens implantation. Pupils of super highly myopic eyes remained smaller than preoperative levels under mesopic conditions after implantable collamer lens implantation.
To investigate the effectiveness of two regimens of ranibizumab-assisted pars plana vitrectomy in the treatment of patients with proliferative diabetic retinopathy.
This is a prospective, 6-month, ...randomized controlled trial. Eighty patients with 87 eyes requiring pars plana vitrectomy treatment for proliferative diabetic retinopathy were included and randomly divided into a 1.0-mg injection group and a 0.5-mg injection group. The ranibizumab was delivered intraoperatively, at the close of surgery. The vitreous hemorrhage grade, best-corrected visual acuity, central macular thickness, and safety data were assessed to Month 6.
The 1.0-mg injection group had a milder grade and a lower reoccurrence rate of early postoperatively vitreous hemorrhage than the 0.5-mg injection group (35.0% and 63.4%, respectively, P = 0.0195). The mean best-corrected visual acuity of two groups was significantly improved from baseline to 6 months after surgery, 1.60 ± 0.72 Logarithm of the Minimum Angle of Resolution (LogMAR) (<20/200) to 0.47 ± 0.49 LogMAR (20/59) for the 1.0-mg injection group and 1.51 ± 0.69 LogMAR (<20/200) to 0.50 ± 0.31 LogMAR (20/63) for the 0.5-mg injection group, but there was no significant difference between the two groups ( P = 0.74). There was no significant difference in the mean decrease in central macular thickness and probability of postoperative adverse events between the two groups.
Intravitreal injection of 1.0 mg of ranibizumab after pars plana vitrectomy compared with the recommended dose of 0.5 mg significantly reduced the recurrence and severity of early postoperative vitreous hemorrhage in patients with proliferative diabetic retinopathy. It also contributed to the early recovery of visual acuity after surgery and did not increase postoperative adverse events.
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