To investigate the association between glaucoma and each of anxiety and depression.
Retrospective case-control study.
Settings: University of North Carolina hospitals and outpatient clinics. Study ...Population: All patients over the age of 18 years seen between July 1, 2008 and October 1, 2015 were included. Observation Procedure: International Classification of Diseases codes were used to identify cases of glaucoma, as well as anxiety and depression. Outcome Measure: Odds ratios (OR) were calculated for glaucoma and each of anxiety and depression. OR were also calculated for above diagnoses separated by age group and sex.
A total of 4 439 518 patients were screened, of which 11 234 (0.3%) have glaucoma, 96 527 (2.2%) have anxiety, and 103 476 (2.3%) have depression. The adjusted OR was 10.6 (95% confidence interval CI 10.0–11.0) for glaucoma and anxiety and 12.3 (95% CI 11.8–12.9) for glaucoma and depression. The likelihood of having anxiety and depression along with glaucoma did not change with age (P = .088, P = .736).
There was a statistically significant association between glaucoma and each of anxiety and depression.
In this report, we describe a case of juvenile open angle glaucoma in a patient with Rett syndrome.
A 39- year-old white woman with a notable history of Rett syndrome was referred to our center with ...a ten-year diagnosis of juvenile open angle glaucoma. Initial exam was notable for complete cupping of the optic nerve. Upon follow up visits, intraocular pressures were elevated and remained refractory to multiple therapies, including SLT and pressure-lowering drops. Medical management was continued due to the risk of surgery and limited visual potential. Because it was declared that patient did not have substantial feedback to visual stimuli and did not exhibit any signs of pain, conservative management with drops was continued.
This is the first report of a patient with concurrent Rett syndrome and juvenile open angle glaucoma, thus expanding on the literature of an ocular manifestation occurring presumably coincidentally with this disorder.
Several artificial intelligence algorithms have been proposed to help diagnose glaucoma by analyzing the functional and/or structural changes in the eye. These algorithms require carefully curated ...datasets with access to ocular images. In the current study, we have modeled and evaluated classifiers to predict self-reported glaucoma using a single, easily obtained ocular feature (intraocular pressure (IOP)) and non-ocular features (age, gender, race, body mass index, systolic and diastolic blood pressure, and comorbidities). The classifiers were trained on publicly available data of 3015 subjects without a glaucoma diagnosis at the time of enrollment. 337 subjects subsequently self-reported a glaucoma diagnosis in a span of 1-12 years after enrollment. The classifiers were evaluated on the ability to identify these subjects by only using their features recorded at the time of enrollment. Support vector machine, logistic regression, and adaptive boosting performed similarly on the dataset with F1 scores of 0.31, 0.30, and 0.28, respectively. Logistic regression had the highest sensitivity at 60% with a specificity of 69%. Predictive classifiers using primarily non-ocular features have the potential to be used for identifying suspected glaucoma in non-eye care settings, including primary care. Further research into finding additional features that improve the performance of predictive classifiers is warranted.
Talent transfer, an accelerated sport pathway to expertise, holds considerable appeal for sports organisations. As an emerging area of academic research across a range of sport disciplines, there is ...opportunity for to advance knowledge and practice. This review aimed to (a) explore how talent transfer has been defined, to develop a synthesised definition; (b) systematically identify the factors that influence talent transfer; and (c) investigate how theory underpins and enhances understanding of talent transfer.
A systematic review was conducted of 12 peer-reviewed journal articles on talent transfer using the PRISMA approach.
Aiming for a comprehensive, multidisciplinary perspective, the results: introduce a clear, synthesised conceptualisation of talent transfer as an accelerated sport pathway in which a highly trained athlete in one sport (donor sport), transitions to a new sport (recipient sport) with the potential of achieving high-performance success; systematically map influencing factors; and outline considered theories. Factors influencing talent transfer span individual, task-related, and environmental constraints. The review exposes a scarcity of theoretical foundation in current research, suggesting ecological dynamics as a promising approach to advance research and practice.
Practical and theoretical implications arise, emphasising the usefulness of a synthesised definition and a multifactorial approach for designing, implementing, evaluating, and researching talent transfer pathways. This benefits sports administrators, managers, and researchers.
To present a novel characterization of a lens condition termed macrophakia which includes large or proportionally large lenses with shallow anterior chamber dimensions that are statistically deviant ...of a normal population.
We identified five eyes from three cases to have significantly large lens parameters and small anterior chamber depths. In all five eyes, the anterior chamber depth was less than 2 mm and the anterior chamber depth to lens thickness ratio was two standard deviations outside the normative range of lens and chamber measurements. These large lenses were all observed in the absence of typical pathology and other biometric abnormalities.
A novel lens characterization termed macrophakia is proposed to describe large or proportionately large lenses. Naming this condition is clinically relevant and will enhance cataract evaluations and patient education.
Clinical studies implicate low cerebrospinal fluid pressure (CSFP) or a high translaminar pressure difference in the pathogenesis of primary open angle glaucoma (POAG) and normal tension glaucoma ...(NTG). This study was performed to examine the effect of age, sex, race and body mass index (BMI) on CSFP.
Electronic medical records from all patients who had a lumbar puncture (LP) performed at the Mayo Clinic from 1996-2009 were reviewed. Information including age, sex, race, height and weight, ocular and medical diagnoses, intraocular pressure (IOP) and LP opening pressure was obtained. Patients using medications or with medical diagnoses known to affect CSFP, and those who underwent neurosurgical procedures or where more than one LP was performed were excluded from analysis.
Electronic medical records of 33,922 patients with a history of having an LP during a 13-year period (1996-2009) were extracted. Of these, 12,118 patients met all entry criteria. Relative to mean CSFP at age group 20-49 (mean 11.5±2.8 mmHg), mean CSFP declined steadily after age 50, with percent reduction of 2.5% for the 50-54 age group (mean 11.2±2.7 mmHg, p<0.002) to 26.9% for the 90-95 group (mean 8.4±2.4 mmHg, p<0.001). Females had lower CSFP than males throughout all age groups. BMI was positively and independently associated with CSFP within all age groups.
There is a sustained and significant reduction of CSFP with age that begins in the 6(th) decade. CSFP is consistently lower in females. BMI is positively and independently associated with CSFP in all age groups. The age where CSFP begins to decline coincides with the age where the prevalence of POAG increases. These data support the hypothesis that reduced CSFP may be a risk factor for POAG and may provide an explanation for the mechanism that underlies the age-related increase in the prevalence of POAG and NTG.
Purpose. To compare two threshold strategies for visual field assessment, ZETA Fast (Optopol Technology) and Humphrey SITA Fast (Carl Zeiss Meditec), in controls and subjects with glaucoma. Patients ...and Methods. A prospective case-control study was carried out in which the clinical practice study included 26 controls and 26 glaucoma subjects. Testing for each strategy was monocular. Quantitative comparisons of mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and test duration were made using two one-sided t-tests and Wilcoxon signed-rank tests. Confusion matrices were constructed to assess Optopol’s detection as a proxy for Zeiss’s detection of early glaucomatous defects. Receiver operating characteristic (ROC) curves were used to assess MD and PSD’s discriminability. Results. The difference in MD values (Optopol-Zeiss) was within the margin for controls (difference = 0.36, p=0.06), but not for glaucomatous subjects (difference = 2.16, p=1.0). The Optopol strategy took longer than the Zeiss strategy in both controls (difference = 23 seconds, p=0.001) and glaucomatous subjects (difference = 49 seconds, p<0.001). PSD values were higher and VFI values were lower from Optopol in glaucomatous subjects (p<0.001 and p=0.002). Optopol was 92% sensitive in capturing early glaucomatous defects with MD <−2 when compared to Zeiss (p<0.001). ROC analysis shows Optopol yields higher discriminability than Zeiss for MD/PSD indices. Conclusions. Both strategies enable effective identification of glaucomatous defects within 6 minutes; they also offer high sensitivity with a high correlation in global indices between the two strategies. The Optopol strategy is an alternative to the Zeiss counterpart with the limitation of a marginally longer testing protocol but a higher sensitivity of detecting glaucomatous defects.
Ocular decompression retinopathy (ODR) is a complication of rapid lowering of intraocular pressure (IOP) resulting in hemorrhages in multiple retinal layers. We report a case of ODR that developed ...within minutes following anterior chamber paracentesis in an adult female with primary open-angle glaucoma. A 61-year-old Black woman with primary open-angle glaucoma presented with marked elevation of IOP (46 mm Hg in the right eye and 30 mm Hg in the left) despite maximal medical therapy and bilateral selective laser trabeculoplasty. Vision in the right eye decreased from counting fingers at 3 feet 1 week earlier to no light perception at the time of presentation. Anterior chamber paracentesis was performed on the right eye to reduce IOP and stabilize the eye until further surgical intervention could be performed. IOP in the right eye decreased to 6 mm Hg postoperatively. Within minutes of the procedure, several intraretinal blot hemorrhages appeared in the periphery of the right eye. During this time, visual acuity remained at no light perception. The findings were consistent with decompression retinopathy. By 12 weeks postoperatively, the ODR had resolved with visual acuity of light perception and normal fundoscopy except for profound cupping. Our case demonstrates how rapidly ocular decompression can form following IOP reduction.
Non-compliance to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy can result in increased disease activity in neovascular age-related macular degeneration (nAMD). Our study ...aims to determine effects of unplanned delay in anti-VEGF injection treatment for nAMD. This retrospective observational study included patients with delays in receiving intravitreal injections for nAMD treatment from March to May 2020 by at least 21 days. Baseline demographic and clinical characteristics, visual acuity (VA), central macular thickness (CMT) measured on optical coherence tomography (OCT), and duration of delayed treatment were analyzed for 3 time points, the pre-delay visit (v1) and post-delay visits (v2 and v3). Data were compared to age-matched controls treated for nAMD in 2019 without delay. Demographic characteristics were compared using two-sample t-tests for continuous variables and Pearson's chi-square tests for categorical variables. For the two primary outcomes of interest, VA and CMT, means and standard deviations were reported for each combination of group and time. Each outcome was modeled using a linear mixed model with the group, time and group-time interaction as fixed effects. A total of 69 patients (99 eyes) in the treatment delay group and 44 patients (69 eyes) in the control group were identified. Statistically significant differences between control and delayed groups were detected for VA (difference in mean logMAR = 0.16; 95% CI 0.06, 0.27; p = 0.002) and CMT (difference in mean CMT = 29; 95% CI 12, 47; p = 0.001) at v2. No differences were detected for v1 and v3 time points for both outcomes. An unplanned delay in intravitreal injection treatment for nAMD resulted in an increase in CMT and worsening of VA compared to controls observed at v2. At v3, CMT and VA recovered to near v1 levels. This study demonstrates that a one-time, brief interruption in treatment for nAMD results in reversible, temporary worsening.
PDF
