Abstract
Introduction: Photodynamic therapy (PDT) has shown substantial benefit in the treatment of choroidal hemangioma (CH) in recent years. This report describes the use of PDT with overlapping ...spots in a patient with Sturge-Weber syndrome (SWS) and large circumscribed CH. Case Presentation: A 9-year-old girl with SWS and a history of glaucoma in her left eye was referred to a retina clinic for possible macular changes. Examination revealed decreased vision in the left eye, pigmentary changes in the macula, and choroidal thickening in the posterior pole. After being lost to follow-up for 2 years, the patient returned with further vision deterioration with best-corrected visual acuity (BCVA) of 20/150 and new subretinal fluid (SRF). Imaging findings were consistent with a diagnosis of CH and SRF. PDT with verteporfin was initiated on the entire area with multiple overlapping spots, resulting in resolution of SRF and improvement in visual acuity and choroidal contour. At 18-month post-treatment, the patient’s BCVA was 20/25 with no recurrence of SRF or increased choroidal thickening. Significant pigmentary changes and subretinal hyper-reflective material were observed in the OCT of the treated area. Conclusion: Multiple overlapping laser spots of PDT can result in longstanding regression of large circumscribed CH in a patient with SWS with excellent final visual acuity. However, significant subretinal changes may also result following this method of treatment.
Purpose
To evaluate multifocal electroretinogram (mfERG) parameters in eyes with diabetic macular edema (DME) and its correlation with vision and optical coherence tomography (OCT) features.
Methods
...Fifty-four eyes of 27 subjects with DME due to nonproliferative diabetic retinopathy were evaluated. MfERG responses were measured in three concentric rings. Macular thickness was measured by OCT in each segment of the three concentric rings, and mfERG rings were superimposed on the macular thickness map. The correlation between macular thickness in specific points of the thickness map and changes of the mfERG parameters in the corresponding points of the mfERG field map was evaluated and the relationship between the OCT and mfERG changes and changes of best-corrected visual acuity (BCVA) was investigated. The central foveal B-scans of SD-OCT were used to evaluate any correlation between the external limiting membrane (ELM) status, ellipsoid zone (EZ) status, presence of cysts or disorganization of retinal inner layers (DRIL), and mfERG parameters at the central corresponding area.
Results
The mean of BCVA was 0.5 ± 0.3 in logMAR, and the central macular thickness was 392.6 ± 123.4 microns. The central ring P1 and N2 amplitudes had a significant correlation with BCVA in univariate and multivariate analyses (
P
= 0.001 for both,
r
= − 0.346 and
r
= − 0.646, respectively). There was a significant correlation between retinal thickness and the N1 amplitude in the central ring (
P
= 0.02,
r
= − 0.343). Outer retinal layer disruption (ELM and EZ) correlated with prolonged P1 implicit time at the corresponding location (
P
= 0.005,
r
= 0.068). The presence of the DRIL was associated with reduced P1 and N2 amplitudes (
P
= 0.037,
r
= − 0.284 and
P
= 0.019,
r
= − 0.562, respectively). A significant correlation was also found between the presence of cysts and a lower central P1 amplitude (
P
= 0.033,
r
= − 0.376).
Conclusion
In diabetic patients, discrete changes of some parameters in the central ring of the mfERG field map (e.g., P1 and N2 amplitudes) have a significant correlation with both structural OCT abnormalities in the corresponding points of the thickness map (like DRIL, intraretinal cyst and ELM/EZ disruption) and BCVA. Predictive models such as those described in this report may make it possible to identify the relationship between specific anatomical and functional characteristics in diabetic retinopathy.
Purpose
The study aims to classify the eyes with proliferative diabetic retinopathy (PDR) and non-proliferative diabetic retinopathy (NPDR) based on the optical coherence tomography angiography ...(OCTA) vascular density maps using a supervised machine learning algorithm.
Methods
OCTA vascular density maps (at superficial capillary plexus (SCP), deep capillary plexus (DCP), and total retina (R) levels) of 148 eyes from 78 patients with diabetic retinopathy (45 PDR and 103 NPDR) was used to classify the images to NPDR and PDR groups based on a supervised machine learning algorithm known as the support vector machine (SVM) classifier optimized by a genetic evolutionary algorithm.
Results
The implemented algorithm in three different models reached up to 85% accuracy in classifying PDR and NPDR in all three levels of vascular density maps. The deep retinal layer vascular density map demonstrated the best performance with a 90% accuracy in discriminating between PDR and NPDR.
Conclusions
The current study on a limited number of patients with diabetic retinopathy demonstrated that a supervised machine learning–based method known as SVM can be used to differentiate PDR and NPDR patients using OCTA vascular density maps.
Abstract Background For the first time in Iran, and to the best of our knowledge in Asia, we assessed the anthropometric indices most closely correlated to cardiovascular disease (CVD) risk factors ...in a large nationally representative sample of children and adolescents to be used as a simple tool for identifying those at risk. Methods This multi-center study was performed among a representative sample of 4811 school students (2248 boys and 2563 girls) aged 6–18 years, as part of the baseline survey of a national surveillance system. Anthropometric indices and CVD risk factors were measured using standard protocols, and their correlation was analyzed by using Receiver Operator Characteristic (ROC) curves and partial correlation. Results The most prevalent CVD risk factors were low HDL-C (28%), followed by hypertriglyceridemia (20.1%), and overweight (17%). The ROC analyses showed that among boys, all anthropometric indices had the same association with CVD risk factors in 6–9.9-year-age group, while in the 10–13.9 and 14–18-year-age groups, respectively waist circumference (WC) and body mass index (BMI) were the best in distinguishing CVD risk factors. Among girls, these indices were respectively BMI and waist to stature ratio (WSR); WC and WSR; and WC. In the partial correlation analysis, in boys, the highest coefficient was found for BMI; BMI and WC; and for WC and WSR; in girls, these indices were BMI; WC and WSR; and BMI respectively. Conclusions In the present study, BMI, WC and WSR were the most appropriate in predicting CVD risk factors. It may be clinically useful in the pediatric population to routinely measure WC and WSR in addition to BMI as a screening tool to identify high-risk youth.
The present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants.
A retrospective cohort study was conducted on infants who had undergone ...screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age
28 weeks), extremely low-birth-weight (
1000 g), and multiple-gestation (MG) infants.
The prevalence of ROP was 27.28% (
= 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion (
< 0.0001,
< 0.0001, and
= 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP (
< 0.0001) were observed in EP and ELBW infants. Birth weight (
= 0.088), history of transfusion (
= 0.066), and intubation (
= 0.053) were not associated with increased risk of ROP in EP infants, while gestational age (
= 0.037) and history of transfusion (
= 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P < 0.001) and birth weight (
= 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis.
ROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines.
•To predict the most and the least feed-efficient beef cattle with the optimum subset of DNA markers.•To identify the most and the least feed-efficient beef cattle using machine learning ...algorithms.•To identify the most and the least feed-efficient beef cattle without monitoring their daily feed intake and performance measures.•Machine learning algorithm is able to select a subset of markers (∼500 SNPs) and predict feed efficiency group of animals as accurate as a model with all 50k SNPs.
The present study evaluated three strategies to find the optimum subset of DNA markers from the 50 K Illumina Bovine panel to classify beef cattle into the most and the least feed-efficient groups without using individual feed intake and performance measures. Residual feed intake (RFI) and 50 K single nucleotide polymorphisms (SNPs) genotype data of 4,057 beef animals from research and commercial herds were included. Initially, all cattle were ranked based on their phenotypic RFI values. Then different datasets were created by selecting animals from the 1%, 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, and 45% range of top and bottom of the ranked RFI values. SNP subsets were selected based on the top-ranked SNPs contributing to the variance of RFI (first strategy), selecting SNPs from the SNP subsets created in the first strategy (strategy 2), and extracting SNPs from 50k SNPs (strategy 3). Then eleven ML algorithms were employed to classify the most and the least feed-efficient groups using 260 datasets generated by combinations of ten RFI phenotype percentage groups and 6, 18, and 2 SNP subsets in the first, second and third strategies, respectively. There was a high degree of accuracy (>69%) for classifying animals in the range of 1% for all ML algorithms under the three strategies and different SNP subsets. Implementing the linear Support Vector Machine algorithm for 15 K SNPs obtained in the first strategy predicted the 1% of the most and the least feed-efficient animals with an accuracy of 84%. In the second strategy, selecting 524 SNPs from the 15 K SNPs subset outperformed the other strategies with an accuracy of 81% for 1% of the population using the Naive Bayes algorithm. It was concluded that a smaller number of SNPs (524) could be used to predict the most and the least feed-efficient animals with an acceptable accuracy to reduce the cost of selection for RFI using genomic information.
The purpose of this study is to evaluate the concentration of vascular endothelial growth factor (VEGF) in the vitreous humor of patients with primary rhegmatogenous retinal detachment (RRD). This is ...a prospective case control study. Eighteen patients with primary RRD without proliferative vitreoretinopathy C (PVR C) were enrolled as cases, and twenty-two non-diabetic retinopathy patients who were candidates for complete pars plana vitrectomy due to Macular Hole or Epiretinal Membrane were included as the control group. Undiluted vitreal samples were collected during the initiation of Pars Plana Vitrectomy (PPV) prior to any infusion into the posterior cavity. Vitreous samples were also collected from 21 fresh cadaveric globes. The vitreous concentration of VEGF was measured by enzyme-linked immunosorbent assay (ELISA) technique and compared between these two groups. The vitreal concentration of VEGF was 0.643 ± 0.088 ng/mL in the RRD group. Measured concentrations of VEGF in controls were 0.043 ± 0.104 ng/mL, and in cadaveric eyes they were 0.033 ± 0.058 ng/mL. The mean VEGF concentration in the RRD group was statistically higher than in the control group (
< 0.0001) and cadaveric eyes (
< 0.0001). Our study shows that vitreal VEGF concentrations significantly increase in patients with RRD.
To examine the relation of dietary and physical activity (PA) patterns with the body mass index (BMI), and the associations between these patterns among children.
A representative sample of 21 111 ...school students aged 6-18 years was selected by multistage random cluster sampling from 23 provinces in the Islamic Republic of Iran. PA and dietary pattern were assessed by self-administered validated questionnaires.
Fruit and vegetables, dairy products and snacks (salty, fatty or sweet) had a similar consumption frequency of approximately twice a day. The type of fat most frequently consumed was hydrogenated solid fat (consumed by 73.8% of families). The PA level was significantly higher among boys than girls, in rural than in urban residents, and in intermediate students than high-school students. Among boys, the frequency of consumption of vegetables and plant proteins (R(2) = 0.46); and among girls, the frequency of consumption of dairy products and fruits, as well as high PA level had a significant inverse association with BMI (R(2) = 0.57). Among boys, the low frequency of consumption of fruits, the time spent on PA and the energy expenditure; and among girls, the time spent on PA and the energy expenditure, had significant relationships with overweight. When controlling for covariates, PA levels had significant relationships with the frequency of consumption of all food groups.
Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life. When examining their health benefits, the interrelationship of dietary and PA behaviours should be considered.
Purpose: To describe a case of bilateral multiple serous retinal detachments (SRD) following bone marrow transplantation (BMT), which showed bilateral response to a single unilateral intravitreal ...bevacizumab injection.
Case Report: A 37-year-old man with acute myelogenous leukemia who had received bone marrow transplantation four months prior was referred to our clinic with the chief complaint of gradually decreasing vision in both eyes for three months. During the funduscopic examination, multiple serous retinal detachments (SRD) were observed bilaterally, and he was diagnosed with multiple foci of central serous chorioretinopathy (CSCR). He was advised to discontinue the steroid dosage, which did not make significant improvement, and he was treated with intravitreal bevacizumab injection in the more severely affected eye. One month later, significant improvement was noticed in both eyes.
Conclusion: Serous retinal detachment is a rare complication following BMT. Significant bilateral improvement after single unilateral intravitreal bevacizumab injection shows not only the possible role of increased level of vascular endothelial growth factor (VEGF) in this case, but also the systemic diffusion of the drug and effect on the contralateral eye following unilateral injection.
PDF
