Publications by authors named "Kristen Nwanyanwu"

Purpose: Hereditary eye diseases (HEDs) are individually rare but affect millions globally. The era of molecular genetics has ushered major advances in the study of these disorders; however, the inclusivity and population diversity of this research is unknown. Questions on the accuracy and applicability of these findings in diverse populations, especially African American patients, came up consistently during counselling sessions.

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Purpose: To study the epidemiology of all domestic violence (DV)-related ocular injuries among pediatric emergency department (ED) patients in the United States.

Methods: This is a retrospective, cross-sectional study of isolated children (<18 years of age) with a diagnosis of DV and primary or secondary diagnosis of ocular injuries in the Nationwide Emergency Department Sample, 2008-2017. We calculated annual incidence of DV-related ocular injuries and prevalence by demographic variables, including age, sex, and income quartile.

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The purpose of this study was to investigate the prevalence of and factors associated with visual impairment among adults with a history of criminal justice involvement (CJI). This retrospective, cross-sectional study reviewed adult respondents from the 2015-2018 National Survey on Drug Use and Health. We analyzed sociodemographic and health characteristics to determine factors associated with visual impairment among adults with and without a history of CJI.

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Purpose: To investigate domestic violence (DV)-related ocular injuries among adult emergency department (ED) patients in the US.

Methods: This was a retrospective, cross-sectional study of patients with a diagnosis of DV and diagnosis of ocular injury in the Nationwide Emergency Department Sample (NEDS) from 2008-2017. We identified patient- and hospital-level variables associated with DV-related ocular injuries.

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Article Synopsis
  • The review explores factors affecting access to and use of eye care services in the U.S. through the Healthy People 2030 framework.
  • It examines social determinants of health that influence various aspects of eye care, including screenings and the use of technology like teleophthalmology.
  • The authors offer hypotheses for existing disparities and suggest recommendations aimed at reducing these gaps and transforming eye care services.
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Article Synopsis
  • The study aimed to assess how different image processing techniques affect quantitative measurements in OCTA images of diabetic patients.
  • Various preprocessing methods and binarization algorithms were applied to OCTA scans to evaluate the impact on vessel density, skeletonized vessel density, and fractal dimension.
  • The results revealed that the choice of image processing method significantly influences OCTA metrics, highlighting the need for standardization in future studies to ensure reliable interpretations.
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Data provide an opportunity to discover disparities and inequities that may otherwise be unrecognized. Within the American Academy of Ophthalmology (AAO) Task Force on Disparities in Eye Care, the Leveraging Data Sub-task Force was charged with identifying data sources to study health disparities in eye care and to leverage data to advance health equity. We evaluated large data sources to determine their strengths, deficiencies, and relative accessibility in relation to the likelihood of identifying eye care disparities.

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Article Synopsis
  • Optical coherence tomography angiography (OCTA) is a non-invasive technique used for imaging the blood vessels in the retina, but assessing image quality is challenging.* -
  • Researchers created a deep learning system using a ResNet152 neural network to classify the quality of OCTA images from 347 scans, with manual validation by independent graders.* -
  • The developed models achieved high accuracy in distinguishing between high and low-quality images (AUC of 0.99 and 0.97, respectively), outperforming traditional machine-reported signal strength methods.*
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Background: Visit no-shows (NS) reduce clinic efficiency and effective resource allocation. Inadequate follow-up among patients with chronic eye disease increases risk of disease progression. Our study identifies demographic, medical, and socioeconomic characteristics that increase odds of NS among patients with chronic eye conditions at high risk of vision-threatening complications.

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Introduction: This study determines the prevalence and associated correlates of people unaware of their diabetic retinopathy diagnosis in the U.S.

Methods: Participants unaware of diabetic retinopathy from the National Health and Nutrition Examination Survey from 2005 to 2008 were identified.

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Purpose: To identify disparities in the use of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic.

Design: A cross-sectional study of completed clinical encounters in an academic ophthalmology center from March 2020 through August 2020.

Participants: A total of 5023 patients comprising 8116 ophthalmic clinical encounters.

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Purpose: The current demographics of the ophthalmology workforce do not reflect the diverse United States population, which has implications for addressing health disparities. The demographics of ophthalmology department faculty may influence the recruitment of underrepresented students into the field. This study sought to determine how the racial and ethnic demographics of ophthalmology department faculty compare with those of other clinical departments at United States medical schools.

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Purpose: To describe follow-up rates for patients referred for outpatient ophthalmic care after emergency department (ED) discharge and identify patient and visit characteristics associated with loss to follow-up (LTFU).

Design: Single-institution retrospective cohort study.

Methods: We analyzed the medical records of 2,206 patients seen in the ED for an eye-related issue who were subsequently scheduled for ophthalmology follow-up between 2013 and 2019 at a single tertiary health system.

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Purpose: To estimate temporal trends in total and out-of-pocket (OOP) expenditures for ophthalmic prescription medications among adults in the United States.

Design: Retrospective, longitudinal cohort study.

Participants: Participants in the 2007 through 2016 Medical Expenditure Panel Survey (MEPS) 18 years of age or older.

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Residence within a disadvantaged US neighborhood was significantly associated with adherence to initial diabetic retinopathy screening. Composite measures of community-level socioeconomic status have the potential to be utilized to inform patient-specific care and policy interventions.

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Background: Diabetic retinopathy (DR) is among the leading causes of vision loss in the USA, yet an estimated 50% of patients with diabetes do not receive recommended annual screening eye exams. Patients with diabetes and low socioeconomic status or who are racial/ethnic minorities are at increased risk for vision loss.

Methods: Qualitative interviews were conducted with 24 patients with diabetes at a federally qualified community health center in an urban area regarding factors influencing their use of screening.

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Hemorrhagic occlusive retinal vasculitis (HORV) is a condition associated with intraocular vancomycin during surgical intervention, most frequently following bilateral sequential cataract surgery. Because of the high rate of ophthalmic vascular complications in this condition, gonioscopic evaluation for identification of neovascularization of the angle and iris is essential. Careful examination can reveal previously asymptomatic and unassociated lesions of the iris or ciliary body.

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Introduction: Community-engaged research (CEnR) allows researchers and community organizations to partner together to improve health outcomes and to decrease health disparities. While prevalent in other fields of medicine, it is rarely used in ophthalmology.

Areas Covered: A comprehensive search of Ovid MEDLINE, NLM Pubmed, Ovid Embase, Scopus and the Cochrane Library for the Medical Subject Headings (MeSH) "Community-based participatory research" and text word variations including in addition to yielded 451 unique references.

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