Advancing healthcare with artificial intelligence: diagnostic accuracy of machine learning algorithm in diagnosis of diabetic retinopathy in the Brazilian population.

Background: In healthcare systems in general, access to diabetic retinopathy (DR) screening is limited. Artificial intelligence has the potential to increase care delivery. Therefore, we trained and evaluated the diagnostic accuracy of a machine learning algorithm for automated detection of DR.

Optical coherence tomography Angio-B mode for early detection of myopic choroidal neovascularization and treatment with Bevacizumab.

Purpose: The purpose of this case report is to outline the management of a 41-year-old female with pathological myopia and type II choroidal neovascularization (CNV) diagnosed by optical coherence tomography angiography (OCT-A) angio-B mode.

Observations: The early detection of CNV with OCT-A angio-B mode and treatment with intra-vitreous injections of Bevacizumab contributed to the amelioration of her vision to 20/20, a better visual acuity than she had prior to treatment.

Conclusions And Importance: This case report suggests that an OCT-A scan may reveal the initial formation of abnormal vasculature before pathological changes are evident in structural OCT, allowing for prompt treatment and resolution in patients with myopic CNV.

Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study.

Background: To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD).

Methods: T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline.

Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy.

Background: Post-transplant diabetes mellitus (PTDM) is a specific subtype of diabetes with an uncertain impact on mortality and morbidity in post-transplant patients. Diabetic retinopathy is the most common microvascular complication of diabetes mellitus, but the long-term clinical progression in PTDM is unknown. New technologies are being used to assess pre-clinical signs of retinal changes, such as swept-source optical coherence tomography (OCT) and OCT-angiography.

Organizational intervention to improve access to retinopathy screening for patients with diabetes mellitus: health care service improvement project in a tertiary public hospital.

Introduction: The aim of this study was to improve the access to diabetic retinopathy (DR) screening with retinographies in a tertiary care center through a process conducted by an interdisciplinary group driven by a nurse.

Materials And Methods: This is a quality improvement study that evaluated the flow for DR screening conducted by an interdisciplinary group using the Plan-Do-Study-Act methodology. As a result measure, we assessed the quantity of retinographies performed after the project implementation, the proportion of patients who presented abnormal retinographies, and the proportion of patients referred to a specialist.

Optic Nerve Head Changes After Intraocular Pressure-Lowering Glaucoma Surgeries Using Optical Coherence Tomography.

Prcis: Optic nerve head (ONH) changes were detected with swept-source optical coherence tomography (SS-OCT) after intraocular pressure (IOP)-lowering glaucoma surgeries.

Purpose: The aim of this study was to detect changes in the ONH with SS-OCT after IOP-lowering procedures.

Patients And Methods: Patients with progressing glaucoma who were referred for IOP-lowering procedures were included.

Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease.

Introduction: Microvascular changes in eye and kidney shares some common factors in diabetes mellitus (DM). The purpose was to evaluate choroidal thickness (CT) and choriocapillaris (CC) density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT).

Research Design And Methods: A cross-sectional study was conducted with patients with T2D with mild or no diabetic retinopathy (DR) and non-diabetic controls.

Early neurovascular retinal changes detected by swept-source OCT in type 2 diabetes and association with diabetic kidney disease.

Purpose: To evaluate retinal thickness and capillary density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT).

Methods: A cross-sectional study was conducted with T2D patients with mild or no diabetic retinopathy (DR) and nondiabetic controls. Inner retinal layer thickness was measured with SS-OCT.

Swept Source Optical Coherence Tomography Documenting Optic Nerve Involvement in an Aggressive T-Cell Lymphoma.

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive neoplasms. The involvement of ocular structures in haematological neoplasms is rare and usually associated with central nervous system involvement, which may occur as a result of orbital invasion and optic nerve infiltration. In this case report, we describe ocular findings using the novel swept source optical coherence tomography (SS-OCT) in a case of aggressive T-cell lymphoma.

Health-related quality of life associated with diabetic retinopathy in patients at a public primary care service in southern Brazil.

Objective: This study aimed to establish the utility values of different health states associated with diabetic retinopathy in a Brazilian sample to provide input to model-based economic evaluations.

Methods: This cross-sectional study was performed in a sample of patients with type 2 diabetes mellitus (T2D) who underwent teleophthalmology screening at a primary care service from 2014 to 2016. Five diabetic retinopathy health states were defined: absent, non-sight-threatening, sight-threatening, and bilateral blindness.

FUNCTIONAL AND STRUCTURAL EFFECTS OF NONDAMAGING RETINAL LASER THERAPY FOR MACULAR TELANGIECTASIA TYPE 2: A Randomized Sham-Controlled Clinical Trial.

Purpose: Macular telangiectasia (MacTel) Type 2 is a progressing neurovascular disease of the macula, currently lacking effective treatment. This study assessed the effect of nondamaging retinal laser therapy (NRT) compared with sham.

Methods: Twelve MacTel patients were enrolled in this double-masked, controlled, randomized clinical trial.

Individual Macular Layer Evaluation with Spectral Domain Optical Coherence Tomography in Normal and Glaucomatous Eyes.

Purpose: To evaluate differences in the thickness of the individual macular layers between early, moderate, and severe glaucomatous eyes and compare them with healthy controls.

Patients And Methods: Subjects with glaucoma presenting typical optic nerve head findings, high intraocular pressure with or without visual field (VF) damage and normal controls were included. All participants underwent 24-2 perimetry and spectral-domain OCT.

The Role of Magnetic Resonance Imaging of the Temporomandibular Joint to Investigate Tinnitus in Adults with Temporomandibular Joint Disorder: A Comparative Study.

 The prevalence of tinnitus is higher in individuals with temporomandibular joint disorder (TMD) than in the general population. Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) is the method of choice for investigation, and it has been hypothesized that specific MRI findings might be observed in TMD with comorbid tinnitus.  To comparatively describe MRI findings in patients with TMD with and without tinnitus, identifying the most common TMJ alterations and determining whether a correlation exists between severity of TMD and tinnitus.

Ophthalmological and Neurologic Manifestations in Pre-clinical and Clinical Phases of Spinocerebellar Ataxia Type 7.

Spinocerebellar ataxia type 7 (SCA7) is a polyglutamine disease that progressively affects the cerebellum, brainstem, and retina. SCA7 is quite rare, and insights into biomarkers and pre-clinical phases are still missing. We aimed to describe neurologic and ophthalmological findings observed in symptomatic and pre-symptomatic SCA7 subjects.

Choroidal thickness in preeclampsia measured by spectral-domain optical coherence tomography.

Purpose: To compare choroidal thickness (CT) measurements in preeclamptic and healthy women in the third trimester of pregnancy using optical coherence tomography.

Methods: This cross-sectional study included 148 eyes of 74 women, divided into two groups: 27 healthy pregnant women in the third trimester (control group) and 47 age-matched pregnant women in the third trimester with preeclampsia (PE group). Of the 47 subjects in preeclampsia group, 26 were classified as having mild PE and 21 as having severe PE.

Plasma levels of miR-29b and miR-200b in type 2 diabetic retinopathy.

MicroRNAs (miRNAs/miRs) are involved in the pathogenesis of diabetes mellitus and its chronic complications, and their circulating levels have emerged as potential biomarkers for the development and progression of diabetes. However, few studies have examined the expression of miRNAs in diabetic retinopathy (DR) in humans. This case-control study aimed to investigate whether the plasma levels of miR-29b and miR-200b are associated with DR in 186 South Brazilians with type 2 diabetes (91 without DR, 46 with non-proliferative DR and 49 with proliferative DR).

Microvascular Complications of Posttransplant Diabetes Mellitus in Kidney Transplant Recipients: A Longitudinal Study.

Objective: To assesses microvascular complications in renal transplant recipients with posttransplant diabetes mellitus (PTDM).

Research Design And Methods: In this observational study, patients with ≥5 years of PTDM were included from a cohort of 895 kidney recipients transplanted from 2000 through 2011. Diabetic retinopathy was evaluated by fundus photographs and optical coherence tomography (OCT).

Microalbuminuria Is Associated With Early Retinal Neurodegeneration in Patients With Type 2 Diabetes.

Background And Objective: To evaluate retinal layer changes in patients with type 2 diabetes, microalbuminuria, and no diabetic retinopathy, and to investigate its possible relationship with age, gender, diabetes duration, urinary albumin excretion (UAE), glycosylated hemoglobin, and hypertension.

Patients And Methods: A prospective, cross-sectional study was performed in 60 patients divided into three groups: diabetic patients with normal UAE, diabetic patients with microalbuminuria, and controls. Retinal thickness was evaluated by Early Treatment Diabetic Retinopathy Study grid using spectral-domain optical coherence tomography.

Changes in choroidal thickness and volume are related to urinary albumin excretion in type 2 diabetic patients without retinopathy.

Purpose: To evaluate choroidal thickness and volume in patients with type 2 diabetes and microalbuminuria using spectral-domain optical coherence tomography.

Methods: We recruited 37 diabetic patients without diabetic retinopathy (18 normoalbuminuric and 19 microalbuminuric) and 21 healthy controls. Choroidal thickness and volume were mapped using the automated Early Treatment Diabetic Retinopathy Study grid and a topographic map of thickness was generated manually.

Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography.

Purpose: To analyze choroidal thickness (CT) of pregnant women with type 1 diabetes mellitus (DM), type 2 DM and gestational diabetes mellitus (GDM) using spectral-domain optical coherence tomography.

Patients And Methods: This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations.

Comparative analysis of choroidal thickness in third trimester pregnant women.

Background: The impact of pregnancy on the choroid is still under investigation. The aim of this study is to compare choroidal thickness measurements of healthy pregnant women in the third trimester and healthy non-pregnant women using spectral-domain optical coherence tomography (OCT).

Methods: This cross-sectional study included 122 eyes of 61 women, divided into two groups: 27 healthy pregnant women in the third trimester and 34 age-matched healthy non-pregnant women.

Novel perspectives on swept-source optical coherence tomography.

Technologies for multimodal digital imaging of vitreoretinal diseases have improved the accuracy of diagnosis and the depth of the knowledge of the mechanisms of disease and their response to treatments. Optic coherence tomography (OCT) has become a mandatory tool for the management and for the follow-up of retinal pathologies. OCT technology evolved in the last two decades from time-domain to spectral domain and recently to the swept-source OCTs (SS-OCT).

Nondamaging Retinal Laser Therapy: Rationale and Applications to the Macula.

Purpose: Retinal photocoagulation and nondamaging laser therapy are used for treatment of macular disorders, without understanding of the response mechanism and with no rationale for dosimetry. To establish a proper titration algorithm, we measured the range of tissue response and damage threshold. We then evaluated safety and efficacy of nondamaging retinal therapy (NRT) based on this algorithm for chronic central serous chorioretinopathy (CSCR) and macular telangiectasia (MacTel).