Publications by authors named "Pradeep Ramulu"
Agreement between the Icare HOME tonometer and the Goldmann Applanation Tonometry in the assessment of the Peak Intraocular Pressure in the Water-Drinking Test.
Ophthalmol Glaucoma
November 2024
Article Synopsis
Purpose: To examine the cross-sectional and longitudinal associations between visual impairment (VI) and falls in United States older adults.
Design: Retrospective cross-sectional and cohort study.
Methods: This study utilized data from the National Health and Aging Trends Study 2021 and 2022.
Article Synopsis
- The review assesses how effective cataract surgery is, both alone and in combination with other procedures, in lowering intraocular pressure (IOP) for patients with ocular hypertension and glaucoma.* -
- Recent findings indicate that cataract surgery can effectively lower IOP, and minimally invasive glaucoma surgery (MIGS) is beneficial for various types of glaucoma, with ongoing studies exploring optimal timing for these procedures.* -
- The summary suggests that cataract surgery alone is helpful for patients with ocular hypertension, while those with more severe glaucoma might need it combined with MIGS or traditional glaucoma surgeries for better IOP control.*
Objective: Multiple studies have attempted to generate visual field (VF) mean deviation (MD) estimates using cross-sectional optical coherence tomography (OCT) data. However, whether such models offer any value in detecting longitudinal VF progression is unclear. We address this by developing a machine learning (ML) model to convert OCT data to MD and assessing its ability to detect longitudinal worsening.
View Article and Find Full Text PDFPurpose: To validate the SiteWise survey as a reliable tool for assessing the accessibility of outpatient ophthalmology clinics for visually impaired patients and to compare accessibility between hospital-based and satellite clinics.
Methods: This quality improvement study, conducted from January to December 2023, used the SiteWise survey to assess design features in seven satellite and two hospital-based clinics within the Wilmer Eye Institute network. Independent surveyors evaluated elements such as parking, sidewalks, entrances, and interior areas.
Article Synopsis
- The Swedish Interactive Thresholding Algorithm (SITA) is the primary method used for visual field assessments with the Humphrey Field Analyser, and the study compares the sensitivity and reliability of its three versions: SITA Standard (SS), Fast (SF), and Faster (SFR).
- The results show that while SFR gives similar sensitivity outputs to SS and SF, it may not be suitable for cases with severe visual field loss, and the study critiques the existing thresholds for measuring test reliability, especially concerning false positives.
- Additionally, the 24-2C test grid can help identify central visual field defects, while the 10-2 grid provides a more detailed assessment; the text also suggests
Objective: Characteristics of individuals with angle closure may be useful in targeted screening of family members. Here, we assess if findings gathered during examination and imaging of patients with a known angle-closure diagnosis (probands) could better determine the risk of angle closure in the patients' siblings.
Design: Cross-sectional study of patients with known angle closure and their siblings.
Purpose: To investigate the relationship between baseline visual field (VF) severity and rates of visual field loss with changes in quality of life (QoL) and fear of falling (FoF) in adults with glaucoma.
Methods: Prospective cohort study, including participants from the Falls In Glaucoma Study. Quality of life and FoF were assessed annually using the Glaucoma Quality of Life-15 Questionnaire, and the University of Illinois at Chicago FoF Questionnaire, respectively, with higher Rasch-analyzed scores (in logits) indicating better QoL and greater FoF.
Importance: If preperimetric glaucoma reduces patient-reported vision-related quality of life (VRQoL), clinicians might consider earlier and more aggressive treatment of some patients with ocular hypertension and early glaucoma.
Objective: To determine the impact of preperimetric glaucoma and early glaucomatous visual field (VF) loss on participants' VRQoL compared with participants who did not develop glaucoma in the Ocular Hypertension Treatment Study (OHTS).
Design, Setting, And Participants: This cross-sectional study used data from participants enrolled in the OHTS from 1994 to 1996 who completed 20-year examination follow-up and VRQoL surveys from January 7, 2016, to November 19, 2019.
Objective: To explore participant-level biological attributes and scan-level methodological attributes associated with retinal nerve fiber layer (RNFL) thickness variability in a population-based sample of elderly United States adults.
Design: Cross-sectional analysis using data from the Framingham Heart Study.
Participants: One thousand three hundred forty-seven eyes from 825 participants with ≥1 OCT scan and axial length data were included.
Purpose: To examine the performance of self-reported visual difficulty (VD) in predicting objective visual impairment (VI) in older adults and explore factors that influence discordance.
Design: Cross-sectional analysis of the National Health and Aging Trends Study (2022).
Methods: Participants reporting blindness or difficulties with distance or near vision were characterized as having VD.
Purpose: To evaluate the impact of baseline and change in vision on the risk of developing dementia.
Design: Retrospective cohort study.
Methods: This longitudinal analysis utilized data from the 2021 and 2022 National Health and Aging Trends Study.
Purpose: To determine the associations between social vulnerability index (SVI) and baseline severity, worsening, and variability of glaucoma, as assessed by visual field (VF) and OCT.
Design: Retrospective longitudinal cohort study.
Participants: Adults with glaucoma or glaucoma suspect status in 1 or both eyes.
Purpose: To explore the impact of objective vision measures on novel metrics of objectively-measured physical activity (PA) in a nationally representative sample of United States (US) older adults.
Design: Cross-sectional analysis using data from the National Health and Aging Trends Study.
Participants: Adults had their distance and near visual acuity (VA) and contrast sensitivity (CS) tested.
Traditionally, clinical outcome assessments have focused on the patient's perspective through patient-reported outcome assessments; however, given the complexity, integration, and interactions of various participants within the clinical ophthalmology setting, we propose that additional diverse clinical perspectives should be explored in order to appreciate fully the value of care provided to patients. In this review we introduce a framework by which clinical outcome assessments (COAs) can be organized. Our COA framework is composed of five outcome measurements that encompass the perspectives of each player in a patient's care: clinical data-reported outcomes, patient-reported outcomes, clinician-reported outcomes, observer-reported outcomes, and reviewer-reported outcomes.
View Article and Find Full Text PDFPurpose: To assess the accuracy of reused iCare probes after disinfection with 70% isopropyl alcohol and ethylene oxide gas compared to new iCare probes and Goldmann applanation tonometry (GAT).
Design: Prospective comparative analysis.
Participants: A total of 118 eyes from 59 patients recruited from the Aravind Eye Hospital glaucoma clinic in Tirupati, South India.
Importance: Vision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic.
Objective: To provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older.
Article Synopsis
- Lower physical activity levels are common in individuals with visual impairment, and the role of home environmental features on their activity is largely unknown.
- This study examined how home environment characteristics, especially lighting, influence daily physical activity in visually impaired patients aged 60 and older with glaucoma.
- Results showed that improved home lighting correlated with an increase in daily steps and physical activity, indicating that modifying home environments could enhance activity levels for this group.
Purpose: Develop and evaluate the performance of a deep learning model (DLM) that forecasts eyes with low future visual field (VF) variability, and study the impact of using this DLM on sample size requirements for neuroprotective trials.
Design: Retrospective cohort and simulation study.
Methods: We included 1 eye per patient with baseline reliable VFs, OCT, clinical measures (demographics, intraocular pressure, and visual acuity), and 5 subsequent reliable VFs to forecast VF variability using DLMs and perform sample size estimates.
Linear regression of optical coherence tomography measurements of peripapillary retinal nerve fiber layer thickness is often used to detect glaucoma progression and forecast future disease course. However, current measurement frequencies suggest that clinicians often apply linear regression to a relatively small number of measurements (e.g.
View Article and Find Full Text PDFBackground: The diagnosis of dry eye and other common ophthalmological conditions can be supported using patient reported symptoms, which is increasingly useful in contexts such as telemedicine. We aim to ascertain visual symptoms that differentiate dry eye from cataract, glaucoma, or glaucoma suspects.
Methods: Adults with dry eye, glaucoma, cataract, and suspected glaucoma (controls) completed a questionnaire to rate the frequency and severity of 28 visual symptoms.
Article Synopsis
- - A deep learning model (DLM) was created to predict which patients with uncontrolled glaucoma might need surgical intervention, using data from 4,898 unique eyes of 4,038 patients over an 8-year period, focusing on factors from their initial eye exams.
- - The model was trained to forecast the likelihood of surgery within multiple time frames, showing notably high accuracy for predicting surgery within 3 months (AUC of 0.92) and effective results for forecasts up to 3 years.
- - Analysis revealed that intraocular pressure (IOP) was consistently one of the most critical features in predicting surgery, along with mean deviation (MD) and retinal nerve fiber layer (RNFL) thickness, demonstrating the
Purpose: To estimate the effect of being below and above the clinician-set target intraocular pressure (IOP) on rates of glaucomatous retinal nerve fiber layer (RNFL) thinning in a treated real-world clinical population.
Design: Retrospective cohort study.
Methods: A total of 3256 eyes (1923 patients) with ≥5 reliable optical coherence tomography scans and 1 baseline visual field test were included.