Publications by authors named "Robert C OʼBrien"

Purpose: Spectral-domain OCT angiography (SD-OCTA) scans were used in an algorithm developed for swept-source OCT angiography (SS-OCTA) scans to determine if SD-OCTA scans yielded similar results for the measurement of hyperreflective foci (HRF) in intermediate age-related macular degeneration (iAMD).

Design: Retrospective study.

Participants: Forty eyes from 35 patients with iAMD.

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  • This study aimed to confirm the reliability of measuring choriocapillaris flow deficit (CCFD) within a specific macular grid and to track these measurements over time.
  • Researchers utilized advanced imaging technology to gather data, excluding certain areas in the scans to accurately calculate CCFD percentages in both normal eyes and those with eye conditions.
  • The findings showed that the methodology is effective for monitoring changes in CCFD, particularly in cases where drusen (eye abnormalities) resolved, demonstrating the practicality of the grid strategy for longitudinal studies.
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  • Age-related macular degeneration (AMD) features large choroidal hypertransmission defects (hyperTDs), which are bright lesions detected via optical coherence tomography (OCT) and indicate loss of retinal pigment epithelium (RPE).
  • Large hyperTDs tend to persist over time, making them critical for understanding the progression from intermediate to late-stage atrophic AMD and useful as endpoints in clinical trials for potential therapies.
  • In a study monitoring 202 AMD eyes for nearly 47 months, a vast majority (99.6%) of the large hyperTDs remained persistent, while only a few showed non-persistence, mainly due to changes in the RPE and retinal area where the hyperTDs were present.
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  • The study aimed to compare the effectiveness of spectral-domain OCT angiography (SD-OCTA) and swept-source OCT angiography (SS-OCTA) in detecting and measuring persistent choroidal hypertransmission defects (hyperTDs) in patients with advanced age-related macular degeneration (AMD).
  • A total of 32 patients underwent both imaging techniques, and the results showed a high level of agreement in the number and size of hyperTDs, with correlation coefficients of 0.969 and 0.999.
  • While there were some statistically significant differences in measurements, these differences were not clinically meaningful, indicating that SD-OCTA can serve as a reliable alternative to SS-OCTA for evaluating hyperTDs.
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Purpose: To determine endothelial cell density (ECD) from real-world donor cornea endothelial cell (EC) images using a self-supervised deep learning segmentation model.

Methods: Two eye banks (Eversight, VisionGift) provided 15,138 single, unique EC images from 8169 donors along with their demographics, tissue characteristics, and ECD. This dataset was utilized for self-supervised training and deep learning inference.

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Purpose: To compare surgical outcomes of phacoemulsification combined with Baerveldt implantation (phaco-tube) or trabeculectomy with mitomycin-C (MMC) (phaco-trab) in patients without prior incisional ocular surgery.

Design: Single-center, retrospective, comparative case series.

Participants: A total of 90 patients underwent surgical treatment, including 45 patients in the phaco-tube group and 45 patients in the phaco-trab group.

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Purpose: Swept-source OCT angiography (SS-OCTA) scans of eyes with age-related macular degeneration (AMD) were used to replace color, autofluorescence, infrared reflectance, and dye-based fundus angiographic imaging for the diagnosis and staging of AMD. Through the use of different algorithms with the SS-OCTA scans, both structural and angiographic information can be viewed and assessed using both cross sectional and en face imaging strategies.

Design: Presented at the 2022 Charles L.

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Purpose: An algorithm developed to obtain drusen area and volume measurements using swept-source OCT angiography (SS-OCTA) scans was tested on spectral-domain OCT angiography (SD-OCTA) scans.

Design: Retrospective study.

Participants: Forty pairs of scans from 27 eyes with intermediate age-related macular degeneration and drusen.

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Background: Breast-conserving therapy with oncoplastic reduction is a useful strategy for partial mastectomy defect reconstruction. The most recently published systematic review of oncoplastic breast reduction outcomes from 2015 showed wound dehiscence in 4.3%, hematoma in 0.

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Background: Anecdotal statements are often made about what percentage of residents go into fellowship versus private practice versus academia after graduation. However, few objective studies have been completed on this topic. This project is designed to shed light on the career choices of plastic surgery residents immediately after graduation from 2018 to 2022.

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Additive manufacturing techniques are being used more and more to perform the precise fabrication of engineering components with complex geometries. The heterogeneity of additively manufactured microstructures deteriorates the mechanical integrity of products. In this paper, we printed AISI 316L stainless steel using the additive manufacturing technique of laser metal deposition.

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Prcis: Monitoring visual fields (VFs) through virtual reality devices proved to have good inter-test and test-retest reliability, as well as easy usability, when self-administered by individuals with and without VF defects in a remote setting.

Purpose: To assess the reliability of remote, self-administered VF monitoring using a virtual reality VF (VRVF) device in individuals without ocular disease and with stable VF defects.

Materials And Methods: Individuals without ocular disease and with stable defects were recruited.

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Background: Age, race, and gender differences in coagulation status of healthy volunteers have been reported in previous case series; however, rigorous multivariate analysis adjusting for these factors is lacking. We aimed to investigate the effects of age, race, and gender on baseline coagulation status in healthy volunteers.

Methods: Thirty healthy volunteer controls with no history of bleeding or thrombotic events and no previous anticoagulant or antiplatelet use were recruited.

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Purpose: The purpose of this study was to evaluate agreement between eye banks (EBs) and an image analysis reading center on endothelial cell density (ECD) determinations using the same image analysis method.

Methods: The Cornea Image Analysis Reading Center (CIARC) determined ECD with a single experienced analyst on EB-obtained central endothelial images from donors intended for keratoplasty from 2 eye banks, Eversight and Lions VisionGift, using the Konan center analysis method. The EBs performed ECD determination on their respective sets of images using the same analysis method with experienced eye bank technicians.

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Importance: A new analytic method can evaluate factors of interest associated with graft failure after Descemet stripping automated endothelial keratoplasty (DSAEK) or more generally in any ophthalmic surgical setting with a time-to-event outcome.

Objective: To reanalyze types of intraoperative complications associated with DSAEK graft failure in the Cornea Preservation Time Study using random survival forests.

Design, Setting, And Participants: This cohort study, initially conceived in April 2019, used a prediction model to conduct a post hoc secondary analysis of data collected in a multicenter, double-masked, randomized clinical trial.

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Purpose: To determine whether intracameral moxifloxacin 500 μg is noninferior to 250 μg for central endothelial cell loss (ECL) after phacoemulsification.

Setting: Aravind Eye Care System.

Design: Prospective masked randomized study.

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Purpose: To identify donor and recipient factors, including eye bank tissue observations, predictive of operative complications in the Cornea Preservation Time Study.

Methods: One thousand three hundred thirty study eyes undergoing Descemet stripping automated endothelial keratoplasty for Fuchs dystrophy or pseudophakic/aphakic corneal edema were randomized to receive a donor cornea with preservation time (PT) of 0 to 7 days (N = 675) or 8 to 14 days (N = 655). Donor factors included demographics, prelamellar corneal and postlamellar lenticule dissection thickness, central endothelial cell density, and tissue processing time.

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Purpose: To examine the association of donor, recipient, and operative factors on graft dislocation after Descemet stripping automated endothelial keratoplasty (DSAEK) in the Cornea Preservation Time Study (CPTS) as well as the effects of graft dislocation and elevated IOP on graft success and endothelial cell density (ECD) 3 years postoperatively.

Design: Cohort study within a multi-center, double-masked, randomized clinical trial.

Methods: 1090 individuals (1330 study eyes), median age 70 years, undergoing DSAEK for Fuchs endothelial corneal dystrophy (94% of eyes) or pseudophakic or aphakic corneal edema (6% of eyes).

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Article Synopsis
  • The study aimed to compare the endothelial cell density (ECD) measurements between eye banks (EBs) and a reading center as part of the Cornea Preservation Time Study.
  • Results showed that EBs typically recorded a higher mean preoperative ECD by 15 cells/mm compared to the reading center, with noticeable variability in individual measurements.
  • Agreement between the two methods improved when analyzing more than 100 cells, indicating more consistent results with larger sample sizes.
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Objectives: Human immunodeficiency virus (HIV)-infected youth are healthier because of effective antiretroviral therapies. We compared anthropometric measurements and prevalence of overweight and obesity between perinatally HIV-infected youth, a local HIV-uninfected comparison group, and 2007 to 2010 National Health and Nutrition Examination Survey (NHANES) data. In addition, we compared only African American HIV-infected youth with NHANES African Americans.

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High levels of cortisol, a sign of potential hypothalamic-pituitary-adrenal (HPA) axis dysregulation, have been associated with poor cognitive outcomes in older adults. Most cortisol research has focused on hippocampal-related abilities such as episodic memory; however, the presence of glucocorticoid receptors in the human prefrontal cortex suggests that cortisol regulation is likely to be associated with prefrontally-mediated executive function abilities. We hypothesized that elevated cortisol levels would be associated with poorer frontal-executive function in addition to episodic memory.

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Although glucocorticoid receptors are highly expressed in the prefrontal cortex, the hippocampus remains the predominant focus in the literature examining relationships between cortisol and brain. We examined phenotypic and genetic associations of cortisol levels with the thickness of prefrontal and anterior cingulate cortex regions, and with hippocampal volume in a sample of 388 middle-aged male twins who were 51-59 years old. Small but significant negative phenotypic associations were found between cortisol levels and the thickness of left dorsolateral (superior frontal gyrus, left rostral middle frontal gyrus) and ventrolateral (pars opercularis, pars triangularis, pars orbitalis) prefrontal regions, and right dorsolateral (superior frontal gyrus) and medial orbital frontal cortex.

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