A Virtual Clinical Reasoning Case for Medical Students Using an Ophthalmology Model: A Case of Red Eye.

Introduction: Triggered by the COVID-19 pandemic, medical education has moved online, tasking medical educators with developing virtual learning experiences. This is particularly challenging for less-represented disciplines, such as ophthalmology. We designed a red eye clinical reasoning case for preclinical medical students, which can be delivered virtually, using video conference software.

Genome-wide polygenic risk score for retinopathy of type 2 diabetes.

Diabetic retinopathy (DR) is a common consequence in type 2 diabetes (T2D) and a leading cause of blindness in working-age adults. Yet, its genetic predisposition is largely unknown. Here, we examined the polygenic architecture underlying DR by deriving and assessing a genome-wide polygenic risk score (PRS) for DR.

Predicting Global Test-Retest Variability of Visual Fields in Glaucoma.

Purpose: To model the global test-retest variability of visual fields (VFs) in glaucoma.

Design: Retrospective cohort study.

Participants: Test-retest VFs from 4044 eyes of 4044 participants.

The vital role for nitric oxide in intraocular pressure homeostasis.

Catalyzed by endothelial nitric oxide (NO) synthase (eNOS) activity, NO is a gaseous signaling molecule maintaining endothelial and cardiovascular homeostasis. Principally, NO regulates the contractility of vascular smooth muscle cells and permeability of endothelial cells in response to either biochemical or biomechanical cues. In the conventional outflow pathway of the eye, the smooth muscle-like trabecular meshwork (TM) cells and Schlemm's canal (SC) endothelium control aqueous humor outflow resistance, and therefore intraocular pressure (IOP).

Inter-Eye Association of Visual Field Defects in Glaucoma and Its Clinical Utility.

Purpose: To investigate intereye associations of visual field (VF) defects.

Methods: We selected 24-2 VF pairs of both eyes from 63,604 patients tested on the same date with mean deviation (MD) ≥ -12 dB. VFs were decomposed into one normal and 15 defect patterns previously identified using archetypal analysis.

An Artificial Intelligence Approach to Assess Spatial Patterns of Retinal Nerve Fiber Layer Thickness Maps in Glaucoma.

Purpose: The purpose of this study was to classify the spatial patterns of retinal nerve fiber layer thickness (RNFLT) and assess their associations with visual field (VF) loss in glaucoma.

Methods: We used paired reliable 24-2 VFs and optical coherence tomography scans of 691 eyes from 691 patients. The RNFLT maps were used to determine the RNFLT patterns (RPs) by non-negative matrix factorization (NMF).

Microinvasive Glaucoma Surgical Training in United States Ophthalmology Residency Programs.

Purpose: The emergence of microinvasive glaucoma surgeries (MIGS) has expanded glaucoma management options. Resident experience with these novel procedures is unclear as no residency minimums exist for them, nor are they part of Accreditation Council for Graduate Medical Education (ACGME) procedure logs. The purpose of this study was to assess resident experience with MIGS in ACGME ophthalmology residency programs across the United States.

Impact of Near-Peer Education in a Student-Run Free Ophthalmology Clinic on Medical Student Teaching Skills.

Objective: To determine the impact of near-peer teaching experiences in the ophthalmology branch of the East Harlem Health Outreach Program (EHHOP), a student-run clinic, on teaching skills of fourth-year medical student Teaching Seniors (TS).

Design: Mixed-methods observational study, including online survey and telephone interview.

Setting: Student-run ophthalmology clinic affiliated with the Icahn School of Medicine at Mount Sinai and Mount Sinai Hospital, a tertiary-care center in New York, NY.

Cohort Study of Nonmelanoma Skin Cancer and the Risk of Exfoliation Glaucoma.

Precis: In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk.

Purpose: The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG.

Methods: We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations.

Twelve tips for teaching ophthalmology in the undergraduate curriculum.

Ophthalmology education in the undergraduate medical curriculum has declined, and graduating healthcare professionals express discomfort with basic evaluation and management of ophthalmic complaints. With the growing aging population, ophthalmic needs will continue to rise, underscoring the need for increased eye care. This article offers 12 tips for increasing undergraduate ophthalmic education, which can be implemented strategically within limited established curricular time, or in novel ways outside the traditional curriculum.

Beta-adrenergic agonist protects retinal pigment epithelium against hydroxycholoroquine toxicity cAMP-PKA signal pathway.

Aim: To test our hypothesis that activation of protein kinase A (PKA) signal pathway by β-adrenergic agonist plays an important role in the protecting of cultured retinal pigment epithelial (RPE) cells against the hydroxychloroquine (HCQ) toxicity.

Methods: Cultured human RPE cells were treated with 1) HCQ, 2) HCQ with salbutamol (a β2-adrenergic receptor agonist), and 3) HCQ with salbutamol and a PKA inhibitor, and compared these to 4) untreated cells (controls). After treated for 24h, cell vacuolation, cells viability, PKA and PKA kinase activity levels were determined by the measurement of the size of vacuoles using Image J software, the cell counting with a dye-exclusion testing, Western blot and PKA kinase detection, respectively.

Monitoring Glaucomatous Functional Loss Using an Artificial Intelligence-Enabled Dashboard.

Purpose: To develop an artificial intelligence (AI) dashboard for monitoring glaucomatous functional loss.

Design: Retrospective, cross-sectional, longitudinal cohort study.

Participants: Of 31 591 visual fields (VFs) on 8077 subjects, 13 231 VFs from the most recent visit of each patient were included to develop the AI dashboard.

Ginkgo Biloba Extract in Ophthalmic and Systemic Disease, With a Focus on Normal-Tension Glaucoma.

Glaucoma is a neurodegenerative eye disease that results in retinal ganglion cell loss and ultimately loss of vision. Elevated intraocular pressure (IOP) is the most common known risk factor for retinal ganglion cell damage and visual field loss, and the only modifiable risk factor proven to reduce the development and progression of glaucoma. This has greatly influenced our approach and assessment in terms of diagnosis and treatment.

Artificial Intelligence Classification of Central Visual Field Patterns in Glaucoma.

Purpose: To quantify the central visual field (VF) loss patterns in glaucoma using artificial intelligence.

Design: Retrospective study.

Participants: VFs of 8712 patients with 13 951 Humphrey 10-2 test results from 13 951 eyes for cross-sectional analyses, and 824 patients with at least 5 reliable 10-2 test results at 6-month intervals or more from 1191 eyes for longitudinal analyses.

LOXL1 folding in exfoliation glaucoma.

Exfoliation syndrome (XFS) is an age-related disease defined by the deposition of aggregated fibrous material (XFM) in the peri-cellular space. Principal morbidity occurs in the eye, where XFM accumulates on the anterior ocular tissues. GWAS have found that certain genetic variants of lysyl oxidase-like 1 (LOXL1), a matrix cross-linking enzyme that is required for elastic fiber formation confer risk for the development of XFS, but are not a single causative factor as many genetically affected individuals do not develop XFS or subsequent glaucoma (XFG).

Characterization of Central Visual Field Loss in End-stage Glaucoma by Unsupervised Artificial Intelligence.

Importance: Although the central visual field (VF) in end-stage glaucoma may substantially vary among patients, structure-function studies and quality-of-life assessments are impeded by the lack of appropriate characterization of end-stage VF loss.

Objective: To provide a quantitative characterization and classification of central VF loss in end-stage glaucoma.

Design, Setting, And Participants: This retrospective cohort study collected data from 5 US glaucoma services from June 1, 1999, through October 1, 2014.

Seven- and eight-year trends in resident and fellow glaucoma surgical experience.

Purpose: This study evaluated US resident and fellow glaucoma surgical experience over a 7- and 8-year period, respectively.

Methods: US ophthalmology resident glaucoma case logs from 2009 to 2016 and glaucoma fellow case logs from 2008 to 2016 were reviewed. The number of total, average, median, and minimum cases, along with percentile data for filtering surgery, shunting surgery, and novel procedures were analyzed for year-to-year trends.

Selective laser trabeculoplasty vs micropulse laser trabeculoplasty in open-angle glaucoma.

Aim: The aim of this study was to prospectively compare the efficacy, safety, and tolerability of selective laser trabeculoplasty (SLT) vs micropulse laser trabeculoplasty (MLT) in reducing intraocular pressure (IOP) in open-angle glaucoma patients.

Patients And Methods: In all, 38 patients were randomized to 360° MLT and 31 patients were randomized to 360° SLT. IOP was measured at intervals of 1 hour and 1, 1-6, 6-12, 6-24, 24-36, and 36-52 weeks.

A case of recurrent hypotony and choroidal effusion in a patient with previous filtration surgery.

Unlabelled: To report a case of recurrent hypotony and choroidal effusion following trabeculectomy.

Observations: A 70 year old male with advanced pseudoexfoliation glaucoma in both eyes underwent trabeculectomy in the left eye. Initially intraocular pressure (IOP) was controlled without topical therapy, but dorzolamide-timolol and brimonidine were added when IOP elevated above target.

Exfoliation Syndrome: A Disease of Autophagy and LOXL1 Proteopathy.

Exfoliation syndrome (XFS) is an age-related disease involving the deposition of aggregated fibrillar material (exfoliation material) at extracellular matrices in tissues that synthesize elastic fibers. Its main morbidity is in the eye, where exfoliation material accumulations form on the surface of the ciliary body, iris, and lens. Exfoliation glaucoma (XFG) occurs in a high proportion of persons with XFS and can be a rapidly progressing disease.

The effect of intensive education on concordance with the Age-Related Eye Disease Study (AREDS) recommendations in a tertiary referral practice.

Background/aims: The Age-Related Eye Disease Study (AREDS) showed that supplementation with their formula led to a significant decrease in progression of age-related macular degeneration (AMD). This study aims to assess the effect of different education protocols on concordance with the trial recommendations in two retinal clinics.

Methods: A prospective controlled survey of concordance with the AREDS recommendations in two retinal clinics was administered to 330 patients with AREDS category 3 or 4 AMD.

Prospective study of lotrafilcon B lenses comparing 2 versus 4 weeks of wear for objective and subjective measures of health, comfort, and vision.

Objective: To examine potential changes in comfort, ocular health, and vision between 2 weeks and 1 month for wearers of lotrafilcon B lenses.

Methods: Up to 120 current wearers of lotrafilcon B lenses were recruited to wear a new pair of lenses for 1 month, using their habitual lens care system. Subjective ratings, biomicroscopy scores, visual acuity, and lens assessments were recorded at 2 weeks and at 1 month.

Lesion morphology in age-related macular degeneration and its therapeutic significance.

Objectives: To quantify and categorize the lesions of neovascular age-related macular degeneration on the basis of fluorescein angiographic morphology.

Methods: We retrospectively reviewed 3580 consecutive cases of neovascular age-related macular degeneration. The lesions were graded in terms of the location, size, and composition and categorized according to the lesion components.

Case series outcomes at 1 week following verteporfin photodynamic therapy.

Purpose: To examine the choroidal neovascularization (CNV) fluorescein angiographic perfusion and visual acuity 1 week after photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis AG, Switzerland) on predominantly classic, subfoveal lesions in age-related macular degeneration (AMD).

Method: A retrospective case series study was conducted on the 1-week outcome of PDT treatment of 76 of 79 consecutive patients with the subfoveal, predominantly classic CNV form of AMD. Leakage from CNV was assessed by fluorescein angiography and best-corrected visual acuity determined on projected Snellen charts using a standardized protocol.