Notes

Outstanding High-Temperature Durability in the Supersaturated Refractory High-Entropy Blend.
To report the clinical profile and visual impairment in various stages of neovascular glaucoma (NVG) at a tertiary eye center in East India.

The electronic medical records of the hospital database of patients with neovascular glaucoma seen between 2013 and 2020 were reviewed. Gonioscopic details were used to stratify patients into nonspecified NVG (Group 1), open-angle NVG (Group 2), and closed-angle NVG (Group 3). The clinical profile, angle features, cause of NVG, systemic associations, visual impairment, and blindness (defined as logarithm of the minimum angle of resolution, LogMar >1.3 at baseline and at final follow-up), and outcomes of medical/surgical interventions were compared between the three groups.

Of 846 eyes of 810 patients with NVG (Group 1, n = 564 eyes, Group 2, n = 61 eyes, and Group 3, n = 220 eyes), at baseline, the blindness rates in Groups 3 and 2 were 90 and 75%, respectively. The time from a previous intervention to the onset of NVG ranged from 3 to 5 months, while the median duration of NVG was about 4-4.5 months (0.03-120 months). Multivariate regression identified a longer duration of NVG as the only variable associated with poor final visual acuity.

Visual morbidity by NVG remains as high as 75-90% in developing countries, even with the availability of anti-VEGFs and after improved management/investigative at all stages.
Visual morbidity by NVG remains as high as 75-90% in developing countries, even with the availability of anti-VEGFs and after improved management/investigative at all stages.
To evaluate long-term perimetric stabilization at set Target (IOPs) in primary angle-closure glaucoma with visual field defects.

Two hundred forty-eight eyes, of 124 primary angle-closure glaucoma (PACG) patients on medical treatment, and 124 eyes, of 95 patients after trabeculectomy performed at least 5 years prior were evaluated. One hundred eighty-five eyes had a follow-up of ≥10 years. Target IOPs for mild, moderate, and severe glaucomatous optic neuropathy were set at ≤18, ≤15, and ≤12 mmHg, respectively. Progression was evaluated by event-based changes on guided progression analysis. Primary outcome measure was therapy required to achieve individualized Target IOP. Secondary outcome measure was assessment of perimetric change over time.

Mean baseline IOP was 23.34 ± 6.16 mmHg in medically treated and 36.08 ± 9.73 mmHg in surgically treated eyes (P = 0.0001). All eyes with a baseline IOP of <25 mmHg were on medications alone, 65.33%, of those with a baseline IOP of 25-30 mmHg were on medicationseutic interventions and Target IOPs are therefore suggested as a clinically validated algorithm of care for different severities of PACG.
30 mmHg to achieve Target IOP. These appropriate initial therapeutic interventions and Target IOPs are therefore suggested as a clinically validated algorithm of care for different severities of PACG.
To study the trend of the rise of intraocular pressure (IOP), with the energy used during Neodymium Yttrium Aluminum Garnet (Nd YAG) posterior capsulotomy.

This is a prospective interventional study undertaken at a tertiary care center. The study was conducted on 221 non-glaucomatous eyes that underwent Nd YAG posterior capsulotomy, of which 181 patients completed the study. find more IOP was recorded before laser and at 1, 2, 3, 4 hours, one day, one week, and one month during the post-laser period. Patients were grouped, depending on the amount of energy used, into Group 1 (≤ 40 mJ), Group 2 (40-80 mJ), and Group 3 (>80 mJ).

Raised IOPs were noted in all the groups at various time points; however, such cases were more in Group 3 (P = <0.001). IOP was noted to peak at the fourth hour and declined to reach baseline by one week in Group 2 and by one month in Group 3.

There exists a relationship between the quantum of energy used and the amount of rising of IOP following Nd YAG laser capsulotomy. In uncomplicated cases without preexisting glaucoma, if the amount of energy for posterior capsulotomy is limited to 40 mJ, routine use of ocular hypotensive medication can be avoided.
There exists a relationship between the quantum of energy used and the amount of rising of IOP following Nd YAG laser capsulotomy. In uncomplicated cases without preexisting glaucoma, if the amount of energy for posterior capsulotomy is limited to 40 mJ, routine use of ocular hypotensive medication can be avoided.
To report the association of procollagen-lysine 2-oxoglutarate 5-dioxygenase 2 (PLOD2) mutations with bilateral primary congenital glaucoma (PCG) in monozygotic twins and with nondominant juvenile-onset primary open-angle glaucoma (JOAG).

We utilized family-based whole-exome sequencing to detect disease-causing mutations in a pair of monozygotic twins with de-novo PCG and compared its existence in 50 nonfamilial cases of JOAG and 30 healthy controls. To validate the identified mutations, direct Sanger sequencing was performed. For further evaluation of gene expression in the ocular tissues, we performed whole-mount in situ hybridization in zebrafish embryos.

We identified a novel missense mutation (c.1925A>G, p.Tyr642Cys) in the PLOD2 gene in the monozygotic twin pair with PCG and another missense mutation (c.1880G>A, p.Arg627Gln) in one JOAG patient. Both mutations identified were heterozygous. Neither the parents of the twins nor the parents of the JOAG patient harbored the mutation and it was probably a de-novo change. The zebrafish in situ hybridization revealed expression of the PLOD2 gene during embryogenesis of the eye.

We observed an association of PLOD2 mutations with PCG and with nonfamilial JOAG. This new gene needs to be further investigated for its role in pathways associated with glaucoma pathogenesis.
We observed an association of PLOD2 mutations with PCG and with nonfamilial JOAG. This new gene needs to be further investigated for its role in pathways associated with glaucoma pathogenesis.
Glaucoma is one of the preeminent causes of incurable visual disability and blindness across the world due to elevated intraocular pressure within the eyes. Accurate and timely diagnosis is essential for preventing visual disability. Manual detection of glaucoma is a challenging task that needs expertise and years of experience.

In this paper, we suggest a powerful and accurate algorithm using a convolutional neural network (CNN) for the automatic diagnosis of glaucoma. In this work, 1113 fundus images consisting of 660 normal and 453 glaucomatous images from four databases have been used for the diagnosis of glaucoma. A 13-layer CNN is potently trained from this dataset to mine vital features, and these features are classified into either glaucomatous or normal class during testing. The proposed algorithm is implemented in Google Colab, which made the task straightforward without spending hours installing the environment and supporting libraries. To evaluate the effectiveness of our algorithm, the dataset is divided into 70% for training, 20% for validation, and the remaining 10% utilized for testing. The training images are augmented to 12012 fundus images.

Our model with SoftMax classifier achieved an accuracy of 93.86%, sensitivity of 85.42%, specificity of 100%, and precision of 100%. In contrast, the model with the SVM classifier achieved accuracy, sensitivity, specificity, and precision of 95.61, 89.58, 100, and 100%, respectively.

These results demonstrate the ability of the deep learning model to identify glaucoma from fundus images and suggest that the proposed system can help ophthalmologists in a fast, accurate, and reliable diagnosis of glaucoma.
These results demonstrate the ability of the deep learning model to identify glaucoma from fundus images and suggest that the proposed system can help ophthalmologists in a fast, accurate, and reliable diagnosis of glaucoma.
To develop predictive models to identify cataract surgery patients who are more likely to benefit from refraction at a four-week postoperative exam.

In this retrospective study, we used data of all 86,776 cataract surgeries performed in 2015 at a large tertiary-care eye hospital in India. The outcome variable was a binary indicator of whether the difference between corrected distance visual acuity and uncorrected visual acuity at the four-week postoperative exam was at least two lines on the Snellen chart. We examined the following statistical models logistic regression, decision tree, pruned decision tree, random forest, weighted k-nearest neighbor, and a neural network. Predictor variables included in each model were patient sex and age, source eye (left or right), preoperative visual acuity, first-day postoperative visual acuity, intraoperative and immediate postoperative complications, and combined surgeries. We compared the predictive performance of models and assessed their clinical impact in test samples.

All models demonstrated predictive accuracy better than chance based on area under the receiver operating characteristic curve. In a targeting exercise with a fixed intervention budget, we found that gains from predictive models in identifying patients who would benefit from refraction ranged from 7.8% (increase from 1500 to 1617 patients) to 74% (increase from 250 to 435 patients).

The use of predictive statistical models to identify patients who are likely to benefit from refraction at follow-up can improve the economic efficiency of interventions. Simpler models like logistic regression perform almost as well as more complex machine-learning models, but are easier to implement.
The use of predictive statistical models to identify patients who are likely to benefit from refraction at follow-up can improve the economic efficiency of interventions. Simpler models like logistic regression perform almost as well as more complex machine-learning models, but are easier to implement.
To evaluate the efficacy and safety of a hinged pupil expansion device (PED) in eyes with small pupils undergoing phacoemulsification.

In this prospective, multicenter, interventional case series of 57 eyes with suboptimal pharmacologic pupil dilation (<5 mm diameter), a hinged PED (I-Ring, Beaver-Visitec International, Waltham, MA) was applied to facilitate surgical visualization during cataract surgery. The pupil diameters (PD) were measured at different stages of the procedure and at the 1-month follow-up visit. Rate of successful intraoperative PED deployment, pupil size, and shape were assessed.

The mean patient age was 70.5 ± 12.1 years. The I-Ring PED was successfully applied in all eyes. The mean PD at various stages were 4.1 ± 1.1 mm (dilation with eye drops only preoperatively), 4.3 ± 1.1 mm (dilation after intracameral epinephrine and ophthalmic viscoelastic device), 6.80 ± 0.00 mm (with PED applied), and 5.7 ± 1.1 mm (end of surgery). A statistically significant difference (P < 0.001) was observed between the mean PD with intracameral medications and with PED application. Postoperative circular pupil was observed in 54 of 57 eyes (94.7%) and the mean eccentricity index (n = 57 eyes) was 0.11 ± 0.22. No significant adverse events were observed.

The I-Ring PED safely and effectively provided and maintained adequate pupil expansion and surgical visualization in eyes with small pupils undergoing cataract surgery. Postoperatively 95% of eyes attained circular pupils. This hinged PED is an additional instrumentation option for the safe and effective expansion of inadequately sized pupils during cataract surgery.
The I-Ring PED safely and effectively provided and maintained adequate pupil expansion and surgical visualization in eyes with small pupils undergoing cataract surgery. Postoperatively 95% of eyes attained circular pupils. This hinged PED is an additional instrumentation option for the safe and effective expansion of inadequately sized pupils during cataract surgery.
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