Notes

Early-Onset Sepsis Among Extremely Preterm Infants.
MDDN is a novel diagnostic tool for corneal diseases that can be used to automatically diagnose KCN, FED, and DES using only AS-OCT images.
To assess the activity of reproxalap, a novel reactive aldehyde species (RASP) inhibitor, relative to vehicle in patients with dry eye disease (DED) DESIGN Randomized, double-masked, vehicle-controlled Phase 2b trial METHODS Three hundred patients with DED were randomly assigned 111 at multiple US sites to receive 0.1% topical ocular reproxalap, 0.25% topical ocular reproxalap, or vehicle. Eyes were treated bilaterally 4 times daily for 12 weeks. Standard signs and symptoms of DED were assessed at baseline and at Weeks 2, 4, 8, and 12.

A dose response was observed for signs and symptoms of DED. Relative to vehicle over 12 weeks of therapy, the largest symptomatic improvement was observed in ocular dryness (0.25%, P=.047), and the largest objective sign improvement was observed in nasal region fluorescein staining (0.25%, P=.030). A greater proportion of patients receiving 0.25% reproxalap vs. vehicle reported dryness scores of 0 (P=.012). Improvements in combined DED symptoms were evident by the first possigns and symptoms of dry eye disease.
To examine the association between cognitive dementia and retinal vascular occlusions.

A retrospective, cross-sectional study.

Single-institution study population we reviewed the electronic medical records of 37,208 individuals older than 65 years of age who were evaluated by an ophthalmologist or an optometrist and who also had a medical visit to our institution over a 6-year period. Individuals with and without retinal vascular occlusions were identified by International Classification of Diseases, version 10 (ICD-10) diagnostic codes.

we analyzed the association between dementia and retinal vascular occlusions after adjusting for covariates which included age, sex, stroke, diabetes mellitus, and hypertension using multiple logistic regression analyses.

Compared to subjects without retinal vascular occlusions, those with retinal vascular occlusions had a higher prevalence of dementia (6.7% vs. 9.3%, respectively; P < .001). After adjusting for either age or stroke, there were no significant associations between retinal vascular occlusions and dementia.

Individuals with retinal vascular occlusions have a higher prevalence of dementia. However, this association is secondary to shared underlying risk factors in this population, such as older age and stroke.
Individuals with retinal vascular occlusions have a higher prevalence of dementia. However, this association is secondary to shared underlying risk factors in this population, such as older age and stroke.
  PURPOSE To evaluate Pentacam and OPD-Scan parameters in the early detection of keratoconus.

Retrospective case-control study.

Case group included 50 clinically unaffected fellow eyes diagnosed with asymmetric keratoconus showing subtle qualitative changes at the 0.5-D sensitivity OPD-Scan scale, as well as normal anterior and back elevation difference map at Belin/Ambrósio enhanced ectasia display (BAD) at the Pentacam. Control group included 172 normal eyes that underwent Lasik surgery and presented no complications throughout the 2-year follow-up period. OPD-Scan and Pentacam parameters were compared, calculating sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). A multivariate analysis was performed using Pentacam or OPD-Scan variables, and a model using variables of both devices.

Pentacam variables with AUC ≥0.8 were keratoconus index (0.85), index of height decentration (0.81), and overall deviation at BAD (0.8). OPD-Scan variables with AUC ≥0.8 were keratoconus prediction index (0.83), surface asymmetry index (0.83), and total of higher-order trefoil aberration (0.8). In the multivariate analysis, the AUC was 0.85 in the case of OPD-Scan whereas it was 0.89 in the case of Pentacam. When combining all variables from the 2 devices, the AUC was 0.93, with a sensitivity of 82% and a specificity of 94%.

Several parameters of OPD-Scan and Pentacam can be useful to differentiate cases from normal control eyes, demonstrating even better results when combining parameters of both devices. Anterior corneal indexes were the most important parameters to discriminate both groups.
Several parameters of OPD-Scan and Pentacam can be useful to differentiate cases from normal control eyes, demonstrating even better results when combining parameters of both devices. Anterior corneal indexes were the most important parameters to discriminate both groups.
To evaluate the relationship between obstructive sleep apnea (OSA) and diabetic macular edema (DME) and the effect of OSA on refractory DME in patients with type 2 diabetes (T2DM).

Retrospective clinical cohort study.

A population-based study was conducted at Chang Gung Memorial Hospital from March 1, 2009, to March 1, 2020. PKI-587 Among 14,152 patients who had undergone polysomnography (PSG) and whose data were registered on the sleep center's PSG database, 121 patients (242 eyes) with T2DM were enrolled according to the International Classification of Diseases, Ninth Revision (ICD-9) code 3620 for diabetic retinopathy (DR). Patients with a secondary cause of macular edema and those lacking medical records were excluded. All patients with T2DM enrolled in our study received both optical coherence tomography (OCT) and PSG. The prevalence of severe (apnea-hypopnea index [AHI] ≥30) and nonsevere (AHI <30) OSA was compared between patients with and without DME and refractory DME.

In total, 102 eyes (54 patients) were divided into groups of 40 eyes with DME or 62 eyes without DME. Severe OSA (odds ratio, 7.36; 95% confidence interval [CI] 1.32-40.96; P=.023) was significantly associated with DME. Refractory DME was significantly more frequent in patients with severe OSA (27%) than in those with nonsevere OSA (0%; P=.009). Cox proportional hazards regression analysis revealed that OSA (hazard ratio, 2.97; CI, 1.08-8.16; P=.034) independently increased the DME risk after adjustment for age, sex, glycohemoglobin level, hypertension, and hypercholesterolemia.

Severe OSA is a risk factor for DME and is associated with having refractory DME.
Severe OSA is a risk factor for DME and is associated with having refractory DME.
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