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Objective Th aim of this study is to explore the diagnostic accuracy of smartphone-based D-EYE ophthalmoscopy in the diagnosis of optic nerve head (ONH) abnormalities and screening for glaucoma. Methods This is a prospective clinical-based validation study performed on 90 patients recruited from a tertiary teaching hospital. Patients underwent dilated fundus examination by slit-lamp and smartphone-based D-EYE fundoscopy operated by two experienced ophthalmologists. Results The diagnostic accuracy of smartphone-based D-EYE ophthalmoscopy of normal vertical cup-to-disc ratio (VCDR) was acceptable (sensitivity 85.8%–96.4%; specificity 51.4%–96.4%). The D-EYE would often underestimate VCDR values as mean VCDR was significantly lower among overall and glaucoma cohorts (all p-value Conclusion We demonstrated that the D-EYE is a highly specific tool for VCDR within the normal range but not in patients with glaucoma. Despite being an easy and portable tool to measure VCDR, it is limited in terms of diagnosing ONH and blood vessel abnormalities.

AIM: To compare the effectiveness of postoperative adjunctive use of subconjunctival bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of intraocular pressure (IOP) and reduction of postoperative bleb vascularization and fibrosis. METHODS: A prospective, one center, randomized, placebo-control study. Fifty-nine patients (59 eyes) with uncontrolled IOP under maximal tolerated medical treatment (MTMT) were recruited. A primary trabeculectomy with mitomycin C (MMC) was done and the patients were randomized to either postoperative subconjunctival injection of bevacizumab (1.25 mg/0.05 mL) or balanced salt solution (BSS). Forty-seven patients (47 eyes) completed at least one year of follow up and were included in the study. The main outcome measure was the IOP, and secondary outcome measures include bleb morphology, vascularization, and fibrosis, as well as the need for glaucoma medications and 5-fluorouracil (5-FU) needling. RESULTS: At 1-year follow up, there was no significant difference between groups for IOP (P=0.65), bleb morphology (P=0.65), and the need for glaucoma medications (P=0.65) or 5-FU needling requirements (P=0.11). However, the bevacizumab group had a higher rate of success results, lower use of glaucoma medications after surgery, and optimal bleb aspect in more patients, but more 5-FU needling procedures required. CONCLUSION: A bigger sample size is needed in order to determine whether the differences found in the bevacizumab group are statistically significant.

Background: Early diagnosis and timely management of Retinoblastoma (RB) patients are essential to improve eye salvage and survival rates. The objective of this study is to evaluate the lev...

Objectives To measure central macular thickness in Jordanian patients with sickle cell disease who did not have retinopathy and compare the findings with age- and sex-matched controls using spectral domain optical coherence tomography (SDOCT). Methods In this cross-sectional study, participants underwent visual acuity testing, slit-lamp bio-microscopy, dilated ophthalmoscopy, and SDOCT imaging to measure central macular thickness. Macular quadrant measurements and thickness difference indexes (TDIs) were compared between groups. Results Twenty eyes with sickle cell disease and 20 control eyes were enrolled. The median visual acuity in both groups was 20/20. The mean macular thickness was significantly lower in eyes with sickle cell disease than in matched controls (mean difference, 22.15 ± 6.44 µm). Peripheral quadrants were all significantly thinner in eyes with sickle cell disease, especially in superior and temporal quadrants. TDIs were lower in eyes with sickle cell disease than in control eyes. Conclusions Eyes with sickle cell disease that had no clinical evidence of retinopathy exhibited significantly lower central macular thickness in all quadrants, compared with eyes in age- and sex-matched controls. SDOCT is a non-invasive imaging modality that can detect preclinical changes in eyes with sickle cell disease and can be used to screen and monitor the disease process.

Our goal is to investigate the opinion and practice pattern of Canadian ophthalmologists regarding the use of and recommendations for complementary and alternative medicine (CAM) for their glaucoma patients.Institutional review board approval for this prospective, cross-sectional survey was obtained from the Research Ethics Board of Sunnybrook Health Sciences Centre. The survey was sent to all ophthalmologists in Canada electronically through the e-mail lists of 4 ophthalmology associations.A total of 241 ophthalmologists representing all provinces in Canada responded to the questionnaire. Twenty-two percent felt that CAM does have a role in glaucoma therapy with specialists being more likely to believe there is a role (P0.05). Of the total respondents, 26% ask their patients if they use CAM with those in practice for20 years more likely to encourage use (P0.05). Of the respondents, 9% recommend CAM and if an ophthalmologist was in practice for20 years he/she was significantly more likely to recommend CAM (P0.01). Respondents (62%) in general do not discourage CAM with younger ophthalmologists (younger than 50 y, P0.02) and ophthalmologists in practice for20 years (P0.05) being less likely to discourage CAM use. Respondents (41%) believe that CAM rarely ever affects compliance with ophthalmologists from an urban practice (P0.01) and academic practice (P0.05) more likely to deny effect on compliance. Respondents believe that CAM sometimes (46%) results in patient morbidity with ophthalmologists being in practice for20 years believing that morbidity is less likely (P0.05).A substantial minority of respondents believe that CAM has a role in glaucoma therapy, recommend its use, and ask their patients if they use CAM. Younger doctors are more likely to encourage alternatives; those in practice for20 years are more likely to ask about alternative medicine use, recommend its use, and believe that morbidity usually does not result from the use of alternative treatments.

To examine the effectiveness of argon (ALT) or selective (SLT) laser trabeculoplasty (LTP) in lowering intraocular pressure (IOP) and to determine whether patient-related factors had any impact on outcome.Retrospective review.500 patients treated with LTP over 14 years.This study was conducted at Sunnybrook Health Sciences Centre, University of Toronto. Five patient-related characteristics were used as dependent variables-age, race, gender, pseudophakic status, and pseudoexfoliation. IOP decrease and treatment failure at 12 months were the main outcome variables.500 eyes of 500 patients were included, 350 after ALT and 150 after SLT. The mean ± standard deviation baseline IOP was significantly higher in the patients treated by ALT than in those treated by SLT (24.2 ± 5.4 versus 22.2 ± 4.6, p0.0001) at baseline but not at 1 year (19.6 ± 5.1 versus 19.5 ± 6.1, p = 0.41). When the final IOP was examined by multiple regression analysis, there was a significant effect in favor of ALT over SLT (p = 0.03) and for patients with higher baseline IOPs (p0.0001). No significant effect was found for any of the demographic subgroupings. However, when the outcome variable was success or failure, only the baseline IOP remained significant.Specific patient characteristics do not significantly influence LTP outcome after 12 months of follow-up. The most powerful predictor of either final IOP or clinical success was a higher baseline IOP, but ALT may have a better ability to lower IOP.