Knowledge of Pelvic Floor Dysfunction in African American and Afro-Caribbean Women Seeking Medical Care in a Primary Care Ambulatory Setting.

IMPORTANCE: Approximately one fourth of U.S. community-dwelling women will develop a pelvic floor dysfunction (PFD) within their lifetimes. Prior research has revealed that knowledge of PFD was low to moderate in the general population and lower among Black patients. OBJECTIVE: This study aimed to assess the proficiency of urinary incontinence and pelvic organ prolapse (POP) in self-identified African American and Afro-Caribbean adult (age ≥ 18 years) female patients seeking medical care in our ambulatory setting. STUDY DESIGN: In this cross-sectional study, we administered the Prolapse and Incontinence Knowledge Questionnaire to patients in primary care and gynecology ambulatory settings at an academic medical center in Central Brooklyn. We used a multivariable Poisson regression model to find characteristics of the participants that are associated with proficiency in Prolapse and Incontinence Knowledge Questionnaire domains. RESULTS: A total of 266 survey participants self-identified as African American or Afro-Caribbean. Overall, using a multivariable model, knowledge of POP was significantly higher among African Americans than Afro-Caribbeans, and 75.5% of our patients reported that they would seek information on urinary incontinence and POP from a medical provider (gynecologist or primary care doctor) compared with other alternatives (eg, internet, 19.6%). CONCLUSIONS: These findings highlight subgroups that could benefit from provider-initiated education regarding PFD. Furthermore, although Black patients are often homogenized in research studies, differences may exist within subgroups likely because of varying interplays of structural racism and other social determinants of health, which may serve as an area of future research.

QUANTITATIVE ANALYSIS OF LONGITUDINAL CHANGES IN MULTIMODAL IMAGING OF LATE-ONSET RETINAL DEGENERATION.

PURPOSE: To quantitatively analyze clinically relevant features on longitudinal multimodal imaging of late-onset retinal degeneration to characterize disease progression. METHODS: Fundus autofluorescence (FAF), infrared reflectance, and optical coherence tomography imaging of 4 patients with late-onset retinal degeneration were acquired over 3 to 15 years (20 visits total). Corresponding regions of interest were analyzed on FAF (reticular pseudodrusen [RPD], "speckled FAF," and chorioretinal atrophy) and infrared reflectance (hyporeflective RPD and target RPD) using quantitative measurements, including contour area, distance to fovea, contour overlap, retinal thickness, and texture features. RESULTS: Cross-sectional analysis revealed a moderate correlation (RPD FAF ∩ RPD infrared reflectance = 63%) between contour area across modalities. Quantification of retinal thickness and texture analysis of areas contoured on FAF objectively differentiated the contour types. A longitudinal analysis of aligned images demonstrates that the contoured region of atrophy both encroaches toward the fovea and grows monotonically with a rate of 0.531 mm/year to 1.969 mm/year (square root of area, n = 5 eyes). A retrospective analysis of precursor lesions of atrophy reveals quantifiable progression from RPD to speckled FAF to atrophy. CONCLUSION: Image analysis of time points before the development of atrophy reveals consistent patterns over time and space in late-onset retinal degeneration that may provide useful outcomes for this and other degenerative retinal diseases.