Diagnostic Utility of Swept-Source OCT-Based Biometry and Fundus Photographs Compared to Spectral Domain OCT in Center-Involving Diabetic Macular Edema.

PURPOSE: This study was aimed to evaluate the agreement between the swept-source optical coherence tomography (SS-OCT)-based biometry, fundus photographs, and their combination, in comparison to the gold standard spectral-domain optical coherence tomography (SD-OCT) for the detection of center-involving diabetic macular edema (CI-DME). METHODS: We conducted a retrospective cross-sectional study involving 55 subjects (78 eyes) diagnosed with diabetic macular edema (DME) detected clinically and on SD-OCT (Carl Zeiss Meditec AG). Post-mydriatic 45-degree color fundus photograph (Crystal-Vue NFC-700), 1 mm macular scan obtained from SS-OCT-based biometry (IOL-Master 700), and macula cube scan obtained from SD-OCT was used to detect and grade DME into CI-DME and NCI-DME. RESULTS: Our findings revealed that SS-OCT-based biometry was noted to have a high sensitivity of 1 (0.94-1.00) and a specificity of 0.63 (0.31-0.89) in detecting CI-DME compared to the gold standard (SD-OCT). When combined with data from fundus photographs, specificity decreased to 0.32 (0.15-0.53). Fundus photographs alone exhibited a low sensitivity of 0.52 (0.38-0.64) and a specificity of 0.45 (0.16-0.76) in CI-DME detection. CONCLUSION: In conclusion, SS-OCT-based biometry can be used as an effective tool for the detection of CI-DME in diabetic patients undergoing cataract surgery and can serve as a screening tool in centers without SD-OCT facilities.

Diabetic Macular Edema (DME); Center Involving Diabetic Macular Edema (CI-DME); Non-Center Involving Diabetic Macular Edema (NCI-DME); Swept-Source Optical Coherence Tomography (SS-OCT); Spectral-Domain Optical Coherence Tomography (SD-OCT); Anti-Vascular Endothelial Growth Factor (Anti-VEGF); Central Retinal Thickness (CRT); Intra Retinal Fluid (IRF); Sub Retinal Fluid (SRF); Diabetic Retinopathy (DR); Non Proliferative Diabetic Retinopathy (NPDR); Proliferative Diabetic Retinopathy (PDR); Best Corrected Visual Acuity (BCVA); Glycosylated hemoglobin (HbA1c); Mean Spherical Error (MSE); Standard Deviation (SD); Positive Predictive value (PPV); Predictive value (PPV); Negative predictive value (NPV); Area under the Curve (AUC).

Association of eGFR with stages of diabetic retinopathy and age-related macular degeneration in Indian population.

PURPOSE: To investigate the influence of glomerular filtration rate in renal disease decline and its association with diabetic retinopathy (DR) and age-related macular degeneration (ARMD) in patients in South India. METHODS: A population-based cross-sectional study was conducted including participants with DR and ARMD recruited from urban and rural populations. The data collection included medical history, anthropometric measurements, and ophthalmic work-up. The estimated glomerular filtration rate (eGFR) was calculated using the equation of chronic kidney disease-epidemiology collaboration (CKD-EPI). The grading of AMD was done by a single experienced (more than 5 years) vitreoretinal surgeon as per the International ARM Epidemiological Study Group and it was staged based on grading in the worsened eye. RESULTS: A decline in eGFR was observed as the severity of DR increased ( P < 0.001). Baseline characteristics such as age ( P < 0.001), duration of diabetes ( P < 0.001), gender ( P < 0.001), creatinine ( P < 0.001), albumin to creatinine ratio (ACR; P < 0.001), albuminuria ( P = 0.023), blood urea ( P < 0.001), and high-density lipoprotein (HDL; P = 0.003) were found to be statistically significant. The risk for developing DR with CKD was found to be 5 times higher in male patients compared to female patients. Age and high blood urea level, diastolic blood pressure, mild and moderate DR were the risk factors associated with CKD. A decline in eGFR was observed as the severity of ARMD increased ( P < 0.001). The risk factors associated with CKD were age, gender, smoking, alcohol consumed, presence of hypertension, duration of diabetes, systolic and diastolic blood pressure, history of diabetes, body mass index (BMI), serum triglycerides, and serum HDL cholesterol. CONCLUSION: Reduced eGFR values were associated with an increase in the severity of DR and ARMD.

Global warming impact of fluorinated gases in ophthalmic surgeries at a tertiary eye center in India.

PURPOSE: Global warming is one of the greatest health threats of the 21 st century. The ophthalmic sector contributes to the emission of greenhouse gases, thus altering the natural environment. There is currently no data on global emissions of fluorinated gases in ophthalmic surgery. This retrospective study from 2017 to 2021 aims to report the carbon dioxide (CO 2 ) equivalence of sulfur hexafluoride (SF 6 ), hexafluoroethane (C 2 F 6 ), and octafluoropropane (C 3 F 8 ) at a tertiary eye center. METHODS: Data collected from 1842 surgical procedures that used injections of fluorinated gases were analyzed. Environmental impact (global warming potential over 100 years) was calculated by converting milliliters to grams by using modified ideal gas law at standard temperature and pressure for the canisters and then to their CO 2 equivalence. RESULTS: Though 70% of surgeries used C 3 F 8 , the least greenhouse effect causing fluorinated gas, the total carbon emission was 1.4 metric tons. The most common indication was macular hole surgery (36.86%). CONCLUSION: This study paves a step toward analyzing the problem statement, thus awakening us to contemplate options to make ophthalmic surgeries greener.