Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers.

PURPOSE: The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. METHODS: The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. RESULTS: The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). CONCLUSION: Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci-garette smoking.

Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers / Avaliação da superfície ocular e das alterações morfológicas nas glândulas meibomianas através de meibografia sem contato em usuários de cigarros eletrônicos

ABSTRACT Purpose: The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. Methods: The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. Results: The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). Conclusion: Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci­garette smoking.

RESUMO Objetivo: Avaliar a superfície ocular e a morfologia da glândula meibomiana em usuários de cigarros eletrônicos. Métodos: Foram avaliadas através de meibografia Sirius as pálpebras superiores e inferiores de 25 usuários de cigarros eletrônicos do sexo masculino e 25 pacientes não usuários saudáveis, também do sexo masculino. A perda nas glândulas meibomianas foi calculada automaticamente com o módulo de software de imagem de meibografia Phoenix. O resultado foi obtido como perda percentual. O questionário Ocular Surface Disease Index (OSDI), o teste do tempo de ruptura lacrimal e o teste de Schirmer II foram administrados em todos os casos. Resultados: A duração média do uso de cigarros eletrônicos foi de 4,9 ± 0,9 anos (intervalo de 3,4-7 anos). O valor médio do teste de Schirmer II foi de 9,16 ± 2,09 mm no grupo de usuários de cigarros eletrônicos e de 11,20 ± 2,14 mm no grupo controle (p=0,003). O valor médio do teste do tempo de ruptura lacrimal foi de 6,96 ± 2,31 segundos no grupo de usuários de cigarros eletrônicos e 9,84 ± 2,13 segundos no grupo controle (p=0,002). O valor médio do Ocular Surface Disease Index foi de 28,60 ± 6,54 e 15,16 ± 7,23 para os grupos de usuários de cigarros eletrônicos e controle, respectivamente (p<0,001). Na meibografia de Sirius, a perda média para a pálpebra superior foi de 23,08 ± 6,55% para o grupo de usuários de cigarros eletrônicos e 17,60 ± 4,94% para o grupo controle (p=0,002), e a perda média para a pálpebra inferior foi de 27,84 ± 5,98% e 18,44 ± 5,91%, respectivamente (p<0,001). Além disso, foi observada uma correlação positiva significativa entre a taxa de perda na meibografia palpebral superior e inferior com a duração do tabagismo eletrônico, respectivamente de (r=0,348, p<0,013) e (r=0,550, p<0,001). Conclusão: O uso prolongado de cigarros eletrônicos causa danos às glândulas meibomianas. Portanto, esses danos devem ser considerados em distúrbios da superfície ocular devidos ao uso desses dispositivos.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study.

BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Repeatability and reproducibility of automatic segmentation of retinal layers in healthy subjects using Spectralis optical coherence tomography.

PURPOSE: To evaluate the repeatability and reproducibility of automatic segmentation in healthy subjects using a Spectralis optical coherence tomography (OCT) system. METHODS: A total of 60 eyes from 60 patients were included in this prospective study. Spectral-domain optical coherence tomography images were generated using the Spectralis OCT system. An automated algorithm was used to segment the macular retina into nine layers and evaluate the thickness of each layer in the foveal, inner, and outer Early Treatment Diabetic Retinopathy Study (ETDRS) subfield rings. The eyes were imaged three times by an examiner to assess intraobserver repeatability and imaged once by a second examiner to assess interobserver reproducibility. The first scan was used for reference, whereas the second and third scans were collected using the device's follow-up mode. Intraclass correlation coefficients (ICCs) of repeatability and reproducibility were analyzed. RESULTS: The examiners achieved high repeatability and reproducibility for all parameters. Good agreement was found for all parameters in all ETDRS subdivisions with an ICC of >0.96 for all measurements. CONCLUSION: It is possible to obtain cross-sections from the same location using the device's follow-up mode, making it virtually impossible to distinguish between repeated measurements taken with the device by different examiners.

Repeatability and reproducibility of automatic segmentation of retinal layers in healthy subjects using Spectralis optical coherence tomography / Repetibilidade e reprodutibilidade da segmentação automática de camadas retinianas em sujeitos saudáveis com tomografia de coerência óptica Spectralis

ABSTRACT Purpose: To evaluate the repeatability and reproducibility of automatic segmentation in healthy subjects using a Spectralis optical coherence tomography (OCT) system. Methods: A total of 60 eyes from 60 patients were included in this prospective study. Spectral-domain optical coherence tomography images were generated using the Spectralis OCT system. An automated algorithm was used to segment the macular retina into nine layers and evaluate the thickness of each layer in the foveal, inner, and outer Early Treatment Diabetic Retinopathy Study (ETDRS) subfield rings. The eyes were imaged three times by an examiner to assess intraobserver repeatability and imaged once by a second examiner to assess interobserver reproducibility. The first scan was used for reference, whereas the second and third scans were collected using the device's follow-up mode. Intraclass correlation coefficients (ICCs) of repeatability and reproducibility were analyzed. Results: The examiners achieved high repeatability and reproducibility for all parameters. Good agreement was found for all parameters in all ETDRS subdivisions with an ICC of >0.96 for all measurements. Conclusion: It is possible to obtain cross-sections from the same location using the device's follow-up mode, making it virtually impossible to distinguish between repeated measurements taken with the device by different examiners.

RESUMO Objetivo: Avaliar a repetibilidade e a reprodutibilidade da segmentação automática com tomografia de coerência óptica Spectralis em indivíduos saudáveis. Métodos: Foram incluídos neste estudo prospectivo um total de 60 olhos de 60 pacientes. As imagens de tomografia de coerência óptica de domínio espectral (SD-OCT) foram geradas com Spectralis OCT (Heidelberg Engineering, Heidelberg, Alemanha). Um algoritmo automatizado foi utilizado para segmentar a retina macular em nove camadas e quantificar a espessura de cada camada em anéis de subcampo ETDRS fovetais, internos e externos. Os olhos de cada paciente foram imaginados três vezes pelo primeiro examinador para avaliar a repetibilidade intra-observador e uma vez pelo segundo examinador para avaliar a reprodutibilidade entre observadores. A primeira verificação foi definida como a varredura de referência, enquanto a segunda e a terceira varredura foram as varreduras de seguimento e foram realizadas com o uso do modo de acompanhamento, respectivamente. O coeficiente de correlação intraclasse (ICC) de repetibilidade e reprodutibilidade foi analisado. Repetibilidade e reprodutibilidade das medidas obtidas foram analisadas utilizando o coeficiente de correlação intraclasse. Resultados: Os examinadores alcançaram alta repetibilidade e reprodutibilidade para todos os parâmetros. Foi encontrado um bom acordo para todos os parâmetros em todas as subdivisões de ETDRS com um coeficientes de correlação intraclasse superior a 0,96 para todas as medições. Conclusão: É possível obter seções transversais do mesmo local usando o modo de acompanhamento, o que torna praticamente impossível distinguir entre medições repetidas do dispositivo independentemente do examinador.