ABSTRACT
This study was performed as a head-to-head comparison of the performance characteristics of (1) two SARS-CoV-2-specific rapid antigen assays with real-time PCR as gold standard as well as (2) a fully automated high-throughput transcription-mediated amplification (TMA) assay and real-time PCR in a latent class analysis-based test comparison without a gold standard with several hundred samples in a low prevalence "real world" setting. Recorded sensitivity and specificity of the NADAL and the LumiraDx antigen assays and the Hologic Aptima SARS-CoV-2 TMA assay were 0.1429 (0.0194, 0.5835), 0.7644 (0.7016, 0.8174), and 0.7157 (0, 1) as well as 0.4545 (0.2022, 0.7326), 0.9954 (0.9817, 0.9988), and 0.9997 (not estimable), respectively. Agreement kappa between the positive results of the two antigen-based assays was 0.060 (0.002, 0.167) and 0.659 (0.492, 0.825) for TMA and real-time PCR. Samples with low viral load as indicated by cycle threshold (Ct) values > 30 were generally missed by both antigen assays, while 1:10 pooling suggested higher sensitivity of TMA compared to real-time PCR. In conclusion, both sensitivity and specificity speak in favor of the use of the LumiraDx rather than the NADAL antigen assay, while TMA results are comparably as accurate as PCR, when applied in a low prevalence setting.
ABSTRACT
Tear gland diseases are comparatively rare in daily ophthalmological practice. The aim of this article is on the one hand to present the necessary basic knowledge and on the other hand to draw a bow to important current publications on the subject in order to provide the reader with sufficient knowledge for daily practice after reading it.Inflammatory (acute and chronic specific dacryoadenitis, idiopathic dacryoadenitis), neoplastic (epithelial and nonepithelial) and structural (cysts etc.) are presented.Diagnostically, the importance of (open) biopsy has increased again in recent years. Only the pleomorphic adenoma of the lacrimal gland has to be removed in-toto in order to avoid a recurrence or malignant degeneration which is difficult to control curatively. Differential diagnostic aids are explained in detail.
Subject(s)
Adenoma, Pleomorphic , Dacryocystitis , Eye Neoplasms , Lacrimal Apparatus Diseases , Lacrimal Apparatus , Humans , Neoplasm Recurrence, LocalABSTRACT
PURPOSE: To develop and compare different analytic approaches for quantifying ischemia in OCT-angiography (OCTA), including vessel-based approaches and intercapillary area analysis. METHODS: En face OCTA (6 × 6) images of the superficial plexus of 20 healthy eyes and 20 eyes with different ischemic retinal diseases were analyzed retrospectively. Included retinal diseases were diabetic retinopathy (n = 9), central (n = 5) and branch retinal vein occlusion (n = 4), hypertensive retinopathy (n = 1), and occlusive retinal vasculitis in sarcoidosis (n = 1). Vessel-based approaches consisted of the mean gray scale, perfusion density, and vessel density. Intercapillary areas (ICAs) were analyzed measuring the distance of each intercapillary pixel from the surrounding vessels. In particular, we applied a vector method to measure the shortest, the mean, and the longest distance in eight predefined directions. Size of ICAs was determined applying different global or local distance thresholds. RESULTS: All approaches revealed significant differences between ischemic and healthy retinae (P < 0.001, with Bonferroni-Holm correction P = 0.001-0.025; Wilcoxon-Mann-Whitney test). Discrimination between the healthy and ischemic retinae based on ROC curves was best in the ICA analysis using a locally set threshold of the shortest distance. CONCLUSIONS: In the present study, ICA analysis was superior to vessel-based approaches in the quantification of retinal ischemia when defining a local or global distance threshold. TRANSLATIONAL RELEVANCE: In order to establish OCTA imaging in everyday clinical and scientific practice, standardized, device-independent image analysis methods are necessary.
