The role of haemorrhage and exudate detection in automated grading of diabetic retinopathy.

BACKGROUND/AIMS: Automated grading has the potential to improve the efficiency of diabetic retinopathy screening services. While disease/no disease grading can be performed using only microaneurysm detection and image-quality assessment, automated recognition of other types of lesions may be advantageous. This study investigated whether inclusion of automated recognition of exudates and haemorrhages improves the detection of observable/referable diabetic retinopathy. METHODS: Images from 1253 patients with observable/referable retinopathy and 6333 patients with non-referable retinopathy were obtained from three grading centres. All images were reference-graded, and automated disease/no disease assessments were made based on microaneurysm detection and combined microaneurysm, exudate and haemorrhage detection. RESULTS: Introduction of algorithms for exudates and haemorrhages resulted in a statistically significant increase in the sensitivity for detection of observable/referable retinopathy from 94.9% (95% CI 93.5 to 96.0) to 96.6% (95.4 to 97.4) without affecting manual grading workload. CONCLUSION: Automated detection of exudates and haemorrhages improved the detection of observable/referable retinopathy.

Anatomical correlate of a persistent paracentral scotoma after an airbag injury.

Ocular injuries caused by deploying airbags are well-described in the literature and can be either mechanical or chemical in nature. To the authors' knowledge, this is the first report describing an isolated paracentral scotoma noted immediately after an airbag injury. The use of optical coherence tomography revealed an anatomical correlate of the scotoma. The authors discuss a likely mechanism for focal damage to the retina based on these findings.

The efficacy of 5% povidone-iodine for 3 minutes prior to cataract surgery.

PURPOSE: To evaluate the efficacy of 3 minutes of 5% povidone-iodine for skin and conjunctival antisepsis prior to cataract surgery as recommended by the European Society of Cataract and Refractive Surgeons. METHODS: A prospective controlled study of 54 patients undergoing unilateral cataract surgery by phacoemulsification was undertaken. The eye undergoing surgery was prepared with 5% povidone-iodine for 3 minutes. The other eye served as control. Swabs were taken from both eyes prior to application of 5% povidone-iodine and 3 minutes after. Proportion of culture-positive swabs, mean number of species, and growth of isolates on culture were compared at different times and between the two groups. RESULTS: Coagulase-negative Staphylococcus (CoNS) was the main species isolated from culture-positive swabs. Use of 5% povidone-iodine for 3 minutes resulted in a statistically significant reduction in proportion of culture-positive swabs (87% vs 30%, p<0.001), mean number of species (0.96-/+0.47 vs 0.30-/+0.46, p<0.001), and growth of CoNS (heavy: 30% vs 0%, moderate: 23% vs 6%, light: 47% vs 94%, p=0.004). No such changes were observed in the control group. CONCLUSIONS: Use of 5% povidone-iodine for 3 minutes prior to cataract surgery achieves a significant reduction in organisms such as CoNS from lid and conjunctival flora.

Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus.

We report a case of spontaneous intraocular lens (IOL) extrusion in association with scleromalacia 10 years after uneventful endocapsular surgery. The patient had a history of iridocyclitis secondary to herpes zoster ophthalmicus in the affected eye. A minimally invasive approach involving repositioning the IOL and closure with a conjunctival flap resulted in restoration of visual acuity.