Comparison of acquisition rate and agreement of axial length with two swept-source optical coherence tomographers and a partial coherence interferometer.

PURPOSE: To assess the acquisition rate and agreement of axial length (AL) measurements with the OA-2000, Anterion, and IOLMaster 500 in cataractous patients. METHODS: In total, 298 eyes of 191 cataractous patients were enrolled and scanned with the three devices in random order. The success rate of AL measurements per device was calculated and a chi-square test was utilized to identify the differences in acquisition rate between the three devices. Logistic regression analysis was applied to evaluate the association of different cataract types and severity with the AL measurement acquisition rate. Bland-Altman plots were mapped to appraise the agreement of AL values. RESULTS: AL measurements were successfully achieved in 288 eyes (96.64%) with the OA-2000, in 282 eyes (94.30%) with the Anteiron, and in 246 eyes (82.55%) with the IOLMaster 500. Significant differences in the acquisition rate were found between either of the SS-OCT devices and IOLMaster 500 by chi-square analysis (P < 0.001). No significant difference was noted between OA-2000 and Anterion. Increasing severity of posterior subcapsular cataract was associated with a higher failure rate with the IOLMaster 500. Bland-Altman analysis identified good agreement between the three biometers with narrow 95% limits of agreement. CONCLUSIONS: The OA-2000 and Anterion showed similarly higher acquisition rate of AL measurements than IOLMaster 500 in cataractous patients. Good agreement for AL values was found between the three biometers in cataractous patients.

Repeatability of a new swept-source optical coherence tomographer and agreement with other three optical biometers.

PURPOSE: To investigate the repeatability of Anterion and compare the agreement of ocular biometric measurements and predicted intraocular lens (IOL) powers with other three optical biometers. METHODS: Flat keratometry (Kf), steep keratometry (Ks), J0 and 45 vectors, central cornea thickness (CCT), anterior chamber depth (ACD), and axial length (AL) from the Anterion, IOLMaster 700, Lenstar LS 900, and OA-2000 were recorded. The IOL powers were calculated with the Hoffer Q, Holladay 1, SRK/T, and Haigis formulas. The repeatability was evaluated using the within-subject standard deviation (Sw), repeatability coefficient (RC), coefficient of variation (COV), and intraclass correlation coefficient (ICC). Inter-device agreement between the four biometers was assessed with the 95% limits of agreement. RESULTS: In total, 101 right eyes of 101 participants were enrolled. The Anterion showed good repeatability for all the included biometric parameters with all the CoV ≤ 0.30% and ICC ≥ 0.930 except for J45 with moderate repeatability (ICC was 0.849). Good agreement was found among the four devices for Kf, Ks, J0, J45, ACD, and AL. Generally, wide 95% LoA was found for the predicted IOL powers with the four IOL calculation formulas between the four devices. CONCLUSIONS: The Anterion showed good repeatability of biometric measurements for most parameters. Good agreement among the four optical biometers was achieved for all the parameters except for CCT and the predicted IOL power. The AL values exhibited the best repeatability with Anterion and the best agreement among the biometers in our study.

Human Immunodeficiency Virus Infection-Associated Mortality during Pulmonary Tuberculosis Treatment in Six Provinces of China.

OBJECTIVE: To investigate the risk factors attributable to tuberculosis-related deaths in areas with human immunodeficiency virus (HIV) infection epidemics. METHODS: A prospective cohort study of newly registered patients in tuberculosis (TB) dispensaries in six representative Chinese provinces was conducted from September 1, 2009 to August 31, 2011. Risk factors for TB-associated death were identified through logistic regression analysis. RESULTS: Of 19,103 newly registered pulmonary TB patients, 925 (4.8%) were found to be HIV-positive. Miliary TB and acid-fast bacillus smear-negative TB were more common among these patients. Out of a total of 322 (1.7%) deaths that occurred during TB treatment, 85 (26%) of the patients were co-infected with HIV. Multivariate analysis revealed that HIV infection was the strongest predictor of death [adjusted odds ratio (aOR) 7.86]. Other significant mortality risk factors included presentation with miliary TB (aOR 4.10; 95% confidence interval: 2.14-7.88), ⋝35 years of age (aOR 3.04), non-Han ethnicity (aOR 1.67), and farming as an occupation (aOR 1.59). For patients with TB/HIV co-infection, miliary TB was the strongest risk factor for death (aOR 5.48). A low CD4 count (⋜200 cells/µL) (aOR 3.27) at the time of TB treatment initiation and a lack of antiretroviral therapy (ART) administration (aOR 3.78) were also correlated with an increased risk of death. CONCLUSION: Infection with HIV was independently associated with increased mortality during TB treatment. Offering HIV testing at the time of diagnosis with TB, early TB diagnosis among HIV/acquired immunodeficiency syndrome patients, and the timely provision of ART were identified as the key approaches that could reduce the number of HIV-associated TB deaths.

Biomechanical comparison of anterior lumbar screw-plate fixation versus posterior lumbar pedicle screw fixation.

Anterior lumbar interbody fusion (ALIF) followed by posterior pedicle screw fixation (PSF) in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by anterior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirmation. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate (ALLSP) by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar specimens (L4-L5) were assigned to four groups: ALIF+PSF group, ALIF+ALLSP (both fixed) group, ALIF group and an untreated control (both non-fixed) group. The first three groups received implantation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bending, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups (P=0.000 for all). The ALIF+ALLSP group had significantly greater axial stiffness under applied axial compression and significantly less angular displacement under rotational forces than the ALIF+PSF group. The angular displacement of the ALIF+ALLSP group was less under flexion than that of the ALIF+PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the anterior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the stability of ALIF.

Comparison of Refractive Prediction Accuracy With Three Optical Devices.

PURPOSE: To investigate refractive prediction accuracy with the OA-2000 (Tomey), Anterion (Heidelberg Engineering), and IOLMaster 500 (Carl Zeiss Meditec AG) in patients with cataract. METHODS: Patients with cataract referred for phacoemulsification were enrolled and scanned with the OA-2000, Anterion, and IOLMaster 500 in random order. The success rate of axial length (AL) measurements per device was calculated and a chi-square test was used to identify the differences in acquisition rate between the three devices. The Bland-Altman method was used to appraise the agreement of biometric parameters between the three devices. Four different formulas (Barrett Universal II [BUII], Haigis, Holladay 1, and SRK/T) were included in the study. The parameters of refractive prediction accuracy comprised predictive error (PE), absolute PE (AE), and percentages of eyes with a PE within ±0.50, ±0.75, and ±1.00 diopters (D). RESULTS: The acquisition rates of AL measurements with the OA-2000 and Anterion were 97.35% and 94.70%, respectively (chi-square = 3.82, P > .05). A significantly lower acquisition rate of 84.82% was obtained with the IOLMaster 500 compared with the other two devices (P < .05). Bland-Altman analysis identified good agreement between the three biometers with narrow 95% limits of agreement for flat and steep keratometry (K1 and K2), anterior chamber depth (ACD), and AL. For PE, only the differences between the Anterion and IOLMaster 500 with the Barrett UII and Haigis formulas were statistically significant (P < .05). The three devices revealed no statistically significant differences in MAE, MedAE, and the proportion of eyes with a PE within ±0.50, ±0.75, and ±1.00 D (P > .05). CONCLUSIONS: The OA-2000 and Anterion showed a similarly higher acquisition rate of AL measurements than the IOLMaster 500 in patients with cataract. Good agreement for K1, K2, ACD, and AL was found between the three biometers. Regarding refractive prediction accuracy, the Anterion did not significantly outperform both the OA-2000 and IOLMaster 500. [J Refract Surg. 2023;39(1):48-55.].

[Comparison of Lenstar and IOLMaster for intraocular lens power calculation].

OBJECTIVE: To evaluate the precision of Intraocular Lens (IOL) power calculation using a new optical low-coherence reflectometry biometer (Lenstar) and compare the results with those obtained with IOLMaster. METHODS: It was a prospective controlled study. Biometry measurements in 157 eyes of 98 cataract patients were performed by the same examiner with Lenstar and IOLMaster. Axial length (AL), corneal keratometry readings (Km), and anterior chamber depth (ACD) were obtained. Correlation and differences of biometry measurements obtained with two biometers were made. Intraocular Lens power were calculated using 4 formulas and the corresponding IOL constants, the target was emmetropia. Then statistical analysis was proceeded. RESULTS: Axial length were (23.65 ± 1.17) mm and (23.65 ± 1.16) mm respectively, Km (44.15 ± 1.58) D and (44.17 ± 1.58) D respectively by Lenstar and IOLMaster and no statistical differences were found (P > 0.05). ACD were (3.09 ± 0.41) mm and (3.05 ± 0.41) mm respectively by Lenstar and IOLMaster and there was statistical difference between them (P = 0.001). All biometry measurements showed good linear correlation (r > 0.9, P < 0.001). IOL power calculations with biometry values between Lenstar and IOLMaster using the 4 formulas showed good agreement. The least difference was obtained with formula SRK/T and the most with formula Haigis. CONCLUSIONS: Lenstar can provide precise and noncontact biometry measurements easily and safely, which are welcome by patients. Providing precise and reliable biometry measurements of cataract patients for Intraocular Lens power calculation, it shows good agreement with IOLMaster and the two biometers can be interchanged.

Repeatability and Agreement of Two Swept-Source Optical Coherence Tomographers for Anterior Segment Parameter Measurements.

PURPOSE: The aim was to evaluate the repeatability and agreement of two swept-source optical coherence tomographers for anterior segment parameters in healthy subjects. PATIENTS AND METHODS: Automated mark of scleral spur and angle recess for the CASIA2 and manual mark of scleral spur and angle recess for the Anterion were performed, and then the measurement values of the related parameters were automatically generated. Subjects with pupil diameter (PD) differing by <15% between the 2 devices were included. PD, lens vault (LV), anterior chamber depth (ACD), angle to angle distance (ATA), anterior chamber width (ACW), anterior chamber angle (ACA), angle opening distance (AOD), and trabecular iris space area (TISA) were measured in the horizontal images with both CASIA2 and Anterion. Intraclass correlation coefficient (ICC) was used to evaluate intradevice repeatability. Bland-Altman plots were performed to assess the agreement between the 2 devices. RESULTS: Thirty-five right eyes of 35 subjects were included with a mean age of 25.60±3.00 years. The CASIA2 showed moderate to good intradevice repeatability (ICCs ranged from 0.786 to 0.989) whereas the Anterion showed good intradevice repeatability (ICCs ranged from 0.921 to 0.998) for anterior segment parameters. Compared with the CASIA2, the Anterion offered larger values of ACA500/750, AOD500/750, and TISA500/750 but smaller values of PD, LV, ACD, ATA, and ACW. Good agreement for PD, ACD, ATA, and ACW was detected with 95% limits of agreement of -1.02 to 1.02 mm, -0.11 to 0.14 mm, -0.17 to 0.19 mm, -0.13 to 0.28 mm, respectively. Poor agreement for LV, ACA500/750, AOD500/750, and TISA500/750 was achieved with the 2 devices. CONCLUSIONS: Anterion outperformed CASIA2 on intradevice repeatability. While agreement was noted for some parameters using manual Anterion and automated CASIA2 approaches, poor agreement of LV and angle parameters indicates that measurements from these optical coherence tomography devices should not be considered interchangeable.

Topography-Guided Versus Wavefront-Optimized LASIK for Myopia With and Without Astigmatism: A Meta-analysis.

PURPOSE: To evaluate the differences in efficacy, predictability, safety, and visual quality between topography-guided customized ablation treatment (TCAT) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) for the treatment of myopia with and without astigmatism. METHODS: A comprehensive literature search of PubMed, Embase, the Cochrane library, Web of Science, and ClinicalTrials was used to identify randomized controlled trials (RCTs) comparing TCAT-LASIK with WFO-LASIK for myopia with and without astigmatism up to September 2020. The references of all searched literature were checked as supplements. Literature was screened according to the inclusion and exclusion criteria and relative data were extracted. RevMan software version 5.3.0 (Cochrane Collaboration) was used for meta-analysis. RESULTS: A total of seven RCTs (1,168 eyes) were included. There were no statistically significant differences in the ratio of uncorrected distance visual acuity of 20/20 or better (relative risk [RR] = 1.01, 95% CI [0.97 to 1.06], P = .64) and 20/16 or better (RR = 0.96, 95% CI [0.80 to 1.16], P = .69). Compared with WFO-LASIK, TCAT-LASIK achieved a higher proportion of postoperative manifest refractive spherical equivalent within ±0.50 diopters of the target (RR = 1.06, 95% CI [1.02 to 1.11], P = .003) and less surgically induced higher order aberrations (weighted mean difference [WMD] = -0.11, 95% CI [-0.15 to -0.0], P < .00001), spherical aberrations (WMD = -0.04, 95% CI [-0.05 to -0.03], P < .00001), and coma (WMD = -0.15, 95% CI [-0.28 to -0.01], P = .03). No patient lost two or more lines of distance-corrected visual acuity postoperatively in the two groups. CONCLUSIONS: This meta-analysis suggests that both TCATLASIK and WFO-LASIK show excellent efficacy, predictability, and safety for myopia. TCAT-LASIK exhibited more accurate postoperative refraction predictability and less surgically induced higher order aberrations, spherical aberrations, and coma. More randomized, prospective, and large sample-sized studies are needed to confirm these conclusions in the long term. [J Refract Surg. 2021;37(10):707-714.].

Combining domestic and foreign investment to expand tuberculosis control in China.

Jia and colleagues describe how a combination of increased domestic funding, supplemented by foreign loans and donations since 2002, have led to a dramatic increase in tuberculosis case finding in China.

Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.

BACKGROUND: A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC. METHODS AND FINDINGS: A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (-1.04, 24.29), P = 0.072]. CONCLUSION: Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR. TRIAL REGISTRATION: ClinicalTrials.gov NCT01772277.

[Study on the risk factors of tuberculosis in four cities and provinces in China].

OBJECTIVE: To investigate the influencing factors on tuberculosis (TB) in four provinces in the eastern and central parts of China. METHODS: From Nov. 2009 to Feb. 2011, three population-based field surveys were conducted among the resident population in several townships/streets in Guangdong, Hunan and Jiangsu provinces and Shanghai municipality to collect TB-related information. 474 sputum smear positive TB patients and 1896 controls were randomly selected from the population under study and each case was matched by province, age and sex using a frequency matching method. Single-variable and multiple non-conditional logistic regression modeling were applied for data analysis, and odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated. RESULTS: Data from Single-variable analysis showed that TB history, history of exposure to TB, DM history, immigrant population and per-capita living space were risk factors for TB, and high level of education was protective factors. RESULTS: from multiple logistic regression showed that the risk factors of TB would include the following items: history of having had TB (OR = 52.356, 95%CI: 18.956 - 144.607), living space over 50 m(2)per-capita (OR = 8.742, 95%CI: 1.107 - 69.064), history of exposure to TB (OR = 6.083, 95%CI: 2.336 - 15.839) and being immigrants (OR = 3.306, 95%CI: 1.907 - 5.734), while having had high degree of education as the protective factor of TB (OR = 0.284, 95%CI: 0.110 - 0.733). CONCLUSION: Control programs targeting those ever having TB patients and contacts to TB patients as well as immigrants should be strengthened.

[Analysis on the spatial clustering of tuberculosis based on provincial level in China from 2008 to 2010].

OBJECTIVE: To study the tuberculosis clustering areas and the changing trend, from 2008 to 2010, so as to provider the reference for tuberculosis control. METHODS: Global spatial autocorrelation and SaTScan methods were used to detect and analyse the spatial clustering of total tuberculosis notification rate and the new smear-positive pulmonary tuberculosis notification rate, at the provincial level from 2008 to 2010. RESULTS: The spatial clustering (SC) phenomenon was significant on total notification rate and new smear-positive pulmonary tuberculosis notification rate from 2008 to 2010 (P < 0.01). The coverages of clustering areas on total notification rate showed a reduction from 19 provinces to 14 provinces, distributed in the south, west and north-east areas of China. The coverages of clustering areas on new smear-positive pulmonary tuberculosis notification rate concentrated in 14 provinces which covered the south and north-east of China. CONCLUSION: The disease burden and the risk of transmission in the clustering areas of tuberculosis both located in the south and the north-east of China. The disease burden of tuberculosis was high in the west of China, but not the areas with high risk of transmission.

[Construction of surveillance and early-warning-index-system on tuberculosis in China].

OBJECTIVE: To establish the surveillance and warning index system corresponding with the epidemic characteristics of tuberculosis, in China. METHODS: Literature review and expert meeting were conducted to formulate the preliminary index system frame. Delphi method was used for screening the index and determining the weight of each index. RESULTS: Two-round Delphi consultations were performed. The activity coefficients were 87.0%, 90.0% respectively, with means of authority coefficient as 0.850±0.055 and 0.917±0.017, respectively. Mean scores of the index were 7.063±1.435, 8.156±0.611 respectively, with the means of coefficient of variation as 0.352±0.161 and 0.170±0.057 respectively. The harmony coefficients were 0.322 (χ2=499.472, P<0.05) and 0.393 (χ2=241.126, P<0.05) respectively. After the two-round consultation, the tuberculosis monitoring and warning index system was developed, including 4 first-class indicators, 9 second-class indicators and 48 third-class indicators. CONCLUSION: An index system was established for tuberculosis monitoring and early warning that could provide evidence for tuberculosis prevention and control as well as for the forecasting and warning model of the disease.

[Spatial analysis on new smear-positive pulmonary tuberculosis in China, 2003 - 2008].

OBJECTIVE: To analyze the notification status on new sputum-smear positive pulmonary tuberculosis (TB) over the recent years in China, and identify the clusters to address the related reasons. METHODS: To spatially and temporally scan the data regarding notification, and to display the results via geographic information system. RESULTS: (1) Spatial analysis identified 6 clusters and their relative risks ranged from 1.03 to 1.83 with statistical significance; (2) Temporal analysis identified there were clusters between 2005 and 2007 in terms of notification on new sputum-smear positive pulmonary TB, and the relative risk was 1.27 (P = 0.001); (3) Spatial and temporal analysis identified 2 clusters and the relative risks of the first class cluster and the second class cluster were 1.35 and 1.49 respectively with statistical significance. Provinces included in the first class cluster were basically the same as these in spatial analysis. CONCLUSION: Distribution of the notification on new sputum-smear positive pulmonary TB was not stochastic at space, time and space-time, and clusters did exist in China.

[Surveillance and analysis of the pediatric pulmonary tuberculosis in new smear positive cases from 1992 to 2004 in China].

OBJECTIVE: To analyze the results of surveillance for new smear positive pediatric tuberculosis (TB) cases at the age of 0 to 14 years in China, to understand the trend of prevalence and finding of the new smear positive pediatric cases with TB, to illuminate the significance of surveillance for pediatric TB in TB epidemiology and to explore how to prevent and control pediatric TB with the modern TB control strategy (directly observed treatment, short-course, DOTS). METHODS: According to the register of new smear positive pediatric TB cases at the age of 0 to 14 years in the National Annual Surveillance Reporting from 1992 - 2004, the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in China, the notification rate of new smear positive pediatric TB, the case detection rate of new smear positive TB in the eastern, central and west parts of China, in Beijing, Tianjin and Shanghai municipalities and 13 provinces where the modern TB control strategies have been implemented in 1992 and 15 provinces where the strategies have not been implemented except Beijing, Tianjin and Shanghai municipalities, were analyzed. RESULTS: From 1992 to 2004, 31,358 new smear positive pediatric cases with TB at the age of 0 to 14 years were registered, among whom 14,727 were males (47%) and 16,631 were females (53%). The proportion of new smear positive pediatric TB cases among all the new smear positive TB cases was 1.26%, while the proportion among males was 0.89% and among females was 2.03%. The proportion among females was higher than that among males (P < 0.01). The notification rate of new smear positive pediatric cases with TB was between 0.42/100,000 and 1.08/100,000. Among the new smear positive pediatric TB cases, 44.9% were from western parts of China, followed by central and eastern parts of China and only 0.9% were from Beijing, Tianjin and Shanghai municipalities. Excluding Beijing, Tianjin and Shanghai municipalities, 13 provinces where DOTS was implemented since 1992 were compared with the other 15 provinces. The notification rate of new smear positive TB was respectively 75% and 25%. Western region of China was listed on the top in the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in every year. CONCLUSION: Among the registered new smear positive pediatric cases with TB, the number of females was higher than that among females and the proportion among males was also higher than that among males. The number of new smear positive pediatric TB cases in western parts of China was higher than that in central and eastern parts of China and the number in DOTS area was higher than that in non-DOTS area, which meant that the case detection of pediatric TB was associated with TB epidemic and DOTS strategy. Thus, in the implementation of DOTS, strengthening the prevention and control of pediatric TB, tracing the infection source of pediatric TB has certain impact on the TB epidemiological status.

[The impact of geriatric tuberculosis patients on the tuberculosis control strategy in China].

OBJECTIVE: To study the current status of geriatric tuberculosis (TB) and its impact on TB control program under the directly observed treatment short-course (DOTS) strategy in China. METHODS: Using the prevalence information regarding the epidemiology of geriatric TB from the National Random Survey in 2000, a case-control study was carried out to analyze the case detection, treatment and management of geriatric TB patients between DOTS area and non-DOTS area. RESULTS: The prevalence of sputum smear positive (SS+) in the age group of 65 or above was 440/100 000 which was 3.6 times of the average prevalence of SS+ of all age groups. Geriatric SS+ patients took up 28.8% of all the TB patients in 13 provinces with implementation of DOTS and 28.9% in 15 provinces without. The population of TB case in the age group 65 or above occupied 11.4% of all the newly registered SS+ case in 13 DOTS provinces from 1992 to 2000. CONCLUSION: The prevalence of geriatric SS+ was high. In both DOTS and non-DOTS areas, the proportion of geriatric SS+ was high but the registration rate of new SS+ was low among all the age groups. Both high prevalence and low case detection rate of geriatric TB became main issues to be under concern in the TB control strategy in China.