Exploring the Feasibility of Estimating Intraocular Pressure Using Vibrational Response of the Eye: A Methodological Approach.

This study addresses the limitations of current tonometry techniques by exploring vibroacoustic properties for estimating intraocular pressure (IOP), a key diagnostic parameter for monitoring glaucoma-a significant risk factor for vision loss. Utilizing vivo porcine eyeballs, we investigated the relationship between IOP and the nonlinear vibration transfer function ratio (NVTFR). Through applying varying vibration levels and analyzing responses with transfer function analysis and univariate regression, we identified a strong negative correlation between NVTFR and IOP, evidenced by a Pearson correlation coefficient of -0.8111 and significant results from generalized linear model (GLM) regression (p-value < 0.001). These findings indicate the potential of NVTFR as a vital indicator of IOP changes. Our study highlights the feasibility of using vibroacoustic properties, specifically NVTFR, to measure IOP. While further refinement is necessary for in vivo application, this approach opens new possibilities for non-invasive and patient-friendly IOP monitoring, potentially enhancing ophthalmology diagnostic techniques and providing a foundation for future research and development in this critical area.

Trends in the Prevalence of Blindness and Correlation With Health Status in Korean Adults: A 10-Year Nationwide Population-Based Study.

BACKGROUND: Contemporary data on vision impairment form an important basis for public health policies. However, most data on the clinical epidemiology of blindness are limited by small sample sizes and focused not on systemic conditions but ophthalmic diseases only. In this study, we examined the ten-year trends of blindness prevalence and its correlation with systemic health status in Korean adults. METHODS: This study investigated 10,000,000 participants randomly extracted from the entire Korean population (aged ≥ 20 years) who underwent a National Health Insurance Service health checkup between 2009 and 2018. Participants with blindness, defined as visual acuity in the better-seeing eye of ≤ 20/200, were identified. The prevalence of blindness was assessed, and the systemic health status was compared between participants with blindness and without blindness. RESULTS: The mean prevalence of blindness was 0.473% (47,115 blindness cases) and tended to decrease over ten years (0.586% in 2009 and 0.348% in 2018; P < 0.001). The following factors were significantly associated with blindness: female sex, underweight (body mass index < 18.5), high serum creatinine (> 1.5 mg/dL), and bilateral hearing loss. In addition, except for those aged 30-39 and 40-49 years, high fasting glucose (≥ 126 mg/dL) and low hemoglobin (male: < 12 g/dL, female: < 10 g/dL) were significantly correlated with prevalent blindness. CONCLUSION: Our ten-year Korean nationwide population-based study suggested a gradual decrease in the prevalence of blindness and its association with specific systemic health status. These conditions might be the cause or consequence of blindness and can be used as a reference for the prevention and/or rehabilitation of blindness to establish public health policies.

Disc hemorrhage following peripapillary retinoschisis in glaucoma: a case report.

BACKGROUND: Disc hemorrhage (DH) is an important factor often associated with the development and especially progression of glaucoma. In contrast, some studies have reported peripapillary retinoschisis in glaucoma, but it is not recognized as a pathognomonic finding, and opinions on the clinical significance of retinoschisis are not consistent. Here,we present the case of DH following peripapillary retinoschisis in the same area within the same glaucomatous eye. CASE PRESENTATION: A 70-year-old man with high intraocular pressure (IOP) was referred to the glaucoma clinic. At the time of the baseline study, the IOP was 30mmHg, and peripapillary retinoschisis was discovered at 7 o'clock on the periphery of the optic nerve with swept-source optical coherence tomography. Accompanying retinal nerve fiber layer defect were manifest in the inferotemporal part with red-free fundus photography. Under the impression of open-angle glaucoma, we prescribe latanoprost ophthalmic solution. Eight months later, the IOP was 17mmHg, and the peripapillary retinoschisis had disappeared. DH was observed in the inferotemporal area in the same direction as that of the previous peripapillary retinoschisis. CONCLUSIONS: The case presented here are the first to report on the relationship between peripapillary retinoschisis and DH. Hopefully future studies will reveal the actual connection between peripapillary retinoschisis and DH.

Rate of central corneal thickness changes in primary angle closure eyes: long-term follow-up results.

BACKGROUND: Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT. METHODS: In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis. RESULTS: A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was - 0.72 ± 0.22 µm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was - 0.53 ± 0.25 µm/yr (P = 0.034) and that of the surgical trabeculectomy group was - 1.32 ± 0.43 µm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was - 0.81 ± 0.31 µm/yr (P = 0.009) and that in patients without an attack was - 0.63 ± 0.30 µm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001). CONCLUSIONS: We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.

Automated Real-Time Evaluation of Condylar Movement in Relation to Three-Dimensional Craniofacial and Temporomandibular Morphometry in Patients with Facial Asymmetry.

The aim of this study was to investigate the correlation between craniofacial morphology, temporomandibular joint (TMJ) characteristics, and condylar functional movement in patients with facial asymmetry using an up-to-date automated real-time jaw-tracking system. A total of 30 patients with mandibular asymmetry and prognathism were included. Three-dimensional (3D) craniofacial and TMJ morphometric variables were analyzed in images captured using cone-beam computed tomography. Three-dimensional condylar movements were recorded during the opening, protrusion, and laterotrusion of the jaw and divided into those for deviated and non-deviated sides. Overall functional and morphometric variables were compared between the sides by a paired t-test. Pearson's correlation analysis and factor analysis were also performed. As a result, significant differences were found between the sides in morphometric and functional variables. The condylar path length was significantly longer and steeper on the deviated side during protrusion and lateral excursion. TMJ morphometric asymmetry, more so than the craniofacial morphologic asymmetry, seemed to be reflected in the functional asymmetry, representing different correlations between the sides, as supported by factor analysis. This study provides evidence explaining why the asymmetric condylar path remained unchanged even after orthognathic surgery for the correction of craniofacial asymmetry.

Preparation and Characterization of Bimetallic Fe-Ni Oxide Nanoparticles Using Liquid Phase Plasma Process.

The Fe-Ni oxide bimetallic nanoparticles (FNOBNPs) were synthesized in the liquid phase plasma (LPP) method employed an iron chloride and nickel chloride as metal precursors. The sphericalshaped FNOBNPs were synthesized by the LPP process and, the size of particles was growing along with the progression of LPP reaction. The synthesized FNOBNPs were comprised of Fe3O4 and NiO. Iron had a higher reduction potential than nickel and resulted in higher iron composition in the synthesized FNOBNPs. The control of molar ratio of metal precursors in initial reactant solution was found that it could be employed as a means to control the composition of the elements in FNOBNP.

Facile Synthesis of Chromium Oxide on Activated Carbon Electrodes for Electrochemical Capacitor Application.

Chromium oxide/carbon nanocomposites (COCNC) were synthesized by using a liquid phase plasma process, and the electrical properties of the supercapacitor electrode were investigated. Spherical chromium oxide (Cr2O3) nanoparticles with the size of 100-150 nm were dispersed uniformly on activated carbon powder surface. The quantity of chromium oxide nanoparticle precipitate increased with increasing LPP reaction time and the specific capacitance of COCNC increased with increasing LPP reaction time.

Traumatic optic neuropathy-associated progressive thinning of the retinal nerve fiber layer and ganglion cell complex: two case reports.

BACKGROUND: Traumatic optic neuropathy (TON) is a form of optic nerve injury that occurs secondary to trauma and is etiologically associated with acute axonal loss with severe vision loss. Here, we reported longitudinal changes in the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) using wide-field swept source optical coherence tomography (SS-OCT) in two cases of TON and identified the source of the damage. CASE PRESENTATION: (Case 1) A 65-year-old man was admitted to the hospital due to an injury in the right eye (OD) and was subsequently diagnosed with indirect TON. He was then treated with high-doses of intravenous steroids. Wide-field SS-OCT was performed at the baseline and after 1 day, 2 days, 1 week, 1 month, and 4 months. The wide-field deviation map detected thinning earlier in the macular GCC than in the peripapillary RNFL. (Case 2) A 63-year-old man was admitted to the hospital with a fractured left maxilla-zygomatic complex attributed to blunt-force trauma to the head and loss of vision in his left eye (OS). He was diagnosed with indirect TON and treated with high-doses of intravenous steroids. Wide-field SS-OCT was performed at the baseline and after 1 week, 2 weeks, 2 months 5 months, and 7 months. The wide-field deviation map detected thinning earlier in the peripapillary RNFL than in the macular GCC. CONCLUSIONS: Wide-field SS-OCT facilitated the identification of various sequential progression patterns in patients with TON. Furthermore, the area in which the structural damage was first detected was seen differently in the peripapillary and macular deviation maps for each case. Thus, wide-field imaging, which includes the macular and peripapillary areas, are useful in monitoring TON.

Incidence of retinal vein occlusion in open-angle glaucoma: a nationwide, population-based study using the Korean Health Insurance Review and Assessment Database.

IMPORTANCE: We determined the association between retinal vein occlusion (RVO) and open-angle glaucoma (OAG) in a Korean population by reviewing a dataset obtained from the Korean Health Insurance Review and Assessment (HIRA). BACKGROUND: To compare the RVO incidence for OAG patients with that for the general population in order to determine the association between RVO and OAG. DESIGN: Nationwide population-based retrospective study. PARTICIPANTS: HIRA data for 2011 through 2015. METHODS: The HIRA data for 2011 through 2015 was analysed in order to determine the incidence rates of RVO in the general population and in OAG patients. The standardized incidence ratios (SIRs) of RVO for OAG patients were determined with respect to the age- and gender-matched general population. MAIN OUTCOME MEASURES: SIRs of RVO. RESULTS: The RVO incidence rate for the general population during the 4-year study period (2012-2015) was 74.16 per 100 000 person-years (95% confidence interval [CI], 73.79-74.54). A total of 272 143 OAG patients were identified in 2011 as the population at risk. The RVO incidence rate for the OAG patients was 528.95 per 100 000 person-years (95% CI, 515.46-542.79). The expected incidences of RVO in the OAG patients were 1760.66 during the 4-year study period. On the other hand, the observed incidences of RVO were 5758. The SIR of RVO for OAG patients in reference to the general population was 3.27 (95% CI, 3.19-3.35). CONCLUSIONS AND RELEVANCE: The RVO incidence rate for OAG patients is significantly higher than that for the general population.

Trend-based Analysis of Ganglion Cell-Inner Plexiform Layer Thickness Changes on Optical Coherence Tomography in Glaucoma Progression.

PURPOSE: To evaluate the rate of thinning in ganglion cell-inner plexiform layer (GCIPL) thickness by optical coherence tomography (OCT) in glaucomatous eyes and to use a trend-based approach to determine its diagnostic ability for detecting glaucoma progression. DESIGN: Prospective, observational study. PARTICIPANTS: Sixty-five patients with primary open-angle glaucoma with a minimum 3-year follow-up involving serial spectral-domain OCT measurement of GCIPL thickness. METHODS: Patients were divided into a nonprogressor group (n = 38) and a progressor group (n = 27) on the basis of serial red-free photography or visual field tests. The rates of GCIPL thinning in the global region, affected hemifield, and 6 macular sectors, and the minimum thickness, were determined by linear regression and compared between groups. The area under the receiver operating characteristic curves (AUCs) were calculated for each parameter. The GCIPL thinning rates were compared between affected hemifields and unaffected hemifields. MAIN OUTCOME MEASURES: The macular GCIPL thinning rates in the progressor and nonprogressor groups and the ability of the GCIPL thinning rate to diagnose glaucoma progression. RESULTS: The GCIPL thinning rate was significantly faster in progressors than in nonprogressors in the global area (P < 0.001); in the affected hemifield (P = 0.001); in the temporal, vertical, and nasal sectors of the affected hemifield (P = 0.017, 0.032, and 0.030, respectively); and in the minimum GCIPL thickness (P < 0.001). In the temporal sectors, the GCIPL thinning rates were significantly faster in the affected than in the unaffected hemifield (P = 0.013). The best GCIPL parameters were the global (AUC = 0.791), minimum (AUC = 0.755), inferior hemifield (AUC = 0.708), and affected hemifield (AUC = 0.702) thinning rates. The global circumpapillary retinal nerve fiber layer thinning rate correlated significantly with the global and inferotemporal sector GCIPL thinning rates (rho = 0.259 and 0.366, respectively). CONCLUSIONS: The GCIPL thinning rate on OCT was significantly faster for patients with glaucoma with progression than for those without progression. The GCIPL thinning rate of the temporal sector was faster in the affected than in the unaffected hemifield, suggesting that the glaucomatous damage may progress locally in a specific sequence. Trend-based analysis of GCIPL thickness on OCT may be useful for assessing glaucoma progression objectively and quantitatively.

Subtypes of Maxillomandibular Advancement Surgery for Patients With Obstructive Sleep Apnea.

Maxillomandibular advancement (MMA) surgery, which is the most effective treatment modality for patients with moderate-to-severe obstructive sleep apnea with apparent skeletal discrepancies, has been modified in conjunction with segmental osteotomies, counterclockwise rotation of maxillomandibular complex, and other adjunctive procedures. However, any single type of MMA could not treat or cure all the patients with obstructive sleep apnea showing different dentofacial and pharyngeal patterns. We aimed to suggest critical decision factors for the selective application of MMA subtypes, categorized as straight MMA with genioplasty, rotational MMA, segmental MMA, and segmental-rotational MMA, in the surgical treatment objective process: anteroposterior position of maxilla, upper lip projection, overjet, lower incisor inclination as sagittal factors, and upper incisor exposure and occlusal plane angle as vertical factors. This case series deserves a clinical basis on the way of case-by-case application of the optimal MMA subtype based on the successful treatment outcomes with short-term stability.

Chiroptical Switching of Electrochromic Polymer Thin Films.

The interaction between light and chiroptical polymers plays a crucial role in chiroptics, spintronics, and chiral-spin selectivity. Despite considerable successes in creating dissymmetric polymer films, the elucidation of chiroptical activities under electrochemical switching remains unexplored. Here homogeneous chiral electrochromics is reported using chiral assembly of conjugated polymers through a transient solidification process with molecular chiral templates. In their neutral state, the chiral electrochromic polymers directly produce a remarkably dissymmetric polarization-dependent transmittance. The circular dichroism (CD) and dissymmetric transmission can be tuned by adjusting the doping level of the electrochemically active polymer films. Under high levels of oxidation, the chiroptical activities are reversed with strong bleaching in the visible, leading to formation of monosignate CD spectra over the infrared region. The matching between circular polarization handedness and chirality of chiroptical polymers makes a distinct impact on optical contrast and color switching dynamics due to the flipped chiroptical activities through polymer redox reactions. The differential circularly polarized transmission in the chiral see-through display can make a well-resolved color change in human eyes, demonstrating proof-of-concept devices for 3D imaging and information encryption. This work serves as a foundation to develop advanced on-chip fabrication of circular polarization-multiplexed display in flexible and highly integrated platforms.

Hemodialysis-induced positional changes in lamina cribrosa.

This study is aimed to investigate the effect of hemodialysis (HD) on the lamina cribrosa (LC) of the optic nerve head (ONH) using swept-source optical coherence tomography (SS-OCT) and other ophthalmological parameters in patients with end-stage kidney disease (ESKD). This prospective observational study included 29 patients who underwent HD for ESKD. ONH parameters including neural canal diameter (NCD), peripapillary vertical height (PVH), and anterior LC depth (LCD), were assessed using SS-OCT. Changes in the ONH parameters before and after HD were statistically analysed. Correlations between changes in the LCD and other ocular and systemic measurements were identified using Pearson's correlation analyses. The mean anterior LCD significantly decreased from 441.6 ± 139.8 µm before HD to 413.5 ± 141.7 µm after HD (P = 0.001). Mean NCD and PVH did not show significant changes after HD (P = 0.841 and P = 0.574, respectively). A significant correlation was found between changes in the anterior LCD and the mean ocular perfusion pressure (r = 0.397, P = 0.036). We observed a significant decrease in anterior LCD after HD. Our study suggests that HD can influence the ONH, especially in the LC.

Prescribing trends of glaucoma medication in Korea from 2007 to 2020: A nationwide population-based study.

PURPOSE: Investigating long-term trends in glaucoma medication. METHODS: All patients diagnosed with glaucoma and prescribed glaucoma eye drops between 2007 and 2020 in Korea's Health Insurance Review and Assessment Service database participated in this study. A weight was assigned to each prescription using the reciprocal of the total number of prescriptions received by the individual in that year. The number of patients who received each type of glaucoma eye drop prescription was calculated by summing the weights for each year. RESULTS: During the study period, prostaglandin analog eye drop monotherapy was the most frequently given type of glaucoma eye drop prescription. Until 2008, the second most frequently given type of glaucoma eye drop prescription was beta blocker eye drop monotherapy; thereafter, it changed to carbonic anhydrase inhibitor/beta blocker fixed-combination eye drop monotherapy. The prescription proportion of single-ingredient glaucoma eye drops decreased (-1.290%/year, P < 0.001), whereas that of fixed-combination glaucoma eye drops increased (1.291%/year, P < 0.001). The number of glaucoma eye drops prescribed per patient remained constant (-0.00030/year, P = 0.167) with an average of 1.302, while the number of active ingredients prescribed per patient increased (0.01737/year, P < 0.001) from 1.659 in 2007 to 1.896 in 2020. CONCLUSION: Over 14 years, there was no change in the number of glaucoma eye drops prescribed to individual patients in Korea. However, the number of active ingredients prescribed increased owing to the increased prescription of fixed-combination eye drops. The current trends in glaucoma medication are expected to help establish future treatment strategies.

Wide-range and selective detection of SARS-CoV-2 DNA via surface modification of electrolyte-gated IGZO thin-film transistors.

The 2019 coronavirus pandemic resulted in a massive global healthcare crisis, highlighting the necessity to develop effective and reproducible platforms capable of rapidly and accurately detecting SARS-CoV-2. In this study, we developed an electrolyte-gated indium-gallium-zinc-oxide (IGZO) thin-film transistor with sequential surface modification to realize the low limit of detection (LoD <50 fM) and a wide detection range from 50 fM to 5 µM with good linearity (R2 = 0.9965), and recyclability. The surface chemical modification was achieved to anchor the single strand of SARS-CoV-2 DNA via selective hybridization. Moreover, the minute electrical signal change following the chemical modification was investigated by in-depth physicochemical analytical techniques. Finally, we demonstrate fully recyclable biosensors based on oxygen plasma treatment. Owing to its cost-effective fabrication, rapid detection at the single-molecule level, and low detection limit, the proposed biosensor can be used as a point-of-care platform to perform timely and effective SARS-CoV-2 detection.

Diagnostic performance of wide-field optical coherence tomography angiography for high myopic glaucoma.

Diagnosing and monitoring glaucoma in high myopic (HM) eyes are becoming very important; however, it is challenging to diagnose this condition. This study aimed to evaluate the diagnostic ability of wide-field optical coherence tomography angiography (WF-OCTA) maps for the detection of glaucomatous damage in eyes with HM and to compare the diagnostic ability of WF-OCTA maps with that of conventional imaging approaches, including swept-source optical coherence tomography (SS-OCT) wide-field maps. In this retrospective observational study, a total 62 HM-healthy eyes and 140 HM eyes with open-angle glaucoma were included. Patients underwent a comprehensive ocular examination, including SS-OCT wide-field and 12 × 12 WF-OCTA scans. The WF-OCTA map represents the peripapillary and macular superficial vascular density maps. Glaucoma specialists determined the presence of glaucomatous damage in HM eyes by reading the WF-OCTA map and comparing its sensitivity and specificity with those of conventional SS-OCT images. The sensitivity and specificity of 12 × 12 WF-OCTA scans for HM-glaucoma diagnosis were 87.28% and 86.94%, respectively, while, the sensitivity and specificity of SS-OCT wide-field maps for HM-glaucoma diagnosis were 87.49% and 80.51%, respectively. The specificity of the WF-OCTA map was significantly higher than that of the SS-OCT wide-field map (p < 0.05). The sensitivity of the WF-OCTA map was comparable with that of the SS-OCT wide-field map (p = 0.078). The WF-OCTA map showed good diagnostic ability for discriminating HM-glaucomatous eyes from HM-healthy eyes. As a complementary method to an alternative imaging modality, WF-OCTA mapping can be a useful tool for the detection of HM glaucoma.

Transparent Electrochromic Polymers with High Optical Contrast and Contrast Ratio.

Colored-to-transmissive electrochromic polymers, known for their wide selection of colors and solution processability, have gained great attraction in thin film electrochromic devices that have entered the market. However, their adoption in the real world is limited due to their limited optical transparency and contrast. This study introduces a new molecular design strategy to overcome these issues. This strategy involves using meta-conjugated linkers (MCLs) and aromatic moieties along polymer backbones, which enable transparent-to-colored electrochromic switching. The MCL interrupts charge delocalization, increasing the band gap in the neutral state and ensuring transparency in the visible region. This innovative approach achieves nearly 100% transmittance in the neutral state and a high absorption in the oxidized state, overcoming residue absorption issues in conventional electrochromic polymers. Simultaneously, the MCL and aromatic moieties enable low oxidation potential, facilitating stable transparent-to-color switching. Polymers developed using this approach exhibit wide color tunability, optical contrast exceeding 93%, and cycling stability over 5000 cycles with less than 3% contrast decay. Our research represents a major advancement in overcoming existing challenges, enabling polymer-based electrochromic devices for visual comfort and energy conservation.

Diagnosis of Glaucoma Based on Few-Shot Learning with Wide-Field Optical Coherence Tomography Angiography.

This study evaluated the utility of incorporating deep learning into the relatively novel imaging technique of wide-field optical coherence tomography angiography (WF-OCTA) for glaucoma diagnosis. To overcome the challenge of limited data associated with this emerging imaging, the application of few-shot learning (FSL) was explored, and the advantages observed during its implementation were examined. A total of 195 eyes, comprising 82 normal controls and 113 patients with glaucoma, were examined in this study. The system was trained using FSL instead of traditional supervised learning. Model training can be presented in two distinct ways. Glaucoma feature detection was performed using ResNet18 as a feature extractor. To implement FSL, the ProtoNet algorithm was utilized to perform task-independent classification. Using this trained model, the performance of WF-OCTA through the FSL technique was evaluated. We trained the WF-OCTA validation method with 10 normal and 10 glaucoma images and subsequently examined the glaucoma detection effectiveness. FSL using the WF-OCTA image achieved an area under the receiver operating characteristic curve (AUC) of 0.93 (95% confidence interval (CI): 0.912-0.954) and an accuracy of 81%. In contrast, supervised learning using WF-OCTA images produced worse results than FSL, with an AUC of 0.80 (95% CI: 0.778-0.823) and an accuracy of 50% (p-values < 0.05). Furthermore, the FSL method using WF-OCTA images demonstrated improvement over the conventional OCT parameter-based results (all p-values < 0.05). This study demonstrated the effectiveness of applying deep learning to WF-OCTA for glaucoma diagnosis, highlighting the potential of WF-OCTA images in glaucoma diagnostics. Additionally, it showed that FSL could overcome the limitations associated with a small dataset and is expected to be applicable in various clinical settings.