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A Erginay

Publications and source records attributed to A Erginay.

18 recordsLinked to original sources

Evaluation of the effect of JPEG and JPEG2000 image compression on the detection of diabetic retinopathy.

AIMS: To compare the effect of classic Joint Photographic Experts Group (JPEG) and JPEG2000 compression algorithms on detection of diabetic retinopathy (DR) lesions. METHODS: In total, 45 colour fundus photographs obtained with a digital nonmydriatic fundus camera were saved in uncompressed Tagged Interchanged Files Format (TIFF) format (1.26 MB). They were graded jointly by two retinal specialists at a 1 month interval for soft exudates, hard exudates, macular oedema, newvessels, intraretinal microvascular abnormalities (IRMA), and retinal haemorrhages and/or microaneurysms. They were compressed to 118, 58, 41, and 27 KB by both algorithms and 24 KB by classic JPEG, placed in random order and graded again jointly by the two retina specialists. Subjective image quality was graded, and sensitivity, specificity, positive and negative predictive values, and kappa statistic were calculated for all lesions at all compression ratios. RESULTS: Compression to 118 KB showed no effect on image quality and kappa values were high (0.94-1). Image degradation became important at 27 KB for both algorithms. At high compression levels, IRMA and HMA detection were most affected with JPEG2000 performing slightly better than classic JPEG. CONCLUSION: Performance of classic JPEG and JPEG2000 algorithms is equivalent when compressing digital images of DR lesions from 1.26 MB to 118 KB and 58 KB. Higher compression ratios show slightly better results with JPEG2000 compression, but may be insufficient for screening purposes.

Algorithms↗

Evaluation of a screening program for diabetic retinopathy in a primary care setting Dodia (Dépistage ophtalmologique du diabète) study.

OBJECTIVES: The aim of this observational study was to evaluate the screening for diabetic retinopathy (DR) using eye fundus photography taken by a nonmydriatic camera and transmitted trough the Internet to an ophthalmological reading centre, as compared to a dilated eye examination performed by an ophthalmologist. METHODS: A total of 456 and 426 diabetic patients were included by two different groups of primary care physicians (PCPs), 358 being screened with the non-mydriatic camera (experimental group) and 320 with dilated eye fundus exam (control group). RESULTS: The proportion of screened patients for whom PCPs received a screening report within the 6-month follow-up period was 74,1% for the experimental group and 71,5% for the control group. Screening for DR was negative in 77,6% of patients with eye fundus photographs vs 89,6% with dilated eye examination. DR was diagnosed in 62 patients (17,3%) with eye fundus photographs versus 31 with dilated eye examination (10,4%). Referral to an ophthalmologist was required in 59 reports of patients with photographs (16.5%), 23 of them due to high grade DR. Finally, the non-mydriatic camera was found of little inconvenience by patients. CONCLUSION: The telemedical approach to DR screening proved to be effective in providing primary care practitioners with information about their patient's eye status. This screening method allowed to identify patients requiring prompt referral to the ophthalmologist for further complete eye examination. In conclusion, this study provided successful results of DR screening using fundus photography in primary care patients, and strongly supports the need to further extend this screening program in a larger number of French sites.

Diabetes Mellitus, Type 1↗

Screening for diabetic retinopathy: the first telemedical approach in a primary care setting in France.

OBJECTIVES: Diabetic retinopathy (DR) remains a major cause of visual impairment in France, due to insufficient regular annual screening. Fundus photography is a sensitive alternative to ophthalmoscopy for DR screening. The aim of our study was to report the first telemedical approach to this screening in a primary care setting in France. METHODS: A DR screening centre equipped with a nonmydriatic camera was opened in the 18th district of northern Paris and placed at the disposal of general practitioners (GPs) of the Réseau de Santé Paris Nord (North Paris Health Network). These GPs were invited to send their diabetic patients who had no known DR and had had no fundus examination for more than one year to this screening center. Retinal photographs were taken by an orthoptist without pupillary dilation and sent for grading through the Internet to the Lariboisière Hopital Ophthalmology Department. RESULTS: During an 18-month period, 912 DR screening examinations were performed in 868 diabetic patients referred to the DR screening center by 240 GPs. Patients' mean +/- SD age was 59.9 +/- 11.1 years. Of these 868 patients, 260 (30%) said they never have had an ophthalmological examination. Diabetic retinopathy was detected in 197 patients (22.7%). The proportion of patients for whom fundus photographs of one or both eyes could not be assessed was 10.1%. 159 patients (18.3%) required referral to an ophthalmologist. CONCLUSION: Nonmydriatic photography, combined with teletransmission to a reading centre, proved to be a feasible valid method for the detection of DR. This screening method allowed the identification of patients requiring prompt referral to an ophthalmologist for further complete eye examination.

Adolescent↗

Evaluation of a new non-mydriatic digital camera for detection of diabetic retinopathy.

AIMS: To compare the results of fundus photography using a new non-mydriatic digital camera with the results of reference standard of Early Treatment Diabetic Retinopathy Study (ETDRS) retinal photographs, for the detection of diabetic retinopathy (DR). METHODS: Fundus colour photographs were taken with a Topcon non-mydriatic camera of 147 eyes of 74 diabetic patients, without pupillary dilation (five overlapping fields of 45 degrees; posterior pole, nasal, temporal, superior and inferior). Three retinal specialists classified the photographs in a masked fashion, as showing no DR or mild non-proliferative DR (NPDR) not requiring referral, moderate or more severe NPDR and/or macular oedema, or as non-gradable image requiring referral. ETDRS 35-mm colour slides served as reference images for DR detection. RESULTS: For moderately severe to severe DR, the sensitivities of detection reported by the three observers were 92, 100 and 92%, respectively, and the specificities, 87, 85, and 88%. For four levels of DR severity (none or mild NPDR, moderate NPDR, severe NPDR and proliferative DR), the percentages of exact agreement between the three observers on the retinopathy grades assigned to the non-mydriatic photographs and to the ETDRS reference slides were 94.6, 93 and 87.6%, respectively (kappa 0.60-0.80). Sixteen eyes of nine patients (11%) were judged ungradable by at least one observer. In a second series of 110 patients, evaluated in the setting of a screening procedure, fewer photographs were ungradable (< 6%). CONCLUSION: These results suggest that fundus photographs taken by the Topcon TRC-NW6S non-mydriatic camera, without pupillary dilation, are suitable for DR screening.

Adult↗

[Diabetic retinopathy in children and adolescents].

Diabetic retinopathy rarely occurs before puberty and is never proliferative in prepubescent children. On the opposite, puberty and adolescence are high-risk periods for diabetic retinopathy progression, and call for strict ophthalmologic monitoring. The period between 16 and 18 years of age is particularly critical. Progression towards florid diabetic retinopathy is to be especially feared and should be prevented in the course of adolescence, as this form can be severe and can lead to blindness. Risk factors are probably many, including diabetes duration, difficulties in achieving glycemic control due to increase in insulin requirements, low compliance to treatment, and hormonal changes related to puberty (abnormalities of the growth hormone (GH)/insulin-like growth factor-I (IGF-1) axis). Systematical diabetic retinopathy screening should be performed in adolescents, notably by non-mydriatic fundus photographs. Furthermore, the anticipation of the switch from pediatric to adult structures, together with the careful information and education of parents and children may improve visual prognosis of young diabetic patients, whose life expectancy is high.

Adolescent↗

Reproducibility of retinal mapping using optical coherence tomography.

OBJECTIVE: To assess the reproducibility of retinal thickness measurement using commercially available mapping software of optical coherence tomography (OCT). METHODS: Six radial scans, 6 mm long and centered on the fixation point, were performed on 10 eyes of 10 healthy volunteers and 10 eyes of 10 diabetic patients with clinically significant macular edema. Retinal thickness was measured automatically using the mapping software of OCT in the 9 macular Early Treatment Diabetic Retinopathy Study areas and in a central area 500 microm in diameter. Measurement reproducibility was tested by means of 3 series of scans performed by 2 different observers on 2 different days. Results were assessed by their repeatability and intraclass correlation coefficients (ICCs). RESULTS: In healthy subjects, intraobserver, interobserver, and intervisit reproducibility of retinal thickness measurements were excellent, with a repeatability coefficient of less than 7 microm and ICCs of greater than 0.89. In diabetic patients, the repeatability coefficient was less than 21 microm in all areas of the macula except one, with an ICC of greater than 0.98. Relative variations in measurements were small in both healthy and diabetic subjects, with reproducibilities of +/- 5% and +/- 6%, respectively. CONCLUSION: Retinal mapping software of OCT allows reproducible measurement of retinal thickness in both healthy subjects and diabetic patients with macular edema.

Adult↗

Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery.

PURPOSE: To examine the preoperative and postoperative anatomical features of the macula using optical coherence tomography in patients who underwent surgery for epiretinal membrane and to correlate these features with functional results. METHODS: In a noncomparative interventional series, 62 eyes of 62 consecutive patients operated on for an idiopathic epiretinal membrane were followed up using a standardized protocol. Preoperative and postoperative examination included best-corrected visual acuity using an Early Treatment Diabetic Retinopathy Study chart, biomicroscopy of the fundus with a contact lens, fundus photography with blue and green filters, fluorescein angiography, and optical coherence tomography. RESULTS: Median preoperative visual acuity was 20/60 (range, 20/32 to 20/320). Median postoperative visual acuity was 20/40 (range, 20/20 to 20/160). Fifty-one eyes (82%) obtained visual acuity of 20/50 or better. Preoperatively, all eyes had increased macular thickness (mean, 419 +/- 105 microm; range, 265.5 to 689 microm), with disappearance of the foveal pit. An epiretinal membrane was visible on optical coherence tomography scans in 26 cases (42%). Intraretinal cystic spaces were present in the thickened macular tissue in 15 cases but corresponded to cystoid macular edema on fluorescein angiography in only three. Postoperatively, mean macular thickness decreased to 300 +/- 65 microm (range, 185 to 511 microm) but returned to normal in only three eyes. The foveal pit reappeared in 20 eyes. Preoperatively, visual acuity correlated with macular thickness (r = 0.56, P <.0001), but not postoperatively (r = 0.12, P =.37). CONCLUSION: Macular thickness decreases after epiretinal membrane surgery, but the macular profile rarely returns to normal. However, this does not preclude satisfactory improvement of visual acuity.

Aged↗

Acute transient myopia induced by indapamide.

PURPOSE: To report on a case of acute transient myopia associated with ciliochoroidal detachment induced by indapamide. METHOD: Case report. Clinical examination, ultrasonography, and fluorescein angiography were performed during the acute phase of disease and convalescence. RESULTS: After indapamide was discontinued, acute bilateral myopia, which was associated with anterior chamber shallowing and diffuse choroidal thickening, resolved spontaneously 8 days after onset. The initial angiography showed scattered islands of delayed fluorescein filling that disappeared without any permanent change by day 30. CONCLUSION: Indapamide can induce spontaneously resolving transient myopia associated with diffuse choroidal thickening.

Acute Disease↗

[Bilateral sino-orbital mucormycosis. A case report].

We report a case of mucormycosis in a 48 year-old diabetic woman. She presented with nasosinusal ulcer accompanied by panophthalmitis in the left eye and central retinal artery occlusion in the right eye. Left eye enucleation was performed and the diagnosis of mucormycosis was made on histopathologic examination displaying fungal micro-organisms in the optic nerve and in the retina. The patient died of stress ulcer hemorrhage. Mucormycoses are rare and severe diseases affecting immunocompromised hosts, especially diabetic patients during ketoacidosis. The treatment includes surgical debridement and amphotericin B but prognosis remains severe.

Amphotericin B↗

Macular hole formation: new data provided by optical coherence tomography.

OBJECTIVE: To establish the sequence of events leading from vitreofoveal traction to full-thickness macular hole formation. METHODS: Both eyes of 76 patients with a full-thickness macular hole in at least 1 eye were examined by biomicroscopy and optical coherence tomography. RESULTS: Sixty-one fellow eyes had a normal macula. Optical coherence tomograms showed central detachment of the posterior hyaloid over the posterior pole in 19 cases (31%) and a perifoveal hyaloid detachment not detected on biomicroscopy in 26 cases (42%). In the 4 impending macular holes, optical coherence tomography disclosed various degrees of intrafoveal split or cyst, with adherence of the posterior hyaloid to the foveal center and convex perifoveal detachment. In the 14 stage 2 holes, eccentric opening of the roof of the hole was observed, and in the 24 stage 3 holes, the posterior hyaloid was detached from the entire posterior pole. CONCLUSIONS: In fellow eyes of eyes with macular holes posterior hyaloid detachment begins around the macula, but the hyaloid remains adherent to the foveolar center, indicating the action of anteroposterior forces. This results in an intraretinal split evolving into a cystic space, and then to the disruption of the outer retinal layer and the opening of the foveal floor, thus constituting a full-thickness macular hole.

Aged↗

Visual outcome of surgery for epiretinal membranes with macular pseudoholes.

OBJECTIVE: To evaluate the effect of macular pseudohole on visual results after epiretinal membrane (ERM) surgery. DESIGN: Retrospective case-control study. PARTICIPANTS: The postoperative results for 50 eyes with ERMs combined with pseudohole were compared with the results for a paired series of idiopathic ERMs without pseudohole operated on during the same period. INTERVENTION: All patients underwent standard three-port pars plana vitrectomy, including core vitrectomy, and removal of the membrane. MAIN OUTCOME MEASURES: Anatomic and functional evaluations were performed before and after surgery. Main outcome measures were postoperative visual acuity and the persistence or disappearance of the pseudohole. RESULTS: For the patients with pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860) and median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 31 (62%) of 50 eyes. Forty eyes (80%) reached visual acuity of 20/50 or more. Pseudohole persisted in 22 eyes (44%) 3 months after surgery and in 15 eyes (30%) at 6 months. There was no difference in visual acuity, whether or not the pseudohole persisted. For the patients without pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860). Median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 37 eyes (74%). In 36 eyes (72%), it was 20/50 or more. Neither preoperative nor postoperative visual acuity differed significantly in the groups with and without pseudohole. CONCLUSION: After surgery for idiopathic ERMs combined with pseudohole, visual outcome is good, and pseudohole has no adverse prognostic value. Pseudohole disappears inconstantly after surgery, but its persistence does not preclude good postoperative visual recovery.

Adult↗

Epiretinal membranes surrounding idiopathic macular holes.

PURPOSE: To describe the features of the epiretinal membranes (ERMs) surrounding idiopathic macular holes. METHODS: The charts of 83 consecutive patients (85 eyes) who underwent macular hole surgery with a systematic search for an ERM around the hole were reviewed. Visual acuity testing, fundus biomicroscopy, red free and blue filter fundus photographs, and fluorescein angiograms were performed before and after surgery. Eyes with and without ERM removal were compared. RESULTS: An ERM was removed from 26 of 85 eyes (30.6%). ERMs were found more frequently in stage 4 than in stage 3 macular holes (76.9% versus 24.6%; P < 0.01). Holes had been present for longer in eyes with ERM than in those without (14.7 versus 8.6 months; P = 0.05). Fewer stage 3 holes with an ERM had an operculum than those without (P = 0.01). The outcome and complication rates were similar in eyes with an ERM and those without. Of the 24 ERMs detectable on blue filter fundus photographs, only 11 (45.6%) were visible on red free photographs. CONCLUSION: We support the hypothesis that the presence of ERMs surrounding idiopathic macular holes is secondary to hole formation.

Aged↗

[Evaluating the results of surgery of choroidal neovessels].

BACKGROUND: Subfoveal choroidal neovascularization has usually a poor visual prognosis. Submacular surgery has been advocated as an alternative treatment. Visual results of this recent surgical technique is under current clinical evaluation. METHODS: We retrospectively reviewed the charts of 16 eyes from 15 patients who underwent submacular surgery through a small retinotomy. Mean follow-up was 8 months (range from 5 to 88 weeks): group 1: submacular hemorrhages caused by age-related macular degeneration, 8 eyes; group 2: advanced subfoveal choroidal neovascularization in age-related macular degeneration, 3 eyes; group 3: young onset subfoveal choroidal neovascularization, 5 eyes. RESULTS: Group 1: mean preoperative visual acuity was 0.024. Postoperative visual acuity increased for 5 eyes (63%) and decreased for 3 eyes (37%) (mean follow-up: 33 weeks). Two eyes had recurrent neovascularization. Group 2: mean preoperative visual acuity was 0.083. Postoperative visual acuity decreased for both eyes (mean follow-up: 58 weeks). Two eyes had recurrent neovascularization. Group 3: mean preoperative visual acuity was 0.082. Postoperative visual acuity increased for both eyes (mean follow-up: 26 weeks). Two eyes had recurrent neovascularization. In both groups, recurrent neovascularization was managed by laser photocoagulation. CONCLUSIONS: Surgery of subfoveal choroidal neovascular membranes may stabilize or improve visual acuity in young patients. In subfoveal choroidal neovascularization due to age-related macular degeneration. this technique does not provide currently measurable visual improvement except in cases complicated by submacular hemorrhage. Results of future trials comparing surgery with spontaneous evolution or laser photocoagulation are necessary.

Adolescent↗

[Results of surgery of vitreomacular traction syndromes].

PURPOSE: The vitreomacular traction syndrome is a rare entity in which partial posterior vitreous detachment is combined with persistent macular adherence, thus causing macular traction. In most cases, an epimacular membrane is associated with this vitreomacular traction. We evaluate here the results of vitreous surgery for this syndrome. METHODS: We reviewed 18 consecutive eyes that had undergone vitrectomy and posterior epiretinal membrane stripping, to define the visual results and complications of surgery for the vitreomacular traction syndrome. Minimum follow-up was 3 months. RESULTS: Patients' average age was 63.5 years. All had evidence of cystic macular changes on biomicroscopic examination. Sixteen patients had an epiretinal membrane, and two, a full-thickness macular hole. Cystoid macular edema was present in 7 eyes on fluorescein angiography. The release of vitreomacular traction improved vision in 72% of eyes, with six patients obtaining 20/40 visual acuity or better. Complications of surgery included progression of nuclear sclerosis, and epiretinal membrane formation. CONCLUSION: Vitrectomy for vitreomacular traction syndrome may improve visual acuity, but the visual prognosis remains poor.

Adult↗

Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software.

PURPOSE: To define the normal retinal thickness in healthy subjects using optical coherence tomography (OCT) mapping software and to assess the ability of OCT to detect early macular thickening in diabetic patients. METHODS: Six radial scans centered on the fixation point were done on 60 healthy eyes and 70 eyes of 35 diabetic patients without macular edema on biomicroscopy. Retinal thickness was measured automatically with OCT mapping software. Mean retinal thickness was compared in subgroups of healthy patients based on age, sex, and eye, and in the eyes of diabetic patients and healthy subjects. Thickening was diagnosed if mean retinal thickness of an area was greater than the mean thickness + 2SD in the corresponding area in healthy subjects; or if the difference between right and left eye exceeded the mean difference + 2 SD in a given area in healthy subjects. RESULTS: In healthy subjects, mean retinal thickness in the central macular area 1000 microm in diameter was 170+/-18 microm. There was no significant difference according to age, or left or right eye, but central macular thickness was significantly greater in men than women (p=0.0139). No difference was observed between the eyes of healthy subjects and diabetic patients without macular edema on biomicroscopy, but OCT detected early macular thickening in 12 diabetic eyes. CONCLUSIONS: In this study average retinal thickness and mean local variations in a normal population were defined using a commercially available mapping software. OCT seems a sensitive tool for detecting early retinal thickening.

Adult↗

[Bilateral macular pseudocoloboma associated with chronic renal insufficiency in two sisters].

We report Meier's syndrome in two sisters, with combined macular pseudocoloboma and end-stage renal failure. The two sisters, aged 12 and 17 years, presented with a bilateral macular coloboma and slight myopic shift reducing visual acuity to 20/60 in one sibling and 20/100 in the other sibling. No other ocular abnormalities were present. The electroretinograms were normal. In both patients renal grafts were performed with good results. The mother and the 4 other siblings were unaffected. This observation underlines the need to check kidney function in case of bilateral pseudocoloboma.

Adolescent↗