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Glaucoma: HELP
Articles from Andhra Pradesh
Based on 142 articles published since 2008
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These are the 142 published articles about Glaucoma that originated from Andhra Pradesh during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Review Lasers in glaucoma. 2018

Kumar, Harsh / Mansoori, Tarannum / Warjri, Gazella B / Somarajan, Bindu I / Bandil, Suman / Gupta, Viney. ·Centre for Sight, Safdarjung Enclave, New Delhi, India. · Anand Eye Institute, Sita Lakshmi Glaucoma Center, Habsiguda, Hyderabad, Telangana, India. · Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. ·Indian J Ophthalmol · Pubmed #30355858.

ABSTRACT: While lasers have been used for many years for the treatment of glaucoma, proper indications and use of the procedures need to be considered before their application. This review summarizes the important laser procedures in Glaucoma.

2 Review Community care for diabetic retinopathy and glaucoma in India: A panel discussion. 2018

Rani, Padmaja Kumari / Nangia, Vinay / Murthy, Krishna R / Khanna, Rohit C / Das, Taraprasad. ·Smt.Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Hyderabad, India. · Department of Glaucoma, Suraj Eye Institute, Nagpur, India. · Department of Retina and Vitreous, Vittala Eye Institute, Bangalore, India. · Gullapalli Prathibha Rao International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India. ·Indian J Ophthalmol · Pubmed #29941730.

ABSTRACT: Diabetic retinopathy (DR) and glaucoma are emerging causes of blindness and visual impairment in India and the world. Both diseases do not have any early warning symptoms, and once the symptoms appear, the diseases are reasonably advanced. Because of the long-standing nature of the diseases, one cannot adopt the cataract detection and treatment model so successfully developed in India. It requires an altogether different approach for screening and related infrastructure including human capital development. The solutions developed to reduce the burden of DR/glaucoma should be customized to urban, semi-urban, and rural areas. Greater advocacy, improving the health-seeking behavior, development of infrastructure and skilled personnel appropriate for the points of care, and an emphasis in comprehensive eye care are some of the solutions.

3 Review Unusual Surprises in Glaucoma Filtering Surgeries: Lessons Learned and Review of Literature. 2018

Rao, Aparna / Padhy, Debananda / Roy, Avik Kumar / Senthil, Sirisha. ·a Glaucoma Services, LV Prasad Eye Institute , Bhubaneswar , India. · b Glaucoma Services, LV Prasad Eye Institute , Hyderabad , India. ·Semin Ophthalmol · Pubmed #27929714.

ABSTRACT: PURPOSE: To describe an unusual series of complications after glaucoma filtering surgeries with their clinical findings and outcome after tailored non-conventional modes of therapy. PATIENTS AND METHODS: Eighteen patients who underwent re-interventions (medical or surgical) after glaucoma filtering surgeries during the period at two tertiary centers, excluding those that required conventional modes of treatment (medical control or re-trabeculectomy, simple wound closure for traumatic wound dehiscence, bleb revision or needling, laser iridotomy), were included. Relevant clinical details with intraoperative videos, intraoperative or postoperative problems, and images with course after re-intervention were retrieved from the hospital database. Clinical details which helped in clinching diagnosis and cause for problems and course after intervention with final vision and intraocular pressure were evaluated. RESULTS: Six of 18 eyes required surgical management for an unusual course of events after an uneventful filtering surgery. Bleb morphology and close follow-up of the conjunctiva, in addition to intraocular pressure (IOP) and anterior chamber (AC) configuration, helped diagnose possible aetiology and appropriate tailored management. All patients had good IOP and visual outcome in all except one with macular scar status after retinal detachment surgery. CONCLUSION: Assessment of the bleb morphology in the postoperative course coupled with monitoring of the conjunctival wound are essential to conventional monitoring of IOP and anterior chamber configuration to arrive at appropriate management for rare unusual events after glaucoma surgery.

4 Review Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. 2017

Flaxman, Seth R / Bourne, Rupert R A / Resnikoff, Serge / Ackland, Peter / Braithwaite, Tasanee / Cicinelli, Maria V / Das, Aditi / Jonas, Jost B / Keeffe, Jill / Kempen, John H / Leasher, Janet / Limburg, Hans / Naidoo, Kovin / Pesudovs, Konrad / Silvester, Alex / Stevens, Gretchen A / Tahhan, Nina / Wong, Tien Y / Taylor, Hugh R / Anonymous15250923. ·Department of Mathematics and Data Science Institute, Imperial College London, London, UK. · Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK. Electronic address: rb@rupertbourne.co.uk. · Brien Holden Vision Institute, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia. · International Agency for the Prevention of Blindness, London, UK. · Moorfields Eye Hospital NHS Foundation Trust, London, UK. · San Raffaele Scientific Institute, Milan, Italy. · York Hospital, York, UK. · Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. · L V Prasad Eye Institute, Hyderabad, India. · Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; Discovery Eye Center, Addis Ababa, Ethiopia; MyungSung Christian Medical Center, Addis Ababa, Ethiopia. · Nova Southeastern University, Fort Lauderdale, FL, USA. · Health Information Services, Grootebroek, Netherlands. · Brien Holden Vision Institute, Sydney, NSW, Australia; African Vision Research Institute, University of Kwazulu-Natal, Glenwood, Durban, South Africa. · National Health and Medical Research Council Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia. · SpaMedica Research Institute, Bolton, UK. · Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland. · Singapore Eye Research Institute, Duke-National University of Singapore Graduate Medical School, National University of Singapore, Singapore. · Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. ·Lancet Glob Health · Pubmed #29032195.

ABSTRACT: BACKGROUND: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. METHODS: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity of <3/60 in the better eye) by cause, age, region, and year. FINDINGS: We identified 288 studies of 3 983 541 participants contributing data from 98 countries. Among the global population with moderate or severe vision impairment in 2015 (216·6 million [80% uncertainty interval 98·5 million to 359·1 million]), the leading causes were uncorrected refractive error (116·3 million [49·4 million to 202·1 million]), cataract (52·6 million [18·2 million to 109·6 million]), age-related macular degeneration (8·4 million [0·9 million to 29·5 million]), glaucoma (4·0 million [0·6 million to 13·3 million]), and diabetic retinopathy (2·6 million [0·2 million to 9·9 million]). Among the global population who were blind in 2015 (36·0 million [12·9 million to 65·4 million]), the leading causes were cataract (12·6 million [3·4 million to 28·7 million]), uncorrected refractive error (7·4 million [2·4 million to 14·8 million]), and glaucoma (2·9 million [0·4 million to 9·9 million]). By 2020, among the global population with moderate or severe vision impairment (237·1 million [101·5 million to 399·0 million]), the number of people affected by uncorrected refractive error is anticipated to rise to 127·7 million (51·0 million to 225·3 million), by cataract to 57·1 million (17·9 million to 124·1 million), by age-related macular degeneration to 8·8 million (0·8 million to 32·1 million), by glaucoma to 4·5 million (0·5 million to 15·4 million), and by diabetic retinopathy to 3·2 million (0·2 million to 12·9 million). By 2020, among the global population who are blind (38·5 million [13·2 million to 70·9 million]), the number of patients blind because of cataract is anticipated to rise to 13·4 million (3·3 million to 31·6 million), because of uncorrected refractive error to 8·0 million (2·5 million to 16·3 million), and because of glaucoma to 3·2 million (0·4 million to 11·0 million). Cataract and uncorrected refractive error combined contributed to 55% of blindness and 77% of vision impairment in adults aged 50 years and older in 2015. World regions varied markedly in the causes of blindness and vision impairment in this age group, with a low prevalence of cataract (<22% for blindness and 14·1-15·9% for vision impairment) and a high prevalence of age-related macular degeneration (>14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48-3·73]) and cataract (1·21 [1·17-1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57-0·86]) and corneal opacity (0·54 [0·43-0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70-1·14]). INTERPRETATION: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss. FUNDING: Brien Holden Vision Institute.

5 Review Impact of Surgery on the Quality of Life of Caregivers of Children with Congenital Glaucoma. 2016

Gothwal, Vijaya K / Bharani, Seelam / Mandal, Anil K. ·Meera and L B Deshpande Centre for Sight Enhancement, Hyderabad, India. · Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India. Electronic address: mandal@lvpei.org. ·Ophthalmology · Pubmed #26725310.

ABSTRACT: -- No abstract --

6 Review Defects in autophagy caused by glaucoma-associated mutations in optineurin. 2016

Sirohi, Kapil / Swarup, Ghanshyam. ·Centre for Cellular and Molecular Biology, Council of Scientific and Industrial Research, Hyderabad 500 007, India. · Centre for Cellular and Molecular Biology, Council of Scientific and Industrial Research, Hyderabad 500 007, India. Electronic address: gshyam@ccmb.res.in. ·Exp Eye Res · Pubmed #26302410.

ABSTRACT: Certain mutations in optineurin (gene OPTN) are associated with primary open angle glaucoma. Optineurin is ubiquitously expressed but it shows high level of expression in certain cells and tissues including retinal ganglion cells. It interacts with many proteins, often acting as an adaptor to link two or more proteins. These interactions play a crucial role in mediating various functions of optineurin such as membrane vesicle trafficking, autophagy, signal transduction etc. Autophagy is basically a quality control mechanism to remove damaged proteins and organelles through lysosomal degradation. Optineurin was identified as an autophagy receptor that directly interacts with autophagosomal protein, LC3, and ubiquitin. These interactions are important for autophagy receptor function. Autophagy receptors recruit their cargo and take it to autophagosomes which fuse with lysosomes to form autolysosomes where degradation of proteins takes place. Optineurin interacts with a motor protein, myosinVI, and this interaction is involved in mediating fusion of autophagosomes with lysosomes. A glaucoma-associated mutant of optineurin, E50K, impairs autophagy as well as vesicle trafficking, leading to death of retinal cells by apoptosis. E50K-OPTN-induced block in autophagy is dependent on a GTPase activating protein, TBC1D17. The E50K mutant also causes other changes in the cells such as altered interaction with TBK1 protein kinase, aggregate formation, generation of reactive oxygen species and inhibition of proteasome, which may contribute to pathogenesis. A polymorphism of optineurin, M98K, associated with glaucoma, causes enhanced autophagy leading to transferrin receptor degradation and apoptotic death of retinal cells. M98K-OPTN-induced autophagic cell death is dependent on Rab12 GTPase. Thus, an optimum level of optineurin-mediated autophagy is crucial for survival of retinal cells, and impaired autophagy is likely to contribute to glaucoma pathogenesis. How impaired autophagy caused by optineurin mutants leads to apoptosis and cell death, is yet to be explored.

7 Review Functional analysis of optineurin and some of its disease-associated mutants. 2015

Bansal, Megha / Swarup, Ghanshyam / Balasubramanian, Dorairajan. ·Centre for Cellular and Molecular Biology, Hyderabad, Telangana, India. ·IUBMB Life · Pubmed #25855473.

ABSTRACT: Optineurin is a multifunctional protein involved in a variety of cellular functions such as protein trafficking by vesicles, autophagy, and signal transduction. Certain mutations in optineurin (gene OPTN) are associated with neurodegenerative diseases like glaucoma and amyotrophic lateral sclerosis (ALS). Optineurin is also seen in pathological structures present in several other neurodegenerative diseases. In glaucoma, loss of vision occurs due to progressive degeneration of retinal ganglion cells, and perhaps loss of photoreceptor cone cells as well. Most of the glaucoma-associated mutations of optineurin are heterozygous missense mutations, whereas the ALS-associated mutations include deletion, truncation, and missense mutations. Optineurin mediates its functions by interacting with various proteins, often acting as an adaptor to provide a link between two or more proteins. Disease-causing mutations alter these interactions leading to functional defects in membrane vesicle trafficking, autophagy, signaling, aggregate formation, and other processes. Some of these functional defects, caused by glaucoma-associated mutants of optineurin, led to retinal cell death mediated by apoptosis and therefore may contribute to pathogenesis directly. Other mutations are likely to cause glaucoma by indirect mechanisms involving other cell types. Mechanisms of ALS pathogenesis by optineurin mutations are yet to be investigated in detail; however, some ALS-associated mutants cause defects in signaling, autophagy, and ubiquitin binding, which might contribute to pathogenesis.

8 Review Causes of vision loss worldwide, 1990-2010: a systematic analysis. 2013

Bourne, Rupert R A / Stevens, Gretchen A / White, Richard A / Smith, Jennifer L / Flaxman, Seth R / Price, Holly / Jonas, Jost B / Keeffe, Jill / Leasher, Janet / Naidoo, Kovin / Pesudovs, Konrad / Resnikoff, Serge / Taylor, Hugh R / Anonymous6320802. ·Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK. Electronic address: rb@rupertbourne.co.uk. · Department of Health Statistics and Information Systems, WHO, Geneva, Switzerland. · Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. · Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. · School of Computer Science and Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA. · Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK. · Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. · LV Prasad Eye Institute, Hyderabad, India. · College of Optometry, Nova Southeastern University, Fort-Lauderdale-Davie, FL, USA. · African Vision Research Institute, University of Kwazulu-Natal, South Africa; Brien Holden Vision Institute, Sydney, NSW, Australia. · NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia. · International Health and Development, Geneva, Switzerland. · Melbourne School of Public Health, University of Melbourne, Melbourne, VIC, Australia. ·Lancet Glob Health · Pubmed #25104599.

ABSTRACT: BACKGROUND: Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. METHODS: We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990-2010 by age, geographical region, and year. FINDINGS: In 2010, 65% (95% uncertainty interval [UI] 61-68) of 32·4 million blind people and 76% (73-79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65-70) of 31·8 million and 80% (78-83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration. INTERPRETATION: The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. FUNDING: Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.

9 Review Surgical management in patient with uveitis. 2013

Murthy, Somasheila I / Pappuru, Rajeev Reddy / Latha, K Madhavi / Kamat, Sripathi / Sangwan, Virender S. ·Department of Cornea and Anterior Segment Service, L.V. Prasad Eye Institute, Hyderabad, India. ·Indian J Ophthalmol · Pubmed #23803480.

ABSTRACT: Surgery in the management of uveitis can be divided based on indication: either for therapeutic or can be for diagnostic purposes or to manage complications. The commonest indications include: Visual rehabilitation: surgery for removal of cataract, band keratopathy, corneal scars, pupillary membranes, removal of dense vitreous membranes, management of complications: anti-glaucoma surgery, vitreous hemorrhage, retinal detachment and chronic hypotony and diagnostic: aqueous tap, vitreous biopsy, tissue biopsy (iris, choroid). In this review, we shall describe the surgical technique for visual rehabilitation and for management of complications.

10 Review Complex genetic mechanisms in glaucoma: an overview. 2011

Rao, Kollu N / Nagireddy, Srujana / Chakrabarti, Subhabrata. ·Kallam Anji Reddy Molecular Genetics Laboratory, Prof Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India. ·Indian J Ophthalmol · Pubmed #21150032.

ABSTRACT: Glaucomas comprise a group of hereditary optic neuropathies characterized by progressive and irreversible visual field loss and damage to the optic nerve head. It is a complex disease with multiple molecular mechanisms underlying its pathogenesis. Genetic heterogeneity is the hallmark of all glaucomas and multiple chromosomal loci have been linked to the disease, but only a few genes have been characterized, viz. myocilin (MYOC), optineurin (OPTN), WDR36 and neurotrophin-4 (NTF4) in primary open angle glaucoma (POAG) and CYP1B1 and LTBP2 in congenital and developmental glaucomas. Case-control-based association studies on candidate genes involved in different stages of glaucoma pathophysiology have indicated a very limited involvement. The complex mechanisms leading to glaucoma pathogenesis indicate that it could be attributed to multiple genes with varying magnitudes of effect. In this review, we provide an appraisal of the various efforts in unraveling the molecular mystery in glaucoma and also some future directions based on the available scientific knowledge and technological developments.

11 Review Optineurin and its mutants: molecules associated with some forms of glaucoma. 2009

Chalasani, Madhavi Latha / Swarup, Ghanshyam / Balasubramanian, Dorairajan. ·Hyderabad Eye Research Foundation, L V Prasad Eye Institute, Hyderabad, India. ·Ophthalmic Res · Pubmed #19672125.

ABSTRACT: AIMS: Optineurin is a gene (OPTN) associated with normal-tension glaucoma and primary open-angle glaucoma. The aim of our study is to understand the functions of the protein optineurin in retinal ganglion cells, and the modifications that come about in its functions when mutations occur in its sequence. METHODS: We have worked with the rat retinal ganglion cell line RGC5, as well as with some others such as HeLa (human cancer cell line), COS-1 (monkey kidney cell line), IMR-32 (human neuroblastoma cell line), and D407 (human retinal pigment epithelial cell line). The cDNAs of wild-type OPTN, and of its mutants H26D, E50K, R454Q and H486R, were transfected into each of these cell lines and the effects studied. Localization of the proteins in cells was monitored by confocal microscopy and cell imaging, and their interaction with other cellular proteins by yeast two-hybrid assay and co-immunoprecipitation. RESULTS: We found optineurin to interact with several proteins, which are involved in NF-kappaB regulation, vesicular trafficking at recycling endosomes, immune response and transcription regulation. Some of these proteins showed altered/reduced interactions with E50K and H486R mutants. E50K, a severe phenotype-related mutant of optineurin, was found to selectively kill RGC5 cells through oxytosis and apoptosis, while none of the other mutants did so. CONCLUSIONS: Our results indicate that several independent mechanisms are likely to be involved in the pathogenesis of glaucoma caused by mutations in optineurin.

12 Article Reverse Pupillary Block After Retinal Detachment Surgery in an Eye with Toric Implantable Collamer Lens. 2019

Mansoori, Tarannum / Agraharam, Satish Gooty. ·Sita Lakshmi Glaucoma Center, Anand Eye Institute, Habsiguda, Hyderabad, Telangana, 500007, India. tarannummansoori@yahoo.com. · Department of Retina, Anand Eye Institute, Habsiguda, Hyderabad, India. ·Int Ophthalmol · Pubmed #29478226.

ABSTRACT: PURPOSE: To report an interesting phenomenon, after vitreoretinal surgery, in an eye with toric implantable collamer lens (ICL). METHODS: A 20-year-old male presented with raised intraocular pressure (IOP) after the retinal detachment surgery in the left eye. He had toric ICL in both the eyes, and left eye showed shallow peripheral anterior chamber depth (ACD), narrow iridocorneal angle (ICA), increased ICL vault and pigments debris blocking central hole. After dilation, peripheral ACD deepened, ICL vault decreased and ICA increased, with posterior bowing of iris. RESULTS: Patient was managed with topical steroids and antiglaucoma medications. A month later, after inflammation subsided, central hole of ICL became patent, peripheral ACD deepened, ICA increased and IOP was normal without medications, however, after dilation, posterior bowing of iris persisted. He was speculated to have unusual presentation of reverse pupillary block in the left eye after mydriasis. This phenomenon was not observed in the right eye. CONCLUSION: Reverse pupillary block, after dilation is an unusual phenomenon, which was seen in a silicone-filled eye with toric ICL implant. In cases of inflammatory debris blocking Aquaport opening of ICL, conservative management with topical steroids and antiglaucoma medications can help reduce inflammation and IOP, alleviating need for any intervention, such as laser iridotomy.

13 Article Commentary: AADI: New kid on the block. 2018

Pathak-Ray, Vanita. ·Senior Glaucoma and Cataract Specialist Centre for Sight, Banjara Hills; Neoretina Eyecare Institute, Abids; Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India. ·Indian J Ophthalmol · Pubmed #30355866.

ABSTRACT:

14 Article Combined cataract extraction with a new nonvalved glaucoma drainage device in adult eyes with cataract and refractory glaucoma. 2018

Rao, Divya P / Pathak-Ray, Vanita. ·VST Centre for Glaucoma, L.V Prasad Eye Institute, Hyderabad, India. · Centre for Sight, Banjara Hills, Hyderabad, India. ·Indian J Ophthalmol · Pubmed #30127140.

ABSTRACT: Purpose: The purpose of the study is to report the outcomes of simultaneous cataract extraction (CE) and a new nonvalved glaucoma drainage device (GDD), Aurolab Aqueous Drainage Implant (AADI), in eyes with cataract and refractory glaucoma. Methods: This was a non-comparative, interventional, retrospective study. Consecutive patients who underwent AADI together with phacoemulsification from June-2015 to January-2017 by a single fellowship trained glaucoma surgeon with documented 3-months of follow-up were included. The main outcomes were intraocular pressure (IOP), antiglaucoma medication (AGM), visual acuity, and complications. Results: We included 19 eyes of 17 patients with average follow-up of 14.4 ± 8.4 months. IOP and AGM reduced from 36.9 ± 11.1 mmHg and 4 ± 0.8 preoperatively to 12 ± 4.5 mmHg and 0.8 ± 1.2, respectively (P < 0.001). Complications were seen in seven eyes (36.8%). Total success was seen in 17 eyes (89.5%). None of the patients lost vision. Conclusion: Combining cataract extraction with the new non-valved Aurolab Aqueous Drainage Implant, appears to be an effective and safe technique in eyes with refractory glaucoma and cataract. Larger studies and further follow-up is recommended for such patients.

15 Article Increased Iris Stiffness in Patients With a History of Angle-Closure Glaucoma: An Image-Based Inverse Modeling Analysis. 2018

Pant, Anup Dev / Gogte, Priyanka / Pathak-Ray, Vanita / Dorairaj, Syril K / Amini, Rouzbeh. ·Department of Biomedical Engineering, The University of Akron, Akron, Ohio, United States. · LV Prasad Eye Institute, Hyderabad, India. · Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, United States. ·Invest Ophthalmol Vis Sci · Pubmed #30105368.

ABSTRACT: Purpose: Previous studies have shown that iris mechanical properties may play a role in the pathophysiology of primary angle-closure glaucoma (PACG). Such studies, however, were not conducted in vivo and as such were limited in application and scope, especially for the development of diagnostic methods or new treatment options. The purpose of this study was to quantify in vivo iris mechanical properties both in patients with a history of angle-closure glaucoma and in healthy volunteers. Methods: We acquired optical coherence tomography scans of anterior segments under standard and dim light conditions. Using a combination of finite element simulation and an inverse fitting algorithm, we quantified the stiffness of the iris. Results: The irides in the eyes of patients with a history of PACG were significantly stiffer when compared with healthy control irides, a result consistent with ex vivo studies. This result was independent of the compressibility assumption (incompressible: 0.97 ± 0.14 vs. 2.72 ± 0.71, P = 0.02; compressible: 0.89 ± 0.13 vs. 2.57 ± 0.69, P = 0.02) when comparing the normalized elastic modulus of the iris between patients with PACG and healthy controls. Conclusions: Our noninvasive, in vivo quantification is free of numerous ethical issues and potential limitations involved with ex vivo examinations. If further studies confirm that the iris stiffness is an omnipresent PACG risk factor and a mechanistic role between increased iris stiffness and angle-closure glaucoma does exist, treatment methods such as lowering the iris stiffness can be developed.

16 Article Tear biomarkers in latanoprost and bimatoprost treated eyes. 2018

Reddy, Shweta / Sahay, Prity / Padhy, Debananda / Sarangi, Sarada / Suar, Mrutyunjay / Modak, Rahul / Rao, Aparna. ·Hyderabad Eye Research Foundation (HERF), L.V. Prasad Eye Institute, Bhubaneswar, India. · School of Biotechnology, KIIT University, Bhubaneswar, India. ·PLoS One · Pubmed #30080906.

ABSTRACT: PURPOSE: Prostaglandin analogues (PGA's) are the mainstay and first line of treatment in current glaucoma practise. Though latanoprost and bimatoprost are the most commonly used PGA's with minimal side effects at lower concentrations like bimaotoprost 0.01%, direct comparison of their cytokine/MMP profile in tears has not been evaluated earlier. The study intends to ascribe PGA to the upregulation of MMPs, Cytokines and Chemokines mediating varied pathways to result in side effects of the drugs. METHODS: Tear sample collection was done from outer canthus of 30 eyes of 30 patients (primary open angle glaucoma (n = 26 and n' = 20), normal tension glaucoma (n = 4 and n' = 10), in latanoprost (n) 0.005% and bimatoprost (n') 0.01% group respectively, with a mean age of 62±10.5 years) on >6 months of PGA use using Tear floTM Schirmer filter strip. Tear samples from 30 eyes of 30 cataract patients without drug treatment were used as the control. Gelatinolytic activity of MMP-9 and MMP-2 were examined by substrate gelatine zymography MMP-1 and TIMP-1 concentrations from tears samples with PGAs were evaluated by ELISA while cytokine concentration in the eluted tears was evaluated using a convenient bioplex kit assay (Milliplex MAP kit, HCYTMAG-60K-PX41, Millipore, Massachusetts, United States). The mean duration of use of PGA in both groups did not differ significantly (median 1.3 years in bimatoprost and 1.1 years in latanoprost eyes, p = 0.6). RESULTS: The tear MMP-9 expression was higher in eyes receiving latanoprost while the MMP-2 expression was higher in eyes receiving bimatoprost with MMP1 protein levels being higher in the former. Latanoprost treated eyes had marginally elevated tear cytokines involved in tissue remodelling while bimatoprost eyes showed elevated cytokines regulating allergic pathways. CONCLUSION: Differential cytokine and MMP expression indicates differential signalling pathways mediating different cellular effects (evident as clinical and side effects) with the two drugs which can be explored further.

17 Article Application of high intensity focused ultrasound for treatment of open-angle glaucoma in Indian patients. 2018

Deb-Joardar, Nilanjana / Reddy, Kasu Prasad. ·Department of Glaucoma, Winvision Eye Hospital, Hyderabad, Telangana, India. · Department of Glaucoma, Maxivision Eye Hospital, Hyderabad, Telangana, India. ·Indian J Ophthalmol · Pubmed #29582811.

ABSTRACT: Purpose: The aim of this study is to assess the efficacy of ultrasound cycloplasty (UCP) in Indian patients with open angle glaucoma (OAG). Methods: A prospective interventional study was designed to treat 73 eyes of 73 patients with OAG with the EyeOP1 device equipped with six miniaturized cylindrical piezoelectric transducers. Two treatment protocols of ultrasound delivery depending on exposure time (8 s and 10 s of shot per transducer) were used. Complete ophthalmic examination, ocular biometry and anterior segment optical coherence tomography were performed preoperatively and patients were followed up at day 1, day 7 and months 1, 2, 3, 6, and 12. The primary outcome measure was "successful" intraocular pressure (IOP) control defined as IOP reduction ≥20% from baseline and IOP value >5 mm Hg at the last follow-up visit. Secondary outcomes were the occurrence of complications and mean IOP during the follow-up period. Results: In all patients, the mean IOP reduced from 23.5 ± 3.0 mmHg before treatment to 15.7 ± 5.4 mmHg at 12 months (P < 0.05). Successful IOP control after a single procedure was 78.3% (79% and 78% in the 8 s and 10 s groups, respectively) at 12 months. Overall, the mean IOP reduction achieved in responding patients was 41% (standard deviation = 12%). Notwithstanding minor side effects such as transient pain, anterior chamber reaction, and refractive error changes, no major intraoperative or postoperative complications (severe hypotony or phthisis) were observed during the follow-up. Conclusion: Our short-term results reveal that UCP is a simple, safe, and noninvasive procedure which enables to significantly reduce the IOP in patients with OAG. The study results in Indian eyes corroborate findings in earlier studies on Caucasian eyes.

18 Article Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections. 2018

Bourne, Rupert R A / Jonas, Jost B / Bron, Alain M / Cicinelli, Maria Vittoria / Das, Aditi / Flaxman, Seth R / Friedman, David S / Keeffe, Jill E / Kempen, John H / Leasher, Janet / Limburg, Hans / Naidoo, Kovin / Pesudovs, Konrad / Peto, Tunde / Saadine, Jinan / Silvester, Alexander J / Tahhan, Nina / Taylor, Hugh R / Varma, Rohit / Wong, Tien Y / Resnikoff, Serge / Anonymous6461055. ·Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK. · Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany. · Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. · INRA, UMR1324 Centre des Sciences du Goût et de l'Alimentation, Dijon, France. · CNRS, UMR6265 Centre des Sciences du Goût et de l'Alimentation, Dijon, France. · Centre des Sciences du Goût et de l'Alimentation, Université Bourgogne Franche-Comté, Dijon, France. · Ophthalmology Department, Dijon University Hospital, Dijon, France. · San Raffaele Scientific Institute, Milan, Italy. · Health Education Yorkshire and the Humber, Leeds, UK. · Department of Mathematics and Data Science Institute, Imperial College London, London, UK. · Department of Statistics, University of Oxford, Oxford, UK. · Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · LV Prasad Eye Institute, Hyderabad, India. · Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. · Discovery Eye Center, Addis Ababa, Ethiopia. · Myungsung Christian Medical Center and Medical School, Addis Ababa, Ethiopia. · Nova Southeastern University, Davie, Florida, USA. · Health Information Services, Grootebroek, The Netherlands. · African Vision Research Institute, University of Kwazulu-Natal, Brien Holden Vision Institute, Durban, South Africa. · NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, South Australia, Australia. · School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. · Centers for Disease Control and Prevention, Atlanta, Georgia, USA. · St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. · Brien Holden Vision Institute, Sydney, New South Wales, Australia. · School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia. · Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia. · Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California, USA. · Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore. ·Br J Ophthalmol · Pubmed #29545417.

ABSTRACT: BACKGROUND: Within a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020. METHODS: Based on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia was estimated for 1990, 2010, 2015, and 2020. RESULTS: Age-standardised prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10-0.46) to 0.15% (0.06-0.26) and from 1.74% (0.76-2.94) to 1.27% (0.55-2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70 000, 630 000 and 610 000, respectively, in Australasia to 980 000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million, respectively, in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI. CONCLUSIONS: While continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem is needed.

19 Article Sampling the Visual Field Based on Individual Retinal Nerve Fiber Layer Thickness Profile. 2018

Ballae Ganeshrao, Shonraj / Turpin, Andrew / McKendrick, Allison M. ·VST Glaucoma Centre, LV Prasad Eye Institute, Hyderabad, India. · Computing and Information Systems, The University of Melbourne, Melbourne, Australia. · Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia. ·Invest Ophthalmol Vis Sci · Pubmed #29490343.

ABSTRACT: Purpose: Current perimeters use fixed grid patterns. We test whether a grid based on an individual's retinal nerve fiber layer (RNFL) thickness profile would find more visual field (VF) defects. Methods: We describe the defect-based method for choosing test locations. First, the 26 VF locations with the highest positive predictive value to detect glaucoma from the 24-2 pattern are chosen. An additional 26 locations are chosen from a 2 × 2 degree grid based on RNFL thickness. An individualized map was used to relate VF locations to peripapillary RNFL thickness. To test whether the 52 locations chosen by the defect-based method find more defects than other test grids, we collected a 386-location (2 × 2 degree grid) VF measurement on 23 glaucoma participants and classed each location in the dataset as either abnormal or normal using a suprathreshold test. Using this data, defect-based sampling was compared to: a method that sampled VF locations uniformly around the optic nerve head (ONH); the 24-2 pattern; a polar pattern; and a reduced polar pattern. The outcome measure was the number of abnormal points that were selected as test locations. Results: For 8 eyes, no method found more abnormal points than would be expected by chance (hypergeometric distribution, P < 0.05). Of the remaining 15 eyes, the defect-based method identified more abnormal locations on nine eyes, which was significantly better than the other three sampling schemes (24-2: 2 eyes, P < 0.001; polar: 2 eyes, P < 0.001; reduced polar: 2 eyes, P < 0.004; and uniform: 1 eye, P < 0.001). Conclusions: Using structural information to choose locations to test in a VF for individual patients identifies more abnormal locations than using existing grid patterns and uniform sampling based on structure.

20 Article Anterior segment morphology after laser iridotomy in primary angle closure suspects. 2018

Mansoori, Tarannum / Balakrishna, Nagalla. ·Department of Glaucoma, Anand Eye Institute, Hyderabad, India. · Department of Statistics, National Institute of Nutrition, Hyderabad, India. ·Clin Exp Optom · Pubmed #29130529.

ABSTRACT: PURPOSE: To evaluate and compare the changes in anterior segment parameters in primary angle closure suspects before and after laser peripheral iridotomy and intrasession repeatability of measurements before laser iridotomy as assessed by Scheimpflug-Placido disc topographer. METHODS: Before laser iridotomy, 56 eyes of 56 primary angle closure suspect patients underwent anterior segment analysis with the Sirius Scheimpflug-Placido disc topographer system using glaucoma analysis mode, which was repeated a week after iridotomy. Anterior segment parameters such as central anterior chamber depth, central corneal thickness, anterior chamber volume and iridocorneal angle were analysed before and after laser iridotomy and compared with paired t-test. Three consecutive scans were obtained to assess the intrasession repeatability of measurements before iridotomy by a single examiner and intraclass correlation co-efficient was calculated. Multivariate regression analysis was performed to evaluate the predictors associated with iridocorneal angle narrowing. RESULTS: Intraclass correlation co-efficient values ranged from 0.982 for anterior chamber volume to 0.998 for the iridocorneal angle. After laser iridotomy, mean central anterior chamber depth increased from 2.14 ± 0.29 mm to 2.21 ± 0.28 mm (p = 0.04), mean anterior chamber volume increased from 96.2 ± 16.98 mm CONCLUSIONS: Laser peripheral iridotomy induces significant changes in the 3-D anterior segment morphology in primary angle closure suspect patients. The Scheimpflug-Placido disc topographer provides reproducible measurements of the iridocorneal angle and other parameters measured and hence, may become clinically useful for non-invasive detection of potentially occludable angles. Predictors of iridocorneal angle widening after iridotomy were older age and anterior chamber volume.

21 Article Effect of central corneal thickness on intraocular pressure and comparison of Topcon CT-80 non-contact tonometry with Goldmann applanation tonometry. 2018

Mansoori, Tarannum / Balakrishna, Nagalla. ·Department of Glaucoma, Anand Eye Institute, Hyderabad, India. · Department of Statistics, National Institute of Nutrition, Hyderabad, India. ·Clin Exp Optom · Pubmed #29044716.

ABSTRACT: BACKGROUND: To compare intraocular pressure (IOP) measurements obtained with the Topcon CT-80 non-contact tonometer (NCT) and Goldmann applanation tonometer (GAT), in different ranges of IOP in normal and glaucoma subjects, and to assess the influence of central corneal thickness (CCT) on the IOP measurements in Asian Indian eyes. METHODS: Four hundred and two eyes of 402 subjects (193 newly diagnosed primary open angle glaucoma [POAG] and 209 normal) were enrolled for this prospective study. For each eye, IOP was measured with GAT by a glaucoma specialist and NCT by a trained optometrist. The IOP values were compared among the tonometers in the three different IOP ranges (≤ 12 mmHg, 13-20 mmHg and ≥ 21 mmHg) using Bland-Altman graphs. Correlation between GAT and NCT was assessed by Pearson correlation co-efficient. CCT was measured with ultrasound pachymetry and its correlation with GAT and NCT was analysed using linear regression analysis. RESULTS: The mean paired difference of IOP between NCT and GAT was 1.556 ± 2.69 mmHg (r = 0.26, p = 0.006) at IOP range of ≤ 12 mmHg, -1.665 ± 2.6 mmHg (r = 0.51, p < 0.0001) in IOP range of 13-20 mmHg and -2.202 ± 3.44 mmHg (r = 0.82, p < 0.0001) in the IOP range of ≥ 21 mmHg. Linear regression analysis showed a mean IOP variation of 0.27 mmHg per 10 μm change in CCT for NCT (p < 0.0001) and IOP change of 0.19 mmHg per 10 μm change in CCT for GAT (p = 0.01). CONCLUSION: In this study of normotensive and POAG subjects, the Topcon CT-80 NCT showed an overestimation of IOP at the lower range and underestimation of IOP in normal and higher ranges of IOP. Clinicians should keep in mind that CCT influences IOP measurement with both types of tonometer and that the IOP readings obtained with these tonometers are not interchangeable.

22 Article Outcomes of lensectomy and risk factors for failure in spherophakic eyes with secondary glaucoma. 2018

Rao, Divya P / John, Praveen J / Ali, Mohammed Hasnat / Kekunnaya, Ramesh / Jalali, Subhadra / Garudadri, Chandra Sekhar / Senthil, Sirisha. ·VST Centre for Glaucoma, L V Prasad Eye Institute, Hyderabad, India. · Department of Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad, India. · Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India. · Srimathi Kanuri Santhamma Vitreoretinal Services, L V Prasad Eye Institute, Hyderabad, India. ·Br J Ophthalmol · Pubmed #28928265.

ABSTRACT: PURPOSE: To report the outcomes of lensectomy in spherophakic eyes with subluxated or dislocated crystalline lenses and secondary glaucoma. METHODS: Lensectomy was performed in 52 eyes, 36 eyes with lens subluxation and 16 eyes with lens dislocation with secondary glaucoma from 1991 to 2016. Glaucoma was diagnosed based on intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage. Complete success was defined as IOP ≥5 and ≤21 mm Hg without antiglaucoma medications (AGMs) or surgery, and eyes needing oral AGM or surgical intervention for IOP control or those with complication causing loss of light perception were considered failure. RESULTS: Median (IQR) age at lensectomy was 12 (6-18) years, and median spherical equivalent was -14.5D (-23.7to -13). Median follow-up was 30.6 (5.4-103.4) months. Median logMAR (logarithm of minimal angle of resolution) visual acuity improved from 0.95 (0.6-1.8) to 0.4 (0.2-1.3) after lensectomy (p=0.01). Median IOP decreased from 22 mm Hg (17-31) to 14 mm Hg (11-19) at final follow-up (p=0.01). Median number of AGM decreased from 2 (2-3) to 1 (0-2) at final follow-up (p<0.0001), and glaucoma surgery was needed in four eyes (7.7% eyes). Complete success probability was 69% at 1 year and 51% at 5 years. Younger age (<6 years), higher presenting IOP (>32 mm Hg) and larger cup to disc ratio at presentation were found to be significant risk factors for failure. CONCLUSION: Lensectomy was effective in controlling IOP in close to half of all eyes with spherophakia and secondary glaucoma, 40% eyes needed AGM and only 7.7% eyes needed glaucoma surgery for IOP control. In this cohort, younger age, higher IOP and larger cup to disc ratio at presentation were risk factors for poor glaucoma control after lensectomy.

23 Article 25G PARS PLANA VITRECTOMY AND IRIDO-ZONULO-HYALOIDO-VITRECTOMY IN THE MANAGEMENT OF MALIGNANT GLAUCOMA IN PHAKIC EYES FOLLOWING TRABECULECTOMY. 2018

Rani, Padmaja K / Gulati, Isha / Rao, Harsha Laxmana / Senthil, Sirisha. ·Kallam Anji Reddy Campus, L.V. Prasad Eye Institute, Hyderabad, India. ·Retin Cases Brief Rep · Pubmed #27504696.

ABSTRACT: PURPOSE: To describe a new surgical technique in the management of malignant glaucoma in phakic eyes. METHODS: We performed 25-gauge pars plana vitrectomy with anterior irido-zonulo-hyaloido-vitrectomy in 2 young phakic patients with malignant glaucoma after trabeculectomy. This technique allowed posteroanterior aqueous communication, relieved aqueous misdirection, helped restoring anterior chamber depth, normalized the intraocular pressure and most importantly helped to preserve the crystalline lens. RESULTS: At 8 months follow-up, both patients have stable visual acuity, normal intraocular pressure, well-functioning blebs, and clear crystalline lens. CONCLUSION: One can consider 25-gauge pars plana vitrectomy with anterior irido-zonulo-hyaloido-vitrectomy as a safe and effective treatment option for the management of malignant glaucoma in phakic eyes.

24 Article Intermediate Term Outcomes of Early Posttrabeculectomy Bleb Leaks Managed by Large Diameter Soft Bandage Contact Lens. 2017

Gollakota, SriRamani / Garudadri, Chandra S / Mohamed, Ashik / Senthil, Sirisha. ·*VST Glaucoma Centre †Ophthalmic Biophysics, L.V. Prasad Eye Institute, Hyderabad, Telangana, India. ·J Glaucoma · Pubmed #28787291.

ABSTRACT: PURPOSE: To study the outcomes of large diameter soft bandage contact lens (BCL) in managing early trabeculectomy bleb leak. MATERIALS AND METHODS: Of 972 eyes that underwent fornix-based trabeculectomy between 2011 and 2015, 19 eyes with bleb leak with at least 1 year follow-up were eligible. Bleb leak was conservatively managed using large diameter BCL (≥15.5 mm in diameter). Success was defined as complete, if bleb leak resolved and the intraocular pressure (IOP) was ≥5 and ≤18 mm Hg with no additional antiglaucoma medication and failure if surgical intervention was needed. RESULTS: Mean age (±SD) of subjects was 43.5±11.9 years. Mitomycin C was used in 15/19 eyes. Median time (interquartile range) from trabeculectomy to bleb leak was 9 days (interquartile range: 8 to 19 d). Bleb leak was treated with 15.5 mm BCL in 16 eyes and 17 mm lens in 3 eyes. Bleb leak resolved with BCL in 17 [89.5%; 95% confidence interval (95% CI), 68.6-97] and 2 eyes (10.5%; 95% CI, 2-31) required bleb resuturing. Mean duration of BCL wear for bleb leak resolution was 23.7±8.9 days. Mean IOP increased from 5.8±2.7 to 12.5±3.1 mm Hg after resolution of bleb leak (P<0.05). At 16 months, complete success probability of trabeculectomy was 89.4% (95% CI, 75.6%-100%). CONCLUSIONS: Large diameter BCL was effective in the management of early bleb leak with good intermediate term success for IOP control. We suggest a trial of soft contact lens of appropriate diameter to manage early bleb leaks, before planning any invasive intervention.

25 Article Joint optic disc and cup boundary extraction from monocular fundus images. 2017

Chakravarty, Arunava / Sivaswamy, Jayanthi. ·Centre for Visual Information Technology, International Institute of Information Technology Hyderabad, 500032, India. Electronic address: arunava.chakravarty@research.iiit.ac.in. · Centre for Visual Information Technology, International Institute of Information Technology Hyderabad, 500032, India. Electronic address: jsivaswamy@iiit.ac.in. ·Comput Methods Programs Biomed · Pubmed #28734530.

ABSTRACT: BACKGROUND AND OBJECTIVE: Accurate segmentation of optic disc and cup from monocular color fundus images plays a significant role in the screening and diagnosis of glaucoma. Though optic cup is characterized by the drop in depth from the disc boundary, most existing methods segment the two structures separately and rely only on color and vessel kink based cues due to the lack of explicit depth information in color fundus images. METHODS: We propose a novel boundary-based Conditional Random Field formulation that extracts both the optic disc and cup boundaries in a single optimization step. In addition to the color gradients, the proposed method explicitly models the depth which is estimated from the fundus image itself using a coupled, sparse dictionary trained on a set of image-depth map (derived from Optical Coherence Tomography) pairs. RESULTS: The estimated depth achieved a correlation coefficient of 0.80 with respect to the ground truth. The proposed segmentation method outperformed several state-of-the-art methods on five public datasets. The average dice coefficient was in the range of 0.87-0.97 for disc segmentation across three datasets and 0.83 for cup segmentation on the DRISHTI-GS1 test set. The method achieved a good glaucoma classification performance with an average AUC of 0.85 for five fold cross-validation on RIM-ONE v2. CONCLUSIONS: We propose a method to jointly segment the optic disc and cup boundaries by modeling the drop in depth between the two structures. Since our method requires a single fundus image per eye during testing it can be employed in the large-scale screening of glaucoma where expensive 3D imaging is unavailable.

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