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AIM: To compare intraocular pressure (IOP) readings obtained with Perkins tonometry, iCare Home, iCare 200, and Tonopen to IOP readings obtained with the manometer of a perfusion system to assess the accuracy and reproducibility of each method of tonometry at set pressures. METHODS: The IOP of human cadaveric eyes (n=2) was measured using a manometer inserted into the eye through the optic nerve. IOP measurements were obtained using a Perkins tonometer, iCare Home, iCare 200, and Tonopen. These measurements were compared to set point IOP measurements of a manometer to determine accuracy and reproducibility of each device. RESULTS: Mean IOP readings obtained with the Perkins tonometer compared to manometer readings demonstrated a difference of -1.0±5.0 mm Hg (P=0.45), indicating a lower reading on average than manometery although not significant. Mean IOP difference between iCare 200 and manometer was 5.3±2.2 mm Hg (P

ObjectiveThis trial was designed to determine if artificial intelligence (AI)-supported diabetic retinopathy (DR) screening with immediate results improved referral uptake in Rwanda.DesignThe RAIDERS (Rwanda Artificial Intelligence for DiabEtic Retinopathy Screening) study was an investigator-masked parallel-group, randomized controlled trial.ParticipantsHave known diabetes, are aged >= 18 and require referral for DR based on AI.MethodsThe RAIDERS study screened for DR using retinal imaging with AI interpretation implemented at four facilities from March-July 2021. Eligible participants were randomly assigned (1:1) to immediate feedback of AI grading (intervention) or communication of referral advice after human grading was completed three-to-five days after the initial screening (control).Main Outcome MeasuresDifference between study groups in the rate of presentation for recommended referral services within 30 days of being informed of the need for a referral visit.ResultsOf the 823 clinic patients with diabetes who met inclusion criteria, a total of 275 participants (33.4%) screened positive for referrable DR based on AI screening and were randomized for inclusion in the trial. Study participants (mean age 50.7 years, 58.2% women) were randomized to intervention (n=136, 49.5%) or control (n=139, 50.5%). There were no significant inter-group differences at baseline, and 100% had main outcome data available for analyses. Referral adherence was statistically significantly higher in the intervention (70/136=51.5%) versus control (55/139=39.6%; p=0.048), a 30.1% increase. Older age (Odds ratio= 1.04, 95% Confidence Interval: 1.02-1.05, pConclusionImmediate feedback on referral status based on AI-supported screening was associated with statistically significantly higher referral adherence compared to delayed communications of results from human graders, necessitated by time for human image review in this setting. These results provide evidence for an important benefit of AI screening in promoting adherence to prescribed treatment for diabetic eyecare in sub-Saharan Africa.

This systematic review and meta-analysis summarizes existing evidence to establish whether vision impairment, ocular morbidity and their treatment are associated with depression and anxiety in children. Understanding and quantifying these associations support early detection and management of mental health symptoms in children with vision impairment and ocular morbidity. Additionally, this review provides evidence in favour of insurance coverage for timely strabismus surgery. We searched nine electronic databases from inception to February 18, 2021, including observational and interventional studies assessing whether vision impairment and/or ocular morbidity and their treatment are associated with depression and/or anxiety in children. We used narrative synthesis and meta-analysis with the residual maximum likelihood method. A protocol was registered and published on The International Prospective Register of Systematic Reviews (PROSPERO, CRD42021233323). Among 28,992 studies, 28,956 (99.9%) were excluded as duplicates or unrelated content. Among 36 remaining studies, 21 (58.3%) were observational studies concerning vision impairment, eight (22.2%) were observational studies concerning strabismus, and seven (19.4%) were interventional studies. Vision-impaired children experienced significantly higher scores of depression (Standard Mean Difference [SMD] 0.57, 95% Confidence Interval (CI) 0.26-0.89, 11 studies) and anxiety (SMD 0.61, 95% CI 0.40-0.821, 14 studies) than normally-sighted children. In particular, myopic children experienced higher scores of depression (SMD 0.59, 95% CI 0.36-0.81, six studies) than normally-sighted children. Strabismus surgery significantly improved symptoms of depression (SMD: 0.59 95% CI 0.12-1.06, three studies) and anxiety (SMD: 0.69 95% CI 0.24-1.14, four studies) in children. Among children, vision impairment is associated with greater symptoms of depression and anxiety. Surgical treatment of strabismus improved these symptoms. Further randomized controlled trials exploring the impact of public health measures for myopia correction on mental health in children are needed. Scaling up access to strabismus surgery could improve the mental health of affected children.

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Additional file of Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study

Additional file of Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study

Additional file 1: Codes used to identify chemotherapy and radiation treatment in Medicare files. This file contains Medicare codes that were used to indicate chemotherapy and radiation treatment. (DOCX 11 KB)

Additional file 1: Codes used to identify chemotherapy and radiation treatment in Medicare files. This file contains Medicare codes that were used to indicate chemotherapy and radiation treatment. (DOCX 11 KB)

Additional file of Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study

Additional file of Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study