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Background: Administrative claims have been used to study the incidence and outcomes of nonarteritic ischemic optic neuropathy (NAION), but the validity of International Classi- fication of Diseases (ICD)-10 codes for identifying NAION has not been examined. Methods: We identified patients at 3 academic centers who received $1 ICD-10 code for NAION in 2018. We abstracted the final diagnosis from clinical documentation and recorded the number of visits with an NAION diagnosis code. We calculated positive predictive value (PPV) for the overall sample and stratified by subspecialty and the number of diagnosis codes. For patients with ophthalmology or neuro-ophthalmology visit data, we recorded presenting symptoms, examination findings, and laboratory data and calculated PPV relative to case definitions of NAION that incorporated sudden onset of symptoms, optic disc edema, afferent pupillary defect, and other characteristics. Results: Among 161 patients, PPV for $1 ICD-10 code was 74.5% (95% CI: 67.2%--80.7%). PPV was similar when restricted to patients who had visited an ophthalmologist (75.8%, 95% CI: 68.4%--82.0%) but increased to 86.8% when restricted to those who had visited neuroophthalmologists (95% CI: 79.2%--91.9%). Of 113 patients with .1 ICD-10 code and complete examination data, 37 (32.7%) had documented sudden onset, optic disc swelling, and an afferent pupillary defect (95% CI: 24.7%--42.0%). Of the 76 patients who did not meet these criteria, 54 (71.0%) still received a final clinical diagnosis of NAION; for most (41/54, 75.9%), this discrepancy was due to lack of documented optic disc edema. Conclusions: The validity of ICD-10 codes for NAION in administrative claims data is high, particularly when combined with provider specialty. [ABSTRACT FROM AUTHOR]

Purpose: To identify ophthalmic findings in Alzheimer's type dementia (ATD) compared to normal subjects.Patients and Methods: This comparative descriptive study included participants from the institution's cognitive fitness center. Complete ophthalmic examinations were performed. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to analyze retinal thickness and vascular density. The Ocular Surface Disease Index (OSDI) score and tear breakup time (TBUT) were used to assess dry eye. The blink rate was counted by a well-trained observer. Cognitive function was evaluated using the Thai Mental State Examination (TMSE) score. Correlation analysis was performed to compare OCT, OCTA parameters, and TMSE.Results: We included 24 ATD patients and 39 normal participants as a control group by age and sex-matched. The prevalence of dry eye using the Asia Dry Eye Society criteria was 15% and 13% in normal and ATD patients, respectively. The differences in OSDI scores, TBUT, and blink rate between the two groups were not statistically significant. The parafoveal and perifoveal macular thickness of the ATD group were significantly lower than that of the control group (p< 0.01). All parameters of the vessel density of the ATD group were significantly lower than in the control group, including the whole macular vessel density (p< 0.01), optic disc vessel density at the nerve head level (p< 0.01), and optic disc vessel density at the radial peripapillary capillary level (p< 0.05). After age adjustment, there were no statistically significant differences in all the OCT and OCTA parameters. There was a positive correlation between retinal thickness and vessel density in the macular and optic disc region and TMSE scores.Conclusion: Perifoveal and parafoveal retinal thickness might be more sensitive than peripapillary RNFL thickness to detect neurodegenerative changes in patients with ATD. Macular thickness and vessel density reduction were also positively correlated with cognitive decline. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the leading cause of dementia worldwide. Early detection is believed to be essential to disease management because it enables physicians to initiate treatment in patients with early-stage AD (early AD), with the possibility of stopping the disease or slowing disease progression, preserving function and ultimately reducing disease burden. The purpose of this study was to review prior research on the use of eye biomarkers and artificial intelligence (AI) for detecting AD and early AD. The PubMed database was searched to identify studies for review. Ocular biomarkers in AD research and AI research on AD were reviewed and summarized. According to numerous studies, there is a high likelihood that ocular biomarkers can be used to detect early AD: tears, corneal nerves, retina, visual function and, in particular, eye movement tracking have been identified as ocular biomarkers with the potential to detect early AD. However, there is currently no ocular biomarker that can be used to definitely detect early AD. A few studies that used AI with ocular biomarkers to detect AD reported promising results, demonstrating that using AI with ocular biomarkers through multimodal imaging could improve the accuracy of identifying AD patients. This strategy may become a screening tool for detecting early AD in older patients prior to the onset of AD symptoms. [ABSTRACT FROM AUTHOR]

Purpose: To study visual recovery and identify the factors that may affect it in patients with ethambutol-induced optic neuropathy (EON). Patients and Methods: Medical charts of patients who developed optic neuropathy after ethambutol (EMB) treatment for tuberculosis infection were retrospectively reviewed. Demographic details and clinical data were examined to assess visual recovery after discontinuation of ethambutol treatment. The univariate and multivariate relationships between various factors and visual recovery were evaluated using regression analysis. Results: Of 5394 patients diagnosed with tuberculosis infection and treated with EMB, 23 patients (0.43%) were diagnosed with EON. Logistic regression analysis found that female sex was the categorical factor significantly associated with good visual recovery with an odds ratio of 12.0 (95% confidence interval 1.56, 92.29; p = 0.02), while linear regression analysis identified good initial visual acuity as the numerical factor significantly related with it (p < 0.001). After adjustment with multivariate analysis, initial visual acuity was found to be the only significant factor associated with visual recovery. All patients with initial visual acuity of better than 20/200 at first visit achieved good visual recovery. Conclusion: The incidence of EON in patients treated with EMB was 0.43% in this hospital-based study. Good visual recovery was noted in 39.13% of these patients, and initial visual acuity was the factor that affected visual recovery. It is recommended that patients on EMB have regular screening by an ophthalmologist for early detection of the disease, and if it is discovered, that the use of the drug be immediately discontinued in order to prevent potentially devastating visual loss. [ABSTRACT FROM AUTHOR]

The purpose is to report ocular surface erosion of health personnel who were exposed to evaporated CoronaVac during a vaccination campaign. A campaign for CoronaVac vaccination was conducted in a closed space of 11.04 × 5.96 m, partially divided into 6 rooms with interconnected area among the rooms. A total of 20 health personnel worked in the vaccination rooms. On the third day of campaign, a vial, containing a single dose of 0.5 mL, of the vaccine was dropped accidentally onto the floor and broken by an administering nurse. A total of 15 personnel had symptoms and signs of ocular surface erosion at the average time from the accident to the onset of 10.2 ± 7.1 h; 4 personnel also had skin rash. These personnel included all 13 persons who already worked in the rooms when the accident occurred and continued for additional 4–6 h and 2 personnel who presented in the rooms 1–2 h after the accident and stayed for 2–3 h. Proximity and timing suggest CoronaVac correlation with the ocular and skin reactions. Cautions should be taken to avoid broken vials, spills, and aerosolization of CoronaVac during the vaccination. [ABSTRACT FROM AUTHOR]