The Experts below are selected from a list of 2106 Experts worldwide ranked by ideXlab platform
Anders Behndig - One of the best experts on this subject based on the ideXlab platform.
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Systemic exposure to intracameral vs topical Mydriatic agents: in cataract surgery.
Clinical ophthalmology (Auckland N.Z.), 2019Co-Authors: José L. Güell, Anders Behndig, Uwe Pleyer, Stéphane Jaulerry, Pascal Rozot, Pierre-jean Pisella, P.-y. Robert, Ines Lanzl, Sayeh Pourjavan, Carlos AguiarAbstract:Objective The objective of this study was to compare systemic exposure to tropicamide/phenylephrine following intracameral or topical administration before cataract surgery. Patients and methods Mydriatics exposure was calculated in patients randomized to intracameral fixed combination of Mydriatics and anesthetic ([ICMA]: tropicamide 0.02%, phenylephrine 0.31%, and lidocaine 1%, N=271) or Mydriatic eye drops ([EDs]: tropicamide 0.5% and phenylephrine 10%, N=283). Additional doses were permitted if required. Mydriatic plasma levels were determined by mass spectrometric HPLC in 15 patients per group before and after administration. Results Most ICMA patients (73.6%) received a single dose (200 µL) representing an exposure to tropicamide of 0.04 mg and phenylephrine of 0.62 mg. None of these patients received additional Mydriatics. In the control group (three administrations), the exposure was 0.45 (11.3-fold higher than ICMA) and 10.2 (16.5-fold higher) mg. When additional ED was used in this group (9.2% of patients), it was 37.5-fold higher for tropicamide (10 drops, 1.5 mg) and 54.8-fold higher for phenylephrine (10 drops, 34 mg) than the recommended ICMA dose. Tropicamide plasma levels were not detectable at any time point in ICMA patients while it was detectable in all ED patients at 12 and 30 minutes. Phenylephrine was detectable in 14.3% of ICMA patients compared to all ED patients at least at one time point. More ED patients experienced a meaningful increase in blood pressure and/or heart rate (11.2% vs 6.0% of ICMA patients; P=0.03). Conclusion Systemic exposure to tropicamide/phenylephrine was lower and cardiovascular (CV) effects were less frequent with ICMA. This could be of particular significance in patients at CV risk.
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ocular tolerance in rabbits after intracameral administration of a fixed combination of tropicamide phenylephrine and lidocaine with and without rinsing
Journal of Cataract and Refractive Surgery, 2017Co-Authors: Rudy M M A Nuijts, Rita Mencucci, Karen Viaudquentric, Pierrepaul Elena, Celine Olmiere, Anders BehndigAbstract:Purpose: To evaluate the safety and tolerability of a single intracameral administration of a combined Mydriatic (tropicamide and phenylephrine) and anesthetic (lidocaine) formulation (Mydrane) wit ...
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Mydriatic insert and intracameral injections compared with Mydriatic eyedrops in cataract surgery controlled studies
Journal of Cataract and Refractive Surgery, 2015Co-Authors: Anders Behndig, Jeanfrancois KorobelnikAbstract:Mydriatic eyedrops are the standard method for pupil dilation in cataract surgery, but their limitations have prompted a search for alternative techniques. Two alternatives an ophthalmic insert con ...
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Mydriatic response to different concentrations of intracameral phenylephrine in humans
Journal of Cataract and Refractive Surgery, 2010Co-Authors: Anders Behndig, Bjorn LundbergAbstract:Results show that phenylephrine injected intracamerally does not have a linear Mydriatic dose-response relationship in humans. At very high concentrations, phenylephrine may bind to and stimulate r ...
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mydriasis with different preparations of topically administered lidocaine hydrochloride
Journal of Cataract and Refractive Surgery, 2009Co-Authors: Martin Claesson, Magdalena Johansson, Anders BehndigAbstract:PURPOSE: To quantify the Mydriatic effect and side effects of topical lidocaine hydrochloride with different pH values and concentrations in healthy volunteers. SETTING: Umea University Hospital Eye Clinic, Umea, Sweden. METHODS: In this intraindividual comparison double-masked randomized study, healthy volunteers were given topical lidocaine 8%, lidocaine 8% pH 6.0, or a placebo 3 times at 90-second intervals. Thereafter, a drop of tropicamide 0.5% or placebo was given (tropicamide setting). Another group of healthy volunteers was given topical lidocaine 4%, 8%, or 16% 3 or 6 times at 90-second intervals (dose-response setting). Before and 15, 30, 60, and 180 minutes after eyedrop instillation, the near point was determined and Scheimpflug photography was performed. RESULTS: The tropicamide setting comprised 26 volunteers (mean age 23.5 years) and the dose-response setting, 10 volunteers (mean age 24.5 years). The direct Mydriatic effect of lidocaine was larger at pH 6.0 (mean peak effect 0.61+/-0.06 [SEM] versus 0.42+/-0.04 mm) (P< .05), and the augmentation of tropicamide mydriasis was larger at pH 6.0. Lidocaine 8% had a better direct Mydriatic effect than lidocaine 4% and lidocaine 16% (mean peak effect 0.60+/-0.09 mm versus 0.19+/-0.08 mm and 0.28+/-0.10 mm, respectively) (P< .01). Lidocaine 16% given 6 times caused corneal side effects. CONCLUSIONS: Lidocaine 8% with pH 6.0 had a maximum direct Mydriatic effect and gave maximum augmentation of tropicamide mydriasis without causing unwanted corneal side effects and thus should be preferable for topical anesthesia in cataract surgery.
S J Aldington - One of the best experts on this subject based on the ideXlab platform.
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Comparison of two reference standards in validating two field Mydriatic digital photography as a method of screening for diabetic retinopathy
The British journal of ophthalmology, 2003Co-Authors: Peter H Scanlon, R Malhotra, Richard Greenwood, S J Aldington, C Foy, M Flatman, Susan M. DownesAbstract:Aim: To compare two reference standards when evaluating a method of screening for referable diabetic retinopathy. Method: Clinics at Oxford and Norwich Hospitals were used in a two centre prospective study of 239 people with diabetes receiving an ophthalmologist’s examination using slit lamp biomicroscopy, seven field 35 mm stereophotography and two field Mydriatic digital photography. Patients were selected from those attending clinics when the ophthalmologist and ophthalmic photographer were able to attend. The main outcome measures were the detection of referable diabetic retinopathy as defined by the Gloucestershire adaptation of the European Working Party guidelines. Results: In comparison with seven field stereophotography, the ophthalmologist’s examination gave a sensitivity of 87.4% (confidence interval 83.5 to 91.5), a specificity of 94.9% (91.5 to 98.3), and a kappa statistic of 0.80. Two field Mydriatic digital photography gave a sensitivity of 80.2% (75.2 to 85.2), specificity of 96.2% (93.2 to 99.2), and a kappa statistic of 0.73. In comparison with the ophthalmologist’s examination, two field Mydriatic digital photography gave a sensitivity of 82.8% (78.0 to 87.6), specificity of 92.9% (89.6 to 96.2), and a kappa statistic of 0.76. Seven field stereo gave a sensitivity of 96.4% (94.0 to 98.8), a specificity of 82.9% (77.4 to 88.4), and a kappa statistic of 0.80. 15.3% of seven field sets, 1.5% of the two field digital photographs, and none of the ophthalmologist’s examinations were ungradeable. Conclusion: An ophthalmologist’s examination compares favourably with seven field stereophotography, and two field digital photography performs well against both reference standards.
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the effectiveness of screening for diabetic retinopathy by digital imaging photography and technician ophthalmoscopy
Diabetic Medicine, 2003Co-Authors: Peter H Scanlon, R Malhotra, S J Aldington, C Foy, G Thomas, J N Kirkpatrick, N Lewisbarned, B HarneyAbstract:AIMS: To evaluate the introduction of a community-based non-Mydriatic and Mydriatic digital photographic screening programme by measuring the sensitivity and specificity compared with a reference standard and assessing the added value of technician direct ophthalmoscopy. METHODS: Study patients had one-field, non-Mydriatic, 45 degrees digital imaging photography prior to Mydriatic two-field digital imaging photography followed by technician ophthalmoscopy. Of these patients, 1549 were then examined by an experienced ophthalmologist using slit lamp biomicroscopy as a reference standard. The setting was general practices in Gloucestershire. Patients were selected by randomizing groups of patients (from within individual general practices) and 3611 patients were included in the study. Patients for reference standard examination were recruited from groups of patients on days when the ophthalmologist was able to attend. The main outcome measure was detection of referable diabetic retinopathy (DR) as defined by the Gloucestershire adaptation of the European Working Party guidelines. RESULTS: For Mydriatic digital photography, the sensitivity was 87.8%, specificity was 86.1% and technical failure rate was 3.7%. Technician ophthalmoscopy did not alter these figures. For non-Mydriatic photography, the sensitivity was 86.0%, specificity was 76.7% and technical failure rate was 19.7%. CONCLUSIONS: Two-field Mydriatic digital photography is an effective method of screening for referable diabetic retinopathy. Non-Mydriatic digital photography has an unacceptable technical failure rate and low specificity.
Bjorn Lundberg - One of the best experts on this subject based on the ideXlab platform.
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Mydriatic response to different concentrations of intracameral phenylephrine in humans
Journal of Cataract and Refractive Surgery, 2010Co-Authors: Anders Behndig, Bjorn LundbergAbstract:Results show that phenylephrine injected intracamerally does not have a linear Mydriatic dose-response relationship in humans. At very high concentrations, phenylephrine may bind to and stimulate r ...
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separate and additive Mydriatic effects of lidocaine hydrochloride phenylephrine and cyclopentolate after intracameral injection
Journal of Cataract and Refractive Surgery, 2008Co-Authors: Bjorn Lundberg, Anders BehndigAbstract:Separate and additive Mydriatic effects of lidocaine hydrochloride, phenylephrine, and cyclopentolate after intracameral injection.
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intracameral Mydriatics in phacoemulsification cataract surgery
Journal of Cataract and Refractive Surgery, 2003Co-Authors: Bjorn Lundberg, Anders BehndigAbstract:PURPOSE: To evaluate intracameral injection of Mydriatics in phacoemulsification cataract surgery and compare the results with those of conventional topical Mydriatics. SETTING: Department of Clini ...
Henrik B Mortensen - One of the best experts on this subject based on the ideXlab platform.
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comparison between early treatment diabetic retinopathy study 7 field retinal photos and non Mydriatic Mydriatic and Mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy
Journal of Diabetes and Its Complications, 2015Co-Authors: Malin Lundberg Rasmussen, Rebecca Broe, Ulrik Frydkjaerolsen, Birthe S Olsen, Henrik B MortensenAbstract:Abstract Aims To compare non-Mydriatic, Mydriatic and steered Mydriatic widefield retinal images with Mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS)-standards in grading diabetic retinopathy (DR). Methods We examined 95 patients (190 eyes) with type 1 diabetes. A non-Mydriatic, a Mydriatic and four steered Mydriatic 200° widefield retinal images were captured (Optos 200Tx, Optos plc, Dunfermline, Scotland) and compared to Mydriatic 7-field 45° ETDRS images (Topcon 3D OCT-2000, Topcon, Tokyo, Japan). Images were graded for DR according to ETDRS-protocol by a trained and certified grader masked to the results of the corresponding grading. For agreement kappa-statistics were used. Results Exact level agreement with 7-field images was found in 76.3%, 76.1% and 70.7% for non-Mydriatic, Mydriatic and steered Mydriatic widefield images, respectively. Corresponding values for one-level agreement were 99.0%, 98.9% and 99.5%, respectively. Non-Mydriatic matched Mydriatic widefield images almost fully with exact and one-level agreement of 96.8% and 100.0%, respectively. Mydriatic steered images resulted in higher grading in 24 eyes. Conclusions Widefield images matched 7-field images favorably. Widefield images can be captured without pupil-dilation and only one image is needed. However, because of overlapping eyelashes and distortion some lesion might be missed. Mydriatic steered images in selected cases may solve some of these problems.
Paula Anne Newmancasey - One of the best experts on this subject based on the ideXlab platform.
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screening for vision threatening diabetic retinopathy in south india comparing portable non Mydriatic and standard fundus cameras and clinical exam
Eye, 2018Co-Authors: Sabyasachi Sengupta, Leslie M. Niziol, Maria A. Woodward, Alan L. Robin, Swati Upadhyaya, Manavi D Sindal, Cagri G Besirli, Rengaraj Venkatesh, Paula Anne NewmancaseyAbstract:PurposeTo evaluate the sensitivity and specificity of a portable non-Mydriatic fundus camera to diagnose vision-threatening diabetic retinopathy (VTDR).Patients and methodsA prospective, single-site, comparative instrument validation study was undertaken at the Aravind Eye Care System. Overall, 155 subjects with and without diabetes were recruited. Images from 275 eyes were obtained with the (1) non-Mydriatic Smartscope, (2) Mydriatic Smartscope, and (3) Mydriatic table-top camera of the macular, nasal, and superotemporal fields. A retina specialist performed a dilated fundus examination (DFE), (reference standard). Two masked retina specialists graded the images. Sensitivity and specificity to detect VTDR with the undilated Smartscope was calculated compared to DFE.ResultsGraders 1 and 2 had a sensitivity of 93% (95% confidence interval (CI): 87-97%) and 88% (95% CI: 81-93%) and a specificity of 84% (95% CI: 77-89%) and 90% (95% CI: 84-94%), respectively, in diagnosing VTDR with the undilated Smartscope compared to DFE. Compared with the dilated Topcon images, graders 1 and 2 had sensitivity of 88% (95% CI: 81-93%) and 82% (95% CI: 73-88%) and specificity of 99% (95% CI: 96-100%) and 99% (95% CI: 95-100%).ConclusionsRemote graders had high sensitivity and specificity in diagnosing VTDR with undilated Smartscope images, suggesting utility where portability is a necessity.
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screening for vision threatening diabetic retinopathy in south india comparing portable non Mydriatic and standard fundus cameras and clinical exam
Eye, 2018Co-Authors: Sabyasachi Sengupta, Leslie M. Niziol, Maria A. Woodward, Alan L. Robin, Swati Upadhyaya, Manavi D Sindal, Cagri G Besirli, Rengaraj Venkatesh, Paula Anne NewmancaseyAbstract:To evaluate the sensitivity and specificity of a portable non-Mydriatic fundus camera to diagnose vision-threatening diabetic retinopathy (VTDR). A prospective, single-site, comparative instrument validation study was undertaken at the Aravind Eye Care System. Overall, 155 subjects with and without diabetes were recruited. Images from 275 eyes were obtained with the (1) non-Mydriatic Smartscope, (2) Mydriatic Smartscope, and (3) Mydriatic table-top camera of the macular, nasal, and superotemporal fields. A retina specialist performed a dilated fundus examination (DFE), (reference standard). Two masked retina specialists graded the images. Sensitivity and specificity to detect VTDR with the undilated Smartscope was calculated compared to DFE. Graders 1 and 2 had a sensitivity of 93% (95% confidence interval (CI): 87–97%) and 88% (95% CI: 81–93%) and a specificity of 84% (95% CI: 77–89%) and 90% (95% CI: 84–94%), respectively, in diagnosing VTDR with the undilated Smartscope compared to DFE. Compared with the dilated Topcon images, graders 1 and 2 had sensitivity of 88% (95% CI: 81–93%) and 82% (95% CI: 73–88%) and specificity of 99% (95% CI: 96–100%) and 99% (95% CI: 95–100%). Remote graders had high sensitivity and specificity in diagnosing VTDR with undilated Smartscope images, suggesting utility where portability is a necessity.
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glaucoma screening in nepal cup to disc estimate with standard Mydriatic fundus camera compared to portable nonMydriatic camera
American Journal of Ophthalmology, 2017Co-Authors: Sarah E Miller, Leslie M. Niziol, Maria A. Woodward, Alan L. Robin, Suman S Thapa, Pradeep Y Ramulu, Indira Paudyal, Ian Pitha, Tyson N Kim, Paula Anne NewmancaseyAbstract:Purpose To compare cup-to-disc ratio (CDR) measurements from images taken with a portable, 45-degree nonMydriatic fundus camera to images from a traditional tabletop Mydriatic fundus camera. Design Prospective, cross-sectional, comparative instrument validation study. Methods Setting: Clinic-based. Study Population: A total of 422 eyes of 211 subjects were recruited from the Tilganga Institute of Ophthalmology (Kathmandu, Nepal). Two masked readers measured CDR and noted possible evidence of glaucoma (CDR ≥ 0.7 or the presence of a notch or disc hemorrhage) from fundus photographs taken with a nonMydriatic portable camera and a Mydriatic standard camera. Each image was graded twice. Main Outcome Measures: Effect of camera modality on CDR measurement; inter- and intraobserver agreement for each camera for the diagnosis of glaucoma. Results A total of 196 eyes (46.5%) were diagnosed with glaucoma by chart review; 41.2%–59.0% of eyes were remotely diagnosed with glaucoma over grader, repeat measurement, and camera modality. There was no significant difference in CDR measurement between cameras after adjusting for grader and measurement order (estimate = 0.004, 95% confidence interval [CI], 0.003–0.011, P = .24). There was moderate interobserver reliability for the diagnosis of glaucoma (Pictor: κ = 0.54, CI, 0.46–0.61; Topcon: κ = 0.63, CI, 0.55–0.70) and moderate intraobserver agreement upon repeat grading (Pictor: κ = 0.63 and 0.64, for graders 1 and 2, respectively; Topcon: κ = 0.72 and 0.80, for graders 1 and 2, respectively). Conclusions A portable, nonMydriatic, fundus camera can facilitate remote evaluation of disc images on par with standard Mydriatic fundus photography.
