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  • 1.
    Malmberg, Filip
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Sandberg-Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Center for Research and Development, Region Gävleborg.
    Söderberg, Per G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Estimating a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head from a commercial OCT device2016In: Ophthalmic Technologies XXVI, Bellingham, WA: SPIE - International Society for Optical Engineering, 2016, article id 96930NConference paper (Refereed)
  • 2.
    Sandberg Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Morphometry of the Optic Nerve Head as a Diagnostic Tool for Glaucoma2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Glaucoma is a chronic optic nerve head (ONH) disease. Gradual retinal ganglion cell and nerve fiber loss lead to morphological ONH change and visual field defects. Initial loss is often focal. Rate of progression and life expectancy guide treatment. Currently, confocal scanning laser tomoghraphy (HRT) and optic coherence tomography (OCT) are available for ONH imaging. However, there is no consensus for which morphometric measurement of ONH nerve fiber content to use for glaucoma follow-up.

    Purpose: To measure ONH nerve fiber content as neuroretinal rim area (NRA) with HRT, estimate NRA measurement variation and its impact on designing a follow-up strategy. To develop a custom algorithm, Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), for measuring ONH nerve fiber content in OCT data cubes. To measure PIMD in glaucomatous eyes, estimate the variance sources for PIMD and their impact on designing strategies for glaucoma follow-up.

    Methods: NRA was measured with HRT in non-glaucomatous and glaucomatous eyes. Sources of variance for NRA were estimated. An OCT data cube of a non-glaucomatous eye was used in developing the PIMD algorithm. PIMD was measured in 500 radii along the ONH circumference. PIMD averaged over the circumference is PIMD-2π. Sources of variance for PIMD-2π were estimated for glaucomatous eyes. Strategies for following PIMD-2π and segments of PIMD-2π within subject over time were proposed.

    Results: Variation among subjects was substantial for NRA and PIMD-2π. Contrarily, within subject variation was small for NRA and PIMD-2π. When within subject variation, a previously reported loss rate for progressing glaucoma, and measuring NRA 3 times every 4 months were applied, a significant loss was detected after 54 months. When within subject variation and a PIMD-2π loss rate resulting in blindness after 20 years were applied, a significant PIMD-2π loss was detected in 16 months with visits every 4 months. Within subject segmental PIMD-2π loss can be detected from the 3rd visit. Loss rate of each PIMD can be estimated with linear regression from the 4th visit. Change in segmental PIMD-2π loss rate can be detected at a later visit.

    Conclusions: Small within subject variation allows for within subject NRA and PIMD follow-up over time. Segmental PIMD-2π has potential to detect focal glaucomatous defects and worsening of existing defects. There is potential to detect a change in segmental PIMD-2π loss rate. Segmental PIMD-2π has potential as a tool for within subject follow-up of glaucoma.

    List of papers
    1. Variance components in confocal scanning laser tomography measurements of neuro-retinal rim area and the effect of repeated measurements on the power to detect loss over time
    Open this publication in new window or tab >>Variance components in confocal scanning laser tomography measurements of neuro-retinal rim area and the effect of repeated measurements on the power to detect loss over time
    Show others...
    2016 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, no 7, p. 705-711Article in journal (Refereed) Published
    Abstract [en]

    PurposeTo estimate the variation in measurements of neuro-retinal rim area (NRA) determined by confocal scanning laser tomography and consequences for clinical follow-up. MethodsAltogether, 24 healthy subjects were randomized on -320m, Moorfields and Standard NRA plane strategies. Additionally, NRA was measured in 32 glaucoma subjects. Variance components for subjects, visits and measurements were estimated with analysis of variance. Sample sizes required to detect a 6.0x10(-2)mm(2) NRA change were estimated assuming a significance level of 0.05 and a power of 0.8. Consequences for independent group, and paired comparison design, respectively, were analysed. Further, precision in estimates within subjects over time was investigated. ResultsThe variation of NRA among subjects was considerably larger than the variation among visits and measurements. For glaucoma subjects, the variation among visits and measurements were of the same order but larger than in healthy subjects. It was found that independent group comparisons require inconveniently large sample sizes. Within-subject paired comparisons over time require sample sizes of below 15 subjects. The estimated variations for glaucoma subjects imply that 54months of follow-up is required for detection of change from baseline. ConclusionsThe variance for subjects is substantial in relation to those for visits and measurements. Cross-sectional independent group comparisons of levels of NRA are unsuitable, due to considerable subject variation. Levels of NRA differences within subjects between visits can be estimated with acceptable precision. Neuro-retinal rim area (NRA) measurement can be used for long-term follow-up of glaucoma progression.

    Keywords
    confocal scanning laser tomography; glaucoma; neuro-retinal rim area; variation
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:uu:diva-295356 (URN)10.1111/aos.13079 (DOI)000386631400044 ()27233465 (PubMedID)
    Available from: 2016-06-05 Created: 2016-06-05 Last updated: 2019-10-01Bibliographically approved
    2. A strategy for OCT estimation of the optic nerve head pigment epithelium central limit-inner limit of the retina minimal distance, PIMD-2π
    Open this publication in new window or tab >>A strategy for OCT estimation of the optic nerve head pigment epithelium central limit-inner limit of the retina minimal distance, PIMD-2π
    2019 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, no 2, p. 208-213Article in journal (Refereed) Published
    Abstract [en]

    Purpose To develop a semi-automatic algorithm for estimation of pigment epithelium central limit-inner limit of the retina minimal distance averaged over 2 pi radians (PIMD-2 pi) and to estimate the precision of the algorithm. Further, the variances in estimates of PIMD-2 pi were to be estimated in a pilot sample of glaucomatous eyes. Methods Three-dimensional cubes of the optic nerve head (ONH) were captured with a commercial SD-OCT device. Raw cube data were exported for semi-automatic segmentation. The inner limit of the retina was automatically detected. Custom software aided the delineation of the ONH pigment epithelium central limit resolved in 500 evenly distributed radii. Sources of variation in PIMD estimates were analysed with an analysis of variance. Results The estimated variance for segmentations and angles was 130 mu m(2) and 1280 mu m(2), respectively. Considering averaging eight segmentations, a 95 % confidence interval for mean PIMD-2 pi was estimated to 212 +/- 10 mu m (df = 7). The coefficient of variation for segmentation was estimated at 0.05. In the glaucomatous eyes, the within-subject variance for captured volumes and for segmentations within volumes was 10 mu m(2) and 50 mu m(2), respectively. Conclusion The developed semi-automatic algorithm enables estimation of PIMD-2 pi in glaucomatous eyes with relevant precision using few segmentations of each captured volume.

    National Category
    Ophthalmology Medical Image Processing
    Research subject
    Computerized Image Processing
    Identifiers
    urn:nbn:se:uu:diva-362723 (URN)10.1111/aos.13908 (DOI)000459637900020 ()30198106 (PubMedID)
    Funder
    Gun och Bertil Stohnes Stiftelse
    Available from: 2018-09-10 Created: 2018-10-09 Last updated: 2019-10-01
    3. Variance components for PIMD-2π estimation of the optic nerve head and consequences in clinical measurements of glaucoma
    Open this publication in new window or tab >>Variance components for PIMD-2π estimation of the optic nerve head and consequences in clinical measurements of glaucoma
    2019 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768Article in journal (Refereed) Epub ahead of print
    Place, publisher, year, edition, pages
    John Wiley & Sons, 2019
    Keywords
    glaucoma, oct, optic nerve head, PIMD, follow-up
    National Category
    Ophthalmology
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-389416 (URN)10.1111/aos. 14197 (DOI)
    Available from: 2019-07-11 Created: 2019-07-11 Last updated: 2019-10-01
    4. Detection and clinical follow-up of segmental glaucomatous optic nerve head damage using OCT.
    Open this publication in new window or tab >>Detection and clinical follow-up of segmental glaucomatous optic nerve head damage using OCT.
    (English)Manuscript (preprint) (Other academic)
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:uu:diva-393969 (URN)
    Available from: 2019-09-30 Created: 2019-09-30 Last updated: 2019-10-01
  • 3.
    Sandberg Melin, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Malmberg, Filip
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Söderberg, Per G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    A strategy for OCT estimation of the optic nerve head pigment epithelium central limit-inner limit of the retina minimal distance, PIMD-2π2019In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, no 2, p. 208-213Article in journal (Refereed)
    Abstract [en]

    Purpose To develop a semi-automatic algorithm for estimation of pigment epithelium central limit-inner limit of the retina minimal distance averaged over 2 pi radians (PIMD-2 pi) and to estimate the precision of the algorithm. Further, the variances in estimates of PIMD-2 pi were to be estimated in a pilot sample of glaucomatous eyes. Methods Three-dimensional cubes of the optic nerve head (ONH) were captured with a commercial SD-OCT device. Raw cube data were exported for semi-automatic segmentation. The inner limit of the retina was automatically detected. Custom software aided the delineation of the ONH pigment epithelium central limit resolved in 500 evenly distributed radii. Sources of variation in PIMD estimates were analysed with an analysis of variance. Results The estimated variance for segmentations and angles was 130 mu m(2) and 1280 mu m(2), respectively. Considering averaging eight segmentations, a 95 % confidence interval for mean PIMD-2 pi was estimated to 212 +/- 10 mu m (df = 7). The coefficient of variation for segmentation was estimated at 0.05. In the glaucomatous eyes, the within-subject variance for captured volumes and for segmentations within volumes was 10 mu m(2) and 50 mu m(2), respectively. Conclusion The developed semi-automatic algorithm enables estimation of PIMD-2 pi in glaucomatous eyes with relevant precision using few segmentations of each captured volume.

  • 4.
    Sandberg Melin, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Malmberg, Filip
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Söderberg, Per G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    An OCT variable for glaucoma follow-up: Pigment epithelium central limit - Inner limit of the retina, Minimal Distance, PIMD2016In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12Article in journal (Other academic)
  • 5.
    Sandberg Melin, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Nuija, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Alm, Albert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Yu, Zhaohua
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Variance components in confocal scanning laser tomography measurements of neuro-retinal rim area and the effect of repeated measurements on the power to detect loss over time2016In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, no 7, p. 705-711Article in journal (Refereed)
    Abstract [en]

    PurposeTo estimate the variation in measurements of neuro-retinal rim area (NRA) determined by confocal scanning laser tomography and consequences for clinical follow-up. MethodsAltogether, 24 healthy subjects were randomized on -320m, Moorfields and Standard NRA plane strategies. Additionally, NRA was measured in 32 glaucoma subjects. Variance components for subjects, visits and measurements were estimated with analysis of variance. Sample sizes required to detect a 6.0x10(-2)mm(2) NRA change were estimated assuming a significance level of 0.05 and a power of 0.8. Consequences for independent group, and paired comparison design, respectively, were analysed. Further, precision in estimates within subjects over time was investigated. ResultsThe variation of NRA among subjects was considerably larger than the variation among visits and measurements. For glaucoma subjects, the variation among visits and measurements were of the same order but larger than in healthy subjects. It was found that independent group comparisons require inconveniently large sample sizes. Within-subject paired comparisons over time require sample sizes of below 15 subjects. The estimated variations for glaucoma subjects imply that 54months of follow-up is required for detection of change from baseline. ConclusionsThe variance for subjects is substantial in relation to those for visits and measurements. Cross-sectional independent group comparisons of levels of NRA are unsuitable, due to considerable subject variation. Levels of NRA differences within subjects between visits can be estimated with acceptable precision. Neuro-retinal rim area (NRA) measurement can be used for long-term follow-up of glaucoma progression.

  • 6.
    Sandberg Melin, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics. centrum för forskning och utveckling Uppsala universitet/Gävleborg.
    Yu, Zhaohua
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics.
    Detection and clinical follow-up of segmental glaucomatous optic nerve head damage using OCT.Manuscript (preprint) (Other academic)
  • 7.
    Sandberg Melin, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Centrum för forskning och utveckling, UU/Region Gävleborg.
    Yu, Zhauhoa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Variance components for PIMD-2π estimation of the optic nerve head and consequences in clinical measurements of glaucoma2019In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768Article in journal (Refereed)
  • 8.
    Söderberg, Per G.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Malmberg, Filip
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Sandberg Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Further analysis of clinical feasibility of OCT-based glaucoma diagnosis with Pigment epithelium central limit–Inner limit of the retina Minimal Distance (PIMD)2017In: Ophthalmic Technologies XXVII, Bellingham, WA: SPIE - International Society for Optical Engineering, 2017, article id 100450RConference paper (Refereed)
  • 9.
    Söderberg, Per G.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Malmberg, Filip
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Sandberg-Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Center for Research and Development, Region Gävleborg.
    Analysis of the variation in OCT measurements of a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head, PIMD-Average [0;2π]2016In: Ophthalmic Technologies XXVI, Bellingham, WA: SPIE - International Society for Optical Engineering, 2016, article id 96930OConference paper (Refereed)
  • 10.
    Söderberg, Per G.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Sandberg Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Gävle Reg Hosp, Gävle, Sweden.
    Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological optic nerve head imaged by OCT2018In: OPHTHALMIC TECHNOLOGIES XXVIII / [ed] Manns, F Soderberg, PG Ho, A, SPIE-INT SOC OPTICAL ENGINEERING , 2018, article id 1047413Conference paper (Refereed)
    Abstract [en]

    The present study aimed to elucidate the angular distribution of the Pigment epithelium central limit-Inner limit of the retina Minimal Distance measured over 2 pi radians in the frontal plane (PIMD-2 pi) in young healthy eyes. Both healthy eyes of 16 subjects aged [20; 30[years were included. In each eye, a volume of the optical nerve head (ONH) was captured three times with a TOPCON DRI OCT Triton (Japan). Each volume renders a representation of the ONH 2.8 mm along the sagittal axis resolved in 993 steps, 6 mm long the frontal axis resolved in 512 steps and 6 x mm along the longitudinal axis resolved in 256 steps. The captured volumes were transferred to a custom made software for semiautomatic segmentation of PIMD around the circumference of the ONH. The phases of iterated volumes were calibrated with cross correlation. It was found that PIMD-2 pi expresses a double hump with a small maximum superiorly, a larger maximum inferiorly, and minima in between. The measurements indicated that there is no difference of PIMD-2 pi between genders nor between dominant and not dominant eye within subject. The variation between eyes within subject is of the same order as the variation among subjects. The variation among volumes within eye is substantially lower.

  • 11.
    Söderberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Sandberg Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Center for Research and Development, Region Gävleborg.
    Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological  optic nerve head imaged by OCT2018In: SPIE Proc, Vol. 10474, p. 38:1-38:7Article in journal (Refereed)
    Abstract [en]

    The present study aimed to elucidate the angular distribution of the Pigment epithelium central limit-Inner limit of the retina Minimal Distance measured over 2π radians in the frontal plane (PIMD-2π) in young healthy eyes. Both healthy eyes of 16 subjects aged [20;30[ years were included. In each eye, a volume of the optical nerve head (ONH) was captured three times with a TOPCON DRI OCT Triton (Japan). Each volume renders a representation of the ONH 2.8 mm along the sagittal axis resolved in 993 steps, 6 mm long the frontal axis resolved in 512 steps and 6 x mm along the longitudinal axis resolved in 256 steps. The captured volumes were transferred to a custom made software for semiautomatic segmentation of PIMD around the circumference of the ONH. The phases of iterated volumes were calibrated with cross correlation. It was found that PIMD-2π expresses a double hump with a small maximum superiorly, a larger maximum inferiorly, and minima in between. The measurements indicated that there is no difference of PIMD-2π between genders nor between dominant and not dominant eye within subject. The variation between eyes within subject is of the same order as the variation among subjects. The variation among volumes within eye is substantially lower.

  • 12.
    Söderberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Yu, Zhaohua
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Malmqvist, Lars D.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Sandberg-Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Galichanin, Konstantin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Talebizadeh, Nooshin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Katarakt -: ett optiskt problem i ögats lins2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, p. 1532-1536, article id D6SCArticle in journal (Refereed)
    Abstract [sv]

    Katarakt definieras som nedsatt syn på grund av en optisk störning i ögats lins.

    Cirka 50 procent av kataraktsjukdomen antas associerad med genetiska faktorer.

    Ultraviolett strålning är epidemiologiskt starkt associerad med barkkatarakt, och rökning med kärnkatarakt.

    Störning av proteinkoncentrationsgradienten i linsen orsakar ljusspridning.

    Kemiska förändringar i linsens vattenlösliga proteiner kan orsaka aggregation av dessa.

    Betydande teknisk utveckling inom kataraktkirurgi reflekteras i en linjär ökning av antalet kataraktoperationer i Sverige under de senaste 35 åren.

    I snö och vid vatten bör solglasögon av filterkategori 3 användas för att skydda ögonen.

  • 13.
    Söderberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics.
    Yu, Zhaohua
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics.
    Sandberg Melin, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Optic nerve head morphometry for glaucoma diagnosis, optimization of clinical measurement strategy2019In: Proceedings of SPIE, ISSN 0277-786X, Vol. 10858, p. 45:1-45:8, article id 108581CArticle in journal (Refereed)
    Abstract [en]

    The present study aimed to develop a strategy for evaluation of instant PIMD-2 pi measurements as a basis for clinical monitoring of glaucoma. PIMD-2 pi is a morphometric measure of the waist of the nerve fiber layer at the optic nerve head (ONH). Clinical measurements of PIMD-2 pi in patients with early to moderate stage glaucoma demonstrated a high variability among subjects. The high variability among subjects renders comparison of instant PIMD-2 pi measurements to tolerance limits for normality derived from a normative database inefficient. It is suggested to instead compare sequential measurements of PIMD-2 pi within a patient. Initially, the difference between an instant measurement and the average of previous measurements can be compared to tolerance limits for difference between measurements within subject. Once, a potential loss of PIMD-2 pi is detected, a sufficient number of measurements within a sufficiently wide time interval can be used to estimate the PIMD-2 pi loss rate with regression and the deviation of the estimated loss rate can be evaluated as a 95 % confidence interval for the loss rate. If the upper confidence limit excludes 0, a significant loss rate has been detected. The currently proposed strategy has the potential to detect glaucoma earlier than the current gold standard, computer perimetry, with less inconvenience for the patient.

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