Abstract
Purpose :
During COVID-19 pandemic, it is desirable for ophthalmologists, to remotely examine patients. However, accurate tests and diagnoses are difficult to be performed remotely, and even when a disease is found, it is difficult to treat the disease remotely. As a means to solve these problems, methods are being sought for the examination, diagnosis, and treatment of posterior segment eye diseases (PSED), by patients themselves.
Methods :
Recording of human self-fundus image (SFI): SFIs were obtained using two smartphones and then, the SFIs were evaluated. Self-diagnosis of PSED: The prepared fundus image was provided into an automatically constructed deep-learning model to determine whether or not the vitreous opacity was found to evaluate the method for self-diagnosis. Human 24 fundus images were divided into two groups: 12 control group and 12 vitreous opacity group. Self-treatment of PSED: To investigate the effectiveness of PSED self-treatment, whether the injection of dexamethasone (DEX) in/on the choroid through a tube suppresses inflammatory vitreous opacity due to endotoxin-induced uveitis was examined in a rabbit model. The tube was inserted in/on the choroid near the optic disc. The tip of tube on the conjunctival side was exposed on the skin through the subconjunctiva and subcutaneous. One hundred ng of the lipopolysaccharide solution was injected intravitreally in 8 eyes. Then 4 eyes were simultaneously injected the DEX solution through the tube on the skin side using the wireless injector (DEX group). Residual 4 eyes were used as controls. On days 2, vitreous opacity was evaluated by clinical observation and protein measurement of vitreous humor.
Results :
For five subjects, clear SFIs were obtained. The deep-learning model was determined whether each of fundus images was vitreous opacity with 100% sensitivity, 100% specificity, and 100% accuracy. Clinical grading scores of the DEX group were significantly lower those of the control group on days 2 (p<0.05). The eyes in DEX group significantly suppressed mean protein concentrations at 2 days compared with the eyes in control group (p<0.05).
Conclusions :
Self-medical care for PSED might be useful to increase patient’s access, decrease the cost, and avoid the infection during COVID-19 pandemic.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.