ABSTRACT Purpose Vision loss and blindness are among the top ten disabilities in the United State... more ABSTRACT Purpose Vision loss and blindness are among the top ten disabilities in the United States, yet access and utilization of eye care remains low. Vision Detroit aimed to address eye-care disparities via community-based screenings. By investigating burden of eye disease and barriers to eye-care utilization in an underserved urban community, we may direct efforts to improve access. Methods Twenty-three screenings were conducted from March 2015-November 2017. Patient information gathered at screenings were demographics, medical and social history, eye exam/referral history, insurance status, primary care physician (PCP) status, and patient-perceived eye-care barriers. Results Three-hundred-eighty patients were screened, 42% African American and 51% Hispanic. Average age was 53 ± 16.4 years, 70% reported vision problems, 50% reported over two years of vision problems, and average habitual visual acuity in best-seeing eye was 20/37. Eye-care underutilization was reported in 61% of type-2 diabetics. Older age and PCP recommendations/referrals were associated with increased utilization in all patients. Insurance was the most common barrier (53%); of the 55% insured, 31% reported financial barriers. Employed patients were more likely than unemployed to report a time barrier (odds ratio = 1.76, 95% confidence interval 1.03–3.01). Those with high school or less education reported “unaware of need”, “unsure where to go”, “transportation”, and “insurance” as barriers more often. Conclusion Visual burden was pervasive, yet access was suboptimal. Financial, logistical, and awareness barriers were common. PCP referral and older age were associated with increased utilization. Those less educated reported more barriers, highlighting the need to address fiscal concerns and eye-health education.
Background: To evaluate uveitis care outcomes in standalone versus a combined ophthalmology-rheum... more Background: To evaluate uveitis care outcomes in standalone versus a combined ophthalmology-rheumatology clinic.Methods: Participants were patients aged 18 years and older with a minimum 12-month history of chronic uveitis prior to being referred to the combined uveitis clinic at Kresge Eye Institute and who were treated in the combined clinic for at least 6 months. Best corrected visual acuity (BCVA), objective markers of inflammation, and achieving targeted dose of immunomodulatory therapy (IMT) were compared in the cohort of uveitis patients 6 months prior to and after the initial evaluation in the combined clinic. Results: Sixty-six percent of study participants were female with a mean age of 51.5 years. BCVA improved from 0.58 logMAR (Snellen: ~20/74) at the initial combined clinic visit to 0.50 logMAR (Snellen: ~20/63) 6 months after the first combined visit (p=0.0137). The establishment of the combined uveitis clinic led to higher frequency of patients at target dose of IMT: ...
Ocular allergy encompasses an inflammatory reaction of the surface of the eye that is caused by i... more Ocular allergy encompasses an inflammatory reaction of the surface of the eye that is caused by inappropriate response of the ocular surface to various environmental allergens. Since the majority of this inflammation involves the conjunctiva, the term “allergic conjunctivitis” is often used interchangeably with ocular allergies. Ocular allergy is a common problem that affects people of all ages in which the presentation may vary from being asymptomatic in mild cases to serious and vision threatening inflammation in severe cases. Subsets of ocular allergy include the predominantly ocular itch-inducing seasonal allergic conjunctivitis (SAC), and perennial allergic conjunctivitis (PAC) to more severe sight-threatening vernal keratoconjunctivitis (VKC), and atopic keratoconjunctivitis (AKC). The management of allergic conjunctivitis ranges from simple life style modifications and the regular use of pharmacologic therapy both topical and systemic, to more advanced therapy including aller...
Purpose To show whether subcutaneous repository corticotropin injection (RCI, Acthar® Gel, a repo... more Purpose To show whether subcutaneous repository corticotropin injection (RCI, Acthar® Gel, a repository corticotropin injection, can be an effective potential therapeutic agent for noninfectious retinal vasculitis. Methods Patients with active retinal vasculitis were followed with serial ultra-wide-field fluorescein angiograms and treated with 80 units of subcutaneous repository corticotropin injection twice weekly. Results Primary outcome of ≥50% improvement in response level (RL) for retinal vasculitis and percent improvement in retinal vasculitis severity scoring (RVSS) by more than one quartile (≥25%) at week 12 was met in 15 and 16 of the 30 total eyes, respectively, including 1 eye with severe retinal vasculitis in each group. Complete resolution of retinal vasculitis was seen in seven eyes with a mean time of 17.1 weeks. Intraocular pressure elevation requiring therapy and cataract progression were noted in two and three eyes, respectively. One patient stopped medication due ...
Journal of Computational and Theoretical Nanoscience, 2020
This Paper proposes method to recommend a set of songs based on the facial emotion state of the u... more This Paper proposes method to recommend a set of songs based on the facial emotion state of the user. Emotion state of the user is detected with the help of google mobile vision SDK. The detected emotion state is fed to Expression-X algorithm that would sort the music (based on emotion value is keyed in) and generates a playlist which suites the emotion state of user. Since emotions are calculated based on the facial expression of a user, achieving 100% accuracy is undoubtedly hard as everyone has their own way of expressing emotions facially, with repetitive testing we have achieved 70–75% success rate in detecting the rite emotion state of the user, and generating the suitable set of song recommendation.
Purpose: This study determines whether fluorescein angiography (FA) with a 250-mg dose of fluores... more Purpose: This study determines whether fluorescein angiography (FA) with a 250-mg dose of fluorescein (half dose) is equal in quality to the standard 500-mg dose of fluorescein (full dose) when using digital ultra-widefield (UWF) technology. Methods: In a randomized, prospective study using a UWF imaging system, FAs performed with half dose were compared with angiograms performed with full dose. Imaging studies were reviewed by 4 reviewers based on 6 characteristics: dye transit, macrovasculature, macula detail, microvasculature, leakage, and overall quality. The scores for macrovasculature, macula detail, microvasculature, and overall quality were converted to a fuzzy rating score to confirm results. Results: Seventy-nine FAs from 67 patients were reviewed for this study, including 12 patients who had both half-dose and full-dose FAs. Of all the factors studied, only microvasculature received a significantly different score between full dose and half dose that was confirmed by the ...
OBJECTIVE To quantify vitreous inflammation in a uveitis cohort using optical coherence tomograph... more OBJECTIVE To quantify vitreous inflammation in a uveitis cohort using optical coherence tomography and correlate findings to gold-standard Nussenblatt scores. DESIGN Prospective cohort study. PARTICIPANTS 36 eyes from 19 patients primarily with pan uveitis. METHODS Study participants were scanned with optical coherence tomography and evaluated by 2 independent graders using open-source ImageJ software. Graders characterized the mean intensity of the vitreous in a 67 500-pixel box immediately above the internal limiting membrane and over the fovea and divided it by the mean intensity of the retinal pigment epithelial layer (RPE). The vitreous to retinal pigment epithelial layer ratio (VIT/RPE) ratios were correlated to Nussenblatt vitreous haze scores recorded by an independent uveitis specialist blinded to the graders' reads. Grader 1 measured intensity a second time after a 48-hour washout period, and the intraclass correlation coefficients (2,1) were calculated for intra- and intergrader reliability. RESULTS 21 (58.3%) eyes had a Nussenblatt score of 0, 9 (25.0%) had a score of 0.5, and the remaining 6 (16.7%) had a score ranging from 1 to 4. The r values for VIT/RPE intensity ratio regressed against Nussenblatt scores were 0.670, 0.672, and 0.660 for grader 1 read 1, grader 1 read 2, and grader 2 read 1, respectively (p < 0.001 for all linear correlations). The intragrader reliability was 0.999 (p < 0.001) and intergrader reliability was 1.000 (p < 0.001). CONCLUSION The VIT/RPE intensity ratio is a clinically relevant measure that reliably captures inflammation in uveitis and correlates well with gold-standard Nussenblatt scores.
ABSTRACT Purpose To report the visual prognosis, electroretinography (ERG) and perimetry outcomes... more ABSTRACT Purpose To report the visual prognosis, electroretinography (ERG) and perimetry outcomes of systemic corticosteroid-sparing immunomodulatory treatment (IMT) for birdshot retinochoroidopathy (BSRC). Methods Retrospective non-comparative case series of 132 patients (264 eyes) with BSRC treated with IMT from Massachusetts Eye Research and Surgery Institution. Results The average follow-up time was 60.1 months. After one year on IMT, 39.4% showed no clinically active inflammation. After 5 years of IMT, 78.0% had no signs of clinical inflammation. No significant differences were observed on best-corrected visual acuity (BCVA), ERG parameters, and perimetry parameters between baseline and subsequent visits on IMT. Conclusion Long-term systemic corticosteroid-sparing IMT was associated with a low rate of BSRC disease exacerbation. While differences were seen on testing parameters, they were not consistent trends and difference were attributed to variability of testing or fluctuation of inflammation that may be expected in the course of the disease.
ABSTRACT Purpose Vision loss and blindness are among the top ten disabilities in the United State... more ABSTRACT Purpose Vision loss and blindness are among the top ten disabilities in the United States, yet access and utilization of eye care remains low. Vision Detroit aimed to address eye-care disparities via community-based screenings. By investigating burden of eye disease and barriers to eye-care utilization in an underserved urban community, we may direct efforts to improve access. Methods Twenty-three screenings were conducted from March 2015-November 2017. Patient information gathered at screenings were demographics, medical and social history, eye exam/referral history, insurance status, primary care physician (PCP) status, and patient-perceived eye-care barriers. Results Three-hundred-eighty patients were screened, 42% African American and 51% Hispanic. Average age was 53 ± 16.4 years, 70% reported vision problems, 50% reported over two years of vision problems, and average habitual visual acuity in best-seeing eye was 20/37. Eye-care underutilization was reported in 61% of type-2 diabetics. Older age and PCP recommendations/referrals were associated with increased utilization in all patients. Insurance was the most common barrier (53%); of the 55% insured, 31% reported financial barriers. Employed patients were more likely than unemployed to report a time barrier (odds ratio = 1.76, 95% confidence interval 1.03–3.01). Those with high school or less education reported “unaware of need”, “unsure where to go”, “transportation”, and “insurance” as barriers more often. Conclusion Visual burden was pervasive, yet access was suboptimal. Financial, logistical, and awareness barriers were common. PCP referral and older age were associated with increased utilization. Those less educated reported more barriers, highlighting the need to address fiscal concerns and eye-health education.
Background: To evaluate uveitis care outcomes in standalone versus a combined ophthalmology-rheum... more Background: To evaluate uveitis care outcomes in standalone versus a combined ophthalmology-rheumatology clinic.Methods: Participants were patients aged 18 years and older with a minimum 12-month history of chronic uveitis prior to being referred to the combined uveitis clinic at Kresge Eye Institute and who were treated in the combined clinic for at least 6 months. Best corrected visual acuity (BCVA), objective markers of inflammation, and achieving targeted dose of immunomodulatory therapy (IMT) were compared in the cohort of uveitis patients 6 months prior to and after the initial evaluation in the combined clinic. Results: Sixty-six percent of study participants were female with a mean age of 51.5 years. BCVA improved from 0.58 logMAR (Snellen: ~20/74) at the initial combined clinic visit to 0.50 logMAR (Snellen: ~20/63) 6 months after the first combined visit (p=0.0137). The establishment of the combined uveitis clinic led to higher frequency of patients at target dose of IMT: ...
Ocular allergy encompasses an inflammatory reaction of the surface of the eye that is caused by i... more Ocular allergy encompasses an inflammatory reaction of the surface of the eye that is caused by inappropriate response of the ocular surface to various environmental allergens. Since the majority of this inflammation involves the conjunctiva, the term “allergic conjunctivitis” is often used interchangeably with ocular allergies. Ocular allergy is a common problem that affects people of all ages in which the presentation may vary from being asymptomatic in mild cases to serious and vision threatening inflammation in severe cases. Subsets of ocular allergy include the predominantly ocular itch-inducing seasonal allergic conjunctivitis (SAC), and perennial allergic conjunctivitis (PAC) to more severe sight-threatening vernal keratoconjunctivitis (VKC), and atopic keratoconjunctivitis (AKC). The management of allergic conjunctivitis ranges from simple life style modifications and the regular use of pharmacologic therapy both topical and systemic, to more advanced therapy including aller...
Purpose To show whether subcutaneous repository corticotropin injection (RCI, Acthar® Gel, a repo... more Purpose To show whether subcutaneous repository corticotropin injection (RCI, Acthar® Gel, a repository corticotropin injection, can be an effective potential therapeutic agent for noninfectious retinal vasculitis. Methods Patients with active retinal vasculitis were followed with serial ultra-wide-field fluorescein angiograms and treated with 80 units of subcutaneous repository corticotropin injection twice weekly. Results Primary outcome of ≥50% improvement in response level (RL) for retinal vasculitis and percent improvement in retinal vasculitis severity scoring (RVSS) by more than one quartile (≥25%) at week 12 was met in 15 and 16 of the 30 total eyes, respectively, including 1 eye with severe retinal vasculitis in each group. Complete resolution of retinal vasculitis was seen in seven eyes with a mean time of 17.1 weeks. Intraocular pressure elevation requiring therapy and cataract progression were noted in two and three eyes, respectively. One patient stopped medication due ...
Journal of Computational and Theoretical Nanoscience, 2020
This Paper proposes method to recommend a set of songs based on the facial emotion state of the u... more This Paper proposes method to recommend a set of songs based on the facial emotion state of the user. Emotion state of the user is detected with the help of google mobile vision SDK. The detected emotion state is fed to Expression-X algorithm that would sort the music (based on emotion value is keyed in) and generates a playlist which suites the emotion state of user. Since emotions are calculated based on the facial expression of a user, achieving 100% accuracy is undoubtedly hard as everyone has their own way of expressing emotions facially, with repetitive testing we have achieved 70–75% success rate in detecting the rite emotion state of the user, and generating the suitable set of song recommendation.
Purpose: This study determines whether fluorescein angiography (FA) with a 250-mg dose of fluores... more Purpose: This study determines whether fluorescein angiography (FA) with a 250-mg dose of fluorescein (half dose) is equal in quality to the standard 500-mg dose of fluorescein (full dose) when using digital ultra-widefield (UWF) technology. Methods: In a randomized, prospective study using a UWF imaging system, FAs performed with half dose were compared with angiograms performed with full dose. Imaging studies were reviewed by 4 reviewers based on 6 characteristics: dye transit, macrovasculature, macula detail, microvasculature, leakage, and overall quality. The scores for macrovasculature, macula detail, microvasculature, and overall quality were converted to a fuzzy rating score to confirm results. Results: Seventy-nine FAs from 67 patients were reviewed for this study, including 12 patients who had both half-dose and full-dose FAs. Of all the factors studied, only microvasculature received a significantly different score between full dose and half dose that was confirmed by the ...
OBJECTIVE To quantify vitreous inflammation in a uveitis cohort using optical coherence tomograph... more OBJECTIVE To quantify vitreous inflammation in a uveitis cohort using optical coherence tomography and correlate findings to gold-standard Nussenblatt scores. DESIGN Prospective cohort study. PARTICIPANTS 36 eyes from 19 patients primarily with pan uveitis. METHODS Study participants were scanned with optical coherence tomography and evaluated by 2 independent graders using open-source ImageJ software. Graders characterized the mean intensity of the vitreous in a 67 500-pixel box immediately above the internal limiting membrane and over the fovea and divided it by the mean intensity of the retinal pigment epithelial layer (RPE). The vitreous to retinal pigment epithelial layer ratio (VIT/RPE) ratios were correlated to Nussenblatt vitreous haze scores recorded by an independent uveitis specialist blinded to the graders' reads. Grader 1 measured intensity a second time after a 48-hour washout period, and the intraclass correlation coefficients (2,1) were calculated for intra- and intergrader reliability. RESULTS 21 (58.3%) eyes had a Nussenblatt score of 0, 9 (25.0%) had a score of 0.5, and the remaining 6 (16.7%) had a score ranging from 1 to 4. The r values for VIT/RPE intensity ratio regressed against Nussenblatt scores were 0.670, 0.672, and 0.660 for grader 1 read 1, grader 1 read 2, and grader 2 read 1, respectively (p < 0.001 for all linear correlations). The intragrader reliability was 0.999 (p < 0.001) and intergrader reliability was 1.000 (p < 0.001). CONCLUSION The VIT/RPE intensity ratio is a clinically relevant measure that reliably captures inflammation in uveitis and correlates well with gold-standard Nussenblatt scores.
ABSTRACT Purpose To report the visual prognosis, electroretinography (ERG) and perimetry outcomes... more ABSTRACT Purpose To report the visual prognosis, electroretinography (ERG) and perimetry outcomes of systemic corticosteroid-sparing immunomodulatory treatment (IMT) for birdshot retinochoroidopathy (BSRC). Methods Retrospective non-comparative case series of 132 patients (264 eyes) with BSRC treated with IMT from Massachusetts Eye Research and Surgery Institution. Results The average follow-up time was 60.1 months. After one year on IMT, 39.4% showed no clinically active inflammation. After 5 years of IMT, 78.0% had no signs of clinical inflammation. No significant differences were observed on best-corrected visual acuity (BCVA), ERG parameters, and perimetry parameters between baseline and subsequent visits on IMT. Conclusion Long-term systemic corticosteroid-sparing IMT was associated with a low rate of BSRC disease exacerbation. While differences were seen on testing parameters, they were not consistent trends and difference were attributed to variability of testing or fluctuation of inflammation that may be expected in the course of the disease.
Uploads
Papers by Sarah Syeda