Browsing by Author "Dotan, Gad"
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Item A national telemedicine network for retinopathy of prematurity screening(2018) Ossandon, Diego; Zanolli, Mario; Stevenson, Ricardo; Agurto, Ricardo; Ortiz, Paula; Dotan, GadTo report the results of retinopathy of prematurity (ROP) screening by a telemedicine sys- tem in Chile and evaluate its usefulness for referring patients who require treatment. METHODS Premature infants at risk of developing ROP from 11 neonatal intensive care units were included. Screening was performed on all infants born at a gestational age of \32 weeks and/or birth weight of\1500 g. A trained nonphysician operator used an imaging system to capture retinal images, which were reviewed by two independent ROP experts. All in- fants that required treatment were referred for further evaluation. RESULTS The study included 2,048 eyes of 1,024 premature infants. Mean gestational age was 28.8 2.2 weeks, and mean birth weight was 1128 279 g. A total of 5,263 telemedicine examinations were performed and reported. The average number of image sets per patient was 2.6 2.5. Of the 5,263 images, 4,903 (93%) were recorded to at least the end of zone II; 5,172 (98%) were graded as having good quality, allowing for staging of ROP disease. Forty-two infants (4%) were referred for treatment. Discharged patients with ROP type 2 that regressed did not present with any complications or adverse effects during 6 months’follow-up. CONCLUSIONS Our study demonstrates the utility of telemedicine screening for ROP with ophthalmologist readers in a developing country. Telemedicine screening was able to detect treatment-requiring ROP. Most of the images had good quality and showed the end of zone II, two variables sufficient to discharge patients.Item Visual outcome following bilateral non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis(BioMed Central, 2017) Keren, Shay; Zanolli, Mario; Dotan, GadBackground: Many patients who suffer unilateral non-arteritic anterior ischemic optic neuropathy (NAION) will eventually develop the same condition in their other eye, worrying them about losing vision in both eyes. The purpose of this meta-analysis is to determine whether it is possible to predict the visual outcome of the consecutive NAION event based on initial presentation and to compare mean visual loss of firstly versus secondly affected eyes. Methods: A systematic review and meta-analysis of studies published between January 1st 1966 and May 31st 2016 reporting on visual acuity and/or visual field loss of both affected eyes, measured either at presentation or follow-up following bilateral NAION. Results: Ten studies were included in the meta- analysis of visual acuity, including 9 retrospective reports and one randomized clinical trial, and five retrospective studies were included in visual field meta-analysis. A significant correlation exists for visual acuity (R = 0.387, P < 0.001) in both eyes of the same patient following bilateral NAION, and also for visual field loss (R = 0.445, P < 0.001) in the two eyes. The calculated coefficient of determination (R2 ) of 0.149 for visual acuity, and 0.198 for visual field loss indicates that for any given individual suffering from unilateral NAION only 15% of visual acuity and 20% of visual field loss in the secondly affected eye can be explained by these outcomes in the first eye. In addition, there was no difference in mean visual outcome of the first versus second NAION events (standardized mean differences of visual acuity 0.008, P = 0.890; and visual field loss, −0.019, P = 0.819). Conclusion: Even though a weak connection exists between visual outcome in both eyes following bilateral NAION it is still impossible to predict with certainty the visual outcome of a sequential contralateral NAION event based on the severity of visual loss in the first affected eye. Measures often taken after the first event are ineffective in improving the visual outcome of a second event should it occur.