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  • 1.
    Abbasi, Mojdeh
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Macquarie Univ, Australia.
    Gupta, Vivek
    Macquarie Univ, Australia.
    Chitranshi, Nitin
    Macquarie Univ, Australia.
    Moustardas, Petros
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Ranjbaran, Reza
    Shiraz Univ Med Sci, Iran.
    Graham, Stuart L.
    Macquarie Univ, Australia.
    Molecular Mechanisms of Glaucoma Pathogenesis with Implications to Caveolin Adaptor Protein and Caveolin-Shp2 Axis2023In: Aging and Disease, ISSN 2152-5250Article, review/survey (Refereed)
    Abstract [en]

    Glaucoma is a common retinal disorder characterized by progressive optic nerve damage, resulting in visual impairment and potential blindness. Elevated intraocular pressure (IOP) is a major risk factor, but some patients still experience disease progression despite IOP-lowering treatments. Genome-wide association studies have linked variations in the Caveolin1/2 (CAV-1/2) gene loci to glaucoma risk. Cav-1, a key protein in caveolae membrane invaginations, is involved in signaling pathways and its absence impairs retinal function. Recent research suggests that Cav-1 is implicated in modulating the BDNF/TrkB signaling pathway in retinal ganglion cells, which plays a critical role in retinal ganglion cell (RGC) health and protection against apoptosis. Understanding the interplay between these proteins could shed light on glaucoma pathogenesis and provide potential therapeutic targets.

  • 2.
    Adnan, Ali
    et al.
    Univ Gothenburg, Sweden.
    Hogmo, Anders
    Karolinska Hosp, Sweden.
    Sjodin, Helena
    Karolinska Hosp, Sweden.
    Gebre-Medhin, Maria
    Lund Univ, Sweden.
    Laurell, Goran
    Uppsala Univ, Sweden.
    Reizenstein, Johan
    Orebro Univ Hosp, Sweden; Orebro Univ, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Norberg, Lena S.
    Umea Univ, Sweden.
    Notstam, Isak
    Umea Univ, Sweden.
    Holmberg, Erik
    Sahlgrens Univ Hosp, Sweden.
    Cange, Hedda H.
    Univ Gothenburg, Sweden.
    Hammerlid, Eva
    Univ Gothenburg, Sweden.
    Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population2020In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 42, no 5, p. 860-872Article in journal (Refereed)
    Abstract [en]

    Background The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors HRQOL was also compared to reference scores from the population. Methods In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results HRQOL was associated with gender, with males scoring better than females on a few scales. Patients HRQOL was more associated with treatment than tumor stage. Patients HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.

  • 3. Order onlineBuy this publication >>
    Al-Hawasi, Abbas
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Retinal ganglion cell examination with Optical Coherence Tomography reflects physiological and pathological changes in the eye and the brain.2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The retinal ganglion cell is situated in the inner retina and its axons, composing the retinal nerve fiber layer (RNFL), leave the eye to form the optic nerve. These cells develop embryologically from the forebrain and later during development re-establish connections with different parts of the brain serving different purposes. This unique position and connections make it possible to be investigated with different methods. Optical Coherence Tomography (OCT) is an accessible and easily operated clinical device that can provide a detailed image of this layer at a few micrometers level of precision in measurements. In this thesis we aimed to see whether examining these cells with OCT could reflect physiological and pathological changes in the eye and brain.

    In cases of optic neuritis (Paper I), the OCT examination showed early thickening of the peripapillary (pRNFL) followed by thinning which takes 6-9 months to reduce to below normal thickness without the ability to distinguish between the real from pseudo thinning. The ganglion cell -inner plexiform layer (GCL-IPL) layer, however, showed a thickness reduction within a few weeks to 3 months without pseudo thinning.         

    In cases of Idiopathic Intracranial Hypertension (IIH) (Paper II), the GCL-IPL remained unchanged and there was no difference in pRNFL thickness compared to healthy controls, whereas  the optic disc parameters of rim thickness, rim area, cup volume and cup/disc ratio differed significantly (P<0.05).

    In cases of benign multiple sclerosis (Paper IV), the OCT could detect that eyes which are not affected by optic neuritis had an annual thinning rate of the RNFL and GCL-IPL similar to a healthy population (P>0.05) which may indicate the benign course of the disease.       

    In cases of physiological factors affecting the GCL in healthy population (Paper III) the OCT examination showed that there was a significant thinning rate of the layer with age (P<0.05), but the thinning was not significant when sex and axial length of the eye were taken into consideration. Males had a thicker GCL volume than females and with age a significant reduction in GCL volume was noted in females but not in males. A Longer axial length of the eye found to be associated with thinner GCL volume.     

    In conclusion retinal ganglion cell changes detected with OCT can reflect physiological and pathological changes in the eye and brain.   

    List of papers
    1. Acute optic neuritis: retinal ganglion cell loss precedes retinal nerve fiber thinning.
    Open this publication in new window or tab >>Acute optic neuritis: retinal ganglion cell loss precedes retinal nerve fiber thinning.
    2015 (English)In: Neurological Sciences, ISSN 1590-1874, E-ISSN 1590-3478, Vol. 36, no 4, p. 617-620Article in journal (Refereed) Published
    Abstract [en]

    Optic neuritis (ON) causes axonal loss as reflected by thinning of retinal nerve fiber layer (RNFL) and can be tracked by optical coherence tomography (OCT) about 6 months after ON onset, when swelling of optic nerve head (ONH) has vanished. Changes of macular ganglion cell layer (GCL) thickness provide another window to track the disease process in ON. GCL thinning over time in relation to RNFL change after ON remains elusive. Using OCT, we followed 4 patients with acute unilateral isolated ON for more than 9 months. A diagnosis of multiple sclerosis (MS) was established in all 4 patients. First follow-up was 2-3 weeks after ON onset, and thereafter every 2-3 months. RNFL swelling peaked during first month after acute ON, followed by rapidly reduced swelling (pseudoatrophy) during following 2 months, and thereafter successively vanished 6 months after ON onset. GCL thinning was observed 1-3 months after ON onset, i.e. already during optic disk swelling and before real RNFL thinning. The results imply that quantifying GCL thickness provides opportunities to monitor early axonal loss and ON-to-MS progression, and facilitates distinguishing real atrophy from pseudoatrophy of RNFL after acute ON.

    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:liu:diva-117096 (URN)10.1007/s10072-014-1982-3 (DOI)000351612200017 ()25311917 (PubMedID)
    Available from: 2015-04-15 Created: 2015-04-15 Last updated: 2023-11-16
    2. OCT measurements of optic nerve head changes in idiopathic intracranial hypertension
    Open this publication in new window or tab >>OCT measurements of optic nerve head changes in idiopathic intracranial hypertension
    2015 (English)In: Clinical neurology and neurosurgery (Dutch-Flemish ed. Print), ISSN 0303-8467, E-ISSN 1872-6968, Vol. 130, p. 122-127Article in journal (Refereed) Published
    Abstract [en]

    Objective: Severity of papilledema and vision loss constitute a basis for therapeutic intervention in idiopathic intracranial hypertension (IIH), but both are often subjective and insensitive in guiding clinical management. The aim of this study was to identify reliable and sensitive measurements of optic nerve head (ONH) and macula, to provide objective guidance for prognostic evaluation and treatment in IIH. We analyzed potential of spectral domain optical coherence tomography (SD-OCT), to measure neuro-retinal rim thickness and area, optic cup-to-disc ratio (C/D) and cup volume of ONH which have not previously been reported in IIH. In parallel, thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer (GCL) together with inner plexiform layer (IPL) (GCL-IPL) were examined. Results: All 7 enrolled IIH patients had increased neuro-retinal rim thickness (p less than 0.01 for both eyes) and rim area (p less than 0.05), decreased C/D (p less than 0.01) and optic cup volume (p less than 0.01) when compared to findings in 18 sex- and age-matched healthy controls (HC). In a longitudinal study, two IIH patients were followed repetitively by SD-OCT before and after measurement of intracranial pressure (ICP) and removal of cerebrospinal fluid (CSF) by lumbar puncture. Rim thickness and area, C/D and optic cup volume remained altered. RNFL thickness may change with very high ICP, but not immediately after CSF removal. GCL-IPL thickness was unchanged irrespective of ICP change or CSF removal. Conclusion: SD-OCT allows detection of ONH changes even in subtle IIH without papilledema and has potential for routine use in IIH.

    Place, publisher, year, edition, pages
    Elsevier, 2015
    Keywords
    Cerebrospinal fluid; Idiopathic intracranial hypertension; Optic nerve head; Optical coherence tomography; Papilledema
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:liu:diva-116821 (URN)10.1016/j.clineuro.2014.12.021 (DOI)000350186200024 ()25614195 (PubMedID)
    Note

    Funding Agencies|County Council of Ostergotland, Sweden [LIO-121641, LiO-207242, LIO-276241]; Linkoping University

    Available from: 2015-04-07 Created: 2015-04-07 Last updated: 2023-11-16
    3. Retinal ganglion cell layer thickness and volume measured by OCT changes with age, sex, and axial length in a healthy population
    Open this publication in new window or tab >>Retinal ganglion cell layer thickness and volume measured by OCT changes with age, sex, and axial length in a healthy population
    2022 (English)In: BMC Ophthalmology, E-ISSN 1471-2415, Vol. 22, no 1, article id 278Article in journal (Refereed) Published
    Abstract [en]

    Background The ganglion cell layer (GCL) measurements with Optical Coherence Tomography (OCT) are important for both ophthalmologists and neurologists because of their association with many ophthalmic and neurological diseases. Different factors can affect these measurements, such as brain pathologies, ocular axial length (AL) as well as age and sex. Studies conducted to measure the GCL have overlooked many of these factors. The purpose of this study is to examine the effect of age, sex, and AL on normal retinal GCL thickness and volume in a healthy population without any neurological diseases. Methods A prospective cross-sectional study was designed to measure GCL thickness and total volume with OCT with automated segmentation and manual correction where needed. Visual acuity, AL, and autorefraction were also measured. A mixed linear model was used to determine the association of the effect of the various parameters on the GCL thickness and volume. Results One hundred and sixteen eyes of 60 subjects (12-76 years of age, 55% female) were examined of which 77% had 0 +/- 2 D of spherical equivalent, and mean axial length was 23.86 mm. About 25% of the OCT-automated GCL measurements required manual correction. GCL thickness did not differ in similar anatomic regions in right and left eyes (P &gt; 0.05). GCL volume was greater in males relative to females after adjustment for age and axial length (1.13 +/- 0.07 mm(3) for males vs 1.09 +/- 0.09 mm(3) for females; P = 0.031). GCL thickness differed between males and females in the inner retinal ring (P = 0.025) but not in the outer ring (P = 0.66). GCL volume declined with age (P = 0.031) but not after adjustment for sex and axial length (P = 0.138). GCL volume declined with longer axial length after adjustment for age and sex (P = 0.048). Conclusion Age, sex and axial length should be taken into consideration when measuring the GCL thickness and volume with OCT. Automated OCT segmentation should be reviewed for manual adjustments.

    Place, publisher, year, edition, pages
    BMC, 2022
    Keywords
    Ganglion cell layer (GCL); Retinal ganglion cell layer (RGCL); Ganglion cell layer thickness (GCLT); Optical coherence tomography (OCT); Ganglion cell volume (GCV)
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:liu:diva-186815 (URN)10.1186/s12886-022-02488-7 (DOI)000815497900004 ()35751115 (PubMedID)
    Note

    Funding Agencies|Linkoping University

    Available from: 2022-07-04 Created: 2022-07-04 Last updated: 2024-01-11
    4. Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis
    Open this publication in new window or tab >>Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis
    2023 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 6, article id 2240Article in journal (Refereed) Published
    Abstract [en]

    A benign form of multiple sclerosis (BMS) is not easily diagnosed, but changes of the retinal ganglion cell layer-inner plexiform layer (GCL-IPL) and retinal nerve fiber layer (RNFL) may be sensitive to the disease. The aim of this study was to use optical coherence tomography (OCT) to investigate longitudinal changes of GCL-IPL and RNFL in BMS. Eighteen patients with BMS and 22 healthy control (HC) subjects were included, with a mean follow-up period of 32.1 months in BMS and 34.3 months in HC. Mean disease duration in BMS was 23.3 years, with 14 patients left untreated. Unilateral optic neuritis (ON) was found in eight patients. Non-ON eyes showed thinner GCL-IPL layer in the BMS group relative to HC (p &lt; 0.001). The thinning rate of GCL-IPL in non-ON BMS, however, was -0.19 +/- 0.15 mu m/year vs. 0 +/- 0.11 mu m/year for HC (p = 0.573, age-adjusted). Thinning rate of RNFL in non-ON BMS was -0.2 +/- 0.27 mu m/year vs. -0.05 +/- 0.3 mu m/year for HC (p = 0.454, age adjusted). Conclusions: Thinning rate of the GCL-IPL and RNFL in BMS is similar to the healthy population but differs from the thinning rate in relapsing-remitting MS, presenting a non-invasive OCT-based criterion for assessing a benign course in multiple sclerosis.

    Place, publisher, year, edition, pages
    MDPI, 2023
    Keywords
    retinal ganglion cell; retinal nerve fiber layer; ganglion cell complex; multiple sclerosis; benign multiple sclerosis; optical coherence tomography; biomarker; neural biomarker
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:liu:diva-193025 (URN)10.3390/jcm12062240 (DOI)000955333800001 ()36983241 (PubMedID)
    Available from: 2023-04-14 Created: 2023-04-14 Last updated: 2023-11-16
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  • 4.
    Al-Hawasi, Abbas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Retinal ganglion cell layer thickness and volume measured by OCT changes with age, sex, and axial length in a healthy population2022In: BMC Ophthalmology, E-ISSN 1471-2415, Vol. 22, no 1, article id 278Article in journal (Refereed)
    Abstract [en]

    Background The ganglion cell layer (GCL) measurements with Optical Coherence Tomography (OCT) are important for both ophthalmologists and neurologists because of their association with many ophthalmic and neurological diseases. Different factors can affect these measurements, such as brain pathologies, ocular axial length (AL) as well as age and sex. Studies conducted to measure the GCL have overlooked many of these factors. The purpose of this study is to examine the effect of age, sex, and AL on normal retinal GCL thickness and volume in a healthy population without any neurological diseases. Methods A prospective cross-sectional study was designed to measure GCL thickness and total volume with OCT with automated segmentation and manual correction where needed. Visual acuity, AL, and autorefraction were also measured. A mixed linear model was used to determine the association of the effect of the various parameters on the GCL thickness and volume. Results One hundred and sixteen eyes of 60 subjects (12-76 years of age, 55% female) were examined of which 77% had 0 +/- 2 D of spherical equivalent, and mean axial length was 23.86 mm. About 25% of the OCT-automated GCL measurements required manual correction. GCL thickness did not differ in similar anatomic regions in right and left eyes (P &gt; 0.05). GCL volume was greater in males relative to females after adjustment for age and axial length (1.13 +/- 0.07 mm(3) for males vs 1.09 +/- 0.09 mm(3) for females; P = 0.031). GCL thickness differed between males and females in the inner retinal ring (P = 0.025) but not in the outer ring (P = 0.66). GCL volume declined with age (P = 0.031) but not after adjustment for sex and axial length (P = 0.138). GCL volume declined with longer axial length after adjustment for age and sex (P = 0.048). Conclusion Age, sex and axial length should be taken into consideration when measuring the GCL thickness and volume with OCT. Automated OCT segmentation should be reviewed for manual adjustments.

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  • 5.
    Al-Hawasi, Abbas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Fagerholm, Per
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Link, Yumin
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Neurologiska kliniken i Linköping.
    Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis2023In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 6, article id 2240Article in journal (Refereed)
    Abstract [en]

    A benign form of multiple sclerosis (BMS) is not easily diagnosed, but changes of the retinal ganglion cell layer-inner plexiform layer (GCL-IPL) and retinal nerve fiber layer (RNFL) may be sensitive to the disease. The aim of this study was to use optical coherence tomography (OCT) to investigate longitudinal changes of GCL-IPL and RNFL in BMS. Eighteen patients with BMS and 22 healthy control (HC) subjects were included, with a mean follow-up period of 32.1 months in BMS and 34.3 months in HC. Mean disease duration in BMS was 23.3 years, with 14 patients left untreated. Unilateral optic neuritis (ON) was found in eight patients. Non-ON eyes showed thinner GCL-IPL layer in the BMS group relative to HC (p &lt; 0.001). The thinning rate of GCL-IPL in non-ON BMS, however, was -0.19 +/- 0.15 mu m/year vs. 0 +/- 0.11 mu m/year for HC (p = 0.573, age-adjusted). Thinning rate of RNFL in non-ON BMS was -0.2 +/- 0.27 mu m/year vs. -0.05 +/- 0.3 mu m/year for HC (p = 0.454, age adjusted). Conclusions: Thinning rate of the GCL-IPL and RNFL in BMS is similar to the healthy population but differs from the thinning rate in relapsing-remitting MS, presenting a non-invasive OCT-based criterion for assessing a benign course in multiple sclerosis.

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  • 6.
    Ali, Zaheer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Zang, Jingjing
    Univ Zurich, Switzerland.
    Lagali, Neil S
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Schmitner, Nicole
    Univ Innsbruck, Austria.
    Salvenmoser, Willi
    Univ Innsbruck, Austria.
    Mukwaya, Anthony
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Neuhauss, Stephan C. F.
    Univ Zurich, Switzerland.
    Jensen, Lasse
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Kimmel, Robin A.
    Univ Innsbruck, Austria.
    Photoreceptor Degeneration Accompanies Vascular Changes in a Zebrafish Model of Diabetic Retinopathy2020In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 61, no 2, article id UNSP 43Article in journal (Refereed)
    Abstract [en]

    PURPOSE. Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness worldwide in the working-age population, and the incidence is rising. Until now it has been difficult to define initiating events and disease progression at the molecular level, as available diabetic rodent models do not present the full spectrum of neural and vascular pathologies. Zebrafish harboring a homozygous mutation in the pancreatic transcription factor pdx1 were previously shown to display a diabetic phenotype from larval stages through adulthood. In this study, pdx1 mutants were examined for retinal vascular and neuronal pathology to demonstrate suitability of these fish for modeling DR. METHODS. Vessel morphology was examined in pdx1 mutant and control fish expressing the fli1a:EGFP transgene. We further characterized vascular and retinal phenotypes in mutants and controls using immunohistochemistry, histology, and electron microscopy. Retinal function was assessed using electroretinography. RESULTS. Pdx1 mutants exhibit clear vascular phenotypes at 2 months of age, and disease progression, including arterial vasculopenia, capillary tortuosity, and hypersprouting, could be detected at stages extending over more than 1 year. Neural-retinal pathologies are consistent with photoreceptor dysfunction and loss, but do not progress to blindness. CONCLUSIONS. This study highlights pdx1 mutant zebrafish as a valuable complement to rodent and other mammalian models of DR, in particular for research into the mechanistic interplay of diabetes with vascular and neuroretinal disease. They are furthermore suited for molecular studies to identify new targets for treatment of early as well as late DR.

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  • 7.
    Andreasson, Mattias
    et al.
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Badian, Reza A.
    Oslo Univ Hosp, Norway.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway.
    Scarpa, Fabio
    Univ Padua, Italy.
    Colonna, Alessia
    Univ Padua, Italy.
    Allgeier, Stephan
    Karlsruhe Inst Technol KIT, Germany.
    Bartschat, Andreas
    Karlsruhe Inst Technol KIT, Germany.
    Koehler, Bernd
    Karlsruhe Inst Technol KIT, Germany.
    Mikut, Ralf
    Karlsruhe Inst Technol KIT, Germany.
    Reichert, Klaus-Martin
    Karlsruhe Inst Technol KIT, Germany.
    Solders, Goran
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Samuelsson, Kristin
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Zetterberg, Henrik
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden; UCL Inst Neurol, England; UK Dementia Res Inst, England.
    Blennow, Kaj
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Svenningsson, Per
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Parkinson's disease with restless legs syndrome - an in vivo corneal confocal microscopy study2021In: NPJ Parkinson's disease, ISSN 2373-8057, Vol. 7, no 1, article id 4Article in journal (Refereed)
    Abstract [en]

    Small fiber neuropathy (SFN) has been suggested as a trigger of restless legs syndrome (RLS). An increased prevalence of peripheral neuropathy has been demonstrated in Parkinsons disease (PD). We aimed to investigate, in a cross-sectional manner, whether SFN is overrepresented in PD patients with concurrent RLS relative to PD patients without RLS, using in vivo corneal confocal microscopy (IVCCM) and quantitative sensory testing (QST) as part of small fiber assessment. Study participants comprised of age- and sex-matched PD patients with (n = 21) and without RLS (n = 21), and controls (n = 13). Diagnosis of RLS was consolidated with the sensory suggested immobilization test. Assessments included nerve conduction studies (NCS), Utah Early Neuropathy Scale (UENS), QST, and IVCCM, with automated determination of corneal nerve fiber length (CNFL) and branch density (CNBD) from wide-area mosaics of the subbasal nerve plexus. Plasma neurofilament light (p-NfL) was determined as a measure of axonal degeneration. No significant differences were found between groups when comparing CNFL (p = 0.81), CNBD (p = 0.92), NCS (p = 0.82), and QST (minimum p = 0.54). UENS scores, however, differed significantly (p = 0.001), with post-hoc pairwise testing revealing higher scores in both PD groups relative to controls (p = 0.018 and p = 0.001). Analysis of all PD patients (n = 42) revealed a correlation between the duration of l-dopa therapy and CNBD (rho = -0.36, p = 0.022), and p-NfL correlated with UENS (rho = 0.35, p = 0.026) and NCS (rho = -0.51, p = 0.001). Small and large fiber neuropathy do not appear to be associated with RLS in PD. Whether peripheral small and/or large fiber pathology associates with central neurodegeneration in PD merits further longitudinal studies.

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  • 8.
    Arshinoff, Steve A.
    et al.
    Department of Ophthalmology and Vision Sciences, University of Toronto, Canada.
    Claoué, CharlesHarley Street Eye Centre, London, UK.Johansson, BjörnLinköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.Pérez-Silguer, DavidComplutense University of Madrid, Spain.Qi, Susan RuyuDepartment of Ophthalmology, Université Laval, Québec, Canada.Chen, Mike Y.Georgetown University School of Medicine, Washington DC, USA.Hébert, MélanieDepartment of Ophthalmology, Université Laval, Québec, Canada.
    Immediately sequential bilateral cataract surgery (ISBCS): global history and methodology2022Collection (editor) (Other academic)
  • 9.
    Arshinoff, Steve A.
    et al.
    University of Toronto, Canada.
    Johansson, Björn
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.
    Hébert, Mélanie
    Université Laval, Québec, Canada.
    Bilateral endophthalmitis risk and intracameral prophylactic antibiotics2022In: Immediately sequential bilateral cataract surgery (ISBCS): global history and methodology / [ed] Steve Arshinoff, Charles Claoue, Björn Johansson, David Perez-Silguero, Susan Qi, Mike Chen, Melanie Hebert, London: Academic Press, 2022, 1, p. 85-96Chapter in book (Other academic)
  • 10.
    Astell, A. J.
    et al.
    School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK, KITE Research Institute, University Health Network Toronto, Toronto, Canada, Department of Occupational Sciences & Occupational Therapy and Department of Psychiatry, University of Toronto, Toronto, Canada.
    Panou, M.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Touliou, K.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Karavidopoulou, Y.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Cabrera-Umpiérrez, M. F.
    Life Supporting Technologies (LifeSTech), Universidad Politécnica de Madrid (UPM), Madrid, Spain.
    Aldaz, E.
    Fundación Instituto Gerontológico Matia (Ingema), San Sebastian, Spain.
    Bizjak, J.
    Institut Jožef Stefan, Ljubljana, Slovenia.
    Black, B.
    Springwood House, Sheffield, UK.
    Buchholz, M.
    VGR-DART, Centre for AT and AAC, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Mata, J. Chamorro
    Consorcio Regional de Transportes de Madrid, Madrid, Spain.
    Cossu-Ergecer, F.
    TMZ, Almelo, The Netherlands.
    Debring, S.
    VGR-DART, Centre for AT and AAC, Sahlgrenska University Hospital, Gothenburg, Sweden.
    van-Weering, M. Dekker
    Roessingh Research and Development, Enschede, The Netherlands.
    Ekström, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Gams, M.
    Institut Jožef Stefan, Ljubljana, Slovenia.
    Soler, A. Garcia
    Fundación Instituto Gerontológico Matia (Ingema), San Sebastian, Spain.
    Gradišek, A.
    Institut Jožef Stefan, Ljubljana, Slovenia.
    Goljuf, K.
    Doktor 24, Ljubljana, Slovenia.
    Kaimakamis, E.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Kaklanis, N.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Kilintzis, V.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Laakso, K.
    VGR-DART, Centre for AT and AAC, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Maglaveras, N.
    CERTH-INAB The Centre for Research and Technology Hellas, Thessaloniki, Greece.
    Colomer, J. B. Montalvá
    Life Supporting Technologies (LifeSTech), Universidad Politécnica de Madrid (UPM), Madrid, Spain.
    Papageorgiou, V.
    General Hospital of Thessaloniki G.Papanikolaou, Thessaloniki, Greece.
    Potter, S.
    University of Sheffield, Sheffield, UK.
    Samuelsson, Christina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Smith, S. K.
    General Hospital of Thessaloniki G.Papanikolaou, Thessaloniki, Greece.
    Tabak, M.
    Roessingh Research and Development, Enschede, The Netherlands.
    Developing a pragmatic evaluation of ICTs for older adults with cognitive impairment at scale: the IN LIFE experience2022In: Universal Access in the Information Society, ISSN 1615-5289, E-ISSN 1615-5297, Vol. 21, no 1, p. 1-19Article in journal (Refereed)
    Abstract [en]

    Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impacton users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, thisrequires evaluation that can accommodate diferent levels of cognitive impairment, alongside input from family and formalcaregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions forthe Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six nationalpilot sites to examine a number of variables including impact on the users, user acceptance of the individual services andthe overall platform, plus the economic case for the IN LIFE platform. The results confrmed the interest and need amongolder adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT).Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to payfor the platform. The fndings provide insights into existing barriers and challenges for adoption of ICT for older peopleliving with cognitive impairment.

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  • 11.
    Axelsson, Lars
    et al.
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Holmberg, Erik
    Reg Canc Ctr Western Sweden, Sweden; Univ Gothenburg, Sweden.
    Nyman, Jan
    Univ Gothenburg, Sweden.
    Hogmo, Anders
    Karolinska Univ Hosp, Sweden.
    Sjodin, Helena
    Karolinska Univ Hosp, Sweden.
    Gebre-Medhin, Maria
    Lund Univ Hosp, Sweden.
    von Beckerath, Mathias
    Orebro Univ Hosp, Sweden.
    Ekberg, Tomas
    Uppsala Univ Hosp, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Talani, Charbél
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Spak, Lena Norberg
    Norrlands Univ Hosp, Sweden.
    Notstam, Isak
    Cty Hosp Sundsvall Harnosand, Sweden.
    Hammerlid, Eva
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival2021In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 25, no 03, p. e433-e442Article in journal (Refereed)
    Abstract [en]

    Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPVpositive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p &lt; 0.001), performance status (p = 0.036), and N stage (p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and ( chemo) radiation and primary (chemo)

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  • 12.
    Badian, Reza A.
    et al.
    Oslo Univ Hosp, Norway.
    Allgeier, Stephan
    Karlsruhe Inst Technol KIT, Germany.
    Scarpa, Fabio
    Univ Padua, Italy.
    Andreasson, Mattias
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Bartschat, Andreas
    Karlsruhe Inst Technol KIT, Germany.
    Mikut, Ralf
    Karlsruhe Inst Technol KIT, Germany.
    Colonna, Alessia
    Univ Padua, Italy.
    Belissario, Marco
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway; Sorlandet Hosp Arendal, Norway.
    Köhler, Bernd
    Karlsruhe Inst Technol KIT, Germany.
    Svenningsson, Per
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Wide-field mosaics of the corneal subbasal nerve plexus in Parkinsons disease using in vivo confocal microscopy2021In: Scientific Data, E-ISSN 2052-4463, Vol. 8, no 1, article id 306Article in journal (Refereed)
    Abstract [en]

    In vivo confocal microscopy (IVCM) is a non-invasive imaging technique facilitating real-time acquisition of images from the live cornea and its layers with high resolution (1-2 mu m) and high magnification (600 to 800-fold). IVCM is extensively used to examine the cornea at a cellular level, including the subbasal nerve plexus (SBNP). IVCM of the cornea has thus gained intense interest for probing ophthalmic and systemic diseases affecting peripheral nerves. One of the main drawbacks, however, is the small field of view of IVCM, preventing an overview of SBNP architecture and necessitating subjective image sampling of small areas of the SBNP for analysis. Here, we provide a high-quality dataset of the corneal SBNP reconstructed by automated mosaicking, with an average mosaic image size corresponding to 48 individual IVCM fields of view. The mosaic dataset represents a group of 42 individuals with Parkinsons disease (PD) with and without concurrent restless leg syndrome. Additionally, mosaics from a control group (n = 13) without PD are also provided, along with clinical data for all included participants.

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  • 13.
    Badian, Reza A.
    et al.
    Oslo Univ Hosp, Norway.
    Andreasson, Mattias
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Svenningsson, Per
    Acad Specialist Ctr, Sweden; Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway; Sorlandet Hosp Arendal, Norway.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    The pattern of the inferocentral whorl region of the corneal subbasal nerve plexus is altered with age2021In: The Ocular Surface, ISSN 1542-0124, Vol. 22, p. 204-212Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe the pattern of the nerves in the inferocentral whorl region of the human corneal subbasal nerve plexus (SBNP) in health and diseases known to affect the subbasal nerves. Methods: Laser-scanning in vivo confocal microscopy (IVCM) was used to image the SBNP bilaterally in 91 healthy subjects, 39 subjects with type 2 diabetes mellitus (T2DM), and 43 subjects with Parkinsons disease (PD). Whorl regions were classified according to nerve orientation relative to age and health/disease status. Results: Of 346 examined eyes, 300 (86.7%) had an identifiable whorl pattern. In healthy subjects, a clockwise nerve orientation of the whorl was most common (67.9%), followed by non-rotatory or seam morphology (21.4%), and counterclockwise (10.7%). The clockwise orientation was more prevalent in healthy subjects than in T2DM or PD (P &lt; 0.001). Healthy individuals below 50 years of age had a predominantly clockwise orientation (93.8%) which was reduced to 51.9% in those over 50 years (P &lt; 0.001). Age but not disease status explained whorl orientation in T2DM and PD groups. Moreover, whorl orientation is bilaterally clockwise in the young, but adopts other orientations and becomes asymmetric across eyes with age. Finally, we report reflective dot-like features confined to the whorl region of the subbasal plexus, sometimes appearing in close association with subbasal nerves and present in 84-93% of examined eyes regardless of disease status, eye or sex. Conclusion: Subbasal nerves in the inferocentral whorl region are predominantly clockwise in young, healthy corneas. With aging and conditions of T2DM and PD, counterclockwise and non-rotatory configurations increase in prevalence, and bilateral symmetry is lost. Mechanisms regulating these changes warrant further investigation.

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  • 14.
    Badian, Reza A.
    et al.
    Oslo Univ Hosp, Norway.
    Ekman, Linnea
    Lund Univ, Sweden.
    Pripp, Are Hugo
    Oslo Univ Hosp, Norway.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway; Sorlandet Hosp Arendal, Norway.
    Englund, Elisabet
    Lund Univ, Sweden.
    Dahlin, Lars
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Rolandsson, Olov
    Umea Univ, Sweden.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Comparison of Novel Wide-Field In Vivo Corneal Confocal Microscopy With Skin Biopsy for Assessing Peripheral Neuropathy in Type 2 Diabetes2023In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 72, no 7, p. 908-917Article in journal (Refereed)
    Abstract [en]

    Diabetic peripheral neuropathy (DPN) is a serious complication of diabetes, where skin biopsy assessing intraepidermal nerve fiber density (IENFD) plays an important diagnostic role. In vivo confocal microscopy (IVCM) of the corneal subbasal nerve plexus has been proposed as a noninvasive diagnostic modality for DPN. Direct comparisons of skin biopsy and IVCM in controlled cohorts are lacking, as IVCM relies on subjective selection of images depicting only 0.2% of the nerve plexus. We compared these diagnosticmodalities in a fixed-age cohort of 41 participants with type 2 diabetes and 36 healthy participants using machine algorithms to create wide-field image mosaics and quantify nerves in an area 37 times the size of prior studies to avoid human bias. In the same participants, and at the same time point, no correlation between IENFD and corneal nerve densitywas found. Corneal nerve density did not correlate with clinicalmeasures of DPN, including neuropathy symptom and disability scores, nerve conduction studies, or quantitative sensory tests. Our findings indicate that corneal and intraepidermal nerves likely mirror different aspects of nerve degeneration, where only intraepidermal nerves appear to reflect the clinical status of DPN, suggesting that scrutiny is warranted concerning methodologies of studies using corneal nerves to assess DPN.

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  • 15.
    Badian, Reza A.
    et al.
    Oslo Univ Hosp, Norway.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway; Sorlandet Hosp Arendal, Norway.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Region of interest and directional analysis of subbasal nerves in wide-area corneal nerve plexus mosaics in type 2 diabetes mellitus2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 10802Article in journal (Refereed)
    Abstract [en]

    In vivo confocal microscopy (IVCM) imaging of the corneal subbasal nerve plexus (SBNP) is a clinical imaging modality gaining popularity for the diagnosis and follow-up of corneal neuropathy in various conditions such as diabetes mellitus. There remain, however, major limitations to the method, hindering its widespread clinical use. Finding the same exact area of the central cornea to standardize image acquisition is difficult without a reference point. Alternatively, creating wide-area mosaics of the SBNP is resource-intensive and has not yet been developed for routine clinical use. Here, we investigated whether IVCM analysis of the corneal SBNP in a predetermined, anatomically standardized region of interest (ROI) could be applied as an equivalent substitution for wide-area SBNP mosaic generation and analysis. Furthermore, we investigated nerve patterns outside the central corneal region for a possible relationship to type 2 diabetes mellitus status using a publicly available dataset. We found that corneal nerve fibre length density (CNFL) based on the ROI underestimated the mosaic-based CNFL by an average of 34% in 90% of cases (150 eyes), and did not exhibit a significant reduction with diabetes, as seen in the full SBNP. Outside the central cornea, nerve orientation differed depending on the anatomic region (left, central or right superior plexus, P&lt;0.001). Moreover, in long-term type 2 diabetes mellitus (&gt;= 10 years, 28 subjects), nerve density in the left superior sector of the SBNP was decreased (P&lt;0.001) while that in the central superior SBNP increased (P=0.01) relative to 35 age-matched healthy subjects with normal glucose tolerance. These results indicate that subbasal nerve degeneration in type 2 diabetes mellitus can vary according to anatomic location, and regions with potential diagnostic value outside the central SBNP may warrant further investigation.

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  • 16.
    Bakken, Ingvild M.
    et al.
    Sorlandet Hosp Arendal, Norway.
    Jackson, Catherine J.
    Ifocus Eye Clin, Norway; Univ Oslo, Norway.
    Utheim, Tor P.
    Sorlandet Hosp Arendal, Norway; Oslo Univ Hosp, Norway; Univ Agder, Norway.
    Villani, Edoardo
    Univ Milan, Italy; San Giuseppe Hosp, Italy.
    Hamrah, Pedram
    Tufts Univ, MA 02111 USA.
    Kheirkhah, Ahmad
    UT Hlth San Antonio, TX USA.
    Nielsen, Esben
    Aarhus Univ Hosp, Denmark.
    Hau, Scott
    Moorfields Eye Hosp NHS Fdn Trust, England; UCL Inst Ophthalmol, England.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    The use of in vivo confocal microscopy in fungal keratitis - Progress and challenges2022In: Ocular Surface, ISSN 1542-0124, Vol. 24, p. 103-118Article in journal (Refereed)
    Abstract [en]

    Fungal keratitis (FK) is a serious and sight-threatening corneal infection with global reach. The need for prompt diagnosis is paramount, as a delay in initiation of treatment could lead to irreversible vision loss. Current "gold standard" diagnostic methods, namely corneal smear and culture, have limitations due to diagnostic insensitivity and their time-consuming nature. PCR is a newer, complementary method used in the diagnosis of fungal keratitis, whose results are also sample-dependent. In vivo confocal microscopy (IVCM) is a promising complementary diagnostic method of increasing importance as it allows non-invasive real-time direct visualization of potential fungal pathogens and manifesting infection directly in the patients cornea. In numerous articles and case reports, FK diagnosis by IVCM has been evaluated, and different features, approaches, sensitivity/specificity, and limitations have been noted. Here, we provide an up-to-date, comprehensive review of the current literature and present the authors combined recommendations for fungal identification in IVCM images, while also looking to the future of FK assessment by IVCM using artificial intelligence methods.

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  • 17.
    Behaegel, Josephine
    et al.
    Univ Antwerp, Belgium; Antwerp Univ Hosp, Belgium.
    Tassignon, Marie-Jose
    Univ Antwerp, Belgium; Antwerp Univ Hosp, Belgium.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Consejo, Alejandra
    Univ Zaragoza, Spain.
    Koppen, Carina
    Univ Antwerp, Belgium; Antwerp Univ Hosp, Belgium.
    Dhubhghaill, Sorcha Ni
    Univ Antwerp, Belgium; Antwerp Univ Hosp, Belgium.
    Outcomes of Human Leukocyte Antigen-Matched Allogeneic Cultivated Limbal Epithelial Transplantation in Aniridia-Associated Keratopathy-A Single-Center Retrospective Analysis2022In: Cornea, ISSN 0277-3740, E-ISSN 1536-4798, Vol. 41, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess the efficacy and safety of human leukocyte antigen-matched allogeneic cultivated limbal epithelial stem cell grafts in the treatment of aniridia-associated keratopathy (AAK). Methods: Six eyes of 6 patients with severe AAK received an allogeneic stem cell graft between January 2010 and March 2017. Anatomical and functional results were assessed at 6 months, 1 year, 2 years, and the final follow-up visit available. Safety analysis was performed by considering all perioperative and postoperative adverse events and additional surgeries required during the follow-up period. Results: The mean follow-up was 53.6 months (range 24-104 months). In most patients (80%), there was an early improvement of the keratopathy postoperatively, which slowly regressed during longer follow-up. At the final follow-up, 4 of the eyes were graded as failure and 1 eye was graded as partial success. Grading the sixth eye was not possible because of an adverse event. None of the patients maintained a total anatomical success in the long-term. Only 1 patient maintained a modest improvement in best-corrected visual acuity from hand motion to counting fingers. Four serious adverse events were recorded in 2 patients. Conclusions: Severe AAK remains a challenging condition to manage. Transplantation of allogenic ex vivo cultivated limbal stem cells may provide a temporary improvement in ocular surface stability, but anatomical and functional results are poor in the long-term. The eyes are prone to adverse events, and any surgical treatment should take this into consideration.

  • 18.
    Berg, Malin
    et al.
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Adnan, Ali
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Högmo, Anders
    Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sjödin, Helena
    Theme Cancer, HHLH, Karolinska University Hospital, Stockholm, Sweden.
    Gebre-Medhin, Maria
    Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
    Laurell, Göran
    Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
    Reizenstein, Johan
    Department of Oncology, Örebro University Hospital and Örebro University, Örebro, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Norberg, Lena Spaak
    Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden.
    Notstam, Isak
    Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden.
    Holmberg, Erik
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Cange, Hedda Haugen
    Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Hammerlid, Eva
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    A national study of health-related quality of life in patients with cancer of the base of the tongue compared to the general population and to patients with tonsillar carcinoma2021In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 43, no 12, p. 3843-3856Article in journal (Refereed)
    Abstract [en]

    Background: This exploratory, registry-based, cross-sectional study aimed to evaluate patients' health-related quality of life (HRQOL) in a subsite of oropharyngeal cancer: cancer of the base of the tongue (CBT). Methods: CBT patients, treated with curative intent, completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires 15 months after diagnosis. The HRQOL of CBT patients was compared to reference scores from the general population and to that of tonsillar carcinoma patients. Results: The 190 CBT patients scored significantly worse than members of the general population on most scales. CBT patients with human papilloma virus (HPV)-positive tumors had significantly better HRQOL on 8 of 28 scales than HPV-negative patients. Compared to 405 tonsillar carcinoma patients, CBT patients had significantly worse HRQOL on 8 of the 28 scales, the majority local head and neck related problems. Conclusion: One year after treatment, CBT patients' HRQOL was significantly worse in many areas compared to that of the general population and slightly worse than that of tonsillar carcinoma patients. © 2021 Wiley Periodicals LLC.

  • 19.
    Bergman, Pia
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Jonkoping Cty Hosp, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Univ Oslo, Norway.
    Harder, Henrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Mäki-Torkko, Elina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study2020In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 24, no 03, p. 338-346Article in journal (Refereed)
    Abstract [en]

    Introduction Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment. Objective To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome. Methods A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years. Results Speech recognition and the overall health-related quality of life improved one year post-CI (p = 0.000), without correlation (rho= 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (p = 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (p = 0.036), and deteriorated three years post-CI (p = 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (p = 0.009). Conclusion The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.

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  • 20.
    Bevan, Samantha
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.
    Ludvigsson, Jennifer
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.
    Speech Language Pathologists' Experience of Working During a Pandemic: A Survey of COVID-19 and its Impact2022Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
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  • 21.
    Boéthius, Helena
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Saarto, Tiina
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland.
    Laurell, Goran
    Uppsala Univ, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Makitie, Antti A.
    Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Univ Helsinki, Finland; Karolinska Inst, Sweden; Karolinska Hosp, Sweden.
    A Nordic survey of the management of palliative care in patients with head and neck cancer2021In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 278, p. 2027-2032Article in journal (Refereed)
    Abstract [en]

    Background The five Nordic countries with a population of 27M people form a rather homogenous region in terms of health care. The management of Head and Neck Cancer (HNC) is centralized to the 21 university hospitals in these countries. Our aim was to survey the current status of organization of palliative care for patients with HNC in the Nordic countries as the field is rapidly developing. Materials and methods A structured web-based questionnaire was sent to all the Departments of Otorhinolaryngology-Head and Neck Surgery and Oncology managing HNC in the Nordic countries. Results All 21 (100%) Nordic university hospitals responded to the survey. A majority (over 90%) of the patients are discussed at diagnosis in a multidisciplinary tumor board (MDT), but the presence of a palliative care specialist is lacking in 95% of these MDTs. The patients have access to specialized palliative care units (n = 14, 67%), teams (n = 10, 48%), and consultants (n = 4, 19%) in the majority of the hospitals. Conclusion The present results show that specialized palliative care services are available at the Nordic university hospitals. A major finding was that the collaboration between head and neck surgeons, oncologists and palliative care specialists is not well structured and the palliative care pathway of patients with HNC is not systematically organized. We suggest that early integrated palliative care needs to be included as an addition to the already existing HNC care pathways in the Nordic countries.

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  • 22.
    Bro, Tomas
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Worldwide ophthalmological research production 2000-2020, with special focus on the Nordic contribution2022In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 100, no 8, p. e1760-e1766Article in journal (Refereed)
    Abstract [en]

    Purpose To explore the trends in worldwide ophthalmic research production over a 21-year period in relation to journals, contributing countries and dominating topics with special focus on the Nordic region. Methods Articles published between 2000 and 2020 in 20 top-ranked ophthalmology journals were included. Number of articles and impact points were measured per country for each year. The most frequently occurring keywords were calculated worldwide and for the top five contributing countries and the Nordic countries. Trends were explored using linear regression. Results The analysis included 65 220 articles. Linear regression showed an increase with 56 articles per year (beta = 56.3, R-2 = 0.72, p-value &lt; 0.01). The United States published the most articles, comprising 35% of the worldwide total, followed by the United Kingdom (9%) and Japan (7%). Population-adjusted productivity revealed that Iceland was the most prolific country with 10 articles per million inhabitants/year. Singapore was second and Denmark third with corresponding numbers of nine and seven. Analysing regional trends, Asia had the largest increase in yearly number of articles (beta = 29.1, R-2 = 0.89, p-value &lt; 0.01). The strongest positive trend was observed in China (beta = 15.7, R-2 = 0.94, p-value &lt; 0.01). The Nordic countries contributed with 3.6% of worldwide ophthalmological papers. Among these, Denmark was the only country with a significant positive trend in impact points per million inhabitants per year (beta = 0.6, R-2 = 0.54, p-value &lt; 0.01). The most frequently occurring eye disease within the whole time frame was myopia (5.8%) followed by macular degeneration (5.4%) and glaucoma (5.3%). Linear regression showed a significant increase in the proportion of articles about diabetic retinopathy (beta = 0.2%, R-2 = 0.88, p-value &lt; 0.01) a significant decrease in the proportion in articles about cataract (beta = -0.1%, R-2 = 0.70, p-value &lt; 0.01) and myopia (beta = -0.1%, R-2 = 0.67, p-value &lt; 0.01). Conclusions The worldwide ophthalmic research productivity has maintained a growing trend from 2000 to 2020. While North America and Europe are the major contributors, the scientific activity in Asia and especially China is growing impressively. With the current progress, Asia is forecast to outweigh Europe in 2025 and North America in 2033. Diabetic retinopathy was the most common eye disease in ophthalmologic papers in 2020, and also the topic with the strongest positive trend during 2000-2020.

  • 23.
    Bro, Tomas
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Department of Ophthalmology, Eksjö, Region Jonkoping County, Sweden.
    Andersson, Jan
    Swedish Natl Rd & Transport Res Inst Linkoping, Linkoping, Sweden.
    The effects of visual field loss from glaucoma on performance in a driving simulator2022In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 100, no 2, p. 218-224Article in journal (Refereed)
    Abstract [en]

    Background To examine the effects of different stages of visual field loss (VFL) from advanced glaucoma on performance in a driving simulator. Methods Data on performance and safety from a traffic simulator test for 104 participants with withdrawn drivers licences due to visual field loss from advanced glaucoma were compared with data from 83 individuals without visual deficits in a cross-sectional study. Individuals with glaucoma that regained their driving licences after a successful simulator test were then followed in a national accident database. Results Glaucoma participants passed the test in 71% (95% confidence interval 61-79%) of the cases. Younger participants were more successful than older. No significant differences on safety or performance measures were detected between glaucoma- and normally sighted participants. Compared with passed glaucoma participants, failed glaucoma participants had more collisions, more critical failed to give way events, longer time headways, and longer reaction times. This group had also a higher extent of central visual field loss. None of the participants with a regained licence were involved in a motor vehicle accident during the 2 to 4 year follow-up after the simulator test. Conclusion Severity of glaucoma predicts driver safety on a group level. However, even individuals with severe visual field loss from glaucoma might drive safely, which highlights the need for individual assessments for licencing purposes.

  • 24.
    Bro, Tomas
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Dept Ophthalmol Eksjo, Reg Jonkoping Cty, Eksjö, Sweden.
    Andersson, Jan
    Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden.
    The Effects of Visual Field Loss from Optic Disc Drusen on Performance in a Driving Simulator2022In: Neuro-ophthalmology (Aeolus Press. 1980), ISSN 0165-8107, E-ISSN 1744-506X, Vol. 46, no 5, p. 290-297Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to compare the driving simulator performance of participants with visual field loss (VFL) from optic disc drusen (ODD) with a normally sighted control group and a group of individuals with glaucoma. Data on performance and safety from a traffic simulator test for five participants with VFL from ODD were retrospectively compared with data from 49 male individuals without visual deficits in a cross-sectional study. VFL of the ODD group was also compared with a group of 20 male glaucoma participants who had failed the same simulator test. Four individuals with ODD regained their driving licences after a successful simulator test and were then followed in a national accident database. All participants with ODD passed the test. No significant differences in safety or performance measures were detected between the normally sighted participants and the ODD group despite severe concentric visual field constrictions. Compared with failed glaucoma male participants, the ODD group had even lower mean sensitivity in the peripheral and peripheral inferior field of vision. None of the four participants with a regained licence were involved in a motor vehicle accident during a 3-year follow-up period after the simulator test. Despite having severe VFL, participants with ODD had no worse performance or safety than controls. As even individuals with severe VFL might drive safely, there is a need for individual practical assessments on licencing issues.

  • 25.
    Bro, Tomas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Andersson, Jan
    Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden.
    The Effects of Visual Field Loss from Stroke on Performance in a Driving Simulator2022In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 99, no 9, p. 679-686Article in journal (Refereed)
    Abstract [en]

    SIGNIFICANCE: Visual field loss is a common consequence of stroke and often precludes driving. However, legal visual requirements for drivers licenses are largely without scientific basis. PURPOSE: This study aimed to examine the effects of different types of homonymous visual field loss after stroke on simulated driving. METHODS: Data on performance and safety from a traffic simulator test for 153 participants with withdrawn drivers licenses due to visual field loss from stroke were retrospectively compared with data from 83 healthy individuals without visual deficits in a cross-sectional study. The 93 individuals in the stroke group who regained their driving licenses after a successful simulator test were then followed in a national accident database. RESULTS: Sixty-five percent of the stroke participants passed the simulator test (95% confidence interval, 57 to 72%). Younger patients were more successful than older. However, classification by neither type of homonymous visual field loss nor side of visual field loss was predictive of driver safety. Participants with hemianopia had their lateral lane position dislocated to the nonaffected side of the visual field. None of the participants with a regained license were involved in motor vehicle accidents 3 to 6 years after the test. CONCLUSIONS: In this large cohort, driver safety could not be predicted from the type of homonymous visual field loss. Even individuals with severe visual field loss might be safe drivers. Therefore, it seems reasonable to provide an opportunity for individualized assessments of practical fitness to drive in circumstances of licensing issues. This study demonstrates the potential of using a standardized driving simulator test for such assessments of fitness to drive.

  • 26.
    Bro, Tomas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Jönköping County, Eksjö, Sweden.
    Fricke, Otto
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Montan, Per
    St Erik Eye Hospital, Stockholm, Sweden; Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Recurrent Enterococcus faecalis Endophthalmitis Following Uneventful Cataract Surgery2021In: Korean journal of ophthalmology : KJO, ISSN 1011-8942, Vol. 35, no 3, p. 251-253Article in journal (Other academic)
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  • 27.
    Bro, Tomas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Department of Ophthalmology Eksjö, Region Jönköping County, Sweden.
    Loefgren, Stefan
    Karolinska Inst, Sweden.
    Relatively Stable Prevalence of Myopia among Swedish Children Aged 4 to 7 Years between 2015 and 20202023In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 100, no 1, p. 91-95Article in journal (Refereed)
    Abstract [en]

    SIGNIFICANCEThe global increase of myopia has caused a lot of debate the last years. Previous research of myopia in the Nordic population has shown diverse results, and only a few Swedish studies have been published in the subject the last two decades.PURPOSEThis study aimed to analyze trends in the prevalence of myopia in a population of Swedish children.METHODSA retrospective analysis of medical records for children between 4 and 7 years of age in a region in Sweden was performed. The inclusion criterion was a first glasses prescription for myopia between 2012 and 2020. Children with other eye diseases or syndromes affecting the eye and vision were excluded. Age, sex, uncorrected visual acuity, and cycloplegic refractive values were extracted. The number of myopic children was compared with population data to calculate incidence and estimate prevalence.RESULTSDuring the study period, 427 children between 4 and 7 years old in an average population of 17,200 children were prescribed glasses for myopia. The incidence for myopia increased from 0.11% in 2012 to 0.39% in 2020 (P &lt; .05). In 2015 to 2020, the prevalence of myopia for the same age group increased from 0.5 to 1.2% (P &lt; .05). Linear regression of the prevalence of myopia showed a significant increase in the age group of 7 years (beta = 0.2%, R-2 = 0.82, P &lt;= .05).CONCLUSIONSThis study found a relatively stable prevalence of myopia among Swedish children aged 4 to 7 years between 2015 and 2020. The prevalence of 1.6% among 7-year-old children is not higher than in previous Scandinavian studies.

  • 28.
    Bruneau, Jonas
    et al.
    Kristianstad Hosp, Sweden.
    Talani, Charbél
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Nilsson, Johan S.
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Exstirpation of symptomatic lingual thyroid with transoral robotic surgery (TORS): A promising novel treatment option2022In: ACTA OTO-LARYNGOLOGICA CASE REPORTS, ISSN 2377-2484, Vol. 7, no 1, p. 48-51Article in journal (Refereed)
    Abstract [en]

    Ectopic thyroid is a rare condition most often found at the base of the tongue, lingual thyroid (LT). The majority of patients are asymptomatic. Recently, transoral robotic surgery (TORS) has emerged as an option for definitive treatment. Here, we present a 20-year-old patient with symptomatic LT, treated with TORS-assisted surgery without adverse events and with depletion of symptoms. We advocate TORS as a very promising means to be considered when encountering the rare condition of symptomatic LT.

  • 29.
    Buznyk, Oleksiy
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. NAMS Ukraine, Ukraine.
    Azharuddin, Mohammad
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Molecular Medicine and Virology. Linköping University, Faculty of Medicine and Health Sciences.
    Islam, Mohammad Mirazul
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Harvard Univ, MA 02114 USA.
    Fagerholm, Per
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Pasyechnikova, Nataliya
    NAMS Ukraine, Ukraine.
    Patra, Hirak K.
    Univ Cambridge, England; Univ Cambridge, England.
    Collagen-based scaffolds with infused anti-VEGF release system as potential cornea substitute for high-risk keratoplasty: A preliminary in vitro evaluation2020In: Heliyon, E-ISSN 2405-8440, Vol. 6, no 10, article id e05105Article in journal (Refereed)
    Abstract [en]

    Currently the only widely accepted corneal blindness treatment is human donor cornea transplantation. However, increasing shortage of donor corneas as well as high risk of rejection in some corneal diseases remain two major problems, which limit the success of corneal transplantation. Corneal neovascularization is considered as one of the main risk factors of graft failure. Different cell-free biosynthetic scaffolds fabricated from collagens or collagen-like peptides are being tested as donor cornea substitutes (DCS). Here, we report for the first-time composite biosynthetic DCS with integrated sustained release system of anti-VEGF drug, bevacizumab and their preliminary in vitro validation. We have tethered gold nanoparticles with bevacizumab and integrated into a collagen-based cell-free hydrogel scaffold. Developed grafts preserved good optical properties and were confirmed not toxic to human corneal epithelial cells. Bevacizumab has been shown to constantly releasing from the DCS up to 3 weeks and preserved its anti-angiogenic properties. These results provide background for further use of infused composite biosynthetic DCS with integrated nanosystem of bevacizumab sustained release in corneal disease accompanied by neovascularisation where conventional corneal transplantation might fail.

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  • 30.
    Carboni, Andrea
    et al.
    CNR, Italy.
    Russo, Dario
    CNR, Italy.
    Moroni, Davide
    CNR, Italy.
    Barsocchi, Paolo
    CNR, Italy.
    Nikolov, Alexander
    SYNYO GmbH, Austria.
    Dantas, Carina
    Caritas Diocesana Coimbra, Portugal.
    Guardado, Diana
    Caritas Diocesana Coimbra, Portugal.
    Leandro, Ana Filipa
    Caritas Diocesana Coimbra, Portugal.
    van Staalduinen, Willeke
    AFEdemy Acad Agefriendly Environm Europe BV, Netherlands.
    Karanastasis, Efstathios
    ICCS, Greece.
    Andronikou, Vassiliki
    ICCS, Greece.
    Ganzarain, Javier
    AFEdemy Acad Agefriendly Environm Europe BV, Netherlands.
    Rus, Silvia
    Fraunhofer Inst Comp Graph Res IGD, Germany.
    Lievens, Frederic
    Lievens Lanckman BVBA, Belgium.
    Vieira, Joana Oliveira
    Caritas Diocesana Coimbra, Portugal.
    Juiz, Carlos
    Univ Balear Isl, Spain.
    Bermejo, Belen
    Univ Balear Isl, Spain.
    Samuelsson, Christina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Ekström, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Cabrera-Umpierrez, Maria Fernanda
    Univ Politecn Madrid, Spain.
    Peres, Silvia de los Rios
    Univ Politecn Madrid, Spain.
    Van Berlo, Ad
    Smart Homes, Netherlands.
    Success and Hindrance Factors of AHA-Oriented Open Service Platforms2021In: ADVANCES IN COMPUTATIONAL COLLECTIVE INTELLIGENCE (ICCCI 2021), SPRINGER INTERNATIONAL PUBLISHING AG , 2021, Vol. 1463, p. 656-668Conference paper (Refereed)
    Abstract [en]

    In the past years, there has been a flourishing of platforms dedicated to Active Assisted Living (AAL) and Active and Healthy Ageing (AHA). Most of them feature as their core elements intelligent systems for the analysis of multisource and multimodal data coming from sensors of various nature inserted in suitable IoT ecosystems. While progress in signal processing and artificial intelligence has shown how these platforms may have a great potential in improving the daylife of seniors or frail subjects, there are still several technological and non-technological barriers that should be torn down before full uptake of the existing solutions. In this paper, we address specifically this issue describing the outcome and creation process of a methodology aimed at evaluating the successful uptake of existing platforms in the field of AHA. We propose a pathway (as part of an overarching methodology) to define and select for Key Performance Indicators (KPIs), taking into account an extensive amount of parameters related to success, uptake and evolution of platforms. For this, we contribute a detailed analysis structured along with the 4 main actions of mapping, observing, understanding, and defining. Our analysis focuses on Platforms, defined as operating environments, under which various applications, agents and intelligent services are designed, implemented, tested, released and maintained. By following the proposed pathway, we were able to define a practical and effective methodology for monitoring and evaluating the uptake and other success indicators of AHA platforms. Besides, by the same token, we were able to provide guidelines and best practices for the development of the next-generation platforms in the AHA domain.

  • 31.
    Clark, Grace T.
    et al.
    NYU, NY 10012 USA.
    Reuterskiöld, Christina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Word Learning With Orthographic Support in Nonspeaking and Minimally Speaking School-Age Autistic Children2023In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 66, no 6, p. 2047-2063Article in journal (Refereed)
    Abstract [en]

    Purpose: Previous research has demonstrated that typically developing children, verbal children with a diagnosis of autism, children with Down syndrome, children with developmental language disorder, and children with dyslexia can all benefit from orthographic support during word learning tasks. This study sought to determine if minimally speaking or nonspeaking children with a diagnosis of autism would also demonstrate an orthographic facilitation effect during a computer-based remote word learning task. Method: Twenty-two school-age children with a diagnosis of autism and little to no spoken language learned four novel words by contrasting the words with known objects. Two novel words were taught with orthographic support present, and two were taught without orthographic support. Participants were exposed to the words a total of 12 times and then given an immediate posttest to assess identification. Parent report measures of receptive vocabulary, expressive vocabulary, autism symptomatology, and reading skills were also collected. Results: During learning tasks, participants performed equally well whether orthographic support was given or not. For the posttest, however, participants performed significantly better for words that were taught with orthographic support. The presence of orthography improved accuracy and supported a greater number of participants to reach the passing criterion compared to the absence of orthography. Orthographic representations aided the word learning of those with lower expressive language significantly more than those with higher expressive language. Conclusions: Minimally speaking or nonspeaking children with a diagnosis of autism benefit from orthographic support when learning new words. Further investigation is warranted to determine if this effect holds during face-to-face interactions using augmentative and alternative communication systems.

  • 32.
    Czajka, Marcin P.
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Frajdenberg, Agata
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Johansson, Björn
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Technique for Sutured Scleral Fixation of One-Piece Hydrophobic Acrylic Intraocular Lenses Dislocated Into the Vitreous2023In: Retina, ISSN 0275-004X, E-ISSN 1539-2864, Vol. 43, no 8, p. 1413-1416Article in journal (Refereed)
    Abstract [en]

    Purpose:To present a suturing technique for safe refixation of posteriorly dislocated one-piece hydrophobic acrylic intraocular lenses (IOLs).Method:Retrospective data analysis of a series of 12 cases operated with vitrectomy, followed by IOL relocation to the retropupillary area, after which polypropylene sutures are passed through the optic-haptic junctions of the dislocated IOL and subsequently secured to the sclera.Results:In all cases, the IOL remained centered throughout the follow-up period (mean 10.5 months, range 3 weeks-36 months). One case was complicated by vitreous hemorrhage the first postoperative day and later cystoid macular edema. Visual acuity was not compromised at the end of follow-up.Conclusion:The presented technique is safe and provides long-term stable refixation in cases of late posterior dislocation of a one-piece hydrophobic acrylic IOL. The risk that sutures looped around haptics will slip off the haptic is thereby avoided.

  • 33.
    Daruich, Alejandra
    et al.
    Paris Cite Univ, France; Sorbonne Paris Cite Univ, France.
    Duncan, Melinda
    Univ Delaware, DE USA.
    Robert, Matthieu P.
    Paris Cite Univ, France; Paris Cite Univ, France.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Semina, Elena V.
    Med Coll Wisconsin, WI 53226 USA.
    Aberdam, Daniel
    Sorbonne Paris Cite Univ, France.
    Ferrari, Stefano
    Fdn Banca Occhi Veneto, Italy.
    Romano, Vito
    Univ Brescia, Italy.
    des Roziers, Cyril Burin
    Sorbonne Paris Cite Univ, France; Ctr Univ Paris, France.
    Benkortebi, Rabia
    Paris Cite Univ, France.
    De Vergnes, Nathalie
    Paris Cite Univ, France.
    Polak, Michel
    Pediatric Endocrinology, Gynecology and Diabetology, Hôpital Universitaire Necker Enfants Malades, Paris Cité University, INSERM, France.
    Chiambaretta, Frederic
    Department of Ophthalmology, CHU Gabriel Monpied, Clermont-Ferrand, France.
    Nischal, Ken K.
    Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA; UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
    Behar-Cohen, Francine
    Sorbonne Paris Cite Univ, France.
    Valleix, Sophie
    Sorbonne Paris Cite Univ, France; Ctr Univ Paris, France.
    Bremond-Gignac, Dominique
    Paris Cite Univ, France; Sorbonne Paris Cite Univ, France.
    Congenital aniridia beyond black eyes: From phenotype and novel genetic mechanisms to innovative therapeutic approaches2023In: Progress in retinal and eye research, ISSN 1350-9462, E-ISSN 1873-1635, Vol. 95, article id 101133Article, review/survey (Refereed)
    Abstract [en]

    Congenital PAX6-aniridia, initially characterized by the absence of the iris, has progressively been shown to be associated with other developmental ocular abnormalities and systemic features making congenital aniridia a complex syndromic disorder rather than a simple isolated disease of the iris. Moreover, foveal hypoplasia is now recognized as a more frequent feature than complete iris hypoplasia and a major visual prognosis determinant, reversing the classical clinical picture of this disease. Conversely, iris malformation is also a feature of various anterior segment dysgenesis disorders caused by PAX6-related developmental genes, adding a level of genetic complexity for accurate molecular diagnosis of aniridia. Therefore, the clinical recognition and differential genetic diagnosis of PAX6-related aniridia has been revealed to be much more challenging than initially thought, and still remains under-investigated. Here, we update specific clinical features of aniridia, with emphasis on their genotype correlations, as well as provide new knowledge regarding the PAX6 gene and its mutational spectrum, and highlight the beneficial utility of clinically implementing targeted Next-Generation Sequencing combined with Whole-Genome Sequencing to increase the genetic diagnostic yield of aniridia. We also present new molecular mechanisms underlying aniridia and aniridia-like phenotypes. Finally, we discuss the appropriate medical and surgical management of aniridic eyes, as well as innovative therapeutic options. Altogether, these combined clinical-genetic approaches will help to accelerate time to diagnosis, provide better determination of the disease prognosis and management, and confirm eligibility for future clinical trials or genetic-specific therapies.

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  • 34.
    Derbring, Sandra
    et al.
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
    Barbos Nordström, Melissa
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Svenningsson, Jenny-Ann
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Ekström, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Ingebrand, Elias
    Linköping University, Department of Culture and Society, Division of Ageing and Social Change. Linköping University, Faculty of Arts and Sciences.
    Samuelsson, Christina
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Laakso, Katja
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Buchholz, Margret
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
    Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives2023In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, no 9, p. 1983-2000Article in journal (Refereed)
    Abstract [en]

    Dementia is a source of growing concern globally, and often impacts on social and commu-nicative functioning. INdependent LIving Support Functions for the Elderly (IN LIFE) was aproject carried out within the European Commission Research and Innovation programmeHorizon 2020 that resulted in the development of two digital communication aids for rem-iniscence intervention for elderly people with dementia and their communication partners.The purpose of this intervention study was to investigate the effects on quality of life forpeople with dementia when using these aids. People with dementia (N = 118) and their for-mal care-givers (N = 187) and relatives (N = 9) were given the communication aids for a per-iod of 4–12 weeks. To assess a range of outcomes, questionnaires developed within theproject were used along with the EQ-5D (European Quality of Life – 5 Dimensions) andQoL-AD (Quality of Life in Alzheimer’s Disease) questionnaires. Quality of life improvedamong people with dementia when measured using EQ-5D ( p < 0.05). There was also a cor-relation between the impact on the participants’ health and wellbeing, the carers’ rating ofthe usefulness of the digital communication aids and the care-givers’ satisfaction with usingtechnology ( p < 0.05). These results indicate that digital communication aids may be usefulin social interaction where one partner has dementia.

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  • 35.
    Derbring, Sandra
    et al.
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
    Nordström, Melissa Barbos
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Svenningsson, Jenny-Ann
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Laakso, Katja
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden,.
    Ekström, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Ingebrand, Elias
    Linköping University, Department of Culture and Society, Division of Ageing and Social Change. Linköping University, Faculty of Arts and Sciences.
    Samuelsson, Christina
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Buchholz, Margret
    DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Correction: Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives - CORRIGENDUM (Oct, 10.1017/S0144686X21001446, 2021)2022In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, article id PII S0144686X21001963Article in journal (Other academic)
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  • 36.
    Drakskog, Cecilia
    et al.
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    de Klerk, Nele
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    Westerberg, Johanna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Mäki-Torkko, Elina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Faculty of Medicine and Health, Örebro University.
    Georén, Susanna Kumlien
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    Cardell, Lars Olaf
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm; Department of ENT Diseases, Karolinska University Hospital, Stockholm.
    Extensive qPCR analysis reveals altered gene expression in middle ear mucosa from cholesteatoma patients2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 9, article id e0239161Article in journal (Refereed)
    Abstract [en]

    The middle ear is a small and hard to reach compartment, limiting the amount of tissue that can be extracted and the possibilities for studying the molecular mechanisms behind diseases like cholesteatoma. In this paper 14 reference gene candidates were evaluated in the middle ear mucosa of cholesteatoma patients and two different control tissues. ACTB and GAPDH were shown to be the optimal genes for the normalisation of target gene expression when investigating middle ear mucosa in multiplex qPCR analysis. Validation of reference genes using c-MYC expression confirmed the suitability of ACTB and GAPDH as reference genes and showed an upregulation of c-MYC in middle ear mucosa during cholesteatoma. The occurrence of participants of the innate immunity, TLR2 and TLR4, were analysed in order to compare healthy middle ear mucosa to cholesteatoma. Analysis of TLR2 and TLR4 showed variable results depending on control tissue used, highlighting the importance of selecting relevant control tissue when investigating causes for disease. It is our belief that a consensus regarding reference genes and control tissue will contribute to the comparability and reproducibility of studies within the field.

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  • 37.
    Ekberg, Mattias
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Andin, Josefine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Stenfelt, Stefan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Effects of mild-to-moderate sensorineuralhearing loss and signal amplification on vocalemotion recognition in middle-aged–olderindividuals2022In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 1, article id e0261354Article in journal (Refereed)
    Abstract [en]

    Previous research has shown deficits in vocal emotion recognition in sub-populations of individuals with hearing loss, making this a high priority research topic. However, previousresearch has only examined vocal emotion recognition using verbal material, in which emotions are expressed through emotional prosody. There is evidence that older individualswith hearing loss suffer from deficits in general prosody recognition, not specific to emotionalprosody. No study has examined the recognition of non-verbal vocalization, which constitutes another important source for the vocal communication of emotions. It might be thecase that individuals with hearing loss have specific difficulties in recognizing emotionsexpressed through prosody in speech, but not non-verbal vocalizations. We aim to examinewhether vocal emotion recognition difficulties in middle- aged-to older individuals with sensorineural mild-moderate hearing loss are better explained by deficits in vocal emotion recognition specifically, or deficits in prosody recognition generally by including both sentencesand non-verbal expressions. Furthermore a, some of the studies which have concluded thatindividuals with mild-moderate hearing loss have deficits in vocal emotion recognition abilityhave also found that the use of hearing aids does not improve recognition accuracy in thisgroup. We aim to examine the effects of linear amplification and audibility on the recognitionof different emotions expressed both verbally and non-verbally. Besides examining accuracy for different emotions we will also look at patterns of confusion (which specific emotionsare mistaken for other specific emotion and at which rates) during both amplified and nonamplified listening, and we will analyze all material acoustically and relate the acoustic content to performance. Together these analyses will provide clues to effects of amplification onthe perception of different emotions. For these purposes, a total of 70 middle-aged-olderindividuals, half with mild-moderate hearing loss and half with normal hearing will perform acomputerized forced-choice vocal emotion recognition task with and without amplification

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  • 38.
    Ekberg, Mattias
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Stavrinos, Georgios
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andin, Josefine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Acoustic Features Distinguishing Emotions in Swedish Speech.2023In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, article id S0892-1997(23)00103-0Article in journal (Refereed)
    Abstract [en]

    Few studies have examined which acoustic features of speech can be used to distinguish between different emotions, and how combinations of acoustic parameters contribute to identification of emotions. The aim of the present study was to investigate which acoustic parameters in Swedish speech are most important for differentiation between, and identification of, the emotions anger, fear, happiness, sadness, and surprise in Swedish sentences. One-way ANOVAs were used to compare acoustic parameters between the emotions and both simple and multiple logistic regression models were used to examine the contribution of different acoustic parameters to differentiation between emotions. Results showed differences between emotions for several acoustic parameters in Swedish speech: surprise was the most distinct emotion, with significant differences compared to the other emotions across a range of acoustic parameters, while anger and happiness did not differ from each other on any parameter. The logistic regression models showed that fear was the best-predicted emotion while happiness was most difficult to predict. Frequency- and spectral-balance-related parameters were best at predicting fear. Amplitude- and temporal-related parameters were most important for surprise, while a combination of frequency-, amplitude- and spectral balance-related parameters are important for sadness. Assuming that there are similarities between acoustic models and how listeners infer emotions in speech, results suggest that individuals with hearing loss, who lack abilities of frequency detection, may compared to normal hearing individuals have difficulties in identifying fear in Swedish speech. Since happiness and fear relied primarily on amplitude- and spectral-balance-related parameters, detection of them are probably facilitated more by hearing aid use.

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  • 39.
    Ekman, Linnea
    et al.
    Lund Univ, Sweden.
    Pourhamidi, Kaveh
    Karolinska Inst, Sweden.
    Englund, Elisabet
    Lund Univ, Sweden.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Rolandsson, Olov
    Umea Univ, Sweden.
    Dahlin, Lars B.
    Lund Univ, Sweden.
    Temporal trend of small nerve fibre degeneration in people with and without type 2 diabetes mellitus2022In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 39, no 3, article id e14691Article in journal (Refereed)
    Abstract [en]

    Aims We investigated the long-term temporal trend of intraepidermal nerve fibre density (IENFD) and the association between changes in IENFD and metabolic factors in individuals with and without type 2 diabetes. Methods A total of 66 participants were enrolled in this longitudinal population-based study, at baseline consisting of 35 individuals (median 61 years) without diabetes and 31 individuals with type 2 diabetes mellitus. Participants underwent clinical and electrophysiological examinations, as well as a skin biopsy both at baseline and at the follow-up visit (mean 8.1 +/- 0.5 years). IENFD was assessed in thin sections of 5 mu m, stained with the protein gene product 9.5-antibody and compared between the groups. Results IENFD decreased during the period in both groups, with a greater decline in the group without diabetes than in type 2 diabetes (-2.3 and -0.6 fibres/mm respectively; p &lt; 0.001). While IENFD at baseline was significantly reduced in type 2 diabetes relative to people without (p &lt; 0.001), no difference in IENFD was found between groups at the follow-up (p = 0.183). Linear mixed model analysis indicated that age, weight and HbA(1c) were associated with decrease in IENFD in the total population (p &lt; 0.007). IENFD also decreased with increasing age and weight, but not with HbA(1c), in the separate groups (p &lt; 0.049). Conclusions Despite lower IENFD levels at baseline in type 2 diabetes, IENFD was equal between the groups at follow-up. A decrease in IENFD is to a limited extent affected by body weight, and HbA(1c), but age seems to be the long-term determinant of IENFD in an elderly population.

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  • 40.
    Ekström, Anna
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Cekaite, Asta
    Linköping University, Department of Thematic Studies, Department of Child Studies. Linköping University, Faculty of Arts and Sciences.
    An exploratory study of childrens peer touch in a Swedish preschool: touch forms, bodily arrangements, and social constellations2023In: European Early Childhood Education Research Journal, ISSN 1350-293X, E-ISSN 1752-1807Article in journal (Refereed)
    Abstract [en]

    This study explores childrens peer touch in a Swedish preschool using video observations. Two main aspects of childrens touch in focus: (1) to what extent do children use touch within the peer group and with whom and (2) in what ways do children touch each other (i.e. what touch forms are used and what areas of other childrens bodies are touched). Data consists of 10 hours of video recordings, featuring 35 children aged 1-5 years. The results suggest that touch is available for children in a range of social arrangements: it was common in childrens peer-group interactions, and it was not limited to specific child constellations. The most prominent categories were affectionate touches (embraces, holding hands, or pats), but the children also used touch to control their peers conduct (grabbing, pulling, and pushing) as well as adult-like embodied directives (shepherding moves). The social and material context of a preschool may contribute to practices where touch is part of ordinary interactions and cultural practices within the peer group. The study demonstrates some differences between educator-child, and childrens peer touch thereby highlighting the importance for educators to consider childrens specific touch cultures when attending to, supporting, and shaping childrens peer - relations.

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  • 41.
    Ekström, Anna
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Lindwall, Oskar
    Göteborgs universitet.
    Redskap och material2020In: Multimodal interaktionsanalys / [ed] Mathias Broth, Leelo Keevallik, Lund: Studentlitteratur AB, 2020, Vol. Sidorna 183-195, p. 183-195Chapter in book (Other academic)
    Abstract [sv]

    Föremål, redskap och material är centrala delar av i princip alla mänskliga aktiviteter. Människor använder, skapar, pratar om och upplever objekt i olika sammanhang och för olika uppgifter i såväl vardagliga som professionella sammanhang. I kapitlet använder vi exempel från matlagning, tandläkarutbildning och slöjdundervisning för att belysa hur materiella objekt ingår i sociala aktiviteter och formar interaktionen.

  • 42.
    Ekström, Anna
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Majlesi, Ali Reza
    Stockholm Univ, Sweden.
    Hydén, Lars-Christer
    Linköping University, Department of Culture and Society, Division of Ageing and Social Change. Linköping University, Faculty of Arts and Sciences.
    Assisted eating as a communicative activity : A framework of joint attention and co-ordinated embodied actions2023In: Journal of Interactional Research in Communication Disorders/Equinox, ISSN 2040-5111, E-ISSN 2040-512X, Vol. 14, no 1, p. 79-105Article in journal (Refereed)
    Abstract [en]

    Background: This study aims to further the understanding of communication involv-ing people with late-stage dementia by highlighting assisted eating as an interactive joint activity. Assisted eating is, on the surface, primarily a care activity with the purpose of feeding the assisted person and thereby facilitating nutritional uptake. Helping someone to eat requires, nevertheless, fine-grained communication and co-ordination of both attention and embodied actions. Method: Using video recordings where a person with late-stage dementia is pro-vided with assistance to eat, we show how assisted eating is sequentially organized into smaller, local communicative projects, and how each projects completion is contingent upon the temporal co-ordination of the participants attention and embodied actions. Results: The analysis shows how actions necessary to carry out the eating (e.g., manipulating the food, bringing the food to the mouth) are also inherently commu-nicative and achieved through an embodied participation framework. Discussion/conclusion: Our findings show that while the caregiving staff perform most of the actions required in the assisted eating, the person with dementia is a central agent whose actions -displays of engagement and disengagement -are deci-sive for the progression of the eating activity and play central roles in the interactive achievement of the activity.

  • 43.
    Ekström, Anna
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Sandgren, Olof
    Lund, Sweden.
    Sahlen, Birgitta
    Lund, Sweden.
    Samuelsson, Christina
    H9 CLINTEC Logopedi, Sweden.
    It depends on who Im with: How young people with developmental language disorder describe their experiences of language and communication in school2023In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984Article in journal (Refereed)
    Abstract [en]

    BackgroundThe risks of developmental language disorder (DLD) for both educational progress and socio-emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. AimsTo understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? Methods & ProceduresThe study is based on data generated from qualitative semi-structured interviews with 23 participants diagnosed with DLD (age 13-19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID-19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. Outcomes & ResultsFour main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. Conclusions & ImplicationsThe results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered. WHAT THIS PAPER ADDSWhat is already known on this subjectChildren and young people have unique knowledge about their language and communication which is instrumental for designing interventions and support strategies. Qualitative analyses of interview data have been able to identify both risk factors and protective strategies in relation to the well-being of individuals with DLD. Despite this, children and young people with DLD are rarely heard in research or clinical discussions. What this paper adds to existing knowledgeIn this study we listen to the voices of young people with DLD as they describe their experiences of language and communication in school. The participants describe a condition that makes them struggle to keep up with peers and puts them at risk of being misjudged by teachers, but also give examples of situations where negative consequences are hardly felt. What are the potential or actual clinical implications of this work?DLD is a complex and dynamic disorder where contextual and social factors interact with individual abilities in creating the end result. The results of the study indicate that DLD can cause persisting problems related to language and communication in school, with impact on educational, social and emotional dimensions. To counteract these effects, SLT services may be needed throughout the school years, and support that goes beyond language abilities must be considered.

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  • 44.
    Ekström, Anna
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.
    Sandgren, Olof
    Lunds universitet.
    Samuelsson, Christina
    Karolinska institutet.
    Sahlén, Birgitta
    Lunds universitet.
    Wallmann, Julia
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Likvärdig utbildning för barn med språkstörning: en studie av måluppfyllelse, erfarenheter och deltagande2023In: Resultatdialog 2023, Stockholm: Vetenskapsrådet , 2023, Vol. Sidorna 32-37, p. 32-37Chapter in book (Other academic)
    Abstract [sv]

    Språkstörning är en funktionsnedsättning som förekommer hos cirka sju procent av alla barn. Eftersom skolans undervisning förutsätter en god språklig förmåga, är risken stor att dessa elever inte når skolans mål. I detta pågående projekt undersöks situationen för elever med språkstörning i den svenska skolan med både kvantitativa och kvalitativa undersökningar.

  • 45.
    Ellis, Rachel
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Plejert, Charlotta
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Combined effects of age and hearing impairment on utterances and requests for clarification in spontaneous conversation and a referential communication task2024In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 59, no 1, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BackgroundThe impact of hearing impairment is typically studied in terms of its effects on speech perception, yet this fails to account for the interactive nature of communication. Recently, there has been a move towards studying the effects of age-related hearing impairment on interaction, often using referential communication tasks; however, little is known about how interaction in these tasks compares to everyday communication. AimsTo investigate utterances and requests for clarification used in one-to-one conversations between older adults with hearing impairment and younger adults without hearing impairment, and between two younger adults without hearing impairment. Methods & ProceduresA total of 42 participants were recruited to the study and split into 21 pairs, 10 with two younger adults without hearing impairment and 11 with one younger adult without hearing impairment and one older participant with age-related hearing impairment (hard of hearing). Results from three tasks-spontaneous conversation and two trials of a referential communication task-were compared. A total of 5 min of interaction in each of the three tasks was transcribed, and the frequency of requests for clarification, mean length of utterance and total utterances were calculated for individual participants and pairs. Outcomes & ResultsWhen engaging in spontaneous conversation, participants made fewer requests for clarification than in the referential communication, regardless of hearing status/age (p & LE; 0.012). Participants who were hard of hearing made significantly more requests for clarification than their partners without hearing impairment in only the second trial of the referential communication task (U = 25, p = 0.019). Mean length of utterance was longer in spontaneous conversation than in the referential communication task in the pairs without hearing impairment (p & LE; 0.021), but not in the pairs including a person who was hard of hearing. However, participants who were hard of hearing used significantly longer utterances than their partners without hearing impairment in the spontaneous conversation (U = 8, p &lt; 0.001) but not in the referential communication tasks. Conclusions & ImplicationsThe findings suggest that patterns of interaction observed in referential communication tasks differ to those observed in spontaneous conversation. The results also suggest that fatigue may be an important consideration when planning studies of interaction that use multiple conditions of a communication task, particularly when participants are older or hard of hearing. WHAT THIS PAPER ADDSWhat is already known on this subjectAge-related hearing impairment is known to affect communication; however, the majority of studies have focused on its impact on speech perception in controlled conditions. This indicates little about the impact on everyday, interactive, communication. What this study adds to the existing knowledgeWe investigated utterance length and requests for clarification in one-to-one conversations between pairs consisting of one older adult who is hard of hearing and one younger adult without hearing impairment, or two younger adults without hearing impairment. Results from three tasks (two trials of a referential communication task and spontaneous conversation) were compared. The findings demonstrated a significant effect of task type on requests for clarification in both groups. Furthermore, in spontaneous conversation, older adults who were hard of hearing used significantly longer utterances than their partners without hearing impairment. This pattern was not observed in the referential communication task. What are the potential or actual clinical implications of this work?These findings have important implications for generalizing results from controlled communication tasks to more everyday conversation. Specifically, they suggest that the previously observed strategy of monopolizing conversation, possibly as an attempt to control it, may be more frequently used by older adults who are hard of hearing in natural conversation than in a more contrived communication task.

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  • 46.
    Ferm, Ulrika
    et al.
    Sahlgrens Univ Hosp, Sweden.
    Ekström, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Larsson, Elias
    Linköping University, Department of Culture and Society, Division of Ageing and Social Change. Linköping University, Faculty of Arts and Sciences.
    Samuelsson, Christina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Tablet computer-supported conversation between people with dementia and their carers: technology as interactional focus2021In: Universal Access in the Information Society, ISSN 1615-5289, E-ISSN 1615-5297, Vol. 20, p. 753-765Article in journal (Refereed)
    Abstract [en]

    The purpose of the study is to explore when and how technology becomes a topic in interactions involving people with dementia and their carers. Three dyads of older women with dementia and their carers participated in the study. The dyads interacted in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (CIRCA) and personalized pictures and films (CIRCUS). The data included twenty-one video-recorded interactions. Topical episode analysis and transcripts of interaction were used to analyze and exemplify when and how technology was talked about in the dyads. The dyads were engaged in exploring the tablets, and six common ways of making technology a topic of conversation were identified: talk about tech problems, commenting actions, expressing uncertainty in navigation, instructing and explaining, expressing surprise, and talk about technical development. The dyads explored the tablets in ways that were reflected in the content of their conversations. If people with dementia and their carers should benefit from todays technology, such as there is evidence for the interactions examined in this study, their homes and daily environments must be equipped with sufficient internet access and technical support.

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  • 47.
    Fineide, Fredrik
    et al.
    Oslo Univ Hosp, Norway; Norwegian Dry Eye Clin, Norway; Oslo Metropolitan Univ, Norway; SimulaMet, Norway.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Adil, Muhammed Yasin
    Oslo Univ Hosp, Norway; Norwegian Dry Eye Clin, Norway.
    Arita, Reiko
    Dept Ophthalmol, Japan.
    Kolko, Miriam
    Univ Copenhagen, Denmark; Copenhagen Univ Hosp, Denmark.
    Vehof, Jelle
    Univ Copenhagen, Denmark; Kings Coll London, England; Univ Groningen, Netherlands; Vestfold Hosp, Norway.
    Utheim, Tor P.
    Oslo Univ Hosp, Norway; Norwegian Dry Eye Clin, Norway; Oslo Metropolitan Univ, Norway; Stavanger Univ Hosp, Norway; Vestre Viken Hosp, Norway; Vestfold Hosp, Norway; Univ Bergen, Norway; Oslo Univ Hosp, Norway; Oslo Metropolitan Univ, Norway; Univ Stavanger, Norway; Univ Oslo, Norway; Univ South Eastern Norway, Norway; Univ Agder, Norway; Sorlandet Hosp Arendal, Norway.
    Topical glaucoma medications - Clinical implications for the ocular surface2022In: Ocular Surface, ISSN 1542-0124, Vol. 26, p. 19-49Article in journal (Refereed)
    Abstract [en]

    Glaucoma is a leading cause of irreversible blindness. The use of topical eye drops to reduce intraocular pressure remains the mainstay treatment. These eye drops frequently contain preservatives designed to ensure sterility of the compound. A growing number of clinical and experimental studies report the detrimental effects of not only these preservatives but also the active pharmaceutical compounds on the ocular surface, with resultant tear film instability and dry eye disease. Herein, we critically appraise the published literature exploring the effects of preservatives and pharmaceutical compounds on the ocular surface.

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  • 48.
    Fries, Fabian N.
    et al.
    Saarland Univ, Germany; Saarland Univ, Germany.
    Moslemani, Kayed
    Saarland Univ, Germany.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Norway; Sorlandet Hosp Arendal, Norway.
    Seitz, Berthold
    Saarland Univ, Germany.
    Kaesmann-Kellner, Barbara
    Saarland Univ, Germany.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Sorlandet Hosp Arendal, Norway.
    Early ocular surface and tear film status in congenital aniridia indicates a supportive treatment window2022In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079Article in journal (Refereed)
    Abstract [en]

    AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p&lt;0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p&lt;0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p&lt;0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression.

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  • 49.
    Fries, Fabian Norbert
    et al.
    Saarland Univ, Germany.
    Naray, Annamaria
    Saarland Univ, Germany; Semmelwe Univ, Hungary.
    Munteanu, Cristian
    Saarland Univ, Germany.
    Stachon, Tanja
    Saarland Univ, Germany.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Seitz, Berthold
    Saarland Univ, Germany.
    Szentmary, Nora
    Saarland Univ, Germany.
    Kaesmann-Kellner, Barbara
    Saarland Univ, Germany.
    A Cross-sectional Analysis of 556 Eyes Entering the Homburg Aniridia Centre2023In: Klinische Monatsblätter für Augenheilkunde, ISSN 0023-2165, E-ISSN 1439-3999Article in journal (Refereed)
    Abstract [en]

    Purpose Congenital aniridia is a severe malformation of almost all eye segments. In addition, endocrinological, metabolic, and central nervous systems diseases may be present. In order to develop better treatment options for this rare disease, an aniridia center must be established. The purpose of this work is to summarize ophthalmic findings of aniridia subjects examined at the Department of Ophthalmology, Saarland University Medical Center in Homburg.Methods Our retrospective single-center study included patients who underwent a comprehensive ophthalmic examination through the head of the KiOLoN ("Kinderophthalmologie", Orthoptics, Low Vision and Neuroophthalmology) Unit of the department between June 2003 and January 2022. Data at the first examination time point have been included.Results Of 286 subjects, 556 eyes of (20.1 & PLUSMN; 20.1 years; 45.5% males) were included. There was nystagmus in 518 (93.7%) eyes, and strabismus in 327 (58.8%) eyes. There were 436 (78.4%) eyes with age-appropriate axial length, 104 (18.7%) eyes with microphthalmos, and 13 (2.3%) eyes with buphthalmos. There was iris malformation with atypical coloboma in 34 eyes (6.1%), more than 6 clock hours of iris remnants in 61 eyes (10.9%), less than 6 clock hours of iris remnants in 96 eyes (17.2%), and complete aniridia in 320 (57.5%) eyes. The patients were graded according to the following aniridia-associated keratopathy (AAK) stages: Stage 0 (96 eyes [17.2%], no keratopathy), Stage 1 (178 eyes [32.0%]), Stage 2 (107 eyes [19.2%]), Stage 3 (67 eyes [12.0%]), Stage 4 (62 eyes [11.1%]), Stage 5 (45 eyes [8.0%]). There was secondary glaucoma in 307 (55.5%), macular hypoplasia in 395 (71.4%), and congenital optic nerve head pathology in 223 (40.3%) eyes. The iris malformation type was significantly positively correlated with AAK stage, lens properties, presence of glaucoma, congenital macular, and optic nerve head properties (p &lt; 0.001 for all), while complete aniridia showed the most complications.Conclusions At the Homburg Aniridia Center, the most common ophthalmic signs in congenital aniridia were AAK, iris malformation, cataract, and macular hypoplasia. The iris malformation type may indicate future expression of AAK, cataract, and glaucoma development and it is correlated with a congenital optic nerve head and macular pathology. Our registry will support further detailed longitudinal analysis of ophthalmic and systemic diseases of aniridia subjects during long-term follow-up.

  • 50.
    Friling, Emma
    et al.
    Karolinska Inst, Sweden; Stockholms Ogonklin, Sweden.
    Johansson, Björn
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Lundström, Mats
    Lund Univ, Sweden.
    Montan, Per
    Karolinska Inst, Sweden; St Erik Eye Hosp, Sweden.
    Postoperative Endophthalmitis in Immediate Sequential Bilateral Cataract Surgery: A Nationwide Registry Study2022In: Ophthalmology, ISSN 0161-6420, E-ISSN 1549-4713, Vol. 129, no 1, p. 26-34Article in journal (Refereed)
    Abstract [en]

    Purpose: To report the incidence of postoperative endophthalmitis (PE) after immediate sequential bilateral cataract surgery (ISBCS) in Sweden. Design: Retrospective cohort registry study. Participants: Patient data from 1 457 172 cataract extractions, including 1 364 934 unilateral surgeries and 92 238 ISBCSs. Methods: Endophthalmitis cases reported to the Swedish National Cataract Register (NCR) during a 16-year period (2002-2017) were analyzed in comparison to all control cases with regard to patient characteristics, surgical technique, and capsule complication. Main Outcome Measure: Incidence and determinants for PE in ISBCS compared with unilateral surgeries. Results: A total of 422 cases of PE were identified in 1 457 172 cataract extractions, yielding an overall incidence of 0.029% (95% confidence interval [CI], 0.0262-0.0317). For unilateral procedures, the rate was 0.0299% (95% CI, 0.0270-0.0328) or 408 cases in 1 364 934 operations, whereas that for ISBCS was 0.0152% (95% CI, 0.0072-0.0231) or 14 incidents in 92 238 operations (P = 0.01). In a logistic regression model including all cataract procedures, nonuse of intracameral (IC) antibiotics (ABs), capsule complication, age 85 years or more, male gender, and ocular comorbidity were found to be independent risk factors for PE. All these parameters were less frequent in ISBCS. Notwithstanding, in the same multivariate analysis, ISBCS in itself was associated with a significantly lower risk for PE. At follow-up, 5 of the 14 PE cases in the ISBCS cohort had a visual acuity (VA) of 20/200 or worse. Of these, one 93-year-old ISBCS patient developed bilateral infection. Conclusions: After ISBCS in Sweden, PE occurred once in 6600 surgeries. The risk of sustaining a final VA of 20/200 or less was 1 incident in 18 000 operated eyes. When counseling potential ISBCS patients about the risk of PE, it seems reasonable to state that the reported risk in the literature is lower than that with unilateral surgery but not negligible. Precautions remain necessary. (C) 2021 by the American Academy of Ophthalmology.

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