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OBJECTIVE: Several artificial intelligence (AI) systems for diabetic retinopathy screening have been validated but there is limited evidence on their performance in real-world settings. This study aimed to assess the performance of an AI software deployed within the diabetic retinopathy screening programme in Dominica. METHODS AND ANALYSIS: We conducted a prospective, cross-sectional clinical validation study. Patients with diabetes aged 18 years and above attending the diabetic retinopathy screening in primary care facilities in Dominica from 5 June to 3 July 2021 were enrolled.Grading was done at the point of care by the field grader, followed by counselling and referral to the eye clinic. Images were then graded by an AI system. Sensitivity, specificity with 95% CIs and area under the curve (AUC) were calculated for comparing the AI to field grader as gold standard. RESULTS: A total of 587 participants were screened. The AI had a sensitivity and specificity for detecting referable diabetic retinopathy of 77.5% and 91.5% compared with the grader, for all participants, including ungradable images. The AUC was 0.8455. Excluding 52 participants deemed ungradable by the grader, the AI had a sensitivity and specificity of 81.4% and 91.5%, with an AUC of 0.9648. CONCLUSION: This study provides evidence that AI has the potential to be deployed to assist a diabetic screening programme in a middle-income real-world setting and perform with reasonable accuracy compared with a specialist grader.

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Sarcoidosis is a chronic multisystemic disease of unknown aetiology, characterised by non-caseating granulomas. Ocular involvement rate ranges from 30% to 60% among individuals with sarcoidosis, and can vary widely, making the diagnosis a challenge to the ophthalmologist. Cutaneous manifestations occur in about 22% of sarcoidosis cases, but eyelid involvement is rare. Eyelid swelling and nodules are the most frequent forms of eyelid involvement, but other findings have been reported. The joint analysis of clinical history, ancillary exams and compatible biopsy is needed for the diagnosis, as well as the exclusion of other possible conditions. This review aims to describe the different forms of presentations, the clinical reasoning and treatment options for ocular, eyelid and orbital sarcoidosis.

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Abstract Background: Eye-related neoplasms in dogs have a significant impact on visual ability, comfort, and longevity. Therapeutic alternatives and prognosis vary according to type of neoplasm and its anatomical location. Objective: To describe the frequency and distribution of eye-related neoplasms affecting dogs in the Aburrá valley (Antioquia province, Colombia). Methods: A retrospective collection of eye-related neoplasms in dogs, diagnosed at the Animal Pathology Laboratory of Universidad de Antioquia (Colombia), was conducted. Data spanning from years 2005 to 2017 were used. Records included age, sex, breed, neoplasm type and location, and cellular origin of neoplasm. A total of 250 eye-related-neoplasm reports affecting 246 dogs were analyzed -one report per animal, with the exception of four animals with both eyes simultaneously affected by the same type of neoplasm. Results: Animals between 8 and 11 years of age were more frequently affected by eye-related neoplasms (43.9%). Labrador retriever (19.1%), mixed-breed dogs (13.4%), and Poodle (12.2%) were the most frequently affected breeds. Neoplasms affected the eyelid in 76.8% of cases. Meibomian gland adenoma was the most frequent neoplasm (22.8%), followed by Meibomian gland epithelioma (20.0%), squamous cell carcinoma (8.8%), and melanocytoma (7.2%). The cellular origin of neoplasms was epithelial in 73.6% of the cases. Conclusion: Meibomian gland adenoma was the most common eye-related neoplasm. To our knowledge, this is the first retrospective report aimed to eye-related neoplasms in dogs published in Colombia.

Resumen Antecedentes: Las neoplasias relacionadas con los ojos en perros tienen un impacto significativo en la capacidad visual, la comodidad y la longevidad del animal. Las opciones terapéuticas y el pronóstico para el perro y para el tejido afectado varían según el tipo de neoplasia y su ubicación anatómica. Objetivo: Describir la frecuencia y distribución de neoplasias relacionadas con los ojos en perros del Valle de Aburrá (Departamento de Antioquia, Colombia). Métodos: Se realizó una evaluación retrospectiva de neoplasias relacionadas con los ojos en perros, diagnosticadas en el laboratorio de patología animal de la Universidad de Antioquia (Colombia). Los registros incluyeron información de 13 años (2005-2017). Los datos recolectados incluyeron edad, sexo, raza, tipo de tumor y ubicación, y origen celular de la neoplasia. Resultados: Se analizó un total de 250 reportes de neoplasias relacionadas con los ojos, afectando 246 perros (un reporte por animal, excepto cuatro animales en los que ambos ojos fueron afectados simultáneamente por el mismo tipo de neoplasia. Los animales entre 8 y 11 años de edad fueron los más frecuentemente afectados por neoplasias relacionadas con los ojos (43,9%). Las razas Labrador retriever (19,1%), perros mestizos (13,4%) y Poodle (12,2%) fueron las más frecuentemente afectadas. Las neoplasias afectaron el párpado en el 76,8% de los casos. El adenoma de la glándula de Meibomio fue la neoplasia más frecuente (22,8%), seguida por el epitelioma de la glándula de Meibomio (20,0%), el carcinoma de células escamosas (8,8%) y el melanocitoma (7,2%). El origen celular de las neoplasias fue epitelial en el 73,6% de los casos. Conclusión: Se encontró que el adenoma de la glándula de Meibomio es la neoplasia ocular más común. Hasta donde sabemos, este es el primer reporte retrospectivo dirigido específicamente a neoplasias relacionadas con ojos en perros publicado en Colombia.

Resumo Antecedentes: As neoplasias relacionadas aos olhos em cães são importantes porque têm um impacto significativo na capacidade visual, conforto e longevidade do animal. As opções terapêuticas e o prognóstico para o cão e para o tecido afetado variam de acordo com o tipo de neoplasia e sua localização anatômica. Objetivo: Descrever a frequência e distribuição das neoplasias relacionadas aos olhos em cães do Valle de Aburrá (Estado de Antioquia, Colômbia). Métodos: Foi realizada uma coleta retrospectiva de neoplasias relacionadas aos olhos em cães diagnosticados no laboratório de patologia animal da Universidade de Antioquia (Colômbia). Os registros coletaram informações de 13 anos (2005-2017). Os dados coletados incluíram idade, sexo, raça, tipo de tumor e localização e origem celular da neoplasia. Resultados: Um total de 250 relatos de neoplasias relacionadas aos olhos foram analisados, afetando 246 cães (um relatório por animal, com exceção de quatro animais, em que ambos os olhos foram afetados simultaneamente para o mesmo tipo de neoplasia relacionada aos olhos). Animais entre 8 e 11 anos foram mais acometidos por neoplasias relacionadas aos olhos (43,9%). As raças Labrador retriever (19,1%), mestiças (13,4%) e Poodle (12,2%) foram as raças mais afetadas. Neoplasias afetaram a pálpebra em 76,8% dos casos. Adenoma da glândula Meibomiana foi a neoplasia mais frequente (22,8%), seguido por epitelioma glândula Meibomiana (20,0%), carcinoma de células escamosas (8,8%) e melanocitoma (7,2%). A origem celular das neoplasias foi epitelial em 73,6% dos casos. Conclusão: Este estudo constatou que o adenoma da glândula Meibomiana é a neoplasia ocular mais comum. Para nosso conhecimento, este é o primeiro relato retrospectivo especificamente voltado para as neoplasias relacionadas aos olhos em cães publicados até o momento na Colômbia.

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Primary familial brain calcification (PFBC) is a rare neurodegenerative disorder characterized by symmetrical and bilateral brain calcification. It is typically inherited as an autosomal dominant disorder, and de novo variants have also been described. Interestingly, just recent studies have reported the first autosomal recessive PFBC-causative gene. PFBC patients exhibit high clinical heterogeneity including Parkinsonism, dystonia, ataxia, depression, and migraine. Mice studies, an important research tool, have been a breakthrough in increasing the understanding of PFBC's main signs and symptoms, and many findings reported in these mice have been subsequently reported in patients. One phenotype that has been observed in PFBC mice models but not in PFBC patients, however, is the development of ophthalmic abnormalities. This way, this report focused on performing an ophthalmic assessment in six Brazilian patients genetically diagnosed with PFBC. The assessments showed that none of the PFBC individuals included presented any of the ophthalmic abnormalities reported in mice models, such as cataracts, ocular calcification, abnormal iris and lens morphology, and retinal deterioration. Additionally, of the six PFBC patients described, two SLC20A2 mutation carriers showed physiological excavation of the optic nerve head and partial vitreous detachment, while just one individual presented bilateral narrowing of retinal arterioles. In summary, no evidence of similar ophthalmological abnormalities found in mice were found in our patients; nonetheless, further studies in larger sample size are warranted to corroborate with our findings. To our knowledge, this study is the first to focus on investigating, in PFBC patients, the ophthalmological phenotypes described in the PFBC mice models.

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