Week in review: Predicting Alzheimer’s disease, anesthesia for cataract surgery, residents taking parental leave

Cataract/Anterior Segment, Comprehensive Ophthalmology, Retina/Vitreous

A weekly roundup of ophthalmic news from around the web.

Retinal photographs may be able to predict Alzheimer’s disease, according to a multinational group of investigators who conducted a retrospective study with the aim of developing, testing, and validating a deep-learning predictive model for Alzheimer’s disease (AD) based on retinal photographs. The datasets included 5598 images from people with AD and 7351 images from people without AD. Both unilateral and bilateral models were better than 83% accurate in distinguishing between those with and without AD-related dementia. Accuracy was maintained when the models factored in gender, age, and the presence of diabetes and/or hypertension. The investigators conclude that this study “provides a unique and generalizable model that could be used in community settings to screen for Alzheimer’s disease.” Lancet Digital Health

Is anesthesia always needed for cataract surgery? Potentially not, based on results from a population-based, retrospective observational cohort study of 36,652 Medicare beneficiaries aged ≥66 years who underwent cataract surgery in 2017. Investigators compared the rate of perioperative complications between those under care of ophthalmologists who (a) never operated with anesthesia (6%), (b) who always operated with anesthesia (77%), or (c) who sometimes operated with anesthesia (17%). Whether the attending ophthalmologist never or always used anesthesia did not have an effect on the rate of complications; in total, 8% of patients experienced at least one systemic complication. Despite the general large-scale use of anesthesia in patients who have cataract surgery, this procedure has the lowest rates of mortality and postoperative complications among similar low-risk procedures (e.g., bronchoscopies, colonoscopies), suggesting that anesthesia can be used more selectively during cataract surgery. JAMA Internal Medicine

Ophthalmology residents do not always feel comfortable taking parental leave. Many ophthalmology residents with families have reported feeling that needing to take parental leave is not viewed favorably by their training programs, may lead to loss of professional opportunities, and places greater burdens on their fellow residents. However, a recent cross-sectional study of data from 249 residents in 10 accredited US ophthalmology programs found no differences between residents who took parental leave and those who did not in terms of research activities, surgical volume, or average Ophthalmic Knowledge Assessment Program (OKAP) percentiles. This was also true for female residents who took parental leave compared with all residents who did not. Nevertheless, the authors recommend that “program and institution leaders continue active discussions on establishing consistent and transparent parental leave policies and strategizing ways to reduce burden on residents…[to] improve resident retention, well-being, and gender equity in the field of ophthalmology.” JAMA Ophthalmology

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