Pediatric liver diseases and ocular changes: What hepatologists and ophthalmologists should know and share with each other

Vitiello, Livio; Bernardo, Maddalena De; Nuzio, Salvatore Guercio; Mandato, Claudia; Rosa, Nicola; Vajro, Pietro

doi:10.1016/j.dld.2019.11.009

Cited by 16 publications

(13 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, an ophthalmic examination can facilitate the screening and referral of some hepatobiliary diseases for patients at risk. 7 Moreover, common hepatobiliary diseases that affect millions of people worldwide, 8 including hepatitis, cirrhosis, liver cancer, and cholelithiasis, frequently present with non-specific ocular abnormalities, such as icteric changes in the conjunctiva and sclera. 9 However, other non-hepatobiliary diseases and pseudojaundice (eg, carotenemia) can also lead to the yellowing of the conjunctiva and sclera.…”

Section: Introductionmentioning

confidence: 99%

Screening and identifying hepatobiliary diseases through deep learning using ocular images: a prospective, multicentre study

Xiao

Huang

Wang

et al. 2021

The Lancet Digital Health

View full text Add to dashboard Cite

Background Ocular changes are traditionally associated with only a few hepatobiliary diseases. These changes are non-specific and have a low detection rate, limiting their potential use as clinically independent diagnostic features. Therefore, we aimed to engineer deep learning models to establish associations between ocular features and major hepatobiliary diseases and to advance automated screening and identification of hepatobiliary diseases from ocular images.Methods We did a multicentre, prospective study to develop models using slit-lamp or retinal fundus images from participants in three hepatobiliary departments and two medical examination centres. Included participants were older than 18 years and had complete clinical information; participants diagnosed with acute hepatobiliary diseases were excluded. We trained seven slit-lamp models and seven fundus models (with or without hepatobiliary disease [screening model] or one specific disease type within six categories [identifying model]) using a development dataset, and we tested the models with an external test dataset. Additionally, we did a visual explanation and occlusion test. Model performances were evaluated using the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and F1* score.

show abstract

Section: Introductionmentioning

confidence: 99%

Screening and identifying hepatobiliary diseases through deep learning using ocular images: a prospective, multicentre study

Xiao

Huang

Wang

et al. 2021

The Lancet Digital Health

View full text Add to dashboard Cite

show abstract

“…In recent years, the use of ocular ultrasonography is spreading more and more in different medical fields, especially due to its safety and ready availability, making it easier for physicians to identify several pathological conditions ( 50 ). Specifically, this ultrasound technique is a non-invasive, non-irradiating, and cheap diagnostic tool that may be used to detect, indirectly, the presence of raised ICP.…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects

et al. 2022

Self Cite

View full text Add to dashboard Cite

In recent years, ultrasonographic measurement of the optic nerve sheath diameter (ONSD) has been widely used to identify the presence of increased intracranial pressure (ICP). Intracranial hypertension is a life-threatening condition that can be caused by various neurological and non-neurological disorders, and it is associated to poor clinical results. Ultrasonography could be used to qualitatively and efficiently detect ICP increases, but to reach this purpose, clear cut-off values are mandatory. The aim of this review is to provide a wide overview of the most important scientific publications on optic nerve ultrasound normal values assessment published in the last 30 years. A total of 42 articles selected from PubMed medical database was included in this review. Our analysis showed that ocular ultrasonography is considered to be a valuable diagnostic tool, especially when intracranial hypertension is suspected, but unfortunately this research provided conflicting results that could be due to the different ultrasound protocols. This is mainly caused by the use of B scan alone, which presents several limitations. The use of B-scan coupled with the standardized A-scan approach could give more accurate, and reliable ultrasound evaluation, assuring higher data objectivity.

show abstract

“…In recent years, ocular ultrasonography has widely spread because of its non-invasiveness, speed of execution, and quick obtainable results useful in the diagnosis of different diseases, such as IIH ( 30 ). Indeed, in all the articles evaluated in this review, transorbital ultrasound proved effective in the diagnosis of increased ICP and even in follow-up evaluation of patients with IIH.…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

et al. 2022

Self Cite

View full text Add to dashboard Cite

Idiopathic intracranial hypertension (IIH) is a disease with a heterogeneity of possible causes, which needs to be quickly diagnosed. Ocular ultrasonography could be considered a useful tool to diagnose this condition in a fast and non-invasive way. In fact, Karl Ossoinig had already proposed this diagnostic tool in the 1970s for the evaluation of intracranial pressure changes under several pathological conditions, including idiopathic intracranial hypertension. The aim of this review is to analyze scientific articles published in the last 30 years concerning the use of ocular ultrasonography to assess optic nerve indices in patients with idiopathic intracranial hypertension. Specifically, 15 published articles found in PubMed database were included and analyzed in the present review. Our conclusion suggests that ocular ultrasonography is a reliable diagnostic technique to be utilized in all the cases of suspected raised intracranial pressure. To obtain the best possible accuracy and precision in the least invasive way, standardized A-scan seems to be the best choice.

show abstract

Pediatric liver diseases and ocular changes: What hepatologists and ophthalmologists should know and share with each other

Cited by 16 publications

References 82 publications

Screening and identifying hepatobiliary diseases through deep learning using ocular images: a prospective, multicentre study

Screening and identifying hepatobiliary diseases through deep learning using ocular images: a prospective, multicentre study

Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

Contact Info

Product

Resources

About