Advancing automated pupillometry:a practical deep learning model utilizing infrared pupil images

AIM:To establish pupil diameter measurement algorithms based on infrared images that can be used in real-world clinical settings.METHODS:A total of 188 patients from outpatient clinic at He Eye Specialist Shenyang Hospital from Spetember to December 2022 were included,and 13470 infrared pupil images were collected for the study.All infrared images for pupil segmentation were labeled using the Labelme software.The computation of pupil diameter is divided into four steps:image pre-processing,pupil identification and localization,pupil segmentation,and diameter calculation.Two major models are used in the computation process:the modified YoloV3 and Deeplabv 3+models,which must be trained beforehand.RESULTS:The test dataset included 1348 infrared pupil images.On the test dataset,the modified YoloV3 model had a detection rate of 99.98% and an average precision(AP)of 0.80 for pupils.The DeeplabV3+model achieved a background intersection over union(IOU)of 99.23%,a pupil IOU of 93.81%,and a mean IOU of 96.52%.The pupil diameters in the test dataset ranged from 20 to 56 pixels,with a mean of 36.06±6.85 pixels.The absolute error in pupil diameters between predicted and actual values ranged from 0 to 7 pixels,with a mean absolute error(MAE)of 1.06±0.96 pixels.CONCLUSION:This study successfully demonstrates a robust infrared image-based pupil diameter measurement algorithm,proven to be highly accurate and reliable for clinical application.

“一带一路”援非国家眼科医生培训调研与思考

目的:调研援非国家眼科医生培训班学员个人及其国家在防治失明和视力障碍方面的挑战与需求,总结培训情况,讨论未来如何进一步助推“一带一路”沿线国家眼健康事业的发展。方法:对2022-08-01/08-30来自肯尼亚、赞比亚、尼日利亚、南非、马拉维、博茨瓦纳6个国家的48名眼科医生进行培训,并进行匿名问卷调查。问卷包含15道题目,包含所在国家视力障碍及失明方面的挑战及对策、培训满意度、在非洲建立视光中心的建议三方面内容。结果:共发放问卷48份,回收有效问卷47份。学员所在国家在眼病防治中的最大挑战是无法负担的眼部护理费用(36.17%),眼科医生个人面临的最大挑战是工资很低(29.79%)。眼科医生认为建设更多眼科医院(38.30%)、提供更多培训(65.96%)最有可能会帮助所在国家和个人。培训组织满意度98%,内容及讲师满意度100%。结论:参培学员及其所在国家在眼病防治方面面临诸多困境,目前迫切需要建设更多眼科医院,提供更多培训机会。该培训项目学员满意度高,反馈良好。

米诺环素对缺氧缺血脑损伤未成熟新生大鼠TLR4、NF-κBp65和TNF-α表达的影响

目的观察米诺环素(Minocycline,MN)对缺氧缺血脑损伤(hypoxic-ischemic brain damage,HIBD)未成熟新生大鼠Toll样受体4(Toll-like receptor 4,TLR4)、核因子-κB(nuclear factor-kappa B,NF-κB)p65和TNF-α表达的影响,探索米诺环素脑保护作用机制。方法将160只生后2 d(P2)Sprague-Dawley(SD)新生大鼠随机分成正常对照组、假手术组、HIBD组、HIBD加MN组。通过结扎左侧颈总动脉及8%氮氧混合气缺氧4 h,制备未成熟新生大鼠缺氧缺血性脑损伤模型。HIBD加MN组大鼠缺氧后予腹腔注射1次MN 45 mg/kg,HIBD组予腹腔注射等剂量的无菌PBS(pH 7.4)。HI后24h、48 h、72 h取材,Western blotting检测TLR4、NF-κBp65和TNF-α蛋白表达,HI后72 h、4周行脑组织HE染色及病理评分,HI后4周行行为学检测。结果 HI后72 h、4周HIBD加MN组脑组织病理损伤较HIBD组减轻,HIBD加MN组半定量病理评分低于HIBD组,差异有统计学意义(P<0.05)。Western blotting显示HI后24、48和72 h HIBD加MN组TLR4、NF-κBp65和TNF-α的表达低于HIBD组,较正常组及假手术组升高。HI后4周,在悬吊试验及斜坡试验中,HIBD加MN组与正常组、假手术组差异无统计学意义(P>0.05)。旷场试验中,HIBD加MN组与正常组、假手术组对比,差异有统计学意义(P<0.05);与HIBD组比较,P=0.375,差异无统计学意义(P>0.05)。圆筒实验中HIBD加MN组左侧上肢触壁百分比较HIBD组降低(P<0.05),与正常组、假手术组差异无统计学意义(P>0.05);右侧触壁百分比的比较中,HIBD加MN组与正常组、假手术组、HIBD组差异无统计学意义(P>0.05)。结论米诺环素对缺氧缺血脑损伤近期及远期具有良好的保护作用,其对缺氧缺血脑损伤的保护作用机制可能与抑制TLR4-NF-κBp65-TNF-α信号途径的激活有关。