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Purpose: To introduce and validate hvf_extraction_script, an open-source software script for the automated extraction and structuring of metadata, value plot data, and percentile plot data from Humphrey visual field (HVF) report images.Methods: Validation was performed on 90 HVF reports over three different report layouts, including a total of 1,530 metadata fields, 15,536 value plot data points, and 10,210 percentile data points, between the computer script and four human extractors, compared against DICOM reference data. Computer extraction and human extraction were compared on extraction time as well as accuracy of extraction for metadata, value plot data, and percentile plot data.Results: Computer extraction required 4.9-8.9 s per report, compared to the 6.5-19 min required by human extractors, representing a more than 40-fold difference in extraction speed. Computer metadata extraction error rate varied from an aggregate 1.2-3.5%, compared to 0.2-9.2% for human metadata extraction across all layouts. Computer value data point extraction had an aggregate error rate of 0.9% for version 1, <0.01% in version 2, and 0.15% in version 3, compared to 0.8-9.2% aggregate error rate for human extraction. Computer percentile data point extraction similarly had very low error rates, with no errors occurring in version 1 and 2, and 0.06% error rate in version 3, compared to 0.06-12.2% error rate for human extraction.Conclusions: This study introduces and validates hvf_extraction_script, an open-source tool for fast, accurate, automated data extraction of HVF reports to facilitate analysis of large-volume HVF datasets, and demonstrates the value of image processing tools in facilitating faster and cheaper large-volume data extraction in research settings.

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Purpose:Infectious keratitis is a vision-threatening condition requiring close follow-up and disciplined eye drop administration to achieve resolution. Although patients presenting to county hospitals often have more severe presentations, there is a paucity of risk and outcomes data in this setting. This study investigates risk factors predicting loss to follow-up (LTFU), medication noncompliance, and poor outcomes for infectious keratitis in the county hospital setting.Methods:This was a retrospective case-control study at Zuckerberg San Francisco General Hospital and Trauma Center. Inclusion criteria were patients who had corneal cultures for suspected infectious bacterial or fungal keratitis between 2010 and 2021. Exclusion criteria were patients with viral keratitis only. Multivariable logistic regression was used to analyze the relationship of social and medical risk factors with LTFU, medication noncompliance, worsened visual acuity (VA), and delayed resolution time.Results:Of 174 patients with infectious keratitis in this analysis, 69 (40.0%) had LTFU. Unemployment was associated with increased risk of LTFU (odds ratio 2.58, P = 0.049) and worse final VA (P = 0.001). Noncompliance trended toward an association with homelessness (odds ratio 3.48, P = 0.095). Increasing age correlated with longer resolution time, with each 1-year increase associated with delayed resolution by 0.549 days (P = 0.042).Conclusions:Patients experiencing unemployment, homelessness, or increased age demonstrate higher risk for treatment barriers including loss to follow-up and medication noncompliance, resulting in worse VA and delayed time to resolution. These risk factors should be considered when determining the need for more deliberate follow-up measures in patients with infectious keratitis.

Purpose: To examine the effect of teaching experience of supervising surgeons on resident cataract surgery intraoperative complication rates. Setting: Zuckerberg San Francisco General Hospital, University of California San Francisco, USA. Design: Retrospective chart review. Methods: Cataract surgeries performed by University of California San Francisco (UCSF) ophthalmology residents from 2010 to 2017 were reviewed. Only cases supervised by anterior segment attendings with more than 10 years of postresidency surgical experience were included. Cases were categorized as being supervised by either full-time UCSF teaching attendings or volunteer private practice attendings. Cases were graded as low risk (0 risk factors), intermediate risk (1 risk factor), or high risk (≥2 risk factors) based on 8 preoperative and intraoperative risk factors. Complication rates were compared between the 2 attending groups among varying risk grades. Results: Of 1377 cases, 101 developed complications. Among low-risk cases, full-time teaching attendings (25/619 [4.04%]) had a similar complication rate to volunteer attendings (17/387 [4.39%]) (odds ratio [OR] 0.92; P = .79). In intermediate-risk cases, full-time teaching attendings (28/195 [14.36%]) had slightly worse complication rates than volunteer attendings (10/88 [11.36%]) (OR 1.63; P = .45). High-risk cases had the highest complication rates, with the complication rates of full-time teaching attendings (16/72 [22.22%]) somewhat lower than those of volunteer attendings (5/16 [31.25%]) (OR 0.64; P = .48). Conclusions: For low-risk resident-performed cataract surgeries, supervision by full-time faculty and volunteer attendings yielded similar complication rates; thus, residency programs might safely recruit volunteer attendings to supervise low-risk cataract surgeries to support resident training. The analysis of higher-risk cases was limited by a low surgical volume.