Ophthalmology (Eye & Ear Hospital) - Research Publications

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Author: Taylor, Hugh × End date: 2009 × Start date: 2005 × Subject: Centre for Eye Research Australia × Subject: vision ×

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    Detecting cataract causing visual impairment using a nonmydriatic fundus camera
    Ferraro, John G. ; Pollard, Tamara ; MULLER, ANDREAS ; Lamoureux, Ecosse L. ; Taylor, Hugh R. (Elsevier, 2005-04)
    To assess the validity of a digital nonmydriatic fundus camera in detecting cataract as a cause of visual impairment. DESIGN: Diagnostic test comparison. METHODS: Photos of the anterior segment of 72 eyes were taken with a nonmydriatic fundus camera and assessed for cataract by two graders. Dilated biomicroscopy examination of the anterior segment of the same 72 eyes was then performed and cataract graded using the Wilmer scale. RESULTS: Grader 1 and 2 reported 90% and 94% sensitivity and 82% and 77% specificity, respectively, when the digital photos were compared with slit-lamp biomicroscopy in determining visually significant cataract. In addition, both graders showed similar subs al photos and slit-lamp biomicroscopy when assessed for cataract (unweighted kappa 0.87 and 0.92, respectively, for graders 1 and 2). CONCLUSION: The nonmydriatic fundus camera may be an alternative method for screening for visually significant cataract in the community.
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    Prevalence of associations of epiretinal membranes in the Visual Impairment Project
    McCarty, Daniel J. ; Mukesh, Bickol N. ; Chikani, Vatsal ; Wang, Jie J. ; MITCHELL, PAUL ; Taylor, Hugh R. ; McCarty, Catherine A. (Elsevier, 2005)
    Epiretinal Membrane also referred as primary retinal folds, silent central vein obstruction, wrinkling of the internal retinal surface, preretinal gliosis, preretinal macular fibrosis, cellophane maculopathy, and macular pucker, is a condition characterised by proliferation of abnormal tissues on the surface of the macula or central retina of the eye.
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    Clinical examination and laboratory tests for estimation of trachoma prevalence in a remote setting: what are they really telling us?
    Wright, Heathcote R. ; Taylor, Hugh R. (Elsevier, 2005-05)
    Worldwide, an estimated 84 million people have active trachoma and 7.6 million people have trachomatous trichiasis. WHO’s SAFE strategy is an effective tool in the worldwide effort to eliminate blinding trachoma, but its institution and monitoring requires a simple, reliable, and cost-effective method to detect disease. To date, clinical examination has provided the main method of diagnosis. Detection of Chlamydia trachomatis with nucleic acid amplification test does not always correlate well with clinical findings, which has prompted the suggestion that these methods should replace clinical examination. However, a review of the research carried out in animals and human beings suggests the relation between laboratory tests and clinical examination is due to the kinetics of trachoma and not to an inherent problem in either detection system. Given the increased difficulties of using laboratory tests in parts of the world where trachoma is endemic, we should not abandon clinical grading as a tool to asses the need for, and the effectiveness of, trachoma intervention programmes.
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    Impact of unilateral and bilateral vision loss on quality of life
    Vu, H. T. V. ; Keeffe, J. E. ; McCarty, C. A. ; Taylor, H. R. (BMJ Publishing Group, 2005-03)
    Aim: To investigate whether unilateral vision loss reduced any aspects of quality of life in comparison with normal vision and to compare its impact with that of bilateral vision loss. Methods: This study used cluster stratified random sample of 3271 urban participants recruited between 1992 and 1994 for the Melbourne Visual Impairment Project. All predictors and outcomes were from the 5 year follow up examinations conducted in 1997–9. Results: There were 2530 participants who attended the follow up survey and had measurement of presenting visual acuity. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the telephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away from home (OR = 2.86, 95% CI 1.16 to 7.08), getting help with chores (OR = 3.09, 95% CI 1.40 to 6.83), and becoming dependent (getting help with meals and chores) (OR = 7.50, 95% CI 1.97 to 28.6). Non-correctable bilateral visual loss was associated with many activities of daily living except falling. Conclusions: Non-correctable unilateral vision loss was associated with issues of safety and independent living while non-correctable bilateral vision loss was associated with nursing home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and attended to.
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    Assessment of optic disc cupping with digital fundus photographs
    Constantinou, M. ; Ferraro, J. G. ; Lamoureux, E. L. ; Taylor, H. R. (Elsevier, 2005)
    PURPOSE: To determine the agreement between the assessment of retinal digital images by using an overlay transparency sheet and the Heidelberg retinal tomograph (HRT) in determining cup-disk ratios greater than 0.6. DESIGN: Diagnostic test comparison. METHODS: Computerized topographic and monoscopic digital images of the optic disk of 628 people aged 70 to 79 years were assessed. A grader (M.C.) defined the disk margin on HRT images, and the operation software computed the area cup-disk ratio. The same grader also determined whether the vertical cup-disk ratio on retinal images was greater than 0.6 by superimposing a transparency overlay sheet over the images. Findings of a second grader (J.G.F.) were used to establish reliability measures. RESULTS:The intragrader reliability for the overlay method and HRT was almost perfect (intraclass correlation coefficient [ICC] = 0.96 and 0.99, respectively), whereas the intergrader reliability was good (ICC = 0.77 and 0.92, respectively). A perfect agreement was found on 28 (85%) of 33 eyes between the overlay and HRT methods in determining cup-disk ratios greater than 0.6. CONCLUSIONS: The overlay transparency method appears to be a reliable and promising alternative in determining cup-disk ratios greater than 0.6 in a community screening setting.
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    Retinopathy in persons with impaired glucose metabolism : The Australian Diabetes Obesity and Lifestyle (AusDiab) Study
    Wong, T. ; Barr, E. ; Tapp, R. ; Harper, C. A. ; Taylor, H. R. ; Zimmet, P. ; Shaw, J. (Elsevier, 2005)
    PURPOSE: To describe risk factors and vascular disease associations of retinopathy in people with impaired glucose metabolism. DESIGN: Population-based cross-sectional study. METHODS: Retinal photographs taken of participants with impaired glucose tolerance and impaired fasting glucose were graded for retinopathy. Risk factors and cardiovascular outcomes were ascertained. RESULTS: Retinopathy was present in 69 (6.7%) of 1027 participants with impaired glucose tolerance or impaired fasting glucose. After multivariate adjustment, retinopathy was associated with prevalent stroke (odds ratio 4.2, 95% confidence interval, 1.8 to 9.7). CONCLUSIONS: Retinopathy is common in persons with impaired glucose metabolism and may be associated with prevalent stroke.