Ophthalmology (Eye & Ear Hospital) - Research Publications

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    Detection of available chairs with second generation suprachoroidal retinal prosthesis
    Moussallem, L ; Kolic, M ; Baglin, E ; Petoe, M ; Abbott1, C ; Lombardi, L ; Stefopoulos, S ; Battiwalla, X ; Walker, J ; Barnes, N ; Allen, P (Wiley, 2022)
    Purpose: Retinal prosthesis recipients have indicated that identification of chairs is a useful tool in the real-world environment. Current device software allows object localisation but does not specifically identify chairs. The aim was to compare accuracy in chair detection using a novel chair-specific vision processing method (ChD) to the current comprehensive vision processing method (Lanczos2; L2) in recipients of the second-generation (44-channel) suprachoroidal retinal prosthesis Method: Four implant recipients (#NCT05158049) with profound vision loss due to retinitis pigmentosa were acclimatised to both vision processing methods. Two mannequins (dressed in white or black) were seated face forward in two of three chairs (right, middle, left) in a square room (4 × 4m) with a white curtain backdrop. Participants (36 trials each, randomised) were asked to detect and navigate to the available chair (white or black) and navigation time was recorded. Results: The ChD vision processing method (87.5 ± 14.6% correct) performed significantly better than L2 vision processing method (19.4 ± 13.2%) for detecting available chairs (p = 0.020, Kruskal-Wallis). Furthermore, ChD performed better than L2 regardless of whether black (p = 0.019) or white (p = 0.015) chairs were used against the white backdrop. There was no difference in time taken to navigate to the available chair (L2 51.6 ± 25.1 s, ChD 48.4 ± 28.7 s; p = 0.564). Conclusion: The ChD processing method performs better than the L2 processing method for the purpose of specifically detecting chairs. Hence, there is potential for ChD to be incorporated into the bionic eye vision processing system to aid real-world navigation.
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    The Association between Serum Lipids and Intraocular Pressure in 2 Large United Kingdom Cohorts.
    Madjedi, KM ; Stuart, KV ; Chua, SYL ; Luben, RN ; Warwick, A ; Pasquale, LR ; Kang, JH ; Wiggs, JL ; Lentjes, MAH ; Aschard, H ; Sattar, N ; Foster, PJ ; Khawaja, AP ; Modifiable Risk Factors for Glaucoma Collaboration and the UK Biobank Eye and Vision Consortium, (Elsevier BV, 2022-09)
    PURPOSE: Serum lipids are modifiable, routinely collected blood test features associated with cardiovascular health. We examined the association of commonly collected serum lipid measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) with intraocular pressure (IOP). DESIGN: Cross-sectional study in the UK Biobank and European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohorts. PARTICIPANTS: We included 94 323 participants from the UK Biobank (mean age, 57 years) and 6230 participants from the EPIC-Norfolk (mean age, 68 years) cohorts with data on TC, HDL-C, LDL-C, and triglycerides collected between 2006 and 2009. METHODS: Multivariate linear regression adjusting for demographic, lifestyle, anthropometric, medical, and ophthalmic covariables was used to examine the associations of serum lipids with corneal-compensated IOP (IOPcc). MAIN OUTCOME MEASURES: Corneal-compensated IOP. RESULTS: Higher levels of TC, HDL-C, and LDL-C were associated independently with higher IOPcc in both cohorts after adjustment for key demographic, medical, and lifestyle factors. For each 1-standard deviation increase in TC, HDL-C, and LDL-C, IOPcc was higher by 0.09 mmHg (95% confidence interval [CI], 0.06-0.11 mmHg; P < 0.001), 0.11 mmHg (95% CI, 0.08-0.13 mmHg; P < 0.001), and 0.07 mmHg (95% CI, 0.05-0.09 mmHg; P < 0.001), respectively, in the UK Biobank cohort. In the EPIC-Norfolk cohort, each 1-standard deviation increase in TC, HDL-C, and LDL-C was associated with a higher IOPcc by 0.19 mmHg (95% CI, 0.07-0.31 mmHg; P = 0.001), 0.14 mmHg (95% CI, 0.03-0.25 mmHg; P = 0.016), and 0.17 mmHg (95% CI, 0.06-0.29 mmHg; P = 0.003). An inverse association between triglyceride levels and IOP in the UK Biobank (-0.05 mmHg; 95% CI, -0.08 to -0.03; P < 0.001) was not replicated in the EPIC-Norfolk cohort (P = 0.30). CONCLUSIONS: Our findings suggest that serum TC, HDL-C, and LDL-C are associated positively with IOP in 2 United Kingdom cohorts and that triglyceride levels may be associated negatively. Future research is required to assess whether these associations are causal in nature.
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    The Circulating Level of IL-1β in Patients with Age-related Macular Degeneration (AMD) in Yogyakarta: Characteristics to Disease Activity
    Supanji, ; Perdamaian, ABI ; Dianratri, A ; Prayogo, ME ; Sasongko, MB ; Wardhana, FS ; Widayanti, TW ; Agni, AN ; Oka, C (Atlantis Press, 2021-01-01)
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    Association Between Polygenic Risk Score and Risk of Myopia
    Mojarrad, NG ; Plotnikov, D ; Williams, C ; Guggenheim, JA ; Aslam, T ; Barman, SA ; Barrett, JH ; Bishop, P ; Blows, P ; Bunce, C ; Carare, RO ; Chakravarthy, U ; Chan, M ; Chua, SYL ; Crabb, DP ; Cumberland, PM ; Day, A ; Desai, P ; Dhillon, B ; Dick, AD ; Egan, C ; Ennis, S ; Foster, P ; Fruttiger, M ; Gallacher, JEJ ; Garway-Heath, DF ; Gibson, J ; Gore, D ; Guggenheim, JA ; Hammond, CJ ; Hardcastle, A ; Harding, SP ; Hogg, RE ; Hysi, P ; Keane, PA ; Khaw, SPT ; Khawaja, AP ; Lascaratos, G ; Lotery, AJ ; Macgillivray, T ; Mackie, S ; Martin, K ; McGaughey, M ; McGuinness, B ; Mckay, GJ ; McKibbin, M ; Mitry, D ; Moore, T ; Morgan, JE ; Muthy, ZA ; O'Sullivan, E ; Owen, CG ; Patel, P ; Paterson, E ; Peto, T ; Petzold, A ; Rahi, JS ; Rudnikca, AR ; Self, J ; Sivaprasad, S ; Steel, D ; Stratton, I ; Strouthidis, N ; Sudlow, C ; Thomas, D ; Trucco, E ; Tufail, A ; Vitart, V ; Vernon, SA ; Viswanathan, AC ; Williams, C ; Williams, K ; Woodside, JV ; Yates, MM ; Yip, J ; Zheng, Y (AMER MEDICAL ASSOC, 2020-01)
    IMPORTANCE: Myopia is a leading cause of untreatable visual impairment and is increasing in prevalence worldwide. Interventions for slowing childhood myopia progression have shown success in randomized clinical trials; hence, there is a need to identify which children would benefit most from treatment intervention. OBJECTIVES: To examine whether genetic information alone can identify children at risk of myopia development and whether including a child's genetic predisposition to educational attainment is associated with improved genetic prediction of the risk of myopia. DESIGN, SETTING, AND PARTICIPANTS: Meta-analysis of 3 genome-wide association studies (GWAS) including a total of 711 984 individuals. These were a published GWAS for educational attainment and 2 GWAS for refractive error in the UK Biobank, which is a multisite cohort study that recruited participants between January 2006 and October 2010. A polygenic risk score was applied in a population-based validation sample examined between September 1998 and September 2000 (Avon Longitudinal Study of Parents and Children [ALSPAC] mothers). Data analysis was performed from February 2018 to May 2019. MAIN OUTCOMES AND MEASURES: The primary outcome was the area under the receiver operating characteristic curve (AUROC) in analyses for predicting myopia, using noncycloplegic autorefraction measurements for myopia severity levels of less than or equal to -0.75 diopter (D) (any), less than or equal to -3.00 D (moderate), or less than or equal to -5.00 D (high). The predictor variable was a polygenic risk score (PRS) derived from genome-wide association study data for refractive error (n = 95 619), age of onset of spectacle wear (n = 287 448), and educational attainment (n = 328 917). RESULTS: A total of 383 067 adults aged 40 to 69 years from the UK Biobank were included in the new GWAS analyses. The PRS was evaluated in 1516 adults aged 24 to 51 years from the ALSPAC mothers cohort. The PRS had an AUROC of 0.67 (95% CI, 0.65-0.70) for myopia, 0.75 (95% CI, 0.70-0.79) for moderate myopia, and 0.73 (95% CI, 0.66-0.80) for high myopia. Inclusion in the PRS of information associated with genetic predisposition to educational attainment marginally improved the AUROC for myopia (AUROC, 0.674 vs 0.668; P = .02), but not those for moderate and high myopia. Individuals with a PRS in the top 10% were at 6.1-fold higher risk (95% CI, 3.4-10.9) of high myopia. CONCLUSIONS AND RELEVANCE: A personalized medicine approach may be feasible for detecting very young children at risk of myopia. However, accuracy must improve further to merit uptake in clinical practice; currently, cycloplegic autorefraction remains a better indicator of myopia risk (AUROC, 0.87).
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    Protecting retinal ganglion cells
    Khatib, TZ ; Martin, KR (NATURE PUBLISHING GROUP, 2017-02)
    Retinal ganglion cell degeneration underlies several conditions which give rise to significant visual compromise, including glaucoma, hereditary optic neuropathies, ischaemic optic neuropathies, and demyelinating disease. In this review, we discuss the emerging strategies for neuroprotection specifically in the context of glaucoma, including pharmacological neuroprotection, mesenchymal stem cells, and gene therapy approaches. We highlight potential pitfalls that need to be considered when developing these strategies and outline future directions, including the prospects for clinical trials.