Publications by authors named "David Keegan"

Purpose: Diabetic retinopathy (DR) is a preventable cause of blindness detectable through screening using retinal digital photography. The Irish National Diabetic Retina Screening (DRS) programme, Diabetic RetinaScreen, provides free screening services to patients with diabetes from aged 12 years and older. A technical failure (TF) occurs when digital retinal imaging is ungradable, resulting in delays in the diagnosis and treatment of sight-threatening disease.

View Article and Find Full Text PDF

(1) Background: Inherited retinal degenertions are rare conditions which may have a dramatic impact on the daily life of those affected and how they interact with their environment. Coordination of clinical services via an ophthalmic genetics multidisciplinary team (OG-MDT) allows better efficiency of time and resources to reach diagnoses and facilitate patient needs. (2) Methods: This clinical case series was conducted by a retrospective review of patient records for patients enrolled in the Target 5000 programme and managed by the OG-MDT, at the Mater Hospital Dublin, Ireland ( = 865) (3) Results: Herein we describe clinical cases and how the use of the OG-MDT optimizes care for isolated and syndromic IRD pedigrees.

View Article and Find Full Text PDF

Purpose: Visual function is a complex process in which external visual stimuli are interpreted. Patients with retinal diseases and prolonged follow-up times may experience changes in their visual function that are not detected by the standard visual acuity measure, as they are a result of other alterations in visual function. With the advancement of different methods to evaluate visual function, additional measurements have become available, and further standardization suggests that some methods may be promising for use in clinical trials or routine clinical practice.

View Article and Find Full Text PDF
Article Synopsis
  • Usher syndrome (USH) is a genetic condition causing deaf-blindness, characterized by retinal degeneration, hearing loss, and balance issues, and affects a significant portion of the Irish population.
  • In a study of 145 Irish USH patients, the majority were classified as USH2, with a genetic diagnosis achieved in over 82% of cases, primarily linked to mutations in MYO7A or USH2A genes.
  • The findings suggest that understanding the genetic diversity of USH in Ireland could improve clinical management and access to treatments for affected individuals and their families.
View Article and Find Full Text PDF
Article Synopsis
  • - Over 15% of patients with inherited retinal degeneration have been diagnosed with Stargardt disease (STGD1), a genetic disorder linked to mutations in the ABCA4 gene, which can be identified through various genetic testing methods.
  • - A specific pathogenic variant, ABCA4 c.4539 + 2028C > T, was found in 25 individuals from an Irish STGD1 cohort and is significant for its role in a pseudoexon inclusion that affects retinal function.
  • - The study highlights the importance of identifying genetic variants within populations, particularly founder variants, as they can aid in diagnosing STGD1 and understanding the condition's severity, showing potential relevance for many individuals of Irish descent worldwide.
View Article and Find Full Text PDF

Background: There is an urgent need to improve structural competency and anti-racism education across health systems. Many leaders in health systems have the ability and responsibility to play a significant role in policy change and transforming healthcare delivery to address health inequities and injustices. The aim of this project was to evaluate a new health leadership Indigenous health course: PLUS4I.

View Article and Find Full Text PDF

Background: The Age-Related Eye Disease Study 2 (AREDS 2) proved the benefit of vitamin and mineral supplementation in preventing advanced age-related macular degeneration (AMD). AREDS 2 supplements are indicated for patients with either bilateral intermediate AMD (AREDS category 3) or unilateral neovascular AMD (AREDS category 4).

Aims: The aims of this telephone survey were to identify the rate of adherence of patients to AREDS 2 supplements and the factors associated with non-compliance in these patient groups.

View Article and Find Full Text PDF

Background: Patient non-attendance following referral to hospital is a significant challenge, in particular, for persons with diabetes.

Aim: We sought to determine the impact on both visual acuity and the subsequent follow-up retinopathy grade of patients when they fail to attend Diabetic Retinopathy Treatment (DRT) Centers following referral from Diabetic RetinaScreen (DRS).

Methods: A retrospective analysis of patients discharged from DRT due to multiple consecutive missed appointments between January 2016 and June 2021.

View Article and Find Full Text PDF

Introduction: The vast majority of the 100 million forcibly displaced persons worldwide live in a state of prolonged uncertainty with limited resettlement prospects and access to resources. Little is known, however, regarding how refugees and asylum-seekers cope with this uncertainty.

Methods: In this study, we investigated the longitudinal association between a measure of how people cope with uncertainty (intolerance of uncertainty (IU)), fears for the future, posttraumatic stress disorder (PTSD) symptoms and depression symptoms.

View Article and Find Full Text PDF

Refugees and asylum seekers in contexts of sustained displacement represent particularly vulnerable communities during the COVID-19 pandemic. The aim of this study was to identify profiles of COVID-19 stressors in refugees in a transit context (i.e.

View Article and Find Full Text PDF

The conjunction of nanophthalmos (NO) and retinitis pigmentosa (RP) provides challenges to effective clinical management while narrowing the genetic spectrum for targeted molecular diagnostics. This case study describes two not knowingly related adult cases of -associated retinopathy and nanophthalmos (MARN). Structural features including short axial lengths (mean 16.

View Article and Find Full Text PDF

Purpose: The purpose of the study was to assess the association of macular atrophy (MA) according to the activity of macular neovascularization (MNV) (inactive, only subretinal fluid [SRFL], or active, i.e. including intraretinal fluid [IRFL]) using optical coherence tomography (OCT) in patients with neovascular age-related macular degeneration (nAMD).

View Article and Find Full Text PDF

Age-related macular degeneration (AMD) is a progressive, degenerative disease of the retina which ultimately results in the irreversible loss of central vision. AMD is one of the foremost causes of blindness in people over the age of 50. Although the precise pathogenesis of AMD has not yet been elucidated, AMD results from a complex interaction between genetic predisposition and environmental provoking factors.

View Article and Find Full Text PDF

There is currently an unprecedented number of forcibly displaced people worldwide. Little is known, however, about how external stressors and internal coping strategies intersect to influence mental health in displaced refugees, particularly whether specific types of coping strategies are more or less effective across different levels of external stress. This study aimed to understand whether positive and negative internal coping strategies were differentially associated with mental health across high and low levels of external stressors in displaced refugees.

View Article and Find Full Text PDF

Aims: Refugees typically spend years in a state of protracted displacement prior to permanent resettlement. Little is known about how various prior displacement contexts influence long-term mental health in resettled refugees. In this study, we aimed to determine whether having lived in refugee camps community settings prior to resettlement impacted the course of refugees' psychological distress over the 4 years following arrival in Australia.

View Article and Find Full Text PDF

Inherited retinal degenerations (IRDs) account for over one third of the underlying causes of blindness in the paediatric population. Patients with IRDs often experience long delays prior to reaching a definitive diagnosis. Children attending a tertiary care paediatric ophthalmology department with phenotypic (i.

View Article and Find Full Text PDF

Usher syndrome (USH) is an autosomal recessively inherited disease characterized by sensorineural hearing loss (SNHL) and retinitis pigmentosa (RP) with or without vestibular dysfunction. It is highly heterogeneous both clinically and genetically. Recently, variants in the arylsulfatase G (ARSG) gene have been reported to underlie USH type IV.

View Article and Find Full Text PDF

Although rare, inherited retinal degenerations (IRDs) are the most common reason for blind registration in the working age population. They are highly genetically heterogeneous (>300 known genetic loci), and confirmation of a molecular diagnosis is a prerequisite for many therapeutic clinical trials and approved treatments. First-tier genetic testing of IRDs with panel-based next-generation sequencing (pNGS) has a diagnostic yield of ≈70-80%, leaving the remaining more challenging cases to be resolved by second-tier testing methods.

View Article and Find Full Text PDF

This study explored the expression of several miRNAs reported to be deregulated in age-related macular degeneration (AMD). Total RNA was isolated from sera from patients with dry AMD ( = 12), wet AMD ( = 14), and controls ( = 10). Forty-two previously investigated miRNAs were selected based on published data and their role in AMD pathogenesis, such as angiogenic and inflammatory effects, and were co-analysed using a miRCURY LNA miRNA SYBR Green PCR kit via quantitative real-time polymerase chain reaction (qRT-PCR) to validate their presence.

View Article and Find Full Text PDF
Article Synopsis
  • The paper looks at how two frameworks, CanMEDS for doctors and LEADS for leadership, work together to help doctors become better leaders throughout their careers.
  • The authors used interviews and discussions to explore similarities and differences between the frameworks and how they can guide doctor training and practice.
  • They found that both frameworks actually support each other, focusing on caring, shared leadership, and preparing doctors for changes in healthcare.
View Article and Find Full Text PDF

Background: Combined rhegmatogenous retinal and choroidal detachment (CRRCD) is a rare phenomenon. It is important that CRRCD is recognised preoperatively so that corticosteroids may be administered as this may make repair surgery easier to do.

Aims: We here report on the anatomical and visual outcomes of 3 patients treated for CRRCD.

View Article and Find Full Text PDF

Objective: To assess the patterns of patient generated aerosol in the context of ophthalmic surgery and ophthalmic examinations. To inform medical teams regarding potential hazards and suggest mitigating measures.

Methods: Qualitatively, real-time time videography assessed exhalation patterns from simulated patients under different clinical scenarios using propylene glycol from an e-cigarette.

View Article and Find Full Text PDF