Publications by authors named "Diana V Do"
Purpose: Identify baseline systemic and ocular characteristics associated with nonproliferative diabetic retinopathy (NPDR) worsening, and the impact of intravitreal aflibercept injection (IAI) on these associations.
Design: Post hoc analysis of PANORAMA.
Participants: Patients with moderately severe to severe NPDR enrolled in the prospective PANORAMA phase 3 trial.
We wrote the letter in response to the insightful comments made by Dr. Vassallo J regarding our recently published study, “Association of Oral Montelukast with Reduced Odds of Developing Exudative Age-Related Macular Degeneration.” Our study underscored the potential treatment for AMD through managing mast cell activation.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to determine if ultra-wide-field fluorescein angiography (UWFFA) at the initial visit impacts the evaluation of disease activity and management in patients at a uveitis clinic.
- A total of 158 patient visits were analyzed, with assessments made using clinical exams, UWFFP, SD-OCT, and UWFFA, comparing evaluations with and without UWFFA.
- Results showed that UWFFA led to a significant increase in identifying active disease and resulted in management changes for over a quarter of the eyes evaluated, highlighting its importance in uveitis assessment.
Article Synopsis
- - The study aimed to analyze risk factors for developing anti-adalimumab antibodies (AAA) in patients with non-infectious uveitis undergoing treatment with adalimumab, using a retrospective case-control method.
- - Out of 31 patients, those who tested positive for AAA had significant differences compared to those who tested negative, particularly concerning gender, systemic disease presence, and baseline inflammation. Notably, interruptions in anti-TNF therapy and disease flare-ups during treatment increased the likelihood of developing AAA.
- - Conversely, patients receiving weekly doses of adalimumab showed a lower risk of developing AAA, indicating that treatment frequency could play a role in patient management for those at higher risk.
Article Synopsis
- * Data from two clinical trials (HARBOR and READ-3) indicated that higher IL-6 concentrations in aqueous humour were associated with poorer visual outcomes over time.
- * The findings suggest that elevated IL-6 levels could be a predictor of suboptimal responses to anti-VEGF monotherapy in patients suffering from nAMD or DMO.
Article Synopsis
- The introduction of biologic medicines that target VEGF has greatly enhanced treatment outcomes for patients with retinal diseases, but their high costs can limit access to care.
- Biosimilars, which are cheaper alternatives that are proven to be clinically equivalent to branded agents, offer a potential solution to financial barriers in treatment.
- Since 2022, anti-VEGF biosimilars have begun to emerge in the US ophthalmology market, prompting a review of their regulatory background, development challenges, and the implications for patient care.
Article Synopsis
- Ocular inflammatory diseases like scleritis and uveitis are treated with immunomodulatory therapies (IMTs) to reduce reliance on steroids, using both conventional and biologic agents, including cyclophosphamide (CP), an effective but potentially harmful treatment option.
- A study reviewed the medical records of 1295 patients at Stanford’s Uveitis Clinic from 2017 to 2022, focusing on 7 patients who received CP therapy for severe ocular inflammatory diseases that didn’t respond to other IMTs.
- The average age of these patients was 61.6 years, with various underlying conditions, and after a mean follow-up of 34.4 months on CP therapy,
Background: A high-dose formulation of intravitreal aflibercept (8 mg) could improve treatment outcomes in diabetic macular oedema (DMO) by requiring fewer injections than the standard comparator, aflibercept 2 mg. We report efficacy and safety results of aflibercept 8 mg versus 2 mg in patients with DMO.
Methods: PHOTON was a randomised, double-masked, non-inferiority, phase 2/3 trial performed at 138 hospitals and specialty retina clinics in seven countries.
Article Synopsis
- The review updates the role of corticosteroids and immunomodulatory therapy (IMT) in treating infectious uveitis, focusing on managing inflammation rather than the infection itself.
- Corticosteroids are mainly used alongside other treatments for infectious uveitis, especially in cases where inflammation worsens or doesn't resolve after initial treatment.
- The review highlights a lack of consensus on IMT's effectiveness in infectious uveitis, pointing out its occasional use in persistent cases, while providing options for clinicians managing these complex conditions.
Purpose: We examine the rate of and reasons for follow-up in an Artificial Intelligence (AI)-based workflow for diabetic retinopathy (DR) screening relative to two human-based workflows.
Patients And Methods: A DR screening program initiated September 2019 between one institution and its affiliated primary care and endocrinology clinics screened 2243 adult patients with type 1 or 2 diabetes without a diagnosis of DR in the previous year in the San Francisco Bay Area. For patients who screened positive for more-than-mild-DR (MTMDR), rates of follow-up were calculated under a store-and-forward human-based DR workflow ("Human Workflow"), an AI-based workflow involving IDx-DR ("AI Workflow"), and a two-step hybrid workflow ("AI-Human Hybrid Workflow").
Article Synopsis
- A study was conducted to examine changes over time in patients with non-paraneoplastic autoimmune retinopathy (npAIR) using various diagnostic methods.
- The research involved a retrospective review of 16 eyes from 8 patients, assessing structural and functional changes through tests like wide-angle fundus photography, optical coherence tomography, and electrophysiological assessments over a median follow-up of 11.5 months.
- Findings indicated that multimodal testing was effective in detecting both structural and functional decline in patients, with adaptive optics scanning laser ophthalmoscopy showing superior sensitivity in monitoring retinal microstructure changes.
Objective: Detection of diabetic retinopathy (DR) outside of specialized eye care settings is an important means of access to vision-preserving health maintenance. Remote interpretation of fundus photographs acquired in a primary care or other nonophthalmic setting in a store-and-forward manner is a predominant paradigm of teleophthalmology screening programs. Artificial intelligence (AI)-based image interpretation offers an alternative means of DR detection.
View Article and Find Full Text PDFWell-known risk factors for anterior segment ischemia (ASI) following strabismus surgery include ipsilateral surgery on three or more rectus muscles, older age, and vasculopathy. ASI is rarely reported in young patients following uneventful strabismus surgery on two ipsilateral rectus muscles. We report a 30-year-old transgender female on long-term estrogen therapy who underwent strabismus surgery involving recessions of both lateral rectus muscles, the right inferior rectus muscle, and the left superior rectus muscle.
View Article and Find Full Text PDFPurpose: This study was conducted to evaluate the association of oral montelukast, selective antagonism for cysteinyl leukotriene receptor 1, with reduced odds of exudative age-related macular degeneration (exAMD) development.
Methods: This case-control study was conducted using institutional cohort finder tool, and included 1913 patients with exAMD (ICD: H35.32 and 362.
Purpose: This work aimed to assess the incidence of proliferative diabetic retinopathy (PDR) events and improvement to mild non-PDR (NPDR) or better after intravitreal aflibercept injection (IAI) or laser treatment (control) in diabetic macular edema (DME).
Methods: PDR events in the VISTA (NCT01363440) and VIVID (NCT01331681) phase 3 clinical trials were evaluated in a combined IAI-treated group (IAI 2 mg every 4 weeks or 2 mg every 8 weeks after 5 initial monthly doses; n = 475) and a macular laser control group (n = 235) through week 100 in eyes without PDR at baseline (Diabetic Retinopathy Severity Scale [DRSS] score ≤ 53). Improvement in the DRSS score to 35 or better was evaluated in those with a baseline DRSS score of 43 or greater.
Background: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Concurrent blood pressure control has been advocated for this purpose, but individual studies have reported varying conclusions regarding the effects of this intervention.
View Article and Find Full Text PDFIntroduction: Following a review of patient-reported outcome (PRO) instruments in the literature, existing PRO instruments may not adequately capture the experience of receiving treatment for proliferative diabetic retinopathy (PDR). Therefore, this study aimed to develop a de novo instrument to comprehensively assess the patient experience of PDR.
Methods: This qualitative, mixed-methods study comprised item generation for the Diabetic Retinopathy-Patient Experience Questionnaire (DR-PEQ), content validation in patients with PDR, and preliminary Rasch measurement theory (RMT) analyses.
Purpose: To present a case of birdshot chorioretinopathy (BCR) in a Chinese patient with HLA-A29 positivity.
Observations: A 45-year-old Chinese female presented at a tertiary Ophthalmology Clinic with complaints of frequent headaches as well as blurred vision, photophobia, and pressure in the left eye (OS). The patient had a significant ocular history of left orbital cavernous hemangioma status post lateral orbitotomy and resection.
Retinitis pigmentosa (RP) is an inherited bilateral retinal degenerative disease with an incidence of 1 in 4000 people. RP affects more than 1 million individuals worldwide. Although night blindness and restricted visual field are the most typical symptoms of these individuals, generalized vision loss due to cataracts can be expected in the latter stages of the disease.
View Article and Find Full Text PDFPurpose: To determine the outcomes of intravenous (IV) tocilizumab (TCZ) in patients with non-infectious uveitis who failed with conventional immunomodulatory and anti-TNFα therapies.
Methods: Records of seven patients with non-infectious uveitis treated with monthly IV TCZ (4-10 mg/kg) or biweekly IV TCZ (8 mg/kg) were reviewed. Outcome measures were changes in visual acuity, anterior chamber cell and flare grade, vitreous haze, central subfield thickness (CST), and fluorescein angiography (FA) score.
Introduction: Few qualitative studies have explored the patient experience of daily life with proliferative diabetic retinopathy (PDR) and associated treatments. Herein, a conceptual model was developed to comprehensively examine symptoms, functional impacts, and treatment experiences in PDR.
Methods: A qualitative, mixed-methods study comprising a literature search and semi-structured interviews with clinicians and patients was conducted.
Wide-Field Swept-Source Optical Coherence Tomography of Optic Disc Pit Maculopathy Demonstrates Connection Between Vitreous and Subretinal Fluid.
Ophthalmic Surg Lasers Imaging Retina
October 2022
The source of subretinal or intraretinal fluid in patients with optic disc pit maculopathy (ODP-M) remains unclear and is often thought to be either vitreous or cerebrospinal fluid.1 Here, we present the case of a 40-year-old man who developed ODP-M. Further imaging with wide-field swept-source optical coherence tomography demonstrated that the macular fluid was tracking from a nasal optic disc pit with superonasal communication to the vitreous.
View Article and Find Full Text PDFPurpose: To evaluate the correlation between longitudinal changes in aqueous flare measured by laser flare photometer (LFP), best-corrected visual acuity (BCVA), and clinical grade using both Standardization of Uveitis Nomenclature (SUN) and modified SUN (MSUN) scales uveitis patients.
Methods: Patients were classified according to both SUN and MSUN grading scales. LFP measurements were acquired (Kowa FM-700) at each visit.