Publications by authors named "Lauren Ayton"

Purpose: To design and build a new disease registry to track the natural history and outcomes of approved gene therapy in patients with inherited retinal diseases (IRDs).

Methods: A core committee of 6 members was convened to oversee the construction of the FIRB! module. A further 11 experts formed a steering committee, which discussed disease classification and variables to form minimum datasets via a consensus approach.

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  • The study aims to evaluate how functional and structural assessments can serve as endpoints in clinical trials for retinal degeneration linked to USH2A mutations.
  • Participants with specific visual capabilities underwent various eye tests over four years, focusing on understanding changes in their vision.
  • Findings indicated that certain tests were more sensitive to detecting changes, influencing the design of future clinical trials related to this condition.
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  • The paper looks at how inherited retinal diseases (IRD) are diagnosed and treated in the Asia-Pacific region.
  • They surveyed 36 centers about their practices, including how they collect patient information and provide help for low vision.
  • The results showed there are important gaps, like many centers not having a database for patients, not enough genetic counselors, and a need for better support for low-vision rehabilitation.
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Purpose: To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years.

Design: Prospective, single-arm, unmasked interventional clinical trial.

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X-linked genetic disorders typically affect females less severely than males owing to the presence of a second X Chromosome not carrying the deleterious variant. However, the phenotypic expression in females is highly variable, which may be explained by an allelic skew in X-Chromosome inactivation. Accurate measurement of X inactivation skew is crucial to understand and predict disease phenotype in carrier females, with prediction especially relevant for degenerative conditions.

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Background/aims: Female choroideremia carriers present with a spectrum of disease severity. Unlike in men, the rate of disease progression has not been well characterised in carriers. This longitudinal study aimed to determine the rate of retinal degeneration in choroideremia carriers, using multimodal imaging and microperimetry.

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Most support programmes for Autistic children are available only after they are diagnosed. Research suggests that parenting supports may be helpful for parents and their infants, when provided in the first 2 years of life - before a formal diagnosis is given, but when information suggests an infant is more likely to be Autistic. However, we do not know how acceptable these types of supports might be to the Autistic and autism communities.

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  • Female carriers of X-linked inherited retinal diseases (IRDs) show different symptoms and how they progress can vary a lot.
  • The study looked at how the blood vessels in the eyes of these carriers react under certain conditions compared to healthy women.
  • Results showed that the expected changes in blood vessel responses during tests were not present in the IRD carriers, which might help doctors understand their condition better.
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Significance: This study has shown a vibrotactile sensory substitution device (SSD) prototype, VibroSight, has the potential to improve functional outcomes (i.e., obstacle avoidance, face detection) for people with profound vision loss, even with brief familiarization (<20 minutes).

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Purpose: To describe visual function and retinal features of female carriers of choroideremia (CHM), using multimodal imaging and microperimetry.

Design: Cross-sectional cohort study.

Participants And Controls: Choroideremia carriers seen in Australia (Melbourne or Perth) or the United Kingdom (Oxford or Cambridge) between 2012 and 2023.

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  • The study investigated post-saccadic oscillations (PSOs) in individuals with age-related macular degeneration (AMD), retinitis pigmentosa (RP), and those with normal vision to understand differences in eye movement stability.
  • Participants' gaze was measured during a horizontal saccade task, and PSO characteristics like amplitude, decay time, and frequency were analyzed using a damped oscillation model.
  • Results showed that those with vision loss exhibited larger oscillation amplitudes and longer decay times compared to normal vision participants, indicating that abnormal PSOs contribute to reduced fixation stability in AMD and RP.
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Purpose: To describe the clinical, electrophysiological and genetic spectrum of inherited retinal diseases associated with variants in the PRPH2 gene.

Methods: A total of 241 patients from 168 families across 15 sites in 9 countries with pathogenic or likely pathogenic variants in PRPH2 were included. Records were reviewed for age at symptom onset, visual acuity, full-field ERG, fundus colour photography, fundus autofluorescence (FAF), and SD-OCT.

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  • Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in older adults, affecting 10-20% of those over 65 in Western countries.
  • AMD causes central vision loss due to the degeneration of critical eye structures and is classified into early, intermediate, and late stages, with late-stage including serious forms like neovascular AMD and geographic atrophy.
  • Treatment options are currently limited, though neovascular AMD is managed with injections; however, a new treatment for geographic atrophy, pegcetacoplan, was recently approved, and there is ongoing research into gene and cell therapies for late-stage AMD.
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Purpose: Stickler Syndromes are multisystem collagenopathies affecting 1 in 7500-9000 individuals and are associated with craniofacial, ocular, auditory, and musculoskeletal complications. Prophylactic retinopexy treatment reduces the risk of retinal detachment, emphasising the need for early detection and multidisciplinary referral. This study evaluated knowledge and awareness of Stickler Syndromes among allied health professionals and their perceived needs for targeted education to improve multidisciplinary care.

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Amidst rapid advancements in ocular gene therapy, understanding patient perspectives is crucial for shaping future treatment choices and research directions. This international cross-sectional survey evaluated knowledge, attitudes, and perceptions of ocular genetic therapies among potential recipients with inherited retinal diseases (IRDs). Survey instruments included the Attitudes to Gene Therapy-Eye (AGT-Eye), EQ-5D-5L, National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and Patient Attitudes to Clinical Trials (PACT-22) instruments.

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This study evaluated patient experiences with genetic testing for inherited retinal diseases (IRDs) and the association between underlying knowledge, testing outcomes, and the perceived value of the results. An online survey was distributed to adults with IRDs and parents/guardians of dependents with IRDs who had had genetic testing. Data included details of genetic testing, pre- and post- test perceptions, Decision Regret Scale, perceived value of results, and knowledge of gene therapy.

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Recent advances have led to therapeutic options becoming available for people with inherited retinal disease. In particular, gene therapy has been shown to hold great promise for slowing vision loss from inherited retinal disease. Recent studies suggest that gene therapy is likely to be most effective when implemented early in the disease process, making consideration of paediatric populations important.

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Purpose: Economic evaluations of interventions for ocular disease require utility scores that accurately represent quality of life in the target population. This study aimed to describe the distribution of EQ-5D-5L utility values among Australian adults with symptomatic inherited retinal diseases (IRDs) and to assess the relationship between these scores and vision-related quality of life.

Methods: A survey was administered predominantly online in 2021.

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The relationship between externally applied force and intraocular pressure was determined using an ex-vivo porcine eye model (N=9). Eyes were indented through the sclera with a convex ophthalmodynamometry head (ODM). Intraocular pressure and ophthalmodynamometric force were simultaneously recorded to establish a calibration curve of this indenter head.

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Female carriers of X-linked inherited retinal diseases (IRDs) are burdened with potentially passing their disease-causing variant to future generations, as well as exhibiting signs of retinal disease themselves. This study aimed to investigate carriers' experiences of genetic testing, emotions relating to having affected children, and their knowledge regarding genetic testing and gene therapy. An online survey was advertised to self-identified carriers worldwide.

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Adaptive optics (AO) imaging enables direct, objective assessments of retinal cells. Applications of AO show great promise in advancing our understanding of the etiology of inherited retinal disease (IRDs) and discovering new imaging biomarkers. This scoping review systematically identifies and summarizes clinical studies evaluating AO imaging in IRDs.

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Purpose: Accurate diagnosis of macular atrophy is paramount to enable appropriate treatment when novel treatments for geographic atrophy and macular dystrophies become available. Genetic testing is useful in distinguishing between the two conditions but is not feasible for the majority of patients in real-world clinical practice. Therefore, we aimed to investigate the potential misdiagnosis of inherited macular dystrophy as age-related macular degeneration (AMD) in real-world ophthalmic practice to assist in the development of guidelines to improve diagnostic accuracy while minimizing genetic testing for targeted patients.

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Article Synopsis
  • A survey was conducted among 516 optometrists in Australia and New Zealand to assess their knowledge and attitudes towards genetic testing and gene therapy for retinal diseases.
  • Key barriers identified to accessing genetic testing included unclear referral pathways (81%), costs (65%), and lack of treatment options (50%).
  • Although optometrists showed a strong interest in ocular genetics, significant knowledge gaps were identified, highlighting the need for better education and communication within the eye care community.
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