Shared Care for Patients with Diabetes at Risk of Retinopathy: A Feasibility Trial.

Purpose: While diabetes is a chronic disease, in many health care systems patients with diabetes at risk of diabetic retinopathy (DR) are managed in hospital settings. Aim of this feasibility study is to assess the quality of care and economic benefits of a shared care model managing patients at risk of DR in a primary eye care clinic (PEC) compared with a current tertiary specialist outpatient clinic (SOC).

Methods: A randomized trial was performed, to compare a PEC with a SOC in Singapore.

Effectiveness of the "living successfully with low vision" self-management program: Results from a randomized controlled trial in Singaporeans with low vision.

Objective: To determine the effectiveness of the "Living Successfully with Low Vision" (LSLV) self-management program to improve patient-reported outcomes in Singaporeans.

Methods: In this randomized controlled trial, 165 participants with low vision (LV) were recruited and assigned to usual care (LV aid training only; N = 82) or LSLV program (N = 83). The LSLV program focuses on problem solving, coping mechanism and anticipation/preparation for future needs.

Retinal ganglion cell neuronal damage in diabetes and diabetic retinopathy.

Background: To examine the association of diabetes and diabetic retinopathy (DR) with retinal ganglion cell (RGC) loss.

Design: Observational case-control study.

Participants: Type 2 diabetes cases and age-gender matched controls without diabetes.

Differential Association of Generalized and Abdominal Obesity With Diabetic Retinopathy in Asian Patients With Type 2 Diabetes.

Importance: The association between obesity and diabetic retinopathy (DR) is equivocal, possibly owing to the strong interrelation between generalized and abdominal obesity leading to a mutually confounding effect. To our knowledge, no study in Asia has investigated the independent associations of these 2 parameters with DR to date.

Objective: To investigate the associations of generalized (defined by body mass index [BMI], calculated as weight in kilograms divided by height in meters squared) and abdominal obesity (assessed by waist to hip ratio [WHR]) with DR in a clinical sample of Asian patients with type 2 diabetes mellitus.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.

Dry Eye-Related Visual Blurring and Irritative Symptoms and Their Association with Depression and Anxiety in Eye Clinic Patients.

Purpose: Dry eye is a common condition known to have many systemic co-morbidities. We aim to report the frequency of depression and anxiety suspects in eye clinic patients and explore the association between dry eye signs and symptoms with depression and anxiety.

Materials And Methods: Adult outpatients were recruited from dry a public tertiary ophthalmology specialist center.

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development.

A randomised controlled trial of a self-management programme for low vision implemented in low vision rehabilitation services.

Objective: To investigate the effectiveness of a low vision self-management programme (LVSMP) in older adults.

Methods: Participants (n=153) were existing clients of a national low vision rehabilitation organisation randomly allocated to usual services (n=60) or usual services plus LVSMP (n=93). The LVSMP was an 8-week group programme facilitated by low vision counsellors.

Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning.

Objective: To examine the impact of glaucoma and visual acuity (VA) and visual field (VF) losses on psychosocial functioning (PF).

Design: Cross-sectional study.

Participants: We compared PF between 192 participants with bilateral glaucoma with VA or VF losses and 40 controls from a tertiary eye hospital clinic in Singapore.

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.

Methods: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART).

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.

Methods: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints.

Ethnic differences in undercorrected refractive error in Asians.

Purpose: To describe the ethnic variations in the prevalence and risk factors for undercorrected refractive error and its impact on vision-specific functioning (VF) in a multiethnic Asian population.

Methods: A total of 3353 Chinese, 3400 Indians, and 3280 Malays in Singapore participated in this population-based cross-sectional study. Distance presenting visual acuity (VA) was measured using a logarithm of the minimum angle of resolution number chart.

Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease.

Background: Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.

Methods: We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD.

Marital status and its relationship with the risk and pattern of visual impairment in a multi-ethnic Asian population.

Background: To examine whether marital status is a significant determinant of visual impairment (VI) in urban multi-ethnic Asian population.

Methods: We conducted a population-based study of Singapore-resident ethnic Malays, Indians and Chinese aged ≥40 years. Ophthalmic examination included the assessment of presenting and best-corrected visual acuity (PVA and BCVA) using standardized procedures.

How much eye care services do Asian populations need? Projection from the Singapore Epidemiology of Eye Disease (SEED) study.

Purpose: We quantified and measured the needs for specific eye care services, including refractive services (RS), annual eye examination services (AES), cataract surgery services (CSS), and low vision services (LVS) in urban adult populations in Asia.

Methods: We conducted three population-based studies of Singapore-resident Chinese, Malays, and Indians aged ≥40 years to measure the proportion of people who needed specific eye care services.

Results: Our data included 3353 Chinese, 3280 Malays, and 3400 Indians (participation rate 73.

Lack of awareness of common eye conditions in the community.

Purpose: Awareness of eye conditions aids health promotion activities and leads to better outcomes. We examined factors influencing the lack of awareness of common eye conditions in a population.

Methods: The Singapore Malay Eye Study examined 3280 (78.

Impact of glaucoma severity and laterality on vision-specific functioning: the Singapore Malay eye study.

Purpose: We determined the impact of glaucoma severity and laterality on vision-specific functioning (VF) in an Asian population.

Methods: The Singapore Malay Eye Study (SiMES) was a population-based cross-sectional study of 3280 Malays aged 40 to 80 years. VF was assessed using the VF-11 questionnaire.

Acceptance, attitudes, and beliefs of Singaporean Chinese toward an ocular implant for glaucoma drug delivery.

Purpose: We investigated patients' attitudes and perceptions toward a subconjunctival implant as a novel ocular drug delivery method for glaucoma.

Methods: We recruited 344 Chinese patients with primary open angle or angle closure glaucoma currently on topical antiglaucoma medication for a minimum of six months from specialist glaucoma clinics. Sociodemographic data, and information about patients' general and ocular health were collected.

Vision impairment and major causes of vision loss impacts on vision-specific functioning independent of socioeconomic factors.

Purpose: To quantify the eye disease-specific impact of unilateral and bilateral vision impairment (VI) on vision-specific functioning (VF).

Design: The Singapore Indian Eye population-based study.

Participants: Ethnic Indians older than 40 years of age living in Singapore.

Critical issues in implementing low vision care in the Asia-Pacific region.

Two-thirds of the world's population with low vision resides in the Asia-Pacific region. Provision of comprehensive low vision services is important to improve vision-related quality of life (QoL) for people with this condition. This review outlines the critical issues and challenges facing the provision of low vision services in the Asia-Pacific region.

Determinants of informed consent in a cataract surgery clinical trial: why patients participate.

Objective: To identify the determinants of patients' decision-making for participation in a cataract surgery clinical trial in a tertiary care hospital.

Design: Prospective observational study.

Participants: We interviewed by questionnaire 40 patients scheduled to have cataract surgery.

The impact of cataract, cataract types, and cataract grades on vision-specific functioning using Rasch analysis.

Purpose: To determine the impact of cataracts and their types and grades on vision-specific functioning.

Design: Prospective population-based cross-sectional study.

Methods: The Singapore Indian Eye Study examined 3400 of 4497 (75.

Assessing disutility associated with diabetic retinopathy, diabetic macular oedema and associated visual impairment using the Vision and Quality of Life Index.

Background: Use of generic multi-attribute utility instruments (MAUI) to assess the impact of diabetic retinopathy (DR) on health-related quality of life (HRQoL) has produced inconsistent findings. Therefore, we assessed the impact of DR, diabetic macular oedema (DME) and associated visual impairment on vision-related QoL (VRQoL) using a vision-specific MAUI.

Methods: In this cross-sectional study, 203 diabetic patients were recruited from specialised eye clinics in a Melbourne tertiary eye hospital.