Comparison of intraocular pressure profiles during the water drinking test and the modified diurnal tension curve.

Objectives: To compare intraocular pressure (IOP) during the water drinking test (WDT) and modified diurnal tension curve (mDTC) in open-angle glaucoma (OAG) patients, using multimodal, observer-masked tonometry.

Methods: Open-angle glaucoma subjects were prospectively enroled, excluding those who had undergone glaucoma filtration or laser surgery. Two-hourly mDTC Goldmann applanation (GAT) and rebound tonometry (RT) was performed between 8:00 and 16:00, and every 15 min for 45 min after ingestion of 800mls of water.

Quantitative brain-derived neurotrophic factor lateral flow assay for point-of-care detection of glaucoma.

Glaucoma, a ruinous group of eye diseases with progressive degeneration of the optic nerve and vision loss, is the leading cause of irreversible blindness. Accurate and timely diagnosis of glaucoma is critical to promote secondary prevention and early disease-modifying therapies. Reliable, cheap, and rapid tests for measuring disease activities are highly required.

Measures of disease activity in glaucoma.

Glaucoma is the leading cause of irreversible blindness globally which significantly affects the quality of life and has a substantial economic impact. Effective detective methods are necessary to identify glaucoma as early as possible. Regular eye examinations are important for detecting the disease early and preventing deterioration of vision and quality of life.

Endocyclophotocoagulation combined with phacoemulsification in surgically naive primary open-angle glaucoma: three-year results.

Objective: To assess the safety and efficacy of endocyclophotocoagulation with phacoemulsification (phaco-ECP) in surgically naive, primary open-angle glaucoma (POAG).

Methods: A retrospective case series of patients undergoing phaco-ECP between 2007 and 2017 at a single centre in London, UK. The primary outcome was intraocular pressure (IOP).

Recent Advancements in the Medical Treatment of Diabetic Retinal Disease.

Diabetic retinal disease remains one of the most common complications of diabetes mellitus (DM) and a leading cause of preventable blindness. The mainstay of management involves glycemic control, intravitreal, and laser therapy. However, intravitreal therapy commonly requires frequent hospital visits and some patients fail to achieve a significant improvement in vision.

TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation.

Purpose: Refractory glaucoma patients continue to require surgical intervention in the form of trabeculectomy surgery or glaucoma drainage device (GDD). Those patients that require a GDD but have thin sclera or scleromalacia present a challenge.

Methods: In this article, we present a novel "TAG sandwich" single surgical procedure in which thinned sclera is reinforced with a pericardial patch graft ("bottom layer of the sandwich") allowing safe implantation of the GDD ("the tube sandwich filling") and then placing another patch graft on top of the tube part of the GDD ("top layer of the sandwich").

Apoptosis in health and diseases of the eye and brain.

Apoptosis is a form of programmed cell death (PCD) and enables the immunologically silent disposal of senescent or unwanted cells, causing minimal damage to the surrounding environment. Apoptosis can occur via intrinsic or extrinsic pathways that initiate a series of intracellular and extracellular signaling events. This ultimately leads to the clearance of the cell by phagocytes.

A 'Real Life' Service Evaluation Model for Multidisciplinary Thyroid Eye Services.

Background/aims: There is no universal consensus on the practical implementation and evaluation of the Amsterdam Declaration on Graves Orbitopathy in a Multidisciplinary Thyroid Eye Disease (MDTED) pathway. Recent recommendations from the UK TEAMeD-5 and BOPSS initiative highlight the importance of prevention, screening, and prompt referral of patients with moderate to severe and sight-threatening thyroid eye disease to multidisciplinary (MDTED) clinics and recommends annual auditing. We propose a practical service evaluation model with Key Performance Indicators (KPI) that are achievable and could be implemented across most TED pathways.

Association of Other Autoimmune Diseases With Thyroid Eye Disease.

Background: Thyroid eye disease (TED) is a potentially disfiguring and sight-threatening autoimmune (AI) orbitopathy, affecting up to 400,000 people in the UK. There are no accurate early predictors of TED severity. Although polyautoimmunity has been shown to affect AI disease severity, its influence on TED severity has never been investigated.

Investigational neuroprotective compounds in clinical trials for retinal disease.

Introduction: Retinal neurodegeneration causes irreversible vision loss, impairing quality of life. By targeting neurotoxic conditions, such as oxidative stress and ischemia, neuroprotectants can slow or stop sight loss resulting from eye disease. Despite limimted clinical use of neuroprotectants, there are several promising compounds in early clinical trials (pre-phase III) which may fulfil new therapeutic roles.

Detecting Apoptosis as a Clinical Endpoint for Proof of a Clinical Principle.

The transparent eye media represent a window through which to observe changes occurring in the retina during pathological processes. In contrast to visualising the extent of neurodegenerative damage that has already occurred, imaging an active process such as apoptosis has the potential to report on disease progression and therefore the threat of irreversible functional loss in various eye and brain diseases. Early diagnosis in these conditions is an important unmet clinical need to avoid or delay irreversible sight loss.

Biometric and refractive errors evaluation in patients with neurofibromatosis type 1.

Purpose: To analyze biometric changes and prevalence of refractive in patients with neurofibromatosis type 1 (NF1).

Methods: Retrospective, case-controlled study involving patients affected by NF1 and healthy control subjects. Data on biometric measurements such as axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), keratometry (K1 and K2) values, and white-to-white (WTW), obtained by use of optical low-coherence reflectometry on a Lenstar LS 900 (Haag-Streit AG, Switzerland) were collected and analyzed.

Age-related retinal thickness in Down's syndrome: A high-risk population for dementia.

Introduction: People with Down's syndrome (DS) have a high prevalence of early-onset Alzheimer's disease. Early markers of Alzheimer's disease pathology identifiable before clinical change are needed for the evaluation of preventative treatments. The retina, an extension of the brain, may provide a noninvasive imaging site.

Scleral Lens Sensor for Ocular Electrolyte Analysis.

The quantitative analysis of tear analytes in point-of-care settings can enable early diagnosis of ocular diseases. Here, a fluorescent scleral lens sensor is developed to quantitatively measure physiological levels of pH, Na , K , Ca , Mg , and Zn ions. Benzenedicarboxylic acid, a pH probe, displays a sensitivity of 0.

Retinal correlates of neurological disorders.

Considering the retina as an extension of the brain provides a platform from which to study diseases of the nervous system. Taking advantage of the clear optical media of the eye and ever-increasing resolution of modern imaging techniques, retinal morphology can now be visualized at a cellular level . This has provided a multitude of possible biomarkers and investigative surrogates that may be used to identify, monitor and study diseases until now limited to the brain.

Ophthalmic Research Lecture 2018: DARC as a Potential Surrogate Marker.

Glaucoma is a progressive, neurodegenerative disease that is increasing in prevalence worldwide. There is a need to develop ways in which to diagnose the disease sooner and more reliably in order to prevent irreversible visual loss and meet the growing demands on healthcare services. Research into neuroprotective therapies in glaucoma is lacking a reliable surrogate marker in order to show treatment efficacy in a meaningful and cost-effective manner.

Intracameral Phenylephrine to Arrest Intraoperative Intraocular Bleeding: A New Technique.

Intraoperative intraocular bleeding can present a major challenge during anterior segment operations, such as cataract and glaucoma surgery. In the presence of significant intraocular bleeding, the surgeon may be unable to proceed if the bleeding cannot be controlled. Uncontrolled bleeding may also result in intraoperative or postoperative complications.

Corneal Sensitivity After Ocular Surgery.

The cornea is densely innervated with free nerve endings to provide a high level of sensitivity to foreign bodies or noxious substances. They also provide trophic support to the tissues of the cornea and facilitate their repair and replacement. Any reduction in the function of the nerve endings through disease, contact lens wear, or surgery may lead to corneal disease, damage, or reduced healing.

Real-Time Imaging of Retinal Ganglion Cell Apoptosis.

Monitoring real-time apoptosis in-vivo is an unmet need of neurodegeneration science, both in clinical and research settings. For patients, earlier diagnosis before the onset of symptoms provides a window of time in which to instigate treatment. For researchers, being able to objectively monitor the rates of underlying degenerative processes at a cellular level provides a biomarker with which to test novel therapeutics.

Real-Time Imaging of Retinal Cell Apoptosis by Confocal Scanning Laser Ophthalmoscopy and Its Role in Glaucoma.

Glaucoma is one of the leading causes of irreversible blindness in the world. It is characterized by the progressive loss of retinal ganglion cells (RGCs), mainly through the process of apoptosis. Glaucoma patients often come to clinical attention when irreversible loss of visual function has been already established; therefore, early recognition of RGC apoptosis is inordinately important in disease prevention.

Annexins in Glaucoma.

Glaucoma is one of the leading causes of irreversible visual loss, which has been estimated to affect 3.5% of those over 40 years old and projected to affect a total of 112 million people by 2040. Such a dramatic increase in affected patients demonstrates the need for continual improvement in the way we diagnose and treat this condition.

Lag time for retinoblastoma in the UK revisited: a retrospective analysis.

Objectives: To explore current delays in diagnosis of retinoblastoma (Rb) and effect on outcome with comparison to a study from the 1990s.

Setting: Primary, secondary, tertiary care: majority from South of England.

Participants: A retrospective analysis of 93 new referrals of sporadic (non-familial) Rb to a specialist Rb unit in London, UK from January 2006 to February 2014.