Moorfields Eye Hospital

About: Moorfields Eye Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Visual acuity & Glaucoma. The organization has 3721 authors who have published 6790 publications receiving 246004 citations.

Major orbital complications of endoscopic sinus surgery

Abstract: BACKGROUND—The paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss. METHODS—A retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery. RESULTS—All the cases suffered medial rectus damage, one had additional injury to the inferior rectus and oblique, and two patients were blinded as a result of direct damage to the optic nerve or its blood supply. CONCLUSION—Some ophthalmic complications of endoscopic sinus surgery are highlighted, the mechanisms responsible are discussed, and recommendations for prevention, early recognition, and management are proposed.

Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion.

Abstract: Branch retinal vein occlusion (BRVO) occurs when a retinal vein that drains part of the retina becomes blocked. BRVO can affect approximately four to five people per 1,000 of the population. Known risk factors for BRVO include hypertension, atherosclerosis, high cholesterol, diabetes mellitus, and other inflammatory or autoimmune conditions. In a BRVO the severity of vision loss is related to the extent of macular involvement by haemorrhage, swelling (oedema), and poor blood supply (ischaemia). The most common cause of visual loss in patients with BRVO is macular oedema (MO). Patients with BRVO in one eye are at risk of a venous occlusion in the fellow eye. Untreated, approximately one third of affected eyes will achieve a high level of vision (20/40 or better). Current "gold" standard treatment is laser photocoagulation which has been shown to reduce the risk of visual loss and improve the vision in up to two thirds of individuals with macular oedema secondary to BRVO, however, limitations to this treatment exist and newer modalities have suggested equal or improved efficacy. Recent studies have suggested that an injection of anti-vascular endothelial growth factor (anti-VEGF) in the eye may be of benefit to patients with BRVO. In this review, we appraise and present the level of current evidence for the use of anti-VEGF injections in the treatment of macular oedema after BRVO. In total, we found one randomised controlled trial and one quasi-randomised controlled trial. One study from the USA. had 397 participants and compared anti-VEGF injections with sham injections. It demonstrated a potential benefit of repeated anti-VEGF injections to improve vision (at least 15 letters) at one year. A second study with 30 participants, conducted in Italy, compared anti-VEGF injections with laser photocoagulation and did not demonstrate an improvement in vision (of at least 15 letters) of anti-VEGF injections over laser photocoagulation at one year. Antiangiogenic treatment was well tolerated in these studies, but since the studies were only of one year duration, we were unable to discuss long-term effects. There are several ongoing studies which undoubtedly will add to the evidence available.

Intrafamilial variation of phenotype in Stargardt macular dystrophy-Fundus flavimaculatus.

Abstract: RESULTS. Large differences between siblings in age of onset (median, 12 years; range, 5‐23 years) were observed in six of the 15 families studied, whereas in 9 families differences in age of onset between siblings were small (median, 1 year; range, 0 ‐3 years). Visual acuity varied two or more lines among siblings in nine families. In 10 families (67%) siblings were found to have different clinical appearance on fundus examination and fundus autofluorescence images, whereas in 5 families (33%), affected siblings had similar clinical features. Electrodiagnostic tests were performed on affected members of 12 families and disclosed similar qualitative findings among siblings. In nine families there was loss of central function only; in two, global loss of cone function; and in one, global loss of cone and rod function. CONCLUSIONS. In this series, although differences in age of onset, visual acuity, and fundus appearance were observed between siblings, electrophysiological studies demonstrated intrafamilial homogeneity in retinal function. The findings are difficult to reconcile with expression studies showing ABCR transcripts in rod photoreceptors but not in cones. (Invest Ophthalmol Vis Sci. 1999;40:2668 ‐2675) I n 1909 Stargardt 1 described a recessive inherited macular dystrophy characterized by the presence of an atrophic macular lesion associated with white flecks. There appeared to be a disproportional loss of visual acuity when compared with the fundus appearance early in the course of the disease. Later, Franceschetti 2 proposed the term “fundus flavimaculatus” to designate a peculiar fundus affection in which the hallmark was the presence of white-yellow deep retinal flecks, varying in size, shape, opaqueness, and density and limited to the posterior pole or extending to the equatorial region. In some patients the macula was involved in a fashion similar to Stargardt’s disease. 3 Despite attempts to devise a

Angiopoietin concentrations in diabetic retinopathy.

Abstract: Background/aim: Angiopoietin 1 and 2 interact with vascular endothelial growth factor (VEGF) to promote angiogenesis in animal and in vitro models. Although VEGF concentrations are elevated, there is little information regarding angiopoietin concentration in the vitreous of patients with diabetic retinopathy. Methods: Angiopoietin concentrations were measured by luminescence immunoassay in vitreous samples from 17 patients with non-proliferative diabetic retinopathy (NPDR) and clinically significant diabetic macular oedema (CSMO), 10 patients with proliferative diabetic retinopathy (PDR), and five patients with macular hole (controls) obtained at pars plana vitrectomy. Results: Angiopoietin 1 concentrations were low in patients with macular hole (median 17 pg/ml) while in NPDR with CSMO they were 2002 pg/ml (range 289–5820 pg/ml) and in PDR 186 pg/ml (range 26–2292 pg/ml). Angiopoietin 2 concentrations in NPDR with CSMO were a median of 4000 pg/ml (range 1341–14 329 pg/ml). For both macular hole and PDR patients angiopoietin 2 was below the limit of detection. Conclusions: Angiopoietin 2 concentration was twice that of angiopoietin 1 in NPDR with CSMO. Angiopoietin 2 is the natural antagonist of angiopoietin 1 which is thought to act as an anti-permeability agent. The predominance of angiopoietin 2 may allow VEGF induced retinal vascular permeability in patients with CSMO. The relatively low concentration of both angiopoietin 1 and 2 in patients with proliferative diabetic retinopathy may reflect the established nature of the neovascularisation in cases proceeding to vitrectomy.