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.

A Qualitative Study in the United Kingdom of Factors Influencing Attendance by Patients with Diabetes at Ophthalmic Outpatient Clinics

Abstract: Introduction:Many diabetics do not have regular eye examinations, although it is known that early diagnosis and treatment of sight-threatening retinopathy reduces the risk of blindness. The barriers that prevent diabetics from attending eye clinics are poorly understood. Purpose:To determine what factors may influence diabetic patients' attendance at eye clinics. Methods: A qualitative survey of both patients and eye care providers was undertaken in a rural district general hospital and in an urban tertiary teaching hospital. Methods employed included semi-structured interviews, focus groups and non-participatory observations. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect emerging themes. Data collection continued until no new themes emerged. Results: Lack of awareness was seen as the greatest barrier by both patients and providers. Patients were aware that diabetes could affect the eye, but not that it could lead to blindness, nor that severe r...

Results of primary retinal reattachment surgery: A prospective audit

Abstract: SUMMARY Purpose: To define the current success rate of primary retinal detachment repair at one centre. Methods: One hundred and fifty-three consecutive patients undergoing surgery for primary retinal detach­ ments over a 6 month period were studied prospect­ ively. Data sheets were completed immediately after surgery and at final follow-up. One hundred and twenty-seven patients completed 6 months of follow­ up. Follow-up data on the remainder were obtained from the referring unit or directly from the patients by telephone. The term primary success was used to describe persisting retinal reattachment after a single operation. Multiple logistic regression was carried out to establish factors associated with failure. Results: One hundred and twenty-three patients (80 %) had persisting retinal reattachment after a single procedure. Of the 30 patients who required further surgery, in 5 the retina remained detached at final follow-up. The final anatomical success rate was 97%. New or missed breaks were the major causes of failure of primary surgery. Failure of primary surgery was associated with the presence of highly elevated breaks ({3 = 0.11, P = 0.03). No other pre-operative factors appeared to predict failure to reattach the retina. Conclusions: Comparison of these results with those of a previous audit carried out at this hospital 23 years ago suggests little improvement in the success rate of primary surgery (75% vs 80%). The improvement in final retinal reattachment has been rather greater (from 88% to 97%). The major impact of recent technical advances in retinal reattachment surgery has been on the success rate of reoperations after failed primary surgery.

Idiopathic intracranial hypertension and visual function

Abstract: Background: Idiopathic intracranial hypertension is a relatively common condition (incidence up to 19/100 000/year in the high-risk group of obese women in reproductive age range) causing headaches with papilloedema Detailed investigations are required to exclude other causes of raised intracrainal pressure The condition may be self-limiting or enter a chronic phase with significant morbidity because of headache and visual loss Methods and results: This includes an overview of literature and internal audit date Discussion and conclusions: Management of hypertension is initially medical, utilizing a combination of managed weight reduction and diuretic therapy Cerebrospinal fluid (CSF) diversion surgery may be required to stabilize vision Options include neurosurgical shunting by lumbar-peritoneal of ventriculoperitoneal routes or by optic nerve sheath fenestration or both High category evidence from randomized trials to guide management decisions is lacking This article sets out to guide current best practice

Ocular gene delivery using lentiviral vectors.

Abstract: Substantial advances in our understanding of lentivirus lifecycles and their various constituent proteins have permitted the bioengineering of lentiviral vectors now considered safe enough for clinical trials for both lethal and non-lethal diseases. They possess distinct properties that make them particularly suitable for gene delivery in ophthalmic diseases, including high expression, consistent targeting of various post-mitotic ocular cells in vivo and a paucity of associated intraocular inflammation, all contributing to their ability to mediate efficient and stable intraocular gene transfer. In this review, the intraocular tropisms and therapeutic applications of both primate and non-primate lentiviral vectors, and how the unique features of the eye influence these, are discussed. The feasibility of therapeutic targeting using these vectors in animal models of both anterior and posterior ophthalmic disorders has been established, and has, in combination with substantial progress in enhancing lentiviral vector bio-safety over the past two decades, paved the way for the first human ophthalmic clinical trials using lentivirus-based gene transfer vectors.

New Developments in Corticosteroid Therapy for Uveitis

Abstract: Corticosteroids remain the mainstay of the management of patients with uveitis. Topical corticosteroids are effective in the control of anterior uveitis, but vary in strength, ocular penetration and side effect profile. Systemic corticosteroids are widely used for the management of posterior segment inflammation which requires treatment, particularly when it is associated with systemic disease or when bilateral ocular disease is present. However, when ocular inflammation is unilateral, or is active in one eye only, local therapy has considerable advantages, and periocular injections of corticosteroid are a useful alternative to systemic medication and are very effective in controlling mild or moderate intraocular inflammation. More recently, the injection of intraocular corticosteroids such as triamcinolone have been found to be effective in reducing macular oedema and improving vision in uveitic eyes which have proved refractory to systemic or periocular corticosteroids. The effect is usually transient, lasting around 3 months, but can be repeated although the side effects of cataract and raised intraocular pressure are increased in frequency with intraocular versus periocular corticosteroid injections. This has led to the development of new intraocular corticosteroid devices which are designed to deliver sustained-release drugs and obviate the need for systemic immunosuppressive treatment. The first such implant was Retisert, which is surgically implanted (in the operating theatre) and is designed to release fluocinolone over a period of about 30 months. More recently, Ozurdex, a 'bioerodible' dexamethasone implant which can be inserted in an office setting, has completed phase III clinical trials in patients with intermediate and posterior uveitis. This implant lasts approximately 6 months, and has been found to be effective with a much better side effect profile than Retisert or intravitreal triamcinolone injection, at least for one injection.