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.

Long-term efficacy of mycophenolate mofetil in the control of severe intraocular inflammation

Abstract: Purpose: To assess whether the previously demonstrated short-term efficacy of the immunosuppressant mycophenolate mofetil (MMF; CellCept, Roche) is maintained in the long-term management of refractory uveitis. Methods: The study was an open-label, non-comparative retrospective series of 14 patients with refractory uveitis and treated with MMF for a mean of>33 months. Mycophenolate mofetil was given at a dosage of 1 g (oral) twice daily. Indications included prednisolone reduction, additive agent with cyclosporin, or replacement therapy (azathioprine or methotrexate). The intraocular inflammatory response, side-effects, and toxicity were monitored. Results: Intraocular inflammation remained under control in 10 patients, unchanged in three and deteriorated in one patient. Transient side-effects included tiredness, headache and dizziness (one patient each, lasting less than 2 weeks from the time of MMF introduction). Mycophenolate mofetil was stopped in one patient because of absence of prolonged clinical improvement. Vision improved in 25% (7 eyes), did not change in 50% (14 eyes), but was reduced in 25% (7 eyes). Conclusions: Mycophenolate mofetil is safe for long-term usage and is recommended for treatment of refractory panuveitis or posterior uveitis with uncontrolled inflammation despite high prednisolone maintenance dosage (>15 mg/day) or toxicity or lack of efficacy of other immuno­suppressive agents. However, MMF is less effective for refractory uveitis unresponsive to azathioprine.

Postsurgical cystoid macular edema

Abstract: Cystoid macular edema (CME) is a primary cause of postoperative reduced vision. It may occur even when the intraoperative course is successful for operations such as cataract and vitreoretinal surgery. Its incidence following modern cataract surgery is 0.1%-2.35%. This risk is increased if there are certain preexisting systemic or ocular conditions and when there are intraoperative complications. The etiology of CME is not completely understood. Prolapsed or incarcerated vitreous and postoperative inflammatory processes have been proposed as causative agents. Pseudophakic CME is characterized by poor postoperative visual acuity. Fluorescein angiography is indispensable in the workup of CME, showing the classical perifoveal petaloid staining pattern and late leakage of the optic disk. Optical coherence tomography is a useful diagnostic tool, which displays cystic spaces in the outer nuclear layer. The most important differential diagnoses include age-related macular degeneration and other causes of CME such as diabetic macular edema. Most cases of pseudophakic CME resolve spontaneously. The value of prophylactic treatment is doubtful. First-line treatment of postsurgical CME should include topical nonsteroidal anti-inflammatory drugs and corticosteroids. Oral carbonic anhydrase inhibitors can be considered complementary. In cases of resistant CME, periocular or intraocular corticosteroids present an option. Antiangiogenic agents, though experimental, should be considered for nonresponsive persistent CME. Surgical options should be reserved for special indications.

A questionnaire assessment of unmet needs for rehabilitation services and resources for people with multiple sclerosis: results of a pilot survey in five European countries

Abstract: Objective: To develop an international services and needs assessment instrument (SUN) for people with multiple sclerosis and their carers and to pilot this in different countries of the European Community. Design: interview study of people with multiple sclerosis, their carers and nominated key professionals examining the unmet needs of patients and carers. Setting: Belgium, Estonia, Greece, Italy and the United Kingdom. Main outcome measures: Needs assessment questionnaire. Results: The study comprised 137 people with multiple sclerosis, 125 carers and ill professionals. Patients reported on average 2.9 unmet needs for themselves; their carers and professionals reported on average 2.4. Needs were categorized into seven broad categories. Due to difficulties experienced by the local researchers in distinguishing between needs and objectives a large proportion of needs had to be assigned to the 'other' category. Conclusions: The SUN is a valuable and practicable tool for the identification of unmet needs for people with multiple sclerosis and their carers. Formal validation and reliability testing of the different language versions is recommended.

Isolated peripheral nerve sheath tumours of the orbit.

Abstract: Fifty-four cases of peripheral nerve sheath tumours within the orbit are reviewed Benign neurilemmomas or neurofibromas occurred in 93% of patients and had an equal incidence There was a family history or other signs of systemic neurofibromatosis in one-quarter of those with solitary neurofibromas, but in none of the patients with neurilemmoma Symptoms and signs were generally those of an orbital mass lesion and pain or sensory loss was unusual, occurring more frequently with malignancy Within the orbit, most peripheral nerve sheath tumours affect the first division of the trigeminal nerve and extension of some tumours through the superior orbital fissure limits their surgical resection Despite incomplete resection of some tumours, with up to 23 years follow-up there have been no recurrences requiring further surgery A postoperative sensory deficit occurred in only 32% of patients with benign neurilemmomas and 72% with neurofibromas

A review and update on the current status of retinal prostheses (bionic eye)

Abstract: Introduction/background The Argus® II is the first retinal prosthesis approved for the treatment of patients blind from retinitis pigmentosa (RP), receiving CE (Conformite Europeenne) marking in March 2011 and FDA approval in February 2013. Alpha-IMS followed closely and obtained CE marking in July 2013. Other devices are being developed, some of which are currently in clinical trials. Sources of data A systematic literature search was conducted on PubMED, Google Scholar and IEEExplore. Areas of agreement Retinal prostheses play a part in restoring vision in blind RP patients providing stable, safe and long-term retinal stimulation. Areas of controversy Objective improvement in visual function does not always translate into consistent improvement in the patient's quality of life. Controversy exists over the use of an external image-capturing device versus internally placed photodiode devices. Growing points The alpha-IMS, a photovoltaic-based retinal prosthesis recently obtained its CE marking in July 2013. Areas timely for developing research Improvement in retinal prosthetic vision depends on: (i) improving visual resolution, (ii) improving the visual field, (iii) developing an accurate neural code for image processing and (iv) improving the biocompatibility of the device to ensure longevity.