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.

Measurement of optic disc size: equivalence of methods to correct for ocular magnification

Abstract: Aims—To compare methods available to correct the magnification of images that result from the optics of the eye and identify errors, and source of error, of the methods. Methods—11 methods were applied to ocular biometry data from three independent cohorts. Each method was compared with the method of Bennett, which uses most biometric data. The diVerence between each method and Bennett’s is the “error” of the method. The relation between the error and axial length, ametropia, and keratometry was explored by linear regression analysis. Results—Methods using axial length had the lowest mean (+0.5 to +2.6%) and standard deviation (0.6 to 1.2%) of errors. Of methods using keratometry and ametropia only, the lowest mean (˛1.4% to +4.4%) and standard deviation (2.9 to 4.3%) of errors was found for a new method described in this paper, and that used by the Heidelberg retina tomograph (HRT). The highest mean error (+2.2 to +7.1%) was found for Littmann’s method. Littmann’s correction was larger than the HRT’s by 3.5 to 3.7%. The mean difference between the new and HRT methods and the “abbreviated axial length” method of Bennett is ˛1.3 to +2.0%. The error of the “keratometry and ametropia” methods is related to axial length. Conclusions—Methods using axial length are most accurate. The abbreviated axial length method of Bennett diVers little from more detailed calculations and is appreciably more accurate than methods using keratometry and ametropia alone. If axial length is unknown, the new and the HRT methods give results closest to the abbreviated axial length method. (Br J Ophthalmol 1998;82:643‐649)

The Relative Effects of Corneal Thickness and Age on Goldmann Applanation Tonometry and Dynamic Contour Tonometry

Abstract: Aims: To establish the effects of central corneal thickness (CCT) on intraocular pressure (IOP) measured with a prototype Pascal dynamic contour tonometer (DCT), to evaluate the effect of CCT and age on the agreement between IOP measured with the Pascal DCT and Goldmann applanation tonometer (GAT), and to compare the interobserver and intraobserver variation of the DCT with the GAT. Methods: GAT and DCT IOP measurements were made on 130 eyes of 130 patients and agreement was assessed by means of Bland-Altman plots. The effect of CCT and age on GAT/DCT IOP differences was assessed by linear regression analysis. Interobserver and intraobserver variations for GAT and DCT were assessed in 100 eyes of 100 patients. Results: The mean difference (95% limits of agreement) between GAT and DCT was −0.7 (−6.3 to 4.9) mm Hg. GAT/DCT IOP differences increased with thicker CCT (slope 0.017 mm Hg/μm, 95% CI 0.004 to 0.03, r2 = 0.05, p = 0.01), and with greater age, slope 0.05 mm Hg/year (95% CI 0.012 to 0.084, r2 = 0.05, p = 0.01). The intraobserver variability of GAT and DCT was 1.7 mm Hg and 3.2 mm Hg, respectively. The interobserver variability was (mean difference (95% limits of agreement)) 0.4 (−3.5 to 4.2) mm Hg for GAT and 0.2 (−4.9 to 5.3) mm Hg for DCT. Conclusions: GAT is significantly more affected than DCT by both CCT and subject age. The effect of age suggests an age related corneal biomechanical change that may induce measurement error additional to that of CCT. The prototype DCT has greater measurement variability than the GAT.

Surgery for idiopathic full-thickness macular hole: two-year results of a randomized clinical trial comparing natural history, vitrectomy, and vitrectomy plus autologous serum: Morfields Macular Hole Study Group RAeport no. 1.

Abstract: Objectives To determine the benefits of idiopathic full-thickness macular hole(FTMH) surgery compared with observation and to evaluate the use of autologousserum as an intraoperative adjunct. Methods A randomized clinical trial was performed to evaluate the anatomic andvisual benefits of FTMH surgery for lesions of 9 months or less symptom durationand visual acuity of 20/60 or less. We compared surgery with natural historyand determined whether use of intraoperative adjunctive autologous serum improvesthe surgical outcome. Eyes were randomized to (1) observation, (2) vitrectomy,or (3) vitrectomy plus serum and were followed for 24 months to assess anatomicstatus and visual function. Results In total, 185 eyes of 174 patients were enrolled. In the observationgroup, spontaneous closure of the FTMH occurred in 7 (11.5%) of 61 patients,with little or no change in overall acuity levels in 24 months. In contrast,the surgical groups had an overall closure rate of 80.6% (100/124) at 24 months,with 45% of eyes achieving Snellen acuity of 20/40 or greater. Surgical eyeshad better median near acuity than observation eyes by 6 lines (N5 vs N14).Use of autologous serum did not seem to affect anatomic or visual results.At 24 months, 72 (58.1%) of 124 surgical eyes had undergone cataract extraction. Conclusions Surgery for FTMH is safe and effective and is associated with significantvisual improvement compared with the natural history. Autologous serum applicationdoes not enhance the results of surgery.

Novel antisense oligonucleotides targeting TGF-beta inhibit in vivo scarring and improve surgical outcome

Abstract: The scarring response is an important factor in many diseases throughout the body. In addition, it is a major problem in influencing results of surgery. In the eye, for example, post-operative scarring can determine the outcome of surgery. This is particularly the case in the blinding disease glaucoma, where several anti-scarring regimens are currently used to improve glaucoma surgery results, but are of limited use clinically because of severe complications. We have recently identified transforming growth factor-beta (TGF-beta) as a target for post-operative anti-scarring therapy in glaucoma, and now report the first study of novel second-generation antisense phosphorothioate oligonucleotides against TGF-beta in vivo. Single applications of a TGF-beta OGN at the time of surgery in two different animal models closely related to the surgical procedure performed in glaucoma patients, significantly reduced post-operative scarring (P<0.05) and improved surgical outcome. Our findings suggest that TGF-beta antisense oligonucleotides have potential as a new therapy for reducing post-surgical scarring. Its long-lasting effects after only a single administration at the time of surgery make it particularly attractive clinically. Furthermore, although we have shown this agent to be useful in the eye, it could have widespread applications anywhere in the body where the wound-healing response requires modulation.