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.

Determinants of intraocular pressure and its association with glaucomatous optic neuropathy in Chinese Singaporeans: The Tanjong Pagar study

Abstract: Purpose: To examine the relationship between intraocular pressure (IOP), anthropomorphic, demographic, socioeconomic, systemic, and ocular factors and glaucomatous optic neuropathy (GON) in Chinese people. Methods: Chinese people (n = 2000), aged 40 to 79 years, were selected from the Singapore electoral register. Of the 1717 considered eligible for examination, 1232 participated, representing a response rate of 71.8%. IOP was estimated with Goldmann applanation tonometry. The drainage angle was assessed with static and dynamic gonioscopy. The optic nerve was examined at high magnification through a dilated pupil with a fundus contact lens or a +78-D lens. Static automated visual field testing was performed on subjects with suspected glaucoma. GON was diagnosed on the basis of structural and functional abnormalities of the optic nerve. Results: The main independent determinants of higher IOP were higher systolic blood pressure (P < 0.001), quadrants of any peripheral anterior synechiae (PAS, P = 0.02) and width of the drainage angle (P = 0.049). A 100-µm increase in corneal thickness was associated with an increase in mean IOP of 1.5 to 1.8 mm Hg (P < 0.001). Odds of GON increased 1.2 times per 1-mm Hg increase in screening IOP. A clear association between corneal thickness and GON was not identified. Conclusions: Clinical IOP estimates are related to systolic blood pressure and corneal thickness. Variation in IOP with angle width may suggest that trabecular compaction significantly contributes to causes of the increase in IOP, independent of angle-closure. GON is an IOP-related phenomenon among Chinese Singaporeans.

Causes of blind certifications in England and Wales: April 1999–March 2000

Abstract: AIM: The last complete report on causes of blindness in England and Wales was for data collected during April 1990 to March 1991. This current study sought to update these figures, with data collected during April 1999 to March 2000, and examine variation in cause by age group. METHODS: In England and Wales, registration for blindness is voluntary and is initiated by certification by a consultant ophthalmologist. The main cause of blindness was ascertained where possible for all certificates completed during April 1999 to March 2000 and tabulated by age group. RESULTS: A total of 34 410 BD8 certificates were received, of which 13 788 (40%) were for people certified as blind. Different causes predominated within different age groups. Age related macular degeneration (AMD) was the lead cause in those aged 65 years and above, diabetic retinopathy was the lead cause in people of working ages (16-64 years), whereas cerebral visual impairment and disorders of the optic nerve accounted for over 40% of blind certificates completed for children. CONCLUSION: Estimates of vision impairment based on certifications for blindness in England and Wales are likely to be imprecise. They do, however, give some measure of the burden at hospital level of sight impairing eye conditions. If factors determining the imprecision remain constant, temporal monitoring of causes may enable changes and development of new conditions leading to vision impairment to be detected.

Intravitreal growth factors in proliferative diabetic retinopathy: correlation with neovascular activity and glycaemic management

Abstract: AIM Many growth factors are implicated in proliferative diabetic retinopathy (PDR). It was decided to test the hypothesis that no one factor is predominant but that a regular profile of levels of different growth factors might be operating, and that the profile might differ according to whether or not insulin therapy was part of the patient’s glycaemic management. The levels of several growth factors in vitrectomy samples were therefore determined from diabetic patients with tractional, non-haemorrhagic sequelae of PDR and these levels were correlated with (a) each other (growth factor profile), (b) neovascular activity, and (c) the method of glycaemic management (insulin treated (IT) or non-insulin treated (NIT)). METHODS 72 samples of vitreous were obtained from either diabetic patients with PDR (n = 51) or non-diabetic (control) patients (n = 21). Levels of bFGF, IGF-I, EGF, and insulin were determined by radioimmunoassay; levels of TGF-β2 by ELISA; and levels of IGF-I binding protein by western ligand blotting. The data were analysed using appropriate statistics. RESULTS There was no regular growth factor profile. bFGF levels were significantly greater in vitreous from NIT patients compared with IT patients and controls. The highest levels of bFGF were found in NIT patients with actively vascularised membranes. TGF-β2 levels were significantly greater in vitreous from IT patients compared with NIT patients and controls The highest levels of TGF-β2 were found in IT patients with actively vascularised membranes. IGF-I levels were significantly greater in diabetics (irrespective of insulin treatment) than non-diabetics and the highest levels of IGF-I were found in IT patients with actively vascularised membranes. A 34 kDa IGFBP was the predominant IGFBP identified in vitreous and was found to be elevated in diabetics patients. CONCLUSION In PDR there is a correlation between intravitreal growth factor levels and both disease state (whether active or fibrotic) and method of glycaemic management.