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.

Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma

Abstract: Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG.

The "cavernous" sinus.

Abstract: THE cavernous sinus is a vascular channel of great importance not only in ophthalmology but in many other branches of medicine. Descriptions of its structure are scattered in books and journals on ophthalmology, otorhinolaryngology, paediatrics, and dentistry as well as in the standard anatomical works. However, the descriptions of the sinus and its contents show great variation and it is the purpose of this paper to clarify the matter. Probably the earliest description of this sinus was by Ridley (1695), who placed the internal carotid artery against the lateral wall, \"leaving no room at all for either blood or serum to be contained there\". He noted with regard to the artery \"a little interstice between itselfand the pituitary gland\", and how this venous space communicated with that of the opposite side. The term \"circular sinus\" was suggested in his book, a name still sometimes applied. The presence of the fibrous trabeculae was first noted by Winslow (1732), but his description of the other structures is not clear: \"The internal carotid is bathed in the blood of the sinus together with the third, fourth, fifth and sixth pairs of nerves.\" It was Winslow who likened the interior of the sinus to that of the corpus cavernosum of the penis and applied the term \"cavernous\", which has been used ever since. The classic description is that of a blood-filled channel completely surrounding the horizontal portion ofthe internal carotid artery and the sixth (abducent) nerve as they pass anteriorly on either side of the sella turcica (Fig. 1). In addition to these two structures, the lumen of the cavernous sinus is usually described as being crossed by numerous fibrous laminae, termed trabeculae, and always depicted as a dense, interlacing mass. This description of the artery, the sixth nerve, and the trabeculae is given in most books dealing with anatomy: Thane (1892), Whitnall (1921), Sobotta (1928), Huber (1930), Spalteholz (1933), Wood Jones (1949), Wolff (1954), Boileau Grant (1958), and in the many applied and clinical works: Mosher (1914), Turner and Reynolds (1926), Campbell (1933), Fabricant (1933), Pace (1941), Herzig (1945), Orton (1947), Elfman (1950), Shaw (1952), Hollinshead (1954), Last (1959), and Duke-Elder (1961). Indeed, the presence of the trabeculae has

Diagnostic accuracy of microbial keratitis with in vivo scanning laser confocal microscopy

Abstract: Aims To determine the accuracy of diagnosing microbial keratitis by masked medical and non-medical observers using the Heidelberg Retina Tomograph II/Rostock Cornea Module in vivo confocal microscope. Methods Confocal images were selected for 62 eyes with culture- or biopsy-proven infections. The cases comprised 26 Acanthamoeba , 12 fungus, three Microsporidia , two Nocardia and 19 bacterial infections (controls). The reference standard for comparison was a positive tissue diagnosis. These images were assessed on two separate occasions by four observers who were masked to the tissue diagnosis. Diagnostic accuracy indices, κ statistic and percentage agreement values were calculated. The Spearman correlation coefficient (r s ) was calculated for the number of correct diagnoses versus duration of disease. Results The highest sensitivity and specificity values were 55.8% and 84.2%, respectively, and the lowest sensitivity and specificity values were 27.9% and 42.1%, respectively. The highest positive and lowest negative likelihood ratios were 2.94 and 0.59, respectively. Agreement values were: fair to moderate (κ 0.22–0.44) for reference standard versus observer diagnosis, moderate to good in intraobserver variability (repeatability, κ 0.56–0.88) and poor to moderate in interobserver variability (reproducibility, κ 0.15–0.47). The correct diagnosis was associated with duration of disease for Acanthamoeba keratitis (r s =0.60, p=0.001). Conclusions The diagnostic accuracy of microbial keratitis by confocal microscopy is dependent on observer experience. Intraobserver repeatability was better than interobserver reproducibility. Difficulty in distinguishing host cells from pathogenic organisms limits the value of confocal microscopy as a stand-alone tool in diagnosing microbial keratitis.

Photopic and Scotopic Fine Matrix Mapping of Retinal Areas of Increased Fundus Autofluorescence in Patients with Age-Related Maculopathy

Abstract: PURPOSE. To investigate photopic and scotopic sensitivity of retinal areas that show increased fundus autofluorescence (FAF) in patients with age-related maculopathy (ARM). METHODS. FAF was imaged with a modified confocal scanning laser ophthalmoscope (cSLO). Fine matrix mapping (FMM) was performed with a modified field analyzer. Photopic and scotopic thresholds were obtained at 100 locations on a 9° X 9° matrix with 1° spacing, centered on a macular area of increased FAF. Inclusion criteria included ARM fundus changes, areas of increased FAF, central and stable fixation, and visual acuity of 20/40 or better. RESULTS. FAF images were reviewed in 436 patients with age-related maculopathy (ARM), of whom 38 met the inclusion criteria. FMM was performed in seven eyes of seven patients. Areas of increased FAF in patients with late ARM (choroidal neovascularization or geographic atrophy) showed normal or only mildly abnormal photopic, but severely reduced scotopic, sensitivity. The central area of increased FAF corresponding to a large foveal druse in a patient with ARM showed moderately reduced photopic and severely reduced scotopic sensitivity. In the other patients with ARM with drusen, areas of increased FAF showed normal or near-normal photopic sensitivity, but moderately reduced scotopic sensitivity. CONCLUSIONS. In retinal areas of increased FAF in patients with ARM, scotopic sensitivity loss considerably exceeded photopic sensitivity loss. This finding is in line with histologic data that have demonstrated a preferential loss of rods in ARM, but does not explain the magnitude of sensitivity loss. The study shows that increased FAF in ARM has a functional correlate.