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Ignacio Rodriguez-Una, Augusto Azuara-Blanco, Anthony J King
BACKGROUND: To evaluate the spectrum of glaucoma surgery and the post-operative follow-up regimes undertaken among glaucoma specialists in the United Kingdom. DESIGN: National survey. PARTICIPANTS: Seventy-five glaucoma specialists (consultants and fellows). METHODS: An eight-question survey was emailed to all glaucoma subspecialists members of the United Kingdom and Eire Glaucoma Society. MAIN OUTCOME MEASURES: Surgery undertaken, post-operative management, awareness of intervention tariff and handling of the follow-up burden generated through surgery...
October 11, 2016: Clinical & Experimental Ophthalmology
Augusto Azuara-Blanco, Jennifer Burr, Craig Ramsay, David Cooper, Paul J Foster, David S Friedman, Graham Scotland, Mehdi Javanbakht, Claire Cochrane, John Norrie
BACKGROUND: Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment. METHODS: From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment...
October 1, 2016: Lancet
Paul McCann, Ruth E Hogg, Richard Fallis, Augusto Azuara-Blanco
PURPOSE: We conducted a systematic review and meta-analysis of observational studies to evaluate the effect of oral statins on intraocular pressure (IOP) and the incidence and progression of glaucoma. METHODS: This was a systematic review of the literature and meta-analysis. Searches of PubMed/Medline and Embase were conducted to include all types of studies. Gray literature abstracts were also considered for inclusion. Last search date was February 2016. Risk of bias was assessed using the Newcastle-Ottawa scale independently by two reviewers...
May 1, 2016: Investigative Ophthalmology & Visual Science
Katie Banister, Charles Boachie, Rupert Bourne, Jonathan Cook, Jennifer M Burr, Craig Ramsay, David Garway-Heath, Joanne Gray, Peter McMeekin, Rodolfo Hernández, Augusto Azuara-Blanco
PURPOSE: To compare the diagnostic performance of automated imaging for glaucoma. DESIGN: Prospective, direct comparison study. PARTICIPANTS: Adults with suspected glaucoma or ocular hypertension referred to hospital eye services in the United Kingdom. METHODS: We evaluated 4 automated imaging test algorithms: the Heidelberg Retinal Tomography (HRT; Heidelberg Engineering, Heidelberg, Germany) glaucoma probability score (GPS), the HRT Moorfields regression analysis (MRA), scanning laser polarimetry (GDx enhanced corneal compensation; Glaucoma Diagnostics (GDx), Carl Zeiss Meditec, Dublin, CA) nerve fiber indicator (NFI), and Spectralis optical coherence tomography (OCT; Heidelberg Engineering) retinal nerve fiber layer (RNFL) classification...
May 2016: Ophthalmology
Palwasha Mokhles, Jan S A G Schouten, Henny J M Beckers, Augusto Azuara-Blanco, Anja Tuulonen, Carroll A B Webers
PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this. METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI...
July 2016: Journal of Glaucoma
Augusto Azuara-Blanco, Katie Banister, Charles Boachie, Peter McMeekin, Joanne Gray, Jennifer Burr, Rupert Bourne, David Garway-Heath, Mark Batterbury, Rodolfo Hernández, Gladys McPherson, Craig Ramsay, Jonathan Cook
BACKGROUND: Many glaucoma referrals from the community to hospital eye services are unnecessary. Imaging technologies can potentially be useful to triage this population. OBJECTIVES: To assess the diagnostic performance and cost-effectiveness of imaging technologies as triage tests for identifying people with glaucoma. DESIGN: Within-patient comparative diagnostic accuracy study. Markov economic model comparing the cost-effectiveness of a triage test with usual care...
January 2016: Health Technology Assessment: HTA
R Hernández, J M Burr, L Vale, A Azuara-Blanco, J A Cook, K Banister, A Tuulonen, M Ryan
OBJECTIVE: To assess the efficiency of alternative monitoring services for people with ocular hypertension (OHT), a glaucoma risk factor. DESIGN: Discrete event simulation model comparing five alternative care pathways: treatment at OHT diagnosis with minimal monitoring; biennial monitoring (primary and secondary care) with treatment if baseline predicted 5-year glaucoma risk is ≥6%; monitoring and treatment aligned to National Institute for Health and Care Excellence (NICE) glaucoma guidance (conservative and intensive)...
September 2016: British Journal of Ophthalmology
A K Krezel, R E Hogg, S Krezel, R Fallis, A Azuara-Blanco
PURPOSE: The selection of suitable outcomes and sample size calculation are critical factors in the design of a randomised controlled trial (RCT). The goal of this study was to identify the range of outcomes and information on sample size calculation in RCTs on geographic atrophy (GA). METHODS: We carried out a systematic review of age-related macular degeneration (AMD) RCTs. We searched MEDLINE, EMBASE, Scopus, Cochrane Library,, and www...
November 2015: Eye
Rehab Ismail, Augusto Azuara-Blanco, Craig R Ramsay
PURPOSE: Comparing the relative effectiveness of interventions across glaucoma trials can be problematic due to differences in definitions of outcomes. We sought to identify a key set of clinical outcomes and reach consensus on how best to measure them from the perspective of glaucoma experts. METHODS: A 2-round electronic Delphi survey was conducted. Round 1 involved 25 items identified from a systematic review. Round 2 was developed based on information gathered in round 1...
June 2016: Journal of Glaucoma
Mayret Castillo, Neil W Scott, Mohammad Z Mustafa, Mohammed S Mustafa, Augusto Azuara-Blanco
BACKGROUND: Seasonal/perennial allergic conjunctivitis is the most common allergic conjunctivitis, usually with acute manifestations when a person is exposed to allergens and with typical signs and symptoms including itching, redness, and tearing. The clinical signs and symptoms of allergic conjunctivitis are mediated by the release of histamine by mast cells. Histamine antagonists (also called antihistamines) inhibit the action of histamine by blocking histamine H1 receptors, antagonising the vasoconstrictor, and to a lesser extent, the vasodilator effects of histamine...
2015: Cochrane Database of Systematic Reviews
U Javed, K McVeigh, N W Scott, A Azuara-Blanco
AIMS: Cataract surgery is one of the most common surgeries performed, but its overuse has been reported. The threshold for cataract surgery has become increasingly lenient; therefore, the selection process and surgical need has been questioned. The aim of this study was to evaluate the changes associated with cataract surgery in patient-reported vision-related quality of life (VR-QoL). METHODS: A prospective cohort study was conducted. Consecutive patients referred to cataract clinics in an NHS unit in Scotland were identified...
July 2015: Eye
Aniela K Krezel, Ruth E Hogg, Augusto Azuara-Blanco
BACKGROUND/AIMS: The purpose of this systematic review was to identify the frequency and type of patient-reported outcome measures (PROMs) used in recent randomised controlled trials (RCTs) for age-related macular degeneration (AMD). METHODS: The authors conducted a systematic search between January 2010 and November 2013 in MEDLINE, EMBASE, Scopus, Cochrane Library (Central) and the clinical trials registries ( and http://www.ClinicalTrials...
November 2015: British Journal of Ophthalmology
Zheng Li, R Rand Allingham, Masakazu Nakano, Liyun Jia, Yuhong Chen, Yoko Ikeda, Baskaran Mani, Li-Jia Chen, Changwon Kee, David F Garway-Heath, Sarangapani Sripriya, Nobuo Fuse, Khaled K Abu-Amero, Chukai Huang, Prasanthi Namburi, Kathryn Burdon, Shamira A Perera, Puya Gharahkhani, Ying Lin, Morio Ueno, Mineo Ozaki, Takanori Mizoguchi, Subbiah Ramasamy Krishnadas, Essam A Osman, Mei Chin Lee, Anita S Y Chan, Liza-Sharmini A Tajudin, Tan Do, Aurelien Goncalves, Pascal Reynier, Hong Zhang, Rupert Bourne, David Goh, David Broadway, Rahat Husain, Anil K Negi, Daniel H Su, Ching-Lin Ho, Augusto Azuara Blanco, Christopher K S Leung, Tina T Wong, Azhany Yakub, Yutao Liu, Monisha E Nongpiur, Jong Chul Han, Do Nhu Hon, Balekudaru Shantha, Bowen Zhao, Jinghong Sang, NiHong Zhang, Ryuichi Sato, Kengo Yoshii, Songhomita Panda-Jonas, Allison E Ashley Koch, Leon W Herndon, Sayoko E Moroi, Pratap Challa, Jia Nee Foo, Jin-Xin Bei, Yi-Xin Zeng, Cameron P Simmons, Tran Nguyen Bich Chau, Philomenadin Ferdinamarie Sharmila, Merwyn Chew, Blanche Lim, Pansy O S Tam, Elaine Chua, Xiao Yu Ng, Victor H K Yong, Yaan Fun Chong, Wee Yang Meah, Saravanan Vijayan, Sohn Seongsoo, Wang Xu, Yik Ying Teo, Jessica N Cooke Bailey, Jae H Kang, Jonathan L Haines, Ching Yu Cheng, Seang-Mei Saw, E-Shyong Tai, Julia E Richards, Robert Ritch, Douglas E Gaasterland, Louis R Pasquale, Jianjun Liu, Jost B Jonas, Dan Milea, Ronnie George, Saleh A Al-Obeidan, Kazuhiko Mori, Stuart Macgregor, Alex W Hewitt, Christopher A Girkin, Mingzhi Zhang, Periasamy Sundaresan, Lingam Vijaya, David A Mackey, Tien Yin Wong, Jamie E Craig, Xinghuai Sun, Shigeru Kinoshita, Janey L Wiggs, Chiea-Chuen Khor, Zhenglin Yang, Chi Pui Pang, Ningli Wang, Michael A Hauser, Kei Tashiro, Tin Aung, Eranga N Vithana
Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array (Illumina) analysis on 3504 POAG cases and 9746 controls with replication of the most significant findings in 9173 POAG cases and 26 780 controls across 18 collections of Asian, African and European descent. Apart from confirming strong evidence of association at CDKN2B-AS1 (rs2157719 [G], odds ratio [OR] = 0.71, P = 2.81 × 10(-33)), we observed one SNP showing significant association to POAG (CDC7-TGFBR3 rs1192415, ORG-allele = 1...
July 1, 2015: Human Molecular Genetics
David F Garway-Heath, David P Crabb, Catey Bunce, Gerassimos Lascaratos, Francesca Amalfitano, Nitin Anand, Augusto Azuara-Blanco, Rupert R Bourne, David C Broadway, Ian A Cunliffe, Jeremy P Diamond, Scott G Fraser, Tuan A Ho, Keith R Martin, Andrew I McNaught, Anil Negi, Krishna Patel, Richard A Russell, Ameet Shah, Paul G Spry, Katsuyoshi Suzuki, Edward T White, Richard P Wormald, Wen Xing, Thierry G Zeyen
BACKGROUND: Treatments for open-angle glaucoma aim to prevent vision loss through lowering of intraocular pressure, but to our knowledge no placebo-controlled trials have assessed visual function preservation, and the observation periods of previous (unmasked) trials have typically been at least 5 years. We assessed vision preservation in patients given latanoprost compared with those given placebo. METHODS: In this randomised, triple-masked, placebo-controlled trial, we enrolled patients with newly diagnosed open-angle glaucoma at ten UK centres (tertiary referral centres, teaching hospitals, and district general hospitals)...
April 4, 2015: Lancet
Mayret M Castillo, Graham Mowatt, Andrew Elders, Noemi Lois, Cynthia Fraser, Rodolfo Hernández, Winfried Amoaku, Jennifer M Burr, Andrew Lotery, Craig R Ramsay, Augusto Azuara-Blanco
TOPIC: To compare the accuracy of optical coherence tomography (OCT) with alternative tests for monitoring neovascular age-related macular degeneration (nAMD) and detecting disease activity among eyes previously treated for this condition. CLINICAL RELEVANCE: Traditionally, fundus fluorescein angiography (FFA) has been considered the reference standard to detect nAMD activity, but FFA is costly and invasive. Replacement of FFA by OCT can be justified if there is a substantial agreement between tests...
February 2015: Ophthalmology
Graham Mowatt, Rodolfo Hernández, Mayret Castillo, Noemi Lois, Andrew Elders, Cynthia Fraser, Olatunde Aremu, Winfried Amoaku, Jennifer Burr, Andrew Lotery, Craig Ramsay, Augusto Azuara-Blanco
BACKGROUND: Age-related macular degeneration is the most common cause of sight impairment in the UK. In neovascular age-related macular degeneration (nAMD), vision worsens rapidly (over weeks) due to abnormal blood vessels developing that leak fluid and blood at the macula. OBJECTIVES: To determine the optimal role of optical coherence tomography (OCT) in diagnosing people newly presenting with suspected nAMD and monitoring those previously diagnosed with the disease...
December 2014: Health Technology Assessment: HTA
M M Castillo, G Mowatt, N Lois, A Elders, C Fraser, W Amoaku, J M Burr, A J Lotery, C R Ramsay, A Azuara-Blanco
UNLABELLED: The purpose is to study the diagnostic performance of optical coherence tomography (OCT) and alternative diagnostic tests for neovascular age-related macular degeneration (nAMD). Methods employed are as follows:systematic review and meta-analysis; INDEX TEST: OCT including time-domain (TD-OCT) and the most recently developed spectral domain (SD-OCT); comparator tests: visual acuity, clinical evaluation (slit lamp), Amsler chart, colour fundus photographs, infra-red reflectance, red-free images/blue reflectance, fundus autofluorescence imaging (FAF), indocyanine green angiography (ICGA), preferential hyperacuity perimetry (PHP), and microperimetry; reference standard: fundus fluorescein angiography...
December 2014: Eye
A Kotecha, S Turner, C Vasilakis, M Utley, N Fulop, A Azuara-Blanco, P J Foster
No abstract text is available yet for this article.
July 2014: Eye
Rehab Ismail, Augusto Azuara-Blanco, Craig R Ramsay
PURPOSE: In randomised clinical trials (RCTs) the selection of appropriate outcomes is crucial to the assessment of whether one intervention is better than another. The purpose of this review is to identify different clinical outcomes reported in glaucoma trials. METHODS: We conducted a systematic review of glaucoma RCTs. A sample or selection of glaucoma trials were included bounded by a time frame (between 2006 and March 2012). Only studies in English language were considered...
April 2014: British Journal of Ophthalmology
Yemisi Takwoingi, Adriana P Botello, Jennifer M Burr, Augusto Azuara-Blanco, David F Garway-Heath, Hans G Lemij, Roshini Sanders, Anthony J King, Jonathan J Deeks
AIMS: To independently evaluate and compare the performance of the Ocular Hypertension Treatment Study-European Glaucoma Prevention Study (OHTS-EGPS) prediction equation for estimating the 5-year risk of open-angle glaucoma (OAG) in four cohorts of adults with ocular hypertension. METHODS: Data from two randomised controlled trials and two observational studies were analysed individually to assess transferability of the prediction equation between different geographical locations and settings...
March 2014: British Journal of Ophthalmology
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