11 results on '"Haralabos Eleftheriadis"'
Search Results
2. Standard threshold laser versus subthreshold micropulse laser for adults with diabetic macular oedema: the DIAMONDS non-inferiority RCT
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Noemi Lois, Christina Campbell, Norman Waugh, Augusto Azuara-Blanco, Mandy Maredza, Hema Mistry, Danny McAuley, Nachiketa Acharya, Tariq M Aslam, Clare Bailey, Victor Chong, Louise Downey, Haralabos Eleftheriadis, Samia Fatum, Sheena George, Faruque Ghanchi, Markus Groppe, Robin Hamilton, Geeta Menon, Ahmed Saad, Sobha Sivaprasad, Marianne Shiew, David H Steel, James Stephen Talks, Paul Doherty, Clíona McDowell, and Mike Clarke
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diabetic macular edema ,dme ,diabetic macular oedema ,dmo ,diabetes ,laser ,micropulse ,subthreshold laser ,photocoagulation ,randomised clinical trial ,rct ,vascular endothelial growth factor ,vegf ,anti-vegfs ,ranibizumab ,aflibercept ,bevacizumab ,steroids ,cost-effectiveness ,eq5d-5l ,eq5d ,visqol ,nei vfq25 ,qol ,quality of life ,Medical technology ,R855-855.5 - Abstract
Background: The National Institute for Health and Care Excellence recommends macular laser to treat diabetic macular oedema with a central retinal subfield thickness of 24 Early Treatment Diabetic Retinopathy Study letters (Snellen equivalent > 20/320) in one/both eyes. Interventions: Participants were randomised 1 : 1 to receive 577 nm subthreshold micropulse laser or standard threshold macular laser (e.g. argon laser, frequency-doubled neodymium-doped yttrium aluminium garnet 532 nm laser); laser treatments could be repeated as needed. Rescue therapy with intravitreal anti-vascular endothelial growth factor therapies or steroids was allowed if a loss of ≥ 10 Early Treatment Diabetic Retinopathy Study letters between visits occurred and/or central retinal subfield thickness increased to > 400 µm. Main outcome measures: The primary outcome was the mean change in best-corrected visual acuity in the study eye at 24 months (non-inferiority margin 5 Early Treatment Diabetic Retinopathy Study letters). Secondary outcomes included the mean change from baseline to 24 months in the following: binocular best-corrected visual acuity; central retinal subfield thickness; the mean deviation of the Humphrey 10–2 visual field in the study eye; the percentage of people meeting driving standards; and the EuroQol-5 Dimensions, five-level version, National Eye Institute Visual Function Questionnaire – 25 and Vision and Quality of Life Index scores. Other secondary outcomes were the cost per quality-adjusted life-years gained, adverse effects, number of laser treatments and additional rescue treatments. Results: The DIAMONDS trial recruited fully (n = 266); 87% of participants in the subthreshold micropulse laser group and 86% of participants in the standard threshold macular laser group had primary outcome data. Groups were balanced regarding baseline characteristics. Mean best-corrected visual acuity change in the study eye from baseline to month 24 was –2.43 letters (standard deviation 8.20 letters) in the subthreshold micropulse laser group and –0.45 letters (standard deviation 6.72 letters) in the standard threshold macular laser group. Subthreshold micropulse laser was deemed to be not only non-inferior but also equivalent to standard threshold macular laser as the 95% confidence interval (–3.9 to –0.04 letters) lay wholly within both the upper and lower margins of the permitted maximum difference (5 Early Treatment Diabetic Retinopathy Study letters). There was no statistically significant difference between groups in any of the secondary outcomes investigated with the exception of the number of laser treatments performed, which was slightly higher in the subthreshold micropulse laser group (mean difference 0.48, 95% confidence interval 0.18 to 0.79; p = 0.002). Base-case analysis indicated no significant difference in the cost per quality-adjusted life-years between groups. Future work: A trial in people with ≥ 400 µm diabetic macular oedema comparing anti-vascular endothelial growth factor therapy alone with anti-vascular endothelial growth factor therapy and macular laser applied at the time when central retinal subfield thickness has decreased to
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- 2022
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3. Estimating excess visual loss from neovascular age-related macular degeneration in the UK during the COVID-19 pandemic: a retrospective clinical audit and simulation model
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Anthony Khawaja, Andrew Lotery, Adnan Tufail, Paul Taylor, Philipp L Müller, Sudeshna Patra, R Khan, E Wilkinson, B Paul, Haralabos Eleftheriadis, Robin Hamilton, S George, V Kumar, R Mukherjee, C Jones, Abraham Olvera-Barrios, Catherine Egan, Roy Schwartz, C Brand, H Palmer, Alasdair Warwick, C Bailey, U Chakravarthy, F Ghanchi, S Mahmood, A Davis, L Downey, G Menon, N Dhingra, R Antcliff, A Lobo, A Patwardhan, T Akerele, Darren S Thomas, Ella Preston, P Lip, S Natha, and J Talks
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Medicine - Abstract
Objectives To report the reduction in new neovascular age-related macular degeneration (nAMD) referrals during the COVID-19 pandemic and estimate the impact of delayed treatment on visual outcomes at 1 year.Design Retrospective clinical audit and simulation model.Setting Multiple UK National Health Service (NHS) ophthalmology centres.Participants Data on the reduction in new nAMD referrals were obtained from four NHS Trusts comparing April 2020 with April 2019. To estimate the potential impact on 1-year visual outcomes, a stratified bootstrap simulation model was developed drawing on an electronic medical records dataset of 20 825 nAMD eyes from 27 NHS Trusts.Main outcome measures Simulated mean visual acuity and proportions of eyes with vision ≤6/60, ≤6/24 and ≥6/12 at 1 year under four hypothetical scenarios: 0-month, 3-month, 6-month and 9-month treatment delays. Estimated additional number of eyes with vision ≤6/60 at 1 year nationally.Results The number of nAMD referrals dropped on average by 72% (range 65%–87%). Simulated 1-year visual outcomes for 1000 nAMD eyes with a 3-month treatment delay suggested an increase in the proportion of eyes with vision ≤6/60 from 15.5% (13.2%–17.9%) to 23.3% (20.7%–25.9%), and a decrease in the proportion of eyes with vision ≥6/12 (driving vision) from 35.1% (32.1%–38.1%) to 26.4% (23.8%–29.2%). Outcomes worsened incrementally with longer modelled delays. Assuming nAMD referrals are reduced to this level for 1 month nationally, these simulated results suggest an additional 186–365 eyes with vision ≤6/60 at 1 year.Conclusions We report a large decrease in nAMD referrals during the COVID-19 lockdown and provide an important public health message regarding the risk of delayed treatment. As a conservative estimate, a treatment delay of 3 months could lead to a >50% relative increase in the number of eyes with vision ≤6/60 and 25% relative decrease in the number of eyes with driving vision at 1 year.
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- 2022
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4. Diabetic macular oedema and diode subthreshold micropulse laser (DIAMONDS): study protocol for a randomised controlled trial
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Noemi Lois, Evie Gardner, Norman Waugh, Augusto Azuara-Blanco, Hema Mistry, Danny McAuley, Nachiketa Acharya, Tariq M. Aslam, Clare Bailey, Victor Chong, Louise Downey, Haralabos Eleftheriadis, Samia Fatum, Sheena George, Faruque Ghanchi, Markus Groppe, Robin Hamilton, Geeta Menon, Ahmed Saad, Sobha Sivaprasad, Marianne Shiew, David H. Steel, James Stephen Talks, Catherine Adams, Christina Campbell, Matthew Mills, Mike Clarke, and On behalf of the DIAMONDS Study Group
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Diabetes ,Oedema ,Edema ,DMO ,DME ,Laser ,Medicine (General) ,R5-920 - Abstract
Abstract Background In the UK, macular laser is the treatment of choice for people with diabetic macular oedema with central retinal subfield thickness (CST)
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- 2019
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5. Evaluation of a New Model of Care for People with Complications of Diabetic Retinopathy
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Noemi Lois, Jonathan A. Cook, Ariel Wang, Stephen Aldington, Hema Mistry, Mandy Maredza, Danny McAuley, Tariq Aslam, Clare Bailey, Victor Chong, Faruque Ganchi, Peter Scanlon, Sobha Sivaprasad, David H. Steel, Caroline Styles, Augusto Azuara-Blanco, Lindsay Prior, Norman Waugh, Ahmed Saad, Daniela Vaideanu-Collins, Christine McNally, Andrew Jackson, Rachael Rice, Clair Barbour, Leontia Bell, Faruque D. Ghanchi, Zeid Madanat, Geeta Menon, Manju Chandran, Sely Mathews, Mohammed Galal, Haralabos Eleftheriadis, Stefanos Efraimidis, Jonathan Cook, William Sones, Nachiketa Acharya, Samia Fatum, Janette Savage, Peter H. Scanlon, Katerina Ivanova, Tariq M. Aslam, and Zaria Ali
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Male ,PPI, patient and public involvement ,DME, diabetic macular edema ,Allied Health Personnel ,SD, spectral-domain ,Fundus (eye) ,Multimodal Imaging ,Prospective Studies ,Ophthalmic graders ,UWF, ultra-widefield ,Ophthalmologists ,Follow-up ,Diabetes ,Standard of Care ,Health Care Costs ,Diabetic retinopathy ,Middle Aged ,VEGF, vascular endothelial growth factor ,Critical Pathways ,Spectral-domain OCT ,Female ,Original Article ,EMERALD, Effectiveness of Multimodal Imaging for the Evaluation of Retinal Oedema and New Vessels in Diabetic Retinopathy ,Early Treatment Diabetic Retinopathy Study ,Tomography, Optical Coherence ,Retinopathy ,Adult ,medicine.medical_specialty ,Adolescent ,7-Field ETDRS images ,PDR, proliferative diabetic retinopathy ,ETDRS, Early Treatment Diabetic Retinopathy Study ,NHS, National Health Service ,PRP, panretinal photocoagulation ,Sensitivity and Specificity ,Macular Edema ,Young Adult ,Ophthalmic photographers ,PDR ,Internal medicine ,Diabetes mellitus ,medicine ,DME ,Humans ,In patient ,Ultra-widefield images ,Multimodal imaging ,Diabetic Retinopathy ,business.industry ,Diabetes prevalence ,medicine.disease ,Confidence interval ,eye diseases ,CI, confidence interval ,Ophthalmology ,Cross-Sectional Studies ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,business ,Delivery of Health Care ,Pathway - Abstract
Purpose The increasing diabetes prevalence and advent of new treatments for its major visual-threatening complications (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]), which require frequent life-long follow-up, have increased hospital demands markedly. Subsequent delays in patient's evaluation and treatment are causing sight loss. Strategies to increase capacity are needed urgently. The retinopathy (EMERALD) study tested diagnostic accuracy, acceptability, and costs of a new health care pathway for people with previously treated DME or PDR. Design Prospective, multicenter, case-referent, cross-sectional, diagnostic accuracy study undertaken in 13 hospitals in the United Kingdom. Participants Adults with type 1 or 2 diabetes previously successfully treated DME or PDR who, at the time of enrollment, had active or inactive disease. Methods A new health care pathway entailing multimodal imaging (spectral-domain OCT for DME, and 7-field Early Treatment Diabetic Retinopathy Study [ETDRS] and ultra-widefield [UWF] fundus images for PDR) interpreted by trained nonmedical staff (ophthalmic graders) to detect reactivation of disease was compared with the current standard care (face-to-face examination by ophthalmologists). Main Outcome Measures Primary outcome: sensitivity of the new pathway. Secondary outcomes: specificity; agreement between pathways; costs; acceptability; proportions requiring subsequent ophthalmologist assessment, unable to undergo imaging, and with inadequate images or indeterminate findings. Results The new pathway showed sensitivity of 97% (95% confidence interval [CI], 92%–99%) and specificity of 31% (95% CI, 23%–40%) to detect DME. For PDR, sensitivity and specificity using 7-field ETDRS images (85% [95% CI, 77%–91%] and 48% [95% CI, 41%–56%], respectively) or UWF images (83% [95% CI, 75%–89%] and 54% [95% CI, 46%–61%], respectively) were comparable. For detection of high-risk PDR, sensitivity and specificity were higher when using UWF images (87% [95% CI, 78%–93%] and 49% [95% CI, 42%–56%], respectively, for UWF versus 80% [95% CI, 69–88%] and 40% [95% CI, 34%–47%], respectively, for 7-field ETDRS images). Participants preferred ophthalmologists’ assessments; in their absence, they preferred immediate feedback by graders, maintaining periodic ophthalmologist evaluations. When compared with the current standard of care, the new pathway could save £1390 per 100 DME visits and between £461 and £1189 per 100 PDR visits. Conclusions The new pathway has acceptable sensitivity and would release resources. Users’ suggestions should guide implementation.
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- 2021
6. Estimating excess visual loss in people with neovascular age-related macular degeneration during the COVID-19 pandemic
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Sudeshna Patra, Catherine A Egan, Darren S. Thomas, Abraham Olvera-Barrios, Haralabos Eleftheriadis, Anthony P Khawaja, Andrew J. Lotery, Ella Preston, Alasdair Warwick, Paul Taylor, Roy Schwartz, Robin Hamilton, Adnan Tufail, and Philipp L. Mueller
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Clinical audit ,Visual acuity ,Coronavirus disease 2019 (COVID-19) ,genetic structures ,business.industry ,Medical record ,Macular degeneration ,medicine.disease ,eye diseases ,Age related ,Pandemic ,medicine ,Optometry ,National level ,medicine.symptom ,business - Abstract
ObjectivesTo report the reduction in new neovascular age-related macular degeneration (nAMD) referrals during the COVID-19 pandemic and estimate the impact of delayed treatment on visual outcomes at one year.DesignRetrospective clinical audit and simulation model.SettingMultiple UK NHS ophthalmology centres.ParticipantsData on the reduction in new nAMD referrals was obtained from four NHS Trusts in England comparing April 2020 to April 2019. To estimate the potential impact on one-year visual outcomes, a stratified bootstrap simulation model was developed drawing on an electronic medical records dataset of 20,825 nAMD eyes from 27 NHS Trusts.Main outcome measuresSimulated mean visual acuity and proportions of eyes with vision ≤6/60, ≤6/24 and ≥6/12 at one year under four hypothetical scenarios: no treatment delay, 3, 6 and 9-month treatment delays. Estimated additional number of eyes with vision ≤6/60 at one year nationally.ResultsThe number of nAMD referrals at four major eye treatment hospital groups based in England dropped on average by 72% (range 65 to 87%) in April 2020 compared to April 2019. Simulated one-year visual outcomes for 1000 nAMD eyes with a 3-month treatment delay suggested an increase in the proportion of eyes with vision ≤6/60 from 15.5% (13.2 to 17.9) to 23.3% (20.7 to25.9), and a decrease in the proportion of eyes with vision ≥6/12 (driving vision) from 35.1% (32.1 to 38.1) to 26.4% (23.8 to29.2). Outcomes worsened incrementally with longer modelled delays. Assuming nAMD referrals are reduced to this level at the national level for only one month, these simulated results suggest an additional 186-365 eyes with vision ≤6/60 at one-year with even a short treatment delay.ConclusionsWe report a large decrease in nAMD referrals during the first month of COVID-19 lockdown and provide an important public health message regarding the risk of delayed treatment. As a conservative estimate, a treatment delay of 3 months could lead to a >50% relative increase in the number of eyes with vision ≤6/60 and 25% relative decrease in the number of eyes with driving vision at one year.
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- 2020
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7. Anatomical and functional outcomes following switching from aflibercept to ranibizumab in neovascular age-related macular degeneration in Europe: SAFARI study
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David Gilmour, Ian Pearce, Deepali Varma, Konstantinos Balaskas, Susan M. Downes, Faruque Ghanchi, Franklin Igwe, Frank G. Holz, Haralabos Eleftheriadis, Nishal Patel, C Santiago, Robin Hamilton, Steffen Schmitz-Valckenberg, Richard Gale, Priya Prakash, Saju Thomas, Andrew J. Lotery, Filis Ayan, Ben J L Burton, Michael Williams, Armin Wolf, Nicole Eter, Rosina H Zakri, Sheena George, and Gavin Walters
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Male ,Vascular Endothelial Growth Factor A ,Visual acuity ,genetic structures ,Visual Acuity ,degeneration ,Angiogenesis Inhibitors ,neovascularisation ,0302 clinical medicine ,Pro re nata ,Germany ,Clinical endpoint ,Single-Blind Method ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Aflibercept ,Aged, 80 and over ,education.field_of_study ,Drug Substitution ,imaging ,clinical trial ,Middle Aged ,Clinical Science ,Sensory Systems ,Intravitreal Injections ,Female ,medicine.symptom ,medicine.drug ,medicine.medical_specialty ,Recombinant Fusion Proteins ,Population ,Retina ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,SDG 3 - Good Health and Well-being ,Ophthalmology ,Ranibizumab ,medicine ,Humans ,macula ,education ,Aged ,business.industry ,Macular degeneration ,medicine.disease ,Choroidal Neovascularization ,United Kingdom ,Receptors, Vascular Endothelial Growth Factor ,030221 ophthalmology & optometry ,Wet Macular Degeneration ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Background/AimsProspective data on switching anti-vascular endothelial growth factors in patients with neovascular age-related macular degeneration (nAMD) who have previously shown no/partial response are limited. This prospective study assessed the effect of switching from aflibercept to ranibizumab on anatomical and functional outcomes in patients with persistent/recurrent disease activity.MethodsSAFARI (NCT02161575) was a 6-month, prospective, single-arm study conducted in the UK and Germany. Patients, meeting strict eligibility criteria for one of two subgroups (primary treatment failure or suboptimal treatment response), received 3 monthly intravitreal ranibizumab injections (0.5 mg). Thereafter, ranibizumab was administered pro re nata at monthly visits. The primary endpoint was change from baseline (CfB) to day 90 in central subfield retinal thickness (CSRT). Best-corrected visual acuity (BCVA) and retinal morphology parameters were assessed.ResultsOne hundred patients were enrolled (primary treatment failure, 1; suboptimal treatment response, 99). In the overall population, there was a significant CfB in median CSRT of −30.75 µm (95% CI −59.50,–20.50; pConclusionSwitching from aflibercept to ranibizumab led to a significant improvement in CSRT, with ~60% experiencing stabilised/improved BCVA. Therefore, patients with nAMD who have shown a suboptimal response to aflibercept may benefit from switching to ranibizumab.
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- 2019
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8. Clinical efficacy and safety of a light mask for prevention of dark adaptation in treating and preventing progression of early diabetic macular oedema at 24 months (CLEOPATRA): a multicentre, phase 3, randomised controlled trial
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Randhir Chavan, S J Aldington, Arevik Ghulakhszian, Roxanne Crosby-Nwaobi, Richard D. Smith, Priya Prakash, Edward Hughes, Geoffrey B. Arden, Debendra N. Sahu, Sarah Walker, Alaistair Denniston, Jackie Sturt, Nirodhini Narendran, Nisha Shah, Abosede Cole, Sobha Sivaprasad, Haralabos Eleftheriadis, Joanna Kelly, Peter H Scanlon, Afsar Jafree, Sheena George, Tatiana Mansour, S Chave, A Dale, Tunde Peto, Namritha Patrao, A Toby Prevost, Ajay Bhatnagar, Joana C. Vasconcelos, Philip Hykin, Douglas Lewin, Gary S. Rubin, Chris Hogg, Caroline Murphy, Gilli Vafidis, Maria Sandinha, Frank Ahfat, Geeta Menon, David P. Crabb, Catherine A Egan, Gillian Hood, Joanathan Gibson, Graham A. Hitman, Ian Grierson, Helen Holmes, Deepthy Menon, Lauren Leitch-Devlin, and National Institute for Health Research
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Male ,Endocrinology, Diabetes and Metabolism ,THERAPY ,law.invention ,0302 clinical medicine ,Endocrinology ,Randomized controlled trial ,law ,SCALE ,Sleep disorder ,Diabetic retinopathy ,Middle Aged ,INTENTION ,Editorial ,Treatment Outcome ,Disease Progression ,Female ,Life Sciences & Biomedicine ,Tomography, Optical Coherence ,medicine.medical_specialty ,Dark Adaptation ,Minimisation (clinical trials) ,Article ,Macular Edema ,Retina ,03 medical and health sciences ,Endocrinology & Metabolism ,SDG 3 - Good Health and Well-being ,Ophthalmology ,Internal Medicine ,medicine ,Journal Article ,Humans ,Adverse effect ,Macular edema ,CLEOPATRA Study Group ,Aged ,Science & Technology ,Diabetic Retinopathy ,business.industry ,Phototherapy ,medicine.disease ,Clinical trial ,Diabetic macular oedema ,030221 ophthalmology & optometry ,RE ,business ,030217 neurology & neurosurgery ,RC - Abstract
BACKGROUND: We aimed to assess 24-month outcomes of wearing an organic light-emitting sleep mask as an intervention to treat and prevent progression of non-central diabetic macular oedema.METHODS: CLEOPATRA was a phase 3, single-blind, parallel-group, randomised controlled trial undertaken at 15 ophthalmic centres in the UK. Adults with non-centre-involving diabetic macular oedema were randomly assigned (1:1) to wearing either a light mask during sleep (Noctura 400 Sleep Mask, PolyPhotonix Medical, Sedgefield, UK) or a sham (non-light) mask, for 24 months. Randomisation was by minimisation generated by a central web-based computer system. Outcome assessors were masked technicians and optometrists. The primary outcome was the change in maximum retinal thickness on optical coherence tomography (OCT) at 24 months, analysed using a linear mixed-effects model incorporating 4-monthly measurements and baseline adjustment. Analysis was done using the intention-to-treat principle in all randomised patients with OCT data. Safety was assessed in all patients. This trial is registered with Controlled-Trials.com, number ISRCTN85596558.FINDINGS: Between April 10, 2014, and June 15, 2015, 308 patients were randomly assigned to wearing the light mask (n=155) or a sham mask (n=153). 277 patients (144 assigned the light mask and 133 the sham mask) contributed to the mixed-effects model over time, including 246 patients with OCT data at 24 months. The change in maximum retinal thickness at 24 months did not differ between treatment groups (mean change -9·2 μm [SE 2·5] for the light mask vs -12·9 μm [SE 2·9] for the sham mask; adjusted mean difference -0·65 μm, 95% CI -6·90 to 5·59; p=0·84). Median compliance with wearing the light mask at 24 months was 19·5% (IQR 1·9-51·6). No serious adverse events were related to either mask. The most frequent adverse events related to the assigned treatment were discomfort on the eyes (14 with the light mask vs seven with the sham mask), painful, sticky, or watery eyes (14 vs six), and sleep disturbance (seven vs one).INTERPRETATION: The light mask as used in this study did not confer long-term therapeutic benefit on non-centre-involving diabetic macular oedema and the study does not support its use for this indication.FUNDING: The Efficacy and Mechanism Evaluation Programme, a Medical Research Council and National Institute for Health Research partnership.
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- 2018
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9. Model for risk-based screening of diabetic retinopathy in people with newly-diagnosed type 2 diabetes mellitus
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Haralabos Eleftheriadis, Khalida Ismail, Sobha Sivaprasad, Kirsty Winkley, Stephanie A. Amiel, Irini Chatziralli, Roxanne Crosby-Nwaobi, and Theodoros N. Sergentanis
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Male ,medicine.medical_specialty ,Population ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Albuminuria ,Humans ,Mass Screening ,education ,Inflammatory ,Aged ,Glycated Hemoglobin ,Univariate analysis ,education.field_of_study ,Diabetic Retinopathy ,medicine.diagnostic_test ,Adiponectin ,Tumor Necrosis Factor-alpha ,business.industry ,Interleukins ,Diabetes ,Type 2 Diabetes Mellitus ,Diabetic retinopathy ,Middle Aged ,Lipid ,medicine.disease ,Lipids ,Logistic Models ,Diabetes Mellitus, Type 2 ,Risk factors ,Cohort ,Immunology ,030221 ophthalmology & optometry ,Female ,Lipid profile ,business ,Biomarkers ,Model - Abstract
Purpose: The purpose of this study was to evaluate the role of inflammatory/lipid markers and potential risk factors for diabetic retinopathy (DR) development in newly diagnosed patients with type 2 diabetes mellitus (T2DM). Methods: Participants in this study were 1062 patients with newly diagnosed T2DM. Demographic and clinical data of patients were collected. Assessment of DR status was performed using digital two-field photography. In addition, HbA1c (%), lipid profile, and urinary albumin were measured at recruitment. The following inflammatory markers were also measured: serum C-reactive protein, white blood cells, platelet, adiponectin, IL-4, IL-6, IL-10, vascular endothelial growth factor, tumor necrosis factor-a (TNF-a), IL-1b, IL-1 receptor antagonist (IL-1RA), and monocyte chemotactic protein-1. Univariate and multivariate analyses of the association of various potential risk factors and DR were conducted.Results: Univariate analysis showed that male sex, any cardiovascular event, and HbA1c were positively associated with DR, while IL-1RA, IL-1b, IL-6, and TNF-a were significantly negatively associated with presence of DR in the cohort. Risk factors that remained significantly associated with DR presence at the multivariate analysis were male sex, any cardiovascular event, HbA1c, and IL-1RA. Conclusions: Our study demonstrated that HbA1c levels, male sex, and previous cardiovascular events were risk factors for presence of DR in people with newly diagnosed T2DM, while IL-1RA seemed to have a protective role. The prevalence of DR in our population was 20.2%, reflecting current practice. Our findings may contribute to future risk-based modelling of screening for DR.
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- 2017
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10. Intravitreal aflibercept (A-IVI) for the treatment of neovascular age-related macular degeneration (nv-AMD): one year experience
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Evangelia Papavasileiou, Zygoura, V., Richardson, T., Cortis, D., Haralabos Eleftheriadis, and Timothy Jackson
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genetic structures ,sense organs ,eye diseases - Abstract
OBJECTIVE: To report the anatomical and functional results of intravitreal injections of aflibercept (Eylea) (A-IVI) for the treatment of naïve eyes with neovascular age-related macular degeneration (nv-AMD). SUBJECTS AND METHODS: This retrospective, one-center, non-comparative chart review included 26 treatment naïve eyes with nv-AMD of 26 patients (14 male) with a mean age of 80.5 (range 63-91) who had a complete follow-up of 14 months. The morphological analysis included spectral domain optical coherence tomography and fundus fluorescein angiography, while the functional assessment included logarithm of the minimum angle of resolution (LogMAR) best correct visual acuity (BCVA). The timing of the follow-up was: baseline, 3, 6, and 14 months. All patients received 8 A-IVI according to the protocol (first 3 consecutive monthly A-IVI, followed by bi-monthly retreatment for the first year, regardless of disease activity as per local guidelines). Statistical analysis was performed using ANOVA. Improvement of visual acuity more than 15 letters was considered as "improvement", less than 5 letters as "stable" and any letter loss as "worsening". RESULTS: Mean±standard deviation LogMAR visual acuity improved from 0.26±0.15 at presentation to 0.14±0.20 at the final follow-up of 14 months (P=0.02). BCVA was stable in 23.1%, improved in 61.5% (16 eyes) worsened in 15.4%. A mean pretreatment central macular thickness of 409μm reduced significantly to 229μm at month 14 (P
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- 2015
11. Primary polypseudophakia for cataract surgery in hypermetropic eyes: refractive results and long term stability of the implants within the capsular bag
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Christopher C. Hull, Haralabos Eleftheriadis, André R Ismail, Christopher Liu, and Andrea Sciscio
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Male ,Refractive error ,medicine.medical_specialty ,Visual acuity ,Biometry ,genetic structures ,Eye disease ,medicine.medical_treatment ,Visual Acuity ,Intraocular lens ,Cataract Extraction ,Refraction, Ocular ,Cataract ,Vision disorder ,Cellular and Molecular Neuroscience ,Lens Implantation, Intraocular ,Ophthalmology ,medicine ,Humans ,Prospective Studies ,Aged ,Ultrasonography ,Aged, 80 and over ,business.industry ,Phacoemulsification ,Cataract surgery ,Middle Aged ,medicine.disease ,Original articles - Clinical science ,Sensory Systems ,eye diseases ,Surgery ,Hyperopia ,Treatment Outcome ,Optic nerve ,Female ,sense organs ,medicine.symptom ,business - Abstract
Aim—To determine the long term visual and refractive results, and stability and complications of primary polypseudophakia using poly(methylmethacrylate) (PMMA) intraocular lenses (IOLs) for cataract surgery in hypermetropic eyes. Methods—Prospective study of 15 short or hypermetropic eyes undergoing phacoemulsification with primary polypseudophakia with two PMMA IOLs implanted within the capsular bag. Results—The spherical equivalent was reduced from a mean +4.87 (SD 3.00) dioptres (D) to ˛0.12 (1.40 D), and the deviation from the intended refraction was +0.005 (1.30) D, 23.6 (12.36) months post-implantation. The deviation from intended refraction was not statistically significant (p = 0.989; paired t test). Postoperative best corrected visual acuity (BCVA) was 6/12 or better in all eyes without macular or optic nerve co-morbidity. Interlenticular opacification (ILO) in the form of peripheral Elschnig pearls was seen in four (26.67%) eyes. A new type of ILO in the form of usually pigmented deposits in the central interface developed in five (33.33%) eyes and resulted in the appearance of Newton’s rings in three. None of the eyes with ILO had any loss of BCVA or hyperopic shift. Six (40%) eyes were within 1 D from the intended refraction and 14 (93.33%) within 2 D. There was no statistically significant diVerence in the accuracy of the two intraocular lens calculation formulas used (SRK II and SRK/T). Conclusion—Peripheral Elschnig pearltype ILO can occur as a late complication of primary in the bag implantation of two PMMA IOLs. A new type of ILO is described. Both types of ILO have not to date resulted in deterioration of visual acuity in our cohort. Use of appropriate biometry techniques and IOL calculation formulas may yield more accurate refractive results. (Br J Ophthalmol 2001;85:1198‐1202)
- Published
- 2001
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