4 results on '"Stanford, Miles"'
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2. Ocular features of Behçet's disease: An international collaborative study.
- Author
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Kitaichi, Nobuyoshi, Miyazaki, Akiko, Stanford, Miles R., Chams, Hormoz, Iwata, Daiju, and Ohno, Shigeaki
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HEALTH surveys , *VISION disorders , *VISUAL acuity , *MEDICAL care , *MEDICAL research - Abstract
Objective: To investigate the clinical features of ocular lesions in Behçet's disease in different countries. Methods: A descriptive questionnaire survey was performed. Results: 25 eye centres in 14 countries returned questionnaires on prevalent cases in 2006. Clinical data were analysed on 1,465 patients with ocular lesions. Recurrent oral aphthous ulcers were reported in 94.5%, skin lesions in 69.5% and genital ulcers in 61.4%. Most of the patients had bilateral and recurrent intraocular inflammation. Poor visual acuity was seen in 18.9% in women, but 24.8% in men (p<0.01). Panuveitis was seen more in men than in women (p<0.01). 23% of the patients had visual acuity equal to or worse than 20/200 at the final visit. The patients with poor vision were more frequently in India, Iran and Japan than in other countries (p<0.01). Conclusions: We report the largest contemporary international case series of patients with ocular involvement in Behçet's disease. Panuveitis was significantly more frequent in men than women, and men tended to have a worse visual prognosis. There were some differences in the clinical pattern of Behçet's disease in different countries. Despite modern treatment, the disease still carries a poor visual prognosis with one-quarter of the patients blind. [ABSTRACT FROM AUTHOR]
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- 2007
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3. Risk of Visual Impairment in Children with Congenital Toxoplasmic Retinochoroiditis
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Tan, Hooi Kuan, Schmidt, Dorthe, Stanford, Miles, Teär-Fahnehjelm, Kristina, Ferret, Nicole, Salt, Alison, Gilbert, Ruth, Teär-Fahnehjelm, Kristina, and European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)
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VISION disorders , *JUVENILE diseases , *GENETICS of blindness , *OCULAR toxoplasmosis , *COMPARATIVE studies , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *OPHTHALMOSCOPY , *PEOPLE with disabilities , *RESEARCH , *TOXOPLASMOSIS , *UVEITIS , *VISUAL acuity , *EVALUATION research - Abstract
Purpose: Reliable information is needed to counsel parents of children with congenital toxoplasmosis regarding the long-term risk of visual impairment resulting from ocular toxoplasmosis.Design: Prospective cohort study of children with congenital toxoplasmosis identified by prenatal or neonatal screening.Methods: After three years of age, ophthalmologists reported the site of retinochoroidal lesions and visual acuity and parents reported visual impairment. An ophthalmologist predicted the child's vision based on the last retinal diagram. Selection biases were minimized by prospective enrollment and data collection, high rates of follow-up, and exclusion of referred cases.Results: Two hundred and eighty-one of 284 infected children who underwent ophthalmic examinations were followed up to a median age of 4.8 years. One in six children (49/281; 17%) had at least one retinochoroidal lesion, two-thirds of whom (32/49; 65%) had a lesion at the posterior pole. In children with retinochoroiditis who had visual acuity measured after 3 years of age, 94% (31/33) had normal vision in the best eye (6/12 Snellen or better), as did 91% of those with a posterior pole lesion (21/23). Analyses based on affected eyes showed that 42% (29/69) had a posterior pole lesion, of which just more than half (15/29, 52%) had normal vision, as did 84% (16/19) of eyes with a peripheral lesion alone. Vision predicted by the ophthalmologist was moderately sensitive (59%) but overestimated impairment associated with posterior pole lesions. Of 44 children with information on acuity, four (9%) had bilateral visual impairment worse than 6/12 Snellen.Conclusions: Severe bilateral impairment occurred in 9% of children with congenital toxoplasmic retinochoroiditis. Half the children with a posterior pole lesion and one in six of those with peripheral lesions alone were visually impaired in the affected eye. [ABSTRACT FROM AUTHOR]- Published
- 2007
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4. Visual loss associated with pediatric uveitis in english primary and referral centers
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Edelsten, Clive, Reddy, M.Ashwin, Stanford, Miles R., and Graham, Elizabeth M.
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UVEITIS , *VISION disorders , *JUVENILE diseases , *ACADEMIC medical centers , *AGE factors in disease , *BLINDNESS , *CHRONIC diseases , *COMPARATIVE studies , *IRIDOCYCLITIS , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL referrals , *OPHTHALMOLOGY , *POSTERIOR uveitis , *PRIMARY health care , *PUBLIC hospitals , *RESEARCH , *EVALUATION research , *DISEASE incidence , *RETROSPECTIVE studies , *DISEASE complications , *DIAGNOSIS - Abstract
: PurposePediatric uveitis is rare and has been reported to cause increased rates of visual loss compared with adult patients. The reasons for this are unclear. Only one study has been population–based, so the effect of referral bias is not known. We examined the pattern of disease in primary and referral centers to establish the unique characteristics of uveitis in children.: DesignCase control study.: MethodsRetrospective, multicenter, observational study of uveitis starting before the age of 20 years. Two hundred forty-nine patients were recruited from three primary and two referral ophthalmic units. Age-related differences in types of uveitis and systemic disease between hospitals were characterized, as were associations with visual loss.: ResultsThe incidence of uveitis in district hospitals at less than 16 years of age was 4.9/100,000: the most frequent diagnosis was idiopathic uveitis (78%). In referral cohorts the most frequent diagnosis was juvenile idiopathic arthritis-associated uveitis (67%). Other systemic diseases were rare. The most frequent type of uveitis at 0 to 7 years of age was chronic anterior uveitis, posterior uveitis in 8- to 15-year-olds, and acute anterior uveitis in 16- to 19-year-olds. Visual loss (any eye < 6/12) occurred in 17% and was not associated with age, sex, or hospital cohort. It was most frequent in posterior uveitis (25%). Treatment variables were independent predictors of visual loss: systemic treatment 2.2 (1.1– 4.6), surgical intervention 8.2 (3.8–17.6).: ConclusionsIdiopathic uveitis was three times more common in district hospitals. Visual loss was similar to adult uveitis in this study. The increased frequency of severe chronic anterior uveitis in children aged 0 to 7 years and posterior uveitis in older children aged 8 to 15 years accounts for the rate of visual loss seen in previous studies. [Copyright &y& Elsevier]
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- 2003
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