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1. DNA methylation age calculators reveal association with diabetic neuropathy in type 1 diabetes

Author

Thomas Donner, P. Rezaeian, John I. Malone, Sharon B. Schwartz, Xiaoyu Gao, Szilard Kiss, Matthew J. Budoff, David R. Sell, A. Dwoskin, Ronald J. Prineas, C. Pittman, M. Reid, C. McDonald, S. Caulder, M. Szpiech, Oscar B. Crofford, Rachel G. Miller, Louis A. Lobes, M. Patronas, C. Canny, M. E. Lackaye, Sandra R. Montezuma, Richard M. Bergenstal, Patricia Gatcomb, Julie A. Stoner, H. Pan, James L. Kinyoun, J. Mortenson, Osama Hamdy, Connie Fountain, David D. Moore, Kusiel Perlman, R. Trail, David A. Lee, J. Sheindlin, Samuel Dagogo-Jack, Jeffrey L. Mahon, Jill P. Crandall, L. Gill, T. Thompson, Lee M. Jampol, K. Koushan, David S. Schade, J. Brown-Friday, M. Basco, S. Dunnigan, J. Bylsma, R. Birk, L. H. Ketai, J. Hotaling, Stephen W. Scherer, W. Mestrezat, Stephan Villavicencio, R. Lyon, M. Carney, John Kramer, Sunder Mudaliar, David M. Nathan, M. Moran, F. Leandre, James W. Albers, L. Survant, Joseph F. Polak, Manjot K. Gill, Anton Orlin, M. Prince, Pamela A. Silver, Amy K. Saenger, John D. Brunzell, Kathleen E. Bainbridge, L. Babbione, Amisha Wallia, J. Vaccaro-Kish, Bradley D. Jones, M. Hebdon, L. McKenzie, Richard M. Hoffman, S. Chang, C. Siebert, George S. Sharuk, D. Counts, A. Lucas, P. Ramos, N. Burkhart, N. Bakshi, N. Flaherty, D. Kenny, M. Driscoll, Harjit Chahal, Ronald K. Mayfield, S. Hensley, E. Weimann, M. Franz, Martin J. Stevens, N. S. Gregory, Christopher J. O'Donnell, J. Laechelt, Pamela Ossorio, Jerry P. Palmer, Rama Natarajan, G. Ziegler, K. Martin, R. Beaser, C. Beck, L. Zhang, T. J. Declue, David M. Kendall, H. Solc, A. Vella, H. Martinez, Cormac T. Taylor, S. Neill, Douglas A. Greene, P. Lee, D. Norman, Andrew J. Barkmeier, Dean P. Hainsworth, Alka Jain, Sapna Gangaputra, N. Thangthaeng, Lorraine Thomas, Michael H. Brent, M. Bracey, Philip Raskin, Q. Clemens, Barbara H. Braffett, Mark S. Mandelcorn, Lloyd Paul Aiello, John E. Godine, T. Speigelberg, R. Chan, R. Hanna, Shelley B. Bull, William I. Sivitz, R. Sussman, C. Kwong, S. Cercone, P. Hollander, N. Leloudes, Joseph M. Terry, J. Wesche, E. A. Tanaka, D. Rosenberg, Wanjie Sun, L. Sun, Tom Clark, Deborah K. Schlossman, Louis M. Luttrell, R. Dunn, A. Farr, K. McVary, Gayle M. Lorenzi, A. Joseph, Catherine C. Cowie, M. Barr, D. Zimbler, S. Mendley, S. Schussler, N. Grove, Matthew D. Davis, Jong Mu Sun, Sophie Rogers, John P. Bantle, Brandy N. Rutledge, Senda Ajroud-Driss, Vincent M. Monnier, Cladd E. Stevens, Y. G. He, M. Phillips, C. Williams, J. MacIndoe, Kaleigh Farrell, Helen Lambeth, Ayad A. Jaffa, J. Quin, Morey W. Haymond, R. Kirby, D. Steinberg, William H. Herman, M. Mech, Arup Das, Robert Detrano, J. Brown, D. McMillan, Linda Snetselaar, Mark W. Johnson, R. Zeitler, T. Taylor, Peter R. Pavan, Michael H. Goldbaum, Bruce A. Perkins, R. G. Campbell, David A. Nicolle, R. J. van der Geest, Irene Hramiak, D. Freking, Lucy A. Levandoski, S. Colson, Charles Campbell, Victoria R. Trapani, Lawrence J. Singerman, D. Meyer, W. Tang, J. Soule, Anita Harrington, Julie A. Nelson, John A. Colwell, Naji Younes, P. Salemi, K. Hansen, Trevor J. Orchard, S. Huddleston, L. Steranchak, C. Sommer, G. Castle, J. Ginsberg, Paula McGee, V. Gama, John Dupre, Z. Strugula, M. Swenson, N. Wong, David A. Bluemke, M. Nutaitis, Anita Agarwal, M. Lin, K. Nickander, Elsayed Z. Soliman, Joao A. Lima, M. L. Schluter, Fred W. Whitehouse, Lisa Diminick, C. Cornish, M. Spencer, Daniel T. Lackland, Ionut Bebu, Hunter Wessells, S. Yacoub-Wasef, A. Determan, L. Van Ottingham, Howard Wolpert, R. Ehrlich, A. Blevins, L. Jovanovic, D. Finegold, Davida F. Kruger, Jye-Yu C. Backlund, K. Chan, Timothy J. Murtha, R. K. Mayfield, Robert W. Cavicchi, Maria F. Lopes-Virella, Thomas A. Weingeist, K. Lee, Mary E. Larkin, B. Blodi, J. Gott, Timothy J. Lyons, J. Selby, Chris Ryan, J. Harth, P. Pugsley, L. Keasler, John D. Maynard, Paul G. Arrigg, Amy B. Karger, P. Colby, J. Farquhar, Mark H. Schutta, Murk-Hein Heinemann, Kathie L. Hermayer, B. Bosco, C. Lovell, A. Bhan, A. Galprin, M. Cayford, M. Schumer, John E. Chapin, D. Rubinstein, F. Miao, V. Asuquo, Catherine L. Martin, Rodney A. Lorenz, Samuel S. Engel, L. Funk, Cyndi F. Liu, Barbara J. Maschak-Carey, Stephen S. Feman, P. Lindsey, M. Giotta, Philip A. Low, S. Kwon, R. Fahlstrom, A. Iannacone, B. French, H. Remtema, L. Cimino, S. Barron, J. McConnell, Jane L. Lynch, L. Kim, T. Williams, A. Degillio, Blanche M. Chavers, M. Novak, Julio V. Santiago, Ronald P. Danis, P. Gaston, Tae Sup Lee, T. Woodfill, R. Cuddihy, Scott M. Steidl, Alanna C. Morrison, E. Ryan, D. Lawrence, D. Cros, T. Adkins, D. Adelman, L. Dews, Patricia A. Cleary, J. Parker, L. Olmos De Koo, C. Kim, Mark R. Palmert, P. Astelford, Stefan Fritz, B. Olson, Kelvin C. Fong, Alan M. Jacobson, Stanley L. Hazen, D. Hornbeck, K. Folino, M. L. Bernal, Gabriel Virella, William V. Tamborlane, Neil H. White, Daniel L. McGee, Denis Daneman, H. Shamoon, William Dahms, S. Elsing, S. Brink, J. Ahern, Delnaz Roshandel, John M. Pach, N. W. Rodger, E. Cupelli, Dara D. Koozekanani, Abbas E. Kitabchi, K. Stoessel, B. Petty, Jamie R. Wood, J. Seegmiller, T. Strand, Y. Li, Eva L. Feldman, Larry Rand, Robert C. Colligan, T. Smith, A. Carlson, David J. Brillon, Margaret L. Bayless, M. Ong, S. Darabian, W. Hsu, Janet E. Olson, B. Rogness, N. Silvers, M. Pfiefer, B. Schaefer, E. Mendelson, S. Braunstein, Maren Nowicki, R. Reed, James S. Floyd, Z. M. Zhang, T. Sandford, R. B. Avery, A. Pratt, Paolo S. Silva, H. Bode, Alexander J. Brucker, Nikhil D. Patel, Alexander R. Lyon, M. Jenner, N. Wimmergren, L. Tuason, J. Rosenzwieg, D. J. Becker, C. Gauthier-Kelly, M. Richardson, Richard S. Crow, Andrew D. Paterson, Mark E. Molitch, Suzanne M. Strowig, S. Pendegast, M. Burger, Ramzi K. Hemady, J. Dingledine, I. H. de Boer, L. Mayer, F. Perdikaris, Om P. Ganda, F. Thoma, Karen J. Cruickshanks, Abraham Thomas, K. Klumpp, Jerry D. Cavallerano, D. Zheng, Annette Barnie, J. L. Canady, C. Wigley, David G. Miller, Sheila Smith-Brewer, D. Ostrowski, P. Crawford, K. Kelly, Robert G. Devenyi, B. Zimmerman, Susan M. Hitt, C. Johnson, L. Gurry, R. Jarboe, E. Angus, David E. Goldstein, A. Killeen, H. Schrott, Orville G. Kolterman, Mark R. Burge, Michael Rubin, J. Lipps Hagan, Alicia J. Jenkins, Hugh D. Wabers, R. Warhol, Edward Chaum, Karen L. Jones, L. Spillers, C. Miao, J. K. Jones, Angelo J. Canty, Rickey E. Carter, Evrim B. Turkbey, B. Burzuk, R. Woodwick, Evica Simjanoski, Michael W. Steffes, S. Crowell, Suresh D. Shah, H. Ricks, J. D. Carey, Paul A. Edwards, S. Holt, W. F. Schwenk, Ronald J. Oudiz, E. Brown, J. Heier, R. L. Ufret-Vincenty, L. M. Aiello, Robert A. Rizza, Karen L. Anderson, Valerie L. Arends, J. Giangiacomo, R. Liss, Aruna V. Sarma, B. Levy, Ellen J. Anderson, S. Catton, P. Callahan, Rodica Pop-Busui, S. Debrabandere, S. Moser, Bernard H. Doft, A. Malayeri, C. Johannes, R. Ramker, J. Rich, M. Fox, Rukhsana G. Mirza, Katherine A. Morgan, Thomas J. Songer, C. Shah, H. Engel, Saul M. Genuth, S. Ferguson, Anushka Patel, C. Haggan, P. Lou, J. Gordon, M. B. Murphy, D. Sandstrom, Dawn M. Ryan, Daniel H. O'Leary, B. Gloeb, Lois E. Schmidt, H. Zegarra, D. Dalton, W. Brown, Tom G. Sheidow, Margaret E. Stockman, Shyam M. Thomas, Charles McKitrick, Jyotika K. Fernandes, P. A. Bourne, L. Baker, G. Friedenberg, Allan Gordon, Allan L. Drash, S. Yoser, D. Wood, S. Johnsonbaugh, A. De Manbey, L. Kaminski, M. May, L. Bestourous, A. Kowarski, M. Geckle, M. Hartmuller, Michael Bryer-Ash, S. List, F. Goetz, V. Reppucci, D. Etzwiler, Rose A. Gubitosi-Klug, M. Brabham, E. Golden, A. Nayate, J. Hu, M. McLellan, Ronald Klein, N. Rude, B. Vittetoe, John M. Lachin, M. Christofi, Zhuo Chen, Isaac Boniuk, C. Strauch, K. Gunyou, L. Delahanty, W. T. Garvey, Andrew P. Boright, Larry D. Hubbard, D. Weiss, Igor Grant, Jonathan Q. Purnell, Jean M. Bucksa, N. Olson, and B. Zinman

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Diabetic neuropathy, Adolescent, 030209 endocrinology & metabolism, Gastroenterology, Nephropathy, Epigenesis, Genetic, Diabetic complications, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Diabetic Neuropathies, Internal medicine, Diabetes mellitus, Albumins, Genetics, Medicine, Humans, Molecular Biology, Genetics (clinical), Whole blood, Oligonucleotide Array Sequence Analysis, Type 1 diabetes, business.industry, Research, dNaM, DNA methylation age, DNA Methylation, medicine.disease, 030104 developmental biology, Blood pressure, Peripheral neuropathy, Diabetes Mellitus, Type 1, CpG Islands, Female, business, Developmental Biology, Genome-Wide Association Study
Abstract

Background Many CpGs become hyper or hypo-methylated with age. Multiple methods have been developed by Horvath et al. to estimate DNA methylation (DNAm) age including Pan-tissue, Skin & Blood, PhenoAge, and GrimAge. Pan-tissue and Skin & Blood try to estimate chronological age in the normal population whereas PhenoAge and GrimAge use surrogate markers associated with mortality to estimate biological age and its departure from chronological age. Here, we applied Horvath’s four methods to calculate and compare DNAm age in 499 subjects with type 1 diabetes (T1D) from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study using DNAm data measured by Illumina EPIC array in the whole blood. Association of the four DNAm ages with development of diabetic complications including cardiovascular diseases (CVD), nephropathy, retinopathy, and neuropathy, and their risk factors were investigated. Results Pan-tissue and GrimAge were higher whereas Skin & Blood and PhenoAge were lower than chronological age (p < 0.0001). DNAm age was not associated with the risk of CVD or retinopathy over 18–20 years after DNAm measurement. However, higher PhenoAge (β = 0.023, p = 0.007) and GrimAge (β = 0.029, p = 0.002) were associated with higher albumin excretion rate (AER), an indicator of diabetic renal disease, measured over time. GrimAge was also associated with development of both diabetic peripheral neuropathy (OR = 1.07, p = 9.24E−3) and cardiovascular autonomic neuropathy (OR = 1.06, p = 0.011). Both HbA1c (β = 0.38, p = 0.026) and T1D duration (β = 0.01, p = 0.043) were associated with higher PhenoAge. Employment (β = − 1.99, p = 0.045) and leisure time (β = − 0.81, p = 0.022) physical activity were associated with lower Pan-tissue and Skin & Blood, respectively. BMI (β = 0.09, p = 0.048) and current smoking (β = 7.13, p = 9.03E−50) were positively associated with Skin & Blood and GrimAge, respectively. Blood pressure, lipid levels, pulse rate, and alcohol consumption were not associated with DNAm age regardless of the method used. Conclusions Various methods of measuring DNAm age are sub-optimal in detecting people at higher risk of developing diabetic complications although some work better than the others.

Published
2020

2. Comparing the Early Treatment Diabetic Retinopathy Study 7-Field System With Ultrawide-Field Imaging

Author

Stephen S Feman

Subjects
Diabetic Retinopathy, Field (physics), Blindness, business.industry, Retinal Vessels, Diabetic retinopathy, medicine.disease, Retina, Ophthalmology, Diabetes mellitus, Medical imaging, Optometry, Medicine, Humans, business, Original Investigation
Abstract

IMPORTANCE: Moderate to substantial agreement between Early Treatment Diabetic Retinopathy Study (ETDRS) 7-field imaging and ultrawide-field (UWF) imaging has been suggested in single-center studies. Comparing images obtained by multiple centers could increase confidence that UWF images can be used reliably in place of ETDRS imaging in future clinical trials. OBJECTIVE: To compare diabetic retinopathy (DR) severity from modified ETDRS 7-field imaging and UWF imaging. DESIGN, SETTING, AND PARTICIPANTS: This preplanned, cross-sectional analysis included modified ETDRS 7-field images obtained using the Diabetic Retinopathy Clinical Research Network acquisition protocol and UWF images obtained captured with the Optos 200Tx system (Optos, PLC) from adult participants (≥18 years old) with type 1 or type 2 diabetes. Both image types were evaluated by trained graders masked to clinical data. Data collection occurred from February 2015 to December 2015, and data analysis from June 2016 to December 2017. MAIN OUTCOMES AND MEASURES: Agreement between UWF images, UWF images masked to include only the ETDRS 7-field area, and ETDRS 7-field images were calculated using κ statistics. RESULTS: A total of 764 eyes from 385 participants were included; participants had a median (IQR) age of 62.2 (53.6-69.2) years, 194 (50.4%) were women, and 256 (66.5%) were white. Of 742 eyes with both ETDRS 7-field images and UWF masked images graded, 359 (48.4% [95% CI, 44.4%-52.4%]) eyes had exact agreement, and 653 eyes (88.0% [95% CI, 85.2%-90.3%]) agreed within 1 step (weighted κ, 0.51 [95% CI, 0.44-0.58]). After open adjudication by an independent senior grader of all images with more than a 2-step discrepancy, perfect agreement was found in 435 eyes (59.0% [95% CI, 55.1%-62.8%]) and agreement within 1 step in 714 eyes (96.9% [95% CI, 95.1%-98.0%]; κ, 0.77 [95% CI, 0.73-0.82]). Ability of the imaging modalities to detect retinopathy severity in an individual eye was considered similar in 59 eyes (50.9% [95% CI, 41.3%-60.4%]), better for ETDRS 7-field imaging in 22 eyes (19.0% [95% CI, 12.5%-27.7%]), and better for UWF-masked images in 31 eyes (26.7% [95% CI 18.8%-36.5%]). Comparing UWF masked and unmasked images, 94 of 751 eyes (12.5%) had DR graded as at least 1 step more severe on UWF unmasked images vs UWF masked images. Predominantly peripheral DR lesions were present in 308 of 751 eyes (41.0%); this suggested increased DR severity by 2 or more steps in 34 eyes (11.0%). CONCLUSIONS AND RELEVANCE: Imaging by the ETDRS 7-field and UWF imaging systems have moderate to substantial agreement when determining the severity of DR within the 7 standard fields. Disparities in an individual eye are equivalently distributed between imaging modalities and can be better or worse on 1 or the other. Longitudinal follow-up will evaluate the primary outcome of this study to determine if peripheral retinal findings are associated with future retinopathy outcomes.

Published
2018

3. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study

Author

W.H. Wilson Tang, Paula McGee, John M. Lachin, Daniel Y. Li, Byron Hoogwerf, Stanley L. Hazen, D.M. Nathan, B. Zinman, O. Crofford, S. Genuth, J. Brown‐Friday, J. Crandall, H. Engel, S. Engel, H. Martinez, M. Phillips, M. Reid, H. Shamoon, J. Sheindlin, R. Gubitosi‐Klug, L. Mayer, S. Pendegast, H. Zegarra, D. Miller, L. Singerman, S. Smith‐Brewer, M. Novak, J. Quin, Saul Genuth, M. Palmert, E. Brown, J. McConnell, P. Pugsley, P. Crawford, W. Dahms, N.S. Gregory, M.E. Lackaye, S. Kiss, R. Chan, A. Orlin, M. Rubin, D. Brillon, V. Reppucci, T. Lee, M. Heinemann, S. Chang, B. Levy, L. Jovanovic, M. Richardson, B. Bosco, A. Dwoskin, R. Hanna, S. Barron, R. Campbell, A. Bhan, D. Kruger, J.K. Jones, P.A. Edwards, J.D. Carey, E. Angus, A. Thomas, A. Galprin, M. McLellan, F. Whitehouse, R. Bergenstal, M. Johnson, K. Gunyou, L. Thomas, J. Laechelt, P. Hollander, M. Spencer, D. Kendall, R. Cuddihy, P. Callahan, S. List, J. Gott, N. Rude, B. Olson, M. Franz, G. Castle, R. Birk, J. Nelson, D. Freking, L. Gill, W. Mestrezat, D. Etzwiler, K. Morgan, L.P. Aiello, E. Golden, P. Arrigg, V. Asuquo, R. Beaser, L. Bestourous, J. Cavallerano, R. Cavicchi, O. Ganda, O. Hamdy, R. Kirby, T. Murtha, D Schlossman, S. Shah, G. Sharuk, P. Silva, P. Silver, M. Stockman, J. Sun, E. Weimann, H. Wolpert, L.M. Aiello, A. Jacobson, L. Rand, J. Rosenzwieg, M.E. Larkin, M. Christofi, K. Folino, J. Godine, P. Lou, C. Stevens, E. Anderson, H. Bode, S. Brink, C. Cornish, D. Cros, L. Delahanty, eManbey, C. Haggan, J. Lynch, C. McKitrick, D. Norman, D. Moore, M. Ong, C. Taylor, D. Zimbler, S. Crowell, S. Fritz, K. Hansen, C. Gauthier‐Kelly, F.J. Service, G. Ziegler, A. Barkmeier, L. Schmidt, B. French, R. Woodwick, R. Rizza, W.F. Schwenk, M. Haymond, J. Pach, J. Mortenson, B. Zimmerman, A. Lucas, R. Colligan, L. Luttrell, M. Lopes‐Virella, S. Caulder, C. Pittman, N. Patel, K. Lee, M. Nutaitis, J. Fernandes, K. Hermayer, S. Kwon, A Blevins, J. Parker, J. Colwell, D. Lee, J. Soule, P. Lindsey, M. Bracey, A. Farr, S. Elsing, T. Thompson, J. Selby, T. Lyons, S. Yacoub‐Wasef, M. Szpiech, D. Wood, R. Mayfield, M. Molitch, D. Adelman, S. Colson, L. Jampol, A. Lyon, M. Gill, Z. Strugula, L. Kaminski, R. Mirza, E. Simjanoski, D. Ryan, C. Johnson, A. Wallia, S. Ajroud‐Driss, P. Astelford, N. Leloudes, A. Degillio, B. Schaefer, S. Mudaliar, G Lorenzi, M. Goldbaum, K. Jones, M. Prince, M. Swenson, I. Grant, R. Reed, R. Lyon, O. Kolterman, M. Giotta, T. Clark, G. Friedenberg, W.I. Sivitz, B. Vittetoe, J. Kramer, M. Bayless, R. Zeitler, H. Schrott, N. Olson, L. Snetselaar, R. Hoffman, J. MacIndoe, T. Weingeist, C. Fountain, R. Miller, S. Johnsonbaugh, M. Patronas, M. Carney, S. Mendley, P. Salemi, R. Liss, M. Hebdon, D. Counts, T. Donner, J. Gordon, R. Hemady, A. Kowarski, D. Ostrowski, S. Steidl, B. Jones, W.H. Herman, C.L. Martin, R. Pop‐Busui, D.A. Greene, M.J. Stevens, N. Burkhart, T. Sandford, J. Floyd, J. Bantle, N. Flaherty, J. Terry, D. Koozekanani, S. Montezuma, N. Wimmergren, B. Rogness, M. Mech, T. Strand, J. Olson, L. McKenzie, C. Kwong, F. Goetz, R. Warhol, D. Hainsworth, D. Goldstein, S. Hitt, J. Giangiacomo, D.S Schade, J.L. Canady, M.R. Burge, A. Das, R.B. Avery, L.H. Ketai, J.E. Chapin, M.L. Schluter, J. Rich, C. Johannes, D. Hornbeck, M. Schutta, P.A. Bourne, A. Brucker, S. Braunstein, S. Schwartz, B.J. Maschak‐Carey, L. Baker, T. Orchard, L. Cimino, T. Songer, B. Doft, S. Olson, D. Becker, D. Rubinstein, R.L. Bergren, J. Fruit, R. Hyre, C. Palmer, N. Silvers, L. Lobes, P. Paczan Rath, P.W. Conrad, S. Yalamanchi, J. Wesche, M. Bratkowksi, S. Arslanian, J. Rinkoff, J. Warnicki, D. Curtin, D. Steinberg, G. Vagstad, R. Harris, L. Steranchak, J. Arch, K. Kelly, P. Ostrosaka, M. Guiliani, M. Good, T. Williams, K. Olsen, A. Campbell, C. Shipe, R. Conwit, D. Finegold, M. Zaucha, A. Drash, A. Morrison, J.I. Malone, M.L. Bernal, P.R. Pavan, N. Grove, E.A. Tanaka, D. McMillan, J. Vaccaro‐Kish, L. Babbione, H. Solc, T.J. DeClue, S. Dagogo‐Jack, C. Wigley, H. Ricks, A. Kitabchi, E. Chaum, M.B. Murphy, S. Moser, D. Meyer, A. Iannacone, S. Yoser, M. Bryer‐Ash, S. Schussler, H. Lambeth, P. Raskin, S. Strowig, M. Basco, S. Cercone, A. Barnie, R. Devenyi, M. Mandelcorn, M. Brent, S. Rogers, A. Gordon, N. Bakshi, B. Perkins, L. Tuason, F. Perdikaris, R. Ehrlich, D. Daneman, K. Perlman, S Ferguson, J. Palmer, R. Fahlstrom, I.H. de Boer, J. Kinyoun, L. Van Ottingham, S. Catton, J. Ginsberg, C. McDonald, J. Harth, M. Driscoll, T. Sheidow, J. Mahon, C. Canny, D. Nicolle, P. Colby, J. Dupre, I. Hramiak, N.W. Rodger, M. Jenner, T. Smith, W. Brown, M. May, J. Lipps Hagan, A. Agarwal, T. Adkins, R. Lorenz, S. Feman, L. Survant, N.H. White, L. Levandoski, G. Grand, M. Thomas, D. Joseph, K. Blinder, G. Shah, D. Burgess, I. Boniuk, J. Santiago, W. Tamborlane, P. Gatcomb, K. Stoessel, P. Ramos, K. Fong, P. Ossorio, J. Ahern, L. Meadema‐Mayer, C. Beck, K. Farrell, J Quin, P. Gaston, R. Trail, J. Lachin, J. Backlund, I. Bebu, B. Braffett, L. Diminick, X. Gao, W. Hsu, K. Klumpp, H. Pan, V. Trapani, P. Cleary, P. McGee, W. Sun, S. Villavicencio, K. Anderson, L. Dews, Naji Younes, B. Rutledge, K. Chan, D. Rosenberg, B. Petty, A. Determan, D. Kenny, C. Williams, C. Cowie, C. Siebert, M. Steffes, V. Arends, J. Bucksa, M. Nowicki, B. Chavers, D. O'Leary, J. Polak, A. Harrington, L. Funk, R Crow, B. Gloeb, S. Thomas, C. O'Donnell, E.Z. Soliman, Z.M. Zhang, Y. Li, C. Campbell, L. Keasler, S. Hensley, J. Hu, M. Barr, T. Taylor, R. Prineas, E.L. Feldman, J.W. Albers, P. Low, C. Sommer, K. Nickander, T. Speigelberg, M. Pfiefer, M. Schumer, M. Moran, J. Farquhar, C. Ryan, D. Sandstrom, M. Geckle, E. Cupelli, F. Thoma, B. Burzuk, T. Woodfill, R. Danis, B. Blodi, D. Lawrence, H. Wabers, S. Gangaputra, S. Neill, M. Burger, J. Dingledine, V. Gama, R. Sussman, M. Davis, L. Hubbard, M. Budoff, S. Darabian, P. Rezaeian, N. Wong, M. Fox, R. Oudiz, L Kim, R. Detrano, K. Cruickshanks, D. Dalton, K. Bainbridge, J. Lima, D. Bluemke, E. Turkbey, der Geest, C. Liu, A. Malayeri, A. Jain, C. Miao, H. Chahal, R. Jarboe, V. Monnier, D. Sell, C. Strauch, S. Hazen, A. Pratt, W. Tang, J. Brunzell, J. Purnell, R. Natarajan, F. Miao, L. Zhang, Z. Chen, A. Paterson, A. Boright, S. Bull, L. Sun, S. Scherer, T.J. Lyons, A. Jenkins, R. Klein, G. Virella, A. Jaffa, R. Carter, J. Stoner, W.T. Garvey, D. Lackland, M. Brabham, D. McGee, D. Zheng, R.K. Mayfield, J. Maynard, H. Wessells, A Sarma, R. Dunn, S. Holt, J. Hotaling, C. Kim, Q. Clemens, J. Brown, and K. McVary

Subjects
medicine.medical_specialty, endocrine system diseases, 030209 endocrinology & metabolism, Disease, 030204 cardiovascular system & hematology, Lower risk, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, Diseases of the circulatory (Cardiovascular) system, Coronary Heart Disease, Glycemic, Original Research, free radical, Inflammation, Type 1 diabetes, biology, business.industry, Paraoxonase, medicine.disease, paraoxonase, 3. Good health, RC666-701, Cohort, diabetes mellitus, biology.protein, Cardiology and Cardiovascular Medicine, business, Oxidant Stress, Oxidative stress, F2Isoprostane, Biomarkers
Abstract

Background Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus. Methods and Results A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments. Conclusions Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.

Published
2018

4. Change in Diabetic Panretinal Photocoagulation Incidence

Author

Stephen S Feman, Thomas E Burroughs, and Jiajing Chen

Subjects
Adult, Male, medicine.medical_specialty, Databases, Factual, Blindness, Panretinal photocoagulation, Diabetes mellitus, Internal medicine, Post-hoc analysis, Diabetes Mellitus, Prevalence, Health insurance, Humans, Medicine, Diabetic Retinopathy, Insurance, Health, Laser Coagulation, business.industry, Incidence, Incidence (epidemiology), Diabetic retinopathy, Middle Aged, medicine.disease, United States, Rate change, Female, business
Abstract

BACKGROUND AND OBJECTIVE: Diabetic blindness occurs most often among working-age people. Panretinal photocoagulation (PRP) can prevent this outcome. Administrative data examined changes in PRP incidence rates. PATIENTS AND METHODS: Anonymous data from the “claims submitted” files of an insurer with nationwide representation was used. This health insurance was a job benefit, and the sample included 6,085,750 U.S. employees and their dependents. Those who received PRP for diabetic retinopathy were compared to all others with diabetes mellitus. Although some enrollees had more than one PRP procedure, each procedure was considered a unique event. The rate change was evaluated by chi-square tests with post hoc tests for pair-wise comparisons. RESULTS: A total of 14,856 PRP procedures were performed. An incidence rate reduction from 0.95% to 0.67% (chi-square = 243.6818, P < .0001) was found within the study interval. CONCLUSION: The incidence of PRP was reduced in this sample of U.S. workers and their dependents.

Published
2012
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5. Quality Control Measures over 30 Years in a Multicenter Clinical Study: Results from the Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

Author

M. Bracey, B. French, Brandy N. Rutledge, Sharon B. Schwartz, D. Steinberg, Peter R. Pavan, Xiaoyu Gao, Alan M. Jacobson, David A. Nicolle, C. Canny, Maria F. Lopes-Virella, A. Kitabchi, K. Hansen, M. E. Lackaye, Denis Daneman, Kandace A. Klumpp, David A. Lee, H. Engel, L. Survant, C. Haggan, K. Lee, G. Ziegler, Dawn M. Ryan, Lloyd Paul Aiello, Tom G. Sheidow, Allan Gordon, Allan L. Drash, S. Johnsonbaugh, L. Kaminski, S. Yoser, David J. Brillon, Osama Hamdy, Connie Fountain, N. Silvers, Kusiel Perlman, S. Caulder, M. Szpiech, D. Freking, Paula McGee, George S. Sharuk, D. Counts, H. Solc, David E. Goldstein, L. Bestourous, W. F. Schwenk, E. Brown, S. Cercone, M. Patronas, James L. Kinyoun, G. Castle, Mark H. Schutta, M. L. Schluter, Anton Orlin, E. Chaum, Daniel P. Joseph, F. Goetz, V. Reppucci, D. Etzwiler, E. Golden, A. Iannacone, R. Kirby, Lucy A. Levandoski, Lawrence J. Singerman, P. Salemi, A. Morrison, G. Vagstad, J. Laechelt, Pamela Ossorio, Tae Sup Lee, R. Cuddihy, S. Hitt, Fred W. Whitehouse, Michael H. Brent, Gayle M. Lorenzi, Anthony D. Morrison, B. Zinman, Szilard Kiss, D. Norman, N. Olson, Thomas Donner, John Dupre, M. Swenson, M. Spencer, Jerry P. Palmer, Scott M. Steidl, M. Franz, R. Beaser, H. Martinez, Samuel S. Engel, L. Diminick, J. Mortenson, David S. Schade, S. Yacoub-Wasef, Misty Good, John E. Chapin, Paolo S. Silva, J. Ginsberg, A. Dwoskin, John P. Bantle, J. D. Carey, D. McMillan, R. G. Campbell, Lisa Diminick, C. Cornish, Ramzi K. Hemady, P. Hollander, A. Farr, D. Zimbler, M. Mech, A. Lucas, Jye-Yu C. Backlund, K. Chan, Timothy J. Murtha, V. Asuquo, A. Bhan, A. Galprin, F. Perdikaris, Michael D. Larsen, L. Gill, Pamela A. Silver, S. Brink, Louis M. Luttrell, Sheila Smith-Brewer, D. Ostrowski, M. Bratkowksi, P. Crawford, M. Bryer-Ash, E. Angus, S. Braunstein, John I. Malone, R. Conwit, C. Pittman, Louis A. Lobes, Rodney A. Lorenz, J. Rosenzwieg, Neil H. White, William I. Sivitz, D. J. Becker, Stephen S. Feman, M. Zaucha, M. Reid, M. Jenner, L. Tuason, C. Gauthier-Kelly, C. McDonald, William H. Herman, John Kramer, Jeffrey L. Mahon, A. Campbell, J. L. Canady, A. Degillio, T. Adkins, P. W. Conrad, Senda Ajroud-Driss, L. Dews, Stephan Villavicencio, David G. Miller, Manjot K. Gill, D. Curtin, J. Brown-Friday, M. Basco, Elsayed Z. Soliman, J. Selby, Bradley D. Jones, M. Hebdon, B. Olson, John M. Pach, N. W. Rodger, K. Stoessel, N. Leloudes, J. Floyd, H. Lambeth, G. Lorenzi, Richard M. Hoffman, S. Chang, M. Guiliani, H. Zegarra, N. Bakshi, Dean P. Hainsworth, Murk-Hein Heinemann, S. Dagogo-Jack, Wanjie Sun, J. Warnicki, Dean B. Burgess, D. Kenny, L. McKenzie, B. Rogness, Martin J. Stevens, M. Nutaitis, William V. Tamborlane, L. Schmidt, Deborah K. Schlossman, J. Giangiacomo, C. Williams, R. Liss, Barbara J. Maschak-Carey, Barbara H. Braffett, Stefan Fritz, J. MacIndoe, Tom Clark, M. Novak, Michael H. Goldbaum, A. DeManbey, J. Ahern, L. Jovanovic, D. Finegold, Davida F. Kruger, Mary E. Larkin, M. Johnson, S. Shah, M. Ong, Catherine L. Martin, M. Giotta, R. Reed, B. Levy, Evica Simjanoski, L. Cimino, P. Callahan, S. Crowell, Rodica Pop-Busui, Howard Wolpert, Bernard H. Doft, J. Arch, C. Shipe, Mark R. Palmert, Philip Raskin, B. Schaefer, P. Astelford, Dara D. Koozekanani, R. B. Avery, Michael W. Steffes, Robert A. Rizza, Karen L. Anderson, Charles McKitrick, P. A. Bourne, L. Baker, G. Friedenberg, D. Wood, J. Wesche, M. Phillips, Gaurav K. Shah, John M. Lachin, M. Christofi, Kevin J. Blinder, R. Ehrlich, J. Rinkoff, Morey W. Haymond, Irene Hramiak, Z. Strugula, A. Blevins, R. Hyre, M. Richardson, Mark E. Molitch, I. H. de Boer, Annette Barnie, Mark R. Burge, M. Prince, P. Ramos, R. Chan, R. Hanna, Jong Mu Sun, Suzanne M. Strowig, C. Wigley, Om P. Ganda, R. Harris, Abraham Thomas, K. Klumpp, K. Kelly, David D. Moore, J. Sheindlin, T. J. Declue, Cormac T. Taylor, C. Kwong, Rose Gubitosi-Klug, T. Sandford, Isaac Boniuk, B. Zimmerman, R. Zeitler, S. Rogers, Joseph M. Terry, C. Johnson, Linda Snetselaar, Naji Younes, Ionut Bebu, N. Wimmergren, Rukhsana G. Mirza, K. Gunyou, Karl R. Olsen, H. Bode, J. Fruit, Michael Rubin, G. Grand, Trevor J. Orchard, Douglas A. Greene, J. Quin, R. Birk, W. Mestrezat, P. Pugsley, Anupam Agarwal, L. Mayer, C. Palmer, Timothy J. Lyons, C. Johannes, A. Determan, L. Van Ottingham, J. Gott, Jerry D. Cavallerano, D. Cros, J. Parker, M. May, Robert Bergren, A. Kowarski, L. Delahanty, Katherine A. Morgan, E. A. Tanaka, Robert W. Cavicchi, Thomas J. Songer, Robert G. Devenyi, J. Harth, Jill P. Crandall, T. Thompson, Lee M. Jampol, H. Schrott, Paul G. Arrigg, Orville G. Kolterman, R. Warhol, L. Thomas, S. Kwon, Jane L. Lynch, Arup Das, Theresa M. Williams, Thomas A. Weingeist, Patricia A. Cleary, Matthew A. Thomas, L. Babbione, Amisha Wallia, J. Lipps Hagan, D. Meyer, D. Rubinstein, P. Lindsey, Mark S. Mandelcorn, R. Fahlstrom, John E. Godine, Kathie L. Hermayer, B. Bosco, J. Rich, K. Folino, M. L. Bernal, S. Yalamanchi, S. Barron, J. McConnell, J. K. Jones, J. Vaccaro-Kish, R. Woodwick, P. Colby, Kelvin C. Fong, Ronald K. Mayfield, L. H. Ketai, Julio V. Santiago, M. B. Murphy, S. Schussler, N. Grove, Larry Rand, Robert C. Colligan, Ronald P. Danis, Valerie L. Arends, S. Ferguson, B. Petty, Christine Stevens, P. Ostrosaka, Margaret L. Bayless, S. Moser, Paul A. Edwards, R. Lyon, M. Carney, Katrina Jones, T. Strand, W. Hsu, Alexander J. Brucker, H. Shamoon, Alice T. Lyon, T. Smith, David M. Nathan, P. Lou, Bruce A. Perkins, Janet E. Olson, D. Rosenberg, H. Ricks, J. Gordon, D. Hornbeck, Nikhil D. Patel, Shelly Olson, Ellen J. Anderson, William Dahms, P. Paczan Rath, S. Elsing, L. Steranchak, L. M. Aiello, Saul Genuth, S. Catton, Sandra R. Montezuma, S. Pendegast, Richard M. Bergenstal, Patricia Gatcomb, Igor Grant, B. Braffett, W. Brown, Margaret E. Stockman, N. Burkhart, David M. Kendall, Jyotika K. Fernandes, S. List, J. Soule, Julie A. Nelson, John A. Colwell, M. McLellan, Silva A. Arslanian, N. Rude, B. Vittetoe, M. Driscoll, and E. Weimann

Subjects
Adult, Male, 030213 general clinical medicine, medicine.medical_specialty, Adolescent, Quality Assurance, Health Care, Psychological intervention, lcsh:Medicine, law.invention, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Health care, medicine, Humans, Medical physics, lcsh:Science, Multidisciplinary, Data collection, business.industry, lcsh:R, Quality control, 3. Good health, Surgery, Data quality, Cohort, 030221 ophthalmology & optometry, Female, lcsh:Q, business, Quality assurance, Follow-Up Studies, Research Article
Abstract

Implementation of multicenter and/or longitudinal studies requires an effective quality assurance program to identify trends, data inconsistencies and process variability of results over time. The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study represent over 30 years of data collection among a cohort of participants across 27 clinical centers. The quality assurance plan is overseen by the Data Coordinating Center and is implemented across the clinical centers and central reading units. Each central unit incorporates specific DCCT/EDIC quality monitoring activities into their routine quality assurance plan. The results are reviewed by a data quality assurance committee whose function is to identify variances in quality that may impact study results from the central units as well as within and across clinical centers, and to recommend implementation of corrective procedures when necessary. Over the 30-year period, changes to the methods, equipment, or clinical procedures have been required to keep procedures current and ensure continued collection of scientifically valid and clinically relevant results. Pilot testing to compare historic processes with contemporary alternatives is performed and comparability is validated prior to incorporation of new procedures into the study. Details of the quality assurance plan across and within the clinical and central reading units are described, and quality outcomes for core measures analyzed by the central reading units (e.g. biochemical samples, fundus photographs, ECGs) are presented.

Published
2015

6. Severe Pupil Distortion Following Transchamber Repair of a Cyclodialysis Cleft

Author

John C Nichols, Dave H Lee, Steven A Shields, and Stephen S Feman

Subjects
medicine.medical_specialty, business.industry, Eye disease, medicine.disease, Pupil, Surgery, Blunt, Suture (anatomy), Ophthalmology, medicine, Examination Under Anesthesia, Tennis ball, business, Complication, Prolene
Abstract

This report describes a potential complication following the repair of a traumatic cyclodialysis cleft in a pediatric patient using a novel technique. A healthy 11 -year-old boy suffered a blunt traumatic tennis ball injury to his left eye. He underwent repair of a retinal dialysis with detachment shordy after the injury. Postoperatively, he developed persistent hypotony, shallow anterior chamber, and hypotony maculopathy. An occult cyclodialysis cleft was suspected. Examination under anesthesia revealed a small cyclodialysis cleft. The cleft was closed by transchamber placement of prolene sutures across the cleft under direct visualization through a Tano lens. Postoperative course was complicated by severe pupillary distortion despite subsequent suture removal. [Ophthalmic Surg Lasers 2002;33:426429]

Published
2002
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7. Genome-Wide Meta-Analysis of Myopia and Hyperopia Provides Evidence for Replication of 11 Loci

Author

Mario Pirastu, G. E. Munn, L. H. Ketai, K. Taylor, Angela Döring, R. Chan, Jeffrey L. Mahon, Bradley D. Jones, M. Hebdon, Williams L. Dews, Douglas A. Greene, Michael D. Weiss, Sapna Gangaputra, E. A. Tanaka, J. Ginsberg, Ben A. Oostra, Alka Jain, D. Singer, M. Burger, Szilard Kiss, David A. Bluemke, Barbara H. Braffett, Jugnoo S Rahi, L. Sun, C. Clark, Richard M. Bergenstal, Patricia Gatcomb, Paul Mitchell, R. Trail, D. Ryan, Robert Bergren, D. D. Joseph, G. Grand, Blanche M. Chavers, J. M.Verhoeven Virginie, David S. Schade, C. Cowie, Sharon B. Schwartz, G. Ziegler, Lloyd Paul Aiello, Michael H. Brent, John I. Malone, C. Pittman, M. Reid, Stephen S. Feman, Maurizio Fossarello, Kathie L. Hermayer, J. Parker, M. N. Iyer, Hamid Mojibian, Rose Gubitosi-Klug, P. W. Conrad, Daniel T. Lackland, Michael Brändle, C. Canny, Alan F. Wright, M. E. Lackaye, David A. Lee, Rickey E. Carter, J. Brown-Friday, J. K. Jones, J. Distad, A. Thomas, Gordon C. Weir, S. Caulder, M. Szpiech, R. Gstalder, D. Rubinstein, Fred W. Whitehouse, T. Adkins, Gayle M. Lorenzi, L. Survant, Naji Younes, Robert Detrano, Lucy A. Levandoski, Charles Campbell, Lawrence J. Singerman, Johannes R. Vingerling, Joao A.C. Lima, D. Counts, V. Gama, D. M. Nathan, John Dupre, Cornelia M. van Duijn, N. Wong, Anita Harrington, Caroline Hayward, Shelley B. Bull, R. Hackel, William I. Sivitz, Enrico Cagliero, M. Spencer, Albert Hofman, Samuel S. Engel, John E. Hokanson, Julio V. Santiago, David M. Kendall, O. Crofford, T. Thompson, Lee M. Jampol, Kevin Morgan, R. Sussman, James W. Albers, Anita Agarwal, Kevin J. Blinder, Anthony D. Morrison, Nikhil D. Patel, R. Prusak, S. Hitt, Alexander R. Lyon, Saul Genuth, J. Sheindlin, J. Vaccaro-Kish, Goran Benčić, P. Titus, Lisa Diminick, N. Wimmergren, Shelly Olson, Z. Strugula, L. Goings, Lennart C. Karssen, A. Blevins, Harjit Chahal, Ronald K. Mayfield, S. Pendegast, T. J. Lyons, Ozren Polasek, Matthew A. Thomas, Annette Barnie, P. Lindsey, L. Funk, James L. Kinyoun, Neil H. White, L. Mayer, Rodney A. Lorenz, Susan G. Elner, R. L. Pate, E. Simjanoski, R. Beaser, J. Gothrup, Tien Yin Wong, Thomas Bettecken, Jae-Ho Lee, Elsayed Z. Soliman, Ronald P. Danis, Phillippa M. Cumberland, J. Selby, Pamela Rath, H. Martinez, S. Neill, D. Rosenberg, D. Zheng, R. Devenyi, Murk-Hein Heinemann, Albert V. Smith, Alicia J. Jenkins, Rukhsana G. Mirza, Konrad Oexle, Osama Hamdy, John D. Brunzell, Trevor J. Orchard, Daniel Cornfeld, K. Nickander, Igor Rudan, L. Kim, T. Williams, Christopher M. Ryan, William Dahms, P. Paczan Rath, S. Elsing, Matthew J. Budoff, Orville G. Kolterman, Seang-Mei Saw, Lisa A. Prosser, A. Determan, M. Espeland, L. Van Ottingham, B. Petty, A. Farr, Brandy N. Rutledge, Patricia A. Cleary, Margaret L. Bayless, E. Cupelli, Ronald J. Prineas, Jonathan Goldstein, Stefan Fritz, J. Harth, K. Stoessel, Jerry P. Palmer, J. Soule, John A. Colwell, Stephen W. Scherer, Cyndi F. Liu, M. Phillips, Alexander J. Brucker, B. Rogness, Caroline C W Klaver, Joan E. Bailey-Wilson, Claire L. Simpson, Gaurav K. Shah, Louis A. Lobes, S. Mohsen Hosseini, Veronique Vitart, Dwight Stambolian, Mark S. Mandelcorn, John E. Godine, Gabriel Virella, A. Cochrane, David A. Nicolle, Timothy J. Lyons, S. Schussler, Abbas E. Kitabchi, N. Grove, Matthew D. Davis, Andrew K. Vine, Joseph F. Polak, Helen Lambeth, Ayad A. Jaffa, S. Rogers, Samuel Dagogo-Jack, C. Siebert, K. Hansen, H. Shamoon, David J. Brillon, D. Schlossman, H. Ricks, Toby A. Gardner, Mary Frances Cotch, J. Quin, Om P. Ganda, Fernando Rivadeneira, F. Thoma, Brian Fleck, K. Klumpp, Manjot K. Gill, R. J. van der Geest, Hunter Wessells, P. Salemi, P. Gaston, Tae Sup Lee, T. Woodfill, Scott M. Steidl, Thomas Meitinger, Laura Portas, John E. Chapin, Robert Wojciechowski, Martin J. Stevens, Z. M. Zhang, John D. Maynard, Paul G. Arrigg, S. Yacoub-Wasef, Andrew D. Paterson, Barbara J. Maschak-Carey, Ramzi K. Hemady, J. Dingledine, Sheila Smith-Brewer, D. Ostrowski, D. Kenny, Leslie J. Raffel, R. Jarboe, E. Angus, G. Sharuk, Jie Jin Wang, Jye-Yu C. Backlund, K. Chan, R. K. Mayfield, M. Nutaitis, William V. Tamborlane, Emily Y. Chew, Michael H. Goldbaum, S. Kwon, Davida F. Kruger, Mary E. Larkin, Catherine L. Martin, M. Novak, David E. Goldstein, J. Rosenzwieg, D. J. Becker, A. E. Boulton, Jean M. Bucksa, Richard S. Crow, Thomas Donner, Philip A. Low, J. Fradkin, K. Folino, M. L. Bernal, Daniel L. McGee, R. D′Agostino, David G. Miller, Evrim B. Turkbey, Eva L. Feldman, Larry Rand, Harry Campbell, Mark R. Palmert, N. Silvers, M. Driscoll, M. Bracey, Mark E. Molitch, Boniuk Burgess, John P. Bantle, J. D. Carey, Edward Chaum, Philip Raskin, I. H. de Boer, Peter R. Pavan, C. Wigley, Maria F. Lopes-Virella, Pirro G. Hysi, C. Sommer, R. Eastman, B. Schaefer, Maren Nowicki, K. Lee, S. Braunstein, Hugh D. Wabers, A. F. Burrows, M. Johnson, B. Zinman, M. Ong, Samir S. Deeb, C. Gauthier-Kelly, S. Novella, C. Miao, S. Strowig, S. Crowell, Teri A. Manolio, S. Yalamanchi, Christian Gieger, D. Meyer, Louis M. Luttrell, Janie Lipps, William H. Herman, Michael W. Steffes, A. Galprin, A. Iannacone, Federico Murgia, E. Steuer, KyungMann Kim, James F. Wilson, S. Genuth, André G. Uitterlinden, Dean P. Hainsworth, J. Giangiacomo, Wanjie Sun, Aruna V. Sarma, R. Liss, S. Catton, Rodica Pop-Busui, S. Moser, Bernard H. Doft, A. Malayeri, B. Gloeb, W. T. Garvey, Andrew P. Boright, Alan M. Jacobson, Larry D. Hubbard, Barbara E.K. Klein, Shyam M. Thomas, Allan Gordon, Allan L. Drash, S. Yoser, S. Johnsonbaugh, L. Kaminski, G. Meekins, Jonathan Q. Purnell, B. Burzuk, John M. Lachin, M. Geckle, Ronald J. Oudiz, Isaac Boniuk, Xiaohui Li, V. Reppucci, H. Wolpert, D. Etzwiler, M. Brabham, Maria Schache, E. Golden, M. Fox, Jyotika K. Fernandes, Jerome I. Rotter, Paul N. Baird, Michael Bryer-Ash, M. Stern, H. Engel, M. Hawkins, Najaf Amin, C. O′Donnell, M. McLellan, G. Comer, Ronald Klein, D. Sandstrom, H. Zegarra, J. Gordon, M. B. Murphy, P. A. Bourne, L. Baker, Cristina Venturini, D. Wood, H.-Erich Wichmann, M. May, A. Kowarski, Timothy W. Olsen, Thomas J. Songer, Christopher J Hammond, P. Lou, Jill P. Crandall, Miao, Xiaoping, Ophthalmology, Obstetrics & Gynecology, Epidemiology, Clinical Genetics, and Internal Medicine

Subjects
Male, Linkage disequilibrium, Refractive error, genetic structures, Epidemiology, Genome-wide association study, Plant Science, Eye, Linkage Disequilibrium, ASSOCIATION SCANS, MULTIPLE, Medicine and Health Sciences, Myopia, 80 and over, 2.1 Biological and endogenous factors, Aetiology, Age of Onset, FAMILIAL AGGREGATION, Genetics, Aged, 80 and over, Multidisciplinary, AUSTRALIAN SCHOOL-CHILDREN, COMMON VARIANTS, Single Nucleotide, Middle Aged, RETINAL-PIGMENT EPITHELIUM, OUTDOOR ACTIVITY, Hyperopia, Phenotype, Genetic Epidemiology, Medicine, Female, Research Article, Genetic Markers, Adult, General Science & Technology, Science, DCCT/EDIC Research Group, European Continental Ancestry Group, Locus (genetics), Single-nucleotide polymorphism, and over, Biology, Disease Surveillance, Polymorphism, Single Nucleotide, White People, medicine, Genome-Wide Association Studies, Humans, Inherited Eye Disorders, Genetic Predisposition to Disease, Allele, Polymorphism, Eye Disease and Disorders of Vision, Alleles, Genetic Association Studies, Aged, Whites, Human Genome, Biology and Life Sciences, Computational Biology, Human Genetics, Heritability, Plant Pathology, medicine.disease, Genome Analysis, GENE, eye diseases, Ophthalmology, REFRACTIVE ERROR, Genetics of Disease, LINKAGE-DISEQUILIBRIUM, Age of onset
Abstract

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10-8), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10-11) and 8q12 (minimum p value 1.82×10-11) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. "Replication-level" association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of refractive error across the distribution.

Published
2014
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8. New discoveries in diabetes- and thyroid-related eye disease

Author

Stephen S. Feman

Subjects
genetic structures, Eye disease, Ocular hypertension, Glaucoma, Disease, Blindness, Bioinformatics, Diabetes Complications, chemistry.chemical_compound, Diabetes mellitus, medicine, Animals, Humans, Diabetic Retinopathy, business.industry, Incidence, General Medicine, Diabetic retinopathy, medicine.disease, Graves Disease, United States, eye diseases, Europe, Vascular endothelial growth factor, Ophthalmology, chemistry, business, Retinopathy
Abstract

Although reports from Europe indicate a reduction in the incidence of diabetes-related visual loss, diabetic retinopathy continues to be the leading cause of blindness. One agent, vascular endothelial growth factor (VEGF), has been found to stimulate angiogenesis and may be the cause of diabetic neovascularization and visual loss. New research implies that the manipulation of the VEGF pathway may be able to prevent diabetic visual loss. Type I (insulin-dependent) and type II (non-insulin-dependent) diabetes mellitus are different disease processes. There have been few attempts in the past to differentiate the retinopathy associated with these two distinct disorders. Recent reports indicate that these disorders have different responses to ocular therapy. Thyroid orbitopathy combined with ocular hypertension can produce true glaucoma. Nevertheless, this requires a prolonged duration of orbitopathy and most patients who have this combination will improve and not develop permanent glaucomatous changes. Similarly, the majority of Graves' disease patients develop improved function over time; however, the psychologic sequelae continue after the disease process is in remission, which warrants further studies.

Published
1997
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9. Serum Angiotensin Converting Enzyme in Diabetic Patients

Author

James M. May, Robert J. Workman, Stephen S. Feman, Robert A. Mericle, and George W. Reed

Subjects
Adult, Male, medicine.medical_specialty, Eye disease, Serum angiotensin converting enzyme, Peptidyl-Dipeptidase A, Gastroenterology, Internal medicine, Diabetes mellitus, medicine, Humans, In patient, Aged, Diabetic Retinopathy, biology, business.industry, Angiotensin-converting enzyme, General Medicine, Diabetic retinopathy, Middle Aged, medicine.disease, Pathophysiology, Endocrinology, biology.protein, Female, business, Retinopathy
Abstract

Serum angiotensin converting enzyme (ACE) levels are higher in patients with diabetes mellitus than in many others. Techniques are available to grade different degrees of diabetic retinopathy, which can demonstrate a relationship between ACE and diabetic retinopathy. In this study, patients with diabetic retinopathy had higher serum ACE levels (6.3 +/- 0.2) than nondiabetic patients (4.3 +/- 0.5) (p0.001). In addition, the mean serum ACE level in diabetic patients with nonproliferative retinopathy (5.55 +/- 0.4) was less than that in diabetic patients with proliferative retinopathy (6.63 +/- 0.25) (p = 0.02). Due to the variability in individual serum ACE levels and the frequent use of ACE inhibitors by hypertensive diabetics, these techniques are not suitable for retinopathy screening programs. However, the graded relationship demonstrated by these data may have relevance for the pathophysiology of diabetic retinopathy.

Published
1993
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10. Incidence and Early Course of Retlnonathy of Prematurity

Author

Earl A. Palmer, John T. Flynn, Robert J. Hardy, Dale L. Phelps, Cynthia L. Phillips, David B. Schaffer, Betty Tung, Frederick J. Elsas, Jan M. Botsford, Karen W. Braune, George Cassady, John A. Jones, James A. Kimble, Lanning Kline, Douglas Witherspoon, Malinda Young, Alan M. Roth, Byron H. Demorest, Roberta Erickson, William S. Gilbert, Georgia A. Chrousos, David S. Friendly, Mohammad Jaafar, Marshall P. Keys, Martin P. Kolsky, Patricia Ann Mercer, Donna O'Neill, John F. O'Neill, Edward S. Parelhoff, Ed Perraut, A. Raymond Pilkerton, David Plotsky, John Clarkson, Gabrielle Lopez, Marilyn T. Miller, Rama Bhat, Steven B. Cohen, Cathleen Cronin, Mark Daily, Donald A. Gagliano, Richard Gieser, Betty Anne Haldi, Kristine McCulloch, David Mittelman, Tonse N. Raju, David Sheftel, Kathleen Skuran, Daniel B. Sobel, Peggy Squires, Charles Vygantas, Forrest D. Ellis, Steve Archer, Eugene M. Helveston, Ken Julian, Gayle Reed, Richard Schreiner, Charles C. Barr, David N. Adamkin, Craig H. Douglas, Gregory K. Whittington, Shirley Wilkerson, Robert A. Gordon, Carolyn Bushaw, W. Michael DeVoe, James G. Diamond, William L. Gill, Donald R. May, Jane E. Reynolds, Thomas G. Storch, Serge de Bustros, Alethia Alford, Janet Graeber, Michael X. Repka, Michael T. Trese, John D. Baker, Ghaleb F. Hatem, Patricia Manatrey, Doreen Medalis, Robert C. Ramsay, C. Gail Summers, J. Douglas Cameron, Kim Chisholm, Rebecca Heikenen, Donna K. Irlbeck, Alvina M. Janda, Leslie A. Kopietz, Robin Kriedeman, Jane D. Lavoie, Molly Maxwell, Ted R. Pier, William P. Rodman, Patty Witt, Amy Woody, Paul Torrisi, Thaddeus Zak, Kathy Cohen, Rajesh J. Dave, Ernest Guillet, David Hakanson, Robert Hampton, Walter Merriam, Henry S. Metz, Ellen Pronobis, Richard Simon, Robert E. Vanderlinde, Nancy E. Wood, Donald N. Zehl, Edward Buckley, Malcolm M. Anderson, Grace Valentine, Susie Wong, Miles J. Burke, Judith C. Johnson, Gary L. Rogers, Don L. Bremer, Leandro Cordero, Rae R. Fellows, Nancy B. Hansen, Richard E. McClead, Arthur A. Aaby, Raul Banagale, Gerda I. Benda, Nancy D. Binder, William J. Brown, Joseph T. Gilhooly, Shawn Goodman, Robert K. Huston, Susan B. LaFrance, Patrick K. Lewallen, John V. McDonald, David L. Murphy, John W. Reynolds, Joseph Robertson, Andrea C. Tongue, Frank W. Bowen, Maria Delivoria-Papadopoulos, Hemant J. Desai, Gary R. Diamond, Joan M. Giannetta, Michael A. Naidoff, George J. Peckham, Jeanette R. Pleasure, Rachael Porat, Graham E. Quinn, Albert W. Biglan, David R. Brown, Bernard H. Doft, Andrew W. Eller, Louis A. Lobes, Richard A. Saunders, Linda M. Christmann, Tom L. Austin, Lesley Berkeley, James G. Ferguson, Wilson G. McWilliams, Karen W. Miller, Sharada Pai, V. Al Pakalnis, Dilip M. Purohit, Stephen S. Feman, Robert Cotton, James H. Elliott, Amy B. Law, Steven D. Steele, Rand Spencer, Priscilla M. Berry, Gary E. Fish, Dwain G. Fuller, William L. Hutton, Joel Lefer, Jean R. Manning, George E. Sanborn, William B. Snyder, David R. Stager, W.A.J. van Heuven, Marilyn B. Escobedo, Maria G. Montez, James W. Speights, Jane D. Kivlin, Susan Bracken, John Carver, Jack Dolcourt, Robert O. Hoffman, Michael Teske, and A. Thomas Williams

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, genetic structures, business.industry, medicine.medical_treatment, Birth weight, Incidence (epidemiology), Gestational age, Retinopathy of prematurity, Cryotherapy, medicine.disease, eye diseases, Ophthalmology, Postnatal age, Multicenter trial, Medicine, business, Retinopathy
Abstract

In the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (ROP), 4099 infants weighing less than 1251 g at birth underwent sequential ophthalmic examinations, beginning at age 4 to 6 weeks, to monitor the incidence and course of ROP. Overall, 65.8% of the infants developed ROP to some degree; 81.6% for infants of less than 1000 g birth weight. As expected, ROP incidence and severity were higher in lower birth weight and gestational age categories. Black infants appeared less susceptible to ROP, of all severity categories, than nonblack infants. The timing of retinal vascular events correlated more closely with postconceptional age than with postnatal age, implicating the level of maturity more than postnatal environmental influences in governing the timing of these vascular events. These results include the current incidence of various severity stages of ROP found in the United States and provide new. insight into the development of ROP.

Published
1991
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11. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial

Author

Timothy W. Olsen, S. Hitt, Thomas J. Songer, Alan M. Jacobson, A. Burwood, R. Beaser, M. Szpiech, H. Martinez, Gayle M. Lorenzi, Anthony D. Morrison, C. Hannon, A. Farr, M. Hebdon, R. Colligan, T. Manolio, C. Wilson, Kathie L. Hermayer, John I. Malone, B. Burzuk, Kathy Glander, N. Silvers, B. Jones, A. Galpirn, M. Reid, David E. Goldstein, L. Sun, J. Giangiacom, P. Lou, Dean P. Hainsworth, Shalamar D. Sibley, Ronald J. Prineas, Louis A. Lobes, H. Wolpert, Mark E. Molitch, J. Sheindlin, Senda Ajroud-Driss, L. Dews, Kate Edwards, John M. Pach, Wanjie Sun, E. Cupelli, K. Stoessel, Samuel Dagogo-Jack, K. Harvey, J. Gordon, M. B. Murphy, John P. Bantle, J. D. Carey, Inger Burnett-Zeigler, Andrew M. Paterson, Henry Ferreyra, Manjot K. Gill, Barbara H. Waberski, B. Rogness, Fred W. Whitehouse, R. Ufret, Gordon C. Weir, Daniel H. O'Leary, S. Thomas, Barbara E. K. Klein, G. Ziegler, C. Wigley, L. Kastorff, C. Siebert, M. Palmert, C. Clark, J. Brown-Friday, S. Braunstein, Martin J. Stevens, M. Nutaitis, S. Catton, Samir S. Deeb, William V. Tamborlane, J. Alappatt, Robert Bergren, R. Eastman, Samuel S. Engel, K. Gehres, John M. Lachin, Davida F. Kruger, Jill P. Crandall, P. Geithman, Blanche M. Chavers, Stephen S. Feman, Mary E. Larkin, Thomas C. Lee, Catherine L. Martin, J. Parker, C. West, A. Gordon, Hugh D. Wabers, Sharon B. Schwartz, B. Zinman, M. Espeland, Neil H. White, M. N. Iyer, Rose Gubitosi-Klug, C. Canny, Robert Detrano, S. MacLean, Alice T. Lyon, M. E. Lackaye, Oscar B. Crofford, David A. Lee, M. Brent, Mark S. Mandelcorn, D. Badal, Lucy A. Levandoski, Barbara J. Maschak-Carey, John E. Godine, M. Hawkins, R. Gstalder, L. Survant, Charles Campbell, Matthew D. Davis, Anupam Agarwal, Lawrence J. Singerman, Brandy N. Rutledge, Anita Harrington, M. Novak, David A. Nicolle, P. Gaston, Isaac Boniuk, William H. Herman, S. Park, D. Counts, J. Quin, Nancy L. Robinson, Enrico Cagliero, T. Adkins, T. Woodfill, Scott M. Steidl, John Dupre, P. A. Bourne, L. Baker, D. Sandstrom, K. Miner, L. Mayer, S. Schussler, N. Grove, N. Wong, A. Iannacone, D. Wood, Lisa Diminick, D. Meyer, Barbara Esser, T. Thompson, David M. Nathan, A. Edwards, Lee M. Jampol, David S. Schade, M. Croswell, Joseph F. Polak, M. Spencer, Helen Lambeth, Paul G. Arrigg, Janie Lipps, H. Zegarra, Rodney A. Lorenz, Ayad A. Jaffa, James W. Albers, P. Astlesford, Thomas A. Weingeist, J. Vaccaro-Kish, Alicia J. Jenkins, Ronald K. Mayfield, M. May, A. Kowarski, Michael W. Steffes, W. T. Garvey, Saul Genuth, D. Zheng, Andrew P. Boright, J. Ginsberg, M. L. Bernal, Daniel L. McGee, Eva L. Feldman, Larry Rand, P. Low, J. Rosenzweig, L. Funk, Larry D. Hubbard, Orville G. Kolterman, D. Blackburn, E. Steuer, D. Rosenberg, Rodica Pop-Busui, S. Moser, John E. Hokanson, Julio V. Santiago, Daniel T. Lackland, James L. Kinyoun, Kevin J. Blinder, K. Taylor, D. Hornbeck, C. O'Donnell, Bernard H. Doft, Susan G. Elner, Dean B. Burgess, D. Kenny, Jeffrey M. Joyce, John D. Brunzell, O. Hamdy, Jerry P. Palmer, Jonathan Q. Purnell, R. Zeither, Douglas A. Greene, E. A. Tanaka, Yu-Guang He, Ramzi K. Hemady, Arup Das, Michael Bryer-Ash, Sheila Smith-Brewer, D. Ostrowski, M. Stern, C. Williams, Andrew K. Vine, M. McLellan, Ronald Klein, Annette Barnie, Michael H. Goldbaum, E. Angus, S. Scherer, R. D'Agostino, Philip Raskin, Santica M. Marcovina, B. Schaefer, A. F. Burrows, K. Morgan, David J. Brillon, H. Ricks, S. Strowig, R. Oudiz, S. Yacoub-Wasef, Jye-Yu C. Backlund, K. Chan, B. Gloeb, M. Johnson, Stephen R. Russell, D. J. Becker, Richard S. Crow, J. L. Canady, David G. Miller, O. Stone, Allan L. Drash, S. Yoser, S. Johnsonbaugh, Edward Chaum, L. Kaminski, M. Fox, J. Kramer, M. Bracey, H. Engel, Peter R. Pavan, Maria F. Lopes-Virella, C. Sommer, Daniel P. Joseph, M. Geckle, V. Reppucci, D. Etzwiler, M. Brabham, J. Fradkin, K. Lee, Jean M. Bucksa, E. Golden, Thomas Donner, Edwin M. Stone, Shelley B. Bull, William I. Sivitz, J. Selby, Pamela Rath, Murk-Hein Heinemann, L. Kim, T. Williams, D. Noller, D. Singer, J. Long, G. Grand, R. Devenyi, J. M. Schluter, B. Petty, Margaret L. Bayless, Alexander J. Brucker, S. Fritz, C. Cowie, Om P. Ganda, F. Thoma, K. Klumpp, Z. Strugula, Timothy J. Lyons, Patricia A. Cleary, A. Blevins, H. Shamoon, J. Soule, John A. Colwell, M. Phillips, Gaurav K. Shah, C. Hurtenbach, S. Rogers, Richard M. Bergenstal, Patricia Gatcomb, R. Trail, H. Culver Boldt, J. Bayless, Jonathan Shankle, David M. Kendall, Matthew A. Thomas, P. G. Sharuk, P. Lindsey, Ronald P. Danis, Christopher M. Ryan, William Dahms, P. Paczan Rath, S. Elsing, Gabriel Virella, Abbas E. Kitabchi, D. Moore, S. Pendegras, Trevor J. Orchard, K. Nickander, A. Determan, L. Van Ottingham, J. Harth, Michael W. Neider, and Shelly Olson

Subjects
Adult, Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Adolescent, Article, law.invention, chemistry.chemical_compound, Young Adult, Randomized controlled trial, law, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Prevalence, Humans, Hypoglycemic Agents, Insulin, Risk factor, Infusion Pumps, Glycated Hemoglobin, Type 1 diabetes, Diabetic Retinopathy, medicine.diagnostic_test, business.industry, Incidence, Fundus photography, Diabetic retinopathy, medicine.disease, Surgery, Ophthalmology, Diabetes Mellitus, Type 1, chemistry, Disease Progression, Female, Glycated hemoglobin, business, Retinopathy, Follow-Up Studies
Abstract

OBJECTIVE To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at near-normal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy. METHODS Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10. Further 3-step progression on the Early Treatment Diabetic Retinopathy Study scale from DCCT closeout was the primary outcome. RESULTS After 10 years of EDIC follow-up, there was no significant difference in mean glycated hemoglobin levels (8.07% vs 7.98%) between the original treatment groups. Nevertheless, compared with the former conventional treatment group, the former intensive group had significantly lower incidences from DCCT close of further retinopathy progression and proliferative retinopathy or worse (hazard reductions, 53%-56%; P < .001). The risk (hazard) reductions at 10 years of EDIC were attenuated compared with the 70% to 71% over the first 4 years of EDIC (P < .001). The persistent beneficial effects of former intensive therapy were largely explained by the difference in glycated hemoglobin levels during DCCT. CONCLUSION The persistent difference in diabetic retinopathy between former intensive and conventional therapy ("metabolic memory") continues for at least 10 years but may be waning. TRIAL REGISTRATION (clinicaltrials.gov) Identifiers: NCT00360815 and NCT00360893.

Published
2008

12. THE THALASSEMIAS 282.4

Author

Stephen S. Feman, Ozgur Yalcinbayir, and Levent Akduman

Subjects
Genetics, business.industry, Thalassemia, Medicine, business, medicine.disease
Published
2008
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13. CONTRIBUTORS

Author

Richard L. Abbott, Natalie A. Afshari, Jaya Agrawal, Shishir Agrawal, Trilok P. Agrawal, Levent Akduman, Esen K. Akpek, Amal Al-Sayyed, Thomas A. Albini, Deborah M. Alcorn, Amar Alwitry, Anouk Amzel, Nicole J. Anderson, Ejaz A. Ansari, Andrew Antoszyk, James H. Antoszyk, James V. Aquavella, Sumaira A. Arain, J. Fernando Arévalo, Guruswami Arunagiri, Carlos W. Arzabe, La-ongsri Atchaneeyasakul, Huban Atilla, Ümit Aykan, Brandon D. Ayres, Juan J. Barbón, Kristi Bailey, Frank G. Baloh, Irina S. Barequet, André Barkhuizen, Michael A. Bearn, Rubens Belfort, A. Robert Bellows, Audina M. Berrocal, Marijke Wefers Bettink-Remeijer, Anuja Bhandari, M. Tariq Bhatti, Mark S. Blumenkranz, Kostas G. Boboridis, James P. Bolling, Vivien Boniuk, Paul Jorge Botelho, Paul W. Brazis, Fion D. Bremner, Edward G. Buckley, John D. Bullock, David Matthew Bushley, Jorge Alberto F. Caldeira, Anne Carricajo, Gian Maria Cavallini, Matilda Frances Chan, Damon B. Chandler, H. Channa, Devron H. Char, Steve Charles, Teresa C. Chen, Steven S.T. Ching, Christophe Chiquet, Phillip Hyunchul, Timothy Y. Chou, Stephen P. Christiansen, Kelly D. Chung, George A. Cioffi, Michael P. Clarke, David K. Coats, Elisabeth J. Cohen, R. Max Conway, Catherine Creuzot-Garcher, Emmett T. Cunningham, Theodore H. Curtis, Roger A. Dailey, Richard M. Davis, Romain De Cock, Jan-Tjeerd H.N. de Faber, Daniel de la Mano, Nick W.H.M. Dekkers, Monte Anthony Del Monte, David A. Della Rocca, Robert C. Della Rocca, Deepinder K. Dhaliwal, Diana V. Do, Peter J. Dolman, Sean P. Donahue, Eric D. Donnenfeld, Graham Duguid, Jay S. Duker, James P. Dunn, Steven P. Dunn, Hon-Vu Q. Duong, Robert A. Egan, Michael D. Eichler, Mays El-Dairi, Forrest J. Ellis, Geoffrey Emerson, M. Vaughn Emerson, Laura B. Enyedi, Teodoro Evans, Julie Falardeau, Bishara M. Faris, Marianne E. Feitl, Warren L. Felton, Stephen S. Feman, Timothy J ffytche, Christina J. Flaxel, Rod Foroozan, Allen Foster, Frederick T. Fraunfelder, Frederick W. Fraunfelder, H. Mackenzie Freeman, Mitchell H. Friedlaender, Larry P. Frohman, Wayne E. Fung, Philippe Gain, Jaime R. Gaitan, Stephen Gancher, Tim Gard, Devin M. Gattey, Peter L. Gehlbach, Mehdi Ghajarnia, Vinícius Coral Ghanem, Amit Kumar Ghosh, Chandak Ghosh, Matthew Giegengack, Geoffrey Gladstone, Daniel H. Gold, Richard L. Golub, Dan S. Gombos, George M. Gombos, William V. Good, Shawn Goodman, John D. Gottsch, Srinivas Goverdhan, Baird S. Grimson, Adolfo Güemes, Roberto Guerra, Julia A. Haller, Kristin M. Hammersmith, Irvin L. Handelman, Roderick N. Hargrove, Michael S. Harney, Richard A. Harper, Sarah R. Hatt, Barbara S. Hawkins, Sohan S. Hayreh, Arnd Heiligenhaus, Carsten Heinz, Leon W. Herndon, Simon J. Hickman, Koji Hirano, Edward J. Holland, Gary N. Holland, Eric R. Holz, Sachiko Hommura, Jeffrey D. Horn, Richard B. Hornick, H. Dunbar Hoskins, James W. Hung, Brian A. Hunter, Krista A. Hunter, Alex P. Hunyor, Brian Hurwitz, Thomas S. Hwang, Robert A. Hyndiuk, Ozge Ilhan-Sarac, Edsel Ing, Masanori Ino-ue, Carlos M. Isada, Saylin Iturriaga, Joseph D. Iuorno, Andrew G. Iwach, Mohan N. Iyer, Natalio J. Izquierdo, Lee M. Jampol, Suzanne Johnston, Sibel Kadayifçilar, Ian H. Kaden, Dieudonne Kaimbo Wa Kaimbo, Rashmis Kapur, Peter R. Kastl, Garyfallia Katsavounidou, Ayat Kazerouni, Michael Kazim, Sanjay R. Kedhar, Ronald V. Keech, Robert C. Kersten, Marshall P. Keys, Sangeeta Khanna, Peng Tee Khaw, James L. Kinyoun, Caitriona Kirwan, Tero Kivelä, Michael L. Klein, Stephen A. Klotz, John Ko, Regis P. Kowalski, Jay H. Krachmer, Theodore Krupin, Ferenc Kuhn, Abhaya Vivek Kulkarni, Robert C. Kwun, Peter R. Laibson, Rohit R. Lakhanpal, Byron L. Lam, Laurent Lamer, David P. Lawlor, Andrew W. Lawton, Alan B. Leahey, Russell LeBoyer, Andrew G. Lee, Wen-Hsiang Lee, William Barry Lee, Sharon S. Lehman, Howard M. Leibowitz, James Leong, Alex V. Levin, Leonard A. Levin, Mark R. Levine, Norman S. Levy, Thomas J. Liesegang, Lyndell L. Lim, Linda H. Lin, Richard D. Lisman, David Litoff, James C. Liu, Evan Loft, Ronald R. Lubritz, David C.W. Mabey, Ian A. Mackie, Srilakshmi Maguluri, M. Maliki, Nick Mamalis, Mark J. Mannis, Steven L. Mansberger, Ahmad M. Mansour, Alexandre S. Marcon, Italo M. Marcon, Peter B. Marsh, Rookaya Mather, William D. Mathers, K. Matti Saari, Louise A. Mawn, Penny J. McAllum, Rex M. McCallum, Peter McCluskey, Gregory J. McCormick, Steven A. McCormick, James P. McCulley, John G. McHenry, Alan A. McNab, Jared J. Mee, Douglas L. Meier, David M. Meisler, Saul C. Merin, Dale R. Meyer, Roger F. Meyer, Kevin S. Michels, Tatyana Milman, Roni Mintz, Chantal F Morel, William R. Morris, Mark L. Moster, John Mourani, Cristina Muccioli, Raghu C. Mudumbai, Fernando H. Murillo-Lopez, Shoib Myint, Parveen K Nagra, A Naoumi, John Nassif, Michelle T. Nee, Marcelo V. Netto, John D. Ng, Hau T. Nguyen, Quan Dong Nguyen, Denis M. O'Day, A. Justin O'Day, Henry S. O'Halloran, Michael O'Keefe, Fumiki Okamoto, Richard J. Olson, James C. Orcutt, Sema Oruc Dundar, Aaron Osbourne, Maristela Amaral Palazzi, Earl A. Palmer, Maria Papadopoulos, Jeffrey R. Parnell, Cameron F. Parsa, Sanjay V. Patel, Emily Patterson, Scott D. Pendergast, Henry D. Perry, Keith Roberson Peters, Stephanie M. Po, Russell Pokroy, Allen Michael Putterman, Rubén Queiro, Nastaran Rafiei, Bahram Rahmani, Christopher J Rapuano, Karim Rasheed, S.R. Rathinam, Lawrence A. Raymond, Russell W. Read, August Lafayette, Franco M. Recchia, James J. Reidy, Adam C. Reynolds, Larry F. Rich, Robert Ritch, Richard M. Robb, Pierre-Yves Robert, Joseph E. Robertson, Shiyoung Roh, Jean-Paul Romanet, Jack Rootman, Barbara L. Roque, Manolette R. Roque, Arthur L. Rosenbaum, James Todd Rosenbaum, F. Hampton Roy, Paul A. Rundle, Alfredo A. Sadun, Norman A. Saffra, Sarwat Salim, John R. Samples, Alvina Pauline D Santiago, David A. Saperstein, Richard A. Saunders, James A. Savage, Tina A. Scheufele, Vivian Schiedler, Thomas K. Schlesinger, Abraham Schlossman, Lee K. Schwartz, Ingrid U. Scott, Jennifer Scruggs, Ernesto I. Segal, Ismail A. Shalaby, Aziz Sheikh, John D. Sheppard, Mark D. Sherman, Carol L. Shields, Jerry A. Shields, Amarpreet Singh, Christopher N. Singh, Eric L. Singman, Donna Siracuse-Lee, Aaron D. Smalley, Patricia W. Smith, Anthony W. Solomon, Hassane Souhail, Daniel H. Spitzberg, Thomas C. Spoor, Robert L. Stamper, Walter J. Stark, Eric A. Steele, Thomas L. Steinemann, Ann U. Stout, J. Timothy Stout, R. Doyle Stulting, Alan Sugar, Joel Sugar, Donny W. Suh, Eric B. Suhler, John H. Sullivan, John Everett Sutphin, Kenneth C. Swan, Khalid F. Tabbara, Mandeep S. Tamber, Angelo P. Tanna, Sinan Tatlipinar, Ramin Tayani, Klaus D. Teichmann, Mark A. Terry, Clement Chee Yung Tham, A. Therzaz, Gilles Thuret, Christopher Graham Tinley, Andrea C. Tongue, Rodrigo J. Torres, Robert N. Tower, Elias I Traboulsi, Rupan Trikha, Brenda J. Tripathi, Ramesh C. Tripathi, Ilknur Tugal-Tutkun, Irene Tung, Judith A. M. Van Evendingen, Jean D. Vaudaux, Niteen S Wairagkar, Joseph D. Walrath, Rory McConn Walsh, David S. Walton, Ronald E. Warwar, Peter G. Watson, John J. Weiter, Richard G. Weleber, Fleming D. Wertz, Igor Westra, David T. Wheeler, Charles P. Wilkinson, David J. Wilson, M. Edward Wilson, Matthew W. Wilson, Steven E Wilson, John L. Wobig, Terry D. Wood, Lihteh Wu, Ozgur Yalcinbayir, Howard Shann-Cherng Ying, Peter N. Youssef, and Gerald W. Zaidman

Published
2008
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14. Comparison of the modified Early Treatment Diabetic Retinopathy Study and mild macular grid laser photocoagulation strategies for diabetic macular edema

Author

Sharon D. Solomon, Samara F. Strauber, David Callanan, Frederick L. Ferris, Craig Kollman, Lloyd Paul Aiello, Adam R. Glassman, Matthew D. Davis, Ronald P. Danis, Scott M. Friedman, Charles A. Garcia, Donald S. Fong, Andreas K. Lauer, Roy W. Beck, Franco M. Recchia, Stephen S. Feman, Dennis P. Han, and Darma Le

Subjects
Male, medicine.medical_specialty, Visual acuity, genetic structures, medicine.medical_treatment, Visual Acuity, Fundus (eye), Macular Edema, Retina, Article, Optical coherence tomography, Edema, Ophthalmology, medicine, Humans, Macular edema, Diabetic Retinopathy, Laser Coagulation, medicine.diagnostic_test, business.industry, Diabetic retinopathy, Middle Aged, medicine.disease, Confidence interval, Surgery, Diabetes Mellitus, Type 1, Treatment Outcome, Diabetes Mellitus, Type 2, Retreatment, Female, medicine.symptom, business, Laser coagulation, Tomography, Optical Coherence, Follow-Up Studies
Abstract

Objective To compare 2 laser photocoagulation techniques for treatment of diabetic macular edema: the modified Early Treatment Diabetic Retinopathy Study (ETDRS) direct/grid photocoagulation technique and a potentially milder (but potentially more extensive) mild macular grid (MMG) laser technique in which microaneurysms are not treated directly and small mild burns are placed throughout the macula, whether or not edema is present. Methods Two hundred sixty-three subjects (mean age, 59 years) with previously untreated diabetic macular edema were randomly assigned to receive laser photocoagulation by either the modified ETDRS (162 eyes) or MMG (161 eyes) technique. Visual acuity, fundus photographs, and optical coherence tomography measurements were obtained at baseline and at 3.5, 8, and 12 months. Treatment was repeated if diabetic macular edema persisted. Main outcome measure Change in optical coherence tomography measurements at 12-month follow-up. Results Among eyes with a baseline central subfield thickness of 250 microm or greater, central subfield thickening decreased by an average of 88 microm in the modified ETDRS group and by 49 microm in the MMG group at 12-month follow-up (adjusted mean difference, 33 microm; 95% confidence interval, 5-61 microm; P = .02). Weighted inner zone thickening by optical coherence tomography decreased by 42 microm in the modified ETDRS group and by 28 microm in the MMG group (adjusted mean difference, 14 microm; 95% confidence interval, 1-27 microm; P = .04); maximum retinal thickening (maximum thickening of the central and 4 inner subfields) decreased by 66 and 39 microm, respectively (adjusted mean difference, 27 microm; 95% confidence interval, 6-47 microm; P = .01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference, 0.3 mm3; 95% confidence interval, 0.02-0.53 mm3; P = .03). At 12 months, the mean change in visual acuity was 0 letters in the modified ETDRS group and 2 letters worse in the MMG group (adjusted mean difference, 2 letters; 95% confidence interval, -0.5 to 5 letters; P = .10). Conclusions At 12 months after treatment, the MMG technique was less effective at reducing optical coherence tomography-measured retinal thickening than the more extensively evaluated current modified ETDRS laser photocoagulation approach. However, the visual acuity outcome with both approaches is not substantially different. Given these findings, a larger long-term trial of the MMG technique is not justified. Application to clinical practice Modified ETDRS focal photocoagulation should continue to be a standard approach for treating diabetic macular edema. Trial registration clinicaltrials.gov Identifier: NCT00071773.

Published
2007

15. Statins ameliorate endothelial barrier permeability changes in the cerebral tissue of streptozotocin-induced diabetic rats

Author

Michael J. Haas, Oksana Batejko, Meri R. Hovsepyan, Stephen S. Feman, and Arshag D. Mooradian

Subjects
Male, medicine.medical_specialty, Simvastatin, Statin, Endothelium, medicine.drug_class, Endocrinology, Diabetes and Metabolism, Retina, Diabetes Mellitus, Experimental, Capillary Permeability, Internal medicine, Coronary Circulation, Blood-Retinal Barrier, Internal Medicine, medicine, Animals, Rosuvastatin, Rosuvastatin Calcium, Fluorescent Dyes, Volume of distribution, Sulfonamides, business.industry, Myocardium, Cardiac muscle, nutritional and metabolic diseases, Brain, Dextrans, Streptozotocin, Rats, Inbred F344, Rats, Fluorobenzenes, Kinetics, Endocrinology, medicine.anatomical_structure, Pyrimidines, Blood-Brain Barrier, Endothelium, Vascular, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Fluorescein-5-isothiocyanate, medicine.drug
Abstract

Statins may have favorable effects on endothelial barrier function. The effect of rosuvastatin and simvastatin therapy (10 mg/kg) for 5 weeks on blood-brain barrier (BBB), blood-retinal barrier (BRB), and cardiac muscle permeability of streptozotocin-induced diabetic rats was studied. The size-selective permeability of different vascular beds to a group of fluorescein isothiocyanate dextrans of varying molecular weights was measured. The volume of distribution of 250-, 70-, and 40-kDa dextrans in the cerebral tissue of diabetic rats were significantly increased. The volume of distribution of these dextrans in cerebral tissue was normalized by both statins. Diabetes did not significantly alter the BRB, but both statins decreased the volume of distribution of 70- and 40-kDa dextrans in the retina. The volume of distribution of 40 kDa in cardiac muscle was increased in diabetes, and this change was prevented with statin treatment. Treatment with rosuvastatin and mevalonate (150 mg/kg in drinking water for 5 weeks) did not alter the volume of distribution measurements. We concluded that 1) diabetes in rats is associated with significant changes in the BBB permeability; 2) statin treatment improves the endothelial barrier function in cerebral tissue, retina, and cardiac muscle; and 3) this statin effect could not be attributed to HMGCoA reductase inhibition.

Published
2005

16. Severe pupil distortion following transchamber repair of a cyclodialysis cleft

Author

John C, Nichols, Dave H, Lee, Stephen S, Feman, and Steven R, Shields

Subjects
Male, Fundus Oculi, Ciliary Body, Suture Techniques, Visual Acuity, Ophthalmologic Surgical Procedures, Retinal Perforations, Wounds, Nonpenetrating, Retina, Eye Injuries, Postoperative Complications, Treatment Outcome, Pupil Disorders, Tennis, Humans, Child
Abstract

This report describes a potential complication following the repair of a traumatic cyclodialysis cleft in a pediatric patient using a novel technique. A healthy 11-year-old boy suffered a blunt traumatic tennis ball injury to his left eye. He underwent repair of a retinal dialysis with detachment shortly after the injury. Postoperatively, he developed persistent hypotony, shallow anterior chamber, and hypotony maculopathy. An occult cyclodialysis cleft was suspected. Examination under anesthesia revealed a small cyclodialysis deft. The cleft was closed by transchamber placement of prolene sutures across the cleft under direct visualization through a Tano lens. Postoperative course was complicated by severe pupillary distortion despite subsequent suture removal.

Published
2002

17. FROSTED BRANCH ANGIITIS SECONDARY TO HERPES SIMPLEX VIRUS INFECTION PROGRESSING TO ACUTE RETINAL NECROSIS

Author

Stephen S. Feman and Andrew J. Barkmeier

Subjects
Herpes simplex virus infection, business.industry, Polymerase chain reaction analysis, Retinal detachment, General Medicine, medicine.disease_cause, medicine.disease, Virology, eye diseases, Ophthalmology, Herpes simplex virus, medicine, Viral disease, Acute retinal necrosis, business
Abstract

Purpose To describe a case of frosted branch angiitis secondary to herpes simplex virus type 2 infection that progressed to acute retinal necrosis. Methods The medical records and clinical photographs were reviewed for a patient with frosted branch angiitis that progressed to acute retinal necrosis. Results The patient rapidly developed acute retinal necrosis followed by rhegmatogenous retinal detachment. Polymerase chain reaction analysis of the vitreous was positive for herpes simplex virus type 2. Discussion Frosted branch angiitis is a clinical sign that may represent active viral disease capable of progressing to acute retinal necrosis.

Published
2009
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18. The decreasing incidence and severity of retinopathy of prematurity

Author

William F. Walsh, Sean P. Donahue, Robbin B. Sinatra, Steven R. Bullard, and Stephen S. Feman

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Birth weight, Severity of Illness Index, Retina, Severity of illness, medicine, Humans, Infant, Very Low Birth Weight, University medical, Retinopathy of Prematurity, Survival rate, Retrospective Studies, business.industry, Incidence (epidemiology), Incidence, Infant, Newborn, Retrospective cohort study, Retinopathy of prematurity, medicine.disease, Tennessee, eye diseases, Survival Rate, Ophthalmology, Pediatrics, Perinatology and Child Health, business
Abstract

Purpose: We sought to determine whether the incidence of retinopathy of prematurity (ROP) at our institution has changed since the Cryo-ROP recruitment period 10 years ago. Methods: We determined the incidences of threshold ROP, prethreshold ROP, less-than-prethreshold ROP, and no disease for each of 3 birth weight classes (

Published
1999

20. Thalassemia

Author

Stephen S. Feman

Subjects
Ophthalmology, Pediatrics, medicine.medical_specialty, Eye Diseases, business.industry, Thalassemia, medicine, Humans, Infant, Blood Transfusion, medicine.disease, business
Published
2006
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21. Diabetes- and thyroid-related eye disease

Author

Stephen S. Feman

Subjects
medicine.medical_specialty, genetic structures, Eye Diseases, Eye disease, Mice, Transgenic, Diabetic Eye Disease, Diabetes Mellitus, Experimental, Diabetes Complications, Mice, Autoimmune Process, Diabetes mellitus, Diabetes Mellitus, Endocrine system, Medicine, Animals, Humans, Epidemiologic Factors, business.industry, Thyroid, General Medicine, medicine.disease, Dermatology, Thyroid Diseases, eye diseases, Disease Models, Animal, Ophthalmology, medicine.anatomical_structure, sense organs, business, Retinopathy
Abstract

Diabetes and thyroid-related eye disease cause significant morbidity. Although these are endocrine disorders, they cause different ocular manifestations. Previously unexamined epidemiologic factors offer new insight to diabetic eye disease. The association of hyperglycemia, systemic medical therapy, and visual loss is reviewed. Although retinopathy remains the leading cause of blindness, multiple "nonretinal" diabetic ocular problems occur and how these correspond with retinopathy is examined. Thyroid-related eye disease, as seen in Graves' ophthalmopathy, is an autoimmune process. This is reexamined and new ultrasound techniques to measure disease activity are described. The advantage of therapies directed against these features is reported.

Published
1996

22. The Vanderbilt Classification System in the evaluation of diabetic retinopathy patients treated with Alredase

Author

S S, Feman, T C, Leonard-Martin, and J R, Redman

Subjects
Adult, Male, Observer Variation, Diabetic Retinopathy, Adolescent, Reproducibility of Results, Middle Aged, Naphthalenes, Tennessee, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Double-Blind Method, Aldehyde Reductase, Humans, Female, Prospective Studies, Enzyme Inhibitors, Aged, Follow-Up Studies, Research Article
Abstract

BACKGROUND: The Vanderbilt Classification System is a quantitative method of measuring features detected in diabetic retinopathy photographs. It does not require comparisons to preexisting standard photographs. This is the first report of the application of this system to a large-scale, multiple-medical-center drug trial. METHODS: This was a prospective, randomized, double-masked, placebo-controlled study that involved 74 medical centers. There were 3,679 out-patients followed for more that 4 years, with some observed for over 9 years. The Vanderbilt Classification System generated patient data for the Early Treatment Diabetic Retinopathy Study (ETDRS) and the Diabetes Control and Complication Trial (DCCT) scales. The deterioration rate was one variable used to assess drug effect. A comprehensive Quality Assurance Program evaluated intergrader and intragrader reliability. RESULTS: Target values for reliability and reproducibility were met or exceeded on all measures of agreement between photo readers and over time. Kappa statistics were 0.610 or greater, with most weighted kappa values greater than 0.810. This represents "almost perfect agreement" and compares favorably with previous reports from the ETDRS and DCCT. CONCLUSION: Diabetic retinopathy can be evaluated in a reliable and reproducible manner with the VCS. The VCS is unique in that it produces a quantitative analysis of retinal lesions. Subtle variations that might be influenced by systemic medications can be measured accurately with this technique.

Published
1996

24. A quantitative system to evaluate diabetic retinopathy from fundus photographs

Author

S S, Feman, T C, Leonard-Martin, J S, Andrews, C C, Armbruster, T L, Burdge, J D, Debelak, A, Lanier, and A G, Fischer

Subjects
Observer Variation, Diabetic Retinopathy, Fundus Oculi, Photography, Humans, Reproducibility of Results, Retina
Abstract

To evaluate a quantitative system to measure the early lesions of diabetic retinopathy seen in stereoscopic fundus photographs.Using a quantitative classification system, photographs of 4657 eyes (7 stereo pairs of 35-mm slides per eye) were scored for 16 diabetic lesions. A single severity level (identical to the ETDRS Interim Scale) was calculated for each eye. The reliability of this technique, and its reproducibility by independent examiners, was evaluated for individual lesions and severity levels using percent agreement, kappa, and weighted kappa statistics.This quantitative technique demonstrated an "almost perfect" agreement (weighted kappaor = 0.810) on all but one lesion by independent observers. For the severity levels, there was a 95.7% perfect agreement (kappa = 0.9428). The reproducibility of agreement over time was "almost perfect" on all but four lesions; with 88% perfect agreement (kappa = 0.8394) for severity levels.When used to evaluate the early lesions of diabetic retinopathy, the Vanderbilt Classification System is highly reliable between graders and over time. This system can gather quantitative data and evaluate incremental changes in an accurate, reproducible manner.

Published
1995

25. The natural history of the first clinically visible features of diabetic retinopathy

Author

S S, Feman

Subjects
Adult, Male, Diabetic Retinopathy, Adolescent, Retinal Vessels, Middle Aged, Aneurysm, Diabetes Mellitus, Type 1, Photography, Humans, Female, sense organs, Follow-Up Studies, Research Article
Abstract

Microaneurysms are the first features of human diabetic retinopathy that can be detected with common clinical techniques. These are found, most often, in photographic field 2 (that is, an area occupying 30 degrees of the ocular fundus centered on the middle of the macula). After the first microaneurysms develop, there will be a tendency for more to appear; however, over time many of the original microaneurysms will become no longer visible with clinical techniques, while other, newer, microaneurysms mature. After the onset of microaneurysms, several years may pass before any other diabetic retinopathic lesions develop. Lesions other than microaneurysms were uncommon in this study; the following is a list in decreasing frequency: retinal hemorrhages, soft exudates, IRMA, hard exudates, and venous beading. During the 4 years of this study, there were no other diabetic retinopathic lesions detected. The duration of insulin-dependent diabetes mellitus was related to the rate of change in microaneurysm counts. The age and sex of patients did not affect this rate of change. The accuracy of metabolic control, as determined by glycosylated hemoglobin levels, may influence this rate of change; however, this was detected only at the extremes of measurement in this study. The equipment available to most ophthalmologists can detect the earliest clinical aspects of diabetic retinopathy. These features can be quantified in a reproducible manner with standardized photographic techniques to permit satisfactory data analysis.

Published
1994

26. QS50. Survival Rate After Curative-Intent Treatment for Prostate Cancer in Patients With Total Visual Impairment

Author

M. Ghazarian, Stephen S Feman, M. Kumar, Katherine S. Virgo, Frank E. Johnson, J.L. VanEps, and L.N. Ledbetter

Subjects
Curative intent, Oncology, medicine.medical_specialty, business.industry, Visual impairment, medicine.disease, Prostate cancer, Internal medicine, Medicine, Surgery, In patient, medicine.symptom, business, Survival rate
Published
2009
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27. Retinopathy of prematurity in infants with cyanotic congenital heart disease

Author

Karla J. Johns, Stephen S. Feman, Debra A. Dodd, and James A. Johns

Subjects
Cyanosis, Heart Defects, Congenital, Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, business.industry, Cyanotic congenital heart disease, Eye disease, Infant, Newborn, Infant, Retinopathy of prematurity, medicine.disease, Pediatrics, Perinatology and Child Health, medicine, Humans, University medical, Female, Retinopathy of Prematurity, Congenital disease, Blood Gas Analysis, business, Hypoxia, Blood gas analysis, Retinopathy
Abstract

We undertook a study of premature infants with cyanotic congenital heart disease to determine whether these infants develop retinopathy of prematurity despite a persistent hypoxemic state. Using the computerized registry of the neonatal intensive care unit of Vanderbilt University Medical Center, Nashville, Tenn, we identified six premature infants (less than 37 weeks' gestational age, with birth weights of 1100 to 2050 g) with cyanotic congenital heart disease who survived the neonatal period and underwent ophthalmologic evaluation. Review of their charts revealed that three of six infants developed retinopathy of prematurity (two had grade 1 and one had grade 3 disease), but none required treatment. Our data support the findings of other investigators that elevated arterial oxygen tension is not the sole factor leading to the development of retinopathy of prematurity. Premature infants with cyanotic congenital heart disease can develop retinopathy of prematurity despite persistent hypoxemia. Cyanotic premature infants should be screened for retinopathy of prematurity with the same thoroughness as other premature infants.

Published
1991

30. The Retinal Features of Acute Zonal Occult Outer Retinopathy (AZOOR)

Author

Christopher Kleber, Scott Smetana, and Stephen S. Feman

Subjects
Adult, Retina, medicine.medical_specialty, Visual acuity, business.industry, Eye disease, Vision Disorders, Retinal, medicine.disease, Ophthalmology, chemistry.chemical_compound, medicine.anatomical_structure, Retinal Diseases, chemistry, Retinaldehyde, medicine, Humans, Female, Visual Fields, medicine.symptom, business, Acute zonal occult outer retinopathy, Retinopathy
Published
2003
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31. Reply

Author

Sean P. Donahue and Steven S. Feman

Subjects
Ophthalmology, Pediatrics, Perinatology and Child Health
Published
1999
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32. Retinal Vascular Abnormalities in Patients With Coarctation of the Aorta

Author

Stephen S. Feman, Karla J. Johns, and James A. Johns

Subjects
Adult, Male, Reoperation, medicine.medical_specialty, Adolescent, Heart disease, Fundus Oculi, Coarctation of the aorta, Hemodynamics, Aortic Coarctation, chemistry.chemical_compound, Internal medicine, Prevalence, medicine, Retinal arteriolar tortuosity, Humans, Abnormalities, Multiple, Child, Retina, business.industry, Infant, Newborn, Infant, Retinal Vessels, Retinal, medicine.disease, Ophthalmology, medicine.anatomical_structure, chemistry, Child, Preschool, cardiovascular system, Cardiology, Female, business, Retinopathy, Artery
Abstract

• Pulsatile three-dimensional retinal arteriolar tortuosity has been previously reported in about 50% of patients with coarctation of the aorta. In a contemporary series of 20 patients with coarctation of the aorta, none exhibited this characteristic retinal vascular abnormality. Our findings suggest that the retinal vascular abnormalities in patients with coarctation of the aorta represent secondary hemodynamic changes. The prevalence of these abnormalities may be decreasing because of earlier surgical repair of coarctation.

Published
1991
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34. Waldenstrom's macroglobulinemia, a hyperviscosity manifestation of venous stasis retinopathy

Author

Richard S. Stein and Stephen S. Feman

Subjects
Adult, Male, medicine.medical_specialty, Venous circulation, Increased igm, Hyperviscosity, Gastroenterology, Retinal Diseases, immune system diseases, hemic and lymphatic diseases, Internal medicine, Humans, Medicine, Vascular Diseases, cardiovascular diseases, business.industry, Venous stasis retinopathy, Retinal Vessels, Macroglobulinemia, Middle Aged, Serum concentration, Blood Viscosity, Ophthalmology, Immunology, Waldenstrom Macroglobulinemia, business
Abstract

Waldenstrom's macroglobulinemia is characterized by hyperviscosity. This is usually the result of an increased serum concentration of IgM molecules; this paraprotein has a high molecular weight and unusual shape. The changes in shear rate associated with increased IgM concentrations produces maximal viscosity in the venous circulation. One of the major causes of retinal venous occlusion is venous stasis retinopathy. The typical patient with this disorder is a young individual with a periphlebitis.. However, the hyperviscosity in Waldenstrom's macroglobulinemia is an ideal representative of a venous stasis that is without associated vascular pathology. To illustrate this situation, two cases are described and their etiologic features are discussed.

Published
1981
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35. Blindness from Presumed Ocular Histoplasmosis in Tennessee

Author

Stephen S. Feman, Steven F. Podgorski, and Marsha K. Penn

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Eye Diseases, Presumed ocular histoplasmosis syndrome, Population, Blindness, Histoplasmosis, Ophthalmology, Retrospective analysis, Humans, Medicine, Prospective Studies, Child, education, Prospective cohort study, Aged, Retrospective Studies, education.field_of_study, business.industry, Incidence (epidemiology), Infant, Newborn, Infant, Retrospective cohort study, Middle Aged, medicine.disease, Tennessee, Dermatology, Child, Preschool, Female, business
Abstract

Tennessee has the highest histoplasmosis infection incidence in the United States. Over 60% of the population reacts positively to skin tests and more than 60 new patients require hospitalization for the treatment of this disorder each year. However, the presumed ocular histoplasmosis syndrome (POHS) remains an uncommon cause of blindness in this state. A retrospective analysis performed with the assistance of 173 Tennessee Ophthalmologists identified 98 new POHS cases in 1980. A similar study, performed in a prospective manner, found 44 new POHS cases in the first six months of 1981. An analysis of recipients of Aid to the Blind revealed 0.5% with POHS; while 2.8% of new applicants for Aid to the Blind had POHS.

Published
1982
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36. Clinical Evaluation of Macular Function

Author

Suresh R. Limaye, James O. Price, and Stephen S. Feman

Subjects
Ophthalmology, medicine.medical_specialty, business.industry, Medicine, General Medicine, business, Clinical evaluation, Macular function
Published
1986
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37. Visual impairment Following Radial Keratotomy

Author

James H. Elliott, Stephen S. Feman, and Denis M. O'Day

Subjects
Refractive error, medicine.medical_specialty, genetic structures, business.industry, medicine.medical_treatment, Eye disease, Visual impairment, Retinal detachment, Astigmatism, medicine.disease, eye diseases, Ophthalmology, Radial keratotomy, Endophthalmitis, medicine, sense organs, medicine.symptom, business, Anisometropia
Abstract

Thirteen patients who underwent radial keratotomy developed complications leading to visual impairment. Three eyes were legally blind. Two groups of complications were seen: (1) those common to surgical procedures involving the eye—optic atrophy, infections, cataract and retinal detachment, and (2) those unique to radial keratotomy—complete failure of the procedure, marked undercorrection, marked overcorrection, and induced astigmatism. Symptoms due to anisometropia were prominent in the latter group who considered themselves visually disabled by the surgery. Radial keratotomy, like all surgical procedures, is liable to complications that may lead to visual impairment, blindness, or loss of an eye.

Published
1986
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39. The Basal Cell Nevus Syndrome

Author

Alan M. Roth, Stephen S. Feman, and Leonard Apt

Subjects
Adult, Eye Manifestations, Male, Pathology, medicine.medical_specialty, Skin Neoplasms, Cysts, business.industry, Basal Cell Nevus Syndrome, Syndrome, Eyelid Neoplasms, Ophthalmology, Scoliosis, Carcinoma, Basal Cell, medicine, Humans, business, Nevus, Jaw Diseases
Published
1974
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40. The Insulin Concentration in Human Ocular Fluids

Author

Jim Turinsky, Stephen S. Feman, and Kwok-Wai Lam

Subjects
medicine.medical_specialty, Insulin Antibodies, medicine.medical_treatment, Serum insulin level, Vitrectomy, Retina, Ophthalmology, Diabetes mellitus, Diabetes Mellitus, Humans, Insulin, Medicine, Eye Proteins, Immunoreactive insulin, Diabetic Retinopathy, business.industry, Retinal Detachment, Retinal detachment, Diabetic retinopathy, medicine.disease, Body Fluids, Vitreous Body, Erythrocyte Count, Subretinal fluid, business
Abstract

We measured immunoreactive insulin concentrations in ocular fluids and serum of 19 patients. In rhegmatogenous retinal detachment patients without diabetes mellitus, the serum insulin level was 7 +/- 2 (SE) microunits/ml and the subretinal fluid insulin levels were mostly undetectable. By contrast, in rhegmatogenous retinal detachment patients with diabetes mellitus, serum insulin was 35 +/- 5 microunits/ml and the subretinal fluid always contained low but detectable amojnts of insulin. The data may suggest a small leak of insulin into the subretinal fluid of rhegmatogenous retinal detachment patients with diabetic retinopathy. In vitrectomy patients with diabetes mellitus there was no insulin in the vitreous in eight out of nine cases.

Published
1978
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41. The Effect of Panretinal Photocoagulation on Optic Nerve Cupping

Author

Stephen S. Feman, Karla J. Johns, and Thomas C Leonard-Martin

Subjects
medicine.medical_specialty, genetic structures, Optic Disk, Nerve fiber layer, Glaucoma, Light Coagulation, Optic cup (anatomical), Retina, Ophthalmology, Preoperative Care, medicine, Humans, Postoperative Care, Diabetic Retinopathy, business.industry, Diabetic retinopathy, medicine.disease, eye diseases, medicine.anatomical_structure, Optic nerve, sense organs, business, Glaucoma, Open-Angle, Retinopathy, Optic disc
Abstract

Panretinal photocoagulation (PRP) can produce damage to all layers of the retina, including the nerve fiber layer. The hypothesis that these changes in the nerve fiber layer may alter the contour of the optic disc and change the cup-to-disc (C/D) ratio was tested. In a masked retrospective study, the authors evaluated the stereoscopic disc photographs of 100 patients with proliferative diabetic retinopathy (PDR) before and 1 year after undergoing PRP. The fellow untreated eyes were used as controls. Neither argon nor xenon PRP produced a significant change in the C/D ratio. Ophthalmology 96:211-216,1989

Published
1989
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42. Lattice Degeneration of the Retina

Author

Robert Y. Foos, Stephan S. Feman, Bradley R. Straatsma, Alan L. Shabo, and Peter D. Zeegen

Subjects
Ophthalmology, medicine.medical_specialty, Retinal pigments, media_common.quotation_subject, Lattice degeneration, medicine, Art history, Art, medicine.disease, Retinal detachment surgery, media_common
Published
1974
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43. Eye Findings Associated with Pediatric Malignancy

Author

Stephen S. Feman and Leonard Apt

Subjects
Ophthalmology, medicine.medical_specialty, business.industry, Pediatric malignancy, Pediatrics, Perinatology and Child Health, medicine, General Medicine, Eye Finding, business, Dermatology
Published
1972
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44. Reticular Cystoid Degeneration of the Peripheral Retina

Author

Robert Y. Foos and Stephen S. Feman

Subjects
Adult, Male, medicine.medical_specialty, business.industry, Retinal Degeneration, Age Factors, Peripheral retina, Middle Aged, California, Retina, Cystoid degeneration, Ophthalmology, Retinal pigments, Sex Factors, Sex factors, Reticular connective tissue, Humans, Medicine, Female, business, Retinal Pigments, Aged
Published
1970
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45. An Enzyme Histochemical Analysis of Human Subretinal Fluid

Author

Kwok-Wai Lam and Stephen S. Feman

Subjects
Male, Cell type, Pathology, medicine.medical_specialty, Visual Acuity, Biology, Histochemical staining, chemistry.chemical_compound, medicine, Humans, Phagocytic Cell, Pigment Epithelium of Eye, Electron microscopic, chemistry.chemical_classification, Staining and Labeling, Macrophages, Retinal Detachment, Retinal detachment, Retinal, Middle Aged, medicine.disease, Body Fluids, Scleral Buckling, Ophthalmology, Enzyme, chemistry, Visual Fields, Subretinal fluid
Abstract

• During rhegmatogenous retinal detachment, two major phagocytic cell populations can be identified in the subretinal fluid. Routine light and electron microscopic studies may be inadequate to assess quantitatively the free-floating retinal pigment epithelial cells and the macrophagic retinal pigment-laden cells. Enzyme histochemical staining permits a simple, rapid, reproducible method of identifying each cell type. This cytologic biochemical differentiation is an important tool for reexamination of the theories associated with subretinal fluid cell activity.

Published
1978
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46. Proliferative Diabetic Retinopathy in Patients with Defects of Platelet Function

Author

L. Clifford McKee, Richard S. Stein, Patrick C. Ho, and Stephen S. Feman

Subjects
Blood Platelets, Male, Pathology, medicine.medical_specialty, Platelet Aggregation, Disease, Neovascularization, chemistry.chemical_compound, Platelet Adhesiveness, Platelet adhesiveness, medicine, Humans, Platelet, Platelet activation, Aged, Blood coagulation test, Diabetic Retinopathy, Factor VIII, business.industry, Retinal, Diabetic retinopathy, Middle Aged, medicine.disease, Blood Cell Count, von Willebrand Diseases, Ophthalmology, chemistry, Female, Blood Coagulation Tests, sense organs, medicine.symptom, business, Thrombocythemia, Essential
Abstract

A 71-year-old woman had von Willebrand's disease, an inheritable abnormality of platelet activity, and developed diabetic retinal neovascularization. A 59-year-old man had a myeoloproliferative disorder with thrombocythemia but may have had retinal changes before the development of his platelet dysfunction. The occurrence of diabetic proliferative retinopathy in patients with reduced platelet activity suggests that platelet induced microcirculatory abnormalities may not be required for neovascularization.

Published
1979
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47. Human Biochemical Components in Retinoschisis and Detachment

Author

Thomas Leonard-Martin, J. Stevens Andrews, Stephen S. Feman, and Maurice James

Subjects
medicine.medical_specialty, Retinal Disorder, Retinoschisis, Biology, chemistry.chemical_compound, Retinal Diseases, Ophthalmology, medicine, Humans, Phospholipids, Retina, Retinal Detachment, Proteins, Retinal detachment, Retinal, Anatomy, Middle Aged, medicine.disease, Body Fluids, Lipoproteins, LDL, Cholesterol, medicine.anatomical_structure, chemistry, Female, lipids (amino acids, peptides, and proteins)
Abstract

• Degenerative retinoschisis and rhegmatogenous retinal detachment are disorders that originate in the peripheral part of the retina. Both of these disorders are associated with biochemical processes that result in the finding of metabolic products within fluid-filled spaces. An attempt at biochemical differentiation of these two retinal disorders is described. Cholesterol, phospholipids, and proteins were present in the fluid samples, but low-density lipoproteins were not found. It is suggested that the cholesterol-to-phospholipid ratio may reflect the degree of retinal cellular destruction.

Published
1981
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48. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings

Author

Robert C. Ramsay, Ephraim Friedman, Edward W. D. Norton, Stuart L. Fine, John E. Harris, Dana Clarke, Lloyd Paul Aiello, Suresh Chandra, Ingolf H. L. Wallow, Genell L. Knatterud, William H. Annesley, Jose C. Briones, John H. Mensher, Yvonne L. Magli, William Tasman, Leonard Joffe, Edward B. McLean, Raymond R. Margherio, Lawrence Rand, Suresh R. Chandra, Aaron Kassoff, Jose Berrocal, Christian R. Klimt, Robert Bradley, Fred Ederer, Delbert Nachazel, Elizabeth P. Wiesner, Jacob Bearman, Jerome Cornfield, Argye I. Hillis, Donald Martin, Matthew D. Davis, Daniel Finkelstein, George H. Bresnick, Max Miller, Stephen S. Feman, Frederick L. Ferris, Thaddeus E. Prout, Paul Segal, Elmer J. Ballintine, Abraham M. Lilienfeld, Guillermo Velazquez, Bradley R. Straatsma, Glen Johnston, Steven Guzak, Bernard Becker, Robert C. Watzke, Stanley Kopelow, Curtis L. Meinert, Felipe U. Huamonte, Frank L. Myers, William Bohart, W. A. J. van Heuven, Brian C. Leonard, Gholam A. Peyman, Christopher L. B. Canny, Marvin L. Sears, J. Wallace McMeel, Thomas R. Pheasant, William H. Knobloch, Diane Makuc, Frederick C. Goetz, Morton F. Goldberg, Alasdair MacCormick, Arnall Patz, F. Tempel Riekhof, Guillermo de Venecia, Mary Dahl, Thomas S. Stevens, George W. Blankenship, and Antonio Ramos-Umpierre

Subjects
Risk, medicine.medical_specialty, Visual acuity, Xenon, Fundus Oculi, Visual Acuity, macromolecular substances, Light Coagulation, Severe nonproliferative retinopathy, Rate of development, Ophthalmology, medicine, Photography, Humans, Stage (cooking), Argon, Interim report, Clinical Trials as Topic, Diabetic Retinopathy, business.industry, Retinal Hemorrhage, Retinal Vessels, Diabetic retinopathy, medicine.disease, eye diseases, Surgery, Visual field, medicine.symptom, Visual Fields, business, Retinopathy, Follow-Up Studies
Abstract

Data from the Diabetic Retinopathy Study (DRS) show that photocoagulation, as used in the Study, reduced the rate of development of severe visual loss and inhibited the progression of retinopathy. These beneficial effects were noted to some degree in all those stages of diabetic retinopathy which were included in the Study. Some deleterious effects of treatment were also found, including losses of visual acuity and constriction of peripheral visual field. The risk of these harmful effects was considered acceptable in eyes with retinopathy in the moderate or severe proliferative stage when the risk of severe visual loss without treatment was great. In early proliferative or severe nonproliferative retinopathy, when the risk of severe visual loss without treatment was less, the risks of harmful treatment effects assumed greater importance. In these earlier stages, DRS findings have not led to a clear choice between prompt treatment and deferral of treatment unless and until progression to a more severe stage occurs. The purpose of this interim report is to present the data on which these conclusions are based. More detailed reports of Study findings will appear in the future.

Published
1978

49. Advances in TV-Fluorangiography

Author

Wichard A. J. van Heuven, Charles A Schaffer, and Stephen S. Feman

Subjects
medicine.diagnostic_test, Computer science, business.industry, Image intensifier, Fluorescein angiography, Fundus camera, law.invention, Basic research, law, Vascular flow, medicine, Computer vision, Artificial intelligence, business, Value (mathematics)
Abstract

For the past seven years, our laboratory has used electronic recording systems with fluorescein angiography. This technique creates a permanent, accurate and immediately available reproduction of the dynamic aspects of retinal vascular flow. The resulting television picture is of value for both the recording of clinical disorders as well as for basic research.

Published
1976
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50. The Precursors of Disciform Macular Degeneration

Author

Wichard A. J. van Heuven and Stephen S. Feman

Subjects
medicine.medical_specialty, Visual acuity, Retinal pigment epithelium, genetic structures, business.industry, Macular degeneration, Disciform macular degeneration, medicine.disease, eye diseases, Older population, Lesion, Macular Lesion, medicine.anatomical_structure, Ophthalmology, medicine, sense organs, medicine.symptom, business, Reduced visual acuity
Abstract

Disciform macular degeneration often causes reduced visual acuity in the older population (Kahn & Moorhead, 1973). Statistical surveys indicate that approximately 25% of the older population has some manifestation of this disorder (SORSBY, 1966). The fluorescein angiographic features of disciform macular degeneration are well known (GASS, 1967). Frequently, both eyes are not involved at the same time; one eye may develop a typical macular lesion at some time before the other. Examination of fellow eyes may reveal disorders that are precursors of the disciform lesion. To understand the predisciform lesion, the fellow eye of every disciform macular degeneration patient needs a detailed examination. The angiographic findings in good seeing fellow eyes, when disciform macular degeneration is first noted in the other eye, are described below

Published
1976
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