ORCID Profile
0000-0003-0523-1927
Current Organisations
La Trobe University
,
Centre for Eye Research Australia
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Publisher: Wiley
Date: 16-05-2019
DOI: 10.1111/CEO.13524
Abstract: The rate and determinants of persistence to topical glaucoma medications are important for identifying patients at high risk of discontinuing medications and designing targeted approaches to improve persistence. To evaluate the rate and determinants of persistence to topical glaucoma medications among middle-aged and older Australian adults. Population-based cohort study. Participants in need of persistent topical glaucoma medications in the 45 and Up Study. The 45 and Up Study is a large-scale population-based cohort study. Participants were classified as needing persistent topical glaucoma medications if at least three claims with related prescriptions were recorded. Persistence was defined as topical glaucoma medications were filled within 90 days. The rates and determinants of medication persistence at 2-year follow-up. A total of 12 899 patients requiring persistent topical glaucoma medications were identified. Among them, 9019 (69.9%) had persisted with their glaucoma medications for at least 2 years. Multiple logistic regression analysis documented significant effects of patient-related factors (gender, socioeconomic status, language spoken at home, lifestyle and comorbidities) and drug-related factors (total number and drug class) on the persistence rate. Those most at risk groups of non-persistence were those patients living in remote areas (odds ratio, OR: 0.59, 95% confidence interval, CI: 0.37-0.92), having family income over 70 000 AUD/year (OR: 0.53, 95% CI: 0.45-0.62), speaking other languages at home (OR: 0.61, 95% CI: 0.53-0.68), and using cholinergic classes of medications (OR: 0.55, 95% CI: 0.38-0.79). Our data has shown a medium level of persistence to topical glaucoma medication among middle-aged and older Australian adults. However, efforts are still needed to improve the rate of persistence.
Publisher: BMJ
Date: 04-09-2019
DOI: 10.1136/BJOPHTHALMOL-2019-313827
Abstract: To investigate the 5-year changes in static and dynamic anterior segment optical coherence tomography (AS-OCT) parameters and their predictors. This was a prospective, population-based cohort study of people aged 50 years and older residing in the Liwan District, Guangzhou, China. Standardised AS-OCT scans were performed in November 2008 and November 2013 under dark and light conditions. Customised software was used to analyse horizontal AS-OCT images. Parameters in dark and measurements of light-to-dark changes were used for analyses. A total of 186 (71.8%) subjects underwent AS-OCT twice, 5 years apart and were included for analyses. The mean age in 2008 was 64.7±7.0 years, and 60.2% were women. The anterior chamber width (ACW) decreased from 11.74±0.44 mm in 2008 to 11.60±0.37 mm in 2013 (p=0.001). There was a trend towards a decrease in dynamic capacity (light-to-dark changes) in the anterior segment, with decreased iris thickness at 750 µm (ΔIT750), ΔACW, Δ anterior chamber area (ACA) and Δ pupil diameter at 5 years (all p .05). After adjusting for age and sex, the following baseline parameters were associated with a greater decrease rate in trabecular iris space area at 500 µm (TISA500) at 5 years: TISA500, IT750 and ACA in dark (p .001 for all). Anterior chamber angle width decreased and the amount of light-to-dark changes declined during 5-year follow-up. Subjects with greater height, wider angle width and thicker iris at baseline have greater angle narrowing at follow-up.
Publisher: Wiley
Date: 16-10-2019
DOI: 10.1111/CEO.13647
Abstract: In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. Population-based cross-sectional study. A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.
Publisher: Wiley
Date: 08-06-2020
DOI: 10.1111/CEO.13779
Publisher: Wiley
Date: 25-07-2019
DOI: 10.1111/CEO.13575
Abstract: Detection of early onset neovascular age-related macular degeneration (AMD) is critical to protecting vision. To describe the development and validation of a deep-learning algorithm (DLA) for the detection of neovascular age-related macular degeneration. Development and validation of a DLA using retrospective datasets. We developed and trained the DLA using 56 113 retinal images and an additional 86 162 images from an independent dataset to externally validate the DLA. All images were non-stereoscopic and retrospectively collected. The internal validation dataset was derived from real-world clinical settings in China. Gold standard grading was assigned when consensus was reached by three in idual ophthalmologists. The DLA classified 31 247 images as gradable and 24 866 as ungradable (poor quality or poor field definition). These ungradable images were used to create a classification model for image quality. Efficiency and diagnostic accuracy were tested using 86 162 images derived from the Melbourne Collaborative Cohort Study. Neovascular AMD and/or ungradable outcome in one or both eyes was considered referable. Area under the receiver operating characteristic curve (AUC), sensitivity and specificity. In the internal validation dataset, the AUC, sensitivity and specificity of the DLA for neovascular AMD was 0.995, 96.7%, 96.4%, respectively. Testing against the independent external dataset achieved an AUC, sensitivity and specificity of 0.967, 100% and 93.4%, respectively. More than 60% of false positive cases displayed other macular pathologies. Amongst the false negative cases (internal validation dataset only), over half (57.2%) proved to be undetected detachment of the neurosensory retina or RPE layer. This DLA shows robust performance for the detection of neovascular AMD amongst retinal images from a multi-ethnic s le and under different imaging protocols. Further research is warranted to investigate where this technology could be best utilized within screening and research settings.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2021
Publisher: BMJ
Date: 04-12-2019
DOI: 10.1136/BJOPHTHALMOL-2019-314853
Abstract: To investigate the association between age-related macular degeneration (AMD) and subjective cognitive complaints (SCCs) in the USA. A total of 5604 participants aged 40 years and older from the 2005–2008 National Health and Nutrition Examination Survey were included. Retinal photography was graded into no AMD, early and late AMD based on the modification of the Wisconsin Age-Related Maculopathy Grading System. SCCs were based on the self-reported difficulty in remembering or confusion. S le weights were used to generate nationally representative data. Multivariate regression analyses were used to assess the association between AMD severity and SCCs, controlling for potential confounders. Participants with any AMD had higher prevalence of SCCs relative to participants without AMD (6.8% vs 13.6%, p .001). After adjusting for potential confounding factors, presence of any AMD was significantly associated with 1.62-fold higher odds of having SCCs (95% CI 1.16 to 2.27, p=0.007). Similarly, participants with early (OR 1.58 95% CI 1.14 to 2.17, p=0.007) and late AMD (OR 2.02 95% CI 1.08 to 3.79, p=0.030) were also associated with elevated odds of reporting SCCs after controlling for confounders. We found significant associations between AMD severity and SCCs in this US population. More attention should be paid on the subjective memory function and potential risk of cognitive decline among patients with AMD.
Publisher: Wiley
Date: 02-08-2019
DOI: 10.1111/CEO.13595
Abstract: Recent US national population-based data on the prevalence of retinopathy in non-diabetic participants is limited. To assess the prevalence and risk factors of retinopathy in a representative US population without diabetes. Population-based, cross-sectional study. A total of 4354 non-diabetic participants 40 years and older with valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey. Diabetes mellitus was defined as glycosylated haemoglobin (HbA1c) ≥6.5%, physician diagnosis of diabetes mellitus or use of diabetic medication. Retinopathy level was based on the Modified Airlie House adaptation from the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Risk profile was assessed from standardized interviews, clinical examinations and laboratory measurements. Prevalence and risk profile of retinopathy in non-diabetic participants. The overall weighted prevalence of retinopathy was 6.7% (n = 341). Among them, 98.2% (n = 331) had signs of minimal-to-mild non-proliferative retinopathy (ETDRS level 14-31) while only 1.8% (n = 10) had moderate-to-severe non-proliferative retinopathy (ETDRS level 41-51). After adjusting for multiple covariates, retinopathy signs in non-diabetic participants were associated with male gender (odds ratio [OR] 1.54 95% confidence interval [CI] 1.22-1.93), systolic blood pressure (OR per 10 mmHg increase 1.11 95% CI 1.03-1.19), HbA1c (OR per % increase 1.43 95% CI 1.01-2.05) and history of stroke (OR 2.39 95% CI 1.14-5.04). Consistent with previous studies, signs of retinopathy are common in US persons without diabetes. Risk factors for retinopathy signs include gender, blood pressure, HbA1c and history of stroke.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2021
No related grants have been discovered for Jane Scheetz.