ORCID Profile
0000-0001-6635-1098
Current Organisations
Lions Eye Institute
,
University of Western Australia
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2019
DOI: 10.1097/OPX.0000000000001395
Abstract: Glaucoma has been shown to impair hazard detection ability and increase crash risk compared to controls. Differences in visual search behavior of the driving scene may explain these differences however, there has been limited investigation of this issue with inconsistent findings. Through eye movement tracking of older drivers with glaucoma, we explored their visual search behavior in comparison with controls while performing the DriveSafe, a slide recognition test purported to predict fitness to drive. Thirty-one drivers with glaucoma (mean age, 71.7 ± 6.3 years average better-eye mean defect,−3 dB average worse-eye mean defect,−12 dB) and 25 age-matched controls underwent measurements of their visual acuity, contrast sensitivity, visual fields, and useful field of view (visual processing speeds). Participants' eye movements were recorded while they completed the DriveSafe test, which consists of brief presentations of static, real-world driving scenes containing various road users (pedestrians, bicycles, vehicles). Participants reported the types, positions, and direction of travel of road users in each image the score was the total number of correctly reported items (maximum, 128). Drivers with glaucoma had significantly worse DriveSafe scores ( P = .03), fixated on road users for shorter durations ( P .001), and exhibited smaller saccades ( P = .02) compared with controls. For all participants, longer fixation times on road users ( P .001) was the eye movement measure most strongly associated with better DriveSafe scores this relationship was not significantly different between groups. Useful field-of-view ided attention was the strongest visual predictor of DriveSafe scores. Eye movement changes in the glaucoma group may reflect increased difficulty in identifying relevant objects in the visual scene, which may be related to their lower DriveSafe scores. Given the DriveSafe’s potential utility in assessing drivers with visual impairment before on-road testing, further investigations on how DriveSafe performance and eye movement patterns compare to those during on-road driving are warranted.
Publisher: Wiley
Date: 11-09-2023
DOI: 10.1111/AOS.15761
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1100/2012/589875
Abstract: Prolonged visually stressful activities aggravate dry eye disease (DED). The duration spent on such activities and their relationship with DED clinical features were investigated. Patients completed an activity log as they performed their usual activities over 1 typical rest day and 1 typical work day. The log included time spent in an air-conditioned environment, windy environment, driving, watching television, computer use, reading, watching a movie in the theatre, and wearing contact lens. Average daily activity hours were calculated and correlated with clinical features of DED. Thirty-five logs were returned. Positive correlation was found between watching television and episodic blurred vision ( P 0.01 ). Computer use was negatively correlated with episodic blur vision, burning sensation, and gritty sensation ( P 0.05 ). Negative correlation was found between time spent in windy environments, driving, reading, and certain DED symptoms ( P 0.05 ). Reading correlated positively with severity of corneal fluorescein staining and reduced Schirmer’s values ( P 0.03 ). The use of air conditioning correlated negatively with episodic blur vision but positively with visual blurring that improves with lubricants ( P = 0.02 ). This study is the first to evaluate the relationship between time spent on DED-aggravating activities and DED clinical features. Negative correlations between certain activities and DED symptoms suggest an unconscious modification of lifestyle to alleviate symptoms.
Publisher: BMJ
Date: 25-10-2019
DOI: 10.1136/BJOPHTHALMOL-2019-314819
Abstract: To report the protocol of a trial designed to evaluate the efficacy, safety and mechanism of action of low-dose atropine (0.01%) eye-drops for reducing progression of myopia in UK children. Multicentre, double-masked, superiority, placebo-controlled, randomised trial. We will enrol children aged 6–12 years with myopia of −0.50 dioptres or worse in both eyes. We will recruit 289 participants with an allocation ratio of 2:1 (193 atropine 96 placebo) from five centres. Participants will instil one drop in each eye every day for 2 years and attend a research centre every 6 months. The vehicle and preservative will be the same in both study arms. The primary outcome is SER of both eyes measured by autorefractor under cycloplegia at 2 years (adjusted for baseline). Secondary outcomes include axial length, best corrected distance visual acuity, near visual acuity, reading speed, pupil diameter, accommodation, adverse event rates and allergic reactions, quality of life (EQ-5D-Y) and tolerability at 2 years. Mechanistic evaluations will include: peripheral axial length, peripheral retinal defocus, anterior chamber depth, iris colour, height and weight, activities questionnaire, ciliary body biometry and chorioretinal thickness. Endpoints from both eyes will be pooled in combined analysis using generalised estimating equations to allow for the correlation between eyes within participant. Three years after cessation of treatment, we will also evaluate refractive error and adverse events. The Childhood Atropine for Myopia Progression in the UK study will be the first randomised trial reporting outcomes of low-dose atropine eye-drops for children with myopia in a UK population. ISRCTN99883695 , NCT03690089 .
Publisher: Wiley
Date: 13-05-2020
DOI: 10.1111/CEO.13772
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-05-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Publisher: Wiley
Date: 04-2020
DOI: 10.1111/CEO.13736
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.OPHTHA.2019.04.041
Abstract: Obstructive sleep apnea (OSA) is linked to increased glaucoma risk in middle-aged and older adults. However, little is known about associations between OSA and glaucoma-related optic disc parameters in young adults. We explored associations between overnight polysomnography-derived measures of OSA and the optic disc in young adults. Cross-sectional cohort study. Eight hundred forty-eight adults 19 to 22 years of age. Participants underwent an ophthalmic examination that included OCT imaging of the optic disc and measurements of intraocular pressure, axial length, and refractive error. Participants then underwent an overnight polysomnography study that obtained measurements of apnea-hypopnea index (AHI), peripheral oxygen saturation level, and number of cortical arousals from sleep. Based on the AHI results, participants were grouped into no OSA (AHI < 5 events/hour), mild OSA (AHI ≥ 5 and <15 events/hour), moderate OSA (AHI ≥ 15 and <30 events/hour), or severe OSA (AHI ≥ 30 events/hour). Neuroretinal rim area, horizontal and vertical widths, and peripapillary retinal nerve fiber layer (RNFL) thickness. The median AHI result across the study cohort was 2.2 events per hour (interquartile range, 1.0-4.4 events/hour). Based on the AHI results, 178 participants (21.0%) demonstrated OSA: 150 with mild OSA, 26 with moderate OSA, and 2 with severe OSA. In the unadjusted analyses, participants with OSA on average showed thinner peripapillary RNFL at the inferotemporal (P = 0.026) and superotemporal (P = 0.008) segments compared with those without OSA. Additionally, higher AHI results were associated with thinner RNFL superotemporally (P = 0.007). These findings remained significant after adjusting for gender, body mass index, ethnicity, and potential ocular confounders. There were no significant differences in optic disc measures between groups of OSA severity. Obstructive sleep apnea may be associated with preclinical thinning of the peripapillary RNFL in young adults. This suggests that an increased glaucoma risk already may be present in in iduals with OSA since young adulthood. Long-term follow-up of this cohort will allow further optic disc changes in relationship to polysomnography parameters to be documented and associations with future glaucoma diagnosis to be explored.
Publisher: Wiley
Date: 09-09-2022
DOI: 10.1111/CEO.14148
Abstract: To test the hypothesis that 0.01% atropine eyedrops are a safe and effective myopia‐control approach in Australian children. Children (6–16 years 49% Europeans, 18% East Asian, 22% South Asian, and 12% other/mixed ancestry) with documented myopia progression were enrolled into this single‐centre randomised, parallel, double‐masked, placebo‐controlled trial and randomised to receive 0.01% atropine ( n = 104) or placebo ( n = 49) eyedrops (2:1 ratio) instilled nightly over 24 months (mean index age = 12.2 ± 2.5 and 11.2 ± 2.8 years, respectively). Outcome measures were the changes in spherical equivalent (SE) and axial length (AL) from baseline. At 12 months, the mean SE and AL change from baseline were −0.31D (95% confidence interval [CI] = −0.39 to −0.22) and 0.16 mm (95%CI = 0.13–0.20) in the atropine group and −0.53D (95%CI = −0.66 to −0.40) and 0.25 mm (95%CI = 0.20–0.30) in the placebo group (group difference p ≤ 0.01). At 24 months, the mean SE and AL change from baseline was −0.64D (95%CI = −0.73 to −0.56) and 0.34 mm (95%CI = 0.30–0.37) in the atropine group, and −0.78D (95%CI = −0.91 to −0.65) and 0.38 mm (95%CI = 0.33–0.43) in the placebo group. Group difference at 24 months was not statistically significant ( p = 0.10). At 24 months, the atropine group had reduced accommodative litude and pupillary light response compared to the placebo group. In Australian children, 0.01% atropine eyedrops were safe, well‐tolerated, and had a modest myopia‐control effect, although there was an apparent decrease in efficacy between 18 and 24 months, which is likely driven by a higher dropout rate in the placebo group.
Publisher: Springer Science and Business Media LLC
Date: 12-07-2013
DOI: 10.1038/EYE.2013.144
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1100/2012/923059
Abstract: Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Singapore. A questionnaire was generated to address the study aims and sent to TCM practitioners listed in the Singapore TCM practitioners’ board database. About three quarters of respondents thought that dry eye was not severe enough to be a public health burden but most thought that TCM was effective in the treatment of dry eye. Acupuncture and herbal medicine were most commonly used TCM modalities in dry eye treatment, and a single TCM treatment session would be charged S$20–50 by the practitioner. The majority of surveyed institutional TCM practitioners in Singapore believe that TCM is relevant in dry eye treatment. Public awareness should be raised regarding the availability of TCM as alternative medicine for dry eye.
Publisher: Wiley
Date: 22-10-2022
DOI: 10.1111/OPO.12905
Abstract: Cross‐sectional studies have variably reported that poor sleep quality may be associated with myopia in children. Longitudinal data, collected over the ages when myopia develops and progresses, could provide new insights into the sleep‐myopia paradigm. This study tested the hypothesis that 12‐year trajectories of sleep behaviour from childhood to adolescence is associated with myopia during young adulthood. At the 5‐, 8‐, 10‐, 14‐ and 17‐year follow‐ups of the longitudinal Raine Study, which has been following a cohort since their birth in 1989–1992, participants' parents/guardians completed the Child Behaviour Checklist questionnaire (CBCL), which collected information on their child's sleep behaviour and quality. The CBCL includes six questions measuring sleep behaviour, which parents rated as 0 = not true, 1 = somewhat/sometimes true, or 2 = very/often true. Scores were summed at each follow‐up to form a composite “sleep behaviour score”. Latent Class Growth Analysis (LCGA) was used to classify participants according to their 12‐year trajectory of sleep behaviour. At the 20‐year follow‐up, an eye examination was performed which included cycloplegic autorefraction and axial length measurement. The LCGA identified three clusters of participants based on their trajectory of sleep behaviour: those with minimal' (43.6% of the total Raine Study s le), ‘declining’ (48.9%), or ‘persistent’ (7.5%) sleep problems. A total of 1194 participants had ophthalmic data and longitudinal sleep data available for analysis (47.2% female, 85.6% Caucasian). No significant differences were observed in regards to age, sex, ethnicity or ocular parameters between trajectory groups. Unadjusted and fully adjusted analyses demonstrated that sleep problem behaviour was not significantly associated with changes in refractive error, axial length or corneal radius. Our findings do not support the hypothesis that there is an association between sleep behaviour and myopia. Future longitudinal studies should explore sleep trajectory data pre‐ and post‐myopia diagnosis to confirm our results.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 12-07-2022
DOI: 10.1167/TVST.11.7.8
Publisher: American Medical Association (AMA)
Date: 02-2022
Publisher: Asia Pacific Academy of Ophthalmology
Date: 2019
DOI: 10.22608/APO.2018329
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-033440
Abstract: Eye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989–1991. As part of the 20-year follow-up of the Raine Study, participants underwent a comprehensive eye examination. As part of the 27- and 28-year follow-ups, eye assessments are being conducted and the data collected will be compared with those of the 20-year follow-up. This will provide an estimate of population incidence and updated prevalence of ocular conditions such as myopia and keratoconus, as well as longitudinal change in ocular parameters in young Australian adults. Additionally, the data will allow exploration of the environmental, health and genetic factors underlying inter-subject differential long-term ocular changes. Participants are being contacted via telephone, email and/or social media and invited to participate in the eye examination. At the 27-year follow-up, participants completed a follow-up eye screening, which assessed visual acuity, autorefraction, ocular biometry and ocular sun exposure. Currently, at the 28-year follow-up, a comprehensive eye examination is being conducted which, in addition to all the eye tests performed at the 27-year follow-up visit, includes tonometry, optical coherence tomography, funduscopy and anterior segment topography, among others. Outcome measures include the incidence of refractive error and pterygium, an updated prevalence of these conditions, and the 8-year change in ocular parameters. The Raine Study is registered in the Australian New Zealand Clinical Trials Registry. The Gen2 20-year, 27-year and 28-year follow-ups are approved by the Human Research Ethics Committee of the University of Western Australia. Findings resulting from the study will be published in health or medical journals and presented at conferences. ACTRN12617001599369 Active, not recruiting.
Publisher: Springer Science and Business Media LLC
Date: 17-03-2021
DOI: 10.1038/S41598-021-85626-3
Abstract: Inflammation and cigarette smoking predispose to macular diseases, and choroidal and retinal thinning. We explored the choroidal and retinal thicknesses in young adults against their 7-year C-reactive protein (CRP) level trajectory and pack-years smoked. Participants from the Raine study, a longitudinal cohort study, had serum CRP levels analysed at the 14-, 17-, and 20-year follow-ups. Group-based trajectory modelling was used to classify participants according to their 7-year CRP levels. At the 20-year follow-up (at 18–22 years old), participants completed questionnaires on their smoking history, and underwent optical coherence tomography imaging to obtain their choroidal and retinal thicknesses at the macula. Three CRP trajectories were identified: consistently low CRP levels (78% of s le), increasing (11%), or consistently high (11%). 340 and 1035 participants were included in the choroidal and retinal thickness analyses, respectively. Compared to those in the “Low” trajectory group, participants in the “Increasing” and “High” groups had 14–21 μm thinner choroids at most macular regions. Every additional pack-year smoked was linked with a 0.06–0.10 μm thinner retina at the inner and outer macular rings, suggesting a dose-dependent relationship between smoking and thinner retinas. These associations may suggest that an increased risk of future visual impairment or eye disease associated with these risk factors may be present since young adulthood.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Wiley
Date: 16-03-2022
DOI: 10.1111/CEO.14071
Abstract: There is a growing body of literature on the effects of sleep disorders, in particular obstructive sleep apnoea (OSA), on ocular health, with consistent evidence of an increased risk of floppy eyelid syndrome, non‐arteritic anterior ischaemic optic neuropathy, diabetic macular oedema, and other retinal vasculature changes in in iduals with OSA. However, reports on OSA's associations with glaucoma, papilloedema, diabetic retinopathy, central serous chorioretinopathy, and keratoconus have been conflicting, while links between OSA and age‐related macular degeneration have only been described fairly recently. Despite numerous suggestions that OSA treatment may reduce risk of these eye diseases, well‐designed studies to support these claims are lacking. In particular, the ocular hypertensive effects of continuous positive airway pressure (CPAP) therapy for OSA requires further investigation into its potential impact on glaucoma risk and management. Reports of ocular surface complications secondary to leaking CPAP masks highlights the importance of ensuring good mask fit. Poor sleep habits have also been linked with increased myopia risk however, the evidence on this association remains weak.
Publisher: F1000 Research Ltd
Date: 25-09-2019
DOI: 10.12688/HRBOPENRES.12914.2
Abstract: Background: The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% unpreserved atropine for myopia control in a European population. Methods: MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine for managing progression of myopia. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia instil eye drops once nightly in both eyes from randomisation to month 24. From month 24 to 36 participants are re-randomised in Phase 2 of the trial, into continued 0.01% atropine, and washout, at 1:1 ratio for those participants initially randomised to the intervention arm (n=167), during which any potential rebound effects on cessation of treatment will be monitored. All participants initially assigned to the placebo (n=83) crossover to the intervention arm of the study for Phase 2, and from month 24 to 36, instil 0.01% atropine eye drops in both eyes once nightly. Further treatment and monitoring beyond 36 months is planned (Phase 3) and will be designed dependent on the outcomes of Phase 1. Results: The primary outcome measure is cycloplegic spherical equivalent refractive error progression at 24 months. Secondary outcome measures include axial length change as well as the rebound, safety and acceptability profile of 0.01% atropine. Additional analyses will include the mechanisms of action of 0.01% atropine for myopia control. Conclusions: The generalisability of results from previous clinical trials investigating atropine for myopia control is limited by the predominantly Asian ethnicity of previous study populations. MOSAIC is the first RCT to explore the efficacy, safety and mechanisms of action of unpreserved 0.01% atropine in a predominantly White population.
Publisher: CRC Press
Date: 05-05-2014
DOI: 10.1201/B17026
Publisher: Wiley
Date: 19-08-2021
DOI: 10.1111/CEO.13980
Abstract: The prevalence of myopia is increasing globally including in Europe and parts of Asia but Australian data are lacking. This study aim described the change in myopia prevalence in middle‐aged Australian adults over approximately a 20‐year period. Two contemporary Western Australian studies (conducted in mid‐late 2010s): the coastal‐regional Busselton Healthy Ageing Study (BHAS) and the urban Gen1 of the Raine Study (G1RS) were compared to two earlier studies (early‐mid 1990s) in Australia: the urban Blue Mountains Eye Study (BMES) and urban/regional Melbourne Visual Impairment Project (MVIP). Refractive error was measured by autorefraction, vertometry, or subjective refraction. Participants (49–70 years) of European descent without self‐reported/diagnosed cataract, corneal disease, or refractive or corneal surgery were included. After exclusions, data were available from 2217, 1760, 700, 2987 and 756 participants from BMES, urban MVIP, regional MVIP, BHAS, and G1RS, respectively. The mean age ranged from 57.1 ± 4.6 years in the G1RS to 60.1 ± 6.0 years in the BMES 44–48% of participants were male. When stratified by location, the contemporary urban G1RS cohort had a higher age‐standardised myopia prevalence than the urban MVIP and BMES cohorts (29.2%, 16.4%, and 23.9%, p 0.001). The contemporary coastal‐regional BHAS had a higher age‐standardised myopia prevalence than the regional MVIP cohort (19.4% vs. 13.8%, p = 0.001). We report an increase in myopia prevalence in older adults in Australia born after World War ll compared to cohorts born before, accounting for urban/regional location. The prevalence of myopia remains relatively low in middle‐aged Australian adults.
Publisher: Wiley
Date: 07-09-2012
DOI: 10.1111/J.1475-1313.2012.00931.X
Abstract: Systemic diseases, smoking, ocular surgeries and contact lens wear have been linked with dry eye but it is not known if these factors are also associated with severity of dry eye. A cross-sectional investigation was conducted on the effect of various systemic and ocular conditions with respect to the severity of dry eye in Asian patients. Prospective recruitment of consecutive new referral patients from a dry eye clinic was performed. Medical history, dry eye symptoms and clinical assessment were coded in a standardised form and analysed. Out of 510 patients (25% men), mean ± S.D. age 53.0 ± 14.1 years, 25 had previous diagnosis of rheumatoid arthritis, 30 had diabetic mellitus, 41 had thyroid disease, and 33 were current smokers 23 and 41 patients had previous LASIK and cataract surgery respectively and 90 were current contact lenses wearers. A previous diagnosis of rheumatoid arthritis was associated with more severe superior corneal fluorescein staining (OR = 11.2, 95% CI 4.6-27.4). Generally, with the exception of rheumatoid arthritis, there were no associations between dry eye severity and systemic diseases, smoking, previous ocular surgeries and contact lens wear. Dry eye patients with rheumatoid arthritis tend to have more severe ocular surface damage in the superior cornea.
Publisher: F1000 Research Ltd
Date: 23-07-2019
DOI: 10.12688/HRBOPENRES.12914.1
Abstract: Background: The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% unpreserved atropine for myopia control in a European population. Methods: MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine for managing progression of myopia. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia instil eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during Phase 2 from month 24 to 36 (washout period) for those participants initially randomised to the intervention arm (n=167), during which any potential rebound effects on cessation of treatment will be monitored. All participants initially assigned to the placebo (n=83) crossover to the intervention arm of the study for Phase 2, and from month 24 to 36, instil 0.01% atropine eye drops in both eyes once nightly. Further treatment and monitoring beyond 36 months is planned (Phase 3) and will be designed dependent on the outcomes of Phase 1. Results: The primary outcome measure is cycloplegic spherical equivalent refractive error progression at 24 months. Secondary outcome measures include axial length change as well as the rebound, safety and acceptability profile of 0.01% atropine. Additional analyses will include the mechanisms of action of 0.01% atropine for myopia control. Conclusions: The generalisability of results from previous clinical trials investigating atropine for myopia control is limited by the predominantly Asian ethnicity of previous study populations. MOSAIC is the first RCT to explore the efficacy, safety and mechanisms of action of unpreserved 0.01% atropine in a predominantly White population. Trial registration: ISRCTN: ISRCTN36732601 (04/10/2017), EudraCTdatabase 2016-003340-37 (03/07/2018).
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.MATURITAS.2022.05.002
Abstract: Worldwide, glaucoma affects about 3% of the population over the age of 50 years and is a leading cause of irreversible visual impairment among older people. Because glaucoma is asymptomatic in its early stages and can be challenging to diagnose clinically, it often remains undiagnosed until substantial vision loss has occurred. Efficient methods of glaucoma screening are therefore warranted for early detection of disease. Identification of risk factors for glaucoma - family history of glaucoma, older age, African or Asian ethnicities, raised intraocular pressure, and thin corneas - have helped inform guidelines on the recommended age at commencement and frequency of glaucoma screenings. A genetic predisposition or family history of glaucoma is one of the most important risk factors for the disease. However, an accurate family history cannot always be ascertained. Genetic testing for genes such as myocilin could help to identify high-risk in iduals and, with further research, could even provide insight into in idual patients' response to treatment. With the ongoing discovery of glaucoma-associated genes and the advent of polygenic risk scores to identify in iduals at high risk of glaucoma, gene-based screening for glaucoma is becoming closer to realisation. In the meantime, regularly screening family members of people with existing glaucoma is an efficient way of detecting early glaucoma. Raising public awareness of glaucoma is also necessary to educate the general public on the key role of routine eye examinations and early disease detection. Future studies should be undertaken to explore efficient public health c aign methods for improving glaucoma awareness.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-04-2020
Publisher: Informa UK Limited
Date: 05-09-2022
DOI: 10.1080/09286586.2021.1968005
Abstract: In 1989-1991, pregnant women completed questionnaires on their current smoking and alcohol drinking patterns. Following the birth of their offspring, information on household smokers was obtained between the 1- and 13-year follow-ups. At the 20-year follow-up, these offspring underwent an eye examination including optical coherence tomography imaging of the RNFL. Participants (n = 1,287) were 19-22 years old at time of eye examination. Most participants (77%) had no
Publisher: BMJ
Date: 23-11-2021
DOI: 10.1136/BJOPHTHALMOL-2021-320284
Abstract: Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting conjunctival damage related to ultraviolet radiation exposure. In cross-sectional studies, CUVAF area is positively associated with self-reported time spent outdoors and pterygium and negatively associated with myopia however, longitudinal studies are scarce. To use a novel deep learning-based tool to assess 8-year change in CUVAF area in young adults, investigate factors associated with this change and identify the number of new onset pterygia. A deep learning-based CUVAF tool was developed to measure CUVAF area. CUVAF area and pterygium status were assessed at three study visits: baseline (participants were approximately 20 years old) and at 7-year and 8-year follow-ups. Participants self-reported sun protection behaviours and ocular history. CUVAF data were available for 1497 participants from at least one study visit 633 (43%) participants had complete CUVAF data. Mean CUVAF areas at baseline and the 7-year and 8-year follow-ups were 48.4, 39.3 and 37.7 mm 2 , respectively. There was a decrease in mean CUVAF area over time (change in total CUVAF area=−0.96 mm 2 per year (95% CI: −1.07 to –0.86)). For participants who wore sunglasses ≥1/2 of the time, CUVAF area decreased by an additional −0.42 mm 2 per year (95% CI: −0.72 to –0.12) on average. Fourteen (1.5%) participants developed a pterygium. In this young adult cohort, CUVAF area declined over an 8-year period. Wearing sunglasses was associated with a faster reduction in CUVAF area. Deep learning-based models can assist in accurate and efficient measurement of CUVAF area.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 05-2023
DOI: 10.1167/IOVS.64.6.2
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-03-2020
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 26-05-2022
DOI: 10.1167/IOVS.63.5.34
Publisher: Springer Science and Business Media LLC
Date: 11-05-2021
DOI: 10.1186/S12916-021-01973-Y
Abstract: Sleep apnoea, a common sleep-disordered breathing condition, is characterised by upper airway collapse during sleep resulting in transient hypoxia, hypoperfusion of the optic nerve, and spike in intracranial pressure. Previous studies have reported conflicting findings on the association of sleep apnoea with glaucoma, and there are limited reports on the link between sleep apnoea and age-related macular degeneration (AMD). Middle-aged and older participants from the longitudinal United Kingdom (UK) Biobank ( n = 502,505) and the Canadian Longitudinal Study on Aging (CLSA n = 24,073) were included in this analysis. Participants in the UK Biobank and the CLSA were followed for 8 and 3 years, respectively. Participants with diagnosed glaucoma or AMD at baseline were excluded from the analysis. In the UK Biobank, sleep apnoea and incident cases of glaucoma and AMD were identified through hospital inpatient admission, primary care records, and self-reported data. Multivariable Cox proportional hazards models were used to explore associations of sleep apnoea with incidence of glaucoma or AMD. During the 8-year follow-up in the UK Biobank, glaucoma incidence rates per 1000 person-years were 2.46 and 1.59 for participants with and without sleep apnoea, and the AMD incidence rates per 1000 person-years were 2.27 and 1.42 for participants with and without sleep apnoea, respectively. Multivariable adjusted hazard ratios of glaucoma and AMD risk for sleep apnoea were 1.33 (95% confidence interval [CI] 1.10–1.60, P = 0.003) and 1.39 (95% CI 1.15–1.68, P 0.001) relative to participants without sleep apnoea. In the CLSA cohort, disease information was collected through in-person interview questionnaires. During the 3-year follow-up, glaucoma incidence rates per 1000 person-years for those with and without sleep apnoea were 9.31 and 6.97, and the AMD incidence rates per 1000 person-years were 8.44 and 6.67, respectively. In the CLSA, similar associations were identified, with glaucoma and AMD odds ratios of 1.43 (95% CI 1.13–1.79) and 1.39 (95% CI 1.08–1.77), respectively, in participants with sleep apnoea compared to those without sleep apnoea (both P 0.001). In two large-scale prospective cohort studies, sleep apnoea is associated with a higher risk of both glaucoma and AMD. These findings indicate that patients with sleep apnoea might benefit from regular ophthalmologic examinations.
Publisher: Wiley
Date: 18-05-2023
DOI: 10.1111/CEO.14240
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 20-12-2011
DOI: 10.1167/IOVS.11-8814
Publisher: CRC Press
Date: 11-02-2014
DOI: 10.1201/B16510
Publisher: Wiley
Date: 17-07-2015
DOI: 10.1111/OPO.12230
Abstract: Optical blur and ageing are known to affect driving performance but their effects on drivers' eye movements are poorly understood. This study examined the effects of optical blur and age on eye movement patterns and performance on the DriveSafe slide recognition test which is purported to predict fitness to drive. Twenty young (27.1 ± 4.6 years) and 20 older (73.3 ± 5.7 years) visually normal drivers performed the DriveSafe under two visual conditions: best-corrected vision and with +2.00 DS blur. The DriveSafe is a Visual Recognition Slide Test that consists of brief presentations of static, real-world driving scenes containing different road users (pedestrians, bicycles and vehicles). Participants reported the types, relative positions and direction of travel of the road users in each image the score was the number of correctly reported items (maximum score of 128). Eye movements were recorded while participants performed the DriveSafe test using a Tobii TX300 eye tracking system. There was a significant main effect of blur on DriveSafe scores (best-corrected: 114.9 vs blur: 93.2 p < 0.001). There was also a significant age and blur interaction on the DriveSafe scores (p < 0.001) such that the young drivers were more negatively affected by blur than the older drivers (reductions of 22% and 13% respectively p < 0.001): with best-corrected vision, the young drivers performed better than the older drivers (DriveSafe scores: 118.4 vs 111.5 p = 0.001), while with blur, the young drivers performed worse than the older drivers (88.6 vs 95.9 p = 0.009). For the eye movement patterns, blur significantly reduced the number of fixations on road users (best-corrected: 5.1 vs blur: 4.5 p < 0.001), fixation duration on road users (2.0 s vs 1.8 s p < 0.001) and saccade litudes (7.4° vs 6.7° p < 0.001). A main effect of age on eye movements was also found where older drivers made smaller saccades than the young drivers (6.7° vs 7.4° p < 0.001). Blur reduced DriveSafe scores for both age groups and this effect was greater for the young drivers. The decrease in number of fixations and fixation duration on road users, as well as the reduction in saccade litudes under the blurred condition, highlight the difficulty experienced in performing the task in the presence of optical blur, which suggests that uncorrected refractive errors may have a detrimental impact on aspects of driving performance.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 10-03-2021
DOI: 10.1167/TVST.10.3.8
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-04-2021
Publisher: Wiley
Date: 19-03-2020
DOI: 10.1111/OPO.12679
Abstract: Executive function and visual search are linked to a number of activities of daily living including driving and mobility. Using a computerised version of the Trail Making Test B (TMT‐B), we compared the executive function and visual search ability of older adults with glaucoma to age‐similar controls and identified which visual function tests best predict TMT‐B performance. Novel low‐contrast and shifting‐target variations of the test were incorporated to explore the effects of different levels of test complexity. Thirty‐one older adults with mild to moderate glaucoma (mean age = 71.2 years [SD 6.9] better‐eye mean deviation [MD]: median = −1.9 dB [IQR = −1.2 to 0.4], worse‐eye MD: median = −11.1 dB [IQR = −14.0 to −7.7]) and 24 age‐similar controls (mean age = 71.9 years [SD 6.6]) with normal vision participated. The groups were matched in age, sex, and cognitive status (mini‐mental state examination [MMSE]). Participants underwent measurements of visual acuity, contrast sensitivity (CS), visual fields, and visual processing speeds using the useful field‐of‐view (UFoV). Participants then completed four variations of a computerised TMT‐B test, with different levels of complexity based on target contrast (high/low‐contrast) and shifts in target position (fixed/shifting locations). Linear mixed‐effect models were used to explore the effects of group, target contrast and shift on TMT‐B completion time. The glaucoma group took 17.3s longer than controls to complete the TMT‐B ( P = 0.028). All participants took 6.5s longer to complete the low‐ compared to the high‐contrast tests ( P = 0.012), and 10.6s longer for the shifting TMT‐B compared to the fixed version ( P 0.001). There was no interaction effect between group, contrast, or target shift on completion time. Across all tests and participant groups, longer completion time was associated with slower UFoV processing speeds ( ided attention: P = 0.003 selective attention: P = 0.006). Poorer CS was associated with longer completion times for the low ( P = 0.007), but not the high‐contrast tests. Our findings suggest that older adults with mild to moderate glaucoma have poorer visual search ability and executive function relative to controls. However, decreasing target contrast or shifting target position did not exacerbate the effects of glaucomatous visual impairment on performance. The UFoV was a strong predictor of TMT‐B performance.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Public Library of Science (PLoS)
Date: 13-04-2022
DOI: 10.1371/JOURNAL.PONE.0266909
Abstract: Changes in retinal thickness are common in various ocular diseases. Transverse magnification due to differing ocular biometrics, in particular axial length, affects measurement of retinal thickness in different regions. This study evaluated the effect of axial length and refractive error on measured macular thickness in two community-based cohorts of healthy young adults. A total of 2160 eyes of 1247 community-based participants (18–30 years 23.4% myopes, mean axial length = 23.6mm) were included in this analysis. Macular thickness measurements were obtained using a spectral-domain optical coherence tomography (which assumes an axial length of 24.385mm). Using a custom program, retinal thickness data were extracted at the 9 Early Treatment of Diabetic Retinopathy Study (ETDRS) regions with and without correction for transverse magnificent effects, with the corrected measurements adjusting according to the participant’s axial length. Linear mixed models were used to analyse the effect of correction and its interaction with axial length or refractive group on retinal thickness. The raw measures (uncorrected for axial length) underestimated the true retinal thickness at the central macula, while overestimating at most non-central macular regions. There was an axial length by correction interaction effect in all but the nasal regions (all p .05). For each 1mm increase in axial length, the central macular thickness is overestimated by 2.7–2.9μm while thicknesses at other regions were underestimated by 0.2–4.1μm. Based on the raw thickness measurements, myopes have thinner retinas than non-myopes at most non-central macular. However, this difference was no longer significant when the corrected data was used. In a community-based s le, the raw measurements underestimate the retinal thickness at the central macula and overestimate the retinal thickness at non-central regions of the ETDRS grid. The effect of axial length and refractive error on retinal thickness is reduced after correcting for transverse magnification effects resulting from axial length differences.
Publisher: Public Library of Science (PLoS)
Date: 06-2017
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 18-08-2023
DOI: 10.1167/TVST.12.8.14
Publisher: Elsevier BV
Date: 04-2023
Publisher: Frontiers Media SA
Date: 27-04-2022
DOI: 10.3389/FPUBH.2022.861044
Abstract: Myopia tends to develop and progress fastest during childhood, and the age of stabilization has been reported to be 15–16 years old. Thus, most studies on myopia have centered on children. Data on the refractive error profile in young adulthood — a time in life when myopia is thought to have stabilized and refractive error is unaffected by age-related pathology such as cataract — are limited. The Raine Study has been following a community-based cohort of young adults representative of the general Western Australia population since their prenatal periods in 1989–1991, with eye examinations performed when participants were 20 and 28 years old. At 20 years old, prevalence of myopia in the cohort was 25.8%. Using long-term trajectory of serum vitamin D levels and conjunctival ultraviolet autofluorescence (CUVAF) area to objectively quantify sun exposure, the Raine Study confirmed a negative relationship between time spent outdoors and myopia prevalence. However, prospective studies are required to determine the amount of CUVAF area or serum vitamin D levels associated with time duration. Combining data from the Raine Study and several other cohorts, Mendelian randomization studies have confirmed a link between myopia and a genetic predisposition toward higher education. Several novel potential associations of myopia or ocular biometry were investigated, including fetal growth trajectory, which was found to be significantly associated with corneal curvature at 20 years. By age 28, myopia prevalence had increased to 33.2%. Between 20 and 28 years old, myopia progressed and axial length elongated, on average, by −0.041D/year and 0.02 mm/year, respectively. Smaller CUVAF area at follow-up, female sex, and parental myopia were significant risk factors for myopia incidence and progression between 20 and 28 years. Given the limited research in young adults, further investigations are warranted to confirm the Raine Study findings, as well as identify novel genetic or environmental factors of myopia incidence and progression in this age group.
Publisher: American Medical Association (AMA)
Date: 04-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-12-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
DOI: 10.1097/OPX.0000000000000903
Abstract: To examine the effects of optical blur, auditory distractors, and age on eye movement patterns while performing a driving hazard perception test (HPT). Twenty young (mean age 27.1 ± 4.6 years) and 20 older (73.3 ± 5.7 years) drivers with normal vision completed a HPT in a repeated-measures counterbalanced design while their eye movements were recorded. Testing was performed under two visual (best-corrected vision and with +2.00DS blur) and two distractor (with and without auditory distraction) conditions. Participants were required to respond to road hazards appearing in the HPT videos of real-world driving scenes and their hazard response times were recorded. Blur and distractors each significantly delayed hazard response time by 0.42 and 0.76 s, respectively (p 0.05). A significant interaction between age and distractors indicated that older drivers were more affected by distractors than young drivers (response with distractors delayed by 0.96 and 0.60 s, respectively). There were no other two- or three-way interaction effects on response time. With blur, for ex le, both groups fixated significantly longer on hazards before responding compared to best-corrected vision. In the presence of distractors, both groups exhibited delayed first fixation on the hazards and spent less time fixating on the hazards. There were also significant differences in eye movement characteristics between groups, where older drivers exhibited smaller saccades, delayed first fixation on hazards, and shorter fixation duration on hazards compared to the young drivers. Collectively, the findings of delayed hazard response times and alterations in eye movement patterns with blur and distractors provide further evidence that visual impairment and distractors are independently detrimental to driving safety given that delayed hazard response times are linked to increased crash risk.
Publisher: Springer Science and Business Media LLC
Date: 24-05-2020
DOI: 10.1186/S12874-020-00996-Y
Abstract: Recent changes in communication technologies, including increased reliance on mobile phones and the internet, may present challenges and/or opportunities to re-engaging inactive study cohorts. We evaluate our ability to recruit participants for the Kidskin Young Adult Myopia Study (KYAMS), a follow-up of the Kidskin Study. KYAMS participants were recruited from the Kidskin Study, a sun exposure-intervention study for 5–6 year-olds running from 1995 to 1999 with most recent follow-up in 2005. From 2015 to 2019, the KYAMS used mail-outs, phone calls and social media to contact Kidskin Study participants. Multivariable logistic regression was used to identify variables associated with successful contact of a Kidskin Study participant or family member and KYAMS participation. Of 1695 eligible participants, 599 (35.5%) participants (or a family member) were contacted and 303 (17.9%) participated in the KYAMS. KYAMS participation was more likely in those who participated in the 2005 follow-up (odds ratio [OR] = 5.09, 95% confidence interval [CI]: 3.67–7.06) and had a mobile phone number on record (OR = 2.25, CI: 1.57–3.23). Of those contacted, participants who were the first point of contact (OR = 4.84, CI: 2.89–8.10) and who were contacted by letter in the first (OR = 6.53, CI: 3.35–12.75) or second (OR = 5.77, CI: 2.85–11.67) round were more likely to participate in the KYAMS, compared to contact by landline phone. We recruited approximately one-fifth of Kidskin Study participants for the KYAMS. Participants were more likely to participate in the KYAMS if they were contacted directly, rather than through a family member, and if they were contacted by invitation letter. ACTRN12617000812392 .
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2018
End Date: 2018
Funder: University of Western Australia
View Funded ActivityStart Date: 2018
End Date: 2018
Funder: University of Western Australia
View Funded ActivityStart Date: 2020
End Date: 2021
Funder: University of Western Australia
View Funded Activity