ORCID Profile
0000-0002-5208-3544
Current Organisation
Legacy Health
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Publisher: American Medical Association (AMA)
Date: 12-2012
DOI: 10.1001/JAMAOPHTHALMOL.2013.1137
Abstract: To compare rates of visual field (VF) change in ocular hypertensive eyes with and without optic dischemorrhage (DH). Ocular Hypertension Treatment Study subjects(minimum 10 reliable VF tests, followed up 5 years) were included. Trend analyses of VF sequences over time of DH and non-DH eyes were assessed by regression of mean deviation (MDR) and pointwise linear regression (PLR). The main outcome measures were rates of VF change in DH and non-DH eyes. Two thousand six hundred seven eyes (1378 participants) were included. The mean (SD) number of VF tests per eye was 23.7 (4.9) spanning a mean (SD) of 12.2 (2.0) years. At least 1 DH was detected in 187 eyes(7.2%), of which 52 eyes had recurrent DH. Mean deviation rate of change was significantly worse in DH compared with non-DH eyes (mean [SD], −0.17 [0.27] vs−0.07 [0.19] dB/y P<.01). Significant PLR progression occurred more frequently in eyes with DH (odds ratio,3.6 P<.01), which increased when 2 or more DHs were present (odds ratio, 4.2 P=.01). Eyes initially randomized to treatment were less likely to have a DH during follow-up. Eyes with DH had more rapid VF deterioration when assessed by global (MDR) or local (PLR)trend analysis than eyes without DH. Eyes with recurrent DH had similar rates of global VF change (MDR)when compared with eyes with a single DH but reached criteria for rapid PLR change more often. Intraocular pressure reduction in ocular hypertension reduces the risk of developing a DH. Ocular hypertensive eyes with DH should be monitored closely and may need more aggressive therapy. clinicaltrials.gov Identifier: NCT00000125
Publisher: Public Library of Science (PLoS)
Date: 10-10-2022
DOI: 10.1371/JOURNAL.PONE.0275807
Abstract: To determine the associations of blindness within rural and urban counties using a registry of blind persons and geospatial analytics. We used the Oregon Commission for the Blind registry to determine the number of persons who are legally blind, as well as licensure data to determine the density of eye care providers (optometrists and ophthalmologists) within each county of the State of Oregon. We used geospatial statistics, analysis of variance, and logistic regression to determine the explanatory variables associated with blindness within counties. We included 8350 in iduals who are legally blind within the state of Oregon in the calendar year 2015. The mean observed prevalence of registered blindness was 0.21% and ranged almost 9-fold from 0.04% to 0.58% among counties (p .001). In univariate models, higher blindness was associated with increasing median age (p = .027), minority race (p .001), decreased median household income (p .001), increased poverty within a county (p .001), and higher density of ophthalmologists (p = .003). Density of optometrists was not associated with prevalence of blindness (p = .89). The final multivariable model showed higher blindness to be associated with lower median household income, higher proportion of black race, and lower proportion of Hispanic race (p .001 for all). Geospatial analytics identified counties with higher and lower than expected proportions of blindness even when adjusted for sociodemographic factors. Clinicians and researchers may use the methods and results of this study to better understand the distribution of in iduals with blindness and the associated factors to help design public health interventions.
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.OHC.2005.05.002
Abstract: This article provides a basis for understanding modern visual field analysis techniques. It describes some of these tests, including their advantages and disadvantages, and the settings in which different tests might be used most successfully. It also includes an examination of the value of visual field assessment from a public health standpoint with particular attention paid to morbidity, cost/benefit ratios, and quality of life correlations.
Publisher: Mary Ann Liebert Inc
Date: 12-2013
Publisher: Elsevier BV
Date: 07-2014
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 03-2007
DOI: 10.1167/IOVS.06-0561
Abstract: To compare the diagnostic performance of multifocal visual evoked potential (mfVEP) and standard automated perimetry (SAP), in eyes with high-risk ocular hypertension or early glaucoma. Both eyes of 185 in iduals with high-risk ocular hypertension or early glaucoma were evaluated. Subjects ranged in age from 37 to 87 (mean +/- SD: 61 +/- 11 years). Pattern-reversal mfVEPs were obtained by using VERIS (Electro-Diagnostic Imaging, San Mateo, CA) with a four-electrode array and were analyzed with custom software. SAP visual fields (SITA-standard Carl Zeiss Meditec, Inc., Dublin, CA) were obtained within 22.3 +/- 27.0 days of the mfVEP. Stereo disc photographs and Heidelberg Retina Tomograph (HRT) images were obtained during one visit, which was within 24.8 +/- 50.4 days of the mfVEP and 33.1 +/- 62.9 days of the SAP visual field. Abnormalities on the mfVEP were defined by using a variety of cluster criteria: SAP with pattern standard deviation (PSD) P </= 0.05 or glaucoma hemifield test (GHT) outside normal limits, according to OHTS criteria (SAP-OHTS). In separate analyses cluster criteria were used to determine SAP abnormalities. Disc photographs were graded as either glaucomatous optic neuropathy (GON) or normal by two independent masked experts, and disagreements were adjudicated by a third masked expert. The overall Moorfields regression analysis (MRA) result from the HRT was used as a separate diagnostic classification. All eyes classified as "borderline" by the MRA were assigned to the normal category (i.e., "within normal limits"). Sensitivity for mfVEP or SAP was defined as the percentage of GON eyes that had an abnormality on the functional test. Specificity for mfVEP or SAP was defined as the percentage of eyes with normal optic disc structure that had normal functional test results. Disc photographs from 50% of eyes were graded GON. Both eyes were graded GON in 71 (38%) of the 185 subjects. Exactly half as many eyes were abnormal by HRT MRA. The average SAP mean deviation (MD) was +0.3 +/- 2.1 dB average PSD was 2.3 +/- 1.9 dB. By OHTS criteria, 83 (22%) of the 370 eyes had an abnormal SAP. Depending on the cluster criterion used, the proportion of eyes with an abnormal SAP ranged from 8% to 26% and with an abnormal mfVEP, from 14% to 45%. A criterion with an estimated specificity in normal subjects of 91% resulted in 102 (28%) eyes with an abnormal mfVEP. For criteria with estimated specificities of 95% and 99%, respectively, 88 (24%) eyes and 52 (14%) eyes had an abnormal mfVEP. Agreement between SAP and mfVEP ranged from 75% to 81%. The sensitivity of SAP-OHTS to detect GON (using the disc photograph as diagnostic standard) was 29%, whereas specificity was 84%. Sensitivity of the mfVEP to detect GON, for cluster criteria with disc structure specificity between 84% and 87%, ranged from 28% to 32%. When the HRT MRA was used as the diagnostic standard, sensitivities of both functional tests to detect GON increased to 42%. The diagnostic performance of mfVEP was similar to that of SAP. However, the two modalities agreed in only approximately 80% of eyes, suggesting that they may detect slightly different functional deficits.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 02-2009
DOI: 10.1167/IOVS.08-1767
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier BV
Date: 02-2017
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 06-2018
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 17-07-2017
Publisher: Elsevier BV
Date: 03-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2016
Publisher: American Medical Association (AMA)
Date: 05-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2008
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2019
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 03-2015
DOI: 10.1167/TVST.4.2.10
Location: United States of America
Location: United States of America
Start Date: 2009
End Date: 2014
Funder: National Eye Institute
View Funded ActivityStart Date: 2011
End Date: 2022
Funder: National Eye Institute
View Funded Activity