ORCID Profile
0000-0003-3854-2991
Current Organisation
The University of Auckland
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Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 02-07-2013
Abstract: To assess the effects of panretinal photocoagulation (PRP) for diabetic retinopathy (DR) on the human corneal subbasal nerve plexus (SBNP) and to investigate correlations between corneal subbasal nerve (SBN) density, corneal sensitivity, and diabetic peripheral neuropathy. Thirty-eight subjects with at least a 10-year history of diabetes mellitus (DM) or DR were included. Subjects were assigned to a PRP group (n = 19), having undergone a treatment of retinopathy in at least one eye or a non-PRP group (n = 19), with no history of PRP. The Michigan Neuropathy Screening Instrument (MNSI) was administered to enable quantification of neuropathic symptoms. Laser scanning in vivo confocal microscopy was performed to capture images of the corneal SBNP to allow determination of SBNP density. Central corneal sensitivity (CST) was evaluated by noncontact aesthesiometry and peripheral vibration perception threshold was measured with a biothesiometer. Mean SBNP densities were 12.27 ± 4.28 mm/mm²) in the PRP group and 12.75 ± 3.59 mm/mm² in the non-PRP group. There were no significant differences in SBNP density (P = 0.71), CST (P = 0.84), MNSI score (P = 0.19), and biothesiometry (P = 0.77) between the PRP and non-PRP groups. When data from both groups (n = 38) were combined, corneal sensitivity was modestly correlated with SBNP density (r = 0.30, P = 0.06), and peripheral biothesiometry (r = 0.26, P = 0.11). In DM correlation of corneal sensitivity, SBNP density, and peripheral biothesiometry may have a potential role in estimating the severity of peripheral neuropathy. Corneal SBNP density and sensitivity appear to be unaffected by PRP laser treatment compared with non-PRP diabetic eyes.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 04-08-2015
Abstract: We investigated the relationship between corneal subbasal nerve (SBN) plexus density, corneal sensitivity, and peripheral and cardiac autonomic neuropathy in patients with type 1 diabetes mellitus. We recruited 53 patients with type 1 diabetes mellitus and 40 normal control participants. Corneal in vivo confocal microscopy (IVCM) and sensitivity testing were performed on one eye of each subject. Autonomic function testing was done and an overall neuropathy score obtained from a combination of a symptomatic neuropathy score, clinical assessment, biothesiometry, and nerve conduction tests. The corneal SBN density (P < 0.001) and corneal sensitivity (P < 0.001) were significantly lower in subjects with diabetes compared to controls. A modest negative correlation between total neuropathy score and SBN density was observed (r = -0.33, P = 0.01). A negative correlation between corneal sensitivity and expiration/inspiration component of the autonomic nerve analysis (ANS-EI) also was noted (r = -0.36, P = 0.008). Corneal SBN density was abnormal in 50% of diabetic subjects classified as "Normal" by the clinical and electrophysiological based tests of total neuropathy score. The correlation of corneal SBN density with total neuropathy score suggests that reduced corneal nerve density reflects peripheral neuropathy in diabetes. Corneal SBN changes precede other clinical and electrophysiology tests of neuropathy supporting a possible role for corneal IVCM and corneal sensitivity testing as surrogate markers in the assessment of diabetic peripheral and cardiac autonomic neuropathy.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: Wiley
Date: 07-12-2016
DOI: 10.1111/CEO.12634
Abstract: The aim is to investigate ethnic variation, in presentation and biometric parameters, within the population undergoing cataract surgery in Auckland. The design is a retrospective study. Four thousand nine hundred thirty-one eyes of 3524 consecutive patients undergoing cataract surgery in Auckland Public Hospital over 18 months were included in the study. Analysis of preoperative medical records was performed. Age, gender, self-reported ethnicity, keratometry, anterior chamber depth, axial length and intraocular lens (IOL) power data were collected. Māori (4.7%) were under-represented compared with the proportion of Māori attending the eye clinic (5.5%) and in the major patient catchment area (8.2%). People of Māori, Pacific and Indian ethnicities presented at a significantly younger age (66.4, 65.9 and 67.9 years, respectively) than those of Caucasian and Asian ethnicities (76.4 and 71.3 years, respectively, P < 0.001). Advanced cataract was more likely in Pacific peoples and Māori than Caucasians. The mean axial length was longest in Asian eyes (23.83 ± 1.52 mm). The mean anterior chamber depth in the eyes of Pacific peoples (3.20 ± 0.39 mm) was significantly greater than that of Caucasians (3.09 ± 0.42 mm, P = 0.001) and Asians (3.05 ± 0.49 mm, P < 0.001). The mean IOL power in Asian eyes was 19.45D. This was significantly lower than the IOL power required by Caucasian (20.72D, P < 0.001) and Pacific ethnicities (20.61D, P = 0.001). With-the-rule astigmatism was highly prevalent in Māori and Pacific peoples, whereas in all other ethnicities, against-the-rule astigmatism was more common. This study identified significant ethnic variation in presentation for cataract surgery and ocular biometric parameters. These data may help identify potential biometric refinements and those at risk of developing ocular morbidities known to be associated with these parameters.
Publisher: Informa UK Limited
Date: 05-2014
DOI: 10.1111/CXO.12110
Abstract: Traditionally, photodynamic therapy (PDT) has been used to treat choroidal neovascularisation. More recently, its use in corneal neovascularisation has provided promising clinical results. The major advantage of PDT is that it is minimally invasive, resulting in closure of the neovascular network without damaging the surrounding healthy tissue. This report describes the positive results of PDT, clinically and microstructurally, as imaged by in vivo confocal microscopy, for treating corneal neovascularisation with lipid keratopathy, secondary to herpes zoster infection.
Publisher: Springer Science and Business Media LLC
Date: 08-12-2018
DOI: 10.1038/EYE.2017.266
Publisher: Wiley
Date: 09-12-2020
DOI: 10.1111/CEO.13685
Publisher: Informa UK Limited
Date: 04-04-2022
Publisher: Informa UK Limited
Date: 03-2013
DOI: 10.1111/CXO.12050
Abstract: The majority of those with keratoconus can maximise visual acuity with spectacle or contact lens correction as they age however, as subjects enter their sixties, cataracts may supervene and contact lens tolerance diminishes with consequent reduction in visual acuity. Following cataract extraction, the complex refractive error associated with keratoconus may not be readily corrected by an intraocular lens alone. This report highlights the planned implantation of a primary posterior chamber toric intraocular lens with a secondary piggyback, sulcus-based, intraocular lens in advanced but stable keratoconus with extreme myopic astigmatism and cataract.
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/848659
Abstract: Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM) and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM in iduals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups ( P = 0.12 and P = 0.33 , resp.). Tear lipid thickness ( P = 0.02 ), stability ( P 0.0001 ), and quantity ( P = 0.01 ) were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group ( P 0.001 ) and tear film stability was inversely associated with total neuropathy score ( r = - 0.29 , P = 0.03 ). Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.NEUINT.2014.01.003
Abstract: Vinpocetine is a natural drug which exerts neuroprotective effects in ischaemia of the brain through actions on cation channels, glutamate receptors and other pathways. This study investigated the effect of vinpocetine on cation channel permeability of inner retinal neurons after acute retinal metabolic insult. We focused on amacrine and ganglion cells immunoreactive for calretinin or parvalbumin due to their previously documented susceptibility to ischaemia. Using the probe, 1-amino-4-guanidobutane (AGB), we observed increased cation channel permeability across amacrine and ganglion cells under ischaemia and hypoglycaemia but not anoxia. Calretinin and parvalbumin immunoreactivity was also reduced during ischaemia and hypoglyacemia but not anoxia. Vinpocetine decreased AGB entry into ischaemic and hypoglycaemic ganglion cells indicating that the drug can modulate unregulated cation entry. In addition, vinpocetine prevented the loss of calretinin and parvalbumin immunoreactivity following ischaemia suggesting it may indirectly regulate intracellular calcium. Vinpocetine also reduced AGB permeability in selected amacrine and ganglion cell populations following N-methyl-D-aspartate (NMDA) but not kainate activation suggesting that vinpocetine's regulation of cation channel permeability may partly involve NMDA sensitive glutamate receptors.
No related grants have been discovered for Stuti Misra.