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Tran B, Vajdic CM, Webber K, Laaksonen MA, Stavrou EP, Tiller K, Suchy S, Bosco AM, Harris MF, Lloyd AR, Goldstein D. Self-reported health, lifestyle and social circumstances of Australian adult cancer survivors: A propensity score weighted cross-sectional study. Cancer Epidemiol 2020; 67:101773. [PMID: 32615538 DOI: 10.1016/j.canep.2020.101773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the prevalence of cancer survivors increasing, their unique needs must be better understood. We examined the health, lifestyles and social circumstances of adults with and without a history of cancer. METHODS We performed a cross-sectional study, using exposure and outcome data from the baseline survey (2006-2009) of participants in the 45 and Up Study, a prospective cohort study in New South Wales, Australia. We compared 20,811 cancer registry-verified adult cancer survivors with 207,148 participants without a history of cancer using propensity score weighting and accounting for multiple testing. The propensity weighting included age, sociodemographic factors and number of self-reported co-morbidities. RESULTS Cancer survivors were more likely to report poorer physical and psychological health and quality of life compared to those without a cancer history, with most deficits still evident more than 10 years after cancer diagnosis. Cancer survivors were more likely to have a higher body mass index, but were less likely to smoke. Cancer survivors had greater functional limitations, including sexual, and were less likely to work full time, volunteer and spend time outdoors. Their social connectedness was, however, similar. Those with haematological cancer, lung cancer, or distant metastases, and those diagnosed at an older age, had the greatest health deficits and functional limitations. CONCLUSIONS A history of cancer is associated with poorer health and less paid and unpaid work. Our findings reinforce the importance of routine long-term, integrated multidisciplinary care for cancer survivors and indicate the subgroups with the greatest unmet needs.
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Affiliation(s)
- Bich Tran
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
| | - Kate Webber
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia; Department of Oncology, Monash Health, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Efty P Stavrou
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | | | - Sue Suchy
- Consumer Advisory Panel, Translational Cancer Research Network, Sydney, Australia
| | - Ann Marie Bosco
- Prince of Wales Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Andrew R Lloyd
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - David Goldstein
- Department of Medical Oncology, Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia
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Chambers GM, Venetis CA, Jorm LR, Stavrou EP, Vajdic CM. Parity: A key measure of confounding in data-linkage studies of outcomes after medically assisted reproduction. Int J Popul Data Sci 2020; 5:1119. [PMID: 32935047 PMCID: PMC7473264 DOI: 10.23889/ijpds.v5i1.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Parity is a potential confounder of the association between medically assisted reproduction (MAR) and health outcomes. This concept paper describes a population-based record linkage study design for selecting MAR-unexposed women matched to the parity of MAR-exposed women, at the time of the first exposure to MAR. Women exposed to MAR were identified from claims for government subsidies for relevant procedures and prescription medicines, linked to perinatal records. Women unexposed to MAR were identified from linked perinatal and death records, matched to exposed women by age, rurality, age of first child (if any) and parity at the date of first MAR. The availability of a longitudinal, whole-of-population dataset (“population spine”) based on enrolments in Australia’s universal health insurance scheme was a critical design element. The example application examines cancer risk in women after exposure to MAR. Parity is a confounder in this setting because it is associated with MAR and hormone-sensitive cancers.
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Affiliation(s)
- G M Chambers
- Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia
| | - C A Venetis
- Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia
| | - L R Jorm
- Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia
| | - E P Stavrou
- Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia
| | - C M Vajdic
- Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia
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Vajdic CM, Stavrou EP, Ward RL, Falster MO, Pearson SA. Minimal excess risk of cancer and reduced risk of death from cancer in Australian Department of Veterans' Affairs clients: a record linkage study. Aust N Z J Public Health 2015; 38:30-4. [PMID: 24494942 DOI: 10.1111/1753-6405.12168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/01/2013] [Accepted: 10/01/2013] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To quantify the risk of incident cancer and cancer-related mortality in Australian Government Department of Veterans' Affairs (DVA) clients. METHODS A population-based record linkage study of 75,482 adult clients residing in New South Wales (NSW) from 2000 to 2007; median age 75 years (interquartile range, 68-79); 57% male. Standardised incidence ratios (SIRs) and mortality ratios (SMRs) for any cancer and by cancer type were calculated, relative to the NSW population. RESULTS The risk of any cancer was slightly increased for males (SIR 1.07, 95%CI 1.04-1.10) but not females (SIR 1.00, 95%CI 0.96-1.04). Males exhibited a significantly elevated risk of prostate cancer (SIR 1.08), cutaneous melanoma (SIR 1.19), head and neck cancer (SIR 1.27) and connective tissue cancer (SIR 1.52). Females did not exhibit excess risk for any cancer type. Risk of cancer death was significantly reduced for any cancer (male SMR 0.78, 95%CI 0.75-0.81; female SMR 0.80, 95%CI 0.76-0.85) and for a range of haematopoietic and solid neoplasms including prostate (SMR 0.57), breast (SMR 0.62) and colon cancer (male SMR 0.67; female SMR 0.71). CONCLUSION Cancer incidence rates are largely similar, and mortality rates moderately lower, for DVA clients compared to the NSW general population. IMPLICATIONS These risk patterns may reflect service-related history, a healthy-survivor effect, competing risk of death, and/or comprehensive health care entitlements with minimal to no co-payments. Our findings suggest DVA clients are probably accessing cancer screening services. Outcomes after cancer diagnosis are good, most probably due to comprehensive health care entitlements.
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Affiliation(s)
- Claire M Vajdic
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales
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Stavrou EP, Ward R, Pearson SA. Oesophagectomy rates and post-resection outcomes in patients with cancer of the oesophagus and gastro-oesophageal junction: a population-based study using linked health administrative linked data. BMC Health Serv Res 2012; 12:384. [PMID: 23136982 PMCID: PMC3556094 DOI: 10.1186/1472-6963-12-384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 10/31/2012] [Indexed: 02/06/2023] Open
Abstract
Background Hospital performance is being benchmarked increasingly against surgical indicators such as 30-day mortality, length-of-stay, survival and post-surgery complication rates. The aim of this paper was to examine oesophagectomy rates and post-surgical outcomes in cancers of the oesophagus and gastro-oesophageal junction and to determine how the addition of gastro-oesophageal cancer to oesophageal cancer impacts on these outcomes. Methods Our study population consisted of patients with a primary invasive oesophageal or gastro-oesophageal cancer identified from the NSW Cancer Registry from July 2000-Dec 2007. Their records were linked to the hospital separation data for determination of resection rates and post-resection outcomes. We used multivariate logistic regression analyses to examine factors associated with oesophagectomy and post-resection outcomes. Cox-proportional hazard regression analysis was used to examine one-year cancer survival following oesophagectomy. Results We observed some changes in resection rates and surgical outcomes with the addition of gastro-oesophageal cancer patients to the oesophageal cancer cohort. 14.6% of oesophageal cancer patients and 26.4% of gastro-oesophageal cancer patients had an oesophagectomy; an overall oesophagectomy rate of 18.2% in the combined cohort. In the combined cohort, oesophagectomy was associated with younger age, being male and Australian-born, having non-metastatic disease or adenocarcinoma and being admitted in a co-located hospital. Rates of length-of-stay >28 days (20.9% vs 19.7%), 30-day mortality (3.8% vs 2.7%) and one-year survival post-surgery (24.5% vs 23.1%) were similar between oesophageal cancer alone and the combined cohort; whilst 30-day complication rates were 21.5% versus 17.0% respectively. Some factors statistically associated with post-resection complication in oesophageal cancer alone were not significant in the overall cohort. Poorer post-resection outcomes were associated with some patient (older age, birthplace) and hospital-related characteristics (fiscal sector, area health service). Conclusion Outcomes following oesophagectomy in oesophageal and gastro-oesophageal cancer patients in NSW are within world benchmarks. Our study demonstrates that the inclusion of gastro-oesophageal cancer did alter some outcomes compared to analysis based solely on oesophageal cancer. As such, care must be taken with analyses based on administrative health data to capture all populations eligible for treatment and to understand the contribution of these subpopulations to overall outcomes.
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Affiliation(s)
- Efty P Stavrou
- Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
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Stavrou EP, Lu CY, Buckley N, Pearson S. The role of comorbidities on the uptake of systemic treatment and 3-year survival in older cancer patients. Ann Oncol 2012; 23:2422-2428. [PMID: 22351742 DOI: 10.1093/annonc/mdr618] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Older patients are notably absent from clinical trials. Thus, observational studies are the primary avenue for understanding the role of comorbidity in cancer care and survival. We examined the impact of comorbidity on systemic treatment initiation and 3-year survival in a cohort of older cancer patients. PATIENTS AND METHODS Our cohort comprised 2753 Australian veterans aged ≥65 years with full health coverage and a cancer registry notification for colorectal (CRC), breast, prostate or non-small-cell lung cancer (NSCLC). We established comorbidities based on drugs prescribed in the 6 months prior to cancer diagnosis. RESULTS Patients with higher comorbidity burden were more likely to receive systemic treatment for prostate cancer [adjusted odds ratio 1.21, 95% confidence interval (CI) 1.05-1.39] but less likely for NSCLC (0.63, 95% CI 0.45-0.86). After adjusting for receipt of treatment, increased comorbidity resulted in shorter survival for CRC [adjusted hazard ratio (aHR) 1.16, 95% CI 1.07-1.26] and breast cancer (aHR 1.23, 95% CI 1.02-1.48). However, we did not demonstrate significant improvements in 3-year survival for patients receiving systemic treatment. CONCLUSION Comorbidity influences systemic treatment uptake and adversely affects survival, with impact dependent upon comorbidity and cancer type. Clinical trials should be undertaken in older patients to better understand the risks and benefits of cancer treatments.
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Affiliation(s)
- E P Stavrou
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - C Y Lu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - N Buckley
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - S Pearson
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
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Stavrou EP, Buckley N, Olivier J, Pearson SA. Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage. BMJ Open 2012; 2:bmjopen-2012-000880. [PMID: 22614172 PMCID: PMC3358623 DOI: 10.1136/bmjopen-2012-000880] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The aim was to examine statin discontinuation rates in a cohort of elderly Australians with newly diagnosed cancer using population-based secondary health data. DESIGN Observational cohort study. SETTING New South Wales, the largest jurisdiction in Australia. The Pharmaceutical Benefits and Repatriation Pharmaceutical Benefits Schemes are national programmes subsidising prescription drugs to the Australian population and Australian Government Department of Veterans' Affairs clients. PARTICIPANTS The cohort comprised 1731 cancer patients aged ≥65 years with evidence of statin use in the 90 days prior to diagnosis. They were matched to 3462 non-cancer patients prescribed statins in the same period. MAIN OUTCOME MEASURE The authors compared statin discontinuation rates up to 4 years post-diagnosis and examined the factors associated with statin discontinuation. RESULTS The proportion of cancer patients discontinuing statin therapy at 4 years (27%) was comparable to the comparison cohort; however, significantly higher proportions of the cancer cohort discontinued statins than the comparison cohort at 3, 6 and 12 months of follow-up (9.7% vs 7.4% at 12 months, respectively). More than 30% of cancer patients who died were dispensed statins within 30 days of death. Discontinuation of statin therapy in cancer patients was associated with regionalised and distant disease spread at diagnosis (p<0.001), older age (p=0.006), upper gastrointestinal organs and liver cancer (aHR 2.95, 95% CI 1.92 to 4.53) and cancer of the lung, bronchus and trachea (aHR 1.99, 95% CI 1.32 to 3.00) and poorer survival. CONCLUSIONS Medications should be rationalised at the time of a cancer diagnosis, especially in the setting of a poor prognosis. At least for some patients in our cohort, statin therapy may be inappropriately continued which adds unnecessarily to therapeutic burden.
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Affiliation(s)
- Efty P Stavrou
- Adult Cancer Program, Prince of Wales Clinical School, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia
| | - Nicholas Buckley
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Jake Olivier
- Adult Cancer Program, Prince of Wales Clinical School, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia
| | - Sallie-Anne Pearson
- Adult Cancer Program, Prince of Wales Clinical School, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia
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Stavrou EP, Ford JB, Shand AW, Morris JM, Roberts CL. Epidemiology and trends for Caesarean section births in New South Wales, Australia: a population-based study. BMC Pregnancy Childbirth 2011; 11:8. [PMID: 21251270 PMCID: PMC3037931 DOI: 10.1186/1471-2393-11-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 01/20/2011] [Indexed: 11/22/2022] Open
Abstract
Background Caesarean section (CS) rates around the world have been increasing and in Australia have reached 30% of all births. Robson's Ten-Group Classification System (10-group classification) provides a clinically relevant classification of CS rates that provides a useful basis for international comparisons and trend analyses. This study aimed to investigate trends in CS rates in New South Wales (NSW), including trends in the components of the 10-group classification. Methods We undertook a cross-sectional study using data from the Midwives Data Collection, a state-wide surveillance system that monitors patterns of pregnancy care, services and pregnancy outcomes in New South Wales, Australia. The study population included all women giving birth between 1st January 1998 and 31st December 2008. Descriptive statistics are presented including age-standardised CS rates, annual percentage change as well as regression analyses. Results From 1998 to 2008 the CS rate in NSW increased from 19.1 to 29.5 per 100 births. There was a significant average annual increase in primary 4.3% (95%CI 3.0-5.7%) and repeat 4.8% (95% CI 3.9-5.7%) CS rates from 1998 to 2008. After adjusting for maternal and pregnancy factors, the increase in CS delivery over time was maintained. When examining CS rates classified according to the 10-group classification, the greatest contributors to the overall CS rate and the largest annual increases occurred among nulliparae at term having elective CS and multipara having elective repeat CS. Conclusions Given that the increased CS rate cannot be explained by known and collected maternal or pregnancy characteristics, the increase may be related to differences in clinical decision making or maternal request. Future efforts to reduce the overall CS rate should be focussed on reducing the primary CS rate.
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Affiliation(s)
- Efty P Stavrou
- Clinical and Population Perinatal Research, Kolling Institute of Medical Research, University of Sydney at Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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P Stavrou E, S Smith G, Baker DF. Surgical outcomes associated with oesophagectomy in New South Wales: an investigation of hospital volume. J Gastrointest Surg 2010; 14:951-7. [PMID: 20414814 DOI: 10.1007/s11605-010-1198-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 03/31/2010] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Resection remains the standard treatment for curable oesophageal cancer. By linking the NSW Central Cancer Registry (CCR) and the NSW Admitted Patient Data Collection (APDC) databases, mortality, post-resection complication and survival associated with oesophagectomy were investigated. METHODS All patients diagnosed with oesophageal cancer from 2000 to 2005 as recorded in the CCR (n = 2,082) were linked with records in the APDC, giving a total of 17,205 episodes of care. Over 15% (n = 321) of all patients underwent an oesophagectomy. RESULTS AND DISCUSSION The overall 30-day mortality rate following resection was 3.7%, ranging from 2.6% in high volume hospitals to 6.4% in low volume hospitals. Three-year absolute survival for localised-regional disease following oesophagectomy was 64% (95%CI 54-73%) in high-volume hospitals, 58% (95%CI 46-68%) in mid-volume and 45% (95%CI 23-65%) in low-volume hospitals. The post-resection complication rate was 19% (95%CI 13-26%) for high-volume hospital, 24% (95%CI 13-40%) in low-volume and 31% (95%CI 22-41%) in mid-volume hospitals. CONCLUSION Oesophagectomy in NSW is performed with satisfactory results. However, there is a suggestion that higher- rather than lower-volume hospitals have better post-resection outcomes.
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Affiliation(s)
- Efty P Stavrou
- Cancer Institute NSW, Monitoring, Evaluation and Research Unit, PO Box 41, Alexandria, NSW 1435, Australia.
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Stavrou EP, McElroy HJ, Baker DF, Smith G, Bishop JF. Adenocarcinoma of the oesophagus: incidence and survival rates in New South Wales, 1972–2005. Med J Aust 2009; 191:310-4. [DOI: 10.5694/j.1326-5377.2009.tb02813.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Accepted: 05/03/2009] [Indexed: 11/17/2022]
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Stavrou EP, Baker DF, Bishop JF. Maternal smoking during pregnancy and childhood cancer in New South Wales: a record linkage investigation. Cancer Causes Control 2009; 20:1551-8. [DOI: 10.1007/s10552-009-9400-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 07/01/2009] [Indexed: 10/20/2022]
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Hine TJ, Wallis G, Wood JM, Stavrou EP. Reflexive Optokinetic Nystagmus in Younger and Older Observers under Photopic and Mesopic Viewing Conditions. ACTA ACUST UNITED AC 2006; 47:5288-94. [PMID: 17122115 DOI: 10.1167/iovs.06-0539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the effect of age on optokinetic nystagmus (OKN) in response to stimuli designed to preferentially stimulate the M-pathway. METHOD OKN was recorded in 10 younger (32.3 +/- 5.98 years) and 10 older (65.6 +/- 6.53) subjects with normal vision. Vertical gratings of 0.43 or 1.08 cpd drifting at 5 degrees /s or 20 degrees /s and presented at either 8% or 80% contrast were displayed on a large screen as full-field stimulation, central stimulation within a central Gaussian-blurred window of 15 degrees diameter, or peripheral stimulation outside this window. All conditions apart from the high-contrast condition were presented in a random order at two light levels, mesopic (1.8 cdm(-2)) and photopic (71.5 cdm(-2)). RESULTS Partial-field data indicated that central stimulation, mesopic light levels, and lower temporal frequency each significantly increased slow-phase velocity (SPV). Although there was no overall difference between groups for partial-field stimulation, full-field stimulation, or low-contrast stimulation, a change in illumination revealed a significant interaction with age: there was a larger decrease in SPV going from photopic to mesopic conditions for the older group than the younger group, especially for higher temporal frequency stimulation. CONCLUSIONS OKN becomes reflexive in conditions conducive to M-pathway stimulation, and this rOKN response is significantly diminished in older healthy adults than in younger healthy adults, indicative of decreased M-pathway sensitivity.
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Affiliation(s)
- Trevor J Hine
- Applied Cognitive Neuroscience Research Centre, School of Psychology, Griffith University, Mt. Gravatt, Queensland, Australia.
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Abstract
PURPOSE To evaluate the efficacy of flicker perimetry compared with that of static perimetry in determining central visual field losses in participants with type 2 diabetes mellitus. METHODS Flicker and static perimetry were performed using the Medmont field analyser on 20 participants with type 2 diabetes mellitus and 24 age-matched control participants. RESULTS Flicker, but not static, perimetry demonstrated significant reductions in thresholds in those participants who had a recent diagnosis of diabetes or who had no or only minimal diabetic retinopathy compared to the control group at eccentricities close to fixation. CONCLUSION Flicker perimetry is recommended for the evaluation of visual field losses in participants with recent onset of diabetes and minimal diabetic retinopathy.
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Affiliation(s)
- Efty P Stavrou
- School of Optometry, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
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Stavrou EP, Wood JM. Letter contrast sensitivity changes in early diabetic retinopathy. Clin Exp Optom 2003; 86:152-6. [PMID: 12767249 DOI: 10.1111/j.1444-0938.2003.tb03097.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2002] [Revised: 01/09/2003] [Accepted: 01/26/2003] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the discriminative ability of letter contrast sensitivity (CS) and visual acuity (VA) in detecting functional losses in participants with type 2 diabetes. METHODS LogMAR VA and letter CS were measured on 20 type 2 diabetic and 24 age-matched control participants. The diabetic participants were sub-grouped according to the level of retinopathy present. RESULTS Letter CS was able to distinguish those participants with and without macular oedema and those with no or minimal diabetic retinopathy from the control group, whereas VA was not. CONCLUSION Letter CS may be used as an effective screening tool to assess damage to the visual pathway of diabetic participants both with and without clinically detectable signs.
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Affiliation(s)
- Efty P Stavrou
- Centre for Eye Research, Queensland University of Technology
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Abstract
Static automated visual field testing is now an integral part of the detection and monitoring of primary open angle glaucoma. However, although many aspects of testing are automated, interpretation of the large amounts of data produced by these instruments is not. Two major challenges facing the practitioner are differentiating between the visual fields of a patient with early glaucoma and those of a normal patient, and identifying whether small reductions in sensitivity are due to a true defect or a product of other factors. This paper presents a clinical overview of how to systematically review visual field plots and how to recognise defects arising from patient factors, as well as some of the alternative testing techniques available for the assessment of the glaucoma patient.
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Affiliation(s)
- Joanne M Wood
- Centre for Eye Research, School of Optometry, QUT Kelvin Grove, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia
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