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Katta M, de Guimaraes TA, Fujinami-Yokokawa Y, Fujinami K, Georgiou M, Mahroo OA, Webster AR, Michaelides M. "Congenital Stationary Night Blindness: Structure, Function and Genotype - Phenotype Correlations in a cohort of 122 patients.". Ophthalmol Retina 2024:S2468-6530(24)00121-0. [PMID: 38522615 DOI: 10.1016/j.oret.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/02/2024] [Revised: 03/04/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To examine the molecular causes of Schubert-Bornschein (S-B) congenital stationary night blindness (CSNB), clinically characterize in detail, and assess genotype-phenotype correlations for retinal function and structure. DESIGN Retrospective, longitudinal, single center case series. PARTICIPANTS 122 patients with S-B CSNB attending Moorfields Eye Hospital, United Kingdom. METHODS All case notes, results of molecular genetic testing, and optical coherence tomography (OCT) were reviewed. MAIN OUTCOME MEASURES Molecular genetics, presenting complaints, rates of nystagmus, nyctalopia, photophobia, strabismus, color vision defects and spherical error of refraction (SER). Retinal thickness, outer nuclear layer thickness (ONL) and ganglion cell layer + inner plexiform layer (GCL+IPL) thickness from OCT imaging. RESULTS X-linked (CACNA1F and NYX) and autosomal recessive (TRPM1, GRM6, GPR179 and CABP4) genotypes were identified. The mean reported age of onset was 4.94 ± 8.99 years. Over the follow-up period, 95.9% of patients reported reduced visual acuity (VA), half had nystagmus and 64.7% reported nyctalopia. Incomplete CSNB (iCSNB) patients more frequently had nystagmus and photophobia. Nyctalopia was similar for iCSNB and complete CSNB (cCSNB). Color vision data was limited but more defects were found in iCSNB. None of these clinical differences met statistical significance. There was no significant difference between groups in VA, with a mean of 0.46 LogMAR, and remained stable over the course of follow-up. cCSNB patients, specifically those with NYX and TRPM1 variants, were more myopic. CACNA1F patients showed the largest refractive variability and the CABP4 patient was hyperopic. No significant differences were found in OCT structural analysis during the follow-up period. CONCLUSIONS Retinal structure in CSNB is stationary and no specific genotype - structure correlates were identified. VA appears to be relatively stable, with rare instances of progression.
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Affiliation(s)
- Mohamed Katta
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK
| | - Thales Ac de Guimaraes
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK
| | - Yu Fujinami-Yokokawa
- UCL Institute of Ophthalmology, University College London, London, UK; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, NHO Tokyo Medical Center, Tokyo 152-8902, Japan; Department of Health Policy and Management, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Kaoru Fujinami
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, NHO Tokyo Medical Center, Tokyo 152-8902, Japan
| | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK; Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Omar A Mahroo
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK
| | - Andrew R Webster
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK; Moorfields Eye Hospital, London, UK.
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Muqit MM, Macri C, Chan WO, Elnaggar M, Casswell EJ, Ng J, Yang E, Katta M, Anguita R. CLINICAL FEATURES AND SURGICAL OUTCOMES OF SCLERAL BUCKLE SURGERY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: MOORFIELDS BUCKLE STUDY. Retina 2024:00006982-990000000-00603. [PMID: 38437825 DOI: 10.1097/iae.0000000000004082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
PURPOSE Long-term study to evaluate the clinical and surgical outcomes of SB surgery for primary rhegmatogenous retinal detachment (RRD) at a large tertiary eye center. METHODS Non-comparative, retrospective case series of 589 eyes of 569 patients with primary RRD who underwent SB surgery between 2004 and 2022 with median follow-up of 6 months. Main outcome measures were best-corrected visual acuity (BCVA), surgical outcomes, complications, and classification of RRD. RESULTS At baseline, 447/589 (76.1%), round hole-RRD and 133/589 (22.7%) retinal dialysis-RRD. Overall primary SB success rate was 83.7% for all RD subtypes, with round hole-RD 84.8% and dialysis-RRD 81.2%. Overall, Baseline BCVA was logMAR 0.42 and final logMAR 0.26 (p<0.0001). In macula-OFF RRD, the BCVA significantly improved from 0.79 to 0.48 logMAR (p<0.0001). Macula-ON RRD patients improved from 0.19 to 0.12 logMAR (p=0.014). Binary logistic regression showed registrar surgeon grade (OR 0.09,95% CI 0.01- 0.55), and partial or complete PVD (OR 0.21,95% CI 0.10 - 0.49) associated with reduced odds of primary success. Higher surgical failure associated with low pre-fellowship SB surgeon experience (p=0.024). CONCLUSION We report favourable visual and functional outcomes in a large series of SB for primary retinal detachment, mainly for round hole and retinal dialysis RRD patients.
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Affiliation(s)
- Mahiul Mk Muqit
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, UK
| | - Carmelo Macri
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Weng Onn Chan
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Mohamed Elnaggar
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Edward J Casswell
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust
| | - James Ng
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Elizabeth Yang
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mohamed Katta
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Rodrigo Anguita
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Switzerland
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Anguita R, Makuloluwa A, Bhalla M, Katta M, Sagoo MS, Charteris DG. Rhegmatogenous retinal detachment in choroidal melanoma: clinical features and surgical outcomes. Eye (Lond) 2024; 38:494-498. [PMID: 37596400 PMCID: PMC10858248 DOI: 10.1038/s41433-023-02709-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE To describe the clinical features, prognostic factors, safety and rate of success of surgery and visual outcomes in patients with rhegmatogenous retinal detachment (RRD) and choroidal melanoma (CM). METHODS A retrospective, observational case-series of 21 patients with rhegmatogenous retinal detachment or combined tractional-rhegmatogenous retinal detachment in patients with choroidal melanoma over a period of 20 years. RESULTS Nineteen patients were included in the final analysis. The mean elevation of CM was 4.0 mm and the mean largest diameter was 11.0 mm. RRD occurred after the CM treatment in 14 eyes at a mean interval of 44.2 months. The RRD was macula-on RRD in 6 eyes, there was posterior vitreous detachment (PVD) in 15 and PVR in 7 eyes. BCVA at presentation was 0.71 logMAR and final was 1.5 logMAR (p = 0.01). The primary surgical success rate was 59%. No intraocular or extraocular tumour dissemination occurred. Mean follow-up was 66 months. CONCLUSION RRD in patients with CM is uncommon but requires multidisciplinary management. Anatomical results are favourable but visual outcomes are poor due to a combination of factors related to melanoma treatment, macular retinal detachment and PVR. Vitrectomy as a surgical intervention for RRD in treated CM appears to be safe in terms tumour dissemination.
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Affiliation(s)
- Rodrigo Anguita
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK.
- Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK.
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland.
| | - Achini Makuloluwa
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Minak Bhalla
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Mohamed Katta
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Mandeep S Sagoo
- Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - David G Charteris
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, EC1V 2PD, UK
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Zaman S, Kane T, Katta M, Georgiou M, Michaelides M. Photoaversion in inherited retinal diseases: clinical phenotypes, biological basis, and qualitative and quantitative assessment. Ophthalmic Genet 2021; 43:143-151. [PMID: 34957896 DOI: 10.1080/13816810.2021.2015789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Severe light sensitivity is a feature common to a range of ophthalmological and neurological diseases. In inherited retinal diseases (IRDs) particularly, this may be accompanied by significant visual disruption. These symptoms are extremely debilitating for affected individuals and have significant implications in terms of day-to-day activities. Underlying mechanisms remain to be fully elucidated. Currently, there are many assessments of photoaversion (PA), however, all have limitations, with quantitative measurement in particular needing further evaluation. To understand the complexities associated with photoaversion from different pathologies, qualitative and quantitative assessments of the light aversion response must be standardized. There is no treatment to date, and strategies to alleviate symptoms focus on light avoidance. With respect to IRDs, however, gene therapy is currently being investigated in clinical trials and promising and further treatments may be on the horizon. The better characterization of these symptoms is an important end point measure in IRD gene therapy trials.
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Affiliation(s)
- Serena Zaman
- Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, University College London, London, UK
| | - Thomas Kane
- Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, University College London, London, UK
| | - Mohamed Katta
- Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, University College London, London, UK
| | - Michalis Georgiou
- Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, University College London, London, UK
| | - Michel Michaelides
- Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, University College London, London, UK
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Anguita R, Roth J, Makuloluwa A, Shahid S, Katta M, Khalid H, Charteris DG. LATE PRESENTATION OF RETINAL DETACHMENT: CLINICAL FEATURES AND SURGICAL OUTCOMES. Retina 2021; 41:1833-1838. [PMID: 34432743 DOI: 10.1097/iae.0000000000003131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/26/2022]
Abstract
PURPOSE To describe and evaluate demographic, clinical features, prognostic factors, and rate of success of surgery and visual outcomes in patients with late presentation of retinal detachment. METHODS A retrospective, comparative, observational case series of patients with late presentation retinal detachment, defined as retinal detachment with the loss of central vision for 4 weeks or more, over a period of 12 months. RESULTS The mean of onset of central visual loss was 12.7 weeks (SD, 21.3). Proliferative vitreoretinopathy at the first operation was identified in 69% of eyes. The overall primary success rate was 69.2%, significantly less than that was found in outcomes for nonselected retinal detachment (primary success rate, 86%; P = 0.006). The initial best-corrected visual acuity was 20/500, and the final was 20/160 (P = 0.0027). There were no identifiable statistically significant socioeconomic factors related to late presentation. CONCLUSION A high rate of established proliferative vitreoretinopathy on presentation was identified, and although cases can be treated with good anatomical results, visual outcomes are often less favorable. Primary surgical success is lower, and more reoperations are required compared with standard retinal detachments.
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Affiliation(s)
- Rodrigo Anguita
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
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Magan T, Pouncey A, Gadhvi K, Katta M, Posner M, Davey C. Prevalence and severity of diabetic retinopathy in patients attending the endocrinology diabetes clinic at Mulago Hospital in Uganda. Diabetes Res Clin Pract 2019; 152:65-70. [PMID: 31063850 DOI: 10.1016/j.diabres.2019.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/30/2019] [Accepted: 04/18/2019] [Indexed: 10/26/2022]
Abstract
AIMS The epidemiology for diabetic retinopathy (DR) has been well described in the western population. Countries in Sub-Saharan Africa have attempted to identify the prevalence of diabetic eye disease, however, there still remains a degree of paucity across the continent due to inadequacy in health system organisations and resource poor settings. We aimed to identify the severity and prevalence of DR and maculopathy of patients attending the diabetes clinic at Mulago Hospital, Kampala, Uganda. METHODS A cross-sectional observational study of 44 patients who attended a diabetes clinic at Mulago Hospital in April 2016. Parameters measured included visual acuity (VA) using a Snellen chart, blood glucose (mmol/l) and blood pressure (mmHg). Screening for DR grading was carried out with indirect fundoscopy and retinal photograph. Only the highest graded eye of retinopathy of each patient was included. RESULTS A total of 41 eyes from 41 patients were included. Of these patients 15 were male. The average age of patients was 50.4 years. Six eyes (14.6%) had a VA < 6/18. Prevalence of DR was 19.5% (8 eyes) and 14.6% (6 eyes) had maculopathy. Of all eyes 14.6% had sight-threatening retinopathy, which was 85.7% of total cases of retinopathy in our study. CONCLUSIONS We observed a high prevalence of DR and maculopathy, particularly sight threatening retinopathy, considering the proportion of patients screened. There is a need for a co-ordinated diabetes screening service through integration of the diabetes clinic and eye clinic at Mulago Hospital to better identify and treat this sight-threatening condition.
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Affiliation(s)
- Tejal Magan
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda.
| | - Anna Pouncey
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda
| | - Kunal Gadhvi
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda
| | - Mohamed Katta
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda
| | - Marcus Posner
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda
| | - Clare Davey
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK; Ophthalmology Department, Mulago Hospital, Kampala, Uganda
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