Ecosse L Lamoureux

Singapore Eye Research Institute, Tumasik, Singapore

Are you Ecosse L Lamoureux?

Claim your profile

Publications (208)576.42 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate characteristics associated with screening positive for depressive symptoms among older adults accessing low-vision rehabilitation and eye-care services and to determine client acceptability of depression screening using the Patient Health Questionnaire-2 (PHQ-2) in these settings.
    Australasian Journal on Ageing 05/2014; · 0.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore. Population-based cross-sectional study. We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study. We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility. The EQ-5D index score and annual QALY loss. The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was -0.044 (95% confidence interval [CI], -0.089 to 0.001) in Chinese, -0.127 (95% CI, -0.237 to -0.017) in Indians, and -0.085 (95% CI, -0.148 to -0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21-12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59-26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11-6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in this study. Visual impairment is associated with substantial health burden among Asians in Singapore. The relatively high burden of VI highlights the importance of VI prevention. The ethnic difference exhibited in this burden warrants further study.
    Ophthalmology 04/2014; · 5.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recent genome-wide association studies for diabetic retinopathy (DR) have identified novel single nucleotide polymorphisms associated with this potentially blinding disease. These markers could prove useful in risk profiling, if the association are validated by replication. To date, these associations have not been well assessed in independent cohorts. The objective of this study was to ascertain any association of these polymorphisms with advanced stages of DR. A total of 463 patients who had either type 1 (n=46) or 2 (n=417) diabetes were genotyped for 24 single nucleotide polymorphisms previously implicated in DR. Cases (n=163) were defined as people with severe non-proliferative DR or proliferative DR. Control participants (n=300) with a confirmed duration of diabetes of at least five years had either no evidence of DR or only mild DR. Two SNPs (rs1073203 and rs4838605) were found to be significantly associated with DR in patients with diabetes after adjusting for co-variants; rs1073203-G (p=0.012, odds ratio (OR)=0.317, 95% CI:0.129-0.778), rs1073203 in a dominant model (p=0.005, OR=0.251, 95% CI:0.096-0.655), rs4838605 in an additive model (p=0.047, OR=1.650, 95% CI:1.007-2.703), In a dominant model rs1073203 (p=0.027, OR=1.400, 95% CI:0.101-0.857), was significantly associated with diabetic retinopathy in type 2 diabetes after adjustment for co-variants. This study was sufficiently powered to replicate previous findings. CONCLUSIONS. This study has confirmed two variants (rs1073203 and rs4838605) are associated with advanced stages of DR in our cohort. The underlying genes in these candidate regions provide interesting future gene association targets for understanding the pathogenesis of DR.
    Investigative ophthalmology & visual science 02/2014; · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To assess factors associated with retinal oximetry values in healthy persons. Methods: Retinal oximetry readings were assessed using the oximetry module of the Vesselmap system in 100 eyes of 50 healthy subjects aged 18 to 58 years. Generalized estimating equation models were used to estimate the associations between candidate variables (age; gender; retinal capillary flow; HbA1c; triglyceride; cholesterol; ocular perfusion pressure and finger oxygen saturation [SO2]) with retinal oximetry measures (arteriolar SO2; venular SO2; and the arterio-venous [A-V] difference). Results: Of the candidate factors assessed, only age and finger SO2 were found to be significantly associated with one or more measures of retinal oximetry in crude analyses. In models adjusting for age, gender and significant factors from crude analyses; age and finger SO2 values remained significant. Age was associated with retinal arteriolar and venular SO2 values (per year increase in age, β = 0.31, 95% confidence interval [CI]: 0.15-0.48 and β = 0.26, 95% CI: 0.08-0.43; respectively), but not associated with the A-V difference. Finger SO2 values were associated with retinal arteriolar SO2 and A-V difference (per percentage change in finger SO2, β = 1.34, 95% CI: 0.40-2.28 and β = 0.74, 95% CI: 0.36-1.11; respectively), but not with venular SO2. Conclusion: In healthy persons, age was positively associated with the retinal and venular SO2 values, while finger SO2 was positively correlated with greater arteriolar SO2 and A-V difference. Our findings serve as a basis for future studies assessing retinal oximetry values in subjects under normal and pathophysiological conditions.
    Investigative ophthalmology & visual science 02/2014; · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Falls result in >$1 billion in treatment, disability, lost output and mortality each year in Australia and people with cataract are at increased risk. Previous research is inconclusive; one large Australian study using linked hospital data found no protective effect of cataract surgery. We aim to examine the impact of cataract-related vision impairment on falls risk and the additional effects of delays in access to surgery, refractive management (type of spectacles and changes to spectacle prescription) and the resulting level of function, particularly binocular function which can impact balance. A prospective, 24-month cohort study is planned involving over 700 patients aged 70 years or older with bilateral cataract presenting for surgery at five public hospital eye clinics in Sydney, Melbourne and Perth, Australia. The primary outcomes will be self-reported falls and falls requiring medical care, assessed objectively using administrative data sets. Secondary outcomes include community participation, quality of life, mood and depressive symptoms. McNemar's test will be used to evaluate differences in falls rate before, after first eye and after second eye cataract surgery. Generalised Estimating Equations linear regression analysis will be undertaken to examine factors associated with falls risk and the secondary outcomes. With limited resources to further shorten public waiting lists, there is a need to better understand an individuals' risk of fall injury or other negative consequences while waiting for surgery. The findings of this project will inform the development of strategies to reduce falls risk in the many older people with cataract.
    Injury Prevention 01/2014; · 1.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore. Design Population-based cross-sectional study. Participants We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study. Methods We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility. Main Outcome Measures The EQ-5D index score and annual QALY loss. Results The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was −0.044 (95% confidence interval [CI], −0.089 to 0.001) in Chinese, −0.127 (95% CI, −0.237 to −0.017) in Indians, and −0.085 (95% CI, −0.148 to −0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21–12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59–26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11–6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in this study. Conclusions Visual impairment is associated with substantial health burden among Asians in Singapore. The relatively high burden of VI highlights the importance of VI prevention. The ethnic difference exhibited in this burden warrants further study.
    Ophthalmology 01/2014; · 5.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Retinal imaging can facilitate the measurement and quantification of subtle variations and abnormalities in retinal vasculature. Retinal vascular imaging may thus offer potential as a noninvasive research tool to probe the role and pathophysiology of the microvasculature, and as a cardiovascular risk prediction tool. In order to perform this, an accurate method must be provided that is statistically sound and repeatable. This paper presents the methodology of such a system that assists physicians in measuring vessel caliber (i.e., diameters or width) from digitized fundus photographs. The system involves texture and edge information to measure and quantify vessel caliber. The graphical user interfaces are developed to allow retinal image graders to select individual vessel area that automatically returns the vessel calibers for noisy images. The accuracy of the method is validated using the measured caliber from graders and an existing method. The system provides very high accuracy vessel caliber measurement which is also reproducible with high consistency.
    Computers in biology and medicine 01/2014; 44:1–9. · 1.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study used Rasch analysis to examine the psychometric validity of the Illness Perception Questionnaire-Revised to assess beliefs about diabetes in 470 participants with Type 2 diabetes and 71 participants with Type 1 diabetes. All Illness Perception Questionnaire-Revised scales had psychometric issues, which included poorly utilised response categories, poor scale precision and multidimensionality. Following re-engineering, only four of the eight scales (Consequences, Illness coherence, Timeline cyclical and Emotional representations) were psychometrically adequate according to the Rasch model. The diabetes-specific version of the Illness Perception Questionnaire-Revised provides suboptimal assessment of beliefs held by patients with diabetes.
    Journal of Health Psychology 12/2013; · 1.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The drug fenofibrate has received major attention as a novel medical treatment for diabetic retinopathy (DR) and other diabetes-induced microvascular complications. This interest stems from two recent large, well-designed clinical trials that demonstrated large reductions in the progression of DR and the need for laser intervention, in addition to a reduction in renal and neurological outcomes, in patients with type 2 diabetes. In both trials, the greatest benefit on DR progression was observed in those patients with DR at baseline. Originally considered a lipid-modifying drug, it now appears that multiple mechanisms may underpin the benefit of fenofibrate on diabetic microvascular end points. Fenofibrate regulates the expression of many different genes, with a range of beneficial effects on lipid control, inflammation, angiogenesis, and cell apoptosis. These factors are believed to be important in the development of DR regardless of the underlying diabetes etiology. Cell experiments have demonstrated improved survival of retinal endothelial and pigment epithelial cells in conjunction with reduced stress signaling under diabetic conditions. Further, fenofibrate improves retinal outcomes in rodent models of diabetes and retinal neovascularization. Given the results of these preclinical studies, further clinical trials are needed to establish the benefits of fenofibrate in other forms of diabetes, including type 1 diabetes. In DR management, fenofibrate could be a useful adjunctive treatment to modifiable risk factor control and regular ophthalmic review. Its incorporation into clinical practice should be continually revised as more information becomes available.
    Diabetes 12/2013; 62(12):3968-3975. · 7.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the ethnic variations in the prevalence and risk factors for undercorrected refractive error and its impact on vision-specific functioning (VF) in a multiethnic Asian population. A total of 3353 Chinese, 3400 Indians, and 3280 Malays in Singapore participated in this population-based cross-sectional study. Distance presenting visual acuity (VA) was measured using a logarithm of the minimum angle of resolution number chart. Best-corrected VA was assessed using the same test protocol as presenting VA. Undercorrected refractive error was defined as an improvement of at least 0.2 logarithm of the minimum angle of resolution (two lines equivalent) in the best-corrected VA compared with the presenting VA in the better eye when presenting VA was less than 20/40 in the better eye. The VF-11 questionnaire measured participants' VF. Multivariate linear regression was performed to assess the impact of undercorrected refractive error on the overall VF score. Regardless of ethnicity, participants with undercorrected refractive error had a reduction in VF score compared to those with normal vision in both eyes. The overall prevalence of undercorrected refractive error was highest in Indians (25.1%), followed by Malays (22.2%) and Chinese (19.7%). Undercorrected refractive error was less common in spectacles or contact lenses wearers than in non-spectacle wearers or non-contact lenses wearers. Adults with mild to moderate refractive errors were most likely to have undercorrected refractive error (p < 0.001). In multivariate analysis, increasing age (p < 0.001), Indian race (p < 0.001), lower education level (p < 0.001) or poorer housing (p < 0.001), having refractive errors (p < 0.001), and not wearing optical corrections (p < 0.001) were significantly associated with increasing undercorrected refractive error. In Singapore, undercorrected refractive error is most prevalent in Indians and least prevalent in Chinese. The impact of undercorrected refractive error on VF was consistent across all three ethnicities. There may be higher barriers to visual correction among Malays or Indians compared with Chinese in Singapore.
    Optometry and vision science: official publication of the American Academy of Optometry 11/2013; · 1.53 Impact Factor
  • Australian Journal of Primary Health 11/2013; · 0.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To investigate the impact of re-testing frequency over a short period on flicker light-induced retinal vasodilation. Methods: 20 healthy participants were included. The retinal vascular response to flicker light stimulation was assessed three times (baseline; and after 5 and 30 minutes of rest [tests 1, 2, and 3, respectively]) in each participant using the Dynamic Vessel Analyzer. Relative dilations of selected arteriole and venule segments during flicker stimulation and resting diameters were measured automatically. Mean vessel dilations and resting diameters were compared using repeated measures analysis of variance. Results: Participants were young (age 33.1 ± 5.7) and mostly female (70%). Maximum arteriolar dilations during flicker stimulation were 3.23 ± 2.06%, 2.44 ± 1.62% and 3.36 ± 2.11% in tests 1, 2, and 3, respectively. Venular dilations were 4.26 ± 1.28%, 3.81 ± 1.61% and 4.43 ± 1.73% in the three consecutive tests. Mean arteriolar dilations were significantly different across the three tests (P < 0.001). Compared with the first test, arteriolar dilations were significantly reduced after 5 min (P = 0.008) but not 30 min of rest (P = 0.437). No significant differences were found over time for mean venular dilations (P = 0.128). Resting diameters of selected vessels were not significantly different between tests. Conclusions: Retinal arteriolar dilation during flicker stimulation is reduced on short-term re-testing without a significant change in baseline vessel diameter, indicating decreased responsiveness to the flicker stimulus. Researchers should allow at least 30 min between consecutive tests to minimize suppression of the flicker response.
    Investigative ophthalmology & visual science 10/2013; · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To determine the relationship between axial length (AL), retinal function, and relative oxygen (O2) consumption to better understand the protective effect of axial elongation on diabetic retinopathy development. Methods: Measurements of AL, multifocal electroretinogram (mfERG) and relative O2 consumption (difference between arteriolar and venular O2 saturation levels or A-V difference) were performed on 50 healthy individuals. The relationships between AL, mfERG amplitude and A-V difference were analysed using linear regression models. Path analysis was performed to determine the direct and indirect effects (via mfERG amplitude) of AL on A-V difference. Results: mfERG P1 amplitude was positively associated with A-V difference (β = 0.33; 95% confidence interval (CI): 0.23 to 0.42). Increased AL was significantly associated with a decrease in A-V difference (β = -1.08; 95%CI: -1.52 to -0.65) as well as a decrease in retinal function (β= -3.14, 95%CI -4.07 to -2.20). Path analysis models including AL (study factor), retinal function (intermediate variable) and A-V difference (outcome variable) showed that AL had little direct association with A-V difference (βp = -0.002), while the indirect effect of AL on A-V difference via changes in retinal function were substantial (βp = -0.51). Conclusion: In eyes with longer AL, the reduction in A-V difference is explained by the parallel reduction in retinal function. These findings suggest that longer eyes have decreased retinal function and O2 consumption, and thus are relatively less hypoxic in the presence of diabetes, which may partly explain the reduced risk of DR in these eyes.
    Investigative ophthalmology & visual science 10/2013; · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To determine the relative importance and associated risk factors of vision-specific distress and depressive symptoms in people with vision impairment. Methods: In this cross-sectional study, 162 adult patients with visual acuity <6/12 were interviewed using telephone administered questionnaires. Vision-specific distress was assessed with the emotional well-being scale of the Impact of Vision Impairment Questionnaire. Depressive symptoms were assessed with the Patient Health Questionnaire-9. Other measures including vision-specific functioning, coping, and social support were also assessed. Multiple regression and commonality analysis were used to determine the relative contribution of factors explaining variance in vision-specific distress and depressive symptoms. Results: Vision-specific distress and depressive symptoms were strongly associated. Vision-specific functioning (βs =0.47, p<0.001), avoidant coping (βs=-0.32, p<0.001), social coping efficacy (βs=-0.17, p=0.001) and depressive symptoms (βs=0.18, p=0.006) were significant determinants of vision-specific distress. Vision-specific functioning accounted for 37.7% of the unique variance in this model. Vision-specific distress was an important risk factor for depression, accounting for 36.6% of the unique variance in depressive symptoms. Conclusions: Vision-specific distress is related to a person's ability to manage the practical and social challenges of vision impairment. Further work is required to distinguish vision-specific distress and depression and to examine what interventions are best to target vision-specific distress.
    Investigative ophthalmology & visual science 10/2013; · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To investigate the relationship of retinal vessel caliber with erectile dysfunction (ED) in males with type 2 diabetes. Methods: A hospital-based cross-sectional study. Male patients with type 2 diabetes were recruited from the Diabetic Management Project. All underwent a complete eye examination, a comprehensive interview, blood and urine tests. Retinal vessel diameter was measured from retinal photographs by trained graders using semi-automated software. ED was defined as problems achieving or maintaining an erection and was assessed using a self-reported questionnaire. Results: 289 male patients with a mean (±SD) age of 65.3 (±11.2) were assessed. After adjusting for age, diastolic blood pressure, duration of diabetes, HbA1c, total cholesterol, presence of diabetic retinopathy and any diabetic complication; narrower retinal arteriolar diameter (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.09 to 2.54; p=0.019) and wider venular diameter (OR 1.58; 95% CI 1.03 to 2.44; p=0.038) were associated with ED. Conclusion: Narrower retinal arteriolar and wider venular diameter are independently associated with an increased risk of self-reported ED. These results suggest a microvascular component in the pathogenesis of this condition.
    Investigative ophthalmology & visual science 10/2013; · 3.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to perform a systematic meta-analysis of biomarkers investigated with diabetic retinopathy (DR) in the vitreous, and to explore the molecular pathway interactions of these markers found to be consistently associated with DR. Relevant databases [PubMed and ISI web of science] were searched for all published articles investigating molecular biomarkers of the vitreous associated with DR. Based on set exclusion/inclusion criteria available data from studies with human vitreous samples were extracted and used for our meta-analysis. The interactions of significant biomarkers in DR were investigated via STRING and KEGG pathway analysis. Our meta-analysis of DR identifies eleven biomarkers as potential therapeutic candidates alternate to current anti-VEGF therapy. Four of these are deemed viable therapeutic targets for PDR; ET receptors (ET A and ET B), anti-PDGF-BB, blocking TGF-β using cell therapy and PEDF. The identification of supplementary or synergistic therapeutic candidates to anti VEGF in the treatment of DR may aid in the development of future treatment trials.
    Journal of diabetes and its complications 10/2013; · 2.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Purpose: Depression is a common problem among people with visual impairment and contributes to functional decline. This article presents a study protocol to evaluate a new model of care for those patients with depressive symptoms in which psychological treatment is integrated into low vision rehabilitation services. Low vision staff will be trained to deliver "problem solving therapy for primary care" (PST-PC), an effective psychological treatment developed specifically for delivery by non-mental health care staff. PST-PC is delivered in 8 weekly telephone sessions of 30-45 minutes duration and 4 monthly maintenance sessions. We predict this new integrated model of care will significantly reduce depressive symptoms and improve the quality of life for people with visual impairment. Methods and Design: A randomized controlled trial of PST-PC will be implemented nationally across low vision rehabilitation services provided by Vision Australia. Clients who screen positive for depressive symptoms and meet study criteria will be randomized to receive PST-PC or usual care, consisting of a referral to their general practitioner for more detailed assessment and treatment. Outcome measures include depressive symptoms and behaviors, quality of life, coping and psychological adjustment to visual impairment. Masked assessments will take place pre- and post-intervention as well as at 6- and 12-month follow-up. Conclusion: We anticipate that this innovative service delivery model will lead to sustained improvements in clients' quality of life in a cost effective manner and provide an innovative service delivery model suitable for other health care areas in which depression is co-morbid.
    Ophthalmic epidemiology 10/2013; 20(5):321-9. · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore. We examined data from Chinese (n = 1177), Malay (n = 774), and Indian (n = 985) adults aged 40--80 years who participated in three independent population based studies conducted from 2004--2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120--139 mm Hg or diastolic BP 80--89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders. The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables. Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
    BMC Public Health 08/2013; 13(1):730. · 2.08 Impact Factor
  • Acta ophthalmologica 08/2013; 91(5):e418-e419. · 2.44 Impact Factor
  • Optometry and vision science: official publication of the American Academy of Optometry 08/2013; 90(8):717-9. · 1.53 Impact Factor

Publication Stats

2k Citations
576.42 Total Impact Points

Institutions

  • 2010–2014
    • Singapore Eye Research Institute
      Tumasik, Singapore
    • University of New South Wales
      • Faculty of Medicine
      Kensington, New South Wales, Australia
  • 2004–2014
    • Royal Victorian Eye and Ear Hospital
      Melbourne, Victoria, Australia
  • 2003–2014
    • University of Melbourne
      • • Centre for Eye Research Australia
      • • Department of Ophthalmology
      Melbourne, Victoria, Australia
  • 2013
    • National University Health System
      Singapore
    • Westmead Millennium Institute
      Sydney, New South Wales, Australia
  • 2009–2013
    • Singapore National Eye Centre
      Tumasik, Singapore
    • L V Prasad Eye Institute
      Bhaganagar, Andhra Pradesh, India
  • 2008–2013
    • Flinders University
      • • Flinders Medical Centre
      • • Department of Ophthalmology
      Tarndarnya, South Australia, Australia
    • Centre for Eye Research Australia
      Melbourne, Victoria, Australia
  • 2012
    • Sun Yat-Sen University
      Shengcheng, Guangdong, China
  • 2009–2012
    • University of South Australia
      Tarndarnya, South Australia, Australia
    • Victoria University Melbourne
      Melbourne, Victoria, Australia
  • 2011
    • Solar Energy Research Institute of Singapore
      Tumasik, Singapore
    • University of Bonn
      • Institutes of Molecular Medicine and Experimental Immunology
      Bonn, North Rhine-Westphalia, Germany
    • The Chinese University of Hong Kong
      • Department of Ophthalmology and Visual Sciences
      Hong Kong, Hong Kong
  • 2001–2003
    • Deakin University
      Geelong, Victoria, Australia