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Publications (7)15.42 Total impact

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    ABSTRACT: To characterise the predisposing pathology and clinical features in the fellow eyes of patients recruited as part of the Scottish Retinal Detachment Study. The Scottish Retinal Detachment Study was a 2-year prospectively recruited population-based epidemiology study that sought to recruit all incident cases of primary rhegmatogenous retinal detachment (RRD) in Scotland. A total of 1202 incident cases of primary RRD were recruited in Scotland, over a 2-year period and in 94% (1130 cases) detailed data on the clinical features of fellow eyes with RRD were available. Full-thickness retinal breaks were found in 8.4% (95/1130) of fellow eyes on presentation. Lattice degeneration was present in 14.5% (164/1130) of fellow eyes. Thirteen per cent (148/1130) of affected fellow eyes had a best corrected visual acuity of 6/18 or worse with previous RRD, the second most common cause of poor vision. Overall, 7.3% (88/1202) of cases had RRD in both eyes; 60% of cases with consecutive bilateral RRD presented before the macula were affected. Rhegmatogenous pathology in the fellow eye represents an important threat to vision. Fellow-eye detachments are more common in pseudophakic individuals and those with a more myopic refractive error. Fellow-eye RRD has a greater likelihood of prompt presentation.
    The British journal of ophthalmology 03/2011; 96(1):110-3. · 2.92 Impact Factor
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    ABSTRACT: Socio-economic deprivation plays a major role in health and disease, but its role in retinal detachment has not been studied. Data from the Scottish Retinal Detachment Study were used to investigate any association between retinal detachment, macular status at presentation and deprivation. Prospective multicentre population-based observational study. Data were collected on all patients with primary retinal detachment presenting in Scotland between 1 November 2007 and 31 October 2008. Every patient was allocated a validated deprivation ranking according to their postcodes based on the Scottish Index of Multiple Deprivation (SIMD), which takes into account income, employment, health, education, housing, geographic accessibility and crime in 6505 postcode-based datazones. The patients were divided into four quartiles according to their SIMD ranking. 572 patients were included. The annual incidence of detachment declined from 15.4/100,000 in the most affluent quartile to 13.6/100,000 in the second, 9.3/100,000 in the third and 6.9/100,000 in the most deprived (chi(2) for trend = 50.2, p<0.0001). The trend was more marked for men than for women but was present in both sexes. There were no differences in the rate of macula-off detachments or the number of quadrants detached. Rates of pseudophakic and myopic detachment were evenly distributed across all quartiles. Retinal detachment appears to be associated with affluence. This has not been previously reported and may be partly responsible for the variation in estimates of the incidence of retinal detachment. It may also have implications for service planning. The reason for this association is unknown.
    The British journal of ophthalmology 09/2009; 93(12):1591-4. · 2.92 Impact Factor
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    ABSTRACT: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition. Obtaining an accurate estimate of RRD incidence in the population is essential in understanding the healthcare burden related to this disorder. A systematic review of all population-based epidemiology studies of RRD published between January 1970 and January 2009 from Medline database searches was performed. RRD incidence demonstrates significant geographical variation and its incidence has been reported to be between 6.3 and 17.9 per 100,000 population. For studies with a sample size >300 the median annual incidence per 100,000 population was 10.5 (IQR 8.1-13.2) and the mean proportion of bilateral RRD was 7.26%. Overall, the mean prevalence of lattice degeneration was 45.7+/-20.3% and myopia was 47.28+/-12.59%. Estimates of RRD incidence have varied threefold, but inclusion criteria and other design features have differed across studies making direct comparisons difficult. The overall incidence of RRD is not yet well established: more incidence studies of adequate methodology are needed to explore temporal changes in incidence. RRD incidence varies with ethnicity and is strongly associated with increasing age, myopia and certain vitreo-retinal degenerations. Due to changes in cataract surgery trends, the proportion of pseudophakic RRD presenting to specialised centres appears to be increasing.
    The British journal of ophthalmology 06/2009; 94(6):678-84. · 2.92 Impact Factor
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    ABSTRACT: To report an unusual case of recurrent episcleritis secondary to IgA nephropathy. Observational case report. A 39-year-old man was seen with recurrent episodes of red and painful left eye suggestive of episcleritis. On routine investigations the patient was found to have haematuria and proteinuria. Further investigations led to the diagnosis of IgA nephropathy on kidney biopsy. IgA nephropathy may present with various eye signs without any other systemic clues. This case highlights the importance of some of the basic tests in clinical practice such as urine examination. This can be conveniently done with testing strip and should be considered in the routine investigation of patients with inflammatory eye diseases.
    Contact lens & anterior eye: the journal of the British Contact Lens Association 05/2009; 32(3):141-2.
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    Eye (London, England) 02/2009; · 1.97 Impact Factor
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    Eye (London, England) 09/2008; 22(11):1449-50. · 1.97 Impact Factor
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    ABSTRACT: To assess the association of floppy iris behaviour during cataract surgery with use of alpha-1-antagonists and diabetes mellitus. 1842 eyes of 1786 patients undergoing phacohoemulsification surgery were prospectively enrolled. The use of commonly prescribed alpha-1-antagonists and the presence or absence of diabetes mellitus were noted. The occurrence of any of the features of the intraoperative floppy iris syndrome (IFIS) was noted by surgeons blinded to the patient's history. 57% of patients receiving tamsulosin showed features of IFIS compared with 1% of the non-tamsulosin group (p<0.001). Of these, more than half the patients manifested the syndrome in an incomplete form. Only 1 of the 51 patients receiving other alpha-1-antagonists had IFIS. Diabetes was also not associated with IFIS (p = 1). Tamsulosin is significantly associated with floppy iris behaviour during cataract surgery. But not all of these patients will necessarily show all or any features of IFIS. The floppy iris syndrome is likely to represent a continuum of severity. Various undefined factors, diabetes not being one of them, may have a contributory role. Non-selective alpha-1-antagonists are unlikely to be associated with IFIS.
    British Journal of Ophthalmology 01/2007; 91(1):40-2. · 2.73 Impact Factor