Catey Bunce

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Verified

Catey verified their affiliation via an institutional email.

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• BSc (Hons), MSc, DSc
• Honorary Professor at London School of Hygiene and Tropical Medicine

Background Primary eye healthcare in India has potential for improvement; enhancing it can play a role in universal health coverage, integrated people-centered eye care, and reducing the burden on overloaded secondary/tertiary facilities. Purpose To assess the unmet need for primary eye care services in Pavagada taluk, Karnataka, India, by estimat...

Background The vitrectomy, subretinal Tissue plasminogen activator and Intravitreal Gas for submacular haemorrhage secondary to Exudative Age-Related macular degeneration (TIGER) trial is a pan-European, two-group, non-commercial, active-control, observer-masked, superiority, randomised controlled surgical clinical trial of an investigational medic...

Importance Understanding the pathogenic mechanisms of Fuchs endothelial corneal dystrophy (FECD) could contribute to developing gene-targeted therapies. Objective To investigate associations between demographic data and age at first keratoplasty in a genetically refined FECD cohort. Design, Setting, and Participants This retrospective cohort stud...

Importance Primary selective laser trabeculoplasty (SLT) is a safe primary treatment for open-angle glaucoma (OAG) and ocular hypertension (OHT). However, there is limited evidence on its use as a secondary treatment, ie, after prior use of ocular hypotensive eye drops. Objective To evaluate outcomes following SLT after using hypotensive eye drops...

636 Background: Testicular germ cell tumours (GCT) are the most common malignancy in young men, mainly in their 30s. While multimodal treatment leads to excellent survival in younger patients (pts), its incidence is rising in men over 50, who often have comorbidities and higher risks of chemotherapy (ChT) toxicity. Limited data on outcomes in this...

Objectives This study aims to report the trends in the certification of both sight impairment (SI) and severe sight impairment (SSI) in England and Wales during the period of 2010 to 2020, prior to the COVID-19 pandemic. The focus is on diabetic retinopathy/maculopathy as the key causative factor. Design Retrospective database analysis. Setting E...

Background In the United Kingdom, it is estimated that 5,000 patients sustain eye injuries or ocular trauma requiring hospital admission annually, of which 250 patients will be permanently blinded. This study explores the cost-effectiveness of Adjunctive Steroid Combination in Ocular Trauma (ASCOT) given during surgery versus standard treatment in...

Importance: Understanding the pathogenic mechanisms of Fuchs endothelial corneal dystrophy (FECD) is essential for developing gene-targeted therapies. Objective: To investigate associations between demographic data and age at first keratoplasty in a large genetically refined FECD cohort. Design, Setting, and Participants: This retrospective cohort...

Background In early breast cancer (EBC) patients, we aimed to determine whether circulating tumor DNA (ctDNA) analysis following primary surgery, before systemic therapy, identified molecular residual disease and was associated with risk of relapse and relapse-free survival (RFS). Methods Plasma was collected, retrospectively, before surgery, 1-14...

Objective To evaluate the output of a child eye health programme in terms of identification, referral, and volume of paediatric cataract surgeries in Kaduna State, Nigeria. Materials and Methods This was a retrospective review of the North-West Nigeria Child Eye Health Initiative programme referral registers at primary, secondary and tertiary hosp...

1010 Background: Circulating tumor DNA (ctDNA) based detection of Molecular Residual Disease (MRD) in breast cancer patients presents a strategy to identify patients at high risk of relapse, although current assays have limited sensitivity for low level ctDNA detection. In this study we profile early breast cancer patients with an ultra-sensitive,...

Background Advance care planning (ACP) was encouraged by policymakers throughout the COVID-19 pandemic. Little is known about use of ACP during this time. Aim To compare use of ACP before and during the COVID-19 pandemic. Design & setting Retrospective, observational cohort study, comparing the creation, use and content of Electronic Palliative C...

Objective To define if keratoconus progression estimates following collagen cross-linkage (CXL) vary according to the parameter used to identify changes in corneal shape. Methods We estimated progression following CXL in 1,677 eyes. We compared standard definitions of keratoconus progression based on published thresholds for Kmax, front K2, or bac...

Working life for some medical statisticians can be dissatisfying, with a sense of playing second fiddle, according to research described here by Catey Bunce, Gill Price, Simon Day and Mona Kanaan on behalf of the Royal Statistical Society Medical Section

Objective: To define how estimates of keratoconus progression following collagen cross-linking (CXL) vary according to the parameter selected to measure corneal shape. Materials and methods: We estimated progression following CXL in 1677 eyes. We compared standard definitions of keratoconus progression based on published thresholds for Kmax, fro...

Prologue Glaucoma surgery has been, for many decades now, dominated by the universal gold standard which is trabeculectomy augmented with antimetabolites. Tubes also came into the scene to complement what we use to call conventional or traditional glaucoma surgery. More recently we experienced a changing glaucoma surgery environment with the “adve...

Background: Macular holes cause severe impairment of sight. With the aim of improving the outcome of surgery for macular holes, particularly larger macular holes (those measuring over 400 μm), a variable period of face-down positioning may be advised. This review is an update of a Cochrane Review published in 2011. Objectives: To evaluate the ef...

Background: PATRIOT was the first-in-human phase I study of the oral ATR (ataxia telangiectasia and Rad3-related) inhibitor ceralasertib (AZD6738) in advanced solid tumors. Methods: Primary objective was safety. Secondary objectives included assessment of anti-tumor responses, pharmacokinetic (PK) and pharmacodynamic (PD) studies. Sixty-seven pa...

Purpose To screen the patients with monofocal intraocular lens (IOL) for incidence of unaided 20/40 and J5 for distance and near (pseudoaccommodation) and to find factors for pseudoaccommodation. Settings University Hospitals Sussex NHS Foundation Trust, UK. Design Prospective study Methods This was a single-eye study (Clinicaltrials.gov: NCT040...

Objective: To define how estimates of keratoconus progression following collagen cross-linking (CXL) vary according to the parameter used to identify changes in corneal shape. Materials and Methods: We estimated progression following CXL in 1677 eyes. We compared standard definitions of keratoconus progression based on published thresholds for Kmax...

Increased advance care planning was endorsed at the start of the Coronavirus disease 2019 (COVID-19) pandemic with the aim of optimizing end-of-life care. This retrospective observational cohort study explores the impact of advanced care planning on place of death. 21,962 records from patients who died during the first year of the pandemic and who...

Background Eyes sustaining open globe trauma are at high risk of severe visual impairment. Proliferative vitreoretinopathy is the most common cause of retinal detachment and visual loss in eyes with open globe trauma. There is evidence from experimental studies and pilot clinical trials that the use of adjunctive steroid medication triamcinolone ac...

Background: Cataract is the leading cause of blindness in the world and, as such, cataract surgery is one of the most commonly performed operations globally. Surgical techniques have changed dramatically over the past half century with associated improvements in outcomes and safety. Femtosecond lasers can be used to perform the key steps in catara...

Background: A sudden, irreversible reduction in visual acuity ('wipe-out') is a feared complication of cataract surgery. Current literature on wipe-out is limited in quantity and quality, and largely predates modern cataract surgery and imaging techniques. The objectives of our study were to estimate the incidence of wipe-out and to identify poten...

TPS1111 Background: The combination of fulvestrant and one of the three approved CDK4/6 inhibitors (i) is the standard of care for patients with ER+/HER2 metastatic breast cancer progressing on first-line endocrine therapy, or relapsing on or within a year of completing adjuvant endocrine therapy. AKT inhibition combined with fulvestrant has recent...

Background At the beginning on the COVID-19 pandemic, advance care planning (ACP) was widely encouraged and endorsed for adults with serious illness to ensure their treatment and care preferences would be honoured, including location of death, often considered a surrogate quality indicator for end-of-life care. Coordinate My Care (CMC) represents t...

Background Mortality forecasts associated with COVID-19 stressed a need to prepare adults with advanced disease for possible severe illness and engage with Advance Care Planning (ACP). We aimed to examine ACP engagement and activity during the COVID-19 pandemic. Methods A retrospective cohort study, comparing the creation, content and use of Coord...

Objectives: To investigate whether MRI-based measurements of fibro-glandular tissue volume, breast density (MRBD), and background parenchymal enhancement (BPE) could be used to stratify two cohorts of healthy women: BRCA carriers and women at population risk of breast cancer. Methods: Pre-menopausal women aged 40-50 years old were scanned at 3 T...

Background: High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ -6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER...

Purpose: To characterise the phenotype and genotype of concurrent keratoconus and Fuchs endothelial corneal dystrophy (KC + FECD). Methods: We recruited 20 patients with concurrent KC + FECD for a retrospective observational case series from the United Kingdom and the Czech Republic. We compared eight parameters of corneal shape (Pentacam, Oculu...

Background: Most patients with early stage oestrogen receptor positive (ER+) and HER2 negative breast cancer will be cured of their cancer. However, up to 20% of patients may experience disease recurrence in the first 10 years. Molecular relapse of ER+ breast cancer can be detected with circulating tumour DNA (ctDNA) before clinical relapse occurs....

Background/aims To investigate the clinical effectiveness of adjunctive triamcinolone acetonide (TA) given at the time of vitreoretinal surgery following open globe trauma (OGT). Methods A phase 3, multicentre, double-masked randomised controlled trial of patients undergoing vitrectomy following OGT comparing adjunctive TA (intravitreal and subten...

Amblyopia is an important public health concern. While home-based screening may present an effective solution, this has not been rigorously assessed in a systematic review. A systematic review was performed using Ovid MEDLINE, PubMed, The Cochrane Library, Embase, Web of Science Core Collection, and Clinicaltrials.gov. All studies reporting the dia...

Background Large lung nodules (≥15 mm) have the highest risk of malignancy, and may exhibit important differences in phenotypic or clinical characteristics to their smaller counterparts. Existing risk models do not stratify large nodules well. We aimed to develop and validate an integrated segmentation and classification pipeline, incorporating dee...

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivale...

Recurrence occurs in up to 36% of patients treated with curative-intent radiotherapy for NSCLC. Identifying patients at higher risk of recurrence for more intensive surveillance may facilitate the earlier introduction of the next line of treatment. We aimed to use radiotherapy planning CT scans to develop radiomic classification models that predict...

Late presentation in glaucoma has been associated with rapid deterioration of visual fields and blindness even with good and effective treatment options. Glaucoma prevalence and risk of blindness is higher among the Igbo tribe, who dominate the Eastern part of Nigeria, hence the focus of this study in this area to determine modifiable risks for lat...

Introduction Hypoaccommodation is common in children born prematurely and those with hypoxic ischaemic encephalopathy (HIE), with the potential to affect wider learning. These children are also at risk of longer-term cerebral visual impairment. It is also well recognised that early intervention for childhood visual pathology is essential, because n...

Background/objectives: The Adjunctive Steroid Combination in Ocular Trauma (ASCOT) trial is a unique pragmatic, multi-centre, patient and assessor masked, randomised controlled trial. We evaluate the clinical characteristics and pathology of this large trial cohort of patients with open globe injuries undergoing vitreoretinal surgery, including th...

The Babies in Glasses (BiG ) Study: Feasibility and acceptability of early spectacle intervention to babies and parents to improve visual outcomes in infants at risk of perinatal brain insult.

Background: Ocular surface burns can be caused by chemicals (alkalis and acids) or direct heat. One effect of the burn is damage to the limbal epithelial stem cells of the ocular surface with delayed re-epithelialisation, stem cell failure, and conjunctivalisation of the cornea. Amniotic membrane transplantation (AMT) performed in the acute phase...

Purpose The LiGHT trial has shown selective laser trabeculoplasty (SLT) to be clinically and cost-effective as a primary treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT) at 3 years. This paper reports health-related quality of life (HRQL) and clinical effectiveness of initial treatment with SLT compared to intra-ocular pressure...

Background Waiting time can considerably increase the cost to both the clinic and the patient and be a major predictor of the satisfaction of eye care users. Efficient management of waiting time remains as a challenge in hospitals. Waiting time management will become even more crucial in the postpandemic era. A key consideration when improving wait...

Aim: To explore if novel non-invasive diagnostic technologies identify early small nerve fibre and retinal neurovascular pathology in prediabetes. Methods: Participants with normoglycaemia, prediabetes or type 2 diabetes underwent an exploratory cross-sectional analysis with optical coherence tomography angiography (OCT-A), handheld electroretin...

Background Post-transplant glomerulonephritis (PTGN) has been associated with inferior long-term allograft survival, and its incidence varies widely in the literature. Methods This is a cohort study of 7,623 patients transplanted between 2005 and 2016 at four major transplant UK centres. The diagnosis of glomerulonephritis (GN) in the allograft wa...

Objective To compare the visual and patient reported outcomes of 2 presbyopia-correcting intraocular lenses (IOLs). Methods A total of 134 eyes (67 patients) that underwent cataract surgery with either a trifocal IOL or an extended depth of focus (EDOF) IOL bilaterally and were assessed 3 months after surgery. Outcome measures were binocular dista...

p>Purpose: Serum lipids are modifiable, routinely collected blood test features associated with cardiovascular health. We examined the association of commonly collected serum lipid measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) with intraocular pressure...

Background Women pregnant with a breech-presenting foetus at term are at increased risk of adverse pregnancy outcomes. The most common intervention used to improve neonatal outcomes is planned delivery by caesarean section. But this is not always possible, and some women prefer to plan a vaginal birth. A number of providers have proposed alternativ...

Importance: Understanding the effects of modifiable risk factors on risk for multiple sclerosis (MS) and associated neurodegeneration is important to guide clinical counseling. Objective: To investigate associations of alcohol use, smoking, and obesity with odds of MS diagnosis and macular ganglion cell layer and inner plexiform layer (mGCIPL) t...

Background Mortality predictions as the COVID-19 pandemic began highlighted a need to prepare adults for possible severe illness, encouraging engagement with Advance Care Planning (ACP). Aim To explore ACP activity and engagement during the COVID-19 pandemic. Methods A retrospective cohort study, comparing the creation, content and use of Coordin...

Background Anticipated severe illness at the start of the COVID-19 pandemic bought increased endorsement, awareness and provision of advance care planning in adults with serious illness. Place of death is often considered a surrogate quality indicator for end-of-life care. Aim To examine the impact of advance care planning on place of death for pa...

Background Age-related macular degeneration accounts for the majority of severe sight impairment and sight impairment registration and certifications in adults in the UK [1, 2]. Whilst these treatments are effective in arresting nAMD progression, there is currently no treatment for GA [1, 3, 4]. Methods This paper provides an update to the data co...

Introduction: Identification of Molecular Residual Disease (MRD) by circulating tumour DNA (ctDNA) analysis has the potential to transform the clinical management of patients with early breast cancer. We present results from a proof-of-principle study to assess ctDNA analysis following primary surgery to identify MRD and anticipate which patients a...

Introduction Patient and Public involvement (PPI) is essential to ensure research is relevant, patient-focused and of high quality. Social distancing recommendations during the COVID-19 pandemic affected how PPI members engaged with research teams. Aims To describe and evaluate PPI in a retrospective study evaluating 73,675 advance care planning r...

Introduction: Recent years have witnessed an upsurge of demand in eye care services in the UK. With a large proportion of patients referred to Hospital Eye Services (HES) for diagnostics and disease management, the referral process results in unnecessary referrals from erroneous diagnoses and delays in access to appropriate treatment. A potential...

Background: Current treatments for amblyopia, typically patching or pharmacological blurring, have limited success. Less than two-thirds of children achieve good acuity of 0.20 logMAR in the amblyopic eye, with limited improvement of stereopsis, and poor adherence to treatment. A new approach, based on presentation of movies or computer games sepa...

Purpose: The true disease status of a population with suspected microbial keratitis (MK) cannot be verified. There is not an accurate (gold) reference standard to confirm infection and inter-test comparisons of sensitivity and specificity therefore lead to bias with questionable estimates of test utility. We present an alternative method to report...

Background Neovascular (wet) age-related macular degeneration (AMD) can be associated with large submacular haemorrhage (SMH). The natural history of SMH is very poor, with typically marked and permanent loss of central vision in the affected eye. Practice surveys indicate varied management approaches including observation, intravitreal anti-vascul...

Introduction Paediatric intracranial hypertension (IH) is a rare but serious condition that can pose deleterious effects on the brain and vision. Estimating intracranial pressure (ICP) in children is difficult. Gold standard direct ICP measurement is invasive and carries risk. It is impractical to routinely perform direct ICP measurements over time...

Aims To assess the diagnostic accuracy of fundoscopy and visual evoked potentials (VEPs) in detecting intracranial hypertension (IH) in patients with craniosynostosis undergoing spring-assisted posterior vault expansion (sPVE). Methods Children with craniosynostosis undergoing sPVE and 48-hour intracranial pressure (ICP) monitoring were included i...

Opticin is an extracellular glycoprotein present in the vitreous. Its antiangiogenic properties offer the potential for therapeutic intervention in conditions such as proliferative diabetic retinopathy and retinopathy of prematurity. Here, we investigated the hypothesis that intravitreal administration of recombinant human opticin can safely protec...

Purpose: To explore the association between retinal neurodegeneration and metabolic parameters in progressive dysglycemia. Method: A cross-sectional study was performed on 68 participants: normal glucose tolerance (n = 23), prediabetes (n = 25), and Type 2 diabetes without diabetic retinopathy (n = 20). Anthropometric assessment and laboratory s...

BACKGROUND Waiting time could considerably increase the cost to both the clinic and the patient, as well as be a major predictor of the satisfaction of eye care users. Efficiently managing waiting time remains a challenge in hospitals. Waiting time management will become even more crucial in the post-pandemic era. A key consideration when improving...

Background Keratoconus is a disease of the cornea affecting vision that is usually first diagnosed in the first three decades. The abnormality of corneal shape and thickness tends to progress until the patient reaches approximately 30 years of age. Epithelium-off corneal cross-linking is a procedure that has been demonstrated to be effective in ran...

Purpose: To determine whether handheld optical coherence tomography (OCT) is feasible and repeatable in children with craniosynostosis. Methods: This was a prospective cross-sectional study. Children with syndromic and non-syndromic craniosynostosis 0 to 18 years of age were recruited between February 13, 2020, and October 1, 2020. Main outcome me...

Importance Glaucoma affects more than 75 million people worldwide. Intraocular pressure (IOP)–lowering surgery is an important treatment for this disease. Interest in reducing surgical morbidity has led to the introduction of minimally invasive glaucoma surgeries (MIGS). Understanding the comparative effectiveness and safety of MIGS is necessary fo...

Background: The quality of cataract surgery can be measured by visual outcome, which is sometimes limited by intraoperative complications, most commonly posterior capsular rupture. Aims: The aim of the study was to assess visual outcome at the last visit (≥8 weeks) following posterior capsule rupture (PCR) in patients who had manual small incisi...

Background: Glaucoma is the leading cause of global irreversible blindness, often associated with raised intraocular pressure (IOP). Where medical or laser treatment has failed or is not tolerated, surgery is often required. Minimally-invasive surgical approaches have been developed in recent years to reduce IOP with lower surgical risks. Supracil...

Objective Management of age-related macular degeneration (AMD) places a high demand on already constrained hospital-based eye services. This study aims to assess the safety and quality of follow-up within the community led by suitably trained non-medical practitioners for the management of quiescent neovascular AMD (QnAMD). Methods/design This is...

Background The threat of antimicrobial resistance has led to intensified efforts to reduce antibiotic utilisation, but serious bacterial infections are increasing in frequency. Objectives To estimate the risks of serious bacterial infections in association with lower antibiotic prescribing and understand stakeholder views with respect to safe anti...

Importance Uncertainty currently exists about whether the same genetic variants are associated with susceptibility to low myopia (LM) and high myopia (HM) and to myopia and hyperopia. Addressing this question is fundamental to understanding the genetics of refractive error and has clinical relevance for genotype-based prediction of children at risk...

In Reply We thank VanderBeek et al and the journal for giving us the opportunity to respond to this letter and hope that our reply offers some reassurance. VanderBeek et al point out that missing data may present issues to the unwary researcher, and we are pleased that our article¹ has drawn attention to this matter. We completely agree that there...

Aims/hypothesis: This study explored the impact of ethnicity on time-to-clinic, time-to-treatment and rates of vision loss in people referred to hospital with diabetic eye disease. Methods: A survival analysis was performed on all referrals from an inner-city diabetic eye screening programme to a tertiary hospital eye service between 1 October 2...

Objective To examine the efficacy and safety of corneal cross linking (CXL) for stabilisation of progressive keratoconus. Design Observer-masked, randomized, controlled, parallel group superiority trial Participants 60 participants aged 10-16 years with progressive keratoconus. One eye of each patient was deemed the study eye. Intervention Accor...

Background: Epiretinal membrane is an abnormal sheet of avascular fibrocellular tissue that develops on the inner surface of the retina. Epiretinal membrane can cause impairment of sight as a consequence of progressive distortion of retinal architecture. Objectives: To determine the effects of surgery compared to no intervention for epiretinal m...

p>Background: associations between microvascular variation and chronic kidney disease (CKD) have been reported previously. Non-invasive retinal fundus imaging enables evaluation of the microvascular network and may offer insight to systemic risk associated with CKD. Methods: retinal microvascular parameters (fractal dimension [FD] – a measure of t...

Primary open-angle glaucoma (POAG), is a heritable common cause of blindness world-wide. To identify risk loci, we conduct a large multi-ethnic meta-analysis of genome-wide association studies on a total of 34,179 cases and 349,321 controls, identifying 44 previously unreported risk loci and confirming 83 loci that were previously known. The majori...

Background: Women pregnant with a breech-presenting foetus at term are at increased risk of adverse pregnancy outcomes. The most common intervention used to improve neonatal outcomes is planned delivery by caesarean section. But this is not always possible, and some women prefer to plan a vaginal birth. A number of providers have proposed alternati...

Background: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma from progressing. OBJECTIVES: In light of the potential benefits for people with open-angle glaucoma and the widespread uptake of the technique, it is im...