Cynthia Owsley

Cynthia Owsley
University of Alabama at Birmingham | UAB · Department of Ophthalmology

PhD, MSPH

About

376
Publications
55,930
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25,677
Citations

Publications

Publications (376)
Article
Full-text available
Purpose: For structure-function research at the transition of aging to age-related macular degeneration, we refined the current consensus optical coherence tomography (OCT) nomenclature and evaluated a novel review software for investigational high-resolution OCT imaging (HR-OCT; <3 µm axial resolution). Method: Volume electron microscopy, immun...
Article
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Background Instrumental activities of daily living (IADL) are typically self-reported ability to perform complex tasks vital for independent living. There is a need for a complementary objective, performance-based approach especially in tracking outcomes in visual rehabilitation for patients with irreversible vision impairment (“low vision”). Our g...
Article
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Purpose In AMD, rod-mediated dark adaptation (RMDA) at 5° eccentricity is slower in eyes with subretinal drusenoid deposits (SDDs) than in eyes without. Here we quantified SDD burden using supervised deep learning for comparison to vision and photoreceptor topography. Methods In persons ≥60 years from the Alabama Study on Early Age-Related Macular...
Article
Precis Diagnosis of glaucoma via telemedicine demonstrates moderate agreement with in-person ophthalmologist and optometrist diagnosis, providing evidence that telemedicine is a timely, accurate screening method in settings where an in-person visit may not be feasible. Purpose To compare diagnostic agreement of glaucoma between in-person ophthalmo...
Article
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Purpose In aging and early-intermediate age-related macular degeneration (AMD), rod-mediated dark adaptation (RMDA) slows more at 5° superior than at 12°. Using optical coherence tomography angiography (OCTA), we asked whether choriocapillaris flow deficits are related to distance from the fovea. Methods Persons ≥60 years stratified for AMD via...
Article
Purpose Accumulating case reports and series have suggested that teprotumumab may significantly increase the risk of hearing impairment that, in some cases, does not resolve. This study investigates the association between hearing impairment and teprotumumab use. Methods A disproportionality analysis was conducted using the United States Food and...
Article
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Purpose Research on Alzheimer's disease (AD) and precursor states demonstrates a thinner retinal nerve fiber layer (NFL) compared to age-similar controls. Because AD and age-related macular degeneration (AMD) both impact older adults and share risk factors, we asked if retinal layer thicknesses, including NFL, are associated with cognition in AMD....
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Purpose: We aimed to identify structural differences in normal eyes, early age-related macular degeneration (AMD), and intermediate AMD eyes using optical coherence tomography (OCT) in a well-characterized, large cross-sectional cohort. Methods: Subjects ≥ 60 years with healthy normal eyes, as well as early or intermediate AMD were enrolled in t...
Article
Introduction: Federally Qualified Health Centers (FQHCs) play a crucial role as safety-net primary health care clinics in the United States, serving medically underserved areas and populations. However, eye services are rarely offered at FQHCs. We examined how telemedicine-generated ocular diagnoses impacted vision-targeted health-related quality o...
Article
PURPOSE: To describe baseline quantitative (short-wavelength) autofluorescence (qAF) findings in a large pseudophakic cohort at age-related macular degeneration (AMD)’s beginnings; to assess qAF8 as an outcome measure and evaluate AREDS and Beckman grading systems. METHODS: In the ALSTAR2 baseline cohort (NCT04112667), 346 pseudophakic eyes of 188...
Article
Purpose To describe the neighborhood-level social risk factors across the three SIGHT Study sites and assess potential characteristics of these populations to help other researchers effectively design and implement targeted glaucoma community-based screening and follow-up programs in high-risk groups. Methods/Results In 2019, Columbia University,...
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A progression sequence for age-related macular degeneration onset may be determinable with consensus neuroanatomical nomenclature augmented by drusen biology and eye-tracked clinical imaging. This narrative review proposes to supplement the Early Treatment of Diabetic Retinopathy Study (sETDRS) grid with a ring to capture high rod densities. Publis...
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Purpose: The vulnerability of rod photoreceptors in aging and early and intermediate age-related macular degeneration (AMD) has been well documented. Rod-mediated dark adaptation (RMDA) is a measure of the recovery of light sensitivity in rod photoreceptors following a bright light. Delays in RMDA during early and intermediate AMD have been widely...
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Purpose Lack of valid end points impedes developing therapeutic strategies for early age-related macular degeneration (AMD). Delayed rod-mediated dark adaptation (RMDA) is the first functional biomarker for incident early AMD. The relationship between RMDA and the status of outer retinal bands on optical coherence tomography (OCT) have not been wel...
Article
Purpose To summarize the glaucoma detection and maintenance programs that utilize existing health care infrastructure to promote up-scalable programs. Methods/Results Healthcare infrastructure that already exists may facilitate glaucoma detection. This infrastructure includes retail-based optometry practices and federally qualified health centers...
Article
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Purpose Despite good photopic visual acuity, glaucoma patients report difficulty performing daily activities under dim light such as reading. Here we investigated the impact of mesopic lighting conditions on reading vision of glaucoma patients. Methods The study design included 39 patients with glaucoma and 40 healthy controls. Reading vision was...
Article
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Purpose Progress toward treatment and prevention of age-related macular degeneration (AMD) requires imaging end points that relate to vision. We investigated choriocapillaris flow signal deficits (FD%) and visual function in eyes of individuals aged ≥60 years, with and without AMD. Methods One eye of each participant in the baseline visit of the A...
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Mitochondria are candidate reflectivity signal sources in optical coherence tomography (OCT) retinal imaging. Here, we use deep-learning-assisted volume electron microscopy of human retina and in vivo imaging to map mitochondria networks in the outer plexiform layer (OPL), where photoreceptors synapse with second-order interneurons. We observed alt...
Preprint
Purpose: While intermediate and late age-Related Macular Degeneration (AMD) have been widely investigated, rare studies were focused on the pathophysiologic mechanism of early AMD. Delayed rod-mediated dark adaptation (RMDA) is the first functional biomarker for incident early AMD. The status of outer retinal bands on optical coherence tomography (...
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Purpose: Reading is involved in various daily activities that operate under a wide range of luminance levels. Rod- and cone-mediated mesopic visual function is known to be impaired even in early/intermediate age-related macular degeneration (AMD). It remains unclear whether and to what extent mesopic reading is impaired in early/intermediate AMD....
Article
Purpose: To describe baseline results of the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) for patients at federally qualified health centers (FQHC's). Candidates were persons at-risk for glaucoma associated diseases (GAD) based on age, race/ethnicity, current diagnosis of GAD, family history, and d...
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Purpose: Photoreceptor (PR) outer segments, retinal pigment epithelium apical processes, and inter-PR matrix contribute to the interdigitation zone (IZ) of optical coherence tomography (OCT). We hypothesize that this interface degrades over adulthood, in concert with a delay of rod mediated dark adaptation (RMDA). To explore this idea, we determin...
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Purpose: We evaluate the impact of test target location in assessing rod-mediated dark adaptation (RMDA) along the transition from normal aging to intermediate age-related macular degeneration (AMD). We consider whether RMDA slows because the test locations are near mechanisms leading to or resulting from high-risk extracellular deposits. Soft dru...
Article
Purpose: The current study seeks to investigate the association between lacrimal disorders and the use of docetaxel and paclitaxel. Methods: A disproportionality analysis was conducted using the United States FDA Adverse Event Reporting System (FAERS). All adverse event reports containing the term docetaxel or paclitaxel were selected. Lacrimal...
Article
Purpose: Studies on age-related macular degeneration (AMD) often use rod-mediated dark adaptation (RMDA) to evaluate macular functional health, studying eyes with cataract and pseudophakic eyes within the same sample. We examine a poorly understood issue - whether rod intercept time (RIT), a measure of RMDA, changes after cataract surgery and intr...
Article
Importance Low dietary nitrate intake has previously been suggested to be a risk factor for age-related macular degeneration (AMD) progression; however, this finding has not been replicated in other cohorts or adjusted for dietary patterns. Objective To determine whether there is an association between dietary nitrate intake and AMD progression....
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Purpose: Quantification of retinal xanthophyll carotenoids in eyes with and without age-related macular degeneration (AMD) via macular pigment optical volume (MPOV), a metric for xanthophyll abundance from dual wavelength autofluorescence, plus correlations to plasma levels, could clarify the role of lutein (L) and zeaxanthin (Z) in health, AMD pro...
Article
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Purpose: The purpose of this study was to investigate quantitative autofluorescence (qAF8) in patients with and without early or intermediate age-related macular degeneration (AMD); to determine the impact of the aged crystalline lens and posterior capsular opacification (PCO). Methods: In phakic and pseudophakic eyes ≥60 years, AMD status was d...
Article
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Purpose: The purpose of this study was to identify low luminance activities of daily living (ADL) relevant to adults with vision impairment using a concept-mapping approach. Methods: "Group concept mapping" was utilized to identify specific ADLs that persons with vision impairment find challenging under low light conditions. In the first "brains...
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Purpose Proper understanding and interaction with the dashboard is an essential aspect of safely operating a motor vehicle. A portion of this task is dependent on vision, yet no published information exists regarding dashboard ergonomics and visual function. This study sought to associate visual functions and person abilities of dashboard ergonomic...
Article
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Older drivers are a rapidly growing demographic group worldwide; many have visual processing impairments. Little is known about their preferences about vehicle instrument cluster design. We evaluated the psychometric properties of a questionnaire on “dashboard” design for a population-based sample of 1000 older drivers. Topics included gauges, knob...
Article
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Purpose: We hypothesize the first visual dysfunction in transitioning to early and intermediate age-related macular degeneration (AMD) is delayed rod-mediated dark adaptation (RMDA), owing to impaired photoreceptor sustenance from the circulation. This analysis from the Alabama Study on Early Age-related Macular Degeneration 2 provides insight on...
Article
Importance: After the Age-Related Eye Disease Study 2 (AREDS2) study, the beta carotene component was replaced by lutein/zeaxanthin for the development of the revised AREDS supplement. However, it is unknown if the increased risk of lung cancer observed in those assigned beta carotene persists beyond the conclusion of the AREDS2 trial and if there...
Poster
Purpose: The Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) utilizes remote optic nerve assessment to identify glaucoma and other eye diseases in patients seen at federally qualified health centers (FQHCs). This study aims to evaluate the satisfaction of participants enrolled in the first year of the...
Poster
Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) program provided evidence-based eye health education tailored for patients at-risk for glaucoma in rural primary care clinics. Education program based on InCHARGE eye health education program designed for African Americans and materials from Prevent Blin...
Article
Clinical trials in general, and age-related macular degeneration trials in particular, are expensive and lengthy. The advent of big data in ophthalmology in the form of large clinical registries and image databases and parallel advances in artificial intelligence created a unique opportunity to mine this data for patterns that carry the potential t...
Article
Objective To evaluate the epidemiologic association between visual acuity and other measures of visual function and motor vehicle collisions (MVCs) as well as their performance as screening tests for MVCs. Design Prospective cohort study. Participants 2,000 licensed drivers aged 70 years and older who resided in the environs of Jefferson County,...
Article
Purpose: To assess associations between visual function and on-road driving performance evaluated by a certified driving rehabilitation specialist (CDRS). Methods: Adults aged 70 and older enrolled and completed assessments of visual acuity, contrast sensitivity, visual processing speed, visual field sensitivity, motion perception and spatial ab...
Article
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Purpose: Subretinal drusenoid deposits (SDD) first appear in the rod-rich perifovea and can extend to the cone-rich fovea. To refine the spatial relationship of visual dysfunction with SDD burden, we determined the topography of mesopic and scotopic light sensitivity in participants with non-neovascular AMD with and without SDD. Methods: Thirty-...
Article
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Purpose: Luminance contrast is the fundamental building block of human spatial vision. Therefore contrast sensitivity, the reciprocal of contrast threshold required for target detection, has been a barometer of human visual function. Although retinal ganglion cells (RGCs) are known to be involved in contrast coding, it still remains unknown whethe...
Article
Importance Case series have identified a macular condition hypothesized to be associated with the use of pentosan polysulfate sodium (PPS). Observational studies seeking to quantify this association have yielded equivocal results. Objective To estimate the association between PPS exposure and maculopathy. Design, Setting, and Participants This di...
Article
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Purpose: Binocular summation refers to better visual performance with two eyes than with one eye. Little is known about the mechanism underlying binocular contrast summation in patients with common eye diseases who often exhibit binocularly asymmetric vision loss and structural changes along the visual pathway. Here we asked whether the mechanism...
Article
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Background and Objectives Older drivers are overrepresented in collisions at intersections while making left turns across oncoming traffic. Using naturalistic driving methods, we evaluated the association between vision impairment and their left-turn characteristics. Research Design and Methods In this prospective, observational study, vision impa...
Article
Recent years have seen an increase in the use of technology to measure behaviors in epidemiologic research. This has clear advantages because it reduces the need to rely on self-reporting and objective yet potentially biased measurements. This is particularly advantageous when the behaviors being measured are embedded in the complexity and unpredic...
Article
Background: This study aimed to evaluate the association between a Certified Driving Rehabilitation Specialist's (CDRS) ratings of on-road driving performance by older drivers and at-fault crash and near-crash involvement using naturalistic driving techniques where crashes and near-crashes are recorded in everyday driving through in-vehicle instru...
Article
Importance Government motor vehicle crash reports used in the study of driver safety can be biased and incomplete. Naturalistic driving methods using in-vehicle instrumentation have been developed in recent years to objectively measure crashes and near crashes as they occur on the road using video and vehicle kinematic data. Objective To examine v...
Article
Purpose To evaluate the relationship between visual function and a five-year history of motor vehicle collision rates in older adults. Motion perception impairment was explored as a risk factor for motor vehicle collisions for the first time in this study. Materials and methods Participants were licensed drivers ≥70 years old enrolled in the Alaba...
Article
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Purpose: To refine estimates of macular soft drusen abundance in eyes with age-related macular degeneration (AMD) and evaluate hypotheses about drusen biogenesis, we investigated topographic distribution and growth rates of drusen by optical coherence tomography (OCT). We compared results to retinal features with similar topographies (cone density...
Article
Prcis: This paper presents the methods and protocol of a community-based telemedicine program to identify glaucoma and other eye diseases. Purpose: To describe the study rationale and design of the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) project. Methods: The study will implement and evalu...
Article
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Purpose: To evaluate the test-retest reliability and validity of the MNREAD test for use in children with vision impairment (VI) and to compare their performance on the test to that of normally sighted children. Methods: Children with VI (n = 62) and without VI (n = 40) were administered the MNREAD test and the Basic Reading Inventory (BRI) on t...
Article
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Purpose: Delayed rod-mediated dark adaptation (RMDA) is a functional biomarker for incipient age-related macular degeneration (AMD). We used anatomically restricted spectral domain optical coherence tomography (SD-OCT) imaging data to localize de novo imaging features associated with and to test hypotheses about delayed RMDA. Methods: Rod interc...
Article
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Purpose: We assessed the association between the abundance of macular xanthophyll carotenoid pigment using dual-wavelength autofluorescence and multimodal vision testing including rod-mediated dark adaptation (RMDA), a measure of retinoid re-supply, in adults ≥60 years old with and without age-related macular degeneration (AMD). Methods: AMD sev...
Article
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Purpose: To assess the performance of adaptive optics scanning laser ophthalmoscopy (AOSLO) in a large sample of eyes with or without age-related macular degeneration (AMD) and with cataracts or intraocular lenses (IOLs). Methods: Patients with various degrees of AMD and age-similar normal subjects underwent fundus photography. Cataract severity...
Article
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Background: Age-related macular degeneration (AMD), a leading cause of irreversible vision impairment in the United States and globally, is a disease of the photoreceptor support system involving the retinal pigment epithelium (RPE), Bruch's membrane, and the choriocapillaris in the setting of characteristic extracellular deposits between outer re...
Article
Purpose Hyperreflective foci (HRF) are optical coherence tomography (OCT) biomarkers for progression of non-neovascular age-related macular degeneration (AMD) attributed to anteriorly migrated retinal pigment epithelial (RPE) cells. We examined associations between rod- and cone-mediated vision and HRF plus smaller hyperreflective specks (HRS); we...
Article
Background The PedsQL 4.0 is a generic health-related quality-of-life (HRQoL) instrument that has been used across many pediatric health conditions. The purpose of this study was to investigate its use in children with vision impairment and to test its ability to distinguish between visually impaired and normally sighted children. Methods Children...
Article
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Background: Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident...
Article
Objective: To examine the rate of self-reported vision impairment, eye disease, and eye care utilization among residents of subsidized senior housing (SSH) communities. Methods: In this cross-sectional, observational study, residents of 14 SSH communities in Jefferson County, AL, USA self-reported their vision status and eye care utilization as par...
Article
Purpose: To describe the progression and regression of individual subretinal drusenoid deposits (SDDs) and surrounding photoreceptors and retina in patients with age-related macular degeneration (AMD) over a 3.5-year period using multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO). Design: Longitudinal observationa...
Article
In a nationally representative cohort study of Medicare beneficiaries 65 years or older, Frank et al¹ report on the bidirectionality of longitudinal associations between self-reported vision impairment and clinically significant symptoms of depression and anxiety. Their finding that baseline vision impairment is associated with incident depression...
Article
Purpose: The purpose was to identify factors associated with older glaucoma patients' knowledge of, perceptions of, and predispositions for telemedicine use. Methods: Established patients age ≥60 years with a diagnosis of primary open angle glaucoma, glaucoma suspect, or ocular hypertension followed by a glaucoma fellowship-trained ophthalmologi...
Article
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Purpose OCT has revealed many details of retinal disease that were not available with older imaging technologies. In eyes of adults older than 60 years with healthy maculas as determined by color fundus photography (CFP) and a validated grading system, we screened for pathologic features using OCT. We also tested visual function to assess potential...
Article
Purpose: To examine the association between sequence variants in genetic risk factors for age-related macular degeneration (AMD) and delayed rod-mediated dark adaptation (RMDA), the first functional biomarker for incident AMD, in older adults with normal macular health and early AMD. Design: Cross-sectional. Participants: Adults 60 years of ag...
Article
Purpose: To determine the level of adherence to the American Academy of Ophthalmology (AAO) preferred practice pattern (PPP) guidelines for quality primary open angle glaucoma (POAG) and POAG suspect (POAGS) care among retail-based optometrists. Methods: Patients with a diagnosis of POAG or POAGS who participated in a telemedicine pilot project...
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This article summarizes the presentations and recommendations of the tenth annual American Geriatrics Society and National Institute on Aging Bench‐to‐Bedside research conference, “Sensory Impairment and Cognitive Decline,” on October 2–3, 2017, in Bethesda, Maryland. The risk of impairment in hearing, vision, and other senses increases with age, a...
Article
Purpose: To analyze the prevalence, incidence, and clinical characteristics of eyes with geographic atrophy (GA) in age-related macular degeneration (AMD), including clinical and genetic factors affecting enlargement. Design: Prospective cohort study within a controlled clinical trial. Participants: Age-Related Eye Disease Study 2 (AREDS2) par...
Article
Background The purpose of this study was to examine the association between secondary task involvement and risk of crash and near-crash involvement among older drivers using naturalistic driving data. Methods Data from drivers aged ≥70 years in the Strategic Highway Research Program (SHRP2) Naturalistic Driving Study database was utilized. The per...
Article
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Background The purpose of this study was to determine the factors associated with glaucoma patients’ satisfaction with their medical care by fellowship-trained glaucoma specialists in an urban tertiary referral clinic in the US. Methods A total of 110 established patients aged ≥60 years with a diagnosis of either primary open angle glaucoma, glauc...
Article
Purpose: To examine the association between macular pigment optical density (MPOD) and rod-mediated dark adaptation (RMDA) in persons ≥60 years old with normal maculas as determined by an accepted color fundus photography grading system. Methods: This cross-sectional analysis used baseline data from eyes in the Alabama Study on Early Age-Related Ma...
Article
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Importance The prevalence of irreversible vision impairment in the United States is expected to increase by 2050. Vision rehabilitation is the primary treatment option. Clinical trials have established its efficacy in improving quality of life. Yet studies indicate that patients experience many barriers to accessing low-vision care. Objectives To...