Niall Patton

• Consultant at Manchester University NHS Foundation Trust

Purpose: To report the role of perfluorocarbon liquid (PFCL) and passive extrusion for management of large full thickness macular holes (FTMHs). Methods: A standard pars plana vitrectomy with induction of posterior vitreous detachment was performed for all patients. After internal limiting membrane (ILM) peel, a bubble of perfluorocarbon liquid...

Background: We investigate novel OCT parameters, based on the volumetric analysis of lamellar macular holes (LMHs), as prognostic indicators for visual outcomes after surgery. Methods: LMHs were divided into degenerative LMHs (D-LMHs) and ERM-foveoschisis (ERM-FS). Pre-operative clinical, OCT linear and volumetric parameters were collected. Volumes...

Purpose- To compare SF6 relative to C2F6 in the anatomical and functional outcomes following pars plana vitrectomy (PPV) for uncomplicated primary pseudophakic rhegmatogenous retinal detachment (PRD) with inferior causative breaks. Methods- This is a retrospective, comparative study on eyes with PRD with inferior causative breaks that had small-ga...

Purpose: To describe the characteristics and outcomes of patients presenting with rhegmatogenous retinal detachment (RRD) after ocriplasmin (OCP) injection. Methods: Retrospective, multi-centre, observational case series with case note review. Results: Eight patients with symptomatic vitreomacular traction (six with concomitant macular hole) w...

There is a significant improvement in visual acuity and macular oedema in patients undergoing either vitrectomy or a combined phacovitrectomy for uveitis related indications Irrespective of the starting visual acuity Irrespective of the primary reason for surgery In conjunction with simultaneous appropriate control of the intraocular inflammation

Floaters are a common ocular condition which form as a consequence of aging changes in the vitreous. Although in most patients the symptoms are minimal, they can cause significant impairment in vision-related quality of life in a small population of patients. Recently there has been an increase in awareness of the visual disability caused by floate...

Aims: To investigate the hypothesis that lymphopenia is an independent predictor of sarcoidosis in new patients presenting with uveitis. Patients and methods: Retrospective case-control study of 112 patients with sarcoidosis-associated uveitis (SAU) against 398 controls with other forms of uveitis. Results: Of the patients with SAU, 30/112 (26...

Purpose: To assess the long-term visual outcomes of macular hole surgery and to correlate structural changes on spectral domain optical coherence tomography after surgery with long-term changes in the best-corrected visual acuity. Methods: A prospective study looking at 36 patients who underwent macular hole surgery between 2008 and 2010. The ma...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.

To report the outcomes of pars plana vitrectomy with epiretinal membrane (ERM) peel, with or without internal limiting membrane peel, in patients with uveitis. Retrospective interventional case series of patients undergoing pars plana vitrectomy with ERM peel between January 2005 and March 2012. Sixteen consecutive patients (16 eyes) were identifie...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.

AimThe objective of this study was to present the results of combined phacovitrectomy using 1.8 mm microincision cataract surgery (MICS) with special emphasis on the anterior segment complications in this group.Methods Retrospective, single-centre case series involving consecutive patients undergoing phacovitrectomy in a single centre in the United...

To assess repeatability of visual function measures in patients with early, intermediate or late age-related macular degeneration (AMD) without active neovascular disease in the study eye, but active neovascular AMD in the fellow eye. One hundred subjects from an ongoing trial were screened for this study in which their LogMAR acuity, contrast sens...

Background: The purpose of this study was to compare the incidence of iatrogenic anterior retinal breaks in 20-G vitrectomy (PPV) with transconjunctival 23-G PPV. Methods: Retrospective, observational review study involving consecutive patients undergoing PPV in a single center in the UK during a 2-year period. Results: Sclerotomy-related entr...

ERM +/- ILM peel in uveitis is a safe procedure but improves VA in only a minority with ERM with or without macular oedema. ILM peel may enhance outcomes (4 of 5 with improved VA underwent ILM peel, compared to 2 of 6 with reduced VA). Vitreomacular traction may respond particularly well with good anatomic success. Adequate peri-operative control o...

Purpose: To investigate the clinical effects and safety of targeted pattern scan laser (Pascal) retinal photocoagulation (TRP) in proliferative diabetic retinopathy (PDR). Methods: Prospective and non-randomized study of 28 eyes with treatment-naive proliferative diabetic retinopathy (PDR). Single-session 20-ms-Pascal TRP strategy applied 1500 burn...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.

Aims/hypothesis: Retinal vascular calibre changes may reflect early subclinical microvascular disease in diabetes. Because of the considerable homology between retinal and cerebral microcirculation, we examined whether retinal vascular calibre, as a proxy of cerebral microvascular disease, was associated with cognitive function in older people wit...

The extent to which visual function, measured as near and distant visual acuity and contrast sensitivity, is correlated with concurrently measured cognitive function and prior intellectual ability was investigated in a narrow age range group known as the Lothian Birth Cohort of 1921 (LBC1921). Participants were aged ~83years at the time of testing...

We describe a technique for combined fluid-gas exchange and phacoemulsification 2 weeks after macular hole surgery to achieve rapid visual rehabilitation. The procedure uses a standard cataract set and requires minimal vitreoretinal expertise. We encountered no significant complications and obtained long-term outcomes comparable to those with conve...

To evaluate pain responses following Pascal 20 ms multi-spot and 100 ms single-spot panretinal photocoagulation (PRP). Single-centre randomised clinical trial. 40 eyes of 24 patients with treatment-naive proliferative diabetic retinopathy randomised to 20 and 100 ms PRP under topical 0.4% oxybuprocaine. A masked grader used a pain questionnaire wit...

Aim: The paper discusses the findings of an audit carried out at Manchester Royal Eye Hospital. Its focus was to explore whether it was necessary for patients to fast 2 hours prior to undergoing surgery (including vitreoretinal) under local anaesthetic.A total of 67 patients were included in the audit (27 female (40%), 40 male (60%)}. Results: Aver...

To investigate the morphologic features and clinical efficacy of barely visible Pascal (Optimedica Corporation) photocoagulation burns in diabetic macular edema (DME) using Fourier-domain optical coherence tomography (FD OCT) and fundus autofluorescence (AF). Interventional case series. Retrospective evaluation of 10 eyes with newly diagnosed DME t...

This article aims to provide an interpretation and perspective on current concepts and recent literature regarding the evidence for individualizing intravitreal therapy (IVT), particularly considering iatrogenic and patient factors in the management of neovascular age-related macular degeneration (AMD). As ocular parameters that govern IVT pharmaco...

To investigate the effects of pattern scanning laser (Pascal; OptiMedica, Santa Clara, California) multispot panretinal photocoagulation given in a single-session (SS-PRP) vs single-spot multiple-session PRP (MS-PRP) on proliferative diabetic retinopathy (PDR). Single-center, randomized clinical trial of 40 eyes. Proliferative diabetic retinopathy...

Lacunar strokes account for 25% of all ischemic strokes and may represent the cerebral manifestation of a systemic small vessel vasculopathy of unknown etiology. Altered retinal vessel fractal dimensions may act as a surrogate marker for diseased cerebral vessels. We used a cross-sectional study to investigate fractal properties of retinal vessels...

To compare in vivo burn morphologic features and healing responses of Pascal 20- and 100-millisecond panretinal photocoagulation (PRP) burns in proliferative diabetic retinopathy. Prospective randomized controlled trial with 24 eyes assigned to either 20- or 100-millisecond Pascal PRP. Fundus autofluorescence and Fourier domain optical coherence to...

Different surgical approaches have been used for the treatment of optic disc pit associated maculopathy, with increasing emphasis on vitrectomy. Case report We report a case of optic disc pit maculopathy where vitrectomy was combined with subretinal fluid drainage using a 42-gauge subretinal cannula connected to a "back-flush" flute handle. No reti...

An accurate assessment of retinopathy of prematurity (ROP) is essential in ensuring correct and timely treatment of this potentially blinding condition. Current modes of assessment are based upon clinical grading by expert examination of retinal changes. However, this may be subjective, unreliable and difficult and there has been significant intere...

Approximately 50% of cases of congenital optic disc pits are associated with serous macular detachment. Long-standing serous detachments (over 1 year) with poor initial presenting acuity are usually associated with cystic degeneration of the macula and loss of pigment from the underlying retinal pigment epithelium, with resultant poor visual outcom...

To examine the evidence for an association between cognitive impairment or dementia and the presence of retinal microvascular abnormalities. A systematic review of observational studies identified through searching five electronic databases and reference lists. Studies were required to have both a recognised cognitive function assessment (either a...

To test the hypothesis that parameters of retinal vascular network geometry are significantly associated with cognition. Three hundred twenty-one community-dwelling, surviving participants in the Scottish Mental Survey of 1932 from the Lothian region of Scotland (Lothian Birth Cohort 1921; all born in 1921 and aged approximately 83 when tested) und...

To describe the types and prevalence of long-term, established pseudophakic dysphotopsia in a typical population more than a year after cataract extraction. Cross-sectional observational study. Fifty-five patients who had undergone cataract surgery more than a year before were administered a questionnaire that was based on photographic images of ph...

Complexity of the retinal vascular network is quantified through the measurement of fractal dimension. A computerized approach enhances and segments the retinal vasculature in digital fundus images with an accuracy of 94% in comparison to the gold standard of manual tracing. Fractal analysis was performed on skeletonized versions of the network in...

Reliability of measurements and measurers is important so that we can trust the measurements we record. However, the statistical techniques used to assess reliability of measurements or measurers in the ophthalmic literature are often inappropriate, and not able to evaluate reliability between measurements/measurers. We review the techniques used i...

To describe a revised formula for the estimation of retinal trunk arteriole widths from their respective arteriolar branch widths that improves the summarizing of retinal arteriolar diameters. A group of young, healthy individuals underwent retinal photography and arteriolar and venular branching points were identified. Vessel widths of the vessel...

Binary vascular networks of the human retina were obtained by computerized processing of digital fundus images. Fractal analysis was performed on skeletonised versions. The effect of three parameters in the vascular segmentation and skeletonization algorithm was quantified, with threshold level found to have the greatest influence. The results were...

This paper presents and tests a comprehensive computerised system of analysis of digital images of posterior capsule opacification (PCO). It updates and expands significantly on a previous presentation to include facilities for selecting user defined central areas and for registering and subsequent merging of images for artefact removal. Also, the...

As digital imaging and computing power increasingly develop, so too does the potential to use these technologies in ophthalmology. Image processing, analysis and computer vision techniques are increasing in prominence in all fields of medical science, and are especially pertinent to modern ophthalmology, as it is heavily dependent on visually orien...

Fundal examination offers a unique opportunity to non-invasively visualize, photograph, and subsequently analyze images of the retinal vasculature in vivo. Technology has developed rapidly, permitting retinal digital image analysis to be readily accessible to both researchers and practicing clinicians via commercial software. Over the past five yea...

Unlabelled: We performed a prospective, randomized trial assessing the "remaining" volume of anesthetic solution that stays within the sub-Tenon's space after administration of 2 different volumes: 3 mL and 5 mL. The remaining volume correlated with motor block (r = 0.72; P < 0.001). The volume lost through the incision as a percentage of total vo...

To explore the association between axial length and retinal vascular network geometry (arteriovenous diameter ratio [AVR], arteriolar branching angles, and junctional exponents). Prospective, cross-sectional study. Patients were recruited from a pseudophakic population that had preexisting axial length measurements. Mean arterial blood pressure and...

Measurements in ophthalmic research may be of parameters such as visual functions, quality of life or physical measures and can involve different types of instruments such as questionnaires and mechanical, chemical or electronic devices. Whatever the mode of measurement, however, all these devices require sufficient evidence for validity before inf...

The retinal and cerebral microvasculatures share many morphological and physiological properties. Assessment of the cerebral microvasculature requires highly specialized and expensive techniques. The potential for using non-invasive clinical assessment of the retinal microvasculature as a marker of the state of the cerebrovasculature offers clear a...

The aim of this study was to develop a system of computerised analysis of digital images of posterior capsule opacification (PCO) that is evidence based, objective and freely available. The paper will present evidence for the reliability and validity of the developed system. The system of PCO analysis was developed considering current published evi...

To design, develop and test a system for analysis of photic phenomena. Extensive background research, patient interviews and theoretical studies led to development of a set of photographic images resembling photic phenomena experienced by patients. These photographic images were processed and digitally altered to create scales of severity for each...

To compare the effect of volume used in sub-Tenon's anaesthesia on efficacy and intraocular pressure (IOP). A prospective, randomised clinical trial was conducted on 52 eyes of 52 consecutive patients undergoing sub-Tenon's anaesthetic for cataract surgery. Eyes were randomly assigned to either 3 mL or 5 mL volume of anaesthetic solution (0.5% bupi...

To review the pathogenesis, clinical characteristics, and management of self-inflicted eye injuries. Review of the medical literature. Psychiatric theories of pathogenesis for self-inflicted behaviour include religious and sexual ideation, symbolism, guilt, and displacement. Biological theories include disorders of serotonergic, dopaminergic, and o...

To develop and test a questionnaire to assess quality of vision in pseudophakic patients. The problems with existing health measurement scales and the need for a new questionnaire are first discussed. Development of the new questionnaire from concept to completion is presented and all stages discussed. The questionnaire is then tested for internal...

To report the clinicopathologic features of a fibrocellular membrane in a pseudophakic eye with retained silicone oil in the absence of any capsular contraction syndrome, necessitating repeat anterior capsulorhexis. Clinicopathologic report of a case. Histopathologic study of the membrane showed absence of any true periodic acid Schiff-positive cap...

Purpose To investigate the correlation between visual acuity, contrast sensitivity, and contrast sensitivity with glare source (glare sensitivity), and the degree of posterior capsule opacification (PCO) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy. Design Prospective interventional case series. Methods Ei...

This paper attempts to clarify the usefulness of various simple pre-operative measures in estimating the potential for a visually successful capsulotomy. 24 patients attending for capsulotomy had pre-operative measures of glare with BAT tester, visibility of posterior pole and grading of posterior capsular pearls and fibrosis seen at slit lamp. Vis...

To evaluate the effect of Nd:YAG capsulotomy for posterior capsular opacification (PCO) on visualisation of the peripheral fundus with scleral indentation. Patients undergoing Nd:YAG capsulotomy for PCO were examined pre- and four weeks post- Nd:YAG capsulotomy. In order to give a quantitative measure of visualisation of the peripheral retina, a no...

Patients are often referred to ophthalmologists with focal visual field defects on routine testing, possibly related to a potential diagnosis of glaucoma. However, examination of the individual patient's ocular characteristics as well as facial characteristics may often reveal a cause of the visual field defect. We describe a patient who was found...

To ascertain whether the Honan intraocular pressure reducer (HIPR) has an effect on the preoperative intraocular pressure (IOP), surgeon's assessment of anesthesia, and patients' analgesic experience when sub-Tenon's anesthesia is used for routine cataract surgery. Princess Alexandra Eye Pavilion, Edinburgh, Scotland. Forty-five eyes of 45 patients...

To report the association of optic atrophy with cobalamin C (cblC) disease. Descriptive case reports on three patients, two of whom were siblings. All three patients with cblC disease exhibited bilateral optic atrophy with decreased visual acuity. Of the two siblings, the younger sister had received cobalamin supplements from birth and the mother h...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.