Sandra Stinnett

Sandra Stinnett
Duke University Medical Center | DUMC · Department of Biostatistics and Bioinformatics

DrPH

About

278
Publications
19,635
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
9,119
Citations
Citations since 2016
80 Research Items
4545 Citations
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
Introduction
I am the statistician for the Duke Eye Center. I assist with statistical analyses for ophthalmology and community and family medicine. I also teach medical statistics in the post-graduate Master of Biomedical Science program.
Additional affiliations
January 2001 - present
Duke University Medical Center
Position
  • Duke University
October 1994 - present
Duke University Medical Center
Position
  • Professor
January 1987 - December 1993

Publications

Publications (278)
Article
This study assessed pregnant individuals’ intention to accept routine and COVID‐19 vaccines for their baby after birth, and to identify key demographic (e.g., age) and non‐demographic characteristics (e.g., prior birth) associated with vaccination intention. We conducted a cross‐sectional survey with pregnant individuals attending prenatal practice...
Article
Full-text available
Purpose: To evaluate visual function (VF) changes in early and intermediate age-related macular degeneration (eAMD and iAMD) over 24 months. Design: Prospective, observational natural history study. Participants: Participants were enrolled at the Duke Eye Center. Methods: A total of 101 subjects (33 with eAMD, 47 with iAMD, and 21 normal con...
Article
Purpose To assess baseline differences and longitudinal rate of change in retinal and choroidal imaging parameters between APOE ε4 carriers and non-carriers with normal cognition. Design Prospective study. Subjects 413 eyes of 218 individuals with normal cognition aged ≥55 years with known APOE status (98 ε4 carriers, 120 non-carriers). Exclusion...
Article
Purpose: To assess retinal microvascular alterations in individuals with amnestic mild cognitive impairment (MCI) and nonamnestic MCI. Methods: One hundred twelve eyes of 59 amnestic MCI participants, 32 eyes of 17 nonamnestic MCI participants, and 111 eyes of 56 controls with normal cognition were included. Optical coherence tomography angiogra...
Article
Full-text available
Dysregulated levels of growth/differentiation factor-15 (GDF15), a divergent member of the transforming growth factor-beta super family, have been found to be associated with the pathology of various diseases. In this study, we evaluated the levels of GDF15 in aqueous humor (AH) and serum samples derived from primary open-angle glaucoma (POAG) and...
Article
Full-text available
Purpose To review the preliminary outcomes of patients with uveal melanoma treated with Iodine-125 plaques using a novel treatment planning approach. Methods This was a single institution, retrospective review of patients treated with ¹²⁵I brachytherapy for uveal melanoma from November 2016 to February 2019. We used 3-dimensional treatment plannin...
Article
Individuals with mild cognitive impairment (MCI) can be categorized into amnestic and non‐amnestic subgroups based on the absence or presence of intact working memory. Patients with amnestic MCI have increased likelihood of progressing to Alzheimer’s disease (AD); however, identification of predictive biomarkers distinguishing amnestic and non‐amne...
Article
The retinal and optic nerve head microvasculature may represent a non‐invasive, inexpensive biomarker for Alzheimer’s disease (AD) and mild cognitive impairment (MCI). In this study, we characterize microvascular changes at the optic nerve head (radial peripapillary capillary network) using optical coherence tomography angiography (OCTA). Optic ner...
Article
Full-text available
Purpose To assess the repeatability of peripapillary optical coherence tomography angiography (OCTA) in Alzheimer disease (AD), Parkinson disease (PD), mild cognitive impairment (MCI), and normal cognition. Design Cross-sectional. Participants Patients with a clinical diagnosis of AD, PD, MCI, or normal cognition were imaged. Those with glaucoma,...
Article
Purpose This proof-of-concept study evaluates the ability to assess eyelid measurements and the reproducibility of eyelid measurements using a simple measurement tool paired with digital cell phone photography in children. Methods Seventy consecutive patients and their siblings, 2-19 years of age, were prospectively enrolled. Participants underwen...
Article
Full-text available
Medical misinformation (MM) is a problem for both medical practitioners and patients in the 21 st century. Medical practitioners have anecdotally reported encounters with patient-held misinformation, but to date we lack evidence that quantifies this phenomenon. We surveyed licensed practitioners in the state of North Carolina to better understand h...
Article
Background and objective: To evaluate retinal microvascular changes in early and late-onset Alzheimer's disease (AD). Patients and methods: Eighty-six eyes of 50 late-onset AD participants, 27 eyes of 15 early onset AD participants, and 111 eyes of 57 cognitively normal controls were included. Optical coherence tomography angiography (OCTA) vess...
Article
Guidelines on managing infants after initial anti-vascular endothelial growth factor (VEGF) treatment (eg, bevacizumab) for retinopathy of prematurity (ROP) are limited. We found that following initial bevacizumab treatment for ROP, prophylactically lasering infant eyes before hospital discharge reduced the number and duration of outpatient ROP scr...
Article
Purpose To quantitatively compare retinal vascular characteristics over time in eyes eventually treated versus not treated for retinopathy of prematurity (ROP), using ROPtool analysis of narrow-field retinal images. Methods This longitudinal study used prospectively collected narrow-field retinal images of infants screened for ROP, prior to treatm...
Article
Full-text available
Cervical cancer mortality is high among Peruvian women of reproductive age. Understanding barriers and facilitators of cervical cancer screening and treatment could facilitate development of contextually-relevant interventions to reduce cervical cancer incidence and mortality. From April to October 2019, we conducted a cross-sectional survey with 2...
Article
Purpose In macula-wide analyses, spectral domain optical coherence tomography (SDOCT) features such as drusen volume, hyperreflective foci and OCT-reflective drusen substructures independently predict onset of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). We sought to identify SDOCT features in the location of new GA...
Article
Purpose To investigate long-term correlations between Matrix Metalloproteinase-9 (MMP-9) testing and dry eye (DE) parameters. Additionally, to evaluate variability in MMP-9 results over time and with anti-inflammatory treatment. Methods Retrospective cohort study of DE patients with equal MMP-9 testing results (positive or negative) in both eyes a...
Article
Background and objective: To investigate the effect of patient sex on presentation and outcomes of branch retinal vein occlusion (BRVO). Patients and methods: Retrospective chart review cohort study of 188 eyes with BRVO and cystoid macular edema (CME); 81 treatment-naïve eyes were selected for subgroup analysis. Results: Males had better visu...
Article
Macular images of infants with early-onset edema (occurring at or before 33 weeks' postmenstrual age [PMA]) and infants with late-onset edema (at or after 36 weeks' PMA) were compared. At first appearance, early-onset edema has a more severe morphology, with foveal bulging and elongated cystoid spaces than late-onset edema, which presents as small...
Article
Full-text available
Purpose: Genipin has been proposed as a possible neuroprotective therapy in myopia and glaucoma. Here, we aim to determine the effects of prolonged genipin-induced scleral stiffening on visual function. Methods: Eyes from Brown Norway rats were treated in vivo with either a single 15 mM genipin retrobulbar injection or sham retrobulbar injection...
Article
Purpose With the recent rise of teleophthalmology due to coronavirus disease, we are in need of accurate and reliable methods of checking visual acuity remotely. We compare the visual acuity as measured by the GoCheck Kids application, HOTV with the amblyopia treatment study (ATS), and our clinic protocol. Design This is a prospective, comparison...
Article
Purpose When International Classification of Disease (ICD) version 9 (ICD-9) transitioned to ICD-10, there was a marked increase in the complexity of ICD codes with potential for improved specificity in clinical database research. The purpose of this study was to characterize the accuracy of coding for stage of diabetic retinopathy (DR) and DR-rela...
Article
Purpose To determine if meibomian gland architecture in a pediatric population is impacted by body mass index (BMI). Methods Prospective evaluation of 175 eyes of 175 pediatric patients from two clinics. Demographic and clinical information were reviewed. Symptoms of dry eye were assessed with the Standard Patient Evaluation of Eye Dryness (SPEED)...
Article
Background: Previous epidemiologic studies have suggested an association between AMD and AD, and several therapeutic agents are being developed based on this principle. However, prior studies have provided conflicting results due in part to their reliance on clinical diagnoses that are not based on gold-standard histopathology. Objective: To use...
Article
Full-text available
Purpose: To assess the effect of an educational video on 1) patient knowledge about cataract surgery, 2) patient perception of preoperative assessment visit quality, 3) face-to-face time with the surgeon, and 4) choices regarding premium intraocular lenses (IOLs) or laser-assisted cataract surgery (LACS). Setting: Eye clinic in an academic medic...
Article
Background and objective: To evaluate the impact of sex differences on the presenting features, treatment patterns, and clinical outcomes in patients with central retinal vein occlusions (CRVO). Patients and methods: This retrospective, longitudinal cohort study included 476 patients diagnosed with CRVO over a 7-year period. Charts were reviewed...
Article
Full-text available
Purpose To investigate the relationship between surgical approach for intraocular tumor biopsy of uveal melanoma and tumor morphologic features such as size and intraocular location and the effect of these variables on diagnostic yield and biopsy outcome. Methods Consecutive patients from nine Ocular Oncology centers with uveal melanoma (UM) under...
Article
Full-text available
Purpose: Central foveal thickness (CFT) measurements from optical coherence tomography (OCT) scans provide a precise measure of severity of pathologic changes in the fovea, progress of disease and response to treatment. Although these measures are additionally valuable to assess foveal development in infants, their reproducibility is not known. Th...
Article
Purpose This article describes treatment patterns and visual outcomes for central retinal vein occlusion (CRVO) in the antivascular endothelial growth factor (anti-VEGF) era. Methods A retrospective cohort study of eyes diagnosed with CRVO between 2009 and 2016 was conducted. Treatment history and visual acuity (VA) measurements were abstracted fr...
Article
Full-text available
Introduction Previous studies evaluating the association between clinically diagnosed Alzheimer’s disease (AD) and age-related macular degeneration (AMD) have generated conflicting results. This study is the first to assess whether AMD prevalence is higher in AD patients than non-AD controls by using histopathology to definitively diagnose AD. Met...
Article
Purpose: To evaluate the association of subretinal hyperreflective material (SHRM) morphological features with visual acuity in eyes with neovascular age-related macular degeneration. Methods: Retrospective analysis of treatment-naïve patients with neovascular age-related macular degeneration enrolled in randomized anti-vascular endothelial grow...
Article
Purpose: To assess macular vasculature in healthy infants and children using OCT angiography (OCTA). Design: Prospective cross-sectional study. Participants: One hundred thirty-five normal maculae of 89 healthy infants and children (mean age, 8.5±5.3 years; range, 9 weeks-17 years) treated at the Duke University Eye Center. Methods: We image...
Article
Objectives: To evaluate a smartphone-based application's (Peek Acuity) ability to assess visual acuity and screen for ocular conditions in children, we compared visual acuity assessment between Peek Acuity and the pediatric ophthalmology examination and evaluated Peek Acuity's ability to identify children with referable ocular conditions. Study d...
Article
Purpose: To assess the safety, efficacy, and patient satisfaction of a newly described technique for the treatment of mild to moderate lash ptosis performed as augmentation to upper eyelid blepharoplasty. Methods: Patient medical records for 27 consecutive cases of upper eyelid blepharoplasty between January 2016 and June 2017 and 19 consecutive...
Article
Purpose: To report the 1-year progression of visual impairment on psychophysical tests of visual function in patients with early and intermediate age-related macular degeneration (AMD). Design: Prospective, observational study. Participants: Patients with early and intermediate AMD were enrolled from the existing population at the Duke Eye Cen...
Article
Purpose: To study the relationship between gene expression profile (GEP) subclass and American Joint Committee on Cancer (AJCC) stage in patients with uveal melanoma (UM). Methods: A retrospective, multicenter study was undertaken with patients entered from nine major ocular oncology centers from across the United States. Three hundred sixty eli...
Article
Purpose To test the hypothesis that the anatomic correlate of the gray optic disc crescent is pigmentation of externally oblique border tissue of Elschnig. Design Retrospective study. Participants African-American adult men with or without clinically apparent gray optic disc crescents. Methods McNemar’s test for paired data and kappa statistic w...
Article
Full-text available
Purpose To determine the relationship between cystoid macular edema (CME) and disease severity and progression in non-paraneoplastic autoimmune retinopathy (npAIR). Methods A retrospective study was conducted on patients seen between 2008 and 2016 with npAIR as defined by electroretinogram (ERG) dysfunction, visual field changes, presence of antir...
Article
Full-text available
Objective: Most retinopathy of prematurity screening involves an ophthalmologist performing indirect ophthalmoscopy, which can be stressful to infants. The purpose of this study is to evaluate the safety profile (using cardiopulmonary events as an indicator) of imaging infants with a non-contact retinal camera compared to examining them using indi...
Article
Purpose: To compare anterior segment spectral-domain optical coherence tomography (OCT) with eye bank technician slit-lamp examination (SLE) in characterizing lesions in donor corneas. Methods: Twenty-nine donor corneas identified by eye bank technicians to have opacities or lesions potentially representing pathologic findings affecting the stro...
Article
Full-text available
Purpose To investigate the association between macular features on spectral-domain optical coherence tomography (SD-OCT) and visual acuity (VA) in Coats' disease. Methods Thirty-nine eyes (39 patients) with SD-OCT from January 1, 2008 to December 31, 2016 were reviewed for SD-OCT features. Central subfield (CSF) SD-OCT findings were analyzed relat...
Article
Full-text available
Purpose: We advance studies of subretinal treatments by developing a microscope-integrated optical coherence tomography (MIOCT) image-based method for measuring the volume of therapeutics delivered into the subretinal space. Methods: A MIOCT image-based volume measurement method was developed and assessed for accuracy and reproducibility by imag...
Article
Purpose: To evaluate the clinical outcomes of thermal pulsation treatment in patients with meibomian gland dysfunction (MGD) and dry eye secondary to Sjogren disease. Methods: Twenty-four eyes from 13 patients with previously diagnosed Sjogren disease who presented to our institution with dry eye symptoms and had thermal pulsation treatment were...
Article
Purpose: In this study, we hypothesized that thickening along the major arcade vessels is a noninvasive marker of inflammation in eyes with birdshot retinochoroiditis (BRC). Methods: In this single-center retrospective study, patients with BRC were identified. Perivascular thickening was categorized as mild, moderate, or severe, based on a set o...
Article
Purpose: To study the relationship between gene expression profile subclass and clinical features in a multicenter cohort of patients with uveal melanoma. Methods: A retrospective, multicenter study was undertaken with patients entered from nine major ocular oncology centers from across the United States. Eligible patients had uveal melanoma and...
Article
Purpose: To evaluate and quantify visual function metrics to be used as endpoints of AMD stages and visual acuity (VA) loss in patients with early and intermediate AMD. Design: Cross-sectional analysis of baseline data from a prospective study. Methods: 101 patients were enrolled at Duke Eye Center: 80 patients with early AMD age-related eye d...
Article
Full-text available
Inner retina in Alzheimer's Disease (AD) may experience neuroinflammation resulting in atrophy. The objective of our study was to determine whether retinal GCIPL (ganglion cell-inner plexiform layer) or nerve fiber layer (NFL) thickness may serve as noninvasive biomarkers to diagnose AD. This cross-sectional case-control study enrolled 15 mild cogn...
Article
Full-text available
Purpose To examine the factors associated with blindness from primary open-angle glaucoma (POAG) among black and white patients at our institution. Patients and methods For this retrospective, case–control study, patients legally blind from POAG (“cases”) were matched on age, race, and gender with non-blind POAG patients (“controls”). Thirty-seven...
Article
Purpose: To assess posterior segment findings on multicolor confocal scanning laser ophthalmoscopy by correlation with spectral domain optical coherence tomography (SD-OCT) and to quantify agreement between these imaging modalities. Methods: Retrospective review of 159 eyes of 96 consecutive patients who underwent concurrent imaging with multico...
Article
Full-text available
Purpose: To determine whether Low Luminance Questionnaire (LLQ) scores are associated with objective measures of visual function in early and intermediate age-related macular degeneration (AMD). Methods: Cross-sectional study of subjects with early AMD Age-Related Eye Disease Study (AREDS) stage 2, N = 33), intermediate AMD (AREDS stage 3, N = 4...
Article
Purpose To evaluate (1) the feasibility of nonophthalmologist healthcare workers (HCWs) obtaining images of sufficient quality for retinopathy of prematurity (ROP) screening using a Food and Drug Administration-approved portable, noncontact, narrow-field fundus camera (i.e., Pictor; Volk Optical, Inc, Mentor, OH) and (2) the accuracy of grading the...
Article
Purpose: To evaluate low versus high dose plaque brachytherapy for juxtapapillary choroidal melanoma. Design: Retrospective interventional case series. Methods: Setting: Single institution. Study population: 47 patients with juxtapapillary choroidal melanoma. Intervention: Iodine-125 plaque brachytherapy. Eyes were divided into apex low do...
Article
Background and objective: To characterize the appearance of three types of artifacts observed on multicolor confocal scanning laser ophthalmoscopy (cSLO). Patients and methods: Retrospective review of 159 eyes of 96 consecutive patients from the Duke Eye Center who underwent multicolor cSLO with spectral-domain optical coherence tomography (SD-O...
Article
Purpose: To examine the clinical implications of positive or negative direct immunofluorescence biopsies (DIF) in patients with clinically typical ocular mucous membrane pemphigoid (MMP). Design: Retrospective cohort study METHODS: The study population was patients with clinically typical ocular MMP disease with documented DIF results who were f...
Article
Previous studies have demonstrated incomplete sunscreen self-application to various facial regions in cosmetic surgery patients, but there is no scientific research on the completeness of facial and periocular sunscreen self-application using ultraviolet (UV) photography for assessment. This prospective, cross-sectional, qualitative study aimed to...
Article
Full-text available
Purpose The goal of this study was to evaluate the effect of thermal pulsation treatment on tear film parameters, specifically osmolarity and matrix metalloproteinase-9 (MMP-9), in patients with meibomian gland dysfunction (MGD) and dry eye disease (DED). Methods A single-center review of 189 eyes that underwent thermal pulsation treatment was per...
Article
Purpose: Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I(125)) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM...
Article
Purpose: To report differences in visual acuities among patients with Coats' disease who sought treatment at a tertiary care university-based practice. Design: Single-center retrospective cohort study. Participants: Patients with Coats' disease diagnosed clinically, angiographically, or both from 1995 through 2015. Methods: Patients were div...
Article
Purpose: To compare a novel anterior segment optical coherence tomography (AS-OCT) bleb grading system with a clinical bleb grading system and both with intraocular pressure (IOP) following trabeculectomy surgery. Materials and methods: A novel AS-OCT grading system based on bleb size and internal reflectivity was developed. An imaging center wa...
Article
Full-text available
Purpose To determine the utility of tear film cytokines as biomarkers for early primary open-angle glaucoma (POAG). Methods Patients without POAG and eye drop-naïve patients with newly diagnosed POAG were recruited from an academic hospital-based glaucoma practice. Tear films of recruited patients were obtained and analyzed using a multiplex, high...
Article
Objective: Some case reports suggest that the translaminar pressure difference is important in cases of papilledema. The purpose of this study was to determine ocular, physiologic, and demographic factors associated with papilledema severity. Design: Retrospective, blinded study. Participants: Patients who had undergone a diagnostic lumbar pun...
Article
Full-text available
Purpose: To evaluate a frequently used regression model and a new, modified regression model to estimate cerebrospinal fluid pressure (CSFP). Methods: Datasets from the Beijing iCOP study from Tongren Hospital, Beijing, China, and the Mayo Clinic, Rochester, Minnesota, were tested in this retrospective, case-control study. An often-used regressi...