Sobha Sivaprasad

Sobha Sivaprasad
Moorfields Eye Hospital NHS Foundation Trust · Department of Medical Retina

MBBS, MS, DM, FRCS, FRCOphth

About

410
Publications
67,784
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
10,691
Citations
Additional affiliations
April 2011 - present
Moorfields Eye Hospital NHS Foundation Trust
Position
  • Consultant
June 2008 - present
King's College London
Position
  • Consultant Ophthalmologist

Publications

Publications (410)
Article
Full-text available
The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (< 70 Early Treatment...
Article
Full-text available
Artificial Intelligence has showcased clear capabilities to automatically grade diabetic retinopathy (DR) on mydriatic retinal images captured by clinical experts on fixed table-top retinal cameras within hospital settings. However, in many low- and middle-income countries, screening for DR revolves around minimally trained field workers using hand...
Article
Purpose: To study the time course to macular atrophy (MA) and associated risk factors in eyes with Acquired Vitelliform Lesions (AVL) as they vary between patients and between eyes of an individual. Design: Single centre, retrospective, observational cohort study. Subjects: Consecutive patients registered between Jan 2009 to Jan 2014 with firs...
Article
To determine survival outcomes following enucleation for uveal melanoma. To compare these outcomes with the 8th edition AJCC classification and determine the influence of cytogenetics, using Fluorescent in situ Hybridisation (FISH), on survival. To determine whether failure to gain sufficient sample for cytogenetics using Fine Needle Aspiration Bio...
Article
Background/aims: To evaluate the cost-effectiveness of non-invasive monitoring tests to detect the onset of neovascular age-related macular degeneration (nAMD) in the unaffected second eye of patients receiving treatment for unilateral nAMD in a UK National Health Service (NHS) hospital outpatient setting. Methods: A patient-level state transiti...
Article
Purpose : Differences in multimodal imaging features between Asians and Caucasians eyes may contribute to our understanding of the etiology of the polypoidal choroidal vasculopathy (PCV). The purpose of this study is to compare the multimodal imaging features of Asian and Caucasian eyes with PCV. Design : Cross-sectional, retrospective, multicente...
Article
Full-text available
There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of p...
Article
Full-text available
Objectives DRAKO (NCT02850263) is a 24-month, prospective, non-interventional, multi-centre cohort study which enroled patients diagnosed with centre-involving diabetic macular oedema (DMO). The study aims to evaluate standard of care with intravitreal aflibercept (IVT-AFL) treatment in the UK. This analysis describes the anti-vascular endothelial...
Article
Full-text available
PurposeTo compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems.Methods Retrospective chart review of consecutive patients with NVG who presented between January 2016 to January 2018 in 5 tertiary-centres in India and o...
Article
Full-text available
Prediction models for population-based screening need, for global usage, to be resource-driven, involving predictors that are affordably resourced. Here, we report the development and validation of three resource-driven risk models to identify people with type 2 diabetes (T2DM) at risk of stage 3 CKD defined by a decline in estimated glomerular fil...
Article
Full-text available
With the increasing prevalence of diabetes in developing and developed countries, the socio‐economic burden of diabetic retinopathy (DR), the leading complication of diabetes, is growing. Diabetic retinopathy (DR) is currently one of the leading causes of blindness in working‐age adults worldwide. Robust methodologies exist to detect and monitor DR...
Article
Full-text available
Objective To evaluate the diagnostic accuracy of routinely used tests of visual function and retinal morphology compared to fundus fluorescein angiography (FFA) to detect onset of active macular neovascularisation in unaffected fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD). Design Prospective diagnosti...
Article
Full-text available
Rare variants in the Complement Factor I (CFI) gene, associated with low serum Factor I (FI) levels, are strong risk factors for developing the advanced stages of Age-Related Macular Degeneration (AMD). No studies have been undertaken on the prevalence of disease-causing CFI mutations in patients with Geographic Atrophy (GA) secondary to AMD. A mul...
Article
Background Licensed ranibizumab (0.5 mg/0.05 ml Lucentis ® ; Novartis International AG, Basel, Switzerland) and aflibercept (2 mg/0.05 ml Eylea ® ; Bayer AG, Leverkusen, Germany) and unlicensed bevacizumab (1.25 mg/0.05 ml Avastin ® ; F. Hoffmann-La Roche AG, Basel, Switzerland) are used to treat macula oedema due to central retinal vein occlusion,...
Article
Full-text available
Purpose To estimate prevalence and incidence of diabetic retinopathy (DR) in a UK region by severity between 2012 and 2016 and risk factors for progression to proliferative DR (PDR). Methods Electronic medical records from people with diabetes (PWD) ≥18 years seen at the Gloucestershire Diabetic Eye Screening Programme (GDESP) and the hospital eye...
Article
Full-text available
Diabetic macular oedema (DMO) is an important cause of moderate vision loss in people with diabetes. Advances in imaging technology have shown that a significant proportion of patients with DMO respond sub-optimally to existing treatment options. Identifying associations and predictors of response before treatment is initiated may help in explainin...
Article
Full-text available
Diseases of the retina are major causes of visual impairment and blindness in developed countries and, due to an ageing population, their prevalence is continually rising. The lack of effective therapies and the limitations of those currently in use highlight the importance of continued research into the pathogenesis of these diseases. Vascular end...
Article
Full-text available
Background Owing to the increasing prevalence of diabetes, the workload related to diabetic macular oedema and proliferative diabetic retinopathy is rising, making it difficult for hospital eye services to meet demands. Objective The objective was to evaluate the diagnostic performance, cost-effectiveness and acceptability of a new pathway using m...
Article
Full-text available
The aim of this review was to discuss frequently encountered themes such as cataract surgery in presence of age-related macular degeneration (AMD), dementia, Immediate Sequential Bilateral Cataract Surgery (ISBCS), discussing non-standard intraocular lens (IOL) options during consultation in the National Health Services (NHS) and the choice of the...
Article
Full-text available
Background The associations between England’s incentivised primary care-based diabetes prevention activities and hard clinical endpoints remain unclear. We aimed to examine the associations between attainment of primary care indicators and incident diabetic retinopathy (DR) among people with type 2 diabetes. Methods A historical cohort ( n = 60,09...
Article
Full-text available
Background: We aimed to assess the cost effectiveness of intravitreal ranibizumab (Lucentis), aflibercept (Eylea) and bevacizumab (Avastin) for the treatment of macular oedema due to central retinal vein occlusion. Methods: We calculated costs and quality-adjusted life-years from the UK National Health Service and Personal Social Services perspe...
Article
Full-text available
Importance Eyes with proliferative diabetic retinopathy have a variable response to treatment with panretinal photocoagulation (PRP) or anti–vascular endothelial growth factor agents. The location of neovascularization (NV) is associated with outcomes (eg, patients with disc NV [NVD] have poorer visual prognosis than those with NV elsewhere [NVE])....
Article
Full-text available
Aims To estimate the incidence of early treatment diabetic retinopathy study (ETDRS) level 47 and 53 and progression to treatment with panretinal photocoagulation (PRP) for proliferative DR (PDR). Methods Log-linear regression was used to estimate the incidence of level 47–53 or worse for 33,009 people with diabetes (PWD) in Gloucestershire during...
Article
Full-text available
Purpose: The aim of this study was to report visual and anatomical outcomes following treatment for diabetic macular edema (DME) in clinical practice in India. Methods: Retrospective chart review of patients with DME who were initiated on treatment and followed up for at least 1 year at 9 tertiary eye care centers during 2016-2017 was performed....
Article
To evaluate the inter-rater reliability for identification of complete retinal pigment epithelium and outer retinal atrophy (cRORA) on SD-OCT images as defined by the Classification of Atrophy Meetings (CAM) group. Fifty images of anonymized SD-OCT line scans of eyes with cRORA due to AMD were selected. Each .tiff image was saved in both black-on-w...
Article
We report the impact of SMS reminder on follow-up visit compliance among patients who are on treatment for diabetic macular edema. The randomization based on intervention did not show any difference between the two study groups.
Article
To evaluate functional clinical endpoints and their structural correlations in AMD, with a focus on subretinal drusenoid deposits (SDD). This prospective study enroled 50 participants (11 controls, 17 intermediate AMD (iAMD) with no SDD, 11 iAMD with SDD and 11 non-foveal atrophic AMD). Participants underwent best-corrected visual acuity (BCVA), lo...
Article
Full-text available
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...
Article
Diabetic macular ischemia (DMI) is a common complication of diabetic retinopathy that can lead to progressive and irreversible visual loss. Despite substantial clinical burden, there are no treatments for DMI, no validated clinical trial endpoints, and few clinical trials focusing on DMI. Therefore, generating consensus on validated endpoints that...
Article
Full-text available
Aims: To examine the impact of attainment of primary care diabetes clinical indicators on the progression to sight threatening diabetic retinopathy (STDR) among those with mild non-proliferative diabetic retinopathy (NPDR). Materials and methods: A historical cohort study of 18,978 adults (43.63% female) diagnosed with type 2 diabetes before 1 A...
Article
Full-text available
Mitochondrial function declines with age and in some diseases, but we have been unable to analyze this in vivo. Here, we optically examine retinal mitochondrial function as well as choroidal oxygenation and hemodynamics in aging C57 and complement factor H (CFH−/−) mice, proposed models of macular degeneration which suffer early retinal mitochondri...
Article
Full-text available
Purpose To develop a deep-learning (DL) system that can detect referable and vision-threatening diabetic retinopathy (RDR and VTDR) from images obtained on ultra-wide field scanning laser ophthalmoscope (UWF-SLO). Design Observational, cross-sectional study. Subjects A total of 9392 UWF-SLO images of 1903 eyes from 1022 subjects with diabetes fro...
Article
Full-text available
Objective To evaluate whether baseline demographic, clinical and optical coherence tomography (OCT) characteristics predict visual acuity outcomes in patients receiving anti-VEGF therapy for ME (macular edema) due to CRVO (central retinal vein occlusion). Design Post-hoc analysis of the randomized noninferiority trial (Lucentis, Eylea, Avastin in...
Article
Full-text available
This study aimed to determine the relation of best corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) in proliferative diabetic retinopathy (PDR) following treatment with either aflibercept or pan-retinal photocoagulation (PRP). The study was conducted as a post-hoc analysis of the CLARITY trial in which naïve and PRP treated PDR...
Article
Full-text available
Introduction The COVID-19 pandemic resulted in a national lockdown in India from midnight on 25 March 2020, with conditional relaxation by phases and zones from 20 April. We evaluated the impact of the lockdown in terms of healthcare provisions, physical health, mental health and social well-being within a multicentre cross-sectional study in India...
Article
A Correction to this paper has been published: https://doi.org/10.1038/s41433-020-01362-4.
Article
Background In chronic central serous chorioretinopathy, fluid accumulates in the subretinal space and causes permanent vision loss in ≈ 30% of patients. There is no definitive treatment. Previous research suggests that the mineralocorticoid receptor antagonist eplerenone is effective but it is not licensed for chronic central serous chorioretinopat...
Article
Full-text available
South Asians constitute approximately 1.6 billion people from the Indian subcontinent, comprising Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka; and make up the largest diaspora globally. Compared to the White European population, this group is at a higher risk of developing type 2 diabetes along with cardiovascul...
Article
Full-text available
Objective Diabetic retinopathy is one of the leading causes of visual impairment after cataract and uncorrected refractive error. It has major public health implications globally, especially in countries such as India where the prevalence of diabetes is high. With timely screening and intervention, the disease progression to blindness can be preven...
Article
Full-text available
Introduction The aim of this study is to develop practical and affordable models to (a) diagnose people with diabetes and prediabetes and (b) identify those at risk of diabetes complications so that these models can be applied to the population in low-income and middle-income countries (LMIC) where laboratory tests are unaffordable. Methods and an...
Article
Full-text available
Diabetic retinopathy (DR) is an emerging preventable cause of blindness in India. All India Ophthalmology Society (AIOS) and Vitreo‑Retinal Society of India (VRSI) have initiated several measures to improve screening of DR screening in India. This article is a consensus statement of the AIOS DR task force and VRSI on practical guidelines of DR scre...
Article
The pachychoroid disease spectrum encompasses seven major retinal conditions including central serous chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV), and pachychoroid neovasculopathy or type I macular neovascularisation (MNV) secondary to chronic persistent thickening and dysfunction of the choroidal vasculature. Drusen are focal...
Article
Introduction: To report the 10 - year rate of vitrectomies and the associated factors in people with proliferative diabetic retinopathy (PDR) from a multicentric cohort of people with diabetes mellitus. Methods: Ten centres in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. People with...
Article
Full-text available
Several circulating biomarkers are reported to be associated with diabetic retinopathy (DR). However, their relative contributions to DR compared to known risk factors, such as hyperglycaemia, hypertension, and hyperlipidaemia, remain unclear. In this data driven study, we used novel models to evaluate the associations of over 400 laboratory parame...
Article
This is a comprehensive review of the principles and applications of adaptive optics (AO) in ophthalmology. It has been combined with flood illumination ophthalmoscopy, scanning laser ophthalmoscopy, as well as optical coherence tomography to image photoreceptors, retinal pigment epithelium (RPE), retinal ganglion cells, lamina cribrosa and the ret...
Article
Full-text available
Purpose: The increasing diabetes prevalence and advent of new treatments for its major visual-threatening complications (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]), which require frequent life-long follow-up, have increased hospital demands markedly. Subsequent delays in patient’s evaluation and treatment are causing...
Conference Paper
Purpose : To examine (1) the retinal structure by optical coherence tomography angiography (OCTA) and function by means of multifocal electroretinography (mfERG) in eyes with and without diabetic retinopathy (DR), (2) if the local retinal function assessed by mfERG latencies and amplitudes have any correspondence with the retinal lesions. Methods...
Conference Paper
Purpose : Deep learning (DL) has been showing great promise in ophthalmology, especially in diagnosis of referable diabetic retinopathy (DR). To date, these advances have always been done using clinically collected datasets. However, the real power of DL is in moving the experience of highly qualified ophthalmologists to community settings, especia...
Conference Paper
Purpose : To provide the real world outcomes of people with Proliferative diabetic retinopathy (PDR) in India and to evaluate their visual acuity, short term outcomes at 6 months and incidence of visual impairment at 5 and 10 years. Methods : 20 centers in India with established vitreoretinal services for over 10 years were invited to provide long...
Conference Paper
Purpose : To develop a deep learning model that can effectively detect referable and vision-threatening diabetic retinopathy (RDR and VTDR) on images obtained from ultra-wide field scanning laser ophthalmoscope (UWF-SLO). Methods : UWF-SLO (Daytona, Optos, Dunfermline, UK) images were retrospectively collected from subjects with diabetes in CUHK E...
Conference Paper
Purpose : To evaluate the efficacy of deep learning (DL) methods for screening diabetic patients for neuropathy (NP) from fundus images collected during normal diabetic retinopathy (DR) screening. We examine the impact of the presence or absence of DR on the predictive power for NP. Methods : We used 23,784 eye images of 1,564 patients from a popu...
Article
Full-text available
New clinical trials for diabetic macular oedema (DMO) are being designed to prove superiority over aflibercept when this agent is already very effective in improving visual acuity (VA) and DMO. The aim of this study was to determine the optimal inclusion–exclusion criteria for trials to aim for superiority in visual outcomes with newer agents. As P...
Article
Background: To describe 10-year trends in visual outcomes, anatomical outcomes and treatment burden of patients receiving antivascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD). Methods: Retrospective cohort study of treatment-naïve, first-affected eyes with nAMD started on ranibizumab...
Article
Full-text available
Diabetic retinopathy (DR) is a microvascular complication of diabetes with a prevalence of ~35%, and is one of the leading causes of visual impairment in people of working age in most developed countries. The earliest stage of DR, non-proliferative DR (NPDR), may progress to sight-threatening DR (STDR). Thus, early detection of DR and active regula...
Preprint
Full-text available
Background: Several circulating biomarkers are reported to be associated with diabetic retinopathy (DR). However, their relative contributions to DR compared to known risk factors, such as hyperglycemia, hypertension, and hyperlipidemia, remain unclear. In this data driven study, we used novel models to evaluate the associations of over 400 laborat...
Article
Full-text available
Purpose: To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no...
Article
Purpose To report a case of posterior microphthalomos (PM) related to PRSS56 gene mutation with long term follow up with multimodal imaging findings. Methods Single retrospective case report. Results A 43-year old male patient presented in 2009 with bilateral reduced vision. Clinical examination and multimodal imaging showed features consistent w...
Article
Purpose: To evaluate the earliest spectral domain OCT (SD-OCT) markers in fellow eyes of asymmetric Type 2 Macular Telangiectasia (MacTel) METHODS:: A multicentered case-control study of SD-OCT images captured on Spectralis Heidelberg Engineering, Germany comparing features of fellow eyes of patients with asymmetric clinical presentation of MacTel...