Tin Aung

Tin Aung
National University of Singapore | NUS ·  Centre for Health Services Research

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827
Publications
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Publications

Publications (827)
Article
Purpose To study the associations between optic nerve head (ONH) strains under intraocular pressure (IOP) elevation with retinal sensitivity in glaucoma subjects. Design Clinic based cross-sectional study. Participants 229 subjects with primary open angle glaucoma (subdivided into 115 high tension glaucoma (HTG) subjects and 114 normal tension gl...
Article
Full-text available
Prcis: A literature review of SLT energy dose response found no definitive relationship between IOP reduction with respect to total or pulse energy, race, pigmentation, or application pattern. Purpose: Selective laser trabeculoplasty (SLT) is a safe and effective treatment for lowering intraocular pressure (IOP). While evidence is mounting for t...
Preprint
Full-text available
\mathbf{Purpose}$: To use artificial intelligence (AI) to: (1) exploit biomechanical knowledge of the optic nerve head (ONH) from a relatively large population; (2) assess ONH robustness from a single optical coherence tomography (OCT) scan of the ONH; (3) identify what critical three-dimensional (3D) structural features make a given ONH robust. $\...
Article
To evaluate machine learning (ML) approaches for structure–function modeling to estimate visual field (VF) loss in glaucoma, models from different ML approaches were trained on optical coherence tomography thickness measurements to estimate global VF mean deviation (VF MD) and focal VF loss from 24‐2 standard automated perimetry. The models were co...
Article
Background/Aims Prophylactic laser peripheral iridotomy (LPI) is performed in primary angle-closure suspect (PACS) eyes to prevent acute angle-closure attacks. However, accelerated cataractogenesis is a potential risk of the procedure that may result in decreased visual acuity. We aimed to assess the long-term impact of LPI on cataract formation in...
Article
Purpose Angle-closure glaucoma is a major cause of blindness worldwide that carries an excess risk of severe, bilateral visual impairment. A common concern among clinicians is precipitating acute angle closure (AAC) attacks by mydriasis. We evaluated the risk of AAC after pharmacologic dilation in Chinese individuals classified as bilateral primary...
Article
Glaucoma, a diverse group of eye disorders that results in the degeneration of retinal ganglion cells, is the world's leading cause of irreversible blindness. Apart from age and ancestry, the major risk factor for glaucoma is increased intraocular pressure (IOP). In primary open-angle glaucoma (POAG), the anterior chamber angle is open but there is...
Preprint
Full-text available
Purpose: The optic nerve head (ONH) undergoes complex and deep 3D morphological changes during the development and progression of glaucoma. Optical coherence tomography (OCT) is the current gold standard to visualize and quantify these changes, however the resulting 3D deep-tissue information has not yet been fully exploited for the diagnosis and p...
Preprint
Full-text available
Purpose: (1) To assess the performance of geometric deep learning (PointNet) in diagnosing glaucoma from a single optical coherence tomography (OCT) 3D scan of the optic nerve head (ONH); (2) To compare its performance to that obtained with a standard 3D convolutional neural network (CNN), and with a gold-standard glaucoma parameter, i.e. retinal n...
Article
Aim: To investigate the association between the extent of iridotrabecular contact and other quantitative anterior segment dimensions measured by swept-source optical coherence tomography (SS-OCT; CASIA SS-1000, Tomey, Nagoya, Japan) with intraocular pressure (IOP). Methods: Cross-sectional study. All subjects who were ≥50 years with no history o...
Article
Purpose: To assess whether the three-dimensional (3D) structural configuration of the central retinal vessel trunk and its branches (CRVT&B) could be used as a diagnostic marker for glaucoma. Design: Retrospective, deep-learning approach diagnosis study. Method: We trained a deep learning network to automatically segment the CRVT&B from the B-...
Article
Purpose To develop a classification system of visual field (VF) abnormalities in highly myopic eyes with and without glaucoma. Design Secondary analysis of VF data from a longitudinal cohort study. Subjects One thousand eight hundred and ninety-three VF tests from 1302 eyes (825 individuals). Methods All participants underwent VF testing (Humphr...
Article
Objective To determine the incidence and risk factors of primary angle closure disease (PACD) over six years in a multi-ethnic Asian population. Design Population-based, longitudinal study. Subjects The Singapore Epidemiology of Eye Diseases study is a population-based cohort study conducted amongst adults aged 40 years or more. The baseline exam...
Article
Corneal diseases, along with glaucoma and cataract, are the leading causes of blindness worldwide. While corneal surgery offers good success rates, early diagnosis and disease prevention is the preferred choice over expensive and complex surgical procedures. Non-contact, high-resolution imaging modalities for imaging the corneal structures are high...
Preprint
Purpose: To study the associations between optic nerve head (ONH) strains under intraocular pressure (IOP) elevation with retinal sensitivity in glaucoma subjects. Design: Clinic based cross-sectional study. Participants: 229 subjects with primary open angle glaucoma (subdivided into 115 high tension glaucoma (HTG) subjects and 114 normal tension g...
Article
Full-text available
Purpose: To investigate modeling of the focal visual field (VF) loss by combining structural measurements and vascular measurements in eyes with early primary open-angle glaucoma (POAG). Methods: In this cross-sectional study, subjects with early glaucoma (VF mean deviation, ≥-6 dB) underwent optical coherence tomography (OCT) imaging, optical c...
Article
Full-text available
Background/aims Early detection and treatment of glaucoma can delay vision loss. In this study, we evaluate the performance of handheld chromatic pupillometry (HCP) for the objective and rapid detection of functional loss in glaucoma. Methods In this clinic-based, prospective study, we enrolled 149 patients (median (IQR) years: 68.5 (13.6) years)...
Article
Full-text available
High myopia is among the most common causes of vision impairment, and it is mainly characterized by abnormal elongation of the axial length, leading to pathologic changes in the ocular structures. Owing to the close relationship between high myopia and glaucoma, the association between intraocular pressure (IOP) and high myopia progression has garn...
Preprint
Full-text available
Purpose: To assess whether the three-dimensional (3D) structural configuration of the central retinal vessel trunk and its branches (CRVT&B) could be used as a diagnostic marker for glaucoma. Method: We trained a deep learning network to automatically segment the CRVT&B from the B-scans of the optical coherence tomography (OCT) volume of the optic...
Article
Purpose Carriers of functionally deficient mutations in the CYP39A1 gene have been recently reported to have a 2-fold increased risk of exfoliation syndrome (XFS). The aim of this study was to evaluate the risk of blindness and related clinical phenotypes of XFS patients carrying the loss-of-function CYP39A1 G204E mutation in comparison to XFS pati...
Article
Full-text available
Purpose: To investigate features of the steady-state pattern electroretinogram (ssPERG) in subjects with glaucoma (G), high myopia (HM; spherical equivalent ≤-6D) and glaucoma with high myopia (GHM). Patients and Methods: Our study included 48 participants divided into 3 groups (G, HM, and GHM) who each underwent monocular ssPERG testing with Diop...
Article
Full-text available
Purpose To evaluate ethnic variations, ocular and systemic determinants of retinal nerve fibre layer (RNFL) thickness and neuroretinal rim area among Asians, using a large consortium of population-based eye studies. Design Cross-sectional pooled-analysis. Participants 22436 participants (22436 eyes) from 10 population-based studies (China, Hong K...
Article
Full-text available
Purpose: To evaluate the biomechanical properties of the iris by evaluating iris movement during pupil constriction and to compare such properties between healthy and primary angle-closure glaucoma (PACG) subjects. Methods: A total of 140 subjects were recruited for this study. In a dark room, the anterior segments of one eye per subject were sc...
Article
Purpose: To assess the generalisability and performance of a deep learning classifier for automated detection of gonioscopic angle closure in anterior segment optical coherence tomography (AS-OCT) images. Methods: A convolutional neural network (CNN) model developed using data from the Chinese American Eye Study (CHES) was used to detect goniosc...
Article
Purpose: To assess baseline ocular biometric risk factors for progression from primary angle closure suspect (PACS) to primary angle closure (PAC) or acute angle closure (AAC). Design: Prospective observational study. Participants: 643 mainland Chinese aged 50 to 70 years with untreated PACS. Methods: Participants received baseline clinical...
Article
Objective To develop and evaluate the performance of a three-dimensional deep-learning based automated digital gonioscopy system (3D DGS) in detecting two major characteristics in eyes suspected to have primary angle closure glaucoma (PACG): 1) narrow iridocorneal angles (static gonioscopy, Task I) and; 2) peripheral anterior synechiae (PAS) (dynam...
Article
Purpose Detection of early glaucoma remains limited with the conventional analysis of the retinal nerve fiber layer (RNFL). To assess whether compensating the RNFL thickness for multiple demographic and anatomical factors improves the detection of glaucoma. Design Cross-sectional study Methods 2699 healthy participants were enrolled to construct...
Article
Objective We hypothesized that the effect of blood lipid-related metabolites on POAG would differ according to specific lipoprotein particles and lipid sub-fractions. We thus investigated the associations of blood levels of lipoprotein particles and lipid sub-fractions with POAG. Design Cross-sectional study. Participants Individuals recruited fo...
Article
Full-text available
Introduction Laser trabeculoplasty is an effective and widely used treatment for glaucoma. A new laser technology, the Eagle direct selective laser trabeculoplasty (DSLT) device, may provide automated, fast, simple, safe and effective laser treatment for glaucoma in a broader range of clinical settings. This trial aims to test the hypothesis that t...
Article
Purpose: To examine the efficacy of laser peripheral iridotomy (LPI) in subjects diagnosed as primary angle closure suspects (PACS) DESIGN: Prospective, randomized controlled trial PARTICIPANTS: This multi-center, randomized controlled trial (NCT00347178, Clinical trials.gov) enrolled 480 subjects over the age of 50 years from glaucoma clinics in...
Article
Background Glaucomatous optic nerve damage is caused by selective death of retinal ganglion cells (RGCs). Another condition with underlying loss of RGCs is autosomal dominant optic atrophy (ADOA). Majority of ADOA patients have mutations in OPA1, gene responsible for mitochondrial fusion final steps. Clinical resemblance between the two diseases ma...
Preprint
Full-text available
Purpose Common LOXL1 protein-altering variants are significant genetic risk factors for exfoliation syndrome (XFS) and the related secondary glaucoma (XFG). A rare LOXL1 missense allele has been associated with protective effects in a Japanese cohort, suggesting that other rare alleles may also exhibit protective effects. The goal of this study was...
Article
Purpose: To develop and test a multi-modal artificial intelligence (AI) algorithm, FusionNet, using the pattern deviation probability plots (PDPs) from visual field (VF) reports and circular peripapillary optical coherence tomography (OCT) to detect glaucomatous optic neuropathy (GON). Design: Cross-sectional study. Subjects: A total of 2463 p...
Article
Full-text available
To investigate the association of peripheral anterior synechiae (PAS) with intraocular pressure (IOP) and anterior-segment parameters in subjects with primary angle-closure glaucoma (PACG). A total of 267 subjects with PACG were recruited and underwent gonioscopy and anterior-segment optical coherence tomography (ASOCT). Customized software was use...
Article
Purpose To evaluate the diagnostic performance of swept-source anterior segment optical coherence tomography (SS-OCT) in differentiating primary angle closure diseases (PACD) from control eyes, as well as primary angle closure (PAC) and primary angle closure glaucoma (PACG) from primary angle closure suspect (PACS) eyes. Design Multi-center cross-...
Article
Full-text available
Purpose To evaluate the performance of swept source optical coherence tomography (SS-OCT) to detect gonioscopic angle closure using different classification algorithms. Methods This was a cross-sectional study of 2028 subjects without ophthalmic symptoms recruited from a community-based clinic. All subjects underwent gonioscopy and SS-OCT (Casia,...
Article
Importance A glaucoma-specific instrument for estimating utilities across the spectrum of glaucoma severity is currently lacking, hindering the assessment of the cost-effectiveness of glaucoma treatments. Objective To develop and validate the preference-based Glaucoma Utility Instrument (Glau-U) and to ascertain the association between Glau-U util...
Article
We report the sensitivity and specificity of van Herick (VH) grading in detecting gonioscopically-defined primary angle closure suspects (PACS) among subjects screened for participation in a population-based trial in southern China. A cut-off of VH≤25% was found to have sensitivity and specificity rates of 98.2% and 25.9%, respectively. Rates were...
Article
Purpose To develop a novel deep-learning approach that can describe the structural phenotype of the glaucomatous ONH and can be used as a robust glaucoma diagnosis tool. Design Retrospective, deep-learning approach diagnosis study. Method We trained a deep learning network to segment three neural-tissue and four connective-tissue layers of the ON...
Article
Full-text available
Optical Coherence Tomography (OCT) enables non-invasive imaging of the retina and is used to diagnose and manage ophthalmic diseases including glaucoma. We present the first large-scale genome-wide association study of inner retinal morphology using phenotypes derived from OCT images of 31,434 UK Biobank participants. We identify 46 loci associated...
Preprint
Purpose To evaluate the biomechanical properties of the iris by evaluating iris movement during pupil constriction and to compare such properties between healthy and primary angle-closure glaucoma (PACG) subjects. Methods A total of 140 subjects were recruited for this study. In a dark room, the anterior segments of one eye per subject were scanne...
Article
Prcis: Laser peripheral iridotomy widened the iridocorneal angle and flattened the iris circumferentially in Caucasian eyes and baseline refractive error, lens vault and iris volume play a significant role in the angle widening. Purpose: To investigate circumferential angle widening and iris changes after laser peripheral iridotomy (LPI) using s...
Article
Aims To validate a deep learning (DL) algorithm (DLA) for 360° angle assessment on swept-source optical coherence tomography (SS-OCT) (CASIA SS-1000, Tomey Corporation, Nagoya, Japan). Methods This was a reliability analysis from a cross-sectional study. An independent test set of 39 936 SS-OCT scans from 312 phakic subjects (128 SS-OCT meridional...
Article
Topic Glaucoma is the leading cause of irreversible blindness despite having good prognosis with early treatment. We evaluated the global extent of undetected glaucoma and the factors associated with it in this systematic review and meta-analysis of population-based epidemiological studies. Clinical relevance Undetected glaucoma increases the risk...
Article
Prcis: Reduction of intraocular pressure by latanoprost in treatment-naïve eyes is significantly correlated to an increase in vessel density at the optic nerve head. Purpose: To evaluate the effect of topical latanoprost on ocular microvasculature using optical coherence tomography angiography (OCTA). Patients and methods: In this prospective...
Article
Objective MYOC (myocilin) mutations account for 3-5% of primary open angle glaucoma (POAG). We aimed to understand the true population-wide penetrance and characteristics of glaucoma among individuals with the most common MYOC variant (p.Gln368Ter) and the impact of a POAG polygenic risk score (PRS) in this population. Design Cross-sectional popul...
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
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
Full-text available
Purpose: Aquaporins (AQPs) facilitate transmembrane osmotic water transport and may play a role in iris fluid conductivity, which is implicated in the pathophysiology of glaucoma. In this study, we compared the iris expression of AQPs and aqueous osmolality between primary angle closure glaucoma (PACG), primary open-angle glaucoma (POAG), and nong...
Chapter
Glaucoma, a multifactorial ocular disease, is clinically and genetically heterogeneous. It is the second leading cause of blindness in elderly population worldwide. Because of the complex nature of glaucoma, the genetic spectrum has not been established globally. In Pakistan, both the familial and the sporadic forms of the disease are common, which...
Article
Purpose To evaluate the effect of signal strength (SS) on optical coherence tomography (OCT) parameters, and devise an algorithm to adjust the effect, when acceptable SS cannot be obtained. Methods 5085 individuals (9582 eyes), aged ≥40 years from the Singapore Epidemiology of Eye Diseases population-based study were included. Everyone underwent a...
Article
Purpose To assess anatomical changes after laser peripheral iridotomy (LPI) and predictors of angle widening based on anterior segment OCT (AS-OCT) and angle opening based on gonioscopy in mainland Chinese primary angle closure suspects (PACS). Design Prospective observational study. Participants 454 subjects aged 50 to 70 years with PACS. Metho...
Article
Full-text available
Background In current approaches to vision screening in the community, a simple and efficient process is needed to identify individuals who should be referred to tertiary eye care centres for vision loss related to eye diseases. The emergence of deep learning technology offers new opportunities to revolutionise this clinical referral pathway. We ai...
Article
Full-text available
Purpose: To evaluate the focal structure-function associations among visual field (VF) loss, optical coherence tomography angiography (OCT-A) vascular measurements, and optical coherence tomography (OCT) structural measurements in glaucoma. Methods: In this cross-sectional study, subjects underwent standard automated perimetry, OCT-based nerve f...
Preprint
The optic nerve head (ONH) typically experiences complex neural- and connective-tissue structural changes with the development and progression of glaucoma, and monitoring these changes could be critical for improved diagnosis and prognosis in the glaucoma clinic. The gold-standard technique to assess structural changes of the ONH clinically is opti...
Article
Full-text available
Aims To compare the shape of the anterior surface of the peripapillary sclera (PPS) between glaucoma and healthy subjects. Methods 88 primary open angle glaucoma (POAG), 98 primary angle closure glaucoma (PACG) and 372 age-matched and gender-matched healthy controls were recruited in this study. The optic nerve head of one randomly selected eye of...
Article
Full-text available
Nuclear cataract is the most common type of age-related cataract and a leading cause of blindness worldwide. Age-related nuclear cataract is heritable (h² = 0.48), but little is known about specific genetic factors underlying this condition. Here we report findings from the largest to date multi-ethnic meta-analysis of genome-wide association studi...
Preprint
Speckle noise and retinal shadows within OCT B-scans occlude important edges, fine textures and deep tissues, preventing accurate and robust diagnosis by algorithms and clinicians. We developed a single process that successfully removed both noise and retinal shadows from unseen single-frame B-scans within 10.4ms. Mean average gradient magnitude (A...
Article
Full-text available
Background: Currently, whether and when intraocular pressure (IOP)-lowering medication should be used in glaucoma suspects with high myopia (GSHM) remains unknown. Glaucoma suspects are visual field (VF) defects that cannot be explained by myopic macular changes or other retinal and neurologic conditions. Glaucoma progression is defined by VF dete...
Article
Objective: To determine the 6-year incidence of primary glaucoma and its risk factors in an Indian population in Singapore DESIGN: Cohort population-based study PARTICIPANTS: Indian adults aged between 40 and 80 years living in Singapore. A total of 3,400 subjects participated in the baseline examination between 2007 and 2009. Of them, 2,200 (resp...
Article
Full-text available
In humans, the longitudinal characterisation of early optic nerve head (ONH) damage in ocular hypertension (OHT) is difficult as patients with glaucoma usually have structural ONH damage at the time of diagnosis. Previous studies assessed glaucomatous ONH cupping by measuring the anterior lamina cribrosa depth (LCD) and minimal rim width (MRW) usin...
Article
Full-text available
By 2040, ~100 million people will have glaucoma. To date, there are a lack of high-efficiency glaucoma diagnostic tools based on visual fields (VFs). Herein, we develop and evaluate the performance of ‘iGlaucoma’, a smartphone application-based deep learning system (DLS) in detecting glaucomatous VF changes. A total of 1,614,808 data points of 10,7...
Article
Purpose: Genome-wide association studies have identified several genes associated with glaucoma. However, their roles in the pathogenesis of glaucoma remain unclear, particularly their effects on retinal nerve fiber layer (RNFL) thickness. The aim of this study was to investigate the associations between the identified glaucoma risk genes and RNFL...
Preprint
Full-text available
Optical Coherence Tomography (OCT) enables non-invasive imaging of the retina and is often used to diagnose and manage multiple ophthalmic diseases including glaucoma. We present the first large-scale quantitative genome-wide association study of inner retinal morphology using phenotypes derived from OCT images of 31,434 UK Biobank participants. We...
Article
Objective To compare the diagnostic performance of an artificial intelligence deep learning system with that of expert neuro‐ophthalmologists in classifying optic disc appearance. Methods The deep learning system was previously trained and validated on 14,341 ocular fundus photographs from 19 international centers. The performance of the system wa...
Article
Purpose To investigate whether recently identified genetic loci for primary angle closure glaucoma (PACG) are associated with disease severity. Design Case-control study Participants A total of 804 PACG patients and 943 controls of Chinese ethnicity from Singapore Methods The 8 PACG-associated single nucleotide polymorphisms (SNPs; rs11024102 at...
Article
Purpose To compare the distribution of plateau iris in eyes across varying severity of primary angle-closure glaucoma (PACG) using standardized ultrasound biomicroscopy (UBM) criteria. Design Cross-sectional study Methods UBM was performed on 210 PACG subjects who had previously undergone laser peripheral iridotomy. Plateau iris was defined as th...
Article
Importance Evidence‐based guidelines are essential for glaucoma screening to work effectively. Background To derive a vertical cup‐to‐disc ratio (VCDR) cut‐off for glaucoma screening in a multi‐ethnic Asian population. Design The Singapore Epidemiology of Eye Diseases (SEED) study is a population‐based study conducted from 2004 to 2011 in a singl...
Conference Paper
Glaucoma is a progressive optic neuropathy that leads to loss of retinal ganglion cells and thinning of retinal nerve fiber layer (RNFL). Circumpapillary RNFL thickness measurements have been used for glaucoma diagnostic and monitoring purposes. However, manual measurement of the RNFL thickness is tedious and subjective. We proposed and evaluated t...