A5075258464- Retinal Imaging and Analysis
- Retinal Diseases and Treatments
- Retinal and Optic Conditions
- Glaucoma and retinal disorders
- Acute Ischemic Stroke Management
- Diabetes Treatment and Management
- Blood Pressure and Hypertension Studies
- Neurological Disorders and Treatments
- Cerebral Venous Sinus Thrombosis
- Retinopathy of Prematurity Studies
- Chronic Kidney Disease and Diabetes
- Health Systems, Economic Evaluations, Quality of Life
- Cerebrovascular and Carotid Artery Diseases
- Antiplatelet Therapy and Cardiovascular Diseases
- Diabetes Management and Research
- Intraocular Surgery and Lenses
- Neurological Complications and Syndromes
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Advanced Glycation End Products research
- Diabetes and associated disorders
- Systemic Sclerosis and Related Diseases
- Diabetes Management and Education
- Global Healthcare and Medical Tourism
- Ocular and Laser Science Research
- Facial Rejuvenation and Surgery Techniques
Cheltenham General Hospital
2003-2024
Gloucestershire Hospitals NHS Foundation Trust
2010-2022
National Health Service
2017-2020
University of Coimbra
2018
Hospitais da Universidade de Coimbra
2018
Association for Innovation and Biomedical Research on Light and Image
2018
Cheltenham Festivals
2009-2017
University of Warwick
2017
Imperial College London
1999-2016
Lung Institute
2016
<h3>Objective</h3> To determine the relationship between tight blood pressure (BP) controland different aspects of diabetic retinopathy in patients with type 2diabetes mellitus (DM). <h3>Setting</h3> Nineteen hospital-based clinics England, Scotland, and Northern Ireland. <h3>Design</h3> Outcome status assessed by 4-field retinal photographyrelated to allocation within a randomized controlled trial comparing tightBP control policy aiming for BP less than 150/85 mm Hg 180/105 Hg....
To determine the incidence of retinopathy and relative importance its risk factors in type 1 diabetes.This is a 7.3-year follow-up 764 1,215 (63%) people with diabetes across Europe, aged 15-60 years at baseline no (the EURODIAB Prospective Complications Study). Retinal photographs were taken assessed to standard protocol.Retinopathy was 56% (429/764, 95% CI 52-59%). Key included duration glycemic control. We found evidence threshold effect for HbA1c on incidence. Univariate associations...
A National Screening Programme for diabetic eye disease in the UK is development. We propose a grading and early management protocol to detect sight-threatening retinopathy any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral hospital service.Expert panel structured discussions between 2000 2002 with review of existing evidence classifications.Principles include: separate maculopathy, minimum number steps, compatible central...
This cross-sectional study evaluated the relationship between 1) functional and structural measurements of neurodegeneration in initial stages diabetic retinopathy (DR) 2) presence early microvascular impairment. We analyzed baseline data 449 patients with type 2 diabetes enrolled European Consortium for Early Treatment Diabetic Retinopathy (EUROCONDOR) (NCT01726075). Functional studies by multifocal electroretinography (mfERG) neurodysfunction, using spectral domain optical coherence...
Background/aims Human grading of digital images from diabetic retinopathy (DR) screening programmes represents a significant challenge, due to the increasing prevalence diabetes. We evaluate performance an automated artificial intelligence (AI) algorithm triage retinal English Diabetic Eye Screening Programme (DESP) into test-positive/technical failure versus test-negative, using human following standard national protocol as reference standard. Methods Retinal 30 405 consecutive episodes...
The English NHS Diabetic Eye Screening Programme was established in 2003. Eligible people are invited annually for digital retinal photography screening. Those found to have potentially sight-threatening diabetic retinopathy (STDR) referred surveillance clinics or Hospital Services.To determine whether personalised screening intervals cost-effective.Risk factors were identified Gloucestershire, UK using survival modelling. A probabilistic decision hidden (unobserved) Markov model with a...
The primary objective of this study was to assess whether the topical administration two neuroprotective drugs (brimonidine and somatostatin) could prevent or arrest retinal neurodysfunction in patients with type 2 diabetes. For purpose, adults aged between 45 75 years a diabetes duration ≥5 an Early Treatment Diabetic Retinopathy Study (ETDRS) level ≤35 were randomly assigned one three arms: placebo, somatostatin, brimonidine. outcome change implicit time (IT) assessed by multifocal...
OBJECTIVE: The importance of screening for diabetic retinopathy has been established, but the best method not yet determined. We report on a trial assessment digital photographs by telemedicine compared with standard retinal same fields and clinical examination ophthalmologists. RESEARCH DESIGN AND METHODS: A total 129 inpatients were screened slit-lamp biomicroscopy performed an ophthalmologist two-field 50 degrees non-stereo fundus assessed six centers that received images electronic mail....
Abstract Aims To evaluate the introduction of a community‐based non‐mydriatic and mydriatic digital photographic screening programme by measuring sensitivity specificity compared with reference standard assessing added value technician direct ophthalmoscopy. Methods Study patients had one‐field, non‐mydriatic, 45° imaging photography prior to two‐field followed Of these patients, 1549 were then examined an experienced ophthalmologist using slit lamp biomicroscopy as standard. The setting was...
OBJECTIVE—To evaluate the effect of age, duration diabetes, cataract, and pupil size on image quality in digital photographic screening. RESEARCH DESIGN AND METHODS—Randomized groups 3,650 patients had one-field, nonmydriatic, 45° retinal imaging photography before mydriatic two-field photography. A total 1,549 were then examined by an experienced ophthalmologist. Outcome measures ungradable rates, detection referable diabetic retinopathy, presence early or obvious central diameter, iris...
The American Diabetes Association and the English NHS Diabetic Eye Screening Program recommend annual screening for diabetic retinopathy (DR) with referral to ophthalmology clinics of patients sight-threatening DR (STDR). Using only longitudinal data from retinal photographs in population-based Gloucestershire, we developed a simple means estimate risk STDR.From 2005, 14,554 no or mild nonproliferative at two consecutive digital photographic screenings were categorized by presence neither,...
Summary Aim to establish the degree which severity of retinopathy determines risk for need subsequent photocoagulation in those with newly diagnosed Type 2 diabetes mellitus. Methods Of 5102 patients entered into UK Prospective Diabetes Study (UKPDS), 3709 had good quality retinal photographs that could be graded at entry. They were followed until end study or lost follow‐up, they received photocoagulation. Retinopathy was categorized as no retinopathy, microaneurysms (MA) only one eye, MA...
Diabet. Med. 28, 345–351 (2011) Abstract Objective To study the association between baseline retinal microaneurysm score and progression regression of diabetic retinopathy, response to treatment with candesartan in people diabetes. Methods This was a multicenter randomized clinical trial. The analysis included 893 patients Type 1 diabetes 526 2 microaneurysms only at baseline. For regression, 438 216 qualified. Microaneurysms were scored from yearly photographs according Early Treatment...
Abnormalities of the retinal circulation may be associated with cerebrovascular disease. We investigated associations between microvascular abnormalities and (1) strokes subclinical cerebral infarcts (2) white matter lesions in a UK-based triethnic population-based cohort.A total 1185 participants (age, 68.8±6.1 years; 77% men) underwent imaging magnetic resonance imaging. Cerebral hyperintensities were identified on imaging, retinopathy was graded, vessels measured.Higher grade (odds ratio...
Abstract Aims To assess whether there is a relationship between delay in retinopathy screening after diagnosis of Type 2 diabetes and level detected. Methods Patients were referred from 88 primary care practices to an English National Health Service diabetic eye programme. Data for screened patients extracted the databases using semi‐automated data collection algorithms supplemented by validation processes. The programme uses two‐field mydriatic digital photographs graded quality assured...
Abstract. Purpose: The Gloucestershire Diabetic Eye Screening Programme offers annual digital photographic screening for diabetic retinopathy to a countywide population of people with diabetes. This study was designed investigate progression in this programme the English NHS Programme. Methods: Mydriatic retinal photographs diabetes screened on at least 2 occasions between 2005 and 2010 were graded included if classification first no DR (R0), background one (R1a) or both eyes (R1b). Times...
AbstractPurpose. Detection and precise quantification of changes in retinal vessel diameter by image analysis techniques is important a number fields research. The vessels have been shown to exhibit pulse related diameter. These may need be taken into account when studying due other causes. This study examined the effect using multiple fundus photographs with without electro-cardiographic synchronisation on size statistical significance mean diameter.Methods. Twelve spaced throughout cardiac...
We aimed to assess 24-month outcomes of wearing an organic light-emitting sleep mask as intervention treat and prevent progression non-central diabetic macular oedema.CLEOPATRA was a phase 3, single-blind, parallel-group, randomised controlled trial undertaken at 15 ophthalmic centres in the UK. Adults with non-centre-involving oedema were randomly assigned (1:1) either light during (Noctura 400 Sleep Mask, PolyPhotonix Medical, Sedgefield, UK) or sham (non-light) mask, for 24 months....
PurposeThe increasing diabetes prevalence and advent of new treatments for its major visual-threatening complications (diabetic macular edema [DME] proliferative diabetic retinopathy [PDR]), which require frequent life-long follow-up, have increased hospital demands markedly. Subsequent delays in patient's evaluation treatment are causing sight loss. Strategies to increase capacity needed urgently. The (EMERALD) study tested diagnostic accuracy, acceptability, costs a health care pathway...